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

XIV International AIDS Conference

Abstracts ThPeC7454-ThPeC7458 451

Presenting author: Steven Goodreau, Center for AIDS and STD, 325 Ninth Ave,
Campus Box 359931, Seattle, WA 98104, United States, Tel.: [phone],
Fax: [phone], E-mail: [email protected]
ThPeC7454 Mobility and the spread of HIV in rural
East-Zimbabwe
H.A.C. Voeten', M. Mlilo2, B.W. Zaba3, E.J. Knoops', J.D.F. Habbemal,
S. Gregson4. 1Department of Public Health, Erasmus University Rotterdam,
Department of Public Health, Faculty of Medicine and Health Sciences, PO Box
1738, 3000 DR Rotterdam, The Netherlands; 2Biomedical Research and
Training Institute, Harare, Zimbabwe; 3Centre for Population Studies, London
School of Hygiene & Tropical Medicine, London, United Kingdom; 4Department
of Infectious Disease Epidemiology, Imperial College School of Medicine,
London, United Kingdom
Background: The rapid rise in HIV prevalence in Zimbabwe may be linked to high
mobility. Cross sectional data from the baseline survey of a population-based cohort study in rural Manicaland are used to analyse the associations of in-migration
and travel with HIV-spread.
Methods: Between 1998-2000 dried blood spots were collected for HIV testing
for 9725 adults who were interviewed about socio-demographic characteristics,
sexual behaviour and mobility. Multivariate analysis is used to describe the association between HIV prevalence and mobility, adjusting odds ratios for age, marital
status and type of location.
Results: Men and women who moved into the study area in the last 10 years had
a higher HIV prevalence than residents: OR=1.4 (1.2-1.7) and 1.5 (1.3-1.7). Adjusting for number of lifetime partners, in-migration retained an association with
HIV infection: OR=1.4 (1.1-1.7) and 1.3 (1.1-1.5). Having an in-migrant spouse
was associated with higher levels of HIV infection in men, OR=1.7 (1.3-2.3), but
not in women. Adjustment for partner migration in men rendered their own migration status insignificant, suggesting that married migrant men are at risk because
their wives are generally migrants (88% have migrant wives). Female in-migrants
are at risk of HIV infection regardless of whether their husband is an in-migrant:
OR=1.7 (1.3-2.3). There was no association between HIV prevalence and indicators for (recent) travelling, such as spending at least one night away from home
last month, living away for more than one month last year, having met the most
recent sex partner outside the community, and not always cohabiting with spouse.
Conclusions: In this cross sectional analysis, in-migration per se seems to be
associated with increased HIV prevalences for women and their spouses but not
for (married) men. Travel seems not to be associated with HIV spread in rural
East Zimbabwe, at this mature stage of the epidemic.
Presenting author: Helene Voeten, Department of Public Health, Faculty of
Medicine and Health Sciences, PO Box 1738, 3000 DR Rotterdam, The Netherlands, Tel.: [phone], Fax: [phone], E-mail: [email protected].
eur.nI
ThPeC7455 Where do people meet new sexual partners in
urban Africa?
S.S. Weir1, N. Coetzee2, X. Mahlalela3, N. Nagot4, F Sssengooba5, S. Nnko6,
J.T. Boerma 1. 'Department of Epidemiology, School of Public Health, University
of North Carolina, Carolina Population Center, MEASURE Evaluation Project,
CB# 8120 University Square, 123 West Franklin Street, Chapel Hill, NC
27516-3997, United States; 2University of Cape Town, Cape Town, South Africa;
3EQUITY Project, Management Sient ces for Health, Pretoria, South Africa;
4Centre Muraz, BoboDioulasso, Burkina Faso; 5Institute of Public Health,
Makerere University, Kampala, Uganda; 6TANESA Tanzania-Netherlands
program to support HIV/AIDS Control, Mwanza, Tanzania
Background: The rate of new sexual partner acquisition in a population drives
HIV incidence. Little is known about the rate and context of new sexual partner
formation in urban Africa, the extent of concurrency in relationships, and whether
sites where partnerships are formed are appropriate targets for AIDS prevention
programs.
Methods: A standard protocol (called Priorities for Local AIDS Control Efforts,
PLACE) was used to identify and characterize sites where people meet new sexual partners in 7 urban neighbourhoods in South Africa, Uganda, Tanzania and
Burkina Faso, with populations ranging from 24,000- >100,000. Key informants
provide information on places where people meet new sexual partners. All sites
are visited and characterized; a sample of people socializing are interviewed.
Results: An average of 300 key informants in each study identified sites where
people meet new sexual partners (range 64-235 sites). More than 60% of the
sites included alcohol consumption, but commercial sex was available at fewer
than 15%. Typically, a site involved 20-50 visitors on a day, with a male - female
ratio of 2:1. The mean number of new sexual partners in the past four weeks
among men socializing at these sites ranged from 0.5 to 1.2, while females reported slightly lower rates (0.3-1.4). Most people with a new partnership also had
another concurrent partnership. It was common to visit multiple sites on the same
evening.

Conclusion: Urban areas have many places where people can go to meet new
sexual partners and such places can be identified systematically using the PLACE
protocol. Large numbers of men and women are participating in sexual networks
evolving around those places. Rates of new partner acquisition are high and concurrent relationships are common. Commercial sex plays a minor role in these
networks. These places should become priorities for local AIDS control efforts.

