European Journal of Medical Research - Deutsche AIDS ...

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June 27, 2007 EUROPEAN JOURNAL OF MEDICAL RESEARCH 1 Abstracts eingeladener Referenten A. Gesellschaftliche Aspekte von HIV und AIDS A.ER.1 Recency estimations of HIV infections and implications for risk analyses: Results from a pilot study in Berlin 2005 - 2007 Bätzing-Feigenbaum J. 1 , Kücherer C. 2 , Loschen S. 2 , Gohlke-Micknis S. 1 , Poggensee G. 1 , Jansen A. 1 , Hamouda O. 1 1 Robert Koch Institute, Department of Infectious Disease Epidemiology, Berlin, Germany, 2 Robert Koch Institute, HIV Variability and Molecular Epidemiology, Berlin, Germany Objective: The number of newly diagnosed HIV infections in Germany re-increased from 1.444 in 2001 to 2.486 in 2005. However, the true incidence of new HIV infections may not be reflected in these numbers, since the time span between infection and diagnosis is highly variable and is influenced by many factors. Incident infections will be discovered only partly by routine clinical care. Methods: Blood samples were collected from adult patients (18 years) with HIV infections newly diagnosed by practitioners and clinics in Berlin between 2005 and early 2007, and tested at RKI using BED-CEIA. This method allows estimating recency of HIV infections. For BED-CEIA negative samples it can be estimated that infections were acquired not longer than 140 days ago. Clinical data were contributed by the physician and data on knowledge, attitudes and behaviour in terms of HIV/AIDS through a patient questionnaire. Date collection was anonymous and unlinked. Results: By end of January 2007 116 individuals were enrolled. 102 were MSM (88%). The proportion of recent infections in MSM is 47% (CI [95%]: 38; 56) and 14% (CI [95%]: 32; 0) in individuals from other groups at risk. In the MSM group the proportion of recent infections is higher in the younger age group 20 – 29 years than in the 30 – 44 year range (64 versus 48%). 33% of MSM recently infected with HIV stated to live in non-monogamous partnerships in the past 6 months. 79% had unprotected sex, 64% unprotected anal intercourse. 30% of them had not used condoms consistently in the past 6 months because they didn’t feel at risk and/or believed their sexual partner were not infected with HIV. Conclusions: Estimating recency of HIV infections allows more relevant analysis of behavioural risk factors for acquiring HIV. This is important since attitudes and behaviour towards HIV change over time. Despite a small number of participants in this pilot study, the results suggest delayed diagnosis in women and other population groups compared with MSM. MSM with recent HIV infections report high risk behaviour with regards to condom use. The findings have implications for prevention strategies and underline the potential usefulness of extending second generation HIV surveillance in Germany. A.ER.2 Intensivierte epidemiologische Surveillance von HIV-Erstdiagnosen in der Schweiz Gebhardt M. 1 , Daneel S. 2 , Vernazza P. 2 , Schüpbach J. 3 , Werner M. 1 , Staub R. 1 , Boubaker K. 1 1 Bundesamt für Gesundheit, Übertragbare Krankheiten, Bern, Switzerland, 2 Kantonsspital St.Gallen, Infektiologie und Spitalhygiene, St. Gallen, Switzerland, 3 Nationales Zentrum für Retroviren, Zürich, Switzerland Ziele: Evidenzbasierte Verbesserung der HIV-Surveillance in der Schweiz. Methodik: Neue HIV-Diagnosen werden von den Labors gemeldet. Ärzte melden ergänzende Informationen mittels eines Formulars (EM). Während eines Jahres (1.7.2005- 30.6.2006) wurde mit jeder neuen HIV-Diagnose wie folgt verfahren: - ein kurzer zusätzlicher Fragebogen für den Arzt (AFB) - ein ausführlicher Fragebogen für den Patienten (PFB) - Durchführung eines Interviews mit dazu einwilligenden Patienten - BED-Aviditäts-Assay zur Identifizierung von frischen Infektionen ("FI",
