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

12th World AIDS Conference

Abstracts 60989-60993 1181

an the goals of education on HIV/AIDS in schools. Teachers consider thegoals of
education on HIV/AIDS at school to be broader on social and educational level:
primarily providing understanding, developing personal skills and charactoriatics,
facilitating choice. Health workers frequently hope that their educational efforts
will result in behaviour change. But behaviour change in usually long process.
School teachers are powerful instruments for the dissemination of information
and promotion of behavioural changes too.
Lessons Learned: Teachers must receive initial and in-service training about
HIV/AIDS. Issues on HIV/AIDS prevention, human sexuality, developing proper
attitudes and skills should be integrated meaningfully into a comprehensive educational programme, rather than becoming additional topics on an overloaded
curriculum.
S60989 Mobilisation of mothers leaving in rural area against
STD/AIDS in Cameroon
Ferdinande Kanal, E. Kembol, C. Ndongmo2, L.N. Kaptuel. 11937
Sidalerte-Cameroon, Yaounde; 2Hematology Laboratory Chu, Yaounde,
Cameroon
Issue: To enlighten rural women on the dangers of STD/AIDS so that they can
undertake personal action plan (faithfulness for those who are married, use of
condoms, or sexual abstinence for those who are not married) and that they
should be more close to the youth to provide them permanent counselling.
Project: Investigation on Knowledge, Attitudes, and Practices (KAP) among
300 mothers concerning STD/AIDS. Meeting with 8 women associations in the
Menoua Division (West - Cameroon). Identification of group leaders. Educative
talks with 24 women during 3 days on the knowledge of common STDs (gonorrhoea, syphilis, chancer, chlamydiasis...) and AIDS (transmission, clinical signs,
prevention). Communication strategies in rural areas (regrouping the youth, use of
local dialects during talks sessions, demonstration on the proper use of condoms,
treatment of STDs and opportunistic infections in HIV patients. Four educative
talk sessions were organised to show examples to peer educators (mothers who
attended the educative talks).
Result: The rural women considered in this study constitute a main group
for the fight against STD/AIDS because more than 95% have sexually active
children. We have been supported in our study by the different women association leaders and by men who were invited. Twenty four peer educators were
trained (3 per association). They represent the active members known for their
devotedness in the association's activities. Following the workshop training and
the field practices, all women were admitted to become peer educators. With the
materials given to these women (3000 leaflets, 5000 condoms, 150 posters, 8
sex models), 16 educative sessions were organised in all meetings of youth, men
and women during the period from February to July 1997.
Lessons Learned: At the end f his work, a large number of persons (women,
youth, and men) have received valuable information on STD/AIDS. Only that, due
to limited resources, we could not do more than this. We exhort the authorities to
provide more mediatic means.
S60990 Health and beauty salon: A strategy for promoting health
seeking behaviour among commercial sex workers in
Tondo Manila, Philippines
Nenita L. Ortega1, N.M.C. Sescon Jose2. 11066 Remedios Street Malate 1004
Manila, 2Remedios AIDS Foundation Inc. Manila, Philippines
Issue: Development of an effective model for the improvement of sexual health
among sex workers in low income community of Tondo Manila Philippines where
STD prevalence is high.
Description: Clinica Remedios is a 2 year pilot Model STD Clinic funded by
WHO/AusAID. It utilizes specific, innovative model community based approaches
that encourages participation by people with health seeking behavior. Alternative
peer education through the beauty salon concept is the focus of activities and has
proved to be an effective mechanism in drawing clients attention with their sexual
health. The concept: "Beauty plus Health Equals Wealth" has been adapted to
promote Clinica Remedios services, thus, promoting health seeking behavior.
Results: The strategy has proved to be very effective in initiating awareness
of ones health through the concept of being beautiful. They avail not only of
the salon services but the model clinic as well. Much has been gained from the
approach and has been noted to steer up future project directions.
Conclusions: In terms of replicability and sustainability, this strategy seems
to be most appropriate. However, the impact on maintaining health seeking behavioural patterns among sex workers has to be followed up. An impact survey
has to be designed to measure this program over the next 3 years.
60991 Correlation between viral load and CD4 count in patients
with and without treatment from Rosario, Argentina
Fabian Fay1, Silvina Benetti2, M. Pedrola1, R. Bortolozzi1, S. Lupo1,
M. Taborda1, O. Fay1. 1CTSP National University Rosario, PTE Roca 740

Rosario 2000; 2Bios Rosario, Rosario, Argentina
Objectives: to correlate the HIV-1 viral load and the CD4 count in patients naive
for antiviral treatment, and patients treated with and without protease inhibitors
(PI).
Materials and Methods: We included 228 patients attending our center. HIV-1
viral load was measured using Quantiplex b-DNA v.2.0 (Chiron). CD4 counts was

measured by flow citometry (Coulter). Patients were divided in 3 groups. Group
A: 89 patients naive for antiviral therapy Group B: 114 patients receiving double
therapy without PI. Group C: 25 patients receiving triple therapy (including PI).
Results:

