Programme Supplement [International Conference on AIDS (16th: 2006: Toronto, Canada)]

Late Breaker Abstracts

Late Breaker
Abstracts

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this initiative on HIV-related practices one month, six months and
12 months following implementation.
Methods: Active, street-recruited crack-smoking IDUs consented
to personal interviews at four time points: six-months PREimplementation (November 2004, N=112); one-month (May 2005,
N=114); six-months (November 2005, N=157); and 12 months (May
2006, N=126) POST-implementation. Descriptive and univariate
analyses were completed.
Results: Uptake of the initiative was immediate, high and
sustained: 80% of crack-smoking IDUs at one and six-months,
and 90% at 12-months post-implementation had collected
crack smoking resources from the NEP. Sharing crack-smoking
equipment declined significantly. Pre-implementation, 85% of
crack-smokers reported sharing implements to smoke crack. At
one-month post-implementation 85%, at six-months 80% and at
12-months 77% reported engagement in this practice (p <0.001).
Among those who continued to share, the proportion sharing
"every time" declined significantly from 37% six-months preimplementation to 31% one-month post-implementation to 12%
at six-months and 12-months post-implementation (p <0.001).
Conclusions: This controversial programme had a significant
impact - maintained at one year - in reducing a practice known
to be associated with HIV transmission suggesting the urgent
utility of replicating this initiative at other NEPs.
THLB0105
Improving HIV surveillance and prevention among armed
forces in central Africa
J. Albergal, T. Ubald2, E. Mpoudi3, J. Hedje2, A. Boupda4, P.
Ba Oumars, A. Adrinkaye6, R. Bagamboula', N. Wolfe', M.
Grillo9'. 'Johns Hopkins Cameroon Program, Yaounde, Cameroon,
2Jonhs Hopkins Cameroon Program, Yaounde, Cameroon,
3Ministry of Defense, Yaounde, Cameroon, 4Care and Health
Program Cameroon, Yaounde, Cameroon, sMinistry of Denfense
Gabon, Libreville, Gabon, 'Ministry of Defense Chad, Ndjamena,
Chad, 'Ministry of Defense Congo Brazzaville, Brazzaville, Congo,
'Johns Hopkins School of Public Health, Epidemiology, Baltimore,
United States, 'US Division of HIV/AIDS Prevention Program, San
Diego, United States
Issues: The prevention of HIV/AIDS in the Armed Forces is a
critical task in Central Africa. Since 2002 the US Department
of Defense HIV/AIDS Prevention Program has been providing
support through the Johns Hopkins Cameroon Program to assist
these countries to improve surveillance and prevention of HIV/
AIDS in Cameroon, Chad, Congo Brazzaville, Congo Kinshasa,
Equatorial Guinea, Gabon, and Sao Tome
Description: Activities conducted include: Advocacy for the
engagement of military high command; training of counselors
and peer educators among personnel and their families;
promotion of behavioral change through peer education and
educational materials; training of laboratory technicians and
medical personnel for better diagnosis, testing and management
of HIV in military health centers; and surveillance to determine
HIV prevalence.
Lessons learned: From 2002-2006, the following results were
achieved: 1,456 peer educators trained among military personnel
and their families; 2,560 Peer education sessions organized;
126 Counselors trained; 10 VCT centers created, 128 Medical
personnel trained, 5 HIV surveillance studies conducted (8,054
samples collected and tested) and 5 KAP surveys conducted;
In addition, the following educational materials were designed,
produced and distributed: 25,500 brochures; 1,329 peer
educators manuals and photo flip charts; 5,250 posters; 6,250
uniforms; 550 artificial penises; and 164,400 condoms. Following
the surveillance studies, the prevalence of HIV in Armed Forces
in 2002 was: Gabon 4.17%, Congo Brazzaville 4.34%, Chad
5.34% and Cameroon 9.8%. These studies will be repeated in
2006-2007.
Recommendations: This innovative effort in the Armed Forces
in Central Africa is the first integrated HIV/AIDS prevention
program in this region and will allow effective implementation of

long-term strategies to fight the disease in this population.

THLB0106
Using geographic information system applications to
improve coverage, access and targeting of HIV/AIDS
interventions
N. Taruberekera, F. Chieza, Y. Madan. Population Services
International/ Zimbabwe, Technical Services, Harare, Zimbabwe
Issues: Zimbabwe is in the mature stage of a generalized HIV/
AIDS epidemic. However, HIV prevalence is unevenly distributed
with respect to age, gender and locality. The following areas have
been identified as high-risk localities with higher than national
HIV prevalence: rural growth points; border towns; displaced
communities; informal settlements; and temporary employment
sites. The above differences underscore the importance of targeted
HIV prevention interventions for specific population groups and
geographical areas. Geographic Information System (GIS) has
potential to accurately identify high-risk areas and establish
coverage and access levels essential for HIV related products and
services.
Description: In 2005, PSI/Z adopted the use of GIS to map
behavioral, surveillance and population indicators to identify
priority areas based on clear defined criteria, including HIV
prevalence, population density, living standard measure and other
demographic factors. The objective of the mapping exercise was
to focus limited project resources for improving linkages and
ensuring maximum impact of prevention interventions: condom
distribution, interpersonal communications activities and VCT
outreach services. In addition, GIS would be used to measure
coverage, quality of coverage of the existing distribution system
for male condoms and mapped access to condoms and VCT
services.
Lessons learned: Use of GIS systems helped improve linkages
between communication activities and product delivery to create
informed demand and improve off-take of male and female
condoms. In addition provision of essential HIV/AIDS services and
products in priority areas were improved; condom distribution
was targeted at areas with low coverage; VCT outreach and
interpersonal communication (IPC) activities were programmed
to ensure comprehensive coverage and access in high risk areas
among vulnerable groups. As a result, PSI/ Z registered significant
increase in male condom distribution in high risk areas and low
coverage areas.
Recommendations: Programs should use GIS to improve
targeting of provision of essential HIV/AIDS services and products
including communication strategies.
THLB0107
A population-based study suggests that the HIV estimate
for India needs major revision
L. Dandonal, V. Lakshmi2, T. Sudha2, G.A. Kumar', R.
Dandona'. 'Administrative Staff College of India, Centre for Human
Development, Hyderabad, India, 2Nizam's Institute of Medical
Sciences, Department of Microbiology, Hyderabad, India
Background: Annual sentinel surveillance data from public health
system are extrapolated to the population for estimating HIV in
India. No population-based study has systematically examined the
validity of this extrapolation.
Methods: We sampled 13,838 15-49 years-old-persons from
66 rural and urban clusters using a stratified random method to
represent adults in Guntur district (population 4.5 million), Andhra
Pradesh state, south India. We interviewed sampled persons and
obtained dried blood spots, which were tested for HIV antibody,
antigen and nucleic acid. We compared the HIV estimate from
these data with the sentinel surveillance.
Results: 12,617 persons, 91.2% of sampled, participated.
Adjusted HIV rate in adults was 1.72% (95% CI 1.35-2.09%); men
1.74% (1.27-2.21%), women 1.70% (1.36-2.04%); rural 1.64%
(1.10-2.18%), urban 1.89% (1.39-2.39%). HIV rates were 2.58%
and 1.20% in the lower and upper halves of a standard of living
index (SLI). Among women pregnant during past 2 years, the 23%

who utilised public antenatal care had over-representation of the

XVI INTERNATIONAL AIDS CONFERENCE * 13-18 AUGUST 2006 * TORONTO CANADA * PROGRAMME SUPPLEMENT