Abstract Book Vol. 1 [International Conference on AIDS (16th: 2006: Toronto, Canada)]

reduce failure rates further. Future research should focus on identifying the key
messages and communication strategies that will effectively promote correct
and consistent condom use for STI/HIV prevention.
TUPEO383
Pattern of condom use and perceived risk of HIV
infection among female sex workers in Ogun state,
Nigeria
A.K. Adeneyes, A.A. Adeneye', M.A. Mafe', A. Adeiga3. 'Nigerian Institute
of Medical Research, Public Health Division, Lagos, Nigeria, 2Lagos State
University College of Medicine, Department of Pharmacology, Ikeja, Lagos,
Nigeria, 3Nigerian Institute of Medical Research, Microbiology Division, Lagos,
Nigeria
Background: Safe sex using condom is vigorously being promoted in Nigeria.
However, little is known about the pattern of condom use among female sex
workers (FSWs) with their clients and regular/trusted sex partners. This is
imperative for planning of effective control strategy to mitigate the spread of
HIV from these high-risk groups to the general population in the country.
Methods: 131 FSWs were interviewed using semi-structured questionnaires in
Ogun State, South-West Nigeria.
Results: With a mean age of 25 years, the FSWs get an average of 5 clients
daily. 98.5% knew of HIV/AIDS and 90.1% believed in its reality. While all used
male condom, only 2.3% had ever used female condom. 75.6% had regular/
trusted partners with 47.5% of these not using condoms. 94.9% of 129 who
used condom with clients used it consistently, 5.1% were inconsistent. 74.8%a
reported frequent condom breakage with clients and 78.6% of them had regular/
trusted partners. As post-exposure prophylaxis following condom breakage,
they take antibiotics (52.0%); water-salt solution (8.2%); gin (7./1%); and
lemonade drink mixed with salt (5.1%). Only 6.1% visited hospital. 83.3%
of 30 with recent STIs had regular/trusted partners, 30.0% recurred. 78.6%
had no perceived risk of HIV infection. Locality significantly determined their
belief about HIV/AIDS reality and incidence of condom breakage (p<0.05).
Younger FSWs had less knowledge of HIV/AIDS, believed in HIV/AIDS reality,
had more perceived risk of HIV infection and used condoms with clients than
older FSWs.
Conclusions: Results showed pervasive condom use with high incidence of
breakage, low self-perceived risk of HIV infection and drug/substance abuse.
Hence, there is need for urgent IEC/BCC interventions on proper condom use
particularly targeting FSWs who use no condom or often experience condom
breakage with clients and deemed it less imperative to use condom with their
regular/trusted partners emphasising their vulnerability to HIV/STIs and
dangers of self-medication.
TU PE0384
Assessing the feasibility of introducing voluntary
counseling and testing (VCT) in mandatory
detoxification and re-education centers for injecting
drug users (IDUs) and commercial sex workers
(CSW) in China
K. Khoshnood', A. Ali', M. Wei3, Z. Wu3. 'Yale School of Public Health, New
Haven, United States, 2Columbia Mailman School of Public Health, New York,
United States, 'National Center for AIDS/STD Control and Prevention, Chinese
Center for Disease Control and Prevention, Beijing, China
Background: Over the past two years, the Chinese government has intensified
its response in addressing the HIV epidemic and has established a 9-point
plan for prevention, care and treatment. Government and international
agencies are warning the epidemic shows no sign of abating, and new cases
are being transmitted primarily through injection drug use and sex. There are
approximately 288,000 drug users living with HIV/AIDS, accounting for 44.3%
of the total number of estimated cases. General knowledge of AIDS remains
gravely low and only 5% of people living with HIV/AIDS in China are aware of
their HIV status. Given the overall low HIV infection nationwide, but the high
prevalence in core populations in particular regions, VCT efforts targeting these
critical populations are urgently needed.
Methods: The study design is a cross-sectional survey among a random
lottery of 349 injecting drug users (IDUs) and 299 commercial sex workers
(CSWs) assessing attitudes towards HIV and testing among IDUs and CSW in
4 mandatory detoxification and re-education centers in Guangdong and Fujian
provinces to inform the introduction of voluntary and counseling and testing
programs (VCT).
Results: Overwhelmingly, more than 80% of IDUs and CSWs were interested
in being tested for HIV. HIV knowledge was significantly associated with interest
in testing: respondents that had greater knowledge of HIV/AIDS prevention
and transmission were 2 times more willing to be tested (p <.05). CSW had
less knowledge of HIV and exhibited greater stigma towards people living with
HIV than IDUs
Conclusions: If confidentiality can be ensured at the detoxification and reeducation centers, VCT is positively supported by the target populations.

Compared to the IDUs, more prevention activities are needed to improve
awareness of knowledge of HIV among CSWs before VCT can be introduced.

