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

122 Abstracts WePeC6161-WePeC6164

XIV International AIDS Conference

was performed, using BMDP software, with lack of awareness as the outcome
variable. Seven factors recorded in the AIDS report form were examined for their
association: exposure category, sex, age at AIDS diagnosis, year of diagnosis
(combined as before or after June 1996), region of residence, occupation, nationality
Results: Of the 22 042 adults who had AIDS diagnosed from January 1994 to December 2000, 6484 (29.4%) were unaware of their HIV(+) status. Lack of awareness of HIV infection was independently associated with being infected through
heterosexual contact (odds ratio 1.8, 95% confidence interval 1.6- 1.9), having
a nationality from a sub-Saharan country (2.7, 2.4-3), being male (1.8, 1.6-1.9),
being aged 50 and over (1.5, 1.4-1.7), being diagnosed after June 1996 (2.5,
2.3-2.6), being a worker (1.3, 1.2-1.8), residing abroad (1.2, 1.1-1.4).
Conclusions: People with the characteristics listed above are more likely than
others to be unaware of their HIV infection before AIDS diagnosis and therefore
are less likely to benefit from effective treatments. The reasons for the failure to
reach those individuals require further investigation. Identifying those at risk for
infection, encouraging theme to be tested and those with positive results to seek
care remain important goals in the fight against HIV infection.
Presenting author: Anne Laporte, Institut de Veille Sanitaire, 12 rue du Val
d'Osne, 94415 Saint-Maurice cedex, France, Tel.: [phone], Fax: +33 1
41 79 67 66, E-mail: [email protected]
WePeC6161 A significant decrease in voluntary HIV testing in
general population in France
M.V. Massari, T.L. Toubiana. INSERM, INSERM U444 Fac. Medecine St
Antoine, 27, rue Chaligny paris, 75012, France
Background: To study trends of voluntary HIV testing in French general population.
Methods: For 15 years, the general practitioners (GP) of the Sentinelles network
which links a representative 1% sample of GP report each week any request for
HIV testing of their subjects to a central computer by electronic mail. For each
case, demographic data, reason for testing, existence of a previous test (since
1997) and serological result were recorded anonymously.
Results: Since 1987, 36,000 HIV tests have been reported. The peak of the number of tests is observed in 1993 with 1585 cases per 100,000 inhabitants. Since
1996 a significant fall is observed from 1224 to 747 per 100,000 in 2001 (p<0.05).
The mean age of tested subjects significantly increased from 34.4 to 36.7 years
(p<0.05). The percentage of subjects with history of STD decreased from 8.7% to
4.5% (p<0.01) and the percentage of patients previously tested decreased from
19.2% in 1997 to 14.1% in 2001 (p <0.05).
Conclusion: Our results show a lower attendance for screening by the general
population after 1996 and this is worrying. Further, the surveillance of AIDS cases
showed in other reports that the number of patients, who find their seropositive
status during the diagnostic procedure, is considerably increasing.
Presenting author: Veronique Massari, INSERM U444 Fac. Medecine St Antoine, 27, rue Chaligny, paris, 75012, France, E-mail: [email protected]
SWePeC6162 Uptake of HIV testing among pregnant women in
Ontario: Results of the HIV seroprevalence study
to June 2001
R.S. Remis1, M. Fearon2, C. Major2, E. Wallace3, M. Millson1, L. Calzavara1,
E. Rea1, S. King4, K. Wu3, M. Vermeulen1, E. Whittingham1. 1University of
Toronto, Toronto, Canada; 2HIV Laboratory Ontario Ministry of Health and
Long-Term Care, 81 resources rd, Etobicoke, ontario, m9p 3tl, Canada;
30ntario Ministry of Health and Long-Term Care, Toronto, Canada; 4Hospital for
Sick Children, Toronto, Canada
Background: Few HIV-infected pregnant women in Ontario received antiretroviral prophylaxis following the release of the ACTG 076 trial results in early 1994.
Therefore, in January 1999, the Ontario Ministry of Health implemented a program to offer HIV screening to all pregnant women. We wished to examine the
patterns of HIV testing and HIV prevalence among pregnant women following the
introduction of the program.
Methods: In Ontario, all prenatal screening for HIV and most syphilis, rubella
and HBsAg screening is carried out at the Public Health Laboratories. We first
determined the number of women receiving any prenatal screening test and the
proportion with an HIV test prescribed. We then determined the number tested
through the separate HIV diagnostic program, using names and dates of birth in
a staged matching procedure allowing for incomplete, inconsistent and erroneous
entries.
Results: From January 1999 to June 2001, 355,116 women had a prenatal test
for at least one infectious marker (mean 2,280 tests/week). The proportion of
women with an HIV test prescribed on the prenatal form or performed through
independent diagnostic testing increased from 38% in January 1999 to 54% in
the first half of 2001; most of the increase occurred from January to May 1999.

