Subject: CDC AIDS Daily Summary for Date: Mon Jun 19 07:01:01 PDT 2000 (221 lines) From: National AIDS Info Clearinghouse Copyright 2000, Information, Inc., Bethesda, MD CDC HIV/STD/TB Prevention News Update Monday, June 19, 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 "Promoting Early Detection of Human Immunodeficiency Virus Infection Among Adolescents" GENERAL MEDIA "With AIDS Drugs, Many Gay Men See Less Danger" "STD Cases on the Rise" "Tuberculosis Cases on Rise, County Reports" "SLU Gets $8.5 Million Grant to Look for AIDS Vaccine" "Expanding Needle Exchanges" "Brazil Blasts Church for AIDS, Condoms Stance" "Tanzania: Government Asks Religious Leaders to Fight AIDS" "Border Ills" *************************************************************** PEER-REVIEWED JOURNALS *************************************************************** "Promoting Early Detection of Human Immunodeficiency Virus Infection Among Adolescents" Archives of Pediatrics and Adolescent Medicine Online (archpedi.ama-assn.org) (05/00) Vol. 154, No. 5, P. 435; Rotheram-Borus, Mary Jane; Futterman, Donna An estimated 50 percent of HIV infections worldwide are among 15-to 24-year-olds, according to the World Health Organization. However, research suggests that many HIV-infected adolescents may not be aware of their status, and only 11 percent of youth living with HIV (YLH) in the United States receive adequate medical care. Several studies have shown the need for identifying HIV infection early, so that life-extending drugs can be provided. Identifying more HIV-infected youth could also reduce the risk of transmission to sexual partners and infants. The authors suggest that HIV testing can also be a useful part of HIV prevention efforts. They note that before launching widespread early detection strategies, several key factors must be considered, including investigating alternative methods for conducting pre- and post-test counseling and addressing barriers to prevention and testing within the HIV system of care. The researchers also recommend initiating community-level intervention efforts that are geared towards adolescents at high risk for contracting the virus. They note that "while similar strategies may benefit adults, the language, settings, facilitators, and guidelines for such programs must be tailored to adolescents' developmental characteristics." **************************************************************** GENERAL MEDIA **************************************************************** "With AIDS Drugs, Many Gay Men See Less Danger" Boston Globe Online (www.boston.com/globe) (06/18/00) P. A1; Abraham, Yvonne A syphilis outbreak among homosexual men late last year has health officials in Boston worried that more gay men are having unprotected sex. Although the number of HIV cases in Massachusetts has not risen, state officials know the symptoms may not appear for months. AIDS activists report that some gay men are developing more relaxed attitudes towards unsafe sex, either because both partners already have HIV, they are tired of having to wear condoms, or the men know that new drug therapies may help them. In the 1980s, the gay community became vigilant about promoting safe sex and changed its overall sexual behavior. However, the recent syphilis outbreaks in Boston and Los Angeles, often involving HIV-positive men, show that the safe sex motto may have lost some of its significance. The attitude shift is mostly attributed to new AIDS drugs, or protease inhibitors. Psychologists also say that early safe sex messages have made older gay patients tired of worrying about avoiding death. The syphilis outbreaks are alarming because the disease makes men more likely to contract HIV during unprotected sex. Dr. Jonathan Fielding, director of public health for Los Angeles County, notes, "Syphilis is treatable. We know we don't have a cure for HIV, and treatment is very arduous. The overall toll is so substantial, so I'm very concerned." "STD Cases on the Rise" Akron Beacon Journal Online (www.ohio.com) (06/18/00); Dorell, Oren Health officials in Ohio are investigating increases in gonorrhea and chlamydia rates among Barberton residents. The majority of cases are among teenagers, but officials are not sure if the rise is due to more cases or better testing. Reported cases of sexually transmitted diseases (STDs) in Barberton soared to 47 last year, after falling from 82 in 1995 to 24 in 1998. Health workers continue to ask STD patients about their partners and histories, but no pattern has been found. Cases of both gonorrhea and chlamydia in Akron have been falling since 1998, and cases in Medina County have remained stable, despite increased STD education efforts. New STD tests could be the cause for the increased diagnoses, but they do not explain the increases in some areas and the decline in Akron. A Centralized Communicable Disease Registry may help physicians discover any patterns or outbreaks. "Tuberculosis Cases on Rise, County Reports" Sacramento Bee (www.sacbee.com) (06/17/00) P. B1; Griffith, Dorsey Sacramento County, California, is seeing a rise in new tuberculosis (TB) cases after two years of decline. Dr. Glennah Trochet said 84 new cases of active TB have been reported this year, compared to 89 cases for all of 1999. While staff shortages will