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

12th World AIDS Conference

Abstracts 60707-60711 1131

trials for the treatment of HIV infection. In an earlier Phase II study of extended
Preveon therapy in which concomitant antiretrovirals were permitted, HIV RT
genotypic analyses revealed that 8 of 29 patients developed genotypic changes
in RT that were possibly associated with Preveon treatment. Importantly, all 8 of
these patients experienced sustained viral load suppression during the dosing
period of 6-12 months.
Methods: In a current Phase III study patients were randomized to add Preveon or placebo to their existing antiretroviral regimens for 24 weeks; drug was
then administered open label during weeks 24-48. The majority of patients had
received >3 nucleosides previously. Genotypic analyses were conducted on RTPCR products containing nucleotides 1-900 of HIV RT generated from patient
plasma samples.
Results: Genotypic analyses of baseline and week 24 HIV RT genes from
126 of 442 enrolled patients have been conducted to date. Baseline samples commonly carried numerous AZT-associated resistance mutations and the
3TC-associated M184V mutation. RT changes from baseline that could not be
attributed to concomitant medications were identified at week 24 in 17 of these
126 patients. One patient developed an S68G mutation, 4 patients developed
amino acid substitutions at codon 69 and the remaining 12 patients developed
AZT-associated resistance mutations. Analyses of these data after study unblinding will be presented. Interestingly, ddl and d4T therapy have been shown to
select for AZT-associated resistance mutations previously and many of these
patients were receiving either or both of these therapies during the study. RT
sequence data from 43 of these 126 patients during the open label phase of the
study identified 7 more patients who developed changes from baseline at -32
weeks: 1 with an L74V/L mutation plus an AZT-associated resistance mutation, 1
with a T69S mutation plus a double serine insertion between RT amino acids 69
and 70, and the remaining 5 with AZT-associated resistance mutations.
Conclusions: The resistance patterns described here are similar to those observed in the Phase II study and confirm that mutations associated with Preveon
resistance do not arise readily during prolonged therapy. Based on in vitro data
these mutations would not be expected to affect subsequent response to most
RT inhibitors, including the closely related analog, PMPA.
60707 Profile of heterosexual couples with HIV infection
attending in a reference center in Vit6ria, Brazil
Isabel Pires', A.E. Miranda2, A.M. Zago2. 'R Luis Fernandes Reis "252/702
praianda costa 29.101-120 Vila Velha:ES; 2Centro de Referencia EM DST/AIDS
Vitoria, ES, Brazil
Objectives: (1) To determine the profile of heterosexual transmission of HIV and
other risk factors associated with the infection, and (2) to assess the prevalence
of serodiscordant couples.
Design: Survey of records.
Methods: Data was collected from the medical records of all heterosexual couples with at least one HIV seropositive partner. The data covers couples attended
from January/1993 to December/1997 in a Reference Center for STD/AIDS in
Vitoria, Brazil.
Results: Forty-nine heterosexual couples were included in the study. Mean
age was: 31.7 years (SD 8.0) for men and 27.7 years (SD 7.7) for women. Concerning education, 64.3% of the sample had only completed elementary school.
All couples were living together at least one year. Out of the couples studied, in
29 (59.2%) both partners were HIV positive, in 14 (28.6%) only the men were
positive, and 6 (12.2%) only the women. Forty-nine (50.0%) patients reported
as their only risk for HIV infection sexual contact with persons at increased risk
for HIV. VDRL tests were positive in 6.8% of the men and 8.7% of the women.
Twenty-two (44.9%) couples did not use condoms and in 13 (26.5%) cases one of
the partners never used. Previous STDs were reported by 28 (57.1 %) men and 13
(26.5%) women. Fourteen (28.6%) men and 2 (4%) women reported IVDU; only
3 (6.1%) men and 2 (4.1%) women reported history of blood transfusion. Bisexual
activity were reported by 5 (10.2%) men. There was not a significant difference
between the negative and positive group regarding the variables analyzed.
Conclusion: Several factors which increase the risk of transmission through
unprotected sex have been identified. Knowledge of these factors could be helpful
for counseling patients infected with HIV and their sexual partners. The use of
condoms seemed to be the most important factor in reducing HIV transmission
and the promotion of safer sexual behaviors is a important way to containing the
AIDS epidemic.
60708 The German women and AIDS network
Corina Tigges', M. Seibertf2, H. Langanke3. 'Network Women & AIDS
Wuppertal Schreinerstrasse 8 42105 Wuppertal; 2Network Women & AIDS
Berlin; 3 Network Women * AIDS Bonn, Germany
Issue: Although the rate of HIV infection for women in Germany is steadingly
rising, women are still not given the attention they deserve and services are
often inadequate. Women with HIV/AIDS come from very diverse segments of
the German population; they do not belong to one homogenous group.

