Subject: CDC AIDS Daily Summary Date: Mon Feb 22 07:31:02 PST 1999 (207 lines) From: National AIDS Info Clearinghouse Copyright 1999, Information, Inc., Bethesda, MD CDC HIV/STD/TB Prevention News Update Monday, February 22, 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 Impact of Condom Distribution in Seattle Schools on Sexual Behavior and Condom Use" GENERAL MEDIA "Health Care Workers Seek Safer Needles" "Hepatitis Victims Blame Gov't Inoculation Program" "Gay Men Not Protected Properly From HIV Virus" "Decline in Birthrates Should Be Attributed to Abstinence and Condom Use" "Less AIDS Money Reaching IV Drug Users" "Banff Is STD Capital" "AIDS Drugs May Rehabilitate the Immune System" "The AIDS Race" *************************************************************** PEER-REVIEWED JOURNALS *************************************************************** "The Impact of Condom Distribution in Seattle Schools on Sexual Behavior and Condom Use" American Journal of Public Health (02/99) Vol. 89, No. 2, P. 182; Kirby, Douglas; Brener, Nancy D.; Brown, Nancy L.; et al. According to a study conducted at 10 Seattle high schools, condom distribution allowed students to obtain a large number of condoms, but did not result in changes in sexual activity or an increase in condom use. Students had access to condoms through vending machines or through baskets in school clinics. Surveys administered before the program initiation in 1993 and during the program in 1995 indicated students obtained an average of 4.6 condoms per year, mostly through the clinics. However, condom use did not increase nor did sexual activity change compared to national samples. The number of sexually experienced students who used a condom the last time they had sex decreased significantly, most notably in the five schools that distributed condoms in the clinics. The authors, led by Dr. Douglas Kirby of ETR Associates in Santa Cruz, Calif., note two possible reasons why condom usage did not increase: students reported already having had significant access to condoms prior to the initiation of the program, so the distribution only allowed the students to obtain the condoms elsewhere without increasing overall use, and the program may not have addressed important reasons why the students were not using condoms. **************************************************************** GENERAL MEDIA **************************************************************** "Health Care Workers Seek Safer Needles" Baltimore Sun (02/22/99) P. 1B; Mosk, Matthew Maryland will consider this week a proposal that would require the state Occupational Safety and Health Advisory Board to develop rules by 2001 mandating safer needles to reduce the risk of accidental needle-sticks. California passed similar legislation last year, and now 19 other states are investigating the issue. The legislation is designed to protect health care workers from accidentally contracting HIV and other blood-borne diseases. However, some Maryland hospitals are not in favor of the bill as it now stands, citing fears about elevating costs associated with instituting safer needles. Yet, according to Andrew Stern, president of the Service Employees International Union which represents 600,000 health care workers, some 3,000 health care workers are accidentally stuck with needles every day. About one-fifth of the needles sold in the United States contain a safety feature. "Hepatitis Victims Blame Gov't Inoculation Program" Mainichi Shimbun Online (02/22/99) Many people infected with hepatitis B virus (HBV) or hepatitis C virus (HCV) in Japan are blaming the government for their infections, noting that the common use of needles in mass inoculation programs years ago spread the diseases. They also blame a delay in the use of safe blood products, which resulted in the spread of HBV, HCV, and HIV. Some of the infected individuals have filed civil suits, demanding that the government compensate them for their infection. The Sapporo District Court is soon expected to reach a decision of the case of five Hokkaido residents who claim that they were infected with HBV through mass inoculations. Mass inoculations have been carried out in the country for over 40 years and there were reports of needle sharing, despite warnings in 1953 from the World Health Organization that the practice could spread hepatitis. The Health Ministry took five years to mandate that patients receive inoculations with clean needles, although the practice was reportedly continued by some physicians for many years. "Gay Men Not Protected Properly From HIV Virus" BBC News Online (02/22/99) In Great Britain, the National AIDS Trust has said that national health authorities are spending more money on HIV prevention among substance abusers than among gay men, even though homosexual men are at higher risk for the virus. The