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

Track D: Social Science: Research, Policy & Action
43 male subjects reported a total of I 607 oral/genital contacts (778 episodes insertive and
829 episodes receptive), and 77 I anal/genital contacts (365 episodes insertive, 30% associated with condom use and 346 episodes receptive, 62% associated with condom use) in
the I 80 days prior to serocoversion. Overall, 3.2% oral/genital contacts and 42% of
anal/genital contacts were reported as occurring with a barrier form of protection. 14 of
the 21I subjects who reported only one sexual partner in the 30 days prior to seroconversion were able to identify the date and sexual activity leading to HIV acquisition; 4 reported
only unprotected oral/genital contact at this sexual encounter. Independent interviews were
conducted with 2 of the 4 source partners who confirmed the history of only oral/genital
contact during the sexual encounter leading to HIV seroconversion.
Conclusion: Our cohort of gay men with recently acquired HIV have many fewer sexual
partners and practiced less receptive anal intercourse than those studied a decade ago.
Currently unprotected oral/genital contact is the most frequent form of unprotected sexual
contact. Our data suggest that oral transmission of HIV may occur more often than previously recognized.
Timothy W. Schacker, M.D., University of Washington I1001 Broadway - Suite 320, Seattle,
WA 98 122, 206-720-4340
Tu.C.2695
SYSTEMIC PROGESTERONE ENHANCES SIV VAGINAL TRANSMISSION AND
PROMOTES DISEASE PROGRESSION.
Marx Preston A/, Gettie A1, Dailey P2, Miller C3,Veazey R4, Spira A1, Ho DD, Claypool
LE5, Alexander NJ6, I. Aaron Diamond AIDS Research Center, New York, NY; 2Chiron
Corporation, Emeryville, CA; 3University of California, Davis, CA; 3Harvard Medical School,
Boston, MA; 5Conrad Program, Arlington,VA; NIH, Bethesda, MD
Objective: To determine if progesterone is a co-factor in the vaginal transmission and
pathogenesis of SIV genital infections in macaques.
Methods: Rhesus macaques were divided into 2 groups that received subcutaneous
implants of 200 mg progesterone or placebo. All were atraumatically inoculated once by
the vaginal route with a low dose of SIVmac25 I.The animals were monitored for SIV infection by virus isolation, antibody PCR and bDNA.
Results: By day 14 post-vaginal inoculation, 14 of 18 progesterone-treated macaques were
virus positive by co-culture. In marked contrast, only I of 10 placebo treated macaques was
SIV infected.The difference was statistically significant.The findings were verified by PCR,
bDNA and antibody studies. In addition, 3 of the 14 progesterone-treated macaques rapidly
progressed to AIDS and bDNA showed that the plasma virus load was 2 to 20 times higher in progesterone-treated animals and as compared to untreated animals in previous
experiments. Progesterone blood levels were elevated and significantly different (placebo
mean = 3.2 ng/ml, progesterone = 17. I ng/ml) at inoculation.
To test one possible mechanism for enhancement of SIV vaginal transmission, additional
macaques were implanted, 3 placebo, 3 progesterone. On days 3 and 4 post-vaginal inoculation, all were euthanized and the genital tracts were removed, evaluated and tested for
