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

12th World AIDS Conference

Abstracts 60492-60497 1091

have used the telephone free phone line. A further 127 men have attended the
community based GUM service, 73 of whom have subsequently re-attended.
Lessons learned: Problems have been encountered with recruiting and training a diverse group of peer educators. Inter-agency collaboration brings many
strengths to an initiative, though it also presents particular costs (e.g. diffusion of
responsibility, inter-agency competitiveness).
S60492 |Sentinel surveillance in STD patients 1992-1997
Ivelisse Garris. Mahatma Gandhi # 351 Santo Domingo, Domican Republic
Objectives: To monitor the HIV epidemic inpatients that attend public health
facilities for STD services.
Design: Sentinel surveillance
Methods: A sentinel post has been established in a clinic that offers STD
services for the general population. Every year since 1992, a number of blood
samples obtained for other purposes from anonymous patients were analyzed
by the ELISA methods. Those that tested positive and 10% of those that tested
negative were validated in an specialized laboratory.
Results: The HIV prevalence is growing. The prevalence in 1992 was 4.3% and
8.1% in 1997. In patients diagnosed with an ulcer, seroprevalence was 23.1%.
Conclusion: HIV epidemic is growing and prevalence is much higher in those
diagnosed with an ulcer disease.
60493 HIV- and hepatitis B and C infection controlled in a
Swiss prison for women over two years
Joachim Nelles. Psychiatric University Services of Bern, Department East
Bolligenstr. 111, CH 3000 Berne 60, Switzerland
Prevalence of HIV and hepatitis B and C infection is severalfold higher in prison
than in the community. In Switzerland, prevalence data in prison were obtained
from questionnaires to prison officers and medical staff only. A pilot project on
drug and HIV-prevention including distribution of sterile syringes, conducted over
a period of one year, and a one year follow-up investigation (finished in July 1996)
offered the chance to study systematically prevalence rates over a period of two
years in a selected prison.
Data collection was based predominatly on structured interviews and written
questionnaires to the inmates. HIV - and hepatitis infection were tested on blood
samples gained from the subjects directly (in the pilot project) and from the
medical report of the inmates (in the follow-up evaluation). All data were given
fully voluntarily after informed consent.
In the pilot phase, HIV-prevalence was 3.2%, prevalences of hepatitis B and C
were 33%, and 25% respectively (calculated from the received data for the whole
inmate population). The data in the follow-up evaluation did not differ significantly
from the results of the pilot project.
Prevalences of blood-borne viruses in Hindelbank prison compare with results
from international studies.
They are up to 60-fold higher, when compared with the known prevalences of
the whole Swiss society.
Knowledge about HIV-infection pathways and self-protection against infection
among prisoners was satisfactory concerning HIV, but strikingly, knowledge about
hepatitis B and C was very poor, even though severity of these infections, infection
pathways and the way of self-protecting are similar with the HIV-infection.
The high levels of HIV- and hepatitis infection among the inmates of Hindelbank
prison reveal the importance of ongoing preventive measures against blood-borne
viruses in prison. Much more efforts are needed to raise awareness about hepatitis
B and C infections from being an almost forgetten to a well attended one.
60494 Project DALIA: Women at workplace - Information on
AIDS. A peer education program focused on improving
risk perception among female population
Vittorio Agnoletto12, M.G. Orsi3, M. Serrentino4, C. Sala5, R. Rossi2,
S. Volpicelli2. 'Piazza Insubria 12 20137 Milano; 2Lila Nazionale Milan; 3Lila
Firenze, Florence; 4Lila Como Como; 5Lila Milano Milan, Italy
Issues: to organise preventive actions addressed to working women who, according to the recent epidemiological studies, represent the part of population
where the spread of HIV virus is increasing (16% 1986-24.5% 1996). To create
groups in work places is the best way to reach people after scholastic ages.
Furthermore, according with the LILA legal service, in work places are concentrated the main problems regarding marginality and discrimination of people living
with HIV/AIDS.
Project: Funded by Istituto Superiore di Sanita of Italian Ministry of Health, the
project has been developed through the creation of two groups of women, the
first working in Milan (Mi) Municipality, the second working in Prato (Po) "Superal"
shopping center. It has been designed with training course of 30 hours, divided
into three stages: First stage: five lessons about scientific, legal, social and ethical
aspects of HIV infection. Second stage: five meetings about own experiences,

using: circle time, training group and role playing techniques. Third stage: five
meetings dedicated to the elaboration of a postcard, a poster and a brochure, as
informative and preventing materials specifically aimed to women. This project
has been developed in the frame of the new Italian law (626/94) concerning the
worker security in work places.
Results: the groups have worked all the time without any defection. The autoevaluation sessions (at the beginning and at the end of the project) has revealed

