Abstract Book Vol. 2 [International Conference on AIDS (14th: 2002: Barcelona, Spain)]

120 Abstracts WePeC6152-WePeC6155

XIV International AIDS Conference

WePeC6152 ]HIV/Syphilis Seroprevalence in Nigeria: results of
the 2000 national sentinel surveillance survey of
patients with STD and Tuberculosis attending
specialized clinics
M. Gboun. NASCAP, Federal Ministry of Health, Federal Ministry of Health,
Department of Public Health, National A/DS/STD Control Programme, Abuja,
Nigeria
Background: Nigeria currently has its HIV epidemic in explosive phase. Surveillance of HIV infection among high-risk groups (PTB and STD) commenced in
1991, and was repeated in 1993, 1995 and in 2000. The survey results prior to
2000 among PTB patients showed 2.2% in 1991, 15.0% in 1995. Similarly STD
patients showed the same increase since 1991.
Methods: For 2000, a total of 24 specialized clinics in 12 states, at least 2 states
from each of Nigeria's 6 health zones states and Federal Capital territory, participated in the survey Two sentinel sites were selected from each of the selected
states using a number criteria of selection. A minimum sample size of 250 was
recruited for PTB and 100 for STD. The presented STD syndromes were also
recorded and analysed for the country for the first time. Overall nationwide and
state, and age-specific seroprevalence estimates were calculated for each state.
Results: A total of 2826 PTB patients and 2195 STD patients were recruited
for the survey. The Syphilis prevalence among STD patients was 8.4% with high
prevalence (10.2%) was found among ages 10-19 years. The overall prevalence
of STD syndromes was 61.0% for lower abdominal pain among women with STD,
65.8% urethral discharge among males, 12.9% genital ulcers and 17.3% inguino
scrotal swelling among males. The HIV prevalence was 11.5%. The HIV prevalence among PTB patients was 17.0% the state prevalence varied from 17.0%35%.
Conclusions: The HIV trend is still increasing in the country among high risk
population groups. The age affected by PTB and STD is astonishing. There is
need to aggressively implement the STD Syndromic management strategy in the
country as well as provision of sustainable treatment of DOTS strategy for PTB
in all centers in order to reduce the public health implication of open tuberculosis
among PLWA. There is also urgent need to look at the behavioural pattern of STD
patients in order to explain the sero-prevalence in the country.
Presenting author: Michael Gboun, Federal Ministry of Health, Department
of Public Health, National AIDS/STD Control Programme, Abuja, Nigeria, Tel.:
[phone], Fax: [phone], E-mail: Email: [email protected];
kwamegboun @yahoo.com
WePeC6153 The Stephen Kelly Case: Impact on HIV testing
behaviour
G. Codere1, D. Goldberg1, S. Cameron2, L. Shaw1, A. Taylor1. 1The Scottish
Centre for Infection and Environmental Health, SCIEH, Clifton House, Clifton
Place, Glasgow, United Kingdom; 2Regional Virus Laboratory Gartnavel
General Hospital, Glasgow, Scotland, United Kingdom
Background: In February 2001, Stephen Kelly, an 33-year old IDU who was infected with HIV during the Glenochil Prison outbreak in 1993, was convicted of
"reckless behaviour and transmitting HIV to Ann Craig", and given a 5-year prison
sentence. In the aftermath, there was much concern among health care professionals that this unique legal action, highly publicised, would deter people from
seeking an HIV test. The investigators sought to gauge HIV testing behaviour
before and after the publicity to test this hypothesis.
Methods: Since 1989, SCIEH has collected data on all persons throughout Scotland who have requested an HIV test. The analysis was confined to the Greater
Glasgow area where Stephen Kelly resided. Screening tests were excluded.
Results: HIV tests, Greater Glasgow Health Board - March to August of indicated year (2001: 6 months post conviction, 1990-2000: Corresponding 6 months
periods prior to conviction)

