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

484 Abstracts ThPeC7599-ThPeC7602

XIV International AIDS Conference

ThPeC7599 Change of Sexually Transmitted Infections ecology
in Bobo Dioulasso, Burkina Faso: what
implications for the syndromic approach and other
HIV/STI control efforts
N. Nagot1, A. Ouangre1, A. Ouedraogo1, N. Meda1, S. Yarol, I. Sombiel,
P. Van de Perre2. 1Centre Muraz, Centre Muraz, BP 390, Bobo Dioulasso,
Burkina Faso; 2Laboratoire bacterio-virologie, Montpellier, France
Background: The introduction in 1996 of the syndromic approach for STI management in Burkina Faso may have had some consequences on STI ecology and
HIV infection.
Methods: STI prevalence and etiological studies performed in Bobo Dioulasso
between 1990 and 2000 in different groups of population including Commercial
Sex Workers, patients consulting for STIs and the general population were selected and reviewed. Sentinel surveillance sites and a general population-based
survey provided data for HIV infection prevalence.
Results: While prevalence of bacterial IST levelled off until 1996, we observed
in all study populations a sharp decrease of these infections from 1998 onwards.
Gonococcal infection and syphilis almost disappeared in 2000 (prevalence below
1% in CSWs). Chlamydial infections nearly halved in CSWs as well as in the general population. The same trend was observed with Trichomonas vaginalis infection while other genital infections remained steady. Interestingly, HIV prevalence
followed the same downward trend since 1996: in the 15-19 years age-group that
was shown to represent a good proxy for HIV incidence, the downward trend was
also significant (p for trend=0,003).
Conclusions: Classical baterial STIs prevalences showed a dramatic decrease
since the introduction of the syndromic approach. The marked increase in condom sales over the same period in the city is likely to have had an effect on STI
prevalence as observed in Thailand with CSWs. Furthermore, the introduction of
the syndromic approach probably lead to a better health seeking behaviour from
the population.
Finally, no data is available regarding other behavioural changes but this aspect probably played a role as well on STIs ecology as previously mentioned
in Uganda.
We stress the need to implement and maintain surveillance to adjust syndromic
approach for STI according to epidemiological changes. Further area of research
are in the non bacterial cause of genital infection.
Presenting author: nicolas nagot, Centre Muraz, BP 390, Bobo Dioulasso, Burkina Faso, Tel.: [phone], Fax: [phone], E-mail: [email protected]
ThPeC7600 High rates of sexually transmitted diseases (STDs),
HIV and risky behaviors among female detainees in
Moscow, Russia
YY. Khromoval, E.A. Safarova1, L.K. Dubovskayal, S.A. Averchenko1,
L.G. Dugasheva1, C. Ryan2, S. Aral2, J. St. Lawrence2, J. Lewis3, J. Braxton 3,
A.D. Shakarishvili3. 1Russian Association for STI Prevention "SANAM", UI. Novij
Arbat 6 - 165, Moscow, 121019, Russian Federation; 2US Centers for Disease
Control and Prevention, Atlanta, United States; 3US Centers for Disease Control
and Prevention, Atlanta, United States
Background: The study objectives were to assess the prevalence of STDs, HIV,
drug use and risk behaviors among various groups of population in Moscow.
Methods: A cross-sectional study in Moscow assessed prevalence of STDs, HIV,
drug use, sexual and other behaviors in juvenile and homeless detainees.
Results: Of 400 female participants aged 15-45 years, 190 (47.5%) reported
exchanging sex (ES) for money or/and other commodities. The mean number
of male sex partners within the last 12 months for women reporting ES was
168.2 (vs. 3.4 for those not reporting ES [nES], p<.01) of which 153.4 were
new sex partners. In ES women the prevalence rates were: HIV - 2.8%; HSV-2 -
29.2%; chlamydia - 27.9%; gonorrhea 29.5% (vs. 24.9% in nES, p<.05); syphilis
- 41.2% (vs. 23.7% in nES, p<.01), and any bacterial STD - 69.5% (vs. 48.0% in
nES, p<.01). Urine drug screening revealed evidence of opiates in 1.1%, metamphetamines in 1.1%, tetrahydrocannabinol in 5.4% of ES. The rates of condom
use were higher in ES than in nES women (89.9% vs. 49.4%, p<.01). ES women
were more likely than nES women to practice oral (63.2% vs. 20.3% in nES,
p<.01) and anal sex (15.8% vs. 6.6% in nES, p<.01). Only 21.3% of ES women
perceived themselves to be sex workers.
Conclusions: The rates of STDs, HIV and risky sexual behaviors are high among
female detainees in Moscow, especially those reporting ES. The high rates of
risky behaviors and of STDs suggest that they are especially vulnerable to acquisition and then transmission of HIV. Services for STD care, risk reduction counseling and condom promotion are being designed for these women.
Presenting author: Yelena Khromova, UI. Novij Arbat 6 - 165, Moscow, 121019,
Russian Federation, Tel.: [phone], Fax: [phone], E-mail: hromova@comtv ru

