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

608 Abstracts 32430-32435

12th World AIDS Conference

ferral and case management procedures, clinical pathways and the development
of community care packages.
ADAHPS has been successful in being able to provide clients with optimum
care and in empowering healthcare workers in clinical settings to embrace the
challenge of developing innovative responses to difficult client's needs. Funding
has been renewed and there is a feeling of optimism for the future of the service.
S32430 Chronical coinfections in HIV(+) IVDU patients
Liliana EloisaRodenas, A. Farroni1, S. Lupo1, R. Bortolozzi, E. Schutze,
M. Apodaca2, 0. Fay1. 1 Centro de Tecnolocia en Salud Publica Suipacha 531
2000 Rosario; 2 Ministerio de Gob. Prov. de Santa Fe, Santa Fe, Argentia
Objectives: To study the prevalence of chronical coinfections among two groups
of HIV(+) patients: Group I: HIV(+) IVDU Public Hospital's patients. Group II:
HIV(+) IVDU prisoners.
Design: Comparative study.
Methods: Group I (311 patients: 38 female - 273 male - range: 16-39 years),
Group II (89 patients: 5 female -84 male - range: 18-40 years) and control group
(volunteers blood donors), were evaluated for antibodies against HVC by EIA,
Lia and Riba (Organon Teknika, Abbott, Ortho); Hbs Ag, HBc, T gondii IgG, CMV
IgG, T cruzi, by EIA (Abbott, Organon Teknika); HTLV I/Il by W Blot (Organon
Teknika, Abbott); Syphilis and Brucellosis by particle agglutination assay (Wiener
Lab)
N/N( ) HCVAb HVB HBsAg/ T gondii CMV B abortus T cruzi Syphilis HTLV 1/11
% HBcAb IgG IgG Ab Ab Ab Ab
Group I 311/205 306/75 228/133 172/91 149/1 112/8 222/25 75/5
66 25 58 53 0.5 7 11 7
Group II 89/74 89/41 89/41 89/78 89/0 89/12 89/16 89/11
83 83 55 88 0 14 18 12
Control 5000/75 5000/160 200/64 200/90 5000/1 5000/250 5000/10 1250/2
group 1.5 3.2 32 45 0.2 5 0.2 0.16
Conclusion: Significant differences (p < 0.05) were found in HCV, HVB and
CMV-lgG when groups I and II were compared. Related to differences among the
groups and the control group, the socio-economical and cultural conditions could
explain them.
S32431 Drug users and HIV-infected patients in general practices
in deprived and non-deprived areas in Amsterdam
Lodewijk Wigersmal, G.H.A. Brussel2, M.C.A. Buster2. 1Department of General
Practice Academic Medical Centre Meibergdreef 15 1015ZG Amsterdam;
2Municipal Health Service Amsterdam, Amsterdam, Netherlands
Objectives: To assess the numbers of HIV-infected patients, intravenous drug
users (IVDU) and HIV-infected IVDU registered with general practitioner (GP)s in
deprived and non-deprived areas in Amsterdam, The Netherlands.
Methods: A questionnaire with items on numbers of HIV-infected patients,
IVDUs, and HIV-infected IVDUs was sent to all 401 GPs in Amsterdam. Results
were analyzed using bivariate and multivariate techniques.
Results: 68% of GPs responded, working in 76% of Amsterdam general practices. 1449 HIV-infected patients, 1477 IVDUs and 240 HIV-infected IVDU were
registered with 84, 73 and 39% of practices, respectively. The ratio between percentages of practices in deprived and non-deprived areas in which these patient
categories were registered were: HIV-infected patients 95/79%, IVDU 82/70%
and HIV-infected IVDU 55/33%. In deprived areas, 40% of practices had 10 or
more IVDU, compared to 17% of practices in non-deprived areas. Of all practices
with IVDUs, 81% also had HIV-infected patients, in contrast to 60% of practices
without IVDU. All differences were significant.
Conclusion: In deprived areas, a significantly higher percentage of GPs see
HIV-infected patients and IVDUs, and also more of these patients per practice,
compared to non-deprived areas. Both patient categories are concentrated in the
same practices. This has serious consequences for the burden of care for GPs
in inner city deprived areas.
32432 | Serving people of color in the US: Federal efforts to
ensure that HIV services target underserved community
Angela Powell, M.G. Gomez, J.F.O. O'Neill, J.E.H. Holloway. US Health
Resources & Services Admin 5600 Fisher Lane, Room 7A03, USA
Issue: In the US, many communities affected by HIV are traditionally underserved due to socio-economic factors, including race and ethnicity. HIV policy and
planning activities of the Federal Health Resources and Services Administration
(HRSA) are designed to ensure the provision of HIV care and support services to
HIV-infected people of color.
Methods: HRSA administers the Ryan White CARE Act, which provides Federal funds for HIV services in the US HRSA has developed four activities to

ensure that CARE Act grantees are responsive to the service and support needs
of PLWH in their communities. 1.) HRSA policy and program guidance require
grantees to provide services according to documented need in the community. 2.)
mandated planning entities, which set service-related priorities, must be reflective
of the demographics of the epidemic in the service area, including race/ethnicity
and exposure category. 3.) grantees are required to compile demographic data on
service recipients; data allow HRSA to track whether caseloads are reflective of

