Subject: CDC Summary 3/19/93 Date: Fri, 19 Mar 1993 11:37:01 PST (198 lines) Archive-Number: 473 From: Billi Goldberg Note: Copyright 1993, Dan R. Greening. Non-commercial reproduction allowed. sold. Copyright 1992, Information, Inc., Bethesda, MD AIDS Daily Summary March 19, 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 ===================================================================== "Teens Living With HIV Warn Others to Be Wary" Philadelphia Inquirer (03/19/93), P. B6 (Collins, Huntly) More than 50 teens gathered yesterday at Drexel University for a "town meeting" about AIDS. Most of the students were from public schools in Philadelphia, and held discussions with each other for three hours on Drexel's student-run radio station, WKDU-FM. Since 1981, when the AIDS epidemic started, there have been just 19 reported instances of full-blown AIDS among Philadelphia teenagers between the ages of 13 and 19. But those statistics hide the long latency period of HIV. Both students and adults who took part in yesterday's discussions stressed that open talk about sex at home and in schools is vital in preventing the spread of the disease. Several teenagers also talked about the various ways they contracted the virus, and their own denial after they discovered they were HIV-positive. The town meeting was sponsored by WKDU-FM in combination with the AIDS Adolescent Education Project and the Black Lutheran Community Development Corp. The show will be rebroadcast in April on radio and on Drexel's Channel 54, which Philadelphia cable subscribers may receive. ===================================================================== "New Test Accurately Measures AIDS Virus Even in Early Stage Patients--Reported in Science" Business Wire (03/18/93) Redwood City, Calif.--A new way to sensitively and accurately determine the amount of circulating virus (viral load) present in the blood of people who have the AIDS virus is discussed in Thursday's issue of Science. The new method is called Quantitative Competitive Polymerase Chain Reaction (QC-PCR), and was developed by a group at Genelabs Technologies Inc. The method was used to test 66 patients in collaborative studies involving researchers at the nationally designated University of Alabama at Birmingham AIDS Center. QC-PCR might help in the evaluation of HIV vaccines, the monitoring of HIV- positive patients, and in basic studies aimed at providing more information about the biology of HIV and AIDS. The new method gives researchers a better way of accurately measuring viral load, including determining virus levels in people in whom the virus cannot be discovered by pre-existing methods. Jeffrey D. Lifson, M.D., vice president of the HIV & Exploratory Research at Genelabs and senior author of the paper, said, "There is an urgent need for new ways to rapidly evaluate the effectiveness of antiviral treatments in HIV- infected patients without having to wait for the development of traditional clinical endpoints like serious worsening of the disease or death." ===================================================================== "The Oprah Winfrey Show Gives Atlanta AIDS Hospice Situation a National Forum" PR Newswire (03/16/93) The popular "Oprah Winfrey Show" taped a satellite remote from Georgia's Elysium House on Wednesday. The AIDS hospice has come under fire for housing up to six dying AIDS patients at a time. The episode will air across the United States on Tuesday, March 23, 1993. ===================================================================== "Spread of HIV-2 Feared in India" United Press International (03/18/93) New Delhi, India--HIV-2, a second strain of the AIDS virus, has been recorded in India's port cities, and could soon spread to the country's inland regions. Arab visitors have had to shoulder most of the blame for the high level of prostitution in the city of Bombay. A recent study showed that at least 30 percent of all Bombay prostitutes were HIV-infected. HIV-2 is predominantly found in west African nations, with only sporadic cases having been reported in the United States and Europe. India remains one of the countries in the Asia- Pacific region that is most threatened by large-scale HIV epidemics. ===================================================================== "Context Effects on Responses to Questions About AIDS" Public Opinion Quarterly (Winter 1992) Vol. 56, No. 4, P. 515 (Colasanto, Diane et al.) Although the public was more knowledgeable about HIV transmission in 1988, there were large increases in misinformation among several demographic subgroups with respect to one knowledge item: whether or not it was possible to contract HIV by donating blood, according to a survey by Eleanor Singer et al. published in the Public Opinion Quarterly in 1991. Moreover, by 1989 the percentage of people believing that HIV could be contracted by donating blood had increased dramatically, from 28.9 percent in October 1988 to 43.5 percent in November 1989, the 1988 survey being done with personal interviews, the 1989 survey by telephone. Perceptions about HIV transmission were measured in both surveys by a question asking respondents to evaluate nine different methods of transmission. In previous tests, the question about donating blood had routinely been asked after the one about blood transfusion. But in November 1989, the questions about transmission were randomly rotated for every respondent. Those who were asked first about donation were more inclined to say that contracting HIV is possible via donation than those who were asked about donation after transfusion. Therefore, clarifying and counteracting respondents' misperceptions about the risks of donating blood are necessary to elicit correct responses, the researchers say. ===================================================================== "Living With the Epidemic--The Tragedy in Africa" American Nurse (03/93) Vol. 25, No. 3, P. 20 (Kirkpatrick, Sharon M.) More effective approaches to AIDS education, prevention, and/or treatment need to be found, or the future will not be bright for sub- Saharan