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

1178 Abstracts 60973-60977

12th World AIDS Conference

oped both quantitative and qualitative indicators in discussion with the partners,
matched with the project outputs.
Results: Participatory monitoring has emerged as a felt need of the partners.
As a result the project has led to a) effective reporting and analysis of information
b) better reflection on the project activities enabling translation into appropriate
programme re-design c) two way experiential learning d) effective implementation of strategies e) identification of impediments/barriers requiring action f)
critical analysis and relating micro experiences to broader socio-economic and
local political environment and g) better focus on accountability and financial
management.
Lessons learnt: Participatory monitoring creates an enabling environment crucial for acheiving project outputs. Process indicators helps in reviewing against
outputs and developing short term and long term strategic plans
S60973 Construction of local networks for STDs and AIDS
prevention and control in Honduras, Central America
Norma Patricia Rivera Scott1, Ritma Loida Cloter2, J.A. Fernandez3, E. Serna4.
1 Col: Lara 2 Calle 2 Ave. Teguc Igalpa Honduras Central America; 2Coordinator
of Education; 3Bid Project, Tegucigalpa; 4Paho Project Senior Advisor,
Tegucigalpa, Honduras
Issues: Honduras counts with 17% of the population in Central America and more
than 50% of the AIDS cases in the region. There is no possibility in the short term
to provide antiretroviral treatment to general population from government budget.
The preventive approach is the only alternative for public health services yet it is
still very weak regarding the dimentions of the epidemy in the country.
Project: The International Development Bank provided 1.8 millon dollars as a
non reimbursable fund for AIDS prevention, based on the strenghtening of the
National Program for STD and AIDS, with a local level approach, providing well
trained and highly professional personel at the local levels (40 municipalities of
priority level). These people act as catalysts in the conbstruction of local problem
awareness and progressive conscious-making and action oriented processes
Results: During the last six months local and regional encounters have been
promoted and supported to provide spaces of interchange of experiences for
local workers in the prevention and control of STDs and AIDS, with innovative
and customer-oriented interventions taking into consideration the particularities
of each group (Gays, CSW, scholars, teachers, teenagers, housewives, prisoners, etc). Program guidelines and indicators have been developed and shared
and networks appear as the most reasonable form of information exchange and
communication.
Local networks provide feedback and motivation for voluntary personel working
in STDs and AIDS prevention and control. Target groups must assume their
role and responsibility in the planning and sustainability of educational programs.
Problem awareness is fundamental for proper problem responses at local levels.
60974 AIDS information flow in private health services in the
State of Sao Paulo, Brazil
Sirlene Caminada, N.J.S. Santos, E.A. Catapano Ruiz, A. Tayra, L.H. Matida.
STD-AIDS Program of Sao Paulo State, R Antonio Carlos 122 - Sao Paulo CEP:
01309-010, Sao Paulo SR Brazil
Objective: Decrease under reporting of AIDS cases seen at private health
services.
Design: Prospective
Method: A simplified instrument for reporting AIDS cases and a specific information flow were created along with health workers from private sector. The
instruments were sent to the main health services afterwards.
Results: During the 2 months that followed the implementation of the project,
67 AIDS adult cases were received by our epidemiology unit, 42 of which by fax.
Eight reports were filled in with patients' initialsinstead of names; 75% of cases
were men and 25% women; 35% were of college level, 46% high school and
19% elementary school. As far as age, 81% were between 30-50 y ears. The
most frequent exposure category among men was homosexual (57%), followed
by heterosexual (26%); among women, the most frequent exposure category was
heterosexual (81%).
Conclusion: The data received indicates under reporting of at least 5% a
month in the current system. The high level of education in relation to the general
population is understood as the patients are assisted by private health facilities.
The possibility of reporting only by using initials and by fax were means of
facilitating arrival of information.
609757 Correlations between spontaneous apoptosis and
plasmatic viremia in HIV infected patients
Sandro Pasquinucci1, Enzo Raise1, C. Ortolani2, F. Belussi1, A. de Toffoli2,
A. Cossarizza1. 1 Divisione di Malattie Infettive Ospedal E Clivile Venezia
Castello 3777; 2Laboratorio di Analisi Ospedale Venezia Venezia, Italia

