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HIV infected women: Impact on contraception
THURSDAY,
SEPTEMBER
7
Nevertheless, each HIV discordant couple desiring a child has to be informed that hypothetically there still exists a remaining risk for virus transmission.
FC4.04.04 HIV INFECTED WOMEN: IMPACT ON CONTRACEPTION J.Magalhaes, P.Giraldo, E.Amaral, J.A.Simoes, State University of Campinas-UNICAMP, Rua Alexandre Coelho 22, Mogi Mirim, SBo Paula, Brazil, 13.800-000. Objectives: The study was developed in order to evaluate the impact of knowledge of HIV infection (diagnosis), with regards to contraception information and choice for HIV+ women. Study Methods: Cross sectional descriptive study.A questionaire was applied to 140 HIV infected women.Statistical analysis was performed by chi-square test, Fisher’s exact test and McNemar test for paired samples(significance of 5%). Results: Most of studied population included young women, with a low education level. A significant increase in the knowledge of contraceptives methods after being told that they were HIV positive,wich include injectables,IUD, and tubal ligation, shows the patients had a chance to receive information, never received before. A significant increase in the prevalence in the use of contraceptive methods was found, specially for condoms and tubal ligation. However, 30% of the HIV+ women still did not use any contraceptive methods. The “double protection” method (combined method)was used by only a small percentage of women, despite counseling. Conclusions: The fact of knowing themselves to be HIV infected had a strong impact on contraceptive practice among HIV infected women. It is expected that Family Planning services could address HIV+ women needs and be prepared to be integrated with HIV/HIV services for women.
FC4.04.05 SQUAMOUS INTRAEPITHELIAL LESIONS IN HIV SEROPOSITIVE PREGNANT WOMEN A. R. Gueglio, A. Paganini, A. Dunaiewsky, Hospital Ramos Mejia, Lugones 2045, Buenos Aires, Argentina, 1430. Objectives: The aim of the study was to evaluate the presence of lesions in the lower genital tract of pregnant women and the relationship between squamous intraepithelial lesions (SIL) with HIV seropositivity during a cyto-colpo-histologyc screening. Study Methods: We evaluated 110 consecutive HIV seropositive pregnant women that attended to Cervical Pathology’s Oficce, from October 1996 to December 1999. Cervicovaginal Papanicolau smears, colposcopy, vulvoscopy and eventual biopsy were performed. The control group was composed of 110 HIV seronegative pregnant women. Results: We found 31 SIL in the 110 HIV positive group (28.18%), while only 8 out of 110 (7.27%) HIV negative had SIL. This difference was statistically significant (p< 0.05, c2 test). The pathology found in the 31 HIV seropositive patients was: Low grade SIL: 27 (87.10%) including 10 condylomatosis, 11 flat condyloma and 6 low grade SIL without HPV, High grade SIL 3 (9.68%); Invasive carcinoma 1 (3.22%). Treatment in HIV seropositive patients with low grade SIL, was 90% trichloracetic acid during pregnancy and reexamination 90 days after delivery. For patients with high grade SIL, conization 90 days after delivery was used as treatment. In the patient with carcinoma, stadification after delivery was made. Conclusions: We found a significant association between SIL and HIV seropositivity in pregnant women. We believe that it is important to screen cyto-colpo-histologically all HIV seropositive patients during pregnancy.
27
FC4.04.06 EFFECT OF VAGINAL DOUCHING ON GENITAL TOLERANCE TO NONOXYNOL-9 U. P. Thasanapradit, S. Limpongsanurak. S. Taneepanichskul, Dept. OBIGYN, Chulalongkorn University, Bangkok, Thailand. Objectives: The aim of this study was to evaluate the effect of vaginal douching with water on the tolerance of genital epithelium to Nonoxynol-9 (N-9). Study Methods: 60 healthy women were recruited in this randomized controlled trial. 30 women were assigned to each of the study groups A and B. Vaginal administration of a film containing 72 mg of N-9 three times per day for 14 consecutive days was done in both groups. Only women in Group B practiced vaginal douching with water 30-60 minutes after insertion of each film. Colposcopic examination and laboratory testing for STDs were done on the admission day, day 7 and day 14 in all women. Results: There were no significant differences in base-line characteristics of women and laboratory results for STDs between these two groups. Disruptions of cervical epithelium were observed in 20% of women in Group A. Only 1 case (3.5%) of epithelial disruption was found in Group B. This difference was statistically significant (~0.05). Conclusions: Vaginal douching with water 30-60 minutes after insertion of N-9 vaginal film was found to decrease the incidence of genital sideeffects of N-9.
