Subject: CDC AIDS Daily Summary for Date: Wed Oct 31 12:31:01 PST 2001 (411 lines) From: National AIDS Info Clearinghouse Copyright 2001, Information, Inc., Bethesda, MD 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 NATIONAL NEWS "Campaign Against AIDS Targets Women Along US-Mexico Border" INTERNATIONAL NEWS "People Living with AIDS and HIV Say Discrimination Tops List of Concerns" "HIV Complacency Fears" "Dr. Peter Piot Discusses the World's AIDS Epidemic and Ways to Combat It" MEDICAL NEWS "HIV Study" LOCAL AND COMMUNITY NEWS "Haunted House Wants Safer Teen Sex" "Advocates Say University Park Paramedics Shunned a Man with AIDS -at an AIDS Awareness Rally" NEWS BRIEFS "South Africa to Spend More Fighting Crime, AIDS" "Across the USA: Michigan" "General Assembly Tentatively Reschedules Children's Summit for May" ************************************************************ NATIONAL NEWS ************************************************************ "Campaign Against AIDS Targets Women Along US-Mexico Border" NewsMexico (10.30.01) A new program, "Women and the HIV Virus," offered through the Binational Committee against AIDS, offers Hispanic women who live in Imperial County, Calif., and Mexicali, Mexico, access to HIV prevention information and free medical analysis in cooperation with area hospitals and medical centers. "We want to focus on women from both sides of the border, in the Imperial valley and Mexicali, because many US Hispanics, like those in the Mexico region, register high indices of contracting AIDS," said Dr. Arturo Hernandez, coordinator of the project. The project intends to help women understand their vulnerability to HIV "even if they have one partner" and to inform them that "there are many preventative public programs that can help reduce those risks," Hernandez explained. According to the CDC, at the end of 1999 there were 24,800 Hispanic women who tested HIV-positive. In the United States, 15 out of every 100,000 Hispanic women have AIDS. This is seven times higher than statistics for white women. In Mexico, in the state of Baja California, 112 women out of every 100,000 women have the illness. ************************************************************ INTERNATIONAL NEWS ************************************************************ "People Living with AIDS and HIV Say Discrimination Tops List of Concerns" Associated Press (10.30.01)::Angela Potter When Elmar Wishart became seriously ill from HIV complications, he said doctors in the South American country of Guyana refused to treat him. "Facilities there are inhuman," said the 45-year-old Guyana native, who was diagnosed with the virus in 1990. Wishart and others at this week's 10th International Conference for People Living with HIV/AIDS in Trinidad say one of the remaining obstacles in the battle against AIDS is the stigma attached to the disease. An estimated 2 percent of people in the Caribbean, excluding Cuba, have HIV/AIDS -the world's highest regional infection rate after sub-Saharan Africa. In Cuba, extensive treatment and prevention have kept infection rates extremely low. But elsewhere in the Caribbean, discrimination has prevented some from getting treatment. In socially conservative Jamaica, for example, 66 percent of AIDS cases are diagnosed just before or after death, according to Jamaica's National HIV/AIDS control program. "People are brought up to think those with HIV are immoral," said Jamaican Dorothy Blake, spokesperson for the Caribbean Regional Network of People Living with HIV/AIDS. Out of 150 HIV-positive Trinidadians attending the conference, none have publicly disclosed their status, said Claudette Francis, coordinator with Community Action Resource, Trinidad's AIDS counseling center. "Stigma is one of the greatest impediments in fighting HIV and AIDS," said Frenk Guni of Zimbabwe, a member of the Global Network for People Living with HIV/AIDS, who has been HIV-positive for 14 years. "When I first came out in the open about my HIV status, my relatives cut relations with me. I was gripped with fear of being abandoned," said Guni. Like Wishart, Guni said many people living with the virus around the world are denied medical treatment. In the Caribbean, about 500,000 people are living with HIV, according to the Caribbean Task Force on HIV/AIDS. "HIV Complacency Fears" BBC News (10.30.01) Members of Parliament are concerned that the British public has become too complacent about the continuing threat of HIV/AIDS. In a backbench debate on sexual health in Westminster Hall Tuesday, members called for a high-profile TV campaign to keep the issue at the forefront of public consciousness. Last year, 3,616 people were diagnosed with HIV -the largest number in a decade, a 20 percent increase from the year before. Dr. Gavin Strang (Labor), who initiated the debate, said, "It is a matter of great concern and disappointment that against a background of the progress made in previous years, we are seeing high numbers of new infections every year. In