Subject: AIDS Treatment News #130
Date: Jul 12 1991 (829 lines)      

&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&
J O H N   J A M E S  writes  on  A I D S
&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&

Copyright 1991 by John S. James;
permission granted for non-commercial use.

AIDS TREATMENT NEWS Issue #130, July 12, 1991
   phone 800/TREEAT-1-2, or 415/255-0588

CONTENTS:  [items are separated by "*****" for this display]

Seventh International Conference on AIDS:
   Vaccine Development
Neuropathy Update
New Trial Recruiting at NIH:  CD4-PE40
Newsletters for Women, Children with HIV
Prison and AIDS Update
Announcements:  Date correction; Atlanta buyers' club;
   SEARCH Alliance; Night hotline; AIDS scams;
   Travel ban letters due



*****

Seventh International Conference on AIDS:
      Vaccine Development

by Michelle Roland

     Much of the Seventh International Conference on AIDS (June
16-21 in Florence, Italy) was devoted to presentations about
vaccine development in laboratory studies, animal models, and
human trials.  Although vaccines have traditionally been used to
prevent uninfected individuals from acquiring a new infection,
much of the HIV-related vaccine research is expected to be of use
to people who are already HIV-positive.  In this article we will
provide a brief overview of the status of vaccine trials, in
addition to relevant news from the Florence conference.  We will
focus mainly on the results of studies in HIV-infected
individuals.

General Overview

     There are currently 13 vaccines in various stages of human
testing around the world, including six which are being used in
HIV-positive volunteers in an attempt to produce an effective
immune response against the virus. Several different approaches
are being tried.  The overall goal is to use a substance which
resembles all or part of HIV and which the human immune system
will see as foreign and thus attack.  The products generated by
this immune response, including antibodies and special types of
activated white blood cells, would hopefully also be effective
against HIV in the bloodstream, and HIV-infected cells, in
people who are already HIV-positive.  In order for a vaccine to
be useful in this population, the immune response to the vaccine
will have to be more effective than that which occurs in the
great majority of people after HIV infection.

     The substances used in the various vaccines are produced by
one of the following methods.  The whole virus can be killed or
inactivated; the Salk HIV vaccine uses this whole killed virus
approach.  Alternatively, small portions of the virus, including
parts of its outer coat (envelope), or portions of its inner
(core) proteins, can be produced by genetic engineering
technology.  These are called the subunit vaccines.  Another
approach, using synthetic peptides, is also being tested; these
are similar to subunit vaccines, but are smaller and produced
using different techniques.  (A peptide is simply a small part of
a protein.)  Finally, some researchers are inserting the gene for
one or more of these proteins into different microbes (viruses,
yeast, bacteria, etc.)  which then produce the protein.  When
these microbes, known as vectors, are injected into people, they
make the HIV proteins which they were genetically engineered to
produce.  This approach is known as the recombinant vector
vaccine. Combinations of these, and other methods of vaccine
production, are currently being tested.

     In the United States at least five vaccine candidates are in
trials separately or in combination with one another. (1)
MicroGeneSys is studying a gp160 subunit vaccine called VaxSyn
(gp160 is a protein which is found in the outer envelope of HIV).
(2) MicroGeneSys has also produced a p24 subunit vaccine (p24 is
one of the inner core proteins of HIV).  (3) Bristol-Meyers
Squibb has a recombinant gp160 vaccine.  By inserting the gene
for gp160 into the vaccinia virus, the modified virus makes gp160
in the human body.  (The vaccinia virus is the same one used for
many years for smallpox vaccines.)  (4) Viral Technologies is
testing HGP-30, a synthetic peptide fragment of p17, one of the
core proteins of HIV.  (5) The killed-virus vaccine developed by
Jonas Salk, M. D., is also in U. S. human trials; however, no new
information about it was presented at the Florence conference.

     The AIDS Vaccine Evaluation Units (AVEUs), a group of five
universities, are the Federal Government's primary testing sites
for vaccines.  The AVEUs are located at Johns Hopkins University,
St. Louis University, University of Rochester, University of
Washington in Seattle, and Vanderbilt University.  They have only
tested vaccines in HIV-negative volunteers so far, looking for
safety data and for the degree of immune response.  Two vaccines
are also being studied at the National Institutes of Health (NIH)
in Bethesda, Maryland; neither of these trials is now recruiting
new volunteers.  For information on vaccine trials in the U. S.,
call 800/TRIALS-A.

