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

XIV International AIDS Conference

Abstracts ThPeC7595-ThPeC7598 483

tients testing positive for Hepatitis B was 34.7 years, and positive for HIV was
23.5 years.
Conclusions: The prevalence found of Hepatitis B and HIV in the STD clinic was
above expeceted. Our populations is predominantly male, young and are a basis
for evaluating prevention programs. Moreover, implementation of a local database
is very important in terms of assessing quality of care offered and preventive measures introduced.
Presenting author: Wong Alencar, Rua Santa Cruz 81, Vila Mariana, Sao Paulo,
S.o Paulo, Brazil, E-mail: [email protected]
ThPeC7595 HIV-infected marginalized and abused women from
Rio de Janeiro, Brazil (BR), are heavily coinfected
with HPV but have low/moderate prevalences for
other sexually transmitted infections (STIs)
R.K. Friedman1, M.C. Lourengo1, V.G. Veloso1, B. Grinsztejn1, M. Schechter2,
F I. Bastos3. 'Evandro Chagas Hospital/Fiocruz, Rua S~o Clemente, 272, Bloco
01, Apto 1308, Botafogo, Rio de Janeiro. CEP 22260-000, Brazil; 2Federal
University of Rio de Janeiro, Rio de Janeiro, Brazil; 3CICT/Fiocruz, Rio de
Janeiro, Brazil
Background: HIV infection has been on increase among socially marginalized
women in BR, especially in the 90s, as well as uterine cancer. HIV/HPV coinfection has been seldom evaluated and properly managed in the Brazilian context
Methods: Baseline interview of 297 HIV+ women followed-up by an HIV/AIDS
reference service in RJ, BR. Women answered a questionnaire on sociodemographics, behavioral, and clinical aspects and were tested for different STIs: T.
vaginalis, N. gonorrhoeae, Candida sp., C. trachomatis, G. vaginalis, HPV, and
cytomegalovirus infection, syphilis and hepatitis B
Results: Those women, from very low social strata (94% with less than basic education and 48% with a monthly income < US$160.00), reported disturbing levels
of domestic violence and sexual abuse (both ~ 24%) and reported to be engaged
in risky behaviors (66% did not use condoms in their last sexual intercourse, 13%
reported the concomitant use of illicit drugs and alcohol, and 4% have injected
cocaine). Over 51% were found to be infected with HPV, whereas syphilis was
found in 11%, hepatitis B in 14%, T. vaginalis in 10%, C. trachomatis in 3%, and
N. gonorrhoeae in 1%
Discussion: The striking differences in HPV vs. other STIs prevalences seem
to be due to high HPV background prevalence, the chronic character of this
infection, and the beneficial effect of broad prophylaxis on bacterial infections.
Those marginalized and stigmatized HIV+ women are under high risk of developing uterine displasia/cancer and should be targeted by comprehensive programs
including social promotion and management of clinical and behavioral problems
to minimize the chances to be (re)infected with different pathogens, to be lost for
follow-up, to drop out treatment or to further spread STIs.
Presenting author: Ruth khalili Friedman, Rua Sdo Clemente, 272, Bloco 01,
Apto 1308, Botafogo, Rio de Janeiro. CEP 22260-000, Brazil, Tel.: +55 21
22862656, Fax: [phone], E-mail: [email protected]
ThPeC7596 What do we know about the sexual practices of
men attending STD clinics in Pune, India?
R.B. Brahme1, S. Sahay1, R. Malhotra-Kohli1, R.R. Gangakhedkar1,
A.D. Divekar1, A.R. Risbud1, R.C. Bollinger2, S.M. Mehendale1. 'NationalAIDS
Research Institute, G-73, MIDC, Post Box 1895, Bhosari, Pune 411026, India;
2Johns Hopkins University, Baltimore, United States
Background: The present study was undertaken to understand the prevalent
sexual risk behavior & practices of men attending STD clinics in Pune, India.
Methods: 1872 men attended two STD clinics from March 1998-May 2000. Data
on their sexual behavior with respect to the age at initiation of sex, first contact
partner, total number of partners, sexual orientation, type of sexual activity, condom use with regular partner & female sex worker (FSW) exposure was collected
at screening visit after informed consent.
Results: Majority of the clinic attendees (68.9%) were 20-30yrs of age and
76% educated up to middle school. Premarital sex was practiced by 85% men
and 3.47% had men as their first sexual contact. First sexual contact was reportedly below 18yrs among 45% men. Initiation of sex at <15 yrs was with
friend/known person(42.7%/22.9%, p<.01)OR3.4(2.4-4.5); at 16-18yrs it was
with FSW (41.6%. p<.01)OR2.03(1.4-2.9) & at >19yrs, initiation of sex was
with FSW(38.7%,p=.006) OR1.8(1.3-2.6). Number of partner was 1, 2 & >=3
among 14.5%, 30.7% & 54.9% men respectively. FSW exposure in last month
was reported by 25.6% men. Of these 51.8% reported condom use and 45.7%
were consistent users. Among 1120 men with regular partners, condom use
with FSW as regular partners was 32.7% as against 4.2% with other regular
partners[p=.00,OR11.6(6.2-18.9)]. Anal sex was practiced by 20.1% [88% insertive & 12% receptive]. Among ever married men (1037), monogamy was re
ported in only 4.05%. Bisexuality was reported in 10.1% men, marked in men
<30 yrs than >30yrs,(82.2%/17.9%,p<.01,OR2.2(1.5-3.3).
Conclusion:As early initiation of sex, sex with acquaintances, bisexuality was
commonly observed in younger STD patients in Pune, creating awareness in
young people is crucial. Communication with couples is important because condom usage with regular partners was negligible. It is also important to discuss
risk reduction in men to men sexual relationships.

