Subject: CDC AIDS Daily Summary for Date: Thu Jan 4 07:01:01 PST 2001 (198 lines) From: National AIDS Info Clearinghouse Copyright 2001, Information, Inc., Bethesda, MD CDC HIV/STD/TB Prevention News Update Thursday, January 4, 2001 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 "Court Ruling Favors Indian Navy's HIV Policy" GENERAL MEDIA "Virginity Pledges by Teenagers Can Be Highly Effective, Federal Study Finds" "India's AIDS Explosion" "Immune Reconstitution Better if HAART Initiated During Primary HIV Infection" "Use of p24 Antigen Screening for HIV May Be Desirable in Primary Care" "TB Exposure Found in 16 at Prison but 'No Active Cases'" "United Nations Urged to Spend More Battling AIDS in Myanmar" "Research Staff Join Fight to Beat TB" "Estonia Starts Mandatory Testing of Prisoners for AIDS Virus" *************************************************************** PEER-REVIEWED JOURNALS *************************************************************** "Court Ruling Favors Indian Navy's HIV Policy" Lancet (www.thelancet.com) (12/30/00) Vol 356, No. 9248, P. 2166; Sharma, Dinesh C. In India recently, the Bombay High Court refused to honor a sailor's plea for re-employment status with the Indian Navy. After serving nearly 15 years as a submariner, the sailor was removed from submarine duty and placed on "low-medical" status because he tested positive for HIV. At the end of his contract, he filed for re-employment, charging that the Navy was in violation of his civil rights, first by relocating him to a lower status and then by denying him re-employment and promotions. The Navy had argued--and the court agreed--that "national security cannot be jeopardized in any manner by endangering proper functioning of submarines." **************************************************************** GENERAL MEDIA **************************************************************** "Virginity Pledges by Teenagers Can Be Highly Effective, Federal Study Finds" New York Times (www.nytimes.com) (01/04/01) P. A16; Schemo, Diana Jean A new study of 6,800 American students concludes that virginity pledges by teenagers can result in them delaying sex much longer than those who do not make such a pledge of chastity. Christine A. Bachrach, head of demographic and behavioral sciences at the National Institute of Child Health and Human Development, which funded the research, said the study "does break new ground" in demonstrating that chastity pledges can delay sex among young people, although she also noted it "doesn't mean that everyone should drop everything and get teenagers out there to take pledges." Researchers Peter S. Bearman of Columbia University and Hannah Bruckner of Yale University found that, after controlling for characteristics linked to delaying intercourse, students who made virginity pledges postponed sex about a year and a half longer than virgins who never made a pledge. The report noted, however, that for many students, the pledge of abstinence was guided by whether his/her peer group members were in agreement. In addition, when the percentage of students pledging abstinence passed the 30-percent mark, teenagers stopped delaying intercourse. Dr. Bearman explains this decline as the response of teenagers identifying with their stance on sex much like they do with club memberships, and once the uniqueness wears off, or the popularity of something increases, the teens may not be as interested. "India's AIDS Explosion" Washington Post (www.washingtonpost.com) (01/04/01) P. A21; Dube, Siddharth In a commentary in the Washington Post, Siddharth Dube discusses the increasing spread of HIV in India. Dube, the author of "Sex, Lies, and AIDS," contends that "because the [Indian] government's prevention efforts are lagging dangerously behind the epidemic's growth, the number of adults infected is doubling every 18 months or so." There are an estimated 3,500 new HIV infections in India every day, and the World Bank has warned that unless aggressive measures are taken, 35 million residents may have HIV by 2005. Dube notes that the commercial sex industry in India is flourishing, while public discussion of sex remains taboo. In addition, there are few sex education programs in schools or prevention programs for men who have sex with men. Although frank information campaigns, increased treatment for sexually transmitted diseases, and some sex education in schools helped stem a severe epidemic in the southern state of Tamil Nadu, Dube asserts that many leaders will likely not take on the challenge and that will result in "calamity for many million Indians." "Immune Reconstitution Better if HAART