July 6, 2000

BIRMINGHAM, AL — The XIII International AIDS Conference will be held July 9-14 in Durban, South Africa. The event is expected to draw nearly 12,000 people — scientists, clinicians, healthcare workers, people with HIV/AIDS and government leaders — from around the world.

Following are highlights of presentations that will be given at the conference by UAB researchers. UAB physicians and researchers are available for media interviews regarding these and other AIDS-related topics.

Craig Wilson, M.D., Associate Professor of Pediatrics
Topic: Adolescents and HIV

Wilson and colleagues will present findings of two studies of HIV in adolescents. One study looked at transmission of drug-resistant HIV among youth. "It was the first study to examine whether adolescents with HIV should be tested for drug-resistance before beginning therapy," says Wilson. "We found that transmission of drug-resistant HIV appears to be uncommon among adolescents, therefore it is probably not necessary to genotype adolescents with sexually-transmitted HIV before beginning treatment.

Wilson and others also will present findings of a study that analyzed HIV-infected adolescents and their susceptibility to anal pre-cancers and cancers associated with human papilloma virus (HPV), an infection commonly found in sexually active adolescents. "Disturbingly, we found anal squamous intra-epithelial lesions to be exceedingly common among young adolescent males and females with HIV," says Wilson. "We found that anal HPV is a strong risk factor for this type of pre-cancerous lesion. The high rate of anal lesions suggests that anal cytology screening should be part of regular health care of HIV infected youth."

Both studies were conducted as part of a larger, multi-center national study in the U.S., called Reaching for Excellence in Adolescent Care and Health (REACH), to gather basic information about HIV in adolescents infected through risky sexual behaviors.

Jeffrey Stringer, M.D., Instructor/Fellow, Department of Obstetrics and Gynecology
Topic: Cost Effectiveness of Perinatal Treatment Strategies

Stringer will present the findings of two studies to measure the cost-effectiveness of perinatal treatment strategies using the drug nevirapine (NVP) to prevent mother-to-baby transmission of HIV. The studies involved pregnant women with HIV in Africa who delivered prematurely or who had not received prenatal care or treatment.

"The cost to treat the mother and the infant at time of delivery is $4.39, verses 14 cents to treat the infant only after delivery," says Stringer. "Our analysis suggests that although it is more costly to treat the mother and the baby at time of delivery, it may be more cost-effective than treating just the infant after delivery. Either strategy is more effective than no treatment, since it costs approximately $300 a year to care for an HIV-positive child. Whether either approach works well is a topic of our continuing research efforts."

Stringer and his colleagues also looked at the effectiveness and affordability of mass treatment compared to targeted treatment. "The prevalence of HIV is so high among women in parts of sub-Saharan Africa that it may be more effective to treat all pregnant women, regardless of whether or not they know their HIV status," says Stringer. "This is especially true where the cost of maintaining a full HIV counseling and testing infrastructure is years away. However, there are still unknowns that need to investigated before we can know for certain which approach is most helpful to mothers and infants in Africa."

The following conference presentations will be given by UAB School of Public Health graduate students:

Saleh M. Rahman, M.D., Graduate Student, Department of Health Behavior
Topic: Ethical Issues of Placebo Controlled Trials in Developing Countries

Delivette Castor, Graduate Student, Department of International Health and Epidemiology
Topic: Sociodemographic and Sexual Factors Associated with HIV Positive Status (Trinidad and Tobago)

JoAna Dodson, Graduate Student, Department of International Health and Epidemiology
Topic: Factors Related to Sexual Activity of Adolescents (Hanover, Jamaica)

Damon Smith, Graduate Student, Department of International Health and Epidemiology
Topic: Sexual Behavior in Rural Adolescents (Hanover, Jamaica)