Subject: CDC AIDS Daily Summary for Date: Tue May 30 07:01:01 PDT 2000 (216 lines) From: National AIDS Info Clearinghouse Copyright 2000, Information, Inc., Bethesda, MD CDC HIV/STD/TB Prevention News Update Tuesday, May 30, 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 "Reservoirs Dog AIDS Therapy" GENERAL MEDIA "Clinton Starts European Trip Discussing Internet, AIDS" "Sexually Transmitted Diseases on Decline [in Cleveland]" "U.S. Could Extend AIDS Drug Help to Asia" "VU and Haiti Joining Forces Against AIDS; Vaccine Experiment Starts in Summer" "World Bank Head Foresees Clearer IMF, Bank Roles" "China Hotel Sparks Controversy Over Free Condoms" "Ghana's First Lady Launches Female Condoms" "Care for a Dying Continent" *************************************************************** PEER-REVIEWED JOURNALS *************************************************************** "Reservoirs Dog AIDS Therapy" Nature (www.nature.com) (05/18/00) Vol. 405, No. 6784, P. 270; Smaglik, Paul While some AIDS researchers, such as Dr. David Ho, director of the Aaron Diamond AIDS Research Center, believe that HIV reservoirs may ultimately be eliminated from the body using highly active antiretroviral therapy (HAART), others are not so optimistic. Robert Siliciano, a virologist at Johns Hopkins University, has studied about 60 patients who are known to be compliant with their drug regimens and found that the size of the virus reservoirs decay so gradually that they will likely continue for life. Ho notes, however, that there are many untested drug regimens, so "we should not completely give up on the eradication idea until we have a good go at attacking with more potent combinations at all the sites available." Another possible approach is using HAART interruptions, or drug holidays, to reduce the toxicity of the treatment while keeping the benefits. Intermittent treatment with interleukin-2 may also show hope in creating a CD4 cell response. A primary focus right now is therapeutic vaccine research, or the use of a vaccine for patients already infected with HIV. The vaccine would not be preventive, but hopefully would bring HIV infection under control permanently. The therapeutic vaccine Remune--which is currently being tested in the United States, Europe, and Thailand--has been shown to cause CD4 cells to proliferate, although there is not yet evidence that the immune response it generates could help control HIV. Also, a candidate vaccine made from an inactivated form of the HIV protein Tat has shown promise in animal studies, prompting renowned AIDS researcher Robert Gallo to suggest that a vaccine based on Tat toxoid could be a part of a multicomponent therapeutic vaccine. **************************************************************** GENERAL MEDIA **************************************************************** "Clinton Starts European Trip Discussing Internet, AIDS" Minneapolis Star Tribune Online (www.startribune.com) (05/30/00) Issues to be discussed during President Clinton's visit to Portugal this week include ways to stem the spread of HIV in Africa and measures to enhance Internet commerce. According to National Security Adviser Sandy Berger, the primary purpose of Clinton's trip is to "build on the vision that the president articulated [in] 1994-a peaceful, undivided, democratic Europe for the first time in history." In terms of AIDS, Portugal has long worked in Africa through its former colonies--including Angola and Mozambique--and researchers in the United States and Portugal are working on international efforts to fight HIV. The White House recently stated that the global AIDS epidemic, which has hit Africa particularly hard, is a threat to national security. "Sexually Transmitted Diseases on Decline [in Cleveland]" Cleveland Plain Dealer (www.cleveland.com) (05/28/00) P. 1B; Hagan, John F. The rate of sexually transmitted diseases (STDs) has decreased in Cleveland, as syphilis cases fell 90 percent from 1995 to 1999, from 834 cases to 84. According to a new report from the city's health department, the number of gonorrhea cases has decreased 51 percent since 1995, although there were 152 more cases of the disease reported in Cleveland last year than in 1998. In addition, reported cases of chlamydia dropped 53 percent, with 6,866 cases in 1995 and 3,207 in 1999. City health director Michele Whitlow said Mayor Michael White's fight to eliminate STDs has helped bring about the overall decline, with an emphasis on avoiding risky sexual behavior, practicing safe sex, and talking to sexual partners. In a statement, White called the declining rates of STDs encouraging, noting that the infections "can have long-term negative health effects on an adult's ability to produce healthy babies and can cause other long-term health problems, even death." "U.S. Could Extend AIDS Drug Help to Asia" Reuters (www.reuters.com) (05/26/00) A White House official said Friday that the United States may loosen patent laws for Asia and countries in the former Soviet Union. Sandra Thurman, head of the White House Office for AIDS Policy, noted that while the AIDS epidemic is currently centered around sub-Saharan Africa, the epicenter will shift to Asia in 15 years