Abstracts Vol. 1 [International Conference on AIDS (11th: 1996: Vancouver, Canada)]

Track D: Social Science: Research, Policy & Acti
tion argues for new educational approaches to be designed in or(rko r
made aware of their HIV risk and HIV status prior to the develolana
Dr Richard CokerThe Jefferiss Wing, St Marys Hospital Praed St
Tel [phone] Fax[phone]
Mo.D. 1877
EFFECT OF HIV-I ASSOCIATED DEMENTIA ON DAILY FUNCTItC;
Todak George*#, Polanco C#,Winston T#, Marder K*#, Doone '
SM#.The Charles A. Dana Consortium on Therapy for HIV Der i,
Clinical and Behavioral Studies, NY State Psychiatric Institute anti ti'
Columbia University, NewYork, NY USA.
Objective: To determine the effect of HIV I associated dementia
cohort of HIV + subjects, as determined by self-reported functioi i,
function, and subject-reported time use.
Methods: Ninety-four subjects were recruited who met either of th:
CD4 _ 200, or (ii) CD4 < 300 and neuropsychological impairmei.
performance in 2 of 8 cognitive domains). Based on functional, ne, i
chologic criteria specified by the Academy of Neurology subject,, w
impaired, HIV I associated minor motor/cognitive disorder, or HIV i
Results: Gay or bisexual men represented 56% of the sample, w isni
was 40.1I. 25.5% (24/94) mnet criteria for dementia, and 21.3% (20/9'i mr
minor motor/cognitive complex. Respondents meeting criteria fcr iern,
cantly more restricted in measures of physical functioning and pilhlrs
subjects reported more time in medical care, more time to comnpete ct
daily activities, and less time outside their homes.The non impaired a:d
tive groups did not significantly differ Self-reported cognitive defi t,
I 1% of the not impaired, 13% of the minor motor/cognitive group, rid
ed group reported deficits.
Conclusions: HIV I associated dementia and the associated minor/,mro
operationally defined. Daily functioning related to cognitive deficit,mpp,
subjects meeting criteria for the minor motor/cognitive complex.
G.Todak, HIV Center, NYS Psychiatric Inst. Unit 10, 722 West 168 C
Tel.: [phone]; Fax: (2 I12) 740-0046
Mo.D.1878
BODY SIZE IN HIV/AIDS:ACTUAL, PERCEIVED AND PREFERRED.
Brunner Robert L.*, Scott BJ*, Lar son,TA*. *University of Nevad, i
Department of Pediatrics, Reno, NV, USA
Objective: To study simple measures of desired body size and at cu t
in order to consider their possible role in the maintenance of a de:,,i:
relatively healthy individuals with HIV/AIDS.
Methods: 22 men and 3 women completed a questionnaire whit:i
items and drawings (ascending in "stoutness") to assess perceptio.f
and shape, satisfaction with current weight and preferred size and i.5.e
surements of relative weight (body mass index), percent ideal body wei
fat and CD4 were also obtained. All participants were patients in,
intervention" clinic.The questionnaire given here was part of a largr i,t
tudinal evaluation of factors involved in AIDS related weight change,n.;
Results: Twenty six percent of subjects described themselves as "sc ie
"about right" and 35% as "somewhat heavy".There were no subjei t" r't
tions that were "extremely thin" or "extremely heavy". Self perceptir -
weight were consistent with objectively measured relative weight [I idy
("somewhat thin"), 23.8 ("about right") and 28.3 ("somewhat heavy')]i
body weight (94%, 99% and 122%, respectively), as both objective,i,,
self reported size and weight. Self-reports of being "somewhat hevy' w
higher CD4 counts (M=397) than either"about right" (M= 189) or"thir
one subject (4%) selected a figure at the extreme thinness as clos'est to
like to be" (preferred size). All remaining subjects chose figures whk h w
continuum of body size. Nevertheless, paired comparisons indicate that
significantly smaller than self reported present size (t=-2.1 1, p <.05).
Conclusions: We found that reported perceptions of body size and, rw,
ed among relatively healthy men and women with HIV/AIDS. Pref.ci
lower than perceived current size, a finding which is consistent vwiti
ple to achieve a slim ideal. A person's preference for thinness should
sibly incompatible with the clinical goal of preventing weight loss in i a/
RL-Brunner, Department of Pediatrics, 4 I I W 2nd St., Reno, NV, UI I -
Telephone:[phone], Fax:[phone]. email:brunnter@urnnedu
Mo.D. 1879
IMPACT OF A BEREAVEMENT SUPPORT GROUP INTERVENTION'
COUNT IN HIV+ AND HIV- HOMOSEXUAL MEN
Goodkin Kar 1.2, uttle, RI, Feaste, D, Blaney NT, Kuma, M i
Fletcher MA 1.2.4,6. I LDept. ol Psychi y 2 PsycIhology, 3 Neut,_.I
Immunology 5 Pithology 6 Medicire, Univeisity of Miani, Floida
Objective: To determine the effects of a bereavement support gi,"
CD4 cell count in HIV+ and HIV homosexual men.
Methods: 176 subjects having sad a loss of a significant other withir i,.
were randomly assigned to a bereavement support group or to, -,nI
condition.The distribution if subjects follows: HIV+ group= 52; t- i,1:
group= 45; HIV contrl 30. Of these, I4 I have completed T2 ( e
mos.) assessmi its. Ethuic composition is 65.9% non Hispanic wI a'.
10.3% African Amerir ns, and I I% othe. 28% were asymptomal t
early symptoms [CDC stage B], and 9% were at CDC Stage C [AIIL
Results: The CD4 cell count showed a signuficant intervention efe

