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

12th World AIDS Conference

Abstracts 60866-60871 1159

Lessons Learned: LUCES has become an empowerment model for Latinos to
address the HIV epidemic in Maryland (USA). The success of Latinos to develop
a linguistically and culturally competent network of services has been enhanced
by working collaboratively and efficiently with different private and public entities.
The potential of a healthy community by participation and action is greater now.
60866 Counselling within the "Groupe chretien pour les
oeuvres sociales/GCOS"
Bernadette Ngbakongo, Dieudonne Assanah. The Christian Group for Social
Actions, Groupe Chretien Pour les Oeuvres Sociale (GCOS) S/C Eglises
Baptistic Ngou-Ciment BP43, Bangui, Central African Rep
Introduction: Counselling within GCOS concerns orphans and their adoptive
families. It is a strategy established in the group in order to help orphans and
their adoptive families in cases of emotional, moral and spiritual crises with a view
to avoid a family flag, juvenile delinquency among boys, indesirable precocious
pregnancies among girls.
Objectifs: To lead orphan to accept Jesus-Christ as the solution to his/her
problems. To create a relationship based on confidence between the orphan
his/her adoptive family and his/her counselor. To bring him/her hope for survival
and brightening. To develop into the adoptive family the sense of affection and
responsibility.
Methods: Counselling is carried out through visits paid at the orphan's home.
Apart from these visits, mutual discussion are undertaken between the counselor
and the orphan or between the counselor and the family. Another method consists
in organizing small groups' discussion for the orphans.
Results: In 1997, 270 visits have been paid to 105 orphans, out of which 60
visits with counselling; 30 of which for the responsibles of the orphans and 30 of
which for the orphans themselves. 4 good account on the social rehabilitation of
the orphans has been made by 24 adoptive families. The orphans themselves
have testified of their own family readoptation. The most interesting aspect is that
10 orphans can make meditation on the Gospel.
Conclusion: Counselling enables to know orphans' environment and to intervene and to fight orphans' instability and the family's lack of responsibility.
608671 Outreach intervention in a population with risky
behaviours: Harm reduction experience of Villa Maraini's
Street Unit
Mauro Santolamazza, Vittorio Lelli, U. Ciervo, L. Grillenzoni, E. Rossi,
R. Chiarelli, A. Tavanti. Villa Maraini Foundation via Bernardino Ramazzini, 31
00151, Rome, Italy
Introduction: In Italy, incidence of new HIV infections in general population is
related in almost 60% of men to intercourses with drug-addicted prostitutes, while
in women in almost 80% of cases it is related to intercourses with subjects with
present or past drug-abuse history. The majority of new HIV infections in general population is then a consequence of intercourses with present or past drug
abusers. A priority, is therefore represented by outreach interventions oriented to
early contact with intravenous drug users (IDU) in order to prevent and to screen
HIV-infection.
Method of Intervention: The Street Unit of the "Villa Maraini Foundation (instituted and directed by M. Barra) is staffed by doctors, psychologists and street
workers, the last ones with past history of drug addiction: those are important for
their experience and training, and are essential to the operation of hooking up
with people on the street. The Unit operates under the aegis of the Italian Red
Cross and with the support of its Relief Volunteers who complete the operating
structure of the Unit.
The Street Unit of "Villa Maraini began operations on March 1992, at the
"Termini" Railway Station in Rome, every day from 6 p.m. to 12 p. m..
Results: During these years, 3,530 medical emergencies have been handled
both for drug addicts and for the general population; 96,397 syringes have been
exchanged with a return of used syringes of approximately 40%; about 4000
condoms have been distributed yearly; 3,460 referrals made to Drop-in Center
and HIV-Unit of Villa Maraini Foundation, for counselling, HIV screening and
addiction treatment.
Lessons Learned: Outreach intervention is a succesfull tool to contact people
not affering to governement or private structures, in order to offer an adequate
support about HIV prevention, screening and counselling.
|60868 Evaluation of effectiveness of antiretroviral therapy in
three groups of HIV +ve drug addicted patients
Mauro Santolamazza1, Vittorio Lelli', M. Santollamazza', U. Ciervo1,
F. Patruno', A. Mondi1, U. Angeloni2, F. Di Macco2. 1 Villa Maraini Foundation via
Bernardio Ramazzini, 31 00151, Rome; 2Central Laboratory Italian Red Cross,
Rome, Italy
All authors are agree to consider new antiretroviral drugs effective to decrease

the HIV viral load, increase the CD4 lymphocites, in most of patients (pts), and
able to consequently improve quality and lenght of life.
Aim: of this work is to compare the efficacy, at short and medium time, of
antiretroviral therapy: in three groups of drug addicted HIV+ve ptd, regularly
followed at "Villa Maraini" Foundation (director: M. Barra).
Methods: 60 pts were enrolled in this study. Pts have been divided in three
groups: group A, drug-free; group B, in therapy with methadone; group C, with

