16 EAST ASIA

THAILAND

Health Minister Concerned Over Spread of AIDS

BK0702011990 Bangkok BANGKOK POST in
English 7 Feb 90 p 6

[Text] Public Health Minister Marut Bunnak yesterday
expressed concern over the rapid spread of AIDS
through sexual contact.

Besides Bangkok, the minister said Chiang Mai, Phayao,
Samut Sakhon, Nakhon Pathom, Rayong and Kanchan-
aburi [provinces] were reported to have an increasing
incidence of the AIDS virus.

He said the infection rate among female prostitutes in 14
provinces has increased from 3.5 percent in June 1988 to
6.6 percent in December 1989.

The spread of the fatal disease was also reported to be
higher among service girls in massage parlours.

Mr Marut said the Public Health Ministry has requested
the Cabinet for some 139 million baht for the construc-
tion of a rehabilitation centre which will be responsible
for educating the public about the danger of the virus.
The centre is also expected to provide occupational
training to AIDS patients.

It is expected that the number of patients infected with
the HIV virus will not exceed 24,000 cases by the end of
next year, he said.

Permanent Secretary for Public Health Dr Somsak
Worakhamin said yesterday that the campaign against
AIDS has shown results as more people use condoms
now.

He said, however, that without an adequate control
system, the number of HIV-positive patients could go as
high as 120,000.

Dr Somsak said the number of patients with vencral
diseases has been decreasing since the middle of last
year, showing that more condoms have been used. He
said this reflected a good sign for AIDS control.

He said VD cases have dropped from 32,000 to about
17,000 a month.

According to the latest statistics of the Ministry, there
are some 35 full-blown AIDS cases of which 17 are alive,
some 106 AIDS-related cases of which some 86 are alive,
and some 14,116 HIV-infected people of which some
14,033 are alive.

Besides intravenous drug users and prostitutes, Dr Thira
Rammasut, director general of the Communicable Dis-
ease Control Department, said the number of potential
blood donors found to be infected has also increased
from 3.7 percent during the first half of last year to 8.2
percent during the second half of last year.

JPRS-TEP-90-003
5 MAR 1990

13,000 Have AIDS, Cases May Double by 1991

BK0102010590 Bangkok BANGKOK POST in
English! Feb 90 p 4

[Text] More than 13,000 people in Thailand have been
found to be infected with the deadly AIDS virus and the
number is expected to double by the end of next year.

Dr Thira Rammasut, direct general of Communicable
Disease Csontrol at the Public Health Ministry, said
some 77 percent of the virus victims were intravenous
drug users,

He added, however, that the number of cases contracted
through sexual transmission was increasing rapidly.

Without proper controls, the number could increase
tenfold by 1996, he said.

According to Dr Wichan Witthayasai of Chiang Mai
University, the northern province has the highest rate of
HIV-infected prostitutes, when compared to other prov-
inces.

Chiang Mai, he said, also has the highest percentage of
HIV infection among blood donors, pregnant women,
male prostitutes and men with venereal disease.

Meanwhile Dr Praphan Phanuphak, an AIDS expert at
Chulalongkon Hospital, said Thailand was very open
about the AIDS situation. He called for other Asian
countries to also be more open about the disease and to
exchange information and cooperation.

According to a report by the World Health Organisation
(WHO), only India, Indonesia, the Philippines and Thai-
land report full-blown AIDS cases to the organisation.
However, the number of reported cases is believed to be
extremely underestimated.

Dr Praphan also called for free trials of safe medicines
for AIDS treatment, such as AZT.

Plans To Upgrade AIDS Control Committee
Approved

BKO0702013190 Bangkok BANGKOK POST in
English 7 Feb 90 p 6

[Text] The Cabinet yesterday approved the Public
Health Ministry’s proposal to improve the efficiency of
the committee for coordinating the prevention and con-
trol of AIDS.

Under the proposal, the committee will be renamed
“National Committee for Coordinating Prevention and
Control of AIDS.”

The Public Health Minister and Deputy Public Health
Minister are the committee’s chairman and deputy
chairman respectively. The panel has 40 other members.

The committee is to formulate policy, strategies and
activities for the prevention and control of AIDS; to
disseminate knowledge on the deadly virus; to promote



JPRS-TEP-90-003
5 MAR 1990

AIDS Fund in providing technical information which
neither bores nor terrifies unnecessarily,” said Jens Ole
Nielsen.

“The life-expectancy of the individual AIDS patient has
tripled over the last few years, and these patients can
now live for a considerable number of years with the
disease, if they receive proper treatment. Denmark has
been in the forefront in proving this to be so, but as long
as no vaccine exists, prevention is all-important,” said
the Chief Physician at the meeting, at which actress
Susse Wold presented awards to producer Per Wenneck,
physician Court Petersen, chef Robert Holm Jensen and
journalist Ruth Northen.

This year’s poster, a lithograph by Bo Bonfils, was also
presented.

He received a kiss from Susse Wold, who said:

“You'll have to be satisfied with a kiss, since that’s all we
can afford.”

However, a little money did subsequently come into the
critically depleted fund, when hospital administrator
Jorgen Frederiksen presented a check for 10,000 kroner
from Copenhagen County.

Program Effectiveness Weighed

90WE0079C Copenhagen BERLINGSKE TIDENDE in
Danish 7 Dec 89 p 11

[Guest commentary by Lone de Neergaard: “AIDS—A
Mutual Responsibility”; first paragraph is BER-
LINGSKE TIDENDE introduction]

{Text] Lone de Neergaard is chief physician of the Board
of Health.

The European Women’s Prize for 1989 was awarded
Saturday at the EEC summit meeting in Strasbourg.
There were 12 national candidates for the award, which
is being given for the third time this year. Today's
feature writer is Denmark’s candidate on the basis of her
great efforts in fighting HIV infection and AIDS.

People often say, why don’t we hear more about AIDS.
Others are saying, we can’t stand to hear any more about
AIDS. Who is right, and what is the problem, if there is one?

FACTS: In September of 1982, there were 50 AIDS cases
in the United States and four in Denmark.

Presently, 500 patients here in Denmark will have
received the grave diagnosis of AIDS. A good half of
them are dead. Approximately 15 new patients are added
every month. The death toll from AIDS is far lower than
for other serious diseases such as cancer and heart
disease, but AIDS strikes young people who would
otherwise be healthy and active.

With respect to the concept of “lost years of life,” AIDS
is presently the sixth or seventh deadliest disease in the

WEST EUROPE 37

United States, ahead of chronic lung disease and dia-
betes, and it will climb even higher on the list.

We know that we have 5,000 HIV-infected individuals
who will develop the AIDS disease and die from it over
the course of 5-10-15 years. They will be contagious
throughout that entire time. Some 20-30 new HIV-
positives are found every month.

The majority of HIV-positives are found among homo-
sexuals and drug abusers. However, there tends to be
more heterosexuals, more women and more children
born with the disease among the new HIV-positives.

It must be stated that, at the moment, there appear to be
no prospects for the appearance of an effective vaccine
or a healing treatment over the coming years. We know
how the disease is transmitted, and we know how to
prevent it, but even if this prevention were to be imple-
mented universally, we would still have a growing
problem in treating and caring for those already infected,
who will develop AIDS at some time or another.

History: 1985. Approximately 45 cases are found in
Denmark, and the Board of Health proposes a special
preventive effort, with stress on education.

1986. The problem is acknowledged politically, and
funds are appropriated to establish a special AIDS
secretariat in the Board of Health, for AIDS workers and
for an intensive educational effort with respect to the
general population.

1987. The Folketing adopts a resolution which requires
that subsequent efforts be based on voluntary participa-
tion, anonymity, open, direct and honest information,
the security of the individual who refers himself to the
health authorities, and a desire to avoid all forms of
discrimination. The Board of Health initiates an inten-
sive information campaign.

1988. The law on venereal disease is repealed. The Board
of Health undertakes, in cooperation with Radio Den-
mark a major information campaign.

1989. The law on registered partnership between homo-
sexuals is adopted. The Board of Health initiates no
central information campaign.

AIDS is an unusual disease—with respect to its severity,
the speed with which research has achieved results and
the nature and scope of changes in the attitude of society
toward it.

Information campaign:
The Danish effort has been characterized by:

—the formulation and tone of the public information
campaign

—the relationship between the highly visible centralized
and less visible decentralized effort. The centralized
effort can stimulate attention and provide knowledge,
whereas local activities can provide more highly


IJPRS-TEP-90-003
5 MAR 1990

CANADA

AIDS Victims Receiving Tainted Blood To Be
Compensated

54200020A Toronto THE GLOBE AND MAIL in
English 15 Dec 89 pp Al, A2

[Article by Mary Gooderham: “Some AIDS Victims To
Be Compensated”)

[Excerpts] The Canadian government will provide $150-
million to people who have AIDS or the virus that causes
the syndrome because of tainted blood products, Health
and Welfare Minister Perrin Beatty said yesterday.

Calling it an “overwhelming public policy” decision, Mr
Beatty said $120,000 in compensation will be given to
each victim as “disaster relief” and as a way of shoring
up confidence in Canada’s blood supply.

However, people who have contracted acquired immune
deficiency syndrome or the human immunodeficiency
virus from sources other than blood transfusions or
blood products will not receive any of the money.

“We're taking this action today in order to ensure public
confidence in Canada’s blood supply system,” Mr Beatty
said. “It’s not designed as an AIDS relief program as
such.”

The Department of Health and Welfare estimates that
1,250 people in Canada, 950 of them hemophiliacs, were
infected with HIV from receiving blood transfusions or
products from 1979 to late 1985, when the Canadian
Red Cross started screening blood donations for HIV.

Members of the Canadian Hemophilia Society, which
has been negotiating with the government for about 18
months to get compensation, said they were satisfied
with the announcement although they originally asked
for $340-million.

“We're pleased that the government is taking leadership
on this and has moved forward,” said Elaine Woloschuk,
president of the society.

Provincial governments are also being asked to provide
compensation, she added.

About 41 percent of the 2,300 hemophiliacs in Canada,
all of whom are male, have been infected with HIV, she
said. Fifty-five of them have died from AIDS and
another 55 have the full disease.

Mr Beatty said that of the 3,272 reported cases of AIDS
to Dec 4, 163 are people who received it from blood
products and 109 of them have died. [Passage omitted]

Canadians with HIV infection who can prove they were
infected by blood received until late 1985 will each get
four yearly tax-free installments of $30,000, starting next
year. If they have died, the money goes to their estate.
[Passage omitted]

WEST EUROPE 33

AIDS National Program Delay, Incidence Reported

Delay in National Program

54200025 Toronto THE GLOBE AND MAIL in
English 8 Jan 90 pp Al, A2

[Article by Christie McLaren: “Long-Awaited Program
To Fight AIDS Won’t Be Available Until. Next
Summer”)

{Excerpt] Canada will not have a national strategy to
combat AIDS until next summer—almost one year after
Health Minister Perrin Beatty suggested he would pro-
duce the long-awaited strategy by the end of 1989.

“It’s going to take rather longer than we liked...more
towards the summer,” Dr. Alastair Clayton, director-
general of the Federal Centre for AIDS, said in a recent
interview.

He blamed the delay on Ottawa’s need to seek further
consultation with the provinces and non-government
organizations.

The delay has angered AIDS community groups, who
expected to wait until February at the latest for a
national, co-ordinated strategy to battle the fatal syn-
drome that is killing thousands of people in their prime.

“It’s a big surprise to us,” said Richard Burzynski,
executive director of the Canadian AIDS Society in
Ottawa.

“We were told publicly in Montreal in front of 10,000
people that there would be a strategy by the end of the
year.”

However, a spokesman for Mr. Beatty said the Minister
made no firm promise.

“He never promised that,” Marie-Diane Faucher, Mr.
Beatty’s press secretary, said in an interview yesterday.

Quoting from the Health Minister’s speech to the Fifth
International Conference on AIDS in Montreal June 3,
Mrs. Faucher said that Mr. Beatty said: “I want to see a
national AIDS strategy produced this year” after broad
consultation.

Mr. Burzynski said the Minister’s office “is passing the
buck.

“The highest person in charge of health in this country
has made a commitment to have an AIDS strategy...be-
fore the whole world.”

He said Mr. Beatty recently suggested that there could be
a delay of several weeks before a strategy is unveiled.

But “if it’s true that it won’t be announced till summer,
then we’re extremely disappointed.”

Last fall, Ottawa produced a draft of what is called the
first national strategy on AIDS.



42 WEST EUROPE

Security, who is also a member of the Swiss AIDS
Commission, no request for an assumption of expenses
for provident care has yet been submitted to his office. A
decision by the Swiss Federal Council is not expected
until the early months of the coming year.

The series of problems associated with provident care for
AIDS-infected persons is, on the other hand, not on the
agenda of the Experts’ Commission which is doing
preliminary work on a revision of the Health Insurance
Fund Law, explained Otto Schoch, commission presi-
dent and Councilor of States (Appenzell Ausserrhoden,
Liberal-Democratic Party) in response to a query. None-
theless, proceedings instituted by an AIDS-infected
person against Gruetli Insurance in this regard are
pending before the Swiss Insurance Tribunal, declared a
spokesman for the Concordat of Swiss Health Insurance
Funds. As a precedent-setting case, the decision could
have an influence on judicial administration.

UNITED KINGDOM

Health Department Reports AIDS Statistics

54500039 London THE DAILY TELEGRAPH in
English 12 Dec 89 p 4

{Article by David Fletcher, health services correspon-
dent and Steve Connor, technology correspondent: 22
Children Among Victims of AIDS”]

[Text] A further 43 people died of AIDS last month,
bringing the total number of 1,465, the Department of
Health announced yesterday. The number of cases rose
by 62 to 2,779, of whom 2,250 are homosexual or
bisexual men.

Children are increasingly being affected. Twenty-two
children of infected parents have developed the disease
and 11 of them have died.

Of 112 women who have developed AIDS, 30 caught the
infection abroad.

Tests of the most promising technique so far for devel-
oping an AIDS vaccine—using a “pickled” virus which
has been shown to protect laboratory monkeys—will
begin in Britain within the next few days.

IPRS-TEP-90-003
5 MAR 1990

Researchers at the Centre for Applied Microbiology
Research at Porton Down are waiting for a laboratory
reagent to arrive from the United States so that they can
repeat the tests of the experimental vaccine used by
scientists at Tulane University, New Orleans.

The reagent, called threonyl muramyl dipeptide, is made
by Syntax Research in Palo Alto, California and was
used to help Tulane’s experimental vaccine protect a
group of rhesus macaque monkeys against a virus that is
similar to the human AIDS virus, said Dr Peter Green-
away, deputy head of pathology at the centre.

The British researchers will inoculate rhesus monkeys
with the reagent along with a whole “pickled” virus that
has been killed by soaking it in formalin. The hope is that
the killed virus will stimulate the immune system of the
monkeys.

“There are some difficulties associated with it,” said Dr
Greenaway. “It is all going to take a long time.”

The following table shows the number of United Kingdom
AIDS cases analysed by patient characteristics. The fig-
ures show cumulative totals up to the end of last month:

Males | Females] Total | Deaths
Homo/Bisexual 2250 — | 250 | 1165
Intravenous drug abuser 59 19 B 35
(VDA)
Homo/Bisexual and [VDA 38 = 38 7
Haemophiliac 163 2 165 Wt
Recipient of Blood:
Abroad " 15 26 18
UK 14 7 21 16
Heterosexual:
Partner with high risk fac- 7 15 2 9
tors
Others:
known exposure abroad 66 30 96 49
no evidence of exposure 9 4 13 7
abroad
Child of at risk/infected 9 3 22 "1
parent
Other/Undetermined 41 7 48 27
Totals 2667 u2_ | 2779 | 1465



10 SUB-SAHARAN AFRICA

Large doses of costly cancer drugs become necessary as
the virus takes its toll.

Top businessmen are among the “hidden” AIDS victims
and are spending up to R5,000 a month just to stay alive.

Ashamed

“Fortunately I have a top position and earn well, but I
don’t know how long I can keep on,” a company director
whose name cannot be revealed told the SUNDAY
TIMES.

“I am ashamed to face people I know who are dying
because they can’t pay for the dose,” said the well-
dressed executive.

The “dose” refers to wonder drug AZT or Zidovudine,
selling at R530 for a minimum quantity one-month supply.

Mr J owes his healthy look to the fact that he can afford
three times this amount—which he needs—plus a cock-
tail of five other cancer drugs.

Produced by American pharmaceutical company Well-
come, AZT “buys time” for the AIDS victim because it
interferes with the multiplication of the dreaded HIV or
AIDS virus.

But AZT is available in Europe at a mere R100 for a
month’s supply and is distributed free of charge by
national health schemes.

In South Africa only a minority have access to it.

Perplexed

The Transvaal Provincial Administration has agreed to
administer AZT to only 10 chosen patients in teaching
hospitals.

“AZT is available at all teaching hospitals but, due to
financial restrictions in limited quantities,” said a
spokesman for the TPA.

South African AIDS victims classified as hospital
patients are given more expensive but less effective drugs
such as Alpha Interferon and Interon A.

A minimum dose of Interon A costs taxpayers R1,800.

The same dose of the more effective AZT costs only
R530.

Doctors consulted said they were “perplexed” by the Gov-
ernment’s preference for the costlier, less effective drug.

Survey on Black Miners’ Awareness of AIDS

54000019A Johannesburg SOWETAN in English
27 Nov 89 p 9

[Text] South Africa’s black miners are a responsible section
of the community and have a broad understanding of
sexually-transmitted diseases (STD's) and AIDS.

JPRS-TEP-90-003
5 MAR 1990

These are the findings of an interview survey recently
carried out by the Chamber of Mines Human Resources
Laboratory.

The purpose of the survey was to examine black mine-
workers’ awareness of AIDS and STD's and the behav-
iour patterns potentially affecting the transmission of
these diseases.

The South African mining industry is acutely aware of the
implications of the worldwide AIDS epidemic and, as a
logical extension of the industry’s concern for workers
health and safety, has developed an AIDS cducational/
counselling programme and has carried out surveys in an
effort to obtain much needed data on the subject.

Sample

The current survey was conducted among a sample of
429 black miners from four South African gold mines
representing 5.6 percent of the labour force of these
mines. Confidential interviews were held with the con-
sent of the respondents.

The results of the survey revealed a general awareness of
AIDS, no fewer than 94.6 percent of the respondents had
heard of the disease. The survey also highlighted a broad
understanding of preventive measures against AIDS.

STD

Fifty percent of those who had heard of AIDS mentioned
single partner relations and a further 11 percent cited
“no casual sex, while 34 percent mentioned the use of
condoms.

However, despite this general understanding of AIDS,
the feeling of personal susceptibility was low, only 20.3
percent believed they could contract the disease.

In addition 15.5 percent of the respondents believed AIDS
was curable, with a further 20.2 percent undecided.

Because of the predominantly sexual transmission of
AIDS, the survey also sought information from respon-
dents about STD's. Every respondent could name at
least one STD.

Treatment

Thirty percent of those who had had an STD sought
treatment from mine doctors and 41 percent from out-
side medical practitioners, while traditional and reli-
gious healers were consulted by a further 30 percent,
often with a medical consultation at the same time.

A negative factor uncovered by the survey was a reluc-
tance to inform sexual partners on contracting an STD,
friends or “someone else” are often told (51 and 19
percent respectively), while wives and girlfriends are told
less often (1.7 and 18 percent respectively).

The mining industry’s news media were found to be the
most important sources of AIDS information followed
by medical staff and friends. Close friends and colleagues



20 LATIN AMERICA

case seen at the regional IHSS hospital in this city was
diagnosed in January of the following year.

The report also indicated that this city ranks first in
diagnosed cases of AIDS, with 158, while Tegucigalpa
ranks second, with 50.

469 Confirmed AIDS Cases

90WE0122A Tegucigalpa LA TRIBUNA in Spanish
24 Jan 90 p 10

[Text] Yesterday the coordinator of the National Com-
mission on AIDS, Jose Enrique Zelaya, declared in San
Pedro Sula that AIDS is spreading nationwide, stressing
that the aforementioned city is still recording the largest
number of cases.

Nevertheless, according to that official, the number of
victims of the fatal disease is continuing to rise in
Comayagua, Choluteca, Danli, El Paraiso, Santa Rosa de
Copan, Santa Barbara, and throughout the entire
country.

He noted that 469 cases have been confirmed in Hon-
duras to date, and announced that the sum of half a
million lempiras is awaiting approval by the National
Congress, to be spent on educational activities, pur-
chases of equipment, reagents, medications, and other
materials, as well as the hiring of personnel.

The official remarked: “If the National Congress
approves this budget for us, we’ll have better weapons
for preventing the fatal disease.”

He indicated that the spread of AIDS is alarming, and
therefore all the country’s community leaders must join
in the campaign to create awareness, for prevention.

PERU

AIDS Developments

Infection Estimates

90WE0098A Lima EL COMERICO in Spanish
1 Dec 89 p 8a

[Text] Some 600 serious cases of AIDS have been found
to date in Peru. Of these more than half the victims have
died. This figure indicates there are some 50,000
infected persons. Most do not know they are carriers of
the deadly disease and are infecting others with whom
they come in contact.

This disclosure was made by Dr. Raul Centella Sala-
verry, president of the Peruvian Foundation Against
AIDS and Malaria [Funmatrop]. He called for height-
ened national awareness of the scourge during obser-
vances of World AIDS Day.

In a speech to educators at Cayetano Heredia University,
he said spread of the disease in Peru is occurring mainly
through blood banks.

