SJPRS-TEP-92-013
July 30 1992

same as 1,000, because this disease does not discrim-
inate among classes. The worst part of it is that AIDS
has been given the dual connotation of death and sin.
In other words, it kills both body and soul. Hence, in
their collective subconscious, everyone is so worried
that they have decided to ignore the problem.

Colombia has “‘condomized” the AIDS problem. Now, it
will be more important to teach people to practice respon-
sible sex.

To achieve this there is no need to use negative messages,
such as advising people not to engage in sex, but rather, to
practice it responsibly, engaging in hygienic sex.

This is because burning the patient’s house was no cure for
tuberculosis during the last century; nor was a ban on eating
fish the cure for cholera.

CUBA

Current AIDS Situation Discussed at Seminar

FL1106211192 Havana Radio Reloj Network
in Spanish 1932 GMT 11 Jun 92

[Text] The forms of contagion as well as the medical,
psychiatric, and social treatment offered to AIDS patients in
Cuba were set forth today at the Latin American seminar on
infectious diseases that is underway in Havana. Being
discussed simultaneously at the seminar’s headquarters,
William Soler Pediatric Hospital, are topics related to
infectious diseases and living standards; and advances in
and prospects for learning more about and treating septic
syndrome and AIDS in Latin America. It was reported at
the seminar that as of 31 May, 785 cases of HIV-positive
people—out of 12 million tests—had been reported in
Cuba. This give us a percentage of 0.006 percent AIDS
patients in Cuba. Most of these cases are in heterosexuals,
and the average age ranges from 15 to 34 years of age.

Panel Discusses AIDS Statistics
FL1507212492 Havana Cuba Vision Network
in Spanish 0105 GMT 15 Jul 92

[Editorial Report] Havana Cuba Vision Network on 15 July
carries the “Open Agenda” program on the subject of AIDS.
Program host Lucia Gonzalez begins by introducing her
guests, Vice Minister of Public Health Dr. Hector Terry and
Dr. Gisela Sanabria, the director of the National Health
Education Center.

Gonzalez asks Terry what the current situation in Cuba is,
how many HIV-positive patients there are, and how many
deaths Cuba has had to date. Terry says that last year ended
with a total of 711 seropositive cases. In the current year,
101 new cases have been detected. Terry adds that there are
currently 55 patients in varying stages of illness. Of the 81
people who have died, 72 died of causes related to the virus
and nine of unrelated causes. The deaths include two young
girls. These are the figures obtained in the six years of the
program and after more than 12,600,000 tests.

Gonzalez asks which province has the highest number of
cases. Terry answers that four provinces have more than the

LATIN AMERICA 15

average number of cases. Pinar del Rio has the highest
incidence in the country with 0.031 percent of the popula-
tion, followed by Havana, Villa Clara, and Sancti Spiritus.
The rest of the provinces in the country have lower inci-
dence rates.

Gonzalez asks which age and sex group has the highest
number of cases reported. Terry says that out of the 812
seropositive cases, 28.6 percent (233 cases) are female and
71.4 percent (579 cases) are male. Terry continues by saying
that sexual conduct has a great influence, since there is a
higher rate among homosexual and bisexual men. This
group represents 58 percent of the cases among males. The
remaining 42 percent pertain to the group that practices
heterosexual relations. The age group most affected is con-
sistent with what is found in other countries: those between
15 and 19 years old. Terry adds that in that age group, the
male/female ratio is one to one, although in older age
groups, the male/female ratio is three or four to one.

Gonzalez asks Sanabria if sexual intercourse is still the main
way of catching the virus and if the frequent change of
sexual partners is the most common risk factor. Sanabria
says: “Right now, from the number of cases that have been
diagnosed since 1986 to date, sexual intercourse is the most
frequent practice through which the HIV illness was
acquired.” Sanabria continues by saying that research has
shown that the population knows what AIDS is and the
means of transmission, and even though they know that
sexual intercourse is one of the main means of transmission
in most cases, there is still a high rate of risky sexual
practices. Sanabria says, “Undoubtably, people do not
believe that they are in danger. They know that the frequent
exchange of partners could cause them to acquire the illness.
They know that they must protect themselves, but there is a
big gap between knowing and doing.”

After showing interviews with several patients, whom
Gonzalez says are not typical of Cuban patients, since they
say they were promiscuous, Sanabria discusses the patterns
of transmission of the HIV virus among homosexuals and
heterosexuals. She notes that the same patterns hold for
other sexually transmitted diseases.

Gonzalez asks how Cuba compares to other countries and
what Cuba will be presenting at the international conference
on AIDS which will be held on 19 July in Amsterdam. Terry
answers: “Cuba still has a very low rate of seropositivity.
The rate is only 0.006 percent.” He adds that this is part of
what Cuba will be presenting at the conference.

Terry says that this congress should supply much informa-
tion on scientific research that is being conducted to develop
new therapeutic methods, drugs, and 20 new vaccines. Terry
says that Cuba will also present its experience in clinical
work and concerning the life expectancy of patients at the
sanitarium and other centers. Terry adds that the incubation
period in Cuba is now about 12 years, while the incubation
period for patients who have led very promiscuous lives and
also those who are bisexual or homosexual is only 7.5 years.

Terry comments on the projected number of AIDS cases in
the world by the end of the decade. He says that today the
number of cases now exceeds 500,000 worldwide. All the



32 WEST EUROPE

No Membership List

The RFHP estimates its membership at 1,500. Sweden has
about 2,300 HIV-infected individuals or AIDS patients who
are still alive, according to government statistics.

“But to protect people, we do not maintain the usual kind of
membership list. Many do not dare receive our information
materials at home. Instead, they get them through their
physician or organizations such as Noah’s Ark,” says Persson.

Back in 1988, the parties in the labor market and the AIDS
Commission adopted a program against job discrimination.

It stipulates that an HIV infection is not legitimate grounds
for firing or transferring an employee. Despite that, HIV-
infected individuals are being forced to quit their jobs.

No Energy To Fight

In most cases, employers have claimed that it is impossible
to work with the person, says Torbjorn Karlsson (not his real
name).

“Most people lack the energy to fight, so they quit rather
than stand up for their rights,” he says.

“People are paid off with the union’s consent. Who is going
to fight for a dying queer?”

Good psychological care is still the most important medi-
cine. So far there are no remedies that will free a person of
HIV or AIDS.

“But people are living longer thanks to medicines that slow
the development of the disease. People live an average of
from 10 to 15 years after being diagnosed as HIV-positive.
This means that HIV and AIDS must be viewed in the same
way as other chronic and fatal diseases such as cancer,” says
Per Olof Persson.

Rejected by State

The RFHP is seeking recognition as an organization for the
disabled, a status that would entitle it to state subsidies. But
so far the state’s Council for the Disabled has said no.

The nearly 400,000 kronor per year that it receives from the
AIDS Commission must suffice for salaries, premises, and
everything else.

If HIV is to be made less frightening, infection must be
removed from the Law on Contagious Diseases, says the
RFHP. Compulsory measures with regard to testing, tracing
the infection to others, and isolation do not belong in a
society governed by law and do not encourage preventive
work, says the RFHP.

“But we can never accept the idea of people knowingly
spreading the HIV infection. Anyone who does that has to
be seriously disturbed mentally,” says Torbjorn Karlsson.

‘Stride Backward’
The government recently decided that the AIDS Commis-

sion should be eliminated and its work taken over by the
new authority, the National Health Institute.

JPRS-TEP-92-013
July 30 1992

“This represents a real stride backward and can be taken as
a signal that work to prevent HIV is no longer so impor-
tant,” says Per Olof Persson.

“It may also be preparing the way for turning HIV and
AIDS back into matters affecting only homosexuals, drug
addicts, and prostitutes.”

UNITED KINGDOM

Statistics on AIDS, Other Illnesses Given
92WE0512A London THE DAILY TELEGRAPH
in English 27 May 92 p 6

[Article by David Fletcher, Health Services Correspondent:
“Heterosexual AIDS Total Is Up by a Third”]

[Text] The number of AIDS cases resulting from heterosexual
intercourse has increased by one third over the past two years,
although the total is still relatively low, the Public Health
Laboratory Service disclosed yesterday.

It said one in six people who developed the disease last
month blamed sexual contact with a member of the opposite
Sex. :

In a monthly report on the progress of the disease, the
service said 112 people developed AIDS in April and 14
people died. Since 1982, when the disease was first reported
in Britain, 5,894 have contracted it, of whom 3,686 (63
percent) have died.

AIDS, however, remains a predominantly homosexual dis-
ease, with 81 of the 112 new cases resulting from sexual
contact between men.

The report said 19 of the 112 cases occurred as a result of
heterosexual intercourse. A further six arose through
injecting drugs and two were the result of treatment with
contaminated blood products.

It said the number of cases among women had risen by 28
percent over the past two years—from 101 to 120—with the
total of AIDS cases resulting from heterosexual intercourse
rising from 139 to 186, or 34 percent.

—Peter Pallot, Health Services Staff, writes: Doctors said
yesterday that people who suffer rectal bleeding are
putting their lives at risk if they do not seek help.

Dr. Stephen Kane, consultant gastroenterologist at the West
Middlesex Hospital in London, said: “Admitting rectal
bleeding means admitting the possibility of rectal cancer.”

But he urged people to overcome their embarrassment
because speed of treatment could radically alter the course
of a disease that killed 17,000 people a year.

He was speaking at a news conference in London to increase
awareness of ulcerative colitis and Crohn’s disease, which
affect more than 80,000 people in Britain. The diseases
often occur between the ages of 16 and 35.

Mr. Roger Leicester, consultant colorectal surgeon at St
George’s Hospital in London, said the survival rate for those
whose cancer was diagnosed early was 90 percent, but only
30 percent where the tumour had spread outside the colon.



SIPRS-TEP-92-013
Tuly 30 1992

The report further says that the 456 male patients have
contracted the disease through sexual relationship in most
cases—to be exact 373 persons, 36 from intravenous drug
use, four from blood transfusion, 17 from medical [as heard]
transmission, and six unidentified causes. Of the 56 female
patients, 38 got the disease through sexual relationship, two
from intravenous drug use, one from blood transfusion, and
15 from medical transmission. Latest report says that 288
AIDS patients are alive.

Official Says 70 Percent of AIDS Victims in
Rural Areas

BK2007014792 Bangkok BANGKOK POST in English
20 Jul 92 p 1

{Text] More than 70 percent of AIDS sufferers live in rural
areas, Deputy Permanent Secretary for Health Dr. Thira
Ramasut said yesterday.

According to the latest information he has received, of 642
AIDS patients, 116 or 18.07 percent live in municipal areas.
Thirty cases or 4.67 percent live in sukhaphiban [suburban]
areas and the remaining 73.36 percent live in rural villages.

He said that of the 910 AIDS-related cases (ARC), 290 are in
municipal areas, 100 in sukhaphiban areas and 448 cases or
49.23 percent in villages.

The trend shows that AIDS has already invaded rural
Thailand, Dr Thira said.

Labourers account for the most AIDS and ARC cases at 41
percent. This is followed by farmers at 15 percent of all
cases.

Of the 910 ARC cases, 28 are housewives, he said, adding
the trend is likely to rise “if there are no proper and effective
controls in all areas.”

EAST ASIA 9

Dr. Thira, however, expressed confidence that the pro-
gramme being implemented by the Public Health Ministry,
which places emphasis on AIDS control and prevention, will
help cope with AIDS.

VIETNAM

Total of 58 Affected With AIDS

BK2904072392 Hanoi VNA in English 0628 GMT
29 Apr 92

[Excerpt] Hanoi VNA April 29—{Passage omitted] The
English-language newspaper VIETNAM NEWS reports that
another Vietnamese, a 20-year-old woman in Ho Chi Minh
City, has tested positive for the AIDS virus, adding that she
is the second Vietnamese and the 58th person in Vietnam
known to be affected with the AIDS virus.

Medical Institute—No HIV Positive Cases Found
in Hanoi

BK1007065992 Hanoi VNA in English 0518 GMT

10 Jul 92

[Text] Hanoi VNA July 10—No one has proved to be HIV
seropositive since April 1990 when the Hanoi medical
service began blood tests on high-risk groups in the city.

In the first half of this year alone, the Municipal Institute for
Epidemics and Hygiene gave blood tests on 3,369 persons,
of them 53 prostitutes, 418 venereal disease patients, and
567 blood donors.

So far 58 persons in Vietnam have been proved to be HIV
seropositive. Of these 58 cases, only, are Vietnamese, and
the rest of 56 are foreigners. [As received]



JPRS-TEP-92-013
Saly 30 1992

period, this means that the majority became infected between
the ages of 15 and 34, very early in their sexual lives.”

The Conasida director, an infectious diseases specialist and
researcher, believes this is not surprising. Adolescence is a
time when people experiment sexually, have multiple sexual
partners, and engage in sexual activity with unknown people
and with people of the same sex, which necessarily implies
homosexuality. What is clear is that “the most important
educational effort we have to make is not with people
already between the ages of 25 and 44, but rather with
people between the ages of 15 and 30, for that is the time
when most people are going to become infected.”

Conasida has prepared a pamphlet titled “Growing Up in the
Time of AIDS,” intended specially for children—some of
whom become infected at the age of 10 or 12—and adoles-
cents. This pamphlet explains what HIV is, what AIDS is, how
it attacks the organism, how a person becomes infected and
does not become infected, what to do to prevent infection,
how to treat a person with AIDS, and general concepts of
human sexuality. It is written in simple language and uses
illustrations to promote better comprehension.

According to Dr. Del Rio, one major advantage Mexico has
is that the largest segment of its population is young,
“people who have not yet had sexual relations and who can
be educated.” To do so, he says, we need “an abrupt
educational change,” which will have to overome strong
resistance on the part of groups that think talking about
human sexuality and AIDS promotes promiscuity.

“That is ridiculous,” protests the Conasida director. “It is like
saying that recommending the use of seat belts in cars pro-
motes speeding.” The important thing—something that is
imperative, from his point of view—is to educate children and
adolescents in the concept of “safe sex” because “everything
indicates that AIDS has come to stay, that at least our children
will have to wrestle with it. A vaccine or a cure is still very far
away, so we had better learn to live with this disease.”

Given the enormity of the job facing Conasida, is its budget
sufficient?

“In general,” answers Del Rio, “no budget is sufficient. Nor
is this one, but it is adequate for a number of things. We
would certainly like to have more money, though.”

In reality, Conasida is not working alone. Educational
aspects are coordinated with the Secretariat of Public Edu-
cation, the UNAM [National Autonomous University of
Mexico], and other educational institutions. Medical and
treatment matters are coordinated with a number of orga-
nizations in the health sector, both public and private, as are
community and social work. Most of Conasida’s budget-—
aside from personnel costs—is spent for laboratory analyses,
information and educational programs, and publications.

Conasida has opened three information centers that have
served primarily to develop models for detecting problems
and meeting the demands that AIDS has generated among
the population. They also provide personalized counseling
and conduct free and confidential HIV testing.

LATIN AMERICA 19

Dr. Del Rio immediately makes it clear that this does not
mean that Conasida operates like a public laboratory. A
number of requirements must be met, and if a person is
unwilling to comply with those requirements and only wants
to be tested for HIV, that person is provided with a list of
very good private laboratories.

The principal reason, he explains, is that this is not a trivial
test that can be given indiscriminately. A positive result will
certainly alter a person’s entire life and will have profound
psychological and social implications. And there is also the
economic factor. On an individual level, the cost of the test
may seem low (30,000 pesos), but if these tests were con-
ducted on a massive scale, costs would soar. “And that
would eat up our entire budget.”

Similar arguments have been used against requiring man-
datory HIV testing before marriage. In addition, it is not
considered much use as a method of prevention because
“today the majority of couples who decide to marry have
already had sexual relations.”

And above all, there is one other problem: the test was
designed to detect the HIV virus in the blood, not for
diagnostic purposes, so it can produce what are medically
called “false positives,” which may even appear in persons
who have never had sexual relations or received a blood
transfusion.

“Just imagine how many people’s lives could be destroyed
with these false positives,” explains Dr. Del Rio.

There is a way to confirm these results, but it is very
expensive. In a special laboratory the entire process, from
initial testing through final confirmation, can cost up to
800,000 pesos.

Dr. Patricia Uribe, director of Consida’s Community Ser-
vices, discusses the three major areas where prevention efforts
have been made: blood, sexual, and perinatal transmission.

The first area was the one in which action was taken most
quickly and easily, for it simply meant changing the General
Health Law, maintaining good control of all blood banks,
and requiring compulsory HIV testing for all transfusions
(1986). Then in 1987, the buying or selling of blood was
prohibited because “paid donors were found to have a
higher incidence of HIV infection” (PROCESO, No 533).

According to INDRE, these measures meant that between
1986 and 1991 at least 605 cases of AIDS may have been
prevented. Dr. Uribe explains that if we assume an average
incubation period of 5 years for people infected by blood
transfusions, we could expect to begin to notice the effect of
these government provisions just last year. The results are
considered satisfactory and mean that very soon “there will
be no or very few people infected in this way.”

Based on Conasida’s information, most hospitals maintain
strict controls. In addition, a campaign is being conducted
urging patients and their families not to accept any transfu-
sion not labeled “safe blood.”

In the area of HIV prevention by sexual contact, the job has
been notably complicated because “sexual habits cannot be
changed by decree.” As an example, Dr. Uribe says “it is



JPRS-TEP-92-013
30 July 1992 4 AIDS

IRELAND

AIDS Deaths Reported To Rise by 20 Percent
[Tom Reddy; Dublin IRISH INDEPENDENT, 22 Apr 92] .....

SPAIN

Total of 14,500 Cases of AIDS, 6,000 Deaths {Madrid RNE-I Radio Network, 17 Jul 92] ..... . 30
SWEDEN
HIV Statistics Reported, Trends Examined
[Kerstin Hellbom; Stockholm DAGENS NYHETER, 29 May 92] . 30
HIV Infected Complain of Job Discrimination
[Vivianne Sprengel; Stockholm DAGENS NYHETER, 22 Jun 92] ..... 31

UNITED KINGDOM

Statistics on AIDS, Other Illnesses Given
[David Fletcher; London THE DAILY TELEGRAPH, 27 May 92]



30 WEST EUROPE

The 60 percent increase in heterosexuals with AIDS repre-
sents nine more people contracting the syndrome in the past
twelve months, 22 homosexuals and 33 intravenous drug
users.