active drug-addiction; all pts were treated by psychotherapy, and followed in a
counselling program, in order to enhance the compliance to antiviral therapy.
37 out of 60 pts were in group A, 9 in group B and 14 in group C. All were
submitted to combined antiretroviral therapy with 2 nucleoside analogues and
with protease inhibitors.
Therapy efficacy was evaluated, before and after 1 and 3 months of treatment,
by quantitative measurement of HIV- 1 plasma viremia, performed by PCR test: a
142 bp (GAG gene) defined by biotinilated primers Sk 431 an Sk 462, was amplified simultaneously with quantitation standard RNA. The amplified products was
revealed by hybridization reaction in separate wells of a microwell plate, coated
with specific oligonucleotides probes. Other blood tests included: evalutation of
CD4 lymphocites count, transaminases, blood cells count. All the samples were
processed at Central Laboratory of Italian Red Cross.
Results: Responce to therapy (considered as a reduction of at least 1 log of
viremia) was: group A 34 pts (92%). group B 8 pts (89%), group C 13 pts (93%).
CD4 lymphocites showed an increase of 70% in all the threee groups ("p" value
between groups >0.05). The incidence of therapy side effects was equivalent in
all three groups.
Conclusions: Results show an omogeneous responce to therapy in the 3
groups considered; as a matter of fact, our experience seems to demonstrate that
the administration of methadone or use of heroin does not influence the antiviral
therapy effectiveness. We have to underline that compliance to retroviral therapy
is related to the psychological support.
60869 New prostitution phenomena in Poland
Zbigniew Izdebski', Anna Boron-Kaczmarska2. Pedagogical University Social
Pedagogy Institute, Plac Slowianski 25 65-625 Zielona Gora; 2Head of Infections
Diseases Department, Szczecin, Poland
Design: Research.
Methods: Questionnaire made in 1996 among 60 female sex workers by
Zbigniew Izdebski and Agnieszka Konarowska "escort agencies".
Systematic observations within streetworking program with a special focus
upon the localities in the Polish-German border areas.
Results: The "escort agencies" are in Poland a new form of facilities for sex
service which is illegal from the point of view of Polish laws. Thus, they are officially
called massage salons, escort agencies, etc. 35% of the surveyed persons had
had vaginal sex, and 23% - anal sex without a condom. 45% of the respondents
had been informed on the principles of safer sex, and 15% had been talked to
about HIV and STD's before they started their work. Despite the fact of the use
of condoms by some of the women, it is alarming that some of them lubricate the
condoms with creams and/or vaseline which dissolve latex. 27% of the "escort
agencies" provide medical care, and 37% of the owners of the agencies require
medical examinations from their employees.
Apart from Poles, more and more women from Central and Eastern Europe
render sexual services in the Polish-German border regions. Such phenomena
require an intensified international cooperation within STD's prevention. At the
same time, the national campaign for safer sex directed to the clients, is inhibited
by the fact that Poland is a Catholic country.
S60870 [MHC genotype predicts disease progression and viral
load levels in a cohort of Caucasians and
African-Americans
Nelson Michael1, R. Garner', D.E. Dayhoff', D.L. Birx1, D. Mann2. 1WRAIR
1600 East Gude DR Rockville; Henry Jackson Foundation Rockville MD: 2Univ
of Maryland Baltimore MD, USA
Objectives: To examine the influence of MHC genotypes on AIDS-free survival
and changes in CD4 count and viral RNA load.
Design: Prospective, controlled study.
Methods: HLA class I, II, and TAP genotypes were determined in a seroprevalent cohort of 91 Caucasians and 48 African-Americans followed for up to 5 years
with extensive T-cell subset and serum viral load testing (Roche). Progression
to the 1987 case definition of AIDS was defined as the progression endpoint.
Subjects were stratified according to their sum inter score of 7 class I allele-TAP
variants (+1) and the -1 3 class I/II/TAP combinations ( 1) previously found to be
associated with disease progression in Caucasians.
Results: Individuals in both racial groups and the combined cohort with sum
scores greater to or equal to 1 were less likely to progress to AIDS during the
observation period compared with subjects with scores of 0 or less. CD4+ T-cell
decline was most rapid and increased viral load most marked in individuals with
MHC scores less than zero.
Conclusions: The results confirm the reported associations of specific MHC
genes with HIV-1 disease progression in Caucasians and extends them to AfricanAmericans and to two well established surrogate markers of disease progression.

60871 ILarge granular lymphocyte proliferation during HIV
infection
Firouze Bani-Sadr12, L. Le Doussal2, R. Garand2, E. Billand2, F. Raffi2. 1Hopital
Raymond Poincare 104 b5d Raymond Poincare 92380 Garches; 2Hotel-Dieu
44035 Nantes, France
The large granular lymphocyte (LGL) proliferation is a relatively rare lymphoproliferative disorder of either T (CD3+) or natural killer (CD3 ) lymphocytes. In