JPRS-TEP-90-003
5 MAR 1990

In the United States, he said, searches turn up | bag of
blood with AIDS in every 20,000 while in Peru 1 of
about every 500 is infected. The situation is even worse
in Callao where AIDS shows up in | out of every 150
bags. “This shows us that the disease spreads most
directly through blood transfusions,” he said.

He also reported that bisexuals have replaced homosex-
uals as the most frequent carriers of AIDS. “They are
more dangerous because they’re generally married and
have contact with several women,” he said.

He released other figures showing that in Peru there are
some 60,000 homosexuals, and about half of them are
involved in “prostitution.” “Eighty percent of the gay
community carries AIDS, and if these homosexuals
don’t change their ways, they will all die between now
and the year 2000.”

He stressed that the only way to avoid the scourge is to
Tefrain from extramarital sex. Young people should wait
until they are married to have sex “if they want to escape
this catastrophe.”

Health Ministry Figures

90WE0098B Lima EL COMERCIO in Spanish
2 Dec 89 p 9a

[Excerpt] An estimated 20,000 persons in Peru are
infected with the immune deficiency virus that causes
AIDS. However, through June of this year, only 400
cases of infection were reported along with 210 patients
with symptoms characteristic of the disease.

Health Minister Paulo Caro Gamarra released these
figures during a press conference at the ministry yes-
terday in observance of World AIDS Day. He placed
special emphasis on the role of youth in preventing and
controlling this scourge.

Also present at the gathering were members of the
Consulting Committee for AIDS Control, Drs. Carmen
Estacio, Alejandro Padron, Manuel Lujan, and Santos
Hinostroza.

The number of reported cases is not alarming, Caro
noted, but there is cause for concern given the experience
of other countries where the incidence of AIDS has risen
geometrically.

He explained that, according to WHO studies, for every
AIDS case found there are 50 or 100 more. This means
that in Peru bearers of the virus number in the thou-
sands, he said.

Of the known cases, he said nine are in Arequipa, eight in
La Libertad, three respectively in Iquitos and Ancash,
and one each in Cuzco and Ica.

He also said it will be about 7 years before AIDS
prevention measures now being put into effect show
results due to the virus’ long incubation period.



38 WEST EUROPE

nuanced opportunities for the dialogue which is nec-
essary to change attitudes and behavior.

—cooperation with those volunteer organizations which
both qualitatively and quantitatively mount an effort
which the public sector could never undertake.

Theses traits are present in the campaigns of most other
countries, and they are recommended in WHO's pro-
gram. However, their application in Denmark has
achieved a form which has won international attention
and acknowledgement.

What have we achieved?

Scarcely three years have gone by, and the battle to
change behavior is long and hard. No one had heretofore
undertaken an information campaign of corresponding
scope. No one imagined that an outward campaign alone
could change anything as fundamental as sexual habits.
However, these campaigns are an extremely effective
and necessary part of a long-term and, consequently,
more compound effort.

This is one of the problems, maintaining the effort.
Interest waxes and wanes independent of the magnitude
of the problem.

Interest will not arise of itself, it must be created by
someone. There is no doubt that the media have been
and are thoroughly decisive in arousing the interest of
both the public and politicians in the subject. However,
the media’s purpose is to pass along news, and when
there is no news pertaining to HIV or AIDS, there is no
interest from the media. It would not be possible to
purchase sufficient attention in the broadcast and print
media, even with much greater resources. For these

reasons, a local effort in the daily environment of the

individual is now more important than ever.

The Danish effort has been strongly criticized—and
internationally famous. There are many good and bad
reasons, the latter among them, why many individuals
and groups cultivate special interests by means of the
AIDS debate. Knowledge of the situation naturally
makes it enjoyable for the informed critic, but it confuses
the picture for the average citizen.

Criticism has been directed against the great emphasis being
placed on the condom. This is understandable per se, but
unfortunately no safer or more acceptable means of limiting
the infection exists. In any case, no one has come forth with
better ideas, since we cannot consider celibacy or an eter-
nally monogamous relationship as realistic life styles for
many people. The starting point is therefore that the use of
condoms, even though they do entail some uncertainty, is
much, much safer than no condoms.

Additionally, the problem is that the subject is far too
extensive and complicated to allow for any comprehen-
sive and in-depth discussion to take place in the media
within the limits of the air time and press offered.

JPRS-TEP-90-003
5 MAR 1990

Many studies and opinion polls which have been taken
indicate that it does help to provide information, even if the
ultimate: goal-behavior patterns—is not reached. Develop-
ments in daily conversation, where terms such as anal sex
and condom are accepted in a completely different way than
previously are another example of this. Condom sales have
increased, although this phenomenon is difficult to evaluate
precisely. Despite some oscillations, the incidence of vene-
real illness has shown a definite downward trend, and today
it is at its lowest point in over 100 years.

What then should happen in 1990?

Our greatest responsibility to the protection of the future
in this context is to find a way to grab the future interest
of the population, the media and politicians with respect
to the necessary changes in behavior—and to keep it. It
is hard to inform people if they are not receptive to the
information. A year ago the message was “‘we can’t stand
to hear any more about AIDS,” and today we ask “why
aren’t we hearing more about AIDS.” This balance is
problematic, but these difficulties will be solved.

The most important task in the coming year will be to
revitalize interest among the people, to influence persons
exhibiting risk behavior, to influence young people with
respect to the establishment of sensible sexual habits,
including the use of condoms, which also prevent other
sexually transmitted diseases,

The spreading of contagious disease continues among
gays and bisexuals, despite all of the information which
has been provided. How can we prevent this? This effort
must be carried out in close cooperation with the
National Association of Gays and Lesbians.

The effort directed towards drug abusers continues to be
inadequate. This effort requires the availability of treat-
ment, which is resource-intensive. The spreading of
contagious disease continues in this group, with its
accompanying risk of spreading to the heterosexual
portion of the population.

Employment problems pertaining to the firing of HIV-
positives indicate that acceptance and tolerance of HIV-
positives as a minority group is a long way off, and this
problem should be one of our educational targets. An
effort must be made in this area.

Finally—the fight against AIDS is a common responsi-
bility, and not the responsibility of the Board of Health
alone.

Greenland Surgeon General Issues AIDS Warning

90WE0085A Nuuk GRONLANDSPOSTEN in Danish
5 Jan 90 p7

[Article by Ole Dall: “Gloomy Report on Greenland
Deaths”; first paragraph is GRONLANDSPOSTEN
introduction]

[Text] The suicide rate in Greenland is the highest in the
world. In his annual report, the surgeon general asks for



JPRS-TEP-90-003
5 MAR 1990

CAMEROON

100 AIDS Cases Detected; Disease Spreading

54000023B Yaounde CAMEROON TRIBUNE in
French 1 Dec 89 p 5

[Article by Claude B. Kingue: “From Bad to Worse”;
editor’s lead is “Some regions of the world are more
affected than others. But AIDS is spreading nonstop
everywhere”)

{Excerpt] While there is no indication that a cure for
AIDS will be developed anytime soon, the number of
people infected with HIV is increasing. True, only a few
poets and old madmen still doubt the existence of AIDS.
Yes, the disease is unequally distributed, with some
regions more affected than others. In Cameroon, for
example, there are only 100 known cases. But here as
elsewhere the peril, like the tide, is rising—irrepressible,
or nearly so. One or two years ago for instance, the
AIDS-prevaience rate in Cameroon was somewhere
between 0.2 and 0.5 percent. Today it is 0.8 percent. The
spread of the disease throughout sub-Saharan Africa has
been just as rapid, if not more so. At the end of last year,
the region had 20,778 AIDS victims. Nine months later
the figure had jumped to 31,000. And if nothing is done,
the number of Africans with AIDS will reach 1 million
by the year 2000. Worrisome! [passages omitted]

Blood Transfusion Guidelines To Limit AIDS

54000023A Yaounde CAMEROON TRIBUNE in
French 20 Nov 89 p 6

[Article by Anyee Anyee: “Reducing the Risks of AIDS
Transmission”; first paragraph is editor’s lead]

{Text] Action by health-care professionals should lessen
the risk of AIDS infection through blood transfusions.
That is one recommendation of the seminar on reducing
blood transfusions held 15 to 17 November in Yaounde.

The workshop seminar on cutting back on blood trans-
fusions, which began 15 November, ended last Friday in
the CUSS (University Center for Health Sciences) “B”
amphitheater. For three days participants came from the
country’s 10 provinces and established the directives for
blood transfusion practice suitable for Cameroon.

The seminar participants described the country’s current
transfusion situation and took a hard look at how
indications for transfusing blood and blood derivatives
are defined. At the same time, they identified alternative
solutions and how to promote their use.

This seminar is a new step in our country’s long-term
campaign to block the spread of AIDS. For as everyone
knows, there is currently neither vaccine nor treatment
against this illness. Research efforts [are focused on] the
different avenues through which the virus affects indi-
viduals. The main avenue of infection is sexual in
Cameroon. For now, efforts are being made to inform,

SUB-SAHARAN AFRICA 1

educate and communicate, to promote behavior that will
protect individuals from the virus.

Another well-known source of infection is transfusion
with untested, infected blood. This cause directly impli-
cates all health-care professionals and “‘it is our actions
that must enable the risks of transmission via transfusion
to be reduced to the minimum,” said Professor Lazare
Kaptue, inspector general of the Ministry of Public
Health.

Cameroon now has tests that can determine whether or
not blood to be used for transfusion has been in contact
with the virus. Besides these tests, our country has also
begun training technicians and supplying laboratories
with re-agents. But given the high cost of the latter, there
is still a supply problem. For if it is good “‘to test blood,
it is better still not to transfuse. Or at least not to do so
except as a last resort.”

GABON

Chinese Aid for Anti-AIDS Research

90WE0093A Libreville L’UNION in French
7 Dec 89 p 6

[Article by Sophie Lenga: “A Chinese Mission in Our
Country”]

[Text] Yesterday morning, Minister of Public Health
and Population Dr Jean-Pierre Okias received PRC
Ambassador An Feng-Shi who had come to propose to
him his government’s contribution to the meeting of
sponsors of the midterm anti- AIDS national plan that
was held recently in our capital.

According to the Chinese ambassador, this contribution
is made up of two parts, one involving bilateral cooper-
ation dealing mainly with the sending of a Chinese study
mission to evaluate, together with Father Gassita, the
significance of Gabonese medicinal plants that could
provide a cure for AIDS.

With regard to the second part, devoted to multilateral
cooperation, Chinese experts would be placed at our
disposal to work with WHO technicians specifically in
anti-AIDS research. It should be pointed out that this
meeting with the minister of public health came about as
a result of the participation of a Chinese embassy repre-
sentative to the latest meeting of the sponsors of the
anti-AIDS campaign on 27 November. An Feng-Shi also
mentioned the confidence the Chinese people have in
the curative properties of medicinal plants that are
already providing positive results in his country, mobi-
lized, following the example of the entire world, to find
a reliable therapy capable of overcoming this illness.

Answering his guest, the health minister expressed his
satisfaction in seeing cooperation in medicine and health
between China and Gabon constantly increasing and
also in seeing the dynamism with which the Chinese
mission in our country works.



JPRS-TEP-90-003
5 MAR 1990

As it turned out, the overwhelming majority of the
persons who were tested had been in hospitals at some
time in the past, which in itself is of interest. However,
this also demonstrates that this method of assessing the
probability of intra-hospital dissemination of HIV is not
very promising.

An enumeration of every possible complaint the subject
could have was included into the questionnaire for the
purpose of identifying the incidence of symptoms which
were described in the literature as typical manifestations
of AIDS: “sweating, fever, lymph node enlargement,
weight loss, stool disorders,” as well as typically neurotic
conditions such as “insomnia, drowsiness, difficult
breathing, nightmares.” In order to avoid arousing sus-
Picion on the part of the queried subjects, the types of
complaints were listed randomly without any system.
Only 5% of the queried persons listed no complaints. A
total of 33.2% listed more than three complaints, and 1%
listed all of the complaints indicated in the question-
naire. The preponderance of neurotic complaints (23.5%
with insomnia, 25.3% with drowsiness, 9% with night-
mares, etc.) certainly was indicative of the large per-
centage of mentally unstable subjects who had come in
for testing. The presence of a large number of hypochon-
triacs who were looking for a “new disease” in their
bodies was inspired by the press, which regularly pub-
lished the “symptoms of AIDS,” which, as we have seen,
are easily discovered by predisposed persons. Among
those who came in for testing, we quickly identified
persons suffering from persecution complexes who com-
plained that they had been deliberately infected with
AIDS, etc. In that connection, beginning in 1988, a
psychiatrist began to work in our anonymous testing
laboratory in order to identify persons who were in need
of psychiatric help.

In our view, anonymous testing, through the use of
questionnaires, enables the collection of essential infor-

“mation regarding the vigor of various modes of trans-

mission and the degree to which the public is aware of
them. However, the query forms need to be more thor-
oughly adapted for purposes of research.

Anonymity of investigations not only promotes the
appearance of persons at risk of infection, but also makes
it possible to obtain valuable supplemental information
that is not attainable in the course of regular testing.

Thus, the ten-month operation of our anonymous AIDS
testing laboratory has proven to be highly effective in
identifying infected persons and in assessing the poten-
tial intensity of various modes of HIV transmission and
the role of various contingents in the introduction of the
virus into the USSR.

Conclusions

1, Anonymous testing for HIV antibodies is a highly
effective method of identifying sources of infection.

SOVIET UNION 31

2. Questionnaire surveys of persons requesting anony-
mous testing can be used to obtain information about the
intensity of virus transmission modes.

3. The USSR has a stratum of the population in which
HIV is rapidly spreading.

4, The permeation of infection into the USSR can occur
in hetero- and homosexual contacts with foreigners, The
virus can permeate the drug addict segment through
sexual contacts with foreigners and homosexuals.

5. When the mass media is used for AIDS prevention
purposes, principal attention should be given to the
sexual route of viral transmission.

Bibliography

1. WHO—Diagnosing AIDS and Controlling It: Current
Status. Copenhagen, 1987.

2. Pokrovskiy, V. V., Yankina, Z. K., and Pokrovskiy, V.
I, ZHURN. MIKROBIOL., No 12, pp 8-11, 1987.

AIDS Testing Lab in Kiev

907C0060B Kiev RADYANSKA UKRAYINA in
Ukrainian 13 Sep 89 p 4

{Interview by Ye. Krasnovskiy, under the rubric “Urgent
Interview”: “Kiev: AIDS Is Detected”; first paragraph is
RADYANSKA UKRAYINA introduction]

[Text] The AIDS testing office at the Kiev Scientific
Research Institute of Epidemiology of Infectious Diseases
imeni L. V. Gromashevskiy has been operating for two
years in the Ukrainian capital (Vorovskaya Street, 20).
Our correspondent interviewed an infectious disease spe-
cialist from the institute, O. P. Purik.

Krasnovskiy: Tell us, please, about the results of your
work.

Purik: Our office is the first of its kind in the Ukraine.
Since we began operating, we have checked 7,000 people.
Most of them are Kievites, but we have also had people
in from other cities of our Republic. We have also
checked foreigners from two Kiev higher institutes of
learning.

Krasnovskiy: And?

Purik: Up until now everything has been OK. But
recently we found two AIDS-stricken patients.

Krasnovskiy: Foreigners?

Purik: No. Both are Kievites, and both are young
women. We guard patients’ secrets, so we did not
attempt to extract theirs. But it is absolutely clear—they
got sick as a result of “free” sexual contact. What forces
people to turn to us? Sometimes it is their excessive
suspiciousness, but most of the time it is their fear for the
possible consequences of their sins.

Krasnovskiy: What will be the fate of the two women?



JPRS-TEP-90-003
5 MAR 1990

studies and researches on AIDS control and prevention;
and to coordinate with government and private agencies
in combating AIDS.

72 Percent of Chiang Mai Prostitutes Have AIDS

BK0202014990 Ann Danaiya Usher; Bangkok THE
NATION in English 2 Feb 90 pp 1, 2

[Article by Ann Danaiya Usher]

[Excerpt] The number of AIDS cases in Chiang Mai
could increase from the current 1,414 carriers to 32,158
by the end of this year, with an estimated 72 percent of
young, poor prostitutes already infected with the disease,
according to new research by Dr Wichan Withiyasai of
Chiang Mai University.

Speaking to a gathering of international AIDS specialists
last night, Wichan said the AIDS situation in Thailand
has reached “alarming” proportions and if action is not
taken soon could become like Uganda, where almost one
in every five urban residents is infected.

Michai Wirawaithaya, director of the Population and
Community Development Association (PDA), who orga-
nized the discussion, described the findings as “‘horren-
dous” and criticized Prime Minister Chatchai Chun-
hawan for refusing to chair the National AIDS
Committee last November.

“If the premier does not recognize this as a real threat to
every person in this society, as well as to the economy,
one year from now it will be too late for regrets,” said
Michai, who urged the government to disclose the
number of AIDS carriers in Bangkok, Phatthaya and
other parts of the country.

EAST ASIA 17

The study showed that AIDS infection among men who sell
blood to Chiang Mai hospital blood banks quadrupled from
1.5 percent in 1988 to almost six percent last year.

Since his initial surveys suggested a rapid spread of
AIDS among northerners early last year, Wichan has
repeatedly stressed that the habit of Thai males—
including students, civil servants, soldiers, farmers and
professionals—to frequent prostitutes is one of the main
routes of AIDS transmission in Thailand.

Sexual intercourse is the most frequent mode of trans-
mission in northern Thailand, with between 59 and 91
percent of infection in Chiang Mai, Lampang and Lam-
phun provinces being spread by sex, Wichan said.

These findings are in sharp contrast to Ministry of Public
Health figures for the whole country that show only 10
percent of AIDS carriers contracting the disease through
sex, while 84 percent contracting AIDS by sharing
infected needles.

Wichan said these often-quoted satistics may be more
representative of Bangkok and mislead the public into
believing that unprotected sex is not dangerous.

Wichan’s survey suggests that 72 percent of Chiang Mai
prostitutes who charge between Bt [baht] 30 and BtS0
carry HIV, while 30 percent of those who charge Bt51 to
Bt100 carry the virus. For those who charge more than
Bt100, 16 percent appear to be infected, according to the
doctor’s survey.

Forty-four percent of infected female prostitutes are less
than 20 years old, while 19 percent are between 20 and
29 years of age. Eight percent of those tested working for
only three months are infected, while 70 percent of those
working for between six and 12 months were shown to be
carrying the contagious disease.

Wichan expressed concern over results showing that 75
percent of male clients go to the least expensive prostitutes
who show the highest seroprevalence.[passage omitted]



SJPRS-TEP-90-003
5 MAR 1990

training courses are conducted for those who operate this
equipment to insure that they use it correctly and accu-
rately.

I then asked Dr, Fathi Shaybah al-Hamad, an undersec-
retary of the Ministry of Health, “What about the tests
that have been conducted in scientific centers and that
have confirmed the presence of the infection in imported
drugs containing blood derivatives?”

Dr. Fathi Shaybah al-Hamad answered, “The tests were
conducted with old and inaccurate equipment. We
cannot rely on this equipment in making such serious
judgments. What confirms this is that the same drugs
have been retested with modern equipment and the
results have been negative, thus confirming that the
drugs are free of the infection. Those who conducted the
second tests are international experts who have their
experience and who have used the latest equipment.
Thus, we have become certain that the belief that these
drugs are polluted is groundless.

I say again that the tests which we have to conduct and in
whose results we trust are tests that must be conducted
with equipment that possesses a certain degree of accu-
racy. These tests must also be conducted in accordance
with certain rules in order that their results may be
complete and accurate.

In conclusion, the danger of AIDS hovers over numerous
countries. At the same time, it is endemic in numerous
other countries. However, we in Egypt must feel reas-
sured and must remain vigilant—reassured because our
country is fundamentally free of the disease and vigilant
so that this disease may not infiltrate our country under
any circumstances. We must not contribute with our
mistakes—the small mistakes before the big ones—to
such an occurrence.

INDIA

Number of AIDS Carriers Rising

545000424 Madras THE HINDU in English
22 Dec 89 p 10

[Text] Three years after the AIDS infection first surfaced
in India, the number of Indians confirmed as carriers of
the AIDS virus has risen to nearly 1,800 with thousands
of undetected cases.

Doctors expect many of the infected people to develop
the full blown fatal disease in the coming decade and
increase the AIDS toll among Indians, which now stands
at 29. The latest surveillance figures released by the
Indian Council of Medical Research (ICMR) indicate
that the average detection rate in India has reached one
new infected case per day. The AIDs virus is transmitted
through sexual contact, blood and products made from
blood. Doctors believe infected blood donors, prostitutes
and promiscuous males are the major agents through
which the infection is spreading in India. More than
1,300 of the 1793 people found infected so far belong to

AR EAST & SOUTH ASIA 23

one of these three categories. The others are relatives of
infected people, recipients of blood and blood products
and those who acquired the infection abroad.

The AIDS infection in India first surfaced among pros-
titutes in Madras in 1986, following which the ICMR
initiated a national surveillance programme. Health
workers in Delhi and Bombay say many prostitutes who
have been found infected and remain active in their
profession are a major source of infection in the metro-
politan centres.

Research groups are now trying to follow up infected
individuals regularly to generate data about the natural
history of the AIDS infection in India, says an ICMR
bulletin.

With many of the infected women still young and in
child-bearing age, doctors believe they could give birth to
AIDS-infected babies.

Studies abroad indicate that 30 to 50 percent of babies
born to infected mothers will themselves be inflected.
Half of all such babies die within two years of birth.
AIDS surveillance centres have also reported finding at
lest 400 blood donors who are infected with the AIDS
virus.

