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

1152 Abstracts 60824-60830

12th World AIDS Conference

60824 Polyhistidine-tagged hepatitis B core particles as carriers
of HIV-1/gpl20 epitopes of different HIV-1 subtypes
Albrecht von Beunn1, Harald Wizemann. 1 Max-von-Pettenuofer-lnstitut
Feodor-Lynen-Strasse 25, 81377 ruencinen, Germany
Hepatitis B core antigen (HBcAg) particles are suitable carriers to potentiate the
immune response to foreign epitopes. We have recently shown that the expression of the V3 loop of the HIV-1 LAI isolate on the hybrid HBcAg particles elicits
a high titered antbody response and induces antibodies capable to inhibit HIV-1
infection in vitro. Because of the high variability of the V3 region it is desirable to
induce an immune response broadly acting against different subtypes.
We therefore try to develop a cocktail of hybrid HBcAg particles expressing V3
regions of different viruses as well as the CD4 binding domain of gp 120. We
have fused the V3 domains of HIV-1 subtypes A, B, O (CM.4354/94, CM.7851/94,
CM.8161/94, CM.5180/91) to an internal position of HBcAg. To improve purification efficiency six histidine residues were fused to amino acid 144. A new
purification scheme of the expression products including denaturation, Ni2+-NTA
affinity chromatography and particle renaturation at high salt conditions results
in highly pure antigen preparations. Wildtype products can be renatured almost
completely to particles. Purification of HBcAg/HIV fusion proteins results in soluble
and insoluble fractions. Latter can be reassociated to particles at various degrees
depending on the size and amino acid composition of the inserts. Immunization
of mice with the different constructs results in heterogeneous antibody titers. The
titers against the V3 region of the 4354 isolate and against the CD4- binding
region (LAI) are very high. In vitro neutralization studies are under way.
A new. protocol for efficient purification of hybrid HBcAg/HIV-1 particles was
developed. Reassociation of fusion proteins to particles depends on size and
amino acid compostion of the inserts. Accordingly, immunization of mice with the
respective antigens can result in very high HIV-1-specific antibody titers.
60825 1"Have safe sex whatever way": Promoting choice for
Flemish gay men in steady relationships
Rudi Bleys12, C. Lambrechts2, F. Vincke3. 1Tolstraat 13 2000 Antwerp;
2AIDSteam Antwerp; 3University of Ghent, Ghent, Belgium
Issues: As elsewhere, relatively many gay men in Flanders too omit condom
use when having sex with their steady partners. New infections with HIV are
actually partially due to this behavioural pattern. Simply recommending condom
use proves inefficacious since a steady relationship is seen by some as a source
of 'imaginary protection'. Other gay men are looking for alternatives after many
years of condom use.
Project: A tailored prevention campaign was set up to tackle the problem
while simultaneously respecting gay partners's desire to have unprotected sex.
Rather than insisting on condom use alone, the AIDSteam now supports gay
men's factual decision to apply negotiated safety, yet only after informing them
about the requirements making this into a genuinely safe strategy. In view of the
prolonged call for 'safe sex' it is important indeed to look at alternatives beyond
mere condom use and 'coach' the choices made by gay people themselves.
Results: Multiple pretests have indicated that a vast majority of gay men
welcomed the new message, yet many made clear at once that they will stick to
condom use now that they are informed more accurately on the hasards of negotiated safety. The unwanted side effect, namely that gay men would interprete
the new message as at odds with familiar recommendations of 'safe sex', did not
occur.
Lessons Learned: HIV-prevention among gay men will be more efficacious
when it acknowledges the factual multiple strategies of 'safe sex'. In view of
the ongoing epidemic, it is important to recognize them and make sure that the
choices made are sound and well informed.
60826 Tailoring for the margins: HIV prevention amidst socially
disadvantaged day men in Flanders, Belgium
Rudi Bleys1, C. Lambrechts1, F. Vincke2. 1Tolstraat 13, AIDS Team, Antwerp;
2University of Ghent, Ghent, Belgium
Issues: Most prevention material for gay men is inadequate for distribution amidst
the socially disadvantaged ones among them, as they reluctantly read it or have
difficulties understanding it. 'Translating' the message into an attractive medium
therefore is inevitable if one wants to facilitate HIV-prevention also in this milieu.
Project: An entirely new product was developed, according to our self-styled
procedure of social marketing and product development. It basically consisting of
a wallet, that was distributed for free among socially disadvantaged gay men. It
contains two condoms and two lubricants, along with a specially designed cartoon
story, visualizing safe sex and making it familiar by the use of a group-specific
language and vocabulary. Illustrated instructions on condom use were included
as well, along with a telephone card advertising the AIDStelephone, apt for
additional information when wanted. The product was pretested throughout the
development and production process, which allowed for crucial improvements.
Results: The project, while initially city-bound, is now extended across the

entire Flemish Community and wallets are distributed in every major city.
Lessons Learned: Developing subgroup-specific prevention material is crucial
for conveying a preventive message. Pretesting amidst the targeted group itself
is crucial even to its efficacy. Proof is given, meanwhile, of the efficacy of the
AIDSteam's Social Marketing and Product Development Model.

