Subject: CDC AIDS Daily Summary for Date: Tue May 16 07:01:00 PDT 2000 (211 lines) From: National AIDS Info Clearinghouse Copyright 2000, Information, Inc., Bethesda, MD CDC HIV/STD/TB Prevention News Update Tuesday, May 16, 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 "Helping the Urban Poor Stay With Antiretroviral HIV Drug Therapy" GENERAL MEDIA "Mbeki vs. AIDS Experts" "House Designates AIDS Funds for Africa" "Virginia Scorecard: Chickenpox Down, Chlamydia Up" "Tracking Killers Comeback; Health: Once a Public Scourge, Tuberculosis Has Been Falling Nationwide" "College Students Skipping TB Test" "Health Expert Proposes More Sex Education in Black Church" "HIV/AIDS Will Curb Botswana's Economic Growth by Third" "Hookers & Haulers" *************************************************************** PEER-REVIEWED JOURNALS *************************************************************** "Helping the Urban Poor Stay With Antiretroviral HIV Drug Therapy" American Journal of Public Health (www.apha.org/journal/AJPH2.htm) (05/00) Vol. 90, No. 5, P. 699; Bamberger, Joshua D.; Unick, Jay; Klein, Pamela; et al. An AIDS treatment facility called Action Point in San Francisco is funded by the city and strives to help the urban poor and the homeless follow antiretroviral HIV drug therapy. After opening in July 1999, Action Point Adherence Project welcomed clients who wanted to follow HAART. The homeless who have HIV are less likely than other HIV patients to be given highly active antiretroviral therapy (HAART) and cannot benefit from new treatments. Many are often addicted to drugs or alcohol, have nowhere to live, or live in poverty. The project had 68 initial clients, of which 42 came at least once a week after the initial five months. Four of the patients did not take HAART. Two patients had higher levels of HIV RNA after taking treatment. Because the urban poor lack access to drugs, they came to Action Point, where the drugs were kept refrigerated if necessary and carefully regulated. Many clients have improved their lives and are benefiting from the facility. **************************************************************** GENERAL MEDIA **************************************************************** "Mbeki vs. AIDS Experts" Washington Post (www.washingtonpost.com) (05/16/00) P. A1; Jeter, Jon South African President Thabo Mbeki first began to question conventional ideas about AIDS treatment when surfing the Internet about eight months ago. Now, Mbeki is ignoring medical advice and refusing to give antiretroviral drugs like AZT to HIV-infected South Africans. In addition, Mbeki last week convened an advisory panel that included scientists who do not believe HIV causes AIDS. Many physicians are confused that Mbeki would begin to question AIDS research and refuse his countrymen treatment. An estimated 10 percent of South Africa's population carries HIV, with about 1,500 to 1,700 new infections every day. Activists fear Mbeki's stance may confuse rural Africans into thinking safe sex is not important. Although the country cannot readily afford multi-drug AIDS cocktails, short-course AZT therapy for poor, pregnant women would cost under $50 per woman, would reduce the risk of mother-to-child HIV transmission, and would save millions of dollars in treatment for infected children. "House Designates AIDS Funds for Africa" Boston Globe Online (www.boston.com/globe) (05/16/00) P. A10; Abrams, Jim The U.S. House of Representatives has moved to create a plan to help fight AIDS in Africa, where some 6,000 people die every day from the disease. The House "Marshall Plan" for Africa calls on the Treasury secretary to help set up a trust fund in the World Bank to fight HIV and AIDS in sub-Saharan Africa. Rep. Barbara Lee (D-Calif.), a co-sponsor of the measure, asserted that "the survival of a continent is at stake." The legislation commits U.S. contributions of $100 million a year for five years that will be used to help raise as much as $1 billion annually from international donors. "Virginia Scorecard: Chickenpox Down, Chlamydia Up" Washington Post--Health (www.washingtonpost.com) (05/16/00) P. 6; Graham, Tom The Virginia Department of Health has reported nearly 3,000 Cases of chickenpox each year during the 1990s, with fewer cases being reported after 1992. The decline in chickenpox is likely because children must be vaccinated against the disease before entering school, officials said. In other health news, Barbara Lea-Kruger, a spokesperson for the health department, reported that gonorrhea cases in Virginia increased by nearly 1 percent between 1998 and 1999, while cases of chlamydia rose from around 6,000 in 1989 to 13,370 in 1998. New incidences of AIDS dropped by over 5 percent last year, to 911. Officials also noted an 11 percent increase in HIV cases, to 918; however, they suggested that may the result of "enhanced reporting and surveillance efforts rather than an actual increase in infections." "Tracking Killers Comeback; Health: