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

1170 Abstracts 60928-60932

12th World AIDS Conference

Migrant communities living in Germany represent a group, which is very affected by the danger of a HIV Infection, because there is not enough information
available and no specific campaigns are being developed for these population.
Campaigns that consider the various social, cultural and linguistic backgrounds
as well as the specific ways to understand sexuality. In 1997, 17% of the new
HIV Infections in the city of Berlin represented migrant communities. The process
of the european unification and the progress on international Mobility demand
urgent initiatives in the field of prevention by the migrant communities.
Since 1996, the AKAM Archiv is advocated to reduce the gap of information
available for these population and to facilitate the prevention efforts made by
AIDS organizations in the field of migration. We receive consults of anonymous
individuals as well as from social-workers, registered organisations, government
dependencies, national agencies, etc. We are begining to act as a network of
distribution, making it posible to share and exchange materials and reports at
international level.
60928 Popular survey in Rosario about attitudes toward
HIV/AIDS infections
Liliana Trape, M.A. Acosta, A. Troglia, A. Celentano, R. Kunc, E. Virgala,
M. Agostini. Argentina AIDS Society (SAS), Rosario; Rodriguez 1215 2000
Rosario, Argentina
Introduction: Programs of diffusion and prevention of HIV/AIDS infection have
to be adapted to the population necessities.
Objective: To evaluate source attitudes on HIV positive person toward and the
use of condoms.
Methods: We made a survey with 373 people from Rosario city, in Argentina,
wich is a representative sample of 22 Police Departments of this city. 176 of them
were men (47%) and 197 (53%) were women with a median age of ys (13-55).
The survey consisted on 22 items in an open and close question system during
June and July 1997.
Result: Toward on HIV positive person: (61%) of the surveyed population
is considered to be informed about the forms to acquiring the infection. In the
situation to share a place of work and/or to study with an infective person 34%
would be afraid of being infected, 17% of the people expressed the derive to force
them to abandon the place.
Toward the use of condom: 80% of the people think that condoms is the main
contraceptive and prevented method on the HIV transmission. 58% of the people
use condoms in their sexual relations. 42% of the women and 48% of the men
to accord the pregnancy and 30% of the women and 42% of the men to prevent
STD. 29% of the women and 40% of the men use condoms just to preventive HIV
transmission. The 40% of the people that considered not to use condoms; 42%
of the women and 19% of the men said that they would be able to use it in future
sexual relations.
Conclusions: 1) More of half of people considerse to have information about
the way of transmissions, 33% would be afraid to been infection howerer in front
of a person infected in situation of social contact, it is known that the transmission
risk doesn't exist. 2) The condoms is considered by the mayority of population
(95%) as the more effective method to prevent the infection, howecer only the
58% uses it. 3) Among the population that use preservative the fear of the
pregnancy it is bigger than the HIV infection.
60929 1 Issues of Italian Cohort Naive Antiretroviral (ICONA)
study and enrollment data
Antonella D'Arminio Monfortel, C. Arici2, G. Ippolito3, G. Rezza4, F. Dianzani5,
M. Moroni6. For The I.C.O.N.A. Group; 1Inst. of Infectious and Tropical Disease
LSacco H Via GB Grassi 74 20157 Milan; 2Dept. Infectious Dis. Spedali Riuniti
Bergamo; 3AIDS Coord. Center IRCCS Spallanzani; National Institute of Health
COA, Rome; 5Institute of Virology Univ. La Sapienza, Rome, Italy
Issues: in May 1997 a cohort study enrolling 3000 antiretrovirals (ARV) naive
patients (pts) has been started in 64 Departments of Infectious Diseases in Italy.
Pts have been enrolled consecutively, regardless of the reasons for not being
on ARV at inclusion. The aim was to set up an observational cohort of HIV
infected pts in order to verify the impact of different therapeutic approaches on
disease progression, considering the increasing number of available therapeutic
options.
Project: Main demographic, clinical and therapeutic data (date of initiation and
of changes in ARV and in therapies for opportunistic infections, and reasons
for) are collected via internet (www.icona.org) at baseline, at every clinical event
and/or therapeutic changes, or at least every 6 months. Collection of plasma
samples and PBMCs are also scheduled. Besides, a nested study on behavioural
changes by a self- administered questionnaire is ongoing. A Steering Commette
and an Operational Group warrant the proper conduction of the study and adherence of partecipants to the relevant protocol. Each of the 6 principal clinical
centers coordinates and checks the data collected by 9-10 satellite centers. The
study will last ten years.
Results: Up to 31 December 1997, 2530 pts have been enrolled. Here are

shown the data at enrolment of the first 1676 pts: 505 (30%) are females; 845 are
previous or active drug addicts (IVDU); 284 are homo/bisexual men. Heterosexual
transmission is more common in females (186/1168 males vs 295/505 females;
p <.0001).
70% of pts belong to CDC group A, 10% to group C. Median CD4+ counts are
460/ L (1-2019), 43% of pts have CD4+ counts >500//pL, 19.5% of pts <200// L.
Median HIV-RNA is 20350 copies/ml (-500-958200); in 11% of pts HIV-RNA is

