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

12th World AIDS Conference

Abstracts 24152-24156 471

Results: 100 HIV-positive women have been included. They were in- and
out-patients followed in a University Hospital. The mean age was 36.01 ~ 7.9, the
mean duration of the seropositivity was 5.4 ~ 3.6 years. The mean MMS score
was 28.4 ~ 1.9 points and the CIS score was 16.3 ~ 11.2. 22% met a diagnosis
of depressive disorder and 16% met a diagnosis of mixed anxiety and depressive
disorders. 48% of women had stopped working since at least 3 years. 67% had
been contaminated through a sexual relationship. 53% had informed their family
and friends of their seopositivity, 37% received no support from their family but
30% considered their familial support as very good. 57% had no children and
58% said they do not want to have children.
Lessons Learned: HIV-positive women presented important scores of emotional distress. The depressive and anxious symptoms appeared to be frequent
in this population. Many women reported to have no or insufficiant social support.
The taking care of these HIV-positive women should be adapted to their specific
concerns.
24152 Implicit sexual cognition and activation in HIV risk:
Predictors of sexual and drug abuse behaviors
Michael Newcomb', A. Stacy2. 'Division of Counceling Psychology, USC, Los
Angeles, California 90089-0031; 2UCLA, Los Angeles, CA, USA
Objectives: The implicit cognition and activation framework of risk behavior
(Stacy, 1997; Stacy, Ames, Sussman, & Dent, 1996) has emerged from basic
research in cognitive science and neurobiology. This approach was used for the
first time to assess and understand nonconscious memory-based tendencies to
engage in risky sexual activities and then related to actual involvement in high-risk
sexual behavior and drug abuse.
Design: Cross-sectional assessment of an adult community sample..
Methods: Participants were 577 ethnically-diverse men and women (average
age = 32). They were randomly sampled as part of a larger community survey
of health habits in Los Angeles County. The sample included respondents with
a range of sexual habits and orientations. Measures of implicit cognition were
assessed using previously validated measures of memory association. Some of
these measures assessed spontaneous thoughts of sex in response to various
word cues. Other implicit cognition measures assessed how spontaneously preventive cognitions (e.g., thoughts of using condoms or becoming infected) came
to mind in response to the word cues. High-risk sexual activity (e.g., lack of
condom use, multiple partners), sexual orientation, drug use, and other health
behaviors also were assessed.
Results: The primary analyses focused on the ability of the implicit cognition
measures to elicit the target responses related to sexual activity and preventive
cognitions (e.g., thoughts of condom use). Results showed that some of the
implicit cognition measures were effective at eliciting the target responses. For
example, some word cues elicited sex-related and prevention-related cognitions.
Although none of the cues led to more than a 10% proportion of the target
responses, the implicit cognition measures yielded a summary index of multiple
responses that was reliably associated with the other measures of risk and should
prove useful for future research.
Conclusion: This initial attempt at applying the implicit cognition perspective
to HIV-related behavior showed that the implicit cognition assessment measure
is an effective index of behavioral risk. Based on this study and previous basic
research, this index capture aspects of cognition that are spontaneous and may
govern behavior relatively automatically, without the necessary involvement of
a reasoned deliberation of the pros and cons of an activity. The approach is
consistent with both neural network approaches to memory association, as well
as with modern concepts of Pavlovian conditioning.
24153 Implicit memory is impaired in HIV-seropositive drug
users
Eileen Martin', T.S. Sullivan1, R. Reed', D. Pitrak', W. Weddington2,
M. Harrow'. 'Dept. of Psychiatry Univ of Illinois, M/C 913, 912 S Wood St,
Chicago, IL; 2VA Medical Center-West Side, Chicago, IL, USA
Objectives: Evidence suggests that HIV-seropositive subjects without a history
of drug abuse fail tasks of motor skill learning, a type of implicit or "nonconscious"
memory mediated by subcortical-frontal neural systems. The current investigation
examined the generality of this deficit by testing HIV-seropositive drug users with
a cognitive implicit learning task that did not involve motor processing.
Design: Prospective controlled study.
Methods: We employed a computerized two-choice probability classification
task failed by patients with basal ganglia disease (Knowlton et. al., Science, 1996).
We tested 44 HIV-seropositive drug users without dementia or other neurologic
AIDS-defining disorders (mean CD4 = 304, viral load <5000 copies/ml in 63%
of subjects) and 39 seronegative drug users matched on age, education and
substance abuse history. Subjects also completed measures of psychological
distress.
Results: 32% of seropositive subjects failed to improve their performance
of the task above chance levels ("poor learners"), compared with only 13% of

