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

XIV International AIDS Conference

Abstracts ThPeE7931-ThOrF1l409 569

this movement. Clearly, targeted support for Caribbean populations and targeted
outreach are needed in the U.S., particularly in collaboration with religious leaders. Increased links between service providers and Caribbean cultural centers is
also critical. Linking primary health facilities in the U.S. and Caribbean countries,
or 'twinning,' is suggested, to bridge care experience and resources.
Presenting author: R. Cameron Wolf, HIV/AIDS Bureau, Office of Science & Epidemiology, 5600 Fishers Lane, Room 7-90, Rockville, MD 20857, United States,
Tel.: [phone], Fax: [phone], E-mail: [email protected]
ThPeE7931 Rapid assessment of Ethio-Djibouti transportation
corridor with regard to high-risk behaviors and
places for the spread of HIV/AIDS in Ethiopia
S.I. Abbas. CDC, PO.Box 21372 code 1000, Addis Ababa, Ethiopia
Background: Ethiopia is in a generalised state of HIV epidemic. In Ethiopia,
though the problems related to HIV/AIDS are wide spread, yet, they have not
been well studied and reported. This study was carried out as part of the Center's for Disease Control and Prevention (CDC) actvities in Ethiopia. The main
objective of the formative research was to provide information on potential target
groups for immediate commencement of intervention activitie.
Methods: The study used qualitative methods i.e., focus group discussions (13),
in-depth interviews (38) and key informant interviews. It was conducted on the two
main highways and 14 towns along the corridor. In each town all places where
high-risk activities taking place and those risk groups involved were explored.
Some of the target study groups included sex workers, truckers + assistants),
youth, the military, construction workers, job-seeking women and bar owners.
Results: The Ethio-Djibouti Corridor can be characterized as a place with
very high mobility. There are many high-risk activities facilitating the spread of
HIV/AIDS & STDs in the general population; and increased migration and attraction of women for sex work. The main high-risk groups identified were female Sex
Workers, truckers, the military and the youth. The medium-Risk groups identified were youth, particularly students and youngsters associated with the railway,
construction workers, taxi drivers, women seeking jobs and brokers by trafficking
women. It seemed that there is a positive attitude towards use of condom among
sex workers. To the contrary, most men had negative attitudes. Condoms are accessible to the majority, but the utilization is very much discouraging, especially
among soldiers, young men and truckers. Main places where high-risk activities
predisposing the public for HIV and STDs are liquor selling establishments, nightclubs, bars, hotels and brothels.
Presenting author: Shabbir Ismail Abbas, PRO.Box 21372 code 1000, Addis
Ababa, Ethiopia, Tel.: [phone], Fax: [phone], E-mail: shabbiria
@ hotmail.com
ThPeE7932 Mobility and HIV-1 infection in a prospective rural
Ugandan Cohort
J.S. Nakiyingi1, A. Ruberantwari1, J. Busingye1, J. Pickering1, B. Wolff1,
S.M. Mbulaiteye2, J.A.G. Whitworth'. 1Medical Research Council Programme
on AIDS in Uganda/Uganda Virus Research Institute, Entebbe, Uganda; 2 Viral
Epidemiology Branch, National Cancer Institute, Rockville, Uganda
Background: Mobility and migration have been described as risk factors for HIV
infection in retrospective studies. Facility studies indicate that sick persons migrate to areas where they can receive adequate care. We set out to study the
residence and mobility patterns in a rural Ugandan longitudinal cohort and their
association with HIV status.
Methods: Since 1989, annual surveillance of approximately 10,000 individuals
collects data on births, deaths, marital status, and mobility for all residents and
joiners. Sera are also collected and tested for HIV antibodies. From 1991, local
leaders were asked to record births and deaths monthly in their villages.
Results: In the first year of follow-up, 8381 (73%) stayed in the same house,
522 (5%) moved within the village, 186 (2%) moved to another study village,
1347 (12%) joined the study area, 877 (8%) left the study area, and 138 (1%)
died. Overall HIV prevalence was 4.5% (0.7% in children and 7.3% in adults)
and remained stable over the study period. It was highest among those who died
(47.1%), then leavers (8.8%), other migrants (5-6% for within village and study
movers, and joiners), and lowest in non-movers (3.5%).
Data from 10 years of follow-up show that HIV prevalence increased steadily
from 2.4% in non-movers to 14.7% in those moving every year (p-value for trend
(P)<0.001, chi2=361). After controlling for age, sex, and marital status, the odds
of HIV infection increased from 1.9 in those who changed residence once to 6.7
in those who never stayed at one place for a year (P<0.001, chi2=181).
The 237 sero-converters experienced higher mobility than the rest of the population both before and after HIV infection.
39% of deaths reported by local leaders were in recent migrants.
Conclusions: This rural population experiences high mobility which is strongly
and positively correlated with increased HIV risk, both as a risk factor and an

outcome.
Presenting author: Jessica Sendegeya Nakiyingi, Medical Research Council
Programme on AIDS in Uganda, and Uganda Virus Research Institute, RO.Box
49, Entebbe, Uganda, Tel.: [phone]/320272, Fax: [phone], Email: [email protected]