FC4.04.07 INVASIVE CERVICAL CANCER AMONG WOMEN WITH AIDS IN EUROPE AND USA, 1994-1998 mSH.’ Selik R, McKenna M, Hamers F, Seeff L. European Centre for Epidemiological Monitoring of AIDS, France Objective: To assess the trends in invasive cervical cancer (CCA) as an AIDS-defining condition. Methods: We analyzed the AIDS surveillance data from Europe (reported by16 countries of the WHO-European region) and the USA, among women aged 15 years or older, 1994 through 1998. Results: During 1994.1998, CCA was the most common malignancy among women with AIDS in both Europe (2.7%, 393114,348) and the USA (2.1%, 580128,024). In Europe and the USA, among women with CCA and AIDS, CCA was the only AIDS-defining condition for 90%. Over the period 1994 to 1998, the percentage of women who had CCA as the AIDS-defining condition remained stable in Europe whereas it declined in the USA from 2.7% to 1.7% (p=
FC4.04.08 IMPACT OF AN INTERVENTION TO IMPROVE TREATMENT SEEKING BEHAVIOR AND PREVENT SEXUALLY TRANSMlTTED DISEASES AMONG NIGERIAN YOUTH: A RANDOMIZEED CONTROLLED TRIAL F.E. Okonofua (1,3), P. Coplan (2,5), F. Oronsaye (l), D. Ogunsakin (l), J.T. Ogonor (3), S. Collins (4), J.A. Kaufman (6), K Hegenhougen (4) 1. Women’s Health and Action Research Center, Nigeria. 2. Merck Research Laboratories, Blue Bell, PA, USA. 3. University of Benin, Nigeria. 4. Dept. of Population and International health, Harvard School of Public Health, MA, USA. 5. University of Pennsylvania Medical School, USA. 6. Ford Foundation, Beijing, China. Objective: The aim of the study was to evaluate the impact of an intervention on the prevalence and treatment-seeking behavior for sexually transmitted diseases among Nigerian youth.
SEPTEMBER
7
Nevertheless, each HIV discordant couple desiring a child has to be informed that hypothetically there still exists a remaining risk for virus transmission.
FC4.04.04 HIV INFECTED WOMEN: IMPACT ON CONTRACEPTION J.Magalhaes, P.Giraldo, E.Amaral, J.A.Simoes, State University of Campinas-UNICAMP, Rua Alexandre Coelho 22, Mogi Mirim, SBo Paula, Brazil, 13.800-000. Objectives: The study was developed in order to evaluate the impact of knowledge of HIV infection (diagnosis), with regards to contraception information and choice for HIV+ women. Study Methods: Cross sectional descriptive study.A questionaire was applied to 140 HIV infected women.Statistical analysis was performed by chi-square test, Fisher’s exact test and McNemar test for paired samples(significance of 5%). Results: Most of studied population included young women, with a low education level. A significant increase in the knowledge of contraceptives methods after being told that they were HIV positive,wich include injectables,IUD, and tubal ligation, shows the patients had a chance to receive information, never received before. A significant increase in the prevalence in the use of contraceptive methods was found, specially for condoms and tubal ligation. However, 30% of the HIV+ women still did not use any contraceptive methods. The “double protection” method (combined method)was used by only a small percentage of women, despite counseling. Conclusions: The fact of knowing themselves to be HIV infected had a strong impact on contraceptive practice among HIV infected women. It is expected that Family Planning services could address HIV+ women needs and be prepared to be integrated with HIV/HIV services for women.