SPAIN

Total of 14,500 Cases of AIDS, 6,000 Deaths

LD1907101292 Madrid RNE-1 Radio Network
in Spanish 1800 GMT 17 Jul 92

[Excerpt] AIDS is progressing in our country and the
number of cases indicates that it is doing so faster than in
the rest of the countries of Europe. These are the latest
statistics on the syndrome, which also include other ques-
tions and other important details, which Victoria Barragan
now reports.

Barragan: According to the report from the Carlos III
Institute, AIDS is still progressing in a worrying way in our
country, despite the fact that the rate of growth is less. At
present over 14,500 people are suffering from this illness,
5,000 more than last year, and it is worth highlighting that
6,000 AIDS patients have died so far, which represents 40
percent of the total. These figures reflect that Spain experi-
enced the largest proportional increase in cases of AIDS in
Europe. [passage omitted]

As for the groups contracting the illness, it should be noted
that the cases of AIDS among drug addicts have stabilized,
although they still represent the most affected group, with
65 percent. In addition the cases of AIDS in children have
fallen, as have those in homosexuals, who have fallen from
18 to 15 percent, while the transmission of AIDS among
heterosexuals shows a small but constant growth.

SWEDEN

HIV Statistics Reported, Trends Examined
92WE0487A Stockholm DAGENS NYHETER
in Swedish 29 May 92 p7

[Article by Kerstin Hellbom: “Young Girls More Easily
Infected With HIV]

[Text] Slightly more than 10 years ago the first cases of HIV
infection were reported in Sweden. Many warned that AIDS
could develop into a disease of the Swedish population—an
epidemic which would spread outside the so-called risk groups
into the general population.

Those fears provided the basis for the campaigns which have
been run since the mid-1980's. Those fears were not realized.
At the same time questions have begun to be asked about
anti-AIDS campaigns. This then is the situation in Sweden,
with the knowledge we currently have.

The risk of getting infected through normal heterosexual
intercourse with an HIV-positive person is about one out of
1,000 occurrences of intercourse. Who gets infected does
not depend strictly on luck. So, for example, it is thought
that young teenage girls are more susceptible to the virus,
inasmuch as they have thinner mucous membranes in their
vaginas than mature women.

SJPRS-TEP-92-013
July 30 1992

There are cases of young women who have gotten infected
when they had their first intercourse with an HIV-positive
man. This is thought to be because of the fact that those cells
located at the entrance to the vagina are thin and fragile.
Sexually transmitted infections attack precisely these cells
which bleed easily, and HIV has an opportunity to attack
them as well.

HIV is still a virus comparatively difficult to contract, at
least through regular heterosexual intercourse in Sweden,
where the hygienic standard is high and where people have
healthy, complete, and uninfected mucous membranes
which act as a barrier against the virus.

Susceptibility to infection among persons who are HIV-
positive varies greatly throughout the course of the disease.
It is higher during the first weeks following the occurrence of
infection and then drops for several years, only to increase
again when the symptoms begin to turn up.

Protective Membrane

According to studies in Germany, approximately one out of
10 live-in partners of heterosexual HIV-positives are
infected in a three-to-four-year period. That this is true in
‘Sweden as well was confirmed by Margareta Bottinger, an
epidemiologist at the National Bacteriological Laboratory,
SBL, even if she said that the risk is naturally dependent on
both the number of intercourses and their type.

The risk grows dramatically if the intercourse is through the
rectum, i.e. anal sex. There are not the same protective
membranes in the rectum as there are in the vagina, blood
vessels break, and the way is open for the virus to reach the
blood circulation.

In purely medical terms, it is appropriate to draw up a risk
list of how the virus can most easily get into the human
body. The list is headed by transfusions with infected blood.
Next comes infection from mother to child in the vagina,
infected needles, and then intercourse with an HIV-positive
person according to the following list of risks: anal sex,
regular heterosexual sex, and finally intercourse in the
mouth, so-called oral sex. Deep kissing as well has been
mentioned as a possible but still much discussed method of
infection. In Italy a study is now underway to see whether
deep kissing with an HIV-positive person could be a risk
factor.

After many years of debate, it has now been established that
breast feeding is a risk factor, to such an extent that
HIV-positive mothers in industrialized countries are urged
Not to breast feed. In the rest of the world breast feeding is
thought to be valuable, despite all the considered risks of the
spread of HIV.

“We do not yet know exactly how great the risk is of
transmitting HIV through breast feeding, but presumably it
isa significant one. The risk is clearly greater than with deep
kissing and oral sex,” said Prof. Hans Wigzell, the head of
the SBL.

Of the between 10 and 12 million HIV-positives in the
world today, it is estimated that close to 80 percent were
infected through heterosexual sex in its various forms. That


16 LATIN AMERICA

world health organizations are concerned that the rate
among the infant population has increased. Gonzalez asks if
there has been an increase in the number of cases among
women, and Terry answers that this seems to be true. He
adds that Cuba has developed a new method to diagnose
HIV-1 and HIV-2, which will be presented at the AIDS
conference.

Gonzalez then reads a question phoned in by a listener
asking what steps a person should take to determine whether
or not he has the virus. Terry explains that the country has
municipal centers of hygiene and epidemiology, and there
are information offices in every province.

The 28-minute program ends with the music composed by
Freddy Mercury, who died of AIDS, for the Barcelona
Olympic Games.

GUYANA
Program Director Confirms 258 Cases of AIDS to
ite

FL0206111392 Bridgetown CANA in English
2302 GMT I Jun 92

[Text] Georgetown, Guyana, June 1, CANA—Guyana has
over 5,000 people infected with the Human Immunodefi-
ciency Virus (HIV) which causes AIDS and 258 confirmed
cases of the deadly Acquired Immune Deficiency Syn-
drome, Dr. Edgar London, head of Guyana’s National AIDS
Programme, said here Monday.

“Five thousand is still conservative,” he said. “It might be
more than that.” Of that number of AIDS victims, 123 have
died so far. The 258 cases have been recorded from 1987 to
March, 1992.

London told CANA that Guyana has recorded 28 confirmed
AIDS cases in the first three months of this year. “We are
not doing very well at all,” he said. Guyana is ranked fourth
in the Caribbean after Bermuda, Barbados, and Trinidad.

Of the total cases 189 were males. There were 135 hetero-
‘sexuals cases of the disease spread mainly by sexual contact,
London said. Ten cases were recorded in 1987, 34 in 1988,
40 in 1989, 61 the following year, and 85 last year.

London said the trend in the risk [words indistinct] changed
from homosexuals to bi-sexuals to heterosexuals. “This
situation tells us that more females will be affected and
therefore more children will be affected,” he said. About
half of the children born to infected mothers will also pick
up the virus, he explained.

Most HIV/AIDS victims are people between the “produc-
tive” ages of 20-39. Lectures and other programmes on the
deadly disease are to be taken into school classrooms to
sensitise students on the danger and ways of preventing its
spread.

“The Ministry of Health is adopting all the ways and means
of getting this message across to the young people as well as
the elderly people,” London said. The material for various
age groups is being prepared and should be Teady for
distribution by monthend, he said.

JPRS-TEP-92-013
July 30 1992

HONDURAS

AIDS Cases Total 2,888 Nationwide

92WE0536B San Pedro Sula TIEMPO in Spanish
6 Jun 92 p4

{Text] Tegucigalpa—According to the May report of the
health authorities, the number of patients infected with the
HIV virus rose to 2,888.

The head of the ministry’s Epidemiology Division, Dr.
Enrique Zelaya, said that 2,888 cases of HIV-infected per-
sons has been recorded. Of these, 1,913 had developed
AIDS. Just last month there were 94 cases, including three
children under 5 years old, who were infected by their
mothers.

It is in the northern part of the country, specifically San
Pedro Sula, where the largest number of cases, 40 percent,
has been recorded, most at national level. Contagion is by
sexual relations.

With an increase of 75 to 78 children infected, the rate goes
up to 3 percent, which places this group in the at-risk
category, preceded by heterosexuals, persons receiving
blood transfusions, and homosexuals, according to Dr.
Zelaya.

The physician, who is coordinator of the AIDS campaign,
said that 97 percent of the population knows what the
disease is, but do not change their habits. This has led the
health authorities to revise preventive campaigns to make
them more effective.

In addition to marital fidelity, they are advocating the use of
condoms and trying to make them more easily accessible, in
view of the fact that youth, especially girls, have begun to
have sexual relations at an earlier age.

He indicated that in departments such as Olancho, where
the number of cases have been low, there were 22 cases last
month. In Gracias a Dios, where no cases have been
reported, there are now three people infected with the HIV
virus. The number of cases have also been on the rise in
Lempira and Islas de la Bahia.

MEXICO
Varying Estimates of HIV Infection Noted

Health Secretariat Epidemiologists Cited
92WE0475A Mexico City LA JORNADA in Spanish
17 Apr 92 p 13

[Report by Luis Alberto Rodriguez]

[Text] During the 11 years since the first case was reported,
9,247 people have developed AIDS. Of that total, about 48
percent of those infected have already died.

Estimates by SSa [Health Secretariat] epidemiologists indi-
cate that more than 100,000 people in Mexico may poten-
tially have already acquired the HIV virus, the causative
agent of AIDS, but the majority are still asymptomatic.



2 NEAR EAST & SOUTH ASIA

As per WHO instructions, no one will lose a job because he
is HIV positive but they may be moved to less active
assignments particularly in the defence forces. °

Officials in the AIDS monitoring cell are disturbed by the
irresponsible estimates and projections on AIDS being
made by doctors and others. A professor from the PGI,
Chandigarh, recently announced that there were 22 cases of
AIDS in Punjab. On cross checking with the director of
health services it was found there were just eight cases.
Some of them have been making these statements in the
hope of getting an AIDS surveillance centre which means
Rs. one lakh a year just for screening. There are 62 AIDS
surveillance centres in the country and each of them screens
anything from 500 to 1,700 cases a month.

The government is still working out the compensation to be
given to doctors, nurses and others who may contract the
infection while on duty. The amount to be paid in case of
death from AIDS will also be announced shortly. The
chances of transmission to doctors and nursing staff is
negligible. Just five cases have been reported in the world so
far.

Effect on Country’s Development
92WE0530B Madras INDIAN EXPRESS in English
15 May 92 p3 °

[Text] Madras: AIDS, the dreaded killer disease, is expected
to have a ripple effect on trade and economic development
in the country, with its impact on the transport sector likely
to be significantly disastrous over the next five years.

Dr. S. Sundararaman of the AIDS Research Foundation of
India disclosed on Tuesday that a recent ‘anonymous
unlinked’ study conducted -in Madras revealed that more
than 1.25 percent of about 15,000 truck drivers who enter
the City daily, tested HIV positive (in screening tests for the
Human Immuno-Deficiency Virus which causes AIDS).
And this figure was expected to rise to 30-35 percent in the
next five years.

The importance of this finding could not be overlooked,
since it would be extremely difficult to replace such a large
body of skilled personnel in a short time and their shortage
was likely to disrupt the flow of agrarian products from the
tural hinterland in a big way.

The primary reason’ why this group of persons had such a
high percentage of infection was that as part of their
lifestyle, they indulged in sex at least twice’ for every 400
kilometres travelled, Dr. Sundararaman added.

Dramatic upsurge in AIDS cases in Madras: Quoting from a
point prevalence centennial surveillance study currently
under way at the Government General Hospital, Madras, he
said that over the last six years a five-fold increase in the
incidence of HIV had been detected. From approximately
one in every five thousand in 1986 (in ’86 less than 50
persons had been identified as HIV positive throughout
Tamil Nadu) the incidence now being reported was in the
range of one in every thousand.

In fact over the past one year, on an average one or two
full-blown AIDS patients a month were turning up at

SJPRS-TEP-92-013
July 30 1992

hospitals for admission. This was very significant in that for
every patient reporting his or her condition there were at
least a thousand cases going unreported.

At the national level the increase in incidence of pulmonary
tuberculosis and pneumonia needed to be taken note of as
this reflected the higher incidence of HIV. In the United
States, where TB had been eradicated, the onset of AIDS
had manifested in a 0.5-5.0 percent increase in cases of TB.

All these figures needed to be viewed with due seriousness
and a disaster management mode as opposed to just a
disease prevention strategy should be adopted. The existing
awareness in society seemed to suffer from a faulty percep-
tion that this problem was confined to high-risk groups like
prostitutes and those suffering from sexually transmitted
diseases, resulting in their marginalisation.

And the human dimensions of this problem could only be
tackled with the help of voluntary non-governmental organ-
isation. Issues like employability of persons testing HIV
positive, social attitudes to discussing hitherto taboo sub-
jects like sexual mores and the male’s attitude to the
condom needed to be focussed on. The condom which had
originally been conceived to prevent birth had now assumed
the role of the single most important preventive of death in
this context, he said.

The government too had awakened to the magnitude of this
problem and recent visits by top health administrators to
East-Africa had served to enlighten them. Zambia, for
example, now had condom manufacture as its single largest
industry.

Dr. Sundaraman was speaking under the aegis of the Rotary
Club of Madras in the City.

Minister Briefs Parliament on Anti-AIDS
Mesaures

BK1507081492 Delhi All India Radio Network
in English 0730 GMT 15 Jul 92

[Text] The health and family welfare minister, Mr. M.L.
Fotedar, has said that the government blood banks have
been modernized to check the spread of AIDS. He told the
Rajya Sabha during question-hour today that out of 608
blood banks, 138 have been fully equipped for observing the
prescribed procedure. He said the Center is seized of the
situation and fully recognizes the dangerous potential of
AIDS. The minister said several surveillance centers have
been established in the country for regular screening of
blood samples, particularly from high-risk individuals. Mr.
Fotedar said a national AIDS control project estimated to
cost 255 crore rupees is to be implemented during 1992-93
with the assistance of the World Bank.

Minister Denies WHO’s Claim of ‘AIDS
Holocaust’

BK2207023692 Delhi THE HINDUSTAN TIMES
in English 16 Jul 92 p9

[Text] New Delhi, July 15—The World Health Organisa-
tion’s claim that there could be an “AIDS holocaust” in



18 LATIN AMERICA

According to epidemiological predictions provided by Dr.
Valdespino and other doctors in a study presented in
mid-1988, by 1991 a cumulative total of 64,000 to 76,000
cases could be expected. And by 1992, there should be
between 36,000 and 46,000 new cases. This means that in
1992 the cumulative total would be approximately 100,000
AIDS cases.

That figure, quite alarming in itself, pales in comparison
when we realize that for each AIDS case it has been
calculated that there are between 30 and 50 HIV-positive
cases. This means that by now, 3 to 5 million people should
already have been infected with the HIV virus.

All these figures are mathematic calculations. In reality, the
disease does not necessarily progress in that manner, as
experience has demonstrated both here and in other countries.

The explanation offered by specialists in infectious diseases
is that every epidemic spreads very rapidly in the beginning
because it finds a susceptible and unprepared population.
Later the rate of contagion begins to decline because within
the same population group there are some who are not
susceptible, who develop immunity, or who take steps to
prevent the disease. Then the spread of the disease tends to
stabilize, and in medical terms it is transformed from an
epidemic and becomes endemic.

AIDS is not immune from that progression, although it does
present some variants because of its characteristics. Organ-
ically, everyone is susceptible to contracting AIDS, and no
one develops an immunity because the immune system is
precisely what the disease attacks. But prevention and the
fact that many people, because of the specific characteristics
of the disease, will never be exposed to it, enables specialists
to predict that the disease will not continue to spread as
rapidly as it did in the beginning.

INDRE Itself believes that the spread of AIDS in Mexico
now has an exponential index of a reduced type (2.1
percent). Epidemiologists and Conasida experts say that
realistically, it can be calculated that for each AIDS case
reported, another case goes unreported. This means that if
nearly 10,000 cases have been reported, the real cumulative
number of AIDS cases in Mexico is about 20,000.

This figure, which is fives times lower than what was
originally calculated, is still disturbing in itself, since if the
AIDS/HIV-positive progression remains at 1/30-50, we can
assume that there are now between 600,000 and 1 million
HIV-positive people in Mexico, with the additional multi-
plier that this entails. And we should add that, contrary to
what was thought in the beginning, clinical experience has
demonstrated that every person infected—every HIV-
positive person—will sooner or later develop AIDS and, as
long as no remedy has been found, that person will die.

According to the AIDS/ETS [Sexually Transmitted Diseases
or STD] Monthly Bulletin published by INDRE in February
1992, 3,132 cases of the cumulative total of 9,239 cases were
reported during the past 12 months; this is equivalent to
33.9 percent. In comparison with the figures for the imme-
diately preceding year, the increase in the incidence of AIDS
was calculated at 18.1 percent.

JPRS-TEP-92-013
Suly 30 1992

During this period, the AIDS cases reported increased in 18
states and declined in 14. The jurisdictions with the greatest
risk of AIDS infection are: the Federal District, with a rate
of 316.5 cases per 1 million inhabitants; Jalisco, 229.9;
Morelos, 209.4; and Yucatan, 169.9. More than half of the
epidemic, 58.4 percent, is concentrated in three areas: the
Federal District, and Mexico and Jalisco States.

The breakdown by sex shows that 85.2 percent of the AIDS
cases occurred in men; the male/female ratio is 6 to 1. By age
group, 65.8 percent of the cases occurred in people between
the ages of 25 and 44, with cases in the age group between 45
and 64 a very distant second, and with lower percentages in
other age groups.

Among males, 87.1 percent of the cases were attributed to
sexual transmission, while among women 61.6 percent of
the cases were attributed to contact with infected blood. An
increase in heterosexual transmission has been observed,
however. In children the major cause of transmission is
perinatal, although there are also cases attributable to blood
transfusion and sexual abuse.

The occupational sector in which most AIDS cases have
occurred is administrative employees (one for each 1,367),
public and personal service workers (one for each 2,187),
and technical workers (one for each 2,224). The lowest rates
are found among housewives, farm workers, and students.

By institutions, the SSa has reported 4,149 cases (44.9
percent); the IMSS [Mexican Social Security Institute] 3,440
(37.2 percent); the ISSSTE [Social Security and Services
Institute for Government Workers] 756 (8.2 percent); and
other institutions have reported 894 cases (9.7 percent). Of
the patients, 47.8 percent (4,418) have died; 43.7 percent
(4,036) are still alive, and there is no information about the
outcome in 8.5 percent of these cases.

