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

XIV International AIDS Conference

Abstracts ThPeC7577-ThPeC7581 479

STI (HIV, hepatitis B and syphilis), practice of prostitution and about other characteristics of persons tested for HIV in a STI clinic in Barcelona during 2000.
Results: Immigrants represented one fourth of all people newly tested for HIV in
2000. Prostitution was practiced by 47% of immigrants compared to 6% of autochtonous (P<0.001). Half of prostitutes came from Colombia, Ecuador or Dominican Republic; 64% of first visits occurred in 2000. One third of prostitutes had
had a previous STI and another third had a STI at time of HIV testing. Immigrants
were more likely than autochtonous to have another STI (P<0.001) and not to
collect the serological tests (P<0.02). HIV prevalence was similar in immigrants
and autochthonous (1.8%-1.7% respectively), but hepatitis B (anti HBc) (19.5%8.3%) (P<001) and syphilis (RPR+TPHA) (3.2%-1.1%) (P<0,01) more frequent
in immigrants.
Conclusions: Compared with autochtonous, immigrants had more frequently a
STI at time of HIV testing. Overall, the results of the serologies showed higher exposures to hepatitis B and syphilis among immigrants, while HIV seroprevalence
was similar in both groups. STI prevalence studies and preventive activities, culturally adapted, prioritized and tailored, should also be directed to immigrants.
Presenting author: Marti Vail Mayans, STI Unit, Av Drassanes 17-21, 08001
Barcelona, Catalonia, Spain, Tel.: [phone], Fax: [phone], E-mail:
[email protected]
ThPeC7577 Declining trends in the sexually transmitted
diseases in patients attending sexually transmitted
diseases clinics in Pune, India
M.V. Ghate1, A.R. Risbud1, A.D. Divekarl, R.R. Gangakhedkarl,
R.G. Brahme1, M. Shephard2, R.C. Bollinger2, S.M. Mehendale1. 1National
AIDS Research Institute, 1123 B, Model Colony, Shivaji Nagar, Pune, 411016,
India; 2Johns Hopkins University, Baltimore, United States
Background: Since the first case of HIV infection in India in 1986, there has been
a national effort to increase HIV awareness and to decrease high-risk behavior.
Sexually transmitted diseases are important cofactors in HIV transmission. It is
not clear whether this effort has resulted in any change in risk behavior in any risk
groups in India.
Methods: Between May 1993 and April 2000 as a part of prospective cohort
study, men and women presenting to STD clinics in Pune were interviewed and
evaluated. Clinical diagnosis of STD was based on detailed physical examination,
as well as microbiological laboratory investigations. HIV screening to consenting
individuals was offered. Prevalence and trends in yearly STD rates were measured.
Results: See table below.
Conclusion: Over eight years, patients presenting to the government STD clinics
in Pune, India demonstrated a significant decrease in the clinical diagnosis of all
STDs. The decline could be resulted due to increased STD/HIV awareness and
risk reduction, including increased condom use. It is also possible that individuals
at highest risk for STDs have shifted their clinical care to the private sector.
Presenting author: Manisha Ghate, 1123 B, Model Colony, Shivaji Nagar, Pune,
411016, India, Tel.: [phone], Fax: [phone], E-mail: mghate
@ hotmail.com
ThPeC7579 High prevalence of HIV and sexually transmitted
infections among young women seeking HIV
testing in Rio de Janeiro
R.L. Cook', S. May2, L.H. Harrison1, R.B. Ness1, R. Ismerio2, M. Schechter2.
1 University of Pittsburgh, Pittsburgh, PA, United States; 2Federal University of
Rio de Janeiro, Rio de Janeiro, Brazil
Background: In Brazil, HIV is spreading most rapidly among younger women,
adolescents, and urban dwellers. Young women seeking HIV testing may be at
risk for other sexually transmitted infections (STIs). This study sought to determine the prevalence of genitourinary infections due to C. trachomatis, N. gonorrhoeae, T Pallidum and HIV among young women seeking HIV testing in Rio de
Janeiro, Brazil.
Methods: Subjects were 200 consecutive, non-pregnant women aged 14 - 29
who presented to an HIV testing site between July and October 2001. Study
nurses collected information on demographic factors, risk behaviors, and health
services. Chlamydia and gonorrhea testing was conducted on self-collected vaginal swabs using the Amplicor PCR assay. HIV and syphilis testing was conducted
on serum samples using HIV ELISA (confirmed by Western Blot) and VDRL (confirmed by FTA-ABS).

