European Journal of Medical Research - Deutsche AIDS ...

30 EUROPEAN JOURNAL OF MEDICAL RESEARCH
June 27, 2007
Method of data collection will be a questionnaire filled out
by doctors in Ukraine and Germany. A number of n = 100 in
each country is seen to be powerful enough for significance of
conclusions. Questions will be e.g. First reported case of HIV
in individual commemoration.
Appraisal of effectiveness of present actions (peer education
programs, safer sex campaigns, governmental approaches).
Causes of escalation of HIV epidemic in Ukraine (financial
lack, stigmata, cultural problem). Own socioeconomic
evaluation and their impact on treatment of HIV/AIDS patients.
Our expectation is the identification of reasons - besides the
general problem of a weak health care system and political insecurity
- why the HIV epidemic existing in Ukraine has such
a severe course.
A.11 (Poster)
HIV und AIDS in der Ukraine - neuere
Entwicklungen
Alberth F. 1
1 Connect plus e.V., Augsburg, Germany
Ziele: Informationen über die epidemiolgische Entwicklung
in der Ukraine
Methodik: Präsentation
Ergebnis: In der Ukraine und in der Russische Förderation
steigen die Neuinfektionszahlen ständig an. Auch die „Bereinigung“
der Statistik hilft wenig. (Momentan werden in der
Statistik des Nationalen Aids-Zentrum nur noch die Menschen
mit HIV und Aids erfasst, die sich beim Gesundheitssystem
registrieren lassen und Kontakt zu den Kliniken
oder Ärzten haben. Die antiretroviralen Medikamente sind
vorhanden, erreichen jedoch nicht in ausreichendem Maße die
Patienten, die dringend eine Therapie brauchen. Die Entwicklung
in einem Hochprävalenzgebiet der Ukraine (Odessa) und
in einem Niedrugprävalenzgebiet (Lemberg) werden
dargestellt und die Reaktion des Staates und der NGO-Landschaft
auf diese Herausforderung aufgezeigt.
Verschiedene in- und ausländische Akteure entwickeln auf
nationaler und lokaler Ebene Programme. Eine kurze Übersicht
stellt den momentanen Stand dar.
Schlussfolgerung: Connect plus arbeitet seit 6 Jahren in der
Qualifizierung von medizinischem und sozial-psychologischen
Fachkräften. Projekte, die auch modellhaft übertragen
werden können werden vorgestellt.
A.12 (Vortrag)
KABaSTI-study results: Self reported incidence of
bacterial sexually transmitted infections (STIs) in
German men who have sex with men (MSM) -
influence of HIV serostatus and sexual risk taking
Marcus U. 1 , Schmidt A.J. 1 , Hamouda O. 1
1 Robert Koch-Institut, Infektionsepidemiologie, Berlin,
Germany
Objectives: An increase of STIs in MSM has been reported
from many Western industrialised countries in recent years.
Repeated behaviour surveys in MSM have demonstrated increasing
numbers of sexual partners and declining use of condoms
for anal intercourse. To better understand the reasons
for increasing rates of STIs in MSM and to identify potential
new approaches to STI prevention, a survey on knowledge,
attitudes and behaviour as to STIs (KABaSTI-study) in MSM
was conducted in 2006.
Methods: Participants were recruited on German internet
MSM contact sites (n=5,928) and country-wide through private
medical practices (n=723) with a high proportion of
MSM clients. 6,833 completed questionnaires were analysed.
Sexually transmitted infections diagnosed in the previous 12
months were assessed.
Results: From all responding participants (n=4,648), 5% each
reported a diagnosis of syphilis or urethral gonorrhoea, and
3,9% a diagnosis of Chlamydia infection. Incidence of these
bacterial STIs (bSTI) was significantly higher in HIV positive
(HIV+) compared to HIV negative (HIV-) or untested men, as
well as in men who reported more than 10 compared to 10 or
less partners (OR=4.9; 95%CI:4.0-5.9), and in men who reported
5 or more episodes of unprotected anal intercourse
(UAI) compared to less than 5 during the last 12 months
(OR=7.3; 95%CI:5.9-9.1). HIV+ men without antiretroviral
treatment (ART) reported higher incidences than HIV+ men
receiving ART (OR=2.0; 95%CI:1.5-2.7). The highest incidences
of bSTIs among HIV+ and HIV- men were reported by
participants recruited through a bareback website. After controlling
for number of partners and frequency of UAI, HIV+
(OR=2.1; 95%CI:1.3-3.3) and HIV- (OR=2.4; 95%CI:1.5-3.9)
men from bareback sites had higher risks of having been diagnosed
with bSTIs than men recruited from other sites.
Conclusions: Incidence of bSTIs is higher in HIV+ than in
HIV- MSM. This can be explained by higher number of partners,
more unprotected intercourse, less intention to use condoms
for prevention of STIs, and formation of high risk sexual
networks in which unprotected sex is common. Receiving
ART may not only reduce the risk of further HIV transmission,
but also the risk for acquisition of STIs by unknown
mechanisms.
Study supported by BMG
A.13 (Poster)
Highly variable use of diagnostic methods for
sexually transmitted infections – results of a
nationwide survey, Germany 2006
Gilsdorf A. 1 , Hamouda O. 1 , Bremer V. 1
1 Robert Koch-Institut, Abt. für Infektionsepidemiologie,
Berlin, Germany
Objective: Syphilis and HIV are the only notifiable sexually
transmitted infections (STI) in Germany. Further data for STI
are collected through a sentinel surveillance system. The use
of diagnostic methods with high sensitivity and specificity are
needed for high data quality and early detection. We asked
sentinel and other physicians about the current use of diagnostic
methods for STIs in order to recognise potential problems
and provide recommendations.
Methods: We performed a nationwide cross-sectional survey
among randomly chosen physicians with a specialisation in
gynaecology, urology and dermato-venerology (DV) as well
as sentinel physicians. We asked physicians about the methods
and the type of samples used to diagnose HIV, chlamydia
(CT), gonorrhoea (GO) and syphilis (SY) and whether they
would perform STI testing in asymptomatic patients. The results
were stratified by medical speciality.
Results: A total of 691/2228 (31.0%) physicians participated.
80.1% participants offered tests for HIV, 84.0% for CT,