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

12th World AIDS Conference

Abstracts 42395-42400 853

S423951 Immunological and virological analysis of a triple
combination pilot study and traditional drugs in HIV-1
infected patients in South India
Matthew Samuel1, S. Paramehwari2, D. Raja3, Jacobmini3, Briannaidoo4
'Dept. of Experimental Medicine & AIDS Rescn, TN Dr. MGR Medical University,
40 Anna Salai, Madras-32; 2Tndrmgrmeduni; 3lbid; 4Roche, Cyprus, India
Background: All indications suggest that between 3 and 5 million people in India
are infected with HIV. ART is prescribed for paying patients. Majority of HIV/AIDS
patients seek therapy from traditional practioners. These drugs are not evaluated
for their suppression of the HIV-1 viral load. Therefore this study is undertaken
to compare ART and traditional herbal medicines (from Ayurveda and Siddha) in
terms of safety and suppression of viral load.
Research Study: 10 adult HIV-1 confirmed patients were studied. RT-PCR for
viral load was performed prior to therapy and at 3 monthly intervals. CD4/CD8
counts were performed by immunomagnetic bead technique (Dynal). Viral load
and CD4/CD8 results will be presented in detail.
Both combination regimens have an excellent safety and were well tolerated.
The HIV-1 viral load suppression is remarkable in triple combination and no
change was observed by traditional medicines. However the patients in this
group gained weight. Further studies are warranted.
42396 Connecting future outcomes with present actions:
Predicting the sexual risk-taking of gay and bisexual men
Robert Appleby', L.C. Miller2, S.T. Murphy2, G. Marks3, G. Mansergh3.
'Department of Psychology - USC Los Angeles CA; 2Anneberg School - USC,
Los Angeles CA, 3Centers for Disease Control & Prevention, Atlanta, GA, USA
Background: Decisions about sexual behavior are often influenced by events in
the immediate sexual encounter. Nevertheless, individual differences in the tendency to consider future consequences of one's actions may provide additional
explanatory power. Are gay and bisexual men who consider the consequences
of their behaviors more likely to practice safer sex than are men who do not?
Methods: 193 white gay or bisexual men (18-41 years old) were approached
in street locations in West Hollywood, California and agreed to complete a selfadministered questionnaire. They answered a range of questions including items
on sexual practices and the Consideration of Future Consequences Scale (CFC)
(Strathman, Gleicher, Boninger, & Edwards, 1994). The data were analyzed using
Spearman correlations and chi-square tests.
Results: The CFC scale had high internal reliability (y =.77). The men who
tended to think about future consequences of their behavior (scored high on the
CFC) had significantly higher incomes, were older, and had more education compared with those who scored low on the scale. Although high scoring respondents
were no less likely to have had anal intercourse in the past year (r =.09), they
had fewer partners with whom they had unprotected anal sex (r =.27) and with
whom anal sex was always unprotected (r =.24). Among those who had anal sex
with a primary partner in the past year, those high on the CFC were less likely
to be the receptive partner in unprotected anal sex with ejaculation (X2 = 5.08, p
S.05). For men who had anal sex with non-primary partners those high in CFC
were less likely to have either receptive anal sex (x2 = 4.97, p <-.05) or insertive
anal sex (X2 = 4.97, p <.05) without a condom.
Conclusion: Gay and bisexual men who consider the future consequences of
their behaviors seem to take fewer sexual risks. The findings suggest that sexual
risk reduction programs might be enhanced by adding components that motivate
individuals to consider the potential future consequences of their actions.
42397 Express yourself... the art as a therapy workshop for
people affected by HIV/AIDS
Jose Narciso M.C. Sescon', M. Acosta Geminiano2, Jeramie Diaz3,
J.K. Jardenil2. 11066 Remedios Malate 1004 Manila; 2Remedios AIDS
Foundation Inc. Manial; 3Pinoy Plus Association Manila, Philippines
Issue: With limiting health care costs in the Philippines, the need to look for
alternative preventive measures has been thought of as best option in curbing
the course of the disease. Art therapy has been thought of as one alternative
treatment for people affected by HIV/AIDS.
Description: Art as a medium of expression has always been an effective tool
in processing unresolved and conflicted emotions through color, shape, depth
and dimension. REMEDIOS AIDS FOUNDATION, INC saw the potential of art
in pursuing a psychosociobehavioral type of therapy among People Living with
HIV/AIDS.
Results: Several painting workshops were conducted at Bahay Lingap, San
Lazaro Hospital (hospice care for PHIVs), members of Pinoy Plus Association
were participants of the project. At the end of the workshop, paintings made are
never-before-seen images of a Filipino PHIV/PWA feeling. It is a breakthrough in
the Philippine art where PHIV/PWAs psyche were seen, feelings that could not
be verbalized. A total of 18 paintings were done in oil pastel, two art works were

made by an inspiring son and a dedicated volunteer worker as they shared the
sentiments of the plight of being a PHIV/PWA. All bitten by the creative bug, they
are, like the rest of the Pinoy Plus community and its support groups deeply aware
of the HIV/AIDS reality. Our debuting artists surprised not only their mentors and
colleagues, but they themselves, with their conscious as well as uncoscious visual
metaphors and their common turning to natural imagery for solace.
Conclusion: The workshop was indeed a revelation for the Pinoy Plus Association. Participants had consciously and unconsciously spoken of their unresolved

