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

1070 Abstracts 60383-60386

12th World AIDS Conference

cells and target cells were autologous B-lymphoblastoid cell lines infected with
clade B recombinant vaccinia viruses. Proliferative assays were performed on
cryopreserved PMBC exposed to whole soluble HIV-1 clade B p24 and gp160
proteins and tested in a standard 3H thymidine uptake assay.
Results: 7/10 chronically infected subjects and 2/6 recent seroconverters
demonstrated HIV-specific CTL activity against clade B targets expressing Gag,
RT, Env and Nef proteins. Lymphocyte proliferative responses to p24 antigens
were observed in 2/10 chronically infected subjects and 0/6 recent seroconverters. The subjects studied demonstrated a broad range of CD4 counts (150-1100
cells/mm3) and viral burdens (510-690,000 copies/ml). Preliminary HIV subtyping
indicated that the predominant HIV clades in the subjects studied were of clade
A and less frequently, clade D.
Conclusion: Infection with non-B clade HIV-1 can induce virus-specific CTL and
proliferative responses that are cross-reactive with clade B. The demonstration
of cross-clade immune responses supports the use of clade B-basedcanarypox
vaccine in the phase I trial that will soon begin in Uganda. Further characterization of the cellular immune responses in non-B clade HIV infection, both in acute
and in chronic infection will facilitate future interventional and therapeutic efforts
worldwide.
60383 Persisting clonal CTL responses in vertical HIV-1
infection
Christian Brander, K. Luziriaga2, P. Goulder2, B. Walker2, S. Kalams2,
N. Jones2, K. Hartman2. 'Massachusetts General Hospital, AIDS Research
Center, 149 13th Street, room #5214, Charlestown MA; 2Dept. of Pediatrics,
Univ of Massachusetts Medical Center, Worcester, MA, USA
Although HIV-1 infection can induce strong CTL responses in adults, less information on CTL responses in vertically infected children is available. We studied
epitope specific, HLA class I restricted CTL responses longitudinally in two infants. One infant, infected intrapartum, had low levels of CTL activity to epitopes
in RT and Nef and showed a rapid decrease in CD4 counts. The other infant,
infected in-utero, had a broadly directed, strong epitope specific CTL response
detectable in samples from 4 through 37 months of age. The strongest response
was directed against a peptide from Gag-p17 (SL9, SLYNTVATL). Tracking the
T cell receptor transcripts of a SL9 specific CTL clone generated from month 37
confirmed the persistence of this clone in cDNA libraries generated from months 3
through 60. Additionally, FACS analysis of antigen specific cells using tetrameric
peptide/MHC complexes showed that even after start of triple-drug therapy and
subsequent undetectable viral burden, SL9 specific cells were present at 0.5%
of total CD8+ cells. These data show that the infant immune system was able to
generate CTL responses of the same strength and specificity as those seen in
adults and that clonal responses can persist for more than 5 years after vertical
HIV infection.
Vertical HIV-1 transmission can induce strong CTL responses which are 1)
directed against epitopes that are also targeted by CTL responses in HIV-1 infected adults and 2) reach similar magnitude of epitope specific responses, as
assessed by precursor frequency analysis and FACS based staining of specific
cells. Tracking of T cell receptor transcript demonstrated the persistence of clonal,
epitope specific responses for more than 5 years.
S60384 Sexual HIV transmission risk among HIV-seropositive
men who have sex with men recruited from three venue
types in two US cities
Ann O'Leary1, J. Parsons2, R.H. Remien3, M. Leach'. 'Centers for Disease
Control, 1600 Clifton Road, Atlanta, GA; 2Jersey City State College, Jersey City,
NJ, 3Columbia University New York, NY USA
Objectives: Few behavioral interventions have been specifically designed to
reduce sexual HIV transmission risk among HIV+ individuals. The present study
sought to identify effective strategies for recruiting high-risk men into a study of
sexual risk to inform a planned intervention trial, the SUMS.
Methods: Participants were recruited in New York City and San Francisco, from
AIDS service organizations (ASOs) (N = 69), mainstream gay venues (MGVs)
such as bars and pride events (N = 53), and public sex environments (PSEs)
(N = 73). They completed questionnaires regarding their sexual behavior in the
previous three months, connections to community services, internalized homophobia, and sexual orientation. We hypothesized that PSE men would be the
least connected to services, least likely to identify as gay, highest in homophobia,
and at highest sexual transmission risk.
Results: Men recruited from PSEs reported significantly more sex partners in
the previous 90days than men from the other two venues, Ms = 19.3 vs. 12.0
and 12.8, p ---.03. No differences were observed in reports of any unprotected
anal intercourse with negative or unknown HIV-serostatus partner in the previous
three months, M = 37%. However, men reporting this risk behavior reported
significantly more frequent visits to sex clubs (1.48 vs. 97 times/month, p -.05)
and cruising areas (1.68 vs. 1.27 times/month, p <.05) to find new sex partners.
PSE men were significantly less connected to gay activities and health services.
Near-significant differences suggest that PSE men are more likely to report being