the demographics of the epidemic in the community. 4.) HRSA provides technical
assistance (TA) to grantees so that affected communities are included in planning
activities. TA includes on-site/peer-based TA on program planning and conflict
resolution. Examples of TA special projects include national conference calls
on participatory planning and technical reports on diverse and representative
planning.
Results: Effectiveness in providing services to people of color has been
demonstrated by documented compliance with program guidance; documented
representative participation in planning bodies; and utilization data showing services are provided to underserved communities, including people of color.
Lessons Learned: HRSA has developed successful policy and planning mechanisms designed to ensure that consumers of services funded by the CARE Act
are reflective of the demographics of the epidemic.
32433 Behavioral and health services research to improve gay
youth's access to HIV/STD services in Latin America
Rafael Mazin-Reynoso', P. Cuchi1, F. Zacarias', J. Watson1, M. Solorzano2,
J.M. Micher2. 1Pan American Health Organization, 525 Twenty Third ST NW,
Washington DC 20037, USA; 2Universidad Autonoma de Mexico Unam Mexico
DF Mexico
Issue: Provision of appropriate services for young males whose sexual orientation/identity does not fit "straight" social and cultural patterns in Latin America.
Project/Methods: A literature review and survey of Latin American experts
which failed to document ongoing research or published papers on how gay
youth's sexual orientation/identity affects their access and/or utilization of specific
health services in Latin America.
Results: Most available models are based on health services for organized
gay communities in industrialized countries. The following areas for further research were identified: a) culturally appropriate definitions of "gay", "straight" and
"bisexual" as applied to young Latin American males; b) sexual identity, self-esteem, self-recognition and their role in sexual performance, exposure to risk,
and health-seeking behavior; and c) health providers' attitudes and the design of
gay/bisexual/transgender-friendly health services.
There is an urgent need to close the knowledge gaps regarding young gay
male sexuality and their utilization of health services in Latin America.
32434 | HIV/AIDS in prisoners of the States of Santa Fe, Argentina
Raul Bortolozzi', M. Tabodra2, I. Padro2, M. Apodaca4, E. Schutze4, S. Lupo5,
O. Fay5. Ministry of the Government, 585 San Juan St, 2000 Rosario; 2Center
of Technology in Public Health, Rosario; 3 Center of Technology in Public Health,
Rosario; 4Penitentiary Health Department, Coronda; 5University of Rosario,
Rosario, Argentina
Objectives: Describe the epidemiological, clinical characteristic and evolution of
prisoners HIV positive, in prisons of the State of Santa Fe, in Argentina.
Materials: The study included 109 male prisoners HIV reactives, follow up from
070196 to 123197. The System of the Classification used was the CDC-93.
Results: The mean of the follow up was 8 months (0.5-18), until this moment
62 continue in prison, 45 have recovered their liberty and 2 have died. The mean
age was of 26 years (18-40). The risk factor of HIV: 94 IVDU, 4 IVDU+HET, 5 non
IVDU+HET, 3 HET and 3 unknown. Level of instructions: 5 illiterated, 32 primary
school incomplete, 41 had it complete and 31 high school incomplete. Place of
origin: 94 Rosario city, 8 state of Buenos Aires, and 7 of other cities of state
Santa Fe. 70 know their serology before entering (18 were diagnosed in a former
detention), only 28 had received controls (16 in a previous detention); 39 were
diagnosed in this detention. 61 had STD antecedents (84 episodes). 12 used
condoms regulary, 10 irregulary and 87 have never used them. 74 were employed
at the moment of the detention. 69 had stable couple, 21 HIV+, 30 HIV- and 18
unknown, 77 had children. 24 hospitalizacions, 11 HIV related complications. 31
were treated with antirretrovirals (26 started it in prison), good compliance in 11.
Initial Stage: A: 68, B: 32, C:9 (TBC 8, PCP 1). Final Stage: A: 62, B:32, C:15
(TBC 3, Toxoplasmosis 2, TBC + Crypstosporidiosis 1 and Kaposi's Sarcoma +
Candidiasis Esophageal 1)
Comments: We want to emphasize the high level of addiction, the low use of
condoms, the low level of instruction. The roll of imprisonment an opportunity for
diagnosis and control, high frequency of the STD, the importance of TBC as the
mayor complication and the low therapeutic compliance.
| 32435 | HIV infection and AIDS in prison: Prevalence
surveys
Horacio Jauregui Rueda1, R. Marino2, R. Silva2, C. Pacheco2, J. Margules2,
A. Monticelli2, J.J. Alvarez Casado2. 'Junin 969 90 "B" 1113 Buenos Aires;
2Unidad21-Servicio Penitenciario Federal, Buenos Aires, Argentina
Background: since unit 21 was created and up to Jan. 5th 1998, 683 HIV positive
patients were hospitalized, in which 587 (86%) had AIDS. That would correspond

to the 4-5% of AIDS in Argentina.
Objectives: prevalence survey about: 1) Predominant risk behavior. 2) Previous marker disease. 3) Actual marker disease. 4) AIDS patients. 5) Patients with
antiretroviral therapy.
Methods and Materials: four prevalence surveys were made; Jan. 92, Mar.
94, Jan. 97, Jan. 98. HIV infection and AIDS classification: CDC 1993, CD4:
immunofluorescent monoclonal antibodies and flow citometry.