low up (F= 186 -4.29, p=.04).There was a substantial decrease n Y i
between TI and T3 [MTI= 433 cells/mm3, sd=33 1;T3: 372 cellsi/n i
to intervention subjects for HIV+'s [MTI= 347 cells/mm3, sd=25; 1:3
sd=350]. CD4 cell count increased in HIV-'s post-intervention [M i

on

Mo.D.1877 - Mo.D.1882

I.. tents are 950, sd=414] while controls decreased [MTI =832, sd= 195; MT3=73 I, sd=94].
S,"1 Conclusion: A bereavement support group intervention buffers against a decrement in. ' 1C, U.K. CD4 cell count following loss in HIV+ individuals and may play a role in deterring disease
progression. As an increment was seen in HIV individuals post-intervention, these results
may also have clini cal health implications for the general population.
K. Goodkin, Dept. of Psychiatry (m836), University of Miami School of Medicine, Miami,
N Florida 33136, U.S.A.Tel: [phone] Fax: [phone]. E Mail:
t, t #, Albert Kgoodk [email protected]. Edu
' 11 " enter for
iif, urology Mo.D.1880
THE SWISS HIV NON-PROGRESSOR STUDY - PARTICIPANT-CENTERED STUDY
nn in a DESIGN AS RESEARCH STRATEGY
"eported Lan Sttefan--, Kopp, C., Federspiel, B.4, Kllin, W2, Schoep, M.3, von Overbeck, j.4. (I Med.
Pol., Inselspital Bern, Switzerland /21nstitut for Psychologie, Universitit Bern, Switzerland/3
I,,. riteria: (i) ISPM, Universitit Bern, Switzerland/4 Div. des Maladies Infectieuses, CHUV Lausanne,,,d by defective Switzerland)
nd neuropsy Objective: The project is building a cohort of non-progressors (CD4 >_ 500/pl, Ist coni: s ed.,s not firmed pos. I IV test _< 1989, asymptomatic, without antiretroviral therapy) in Switzerland
o iat, I rdementia. aisd investig iting into immunological, virological and psycho-social cofactors of non-progres-.. hie mean age si-n. Specirl weight is given on taking the participants' points of view into consideration in
et c teria for the recruitment strategies, in the study setting, and in research priorities.,"t,,were signifi- Methods: We hypothesized that increasing duration of infection correlates with distance to
of tine use.These the rmedical systerm. Consequently we recruited primarily through the media (newspaper &
hotre, more help in magazine articles, radio broadcasts).A cellular phone allowed to give day-round direct informiintor motor/cogni- motion to interested persons.A short administrative questionnaire and an information assem'w'ed thist' pattern: bly in the beginning of the study helped to structure the study considering the participants'
50% of the dement- interests A study bulletin keeps participants informed on the study and on non progression.
Results: Out of 157 persons interested in participation, 64 persons could so far be included.
>r,,,;plex can be 64% of these were not recruited through the Swiss HIV Cohort Study (SHCS). 4 1% are
It spared in women. At present, the following psycho-social inventories have been completed with 30 per
sons: A structured interview ascertains participants' illness models based on concepts of medN.Y f"Y 10032 cal anthropology and includes demographic and socio-economic data, use of (para)medical
care, sexual relations and protective behavior, discrimination, drug use, diet, social and physical
activity A questionnaire consists of instruments to assess psychosomatic complaints (SCL-90 -R) and well-being (BFW), coping in general (CISS) and HIV-specific (BEFO-S), generalized selfefficacy social support (F-SOZU), as well as the perceived causes that contributed to the
infectior (PUK) ad future infection-related control attributions (EKOA).
Mdi Conclusions: The recruitment campaign through the media proofed to be successful and
-f assessed size cost efficient in r ecruiting a relatively high number of non progressors. Putting efforts in
information policy and considering participants' interests in research priorities leads to a
v-)[!weight in highly motivated group which is crucial to gather valid data and keep dropout minimal.The,utite soice csomplete description of the cohort and evaluations will be presented at the conference.