     Outside the U. S., the drug companies Chiron and Ciba-Geigy
are jointly developing a gp120 vaccine (gp120 is another envelope
protein).  A French scientist, Daniel Zagury, M. D., from the
University of Paris, is using a novel combination approach which
includes some of the products discussed above, in addition to
inactivated white blood cells and inactivated products of these
cells, in an attempt to restore immune function in people with
HIV infection.

Florence Conference News

     The overall sentiment of researchers at the Florence
conference can be summarized in the following statement by
Anthony Fauci, M. D., the U. S. government's highest official
AIDS researcher, from the opening session of the conference:
"...Vaccine development creates an imposing challenge to the
biomedical research community...  Hopefully, and I am optimistic
in this regard, we will witness the availability of a safe and
effective vaccine against HIV in the decade of the 1990s."
According to Daniel Bolognesi, M. D., one of the leaders in HIV
vaccine research from Duke University, several vaccines should be
ready to enter large-scale human trials for testing of
effectiveness in the next three years.  Currently, several small
clinical trials are ongoing.  We will describe the preliminary
results of most of these studies as they were presented at the
conference.

Subunit Vaccine:  VaxSyn

     The recently published report from the Walter Reed Army
Institute of Research, using VaxSyn in thirty HIV-positive
volunteers with greater than 400 T-helper cells, received
widespread media attention in the United States during the week
of the Florence conference (Redfield RR, Birx DL, Ketter N, and
others.  A phase I evaluation of the safety and immunogenicity of
vaccination with recombinant gp160 in patients with early human
immunodeficiency virus infection.  New England Journal of
Medicine, June 13, 1991; volume 324, number 24, pages 1677-1684.)
This study found that the vaccine was safe and caused an immune
response in 19 of the 30 volunteers.  Those who were able to
mount an immune response tended to have higher T-helper cell
counts when they entered the study; they were also more often in
the group which received six injections rather than three.  T-
helper cell counts remained stable in the 19 vaccine responders
over a ten-month period, but dropped approximately seven percent
in the group which did not respond, suggesting that the immune
response to the vaccine may have had some protective effect.

     Another small study of VaxSyn, looking at two doses in 20
patients in Montreal, was presented at the conference (abstract #
M. A. 1329).  Eight of the nine patients who had been followed
for over 180 days were reported to have developed an increased
antibody response.  In addition, T-helper cell counts stabilized
above their baseline values, and HIV could not be cultured from
the blood.

     VaxSyn is also being studied in HIV-negative volunteers and
at several other sites in people with HIV infection.  In addition
to studies of this compound by itself, it has been combined with
several other vaccine approaches.

Combination of Two Subunit Vaccines:  VaxSyn Plus p24

     Gary Blick, M. D., from Greenwich, Connecticut, reported on
the first of two community-based trials of gp160 (the VaxSyn
product) in combination with a recombinant p24 vaccine (abstract
# M. A. 1343).  In the first study, data from 25 patients,
including 16 without symptoms and nine with AIDS or symptomatic
HIV infection, were presented.  The vaccines appeared to be safe
and well tolerated.  p24 antibodies were increased; analysis of
the response to gp160 has not yet been completed.  After five
months the majority of patients with initial T-helper cell counts
above 200 demonstrated small but statistically significant
increases in their T-helper cell counts and other T-cell
measures.  There were no significant increases in the group with
T-helper counts less than 200 at study entry.  Five of 30
original patients withdrew from the study because of development
of new opportunistic infections.

     Dr. Blick began a second study in May of this year in which
all volunteers receive gp160, but half are randomized to receive
the p24 vaccine in addition, with the other half receiving a
placebo.  This study is designed to learn if adding the p24
increases the effectiveness.  In addition, this vaccine will be
given by a different route than that used in most other HIV
vaccine trials -- by intradermal instead of intramuscular
injections.  It is possible that the vaccine will produce a
greater immune response when deposited directly under the skin,
where large numbers of immune cells are located.

