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

1174 Abstracts 60949-60955

12th World AIDS Conference

60949 Gastrointestinal endoscopy in HIV-1 infected patients
Raquel Barba, J. Marco, L. Rabago, p. rondon, R. Torres, M. Cervero, J. Gomez
Rodrigo. Hospital Severo Ochoa, Madrid, Spain
Aims and Methodology: Retrospective analysis of the upper and lower gastrointestinal endoscopic studies performed in our hospital to HIV-1 infected patients
with the aims of assessing their frequency of use and diagnostic yield.
Results: Seventy- two endoscopic studies performed from 1992 to 1997 pertaining to 61 HIV-1 infected patients are analyzed (49 esophagogastroscopy, 5
colonoscopy, 16 sigmoidoscopy). Mean age: 33.8 (males) and 29.1 (females).
Forty five patients (65.2%) were in CDC stage C, and mean CD4 count was
116 cells/mcL, with a mean survival of 12.6 months after the first endoscopy.
Most of the studies were performed during hospital admission (42.58%) whilst
the rest of them were evenly distributed between the outpatient clinics and the
emergency department (21% respectively). Main symptoms leading to the procedure were dysphagia, (21% of patients), diarrhea (14%), hematemesis (11%),
rectorragia (8%) and vomiting (8%). A clinical diagnosis was seldom recorded in
the petition form, being Candida or CMV the most often suspected diseases (16%
respectively). The endoscopical diagnosis by inspection alone were: Non-specific
peptic disease in 24 cases (34%), candidiasis in 14 (19%), and no disease in
23 (33%). Besides inspection, biopsy (28%), microbiological exam (19%) or both
(4%) were performed when a lesion was found, regardless of the origin of the
petition (emergency room, clinical ward, or outpatient clinic). Main final diagnoses
were: normal endoscopy (40%), candidiasis (15%), CMV disease (7%), Kaposi's
sarcoma (3%) and non-specific gastrointestinal disease (34%). Clinical diagnosis was concordant with endoscopical diagnosis in 12.5%, and endoscopical
diagnosis was concordant with final diagnosis in 76% of the cases.
Conclusions: 1) Gastrointestinal endoscopies are performed mainly in patients with advanced disease in our hospital. 2) A high proportion of studies were
normal. 3) The concordance between the inspection and the final diagnosis is
high. 4) since the accuracy of clinical diagnosis is poor, most empirical treatments
should be avoided and an endoscopy should be done in all symptomatic patients.
60950 1Innovative approach of the 40-60 years old (those who
have a tendency to think that they are not concerned by
AIDS)
Thomas Huizer. Groupe Sida Zura, Fbg des Capucins 23, Delemont, Switzerland
Issues: In Switzerland, and more specifically in our region (small town & villages)
one major problem is AIDS awareness among the 40-60 years old population.
Living in a region where catholicism is predominant, contacts were taken to set
up a project which would actively involve our churches. Additionally the fact that
we had to negotiate with catholic authorities was in itself a challenge considering
the position of the Vatican.
Results: The results were slightly below expectancy. Although the leaders were
actively interested in our project and planned to insert an "AIDS-parenthese" during the mass, locally not all priests followed these instructions. Nevertheless, our
objectives were reached as we knew that we were attempting something difficult.
Lessons Learned: Even in extremely catholic regions it is possible to talk
openly about AIDS. The question is all about the how to talk about it. It was for all
those who worked on this a very challenging task and certainly is the beginning
of ongoing activities with the catholic church.
609511 Hindrances from religion and traditional medicine in the
prevention of HIV/AIDS in Cameroon
Adonis Touko, J. Kemmegne. Cameroon Psychology Forum, Yaunde, Cameroon
Introduction: Seroprevalence studies undertaken in Cameroon show an increasing seropositive tendency; rising from 0.5% in 1987 to 5.5% in 1994, and to 6%
more recently. In reaction to such a threat, the Ministry of Public Health through
the National AIDS Programme has initiated a multisectorial mobilisation programme also involving religious leaders and traditional healers for AIDS control.
Nevertheless, the emergence of controversial views, especially among religious
groups and traditional healers who claim to possess a cure for AIDS can distort
the public understanding of the scientific message.
Objectives: - To identify common factors to religion and traditional medicine
that can facilitate the success of the AIDS control programme. - To make proposals that can lead to the incorporation of such factors in the information, education
and counselling campaign.
Methods: Observation. Structured interviews with, leaders of some religious
groups, their members and traditional healers in Douala, Cameroon. Qualitative
analysis of data collected on tape recorder.
Preliminary Results: In the religious domain, some people claim to have
special powers that can enable them cure all believers who are infected by
HIV/AIDS. Worst of all, they even claim to have successfully healed AIDS patients through intense prayers. On the other hand, imposing sign boards can be
found on strategic points in big cities, inviting HIV seropositves and AIDS patients
to speedy and accurate treatments by tradipractitioners. Such messages might

have special attention, in our society where some diseases are believed to be
caused by witchcraft and are treated only by traditional healers. In this light, there
is an increasing demand for the services of traditional healers by AIDS patients
which are rendered at exhorbitant prices.
Conclusion: In the present state of biomedical research on HIV, these messages and practices are likely to hamper social communication and to negatively
influence the success of educational campaigns.