Analysis of the correlations between spontaneous apoptosis of mononuclear circulating cells in HIV infected patients and plasmatic HIV-viremia, was the aim of
this study.
Patients: We studied as controls 41 healthy HIV negative patients (26 were
male, 15 female 35 years was the mean age) and 53 HIV infected patients (38
male, 15 female, mean age 39 years). Out of the 53 HIV positive patients, 4 were
asymptomatic "long term non progressor" patients with HIV infection lasting for

more than 6 years, with CD4+ cell count >500 cells/ml and "naive" for antiretroviral therapy (LTNP), 4 were asymptomatic patients with HIV infection lasting for
less than 6 years, with CD4+ cell count >500 cells/ml and "naive" for antiretroviral
therapy (AS), 30 were patients with symptomatic infection (LAS/ARC) and 15
were patients with AIDS.
Methods: 2 samples of 100 microliters of whole blood from each patient or
control subject was delivered and coltivated in 9 ml of 20% FCS-supplemented
RPMI 1640. Coltures were incubated at 37 C in a 95% humidified atmosphere
with 5% C02. At 24 and 48 hours respectively, the percentage of mononuclear
apoptotic cells was evaluated using a FACScan flow cytometer, after 20' incubation with anti-CD15 FITC coniugated MoAb, followed by permeabilization with
cold 70% ethanol and sospension in propidium iodide (PI 10 micrograms/ml in
PBS). Anti-CD15 FITC coniugated MoAb was used to distinguish mononuclear
cells from polimorphonuclear cells. Plasmatic HIV viremia was performed with a
commercial kit (Amplicor - Roche). Statistical analysis of the data was performed
with Student T test and linear regression.
Conclusions: The preliminary data of this study: 1) demonstrate that, in HIV
infected patients, spontaneous apoptosis of mononuclear circulating cells is significantly more elevated than in healthy HIV negative controls; 2) in HIV patients
there is a correlation between the grade of mononuclear circulating cells spontaneous apoptosis, clinical staging of patients and plasmatic viremia; 3) in the 4
LTNP patients spontaneous apoptosis was similar to that of healthy HIV negative
subjects; 4) the used method for testing apoptosis on whole blood is easy to
perform, easly reproducible and non expensive.
160976 The health belief model and the theory of reasoned
action: Research agenda for explaining HIV/AIDS in
Nepal and the developing world
Surendra Adhikari. Department of Sociology, Olin Hall The University of Akron,
Akron, OH, USA
Objectives: To apply the Health Belief Model and the Theory of Reasoned Action to glean important research priorities to understand the growing HIV/AIDS
pandemic in Nepal and the developing world.
Methods: Given the growing problem of HIV/AIDS pandemic in developing
nations, this research applies the Health Belief Model (HBM) and the Theory of
Reasoned Action (TRA) to glean identifiable research priorities that each theory suggests for addressing the growth of HIV/AIIDS cases in the developing
world-with specific reference to Nepal. From the Health Belief Model, the major
components addressed were perceived susceptibility, perceived severity, perceived benefits, and perceived barriers. As for the Theory of Reasoned Action,
the research primarily looked at behavioral beliefs and outcome expectations for
"attitude toward the behavior" and normative beliefs and motivation to comply for
the "subjective norm" component.
Results: As far as HBM was concerned, "perceived barriers" (that is, the potential negative aspects of a particular health action), demographic and structural
variables (such as social values and religion) were found to be the most powerful
predictors to be used for designing effective risk-reducing interventions. As for
TRA, social network affiliation and peer norms, contraceptive use behavior (as
a safe sex behavior) were found to be the two crucial explanatory variables for
possible inclusion in behavior-modifying intervention mechanisms.
Even though both HBM and TRA have their own individual strength, it looked
appropriate to take an integrated approach to combine both in coming up with
suitable research priorities to design any suitable intervention mechanisms to
combat the growing problem of HIV/AIDS in developing nations like Nepal.
60977 Risk practices and risk perception to STD and HIV/AIDS
among commercials sex workers in Kampala
Simon Sentumbwe, D.S. Nakkazi. Centre for Peace Research, PO Box 12785,
Kampala, Uganda
Objective: To determine the risk practices and assess the risk perceptions to
STD & HIV/AIDS among sex workers in Kampala city.
Design: It was a cross-sectional descriptive study.
Methods: A combination of accidental and purposive sampling methods were
used to select respondents. Data was entered and analyzed using Epiinfo 6
statistical software.
Results: A total of 201 sex workers were interviewed. Mean age was 21.8
years. 45% had ever contracted an STD with a mean number of 2.5 episodes in
the past one year. 87.4% experienced vaginal discharges, 52.9% dysuria, 39.1%
genital sores, 10.3% weight loss and 4.6% abdominal pain. Mean number of
clients was 2 per day and 30% had never used condoms. 98% new of some
one with AIDS disease within the sex work community. 56.9% thought they could
easily get infected with HIV in future while 37.5% thought they might already be
infected due to their past behaviors. As a result of the AIDS scourge, 63.1% had
reduced the number of clients to avoid infection.
Conclusion: Risk practices to HIV/AIDS were highly prevalent through multiple sex relations and lack or inconsistent use of condoms. Risk perception to

HIV/AIDS was high and majority were changing their sexual behavior for safer
sex.