Among the 181,754 women tested for HIV, 73 were HIV-positive, for a rate of 0.40
per 1,000. Of women tested for the first time, 45 were HIV-positive (rate 0.33 per
1,000). The positivity rate increased from 0.27 per 1,000 in Janury 1999-June
2000 to 0.57 per 1,000 in July 2000-June 2001. The 2.1-fold increase was statistically significant (p=0.002).
Conclusions: Uptake of HIV testing has improved with the implementation of the
screening program but is still unacceptably low. However, our results do not in
dicate whether the test was not offered or offered but refused. A communication
program for physicians and women is planned.
Presenting author: m fearon, 81 resources rd, Etobicoke, ontario, m9p 3t1,
Canada, Tel.: [phone], Fax: [phone], E-mail: margaret.fearon
@moh.gov.on.ca
WePeC6163 A qualitative assessment to identify hiv risk
behaviors and barriers to prevention among
aamsm
D. Porchel, R. Swayzer III2. 1Louisiana State University Health Sciences
Center, 931 Independence, New Orleans, Louisiana, 70117, United States;
2Brotherhood, Incorporated, New Orleans, United States
Background: HIV/AIDS incidence rates continue to disproportionately impact the
African American community. Within the African American community, the majority of HIV/AIDS cases are found among African American men who have sex with
men (AAMSM). These rates indicate that AAMSM continue to engage in high risk
behaviors.
Methods: The objectives of this qualitative needs assessment were to identify 1)
risk behaviors; 2) barriers to HIV testing; and 3) barriers to safer sex practices
among AAMSM. Focus groups were conducted with African American MSM by
a trained facilitator according to an interview schedule designed for this study
and transcribed verbatim. Thematic analysis was conducted to identify recurring
themes in the areas of risk behaviors, barriers to HIV testing, and barriers to safer
sex practices. Investigator triangulation was utilized to confirm themes.
Results: Seven focus groups were conducted with a total of 40 participants. Ages
ranged from 19-53, with an average age of 27.3 years. Barriers to HIV testing
were fear, knowledge of and location of testing site, risk of being stigmatized, and
lack of perceived risk. Barriers to safer sex were careless behavior, societal/peer
pressure, arousal/intimacy, drugs/alcohol use, and knowledge deficit. Risk behaviors identified included unprotected anal and oral sex, promiscuity, sex under the
influence of drugs and/or alcohol, sexual exploration, and prostitution.
Conclusions: Despite broad focused HIV prevention interventions, AAMSM continue to engage in behaviors that place them at risk for HIV infection. HIV prevention interventions in AAMSM should be directed towards reducing the barriers
identified in this study. Future research should identify the social, economic, and
cultural antecedents that influence the sexual behaviors of AAMSM.
Presenting author: Demetrius Porche, 931 Independence, New Orleans,
Louisiana, 70117, United States, Tel.: [phone], Fax: [phone],
E-mail: [email protected]
WePeC6164 Behavioral surveillance survey (BSS) among
entertainment establishment-based sex workers:
baseline study for 100% condom use programme
in Wuhan
Z.D. Chen1, X. Wang 1, W.D. Shi 2, HF. Wang 1, Y.H. Xu 2, J.L. Li 3, Q.Y. Li 3
' Public Health and Anti-epidemic Station, No.24, Jianghanbei Road, Wuhan,
430022, China; 2Institute of STI Prevention and Control, Wuhan, China;
3Institute of Health Education, Wuhan, China
Background: In November 2000, Huangpi District, Wuhan City was selected to
pilot the 100% Condom Use Programme in entertainment establishments (EEs)
funded by WHO.
Objective: To understand STI-related KABP of EE-based sex workers (SWs) to
provide information for development of effective ways of intervention and for evaluation of the project.
Method: 170 SWs were surveyed at their workplace by face-to-face interview
and questionnaires and were examined physically. Sampling was carried out
through:(1) Geographical and social mapping of sex EEs to develop sampling
frame and procedure; (2) Random selection of FSWs to be interviewed. The questionnaire was designed and pre-tested before being used in the field.
Results: There were 50 to 60 sex EEs with 300 to 400 SWs in Huangpi District.
SWs were highly mobile and stayed at an EE no more than 3 months generally. The mean number of clients was 5.9 per week. 96.4% had ever used condoms, but reported consistent condom use in last three months was only 18.5%.
55.7% claimed having never used condoms with regular partners. A significant
proportion (41.8%) of ever users of condom reported having experience of broken condoms. Most SWs had undertaken wrong measures to prevent STI, such
as douching (84.6%), taking or injecting antibiotics regularly (72.2%), etc. 62.4%
reported having had STD symptoms in the last 6 months, 73.3% of whom sought
treatment from private clinics. 28.9% were tested to be infected with STDs and no
one was HIV-positive. The result from logistic regression revealed that the SWs
who were from rural areas, had longer duration of sex work and less usage of
condom were more likely to have STDs (p<0.05).
Conclusions: The SWs are already at risk of HIV infection. There is an urgent
need to fully implement the newly approved local policy on 100% CUP to en
sure its success. Comprehensive measures (outreach, provision of comprehensive STI service and supply of quality condoms, etc) should be conducted.
Presenting author: Zhongdan Chen, No.24, Jianghanbei Road, Wuhan, 430022,
China, Tel.: [phone], Fax: [phone], E-mail: czd21cn@21cn.
com