Results: The mean age of the 200 participants was 22.5 years, 65.5% had less
than a high-school education, 78% were not married/not living with a partner, 60%
reported genital symptoms, and 46% reported more than one sexual partner over
the past year. Vaginal swab sampling was well accepted (100% acceptance rate).
The prevalence of infections was: HIV (8.0%), syphilis (6.5%), chlamydia (8.5%),
and gonorrhea (9.5%). Three of 16 persons with HIV infection were co-infected
with another STI; two had gonorrhea and one had syphilis. 20.5% of participants
had at least one treatable STI (other than HIV).
Conclusions: STIs are very common among young women seeking HIV testing
in Brazil and may be contributing to an increased risk of HIV transmission. HIV
testing sites should offer screening and treatment services for STIs.
Presenting author: Robert Cook, University of Pittsburgh, E820 MUH, 200
Lothrop St, Pittsburgh, PA 15213, United States, Tel.: [phone], Fax: +1
412-692-4838, E-mail: [email protected]
ThPeC7580 Natural history of bacterial vaginosis in young Thai
women
S. Sriplienchan1, S. Lamlertkittikul2, P. Wannaro2, A. Wongthanee3,
S. Pinjaroen4, K. Soonthornpun4, C.S. Morrison5, D.D. Celentano1. 'Johns
Hopkins University, Research Institute for Health Sciences, Chiang Mai
University, PO Box 80, CMU, Muang, Chiang Mai, 50202, United States;
2Department of Obstetrics and Gynecology Hat Yai Hospital, Songkla, Thailand;
3Research Institute for Health Sciences, Chiang Mai University, Chiang Mai,
Thailand; 4 Department of Obstetrics and Gynecology, Faculty of Medicine,
Prince of Songkla University, Songkla, Thailand; 5Family Health International,
Research Triangle Park, North Carolina, United States
Background: Bacterial vaginosis (BV) has been identified as a risk factor for HIV
acquisition in many studies. HIV prevalence and incidence varies geographically
in Thailand. We consider the prevalence and incidence of BV by region as well as
other risk factors for BV.
Methods: We enrolled 1,585 young (18-35 years) HIV-negative Thai women who
sought family planning services and participated in "Hormonal Contraception and
the Risk of HIV Acquisition Study" from 11/99-11/01. At baseline, they used low
dose combined oral contraception (28%), injectable Depo-provera (41%) or nonhormonal methods (31%); were sexually active; and at least 4.5 months postpartum if parous. BV was diagnosed by using Amsel's criteria at each 3-month
follow-up visit.
Results: BV prevalence at baseline varied by region: 2.5% (north), 3.3 % (south),
3.7% (Central) and 6.4% (northeast). BV incidence, the event of positive testing after negative at previous visit, was 7.9% (central), 10.03% (north), 10.46%
(northeast), 13% (south). We look for correlation of BV prevalence and other
risk factor in the last 3 months in multivariate model. BV prevalence was significantly associated with vaginal cleaning (OR=2.39, 95%CI=1.23-4.66, p=0.01)
and knowing whether their partner had sex with other (OR=0.21, 95%CI=0.05 -0.89, p=0.03), after controlling for region, multiple sexual partners, having new
partner, partner circumcision, smoking and alcohol use.
Conclusions: BV prevalence is highest in the northeast region while incident rate
is highest in the south. In addition to region, risk factors for prevalent BV included
vaginal cleaning and knowing whether their partner had sex with others.
Presenting author: Somchai Sriplienchan, Research Institute for Health Sciences, Chiang Mai University, PO Box 80, CMU, Muang, Chiang Mai, 50202,
Thailand, Tel.: [phone], Fax: [phone], E-mail: [email protected]
ThPeC7581 I Changing patterns in sexually transmitted diseases
syndromes in Kenya after the introduction of a
syndromic management approach
B. Cheluget, K. Chebet, E. Munisia, C. Wandera, M. Kisoo. National AIDS &
STD Control Programme, National AIDS & STD Control Programme, PO. Box
19361, Nairobi, Kenya
Background: Epidemiological studies suggest that the presence of genital ulcers
and urethral and vaginal discharge increase risk of HIV acquisition and transmission. Thus, treatment and monitoring of STD syndromes should be an important
component of HIV prevention efforts.
Methods: Data on STD syndromes were collected from consecutive STD patients
during the annual HIV sentinel surveillance exercise in Kenya. This analysis was
conducted to evaluate the trends in proportion of STD syndromes in these STD
patients. We excluded the years of 1995 and 1999 in the trend analysis because
of small sample sizes.

Abstract ThPeC7577 - Table
Character Year 1993 Year 1994 Year 1995 Year 1996 Year 1997 Year 1998 Year 1999 Year 2000* p value
Total clinic attendees 1796 1930 1946 2097 1146 1057 1157 361.001
HIV seropositivity 434 389 411 521 272 257 283 95.008
Total STD patients 1156 1343 1174 880 414 281 241 69.001
Primary syphilis 108 186 110 46 23 19 8 3.001
Chancroid 572 435 486 325 144 107 79 19.001
Gonorrhea 89 391 267 229 76 32 37 12.001
Herpes 177 190 139 117 80 43 61 17.001
Trichomoniasis 34 64 37 10 4 8 2 0.001
Genital warts 93 88 91 70 38 34 23 10.001
*Data available for first 4 months of 2000; p value: by trend analysis among total clinic attendees