JPRS-TEP-92-021
23 December1992

Dr. Surin said it should be accepted that government
hospitals alone cannot meet the need of the increasing
number of people.

During his report to the meeting, Dr. Thaveesak Bam-
rungtakul said HIV infected people are sources of tuber-
culosis disease.

He said “patients with HIV are a source of infection of
TB, which is the communicable disease causing the
maximum number of deaths.”

Dr. Thaveesak said earlier TB declined steadily but after
the AIDS explosion, the rate of TB reduction has
remained constant.

Quoting the statistics recently collected by Bamrungrad
Naradun Hospital, he said 47 percent of AIDS patients
are found to have also been suffering from TB.

Although the disease is gradually declining nationwide,
the number of TB infected patients is increasing in
Bangkok and is higher than that of other parts of the
country.

Dr. Thaveesak said the Public Health Department’s
hospitals could treat as many as 60 percent of new
patients with TB but as TB treatment takes time, the
hospitals’ ability to accept new patients is reduced to
only 30 percent.

Babies Born to HIV Women; IV Drug Use

93WE0004A Bangkok BANGKOK POST
in English 4 Sep 92 p 3

[Article by Nusara Thaithawat. Words in boldface, as
published.]

[Text] Pattaya—At least 3,000 infants were born to
HIV-infected mothers nationwide since the first preg-
nant woman tested HIV-positive three years ago,
according to Dr. Supachai Rerk-ngam, director of the
Public Health Ministry’s AIDS Division.

Dr. Supachai did not say how many of the 3,000 infants
tested HIV- positive.

Doctors explained that the youngest age when the HIV
virus could be detected was at least 15 months. Not all
infants born to HIV-infected mothers carry the virus.
The risk percentage of prenatal transmission is yet to be
confirmed.

Dr. Supachai said it had been believed once that house-
wives faced the least AIDS risk, but it turned out that
“housewives are at risk with the risk behaviour of their
beloved husbands.”

He said the first three Sentinal surveillances reported no
cases of housewives testing HIV-positive.

As for the age of HIV carriers, he said “there is no
specific age group.”

EAST ASIA 15

“AIDS statistics are unlike those of other communicable
diseases, due to its incubation period. It was reported
that some 50 percent of HIV carriers will show symp-
toms only ten years later,” he said.

The ministry has received reports of 1,753 AIDS-related
and full-blown cases since 1984; half of whom have
already died.

Dr. Supachai said HIV-infection was spreading across
the board. “The figure is higher from each Sentinal
surveillance for commercial sex workers (CSW) and also
for indirect CSW,” he said. The same applies to patients
at the ministry’s VD clinics.

As for intravenous drug users (IVDU), Dr. Supachai said
the figure was lower but the group remained a great
concern to the ministry. It is difficult to give specific
figures because of the constant influx and outflux among
IVDUs.

Dr. Supachai also said that still more men than women
were reported to be HIV-positive, at a mean ratio of 6:1.

AIDS Cases in High School

92WE0683A Bangkok MATICHON
in Thai 4 Aug 92 p 17

[Excerpts] [passage omitted] Mr. Michai Wirawaithaya,
the minister attached to the prime minister, talked about
the AIDS situation during a speech. [passage omitted]
He said that at present, some students entering the
university are definitely infected with the AIDS virus.
Data show that the rate of infection among male and
female secondary school students is 1.9 and 0.6 percent
respectively. By the time they start their post-secondary
school studies, they are already infected. [passage
omitted]

Prostitutes’, IV Drug Users’ AIDS Statistics

93WE0005A Bangkok LAK THAI in Thai
5-11 Sep 92 p 3

[Excerpt] The most recent report given by Mr. Michai
Wirawaithaya, the minister attached to the Office of the
Prime Minister, to the cabinet concerning the AIDS
situation states that people with the AIDS virus can be
found in every province and that the disease is spreading
rapidly. In particular, those who work directly as prosti-
tutes have the highest incidence of AIDS. For example,
in Phetburi Province, 64 percent of the prostitutes have
the virus. In Pathum Thani Province, 58 percent have
the virus. In Chiang Rai, Nakhon Pathom, and Samut
Sakhon provinces, the rate is 58, 49, and 48 percent
respectively. As for those who work secretly as prosti-
tutes, that is, women who sell their services at coffee
shops, discos, food parks, and so on, in Pathum Thani
Province, 33 percent are infected. In Kalasin and Kan-
chanaburi provinces, 25 and 24 percent respectively are
infected with the virus.



36 CENTRAL EURASIA

Health Official Claims Spread of AIDS Checked

PMO0110100992 Moscow ROSSIYSKIYE VESTI
in Russian 29 Sep 92 p 3

[Unattributed report from ITAR-TASS, RIA, IMA-
PRESS “News” column: “Anti-AIDS Repressions?”]

[Text] Moscow—A total of 578 people and 270 children
have now been infected with the AIDS virus in the
country. Some 55 people have already died and in 30
cases the disease is in a life-threatening form. This was
announced by Vadim Pokrovskiy, leader of Russia's
scientific and method center for the prevention and fight
against AIDS and head of the State Committee for
Sanitary and Epidemiological Control Central Epidemi-
ology Research Institute AIDS epidemiology and pre-
vention laboratory. The forecasts of some scientists that
by 1992 there would be tens of thousands of AIDS
sufferers in Russia have not been realized. According to
Pokrovskiy, it has been possible to ward off the first
AIDS wave with such measures as blanket checks on all
foreigners entering the country and on Soviet citizens
returning from abroad and compulsory AIDS screening
(in 1991 alone 25 million people were screened in
Russia). Owing to supervision of medical establishments
in Russia there have been no cases of infection in
hospital conditions for more than 2.5 years now.

However, humans rights supporters in Russia are
pressing for an end to the “repressive” approach toward

JPRS-TEP-92-021
23 December1992

control and for it to be replaced by the democratic
approach adopted in Western Europe. If that happens,
Pokrovskiy thinks, doctors will no longer be in control of
the situation and the country will fall prey to a mass
outbreak of the disease.

Two AIDS Patients, 14 HIV-Carriers Registered
in Country

OW1710185692 Moscow BALTFAX in English

1631 GMT 17 Oct 92

[Following item transmitted via KYODO]

[Text] The head of the Latvian AIDS center Juris Zalc-
manis says two AIDS patients and 14 HIV-carriers have
been registered in the republic. Briefing newsmen on the
spread of AIDS in Latvia, Juris Zalcmanis said the
carriers were males in the 29 to 60 age bracket.

AIDS Cases in Gomel Oblast

PM2110145792 Moscow KOMSOMOLSKAYA
PRAVDA in Russian 20 Oct 92 p 2

[IMA-PRESS report: “AIDS”]

[Text] According to an IMA-PRESS report 10 people
infected with the AIDS virus have been registered in
Gomel Oblast. One of them has already died.



32 CENTRAL EURASIA

Short Report on AIDS Research in 1990 Under
the State Scientific-Technical Program ‘Control of
the Most Widespread Diseases’

93WE0015A Moscow VOPROSY VIRUSOLOGII

in Russian No 3, May-Jun 91 pp 262-264

[Report by the Expert Council on Scientific Problems of
AIDS under the Presidium of the USSR Academy of
Medical Sciences]

[Text] Research on the AIDS problem in 1990 within the
framework of the State Scientific-Technical Program
“Control of the Most Widespread Diseases” (Direction
6) was conducted in 61 of the country’s institutions in
201 topics. Research on nine topics was to be concluded.
Reports were submitted on 196 topics.

All of the submitted reports were subjected to expert
evaluation, during which not only the research results
but also the correspondence of the research results to the
previously proposed plan and completion deadlines was
assessed.

As a rule, assignments were completed in accordance
with calendar plans.

The following results were obtained as a result of the
research.

1, Improvement of Existing and Development of a New
Generation of Diagnostic Resources and Methods

The previously developed diagnostic test system based
on recombinant HIV proteins (“Recombinant-HIV”)
was modernized by the addition of supplementary anti-
gens, making it possible to identify antibodies not only to
HIV-1 but also to HIV-2. Production of the “Recombi-
nant-HIV” test system on a large scale was organized at
five of the country’s industrial enterprises (Scientific
Research Institute of Viral Preparations, AMN SSSR
[USSR Academy of Medical Sciences]).

The first experimental lots of IFA have been produced
for the ‘“Peptoscreen-Rekkit” [transliteration] test
system, based on recombinant proteins and capable of
identifying antibodies to HIV-1 and HIV-2 (Institute of
Bioorganic Chemistry imeni M. M. Shemyakin, AN
SSSR [USSR Academy of Sciences]; Biotekhnologiya
Scientific-Production Association, USSR Ministry of
Medical Industry).

The “Peptoscreen-2” diagnostic test system, based on
synthetic peptides, was improved by introducing new
peptides, and is now in production (Immunology Insti-
tute and Central Scientific Research Institute of Epide-
miology, USSR Ministry of Health; Experimental Car-
diology Institute of the VKNTs [All-Union Cardiological
Scientific Center], AMN SSSR; Bioorganic Chemistry
Institute imeni M. M. Shemyakin, AN SSSR).

Work was done to improve the “Antigen” diagnostic test
system, based on a natural viral lysate (Virology Institute
imeni D. I. Ivanovskiy and Scientific Research Institute

JPRS-TEP-92-021
23 December1992

of Viral Preparations, AMN SSSR; Vektor Scientific-
Production Association, USSR Ministry of Medical
Industry).

The first laboratory samples of hemagglutination and
latex tests based on the natural virus and recombinant
proteins were prepared (Scientific Research Institute of
Viral Preparation, AMN SSSR; Vektor Scientific-
Production Association, USSR Ministry of Medical
Industry).

Scientific and technical documents related to production
of the “Immunoblot” confirming test system were pre-
pared and submitted to the GISK [not further identified]
imeni L. A. Tarasevich of the USSR Ministry of Health,
which will make it possible to begin industrial produc-
tion of the preparation in 1991 (Virology Institute imeni
D. I. Ivanovskiy and Scientific Research Institute of
Viral Preparations, AMN SSSR).

Scientific and technical documents for the production of
three diagnostic test systems have been prepared: a test
system based on the indirect variant of immunoenzy-
matic analysis (All-Union Scientific Research Institute
of Especially Pure Biological Preparations, USSR Min-
istry of Medical Industry), and the immunoenzymatic
test systems “Farmpribor” (Virology Institute imeni D.
I. Ivanovskiy, AMN SSSR; All-Union Research Institute
of Especially Pure Biological Preparations, USSR Min-
istry of Medical Industry) and “Mikrogen” (Virology
Institute imeni D. I. Ivanovskiy, AMN SSSR; Scientific
Center for the Development and Introduction of
Modern Methods of Molecular Diagnosis, USSR Min-
istry of Health).

Several series of cellular hybridomas producing mono-
clonal antibodies to different antigenic determinants of
proteins of the virion capsid (gp120 and gp41) and
nucleoid (p24, p15) were obtained (Scientific Research
Institute of Viral Preparations and Virology Institute
imeni D. I. Ivanovskiy, AMN SSSR; Vektor Scientific-
Production Association, USSR Ministry of Medical
Industry; Moscow NIIEM [Scientific Research Institute
of Experimental Medicine] imeni G. N. Gabrichevskiy,
RSFSR Ministry of Health). Research aimed at
obtaining monoclonal antibodies to virus-specific
enzymes providing for replication of a virus’s genetic
material was continued (Virology Institute imeni D. I.
Ivanovskiy, AMN SSSR; Institute of Biochemistry and
Physiology of Microorganisms, AN SSSR).

An immunoprecipitation test to reveal early and weak
seroconversion in the presence of HIV infection was
developed (Virology Institute imeni D. I. Ivanovskiy,
and Scientific Research Institute of Viral Preparations,
AMN SSSR). The method is a test used in laboratory
confirmation of cases of difficult diagnosis of HIV
infection; it was used to interpret and confirm the
diagnosis of HIV infection in children in Elista, Vol-
gograd and Rostov-on-Don (Central Scientific Research
Institute of Epidemiology, USSR Ministry of Health).



SPRS-TEP-92-021
23 December1992

Whether he is charged with infecting someone with the
disease, even though the doctor’s report may not be
available beforehand, is based on the prosecutor's
judgment.

It is rare throughout the world for an HIV-positive
victim to bring charges against his infecter. There is one
precedent in Finland in a trial in which only infection
with HIV was at issue. One partner in a gay relationship
was convicted of aggravated assault and gross involun-
tary manslaughter because he had not informed his
partner that he was HIV-positive. His partner became
infected, which later caused his death.

Cases are known in Germany in which a sentence for
aggravated assault or attempted assault was handed
down, even though protected sex was involved. The
penalty was based on the fact that the partner had not
been informed by the perpetrator that he was HIV-
positive. And this despite the fact that in two out of three
cases the partners were not infected.

Tracing Partners

Since HIV is an infectious disease that must be reported,
the doctor has to send a report on the infected patient to
the Public Health laboratory. He must ask the patient
about any possible sources of infection and he is obli-
gated to report his impression as to how far the disease
has progressed. The patient is asked to inform any
former and current sex partners that they should seek
testing. The patient may also leave it to health officials to
inform them.

Doctors admit there is room for improvement in tracing
contacts. When a patient promises to inform his partners
himself, their names are not asked for nor does anyone
check on them to see whether the information reached its
destination and whether the partners have sought
testing.

Some doctors take a casual view of the matter: For them
it is a relief if the patient assumes reponsibility for
informing them since it is a troublesome chore.

When Kyosti Rikala, an AIDS patient psychiatrist at
Aurora Hospital, conducted a survey of the first 50
Finnish HIV-positive patients, she found that only 23 of
them had informed their partners that they were
infected.

This year Aurora Hospital has begun to trace HIV-
Positive patients’ sexual contacts more effectively.
According to chief physician Juhani Lahdevirta, how-
ever, only less than half of the partners they reach come
in for testing.

If HIV were an infectious disease considered to be a
public danger, like syphilis, an infected person would
have to report the names of their sex partners and the
latter would have to come in for testing. The fact that it
was a public danger would also make it mandatory for
health-care personnel to actively trace their contacts.

WEST EUROPE 41

Concerning syphilis, venereal disease clinics operate in
an experienced manner: The partner receives a polite
invitation to visit the clinic, and the clinic’s name does
not appear on the envelope.

As early as 1987, the Physicians Association proposed
that HIV be classified as an infectious disease that is a
public danger, but doctors do not support compulsory
tests.

Chief physician Lahdevirta opposes a change in the
classification of the disease. “Compulsory measures
are not appropriate in a modern, civilized state, nor do
the police have enough resources and manpower to
bring people in for testing. We must look for modern
methods.”

The World Health Organization (WHO) and the Euro-
pean Community also oppose compulsory measures.
They do not, however, place any obstacles in the way of
classifying HIV as a public danger.

According to the law, a person ill with an infectious
disease that is a public danger may also be isolated. The
authorities do not, however, believe that quarantining
them will stop people who deliberately infect others.
Sweden is the only country in which they had begun to
isolate such people and even there they are abandoning
the idea. Quarantine is primarily used there to treat
HIV-positive drug addicts.

Dermatologist and venereal disease specialist Sirkka-
Liisa Valle said that quarantine is unnecessary because
most people who are infected behave responsibly. In any
case, there have to be ways of isolating dangerous indi-
viduals.

In Valle’s opinion, it is essential for us to be able to test
people suspected of being infected, even against their
will. Then they would be made conscious of their infec-
tion, could be gotten into treatment—and within the
compass of criminal law. HIV-positive individuals
should also be obliged to regularly see a doctor so that
the risks associated with the disease—for the patient as
well as for his partners—can be kept under observation.

Aurora Hospital AIDS patient psychiatrist Kyosti Rikala
would entirely disregard the debate over the infectious
disease classification. “It’s obvious to me that a doctor
must be able to make tests on a patient, including the
HIV test. I don’t understand why he shouldn’t be
allowed to do so. I believe that people would get used to
it quickly.”

Rikala does not think that compulsory measures would
be abused. She is convinced that most people, HIV-
Positive people as well, would accept compulsory mea-
sures:

“Most of the patients I’ve met are open and honest, and
most concerned over whether they have infected others
with the disease. They place their trust in the community
and I don’t think that they would consider such measures
to be a threat to themselves,” Kyosti Rikala said.



JPRS-TEP-92-021
23 December1992

Over 900 HIV Cases Discovered by
Mid-September

HK0810145192 Beijing XINHUA Hong Kong Service
in Chinese 1031 GMT 22 Sep 92

[Article by reporter Chen Ke (7115 0668) ]

[Text] Kunming, 22 Sep (XINHUA)—By mid-
September of this year, a total of 932 cases of HIV had
been discovered in China, including 11 cases of AIDS,
nine of whom have already died.

This announcement was made by He Jiesheng, vice
minister of public health and director of the National
AIDS Prevention and Treatment Center, at the
“Regional Seminar on AIDS’ Impact on Social and
Economic Development” held this morning.

More than 100 officials and experts in AIDS prevention
and control from the UN Development Program, World
Health Organization, Ford Foundation, and from China,
India, Burma, Vietnam, Thailand, Hong Kong, and
Macao have gathered in Kunming, Yunnan to partici-
pate in a three-day discussion on ways to enhance
regional and international cooperation in AIDS preven-
tion and control.

Addressing the seminar, He Jiesheng noted: Nowadays,
the jeopardy of AIDS is not only a public health problem
but also an extremely important issue which has a
bearing on the social and economic development of all
nations. Having fully realized the perniciousness of
AIDS, over the past few years the Chinese Government
has drawn on resources of all social sectors in its efforts
to fight AIDS, and a great deal of work has been done in
organizing and performing AIDS prevention and con-
trol, as well as the relevant epidemic monitoring, legis-
lation, propaganda, education, training, research, and
international cooperation.

He Jiesheng emphasized: “We have fully understood
that China, with a quarter of the world’s population, will
make a major contribution to the global AIDS control
effort if it succeeds in curbing the spread of AIDS at
home. To meet the challenge of AIDS, we are also eagerly
looking forward to more extensive cooperation with all
international organizations, countries, and areas, and we
are ready to make new efforts to implement the global
AIDS control strategy.”

Eleven People Test HIV-Positive at Guangzhou
Border This Year

HKO0910001592 Hong Kong TA KUNG PAO in Chinese
29 Sep 92 p 2

{“Special dispatch:” “Eleven AIDS Cases Discovered in
Guangzhou Recently”)

{Text] Guangzhou, 28 (TA KUNG PAO}—Guangzhou
Public Health and Quarantine Bureauhas revealed that
they have two people who tested HIV-positive from
among those who recently entered the country at Baiyun

CHINA 9

Airport. So far this year the bureau has found 11 cases of
people testing HIV-positive from those who entered the
borders. The incident prompted the Guangzhou Public
Health Bureau to issue a call for people to pay attention
to hygiene on international travel and guard against the
contraction of HIV virus.

According to sources, all of the 11 HIV-positives came
from Thailand and Kenya, especially Thailand, where 10
of the HIV- positives came from. These people worked,
did business, travelled or visited relatives in foreign
countries, staying overseas for as long as a decade, or just
four months. Some carriers admitted they had gone to
red light districts, some had received treatment for
illness involving injections. But all denied that they had
a history of contraction through injection of drugs.

At present the bureau has, in accordance with state
regulations, separated these carriers for treatment and to
prevent the spread of the disease in the country.

Report Links AIDS Cases With Drug Abuse in
Provinces

HK2910030492 Beijing CHINA DAILY in English
29 Oct 92 p 1

[Article by staff reporter Zhu Baoxia: “Drug Abuse
Doubles Since 1990”]

[Text] The number of known drug abusers in China had
reached 148,000 by June, twice the figure in 1990,
according to an official report released yesterday.

And so far, some 890 Chinese residents have been
detected as carriers of HIV [human immunodeficiency
virus], which leads to the fatal disease of AIDS (Acquired
Immune-deficiency Syndrome).

Most of the verified HIV carriers were drug abusers in
the southern province of Yunnan and had contracted the
virus by sharing needles, the report said.

The report was released yesterday by the Drug Admin-
istration Department under the Ministry of Public
Health at the ongoing Conference on Narcotic Control
and Reduction of Demand for Drugs on Chinese Main-
land, Hong Kong and Macao being held in Beijing.

More than 30 officials and experts from the Chinese
mainland, Hong Kong, Macao, Japan, the United States,
and some international organizations are attending the
three-day meeting, which ends tomorrow.

The conference is a follow-up workshop of last year’s
Hong Kong seminar on narcotics control in the main-
land and the two regions.

Pan Xuetian, director in charge of narcotics from the
Ministry of Public Health said China will take further
actions to crackdown on drug trafficking and abuse. He
called for a drive to raise the public’s consciousness
about the danger of drug addiction and help teenager
establish healthy living habits.



SPRS-TEP-92-021
23 December1992

Under the much advertised transparency of both Anand
administrations, which included Thailand’s most artic-
ulate anti-AIDS campaigner, Mechai Viravaidya, in the
PM’s Office, this move to amend the Entertainment
Places Act was kept secret from the public.

The first lead on the amendments came only last month
when news broke of the police busting tea houses in
Bangkok’s Chinatown and allegedly forcing prostitutes
to have blood tests for the HIV virus.

A group of 25 NGOs which work on AIDS education, led
by Dr. Prawase Wasi, protested against the forced testing
which they said was not only a violation of human rights
but a clear indication of the total lack of understanding
about AIDS in Thai society.

At that time, no one realized that the police were in fact
collecting data on the AIDS spread in tea houses and
brothels to back up their move to amend the Entertain-
ment Places Act.

The committee in the last month alone has busted 28 tea
houses and tested 700 women in the city. The figures for
the provinces are still to be finalized and forwarded to
Bangkok.

Pol Maj. Gen. Sombat denied police “forced” prostitutes
to have blood tests conducted by officials from the
Ministry of Public Health.

“We are testing only those who are willing and, in many
cases, many of the prostitutes refused and we did not
force them.”

He said the police did not record the identities of the
women who agreed to tests.

“We don’t know their names, only the results.”

Then PM’s Office Minister Saisuree was kept informed
of the project and the results of the tests, Maj. Gen.
Sombat said.

A team comprising committee members and Public
Health officials would go to see the owners of the
entertainment places and ask whether any of the prosti-
tutes would be willing to have blood tests, he said.

“The ministry asked for blood tests. They asked for
police cooperation because they had run into problems
in the past when truing to deal with these establish-
ments,” said Maj. Gen. sombat.

Meanwhile, surveys conducted by various medical and
social institutions, as well as a number of prominent
doctors including Dr. Vicharn Vithayasai of Chiang Mai
University, have indicated that the speed of HIV infec-
tion among non-HIV infected prostitutes in brothels can
be dramatically high.

Research by Dr. Vicharn and his team indicated that in
some popular places in the North, between 30 and 40
percent of the “new” prostitutes become HIV-infected
within six months.

EAST ASIA 19

“Removing infected women will only speed the rate of
infection. Old women go, new women come. The women
move to another brothel or even to another province.
The best way to curb the spread is through prevention by
use of condoms,” Dr. Vicharn said.

His comments remain valid against the background of
moves to amend the Act.

But Pol Maj. Gen. Sombat said the flow of new women
into the flesh trade cannot be blocked anyway.

“I have discussed this issue with Minister Saisuree.
There was concern that infected women having to leave
prostitution would create a gap in which more women
would have to be recruited,” he said.

He cited statistics from 1979 when there were said to be
only 30,000 prostitutes in the country and today’s offi-
cial statistics of 60,000.

“The inflow cannot be blocked. It is an economic ques-
tion. There are a large number of unemployed women,”
he said.

HIV-infected women leaving one place will find work in
another place, maybe in the same province or in another,
continuing to spread the disease, Maj. Gen. Sombat said.

“Nowadays the owners are aware of the problem and do
not want infected women to work for them because they
are concerned about their reputation. It has become
more widespread so that now before a woman can work
in these places they have to be HIV-free.

The Technical Division of the Police Department is
drafting the amendments which will be submitted to
Interior Minister Gen. Chavalit Yongchaiyudh who is to
seek approval from Parliament.

“Just one clause will be added to Article 16 of the Act.
We expect to submit the amendments to Parliament this
October or November,” Maj. Gen. Sombat said.

