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

134 Abstracts WePeC6213-WePeC6217

XIV International AIDS Conference

WePeC6213I Results of study to know reasons for not using
condoms for disease prevention among patients
presenting with signs and symptoms of sexually
transmitted infections in Karachi, Pakistan
N.A.B. Baloch', S.A. Shah2. 1sindh services hospital, b-140, block 13d-1,
gulshan-e-iqbal, karachi-75300, Pakistan; 2Aids Control Program, Karachi,
Pakistan
Background: use of condoms for prevention of sexually transmitted infections including hiv/aids in pakistan is very low. the purpose of this study was to know the
reasons for low use of condoms so that appropriate interventions are planned for
promotion of condoms for disease prevention.
Methods: pre-structured questionnaire was administered among 100, male patients presenting with signs and symptoms of sexually transmitted infections
Results: about 1/3rd of total interviewed patients did not know, that condoms
could prevent transmission of sexually transmitted infections including hiv/aids.
more than 50% of study participants perceived that condoms reduce sexual pleasure therefore they do not use condoms. about 20% of study participants did not
use condoms because they could not maintain erection, about 10% of patients,
forgot to use condoms, for being under influence of alcohol or drugs. conclusion:
lack of information about role of condoms in disease prevention, perceived belief
use of condoms reduce sexual pleasure fear of losing erection and influence of
drugs were main reasons for not using condoms among patients presenting with
sign and symptoms of sexually transmitted infection.
Presenting author: naseer baloch, b-140, block 13d-1, gulshan-e-iqbal, karachi75300, Pakistan, Tel.: [phone], Fax: [phone], E-mail: naseerbaloch @yahoo.com
WePeC62144 HIV: perception of risk and access to care in East
and Central Harlem
C. Carriero. North General Hospital, 1879 Madison Ave, New York, NY 10035,
United States
Background: The United States has seen a shift in the AIDS epidemic from a
predominantly white gay population to communities of color with mixed risk factors. African-Americans and Hispanics account for greater than 70% of all newly
diagnosed AIDS cases. Women account for 21% of all adult cases and women
of color represent 86% of that sector. African-American and Hispanic children
account for 92% of all pediatric AIDS cases.
We propose that the increase in HIV/AIDS cases is attributable to continued highrisk behavior despite the known threat of HIV infection. To optimize our prevention
and outreach strategies we conducted a survey to identify perceived risks for HIV
infection, HIV knowledge base, and barriers to HIV testing.
Methods: A standardized questionnaire was distributed at a community event.
The respondents report on demographics, lifestyle, risk behaviors, psychosocial
status, socioeconomic conditions, and knowledge about HIV infection.
Results: Ninety of 200 questionnaires were analyzed. Preliminary results are
from 79 survey. Gender and racial/ethnic breakdown is: female (62%), Black
(59%), Puerto Rican/Caribbean Hispanic (27%). Ages were: 30-39 years old
(29%), 20-29 years old (18%), 13-19 years old (20%). Ninety six percent of respondents identified HIV as an infection and 95% considered HIV the cause of
AIDS. Sixty two percent reported a previous HIV test. 82% of those previously
tested were in monogamous relationships; 17% had multiple sex partners. Six
percent of respondents have a history of IDU and 14% report a history of crack
use. One in five respondents had a STD. 21% of those surveyed consider themselves to be at risk for HIV infection and 17% desired an HIV test.
Conclusion: Preliminary data suggest that respondents are reluctant to test for
HIV despite known risk factors. Future analyses of a number of variables in a
larger cohort will attempt to identify high-risk groups and the barriers to HIV testing and care.
Presenting author: Damaris Carriero, 1879 Madison Ave, New York, NY, 10035,
United States, Tel.: [phone], Fax: [phone], E-mail: damaris.carriero @ verizon, net
WePeC6215 Survey of risk behavior and hiv prevalence in
peruvian prisons
J. Best', D. Blitchtein-Winicki2, R. Leiva-Rosado2, A. Valverde3,
L.A.N. Suarez-Ognio2, H. Manrique-Chicoma4. NAtional Penitenciary nstitute,
mpun @oge.sld.pe, Peru; 2Ministry of Health. General Epidemiology Office, Lima,
Peru; 3Ministry of Health National HealthInstitute, Lima, Peru; 4Ministry of
Health.National Health/Institute, Lima, Peru
Background: In 1999, the Ministry of Health and the National Penitentiary Institute in Peru decided to perform a surveillance to estimate the prevalence of
syphilis and HIV and obtain information about related behavioral risk factors in
prisons.