IRAN

Six Reportedly Die of AIDS

90010075L London KEYHAN in Persian
7 Dec 89 pp 1,9

[Text] A few days ago, Dr. Bijan Sadrizadeh, director of
the AIDS Combat Committee in the Islamic Republic’s
Ministry of Health, Treatment, and Medical Education
announced: So far only six people infected with the
AIDS disease have died in Iran. Five of these individuals
contracted AIDS through the transfusion of blood which
was contaminated with the AIDS virus, and one indi-
vidual got AIDS by way of sexual contact, in the Western
countries, with women who carry the disease.

Dr. Sadrizadeh further explained: From among more
than 300 individuals afflicted with AIDS in the eastern
part of the Mediterranean, only six used to live in Iran,
all of whom have so far passed away. Dr. Sadrizadeh did
not mention anything about the number of people in
Iran suffering from AIDS who are still living. However,
some time ago an Iranian doctor who had come to
Europe told KEYHAN:

During the last years of the war with Iraq, the Islamic
Republic’s regime purchased a great quantity of cheap
blood from the third world countries for the purpose of
injection and transfusion of the war wounded individ-
uals, and many of the people who received this blood are
carrying the AIDS virus at the present time. The director
of the AIDS Combat Committee also stated: A detailed
publicity program has been prepared to familiarize the
general public with the AIDS virus.



JPRS-TEP-90-003
5 MAR 1990

HONDURAS

Breakdown of AIDS Statistics Presented

90WE0121B San Pedro Sula LA PRENSA in Spanish
9 Jan 90 p9

[Text] In Honduras, of every 10 persons infected with
acquired immuno-deficiency syndrome (AIDS), six are
men and four are women, representing 62 percent of all
men and 37 percent of all women.

This announcement was made yesterday by the
chairman of the Commission To Combat AIDS and
chief of the Health Ministry’s Epidemiology Division,
Enrique Zelaya. He added that the highest risk group
consists of persons engaging in heterosexual relations,
with 345 cases out of a total of 469 recorded between
1985 and 1989, a period during which the disease took
the lives of 211 persons.

According to the final report for that period, prepared by
the health authorities, San Pedro Sula still ranks first for
AIDS incidence, with 289 cases.

The Sixth Health Region has recorded 51 cases, and
Tegucigalpa, 50. Other cities and towns with smaller
populations follow in descending order.

A total of 47 persons were infected as a result of
homosexual relations; 40, from bisexual relations, 25,
from blood transfusions; and one, from drug addiction.
Seven unborn children were infected by their mothers,
and there is one case wherein the cause of infection is
unknown.

At present, the whereabouts of 176 carriers of the virus is
unknown, and 82 are known to be alive.

Based on age, the majority of cases of infection have
been recorded in the 20-29 age group, with 42.9 percent;
the 30-39 age group accounts for 30.7 percent; and the
40-49 age group comprises 12 percent.

According to year, the cases officially reported and
confirmed were: for 1985, three; 1986, 17; 1988, 215;
and 1989, 152.

Zelaya estimated that the prevention campaign spon-
sored by the Health Ministry has reduced the prolifera-
tion of cases, but he also denied that the use of condoms
has fostered promiscuity, as people have been led to
believe.

237 Cases of AIDS Detected

90WE0103A San Pedro Sula TIEMPO in Spanish
3 Jan 90 p17

[Text] Between January 1986 and October 1987, 237
cases of Acquired Immune Deficiency Syndrome (AIDS)
were identified at the regional hospital of the Honduran
Social Security Institute (IHSS) in this city, the head of
the Microbiology Section at the IHSS, Jose Maria
Dubon, announced yesterday.

LATIN AMERICA 19

This physician explained that of the 237 patients who
tested positive for the AIDS virus, 136 were placed
under medical supervision, and 71 percent (97) were
confirmed by means of the Western blot test, which is
given at the IHSS hospital.

He added that the samples taken from the 136 patients
showed that 46.3 percent were asymptomatic when the
disease was detected. In other words, they showed no
symptoms of the disease, and were pursuing normal lives
among the citizenry, with the resultant risk.

On the subject of the sex of the patients, he said that of
the 136 cases studied, 112 were men and 24 women, and
that 47 percent were single, 24 percent were married, and
28 percent were involved in free sexual unions. He added
that the group most commonly affected was that between
26 and 40 years of age, for both sexes.

As to the sexual orientation of the patients diagnosed as
HIV positive, 84 percent were heterosexuals (promiscu-
ous, relations with several individuals), 10 percent were
homosexual, and 6 percent were bisexual.

Dr Dubon explained that the above data were obtained
during an epidemiological clinical study of patients
testing HIV positive carried out by the IHSS in this city
under the responsibility of Drs Luis Reyes Silva, Ada de
Romero, and himself.

He explained that the areas in San Pedro Sula which are
most seriously affected are the eastern and southeastern
sectors, since 62.5 percent of the patients tested live in
those areas. This is also where approximately 50 percent
of the city’s population is concentrated.

Dr Jose Maria Dubon, a specialist in clinical pathology
and medical microbiology, said that the predominant
clinical symptoms observed when the patients were
tested were persistent coughs, a loss of more than 10
percent of normal weight, chronic or intermittent diar-
thea at least once a month, and chronic or intermittent
fever of over 38 degrees centigrade lasting at least a
month.

He said that the AIDS patients also proved to be
suffering from adenopathy, or inflammation of the lym-
phatic ganglia, and candidiasis, evidenced by white
patches inside the mouth (tongue and cheeks).

Between 1986 and 1989, the IHSS reported finding 11
HIV positive individuals, representing 3.28 percent,
among 335 blood donors, Dr Dubon added.

The breakdown of the population contributing to and
covered by the IHSS in this city in 1988 was 60.6 percent
male and 39.4 percent female. The doctor added that
77.8 percent of the IHSS beneficiaries are the children of
insured persons, while 22.2 percent are wives or live-in
companions of insured males.

This same study showed that the first case of this deadly
disease in Honduras was diagnosed in 1985, but the first



32 SOVIET UNION

Purik: They will undergo medical treatment, either at
our Institute or in Moscow. But you certainly understand
that all in all their fate is unenviable. This is why I would
again like to tell everybody: there is no effective medi-
cine for curing AIDS victims yet. Therefore, the main
guarantee of preventing AIDS lies in a person’s behavior
and healthy way of life. I would like to inform the readers
of our new schedule. We are open Monday, Wednesday
and Friday from 1 p.m. to 7 p.m., and Tuesday,
Thursday and Saturday from 8 a.m. to 2 p.m.

AIDS Discovered Accidentally in Foreign Students

907C0060A Kiev RADYANSKA UKRAYINA in
Ukrainian 8 Sep 89 p 4

[Article by Department Head, ZORYA POL-
TAVSHCHNY newspaper, G. Grin, under the rubric
“Extreme Situation”: “Diagnosis: AIDS”; the article has
a dateline of Poltava, September 7; the interview that is
included was conducted by telephone]

[Text] Is it conceivable that a patient who has been
diagnosed for AIDS today will be discharged from a
hospital tomorrow?

It is inconceivable, but here is the fact: on July 14, 1989,
the AIDS virus was for the second time found in the
blood of Doambo Eme, a student from Burkina enrolled
at the Kremenchug Civil Aviation School (the first
positive result was obtained in a lab analysis by the city
blood transfusion office on July 7). And on July 15 he
was already discharged. The patient returned to hotel
“Kremen,” where he and his compatriots stay. They
have come to the city along the Dnieper, according to a
reference from the All-Union Cost-Accounting Foreign
Economic Association “Aviaeksport” and the company
“Aviatekhservis.”

The group of Burkina citizens arrived at Kremenchug for
classes on June 10. The day before, they were in Moscow,
where they had to undergo a mandatory AIDS test. But...
Here is how V. O. Korshenko, an oblast sanitary and
epidemiology office physician in charge of AIDS super-
vision, described the situation:

IPRS-TEP-90-003
5 MAR 1990

“In Moscow the group was not tested for AIDS. Nor was
it done in Kremenchug. On June 29 Doambo Eme was
hospitalized at the 2nd City Hospital with nephritis. The
same day, his blood sample was drawn for the enzyme
immunoassay—the EIA. Results of two tests were posi-
tive. On July 15 a third blood sample was drawn, and on
the evening of July 16 it was sent to the Problem
Laboratory of the Kiev Scientific Research Institute of
Epidemiology of Infectious Diseases. Kiev confirmed
the diagnosis, but according to the regulations the Cen-
tral Scientific Research Institute of Epidemiology, USSR
Ministry of Health, has the last word. On August 4, a
telegram arrived from Moscow, it confirmed that, yes,
there is AIDS in Kremenchug.”

In the meantime, the sick man had been staying in the
hotel and had had contacts with the hotel staff, tourists
from various cities in our country, and foreign tourists.
He might even have had sexual intercourse. He had not
been isolated at the 2nd City Hospital, either.

Only after the telegram from Moscow arrived, were
competent city and oblast commissions organized. At
their request, the entire Burkina group was subjected to
a comprehensive checkup. The result was astonishing—
the AIDS virus was detected in the blood of three more
people. All four were sent to Moscow for hospitalization.

That is the story in a nutshell. We can only add that this
extraordinary event gave rise to numerous rumors and
gossip in the city and oblast. As early as August 24, a
meeting of the Kremenchug Executive Committee of the
City Council of Peoples Deputies took place. The man-
ager of the Medical Sanitary Division of the Civil
Aviation School V. M. Chernichok, epidemiologist Yu.
V. Talnitskiy, and the assistant school commander in
charge of foreign student affairs V. V. Studenitskiy were
fired. Strict penalties were imposed on school com-
mander P. S. Kondratenko, chief physicians of the 2nd
City Hospital and City Blood Transfusion Station I. I.
Bonchuk and V. V. Zinovyeva, and a number of other
officials who had demonstrated exceptional apathy and
negligence. City internal affairs agencies are conducting
a search for promiscuous women who might have had
contacts with the infected foreigners (and one is under
suspicion). So, there still is a dangerous possibility that
imported AIDS can get a Kremenchug passport.



14 CHINA

Dr Li heads the AIDS Counselling Unit at Queen Eliz-
abeth Hospital in Kowloon.

“I think the problem is complacency,” said Mr Peter
Moss, Assistant Director of the Information Services
Department.

“Like so many other people addicts become compla-
cent—they have always done it and are at risk of
continuing to do it unless we continue to remind them,”
he said.

Publicity chiefs are also putting the finishing touches to
another TV AIDS warning designed to discourage pro-
miscuous sex and proclaim the safety of condoms.

JPRS-TEP-90-003
5 MAR 1990

It is expected to go on air early in the new year.

Mr Moss claimed it, too, would adopt a more hard-
hitting approach than previous AIDS messages which
had come in for a lot of criticism.

The Government has spent $600,000 on the current
campaign, an amount that has been criticized as being
insufficient.

In comparison, it allocated $1.5 million to the current
environmental protection campaign.



6 SUB-SAHARAN AFRICA

Gloria Macassa said that she and her colleague plan to
make copies of the work to present to the bodies “which
helped us.”

NIGER

Health Minister Responds to AIDS Figures

90WEOI05A Niamey LE SAHEL in French
1 Dec 89 p 12

{Excerpts from a speech made by the minister of public
health on the second World Anti-AIDS Day]

[Text] Ladies and Gentlemen:

On this 1 December, 1989, all of humanity feels the great
importance and utmost urgency of commemorating this
second World Anti-AIDS Day. Niger, through my voice,
joins member states of the World Health Organization
(WHO}] in participating in this momentous event.

No one today is unaware of the pandemic, swift acting,
and murderous nature of this plague, which is exacting a
heavy price from all peoples of the world—and Niger has
not been spared.

In 1988, 120,000 cases of AIDS were reported in the
world, 20,778 of which were in Africa.

* In September 1989, 2 months before the commemo-
ration of the 2d World Anti-AIDS Day, 182,463 cases
were counted in 152 WHO member countries, and
our continent had 31,000, or a jump of 50 percent
over 1988 figures.

+ In Niger, there were 39 cases of AIDS reported in
1988. Studies conducted for the same period show
seroprevalence in 0.5 percent of the general popula-
tion, which means that five of every 1,000 people
carry the disease virus. This seroprevalence is higher
in at-risk groups: for the period in question it was 7.5
percent in prostitutes.

« In 1989, the latest national anti-AIDS report cited 56
cases, or a 22-percent increase in just one year.

That means, my dear fellow countrymen, that the AIDS
situation is alarming and of the utmost concern to us. We
are all concerned: men, women, young people, adults,
and the elderly.

We must individually and collectively mobilize to block
AIDS, a scourge against which we have neither medica-
tion nor an effective vaccine and [against which) our
only weapon is prevention. [passages omitted]

We can and must mobilize and organize to effectively
prevent this disease by adopting good health habits. In
particular, we should:

* avoid dangerous sexual behavior by wearing con-
doms;

* use sterile material for injections and wound dress-
ings;

* obtain tested blood before any transfusions.

JPRS-TEP-90-003
5 MAR 1990

Ladies and Gentlemen, to combat this scourge our country
set up a National Anti-AIDS Program that has been
functioning since 1987. This was done by drafting and
implementing a short-term plan with the assistance of the
World Health Organization and friendly countries and
organizations. A National Committee for the Prevention
and Surveillance of AIDS was created in 1987 and a
national program director was named. A three-year
medium-term program drawn up with the help of WHO in
November, 1988 will, following evaluation by WHO, be
the topic of the round table of moneylenders in January,
1990. The objectives of this medium-term program are:

* to prevent transmission of the human immunodefi-
ciency virus;

* to reduce morbidity and mortality associated with
HIV infection;

+ to lessen the discase’s impact on society.

The strategies adopted to reach these goals are:

* improving organization of the program;

* epidemiological surveillance and research;

* prevention of sexual transmission;

* prevention of transmission via contaminated blood;

* prevention of perinatal transmission;

* provision of psycho-emotional and social care of
patients.

Ladies and gentlemen, this second World AIDS Day,
which offers a wealth of information, must make us more
aware of the real danger of extinction of the human race
through HIV infection unless appropriate, urgent and
simple measures are individually and collectively taken.
Allow me to remind you that 20 percent of AIDS victims
are young people between the ages of 20 and 30, that is,
the able-bodied members of a given community. In
Niger, 45 percent of the population is consists of young
people. That is why, as part of our national movement
for a Society of Development launched by the president
of the high council of National Orientation, General Ai
Saibou, I appeal to the spirit of cooperation of all, and of
young people in particular, to fight against AIDS, a
serious threat to our human capital.

I would like to take this opportunity to thank the World
Health Organization for its unfailing support of my
country in the fight against disease, in general, and AIDS,
in particular. I would also like to take the same opportu-
nity to appeal to bilateral and multilateral organizations
and aid groups, nongovernmental organizations, and
friendly countries to ask for their support in implementing
our medium-term anti-AIDS program whose moneylender
round table is scheduled for January, 1990.

Long live international cooperation.
Long live Niger.

I thank you for your kind attention.



JPRS-TEP-90-003

5 MAR 1990 SOVIET UNION 29

Table 1. Percent Distribution of Queried Persons Indicating Various Numbers of Sex Partners in Age Groups
Number of sex partners

Age, in years 0 1 2 35 610 | 11-20 | 21-30 | 31-50 | 50-100 Over Not indicated

Women

16-20 33 | 28 11.2 314 | 101 44 5.6 0 ma 0 49

21-5 23 17.6 14.4 38.5 78 31 14 0.86 14 0.57 12.07

26-30 0.4 | 29.59 | 206 30.8 84 2.8 0.9 0.23 | 08 0.48 3

31-35, 0.3 24.7 24.4 37.4 47 0.8 0 0.6 0.3 0.3 6.5

36-40 27 | 226 25.8 33.9 59 0.9 0 045 | 045 | 0 73

41-50 28 54.5 18.5 214 2.8 0 0 0 0 0 8.5

51 and older 19.7 | 43.9 44 14.2 1 0 0 0 0 0 16.8

Men

16-20 34.5 9.9 13.5 29.6 8.6 0 12 246 | 0 0 0.24

21-25 341 | 14.2 10.2 36.4 | 125 7A 2.56 14 17 0.28 10.25

26-30 04 | 208 9 39.4 | 10.3 48 2.4 14 12 0 10.3

31-35 23 | 264 8.8 42.6 16 28 0.5 23 113 | 0 5.87

36-40 3 24.7 14.1 26.5 aaa | 4 0.88 | 2.21 0 0.44 15.33

41-50 94 | 4346 | 842 | 242 | 1052 | 1 1 1 1 0 24

51 and older 208 | 37.5 5.2 28.9 Lt 0.57 | 0 0 0 0 5.93

Results and Discussion

A total of 10,117 tests were performed in 1987, although
the number of examined persons was in fact somewhat
less than that number, since some particularly hypo-
chondriacal persons submitted blood specimens as many
as five times.

We identified 11 persons with HIV antibodies, four of
whom were USSR citizens and seven of whom were
foreigners. The epidemiological investigation of the
infection among the Soviet citizens’ has not yet been
completed, and its results will be published in a separate
report. All of the foreigners with antibodies to HIV had
been previously identified in the course of scheduled
examination procedures and came to be examined for
the purpose of verifying previous test results.

On the whole, the effectiveness of anonymous testing has
turned out to be highest in the USSR, where one person
out of every 2,500 USSR citizens who were tested had
HIV antibodies, with an average index of 1 per 70,000-
90,000 persons for citizens of the USSR, including
persons tested because they had contact with HIV
infected individuals, and 1 per 200,000-300,000 person
in the regularly screening of donors, venereal disease
patients, pregnant women, and risk groups.

A total of 5,014 questionnaires were completed, and 511
of them were defective or unsuitable for analysis and
apparently belonged to persons who did not trust the
anonymity of the testing procedures. Of the 4,503 prop-
erly completed survey forms, 2,160 belonged to men and
2,272 to women. Seventy-one forms did not indicate the
subject’s sex. There were eight children under 15, of

which one girl and two boys were brought in to be tested
by their parents in connection with a rape. One boy was
brought in by his foster parents in order to certify his
health, and the remaining children were tested in con-
nection with blood transfusions (one was a hemophiliac).

Adult sexual activity was of the greatest interest for the
purposes of our epidemiological investigation of HIV
infection. Men indicated an average of 4.45 partners
over a five-year period, and women indicated an average
of 3.55 partners, which is sufficient for the spread of
HIV, although that rate was not characteristic of the total
population’s sexual behavior, which, judging from the
questionnaires, was varied (Table 1).

A rather considerable percentage of the individuals (28%
of the men and women) of sexually active age indicated
that they did not have any or had only one sexual partner
over the last five years. This certainly indicates that there
is a significant segment of the population that is out of
danger with respect to HIV infection via sexual trans-
mission. A total of 37.4% of the men and 32% of the
women reported that they had three to five partners over
the five-year period. This is considered the minimum
hazardous level for the spread of HIV.

A total of 294 men (16%) and 176 women (7.9%)
indicated that they had more than five partners. Guided
by previously obtained data,” we classified those persons
as a high-risk group, along with persons who indicated
they had had homosexual relationships, had had sexual
relations with foreigners, or had used drugs intrave-
nously. That risk group (Table 2) comprised 800 persons
(17.8% of the properly completed questionnaires). The
group included 74 men who indicated they had had


6 SOVIET UNION

Unified Strategy Needed To Combat AIDS

907C0061a Moscow IZVESTIYA in Russian 31 Aug 89
Morning Edition p 3

[Article by S. Tutorskaya: “Is AIDS So Unimportant to
Us?: Why the Fight Against the Most Dangerous Infec-
tion Is Still Lacking a Unified Strategy in Our Country”}

[Text] “No, there is good reason why the Russian card is
backed by an ice hummock: Cold is identically terrifying
both to AIDS and to Bonaparte.” One of our poets wrote
these lines some 3 years ago. And he was not the only one
who was misled: Serious specialists and the country’s
prominent virologists asserted that AIDS was unimpor-
tant to us.

Many countries have gone through a stage of denial (“no,
anywhere but here”). And although according to the
latest data we are at the “tail end” in regard to the rate of
the epidemic’s development in Europe, we shouldn’t
delude ourselves. In our reality, everything is aggravated
by archaic ideas about cleanliness and sterility, by the
absence of disinfectants and disposable resources for
treating and caring for patients, and by the low level of
the population’s mass public health awareness. Improb-
able and immediate efforts are needed to shut the gate in
the face of the widespread infection.

Who is undertaking these efforts? The board of the
USSR Ministry of Health met quite recently. Reports
were given on production of diagnosticums (the work is
now moving ahead, and a huge lot has been produced);
about efforts to create a Soviet culture of the virus (an
intense search is being conducted in the Scientific
Research Institute of Virology imeni D. Ivanovskiy);
about efforts to provide hospitals with disposable
syringes and blood transfusion systems (supply con-
tinues to be enormously and painfully far behind
demand).

At the moment I am sitting in an entirely different place,
with another sort of people. We have already been
talking a whole hour. And the thought that nags me is
this: How was it possible that what I was hearing really
happened? I was discussing the subject with doctors of
the hospital that works on AIDS carriers and patients.
The first operations on infected patients were performed
back in 1975. These doctors are distinguished by a kind,
sympathetic attitude toward their patients.

A young woman sits opposite to me at the table. A sweet
round face, gray eyes. And another, older. Surgeons. A
week ago they operated on a female AIDS patient. It was
a major, difficult operation. Neither were able to protect
themselves—they injured their hands with the surgical
needle: Ordinary thin rubber gloves offer no protection
against this.

