Subject: CDC AIDS Daily Summary Date: Wed Mar 5 07:31:02 PST 1997 (191 lines) From: National AIDS Info Clearinghouse Copyright 1997, Information, Inc., Bethesda, MD AIDS Daily Summary March 5, 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 ****************************************************** "Study Finds Needle Swap Is Imperative" "Across the USA: Arizona, Hawaii, South Dakota" "Chronicling the End for 20: Hard Choices Are Harder When Wishes Go Unsaid" "Health Care: Here It Grows Again" "A Chance to Dance to a Very Different Drummer" "We Won a Battle, But AIDS War Must Go On" "U.S. Health: AIDS Deaths Decline, but Groups Warn" "'Negotiated Safety': Common HIV Prevention Strategy Among Homosexual Men" "CDC: Better Needlestick Reporting Required" "'Provide' Services" ****************************************************** "Study Finds Needle Swap Is Imperative" Washington Post (03/05/97) P. B1; Goldstein, Amy On the heels of a report that Washington, D.C., health officials could have prevented as many as 650 HIV infections among injection drug users had they started a needle-exchange program 10 years ago, D.C.'s Whitman-Walker Clinic will announce today that it has received a contract for the city's first large needle-exchange program. Research published this week in the Lancet suggests that because drug use plays an especially significant role in the Washington AIDS epidemic, a needle-exchange program would have been particularly beneficial. Under the new program, 100,000 sterile syringes will be distributed during the next year from Whitman Walker's site in Anacostia and from four mobile units near areas of high drug activity. Clinic director Jim Graham predicts that the program, along with the use of a new oral HIV test that can be used in city neighborhoods, will begin to control the epidemic among injection drug users. "Across the USA: Arizona, Hawaii, South Dakota" USA Today (03/05/97) P. 9A The number of AIDS-related deaths declined in Arizona last year, officials report. A total of 26 AIDS deaths were reported in the first six months of 1996 versus 98 during the same period in 1995. Separately, in Hawaii, a needle-exchange program has helped reduce the spread of HIV among injection drug users. Researchers say that as of Sept. 30, 1996, 77 percent of participants said they had not shared a needle in the preceding month. Meanwhile, state lawmakers in South Dakota approved a bill that would require schools to teach values like honesty, self-respect, and sexual abstinence. Gov. Janklow has not said whether he will sign the measure. "Chronicling the End for 20: Hard Choices Are Harder When Wishes Go Unsaid" New York Times (03/05/97) P. A23; Fein, Esther B. A collection of stories in the New York Times chronicles the end-of-life decisions of 20 people who died at Beth Israel Medical Center between Nov. 1 and Nov. 11, 1995. Four of these individuals were AIDS patients, including a man who had been hospitalized for two-and-a-half months and died after a serious case of pneumonia. His partner and his mother signed a "do not resuscitate" order after the patient developed an infection and a fever. "Do not resuscitate" orders, unlike removing someone from life support, can be signed through a surrogate for a mentally incapacitated patient, since it does not relate to the removal of treatment, but instead to the choice not to initiate certain treatment. In another case, a 44-year-old advanced AIDS patient who was a drug addict and had AIDS-related dementia was brought to the hospital by his family. He was disoriented and shaking from fever and chills related to pneumonia. His brother, who had been named as his advocate, asked that no aggressive treatment be given. "Health Care: Here it Grows Again" Washington Post (03/05/97) P. C1; Auerbach, Stuart Health-care analysts warn that while managed-care kept the increase in health-care costs to 3 percent last year, steeper increases are expected as further cuts become harder to achieve. "There are certainly pressures that suggest the low rate of increase can't continue. Managed-care plans ... have gotten their premiums down to where their costs are pressing on them to charge more," said Matt Quade of ADP Benefit Service. Advances in medical knowledge are contributing to the higher costs, evidenced by more expensive combination therapy for AIDS and the greater efficacy of bone-marrow transplants for cancer treatment. "A Chance to Dance to a Very Different Drummer" Philadelphia Inquirer (03/05/97) P. D1; Kasrel, Deni For the annual Philadelphia fund-raiser Shut Up and Dance, choreographer Rennie Harris is working with volunteer members of the Pennsylvania Ballet to put on a show that will benefit Manna, a city agency that