Subject: CDC AIDS Daily Summary for Date: Fri Mar 17 07:01:00 PST 2000 (219 lines) From: National AIDS Info Clearinghouse Copyright 2000, Information, Inc., Bethesda, MD CDC HIV/STD/TB Prevention News Update Friday, March 17, 2000 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. Contact the sources of the articles abstracted below for full texts of the articles. HEADLINES PEER-REVIEWED JOURNALS "A Program to Provide Antiretroviral Prophylaxis to Health Care Personnel Working Overseas" "Is There a Case for School-Based Screening for Sexually Transmitted Diseases?" GENERAL MEDIA "India Concerned at AIDS Spread in Northeast" "Market Exists for AIDS Cream, Experts Say" "High Acceptance Rate Anticipated for Anti-HIV Microbicide Among Gay Men" "Blue-Green Algae Protein a Promising Anti-HIV Microbicide Candidate" "Many at Risk Called Unafraid of AIDS" "New Sperm Bank Test Can Detect Semen Infected With Chlamydia" "10 Percent of Thai Army Recruits HIV Positive" "Zambia Steps Up Fight Against AIDS" *************************************************************** PEER-REVIEWED JOURNALS *************************************************************** "A Program to Provide Antiretroviral Prophylaxis to Health Care Personnel Working Overseas" Journal of the American Medical Association (www.jama.com) (03/08/00) Vol. 283, No. 10, P. 1292; Russi, Mark; Hajdun, Michael; Barry, Michele As part of an international health program at Yale-New Haven Hospital and the Yale University School of Medicine, medical residents placed throughout the world are supplied with a packaged six-day supply of zidovudine, lamivudine, and nelfinavir in case of accidental exposure to HIV. Statistics show that 55 health workers are known to have contracted HIV from occupational hazards in America, but little attention has been given to prophylaxis for medical workers abroad. The Yale program chose a regimen that involved an easy dosage and had a favorable adverse effect profile. Under the program, medical personnel exposed to known or probable HIV-positive blood can call a hotline seven days a week and the remainder of the four-week prescription is shipped to them. The program costs about $200 for the initial drug supply, $1,000 for the 28-day drug packages, and up to $250 for express delivery. In cases where express delivery is not an option, the full supply of preventative drugs is provided before the individual leaves. The authors, from the Yale School of Medicine, note that out of the approximately 20 individuals who have received counseling and medication packages, so far there have been no blood-borne pathogen exposures. "Is There a Case for School-Based Screening for Sexually Transmitted Diseases?" Lancet (www.thelancet.com) (03/11/00) Vol. 355, No. 9207, P. 864; Hicks, David In The Lancet, David Hicks of Royal Hallamshire Hospital in the United Kingdom discusses school-based testing for sexually transmitted diseases (STDs). Hicks' commentary comes in response to a survey in Pediatrics (1999;104:1281-1285) of the prevalence of chlamydial and gonorrheal infections in 14- to 17-year-olds in Louisiana schools. The study found that 12 percent of girls and 6 percent of boys had chlamydial infection, and that 3 percent of girls and 1 percent of boys had gonorrhea at their first screen. By the final screen, the prevalence of chlamydia among boys had dropped to 3 percent, and among girls it fell to 10 percent. Participants were identified only by unique identifiers, and parents were not informed of the results. Hicks questions whether a similar program could help elsewhere in the world. He notes that several factors must be considered, including the fact that some girls already go to family planning or abortion clinics, where they can learn about safe sex. In conclusion, Hicks notes that "school is one of the few places where adolescent boys are found en masse. School-based screening for [STDs] may thus provide the opportunity for discussing with them their responsibilities in relation to sexual behavior." **************************************************************** GENERAL MEDIA **************************************************************** "India Concerned at AIDS Spread in Northeast" Agence France Presse (03/17/00) Indian health officials have warned that AIDS is threatening a remote northeast region where prostitution and intravenous drug use are on the rise. B.K. Borgohain, regional director of the Indian Health Ministry, said HIV is spreading at an alarming rate in the northeast, with an estimated 50,000 HIV infections in the seven northeastern states. Injection drug use is a big problem in the region, which borders the heroin-producing Gold Triangle of Thailand, Laos, and Myanmar. At a meeting in Guwahati, participants highlighted the need to educate both drug users and prostitutes, following reports that many area sex workers were having unprotected intercourse. "Market Exists for AIDS Cream, Experts Say" Reuters (03/16/00); Fox, Maggie Experts said Thursday that American college students appear to be interested in a cream or gel that could protect against HIV and other sexually transmitted diseases (STDs). Bethany Young Holt, a researcher at the University of California at Berkeley, reported that a survey of 20 women and four men who were currently