delay the immediate analysis of the new cases, health officials have determined a link between six of the individuals, who had all taken part in services for the homeless in the downtown area. Dr. Glennah Trochet, the county's health officer, noted that none of the cases are multidrug resistant, crediting the county's aggressive directly observed therapy program. "SLU Gets $8.5 Million Grant to Look for AIDS Vaccine" St. Louis Post-Dispatch (www.stlnet.com) (06/17/00) P. 7; Riley, Marianna St. Louis University has been given a five-year, $8.5 million grant from the National Institute of Allergy and Infectious Diseases to research an AIDS vaccine. The grant is part of a testing network that includes eight other clinics. Dr. Robert Belshe, head of the division of infectious diseases and director of the vaccine center of the university's School of Medicine, will lead the studies in St. Louis, which will test a combination of two vaccines in two phases. The grant is the largest research grant St. Louis University has ever received. "Expanding Needle Exchanges" Boston Globe (www.boston.com/globe) (06/17/00) P. A14 An editorial in the Boston Globe notes the success of needle exchange programs in four Massachusetts cities in reducing HIV and hepatitis C transmission without promoting drug use. However, HIV continues to infect intravenous drug users in other cities without needle exchanges. Lowell, New Bedford, and Worcester are most affected, and require city approval to start the exchange programs. Although some opponents fear that a community with a needle exchange will attract drug users and confuse children about drugs, the editors write that exchanging dirty syringes is often the first step for drug addicts to get into drug treatment programs. Massachusetts' Senate has included a measure in its budget that would allow the Department of Public Health to establish needle exchanges without local approval, as long as it works with a community advisory committee. The editors, citing a recent study that showed high support for needle exchanges among registered voters in the state, assert that "the Legislature should second the voters' good sense by approving the Senate outside section." "Brazil Blasts Church for AIDS, Condoms Stance" Reuters (www.reuters.com) (06/17/00); Khalip, Andrei Brazil's government has criticized the local Roman Catholic church for not supporting condom use to help prevent HIV infection. The Health Ministry noted that while the church recommends abstinence and fidelity, the church should not ignore science and serious public health matters that must be addressed. The National Bishops' Association restated last week the church's opposition to Catholics using condoms, although some clergymen who work with AIDS patients reportedly disagreed with the ruling. A 1999 study estimated there were at least 540,000 HIV-infected individuals in Brazil, out of an overall population of 160 million. "Tanzania: Government Asks Religious Leaders to Fight AIDS" Africa News Service (www.africanews.org) (06/16/00) The Tanzanian government has called on religious leaders in the country to help fight the AIDS epidemic. Vice President Dr. Omari Juma said that AIDS should be made a priority and that Tanzanians "should ... abandon the customs and traditions which contribute to the spread of AIDS, such as wife sharing." According to 1998 estimates, approximately 1.6 million Tanzanians have HIV, among a population of 30 million. "Border Ills" Education Week (www.edweek.org) (05/31/00) Vol.19, No. 38, P. 28; Portner, Jessica Along the Mexican border in Texas, schoolchildren are frequently sickened by diseases that are preventable. Mass inoculation campaigns have helped, but with the flow of people between Mexico, it is hard to keep illness at bay. The United States has successfully eradicated polio and reduced diphtheria, tetanus, and measles. However, hepatitis A, chicken pox, dengue fever, and tuberculosis (TB) rates along the counties on the Mexican border are high. Infections are rampant because of unsanitary and crowded living conditions, and endemic disease from Mexico is common. The polluted Rio Grande River also is a cause for cases of gastroenteritis. Unsanitary conditions in colonies along the border affect children in school, and immunization clinics are necessary to keep them healthy and alert for classes. The nurses inoculate for hepatitis A and B, chicken pox, measles, mumps, rubella, TB, diphtheria, pertussis, tetanus, and polio. In Webb County, over 30 per 100,000 people tested positive for TB exposure, which is three times the rate for the entire state, and all potential school employees are tested for the disease before being hired. The area has few pediatricians, however, and one doctor reports seeing 100 to 200 patients a day. A 1990 measles outbreak in Laredo took over five months to contain, involving the immunization of some 20,000 children. However, there has not been a major outbreak there in years, and the chicken pox rate has declined below the state average. The shots for most children are free, but migrant workers are hard to locate for repeated doses. Laurie Henfey of Texas' immunization program notes, "It's a constant battle to get [children] vaccinated. There's never going to be a time where we can say, 'Oh, we're done."