AIDS Daily Summary November 9, 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 "Heterosexuals Limiting Number of Partners" Washington Post (Health) (11/09/93) P. 5 (Squires, Sally) As heterosexual transmission of HIV continues to mount, most heterosexuals have limited themselves to monogamous relationships, according to a report from the National AIDS Behavioral Surveys. An estimated 10 percent, however, still have two or more sexual partners and continue to participate in other behavior that places them at high risk for HIV infection. The surveys of nearly 11,000 people compared a national sample of heterosexuals with a group extracted from 24 high-risk cities. Nine percent of the national sample and 12 percent of the high-risk group had more than one sexual partner within the past year. Of those, men were more likely to have multiple partners, as were unmarried individuals. Similarly, adults aged 18 to 29 were five times more likely than adults aged 60 and older to have two or more partners. In most instances, heterosexuals with multiple partners increased risk for HIV infection by neglecting to consistently use condoms with primary and secondary partners. Only 11 percent of the national sample and 17 percent of the high-risk group used condoms during sex. The study is published in the current issue of Family Planning Perspectives. "AIDS Message in a Subway Comic Strip" New York Times (11/09/93) P. B1 (Barron, James) The New York City Health Department is trying a new tactic to reach young Hispanics who officials fear are ignoring other AIDS education resources. The new attention-getter is an informative comic strip called "Decision," that is strategically placed--in both English and Spanish versions--on trains in the city's subway system. With five episodes displayed so far, "Decision" is one quarter soap opera, one quarter language instruction, and mostly AIDS education. The Health Department has also published the first four segments in a comic book, which it provides to the public free of charge. "Decision" began in 1989 with a $60,000 grant from the Centers for Disease Control for public service announcements, and initially appeared both in comic strip form and in 30-second commercials. When the advertising-agency contract ended, the Health Department continued the project on its own. Now, before each episode, health official Ann Sternberg meets with a half-dozen other officials who all brainstorm for story lines that will maintain a dramatic pace while presenting a serious public health message. The next strip, "Decision V," is scheduled to appear within the next 90 days. "Australian 1981 AIDS Case May Have Been Asia's First" Reuters (11/08/93) Sydney, Australia--Tests conducted on the tissue of a 72-year-old Australian who died in 1981 indicate that he was infected with HIV at least a year before the disease was identified by American doctors and scientists. The man died of pneumocystis pneumonia, a respiratory disease that is now often associated with AIDS. The virus was found in the man when tests were conducted on tissue samples kept for over a decade by baffled doctors who couldn't fathom why the man had such a severe form of pneumonia when he had no apparent immune disorder. The patient was admitted to the hospital in February 1981, just one month after deaths from the disease began being reported in America. Tests on tissue from a 1980 prostate operation showed that the man was already infected at that time. His death came two years earlier than the first known AIDS diagnosis in Australia, according to a spokeswoman for the National Center for HIV Epidemiology and Clinical Research. She added that the find is the first recorded AIDS death and probably the first detected HIV in the Asia Pacific area. It is not known how the man contracted the virus. "German Researchers Develop New, Fast AIDS Test" Reuters (11/05/93) Munich, Germany--Researchers in Germany say they have developed a new AIDS test that can identify the AIDS virus in less than 10 minutes. According to the team at the respected Fraunhofer Society, the test uses a biosensor to recognize HIV antibodies in blood. Because it is fully automatic, contend researchers, there is no risk of infection to the test administrator. The research team concludes that the new test is significantly faster, easier, and cheaper than the current methods, which take several hours to test a blood sample. In addition, the institute claims the test can be used to screen blood products shortly before use. In the wake of Germany's contaminated blood scandal, thousands of Germans have postponed operations and refused blood transfusions. The research team gave no indication as to when the test would become available on the market. "Officials Warned in 1987 About Blood Firm-Magazine" Reuters (11/06/93) German magazine Der Speigel reported in its Monday issue that officials responsible for monitoring UB Plasma, the pharmaceutical firm at the core of the country's AIDS scandal, warned authorities about the company six years ago. "The authorities were told of serious medical deficiencies and possible crimes at the Koblenz firm as far back as March 1987," but the warnings were filed away with no action taken, reported the magazine. UB Plasma was closed down and four employees arrested last week following allegations of inadequate testing and fears that contaminated plasma may have been distributed throughout Europe. In another report, Focus newsmagazine disclosed that two hospitals delayed informing authorities for months that three patients had become HIV-infected through UB Plasma products. "The laboratory head at Frankfurt's Northwest Hospital said prompt notification might have brought the AIDS-blood scandal at UB Plasma into the public domain three months ago," reported Focus. "German Doctors Warn Against Mass AIDS Panic" United Press International (11/06/93) Doctors and medical officials in Germany hoped to calm citizens there, asserting that fears caused by a major AIDS scare were not justified. Medical experts blamed Health Minister Horst Seehofer for the mass hysteria, saying that he neglected to inform the public that the risks of infection from untested batches of blood plasma were limited. Karsten Vilmar, president of the federal medical association, lambasted Seehofer and said he was fearful that more people might now