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

470 Abstracts 24147-24151

12th World AIDS Conference

The interplay between these characters have created situations, ranging from
dread, euphoric hope, cynicism, anger and often isolation. The possible influence
of these actors upon the progression of the epidemic, the quality of responses
and the moral of individual worker is described in quasi-qualitative terms.
24147 Emotional needs and behavioral problems in uninfected
children born of HIV-seropositive mothers
Nicola Principi1, Susanna Esposito2, L. Musetti2, R. Tornaghi2, S.S. Corbella1,
E. Massironi2, P. Marchisio2, A. Guareschi1. 1Pediatric Dept. 4 University of
Milan, Milan; 2Pediatric Neuropsychiatri Dept. Milan, Italy
Issue: Uninfected children born of HIV-seropositive mothers (SR) need to express
their individual and social distress, because the impact of negative stressful life
events during the first years of life can cause psychological effects persisting in
the adult age.
Project: Thirty-three SR children and 28 children from families without HIV
infection or other chronic illnesses were compared in order to evaluate the mental
health of SR children. Subjects and controls were aged 6 to 14 years and were
matched by age, sex, and socioeconomic characteristics. Parents completed
the Child Behavior Checklist (CBCL), whereas children completed the Children's
Depression Inventory (CDI) and the Children's Manifest Anxiety Scale (CMAS).
Data were compared using a 2-tail t test.
Results: Total CBCL scores were significantly higher in SR children compared
with control children (p < 0.01). Moreover, analyses of each item evaluated by
the CBCL showed that SR children differed significantly from the control children
as regards social problems (p < 0.05), attention problems (p < 0.05) and factors related to aggressive (p < 0.01) and delinquent (p < 0.01) behaviors. No
significant differences between the groups were observed as regards thought
problems, somatic complaints and withdrawn and anxious/depressed behaviors
(p > 0.05). Parents' perception was different from children's subjective perception
as regards psychological profile. Compared with control children, SR children
were found to be more depressed by the CDI (p < 0.01) and more anxious by the
CMAS (p < 0.01). No differences of the behavioral and psychological measures
were observed neither between SR children whose mothers were alive and those
whose mothers had died, nor between SR children whose mothers were drug
users and those whose mothers were not drug users.
Lessons Learned: Uninfected children born of HIV-infected mothers show
psychological and behavioral problems. Parental HIV infection, together with discrepancy between parents' and children's perception, may constitute emotional
risk factors. Innovative support and psychotherapeutic programmes should take
into account the needs of the children who will be the survivors of the AIDS epidemic, because early interventions, when appropriate, may improve the quality
of their life.
24148 1 Longitudinal assessment of neuropsychological
performance in HIV+ women (baseline and 6 months)
Ramani Durvasula, E.N. Miller, G.E. Wyatt. UCLA, 760 Westwood Plaza NPI
C9-533, Los Angeles, CA 90024, USA
Background: The neuropsychological (NP) effects of HIV-1 infection, characterized by psychomotor slowing and memory impairments have been widely
documented, largely in samples of White gay men. Little of this work has focused on women or ethnic minority samples. The present investigation provides
longitudinal analysis (baseline and 6 month) of NP performance in a multiethnic
community sample of HIV+ (N = 104) and HIV-women (N = 46).
Methods: Women enrolled in the UCLAWomen and Family Project, an ongoing
longitudinal study of risk taking and adjustment in a multiethnic community sample
of women are administered NP testing every 6 months for a period of 24 months.
The present investigation will present baseline and 6 month data for 150 women.
This sample of 150 women (mean age = 36.5 yrs; mean education = 12.9 yrs) is
comprised of African American (46%), American Indian (3%), Caucasian (32%),
and Latina (19%) women residing in Los Angeles county. Repeated measures
analysis of covariance (ANCOVA) with time as the within subjects factor (baseline
& 6 months), and HIV status (positive and negative) as the between subjects factor were conducted with measures of verbal memory (WHO-AVLT), computerized
reaction time (CalCAP Simple RT, Choice RT, and Sequential RT), psychomotor
speed (Symbol Digit Modalities Test), and motor speed (Grooved Pegboard) as
the dependent variables. Age and education were employed as covariates.
Results: Repeated measures ANCOVA revealed an interaction of time and
HIV status on measures of verbal memory (total words learned (p <.000), short
delay recall (p <.02), long delay recall (p <.004)) with HIV+ women evidencing
less improvement at Time 2 compared to HIV- women. A main effect of HIV-1
serostatus was also obtained, with HIV+ women evidencing slower reaction time
(Sequential RT (p <.02)), and slowed motor speed (pegboard dominant hand (p
<.02) and non-dominant hand (p <.02)) than HIV- women.
Conclusion: While improvement was evidenced by both HIV+ and HIVwomen at follow-up, HIV+ women demonstrated relatively less improvement on
tests of verbal memory, a finding which may be suggestive of early signs of

memory difficulties attributable to HIV. Slowed reaction time and motor speed
among HIV+ women is consistent with extant literature describing motor slowing
secondary to HIV. Longitudinal investigations of NP impairment in women will
be an important tool in describing the pattern of NP decline observed in HIV+
women.