     All three of the studies using VaxSyn suggest that this
vaccine, either alone or in combination with a p24 vaccine, does
cause an immune response.  There is also preliminary data
suggesting that there may be some clinical benefit for
individuals with relatively high T-helper counts.  None,
however, have proven to be effective in helping people with HIV
infection stay healthier longer.  It is impossible to know
whether the immune response elicited by the vaccine will be more
helpful than that which the body creates on its own in response
to HIV infection.  It is clear, however, that the immune response
elicited to VaxSyn is different from that elicited by HIV
infection (see abstract # M. A. 1344).

     Larger, controlled trials will be required to determine if
this vaccine will be helpful clinically.  It will also be
important to learn how to use it in combination with other
vaccines, in combination with antiviral and/or immune-enhancing
drugs, or when administered by different routes, in different
dosages, with different frequencies, etc.  None of the studies so
far can answer these questions; they do, however, show the
importance of further research in this area.

     Live Virus Vector Priming Followed by Subunit Boost: HIVAC-
1e, Then VaxSyn

     Two studies, one in macaque monkeys and one in HIV-negative
people, demonstrated that a technique of using two different
types of vaccine elicited a larger, potentially more effective,
immune response than did either approach alone.  Barney S.
Graham, M. D., Ph.D., from Vanderbilt University's AVEU, reported
on a small study using Oncogen/Bristol-Myers Squibb's recombinant
gp160 vaccinia virus vector (called HIVAC-1e) as a priming
immunization, followed several months later by a booster
immunization with VaxSyn (oral presentation # F. A. 1).
According to the study authors, this combination produced a
larger, longer-lasting immune response than either had produced
alone.  In addition, a greater proportion of those immunized with
both vaccines produced so-called neutralizing antibodies, which
are expected to be effective against HIV.

     Shiu-Lok Hu, M. D., of the University of Washington reported
on a study in macaque monkeys using this same approach (abstract
Th.A. 12).  These monkeys were protected against infection with
SIV (simian immunodeficiency virus, which is similar to HIV and
infects some kinds of monkeys).  Dr. Hu only used one strain of
SIV, the same one from which the vaccines were developed; it is
not known if this approach would protect the monkeys from
infection with another SIV strain.

     Dr. Bolognesi noted that the human trials reported by Dr.
Graham, and being conducted at the University of Washington in
Seattle by Larry Corey, M. D., are showing impressive immune
responses in HIV-negative volunteers (keynote speech, June 21
plenary session). However, he warned that the vaccinia virus
vector may not be safe for use in HIV-positive individuals.
Developing alternative vectors is therefore crucial for the
application of this approach to those who are already HIV-
infected.  He described ongoing research into several alternative
vectors, and stated that a combination of vectors and a
combination of subunits will probably be even more effective.

Combination Vaccine Approach

from France

     A French researcher, Daniel Zagury, M. D., discussed his
results from an uncontrolled trial of six individuals with HIV
infection (abstract # M. A. 67).  Dr. Zagury's strategy combines
a number of different elements into what he calls an anti-
cytostatic immunization regimen.  Although he claims that the
patients in his trial have all experienced either stabilization
or increases in T-helper cell counts and weight, in addition to
other clinical and laboratory signs which suggest improved immune
function, criticisms of his program voiced at the conference were
significant.  Researchers were concerned that Dr. Zagury tested a
combination of compounds without testing each one individually,
making it impossible to determine which one or ones were
effective.  In addition, he was criticized for not using a
control group to see if there was a difference between those
patients treated and those who remained untreated.

     Although valid concerns were raised, it was impossible to
tell how much of the criticism arose from historical hostility
which many of those present at the conference seem to feel
towards Dr. Zagury.  In any case, Dr. Zagury's combination of HIV
peptides, HIV pseudovirions, inactivated alpha-interferon and
inactivated suppressor T-cells, a combination which he devised
based on a new theory of immune function and dysfunction in HIV
infection, is intriguing.  The results he claims suggest that
this approach deserves serious consideration.

Conclusion

     In addition to the human studies discussed above, many
reports of progress in the design of new and improved vaccine
approaches, and early animal studies in various models of HIV
infection, show hopeful signs in the development of safe and
effective vaccines.  These studies could lead to development of a
significant additional tool for the treatment of HIV.  For this
goal to be achieved, significant funding, along with
international scientific and political cooperation, will be
crucial.


