Awareness campaigns: experience in Mexico.

The current total of AIDS cases in Mexico is 37,000 of which 86% have occurred in men. The major route of transmission is sexual. The campaign to prevent AIDS has fallen into four phases, and has now been extended to other sexually transmitted diseases, including hepatitis B. The first phase (1985-1989) was based around question and answer brochures, which increased awareness but did not remove misconceptions. A mass media campaign addressed these misconceptions and stressed preventive measures. The campaign was halted by opposition to the promotion of condom use on the grounds that it encouraged promiscuity. The second phase (1989-1992) used more conservative messages, but these were too obscure and failed to reach the target audience. A poster campaign using popular lottery characters was widely accepted. In the third phase (1992-1994), a combination of messages was targeted at different populations, including parents and women, and general public sympathy for social support for people with AIDS was encouraged. In the fourth phase (1996-2000), a mass media campaign was aimed at teenagers, with parents and teachers as support groups. The campaign was widened to include HBV infection, and posters and brochures for teenagers were produced. These are distributed as part of a collaboration with non-governmental organizations providing sex education. The private medical sector is being encouraged to provide facilities for hepatitis B vaccination. So far the campaign has only been established in Mexico City, but it is hoped that this will be extended nationwide. Hepatitis B vaccination has been recently included in the National Immunization Programme for infants in the first year of life and it is officially recommended for at-risk populations.

CD4+ T-lymphocyte variations in patients with advanced human immunodeficiency virus infection and counts below 100 cells per microliter.

Variability in CD4+ T-lymphocyte measurements has been described for both normal and human immunodeficiency virus (HIV)-infected persons. Clinical protocols use CD4+ cell counts as surrogate markers for disease progression or response. In this study, we determined the variability of CD4+ T-lymphocytes below 100 cells/microl when measured less than 7 days apart. Two consecutive lymphocyte subset measurements were performed in 55 patients using CD3/CD4 antibodies in a flow cytometer (Epics Profile II). Specimens were collected between 8:00 and 10:00 am within the same week. Data from the first and second measurements were compared. The average total lymphocyte count on the first measurement was 1,064 (360-2,853), and on the second 1,162 (320-2,223; P = 0.07); the percentage CD4 was 1.76 (0-8) on the first, and on the second 1.98 (0-9; P = 0.3); the absolute CD4 cell count on the first measurement was 16.6 (0-57) and on the second 22.8 (0-93; P = 0.01). Statistically significant differences were found between the first and second absolute CD4 T-lymphocytes but not in the CD4 percentage. These differences probably are due to variations in total lymphocyte count. For research protocols, repeating CD4+ cell determinations within a short period is advisable, to ensure a homogeneous population. On the other hand, for day-to-day patient follow-up, a combination of clinical criteria and both percentage and absolute CD4+ cell counts should be used to make treatment decisions, because repeating CD4 cell measurements can be very costly.

Optimism rises on combination therapy and protease inhibitor data.

AIDS: The National Institutes of Health (NIH), the Centers for Disease Control and Prevention (CDC), and the Infectious Diseases Society of America convened a third major conference for HIV/AIDS researchers in early 1996. The conference's theme was the demise of AZT monotherapy. Data was presented on protease inhibitors, particularly the most potent ones, indinavir and ritonavir, which decrease viral load by two to three logs in some studies. Research is showing viral load to be an excellent marker for clinical decision making. Specific conference topics included: HIV and tuberculosis, HIV pathogenesis, wasting, pediatrics, antiretrovirals, women and HIV, opportunistic infections, perinatal transmission, and occupational exposure. Each topic is briefly discussed.^ieng

[Prostitution and AIDS in the city of Mexico]. / Prostitución y SIDA en la Ciudad de México.

Since 1987 The National AIDS Council in Mexico (CONASIDA), has conducted research projects among female commercial sex workers (CSW), who are seen at the AIDS Information Centers. Through these studies, we have been able to find out how different issues influence commercial sex work in Mexico City. Since the beginning of our own studies in 1989, HIV prevalence in this particular group has remained low (0.04%-0.2%). Factors found to be associated with condom use were: educational level, not having children, more experience in sex work and younger age. Condom use was reported by 88% of the women; however, qualitative information and high STD prevalence rates suggest a much lower condom use. Mandatory HIV testing is not useful as a preventive measure among sex workers. Persuasive and structural interventions must be implemented in accordance with local and legal situations.