SJPRS-TEP-91-020
24 September 1991

Twenty-five state CID chiefs from throughout the
country attended the one-day biannual conference
focusing mainly on improvement in the department’s
operations and public-police cooperation and the overall
security and crime situation in the country.

TAIWAN

Draftees Ordered to Take AIDS Test

WA0823104091 Hong Kong THE HONG KONG
STANDARD in English 24 Jul 91 p 10

[Text] TAIPEI: Taiwan’s health authorities have ordered
that all military draftees and high-risk groups be given
mandatory tests for AIDS to prevent its spread, officials
said yesterday.

“We have sponsored special programmes since last year,
giving AIDS tests for all draftees and having all public
hospitals conduct such tests on suspected patients and
blood donors,” said Ou Nai-ming, a specialist at Tai-
wan’s AIDS Prevention and Control Centre.

Mandatory tests had also been conducted in all prisons
and reformatory centres here, while licensed prostitutes
were required to take the tests, said Huang Cheng-yi, a
specialist of the Institute of Women and Children Health
Care.

Mr. Ou said two draftees and two prisoners were found
to have contracted AIDS last year.

Health officials admitted that alarm over AIDS arose
only after six students were found to be carriers of the
deadly virus early this month.

Currently, Taiwan has 204 confirmed carriers of the
AIDS virus, but doctors say the actual number may
exceed 2,000.

THAILAND

Army Says New AIDS Test Detects Virus More
Quickly

BK1708034891 Bangkok THE NATION in English
17 Aug 91 p A2

[Text] The Army Medical Department laid claims yes-
terday to having developed a technique to detect the

EAST ASIA 15

AIDS virus after it has invaded human bodies for only
24 hours and tests on more than 50 cases had turned in
accurate results.

The department chief, Surgeon-General Lt Gen Phinyo
Siriyaphan, said the technique had been developed by
the Faculty of Biochemistry of King Mongkut Medical
College nine months ago.

He said current practice could reveal the AIDS infection
three months after contracting the virus. He added the
new method can tell within 24 hours whether a person
got AIDS.

Capt. Dr. Suwicha Chitrapatima of the faculty said the
technique sought to detect AIDS or HIV virus in chro-
mosomes of white blood cells. Chromosomes are thread-
like bodies found in all living cells; it contains genes
which determine what characteristics the animal or plant
will have.

Acquired Immune Deficiency Syndrome or Human
Immunodeficiency Virus destroys white blood cells
which act like guards against all diseases and irregulari-
ties which have entered the body.

Suwicha said since the technique checked for irregulari-
ties in white blood cells, it could show up the infection
only 24 hours after exposure.

The doctor said the technique, which would cost Bt150
for each check, could also tell the amount of virus in the
body.

Suwicha said he hoped that the technique would help
slow down the spread of AIDS. He said people would try
not to pass the virus once they learn they have acquired
the killer disease.

He said the technique could be used to check whether
new-born infants from AIDS-infected mothers have
been infected. The check could be done 24 hours after
birth instead of waiting for 15 months as was the case
currently, Suwicha added.

Phinyo said the technique had been used on over 50
people and yielded accurate results.



IJPRS-TEP-91-020

36 WEST EUROPE 24 September 1991
Lisbon
Extramarital Sex
(Individuals Age 21 and Over)
Men Women
Admitted 207 8.9
Estimate of Partners’ Infidelity 14.9 37
Lisbon
Perception of Personal Risk of AIDS
No Yes Never Thought of It
Individuals under age 21 674 20.3 12.3
Individuals age 21 or over 73.5 20.5 6.0
Lisbon
Change in Behavior Due to AIDS
Did Not Change ‘Changed No Answer
Individuals under age 21 74.9 13.2 11.9
Individuals age 21 and over 73.5 13.8 12.7
Lisbon
Use of a Condom in the Past Year
Never ‘Occasionally Almost Always Always No Answer
Individuals under age 21 40.7 24.6 22.8 12.0 -
Individuals age 21 and over $2.2 19.3 8.8 8.0 11.3
Lisbon
Number of Sexual Partners in the Past Year Cited by Persons Under Age 21
Number of Sexual Partners
1 2or3 4orS 6 or more No Answer
Men 49 25 6 8 12
Women 80 10 1 1 8
Lisbon
Number of Sexual Partners in the Past Year Cited by Persons Age 21 and Over
Number of Sexual Partners
1 2or3 dors 6 or more No Answer
Men 60 20 6 5 9
Women 79 7 2 2 10
Numbers and AIDS By 31 March 1991, 317 Portuguese had died of AIDS.

As of 31 June 1991, 676 Portuguese had contracted
AIDS, 54 more than on 31 March. Of the total, 543 were
men and 79 women, with 328 residing in Lisbon and 46

in Porto.

[passage omitted]

AIDS is not a disease for which reporting is compulsory
in Portugal.

The AIDS Group is conducting the first epidemiological

study among drug addicts. [passage omitted]


32 WEST EUROPE

threatened cities of Africa, would then have to demon-
strate whether and according to what pattern vaccination
may also reduce the risk of natural infection. Despite the
clear-cut planning, it will be some years yet before that
stage is reached. Until then, Gerhard Hunsmann hopes
most of all that “they give us enough money and leave us
to get on with it.”

PORTUGAL

AIDS Poll, Research Reveal Extent of Problem

AIDS Campaigns ‘Insufficient’

91WE0475A Lisbon SEMANARIO in Portuguese
20 Jul 91 p 28

[Text] The Portuguese people are dissatisfied with the
performance of those responsible for AIDS prevention and
information. This Norma/SEMANARIO poll reveals that
the overwhelming majority of Porto and Lisbon residents
consider the anti-AIDS campaigns inadequate by far. And
this is not a simple majority: It represents 77.3 percent of
those interviewed in Porto and 85 percent of those in
Lisbon.

SJPRS-TEP-91-020
24 September 1991

This opinion is, obviously, even more marked among
men than among women and maintains a moderate
balance among the various age groups. The inhabitants
of the south complain more than do those in the north of
the campaigns’ inadequacy—85.3 percent dissatisifed in
Lisbon, as compared with only 77.3 percent in Porto.

As for learning whether summer has an effect on Portu-
guese sexual habits, the replies to the first question leave
no room for doubt. Nearly all think that AIDS alarms
people more during the summer season. A considerable
although clearly a minority number are equally concerned
during summer and the rest of the year. Finally, and
inexplicably, a group ranging between 3 and 11.9 percent is
less concerned about AIDS during the hot weather months.
Why? The rise in room temperature probably reduces the
power of rational over corporal motivations.

The conclusion that may be drawn from this poll is that, in
this realm of behavior, we are still quite different from our
fellow Community members, who often appear saturated
with information on AIDS. In Portugal, habits are stodgy,
the advertising of condoms causes controversy, the discus-
sion of sexual matters is usually deliberately superficial,
and silence is golden. This is probably why the number of
persons stricken by AIDS increased so much last year,
while stabilizing in other countries. Who is to blame? Do
we have to attain the Spanish or French statistics to discuss
the issue more?

Lisbon
Sex Age
Total Male | __Female 1834 | 3854 | Over 84
With summer and tourism, are people more or less concerned about AIDS?
More concerned 747 74.6 747 813 75.0 68.0
Less concerned 8.7 11.9 6.0 6.3 ILS 8.0
Equally concerned 16.0 11.9 19.3 12.5 13.5 22.0
No answer 87 13 = = = 2.0
‘Are anti-AIDS campaigns sufficient or insufficient?
Sufficient 13.3 9.0 169 16.7 173 60
Insufficient 85.3 91.0 80.7 833 82.7 90.0
No answer 13 = 24 = = 4.0
Porto
Sex Age
Total Male [___ Femate 18-34 35-54 Over 54
With summer and tourism, are people more or less concerned about AIDS?
More concerned 80.0 75.4 83.5 80.4 76.5 83.7
Less concerned 73 92 5.9 10.7 39 7.0
Equally concerned 12.7 15.4 10.6 89 19.6 93
No answer = _ — - = =_
‘Are anti-AIDS campaigns sufficient or insufficient?
Sufficient 213 16.9 24.7 21.4 176 25.6
Insufficient 773 83.1 2.9 76.8 804 744
No answer 13 = 24 18 2.0 =



JPRS-TEP-91-020
24 September 1991

Available evidence, the report says, suggests South
Africa is at the early stage of a potentially massive
epidemic. Key findings of the actuarial model used by
the compilers show that by the year 2000 it is estimated
there will be 5.2-million HIV positive people (i.e. diag-
nosed as having latent AIDS) and cumulative AIDS
deaths of 667,000. By 2005, there could be 7.4-million
HIV infected individuals and cumulative AIDS deaths
of around 2.9-million.

Health Minister on Economic Implications of
AIDS

MB1907123491 Johannesburg South African
Broadcasting Corporation Network in English
1100 GMT 19 Jul 91

[Text] The minister of national health and population
development, Dr. Rina Venter, has appealed for the
establishment of an independent organization to advise
her department on the economic implications of AIDS.

Dr. Venter says nearly 300 people are infected with the
AIDS virus daily. Fifty are babies whose mothers are
carriers.

Dr. Venter said companies would have to start taking
this into account and begin altering their policies to suit
the implications.

Minister Comments on AIDS Statistics

91WE0508B Johannesburg THE CITIZEN in English
20 Jul 91 p 13

{Text] About 300 South Africans are infected every day
by the virus that causes AIDS, says Health Minister Rina
Venter.

Speaking at the opening of the AIDS Economic Forum,
at Midrand yesterday, Dr. Venter said estimates indi-
cated at least 100,000 South Africans were infected with
the virus. They were mainly young adults of both sexes
and children born to infected mothers.

These were conservative estimates, based on carefully
planned scientific surveys, she said.

Because of the long latency between infection and even-
tual illness, there had been less than 800 confirmed cases
of AIDS.

In five capital cities in eastern and central African
countries, one in four of all young adults were infected
with the virus.

“This underlines the diffuse nature of the pandemic, and
the need to mount a united wide-ranging response.”

Dr. Venter said the Department of National Health and
Population Development had set up AIDS training and
counselling centres and a dedicated AIDS Unit.

SUB-SAHARAN AFRICA 9

The conference was attended by representatives of sev-
eral major corporations, trade unions, the AIDS Advi-
sory Group and self-governing states.

Another speaker, insurer Mr. Peter Doyle, said AIDS
would slow down South Africa’s growth because skilled
workers would be lost to the work force.

He said the virus was more prevalent among skilled and
educated people.

The business sector should plan now for the replacement
of skilled workers. Companies should also impliment
information programmes on AIDS to prevent the
spreading of the disease.

Unions, Businesses Form Committees To Fight
AIDS

91WE0508A Johannesburg THE CITIZEN in English
20 Jul 91 p 15

[Text] Two committees were formed yesterday to coor-
dinate formal business and trade union efforts in the
fight against AIDS.

The committees were formed during an AIDS confer-
ence held at Midrand by the Department of National
Health and Population Development.

Although no official titles have been given to the com-
mittees, the first is an economic advisory group con-
sisting of Mr. Peter Doyle, of Metropolitan Life; Mr.
Graham Prentice, of Old Mutual; Professor Willie
Mostert, of the Human Sciences Research Council; and
Mr. Nicky Padaychee.

Consensus on the projections of the economic advisory
group has not yet been reached.

The second group will aim at pooling resources and
making them available to the formal business sector and
trade unions.

It will provide a central resource centre which will
disseminate information on AIDS, provide education
programmes, do counselling and co-ordinate a policy in
the work-place.

This group consists of Dr. Jonathan Blumberg, of the
University of the Witwatersrand, Ms. Dawn Mokgobo of
Anglo American Corporation, Mr. H. Breedt, of the
Federation of Staff Associations; Dr. Manda Holmshaw;
Mr. Kenneth Marcus, of the AIDS Foundation; Mr.
Francois Marais, of Life Officers’ Association; and Dr.
Izak Fourie, of the Chamber of Mines.

Government Establishes AIDS Hotline
MB1708064691 Johannesburg SAPA in English
0556 GMT 17 Aug 91

[Text] Pretoria Aug 17 SAPA—South Africa has become
the first country in the world to offer a 24-hour AIDS


IJPRS-TEP-91-020
24 September 1991

In addition, the ministry knows of 350 people who are
only carriers, that is, they have the AIDS virus but have
not developed the disease. The authorities estimate that
approximately 15,000 people are in this condition but do
not know it.

According to the statistics, homosexuals are the group
most affected by this ailment (57 percent), bisexuals (14
percent), and hemophiliacs (10 percent).

In descending order, the list continues with heterosex-
uals, newborns, blood transfusion victims, and intrave-
nous drug addicts.

The AIDS virus is transmitted through sexual contact,
blood transfusions, and injections infected by people
with the virus.

The AIDS Control Department has indicated that out of
the 271 registered cases, 87 people are still alive, the
whereabouts of 10 is unknown, and 174 have already
died.

The sickness has mostly affected men. Some 248 men
(91.5 percent of the total) have the sickness, as opposed
to only 23 (8.5 percent) women.

The number of women with AIDS tends to increase and
the same occurs with heterosexuals.

According to the same source, most cases involved
young men between 23 and 34 years old and, although
most of them are from San Jose, there are also AIDS
victims in all the provinces and in all economic levels.

CUBA

AIDS Reference, Orientation Center Opens in
Havana

FL2808135991 Havana Radio Rebelde Network
in Spanish 2300 GMT 27 Aug 91

{Report by Susana del Calvo]

[Text] Up to now, AIDS is a disease that has no cure and
has turned pandemic in a few years. Nowadays, it
constitutes a scourge to humankind. We have not been
immune to this and over 600 carriers have been detected
so far. Although it is true that our anti-AIDS program
has caused controversy in the world it is also true that we
have been able to halt the geometric progression of the
disease which is rampant in the rest of the globe. This
alone speaks in favor of the Cuban program.

A few days ago we read a report from Colombia in which
Health Minister Camilo Gonzalez asserted that, in
Bogota alone, one out of 250 people in the streets has
AIDS. The Colombian capital is a city with a population
of some 6 million people. WHO AIDS expert, Michael
Melsum, said 10 million adults and 1 million children
have been affected by the AIDS virus world-wide. The
specialist adds that there will be 40 million adults and

LATIN AMERICA 19

children with AIDS in the year 2,000. He explained that
each mother infected with AIDS loses at least one child.

Prevention is an effective weapon against this disease. It
is the only existing weapon. Prevention includes the use
of prophylactics and the election of a partner. Making
love should not be a sport or a simple competition but a
conscious act between you—who are the responsible
party—and the selected partner.

A lot can be said about this subject and we are interested
in also learning about your opinions. I believe that more
cultural activities should be held such as the concert
given by Evesio Alejandro in December marking the
world’s day against AIDS.

I congratulate the Public Health Ministry for creating an
AIDS reference and orientation center located in I Street
between 23d and 25th Streets here in Vedado. At the
same time, I believe that it needs more publicity because
not everyone goes by the place and the information can
stay up in the air. I think this center is very important
and that similar centers will open in the rest of the
country, especially in heavily populated cities.

HONDURAS

AIDS Victims Estimated at 35,000

91WE0481A San Pedro Sula TIEMPO in Spanish
19 Jun 91 p 2

[Text] Tegucigalpa—The director of epidemiology of the
Ministry of Public Health, Doctor Enrique Zelaya, said
on June 18 that approximately 35,000 persons in the
country might be infected by the ‘Acquired Immunode-
ficiency Syndrome (AIDS).

So far, 1,130 confirmed cases of the disease have been
recorded, but according to Zelaya the number of infected
persons nationally is in the neighborhood of 35,000.

‘We are diagnosing two or three cases of AIDS daily,
mostly persons who became infected four years ago and
who are still developing the symptoms,’ he stated.

The official said that of the 1,130 confirmed cases, 65
percent are men and 35 percent women.

He pointed out that during the last three years two children
per month contracted the disease, and the infection has
developed in 35 children under the age of 10.

‘When an infant develops the infection it generally dies
before reaching its first birthday; when adults develop
the disease they die in two or three years.



SJPRS-TEP-91-020
24 September 1991

Poll Reveals Fear, Awareness of AIDS

91WE0485B Lisbon DIARIO DE NOTICIAS
in Portuguese 23 Jul 91 p 2

[Excerpts] The majority of Portuguese consider AIDS to
be the most worrying disease of this century, placing it
ahead of cancer, hepatitis B, and stress. They are wor-
ried, yes, but they are also aware, since two-thirds of the
Portuguese consider themselves well informed about the
rules for preventing acquired immunodeficiency syn-
drome. This is revealed by a DIARIO DE NOTICIAS/
Marktest poll that included indicators on how informed
and concerned the Portuguese are about health.

For example, it is learned that 66.9 percent of the
Portuguese have never had a checkup and that 33.1
percent of our citizens nationwide have at some time
undergone that type of thorough medical examination as
a means of prevention. Of those who have done so, 46.5
percent do so regularly, and 53.5 percent do so only
sporadically. Of those who get that type of examination,
an overwhelming majority—82.2 percent—consider it
“very important,” 16.8 percent feel it is “somewhat
important,” zero percent think it is “not very impor-
tant,” and 1 percent are of the opinion that such an
examination is “not important at all.”

On the question of which diseases are considered the
most worrying of this century, 54.8 percent of the
Portuguese feel that AIDS occupies that position, 28.2
percent say it is cancer, 10.2 percent say that hepatitis B
is more worrying, and 6.9 percent choose stress.

On the question of how well informed people are con-
cerning AIDS, 76.7 percent of the Portuguese consider
themselves well informed about the rules of prevention,
and 23.3 percent say they are poorly informed.

Concerning cancer, 25.2 percent of the Portuguese say
they have thought about having a scan, but in the case of
hepatitis B, only 16.4 percent have thought about doing
so. [passage omitted]

Have you ever had a checkup?

WEST EUROPE

37

In your opinion, what is the most worrying disease of the

century?
Answer Percent
AIDS. 54.8
Cancer 28.2
Hepatitis B 10.2
Stress 69

Answer Percent
No 66.9
Yes 33.1

Do you consider youself well informed about the rules for

preventing AIDS?
Answer Percent
‘Well informed 16.7
Poorly informed 23.3

Technical Data

This poll is representative of the population over 18 and
less than 65 years of age residing in homes with tele-
phones in the areas of Greater Lisbon (municipalities of
Lisbon, Oeiras, Cascais, Amadora, Sintra, Loures, and
Almada) and Greater Porto (municipalities of Porto,
Matosinhos, Vila Nova de Gaia, Gondomar, Valongo,
and Maia).

