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

12th World AIDS Conference

Abstracts 60537-60541 1099

over 90% of sampled respondents agreeing to participate in the research. The
quality of survey data was uniformly high. Findings are directly contributing to
more informed and targeted planning for services.
Lessons learned: Advantages of PLWA involvement in research include, for
the researcher: legitimacy - acceptance in the community; improved questionnaires-what to ask and how to ask it; access-gaining entree to hard-to-reach subgroups; training assistance-sensitizing field staff; deeper analysis-interpretation
of findings. Advantages for PLWAs: understanding research-learning the need for
studies and the research process; informed advocacy-having empirical data to
back up claims for services needed; and ownership - experiencing an opportunity
for giving voice to PLWA concerns.
-605371 Psycho-spiritual counselling: An alternative approach to
developing and organizing people living with HIV/AIDS
(PLWHIV/AIDS)
Judea P. Asuncion1, J. Diaz2, E.A. Davis1, B.S. Leoligao. ' Olongapo City AIDS
Foundation Inc., City Health Dept., Olangapo City; 2Pinoy Plus, Manila,
Philippines
Issue: Since 1992, the Olongapo City AIDS Foundation, Inc.(OCAFI) have been
conducting Spiritual Retreat and Counselling for PLWHIV/AIDS from Olongapo
City as a means to develop and organize them as partners in their program
implementation.
Project: On 1996, OCAFI and Pinoy Plus (a Manila based national organization
of PLWHIV/AIDS) conducted a joint project to organize and develop members
of their organization. Through funding support from PHanSUP and ALLIANCE,
a six-day retreat and teambuilding seminar was conducted. 18 members and
officers of Pinoy Plus participated in the said activity. The module was designed
and implemented in partnership with a PLWHIV/AIDS and was made responsive
to the emotional and spiritual needs of the participants to develop them as a
person and build their organizational capability as a team. The venue for this
activity was carefully selected to maintain confidentiality of the proceedings. Facilitators were chosen on the basis of their experience and manifest support and
concern for PLWHIV/AIDS. Structured learning experiences coupled with group
dynamics and sharing sessions were some of the strategies used during the
entire activity. Scheduling of sessions were done according to the convenience of
the participants and the direction of the sessions were guided by the immediate
need of the pax.
Result: Better working relationship among members of the organization vital
to program implementation.
The project demonstrates the potential of psychospiritual counselling in developing and organizing PLWHIV/AIDS. Emotional stability is necessary for one to
become a productive member of the society regardless of one's HIV status.
60538 Turning difficulties into opportunity: Resource
management and community mobilization in HIV/AIDS
campaign
Joseph Freden Leoligao, J.P. Asuncion. Olongapo City AIDS Foundation Inc.,
City Health Department, Olongapo City, Philippines
Issue: For two consecutive years, OCAFI's funding grant ran short during the
World AIDS Day Campaign. Funding grant ends on November, which leaves
minimal financial resources to spend for the transportation allowance of their staff
who actually receives no salary
Project: In an effort to pursue its campaign and come up with a meaningful
WAD celebration which would entail a bigger budget-instead of cancelling the
celebration OCAFI made it an opportunity to raise funds and establish additional
linkage to other organization. A week-long celebration was done ensuring the
participation of almost all sectors of the community, a partnership was formed with
OCAFI providing the technical assistance and the finances and materials coming
from the community members. Slots for sponsorships of different activities which
includes the budget requirements, description of activity, and other mechanics
were distributed to prospective partners to allow them to choose which appeals
to them.
Result: A week-long WAD celebration was successfully undertaken with minimal expenses. Additional funds were gathered from the activity. On WAD celebration done on 1997 - the organizations were already the ones volunteering to
sponsor activity. Sample activities conducted were as follows: Quiz Bee, Poster
Making Contest, Ms. Gay Olongapo, Parade for a Cause, Stage Play, Church
Bell ringing and noise barrage, Motorcade and "Peso for a red ribbon."
Lesson Learned: Effective resource management could be best achieved
through linkage with other sectors of the society. Every sector of the community play could be reached and mobilize through a well-planned and carefully
implemented External Relations Program.
S60539 STD, HIV/AIDS awareness and educational program in
expansion project in the First District of Zambales

