Subject: CDC AIDS Daily Summary for 12/10/02 Date: Tue Dec 10 10:41:05 PST 2002 (424 lines) From: National AIDS Info Clearinghouse Copyright 2002, Information, Inc., Bethesda, MD CDC HIV/STD/TB Prevention News Update Tuesday, December 10, 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 "Researchers to Study Florida's Public Health Role in Control and Prevention" INTERNATIONAL NEWS "$2.5 Million Pilot Program Set Up in AIDS Fight" "Battling AIDS, a Song at a Time" MEDICAL NEWS "Efficacy of Strategies to Reduce Mother-to-Child HIV-1 Transmission in Argentina, 1993-2000" LOCAL AND COMMUNITY NEWS "Pownal Woman Will Open Home to People with AIDS" "Inupiat Woman Shares Story of AIDS Tragedy" "Self-Respect Key to AIDS Prevention, Activist Says" NEWS BRIEFS "Old Court Middle Pupils, Teachers to Be Screened" "Stigma of AIDS" "Planned Parenthood Looks to Form Sex-ed Partnership with Churches" "Omaha AIDS Benefit Raises $250,000" ************************************************************ NATIONAL NEWS ************************************************************ "Researchers to Study Florida's Public Health Role in Control and Prevention" TB & Outbreaks Week (12.03.02) STDs remain one of the most preventable yet highly prevalent types of disease in Florida, but the state-run STD clinics, which provide low-cost diagnosis and treatment services, are seeing fewer patients. In order to determine problems associated with diagnosis and STD reinfections in Florida, University of Florida nurse researchers are conducting two studies examining the behaviors, attitudes and motivations toward STDs among people in Florida. The studies will include in-depth interviews and focus groups and will utilize census data and health records to assess why people are not visiting state-run STD clinics and whether they are obtaining treatment elsewhere. The first study will be conducted in Broward, Duval, St. Lucie and Palm Beach counties to gauge people's perceptions of the communities' STD clinics. "It's a big concern because we do not know where these people are going to be treated or if they are even being treated at all," said Sharleen Simpson, PhD, ARNP, director of the studies and an associate professor at the UF College of Nursing. "We can't assume that all of these patients are going to the private sector for care, where oftentimes it is more expensive and requires medical insurance, which patients may not possess." According to a 2000 report from the CDC, more than 65 million people are living with an incurable STD, and 15 million new STD cases are discovered each year, one-fourth of which are contracted by teenagers. However, STDs are one of the most underrecognized health problems in the country today, Simpson said. The researchers' second study will be a collaboration with the State Bureau of STD Prevention and Control and the CDC. The studies are funded by a $160,000 grant from the Florida Department of Health's State Bureau of STD Prevention and Control. Results are expected in 2003. ************************************************************ INTERNATIONAL NEWS ************************************************************ "$2.5 Million Pilot Program Set Up in AIDS Fight" St. Petersburg Times (Russia) (12.03.02)::Robin Munro A comprehensive, two-year program to reduce the spread of HIV/AIDS and STDs among young adults in the Altai and Volgograd (formerly Stalingrad) regions started Monday. The $2.5 million program is intended to serve as a national model for dealing with the AIDS epidemic. "The HIV epidemic had a late start here," UN Resident Coordinator Frederick Lyons said Monday at a news conference. "It's catching up with merciless speed, and Russia is in the region that has had the highest rates of growth in the world in the last couple of years." More than 80 percent of registered HIV cases - 220,545 as of last month - are people under age 30, and more than 20 percent are teenagers, Lyons said. However, because the epidemic is concentrated in distinct high-risk groups - intravenous drug users and sex workers - targeted campaigns could make a large impact, he said. The project is being jointly funded by Britain's Department of International Development and the UN Foundation. It will involve six UN agencies, the US Agency for International Development, the Open Society Institute (Soros Foundation) and federal and regional ministries. Tatyana Shoumilina, program coordinator for UNAIDS in Moscow, said the two regions were selected from 17 with which UNAIDS has worked since 1999 to develop a strategic plan to counter the disease. The Volgograd and Altai regions were chosen for the commitment shown by the regions' nongovernmental groups and administrators and for their collaboration with each other, as well as for the number of UN agencies already operating there. The two regions also complement each other; Siberia's Altai region is agricultural, while Southern Russia's Volgograd is industrial, Shoumilina said. According to federal statistics, registered HIV cases in the Volgograd region rose from 1,605 at the end of last year to 3,047 by Oct. 28. In Altai, HIV cases rose from 2,154 to 2,612. "Battling AIDS, a Song at a Time" Philadelphia Inquirer (12.09.02)::Peter Sigal For nine years, Nomusa