He said that if the changes are passed by the House of
Representatives, the committee will no longer directly be
involved but the Crime Suppression Division and local
police in their respective areas of jurisdiction nationwide
will be responsible.

As for monitoring, Maj. Gen. Sombat said random blood
tests will be conducted periodically, maybe every one or
two months.

“In monitoring, we can only give advice, we cannot
force,” he said.

He said that since the KTP started the project, the
monthly figures have already been showing signs of
improvement.

He cited last month’s figure of 700 prostitutes tested for
HIV virus, of whom only one was positive.



SJPRS-TEP-92-021
23 December1992

DENMARK

High Proportion of Youths Tested for HIV

92WE0703A Copenhagen BERLINGSKE AFTEN
in Danish 25 Sep-1 Oct 92 p 12

[Article by Marianne Juhl: “Beginners’ Sex and Fear of
AIDS”]

[Text] AIDS. Young people are so afraid of the deadly
disease that they are having themselves tested in large
numbers.

More than 90,000 Danes go to the doctor each year to get
the HIV test. Among them are many young people
between the ages of 16 and 25. They have fairly ordinary
heterosexual relationships with boyfriends and girl-
friends in their age group and today the incidence of
AIDS in this group is just about zero. Why, then, do they
have themselves tested?

It is because they are afraid, doctors believe; because
they do not know what to think about their partners;
because the requirement to use a condom every time
cannot be fulfilled. That is easy to say but hard to comply
with when you are a bit drunk and very much in love, not
to mention being both things at once. And then, is it as
important as they say? What should you do when havea
steady boyfriend and also use birth control pills? Should
you stay with the unamusing condom? Can you really tie
up an entire generation’s sex life with belts and straps
forever? There are far too many unanswered questions
for this group, which following the trend for the age
group, has many changing steady friendships. The high
number of tests reflects doubt and anxiety.

At the same time, the enthusiasm for the test shows that
young people are not sticking with safe sex with a
condom. If they used one, they certainly would have no
reason to reassure themselves and their partners by being
tested for HIV. Safe sex with a condom means that the
condom must be used at all times, from preliminary
foreplay to final intercourse. Young men complain of
decfeased sensitivity. Girls complain about the taste of
Tul Tr.

They also “forget” the condom now and then. Then
comes the anxiety and the desire to be tested. Doctors
can see that young people “forget” the condom because
there are many cases of other forms of sexually trans-
mitted infections: anal warts and chlamydia.

The young people still get a negative response to their
HIV test. If it were positive, it was also too early, besides,
what use is it anyway? After a test, if they continue with
what is called sexually risky behavior, they will have to
reassure themselves with new tests, etc. It slightly resem-
bles the way of getting out of a night when you “forget”
called an abortion, except that no one can get rid of HIV.
Besides, several months pass between the time of infec-
tion and the time of a positive HIV test. Most frequently

WEST EUROPE 37

six to 12 weeks, sometimes, but seldom up to half a year.
So that makes for a longer period during which you still
know nothing whatever about yourself and your partner.

Testing is not the solution, doctors say. They would
prefer to have the many tests replaced by rational
behavior. A committee of general practitioners and
representatives of the National Board of Health have
compiled an updated brochure, which will be directed at
both the general population through the media and at
general practitioners. Now they will be able to find the
answers to all these sensitive questions. The old | message
that all young people should use condoms in every
situation is not good enough. For the simple reason that
they will not comply with it. It only creates fear of
AIDS—which all the testing shows—but it does not get
young people to alter their behavior. What they need to
be taught now is to distinguish between what is stupid
behavior and what is rational. It is completely stupid to
go to bed with an unknown partner and not use a
condom.

But when is a partner known, and what about his
unknown past?

This is the sort of question doctors encounter in their
practice and on which they will give individual coun-
seling in the future. Young couples come hand in hand to
a doctor’s office to be tested for HIV. They have known
one another for a while. She protects herself against
unwanted pregnancy by taking birth control pills and
now they would prefer to throw away the condom. Do
they dare? The response depends on their prior sexual
behavior and on how permanent they see their relation-
ship as being. That is the sort of question that a talk with
the doctor should clear up.

One of the advisory committee’s members is Henrik
Haxholdt, a general practitioner in the Norrebro neigh-
borhood. He told WEEKENDAVISEN:

“Tt does not help to tell young people: If you don’t use a
condom, you’ll get AIDS. It’s not correct, and wrong
messages don’t work. Nor must we destroy an entire
generation’s sex life. You shouldn’t use a condom
because you’re scared, but because of a lot of other good
reasons, for example, because it protects against other
types of infection.

“When we treat them for another sexual infection or
when they come to get tested for HIV, they’re well
motivated for a behavioral change. So we have to talk
with them about their previous behavior and get them to
get their act together in the future and behave rationally.
AIDS is like traffic. If you teach your children how to
move in traffic, the risk of their being run over decreases.
You don’t solve the problem by locking it up.

“We also have to talk openly with them about using a
condom. Not just how to put it on and other technical
fine points, but also why they’re tired of using it and how
they can feel more comfortable with it.”



JPRS-TEP-92-021
23 December 1992 4 AIDS

WEST EUROPE
DENMARK

High Proportion of Youths Tested for HIV
[Marianne Juhl; Copenhagen BERLINGSKE AFTEN, 25 Sep-1 Oct 92]

FINLAND

Tuberculosis Resurgence, AIDS Link Discussed
[Janne Ora; Helsinki HELSINGIN SANOMAT, 2 Sep 92) ..
Voluntarism in AIDS Policy Under Attack ..
Carrier Arrested After Infecting [Helsinl i 2]
Testing, Disclosure Rules Debated [Helsinki HELSINGIN SMNOMAT 7s Sep 92]

IRELAND

Reporting Policy on AIDS Deaths Told
[Eilish O’Regan; Dublin IRISH INDEPENDENT, | Sep 92] ..

PORTUGAL

Transracial HIV-2 Incidence Growing /Lisbon O JORNAL, 11 Sep 92] ......+
SWEDEN

Studies Link Wider Use of Condoms, AIDS Concern
[Anna-Lena Haverdahl; Stockholm SVENSKA DAGBLADET, | Oct 92] .....

INTERNATIONAL

International AIDS Conference Held in Amsterdam [Vishwambhar Vyas; Varnasi AJ, 6 Sep 92] sss



30 NEAR EAST AND SOUTH ASIA

cases in Pakistan for the last few years, he said the
government was still at the stage universally recognised
as the “denial-stage.” “This denial is the greatest hurdle
in the way of AIDS control,” he said.

“At next stage there would be a tremendous increase in
HIV cases,” he warned, emphasising that emergency
measures must be taken now. He also warned that the
spread of AIDS would overburden Health Services and
the Budget, family disintegration and a tremendous
reduction in the work force of the country as the age
group that is hit hardest by the disease in Pakistan is
30-39.

Dr. Masood then listed the factors which fueled the
spread of the virus in Pakistan. These were sexual
promiscuity, illegal prostitution which inhibited the
enforcement of AIDS checks on prostitutes, intra-venous
drug abuse, blood transfusions without proper screening
and the application of used blades by barbers. He,
however, refuted myths that the virus can be transmitted
through everyday contact such as shaking hands and
sharing food.

Dr. Masood also mentioned the steps taken so far for the
prevention and control of the spread of the virus, which
included the setting up of a Federal Committee for the
purpose, the undertaking by National Institute of AIDS
Control of a programme for educating the public and
setting up labs and blood banks and a short-term plan for
1988 and a mid-term plan for 1990-93.

Earlier, Dr. Sameen Siddiqui, dilated on the history and
nature of the disease and explained with the help of
slides, how the HIV had spread in the West and Africa.

The motto of the awareness on AIDS campaign, the two
doctors said, is Don’t Die of Ignorance.

First Positive Case

92WE0698B Peshawar THE FRONTIER POST
in English 13 Aug 92 p 4

[Article: “First Ever AIDS Case Detected”]

[Text] Islamabad (APP)—A-35-year-old unmarried
sailor from a village in the vicinity of Rawalpindi has
been described as the first ever positive case of deadly
AIDS, the doctors are quoted to have confirmed.

Daily PAKISTAN OBSERVER carrying the report
states that the history of the unnamed patient shows that
he had been working on a foreign flag ship for over 15
years. He has returned to Rawalpindi in 1990, had has
been living with his parents and sisters.

He is suffering from acute fever and persistent loss of
weight, the doctors have disclosed.

According to them, besides getting private medical treat-
ment, the AIDS patient remained admitted to the Holy

IPRS-TEP-92-021
23 December1992

Family Hospital, where sample of his blood was taken
and sent for suspected AIDS test to the National Insti-
tute of Health (NIH).

While the positive blood analysis report was yet awaited,
the patient superstitiously left the hospital on July 21
last, the medical superintendent of the Holy Family
Hospital reported the matter to the district health
authorities, the report said.

The report said, a team of doctors comprising district
health officer Rawalpindi, Dr. Fayaz Ahmed Ranjha,
assistant district health officer, Dr. Fazal Mahmud and
an officer of the communicable diseases control (CDC),
succeeded the AIDS patient, in a nearby village, in the
wake of frantic efforts.

Dr. Ranjha has taken steps to protect those who had
come into contact with the patient, through counselling
and blood tests, the report added.

Although, this is the first notified AIDS case in Rawal-
pindi district, 14 suspected AIDS patients have already
been reported in the country.

Doctors are intentionally keeping the identity of the
AIDS patient secret, the report said.

AIDS Said Spreading in Islamabad

93WE0001A Lahore NAWA-I-WAQT
in Urdu 14 Sept 92 p 8

[News Report: “A Number of Persons Infected With
AIDS in Rawalpindi and Islamabad; Doctors, Surgeons
and Barbers Used Razors With Which They Had Shaved
AIDS-Infected Individuals on Other Persons [as
received] ”]

[Text] Islamabad (special correspondent): According to
teliable sources, numerous people living in Rawalpindi,
Islamabad, and surrounding areas are infected with
AIDS; employees of the National AIDS Project of the
National Health Organization, with the cooperation of
the World Health Organization, are trying to reach these
individuals. According to the sources, in Islamabad and
its surrounding areas, the National Health Organization
has found some AIDS patients in the last stages of the
illness through whom the disease has spread to others in
the area; these latter individuals are not aware that they
have been infected. It is reported that the AIDS-infected
individuals did not tell their attending physicians that
they were suffering from the illness; as a result, the
physicians continued to employ the syringes used on
their AIDS-infected patients to treat others, thus
infecting them as well. Barbers who shaved AIDS-
infected individuals were not aware of the illnesses of
their customer and used contaminated razors on their
other customers.


16 EAST ASIA

As for men who have a venereal disease, in Phayao,
Chiang Rai, Rayong, Ranong, and Pathum Thani prov-
inces, 36, 31, 30, 17, and 15 percent respectively also
have the AIDS virus.

As for drug addicts who have the AIDS virus, the
percentages are as follows: Mae Hong Son, 100 percent;
Trat, 78.5 percent; Chumphon, 75 percent; Samut
Sakhon, 68 percent; and Yala, 66 percent. As for those
who contracted the AIDS virus from blood transfusions,
the percentages for Chiang Mai, Mae Hong Son, Phayao,
Phetburi, and Chiang Rai are 10, 7.5, 6.7, 3.7, and 3.6
percent respectively.

Furthermore, a report issued by the World Health Orga-
nization on the AIDS situation in Asia states that India,
Burma, and Thailand have 95 percent of the AIDS
victims. But this is still the initial stage. A survey
conducted in May indicates that of the 344 people with
AIDS, 179 are in Thailand. [passage omitted]

Rayong AIDS Second in Nation

93WE0078A Bangkok BAN MUANG
in Thai 2 Oct 92 p 17

{Excerpt] Mr. Hem Bunphrom-on, the head of the
Rayong Province task force for labor, welfare, and pro-
tection revealed that AIDS was a disease which still
could not be cured and would spread. It had been learned
that the Division of Communicable Disease Control of
the Ministry of Public Health had very disturbing statis-
tics: in Rayong 30 percent of the men requesting tests for
venereal disease had the AIDS virus, and Rayong was
second in the nation for pregnant women with AIDS
giving birth to AIDS infected babies. Phrae Province was
first with 8.8 percent, Rayong Province was second with
6.67 percent, Mae Hong Son Province was third with
4.25 percent, and Chiang Rai Province and Phetburi
Province were fourth with 4 percent. It was not a time
when concealment would help prevent this disease. [pas-
sage omitted]

AIDS Statistics Updated

93WE0073B Bangkok DAILY NEWS
in Thai 3 Oct 92 p 26

[Report by Naphaphon Phanitchat: “A Center for the
Control of AIDS, Before It’s Too Late....””

[Excerpts] [passage omitted] At present in Bangkok there
are about 40,000 drug addicts, and 40 percent have been
found to have infectious diseases. [Passage omitted]

The statistics on those sick with AIDS in Thailand
indicate that there have been 792 people sick with AIDS
of whom 450 are still alive and 342 are dead. There are
1,067 with the AIDS related complex and an estimated
350,000 to 500,000 with the AIDS virus. In Bangkok
there have been 114 people sick with AIDS of whom 65
are still alive and 49 are dead. There are 257 with the
AIDS related complex and about 100,000 with the AIDS

JPRS-TEP-92-021
23 December1992

virus. The ratio of male to female for those with the
AIDS virus is six to one in the 20 to 44 age group. Those
with the AIDS virus show symptoms about five to 10
years after they contract the AIDS virus. Therefore there
is concern that in five years there will be 100,000 to
150,000 people sick with AIDS. Bangkok will be
crowded with 30,000 people sick with AIDS, and the
trend is for there to be many more sick with AIDS
especially among housewives who contract the virus
from husbands who use female prostitutes. [Passage
omitted]

With regard to prevention Dr. Chaiyan Kampanatsaen-
yakon, the deputy public health director for Bangkok
and the chairman of the Center for the Prevention and
Control of AIDS, said that if we were just not sexually
promiscuous or wore condoms when using female pros-
titutes, it would be enough because the AIDS virus could
not survive long outside the body. There were still some
who misunderstood this and thought that it was a disease
which was communicated easily. [passage omitted]

AIDS Statistics by Risk Group
93WE0073A Bangkok DAO SIAM in Thai 4 Oct 92 p 2

[Text] The latest survey to determine the rate of spread
of the AIDS virus in six target groups of the population
found that pregnant women showed an alarming
increase in contracting AIDS while drug addicts and
open female prostitutes showed a small increase in
contracting AIDS. The incidence for secret female pros-
titutes, men requesting tests for venereal disease, and
those supplying blood did not show much increase.

A report from the Epidemiological Division of the Min-
istry of Public Health stated that regarding the survey to
determine the incidence of the AIDS virus in the six
target groups of the population which was done every six
months, the latest survey in June found that the increase
in the spread of the AIDS virus throughout the country
in the target groups was as follows: The incidence for
intravenous drug users in various provinces varied from
0 to 71.43 percent with an average incidence of 35.83
percent. This was only a small increase from six months
earlier in December 1992 when the incidence was 33.89
percent. The top five provinces for those with the AIDS
virus [in this group] were: Phatthalung Province, Rayong
Province, Krabi Province, Trat Province and Nakhon Si
Thammarat Province. In these provinces the incidence
was over 56 percent.

The incidence for open female prostitutes with the AIDS
virus was between 3.23 and 67.2 percent with an average
incidence of 23.76 percent. This was only a small
increase from the past incidence of 21.65 percent. But a
trend for the incidence to increase a great deal was noted
in some provinces, especially for provinces in the upper
part of the North. The top five provinces for those with
the AIDS virus were: Nakhon Pathom Province, Phayao
Province, Lamphun Province, Chiang Rai Province, and
Lampang Province. In these provinces the rate was over
50 percent.



2 EAST EUROPE

ALBANIA

Ministry Spokesman Reports Danger of AIDS
‘Increasing’

AU2909180192 Tirana ATA in English

1122 GMT 29 Sep 92

[Text] Tirana, September 29 (ATA)—Although not a
single case of infection with AIDS is found as a result of
about 3,500 tests made, a spokesman of the Ministry of
Health and Environmental Protection and of the
National Commission of the Struggle Against AIDS
thinks that Albania is not immunized from it.

The mortal disease, which in the neighbouring coun-
tries of Albania has reached the figure of 273 cases in
Yugoslavia and 559 cases in Greece, may be favoured
by numerous movements of the Albanians in the
neighbouring countries, the way of their living, exten-
sion of tourism, the coming of foreign businessmen,
and going of local ones. But there are also other ways
which increase the danger of AIDS, because sterile
plastic syringes and needles for one use only are not yet
used in the Albanian medical system; subjective short-
ages are noticed in sterilization of means of injection,
surgical, obstetric gynecological, and dental means;
compulsory control of blood for the virus of AIDS is
not yet exercised.

Proceeding from this situation, it is indispensable that a
national policy against AIDS in Albania be formulated,
the spokesman says informing that to this end a national
conference will be organized in Tirana from September
29-October 1 by the Ministry of Health and Environ-
mental Protection and the National Office of AIDS, with
the support of the World Health Organization. The
conference will be organized under the auspices of the
president of the Republic, Sali Berisha.

Conference Stresses Need for ‘National Policy’
Against AIDS

AU3009150592 Tirana ATA in English
1120 GMT 30 Sep 92

[Text] Tirana, September 30 (ATA)}—The national con-
ference to prevent and fight AIDS in Albania organised
by the Ministry of Health and Environmental Protec-
tion, the National Commission of the War Against
AIDS, and the National Office of AIDS, in cooperation
with the World Health Organisation, began its proceed-
ings in Tirana on September 29. The conference, which
will continue its proceedings until October 1, is held
under the auspices of the president of the Republic, Sali
Berisha.

Health experts in Albania say that Albania ranks among
the countries with a low prevalence of HIV infection (the
virus causing AIDS), although no person infected or sick
with AIDS is found in the contingents checked up so far.
They point to the fact that the formulation of a national
policy against AIDS in Albania is indispensable.

JPRS-TEP-92-021
23 December1992

The participants in the conference were greeted by the
minister of health and environmental protection, Tritan
Shehu.

Sven Eikeid, vice-director of the global programme of
the WHO, described the conference as a first important
step and the first of its kind held in one of the countries
of Eastern and Central Europe.

The conference was greeted also by Ilion Kikbush, direc-
tress in the Regional Bureau of Europe in Copenhagen.

Then, Dr. Besim Nuri, deputy minister of health and
environmental protection, read out the topic “What is
AIDS and the ways it spreads.” The conference will hold
its proceedings in plenary sitting also in five working
groups.

AIDS Conference Ends, Recommends Individual
Testing

AU0310220092 Tirana ATA in English
1119 GMT 2 Oct 92

[Text] Tirana, October 2 (ATA)—The national confer-
ence for combating AIDS held under the auspices of the
President of the Republic Sali Berisha ended in Tirana.

This conference discussed extensively the ways of dis-
seminating AIDS, the social and economic impact of
HIV infection, the human rights and discrimination,
epidemiologic state and possibilities of infections with
AIDS in Albania, the interference and strategies of the
World Health Organization for preventing and com-
bating AIDS, for drafting politics towards it.

The goal of the conference is to draft a policy of national
understanding to AIDS, which will be a base for cooper-
ation of all sectors against this disease. So far there is
none in Albania afflicted with this disease.

The conference jumped at the conclusion that it is
necessary to make aware of this disease the government
and nongovernment organizations, health service at all
levels, and the whole social opinion. As for the policy in
regard to AIDS, the conference recommended to make
tests for separate individuals and groups, to establish
control on blood donators, to make a broad sero- epide-
miologic examination, etc.

In the later time some seminars will be held with groups
of specialists to treat of particular aspects to prevent
AIDS, and working groups will be set up to draft a
long-and-middle term strategic plan. [Sentence as
received]


18 EAST ASIA

Interior Ministry Anti-AIDS Efforts Discussed

93WE0056A Bangkok THE SUNDAY POST in English
11 Oct 92 p 20

[Text] The Interior Ministry wants power to revoke
permits of entertainment places which employ service
women or men infected with serious communicable
diseases.

The move, recommended by the Police Department,
involves amending the Entertainment Act.

Deputy chairman of the Committee of Coordination and
Inspection of Crime Suppression Pol Major General
Sombat Amornvivat said the amendment is aimed at
controlling Acquire Immune Deficiency Syndrome
(AIDS) which is spreading rapidly in tea houses and
brothels which provide cheap sexual services to low-
income customers.

One might be tempted to say cynically: “We've heard
this all before”.

In the past there have been several attempts at legis-
lative amendments to tackle prostitution and to curb
the spread of the deadly disease by solely penalizing
prostitutes.

The latest attempt was made by the first government of
Anand Panyarachun which sought to amend the Anti-
Prostitution Act and which, like previous attempts, met
strong criticism from non-government organizations
(NGOs) and feminist groups.

Under the then proposed amendments, all prostitutes at
least 18 years of age, are to be issued with health cards to
certify that they are free from serious communicable
diseases which are sexually transmitted.

Those without health cards are prohibited from working.

Though it was left open for the director-general of the Public
Welfare Department to finalize the time span, the health
cards are to be renewed periodically upon regular medical
check-ups by designated medical establishments.

The more positive point of the proposed amendments is
to seek heavier penalties for procurers, pimps, and the
owners of sex establishments especially when under-age
prostitutes are involved.

However, the existing Criminal Code still provides
heavier penalties, although hardly ever used, when
dealing with matters of prostitution.

The proposed amendments were, nevertheless, put on
the agenda, but owing to the lack of time of the Anand I
administration they were never deliberated.

This time, the Police Department is seeking to add one
clause to Article 16 of the entertainment Places Act:
prohibiting entertainment places from employing per-
sons infected with serious communicable diseases which
are sexually transmitted, specifically AIDS.

JPRS-TEP-92-021
23 December1992

Violations of Article 16 are punishable under Article 12:
revocation of the permit to open and operate an enter-
tainment place.

Another deja vu aspect is to provide “help” for women
who are to leave prostitution, through training and reha-
bilitation programs with the Public Welfare Department.

Pol Maj. Gen. Sombat explained the police initiative to
amend the Act results from consultations with then
Prime Minister’s Office Minister Saisuree Chutikul and
Police chief Gen. Sawat Amornvivat.

“Minister Saisuree wanted the police to have a bigger
role in helping curb the spread of HIV, saying it had the
manpower covering the entire country. The police are
also involved in arrests of procurers for brothels and tea
houses. So that’s how we started,” Pol Maj. Gen. Sombat
said.

The committee began seeking cooperation from owners
of entertainment places which cater to low-income cus-
tomers and also to collect data on the AIDS situation in
tea houses and brothels nationwide.

Pol Maj. Gen. Sombat said surveys between June 1991
and July this year indicate that an average of 31 percent
of service women in tea houses and brothels are infected
with the Human Immunodeficiency Virus (HIV).

“These entertainment places cater to the low income
group. These people are uneducated, especially in the use
of condoms, and that is why AIDS is spreading so
rapidly.

“We are concerned about this group and therefore
decided to review the role of the police.”

He said there were two items of legislation which the
police can use to curb the spread of HIV: the Entertain-
ment Places Act and the Anti-Prostitution Act.

“The police can seek cooperation and/or pressure the
owners of entertainment places not to allow HIV-
infected women to receive customers and further spread
the disease.

“If they are HIV-infected, they should not spread it and
should take up another job other than sexual services.”

He said that even though there is an active campaign for
the use of condoms to prevent HIV transmission, “some
men still do not like to use condoms and simply refuse to
use them”.

“The men who visit these places are willing to pay 80
baht for the women but not five baht for a condom. We
must continue to educate them. The best course, how-
ever, is that the women should not be infected,” he said.



JPRS-TEP-92-021
23 December1992

Rapid Spread of AIDS Forecast in Urban Areas

93WE0014A Lahore THE NATION in English
15 Sep 92 p 2

[Text] Lahore—A doorway to South and South-East
Asia, Pakistan is a high-risk area for the spread of killer
Acquired Immune Deficiency Syndrome (AIDS). Still an
urban and suburban phenomenon, the AIDS victims are
found in almost every City of Pakistan.