provides meals to homebound people with AIDS. The fifth annual event will take place Saturday night and will be performed by members of the Pennsylvania Ballet on a volunteer basis. Nick Stuccio, a founder of the event, said the idea came from the company's thought that "maybe we should do a special show to give something back to the community. We decided to choose an AIDS organization since AIDS affected the dance community so strongly." "We Won a Battle, But AIDS War Must Go On" Boston Globe (03/04/97) P. A14; Sturgis, Ellen The battle against AIDS must be continued, urges Ellen Sturgis in a letter to the editor of the Boston Globe. She says complacency must not follow the recent report that AIDS-related deaths have declined, especially because the number of new AIDS cases is growing among women and minorities. "U.S. Health: AIDS Deaths Decline, but Groups Warn" IPS Wire (03/03/97) Despite the recent report that AIDS-related deaths in the United States decreased last year, health groups warn that AIDS remains a threat for many people, especially the poor. Michael Isbell, director of Gay Men's Health Crisis, notes that although AIDS deaths did decline overall, "mortality related to HIV continues to grow in certain populations, particularly women and racial and ethnic minorities." The Centers for Disease Control and Prevention reported last week that while AIDS deaths among men decreased 15 percent, the figure rose by 3 percent among women between early 1995 and early 1996. The agency also said that the rate of AIDS progression from HIV infection among African Americans is seven times higher than it is for whites and three times higher for Latinos. "Homeless people, poor people of color--these people are going to die" if they contract HIV, said Keith Cylar of Housing Works, a New York agency for poor or homeless AIDS patients. "'Negotiated Safety': Common HIV Prevention Strategy Among Homosexual Men" Reuters (03/04/97) Research shows that negotiated safety among HIV-negative homosexual men in relationships may help them remain uninfected. Susan Kippax of Macquarie University in Sydney, Australia, and colleagues report in the February issue of AIDS that "a significant number of men used negotiated safety as an HIV prevention strategy." Among a study group of 1,000 men, Kippax found that 62 percent of subjects who claimed to be in a regular seroconcordant HIV-negative relationship reported having unprotected anal sex within a relationship with an HIV-negative partner. Some 91 percent of these men said that they did not have unprotected anal sex outside of that relationship. "CDC: Better Needlestick Reporting Required" AIDS Alert (03/97) Vol. 12, No. 3, P. 30 A recent study of the number of needlestick injuries among health care workers agreed with previous studies which showed that only about half of such injuries are reported to hospital surveillance systems. In light of the success of post-exposure prophylaxis in reducing occupational HIV transmission, the Centers for Disease Control and Prevention has recommended that health care facilities work to improve reporting. The year-long CDC study of health-care professionals revealed that on average 54 percent of needlestick injuries were reported, though reporting rates varied by occupation. Janine Jagger, director of the International Health Care Worker Safety Research and Resource Center, says some workers fail to report injuries because they do not consider a needlestick a high-risk event. Others, she notes, are concerned about the potential problems associated with contracting a bloodborne pathogen. The CDC, which recently issued recommendations for post-exposure prophylaxis, hopes that reports confirming the benefit of treatment will improve reporting of accidents. Setting up a 24-hour hotline for employees is one way to improve reporting by making it convenient and confidential. "'Provide' Services" POZ (03/97) P. 28 To help the AIDS Resource Center of Wisconsin coordinate medical, food, and social programs for its 900 clients, Groupware Technologies, a management-consulting firm, created the software program Provide. The application automatically performs routine activities such as daily scheduling, eligibility screening, and referral generation, and allows users to create and maintain databases. "With a single keystroke you can find out who's eligible for which services in the community," said Paul Milakovich of ARCW. "When you enter a client's data, the computer immediately lets you know what the client's eligible for." Information on Groupware Technologies is accessible on the Internet at http://www.grouptech.com. The firm is marketing the program to 2,500 U.S. AIDS service organizations for $900 per caseworker.