Subject: CDC AIDS Daily Summary for 12/04/02 Date: Wed Dec 4 11:31:02 PST 2002 (373 lines) From: National AIDS Info Clearinghouse Copyright 2002, Information, Inc., Bethesda, MD CDC HIV/STD/TB Prevention News Update Wednesday, December 04, 2002 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 "Powell Urges Foreign Governments to Make AIDS Fight a Top Priority" INTERNATIONAL NEWS "Groups Discuss How to Help Africans Suffering from Famine and AIDS" MEDICAL NEWS "CDC Study Finds Higher Cervical Cancer Rates Among Hispanic Women and Women over 50" "More Unsupervised Teen Time Means More Sex, STDs" LOCAL AND COMMUNITY NEWS "Mayor Backs Hypodermic Sales over the Counter" "Homeless New Yorkers with AIDS on Rise" "Churches Join Effort to Give AIDS Alert" NEWS BRIEFS "Magic Johnson Says AIDS Medications Should Be Cheaper" "Mandela Backs New Treatment Program for AIDS Sufferers" "Amnesty: Rights Crucial in AIDS Fight" "Official: Russia's AIDS Problem Exploding Despite Dip in Official Data" ************************************************************ NATIONAL NEWS ************************************************************ "Powell Urges Foreign Governments to Make AIDS Fight a Top Priority" Associated Press (12.03.02)::Eun-Kyung Kim Secretary of State Colin Powell encouraged ambassadors and other foreign diplomats at the State Department Tuesday to stress to their governments the importance of political leadership in fighting AIDS. "The positions we hold in our governments give our voices resonance at home and abroad," he told the gathering. "We can and we must use our voices to convince others of the urgency of this global problem." "HIV... undermines the social, economic and political systems that underpin entire nations and regions," he said. The department invited 164 governments to hear Powell's speech, and 86 nations sent representatives. Powell stressed that world leaders must be educated about how the disease spreads and how it can be prevented and treated. Powell cited Ugandan President Yoweri Museveni, who recognized early in his tenure the threat AIDS posed to the country's national security. Museveni personally oversaw the creation of a center for AIDS research studies and, as a result, Uganda has reduced infections by 50 percent since 1992. Health and Human Services Secretary Tommy Thompson joined the gathering and said the government's $500 million two-year pledge made to the Global Fund to Fight AIDS is the fund's largest. "The United States is well aware that investing in global health is not only a matter of increasing economic growth or improving political stability, it will help us do nothing less than save the next generation." But Tom Hart, government relations director for the Episcopal Church, said, "First, that's not saying much - contributions are grossly inadequate, and the Global Fund needs $8 billion more in the next two years. Second, it's a very misleading claim, because European Union countries give far more as a share of their economy." Hart said the US economy matches that of the EU, which has committed $1.1 billion to the fund. Health GAP's Paul Davis said, "It's past time for the Bush administration to stop saying AIDS is a crisis and start treating it like one." ************************************************************ INTERNATIONAL NEWS ************************************************************ "Groups Discuss How to Help Africans Suffering from Famine and AIDS" Associated Press (12.04.02)::Angela Potter Fifteen American humanitarian groups met with a UN envoy on Tuesday in Baltimore to urge governments, citizens' groups and private citizens to help Africans plagued by famine and AIDS. If food shipments are not increased in the coming months, millions of Africans will face conditions similar to the Ethiopian famine of the mid-1980s, the international relief organizations said. The relief groups, which include the American Red Cross, Save the Children and Catholic Relief Services, said more than 34 million people in sub-Saharan Africa face death by starvation in the next six to eight months. "The magnitude of the disaster unfolding in Africa has not yet been fully grasped by the international community," said James Morris, executive director of the World Food Program and UN Special Envoy for the Humanitarian Crisis in southern Africa. "An exceptional effort is urgently needed if a major catastrophe is to be averted. Business as usual will not do." Twenty-five African countries are facing serious food shortages, with Zimbabwe, Ethiopia and Eritrea in particular danger, according to the UN Food and Agriculture Organization. The 15 American relief agencies, known together as the Coalition for Food Aid, said the effects of this famine will be even worse than the famine of 20 years ago because starvation in African nations is now compounded by the HIV/AIDS epidemic. Malnutrition accelerates the onset of AIDS, and those infected with the disease need 30-50 percent more calories than