This was disclosed by National AIDS Programme Paki-
stan Manager Dr. Kamran Masood while addressing a
one-day seminar on AIDS and the role of mass media,
public representatives and ulema, held here on Monday.

Pir Kabir Ali Shah of Choora Sharif presided over the
seminar while Provincial Health Minister Ch Jaffer
Iqbal addressed it as the chief guest. Provincial Parlia-
mentary Secretary Mian Abdus Sattar, the PML [Paki-
stan Muslim League] Punjab Joint Secretary S M Bashir
and Dr. Jamil Tahir also spoke on the occasion.

Dr. Kamran Masood said by the year 2000, the AIDS
victims number might touch 15 million figure. He said a
that much [higher] number of the virus victims might
still be there, but unreported. Most of them might not be
the AIDS carriers but the victim of Human Immuno-
deficiency Virus (HIV), an early stage of the killer
disease. The research has proved that any one who was
found positive for the HIV, could never escape AIDS, he
added.

He informed that AIDS victims number was highest, 6.5
million, in South and South East Asia. In Muslim
countries, there are a large number of AIDS victims, but
not reported by the respective governments, he added.

He maintained that first AIDS case in Pakistan came
into fore in 1987, after the examination of blood spec-
imen of about 250,000 people—35 such victims have
been detected so far. Most of these AIDS carriers were
those who returned from the Gulf countries.

He said the prostitution in Thailand and India was
legalized and a routine medical checkups of the women
in the business revealed that about 72 percent of them
were found positive for AIDS.

He said though termed by some Muslim countries as a
western disease, a result of massive illicit and open
sexual contact, the virus was fast becoming a problem in
the Muslim countries. With the increasing awareness
more and more people were approaching AIDS detection
centers to get themselves tested for the virus. As the
number of the victims is growing, more cases would
come to surface with the passage of time, he added.

He said that about 50 percent of the total cases detected
in Pakistan were from the younger generation, 32 to 39
years of age, while 16 of them were Pakistanis and others
were foreigners. He said though the problem was still
urban and suburban in Pakistan, with the return of

NEAR EAST AND SOUTH ASIA 31

Pakistani immigrants, belonging to the rural areas from
the Gulf and other countries, the AIDS might be found
anywhere in the country.

Relating to the steps taken by the Pakistani Government,
Dr. Kamran said after the detection of the first AIDS
victim, who flew in from Tanzania, so far 25 AIDS
detection centers had been established in the country. All
the Ministries, including Health, Interior, Religious
Affairs, having a connection with the immigrants, are
coordinating to deal with the detection.

The Government has also declared the AIDS as a noti-
fiable disease. Any one who comes from abroad to live
for more than a year should be scanned in a Detection
Center, he added.

He told the participants that the National AIDS Pro-
gramme Pakistan is being supported by the World
Health Organization. Under the programme, so far, the
Government had arranged seminars targeted at various
sections of the society and to create awareness about the
disease. However, due to lack of resources, the efforts
could not make desirable effects, he added.

He maintained that knowing the importance of ulema,
public representatives and mass media, the national
AIDS Programme would carry out its operation in their
collaboration.

He said religious leaders were so far very helpful and
cooperating and were in favor of mass media’s partici-
pation to create an awareness about the AIDS.

He stressed the need for a cooperation between the
Programme and mass media for the purpose.

Speaking on the occasion, Pir Kabir Ali shah of Choora
Sharif highlighted various Islamic injunctions against
the illicit sexual relationship, the biggest cause of the
AIDS spread. He was of the view that the disease would
never spread in Pakistan if the people remained com-
mitted to Islamic injunctions and values.

Addressing the seminar, Provincial Health Minister Ch
Jaffer Iqbal said about 12 years back, the disease was not
known to the world. However, in a short span of time it
engulfed the entire globe with its devastating effects.

So far no cure or preventive vaccine for the disease has
been discovered, he added.

He said with so much of travelling facilities, the world
had turned into a global village and the disease which
devastated large population in Africa, was fast spreading
around the world. However, he maintained that due to
people’s adherence to Islamic principles, the AIDS
spread in Pakistan was limited.

He was of the view that by creating more awareness
about the virus through mass media, religious leaders
and public representatives, the Government would suc-
ceed in preventing the AIDS spread.



JPRS-TEP-92-021
23 December1992

The white paper also urged the wide use of a teachers’
guide on AIDS that is scheduled to be released to
elementary, middle, and high school teachers next
month. [Passage omitted]

SOUTH KOREA

Eight Discovered Infected With AIDS Virus in
September

'SK3009131692 Seoul YONHAP in English 1033 GMT
30 Sep 92

[Text] Seoul, Sept. 30 (YONHAP)—Eight persons were
found to have been infected by AIDS virus during the
month of September.

The Ministry of Health and Social Affairs reported
Wednesday that the additional victims bring to 221 the
total number of those found in the country to have been
stricken by AIDS virus so far.

Of the total, 21 died, one left the country and the 199
remainders—181 men and 18 women—are presently
under medical management, the ministry said.

Of the eight new victims, it said, four were infected
through sexual contacts abroad, one through homo-
sexuality and another through sexual contacts in the
country.

The total victims include 16 foreigners found in the
country to have been affected by the AIDS virus, the
ministry said.

Health Ministry Watching 199 AIDS Patients

SK0910051192 Seoul THE KOREA TIMES in English
9 Oct 92 p3

[Text] A total of 199 AIDS patients are now under
surveillance and 21 patients have died since 1985, the
Ministry of Health-Social Affairs said yesterday.

About 221 people developed the fatal disease from 1985
to September this year and 21 of them died and one
emigrated, according to a report by the ministry to the
National Assembly.

Checks have been conducted on donated blood to deter-
mine infection by the human immunodeficiency virus
(HIV) and medical examinations have also been con-
ducted on 1,893 prostitutes and seamen for overseas
service.

Under the relevant law, those entertainers who have
traveled for more than 91 days are required to take
medical checks.

A total of 676 foreigners have taken AIDS tests and 15 of
them who were HIV carriers were expelled, according to
the ministry report.

EAST ASIA 13

The ministry is also notified by the U.S. Forces Korea of
the number of American servicemen here who turn out
to be carrying the HIV virus every three months.

So far, 35 American servicemen who were infected by
the virus have been sent back to the United States, the
ministry report said.

Eleven More Test HIV Positive

SK0311035592 Seoul THE KOREA TIMES in English
3 Nov 92 p3

[Text] Eleven Koreans tested positive for the HIV
(human immunodeficiency virus) virus and four AIDS
patients died during the month of October, the Ministry
of Health and Social Affairs announced yesterday.

So far, a total of 232 people are reportedly infected by
the deadly virus.

Among them, 25 people died, one emigrated to a foreign
country and 206 people are under surveillance by health
authorities.

Out of the 11 people who turned out to be infected by the
HIV virus last month, three men in their 30s were
reportedly infected overseas, another three through
homosexual relations and a 29-year-old woman by her
husband, according to the ministry. The remaining four
are under probe, the ministry said.

Two of the four who died last month were due to
tuberculosis, one died after operation and the other was
presumed to have killed himself.

MALAYSIA

Five Hundred Prisoners Identified as HIV
Carriers

BK1011030292 Kuala Lumpur BERITA HARIAN
in Malay 4 Nov 92 p 4

[Excerpt] Muar, Tuesday—Five hundred prisoners in
three prisons and a remand center in the country have
been identified as HIV carriers that can lead to AIDS.

Mohamed Nadziri Khusairy, deputy director of the Prisons
Department, said that 67 of them were in the Johor Baharu
Prison and the rest were in the Kajang and Taiping prisons
and a remand center in Simpang Renggam.

He said that the department was accordingly taking
various precautionary measures, including issuing a
guideline to prevent prison personnel from being
infected with the virus. [passage omitted]



SPRS-TEP-92-021
23 December1992

We already know that AIDS has no cure and no vaccine
despite the intensive research efforts. Therefore preven-
tion remains for us the strategy we must employ.

We do have a problem with the efforts being made by the
South African Government, in that the efforts by the
government to introduce preventative measures are
viewed with suspicion and as a ploy to control the
population. This government does not have the credi-
bility to convince the majority of black South Africans to
change their sexual behaviour.

Our first thought must be the protection of our people
against this disease, and therefore, it is necessary that we
adopt a broad front approach to the problem.

All sectors of our community must become engaged in
this battle and resources available from the government
must be distributed to our communities.

This problem does not allow anyone the luxury of
political bias or hearts- and- minds winning exercises.
We need to set up a structure at national, regional and
local levels which goes beyond health workers and the
government.

AIDS exposes an aspect of our lives that we are most
loath to discuss openly, but it also touches on religious
and cultural sensitivities. We must be sensitive to these,
yet be bold to explore all avenues that will ensure that
our message is not only received but well received. The
only sure way of achieving this is by involving all of us in
our home, our institutions, organisations, places of wor-
ship and work.

I believe that a central component of our intervention
strategy must be to strengthen the capacity of our people
individually and collectively to recognise, understand
and act decisively against this scourge.

Let us ensure that everybody understands that a suc-
cessful fight against AIDS, is not a success only for
individuals, but for families, communities and indeed
for our country as a whole.

In this regard I wish to make a special appeal to the
government, the business community and other forma-
tions to, as a matter of urgency, make resources available
for a speedy implementation of the recommendations
that will come from this convention.

T have already said that education is our most potent
medicine against this virus—we need to bring home to
parents, church leaders, political organisations and all
other organs of civil society that stigmatisation of AIDS
victims does not solve the problem. The victims of AIDS
are victims of the illnesses in our society and we need to
proceed from that basis.

Many of us find it difficult to talk about sex to our
children, but nature’s truth is that unless we guide the
youth towards safer sex, the alternative is playing into
the hands of a killer disease. In this regard I wish to

SUB-SAHARAN AFRICA 5

endorse the idea of an AIDS charter which will educate
and activate our population, as well entrench the rights
of AIDS victims.

Compatriots we have an obligation to move decisively to
remove all those obstacles which limit our capacity to
deal effectively with this scourge. Do we really have any
justification for perpetuating such practices as the
migrant labour system, single sex hostels, which not only
destroy family life, but certainly limit our capacity to
establish stable self-reliant communities that can be the
core of a dynamic society able to cope with this and other
problems? Is it not time we address the problem of
illiteracy, poverty and empower our women folk—all
crucial factors for an effective intervention strategy?

Very few, if any, diseases better illustrate the truth in the
dictum “prevention is better than cure”.

Lastly, AIDS definitely has profound direct micro and
macro- economic impacts. In the years ahead, as we face
the process of national reconstruction, we shall need the
best possible performance of our national economy. Let
us therefore act now to ensure that our efforts at nation
building and democratic transformation will not be
frustrated.

National AIDS Conference Formulates Strategy

MB2410163592 Johannesburg SAPA in English
1526 GMT 24 Oct 92

[Text] Johannesburg Oct 24 SAPA—A national AIDS
conference formulated a strategy at the weekend to try
and control and prevent the killer epidemic in South
Africa and ensure appropriate care for affected people
and their dependants. Target groups for AIDS pro-
grammes were identified and principles devised to
combat the disease at the National AIDS Convention of
SA, the first of its kind. It was attended by all parties
concerned about AIDS including health and political
organisations, government and non-government bodies,
unions, churches and civic assocations.

The strategy will be based on basic human rights and
integration with socio-economic development strategies,
the conference decided. Community participation was
seen as critical, as was coordination and networking
between various groups dealing with AIDS. The national
strategy will also be aided by the experience of other
countries and global AIDS strategies. Elements of the
programme include education and training, counselling,
preventative measures, health care, welfare and research.

Among identified target groups were students, commer-
cial sex workers, prisoners, the uniformed services,
people in informal settlements, politicians, hostel
dwellers, truckers and the media.

AIDS has a doubling rate of six months in South Africa
with an estimated 200,000 known HIV infected persons,
according to government figures. Of the 1316 reported
cases since 1982, 446 or 34 per cent have died. Statistics



28 NEAR EAST AND SOUTH ASIA

The director, national AIDS control programme, said a
special board has been set up to deal with the AIDS
programmes. This has been done to give them quicker
clearance as the government cannot afford to lose time.

At least 21 states have also initiated AIDS control
programmes, he said. A policy was also being developed
for the non-governmental organisations to seek their
help in various programmes. These NGOs would not
only be helped with funds but also with technical guid-
ance, he said.

Calcutta Center’s Problems

93WE0039B Calcutta THE TELEGRAPH in English
19 Sep 92 p 6

[Article by Sanjoy Basak]

[Text] Calcutta, 18 September: For the last 19 months,
the National Medical College has been unable to conduct
AIDS tests on patients suffering from the sexually trans-
mitted diseases as well as blood donors due to the closure
of its AIDS screening centre.

This has caused considerable concern as AIDS cases in
Calcutta are increasing alarmingly. In the past few
weeks, three more AIDS cases (seropositive) have been
detected in the city, taking the total cases to 47. The
deputy secretary of the health department, Mr. A. Bhat-
tacharya, said, “Who knows as I am talking to you, a few
more cases are probably being detected.”

However, despite the rapid rise, the AIDS screening
centre at the National Medical College, one of six such
centres in Calcutta, functioned for only three months.
The centre, which was opened in December 1990, closed
down in March last year, following non- availability of
air conditioners and refrigerators.

After repeated letters and requests to the state govern-
ment, the college has recently managed to get the neces-
sary sanction of four air conditioners. But refrigerators
“remain a distant dream and the centre cannot be
resumed without these basic facilities,” a professor of the
college’s pathology department said.

When contacted, the head of the department of the
college’s pathology department, Dr. K.K. Chatterjee,
maintained that, “Even though there were no air condi-
tioners, we were supplied two refrigerators when the unit
was set up. But those never functioned from day one.”

It was learnt that the health department was set up by the
screening centre in the college without installing the air
conditioners. However, the doctors “somehow carried
out the tests as the centre was set up during winter and
the room temperature was adequate for carrying out
AIDS detection,” Dr. Chatterjee said.

But as “summer started approaching, it became difficult
as the rise in room temperature was affecting the results”
he said. “The situation became alarming, when the

SIPRS-TEP-92-021
23 December1992

experts carrying out AIDS tests at the centre started
getting wrong results,” he added.

For instance most of the people tested for AIDS were
found to be positive during the Elisa test, but were
reported negative when the samples were sent outside for
confirmatory tests (Western Blot). “Finally we had to
close down the centre,” Dr. Chatterjee said.

Calcutta Prostitutes Infected

93WE0039C Bombay THE TIMES OF INDIA
in English 28 Sep 92 p 7

[Text] Calcutta, 27 September: The first official HIV
survey carried out in Calcutta’s largest red light area,
known as Sonagachhi, showed that 55 of the 5,000
prostitutes staying there are probable AIDS carriers. The
All-India Institute of Hygiene and Public Health, which
carried out the survey for five months this year, collected
442 serum samples, five of which tested HIV positive.

This, in other words, meant one out of every 100
prostitutes at Sonagachhi is infected with the fatal
disease.

The survey stumbled on the surprising fact that a
majority of the prostitutes at Sonagachhi do not use any
form of contraceptives to prevent pregnancy. Only 13.56
percent take oral pills and another 11.56 percent have
undergone ligation. Clients of only 1.11 percent of the
prostitutes use condoms. As many as 76.33 percent have
a history of pregnancy and 46 percent have undergone
abortion.

Among the prostitutes, 15.11 percent are from Nepal
and 11.78 percent from West Bengal districts bordering
Bangladesh. As large as 84.5 percent of them are illit-
erate. Their weekly income vary from Rs. 500 to Rs.
5,000, according to the status of the prostitutes. On an
average, a prostitute attends to two to ten clients a day,
the survey says.

Problems in Fight Against AIDS Told

Increase in Madras

93WE0075A Madras THE HINDU in English
15 Oct 92 p 3

[Article: “Many College Students Testing Positive for
HIV”]

[Text] Madras, Oct. 14. There has been a noticeable
increase in the number of persons testing positive for
HIV (Human Immunodeficiency Virus), which causes
AIDS, in the past few months in Madras.

Against just one or two cases testing positive for HIV
every week a couple of months back, the AIDS Cell at the
Madras Medical College now receives at least two cases
a day. There have also been five full-blown AIDS cases
so far at the MMC.



JPRS-TEP-92-021
23 December1992

AIDS victims in Honduras are not being treated with the
only drug effective in AIDS treatment, AZT, because of
the high cost. However, officials are trying to initiate a
program for 60 infected persons that will cost some
$100,000, to be financed by the Inter-American Devel-
opment Bank (IDB). persons.

Treatment of AIDS victims in the nation’s hospitals lasts
15 to 20 days and only 90 percent of those infected
receive treatment.

Over 1,100 AIDS Cases in Regional Capital

92WE0705B Tegucigalpa EL HERALDO
in Spanish 11 Sep 92 p 26

{Text] San Pedro Sula—Health Region No. 3 confirmed
yesterday that over 1,100 persons in this city have been
infected with Acquired Immunodeficiency Syndrome
(AIDS).

Felipe Aguilera, head of the region, said the spread of the
disease results from the fact that people fail to take the
necessary preventive measures when they visit houses of
prostitution or other places frequented by persons with
the disease and where the virus is therefore likely to be
contracted.

He reported that the region is conducting patrols in an
effort to check the spread of the disease and warn those
who do not yet have it, but who could be infected at any

LATIN AMERICA 25

time because they take no precautions when frequenting
prostitutes, drug addicts, or carriers of the virus.

Aguilera appealed to the population to abstain from
visiting “centers of corruption” since this is where most
AIDS victims report they were infected with the HIV
virus.

He added that the number of persons undergoing AIDS
testing has risen of late, either because all places of work
require it or because they wish to see whether they carry
the fatal disease.

ST. CHRISTOPHER AND NEVIS

Health Official Reports 35 AIDS Cases

FL2909182992 Bridgetown CANA
in English 1643 GMT 29 Sep 92

[Text] Basseterre, St. Kitts, Sept 29, CANA—St. Kitts-
Nevis has recorded a total of 35 AIDS cases since 1985
when authorities started keeping records of the disease, a
senior health official said.

Chief medical officer, Dr. Thomas Jones, speaking
Monday at the start of a two-day workshop on AIDS and
sexually transmitted diseases, said a child under the age
of five was among the 35 cases.

An almost equal number of males and females in the
20-49 age range, accounted for the remaining 34 cases.



2 SUB-SAHARAN AFRICA

The shortage of medicines is such that, according to
calculations based on the available stocks of prophylac-
tics in the country, if Mozambicans want to practice safe
sex, they can only do so once a year. If condoms were
distributed to the entire adult population, there would be
only one condom per inhabitant per year.

Prevention Campaigns More Difficult in Africa

Regarding AIDS prevention, which is the primary and
priority activity of his service, Avertino Barreto noted
that, if it “is not easy to change the behavior of popula-
tions” in general, “it is much more difficult in Africa.”

There are studies and education campaigns among pros-
titutes, pregnant women, and other risk groups, such as
the carriers [“camionistas”], as well as among some
young and heterogeneous populations. “However,” the
specialist warns, “even with major education programs
directed at the young people, the prospects are very
bleak. By the time these programs begin to have a
practical effect, within 15 years, probably 10 to 15
percent of the adult population will have died already.”

In addition to the rise in certain diseases whose resur-
gence is related to AIDS (tuberculosis, for example),
there are other pathologies that require immediate inter-
vention in Mozambique. These diseases include, among
others, malaria, cholera, and measles, all of which affect
children and which are fatal to thousands. Not to ignore,
certainly, war, famine, and malnutrition.

NIGERIA

Minister Reports Rising AIDS Infection Rate

93WE0044A Lagos THE GUARDIAN
in English 10 Aug 92 p 3

[Article by Ben Ukwuoma]

[Text] No fewer than 63,000 people out of 300,000
screened for the Acquired Immune Deficiency Syn-
drome (AIDS) are infected with the virus in Nigeria,
Health and Human Services Minister Professor Olikoye
Ransome-Kuti has said.

Prof. Ransome-Kuti, represented by the national co-
ordinator of the AIDS Control Programme, Dr. Abiola
Tilley-Gyado, spoke at a workshop in Ibadan, organised
by the Pan African News Agency (PANA) and the
International Development Research Centre in Canada.

He said further data from Sentinel sero-surveillance
centres among populations engaged in high-risk activi-
ties corroborated the rising rate of infection nation-wide.

“In some of these centres, we have rates ranging between
18 percent and 81 percent among commercial sex work-
ers,” he added.

Prof. Ransome-Kuti expressed worry about the rising
rate of infection among expectant women who are sup-
posed to represent a low-risk group in urban centres.

JPRS-TEP-92-021
23 December1992

The rates of infection in expectant women in the Sentinel
sites range between two and 5.8 percent.

The statistics have obvious implications in terms of
potential paediatric AIDS cases and children that would
be orphaned within the next two years.

Speaking on “the Role of the Mass Media in Health
Delivery: AIDS and Population,” Prof. Ransome-Kuti
regretted the under-reporting of AIDS cases, saying “a
total of 394 cases had been reported to the National
AIDS Control Programme.”

He said the number could be more as reported cases
came from teaching and specialist hospitals as well as
state hospitals and surveillance centres,

Analysis of the cases reported for the national control
programme, shows that sex was a major means of
transmitting the epidemic.

Informing, educating and supporting sexually-active
people to protect themselves from HIV-infected people
either by remaining in mutually faithful relationships
with other uninfected people or by practising safe sex
was essential, he said.

He believed that with aggressive national programmes
that did not shrink from the public health challenge of
AIDS prevention, millions of people might be spared
infection by the year 2000.

RWANDA

Aspects of AIDS Situation Discussed

93WE0029A Paris L'EXPRESS in French
9 Oct 92 pp 25-26

[Article by special correspondent Sylvie Perez: “AIDS
Children”—first paragraph is L’EXPRESS introduction]

[Text] In Rwanda, as in the rest of black Africa, the
AIDS epidemic has devastating effects. It leaves thou-
sands of orphans in a state of total abandonment. Who
can take them in? This is what we saw.

A family unlike other families: 48 children ranging from
two months to 18 years, living like brothers and sisters.
They are playing in the inner yard or on the red earth
road that leads down to Lake Kivu. At night, they huddle
up together like Russian dolls on the large mat spread
directly on the ground. In Gisenyi, in northern Rwanda,
Mom Christine’s household is an island of hope. For 40
years now, this 70-year-old handsome Zairian woman
with regular features, looking motherly in her ample
colored dress, has taken in over 405 orphans in her
shacks. People bring her a young child? “I love it right
away. I take it in my arms, I wash it, and I wrap it in my
clothes to keep it warm.” For these fatherless and
motherless survivors, this is like a second baptism. They
are the AIDS orphans.



SJPRS-TEP-92-021
23 December1992

MOZAMBIQUE

AIDS in Cabo Delgado Province

MB0609193992 Maputo Radio Mozambique Network
in Portuguese 1030 GMT 3 Sep 92

[Editorial Report] So far fifteen AIDS cases have been
reported in Cabo Delgado Province. Health authorities
in the area say they have been informing the residents on
measures to adopt in order to prevent the spread of the
disease.

High Cost Imperils AIDS-Prevention Campaign

93WE0009A Lisbon PUBLICO
in Portuguese 22 Sep 92 p 23

[Article by Imtiaz Juma: “AIDS in Mozambique: Immi-
nent Disaster”; first paragraph is PUBLICO introduction]

[Text] There is a risk that the blood in Mozambican
hospitals may no longer be safe, because of financial
problems. The Swiss Government decided to divert
funds to support to education in Mozambique, taking
financing away from [blood testing]. The country has
already registered 522 cases of AIDS and it has only
one prophylactic per inhabitant per year. Disaster is
imminent.

Starting next year, the blood in the banks of Mozamb-
ican hospitals may no longer be analyzed, because of
financial problems, PUBLICO learned in an interview
with Avertino Barreto, director of the Department of
Epidemiology and Endemic Diseases in the Mozamb-
ican Ministry of Health.

According to the specialist, who is also director of the
National Program for Control of Sexually Transmitted
Diseases and AIDS in Mozambique, there is a “risk that
the screening’ of blood could be suspended, since the
country depends on donations from other nations and
nongovernmental organizations and the current donor
has defined other priorities (the costs are very high).”
Avertino Barreto concluded: “The prospects for next
year are catastrophic.”

