AIDS Daily Summary December 2, 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 "AIDS Patient, Protester Ask Clinton to Do More" Washington Post (12/02/93) P. A31 (Devroy, Ann) President Clinton yesterday encountered the public rage of an AIDS protester who interrupted his speech at Georgetown University Hospital, and then delivered his own 60-second tirade on the administration's inaction before he was finally led away unmolested by security. "Talk is cheap and we need action," shouted the young man, who identified himself as a member of the AIDS activist group, ACT-UP. "We should have never trusted you. You are doing nothing while we die," accused the man. Just hours earlier, the same heckler presented a similar performance during a program by Health and Human Services Secretary Donna E. Shalala and U.S. Surgeon General Joycelyn Elders. Clinton calmly accepted the activist's criticism, then offered a modest defense. The president insisted that his administration had done a "good job ... if you measure 'good job' in terms of organizing ourselves properly, funding the effort more adequately, identifying some of the major problems in the bureaucracy and going after them." He pointed to increased funding for AIDS research, the appointment of an AIDS coordinator, and his willingness to discuss the disease, among other actions he has taken against AIDS. "I invite you to tell what else you think I can do and to ask yourselves what else you can do," he told the audience. The encounter with the protester occurred during a speech given after Clinton had visited with seven AIDS patients, one of whom also felt the government response to the epidemic was inadequate and did some informal lobbying for AIDS money. Related Stories: New York Times (12/02) P. A1; Baltimore Sun (12/02) P. 12A "Sexually Transmitted Diseases Lift AIDS Risk" Chicago Tribune (12/01/93) P. 1-5 (Kotulak, Ronald) A new study showing rates of sexually transmitted diseases (STDs) in young adults that surpass expected numbers has raised concerns among public health authorities that AIDS, too, may become more common in the general public. "If STDs are out there in big numbers, and HIV is another STD, then we can expect HIV infections to increase in this group," summarizes epidemiologist Sandra Melnick, a project officer at the Women's Interagency HIV Study for the National Institutes of Health. Melnick adds that this is probably already occurring because HIV rates in adolescents are rapidly increasing. According to Dr. John Ward, chief of the AIDS surveillance branch of the Centers for Disease Control, adolescents are especially vulnerable because they are experimenting with sex for the first time and often do not take safe-sex measures to prevent STDs. Other studies suggest that people with STD infections are at a much greater risk for HIV infection, says Melnick. Prompt action for the prevention and treatment of STDs--including health education promoting abstinence, condom use, limiting sex partners, and knowing partners' sexual histories--is necessary to curb infection rates, she says. "Scotland's Elegant Capital Deals Calmly, Quietly With Sudden Outbreak of AIDS" Baltimore Sun (12/01/93) P. 8A (Schoettler, Carl) AIDS and widespread intravenous drug use surfaced simultaneously in Scotland and, almost overnight, presented the country with an HIV problem, most severe in the capital city of Edinburgh. City and regional health authorities recognized the threat early, and responded quickly with inventive ideas and far-reaching programs that were virtually nonexistent in the West. Preventive measures such as needle exchange and condom programs--which are still controversial in the United States--have been given credit for the dramatic reduction of HIV infections among IV-drug users. And Edinburgh provides these services in the most non-judgmental of manners, without undue fuss, sensation, or self-congratulation. "We don't tell people not to use drugs," explains Frank Gough, a member of the Harm Reduction Team of the Spittal Street Center. "Our main thing is trying to get a clean set of works [injection paraphernalia] to the clients who are using." The city's efforts to stop the spread of AIDS through sex include programs like the C-Card, which entitles the cardholder to a virtually unlimited supply of condoms. The Scottish Prostitutes Education Project (ScotPEP) provides information, advice, education, and support services to commercial sex workers, in addition to distributing thousands of condoms. Ruth Morgan-Jones, director of ScotPEP, says the group has a policy of not refusing to help people under a certain age. "If we find a young boy of 14 who is working, we will give him information on how to protect himself," she says. "Our role is to prevent HIV within the sex industry. And we see that being possible only if we're prepared to accept the people who work." "Filipino Marchers Call for War on AIDS" Reuters (12/01/93) Manila--Philippines Health Minister Juan Flavier on Wednesday marched through Manila's financial district with 5,000 other demonstrators, as they called for an all-out war against AIDS. Cries of "condom, condom" and "safe sex, safe sex" were heard as the marchers warned the country about the dangers of the virus in their country, which houses one of Asia's largest commercial sex industries. Flavier said that if people did not begin taking precautions, the number of infected Filipinos could reach 500,000 in the next five years. If the spread of AIDS is not curbed, he said, it will begin affecting the economy because the majority of infected persons would be under 45 years old and members of the country's most productive sector. Of 463 confirmed HIV infections in the Philippines, 111 progressed to cases of full-blown AIDS, and 72 carriers died, Flavier said. But health officials estimate that for every confirmed case of HIV, 100 others go undetected. "St. Louis U. Takes Strides Toward AIDS Vaccine" St. Louis Post-Dispatch (11/30/93) P. 3C (Schlinkmann, Mark) A potential AIDS vaccine studied at St. Louis University produced antibodies which destroyed a non-deadly laboratory strain of the AIDS virus, the school announced Monday. The vaccine, developed by an Austrian company, is called gp160. Through genetic manipulation, it includes a synthetic protein that apes one protein HIV. When injected into the human body, the vaccine generates production of antibodies that prod the immune system into defending itself against the lab strain of the virus. The vaccine appeared to display no major side effects. "We don't know if this means that the vaccine will work against a 'real world' strain of HIV, but we're on the right track," said Dr. Robert Belshe, a professor of internal medicine. The study, which involved 60 volunteers at St. Louis University and four other schools, is a promising step toward the development of an AIDS vaccine, Belshe said, although that event is at least five years in the making. "Tainted Blood Infects 30 