FC4.04.05 SQUAMOUS INTRAEPITHELIAL LESIONS IN HIV SEROPOSITIVE PREGNANT WOMEN A. R. Gueglio, A. Paganini, A. Dunaiewsky, Hospital Ramos Mejia, Lugones 2045, Buenos Aires, Argentina, 1430. Objectives: The aim of the study was to evaluate the presence of lesions in the lower genital tract of pregnant women and the relationship between squamous intraepithelial lesions (SIL) with HIV seropositivity during a cyto-colpo-histologyc screening. Study Methods: We evaluated 110 consecutive HIV seropositive pregnant women that attended to Cervical Pathology’s Oficce, from October 1996 to December 1999. Cervicovaginal Papanicolau smears, colposcopy, vulvoscopy and eventual biopsy were performed. The control group was composed of 110 HIV seronegative pregnant women. Results: We found 31 SIL in the 110 HIV positive group (28.18%), while only 8 out of 110 (7.27%) HIV negative had SIL. This difference was statistically significant (p< 0.05, c2 test). The pathology found in the 31 HIV seropositive patients was: Low grade SIL: 27 (87.10%) including 10 condylomatosis, 11 flat condyloma and 6 low grade SIL without HPV, High grade SIL 3 (9.68%); Invasive carcinoma 1 (3.22%). Treatment in HIV seropositive patients with low grade SIL, was 90% trichloracetic acid during pregnancy and reexamination 90 days after delivery. For patients with high grade SIL, conization 90 days after delivery was used as treatment. In the patient with carcinoma, stadification after delivery was made. Conclusions: We found a significant association between SIL and HIV seropositivity in pregnant women. We believe that it is important to screen cyto-colpo-histologically all HIV seropositive patients during pregnancy.
27
FC4.04.06 EFFECT OF VAGINAL DOUCHING ON GENITAL TOLERANCE TO NONOXYNOL-9 U. P. Thasanapradit, S. Limpongsanurak. S. Taneepanichskul, Dept. OBIGYN, Chulalongkorn University, Bangkok, Thailand. Objectives: The aim of this study was to evaluate the effect of vaginal douching with water on the tolerance of genital epithelium to Nonoxynol-9 (N-9). Study Methods: 60 healthy women were recruited in this randomized controlled trial. 30 women were assigned to each of the study groups A and B. Vaginal administration of a film containing 72 mg of N-9 three times per day for 14 consecutive days was done in both groups. Only women in Group B practiced vaginal douching with water 30-60 minutes after insertion of each film. Colposcopic examination and laboratory testing for STDs were done on the admission day, day 7 and day 14 in all women. Results: There were no significant differences in base-line characteristics of women and laboratory results for STDs between these two groups. Disruptions of cervical epithelium were observed in 20% of women in Group A. Only 1 case (3.5%) of epithelial disruption was found in Group B. This difference was statistically significant (~0.05). Conclusions: Vaginal douching with water 30-60 minutes after insertion of N-9 vaginal film was found to decrease the incidence of genital sideeffects of N-9.
FC4.04.07 INVASIVE CERVICAL CANCER AMONG WOMEN WITH AIDS IN EUROPE AND USA, 1994-1998 mSH.’ Selik R, McKenna M, Hamers F, Seeff L. European Centre for Epidemiological Monitoring of AIDS, France Objective: To assess the trends in invasive cervical cancer (CCA) as an AIDS-defining condition. Methods: We analyzed the AIDS surveillance data from Europe (reported by16 countries of the WHO-European region) and the USA, among women aged 15 years or older, 1994 through 1998. Results: During 1994.1998, CCA was the most common malignancy among women with AIDS in both Europe (2.7%, 393114,348) and the USA (2.1%, 580128,024). In Europe and the USA, among women with CCA and AIDS, CCA was the only AIDS-defining condition for 90%. Over the period 1994 to 1998, the percentage of women who had CCA as the AIDS-defining condition remained stable in Europe whereas it declined in the USA from 2.7% to 1.7% (p=
FC4.04.08 IMPACT OF AN INTERVENTION TO IMPROVE TREATMENT SEEKING BEHAVIOR AND PREVENT SEXUALLY TRANSMlTTED DISEASES AMONG NIGERIAN YOUTH: A RANDOMIZEED CONTROLLED TRIAL F.E. Okonofua (1,3), P. Coplan (2,5), F. Oronsaye (l), D. Ogunsakin (l), J.T. Ogonor (3), S. Collins (4), J.A. Kaufman (6), K Hegenhougen (4) 1. Women’s Health and Action Research Center, Nigeria. 2. Merck Research Laboratories, Blue Bell, PA, USA. 3. University of Benin, Nigeria. 4. Dept. of Population and International health, Harvard School of Public Health, MA, USA. 5. University of Pennsylvania Medical School, USA. 6. Ford Foundation, Beijing, China. Objective: The aim of the study was to evaluate the impact of an intervention on the prevalence and treatment-seeking behavior for sexually transmitted diseases among Nigerian youth.