others. Officials issued "The Baltimore Declaration" in which they asked governments and humanitarian groups to "recognize the enormity of the crisis confronting Africa and to join in a massive and urgent response." Andrew Natsios, who heads the US Agency for International Development, said the Bush administration agreed to boost spending by $335 million to help alleviate hunger in developing countries. Congress has not yet approved the increase. ************************************************************ MEDICAL NEWS ************************************************************ "CDC Study Finds Higher Cervical Cancer Rates Among Hispanic Women and Women over 50" Associated Press (11.28.02)::Daniel Yee Hispanic women contract cervical cancer almost twice as often as other women, indicating that not enough of them are having Pap tests, according to a CDC study. The report, "Invasive Cervical Cancer Among Hispanic and Non-Hispanic Women," was published in Morbidity and Mortality Weekly Report (2002;51(47):1067-1070). The study also found that older women of all ethnic groups were more likely to show advanced cases of the disease when first diagnosed. These women sometimes lack easy access to screening tests because of their age, low education, low income and lack of health insurance, the CDC's Dr. Sidibe Kassim said. The CDC study analyzed 14,759 new invasive cervical cancer cases between 1992 and 1999. The disease was found at a rate of 16.9 per 100,000 Hispanic women 30 and older, compared with 8.9 per 100,000 non- Hispanic women. Forty percent of the patients were diagnosed with advanced cases of the disease; among women 50 or older, the rate rose to 52 percent. The CDC noted the high rates came in the face of a 50 percent drop in cervical cancer cases among all American women in the last three decades. Better cervical cancer education, screening and treatment led to that decline, Kassim said. "What's critical for people to realize is for many cervical cancers, it takes years for an early cancer to become established as an invasive or potentially fatal case," said Dr. William Golden, a University of Arkansas for Medical Sciences professor, who was not involved in the study. The CDC estimates that 13,000 new cases of invasive cervical cancer will be diagnosed this year, and about 4,100 women will die from the disease. The Pap test identifies precancerous lesions and leads to early treatment. Screening programs for cervical cancer exist in each state, but some women may not realize they need to be tested, Kassim said. The tests are recommended every three years for women who are sexually active. Cervical cancer is virtually always caused by the sexually transmitted human papillomavirus. "More Unsupervised Teen Time Means More Sex, STDs" Reuters Health (12.02.02)::Alison McCook New research on US teens who attend urban public schools reveals that teens who spend more time without adult supervision are more likely to have sex and acquire STDs. The study, conducted by Dr. Deborah A. Cohen of the nonprofit RAND Corporation and colleagues, found that 80 percent of teens who spent at least 30 unsupervised hours each week reported that they were sexually active. By comparison, only 68 percent of teens who spent less than five unsupervised hours per week reported sexual activity. "A lot of kids are home alone for long hours," Cohen said. "And they take advantage of that time to engage in risk behavior." Ninety-one percent of teens who reported having sex said they had done so the last time at a home, either theirs or someone else's, the authors reported. Their study, "When and Where Do Youths Have Sex? The Potential Role of Adult Supervision" was published in the December online edition of Pediatrics (2002;110:e66). They also found that boys who spent more than five hours per week after school without an adult present were twice as likely as other boys to have gonorrhea or chlamydia. Teen sex "is not risk free," Cohen stated. "They're getting diseases for this behavior." Cohen suggested that reducing the number of hours teens spend unsupervised would be a good way to reduce how often they have sex and potentially put their health at risk. Although most parents have to work, she noted that schools and local governments could sponsor after- school activities for teens without incurring exorbitant expense. Such activities would keep them busy "where their interests are diverted to something that's more developmentally appropriate to them." Fifty-nine percent of the girls in the study who participated in after-school activities reported being sexually active, compared with seventy-one percent of the girls with no after-school activities. Study data came from surveys Cohen and her colleagues distributed to 2,034 teens, mainly African-Americans, at six public high schools in an urban area. The teens were tested for gonorrhea and chlamydia. The investigators found no difference in time spent alone among teens from single-parent homes and