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

12th World AIDS Conference

Abstracts 60377-60382 1069

Task Force has provided a model to be used as a guide in the development of a
Family-based response
Results: The Family-based support model was very well received by the 28
community representatives who attended a forum on HIV/AIDS and how it is
linked to many other issues in our communities. The reality of the high rates of
addictions, family violence, poverty, discrimination, prostitution etc. among the 1st
Nation population is a direct link to the high rate of reported AIDS cases among
the 1st Nation population
Lessons Learned: Using the teachings of the past and accepting the reality
of today we can collaborate with other agencies to address, support, advocate
and empower those infected and affected by HIV/AIDS. This also works as a
prevention when shared with the whole community.
77 Empowering youth to confront HIV/AIDS in Canada:
Models of prevention education programs
Marc-Andre Leblanc. 400-100 Sparks Street Ottawa Ontario K1P 5B7, Canada
Issues: HIV/AIDS prevention education programs for marginalized youth must
be developed and implemented by youth to be effective and responsive to their
needs.
Project: The Empowering Youth to Confront HIV/AIDS project conducted a literature review on factors in the effectiveness of AIDS prevention programs. It also
identified and documented models of existing innovative youth-driven programs.
Results: A national youth working group produced a manual on model youthdriven HIV/AIDS prevention education programs. This manual and the literature
review serve as tools for community-based AIDS organizations and youth agencies that are planning and delivering youth programming.
Lessons learned: Significant youth involvement in HIV/AIDS prevention education programs can be a measure of success. Six Canadian programs serve as
models on how such programs can be developed for marginalized youth.
60378 Labour force participation for people living with HIV
Rodney Kort, J. Zamprelli. Canadian AIDS Society, #400-100 Sparks Street
Ottawa, Ontario, Canada
ISSUE: Comprehensive research is required to assess the labour force participation needs of people living with HIV and review public and private sector income
support programs for their ability to meet these needs.
PROJECT: Due to recent advances in the clinical treatment of HIV, a rapidly
emerging issue for many people with HIV is the prospect of returning to or remaining in the labour force. To respond to the lack of comprehensive data on this issue,
the Canadian AIDS Society established a national research project to assess the
employment needs of people living with HIV and review public and private sector
policies and programs related to this issue. Research methodology included a
national survey, distributed through community groups and physicians, as well as
a series of consultations with people living with HIV and key stakeholders such
as private insurers, government income support program providers, vocational
rehabilitation providers and community-based AIDS organizations.
Results: Appropriate health insurance and flexible work/income support programming is essential; many stakeholders are not well-informed on HIV-related
workforce issues.
Lessons Learned: Substantial advocacy must be undertaken by community
organizations with stakeholders to ensure appropriate policies and programs are
in place; consumers must also have better information to inform their decisions
about whether to (re)enter or remain in the workforce.
60379 International index of guidelines on antiretroviral
therapies and approved drugs for HIV infection
Alyson Browett', C.G. Cadden', D. Katz2, C.J. Mackison'. 12277 Research
Boulevard Mailstop 9S, HIV/AIDS Treatment Information Service, Rockville
Maryland 20850; 2National Institutes of Health/NIAID, Bethesda, MD, USA
Issue: Global information-sharing of HIV/AIDS treatment methods helps practitioners answer treatment questions using available study results, resources, and
interventions.
Project: Due to an increase in requests for information on international treatments at the HIV/AIDS Treatment Information Service (ATIS), and realizing the
increase in the publication of treatment guidelines, an index of international
treatment guidelines, practices, and approved medications was created. Select
national AIDS service organizations were contacted through electronic and traditional mail, ans asked about treatment practices in their respective countries.
Organizations in each country were asked to respond to questions regarding
established treatment guidelines, approved medications, treatments used, and
treatment accessibility.
Results: Response rate to the electronic mail was high, proving it an easy
method for international communication. Traditional mail received fewer responses, and response time was slow. Many of the treatment guidelines and

answers to the queries are accessible on the World Wide Web. Analysis of
the guidelines included in the index show strong similarities among developed
nations' recommendations for combination antiviral therapy and clinical markers
used to make those recommendations. It is also apparent that developing nations
lack the resources to treat to the standards of the developed nations, and in
some cases do not have minimum treatment guidelines for persons infected with
HIV.