2 EUROPEAN JOURNAL OF MEDICAL RESEARCH June 27, 2007 A.ER.3 Trends in the syphilis epidemic in Germany Marcus U. 1 , Schmidt A.J. 1 , Hamouda O. 1 1 Robert Koch-Institut, Infektionsepidemiologie, Berlin, Germany Objectives: Since the implementation of the Protection against Infection Act (IfSG) in 2001 the number of reported syphilis infections in Germany has almost doubled from 1697 in 2001 to 3353 in 2004, and has levelled off since 2004. For 2006 a similar number of reports are expected as for 2004 and 2005. Methods: Reports on newly diagnosed cases of syphilis are analysed as to gender, mode of transmission (heterosexual or men who have sex with men - MSM), regional distribution and trends. Routine surveillance data are interpreted in the light of additional behavioural surveillance data derived from a large study on knowledge, attitudes and behaviour of German MSM as to sexually transmitted infections (KABaSTIstudy). Results: The proportion of male cases has increased from 81% in 2001 to 90% in 2004 and has stabilized at this level. The proportion of reports without information on mode of transmission has declined from 43% in 2001 to 27% in 2006. The proportion of MSM in the reports with information on mode of transmission has increased steadily from 61% in 2001 to 78% in 2006. An increase in incidence from 2005 to 2006 could be observed in central, western and southern parts of Germany (regions around Freiburg, Stuttgart, Trier, Düsseldorf, Cologne, Arnsberg, Detmold) while other regions reported similar numbers or less cases than in 2005. Slight increases in the number of heterosexual cases were registered mainly in metropolitan areas. A sex work related outbreak in the region of Aachen which began in 2004 is still ongoing. In metropolitan areas around half of the reported new cases among MSM in 2006 were re-infections. According to KABaSTI results currently up to 50 % of syphilis cases among MSM are diagnosed in HIV positive MSM. More than half of these HIV positive MSM with syphilis coinfection are not yet treated with antiretroviral therapy. Conclusions: Syphilis among MSM seems to circulate mainly in a core subgroup of men at increased risk due to high levels of risk behaviour. However, local and regional outbreaks in MSM in less affected areas do still occur. Smaller and larger outbreaks among heterosexual men and women require continuous epidemiological vigilance and intensified and coordinated local/regional control measures. A.ER.4 Sexually transmitted infections in female sex workers in Germany – results of the STI sentinel surveillance Bremer V. 1 , Marcus U. 1 , Hofmann A. 1 , Hamouda O. 1 1 Robert Koch-Institut, Abt. für Infektionsepidemiologie, Berlin, Germany Objectives: Approximately 2-400,000 female sex workers (FSW) work in Germany. We described FSW with STIs (FSWS) as collected by the German sentinel surveillance system and compared FSWS with other female STI patients (OFSP) in order to identify most vulnerable groups among FSW. Methods: Since 2002, information on STIs is collected through a nation-wide sentinel surveillance system including local health offices, hospital-based STI clinics and private practitioners. For every case of HIV, gonorrhoea, chlamydia, syphilis and trichomonas infection, physicians completed a questionnaire regarding diagnosis, presumed mode of transmission and demographic information. Patients completed an anonymous questionnaire about sexual risk behaviour and the likely route of transmission. FSWS were defined as women diagnosed with a STI, for whom the patient herself or the sentinel physician reported sex work. Data from January 2003 and September 2006 were used to describe FSWS and compare them with OFSP. Results: Between 1.1.03 and 30.09.06, sentinel sites documented 1,780 FSWS and 1005 OFSP. FSWS had a median age of 27 years and 70.8% were of non-German origin. Of the non-German FSWS, 418 (33.2%), 333 (26.4%) and 257 (20.4%) were of Eastern or Central European or Latin American origin, respectively. 386 (21.7%) FSWS and 158 (15.7%) OFSP reportedly had an STI in the past (Chi-square test; p
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