The sample was selected by the quota method on the
basis of sex and age.

The homes to be contacted were selected randomly, as
was the individual to be interviewed in each home, the
proper quota requirements being observed.

A total of 305 individuals were contacted by the tele-
phone interview method during the period between 9
and 18 July 1991.

Considering the size of the sample used, the maximum
sampling error (P=50) (with a degree of confidence of 95
percent) is 5.6 percent.

The computer-assisted interviews were conducted from
Marktest’s offices in Lisbon and Porto and were vali-
dated and checked using the Marktel system. Responsi-
bility for carrying out the poll belongs to Marktest, which
conducted it in accordance with the Code of Practice
published by Esomar (European Society for Opinion and
Marketing Research), to which Marktest subscribes.

Note: Responsibility for interpreting the results belongs
to DIARIO DE NOTICIAS in accordance with the
ethical and formal principles contained in the “Journal-
ists Guide to the Publication of Opinion Survey Results”
by Robert M. Worcester, published by Esomar.



IPRS-TEP-91-020
24 September 1991 4 AIDS

Developments in Fight Against AIDS. .......
Help From WHO [Madras INDIAN EXPRESS, 16 Jul 91]
Probe in Delhi /New Delhi PATRIOT, 17 Jul 91] ......
Details of Tamil Nadu Fight Against AIDS [Madras THE HINDU, 2 Aug 91]
IRAN

Regime Claims 300 Infected with AIDS /London KEYHAN, 4 Jul 91] ....

Hemophiliacs Infected With AIDS /Tehran KAYHAN INTERNATIONAL,

Four Hundred Cases of AIDS Confirmed /London KEYHAN, 8 Aug 91] ....
SOVIET UNION

Children Infected With AIDS at Volgograd Hospital
[Bjorn Arild Hansen and Jan P. Solberg; Copenhagen BERLINGSKE TIDENDE, 3 Sep 91]

WEST EUROPE
REGIONAL AFFAIRS

EC 1991-93 AIDS Action Plan Outlined
[Luxembourg OFFICIAL JOURNAL OF THE EUROPEAN COMMUNITIES, No L175,
4 Jul 9]...

DENMARK

Agency To Lead International AIDS Project

[Kirstin Sorrig; BERLINGSKE TIDENDE, 25 Jun 91]
Minister Backs Disclosure of AIDS Cases {Copenhagen BERLINGSKE TIDENDE, 26 Jul 91]
First County AIDS ‘Support Corps’ Formed.

[Copenhagen BERLINGSKE TIDENDE, 31 Jul 91] .....
Greenland Sets Safe-Sex Campaign /Nuuk GRONLANDSPOSTEN, 2 Aug 91]
AIDS Victims To Get Benefits Before Death

[Sten Jensen; Copenhagen BERLINGSKE TIDENDE, 7 Aug 91]

GERMANY

29

AIDS Vaccine Tested Successfully on Primates [Klaus Koch; Bonn DIE WELT, 8 Jul 91]
PORTUGAL

AIDS Poll, Research Reveal Extent of Problem
AIDS Campaigns ‘Insufficient’ [Lisbon SEMANARIO, 20 Jul 91]
Behavior Surveyed [Isabel Coutinho, Isabel Salema; Lisbon PUBLICO, 27 Jul 91]

Poll Reveals Fear, Awareness of AIDS [Lisbon DIARIO DE NOTICIAS, 23 Jul 91] ..


30 WEST EUROPE

With his statement, Per Hors maintains the Medical
Association’s previous standards of violations of profes-
sional confidentiality. Namely, that this should be disre-
garded in this one situation. But he also thinks that with
regard to the HIV and the AIDS issue, it is equally
important to discuss the problems as the society is
constantly changing.

Not Thoroughly Thought Out

The National Association of Gays and Lesbians thinks
that the appeal may have incaluclable consequences for
the future fight against AIDS infection.

The National Association of Gays and Lesbians calls the
minister’s appeal both dangerous and not thoroughly
thought out because the result will be an alarmed popu-
lation that no longer dares go to the doctor. On top of
that, the HIV-infected are often in a situation where they
need medical and psychological aid the most. This will
bring about the opposite results in connection with the
fight against infection, says the National Association of
Gays and Lesbians.

First County AIDS ‘Support Corps’ Formed

91WE0486B Copenhagen BERLINGSKE TIDENDE
in Danish 31 Jul 91 p 2

[Ritzau News Agency (RB) report: “First HIV/AIDS
Corps”]

[Text] Odense (RB}—Fyn County is the first in the
country to start forming a corps of volunteer support
people who can fill an acute need for both emotional and
practical support for people who are HIV positive and
AIDS victims.

The purpose is to break a vicious circle of apathy-anxiety
and isolation that often follows in the wake of a diagnosis
of HIV infection and leads to many so-called social
hospital admissions, according to FYENS STIFTSTI-
DENDE.

The Fyn County finance committee has appropriated
325,000 kroner for setting up a social network for those
infected with HIV or suffering from AIDS.

A working group of Fyn AIDS Info and Odense Hospital
representatives is behind the experimental project.

The group has expanded on experiences from a similar
support project in San Francisco.

Greenland Sets Safe-Sex Campaign
91WE0486C Nuuk GRONLANDSPOSTEN in Danish

2 Aug 91 p 3
[Article by “JTH”: “Use Condoms”]

[Text] Nuuk—There are a great many wonderful things
about life in Greenland but it is necessary to take

JPRS-TEP-91-020
24 September 1991

precautions, for otherwise things could change drasti-
cally. Such a change could occur if AIDS becomes
widespread in Greenland, for example.

That is the message in Paarisa’s condom campaign this
year.

In coming weeks Paarisa, the Greenland Contraception
Council, will make a special effort to combat the threat
of AIDS. In a series of ads on KNR-TV people will be
reminded that life is wonderful if you take care to keep it
that way.

In a press release Paarisa writes that the council will
work hard to get people to use condoms if they have
more than one sexual partner or if their partner falls in
this category.

Along with the TV ads Paarisa will send posters, stickers
and condom samples to stores, restaurants, and taxi
services. Paarisa is hoping that the stores, restaurants,
and taxi drivers will support the campaign by selling
Paarisa’s “A.N.” condom, which stands for “AIDS?
Naamik.” (AIDS? No thanks.)

“There is a lot that is wonderful about life in Greenland
but it is necessary to take precautions for otherwise it
could be changed drastically, as would happen, for
example, if AIDS becomes widespread,” the Contracep-
tion Council writes and continues: “This is true of the
individual who is stricken with AIDS and it also applies
to society as a whole. By protecting yourself from sexual
diseases you are helping prevent the spread of AIDS,”
Paarisa concludes.

AIDS Victims To Get Benefits Before Death

91WE0486A Copenhagen BERLINGSKE TIDENDE
in Danish 7 Aug 91 p 5

[Article by Sten Jensen: “Law Change Will Help AIDS
Victims”—first paragraph is BERLINGSKE TIDENDE
introduction]

[Text] A current case involving a father with AIDS is a
factor in a proposal to change the compensation law so
that in the future the full amount can be paid to people
who are mortally ill. This will be a ministerial decision.

“We are preparing a revision of the law here at the
Occupational Injury Board in cooperation with the
Social Affairs Ministry.

“The current question of whether there should be greater
latitude to capitalize (pay the full amount, Ed.) payments
to people who are mortally ill will be thoroughly exam-
ined. But ultimately this is a ministerial decision,” said
Occupational Injury Board section chief Ole Pontopp-
idan.

The statement was a comment on the case of an AIDS-
stricken family man Ib Pedersen who, as we reported


16 EAST EUROPE

YUGOSLAVIA

Over 200 Registered AIDS Cases
LD0709095891 Belgrade TANJUG Domestic Service
in Serbo-Croatian 1044 GMT 6 Sep 91

[Text] Belgrade, 6 Sep (TANJUG)—Belgrade still holds
the infamous record for the number of registered AIDS

JPRS-TEP-91-020
24 September 1991

cases. According to the latest information, 114 AIDS
cases are reported in Belgrade out of 225 cases registered
in the country. So far, 60 people have died of AIDS in
Belgrade. [passage indistinct] In central Serbia, 130
AIDS cases have been registered so far, in Vojvodina 15
and in Kosovo and Metohija four.


2 NEAR EAST & SOUTH ASIA

INDIA

First AIDS Victim in Kolhapur

91WD1065 New Delhi PATRIOT in English
11 Jul 91 pS

[Text] Kolhapur, 10 July (PTI)—Acquired Immune
Deficiency Syndrome (AIDS) claimed its first victim in
the city, a 45-year-old woman, who died in the Chhatra-
pati Pramila Raje Hospital here last night, civil surgeon
Dr. R.A. Pathak told PTI today.

Mrs. Baby Jagtap was admitted on 26 June to the
hospital, he said.

A team of experts, comprising World Health Organisa-
tion member and adviser to the State Government Dr.
Bhadkamkar, deputy secretary of public health Atre and
programme officer Dr. Subash Salunkhe, is scheduled to
visit the city on Saturday to review the situation and
extent to which AIDS had spread in the city, Dr. Pathak
added.

Developments in Fight Against AIDS

Help From WHO

91WE0498A Madras INDIAN EXPRESS in English
16 Jul 91 p 6

[Text] New Delhi, 15 July (UNI}—The World Health
Organisation (WHO) has agreed to provide assistance of
more than $1.3 million for financing the action plans to
combat AIDS in Maharashira, Tamil Nadu, West Bengal
and Delhi.

Minister of State for Health and Family Welfare D.K.
Tara Devi informed the Lok Sabha in a written reply on
Monday that Maharashtra would receive $445,000, West
Bengal $367,000, Tamil Nadu $287,000, Delhi $142,000
and Manipur $63,000.

The control measures included information, education
and communication about sexually transmitted diseases,
she said.

The Minister was asked to comment on a news item
appearing in a section of the press stating that a U.S.
Congressman had reported India to be on the brink of an
AIDS catastrophe.

She said the U.S. Congressman who had visited India in
April this year had based his estimates on prevalence of
infection among prostitutes and spread of infection
among their clients in Bombay.

Probe in Delhi

91WE0498B New Delhi PATRIOT in English
17 Jul 91 p 5

[Excerpt] The government has instituted a high-level
inquiry to review arrangements for dealing with AIDS/
HIV positive cases in all the 13 hospitals in the Capital

JPRS-TEP-91-020
24 September 1991

including the All India Institute of Medical Sciences
[AIIMS], Health Minister M.L. Fotedar told the Rajya
Sabha on Tuesday, reports PTI.

He told Mr. Ghufran Azam and Mrs. Satya Bahin in a
written reply that the review had been ordered after the
Government's attention was drawn to reports of AIIMS
doctors refusing to deliver a baby of an AIDS infected
woman in May this year. [Passage omitted]

Details of Tamil Nadu Fight Against AIDS

91WE0512 Madras THE HINDU in English
2 Aug 91 p 3

[Text] Madras, Aug 1—The AIDS control programme in
Tamil Nadu has got a boost with WHO assistance of
$286,000.

The nearly Rs. 7.25-crore aid will be used for health
education and training, surveillance and control, labora-
tory support, and programme management. The amount
is to be spent over a one year period for prevention and
control of AIDS in the State.

Getting top priority under the assistance is the health
education and training component which will cover four
groups—the policy makers, general public, high risk
groups and medical personnel. The WHO will also make
available equipment such as computers, audio-visual
aids, and certain laboratory reagents.

The aid was finalised by the State Government a couple
of days ago after the WHO representative, Dr. Kodaka-
weich, who is in charge of the National AIDS Control
Programme and attached to the Union Ministry of
Health, had discussions with the State Government
officials and medical professionals connected with pro-
gramme implementation. A quarterly report on the pro-
gramme will have to be furnished to the WHO.

Surveillance programme

As part of the surveillance programme, the AIDS cell at
the Madras Medical College has taken up ‘sentinel
surveillance’ of patients coming to the various outpatient
departments of the General Hospital.

Under this scheme, blood samples of patients coming to
the O.P. departments are taken without knowledge of the
patients and getting details from them. A number of such
samples have found to be seropositive for HIV and most
of them are from those coming to the STD department
and professional blood donors.

Besides this, the samples of all blood donors at the
Government hospitals and a few private hospitals are
screened at the AIDS cell at the MMC. About 150 to 200
blood samples are screened every day and roughly seven
per 1,000 samples prove positive for HIV. The AIDS cell
also receives ‘query clinical cases’ for testing, especially
the blood samples of those who suffer fever of unknown
origin for a long time.


18 LATIN AMERICA

The system of “conjugal visits” begun in 1984, permit-
ting sexual contacts between prisoners and their part-
ners, is also of concern, says Schechtmann, because it
helps transmit AIDS both from the prisons to society
and from society to the prisons.

“I do not make any moral judgements on the conjugal
visits,” the doctor says, “but rather on their effects in
transmitting AIDS. Every week 350 visits occur in the
Penitentiary and 2,000 in the House of Detention. In the
Penitentiary it has already been possible to create cri-
teria for such visits, such as submitting men and women
to tests. But in the House of Detention there is a great
deal of resistance on the part of the administration.”

Homosexual practices in prison also contribute. It is not
uncommon for transvestites who are already infected to
enter the prison, and not warn anyone for fear of
discrimination. They then become a source of trans-
mittal.

Overcrowding in the prisons contributes significantly to
worsening the problem. Dirty, dark, and overcrowded
cells (often housing triple the number of people than
their capacity) lead to growing promiscuity and a general
deterioration in health. In addition, health facilities are
weak and a shortage of water for bathing and personal
hygiene is “normal.”

Despite the overcrowding, the severity of the legal
system hampers the freeing of prisoners who could
already be out of jail or in a system of partial incarcer-
ation. That includes terminal AIDS patients who should
have the right to spend their last days with their fami-
lies—as mandated by the World Health Organization, of
which Schechtmann is a member.

In general, living conditions in the prisons are a night-
mare worthy of Franz Kafka. “Stored leftover food
contributes to the spread of pests, particularly rats and
cockroaches, from which the prisoners are covered with
bites,” says Professor Sergio Adorno of the USP [Uni-
versity of Sao Paulo] Nucleus for Studies of Violence, in
his article “The Brazilian Penitentiary System,” from
USP Magazine no. 9 (March-May 1991).

The result, says Schechtmann, is an outbreak of diseases
that had been believed to be eradicated. In the first five
months of 1991, 161 new cases of tuberculosis, 22 cases
of hepatitis and three of hanseniase appeared.

“If we continue in this way, within five years we will not
need a prison director, but rather hospitals, because
everyone will be sick,” Schechtmann stated.

Sao Paulo—400 New AIDS Cases in June

91WE0464C Sao Paulo O ESTADO DE SAO PAULO
in Portuguese 12 Jul 91 p 10

[Text] The State of Sao Paulo has already recorded
12,000 cases of AIDS, with 400 new ones diagnosed in
the month of June. Most of them (61 percent) occurred
in the capital, where the highest incidence continues to

IJPRS-TEP-91-020
24 September 1991

be in the central area (29 percent) and in the neighbor-
hoods of the northern zone (19.3 percent). These num-
bers come from the Secretary of State for Health’s Center
for AIDS Research. A study by the Center, which is still
in progress, shows that the disease is concentrated in
areas where the poorest social classes live—a conse-
quence of the use of intravenous drugs with shared
needles.

“While an addict of reasonable purchasing power aspires
to an entire dose of drugs to himself, the poorest ones
dilute the cocaine and succeed in sharing the dose among
four users through injection,” explains Dr. Paulo Rob-
erto Teixeira, who coordinates the Research Center. In
interviews he had with users, the doctor heard that
cocaine produces a greater effect when injected. He also
found that the user always sucks a little blood into the
syringe, the result of hitting a vein. “It is that blood from
a contaminated user that, reinjected into someone else’s
vein, spreads the disease,” he said.

Shooting Gallery

Doctors’ concerns with the spread of the disease among
drug users increased with the recent discovery of the first
Brazilian “shooting gallery,” a bar where the user buys a
dose of cocaine already in the syringe, injects the drug
and returns the syringe to the proprietor. The “shooting
gallery,” relatively common in the United States, but
which was identified in Brazil for the first time by a
Research Center specialist, was in a city in the interior of
the state, the name of which the doctors requested not be
released.

The explanation for the secrecy is that from an epidemi-
ological point of view nothing would be resolved if the
police were to close that luncheonette. What doctors
want is to study the phenomenon and seck a formula that
will assure the use of disposable syringes, or at least
disinfection of the syringes.

Implementation of the third phase of the federal govern-
ment’s AIDS campaign—which will begin to be televised
next month—will exhaust the $500,000 collected this
year by the Health Ministry’s AIDS Coordination in
Brasilia for broadcasting information on the disease.
This money had been donated by ten private companies.

COSTA RICA

AIDS Advances In Country; 174 Deaths

PA1408223491 Paris AFP in Spanish 0125 GMT
12 Aug 91

[Text] San Jose, Aug 11 (AFP)—The Health Ministry has
confirmed that AIDS cases have increased every year
since the first diagnosed case in 1983. So far, 174 people,
including three foreigners, have died of this disease.

The AIDS Control Department reports that 271 cases
have been registered over the past seven years, including
70 in 1990 and 40 until July 1991.


JPRS-TEP-91-020
24 September 1991

Monday, is demanding full payment of an injury com-
pensation of 440,000 kroner now instead of in monthly
installments of around 3,000 kroner.

Tb Pedersen fears he will die within a short time and if
that happens his family will not see one krone of the
compensation. Next Monday he will start a hunger strike
in front of Christiansborg in protest.

Paid 1.2 Million Kroner

Preben Groes, department manager of the Occupational
Injury Board, said the man had received around 1.2 million
kroner since the middle of the 1970’s in occupational injury
benefits and compensation for the AIDS he incurred and
now wants the remainder paid in a lump sum.

The law says that one can ask to have compensation
entirely or partially capitalized unless the administration
considers this financially unadvisable.