undetectable, in 42% HIV- RNA is >30000 copies/ml. 602 pts have initiated ARV
at enrolment, 329 (55%) with three drugs.
Lessons Learned: The high prevalence of IVDUs and of heterosexually infected females is a peculiarity of this Italian Cohort. The data collected in the main
cohort and in various nestes studies will enlight our knowledge on the therapy
driven course of HIV infection and provide evidence of the impact of the increasing
number of available ARV combinations on the outcome of the disease.
60930 The impact of peer education in communities
Nabateesa Proscovia Mwandha1, Beatrice Were2. 1 Taso Mulago, RO. Box
11485, Kampala; 2Social Scientist NAcwola, Kampala, Uganda
Issue: Peer Education as an instrument in mobilization and sensitisation of
Communities about HIV/AIDS.
Project: Due to increase in the number of HIV infected people, The AIDS
Support Organisation (TASO) started a Peer Group comprising of PWAS at the
Centre, including me. Through Testimonies, Music, dance and Dramma, backed
by a counsellor and a Medical Practitioner, we sensitise communities using;
(a) Pre-contemplation (b) Enlightening about safer sex (c) Dymistify faulse beliefs (d) Introduce positive living (e) Assessment of Communities' attitudes towards
PWAS (f) Encourage responsible bevaviour (g) Give refferrals for support.
Results: (a) Wide spread of AIDS Awareness (b) Behaviour change (c) Reduction in stigma and Discrimination of PWAS (d) PWAS can easily cope with
HIV/AIDS (e) Communites' attitude towards TASO has changed (f) Formation of
more PWA Organisations (g) Promotion of TASO mission. i.e "Restoring Hope
and improving the quality of life of persons and communities affected by HIV
infection and disease".
Lessons Learned: Peer Groups need more financial empowerment to improve
their capacity in mobilisation of Communities about HIV/AIDS Prevention. PWAS
remain a very important isntrument in information, Education and communication
in a poor resourced environment because of the reality and cost effectiveness of
the strategy.
S60931 Mini-residency/mini-preceptorships in HIV/AIDS:
Designing an individualized experience
Carolyn E. Sabo1, V.L. Carwein2, R. Yuhos3. 'UNLV College of Health Sciences,
PO Box 453019 Las Vegas, NV; 2University of Washington, Tacoma, Tacoma,
WA; 3So. Nevada Area Health Education Center, Las Vegas, NV, USA
The ability of all health care institutions, large and small, to have a dedicated
unit with health care providers specializing in the care of clients with HIV disease
is not possible. Further, we often have situations where many clients with HIV
disease live in geographical areas where a commute to available dedicated units
is neither practical nor feasible, coupled with the continued return of many of these
individuals from large metropolitan areas to family and other personal support in
rural communities. Therefore, it is mandatory that providers from a wide variety
of health care settings be given the opportunity to increase their knowledge base
and clinical experience in the care of clients with HIV disease. The challenge
for educators in AIDS Education Training Centers (ETC) is to design educational
experiences that provide a strong theoretical and clinical base, yet allow for individualization of the experience to meet the needs of a potentially diverse group
of health care providers from a variety of physician and nurse practice arenas.
The So. Nevada AIDS ETC initiated and has modified a 40 contract hour (over
five days) education experience including both didactic and one-on-one clinical
experiences with HIV specialty physicians and nurses in selected HIV/AIDS clinical setting. Additional, optional evening experiences are provided each day of
the program in AIDS related support service agencies. Clinical experiences are
based on a foundation formed in the didactic sessions and on needs identified
from the written and interview application materials. Preceptors are also identified
depending on the specific learning needs and prior experiences of the participant.
A substantial packet of material is provided to each participant for study prior
to beginning the training experience. This information is updated on a routine
basis to represent the latest research on the care of clients with HIV disease.
The unique nature of this mini-residency or preceptorship lies in the ability to
individualized block of both didactic and clinical time to the learning needs of
the participant based on the one-on-one format. The format and examples for
optional experiences in the training program will be presented. Further, rationale
for modifications in the original format based on exit interviews with participants
and assessment of potential unique qualities of health care settings to which the
participant will return will be discussed.
60932 Education attainment and HIV-1 seroprevalence in rural
Rakai District, Uganda: Results from a population-based
study
Jennifer S. Smith1, F. Nalagoda2, M. Wawer3, D. Serwadda4, N. Sewankambo5,
J. Konde-Lule4, T. Lutalo2. 1150, Cours Albert Thomas, 69008 Lyon, France;
2The Rakai Project; Uganda Virus Research Inst., Entebbe; 4 Institute of Public

Health, Makarere Univer., Kampala; 5Department of Medicine, Makarere
University, Kampala, Uganda; 3Columbia University, School of Public Health,
New York, USA
Objective: To examine the association between education and prevalent HIV-1
infection
Design: Cross-sectional analysis of a population-based cohort