this day and age, every new HIV infection represents a failure of prevention. This prevention work has been allowed to go off the boil in the latter years of the epidemic. There is a real sense in which prevention work has not kept up with the changing nature of the epidemic." The 1980s effort to raise HIV/AIDS awareness had not been sustained, he said. "This may be at least in part because of a measure of complacency because combination therapy means many are now leading relatively normal lives who would not otherwise be doing so." Dr. Evan Harris, spokesperson for the Liberal Democrats, called on ministers to repeal the controversial Section 28 legislation outlawing the promotion of homosexuality, saying the policy was inhibiting progress in sexual health education. Tory health spokesperson Simon Burns said the public's level of ignorance about sexual health, especially HIV/AIDS, was "staggering." He remarked that a 1980s TV campaign on AIDS, while "highly controversial," was also effective. The government was criticized over delaying publication of its HIV/AIDS strategy, which was released in July after four years' work. Junior Health Minister Hazel Blears said the delay was due in part to the need for extensive consultation with people in the field to learn "what kind of promotion work is actually effective." "Dr. Peter Piot Discusses the World's AIDS Epidemic and Ways to Combat It" Fresh Air -National Public Radio (10.24.01)::Terry Gross Dr. Peter Piot is executive director of UNAIDS, the United Nations agency coordinating the fight against AIDS. He is a physician and microbiologist and one of the co-discoverers of the Ebola virus. He grew up in Belgium. Excerpts from his interview follow. GROSS: "What's the connection between AIDS and political instability? PIOT: "... In January 2000, ... the UN Security Council held a debate for the first time on AIDS as a security issue. And it was both a breakthrough in the concept of how we looked at AIDS, but also in how we look at security.... [Security is]...the absence of fear, absence of hunger, absence of fatal epidemics, just as AIDS is. And AIDS is definitely a factor of instability. ... We have countries where 30 to 40 percent of the adult population is infected; in other words, one out of three people, nearly one out of two adults. And what are the implications of that? First, that these people will die prematurely... secondly, AIDS doesn't only affect the poor; it also affects the skilled, the well-educated. For example, in several countries, a country like Zambia in Central Africa, today there are as many teachers who die from AIDS as the country trains every year. So that's a disaster. We see the same... in businesses.... They're all dying from AIDS.... And then we've got the orphans, those who are left behind.... We have also, the fact that many of the armies in Africa are very, very heavily infected with HIV, well over 50 percent.... "Wars have been major conduits for the spread of classic sexually transmitted diseases.... And that has to do with the fact that war is associated with violence. Violence often includes, also, sexual violence. And this is what we've seen throughout the world, that women get raped, that they often, in addition to being raped, are also being infected with HIV. We've seen it during the genocide in Rwanda a few years ago.... There are displaced populations, sometimes millions, on the run; refugee camps; people, particularly women, having only their body to sell in order to survive to feed their kids." GROSS: "One of the things you're up against is that AIDS awareness means talking openly about sex...." PIOT: "...I was actually, in a sense, happy that during the debates of the special session of the General Assembly at the UN [in June] that homosexuality, women's rights, women's control over their sexuality, sex education -that all that was discussed in rather non-diplomatic terms.... We went to the heart of the discussion. And that's the real problem for us.... This is an issue about every single country I have been in and is also a problem in Western countries." GROSS: "Has the pope and the Catholic Church been an obstacle for you on [condoms]?" PIOT: "Yeah, the condom issue is one of the more difficult ones in our daily work. And there -it is still true that the Catholic Church objects to the use of condoms. When we look at what happens in practice, it's a bit different. First, our position in UNAIDS in the following one, and that is that we -when it comes to preventing sexual transmission of HIV, we have A, B, C. And by that I mean, A for 'abstinence,' B for 'be faithful' and C for 'condom." It's easy to explain. The Catholic Church says A, B and we complete the alphabet to go to A, B, C." GROSS: "Why have you stayed with the AIDS epidemic for so long?" PIOT: "...My ambition is more of a political nature now in the sense that to make sure that AIDS is at the top of every country's agenda in the world and that the money is there. So it's because probably