Project: In 1992 a small group of active women founded a Network. The organisation strives to create a network of local centres and a lobby for HIV-infected
women. It serves to collect and distribute information, create projects and exchange experiences on the topic Women and AIDS. The Network produces a
newsletter DHIVA. It also runs seminars and work groups on various topics (public
relations, drugs, lesbians, law, medicine, prevention) as well as developing policies and politics around women, HIV/AIDS. The organisation's work includes the

creation and expansion of an information pool on women and HIV; the promotion
of various approaches to prevention; counselling and self-help specifically for
women; support of medical research and psychological care geared to meet the
specific needs of women; and the formation of a political forum.
Results: Today there are more than 100 women from all over Germany
connected to each other through the Women & AIDS Network. The Network confronted the German,, Women's Movement" with the subject of women, HIV/AIDS.
It created a conversation with feminist groups and unions and is involved in
celebrations and events such as International Women and Lesbian Pride Day on
march 8th.
Lessons Learned: The Women & AIDS Network is a country-wide joint operation by and for women with HIV/AIDS and for women who work in the field. The
Network is also a political action group for women with HIV/AIDS. Women with
HIV/AIDS have become more and more public in Germany and now do a lot of
intensive work.
S60709 Harm reduction among south asian men who have sex
with men at Toronto bathhouses
Indra Ramkissoon, Z. Tengra2. 'Alliance-South Asian AIDS Prevention 20
Carlton St. #126 Toronto Ontario, Canada
Issue: Population vulnerable to HIV/AIDS because of denial, cultural and linguistic barriers to information and education, and require sensitive and appropriate
intervention to reduce harm of HIV/AIDS.
Project: A South Asian worker conversant in several South Asian Languages
and aware of cultural diversity, targets South Asian men who have sex with men
at 3 Toronto bathhouses. They include men who deny they are homosexual. He
provides culturally sensitive and linguistically appropriate information and literature. Main strategy is developing trusting relationships with repeat clients with the
goal of enhancing clients' self esteem and acceptance of their sexuality, leading
to long term behavior change to safer sex practices.
Results: In the last 12 months our educator connected with 200 South Asian
bathhouses patrons. 90% accepted condoms. 60% sought more information.
Educator/client relationship with 30% of repeat patrons were developed. 1 person
became a client at our office and 1 person a volunteer. Literature and condoms
left at bathhouses are always taken away. Cleaners report that all our discarded
condom packages are used ones. About 50% of the clients with whom trusting
relationships have developed ask for extra condoms to use on future occasions.
About 10% patrons avoid South Asian educator (fear of losing anonymity).
Lessons Learned: Harm reduction can be achieved among South Asian men
who have sex with men, through sensitive intervention which enhances their self
esteem resulting in a desire to practice safer sex.
S60710 Programmes that benefit tribal women in reducing the
risks of contracting AIDS
Ralana Maneeprasert', Elawat Chandraprasert2, Munintorn Tiyayon2. Tribal
Research Institute Chaingmai 50200; 2Director General, Dept. of Public Welfare
Bangkok, Thailand
Issue: The Thai hill tribes women most vulnerable to HIV/AIDS can reduce the
risks of contacting AIDS by promoting traditional values of sexual relationship.
Project: An intervention approach to research on AIDS in tribal communities of
Thailand by the Tribal Research Institute, Department of Public Welfare, attempts
to rectify the problems by establishing a revolving village fund, implementing a
pilot programme to bring older traditional and younger tribal people together in
order to promote traditional values among the young.
Results: Among the hill tribes of northern Thailand, there are strong social
presures to follow traditional sexual customs, even to the extent of imposing
fines for transgressions of traditional mores. Consequently, married women have
limited options in protecting themselves against AIDS, even if the wife knows
that her husband is at risk from other sexual relationship. Women prefer to stay
in their villages where there is a lower risk of contacting AIDS. Once they enter
urban area for jobs, they often have sexual relationship with tribal men even
though they realize that tribal men in urban area are high AIDS risks. Within
one year experimented our strategies, the young village women, 36% of total
population become economically self-sufficient in their own villages. And about
45% of young women who reject traditional tribal values give more respect to
their eleder members of the family.
Lessons Learned: To bring together older traditional and younger tribal people
can sustain the traditional values among the young that should help reduce high
risk of contacting AIDS.
| 60711 Reproductive health counselling among PLWHIV/PWAS
Glenda Narra Pugh', Sesson Jose Narciso2. 'Bahay Lin Gap San Lazaro
Hospital Quiricada, St. Sta Cruz, Manila; 2Remedios AIDS Foundation, Manila,
Philippines 1014

Issue: Reproductive Health as one of the pressing concerns among PLWHIV/
PWAs especially couples.
Project: Remedies AIDS foundation, a partner NGO of Pinoy Plus Association
(the sole organization of PWAs in the country) conducted a Reproductive Health
Counselling seminar among couples with HIV and even singles. This project aims
to provide basic infromation on family planning, maternal health and other RH
issues followed by one-on-one counselling or couple's counselling to help them