What sort of protection is required in such cases? There
must be something. No one, after all, is seriously going to
send a fireman into a fire without his turnouts... But our
surgeons have nothing. (“You should see how we dressed

JPRS-TEP-90-003
5 MAR 1990

for the operation. Polyethylene bags on our arms above
the gloves, and polyethylene sacks over our bakhiya
[translation unknown] as well... Talk about primitive!)

Protective resources for such situations are available
abroad. But special surgical gloves with a cord lining,
which reduce the risk of hand injury, are not available
here in our country. Special disposable, moisture-proof
sterile clothing is not available. Transparent face shields
are not available...

The doctors have not been sitting around—they’ve been
sounding the alarm for a long time. There was no one
they didn’t appeal to before phoning the editor, said
Doctor Vladimir Pavlovich Skvortsov, the party bureau
secretary. A few months ago they took their concerns to
specialists of the Central Scientific Research Institute of
Epidemiology—just across the strect. They stepped in to
see laboratory director V. Pokrovskiy: Please help us!,
and his answer was this: “There are some things avail-
able abroad, find out what they are yourselves, and then
we'll help you.” That was as far as it went—where were
the doctors going to get special catalogs from foreign
companies?!

And what is the payment for the daily risk? Today,
medical personnel who deliver the babics of AIDS car-
riers and patients, perform surgery and apply dressings
receive “hazardous duty pay’ totaling but 15 to 18
rubles per month.

The number of carriers and patients in the country is
growing. Of 14 of our patients (three of them foreigners),
10 have already died. A 40-year-old man from Moscow
became the most recent victim. Seven years ago he
worked in the Congo, and was unaware of his discasc.
The diagnosis was made when the Patient was delivered
to the hospital by an ambulance in serious con
The circumstances of this case are being investigated,
and the health of the deceased victim’s relatives is being
checked.

It cannot be said that the experience with Olga G. from
Leningrad didn’t teach the doctors anything. The
training being given to specialists intensively by the
USSR Ministry of Health is beginning to produce results.
In the last while, doctors examined 1,672,665 patients
whose condition raised the suspicion of AIDS. Of them,
19 were found to be stricken. Nonetheless I can’t get
away from the idea that the efforts can and must be
accelerated. That given the small quantity of resources
directed at preventing and revealing AIDS, the impact is
still insufficient.

And the reasons for this are quite palpable. It was
reported in recent conferences that tiny Denmark spends
more money on public health propaganda on AIDS
prevention than we. Consider how many articles have
been written sounding the alarm on the problem of
disposable treatment and patient care resources!

Once again we are compelled to speak of the lack of
responsibility on the part of workers of a number of



IJPRS-TEP-90-003
5 MAR 1990

stopped in Abidjan because the hallucinating image of a
sick person exposed in front of the city’s traffic red lights
was judged “bad for tourism.” However, other warnings
will be given over radio and television and plastered on
walls,

A special team answers the telephone number 33-14-68,
namely “AIDS Direct.” An official said, “People now
admit the reality of the problem.” Calls are even coming
in from neighboring countries.

MADAGASCAR

First Cases of AIDS Now Surfacing

90WE0107A Antananarivo MIDI MADAGASIKARA in
French 2 Dec 89 p 1

[Article: “AIDS Is Here!”]

[Text] AIDS is really here! The first two of our seropos-
itives have had their cases develop into the pathological
phase. Doctor Jean-Jacques Seraphin, minister of health,
acknowledged it yesterday in his message on the occa-
sion of World AIDS Day.

True, there is no reason to panic. Statistically, Madagas-
car, with seven seropositive cases and only two manifes-
tations of illness, is very far behind the most affected
countries where seropositive cases are counted by the
thousands. But it must also be recognized, since one of
our two sick persons is a streetwalker, that the disease

could have spread widely, since if she only “turns”.

around ten “tricks” per day that would be 1,000 to 1,500
“clients” per year! And, therefore, the same number of
“spreaders” of the HIV virus!

We do not engage in these calculations in order to violate
the obligation to respect the confidentiality observed in
medical circles. Rather, it is to attract the public’s attention
to how easy it is for the terrible disease to spread.

Yes, unhappily, AIDS is indeed here.

MOZAMBIQUE

AIDS Education Priority for Rural Areas

90WE0051A Maputo NOTICIAS in Portuguese
16 Oct 89 p 4

[Article by Ernesto Zucule]

[Text] The public education programs pertaining to
AIDS must continue to reach more of the less literate (in
Portuguese) rural population, because it is this popula-
tion sector which has the least -access to written and
broadcasted information in the official language. As a
result, this stratum has greater difficulty understanding
the seriousness of AIDS, even though its members have
been provided with some idea of what the illness is. This
is the first recommendation to emerge from a survey

SUB-SAHARAN AFRICA 3

made last June in the district of Manica, in the province
of the same name, by Faculty of Medicine students at
Eduardo Mondlane University. The results of this survey
were presented by Gloria Macassa and Inacio Barreto
during the recent 9-day Student Scientific Competition
Campaign (JECE) sponsored by that faculty. This scien-
tific work was not complete, but is of acceptable quality,
and for this reason it won the second prize in the public
health category. The study recommends the broad dis-
tribution of pamphlets explaining the use of condoms,
among other things, and urges more intensive use of the
national languages, both on radio and in pamphlets, so
that target groups (those less well educated in Portu-
guese, but able to read and write in their local languages)
can be assured of the ability to follow all of the educa-
tional programs.

The survey, which covered 630 persons in 30 different
zones in the populated areas of Vanduz, Herois Mocam-
bicanos, Jecua, Messica, Manica, Penhalonga, Mundon-
guara, Machipanda, Zona Tobaco, Tandara | and Tan-
dara 2, Bandula, and Chinhuambuzi, including peasants,
teachers, and IFLOMA [Manica Forest Industries Enter-
prise] and health workers, concluded that the least lit-
erate men and women—the females, above all—are
those who know least about how AIDS is transmitted
and prevented, because they have least access to the
information broadcast by radio in the official language
or published in the newspapers.

According to this study, understanding differs on the
basis of education and sex. The better educated men had
the largest percentage of correct answers, followed by the
more educated women, the less educated men, and the
less educated women.

This situation shows that newspapers and radio are the
main sources of important information on AIDS for
educated men and women. The main source for those
less well educated is the newspapers. This hypothesis
allows for the fact that not all of the information read or
heard is passed on to third persons in the form it was
heard on the radio or read in the newspapers.

Also, one of the conclusions reached as a result of the
survey has to do with the differences in thinking and
responses between men and women, depending on edu-
cational level, as to the position a spouse should adopt if
his or her mate is afflicted with AIDS.

The majority believe that the spouse could care for his
mate, but the uneducated men were more likely to
believe that the husband of a woman with AIDS could
divorce her. This attitude casts light on the threat AIDS
poses for women, since they are least likely to know how
the disease is prevented. They also receive the least
information and most frequently have spouses who
might divorce them if they had AIDS. This is the
conclusion reached by the study following an analysis of
the conduct of both sexes which took these differences
into account.



2 SUB-SAHARAN AFRICA

AIDS Figures Reflect Only ‘Tip of Iceberg’

90WE0093B Libreville L’UNION in French
4 Dec 89 p3

[Article by N. d’A., from AGP [Gabonese Press Agency]:
“8,000 Positive AIDS Cases in Gabon”]

[Text] The AIDS detection method, called the “Ander-
son Method,” has resulted in our specialized centers
recording 8,000 AIDS cases in Gabon since 1986, the
year when the first case was recorded. Close to 50
stricken persons have already died, according to a state-
ment made by Minister of Public Health and Population
Dr Jean-Pierre Okias last Monday.

Mr Okias, who on that day chaired a meeting of sponsors
for the midterm anti-AIDS national plan, indicated that
the positive AIDS rate in Gabon was close to two percent.
According to him, the 8,000 cases provide us with the
dimensions of the challenge to humanity and Africa, even
if these figures represent only the “visible part” of the
iceberg. This is a situation that the minister hopes to
alleviate in conjunction with the help of the sponsors, but
above all by counting on a worldwide effort that, perhaps,
would permit completely wiping out this virus.

For the time being, there is no effective treatment of nor
vaccine for AIDS. It is up to all to protect themselves as
best they can while waiting for the campaign to be
planned.

IVORY COAST

AIDS Cases Up: Recognized National Disaster

90WE0092A Paris LE MONDE in French
10 Jan 90 p9

{Article by J.de la G.: “The Great Distress of AIDS
Patients”)

{Text] With a life expectancy of over 57 years, Ivory
Coast ranks among countries with middle income thanks
to effective vaccination programs and to a satisfactory
supply of drinking water to rural populations. The health
program budget is almost double the average such
budget of sub-Saharan countries but the effects of the
crisis are being felt more and more in hospitals. Prescrip-
tions are filled but the medicine itself is paid for by the
patients except for tuberculosis and leprosy cases. For
operations to be performed, the patient himself must
bring his own antibiotics and anesthetic drugs.

A civil servant mutual benefit insurance company used
to partially make up for the absence of social security but
it has ceased making payments. Completed in the spring,
the Yopougon Hospital, the third CHU [University
Hospital Center] of Abidjan, still had not openend at the
end of the year because it lacked the 8 million francs to
build up its stock of indispensable drugs.

Under such conditions the arrival of AIDS assumed
dimensions of a national catastrophe that officials are no

IPRS-TEP-90-003
5 MAR 1990

longer trying to hide. The man who met the problem
head on, namely Professor Koudou Odehoury, works at
the Treichville CHU, a former nightclub quarter that is
currently quiet because of the lack of security there and
other evils of the times.

The spectacle of families of sick people preparing their
meals out in the open in the middle of linens drying out
on the grass lets us know at once about the very relative
nature of the concept of public services. Nevertheless,
this jolly kind of disorder stops at the entrance to the
infectious diseases ward. Walking corpses that are
dropped off there leave no doubt whatsoever about the
nature of their illness. The 100 beds of the ward are
occupied by “‘plague-stricken victims” of the last decade
of the century, while bed “rotation” is quick given the
fact that most victims arrive in the terminal phase.

Prof. Odehoury told us, “There are already enough
problems getting nivaquine while you can just imagine
that getting AZT is out of the question. Here alone we
have three new cases a day. We must hope to find a
vaccine or an effective drug, otherwise we are heading
for a major disaster.”

The first official figures were issued in October: 1,500
AIDS cases out of a population of 12 million inhabitants
and 400,000 who tested positive. According to a survey
conducted in February 1989 on 5,000 persons, the preva-
lence rate was 5 percent in the countryside and 7.3 percent
in the cities. A high-ranking Ministry of Health official
admitted, “We have made examinations beginning at age
15 with the result that we have come to an impasse with
regard to children born to mothers who have tested posi-
tive and, believe me, that’s a lot of people.” Officially, the
fact that there are four men for one woman among those
reported ill is described as astonishing. The same Health
Ministry official cooly explained, “It’s very simply because
a woman does not to go a hospital as easily as a man.
There's no scientific mystery there.”

For lack of offering these AIDS patients anything but a
home for the aged, stress is placed on prevention and
information. With the assistance of the EEC, a check and
control plan of action to avoid blood contamination is
scheduled to be put into effect in February. The WHO is
contributing to setting up small detection centers where
an examination will cost less than 20 francs. U.S. aid has
furnished more than 3 million condoms and has prom-
ised 5 million more.

Alas, although AIDS has become commonplace it
remains a “shameful” disease. An elected official of
Abidjan told us, “I’ve just returned from the funeral of a
friend’s son. Everybody knew what it was all about but
they made out as if it was tuberculosis.” Nevertheless,
the danger is now present in people’s minds. Condoms
are displayed near pharmacy registers. Women are
accepting with more and more difficulty the existence of
the “second office” (mistress) of their husbands. Even in
high schools posters warn, “AIDS is there. It kills.” A
campaign entrusted to an advertising agency was



JPRS-TEP-90-003
5 MAR 1990

HONG KONG

Trend Points to 30,000 AIDS Patients by Year
2000

54004057 Hong Kong SOUTH CHINA MORNING
POST in English 28 Dec 89 pp 1-2

[Article by Helen Signy]

[Text] The number of AIDS patients in Hong Kong
could multiply 1,000 fold to reach 30,000 by the year
2,000, if present trends continue, doctors warned yes-
terday.

The head of the AIDS Counselling and Education Ser-
vice, Dr Patrick Li Chung-ki, said with the discovery of
two more AIDS patients this month, the total number of
people with AIDS had reached 32—double the number
for last January compared with only nine in January
1988.

And as Dr Li warned that if the number continued
doubling every year, there would be more than 30,000
with the disease by the end of the next decade, social
hygiene clinics were being swamped by people wanting
AIDS test.

Appeal for Early AIDS Tests as Two Die

54004056 Hong Kong SOUTH CHINA MORNING
POST in English 29 Nov 89 pp 1, 2

[Article by Mary Ann Benitez]

[Text] Two more people have died of Acquired Immune
Deficiency Syndrome (AIDS), prompting Government
doctors to appeal for more people to come forward for
early screening for the HIV infection.

The latest deaths bring to 17 the number of fatalities so
far. One of the two was a previously undetected case of a
Chinese male adult who became infected sexually.

The other was one of the 14 known sufferers undergoing
treatment.

The doctors said the deaths could be attributed to the
delay in treating secondary infections that usually prove
fatal.

The chairman of the AIDS scientific committee, Dr
Yeoh Eng-kiong, said early detection of HIV exposure
could help prolong survival as the carriers could be
properly monitored.

Once the opportunistic infections set in, which charac-
terizes the development of AIDS, appropriate treatment
could be instituted to stop the infection from worsening.

Although no cure has been found for AIDS, drugs are
available to extend the lives of sufferers.

EAST ASIA 15

Dr Yeoh said that an analysis of the patients’ histories
showed that 20 patients developed AIDS less than six
months after confirmation of HIV infection.

Of them, 17 have died with an average survival of three
months.

In contrast, 10 patients developed AIDS more than six
months after detection of HIV. All are alive, with the
average survival estimated at 8 ‘2 months so far.

This was comparable with survival rates in most
Western countries, he said.

“What this means is that HIV carriers will be on the alert
when they start to develop AIDS, present themselves to
doctors early. The doctors can make a diagnosis early
and give appropriate treatment.

“I hope this is one of the things that will encourage
people to be tested early for the presence of the AIDS
antibody,” he said.

Another factor is that the drug, AZT, which has been
shown to prolong survival could be recommended to
AIDS patients and to HIV carriers to delay the onset of
AIDS.

Dr Yeoh also defended the Government’s handling of
AIDS patients, saying they received the best treatment
available.

He said that Government policy was to treat patients in
regional hospitals and not create a special AIDS ward.

This would develop expertise in the disease among
hospitals and also would guard against prejudices to
AIDS patients, he said.

An AIDS patient earlier criticized the Government for
not providing enough services or care.

The Department of Health has also detected two other
people infected with HIV but showing no signs of AIDS.

A total of 164, including the 30 AIDS confirmed cases,
have so far been detected to be harboring the virus in the
surveillance program which began in 1985.

Of the 164 carriers, 55 were hemophiliacs, one was an
intravenous drug abuser, 17 were people who attended
social hygiene clinics, 52 were patients from government
hospitals and clinics and 39 were referrals from private
doctors and subvented organizations.

A total of 142,759 blood specimens had been tested for
the AIDS virus.

Meanwhile, the Hong Kong Red Cross Blood Transfu-
sion Service’s screening of blood donors tested a total of
631,807 units of blood of which nine have been found
positive since 1985.



IJPRS-TEP-90-003
5 MAR 1990

accept condoms? “All of the answers were confidential,
and the interpreters were pledged not to discuss this
work with anyone. Remember that the last part of the
survey involved questions dealing with the intimate lives
of those surveyed, and depending on their attitudes,
some responded and others simply would not,” Gloria
Macassa said.

She stated that the survey made it possible to establish
some interesting groups of answers. For example, con-
cerning condoms, it was possible to determine that 26
percent of the men surveyed who had more than 3 years of
schooling said that they did not like to use them because
they “interfere with sexual pleasure,” while this same
response was also given by men with less education.

While 32 percent of the first group of men do not use
condoms because they are “ashamed to buy them” (there
are certain behaviors among peasants which are not
surprising), 59 percent of those in the second group did
not know about condoms as of the day they were
questioned. Nearly 30 percent of the men with some
education do not use condoms because “they do not
want to be misunderstood by their partners,” while 31
percent “do not have the money” to buy them.

Among the other interesting details is the confidence the
individuals questioned have in the ability of doctors or
medicine men to cure AIDS. More than 30 percent of the
men expressed the belief that doctors can treat the
disease, while about another 14 percent have faith in
medicine men. The percentages reflect the level of edu-
cation of each of the groups questioned, and it should be
noted that based on these differences, the percentage
rates for all the types of questions were classified in the
categories high, medium, and low.

Generally speaking, the survey revealed that of those
questioned, 85 percent already knew of the existence of a
disease called AIDS, and a good percentage also knew
about the condom under the name “julex” (this spelling
merely represents the sound of the word as pronounced,
since this reporter was unable to confirm the proper
spelling of this word popularly used in Zimbabwe for
condom).

The district of Manica is on the border with Zimbabwe,
and is influenced in many ways by it. It suffices to note
that in addition to Chimanica, the bulk of the population
also speaks some of the national languages of that country.
People listen more to radio broadcasts from Zimbabwe
than from our country, a situation which is aggravated by
the fact that our transmitter is not powerful enough to
offset the mountainous nature of the district.

Inhabited by 99,801 persons, this district was chosen for
the survey because it is a zone where the flow of
individuals is steady, and people live in relative security.

It will be noted that individuals affiliated with the Beira
Corridor project pass through Manica, and it also enjoys
the advantage of having infrastructure which makes it a
substantial tourist and leisure center in peacetime.

SUB-SAHARAN AFRICA 5

The province of Manica has an estimated 2 to 3 percent
serum positive rate, and one case of AIDS was reported
last May.

Researcher Is Proud

“I am honored to have done this work.” This is how
Gloria Macassa expresses her feeling of happiness at
having been able to carry out the task assigned by the
Faculty of Medicine within the context of the July
Activities, and having won an award for the work.

Of the two separate themes presented during the most
recent Student Scientific Competition Campaign on
subjects pertaining to public health, entitled “Criminal
Abortion in the City of Maputo” and “Survey of
Behavior, Attitudes, and Practices (CAP) With Regard
to AIDS in the District of Manica,” both of which won
three prizes, the latter received the only award.

Gloria Macassa makes no secret of her happiness of
having been able to present an interesting scientific
work, with the support of her colleague, Inacio Barreto.
She said that this was an interesting experience, as well.

She stated that more surveys should be carried out in the
rural sector, mainly in the districts, in order to obtain
information about the impact of the health education
programs related to AIDS, and others, and also in order
to be able to complete the study.

She said that continuation of the research work through
surveys of this type will make it possible, for example,
for the health bodies to plan health education programs
more effectively, and to make constant corrections to
eliminate the methodological errors which sometimes
hinder the development of the projects launched.

In the specific case of the programs pertaining to AIDS,
which is a disease which is just beginning, “it is impor-
tant that all available resources be put to use in order to
make information about the disease known as widely as
possible, thus helping all citizens to protect themselves.”

Speaking with the simplicity and reserve which only a
dedicated interviewer could bring to the surface, Gloria
Macassa said that she feels fulfilled by this work, which
has encouraged her to pursue her inclination to become
increasingly involved in research.

“Whether or not the work proved good, I felt that I had
performed a duty and carried out an obligation,” she said,
adding that the students received financial and material
support from many bodies for carrying out the project.

“This is the result of that support, and nothing could
justify it better than this.”

Gathering the field data was done by a group of six
Faculty of Medicine students. The processing and anal-
ysis of all of the data obtained was the responsibility of
Gloria Macassa, who was assisted by Inacio Barreto, in
conjunction with whom she presented the work at the
JECE [not further expanded].



SJPRS-TEP-90-003
5 MAR 1990

However, he pointed out that an information and edu-
cation program has begun. It stresses fidelity and aims
specifically at getting young people to modify their
sexual behavior accordingly.

This undertaking, he said, complements an intensive,
government-supported effort to detect AIDS in hospitals
and blood banks through use of the so-called Elisa test.

However, he emphasized it’s up to everyone to prevent
AIDS. In this regard, he said the population must be
sensitized to the need to take an active role in this task.

Peru reported its first AIDS case in May 1983. In 1985,
there were 4 cases; in 1985, 7; in 1986, 18; in 1987, 40;
and in 1988, known AIDS cases numbered 87.

Of the victims, 75 percent were between the ages of 25
and 44; 79 percent engaged in homosexual or bisexual
conduct; and 93 percent were male. [passage omitted]

Anti-AIDS Pill Announced
90WE0098C Lima EL COMERCIO in Spanish
3 Dec 89 p 9a

[Text] Peruvian researchers have developed a pill to
prevent AIDS from the “cat’s paw” plant which is native

LATIN AMERICA 2

to jungle areas of this country. The National Council for
Science and Technology [Concytec] made the discovery
public in a press release emphasizing that this advance
was the work of Peruvian doctors.

The announcement indicated the so-called “‘anti-AIDS
capsule” was prepared at the LUSA [not further
expanded] laboratories and presented at the recent
Pacific International Fair.

