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

XIV International AIDS Conference

Abstracts ThPeD7778-ThOrE1405 529

ference is obvious because most clients were with high-risk behavior, spouses or
children of PLWH and/or guided for their Symptoms by family physicians.
Lessons Learned: VCT plays a pivotal role in curbing not only HIV/AIDS transmission but also in decreasing the risk of STDs and controlling parallel epidemics
of 01 like TB. It is also the best strategy in "normalizing" discrimination and stigmatization.
Recommendation: The VCT strategies discussed above should be adopted as
an ideal model for HIV prevention. Couple testing & counseling for MTCT prevention is another suggestion.
Presenting author: Vaishali Dodiya, FXB India Society, 317/11, Nirlon CHS, S V
Road, Goregoan (W), Mumbai - 400062, India, Tel.: [phone], Fax: +91
22 877 31 44, E-mail: [email protected]
ThPeD7778 Uptake of a package to prevent mother-to-child
transmission (PMTCT) of HIV in Abidjan, Cote
d'Ivoire. The Ditrame Plus ANRS 1201/1202 Project
D.K. Ekouevi1, V. Leroy2, I. Viho1, L. Bequet1, C. Sakarovitch2, A. Horo1,
C. Welffens-Ekra3, F. Dabis2. 1Project DITRAME PLUS, Programme PACCI,
Programme PACCI, Projet Ditrame Plus, 18 BP 1954 ABIDJAN 18, Cote dIvoire;
2Unite INSERM 330, Bordeaux, France; 3CHU de Yopougon, Abidjan, Cote
dIvoire
Background: Despite rapid implementation of PMTCT interventions in developing countries, the uptake in pilot projects remains generally low. We describe the
frequency of missed opportunities for PMTCT in a West African setting and study
the profile of HIV-infected (HIV+) pregnant women who end up not participating
to a PMTCT program.
Methods: Individual counseling and prenatal HIV testing are conducted in three
community-based antenatal clinics in Abidjan, Cote d'lvoire using on site rapid
HIV testing (Determine and Genie2); results available after 24 hours. Consenting pregnant women, age >=18 years and uterine height >=16 cm are included.
PMTCT package proposed to all HIV+ pregnant women informed includes antiretroviral prophylaxis (zidovudine + nevirapine) starting >=36 weeks of gestation and two alternatives to predominant breastfeeding discussed from inclusion:
formula feeding at birth or exclusive breastfeeding for 3 months followed by rapid
weaning.
Results: Between Nov. 7th 2000 and Nov. 15th 2001, 7297 pregnant women
have received the proposal of HIV testing. Acceptance of testing was 89%. The
return rate for results was 70% and global acceptability of HIV testing was 62%
(n=4512). The HIV-1 prevalence was 11.7% (n=754). Among the 522 women
(70%) who were informed of their HIV+ status, 151 women (29%) were included
as of Nov 15th, 2001 and started peripartum intervention. Women treated and
those HIV+ women not included in the project were similar in terms of sociodemographic characteristics (age, gestation age at first booking, parity, education
level and socioeconomic status).
Conclusion: Our preliminary results show that the acceptability of a comprehensive peripartum and post-partum PMTCT package remains insufficient in a
context of high HIV prevalence (12%), despite the availability of rapid HIV testing
on site. The frequent missed opportunities require further investigations and the
development of a plan for community mobilization.
Presenting author: Koumavi Ekouevi, Programme PACCI, Projet Ditrame Plus,
18 BP 1954 ABIDJAN 18, Cote d'voire, Tel.: [phone], Fax: [phone]
90 69, E-mail: [email protected]
ThOrE1403 Incarcerated adolescents in Sao Paulo, Brazil: Are
they really at higher risk for HIV/AIDS than their
peers?
C.A. Peres', R.A. Peres2, F. da Silveira2, V. Paiva2, N. Hearst3. 1Sao Paulo
State STD/AIDS Program, University of California, UCSF Box 0900, San
Francisco, CA 94143, Brazil; 2NEPAIDS-University of Sao Paulo, Sao Paulo,
Brazil; 3University of California, San Francisco, San Francisco, United States
Background: Incarcerated adolescents are at extremely high social risk and in
some settings have high HIV prevalence. Little is known, however, about how
these adolescents compare to their peers in AIDS knowledge, attitudes, and risk
behavior.
Mehtods: In 1998, 276 boys were randomly selected from the FEBEM juvenile
detention system in Sao Paulo for an anonymous self-administered questionnaire
following informed consent. We compared their responses to 223 boys attending
night school in a poor district of Sao Paulo who completed a similar questionnaire
in the same year.
Results: The two groups were similar in many demographic aspects, including
age and neighborhoods of origin. 23% of students reported having friends or relatives in FEBEM. 72% of students lived with both parents vs. 44% of boys before
entering FEBEM. FEBEM boys reported higher rates of leaving home due to police problems (34% vs. 1%; p<.001) and having been wounded with a knife or

gun (35% vs. 5%; p<.001), but many in both groups said there was a high possibility they might die from a policeman's bullet (32% vs. 28%; NS). Overall AIDS
knowledge was similar and fairly good in both groups, though the FEBEM boys
scored higher on questions related to knowledge from experience. FEBEM boys
reported much higher rates of drug use (85% vs. 13% and 59% vs. 5% for marijuana and cocaine respectively; p<.001 for both). FEBEM boys were more likely
to be sexually active (97% vs. 58%; p<.001) but similarly likely to use a condom

