Subject: CDC AIDS Daily Summary Date: Mon Apr 7 07:31:02 PST 1997 (194 lines) From: National AIDS Info Clearinghouse Copyright 1997, Information, Inc., Bethesda, MD AIDS Daily Summary April 7, 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 1997, Information, Inc., Bethesda, MD ****************************************************** "Clinton to Name New Czar for AIDS" "In Finland, HIV Case Makes Headlines" "Teenagers Alter Sexual Practices, Thinking Risks Will Be Avoided" "Beliefs: The Issue of Doctor-Assisted Suicide Is Put on the Scales of Justice, and Philosophers Weigh In" "TB Cases Increase in Uganda" "Infection Rate Rising in Russia" "Doctors Urge Global Alert for Emerging Diseases" "Ethiopia Launches TB, Leprosy Prevention Program" "On Death and Dying: The Final Hurry" "Czar McCaffrey Fails to Cut Supply of Illegal Narcotics" ****************************************************** "Clinton to Name New Czar for AIDS" Washington Times (04/07/97) P. A1; Bedard, Paul President Clinton is expected today to name Sandy Thurman, former director of AID Atlanta, as his third AIDS czar. Thurman will replace Patsy Fleming, who left the post of director of the Office of National AIDS Policy several months ago. A long-time AIDS activist, Thurman, now a board member of AID Atlanta, is also a member of Clinton's AIDS advisory panel. The President's announcement is expected to coincide with the meeting of the Presidential Advisory Council on HIV/AIDS, which began Saturday and ends Tuesday. In response to news of Thurman's appointment, ACT-UP's Steve Michael said "This is just another bureaucrat who has worked for Clinton and who will do his PR. If the AIDS czar is going to continue to be a branch of the press office, then we should just abolish it." AIDS activists have been calling for the appointment of a prominent politician to the post. Two other key medical jobs that still require filling are those of Surgeon General and Director of the Food and Drug Administration. Officials note that the White House expects both positions to play a role in the war against AIDS, with the Surgeon General supporting sexual abstinence and the FDA head helping to speed the approval of anti-HIV and AIDS drugs. "In Finland, HIV Case Makes Headlines" Philadelphia Inquirer (04/07/97) P. A3; Saffron, Inga American rap artist Steven Thomas has become a controversial figure in Finland, after having been publicly identified as the first person in the country to be charged with attempted manslaughter for knowingly spreading HIV. Thomas' name and picture have appeared in the Finnish media, and his sexual habits have been reported and debated on talk shows. Bengt Lindblom, director of the Finnish AIDS Council, says his center received many calls from concerned women who had uncertain recollections of encounters with black men. "I don't think they would have published [the picture of Thomas on the cover of an afternoon tabloid, which proclaimed, 'This man has HIV,'] if he had been a white Finnish man, and middle-class," he said. The black population has been made to "feel they are the main AIDS bearers," he added. "Teenagers Alter Sexual Practices, Thinking Risks Will Be Avoided" New York Times (04/05/97) P. 8; Lewin, Tamar Due to the increased awareness of AIDS and other sex-related risks among teens, those engaging in sex are more likely to practice oral sex than intercourse, experts say. "Times change, and the norms of adolescent sexual behavior change with them," said Dr. Mark Schuster, lead author of a study of teenage sexual practices. "In an era when vaginal intercourse is seen as dangerous, especially in major cities where AIDS is more prominent, many adolescents view oral sex as an alternative," he said, adding that "this doesn't mean that they don't go on to vaginal intercourse." However, the trend concerns some experts because many teens wrongly believe that oral sex is safe and that precautions against sexually transmitted diseases are unnecessary. Interviews with teenagers reveal that oral sex is perceived as less risky and less intimate than intercourse, and that it is becoming increasing casual. "Everybody understands that intercourse is dangerous and that it requires a real commitment," said one 14-year-old boy, who said that oral sex does not necessarily imply a real relationship. "Beliefs: The Issue of Doctor-Assisted Suicide Is Put on the Scales of Justice, and Philosophers Weigh In" New York Times (04/05/97) P. 12; Steinfels, Peter Adding their perspective to the current assisted-suicide debate, six leading philosophers have submitted a friend-of-the-court brief to the Supreme Court to uphold two federal appeals court rulings that patients have a constitutional right to have a doctor help them commit suicide. The "Philosophers' Brief" holds that in personal and momentous decisions, each individual must be free to make his or her own choice without government interference. "TB Cases Increase in Uganda" Xinhua News Agency (04/07/97) The number of