Dr. Jorge Aguila, president of the company, said Peru-
vian researchers have diligently studied the cat’s paw
plant and their surprising advances have caused a stir
among doctors worldwide. He said that because of the
plant’s importance many foreigners are exporting it in
order to study and make use of it, and this makes it
necessary to take care of our natural heritage.

Dr. Aguila praised Concytec for the support it lent to the
achievement of this scientific advance.

He said this accomplishment has raised high expecta-
tions around the world. In addition to European coun-
tries and the United States, he listed such Latin Amer-
ican nations as Brazil, Argentina, Colombia, and Mexico
among those expressing interest in the development.



JPRS-TEP-90-003
5 MARCH 1990

Foreicn
Broapcast
INFORMATION
Service

PRS Report—

Epidemiology

REPRODUCED BY

U.S. DEPARTMENT OF COMMERCE

NATIONAL TECHNICAL INFORMATION SERVICE
SPRINGFIELD, VA. 22161

DIG QUALITY INarEUrED 5

AIDS

880 bb2b8ool



8 SUB-SAHARAN AFRICA

through him all of his colleagues whose commitment to
our causes does not need to be proved.

May I also be permitted on this occasion to express our
ardent support to all those who, at our side, are carrying
out the fight against this scourge, meaning the Anti-
AIDS Youth Association, the NGOs [nongovernmental
organizations} such as the Third World-ENDA [expan-
sion unknown] and the OLCPSI [Organization for the
Fight Against the Spread of AIDS].

I know that other forms of initiative will join ours. ! am
thinking primarily to the contribution of women’s orga-
nizations.

Information and education remain fundamental for the
prevention of AIDS. To be effective they need the
involvement of all development protagonists, particu-
larly the youth.

As the president of the republic mentioned the other day,
young people constitute the priority for this five-year
period. It is not, therefore, by chance that the present day
is devoted to them.

Mbengue: Madame Minister, talk to us about the activ-
ities scheduled on a national level to commemorate the
World Day Against AIDS.

King: Besides conventional activities such as the inaugu-
ration of exhibits and the holding of lectures that I will
personally preside over, the NGOs, as well as various
groups and organizations will take an active part in the
commemoration of the day. Thus, the Anti-AIDS Youth
Association will organize a cultural soiree at the Cite
Claudel, while the NGO of Djamra will organize an
anti-AIDS march that will go from the Medina Post
Office square to the Alassane Ndiaye Allou School, to the
Tilene market. The very dynamic OLCPSI will go to
Kaolack where, in collaboration with the regional com-
mittee, it will organize an anti-AIDS show. The Federa-
tion of Women’s Organization will also be active because
it will organize a lecture in Kaolack with its theme
“Women and AIDS.”

Mbengue: As for the Third World-ENDA, will it be in
Matam and Ziguichor where a series of activities are
scheduled for this important event?

King: The commemoration of the World Day Against
AIDS coincides with the evaluation of the first year’s
implementation of the national anti-AIDS campaign in
Senegal.

This evaluation made by international experts stresses
the need to better direct our efforts toward organized
groups and to involve all social workers so that in the
long run the results expected might be achieved.

I, therefore, issue an appeal to all Senegalese in all walks
of life, of both sexes, of all religions, to join us in barring
the way to AIDS.

JPRS-TEP-90-003
5 MAR 1990

I will conclude by citing Dr. Jonathan Mann, director of
the World Anti-AIDS Program, “If a given group, a
people or any given country were to relax their vigilance
with regard to AIDS, public health would be seriously
threatened.”

Increased Availability of Condom Urged

90WE0094A Dakar SUD HEBDO in French
30 Nov 89 pp 1, 3

[Article by Saphic Ly: “And What If We Talked About
Condoms?"}

{Text] Prevention. Confronted by AIDS that has been
spreading rapidly, the best remedy is undoubtedly
informing and making people aware of the disease and
finding ways to prevent it. Only a resolute approach can
help in overcoming the disease. More than ever before we
must persuade the people about the need to use condoms, to
liberalize their sales, and to reverse the present market trend
where demand is greater than the supply. In Senegal, where
269 AIDS cases have been reported, AIDS Day celebrated
tomorrow should help to inform the people more, especially
young people, about the dangers to which they are exposed.
The low positive AIDS rate of 0.6 percent compared to the
four to eight percent in certain countries of the subregion
should not lead to apathy. Vigilance is required all the more
so when the rate of high-risk category persons carrying the
virus, such as prostitutes, is high: 20 to 25 percent in Dakar,
28 to 30 percent in Kaolack, and more than 40 percent in
Ziguinchor.

AIDS. Because of the sense of modesty or through
ignorance, Senegal has not allowed itself to be overcome
by a psychosis or even anxiety that one had every right to
expect. Nevertheless, the disease is present and is
spreading. Up to now, 269 cases have been reported in
Senegal. To this troublesome figure we must add others
caused by the delays in biological diagnosis. Tests con-
ducted need rather long confirmation time thus causing
statistics to become unreliable. At the time statistics are
published suspect cases are still waiting to be confirmed.

The prevalence of carriers, in other words, that element
of the population that carries the virus without any
apparent sign of the disease, is estimated at 0.6 percent.
This figure of under one percent can be considered low
compared to the four to eight percent reported in the
Ivory Coast and Central Africa.

Percentages, nevertheless, vary significantly when statis-
tics are centered on so-called at “risk groups,” namely
prostitutes and persons with MST [Sexually Transmitted
Diseases].

Dakar, being the capital and an international center and
because of its urban concentration, has recorded 22 to 25
percent of its prostitues as being AIDS positive carriers,
while in Kaolack, a commercial crossroads between
Senegal and Gambia, the figure stands at 28 to 30
percent. Finally, in Ziguinchor, one of the primary
centers of tourism, the figure rises to a record 40 percent.



JPRS-TEP-90-003
5 MAR 1990

SENEGAL

Health Minister Says AIDS ‘Under Control’

90WE0097A Dakar LE SOLEIL in French
1 Dec 89 p 3

[Interview with Minister of Public Health Therese King
by Khalifa Mbengue on 30 November in Dakar]

[Text] Yesterday, on the eve of the commemoration of
World AIDS Day, Minister of Public Health Therese
King called on all Senegalese to join in the fight against
this terrible scourge. The following is the complete text
of her radio and television interview.

Mbengue: Madame Minister, the World Day Against
AIDS will be commemorated throughout the world. Can
you make clear to us the objectives targeted for this day?

King: As you just said, the entire world including Senegal
will commemorate the World Day Against AIDS
tomorrow. I will, first of all, mention that this day was
chosen by the world summit of health ministers that met
in London on 26-28 January 1988.

The first commemoration of this day in December 1988
met with a striking success. Indeed, it marked a great
step forward in making the public more aware of the
problem and in having it participate in prevention
activities. So, for the second time now the World Day
Against AIDS will be commemorated tomorrow with its
theme “Youth and AIDS.”

The objectives remain the same. They are the following:

1, Make the people more aware of the risks in contracting
the disease by informing them about methods of trans-
mission, stressing risky forms of behavior, and the
means to protect themselves.

2. Increase prevention and anti-AIDS activities and
programs at all levels of society.

3. Lay the foundations for continuous activities against
AIDS because the fight against this scourge cannot
assume a limited and restricted nature.

4. Inspire respect and compassion for people stricken
with the disease.

Mbengue: The theme for the commemoration of the
World Day Against AIDS is, therefore, “Youth and
AIDS.” Why this stress on youth?

King: The theme “Youth and AIDS” was the one chosen.
You know that youth constitute the most important age
bracket of our people. Youth, therefore, constitute the
future of our country.

However, if we do not take care the hope we have in
them risks disappearing, threatened as they are by the
scourge of AIDS to which they are particularly exposed.

SUB-SAHARAN AFRICA 7

Statistics at hand reveal that the age bracket most
affected by AIDS in Africa is the one between the ages of
20 and 30 both for boys as well as for girls.

At the rate AIDS cases in Africa is increasing, that is
close to 50 percent each year, you can just imagine that
if nothing were done our youth would be doomed to
disappear.

In Senegal, the situation is still under control, The
prevalence of AIDS positive cases, in other words the
rate of AIDS virus carriers, is under one percent of the
total population of the country.

However, the 269 AIDS cases that we have already
registered must exhort us to become more vigilant and to
implement more and more effective prevention pro-
grams targeted at groups whose behavior exposes them
to risks of infection by the virus, particularly the young.

Often less informed of the risks that they are running to
become infected, and more inclined than others to let
themselves be tempted by dangerous behavior, young
people will be the special target this year of information
and warnings on the occasion of the World Day Against
AIDS.

Mbengue: What has been done so far to protect youth
against AIDS?

King: Activities carried out for a year now have been of
an operational nature over various stages with the objec-
tive being that by informing and educating the public
and young people, in particular, they would effectively
change their behavior.

Confronted by AIDS, young people comprise the group
most exposed to the risk of infection by the HIV. This is
also the group on which all of our hopes for future
development lie.

That is why, during the 39th session of the WHO
regional commitee held in Niamey in September 1989,
African health ministers expressed their “preoccupation
with the particular threat that menaces young people
because of the great prevalence of infection and of the
disease in this group and by the negative impact of such
a situation on the socio-economic development and
equilibrium of the countries of the region.”

In our country, the need to put emphasis on this age
bracket of the population has always been in the plan-
ning priorities.

Thus, an internal committee for the prevention of AIDS
has been operating in the Ministry of Youth and Sports
for close to a year now. This committee has been active
in providing information and warnings, something that
reinforces the multidisciplinary nature of the fight
against AIDS.

May I be permitted at this point to sincerely thank my
colleague in the Ministry of Youth and Sports and



40 WEST EUROPE

And the Union of Students in Ireland (USA), repre-
senting 120,000 students in third level education both
North and South has called on the Irish Government to
undertake an AIDS awareness campaign to erode peo-
ple’s ignorance of the virus and to provide more medical
facilities for carriers.

Ann Marie Keary, vice-president of USI, said in Dublin:
“There has to be proper support for HIV sufferers and a
full information campaign for safe sex. And whatever
objections people have about the use of condoms, they
are far outweighted by the growing crises of AIDS
sufferers in Ireland.

Increase Among Women

54500053 Dublin IRISH INDEPENDENT in English
30 Nov 89 p 6

[Article by Geraldine Collins and Michael Lavery]

[Text] The real figure for Irish women infected with the
HIV virus could be 10 times more than the 120 known to
be infected, a health expert warned yesterday. She said a
big increase in the number of AIDS mothers was likely.

Dearbhla Murray, an Irish-born World Health Organi-
sation (WHO) consultant on AIDS, said up to 1,200 Irish
women might be HIV positive and over 60 percent of
them would go onto develop full-blown AIDS.

Speaking at a seminar in the Mater Hospital, Dublin, Ms
Murray described the HIV infection in women as
“hidden, silent but growing epidemic.”

She spoke of the lack of attention being given to women
in the AIDS epidemic and said that, where other infected
groups were pitted or seen as innocent victims, women
were “blamed” by society for giving birth to HIV-
infected babies. The attitude towards women at risk,
such as drug users, were that they were “hopeless and
irresponsible for producing infected babies.”

Ms Murray told the seminar, organised by the Women in
Social Work committee of the Irish Association of Social
Workers, that there had not been any largescale search
for HIV-positive women.

Women did not perceive themselves as at risk of infec-
tion and it was difficult to reach them. “Young sexually
active women are not inclined to practice safer sex,” she
warned.

However, it was women, the traditional carers, who had
taken on the role of carer for husbands, boyfriends or
children in the course of the epidemic—often to the
detriment of themselves.

A joint presentation by Shane Butler, lecturer in Social
Studies at TCD, and Marguerite Woods, counsellor in
the Ana Liffey Project, also pointed to the caring role
played by women in the AIDS epidemic. “The advent of
HIV has merely served to highlight the tendency of
women to care for others,” they said.

JPRS-TEP-90-003
5 MAR 1990

Their research showed that to date HIV was mainly a
problem for working class women from deprived urban
areas.

ITALY

High Percentage of Women, Children With AIDS
90WE0075A Milan L’UNITA in Italian 29 Nov 89 p 9

[Article by Ennio Elena: “Data Furnished by the Minis-
terial Commission: Children and Women Stricken With
AIDS in Italy More Than in America”)

{Text] The World Health Organization has made an
apocalyptic prediction: There is a danger that, in the
future, 50 percent of all adolescents will get AIDS,
acquired immune deficiency syndrome. This was
reported by Professor Mauro Moroni, expert in infec-
tious diseases, vice president of the National Association
for Combatting AIDS, and member of the national
commission of the Ministry of Health concerned with
the terrible sickness, in the course of a press conference
held upon the opening of a new pavillion of the “Sacco”
hospital, where there is presntly a large number of
patients with AIDS. The same prediction had been
reported a few days earlier in another meeting dedicated
to AIDS. At that mecting, quoting the same source, a
discussion was held on the risk faced by 15-
to-20-year-olds to contract AIDS during the next 15
years. This risk was placed at between 45 and 50 percent.
It must be said that, in addition to being catastrophic,
these forecasts are theoretical and are based on the
hypothesis of preventive action failing and life styles not
changing. Prof. Moroni himself confirmed this in an
interview. They are therefore to be taken with reserve
because, if underestimating and ignoring them would be
a mistake, so would raising alarms over them.

However, it must be added that the figures furnished by
Prof. Moroni confirm, apart from any self-interested
inflation, the seriousness of the problem. As of last 30
September, there were 160,000 cases reported in the
world and 600,000 estimated. By 1991, 500,000 cases
are foreseen, and they should reach to no fewer than
5,000,000 in the year 2000—but here we are still in the
field of predictions. Not a prediction but an estimate is
the one that indicates as a variable figure of from
6,000,000 to 10,000,000 the number of serum positive
persons in the world. (A person is serum positive when
he develops the antibodies specific to the HIV, the virus
of human immune deficiency.) In Europe, Italy is in
second place (data of last 30 June) with 4,158 cases,
preceded by France (7,149), and followed by the Federal
Republic of Germany (3,872). The total number of cases
in Europe as of 30 June was 25,905.

As far as Italy is concerned, on 30 September last, the
number of cases reported was 4,663. At the head of this
sad listing was Lombardy (1,536 cases), followed at a
considerable distance by Latium (608). Particularly wor-
risome were the data concerning women and children



28 SOVIET UNION

account, and we extend an apology to readers). The
International AIDS Congress in Montreal recently con-
firmed the right of carriers to work, to medical services
and to the protection of the law.

There is one last bit of news, even if it is not all that
comforting. Out of the half-billion in hard currency allo-
cated for acquisition of imported medicines, several tens of
millions are earmarked for the purchase of disposable
syringes, primarily for children’s and maternity hospitals.
Of course, this is only the first step. All of the society must
be protected from infection. An appeal by scientists
(IZVESTIYA, No 246, 1987) to test every hospital visitor
for AIDS has been left unanswered for some reason by
public health organizers. Only in this way, many specialists
feel, will we obtain a more complete and reliable picture of
the infection’s spread. Doctor R. Dybov from Moscow feels
we need to test everyone who worked abroad in the last few
years—within the last 10 or more years.

This task is not all that simple from a technical stand-
point. But besides fear and compulsion, there is also our
personal sense of responsibility for the health of close
ones! The threat that is confronting us is so serious that
no opportunities should be left untaken, and not a single
day should be wasted.

UDC 616.98:578.828.6]-092:612.017.1.064]-
008.6]-078.73

Anonymous Testing of the Public for AIDS Virus
Antibodies

54001022 Moscow ZHURNAL MIKROBIOLOGII,
EPIDEMIOLOGII I IMMUNOLOGII in Russian

No 3, Mar 89 (manuscript received 12 Apr 88) pp 53-58

[Article by V. V. Pokrovskiy, A. I. Mazus, and A. I.
Akimov, Central Scientific-Research Institute of Epide-
miology, USSR Ministry of Health, Moscow]

[Text] In the light of the current pandemic caused by the
human immunodeficiency virus (HIV), decisive impor-
tance in preventing the spread of AIDS attaches to
prophylactic measures that consist primarily of instruc-
tion of the public on safe sexual behavior and to antie-
pidemic measures that constitute a timely identification
of sources of infection and restriction of their activity.

The minimum antiepidemic activity in most countries of
the world is limited to the testing of blood donors, which
allows for a significant reduction in the transmission of
the virus in blood and its derivatives. Moreover, testing
of blood donors at blood transfusion clinics does not
present any particular difficulties. A much more difficult
problem is the testing of risk groups, i.e., persons who
have a large number of sex partners, including male
homosexuals, plus drug addicts who take narcotics intra-
venously.

The regular testing of prostitutes, drug addicts, and
homosexuals does not ensure the testing of a large
segment of persons who are actually subject to the

JPRS-TEP-90-003
5 MAR 1990

hazard of infection, because in most cases the social
status of such persons is difficult to prove. Legislation
that currently exists in a number of countries which
prosecutes drug addiction, prostitution or homosexu-
ality, as well as the traditionally negative public attitude
toward behavior that threatens infection, presents an
obstacle to the voluntary appearance of risk groups for
testing for HIV antibodies.!

A certain number of virus carriers can be identified by
examining patients at medical facilities in which persons
with sexually transmitted diseases are treated. However,
the prevalence of self-treatment and underground treat-
ment of homosexuals and prostitutes reduces the effec-
tiveness of that measure.

In order to encourage groups at high risk for HIV
infection to come in for examination, we opened an
anonymous center for testing the public for HIV anti-
bodies. Along with handling our basic objective, we
attempted to identify the features of sexual behavior
among the population and to determine how informed
persons who came to be tested were about the modes of
viral transmission, evaluate degree of infection risk for
various population groups, and ascertain the effective-
ness of hygiene education. Persons who came to the
center for testing were asked to complete a special
anonymous questionnaire.

The present report gives the results of the examinations
and an analysis of the answers to the survey questions.

Materials and Methods

Beginning on February 25, 1987, three to five milliliters
of blood from the ulnar vein was taken with a disposable
syringe (which was of psychological significance) on a
regular schedule of two times a week during non-work
hours from all those who desired such testing. The blood
sera was tested for HIV antibodies by a test system
manufactured by the Wellcome Company, with subse-
quent verification with a Dupont immune blotting test.
The results of the tests were reported by telephone one
day later to the caller who identified himself by ques-
tionnaire number.

The survey of those requesting tests was conducted
between February and July 1987, during an intensive
medical education campaign on AIDS that was carried
through the mass media. The survey included questions
about sex, age, number of sex partners during the last
five years, worrisome illnesses, sexual relations with
foreigners or with persons of one’s own sex, the use of
needle-administered drugs, receipt of blood transfusions,
and hospital stays. The completion of the anonymous
questionnaire was an obligatory condition for the testing
procedure. A physician spoke either personally or by
telephone to the persons wishing to be tested. These
discussions also enabled us to evaluate the public's
awareness and knowledge about AIDS.



JPRS-TEP-90-003
5 MAR 1990

industrial ministries. All right, granted that it’s not an
easy thing to create diagnosticums for AIDS on our own.
Last year 66,000 diagnosticums developed by the Scien-
tific Research Institute of Virus Preparations were pro-
duced. Production of Peptoskrin diagnosticums is begin-
ning. They will be made by an experimental plant of the
VKNTs [not further identified] on the basis of develop-
ments of the USSR Ministry of Health’s Immunology
Institute. At the moment our diagnosticums are charac-
terized by 10 to 18 percent error, according to testimony
from RSFSR Minister of Public Health A. Potapov.
Disappointing, but correctible. The quality of diagnosti-
cums, creation of which requires especially pure sub-
stances and precise production processes, will improve.

A diagnosticum is simply a collection of reagents.
Revealing what they show requires a spectrophotometer.
This instrument is not all that complex, and it does not
require mastery of new technologies. The USSR Min-
istry of Medical and Microbiological Industry and the
USSR Ministry of Instrument Making, Automation
Equipment and Control Systems accepted the responsi-
bility for producing it. As of today, the former has
provided medical personnel with 100 out of the 800
spectrophotometers planned. The latter has not pro-
vided any of the planned 50. Is there any need for
commentary? Or administrative analysis?

There is another side to this—an ethical one. I. Berzon,
the main physician of Krasnoyarsk’s Hospital No 20,
writes anxiously about the ethics of the profession.
“There aren’t all that many irresponsible nurses,” he
notes. “But alas, just a tiny slip-up is enough to allow
AIDS to continue to spread gradually through hospital
channels—specifically ’our’ channels...” The lack of
professional responsibility and carelessness fit in well
with the poverty of the hospitals, and are fed by it. If
some nurses have only four “reusable” syringes for 60
patients—and such situations are encountered in more
than just one or two hospitals, said participants of the
board meeting of the USSR Ministry of Health, how is a
nurse to maintain completely sterile conditions?

This is the way industry responds to the urgent needs of
society—a way that has evolved over a period of many
years. While in former times industrial ministries simply
forced medical personnel to submit orders only for the
number of syringes that they could actually make (the
orders were filled out after the fact), now industrialists
readily accept any responsibilities, and fail to meet them
just as readily.

So what does all of this mean? What are we waiting for?
“I’m ready to do extra work on Saturdays,” writes
Barnaul resident A. Govorova. “Just give me the assur-
ance that this money will not be cast to the winds, but
will go for disposable syringes, for cleanliness in hospi-
tals, for additional pay for nurses....”

If a simple person can display such willingness to act,
then why can’t the Committee for AIDS Prevention and

SOVIET UNION 27

Control? And it is constantly being said in all of the
conferences that money to fight AIDS will certainly be
found.