*****

Neuropathy Update

by Denny Smith

     Issue #121 of AIDS TREATMENT NEWS contained a short overview
of possible treatments for HIV-related peripheral neuropathy,
with a call for our readers to share their experience with us.
Two people did so, and we relay that information below, as well
as some brief news regarding neuropathy presented at the Seventh
International Conference on AIDS in Florence.

     A number of studies of peripheral neuropathy were discussed
at Florence, but most of them dealt with laboratory descriptions
of cell pathology more than treatment for neuropathy.  An Italian
study from the University of Pavia described the development of
neuropathy in patients after treatment with AZT (abstract # M. B.
2115).  AZT is already associated with muscle tissue damage, or
myopathy, after prolonged use in some people.

     Preliminary results of the California mexiletine study that
we mentioned in our last neuropathy report were included in the
Conference abstracts.  The authors state that mexiletine has been
well-tolerated in the study participants, but proof of efficacy
is not yet established (abstract # M. B. 2068).

     After our last report on neuropathy, one friend of the
newsletter called to say that had he obtained substantial relief
with chiropractic treatments.  His neuropathy was apparently
caused not by HIV but by a three-week regimen of intravenous
pentamidine.  Following the pentamidine he experienced a severe,
chronic pain in one arm which was diagnosed by his primary
physician as neuropathy.  Our friend sought the attention of an
HIV-knowledgeable chiropractor, who initiated weekly treatments.
Within ten treatments he noticed nearly complete relief from the
neuropathy.  (Drug-induced neuropathy can often resolve itself if
the problem drug is discontinued or reduced in dosage soon
enough.)

     Jeanne Day of the Community Research Initiative of New
England told us that they are conducting a study of acupuncture
to treat HIV-associated neuropathy.  This study, funded by the
American Foundation for AIDS Research (AmFAR), began recruiting
last November and is still open to new participants.

     Ms. Day said that although it is too early to report the
results of formal neurological assessments, the acupuncturists
administering the treatments are optimistic with their patients'
progress so far.  People interested in the study can call
617/424-1524. Incidentally, a very good general discussion of
acupuncture therapy in HIV infection appeared in the May 15,
1991, edition of Treatment Issues, published by the Gay Men's
Health Crisis in New York.

     Fortunately, many of the drugs now tried experimentally to
relieve neuropathy, including nortriptyline, imipramine,
mexiletine, and topical preparations of capsaicin, are already
approved for other indications and so are available for the cost
of a prescription.  But looking for conceptually new options in
established forums like the International AIDS Conferences can be
unrewarding. Sustainable, low-cost treatment possibilities like
acupuncture represent an innovative direction in AIDS research,
but will probably require community interest and community-based
organizations to do the research which is necessary.


*****

New Trial Recruiting at NIH:  CD4-PE40

by Michelle Roland

     The first study of a new compound, called CD4-PE40, is
currently seeking volunteers with T-helper counts of 500 or less.
They must be willing to abstain from all other experimental
therapies for four weeks prior to the trial and during the course
of the four-week study; they may, however, take AZT if they wish.
This is a dose escalation study looking primarily at how the new
drug behaves in the body (pharmacokinetics) and at
safety/toxicity.  It requires at least three days of
hospitalization and three subsequent outpatient visits at the
National Institutes of Health (NIH) in Bethesda, Maryland, near
Washington, D. C. This is not a long-term treatment trial; there
are not expected to be any medical benefits for study
participants.  For more information, call Chris Boenning, R. N.,
M. S. N., at 800/772-5464, ext. 410, or Betsy Herpin, R. N., M.
S. N., at ext. 304.

     Note:  Earlier clinical trials of soluble CD4 (and of CD4-
IgG, the CD4 molecule with an IgG antibody attached to it to keep
the compound in the bloodstream longer) have been disappointing,
demonstrating no substantial signs of effectiveness in spite of
dramatic anti-HIV results in test-tube studies.  While most of
the human trials of these compounds in adults are being
abandoned, researchers at The Upjohn Company and the National
Institutes of Health hope that by attaching pseudomonas exotoxin
(PE40, a truncated form of a poison produced by the bacteria
pseudomonas) to the CD4 molecule, they may achieve significant
antiviral activity in people, as well as in laboratory studies.