Mpanza lived with a secret. In 1993, her newborn daughter was diagnosed with AIDS, and the South African woman realized that she herself was HIV-positive. Yet it was only after her daughter died of the disease this year that she publicly acknowledged her own status. It was a brave step in a country that ostracizes, stigmatizes, and even physically attacks those with AIDS. But she was not content to merely live with HIV. Since May, Mpanza has been part of a 21-member choir of HIV- positive men and women from South Africa touring the United States. They are trying to raise money for costly antiviral drugs, and to help end the fear and animosity felt toward AIDS patients in South Africa, where one in nine people are infected with HIV. The US tour is sponsored by the Church World Service, a New York agency that provides humanitarian aid in developing countries. "It makes me feel great," Mpanza, 29, said Sunday evening before the group performed at the First United Methodist Church of Germantown, Pa. "It helps us show other people that there's life after HIV." The 18 women and three men are outpatients at the Sinikithemba center in Durban, which provides pre- and post- diagnosis counseling, medical treatment, and the opportunity to earn a living through traditional Zulu beadwork. The center sees about 1,800 people a month, social worker Nonnhlanhla Mhlongo said. Mpanza and Bhekani Mbemela, another choir member, said they are battling both ignorance and a government that has been criticized for its intransigence toward the disease. "I don't think our country is ready yet to deal with the situation," said Mbemela, 32. He was diagnosed with HIV in 1998, he said, three years after he first suspected he was infected. "Being HIV- positive doesn't mean death," he said. Mpanza said she dreams of the day when she can finish her education, get a job as a social worker, and build a home for herself and her four-year-old daughter. ************************************************************ MEDICAL NEWS ************************************************************ "Efficacy of Strategies to Reduce Mother-to-Child HIV-1 Transmission in Argentina, 1993-2000" Journal of Acquired Immune Deficiency Syndromes (11.01.02) Vol. 31; No. 3: P. 348-335::Ana Ceballos; María de Los Angeles Pando; Diana Liberatore; Mirna Biglione; Patricia Coll Cárdenas; Marina Martínez; María Luisa Celadilla; María M. Avila; Liliana Martínez Peralta In Argentina, the National Program on Human Retrovirus of the Health Ministry reported 3,526 cases of AIDS in women older than 12 from 1988 to 2000. During that time, the male-to-female ratio of AIDS decreased from 20:1 in 1988 to 3:1 in 2000. During 2000, 166,133 pregnant women were tested for HIV; the prevalence of HIV infection was 0.60 percent. In addition, as of September 2000, 1,255 cases of AIDS in children due to mother-to-child transmission (MTCT) were reported, representing 7 percent of the total AIDS cases in Argentina. The current study describes the trends in interventions to prevent MTCT in HIV-infected parents and their infants in Buenos Aires and surroundings, the area where most HIV-infected people are identified in Argentina. The authors used findings from 874 children under 12 months of age, born to HIV-infected mothers, and their parents. The families were referred from three hospitals in Buenos Aires to the National Reference Center for AIDS (CNRS) for diagnosis of pediatric HIV infection during 1993- 2000. The average age of the mothers was 25.4 years; the fathers' average age was 29.5 years. Eighty-one percent of the infants were younger than 6 months at the first diagnostic visit. The remaining 19 percent were 7-12 months old. Although zidovudine treatment had been offered to pregnant women in some Argentinean hospitals since 1995, it was not until 1997 that the Ministry of Health ruled that diagnosis and treatment of HIV infection for prevention of MTCT should be included in the national medical practice. Of the mothers referred to CNRS for HIV diagnosis for their infants before 1995, 72.4 percent were asymptomatic. The percentage significantly increased to 90.2 percent between 1995 and 2000. During the observation period (1993-2000) 20 of 874 infants, 22 of 636 mothers, and 14 of 341 fathers died of AIDS. From 1993 to 2000, the proportion of HIV-infected mothers who received prenatal treatment for MTCT prevention increased from 3.2 percent to 73.1 percent. Researchers also found an increase in the use of cesarean section, up to 54.8 percent in 1999-2000, when elective cesarean delivery started to be routinely offered to HIV-infected mothers. MTCT decreased from 37.3 percent before 1995 to 10.7 percent in 1999-2000, and 6.5 percent up to September 2001. The proportion of HIV-infected mothers who breast-fed remained steady throughout the study period. Although Argentine medical personnel do not recommend that HIV-infected women breast-feed, and formula feeding is offered free, limited access to information and health care probably accounts for this finding, the authors noted. The most frequent risk factor for the 636 mothers was sexual contact (73 percent) followed by IDU (17 percent). For the 341 fathers, IDU was the most frequent risk factor (67 