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

12th World AIDS Conference

Abstracts 60819-60823 1151

Capcellia" CD4/CD8 that provides absolute counts of CD4~ and CD8+ T cells in
whole blood without preparing PBMC suspensions.
Methods: EDTA-anticoagulated blood specimens were obtained from twelve
healthy donors and sixty-four HIV-1-infected patients. The Capcellia" assay is
based on T cell separation from whole blood by using an anti-CD2 magnetic
bead suspension followed by reaction of the CD4 or CD8 molecules with the
corresponding MAb coupled to peroxidase. Calibrated freeze-dried human T cells
are used as standards and treated similarly. Capcellia" counts were compared
to those obtained by flow cytometry, taken as reference.
Results: The reproducibility of the assay was demonstrated by testing representative blood samples ten times; the coefficient of variation ranged from 3.2
to 7.8. The correlation coefficients for absolute CD4+ and CD8+ T cell counts
between flow cytometry and Capcellia were 0.97 and 0.90 for CD4+ and CD8+ T
cells, respectively (n = 76). Correlation between CD4+ T cells counts determined
by two trained experimenters was significant (r = 0.98, n = 76).
Conclusion: Results of CD4+ and CD8+ T cell determinations confirmed that
the whole blood Capcellia' CD4/CD8 assay performed well relative to flow cytometry and is simpler and less expensive. The specificity of the evaluation of the
CD4+ T cells excludes the contamination by CD4 monocytes. This new technique
for lymphocyte immunophenotyping appears to be an efficient alternative to the
standard flow cytometry and hematology.
60819 Outreach and the many "faces" of the sex industry in
Metro Manila
Irene Fonacier-Fellizar', Arnold Dendiego2. 1618 Jose Abad Santos, Little
Baguio, San Juan; 2Interventions for Freedom and the Future, Metro Manila,
Philippines
Issue: The impact of Outreach as a Preventive Intervention lies in the flexible
and adaptable strategies and approaches used with a specific population
Project: Inspite of the closure in 1992 of all establishments, the City of Manila
has succeeded in painting a new "face" to the Sex Industry. While majority of
the workers joined the freelance group, others set out to finally operate "illegally"
in the same area as before. The unending and worsening, socio-eco-political
environment has encouraged continuous operation in this form. A project that
dealt with the expansion and development of creative Outreach Strategies was
embarked on by a small group made up of "trailblazers in HIV/AIDS Work" was
initiated. This was conducted to support the field requirements of other NGOs
and GOs to get to the "difficult to reach sector of the society.
Results: An increase in the number of people reporting for Reproductive Health
and Sexually transmitted diseases; the set-up of additional service facilities by
NGOs and GOs; and, new approaches to Outreach were defined
Lessons: Any intervention for HIV/AIDS needs approaches that will match with
the type of population being affected. Other groups can be asked to collaborate
on areas of work found difficult but have no time for skills building. Continuous
"face-lifting " of interventions must be experienced as the population undergoes
the same.
60820 Positive life style changes
Cynara Chatman-Dillon', Gloria Lockett2, T. Jenkins2. 12696 Parker Ave
Oakland Calif 94605; 2CAI-PEP Oakland CA, USA
Issues: Despite the widespread epidemic of HIV/AIDS in the African American
Community, there is a great sense of denial resulting in many Afro Americans in
low and high risk situations not testing. This denial has led to a lack of participation
of those infected in managing their disease leading possibly to an early death;
moreover, such denial also results in perpetuating the epidemic by way of unsafe
practices.
Project: The objective was to increase testing among People of Color and to
increase the participation in managing their disease. Activities took place during
peer-lead support groups at HIV/AIDS Clinics, housing and substance abuse
centers.
As both consumer and advocate, camaraderie was easily established. Sessions
involved AIDS 101, alternative treatment, current traditional treatments, disclosure, communication with medical providers, housing, and relationship issues.
Empowerment develops when participants open up and collectively discuss
their medications, side effects, other issues as well as feelings. The common
denominator of dealing with the same issues as our participants establishes a
safe place to discuss and share life experiences
Results: There was a 200% (97-178) increase of HIV positive clients attending support group. Moreover, there is anecdotal evidence reported from medical
providers that was a significant increase of participants disclosing their status,
greater compliance with medications and medical appointments..
Lessons Learned: When the HIV positive African American community can
identify with peers, it is easy for them to accept the information, make behavior
changes to reduce transmission and enhance medical treatment. This is accomplished by specifically addressing participants needs and understanding cultural
differences.

