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

1096 Abstracts 60520-60525

12th World AIDS Conference

HHV8 infection in different populations in France, we set up a prospective study
in a STD department.
Methods: during one year, persons presenting at the Bordeaux Hospital STD
clinic for anonymous HIV screening were proposed to be enrolled in the study
which corresponded to a blood sampling and a questionnaire regarding the sexual
behaviour. HHV8 DNA extracted from the PBMC was submitted to a 38-cycle PCR
followed by liquid hybridization and ELISA detection, blindy in regard with the caracteristics of the patients. Confirmation of positive results using non overlapping
primers and serological studies are in progress.
Results: between April 1996 and October 1997, 153 persons entered into our
study. Two different groups were enrolled: a group of 102 heterosexuals, with a
sex ratio at 1.7, and a group of 51 homo- or bisexual men. Results are expressed
in table:

(%)
HHV8 PCR positivity

Heterosexuals Homo or bisexuals
3.9% 11.7%

Noteworthy, the HHV8 DNA prevalence was 7.3% in the group of heterosexual
men, and in contrast 0% for the women.
Conclusion: HHV8 prevalence, measured by PCR, exhibited a positive gradient from female population to male heterosexual patients, and to homo-or
bisexual men, in persons presenting at a STD clinic. These findings may support the hypothesis of the importance of sexual behaviour in regard with HHV8
transmission.
60520 HIV/AIDS and the impact on the religious communities
Desiree Rushing. 815 8th. st Berkeley Calif 94608, USA
At the beginning of the HIV/AIDS epidemic, the religious communities shied away
from dealing with the issue. In 1996, I started a HIV/AIDS ministry at my church,
other churches started opening their eyes. Hosea 4:6 says (MY PEOPLE WILL
DIE FOR LACK OF KNOWLEDGE). I expressed to the religious communities we
shouldn't close our eyes to things we don't understand, but seek knowledge to
help the infected com-munities.
Since the HIV/AIDS workshop there is a 20% increase of attendance of
HIV/AIDS individuals at my church.
60521 Back to the future: Return to work programming issues
for people living with HIV/AIDS
Roger Larade. 399 Church St., 4th Floor Toronto Ontario, Canada
SINCE protease inhibitors became available in 1996, combination anti-retroviral
therapy has led to significant improvements in the health of many, though not all,
persons living with HIV/AIDS (PHAs). As these PHAs regain their health, AIDS
service organizations (ASOs) are being required to respond to an emerging need
for programs and services designed to assist those considering or wanting to
return to the work force. This situation presents significant challenges to the way
ASOs have traditionally provided support to PHAs.
This session will present the work of the AIDS Committee of Toronto in responding to these challenges, including needs assessment and issues identification,
strategic directions response, and program development.
The multiple issues involved in this emerging area necessitate careful consideration before proceeding to program initiatives. Both integration into existing
programming and new programming are required in addressing relevant needs.
60522 Functional illiteracy and AIDS education: The
marginalisation of the marginalised in Vancouver, Canada
John P. Egan. 408-621 East 6th Avenue, Vancouver, BC V5T 4H3, Canada
Issues: Current AIDS education strategies in Vancouver rely on printed materials
such as flyers and posters. Such materials are of little relevance to those who are
functionally illiterate.
Project: Three communities are examples of how printed educational materials
can be ineffectual in identifying and changing risk behaviour, Injecting drug users
are often rendered illiterate due to sensory impairment. Those whose English language reading skills are limited (often new Canadians who are proficient in other
languages) may be able to converse in English, but cannot read. Impoverished
persons (a disproportionate number who are aboriginal), of whom many have not
successfully completed formal schooling, seek other venues of information, such
as informal discussions, and broadcast media.
Results: The value of printed materials for a majority of Vancouverites is not
in question. But it is often the more marginalised of our communities who cannot
access harm reduction information in printed English. Community groups which
target specific cultural groups (ASIA, Atish among others) have thus produced
their own materials in other languages. But for anglophones who are illiterate,
interpersonal verbal interventions must remain the focus of educational efforts.
Pursuance of the broadcasting via the public service announcement functions
mandated by the CRTC can also be a strategy, though sexphobia and drugphobia
problematize this venue.
Lessons Learned: With the governmental support of community interventions
in question, a political will must be found to ensure that community-centred interventions are not only sustained, but developed beyond current funding levels.
Community groups can also pursue more overt uses of broadcast media to carry
the messages of harm reduction.