Mexico ranks 10th in the world and third in the Americas in
terms of AIDS incidence.

Dr. Carlos del Rio, Conasida’s executive director, does not
really like to talk about numbers. Especially when those
numbers come from other sources. He is convinced that 90
percent of Mexico’s doctors do not even know they are
required to report all AIDS cases that they find to the
INDRE.

He would rather talk about the major patterns of this
disease. One such pattern is the age group that has primarily
been affected. In the United States, people now use the
concept of “potentially productive years of life lost.”

This means, explains Dr. del Rio, “that the majority of the
patients who die of AIDS stop leading productive lives
early, 20 to 30 years before the end of their normal lifespan.
It means that the investment made in them by the state,
society, their family, goes directly into the casket. And that
is not all. For they also stop consuming, paying taxes, and
many of them also stop supporting a family.”

Another important fact arising from the age group that has
been hardest hit is the time when the infection is contracted.
“Tf AIDS cases appear primarily among the group between the
ages of 25 to 44 and because AIDS has a 10-year latency



SPRS-TEP-92-013
July 30 1992

the virus had spread like an epidemic in major parts of the
Third World is thought to be due in part to the fact that
sexual diseases, which weaken the mucous membranes, are
common.

In Sweden, there is very little domestic heterosexual
spreading. There is surprisingly little of it, according to
recent, more accurate statistics of the sources of infection
for the heterosexual HIV-positive group.

Infected Needles

The domestic spread is still the greatest, and still growing,
among homosexual men, among whom anal sex is a
common form of intercourse. The second major way the
infection is spread in Sweden is the used drug syringe, even
if the number of newly infected drug users has been drop-
ping for some years.

In Sweden, 728 people have been infected heterosexually,
according to the SBL’s statistics of reported cases of HIV-
positives during the period running from November 1985,
when reporting HIV became obligatory, to | January 1992.
Of these people, 79 were Swedes infected by Swedes. That
works out to approximately 13 people per year or one per
month. (See table.)

But outside Sweden the picture looks quite different.

“The world is so, so big, and our ambition truly is to be a
part of that world. So I cannot at all see the point of keeping
up with these provincial blue-and-gold [the colors of the
Swedish flag] statistics. Instead we must recognize the fact
that HIV is an infection that covers the whole world,” said
Prof. Sven Britton, the head of the infectious diseases clinic
at Huddinge Hospital.

“Nor can we overlook the fact that the reason the situation
is as good as it is in Sweden is tied to the AIDS Delegation’s
work,” he said.

“Managed Well”

That point was also made by Goran Rado, the chairman of
the AIDS Delegation, commenting on criticism which has
been made of the AIDS Delegation’s campaigns aimed at
the general public instead of at risk groups.

“We have managed well in Sweden, but how would the
situation have looked without the campaigns? Furthermore,
a small portion of the AIDS Delegation’s total budget goes
into our own campaigns,” he said.

Of the AIDS Delegation’s appropriation of 193 million
[kronor], 13 million go into its own campaigns. 63 million
goes to care of drug users, 40 [million] to voluntary organi-
zations, 31 [million] into efforts aimed at youth, 17 million
into information and education, 10 million into psychoso-
cial support, and 4 million to immigrant organizations.

“We still believe that campaigns aimed at the general
population are important, but at our next meeting in early
June we will probably decide to reduce that allotment
somewhat,” Rado said.

WEST EUROPE 31

HIV-Positives in Sweden Reported During the Period
November 1985 to 31 December 1991

Number of HIV-positives Reported
Homosexual/bisexual 1,405,
Heterosexual 728
Intravenous drug users 605
Received blood products 195
Unknown source of infection 20
Mother-to-child infection 19
Total 2,972

Number of Those Infected Heterosexually

‘Swedes infected by Swedes 19
‘Swedes infected by immigrants in 13
Sweden

‘Swedes infected abroad 128
Immigrants from other countries 66
Immigrants of African origin 442

Number of HIV-Positive Youth Under the Age of 19

Homosexual 7
Intravenous drug users 1
Heterosexual o
Total 14

All six of these are girls. Four were infected by Africans, two were
infected by Southern Europeans.

HIV Infected Complain of Job Discrimination
92WE0539A Stockholm DAGENS NYHETER
in Swedish 22 Jun 92 p AS

er by Vivianne Sprengel: “‘HIV Infected Get the
Sack””’

[Text] (TT)—Individuals infected with the HIV virus are
being discriminated against and forced to quit their jobs in
violation of the rules adopted by the parties in the labor
market.

Several people have been paid off with the union’s consent,
according to the National Association for the HIV Infected
(RFHP).

“We are therefore advising infected individuals not to tell
anyone at work about their disease,” said Per Olof Persson,
deputy chairman of the RFHP, in an interview with the TT
[Press Wire Service].

“For an HIV-infected person, it would be best if he could

talk about his distress and all the practical aspects of HIV
infection: doctor visits, sick leave, and so on.

“But there is not much sympathy, and people are still afraid.
It will be a long time before HIV-infected individuals are
treated in a manner worthy of human beings.”

Persson is the RFHP’s deputy chairman and works for it full

time. The RFHP is a patients’ organization that was formed
in 1990 as a alliance of associations.



JPRS-TEP-92-013

July 30 1992 LATIN AMERICA 13
Drugs at the Forefront
Infections Increase Faster Among Drag Users in the State of Sao Paulo (In Percent)
Year Homosex- Bisexuals | Heterosex- | Intravenoas | Hemophil- | Blood Trans- | Vertical | Under Inves-
vals eals Drug Users ines fasion tigation

1980 = 100 = = = = = =

1983 56 24 4 4 = 4 = 8

1985 59.5 25.2 37 31 2.4 2 = 4.1
1988 36.8 13.4 8.1 25.2 14 42 28 19
1991 22.3, 10.8 143 35.6 0.7 17 27 1.7
1992* 26.1 11.8 17.3 30.6 16 14 14 98

*Preliminary figures as of 31 March.

‘Source: Center for Epidemiological Monitoring, Sao Paulo State Health Department.

Population

According to Loures, that sampling will make it possible to
measure the progress of the disease in a population of
predominately heterosexual behavior in which the members
are in the habit of getting physical examinations. “It is a
population that also seeks out health services relatively
frequently. Moreover, the number of pregnant women and
carriers of sexually transmitted diseases is stable and does
not vary much from one year to the next,” he said.

According to Ramos, “Programs to measure the prevalence
of antibodies in serum are nothing new, but they have never
been conducted in a periodic fashion among the same
population and over such a broad geographical area. Suc-
cessive tests will enable us to trace the profile of the
epidemic.”

Government, WHO Sign Agreement on AIDS
Research een

PY1107013892 Brasilia Voz do Brasil Network
in Portuguese 2200 GMT 10 Jul 92

[Text] The Brazilian Government and WHO agreed today
‘on Brazil’s entry into the areas of research and control of
AIDS vaccines.

WHO will release $1.5 million for the expansion of the
network of laboratories that will isolate and characterize the
types of viruses existing in Brazil. Moreover, WHO will
provide specialized training to Brazilian scientists.

Today’s agreement will allow Brazil to study the effective-
ness of the 14 anti-AIDS vaccines being developed in
industrialized countries.

The agreement also states that the vaccines will be tested
here only after the conclusion of the tests for effectiveness
conducted in the originating countries.

According to National AIDS Program Coordinator (Lair
Guerra de Macedo), the first step now is to characterize the
virus or viruses found in the country:

[Begin recording] If the vaccines being tested do not corre-
spond to the characteristics of the viruses circulating in
Brazil, a process of dialogue and negotiations probably will
begin in Brazil so that those viruses will be included among

those already existing, or to determine the possibility of
producing a new vaccine to meet the specific needs of
Brazil. [end recording]

The characterization process is the most important stage for
the production of vaccine because the viruses found in
Brazil might be different from those in other countries.

COLOMBIA

AIDS Statistics Given, Programs Described
92WE0478A Santa Fe de Bogota EL ESPECTADOR
in Spanish 19 Apr 92 p 11-A

[Article by Gilda Sarmiento: “Millions Invested To Fight
AIDS”)

[Text] Santa Fe de Bogota—Every day an AIDS patient dies
in Colombia. Nevertheless, there are no reliable statistics
because of the fear of social stigmatization on the part of
patients and their relatives.

Meanwhile, the epidemic is continuing its precipitous lethal
course. Since 1986, at the Social Security Institute [ISS]
alone, 349 patients have died, and the cost of treatment
exceeds 3 billion pesos.

The ISS figures do not appear to be causing alarm because
the agency treats half of the cases in the country; and out of
a beneficiary population of 4.7 million (members and enti-
tled persons), 917 individuals, including those infected,
sick, and dead, were recorded during the period 1986-92.

But whereas, in 1986, six infected, four sick, and three dead
were recorded, thus far this year there have been 98 infected
and 151 sick.

The disease does not discriminate between rich and poor,
nor between adults and children (whose immune systems
are weaker).

Sexual relations are still the main carrier of the contagious
disease: accounting for 90 or 95 percent of the cases.

With the advances made in diagnosis, certain taboos are
beginning to be discarded. For example, this is not a disease
exclusive to homosexuals, promiscuous persons, and pros-
titutes. Those suffering from another type of venereal dis-
ease and with risky habits, such as unconventional sexual



SIPRS-TEP-92-013
July 30 1992

AIDS Drug Development Center Established in
Lianyungang

92P60337D Nanjiang JIANGSU KEJI BAO in Chinese
3 May 92 p 4

[Article by Liu Bo [0491 3134] and Chen Jianjun [7115
1696 6511}]

[Summary] The first AIDS Drug Development Center for
developing drugs for the treatment of AIDS has been jointly
established in Lianyungang [Jiangsu Province] by the Basic
Theory Department of the Institute of Traditional Chinese
Medicine and the Lianyungang Dongfeng Pharmaceutical
Plant. The center is planning to put out a new AIDS drug
“keaike” [0344 5337 0668] in June 1992, and two other new
drugs by the end of 1992 and in June 1993 respectively.

Over 700 HIV-Infected Persons Discovered by
End of 1991

HK1006143592 Beijing ZHONGGUO XINWEN SHE
in English 1404 GMT 10 Jun 92

[Text] Hong Kong, June 10 (CNS)—The June edition of
“CHINA’S DIGEST” (CHUNG HUA WENCHAI] dis-
closed today the situation regarding AIDS facing the Main-
land. By the end of last year, the Mainland had discovered
705 cases of persons infected with the HIV virus leading to
AIDS and eight full-blown cases, three of which were
Mainland residents, all of whom died last year.

The 705 cases were diagnosed and confirmed to have the
disease from serum tests carried out on 480,000 persons in
15 provinces, cities and autonomous regions including
Liaoning Province, Yunnan Province, the Guangxi Zhuang
Autonomous Region, Guangdong Province and Beijing
Municipality. The Director of the Sanitation and Anti-
epidemic Department of the Ministry of Public Health, Mr.
Dai Zhicheng, was not optimistic about the outcome of the
tests. He added that there might be virus carriers “going
unchecked”.

The number of persons infected with the fatal disease has
shown rapid growth since the first case involving a Main-
land resident was discovered in 1988, Mr. Dai said. It
developed from cases where the infection was brought in
from overseas into ones spreading among domestic resi-
dents. Persons with the AIDS virus are mainly drug addicts,
people with venereal diseases, prostitutes, returnees from
abroad or from undertaking labour service overseas, spouses

CHINA 5

of virus-carriers and haemophiliacs. Transmission is mainly
from sexual and blood contacts. There also exists a potential
risk of mother-to-baby transmission, although no such case
has yet been discovered.

The Chinese government has made AIDS one of the diseases
receiving state priority in preventive work and treatment
and has set up an expert commission for the prevention and
control of AIDS with the aim of curbing the spread of the
disease.

Jilin To Export Anti-AIDS Medicine
0W0607043192 Beijing XINHUA in English
0321 GMT 6 Jul 92

[Text] Changchun, July 6 (XINHUA)—Northeast China’s
Jilin Province will export its newly developed traditional
Chinese medicine called “Milingwang”, which is believed to
be able to prevent and cure the disease of AIDS (acquired
immune deficiency syndrome).

According to a contract signed recently between the Jilin
Provincial Technological Import and Export Company and
Finehandle Limited Aps of Denmark, Jilin Province is
expected to provide the Danish company with 40 tons of
“Milingwang” capsules worth 260 million U.S. dollars a
year. The first group of “Milingwang” capsules will be
exported to Denmark in October.

The medicine was developed after many years’ effort by Lin
Haifeng, director of the Tonghua Institute of Medicines for
AIDS Prevention and Cure, combining his related secret
recipe handed down from generation to generation with
contemporary theories of medical sciences.

Reports based on experiments from the Chinese Academy
of Preventive Sciences and Dr. Bethune Medical University
prove that the medicine can effectively control the propa-
gation of the AIDS virus and can also enhance the immunity
of an organism, but does not harm the liver or kidney of the
human body.

Clinical tests have also been carried out in southwest
China’s Yunnan Province, Argentine, Brazil, and Tanzania
and research reports show that the medicine has certain
curative effects over some AIDS patients.

Local officials said “Milingwang” medicine will soon be
batch produced by the Tonghua No. 2 Pharmaceutical
Factory in the province.



28 WEST EUROPE

DENMARK

Poll Results Show Condom Campaign Successful
92WE0527A Copenhagen BERLINGSKE TIDENDE
in Danish 22 Jun 92 p 1-4

[Article by Henrik Dannemand: “Comdom Campaigns
Have Changed Young People’s Behavior”]

[Text] The campaign for condoms as protection against
AIDS has been effective, according to a survey taken by the
Gallup Institute for BERLINGSKE TIDENDE.

Since 1985 there has been a dramatic change in people’s
attitudes toward condoms as a means of protection. One
thousand people were asked if they believed if condoms
offer effective protection against AIDS. In 1985 only 36
percent answered in the affirmative, while today the figure
is up to 92 percent. Gallup also asked whether people had
changed their behavior due to the risk of AIDS. Twenty
percent have changed their behavior, while 77 percent said
they had not.

The campaigns have made an impression on young people,
in particular. In the 15 to 24 year age group, 44 percent said
that the risk of AIDS had made them change their behavior.

Much Local Work Done

“It is gratifying that so many people know that it is
important to use condoms. But there are still people being
infected. People know how to protect themselves, but that is
not always enough to make them change their behavior.
There is an unfortunate disparity between knowledge and
behavior,” said Dr. Niels Peter Rothgardt, head of the AIDS
office of the Health Board.

He said that the large-scale campaigns were not well-suited
to changing people’s attitudes and behavior.

“The campaigns are well-suited to drawing attention and
disseminating knowledge, but not to changing attitudes and
behavior. These are things that are affected by the local
environment—on the job, at institutions, and at home. For
this reason, we have also worked hard on the local level. We
are supporting this work with educational materials and
money,” Rothgardt said.

JPRS-TEP-92-013
July 30 1992

Effective Condom Campaign Against AIDS

It is noteworthy that, in the relatively short time since 1985,
practically the entire populace has been taught the impor-
tance of condoms as a means of protection against AIDS.
While in 1985 only slightly over one-third (36 percent)
believed that condoms provided effective protection, the
figure has now risen to 92 percent. In practice, this is as
close as possible to convincing everyone.

This was indicated by a poll taken by the Gallup Institute,
which was a repetition of two previous polls taken in 1985
and 1987.

In these surveys, a representative sampling of approxi-
mately 1,000 adults was asked the following question:

“Do you believe that the use of condoms offers effective
protection against AIDS?”

The latest survey was conducted in June 1992 and it gave
the following results, compared to the previous surveys:

[ October 1985 [June 1985 | June 1992
An percent
Yes 36 14 92
No 33 9 4
Do not know 31 "7 4
Total 100 100 100

As indicated, the trend during the past seven years has been
dramatic. The “do not know” category has been practically
eliminated since 1985, dropping from 31 percent to 4
percent, as has the idea that condoms do not offer effective
protection. This figure dropped from 33 percent to 4 per-
cent.

A closer analysis showed that the trend was not identical for
all groups of society. It has been extremely strong among
young people between 15 and 24 years of age, 97 percent of
whom now answer the question in the affirmative.

Of course, knowledge is one thing and implementing the
knowledge is yet another. To find out whether the condom
propaganda also changed behavior patterns, pollsters also
asked the following question:

“Have you changed your behavior in this area because of the
risk of AIDS?”

This question was answered in the following manner:

I ‘Yes I No [Always used condoms | Noresponse | Total
In percent

Total 20 7 2 1 100
Age:
15-24 years “4 49 7 = 100
25.39 27 a 2 = 100
40-59 2 86 = 2 100
Marital status:
Single 32 61 4 3 100
Married or living 14 4 1 1 100
together



IJPRS-TEP-92-013
Tuly 30 1992

decision of the Saint Petersburg soviet suspending the order
written by specialists. Unfortunately the decision was made
right at the moment when relations between the medical
commission of the Saint Petersburg soviet and the mayor’s
public health committee had deteriorated. We, alas, are
living in a time of real dual sovereignty, in a time of endless
clarification of relations between executive and legislative
powers. And each person who has been slighted selects that
power which is more convenient to him.

A decision was made at the AIDS center not to carry out the
order of the public health committee; instead, a complaint
was filed with the Saint Petersburg soviet’s commission.
And so the AIDS service became hostage to the complex
relations between the commission and the committee. And
as far as concerns the opinion of the specialists who had
dealt with the AIDS problem from the very first, who
revealed the first cases of infection, who made the first
diagnoses, who treated the first patients and who are recog-
nized professionals, no one is interested in it. Moreover
these specialists are being instructed, just like in the good
old days, what they should be doing, and how. The service is
being isolated from those who established it and who are
directly responsible for it.

Rather than this, what professionals expect from the politi-
cians is concrete assistance in solving the most difficult
problems of legislation, financing and material and tech-
nical support. It is no secret, after all, that in the last 2 years
we have not received a single kopeck in hard currency from
the city with which to purchase expert diagnostics and
pharmaceuticals. Or that the repressive nature of the legis-
lation, existence of the article requiring criminal prosecu-
tion of homosexuals, and many other things, are essentially
blocking the approaches to cooperation with risk groups and
creating obstacles to establishment of cooperation with
them for deeper study of the epidemic’s development.

