Subject: CDC Summary 1/29/93 Date: Fri, 29 Jan 1993 07:42:52 PST (253 lines) Note: Copyright 1992, Dan R. Greening. Non-commercial reproduction allowed. sold. Copyright 1992, Information, Inc., Bethesda, MD Archive-Number: 59 AIDS Daily Summary January 29, 1993 The Centers for Disease Control and Prevention (CDC) National AIDS Clearinghouse makes available the following information as a public service only. Providing this information does not constitute endorsement by the CDC, the CDC Clearinghouse, or any other organization. Reproduction of this text is encouraged; however, copies may not be sold. Copyright 1992, Information, Inc., Bethesda, MD ======================================================================= "After Magic Johnson's Disclosure, Risky Sex Dropped, Study Finds" New York Times (01/29/93), P. A16 Once basketball star Magic Johnson revealed his HIV-positive status, fewer people in a Maryland clinic reported having one-time sexual encounters and multiple sexual partners, according to a study by the Centers for Disease Control released yesterday. The study was the first to examine reaction to a celebrity's disclosure about being infected with HIV that did not exude a bias that could affect the findings, said the CDC. The agency surveyed 283 people at a sexually transmitted disease clinic in Montgomery County, Md., from July 29, 1991, through Feb. 14, 1992, about high-risk sexual activity. The CDC asked how often in the last three months each person had a one-time sexual encounter or had three or more sexual partners. In addition, the CDC asked how often the subjects used condoms. Magic Johnson disclosed that he was infected with HIV and would retire as a player with the Los Angeles Lakers on Nov. 7, 1991. By that time, more than half of the participants had been surveyed. Among the 186 individuals surveyed before the disclosure, 31 percent reported having one-time sexual encounters in the previous three months and 32 percent reported three or more sexual partners, said the CDC. Following the revelation, 20 percent of the 97 people surveyed reported one-time sexual encounters and 21 percent reported three or more partners. The remaining 24 people in the study were the only ones who were surveyed a full three months after Johnson's announcement, and they had the largest decline in high-risk sexual behavior. Related Story: Baltimore Sun (01/29) P. 2B ======================================================================= "Clinton Talk is Urged" New York Times (01/29/93), P. A16 The National Commission on AIDS has requested that President Clinton address the American public about AIDS. In addition, the commission also urged him to boost research spending on the disease and lift the immigration ban on HIV-positive foreigners. The 15-member commission issued a letter yesterday that it had sent the President, encouraging him to follow through with his campaign vow to "discuss the AIDS crisis with the American people" early and frequently and to appoint a White House-level AIDS coordinator. The letter said, "Americans have heard almost no discussion of AIDS by our Presidents during the first 12 years of the AIDS epidemic." It also said that although the consequences of the epidemic are devastating, the country still lacked a comprehensive plan to combat the disease. The commission also advised the president to instruct Secretary of Health and Human Services DonnaJE. Shalala to create "a national strategic plan to confront the epidemic," including candid prevention programs that deal with sex and drugs. The group asked Clinton to provide full funding for the Ryan White CARE Act, which is targeted at cities that have been hit hardest by the epidemic. The current allocation of $348 million is less than half the amount Congress approved. Lifting the restrictions on HIV-positive people was another commission request. It said the government should stop compelling military recruits, Peace Corps applicants, and others to undergo HIV testing. The group also suggested providing immediate treatment for drug addicts who seek aid. Despite its requests, the commission is expected to be discontinued in September. ======================================================================= "Private AIDS Foundation is Sponsored by UNESCO" Wall Street Journal (01/29/93), P. B2B HIV discoverer Luc Montagnier and United Nations Education, Scientific, and Cultural Organization (UNESCO) chief Federico Mayor have established a private foundation to hasten AIDS research and care for AIDS patients and their families. Montagnier, who discovered the virus in 1984, said, "We can no longer depend on governments and international organizations." The World Health Organization predicts that 13 million people are infected with HIV worldwide. The foundation, co-sponsored by UNESCO, will establish medical facilities in Europe, North America, and Africa to use findings from laboratory research in clinical research. Montagnier said the foundation would have close relations with AIDS research centers in France and the United States, in addition to international organizations like the U.N. Development Program and the WHO. French Health Minister Bernard Kouchner revealed that the first pilot center will open in Paris later this year, but would not say when. He said the foundation would open a facility in Abidjan, Ivory Coast, to treat and research Africans' immunological systems and make scholarships available for African children orphaned by AIDS. The foundation, which has been in the developmental phase for several years, has already acquired $500,000 in grants. Related Story: New York Times (01/29) P. B4 ======================================================================= "CDC-HIV Count" Associated Press (01/28/93) (Neergaard, Lauran) Decatur, Ga.