Teresita Cea, B.V. Leoligao, J.P. Asuncion. Olongapo City AIDS Foundation Inc.,
City Health Department, Olongapo City, Philippines
Issue: Increasing STD rate and lack of HIV/AIDS education in the 1st District of
Zambales.
Project: Advocating STD, HIV/AIDS information and prevention in expansion
project in the 1st district of Zambales targetting the general community involving

the direct participation of the local Government officials, NGOs, GOs, Peoples
Organization and Community-based Organizations. Coordination and courtesy
calls was conducted to the national government down to the local government
officials so as to formalize the setting up of the project. This was followed by a
consultative workshop with different organizations including GOs from the said
district which is composed of three municipalities. The workshop came up with
a plan to integrate STD-HIV/AIDS concern in the Health Component of each
municipality having the local government unit as the star player in mobilizing the
committees from different sectors to act on HIV/AIDS Issues in their home town.
Result: A resolution for setting up committees responsible for STD-HIV/AIDS
prevention was ratified. Resolution to allot budget for trainings, seminars and
other activities pertinent to AIDS Volunteer educator from the community was
formed, STD rate decreased and AIDS patient was given an assistance through
the initiative of the community leader.
Lessons Learned: Trust, comraderie and involvement of Local Government
officials in planning AIDS action plan can lead to quick and smooth implementation
of the program.
r 60540 The effect of HIV infection on tuberculosis in Harare
Philippa Easterbrook1, R. Makombe2, L. Valenti, A. Ndousa3, O. Harahe3,
0. Tobaiwa3, A. Ferguson3. 'Chelsea and Westminister Hospital, London, UK:
2City Health Department, Harare; 3University of Zimbabwe, Harare, Zimbabwe
Objectives: To determine the current prevalence of HIV infection in smear positive
tuberculosis patients, and the effect of HIV status and level of immunosuppression
on the epidemiological and clinical features.
Design: Prospective cohort study
Methods: 488 consecutive adult smear positive pulmonary tuberculosis patients presenting to the Beatrice Road Infectious Diseases Hospital in Harare
between May to October 1997 were enrolled. A detailed interviewer-administered
epidemiological questionnaire was completed, and HIV (based on 2 ELISA) and
CD4 testing were performed on each patient.
Results: The majority (65%) of patients were male, with a median age of
31 yrs at presentation; 41.1% of patients gave a history of recent contact with
tuberculosis, and 8.2% had a past history of TB. The overall HIV seroprevalence
was 72.8%, but HIV prevalence and level of immunodeficiency varied significantly
according to age: 18-24 (42.5%, median CD4 cell count 315 cells); 25-29 (74.6%,
225 CD4 cells); 30-34 (88.2%, 139 CD4 cells); 35-39 (85.3%, 126 CD4 cells);
40-44 (81.3%, 106 CD4 cells); -45 years (63.9%, 92 CD4 cells). In a multivariate
analysis, independent indicators of concurrent HIV infection were age, a history
of recurrent genital ulcers (OR = 11.5, 95%CI = 3.2-41.6), and on exam, a zoster
rash (OR = 14.6, 95%CI = 1.8-72) and oral thrush (OR = 7.3, 95%CI = 1.4-38.2).
There was no association between either HIV status or CD4 cell count and gender, marital status, smoking or alcohol history, duration or nature of symptoms,
occupation, household crowding, past history of TB or recent TB contact.
Conclusions: The prevalence of HIV infection in this cohort of TB patients is
higher than previously reported in Zimbabwe or other sub-Saharan countries, especially in the 30- to 39- year age group. Ongoing extensive transmission of TB in
HIV infected persons has major implications for national TB control programmes.
60541 Antiretroviral therapy in a dialysis-dependent patient:
A case report
Pushpa Bhatt1, R.A.J. Baltes2. 1Project Manager, Meen Bhawan, Shanti Nagar,
G.PO. 8973 E.PC. 7323, Kathmandu, Nepal, 2Consultant to the Project
D66636Tholey, Germay
Objective: To describe a case of antiretroviral therapy in a patient receiving
dialysis
Diagnosis of HIV-lnfection and start with AZT 1991. From Jan. 1992, CD4 count
of only 10 cells/pL. From mid-1995, AIDS with multiple opportunistic infections
and wasting. Dec.1996-Jan. 1997: Cidofovir therapy for CMV retinitis, given currently with an antiretroviral regimen of AZT, 3TC, sequinavir and ritonavir, led to
kidney failure and permanent dialysis dependence in a matter of weeks.
On 1 April 1997, following a two-month interruption in antiretroviral therapy, the
patient was starter on 150 mg DDI, 25 mg 3TC (solution), 1800 mg saguinavir
and 2250 mg nelfinavir. He remained on dialysis and had a CD4 count at the time
of 3 cells// L and a viral load of 10.6 KEq/mL (bDNA).
The regimen is being tolerated without adverse reactions. The ARC and wasting syndrome and persistent mycoses have resolved completely, and there have
been no new opportunistic infections. There is no CMV retinitis activity, but the
patient does show progressive cataract formation. Since the new antiretroviral
regimen was instituted, viral load has fallen below the limit of detection, and for
the first time in five years there has been a slight rise in CD4 count, peaking at
40 cells/p L (most recently, 30 cells// L).
Summary: HIV infection in a 49-year-old dialysis-dependent patient has been
successfully managed for the last ten months using a multi-drug antiretroviral
regimen of DDI, 3TC, saquinavir and nelfinavir.