percent) followed by sexual contact (21 percent). Approximately 42 percent of the mothers studied from 1997 to 2000 knew their HIV status before pregnancy; 44.8 percent knew during pregnancy; and 12.3 percent knew after the birth of their child. Data in this study suggest that MTCT of HIV is decreasing and a consequent decrease in pediatric AIDS cases should be expected in the future. However, the figures on incomplete treatment and diagnosis after birth indicate that many women are not completely aware of the importance of monitoring their infection status during their pregnancies. To improve the universal counseling and testing of pregnant women, there is an urgent need to stimulate the desire and facilitate medical monitoring during pregnancy, particularly among the lower socioeconomic classes. The study also recommended the development of educational programs to improve the awareness of HIV risk among men with a history of IDU who are partners of pregnant women. ************************************************************ LOCAL AND COMMUNITY NEWS ************************************************************ "Pownal Woman Will Open Home to People with AIDS" Associated Press (12.07.02)::Anne Wallace Allen Revolutionary, innkeeper, caregiver: Sunshine Wohl is taking on all those roles as she fearlessly opens her spruced-up Pownal, Vt., farmhouse to AIDS patients who are facing the end of life. Residents will stay free at Wohl's Chrysalis Community, which has five guest bedrooms. While there, Wohl says, they will experience physical and metaphysical renewal through conventional medicine and complements such as reiki healing touch, drumming, yoga, and healing circles. Wohl's goal? To bring about healing - and to create a place "where people can live and die with love." Wohl's type of community will be the first of its type in Vermont, according to those who work with AIDS patients. Vermont CARES, an AIDS service organization in Burlington, has apartments for people with AIDS, but participants have to pay a third of their income to live there, said Executive Director Kendall Farrell. About 220 people in Vermont have HIV, Farrell said. Wohl will start working hands-on with people with AIDS at Chrysalis Community starting late this winter or early next spring. Wohl will choose who lives in the house. There are only two requirements: that they have health insurance, and that they be open, physically and psychically, for the kind of healing that Wohl espouses. Chrysalis Community is a nonprofit. Wohl is the founder and director; her 28-year-old son is the vice president. Because no medication will be administered there, Wohl does not need to undergo a lengthy permitting process to open her home to AIDS patients. People needing medical care can go to Bennington Hospital, said Wohl. She used the money from selling her Williamstown, Mass., house to buy and renovate the farmhouse and its 108 acres, but says donations and volunteering are what will keep it going. If things work out, Wohl would like to expand the community to other homes she would build on her land. She sees Chrysalis as a national movement, if not an international one, that will catch on as treatment of the terminally ill moves away from hospitals and hospices and toward communities that emphasize natural and spiritual healing. "Inupiat Woman Shares Story of AIDS Tragedy" Associated Press (12.01.02) Health officials trying to stem the spread of AIDS among Alaskan Natives are hoping an Inupiat woman will help to crack the wall of silence about the virus in rural Alaska. Selina Moose is traveling from village to village telling the story of her 40- year-old brother, who discovered he was in the advanced stages of AIDS last summer. The family decided to go public, sharing the news with their village of 400 in the Northwest Alaska Native Association (NANA) region. They held a village meeting. Shocked at first, people came to respect their honesty, especially the elders, health officials said. "HIV can wipe a village out," Moose told a crowd recently marking World AIDS Day at the Alaska Native Heritage Center. "We had to tell our people because not telling them meant extinction." Today, Moose's brother is battling AIDS without medication, at home. He is getting visits from friends and eating local foods, she said. Moose's story could go a long way, health officials said at the ANHC meeting, because AIDS is not discussed much among Alaska Natives. Natives often do not discuss sexuality openly, complicating efforts to raise awareness of prevention and treatment, said Diane Johnson-Van Parijs, development director of the Alaskan AIDS Assistance Association. Alaska Natives have accounted for nearly a quarter of Alaska's roughly 820 reported HIV cases, yet represent 16 percent of Alaska's population. More than 130 people have died of AIDS in Alaska. Most HIV cases are among urban Natives, said Michael Covone, HIV/AIDS prevention program manager for the Alaska Native Health Board. But nobody knows how big the problem is in villages because nobody wants to talk about it, Covone said. "What Selina has done is open discussion... If every Alaska family did this, HIV would be a very different disease." To combat the stigma of AIDS in