--Because the Centers for Disease Control is contemplating implementing a means of reporting HIV cases by name, AIDS experts warned that HIV-positive Americans may not trust the government enough to reveal their names. Jeffrey Levi of the AIDS Action Council said to the CDC, "When do they hear the CDC is interested in them? When they want their names. They have to feel they're going to get something back in return." On Wednesday, the CDC convened a meeting of AIDS experts in suburban Atlanta to help it establish guidelines to determine exactly how many Americans are infected with HIV. The agency is considering whether to advise states to report HIV cases by identifying patients, either by name or special code. This type of reporting would guarantee that patients aren't counted twice and would enable physicians to give them appropriate care, said the CDC. State health departments have collected the names of patients with full-blown AIDS and forwarded that number to the CDC since the beginning of the epidemic. Only 24 states count by name the people who test HIV- positive but do not yet have AIDS, so there is no real data on HIV cases. Since many people fear that their confidentiality may be violated, they might avoid identified testing altogether, said Levi. He urged the CDC to push for a federal confidentiality law that would be more forceful than CDC regulations or state laws. Dr. James Curran, the CDC's associate AIDS director, admitted that the CDC's image has been tarnished by the Bush and Reagan administration policy against expanding AIDS services. But he said the CDC could improve its work with better knowledge of the prevalence of HIV infection. ======================================================================= "AIDS a Minefield, Woman Tells Hearing" Toronto Globe and Mail (01/28/93), P. A6 (Downey, Donn) A Canadian woman spoke of her plight with AIDS in Toronto Wednesday at a hearing held to determine the penalty on her family's former doctor, who did not tell the woman's husband he might have received an HIV-tainted blood transfusion during his heart surgery in 1984. Consequently, Rochelle Pittman's husband, Kenneth, contracted HIV and infected her as well. Kenneth Pittman died of AIDS in March 1990 at the age of 59, still unaware that he was infected. That following September Rochelle discovered that he infected her with HIV. She said that it is impossible to live a normal life when a person's immune system has to be assessed every three months. She admitted that she is neurotic and depressed. Dr. Stanley Bain, the former president of the College of Physicians and Surgeons, was found guilty of two counts of professional misconduct. In November, he testified that he thought it was best not to tell Pittman of his condition because he thought the man would be devastated by the news. However, Rochelle said, "He was a fighter," adding that suicide would not have been an option. If he knew earlier of his AIDS-related condition, her husband could have lived longer, said Rochelle, and would have been able to spend more time with their four children to prepare them for his death. Rochelle Pittman is suing Dr. Bain, the Canadian Red Cross, and Toronto Hospital for $2 million. The disciplinary committee of the College of Physicians and Surgeons of Ontario could reprimand Dr. Bain, suspend him, or revoke his license to practice medicine. It reserved its decision Wednesday on Bain's penalty. ======================================================================= "Massachusetts Launches Gay Teen Health Campaign" United Press International (01/28/93) Boston--A Massachusetts commission on gay youth announced a new state-operated public health effort targeted at homosexual teenagers. The program is the first of its kind in the nation. The Governor's Commission on Gay and Lesbian Youth, formed by Republican Gov. William Weld last February, said homosexual teenagers will be paid about $6 an hour to advise other teenagers on gay health issues. Commission Chairman David LaFontaine said the campaign will concentrate mostly on AIDS, suicide by gay youths, and alcoholism. LaFontaine said, "This is the first time that any governor has used the resources of the state government to reach out to gay and lesbian youth." He added, "Governor Weld deserves a lot of credit, especially as a Republican, for putting forth these kinds of programs." About $200,000 was allotted last year to provide training and education of the gay teens who will lecture on health issues, said LaFontaine. Homosexual teenagers throughout the state attended public hearings in November to learn how they could join the program. The sessions will occur at community-based health centers across the state, with the aid of the state Department of Public Health. LaFontaine mentioned that he has met with officials in Rhode Island and Connecticut, who are pushing for similar programs in their own areas, and he said he hopes other states will follow their