Subject: CDC AIDS Daily Summary Date: Mon, 19 Aug 1996 06:46:14 PDT (171 lines of text) From: National AIDS Info Clearinghouse Copyright 1996, Information, Inc., Bethesda, MD AIDS Daily Summary August 19, 1996 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 National AIDS Clearinghouse, or any other organization. Reproduction of this text is encouraged; however, copies may not be sold, and the CDC National AIDS Clearinghouse should be cited as the source of this information. Copyright 1996, Information, Inc., Bethesda, MD ****************************************************** "Across the USA: Indiana" "Understanding the Kassebaum-Kennedy Health Coverage Bill" "AIDS Agency's Message Questioned Over Drug Use at Fire I. Fund-Raiser" "D.C.'s Spreading Tuberculosis Problem" "A Step Toward 'Classism and Sexism'" "Patients in Britain Face AIDS Risk" "Life Expectancy Shortened in Uganda" "Youths at High Risk for HIV Report Consistent Condom Use" "Montreal Needle-Exchange Surprise" "Editorial: Time to End the Death Trials" ****************************************************** "Across the USA: Indiana" USA Today (08/19/96) P. 8A More women have HIV or AIDS in northwestern Indiana than in any other part of the state, the state Department of Health announced. Lake County has the highest incidence, with 128 cases, or 51.7 cases per 100,000 women. "Understanding the Kassebaum-Kennedy Health Coverage Bill" Washington Post (08/19/96) P. A13; Skidmore, Dave In a question and answer format, the Washington Post details provisions of the health insurance bill recently passed by Congress. Among them is a change in policy for people who are chronically or terminally ill. The new bill would allow such patients tax deductions for the cost of long-term care, at home or in a nursing home, and would allow penalty-free IRA withdrawals for medical expenses exceeding 7.5 percent of income. In addition, the revenue terminally ill patients receive for selling a life insurance policy would be tax-exempt, and chronically ill patients would be able to cash in or sell a policy to pay for long-term care. "AIDS Agency's Message Questioned Over Drug Use at Fire I. Fund-Raiser" New York Times (08/17/96) P. 22; Dunlap, David W. The Morning Party, an annual gay dance held at Fire Island Pines on the Atlantic's edge, is a popular fundraising event which raises hundreds of thousands of dollars for the Gay Men's Health Crisis (GMHC). Critics say the group, an important private AIDS service organization, should not be involved in the event because the rampant drug use at the party often leads to unsafe sex. Leaders of the GMHC defend the organization's link to the party, and say some of the benefits of the fund-raiser even helped launch a substance-use counseling and education program. The group also said drug use at the party is not condoned. "D.C.'s Spreading Tuberculosis Problem" Washington Post (08/18/96) P. C8; Schiraldi, Vincent; May, Mary Elizabeth The conditions of Washington, D.C.'s prisons are conducive to the spread of tuberculosis (TB) and pose a public health threat, claims Vincent Schiraldi, executive director of the District's Center on Juvenile and Criminal Justice, in a Washington Post letter to the editor. Schiraldi argues that the negative impact of the city's high incarceration rate and the poor medical care of inmates outweighs any benefit of incarceration. In a second letter to the editor, Mary Elizabeth May, a student of public health at George Washington University, criticizes the District's public health system for its poor response to the city's TB crisis. Most of the city's TB patients are prisoners and homeless people, she says, and the disease should therefore be monitored and treated through related channels. She notes that the city's TB bureau must use creativity and flexibility to reach the homeless TB-infected population. "A Step Toward 'Classism and Sexism'" Washington Post (08/17/96) P. A24; Lin, David In a letter to the editor of the Washington Post, David Lin argues that the mandatory HIV testing of newborns can lead to classism, sexism, and discrimination against mothers found to have HIV and AIDS. He claims that the women who can afford to be denied health insurance and employment because they are found to have HIV will still be able to afford to support themselves, but poor mothers will face financial hardships. Lin suggests that the fathers of newborns also be tested, as well as other members of the population who may be at risk. "Patients in Britain Face AIDS Risk" Xinhua News Agency (08/18/96) Thousands of British patients are at risk of contracting HIV and hepatitis from tainted blood products, the government's Medicines Control Agency reported following a spot-check of the country's blood centers. The agency said that equipment for screening blood for the viruses is not being properly maintained, blood is not being properly labeled, and blood packs are neither being kept sterile nor being stored at the correct temperature. Simon Hughes, the Liberal Democrat health spokesman, called for an inquiry into the National Blood Authority, calling the situation "a life or death issue." "Life Expectancy Shortened in Uganda" Xinhua News Agency (08/18/96) AIDS has caused the life expectancy in Uganda to decrease from 45 years in 1993 to 37 years now, Popcare's Sam Ruteikara reports. The increase in HIV infections, he said, caused the average age at death to be 27 for women and 30 for men, he said. In his report, titled "AIDS: A Challenge to Church Ministry and National Development," Ruteikara said that the lower average dying age, combined with the higher number of infants being born with HIV, resulted in the life expectancy of 37 years. The total number of Ugandans infected with HIV is estimated at 2 million, representing 10 percent of the population. "Youths at High Risk for HIV Report Consistent Condom Use" Reuters (08/16/96) A survey of African-Americans aged 12 to 21 found that a sizable proportion reported consistent condom use for at least a six-month period, and many for a one year period. Ralph J. DiClemente, of the University of Alabama at Birmingham, and colleagues concluded that youths "who perceived peer norms as supporting condom use...had greater impulse control...were male... and were younger...were more likely to report consistent condom use." DiClemente suggested that HIV and sexually transmitted disease prevention programs be timed to precede the development of high-risk behaviors. "Montreal Needle-Exchange Surprise" Lancet (08/03/96) Vol. 348, No. 9023; P. 324 A study of nearly 1,600 injection drug users in Montreal found that those who participated in the city's needle exchange program had a greater chance of becoming infected with HIV than those who did not participate. According to researchers at McGill and Montreal universities, the drug users who took part in the needle exchange had a 33 percent cumulative probability of HIV seroconversion, versus 13 percent for drug users who did not participate. There was no known explanation for the unusual findings, which according to researcher Julie Bruneau, were "substantial and consistent...despite extensive adjustment for confounders." "Editorial: Time to End the Death Trials" AIDS Treatment News (08/02/96) No. 252; P. 1; James, John S. In an editorial, John S. James, editor of AIDS Treatment News, argues that the Food and Drug Administration's standards for clinical trials to test new antiretroviral drugs should be changed in light of the greater credibility of viral load tests. James says that the clinical trial system does not give physicians useful data for treating their patients. Currently, drugs can be approved under "accelerated approval" based on easily observed evidence of disease status, provided the drug company agrees to complete larger and longer trials which assess a drug's efficacy based on "clinical endpoints" such as death or disease progression. This standard requires unnecessary financial cost and a high number of deaths to prove that a treatment, which is already being used widely, is effective, James contends. He also points out the ethical conflicts inherent in the system, in which trials are designed with the assumption that one drug will probably work better than another. James suggests that several smaller trials would be more useful to doctors, by providing information, for example, about the drug's endurance, how combinations affect effectiveness, and the safety of the drug for people with medical complications, children, or other populations.