rural Alaska, ANHB has created a series of public service announcements in English and Yupik, likening AIDS to earlier diseases brought to Native communities by Europeans, such as smallpox, tuberculosis and influenza. "Self-Respect Key to AIDS Prevention, Activist Says" Oakland Tribune (12.01.02)::Suzanne Bohan Paulette Hogan, who has performed in musicals since she was a child, said her favorite role yet was Evileen in the "The Wiz," when she sang "Nobody Bring Me No Bad News." But the 39-year-old Oakland resident got almost more bad news than she could bear in February 2001. Hogan learned she was HIV-positive. "There's this wonderful life that I've had. I was knocking on all kinds of doors," she said in an interview, "But when I tested positive, for some reason my knock was stopped. I didn't know how much time I had." Hogan's knocking on doors again, however, and this time it's with an impassioned message: The best protection against HIV/AIDS is self-respect. "When you respect yourself, you do not allow yourself to get involved in risky behavior," Hogan said. Hogan, who is also an ordained minister, now travels the country spreading her gospel. This summer, she addressed about 2,000 people at Detroit's gay pride festival, and in honor of World AIDS Day, she talked to about 400 people at the Berkeley, Calif., church she attends. The mother of two teenagers struggled for months with shock and fear, and felt isolated even in the HIV/AIDS support groups she attended. But an encounter with Women Organized to Respond to Life-Threatening Disease, an Oakland advocacy group for HIV- positive women, lifted her attitude. "It was the beginning of my living again," Hogan said. What women need most to protect themselves from HIV, Hogan emphasized, is better self-care. "Among African-American women, the rates will continue to rise until we start feeling better about ourselves," she said. "We must start taking care of ourselves. Stop using the ER as your primary care," and visit a doctor for checkups and at the first sign of illness, she said. And, she emphasized, get tested for HIV. "It's far better to know your status," Hogan said. ************************************************************ NEWS BRIEFS ************************************************************ "Old Court Middle Pupils, Teachers to Be Screened" Baltimore Sun (12.10.02)::Jonathan D. Rockoff A seventh-grader at Old Court Middle School has tested positive for tuberculosis, the Baltimore County school system said yesterday. County health workers are preparing to test classmates and teachers who might have come in contact with the pupil, said Charles A. Herndon, a school system spokesperson. The pupil, who was not identified, was found to have the communicable disease about a week ago, said school spokesperson Douglas J. Neilson. The seventh-grader has a sibling at Winand Elementary School, but the sibling did not contract the disease and the system has no plans to test pupils at that school, Neilson said. "Stigma of AIDS" Washington Times (12.03.02)::James Morrison South African Ambassador Sheila Sisulu criticized African governments and businesses for contributing to the stigma people with AIDS suffer along with the disease. Sisulu, speaking last week at an AIDS Forum at the Center for Strategic and International Studies, said some African mortgage companies require loan applicants to submit to an AIDS test, and some insurance firms will refuse to pay claims if their clients die within two years of receiving life insurance policies. The ambassador said those policies add to the stigma and discourage people with AIDS from disclosing their disease and seeking medical help. "Planned Parenthood Looks to Form Sex-ed Partnership with Churches" Associated Press (12.05.02) Planned Parenthood wants to work with churches and clergy in two Indiana cities to form a faith-based program on sexual education. The group hopes to begin the program in Fort Wayne and Indianapolis, cities chosen because the teen birth rates are higher than the national average. "We believe a faith-based setting is ideal for sexuality education programming since religious values can provide a solid foundation for these programs to be built upon," Kathleen Baldwin, vice president for education and training for Planned Parenthood of Greater Indiana. The program will be financed by a $50,000 grant from the Nina Mason Pulliam Charitable Trust and a $48,000 grant from the Florida-based Engelberg Foundation. No churches have yet agreed to participate. "Omaha AIDS Benefit Raises $250,000" Associated Press (12.09.02) The 10th Annual Night of a Thousand Stars in Omaha over the weekend raised an estimated $250,000 for AIDS prevention efforts. Sponsored by the Nebraska AIDS Project, 80 dinner parties were held throughout Omaha for the event, where hosts charged guests for attending and then donated the proceeds to NAP, said Tim Sullivan, the group's executive director. After the dinners, participants gathered at Regency Court for desserts and cocktails. Sullivan said about 3,500 people attended. Money raised from the event will go toward educational programs and direct services for clients and their families coping with AIDS in Nebraska and southwest Iowa, Sullivan said.