Just for the provincial capitals and some rural hospitals,
the cost of screening is between $250,000 and $300,000,
or 31,000 to 35,000 contos. For the last four years, the
screening has been financed by the Swiss Government,
through the Swiss Red Cross, and was routine practice in
all the cities of the country.

According to Avertino Barreto, the country “has neither
the means nor the money,” and “has yet to find a donor
who will pledge to provide the tests.” The physician
added: “Disaster is imminent.”

Twelve New AIDS Cases a Year

In this context, AIDS is emerging as a very great concern,
In Mozambique, 2.5 percent to 4 percent of the popula-
tion is now infected with the virus, which means that, in

SUB-SAHARAN AFRICA 1

a population of 15 million inhabitants, between 375,000
and 600,000 are HIV-positive.

“At the end of June, Mozambique had 493 confirmed
cases of AIDS,” Avertino Barreto revealed, and, of these,
“more than 400 have already died.” In August, however,
there were 522 officially recognized cases.

Estimates based on international statistics indicate that
12 new cases of AIDS emerge every year in Mozambique
and, according to projections, by 1995 more than
100,000 people could be infected with the virus. If, on
one hand, certain figures suggest that “at the moment the
disease does not appear to be as alarming as it is in
neighboring countries,” on the other hand the estimate
could be low, given the impossibility of covering the
entire country.

“There are large areas which, because of the war, are
inaccessible to the medical teams that study AIDS,” said
the official, who noted that the “‘screening” of blood
covers only 60 percent of the Mozambican donors.

Safe Sex Once a Year

The war was a factor in aggravating the situation. Some
regions were totally inaccessible to the health authorities
and many physicians and nurses were killed in
ambushes. The problem is even more serious in that “in
the regions where the concentration of military forces
(and not just Mozambican troops, but also foreign
troops) was greatest, there was an accelerated growth in
the number of HIV-positive individuals and even AIDS
cases.”

Here, Barreto said, “‘we are certain that the effects of the
epidemic will not be visible until the war ends.”

Support to AIDS patients, particularly in terms of treat-
ment with drugs, is minimal. “With the shortage of
medicines which the country is experiencing (often there
are interruptions in supplies of important medicines,
interruptions which, in certain more remote regions,
may last for months) and inadequate medical assistance,
we do not have the economic capacity to treat these
patients with more modern, more effective, and, natu-
rally, more expensive medication,” explained the
director of the Department of Epidemiology and
Endemic Diseases.

“When we know that a patient is suffering from AIDS,
we try to counsel him, to educate him and his family, and
to enable him to die with as much dignity as possible,”
he said, allowing that it was possible to “treat one or
another more responsive complication, that is, within
the capacity of the country’s medical supplies,” but
nothing more.



14 EAST ASIA

Health Minister Says 70 HIV Carriers Identified

BKO0511131092 Kuala Lumpur NEW STRAITS TIMES
in English 4 Nov 92 p 13

[Excerpts] Klang, Tues—Health Minister Datuk Lee
Kim Sai said 70 prostitutes have been identified as
Human-Immuno-deficiency Virus (HIV) carriers
through checks conducted by health officials.

The prostitutes, of whom 45 are Thais, are believed to be
continuing their activities in various red light districts in
Klang Valley. [passage omitted].

Lee added that the ministry had yet to finalise plans to
quarantine prostitutes with HIV.

“We are still studying the plans as the HIV virus is now
being spread more extensively through prostitution,” he
said, adding that the finding was based on studies on
local cases.

Between 100 and 150 people, 80 percent of whom are
drug addicts, acquire HIV every month.

On the setting up of a special hospital for AIDS victims,
Lee said studies have revealed there was no need for that.
[passage omitted].

THAILAND

AIDS Incidence in Upper North

93WE0005B Bangkok DAO SIAM in Thai
30 Aug 92 pp 11, 15

[Text] Dr. Phatsakon Akkhonseri, an expert in preventive
medicine with the Zone 10 (upper northern region) Com-
municable Disease Control Office, said that the Ministry
of Public Health has implemented two systems for moni-
toring the spread of AIDS. One is the system for reporting
those who have the disease and who have AIDS-related
symptoms. The other is the system for monitoring the
spread of this disease. As of 30 June, there were 642 people
with the AIDS disease and another 895 people with
AIDS-related symptoms for a total of 1,537.

“There were only 110 reported cases of AIDS during the
period 1984-1990. But in 1991 alone, 362 cases were
reported, which is triple the number reported during the
previous seven years. The north has the highest number
of cases. As compared with the national average, which is
0.4 percent of the population, the average number for the
north is almost double that.”

Dr. Phatsakon said that the provinces with the largest
number of people with AIDS and AIDS-related symp-
toms are Bangkok, with 357 cases, Chiang Rai, with 256
cases, Chiang Mai, with 233 cases, Phayao, with 58
cases, and Lampang, with 58 cases. Excluding Bangkok,
the five upper northern provinces have the highest
incidence of AIDS. Surveys on the number of AIDS
victims nationwide indicate that the 17 northern prov-
inces have 733 cases of AIDS, 47.69 percent, the central

SJPRS-TEP-92-021
23 December1992

region has 238 cases, 15.48 percent, the northeast has
139 cases, 9.05 percent, the south has 70 cases, 4.55
percent, and Bangkok has 357 cases, 23.23 percent.

“These statistics may be lower than the actual. number,
because since 1991, the Ministry of Public Health has
had a policy of keeping certain statistics a secret out of
humanitarian concern and out of concern for Thailand’s
image.”

Dr, Phatsakon said that from monitoring the spread of
AIDS among various groups during the period June
1992 to June 1992 [as published], it has been found that
AIDS has spread to all 73 provinces. Among those who
work directly as prostitutes, the incidence of AIDS has
increased from 3.5 percent to 20.69 percent. On the
average, the rate of incidence has increased approxi-
mately 3 percent every six months. Among those who as
prostitutes as a sideline, the incidence of AIDS has
increased from zero to 6.01 percent.

The rate of incidence among male prostitutes has
increased from 2.7 percent to 7.9 percent. Among men
examined for a venereal disease, it has been found that
the incidence of AIDS has increased from zero to 5.56
percent. The rate among IV drug users has declined 39
percent, with the rate now being 30-35 percent. During
the period 1989-1990, the incidence of AIDS among
pregnant women was zero, but by December 1991, the
rate was 0.67 percent. Among blood donors, the rate has
increased from 0.2 to 0.7 percent.

Conference Notes AIDS, TB Link

93WE0004B Bangkok BANGKOK POST
in English 4 Sep 92 p 3

[Article by Aphaluck Bhatiasevi. First paragraph is intro-
duction.]

[Text] Pattaya—AIDS remains the most serious commu-
nicable disease in Thailand, followed by sexually trans-
mitted diseases (STD) and tuberculosis.

The Communicable Diseases Control Department
opened its annual meeting here yesterday.

Some 320 participants from provinces all over the
country were told that most of the communicable dis-
eases in Thailand have decreased significantly or are
under control, except for AIDS.

Department chief Dr. Surin Pinichpongse said thanks to
technology, communicable diseases are gradually
declining.

He added however that technology alone cannot cure
diseases, other components, such as politics, economics,
social structure, action of the government and provision
of services are important factors.



4 SUB-SAHARAN AFRICA

HIV-Positive Prison Population Revealed

93WE0008A Johannesburg THE NEW NATION
in English 4-10 Sep 92 p 4

[Text] There are more than 200 prisoners countrywide
who have tested HIV-positive, the Department of Cor-
rectional Services (DCS) said this week.

The HIV (human-immuno-deficiency-virus) can lead to
full-blown AIDS (acquired-immuno-deficiency-
syndrome).

DCS spokesperson Colonel Danie Immelman told
NEW NATION that the infected prisoners were under
the supervision of trained personnel to protect other
prisoners.

He said homosexual activity—reportedly rife among
common-law prisoners and one of the easiest ways to
spread the virus—was not tolerated.

“Necessary criminal or disciplinary action is taken
against any transgressors,” he said.

High risk

With the help of the Department of Health, the DCS was
able to identify prisoners who should be regarded as
being in the “high risk” category.

“Blood tests are taken from all such prisoners on admis-
sion, and from those who requested to be tested,”
Immelman said.

All confirmed sufferers and carriers of the disease had
separate sleeping quarters to prevent possible further
contamination.

He said steps were taken to ensure that confidentiality
was maintained in all cases.

In an attempt to stop the spread of AIDS, Immelman
said the DCS conducted educational programmes con-
cerning AIDS, its dangers and preventative measures.

He said trained nursing and other specialised medical
staff regularly counselled prisoners.

Mandela Speech at AIDS Conference

MB2310082692 Johannesburg SAPA in English
0644 GMT 23 Oct 92

[SAPA PR Wire Service issued by the African National
Congress (ANC); embargoed until delivery; speech by
ANC President Nelson Mandela delivered at national
conference on AIDS at Nasrec, 23 October 1992]

[Text] Comrades and compatriots

When I was asked to open this conference some months
ago, I felt greatly honoured by the invitation and at the
same time, greatly humbled by the enormity of this
problem facing our own country and many other coun-
tries. My mind was sharply focused on the words in

SJPRS-TEP-92-021
23 December1992

Hemingway’s novel that: “Man is not an island he is not
an entity into himself therefore ask not for whom the
bells toll they toll for thee”.

The reality of the AIDS epidemic worldwide is that it is
not merely a medical condition, it is a disease with
socio-medical implication.

In South Africa, this problem challenges the entire socio-
economic fabric of our society and poses a threats to
future generations. Statistics indicate that those forced to
live in poor socio-economic conditions are the highest at
risk in our population.

As at the 30th June this year, 1,316 cases of AIDS were
recorded, and the majority of these were recorded in
Natal, with the highest incidences of AIDS country-
wide being recorded in the urban areas. Apartheids
legacy has played a great role in this factor, particularly
in the black communities where overcrowding in
homes does not provide for privacy within the family;
where lack of housing and the creation of informal
settlements as well as the lack of recreation facilities
makes the black community even more susceptible to
the sex related virus.

Single sex hostels lead to the disintegration of family
units in rural areas and hostel dwellers are forced to have
casual relationships since they cannot live with their
families.

Another startling statistic is the incidence of AIDS in
young children. Most children born with the AIDS virus,
die before they reach their second birthday. The fact that
the virus attacks the most economically active age group
in our population, is also an issue worthy of discussion.

The serious consequences of inadequate health care
facilities nationally, as well as the fact that there is
limited access to the health facilities which treat sexually
transmitted diseases, is a matter which this conference
must pay serious attention to.

Women are the most seriously affected by the AIDS
virus. They are the poorest people in our country due to
the lack of education and work opportunities. The posi-
tion of women in our society forces them into a situation
where they are unable to protect themselves or an
unborn infant against the virus. Many women find it
very difficult to insist that their partners wear condoms
due the socialisation of both men and women on the
issue of sex.

Our most potent weapon against this virus is education.
We have, perhaps, for some time, allowed ourselves to
believe that like other epidemics it will come and go; that
the great advances of our time in science and technology
will offer us appropriate quick intervention.

The key to our success is our own collective effort. The
time for rhetorical arguments and victim blaming has
passed. Now is the time for action. What we know about
this desease already is enough to enable us to put in place
compreliensive and appropriate intervention strategies.



20 EAST ASIA

“For now, we can deal only with the cheap establish-
ments which cater to the low-income group, tea houses
and brothels. In due time we move on the more expen-
sive establishments which serve as fronts for prostitu-
tion,” he said.

Thirty-Five Percent of Drug Addicts HIV Positive

BKO111074092 Bangkok Radio Thailand Network
in Thai 0000 GMT I Nov 92

[Text] The Public Health Ministry has been mobilizing
resources from both the state and private sectors for
prevention and control of AIDS from intravenous nar-
cotics use. The number of AIDS patients is now on the
rise. Dr. Withun Saengsingkeo, director general of the
Medical Service Department, disclosed that there are
300,000 drug addicts nationwide and 50,000 have
sought medical treatment. He said a study shows that 35
percent of the number seeking medical treatment have
contracted the AIDS virus.

Paper Examines Spread of AIDS

BK1011052992 Bangkok THE NATION
in English 10 Nov 92 pp B7, B8&

[Excerpts] The acquired immuno-deficiency syndrome
(AIDS) virus, which only three years ago was confined to
high risk groups, is steadily spreading among the general
population in spite of awareness campaigns.

A group of doctors attending the 18th Congress on
Science and Technology of Thailand last month who
portrayed the AIDS scenario in Thailand said the epi-
demic is encroaching on unsuspecting segments of the
society.

Less than a decade after the first case of AIDS was
reported, Thailand is already the country with the
highest number of cases testing HIV positive in Asia.

“Data gathered by us show that the number of HIV
positive cases among drug addicts has stabilized at about
35-40 percent since 1989. The rate of increase of infec-
tion among members of high risk groups like prostitutes
and their male clients is falling. On the other hand,
however, we find the percentage of people representing
the general population testing HIV positive to be on the
rise,” said Dr. Khanchit Limpakanchanarat, a Thai
Public Health Ministry official who also directs the
HIV/AIDS Collaboration, a joint project of the US
Centres for Disease Control and the Thailand Ministry
of Public Health.

Such a trend, Kanchit added, spells both social and
economic disaster.

“In the estimate of Thai Working Group, a non-
governmental organization set up by former Deputy
Minister Michai Ruchupan [as published], Thailand will
have the about 2.4 million human hosts of the HIV virus
by 2000. Each patient will require a spending of Baht
500,000 to Baht 1,000,000 on medication to keep alive,

IJPRS-TEP-92-021
23 December1992

and will not be productive during the time. It will
amount to an economic drain of Baht 1.5-2.4 trillion,” he
said.

Public health officials are concerned that pregnant
women, considered one of the lowest risk groups, are
increasingly reporting cases HIV positive the number of
cases rose from nill in the middle of 1990 to 1 per cent
this year. [Sentence as received]

“With about one million pregnant women in Thailand, it
means 10,000 mothers-to-be are coming down with the
AIDS virus each year. Statistically one-third of them will
pass the virus to the child. That is, over 3,000 children
will inherit the HIV annually. The number will increase
as the percentage of HIV in pregnant women rises,” he
said.

Khanchit’s estimate concurs with a recent report sub-
mitted to the Public Health Ministry which counts 3,000
mothers with the AIDS virus. The real figure be could be
higher.

“The data came from big public hospitals in major
provinces with the facility to check expectant women’s
blood samples,” said a medical source in the public
[health] ministry.

“But the figure does not cover other medical facilities
like private hospitals and rural medical clinics. The
actual figure could, therefore, be higher,” the source
added.

Kanchit said the Public Health Ministry is making
concerted efforts to bring the disease among all the
groups under control though without much success.

“I must admit we have not succeeded everywhere. For
example we have been able to control the spread of the
virus in drug addicts and, after launching the ‘100
percent condom’ programme, prostitutes. But we have
yet to think up of measure to effectively clamp down on
the virus’ growth in other groups such as pregnant
women. Part of the problem, he said, stems from hus-
bands being reluctant to use condoms during intercourse
with their wives. ”The husband who is willing to use a
condom when visiting a prostitute thinks otherwise
when asked to do the same with the spouse. The problem
stems from men’s attitudes toward the use of condoms;
disease prevention in the first case and birth control in
the second,“ he said.

The worry over AIDS is not confined to the Public
Health Ministry. At least one other government organi-
zation is equally concerned: the Thai military.

Thai military officials have admitted that there are AIDS
cases among their men in the northern provinces. “Data
on new recruits force us to designate the northern
provinces as areas of alarm with over 10 percent cases
reported,” said Col. Dr. Narongrit Sirisopha, who works
at the Armed Forces Research Institute of Medical
Sciences (AFRIMS). “I never thought we would see a



JPRS-TEP-92-021
23 December 1992

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JPRS-TEP-92-021
23 December1992

Result Is Confirmed

The result is confirmed by a similar study of 800 high
school students in Boras undertaken in the spring of
1990. Of the 50 percent that had already had their first
sexual encounter, 52 percent of the girls and 57 percent
of the boys said they had used condoms the first time.
Only 8 percent of the girls said they had used birth
control pills.

“Girls today tend to restrict their use of birth control
pills to short, limited periods. When a relationship ends,
they stop taking the pills. In general, a clear shift from
birth control pills to condoms has taken place, both in
the first and most recent sexual encounters,” said Dr.
Goran Svedin of Mother and Child Health Care in
Ostersund, who directed the studies.

He finds it heartening that boys to a greater extent are
beginning to take responsibility for their sexuality. But,
at the same time, they are uneasy about the conse-
quences of the drop in use of birth control pills by the
girls.

Five years ago 85 percent of the girls used birth control
pills when involved in lengthy relationships. Today, this
figure has dropped to 70 percent. This combined with
the fact that a higher percentage of youth today say they

WEST EUROPE 4B

have had sexual relations without protection increases
the risk of unwanted pregnancies.

The main reason for not taking birth control pills is fear
of side effects. In certain cases, economic grounds are
given as the reason for the drop in use. The HIV
epidemic has also contributed to the increased interest in
condoms for both sexes.

The increased use of condoms has contributed among
other things to the drop in cases of chlamydia among
girls at the county youth clinic. On the other hand, the
number of teenage abortions continues to remain at the
same level in this part of the country while dropping in
large parts of the rest of the country. Overall, the use of
preventive measures by the group has not risen since
1986 when the earlier study was done.

Later Sexual Contact

The median age for the first sexual encounter now lies at
16.2 years for girls and 17 years for boys. This represents
an increase of 10 months for the girls and nine months
for the boys compared with five years ago. Yet the first
sexual experience continues to be 14 years of age for 15
percent of the girls and 8 percent of the boys. As before,
the median age for the first sexual encounter is lowest
among youth following the technical curriculum in high
school as well as among boys in rural schools.



JPRS-TEP-92-021
23 December1992

ZIMBABWE

Forty-Five Percent of TB Patients HIV Positive

93WE0042A Harare THE SUNDAY MAIL
in English 9 Aug 92 p 7

[Text] Forty-five percent of the city’s tuberculosis
patients are HIV positive, a study carried out by the City
Health Department has shown.

A TB/HIV study carried out in the city in 1988/89
showed that 45 percent of the TB patients were HIV
positive, bringing the figure in the sexually active group
to 60 percent.

There were 2,798 TB patients admitted at the Beatrice
Road Infectious Disease Hospital and the Wilkins Hos-
pital last year. And 313 of them died at the former
hospital. Of these, 108 were identified as HIV related
deaths, constituting 34.5 percent of all TB deaths at the
hospital.

Generally, the number of TB cases in the city continued
to rise, adding the risk of exposure to infection to the
general public, especially to children. In 1990 there were
97 TB cases per 100,000 and this rose to 158 cases per
100,000 in 1991.

Because of the increase, it was important that priority be
given to detection and treatment of tuberculosis cases to
prevent a complete breakdown of the city’s TB control
programme.

According to the City Health Department, the increase
in TB cases was not only within the City of Harare, but
throughout the country. The disease was no longer a
chronic condition, but an acute medical illness because
of the association with HIV illness.

The increase in TB caseload had put an enormous strain
on the TB services in the city. Resources needed for
management were stretched and drug supplies had been
erratic and as a result the base treatment was often not
available for patients.

Wilkins Hospital which serves the northern half of the city
and receives patients from Parirenyatwa Hospital and the
private sector, had only nine beds for TB patients which
was grossly inadequate. The average stay for TB patients
was 14 days and in some cases patients had to be dis-
charged prematurely to make way for other patients.

There were 177 TB admissions at the hospital last year
compared to 112 in 1990, an increase of 58 percent. Of
these, 107 were men, 40 women and 30 children.

Conditions

The poor socio-economic conditions currently prevailing
(for example, overcrowding, malnutrition and rural
migration due to drought; and lack of expansion of
resources, both material and human to match the esca-
lating problem), were some of the problems facing the
TB control programme.

SUB-SAHARAN AFRICA 7

There were 2,751 admissions of TB patients at the
Beatrice Road Infectious Disease Hospital last year
compared to 2,197 in 1990 and 1,627 in 1989. This
constituted an increase of 69 percent over two years and
282 percent in deaths. Sixty-one patients who died had
clinical signs of immunosuppression but their HIV tests
were either not done or results were not back at the time
of death, while 13.2 percent were patients with relapses
and most of them had defaulted in treatment earlier.

Many of the patients seen were more sick than when
previously seen. TB meningitis had doubled from 23
cases in 1990 to 53 cases in 1991, and military TB had
gone up four times to 186 in 1991. The patients needed
more intensive nursing including terminal care nursing,
and more treatment and counselling. There was pressing
need for a full-time social worker in the tuberculosis
section at the hospital.

The city health department was trying to discharge the
patients on a daily basis to their provinces or district
hospitals so that they could be near their families.

Because the patients recovered slowly and were on
treatment for longer periods, there was need for a follow-
up system to ensure that treatment was continued.
However, lack of transport for community and environ-
mental staff hampered the follow-up programme,
resulting in patients defaulting treatments.

The department was also concerned that due to the
economic structural adjustment programme, patients
were in poorer conditions in terms of housing, nutrition
and sanitation.

Sometimes patients with TB and AIDS were made to
sleep in a room with other people, sharing the same toilet
with 20 others, this, according to the department, frus-
trated and depressed the health workers who were trying
their best to help patients.

Plans were under way for an extension at Wilkins
Hospital to provide more beds for TB patients.

Last year the TB control programme faced some setbacks
due to the resignation of senior staff members and the
serious drug shortage, especially Rifampicin, one of the
key drugs in TB management.

The burden that TB was causing was increasing, causing
loss of productivity and resulting in extra hardships to
families.

The city health department made a number of objectives
and recommendations to be carried out in 1992 and
these are:

¢ To attain a further 10 percent of clients attending
Medical Examination Centre by encouraging further
peripheral screening and concentrating on high risk
people;

To increase the level of TB detection by mass miniature
radiography to 2 percent from the present 1.34 percent.



6 SUB-SAHARAN AFRICA

may be inaccurate due to serious under-reporting of the
disease, and some experts say the real figure of AIDS
sufferers and HIV-infected persons could be ten times
higher.

The conference’s ten member steering committee was
retained and mandated to broaden representation to
include non-governmental organisations and consider
regional representation. The conference will continue
its work as the National AIDS Coordinating Com-
mittee of South Africa. The steering committee is
currently made up of representatives from the ANC
[African National Congress], the government,
Chamber of Mines, South African Consultative Com-
mittee on Labour Affairs, Congress of South African
Trade Unions, South African Council of Churches,
National Federated Chamber of Commerce and South
African National Civic Organisation.

Also discussed at the conference was condom distribu-
tion, pricing and subsidy. South Africans use an esti-
mated 25 million condoms annually, according to LRC
Industries International MD [managing director] Peter
Smith. LRC is the manufacturer of Durex condoms.

After refusing for years, the SABC agreed recently to
allow the flighting of condom commercials on television.

TANZANIA

Report Says 700,000 Carry AIDS Virus

£A0610144592 Dares Salaam Radio Tanzania Network
in Swahili 0330 GMT 3 Oct 92

[From the press review]

[Text] The leading story on the front page of UHURU is
on AIDS in the Dar es Salaam region. We read that the
region now leads in having the highest number of AIDS
patients in Tanzania, which is currently reported to have
a total of 120,000 patients.

A Ministry of Health report released in Dar es Salaam
yesterday says as of May, Dar es Salaam had 8,692 AIDS
patients, more than other regions in the country. The
report also says that there are 700,000 people who have
the AIDS virus in Tanzania, adding that only 34,605 of
them have reported to various hospitals in the country.
The report goes on to say that of every 100,000 people—
out of a total population of 1.2 million in Dar es
Salaam—700 are suspected to have the AIDS virus, a
dangerous situation calling for drastic measures to curb
the rapid spread of the disease.

UGANDA

AIDS Wiping Out Small Villages
92WE0702A Algiers LE SOIR D'ALGERIE in French
11 Aug 92 p 6

[Text] In the Rakai area, a once flourishing region of
Uganda along the border with Rwanda, AIDS is the

SJPRS-TEP-92-021
23 December1992

cause of the closing of the sugar factory and the paralysis
in the construction industry. Orphanages are the only
buildings still going up.