seronegative controls (p <.05). Group differences on the task were not a function
of age, education, psychological distress or substance abuse. CD4 counts and
viral loads did not differ significantly for seropositive "good learners" and "poor
learners" (p >.25 in each instance).
Conclusions: Cognitive as well as motor implicit learning is impaired in HIVseropositive subjects without dementia and can be studied meaningfully in HIVseropositive drug users. Cognitive neuropsychological studies of frontal-subcor
tical dysfunction provide a useful model and help advance knowledge of HIV's
neurocognitive effects.
S24154 Changes in HIV psychiatric network practice after 18
months of new antiviral therapy: The Parisian experience
Serge Hefez, T. Greacen, A. Marzloff. Espas Paris, France
Issues: Improved clinical health of people living with HIV taking new antiretroviral medication is not correlated with reduced recourse to a major professional
psychiatric network in the Paris area. Significant changes in patient profile and
psychiatric and psychological support needs are discussed.
Project: ESPAS is a professional network created in 1991 in the Parisian public
and private psychiatric health system coordinating professional response to care
needs of patients living with HIV/AIDS. Some two thousand patients have used
the network. Improved patient health since the arrival of new antiviral therapy has
not reduced patient use of the network. However the nature of patient needs has
changed significantly, resulting in new training needs for professionals.
Results: Main new care needs include support for patients with treatment compliance problems, difficulty in maintaining safer sex practices when re-establishing
long term relationships, counselling needs for couples wishing to have children,
resurgence of problems assuming own homosexuality after years of HIV being
the main problem, depression and suicidal tendencies associated with changes in
length of life expectation, difficulties facing the prospect of living a longer life but
with permanent physical handicaps or neurological or brain damage, difficulties
for institutions and associations that have to rethink care strategy and objectives
in a new chronic disease context.
Lessons Learned: The diversity and novelty of patient needs with the new HIV
therapeutical paradigm has caused a total rethinking of network functioning and
training needs of professionals working in psychiatry.
24155 1Perceived threat of AIDS among college students:
Motivational and personality influences
Joy Pentecostes. 33 St Therese St, Maries Village Antipolo Rizal, Philippines
Objectives: This study is based on a theoretical framework incorporating motivational and personality influences on illness cognition. The objectives are: 1) To
determine the level of perceived AIDS threat among college students along the
following dimensions: perceived seriousness, perceived treatability, perceived link
between HIV status and AIDS, perceived vulnerability, and perceived prevalence;
and 2) To determine the association between perceived threat of AIDS, and
optimism and hypochondria.
Method: Self-administered questionnaire distributed to 75 undergraduate students from the University of the Philippines, Diliman.
Results: Descriptive and correlational statistics were employed in the analysis.
In general, respondents exhibited high perceived threat of AIDS: they reported
high seriousness of AIDS, low treatability, and a strong link between HIV status
and AIDS. However, they reported low perceived vulnerability and low perceived
prevalence of AIDS. Greater optimism was significantly associated with lower
perceived prevalence of AIDS. Hypochondria was not significantly associated
with any dimension of perceived AIDS threat.
Conclusion: Although AIDS is an illness that elicits a high degree of threat,
respondents in this study did not feel personally threatened by AIDS. This may be
explained by the motivational bias towards self-enhancement. Personality factors
may have limited influence on one's perceived level of threat.
24156 The Rorschach test and AIDS: Study of the Rorschach of
30 patients from USAC, Abidjan
Yafflo W. Ouattaral, Emmanuel Bissagnene2, Vincent Guei Kore3
Antoinette Boka Yao2, Makan Coulibaly2, Regina Konan Koko2, Auguste Kadio2.
'Support Rural Communities Against AIDS, Bondoukou, BP 36 Bondoukou;
2SMIT, Abidjan; 3Cocody University, Abidjan, Cote d'lvoire
Objective: make out a rorschach profile with AIDS patients.
Methods: The Rorschach protocols of 30 patients living with HIV have been
analysed. Those patients were treated in walking care for various affections and
were recruted at random.
Results: The sample consisted of fourteen (14) males and sixteen (16) females. The average of the ages was thirty (30) years with some extremes of
eighteen (18) and fourty-five (45).
An average of seventeen answers per protocol was found with a production
very near to the normal standard. The refusals are current (one refusal per
protocol). The sixth image is the most refused and the least liked. The refusals
observed in this study are quite different from those of the general population.
Ninety percent of the patients are likely to give answers linked to the image and
the average F% is 65%. The answers are also in good forms. The TRI of an
extratensive type is also observable in 70% of the cases. In every protocol, the
average anatomic answers is three (3) with a predominance of male protocols

(4 versus 2 anatomic answers with female protocols). The observations made
upon the image are made by 63% of the patients with an average of 2 for each
protocol. Eighty percent (80%) of the patients have a sign of distress quite over
the meaningful threshold (average = 32.6%)
Conclusion: Notwithstandingly the still limited aspect of this approach, those
protocols seem to reveal identical characteristics: a production just near the
standards, current refusals on images VI, II, IV and X, a TRI going in the ex