Abstract Book Vol. 2 [International Conference on AIDS (14th: 2002: Barcelona, Spain)]

634 Abstracts ThPeF8203-ThPeF8207

XIV International AIDS Conference

ThPeF8203 Improvement of depression and anxiety trought a
psychotherapy program for HIV-infected patients in
a public mental health setting
A. Rousaud1, J. Blanch1, M. Hautzinger2, E. Martinez3, J.M. Peri4, J. De
Pablo4, J.M. Gatell3. Ilnstitut Clinic de Psiquiatria i Psicologia, Hospital Clinic
Universitari, Barcelona, Spain; 2Clinical and Physiological Psychology
Department, Eberhard-Kar/s-University of Tubingen., Tubingen,; 3Infectious
Diseases and Microbiology Department, Barcelona, Spain; 4nstitut de Clinic
Psiquiatria i Psicologia, Barcelona, Spain
Most HIV-infected patients attending a consultation-liaison psychiatry service
show symptoms of anxiety and depression. The present study sought to evaluate
the immediate and long-term efficacy of a structured cognitive-behavioral group
therapy in reducing anxiety and depression in HIV-infected patients referred to
a consultation-liaison psychiatry department, and to identify baseline variables
predictive of greater improvement.
Methods: Repeated measures ANOVA was used to analyse changes on the
Beck Depression Inventory and the state subscale of the State/Trait Anxiety Inventory administered to 39 participants at four time points: Ti (one month before
beginning of the therapy), T2 (during the first session), T3 (during the last session) and T4 (three months after the last session). The therapy consisted of 16
weekly two-hour sessions following a structured time-limited cognitive-behavioral
group psychotherapy program.
Results: During the intervention time (between T2 and T3) an improvement was
observed in depression (F(1,38)=20.430, p=0.000) and anxiety (F(1,38)=13.472,
p=0.001), which persisted after the 3-month follow-up period (between T3 and
T4). No changes were observed during baseline (between T1 and T2). Patients
with higher levels of anxiety at baseline showed greater improvement in STAIstate subscale scores (*= 0.597, F(1,37)= 20.51, p=0.001). Transmission of HIV
infection through intravenous drug use was associated with less improvement on
the BDI (*= -0.460, F(1,37), p=0.003).
Conclusions: This is the first report of an ongoing study which suggests the long
lasting efficacy of a structured cognitive-behavioral oriented group psychotherapy program in a heterogeneous sample of HIV-1 infected patients referred to a
consultation-liaison psychiatry unit.
Presenting author: Araceli Rousaud, Institut Clinic de Psiquiatria i Psicologia, Hospital Clinic Universitari, Villarroel 170, 08036 Barcelona, Spain, Tel.:
[phone], Fax: [phone], E-mail: [email protected]
ThPeF8204 Leadership in fighting an epidemic (LIFE), n'ew
intervention to improve the healthy and quality of
life of PLWAs. TASO experience
K.E.P. Katamuuna, M.J. Mayanaja James, K.M. Rev. Kakonge Mpomba,
M.A. Mugume Alex. The AIDS Support Organisation (TASO)(U) Ltd, Rua Nicolau
Coelho n090.R/C, 1 ~and 2~, P0 Box 38, Beira, Uganda
Issues: Worldwide, HIV/AIDS is recognized as a dynamic epidemic, which needs
new interventions always to deal and live with it. It is in this light that TASO proposed additional activities to its strategy to improve the healthy and quality of life
of its clients.
Project: The additional activities in life include: - additional follow up support to
HIV/AIDS activities in districts without TASO, - adopting INH prophylaxis as a
preventive therapy against TB, -adopting cotrimaxazole as a preventive therapy
against other opportunistic infections, - greater involvement of youth in HIV/AIDS
prevention programs, - expanding AIDS support to disadvantaged children and
care for the careers.
Results: Through these activities 1400 PLWAs would have benefited from prophylactics, 175 youth from 7 centers would have trained in peer education, 35
medical staff trained in clinical management of TB and 300 children would have
trained through apprenticeship.
Conclusion: All in all, TASO clients would have benefited a lot from these activities as far as prevention, care and support, orphans and HIV/AIDS and in capacity
building/infrastructure.
Presenting author: Emilly Peace Katamujuna, Rua Nicolau Coelho no90.R/C,
1~and 2~, P.O Box 38, Beira, Mozambique, Fax: [phone], E-mail: [email protected]
ThPeF8205 Nutrition management package to support people
with HIV/AIDS (PWH/A) in Indonesia
PR Matulessy1, M.r Forina2, G.M. Tirza2. 1ESG.NH-Christian University of
Indonesia, Jakarta, Indonesia;;2PALMA Foundation, Jakarta, Indonesia
Issues: Economic crisis & unstable political situation in Indonesia, with 210 million population, induced more than 1,600,000 drugs user shifted to IDU with
sharing needle for economical reasons, found 20-60% infected by HIV. Fac
ing this HIV/AIDS pandemic codition, PWH/A can not effort to buy the expensive anti-retroviral drugs, nutrition support will be the main alternative for treatment base on the pathogenesis of HIV infection which micronutrients deficiency
caused by metaboilc failure. Several Micronutrients like B-carrotene, Vitamin B,
C, Zn, SE, Fe are affected by HIV infection, while macronutrients loss will impact
the metabolism and body weight loss drastically. "Balloon syndrome" caused by
metabolic failure are specifically for micronutrients deficiency, this condition will
predict not agood prognosis.