Certain villages, almost abandoned, are disappearing in
the brush, which has grown over them. In other villages,
the only survivors are the children and the grandparents.

The Ugandans have learned as painfully as possible that,
whatever the results of the conference in Amsterdam, it
is necessary to act quickly. In this country with 17
million inhabitants, 1.5 million children are already
orphans, while 1.5 million adults and children are
infected with the HIV virus.

Alex Bagarukayo, of the “Save the Children” Founda-
tion, explained: “This epidemic affects the most produc-
tive people in all sectors, including government officials,
engineers, businessmen, and farmers.”

Furthermore, a number of those responsible for the fight
against AIDS explain that the mortality rate, far from
benefiting the developing countries by reducing their
population, as some people think, is increasing poverty
tenfold.

In the Rakai area, perhaps the region most affected on
the African continent, the decimated population is
fighting to stay alive. Meabh McMahon, a member of
“Concern,” an Irish humanitarian association,
explained: “The fortunate ones were the first to leave,
and jobs left with them. There is no longer any invest-
ment. People prefer to consume their savings.”

In Kampala, the capital of the country, the first victims
were also the technicians, specialized workers, bankers,
and businessmen. Those who have survived neglect their
jobs to take care of their sick relatives.

Sister Miriam Duggan, who has resigned from her posi-
tion as medical director of Nsambeya Hospital in Kam-
pala to devote all of her time to the fight against this
scourge, sadly said: “We do not know what to do or
where to turn to obtain money.”

By virtue of their experience, the groups of Ugandan
volunteers are among the most efficient in the world
when it is a matter of preventing disease and helping the
sick. However, the volunteers fear that the epidemic will
affect them and that the people will give up.

Manuel Pinto, a deputy who was born in the Rakai area,
said: “If you sit down and think about it, you will be
tempted to stop trying to do anything. People ask them-
selves, ‘What is the use of fighting this disease? Who will
be the next to come down with it?”

Absalom Bwanika-Braale, an official in the Ministry of
Health, went even further: “Uganda is not going to
disappear from the surface of the earth. However, we are
all damned.”



IJPRS-TEP-92-021
23 December1992

years later. Older and sick people have lower resistance,
and an old contagion can flare into full-fledged tubercu-
losis,” noted Tala.

Modern Medicine Cures Tuberculosis

According to Professor Tala, however, people born in the
1930’s and later need not worry. Only a few people
infected with the tubercle bacillus actually fall ill. “The
tule of thumb I teach my students is: About 10 percent of
people who are exposed to tuberculosis actually develop
the disease,” he said.

“Among younger generations, almost no one has become
contagious, and everybody has been vaccinated,” he
added.

Tuberculosis does not constitute a problem for modern
medical science, but treatment takes a long time. A few
weeks in a hospital and half a year on antibiotics is
almost always enough to cure the patient.

Voluntarism in AIDS Policy Under Attack

Carrier Arrested After Infecting

93WE0046A Helsinki HELSINGIN SANOMAT
in Finnish 22 Sep 92 p 9

[Unattributed article: “African Man Suspected of Two
New Rapes Involving HIV; Five Cases Have Already
Come to Light Within a Year”)

[Text] Ugandan John Karara, diagnosed as HIV-
positive, is suspected in two new rapes. Arrested for one
rape in September, this man had been convicted for one
case before and is being tried for one rape in Helsinki
Municipal Court, so there are all told five cases.

Two of the three cases being investigated took place this
summer. The third case that has come to light took place
last year. All of them occurred in Helsinki.

According to the new victims’ reports, the cases are
similar to the earlier ones: The victims had left a
restaurant to go somewhere else when the rape occurred.

Earlier Probation Sentence

Karara was arrested a week ago, suspected of having
committed rape a few days before. The crime was
specified as attempted homicide since Karara is HIV-
positive. The police are also investigating the new cases
as attempted homicide.

The 29-year-old Karara was given a short prison sen-
tence with probation for the rape that occurred in
December of last year.

With reference to the case in March, Karara was charged
with attempted homicide. The ongoing trial is being
conducted behind closed doors.

The man is charged with attempted homicide because it
was already suspected at the time of the March incident

WEST: EUROPE 39

that he knew that he was HIV-positive. In connection
with that, the man himself denied that he knew he was
infected.

Because he was suspected of rape in March, Karara was
a prisoner on remand until May, when the court released
him.

The two cases of suspicion of rape occurred after that.

The African man has been in Finland for a year and a
half. At his hearings the man said that he has had 10
partners with whom he had unprotected sexual contact.

Testing, Disclosure Rules Debated

93WE0046B Helsinki HELSINGIN SANOMAT
in Finnish 27 Sep 92 pp C1-2

[Article by Anna-Stina Nykanen: “AIDS: HIV Is Virus
That Leads to AIDS; Who Is Responsible for Spreading
Fatal Disease?”’]

[Text] Finns’ only weapon against people who infect
others with HIV is the doctor's ability to talk some sense
into them. When an HIV-positive African man was
recently arrested on suspicion of having raped five women,
it had to be admitted that talking sense into him was not
enough. Society has to have something other for AIDS
than foreknowledge and preventive care.

The law stipulates that an HIV infection must be
reported as an infectious disease. If it were classified as
an infectious disease representing a danger to the public,
anyone suspected of spreading it could be forced to
undergo testing or even be isolated for several months.

At present no one can be forced to take a test for HIV.
According to criminal law, however, a person who
infects anyone else with the disease can be punished if he
is aware of his infection or if he has deliberately avoided
going in for a test. Infecting someone with the disease
may also be punishable when the carrier is not aware that
he is HIV-positive.

A doctor cannot, however, irresponsibly interfere in an
infected person’s affairs: Professional secrecy prevents
him from even telling the infected person’s spouse that
he or she is HIV-positive.

Last spring, when a group of parliamentary representa-
tives asked the government in writing what steps it plans
to take to classify HIV as a public danger, the reply was:
none whatsoever. It did not view compulsory measures
as being suited to the basic Finnish strategy for combat-
ting HIV, the mainstays of which are education, volun-
tariness, and a positive attitude toward those infected
with the disease. The government feels that compulsory
measures would constitute more of a threat to the success
of the strategy that has been chosen.

An intensive search for people infected with HIV is not
considered necessary either because anyone can volun-
tarily prevent infection by practicing protected sex. By



JPRS-TEP-92-021
23 December1992

expressed his concern over the rapid spread of HIV cases
in Manipur among other places in South Asia and
underscored the emergent need for firmly dealing with
the situation.

The health experts working on AIDS in Manipur suspect
the existence of about 400 AIDS cases in Manipur only.
Going by the present number of HIV cases, experts fear
that by 1994, the total number of full blown AIDS cases
will go upto 2,000. In Nagaland, there are about 5,000
drug addicts of whom about 2,500 are suspected to have
been infected with HIV infection.

While, at present there are more than 100 full-blown
AIDS cases in Nagaland alone, experts fear that by 1994
the total number of AIDS patients will be about 500.

Dr. Swarup Sarkar, senior research officer of ICMR unit
on AIDS in the North-eastern States, said that according
to a scientific survey about 20 percent of HIV cases take
about five years to become full blown AIDS cases and
about 50 percent such HIV patients usually take about
10 years to become AIDS patients.

According to Dr. Sarkar, in Manipur out of every eight
people, one is a drug addict and of every two addicts one
is infected with HIV. Another alarming feature is the
latest finding of about 1 percent of pregnant women in
Manipur of being HIV victims. In 40 percent cases there
is every chance of the new borns becoming infected with
HIV, it is said.

The HIV sero-surveillance programme was taken up by
the Regional Medical College, Imphal, since July 1986,
but none of the samples screened by the “ELISA” up to
September 1989 was found to be positive. But since
October 1989, a large number of such cases were found
to be positive. In the late seventies, a major addiction in
Manipur was mild tranquillizers and methaqualone.
Injectable morphine and pethidine were also commonly
used.

Gradually, heroin substituted other psychotropic drugs
and at present it is the only form of addiction. On an
average three to five addicts of the same age group and
sex share the “shot” after dissolving the heroin in a
container (broken spoon or containers of vicks vaporub
is commonly used). The solution is then taken by an
improvised syringe usually an ink dropper, which is
connected with a hypodermic needle. The needles are
simply cleaned and not washed. The intravenous drug
users range between 12 and 45 years. The majority of
them are between 15 and 35 years.

According to the Manipur Government sources, most of
the HIV cases have been detected in Chaurachandpur
district of Manipur. But the area being dominated by
Mizos, a section of Meitei officials of the Manipur
Health Department are not reportedly sincere in con-
ducting the required tests relating to blood transfusion.

Dr. S.C. Pal, the principal investigator of the ICMR unit
for research on AIDS in North-eastern States, said that a

NEAR EAST AND SOUTH ASIA 2

series of steps were being taken to effectively combat the
dreaded disease. Dr. Jacob K. John, a well-known pro-
fessor in psychiatry would soon conduct a workshop in
Imphal on the art of counselling on this problem.

Dr. Pal said that once the WHO’s project was imple-
mented the ICMR unit in Imphal would be strengthened
in all senses.

Continued Reportage on Fight Against AIDS

National Statistics Given

93WE0039A Bombay THE TIMES OF INDIA
in English 29 Sep 92 p 10

[Text] New Delhi, 28 September: The national AIDS
control organisation (NACO) officials are working out
new strategies to give the much-needed impetus to its
plan for prevention and control of the killer disease in
the country.

The plan which broadly deals with activities like surveil-
lance, information, education and communication
(IEC), clinical management, blood and blood products
safety will cover a larger arena and include participation
of non-government organisations/institutions.

Even though the first cases of HIV infection (human
immunodeficiency virus which causes AIDS) were
detected in 1986, precious little has been achieved in the
national AIDS control project since, admit officials.
Lack of funds, they claim, was the major handicap. Not
any more for the World Bank aid of $85 million (Rs. 250
crores) has finally come through. The tap is now on, says
the NACO project director, Mr. P.R. Dasgupta.

However, the plans were already under way, he adds.
Experience has now shown that surveillance activity,
which was mainly restricted to high- risk group—
prostitutes, professional blood donors, intravenous drug
users, STD clinic attendants, etc. did neither give a
reliable picture nor the population trend.

While statistics only show 10,800 people as infected with
220 having full blown AIDS, some experts forecast that
there are already about 1.5 to two million people
infected others say about 400,000.

Thus surveillance activity will now cover low-risk group
and have a wider data base. It is going to be community-
based. Certain areas/localities, for example, will be cov-
ered under this activity. And for all you know it may just
give us an entirely different picture on the prevalence
rate of HIV infection there, explains the official.

Meanwhile, more than 600 of the five lakh people in the
capital whose blood was tested were found HIV positive.

Ata workshop on “media and AIDS,” organised by the
Delhi administration, its director of health services, Dr.
V.P. Varshney, said though this ration was less than the
national average, one could not afford to take it lightly.



44 INTERNATIONAL

International AIDS Conference Held in Amsterdam

93WE0011A Varnasi AJ (Supplement)
in Hindi 6 Sep 92 pp |, lll

[Article by Dr. Vishwambhar Vyas: Careful! AIDS Has
Gotten a Foothold in India“]

{Text] Recently a conference in Holland’s capital, Amster-
dam, was held in which 11,000 scientists participated. The
subject was the AIDS epidemic. The scientist reported their
research findings in this 8th international conference on
AIDS. However, all of them said the same thing as they did
eight years ago when AIDS was not well-known. At that
time, the scientists assured us that they were going to find a
cure for this fatal disease within two years. The scientists,
however, are still running around in a dark tunnel. In one
way, the Amsterdam conference was just to show the
frustrations of these scientists.

During the 8th international conference on AIDS more
scary facts about the disease were shared than the success of
research. Information about some new complications of this
disease were also shared. The specter of the AIDS epidemic
appears more serious to those who are not experts. AIDS
was first mentioned in a U.S. weekly report on 5 June 1981.
At that time, the number of HIV-infected persons was
estimated to be about 100,000. This number has increased
to tens of millions during the last 11 years.

The scientists disagree on the number of persons suffering
from AIDS. The way this epidemic has spread in Third World
countries, especially Africa, during the last six to eight years
has made it difficult to make a correct estimate. Of the 7
million AIDS patients reported in 1992, 70 percent are
Africans. Five years ago, only a small part of the urban
population of central and eastern Africa was found to be HIV
positive. However, HIV has now spread throughout the entire
African continent. In South Africa alone, over 3 million
nonwhites tested HIV positive. According to a British scien-
tist, the population growth rate in Uganda will be 20 percent
less in 15 years because of the AIDS epidemic. The United
States of America with 16 percent of AIDS patients is second
to Africa, and the rest of the American continent has another
nine percent. Five percent of the patients are in Europe and
the remaining are in Asia and Australia, Women constitute 36
percent of AIDS-infected people, however, this portion is
expected to rise to 50 percent by the end of this decade. It is
obvious that during the next eight or 10 years children and
family life will be greatly effected by the spread of HIV. The
situation in the Saharan region of Africa is really frightening.
One person among every 40 is suffering from AIDS. Every
hour, 200 persons in the world become infected with HIV,
and half of them are Africans. During this decade, this
epidemic has spread rapidly in the countries in Africa, Asia,
and South America. By 2000, 10 percent of the new AIDS
patients will be in industrialized countries. It means that until
now AIDS was spreading rapidly in the United States and
other industrialized countries and this epidemic will spread
more in Third World countries during the next decade. Africa
is already in the clutches of this epidemic. The next focus of
this epidemic will be Asian countries. Among these, Thailand
and India are especially mentioned.

According to the WHO, India has the same conditions as
Africa did 10 years ago. In other words, during the next few
years, this disease will rapidly spread in India the same way

JPRS-TEP-92-021
23 December1992

as in Thailand where this disease spread 150 percent faster
between 1987-91. This disease will spread 500 percent faster
during the next five years. In July 1991, there were only 65
cases of AIDS registered in India. According to experts, the
number of people tested HIV positive is increasing daily.
Ten percent of the patients who come to sex disease clinics
for treatment have the HIV. It is obvious that India is on the
brink of spread of an AIDS epidemic.

The strange thing is that in spite of billions of dollars spent
in research and being given a top priority in government
programs, AIDS is still a mysterious disease. Scientists have
failed to understand the genealogy and manner in which this
virus spreads. AIDS is still the most difficult and mysterious
disease in the history of medical science. The starting point
of AIDS is the HIV. The scientists have failed to understand
how this virus weakens the human immune system. The
human body has white cells that fight disease. When these
cells become weak, the human body becomes easily dis-
eased. The HIV bacteria are the CD-4 type, which are the
major antibodies.

Scientists are trying to learn how the HIV enters the human
body; how it manages to stay idle in human cells and then
become active to suddenly destroy the immune system.
According to scientists, when the HIV bacteria becomes
active, it destroys the immune system so quickly that there
is no time for a medicine to take effect. The scientists found
that HIV has managed to defeat every medicine so far.
Various drug companies claim to have developed a medi-
cine for controlling HIV, however, these have failed during
tests and they have to start research all over again.

Researcher are working on about a dozen vaccines to control
AIDS. It will take at least two years to find anything effective.
The researchers are giving priority to developing an injection
that stops HIV infection. It will take years to find a cure for
AIDS to keep patients alive. No AIDS patient has succeeded
in remaining alive so far. AIDS means death! The major
reason for the spread of HIV is homosexual relationships.
Fifty-eight percent of AIDS patients acquired this disease
because of it. Twenty-three percent get this disease from drug
use and 2 percent from blood transfusions. A sensational
report presented at the 8th international conference in
Amsterdam revealed that one can get AIDS without getting
the HIV. Scientists attending this conference were shocked by
this new information that many cases of AIDS without HIV
infection were discovered. It means that AIDS can be caused
by another virus also. This will require research starting over
again. The presence of a new virus after 10 years of research
is scaring the scientists and doctors.

In sum, during the 8th international conference in
Amsterdam, the scientists expressed their helplessness
and disappointments. This conference has proved once
again that it is difficult to control this epidemic through
treatment. Therefore, the world community will have to
pay more attention to public education during the next
one or two decades. Major campaigns to educate people
about the threat this epidemic must be launched. The
WHO and industrialized nations must provide assis-
tance to Third World countries. The most effective
method of controlling this epidemic has been public
education. We must start campaigns at the international
level against the immoral practices that spread HIV and
AIDS. India should be especially alert about it.



26 NEAR EAST AND SOUTH ASIA

INDIA

Concern Expressed Over Progress of AIDS
‘Pandemic’

India Second to Thailand

93WE0020A Madras THE HINDU
in English 11 Sep 92 p 11

[Article: “Alarm Over Spread of AIDS”)

[Text] New Delhi, Sept. 10—Since 1984 when the first
case of infection with the AIDS causing human immun-
odeficiency virus (HIV) was identified in the South East
Asian region, the disease has spread rapidly with as
many as 45,000 infected persons in eight countries of the
region. While Bhutan, North Korea and Mongolia
remain AIDS free, in Thailand it has reached epidemic
proportions—34,545 of the 45,000 persons identified as
infected till May this year in this region are in Thailand.

The South East Asian regional office of the World Health
Organisation at its recently concluded regional com-
mittee meeting reviewed the deteriorating AIDS situa-
tion. India comes next to Thailand in this region with
7,272 HIV infected persons identified. Of the 344 full
blown AIDS cases in the region, 179 were in Thailand
and 116 in India.

The WHO studies have shown that the disease is
spreading rapidly from intravenous drug users and pros-
titutes to the general population through heterosexual
contact, a major mode of transmission of this disease in
this region.

In India, HIV infection has increased rapidly among
prostitutes in Bombay and Tamil Nadu. In Bombay 35
percent of the brothel prostitutes are carriers of the HIV
infection and in Vellore in Tamil Nadu the rate of
infection has increased among prostitutes from 0.5 per-
cent in 1986 to 34.5 percent in 1990. Of the intravenous
drug users tested in the North-Eastern states, almost 50
percent have been found to be infected.

Although the AIDS pandemic in this region is still in its
early stages.

Alarm in Tamil Nadu

93WE0020B Madras THE HINDU
in English 14 Sep 92 p 3

[Article: “AIDS Cases on the Rise”]

[Text] Salem, Sept. 13. The State Government proposes
to setup an AIDS awareness centre in Madras and the
USS. has agreed to provide all the facilities and material
necessary for it, the Secretary for Health and Family
Welfare, Mr. K. Inbasagaran, has said.

Inaugurating an AIDS awareness campaign organised by
Prakriti, a voluntary organisation, here on Sunday he
said the setting up of the centre would be the first step in

SPRS-TEP-92-021
23 December1992

disseminating knowledge about the disease which had
started causing alarm in Tamil Nadu. The incidence of
AIDS, which was 2.5 per 1,000 in 1986, had risen to 5.24
per thousand in 1991. According to a recent study, 18
percent of the rural population around Madras was
suffering from venereal disease.

Among voluntary blood donors, HIV-infected cases had
doubled to 0.2 percent in the last four to five years. As
blood was found to be among the major carriers of the
virus, all the blood banks had been instructed to test the
blood for HIV, collect all the details about the donors
and preserve 10ml of every unit of blood so that it could
be tested by the Government authorities. “So far there
had been a lot of laxity with regard to the functioning of
the blood banks. Hereafter stringent action would be
taken against them,” Mr. Inbasagaran said. His depart-
ment would provide HIV testing kits wherever neces-
sary. The public should also insist upon the blood test
report before transfusion.

The main reason: However only two percent of the AIDS
incidence was due to blood transfusion. It was mostly
due to wrong sexual practices.

Campaign in Northeast

93WE0020C Calcutta THE STATESMAN
in English 25 Aug 92 p 16

{Article: “Fighting AIDS in Manipur”)

[Text] In view of the rapid increase in the number of
HIV infection cases among intravenous drug users and
detection of full blown AIDS cases in some North-
eastern States, particularly in Manipur and Nagaland,
the World Health Organization has chalked out a blue-
print to actively support the Indian Council of Medical
Research [ICMR] in combating the rapid growth of the
dreaded disease in these areas.

According to the WHO plan, it will offer Rs [Rupees] 1.5
crores to the ICMR’s Imphal-based unit for combating
AIDS. The money will be spent for undertaking a three-
year project which include continuing “cohort studies”
for constantly analysing selected HIV cases, improve-
ment of existing clinical and laboratory facilities,
encouraging use of clean needle and condoms among the
drug pushers and scientific counselling on AIDS prob-
lems among the HIV patients, drug addicts and the
personnel dealing with the problem. The WHO project is
likely to be cleared by the Centre in the near future.

The health scenario in Manipur and Nagaland in partic-
ular is fast deteriorating following the detection of
alarming number of HIV cases. The experts dealing in
AIDS pointed out that there were about 20,000 intrave-
nous drug users in Manipur and suspected that about 50
percent of them might have been infected with HIV.

At the recently held international conference on AIDS in
Amsterdam, Dr. Michael Merson, the Director of
WHO's global programme on AIDS, has reportedly



IJPRS-TEP-92-021
23 December1992

The disease is devastating Africa’s great lakes region. In
towns, almost one adult out of three is seropositive. A
generation is disappearing, leaving children alone
behind. According to the WHO, they will number 15
million throughout the world by the year 2000—90
percent of them in black Africa. In Rwanda and Burundi,
where the birthrate is 6.9 children per woman, the
situation is turning into a nightmare. These twin coun-
tries, hilly regions covered with a mosaic of tea fields,
look peaceful. According to the legend, this is where
Adam and Eve lived. This is where God put his paradise.
Today, it is hell.

Nyabaranda, the south district of Bujumbura, Burundi’s
capital: The graveyard, large like a city, extends from the
road to the shore of Lake Tanganyika. Few relatives still
come to pray on the graves. The graveyard was open in
1983; it is now full. A new plot had to be found, west of
the town. Late in the afternoon, when the sun filters
through the clouds in “biblical” rays, hearses converge
there, followed by families in crowded pick-up trucks.
Barechested convicts dig graves without looking up.
Already 50 graves or so in just a few days. “No week goes
by without my going to a funeral: relatives, colleagues,
etc. You see people dying around you. You feel it is
fate.” Sylvana is a government employee in Bujumbura.
She has just lost her brother and her sister-in-law. AIDS,
of course. They left five orphans. Sylvana would like to
take them with her. But she already has two children; the
house would be too small. And she has only one fear: that
she, too, should die and leave them alone.

‘Remain Together’

As for Lavan, he was suddenly propelled into the adult
world. At 16, he is head of the household, in charge of his
four brothers and sisters. Their mothers left them one
year ago, following her husband in the unbearable suf-
ferings of the final stage. Her last instructions to the
small tribe: “Remain together.” Lavan, tall and slender
in his gray schoolboy uniform, dreams to be one of the
10 percent of students selected to attend high school.
That would enable him to find work, to forget perhaps
about day-to-day survival. For the time being, every
evening after school he makes the rounds of neighboring
houses. On good days, he brings back a pot of beans that
they share in the dank and dark cottage, squatting on the
mud floor. “Often, we don’t eat. People here are poor
and don’t have enough for their own children,” he
explained in a toneless voice, his pleasant face impassive
as if forever. Glorious, the youngest child, is ill and in
bed. This time, it is malaria. Her brothers take turns
watching her. “When she cries, I pretend I am her
father,” James, 10, said.

Until now, rural areas (accounting for 90 percent of the
population) had been spared from AIDS, a city disease.
But, because of the population explosion, fields are
divided into minute plots. Exhausted from being over-
tilled, the soil of the “rugo,” the family plot, can no
longer support the family. The husband leaves for the
town, looking for additional income. He comes back

SUB-SAHARAN AFRICA 3

carrying the virus. The drift away from the land spreads
the disease. Now, at the turn of mountain roads, you can
see a sight out of the Middle Ages: sick people being
carried downhill on makeshift stretchers. No one can
help them, anyhow...

In ward 4 at the Kigali Hospital, in the Rwanda capital,
72 women are sharing some 30 beds. Occupancy rate:
220 percent. Head to foot, they stare at the ceiling so as
not to meet the despairing eyes of their neighbor. Under
the beds, the children lives are punctuated by their
mother’s groans. Here, people die of tuberculosis or
malaria. “Opportunistic diseases” take advantage of the
AIDS victims’ immunodeficiency. AZT could slow down
the progress of the disease. It is too costly: $6,000 per
person per year, when annual health expenditures per
person in Africa range from $8 to $50. “We have no
drugs to give them,” a doctor acknowledged. “And
whatever we prescribe, they cannot afford to buy it. We
should overcome poverty in order to fight AIDS.”