SIVThe vaginal epithelia were significantly thinner in the progesterone-treated group as
compared to the placebo group and 2 of 3 progesterone treated were virus positive in
blood, spleen or nodes draining the genital tract and placebo-treated macaques were negative.
Conclusion: Progesterone changes the thickness and protective effect of vaginal epithelia
against SIV infection of vagina.We conclude that studies should be conducted to determine
if there is an increased risk for HIV vaginal transmission in women who use progesteronebased contraceptives.
PA Marx, RR I, Long Meadow Road,Tuxedo, NY 10987-9801 Telephone: 914-35 I -4597 Fax:
9 14-35 I -20 I 5, email: [email protected]
Tu.C.2697
GENETIC DETERMINANTS OF SUSCEPTIBILITY TO HIV INFECTION AND PROGRESSION TO AIDS:ANALYSIS OF GENES INVOLVED IN THE IMMUNE RESPONSE
Patrosso MC*, Giannetto C*, Lando G*, Frattini A*, Lazzarin A**, Rezza G***,Vezzoni P*,
Nicolosi A*. *CNR, ITBA, Milano;**Ospedale San Raffaele, Milano,***Istituto Superiore
Sanita', Roma-Italy
Objective:Susceptibility to HIV Infection and Progression to AIDS is not the same in all subjects.This difference in response may be due to the genetic background of the individual.
Our study is aimed at identifying genetic determinants in the susceptibility to HIV infection
and in AIDS progression in two series of patients and controls. In particular we intend to
study HLA class II, C4 and CD40L genes.
Methods: In contrast to previous studies where various types of bias could not be excluded, subjects in this project were sampled from epidemiological studies of new seroconversions. Southern hybridization were performed to identify null alleles of C4 genes. Alul digestion on PCR products were executed to determine DPA alleles. ASO hybridization techniques were used to analyze an insertion into the C4A gene and DPB and DQ alleles;
PCR-SSP method was applied in a parallel way Analyses on the CD40L gene were carried
out using microsatellites amplification and electrophoresis analysis.
Results: DNA from 39 subjects was analyzed: to date 14 of them belonging to the AIDS
progression study, and 25 to the HIV infection susceptibility studyThe two aplotypes of
DPAI locus were analyzed by using PCR and Alul digestion detecting the absence of 02
alleles in our AIDS progression study population. At this time we performed ASO experiments regarding DPB (19 different alleles), DQA (8 alleles) end DQB (14 alleles) aplotypes
on our first 39 subjects and we are optimizing PCR-SSP protocols in order to confirm
uncertain cases.The complement C4A and C4B genes was analysed by hybridization on
TaqI digestion products in order to identify null alleles, that in literature are found to be
associated with the progression of the illness. At the same time we began the analysis of
polymorphisms in the C4d hypervariable region.The presence of a 2 bp insertion in this
region was found in only one subject. Analyses on CD40L gene revealed a higher (CA)n
repeats average in our population than published data on U.S. caucasian population.
Conclusions: In order to make meaningful statistical analyses of our data, we will continue
to recruit subjects according to the study protocol until we reach I50 samples in the next