Presenting author: Sharon Weir, Carolina Population Center, MEASURE Evaluation Project, CB# 8120 University Square, 123 West Franklin Street, Chapel Hill,
NC 27516-3997, United States, Tel.: [phone], Fax: [phone],
E-mail: sharon [email protected]
ThPeC7456 Creation of a people living with HIV/AIDS (PLWH)
networking at Dakar, Senegal named "Bok Jef:
acting together
S.D. Sylla Ndene, S.B. Saidou Ba, A.F. Aby Faye, K.G. Khady Gassama,
B.M. Boubacar Mane, I.S. Idrissa Sow, L.B. Lucie Bokhoyo, N.F.N. Ndeye Fatou
Ngom Gueye. Ambulatory Treatment Center, [email protected], Senegal
Background: Bok Jef was created by PLWH who met during the focus group
organised at The CTA (Ambulatory Treatment Center) at Fann Hospital. Its consisted to experiences sharing concerning the social daily life of the different members of this association. The main objective was to give psychological and medical
support to their HIV members.
Methods: The activities within the Bok Jef Association consisted to home visit,
pscyhological support for hospitalized members and social permanent help for
PLWH.
Results: The Bok Jef Association has 60 members actually. The secretary of the
Association is located at the CTA and financial and technical support were obtained from the Alliance Nationale de Lutte contre le SIDA (ANCS). The activities
for home and hospital visits were very appreciated by the members which help
them for psychological support. Limited resources were the main constraints of
the Bok Jef Association.
Conclusion: There is a need for parternship between Association of PLWH and
the donors working in the field of HIV/AIDS. This will facilitate access to drugs
and moral nutritional support.
Presenting author: Nd6ne SYLLA, [email protected], Senegal, Tel.: +221 825
06 62, Fax: [phone], E-mail: [email protected]
ThPeC7457 Why aren't the HIV(+) urban poor receiving
Opportunistic Infection prophylaxis?
E.D. Charlebois, S. Perry, D.R. Bangsberg, R. Clark, A.R. Moss. University of
California, San Francisco General Hospital, 1001 Potrero Ave. UCSF 1372, San
Francisco, CA. 94110, United States
Background: Opportunistic Infection (OI) prophylaxis is not universal among the
HIV(+) urban poor and deaths from Pneumocystis carinii pneumonia (PCP) still
occur. We examined failure to receive and adherence to recommended OI prophylaxis and incidence of Ol's among a representative sample of HIV(+) homeless
and marginally housed adults in San Francisco.
Methods: 330 adults from a population-based sample of HIV+ people identified
(1996-2000) through HIV screening in low-income single room occupancy hotels,
homeless shelters and free food lunch lines (REACH Cohort) were interviewed
and followed monthly. HIV treatment, diagnoses and OI prophylaxis data were
collected through questionnaires with the aid of pill cards.
Results: 112/330 of the cohort developed CDC-defined AIDS. 46% of AIDS
cases were diagnosed with an 01. Together PCP, MAC, & TB, accounted for 65%
of the total Ols diagnosed. 6/36 deaths (17%) were directly attributable to preventable Ols, 3 PCP, 3 MAC, 1 PCP & MAC. 114/330 (35%) of subjects reported
being prescribed PCP prophylaxis. Among those with CD4 < 200, 17% have
never been prescribed PCP prophylaxis. 5/18 subjects observed to develop PCP
reported never receiving PCP prophylaxis. Of 4 subjects dying with PCP only 2
were on PCP prophylaxis within 6 months prior to death. One had never taken
PCP prophylaxis. Among 95 subjects who reported that they were supposed to
be taking PCP prophylaxis, 22% had taken no medication in the last 7 days. Only
58% reported having taken 100% of their doses.
Conclusions: The urban poor are failing to receive recommended 01 prophylaxis. Adherence to 01 prophylaxis is low. Targeted efforts to increase receipt and
adherence to OI prophylaxis in the population should be made.
Presenting author: Edwin Charlebois, San Francisco General Hospital, 1001
Potrero Ave. UCSF 1372, San Francisco, CA. 94110, United States, Tel.: [phone], Fax: [phone], E-mail: [email protected]
ThPeC7458 Incidence of first episodes of HIV - opportunistic
diseases and its changes over time in the period
1987 - 2001 in the COMESEM Cohort Study
G. Gaspar, A. Monereo', C. Barros2, V. Castilla3, J. Gomez rodrigo4, J. Sanz5,
J.C. Alberdi6. 'Getafe Hospital, c/ Cerro Perdigones 3, p-3, bajo, Pozuelo de
Alarcon, 28224 - Madrid, Spain; 2 Mostoles Hospital, Mostoles (Madrid), Spain;
3Alcorcon Hospital, Alcorcon (Madrid), Spain; 4Leganes Hospital, Leganes
(Madrid), Spain; 5Alcala Hospital Alcala (Madrid), Spain; 60ficina de
Seguimiento epidemiologica del SIDA, Madrid, Spain

Background: The incidence of AIDS-defining diseases has dramatically dropped
in the last few years in developed countries. HIV infection in Spain shows the
highest rate of incidence among all European countries and has specific epidemiologic characteristics. Our study pretended to establish the incidence of HIVrelated opportunistic diseases, and its changes over time in the spanish COMESEM cohort.