s n body size Stefan Lang HIV-Sprechstunde, Med. Pol., Inselspital, CH-3010 Bern, Switzerland
(i b s ive mea- Phone +l I I31 632 27 45; Fax: [phone]; e-mail: [email protected]
t. pe--,.:ent body
'i)uIt. bhsed "early Mo.D. 1 88 I
So red at longi THE MEANINGS OF QUALITY OF LIFE AMONG HEALTH CARE PROVIDERS AND
wistng. PEOPLE LIVING WITH HIV/AIDS & THEIR RELATIONSHIP TO TREATMENT,iai i then", 39% as Cohen MitchellI.Fischer Laurent2. IPartnership For Community Health, NewYork, NY:
otiring self percep- Hoffmannt- La Roche, Nutley NJ.
)I present size and Issue: Health care providers and persons living with HIV/AIDS (PLWH/As) use "quality of
ni ss index = 21.5 life" to refer to many different indicators. A clearer understanding of what is meant by "qualrsI percent ideal ity of life" and its relationship to treatment is useful in choosing individualized treatment.
uri re' s.nded with Project: This research provides a link between health-related quality-of life (hrql) research and
ere sciiated with different quality of life criteria used by providers and PLWH/As.Three focus groups with
"(hi 193). Only providers and 5 focus groups with PLWH/As (2 gay 2 heterosexual, and I hispanic) were
-' s ze he "would conducted. Participants completed the MOS-HIV hrql instrument and a detailed questionnaire
ere entral on the on treatment.
t prefer red size was Preliminary findings indicate: (I) quality of life has many meanings that reflect the broad cultural and socioeconomic status of care givers and PLWH/A and impacts therapy participaight r not distort- tion in clinical trials, and prophylactic treatments; (2) the meaning of quality of life changes
rz vvs-i ignificantly over the stages of infection. In early stages of HIV infection, it sometimes means being able:. many peo- to continue life as before and can be accompanied by denial while in other it is associated,,,der god as pos- with depression and fatalism about dying. Both interpretations translate into avoiding treati.. rment. Dur in g later stages of infection, quality of life is associated with managing HIV infec-, ton and AIDS indch translates into actively seeking treatment; (3) all participants place great
weight on mobility independence and energy level (4) Physicians generally perceive their
patients is compliant with drug treatments, while patients tend to self-medicate and engage
in complimentary treatment (5) Dementia is a serious concern for PLWH/As and
OI' CD4 CELL providers. (6) Case managers are involved in meeting the needs of their clients but are
somehow removed f6orn treatment issues related to quality of life; (7) most participants
i, P 1,,4,5 named, besides he negative manifestations of the infection, a number of positive quality of
1.1 -::! oloy an slte sitnges ur irpoose to HIV infection.
y ad Lessons Learned: Qulsty of life indcatrs regarding HIV/AIDS differ between and anmong
ron the physicui s, PLWHIA and case managers. Understanding and disseminating information about
quai O1 lilt' teeds and treatment related Quality-of Life effects can assist care givers in
suosthi ucbpreset bi ts indvdualized treatment and empower PLWH/A to seek appropriate treatment.
r o tae control Mitchell iohen, Partnership for Community Health, 250 West 24th street 6GE, New York,
rtr i -; HIV- NY I00 IL USA; Tel/Fax. 212 807 I973, e-mail: 766 [email protected]. mI 07 T3 (6
H s:pns.cs Mo.D. 1882
t,e A]: 63% had PSYCHOTHERAPY AND AIDS: INTERACTION PSYCHOTHERAPEUTICAL TREATMENT AND MEDICAL TREATMENT..g,. r nrh fol-- Cadtelis, Falistocco, C, Ceballos, J, Materazzi, F.
t o/, trols Spes Foundation, Psychopathology Department, Buenos Aires Argentina
d1 200] com ared Issue: The diagnosis of HIV infection creates a situation of vital crisis: it is difficult for the
I tan-, patient, to elaborate and overcome this crisis spontaneously or through their own resources.
d bI; MT3: The tiplemerntaton of changes of the emotional behaviour is fundamental for this process.

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