attending or had recently graduated from college found that all 24 said they would purchase a microbicide. Holt noted that while the women said they would prefer an invisible product, the male subjects wanted a flavored product so they could tell it was being used. Participants at the Microbicides 2000 Conference, being held this week in Alexandria, Virginia, also heard from Dr. Alan Stone of Britain's Medical Research Council, who noted that drug companies are hesitant to develop a foam or gel used for protection because the primary market would be in poorer countries. "High Acceptance Rate Anticipated for Anti-HIV Microbicide Among Gay Men" Reuters Health Information Services (03/16/00) Columbia University's Dr. Alex Carballo-Dieguez discussed at the Microbicides 2000 conference this week the use of a vaginal microbicide for anal intercourse among gay men. According to a study conducted among 307 Hispanic men in New York City who reported having sex with men, 93 percent said they had receptive anal sex within the past 12 months and half of these individuals said that condoms were either not used or only used sometimes. Many of the men, however, reported using lubricants most of the time, and 92 percent said they would be interested in a microbicide, if it were available. While he noted that the study sample was non-random, Carballo-Dieguez said the preliminary study supports the idea that this high-risk population would use a microbicide-containing lubricant. "Blue-Green Algae Protein a Promising Anti-HIV Microbicide Candidate" Reuters Health Information Services (03/16/00); Mitchell, Deborah Cyanovirin-N (CV-N) is an antiviral protein found in a blue-green algae species that appears to work as an anti-HIV microbicide candidate. The protein inactivates HIV, prevents viral entry into cells, and does not appear to be toxic, according to Dr. Michael Boyd of the National Cancer Institute. Boyd's research team produced CV-N in a recombinant form with Escherichia coli, and found that when the protein is fixed to a solid matrix, HIV becomes immobilized. Boyd reported his findings at the Microbicides 2000 conference in Alexandria, Virginia. "Many at Risk Called Unafraid of AIDS" Sacramento Bee Online (www.sacbee.com) (03/16/00); Hubert, Cynthia The 12th annual HIV and AIDS Update Conference in San Francisco highlighted the fact that many of the people most at risk for HIV infection have become complacent about contracting the disease, as death rates have declined in recent years. Dr. Mervyn Silverman, chairman of the conference, and others said that news of better treatments and a lack of emphasis on prevention are contributing to the complacency. One study found that 87 percent of young Americans feel they are not at risk for HIV, although 25 percent of new infections occur among people 25 years of age and younger. In addition, a study of 3,000 gay men between the ages of 15 and 25 revealed that 41 percent had recently participated in unprotected sex. Although new AIDS drugs can help people live longer, the drugs have potent side effects and they do not help everyone. Patricia Fleming, the former White House AIDS policy director, emphasized the importance of prevention and asserted that the government needs to spend more on prevention efforts, including the promotion of needle exchange programs. "New Sperm Bank Test Can Detect Semen Infected With Chlamydia" Ottawa Citizen Online (www.ottawacitizen.com) (03/17/00) P. A6; Blanchfield, Mike Health Canada announced Thursday a new test to screen for chlamydia in semen donated to the country's 49 sperm banks. Last year, a woman contracted the disease after receiving semen from a sperm bank. Errors identified in both record keeping and donor screening have since been corrected, according to Dr. Robert Peterson, the associate director of general therapeutic products for Health Canada. Under the new guidelines, the Nucleic Acid Amplification Test will be used to screen new semen samples and also quarantined semen that has not been used because of the ongoing chlamydia investigation. "10 Percent of Thai Army Recruits HIV Positive" United Press International (03/17/00); Hail, John A news report quoting Maj. Gen. Saksin Tipyakaysorn, chief of the Thailand army's Reserve Affairs Department, states that 10 percent of last year's conscripts and volunteers were discharged for being HIV-positive. According to the report in the Bangkok Post, most of the HIV-infected individuals were former drug addicts. The Thai military plans to recruit about 5,000 more people this year because of the high incidence of HIV. "Zambia Steps Up Fight Against AIDS" Reuters (03/16/00); Esipisu, Manoah Zambia announced on Thursday the formation of a cabinet AIDS council and a national secretariat to coordinate the fight against the disease. Information Minister Newstead Zimba said that 25 percent to 30 percent of adults in urban areas and up to 15 percent of those in rural areas have HIV. The new council will focus on HIV prevention and offer care to those already infected. Zimba noted that HIV and AIDS have significantly increased health spending in Zambia, which is expected to increase from $3.4 million annually 10 years ago to $18.3 million by 2004. ****************************************************************