ThPeC7601I Epidemiology of HIV-2 infection in Spain
C. Toro1, B. Rodesr, E. Poveda, J. Garcia2, A. Aguilera3, C. Tuset4, R. Ortiz
de Lejarazu5, J.M. Eiros5, E. Caballero6, J. del Romero7, V. Soriano'. 1Hospital
Carlos ///, Madrid, Spain; 2Hospital Pinor, Ourense, Spain; 3Hospital Xeral,
Santiago de Compostela, Spain; 4Hospital General Universitario, Valencia,
Spain; 5Hospital Clinico Universitario, Valladolid, Spain; 6Hospital Vail d'Hebron,
Barcelona, Spain; 7Centro Sanitario Sandoval, Madrid, Spain
Objective: We describe the main characteristics of subjetcs with HIV-2 infection
reported in Spain up to January 2002, by examining report forms from the HIV-2
National Registry Database.
Material and Methods: Serologic and genetic methods are requested to consider for new HIV-2 infections and data are collected by the HIV-2 Spanish Study
Group. The
Group was founded in 1990, and includes participants from more than 30 diagnostic centers distributed all over the Spanish geographic.
Results: One hundred and five cases of HIV-2 infection have been reported.
Seventy-six (72.3 %) of them were male adults except for one boy who acquired
the infection vertically. Most of them were inmigrants (n=77) mainly from African
countries. The remaining were Spanish native subjects, often with a past history
of traveliling to or having sex with people from endemic areas. The main route of
infection was through heterosexual contact in most individuals (56%), although
10 were homo/bisexual men, and 2 had been intravenous drug users. Twenty
(19%) have developed AIDS and 8 have died; the rest remains asymptomatic. In
10 subjects, co-infection with HIV-1 was confirmed by both serological and PCR
methods. HIV-2 subtypes have been examinated in 27 patients: 22 belonged to
subtype A (Spaniards and Africans) and 5 to subtype B. Interestingly all patients
coming from Equatorial Guinea were infected with B subtypes, as well as two
Spanish seamen who had been in the West Coast of Africa for long periods. We
have not observed an increase in the number of reported cases over time. HIV-2 -infected individuals have been diagnosed, primarily in large urban areas.
Conclusions: HIV-2 infection is currently circulating in Spain, although with low
prevalence and without evidence of increase over time. The main HIV-2 subtypes,
A and B, are recognized in both Spaniards and Africans. However, patients from
Equatorial Guinea, carried the subtype B.
Presenting author: Eva Poveda, Hospital Carlos III, Sinesio Delgado,10, 28029,
Madrid, Spain, Tel.: [phone], Fax: [phone], E-mail: evapoveda
@ hotmail.com
ThPeC7602I Increase in severe malaria in HIV-positive adults in
South Africa
C. Cohen1, A. Karstaedt2, N. Govender2, J. Thomas2, D. Hlatshwayo2, L. Dini1,
J. Frean 1, J. Galpin2, H. Crewe Brown1. INational Health Laboratory Services
and University of the Witwatersrand, 12 Jacaranda Lodge, 4 Main Rd Melville,
2092, Johannesburg, South Africa; 2University of the Witwatersrand,
Johannesburg, South Africa
Background: HIV and malaria are common infectious diseases in sub-Saharan
Africa. Greater parasite densities and rates of clinical malaria have been demonstrated in HIV-positive patients from Uganda. Our aim was to determine whether
HIV-positivity affects clinical severity and parasitaemia in adult South African patients with falciparum malaria.
Methods: A prospective cohort study was conducted at Chris Hani Baragwanath
Hospital from January to June 2001/2002. All adult patients admitted with falciparum malaria were approached for inclusion in the study. Study participants
were tested for HIV status and CD4+ count. Patients were followed up for the
duration of hospitalisation. Features of severe malaria as defined by WHO criteria were noted. HIV-positive patients were stratified by CD4+ cell count and
clinically staged. All malaria smears were reviewed. HIV-positive and -negative
groups were compared. Ethical approval was obtained.
Results: 253 patients were enrolled in the study during 2001. 31% of patients
were HIV-positive. HIV-positive patients had significantly increased rates of severe and complicated malaria when compared to HIV-negative patients (15/79
14% vs. 14/174 8% p=0.02). Patients with CD4+ cell count below 200 had increased rates of severe malaria when compared to those with CD4+ cell count
above 200 and HIV-negative (p=0.05). HIV-positive patients had significantly increased rates of renal failure, severe anaemia and DIC. The increase in severe
malaria was more marked in South African patients with no immunity to malaria
than in patients from malaria-endemic areas.
Data collected during the malaria season of 2002 will also be presented.
Conclusions: HIV-positive South African patients have an increased risk of severe malaria. This risk increases as CD4+ cell count decreases. This has important public health implications.
Presenting author: Cheryl Cohen, 12 Jacaranda Lodge, 4 Main Rd Melville,
2092, Johannesburg, South Africa, E-mail: [email protected]