And that is precisely what happened. It would clearly be an
advantage for Ib Jensen [as published] to have the sum
paid in full, but unfortunately for him the Social Appeals
Board ruled in favor of the Occupational Injury Board.

GERMANY

AIDS Vaccine Tested Successfully on Primates
91MI0437 Bonn DIE WELT in German 8 Jul 91 p 19

[Article by Klaus Koch: “Glimmer of Hope for AIDS
Vaccination”]

[Text] There are growing signs that a vaccine against the
HIV immunodeficiency virus could be developed by the
end of the millenium, despite the fact that as little as
three years ago many scientists were pessimistic about
whether vaccination against the AIDS virus would ever
be possible at all.

The most recent success has been announced by the
Goettingen Primate Center, where Professor Gerhard
Hunsmann’s team has succeeded in protecting four out
of seven rhesus monkeys from SIV [Simian Immunode-
ficiency Virus] with four inoculations over a period of 16
weeks. SIV is closely related to the human AIDS virus,
and in rhesus monkeys it provokes an immunodeficiency
similar to that found in humans. An American group
reported similar results with rhesus monkeys last year.

“Back to basics” could be the watchword of the success at
Goettingen. Well-tried but laborious methods were used to
produce the vaccine. To make only a few milligrams,
monkey viruses had to be isolated from 100 liters of cell
culture medium. “Back-breaking work,” is how Professor
Hunsmann describes it. A detergent, a soap-like com-
pound, was then used to extract the protein components
from the virus concentrate, and any surviving viruses were
killed with an ether treatment. Aluminum hydroxide, an
additive that assists immunization was then added to the

WEST EUROPE 31

solution. This is how vaccines against influenza and mea-
sles viruses have been produced for over 20 years.

Although the traditional method of vaccine production
used in Goettingen seems safe, a future HIV vaccine,
should there ever be one, is unlikely to be made in this way
to rule out the risk of contamination by living viruses. For
this reason, the crucial virus components must be identi-
fied now so that genetic engineering methods can subse-
quently be used to make them from bacteria or other cells.
This method of vaccine production also has other advan-
tages: There is no danger of infection, even during produc-
tion, the vaccine can be produced with consistent quality,
and manufacturing costs are significantly lower.

The mixture used in Goettingen must now be separated
into its fractions. It will then be possible to identify
systematically those virus proteins which, individually or
in combination, actually produce the protection against
living viruses. Here again, the European work-sharing that
is behind the Goettingen team’s success will come into its
own. Nine institutes from six EC countries had shared out
the research work between them on a rational basis in
order to save on animal experiments, resources, time, and
money. The success of the team at the German Primate
Center shows that the European concept adopted for the
“First European AIDS Vaccine Trial,” to give it its official
title, was the correct one.

What must now be examined is how long the inoculated
monkeys will retain their immunity and whether the
reason why three of the animals were not immune was
merely that they were given too small a dose of the vaccine.

Apart from the protective effect itself, the Goettingen team
hopes it has uncovered a second important detail. Only in
the blood of the four protected monkeys did the SIV
infection trigger the multiplication of an important cell
group of the immune system, to which the T-cells belong.
If it is confirmed that this easily measurable reaction is a
sure sign of immunity, a large number of animal experi-
ments and a whole year’s work could be saved, says
Hunsmann. Instead of using live monkeys, many of the
experiments required in the search for the virus com-
ponenets responsible could be carried out on animal blood
samples.

However the crucial SIV proteins are found, the next step
consists in transferring the results to the human AIDS
virus. Only at this stage does Hunsmann contemplate
experiments involving chimpanzees. Unlike rhesus mon-
keys, anthropoid apes can be infected with the human
AIDS virus, but they do not develop the typical symptoms
of the disease. Last year, an American team succeeded in
inoculating three chimpanzees, man’s closest relative in
the animal kingdom. However, the very fact that chimpan-
zees are so rare means that detailed, prolonged series of
experiments on these animals are out of the question.

Finally, if an HIV vaccine really does promise long-term
protection, trials will have to be run on human beings.
Tests on high-risk groups such as homosexuals, and pos-
sibly also large-scale test programs in the particularly



IJPRS-TEP-91-020
24 September 1991

HONG KONG

Carriers Recruited in War on AIDS

WA2208080091 Hong Kong SOUTH CHINA
MORNING POST in English 28 Jun 91 p 3

[Article by Helen Signy]

[Text] Prostitutes, drug addicts, homosexuals and car-
riers of the HIV virus will be recruited to spread infor-
mation about AIDS to people the Government has been
unable to reach.

The Director of Health, Dr. Lee Shiu-hung, admitted
yesterday the Government's information campaigns had
only had limited success because they were not able to
reach people most at risk from AIDS without appearing
to be coercive.

He was speaking at the launch of the Hong Kong AIDS
Foundation, established with a $15 million grant from
the Government to achieve more community participa-
tion in the battle against the fatal disease.

“The Government in the past has been trying to
approach prostitutes and homosexuals, but there are
problems because being the Government, we can’t go all
the way to approach them,” Dr. Lee said.

“We plan to recruit volunteers, and we aren’t concerned
about their background. It could be a person in a high
risk group or a person who already has the infection—it
doesn’t matter if they can help in communicating the
message to their friends,” he added.

A total of 49 AIDS cases have been recorded in Hong
Kong, of whom 36 have died, while it is estimated there
are between 3,000 and 5,000 carriers of the HIV virus in
the territory who have not yet developed the full-blown
disease.

The Government’s AIDS information campaign was
introduced in 1983, two years before Hong Kong’s first
AIDS patient was diagnosed.

“The AIDS Foundation will take a more positive step
and actively approach the people at risk: being a volun-
tary organization, it will have more flexibility and can
introduce more innovative ideas than the Government,”
Dr. Lee said.

The AIDS Foundation is likely to be inaugurated on
World AIDS Day, on 1 December.

Twelve More AIDS Victims Found in Territory
WA2208101091 Hong Kong SOUTH CHINA

MORNING POST in English 3 Jul 91 p 7
[Article by Helen Signy]

{Text] AIDS has struck 12 more people in Hong Kong,
with eight men contracting the HIV virus and four

EAST ASIA 13

developing the full-blown disease last month, the Gov-
ernment announced yesterday.

The head of the AIDS Counselling and Health Education
Service, Dr. Patrick Li Chung-ki, said all the new AIDS
patients were Chinese, three of them heterosexuals and
one a haemophiliac.

They bring the total number of AIDS patients so far
recorded in Hong Kong to 53, of whom 36 have died.

Two expatriate men and six Chinese men were also
infected with the HIV virus, four of them through
homosexual intercourse, three heterosexual, and one
whose method of transmission was undetermined.

There are now 177 people who have been recorded as
carrying the HIV virus without yet developing the full-
blown disease.

The Government estimates, however, that there could be
3,000 to 5,000 carriers of the virus in Hong Kong.

World figures indicate that 70 percent of AIDS victims
are heterosexuals, which is likely to rise to 80 percent by
the year 2000.

Meanwhile, a new multi-purpose disinfectant which can
kill both the HIV and hepatitis viruses is being marketed
in Hong Kong for use in hospitals, hotels, the police force
and penal institutions.

The product manager for Jebsen Chemical, Ms. Marie-
Louise Lycke, said the new Phoraid iodine-based disin-
fectant could kill viruses for up to a year without
harming equipment or skin. It was developed in Britain
last year for the Greater Manchester Police Force to be
used when officers came in contact with bodily fluids.

Ms. Lycke said the disinfectant could be used by airlines,
caterers, dentists, chemists, doctors and beauty thera-
pists and was being tested by the police, the Correctional
Services Department and hospitals.

“Even if you have a wound, it will close it and protect
you if you’re in contact with blood so you won’t be able
to get AIDS or hepatitis,” she said.

The Government used chlorine to disinfect apparatus
which had been in contact with AIDS or hepatitis
patients, but that was smelly and corrosive, she said.

Government approval for an antiseptic form of Phoraid
is expected by August.

First AIDS-Infected Prostitute is Found

WA0823091691 Hong Kong THE HONG KONG
STANDARD in English 1 Aug 91 p 6

[Article by Ursula Yeung]

[Text] The first case in Hong Kong of a prostitute testing
HIV-positive has been found.



JPRS-TEP-91-020
24 September 1991

new cases are appearing among women, indicating that
both sexes are equally susceptible to the disease.

By age group, the epidemiological data at our disposal
show that young people between 20 to 40 years of age are
more exposed to infection by the AIDS virus than are
other groups. However, although the numbers are still
low, the prevalence of serum-positive results among
new-born infants should be noted, indicating that a large
number of women who conceive carry the AIDS virus.

Although HIV-2 has been detected in Mozambique,
most of the diagnosed cases are still of the HIV-1 type.
However, the distribution of cases by age group indicates
that HIV-2 occurs more frequently in the older groups,
whereas HIV-1 is more frequent in the younger age
groups.

This may be explained by the fact that, according to
scientific studies of the behavior of each of the types of
virus, the period of incubation for the HIV-2 type is
longer than it is for HIV-1. [passage omitted]

Counseling Centers

91WE0476B Maputo NOTICIAS in Portuguese
20 Jul 91 p 4

{Excerpt] The AIDS Coordination Center [CCS] is orga-
nizing a counseling service for AIDS patients and HIV-
positive individuals, aimed not only at providing the
psychological and social support that AIDS patients
often need, but also to contribute to the continuing
education of the citizens, to persuade them to effect a
change in their sexual conduct.

The counseling centers, as the word itself implies, will
function to give advice on how to behave and what kind
of life to lead to avoid spreading the disease, among
other aspects.

Since last January, a counseling service has been func-
tioning at the Central Hospital of Maputo, for patients
interned in the various wards; at this time it is seeing
patients in at least five wards.

Based on the work already in progress, it is expected that
by the end of this year the counseling service will be open
to the public, functioning, in a first phase, at the Central
Hospital of Maputo, and gradually, also starting this
year, in the general hospitals and health centers in the
capital.

Considering that Maputo Province is one of the two
zones in the country with a large number of diagnosed.
cases, this year the AIDS Coordination Center, through
the Counseling Service now being created, also plans to
initiate pilot counseling services in the cities of Chimoio
and/or the district seat of Manica, a few meters from the
border with Zimbabwe.

ACCS spokesman said that a variety of actions are being
taken to organize and train the personnel who will be
involved in counseling the public about AIDS.

SUB-SAHARAN AFRICA 5

A recent survey showed that, although the nurses and
other technicians at the Central Hospital of Maputo
know about AIDS, they are not yet really prepared to
work with patients and counsel them.

A major training and education effort has been in
progress for two months, to equip the health personnel to
handle AIDS patients and HIV-positive individuals, the
number of whom is becoming alarming.

About a year, ago, a survey conducted in Maputo showed
that many residents did not believe in the existence of
any AIDS victims. Today, few people are in any doubt
about the existence of AIDS—and if there are still any
who have doubts, we are prepared to offer proof. [pas-
sage omitted]

Manica Province: Sixty Confirmed AIDS Cases

MB3108112991 Maputo Radio Mozambique Network
in Portuguese 1045 GMT 31 Aug 91

[Excerpt] Since June, another eight confirmed AIDS
cases have been reported in Manica Province. Four of
those cases were detected in Manica District, on the
border with Zimbabwe, a country where many con-
firmed AIDS cases have been reported. Manica Province
now has 60 confirmed AIDS cases. [passage omitted]

AIDS Cases in Six Provinces Increases to 251

MB1409125291 Maputo Radio Mozambique Network
in Portuguese 1030 GMT 14 Sep 91

{Text] The number of AIDS cases increased to 251 in
July. A total of 18 cases have been diagnosed in only six
provinces.

Another two AIDS cases have been confirmed in Cabo
Delgado Province, bringing to 15 the number of con-
firmed AIDS cases since the first case was reported in
that province in 1986.

NAMIBIA

Over 900 AIDS Cases; Control Program Planned

91WE0503A Windhoek TIMES OF NAMIBIA
in English 21 Jul 91 p 3

[Article: “Condoms for All in New AIDS Drive”]

[Text] The National AIDS Control Programme will
move into full gear with a National Safe Sex Promotion
Week in July.

The drive will include a chain of seminars and panel
discussions, promotional material, and radio and TV
programmes.

National co-ordinator of the National AIDS Control
Programme, Abner Xoagub, indicated that a large
number of condoms would be distributed free of charge
to the public.



28 WEST EUROPE

- Support for the European Centre for the Epidemiolog-
ical Monitoring of AIDS (WHO-EC Collaborative
Centre in Paris) in order to continue to ensure that there
is a reliable and widely accessible database at Commu-
nity level and dissemination of epidemiological data and
reliable analyses.

- Study on the feasibility of establishing common and/or
comparable methodologies for gathering data on HIV
infection, with due regard for the principle of the confi-
dentiality of personal data and of appropriate informa-
tion for the persons concerned.

ACTION 8: Enhancement of human resources

- Surveys of pre- and post-qualification training given to
public health workers and to workers responsible for
health care, social support and counselling for HIV-
infected persons and persons close to them; exchange of
experience.

- Introduction of an exchange programme for the profes-
sionals concerned.

- Exchange of information and promotion of appropriate
teaching materials and tools to accelerate the education
and continuous training of professionals.

ACTION 9: Measures to combat discrimination against
HIV-infected persons and persons close to them

- Regular analysis at Community level, in cooperation
with the Member States, of situations which might be
discriminatory.

- Exchange of information on measures taken by the
Member States to avoid discrimination.

- Where necessary, proposal of appropriate measures at
Community level.

ACTION 10: Research and international cooperation

- Contribution to Community action within the third
framework programme of research and contribution to
the field of international cooperation.

© OJ No C 158, 17. 6, 1991.

©) Opinion delivered on 29 May 1991 (not yet published
in the Official Journal).

© OJ No C 10, 16. 1. 1991, p 3.
DENMARK

Agency To Lead International AIDS Project

91WE0443A Copenhagen BERLINGSKE TIDENDE
in Danish 25 Jun 91 p 9

[Article by Kirstin Sorrig: “AIDS Is Hitting More and
More Women”—first paragraph is BERLINGSKE
TIDENDE introduction)

JPRS-TEP-91-020
24 September 1991

[Text] A new research project supported by the Danish
International Development Authority (DANIDA) is to
provide more information about skin diseases and
AIDS. The center of the project will be the Bispebjerg
Hospital, which is to cooperate with research workers
from Haiti, Brazil, and Thailand, where AIDS is
increasing explosively. “Observation of developments
has shown that women are in just as much danger as
men,” a research worker on AIDS from Thailand says.

“Women are infected with AIDS just as easily as men.
There is no reason to believe that they are more resis-
tant.” The Thai AIDS research worker from the Univer-
sity in Chiang Mai, Prakong Vithayasai, is completely
convinced of that after following the development of
AIDS since the first case occurred in Thailand in 1984.

Prakong Vithayasai was here in Copenhagen recently in
connection with a new program of international cooper-
ation between the Bispebjerg Hospital and research
workers from Thailand, Haiti, and Brazil. The project,
which is supported by DANIDA, is to collect material on
skin diseases in connection with AIDS for a period of a
year.

Material from the three countries, which all are experi-
encing an explosive increase in the number of AIDS
cases at present, is to be assembled and analyzed at the
Bispebjerg Hospital.

As was mentioned in BERLINGSKE TIDENDE yes-
terday, the new official AIDS figures for Thailand show
that about 300,000 individuals are HIV-positive. That
figure is expected to increase to 575,000 by the end of
1991. The greatest spread is taking place in the Chiang
Mai area, and Bangkok is in second place in that respect.

“We discovered the first HIV-positive prostitute in the
Chiang Mai area in 1988. An explosive increase has
taken place since then that shows that women are in at
least just as much danger as men. Spot-checks show that
1 percent of the pregnant women in the area are HIV-
positive. That is an enormously large number by com-
parison with Denmark, for example,” says Prakong
Vithayasai.

Checks also show that more than half of the prostitutes
are HIV-positive after working as prostitutes for six
months. After six to 12 months, more than 70 percent
are infected. There is a big difference among the girls in
different categories. At the moment, 72 percent of the
“cheapest ones” and 16 percent of the “most expensive
ones” are infected.

“The girls can have up to 30 customers a day, so the
danger of infection is very high,” Prakong Vithayasai
says, “and it is spread over the entire country, for it
certainly is not just foreign tourists who use the services
of prostitutes. Thai men are also frequent customers.
They begin when they are still young because, according
to Thai standards, such relationships are not acceptable


IPRS-TEP-91-020
24 September 1991

Children Infected With AIDS at Volgograd
Hospital

PM0509132291 Copenhagen BERLINGSKE TIDENDE
in Danish 3 Sep 91 p 1

[Report by Bjorn Arild Hansen and Jan P. Solberg: “268
Soviet Children Injected With AIDS”)

[Text] Leningrad—A little prick in the arm was all the
268 children noticed at the Russian hospital in Elista two
years ago. But today most of these children are dead,
HIV-positive, or ill with AIDS. For all of them were
injected using the same needle.

Today the children are behind the walls of a hospital
outside Leningrad. It was never intended that the world
should know anything about their fate. But the director
of Russia’s AIDS hospital, Dr. Yevgeniy Voronin, has
now come forward to tell their story.

SOVIET UNION 25

The 268 children were patients at a hospital in Elista
south of Volgograd and were suffering from other ill-
nesses when the tragedy happened two years ago. At the
hospital a child was born which, it was later discovered,
was HIV-positive and subsequently died. But before it
died the baby received an injection and the same syringe
was used on the other children in the hospital.

The 268 children have all been called to the AIDS clinic
southeast of Leningrad. So far only 70 of the children
have been to the clinic because their parents must foot
the transport bill themselves.

But now the Salvation Army has entered the picture. It is
paying for all the sick children’s travel. Of the first 70 all
but three were infected.

Voronin fears that the number of those HIV-positive will
far exceed the 268 who so far have been identified and
shown signs of infection. “They are only the tip of the
iceberg,” he said. He expects that the final figure for
those infected at the Elista hospital will be double the
current figure.


2 SUB-SAHARAN AFRICA

A recent study by Peter Doyle also showed that AIDS
would not result in a negative growth rate.

On the demographic effects of HIV and AIDS in Zim-
babwe, Mr. Whiteside said studies showed there would
not be a fall in the population level in that country either.

It was more likely that the population growth would
decline and then stabilise.