Lessons Learned: The Internet is accessible in many parts of the world and
could prove to be a useful tool for the exchange of HIV/AIDS treatment information. Continuing collection and analysis of treatment guidelines may lead to
better information-sharing and development of more broadly accepted standards
of care.
60380 Results of HIV prevention intervention among
out-of-treatment drug abusers with and without
psychiatric comorbidity
Wilson M. Compton, L.B. Cotter, A. Ben-Abdallah, R.M. Cunningham-Williams.
Washington University/Dept Psychiatry 40 N Kings Highway Suite 4 St. Louis,
MO 63108, USA
Objective: To compare the effectiveness of the NIDA standard HIV testing and
counseling protocol to a four session, peer-delivered educational intervention
among drug abusers with psychiatric comorbidity who are at high risk for becoming exposed to HIV.
Design: Randomized, controlled, 3-month follow-up study.
Methods: In this randomized, NIDA-funded (Grant DA08324) HIV prevention
study, 897 out-of-treatment injection drug (IDU) or crack cocaine using subjects
have completed the three month follow-up so far. Psychiatric diagnoses of antisocial personality disorder (ASPD) and depression were based on the Diagnostic
Interview Schedule, Version Ill-R administered at baseline. HIV risk behaviors
were assessed with the NIDA Risk Behavior Assessment administered at baseline
and at the three month follow-up.
Results: We found significant improvement for both intervention groups in:
crack cocaine use and number of drug injections, number of IDU sex partners
and overall sex partners, but not condom use. In addition, subjects in the peerdelivered intervention improved more than the standard on crack cocaine use
(84% vs. 78%, p -.05). We are now focusing on the effects of antisocial personality disorder (ASPD) and major depression on the prevention interventions
because these disorders have been associated with higher than expected rates
of HIV risk behaviors. For subjects with ASPD, the peer-delivered intervention is
significantly (p -.05) more effective than the standard in reducing the number
of IDU sex partners. Depression is not associated with differential intervention
outcome.
Conclusion: If these preliminary results are confirmed by further analyses
on the complete sample, we conclude that ASPD should be considered when
evaluating the results of HIV prevention studies because persons with ASPD
need more intensive intervention that those without ASPD.
60381 Development of nationwide HIV/AIDS herbal formulary
Andrea Ho-Kean, L.K. Gajewski, S.M. Lewis, G.J. Vanscoy, E. Archibeque.
Stadtlanders Managed Pharmacy Services, 600 Penn Center Blvd Ste 300
Pittsburgh PA 15235-2487, USA
Project: The use of herbal products is becoming well accepted among a growing
number of HIV/AIDS patients, yet rigorous clinical data is limited and not readily accessible. Misuse of herbal products can contribute to the development of
adverse reactions, drug-herbal interactions and may delay patients from seeking necessary medical attention. The need to develop a process that promotes
safe and informed use of herbal products was identified. Thirty seven commonly
used herbal products by HIV/AIDS patients in the United States were identified.
Relevant literature were evaluated and agents were categorized according to
safety and efficacy data: level 1- considered safe and effective: level II-reported
to be effective but dosing and safety data are inconsistent, level III -documented
as harmful. Classification criteria and products selected for formulary inclusions
were reviewed and approved by a national panel of HIV/AIDS physician experts.
Results: Comprehensive formulary monographs were developed for all level I
and II products. A unique formulary which ranks commonly used herbal products
according to the specified categories were developed. Twelve herbal products
were evaluated to be safe and effective, seven were found to have conflicting data,
and eighteen were determined harmful. This formulary will be used to educate
HIV patients, providers, and payors regarding the safe use of herbal products.
The development of a national HIV/AIDS Herbal Formulary is a valuable tool in
promoting safe and informed use of herbal products.
|60382 Cellular immune responses in HIV-1 infected Ugandans
Huyen Cao', C. Othieno3, R. Vincent', R.D. Mugerwa4, P.N. Mugyenyi4,
J. Ellner2, B.D. Walker1. 1Massachusetts General Hospital, ID Unit Gray 5, Fruit
St, Boston, MA 02114; 2Case Western Reserve University Cleveland, Oh, USA:
3Joint Clinical Research Centre in Kampala, Kampala: "Makerere University,
Kampala, Uganda
Background: Although the correlates of immune protection in HIV-1 infection are
not known, HIV-1 specific cytotoxicT lymphocyte (CTL) and lymphoproliferative
responses have been shown to play an important role in the host defense against
infection. Characterization of the cellular immune responses in non B clade HIV

infection offers important information in the design of an effective vaccine in areas
where non-B clade viruses predominate.
Methods: Sixteen HIV-1 infected Ugandan subjects [10 chronically infected
and 6 recent seroconverters (-:6 months)] were evaluated at the Joint Clinical
Research Centre in Kampala, Uganda. CTL activity was evaluated using the
standard chromium release assay. Effector cells were expanded CD8+ polyclonal