die from refusing blood transfusions than from contracting HIV. "Lives at Risk as Germans Refuse Blood Transfusions" Reuters (11/07/93) Bonn--Officials in Germany have warned that the hysteria following the country's widening HIV scandal is threatening to claim lives because thousands of patients, afraid of receiving contaminated blood products, are refusing to undergo transfusions. More people are likely to die as a result of rejecting treatment than through actual infection, said Sabine Bergmann-Pohl, junior health minister. Evidence that UB Plasma, a Koblenz-based firm, failed to test plasma products for the AIDS virus has caused a panic to take hold of millions of former patients who fear they may have been infected through routine surgery. Norbert Weise, the prosecutor conducting the investigation of UB Plasma, said that it will be well into next year to clear up the company's affairs. He said that 20,000 blood-product samples need to be screened, and 5,000 blood donors have to be interviewed. So far, only three cases of actual transmission through UB Plasma have been documented. "I don't want to cause panic, but I can't rule out that further cases of infection will be revealed," he said. The hysteria has spread to other European countries such as Italy, Switzerland, and Austria, which have all recalled blood products from UB Plasma. "U.S. Embassy in Bonn Sets Up AIDS Recorded Message" Reuters (11/06/93) Bonn--The U.S. Embassy in Bonn has activated a recorded telephone message for the estimated 185,000 American citizens living in Germany and the 1.25 million tourists who visit the country each year. The tape recording does not provide safety guidelines, but promises that advice would be available as soon as the facts were clear. "The embassy has been following media reports about possible HIV infected blood supplies in Germany," says the message. "We are constantly in contact with German officials concerned with the issue and are seeking comprehensive and accurate information." Hysteria has gripped the entire country after a pharmaceutical company was accused of neglecting to adequately screen blood products for the AIDS virus. Hospitals, doctors, and health agencies were inundated with phone calls from panicked patients asking if they need AIDS testing. "France Urges Citizens Not to Worry About Blood" Reuters (11/07/93) Paris--French officials urged citizens not to worry about blood products, saying that the country's ban on two products in the wake of the German HIV scandal is nothing more than a precautionary measure. The French Health Ministry Saturday provisionally banned the sale of Feiba and Tissucol, two products manufactured by Immuno GmbH, because of uncertainty as to whether they were derived from plasma marketed by German company UB Plasma. Although the health ministry said France has not imported any blood plasma from UB Plasma, sale of the two Immuno products were being halted pending an inquiry into the source of the plasma. "I want to reassure French people and tell them we are constantly doing all we can to check all products," said Health Minister Simone Veil. "Partner Notification for Control of HIV: Results After 2 Years of a Statewide Program in Utah" American Journal of Public Health (10/93) Vol. 83, No. 10, P. 1418 (Pavia, Andrew et al.) Contact tracing, or partner notification, is the attempt by infected patients or health authorities to locate, inform, counsel, and treat individuals who have been exposed to a sexually transmitted disease. Partner notification has been instrumental in controlling syphilis and gonorrhea since the 1940s and, now, some have called for contact tracing for partners of HIV-infected patients. They assert that this practice could target interventions to those at high risk, notify unsuspecting female partners to prevent perinatal HIV transmission, to treat asymptomatic persons, and to counsel those who cannot be reached through other educational messages. High cost, difficulty in locating partners because of the long HIV incubation period, confidentiality concerns, and lack of proven efficacy, however, have led others to oppose the practice of contact tracing. A Utah study sought to evaluate the utility of partner notification, and to identify subgroups in which it might be particularly effective. All persons diagnosed with the virus between October 1, 1988 and September 30, 1990 were interviewed. Personnel costs, including benefits added up to about $62,500 per year. The study concluded that partner notification was acceptable to most HIV-positive patients, and identified a group with a high HIV seroprevalence. It was most effective among populations that are difficult to reach with other interventions, such as drug users, women, and minorities. The benefits appear to outweigh the negatives, but the precise role of contact tracing is yet undetermined. "AIDS, by Regions" Industry Week (10/04/93) Vol. 242, No. 19, P. 33 AIDS is the leading cause of death among males between the ages of 25 and 64 in Buffalo, Minneapolis, and Orlando, according to a report published in the Journal of the American Medical Association. The report also found that, in San Francisco, AIDS accounts for 61 percent of deaths of men aged 25 to 44. In Baltimore, 43 percent of female deaths are attributable to the deadly disease. "Natural History of AIDS Related Sclerosing Cholangitis: A Study of 20 Cases" Journal of American Medical Association (10/13/93) Vol. 270, No. 14, P. 1686 (Forbes, A. et al.) A study of AIDS-related sclerosing cholangitis by Forbes et al. shows that the infection does not have an overall impact on prognosis, but does reverse an unusual inverse correlation between age and survival in HIV infection. For at least 10 months, or until death, 20 consecutive patients, aged 27 to 50, with AIDS-related sclerosing cholangitis were tracked. Seventeen patients of those died at an average of seven months, and three are still living without sclerosing cholangitis symptoms. Controls for age, CD4, and infection had virtually the same end result of average survival at 7.5 months and expected worse prognosis with increasing age. Growing older, however, seemed protective in AIDS-related sclerosing; this striking phenomenon cannot be explained by either disproportionate immunosuppression or opportunistic infection. ------- End of Forwarded Message