“Unfortunately, there will probably be an increase in
infant mortality and many potential mothers will die.”

But AIDS could also have a positive result.

“Education campaigns will lead to changing behaviour
patters with fewer multi-partner relationships, the use of
condoms, and most importantly—the empowerment of
women—with them having the ability to space births.

“This could result in a decline in the birth rate for the
right reasons,” he said.

Mr. Whiteside said prevalence of the disease in Zim-
babwe was among the wealthier class, although it would
eventually spread to the lower socio-economic groups.

“As with all diseases these people will be more vulner-
able. They will have lower nutritional status, will be
more subject to other diseases, will not have the same
access to information and may not have the ability to
make behavioral changes.”

This was backed up by Dr. Sher, but he said South Africa
was the exception in the region.

Figures here showed AIDS was not restricted to one
particular class but affected the entire society.

He said the eventual cost of AIDS to South African
society would depend on many factors.

“It depends on the drugs that are developed and whether
AIDS patients are hospitalised.

“If they are hospitalised and treated with AZT the cost to
the country will be exorbitant.”

Alternatives would have to be looked into, including
home care with regular visits by counsellors, doctors and
nurses.

“That may not be warranted at the moment, but we’re
definitely going to have to look at alternatives (to hospi-
talisation).”

Mr. Whiteside said Zimbabwe would also need alterna-
tives to hospitalisation.

“T believe there is an urgent need to establish home-
based care and a treatment protocol.

“It is not fair to expect doctors to make decisions about
the level of treatment they are going to provide HIV
patients.”

JPRS-TEP-91-020
24 September 1991

BENIN

Seminar on AIDS Begins; Statistics Announced

AB0908194591 Cotonou Office de Radiodiffusion-
Television du Benin Radio Network in French
1930 GMT 7 Aug 91

[Excerpt] A seminar on AIDS has begun in Abomey. The
facilitators and supervisors will update the knowledge of
nurses, midwives, and assistant nurses about AIDS. On
the line to Abomey is Eloja Kouapo with the details:

Kouapo: AIDS has become one of the greatest health
concerns of our time. It affects children, youth, and
adults, both men and women. AIDS has become a major
health problem in Benin, where the first case was
detected in 1985. Since then, the number of AIDS cases
has risen from 84 as of 1 January 1990 to 158 as of 30
July 1991. In the absence of a known cure or vaccine, the
only available tool for combating AIDS is to inform and
educate the public. [passage omitted]

DJIBOUTI

AIDS, HIV Situation, Prospects Reviewed

91WE0502A Djibouti LA NATION DE DJIBOUTI
in French 20 Jun 91 p 4

[Article entitled: “Epidemiological Status of Human
Immunodeficiency Virus (HIV) Infection and of AIDS
in the Republic of Djibouti”; first two paragraphs are LA
NATION DE DJIBOUTI introduction]

[Text] The AIDS virus, which according to the World
Health Organization (WHO) will infect 40 million
people by the year 2000, remains a “scientific challenge”
that will be reflected by the Seventh International AIDS
Conference opening Sunday in Florence (Italy).

From Monday to Friday, researchers will take stock of
the progress they have made in knowledge of AIDS and
[in understanding] how the virus functions. Medications
that are under development and vaccination and immu-
notherapy strategies are on the agenda. We take advan-
tage of this conference to examine AIDS in Djibouti.

Djibouti is one of the African countries to which the
human immunodeficiency virus was a latecomer.
Indeed, the first case of seropositivity was discovered in
1986, and the number of infected persons has grown
steadily since. Whereas in 1986 only one seropositive
case had been diagnosed, seven seropositive cases were
reported in 1987, 27 in 1988, 108 in 1989, and 259 in
1990.

The studies made in the Republic of Djibouti in 1987,
1988, 1990, and 1991 showed that certain population
groups were at high risk for contracting the HIV infec-
tion. They included illegal prostitutes, bar girls, and
patients with sexually transmitted diseases (STDs).
Indeed, while the studies conducted in October 1987


SJPRS-TEP-91-020
24 September 1991

REGIONAL AFFAIRS

Malawi, Zimbabwe, Zambia Lead in Confirmed
AIDS Cases

MB1408135691 Johannesburg SAPA in English
1331 GMT 14 Aug 91

[Text] Harare Aug 14 SAPA—Zimbabwe has the second
highest total of AIDS cases in southern Africa after
Malawi, but the country is nearing the end of the HIV
epidemic, a visiting South African senior research fellow
said in Harare on Wednesday, reports ZIANA National
News Agency.

Mr. Alan Whiteside, of the Economic Research Unit of
the University of Natal and Southern Africa Foundation
for Economic Research fellow, said this when he
addressed a breakfast seminar on the implications of
HIV infection and AIDS to industry.

“Zimbabwe currently has the highest total of AIDS cases
in southern Africa after Malawi,” said Mr Whiteside,
quoting latest World Health Organisation figures which
show that Malawi leads with 7,160 confirmed cases,
followed by Zimbabwe with 5,249.

Zambia has the third highest cases having reported
4,036.

“There is under-reporting of AIDS cases. The under-
reporting may occur because of lack of coverage, people
die without being seen by the Western medical system,
or because of inefficiency.

“I can’t speculate on what level of under-reporting there
is in Zimbabwe. The original cover-up of AIDS data no
longer applies and I think that the country has made
great strides in assessing the true situation,” he said.

AIDS Experts Cited on Impact of Disease in
Southern Africa

MB1908203891 Johannesburg SAPA in English
2012 GMT 19 Aug 91

{Text] Johannesburg Aug 19 SAPA—Contrary to a
recent prediction that the HIV epidemic in Zimbabwe is
nearing an end, AIDS expert Dr. Ruben Sher believes
southern Africa has seen only the beginning of an AIDS
crisis.

But he ruled out the doomsday AIDS figures often seen
in the media recently predicting a majority of the popu-
lation dying of the disease.

Speaking in Harare last week, Mr. Alan Whiteside of the
economic research unit of the University of Natal said
Zimbabwe had the second highest total of AIDS cases in
southern Africa after Malawi.

Malawi leads with 7,160 confirmed cases, followed by
Zimbabwe with 5,249 and Zambia with 4,036.

SUB-SAHARAN AFRICA 1

However, despite a degree of under-reporting, he
believed the HIV epidemic in Zimbabwe was nearing an
end.

“I would guess at the moment, the level of HIV preva-
lence in the Zimbabwean population is between 18 and
20 percent. In my opinion, you are nearing the end of the
HIV epidemic,” Mr. Whiteside said.

“The good news is that it seems that in general, the level
of HIV infection in a population will not exceed 30 to 35
percent.” .

According to Dr. Ruben Sher of the SA [South African]
Institute of Medical Research: “We’re already at an
epidemic level. In fact, there’s a pan epidemic (in
southern Africa) and we’re only at the beginning. More
and more cases are being reported every year.

From the looks of things, Zimbabwe is also only at the
beginning of an AIDS epidemic.

“Figures of 30 to 40 percent saturation level are only a
guideline. In some cities in the United States levels
reached 50 percent.

“It’s true that in some places in the U.S. HIV figures
levelled off, but that doesn’t mean it’s over. There are
constantly young men becoming newly homosexual.
Others are starting to get lax about precautions because
they think the threat of AIDS is over.”

Although South Africa had the lowest total of AIDS
cases—8 18 reported cases by July 1—in southern Africa,
Dr. Sher believed this figure was at least 20 percent
under-reported.

“We have to look at the reasons why,” he said. “There
are political reasons, people don’t want to disclose the
real figures because this will damage tourism and invest-
ment.

“There are not enough doctors who can diagnose AIDS
and there are not enough facilities either.

“Also, there are people who die of AIDS without ever
seeing a doctor.”

Dr. Sher believed AIDS in South Africa would reach
saturation point at 30 to 40 percent of the population,
drawing a parallel with the prevalence of syphilis before
the discovery of penicillin in the 1940's.

“People will change their behaviour as the epidemic
progresses.”

In ruling out the doomsday AIDS predictions, Dr. Sher
said: “It will be more like five to six million South
Africans dying by 2005. This is a worst case scenario and
depends largely on the kind of drugs that are developed
over the years.”

Although the figure was serious, he added it was “more
realistic than the doomsday predictions.”



14 EAST ASIA

The heterosexual population in Hong Kong was yes-
terday urged to practice safe sex when dealing with
prostitutes.

Releasing the latest statistics on AIDS and HIV infec-
tion, the head of the AIDS Counselling and Health
Service, Patrick Li, said the Government had identified
the first AIDS carrier among local prostitutes since it
began testing the group in 1985.

But Dr. Li warned that while the woman might be the
first known prostitute AIDS carrier, she would certainly
not be the only one.

“The fact that there were previous cases of AIDS
reported to have been caused by sexual contact with local
prostitutes tells us that there are more than one AIDS
carrier among local prostitutes,” he said.

Dr. Li said he expected the incidence of identified HIV
infection among prostitutes to increase over the next few
months as more prostitutes came forward for testing.

As the incidence of heterosexual infection rose, the
number of infected prostitutes would also inevitably rise,
he said.

This had been the situation in other Southeast Asian
countries including Thailand, India, the Philippines and
Japan.

Dr. Li estimated that there were “about 10 or maybe
more” AIDS carriers among local prostitutes.

The detected HIV-infected prostitute was receiving
counselling and care by health nurses at a Government
social hygiene clinic, he said.

Health nurses had been sent to places, including bars,
frequented by prostitutes to distribute leaflets on the
killer disease and encourage them to take a HIV test, he
said.

To step up education on AIDS among local prostitutes, a
video would be shown to prostitutes at Government
social hygiene clinics.

Since the beginning of the year, condoms had also been
given to prostitutes seeking treatment at social hygiene
clinics.

“They are given about 30 condoms each every time they
come for check-up. By doing so, we hope to remind them
of the risk they and their clients are exposed to and the
importance of taking precautions,” Dr. Li said.

He said most of the prostitutes the clinics contacted
supported the use of condoms. However, some said
clients did not like using condoms.

Dr. Li warned people to take precautions in contact with
prostitutes, locally and abroad.

IJPRS-TEP-91-020
24 September 1991

He said about 2,000 to 3,000 prostitutes attended the
Government social hygiene clinics—a figure he esti-
mated to be only one-third of Hong Kong’s total number
of prostitutes.

He urged voluntary agencies and private doctors who
had prostitute patients to refer suspected AIDS carriers
to Government hospitals or clinics.

Latest Government statistics show that 179 people have
tested HIV-positive, while 54 have developed AIDS. Of
the 54, 37 are dead and six have left the territory.

SOUTH KOREA

Ministry Confirms 3 New AIDS Cases

SK0309030891 Seoul THE KOREA TIMES in English
3 Sep 91 p3

[Text] Three more people tested positive for the AIDS
virus during August, the Health-Social Affairs Ministry
said yesterday.

Two men, identified as Pak, 35, and Cha, 33, are
believed to have picked up the deadly virus during their
stay in foreign countries, the ministry said.

The ministry is currently tracking down the infection
route of the other man, identified as Yu, 29.

So far, a total of 157 people have tested positive for the
AIDS virus. Of them, 13 died and one went overseas.

MALAYSIA

Anti-AIDS Measures Noted; 1,000 Carriers
Reported

BK1109131291 Kuala Lumpur BERNAMA in English
0942 GMT 11 Sep 91

[Text] Kuching, Sept 11 (OANA-BERNAMA)—Police
are scrutinizing visitors from AIDS-prevalent areas in
Malaysia in efforts to stamp out the country’s number
one public enemy.

CID [Criminal Investigation Department] Chief Zaman
Khan said Wednesday this included isolating detected
cases and deporting them to their country of origin.

The move was part of the overall anti-AIDS campaign to
effectively reduce the number of AIDS carriers in the
country, he told reporters after chairing a meeting of
state CID chiefs here.

He said currently there were slightly over 1,000 AIDS
carriers in the country, but added that the figure was
considered “relatively low” compared with other areas
in the region.

Most of the carriers had been identified as having
acquired the AIDS virus through drug abuse and prosti-
tution activities, he added.



4 SUB-SAHARAN AFRICA

IVORY COAST

Health Minister on Free Treatment Of AIDS
Patients

AB1107070591 Abidjan FRATERNITE MATIN
in French 10 Jul 91 p 3

[Article by Leon Francis Lebry]

[Summary] A film on AIDS, entitled Partners, was
shown at the Hotel Ivoire on 8 July. Present were the
ministers of communications and health. A seminar on
AIDS was held after the session.

At the seminar, the minister of health announced that at
a donors’ meeting from 27 to 28 June, over 3.5 billion
CFA francs were offered to Ivory Coast for funding its
AIDS program in the next five years. The minister also
announced that AIDS patients would now be treated free
of charge at the Treichville teaching hospital because
HIV-infections [as published] and AIDS are now the
number one cause of morbidity and mortality in the
Ivory Coast, notably among men (14 percent of admis-
sions in the clinical wards at the two teaching hospitals)
and the second cause among women.

MALAWI

Minister Reports 15,719 AIDS Cases up to
March

MB2008165691 Dakar PANA in French 1555 GMT
20 Aug 91

[Text] Blantyre (Malawi) 20 Aug (MANA/
PANA)—Health Minister [title as heard] Dr. Hether-
wick Ntaba has disclosed that Malawi had recorded
15,719 AIDS cases up to March 1991. Mr. Ntaba, who
said this in Lilongwe after a one-day meeting of the
National Committee on AIDS, added that the govern-
ment is concerned about the sharp increase in the
number of people dying of AIDS-related diseases. He
noted that AIDS cases had totalled 12,074 in October of
1990,

“The issue of AIDS is very important and we must tackle
it with sincerity and without reservations,” Minister
Ntaba said during a meeting with Malawi Congress Party
delegates, traditional rulers, religious figures, and gov-
ernment officials. Mr. Ntaba noted that 7,000 AIDS
cases had been recorded up to 1989. He added that the
struggle and preventive work against AIDS must be
intensified.

JPRS-TEP-91-020
24 September 1991

MOZAMBIQUE

Country’s AIDS Statistics Being Revised

Breakdown of Cases

91WE0476A Maputo NOTICIAS in Portuguese
20 Jul 91 p 4

[Excerpt] At the end of 1990, there were 314,611 reported
cases of AIDS worldwide, 81,019 of which were on the
African continent. Only 162 of these, or about 0.09 per-
cent, were in Mozambique. At that time, the number was
among the lowest on the African continent, even taking
into account the possibility of underreporting.

Only six months later, although Mozambique is still on
the list of countries that have among the fewest cases, the
situation has changed radically; it is now believed that
we probably have as many cases as other African coun-
tries considered to have low infection rates.

We see that 54 cases were reported from January to May;
that is, an average of 10 cases per month have been
diagnosed throughout the country since January. If, on
one hand, the increase in number is an indication of how
troubling the AIDS problem is, on the other hand it
demonstrates that, to the extent to which the country is
developing the technical and material capacity to suspect
and diagnose cases, we are coming closer to the actual
picture of the extent of AIDS.

From an analysis of the data at our disposal, from 1986,
when the first AIDS case was diagnosed in Mozambique,
to date (July), the number of cases has increased alarm-
ingly. In 1990, the total number of diagnosed cases was
almost triple the number in the preceding year. There
were 37 cases in 1989 and 98 cases in 1990. The
explanation for this is contained in the previous para-
graph.

Analyzing the distribution of cases by province, as in
prior years, we continue to observe that Maputo City has
the largest number of cases, or almost 41 percent of the
total. The nation’s capital is followed by Manica Prov-
ince, with 20 percent of the total cases.

In the case of Maputo City, the high percentage is
explained by the city’s proximity to the National AIDS
Referral Laboratory and by the fact that this is where the
activity and dynamic of the central agencies that are
devoted to the problem have the greatest impact. With
regard to Manica Province, one possible explanation is
the large movement of people between this zone and
Zimbabwe, which is known as one of the African coun-
tries with a large number of AIDS cases.

Up to now, the distribution of reported AIDS cases in
the country indicates that the primary means of trans-
mission is heterosexual, from male to female and vice
versa. Moreover, as time passes, it is observed that more


20 LATIN AMERICA

Report Notes 60 New AIDS Cases Reported
Monthly

PA1108134391 Mexico City NOTIMEX in Spanish
1857 GMT 9 Aug 91

[Text] Tegucigalpa, 9 Aug (NOTIMEX)—Enrique
Zelaya, chief of the Epidemiology Department of the
Health Ministry, has reported that in Honduras there are
approximately 60 new cases of AIDS every month,
which is the equivalent of two new cases daily.

Zelaya told the local media that according to the latest
report on AIDS, issued in July, there are at least 2,055
people suffering from this disease. Of this 2,055 people,
approximately 1,344 are in the final phase, that is, they
have the symptoms and their immunity system is very
deteriorated, Zelaya explained.

Zelaya added that according to Health Ministry esti-
mates, approximately 60,000 people who are infected
with the virus but who show no symptoms, represent a
“grave danger” to the population and move freely
throughout the country.

He said: “Unfortunately, these people think they are
completely healthy. They show no symptoms and we
cannot identify them unless we conduct laboratory tests
on them.”

Zelaya explained that the cities with the largest number
of AIDS cases are San Pedro Sula, Tegucigalpa, El
Progreso, Comayagua, La Cieba, Santa Rosa de Copan,
and Choluteca.

Zelaya said that the health authorities have detected 35
cases of children infected with the virus and noted that
the number could be larger considering that probably
there are asymptomatic cases.

JAMAICA

Health Authorities Report 19 New Cases of AIDS

FL2108171291 Bridgetown CANA in English
1654 GMT 21 Aug 91

[Text] Kingston, Jamaica, Aug 17, CANA—There were
19 new cases of Acquired Immune Deficiency Syndrome
(AIDS) reported in July, pushing the number of Jamai-
cans with the deadly disease to 253, health authorities
reported. The July report from the National HIV/STD
Control Programme says 12 males and seven females
were diagnosed with AIDS.

In all, 168 males and 85 females (including 29 children
under five and three teenagers) have been reported with
the disease. The report indicated that 157 of the adults
with AIDS were infected with the Human Immuno-
Deficiency Virus (HIV) which causes AIDS, during het-
erosexual intercourse. Of the reported AIDS cases, 25 are
male homosexuals, 20 are bi-sexuals, and the sexual
practice of the others is unknown. According to the

JPRS-TEP-91-020
24 September 1991

programme, 129 adults who developed AIDS were
infected in Jamaica and 64 got the virus abroad.

