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

XIV International AIDS Conference

Abstracts WePeC6218-WePeC6222 135

Tanzania. This gradual process has maximized the utility of surveillance data for
program planning and policy development.
Presenting author: Geoffrey Somi, Box 11857, Dar es Salaam, Tanzania, Tel.:
[phone], Fax: [phone], E-mail: [email protected]
WePeC6218 Different aids epidemics in Brazil and their trends
- a demographic analysis
D. Barreira, M.G. Fonseca, A. Barbosa Jr., C. Dhalia. Ministry of Health - Brazil,
Coordenagdo Nacional de DST/Aids, SEPN 511 - Bloco C Brasilia - DF
70750-537, Brazil
Background: According to the latest analyses, the AIDS epidemic in Brazil is
leveling off and there has been a substantial drop in AIDS-related mortality rates.
Nevertheless, careful examination of the analyses and reports from a demographic and geographical point of view reveal a number of different trends. These
have to be taken into account in the formulation of prevention and care policies.
Methods: The analysis was based upon the AIDS cases notified to the National
STD/AIDS Programme Office, as well as the deaths due to AIDS registered in
the Mortality Information System.To calculate incidence and mortality rates, the
Demographic Census done by the Brazilian Institute of Geography and Statistics
was employed. Annual percentage increases out of different rates were calculated on an annual basis and the relative variation between mortality and AIDS
incidence were observed according to sex, geographical area and age group.
Results: Between 1996 and 1999, the rate of AIDS incidence stayed around 14
cases per 100,000 inhab. However, a number of important regional differences
were noted: there was an increase of AIDS incidence in the N (7% / year), NE and
S regions of Brazil (over 13%) and a reduction in the Centre-West region (3.2%)
and SE (2%). Genders also indexed differences: among men the incidence fell
by 1.7%, and an increase of 11.2% among women was noted. The general trend
towards reduced mortality rates also less pronounced among women (7.9%) compared with the male trend - a fall of 16,2% per year. The picture becomes more
unbalanced when incidence rates in different areas of the country are compared.
Key demographic and regional variations have been noted in the number of cases
according to exposure categories.
Conclusions: Stratified analysis on the basis of demographic and geographical
variables has been demonstrated to be useful. Important data has been collected
for purposes of planning HIV and AIDS prevention and control activities in Brazil.
Presenting author: Draurio Barreira, Coordenag.o Nacional de DST/Aids,
SEPN 511 - Bloco C Brasilia - DF, 70750-537, Brazil, Tel.: [phone],
Fax: [phone], E-mail: [email protected]
WePeC6219 Prevalence of HIV infection in parturients in Brazil
M.FC. Felqa de Carvalho. Health Ministery, QE 12 Bloco D apt 204 - Guard I,
Brazil
Background: To determine the prevalence of HIV infection in parturients.
Methodology: 18000 samples would be needed for determining the prevalence
of HIV among parturients. Therefore, 150 maternity were selected at random. In
each of the five macro-regions maternity were chosen out of municipalities classified within one of the following size bands. The number of parturients sampled
was proportional to the number of parturients of fertile age sampled in each of
the states studied. The number of maternity under study was proportional to the
number of parturients sampled for each of the strata. In each maternity were collected samples from the first 120 parturients from 15 to 49 years old and have had
blood sampled during delivery routine. The test was anonymous and the whole
project received a favourible opinion from the Ethics Committee.
Results: 16.477 samples were analysed from the 18000 that were collected from
150 maternity clinics. Out of this total of samples 110 were HIV positive, which
gave a reading of 0.61% prevalence (0.49 - 0.73; IC 95%). If we compare the
soroprevalences in parturients carried out over the period from 1997 to the year
2000, we can observe that the highest prevalence in the period was in March
1997 (1.2%); followed by 0.8% in October 1997 and 1999, 0.7% in March 1999;
0.6% in October 1998 and the lowest was recorded in March 1998 (0.5%)
Conclusions: The prevalence of 0.6% does not represent a significant statistical difference, and could indicate a levelling off of the levels of HIV infection in
parturients. The study certainly has helped to oriente the activities in the fileds of
prevention and control of the epidemic in the national level, making it possible to
identify and monitor HIV infection in parturients and servining as an indicator for
the health and sanitary authorities for planning purposes and for organising and
putting into action the control activities concerned with the HIV and Aids epidemic.
Presenting author: Marcelo Felga de carvalho, QE 12 Bloco D apt 204 - Guard
I, Brazil, Tel.: [phone], Fax: [phone], E-mail: [email protected]
WePeC6220 HIV epidemic more severe in Rural India

Y.M. Italia1, I.S. Gilada2. 1People's Health Organization (India) PHO-Valsad
Branch, Peoples Health Organization (India) PHO-Valsad branch, Valsad
Raktdan Kendra, Kacheri Road., Valsad - 396 001., India; 2PHO, Mumbai, India
Issues: Of a billion people in India, 70% are in rural area with low literacy rate (M:
64%; F: 40%) and poor access to HIV awareness. Due to popular belief that HIV
is mainly urban disease, rural people are complacent and awareness is negligible.