S60523 Protease inhibitors: Use and effects in an HIV clinic
Virginia Waring, A. Moses, S. Walmsley, I.E. Salit. G331 101 College Street, The
Toronto Hospital, Toronto, Ontario, Canada
Objective: Information is needed on protease inhibitor (PI) use, tolerability and
efficacy in a clinic setting outside of clinical trials.
Methods: We examined antiretroviral (ARV) use among 300 unselected HIV
clinic pts. in a tertiary care hospital (June 1995-December 1997). The pts. were
predominantly male (89%), white (71%) and homosexual (74%) with an average
age of 41; 2% were intravenous drug users.
Results: The history of ARV therapy is as follows: reverse transcriptase inhibitors (RTI's) 95%; Pi's (77%); no ARV therapy (5%). Combination therapy was
most frequent among current ARV users: dual (20%); triple (59%); quadruple
(18%). Of pts. ever on Pl's, 91% were still on a PI. However, 60% who were on PI
therapy changed Pi's at least once: 60% initially switched from saquinavir (Saq)
to other Pl's. Reasons for changing or discontinuing Pi's included: adverse drug
reactions (27%) or poor viral load/CD4 response (39%). Current use of Pi's is:
indinavir (45%); nelfinavir (22%); saq + ritonavir (Rit) (13%); Saq alone (11%);
Rit alone (6%). For all pts. who were on Pi's, 94% had an TCD4 count (mean
increase = 137 cells). Viral loads decreased by a mean of 1.5 logs and 76% had
no detectable plasma viremia at least once after PI therapy. Weight gain occurred
in 82% of patients with a >2 kg weight gain in 52% and a mean increase of 3.4
kg. Current use of Pl's is higher in white (74%) versus black patients. (51%) (P
<.05) and also higher in males (73%) versus females (44%) (P <.05). Pi's are
provided at variable cost to patients depending on their insurance plans. Those
patients without full third-party payment for PI therapy were more frequently on
another antiretroviral regimen.
Conclusions: More than 75% of the patients in our sample had used a PI and
experienced TCD4 counts, undetectable (<500 copies/ml) viral loads and Tbody
weight. PI usage was disproportionately low among visible minorities, women and
those without financial drug coverage.
S60524 Comparison between young men having sex with men
(MSM) participating in two cohort studies in Montreal and
Vancouver, Canada
Annie Dufour1, S. Strathdee2, M. Alary3, S.L. Martindale2, J. Otis4, R.S. Remis5,
M.T. Schechter2. 1CHA-Pavillion St-Sacrement 1050 Chemin Ste-Foy, Quebec,
QC G1S 4L8; 2BC Centre for Excellence in HIV/AIDS Vancouver BC;
3Epidemiology Group, Laval University Quebec QC; 4Dept. of Sexology, UQAM
Montreal QC; 5Dept. Public Health SC., U. of Toronto Toronto ON, Canada
Background: The objective of this study was to compare sociodemographic characteristics and risk behaviors of young MSM in Montreal (MTL) and Vancouver
(VCV), Canada.
Methods: MSM not previously testing HIV positive were enrolled in prospective
cohorts in MTL since October 1996 and VCV since May 1995. MSM underwent
HIV tests and similar questionnaires on demographics and risk behaviors at
baseline. Analysis was restricted to MSM aged 18-30 years who enrolled by
December 1997. Contingency table analysis was used to compare data between
cities.
Results: Compared to MSM in VCV (n = 631), a greater proportion of MSM in
MTL (n = 392) were aged 20 years or less (19% vs 12%, p = 0.003), reported an
annual income <$25 000 (78% vs 64%, p = 0.001), were unemployed students
(22% vs 7%, p = 0.001) and were receiving unemployment insurance (6% vs
3%, p = 0.06) or welfare (8% vs 2%, p = 0.001). However, MSM in MTL were
more likely to have completed high school (14% vs 5%, p = 0.001) and to have
attended university (35% vs 29%, p = 0.035) than MSM in VCV. MSM in MTL
were less likely to report currently having sex with both sexes (5% vs 12%, p =
0.001), reported fewer female lifetime partners (<6) (93% vs 81%, p = 0.001) and
less often had unprotected anal sex with sex trade clients (4% vs 9%, p = 0.002)
or male sex workers (<1% vs 5%, p = 0.001). However, MSM in MTL were more
likely to report having sex with >20 partners during the previous six months (11%
vs 8%, p = 0.064). During the previous six months, 79% and 42% of MSM in MTL
reported anal sex and unprotected anal sex respectively whereas 83% and 53%
of MSM in VCV respectively reported these behaviors during the previous year.
One MSM (0.3%) in MTL was HIV+ at baseline interview vs 2% of MSM in VCV
(p = 0.039).
Conclusion: These data indicate that a significant proportion of young MSM in
at least two Canadian cities continue to be at high risk of HIV infection. Moreover,
this similar profile of risk behaviour was derived from 2 populations with distinct sociodemographic differences. These data suggest that continuing high risk
behaviour in young MSM is not necessarily restricted to one sociodemographic
subgroup, and may be more pervasive in this community.
160525 Methionine enkephalin: a new cytokine inhibits HIV
replication in PBMC
Richard Novak1, Mahmood Ghassemi1, Nick Plotnikoff2. 1808 S. Wood Chicago

IL 6 06 12; 2285C, M/C 865 833 S. Wood St. Chicago IL, USA
Objectives: To measure the effect of Met-Enk on HIV replication in PBMC
Study Design: in vitro antiviral assay
Methods: Antiviral Activity in PHA-Lymphoblasts: PBMC were obtained from
normal donors and stimulated with PHA-M for 72 hours, then infected with S5G7,
a subclone of HIV-13B at a MOI of 0.01 for 2 hours at 37 C. Cells were then
washed and plated with varying concentrations of the Met Enk or AZT (positive