MEXICO

Group Refutes Government's Statistics on AIDS

PA1408220791 Paris AFP in Spanish 0715 GMT
14 Aug 91

[Text] Mexico City, 13 Aug (AFP)—The Mexicans
Against AIDS group, which is made up of nongovern-
mental organizations, issued a communique on 13
March stating that there are 13,208 cases of AIDS in the
country and between 650,000 and 1.3 million HIV-
positive cases.

The organization maintains that the official figures of
7,300 AIDS cases “do not reflect the truth of the epi-
demic,” and refutes the statement that the disease “has
reached its peak, as some public health officials have
claimed.”

“The status of AIDS in Mexico should not be mini-
mized.... The facts indicate that the almost total absence
of permanent, systematic, and efficient preventive cam-
paigns have led to social and individual apathy regarding
AIDS and even taking the test for its detection,” the
group’s document states.

“The less people who take the detection test, the less
detected cases there will be,” the group adds.

PANAMA

Minister Reports 172 AIDS-Related Deaths to
Date

PA2708015891 Paris AFP in Spanish 2239 GMT
26 Aug 91

[Text] Panama City, 25 Aug [date as received] (AFP)—
The Health Ministry announced today that 172 people
have died of AIDS in this country, there are 2,800
carriers, and 108 people are ill with the disease.

Health Minister Guillermo Rolla told AFP that of 280
cases detected since 1984, 237 were men and 43 were
women,

“In most cases, the disease was contacted as a result of
homosexual practices,” Rolla said.

A report issued by the Panama Epidemiological Depart-
ment indicated that there were three cases involving
children under three years of age, and 209 cases of
individuals aged from 20 to 44 years.


JPRS-TEP-91-020
24. SEPTEMBER 1991

Foreign
Broadcast

Information
Service

ANNIVERSARY
1941 - 1991

PRS Report—

Epidemiology

AIDS

“ DITABUTION aT a
SSTRBUTION STATENENT &

Approved for pubile release,
Uniimited i

19980506 028. ==="

REPRODUCED BY
U.S. DEPARTMENT OF COMMERCE
NATIONAL TECHNICAL,
INFORMATION SERVICE
' SPRINGFIELD, VA 22161



JPRS-TEP-91-020
24 September 1991

to the virus will be debated, with a view to the develop-
ment of a national policy as a framework for Cosatu
AIDS programmes.

AIDS is moving up the union agenda: the Food and
Allied Workers’ Union recently adopted an advanced
AIDS policy, and the issue is set to be debated at
Cosatu’s upcoming national congress.

“There is a general concern about the appalling level of
AIDS education aimed at the workforce,” said David
Morake, organiser of the conference, “‘and the unions
need to start building up education for workers.

“The epidemic is growing rapidly, and we are not happy
with government and management attempts to consci-
entise workers about the issue.

“The impression is created that only black people get
AIDS. Government campaigns are racist, or through
smear campaigns, they imply that it is the African
National Congress cadres who are bringing the virus into
the country.”

Education programmes devised by employers were coun-
terproductive in that they reinforced stereotypical views,
and thereby alienated workers. “AIDS information
needs to counter-balance this, and there is a recognition
that worker education is now the responsibility of the
unions,” Morake said, “We will educate employers in
the process.”

Prejudice about AIDS also needed to be addressed, he
added. “Some workers don’t believe that AIDS exists,
and issues are misconstrued.”

Target groups will be identified at the conference, and
appropriate mechanisms set up for education and
training.

Among the issues to be addressed at the conference will
be pre-employment and pre-training testing, AIDS and
migrant labour, state policy and AIDS in relation to
medical and pension benefits.

Attending the conference will be unionists from Aus-
tralia, Zimbabwe and Namibia.

Puppet Group Teaches AIDS Awareness in Rural
Natal

91WE0474A Johannesburg THE WEEKLY MAIL
in English 5-11 Jul 91 p 8

[Article by John Perlman: “65,000 Condoms Later—
Still a Lot To Be Done”]

[Text] Five weeks, 30 towns and 65,000 condoms later,
Nyanga Tshabalala, Rosie Fiore and Gary Friedman
have reason to feel that they’ve done some work.

They have put on 60 performances of their show, “Pup-
pets Against AIDS,” and travelled 10,000 km, heading
northwards from Durban and crisscrossing Zululand on
their route. They have been seen by some 50,000 people,

SUB-SAHARAN AFRICA 7

handed out 40,000 AIDS education pamphlets, dis-
pensed thousands of condoms and answered countless
questions.

The trio has come away with a sobering sense of the
enormous task ahead if South Africa’s rural areas are to
be effectively educated and protected against AIDS.

Natal, urban and rural, is one of the areas where the
human immuno-deficiency virus (HIV) has made
deepest inroads. In some areas blood-transfusion ser-
vices no longer collect blood because of the risks.

And yet the large crowd gathered outside the bottle store
in Jozini—a small hilltop town not far from the point
where Swaziland, Mozambique and South Africa meet—
are getting from the puppets the first comprehensive
AIDS education they’ve had.

“Everywhere we have found that people have heard
about AIDS, but they know nothing about how it is
transmitted—even some of the nurses we’ve met,” says
Tshabalala, who narrates the show. “But people are very
eager to get the knowledge.”

The crowd tap its feet to the music that gets the show
started and laugh at the lusty antics of the main character,
Joe, who just can’t get enough. There are some grunts of
approval when a member of the audience yells “inyama
enyameni” (“flesh to flesh”) after Joe’s friend, Harry,
suggests that he start using a condom. But when Joe
becomes sick and dies—having also infected his wife and
newborn child—the crowd becomes silent and pensive.

That mood finds release in the question-and-answer
session, which runs for nearly an hour.

“Can you get AIDS from mosquitoes? From kissing?
How can I use condoms when it’s so much better without
them?”—It’s a familiar mix of resistance to the things
that can protect you and deep fear of things that can’t
hurt at all.

But there is progress. Piles of pamphlets are handed out
and men and women wait patiently for a handful of
condoms. A couple of people ask if the show can be done
again for some people who arrived late, but it’s time to
move on—another village or town, and another audience
is waiting.

“Puppets Against AIDS,” a project of the African
Research and Educational Puppetry Programme, seems
to get the key messages across.

“The show gets through because it is dramatic,” says a
health worker. “Many people here say that if AIDS is
such a big thing, why do we never see anybody suffering
from it. If you are just a nurse alone, people don’t really
listen to you.”



6 SUB-SAHARAN AFRICA

Xoagub said there were 954 cases of HIV/AIDS cases in
Namibia, with the ratio between men and women
roughly equal.

The main theme of his statement, however, was that
more women were getting infected. According to Xoagub
there were several reasons for this new worrying phe-
nomenon.

Firstly, sex was usually a taboo subject in Africa, and
women were traditionally not even allowed to talk about
or even enjoy sex. They were simply regarded as objects
to satisfy men’s desires, he said.

Polygamous relationships or marriages, in Africa and
Namibia, were also contributing factors to women’s
vulnerability to HIV infection. Further the Christian
background and influence in Namibia was an inhabiting
factor when it came to addressing problems of sexuality.

In addition, illiteracy and unemployment forced women,
especially in urban areas, to turn to prostitution. Another
tragedy was that, as loyal and faithful wives, women were
vulnerable because of unfaithful husbands. Furthermore,
migrant workers and contract workers employed far
from their houses were encouraged to take up casual
relationships. Xoagub said these were only some of the
contributing factors to HIV infection in Namibia.

He emphasized that male domination was still the order
of the day in many fields. “...We need to arm women
with the necessary vocabulary and language to commu-
nicate with their sexual partners in order for them to
practice safe sex,” he advocated.

AIDS, HIV Figure Hits 1,320

MB2908155391 Windhoek THE NAMIBIAN in English
23 Aug 91 pp I, 2

(Unattributed report: “AIDS, HIV Figure Hits 1,320
Mark”]

[Excerpt] Namibians could witness an increase in the
number of AIDS cases and HIV infections in the months
ahead, Health and Social Services Minister Dr. Nicky
Iyambo warned yesterday.

For this reason it was important that health workers
should give their “fullest attention” to the struggle
against “this dreadful disease,” Iyambo added.

The Minister’s serious warning was given at a three-day
workshop on nursing management of HIV-infected
people which opened here on Wednesday night.

Iyambo pointed out that although the latest count of
AIDS and HIV infections stood at 1,320, the incidence
of such cases could be much higher. [passage omitted]

SJPRS-TEP-91-020
24 September 1991

SOUTH AFRICA

AIDS Statistics for Western Cape Revealed

91WE0516A Cape Town THE ARGUS in English
14 Apr 91 pI

[Article by Vivien Horler, Medical Reporter: “Nearly
500 in W Cape With AIDS Virus”]

[Text] There are almost 500 confirmed HIV-positive
people in the Peninsula and Boland—more than in the
rest of the Cape Province, according to the latest figures
from the Department of Health.

And, says a spokesman for the department’s regional
office in Bellville, this figure represents only the people
who have been tested, who are “a small proportion” of
the number of people actually infected.

Another 65 people have tested HIV positive in the
Southern Cape, 40 in the East London area, 14 in the
Port Elizabeth area, and nine in the Kimberley area.

There are now few areas in the Cape which are HIV-free.
Six cases have been reported in Namaqualand, two in
Gordonia, 16 in the Karoo, and three in Walvis Bay.

The spokesman said: “There is no reason to suppose
we're not going to develop the same kind of epidemic
that has happened in countries north of South Africa. We
certainly seem to be heading the same way.”

In October last year about 14,000 pregnant women—half
the pregnant women in South Africa—were tested for
HIV, and this wide-ranging test will be repeated in
October this year. “Those results will be interesting,
seeing how the figures have changed.”

The last results indicated that just under one percent of
the population, excluding the national states, are
infected.

Unions Formulating AIDS Policies

91WE0474C Johannesburg THE WEEKLY MAIL
in English 4 Jul 91 p 12

[Article by Jennifer Pogrund: “Conference on AIDS ‘As
a Union Issue’]

[Text] AIDS as “a union issue” is the main thrust of a
precedent-setting Congress of South African Trade
Unions three-day national conference which starts in
Johannesburg today.

South Africa’s first AIDS conference centring on the
workplace, it will be addressed by world-renowned AIDS
expert Renee Sabatier, international union delegates,
and local lawyers, doctors and union specialists in the
field.

Policies on workers’ education, AIDS in the workplace,
and an assessment of state and management’s response


SJPRS-TEP-91-020
24 September 1991

Article 3

1. The Commission, in collaboration with the advisory
committee referred to in Article 1“, shall continuously
assess the action undertaken and the priorities set.

2. The Council and the Ministers for Health of the
Member States, meeting within the Council, shall carry
out an evaluation of the effectiveness of the action
undertaken.

To this end, the Commission shall submit to the Council
a report on the subject during the second half of 1992.
That report shall also be sent to the European Parlia-
ment.

Done at Luxembourg, 4 June 1991.
The President
J. LAHURE
ANNEX
1991 TO 1993 PLAN OF ACTION

ACTION 1: Assessment of the knowledge, attitudes and
behaviour of the general public and target groups

- Examining the results of surveys on knowledge, atti-
tudes and behaviour carried out in the Member States
and at Community level; assessment and dissemination
of the results.

~ Regular examination of the surveys to be carried out at
Community level in this area, particularly as part of the
Eurobarometer system.

ACTION 2: Informing and increasing the awareness of
the public and certain target groups

- Studies of the information campaigns for the general
public and target sections of the population and of
measures to influence behaviour carried out in the
Member States; dissemination of the results; encourage-
ment of exchanges allowing experience in the Member
States to be compared.

- Feasibility studies:

—with a view to coordinated Community action to
foster the awareness of the general public and certain
target groups to complement the campaigns carried out
in the Member States; preparation, if appropriate, of
action proposals,

—for the preparation of a European code, written in
layman’s language and placing particular emphasis on
non-discrimination against persons infected by HIV.

ACTION 3: Health education for young people

- Development of exchanges of information on health
education measures undertaken in schools and in var-
ious training and apprenticeship schemes; encourage-
ment of exchanges of professionals and of teaching

WEST EUROPE 27

materials and cooperation through the organization of
specific seminars, intended in particular for teacher-
training staff and geared towards the dissemination of
new methods.

- Exchanges of experience and promotion of pilot
projects to make young people who are not at school
aware of the need to prevent HIV infection.

ACTION 4: Prevention of HIV transmission

- Fostering Community self-sufficiency in blood prod-
ucts by encouraging voluntary unpaid donors and con-
tinuing the efforts made to ensure transfusion safety.

- Adoption of Community measures for maintaining
and/or improving the quality of condoms; exchanges of
information on the promotion of condoms to the public
at large and target groups.

- Assessment of the measures implemented in the
Member States to supply safer injecting materials,
including new types of disposable syringes and needles.

- Exchange of information on new approaches to pre-
venting HIV transmission among certain target groups
and promotion of pilot projects, if appropriate.

ACTION 5: Social support, counselling and medical
treatment

- Exchanges of experience, evaluation and, where appro-
priate, promotion of ‘helplines’ which respect the confi-
dentiality of calls, including encouragement of appro-
priate ways of informing the public that they exist.

- Promotion of appropriate ways of informing persons
infected by HIV about the various forms of social
support, counselling and medical help available,
including the various methods of care, self-support,
home care, housing or other forms of accommodation.

- Promotion of appropriate ways of informing health
professionals about the various forms of social support,
counselling and medical help available and promotion of
exchanges of practical experience of them.

ACTION 6: Estimating the cost of managing HIV infec-
tion

- Examination of the parameters used in the Member
States for identifying the health and social costs of
managing HIV infection; feasibility study for the pur-
pose of developing common approaches in this area.

- Appraisal of existing HIV cost projection models with
a view to the planning of social and health services and
of access to early treatment; feasibility study for
common approaches.

ACTION 7: Gathering data on HIV/AIDS

- Appropriate support for epidemiological monitoring
systems in the Member States to improve the quality of
data at Community level.



26 WEST EUROPE

REGIONAL AFFAIRS

EC 1991-93 AIDS Action Plan Outlined
91WS0466I Luxembourg OFFICIAL JOURNAL OF

THE EUROPEAN COMMUNITIES in English
No L175, 4 Jul 91 pp 26-29

[Text]

COUNCIL

Decision of the Council and the Ministers for Health of
the Member States, Meeting Within the Council

of 4 June 1991

adopting a plan of action in the framework of the 1991 to
1993 ‘Europe against AIDS’ programme

(91/317/EEC)

THE COUNCIL OF THE EUROPEAN COMMUNI-
TIES AND THE MINISTERS FOR HEALTH OF THE
MEMBER STATES, MEETING WITHIN THE
COUNCIL,

Having regard to the Treaty establishing the European
Economic Community,

Having regard to the proposal from the Commission,

Having regard to the opinion of the European
ParliamentTM,

Having regard to the opinion of the Economic and Social ©

Committee,

Whereas the increase in AIDS is of major concern to
Member States and the Community as demonstrated by
the various instruments and Community texts adopted
with a view to combating AIDS; whereas, in particular,
in their resolution of 22 December 1989 on the fight
against AIDS®, the Council and the Ministers for
Health, meeting within the Council, requested the Com-
mission to develop exchanges of information and expe-
rience, defining, as a matter of priority, the details and
contents of an action plan incorporating appropriate
measures to prevent and control AIDS;

Whereas the present plan of action for the programme
‘Europe against AIDS’ includes the guidelines already
adopted; whereas it also contains other measures
intended to contain AIDS;

Whereas, without prejudice to the responsibilities of the
Member States in this area, promoting cooperation and
the coordination of national activities as well as their
assessment at Community level and the stimulation of
Community activities make a valuable contribution to
the fight against AIDS;

Whereas it is appropriate that a three-year plan of action
should be laid down;

Whereas it is necessary to estimate the Community
financial resources required for implementing this plan

SJPRS-TEP-91-020
24 September 1991

of action; whereas the amount of these resources must be
included in the financial perspective defined in the
interinstitutional Agreements,

HAVE DECIDED AS FOLLOWS:
Article 1

1, The Commission shall implement, in close coopera-
tion with the competent authorities of the Member
States, the 1991 to 1993 plan of action set out in the
Annex.

For this purpose it shall be assisted by an advisory
committee composed of representatives of Member
States and chaired by the representative of the Commis-
sion.

The duties of the committee shall in particular be:

-to examine projects and measures involving cofinancing
from public funds,

-to coordinate, at national level, projects partly financed
by non-governmental organizations.

The Commission representative shall submit to the
committee a draft of the measures to be taken. The
committee shall deliver its opinion on the draft within a
time limit which the chairman may lay down according
to the urgency of the matter, if necessary by taking a
vote.

The opinion shall be recorded in the minutes; in addi-
tion, each Member State shall have the right to ask to
have its position recorded in the minutes.

The Commission shall take the utmost account of the
opinion delivered by the committee. It shall inform the
committee of the manner in which its opinion has been
taken into account.

2, When implementing the plan of action, the Commis-
sion shall take account of projects financed under its
biomedicine and health research programme and of its
results, and incorporate these in the relevant measures
under the action plan, ensuring that they have a comple-
mentary and synergistic effect.

3. The Commission shall collaborate with international
organizations active in this field, such as the World
Health Organization (WHO) and the Council of Europe.

4. The Commission shall regularly publish technical
information on the progress of the plan of action.

Article 2

1, The annual appropriations allocated for the activities
provided for under the programme shall be adopted
within the budgetary procedure.

2. The amount of the Community contribution deemed
necessary to implement the action covered by this Deci-
sion for 1991 to 1992 shall be ECU 6 million.


» JPRS-TEP-91-020
24 September 1991

found seropositivity rates of 3.0-percent among illegal’

prostitutes, 1.4 percent among bar girls, and 0.8 percent
among men with STDs, respectively, in June of 1988 the
seropositivity rate was’ estimated at 9.0 ‘percent, 2.7-
percent, and 0.8 percent for the same three groups. In’

January 1990, the studies found that the seropositivity .

rate had climbed to 41.9 percent among illegal prosti-
tutes, 5.8 percent among bar girls, and 2.2 percent among
men suffering from STDs. - . : :

The 1991 prevalence rate is ‘estimated at 39.6 percent
among. illegal prostitutes, 13.9 percent among bar girls,
and 9.6 percent among men with STDs.