at last sex (34% vs. 33%; NS). FEBEM boys expressed higher confidence in their
ability to obtain condoms and convince a partner to use one (96% vs. 87% and
61% vs. 33%; p<.001 for both).
Conclusions: Boys in FEBEM appear to be at higher risk for HIV/AIDS because
of drug use and higher levels of sexual activity. But despite stereotypes to the
contrary, their knowledge, attitudes, and rates of condom use appear to be at
least as good as those of their peers.
Presenting author: Norman Hearst, University of California, UCSF Box 0900,
San Francisco, CA 94143, United States, Tel.: [phone], Fax: [phone]
6051, E-mail: [email protected]
ThOrE1404 Sexual thoughts, intentions, and experimentation in
pre-teens
K.S. Miller', S.C. Wyckoff2, D.J. Whitaker1, R.L. Forehand3, L.P. Armistead4,
B.A. Kotchick3, N. Long5, A. Shaffer3, V.M. Murry3, A. Kelly5, L.C. Jackson4.
1 Centers for Disease Control and Prevention, 1600 clifton road, ms-e45, Atlanta,
Georgia, 30333, United States; 2TRW, Atlanta, United States; 3University of
Georgia, Athens, United States; 4Georgia State University, Atlanta, United
States; 5University of Arkansas Medical School, Little Rock, United States
Background: Signs of sexual awareness are evident in pre-teens.
Methods: The first 345 of 1200 pre-teens (9-12 years of age) enrolled in a longitudinal, community based, US intervention trial of families in the Southeastern
US, were surveyed about sexual thoughts, intentions and behaviors.
Results: When asked how many times they had thought about having sex with
a boy/girl 25% (N=85) of pre-teens (mean age=10.4 years) responded at least
once, with 20% of those (N=1 7) responding "a lot of times". Of the 85, 36% (N=31)
responded "a little true" and 18% (N=15) "very true" to the statement "I would like
to have sex to see what it's like". Eleven percent (N=9) responded '"very true" to
the statement "I think I'm ready to have sex". Examining intention to have sex,
14% (N=12) responded that they "probably will" and 7% (N=6) are "sure they will"
have sex in the next year. Twenty-one percent (N=18) responded "a little true" and
11% (N=9) "very true" that they would have sex now if they had a boy/girlfriend
who would do it with them. Half (N=43) currently have a boy/girlfriend, 56% (N=48)
have kissed a boy/girl, and 28% (N=24) have willingly let a boy or girl put their
hands under their clothes, or willingly put their hands under a boy's/girl's clothes.
Eighteen percent (N=15) have ever willingly touched a boy's or girl's private parts,
or ever let a boy/girl touch their private parts. Two percent (N=2) have received or
given oral sex and 6% (N=5) have willingly engaged in penile-vaginal intercourse.
Conclusions: A substantial proportion of pre-teens surveyed show signs of sexual readiness, suggesting that HIV-prevention efforts should start before the teen
years.
Presenting author: Kim Miller, 1600 clifton road, ms-e45, Atlanta, Georgia,
30333, United States, Tel.: [phone], Fax: [phone], E-mail: kxm3
@cdc.gov
ThOrE1l405 Perceptions of AIDS among young people in rural
Mwanza, Tanzania
G. Mshanal, J. Wamoyi1, M. Plummer', D. Wight2, D. Ross', Z. Salambal.
'NIMR/AMREF/LSHTM, PO Box 11936, Mwanza, Tanzania; 2 MRC-UK,
Glasgow, United Kingdom
Background: Young people's perceptions of HIV and AIDS in rural Africa have
rarely been explored.
Methods: 20 HIV positive, 3 pregnant and 49 randomly selected primary school
pupils participated in in-depth interviews. A series of 3-4 focus group discussions
were held with a male and a female group of young people in each of 3 villages.
Participant observation was carried out in 7 villages (total 110 person-weeks).
Results: Symptoms that people associated with AIDS were dramatic weight loss,
change of hair texture to become soft like cat fur, severe vomiting, diarrhoea, a
skin rash and red lips. People with AIDS are believed to have a large appetite
and like eating expensive, fatty foods. The distinction between asymptomatic HIV
infection and AIDS is not clear. Most respondents express doubt that people suspected to have died from AIDS actually had had AIDS, because their spouses and
children continue to be healthy for several years. Most young people report that
there are two types of AIDS. One is caused by HIV, is transmitted through sexual
contact, and has no cure. Another is caused by witchcraft and can be cured by
traditional healers. Most rural young people also believe AIDS only affects adults
and/or people from towns. However, both male and female newcomers to villages
are preferred and sought-after sex partners. Local people with a reputation for
promiscuity, such as young unmarried mothers (wasimbe) and their partners, are
not regarded as being in danger of getting AIDS. Finally, condom use is reportedly
very low in all villages. This relates to widespread beliefs that unused condoms
are deliberately contaminated with HIV, that the use of condoms reduces sexual
pleasure, and/or their use indicates mistrust of a partner.
Conclusions: AIDS prevention and care interventions need to address local mis
conceptions about HIV and AIDS. In addition, preference for newcomers as sex
partners indicates a need to improve young people's risk assessment skills.
Presenting author: Gerry Mshana, PO Box 11936, Mwanza, Tanzania, Tel.:
[phone], Fax: [phone], E-mail: [email protected]