Once a Public Scourge, Tuberculosis Has Been Falling Nationwide" Los Angeles Times (www.latimes.com) (05/15/00) P. B1; Talev, Margaret Although tuberculosis (TB) cases have been declining throughout the nation in the last 10 years, cases in Ventura County, California, are rising. Officials have found that more senior citizens, including those foreign-born, have the disease, than younger citizens. According to Marilyn Billimek, county director of communicable diseases, the cases of TB seen among the elderly represent an epidemic of the past. As the seniors age, they become vulnerable to infection that has remained dormant for most of their lives but now becomes active in older age. A health outreach team is visiting migrant camps and plants, along with senior citizens, to search for TB cases. Locally, infections have occurred in children under age nine, including many immigrants. Hispanic communities have disproportionately high rates of TB, especially in Oxnard. Those at risk for TB are drug users, diabetics, and people with HIV. Without proper antibiotic treatment, the disease can resist drugs and take months or years to fight. Ventura County's TB rate in 1998 was seven in 100,000 overall, but the rate soared to 21 in 100,000 among residents ages 70 to 79 and 26 per 100,000 among those 80 years of age and older. "College Students Skipping TB Test" Reuters Health Information Services (www.reutershealth.com) (05/15/00); Johnston, Cameron According to Dr. Venkatarama Koppaka of the Centers for Disease Control and Prevention, only 56 percent of students at Virginia Commonwealth University (VCU) in the 1998-1999 school year had the required tuberculosis (TB) test at the time of enrollment. While 13 percent had the test within their first year of school, some 30 percent of students were never tested. Koppaka, who noted that about 5 percent of the students who were screened tested positive for the disease, said that 61 percent of U.S. colleges and universities require TB testing; however, some do not enforce the rule too stringently for fear of discouraging potential students. At a meeting of the American Thoracic Society, Koppaka--who also holds a position at VCU--recommended that student groups with specific risk factors be targeted for testing. "Health Expert Proposes More Sex Education in Black Church" Dayton Daily News (www.activedayton.com/ddn) (05/15/00) P. 1A; Shimron, Yonat A survey by Chapel Hill public health practitioner Tamera Coyne-Beasley shows that about three-quarters of African-American clergy in North Carolina reported discussing AIDS, drug and alcohol prevention with youths aged 11 to 14. Coyne explained, "The purpose of my study was to see whether a select group of clergy would be interested in extending the health education roles of the church beyond cancer prevention and nutrition education." Public schools in North Carolina must teach abstinence only, and many of the clergy Coyne surveyed said they would consider holding additional classes on sexuality. Nearly one-third, however, said they would not discuss certain other topics, such as homosexuality, and just 6 percent said they would distribute condoms in their churches. Rev. Tyrone Ashley of the Redeeming Love Baptist Church in Raleigh noted that the situation is difficult because "the reality is children are sexually engaged and we should be teaching them ... how to protect themselves. But we have to teach what the parents want." "HIV/AIDS Will Curb Botswana's Economic Growth by Third" Agence France Presse (www.afp.com) (05/15/00) A government report in Botswana shows that the AIDS epidemic Will cut the country's economic growth by a third over the next decade. According to the report from the independent Botswana Institute for Development Policy Analysis, 25 percent of economically active adults in the country are infected with HIV. AIDS will cause a shortage of workers, as government revenues fall and the deficit grows, the study said. The report also stated that AIDS will cause a swift increase in the number of poverty-stricken families, with the per-capita household income for the poorest households expected to decrease 13 percent. "Hookers & Haulers" Discover (www.discover.com) (05/00) Vol. 21, No. 5, P. 18; Glausiusz, Josie Dale Stratford, a medical anthropologist at the Centers for Disease Control and Prevention, has completed the first study of sexual behavior among U.S. truck drivers. For nine months, Stratford interviewed 71 male truckers at four Florida stops. Nearly one-third of the men said they had frequent sex with prostitutes, and condom use was rare. Some of the truckers acknowledged using drugs, primarily methamphetamines, cocaine, and alcohol. Many of the drivers knew little about AIDS, with some believing it was a disease that only affects gay men or that condoms were of no use. Stratford said the study's results demonstrate the need to establish clinics to screen, treat, and educate truckers about a variety of health issues, including HIV.