those from two-parent families. Most sexually active teens reported that they last had sex during the week. The current results suggest teens need more information on safe sex practices, but Cohen also said she believes an adult's presence can have a major impact on how many times teens have sex, safely or not. "I think a lot of sexual activity is opportunistic," she said. "And if they have fewer opportunities, there's going to be less risk- taking." ************************************************************ LOCAL AND COMMUNITY NEWS ************************************************************ "Mayor Backs Hypodermic Sales over the Counter" Boston Herald (12.03.02)::Michael Lasalandra On Monday, Boston Mayor Thomas M. Menino said he will file a controversial bill that would allow hypodermic needles to be sold over the counter in Boston pharmacies. The mayor, who announced the plan at World AIDS Day observances, said he would file the bill in the Legislature on Tuesday. "The AIDS crisis is not over," he said in an interview. "We've got to do something. We need another tool in place." Menino said the bill would allow sales in Boston pharmacies, but he hopes it would be enacted statewide in time. Boston already has a needle exchange program - one of four in the state - that is designed to help curb the spread of HIV. Currently, a doctor's prescription is required to purchase a syringe. Supporters argue that over-the-counter sales would further reduce the spread of HIV and hepatitis among drug users. Opponents say it would condone drug use. "It's the wrong direction to be going in. It would encourage further drug abuse by making needles more available," said Gerry D'Avolio, executive director of the Massachusetts Catholic Conference, which represents the Catholic Church on public policy issues. John Auerbach, executive director of the Boston Public Health Commission, said pharmacies in Connecticut are allowed to sell needles without prescriptions, and studies have shown the rate of needle sharing among addicts there has dropped. In October, California Gov. Gray Davis vetoed a similar bill. According to a report issued Monday by the Massachusetts Department of Public Health, some 32 percent of all AIDS cases in the state are attributable to IV drug use - about the same number as those cases linked to homosexual transmission. In certain areas of the state, however, as many as 45 percent of cases are linked to IV drug use. "Homeless New Yorkers with AIDS on Rise" New York Blade (11.15.02)::Steve Weinstein The recent New York City Council hearing on the HIV/AIDS Services Administration (HSSA) highlighted the city's increase in homelessness among people with AIDS. Over 30,000 New Yorkers with AIDS currently live in shelters, on the streets, or in inadequate and filthy housing, usually single-room occupancy tenement hotels. The caseload is rising at the rate of about 10 percent each year. "However you look at it, the numbers have gone up since the late 1990s," said Gina Quattrochi, the executive director of Bailey House. Quattrochi pointed to several units that could be available if the city would streamline the approval process for both clients and housing. The situation has gotten so desperate that several people with AIDS are being warehoused in hostels like Rivington House on the Lower East Side. New York City AIDS Housing Network Director Jennifer Flynn echoed Quattrochi's concern. "We could be housing many more [clients] than we are now just by getting them away from bureaucratic barriers." Flynn said prospects of cuts in HSSA "is the most dangerous and short-sighted public policy possible." Emergency shelter costs significantly more than permanent housing in the long run, but the city, under court order, is forced to make such short-term housing available. Such remedies will only perpetuate the problem, advocates say. "The Bloomberg administration is long on p.r. but short on substance," said Armen Merjian, the attorney for Housing Works. "There's no substantive change from the previous administration." "Common sense and public health principles dictate that people with AIDS and HIV are entitled to decent, affordable housing and to the services they need to remain stable, healthy and independent," said Merjian. "Yet society's response to this crisis has been late and inadequate." On Dec. 5, several groups dedicated to housing for people with AIDS will hold a rally on the steps of City Hall. "Churches Join Effort to Give AIDS Alert" Los Angeles Times (12.02.02)::Jeff Gottlieb St. Brigid's Catholic Church in South Central Los Angeles was one of more than 40 predominantly black churches in Los Angeles County that commemorated World AIDS Day on Sunday - some with the message of safe sex, others with abstinence - offering the patients compassion and mercy. St. Brigid's commemorated World AIDS Day with free HIV testing offered by the Charles R. Drew University of Medicine and Science, and members of the congregation were given