I don’t understand. Why is this money not available to
surgeons of Infection Hospital No 2? Why have no
changes been made in the pay of nurses working in
general polyclinics and hospitals? Why not direct public
activity into organizing public control over the work of
those hospitals? We’ve been talking so much about the
need for such control, but we haven’t moved an inch.

Hard currency is now being allocated for equipment for
22 AIDS prevention and treatment centers being created
in the republics. Outfits of the latest equipment have
been purchased for these centers, reported USSR Deputy
Minister of Public Health A. Kondrusev. First of all we
would like to know whether these outfits include
resources to protect medical personnel. And another
thing: Could it be that we need to invite, from abroad to
work under contract, not only builders but also workers
and engineers, knowing how to produce medical equip-
ment—those same syringes and other disposable articles
used in the treatment of patients, and personal hygiene
articles? The virus is not waiting. It won’t be stopped by
bureaucratic discord, by habitual crash campaigns.

The procurator phoned the editor’s office while I was
writing these lines. An AIDS patient was revealed in a
certain city in Donetsk Oblast. He was treated in the
hospital, he was given instructions, and he was released
to his home. But he failed to heed the doctors, and he
engaged in intimate relations knowing that he was ill,
saying nothing to his partners.

Now this patient is being treated in isolation. But what
are we supposed to do in such a situation?, the procu-
rator asked, Was what we did legal? How are we to judge
this person? How are we to investigate the health of all
who had been in contact with this patient if they refuse?

We went to the USSR Ministry of Health for explana-
tions, and here is what we learned. Amendments and
supplements to legislative acts of the RSFSR concerning
responsibility for consciously spreading AIDS have been
prepared. It is not for journalists to judge whether a
patient who has failed to follow the instructions of a
doctor may be subjected to criminal prosecution. Only
physicians can determine whether or not he is competent
(mental degradation is one of the clinical symptoms of
AIDS). But isolating such a patient in a closed hospital is
fully legal. New supplements will soon go into effect, and
it will become possible to conduct AIDS surveys with the
sanction of the procurator. Introducing articles on the
responsibility of medical workers for publicly revealing
AIDS diagnoses and causing harm to a patient’s health
into RSFSR legislation has been proposed.

The demands contained in many letters in our mail go
almost as far as secluding patients on some uninhabited
isle. This is totally unrealistic. Let me recall that casual
contact is not dangerous (this does not of course mean
sharing toothbrushes—we were inaccurate on this



4 SUB-SAHARAN AFRICA

Recommendations

Summarizing the results obtained on six points, the
study urges the need to establish health education bri-
gades for the purpose of explaining to the entire popula-
tion, and mainly to the target group (less educated
women), the nature and symptoms of the disease, and
also ensuring broad distribution of pamphlets explaining
the use of condoms in preventing AIDS.

Special attention is called to the need for the majority of
the pamphlets to be written, when possible, in the local
languages—those spoken and written by everyone in
each of the areas, since often the peasants do not know
how to read and write Portuguese but can read Bibles
and other religious writings in their local languages.

The use of condoms should also be encouraged by means
of discussions, with the introduction of attitudes
allowing women to offer them to their partners and to
persuade them to use them. On the other hand, coordi-
nation between the health and information bodies is
urged, with a view to ensuring, for example, that the
majority of the radio programs are broadcast, on the
provincial level, in the national languages, and that
whenever possible the pamphlets distributed in the prov-
inces are written in the national language or languages
most used (or at least read, since many individuals who
cannot write can read) by the peasant population in the
more remote zones.

Where radio programs are concerned, it is suggested that
they be broadcast in the time periods which will reach
the majority of the peasants in the target group.

It is recommended that regular seminars be held, with
health workers, Red Cross aides, mass organizations,
and other political and administrative bodies partici-
pating, for the purpose of providing an understanding
about this disease, so that these participants can subse-
quently pass on this knowledge to the general popula-
tion.

However, the recommendation of greatest interest is that
urging that the provincial health offices be encouraged to
train personnel and to carry out smaller local surveys in
order to check on the development of knowledge, atti-
tudes, and practices having to do with AIDS in the
districts.

The publication of these conclusions and recommenda-
tions is being done by this writer in the belief that they
pertain to situations which may be common to many
districts and provinces in the country.

The Rural Survey

According to Gloria Macassa, this survey was carried out
within the framework of the July Activities this year, for
the general purpose of studying the Knowledge, Atti-
tudes, and Practices (CAP) of the people with regard to
the disease known as Acquired Immune Deficiency
Syndrome, which has become known throughout the
world as AIDS. Subordinate to this general interest,

JPRS-TEP-90-003
5 MAR 1990

there were specific goals pertaining to the Knowledge,
Attitudes, and Practices with regard to this disease, as
follows:

+ In the knowledge category, it was necessary to learn
about people’s thinking concerning AIDS and the
prevention of it; to know from what source of infor-
mation the majority of the people have heard about
AIDS, or where information about it came from; to
learn what health workers think about the disease and
what they are doing in health units to prevent it; and
to establish whether people know about or use con-
doms.

* In connection with attitudes, an effort was made to
learn how people feel about their sexual partners and
about condoms.

* And in connection with practices, an effort was made
to learn what the illiterate or less educated peasant
would think and do if someone in his family, his
spouse, or a friend were to contract the disease.

Combining this and other information in light of the
survey, the students attempted to draft a study which
would enable them to make better plans for district
health education and to identify the target groups which
should be the focus of the greatest attention, while at the
same time familiarizing themselves with new research
techniques in the public health sector.

Gloria Macassa said that the survey in Manica used
individual, not group {eta, pas multiplas], methodology.
She described it as the first such study to be carried out
by students at the Faculty of Medicine, since normally

* the “WHO sampling method” is used.

The method employed covered individuals of both sexes
speaking Portuguese or Chimanica between 15 and 50
years of age.

Prior to the survey as such, training work was done with
10 Red Cross aides who served as interpreters in all cases
in which the interviews involved peasants who only
spoke Chimanica. This process was followed by a pilot
survey designed to train the teams. “And this was very
good, because it enabled us to modify some features
subsequently,” Macassa recalled, adding that the teams
carried out an average of 12 interviews each, and when-
ever an investigator knew or had known the subject, that
interview was eliminated.

A Flood of Questions

The survey included 80 widely varied questions about
the specific, general, and personal situation of an indi-
vidual with regard to the disease. The questions were
asked of a total of 630 individuals, 371 of whom were
peasants, while the rest were teachers, health and
IFLOMA workers, and displaced persons.

Some of the questions were: From whom did you hear
about AIDS? Do you think it can be communicated by
means of sexual relations? Could you live in the same
house with an AIDS patient? Why can’t some people



18 EAST EUROPE

ROMANIA

AIDS Data Reported for First Time
90WEO115SA Budapest NEPSZAVA in Hungarian
8 Jan 90 p7

[Article: “AIDS Children in Romania”)

[Text] By now Romanians acknowledge that there is
AIDS [Acquired Immune Deficiency Syndrome] in
Romania.

IJPRS-TEP-90-003
5 MAR 1990

Last Friday [5 Jan] Romanian television reported for the
first time official data concerning the country’s AIDS
situation. It stated that in Romania 213 children had
been infected by hypodermic syringes that were not
sterilized. Fifty-five infected adults were recorded. Five
persons in Romania died from AIDS last year. At
present they are aware of 15 infected persons already
showing the symptoms of the disease. During Ceaus-
escu’s regime the fact that there was AIDS in Romania
was denied all along. They claimed that the infection
occurs only in decadent countries.



SPRS-TEP-90-003
5 MAR 1990

be infected, but that so few HIV viruses are transmitted
that it has not been possible to detect it. At Hvidovre, it
has not yet been possible to confirm this supposition.
[passage omitted]

Insurance Firms Start Mandatory AIDS Testing

90WE0106A Copenhagen BERLINGSKE TIDENDE in
Danish 8 Jan 90 p 2

{Article by Uffe Gardel “Insurance Companies: AIDS
Tests Are Anonymous”]

[Text] AIDS test to be mandatory when taking out large
life insurance; the customers will be guaranteed ano-
nymity with regard to their insurance companies.

Life insurance buyers who are required to have an AIDS
test need not be afraid to be registered with the insurance
companies.

As discussed in BERLINGSKE TIDENDE on 12
October last year, the insurance companies will as of the
beginning of the this year require a negative (not conta-
gious) test for the HIV virus if a person wants to take out
a life insurance contract for over 2 million kroner. The
requirement applies to individually signed insurance
contracts and compulsory pension schemes if the busi-
ness employs less than 10 people.

But the customers do not have to tell the insurance
company about the test result if it is positive. They
only have to report their application for a life insur-
ance. The company will never find out whether it was
because of the test result or in the meantime, the
customer received a better offer from another insur-
ance company.

“We want to guarantee the anonymity to the insurance
companies,” says Bjorn Iversen, deputy director in the
Assurandor Society. “An applicant for life insurance
receives a message to go to his or her doctor to be
tested. The applicant receives the test result directly
from his or her doctor and the test result is not sent to
the insurance company until the applicant has given
permission.”

Several months may pass from the time a person is
infected with the HIV virus until the infection can be
confirmed by a blood test. As a result, the insurance
companies constantly run the risk of signing large
insurance contracts for people who have recently been
infected with the HIV virus. But the companies want to
live with that risk, according to Bjorn Iversen. It is the
test result at the time of application that counts.

If an HIV infection is confirmed after the person has
signed an insurance contract, the individual is not obli-
gated to report that to the insurance company.

WEST EUROPE 35

Studies Reveal AIDS Spread Patterns

Geographic Distribution

90WE0079A Copenhagen BERLINGSKE TIDENDE in
Danish 25 Nov 89 p 5

[“AIDS Over The Entire Country”; first paragraph is
BERLINGSKE TIDENDE introduction}

[Text] Over half of the 484 Danes who have been
determined to have had full-blown AIDS are now dead.
All counties have experienced the problem.

New figures from the Board of Health indicate that all of
the country’s counties have AIDS patients.

The great majority of the 484 AIDS cases with which the
Board is familiar stem from the area of the capital,
particularly Copenhagen County, while Bornholm has
two cases and North Schleswig county has one.

Of the 484 people found to have full-blown AIDS, 270
are dead today.

Most of those infected contracted the disease through
sexual contact. This applies first and foremost to homo-
sexuals, but 30 men and women have become infected
through heterosexual contact.

Some 121 new AIDS cases have been registered this year
so far, in comparison with 123 for all of last year and 98
for 1987. Approximately 2,000 Danes have tested posi-
tive for HIV infection, which can later lead to full-blown
AIDS. Because many people in the at-risk groups are not
tested, the Board of Health estimates that a total of 5,000
HIV-positives are present today.

AIDS Today
Reported AIDS cases as of 10/31/1989
Infected by Men Women
Homosexual contact 381 0
Intravenous drug abuse 9 8
Homosexual contact and intravenous 6 0
drug abuse
Treatment of blood disease 12 0
Blood transfusion 3 7
Heterosexual contact 21 9
Birth or pregnancy 3 2
Unknown mode of infection 23 0
Total 458 26



WEST EUROPE

JPRS-TEP-90-003
5 MAR 1990

lumber of AIDS

Nordjyllands Amt 6

25-30 Cases Monthly

90WE0079B Copenhagen BERLINGSKE TIDENDE in
Danish 1 Dec 89 p 9

[Article by Henning Ziebe: “New HIV Infection Almost
Every Day’’; first paragraph is BERLINGSKE
TIDENDE introduction)

[Text] Denmark has almost reached AIDS-patient
number 500, and 25-30 new cases of HIV infection are
discovered every month—almost one per day. There is
nothing to indicate that AIDS is under control.

On the contrary, there is a greater need for information
about AIDS than ever before.

These words of warning were uttered by Chief Physician
Jens Ole Nielsen, M.D., chairman of the AIDS Fund, to
start off the worldwide AIDS day today.

Bornholms Amt 2

Storstrems Amt 8

“The significant reduction in the public effort against
AIDS is also extremely dire. It is not enough to place
condom placards on buses. A year-round prevention
education effort is needed—and just at a time when
many are probably tired of hearing about HIV and think
that a temporary stagnation in the AIDS curves indicate
that we can take it easier,” said Jens Ole Nielsen.

“We are seeing that more women are becoming infected
with AIDS, that married couples are becoming infected,
that newborns are becoming infected, indicating that the
disease is far from under control. It is good that the
disease itself and the individual AIDS patient is perhaps
not of such interest any more, but it would be unfortu-
nate if the battle to prevent AIDS should come to a
standstill. Therefore there continues to be a use for the



24 NEAR EAST & SOUTH A

In addition, poverty and prostitution, which are quite
prevalent in Iran beyond any imaginable limits, could
also be cited as other reasons for the spread of AIDS.

Another specialized physician who had served in Tehran
and Shiraz hospitals and who had recently traveled to
Europe, told the London KEYHAN: I, myself had sev-
eral AIDS patients in the two hospitals where I used to
work,

Here it should be noted that the AIDS virus, in the final
stages, causes severe illness which ends in death. There
are hundreds of individuals who are carrying the AIDS
virus and through contact can transfer the same to others
as well. Many of these individuals in the underdeveloped
countries know that they are the carriers of the AIDS
virus,

TUNISIA

Conference on AIDS Sponsored for 1990

90WE0087A Tunis LA PRESSE DE TUNISIE in
French 3 Dec 89 p 5

[Article by Soufiane Ben Farhat: “AIDS—People Are
Talking About It”; first paragraph is LA PRESSE DE
TUNISIE introduction}

[Text] Tunisia will sponsor a nine-country Mediterra-
nean conference to draw up a joint strategy to fight the
epidemic.

“AIDS—let’s talk about it,” this is the slogan of the
public awareness campaign that was put together and
recently unveiled by the minister of public health
together with other agencies.

And, since public awareness perforce involves informa-
tion, two days ago Messrs Daly Jazi and Habib Boulares,
the ministers of public health and culture and informa-
tion, respectively, sponsored a dinner debate on the
topic: “AIDS—let’s talk about it.” It was a debate to
which many colleagues representing different elements
of the press were invited.

Two communities met to debate. On the one side were
the professors, doctors, researchers, and patricians from
the various levels of the fight against AIDS in Tunisia.
On the other side were the information and communi-
cation professionals, the very people whose work makes
them true links between public opinion and decision-
makers.

For several years the two “communities” met silently.
There was the silence of the researcher in his laboratory,
the silence of the practitioner tracing symptoms and
delivering care, and there was the silence of the specialist
charting the extent of the disease and the way it is
transmitted. As for the journalists, for a long time they
have been poorly or insufficiently informed on the issue
and thus could not satisfy the information needs of
citizens. Whence, the appearance of a whole set of myths

JPRS-TEP-90-003
5 MAR 1990

and huge fears and panics relating to AIDS. The wall of
silence has now been broken. And in this are we not
children of this century, inasmuch as the destruction of
walls is on the agenda everywhere, here as well as in
Berlin?

Filtering the Discourse

But we should particularly not think that we have been
content to rest on our laurels up to this point. As proof,
there are the documents supplied by the relevant offices
within the Ministry of Health. From these documents it
appears that an AIDS tracing program has been in
operation for several years and that it has resulted in the
identification of 154 cases. This has led specialists to this
“hard-as-a-rock” conviction: AIDS has not yet reached
the large-scale epidemic stage in Tunisia.

In this regard, journalists wonder and ask: Was the entire
population systematically traced? Do the 154 cases
uncovered represent the status of AIDS in Tunisia or are
there still other cases running around?

For Professors Ben Ammar, Zribi, and Dellagi, this
figure is a revealing index; “Truth is a hard thing to pin
down,” said Professor Qosay Dellagi (of the Pasteur
Institute). In a word, the epidemic is still in a prelimi-
nary stage in our country. “The Maghreb is seen, even by
the WHO, as a protected area, a sort of cordon, owing to
many factors, one of them being sociocultural,” added
Professor Zribi, the head of the AIDS treatment depart-
ment.

In this country the public awareness and prevention
strategy that the Ministry of Health has launched is very
important. Whatever the cost may be, the ways in which
the illness is spread must be limited. Mr Daly Jazi
forcefully underlined the fact that, unlike other sexually
transmitted discases, AIDS kills.

“The death of any man diminishes me,” a journalist will
say before dwelling in particular on the way in which the
media are given information. Should we resort to adver-
tising condoms on television, knowing that condom use
is the principal means of prevention identified thus far?
It is a sort of ethical question.

“We might have to resort to that in a few years, but right
now, people's sensibilities should hardly be jolted,”
replied Mr Jazi.

In fact, the public debate on AIDS, how it is sexually
transmitted, and condom use bring up issues relating to
taboos and widely held notions about chastity and mod-
esty; in a word, issues relating to matters no one talks
about.

Working Together

Professor Ben Ammar insisted that it is necessary to
know how to filter the discourse so as not to risk
producing reactions that are the opposite of what is
expected from public awareness. But not to worry. A
journalist in favor of advertising condoms on television



IPRS-TEP-90-003
5 MARCH 1990 3 AIDS

SOVIET UNION

Unified Strategy Needed To Combat AIDS /S. Tutorskaya; Moscow IZVESTIYA, 31 Aug 89] .....
Anonymous Testing of the Public for AIDS Virus Antibodies
[V. V. Pokrovskiy, A. I. Mazus, et al; Moscow ZHURNAL MIKROBIOLOGII, EPIDEMIOLOGIH I
IMMUNOLOGII, No 3, Mar 89] .
AIDS Testing Lab in Kiev 0. P. Purik Interview; Kiev RADYANSKA UKRAYIN.
AIDS Discovered Accidentally in Foreign Students
{G. Grin; Kiev RADYANSKA UKRAYINA, 8 Sep 89] ....

WEST EUROPE
CANADA

AIDS Victims Receiving Tainted Blood To Be Compensated
[Mary Gooderham; THE GLOBE AND MAIL, 15 Dec 89] 33
AIDS National Program Delay, Incidence Reported ..... .
Delay in National Program

[Christie McLaren; Toronto THE GLOBE AND MAIL, 8 Jan 90] .. . 33
3,373 Cases [Andre Picard; Toronto THE GLOBE AND MAIL, 10 Jan 90] 34
DENMARK
Health Agency Seeks Law To Trace HIV In Blood Supply
[Henning Ziebe; Copenhagen BERLINGSKE TIDENDE, 27 Jan 89] ... . 34
AIDS Research Grants Announced
[Henning Ziebe; Copenhagen BERLINGSKE TIDENDE, 12 Jan 90) .... . 34
Insurance Firms Start Mandatory AIDS Testing
[Uffe Gardel; Copenhagen BERLINGSKE TIDENDE, 8 Jan 90] . 35
Studies Reveal AIDS Spread Patterns .... 35
Geographic Distribution [Copenhagen BERLINGSKE ] 35
25-30 Cases Monthly /Henning Ziebe; Copenhagen BERLINGSKE TIDENDE, 1 Dec 8 36
Program Effectiveness Weighed {Copenhagen BERLINGSKE TIDENDE, 7 Dec 89] .. 37
Greenland Surgeon General Issues AIDS Warning
[Ole Dall; Nuuk GRONLANDSPOSTEN, 5 Jan 90] . 38
IRELAND
Reportage on Spread of AIDS Continues ..... . 39
Openness Urged, Statistics Given (Mary Carolan; . 39
Increase Among Women
[Geraldine Collins, Michael Lavery; Dublin IRISH INDEPENDENT 30 Nov 89] . 40
ITALY
High Percentage of Women, Children With AIDS [Ennio Elena; Milan L’UNITA, 29 Nov 89] ..... 40
SWEDEN
AIDS Prevention Funds Cut in 1990 Budget [Stockholm DAGENS NYHETER, 20 Dec 89] ......... 41
SWITZERLAND

Cost of Treatment of HIV-Positives Debated
[Zurich NEUE ZUERCHER ZEITUNG, 30 Dec 89] ....

UNITED KINGDOM

Health Department Reports AIDS Statistics
[David Fletcher, Steve Connor; London THE DAILY TELEGRAPH, 12 Dec 89] ....



JPRS-TEP-90-003
5 MAR 1990

stricken with AIDS in Italy. The former represent 19
percent, as compared with 9.3 percent in the United
States and 12 percent in the rest of Europe; the latter
record a percentage of 3.2 percent, as compared with 1.6
percent for the United States and 1.2 percent for the rest
of Europe.

It is to be noted that, while the highest percentage of
patients consists of drug addicts (68.2 percent), followed
by homosexuals (16.2 percent), a considerable jump in
cases due to heterosexual relations is foreseen. By 1992,
these should pass from the present 6.8 percent to 19
percent. This is a phenomenon in rapid growth, one that
in the United States represents the chief cause of death of
youth but that, Moroni said, has fortunately not
recorded the exponential growth feared.

SWEDEN

AIDS Prevention Funds Cut in 1990 Budget

90WE0114B Stockholm DAGENS NYHETER in
Swedish 20 Dec 89 p 12

[Article: “Fight Against AIDS Gets Less Money”]

[Text] The amount of money appropriated for preven-
tive measures in the fight against HIV and AIDS will
decrease by 11 million [kronor] in the national budget to
be presented in January, Tidningarnas Telegrambyra
[Swedish Press Agency] has learned. The National Board
of Education will receive no special grants and in other
areas the meat ax principle will be applied.

The overall figure will be 215 million kronor, compared
with 226 million for the current budget year.

Subsidies to the major cities—120 million—remain in
the budget. The government has announced that towns
and county councils in the major urban areas should no
longer need special development grants.