ThPeE7933 Residence at the time of HIV infection for Latin
American immigrants to Houston Texas USA
R.M. Grimes 1, D. Erickson2, M. Ross3, C. Lahart 4 1 The University of Texas
Houston Health Science Center, Houston, Texas, United States; 2Texas Liver
Coalition, Houston Texas, United States; 3 The University of Texas Houston
Health Science Center, RAS 319, P0. Box 20186, United States; 4Baylor
College of Medicine, Houston Texas, United States
Background: Houston, Texas, USA experiences significant in-migration from
Latin America. It is not known if HIV+ migrants are infected before their migration to the USA. It is also not known whether those infected prior to migration go
to the USA to receive medical care.
Methods: Patients were surveyed to determine the date of immigration. CD4
counts were obtained at their entry to medical care. Average CD4 counts for uninfected persons have been shown to be 1017 (S.D. = 329) for men and 1079
(S.D. = 330) for women. HIV infected persons lose about 80 CD4 cells per year
(6.67/month). The number of months since infection for men can be estimated by
the formula: (1017 - entry CD4 count)/6.67. Subtracting this from the date of the
first CD4 count gives the estimated date of infection (EstDOI). An estimated early
date of (EarDOl) infection for men can be estimated by date of first CD4 count -
(1017 - 329 [the standard deviation] - entry CD4 count)/6.67 or date of first CD4
count -1079 - 330)/6.67 for women. Patients whose EarDOI was prior to migration
were classified as highly likely to have been infected in their home countries and
those between the EarDOI and the EstDOI were considered likely to have been
infected in the home country The time between migration and entry to care was
used to determine if migration was to seek care.
Results: 96 patients were included (68M, 28F). All patients were born in Mexico (n=61), or Central (n=25) or South America (n=1 1). 35 patients (36.5%) were
classified as highly likely and 23 (24%) as likely to have been infected in their
home countries. The average CD4 count at entry to care was 195 and the mean
time between migration and care seeking was 9.5 years.
Conclusions: Importation of HIV from Latin America to the USA seems to be
a frequent occurrence. This has important epidemiological implications as non-B
clades become more prevalent in Latin America. Most patients do not seem to be
migrating to receive medical care.
Presenting author: Richard Grimes, RAS 319, PO. Box 20186, United States,
Tel.: [phone], Fax: [phone], E-mail: [email protected]
ThPeE7934 Knowledge of HIV/AIDS among women farm
workers in the midwest region of the United States
J. Chakraborty, K. Fitzgerald, T. Shah, S. Khudar, J. Duggan. Physiology and
Molecular Medicine, Medical College of Ohio, Toledo, OH, United States
Issues: In the United States, the HIV infection rate among the migrant farm
worker community is 10 times higher than the national average. Data is needed to
understand and evaluate the reason for the high infection rate in this population.
Description; A 24-item survey questionnaire was developed and translated into
the Spanish language. Seven Promatoras were recruited and trained to conduct
face-to-face interviews with 106 female farm workers from 9 Northwest counties
of Ohio. Besides demographic questions, 3 major types of questions were asked:
1) HIV/AIDS basic knowledge; 2) HIV/AIDS specific knowledge; 3) HIV/STD risk
behavior.
Lessons Learned: The majority had a home base in texas (45%); 74% were
Spanish speaking; 62% were married; 67% had an 8th grade education; 19% had
a high school and 3% had a 2-year college education; 75% were familiar with the
term "HIV/VIH" and 91% knew about AIDS/SIDA. The vast majority correctly identified sex (82%), blood (68%) and needle use (61%) as important transmission
routes. The majority (65%) indicated that both homosexuals and heterosexuals
were at risk of HIV infection;84% knew that a vaccine for HIV is not available and
83% knew that HIV can be detected by a simple blood test; 35% did not know that
treatment is available. Nearly half (49%) did not discuss HIV or AIDS with their
sexual partner. Many felt that men in the camps have multiple sexual partners;
70% stated that rape occurs in the camps. The majority of women (60%), who
answered many of the questions correctly, attended HIV lectures at a camp or at
another farm workers' gathering.
Recommendations: Although the female farm workers had some knowledge
about HIV/AIDS, additional areas of increased educational efforts (including treatment, prevention and perinatal transmission) need to be implemented among this
population.
Presenting author: Joana Chakraborty, Physiology and Molecular medicine,
Medical College of Ohio, 3035 Arlington avenue, Toledo, Ohio 43614-5804,
United States, Tel.: [phone], Fax: [phone], E-mail: jchakraborty
@mco.edu

ThOrF1 409 Increasing access to medical treatment for
HIV-positive staff of AIDS non-governmental
organizations in developing countries
D. Patterson1, T. Sellers2, J. O'Malley2. 1Canadian HIV/AIDS Legal Network,
Canadian HIV/AIDS Legal Network, 417 Saint-Pierre St, suite 408, Montreal QC
H2Y 2M4, Canada; 2nternational HIV/AIDS Alliance, Brighton, United Kingdom
Issues: HIV/AIDS treatments, including anti-retroviral therapies, are increasingly
provided in resource-poor settings in contexts such as the mining industry, or to