Children in Canada" Boston Globe (11/30/93) P. 10 (Langan, Fred) Because the Canadian Red Cross did not begin testing blood supplies for HIV until November 1985, 30 children have contracted the virus through contaminated blood given to them at the country's leading children's hospital. "Certainly this is a higher incidence than anybody expected," commented Dr. Susan King, director of the HIV Information Project at the Hospital for Sick Children in Toronto. But because nearly 17,000 children may have been exposed to tainted blood between 1980 and 1985, doctors predict that the number of infected children will surely rise. The incidence of child infections was highest among those who underwent heart surgery. In April, the hospital began alerting the parents of 1,700 heart surgery patients to the possibility that their children may have received contaminated blood. The high number of children who tested HIV-positive almost certainly points to an adult population that also received tainted blood within the same time frame. "We estimate there could be as many as 1,000 people across Canada who don't know they're infected," disclosed Jerry Freise, spokesperson for the HIV-T Group, which represents people infected with AIDS through blood transfusions. "People shouldn't panic, but they should be concerned enough to have a test. Otherwise people infected won't get treatment and they may pass on the virus to others." "Tainted-Blood Victims, Families to Receive $17,000 More" Toronto Globe and Mail (Canada) (12/01/93) P. A5 (Mittelstaedt, Martin) Canadians who contracted the AIDS virus through contaminated blood will receive improved compensation under a new agreement. The adjusted package provides an additional $17,000 for each patient and their families. The additional money will be generated by four pharmaceutical firms whose blood products were tainted. To secure the money under the compensation package, patients must sign a waiver saying they will not litigate; the four companies are named on this waiver. "Anything we can do to enhance the package is good," said Ontario Health Minister Ruth Grier. Earlier in the year, Canadian provinces and territories offered a $139-million compensation package for those infected through contaminated blood. Under the new package, which is worth about $150 million, infected patients will be eligible for $30,000 annually for life. More than 1,000 Canadians contracted HIV from tainted blood and blood products before compulsory testing was mandated in 1985. "Some Biotech Firms Say Clinton Plan Hurts" Philadelphia Inquirer (12/01/93) P. C1 (Shaw, Donna) Four of 10 biotechnology firms engaged in AIDS research claim that President Clinton's health-care proposals hinder their ability to attract funding, according to an industry survey by the Biotechnology Industry Organization. The poll cited that 47 percent of the 30 responding companies said their AIDS research was being delayed or curtailed by the lack of money. Another 63 percent contended that research would fall back even further if Clinton's initiatives--especially those concerning drug prices--were approved. Two specific elements have drawn the ire of the biotechnology industry because they do not include direct price-control provisions. As submitted to Congress, the plan calls for a "breakthrough-drug committee," an advisory panel that could review introductory prices, although it wouldn't have the power to curtail them. The plan would also permit the Health and Human Services secretary to prohibit Medicare payments for a drug whose price she thinks is too high. The administration justifies these by saying they are aimed at price-gouging by drug companies. But biotech officials insist that small, more innovative firms are feeling the burden--even if they are not the intended target. Investors simply are not willing to take the risk, they say. "Health-Care Reform Must Include Insurance Coverage for AIDS Victims" Philadelphia Inquirer (12/01/93) P. A17 (Shalala, Donna E.) Since the beginning of the AIDS epidemic, thousands of infected people have been systematically excluded from the private insurance market, notes Health and Human Services Secretary Donna E. Shalala. Insurance companies and employers alike have used various tactics to keep infected employees from receiving coverage. The result, says Shalala, is an estimated 27 percent of AIDS patients who are uninsured. Medicaid covers 45 percent more, while 4 percent are covered by Medicare. The rest live in fear that one day their limited coverage will be priced beyond their reach, or simply disappear altogether. Shalala contends that the lack of insurance coverage can prevent HIV/AIDS patients from taking advantage of research and treatment devices. Clinton's health reform can stop this, she asserts, by providing affordable, portable, and permanent coverage for all Americans. First, the reform package will ban exclusion on the basis of a pre-existing condition and bar the use of lifetime or disease-specific limitations. Secondly, the Medicaid population will be incorporated into the regional health alliances and given a comprehensive package equal to that of other Americans. Next, all plans will provide extensive coverage of expenses for outpatient prescription drugs, which can normally amount to thousands of dollars per year. Finally, says Shalala, out-of-pocket medical costs will be limited to no more than $1,500 for individuals or $3,000 for families. "U.S. Prison Systems Struggle to Cope With HIV/AIDS Pandemic" Nation's Health (11/93) Vol. 23, No. 9, P. 12 In 1991, the Centers for Disease Control reported that prisons had the highest incidence of HIV of any public institution. And with inmate cases of HIV/AIDS continuing to spiral out of control, few correctional facilities can ignore the issue. The increase in HIV infection has caused a small resurgence in prison-related legislation; two bills out of 25 that were introduced this year have already been approved. Another factor is pressure from prison and civil rights groups, which want a guarantee that inmates are not tested without permission, receive proper medical attention, are protected from discrimination and violations of confidentiality, and have access to accurate HIV/AIDS information. Some prisons, however, have been criticized for facilities that are inadequate or negligent in terms of providing care and support services for infected inmates. Providing these needs for prisoners is now one of the most serious prisoners' rights issues. Systems are faced with the challenge of trying to find the most effective way to deal with HIV/AIDS in correctional facilities. In addition, they must consider the increasing number of incarcerated women and teens, the growing incidence of TB, and the demand to improve treatment for drug addicts. In light of these challenges, state and local officials, prisoners, and their advocates are teaming up to determine the best ways to implement policies for infected inmates.