TUPE0385
Effects of exposure time and pH on inactivating
HIV-1 in crack injection
M.C. Clatts1, D. Volsky2, L.A. Goldsamt', J. Nitkiewicz2. 'National Development
and ResearchInstitutes, Institute for International Research on Youth At Risk,
New York City, United States, 2St. Luke's-Roosevelt Hospital Center, New York
City, United States
Background: While injection as a mode of administration of crack cocaine has
been documented, variability in practices used to prepare drug solutions, and
their import for viral transmission, have not yet been examined.
Methods: An ethno-epidemiological study of crack injection practices was
conducted in seven North American cities, and included self-reported practices
from semi-structured interviews (N=173) as well as direct observations of crack
injections (N=39), to characterize behavioral variability in transforming crack
into soluble form for injection. Data were used to model laboratory studies
using PCR analysis, in which the extent of p24 capsid protein production over
time was used to measure replication of HIV-1, to assess the impact of both
acid type and exposure time on the survival of cell-free and cell-associated
HIV-1.
Results: Interview and observational data revealed variability in the types
of acids that are employed, including vinegar (49%), lemon juice (39%) and
ascorbic acid (12%). PCR analyses showed a relationship between the pH of
solutions, exposure time, and inactivation of HIV-1. Exposure to pH of less
than 2.0 for as little as ten seconds reduced infectivity to undetectable levels in
cell-free virus. However, salt concentration due to the addition of baking soda
(a common additive in crack cocaine) also affected viability of the virus, such
that solutions with higher concentrations of baking soda, and hence higher pH,
also inactivated cell-free virus. When analyses examined cell-associated virus,
similar findings were seen with low levels of virus. However, analyses using tenfold higher levels of cell-associated virus indicated incomplete inactivation.
TUPE0386
Coclskyiosurnje tion lctihealthreommendtilnsargte injec of
ascic cd saS:nso reducing HIVafeansjectio nh rik isccurintin
inactivate cell-assPociatneanHIV-1.
Identification of new sources of HIV transmission in
young IDU's in Vietnam
M.C. Clatts, G.M. Le, L.A. Goldsamt, H. Yi. National Development and
Research Institutes, Institute for International Research on Youth At Risk,
New York City, United States
Background: Young heroin injectors in Hanoi, Vietnam report a novel injection
practice in which a needle is used to create sclerosis of an injection site,
resulting in a soft tissue injection portal or "sac."
Methods: Active heroin injectors (ages 16-29) completed structured behavioral
interviews on injection practices (n=920). A subset participated in open-ended
ethnographic interviews about use of a sac (n=11).
Results: Among 850 men/70 women, 42% ever had a sac and 89% currently
had a sac, 72% had 1 sac, 28% had 2 or more sac), typically in the groin
(79%). Given the young age of the sample, high rates of self-reported HIV
infection were observed across the sample (overall 42% tested, 22% disclosed
being HIV+). Those who use a sac were more likely to have Hepatitis B infection
(p <.001), Endocarditis (p <.002), and pneumonia (p <.002). In ethnographic
interviews, injectors described purposeful cultivation of sacs soon after onset of
habitual heroin injection, highlighting two inter-related rationales: 1) Sac offers
an advantage over features of the social environment, including high risk for
arrest and interdiction, which requires immediate consumption of heroin after
purchase, often in public or semi-public settings where there rapid and reliable
access to a vein may otherwise be difficult. 2) Additionally, injectors report
co-morbid use of Promethazine (to enhance effects of heroin, delay onset of
withdrawal, and offset high cost/situational scarcity of heroin) and report the
belief that sacs mitigate high risk for vein damage from Promethazine.
Conclusions: Research is needed on potential of sacs to draw increased
lymphocytes to the injection site and thereby increase HIV transmission
risk. Early interventions for young injectors in Vietnam are urgently needed,
targeting vein health and related sources of injection-mediated harm.
Risky injection locations as potential safe injection
sites: reducing unsafe injection where it is occurring
N. Degani', A. Bayoumi', L. Caizavara', D. Behrens', P. Millson'. 'University
of Toronto, Public Health Sciences, HIV Studies Unit, Toronto, Canada,
'St. Michael's Hospital, Inner City Health Resarch Unit, Toronto, Canada,
'University of Toronto, Sociology, Toronto, Canada

Background: Safe injection sites (SIS) are in place or being considered in
a number of Canadian cities. One option is to situate SIS in high drug using
neighbourhoods; an alternative is to focus on making current injection sites
safer. The latter may be appealing if high risk behaviour is associated with
specific injection sites.
Objectives: To assess the associations between a measure of risk behaviour
(receipt of used needles) and injection site in Toronto.
Methods: Data from 75 male and 75 female injection drug users (IDUs)
in Toronto were collected during 2004. Participants provided information

XVI INTERNATIONAL AIDS CONFERENCE * 13-18 AUGUST 2006 * TORONTO CANADA * ABSTRACT BOOK VOLUME 1