Subject: CDC AIDS Daily Summary Date: Tue Feb 23 07:31:02 PST 1999 (191 lines) From: National AIDS Info Clearinghouse Copyright 1999, Information, Inc., Bethesda, MD CDC HIV/STD/TB Prevention News Update Tuesday, February 23, 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 "Big Health Threat From Drug Abuse in South Asia" GENERAL MEDIA "STD Testing Can Carry Risk" "Across the USA: Indiana, New Hampshire, West Virginia" "Condom Use Goals Still Not Met" "The Health Gap for Men of Color" "Canadians to Expand Tainted Blood Lawsuit to U.S." "AIDS/HIV Cases on the Rise in PNG" "Outsmarting the Virus" "Viruses as Vectors" *************************************************************** PEER-REVIEWED JOURNALS *************************************************************** "Big Health Threat From Drug Abuse in South Asia" Lancet (www.lancet.com) (02/20/99) P. 651; Kumar, Sanjay A report by the United Nations International Drug Control Program found that drug abuse will be one of the leading causes of sickness in south Asia by 2020. At that time, according to the report, there will be approximately 4 million drug users in the region. Users are apparently switching from opium use to synthetic drugs like diazepam and injected cough syrups containing codeine. The agency noted that the increased number of injecting drug users presents a problem for HIV and hepatitis C control. **************************************************************** GENERAL MEDIA **************************************************************** "STD Testing Can Carry Risk" Washington Post--Health (www.washingtonpost.com) (02/23/99) P. 4; Adams, Michael Michael Adams, staff counsel for the American Civil Liberties Union AIDS Project, asserts that increased surveillance of sexually transmitted diseases does not always result in better information or improved public health. In a letter to the Washington Post, Adams cites research by the ACLU that shows some people at risk for HIV did not seek testing due to concerns over confidentiality. Adams argues that "if counting of HIV cases is necessary to learn more about the epidemic, it should be done by a means other than names so that people's confidentiality and confidence in testing will be protected." He adds that the ACLU supports the use of unique identifiers that allow for HIV tracking without the use of names. "Across the USA: Indiana, New Hampshire, West Virginia" USA Today (www.usatoday.com) (02/23/99) P. 10A Tuberculosis cases in LaPorte County, Indiana, reached an all-time high with four new cases this year, and officials expect the situation to get worse. The county had the highest infection rate in the state last year, with 22 TB cases. Separately, New Hampshire officials are debating whether to initiate name reporting of HIV-infected patients. The state currently records HIV cases using identifying codes. Meanwhile in West Virginia, people who received blood transfusions between 1991 and 1996 at the Weirton Medical Center or between July 1993 and November 1996 at Fairmont General Hospital are advised to be tested for HIV due to concerns that the blood may have been mishandled. "Condom Use Goals Still Not Met" Fox News Online (www.foxnews.com) (02/22/99) A 1996 survey of U.S. adults shows that condom use has not met levels aimed at by the Healthy People 2000 national health objective. According to John E. Anderson of the Centers for Disease Control and Prevention and others, condom use has increased overall, but the adoption of condom use by high-risk individuals needs to be at higher levels. The researchers, who published their findings in the journal Family Planning Perspectives, particularly noted that high-risk individuals need to increasingly use condoms with their steady partners. The objectives call for 50 percent condom use among sexually active, unmarried people by the year 2000; however, the 1996 survey indicated that 40 percent of these people use condoms. Condom use, within an ongoing relationship, was also determined to be higher among African-Americans, younger people, people from urban areas, and people of lower income. "The Health Gap for Men of Color" Boston Globe Online (www.boston.com/globe) (02/23/99) P. A23; Payton, Gary; Simpson, Georgia Numerous studies show that there is an increasing health gap between whites and minorities, with whites experiencing lower rates of death due to heart disease, stroke, tuberculosis, and other diseases. Public health officials blame a lack of access to health insurance and treatment for the higher rates. In a commentary, Todd Payton and Georgia Simpson report that in Massachusetts, the Men of Color Health Initiative was created to help alleviate this problem. An $800,000 grant provided by the state Department of Public Health and the Department of Medical Security helped create the initiative, of which Payton is the director and Simpson is the coordinator. The program investigated the causes behind the health discrepancies, finding that there was a distrust of the health system among minority men. The researchers further concluded that hospitals were often insensitive, inefficient, and biased in dealings with male minorities. System-wide changes have been instituted to change this, with the expansion of community health centers, minority health education, and treatment programs. The authors note, however, that funding for the initiative has declined and that some programs have been defunded altogether. "Canadians to Expand Tainted Blood Lawsuit to U.S." Reuters (02/22/99); Hopps, Jason A group of Canadians who contracted hepatitis C virus through tainted blood are considering expanding a current lawsuit against the Canadian government and two companies to the United States. The 400 Canadians filed a C$1 billion suit against the government and companies, claiming they were involved in the distribution of blood collected from Arkansas prisoners. A spokesman for Hemophilia Ontario noted the plaintiffs may expand their lawsuit to include the U.S. Food and Drug Administration, the state of Arkansas, and possibly President Clinton, the former governor of Arkansas. The lawyer for the group, David Harvey, questioned why the plasma was exported when it was not deemed appropriate for use in the United States. "AIDS/HIV Cases on the Rise in PNG" Australian Associated Press (02/23/99) Data from the Papua New Guinea Health Department indicate that the number of new HIV cases in the country almost doubled last year. There were 642 new HIV infections reported in 1998, compared to 351 cases the previous year. Additionally, 185 people were diagnosed with AIDS, compared to 120 people in 1997. The Health Department reports that there are 1,556 HIV cases in the country, but the actual number of people infected with the virus is probably 10 times greater. The country has the highest HIV infection rate in the Pacific region. "Outsmarting the Virus" Business Week (www.businessweek.com) (02/22/99) No. 3617, P. 142; Carey, John Due to HIV's propensity to develop drug resistance, scientists and physicians are attempting to create methods to treat patients infected with resistant strains. While anti-HIV medication may fail in as many as half of all patients, researchers have developed a method that may increase treatment success. With resistance testing, physicians may be able to determine if patients will succeed on a regimen before they even begin taking the drugs. Two types of tests exist: genotypic and phenotypic. The genotypic test is fast and relatively cheap, but results can be difficult to interpret. The phenotypic test offers clearer results, but can take several weeks and costs about twice as much. Both tests appear to be cost-saving, however, as they can prevent patients from spending money on expensive drugs to which their HIV strain may be resistant. Recent research shows that the tests are fairly effective in helping determine if patients have a resistant strain and what drugs they are resistant to, thereby helping their physicians plot an appropriate regimen. Although there are still doubters in the medical field and insurers have not yet agreed to pay for the service, the cost-effectiveness and initial indications of the efficiency of the tests should change this. "Viruses as Vectors" Scientist (www.the-scientist.com) (02/15/99) Vol. 13, No. 4, P. 6 Recent discoveries have helped researchers engineer HIV for possible use as a vector system. Prior to the use of lentiviruses as vectors, scientists could only infect nondividing cells ex vivo, so cells in the liver and brain would not benefit from gene therapy. In 1996, Inder Verma, of the Salk Institute for Biological Studies, first reported the use of the retrovirus as a vector system. Verma and others deleted the genes in HIV that allow it to replicate, leaving the genes that allow the virus to integrate into the host genome. The system has been used to deliver genetic material to nondividing cells in mouse and rat models without adverse immunological effects.