60827 1 Treatment Directory France: A concerted approach
Yassia Benai, R. Landman, K. Cherabi, D. Heard, C. Rouzioux, E. Hirsch,
J.M. Faucher. ARCAT - Sida, 96-102 Rue De Buzenval, Paris, France
In 1992 ARCAT-SIDA set up a national information gathering system concerning
all clinical trials conducted in France in the field of HIV infection and its complications. The data base is published each year in the Clinical Trials Directory with
the support of the French National AIDS Research Agency (ANRS), the French
Medicines Agency, the AIDS division of the French Health Directorate, pharmaceutical laboratories most involved in AIDS research, and investigators and clinicians.
Aims: the principal objective of this program is to develop sound medical and
scientific information on the state of clinical AIDS research and therapy in France.
Specific aims are to promote clinical research activity, to improve communication
between the different actors (patients, physicians, methodologists, sponsors and
manufacturers) and to ensure free informed patient participation in trials.
Methodology: Scientific information is collected from all those participating
in therapeutic trials in France. The information is rendered accessible to the
largest possible proportion of the target audience. The Clinical Trials Directory
is composed of files describing each of the trials, i.e. the aims, methodology
and enrollment conditions (allowing the largest possible number of patients to
participate in ongoing trials), and the results of terminated trials.
Results: The fifth edition of the HIV-AIDS Clinical Trials Directory lists 132
therapeutic trials, 72 of which were ongoing and 60 terminated. The trials are
given in four categories: primary infection (two trials); mother-child transmission
(four trials); pediatrics (three trials); and HIV infection in adults (fifty-three trials).
Conclusion: The Clinical Trials Directory offers sound scientific information to
physicians, methodologists, sponsors and drug manufacturers. The high quality of the information it contains improves patients' personal involvement and
compliance.
608281 STDIAIDS prevention program to Santos teenagers
Tania Maria Justo. Aj. Bernardo De Campos, Brazil
Issues: Santos has presented high AIDS incidence for consecutive years. The
city is into AN international drugsroute. The teenagers and young adults increasing number to HIV soropositive and the subject awareness by them is estimated
in na 60% error, verifying through a research with 2087 students (10/18 years
old) at 3 schools in Santos, placed at high AIDS incidence areas in Santos.
Project: Since 1992 Santos city hall has been developing, together with Health
Ministery an AIDS/STD prevention program, focusing teens and young adults,
disposing of enabled STD/AIDS professionals. The objectives to promote meeting
inside school areas, so that STD/AIDS, sexuality and drug addiction can be clearly
discused games, group dinamic technics are elaborated according to students
age, creating a space for their doubts, questions and critics, promoting their active
participation, which will force them reflect over their responsibility with their own
bodies and their partners bodies.
Results: In 6 years, about 45300 teenagers and young adults were reached,
moreover 5000 parents, 2500 educationers. The team has already enabled education and health. Professionals of different estates (ES and MG), besides
UNESP/Presidente Prudente educationers, interested in Santos experience of
teens and young adults prevention.
Lessons Learneds: STD/AIDS teenagers and young adults intervention requires specific enabled professionals, differente systemic approach and intervention, once the population group presents risk exposure HIV infection behaviour.
60829 1 Teenagers living in the slums: A proposal for prevention
OS STD/AIDS - Rio de Janeiro, Brazil
M. Mota. Praga Rui Barbosa Andar Santos, Sao Paulo, Brazil
Issue: This job focus do develop a methodological intervention proposal to
low-income youngsters living in the slums, initially developed, inside Rocinha
Community, the largest slum i Latin America, where yougsters are found very
vulnerable to STD/AIDS.
Method: Intervention strategies were developed viewing the social cultural
needs of the youngsters living in the area. The methodology is focusing the
information multipliesr of the STD/AIDS, from entertaining activities like: dancing,
theater, sports and communiktary radio.
Results: Developing such intervention methodology of cultural movemententertainment, we enable the formation of a group skilled people talk about prevention
strategies, where young people talk about prevention to another amount of young
people, making use of their own language and view, cultural values and world view.
Lesson Learned: We conclude the intervention methodology to prevent
STD/AIDS, should take into consideration the social and cultural universe of
teh aimed public, the proposal of a programs that elicits about prevention from
cultural movement has gained positive support from the community and may be
a model to be reaplied among other slums.

S60830 IL-16: Gene structure and promoter function
Michael Baler, N. Bannert, N. Mathy, A. Werner, R. Uurth. Paul-Ehrlich-lnstitut;
Paul-Ehrlich-STR.51-59; 63225 Langen, Germany
Interleukin 16 (IL-16) has been shown to function as chemoattractant factor, as
a modulator of T-cell activation, and as an inhibitor of immunodeficiency virus
replication. The recent identification of inconsistencies in published IL-16 cDNA