Subject: CDC Summary Date: Tue, 30 Aug 1994 06:31:52 PDT (166 lines) From: National AIDS Info Clearinghouse Copyright 1994, Information, Inc., Bethesda, MD AIDS Daily Summary August 30, 1994 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, and the CDC Clearinghouse should be cited as the source of this information. Copyright 1994, Information, Inc., Bethesda, MD ************************************************************ "Thai Parents Force Children Into Prostitution" "The Condom King Curbs Population Growth" "Celgene Announces Financial Results for Second Quarter; Chiral Product Revenues Increased for Fifth Consecutive Quarter" "Mexican Homosexual Granted U.S. Asylum Dies of AIDS" "AIDS Chief Promises a Shift Towards Basic Research" "U.S. Teens Know the Score, But Take Risks" "Stavudine (d4T) for HIV" "Aiming at AIDS" ************************************************************ "Thai Parents Force Children Into Prostitution" United Press International (08/30/94); Ehrlich, Richard S. Saisuree Chutikul, Thailand's top women's rights activist, says that Thai parents often force their children to become prostitutes and don't care if they contract AIDS. More than 700,000 Thais already are infected with HIV. United Nations officials report that Thailand's increasing infection rate is among the fastest in the world. While Thai Prime Minister Chuan Leekpai admits that prostitution is too difficult to control in Thailand, he has made a commitment to attempt to stop children from being sexually exploited by both natives and foreigners. "The Condom King Curbs Population Growth" United Press International (08/30/94); Hail, John Meechai Viravaidya, founder and board chairman of the private Population and Community Development Association, has been credited with making substantial gains in slowing Thailand's population growth through the promotion of condoms and other family planning methods. Viravaidya estimates that the widespread use of condoms has resulted in a 77 percent decline in sexually transmitted diseases from 1991 to 1993. Bangkok, known for its sex industry, has seen business decline as much as 60 percent because of fears resulting from the AIDS epidemic. Public health officials estimate that approximately 600,000 Thais are currently infected with HIV. Viravaidya says that number would have reached between 2 million and 4 million by the year 2000 if Thailand had done nothing to raise the awareness of the disease. Since the mid-1980s, Viravaidya and his group have been Thai's leading promoters of AIDS awareness, distributing safe sex pamphlets throughout the country's red light districts. "Celgene Announces Financial Results for Second Quarter; Chiral Product Revenues Increased for Fifth Consecutive Quarter" Business Wire (08/29/94) Despite the announcement that revenues for the second quarter ended June 30 were down from the same period last year, Celgene Corp. has made some advances. For example, the company is poised to initiate Phase II clinical trials of Synovir, its thalidomide-based treatment for cachexia in AIDS patients. Findings presented at the Tenth International Conference on AIDS in Yokohama, Japan indicated that thalidomide has a positive effect on AIDS patients' weight loss. "Mexican Homosexual Granted U.S. Asylum Dies of AIDS" Reuters (08/30/94) The San Francisco law firm of Marc van der Hout announced on Monday that Ariel Da Silva, a Mexican native previously known by the pseudonym of Jose Garcia, died of AIDS at the age of 36. Da Silva was the first immigrant granted political asylum based on persecution due to his homosexuality. His lawyers said that Da Silva's case pushed the American government to review its position on persecution of homosexuals. Attorney General Janet Reno has issued a ruling that persecution for sexual orientation is grounds for political asylum. "AIDS Chief Promises a Shift Towards Basic Research" Nature (08/18/94) Vol. 370, No. 6490, P. 494; Swinbanks, David Describing basic research as "the engine that will drive the entire AIDS research enterprise forward," William E. Paul--director of the Office of AIDS Research at NIH--announced that the United States will realign its fight against the disease to focus on such broad-based research. He reaffirmed NIH's commitment to clinical research, but said it will be redesigned to make it "more complete, coherent, and cost-effective." He also appealed to the pharmaceutical industry to help assume the financial burden of large phase III clinical trials. According to Paul, the inadequacy of current treatments that target the virus itself--such as AZT--are the result of a lack of understanding of the virus itself. A broader approach would be adopted to develop new agents that intervene in the immunopathogenesis of HIV, as well as to discover new methods--like gene therapy--to attack the virus. "U.S. Teens Know the Score, But Take Risks" Insight (09/05/94) Vol. 10, No. 36, P. 29; Wetzstein, Cheryl High-risk sexual activity between males represents the greatest number of AIDS cases among Americans between the ages of 13 and 21, according to a study by the University of Minnesota Hospital and Clinics. Despite scoring high awareness of AIDS, more than 60 percent of the 239 young men surveyed continue to participate in risky behavior and are at "extreme risk" for exposure to HIV. Some teens have a fatalistic view about AIDS, explains Gary Remafedi, the study's lead researcher. They believe they will get AIDS, regardless, because they are gay--it is therefore useless to struggle against it, he elaborates. Those who have intercourse most frequently are also most likely to use condoms inconsistently. However, it is in the longer-term relationships that HIV transmissions take place. In this situation, partners can assume that their lovers are not infected when, in fact, they are. Young men, Remafedi adds, also may be hesitant to ask partners to use condoms because they are shy, or because they don't want to "spoil the mood." "Stavudine (d4T) for HIV" American Pharmacy (08/94) Vol. 34, No. 8, P. 9 The FDA has granted approval to Bristol-Myers Squibb's anti-HIV drug Stavudine because it was shown to be effective on a surrogate endpoint and satisfied an unmet medical need. Like the other three approved HIV antivirals, stavudine is a nucleoside analog thought to slow the progression of the virus by blocking replication. It is indicated for patients with advanced HIV who cannot tolerate or do not benefit from other drugs. In October 1992, the FDA made stavudine the first drug to receive "parallel track" status, meaning that it became available before approval. The predominant side effect reported was peripheral neuropathy with symptoms including numbness, tingling, or pain in the hands or feet. The safety of stavudine use has not been investigated in elderly patients, children, pregnant women, or women who are breast-feeding. "Aiming at AIDS" American Druggist (08/94) Vol. 210, No. 4, P. 35; Shannon, Jacqueline Pharmacists Paul Stephan, Greg Aspacher, Steven Chang, David Zeiger, and Steve Bryant were all disturbed by the poor quality of pharmacy care received by AIDS patients, and each responded separately by developing pharmacies specializing in AIDS treatment. All of these pharmacies maintain information sources specifically for AIDS patients. Some advertise via gay and community newspapers or use telemarketing and personal visits to doctors, but they all agree that participation in local HIV/AIDS service organizations is the best form of promotion. Specializing in AIDS treatment requires a lot of time to sort outside effects and potential interactions of the myriad drugs taken by AIDS patients. Stephan points out that the pharmacist of an AIDS-specialty practice must be able to put personal prejudices aside when dealing with patients. Profits are not easy, with the insurance difficulties and reimbursement problems associated with AIDS cases. Bryant recommends that no one enter this field with the sole intention of making money. One of the primary benefits of pharmacies specializing in AIDS is that because the pharmacist sees the patients much more frequently than the doctor, he can notice both gradual and sudden changes. The pharmacists are then able to alert doctors.