Subject: CDC AIDS Daily Summary for Date: Thu Jun 15 07:01:01 PDT 2000 (190 lines) From: National AIDS Info Clearinghouse Copyright 2000, Information, Inc., Bethesda, MD CDC HIV/STD/TB Prevention News Update Thursday, June 15, 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 "Control of Sexually Transmitted Diseases for HIV-1 Prevention: Understanding the Implications of the Mwanza and Rakai Trials" GENERAL MEDIA "Domestic Spending Bill Passes Narrowly" "New Funding Targets AIDS Among Hub Minorities" "Summers Sees Progress in Tanzania, Goes to S. Africa" "Knowledge of HIV Postexposure Prevention Unrelated to Sexual Risk-Taking" "Expert Warns of AIDS Disaster in China: Report" "Ghana: 400,000 Ghanaians Have AIDS" "Mauritius: Over 40 Percent of Mauritians Think AIDS Is Not Their Concern" "Saving Grace" *************************************************************** PEER-REVIEWED JOURNALS *************************************************************** "Control of Sexually Transmitted Diseases for HIV-1 Prevention: Understanding the Implications of the Mwanza and Rakai Trials" Lancet (www.thelancet.com) (06/03/00) Vol. 355, No. 9219, P. 1981; Grosskurth, Heiner; Gray, Ronald; Hayes, Richard; et al. Two controlled trials of sexually transmitted disease (STD) treatment conducted to prevent HIV infection, took place in Mwanza, Tanzania and Rakai, Uganda. The idea that controlling STDs can reduce HIV transmission was evaluated during the trials. One study collected data on uncontrolled intervention studies among sex workers, while the other studied community-based randomized trials in general populations. The trial in Mwanza region revealed that STD intervention did help reduce HIV incidence, but behavioral change was not a factor. In Rakai, the trial tested if repeated mass treatments for STDs could reduce STD rates and HIV-1 transmission. The intervention consisted of single-dose oral antibiotic treatment. A survey of the entire population aged 15 to 59 showed no effect on HIV incidence even among subgroups like pregnant women. There was no significant effect on the incidence of new syphilis cases . However, the researchers note that possible explanations for the findings could be differences in stage of the HIV-1 epidemic, possible differences in the prevalence of incurable STDs, and possible greater effectiveness of continuously available services than of intermittent mass treatment to help control rapid STD reinfection. The results of both these trials suggest that policies on STD control should take into account their effect as cofactors for HIV transmission. STD control should remain in place for these countries and their AIDS programs. Targeted STD control can work best in areas with little funding and rampant commercial sex. Providing basic access to healthcare is also necessary to help reduce STD cases. **************************************************************** GENERAL MEDIA **************************************************************** "Domestic Spending Bill Passes Narrowly" Washington Post (www.washingtonpost.com) (06/15/00) P. A14; Pianin, Eric The House has approved new spending for education and health. With a vote of 217 to 214, the $339.5 billion domestic spending bill for the upcoming fiscal year just narrowly passed. Seven Republicans joined the majority of Democrats who voted against the giant health and education bill that would cut several White House initiatives for education and job training. Under the measure, the National Institutes of Health would receive $1 billion more in funding, for about $18.8 billion. The labor-health-education bill was debated hotly as Rep. Tom Coburn (R-Okla.) and other conservatives insisted that an emergency $500 million in funding for the Centers for Disease Control and Prevention be removed. "New Funding Targets AIDS Among Hub Minorities" Boston Herald (www.bostonherald.com) (06/14/00) P. 12; Lasalandra, Michael Boston Mayor Thomas Menino has announced that $1.7 million will be given to AIDS programs in the city. The funds include $400,000 from the Ryan White CARE Act and $1.3 million in city funds. The federal funds will be divided amongst five agencies, while 21 will split the city money. Menino noted that cases of HIV and AIDS are increasing among minorities in the city. "Summers Sees Progress in Tanzania, Goes to S. Africa" Reuters (www.reuters.com) (06/14/00); Engelmann, Knut