red ribbons. "I have anointed people, some priests, some lay people, who have died of this disease," said Father John Harfmann. "It's not a pretty thing to see. When we wear this [ribbon], it's not just a symbol. It means be aware." The African-American community has been especially hard hit by the epidemic. According to the Los Angeles County Department of Health Services, African-Americans, who make up 9.5 percent of the county population, account for 20 percent of the AIDS cases and 34 percent of the pediatric HIV cases. Cynthia Davis, director of the university's HIV Testing and Outreach Project, said the highest HIV rates in her testing project are among Hollywood street youth, where they reach 10 percent, and on "skid row", where they range from 3 percent to 5 percent. Though St. Brigid's might still be called a black church, about 30 percent of its members are Latino, Harfmann said. Maritza Aguilar, 32, was walking with her two young children on Western Avenue when she saw the free HIV testing. Although she is married, she decided to get tested for the first time. "With husbands, you never know," she said. "Once in a while, it's good to be sure." HIV counselor Madison Brown said those who are tested must return in a week to get the results. Only about half are expected to show up, she said. St. Brigid's HIV/AIDS ministry also delivers food, companionship and supplies to AIDS patients. ************************************************************ NEWS BRIEFS ************************************************************ "Magic Johnson Says AIDS Medications Should Be Cheaper" Associated Press (12.04.02) During a speech at Drake University in Des Moines, Iowa, on Tuesday, former Los Angeles Laker Earvin "Magic" Johnson said affordable medications to treat AIDS should be available to more people, especially minorities living in the inner cities. Johnson gave a brief speech on living with HIV, saying that new cases have been reported among blacks and women. He stressed the importance of AIDS education, especially in inner-city neighborhoods. Johnson, 43, who remains free of AIDS 11 years after his HIV diagnosis, said he exercises regularly and takes medications. He also said his positive attitude and religious faith have helped keep him healthy. The Martin Bucksbaum Distinguished Lecture, "An Evening with Magic Johnson: A Perspective on HIV and AIDS," drew an estimated crowd of 4,000. "Mandela Backs New Treatment Program for AIDS Sufferers" Associated Press (12.03.02) On Tuesday, former South African President Nelson Mandela gave his backing to a new program to supply medication to 9,000 AIDS patients who cannot afford it. Mandela is to act as the patron of the program, a joint initiative between a charitable foundation bearing his name and the South African government. The treatment program is named for Tshepang, a baby who survived being gang raped last year. The effort hopes to raise 80 million rand (US $8.6 million) from local and international donors. Poverty in the nation is deepening, and most HIV- infected people are being left untreated, Mandela said at the launch. "Talk is necessary but is not sufficient," he said. "The test is what you are doing on the ground." "Amnesty: Rights Crucial in AIDS Fight" Associated Press (12.01.02)::Jane Wardell In a statement on World AIDS Day, London-based Amnesty International called for more efforts worldwide to dispel myths and prejudices surrounding HIV/AIDS. "Those who are on the social margins of society, who are denied access to their most basic human rights - to freedom from discrimination, to education, to physical integrity, to health care and to economic security - are the most vulnerable to HIV infection," the statement said, citing in particular the plight of women in many societies. "Once it is known or suspected that they are infected with HIV they may be stigmatized, subjected to ill treatment, denied entry into foreign countries, rejected by the social service and health care systems or denied housing and employment." "Official: Russia's AIDS Problem Exploding Despite Dip in Official Data" Associated Press (11.27.02)::Eric Engleman Some 43,000 new HIV cases were registered in Russia in the first 11 months of 2002, down more than 50 percent from the 87,000 cases registered last year. But these official statistics are misleading, said Vadim Pokrovsky, the country's top AIDS expert and director of the Center for AIDS Prevention and Treatment. Pokrovsky said the Health Ministry had stopped paying for HIV tests, forcing individual regions to pick up the cost. That means fewer Russians are being tested, and thus a large number of HIV-infected people are not being registered. Pokrovsky estimates that between 800,000 and 1.2 million Russians are currently infected with HIV, while the official total stands at 220,545 HIV cases. Each year, $3.1 million goes to treating HIV in Russia, including the purchase of expensive medicines, while only $781,000 goes to prevention.