SWITZERLAND

Cost of Treatment of HIV-Positives Debated

90WE0086A Zurich NEUE ZUERCHER ZEITUNG in
German 30 Dec 89 p 24

[Text] Swiss federal authorities are having to deal with the
issue of what social services HIV-positive persons who have
not yet developed AIDS are entitled to. The question
demands an answer because drugs are already being tested
which can delay the manifestation of the disease.

Controversial Definition

In order for provident care to be recognized by health
insurance carriers, HIV-infected persons would have to
be categorized as being ill. Those concerned regard such
a categorization as discrimination. In today’s practice,
only patients in whom the disease has manifested itself

WEST EUROPE 41

and is readily apparent by the presence of infections and
tumors are considered to be AIDS sufferers. This
opinion is shared by the World Health Organization and
the Federal Office of Public Health. In this way, discrim-
ination against AIDS-infected persons—for example by
the health insurance carriers or in the workplace—is
supposed to be avoided. The costs of hospital care and
treatment by physcians are assumed by the health insur-
ance carriers after the open manifestation of the disease.
At present, most AIDS sufferers in Switzerland are being
treated with the AIDS drugs AZT or Zidovudine under
strict medical supervision.

A recently completed study in the United States
involving 2,300 HIV-infected persons with already
altered blood composition and antibodies has shown
that AZT can delay the manifestation of the disease. A
clinical study is also to be conducted in Switzerland in
1990 in which HIV-infected persons who already show
weakening of the immune cells are to be treated with
AZT. Reservations are being expressed concerning this
treatment, however. Indeed, at the AIDS Conference in
Montreal in June it was characterized as “disappoint-
ing.” The effectiveness of AZT only lasts for the first
several years and the side effects and aftereffects are
barely known. Nonetheless, early preventive treatment is
advocated in the United States. If the Swiss study
produces convincing results, the question will still
remain as to who should pay. The costs are estimated at
between 4,000 to 6,000 Swiss francs per patient per year.

Who Pays?

According to the Health Insurance Fund Law, the insur-
ance carriers are not obligated to assume the costs of
preventive treatment. The Association of Swiss Physi-
cians (FMH) takes the position in its “AIDS Concept
Paper” that the HIV infection—from the moment of its
appearance and independent of its stage of develop-
ment—is a disease, and that the costs for its treatment
should be borne by the health insurance carriers. The
Concordat of Swiss Health Insurance Funds says some-
thing different: If HIV-infected persons are regarded as
suffering from an illness, the health insurance carriers
want to reserve the right to include a proviso against
providing coverage for them. The Swiss AIDS Assistance
Organization is opposed to classifying HIV-positive per-
sons as ill in any case: In its opinion, this step has
discriminatory consequences on the social level.

Compromise Solution?

A compromise solution already exists in the United
States where HIV-infected persons are not categorized as
being ill. The costs of provident care are covered by a
special credit. The Federal Office for Social Security
regards it as feasible to retain the present legal principle
and to create a supplementary fund in Switzerland which
would be financed in part by the federal government and
in part by the health insurance providers, The issue has
already been discussed in the appropriate federal offices.
According to Peter Koch of the Federal Office for Social



JPRS-TEP-90-003
5 MAR 1990

were considered to be the most important sources of infor-
mation of STD’s with medical staff a secondary source.

Home

The results of the survey also revealed a low incidence of
sexual promiscuity. Only two percent of the respondents
had had sexual contact with a prostitute in the month
before the survey.

Almost 35 percent of the miners had a girlfriend at home
but not near the mine, while 14 percent had a girlfriend
near the mine. Of the 181 men who had slept with a
girlfriend in the previous month, 24 percent said they
always used condoms and 63 percent of those gave
prevention of AIDS and STD’s as reasons.

The main reason given for not using condoms was trust
that the women involved were free of STD’s and AIDS
(57 percent). The usage of condoms was low but the
consultants monitoring the survey believe it is high
compared with the rest of Africa.

In conclusion, the report states: “The promiscuity of
black miners, so often alluded to in discussions about
AIDS in South Africa, is not borne out by this survey.

A prevalent understanding of the dangers of promiscuity in
the spread of STD's and AIDS was shown in this study.

TANZANIA

Devastation From AIDS Traced to Ancient Sex
Mores

90WE0102A Copenhagen BERLINGSKE TIDENDE in
Danish 8 Jan 90 p 21

[Article by Michael Ulveman: “AIDS Is Killing Africa’s
Young People”; first paragraph is BERLINGKSE
TIDENDE introduction]

[Text] Towns in northwestern Tanzania have lost all of
their young people. Fields and plantations lie fallow and
thousands of children are without parents. The sex
traditions of the area have turned AIDS into an epidemic
which could put a stop to all progress.

MWANZA. Tanzania’s young people are dying.

The productive segment of the population, the one which
should be caring for the children and the old people, is
falling to AIDS to an extent which only recently became
apparent to international assistance organizations.

AIDS—Africa’s new epidemic—is destroying the entire
agricultural village society in northern Tanzania up to
the Uganda border. The disease is spreading at high
speed along the travel routes into Dar-es-Salaam, a city
of a million inhabitants.

The International Red Cross first introduced their assis-
tance effort into the Kagera district near Lake Victoria,
which is the hardest-hit area, only nine months ago.

SUB-SAHARAN AFRICA

i

Nine villages have been chosen for a pilot project, which
is still in the initial stages. A full grasp of the scope of the
catastrophe is yet to be achieved. Health statistics are
lacking. Whether an inhabitant is registered as having
died of AIDS or diarrhea is a matter of circumstance.

A Wild and Unrestricted Sex Life

Studies conducted in the area indicate that up to 50 percent
of the reproductive population is affected. This figure has
shocked workers involved in the Red Cross project, to which
Denmark has contributed 10 million kroner.

Danish nurse Else Melgaard is standing in front of the
Red Cross mission in Dar-es-Salaam. From a storage
room with a pile of used car tires in the corner and a
telephone that doesn’t work, she attempts to coordinate
the project together with nine coworkers.

Else Melgaard is the only Dane.

She says that it was determined a few months ago that
there are approximately 4,000 children in the Kagera
district without parents because of the AIDS epidemic.
However, the actual number today is far greater.

“It has enormous consequences. The fields and planta-
tions in Kagera lie fallow. The old people are too old to
cultivate them, and the young people are too young.
There is no one to take care of the things we live from.
Who will care for future development?” she asks.

The explosive growth in the number of AIDS cases is
blamed on a wild and unrestricted sex life, which is part
of the region’s centuries-old tradition. This has previ-
ously led to major outbreaks of syphilis and other
sexually transmitted diseases.

Red Cross project workers have worked intensively to
determine the nature of these sex traditions, but they
have met with a wall of silence. Sex is a taboo subject,
one which is not discussed.

“Down here they don’t talk about sex, but they do it a
lot. It is very secret. They are also very reluctant to
change their sex life. Many of them have nothing else to
do than engage in sex,” explains Else Melgaard.

Success in breaking down the barriers of silence has been
achieved of late. The AIDS project workers now have a
theory as to how the AIDS virus might be spread here.

When a woman of the Haya tribe, which is the largest
tribe in Kagera, is to marry, she receives a special plant
from her mother-in-law. This plant stimulates the
woman and makes her especially lusty.

The traditions here prescribe that the man should strike
his penis against the woman’s clitoris during foreplay.

The theory is that, even though this act is not particularly
violent, it causes scratches through which the HIV virus
can pass.



IJPRS-TEP-90-003
5 MAR 1990

AIDS-Free Health Certificates Required for
Inbound Travellers

54004060 Hong Kong SOUTH CHINA MORNING
POST in English 2 Jan 90 pp 1, 5

[Text] China’s new immigration requirement for
inbound travellers to produce an AIDS-free health cer-
tificate came into effect yesterday but there were no
reports of Hong Kong people being denied entry under
the rule.

This is despite the fact that the Hong Kong authorities
issue no certificates to prove that local residents are clear
of AIDS and venereal diseases.

Health officials in Shanghai disinfected a hotel after one
of its American guests was found to be China’s 33rd
AIDS case, a Shanghai newspaper reported.

The man, said to be a homosexual and identified only as
“Mr J”, was sent back to the United States, through
Hong Kong, last Friday “under the supervision of Chi-
nese doctors”, the Liberation Daily said.

The paper did not specify whether the man was suffering
full-blown AIDS or was merely found to have been
exposed to the HIV virus.

He had arrived in Shanghai on Christmas Day, planning
to visit several Chinese cities, but he failed to inform
quarantine officials upon arrival that he was an AIDS
sufferer.

Two days later “Mr J’ left for Guilin, a popular resort
city in the southwest, pursued by health officials who
were tipped off about medicine that he had left behind.

He was escorted back to Shanghai, tested positive for
AIDS, then expelled from China as health officials
“disinfected the guest house and other places that he had
been”, the report said.

A Hong Kong Department of Health spokesman yes-
terday maintained that the Hong Kong Government
made it clear, before it received China’s notification of
the new requirement for health checks, that it would not
carry out screening tests.

The department has sought clarification with China
about the scheme and is still awaiting a reply, the
spokesman said.

An Immigration Department duty officer at the Lowu
checkpoint said staff there were not aware of any case of
Hong Kong visitors to China being refused entry yes-
terday because of failure to provide such health certifi-
cates.

The new regulation, first reported in the Shenzhen Daily
last Tuesday, stipulates that the health certificate was
required of Chinese from Hong Kong, Macau, Taiwan
and overseas who want to work or settle in China.

CHINA 13

The rule also applies to returning mainland Chinese who
have been abroad for more than three months.

Those who do not have the necessary health certificates
will have to be tested in China.

All inbound foreign travellers to China must fill out a
quarantine declaration form in which they are asked,
among other medical questions, whether they are AIDS
sufferers.

Foreigners planning to live in China must also undergo
an AIDS test.

The case of “Mr J” brought to 33 the number of AIDS
carriers found in China since 1985. Most of them were
foreigners who were subsequently ordered out of the
country.

Of six Chinese cases, four contracted the disease through
contaminated blood products imported from overseas.
The others were a Chinese who had been in Africa, and
a Beijing man who had homosexual contact with for-
eigners.

New Anti-AIDS Campaign To Focus on Youth

54004059 Hong Kong STANDARD in English
2 Dec 89 p 5

[Article by Andrew Bomford]

[Text] The Government yesterday unveiled its new
AIDS (Acquired Immune Deficiency Syndrome) educa-
tion package which is targeted at the territory’s youth
who constitute the main risk group.

The launching of the new campaign coincides with the
second World AIDS Day, a global effort to promote
community awareness of the disease.

The campaign includes a graphic TV warning that
focuses on the risks involved when intravenous drug
users share needles.

The first announcement was screened last night. It
showed a group of addicts injecting each other with the
same hypodermic syringe.

However, the campaign officially kicks off this Sunday
with an AIDS youth concert at Kowloon Park.

The decision to aim the campaign’s TV messages at
intravenous drug users reflects a desire to nip a potential
problem area in the bud, before AIDS takes hold of the
territory’s addict community.

According to AIDS experts many of the territory’s drug
users still share needles, despite the fact this same
practice abroad has contributed to an explosion in the
number of victims.

“If they continue to share needles there is a distinct
possibility we will have a similar problem here as we
have already seen in other countries,” said Dr Patrick Li.



SJPRS-TEP-90-003
5 MARCH 1990 2 AIDS

CHINA
AIDS-Free Health Certificates Required for Inbound Travellers
[Hong Kong SOUTH CHINA MORNING POST, 2 Jan 90] .....
New Anti-AIDS Campaign To Focus on Youth
[Andrew Bomford; Hong Kong STANDARD, 2 Dec 89]

EAST ASIA
HONG KONG

Trend Points to 30,000 AIDS Patients by Year 2000

[Helen Signy; Hong Kong SOUTH CHINA MORNING POST, 28 Dec 89]
Appeal for Early AIDS Tests as Two Die

[Mary Ann Benitez; SOUTH CHINA MORNING POST, 29 Nov 89] +...

THAILAND

Health Minister Concerned Over Spread of AIDS [Bangkok BANGKOK POST, 7 Feb 90]
13,000 Have AIDS, Cases May Double by 1991 Bangkok, BANGKOK POST, 1 Feb 90] ..
Plans To Upgrade AIDS Control! Committee Approved

[Bangkok BANGKOK POST, 7 Feb 90] ....
72 Percent of Chiang Mai Prostitutes Have AIDS

[Ann Danaiya Usher; Bangkok THE NATION, 2 Feb 90]

EAST EUROPE
ROMANIA

AIDS Data Reported for First Time /Budapest NEPSZAVA, 8 Jan 90] .... 18
LATIN AMERICA
HONDURAS
Breakdown of AIDS Statistics Presented /San Pedro Sula LA PRENSA, 9 Jan 90] . 19

237 Cases of AIDS Detected (San Pedro Sula TIEMPO, 3 Jan 90]
469 Confirmed AIDS Cases [Tegucigalpa LA TRIBUNA, 24 Jan 90]

PERU

AIDS Developments ....
Infection Estimates /Lima EL COMERCIO, I Dec 89]
Health Ministry Figures /Lima EL COMERCIO, 2 Dec 89]
Anti-AIDS Pill Announced /Lima EL COMERCIO, 3 Dec

NEAR EAST & SOUTH ASIA
EGYPT

Minister Discusses AIDS Cases, Foreign Origin {Cairo AKHBAR AL-YAWM, 9 Dec 89] cesses. 22
INDIA
Number of AIDS Carriers Rising {Madras THE HINDU, 22 Dec 89] .... . 23

IRAN

Six Reportedly Die of AIDS {London KEYHAN, 7 Dec 89]
TUNISIA

Conference on AIDS Sponsored for 1990
[Soufiane Ben Farhat; Tunis LA PRESSE DE TUNISIE, 3 Dec 89) .......



34 WEST EUROPE

The 56-page consultants’ document—which called for
“immediate, urgent action” to combat AIDS—outlined
the proposed roles of the federal and provincial govern-
ments as well as community groups. It called for a new
AIDS agency to oversee a dramatically expanded fight
against the syndrome.

At the end of November, Mr. Beatty refused to reveal
whether Ottawa would spend more time and money on
the AIDS fight.

The draft strategy was circulated to the provinces and
other groups for comment, but some provinces have
been slow to respond, Dr. Clayton said.

After a second draft is issued, he said, it will be circulated
for further comment before a final document is produced.

Mr. Burzynski said community groups that depend on
government financing to provide social support to
people with AIDS are running out of money, and cannot
wait another six months to find out whether they will be
able to continue to operate. [passage omitted}

3,373 Cases

54200025 Toronto THE GLOBE AND MAIL in
English 10 Jan 90 p A9

[Article by Andre Picard: “Fiery Nationalist Leader
Quits Quebec Politics To Help People With AIDS”]

[Excerpts] The leader of Quebec’s radical Parti Indepen-
dantiste is quitting politics to work with people with
AIDS because he believes he has the illness himself.

“Hundreds of thousands of people every day are con-
fronted with a paralyzing fear, the fear that "Oh my God,
maybe I have AIDS,” Gilles Rheaume said in an inter-
view yesterday. “Rather than hide or sit at home and cry,
Ihave decided to act.” He said he has not been tested for
the human immune deficiency virus, but he has “good
reason to believe” he is infected because two close
friends died of AIDS in recent months. [passage omitted]

Mr. Rheaume, a former president of the powerful
Societe St-Jean-Baptiste known for his fiery oratory, has
joined the Montreal AIDS Support Committee and
intends to use his political contacts to advance the cause
of Quebeckers with AIDS. [passage omitted]

As leader of the Parti Independantiste, Mr. Rheaume
actively encouraged his members to spray-paint and van-
dalize stores that did not obey the province’s sign laws, and
he did not hesitate to verbally attack any person or group he
believed threatened French-language rights in Quebec. He
said he will promote a similarly militant approach among
people with AIDS. [passage omitted]

Statistics published this week by the Federal Centre for
AIDS indicated that 3,373 Canadians are known to have
developed acquired immune deficiency syndrome, and
2,012 of them have died. In Quebec, 977 people have
contracted AIDS, and there have been 537 deaths.

JIPRS-TEP-90-003
5 MAR 1990

DENMARK

Health Agency Seeks Law To Trace HIV In
Blood Supply

90WE0116B Copenhagen BERLINGSKE TIDENDE in
Danish 27 Jan 90 p 4

[Article by Henning Ziebe: “Increased Monitoring of the
Spread of HIV”; first paragraph is BERLINGSKE
TIDENDE introduction]

[Excerpt] The Board of Health is seeking permission to
examine anonymously “leftover” blood from a number
of blood tests at hospitals and laboratories.

The Board of Health is asking the Health Ministry for
permission to conduct HIV tests on a number of anonymous
blood samples at hospitals and elsewhere to determine more
precisely the spread of the AIDS virus in Denmark.

The board wants to test excess blood from groups of
patients who would not be consulted in advance. For
example, they may be patients at vencreal disease clinics,
women seeking an abortion, or other pregnant women
who come in to the hospital. All personal information is
deleted before the test, so that the results cannot be
linked to the individual patient at a later time.

This method could give an indication that there is an
increase in infection within a certain social group, so that
the level of preparedness can be raised. For example, if a
sudden increase is noted in the number of those infected
with HIV among women seeking abortions, then this would
signal an increase in infection among heterosexuals.

As soon as the minister gives the green light, the board
will ask the State Serum Institute to have a working
group prepare for the new tests. [passage omitted}

AIDS Research Grants Announced

90WE0106B Copenhagen BERLINGSKE TIDENDE in
Danish 12 Jan 90 p 3

[Article by Henning Ziebe: “Millions to Research of HIV
Testing”)

[Excerpt] [Passage omitted] A test for detecting very
small quantities of the AIDS infecting HIV virus and the
detection of a substance in the blood that looks like it
could counteract bacterial attack are some of the things
that the National Social Science Research Council has
supported with millions of kroner. A total of 27 million
kroner has been distributed to a number of projects.

Chief Physician Jens Ole Nielsen at the Hvidovre Hos-
pital has received three million kroner for work with the
HIV test. It can, among other things, be used for
detecting very small quantities of the HIV virus, for
example, in the umbilical cord blood to see whether the
fetus is infected with HIV from the mother. But it can
also be used to test the suspected silent carrier of HIV,
for example, a partner of an infected person for 15 years.
Abroad, it has been stated that the partner can very well



2 NEAR EAST & SOUTH ASIA

EGYPT

Minister Discusses AIDS Cases, Foreign Origin

90WE0109A Cairo AKHBAR AL-YAWM in Arabic
9 Dec 89 p 4

[Interview With Dr. Muhammad Raghib Duwaydar,
minister of health, by Dr. Rifat Kamal; “154 Egyptian
Eyes Prevent ‘Importation’ of AIDS; Minister of Health:
Egypt Is Free of Disease; Contagion Always Comes From
Abroad”; First paragraph is AKHBAR AL-YAWM
introduction; date, place not given“]

Text] Can AIDS reach your home? Dr. Muhammad
Raghib Duwaydar, the minister of health, says with utter
confidence: No. Emphasizing his opinion, the minister
says: We have found out from where AIDS can get into
Egypt and we have formulated a plan that guarantees
that it will not enter. There are 154 eyes, which are in
fact the latest discoveries offered by science, to expose
the presence of AIDS. These eyes examine and isolate
whatever may bring the contagion into our country.
What confirms that our country is safe is this fact which
has been proven decisively and which states that AIDS is
a disease exported to us from abroad.

AKHBAR AL-YAWM: I asked the minister of health
about the number of AIDS cases found in Egypt.

Duwaydar: Fifty AIDS cases have been discovered. What
is interesting is that most of these cases involve Egyp-
tians who went for treatment and surgery abroad. They
contracted the disease during their treatment and
returned with it to Egypt. In addition to these, there is
the Egyptian who lived abroad for many years and then
decided to return to die in his country, Egypt, when he
discovered that he was afflicted with the disease.

Besides these, there is the foreigner who came to work in
our country and who was infected with the disease to
start with.

Thus, we find that in all these cases, the infection came
from abroad. Our country is fundamentally clear of the
disease.

AKHBAR AL-YAWM: How can we insure that the
infection will not spread?

Duwaydar: The world has learned that the disease can be
transmitted through the transfusion of infected blood.
Hence the first preventive step: It is totally forbidden to
import blood from abroad.

Thus, there remains the possibility of infection transmis-
sion through an Egyptian donor living in Egypt with his
infected blood.

To eliminate this possibility, it is required that every bag
of blood be examined to make certain that it is free of

JPRS-TEP-90-003
5 MAR 1990

AIDS. Yes, analysis is compulsory for every blood trans-
fusion. We thus insure that the infection is not trans-
mitted by this means. We now come to imported drugs
containing blood derivatives.

We could be content with the medical certification which
is provided with every consignment we import and
which ascertains that it is free of AIDS. But we have not
been content with this certification and we have decided
to reexamine the drugs here in Egypt. This is done by
analyzing every consignment in three different laborato-
ries to make sure of the results.

If one of the three laboratories determines that the drug
consignment is infected with AIDS, we destroy the
consignment immediately. It is essential that the results
received from the three laboratories confirm that the
consignment is safe in order that its use may be allowed.

There is a third means for transmitting the infection,
namely man. This is why the technical scientific com-
mittee specialized in this disease and formed by the
Ministry of Health—a committee which includes the
greatest experts from the various scientific circles—has
checked the individuals who must be examined to make
sure that they are free of the disease, such as foreigners
who come to work in Egypt, airline and maritime trans-
port workers whose conditions require them to stay
abroad for long periods of time, and even workers of the
American University and of foreign embassies.