But only the politicians can change the law. We don’t need
confrontation. Extremely difficult tasks await us. AIDS is a
challenge to our reason and our ability to cooperate. AIDS is
a major social problem, and we need to solve it together. But
everyone must do his own part.

AIDS Case in Khabarovsk

92WE0471B Moscow KOMSOMOLSKAYA PRAVDA
in Russian 28 Apr 92 p 2

[Article by G. Mironova: “AIDS, As We Know, Is Incurable,
Which Is Why Doctors Are So Unruffled”]

[Text] A horrified acqaintance of mine told me the news:
“AIDS was discovered in Khabarovsk. A blood donor was
found to have the disease!”

As always, you hear the most shocking news in the streets
first. But the medical community was suspiciously silent
about it. The chief of the local health department did finally
speak. In a meeting with Americans he suddenly blurted out
that there were 300 carriers and one AIDS patient in
Khabarovsk. Everyone’s hair stood on end. The foreigners
were persuaded later on, of course, that the translation had
been incorrect: Only one HIV carrier was found. How?
Where? Was he a donor?

CENTRAL EURASIA 25

An injured person was delivered to Khabarovsk Kray Hos-
pital during a late March evening. The on-call physician,
who accepted the patient and did everything necessary, did
the unusual thing of ordering a blood sample from him for
AIDS testing. Something about the man’s appearance
seemed strange to the emergency room specialist; he sus-
pected him of being a homosexual, and was just making
sure. A few days later the AIDS test proved positive.

Such tests have been conducted in the country for over 2
years. Laboratories have encountered hundreds of positive
HIV tests. This evoked considerable panic at first. But bitter
experience taught laboratory technicians to be doubtful of
the first test results, since a positive reaction to AIDS could
occur with blood from pregnant women and from rheuma-
tism patients. Three hundred persons whom the kray health
department director classified as being HIV carriers were
simply people with such blood. Only one expensive and
complex test—the immunoblot—can provide a final diag-
nosis. This test was formerly carried out only in Moscow,
and patients were uncertain of their fate for months on end.
Now the immunoblot is also available in Khabarovsk. Thus
9 days later the blood of the injured patient revealed without
doubt that the first HIV carrier had been discovered.

He had lain all this time in a common five-patient ward, like
an ordinary patient. Sixteen persons of the hospital staff
handled his blood (they were subsequently placed under
observation, although no violations of epidemiological con-
trol regulations were committed). All physicians were sworn
to secrecy.

AIDS services were established in the country at full gallop.
Thousands of laboratories and centers for prevention and
control exist in all kray and oblast cities, in addition to six
regional subdivisions. In Khabarovsk for example, two
centers were established right next door—a regional and a
territorial one. In separate buildings, with a sizable staff of
associates, who receive 60 percent extra hazardous-duty
pay. No money was spared in the purchase of equipment or
acquisition of drugs. A huge net had been cast, it seemed.
AIDS would not get through! In 2 years, 4 million persons
were tested just in the Far East. The terrible virus had not
been found. But only the naive man-in-the-street could
reassure himself that if it hasn’t been found, it isn’t around.

“Why is the newspaper conducting some sort of investiga-
tion? What right do you have? We'll get to the bottom of this
with the physicians who supply us the information!”’: The
indignation expressed at the kray AIDS center was perhaps
a little too nervous.

All information was kept secret supposedly in the interests
of the patient. We of course have not yet come to the point
where we can relate calmly, sympathetically and in a
friendly manner to a neighbor with AIDS, even though for
example we would be totally untroubled if he had jaundice.
Still, no one was expressing a desire to dig into someone
else’s private life. All that was important was to know how
well the services were working, whether or not the spread of
the virus had been averted, and ultimately, whether the
donor was ill or not. “What, are you going to inspect us or
something?” they asked sarcastically at the center. The



2 SUB-SAHARAN AFRICA

Cabinet Approves AIDS Control Policy
92WE0580A Windhoek THE NAMIBIAN in English
12 Jun 92 p 3

[Article: “New Action on AIDS”]

[Text] The Cabinet has approved the Policy and Guidelines
for HIV/AIDS Prevention and Control in the country which
stress the rights and responsibilities of the individuals and
society.

The guidelines focus on, among other things, insurance for
HIV infected persons, research projects and therapeutical
trials.

The National AIDS Control Programme in Namibia has
devised preliminary, medium- and long-term plans for the
control of AIDS in line with those of the World Health
Organisation.

Detailed information on the Policy and Guidelines for
HIV/AIDS Prevention and Control in the country can be
obtained from the Ministry of Health and Social Services.

SENEGAL

AIDS Cases Total 648 to Date
92WE0451A Dakar LE SOLEIL in French
9 Apr 92 p4

[Article by Fara Diaw: “AIDS Is Gaining Ground”)

[Excerpt] [passage omitted] The number of AIDS cases
totaled 648 as of the end of March 1992, according to the
official count made by the Multidisciplinary National Com-
mittee To Combat AIDS [CNPS] in Senegal. As of June
1991 the total had been 552. In nine months, 96 additional
cases were reported in the various hospitals in Dakar and in
the other regions.

According to Dr. Ibra Ndoye, coordinator of the CNPS, the
epidemiological situation in Senegal is still controllable,
because it is possible—thanks to the efforts pursued in the
areas of information, education, and communications—to
prevent HIV infection and its spread to the bulk of the
population.

Dr. Ndoye explained that the CNPS will intensify its efforts
in the targeted area of prevention, which in the opinion of a
number of international experts (in epidemiology and IEC
{expansion not given]) is the technique that could be of
greatest assistance in modifying behavior. This would be in
addition to preservation of the achievements made in regard
to safety in blood transfusions throughout the national
territory; seroepidemiological surveillance at five sites
(Dakar, Kaolack, Saint-Louis, Ziguinchor, and Thies); and
the IEC of prostitutes (the most important group at risk),
involving follow-up monitoring of the frequency of their
contacts. With respect to sexually transmissible diseases,
Dr. Ibra Ndoye pointed out that collaboration with the
NGO's {nongovernmental organizations], young people’s
associations, and women’s groups will be strengthened in
order better to reach the interior of the country, where the
HIV infection is now present. [passage omitted]

IPRS-TEP-92-013
July 30 1992

SOUTH AFRICA

Six-Fold Increase in Chances of HIV-Positive
People Contracting Active Tuberculosis
MB0304150992 Johannesburg SAPA in English
1432 GMT 3 Apr 92

[Text] Parliament April 3 SAPA—The chances of HIV-
Positive people contracting active tuberculosis was esti-
mated to increase six-fold compared to those who were
HIV-negative, according to the annual report of the Depart-
ment of National Health and Population Development
tabled here on Friday.

The report said that the incidence of TB had increased by
26.8 percent from 1988 to 1990 after a progressive decline
from 1960 to 1986.

Incomplete and unrest-disrupted treatment were important
factors promoting the transmission of TB. Measures had
been instituted to improve supervision of medication and
treatment.

The unfavourable economic climate, high unemployment,
the increase in informal settlements and unrest contributed
to the activation of dormant tuberculosis.

The report said the spread of multi-resistant strains of
tuberculosis caused “considerable concern”, but supervised
therapy had contributed to a drop in the incidence of
resistant cases from 28.8 percent during 1965-1970 to 14.2
percent during 1980-1989.

It is currently estimated that about one percent of TB cases
are multi-drug resistant.

Heterosexual Contact Most Important Mode To
Transmit AIDS

MB2307175692 Johannesburg SAPA in English

1546 GMT 23 Jul 92

[Text] Pretoria July 23 SAPA—Heterosexual contact was
the most important mode of transmission of acquired
immune deficiency syndrome (AIDS) in South Africa, the
Department of National Health said on Thursday (23 July).
Of the reported South African cases, 53 percent contracted
AIDS through heterosexual contact, while 30 percent
acquired the disease through homosexual or bisexual con-
tact. Since 1987 the number of heterosexually acquired
AIDS cases had “increased dramatically”, namely 17 cases
in 1988, 55 in 1989, 159 in 1990, 288 last year and 173 cases
up to June 30 this year.

Women were generally infected at a younger age, with eight
percent of the reported female AIDS cases being under 20
years of age. The heterosexual spread of AIDS was accom-
panied by a corresponding increase in paediatric AIDS, with
three cases diagnosed in 1988. Since then another 182
children have acquired the disease as a result of mother-
to-child transmission.

Most of the total of 1,316 South African AIDS cases are
from Transvaal, with 41 percent or 546 cases. Natal had 453
AIDS cases and the Cape Province reported 17 percent of



IPRS-TEP-92-013
Tuly 30 1992

MOZAMBIQUE

Health Official Says AIDS Cases Greater Than
Reported

MB2805141492 Maputo Radio Mozambique Network
in Portuguese 1030 GMT 28 May 92

{Report on interview with Dr. Rui Bastos, member of the
Fight Against AIDS Program Coordination Commission, by
unidentified Radio Mozambique reporter, place and date
not given—first paragraph studio introduction]

[Excerpt] Radio Mozambique has recently learned from Dr.
Rui Bastos, a member of the Fight Against AIDS Program
Coordination Commission, that AIDS has made geomet-
tical progression in our country over the last few years. He
said that the cases reported so far total more than 400, and
he added that the principal work being done at present is to
educate the main target groups, including venereal disease
carriers, soldiers, students, and workers.

[Begin Bastos recording] I am almost certain that this is not
the correct figure for AIDS cases in this country. This is only
the number we know, and which reflects known AIDS cases.
A substantial portion of the Mozambican population has no
access whatever to health care. Certain population groups,
like displaced people, for instance, show a high HIV pres-
ence. Thus, it is certain there must be a much greater
number of AIDS carriers in the country. [passage omitted]
[end recording}

Seveally anomie Diseases

'MB1407074392 Maputo Radio Mozambique Network
in Portuguese 0500 GMT 14 Jul 92

[Text] The EEC [European Economic Community] has
granted Mozambique more than 980,000 ECUs [European
Currency Units] to support the Fight Against Sexually
Transmitted Diseases Program. AIDS is one of the diseases
targeted by that program.

That amount, which was granted following the signing of an
accord to assist that program, will be used in the fields of
management, research, information, education, diagnosis,
treatment, and cadre training, as well as to help our country
participate in international conferences on such diseases.

The accord signed in Maputo yesterday was the third of its
kind, and it will be valid for 18 months.
NAMIBIA

Six Students Diagnosed HIV Positive
92WE0557A Windhoek THE NAMIBIAN in English
21 May 92 pp 1, 2

[Article by Kate Burling: “Student AIDS Shock Raises Key
Questions”)

SUB-SAHARAN AFRICA 1

{Text] Church and parental prudishness is largely to blame
for slow progress on AIDS education in schools, which is in
turn partly responsible for the spread of HIV infection
among school-children.

National AIDS Control Programme (NACP) officer Dempa
Mwashakele said people were “closing their eyes to reality”
when it came to effective AIDS education for Namibian
youngsters.

Speaking in the wake of news that six school students have
been diagnosed HIV positive, Mwashakele said Namibia
had a high rate of teenage pregnancy and VD, which “shows
our youngsters are sexually active and need protecting
against HIV.”

The six students, in their late teens and early twenties, are
from various schools in Windhoek. They were detected HIV
Positive when their blood was screened by the Blood Trans-
fusion Service, after they had gone to give blood.

Though there was widespread shock at the news of “school-
children” being infected with the killer disease, doctors
working in the community have been encountering HIV
infection in youngsters since last year. At the moment there
is no set policy on whether the parents of minors should be
told about their children’s illness, or indeed whether schools
should be informed of the situation.

Getting any kind of consensus on dealing with AIDS among
parents, schools and churches, seems to be a major battle.

Mwashakele said that was one of the main reasons AIDS
education in schools had been relatively ineffective. Mate-
rials had been prepared by the NACP and Abacus, but
various schools had complained about its content.

“We talk about two main lines of defence: abstinence and
the use of condoms,” Mwashakele explained. However,
some teachers, parents and church representatives had
condemned any talk of condoms as an incitement to sexual
promiscuity among Namibian youngsters.

Prolonged negotiations has made little progress, and after a
recent meeting with the Ministry of Health and Social
Services, the NACP had come up with an ultimatum.
Existing educational material would be sent to all schools,
and those refusing to use it must come up with an acceptable
alternative by a given date.

Mwashakele described one “alternative” AIDS education
panflet [word as published] issued by ELCIN. Its strongly
“anti-condom” stand was conveyed in Oshiwambo: con-
doms were only to be used by married couples where one
party had been diagnosed HIV positive.

“Where are most people getting AIDS, if they aren’t
involved in extra-marital sex?” she demanded. AIDS edu-
cation was not a question of idealistic niceties; it was a
matter of life and death, and everyone needed to wake up to
the fact, she said.


14 LATIN AMERICA

Practices, are more susceptible to contracting the virus and
display shorter incubation periods.

In Colombia the greatest number of victims are male. As of
1990 there were 630 cases among males and 35 among
females. Most of the cases are concentrated in the 20-49 year
age group.

Decree 559 of 1991, which ordered confidentiality
regarding the person who is infected or suspected of having
the disease, has compounded the fear of discrimination.

The same law expressly forbids the requirement of serolog-
ical tests to detect AIDS for admission or continuation in
educational, sports, or social centers and for access to or
continuation of any work activity.

EL ESPECTADOR learned that despite this, certain busi-
ness firms, for the alleged purpose of conducting other types
of medical examinations, take advantage of them to extract
blood and perform the test, and even dismiss employees.

This situation has prompted many government officials to
handle the statistics on human immunodeficiency syn-
drome [HIV] with extreme caution, so as not to alarm
employers nor hurt the worker.

What Is Expected

Although the problem in the ISS has not reached unman-
ageable limits, the worst is yet to come, because it is
anticipated that persons who incubated the virus during the
1980’s will begin developing the disease and that the fatal-
ities will surely multiply.

The most disturbing aspect is that the increase in those
infected is becoming greater (70 percent) and there is no
vaccine to halt the disease.

In order to understand the problem, one must know the
difference between an infected and a sick person. This was
explained by Carlos Jaramillo, chief of the National Divi-
sion of Support Services; Adalgiza Magana, a health edu-
cator; and Alfonso Figueroa, director of the ISS National
Community Health Office.

* Infected: The person has acquired AIDS, that is, HIV.
Within this group there are symptomatic and asymp-
tomatic persons. The latter account for 70 percent or
more of the cases and show no symptoms. They may
even not develop the disease, but transmit it.

« Sick: This group comprises 20 percent of individuals
whose disease is recent. The remaining 5 or 10
percent are the terminally ill, that is, the ones with no
life expectancy.

The treatment for an AIDS patient costs between 7 and 10
million pesos per year in the ISS, and the survival period
depends on his condition. If the disease is advanced, it
ranges from three to six months; and in infected persons it
is more than five years.

Regarding the controversy over the costs for a terminal
patient, who is going to die in any event, the professionals
indicated that, as physicians, it is their obligation to help

IJPRS-TEP-92-013
Suly 30 1992

him have a reasonable quality of life and to console him in
his physical and moral suffering, but not to leave the family
bankrupt.

National Control Plan

In countries in which the virus appeared during the 1960's
or 1970's, the cases reached their maturation period during
the 1980's.

In Colombia, where the first AIDS case was detected in a
prostitute in Cartagena during 1983, it is expected that
many persons have incubated the disease and that the cases
will increase considerably from now on.

Annual Trends in AIDS, 1986-91

Year Infected Sick Dead
1986 6 4 3
1987 30 31 18
1988 68 61 42
1989 131 105 61
1990 188 171 109
1991 98 151 116
Total 521 523 349
Source: ISS Statistics, 1986-1991

To cope with the epidemic, because the worst is yet to come,
Social Security will invest 2.5 billion pesos over the next two
years in a National Control Plan directed toward its 4.7
million beneficiaries.

The plan i is financed, and its goal is twofold: to prevent the
transmission of the virus and to reduce the social, economic,
psychological, and occupational impact on the infected
patient.

The comprehensive plan consists of several programs:

« Educational: Approximately 1.2 billion pesos will be
invested in education on habits, risk factors, and
health care, with the realization that the only vaccine
existing is education and efforts at prevention.

* Blood program: It is intended to promote the altru-
istic donation of healthy blood in large volumes.
Individuals should feel that this is not an obligation
nor an imposition, but rather an investment for the
future, which could be today, because no one is
immune from an accident. This program calls for an
improvement in infrastructure, with an investment of
approximately 500 million pesos in equipment.

« Treatment and management of the patient and of
persons who have the disease: For this purpose a
complete treatment model is being developed, in
which consideration is given to the psychological,
sociological, medical, dental, occupational, and even
legal problems faced by those suffering from AIDS.
For example, anxiety can lead to suicide, and people
are discriminated against in the social environment.

« Information program: The Social Security Institute is
not interested in counting deaths. One death is the



4 SUB-SAHARAN AFRICA

It is estimated that the actual number of AIDS cases that
have already occurred may be more than threefold the
reported figure.

Total of 1,963 New AIDS Cases in First Four
Months of 1992

92WEO0556A Harare THE HERALD in English

13 May 92 p 1

[Text] A total of 1,963 new cases of full-blown AIDS have
been recorded in the first four months of this year, bringing
the overall total of AIDS cases in Zimbabwe since 1987 to
12,514. *

Most of the new cases—1,165—were reported ii in the 20 to
39-year age group. The figures continue to rise despite an
increase in demand for condoms in the past year. Twenty-
four million condoms were distributed last year.

Figures released by the AIDS Control Programme [ACP]
yesterday showed that in the first quarter of the year, 306
children aged between zero and four years had the disease.
Of these, 139 were girls and 166 were boys, with one case
recorded as unknown. Only 12 cases were reported as
having the disease among those between five and 14 years.
Seven of them were girls and five boys.

The number of cases among those below four years were
mainly as a result of the disease being passed to them by
their infected mothers during pregnancy. Those between
five and 14 years could have contracted the disease through
child abuse by infected adults. It is also a possibility that
they could have contracted the disease during their infancy.

The AIDS cases picked up significantly in the sexually
active age groups. A total of 552 cases were reported in the
20 to 29-year age group. Of these, 303 were females and 248
were males, with one case recorded as unknown.

