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

12th World AIDS Conference

Abstracts 60185-60190 1033

neurologic 43%, and joint diseases 21%. Weight gain was observed in 8 patients
on bitherapy, 2 on tritherapy and none for the untreated. CD4 cells count showed
few usefulness. Most secondary effects were observed with Hivid, Retrovir and
Videx. Only 2 patients on 14 were compliant during 6 months. 1 patient on
tritherapy died and 1 among the untreated, the one on stage IV.
Conclusion: Morbid events and 01 may be present during ARV treatment.
ARV are associated with a better life but showed a poor effect on CD4 cells count.
In African context bitherapy is as good as tritherapy. Compliance is the major
problem and may compromise all the benefit of ARV.
60185 Window period and its implications in HIV antibody
testing
Onani Mughogho. Lilongwe AIDS Counselling & Education Cen. PO. Box 31308
Lilongwe 3 Malawi, Central Africa
Issue: The serious implications of window period variations in pre-married couples.
Project: The adult HIV prevalence in urban areas of Malawi is at 30%. This is
much higher than the national sero-prevalence of 14% in the urban, and 11% in
the rural areas. An intervention to reinforce primary and secondary prevention of
HIV infection was developed. Through on-the-job trained Counsellors and qualified Laboratory Technicians, counselling and blood testing is being offered to the
general public. The beneficiaries include; students, married couples, widowed,
separated, pre-married couples, e.t.c.
Results: 70% of the clients coming are male and 30% are female. 10% are
widowed clients, 40% are married and 50% (1,400) are pre-married clients. 142
pre-married clients were HIV reactive, 80 pre-married clients stayed on window
period for about 3 months. 44 pre-married clients stayed on window period for
about 5 months. 18 pre-married clients stayed on window period for about 7
months.
Lesson Learnt: The variation in length of window period has devastating
effects on people who test for HIV for marriage purposes. If the couple to be
married belongs to the category of people with a long-term window period, the
implications of the initial non-reactive test result will mean a risk to HIV infection
or re-infection to either one or both of them.
60186 Availability of a printed source of information about
HIV/AIDS
David Murillo. Avenida Universidad 1330-1402-C Colonia Del Carmen, 04100,
Coyoacan, D.F, Mexico
Objectives: To give basic and specialized information to the medical and
paramedical personnel, to people living with HIV/AIDS, his relatives, friends,
students and researchers of the matter.
To obtain the participation of the outstanding specialists, the health authorities,
the pharmaceutical industry and the people living with HIV/AIDS elaboration of
the book.
Methods: An editorial committee decides the specific subjects to be publish,
and who will be the most suitables collaborators to write them down. All the
articles are under the supervision of CONASIDA, the top authority on AIDS in
Mexico, and other importants health authorities.
Results: To spread as much information as possible, through one of the most
popular source of primary information in our country, with a large number of
articles, covering a high spectrum of aspects regarding the pandemia.
Lesson Learned: It's is possible to produce editorial material with the participation of all the actors of the society included NGO, health authorities, private
enterprises and people living with HIV/AIDS, specially when there is an urgent
and bad need of them.
60187 Religious ethics and struggle campaigns against
HIV/AIDS
Mutombo Tshizubu', Mwayuma Kabwe2. 'Boulevard 30 Juin Immeuble Royal
B.P 7248, Kinshasa; 2Network On Ethics Law and HIV, Congo, Kinshasa,
Democratic, Congo
Issue: The religious phenomena in our country have a considerable impact on
the population behaviour which doesn't spare the fight domain against AIDS.
Project: A small survey was carried out to a young girls group of 17 to 22 years
old. Among questions asked, one was answerable for their comment about the
speech developed by religious responsibles, stigmatizing Condoms use during
sexual relations, and the speech developed during our fight campaigns against
AIDS.
Results: From results obtained, 98.52% of people asked have approved the
religious responsibles speech and rejected ipso facto the one developed during
the fight campaigns against AIDS while only 1.48% of people have a shared
opinion between the two speeches.
Lessons Learned: We estimate that this little survey results translates a reality

which must be taken into account in the struggle against HIV/AIDS. We must
revise and fit our fight strategies to the social context of target population in sight
to maximize the positive results of our action.