6 months.
Patrosso MC,Via Ampere 56, 20131 Milano Italy Tel: [phone] Fax: [phone]
email:[email protected]

Tu.C.2695 - Tu.D.2700
Tu.D.2698
GAY MEN IN REGULAR RELATIONSHIPS AND HIV RISK
Bartos Michael R, Middleton H, Smith G. Macquarie University: Sydney Australia
Objective: To examine the nature of sexual negotiation and condom use or non-use by gay
men in couples.
Background: Gay men have consistently been found to be less likely to use condoms for
anal intercourse with regular partners than with casual partners.The question of whether
anal intercourse without condoms in a regular relationship is an HIV risk-reduction strategy
has been contentious,
Methods: In late 1995, long unstructured interviews were conducted with gay men in couples (n=48) from Sydney, Cairns and Adelaide, Australia. Information from the interviews
was analysed and compared with data from long unstructured interviews with men on the
periphery of the Sydney gay community (n=38) and the continuing Sydney Men and Sexual
Health cohort study
Results: For most, but not all, of the men, anal intercourse with their regular partner represented their commitment to the relationship. As well, for all the men, trust between partners tended to be seen as the measure of a good relationship. As a consequence, for many
of those men for whom anal sex was important, the decision not to use condoms symbolically represented trust with their partner, and was thus central to the quality of their relationship.The decision not to use condoms was most often negotiated explicitly and verbally
but in terms of love and trust and not as a consequence of known HIV status.These
dynamics applied irrespective of the HIV status of the partners (the sample includes concordant positive, concordant negative and sero-discordant couples). For men in sero-discordant relationships, HIV protection strategies included unprotected anal intercourse without
ejaculation and receptive intercourse only for the HIV-positive partner.
Conclusions: HIV education addressing gay men in regular relationships needs to displace
the conflation of trust and non-use of condoms, and attend to the sequence of HIV testing
and abandoning condom use.
Michael Bartos, NCHSR, Macquarie University Sydney NSW 2 109, Australia Telephone:
[phone] Fax: [phone] Email: [email protected]
Tu.D.2699
SEXUAL TROUBLES AS RISK FACTORS IN STDS/AIDS INFECTION
Kuate Jean Roger*, Kaptue L**, Penda Melone J.*, Makang Ma Mbog M.**. * H6pital Jamot
de Yaounde (Cameroon); ** Facultrd de Medecine et des Sciences Biomedicales (FMSBM)
Yaounde
Introduction: In Africa, the taboo on sexuality remains a major drawback for the
STDs/AIDS prevention. However, troubles in sexual relationships are a frequent cause to
consulting pychologists (more than 47 %). Are these patients really sheltered from STDs
and AIDS because of this?
Objectives: Initiate a better understanding of sexual behaviour in people suffering a sexual
pathology (frigidity sexual asthenia, ejaculatory troubles) in order to give them better counselling and reduce STDs/AIDS infectious hazards.Thus eliminate additional fear for possible
hazardous sexual behaviour
Methods: 50 patients attending psychological consultations were surveyed during the first
quarter of 1995 in the H6pital Jamot in Yaounde. During the medical examination and the
interview about their sexual history they are asked how they deal with sexuality since they
have acknowledged the sexual trouble for which they are consulting.
Results: 48 interviewed persons (96 %) have changed sexual partners several times. 2 interviewed person only changed once after the crucial intercourse. 39 interviewed persons (78
%) said they did not use or ask for the use of condoms during these later intercourses. 5
systematically used them (10 %). 6 used them from time to time (I 2 %). 31 patients (62 %)
said they are aware of the AIDS hazard and 42 are really afraid of STDs (i.e. 84 %).Why
they did not use condoms after the crucial sexual intercourse is: - patients though condoms
can induce sexual impotence (78 %) -patients expect to increase sexual desire, the amount
of sexual stimulation, sexual pleasure (79 %) -the patient's weak erection did not allow him
to easily use the condom (1I9 %).
Conclusions: Sexual troubles increase STDs/AIDS infectious hazards, due to an increase in
various sexual partners during the period of troubles. In spite of AIDS hazard, condoms are
still thought of as impeding sexual pleasure. Every treatment of patients consulting for sexual troubles should emphasize on the issue of avoiding infectious hazards by means of looking for sexual equilibrium.
Kuate Jean Roger BP 4675 Yaounde - Cameroon;Tel/Fax: [phone].
Tu.D.2700
A SURVEY ON THE SEXUAL BEHAVIOR OF RESIDENTS OF A PROVINCIAL CITY IN
JAPAN
Uchino H/,Tsuchida S2, SawazakiY3, Hirose H4, IshitsukaT5. I Komoro Public Health
Cente Nagano, Japan; 2Meiji Universit, Tokyo; 3Japanese Foundation For AIDS Prevention;
4Tokyo Women's Christian University; The National Center for University Entrance
Examination.
Objective: To better understand the sexual behavior and attitudes of the population of a
selected city in Nagano Prefecture.
Methods: This survey was carried out in Komoro city Nagano Prefecture, which has a population of 45,030. 200 people chosen at random from 23,700 residents aged 20 to 59 were
visited and given a survey Out of those samples, 156 people responded to the survey (a
78.0% response rate), which was composed of 56 questions concerning areas such as the
respondent profile, sexual history, and sexual attitudes, including awareness of AIDS.The
results of the collected responses have been statistically analyzed.
Results: Respondents who have had one or no sexual partners to date were 34.7% for
men and 63.0% for women.Those who have had more than five partners to date were
36.0% for men and 8.2% for women. 62.5% of the male and 87.5% of the female respondents have had one or no sexual partners in the past 5 years, while 19.4% of the men and
2.8% of the women have had more than five.The difference in number of sexual partners

between the men and women was more remarkable over a long period than a short. A
strikingly high 45.7% of youths in their 20s have had more than two partners in the past 5
years.The survey suggests that elements most related to the increase in sexual partners
include a tolerance toward sex, the first sexual experience occurring at an increasingly

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