Africa, writes Sharon M. Kirkpatrick, PhD, RN, president of the Missouri Nurses Association. The World Health Organization says sub- Saharan Africa continues to have the highest prevalence of AIDS, with an estimated one million AIDS cases and another 6.5 million HIV- positive cases. The children feel the profound impact of AIDS both directly and indirectly. About 750,000 infants are HIV-positive; another 10-15 million children under age 10 are projected to be orphaned as a result of AIDS by the year 2000. UNICEF states that HIV- positive infants develop full-blown AIDS more quickly than adults and are often the first indication that the virus is within the family. One of the reasons for the rampant spread of HIV in Africa is traditions related to polygamy. Another belief states that women are expected to remarry quickly when they are widowed. If the husband died of AIDS and the widow is HIV-positive, than the virus has the potential to be spread further by exposing another person when the woman remarries. Many African health-care workers have said they see little change in sexual behavior, despite warnings of the risks of HIV infection. For some, economic considerations discourage behavioral changes because condoms are too expensive for most villagers to use. Other Africans seem to have a fatalistic outlook, believing AIDS will be an inevitable part of their future. Even though there are several excellent programs being implemented in many areas, the fight against AIDS appears to be making little or no progress in most places, concludes Kirkpatrick. ===================================================================== "Dronabinol Approved for Use in Anorexia Associated With Weight Loss in Patients With AIDS" Journal of the American Medical Association (03/17/93) Vol. 269, No. 11, P. 1361 (Nightingale, Stuart L.) The Food and Drug Administration has endorsed a supplemental new drug application for dronabinol that treats anorexia associated with weight loss in AIDS patients. The new finding is based on clinical studies involving AIDS patients, in which the appetite-stimulation effect of dronabinol was carried out for up to 5 months. Dronabinol is chemically synthesized tetrahydrocannabinol, the main active ingredient in marijuana. In 1985, dronabinol was initially approved as an antiemetic for treatment of nausea and vomiting related to cancer chemotherapy. But in January 1991, dronabinol was given Orphan Drug status for appetite stimulation in AIDS patients with weight loss problems. Orphan Drug status gives financial incentives to a sponsor for developing treatments for diseases or conditions affecting fewer than 200,000 people in the United States. As a result of the potential for abuse, dronabinol remains a Schedule II controlled substance. The approved product labeling mentions that doctors and pharmacists should use the same care in prescribing and accounting for dronabinol as they would with morphine sulfate or other drugs controlled under Schedule II. The Drug Enforcement Administration announced a new policy to monitor dronabinol for diversion and illicit use at the time of dronabinol's initial approval and control in Schedule II. ===================================================================== "News in Brief: Wisconsin" Advocate (03/09/93) No. 624, P. 27 Forced HIV testing of rape suspects does not infringe on the privacy rights contained in the Wisconsin constitution, ruled state district court judge Janine P. Geske on Jan. 26. Geske said that by allowing victims of sexual assaults "access to all of the relevant information regarding her HIV status and her alleged attacker's status, the courts are allowing a reasonable and minimal intrusion upon an accused sexual offender." The judge revealed the decision in a case involving John S. Benson, a rape suspect who is confined in the Milwaukee county jail. Benson's lawyers said they would not appeal the ruling and Benson would undergo the testing. But Doug Nelson, executive director of the Milwaukee AIDS Project, said that "no one would rely on the HIV test of another individual to access their own HIV status. Victims of sexual assault must obtain their own tests." Milwaukee assistant district attorney Donald Jackson said that in the year since the forced-testing law was enacted, county prosecutors have used it fewer than ten times. ===================================================================== "AIDS Patient Care Challenges Nursing" American Nurse (03/93) Vol. 25, No. 3, P. 1 (Cassetta, Robin A.) As the AIDS epidemic spreads to all segments of society, nurses will face the challenge of caring for a growing number of AIDS patients. AIDS education is imperative to guarantee safety for health care workers and adequate care for patients. Mia Taylor, RN, nurse clinician and case manager at the McAuley Clinic in Grand Rapids, Mich., said, "HIV/AIDS can't be a specialty anymore; all nurses and physicians need to be educated in HIV/AIDS." The increasing rate of HIV infection among the public will demand a movement toward community care in order to maintain a continuity of care for AIDS patients. Nurses are the primary source of support and education to the friends and family of the AIDS patient, and must educate the community to help provide the AIDS patient with a high quality of life. Nurses must also learn to handle the specific needs of AIDS patients including psychosocial, employment, emotional, and financial needs. To address all of these needs, multi-disciplinary teams of health-care workers can be effective. Health-care workers can avoid having a similar problem develop somewhere else by addressing a problem from all aspects of treatment. Moreover, nurses must be updated on all of the recent developments in AIDS research and treatment to ensure the best care for their patients. Taylor said by long-term caregiving and by educating others, nurses can find the reward of "personal satisfaction in knowing that these patients are very discriminated against, have a terminal illness and although we cannot cure them, we can improve their quantity and quality of life."