Group n

89
114
25

Viral Load
Non Detectable Detectable
12(13.4%.) 77 (86.6%)
16(14.0%) 98(86.0%)
10(40.0%) 15(60.0%)

CD4 count
Mean ~ SD (logs) Mean 4 SD (cells/m3)
4.4 ~ 0.9 370 + 289
4.1 0.9 287 1 230
3.8 0.9 188 L 124

The viral load mean was calculated between patients with detectable values.
The comparison of the proportions of patients with non-detectable viral load in
Group C in relation to Group A and B showed a significant increase. (P - 0.01).
Between Group A and B there was no difference.
Conclusions: There is a higher proportion of patients with undetectable levels
of viral load in patients receiving triple therapy (with PI) in relation to patients receiving double therapy (without PI) or naive patients. (P - 0.01). In naive patients
(most of them, in their first visit to our center) a higher viral load is observed and
also a higher CD4 count, probably because a short time of infection.
160992 Comparison of viral load mean in the same center before
and after implementation of triple therapy with protease
inhibitors (PI)
Fabian Fay1, S. Benetti2, E. Gonzalez3, M. Taborda1, 0. Fay'. 1PTE Roca 740
Rosario 2000, CTSP National University Rosario; 2Bios Rosario, Rosario;
3Centro Diagnostico Molecular, Buenos Aires, Argentina
Objectives: to compare viral load mean of the patients attending our center
before and after implementation of triple therapy with PI.
Materials and Method: 2071 samples with known viral load defined by Quantiplex-bDNA v.2.0 (Chiron) were included. Group A: 536 samples obtained from
patients attending our center between July 96 and October 96 when no Protease
Inhibitors were available. Group B: 1535 samples obtained from patients attending
our center between May 97 and December 97.
Results: 62 (11.5%) out of the 536 samples of group A have undetectable
viral load (lower than 2.7 logs). The mean viral load of the 474 detectable samples was 4.50 + 0.86 logs. In group B, 381 (24.8%) out of the 1535 samples
had undetectable levels of viral load, while in the 1154 detectable samples the
mean viral load was 3.71 t 0.71 logs. The comparison of the proportion of
non-detectable samples decreased significantly (P -< 0.001). The t-test shows a
significant difference in the mean viral load of both groups. (Mean difference: 0.79
logs. 95% CI = 0.71 - 0.87 P < 0.001.)
Conclusions: Despite the fact that only a low proportion of the patients is
receiving triple therapy with PI, the mean viral load of the patients attending our
center decreased significantly (P - 0.001) after introduction of PI as an alternative
for antiretroviral therapy. Besides, the new chance of effective treatment induces
a higher numbers of patients to assists our center for the monitoring of their viral
load, most of them asymptomatic and with short time of infection.
60993 Community-randomized trial of a programme to prevent
HIV infection and enhance reproductive health among
adolescents in rural Tanzania: Design of impact
evaluation
David Mabey', Frank Mosha2, J. Todd3, H. Grosskurth', R. Hayes1,
J. Changalucha2, D. Ross4, R. Gabone2. 1London SCH Hygiene and Trop.
Medicine Keppel Street, London, England; 2NIMR, Mwanza, Tanzania; 3NIMR
and LSHTM, Mwanza and London, Tanzania and UK; 4NIMR and LSHTM and
AMREF, Mwanza and London, UK and Tanzania
Background: A community-randomized trial to assess the impact of an adolescent reproductive and sexual health intervention has recently commenced in
Mwanza Region, Tanzania. The rationale and design of the intervention are described in a separate presentation. The specific objectives of the impact evaluation
are to measure the impact of the intervention on reported sexual behaviour, use
of protective measures and reproductive health services, and health outcomes
including HIV infection, sexually transmitted diseases (STDs), and unintended
pregnancy.
Design: Ten intervention communities will be compared with ten comparison
communities. An initial community-based survey of HIV and STDs among 15-19
year olds will be used to stratify the study communities prior to randomization.
The impact of the intervention will be evaluated in a cohort of 8,000 adolescents
aged 14-15 years, recruited in primary school and followed up for 3 years.
Outcome measures: Seroincidence of HIV, syphilis and HSV-2; prevalence
of gonorrhoea and chlamydia; incidence of pregnancy; knowledge, attitudes and
perceived norms relating to sexual behaviour, contraception and STD transmission; reported sexual behaviour; and use of STD treatment and contraceptive
services. The trial will have 80% power to detect a 50% reduction in HIV incidence
over three years of follow-up.
Conclusions: A number of studies both in industrialized and developing
countries are measuring the effectiveness of sexual and reproductive health interventions among adolescents, but this is the first randomized trial specifically
designed to measure the impact of such an intervention on HIV incidence as
well as other STDs. The trial will take five years to complete, and is now in
progress.