Inside the country, there are other groups who are likely
to be infected with the disease or are carriers of the
infection who show no symptoms of the disease.

People charged in vice cases, prisoners, addicts, and
those who sell their blood habitually are examined
periodically. A foreign drug smuggler who had been
caught and sentenced to a jail term was found to be
infected with the disease. When the discovery was made,
a republican decree was issued pardoning him and the
man was deported to his country immediately.

All this confirms that Egypt is fundamentally free of the
disease and that the infection always comes from abroad.
All the Ministry of Health agencies carefully observe the
inlets through which the disease may enter the country.

I then asked Dr. Hasan al-Dhib, an undersecretary of the
Ministry of Health, “What about the equipment used to
test the samples and to make certain that they are
healthy?”

Dr. Hasan al-Dhib responded, “The ministry has been
careful to provide the latest and most accurate equip-
ment (the price of a single apparatus is $75,000). These
apparatuses, totaling 154, have been supplied to the
Ministry of Health laboratories, to blood banks, to the
Therapeutic Institution Hospital, and to the laboratories
of teaching hospitals. All these units are supplied with
the materials needed for analyses. At the same time,



n

Epidemiology
AIDS

JPRS-TEP-90-003 * CONTENTS 5 MARCH 1990

[This EPIDEMIOLOGY report contains only material on AIDS. Other epidemiology topics will be covered in a later
issue.]

SUB-SAHARAN AFRICA
CAMEROON

100 AIDS Cases Detected; Disease Spreading
[Claude B. Kingue; Yaounde CAMEROON TRIBUNE, ! Dec 89} ....
Blood Transfusion Guidelines To Limit AIDS
[Anyee Anyee; Yaounde CAMEROON TRIBUNE, 20 Nov 89] ......

GABON

Chinese Aid for Anti-AIDS Research Sophie Lenga; Libreville L’'UNION, 7 Dec 89]

AIDS Figures Reflect Only ‘Tip of Iceberg’ (Libreville L’UNION, 4 Dec 89] 2
IVORY COAST

AIDS Cases Up: Recognized National Disaster /Paris LE MONDE, 10 Jan 90] 2
MADAGASCAR

First Cases of AIDS Now Surfacing [Antananarivo MIDI MADAGASIKARA, 2 Dec 89] .... 3
MOZAMBIQUE

AIDS Education Priority for Rural Areas /Ernesto Zucule; Maputo NOTICAS, 16 Oct 89) ... 3
NIGER

Health Minister Responds to AIDS Figures /Niamey LE SAHEL, ! Dec 89] .... 6
SENEGAL

Health Minister Says AIDS ‘Under Control’ (Dakar LE SOLEIL, 1 Dec 89] .... 7

Increased Availability of Condom Urged /Saphie Ly; Dakar SUD HEBDO, 30 Nov 89] 8

SOUTH AFRICA

Number of AIDS Carriers Reaches 35,000
[Felicity Levine; Johannesburg SUNDAY TIMES, 14 Jan 90] ....
Survey on Black Miners’ Awareness of AIDS [Johannesburg SOWETAN, 27 Nov 89]

TANZANIA

Devastation From AIDS Traced to Ancient Sex Mores
[Michael Ulveman; Copenhagen BERLINGKSE TIDENDE, 8 Jan 90] ....

ZAIRE

Mobutu’s Son in Belgian Clinic; AIDS Speculated
[London AFRICA CONFIDENTIAL, 15 Dec 89]



30

homosexual relations, 25 lesbians, 44 persons who had
used drugs intravenously, and 105 men and 229 women
who indicated they had had relationships with for-
eigners. Many individuals in this group had several
factors of risk of infection (see Table 2).

For example, of the men who had had sexual contacts with
foreigners, 50 reported more than five contacts, and four of
them were drug addicts and 14 were homosexuals.

The women who reported sexual relations with for-
eigners indicated an average of 9.48 partners over a
five-year period (12 women did not indicate the number
of partners), i.e., considerably higher than the average
level of surveyed persons who indicated that they had
sexual partners (3.85). A total of 14.9% of those persons
had one partner, 10.9% had two partners, 39.4% had
three to five partners, and 34.7% were considered in the
highest-risk group also because of the number of sex
partners in comparison to the 12.5% of all tested persons.
This group consequently represents a considerable
danger in terms of spreading HIV infection. Six of those
persons (26%) were intravenous drug users, which
increases the epidemiological role of this contingent.
Among the 47 women who indicated more than 30 sex

SOVIET UNION

JPRS-TEP-90-003
5 MAR 1990

partners, many were apparently prostitutes, as is
reflected by the fact that 21 women of this group
reported relationships with forcigners.

Male homosexuals and bisexuals, who constitute a gen-
erally acknowledged AIDS risk group and who reported
their sexual behavior in the questionnaire, made up 3.3%
of the surveyed persons. Four of those persons did not
indicate the number of partners, 12 reported one
partner, two persons reported having two partners, 15
reported three to five partners, and the remaining
reported having more than five partners. Fourteen male
homosexuals had sexual relations with foreigners. Thus,
this group could be considered a bridge for the penetra-
tion of HIV into the USSR. In addition, three male
homosexuals were drug users, two of which also had
relations with foreigners, which could be of significance
with respect to the virus’ penetration into the drug-
addict environment.

Women who have had homosexual relationships are not
usually considered to be a risk group with respect to HIV
infection, but a high incidence of drug addiction has
been noted among them. Out of the 25 women who
indicated that they engaged in homosexual relations, one
woman reported drug use and relations with foreigners,
and five reported having had relations with foreigners.

Table 2. Occurrence of Several Factors of Possible HIV Infection in a High Risk Group

HIV transmission factors
Men Women

Risk groups Homosexual | Drug Sexual More than | Homosexual | Drug Sexual More than

relations. | addiction | relations five relations. | addiction | relations five
with partners with Partners
forcigners forcigners

Homosexuals 74 4 14 37 25 1 6 3

Drug addicts 4 29 4 13 1 15 6 6

Persons who had 14 4 105 50 6 6 229 65

sexual relations with

foreigners

Persons with more 37 13 50 325 3 6 65 173

than five sex partners

Unfortunately, the questionnaire did not enable us to
identify the bisexual subjects who were obviously
broadly represented in the homosexual group of the
tested persons.

Forty-four persons (0.86% of those queried) reported the
parenteral use of drugs. Three of the 12 women drug
addicts who indicated the number of sex partners
reported having more than 100 partners, including for-
eigners. This group had the highest average number of
partners, i.e., 33.9. The male members of this group had
an average of 26.8 partners. Four of that group had
sexual relations with foreigners. Two indicated having
had relations with 100 foreigners, one person reported
50 to 100 contacts, and one reported having 6 to 10
partners.

Drug addicts consequently represent a group with a
triple risk for the spread of HIV.

Our analysis of the questionnaires took into consider-
ation the probability of false answers to questions, par-
ticularly relating to risk factors. This was confirmed in
the gathering of epidemiological case histories of four
persons identified with HIV antibodies: they belonged to
the high-risk group, but none of them completed the
questionnaire correctly. Apparently, the true risk groups
among the tested persons were two to three times greater
than was indicated in the questionnaires. This under-
scores the high degree of effectiveness of anonymous
testing methods and its attractiveness to the risk groups.

The presence among those tested of a large number
individuals who had reccived blood transfusions
(14.7%)—apparently the primary reason for their
coming to the center to be tested—indicates the public’s
special concern about possible infection via blood trans-
fusions.



JPRS-TEP-90-003
5 MAR 1990

political intervention in the overindulgence in alcohol.
Hopes to avoid AIDS disaster, but “changes in sexual
conduct are necessary.”

Prohibit consumption of alcohol at all places of work.

In his annual report, the surgeon general of Greenland,
Jens Misfeldt, gives the preceding advice to Greenland
politicians. At the same time, he asks for “‘clear political
signals regarding the overindulgence in alcohol and a
continued and diversified information campaign to
change attitudes.”

The annual report also mentions the high murder and
suicide rates in Greenland. Nonnatural deaths—
suicides, homicides, and accidents—account for approx-
imately one-third of all deaths.

Surgeon general Jens Misfeldt and Jorgen Thorslund,
M.A., have analysed the large number of suicides.
Thorslund notes that “the suicide rate is the highest one
ever recorded in a society.”

Standing Between Two Cultures

Urban societies that have fallen behind in development
are especially hit by suicides, which are often committed
by jobless or casual laborers. Consumption of alcohol is
often a contributory cause in impulsive acts of suicide.

Jorgen Thorslund, furthermore, points out that the large
number of suicides “may result from the fact that a
group of young people does not have the possibility of
adopting either a traditional or a modern culture.”

Methods of upbringing are also mentioned as a possible
explanation of the record-breaking suicide rate.

“A traditional method of upbringing where one ridicules
the child or ignores it by way of punishment instead of
scolding it may give the child a feeling of not being good
enough. Such a method of upbringing may conceivably
predispose the child to committing suicide,” it says in
the annual report.

On the issue of homicides, the report states that they
often occur after quarrels, and “usually both killer and
victim are under the influence of alcohol.”

When it comes to venereal diseases, such as gonorrhea or
syphilis, there is a considerable decline in the number of
reported cases, but compared with Denmark, the figures
remain high.

The many sexually transmitted diseases in Greenland
earlier caused the surgeon general to give the AIDS
alarm. Jens Misfeldt notes that “marked changes in
sexual conduct are necessary,” but he expresses the hope
that a disastrous spread of the disease may be avoided.

The fear of an AIDS disaster has, among other things, led
to the following examinations for HIV infection:

+ All patients examined for venereal diseases must also
be offered a blood test for HIV antibodies.

WEST EUROPE 39

« In connection with the first medical examination at
which pregnancy is ascertained, all pregnant women
must be offered a blood test for HIV antibodies.

All blood donors in Greenland must be examined for
HIV antibodies with every drawing of blood and,
moreover, at least once a year.

IRELAND

Reportage on Spread of AIDS Continues

Openness Urged, Statistics Given

54500053 Dublin THE IRISH NEWS in English
2 Dec 89 p 5

[Article by Mary Carolan]

[Text] A Larne priest who is dying of AIDS said yes-
terday that people must talk openly about the disease
instead of hiding from it.

Father John White, a 43-year-old Kiltegan Priest, was in
Dublin for World AIDS Day sponsored by the World
Health Organisation. Based in London where he is a
counsellor with the Lighthouse Hospice and works with
the Catholic AIDS League Helpline, he said: “We must
talk about it. There is no easy way around it. People have
asked me about my ‘condition’ or that type of thing and
they think they are being kind. I talk openly about it. It
is only a virus at the end of the day.

“Tt doesn’t matter whether you are man or woman, black
or white, or your sexual orientation. It doesn’t matter
even if you are wearing a Roman collar.”

Fr White, a former pupil of St Comgall’s Secondary
School in Larne who has celebrated Mass in St Mac-
Nissis was speaking after a poll revealed that one in three
people in the Republic believe AIDS can be picked up
through shaking hands or using cutlery touched by AIDS
sufferers.

“In the Republic, I think there is a kind of wait and see
attitude and hope that it might go away. I don’t think
there is any cohesive plan to deal with AIDS,” he said.

“In London I work with so many Irish people with AIDS.
Their families coming over are wonderful people who
are coming back here feeling totally unsupported, so
locked up in fear that they can’t tell even members of
their own family that their son or daughter died of AIDS
in London. That is a terrible statement about where we
are.”

Since monitoring began in the Republic five years ago,
113 known fully blown AIDS cases have come to light
and 54 people have died. The AIDS Action Alliance says
that the South’s doubling of its AIDS figures every 10
months is the highest in the EC.



IJPRS-TEP-90-003
5 MAR 1990

concluded that: “It’s better to shake up a big prejudice
than to hem yourself in with small certainties.”

Mr Habib Boulares emphasized the need to talk about
AIDS without offending citizens’ sensibilities by
knowing how to speak of things in a way that does not
arouse suspicion or gut reactions. In a word, it was a
colorful debate that at times became heated. “So much
the better,” said Mr Boulares, “this debate by itself
makes us appreciate the nature of the public awareness
job we must undertake together.”

In fact, a communications and preventive public awareness
task force has already been jointly established by the Min-
istry of Health and the Ministry of Culture and Information.
But work will not be limited to just these two agencies. The
minister of education, higher education, and scientific

NEAR EAST & SOUTH ASIA 25

research has already begun an awareness program among
teachers and the education community so that these people
may in turn make their students familiar with the issue.

In addition to the public awareness effort that needs to
be undertaken and that has already been designed for
Tunisians living abroad, during the first half of 1990,
Tunisia will sponsor a conference that will bring together
the five countries of the Arab Maghreb Union and four
Mediterranean countries (France, Italy, Spain, and
Greece) and focus on exchanging information and expe-
rience and setting up of a joint strategy to fight AIDS.

The dinner debate that began at 2100 hours concluded
just before midnight. This did not stop journalists and
health specialists from discussing [the issue] in front of
the Oriental Palace until well into the night.



JPRS-TEP-90-003
5 MAR 1990

All of the above mentioned groups are “carriers without
symptoms” (without any apparent signs of the disease
compared to the notion of “healthy carriers”) who are
susceptible to developing the disease in five to seven years.
That is where the danger lies. There is the problem of
prevention. Condoms. Demand exists. The only thing is that
supply is quite smaller, according to some medical circles.
For economic and sociocultural reasons condoms are not
accessible to all. At least that is what politicians and other
professionals have decided. So, instead of holding debates,
they have chosen for the people what they would accept or
not. Nevertheless, the popularization of condoms is effected
through open sales. The state does not have a clear position
on this matter and pharmaceutical lobbies are holding on to
their monopoly in distribution.

This liberalization implies, nevertheless, rigorous con-
trols that would tackle the matter of condom resales as
can be observed in the port of Dakar with the inevitable
dangers of bad storage. Otherwise, this liberalization
would stray from its objective and miss it.

World AIDS Day will be celebrated tomorrow. The
WHO thus wants to expand information and public
education. Several demonstrations are scheduled for
Dakar, marches, exhibits, and a stand providing infor-
mation anonymously. And what if we talked about
condoms? Loudly and for everybody.

A study conducted in Senegal puts the average age of the
population at 32 to 33. Another study by the WHO drops
the average age of Africans to 20 to 30. The population
of Africa being composed essentially of young people we
can readily see the seriousness of the situation and
understand the urgency of the measures to be taken.

It is acknowledged that AIDS spreads more particularly
among those elements of the population that travels.
Nevertheless, this observation should be qualified. Sta-
tistics indicate a large number of ill persons who have
never left the country.

Many persons stricken with the disease who come back
from infected regions disperse themselves throughout
the country and increase the number of cases even to
such regions as Matam and Bakel.

In the face of a disease that travels and spreads on a
continental basis, a need for information and collaboration
among African countries is evident. This obviously raises
the question of individual freedoms. How do you protect
the people without stricking at the dignity of man and his
freedoms?

SOUTH AFRICA

Number of AIDS Carriers Reaches 35,000

54000033A Johannesburg SUNDAY TIMES in English
14 Jan 90 p 3

{Article by Felicity Levine: “Now AIDS Carriers
Number 35,000”)

SUB-SAHARAN AFRICA 9

[Text] Shocking new AIDS statistics were released this
week as a South African businessman and father of two
spoke about his desperate battle against the killer virus.

The number of people with full-blown AIDS in the
country has risen to 332 and it is estimated that 35,000
people carry the virus.

Said Dr Ruben Sher, AIDS expert at the South African
Institute for Medical Research: “The number of people
with AIDS doubles every eight months.”

Victim Mr Johan van Rooy, 36, has opened his Hillbrow
home to hundreds of fellow sufferers since he discovered
he was infected 18 months ago.

“People need to face up to the fact that the country is
crawling with undiagnosed HIV-positives,” said Mr Van
Rooy, who runs the AIDS support group Body Positive.

Support

Body Positive has a growing membership of 600 and
among its ranks are top professional people and pillars of
society.

These AIDS victims, from all walks of life, give one
another financial and emotional support.

“As well as lending a hand with rents and medication we
help one another face up to the fact that for us there is no
tomorrow,” said Mr Van Rooy.

“Forty-eight of our members have died in the past nine
months and 14 in August and September alone.”

Mr Van Rooy said his two young daughters were dis-
criminated against by teachers at their Durban school
when it was revealed that he had AIDS.

He said he had successfully managed a large furniture
shop until October when increasing sickness stayaways
cost him his job.

Panic

His own descent into hell started 18 months ago with a
chance decision to have his blood tested for HIV infec-
tion.

“I was having a routine medical check-up and being
homosexual, considered a ‘high risk’ group, I asked to be
tested for HIV at the same time.”

And in October 1988 Mr Van Rooy learnt that he was a
“healthy” HIV carrier—the start of a trip ending in
death.

“I went into a total panic,” he said. “I felt sick and
disgusted, robbed of my future. But once I'd got over the
initial terror I was relieved that the virus had been
diagnosed so early, because they started giving me sub-
stances to boost my immune system,” he said.

Paying for medication is a major problem for victims.



122 SUB-SAHARAN AFRICA

Else Melgaard says that loose sexual mores are also a
centuries-old tradition.

“Previously it was quite common for a man to go toa bar
with an entire harem of women, with whom he would
disappear into a back room one by one. There was
prestige in this. Many also sell sex, because they have no
money. Girls receive gifts and reciprocate with sex.”

“When we tell them that multiple sex partners can
spread the disease, they respond with statements such as:
“You can’t eat chicken every day,” according to Else
Melgaard.

The inhabitants know the disease well. They have dubbed it
the “slim disease,” because afflicted persons get diarrhea
and become very thin. Another word is “Juliana disease”
which means “nice clothes” in Swahili.

The relatively healthy portion of the country engages in
lively trade across the border with Uganda. It has been
found that the young traders who wear nice clothes and
travel across the border have brought the disease with
them.

However, even though everyone knows of the origins of
the incurable disease, Red Cross workers have detected a
fatalistic attitude towards it. This is due in part to the
fact that the Kagerans have known plague and cholera
over thé years.

“They all know what AIDS is, but they are extremely
misinformed. They associate it with superstition—it is
God’s punishment. There is also a widespread belief that
the Americans have spread the disease by sending con-
doms infected with the virus. Condoms have been
known as a family planning tool for many years, but they
have never really been accepted. The traditional village
healers have said that it is not good to use condoms. Sex
must be performed skin against skin, and not rubber
against rubber,” says Else Melgaard.

The understanding that the disease is incurable has also
meant that many do not dare to take an HIV test. In the
villages there are AIDS victims waiting alone for death
to come. They are isolated because the village inhabit-
ants don’t dare have anything to do with them. The
hospitals seldom see them. The number of sick people
seeking hospital care is falling.

The highly-religious population also listens to the advice of
the church. The church asks people to submit to an AIDS
test before they marry. If the test result is positive, the
church asks the young people to postpone the wedding.

This has led to corruption with regard to medical certifi-
cates. It is possible to bribe doctors to provide falsified
results. This corruption is increased by the fact that no
public officials in Tanzania can survive on their salaries,
and they are compelled to seek a second source of income.

The Red Cross project is involved first and foremost
with information. Red Cross workers go into the schools
and talk to students in the fifth through seventh grades.

IJPRS-TEP-90-003
5 MAR 1990

However, this is a hard job, and not only because sex is
a taboo subject. The Tanzanian authorities also prohibit
discussion of sex in the schools. Only AIDS prevention
may be discussed, without touching on the forbidden
subject. Only married women may receive eduction with
respect to sex, and by then it is usually too late.

The Disease Cannot Be Solved in Isolation

Else Melgaard emphasizes that the AIDS catastrophe cannot
be solved in isolation. The effort must be coordinated with
other areas: “People who receive proper nutrition can live
longer. Positive outlook and psychological treatment of the
disease is also significant. The disease develops more
quickly here than in the western world, perhaps because of
the lack of nutritious food. Some have claimed that it takes
only six months from the time one becomes infected until
one dies. It certainly happens more rapidly from the time
the first symptoms become apparent,” says Else Melgaard.
The Tanzanian authorities have recently established an
AIDS department in the Ministry of Health. Nevertheless,
the disease is not viewed as the gravest danger in the
country, where 70,000 die of malaria annually,

It is, therefore, the job of the Red Cross to make it clear
that the disease is being spread from generation to
generation through pregnant women, who pass it to their
children.

An entire generation in Kagera is lost. A new onc must be
saved,

ZAIRE

Mobutu’s Son in Belgian Clinic; AIDS Speculated

54000031 London AFRICA CONFIDENTIAL in
English 15 Dec 89 p 8

[Text] Mobutu Nyiwa, the son of Zaire’s president and
state secretary for international cooperation, has becn
admitted to a private clinic in Belgium after being
transferred from a hospital in Kinshasa.

Nyiwa has made no appearances since early this year at
official ceremonies or on Zairean television. His minis-
terial work has been taken over by Nkema Liloo, one of
President Mobutu Sese Seko’s security advisers, or by
Foreign Minister Nguza Karl-i-Bond. A former informa-
tion minister, Madame Ekila Lionda, is tipped to replace
Nyiwa in due course.

Radio trottoir in Kinshasa has been dwelling on the fact
that Nyiwa’s girlfriend died from AIDS last May. Her
family received an ex-gratia payment from President
Mobutu through the mediation of Nsinga Udjuu Ong-
wakebi, the president of the judicial council, a close
friend of the family of the deceased.

Since March 1989, Nyiwa has been a regular patient at
the special clinic run by Professor Luruma at the Mama
Yemo hospital in Kinshasa.