Emerging Epidemics in China and Russia
CDC studies presented at the XIV International AIDS Conference in Barcelona provide important insight into the emerging HIV epidemics in China and Russia. New data from China indicate significant gaps in knowledge about HIV among the general population, pointing to the need for widespread education efforts as the country's epidemic continues to increase. In Russia, high rates of sexually transmitted diseases (STDs) and risk behavior among individuals who are homeless or in detention centers in Moscow underscore the need for interventions to prevent significant increases in HIV among at-risk heterosexual populations.
Each of the studies below is embargoed until the indicated time of presentation.
Most Chinese lack basic knowledge about HIV/AIDS. Nearly 17 percent of people in China have never heard of AIDS and more than half (54.4 percent) do not know the cause of the disease, according to the first major study of AIDS-related knowledge among the country's general population. Led by CDC's Deborah Holtzman, Ph.D., researchers analyzed data from a survey of more than 7,000 randomly selected people, ages 15 to 49, in seven counties of China. Of those familiar with AIDS, most said they were aware that it can be transmitted from person-to-person and that it is preventable. However, more than 75 percent of all those surveyed did not know that transmission can be prevented by correctly using condoms, or by avoiding unsafe blood transfusions, or by not sharing hypodermic needles. Additionally, more than 80 percent did not know that infected women can pass the infection on to their infants. These findings underscore the urgent need for widespread educational campaigns on HIV/AIDS in China, where the toll of the epidemic threatens to expand rapidly. Abstract TuPeD4877, "HIV/AIDS-related knowledge among residents in seven counties in China: implications for action," Poster, Tuesday, 9 July 2002, 8:00 (2:00 AM EDT)
High rates of STDs and high-risk sexual behavior seen among homeless in Moscow. More than 30 percent of homeless people in a Moscow-based study were infected with at least one bacterial sexually transmitted disease (STD), and many were engaging in sexual behavior that put them at high risk for HIV infection, according to research led by CDC's Anna Shakarishvili, M.D. In a study of 200 men and 200 women, ages 18 to 45, in three homeless detention centers, a significant proportion were infected with syphilis (32 percent), gonorrhea (17 percent), or chlamydia (11 percent). HIV prevalence was relatively high among this population, at one percent, compared to an estimated 0.18 percent for the Russian general population. Rates of STD and HIV infection were especially high among homeless women - more than half had positive blood tests for syphilis and three percent were HIV positive. Among study participants who had intercourse during the previous year, more than 64 percent of men and 40 percent of women had not used a condom in any of their 10 previous sexual encounters. Additionally, most people in the study reported that they lacked access to basic health care, suggesting missed opportunities for counseling, testing, and care among this high-risk population. The study's findings suggest that homeless people in Moscow are in urgent need of HIV and STD services aimed at treating existing infections and reducing risk behavior. Abstract ThPeCC7431, "High rates of sexually transmitted diseases (STDs) and related risk behaviors in homeless population in Moscow, Russia - Potential impact for HIV transmission," Poster, Thursday, 11 July 2002, 8:00 (2:00 AM EDT)
Sex work, HIV and STD infection common among women in Moscow's homeless and juvenile detention centers. Nearly half of female homeless and juvenile detainees in a Moscow-based CDC study reported exchanging sex for money or other commodities. Led by Yelena Khromova, M.D., researchers examined STD and HIV prevalence, drug use, and risk behavior among 400 women in Moscow, including 200 homeless detainees and 200 women, ages 15 to 17, from juvenile detention centers. While HIV infection and STDs were common among all women in the study, they were particularly widespread among those who had exchanged sex for money - 2.8 percent of these women were HIV positive, 41 percent had a positive blood test for syphilis, and nearly 70 percent had at least one bacterial STD. Those who exchanged sex for money had a significantly greater number of partners than women who had not engaged in sex work - a mean of 168.2 partners in the past 12 months, compared to 3.4 partners for women who had not exchanged sex for money. The high rates of HIV, STDs, and risk behavior among women in this study further underscore the importance of efforts to reduce HIV risk among vulnerable populations in Russia. Abstract ThPeC7600, "High rates of sexually transmitted diseases (STDs), HIV and risky behaviors among female detainees in Moscow, Russia," Poster, Thursday, 11 July 2002, 8:00 (2:00 AM EDT)