From: "ANNE WILSON, CDC NAC" AIDS Daily Summary November 4, 1993 The Centers for Disease Control and Prevention (CDC) National AIDS Clearinghouse makes available the following information as a public service only. Providing this information does not constitute endorsement by the CDC, the CDC Clearinghouse, or any other organization. Reproduction of this text is encouraged; however, copies may not be sold, and the CDC Clearinghouse should be cited as the source of this information. Copyright 1993, Information, Inc., Bethesda, MD "German Blood Recipients Urged to Take AIDS Test" Philadelphia Inquirer (11/04/93) P. A13 (Atkinson, Rick) As the German HIV scandal over contaminated blood continues to expand, health officials there have urged AIDS testing for all patients who have received blood products or transfusions since the early 1980s. Hospitals and clinics are preparing for the flood of panicked patients who will undoubtedly sap the country's AIDS-testing capacity. German Health Minister Horst Seehofer announced that the expense of the testing would be covered by the country's health-insurance system. The latest development in the scandal involves UB Plasma, a blood products company that evidently distributed its products to some 60 German hospitals and clinics even though it was aware that the products were contaminated with the AIDS virus. So far, there is no evidence that the tainted blood was shipped to the United States. Because some American hospitals in Germany have relied somewhat on the blood banks there, concern continues to grow among hundreds of thousands of U.S. military personnel and their families who have served in Germany within the past decade. Related Story: Washington Post (11/04) P. A1 "Suit Denied Over Failure to Tell Partner About AIDS Test Result" New York Times (11/04/93) P. B14 A Federal judge agreed that a man, identified only as J.B., was indeed betrayed by a male lover who kept his AIDS condition secret, but ruled that the man could not collect damages from his partner's estate. Although Federal Judge H. Lee Sarokin was clearly sympathetic to J.B., he dismissed the case because the plaintiff, who has tested negative for the AIDS virus, "presented no competent evidence of severe emotional distress." Michael Isbell of the Lambda Legal Defense and Education Fund, a nonprofit group representing homosexual clients and AIDS patients in court cases, praised the decision. Allowing damages when there has been no injury sends out the wrong message, said Isbell, who contends there is a risk that such cases will be abused. "If you open the floodgates on this kind of lawsuit, there's no way to stop it," he said. "White House Says AIDS Vaccine Needs Foreign Test" Reuters (11/03/93) Atlanta--A vaccine for AIDS is still out of reach, but when one is finally developed, the White House Office of Science and Technology asserts that it should be tested in countries with high rates of AIDS infection. The White House policy group, in a report released by the Centers for Disease Control and Prevention, said that "complete evaluation of the most promising HIV vaccines will require both domestic and international field trials." The agency explained that international trials in countries with high infection rates would yield answers about efficacy in the shortest feasible length of time. World health authorities have identified Africa as having the current highest rates of AIDS infection. Like most other opinions, the White House office concludes that the likelihood of a vaccine being developed quickly is slim. "When one or more potential HIV vaccines will be available for widespread trial of their effectiveness is unknown," said the report. "Evaluation of an HIV vaccine is complex because the virus changes rapidly, and, in addition, because social and behavioral factors are associated with transmission." "Russia--AIDS" Associated Press (11/03/93) Moscow--Some 682 Russians have been diagnosed with the AIDS virus, according to Mikhail Narkevitch, deputy chief of the Russian Health Ministry's disease prevention division. Aware that the number could increase, Narkevitch said, "The figures are valid for today but we do not entertain any illusions." Russia's first instance of AIDS, which is transmitted in the country primarily through sexual contact, was reported in 1987. "Health Ministers Alarmed by Spreading AIDS" Reuters (11/03/93) Dhaka--Close to 1.5 million people in Southeast Asia and Pacific countries are infected with the AIDS virus, and that figure could skyrocket to 2.5 million by the year 2000. The disheartening statistics were discussed at a three-day conference of regional health ministers held earlier this week in Dhaka, Bangladesh, by the World Health Organization. Participants at the conference expressed deep concern for the rapid growth of the disease and discussed strategies to combat it, according to a spokesperson. He also said attendees felt the need to create more awareness to curb the spread of AIDS. "Nominee for NIH Chief Stresses Need to Support Basic Research" Washington Post (11/04/93) P. A28 (Schwartz, John) During a confirmation hearing before the Senate Labor and Human Resources Committee, President Clinton's choice to head the National Institutes of Health defended the value of basic research and pledged to combat racial and sexual discrimination within the agency. Harold E. Varmus, 53, is a professor at the University of California at San Francisco, and a co-recipient of the 1989 Nobel Prize in Physiology or Medicine. Sen. Edward M. Kennedy (D-Mass.), committee chairman, said Varmus is "an outstanding choice for NIH director" who "has the vision and the skill to lead this nation's biomedical research into the 21st century." NIH is the primary agency for such research in the United States. Its $11-billion budget funds work in fields such as AIDS, cancer, and human behavior at 18 research institutions. The committee expects to vote on Varmus' nomination next Tuesday, with the full Senate voting soon after. "AIDS Research: Which Institutions Are Most Productive and Influential?" Scientist (10/18/93) Vol. 7, No. 20, P. 14 In the early years of the AIDS epidemic, the majority of related research papers was produced by institutions in the public sector, such as the National Institutes of Health. In