24149 1 Neurocognitive function predicts employment status in
HIV-seropositive women: The Women's Interagency HIV
Study (WIHS) - Chicago Consortium
Eileen Martin, M. Cohen2, J. Cook1, V. Carson1, R. Reed1, J. Burke3,
R. Hershow1. Dept. of Psychiatry, 1 University of Illinois, 912 S. Wood St.,
Chicago, 2Cook County Hospital, Chicago; 3Hektoen Research Institute,
Chicago, IL, USA
Objectives: There are few available data on the neurobehavioral status of HIVseropositive women or its relationship to daily or occupational functioning. The
object of this study was to evaluate the performance of HIV-seropositive women
and seronegative controls on measures of neurocognitive function and determine
the association between neuropsychological impairment and employment.
Design: Prospective controlled study.
Method: We administered a battery of neuropsychological (NP) tests to 101
women enrolled at Chicago sites for the Women's Interagency HIV Study (WIHS),
a multicenter study of HIV disease progression in women. Groups included 77
HIV-seropositive women without dementia (median CD4 = 446, 14% with CD4
< 200) and 24 high-risk seronegative women. Groups were matched on age,
education, substance abuse history and current psychological distress.
Results: NP protocols of 31% of seropositive women but only 8% of seronegative women were classified as abnormal (p =.05). 25% of seronegative women
and 26% of seropositive women with normal NP protocols but only 4% of
seropositive women with abnormal protocols were employed currently (p =.01).
CD4 counts, educational levels, and prevalence of antiretroviral therapy did not
differ significantly between seropositive women with normal and abnormal NP
protocols. Rates of substance abuse (64% for seronegative vs. 67% for seropositive women) and depression (54% vs. 53%) were very high and did not differ
significantly between groups.
Conclusion: Neurocognitive abnormalities are significantly more frequent
among HIV-seropositive women compared with seronegative controls despite
high and similar rates of psychological distress and substance abuse. Neuropsychological function appears to be a stronger predictor of current employment
status than disease progression in this group of seropositive women and should
be studied further in relation to psychosocial function and medication adherence.
594*/24150 Psychosocial differences in European and African
HIV-positive women
Catherine Bungener1, N. Marchard-Gonod2, F. Bricaire2. 1 CNRS URA 1957,
Hopital Salpetriere, 47 BD, Hopital 75013, Paris; 2Hopital Salpetriere, Dept
Infectious D. 75013, Paris, France
Background: The cultural background of HIV-positive women implies different
psychological reactions and different social supports. Now more and more African
women are followed for their HIV-infection in France. They live in France, but they
keep their African way of life. Very few studies have been undertaken to consider
the specificity of each culture.
Objectives: The aim of this study was to compare the psychological concerns
and the psychosocial environment of African and European HIV-positive women.
Methods: All women were seen for a semi structured interview to assess
their personal history, the history of their HIV-infection, their social and familial relationships, their preoccupation of pregancy and their concerns about the
HIV-infection.
Results: 60 European HIV-positive women and 40 African HIV-positive women
have been included. 65% of women in both groups have been contaminated
through sexual intercourse, 15% were intravenous drug users. 40% in both
groups learned their seropositivity after a medical survey visit, 30% consulted
because they had somatic problems. 65% of European women talked of their
seropositivity to someone, but only 33% of African did. 72% of European but only
50% of African women received support from their family. 80% of both groups
received no counselling, at any time of their infection, nor contacted any AIDS
association. Only 37% of European but 56% of African desire to have children.
Conclusion: Important differences appeared between African and Europen
women. This implies that the medical and psychological care of these women
should consider their cultural origin. Being seropositive has different psychological
and social impacts according to the culture. In Africa a women is really considered
as part of the society if she is a mother. This contribute to explain why having
children is so important to them.
124151 Psychopathological and psychosocial aspects in
HIV-positive women
Catherine Bungener1, Nicole Marchard-Gonod2, F. Bricaire2. 1CNRS URA 1957,
Hopital Salpetriere, 47 BD Hospital 75013, Paris; 2Hopital Salpetriere, Dept.
Infectious D, 75013, Paris, France
Issues: The psychological, psychopathological or social aspects of the HIV-infection have been widely assessed in men but not in women. In fact, women appear
more and more concerned by the HIV-infection.

Project: The aim of the study was to assess the psychiatric symptoms, psychological reactions and psychosocial aspects observed in HIV-positive women.
All women were seen for a semi structured interview in order to assess their
history, the history of their disease, their social and familial environment, their
concerns about the HIV-infection and their attitude toward pregnancy. Then all
were asked to answer a computerized psychiatric interview (CIS). A MMS was
also assessed.