Description: The project is to support PWH/A with their family, hand by hand,
to delay the progress of HIV & facing their health problems. Clinical care & nutrition management package are carried out for one year for PWH/A, counseling
& training were carried out to their family. Family classes meeting 3 days a week
to motivate & change behaviorto improve their knowledge & skill for food & nutrition preparation. The NMP are consist of 3 packages, surveillance of nutritional
status, nutrition intervention package & nutrition education-counseling. Specific
menu based on Coconut, Tempe (fermented soybean), Carrots & fruits are Nutrition Intervention Package were given to both PWH/A.
Lessons learned: Nutrients supplementation to PWH will improve their nutritional status & to delay HIV infection progress as long as the nutrients are not fall
into deficiency To increase Quality of life of PWA. Maintaining nutritional status of
PWH/A are very important indicator of AIDS progress.
Recommendation: Need to do Case Control study or Experimental to detect the
impact of HIV infection to nutritional status of PWH/A & the effect of Micronutrients
deficiency.
Presenting author: Tirza Gwendolyn Matulessy, JI. Bangka IIC/31, Pela Mampang, Jakarta 12720, Indonesia, Tel.: [phone], Fax: [phone],
E-mail: [email protected]
ThPeF8206 Inadequate food and micronutrient intake in HIV+
drug users
A. Campa1, Z. Yang1, S. Sales1, J.C. Philllips 1, H. Lai2, S. Lai2, B. Page 3
'Florida International University, Florida International University University Park,
CH 230, Miaml FL 33199, United States; 2John Hopkins University, Baltimore,
MD, United States; 3 Univeristy of Miami, Miami, FL, United States
Background: Inadequate nutritional status has been shown to facilitate HIV related disease progression and mortality. The causes of poor nutritional status
include HIV-related gastro-intestinal diseases and abnormalities, as well as increased requirement for energy and nutrients. Poor dietary intake may also be
an important contributing factor to inadequate nutritional status in some groups of
HIV-infected individuals.
Methods: 39 consecutive HIV+ drug users were recruited at the Camillus House
clinic in Miami, FI. After obtaining consent, participants were pre-screened for
HIV status and current use of drugs. A trained interviewer administered questionnaires for demographics, patterns of drug use, risk behaviors, food security and
typical dietary intake. Data were coded and analyzed using SPSS.
Results: Most of the study participants were poor (mean income=$299/month),
predominantly male (82%), and black (91%). Despite being eligible, only one third
(32%) of the group received food stamps in the last month. Greater than one
third (34%) spent more than 4 days without food, and nearly half (47%) skipped
meals frequently. Mean Zinc (Zn) intake was low (7.75mg/day). Eighty-two percent (n=31) had Zn intake lower than the US Recommended Dietary Allowance
(<15 mg/day), and 55% (n =21) had Zn intakes (<9.3 mg/day), associated with
mortality in our previous study Average caloric intake for the Zn adequate group
was 2627kcal/day, while for the Zn deficient group was 889kcal/day. Zn intake
was strongly correlated to caloric intake (P<0.01).
Conclusion: HIV+ drug users are at high risk for developing poor nutritional status, particularly zinc deficiency, due to poor intake of Zn, which is strongly and
significantly associated with inadequate caloric intake. Poor dietary intake is related to lack of income, and social barriers to food-aid.
Support: NIDA
Presenting author: Adriana Campa, Florida International University, University
Park, CH 230, Miami, FL 33199, United States, Tel.: [phone], Fax: [phone], E-mail: [email protected]
ThPeF8207 A combined approach to nutrition, exercise, and
smoking cessation to reduce lipodystrophy and
ill-health in people with HIV taking HAART
V. Pribram1, C. Gilbert2. 1 Whipps Cross University Hospital, Flat D, 3 Chapter
Street, London, SWiP 4NY United Kingdom; 2GLL/Kelmscott Leisure Centre,
London, United Kingdom
Issues: People taking HAART may have an increased risk of body shape and
metabolic disturbances and other adverse effects. While the benefits of nutrition,
exercise and smoking cessation interventions on these and other illnesses are
well known in the general population, they have been inadequately investigated
in this group.
Description: Participants have access to a specialist state registered dietitian,
a qualified instructor, locally-based gyms with creches, and a Health Authority
smoking cessation service.
Proposed benefits of this combined approach include improvements in body
shape, weight, metabolic control, muscle mass, lung function, blood pressure,
psychological well being, reduced cardiovascular disease risk, and greater social
exposure through access to local facilities.

Lessons learned: In 3 months, there were 15 referrals for exercise from those
receiving dietary advice. Of those referred 20% were white men and 80% were
African people of whom 75% were women. Mean BMI was 28.6, indicating potential health benefits from weight reduction. Reported and observed outcomes
to date include improved muscle mass, reduced anxiety, depression, obesity, and
waist size, and greater equality of access to health services. Repeat measurements and more smoking cessation referrals are planned.