Initiated During Primary HIV Infection" Reuters Health Information Services (www.reutershealth.com) (01/03/01) A recent report in the journal AIDS (2000;14:2643-2651) suggests that individuals who take highly active antiretroviral therapy (HAART) during primary HIV infection see faster and more complete immune reconstitution than patients who start treatment later. Researchers from St. Vincent's Hospital in Sydney, Australia, conducted a prospective study of 58 treatment-naive patients who were given indinavir or nelfinavir plus two nucleoside reverse transcriptase inhibitors. After one year, the median CD4 cell count in the patients with primary HIV-1 infection rose from 470 to 758, while the median increase among the chronically infected patients was much smaller, from 204 to 310. The researchers also found that, compared to those with chronic infection, patients with primary HIV-1 infection saw much larger increases in the number of naive and memory T cells. "Use of p24 Antigen Screening for HIV May Be Desirable in Primary Care" Reuters Health Information Services (www.reutershealth.com) (01/03/01) New research indicates that the p24 antigen assay may be useful in primary care practices for the diagnosis of primary HIV infection. The prospective study of 436 patients with symptoms suggestive of primary HIV infection, including 12.4 percent who had a positive result on a virologic test but undetectable HIV antibodies or indeterminate Western blot test results, found that no sign or symptom correctly predicted acute HIV infection. Scientists, led by Dr. Eric S. Daar of Cedars-Sinai Medical Center in Los Angeles, report that the HIV RNA assay was more sensitive than the p24 test (100 percent vs. 88.7 percent), but it was also much more expensive and had lower specificity. In an editorial accompanying the report in the January 2 Annals of Internal Medicine (2001;134:25-29), researchers from the Brown University School of Medicine support the use of the p24 antigen assay over the HIV RNA test, even if it does not detect a small percentage of HIV infections. "TB Exposure Found in 16 at Prison but 'No Active Cases'" (01/03/01) P. B2; Locker, Richard A small group of inmates and employees of the West Tennessee State Penitentiary near Henning are receiving treatment after skins tests showed they had been exposed to tuberculosis (TB). The skin tests revealed that 10 inmates and six prison employees had positive skin tests for TB, but a spokesman said there is no outbreak of the disease. According to the spokesman, there are currently no active or contagious cases of TB in the prison, and the preventive treatment is required per departmental policy and procedure. "United Nations Urged to Spend More Battling AIDS in Myanmar" Reuters (www.reuters.com) (01/03/01) A panel experts said Wednesday that the United Nation's level of spending to fight AIDS in Myanmar should be increased significantly. For the 30 months between mid-1999 and year-end 2001, the U.N. Development Program has allocated $3 million for the AIDS battle in Myanmar. However, the experts said the funds, while useful, represented less than one-tenth of what international donors are giving neighboring countries with similar infection rates. According to UNAIDS, 1.99 percent of adults in Myanmar are infected with HIV--the third highest infection rate in southern and southeastern Asia. "Research Staff Join Fight to Beat TB" Newcastle Evening Chronicle (www.evening-chronicle.co.uk) (01/03/01) P. 14 Researchers from Newcastle University in the United Kingdom are working to develop drugs to cure new strains of tuberculosis (TB). Lead researcher Prof. Gurdyal Besra noted that while many groups are attempting to modify existing TB drugs, his team is trying to create "completely new types of drugs which will last at least 40 years." The group is now testing the safety and efficacy of six potential TB drugs. "Estonia Starts Mandatory Testing of Prisoners for AIDS Virus" Agence France Presse (www.afp.com) (01/03/01) Estonia officials decreed that as of January 1, every new prison inmate would be required to undergo HIV testing. Justice Ministry Prison specialist Peeter Krall said, "We need to step up the level of medical examinations of new inmates because of the explosion in the number of those affected by HIV in Estonia over the past year." He also noted that because the prisons are so overcrowded, any effort made to avert a massive outbreak is wise. **************************************************************** The PreventioNews Mailing List is maintained by the National Prevention Network (NPIN), part of the Centers for Disease