new tuberculosis cases is rising in Uganda, with more than 113,000 new cases reported in the last five years compared to an annual rate of 5,000 cases in the 1970s. Health Minister Crispus Kiyonga said the reported cases represent only about half the number of cases actually expected. He noted, moreover, that TB will claim at least 3 million lives within the next 10 years if current trends continue. "It is likely that no other infectious disease is creating as many orphans and devastating as many families as TB," he said. "Infection Rate Rising in Russia" Itar Wire Service (04/07/97) Between 33 million and 44 million cases of infectious disease are reported each year in Russia, the Health Care Ministry said today, which marks International Health Care Day. The theme of this year's observance is battling the global threat of infectious diseases. Health officials are especially concerned about the rise in the number of tuberculosis cases. Men between the ages of 20 and 39 are most frequently affected, and the TB incidence is 42 times higher in prisons than in the general population. "Doctors Urge Global Alert for Emerging Diseases" Reuters (04/06/97); Kaban, Elif The World Health Organization warned Sunday about the emergence of numerous infectious diseases and bacteria. WHO director-general Hiroshi Nakajima called on governments to increase their funding against the threat, saying "infectious diseases are with us. They respect no frontiers. We must work together globally to control them." WHO noted that a false sense of security had lulled physicians into thinking that many diseases had been subdued and others would soon join them. However, as an example of their error, the group pointed to AIDS, which could affect some 30 million adults by the turn of the century. WHO attributed the spread of disease to such factors as the rapid increase in air travel, growth of mega-cities, insufficient safe water and sanitation. "Ethiopia Launches TB, Leprosy Prevention Program" Xinhua News Agency (04/06/97) A coordinated effort to fight tuberculosis and leprosy was launched in Ethiopia on Sunday, as Health Minister Adem Ibrahim called for collaboration among government and non-government groups, international organizations, donors, religious leaders, professional associations, and the private sector. Ibrahim reported that TB was the leading killer disease in Ethiopia last year, followed by malaria and dysentery. TB has resurged as a result of the country's AIDS epidemic, he said. "On Death and Dying: The Final Hurry" Economist (03/22/97) Vol. 342, No. 8009, P. 32 Although most Americans would prefer to die at home, in relative comfort, they are more likely to die in a hospital. This disparity exists because many terminally ill patients are willing to try desperate measures to live longer, and because federal policies restrict the use of hospice services. Under current policy, patients are eligible for hospice care if they are thought to have less than six months to live, and they can qualify for four hospice benefit periods. As a result, people tend to wait until they are approaching death to seek hospice care. However, in recent years, the government has also been investigating hospices suspected of abusing the system. Hospices have become more cautious about accepting patients as a result. Although clear violations, such as premature admission, were found at some facilities, most cases were too ambiguous to find blame. The impact of the federal audit will be especially noticeable for non-cancer patients, because the course of terminal diseases like AIDS and congestive heart failure is more difficult to predict. To clarify the policy regarding use of hospices, reformers advocate changes that would both increase flexibility and allow for the use of some life-prolonging interventions. "Czar McCaffrey Fails to Cut Supply of Illegal Narcotics" Insight (03/31/97) Vol. 13, No. 12, P. 13; Dettmer, Jamie Rising concerns about federal drug policy, prompted by recent news of increasing teenage drug use and narcotics-related corruption in Mexico, have led some members of Congress to question the demand-reduction strategy proposed by drug czar Gen. Barry McCaffrey. In an Insight commentary, Jamie Dettmer contends that such concerns are justified and that the White House's plan to reduce the demand for drugs is misguided. McCaffrey says he believes in prevention and education, but his budget devotes more money to treatment than these efforts, Dettmer points out. He also criticizes McCaffrey for not responding to findings that treatment is an ineffective intervention. Dettmer claims, moreover, that the value of McCaffrey's strategy of linking alcohol and tobacco use with illicit drug use has not been proven. Rep. Bob Barr (R-Ga.) has noted that "if we constantly keep talking about drugs, tobacco, and alcohol, we're not going to raise the kids' perception of how serious tobacco use is, we're going to lower their perception of how dangerous illicit drugs are."