HIV has been spreading faster in rural areas that can be established by sentinel
surveillance data of urban/rural areas (in Maharashtra 13/30 districts have higher
HIV rates than Mumbai). Being a country in transition from developing to developed, migration in constructions, industries and for other jobs end up making single male migrants (29% men in Mumbai are single-mostly migrants). Fishermen
go fishing and sailors on merchant navy.
Description: Study of 13 years work amongst migrants and native people of rural and coastal area, where males away and females being alone at homes, both
have liberty to enjoy culturally acceptable casual sex. High prevalence of conventional STDs (3 fold rise in last 3 years), HIV (cumulative:0.7%; current 1.5%) and
MTP are seen.
Lessons Learned: Condom usage was promoted only for family Planning purpose by married couples; which is miniscule. KABP about use of condom for
STD/HIV prevention is abysmally poor amongst the tribal population. HIV prevalence in coastal area (2.1%) is higher than interior tribal population (1.2%). The
KABP survey among students along with workers of various co-operative societies, responsible for providing jobs for youths in tribal areas, is revealing. The
paper discusses about the various causes of HIV infection including Sexual Corruption.
Recommendations: Analyses of KABP survey, STD/HIV prevalence studies and
experience suggests appropriate measures to interrupt HIV spread in rural India
on war-footing with peer education model using folk and mass media. Migrants
should be provided access to HIV information, tools for prevention, counseling,
testing and care and awareness among 70% rural population of India.
Presenting author: Yazdi Italia, People's Health Organization (India) PHOValsad branch, Valsad Raktdan Kendra, Kacheri Road., Valsad - 396 001., India,
Tel.: [phone], Fax: [phone], E-mail: [email protected]
WePeC6221 HIV surveillance among female sex workers in the
Philippines
R.J. Mateo, M.C. Lim-Quizon. National Epidemiology Center - Department of
Health, national epidemiology center - department of health, bldg. 9, san lazaro
compound, rizal avenue, sta. cruz, manila, Philippines
Background: To track the epidemiology of HIV among female sex workers
(FSWs) in the Philippines, the Philippine Department of Health established HIV
Serologic Surveillance (HSS) in 1993 and Behavioral Sentinel Surveillance (BSS)
in 1997. The HSS is primarily a warning system that is triggered when the critical HIV prevalence of less than 1% is breached. The BSS is intended to guide
planners to arrive at evidence-based intervention programs.
Methods: The HSS was conducted in 10 cities. Subjects were FSWs and were
categorized as establishment-based (EFSW) and freelancers (FFSW). The desired sample size was 300 per group per city. When possible, sampling areas
were randomly selected. Subject enrollment was voluntary confidential. Particle
Agglutination was used for screening blood samples and Western Blot for confirmation.
The BSS employed the same methods for subject selection. Sample size was 120
per group per city Subjects were interviewed using a standard questionnaire.
Results: HIV prevalence among FSWs was low at 0.06-0.19% among EFSWs
and 0.00-0.07% among FFSWs from 1993 to 2001. However, there were cities
where HIV prevalence was greater than or equal to 1%.
The average numbers of sex partners per week were 2 and 4 for the EFSW and
the FFSW, respectively Majority of FSWs knew that condom use prevents HIV
transmission, but, only 34-42% of EFSWs and 25-32% of FFSWs consistently
used condoms during sex.
Conclusions: HIV prevalence is low and the transmission is slow among FSWs
in the Philippines. This may be due to the FSWs' fewer number of sex partners
compared to their counterparts abroad. The "low and slow" scenario for HIV/AIDS
in the Philippines is not something that will remain so forever especially with the
low consistent condom use rate among FSWs. Especially in cities where the 1%
HIV prevalence was breached, AIDS Councils were established, ordinances on
100% condom use were enacted and HSS and BSS were institutionalized.
Presenting author: ricardo, jr. mateo, national epidemiology center - department
of health, bldg. 9, san lazaro compound, rizal avenue, sta. cruz, manila, Philippines, Tel.: [phone], Fax: [phone], E-mail: [email protected]
WePeC6222 HIV/AIDS registry in the Philippines
N.S. Palaypayon1, M.C. Quizon2, R. Mateo3. National Epidemiology Center,
Department of Health, Manila, Philippines; 2Department of Health, Manila,
Philippines; 3National Epidemiology Center, Department of Health, Manila,
Philippines
Background: The Philippine Department of Health (PDOH), in its desire to keep
track of the HIV epidemic, classified HIV/AIDS as a notifiable disease in 1986.
The following year the PDOH established the HIV/AIDS registry, which is a passive surveillance that aimed to log all confirmed HIV/AIDS cases, analyze their

profiles and monitor progression of the disease. In 1996 the PDOH and WHO
projected that by the year 2000, there will be 38,000 HIV/AIDS cases in the Philippines.
Methods: All HIV reactive samples from PDOH-accredited hospitals, laboratories, clinics and blood banks are submitted to the STD/AIDS reference laboratory
for western blot testing. Once confirmed, a standard reporting form is submitted to
the PDOH with the following information: demographics, probable mode of trans