conflicts created by HIV/AIDS. Few descriptive words were said but a thousand
things can be seen unfolding. Indeed, each work represent a psychosocial puzzle
for us to solve.
72*/42398 Evolution of primary health care concepts in
community responses to HIV/AIDS in a northern
Thai HIV epicenter
Narumol Silarug', Paichit Pawabutra2, P. Sawanpanyalert3, M. Vamananda2,
S. Leevutthinan4. 1Division of Epidemiology, Ministry of Public Health Muang
Monthaburt 11000; 2PHC Development Foundation, Nonthaburi; 3Bureau of
Medical Technical Development, Nonthaburi; 4 Office of PHC Commission,
Nonthaburi, Thailand
Issue: The concepts of primary health care (PHC) has been adopted as an
ideology for health development in Thailand for almost 20 years. It is important to
describe evolution of these concepts so that reorientation and/or reinforcement,
if needed, can be supported.
Project: The study is concerned with community responses to HIV/AIDS problems in Phayao province, northern part of Thailand (during 1989-1997) which
use PHC concepts emphasizing people's participation and intersecctoral collaboration. Data were collected from health personnel, HIV-infected persons, and
village leaders through in-depth interviews and focus group discussion.
Results: Community respnses to HIV/AIDS problems can be grouped into
two components, i.e. local initiatives and induction from government and other
sectors. Local initiatives strated early in the epidemic when sick people received
benefits in kind (e.g.food) as part of religious, coremonial and other activities in
the villages. AsHIV/AIDS grew, villagers became more aware of the problems,
and HIV infection became less stigmatized, they can help one another. At the
same time, villagers were trained by the provincial authortly (both health and
non-health sectors) so that they can take part in their own problem identification and prioritization, and solution implementation and evaluation. Participatory
rural appraisal (PRA) technique was used to emphasize local resources int the
training process, encouragement of pepole's participation and rapid walk-through
surveys. Various non-governmental organization (NGO's) were also supportive
of providing family and community care of AIDS and offering job opportunities.
Lessons learned: Strong existing infrastructures in the community allow for
more rapid reactions. Despite its limited budget and personnel, government can
be catalytic in augmenting comunity reponses to HIV/AIDS. The government's
roles can also be complemented by NGOs.
42399 Serum --globulin level as a predictor of HIV infection in
perinatally exposed children
Marinella Della Negra, W. Queiroz, Y.C. Lian, A.P.V. Gomes, S.R. Pimentel,
M.A.O. Goes. Instituto de Infectologia Emilio Ribas, Rua Pamplona 356, 11
Andar, Sao Paulo, SP, Brazil
Objective: The aim of this study was to analyze the probability of having a
presumptive HIV infection diagnosis before 18 months of age, through serum
quantitative y-globulin test, once in developing countries tests like PCR, P24
antigen or HIV culture are not easily available.
Methods: One hundred and nine HIV seropositive, vertically exposed children,
asymptomatic, aged between 0 to 18 months (mean = 9.6 ~ 4.2 mo.) were followed in our service. All of these children had blood samples collected for serum
protein electrophoresis assay as well as HIV serology until the age of 18 months
(ELISA+Western blot). The values of serum y-globulin were analyzed (Reference
levels between 0.85 to 1.46 g/dL). None of this children were receiving any drug
therapy. Mann Whitney test was used for statistical analysis.
Results: Seventy (64.2%) were male and 39 (35.8%) were female. Forty nine
(45.0%) had their HIV infection serologically confirmed after the age of 18 months
and 60 (55.0%) seroreverted. The mean values for y-globulin among the seroreverters subjects was 0.995 g/dL (SD ~ 0.519) while the mean values found among
the HIV infected children was 2.573 g/dL (SD ~ 1062) and this difference was
statistically significant (p = 0.000). Ten percent of the seroreverters and 89.8%
of the HIV infected children showed y-globulin values above 1.5 g/dL. When
analyzing y-globulin values higher than 1.9 g/dL, 91.9% of the children were HIV
infected and this percentage can reach 100% with y-globulin values higher than
3.1 g/dL.
Conclusions: Serum y-globulin titers may be useful for the presumptive diagnosis of HIV infection in HIV seropositive, vertically exposed children under
18 months of age, when more sophisticated tests are not available, helping the
management and medical decisions. Greater cohorts may establish the actual
predictive value of this test.
504*/42400 | Pozfit, positively fit: A prospective, pilot project in
community-based HIV rehabilitation services
Gerry Bally', G.R. Murphy2. 'Jeanne Mance Building, Tunney's Pasture Postal
Locator: 1918B1, Ottawa, Ontario; 2 Victoria AIDS Respite Care Society Victoria,

British Columbia, Canada
Issue: Community-based, consumer-driven rehabilitation services delivered
within the context of an AIDS Service Organization (ASO) may increase the
quality of life and functional capacity of people living with HIV disease (PWAs).
Project: Within the context of an established ASO, a prospective research
study was undertaken using the participatory action research (PAR) model. PAR