60821 Male sexual health programme for males who have sex
with males in 10 cities/towns of Tamil Nadu
V.N. Sabapathy Sabapathy', S. Sunil Menon2, Lalitha Kumaramangalam2,
Shivananda Khan3. No 6 Jaganathan Road Nungambakkam Chennai 600034;
2Prakriti Chennai TN, India; 3NAZ Foundation London, England
Issue: Through various workshops conducted for Males who have sex with Males
(MSM) it came to light that the level of STD/HIV knowledge amongst MSM was
appalling low and that risky sexual practices were very high amongst them.
Project: Anectodal and direct research conducted revealed very high levels
of male to male sex in Tamilnadu. Many of these males also have sex with
females. To improve sexual health & condom usage amongst msm the project
developed appropriate and accessible STD services, provided IEC through outreach, distributed condoms and provided appropriate counselling. 100 men from
the msm network (10 men in each location) were identified, recruited & trained in
sexual health & safer sex practices and used to influence their peers to change
behaviour.
Results: The project was successful in developing MSM networks and using participatory methodologies rendered STD/HIV education and awareness to
promote behaviour change amongst msm in Tamil Nadu.
Lessons Learned: Because of stigma, repression and fear, male to male
sexual behaviours are invisible and denied. Hence there are almost no sexual
health services focused on msm - they primarily focus on so-called heterosexual
behaviour ie. vaginal & oral sex. Specific sexual health services for msm have
to be developed to encourage safer sex and health seeking behaviour amongst
them.
60822 Conflicts related to sexuality as determinants of
vulnerability to HIV/AIDS on heterosexual men
Celi Denise Cavallari. Rui Silvio Sacramento, Sao Paulo; Delfos-Mental Health
Prevention/APTA, Sao Paulo, Brasil
Objectives: In the investigation The Impact of HIV+ Diagnosis accomplished
with hetero women and hetero, homo and bisexual men it has been noticed
that heterosexual subjects believed they were not at risk. Interviews with 4 male
heterosexual subjects were analysed subsequently to study psychological factors
which influenced exposition to HIV transmission.
Methods: Psychological interviews were performed with patients who sought
prophylatic treatment after their HIV+ diagnosis. It took place at the Immunology
Service of Clinicas Hospital of S. Paulo University (Al IS). It was used the clinical
method with a psychoanalytical theoretical frame used in the analysis.
Results: 1-Denial of risk: because of fear from psychic taboos related to sex,
blood and death; to preserve one's own narcisism (denial of ideas of weakness
and vulnerability/fantasies of exclusivity on sexual partnership or of women not
using condom only with him). 2-Defense against identification with aspects associated to male homosexuality. 3-Condom use associated to sexual desire and not
recognized as a sanitary necessity. 4-Self-punishment: due guilty feelings related
to sexual repression.
Conclusion: Patients did not recognize vulnerability to HIV/AIDS because
of conflicts related to sexuality. To increase effectiveness of preventive actions
is necessary to consider subjects' psychism to reduce resistance to received
information.
60823 AIDS orphan's assistance: The case study of AIDS
orphans caring in Yaounde, Cameroon
Eveline Claire Makamte, L. Kaptue, S. Ngnie Su, E. Kembou.
Sidalerte-Cameroun ET FMSB. Sidalerte-Cameroun, PO Box 1937 Yaounde,
Cameroon
Objectives: to explore socio-economic factors and to assess traditional mechanisms that could be most appreciate in the process of taking care of massie
AIDS orphans; to establish a socio-economic model for coping with the problem
of AIDS orphans.
Methods: By August 1996 the recorded figure of AIDS orphans in Yaounde
region was 101 (30 recorded/studied in 1996-1997; 29.75% studied in 1996 and
45% studied in 1997). Six underlying socio-economic factors were identified and
thus tested to establish statistical data.
Results: (1) Caretaking: 95.8 of orphans were being taken care under traditional mechanisms with subsidy programs (school fees, furnitures, uniforms)
by SidAlerte/Cameroun (NGO). (2) Educating: 40% attend secondary education;
34.5% have completed primary school education; 19.5% are below 6 years and
4% engage in antisocial delinquent behaviour and are exposed to unprotected
sex. (3) Health care: 85% have accessibility to health care while 10.5% are
affected by malnutrition and infection.
Conclusion: Though there are still heavy costs for taking care of AIDS patients
and burial costs, but socio-economic conditions for AIDS orphans in Yaounde
region have improved. Therefore, traditional mechanisms under the philosophy
of extended family system proove to be the best approach in coping-up with the

problem of massive AIDS-orphans in subsahara Africa.