Bridging the Gap: Conference Record [Abstract book, International Conference on AIDS (12th: 1998: Geneva, Switzerland)]

12th World AIDS Conference

Abstracts 60014-60020 1005

60014 Bridging the gap between infected/affected
Urmila Varadpande. 24, Karvenagar, Nagpur, India
Objectives: (1) Boosting the moral of HIV infected and affected. (2) The need to
overcome anxiety, depression and other possible challenges. (3) Providing social,
psychological support to fight AIDS. (4) Reduction of spread of HIV/AIDS. (5)
Imparting meditation and health education. (6) Forming self-help groups which
will lead way for sociological research and solutions to the problems.
Project: From routine counselling work the very idea of bridging the gap between infected persons was struck and to achieve above objectives a special
clinic for HIV infected and affected persons was started six months back. Clinic
was started with 12 members and today the number is almost 100. The special
clinic is held monthly and all members are very cooperative and enthusiastic
in helping each other. In affected individuals wives (contact tracing was done)
mothers, fathers and brothers are in maximum number. In rare cases friends
accompanied positive persons. It was a pleasant surprise to know that in few
cases in-laws were very kind hearted. In all the cases affected persons carefully
asked regarding the care of infected persons and how to control the spread of
disease.
Conclusion: Counselling or consolation to infected persons by a infected
person is more effective.7/8 HIV +ve individuals came very close to each other
within months. Formidable task of caring HIV/AIDS patients can be made easy by
encouraging the infected and affected ones to form peer-group. Paucity of funds
is the stumbling block in bridging the gap between infected, affected and general
masses.
60015 Hepatic histopathology in HIV infection and AIDS
Karl-Anton Kreuzer', Andreas H. Trojan2, R. Flury3, M. Schmid4, M. Schneider4,
S. Schroeder5. 1 Univ. of Bonn, Dpt. of Medicine, Bonn, Wilhelmshavener Str. 18
10551 Berlin; 5 nstitute for Immunology, Pathology & Molecular Biology,
Namburg, FRG; 2Dept. of Medicine, Univ. of Zuerich, Zurich; 3Dpt. of Pathology,
Kantonsspital Wintertnur, Wintertnur; 4Dpt. of Pathology, Univ. of Zuerich,
Zuerich, CM
Besides the characteristic opportunistic complications in HIV infection the liver
may be either diectly or indirectly affected by this type of immune deficiency.
Further, it was speculated that coinfection with HIV and HBV or HCV may lead to
an only moderate course of chronic hepatitis. The aim of the present study was
to determine the frequency and type of pathological changes of the liver in HIV
seropositive patients. Additionally, histological features of HIV/HBV and HIV/HCV
coinfections were evaluated. In a retrospective study of a 12 years period liver
histopathology was analysed in 227 autopsied patients infected with HIV. Standard
staining methods were applied as well as pathogen specific stainings and PCR
techniques. Briefly, the follwing histopathological features were observed: Normal
histology 13%. Non specific findings: staetosis 34%, haemosiderosis 10%, nonspecific reactive hepatitis 7%, peliosis 2%. Opportunistic diseases: CMV induced
hepatitis 8%, Toxoplasma gondii 5%, Leishmania donovani 1%, Cryptococcus
neoformans and Pneumocystis carinii (each 0.5%), typical mycobacteria (1%),
atypical mycobacteria in 6%. Viral hepatitits: HBV 7%, HCV 3%. Neoplasms: nonHodgkin's lymphomas 6%, Hodgkin's lymphoma 1%, hepatocellular carcinoma
1%.
In conclusion, the liver is affected in a vast majority of HIV seropositive individuals. Thus, treatable causes of liver diseases should be evaluated with special
care in HIV infection. Furthermore, we could not observe that histopathology of
HIV/HBV or HIV/HCV coinfection is different from only viral hepatitis. Therefore,
anti hepatitis treatment should be performed whenever clinically indicated.
60016 Intraoperative neurophysiologic monitoring in aneurysm
and surgery
Safiqurrahman Mozumder. Matlab Degree College Matlabgont Dist., Chandpur,
Bangladesh
The aim of the study was to investigate the usefulness of intraoperative neurophysiologic monitoring in aneurysm and AVM surgery.
A series of 60 patients with aneurysm and AVMs and a total of 83 over the
last 3 years underwent intraoperative neurophysiologic monitoring. All patients
with aneurysms had SSEP monitoring with median or tibial nerve stimulation.
One patient with a posterior cerebral artery aneurysm had BAER monitoring
in adidtion. Seven patients three with medial temporateal AVM's and fair with
cellosal AVMs also had SSEP monitoring. Four patients with perirotandic AVMs
had intraoperative central suleus mapping.
In three patients with aneurysms and three patients with perirolandie AVMs, the
information provided by the monitoring was critical and change the intraoperative
strategy. These cases and one other in which there was an adverse outcome
without any change in the SSEP will be presented in detail.
We conclude that intraoperative neurophysiologie monitoring has an important
role in both aneurysm and AVM surgery in avoiding adverse outcome.