I've dealt with various aspects from the virus to the people to the politics. And secondly, I think in general, I'm someone who's more of, let's say, a marathon runner than a sprinter, so I guess we get less easily burned out, take it one step at a time." GROSS: "What's the most devastating example of AIDS you've seen in your travels around the world?" PIOT: "One is in Rwanda, you know, a country where one million people were killed in genocide several years ago. And I met with a group of women who were survivors of the genocide and who were HIV positive and who had been raped during the genocide and who their rapists had left alive, as even a worse punishment, if you want, than if they would had been killed. And that we absolutely just - I couldn't imagine how people could behave like that. And they were without treatment. It's the same story in most developing countries. People with HIV have no treatment. They lose everything." GROSS: "Maybe you can choose a country for us that you think has been doing an effective job in stopping the spread of AIDS and give us a brief description of what they've done that's been so helpful." PIOT: "...Uganda is in eastern Africa, and in the early '90s, over 20 percent of the adult population in the country were HIV positive. Today that's something around 8 percent; still very high by any standard, but a major drop. ...Well, there's no secret: hard work, leadership. The president, Museveni, took it on as a national cause, and imposed on all his Cabinet, on all leaders in the country, to talk constantly about AIDS, to take this on in their work.... And secondly, far more openness about AIDS. Thirdly, people with HIV got themselves organized... Major investment in sex education for young people, in condom promotion, and it has results in a later age of first sexual intercourse, less sex partners in the population and far more condom use...." ************************************************************ MEDICAL NEWS ************************************************************ "HIV Study" City News Service (Los Angeles) (10.22.01) It's no secret that stress is bad for your health, but the consequences could be especially severe for those infected with HIV, according to a UCLA study. Stress "enables HIV to spread more quickly in infected persons and prevents antiretroviral drugs from restoring immune system function," according to a UCLA statement. The study -"Impaired Response to HAART in HIV- Infected Individuals with High Autonomic Nervous System Activity," Proceedings of the National Academy of Sciences (October 23, 2001;98(22):12695-12700) -is the first to pinpoint the molecular mechanisms linking stress and HIV infection. The UCLA team studied 13 HIV-positive men between ages 25 and 54 who had never taken combination antiretroviral drugs. In addition to the men's baseline AIDS viral load, the scientists measured stress indicators such as blood pressure and heart and pulse rates while the men were at rest, and again after they had been subjected to unexpected noises, mental arithmetic and exercises under pressure. All 13 men were put on a powerful antiretroviral drug regimen to combat their HIV infection. Over the next 11 months, researchers again measured each man's viral load and CD-4 cell count -indicators of how much the HIV had spread and how well their immune systems were fighting the infection. The UCLA team compared these figures to the men's stress level ranking before they took the drugs. "Our findings propose that high levels of stress, day in and day out, may eventually wear down the immune system. It's like a wave hitting a rock on the beach. One wave won't do much damage, but years later, that rock gets ground down into the sand," said Dr. Steve Cole, UCLA assistant professor of hematology-oncology and the lead author of the report. "Our findings suggest that the nervous system has a direct effect on viral replications," Cole said. "This implies we may be able to alter that effect by reducing stress levels. Even anti-HIV drugs prove more effective in people with low [autonomic nervous system] activity." ************************************************************ LOCAL AND COMMUNITY NEWS ************************************************************ "Haunted House Wants Safer Teen Sex" Newsday (New York) (10.30.01)::Lucas L Johnson II Teenagers may have outgrown their fear of ghouls and goblins, but Nashville health officials believe their haunted house has something far scarier: gonorrhea and genital warts. Hoping to combat one of the nation's highest rates of STDs, health officials have staged the "STD Free! Haunted House." "We want to scare their pants back on," said Elizabeth Frazier, a registered nurse at Tennessee State University's health center. "We encourage abstinence. But if they can't do that, then use protection." The haunted house was developed three years ago after Nashville reported the second-highest rate of syphilis in the country: 45 cases per 100,000 people. As visitors make