Subject: CDC AIDS Daily Summary Date: Thu Jan 30 07:31:02 PST 1997 (193 lines) From: National AIDS Info Clearinghouse Copyright 1997, Information, Inc., Bethesda, MD AIDS Daily Summary January 30, 1997 The CDC National Center for HIV, STD, and TB Prevention makes available the following information as a public service only. Providing this information does not constitute endorsement by the CDC. 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 ****************************************************** "Medical Journal Says U.S. Stance Against Marijuana Is 'Inhumane'" "Changes Force AIDS Hospices to Close" "Campaign For an AIDS Vaccine" "A Place to Share Ideas" "Heated Battle Is Expected on Financing Birth Control" "New AIDS Cases Stabilizing in EU" "Health-HIV/AIDS: China Finds Prevention Better" "False-Positive HIV Test Results Can Lead to Litigation" "Evaluation of Safety Devices for Preventing Percutaneous Injuries Among Health-Care Workers During Phlebotomy Procedures--Minneapolis-St. Paul, New York City, and San Francisco, 1993-1995" "Who Decides?" ****************************************************** "Medical Journal Says U.S. Stance Against Marijuana Is 'Inhumane'" Washington Post (01/30/97) P. A2 The federal government's stand against the medical use of marijuana is "misguided, heavy-handed, and inhumane," according to the editors of the New England Journal of Medicine. An editorial written by Jerome P. Kassirer, the journal's editor, in the Jan. 30 issue, supports doctors' rights to prescribe the drug for the seriously ill and adds that marijuana is safer than some legal alternative treatments like morphine. Kassirer noted that studies to prove the drug's benefit would be difficult to conduct because of the difficulty of measuring such responses as nausea. "What really counts for a therapy with this kind of safety margin is whether a seriously ill patient feels relief as a result of the intervention, not whether a controlled trial 'proves' its efficacy," Kassirer concluded. "Changes Force AIDS Hospices to Close" Richmond Times-Dispatch (01/30/97) P. A2; Estrin, Robin Advances in AIDS treatment and greater acceptance of AIDS patients are causing a decline in demand at hospices, forcing many to close. AIDS deaths still claim as many as 40,000 Americans each year, but new drugs have restored the health of many patients and more dying patients are being accepted by family members and going home to die. Hospice workers are now making house calls to aid caretakers as they deal with the diarrhea, dementia, and pain the disease causes. Boston's Hospice at Mission Hill, as well as other hospices in Pennsylvania and California, has closed due to reduced demand. Some patient advocates are concerned that the trend could leave a number of AIDS patients without a proper facility as they approach death. "Campaign For an AIDS Vaccine" Boston Globe (01/29/97) P. A12 An AIDS vaccine is critical to ending the AIDS epidemic, but the government's current vaccine strategy is inadequate, argues a Boston Globe editorial. The editors point out that powerful new AIDS drugs are too costly and impractical for the poor in the United States as well as the developing world. They endorse, however, the recommendations of Max Essex, chairman of the Harvard AIDS Institute, to fully fund the U.S. military's vaccine research effort or create a private organization like the March of Dimes, and for the Clinton administration to set a goal for an AIDS vaccine by 2005, the 50th anniversary of the polio vaccine. "A Place to Share Ideas" Richmond Times-Dispatch (01/30/97) P. A5 At the World Economic Forum, a six-day meeting of the world's leaders in politics, business, and science, AIDS researcher Luc Montagnier will discuss the threat of emerging diseases. Montagnier, credited as a co-discoverer of HIV, will be among 1,700 participants at the Davos, Switzerland meeting. Other figures attending the event, which opens today, include Israeli Prime Minister Benjamin Netanyahu, Microsoft's Bill Gates, and U.S. House Speaker Newt Gingrich. "Heated Battle Is Expected on Financing Birth Control" New York Times (01/30/97) P. B6; Seelye, Katherine Q. The Clinton administration is preparing a proposal to Congress that would accelerate spending on international family planning aid, a move that abortion opponents say would further the White House's "abortion crusade" in foreign countries. If the measure passes, $215 million for condoms, birth-control pills, and IUDs would be released by March 1. However, if it does not pass, the amount would be reduced to $92 million and would be released on July 1. The administration will argue that the loss of the $123 million would reduce the number of condoms to be distributed by 50 million, birth control pill cycles by 4.8 million, and IUDs by 500,000. Abortion