WePeC6154 A community based intervention program
encouraging greater self-disclosure of HIV/AIDS
status amongst commercial sex workers of
Kalighat, Calcutta, (KOLKATA) India
U. Basu. Missionaries of the Word, 11UA, Mani Towers, 31/41 Binoba Bhave
Road, Kolkata - 700038, West Bengal, India
Issues: HIV infection was first detected in India in 1986 thereafter exploding
among commercial sex workers (CSW) and other high-risk groups. The National
AIDS Control Organization (NACO) indicated - 7 million HIV infections & 2 million full-blown AIDS cases at the beginning of the new millennium. In a city as
densely populated as Kolkata and having a large male migratory population, the
female CSW are at the highest peril. Since the beginning of the intervention program in the city there has been little change in the scenario in terms of greater
awareness and altered sexual practices. The reasons are poverty, illiteracy and
cultural beliefs. No intervention strategy can be successful here unless there is
openness and acceptance of HIV/AIDS.
Description: This paper attempts to explore the nature and extent of the incidence of HIV/AIDS cases in Kalighat. Specifically: 1.To create awareness regarding the symptoms of HIV/AIDS amongst the CSW through workshops, films,
posters and interactive sessions with the project workers. 2.To encourage voluntary disclosure of all illness keeping the ethical and human rights issues associated with HIV/AIDS in mind. 3.To provide better diagnostic and treatment facilities
by networking with various NGOs. 4. Fostering situations of trust cooperation and
bonding amongst the CSW to ensure usage of condoms universally.
Lessons learned: This intervention program indicates that only social and economic empowerment initiated through education, awareness and issue specific
information can fight the stigma and isolation associated with HIV/AIDS. As the
stigmatization reduces there would be more voluntary disclosure and greater control of HIV/AIDS incidences.
Recommendation: This intervention model is followed at other CSW communities to encourage an atmosphere of trust, empathy, continued psycho-socioeconomic support and ensured treatment availability to encourage voluntary testing and disclosure of HIV/AIDS status.
Presenting author: Urmi Basu, 11UA, Mani Towers, 31/41 Binoba Bhave Road,
Kolkata - 700038, West Bengal, India, Tel.: [phone], Fax: [phone],
E-mail: [email protected]
WePeC61 55 Unrecognized HIV infection and barriers to testing
among young Asian American men who have sex
with men
H. Ngol, W. McFarland1, T. Kellogg', G. Secura2, S. Behel2, D. MacKellar2,
K. Choi3. ISan Francisco Department of Public Health, AIDS Office, San
Francisco Department of Public Health, 25 Van Ness Avenue, Suite 500, San
Francisco, CA 94102, United States; 2Centers for Disease Control and
Prevention, Atlanta, United States; 3Center for AIDS Prevention Studies,
University of California, San Francisco, S, United States
Background: The background prevalence and rate of HIV transmission among
men who have sex with men (MSM) in San Francisco (USA) remains high. HIV
counseling and testing is a means of slowing the spread of HIV by increasing the
proportion of persons who know they are infected and counseling persons to reduce their risk of acquiring HIV or transmitting infection to others. Little is known
about test seeking behavior among Asian and Pacific Islander (API) MSM.
Methods: From January 2000 to September 2001, API MSM aged 18 to 29 years
were sampled from 30 randomly selected gay-identified venues in San Francisco.
Men completed a face-to-face standard questionnaire and were counseled and
screened for HIV and STD.
Results: Data are preliminary. Of 503 Asian-American MSM enrolled, 30% were
ethnic Chinese, 29% Filipino, 17% Vietnamese, 6% Japanese, 4% Thai, and 4%
Korean. Overall, 122 (24%) had never tested for HIV. The most common reasons
for not testing were perceived low risk for infection (51%), afraid of knowing results
(45%), and fear of needles (25%). Men who were younger, with less education,
and without access to a primary health care provider were significantly less likely
to have ever tested (p<0.05). Of 13 men testing HIV+ (prevalence 2.6%), only 4
(31%) reported that they previously knew their HIV infection status. Men of Thai
ethnicity were less likely to have tested (52% vs. 76%, p<0.01), yet were more
likely to be HIV+ (9.5% vs. 1.9%, p<0.05) than other ethnic groups.
Conclusions:: A large proportion of Asian American MSM at risk for HIV in San
Francisco have never tested and many who are HIV+ are unaware of their infection. Findings suggest the need to specifically increase access to testing among
Asian American MSM of lower socio-economic status, increase the availability of
oral fluid testing, and conduct outreach to communities that may be isolated by
language and cultural barriers.
Presenting author: Houston Ngo, AIDS Office, San Francisco Department of
Public Health, 25 Van Ness Avenue, Suite 500, San Francisco, CA 94102, United
States, Tel.: [phone], Fax: [phone], E-mail: willi.mcfarland@sfdph.

org

Exposure Cat.
MSM
IDU
Hetero
Other
Total

1990
Tests/Pos
164/9
258/5
529/4
302/5
1248/23

1995
Tests/Pos
251/9
288/6
1107/11
267/7
1910/33

1999
Tests/Pos
299/13
429/5
1221/9
391/4
2334/30

2000
Tests/Pos
291/11
409/3
1232/4
424/1
2348/19

2001
Tests/Pos
348/13
383/2
1708/10
365/3
2800/28

Figures include only those cases where reason tested = PATIENT CONCERNED
or DOCTOR CONCERNED or OTHER or NOT KNOWN
A small number of cases are included in both the MSM and IDU groups
Conclusion: There was no evidence that the publicity surrounding the case led
to a reduction in HIV testing behaviour among those at risk and those at highest
risk, as indicated by no reduction in HIV positivity yield. If anything, there has
been an increase in testing demand, possibly due to the sublimal effect of the
publicity surrounding the case.
Presenting author: Glenn Codere, SCIEH, Clifton House, Clifton Place, Glasgow, United Kingdom, Tel.: [phone], Fax: [phone], E-mail:
[email protected]