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

Track D: Social Science: Research, Policy & Action
Results: The mean age of patients was 38.5 years (range 25-76; sd 8.53). Eighty percent of
patients were Caucasian, 10% African American, 5% Asian/Pacific Islander and 6% other
race. Deli, ium was diagnosed prior to the study in only one patient. Delirium was diagnosed via chart review, using the CAM, in 46% (n=63) of patients; interrater reliability was
good (-0.78). Seveteen percent of patients (n= I I) had more than one episode of delirium
during their stayThere were no significant differences between the delirious and non-delirious patient groups with respect to age, race, relationship status, IIIV exposure category,
source of iadmission, source of payment, or AIDS-defining conditions.The average length of
stay at the faIcility was 77.9 days (range 1-4 I 5; sd 75.8). Eighty-eight percent of patients died
it the facility; delirious patients were more likely to die at the facrihlty than non delirious
patients (X2 8.2;df I;p<0.004). Factors associated with deliriun in this study include: fever
(47.6%); medication effect (46.0%); infection (20.6%); central nervous system condition
(I I ~); metabolic abnormality (7.9%); pulmonary problem (6.3 %); hepatic dysfunction
(4.8%); pain (4.8%); anrid other (e.g. anermia, trauma, sleep deprivalion) causes (15.8%).
Specific medications associated with delirium in AIDS patients include narcotics (OR 7.9; ClI
3. I 19.8), benzodiazepines (OR 4.6; CI I1.8- I.9), anticholinergic/antihitarminics (OR 4.4; ClI
I.5 -12.9) and steroids (OR 3.0; Cl.I 2-7.2).
Conclusions: Delirium is a common problem among AIDS patients in long term care facilities. It is poorly recognized and therefore, undertreated. Further study is needed to assess
the impact of physiologic assessment and judicious medication usage on episodes of delirium.
Kar ina K. Uldall, 100 I Broadway Avenue, Suite 2 I 7, Seattle,WA 98 I 22 USA
Phone: (206)654t-3306 Fax: [phone] email: keegan @u.washington.edu
Mo.D. 1890
FIRST INTERVIEW WITH THE PSYCHOLOGIST:THE EXPRESSIONS OF A SUBJECT
WHO KNOWS HE IS INFECTED WITH HIV.
Benetucci orge, Aguilera, E., Rocca,V, Silverio, A. Psychology Area Unit No i7 Hospital Of
Infections: Francisco J. Muriz - Buenos Aires - Argentina
Issue: The psychology Area receives a natural demand of asintomatic subjects infected with
IlV. This Area belongs to the Aids Unit No 17 of the Hospital Infections: Francisco J. Mufniz.
Project: Psychological interview have been made from 1990 up to 1995 anrid their caracteristics are the following: * Individuals; * Time: 45 minutes;* Opened, that is to say to listen to
the patient's expressions, asking them about themselves.
Results: Although the reason of the psychological demand is knowing himself infected with
HIIV, it only masquerades the particular conflict that the subject will relate. It means that this
demand will bring to light the Clinical structure sorrounded by historical and social events
and not as an unique maniflestation of the organic data of the serology
Lessons Learned: I. The position of the subject confronted to the fact of being infected with
HIV, is one of a singular order and due to this, the importance and necessity of attending
each case in particular: 2. As it was mentioned before this position shows the flow of the
TRIEB" of thle subject making possible some kind of demand when thle flow is nearer Eros
than Tanatos. 3.1 hlie consequence of point I. and 2. is the inefficacy of prescribing interviews
anrid psychological treatrments as a receipt that makes longer the well being of the subject.
J. Benetucci, Unit N7 17 Hospital of Infections: F. J. Muniz, Uspallata 2272, CP I 282,
Buenos Aires, Argentina.Tel.: 54 (01I) 305 2812.
Mo.D. 189 I1
RISK-RELATED SEXUAL BEHAVIOR: DIFFERENCES BETWEEN HIV-POSITIVE
HETEROSEXUAL MALES AND FEMALES
De Bertolini (LScarso, C.," Andreetto*,U.,* Bertuzzo*, P.,* Milan*, E.,.* Favero, E.,*
Cadrobbi,P,* Cattelan, A.M.,*Rupolo, G.P.,*Dept. of Clinical Psychiatry, University of Padova,
"Infectious Diseases Dept.- General Hospital - University of Padova
Objectives: To identify any differences in sexual behavior between the male and female
HIV-positive population before and after their diagnosis of HIV positivity.
Method: As part of a more extensive research program, a semi structured interview was
used to collect detailed information on sexual behavior before and after the diagnosis of
HIV positivity of 36 female and 5 I male heterosexuals. Findings were compared with data
on a group of HIV-positive ex-drug addicts (24 females and 116 males).
Results: The most significant findings emerging from the study were that: before the diagnosis of HIV positivity the heterosexual females tended to have a more stable monogamic
relationship than the males (55% vs 4%).The majority of the women had previously had a
drug addicted partner (70%), which was true of only 23% of the ren, who reported having
had exclusively heterosexual relations in 47% of cases. Both sexes (100%) reported taking
no suitable precautions and awareness of the risks they ran was very low (0% among
femnales and 12% among males). After the diagnosis of HIV positivity, 43% of the females
and 35% of the mrales continued to have sexual intercourse with a stable partner; none of
the women, but 14% of the men reported having intercourse with occasional partners.
Fifty four percent of the women and 46% of the men no longer had a partnen;The majority
of the women (95%) informed their partners that they were HIVpositive, while only 74%
of the males did so. Of the subjects who still had a partnern most of tie womens partners
(64%) were HIVpositive, whereas 68y% of the males partners were HIVnegative.There was
a persistent filur e to take adequate precautions during sexual intercourse in a proportion
cf bot sexes (2 I% of the women and 29% of the nen).Albeit with sone differences,
these findings tend to reflect the situation emerging flom a comparison between the two
sexes among HIV-positive ex drug addicts.
Conclusions: Several important and significant differences emerged in the sexual behavior
of HI Vpositive males and females, both before and after the diagnosis of their HIV positivity This fnding suggests that it is worth considering tle formulation of different preventive
messages for targeting the male and female population.
(ludio de Bertolini Departrient of Clinical Psychiatry, University of PadovaVia Giustiniani,
2 f5128 Padovs, ITALYtel.: +t9 49 821383i

