Subject: CDC NCHSTP Daily News Update Date: Fri Jan 9 07:31:03 PST 1998 (255 lines) From: National AIDS Info Clearinghouse Copyright 1998, Information, Inc., Bethesda, MD CDC NCHSTP Daily News Update January 9, 1998 The CDC National Center for HIV, STD and TB Prevention provides the following information as a public service only. Providing synopses of key scientific articles and lay media reports on HIV/AIDS, other sexually transmitted diseases and tuberculosis does not constitute CDC endorsement. This daily update also includes information from CDC and other government agencies, such as background on Morbidity and Mortality Weekly Report (MMWR) articles, fact sheets, press releases and announcements. Reproduction of this text is encouraged; however, copies may not be sold, and the CDC NCHSTP Daily News Update should be cited as the source of the information. Copyright 1997, Information Inc., Bethesda, MD. HEADLINES --------- PEER-REVIEWED JOURNALS "Model For Sexual Health Found in India's West Bengal" GENERAL MEDIA "City Ranks No. 1 in Syphilis" "CDC: Tracking HIV More Reliable by Names Than Codes" "Brazil Turns to Women to Stop Dramatic Rise in AIDS Cases" "Congenital TB Linked to Maternal Coinfection With HIV and TB" "Saliva Component Blocks AIDS Virus" "Clinton Administration Awards More than $39 Million in Grants" "Chemical Key to TB Genes" "Settlement Reached in AIDS Lawsuit" "AIDS Hysteria Hits Mongolia" INFORMATION FROM THE CENTERS FOR DISEASE CONTROL AND PREVENTION "Evaluation of HIV Case Surveillance Through the Use of Non-Named Unique Identifiers--Maryland and Texas, 1994-1996" *************************************************************** PEER-REVIEWED JOURNALS *************************************************************** "Model For Sexual Health Found in India's West Bengal" Lancet (01/03/98) Vol. 351, No.9095, P. 46; Kumar, Sanjay The West Bengal Sexual Health Project (WBSHP) has been named a model intervention group for the treatment of sexually transmitted diseases by the Indian National AIDS Control Organization. Indian officials have called the five-year project, which receives some $6.5 million from the U.K. Department of International Development, a "trend setter." WBSHP--which focuses on diagnosis and treatment, behavioral change, increased communication, and condom promotion--has seen its most success among brothel-based prostitutes. Other groups targeted in the eight interventions include street children, men who have sex with men, and others from Calcutta's "red-light" district. Between October 1996 and June 1997, the group reached about 150,000 individuals, according to project director Judy Hague. In all, staff trained almost 650 peer educators, counseled 15,000 people about STDs, and treated 6,000 others. Also, 1.3 million condoms were distributed. **************************************************************** GENERAL MEDIA **************************************************************** "City Ranks No. 1 in Syphilis" Baltimore Sun (01/09/98) P. 1B; Matthews, Robert Guy Statistics from the Centers for Disease Control and Prevention show that the number of syphilis cases reported in Baltimore during 1996 more than triples 1990's figure, ranking the Maryland city No. 1 in the nation in the rate of reported syphilis cases. In fact, the CDC says Baltimore has twice the rate of cases as the No. 2 city, which is Memphis, TN. Baltimore's deputy health commissioner, Elias Dorsey, suggested that the high rate of infection was due to the crack-for-sex trade. Richard Dunning of Baltimore's Bureau of Disease Control, meanwhile, warns that the increase in syphilis may spark an increase in the number of HIV cases in the city, although no change has been seen to date. City health officials are now calling upon Mayor Kurt L. Schmoke to increase education and treatment funding for the city's health clinics. Schmoke has already agreed to shift additional money and resources to fight the syphilis outbreaks. Health officials say that Baltimore's labor-intensive syphilis tracking system may have contributed to the increase in reported cases, noting that when a person tests positive for syphilis, clinicians search for the person's past sexual partners and also test them for the disease. "CDC: Tracking HIV More Reliable by Names Than Codes" Boston Globe Online (01/08/98) The Centers for Disease Control and Prevention said Thursday that reporting HIV cases by name, rather than by codes, is an efficient and accurate method of counting infections. However, the federal agency added that it still supports anonymous testing. In 1994, health officials in Maryland and Texas began listing patients by a 12-digit code--a combination of the patient's social security number, date of birth, and digits representing gender and race--instead of by name. However, the CDC noted that a three-year analysis of the two systems found that the codes used were frequently incomplete, making it difficult to connect them to actual patients. Currently, 31 states monitor HIV cases, in addition to AIDS cases, by name. "Brazil Turns to Women to Stop Dramatic Rise in AIDS Cases" Christian Science Monitor (01/09/98) P. 7; McDaniels, Andrea According to a report released in November by the Joint United Nations Program on HIV/AIDS, Brazil has the second-highest number of reported HIV infections behind the United States. Meanwhile, a report released at the Pan-American Conference on AIDS last month showed that many of Brazil's new cases occur among married women with children. In part, the increase of infections among this demographic group is attributed to the fact that most Brazilians simply do not like condoms, which are also opposed by the Roman Catholic Church and are more expensive than they are in the United States. Another problem is Brazil's machistic society. As Guido Carlos Levi of Emilio Ribas Hospital's health department explains: "Women are afraid of asking their men to have safe sex, afraid of getting beaten, afraid of losing their economic support." To compound the issue, many Latin men in supposedly monogamous relationships have affairs. Public health officials are now supporting a campaign that calls upon Brazilian women to protect themselves by using female condoms. Priced at $2.50 each, though, the condoms may not be popular. Many women with AIDS say they