The figure rose even further for the 30-to 39-year age group,
where 613 cases of AIDS were reported. Of these, 219 were
females and 393 were males with one case unknown.

JPRS-TEP-92-013
July 30 1992

A further 220 cases were reported in the 40 to 49-year age
group, with 63 of them being women and 156 men. Sixty-
seven men and 19 women between 50 and 59 years have the
disease. Fifteen people over 60 years—14 of them men—
have the disease.

A high figure of 123 cases of AIDS cases—41 women and 73
men—was also recorded for those whose ages were not
known,

The cumulative total number of AIDS patients of those
below four years, according to figures released yesterday, is
2,199. From this, 1,019 are girls and 1,162 are boys. The
total number of those between five and 14 years is now 72,
with both sexes accounting equally for the figure.

Between 15 and 19 years, girls account for 240 cases of the
total 282 cases, with boys recording 38 cases. Women again
account for the largest share in the 20 to 29 age group, which
has a total of 3,613 cases. Of these, women account for
1,968 with men recording 1,635 cases.

Again the sexually active group in the 30 to 39-year age
group are recording high cases. A total of 3,412 cases were
recorded in the last five years, with men accounting for
2,210 cases and women 1,193. As the ages progress, the
figures begin to go down.

In the 40 to 49-year age group, 1,261 cases have been
recorded—897 men and 361 women. Men again dominate
in the 515 cases reported in the 50 to 59 age group. They
account for 390 cases. To date, there are 115 cases of AIDS
in the over-60 age group and 1,045 whose ages are unknown.
The ACP has increased its awareness campaign over the
past few years.

The United States Agency for International Development
has said that in some developing countries, HIV and AIDS
could become the leading killer of children by the year 2000.
It also said that in some African countries, virtually all the
reductions in child mortality achieved through immunisa-
tion and other health measures could be cancelled out by
AIDS.



20 LATIN AMERICA

very hard to get a 40-year-old man who has spent a good
part of his life engaging in unprotected sexual practices with
a variety of partners to alter his habits.”

In any event, Conasida is still working on this issue, both on a
broad scale for the general public and on an individual basis.

While on a broad public scale the communications media
provide an adequate vehicle because of the number of
people they reach, their effectiveness is relative “because we
cannot convey a clear and graphic message through the
media about how to prevent spreading the disease by sexual
transmission.” Much also depends on the time and atmo-
sphere in whch the message is received for it to have an
effect. In addition, conservative social groups have con-
ducted a real campaign against large-scale information on
AIDS, as they feel it offends “against decency and good
habits.” (PROCESO, No 663).

Consequently, Dr. Patricia Uribe says that what has been
found most effective is personal, face-to-face information.
“A confidential, respectful interview in which the most
appropriate methods are analyzed with the individual. We
are talking about people’s intimate lives.”

Unfortunately, this method is inefficient in terms of time,
numbers, and cost. Nonetheless, the Conasida information
centers are frequently saturated and the Telsida line [AIDS
hotline] is always busy.

Conasida also provides training courses for volunteers and
workshops on sexual protection for people who may engage
in high-risk practices. But sometimes this can be compli-
cated, too, for example, “if we give a workshop to a group of
women, when historically and culturally in our society
women have never had the power to decide what is done or
not done in terms of the couple’s relations.”

Dr. Uribe says that women have come in who were beaten
because “they dared” to suggest to their partner that he
should use a condom. It is also a sensitive and difficult
matter to suggest to a woman that her partner may be
deceiving her. “She has to reach that conclusion on her own,
but normally there is a very strong psychological barrier
against that.”

It is so strong that “we have women married to AIDS
patients who continue to have unprotected sexual rela-
tions.” Some have done so for two years and have not
become infected. “How can I convince them it is a matter of
probability, like a lottery? Some people have been infected
by a single sexual contact. And people think we are exagger-
ating!”

In this job of persuasion, says Dr. Uribe, it is necessary to
rely a great deal on nongovernmental, community-based
organizations: civic groups, neighborhood, ‘ejido’ associa-
tions, unions, sports clubs, social clubs, etc. In this context,
Conasida’s function is simply to provide information about
the prevention methods that exist, “but the alternative has

JPRS-TEP-92-013
Tuly 30 1992

to come from within the community itself, based on its
values, its beliefs, its habits. It cannot be imposed by us.”

Along with Dr. Del Rio, Dr. Uribe is convinced that the
focus of this work must be on children and adolescents
because their sexual habits are still in the process of forma-
tion. So, she insists, it could be very useful to provide
information in the schools, and for that reason, the debates
about sex education have been revived.

“If we really had adequate sex education, with parents,
teachers, and some institutions participating, we could
avoid not only the spread of AIDS, but of many other
sexually transmitted diseases, and improve other problems
as well, like family planning,” summarized the director of
Conasida’s Community Services.

In fact, this entire situation would also have an impact on
the perinatal-control area because the infected mother trans-
mits the disease to her child during pregnancy or birth.
“And there are women who just learn they are HIV-positive
when they are going to have their third or fourth child.”

Beyond the ignorance and prejudices that have made pre-
venting AIDS through sexual contact so difficult, Conasida
is trying to combat the feeling of “false security” generated
among a good part of the population because of talk about
high-risk groups early in the AIDS epidemic.

The fact that AIDS is classified among what used to be
called “‘secret diseases” and initially occurred in historically
marginal groups, like homosexuals, bisexuals, prostitutes,
drug addicts, promiscuous persons, etc., led many people to
believe that they could not be infected if they did not belong
to those groups.

So—although technically appropriate—Consida has tried
very hard to replace the concept of high-risk groups with the
concept of high-risk practices. “If you engage in these
practices, no matter what social group you belong to, even if
you are in the Church, you can be infected,” emphasizes Dr.
Uribe.

This has begun to happen. Increasing numbers of hetero-
sexual men, women who are not prostitutes, and children
have been infected. “This does not mean that we should
panic, but we do recommend that people know what high-
risk practices are and try to avoid them.”

With this goal in mind, Conasida has also begun to work
with marginalized social groups. These groups are not
marginalized because of their sexual practices, but are
socially marginalized: migrant farm workers, street chil-
dren, people who live in rural or depressed areas. These
people may frequently be exposed to high-risk behaviors
and, for lack of information and resources, cannot protect
themselves.

The major challenge is to create a national awareness in
which balance will prevail: neither panic nor irresponsi-
bility. Simply prevention.



JPRS-TEP-92-013
30 JULY 1992

|

| Foreicn
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INFORMATION
Service

_____JPRS Report—

Epidemiology

AIDS

DISTRIBUTION STATEMENT A

190g0112 10¢ | sare

U.S. DEPARTMENT OF COMMERCE
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SPRINGFIELD, VA 22161

DTIc QuaLrry INSPR 8

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}



JPRS-TEP-92-013
July 30 1992

percent in pregnant women. But the rate of AIDS among
low-class prostitutes climbed from 15 percent to 21 percent,
and it rose from 4 percent to 5 percent among high-class
prostitutes. The rate among men who use the services of
prostitutes remained unchanged at 5 percent.

Researchers on Prostitute Demographics, Views,
AIDS

92WE0436C Bangkok THAI RAT in Thai
15 Apr 92 p 5

[Excerpt] [passage omitted] There is a new study out con-
cerning the behavior of prostitutes that touches on AIDS.
Those who conducted the study included Dr. Phatson
Limanon, Dr. Phenphon Thirasawat, Nopphawan Chong-
wattana, and Mayuri Nokyungthong of the Institute of
Population Studies, Chulalongkorn University.

Dr. Phatson, the head of the research team, summarized
what she and her fellow researchers wrote:

“Based on our detailed studies on this subject, even though
prostitutes come from different families, including some
who come from families that are relatively prosperous, the
great majority come from poor agricultural families. These
girls have not completed Grade 6, and most are between the
ages of 15 and 24. Almost all of them come from the north.

“Most of the prostitutes are satisfied with the money that
they earn from prostitution, and they are proud of the fact
that they are able to send money to help support their
parents. But many of the prostitutes are forced to stay in this
profession, because they owe money. They sent money to
their parents in advance and still owe money to the pimps
and bar owners.

“With respect to the AIDS public relations activities of
public health officials, most of the prostitutes know how
AIDS is transmitted, and they are well aware of what should
be done to prevent AIDS. Almost all of them have heard
about AIDS. However, more of the prostitutes who work at
restaurants or coffee shops are aware of the AIDS problem
than are those who work at brothels. This is because those
who work at restaurants and coffee shops have a chance to
obtain information, and they have more contact with people
on the outside.

“Our study showed that for prostitutes, television is the
most important source of information about AIDS. They
also receive information from health clinics, hospitals, the
radio, and newspapers and from chatting with friends and
relatives. A final source of information is the movies.

“As for the views of prostitutes on AIDS and those with
AIDS, our research team first tried to focus on issues remote
from the person being interviewed and then gradually focus
in on issues affecting them directly. Seventy-five percent of
the prostitutes said that they are afraid of AIDS. About 15
percent said that they are not afraid or that they are
indifferent. The others did not answer the question or did
not answer the question properly.

“When asked how they felt about AIDS victims, the respon-
dents gave four main responses. About one-third of the
prostitutes said that they fear and hate these people and that

EAST ASIA 7

their first priority is to protect themselves. About one-fourth
of the prostitutes said that they feel sorry for those with
AIDS. Another one-fourth of the respondents refused to
answer the question. Finally, about one-tenth of the respon-
dents said that they are not afraid of those with AIDS or are
hardened to things and can put up with anything.

“The prostitutes in the sample were asked what they would
do if they contracted AIDS. The responses showed that
about half of the prostitutes are so afraid of AIDS that they
would kill themselves. About 25 percent said that they
didn’t know what they would do or that they would simply
leave it to fate. Some said that they didn’t care and were not
afraid. And some said that they would give up this profes-
sion and return home. They said that they wouldn’t want to
become involved with anyone.

“Based on the above responses, the researchers asked, If you
are afraid of AIDS, do you want to get out of this profession?
In response, 14.1 percent of the prostitutes said that after
leaving the brothels, they will engage in the same work, but
they will work out of restaurants instead. About 56.5 per-
cent said that if they have a chance to get out of this
profession, they will return home and work as farmers. And
18.8 percent said that they would like to get out of this
profession, return home, and do whatever type of work they
can. Another 5.9 percent said that they would like to get out
of this profession and become housekeepers, and 4.7 percent
said that they would like to leave this profession but that
they don’t know what other type of work they could do.

“Based on these data, it can be concluded that most of the
prostitutes would like to return to their native villages in
order to engage in another line of work that they have the
capabilities and money to do. In view of this, those con-
cerned and the people responsible should look for ways to
help prostitutes find secure and safe jobs as soon as possible.

“The research team feels that AIDS is spreading very
rapidly. Thus, prostitution is not just a social problem. It is
also an important public health problem of the country.
Solving this problem requires that continuous and resolute
action be taken, and all sectors must cooperate. If this is
done, this problem should become manageable for society.
[passage omitted]

AIDS Control and Prevention Priority

BK0205022692 Bangkok BANGKOK POST in English
2 May 92 pp 1, 3

{Excerpt] The Suchinda Government has vowed to support
and promote press freedom and to make bureaucrats more
receptive to public opinion.

A government policy statement, to be delivered by the
Prime Minister to Parliament next Wednesday, also prom-
ises to encourage the development by the private sector of
commercial tree farms and public participation in the
conservation of natural resources.

AIDS control and prevention are regarded as a priority but
publicity must not be such as to jeopardise the tourism
industry.



6 EAST ASIA

SOUTH KOREA

Seven People Test HIV-Positive in June

'SK3006050892 Seoul YONHAP in English 0255 GMT
30 Jun 92

[Text] Seoul, June 30 (YONHAP}—Seven people tested
positive for the virus that causes AIDS in June, the Health
and Social Affairs Ministry said Tuesday.

A 26-year-old factory worker and a 29-year-old bar
employee were infected with the human immunodeficiency
virus overseas, and a 22- year-old was infected in Korea, all
three through unprotected heterosexual contacts.

Three people, aged 40, 28, and 30, were infected through
homosexual contacts, and the method of infection of the
remaining person (age 41) is unknown.

Koreans who have tested HIV-positive now total 202, of
whom 18 have died (including eight full-blown AIDS
patients). One person has departed overseas, leaving 183
people (166 men, 17 women) alive and under the supervi-
sion of health authorities.

MALAYSIA

End of May, 3,371 HIV Cases Detected; 37 Dead

BK0407092392 Kuala Lumpur NEW STRAITS TIMES
in English 3 Jul 92 p 2

[Excerpts] Kuala Lumpur, Thursday—The Health Ministry
is expected to spend about [Malaysian] $53 million on the
AZT drug for AIDS patients over the next three years, its
minister Datuk Lee Kim Sai said tonight.

AZT or azidothymidine is the world’s first licensed drug
treating AIDS.

Lee said the ministry would require at least [Malaysian]
$200 million to finance anti-AIDS programmes for the
period. [passage omitted]

As at the end of May, there were 3,371 HIV cases with 52
people confirmed as AIDS cases and 37 deaths.

Lee urged all sectors, including community service organi-
sations to play their role in curbing the deadly disease.

“Malaysia is a fast developing country. We need healthy
people to work hand in hand with the government in pursuit
of becoming an industrialised nation by the year 2020,” he
said. [Passage omitte]

Eight More HIV Cases Found in Perlis State

BK1507141492 Kuala Lumpur Radio Malaysia
Network in English 1330 GMT 15 Jul 92

[Text] Eight Perlis fishermen have been found to be carriers
of the HIV virus which causes AIDS. Mentri Besar [Chief
Minister] Dr. Abdul Hamid Pawan Teh said they contracted
the virus through drug abuse. Since 1989 up to last month,
65 cases of HIV carriers had been detected in Perlis,
including 13 this year. Three of them had died.

JPRS-TEP-92-013
July 30 1992

THAILAND

AIDS in Pregnant Women
92WE0436A Bangkok DAO SIAM in Thai 9 Apr 92 p 2

[Excerpt] On 8 April 1992, Dr. Wanlop Thainua, the chief
doctor with the Health Department, presided at the opening
of a seminar on “Revising the Manuals Used in Preventing
the Spread of AIDS in Obstetrics and Pediatrics and Pro-
viding Recommendations.” Dr. Surasak Thaniphanitsakun,
the head of the Mothers and Children Health Development
Section, Family Health Division, gave a report.

AIDS has now spread to the family system. This shows that
everyone concerned, including the people, must give atten-
tion to controlling this disease so that it does not continue to
spread. Statistics compiled by the Epidemiology Division,
Ministry of Public Health, in 1991 show that in some places
as many as 8.8 percent of the pregnant women there have
the AIDS virus. At least 30 percent of these women will
transmit the virus to their babies through the blood, through
the umbilical cord, through the semen and mucous in the
vagina, or through the mother’s milk. Moreover, those
assisting in the birth or looking after the patient could
contract the disease from them. [passage omitted]

Ministry Organizes Anti-AIDS Effort
92WE0436B Bangkok BAN MUANG in Thai
15 Apr 92 p 5

[Excerpt] [passage omitted] In his capacity as spokesman for
the Ministry of Public Health, Dr. Thira Rammasut, the
deputy under secretary of public health, said that the
ministry is making a greater effort to prevent and control
AIDS. The ministry has organized 12 model provinces
nationwide to take resolute action to prevent and control
AIDS. The 12 provinces are Saraburi, Chonburi, Rayong,
Trat, Chiang Rai, Lampang, Songkhla, Pattani, Phetburi,
Khon Kaen, Ubon Ratchasima, and Nakhon Ratchasima. A
level-10 administrator from the Ministry of Public Health
will be sent to each of these provinces to head the coordi-
nation and support teams in these provinces. Each team will
include a level-9 official and a level 6-7 expert. They will
attend meetings with the provincial AIDS committees,
which are chaired by the provincial governors. They will
also provide full support and coordinate things. Inspectors
from the Ministry of Interior and senior police officers from
the commissioner’s offices and provincial police offices will
periodically be asked to support this work.

Dr. Thira said that this model form in fighting AIDS will
have the support of all units, and it is thought that this will
achieve results in reducing the incidence of AIDS faster than
before. It should also be possible for other provinces to use
this model.

In December 1991, the Ministry of Public Health conducted
the sixth AIDS inspection. This inspection is conducted
every 6 months in particular localities. The inspection
conducted in December showed an improvement as com-
pared with the previous inspection, that is, the inspection
conducted in June 1991. It was found that the incidence of
AIDS declined 3 percent in intravenous drug addicts and 15



SIPRS-TEP-92-013
Tuly 30 1992

Europe the virus began to spread significanly later, but it
may develop here on the same terrifying scale unless we
raise an alarm before it’s too late” Glazovsky believes.

An AIDS case where the virus was transferred by a Polish
citizen has already been registered, the physician said. All
Byelarusian newspapers reported about a lying-in woman in
Vitebsk who got the virus from a boyfriend from the
neighboring Smolensk region. Byelarus is the first CIS
country to register AIDS cases among drug addicts. “We are
deeply concerned with the problem of surveying drug

CENTRAL EURASIA 27

addicts, for the disease spreads among them with a speed of
lightning,” Glazovsky pointed out. “However, over 800
drug addicts registered in the republic avoid medical exam-
ination.” he said.

Glazovsky added that he hopes an interdepartmental AIDS-
prevention committee and a coordination center will be
created within the CIS to restore ties between physicians
that were broken when the former Soviet republics gained
sovereignty.



26 CENTRAL EURASIA

mysterious illness which had frightened us so deeply virtu-
ally affixed a seal of secrecy and special importance upon
the AIDS services themselves as well. Transgression upon
their authority and information was viewed as something
verging on blasphemy.

The patient was put in isolation. He was told of the infection
they discovered, and although he had no manifestations of
AIDS, not every he-man will accept such a sentence without
losing his head. Now, much depended on himself alone: He
had to remember his last years of life, and the people with
whom he had contact. An experienced venerologist was
invited in for this confidential interview. But what was
needed was a liberal physician-psychologist acquainted with
the homosexual milieu and knowing how to approach a
patient. There was no such person at the AIDS center. The
job of revealing people in the risk group that had to be tested
on priority was turned over wholly and completely to the
militia. They came back with information on persons regis-
tered with them—three prostitutes. Good contacts were not
established from the very beginning with the militia, and
AIDS specialists are not making any effort at all to work in
some other way with drug addicts, homosexuals and prosti-
tutes. All of this is dangerous, “dirty work,” and the entire
center is made up of office workers. They monitor the
laboratories, explain AIDS to other physicians, from time to
time they examine the disease histories in hospitals, and
they write reports. It may be possible that people of an
entirely different kind are needed to go into the crowd, and
even into an environment in which AIDS may actually be
Present.