The total nuniber of AIDS cases reported as of 31
December, 1990 was:58,' while 30'cases of AIDS were
reported during the first quarter of 1991.

The age and sex distribution of AIDS cases diagnosed in
1990 shows that over 70 percent of AIDS patients are
male, and that the age group most affected are 20 to
39-year-olds, who make up about 80 percent of AIDS
cases.

It is important to point out ‘that the figures-for AIDS

cases and seropositive individuals are certainly underes-

timated, and that available figures must be multiplied by
. ten to get an idea of the real situation.

As these figures show, the situation’ with respect to
human immunodeficiency virus infection and AIDS in
Djibouti is increasingly worrisome. Indeed, if we look at
the number of cases reported in 1990, the increase over
the preceding year, 1989, is estimated at 750 percent.
The fact that men outnumber women can be explained
by the beginning stages of the epidemic.

Since it is men who go to prostitutes—who make up the
reservoir of the infection—it is understandably men who
compose the majority of seropositive individuals
reported in the initial phase of the epidemic. With time
however, seropositive men will transmit the infection to
their non-prostitute sexual partners. This means that
after a certain interval men and women will be afflicted
in the same proportions. Ht is at that point that a
worrisome number of AIDS cases will begin to be
reported among children under five, due to mother-child
transmission of the HIV infection, which will be higher
than it is now. ,

In addition, the rise in the prevalence rate of HIV
infection among tuberculosis patients raises the specter
of an increase in their number in the coming years, as has
happened in the other African countries. Another disqui-
eting fact is that it is the young (20 to 39 years old), who
supply the main strength for the country’s socioeco-
nomic development, that are being stricken.

Yet the HIV infection rate among blood donors, which is
estimated at 0.49 percent (less than | percent), suggests
that the prevalence of HIV infection in the general
population is still low, and that it is time to protect the

“SUB-SAHARAN AFRICA |. | 3

Jatter by giving it accurate information on modes of
transmission and protective measures.

People must know that over 80 percent of AIDS cases are
transmitted sexually (at least in Djibouti), through the

- blood, and from mother to child. They must also know
_ that abstinence and fidelity between sexual partners are

the only means to protect ‘themselves against AIDS.
Condoms are an alternative for those who, for their own
reasons, cannot respect the two golden rules.

- Itshould be stressed, however, that AIDS information is

a challenge in itself, in the sense that providing informa-
tion is not enough to induce individuals or communities
to change or adopt a specific behavior. Dissemination of
information on AIDS must take into account an entire
social, cultural, and religious environment.

Because of this, information to combat AIDS is no
longer the concern of the Ministry of Public Health and
Social Affairs alone. It is the concern of our whole

- society. All sectors striving to develop the country

socially and economically must feel that they are partic-
ipants in the fight against AIDS.

GHANA

AIDS Control Program Manager Details Policy

AB2508211791 Accra Ghana Broadcasting Corporation
Radio Network in English 0700 GMT 25 Aug 91

[Excerpts] A PNDC [Provisional National Defense
Council] member, Dr. Mary Grant, has said there is the
need to revive the AIDS education campaign to make
the needed impact. She noted that the educational mes-
sages in the media have been stopped for sometime now
and this has led many Ghanaians to conclude that AIDS
has disappeared from the country or is no longer a
problem. This was in an address read on her behalf by
the secretary for health, Colonel E.M. Osei-Wusu, at the
launching of the mass media campaign on AIDS in
Kumasi. The one-year long [campaign] is to involve the
mass media in educating the public on the prevention
and control of AIDS. [passage omitted]

In aid of the campaign, the United States ambassador,
Mr. Raymond Ewing, on behalf of his country pledged
$5 million. The pledge follows an earlier contribution of
$1.3 million during the 1989-1990 campaign. The
ambassador said the United States is supporting the
program because she shares with Ghana the belief that it
is possible to control the spread of AIDS through infor-
mation, education, and communication.

The AIDS control program manager, Dr. Phyllis Antwi,
said reported AIDS figures through the end of March this
year were 2,474 [not further specified] with Ashanti
region topping the list.



SJPRS-TEP-91-020
24 September 1991

ARGENTINA
Over 1,000 People Infected With AIDS Since

PY1008155691 Buenos Aires TELAM in Spanish
2235 GMT 7 Aug 91

[Summary] Buenos Aires, 7 Aug (NA)—Laura Astaloa,
coordinator of the National Program on AIDS, reported
here today that 1,019 people have been infected with
AIDS since 1982, and that 60 percent of them have died.
She added that of the 1,019 cases, 60 percent of the
patients were infected through sexual contact, while 20
percent of them are intravenous drug addicts.

AIDS Cases Seen Linked to Drug Trafficking

91P40422A Buenos Aires LA PRENSA in Spanish
17 Aug 91 p 6

[Editorial]

[Text] More than half the AIDS victims registered in
Argentina since 1982 have died. According to the coor-
dinator for the National AIDS Program, of the 1,019
cases recorded since that year, 60 percent, or more than
600 patients, are no longer living.

The official presented the information during her stay in
the capital city of La Pampa Province as part of a
national campaign to identify methods for preventing
the disease. She also stated that most of the resources are
being used to reinforce safety measures in blood banks.
In addition, she claimed that the campaign to prevent
sexual transmission of the disease was having a “strong
impact” on the population.

Regarding the causes of transmissions, she said that 60
percent of the cases were through sexual relations and an
estimated 20 percent by intravenous drug use. With statis-
tics that show a clear correspondence, the U.S. Senate
commission dealing with AIDS also has reported that 32
percent of [AIDS] cases are due to the promiscuous use of
syringes by drug addicts, to unprotected sexual relations
among those under the influence of narcotics, or to drug
addicts who, having contracted the disease, have become
potential agents of its transmission.

Thus, the statistics confirm the necessity of fighting
narcotics trafficking which, as has been noted, widely
promotes the spread of AIDS. Wherever drugs are sold,
furrows of death are opened in society, especially among
young people. Therefore the solution would not be the
legal sale of elements used in drug addiction, as proposed
by the aforementioned North American senatorial com-
mission, which argues that the exchange of used syringes
would thereby be avoided. But this would in fact legalize
drug addiction and, by extension, narcotics trafficking as
well.

At a time when drug trafficking organizations must be
broken up, it is necessary to continue prevention cam-
paigns, not only against drug addiction, but also against

LATIN AMERICA 17

sexual habits which, in light of the sad situation
described, have characteristics that are hardly healthy
and are even abnormal.

BOLIVIA

Government Reports 32 AIDS Cases in Santa
Cruz

PY1008142291 La Paz EL DIARIO in Spanish
2 Aug 91 p 12

[Summary] Santa Cruz, 1 Aug—Health Department
Director Jose Henicke has reported 32 AIDS cases in
Santa Cruz. He said 22 are Bolivians and 10 are for-
eigners. He added that 12 people have already died, nine
have left the country, three live in Santa Cruz, and four
live abroad. He also disclosed that 27 are males and five
are females. He stated that 12 are homosexuals, seven
are bisexuals, 11 are heterosexuals, and there is no
information on two cases. Henicke also reported that 27
were infected through sexual relations, two through
blood transfusions, and three through drug injections.

BRAZIL

Sao Paulo Prisoners Die ‘Daily’ of AIDS

91WE0464B Sao Paulo FOLHA DE SAO PAULO
in Portuguese 10 Jul 91 p 4-1

[Article by Jose Arbex]

[Text] During the month of June AIDS was responsible
for the death of one prisoner a day in the Sao Paulo State
prison system, Dr. Manuel Schechtmann, 58, System
Health Department Director since 1989, told FOLHA.

According to the doctor, out of a population of 45,000
prisoners, 700 have AIDS. The proportion (1 in 65) is 30
times higher than the rate in the city of Santos (one AIDS
patient out of 2,000 inhabitants), the highest in the
country.

AIDS alone is responsible for 80 percent of the deaths in
the penitentiary system. It is calculated that 20 percent
of male prisoners and 33 percent of female prisoners are
infected, a total of at least 9,000 carriers of the virus.

Amid such tragic numbers, the “good news” is that in
August AIDS-infected prisoners received AZT tablets for
the first time (6,000 tablets donated by their manufac-
turer, Wellcome Laboratories).

The primary cause of the spread of AIDS, according to
Schechtmann, is the use of intravenous drugs. Some 66
percent of carriers of the virus are intravenous drug-
users, and 22 percent both use drugs and are homosex-
ual—that is, intravenous drugs are responsible for up to
88 percent of the AIDS cases.



34 WEST EUROPE

unfaithful during the past year. Nevertheless, 58 percent
gave the opposite answer. Among women, official mar-
riage also entails greater fidelity: 17 percent of unmar-
ried women with regular partners admit having been
unfaithful, while the negative responses, compared with
those of married women, decline to 82 percent.

According to Joao Santos Lucas, the adoption of safe
behavior by the Portuguese population is his major
concern. “That’s my main point. I’m trying to find out
who practices it and the factors associated with safe
behavior, and, on the other hand, those with risky
behavior.” What is safe behavior? “Having sexual rela-
tions with the use of a condom.”

Women More Faithful

Also in connection with fidelity, the behavior of women,
even in homosexual relations, is more constant. “There
are more women having relations only with women than
men only with men. Thus, among women with homo-
sexual or bisexual behavior, homosexuality is far more
common than bisexuality.”

As for homosexuality and bisexuality, 1 percent of
women and men between the ages of 18 and 34 claim to
engage in this type of relationship. “These figures result
from the information that individuals gave us. The
reality is certainly different from this. However, I can say
that the situation depicted is clearly similar to that in
other European countries.”

The poll also discovered that 76 percent of those queried
claim never to have had a sexually transmissible disease.
In the case of one of them (gonorrhea), the study
revealed that “Porto has more experience with gonor-
rhea.” The northern city has 8 percent of such cases, and
Greater Porto 6 percent. In the capital, only 6 percent
have experienced the disease, and, in Greater Lisbon, 5
percent. This is a trend contrary to the AIDS experience
recorded in the two cities. According to recent data from
the National Health Institute, in March 1991 there were
328 Lisbon residents and only 46 Porto residents with
AIDS. [passage omitted]

Sex: How Lisbon Is Faring

This is a study on sexual behavior in the nation’s capital,
in which 800 persons were questioned. Two-thirds of the
adults over age 20 admitted having experienced one of
these situations during the past year: having extramarital
relations, having two or more sexual partners, never
using a condom, having homosexual or bisexual rela-
tions, procuring prostitutes, or having sexual relations
with persons whose past is unknown to them—all of this
during an AIDS era.

Adolescents born between 1970 and 1974 became sexu-
ally initiated later than the group of Lisbon residents
born during the 1960’s. This was one of the surprises
resulting from a poll on the sexual behavior of Lisbon
residents based on 800 interviews and taken for the

SJPRS-TEP-91-020
24 September 1991

purpose of obtaining more information on the sexual
habits of the Portuguese population and on the risk of
AIDS.

Of the young men and women currently between the
ages of 16 and 20, only 55.7 percent of those polled
responded that they had already had their first sexual
relations. But, among the group of Lisbon residents
born between 1961 and 1969, 80.5 percent of those
queried began before age 20.

Sociologist Fausto Amaro, coauthor, with nurse Louise
da Cunha Teles and psychologist A. Dantas, of the study
“Sexual Behavior in the City of Lisbon,” produced from
the double poll in March 1990, makes this claim:
“People are beginning later. We can’t claim that this is
due to AIDS, but we can cite the possibility that the
disease is having a retarding effect on sexual initiation.”
The first results of the study were presented in June at
the Seventh International Conference on AIDS, in Flo-
rence, and will soon be published in their entirety.

“Don’t you agree with me?” asks Fausto Amaro,
addressing Louise da Cunha Teles, who confirmed with
an affirmative nod the possibility that fear of infection
may have caused some restraint in the sexual behavior of
adolescents.

Nevertheless, of those adolescents, only 20.3 percent
view AIDS as a personal risk, and only 13.2 percent
admit having changed their sexual behavior because of
the disease. In the United States, where 179,000 persons
have already become infected, according to the latest
World Health Organization figures, the studies made
show an increased awareness of the dimensions of the
infection risk.

Condoms: Seldom Used

The Portuguese poll reveals that only 12 percent of
individuals under age 21 always use condoms during
casual sexual contacts, and, among adults, the number
declines to 8 percent. Fausto Amaro, who does not seem
alarmed by the data collected, adds: “Regular use is very
slight. And the motivation for its use is as a birth control
method.”

He remarks that, when sexual behavior and attitudes
toward AIDS prevention become known, it still remains
to be learned why people fail to change their habits from
the standpoint of risk. “Only someone not struggling
with behavioral problems could assume that they can be
easily changed.”

In any event, resulting from the experience of the poll are
what Fausto Amaro terms “a few assumptions”: Few
condoms are used because people fail to see their useful-
ness. AIDS is still considered a major health problem for
the society, in general, but those interviewed do not
regard themselves as being at risk; it is an abstract risk.

“People change their behavior only when the benefits
outweigh the costs. And what are the psychological costs?


JPRS-TEP-91-020
24 September 1991

Changing behavior, purchasing condoms, and being
ashamed of exposure.” For example, during the poll, a
woman showed up fearful of becoming infected because
she thought her husband was unfaithful to her. Never-
theless, she opted not to introduce condoms into their
marital relations because she was afraid of the conse-
quences of verbalizng that distrust.

Only Fear of Death

Louise da Cunha Teles, for her part, is less optimistic.
She thinks that many people will have to die before
behavior will change. “We know from the history of
health that only a few individuals assume attitudes as a
means of primary prevention. Most of them have to
observe the disease in all its fatal dimensions.” She also
gives a reminder that, in the United States, it was only
after many homosexuals died that the country began
noticing a different behavior regarding casual sex.

Fausto Amaro disagrees and retorts that only the best
educated homosexuals have changed their behavior, and
the young people who were sexually initiated during the
AIDS era are not taking precautions. “We know very
little about what prompts individuals not to change their
behavior when they see their friends dying. There has not
yet been sufficient research. This is our next step:
behavior and the problems of changing it, making a
psychosociological study—that is, of what prompts
people to have one kind of behavior and not another.”

Notions of Fidelity

During the poll, it was learned that 7.6 percent of the
men had relations with prostitutes during the past year,
and 27.7 percent engaged in sex outside of marriage. The
women are less promiscuous (Fausto Amaro concluded,
without surprise) because only 8.9 percent were
unfaithful to their husbands. The researchers also man-
aged to discover that only 14.9 percent of the women
admitted that their husbands had extramarital sexual
relations and that some men did not consider it infidelity
to have sex with prostitutes.

Thus, it was concluded that “many women are confident
of their husbands’ fidelity and would not take any
precautions against AIDS.” Furthermore, it was also
clear that the notion of infidelity is not the same for
everyone. On the basis of the example of the men who do
not regard sexual relations with prostitutes as an act of
infidelity, a prevention campaign associating the use of
condoms with infidelity, for example, would not succeed
among such men. Fausto Amaro explains: “If we don’t
conduct this type of study, we run the risk of devising
prevention campaigns against AIDS based on what we
think the reality is and not on the reality per se.”

But there are more examples given by the researchers on
the sexual behavior of Lisbon residents. Anal sex is
practiced by 14.8 percent of the men and 6.5 percent of
the women, while 3.1 percent of the men under age 21
and 2.2 percent of those over that age admit having had

WEST EUROPE 35

homosexual relations during the past year. The sociolo-
gist claims: “The risk of infection increases 20 times with
the practice of anal relations.”

With regard to oral sex, 33.5 percent of the men and 25.8
percent of the women claim to practice it. As for aware-
ness of the sexual habits of partners during the past year,
14.6 percent of the men and 3.3 percent of the women
admit ignorance of them.

Among those under age 21, nearly 50 percent of the men
had only one partner during 1990, whereas under 30
percent had two or three. In the case of women in the
same age group, the single partner status rose to 80
percent, and only 10 percent claimed to have had two or
more partners. Nearly 60 percent of the older men admit
having had one partner during the past year; among
women in this group, the percentage with single partners
is equal to that among adolescents. And only under 20
percent of the men claim to have had two or more
partners.

In a general summary, two-thirds of the adults over age
20 admitted having experienced one of the following
situations during the past year: extramarital relations,
two or more partners, no systematic use of condoms,
homosexual relations, sexual relations with prostitutes
and bisexuals, and sexual relations with persons of an
unknown past.

Fausto Amaro declares: “Our attitude is not moralistic
but merely scientific. We aren’t saying: Behave this way
or that. All we intend to do with this study is to publish
it.” However, in the findings contained in the report
submitted in Florence at the international conference
devoted to AIDS, it is written: “This investigation sug-
gests several ideas that could be used in educational
programs.”

Polling Method

The size of the sample was determined on the basis of the
1981 census, which records 807,000 persons in Lisbon.
Thus, the poll included 800 persons, divided into two
groups. The first consists of youths between the ages of
16 and 20. The second covers the adult population over
age 20, with 52 percent women, in an attempt to obtain
a sample representing the city’s demographic reality. The
sampling method is aleatory because the residences were
selected at random. The contact was personal. Two
questionnaires were prepared. In the first, the individ-
uals were asked 25 questions to which verbal responses
could be given: sexually-related attitudes and values, and
some specific types of sexual behavior. The second
questionnaire was written, anonymous, and confidential.
With 58 queries for adults and 65 for the youth group,
the questions dealt with the individual’s own sexual
attitudes and behavior.



JPRS-TEP-91-020
24 September 1991

As part of the control programme, the WHO has sug-
gested that a full-time professional working in this field
be posted to look after the programme and its implemen-
tation.

Resource group formed

An AIDS Resource Group, comprising Dr. Suniti
Solomon, Additional Professor of Microbiology, Dr. M.
Ganapathy, Additional Professor of Serology, Dr. S.A.
Jayakar Paul, Physician in charge of AIDS, Dr. A.
Rajkumar, Additional Professor of Psychiatry and Dr.
Dharmalingam, Additional Professor of Sexually Trans-
mitted Diseases, has been formed at the MMC.