Unable to treat the disease, authorities then try to
prevent it. With UNICEF support, they organize aware-
ness campaigns. But prevention comes up against strong
obstacles. The Catholic Church continues to ban the use
of condoms. A heavy responsibility... Rumors spread
nonsense. According to some, condoms will transmit
AIDS. According to others, the propaganda advocating
the use of condoms is just a family planning ploy.
Inconsistence in the face of a disease that they cannot
understand. How can people be persuaded to stop having
children when a large family remains the last symbol of
wealth and happiness? In Rwanda and Burundi, people
are bringing forth children without daring to think about
the future. The future of the AIDS orphans.

SOUTH AFRICA

Health Department To Distribute Condoms

92WE0674B Johannesburg THE STAR
in English 27 Aug 92 p 13

[Article: “25-m Condoms on Hand for Safe-Sex Drive”)

{Text] About 25 million condoms will be distributed
through more than 62,000 outlets this year, the Depart-
ment of National Health and Population Development
announced yesterday.

Director-general Dr. C.F. Slabber said the budget for this
financial year’s AIDS programme was R12,982 million.

Dr. Slabber said the health hazard posed by the AIDS
pandemic and its future socio-economic impact on
southern African society was a mater of great concern.

—The Department of National Health and Population
Development added that findings of an inquiry into
“internal problems” at its AIDS Unit could not be
published because an appeal against the findings had
been lodged.



SPRS-TEP-92-021
23 December1992

The incidence for secret female prostitutes with the
AIDS virus was between 0 and 39.73 percent with an
average incidence of 4.73 percent. This was slightly
lower than the survey six months ago when the incidence
was 5.41 percent, but in some provinces the incidence
increased a great deal especially in the provinces of the
central region. The top five provinces for those with the
AIDS virus were Sisaket Province, Pathum Thani Prov-
ince, Suphan Buri Province, Sing Buri Province, and
Chainat Province.

The incidence for men coming for tests for venereal
disease throughout the country was between 0 and 45
percent with an average incidence of 5.73 percent. This
incidence was very close to the incidence in the last
survey which was 5.56 percent, but there were many
provinces in the North where a high incidence was
found. The top five provinces for men with the AIDS
virus discovered during tests for venereal disease were:
Phayao Province, Lamphun Province, Chiang Rai Prov-
ince, Rayong Province, and Chiang Mai Province.

The incidence for pregnant women with the AIDS virus
was between 0 and 7.38 percent with an average inci-
dence of 1 percent. This was an increase from the past
survey—it increased from 0.67 percent to | percent. This
indicated that the AIDS virus had spread to the general
population. Since each year about | million women have
babies, therefore about 10,000 of them throughout the
country would have AIDS, and about 30 percent of the
babies would be at risk of contracting the AIDS virus
from their mothers. Or one could say, of the 1 million
babies born each year, about 3,000 would have the AIDS
virus. The increase in the incidence for this group
therefore caused great concern because a report had been
received that there were pregnant women with the AIDS
virus in all 73 provinces. The provinces with the highest
incidence were: Rayong Province with 7.38 percent,
Phet Buri Province with 7 percent, Phrae Province with
6.25 percent, Chiang Rai Province with 6 percent, and
Phayao Province with 5.11 percent.

Minister Links AIDS, Nordic Tourists

93WE0028A Stockholm SVENSKA DAGBLADET
in Swedish 6 Sep 92 p 22

[Article by Benita Andersson: “Sex Tourists Are Unciv-
ilized”]

[Excerpts] He is around 45, Swedish, big and has a
slightly reddish sunburn. She is not quite 15, with
slender limbs and exotic beauty. She smiles when she
does not understand his language, smiles when he talks
about his children over dinner, and she is still smiling
when under his strong upper arm she disappears into the
cheap hotel.

It is time to do her part for the food and the 1,000 baht
which the rich, Swedish tourist has paid for her body.

The girl is not alone in this gratitude. The same scene is
played out daily and everywhere in Pattaya, Bangkok

EAST ASIA 17

and Phuket, in Manila, on the Gambian beaches and in
other cheap vacation paradises; thousands upon thou-
sands of European, American, Australian and Japanese
men are buying love at cheap prices from a poor family.
[passage omitted]

Excuses

Most are men, who in their home countries speak with
disdain about prostitutes, but who during their vaca-
tion—and quite without compunction—pay for inter-
course, for a night or a week of their vacation. Or as two
Swedes with advanced education expressed it after a few
months in Thailand:

“It takes a couple of weeks before you get over the
inhibition. But once you have paid for one girl, you
continue. These girls are not like the Swedish whores.
These girls are soft and nice. And, above all, they are
submissive and grateful.”

Sex tourists justify their behavior with the fact that
prostitution is an old custom and that they are only
doing the countries, the girls and their families a finan-
cial favor. But according to Thailand’s “AIDS minister,”
Mechai Viravaidya, in reality it is only the sex industry
and its employees which welcome the sex tourists.

“We want an end to the sexual exploitation of women
and children,” he says. “Those who make sperm trips to
Thailand can stay home. To travel to a poor country and
destroy the future of women and children is beneath the
dignity of a civilized and well-educated society.”

Mechai Viravaidya even goes so far as to demand action
on the part of the airline industry. For how do the sex
tourists get to Thailand? he asks rhetorically. Why, by
airplane.

“SAS and other airlines must be aware of these men’s
purpose for their trips and they should set limits. The
airlines cannot just sit back and say that they have
nothing to do with this.”

Thai tourism is up quite sharply over the last few years.
In 1990 the country received 5.2 million visitors, who
brought in a total of 4.6 billion kronor. Far more than
half of the tourists were men, and last year 70,000
Swedes visited the country.

Health Cards a Sham

But the sex tourists who visit Thailand do not just
jeopardize the culture and the girls’ future. They also run
the risk of getting AIDS. So far at least nine Swedes, four
of them heterosexual, have been infected with HIV in
Thailand. Many Swedish sex buyers have not been AIDS
tested, however, and the spread of HIV increased very
drastically during the last year in the tourist areas.
[passage omitted]



34 CENTRAL EURASIA

Phosphorus-containing analogues of azidonucleosides
and the combination of nucleosides and interferon and
its inducers may show promise in the future (Molecular
Biology Institute imeni V. A. Engelgardt, AN SSSR;
Virology Institute imeni D. I. Ivanovskiy, NIIEM imeni
N. F. Gamaley, AMN SSSR; Belorussian NIIEM, BSSR
Ministry of Health).

Research was conducted with the purpose of finding
AIDS treating preparations among antibiotics and plant
substances (Institute for Exploration of New Antibiotics,
AMN SSSR; All-Union Scientific Research Institute of
Medicinal Plants, USSR Ministry of Medical Industry).
Some carminomycin producers and a substance of plant
origin—alpizarin—were found to have pronounced anti-
HIV activity in cell culture.

4. Epidemiological Analysis

A previously developed automated system employing
computerized data recording used to survey the coun-
try’s population for HIV antibodies was introduced and
is now operating, more than 80 million persons were
surveyed (Central Scientific Research Institute of Epide-
miology, USSR Ministry of Health).

Software and procedures for introducing an automated
system of serological examination and epidemiological
control of the rate of HIV infection among blood donors
was created (All-Union Hematological Scientific Center,
USSR Ministry of Health).

Research was conducted with the purpose of evaluating
the role of different epidemic control measures in HIV
infection: The effectiveness of combining epidemiolog-
ical surveillance based on mass examination of the
USSR population for HIV antibodies with epidemiolog-
ical investigation of individual cases of HIV infection
was demonstrated using localized foci of HIV as an
example (Elista, Volgograd, Rostov-on-Don) (Central
Scientific Research Institute of Epidemiology, USSR
Ministry of Health).

An effective organizational structure for serological
examination of blood donors and plasma for HIV infec-
tion was introduced together with a system for verifying
and referencing results and control analyses of standard
samples by the blind method.

The mechanism behind the potential danger of infection
of plasma donors was revealed, and recommendations
on its prevention were drawn up; the causes of falsely
positive reactions in the blood service were evaluated
(All-Union Hematological Scientific Center, USSR Min-
istry of Health).

5. Study of the Pathogenesis and Features of the
Clinical Course of AI

A clinical classification of HIV infection making it
possible to use a unified approach to establishing groups
of patients suffering HIV infection for clinical testing of
medicinal preparations in different institutions was

JPRS-TEP-92-021
23 December1992

developed (Central Scientific Research Institute of Epi-
demiology, USSR Ministry of Health).

Clinical tests were conducted on a domestic azidothymi-
dine preparation. The preparation was used to treat 46
patients in different stages of disease: in late stages of
illness—on the basis of vital indications, and at the
beginning of the stage of secondary diseases—to improve
the long-term prognosis of the course of illness. Prelim-
inary test results indicate that the preparation’s toxicity
is rather low, and it is clinically effective.

Tests were continued on a domestic preparation of
normal human immunoglobulin as a component of inte-
grated therapy of secondary diseases accompanying HIV
infection; a pronounced positive impact was revealed
(Central Scientific Research Institute of Epidemiology,
USSR Ministry of Health).

Research was conducted on the auto-immune compo-
nent of HIV infection, on idiotype - anti-idiotype inter-
actions, on T-cell subpopulations and on the role of
complement (NIIEM imeni N. F. Gamaley, Scientific
Research Institute of Viral Preparation, Carcinogenesis
Institute of the VONTs [All-Union Oncological Scien-
tific Center], AMN SSSR; Moscow NIIEM imeni G. N.
Gabrichevskiy, RSFSR Ministry of Health; All-Union
Scientific Research Institute of Especially Pure Biolog-
ical Preparations, USSR Ministry of Medical Industry).

It was shown that antibodies directed at conservative
class II MNS [not further identified] and synthetic HIV
peptides are determined in the sera of 70 percent of HIV
carriers; acquisition of anti-idiotypic antibodies, which
block the activity of antibodies eliciting immunodefi-
ciency, is proposed (Carcinogenesis Institute, VONTs,
AMN SSSR).

Antilymphocytic autoantibodies that disturb antigen
presentation, activate suppressor cells and suppress pro-
duction of interleukin-2 were discovered in the sera of
HIV carriers and leukosis patients. Efforts to obtain
panels of monoclonal antibodies against lymphocyte
autoantigens are presently under way (Central Scientific
Research Institute of Epidemiology, USSR Ministry of
Health).

Anti-idiotypic antibodies against monoclonal antibodies
to the domain of the CD4-receptor were obtained. It was
shown that the obtained antibodies blocked interaction
of the CD4-receptor with anti-CD4-antibodies; blocking
the binding of HIV with the CD4-receptor with their
assistance is proposed (NIIEM imeni N. F. Gamaley,
AMN SSSR).

Research was conducted on the epitopes of class I and II
MNS molecules recognized by T-cell subpopulations; it
was shown that the precursors of cytotoxic T-cells and
effector cytotoxic lymphocytes recognize different
epitopes of class I MNS molecules, while T-suppressors
interact with the short (five amino acids) determinant of
the class II MNS (Institute of Carcinogenesis, VONTs,
AMN SSSR).



SJPRS-TEP-92-021
23 December1992

It was demonstrated that the complement system of HIV
carriers undergoes activation by the classical and an
alternative pathway, with activation by the alternative
pathway being less pronounced (Moscow NIIEM imeni
G. N. Gabrichevskiy, RSFSR Ministry of Health).

6. Isolation and Study of the Biological Properties of
Different HIV Strains; Study of the Molecular
Mechanisms of HIV Interaction With the Cell

Efforts were carried out to improve the methods of
isolating HIV. This included: organizing the means of
preserving blood preparations during transportation;
utilizing different types of combined growth of periph-
eral blood lymphocytes with normal donor lymphocytes
and with subinoculated cell cultures; using a broad
arsenal of different methods and techniques (dot-
hybridization, the polymerase chain reaction, electron
microscope analysis employing antibodies labeled with
colloidal gold, creation of domestic quantitative tests for
determining HIV antigens in cell cultures, cellular
immunofluorescent analysis).

Over 50 HIV isolates were isolated from Soviet and
foreign citizens in different regions of the country. More
than 30 of these strains were fixed in subinoculated cell
lines of lymphoblastoidal origin (Virology Institute and
Scientific Research Institute of Viral Preparations, AMN
SSSR; Leningrad NIIEM imeni Pasteur, RSFSR Min-
istry of Health; Belorussian NIIEM, BSSR Ministry of
Health; Vektor Scientific-Production Association, USSR.
Ministry of Medical Industry; Central Scientific
Research Institute of Epidemiology, USSR Ministry of
Health).

Research was conducted on the biological and physico-
chemical properties of the isolates. A large fraction of the
isolates were placed in the category of slowly multiplying
viruses on the basis of an analysis of their lengthy growth
in cell cultures and an assessment of production level
using immunofluorescent analysis, immunoblot, OT-
activity, indirect immunofluorescence, dot-
hybridization, electron microscopy and other tests. Of
the isolates, the five most productive were selected as
candidates for production lines (Virology Institute imeni
D. I. Ivanovskiy, Scientific Research Institute of Viral
Preparations, AMN SSSR; Belorussian NIIEM, BSSR
Ministry of Health; Vektor Scientific-Production Asso-
ciation, USSR Ministry of Medical Industry).

The ultrastructure of HIV-1 virions and the stages of
their formation were studied; priority data on the mor-
phogenesis and patterns of synthesis of virus-specific
components in HIV-infected cells were obtained (Virol-
ogy Institute imeni D. I. Ivanovskiy, Institute of Viral
Preparations, NIIEM imeni N. F. Gamaley, AMN SSSR;
Vektor Scientific-Production Association, USSR Min-
istry of Medical Industry).

CENTRAL EURASIA 38

Research conducted on growth of HIV viruses provided
a possibility for obtaining recombinant DNA carrying
HIV genetic material with the purpose of subsequently
analyzing the structure of HIV genomes and obtaining
recombinant HIV proteins in preparative quantities
(Virology Institute imeni D. I. Ivanovskiy, Scientific
Research Institute of Viral Preparations, AMN SSSR;
Vektor Scientific-Production Association; All-Union
Scientific Research Institute of Especially Pure Biolog-
ical Preparations, USSR Ministry of Medical Industry).

Viral isolates obtained from Soviet and foreign citizens
in different regions of the country made it possible to lay
the foundation for establishing a Soviet collection of
HIV strains.

The virus SIV,,m was isolated from monkeys (African
green marmosets); study of it has begun (Institute of
Experimental Pathology and Therapy, AMN SSSR).

Summarizing the results of work done under the “Con-
trol of the Most Widespread Diseases” state program in
relation to the AIDS problem, it should be noted that the
insigificance of the financing allotted to the problem is
holding back timely research of the needed volume.

It should also be noted that in the course of an enormous
amount of meticulous work carried out by a commission
of experts of the Expert Council on Scientific Problems
of AIDS under the Presidium of the USSR Academy of
Medical Sciences to review the reports, not only were
research results on 196 topics obtained in 1990 evalu-
ated, but also recommendations on continuing the
research and its financing were proposed. Expert anal-
ysis of the submitted reports casts doubt upon the
promise and the need for further development and
financing of certain developments.

COPYRIGHT: Izdatelstvo “Meditsina”, 1991

CIS and Baltic AIDS Conference

92WE0587H Moscow NEZAVISIMAYA GAZETA
in Russian 17 Jun 92 p 6

{Article: “AIDS Problem Discussed in CIS”]

[Text] A conference of the health departments of CIS
and Baltic countries on the problems of the spread of
AIDS was held in Minsk. The directors of national
anti-AIDS organizations agreed to exchange information
and mutual assistance in the search for sources of infec-
tion. The meeting was attended by representatives of the
World Health Organization. It was suggested at the
conference that national Belarusian anti-AIDS programs
in the direction of prevention and public information.
Among republics of the former USSR, Belarus now
occupies third place in the number of persons infected
with the AIDS virus.



JPRS-TEP-92-021
23 December1992

ARGENTINA

Non-HIV-Screened Blood Used Until 1989

PY0211215092 Buenos Aires BUENOS AIRES
HERALD in English 2 Nov 92 p7

[Text] (DYN)—Senator and former Health Minister
Conrado Storani yesterday reported that screening for
the AIDS-causing HIV virus at bloodbanks and of blood-
derived products didn’t take place in Argentina until
1989 when a decree was signed establishing measures to
prevent the spread of the disease.

An article that appeared in the French daily LE MONDE
reported that the French Merieux laboratory exported to
Argentina between 1983 and 1986 an unknown quantity
of the Factor VIII blood derivative that may have been
contaminated with the HIV virus.

Storani said that after international meetings on AIDS.
that took place in 1986 and 1987 the World Health
Organization drew up a series of specific recommenda-
tions to avoid contamination through blood transfu-
sions. He also said that he doesn’t recall that authoriza-
tion was granted to import Factor VIII during his term
from April to September 1987.

Clinicas Hospital Director Florentino Sanguinetti agreed
with Storani’s account that there was no HIV-detecting
test in place before 1989. “It was a period of transition...
For the last three years they have carried out very
rigorous checks.”

Between 1983 and 1985 blood-derived products origi-
nating in the United States were exported by Merieux
laboratory—with the approval of French authorities—
without undergoing a heating process that would have
killed the virus.

The dissemination of contaminated Factor VIII through
the National Blood Transfusion Centre of France has

been estimated to have infected 1,200 haemophiliacs
with AIDS, 256 of whom have died.

CUBA

Santiago de Cuba Province Reports 28 Cases of
AIDS

FL0610202792 Havana Radio Reloj Network
in Spanish 1948 GMT 6 Oct 92

[Excerpt] [Passage omitted on business hours, services of
new AIDS information bureau] With a million residents,
Santiago de Cuba is one of the provinces least affected by
AIDS. Currently, there are 28 seropositive cases, of
which 23 are interned in the Dos Caminos sanatorium in
San Luis.

LATIN AMERICA 23

First International AIDS Seminar Opens 30 Oct

FL3010174292 Havana Radio Rebelde Network
in Spanish 1255 GMT 30 Oct 92

[Text] The first international seminar on HIV infection,
which causes AIDS, begins today, sponsored by the
Pedro Kouri Institute of Tropical Medicine. During the
two days of meetings at the Habana Libre Hotel in
Havana, Cuba’s experience in testing to detect anti-
bodies against HIV and treating those who are carriers of
the virus or afflicted with AIDS will be presented.

This seminar will include a series of participatory work-
shops and roundtables at which specialists from the
Institute of Tropical Medicine and others who work in
the sanatoriums will discuss psychological and clinical-
therapeutic aspects, as well as the results of laboratory
research concerning HIV.

For the first time, there will be a discussion of AIDS and
the law—an extremely controversial topic—during
which Cuban Public Health Ministry officials will pro-
vide information on the efforts being made to provide
better care to those who live with the AIDS virus.

Public Health Ministry Reports on AIDS Plan

FL0211031792 Havana Radio Rebelde Network
in Spanish 1000 GMT 31 Oct 92

[Text] The Public Health Ministry has reported that
more than 3 million tests have been carried out in Cuba
to detect antibodies to HIV, and this has made it possible
to identify seropositive cases within three months.
According to statements by Dr. Hector Terry Molinet, a
deputy public health minister, this plan and the special-
ized care provided to those infected are part of an action
campaign aimed at preventing the AIDS virus from
becoming a serious health problem.

For her part, Dr. Dorothy Blake, the deputy director of
the world program against AIDS, has stated in Havana
that the treatment for AIDS sufferers is expensive, and in
some countries the patients are left to suffer and not
provided with medicine that will alleviate their illness. It
is currently estimated that from 10 to 20 million adults
have been infected with the AIDS virus. Of that number,
2 million live in the Americas.

First AIDS Seminar in Havana Under Way

FL0211031892 Havana Radio Rebelde Network
in Spanish 1800 GMT 31 Oct 92

{Text] The first seminar on infection by the AIDS virus
is being held in Havana with the participation of several
countries of this region and Europe. Here is Luci Gispert
with her report for us from the Habana Libre Hotel,
where the event is taking place.

Gispert: The experience of our health care system in the
field of clinical and therapeutic epidemiology, patholog-
ical anatomy, psychology, and sanatorium care, among
other subjects, has been presented in these two days of



JPRS-TEP-92-021
23 December 1992 3. AIDS

LATIN AMERICA
ARGENTINA

Non-HIV-Screened Blood Used Until 1989
[Buenos Aires BUENOS AIRES HERALD, 2 Nov 92] ....

CUBA

Santiago de Cuba Province Reports 28 Cases of AIDS /Havana Radio Reloj Network, 6 Oct 92] .. 23
First International AIDS Seminar Opens 30 Oct [Havana Radio Rebelde Network, 30 Oct 92] 23
Public Health Ministry Reports on AIDS Plan [Havana Radio Rebelde Network, 31 Oct 92]

First AIDS Seminar in Havana Under Way [Havana Radio Rebelde Network, 31 Oct 92] .....
Researchers Seek To Identify AIDS Virus Variants /Havana Radio Progreso Network, 2 Nov 92] . 24

GUYANA

National AIDS Secretariat Confirms 333 Cases [Bridgetown CANA, 30 Oct 92] .
HONDURAS

Public Health Official Reports on AIDS San Pedro Sula TIEMPO, 2 Sep 92] ....
Over 1,100 AIDS Cases in Regional Capital /Tegucigalpa EL HERALDO, 11 Sep 92] .

ST. CHRISTOPHER AND NEVIS

Health Official Reports 35 AIDS Cases [Bridgetown CANA, 29 Sep 92] ...
NEAR EAST AND SOUTH ASIA
INDIA

Concern Expressed Over Progress of AIDS ‘Pandemic’ ..
India Second to Thailand /Madras THE HIND'

Alarm in Tamil Nadu [Madras THE HINDU, 14 Sep 92] .. 26
Campaign in Northeast /Calcutta THE STATESMAN, 25 Aug 92] .. 26
Continued Reportage on Fight Against AIDS ...... 27
National Statistics Given {Bombay THE TIMES OF INDIA, 29 Sep 92] 27

Calcutta Center’s Problems /Sanjoy Basak; Calcutta THE TELEGRAPH, 19 Sep 92]

Calcutta Prostitutes Infected {Bombay THE TIMES OF INDIA, 28 Sep 92] .
Problems in Fight Against AIDS Told .......

Increase in Madras {Madras THE HINDU, 15 Oct 92]

Statistics for Northeast /New Delhi PATRIOT, 1 Oct 92]

PAKISTAN

Papers Report on Fight Against AIDS

Lahore Seminar /Lahore THE NATION, 10 Aug 92] 29
First Positive Case {Peshawar THE FRONTIER POST, 13 Aug 92] 30
AIDS Said Spreading in Islamabad [Lahore NAWA-I-WAQT, 14 Sep 92] 30
Rapid Spread of AIDS Forecast in Urban Areas
CENTRAL EURASIA

Short Report on AIDS Research in 1990 Under the State Scientific-Technical Program ‘Control of the
Most Widespread Diseases’ /Moscow VOPROSY VIRUSOLOGII, May-Jun 91] .... 32
CIS and Baltic AIDS Conference [Moscow NEZAVISIMAYA GAZETA, 17 Jun 92]
Health Official Claims Spread of AIDS Checked /Moscow ROSSIYSKIYE VESTI, 29 Sep 92]
Two AIDS Patients, 14 HIV-Carriers Registered in Country [Moscow BALTFAX, 17 Oct 92]
AIDS Cases in Gomel Oblast /Moscow KOMSOMOLSKAYA PRAVDA, 20 Oct 92] «....



42 WEST EUROPE

“Tt is a doctor’s right and obligation to protect life. We
may well ask whether it is ethically right to limit the ways
he can do this.”

IRELAND

Reporting Policy on AIDS Deaths Told

93WE0063A Dublin IRISH INDEPENDENT
in English 1 Sep 92 p 12

{Article by Eilish O’Regan]

[Text] AIDS is never recorded as a cause of death on any
death certificate issued in this country—despite latest
figures showing 120 people having died of the disease, it
emerged yesterday.