and then on to the former Soviet Union. An executive order signed by President Clinton recently will help countries in sub-Saharan Africa obtain cheaper AIDS drugs via compulsory licensing and parallel importing. Thurman noted that Asia and the former Soviet states will also need consideration in terms of lower-cost AIDS drugs as time goes on. "VU and Haiti Joining Forces Against AIDS; Vaccine Experiment Starts in Summer" Tennessean (www.tennessean.com) (05/27/00) P. 1A; Snyder, Bill Vanderbilt University will conduct testing of an HIV vaccine at its campus in Nashville this summer and in Haiti this fall, according to Dr. Peter F. Wright, head of Vanderbilt's AIDS Vaccine Evaluation Unit with Dr. Barney S. Graham. Graham noted that if those tests are successful, large-scale efficacy trials of the canary pox vaccine could start next year. He added that a long-standing federal grant has also been renewed, providing about $2 million annually for Vanderbilt's research through 2005. Vanderbilt is a member of the new HIV Vaccine Trials Network coordinated by the Fred Hutchinson Cancer Research Center in Seattle. "World Bank Head Foresees Clearer IMF, Bank Roles" Reuters (www.reuters.com) (05/29/00) World Bank President James Wolfensohn said Monday that the World Bank and International Monetary Fund (IMF) will have clearer roles in the next year, as the IMF will focus on fiscal and monetary policies. Wolfensohn stated that the World Bank's leading cause is HIV prevention and that the bank expects to provide another $1 billion for AIDS-related efforts. The official also highlighted the AIDS problem in India and Africa, noting that the disease has reduced life expectancy in some nations by 17 years. "China Hotel Sparks Controversy Over Free Condoms" Kyodo News Service (home.kyodo.co.jp) (05/27/00); Murray, Geoffrey A hotel in China's southwestern Sichuan Province has become the first in the country to provide condoms in its rooms, a controversial move done to encourage HIV prevention. While other hotels in the region have said they do not plan to follow suit, an official at the Chengdu Technological Instruction Institute for Family Planning has voiced his support for the New Century Hotel's plan, particularly if it helps prevent HIV. Sichuan Province has the fifth highest rate of HIV and AIDS in China, with injection drug use and sexual contact the primary means of transmission. Official statistics indicate there are more than 400,000 HIV cases in China, although some experts claim the actual number is much higher. "Ghana's First Lady Launches Female Condoms" PANA Wire Service (www.africanews.org/PANA) (05/26/00) Ghana's First Lady, Nana Konadu Agyeman Rawlings, has supported the use of female condoms in her country. On Thursday, at the official launch of the female condom in Accra, she called for female empowerment to prevent HIV, citing the female condom as the best barrier method that women can use to prevent pregnancy, HIV infection, and other sexually transmitted diseases. Rawlings also asked the community to talk to their children about sex, noting that "while our messages to adolescents emphasize morality and abstaining from sex, they should not be denied information and services when needed." The female condom will be sold in Ghana for about 300 cedis each, with US $1 equaling about 4,800 cedis. "Care for a Dying Continent" Scientific American (www.sciam.com) (05/00) Vol. 282, No. 5, P. 96; Ezzell, Carol In Zimbabwe, where between 20 percent and 25 percent of the population is infected with HIV, counselors at clinics struggle to help their patients. In Africa, HIV is primarily transmitted via heterosexual sex and from mother to child. Women are often the focus of studies, since they are used to visiting clinics during pregnancy and to obtain contraceptives. However, HIV's spread is furthered by the nation's male-dominated society and the fact that many men leave their families behind when they travel to the cities to find work, returning home only infrequently. As a result, some of the men visit prostitutes or take girlfriends, while some of the wives sometimes sell sex to make ends meet. The preference by many men for dry sex, in which the vaginal walls are dry and thus feel tighter, is also a contributing factor in HIV infection, as the practices used to dry--including inserting detergents and herbs--can disrupt the normal balance of healthy bacteria in the vagina, making it more susceptible for sexually transmitted diseases. Dry sex also increases the risk that condoms will break. A condom acceptability study conducted by Nancy S. Padian of the University of California at San Francisco and Z. Michael Chirenje of the University of Zimbabwe has been able to get about 50 percent of the female participants to convince their husbands to use condoms. In the study, which is funded by the U.S. Centers for Disease Control and Prevention, women who cannot get their husbands to use the prophylactics are offered other options, such as the female condom. Although the final data is not yet in, some researchers have noted that the female condom is not as popular as the male condom, citing complaints about its appearance and that it may squeak during sex.