bisexual, and have higher levels of internalized homophobia, than men from the
other venues. Data on effort needed to recruit participants from the three venues
will also be reported.
Conclusions: Results are suggestive of some differences between men who
frequent PSEs and those who do not, or who do so less frequently. Further
research on specific risk patterns of individuals recruited from different types of

settings and with different behavioral risk criteria is needed in order to target
interventions to those at highest risk of transmitting HIV.
60385 US bathhouses do HIV prevention: Some better than
others
Diane Binson', William J. Woods', T.J. Mayne2. ' UCSF - Center for AIDS
Prevention Studies, San Francisco, CA; 2New York University, New York, NY,
USA
Objective: Advocates for bathhouses have argued that these spaces provide an
opportunity to educate hard-to-reach populations. This study examined whether
businesses in the US that exist primarily to provide opportunities for sexual encounters between men (herein referred to as bathhouses) also provide patrons
with HIV prevention programs.
Methods: The sample was a census of bathhouses (includes bathhouses,
sex clubs, etc.) that provide spaces for sex (n = 104), listed in two 1996/1997
gay travel guides. Of the bathhouses listed, 20 had closed, and 4 reported that
they did not provide space for sexual activity, leaving a population of 80 venues.
Between October 1996 and February 1997, we conducted structured telephone
interviews with the managers of 63 bathhouses in 22 different cities in the United
States. The response rate was 79% (63 completed the interview; 5 refused to
participate; 12 could not be reached by phone).
Results: Private rooms were available in 81% of the bathhouses; 43% of the
bathhouses allowed sex in some public areas; and 25% provided private and
public areas for sex. 100% of the bathhouses provided condoms, 95% displayed
educational materials such as posters or flyers about HIV/AIDS, and 79% promoted safer sex behaviors through special events (e.g., events sponsored by
community based organizations). Almost half the bathhouses (40%) supported
on-site HIV testing, with about half of these offering STD testing as well. We
defined "high quality prevention" to include HIV testing or special events. Bathhouses in the West (96.3%) and the South (92.3%) were more likely than the
Midwest (66.7%) and the East (57.1%) to have high quality prevention (p <.01).
In California 100% of the bathhouses provided high quality HIV prevention. In the
rest of the country, bathhouses with private areas for sex were more likely than
those with no private areas for sex, to support high quality HIV prevention (p <.05).
HIV Prevention in Bathhouses Providing Different Areas for Sexual Encounters (Excluding California)

Quality of HIV Prevention

% Bathhouses with
Some Private Areas
19.1
80.9

% Bathhouses with
No Private Areas
60.0
40.0

Low
High

Conclusions: These data show that bathhouses can, and do, provide HIV
prevention messages and programs. Bathhouse managers, in collaboration with
community organizations and public health advocates, need to ensure that high
quality HIV prevention becomes standard practice in these environments. In
addition, their collaboration is key in research that identifies the factors that facilitate HIV prevention efforts in bathhouses and that determines which prevention
activities work best.
60386 Names reporting of HIV-positives would reduce HIV
testing among men who have high-risk sex with men in
San Francisco, CA
William Woods', W. McFarland3, J. Sabatino', J. Rinaldi1, B. Adler', T. Lihatsh1,
J. Dilley'. UCSF - 1AIDS Health Project, 2Center of AIDS Prevention Studies, 74
New Montgomery St., San Francisco; 3 Office of AIDS, SF Dept. of Health, San
Francisco, CA, USA
Background: The extent to which high-risk individuals would refrain from testing
for HIV is one of the most serious concerns around implementing a policy of
names reporting. The objective of this study was to identify, among men who
have high-risk sex with men, the potential effects of proposed HIV-positive names
reporting on intentions to take an HIV antibody test.
Methods: Participants (N = 73) were recruited when scheduling an anonymous
HIV antibody test; they were non-IDU and had at least one prior test, were
HIV-negative on their previous test, and had unprotected anal intercourse with
an HIV-positive man or man of unknown status in the last year. Participants were
randomly assigned to one of two groups that differed on when the public health
benefits of names-reporting were presented to them, as described in the Table 1.
The question asked was whether they would test for HIV if names reporting was
required.

Table 1
Group A (n = 38)
1) Question
2) Benefits
3) Question

Group B (n = 35)
1) Benefits
2) Questions

Results: Table 2 shows the percent not willing to test if names reporting were
required. Of the 38 who were asked before hearing of the public health benefits
(Group A), 26 (68%) said they would not be willing to test if names reporting were
required. Only 3 of the 26 (12%) changed their minds after hearing the benefits.
Of the 35 who were only asked after hearing of the benefits (Group B), 16 (46%)
said they would not test if names reporting were required.