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

12th World AIDS Conference

Abstracts 60978-60982 1179

S60978 Mass media for the prevention of the HIV AIDS infection
in Argentina: Managers of opinion?
Joan Carlos Gonzales Blanco', Adriana Portas2, J.C. Gonzalez Blanco2,
F. Mauro3, D. Placartea3, S. Martinez:. 'San Juan 3276 Dto 31 floor 6 1233;
2Neuropsychiatric Hospital Jose T Borda; 3Television Producer Buenos Aires,
Argentina
In Argentina, the first known cases of deaths caused by AIDS date from 1982;
the disease takes the country by surprise in a badly deteriorated health systems,
the health policies do not find the right way and only in 1989 they do try to pass
a bill on AIDS and the possible problems of discrimination to those already ill or
infected. AIDS appear on the Argentine stage as an imported disease and as a
disease of other human beings called homosexuals, with a chance of spreading
onto the rest of the citizens by means of blood transfusions. When AIDS suddenly
appeared and for a long time, the homosexuals, drug addicts and prostitutes,
that is to say, those who practices matched the idea of life style, where framed
as risk groups. These associations were and still are the consequence of discriminatory idea where AIDS is caught because the person wanted to catch it
or neglected something. Besides, manu people feel better if they think this is a
problem other people have making those who suffer the disease and the ones
around them to hide what is socially unacceptable. From 1989, some changes in
the social response to AIDS have been observed; it appears as a problem fr the
heterosexual population and on those days in Argentina the screening test was
given to identify individuals indiscriminately. The use of this test was given up not
because of a law but for economic problems. In the public opinion there is still a
feeling of fear caused by the identification and spread of the virus, relating sexual
activities, blood, drugs and death. In schools, there is still the problem of who is
going to give sexual education and how to do it and when t is done, it is only
limited to explaining the genitals and the menstrual cycle. They make the mistake
of taking about sex to talk about AIDS and this way they approach the subject of
sexuality by means of the disease, In the las few years there has been a change
which is mainly expressed in the cultural environment; the cinema, the theatre
where a superficial and barely understandable treatment has given way to a more
concrete method of approaching this hard reality. AIDS cases in schools ar no
longer the cover headlines in newspapers. But we cannot state if this change
has taken place in each member of our society. In this present research we
are trying to stress the differences existing between the concepts of information
and education; to stress that the population is informed by this knowledge has
not produced changes in their conduct; to describe the characteristics of the
campaigns that been made in Argentina and their impact on people. We will point
out some of the campaigns carried out and the characteristics of the populations
they were intended to. We will also show some guidelines for the production of
campaigns based on the experience we have acquired during our nine-year-old
experience in the assistance and within the community.
Conclusions: to stress the role played by the mass media, the ideology shown
in them and the fact that these media are not always efficient enough and sometimes not well used not only because of the content shown in them but also
because of the wrong application of the economic resources.
60979 Viral load in HIV-1/AIDS patients: Distribution and
correlation to LTCD4+ and antiretroviral therapy
Gabriel Deluchi, A. Petroni, J.A. Benetucci, C. Rodriguez Claudia. Rivadavia
2057 3H 1033 Buenos Aires; Fundai-Hospita Muniz Uspallata 2272 (1282)
Buenos Aires, Argentina
Aims: To compare plasmatic viral load levels (VL) in HIV-1+ patients with and
without antiretroviral treatment. To relate VL, LTCD41 counts and CDC status.
Materials and Methods: VLs of plasma samples from 350 HIV-1~ patients
(109 female, 241 males) were analyzed by RT-PCR methodology (Amplicor
HIV-1 Monitor, Roche Diagnostics). Mean age was 32 (range 4-58) years old.
Results: comparative distributions of loglo VL of treated and untreated patients
"vs" CDC status and LTCD4+ counts are shown in table.