U.S. Treasury Secretary Lawrence Summers has left Tanzania for South Africa, after encouraging Tanzanian President Benjamin Mpaka to increase the fight against AIDS and spend more money on agriculture. Summers, in the middle of a nine-day trip to five African nations, will visit Mozambique and Egypt later in the week. The trip includes visits to several AIDS clinics. Summers announced Wednesday that the United States would increase its support for HIV prevention efforts in Tanzania. "Knowledge of HIV Postexposure Prevention Unrelated to Sexual Risk-Taking" Reuters Health Information Services (www.reutershealth.com) (06/14/00) A study performed by Dr. Craig Waldo of the AIDS Research Institute in San Francisco determined that homosexual men are not likely to put themselves at greater risk of sexual exposure to HIV even though they are aware that postexposure prevention is available. Street interviews with 295 gay men in 1998 revealed that 24 percent of the subjects who knew of the postexposure treatment reported unprotected sex in the last three months, versus 26 percent who were not familiar with the treatment. After a community-wide effort to highlight the availability of postexposure prevention, a survey of 234 gay men in January 1999 found that high-risk sex was reported by 37 percent of the men familiar with treatment and 26 percent of those not aware of it. In both surveys, men who knew about postexposure prevention were no more likely than those unaware of the treatment to have unprotected anal sex. "Expert Warns of AIDS Disaster in China: Report" Kyodo News Service (home.kyodo.co.jp) (06/14/00) China is seeing a 30 percent growth of HIV infections per year, according to a new report. Professor Zeng Yi of the Chinese Academy of Preventive Medicine said that unless aggressive measures are taken, the government may not be able to meet its goal of limiting HIV infections to 1.5 million by 2010. The United Nations estimates that 500,000 Chinese are infected with HIV, primarily the result of needle sharing. "Ghana: 400,000 Ghanaians Have AIDS" Africa News Service (www.africanews.org) (06/14/00); Archer, Raymond More than 37,000 cases of HIV infection have been reported in Ghana, but up to 400,000 more may be infected and show no signs or symptoms. Dr. Kweku Yeboah, the national coordinator of AIDS Control, said that an estimated 120,000 children have been orphaned by AIDS in Ghana and that about 50 percent of the reported AIDS cases are among young people. Dr. George Puplampu of the Ghana National Commission on Children also noted that "the cost of treatment for AIDS ... puts a strain on both human and material resources." Education about sexually transmitted diseases, including HIV, has been hampered by taboos about premarital sex and fears of societal disapproval. "Mauritius: Over 40 Percent of Mauritians Think AIDS Is Not Their Concern" PANA Wire Service (www.africanews.org/PANA) (06/14/00) A study by students at the University of Mauritius shows that at least 42 percent of the country is not concerned over AIDS, although most people--98 percent--are aware of the disease. Thirty-four percent of the respondents said the disease is simple, 16.5 percent said it was dangerous, and nearly 20 percent considered it just another sexually transmitted infection. According to the report, only 24 percent of the respondents knew how HIV is transmitted. Statistics show that 15 new cases of HIV have been reported on the island since the beginning of the year, bringing the total number of people living with HIV in the country to 184. "Saving Grace" New Scientist (www.newscientist.com) (05/27/00) Vol. 166, No. 2240, P. 12; Cohen, Phil Mutating viruses are hard for the body to fight because of a phenomenon known as "original antigenic sin," according to David Anderson of the University of California at Davis. Anderson and colleagues prepared thousands of peptides from SIV and then immunized mice with them. Two groups of control mice each received a single peptide from two SIV strains that were not used in the peptide combination. The researchers discovered that exposure to the peptide mixture significantly increased the number of cells that responded to inactivated SIV, compared to the two control groups. Anderson theorizes that by exposing it to many different peptides, the immune system was prompted to generate cells with much broader targets.