     Richard Davey, M. D., the principal investigator for this
study, explained that part of the problem with previous CD4
molecules may have been that not enough of the drug was able to
bind to HIV in the bloodstream to prevent the virus from
infecting cells.  It is hoped that the new compound will only
need to bind to a few receptors on an HIV-infected cell in order
to kill that cell.  Dr. Davey believes that if this compound is
helpful, it will probably need to be used in combination with
antiretrovirals such as AZT, ddC, ddI, or one of the newer agents
now being developed.  The reason is that when HIV-infected cells
are killed, virus may be released into the bloodstream, and
antiviral drugs may then be needed to prevent the freed virus
from replicating further.

     The idea of combining CD4 with pseudomonas exotoxin is not
new; a report that the combined protein selectively killed HIV-
infected cells was published in Nature, September 22, 1988.  The
trial announced above is the first human test of this potential
drug.


*****

Newsletters for Women, Children with HIV

by Michelle Roland

     * The Positive Woman is a national newsletter by and for
HIV-positive women and their families and friends.  It includes
news on standard medical treatments, "alternative" treatments,
referral information, and letters from subscribers.  Recent
issues have included articles on legal matters, sexuality,
spirituality, vaccine and drug trials, and a listing of
Washington, D. C. area clinics which provide care to persons who
are homeless.

     The Positive Woman is published every other month. Yearly
subscriptions are $12 for individuals, $40 for non-profit
organizations, and $75 for businesses.  For more information call
202/898-0732, or write to The Positive Woman, P. O. Box 34372,
Washington, DC 20043.

     * WORLD  (Women Organized to Respond to Life-Threatening
Diseases), a new monthly newsletter in English and in Spanish, is
published for women with HIV in Northern California.  The first
issue includes an article on gynecological manifestations of HIV,
listings of support groups, a calendar of events, information on
research studies and political groups, and a personal
testimonial.

     The second issue expanded coverage of events from the San
Francisco area to Northern California; coverage will expand
beyond Northern California when women in other areas express
interest.  Future plans include a series of informal surveys to
assess the needs, thoughts, and desires of women living with
AIDS.

     WORLD is free, but donations are appreciated.  To be
included on the mailing list, or for more information, write:
WORLD, P. O. Box 11535, Oakland, CA 94611, or phone 415/658-6930.
Specify whether you want the English or the Spanish edition.

     * Children with AIDS, published every two months, covers
medical issues, legal issues, social services, and the needs of
drug-exposed and of HIV-positive children and their families.
Articles are targeted to professionals working with children,
family members, policy makers, and the public.  Recent issues
have included articles on civil rights for children with AIDS or
HIV, and reports from the Sixth National Pediatric AIDS
Conference and from the First National Conference on AIDS and
Homeless Youth.

     Annual subscriptions are $25.  For more information, write:
Children with AIDS, 1800 Columbus Avenue, Roxbury, MA 02119, or
phone 617/442-7442.  Article submissions also welcome.


*****

Prison and AIDS Update

by Denny Smith

     Issue #126 of AIDS TREATMENT NEWS included an interview with
three physicians who work at a California correctional facility
in Vacaville -- Drs. Jessica Clarke, German Maisonet and Jan
Diamond.  Since then, a number of related developments have come
to our attention.

Reports of Poor Treatment

     The HIV medical care at Vacaville is provided by
compassionate and expert physicians.  The care for inmates at
many other prisons, however, and during transfers between
prisons, is inadequate or neglectful. We have been told, by
trusted sources, of very ill persons who were housed in a simple
infirmary for two months or more before transfer to a medical
facility equipped to treat AIDS.  By the time they were finally
moved, some were sick with infections that long had gone
untreated at the previous facility.  For example, one man known
to have less than 100 helper cells had been experiencing severe
headaches for three months without receiving a diagnosis.  By the
time he was transferred to an appropriate physician, he was found
to have very advanced cryptococcal meningitis, renal failure, and
hearing loss, conditions which might have been controlled with
timely treatment.  Another man was transferred with advanced
disseminated tuberculosis, and he died three days after the
transfer.  Diagnosed early, TB is a completely treatable disease.