the past five years, however, corporate laboratories have surfaced and become increasingly involved in this field of research. The newsletter Science Watch reports that data from 1988-92 places several commercial firms among the leading 25 for AIDS-related publications, either in terms of the number of papers published within that time frame, or in the number of times their papers were cited in reports by other researchers. The Philadelphia-based Institute for Scientific Information (ISI), the publisher of Science Watch, identified some 24,515 papers. The data indicate that only 14 institutions produced more AIDS papers than the British pharmaceutical giant Wellcome PLC, and American biotech company Genentech Inc. was actually the leader in terms of citation impact. Also performing admirably were Abbott Laboratories and Merck. In comparison, between 1981-92, no biotechnology or pharmaceutical firm is listed among the top 25 ranked institutions. The data reflect a trend showing that, in recent years, the private sector has taken an increasingly larger leadership function in AIDS research. "Estimated Condom Failure and Frequency of Condom Use Among Gay Men" American Journal of Public Health (10/93) Vol. 83, No. 10, P. 1409 (Thompson, John L.P. et al.) Condoms are designed to prevent transmissions of sexually transmitted diseases, including HIV. While they are generally effective, they sometimes fail through breakage or slippage. Because of the increased risk of AIDS via anal and oral sex, condom use has increased heavily among gay male users. Thompson et al. recorded instances of condom failure among a sample of homosexual men in New York throughout the course of one year. The findings identified a link between condom failure and user experience. In general, the risk of condom failure was high for each sexual episode--especially anal sex--among men who had engaged in each act only a few times in the past year. Condom failure decreased rapidly with experience. Breakage and slippage was less frequent for oral than anal sex, and estimated risk of failure also declined with experience. Thompson et al. conclude that gay men should be especially cautious the first few times that they use a condom, but should expect a lower risk of failure after becoming moderately experienced with condom use. "Family Physicians' Support for School-Based HIV Prevention Education Programs" Journal of the American Medical Association (10/27/93) Vol. 270, No. 16, P. 1922 (Ryan, John G.) Sexually active adolescents are at high risk for HIV infection. Education programs effectively prevent infection, but family doctors often are not directly involved in the design and implementation of these programs. To determine the extent to which family physicians do support school-based HIV education programs, a systematic random sample of 2660 family doctors were mailed surveys; 63.7 percent responded. In general, views of school-based HIV counseling were widely supportive. Residency trained and female doctors expressed the greatest support for these programs. Also likely to favor them were the physicians who had fewer professional reservations about direct treatment of people with AIDS, and who believed that communication with patients about sexuality is acceptable. Doctors' attitudes about school-based programs including condom distribution, however, were significantly less favorable. The study concluded that family physicians do have an important part in implementing HIV education programs in the schools, and can be depended upon for their support. School and public health authorities should enlist family physician support when planning and establishing such programs. "HIV Antibody Testing Among Those at Risk for Infection" Journal of the American Medical Association (10/06/93) Vol. 270, No. 13, P. 1576 (Berrios, Daniel C. et al.) Researchers from the Center for AIDS Prevention Studies in San Francisco conducted a study to determine the prevalence of HIV testing among adults at risk for infection. Berrios et al. interviewed a random sample of 13,786 people, aged 18 to 75 years old, about their testing, sexual, and intravenous drug abuse histories. The results showed that, at less than 40 percent, overall testing was low in high-risk groups. The exceptions were men engaging in same-sex intercourse (60 percent), and male and female injection drug users (46 and 73 percent). At only 35 percent, the lowest rate of testing, much to the concern of Berrios et al., was the group most at risk--heterosexuals having unprotected sex with multiple partners. In general, men reported testing more commonly than women, unmarried persons more commonly than married persons, and blacks and Hispanics more commonly that whites, Asians, and other ethnic groups. To encourage antibody testing among the groups at risk, Berrios et al. suggest the use of promotional campaigns that are designed to reach all segments of the population. "HIV Data Open Window on Future of the AIDS Epidemic" AIDS Alert (10/93) Vol. 8, No. 10, P. 156 First-time compilation of state data reporting HIV cases is creating proof that in the second decade of the AIDS epidemic health care workers will treat fewer homosexual men, and more women, blacks, and adolescents, especially teenage girls. The data indicates that gay men account for only 39 percent of HIV infections, but 62 percent of AIDS cases. The epidemic is shifting towards young heterosexuals, with teens making up 3 percent of HIV infections and .15 percent of AIDS cases. Epidemiologists say this tells them that infection is happening at a younger age than it was in the previous decade. Women, too, are becoming infected with greater frequency. They now contribute to 18 percent of HIV infections and 10 percent of AIDS cases. Further evidence shows that the epidemic is spreading disproportionately among blacks. The data was extracted from 22 states that legislate name reporting of HIV cases. This reporting system can help epidemiologists improve services and identify where prevention resources need to be located, but civil liberty issues surrounding name reporting have fueled flames of controversy. President Clinton's health proposals, however, could create legal protection that will make the practice more widely accepted. ------- End of Forwarded Message