60952 Title not indicated
Moses Henry Bateganya1, A. Merriman2, A. Mukiibi3. 1Medical Officer; 2Medical
Director; 3Senior nursing Sister, Hospice Uganda PO Box 7757 Kampala,
Uganda
Issue: Palliative care delivery to AIDS patients in Uganda. Survey of 238 patients
seen at Hospice Uganda between 1993-1997.
Project: Hospice Uganda was set up as a model hospice for Hospice Africa
whose aims was to train health professionals in modern methods of pain and
symptom control for cancer patients.
It eventually became necessary to offer pain relief to AIDS patients in whom
pain is a significant problem in 25% CAr Elly kalabira personal communication.
It is estimated that there were 165,000 AIDS patients (AR E. MADRA) 25% of
whom need control
Results: A total of 238 patients is described. 100% were referred for pain
control. Pain was controlled in over 90%
A significant number of cancer patients seen at Hospice Uganda are also HIV
positive. Pain in AIDS can be controlled using modern methods promoted by the
WHO.
| 60953 Practices risking the infection of HIV/AIDS in the
grassfield zone of Cameroon
Mirabelle Wulleh Sonkey1, Kuate Jean Roger1, Tonye Julbert1, Teyou
Pierre Wolf2, Kum Philip3. 1SOS PSY PO. Box 4675 Yaounae; 2 Youth Promo,
Bafoussam; 3AYA Aghem Youths Association, Bamenda, Cameron
Objective: To evaluate the attitude and behaviours linked to the culture of the
rural population of the grassfield favouring the transmission of HIV/AIDS.
Methodology: A study was carried out from february 1995 to september 1997
near by persons of the third age, traditional doctors, youth leaders and peers
educators on HIV/AIDS. This study was carried out in the North West and West
provinces of Cameroon through indirect interviews on practices susceptible to
expose the infection of HIV/AIDS and by direct observations.
Results: Polygamy is common, as such the man's infidelity is tolerated and
common too.
Certain social gatherings encourage sexual promiscuity, e.g. (bottle dance) in
the North-West where the men usually go with the victims of their charms "female"
Women are very exposed because they go to traditional doctors for protection
and treatment where by the latter uses the same blade for the scarification of
many persons.
Traditional autopsy (Dschang) is practised without protection (Gloves, mask,
etc...) on the corpses where the dead is suspected to have been bewitched.
When your husband dies (even of AIDS) the widow is obliged to marry the
brother of her late husband.
Conclusion: To fight against AIDS in the rural areas of Cameroon, it is important to know the practices which favours the transmission of HIV/AIDS and to
sensitize traditional leaders on the dangers of such practices in view of eradicating
these practices or to reduce their risk of transmission of HIV/AIDS
60954 The importance of information technology in control of
HIV/AIDS in a developing country: A case study from
Uganda
Philip Twesigye, M. Nakanjako. ANPCANN, PO. Box 41, Kampala, Uganda
Objective: To investigate the importance of information technology in HIV/AIDS
awareness, and eventual behaviour change, among the Uganda population.
Methods: 50 agencies including: NGOs, CBOs implementing HIV/AIDS activities were interviewed using an interview schedule. 50 key informants who included
project managers of key NGOs, religious leaders, district health officials, local
leaders, representatives of local and international donors and people living with
AIDS were also interviewed. 5 focus group discussions (FGDs) were conducted.
Results: We are in the final stages of data analysis: however preliminary
findings indicate that 45 institutions out of 50 that were interviewed expressed
great need to have modern information techniques introduced. 2 did not show
any interest. 3 were neutral. All key informants interviewed were in favour of
modernisation of HIV/AIDS information. The focus group discussions were also
very postive to the introduction of appropriate information technology.
Conclusions: Preliminary findings have revealed that an appropriate network
of information system will help all actors, donors, PLWAs, communities, and
goverments share important information on HIV/AIDS in the struggle against the
scourge.
160955 Triumphs and tribulations of developing an AIDS service
organization (ASO) by PHAs with a heterosexual
perspective in Toronto, Canada
lan Rambihar, L. Buzzelli. Positive Straight Men (PSM), Suite 1002-790 Bay St,

Toronto Ontario M5G IN9, Canada
Issue: To provide appropriate and accessible support and information to heterosexual PHAs in a marginalized setting.
Project: To develop an ASO targetting heterosexual men living with HIV and to
address high risk behaviour within the heterosexual population. After a positive
diagnosis, it was impossible to find appropriate support within the existing AIDS
structure in Toronto. Heterosexual men living with HIV had to address a double