     We were told that a common problem is undiagnosed changes in
mental status.  HIV-related processes can result in erratic
behavior in some people.  But in prison, a change in someone's
behavior frequently will be labeled a disciplinary problem, so
that people who require medical intervention for neurologic
infections, or HIV-related dementia, may easily find themselves
in "lockdown" instead.

Interview With James Camarillo

     After reading the Vacaville interview, James Camarillo, who
is now incarcerated there and has actively challenged some of the
regressive policies of the California Department of Corrections,
contacted us to share his experiences.

     DS:  James, is Vacaville the only prison that you're
familiar with?

     JC:  No, before this I was at Chino East.  That's where I
found out I was HIV+.  I got no counselling, just notification
that I'd be transferred.

     DS:  How was the care there?

     JC:  It was poor, even before they knew I had HIV.

     DS:  How do you feel about the care you've gotten since you
were transferred to Vacaville?

     JC:  It's better; they have three doctors who know what
they're doing.

     DS:  I understand that you have been involved in a class-
action suit.  What was the basis of the suit?

     JC:  To get the same education and job opportunities that
guys on the mainline have.  Segregation is an obstacle to those
opportunities.

     DS:  What about the concern voiced by the correctional
system that inmates known to be positive might be targets of
violence?

     JC:  That's changed.  Some of us have been educating inmates
on the mainline.  We're accepted now.  A lot of them know that
they could have HIV, too, but they don't want to be tested
because they don't want to be segregated.

     DS:  So they could actually be missing out on treatment they
may need, for fear of segregation.

     JC:  That's right.

     DS:  The rules against condoms -- does anyone have access to
them?

     JC:  Only for conjugal visits, and afterwards you have to
return the condoms, used or not.  Anyone caught with a condom
outside of a conjugal visit gets a disciplinary writeup.  And
inmates known to have HIV aren't even allowed conjugal visits.

     DS:  That's outrageous.  Regarding treatment information,
would inmates make use of printed material if it was available to
them?

     JC:  Yes, they would; in fact, Dr. Diamond here tried to
provide some reading materials for us in segregation, but the
guys on the mainline need it, too.

     DS:  It sounds like what you want is what the doctors there
would like as well -- an end to segregation, conjugal rights for
inmates with HIV, unpressured testing and treatment information
for those on the mainline, and condoms for everyone.  What would
you say to people in prisons elsewhere, especially in other
states, where conditions are sometimes much worse?

     JC:  Legal action.  I used to sit in the little yard set
aside for us with HIV, reading books that a prison library clerk
would bring me.  One day I asked him, "How can I ever get out of
here [segregation]?" He said "File a lawsuit."  I didn't know
where to start, so he gave me a book, and that's how I got going.
It's the only thing they will listen to.

Interview with Mary Lucey

     During a recent state activist conference in May, we met
Mary Lucey, who began working with ACT UP/LA after her release
from the women's prison in Southern California.  Following are
highlights of a conversation we had.

     DS:  Mary, you were held at the California Institute for
Women?

     ML:  Yes, at Frontera.  There are other facilities for
women, but Frontera is where any woman known to have HIV is sent.
During the transfer to Frontera, they told me I had to wear a
mask.  But the weather was really hot, and I refused to put the
mask on.  They punished me by turning off the air conditioning.
When we arrived at Frontera they immediately took my AZT away
from me.  They said I had to be evaluated by a doctor first, and
be tested for HIV antibodies, have my blood counts done, and then
I could have AZT.  Well, we're talking about a six-month delay.

     DS:  Are inmates with HIV segregated at Frontera?

     ML:  Yes, and in fact, the fear of being segregated
discourages women on the mainline or at other facilities from
being open about their serostatus, or getting tested to find out.

     DS:  Just like at the men's prisons.  It makes early
treatment an impossibility for those people.

     ML:  And segregation also means no private visits with their
kids or spouses, no conjugal visits.

     DS:  What's the care like in the segregated section of
Frontera?  Is bloodwork monitored on any regular basis?

     ML:  Well, the unit is called Walker A, and it has 40 beds.
It's surrounded by a white mesh fence that you can't see through.
The unit itself houses anyone with HIV, regardless of their
health requirements, regardless of their conviction or sentencing
status.  Bloodwork is drawn maybe every six months.  Frontera is
the largest women's prison in the United States, but there is no
infectious disease specialist on staff; in fact, the chief
medical officer of the prison is a psychiatrist with no HIV
expertise.