The Department of Health employs a scanning method
instead to detect AIDS victims by looking for clues in the
death certificate which might point to the cause of death.

A confidential system also operates whereby doctors who
have treated people who died from AIDS inform the
Department of Health, according to THE IRISH MED-
ICAL NEWS.

Dr. James Walsh, consultant on AIDS policy to the
Department of Health, said AIDS patients die from
pneumonia or cancer and AIDS is secondary.

Commenting on the procedure, Ger Philpott of the
organisation Aidswise said he respected the good inten-
tions of the practice which is often necessary in cases
where insurance companies will not pay out policies if it
emerges a person has died of AIDS. But he said it is not
helping to create awareness of the disease.

AIDS is now recorded on death certs in Britain and it is
feared that this has resulted in under-reporting of the
disease. This fear is due to the fact that death certificates
are open to public inspection and relatives of the
deceased who may fear the implications of admitting the
real cause of death are failing to put down AIDS when
they should.

PORTUGAL

Transracial HIV-2 Incidence Growing

93WE0003A Lisbon O JORNAL in Portuguese
11 Sep 92 p 25

[Article by M.P.: “HIV-2 Increasing in White and Het-
erosexual Population”)

[Text] A study to which O JORNAL obtained access
indicates that ‘““HIV-2 infection is beginning to be
detected in the white population living in this country.”
The study was carried out among 10,793 white and black

IJPRS-TEP-92-021
23 December1992

individuals in the Portuguese capital. Of the 726 indi-
viduals who tested serum positive for HIV-2, 19 percent
are members of the Caucasian race, and the remaining
80.9 percent are Africans.

This information, the product of perhaps one of the only
systematic surveys including citizens of PALOP [Portu-
guese-speaking African countries] for purposes of future
use (blood samples were collected between 1984 and
1990), contradicts the figures released by the National
Commission for Combating AIDS (CNLS).

Maria Odete Santos Ferreira, a member of the Faculty of
Pharmacy in Lisbon, is coauthor of the study, together
with experts from the Santa Maria Hospital, Egas Moniz,
and the Institute of Tropical Medicine and Hygiene. She
explained that HIV-2 is the predominant virus in Africa,
but it has begun to proliferate in Europe, as well, because
of the contacts maintained with the countries on that
continent.

According to the most recent CNLS report, 10 percent of
the 971 cases of AIDS reported in Portugal resulted from
HIV-2 infection. Only 32 percent of all of the individuals
infected with the HIV-2 virus are women, and 12 percent
are Africans. The majority—59.1 percent—are hetero-
sexuals.

SWEDEN

Studies Link Wider Use of Condoms, AIDS
Concern

93WE0032A Stockholm SVENSKA DAGBLADET
in Swedish 1 Oct 92 p 17

[Article by Anna-Lena Haverdahl: “More Youths Use
Condoms; Birth Control Pills Now Less Popular}

[Text] The use of condoms among youths is increasing at
the expense of birth control pills. At the same time, the
median age for the first sexual encounter is rising for
both sexes.

That is the result of two interview surveys involving a
total of 1,000 high school students in Ostersund.

The surveys, reported in the newsletter “HIV News,”
formed part of Jamtland’s county council program
aimed at reducing the risk of sexual diseases and
unwanted pregnancies.

The studies, which were undertaken five years apart, in
1986 and 1991, show that condoms are now preferred by
both sexes as a preventive method over birth control
pills.

Five years ago a third of the girls used birth control pills
in their first sexual encounter. Today the corresponding
figure is only 10 percent. Approximately 50 percent said
they used condoms in the first encounter compared to 30
percent five years ago.



40 WEST EUROPE

the same principle, a polio epidemic would be combatted
without sugar cubes—by relying on everyone’s washing
his hands when he goes to the toilet.

Nevertheless, we know that some people who are HIV-
positive are not responsible for spreading the infection.
The group is a small one, but it in particular includes
persons who have many sexual contacts.

Some HIV-positive patients return to the doctor’s office
with new sexually transmitted diseases, evidently as a
result of unprotected sexual relations. We also know of
cases in which a patient diagnosed as HIV-positive says
outright that he has no intention of telling anyone about
his infection and that he is not going to change his
behavior. The reason may lie, for example, in his world
view or even in the belief that a person’s life is in greater
hands and so, if someone is infected, it is attributable to
fate, God, or the position of the stars...

Infecters’ responsibility is minimized by appealing to the
belief that nowadays everyone has to be capable of
suspecting that all partners may be HIV-positive and
that they must have protected themselves in any event.
The responsibility for infection should always be just as
great for both parties.

In rape cases, however, the responsibility lies undeniably
with the infecter alone. Now, at the latest, we must
consider what measures are to be employed to get the
infecter to assume responsibility for his actions.

When the rapes committed by the HIV-positive hetero-
sexual man were made public, Justice Minister Hannele
Pokka quickly promised to discuss legislation with cur-
rent Health Minister Jorma Huuhtanen. Huuhtanen
happens to be one of the signatories of the open letter
pursuing the public danger of HIV that was addressed to
the government last spring.

It went off as predicted. The threat of AIDS was only
taken seriously when it was clearly aimed at the hetero-
sexual majority of the population who do not use drugs,
prostitutes, and do not engage in homosexual relations.
The same thing happened in England, among other
countries, where a debate on the limits of doctors’
professional secrecy exploded into motion when a young
man who had been infected through blood products
spread the disease to young women.

Gay special-interest groups, in Finland SETA [expansion
unknown] and the AIDS Support Center in particular,
have always stressed the importance of protected sex.
Now they concentrate chiefly on protecting those who
are infected with HIV and on concealing infections at the
tisk of others’ being exposed to the disease.

At present, the surest way of avoiding one’s legal respon-
sibility with regard to infecting others with HIV is to fail
to be tested for HIV. If the man who received attention
as an HIV-positive rapist had only been a vague African
danger and he had used just charm instead of force,

SPRS-TEP-92-021
23 December1992

perhaps they would never have been able to bring him to
justice for infecting others with the disease, even though
that in itself is a crime.

The man was arrested for rape, but during the investiga-
tion of the first case they did not even test him for HIV.

When the man was charged with the second rape, he was
tested and confirmed positive. The stage of the disease
indicated that he had been ill with it for many years. Up
to now, the official prosecutor has not charged him with
infecting anyone with the disease in this case. The trial of
the case was postponed until after this summer so that it
might be determined whether he infected the victim with
HIV or not. The man was released.

It is not yet known whether any of the rapist’s victims or
possible voluntary partners has been infected with HIV
by him. The stage of HIV disease in the infecter, the
virulence of the virus, and the victim’s state of health,
among other factors, all affect the possibility of being
infected. Ruptures from which blood flows increase the
risk of infection during rapes. The likelihood of infection
is also increased if there is anal intercourse.

According to studies, women are more susceptible to
infection than men, over short spans of time.

A total of 455 HIV-positive individuals, 67 of whom
were women, was confirmed by the end of June in
Finland. Over the past few years, the number of infected
women has remained roughly the same; the number of
infected men has diminished. The peak year was 1990,
when there were 91 HIV-positive individuals in Finland.
Last year there were 57 new cases. This year 33 cases of
infection were confirmed by as early as the end of July.

Infecting Others Is a Crime

In the eyes of the law, consciously infecting others is
always a crime. It is a crime even though rape is not
involved, but fully consenting sex. The legal principle is
that the crime must be considered on the basis of the
actions of the perpetrator, not the victim. Killing a
person is to be condemned, even if the victim wants to be
killed. Attempted homicide is also a crime.

Since we know with certainty that HIV is a disease that
kills sooner or later, a person who deliberately infects
another with it can be charged with homicide, attempted
homicide, assault, inflicting bodily harm, or endangering
a person’s health. Criminal law does not distinguish
between the ways crimes are committed—a knife or a
virus, it is all the same.

It is difficult to prove that the perpetrator infected the
victim deliberately or tried to. Confidentiality with
regard to information on a patient only becomes null and
void if the patient is charged with a crime the maximum
penalty for which is at least six years.



SJPRS-TEP-92-021

10 CHINA 23 December1992

Treatment and rehabilitation services for drug addicts
must also be upgraded, he added.

Chinese drug abusers are mainly young males, the Min-
istry of Public Health report said. The result of an
epidemiological survey of 5,000 people conducted in

Xian last year found 90 percent of local drug addicts
were males under 25 years of age.

The Xian report found abusers used mostly opium and
heroin. In Yunnan Province, heroin is common, while in
Guizhou, Sichuan and Inner Mongolia Autonomous
Region, opium is used extensively.


12 EAST ASIA

But a spokesman for the AIDS Foundation is contacting
each hospital in a bid to get them to reverse the contro-
versial policy. A spokeswoman for the Hong Kong San-
atorium and Hospital said HIV patients, or those with
full-blown AIDS, would be transferred to a government
hospital as soon as they found out the patient had the
disease.

The same attitude was shared by the Hong Kong Central
Hospital. A spokeswoman said the presence of HIV
patients would jeopardise the health of other patients.
Ms. Teresa Yip, administrator of Precious Blood Hos-
pital, said: “We don’t want to accept them here. They
must go to a government hospital so we will transfer
them.”

The medical director of Evangel Hospital, Dr. Lam
Ching-choi, said patients would be transferred elsewhere
“with their consent”. “We don’t have an isolation
ward,” he said. “So we treat the acute phase and then
would prefer to transfer them.”

Both St Paul’s and Tsuen Wan Adventist hospitals had
the same admission policies.

The Adventist Hospital in Stubbs Road refused to accept
HIV patients because it was not regarded as its “forte”.
“We firmly realise it is not our strength of service,” said
Mr. Wayne Woodhams, a spokesman for the Adventist.
“Assuming we don’t know a patient is HIV when we
admit them, once we find out we will do anything to
stabilise the condition and then transfer them. This is a
general policy based on our recognition that the types of
things we need, both treatment and protection-wise, we
just don’t have.”

Mr. Woodhams said a number of patients had already
been transferred.

But Dr. Patrick Li Chung-ki, who represents the Hong
Kong AIDS Foundation, said treating HIV patients
differently was dangerous and would give rise to more
fear of the disease. “Our objective is to eliminate any
form of discrimination,” he said. “There is no reason to
treat this person differently.” Dr. Li said he would talk to
hospitals about their reasons and try to change their
attitude.

“While all hospitals should provide care, the major
problem is there are no rules to govern what the hospitals
should do,” he said. “We can’t ask the Government to
ask them to do a certain thing.”

Ms. Lisa Ross, of AIDS Concern, described the attitude
of these hospitals as “very unfair”, especially when
someone has always gone to a certain hospital for med-
ical care and is turned down for treatment after con-
tracting the HIV virus.

Legislative Councillor, Dr. Huang Chen-ya, said in some
cases HIV patients may be better off going to a Govern-
ment hospital where staff had been trained to deal with
the virus. But in other cases, private hospitals may refuse
to admit HIV patients because of adverse publicity.

SPRS-TEP-92-021
23 December1992

“This is totally unnecessary because hospitals have a
duty to look after them and HIV is no different from any
other disease,” he said.

The territory’s leading AIDS specialist, Dr. Lee Shui-
shan, said hospital workers generally were not comfort-
able around HIV, although the risk was no greater. He
said the attitude of private hospitals could place an
unnecessary burden on the Queen Elizabeth Hospital,
which was where most HIV patients were referred.

But a small number of private hospitals are becoming
more liberal. The medical superintendent of the Matilda
War and memorial Hospital, Dr. Tim Dawbarn, said
HIV patients would be admitted. “We feel it is impor-
tant for hospitals to offer care to all people, and to realise
that providing care doesn’t put them at risk,” he said.
“To reject a patient on those grounds is like making
moral judgements and is quite wrong.”

The Canossa is also willing to treat HIV patients,
according to its medical superintendent, Dr. Arthur
Langenburg.

INDONESIA

Extending Western Influence Brings Genital
Diseases

BK2710135992 Jakarta Radio Republik Indonesia
Network in Indonesian 1200 GMT 27 Oct 92

[Text] The number of genital disease patients in Indo-
nesia has tended to increase due to the strong influence
of Western culture and lack of awareness about medical
treatment. Speaking after he met with Vice President
Sudharmono in Jakarta today, Edi Yusuf, chairman of
the Association of Doctors Specialising in Skin and
Genital Diseases, noted that extramarital sex is consid-
ered normal by members of the urban communities. This
has indirectly contributed to the spread of genital dis-
eases in Indonesia, which also include the incurable
AIDS. The doctors delegation met with the vice presi-
dent to report on their preparations for holding the
association’s congress in Bukit Tinggi on 12 November.

AN

White Paper Stresses AIDS Awareness

0W2310065392 Tokyo KYODO in English 0537 GMT
23 Oct 92

[Text] Tokyo, Oct. 23 KYODO—Greater awareness of
the threat posed by AIDS and stronger education policies
on AIDS prevention are called for in the Education
Ministry’s annual white paper released Friday.

It is the first-ever reference to AIDS in a government
white paper.



JPRS-TEP-92-021
23 December 1992 2: AIDS

CAMBODIA
Overview of VD Problem {Bangkok BANGKOK POST, 10 Oct 92] ..
HONG KONG

Local Hospitals Refuse HIV, AIDS Patients
[Kavita Daswani; Hong Kong SOUTH CHINA SUNDAY MORNING POST, 18 Oct 92) ..

INDONESIA.

Extending Western Influence Brings Genital Diseases
[Jakarta Radio Republik Indonesia Network, 27 Oct 92] ..

JAPAN
White Paper Stresses AIDS Awareness {Tokyo KYODO, 23 Oct 92]
SOUTH KOREA
Eight Discovered Infected With AIDS Virus in September /Seoul YONHAP, 30 Sep 92] 13
Health Ministry Watching 199 AIDS Patients /Seoul THE KOREA TIMES, 9 Oct 92] ..
Eleven More Test HIV Positive /Seoul THE KOREA TIMES, 3 Nov 92] .....

MALAYSIA

Five Hundred Prisoners Identified as HIV Carriers

[Kuala Lumpur BERITA HARIAN, 4 Nov 92] ...... 13
Health Minister Says 70 HIV Carriers Identified
[Kuala Lumpur NEW STRAITS TIMES, 4 Nov 92] ..... 14

THAILAND

AIDS Incidence in Upper North [Bangkok DAO SIAM, 30 Aug 92] os
Conference Notes AIDS, TB Link /Aphaluck Bhatiasevi; Bangkok BANGKOK POST, 4 Sep 92] ... 14
Babies Born to HIV Women; IV Drug Use

[Nusara Thaithawat; Bangkok BANGKOK POST, 4 Sep 92] ...
AIDS Cases in High School /Bangkok MATICHON, 4 Aug 92] ..
Prostitutes’, IV Drug Users’ AIDS Statistics /Bangkok LAK THAI, 5-11 Sep 92]
Rayong AIDS Second in Nation /Bangkok BAN MUANG, 2 Oct 92] ....
AIDS Statistics Updated /Naphaphon Phanitchat; Bangkok DAILY NEWS, 3 Oct 92]
AIDS Statistics by Risk Group [Bangkok DAO SIAM, 4 Oct 92]
Minister Links AIDS, Nordic Tourists

[Benita Andersson; Stockholm SVENSKA DAGBLADET, 7 Oct 92]
Interior Ministry Anti-AIDS Efforts Discussed
Thirty-Five Percent of Drug Addicts HIV Positive

[Bangkok Radio Thailand Network, 1 Nov 92] ......
Paper Examines Spread of AIDS /Bangkok THE NATION, 10 Nov 92]

VIETNAM

Pasteur Institute Detects 76 HIV Positive Cases [Hanoi VNA, 4 Oct 92] .
One More Vietnamese Infected With HIV, Total Now 7 [Hanoi VNA, 7 Ne

EAST EUROPE
ALBANIA

Ministry Spokesman Reports Danger of AIDS ‘Increasing’ [Tirana ATA, 29 Sep 92] ..
Conference Stresses Need for ‘National Policy’ Against AIDS [Tirana ATA, 30 Sep 92]
AIDS Conference Ends, Recommends Individual Testing /Tirana ATA, 2 Oct 92] .



SJPRS-TEP-92-021
23 December1992

2. Development of AIDS Prevention Resources

Research on the behavioral, psychopathological and
immunological features of drug addicts was continued:
An epidemiological questionnaire containing a number
of questions regarding the nature of use of narcotics, the
sex life of drug addicts and other risk factors was
developed; a booklet on safe use of drugs and safe sex
was also written; a large number of samples of blood sera
from registered drug addicts were examined; 50 drug
addicts using drugs intravenously were surveyed; the
immune status of 30 patients was analyzed. Several
features characteristic of drug addicts in our country
were revealed (Scientific Research Institute of Epidemi-
ology, USSR Ministry of Health; Moscow Scientific
Research Institute of Psychiatry, RSFSR Ministry of
Health).

The general principles of organizing publicity on AIDS
prevention within the USSR population and programs
oriented on particular regions (Central Asian, Baltic,
Leningrad etc.) and on particular population groups
(blood donors, drug addicts, persons at heightened risk)
were developed and introduced; various booklets, leaf-
lets and the special newspaper SPID-INFO (with a
circulation of over 10 million) directed at preventing
HIV infection were prepared and published (Central
Scientific Research Institute of Epidemiology and the
All-Union Hematological Scientific Center, USSR Min-
istry of Health; Leningrad NIIEM imeni Pasteur, RSFSR
Ministry of Health; Kirghiz Scientific Research Institute
of Ecology and Prevention of Infectious Diseases, Kir-
ghiz SSR Ministry of Health; Kaunas Medical Academy,
Association for AIDS Control).

Research is being conducted with the purpose of devel-
oping approaches to creating synthetic vaccines (Immu-
nology Institute, USSR Ministry of Health; Bioorganic
Chemistry Institute imeni M. M. Shemyakin, AN SSSR;
All-Union Scientific Research Institute of Especially
Pure Biological Preparations and Immunology Institute,
USSR Ministry of Medical Industry).

Recombinant strains of vaccine virus expressing pro-
teins of the capsid and nucleoid of the HIV virion were
obtained; formation of particles in cell cultures infected
with this virus that were HIV-like but devoid of their
own genetic material, in distinction from a complete
HIV virus, was demonstrated (Virology Institute imeni
D. I. Ivanovskiy, AMN SSSR; All-Union Scientific
Research Institute of Especially Pure Biological Prepa-
rations, USSR Ministry of Medical Industry).

A number of recombinant plasmids effectively
expressing the genes of HIV proteins responsible for
production of protective antibodies were obtained;
methods of effectively purifying such proteins, which are
capable of becoming components of a future vaccine,
and the methods of assessing their immunogenicity are
presently being developed (Scientific Research Institute
of Viral Preparation and Virology Institute imeni D. I.
Ivanovskiy, AMN SSSR; All-Union Scientific Research

CENTRAL EURASIA 33

Institute of Especially Pure Biological Preparations and
Vektor Scientific-Production Association, USSR Min-
istry of Medical Industry; Institute of Biochemistry and
Physiology of Microorganisms, AN SSSR).

A procedure for obtaining preparative quantities of
synthetic peptides corresponding to the “actual” anti-
genic determinants of HIV proteins gag, env, pol and
nef was developed (Bioorganic Chemistry Institute
imeni M. M. Shemyakin, AN SSSR; Immunology
Institute, USSR Ministry of Health; All-Union Scien-
tific Research Institute of Especially Pure Biological
Preparations and Immunology Institute, USSR Min-
istry of Medical Industry).

3. Development of AIDS Treatment Resources and
Methods

Acquisition of azidothymidine, which underwent com-
prehensive stage-by-stage study and was introduced for
treatment of HIV infection, was proposed; its laboratory
synthesis on a large scale was established; azidothymi-
dine capsules were prepared (Molecular Biology Institute
imeni V. A. Engelgardt and Bioorganic Chemistry Insti-
tute imeni M. M. Shemyakin, AN SSSR; Institute of
Experimental Cardiology of the VKNTs and Virology
Institute imeni D. I. Ivanovskiy, AMN SSSR; Central
Scientific Research Institute of Epidemiology, USSR
Ministry of Health).

An experimental industrial procedure for complete
synthesis of azidothymidine (“glucose”) consisting of
two stages was developed and introduced: I—
acquisition of thymidine out of glucose and thymine,
and II—acquisition of azidothymidine and thymidine,
making it possible to increase azidothymidine produc-
tion by several times, significantly reduce the cost of its
production, and eliminate the use of expensive
imported thymidine (Molecular Biology Institute
imeni V. A. Engelgardt and Bioorganic Chemistry
Institute imeni M. M. Shemyakin, AN SSSR; Vitamin
Scientific-Production Association, USSR Ministry of
Medical Industry; Samarskiy University).

A cycle of studies was conducted with the purpose of
obtaining new preparations acting as inhibitors of HIV
reverse transcriptase. Effective anti-HIV preparations
were revealed among analogues of nucleoside-
triphosphates-diphosphates-phosphonates. The research
results are protected by an author’s certificate and a
patent, and they were reproduced abroad (Molecular
Biology Institute imeni V. A. Engelgardt, AN SSSR;
Virology Institute imeni D. I. Ivanovskiy and Experi-
mental Cardiology Institute, VKNTs, AMN SSSR).

A number of biological and chemical preparations acting
as potential HIV inhibitors were synthesized and tested:
The activity of nucleoside analogues acting as preinhib-
itors of reverse transcriptase of HIV with a high anti-
HIV action was studied; the action of acyclic nucleo-
sides, protease inhibitors, interferon formation inducers
and of the combination of azidothymidine and inter-
feron inducer were investigated (with a positive result).



SJPRS-TEP-92-021
23 December1992

redmarked map once again since the days of communist
insurgency decades ago,” he said.

According to Narongrit, a survey by the military shows
an overall increase in the percentage of HIV positive
cases among army recruits from 0.5 in 1989 to 3.2 this
year.

“But that is the overall figure. If we separate by region,
the northem military district comes first with 7 percent.
The figure is higher when we consider provinces such as
Payao (20 percent), or Chiang Mai (14 percent). We
found out that about 60 percent of recruits tested posi-
tive were living in the North Easter region of the country
two years before they joined us,” he said.

To counter the problem, the Thai military is joining
hands with the US Army, the Public Health Ministry and
the World Health Organization in a project that will
mark the first test of AIDS vaccine in Thailand.

Col. Dr. Sorachai Phithayaphan, Dr. Narongrit’s col-
league, said: “‘We have submitted two protocols to the
National AIDS Committee set up by the Public Health
Ministry to oversee the AIDS situation. One concerns
the testing of the vaccine in HIV positive volunteers; the
second concerns the testing procedure on unaffected
people.

“The World Health Organization is helping draw up a
National AIDS Vaccine Plan which will offer guidelines
for groups wanting to test the vaccine in Thailand,” he
said.

He said the AFRIMS plan was not the same as the one
earlier announced by the World Health Organization.

“WHO thought earlier that they would be able to launch
an AIDS vaccine test in Thailand. Later, they changed
their mind and decided to play a guiding body instead,”
he said.

If all goes well, the first test can begin next year and the
second within six months. The vaccine, he added, would
still be GP160, which is engineered from a part of the
genetic code making up the HIV virus.

“We plan to use 60 HIV Positive volunteers in the first
test and 120 normal persons in the second,” he said.
[Passage omitted]

EAST ASIA 21

Dr. Sorachai stressed that the only way to stop the spread
of the disease is for all government departments to join
hands in the fight against the disease.

“The AIDS problem is a very, very serious one to be
handled by any one department. We need to collaborate
if we are to control it,” he said.

VIETNAM

Pasteur Institute Detects 76 HIV Positive Cases

BK0410063492 Hanoi VNA in English
0554 GMT 4 Oct 92

{Text] Hanoi VNA Oct. 4—The Pasteur Institute of Ho
Chi Minh City has detected 76 HIV seropositive cases.
Of the total 68 are foreigners, three are overseas
Vietnamese returning home to get married, and five
are Vietnamese citizens. The Vietnamese carriers of
this deadly disease are four women and one man, all of
whom reside in Ho Chi Minh City, Tay Ninh, Tien
Giang and Hau Giang provinces. The youngest one is a
16-year-old girl.