To ensure better implementation of the programme,
official sources say, all the microbiology laboratories in

, the Government hospitals have to be upgraded and
equipped with ELISA readers to help in diagnosing the
cases.

During the last one year, the Resource Group has
detected 14 full blown AIDS cases at the General Hos-
pital. The seropositivity in the State is increasing and
there are over 2,000 seropositive cases as of now. ‘Even
with the limited facility available with us, we have been
able to detect these cases,’ the sources say and point out
that testing facilities are available only at Madras, CMC,
Vellore, and Madurai.

Though the number of seropositive cases in the country
have been estimated to be around 5,000, the WHO has
projected it to be anywhere around one million, espe-
cially since most of the States do not have adequate
testing facilities.

Training for detection

On the education and training aspect, workshops have
been held for medical personnel. An Indo-U.K. work-
shop was conducted for medical personnel in the State.

IRAN

Regime Claims 300 Infected with AIDS
91AS1098d London KEYHAN in Persian 4 Jul 91 p 4

[Text] Dr. Cheraghchi, general manager of the Ministry
of Health, Treatment and Medical Education’s cam-
paign against contagious diseases for the Islamic
Republic, said that 280 to 300 people in Iran are infected
with the AIDS virus. Speaking in Semnan in an inter-
view with the newspaper JOMHURI-YE ESLAMI, he
discussed the AIDS illness in the country. He said: In
Iran, the biggest problem with AIDS is hemophilia
patients, seven percent of whom are infected with the
AIDS virus.

Dr. Cheraghchi added: In this regard, so far 2,000 of
these patients have been tested, of whom seven percent
are infected. In view of the fact that it is estimated that

NEAR EAST & SOUTH ASIA 23

we have 4,000 hemophiliacs in Iran, there are between
280 and 300 people infected with the AIDS virus.

He announced that there are 19 people afflicted with
AIDS (people in whom the symptoms of the disease have
appeared). He said: A number of these people have died.

The general manager of the regime’s Ministry of Health,
Treatment and Medical Education claimed that most of
these people have traveled outside the country or are
addicted to injected narcotics.

The Islamic Republic regime has always concealed the
real figures on those infected with the AIDS virus, and
has even refrained from giving exact information in this
regard to the World Health Organization, yet testimony
from the nation’s physicians, even before the end of the
Iran-Iraq war, cited thousands of AIDS cases in the
Islamic Republic. According to these physicians, there
are three major factors in the spread of AIDS in the
Islamic Republic: The use of infected blood in transfu-
sions to war wounded at hospitals behind the lines (some
of which was imported directly from Third-World coun-
tries by the revolution guards at low prices), widespread
drug addiction and prostitution, and the government's
concealment and failure to educate the public con-
cerning sexual relations.

Dr. Cheraghchi also failed to mention the real factors in
the spread of AIDS in Iran, but he did admit that: In
view of the fact that our region (the Middle East) has a
great capacity for spreading this disease, we have a
comprehensive prevention and education program, and
educational programs have also been started in the
provinces. An anti-AIDS committee has also been
formed. He also said: In addition to education, we have
also tested all the endangered groups.

The regime’s “health” official did not discuss the educa-
tional programs and how the “endangered groups” are
being tested. However, those familiar with health issues
believe that a regime that punishes extramarital sexual
relations, homosexuality and addiction to narcotics with
imprisonment, flogging, stoning and the like, and which
refuses to promote and distribute the means to prevent
the spread of AIDS through sexual relations and the
injection of narcotics, will be absolutely incapable of
fighting this terrifying disease. Addicts, homosexuals,
and those who have what the government considers to be
“illicit” sexual relations, prefer to conceal their illness
and probably infect others. Fearing punishment, how-
ever, they do not seek such devices as condoms and
syringes and they refuse to go to physicians and clinics
for treatment.

Hemophiliacs Infected With AIDS

91WE0500 Tehran KAYHAN INTERNATIONAL
in English 30 Jul 91 p 1

[Text] Tehran (IRNA}—Hemophiliacs in Iran number
4,675 of whom 150 have been diagnosed as having
contracted the deadly ‘Acquired Immune Deficiency



IJPRS-TEP-91-020
24 September 1991 3 AIDS

EAST EUROPE
YUGOSLAVIA
Over 200 Registered AIDS Cases (Belgrade TANJUG Domestic Service, 6 Sep 91]
LATIN AMERICA

ARGENTINA
Over 1,000 People Infected With AIDS Since 1982 Buenos Aires TELAM, 7 Aug 91] 17
AIDS Cases Seen Linked to Drug Trafficking /Buenos Aires LA PRENSA, 17 Aug 91] 17

BOLIVIA

Government Reports 32 AIDS Cases in Santa Cruz [La Paz EL DIARIO, 2 Aug 91] ..
BRAZIL

Sao Paulo Prisoners Die ‘Daily’ of AIDS

[Jose Arbex; Sao Paulo FOLHA DE SAO PAULO, 10 Jul 91] ..... .

Sao Paulo—400 New AIDS Cases in June [Sao Paulo O ESTADO DE SAO PAULO, 12 Jul 91] .. 18
COSTA RICA

AIDS Advances In Country; 174 Deaths [Paris AFP, 12 Aug 91]

CUBA

AIDS Reference, Orientation Center Opens in Havana
[Susana del Calvo; Havana Radio Rebelde Network, 27 Aug 91] .....

HONDURAS

19

AIDS Victims Estimated at 35,000 [San Pedro Sula TIEMPO, 19 Jun 91] ....
Report Notes 60 New AIDS Cases Reported Monthly [Mexico City NOTIMEX, 9 Aug 91] .

JAMAICA

Health Authorities Report 19 New Cases of AIDS [Bridgetown CANA, 21 Aug 91] ..... 20
MEXICO

Group Refutes Government’s Statistics on AIDS Paris AFP, 14 Aug 91] ..... 20

PANAMA

Minister Reports 172 AIDS-Related Deaths to Date [Paris AFP, 26 Aug 91] ...
URUGUAY

Health Minister Reports 960 AIDS Cases, 197 Deaths [Madrid EFE, 22 Aug 91]
Twenty-seven Deaths From AIDS in First Eight Months of 1991 (Madrid EFE, 5 Sep 91]

NEAR EAST & SOUTH ASIA
INDIA

First AIDS Victim in Kolhapur {New Delhi PATRIOT, 11 Jul 91]



10 SUB-SAHARAN AFRICA

telephone help line, reports SABC [South African Broad-
casting Corporation] radio news.

The phone-in advice service was announced at the
national conference of Life Line in Pretoria.

A spokesman said the service would be offered jointly by
Life Line and the Department of Health and Population
Development.

AIDS Expected To Be Endemic by Year 2005

MB1109143091 Johannesburg SAPA in English
1421 GMT I1 Sep 91

[Article by Johann van Heerden]}

[Text] Johannesburg Sept 11 SAPA—Pension fund man-
agers and medical aid societies face severe cost escala-
tion and diminishing returns as acquired immune-
deficiency syndrome (AIDS) spreads wider in South
Africa.

According to projected figures released to a Southern
Life seminar on AIDS on Wednesday, AIDS in the
endemic stage is due to reach South Africa by 2005 when
AIDS among adults is calculated at 25 percent.

Until about 1995, AIDS deaths are projected to be
relatively insignificant but after that AIDS-related
deaths increase to about 20,000 a year.

“Demand for goods and services will be affected as
individuals who are infected need to divert income to
provide medical treatment and incomes are reduced
because of loss of ability to work,” said Southern’s Don
Brown of the company’s employee benefits actuarial
service.

Scarce resources have to be reallocated from retirement
benefits to death and disability benefits.

Inevitably AIDS would impact on pension fund assets
and investments through declinining demand, lower
company profits and falling share prices with significant
implications for pension funds.

“Associated with this is the ability of a company to meet
additional costs from falling profits,” Mr. Brown said.

According to estimates, endemic incidence of AIDS in
South Africa would reduce gross domestic product by
about 5 percent over the next 15 years.

Medical costs would be staggering, even without the
latest drugs available to medical care.

One estimate was that if a company had a 1 percent
AIDS incidence among employees, medical aid contri-
butions by workers would have to increase more than 30
percent.

“Medical aid societies will almost certainly face extreme
difficulty in coping with AIDS,” Mr. Brown said.

SJPRS-TEP-91-020
24 September 1991

“The medical system in South Africa will be severely
stretched to deal with AIDS and difficult decisions will
have to be made about the level of treatment AIDS
sufferers will receive.”

TANZANIA

Iringa Region Has 617 New AIDS Cases

91WE0504B Dar es Salaam DAILY NEWS in English
27 Jun 91 p 5

{Article: “Iringa Reports 617 New AIDS Cases”)

{Text] Iringa Region has in the first four months of this
year recorded 617 new cases of the Acquired Immune
Deficiency Syndrome (AIDS) cases reported from 14
hospitals in the region, the Regional AIDS Control
Programme Co-ordinator, Godlove Kiambile said this
week.

Ndugu Kiambile said that there was an increase of about
410 cases from those reported last year. Only 207 new
cases were reported last year.

He said that from January to April this year, Makete
District reported 206 new cases, followed by Njombe
with 117 cases, Iringa Urban 114 cases, Iringa Rural 103,
Ludewa 52 and Mufindi District 25 new cases.

Ndugu Kiambile said the problem is becoming more
acute in Makete District which last year reported only 48
cases but in just four months, the number has jumped to
over 200 cases.

He said that last year Iringa Urban District reported only
10 cases, Njombe 20 cases, Ludewa four, Mufindi 16 and
Tringa Rural 103 cases.

The coordinator said most of the cases in Makete and
Njombe are mostly of people coming back from coffee
and tea estates in Mbeya Region and tea estate in
Mufindi District.

He said the ratio between men and women remained
generally equal, about one to one except for Iringa Urban
where it is 2.6 women to one man.

Last year, the Regional AIDS Control Programme in
collaboration with the African Medical Research Foun-
dation (AMREF) launched a project known as “‘the truck
drivers AIDS intervention project” to check the spread
of the disease along the Tanzania-Zambia Highway but
Kiambile said that the disease is now moving away from
the highway into the rural areas.

Last week, the programme, through the region’s taxi
drivers association began to distribute condoms to taxi
drivers to be given to customers in an attempt to control
the spread of AIDS in the municipality.


12 CHINA

Tianjin Develops Anti-AIDS Disinfectant

0W0209022091 Beijing XINHUA in English
0147 GMT 2 Sep 91

[Text] Tianjin, September 2 (XINHUA)—A new disinfec-
tant developed from Chinese medical herbs which can kill
the virus of AIDS and other diseases was put into produc-
tion recently in Baomin Hygienic Factory in Tianjin.

The disinfectant, named “sd xiangle” [as received] and
jointly developed by Tianjin disease prevention center,
Tianjin Medical Research Institute and Infectious Dis-
ease Hospital, has passed the appraisal of Tianjin Dis-
ease Prevention Center, Tianjin’s authoritative estab-
lishment for medicine appraisal.

JPRS-TEP-91-020
24 September 1991

In addition to AIDS, “sd xiangle” is also capable of
killing the virus of Hepatitis B and gonorrhea, bacteria
of hay fever, colibacillosis and staphylococcus. Yet it
has no poisonous or side effect to the human body.

The disinfectant which is made into transparent liquid
with fragrance is convenient to spray or smear and has a
long preserving period, adoptable in hotels, restaurants,
home and public places.

Tianjin Baomin Hygienic Factory is planning to coop-
erate with foreign enterprises to enlarge the production
scale.


JPRS-TEP-91-020 : - . ;
24 September 1991 roe Loe AIDS

Puppet Group Teaches AIDS Awareness in Rural Natal

(John Perlman; Johannesburg THE WEEKLY MAIL, 5-11 Jul 91] 7
Report: Negative Impact of AIDS ‘Exaggerated’ .
[Reg Rumney; Johannesburg THE WEEKLY MAIL, 5-11 Jul. 91)... . 8

Health Minister on Economic Implications of AIDS
[Johannesburg South African Broadcasting Corporation Network, 19 Jul 91)
Minister Comments on AIDS Statistics. (Johannesburg THE CITIZEN, 20 Ji
Unions, Businesses Form Committees To Fight AIDS .
[Johannesburg THE CITIZEN, 20 Jul 91]...
Government Establishes AIDS Hotline [Johannesburg SAPA, 17 Aug 91]
AIDS Expected To Be Endemic by Year 2005 a
(Johann van Heerden; Johannesburg SAPA, 11 Sep 91] ...

TANZANIA

Tringa Region Has 617 New AIDS Cases Dar es Salaam DAILY NEWS, 27 Jun 91] ... 10
ZAMBIA ~ ——- °
Five Thousand AIDS Cases—Mainly Young People {Lusaka TIMES OF ZAMBIA, 6 Jul 91]... 1
ZIMBABWE :
Testing To Begin on New Anti-AIDS Vaccine Johannesburg SAPA, 4 Sep 91] .... 11
Mugabe Asks Churches To Help Curb Looming AIDS Disaster
(Johannesburg Radio RSA,.8 Sep 91] 11
Health Ministry Reports 18,000 AIDS Carriers
[Johannesburg South African Broadcasting Corporation Network, 14 Sep 91] 1
CHINA
Tianjin Develops Anti-AIDS Disinfectant [Beijing XINHUA, 2 Sep 91] 12

EAST ASIA
HONG KONG
Carriers Recruited in War on AIDS - : a
[Helen Signy; SOUTH CHINA MORNING POST, 28 Jun 91]
Twelve More AIDS Victims Found in Territot
[Helen Signy; Hong Kong SOUTH CHINA MORNING POST, 3 Jul 91]
First AIDS-Infected Prostitute is Found .
[Ursula Yeung; Hong Kong THE HONG KONG STANDARD, | Aug 91]
SOUTH KOREA . .
Ministry Confirms 3 New AIDS Cases [Seoul THE KOREA TIMES, 3 Sep 91]

MALAYSIA

13
13

Anti-AIDS Measures Noted; 1,000 Carriers Reported [Kuala Lumpur BERNAMA, 11 Sep 7 | on 14
TAIWAN

Draftees Ordered to Take AIDS Test /Hong Kong THE HONG KONG STANDARD, 24 Jul 91) ... 15
THAILAND

Army Says New AIDS Test Detects Virus More Quickly {Bangkok THE NATION, 17 Aug 91 wee AS


SJPRS-TEP-91-020
24 September 1991

Technical Record

Universe: Individuals over age 18 residing in the cities of
Lisbon and Porto, in households with a telephone.

Sample: Proportional, on each municipal level, using the
quota method with the control variables of sex, age, and
occupation. Three hundred individuals were queried.

Sampling: Based on a telephone list, with random selec-
tion.

Interview: Telephonic, using a structured questionnaire.
Fieldwork: Interviews held on 17 July 1991.

Institution Responsible: The research was directed by
NORMA, Inc., Portuguese member of Gallup Interna-
tional.

Behavior Surveyed

91WE0475B Lisbon PUBLICO in Portuguese
27 Jul 91 pp 2-5

{Article by Isabel Coutinho and Isabel Salema: “AIDS:
The Head Buried in the Sand”—first paragraph is PUB-
LICO introduction]

[Excerpts] A bucolic nation with moderate habits, minor
ambitions, and small joys, Portugal is still behaving as if
AIDS were something that only happens to others. This
holds true even in instances wherein the real risk would
advise the greatest precaution. The picture shown by the
sociological study we are presenting of the Portuguese
people’s sexuality is that of a country considerably more
faithful and virginal than might be expected, but one in
which the risk behavior is unbalanced because virtually
no care is taken for prevention here.

“When we began receiving these data, we discerned how
serious the situation was from a behavioral standpoint.
This doesn’t mean that we are already in an epidemic
situation, with a large-scale spread of the virus; but the
existing behavior is fostering rapid transmission of
AIDS. That’s the problem.” These remarks were made
by sociologist Joao Santos Lucas, the author of a study
conducted in Portugal on the sexual behavior of the
Portuguese titled “Knowledge, Attitudes, Beliefs, and
Practices Associated With AIDS.”

This researcher cites the “highly disturbing” figures on the
systematic use of condoms if the person knows that the
partner has used drugs. Among men, the percentage giving
a positive response is 21, and among women, it is 9.

But, if we check the number of persons claiming never to
use a condom in such situations, the figures are even
more enlightening: 46 percent of the men say they never
use a condom, while 51 percent of the women make the
same assertion. Santos Lucas, who took a poll among
2,500 Portuguese in some 60 localities with over 10
residents, claims: “This is another extremely alarming

WEST EUROPE 33

situation. The women seem to have less will power in
these circumstances and less often succeed in forcing the
use of a condom.”

Fear of Losing the Client

Men and women between the ages of 18 and 49
responded, in direct interviews, to nearly 200 questions
devised by 20 researchers from the World Health Orga-
nization, a group of which Joao Santos Lucas is a
member. The poll was taken between November 1990
and January 1991. The idea, after achieving uniformity
on the international level, was to make a comparative
study on the sexual behavior of the various populations.

According to the sociologist, the first “extremely disturb-
ing” finding is the percentage of persons engaging in
sexual relations in exchange for favors or money who
claim always to use a condom: only 31 percent. “Prosti-
tutes know that they should use a condom, but they are
afraid of losing clients if they demand its use. And many
men refuse to use it.”

This poll, unlike the one taken in Lisbon, did not make
a distinction regarding the use of condoms for casual sex
but, rather, covered their use in all sexual relations. The
methodology here opted to differentiate by age and
relationship status. It was found that 77 percent of
married men claim never to have used a condom during
the past four weeks, while 8.1 percent responded
“always,” and 15 percent “occasionally.” On the other
hand, among unmarried men with regular partners,
fewer responded that they had never used a condom
during the past month: 62 percent. And more claim to
have always (20.4 percent) or occasionally (17.6 percent)
used one. The group of single men without regular
partners revealed a surprising behavior: The number of
those claiming never to have used a condom is higher
than among married men (78 percent), although more
claim always to do so. Hence, the ones taking the most
precautions against the risk of AIDS infection are not
single men, as might be expected, but, rather, unmarried
men with partners.

The Importance of Marriage

During the past 12 months, 22 percent of the husbands
questioned admit having committed adultery. On the
other hand, two-thirds of the husbands claim not to have
had extramarital relations during the past year. And 3
percent refused to answer the question.