their way through a dimly lit, S-shaped maze, they view startling, full-color photos of canker sores and genital warts on female and male genitalia infected with STDs. An empty casket at the end sends a message that death awaits anyone who does not practice safe sex. The haunted house visitors are given "goody bags" filled with brochures on STDs, and they can get a free STD test once they complete the maze. Last year, more than 1,600 visited the haunted house, and 60 students were tested for HIV and syphilis. "I think it will have a positive effect and deter freshman like myself from making mistakes," said Jordan Williams, a freshman from Toledo, Ohio, who planned to take a tour when the house opened Wednesday. Lynette Winslow, program specialist for the Nashville Health Department, said even some football players could barely make it through last year's haunted house. "Guys would come up and say nothing scares them. Then before they could get around the corner ... I could hear them screaming." "Advocates Say University Park Paramedics Shunned a Man with AIDS -at an AIDS Awareness Rally" Dallas Observer (10.25.01)::Thomas Korosec Ricardo Vasquez was attending an AIDS awareness rally on the Southern Methodist University (SMU) campus recently when he had a seizure. Bystanders pulled out their cell phones and called 911. As the two fire department medics approached, someone informed them that Vasquez had AIDS, so they should avoid exposing themselves to his blood and saliva. But instead of merely taking precautions, the medics "didn't want to touch him ... they never did," said Sheila Dolezal, human resources director for AIDS Services of Dallas, who was at Vasquez's side, holding his head throughout the incident. David Parks, the organization's development director said, "They acted like they did not either want to help this man or did not care." Witnesses said the medics' clumsy attempt to draw blood caused Vasquez to bleed profusely, and that they dragged him by the shoulders down stone steps before placing him on a gurney. "It amazes me this could happen in 2001," said Don Maison, president of AIDS Services, an HIV/AIDS housing and support organization where Vasquez lives. "This was callous." Maison, who is also a lawyer, took the statements of his staff members and sent them to University Park officials. In a letter, he asked the well-to-do suburb to take "steps to eliminate such unprofessional behavior in the future." David Ledbetter, the city's fire chief, said he is conducting an internal review and conceded that there were problems with the city's response. He said he found problems with the paramedic's training and deficiencies with supplies. Responding to AIDS Services in a letter he delivered personally, Ledbetter said, "It is my responsibility to ensure professionalism and courtesy is extended to each of our customers." He said the two paramedics would attend additional training in handling seizures and that "all personnel will be given cultural diversity classes. I will solicit training that will re-educate each of us on HIV-sensitive issues." ************************************************************ NEWS BRIEFS ************************************************************ "South Africa to Spend More Fighting Crime, AIDS" Associated Press (10.30.01) South Africa plans to boost spending to fight crime and the AIDS pandemic over the next three years, Finance Minister Trevor Manuel told Parliament Tuesday. Provincial governments spent $430 million this year on HIV-related disease. That spending will increase over the next three years, Manuel said, though he gave no specific figures. An estimated 4.7 million South Africans are infected with HIV. Spending on the government's integrated HIV strategy was to rise from $14 million this year to $35 million in 2002, $47 million in 2003 and $60 million in 2004, according to the budget plan. "Across the USA: Michigan" USA Today (10.29.01) Magic Johnson, a former Michigan State basketball star, is returning to play against the Spartans in an AIDS benefit. The former Los Angeles Laker will lead his own all-star squad in the exhibition game Friday at the Breslin Center in East Lansing, Mich. Johnson, who tested HIV-positive 10 years ago, has been raising funds to fight AIDS. "General Assembly Tentatively Reschedules Children's Summit for May" Associated Press (10.30.01) The UN Children's Summit, which was postponed because of the terror attacks on the United States, has been tentatively rescheduled for May, UN officials said Tuesday. All regional groups in the General Assembly have agreed to hold the summit May 8-10. More than 75 world leaders, thousands of delegates and hundreds of children had been scheduled to attend the Sept. 19-21 summit. The first World Summit for Children was held in 1990, and delegates at the upcoming summit will assess the successes and failures of the last decade and adopt a new plan to tackle tragedies such as AIDS orphans, child soldiers and trafficking in children.