60017 Point de Reperes: More than a needle exchange site
Helene Gagnon12, Gilles Marquis, N. Marcoux, M. Gagnon. 1335 de St. Vallier
Est Quebec, Quebec 3P7; 2Point de Reperes, Quebec, Canada
Issue: Needle exchange is pivotal to HIV prevention among IDUs but it is only
one of the needed components to accomplish this goal. Indeed, needle access

can't do much by itself for such key issues as social disorganization, deathwishes
or lack of self-esteem.
Project: Point de Reperes is a Canadian prevention programme aimed at
preventing STDs and AIDS among IDUs. Inspired by harm reduction strategies,
our programme reaches around 8 000 IDUs by reaching out to them in the streets,
detention center and shooting galleries of Quebec city. We offer needle exchanges
as well as condom distribution, vaccination against hepatitis B and anonymous
testing for HIV. We are also there for the individuals who need someone to talk to.
We support, refer, and accompany our clients to the appropriate ressources. Our
outreach activities go beyond knowledge transfer about HIV and are aimed at
skill building. Numerous collaborators among correctionnal, health, epidemiology,
evaluation, and drug abuse institutions allow us to fine-tune our work to the reality
of IDUs.
Results: Since its implementation in 1991, Point de Reperes distributed around
100 000 syringes per year and recovered around 82 000 of those. Moreover, we
have observed increasing numbers of drug-free periods among our clients.
Lessons Learned: The support we offer has allowed us to establish a relationship of trust with the IDUs we serve. This has made it possible, in view of the
service continuum we offer, to make IDUs feel responsible for their own injection
material and sexual behaviors.
60018 Effective and equitable distribution management of
finance and equipment
Michael Ofoe Duodo, E. Sarfo, A. Arhin, F.M. Frimpong, B. Zack, K.B. Adusei.
Beware of AIDS (BAWA), POB 76, Offinso-Ashanti, Ghana
Until a more serious look is taken to the creation of "POSITIVE AWARENESS"
on AIDS to the rural dwellers AIDS PREVENTION" and more importantly, A
MECHANISM TO "SUPERVISE" FUNDS "PUMPED" FOR THE SAKE OF AIDS
EDUCATION, the rate of increase in resource would be at par with the rate of
increase in new AIDS Cases. This sterm from the fact that about 90% of the
Education ON AIDS is done in the Urban Centres with the rural areas almost
neglected. Meanwhile, many rural people disbelieve the existence of AIDS, even
the few who do believe in the existence of AIDS, do not believe in the mode of
its spread, kinds of prevention and at times are confused by taboos and certain
backward spiritual believes. The greatest danger is the lack of effective primary
health care deliver and Family Planning methods in these rural areas. When
there is no effective supervisory mechanism to keep a link between the Urban
and Rural Areas as far as sex education and its compliance to an extent are
concerned. The rural areas are noted for poor nutrition, lack of proper care for
the children and lack of proper control over the youth about the dos and don'ts of
the society. The high rate of "teenage Pregnancy" in these areas is a result of the
above. A hungry, Uncontrolled, Unprotected child could fall a victim to STD/AIDS,
STD/AIDS is an economic problem as well.
DEFINITELY, THE TIME TO ACT IS NOW, BEFORE THE FEW DONOR
ORGANIZATIONS COME TO REALIZE THAT THEIR EFFORTS MIGHT NOT
YIELD THE EXPECTED RESULTS AFTER ALL. IN WHICH CASE ONE COULD
DESCRIBE AS A LICENSE FOR MAN'S EXTENSION.
60019 Home care and nursing for an AIDS patient (HIV)
Ronald S. Semakula, Musisi Gavah. Mudinet PO. Box Mukomo 287, Kampala,
Uganda
Objectives: To compare how the HIV patients are treated and cared for in a
community of complicated cases with Antibiotics drugs.
Design: The drugs include the following: Apacin, Gentamycin, X-pen,
Chrolophenical, Chrolocin, and Fragile.
Methods: The drugs are prepared in syringes, Scalp vein needles or canular
and a string for tightening the site known as tourniquet. Its advisable to be given
by a medical doctor and a qualified medical personnel. Fragile and Gentamycin
are said to be given in treatment of Sepsis cases, the rest are effective in several
cases. With Nursing care must be Re-assured, Cleanliness must be observed to
avoid contermination with other infections e.g. Fatigue and pains.
Results: Its cheapest method in Home Care to fasten the reaction of drugs in
the patient.
Conclusion: It appears in both Home Care and Nursing that Intravenous
methods in HIV patients helps to reduce financial expenses.
S60020 |Prayer and love: The greatest power in the world
Patricia Amadi. St John's Hospital, P.O. Box 18, Mzuzu, Malawi
Objective: To show the supportive Role Widows play in restoring hope to estranged and rejected widows in order to change attitudes of people in their
matrimonial homes.
Background: Malawian widows continue to suffer rejection and discrimination
and abandonment by relatives when their husbands die. Life becomes a prison
of torture and destitution.

Method: Volunteer widows visit fellow distressed widows on weekly basis. The
visiting widows bring with them food items and other basic needs within their
reach. After helping with chores around home; drawing water, cleaning/washing
items, they conduct prayers together.
Results: The ostracized widows gradually recapture hope and are able to
stand up and carry on with the struggles of life again. The support, comfort and
love is offered by people who are widows themselves. The effects do not stop