opponents claim the money would be used to promote abortion. "New AIDS Cases Stabilizing in EU" Reuters (01/29/97) Although the number of new AIDS cases in Spain, Portugal, and Italy is still rising, the epidemic is stabilizing in the European Union as a whole. A total of 17,778 new AIDS cases were reported in all 15 countries in the first nine months of 1996, compared to 22,383 in 1995, the European Commission said Wednesday. Just under half the cases were attributed to intravenous drug use. Women accounted for 20 percent of HIV cases in 1995, up from 12 percent in 1986, the commission reported. "Health-HIV/AIDS: China Finds Prevention Better" IPS Wire (01/28/97) An AIDS epidemic similar to the one in Africa can be avoided in China, officials say, pointing to strict measures to curb the spread of the disease. While the incidence of HIV infection is still relatively low in China, the Ministry of Public Health has revealed a medium- and long-term agenda for HIV prevention. The goal of the program, which will feature a nationwide monitoring network with 400 clinics and an advanced national laboratory, is to control the spread of the disease by 2000. The program will involve government agencies, schools, and the public in AIDS education and will crack down on the illegal blood market, drug abuse, and prostitution. "False-Positive HIV Test Results Can Lead to Litigation" Reuters (01/29/97) False reports of HIV infection usually result in lawsuits against physicians and laboratories, according to a report in Medical Economics. Doctors who inform patients of HIV test results or who treat patients for HIV should protect themselves from litigation. David Curtin, a Washington, D.C. lawyer who has represented a patient in such a case, said doctors are surprisingly willing "to begin treating a patient for HIV simply on the basis of a single--and often unreliable--test." "Evaluation of Safety Devices for Preventing Percutaneous Injuries Among Health-Care Workers During Phlebotomy Procedures--Minneapolis-St. Paul, New York City, and San Francisco, 1993-1995" Morbidity and Mortality Weekly Report (01/17/97) Vol. 46, No. 2, Mendelson, M. Of the 51 documented cases of health care workers becoming HIV-infected from an occupational exposure, 39 percent are associated with needle-stick injuries while drawing blood. Safety devices designed to prevent such injuries have been available in the United States, but their benefit has been difficult to evaluate, in part because many percutaneous injuries are not reported and observation of all procedures is not possible. To evaluate safety devices for phlebotomy, researchers from the Centers for Disease Control and Prevention, working with hospitals in New York City, Minneapolis-St. Paul, and San Francisco, compared the use of three safety devices to conventional devices. The devices were a reheatable winged steel needle, a bluntable vacuum-tube blood-collection needle, and a vacuum-tube blood-collection needle with a hinged recapping sheath. A total of 86 injuries were reported during the period when conventional devices were used, compared to 41 injuries during the period when the safety devices were in use. Of those 41 cases, 83 percent involved winged steel needles, while 17 percent were associated with the use of vacuum-tube blood-collection needles. In 61 percent of the cases, the injury occurred before the safety feature was activated, while in 15 percent, it happened during activation. In one-fifth of the injuries, the safety feature had not been activated. An editorial note accompanying the report says the results suggest that the safety devices can reduce the risk of occupational injury among health care workers, and that a significant risk reduction was associated with the vacuum-tube blood collection devices. "Who Decides?" Forbes (01/27/97) Vol. 159, No. 2, P. 47; Brimelow, Peter An evaluation of federal funding for disease research reveals that of the National Institutes of Health's total expenditures, more is spent on AIDS research than any other disease. The NIH allocates a total of $1.34 billion to AIDS, or $31,453 per AIDS-related death. By comparison, $364 million is spent on breast cancer, or $8,210 per death, and $123 million is spent on lung cancer, or $815 per death. Analysts say the disparity is due, in part, to the fact that AIDS is a new disease and is being funded at a high level because of its immediate threat. Merrill Matthews of the National Center for Policy Analysis also notes that "political pressure works." The analyst points out that both AIDS and lung cancer can usually be attributed to personal behavior. However, Matthews notes that the funding disparity shows that Americans are more likely to think of AIDS patients as innocent while smokers are held more responsible for their disease.