60980 Cervical neoplasia and condylomata in a cohort of HIV-1
infected women
Miriam Gargiulo', Giuseppina Liuzzi2, Matilde Sansone3, Pietro Martinelli',
Rodolfo Punzi4, Roberto Piccoli3, Ettore Soscia3. 1 Via lannelli 220 Napoli; 21st
Mal Inf II FAC Medica Universita Federico II Napoli; 3CATT Ginecologia
Universita Federico II Napoli; 4Ospedale Cotugno II Divisione Napoli, Italy
Objective: to estimate the prevalence of HPV-Cervical intraepithelial neoplasia
(CIN) lesions and condylomata in cohort of HIV seropositive women observed
from January 1993 to february 1997.
Patients and Methods: Gynecological examination, colposcopy with biopsy
and immunological parameters were performed on 110 women patients consecutively observed. The mean age was 31.2 yrs: 42 patients were intravenous
drug addicts, 63 had heterosexual contacts and 5 were transfused. Out of 63
heterosexual patients 70% had had only one sexual partner. 48 (43.6%) patients
were on category A; 62 were symptomatic: 35 were on category B and 27 on C.
65/110 patients were under treatment with antiretroviral compounds.
Results: At the time of enrollment HPV-CIN lesions were found in 21/110
patients (19.1%) and condylomata in 12/110 patients (10.9%). CIN I lesions were
present in 6, CIN II in 8 and CIN III in 7 out 21 patients. 18 out of 21 patients were
symptomatic (7 on category B and 11 on category C) and 17/21 reported only
one sexual partner. Visual or colposcopic inspection of genital tract demonstrated
that condylomata were present on vulva (4 patients), portio (6 patients), vagina
and anus (2 patients) respectively.
Conclusions: The prevalence of HPV-CIN lesions and condylomata in our
cohort is in agreement with the data of other studies, but worthwhile is that in
our cohort 71.1% of the heterosexual women had had only one sexual partner so
being considerated not at high risk of HIV infection and HPV-CIN lesions.
60981 Emerging into our life story: Transformation begins with
taking a risk
Philip Lundrigan12, John Baker2, Bobbie Boland2. P.O. Box 875 Spaniards Bay
Newfoundland; 2NFLD & Lab AIDS Committee St Johns NF Canada
Issues: The indicators of Transformative Grief are evident in the experience
of five individuals who over three years agreed to be involved in two research
projects focusing on grief and storytelling. Two of those individuals continue on
their course of self empowerment in sharing their experience.
Project: Building on two previous experiences (1) A retreat focussed on life
losses for PWHIV (2) Research interviews and publication of their personal stories, the presenters choose to become involved in an action reflection research
project inquiring as to why the previous experiences has been successful for
participants. The project was a collaborative experience with the participants approving the data that was used and the way it was interpreted. This paper focuses
on the transformative grief indicators: validation, self empowerment, witnessing
and best self.
Results: For those grieving the death of a loved one, the story/book has taken
on the meaning of a lasting memorial. Others have been validated. The reality of
having their story out there in the outer world has allowed them to move on, let
go of the pain and loss and reinvest in their own future. In particular, caregivers
experienced validation of their experience. The publication was self empowering,
provided an opportunity for disclosure to more people, and through this witnessing support networks widened. For all participants the printed stories provide
a marker point and ensure their stories are permanent within our culture. The
placement of one's story with others in similar circumstances provides a sense
of community and solidarity and opportunity for transformation. All participants
experienced themselves as having operated from their best self, particularly in
relation to making a contribution that would benefit others in future.
Lessons Learned: If people remain in charge of their own process and are
provided with opportunities to emerge, at their own time and place, into their own
life stories - transformation is possible and probable. It is an affirming and growth
encouraging experience.
60982 From a self-support group to an association's structure:
Managing, structuring and respecting communities
Bertrand Audoin', J. Gauthier-Joubaud2, E. Billot2. 'ECS-228 Rue du FBG St.
Martin, 75010 Paris; 2Ensemble Contre le Sida Paris, France
Issue: Through the financial subsidies and organisational support Ensemble
Contre le Sida has made available to French organisations since its creation in
1994, Ensemble Contre le Sida has helped many community-based or specific
self-support groups build an independent and self-relying structure. As part of
this support, and in cooperation with these structures, Ensemble Contre le Sida
has recently started addressing issues on the middle-and long-term prospects of
self-support groups and the evolution of community-based actions within them.
Project: Today, self-support groups' long-term durability sometimes still can
be uncertain: renewing and/or keeping self-support group members in track is
not an easy thing to do; getting substantial subsidies can mean you have the

means to keep your action going, but too much pressure from financial partners
to still have it actually based on a community. It is particularly true in France,
where a community-based action can be contradictory with the French Republic's
"equality" principle, based on the idea that every citizen belongs to one national
community only: this often is an important aspect of self-support groups' relations
to the French authorities.

Loglo VL
CDCc
A1-A3
B1-B3
C1-C3
LCD4c
500
500-200
S200

n
139
114
64
33
17
112
19
52
41

No treatment
q25 Median q75 p
3.6 4.5 5.3

3.4
4.0
4.5
2.3
3.6
4.5

4.2
4.9
5.1
3.7
4.2
5.3

5.2
5.5
5.5
4.5
5.1
5.7

valueb n
- 148
136
71
28
0.01 37
135
18 2.3
62 2.4
0.001 55

Treatment
q25 Median q75 p valueb
2.6 3.7 4.7. 0.001

2.3
2.7
3.5
2.6
3.4
3.5

3.4
3.8
4.7
3.9
4.1
4.3

4.1
4.7
5.2

b Kruskal-Wallis test. c Total numbers (n) for each variable may not match with the number
of patients studied due to unavailability data. Spearman's analysis showed a good correlation
between VL and LTCD4+ counts both for treated and untreated patients (r = 0.47, p. 0.001
and r = 0.43, p - 0.001, respectively).
Conclusions: Vls of treated patients were significantly lower than those of
naive patients. A significative increment in the VL was observed progression of
the CDC status. We have also found a correlation between high levels of VL and
low LTCD4+ counts in agreement with the data already reported.