That injured patient admitted almost right away that he had
been a voluntary blood donor three or four times. This was
a most dangerous situation, since the chance of infection of
a blood recipient is practically 100 percent with blood
transfusion. But when the donor himself had been infected
could not be established. Epidemiologists began tracing the
path taken by all of the blood. At the transfusion station it
underwent the required testing, and was processed into
specific preparations. A few liters were discarded, but the
list of donors was not to be found. In another case plasma
was sent to a maternity hospital, but the woman in child-
birth was given two containers from another donor, and the
third was not needed. Finally, the last blood donation in
November 1989. The plasma was transfused to a seriously
ill patient in neurosurgery. He was still alive, and tests
revealed that he was not infected. Consequently the donor
was also healthy at least until the end of 1989.

So what was there that had to be so carefully concealed?

In the meantime you can imagine the kind of conjectures
and suppositions regarding AIDS that I heard from medical
personne! who somehow came to know certain things in
roundabout ways. You can imagine what people riding the
buses are saying! Could it be that such commotion, fear and
ignorance are very much to someone’s benefit? After all,
AIDS research has turned out to be a good life for retrained

IJPRS-TEP-92-013
July 30 1992

physicians. The work is not dirty or demanding. As we
know, AIDS is incurable, which is why doctors are so
completely unruffled!

By the Way
We were barred from the meeting.

“The main demand of the participants was that there would
be no one from the press,” explained Gennadiy Roshchup-
kin, one of the organizers of the constituent meeting of a
Russian voluntary benevolent society in support of the
national AIDS program “We and You.”

Of the 30 persons who convened in the Russian academy’s
administration building last Saturday, 15 were undergoing
treatment at Pokrovskiy Center. They are still trying to live
unnoticed, separating the world into the sick and the
healthy, and they expect nothing good from society: In the
words of one of the participants of the meeting, last year the
number of conflicts arising out of AIDS nearly doubled.

“People are being fired as soon as it becomes known that
they are sick, and they are being put out of their apartments.
Despite the loud pronouncements of officials from the
Ministry of Health, the state continues to give the appear-
ance that the AIDS problem simply doesn’t exist in the
country,” he said.

The founders of the “We and You” Society include the
newspaper SPID-INFO, the journal ZDOROVYE, Authors’
Television, and Roman Viktyuk’s theater.

“Our main goal is to defend the rights of HIV carriers,” said
Gennadiy Roshchupkin. “That means political, civil and
economic rights. We will simply try to demonstrate to
people that the ill can also be of service to society.”

Government Reports 7 Cases of AIDS

OW 1606224792 Moscow INTERFAX in English
1930 GMT 16 Jun 92

[Following item transmitted via KYODO]

{Text] The Republican AIDS Prevention Center reported
that 7 residents infected with HIV have been registered in
Uzbekistan.

HIV also has been revealed in 16 foreign students who study
in the republic.

Sharp Increase in AIDS Forecast for Byelarus

LD2606220892 Moscow ITAR-TASS in English
0747 GMT 26 Jun 92

[Article by BELTA correspondent Lidia Peresypkina—
TASS]

[Text] Minsk, June 26—Byelarusian physicians forecast a
sharp increase of HIV disease rate in the current and next
years due to the removal of “the iron curtain” from the CIS
borders. “However, it appears that there is no reason to
panic. So far, there have been only 79 HIV-positive people
registered in the republic. Only two people died from the
disease.” Head physician of the anti-AIDS center Victor
Glazovsky said. “There are 70,000 AIDS cases and 2
million HIV-positive people in Western Europe. In Eastern



IJPRS-TEP-92-013
July 30 1992

the total number of cases. The Orange Free State, with a
figure of 88, has the lowest number of reported AIDS cases.

Since the beginning of this year up to June, 446 AIDS-
related deaths had occurred in South Africa, while 210 new
patients had been diagnosed. The deaths represented “only
part” of the actual number of AIDS-related deaths as many
patients never returned after their diagnosis, the department
said.

The Department of National Health and Population Devel-
opment was currently increasing the distribution of con-
doms countrywide to combat the disease. In addition, the
department had allocated R{rand]3.6-million to sexually
transmitted diseases (STDS) for this financial year over and
above the AIDS budget of R21-million.

ZAMBIA

Number of AIDS Babies, Orphans Increasing

92WE0555A Lusaka THE WEEKLY POST in English
22-28 May 92 p 8

[Article by Patu Mwanza; first paragraph is THE WEEKLY
POST introduction]

[Text] The number of orphans in Zambia is on the increase
mainly because of AIDS. There were 80,000 orphans in
1990, but this number is expected to reach half a million by
the year 2,000 reports Patu Mwanza.

Two years ago, a Lusaka mother who thought she had given
birth to an HIV positive baby, threw it into a fire to kill it.

As the baby’s skin scorched, the mother hard heartedly
walked away thinking she had done away with it.

Fortunately for this baby, it was rescued and taken to the
University Teaching Hospital, UTH, where it was truly
diagnosed HIV positive. The hospital looked after this baby
for sometime, and later, its mother’s relatives.

The story of this baby, is similar to that of many others.
According to Dr. Shilalukey Ngoma, a Pediatrician con-
sultant at the UTH, the number of dumped babies is
growing rapidly and so is the number of AIDS orphans.

She said there were 80,000 orphans in the country in 1990
but the number is expected to reach half a million by the
year 2000.

Dr. Ngoma says children, particularly those suspected to be
HIV positive, have been banished by their mothers at an
average of two per month. The majority of these children
are those left behind in the hospital by their worried
mothers after they have been discovered to be HIV positive.

It is the increasing number of orphans, mainly because of
AIDS, that prompted medical professionals to form what is
now called the Children in Distress, (CINDI).

Like the National AIDS Support Organisation in Uganda,
CINDI which is being funded by NORAD, Family Health
Trust and UNICEF, motivates people in recognising
orphans with the aim of helping them with whatever they
may need in their daily life.

SUB-SAHARAN AFRICA 3

Although CINDI operates as a non-governmental organisa-
tion with the help of the Ministry of Health, its officials
believe other government ministries should come in if the
organisation has to achieve its intended goals.

With stunning revelation made at a recent AIDS seminar
that 25 percent of women between 15 and 35 which is the
child bearing age are HIV positive, CINDI and orphanages
like Kasisi mission that take in these children are certainly
needed,

Already, according to Dr. Chewe Luo, a senior registrar in
the department of pediatrics and child health care, a study
among the malnourished children in the country showed
that 21 percent were infected with the virus, while 32
percent of those infected with TB are also HIV positive.

This is an indication that the number of AIDS babies is on
the increase and so too is the number of AIDS orphans with
many AIDS babies now being abandoned by their parents.

ZIMBABWE

AIDS Spreading; Condom Distribution Grows
92WE0502A Harare THE HERALD in English
1 May 92 p1

[Text] As the AIDS epidemic rapidly gains momentum with
many people experiencing the unprecedented realities of the
disease, there has been an increased demand for condoms
by Zimbabweans, with almost 20.5 million having been
distributed in 1990 and over 24 million last year.

An annual report of the AIDS Control Programme in
Zimbabwe for 1991 said an increasing number of AIDS
cases and deaths occurred last year while at the same time
awareness campaigns were intensified, resulting in the
denial of the existence of AIDS among the public becoming
less pronounced than before.

Several groups or organisations including the AIDS Control
Programme unit were involved in AIDS education, counsel-
ling and care and the broadening of AIDS prevention and
control activities.

“Besides focusing on education and awareness for the
general public and target groups, training of health care
providers in various aspects of AIDS prevention and control
was one of the priority areas of the programme,” the report
said.

The programme was fully supported by the international
community which provided funds for many of its activities.

According to the report: “There has been an upward trend
in the demand for condoms, with 20,489,500 having been
distributed in 1990 and 24,215,328 in 1991.”

However, the report said sentinel surveillance among ante-
natal attendants and patients with sexually transmitted
diseases showed “very high HIV seroprevalence rates.”

Meanwhile, the number of cumulative reported full-blown
AIDS cases rose from 117 in 1987 to 10,551 by the end of
last year.



SJPRS-TEP-92-013
July 30 1992

Slightly more than 58 percent of the 9,247 AIDS cases are
concentrated in the Federal District and Jalisco and Mexico
States, in that order. In the capital, 3,137 cases have been
reported.

Campeche has reported the fewest AIDS cases: 20 between
1981 and 1992. States reporting approximately 30 AIDS
cases during that period are: Aguascalientes, Baja California
Sur, Colima, Hidalgo, Queretaro, Quintana Roo, Tabasco,
Zacatecas, and Chiapas. In Chiapas, not a single case had
yet been reported in 1992 as of mid-March.

According to the Ssa epidemiologists, the increase in cases
“remains exponential, but of a reduced type.” An indicator
that people are being more careful about avoiding the risks
of infection is that sexually transmitted diseases have
declined in recent years.

As an example, during the first two months of 1991 3,453
cases of gonococcal infections were reported, but during the
same period of 1992 only 1,209 cases were reported. Only
208 cases of syphilis have been reported to the SSa’s
Epidemiology Division.

These statistics only include notifications made by public
health institutions, but they do reflect trends to some extent.

Puebla is another state with a large number of AIDS cases
reported during the last 11 years: 431. As of mid-March
1992, it was second after the Federal District in the number
of new AIDS cases reported during 1992. Forty-four cases of
AIDS have been reported.

In Puebla there was a large increase in cases in relation to
the first 10 weeks of 1991. Puebla was the only state in
Mexico with a significant rise in reported cases of AIDS.

The SSa epidemiologists believe there is still a substantial
backlog in timely reporting of new AIDS cases.

Mexico is the third country in terms of AIDS cases in the
Americas, following the United States and Brazil.
Throughout the Americas, 250,623 AIDS cases have been
reported since 1981. In terms of the rate of prevalence, this
means that for every 1 million persons, 357 are HIV-
Positive. The indicator for Mexico is 119 for every | million
Persons.

The rate of new cases is comparable to the cumulative
incidence between 1983 and 1986. The rate of infection
continues to rise among women, though since 1981, 85.2
percent of the total AIDS cases reported have been in men.

The report estimates that six times more men than women
are infected.

Sexual transmission accounts for 87.1 percent of the cases.
“There is stability” in the rates of homosexually transmitted
AIDS cases, a decline in the rate of bisexual transmission,
but an increase in heterosexually transmitted AIDS cases.

By mid-March, 358 new cases of AIDS had been reported
during 1992. Twenty-four of these cases were children.
Eleven of these children were infected perinatally; six by
hemophilia; three by blood transfusions; two by hetero-
sexual relations, and in two cases the mode of transmission
is unknown.

LATIN AMERICA 17

Of the 334 remaining cases, 100 were male homosexuals; 99
were heterosexuals; 62 were male bisexuals; 43 had received
blood transfusions; six had contracted the virus from blood
donations; six were homosexual intravenous drug users;
four were hemophiliacs, and in 15 cases the manner of HIV
infection is unknown.

INDRE Figures Provided

92WE0475B Mexico City PROCESO in Spanish
No 806, 13 Apr 92 pp 44-47

[Report by Lucia Luna]

[Text] The first case of a patient infected by the HIV virus
was officially reported in Mexico 11 years ago. Today AIDS
has taken root in our country, and both present and future
generations will have to learn to live—or die—with it.

This disease, which is transmitted by blood or sexual
contact, was initially found in specific groups, labeled
high-risk groups. Now it has begun to spread to other sectors
of the population. Overcrowded hospitals, underfunding of
the National Health System, ruined families, a decimated
generation—not to mention the human tragedy—is the
scenario we can expect during the coming years.

Sexual irresponsibility and ignorance are the principal
vehicle: for the spread of AIDS. Only information and
education can counter these problems. It is a race against
time, and a great many obstacles lie ahead.

The Conasida [National Council for AIDS Prevention and
Control}, which was started as a committee set up by the SSa
in 1986, is now preparing for this race. In 1988 Conasida
was transformed into a council because of the need for a
normative and operational entity to implement policies to
cope with this new disease.

Financed originally with funds from the National Epidemi-
ology Division plus international funds and donations,
Conasida grew in a few years from a group of people to a
complex bureaucratic structure with a regular staff. Last
year its federal budget was 10 billion pesos.

Its central offices bustle with activity. The telephones ring
incessantly. Doctors, researchers, government officials,
reporters, and students are constantly contacting the office
to obtain information or to discuss AIDS-related issues.

According to official statistics prepared by the INDRE
[National Epidemiological Diagnostic and Reference Insti-
tute], whose director, Dr. Jose Luis Valdespino, is also
coordinator of Conasida’s Epidemiology Committee, as of
31 January a cumulative total of 9,239 AIDS cases had been
reported in Mexico.

The somewhat questionable accuracy of these statistics
comes from the reports themselves. AIDS has officially been
added to the list of diseases for which epidemiological
monitoring is maintained and immediate notification is
mandatory, in accordance with Articles 134 and 136 of the
General Health Law. However, it has been found that the
vast majority of cases are reported after delays ranging from
six months to five years. On the average, the delay is at least
two years.



SJPRS-TEP-92-013
Tuly 30 1992

India was not true, Union Health Minister M.L. Fotedar
said in the Rajya Sabha today.

Answering Congress member K-K. Birla’s question, Mr.
Fotedar said the Government would consider making man-
datory for all blood banks and hospitals in the country to
test for AIDS virus (HIV positive) before blood transfusion
was undertaken.

During question hour, Mr. Fotedar told members that, at
present, there were only guidelines issued by the Centre to
all State Governments in this regard and all hospitals and
blood banks were expected to follow them strictly.

In Mr. Fotedar’s opinion blood transfusion would have
greater chances of spreading AIDS “than sexual promiscu-
ity”. Two out of every thousand people stood a chance of
contracting the AIDS virus through the sexual route whereas
1,000 out of every 10,000 people receiving contaminated
blood through transfusion could get the AIDS virus, he
pointed out.

Tt was not true that there could be an “AIDS holocaust” in
India as claimed by the WHO and reported in a Delhi daily,
the health Minister claimed.

In 1985-86, he said there was only one single case of AIDS
but today the number of AIDS cases in India was 194 and
8,000 people had tested HIV positive.

At the same time, he said, the Government was seized of the
situation and fully recognised the dangerous potential and
that a series of steps had been taken to check the spread of
the AIDS disease.

Safety of blood and blood products had been improved by
strengthening and modernisation of blood banks. Out of a
total of 608 blood banks, 138 had been fully equipped for
observing the prescribed procedure laid down in the drugs
and cosmetics rules including screening of blood for HIV
infection, the Minister said.

According to him, the rules for regulating the working of
blood banks and screening of every unit of blood for HIV
infection had been notified in the rules framed under the
Drugs and Cosmetics Act of 1940. The Drugs Controller of
India had also instructed the manufacturers of blood prod-
ucts to comply with the guidelines on this regard.

To further tighten the enforcement of the guidelines Mr.
Fotedar said, the Government was taking steps to make the
approval of the drug, controller for licensing of blood and
blood products mandatory.

NEAR EAST & SOUTH ASIA 23

ISRAEL

Health Ministry’s Low AIDS Data Said
‘Misleading’

TA0907160792 Tel Aviv HADASHOT in Hebrew

9 Jul 92 p 12

[Report by ’Adi Katz}

[Excerpts] “The statement of Health Ministry Director
General Shlomo Mashiah that last year only two AIDS cases
were recorded in Israel was dishonest and misleading. The
rate of people contracting AIDS in Israel is high, almost as
high as in Western Europe,” said Serge Diehas, a spokesman
for the Anti-AIDS Society, in reaction yesterday to Mash-
iah’s statement that the Israeli rate of AIDS transmission
was one of the lowest in the Western world. [passage
omitted]

“While the situation in Israel is on the brink of a catas-
trophe, Mashiah continues deceiving the public and con-
cealing the appalling truth. The number of carriers is steeply
rising in Israel. Last year, the number of carriers was 300
percent higher than that in the preceding year. The number
of people who contracted the disease in the first five months
of 1992 is equal to the total figure for all of 1990.” [passage
omitted]

Diehas added: “The Health Ministry’s poorly conducted
anti-AIDS campaign and the lack of investment in it are
directly responsible for the transmission of the disease and
for the victims’ suffering and death.”

PAKISTAN
Minister Says AIDS Situation Not Alarming; 130
Cases

BK0106142692 Islamabad PTV Television Network
in English 1400 GMT I Jun 92

{Text] A national seminar on AIDS began in Islamabad
today. Inaugurating the seminar, the federeal health min-
ister, Syed Tasnim Nawaz Gardezi, said the situation of
AIDS in the country is far from alarming. He said there has
been a total of 130 HIV positive cases officially notified and
this might be under reporting. The situation is not, however,
grave as compared to some neighboring countries. He said
this does not mean that we should become complacent and
shut our eyes to the impending danger. The minister said
this attitude was adopted in India and Thailand and today
they are facing very serious problems. The minister said we
must try to keep our country as free from AIDS as possible.
There is no treatment available for AIDS and the problem
could only be overcome through health education.



SJPRS-TEP-92-013
30 July 1992 3 AIDS
HONDURAS
AIDS Cases Total 2,888 Nationwide /San Pedro Sula TIEMPO, 6 Jun 92]
MEXICO
Varying Estimates of HIV Infection Noted
Health Secretariat Epidemiologists Cit
[Luis Alberto Rodriguez; Mexico City LA JORNADA, 17 Apr 92]
INDRE Figures Provided /Lucia Luna; Mexico City PROCESO, 13 Apr 92]
NEAR EAST & SOUTH ASIA
BANGLADESH
Nine AIDS Carriers Identified Through 31 May {Dhaka Radio Bangladesh Network, 8 Jul 92] .... 21
INDIA
Official Reports on AIDS Cases in Delhi . /New Delhi PATRIOT, 21 Apr 92]
Difficulties in Fight Against AIDS. .....
Problems of Reporting /Usha Rai; Madras INDIAN EXPRESS, 15 May 92]
Effect on Country’s Development {Madras INDIAN EXPRESS, 15 May 92]
Minister Briefs Parliament on Anti-AIDS Mesaures [Delhi All India Radio Network, 15 Jul 92] ... 22
Minister Denies WHO's Claim of ‘AIDS Holocaust’
[Delhi THE HINDUSTAN TIMES, 16 Jul 92]
ISRAEL

Health Ministry’s Low AIDS Data Said ‘Misleading’
['Adi Katz; Tel Aviv HADASHOT, 9 Jul 92]

PAKISTAN

. 23

Minister Says AIDS Situation Not Alarming; 130 Cases
[Islamabad PTV Television Network, 1 Jun 92] ...