Mo.D.1890 - Mo.D.1894
Mo.D. 1892
PRELIMINARY QUANTITATIVE RORSCHACH TEST FINDINGS IN HIV-POSITIVE
SUBJECTS
Andreetto,U.,* Rupolo, G.P Bontempelli,S.,* Tomrmnasella, E.,* Garofoli*, Foti, F.,* Cadrobbi,
P,* Cattelan, A.M.,* de Bertolini, C.,* Dept. of Clinical Psychiatry University of Padova,
**Infectious Diseases Dept. - General Hospital - University of Padova
Objectives: The aim of this work was to achieve a preliminary quantitative evaluation of
data emerging from the Rorschach test applied to a cohort of HIV-positive subjects, with a
view to identifying any altered test indices that may help the therapist to understand the
patients' AIDS-related intra-psychological dynamics and consequently implement and orient
suitable psychotherapeutic support.
Methods: The Rorschach projection test was administered to 36 HIV-positive patients referring exclusively to the day hospital of the Infectious Diseases Department at Padua General
Hospital (thIe sample included no drug addicts or hospitalized cases).The marking and tabulation of test results was done by the same examiner in all cases to avoid unwanted variables due to different operators' personalities and attitudes.The distribution of the sample
was compared with the standard percentiles in order to calculate the number of subjects
providing normal values for each test index.
Results:
INDICES Normal X Samples X Standard No. of % of- -
percentiles near-normal near-normal
cases cases

