Subject: CDC AIDS Daily Summary Date: Tue Feb 9 10:31:02 PST 1999 (183 lines) From: National AIDS Info Clearinghouse Copyright 1999, Information, Inc., Bethesda, MD CDC HIV/STD/TB Prevention News Update Tuesday, February 9, 1999 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 HIV/STD/TB Prevention News Update should be cited as the source of the information. HEADLINES PEER-REVIEWED JOURNALS "The Effectiveness of the Reach for Health Community Youth Service Learning Program in Reducing Early and Unprotected Sex Among Urban Middle School Students" GENERAL MEDIA "Rhone-Poulenc Testing AIDS Vaccine in Africa; VaxGen Plans Thai Trial" "Women's Advances Slowed, Forum Told" "Good News, Bad News for Patients With AIDS" "Australian Researchers Report Four Cases of Nosocomial HIV-1 Transmission" "Protease Inhibitors Linked With 'Dramatic' Increase in Oral Warts" "Health--Pakistan: Women More Vulnerable to TB" "Vits Help the Rits Go Down" *************************************************************** PEER-REVIEWED JOURNALS *************************************************************** "The Effectiveness of the Reach for Health Community Youth Service Learning Program in Reducing Early and Unprotected Sex Among Urban Middle School Students" American Journal of Public Health (02/99) Vol. 89, No. 2, P. 176; O'Donnell, Lydia; Stueve, Ann; San Doval, Alexi; et al. A team of researchers from the Columbia University School of Public Health and elsewhere conducted a series of intervention programs among 1,061 seventh and eight grade students at two urban middle schools almost completely composed of minority students. Some of the students participated in a Reach for Health community youth service (CYS), which involved health education focusing on drug and alcohol use, violence, and sexual behaviors that can result in the spread of sexually transmitted diseases. These students were also active in community service projects. A second group received only the Reach for Health classroom education program, with students from other schools serving as a control group. The researchers found that the CYS students showed less recent sexual activity at six-months follow-up and scored lower on a sexual activity index compared to the control group. Eight graders seemed to be most affected by the service program, while special education students also appeared to derive a great benefit from the curriculum-only intervention. While the students who received only health education did not have a significant decrease in sexual activity, there were trend-level reductions in the group. The authors note that future studies need to determine why the CYS program was effective in reducing sexual activity. **************************************************************** GENERAL MEDIA **************************************************************** "Rhone-Poulenc Testing AIDS Vaccine in Africa; VaxGen Plans Thai Trial" Wall Street Journal (02/09/99) P. B6; Waldholz, Michael; King Jr., Ralph T. Pasteur Merieux Connaught, a unit of Rhone Poulenc Group, said it has started a clinical trial of an experimental AIDS vaccine that will involve 40 persons at a research hospital in Kampala, Uganda. At the outset of the study, two healthy volunteers will be vaccinated to test the safety of Alvac-HIV and to determine if the vaccine can induce a measurable response in white blood cells. Separately, VaxGen said Thai officials have granted permission to proceed with a large-scale trial of a vaccine to protect against two HIV strains that are common in Thailand. That trial will involve 2,500 healthy, but at-risk intravenous drug users in Bangkok. VaxGen expects to review data from the Thailand trial and a separate U.S. trial in mid-2001. "Women's Advances Slowed, Forum Told" Boston Globe Online (02/09/99) P. A8 At a United Nations population conference on Monday, AIDS prevention was made a top priority. The Hague Forum, which includes delegates from 180 nations worldwide, is the first key follow-up to the 1994 Cairo conference, in which it was declared that empowering women and contributing to their reproductive health could help stem population growth. On Monday, UNAIDS head Peter Piot noted that the AIDS epidemic is obstructing progress in increasing women's health care. Piot explained that with 16,000 new HIV infections each day--a figure two times that reported in 1994--AIDS could possibly eliminate any gains made since the Cairo conference. "Good News, Bad News for Patients With AIDS" Washington Times (02/09/99) P. A1; Larson, Ruth The availability of potent anti-HIV drugs is allowing many AIDS patients to live longer, but with that change also comes several new problems. Statistics show that between 1996 and 1997, the number of AIDS-related deaths fell 47 percent. Furthermore, between 1995 and 1998, AIDS-related deaths among homosexual men dropped by 81 percent, and by 60 percent among heterosexuals, Johns Hopkins University researchers report. Dr. Anthony Fauci, head of the National Institute of Allergy and Infectious Diseases, notes that with the new drugs, "there is less suppression of the immune response, or the immune system is able to rebound to fight the virus." However, Fauci notes that the drugs do not completely suppress HIV and that the AIDS cocktails require patients to follow a complex regimen and special diets. Some individuals have also been lulled into a sense of complacency because of the drugs, especially sexually active youths. New cases of HIV infection are on the rise, with half of the 40,000 new cases each year reported among individuals under age 25. "Australian Researchers Report Four Cases of Nosocomial HIV-1 Transmission" Reuters Health Information Services (02/08/99) Researchers from Australia reported at the 6th Conference on Retroviruses and Opportunistic Infections last week four cases of nosocomial HIV-1 transmission in 1989. Genetic analysis of the patients, who all attended a dermatology clinic in Sydney, indicated a common source of infection, and phylogenetic clustering suggested that infection occurred in all four on the same day. The researchers believe that the infections were the result of improperly sterilized medical equipment. "Protease Inhibitors Linked With 'Dramatic' Increase in Oral Warts" Reuters Health Information Services (02/08/99) University of California at San Francisco researchers have found that, since the advent of protease inhibitors, oral warts have become a growing problem among HIV-infected individuals. The researchers, who presented their findings last week at the 6th Conference on Retroviruses and Opportunistic Infections, noted an overall decline in the incidence of most common oral lesions in HIV-infected patients, including hairy leukoplakia and oral candidiasis. However, the scientists also observed a substantial increase in oral warts, primarily linked to protease inhibitor use. "Health--Pakistan: Women More Vulnerable to TB" IPS Wire (02/08/99) In Pakistan, circumstantial evidence indicates that tuberculosis kills more women than all causes of maternal mortality. Some of the reasons behind this are the lower TB detection rate, unreliable treatment, and higher illiteracy rate of women compared to men. Researchers also cite the stigma that is attached to TB, forcing many infected individuals to conceal their disease. Tuberculosis accounts for more than 25 percent of preventable adult deaths in Pakistan. According to a survey by the Karachi TB association, only one physician out of seven was able to prescribe medicine that was effective. "Vits Help the Rits Go Down" POZ (02/99) No. 44, P. 75; Lands, Lark Rhode Island researchers have found that taking vitamins in conjunction with ritonavir may increase patient tolerance to the drug. The protease inhibitor can cause gastrointestinal symptoms that may lead to drug discontinuation. The scientists, who studied 322 tolerant and intolerant patients, found that dosage was a factor in drug tolerance. They also discovered that those patients with pre-existing micronutrient deficiencies and lower body fat were more likely to be intolerant of the drug. Fifty-eight percent of the intolerant patients showed micronutrient deficiency, compared to 27 percent of tolerant patients. Additionally, only 32 percent of the intolerant group took vitamin supplements, compared to 69 percent of drug-tolerant patients. The researchers measured for vitamins C, E, B-12, folic acid, and beta-carotene.