CENTRAL EURASIA

. 23

Saint Petersburg AIDS Service Controversy

[Andrey Kozlov, Aza Rakhmanova, et al.; Saint Petersburg NEVSKOYE VREMYA, 20 Mar 92]
AIDS Case in Khabarovsk {Moscow KOMSOMOLSKAYA PRAVDA, 28 Apr 92]
Government Reports 7 Cases of AIDS [Moscow INTERFAX, 16 Jun 92] ......
Sharp Increase in AIDS Forecast for Byelarus Lidia Peresypkina; Moscow ITAR-TASS, 26 Jun 92]

WEST EUROPE
DENMARK

Poll Results Show Condom Campaign Successful
[Henrik Dannemand; Copenhagen BERLINGSKE TIDENDE, 22 Jun 92] .....

FRANCE

. 28

AIDS Awareness Is Increasing Among Young
[Stephane Dax; Paris LE QUOTIDIEN DE PARIS, 25 Jun 92] ....
Increased Use of Personal Needles [Paris LIBERATION, 26 Jun 92]



10 EAST EUROPE

ALBANIA

Programs for AIDS Detection, Prevention

92P20289 Tirana BASHKIMI in Albanian
5 Mar 92 p3

[Interview with Yli Savolli, director of the Directorate of
Hygiene, deputy chairman of the National Commission for
Combatting AIDS; place and date not given: “In Response
to the Question: ‘Is There AIDS in Albania?”]

[Text] BASHKIMI reporter: For a long time, the “news” has
been circulating that there have been cases of AIDS in our
country. What is the true story?

Savolli: According to our data, so far, among the persons
tested, no HIV [Human Immunodeficiency Virus]-positive
person, that is, no carrier of the AIDS virus has been
identified in Albania. Some 8,000 persons with a high risk of
infection have been tested since 1988 when the laboratory
for the diagnosis of AIDS was set up in the Institute of
Hygiene and the sero-epidemiological study of the disease
began. However, these data are not valid proof that we do
not have AIDS in our country. On the one hand, the small
number of people tested because of the lack of diagnostic
kits and the imperfect structure which we have for combat-
ting and preventing the disease and, on the other hand, the
increase in the number of persons at risk affect the value of
these data. With this in mind, the National Commission for
Combatting AIDS, which is headed by the minister of
health, evaluated the situation and, in its most recent
meeting, concluded that Albania is in immediate danger of
the entry of AIDS into the country and perhaps the virus has
already arrived. For this reason, it would be desirable for us
to detect a case through testing in order to sensitize public
opinion.

BASHKIMI reporter: What experience have we had in
preventing the spread of the virus?

Savolli: The period from 1984 to 1987 was a time for
learning about the disease and training the first specialists
by means of short specialization courses, mainly in Paris. In
1987, the National Commission for Studying, Preventing,
and Combatting AIDS was established and the first program
for combatting AIDS was drawn up. In 1988, a laboratory
for the diagnosis of AIDS was set up in the Institute of
Hygiene. In 1989, the second program, for the 1989-1990
period, was drawn up. The World Health Organization
[WHO] provided 150,000 dollars to finance the establish-
ment of the laboratory in the Institute of Hygiene and
Epidemiology, short-term specialization courses for cadres,
and teaching materials and equipment, etc. For the 1990-
1993 period, a medium-term program has been drawn up
which will also be implemented with WHO assistance. For
this program, WHO will give us about 800,000 dollars in
assistance.

BASHKIMI reporter: Do you think that the implementa-
tion of this program will protect our country from the
danger of AIDS?

Savolli: I think that the implementation of the program will
make it possible to create the necessary network and the

IJPRS-TEP-92-013
July 30 1992

essential structure for facing all the problems posed by the
disease. However, AIDS is a disease which is linked to social
causes, to the formation of an individual, to his lifestyle,
morals, etc.

POLAND

Recent Statistics on AIDS Noted, Reviewed

92WE0516A Warsaw SLUZBA ZDROWIA in Polish
No 19, 10 May 92 pp 6-7

[Article by Wanda Szata: “AIDS in Poland and World-
wide”}

[Text] According to the most recent data, in Poland at
present there are 87 people stricken with AIDS, 42 people
who have died of AIDS and 2,074 people who are infected
with AIDS. The first case of someone’s being HIV positive
was diagnosed in Poland in 1985 and the first case of AIDS
was recorded a year later. In the years that followed more
cases were diagnosed: by 31 January 1992, a total of 87 cases
was recorded (1986—1; 1987—2, 1988—2; 1989—24;
1990—21; 1991—35, and January 1992—2). Initially, pri-
marily homosexuals and bisexuals were infected, but since
1989, persons of both sexes who used drugs intravenously
have been infected. Of the fatal cases, 78.6 percent have
been homosexuals and bisexuals.

Among those stricken, men predominate numerically (79
men and 8 women). Except for one woman, who was
infected through heterosexual contact, the women are all
intravenous drug users. Going by decades, the largest
number (29 patients) is from the 30-39 age group.

At the time of the AIDS diagnosis, in most cases (78),
opportunistic infections were occurring. In 5 cases, there
were opportunistic infections and Kaposi sarcoma, and in
individual cases: Kaposi sarcoma, lymphoma, encephalitis,
and the other AIDS-related complexes characteristic of the
progress of an HIV infection.

Of the 87 people infected with AIDS, 42 (48.3 percent) gave
the Warsaw Voivodship as their permanent place of resi-
dence. The rest came from the following places: Radom—S5,
Wroclaw and Zielona Gora—4 each, Bydgoszcz, Gdansk,
Katowice, and Siedlce—3 each, Bielsko and Lodz—2 each
and | each from the other 16 voivodships.

Since 1985, when studies on the presence of anti-HIV
antibodies were initiated, until 31 January 1992, 2,074 cases
of HIV infections were noted among the citizens of our
country (from 1985-1987—52 people, 1988—59 people,
1989—518 people, 1990—809 people, 1991—562 people
and in January 1992—74 people). A marked increase in this
number was noted in 1989. Those affected were primarily
people who used drugs intravenously. Among them the first
HIV infection was diagnosed in Poland in September 1988,
when the number of examinations done among people in
this group was 2,505.

Thus, in subsequent years, the number of infections noted
among those using drugs intravenously was as follows:
1985-1987—0, 1988—12 people, 1989—411 people,
1990—653 people, 1991—402 people and in January



12 LATIN AMERICA

BRAZIL

New System To Track AIDS Incidence

92WE0544A Sao Paulo O ESTADO DE SAO PAULO
in Portuguese 29 Jun 92 p 11

[Report by Daniel Hessel Teich]

[Text] Starting in the latter half of this year, the Ministry of
Health will implement a new epidemiological monitoring
system to track AIDS cases in the 10 Brazilian states that
have the highest incidence of the disease. The new statistical
system, based on serological tests of population groups, will
measure the incidence of asymptomatic carriers among
Brazilians.

“The current figures refer to infections contracted at least
five years ago,” explained the acting coordinator of the
Ministry of Health’s National Division of Sexually-
Transmissible Diseases and AIDS, Celso Ferreira Ramos
Filho. “It is unlikely that the data we have on the epidemic
and its tendency to spread reflect the true situation,” he
said.

Backed by the World Health Organization (WHO), which
supplied some of the $150,000 that will be spent on the
program—the new tracking strategy, dubbed Sentinel, will

SJPRS-TEP-92-013
Suly 30 1992

function alongside the system now used by the ministry and
the state health departments.

Anonymous Testing

In order to reverse the current situation in which the actual
percentage of Brazilians infected by the HIV virus is
unknown, the project is starting with a bold concept: blood
will be drawn at random from part of the population and
tested, but the people whose blood is tested will not learn the
results, nor will the technician who analyzes the samples
have any way to identify their origin.

“These analyses will be done for purely statistical purposes,
and we are not interested in knowing who the samples
belong to,” said Luis Antonio Loures, coordinator of the
Sentinel program and head of the Epidemiological Moni-
toring and Research Support Unit in the Ministry of
Health’s National Division of Sexually Transmitted Dis-
eases and AIDS. The system is described by Loures as
“anonymous, uncorrelated serology.”

Four hundred blood samples will be collected in each of the
ten states. Initially, blood will be drawn from people who
seek treatment for STD’s and women undergoing prenatal
examinations.

8. .ogaritnes scale projection

Growth By Region
Annual Incidence of AIDS in Brazil*
10 os : =
7 it
1_|_1- Cases por 100,000 inhabitants —| ‘
0,1_|_2. Southeast f —
= 4 = S
“23. Sout ‘
0,01 4. West Central bst__ _
1982 83 cy 8s 86 87 88 89 90 1991

ic acti
‘Source: National Division of Sexually Transmitted Diseases and AIDS, Ministry of Health



SJPRS-TEP-92-013
30 July 1992 2 AIDS

MALAYSIA

End of May, 3,371 HIV Cases Detected; 37 Dead
[Kuala Lumpur NEW STRAITS TIMES, 3 Jul 92].
Eight More HIV Cases Found in Perlis State
[Kuala Lumpur Radio Malaysia Network, 15 Jul 92]

THAILAND

AIDS in Pregnant Women [Bangkok DAO SIAM, 9 Apr 92]
Ministry Organizes Anti-AIDS Effort {Bangkok BAN MUANG, {p)
Researchers on Prostitute Demographics, Views, AIDS [Bangkok THAI RAT,
AIDS Control and Prevention Priority {Bangkok BANGKOK POST, 2 May 92] _....
AIDS Carrier Allowed Entry, Regulations Changed [Bangkok SIAM RAT, 13 May 92]
Paper Reports Death Toll From AIDS in North [Bangkok BANGKOK POST, 4 Jun 92] ..
Total of 1,234 AIDS Patients Reported After Middle of May

[Bangkok Radio Thailand Network, 15 Jul 92] .....
Official Says 70 Percent of AIDS Victims in Rural Areas

[Bangkok BANGKOK POST, 20 Jul 92] .

0 © WMOIIAD

VIETNAM

Total of 58 Affected With AIDS [Hanoi VNA, 29 Apr 92]
Medical Institute—No HIV Positive Cases Found in Hanoi [Hanoi VNA, 10 Jul 92]

EAST EUROPE
ALBANIA
Programs for AIDS Detection, Prevention /Tirana BASHKIMI, 5 Mar 92] .....
POLAND

Recent Statistics on AIDS Noted, Reviewed
[Wanda Szata; Warsaw SLUZBA ZDROWIA, 10 May 92]

LATIN AMERICA
BRAZIL
New System To Track AIDS Incidence
[Daniel Hessel Teich; Sao Paulo O ESTADO DE SAO PAULO, 29 Jun 92) .....
Government, WHO Sign Agreement on AIDS Research
[Brasilia Voz do Brasil Network, 10 Jul 92]

COLOMBIA

AIDS Statistics Given, Programs Described
[Gilda Sarmiento; Santa Fe de Bogota EL ESPECTADOR, 19 Apr 92] ...

CUBA

Current AIDS Situation Discussed at Seminar /Havana Radio Reloj Network, 11 Jun 92]
Panel Discusses AIDS Statistics /Havana Cuba Vision Network, 15 Jul 92] .....

GUYANA

Program Director Confirms 258 Cases of AIDS to Date [Bridgetown CANA; I Jun 92]



Wis

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R288 PORT ROYAL RE
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IJPRS-TEP-92-013
July 30 1992

BANGLADESH

Nine AIDS Carriers Identified Through 31 May

BK0807155592 Dhaka Radio Bangladesh Network
in English 1530 GMT 8 Jul 92

[Excerpts] The Jatiya Sangsad [parliament] was informed
during question hour today that students would be admitted
to the proposed Dinajpur Medical College from the 1992-93
academic session. [Passage omitted] The deputy minister
further informed the house that nine AIDS virus carriers
have been identified in Bangladesh up to the 31st of May
this year. [Passage omitted}

INDIA

Official Reports on AIDS Cases in Delhi
92WE0491A New Delhi PATRIOT in English 21 Apr 92
pl

[Article: “16 AIDS Cases in City”]

{Text] Out of 499 persons who tested positive for HIV virus
in the Capital, 16 are full blown cases of AIDS, the dreaded
disease, according to Dr. V. P. Varshney, Director (Health)
of Delhi Administration, reports PTI.

He said some of the persons having AIDS might have died.

He refused to divulge the area in which the AIDS afflicted
persons lived. Reports of an African couple having AIDS
virus came to light early this month when a student of
Jawaharlal Nehru University delivered a baby in the Saf-
darjung Hospital after the father donated blood for his baby
which was found HIV positive.

Dr. Varshney said Delhi Administration has intensified its
programme to educate the people about the incurable dis-
ease for the past two years with a special emphasis on the
city’s red light area.

Difficulties in Fight Against AIDS

Problems of Reporting
92WE0530A Madras INDIAN EXPRESS in English
15 May 92 p9

[Article by Usha Rai. Words in boldface, as published.]

[Text] New Delhi: Two hundred and sixty-eight foreigners
to India, 204 of them students, were found to be HIV
positive since 1987 when the National Programme on AIDS
was launched. But no one knows just how many of them
have actually been deported as very clearly prescribed in the
guidelines issued by the Health Ministry. The number of
full- blown AIDS cases deported from India is 14 and of
these there is a record.

Indians abroad too on being found HIV positive are being
deported back to India. But neither the Health Ministry nor
the Ministry of Home Affairs has any figures of their exact
numbers or into which part of India they have disappeared
after landing on the Indian shores. This is supposed to be
the responsibility of the state health services.

NEAR EAST & SOUTH ASIA a

It was a stray remark by a Health Ministry official dealing
specifically with AIDS that there were a large number of
HIV positive Indians being deported to India from the Gulf
that set this correspondent investigating. The figure men-
tioned was 130. Subsequently the official said there were 22
Indians with AIDS who had been sent back to India. But
there was no trace of them in the files maintained in the
international section and the special AIDS monitoring cell
of the Health Ministry.

After a fortnight of searching through files, three cases were
traced. Two of them, a 23-year-old office boy and a 36-year
wall painter, had been deported to Bombay from Qatar in
August and November 1988. The third case pertained to a
44-year-old bachelor from Kampala, Uganda, who was
deported to Kerala.

But the numbers being deported to India is probably much
higher. With three ministries—External Affairs, Home and
Health—sharing responsibilities, each is passing the buck to
the other. It is indeed a pathetic way to deal with a dreaded
disease for which a whopping Rs. 270 crores has been
provided and foreign aid continues to pour in.

Whatever happened to the HIV positive case of 26-year-old
Sajeevan of Kottuvally village of Aluva near Kochi,
reported in this newspaper three weeks ago. Sajeevan was
probably deported from the Gulf because he was HIV
positive. He and his family are being ostracised by the
ignorant people of the village. Two officials recalled too a
HIV positive case that had been deported to India a few
years ago. The young man was from Kangra. But there
seems to be a lack of coordination between the three
ministries and no truly comprehensive list of the cases being
sent home from various parts of the world. Even the exact
number of foreigners deported is not known.

As per the Health Ministry guidelines “‘on receipt of detailed
information about the AIDS infected foreigner, the Ministry
of Home Affairs will take further action for deportation.
Needless to say, strict confidentiality should be main-
tained.” Surely confidentiality does not mean there should
be no proper record of all these cases.

Information lacking: This does not mean that the AIDS
monitoring cell in the Health Ministry is not doing a good
job. It merely means that all information is not being
provided to it till it actually goes round soliciting it. Though
the visa and residential permit of foreigners found HIV
positive is cancelled, the funds for their deportation are not
readily available. It has to be provided by the embassy, the
students or their parents who are supposed to recall them.
Till then the students will be floating around.

In April of the 1,348,965 persons screened, 7,272 were
sero-positive. There were 116 cases of AIDS of which 103
were Indians and 13 were foreigners.

Out of the 41,315 defence personnel screened between
October 1987 and January 1992 in eight surveillance cen-
tres, 81 cases were found HIV positive. A hundred BSF
[Border Security Force] personnel were also tested and
found to be free of infection. The CRPF [Central Reserve
Police Force] is now going through the tests.



Epidemiology
AIDS

JPRS-TEP-92-013 CONTENTS 30 July 1992
[This EPIDEMIOLOGY report contains only material on AIDS. Other epidemiology topics are covered in a later
issue.]
SUB-SAHARAN AFRICA
MOZAMBIQUE
Health Official Says AIDS Cases Greater Than Reported
[Maputo Radio Mozambique Network, 28 May 92] .....
EEC Supports Program Against Sexually Transmitted Diseases
[Maputo Radio Mozambique Network, 14 Jul 92] ....

NAMIBIA

Six Students Diagnosed HIV Positive [Kate Burling; Windhoek THE NAMIBIAN, 21 May 92]
Cabinet Approves AIDS Control Policy [Windhoek THE NAMIBIAN, 12 Jun 92]

SENEGAL

AIDS Cases Total 648 to Date [Fara Diaw; Dakar LE SOLEIL, 9 Apr 92] ....
SOUTH AFRICA

Six-Fold Increase in Chances of HIV-Positive People Contracting Active Tuberculosis
[Johannesburg SAPA, 3 Apr 92]
Heterosexual Contact Most Important Mode To Transmit AIDS
[Johannesburg SAPA, 23 Jul 92] .....

ZAMBIA

Number of AIDS Babies, Orphans Increasing
[Patu Mwanza; Lusaka THE WEEKLY POST, 22-28 May 92] ....