examples. ======================================================================= "Selected Behaviors That Increase Risk for HIV Infection, Other Sexually Transmitted Diseases, and Unintended Pregnancy Among High School Students--United States, 1991" Journal of the American Medical Association (01/20/93) Vol. 269, No. 3, P. 329 The rates of sexual activity among adolescents in the United States has increased since 1970 along with the rate of sexually transmitted diseases, including HIV infection. A national survey was conducted by the Centers for Disease Control's Youth Risk Behavior Surveillance System. It obtained a sample of 12,272 students representative of students in grades 9-12 in the 50 states and the District of Columbia. Among the students participating in the state and local surveys, 33-79 percent reported ever having had sexual intercourse (median: 55 percent; national prevalence: 54 percent); 54- 78 percent reported being currently sexually active (median: 70 percent; national prevalence: 69 percent); and 8-46 percent (median: 20 percent; the national prevalence: 19 percent) reported having had sexual intercourse with four or more partners during their lifetime. In 27 of 28 sites, male students were more inclined than female students to report ever having had sexual intercourse and having had four or more sex partners during their lifetime. But in 26 of 28 sites, female students were more likely than male students to report being currently sexually active. The percentage of students who reported IV-drug use ranged from 1-4 percent (median: 2 percent; national prevalence: 2 percent). And 5 percent or less of male and female students reported IV-drug use in all sites. Of the students participating in the state and local surveys who reported current sexual activity, 58-87 percent (median 77 percent; national prevalence: 82 percent) reported they or their partner used contraception, including condom use. ======================================================================= "Sclerotherapy for the Treatment of Nodular Intraoral Kaposi's Sarcoma in Patients with AIDS" New England Journal of Medicine (01/21/93) Vol. 328, No. 3, P. 210 (Muzyka, Brian C. and Glick, Michael) Intraoral injection with sodium tetradecyl sulfate is a rapidly effective and well-tolerated treatment for nodular intraoral Kaposi's sarcoma (KS) and should be considered an alternative regimen for these lesions, write Brian C. Muzyka and Michael Glick of Temple University School of Dentistry in Philadelphia, Pa. Kaposi's sarcoma frequently presents as a cutaneous lesion, but intraoral lesions are the initial manifestation in 20 percent of AIDS patients. Treatment of intraoral KS is necessary to reduce the size and the number of lesions. Radiation therapy is most common, but it may induce severe mucositis. Due to the vascular nature of these lesions, sclerosing solutions may be either an appropriate primary treatment or an adjunctive treatment to reduce the size of the lesions before radio-therapy. The researchers used intralesional injections of 3 percent sodium tetradecyl sulfate to treat 12 AIDS patients who had 14 clinically or histologically confirmed intraoral lesions of KS; 4 of the patients also had cutaneous lesions. Because of the potential for injection necrosis, no more than two intraoral lesions were treated at one time in any patient. The treated lesions, which ranged in size from 4-15 mm, changed color from purple to black immediately after the injections, but no associated pain or other side effects were reported. The injections were repeated in three days if the lesions had not decreased in size. Overall, their size decreased by an average of 80 percent within 14 to 21 days, and the lesions disappeared in four patients. No additional clinical progression of the lesions was found in the follow-up evaluation of all patients 24 weeks after treatment, the researchers conclude. ======================================================================= "A Global Agenda for AIDS" Lancet (01/23/93), P. 234 (Horton, Richard) The main factor contributing to the spread of the worldwide AIDS epidemic is indigence, according to the first full-scale progress report by the World Health Organization's Global Program on AIDS (GPA). Poverty causes men to leave families to find work, encourages drug use, and makes prostitution a means of survival for women and children. The GPA said, "AIDS then completes the vicious circle by making the community even poorer." There were approximately 11.5 million cases of AIDS and HIV infection worldwide as of January 1992, reported WHO. The number of cases could reach 30-40 million, with 90 percent of those affected living in developing countries, by the year 2000. While the annual prevalence of HIV infection in developed countries is thought to have peaked in the mid-1980s, the incidence continues to rise in Africa, Asia, and Latin America. The GPA's budget was deeply affected in early 1991 by the Gulf War. From an expected annual income of $100 million, only $17.9 million had been received from contributing countries during the first six months. The final total was $82 million. Regardless of the threat to the funding, 135 research projects were backed by the GPA, and over 45 percent of them were based in Africa and Asia. The chief research areas have been vaccine development, clinical research and drug development, diagnostics, and epidemiological surveys.