the improving of information, comprehension, awareness of the problem in both
groups. Milan Municipality work women has constituted a group of work aim
to promote and spread their experience shared during the course by means of
brochures distributed in their working place. This experience besides has been
published on women review with national wide circulation.
Lesson Learned: project proceeding confirmed the necessity of shifting our
approach towards HIV infection, to privilege the training of peer supporter able
to promote a new culture about prevention AIDS, which should take in account
the differences (social and cultural) between contexts. Moreover, peer operator
inside work places can increase the firm's attention regarding discrimination
60495 Homeopathic growth factors support survival and
maintain low viral loads
Barbara Brewitt', N. Polissar2. BIOMED Comm. Inc., Two Nickerson Street
#102, Seattle; 2Mountain Whisper Light Statistical Consults, Seattle, WA, USA
Hypothesis: Patients, infected 9 ~ 4 years, using a combination of four homeopathic growth factors (hGF) would survive as long as an equal cohort using
antiviral therapy (AV). A double-blind, placebo controlled and an open label study
(n = 30), determined statistically significant differences in CD4, CD8 counts, viral
load, and ESR between hGFs and only natural therapies (NAT) in 1995. The
hGF were; insulin-like-1, platelet-derived-BB, transforming-beta-1, and granulocyte-macrophage colony stimulating.
Methods: Four quarterly tests on CD4, CD8, viral load (VL), and ESR were
made on 26 of original patients. In 1996, 3 voluntary sub-groups formed: 1) GF,
n = 6, continuously used hGFs; 2) AV, n = 14, began antiviral therapy of some
type; 3) NAT, n = 5, natural therapy.
Results: At 32 months post-entry there was no statistically significant differences between AV and GF groups in CD4, CD8 or HIV VL. In the GF group, VL
went from 19,825 ~ 11,583 to 7,950 -1 3,343 RNA copies/ml, CD4 from 219 ~
23 to 242 ~ 27 cells/ul, and CD8 from 780 ~ 192 to 805 ~ 154 cells/ul. In the AV
group VL went from 7,907 ~ 3,728 to 10, 429 ~ 8,737 RNA copies/ml, CD4 from
281 i 48 to 252 ~ 27 cells/ul, and CD8 from 834 ~ 123 to 849 ~ 119 cells/ul. ESR
values in GF were normal at each time point with mean of 17.3 ~ 2.5 mm/hr; in
AV the ESR was abnormal 75% of the time, mean of 25.6 ~ 2.8 mm/hr indicating
some form of general inflammation or infection in the body (P = 0.05). Quality of
life measures of perceived physical functioning in the GF group was statistically
higher than in the AV group (P = 0.01). After 28 months post-entry into the original
study, 80% in NAT, 25% in AV and 0% in GF were hospitalized or reported Ols.
Additional measures of disease progression over nine months were CD4 counts
from 179 + 43 to 138 1 71 cells/ul, CD8 from 863 ~ 230 to 523 ~ 56 cells/ul and
VL from 293,480 ~ 91,741 to 131,066 - 68,917 RNA copies/ml.
Conclusions: Homeopathic growth factors with or without antiviral therapy
support long term survival, in contrast to other natural therapeutic approaches.
Immune function as indicated by normal ESR values may be better supported by
GF treatment than AV alone. These important observation need larger sample
sizes for further validation. HGFs represent a cost-effective natural, non-toxic
approach to HIV infection.
60496 Epstein-Barr virus (EBV) PCR of CSF: Is it useful in the
diagnosis of primary CNS lymphoma in HIV patients?
Alec Bonington', P.E. Klapper2, J.I.G. Strang3, E.G.L. Wilkins4. 1Monsall Unit,
Infectious Diseases Research Dept, Delaunays Road, Manchester; 2Department
of Pathological Sciences Manchester; 3Celilia Makiwane Hospital Mdantsane;
4North Manchester General Hospital Manchester, UK
Objectives: To evaluate the role of EBV PCR (polymerase chain reaction) in the
diagnosis of primary central nervous system (CNS) lymphoma in patients with
HIV infection.
Design: Combined prospective and retrospective study.
Methods: Samples of cerebrospinal fluid (CSF) were collected prospectively
from HIV-positive patients undergoing lumbar puncture at an HIV Unit in the
UK, and a District Hospital in the Republic of South Africa. Forty CSF samples
were collected from 26 patients in the UK and 27 samples from 22 patients in
South Africa. In addition, 50 CSF samples from 45 UK patients were retrieved
retrospectively. Each CSF sample was tested using an EBV PCR ELISA test
capable of detecting approximately 1 EBV genome/5 /I sample of CSF.
Results: A total of 12/93 HIV-positive patients were EBV PCR-positive; 4/71
patients from the UK and 8/22 patients from South Africa. Two of these PCRpositive patients were diagnosed as primary CNS lymphoma. The remaining 10
patients had alternative diagnoses including 2 with cryptococcal meningitis and 2
confirmed tuberculous meningitis.
Conclusion: Although this study confirms that EBV PCR has a 100% sensitivity
for the diagnosis of primary CNS lymphoma in HIV-positive patients, its specificity
is only 89%.
|60497| HIV infection in Asians resident in the United Kingdom

Beng-Tin Goh, A.M. Wrigth. Ambrose King Centre Royal London Hospital, White
Chapel London, UK
Introduction: HIV infection in Africans resident in the UK had a spectrum of
pathology which was ermediate between that in Africa and in the UK, the majority
of whom are heterosexually acquired. There is however very little information on
Asians resident in the UK.