At a press conference, Professor Ha Ba Khiem, director
of the Pasteur Institute, said three of the four women
patients were reported to have had sexually-related
activities.

It is known that one HIV seropositive case has been
detected in a man in North Vietnam.

Qne More Vietnamese Infected With HIV, Total
Now
BK0711143692 Hanoi VNA in English

1344 GMT 7 Nov 92

[Text] Hanoi VNA Nov. 7—The Ho Chi Minh City
Dermatology Center recently gave VD treatment to a
27-year-old Vietnamese man and found him HIV
seropositive.

Thus seven Vietnamese citizens so far have been deter-
mined to be carriers of the AIDS virus - one in Hanoi,
two in Tay Ninh Province, one in Tieng, two in Ho Chi
Minh City and one in Soc Trang.

The Pasteur Institute in Ho Chi Minh City has also
detected the virus in 71 persons from abroad including
three overseas Vietnamese returning to Vietnam to get
married.

Sources from the institute said all the infected Viet-
namese are reported having had sexual relations with
foreigners.



Epidemiology
AIDS

JPRS-TEP-92-021 CONTENTS 23 December 1992
[This EPIDEMIOLOGY report contains only material on AIDS. Other epidemiology topics are covered in a later
issue.]
SUB-SAHARAN AFRICA

MOZAMBIQUE

AIDS in Cabo Delgado Province /Radio Mozambique Network, 3 Sep 92] 1
High Cost Imperils AIDS-Prevention Campaign [Imtiaz Juma; Lisbon PUI

NIGERIA

Minister Reports Rising AIDS Infection Rate
[Ben Ukwuoma; Lagos THE GUARDIAN, 10 Aug 92] ...

RWANDA
Aspects of AIDS Situation Discussed [Sylvie Perez; Paris L‘EXPRESS, 9 Oct 92] .....
SOUTH AFRICA

Health Department To Distribute Condoms Johannesburg THE STAR, 27 Aug 92] ...

HIV-Positive Prison Population Revealed [Johannesburg THE NEW NATION, 4-10 Sep 92]
Mandela Speech at AIDS Conference /Johannesburg SAPA, 23 Oct 92]
National AIDS Conference Formulates Strategy (Johannesburg SAPA,

TANZANIA

UbRw

Report Says 700,000 Carry AIDS Virus /Dares Salaam Radio Tanzania Network, 3 Oct 92]... 6
UGANDA
AIDS Wiping Out Small Villages [Algiers LE SOIR D'ALGERIE, 11 Aug 92]

ZIMBABWE

Forty-Five Percent of TB Patients HIV Positive /Harare THE SUNDAY MAIL, 9 Aug 92]
Network Formed to Set Up HIV/AIDS Database /Harare THE HERALD, 15 Aug 92] ..

CHINA

Over 900 HIV Cases Discovered by Mid-September
[Chen Ke; Beijing XINHUA Hong Kong Service, 22 Sep 92] .....+.
Eleven People Test HIV-Positive at Guangzhou Border This Year
[Hong Kong TA KUNG PAO, 29 Sep 92] ....
Report Links AIDS Cases With Drug Abuse in Provinces
[Zhu Baoxia; Beijing CHINA DAILY, 29 Oct 92] .....

EAST ASIA
BURMA

Health Minister Leaves for AIDS Conference in India /Rangoon Radio Burma, 5 Nov 92] ssw... ll



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JPRS-TEP-92-021
23 December1992

The AIDS Cell screens between 150 and 200 samples of
blood every day and it has the facility to perform the
preliminary ELISA test and the more advanced Western
Blot test, which is used as a confirmatory test.

But what is causing alarm to doctors involved in the
AIDS control programme in Tamil Nadu is the
increasing number of college students testing positive for
HIV. “This only goes to show that we should concentrate
a major portion of the AIDS control programme on
schools and colleges. We should take up sex education in
schools in right earnest,” the doctors say.

College students are said to have admitted that they
would have gone in for protective measures while having
sex if they had been aware of the consequences. Of late,
there have also been instances of school students getting
treated for sexually transmitted diseases.

Screening blood samples: Among those who voluntarily
give their blood for screening at the MMC, there has
been a rise in the HIV positive cases. In 1987, all the 11
samples tested negative for HIV; in 1990 of the 74
samples again all were negative.

However, in 1991, when health education on AIDS was
started, two of the 136 samples tested positive for HIV.
So far, this year, of the 153 cases screened, 14 tested
Positive for HIV. A majority of these cases were students
and below the age of 20.

The status report of the AIDS Cell of the Directorate
General of Health Services, Government of India, (for
the period October 1, 1985—June 1, 1992) states that
13,433 samples of the total of 15,18,818 screened during
the period were ELISA positive. Of this, 8081 were
confirmed by the Western Blot test showing a sero-
positivity rate of 5.32 per 1,000.

Of the sero-positive cases, heterosexually promiscuous
cases formed a huge chunk with 46.13 percent of the
total confirmed by the Western Blot test, followed by
intravenous drug users with 18.76 percent of blood
donors with 17.91 percent.

Among the States with the highest number of ELISA and
Western Blot positive cases, Maharashtra tops followed
by Tamil Nadu and Manipur. “The number of HIV
positive cases will definitely be much higher than what
has been recorded by the DGHS as the surveillance
mechanism is very poor in most States,” doctors here
point out.

Statistics for Northeast

93WE0075B New Delhi PATRIOT in English
1 Oct 92 p 1

[Article: “Manipur in N-E Tops in AIDS Cases”}

[Text] Kohima, Sept 29 (UNI)—Manipur tops the list of
Northeastern States for positive HIV cases, according to
a recent Union Home Ministry note.

NEAR EAST AND SOUTH ASIA 29

Of the 9,797 blood samples screened in Manipur, 1,554
were HIV positive. In Nagaland, the second most
affected State 78 HIV positive cases here detected, from
6,994 samples.

However, the rate of HIV positive cases in Mizoram and
Assam was as low as 12 and 0.48 per thousand.

The spread of AIDS is attributed to a rapid increase in
drug addition in the region, particularly in Manipur,
where 15,000 people were estimated to be drug-abusers,
according to a survey conducted by the Indian Council
of Medical Research in 1990.

The note circulated at a meeting of officials of the Centre
and the State Governments of the region observed that
factors responsible for emergence of drug abuse in
Northeast included proximity of the area to the “golden
triangle” of Myanmar, Thailand and Laos, considered a
major drug producing region and the free movement
allowed in a 40 km belt on both sides of Indo-Myanmar
border.

About 2.5 lakh people comprising same or similar ethnic
groups were estimated to be involved in the trans-border
movement, the note added.

The note regretted that despite repeated requests, no
Northeastern State, barring Nagaland, had implemented
the action plan drawn up at an interministerial meeting
which had outlined preventive, reformative and punitive
measures to check drug abuse.

PAKISTAN

Papers Report on Fight Against AIDS

Lahore Seminar

92WE0698A Lahore THE NATION in English
10 Aug 92 p 3

[Article: “HIV Cases: ‘Govt Not Paying Attention’”]

[Text] Lahore—The number of “HIV positive” cases
reported in Pakistan is just the ‘tip of the iceberg’ but the
government is not realising the gravity of the problem,
the country’s National AIDS Manager in World Health
Organisation (WHO), Dr. Kamran Masood said here on
Sunday.

Dr. Masood was speaking at a seminar on AIDS
organised by the Rotary Club Lahore at a local hotel.
Dr. Sameen Siddiqui of Para Medical Institute, Islam-
abad and an Assistant Professor at the Post Graduate
Institute, Quaid-i-Azam University also spoke on the
occasion.

“Though there are 153 HIV positive cases reported out
of only the 250,000 persons screened for the purpose, the
actual number of people who are HIV positive is prob-
ably much larger,” Dr. Masood said. Nothing that there
had been a marked rise in the number of HIV positive



38 WEST EUROPE

But is there time for this?

“There’s no time for an hour-long talk,” Haxholdt
admitted, “but that’s also why the committee has now
compiled a brochure about some conversational tech-
niques doctors can use so the counseling can be kept
within what is possible in terms of time.”

FINLAND

Tuberculosis Resurgence, AIDS Link Discussed

92WE0694A Helsinki HELSINGIN SANOMAT
in Finnish 2 Sep 92 p C5

[Article by Janne Ora: “Finns Successful in Preventing
Tuberculosis”)

[Text] The number of diagnosed cases of tuberculosis
have decreased by more than 60 percent since the
beginning of the 1980's.

During the last decade, the decrease in tuberculosis cases
has been more significant in Finland than in any other
European country.

“The trend in Finland is clearly decreasing, and the
number of new cases annually could possibly drop to 300
by the year 2000,” noted Prof. Eero Tala.

During the years 1980-89, the average number of new
tuberculosis cases was more than 2,000 each year. In
1990, 772 new cases of tuberculosis were registered,
while the figure last year was 771.

As recently as 1987, 1,440 new cases were diagnosed in
Finland, more than in all the other Nordic countries
combined. This year there have been fewer than 300
confirmed cases in Finland. According to Tala, there are
very few cases of tuberculosis among young people in
Finland. “As far as the younger generation is concerned,
we have reached the same level as Sweden. Our total is
still higher, however, because people belonging to older
age groups still experience fairly high morbidity,” he
d.

Tala is a leading expert on tuberculosis in Finland. He
works at the Clinic for Pulmonary Disease at Turku
University Hospital in Paimio and also acts as an expert
for WHO, the World Health Organization.

Eradication Next

There are many reasons for the drop in reported cases of
tuberculosis, but one is especially important:

“Our protracted and relentless struggle against tubercu-
losis is little by little bearing fruit,” Tala stated. He
emphasizes that the next goal is the complete eradication
of the disease from Finland.

Statistically, Finland is near the European average. Last
year there were 15.5 new cases of tuberculosis per
100,000 people in Finland. The other Nordic countries

SJPRS-TEP-92-021
23 December1992

have fewer incidents than anywhere in the world; the
number of cases per 100,000 people were fewer than 10
in each country.

According to statistics released by WHO, the number of
tuberculosis cases in Sweden decreased in 1990 by more
than 20 percent compared to the average in the 1980’s.
In Norway and Denmark, new cases decreased by about
5 percent. In Iceland, there are fewer than 20 annual
occurrences of tuberculosis among the total population.

AIDS Patients More Susceptible

Tuberculosis is again becoming more common in many
European welfare states. During the last few years, the
number of tuberculosis cases have increased in Switzer-
land, Italy, Ireland, and Austria. In Switzerland the
increase has been as high as one-third between 1986 and
1990.

There are two main reasons for the resurgence of tuber-
culosis: AIDS and HIV infections, and mass migration.

As AIDS spreads, so does tuberculosis because of the
lowered resistance of people suffering from AIDS.
According to the more pessimistic estimates by WHO, in
Asia alone, more than a million AIDS patients suffer
from tuberculosis.

Anew tuberculosis strain, which is resistant to drugs, has
evolved in the United States. It is most prevalent among
the disadvantaged, drug users, alcoholics, and homeless
people. Tala, however, does not consider it very probable
that this strain will reach Finland.

In his estimate, fewer than 1 percent of the tuberculosis
strains in Finland have developed resistance to drugs. In
some countries up to 30-40 percent of tuberculosis cases
are caused by drug resistant strains.

On the other hand, the avium intracellulare bacteria,
which causes the so-called fowl tuberculosis, has been
found in AIDS patients to some extent.

Main Population Not Threatened

Of all tuberculosis cases in the world, 95 percent occur in
developing countries. Migratory movement has caused
tuberculosis to become more prevalent in the West.

According to Professor Tala, tuberculosis possibly car-
tied by refugees and immigrants is still not a problem as
long as we are cognizant of the danger. “Considering
modern drugs and our current resources, tuberculosis is
quite treatable today. The disease does not constitute a
threat to the population at large,” he assured.

“During the 1930's, tuberculosis was so common in
Finland that every hour a sufferer died from it. The
majority of the population contracted the disease.
Tuberculosis is a strange disease, in that one can become
ill immediately, in a few weeks, in a year, or even 80



24 LATIN AMERICA

work. Opening the event, Dr. Jorge Perez Avila, the
director of the sanatorium in Santiago de las Vegas,
mentioned that the strategy followed here with AIDS
patients is based on man’s right to life and to receive
medical care and social security. But he said that he
believes that citizens’ duties must go hand in hand with
these rights.

For his part, Dr. Rodolfo Rodriguez, the director of
epidemiology at the Ministry of Public Health, asserted
that the policy we have followed with this disease has
made it possible to keep the levels of infection lower than
in other nations, as has been verified by institutions like
the WHO. He stated that AIDS is not a serious health
problem in Cuba.

The first case of AIDS in Cuba was reported in 1986.
Since then, 851 seropositive cases have been detected. Of
these, 151 have become ill, and 83 have already died.

Researchers Seek To Identify AIDS Virus
Variants

FL0211151092 Havana Radio Progreso Network
in Spanish 1200 GMT 2 Nov 92

[Text] Scientists from Cuba’s AIDS research laboratory
have recently instituted a system of vigilance over the
variants of the virus that are circulating in our country,
with the objective of identifying their characteristics
from the biological and genetic point of view as well as in
other ways. Dr. Francisco Machado, director of Cuba’s
AIDS research laboratory, said this work seeks to iden-
tify the variants that exist in Cuba, detect any new
variants of this same virus, and form a national virus
stock bank.

GUYANA

National AIDS Secretariat Confirms 333 Cases

FL3110015692 Bridgetown CANA in English
2108 GMT 30 Oct 92

[Text] Georgetown, Guyana, Oct 30, CANA—Guyana
has 333 confirmed cases of the deadly acquired immune
deficiency syndrome (AIDS), head of the National AIDS
Secretariat, Dr. Edgar London, said here Friday.

He said 103 new cases were recorded for the first nine
months of this year, compared with 60 for the corre-
sponding period last year.

During the first three months, 28 people tested positive,
43 in the second and 32 in the third.

Dr. London says the recorded drop in confirmed cases in
the second quarter was due to reduced testing because of
a shortage of “certain kits” to conduct testing.

“We were out of certain kits so that testing was held up
for about two or three weeks and that is the reason for
the drop in numbers, but perhaps the number in the last
quarter might be a larger numbers,” he said.

SIPRS-TEP-92-021
23 December1992

London said the AIDS Secretariat has recorded about
750 cases of HIV (human immuno-deficiency virus
which causes AIDS) and has multiplied the figure by 10
according to international practices to get an estimate of
HIV cases countrywide.

He said the secretariat is focusing heavily on education
as the major source of prevention.

Guyana’s first confirmed AIDS case was reported in
1987, but London said he suspected a young girl died of
the disease in 1983.

HONDURAS

Public Health Official Reports on AIDS

92WE0705A San Pedro Sula TIEMPO
in Spanish 2 Sep 92 p 4

[Text] Tegucigalpa—Treatment for a patient with
Acquired Immune Deficiency Syndrome (AIDS) costs
6,000 lempiras, Enrique Zelaya, head of the AIDS Pre-
vention Campaign, reported yesterday.

The official said that to date, 3,146 persons have been
infected with the Human Immunodeficiency Virus
(HIV) and 2,064 of these individuals have now devel-
oped AIDS. San Pedro Sula has 831 of the cases and 288
are in the capital.

Men make up 65 percent of the cases, while 55 percent of
the asymptomatic carriers are women, “asymptomatic”
meaning that they are infected but have developed no
symptoms.

In August alone, 43 cases were reported. Three of these
are children under the age of 10 infected by their
mothers. The number of cases recorded so far this year
exceeds last year’s total. Health officials predict that if
the disease continues at this accelerated rate, some 6
million lempiras will be spent on it in 1993.

Zelaya said the extra budget allocated for AIDS is 6
million lempiras, funds used on education, the purchase
of equipment, and Health personnel. The allocation
sought for next year is 2.8 million, plus another $600,000
in international aid.

He said the average life expectancy of Hondurans is 62
and that most AIDS victims die at around the age of 27
or 28. In other words, their lives are shortened by more
than 30 years, with the resulting impact on the country’s
productive process.

Over 97 percent of our people are aware of the existence
of AIDS, according to polls conducted by the Ministry of
Health, but still reject means used to prevent the disease,
particularly the condom.

The official said it is the people who live on the northern
coast who are the most opposed to using condoms—only
six or eight out of 10 do—in contrast with those in the
central zone, where 100 percent use them.



8 SUB-SAHARAN AFRICA

And to formulate ways of increasing the detection of TB
by contact screening and also strengthening the follow-
up services to reduce the defaulter rate; to still try and
forge good communication between the City of Harare
and other bodies dealing with TB (Ministry of Health
and Child Welfare, Chitungwiza Town Council, the
police, the army and prisons); and to emphasise TB as an
important public concern.

The existing facilities which were currently over-
stretched had to be improved; drug supply had to be
improved so as to have short course therapeutic regi-
mens and discourage resistance; involve all members of
the medical fraternity and the public in TB control;
increase the level of health education about TB so as to
yield a high voluntary turn-out and awareness of TB/
HIV explosion; develop further ideas of community-
based care especially in view of the limited hospital
space and to divert more resources, both human and
material to TB control.

Network Formed to Set Up HIV/AIDS Database

93WE0042B Harare THE HERALD
in English 15 Aug 92 p 3

[Text] A national network of individuals and organisa-
tions involved in the collections and analysis of HIV
infections and AIDS cases has been set up to integrate
the widely fragmented efforts which have so far charac-
terised the local nature of the fight against the killer
disease.

The new body, Zimbabwe AIDS Information Network
(ZAINet), was formally established in Harare yesterday
at a day-long seminar which followed an initiative set in
motion in February by the Southern Africa Foundation
for Economic Research.

A steering committee has been in place laying the
groundwork for the eventual formation of the network. A
formal committee was expected to have been elected by
the end of yesterday’s seminar which was attended by
scores of people from non-governmental organisations
and the private and public sectors.

SAFER is an independent economic research foundation
whose research focuses on, among other things, commu-
nity development and democratisation with emphasis on
creating societies where citizens have access to informa-
tion and decision-making.

ZAINet is expected to support the Ministry of Health
and Child Welfare in its data collection programme and
assist organisations and individuals in the collection,
analysis and interpretation of information on the AIDS

JPRS-TEP-92-021
23 December1992

epidemic. It will also involve, and provide service to a
wide range of institutions in information, policy and
public awareness.

In an interview at the seminar, in Harare, SAFER
executive director Cde. Joshua Mushauri said a SAFER-
commissioned study had established that AIDS was
rapidly spreading in Zimbabwe and indicated that the
country’s population could drop significantly as a result,
seriously affecting its economic capability.

The study had also shown that AIDS awareness efforts
were fragmented with individual efforts to reflect the
problem often failing to show the true picture.

“We were so concerned about this misrepresentation
that we decided to form a group of all these people,” said
Cde Mushauri.

Such is the general concern about AIDS information
dissemination that, opening the seminar, the Minister of
Health and Child Welfare, Dr. Timothy Stamps told
seminar delegates: “Do not be unguided missiles. If you
want to shoot, use a single rifle not a shotgun—there is a
tendency to shoot with a shotgun.”

He said use of AIDS information carried a heavy respon-
sibility. The information on the disease had to be used to
promote interest in control measures and to quantify
those measures and not to alarm the public.

“And that information has to be fed back to suppliers.
But, most importantly, use of the information must
promote human dignity. Feedback must be promoted.
We need to develop observation as to how the exotic
ways of HIV transmission impinges on social life,” he
said.

The minister said a total of 14,023 AIDS patients and
23,500 HIV-related cases had been reported since
screening began in 1985, bringing the total to about
40,000. About 20 percent were children under five for
both categories.

ZAINet hopes to take the message in a three-pronged
programme strategy.

The first of these will be the establishment of a comput-
erised database of records of HIV and AIDS cases from
as many sources as possible within Zimbabwe but par-
ticularly from its network.

The second aspect will seek to encourage members of the
network and other researchers to develop and use new
analytical tools and models.

ZAINet will also be expected to take steps to provide
regular, preferably quarterly, bulletins on trends in the
AIDS epidemic.


JPRS-TEP-92-021
23 December1992 .

BURMA

Health Minister Leaves for AIDS Conference in
India

BK0511145792 Rangoon Radio Burma in Burmese
1330 GMT 5 Nov 92

[Text] A Myanmar [Burmese] delegation led by Rear
Admiral Than Nyunt, minister of health, left by air this
morning for New Delhi to attend the Second Interna-
tional AIDS Conference for Asia and Pacific from 8 to
12 November. Rear Admiral Than Nyunt, health min-
ister, was seen off at the airport by Colonel Pe Thein,
minister of education; U Khin Maung Thein, energy
minister; Dr. Klaus Wagner, WHO resident representa-
tive in Yangon [Rangoon]; and directors general and
responsible officials from Health Ministry departments.

CAMBODIA

Overview of VD Problem

93WE0057A Bangkok BANGKOK POST in English
10 Oct 92 p 2

[Text] Phnom Penh (Reuter)}—Sexually transmitted dis-
eases, the hidden enemy of soldiers down the ages, are
hitting the ranks of Un peacekeeping force in Cambodia,
medical and military sources say.

The civilian and military chiefs of the United Nations
Transitional Authority in Cambodia (UNTAC) have
expressed serious concern over the problem.

A memorandum posted on unit notice boards talks of
“the growing number of venereal disease cases reported
amongst various component personnel.”

“The matter needs urgent attention in view of the three
cases of AIDS detected amongst the residents of red-light
localities,” it said.

UNTAC has yet to compile figures but medical sources
said on average about three or four cases of sexually
transmitted diseases a day were diagnosed at a field
hospital and a clinic run by the German army.

The most common afflictions are gonorrhea, syphilis,
and scabies. The deadly AIDS is not widespread in
Cambodia—the country was isolated from most of the
world during a decade of warfare—but is emerging.

More than 15,000 soldiers from 31 different countries
are in Cambodia to oversee the transition from war to
elections. There are also several thousand UNTAC
police and civilians.

Prostitution, widespread in the capital before UNTAC’s
arrival, is now more prolific than ever in establishments
ranging from hotel dance-halls to squalid shacks in
shantytowns. Many of the prostitutes are poor young
girls from neighboring Vietnam.

EAST ASIA 11

“Tt is inevitable. You cannot put thousands of young
men into an isolated place, away from their families and
where prostitutes are easily available, and expect it not to
happen,” said an UNTAC medical source.

He also said it would be wrong to point the finger at
soldiers alone. Police, civilian officials, staff of non-
government aid and relief agericies, and even foreign
journalists show up at clinics for treatment.

“Initially I never thought we would have so many cases,”
Indian Lt-Col V.K. Singh, UNTAC deputy chief medical
officer, told Reuters.

The Germans brought 50,000 condoms with them but
not many people had asked for them, one source said.

“African units ask for protection because they have good
AIDS education at home,” he said. “The Europeans
don’t so much. It’s a typical male thing to get drunk and
do it without thinking.

“People might be buying condoms on the local market
but these are poor quality and break easily.”

Some officers have threatened to send men home who
catch a dose, the sources said. Religious beliefs and
customs—there are many Catholics and Muslims—
might discourage the use of condoms.

The problem is made worse because many UNTAC
personnel go for “rest and recreation” in the Thai capital
Bangkok and resort of Pattaya, where the sex industry is
huge.

Thai businessmen are also visiting Phnom Penh in
droves.

“UNTAC adds to the problem but you cannot blame it
on the mission alone,” said a medical source.

“Cambodians are very promiscuous too. We get many
women coming for treatment who are not prostitutes
who must have caught it from the husbands.”

HONG KONG

Local Hospitals Refuse HIV, AIDS Patients

HK1810064192 Hong Kong SOUTH CHINA SUNDAY
MORNING POST in English 18 Oct 92 p 3

[Article by Kavita Daswani]

[Text] The majority of Hong Kong’s private hospitals are
turning away patients infected with the HIV virus—a
policy that has been described as “ignorant” and “dis-
criminatory” by health experts and AIDS campaigners.

The hospitals are refusing to continue treating anyone
found carrying the virus, and transfer the patients to a
Government facility—usually the AIDS unit at the Queen
Elizabeth Hospital. The policy is justified by the hospitals,
which claim they do not have the right facilities.