Methods: A randomized anonymous, voluntary linked for syphilis and unlinked
for HIV study was undertaken to determine HIV and syphilis infection and identify
risk factors for the spread of both infections in Peruvian prisons.
Results: 6963 inmates participated from 22 penitentiary establishments in 15
Departments of the country. 33% of the originally selected inmates refused to
participate and substitutes were chosen. Infection prevalence was 1.1% for HIV,
and 4.1% for syphilis. The most significant HIV risks factors were drug consume

(OR 2.7), sexual infection diseases (OR:2.3), male having sex with same sex
partner (OR:2.2), cocaine use(OR:2.1), genital ulcer(OR:2.1), being incarcerated
before(OR:2), and having a tattoo(OR:1.99). The most significant syphilis risks
factors were, having sex with same sex partner (male OR:2.8), sexual infection diseases(OR:2.4), genital ulcer (OR:1.8), having sexual relations with sex
worker(OR:1.5) and having more than two sexual partners (OR:1.5).
Using a structural equation model it has been found association between HIV infection and having a tattoo, having more tan two sexual partners, more than one
previous imprisonment, genital ulcer.
Conclusions: This was a baseline study, this data can provide an estimation of
HIV and syphilis prevalence and related risk behavior in this population, if similar studies continue in the future it will be possible to know trends of them The
results support the hypotheses of HIV epidemic in Peruvian prisons has a predominantly sexual transmition.Health measures should be tacked in prisons like
medical attention and education for prevention and treatment of sexual transmitted diseases, tattoo instruments sterilization, condom supplies.
Presenting author: Jose Best, [email protected], Peru, Tel.: [phone], Fax:
[phone], E-mail: [email protected]
WePeC62166 Are unhygienic injecting practices among drug
users decreasing in spain?
M. Bravo1, L. Royuela', G. Barrio 1, A. Rodriguez 2, L. De la Fuente3,
V. Marquez4. IDGPNSD, Calle D Pedro no 6, 4 ext iquda, Madrid, 28005, Spain;
2Medicos delMundo, Madrid, Spain; 3/SC///-PNS, Madrid, Spain; 4Medicos del
Mundo, Sevilla, Spain; 5 Work Group for monitorization of HIV and risk practices
among drug injectors in SpainMdM, Galicia, Madrid, Sevilla, Valencia, Spain
Background: For many years, injection-behavioural surveillance among drug
users has included almost exclusively syringe sharing practices, generally receiving syringes (RS). The authors consider that in order to assess the real modifications on risk injecting behaviour, syringe-mediated drug sharing (SMDS) should
be always included in follow up and cross sectional studies. This study provided
trend data on RS and SMDS in Spain.
Methods: Three cross-sectional surveys. Face to face questionnaires were conducted with 1788 street recruited injectors in three cities in Madrid (n=470), Valencia (n=485), a geographical area composed by several cities in Galicia (n=438)
and Seville (n=245) where only two surveys were conducted. All participants were
recruited at a mobile Needle Exchange Programme from 1998-2001. Sociodemographical profile, RS, SMDS (front-backloading, sharing from the cooker, sharing
syringe-cleaning solution) were included. Reference period for risk behaviours:
last 30 days.
Results: Madrid (1998-99: 6%, 1999-00:7%, 00-2001: 2%; p=0,07) and Valencia
(14%, 15%, 10%; p=0,3) showed a declining but not significant trend of RS. Gallcia (13%, 21%, 14%) and Seville (17%, 18%) did not show clear trends. In all the
cities front-backloading (Madrid: 9%, 10%, 16%; Valencia: 12%, 8%, 15%; Galicia: 19%, 25%, 19%; Seville: 25%, 14%) was practically always equal or higher
than RS. Among those who did not RS, a considerable percentage were at risk of
become infected through SMDS (Madrid: 20%, 21%, 35%; Valencia: 23%, 14%,
26%; Galicia: 25%, 32%, 20%; Sevilla: 38%, 32%).
Conclusions: Unhygienic injecting practices are still very prevalent in Spain. Behavioural surveillance based only on RS underestimate risk behaviours for transmission of HIV and other blood-borne pathogens. A substancial amount of injectors probably think that they are not at risk nevertheless they could become
infected. Standard SMDS variables should always be included. (FIS Grant no
98/1197).
Presenting author: Maria Bravo, Calle D Pedro no 6, 40 ext iquda, Madrid, 28005,
Spain, Tel.: [phone], E-mail: [email protected]
WePeC6217 A comprehensive process of strengthening
HIV/AIDS and STI surveillance in Tanzania
G.R. Somi. NACP Tanzania, Box 11857, Dar es Salaam, Tanzania
Background: Sentinel surveillance of HIV/AIDS and STI among pregnant women
was first initiated in one region of Tanzania in late 80's. In early 90s sentinel
surveillance was expanded to 11 regions and performed well for several years.
In recent years, second generation surveillance has emerged as an effective tool
for exploring dynamics of HIV infection and monitoring and evaluating program
response.
To address growing information needs, concepts of second-generation surveillance were incorporated in the national H-IV surveillance system.
Methods: In 1999 following a national situation analysis a multidisciplinary team
developed Guidelines for Monitoring and Evaluation (M&E). Protocols by strategic programme areas were developed. A study team of local and national surveillance staff was developed to supervise and coordinate all phases of surveillance.
In 2001 the study team conducted a national HIV/STI serosurveillance protocol
training of all ANC surveillance personnel. A team of behavioural scientists at

the university of Dar es Salaam worked closely with NACP and developed behavioural surveys in 2 regions of Tanzania. Serosurveillance and behavioural surveys data collection began in January 2002.
Results: Behavioural data support serosurveillance trends seen throughout Tanzania.
Conclusion: A comprehensive process of assessment, protocol development,
expansion of sites and process standardization has enhanced surveillance in