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

1048 Abstracts 60268-60272

12th World AIDS Conference

with common duration of the disease 1-6 weeks. We did not observed in our
HIV-positive patients symptom and signs of impairement of CNS associated with
VZV.
Conclusion: This study allowed to describe the clinical forms of VZV-infection
in adults, including HIV-1 seropositive ones, as well as to optimise the scheme of
management of VZV-infection, including step-by-step treatment with participation
of different specialists.
60268 1Do all high risk behaviors come from abroad?
A behavioral study on Bangladesh migrant workers
Joachim Victor Gomes', S.M. Morshed2, E. Barua', K. Sarkar', M.D.A. Bashar2,
H.I. Shaon2, M. Bloem2. 'CCDB, 88 Senpara Parbata; Mirpur-lO, Dhaka-1216;
2Dhaka, Bangladesh
Objective: (1) To assess the prevalence of HIV related risk factors among
Bangladesh migrants returned from abroad, (2) To assess the HIV related risk behaviors of departing migrants, and (3) To identify possible intervention strategies
for establishing safer behaviors among these groups of people.
Methods: A behavioral study was conducted with a sample size of 121 overseas
job seekers. The study included questionnaire survey and in-depth interviews. The
questionnaire survey was done at the clinics where the leaving migrants come for
their medical check ups, during the months of November and December, 1997.
Data was analyzed through SPSS software.
Results: Various kinds of pre and extra marital sexual activities before departure where revealed (44.6%). It became clear that high risk behaviors were
significantly different between first time leaving migrants (52.9%) and returnees
(25%) which includes multiple sex with males and females etc. Of all migrants
who had sex with multiple partners only 17.2% have used condom. Only 3.3%
have proper knowledge on AIDS, 25.6% have partial knowledge and about 62%
have no idea about AIDS. These migrants do not consider themselves as being at risk. Prevention methods of HIV/AIDS mentioned by both groups are not
satisfactory. The in depth interviews confirmed the results of the questionnaire.
41.2% migrant and 30.6% returnees received most of the knowledge from TV
and through personal contact returnees (44.4%) received more knowledge than
the 1st time migrants (30.6%).
Conclusion: The assumption that high risk behaviors are brought in from other
countries into Bangladesh is highly questionable. HIV/AIDS intervention program
should be integrated in current development programs for possible and potential
migrants and their families. In addition, pre-departure programs are needed in
sending countries and thorough post-departure programs (in countries of destination) based on personal contact i.e. peer education (in-country) and peer
education and peer pressure (abroad).
602691 Factors associated with self-reported HIV disease among
women enrolled in the Women's Interagency HIV Study
(WIHS), United States
Nancy A. Hessol', N. Ameli1, K. Anastos2, S. Barkan3, A. Levine4, S. Silver5,
K. Weber6. 1University of California, San Francisco, San Francisco, 405 Irving
Street, 2nd Floor, San Francisco, CA; 2Catholic Medical Center, Jamaica, NY;
3King County Public Health Department, Seattle, WA; 4 University of Southern
California, Los Angeles, CA; 5George Washington University, Washington DC;
6Cook County Hospital, USA
Objective: To describe self-reported HIV disease at baseline interview and correlate with laboratory CD4 cell count, HIV viral load, and socio-demographic
variables.
Methods: The WIHS is a cohort study comprised of 2058 HIV-infected (HIV+)
and 567 high risk HIV-uninfected women, enrolled between October 1994 and
November 1995 in six sites across the United States. Baseline data on the HIV+
women was analyzed using chi-square and multivariate logistic regression to determine the correlates of HIV disease. Socio-demographic variables included age,
race/ethnicity, HIV risk category, site of enrollment, years of education, number of
live born children, and cigarette smoking. HIV disease was categorized according
to the 1993 CDC classification system. Laboratory measures included were CD4
cell count and HIV RNA viral load.
Results: Of the 2058 HIV+ women interviewed at baseline, 987 (48%) reported
having had an AIDS-defining condition, 583 (29%) reported having had class
B symptoms only, and 478 (23%) reported having had no symptoms. Among
those with AIDS-defining conditions, the most frequent was a CD4 count of <200
(72%), followed by esophageal candidiasis (17%) and PCP (16%). Among HIV+
women, the median age was 36, 56% were African American, 34% reported a
history of injection drug use, 69% reported under 13 years of schooling, 79% had
children, and 56% were current smokers. Self-reported HIV disease classification
was highly correlated with CD4 cell count measured at baseline (p < 0.02). In
multivariate analyses, women with AIDS were statistically more likely to be older
(p < 0.0.1), be current smokers (p < 0.01), have lower CD4 cell counts (p <
0.01), and have viral load >100,000 copies (<0.01). Women with AIDS were also
less likely to be African American (p = 0.03).