Presenting author: Radhika Brahme, G-73, MIDC, Post Box 1895, Bhosari,
Pune 411026, India, Tel.: [phone], Fax: [phone], E-mail:
rbrahme @ hotmail.com
ThPeC7597I Performance of on-site testing for syphilis in rural
antenatal clinics, Eastern Cape Province, South
Africa
R.N. Bronzan1, C.D. Mwesigwa-Kayongo2, D. Narkunas1, G. Fehler3,
S. Vasaikar2, J. Ddamba4, G. Hoyi4, P. Karuhije4, E. Nombekela4, P. Dlali2,
W. Ngqovu2, Y. Htun3, G. Neilsen5, G. Schmid1, B. Brady1, K. Parker1,
D. Allen 1, C. Ryan'1. 1 Centers for Disease Control and Prevention, 1600 Clifton
Road, Mailstop E-02, Atlanta, GA, 30333, United States; 2University of Transkei,
Umtata, South Africa; 3South African Institute of Medical Research,
Johannesburg, South Africa; 'Department of Health, Pretoria, South Africa;
5Department of Health, Johannesburg, South Africa
Background: Syphilis can increase HIV transmission ten-fold. In South Africa,
syphilis rates among antenatal women are estimated at 8.4%. In Eastern Cape
Province less than 25% of rural antenatal clinics (ANC) routinely conduct syphilis
testing, mostly due to lack of transportation to and from district laboratories. This
study evaluates feasibility, acceptability and cost-effectiveness of implementing
on-site syphilis testing in rural clinics, comparing traditional rapid plasma reagin
(RPR) with a new, rapid immunochromographic strip (ICS) syphilis test. Successful on-site diagnosis and treatment of syphilis would reduce congenital syphilis as
well as the impact of syphilis on HIV transmission.
Methods: Nurses from eight rural Eastern Cape clinics were trained to perform
the RPR (non-specific) and ICS (treponemal) tests. On-site syphilis testing was
conducted for consenting women over 18 presenting for prenatal care without a
current syphilis test. Women with a positive on-site test were treated immediately.
Quality control testing was conducted in a reference laboratory using RPR, ICS,
and Treponema Pallidum Hemagglutination (TPHA) tests.
Results: Of a target sample of 960 women, 437 have enrolled to date. Syphilis
rates from the reference laboratory are 9.3% by RPR (95%CI 6.6-12.6), 16.0%
by ICS (95%CI 12.5-20.0), and 14.2% by TPHA (95%CI 10.6-17.8). In contrast,
on-site testing rates were 2.8% by RPR (95%CI 1.1-5.7) and 6.9% by ICS (95%CI
3.7-11.5). Evaluation of discrepant results is in progress.
Conclusions: Point estimates for active (RPR) and lifetime (ICS or TPHA)
syphilis infection rates differed significantly for on-site versus reference laboratory tests, suggesting on-site testing may be problematic even with simple ICS
tests. Cost-effectiveness analysis including test performance will guide recommendations on expanded use of these tests and will help estimate the impact of
each test on adverse outcomes related to syphilis, including HIV transmission.
Presenting author: Rachel Bronzan, 1600 Clifton Road, Mailstop E-02, Atlanta,
GA, 30333, United States, Tel.: [phone], Fax: [phone], E-mail:
[email protected]
ThPeC7598 High rates of sexually transmitted diseases (STDs)
and related risky behavior in the homeless
population in Moscow, Russia - potential impact for
HIV transmission
A. Shakarishvili1, L. Dubovskaya2, Y. Khromova2, E. Safarova3, L. Dugasheva2
S. Averchenko3, S.O. Aral1, J. St. Lawrence', J. Lewis1, J. Braxton1, K. Parker1,
C. Ryan1. '1US Centers for Disease Control and Prevention, 1600 clifton rd,
atlanta, ga, United States; 2Russian Association "Sanam", Moscow, Russian
Federation; 3Russian Association "Sanam", Moscow, Russian Federation
Background: The objectives were to determine the prevalence of STDs, HIV,
drug use, health seeking and other behaviors, and social conditions affecting
transmission and acquisition of STDs and HIV among the homeless population in
Moscow.
Methods: A cross-sectional study of 200 females (F) and 200 males (M) aged
18-45 years was carried out at homeless detention centers.
Results: Overall prevalence rates were: syphilis - 32% (51% for F vs. 11% for M,
p<.01); chlamydia - 11% (20% for F vs. 3% for M, p<.01); gonorrhea - 17% (26%
for F vs. 8% for M, p<.01); HSV-2 - 21% (35% for F vs. 6% for M, p<.01); HIV -
1% (3% among F reporting commercial sex work). Only 1%, 3%, 1% were found
to have used opiates, metamphetamines, marijuana, respectively. No cocaine or
amphetamine use was detected. Overall, F were more likely to have exchanged
sex for money (52% for F vs. 2% for M, p<.01), drugs (4% for F vs. 1% for M,
p=0.05), and other commodities (8% for F vs. 1% for M, p<.01), and to have
bacterial STDs (43% for F vs. 19% for M, p<.01). Of those who reported having
sex partner in the last year, 29% of F vs. 6% of M had >10 partners (p<.01). Of
those reporting sexual activity, over 64% of M and 40% of F did not use a condom
during the last 10 intercourses.
Conclusions: This population had surprisingly high rates of STDs and risky sexual behavior that is worrisome given the potential for HIV spread. The rate of
HIV is relatively high compared with other non-drug using groups in Moscow. The

findings will guide the design and implementation of effective STD/HIV prevention
strategies for this population in Moscow.
Presenting author: anna shakarishvili, 1600 clifton rd, atlanta, ga, United States,
Tel.: [phone], Fax: [phone], E-mail: [email protected]