R
G
G%
G+%
D%
F%
F+%
A%
H%
K
FC
CF
C
FCho
Ban%

20.2
9.3
51.1
87.9
43.6
67.0
82.7
46.5
15.6
1.3
1.2
I.4
0.2
1.2
27.7

15.8
8.7
59.5
81.7
34.2
61.1
74.8
41.4
24. I
2.0
0.4
1.1
0.3
I.I
24.8

14-23
7- 11
37-61
78-100
33-56
56-76
74-92
35-55
9-21
0-2
0-2
0-2
00
0-2
20-36

8
17
14
13
13
II
10
16
14
16
10
II
10
14
19

22.1
47.2
38.8
36.1
36.1
30.5
27.7
44.4
38.8
44.4
27.7
30.5
27.7
38.8
52.7

ON:",
>Q
0
V
cc
C
acc
0
Q)
5)
cc
5)
5)
cO
0
C
c5)
cc
C
C
Xd

Data comparison revealed that the mean of the indices of our sample was generally
markedly skew.The finding is confirmed by the number of cases and corresponding percentage of subjects near normal in relation to the standard percentile values.This preliminary quantitative finding shows how much HIV infection psychologically affects patients,
weakening their cognitive function (see <G%; F+%; D%), affective state (see FC; CF; C), and
relational adjustment (see K; H%).
Conclusions: bTogether with the qualitative findings, a quantitative analysis of Rorschach
scores provides a first "snapshot" of psychological distress in HIV-positive individuals,
enabling the clinician to evaluate the intensity of this distress and to orient psychotherapeutic support towards improving the patients' quality of life and preventing their recourse to
risk-related behavior.
Umberto Andreetto, Department of Clinical Psychiatry University of Padova,Via Giustiniani.
2 - 35128 Padova ItalyTel.: + 39 49 8213831I
Mo.D. 1893
EARLY PREDICTORS OF COGNITIVE DEFICITS IN HIV INFECTED SUBJECTS IN
BRAZIL
Oliveira ACP, De Castro SHP Jacques de Moraes M, Monteiro DT, Krzesinski AL, Aoki FH.
Dalgalarrondo P.R AIDS Division, University General Hospital, State University of Campinas,
Brazil.
Preliminary data from a follow-up study on AIDS outcome in Brazil will be presented. In
order to identify socio-demographic, clinical and immunological variables associated with
early cognitive deficits in HIV infected subjects, a comprehensive neuropsychological protocol was applied. 80 adult subjects with a CD4 count between 50 and 250, without active
infection, major neurologic disorders, and previous antiretroviral treatment were included in
the study Neuropsychological tests included the Mini Mental State,Verbal Fluency, DigitSymbol, Digit-Span, Logic Memory Test, and Trail Making A and B. Moreover, a standardized
neurological examination, a scale for depression and anxiety (HAD) and a screening test for
alcohol abuse (CAGE) were performed.These tests are considered sensitive to areas
involved in the AIDS cognitive-motor complex.The protocol proved simple to administer
and acceptable both for patients and interviewers. Significant associations between demographic, clinical and immunological status and neuropsychological deficits will be presented.
Some implications of early detection of factors associated with the AIDS cognitive motor
complex in a developing country will be discussed.
AIDS Division, University General Hospital, State University of Campinas, Brazil. Cidade
Universitairia Zeferino Vaz 13083-970 Campinas - SP Fax: [phone]
Mo.D. 1894
EARLY PREDICTORS OF COGNITIVE DEFICITS IN HIV INFECTED SUBJECTS IN
BRAZIL
Jacques De Moraes Monica
Preliminary data frorn a follow-up study on AIDS outcome in Brazil will be presented. In
order to identify socio-demographic, clinical and immunological variables associated with
early cognitive deficits in HIV infected subjects, a comprehensive neuropsychological protocol was applied. 80 adult subjects with a CD4 count between 50 and 250, without active
infection, major neurologic disorders, and previous antiretroviral treatment were included in
the study Neuropsychological tests included the Mini Mental State,Verbal Fluency, DigitSymbol, Digit-Span, Logic Memory Test, and Trail Malking A and B. Moreover, a standardized
neurological examination, a scale for depression and anxiety (HAD) and a screening test for

204