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

1060 Abstracts 60329-60334

12th World AIDS Conference

about sex. The group has been able to persuade a large number of men to
practice safe/safer sex.
Lessons Learned: There is an urgent need of widening the parameters of our
work to include other social groups also.
60329 Comparison study between the clinical and laboratory
diagnosis for STDs in female prostitutes, Costa Rica,
1997
Manuel Moraga1, G. Miranda2, E. Casas2, R. Leon2, Z. Garcia3, K. Visona3,
G. Herrera1. 'Calle 10 - Avenida 34, Contigou Plaza Deportes, Cristo Rey, San
Jose; 2Depto. AIDS Control, Ministry of Health, San Jose; 31CMRT Cartago,
Costa Rica
Objective: To determine the sensitivity and specificity of the syndromic management of the female prostitute population versus the use of laboratory based
intervention.
Methods: Of 270 female prostitutes attending the routine control examination
at the Ministry of Health from March to August, 1997, endocervical and vaginal
samples were collected using a swap. A Gram stain was performed of both
specimens and then analyzed in saline solution by light microscopy. Additionally,
the samples were cultured in a medium of Thayer and Martin. Chlamydia t. (C.t.)
was determined using the Amplicor kit (Roche).
Results: The laboratory results of the 270 female prostitutes were as follows:
Bacterial vaginosis (B.v) 55%; C.t. 17%; Trichomonas sp. 4%; Candida sp. 4%;
N. gonorrhea 2%. The medical clinical evaluation resulted as follows: B.v. 9%;
C.t. 6%; Trichomoniasis 8%; Candidiasis 5%; Gonorrhea 9%. A total of 167 of
the population resulted clinically asymptomatic and did not receive any treatment,
however, of these, 107 individuals resulted to be infected with one or more of the
agents based on the laboratory results.
Conclusion: The results revealed an important difference in the use of clinical
versus laboratory diagnostic methods to establish STD's specially in individuals
infected with B.v. and C.t., since these are often asymptomatic. If only the clinical
aspect would be used as a treatment criteria the intervention would be deficient.
The study also showed the need to use both endocervical and vaginal specimens
for the laboratory testing to obtain a higher sensitivity rate.
S60330 Improving HIV/AIDS epidemiological surveillance in
Liberia: Do health facilities have the capacity?
Alex Gasasira1, I.V. Simbeye2, A.O. Harris2, L.M. Bruce2, J.A. Kamara2. 1NACP
c/o WHO, Liberia PO. Box 1608, New York, NY, USA; 2National AIDS/STD
Control Programme, Monrovilla; 3 World Health Organization, Monrovia, Liberia
Issue: Strengthening HIV/AIDS epidemiological surveillance in a developing
country, emerging from a seven year civil conflict with is believed to have have
had a profound effect on an existing nascent HIV epidemic.
Project: During the seven year civil crisis in Liberia, factors that foster the
spread of HIV/AIDS BECAME RAMPANT. Realizing that an accurate understanding of the magnitude and determinants in this post war era is an important
requirement for effective interventions to be developed, the National AIDS &
STD Control Programme has embarked on strengthening its epidemiological
surveillance system. Assessment of existing structures, capacity building and
refocusing goals and strategies in data collection are some of the components in
this exercise. An initial situation analysis of health facilities capacity to participate
in HIV/AIDS surveillance activities is being undertaken nation-wide.
Result: To date 32 health facilities have been assessed. 34% of these are urban, 19% periurban and 41% rural. 65% do not have electricity or pipe water. 75%
have a basic functioning laboratory. Less than 30% of these facilities have health
workers who have undergone any form of HIV/AIDS training. All the facilities
assessed run out-patient clinics, 84% run antenatal services, and 34% perform
blood donor recruitment. Only 25% report having ever handled a suspected or
confirmed AIDS patient, while HIV sero-prevalence among blood donors in 1997
was 3.9%
Lessons Learned: Despite the recent war, many health facilities possess the
necessary physical infrastructure for HIV/AIDS surveillance, have access to potential sentinel population, and only require support in terms of provision of hardy
HIV test kits, appropriate AIDS case definition and data collection tools,
S60331 The natural history of HIV-1/2 in Mumbai, India
Subhash Hira1, C. Oberai2, D.N. Lanjewar2, H.J. Shroff3, J. Bakshani4.
University of Texas & ARCON 502 Debonair Apts Cadel Rd Mahim Mumbai
400016; 2Sir J.J. Hospital Mumbai 400008; 3L & T Mumbai 400001; 4Mahatma
Gandhi Medical College New Mumbai 429210, India
Objective: To study disease progression among HIV-infected persons.
Design: Prospective, prevalent cohort study.
Methods: Adult patients with confirmed HIV infection and presenting either
with features suggestive of immune suppression or with an STD were recruited

in the natural history study in Mumbai, India. 522 patients who were followed
prospectively for at least six months comprised of 284 asymptomatic, 126 with
ARC and 112 with AIDS. HIV related disease progression was defined as change
of clinical stage to a higher stage or death or by diagnosis of AIDS-defining
opportunistic infections during the period of followup.
Results: Among 522 persons followed for 751 person-years (p-y), male to female ratio was 4.6:1. The annual incidence of disease progression was 21.7/100