Among the female sex, marriage actually appears to be a
matter of fidelity because only 1 percent of the married
women admitted having had extramarital relations
during the past 12 months, while nearly all (98 percent)
gave a negative response.

To acertain extent, it is possible to conclude that passage
through the registry office influences the notion of
fidelity among Portuguese men. The fact is that, insofar
as extramarital relations are concerned, 41 percent of
unmarried men with regular partners claim to have been



IJPRS-TEP-91-020
24 September 1991

URUGUAY

Health Minister Reports 960 AIDS Cases, 197
Deaths

PY2308191391 Madrid EFE in Spanish 1927 GMT
22 Aug 91

[Summary] Montevideo, 22 Aug (EFE)—Dr. Gloria
Ruocco, the director of the Uruguayan Public Health
Ministry Epidemiology Department, today reported that
960 people are infected with the AIDS virus in Uruguay
and that 197 of them have died.

LATIN AMERICA 2

Twenty-seven Deaths From AIDS in First Eight
Months of 1991

PY0809030291 Madrid EFE in Spanish 0340 GMT
5 Sep 91

[Summary] Twenty-seven people died of AIDS in Uru-
guay during the first eight months of 1991. The total
number of people who have died of AIDS since it was
detected in the country in 1983 now stands at 103. A
total of 776 AIDS carriers already have been registered
in the country since 1983.



Epidemiology
AIDS

JPRS-TEP-91-020 CONTENTS 24 September 1991

[This EPIDEMIOLOGY report contains only material on AIDS. Other epidemiology topics are covered in a later issue.)
SUB-SAHARAN AFRICA
REGIONAL AFFAIRS

Malawi, Zimbabwe, Zambia Lead in Confirmed AIDS Cases [Johannesburg SAPA, 14 Aug 91]... 1
AIDS Experts Cited on Impact of Disease in Southern Africa (Johannesburg SAPA, 19 Aug 91]... 1

BENIN

Seminar on AIDS Begins; Statistics Announced

[Cotonou Office de Radiodiffusion-Television du Benin Radio Network, 7 Aug 91] .. 2
DJIBOUTI
AIDS, HIV Situation, Prospects Reviewed [Djibouti LA NATION DE DJIBOUTI, 20 Jun 91] ..... 2
GHANA
AIDS Control Program Manager Details Policy
{Accra Ghana Broadcasting Corporation Radio Network, 25 Aug 91] .... 3
IVORY COAST
Health Minister on Free Treatment Of AIDS Patients
[Leon Francis Lebry; Abidjan FRATERNITE MATIN, 10 Jul 91] ..... 4
MALAWI
Minister Reports 15,719 AIDS Cases up to March {Dakar PANA, 20 Aug 91] ..... 4
MOZAMBIQUE
Country’s AIDS Statistics Being Revised _.. 4
Breakdown of Cases {Maputo NOTICIAS, 20 Jul 91] .. 4
Counseling Centers [Maputo NOTICIAS, 20 Jul 91] 5
Manica Province: Sixty Confirmed AIDS Cases
[Maputo Radio Mozambique Network, 31 Aug 91] .... 5
AIDS Cases in Six Provinces Increases to 251
[Maputo Radio Mozambique Network, 14 Sep 91) ..... 5

NAMIBIA

Over 900 AIDS Cases; Control Program Planned /Windhoek TIMES OF NAMIBIA, 21 Jul 91] .. 5
AIDS, HIV Figure Hits 1,320 (Windhoek THE NAMIBIAN, 23 Aug 91]

SOUTH AFRICA

AIDS Statistics for Western Cape Revealed

[Vivien Horler; Cape Town THE ARGUS, 14 Apr 91]... 6
Unions Formulating AIDS Policies
[Jennifer Pogrund; Johannesburg THE WEEKLY MAIL, 4 Jul 91] 6



JPRS-TEP-91-020
24 September 1991

among young people in the same circle of acquaintances.
For that reason the young men go to strangers—to
prostitutes.”

Ifa Thai man goes on vacation, a visit to a brothel is also
on the program, as a rule. If not, it is said that he did not
have a real vacation. And if he goes to the city with
business associates, the trip also often ends with com-
mercial sex.

Skin Diseases and AIDS

“Married men also go to prostitutes. They regard it as
simply a part of a man’s life. That provides fertile soil for
an entirely uncontrolled spreading of diseases, and there-
fore we are currently conducting a number of informa-
tion campaigns on safe sex and how important it is to use
condoms. And fortunately, our first checks indicate that
the campaigns are having an effect,” she says.

It is the Bispebjerg Hospital’s ward for skin and venereal
diseases that is to be in charge of the new international
cooperation on research. As a matter of fact, some of the
very first symptoms of AIDS appear as changes in the
skin and the mucous membranes. Indeed, those changes
take place in some cases even before changes in the blood
occur—that is, before one can demonstrate through
AIDS tests that a person is HIV-positive.

“The more information we get on skin diseases in
connection with AIDS, the better will be our ability to
get a timely treatment going—when a treatment is dis-
covered,” Superintendent Kaare Weismann of the Bis-
pebjerg Hospital says. He is in charge of the new research
project along with his colleague Jorgen Sondergaard.

The two doctors are also the coauthors of the book
entitled Skin Symptoms in Connection with AIDS, which
has come out in English, French, and Spanish.

“Denmark is very far ahead internationally where
research on skin diseases in connection with AIDS is
concerned,” says Jorgen Sondergaard. “We got started as
early as 1984, and we have kept track of a big group of
HIV-positive individuals since 1986,” he says.

Although a way of treating and curing AIDS has not yet
been discovered, research on skin diseases has produced
results by which AIDS patients also benefit. For
example, it is possible to treat the feared Kaposi Sarkom
skin cancer, which is an indication that AIDS is breaking
out. The same is true of a special type of facial warts.

“When a person gets Kaposi Sarkom or facial warts, that
is something like a clear-cut indication, for many people
want to know what is wrong immediately. Therefore, the
fact that the disease can now be treated in such a way
that the skin eruptions disappear entirely is naturally
fantastically important,” Kaare Weismann says.

“Treatment of skin diseases does not mean just some-
thing psychic. If we can make a contribution toward
reducing the ailment or increasing the mucous mem-
branes’ resistance, we will also increase resistance to the

WEST EUROPE 29

many complications that endanger AIDS patients. Fur-
thermore, by considering the various skin diseases, we
can often see how far the disease has advanced,” he says.

Cooperation with Thailand, Haiti, and Brazil will pro-
vide the doctors with much more research material than
they have at present. It will also be possible to use the
knowledge they obtain in connection with the collecting
of material to produce more knowledge concerning rare
diseases.

For example, Dr. Prakong Vithayasai has discovered
that AIDS patients in Thailand come down with the
otherwise tremendously rare fungus infection Penicil-
lium Marneffei amazingly often. It is so rare that only
about 35 people in the whole world get it in a year. That
is to say, at least that is what people thought until
Prakong Vithayasai found it in 10 of her AIDS patients
last year.

Minister Backs Disclosure of AIDS Cases

91WE0493A Copenhagen BERLINGSKE TIDENDE
in Danish 26 Jul 91 p 4

[Article: “Minister: The Doctors Must Disclose AIDS
Cases”—first paragraph is BERLINGSKE TIDENDE
introduction]

[Text] Physicians’ professional confidentiality can be
broken in special instances. The minister of health thinks
that physicians have the obligation to disclose cases of
HIV-infected patients if the infected person does not
want to inform the partner.

The doctors are faced with a problem when an HIV-
infected patient does not want to inform the partner
about the risk of infection.

“The HIV and the professional confidentiality are prob-
lematic,” says Per Hors, deputy chairman of the General
Danish Medical Association.

“In principle, the doctors should, of course, maintain
their professional confidentiality, especially with regard
to the confidence between doctor and patient. In fact, we
have had a real case where we felt that it was appropriate
to intervene and tell a spouse that the other spouse was
HIV-infected, as the party did not do it on his own.”

Health Minister Ester Larsen (V) has appealed to the
doctors to break the professional confidentiality if HIV-
positive patients do not tell their partners that they are
infected.

Ester Larsen’s appeal is based on Paragraph 9 of the
medical law. It is stated there that a doctor can break his
professional confidentiality if he is acting “to justify the
protection of public interest or because of the patient’s or
someone else’s need.”



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Back issues or single copies of the DAILY
REPORTs and JPRS publications are not available.
Both the DAILY REPORTs and the JPRS publications
are on file for public reference at the Library of
Congress and at many Federal Depository Libraries.
Reference copies may also be seen at many public
and university libraries throughout the United
States.


24 NEAR EAST & SOUTH ASIA

Syndrome’ (AIDS). Seventeen people have already suc-
cumbed to the dreaded disease, technical deputy of the
Blood Transfusion Organization said Sunday.

According to Dr. Faramarz Sulaiman-Pour another 25
non-hemophiliacs suffering from AIDS have been iden-
tified, of whom eight have already died.

He said 30 percent of the construction work on a large
blood refining plant in Tehran has been completed.

Putting blood products imports at $10m annually, he
said once the plant is completed, Iran would export
$10m worth of blood products in addition to meeting its
domestic needs.

The plant, which has a blood plasma capacity of 80,000
liters, is to be inaugurated next calendar year (to start 21
March 1992).

IJPRS-TEP-91-020
24 September 1991

Four Hundred Cases of AIDS Confirmed
914S1344f London KEYHAN in Persian 8 Aug 9] p 2

[Text] Bijan Sadrzadeh, deputy minister of health care
for the Ministry of Health, announced this week in
Tehran: 400 people in Iran have been afflicted with
AIDS. Sadrzadeh said: We have treated only 154 of the
victims, because the rest either do not know about their
disease or are afraid to contact a physician. Sadrzadeh
said 33 people in Iran have died of AIDS since 1987.
Recently a prominent university physician living in Iran
told KEYHAN in an interview that there are about 1,000
people afflicted with AIDS in Iran.

An army physician also recently told KEYHAN: A
considerable amount of the blood given to the injured
during the Iran-Iraq war had not been tested, having
been imported from Asian and African countries, and
therefore some of the people who underwent surgery in
those years are now HIV positive, which is the beginning
of the AIDS virus, and now, several years after the war,
this virus is active in the bodies of these individuals.


8 SUB-SAHARAN AFRICA

After two years in the field, Tshabalala and the others
know that while they are effective, they can only do so
much. After they leave Jozini, and the next town and the
next, what next?

Health workers say more people come to them for
condoms after the show, but often they don’t have any to
give them. “If condoms are not available, people will just
go back to the very same things,” says Tshabalala. “The
puppets really act as a pathbreaker—after that the mes-
sages need to be reinforced.”

Says a health worker: “We don’t have any pamphlets to
give people. We managed to get hold of some videos
privately, but with the big distances here it is hard to get
the information to people.”

“This is our biggest frustration,” says Friedman, who
created the show and does the puppeteering. “We try to
do workshops as well, to teach people in the area to do
their own back-up work, but we just don’t have the
resources. When you get any distance from the big
towns, there is very littlk—no pamphlets and often no
condoms. We have found a lot of ignorance and a lot of
fear.”

The social circumstances of many people make AIDS
education all the more difficult. ‘A lot of the guys in
Jozini were road workers moving from place to place,”
says Tshabalala. “Many expressed fear of losing their
jobs because they are far from clinics—they don’t have a
mobile clinic—and they would have to take time off
work to go for treatment. Getting condoms is also
difficult: by the time they knock off, the clinics are
usually closed.”

Friedman adds: “Families being split up creates all kinds
of problems. It is very hard, for example, for a women
just to get her husband to start using condoms. You have
to reach both partners and that’s difficult when they are
living separate lives.”

Fiore, who does the sound mixing and the music, iden-
tifies another problem: “‘You get dismissive statements
from a lot of employers and officials who say, ‘we have
tried AIDS education and giving out condoms, and it
just doesn’t work.’ I think it’s just their attitude, because
that hasn’t been our experience. At one place, workers
had to go to the manager’s office if they wanted con-
doms.

“There have also been signs that whites don’t think
AIDS affects them. It has been very noticeable that while
employers make it obligatory for black workers to attend
our show, white workers can come if they want. They
hardly ever do,” Fiore says.

“People have resisted condoms in the past because they
have been told about them in the wrong way, without
any understanding about their lives,” says Tshabalala.
“When they say they find sex ‘flésh to flesh’ more
enjoyable, I don’t condemn them for that.

JPRS-TEP-91-020
24 September 1991

“But then we discuss things like the fact that they may be
sleeping around now, but will want families later. We
talk about the fact that they risk taking AIDS and other
sexually transmitted diseases back to their wives at
home. They seem to understand that kind of approach.”

The puppets’ tour of Natal was organised by the Natal
Parks Board and the Progressive Primary Healthcare
Network, and was sponsored by two South African
corporations and a foreign-aid organisation. For more
shows, and the necessary back-up, further resources will
have to be found.

But senior officials in the region have indicated that
available resources are already stretched.

KwaZulu Health Minister Dr. Frank Mdlalose spoke of
“the ever-increasing threat of AIDS” while delivering his
budget speech recently. Mdlalose said 450 cases of HIV
infection had been found in 1990, three times as many as
the combined totals from 1986 to 1989.

Report: Negative Impact of AIDS ‘Exaggerated’

91WE0474B Johannesburg THE WEEKLY MAIL
in English 5-11 Jul 91 p 8

[Article by Reg Rumney: “Forecasts on AIDS Called
“Overblown”]

[Text] Forecasts of the economic impact of AIDS have
been overblown and alarmist.

This is a conclusion of a major new study, using sophis-
ticated economic modelling techniques, of the economic
impact of AIDS.

The report, by the Centre for Health Policy at Wits
University Medical School’s Department of Community
Health, does not minimise the vast human tragedy facing
South Africa. But it points out that faulty research
leading to huge total costs creates a sense of helplessness
and paralysis in the face of the epidemic.

“Most research on the economic impact of AIDS in
South Africa has been limited and superficial, and in
many cases, has stemmed from parochial sources with a
narrow perspective.”

It says pessimistic projections for South Africa suggest
that macro-economic impact will occur through serious
labour supply shortages and by reductions in markets for
goods.

“We believe that the overall impact of these trends in the
next 10 to 15 years has been exaggerated.

“High unemployment is likely to mean that a significant
number of those in the workforce who are disabled or
dying from AIDS will be replaced, so that temporary
labour supply bottlenecks, and frictional costs, rather
than substantial and lasting labour supply shortages are
likely to impact on the economy.”


JPRS-TEP-91-020
24 September 1991

ZAMBIA

Five Thousand AIDS Cases—Mainly Young
People

91WEO0505A Lusaka TIMES OF ZAMBIA in English
6 Jul 91 p2

[Article: “AIDS Cases Top 5,000”]

{Text] AIDS cases in Zambia have reached the 4,690
marks, it has been learnt.

This is according to World Health Organisation (WHO)
AIDS surveillance report presented by chairman of
national AIDS committee in Zambia Dr. Benson
Himoonga.

Dr. Himoonga who was speaking at a nurse tutors AIDS
seminar being held at the Ndola Central Hospital said
the number reported could be low because many cases
had not been reported.

He said the figure was as on May 31 and that was why the
home-care idea was brought up so that more cases could
be reported.

It was learnt that those mostly affected were between the
ages of 15 and 39.

This age group was mostly affected because it was the
most active sexually.

But there was a problem of behaviour change which was
a worldwide problem trend. The only way to control the
spread of the disease was to change the behaviour
because if people did not, the disease would then be in
Zambia forever.

Dr. Himoonga said the ministry of health had drafted an
HIV policy which would be submitted to Parliament
soon.

Some of the issues tackled in the draft of the HIV policy
in Zambia was the protection of human rights and the
dignity of those who were HIV positive and had AIDS.

ZIMBABWE

Testing To Begin on New Anti-AIDS Vaccine

MB0409140291 Johannesburg SAPA in English
1337 GMT 4 Sep 91

[Text] Harare Sept 4 SAPA—Zimbabwe’s minister of
health,-Dr. Timothy Stamps, said the country hoped to
test a new anti-AIDS vaccine over the next 12 months.

The national news agency, ZIANA, on Wednesday
quoted Dr. Stamps as telling a religious youth conference
that an estimated one million people were infected with
the HIV virus in Zimbabwe—which has about 9 million
people.

SUB-SAHARAN AFRICA a0

Dr. Stamps said the drug, which carries the chemical
name CD4 Immunoadhesin, was recently tested on
chimpanzees and may be able to block the transfer of the
HIV virus from mother to child.

The drug will be the second anti-AIDS vaccine to be
tested in Zimbabwe after the Kenyan-made drug, Kem-
ron.

Tests with Kemron were discontinued in Zimbabwe
because it had become unavailable.

Dr. Stamps noted that the HIV virus had also developed
the capacity to become dormant at times, thus making it
impossible to detect and deal with it at those moments.

“] think it is a great challenge to you young people to face
up to the challenge of the time,” Dr. Stamps told the
conference.

He pointed out that not only people with immoral or
promiscuous behaviour suffered from AIDS.

Morally upright people also got AIDS—mostly faithful
women with promiscuous husbands who they could not
tell to wear condoms as the wives would then be blamed
of promiscuity.

“The only one immunisation is a mutually faithful
life-long partnership,” he urged his young audience.

Mugabe Asks Churches To Help Curb Looming
AIDS Disaster

MB0809125491 Johannesburg Radio RSA in English
1100 GMT 8 Sep 91

[Text] Zimbabwean President Robert Mugabe says that
the country is on the verge of a disaster because of AIDS.
Mr. Mugabe called on Zimbabwe’s churches to coop-
erate with the government to curb the incidence of the
disease in the country. He said the support of the
churches was vital to counteract what he referred to as
loud [words indistinct] in Zimbabwe.

Health Ministry Reports 18,000 AIDS Carriers

MB1409173491 Johannesburg South African
Broadcasting Corporation Network in English
1600 GMT 14 Sep 91

[Text] Authorities in Harare said they may have to insist
soon that bodies of AIDS victims be cremated rather
than buried because of a shortage of cemetery space.
They say the city’s four main cemeteries will run out of
space within three years.

Zimbabwean Ministry of Health figures show that
18,000 Zimbabweans have AIDS and one million or 10
percent of the entire population are believed to be
carriers of the AIDS virus.