S60188 Confidentiality
Musuamba Ndala1, Mwayuma Kabwe2, Mutombo Tshizubu2. 'Boulevard 30 juin
Immeuble Royal PNUD B.P 7248, Kinshasa; 2Network On Ethics Law and HIV
Congo, Kinshasa, Democratic Rep. of Congo
Issue: Physicians are confronted to the medical secret problem because family
members who support medical cares want to know the diagnostic in order to
continue to give money.
Project: Information Campaign Program to help physicians to guarantee right
to the confidentiality of persons living with HIV on practicing the "shared confidentiality" for their interests. From 1995 to december 1997, 15 debates-conferences
were organized to the Clinical medicine and medicine Faculty of Kinshasa University, and to the Ndjili Hospital on the topic: "Medical secret and HIV infection".
Results: More than 200 physicians and attending terms physicians were sufficiently informed:
-At the beginning, about 90% of physicians approved only the absolute medical secret; any family member couldn't be informed of diagnostic, even not the
partner. After some debates-conferences in which discussions were very hot,
physicians became aware of the situation. And about 60% of them agree the
shared confidentiality when it is for the sick person interest.
Lessons Learned: Medical secret can't be cut out anymore. His violation
justificatory motives allow to safeguard confidentiality and right respect to the
private life of people living with HIV in medical institutions. Some exceptions are
left to the high consciousness and sovereign appreciation of practitioners. That's
why physicians must be formed and sensibilized.
S60189 Evaluation of the efficacy and tolerance of AZT and
lamivudine in South Indian HIV-1 infected patients
Matthew Samuel', S. Parameshwari2, D. Raja2, Jacobmini2, Amandamurphy3,
H. Geiger4, H. Jager5. 'Dept. of Experimental Medicine & AIDS Rescntn, DR
MGR Medical University, 40 Anna Salai, Madras-32; 2Tndrmgrmeduni, Madras;
3 Teddytrust Madurai, India; 4 Graflehndorff; 5Kuratoriumfurimmuschwache,
Germany
Background: ART for HIV infection is not available in India. Modified treatment
regimens are likely to reduce infectiousness, making medical treatment a more
effective strategy for preventing further transmission. Combination therapy, however, is expensive and it may be difficult to offer it to everyone who is HIV1
infected in India.
Objective: To administer AZT and lamivudine to HIV patients in two settings
(urban and rural) to evaluate their tolerability, safety and immunological and
virological efficacy and patients adherence.
Patients and Methods: 17 adult HIV1 infection confirmed patients were entered in the study. They were given AZT 300 mg and lamivudin 300 mg per
day. Plasma samples were obtained prior to therapy and subsequently every 3
months. HIV1 RNA was assayed by means of RTPCR (Roche). CD4/CD8 counts
were performed by immunomagnetic bead technique (Dynal).
Results: Both drugs were well tolerated. One patient dropped out due to
adverse reactions. Plasma viral loads in all patients were reduced and continue
to maintain the suppression. CD4 counts were higher by 5% than the original
values.
Conclusions: AZT and lamivudine have an excellent tolerability and safety
profile in Indian patients. Urban and rural patients compliance was remarkable.
The implications of this study go further than the benefits to the individual, influencing public health issues, preventive strategies and anti retroviral treatment
costs.
60190 HIV/AIDS in the fishermen population of Galicia (Spain)
and north region of Portugal
Isabel M. Graha', J.L. Aboal2, F. Amaro3, H. Lecour3, J. Monteagudo2,
A. Mota4, J.A. Taboada2. 1D.X. Saude Publica-Camiho Frances 10 15771
Santiago De Compostela (Galicia); 2Direccidn Xeral De Sau De Publica
Santiago Compo St., Spain; 3Universidade Internacional 2685 Portela LRS;
4Facultade De Medicia Porto, Portugal
Issue: To study the prevalence of risk factors; the level of knowledge and
attitudes/beliefs of the mentioned population in respect to HIV transmission.
Project: Personal interviews to a sample of the population through a structured
questionary with twenty items. The participation in the study was voluntary. A
blood test was done on all the persons interviewed Interviews with experts: doctors of the Naval Health Care Service. Other informations: AIDS registry; previous
studys of HIV/HBV seroprevalence.
Results: Even though the level of knowledge in respect to HIV transmission
is high, the prevalence of exposure to HIV is also high: multiple sexual partners;
contact with prostitutes without any protection; tattooing and sugery in countries
without sterilization guarantee; sharing and reuse of injection equipment. The
prevalence of HIV/HBV and STD's is higher than in the general population.

Lessons Learned: The risk of HIV/STD's transmission is higher among the
fishermen than in the general population. It's clear that some kind of intervention
is needed. From July 1995 to July 1997 the program "Prevention of HIV/AIDS
and other agents in the fishermen population" was implemented, cofunded by the
Comission of the European Union.