organization said that about 2,500 people in England contract HIV annually, three-fifths of whom are homosexual men. However, only one-fifth of prevention budgets target gay men, the trust argued. The National AIDS Trust called on health authorities to re-evaluate their funding process. "Decline in Birthrates Should Be Attributed to Abstinence and Condom Use" Washington Times (02/20/99) P. C2; Zingale, Daniel; Harvey, David; Wagoner, James; et al. In a letter to the editor of the Washington Times, Daniel Zingale, the executive director of the AIDS Action, and others state that the Times was erroneous in attributing declines in teen birth rates strictly to abstinence-until-marriage education. In reply to a Feb. 11 article, the authors assert that the declines were due to both increased abstinence and condom use. They cite data compiled by the National Center for Urban Health Statistics and from the Urban Institute that show that condom use was also involved in decreasing the teen birth rate. The authors note that comprehensive sexual education is supported by the National Institutes of Health, the Institute of Medicine, the Centers for Disease Control and Prevention, the American Medical Association, and the American Academy of Pediatrics. Furthermore, a recent analysis by the World Health Organization indicates that sex education programs do not encourage earlier or increased teen promiscuity. Zingale et al. argue that "empowering young people with the information they need gives them the ability to make responsible decisions." "Less AIDS Money Reaching IV Drug Users" Denver Post Online (02/20/99); Schrader, Ann; Chronis, Peter G. The percentage of HIV-positive people who use intravenous drugs has increased in Colorado in recent years, but the amount of money allocated to treat these patients has declined. While 27 percent of HIV-positive patients in the state are IDUs--compared to 17 percent in 1988--HIV-infected IDUs only receive 3.1 percent of federal funds designated for HIV care. In 1994, IDUs received 4.7 percent of those funds. Meanwhile, research presented at the 14th annual Rocky Mountain Regional Conference on HIV Disease indicates that treatment and education of IDUs reduces the likelihood that they will spread the virus. "Banff Is STD Capital" Canadian National Post Online (02/20/99); Arnold, Tom Banff, Alberta, was labeled as the Canadian capital of sexually transmitted diseases by Rolling Stone Magazine. The magazine dubbed Banff as a "party town" for college students on spring break, where sex and drug use was rampant. The town joined Rolling Stone's list of hedonistic havens, including Cancun, Steamboat Springs, Barbados, and other areas. "AIDS Drugs May Rehabilitate the Immune System" Business Week (02/15/99) No. 3616, P. 107; Carey, John Researchers in Madrid and Barcelona investigated Pneumocystis carinii pneumonia (PCP) rates in patients who were removed from anti-HIV therapy. The study involved 332 HIV-positive patients whose CD4 cell counts had increased since beginning treatment. About half of the patients in the study had stopped their drug regimen. None of the patients in the study developed PCP after six months of follow-up, indicating that the patients may have recovered some immune function. The results were reported at the Sixth Conference on Retroviruses and Opportunistic Infections recently held in Chicago. "The AIDS Race" Village Voice Online (02/10/99-02/16/99); Schoofs, Mark A growing number of HIV-infected individuals taking drug cocktails that include protease inhibitors are now failing treatment, and researchers are unsure what consequences such failure will bring. While some thought that there would be an increase in the number of people developing AIDS as a result, many of the patients have maintained their infections without progressing to AIDS. Meanwhile, in some patients in whom the drugs suppress HIV only partially, or in whom the virus is pushed to undetectable levels and then it returns, there has been sustained improvement. One theory regarding these "partial responders" is that they have mutated HIV in their system that is moderately resistant to drugs. Some scientists believe that the strains will continue to develop resistance until they are strongly resistant; but a Canadian study found the strains to be somewhat less virulent in the presence of protease inhibitors, regardless of the drugs' ability to affect replication. Partial responders face the decision whether to continue treatment--and possibly develop multidrug resistant strains of HIV--or to abandon treatment and face potentially higher viral levels. Finally, research is also focusing on the immune system's control of HIV, without using drugs. Three U.S. research groups have started trials in which certain patients are taken off all therapy in the hopes of stimulating the immune system.