p-y (163/751), that of active clinical tuberculosis was 8.2/100 p-y (58/707) and
that of death was 7.3/100 p-y (55/751). Median survival time after diagnosis of
AIDS was 11.5 months. The important co-factors for disease progression were:
unemployed males (OR = 1.4; Cl 0.78, 2.51), age greater than 35 years (OR =
1.6; Cl 1.29, 1.92), and incident tuberculosis (OR = 27.7; Cl 12.19, 42.54). There
was no correlation between gender and disease progression.
Conclusions: HIV-disease progression and death in Mumbai is comparable
with that in Uganda. It is twice faster than that reported for gay men and IVDU
in San Francisco. Incident tuberculosis emerged as the major cause of morbidity
and mortality.
60332 HIV seroprevalence among high and low risk women in
Costa Rica, 1997
Emilia Monge1, L. Leza Ma2, M. Moraga2. 1Calle 10-Avenid A37, Contiguo
Plaza Deportes. Cristo Rey, San Jose; 2De Pto. AIDS Control, Ministry of
Health, San Jose, Costa Rica
Objective: To determine the HIV seroprevalence among high and low risk women
in Costa Rica.
Methods: Low risk women: Sentinel Study - anonymous and unliked. Samples: Group A: 800 pregnant women from Carit's Maternity Hospital in San Jose
(Capital), April 1997. Group B: 800 pregnant women from Dr. Tony Facio Hospital
in Lim6n (Caribbean Coast), June 1997.
High risk women: Group C: AIDS and STD Program is the encharge of control
and care of sexual workers. They assist each 15 days for control. The HIV test is
voluntary and they ask for it each three months.
Analysis of 1995 serological studies for HIV among sexual workers women
attended during 1997. The tests used were EIA and Western blot.
Results: Group A and B had a prevalence of 0.25% and 0.13%, respectively.
Group c had a prevalence of 0.25%.
Conclusions: The seroprevalence is low (less than 1%). This situation must
maintain; in consecuence, is necessary continue with the preventive programs
for detection and treatment of Sexually Transmitted Infections and to promote
specific interventions for women, taking in mind their specific needs.
1603331 How can women's values interfere in STD/AIDS
prevention?
Valquiria Padilha, S.B. Bellucci, A.S.D. Guarabyra, N.R.A. Borges. Centro
Corsini, Campinas, SP Brazil
This study is based on a qualitative social research carried out to assess the
situation of non-virginal women of low income and low schooling from Campinas,
State of Sao Paulo, Brazil. This study is part of a STD/AIDS prevention program,
which has taken place since 1991. For the purpose of this study, 278 women of
the periphery of Campinas were submitted to a structured interview. The objective
of the study was to investigate the women's values in relation to sexuality, body,
health and STD/AIDS, in order to deepen the educational activities of the program
and to direct to the regional advertising campaign for STD/AIDS prevention. The
study's main hypothesis states that AIDS is part of the same social auditorium,
i.e., speaking about virginity, sex, health, physician, prevention, religion or AIDS
implies in recuperating the same matrix of values. As the theoretical-methodological referential, VYGOTSKY'S "historical-cultural" approach was used, which
comprehends the human being as a result of internalized social relationships,
which have, on its turn, the semiotic mediation as their nucleus. It is through
this mediation that the polisemy of the words and the polyphony contained in the
women's statements can be understood. The results of the interviews demonstrate that the women's statements are replete with contradictions and doubts
regarding the themes proposed. Further, an association of the same matrix of values between "marriage and fidelity", "AIDS and wrong attitude", "homosexualism
and disgust", "virginity and purity", etc. was found.
Conclusion: The contradiction is created because these women did not assume the official scientific knowledge, since they do not have the schooling
needed in order to do so, and because the values created by them through the
social relationships of its culture do not correspond to their daily reality. Therefore,
preventive educational action for these women must be based on the negotiation
of the significations of their knowledge and their values about sexuality and AIDS.
S60334 |A pentapeptide from HIV-1 gpl20 V3 region is reducing
PC12 neuronal cell line viability
Parvaneh Rahimi-Moghaddam1, S. Bar-Jurado2, J.S. Richardson2, A. Jurado2.
1 Department of Pharmacology University of Saskatchewan 107 Wiggins Road
S7N5E5; 2 University of Saskatchewan, Saskatoon, SK, Canada
Preamble: HIV-1-associated cognitive/motor complex (CMC) is a common manifestation in AIDS patients. A possible factor for induction of CMC is the HIV-1
envelop glycoprotein gp120, shown to mediate damaging effects to neurons in
vitro and in transgenic mouse models. On the other hand, the third variable region

(V3) of gp120 is important in cell tropism and pathogenicity of the virus. It is
possible that part of this 35 amino acid region is crucial for neurodegeneration.
Methods: Using computer-aided programs, the sequence similarity search was
applied to find similar sequences. PC12 neuronal cell lines were cultured in 96
well plates and the cell viability was tested by an MTT assay.
Results: We found that residues 316-320 of the gp120 protein (residues
14-18 of the V3 region) is homologous to part of the viral fusion protein in