     DS:  That tells you something about their attitude toward
women who are sick -- all they need is a psychiatrist.

     ML:  Right.  It's all in our heads! They do have a counselor
for the unit, and she's called "the grim reaper" because of her
"you're going to die" negativity.  She once asked me "So what is
the average T-cell count for a healthy person?" I had to be her
teacher.  The M.D.s aren't HIV-educated, either.  A major
problem if you become sick in there is just getting them to know
that you're sick.  Then, if they're nice enough, they'll try to
help.  If not, if they think you're faking it, well, you could
die.

     DS:  What about the charges that lack of medical attention
has contributed to unnecessary illnesses and deaths?

     ML:  One time when I was on the mainline, I came down with
hepatitis.  I was bright yellow, and I'd lost 20 pounds -- I
obviously had hepatitis.  They gave me an appointment six weeks
away.  But I marched into the clinic and just said, "Look, I'm
seeing a doctor today."  So they put me in isolation in the
prison hospital, but didn't treat me.  Doctors don't make rounds
there -- they come by and count you three times a day.  I became
really dehydrated and scared.  Finally I caught a sergeant's
attention by beating on the door.  When she saw the shape I was
in, she ordered juices and medication for the diarrhea and
nausea.  Another woman, a transsexual, was dead for three days in
her cell before they noticed her food trays stacking up.
Sometimes medical officers have been caught falsifying death
records.  One woman who is still quite alive was reported as
deceased several months after she appeared at a hearing to
testify against the prison.  But a lot of women in institutions
don't know how to fight for themselves.

     DS:  If they could, a lot of them probably wouldn't be
there.  Everything you're talking about sounds like lawsuit
material.  Is there any legal action taking place now?

     ML:  There are some class-action suits going on, but they're
not resolved yet.  We've testified in Sacramento, and were
essentially ignored.  John Burton [California state assemblyman]
was great at the hearings, though.  He jabbed the Department of
Correction's policy on limiting visits for HIV+ inmates by asking
if the Department was worried that incarcerated women might
infect their kids by having sex with them during visits.  They
said "No, of course not".  Then he asked if they were afraid they
might give their kids drugs.  "Oh, no, no.  " Finally he
said,"OK, I got it.  They're performing minor surgery."

     DS:  The joke was on them, but I bet they didn't even know
it.

     ML:  Well, these women know it.  There are some real
fighters in there trying to make waves.  I know one woman who has
been fighting tooth and nail, even with CMV and encephalitis.
Now she's ready for a hospice, but there's no hospice to go to.
These women call me on the phone and they're crying, they're
scared to death. Sometimes I lay awake at night trying to come up
with some way to move the sons of bitches who control the
correctional system.  People who want to support us should write
to James Gomez, the Director of Corrections [1515  S  Street,
Sacramento, CA, 95814].  Tell him we need a real infectious
disease specialist for those women. And they have to improve the
nutrition of their meals. And we want an end to HIV segregation.

Treatment Libraries Proposal

     Joe Guimento, Research Coordinator for the AIDS/HIV
Treatment Directory published by the American Foundation For AIDS
Research (AmFAR), called us after the Vacaville interview to say
that AmFAR also receives a substantial amount of correspondence
from prisoners who need current treatment information.  Joe
proposed to us and to Judy Greenspan of the National Prison
Project of the American Civil Liberties Union the idea of HIV
"minilibraries" in every correctional institution -- collections
of printed material which could relieve individual inmates from
having to search for information by mail, and vastly improve the
access prisoners in general have to treatment developments.

     The libraries could grow in scope as possible, but would
begin with subscriptions to some basic community news sources --
BETA, Notes From the Underground, PI Perspectives, and Treatment
Issues -- as well as AmFAR's AIDS/HIV Treatment Directory and
AIDS TREATMENT NEWS.  Prisoners or correctional workers who are
interested in establishing such a library should write to Joe
Guimento at AmFAR, 1515 Broadway, Suite 3601, New York, NY,
10036.


*****

Announcements

** Correction:  Date of Last Issue

     Our last issue was incorrectly dated July 26.  The date
should have been June 28.