Conclusions: The WIHS recruited a cohort of HIV+ women of whom almost
half reported having an AIDS-defining condition and under a quarter reported
being asymptomatic prior to enrollment. Among the HIV+ women who reported
having AIDS, the most common AIDS defining condition was a history of CD4
< 200 or < 14%. Similar to other studies of HIV+ adults, we found that more
advanced disease was associated with lower CD4 count. Due to the potential for
recruitment bias and the cross-sectional nature of these analyses, these prelimi
nary results should be interpreted with caution and will need to be confirmed by
additional prospective analyses.
60270 1 Beyond words: The art of living with AIDS
Emily Piccirillo12, J. Menzer', S. Hyman1. 1300 / Street, N.E. Suite 106
Washington DC; 2Consortium for Child Welfare, Washington, DC, USA
Issues: Due to the overwhelming nature of AIDS, with its secrecy and stigma,
words typically fail or are forbidden to children living with it. By compounding
confusion, social isolation and despair, this can severely compromise their overall
well-being. Being visual rather than verbal, active instead of passive, art therapy
is uniquely suited to help them express themselves.
Project: In response to the needs of families coping with AIDS in Washington,
D.C., the collaborative Family Ties Project provides comprehensive permanency
planning services - legal, social and mental health. Individual and family art therapy goals aim to improve communication and coping skills, to increase a sense
of belonging and of competence, to provide acceptance throughout the course of
the illness, and to support the grief process. The children are introduced to a wide
range of media, given any necessary basic instruction, and then encouraged to
use their imaginations to make discoveries.
Results: The art of children living with AIDS highlights the natural human
capacity to realize potential in the face adversity. Many of those served, typically
poor urban children of color, define and reveal their distressing issues from within
the safety and permission of the art process, making room for their continued
growth. Ultimately, the power of this body of imagery helps to increase the awareness of viewers, transforming the impact and meaning of HIV for the individual
and for the world.
Lessons Learned: Art therapy is a highly effective intervention for children
living with AIDS. Their art reveals their ideas and feelings about the complex
demands of the virus, and provides an enduring source of strength and clarity in
their daily lives. Through the creative process, they give shape to their worlds,
indeed, to how the virus itself is understood.
[60271 New and long-term injection drug users risk comparison
for HIV exposure
Dale D. Chitwood', R. Kitner Kathi2, D. Chitwood Janet3, C. McBride Duane4,
B. McCoy Clyde2. 15665 Ponce DeLeon Coral Gables Florida 33146-0719;
2University of Miami, Miami, FL; 3St. Thomas University, Miami, FL; 4Andrews
University, Miami, FL, USA
Background: The purpose of this study is to assess whether persons who recently began to inject drugs are at greater or lesser risk for HIV exposure than
persons who are long term injectors.
Methods: New injection drug users (NIDUs) who had initiated injection within
the last four years and long term injection drug users (LTIDUs) who had initiated
injection prior to 1985 were recruited by outreach workers from the "streets" of
Miami-Dade County, FL. After screening for eligibility, which included a urine
test to confirm current drug use, participants were interviewed using a structured
questionnaire concerning high risk injection behaviors in the prior 30 day period.
Approximately 80% of all enrollees were daily injectors, 100% reported heroin
injection, 56% cocaine injection and 64% speedball injection.
Findings: A majority of all injectors reported one or more injection risk factors
for HIV although LTIDUs were more likely to engage in most high risk injection
practices. For example, LTIDUs were more likely than NIDUs to share needles/syringes (49% vs 28%), share cookers (68% vs 57%), share cottons (68%
vs 43%), share rinse water (55% vs 39%), and transfer drugs between syringes
(35% vs 9%) in the 30 days prior to interview. Conversely, 39% of NIDUs and
31% of LTIDUs had used a shooting gallery in that time period.
Conclusions: High risk injection behaviors were reported by drug users who
initiated injection within the last 4 years and by others who had injected for at least
12 years. New injectors were somewhat less likely to share syringes, cookers,
cottons, and rinse water, and transfer drugs between syringes but somewhat
more likely to have used a shooting gallery. New injectors may be less immersed
in the injection lifestyle and intervention programs are needed to reach these
people early in their drug injection career.
S60272 Knowledge of ACTG 076 increases willingness to take
AZT during pregnancy
Gary Reiterv, E. Benjamin2. 1 River Valley HIV Clinic, Suite 403, 15 Hospital
Drive, Holyoke, MA; 2Baystate Medical Center, Springfield, MA, USA
Issues: Vertical transmission of HIV is the leading cause of HIV infection in
children. Data from ACTG 076 documenting a 66% reduction in maternal-fetal
transmission of HIV in women taking AZT during pregnancy has led health care
providers to seek methods of increasing the acceptability of AZT therapy in HIV
infected pregnant women.
Project: We surveyed 50 HIV positive women of childbearing age to discover

if personal knowledge of ACTG 076 correlated with willingness to take AZT in
pregnancy.
Results: Fifty women, with the following demographic characteristics were
surveyed: 52% Hispanic, 19%African American, 15% Caucasian and 14% other.
Spanish was the primary language for 59%, English was in the remainder. 22%
had some high school, 36% graduated from high school and 26% had some
college.