ZIMBABWE

AIDS Spreading; Condom Distribution Grows [Harare THE HERALD, I May 92] ....
Total of 1,963 New AIDS Cases in First Four Months of 1992
[Harare THE HERALD, 13 May 92]

CHINA

AIDS Drug Development Center Established in Lianyungang
[Liu Bo, Chen Jianjun; Nanjiang JIANGSU KEJI BAO, 3 May 92]
Over 700 HIV-Infected Persons Discovered by End of 1991
[Beijing ZHONGGUO XINWEN SHE, 10 Jun 92]
Jilin To Export Anti-AIDS Medicine [Beijing XINH|

EAST ASIA
SOUTH KOREA

un

Seven People Test HIV-Positive in June /Seoul YONHAP, 30 Jun 92]



SIPRS-TEP-92-013
Tuly 30 1992

Since the survey could not ask many detailed questions
concerning sexual behavior, the responses to this question
give only an indication of changes in behavior.

Thus, one out of five (20 percent) have changed their
behavior and, as indicated, the campaign has had the
greatest influence on young people. Almost half (44 percent)
answered in the affirmative. This is seen as being related to
the fact that single people, most of whom are young, have
changed their behavior to a greater extent that those who are
not single.

Thus, in conclusion, we may say that the campaign for
condoms has been extremely effective at informing the
people and at least somewhat effective at influencing the
groups in which the need is believed to be greatest.

FRANCE

AIDS Awareness Is Increasing Among Young

92WE0542C Paris LE QUOTIDIEN DE PARIS
in French 25 Jun 92 p7

[Article by Stephane Dax: “Adolescents Aware of AIDS
Threat”)

[Excerpt] According to a recent opinion survey, the sexual
behavior of 13 to 18 year olds—romantic and modest in
many ways—has changed to take into account the dangers
posed by this scourge.

The word is starting to get out. We can rest easier. “They”
will not be the ones who spread AIDS, “they” being the 13
to 18 year olds surveyed by ABC+ for EVENEMENT DU
JEUDI and SCIENCE ET VIE JUNIOR. And we learn with
a certain satisfaction that they are not indifferent to AIDS
and that condoms are no longer the unmentionable subject
they were in the past. The proof: 64.5 percent of boys and
61.5 percent of girls say they use one whenever they make
love. Some 23.5 percent of boys and 31.5 percent of girls
believe this precaution is necessary only in the beginning,
not in a steady, more permanent relationship. But only 7.5
percent [of boys] and 3.5 percent [of girls] still think “it’s not
worth the trouble when you trust your partner.”

Three out of four youths have held a rubber in their hands.
Which does not mean they do the buying themselves. Some
55.5 percent of boys and 85.5 percent of girls admit they
have never purchased condoms. Instead, condoms are pro-
cured by more devious means. Not only because of embar-
rassment, but because of the difficulty of finding them in
certain locales and, above all, the cost, which is more than
many adolescents can afford. {passage omitted]

Increased Use of Personal Needles

92WE0542A Paris LIBERATION in French
26 Jun 92 p 31

{Article by F.Dt.: “AIDS: Needles No Longer Being
Shared”]

[Text] According to a study, drug addicts now routinely go to
the pharmacy to buy personal needles for injecting drugs.

WEST EUROPE 29

In the five years since February 1987, when syringe sales
were decontrolled, heroin addicts have clearly modified
their behavior in the face of the AIDS epidemic. According
toa study financed by the National Agency for Research on
AIDS, non-sharing of syringes—which are vectors of infec-
tion for the HIV virus—has become so commonplace that
the drug addict has become “just another customer” for
most pharmacists.

In the study, 95 percent of drug addicts questioned say they
buy their own needles at the pharmacy. Needle-sharing thus
seems to be the exception (mainly practiced by couples), and
pharmacists have become accustomed to dispensing
syringes. In Paris, out of 30 dispensaries visited, only two
refused to sell syringes (which are priced between 2.50 and
10 French francs). Thus, “drug addicts as a risk-group
appear to have changed their behavior patterns very quickly
in order to reduce the chances of contracting the virus, at
least through infected blood.”

Thus, sexual behavior is now more than ever the leading
means of the malady’s transmission. The study shows an
increase in the use of condoms (45 percent, compared to 22
percent in 1987-1988), but primarily among HIV-positive
subjects (43 percent utilization, compared to 16 percent for
HIV-negatives). It also notes a very low prevalence of HIV
among drug addicts who have been using heroin for less
than 5 years (3 percent), although the percentage may be
distorted by the fact that young heroin addicts are also the
most reluctant to take the HIV test and the least likely to use
condoms. “It is certainly the most problematic group with
regard to the transmission of HIV. To varying degrees, they
exhibit the desire ‘not to know’ (...) Among this group, AIDS
is less likely to be perceived as an illness like any other—
cancer, for example—than as a more fearsome malady like
the plague.” The study concludes: “Word has gotten out,
needle-sharing is no longer commonplace, the use of con-
doms has increased somewhat. But maintaining and rein-
forcing these new habits will require a more adequate
sanitary environment.”

IRELAND

AIDS Deaths Reported To Rise by 20 Percent
92WE0492A Dublin IRISH INDEPENDENT
in English 22 Apr 92 p 3

[Article by Tom Reddy: “AIDS Death Rate Warning”]

[Text] A new initiative to combat AIDS was demanded last
night as new figures showed an increase in deaths related to
the disease.

The number of deaths from the syndrome in the twelve
month period to the beginning of April this year has
increased by 20 on the same period last year.

The number of AIDS cases in Ireland has increased by 60

percent among heterosexuals, and 30 percent among homo-
sexuals in the past twelve months.

The number of intravenous drug users who have developed
AIDS has increased by 46 percent bringing the total number
of AIDS cases to 266, the AIDS help group AIDSWISE said
last night.



24 CENTRAL EURASIA

Saint Petersburg AIDS Service Controversy
92WE0471IC Saint Petersburg NEVSKOYE VREMYA
in Russian 20 Mar 92 p 2

[Article by Andrey Kozlov, director of the Bruce Rappaport
Biomedical Center, Aza Rakhmanova, professor, chief
infection specialist for Saint Petersburg; Galina Volkova,
director of the department of especially dangerous infec-
tions of the State Epidemiological Station: “AIDS—A Chal-
lenge to Our Reason”]

[Text] Last year twice the number of HIV carriers were
revealed in our city than in the previous year. The Ameri-
cans found themselves facing such a prugression in the early
1980s. If the epidemic maintains such explosive, avalanche
behavior, this will be a truly serious danger to the city. Is it
ready to deal with the possible unfavorable development of
events? It will be, if scientists, medical personnel, politicians
and public officials are able to stand together on a unified
front.

This is the way things were until recently. As a result, an
entire service was established practically out of nothing to
fight AIDS. And the fact that new cases of infection are
continually being revealed is the best evidence of the effec-
tiveness of laboratory screening. But the organizational
problems of this service have now been the object of heated
debates for several months between the city soviet’s medical
support commission and the mayor’s corresponding com-
mittee; these debates have also spilled over into the news-
Papers.

The layman may gain the impression that irresponsible
executives of the city health department and the AIDS
service are doing everything to destroy this service and leave
the city defenseless against the advancing epidemic. But in
the opinion of the specialists, these discussions and debates
are absurd, because the real problems of the entire service
are being substituted by the problems of just one of its
subdivisions—the AIDS prevention and control center.

Without boring the readers with the technical details, we
will try to explain what this service is. The efforts of several
public health institutes and practical institutions were suc-
cessfully united to solve this highly complex problem from
the very beginning. These included the State Institute for the
Advanced Training of Physicians, the All-Union Scientific
Research Institute of Especially Pure Preparations, the city
epidemiological station, the Hospital imeni Botkin, the
Military Medical Academy, the Institute of Epidemiology
and Microbiology imeni Pasteur, and the plague control
station. An infection surveillance service, a consulting and
diagnostic office that was later transformed into a poly-
clinic, a hospital department, 15 screening laboratories and
an expert laboratory were also established through joint
effort. And all of this in extremely short time, with min-
imum staff and financing! It must be said that our city’s
AIDS service was one of the first to be created in the
country, and in many respects it became an example for
organizing similar structures in other regions.

What kind of people come here? Primarily, of course, the
victims of AIDS—virus carriers who do not exhibit disease
symptoms for a certain while, and patients needing medical

SIPRS-TEP-92-013
Tuly 30 1992

care. Both require qualified outpatient or inpatient obser-
vation. Excluding foreigners, there are a little more than 50
such people in Saint Petersburg, of whom only 33 are
permanent residents of the city. All others, thank God, come
here simply because they learned of this “plague” of the
20th century from radio and television reports. And logic
suggests that the AIDS service should have two directions—
therapeutic and preventive. Therapeutic for those who
already need or will soon require specialized care. There is a
hospital for them—the Infection Hospital imeni Botkin
with its huge laboratory and diagnostic service, polyclinic,
day hospital and patient support service. The hospital,
which will soon celebrate its 110th anniversary, is famous
for its personnel and traditions. The first laboratories, an
anonymous testing office, a polyclinic and a hospital for
HIV-positive people were created within it.

The preventive direction concerns the over 5 million
healthy citizens of Saint Petersburg, who need to be taught
the elementary measures of AIDS prevention—safe sex.
Differentiated information and training programs need to
be developed. AIDS is a common problem, and prevention
is the main factor in the strategy to fight it. This means, first
of all, education, information on the pathways of the infec-
tion’s transmission, and meticulous work with persons in
the high risk groups. And the task of the AIDS prevention
center established by decision of the Ministry of Health is
primarily to implement these programs.

But the mistake that was made from the very beginning was
that the prevention center was put in charge of the polyclinic
that was to work with infected individuals. Prior to this, the
polyclinic was a structural subdivision of Botkin Hospital.
But G. V. Bogoyavienskiy, the center’s chief physician,
transferred the polyclinic to the building on Gaz Prospect,
where a clinical and diagnostic center for young girls is
located next door to the center, under the same roof. A
strange and unexplainable combination—people infected
with AIDS, drug addicts and prostitutes neighboring with
young girls!

And so, having neither the grounds nor the forces to do so,
the AIDS center attempted to monopolize the entire
problem, placing the service on the brink of disaster. The
relationship between the polyclinic and the hospital was
broken, causing an interruption in the continuity of treat-
ment. Contacts with institutes were broken (remember that
AIDS is a science-intensive problem), and even the proce-
dure of having the final diagnosis made in the expert
laboratory was not always followed. Nor was information on
new cases of infection promptly provided, making it impos-
sible to implement emergency measures to prevent the
spread of infection.

And most importantly, the prevention center did nothing in
the way of prevention. This is why it became necessary to
reorganize the AIDS center, to return patients to Botkin
Hospital and to reorient the center’s activity only on pre-
vention.

This is when the center’s associates finally activated their
long-dormant energy. The first reaction was to complain to
the city’s soviet of people’s deputies. Then followed the



8 EAST ASIA

According to Parliament President Ukrit Mongkhonnawin,

Wednesday’s debate on the statement may last until mid-

night.

—On press freedom, the Government says it will support
and promote freedom of the mass media in presenting the
news speedily and in obtaining information accurately.

—On public safety, the Government says it will step up
suppression of all forms of crime, especially illegal logging
and white collar crime. Narcotics producers and traf-
fickers will also be dealt with decisively.

On AIDS, the Government emphasises the need to control
and prevent the spread of AIDS and to improve the treat-
ment of AIDS suffers.

Steps will also be taken to enable HIV carries and AIDS
suffers to function in society normally.

Non-governmental organisations, charities and the public
sector will take part in AIDS control. But AIDS publicity
must be done in a manner that will not affect the tourism
industry. [Passage omitted]

AIDS Carrier Allowed Entry, Regulations
Changed

92WE0500A Bangkok SIAM RAT in Thai

13 May 92 p7

[Excerpt] [passage omitted] The Ministry of Interior
reported that when General Itsaraphong Nunphakdi was the
minister of interior, the ministry issued the 14th regulation
(1992) under the Immigration Act of 1979 which will
rescind the previous regulation in effect from 1986. The new
regulation denies entry into Thailand to foreign lepers or
foreigners suffering at an advanced stage of leprosy, of
elephantiasis, at the third stage of syphilis, alcoholics, and
drug addicts. The regulation lifts the ban on foreigners who
contract AIDS.

The report stated that the new regulation allowing entry to
AIDS carriers has been in effect since 20 February 1991.
The reason for lifting the ban is that circumstances
involving AIDS have changed considerably. Moreover, to
deny AIDS carriers entry is not effective in preventing the
spread of AIDS.

This reporter has inquired at the AIDS Division of the
Ministry of Public Health, about the new regulation and
learned that lifting the ban on the AIDS carriers was the
Public Health Ministry’ s initiative, and that it faced no
objection from the Ministry of Interior.

“After due consideration, the Ministry of Public Health
reasoned that it should avoid discrimination because it is
difficult to determine if the AIDS carriers contract the
disease through sexual contact, sharing needles, or blood
transfusion. Furthermore, there are millions of tourists each
year. We do not have enough personnel to examine them.
Hence, it is better to abolish the previous regulation. The
best method possible at present is to provide the most
information on AIDS prevention to the Thai people. As for
the other diseases that are banned, most of them can be
detected clearly by the naked eye. AIDS, on the contrary,

SPRS-TEP-92-013
Tuly 30 1992

has internal symptoms. When it is really serious, the AIDS
carriers will not make a trip any way. The more important
issue here is that we want to avoid being accused by other
countries on the charge of discrimination against the AIDS
carriers,” the official said.

Paper Reports Death Toll From AIDS in North
BK0406023992 Bangkok BANGKOK POST in English
4 Jun 92 p7

[From the “Horizons” section]

[Text] The dreaded AIDS disease has spread rapidly in this
northern capital claiming a total of 84 lives from 1988-1992,
a Chiang Mai medical specialist revealed recently. She said
the death toll from AIDS would continue to rise as men
continued to indulge in unsafe sex with prostitutes.

Doctor Petchari Siriniran, a medical specialist at the Chiang
Mai Provincial Public Health Centre said apart from those
who had already died, there were 365 cases of patients with
AIDS.

“About 309 of the 365 AIDS patients are middle aged men,”
she told HORIZONS. However, more disturbing than the
AIDS count is the fact that the authorities do not have the
figures on people who have tested HIV positive.

Dr. Petchari said blood tests on high risk groups have been
carried out every 6 months since 1989, particularly in
Chiang Mai’s Muang District where there are many prosti-
tutes and service girls.

The impact on society must be taken seriously. It has now
been proven that the fatal disease spreads from service girls
to men, who in turn pass it on to their wives (in both city
and rural areas). It is then passed on to their babies,“ she
said of the possible AIDS explosion.

“The number of people infected through unsafe sex is
increasing. In June we will test more prostitutes to assess the
rate of infection. Since June 1989, 30 percent of all the
prostitutes we tested were found to be HIV positive.

Meanwhile, she noted that the spread of AIDS among
service girls, who are not professional prostitutes, had
increased from five to 12 percent from June 1989 to
December 1991.

Total of 1,234 AIDS Patients Reported After
Middle of May

BK1507081292 Bangkok Radio Thailand Network
in English 0000 GMT 15 Jul 92

[All figures as heard]

[Text] After the middle of May this year, 1,234 AIDS and
AIDS-related patients are reported in Thailand, of this
number 1,056 are male and 176 female. The Ministry of
Public Health says in its AIDS update report that the ratio
of male to female AIDS and AIDS-related patients in
Thailand is six to one. Of the reported cases, 512 are
full-blown AIDS. The rest 722 are HIV infected at different
Stages.



IPRS-TEP-92-013
July 30 1992

1992—44 people). This constituted the following percentage
of the total number of HIV infections in Poland noted in the
following years: 0, 20.3, 79.3, 80.7, 71.5 and 59.5.

The spread in HIV infections among drug users not only
increased the number of infections in this group to at least
1,522 (which is the total from 1986-January 1992 data), but
it also bore other consequences:

* Achange in the proportions of infected women com-
pared to infected men from 1:9 from 1985-1988, and
even 1:20 in 1988 to approximately 1:4 currently;

« The lowering of the age of those infected with HIV—
at present nearly 60 percent are in the 20-29 age
range, and another 12 percent are under 20 years of

age;

© The birth of children in whom anti-HIV antibodies
are present, which means the future occurrence of a
certain number of children infected and ill with
AIDS;

« The presence of intravenous drug users among blood
donor candidates; in 1989, there were 23 such persons
among a total number of 47 serologically positive
blood donor candidates, and in 1990 there were 17
such persons from a total number of 39.

Who Was Tested?

From 1985-1990, 4,800,763 tests were performed to deter-
mine the presence of anti-HIV antibodies among Polish
citizens.

A total of 4,587,950 tests (95.5 percent) was done on blood
donor candidates. Among them, infections were diagnosed
among 107 persons (0.002 per 100 tests). Moreover, 15,028
tests were done among those who were intravenous drug

EAST EUROPE 11

users, 7,205 were done among prostitutes, 6,482 were done
among blood recipients, 3,017 were done among homosex-
uals and bisexuals, 1,980 were done among hemophiliacs
and 179,101 were done among other persons (for example,
people going abroad who had been infected through hetero-
sexual contact).

From 1985-1990, 21,813 tests were done in addition to the
tests of blood donors. As a result of these tests, 1,331
persons were found to be infected with HIV. This consti-
tutes 0.6 per 100 studies. Detailed data on the number of
tests done in 1991 is now being gathered. It will be made
available after figures are totaled and an analysis is done.

Those infected with HIV are primarily the residents of large
urban concentrations and suburban areas. Twenty-one per-
cent of them gave their permanent address as the Warsaw
Voivodship. In the last two years, a relatively large number
of infections was noted in the voivodships of southwestern
Poland.

For years, data on those afflicted with AIDS, as well as those
infected with HIV in Poland has been sent to the Regional
Office of the World Health Organization [WHO] and the
European Center for Epidemiological Inspection of AIDS.

It is known that the 179 countries of the world are obliged to
report this data. To date, 159 countries have done so. These
include 52 in Africa, 44 in both Americas, 27 in Asia, 28 in
Europe, and 8 in Oceania. Of those countries which have
not reported cases of illness, 11 are in Asia, 7 are in Oceania,
1 is in Africa and in Europe, only Albania has failed to file
reports. According to the assessment of WHO experts, the
number of countries of the world which have reported cases
of illness reflects accurately the worldwide scope and extent
of the problem.