would have been no more likely to have used a female condom than a traditional one. "Congenital TB Linked to Maternal Coinfection With HIV and TB" Reuters Health Information Services (01/08/98) In the December issue of the Pediatric Infectious Disease Journal, researchers from the University of Natal report that they examined all neonates born in the King Edward VIII Hospital over the course of one year to identify possible cases of perinatal tuberculosis in association with maternal HIV and TB coinfection. Dr. Thillagavathie Pillay and colleagues discovered 11 infants who tested positive for TB, six of whom were born to mothers with HIV and TB coinfection. The researchers suggest that the findings indicate a possible accentuation of the relationship between HIV and TB in coinfected pregnant women. Therefore, more thorough maternal histories should be taken. However, the researchers add, more research with larger cohorts is needed to confirm their hypothesis. "Saliva Component Blocks AIDS Virus" Reuters (01/08/98) Research published in the January 5 issue of the Journal of Experimental Medicine suggests that thrombospondin (TSP)--a natural sugar-protein found in human saliva--can block the growth of laboratory strains of HIV. Drs. Ralph Nachman, Roy Silverstein, and Jeffrey Laurence of the New York Hospital-Cornell Medical Center explained that they initially began exploring why there are relatively small amounts of HIV in saliva, and why human saliva is effective at inhibiting HIV growth in the test tube. The finding could lead to the creation of natural inhibitors of HIV transmission. In addition, Nachman noted that TSP derivatives could possibly also be used in condoms, foams, suppositories, toothpastes, and mouthwashes to block HIV transmission. "Clinton Administration Awards More than $39 Million in Grants" U.S. Newswire (01/08/98) Health and Human Services Secretary Donna E. Shalala has awarded over $39 million in grants to 94 primary health care groups in 29 states, the District of Columbia, and Puerto Rico, to provide outpatient treatments targeting low-income individuals with HIV or AIDS. "HIV/AIDS patients are best served with comprehensive services tailored to their unique needs," Shalala noted. "Funded organizations can use these grants to continue the range of preventive and primary care and special services most helpful to people with HIV and AIDS." The majority of the funds have already been given to 67 community-based clinics and hospitals in parts of the United States with high caseloads or rates of infection. The other 27 grants, totaling almost $9 million, will be funded starting July 1. The grants are financed under Title III of the Ryan White CARE Act. "Chemical Key to TB Genes" Financial Times (01/08/98) P. 19; Abdulla, Sara Researchers in the United Kingdom and France have finished mapping the genome sequence of the micro-organism that causes tuberculosis, improving the possibility of success in developing a vaccine. Current treatments involve expensive combination therapies with three or more drugs--taken for up to six months --that are difficult to administer. Researchers hope to develop a less expensive treatment with fewer side effects that can be administered orally. One method researchers might try would compare the genes of the TB pathogen with genes from similar organisms, in order to further understanding of how it functions. The sequencing data will also help researchers understand how the disease spreads and what environmental factors could be changed to help prevent transmission. "Settlement Reached in AIDS Lawsuit" United Press International (01/08/98) Arbor Drugs has made an undisclosed, out-of-court settlement with an AIDS patient who alleged that one of the store's pharmacy workers leaked word of his condition to his children. Stanley Grzadzinski said he and his wife had tried to keep his infection secret in an effort to protect their children. However, he claimed, the pharmacy clerk who handled his AIDS prescriptions revealed his condition to her son, who mocked Grzadzinski's children at school. "AIDS Hysteria Hits Mongolia" Baltimore Sun (01/09/98) P. 10A In Mongolia, several parliament members are urging the government to declare a national health emergency following reports that a visiting Cameroon man with HIV might have slept with four local prostitutes. Health officials have thus far located 56 of an estimated 80 people who later visited the prostitutes. **************************************************************** INFORMATION FROM THE CENTERS FOR DISEASE CONTROL AND PREVENTION **************************************************************** "Evaluation of HIV Case Surveillance Through the Use of Non-Named Unique Identifiers--Maryland and Texas, 1994-1996" Centers for Disease Control and Prevention CDC (01/08/98) This article reports findings from a three-year evaluation of HIV surveillance systems which utilize unique identifiers (UI) as the basis for HIV case reporting. Currently, 31 states conduct name-based HIV surveillance as an extension of their AIDS surveillance systems (3 for pediatric HIV infection only). Because of concerns about name-based reporting, CDC has worked with Maryland and Texas since 1994 to evaluate HIV surveillance systems which use a UI, based primarily on social security number, to report HIV cases. The evaluation revealed several problems with these UI systems, including a high number of reports with incomplete codes (approximately 30-40%), low rates of completeness in reporting (approximately 25-50% complete), difficulty in conducting follow-up on specific cases, and the absence of behavioral risk data in this system. Additionally, a UI-based system may not reduce the potential risk for a breach of confidentiality. Providers are required to maintain lists to link the UI with patients, and this approach increases the number of lists that could be disclosed in a breach of confidentiality. ***************************************************************** The AIDSNews Mailing List is maintained by the CDC National Center for HIV, STD and TB Prevention. Regular postings include the CDC NCHSTP Daily News Update, conference announcements, clinical trials information, current funding opportunities, and selected MMWR articles. 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