     AIDS TREATMENT NEWS is usually published on the first and
third Friday of each month.  The June 28 and both July issues
have been delayed a week due to travel to conferences.  Our next
issue will be dated July 27 (a Saturday), to avoid the confusion
of July 26 appearing as the date on two issues.

** Atlanta:  New Buyers' Club

     People living in the Atlanta area will have increased access
to some promising HIV and AIDS-related treatments through a new
buyers' club opening there. The Atlanta Buyers Club (ABC), is a
non-profit community organization pledged to offer its members a
forum for information and a source for alternative treatments.
Like other buyers' clubs around the country serving people with
HIV, ABC cannot make professional medical recommendations.  ABC
members will be encouraged to discuss all treatment decisions
with their doctors, and the organizers of the club told us that
they are seeking productive communication with HIV health
providers in Atlanta.

     To contact ABC, interested persons may call 404/874-4845,
or write to P. O. Box 77003, Atlanta, GA, 30357.

** SEARCH Alliance Seeks Executive Director

     SEARCH Alliance, a community-based AIDS treatment research
organization in Los Angeles (see AIDS TREATMENT NEWS #105, June
15, 1990) is looking for an executive director.  The candidate
must have proven fundraising ability and strong administrative
experience. Send resume to:  William Zimmerman, Suite 901, 14724
Ventura Blvd., Sherman Oaks, CA 91403.

** San Francisco:  HIV "Nightline" Sponsored by Suicide
   Prevention Project

     Two years ago, San Francisco Suicide Prevention established
a hotline to offer nighttime support and information to people
with emotional concerns about HIV.  The "AIDS/HIV Nightline," the
only service of its kind in the U. S., receives calls from around
the country, and is staffed by volunteers who are trained to
speak compassionately and knowledgeably about a range of issues
related to HIV infection and crisis intervention.

     The line is open 9 p.m. to 5 a.m. on Mondays through
Fridays, and 5 p.m. to 5 a.m. Saturdays and Sundays.  The number
to call from San Francisco and outside of Northern California is
415/668-AIDS, and throughout Northern California, 800/273-AIDS.
Volunteers and donations for the Nightline are welcomed.

** AIDS Frauds and Scams:  Journalist Seeks Interviews

     The Center for Investigative Reporting (CIR) in San
Francisco has been asked to provide an article on AIDS fraud for
a publication which goes mainly to physicians' offices.  We spoke
with Sarah Henry of CIR, who is doing this story, and found that
unlike many reporters who approach it, she is well aware of the
difference between legitimate experimentation and unconscionable
exploitation; she wants to focus her article on the latter.
Anyone who has had personal experience with a suspected treatment
scam and wants to talk with a journalist about it can contact
Sarah Henry at CIR:  phone 415/543-1200, or fax 415/543-8311, or
mail to CIR, 530 Howard Street, 2nd Floor, San Francisco, CA
94105.  She needs to hear from people as soon as possible.

** Travel/Immigration Reminder:  Letters Must Be
   Received by August 2

     By the time you receive the next issue of AIDS TREATMENT
NEWS, it will be too late to write your letter or postcard
supporting the end of the ban on visitors and immigrants with HIV
entering the United States.  Public comments must be received in
Atlanta, Georgia by August 2 in order to be considered.

     Your letter could urge that the final rule proposed by the
Department of Health and Human Services (HHS), and published in
the Federal Register on January 23, be adopted.  This proposal,
that only persons with active tuberculosis be automatically
excluded from the United States on public-health grounds, is the
recommendation of experts within HHS and is supported by all
medical authorities.  (Political pressure from conservatives, and
from the U. S. Department of Justice, prevented this rule from
being implemented as scheduled on June 1.)

     Write to:  Director, Division of Quarantine, Center for
Prevention Services, Centers for Disease Control, Mail Stop E04,
Atlanta, GA 30333.

     For extensive background on this issue, which threatens the
Eighth International Conference on AIDS scheduled for Boston in
May, 1992, see AIDS TREATMENT NEWS #128.  If you need a copy,
send us a self-addressed stamped envelope and a note requesting
issue #128.

     Note:  Perhaps the best short statement of the case against
the travel and immigration ban is the lead editorial in The New
York Times, Wednesday, June 19, 1991.

[Obsolete subscription information has been removed.  See the
latest issues for up-to-date information. -- sysop]

&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&
           End of display