AIDS Daily Summary December 8, 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 Expert Says Africa Faces a Deluge of Disease" Reuters (12/08/93) (Hughes, Stephen) Casablanca--Approximately 3,500 Africans are infected with the AIDS virus each day, and the continent is facing "an impending catastrophe, a deluge of disease," warns an AIDS expert. The only hope for Africa is prevention and, unless the virus is arrested, "it is possible that within 10 years the elite in African countries will be simply wiped out," predicted Professor Abdallah Bensliman. He finds that anti-AIDS policy since 1985 has been "disastrous" for a number of reasons, beginning with finance. Of the 42 poorest countries in the world, 29 are in Africa. Financial assistance for AIDS programs in Africa is being diverted to Asia and Europe, says Bensliman. How to distribute the money that is available also presents a dilemma in Africa. In addition, most Africans cannot afford the expense of condoms and/or AIDS testing. Illiteracy and superstition also complicate the AIDS issue in Africa, often giving rise to charlatans who offer "miracle cures." There is a solution to the AIDS crisis, says Bensliman. "The answer is in three words: fidelity, abstinence, and protection," he declared. "No one, no religion, can quarrel with that." He noted that Islam, Judaism, and Christianity all preach fidelity. "If everyone practices what those religions preach, the spread of AIDS will diminish." "Panel to Advise Phila. on Spending AIDS Money" Philadelphia Inquirer (12/08/93) P. B3 (Collins, Huntly) A newly formed advisory committee will offer recommendations to the acting Health Commissioner on how to allocate an anticipated $7 million in federal AIDS funding for the Philadelphia region, the city's Health Department announced yesterday. The funds are provided under the Ryan White CARE Act, which finances services and medical care for people with HIV/AIDS. The 12-member panel of four whites, six blacks, and two Latinos is a remedy for last year, when the city's system for allocating the money was criticized by federal officials for alleged conflicts of interest. Some of the people who determined how the money was to be spent also headed agencies that received the money. The advisory committee, however, is "an extremely balanced group," and has no financial affiliations with the AIDS service organizations that will vie for their share of the federal money, said Richard Scott, director of the city's AIDS Activities Coordinating Office. Three members are appointed by the Health Department, three by the Philadelphia AIDS Consortium, and six are jointly-appointed HIV/AIDS patients. "We are now trying to respond to [the federal] concern about having an objective review process and conflict-free allocation," Scott said. "Dermatologists See Rise in Cases of Latex Irritation" Philadelphia Inquirer (10/08/93) P. A8 Doctors attending the annual meeting of the American Academy of Dermatology agree that there has been a sharp increase in the number of allergic reactions to natural rubber latex, the elastic material used to make products such as condoms and surgical gloves. Dr. Ronald R. Brancaccio of the New York University Medical Center reported that, although no comprehensive study has been conducted, he and other physicians have observed widespread cases of allergic reaction ranging in severity from mild irritation to life-threatening shock. Hives and other allergy reactions are being reported "more and more commonly," particularly among medical employees, said Brancaccio. According to one study, he said, 7 percent of surgeons and 5 percent of operating room nurses were allergic to the latex in their surgical gloves. Surgical gloves are instrumental in preventing HIV transmission through exchange of blood and other body fluids, and condoms are critical to curbing the spread of the virus through sexual contact. "Tainted-Blood Victims Oppose Terms of Deal" Toronto Globe and Mail (Canada) (12/07/93) P. A10 (Picard, Andre) Canadian hemophiliacs and transfusion patients who contracted AIDS through HIV-contaminated blood are denouncing the terms of a new government compensation package as heavy-handed and contemptuous of the judicial process. The infected citizens are upset that, in order to qualify for assistance, they must drop all civil suits and meet a March 15 deadline, which falls well before the results are due from a judicial probe into the tragedy. "It seems to me that the least we can expect is to have all the facts before we make a decision," reasoned Ed Kubin, spokesperson for Canadian Hemophiliacs with HIV-AIDS. "Saying 'sign now and we'll hear the evidence later' shows a blatant disregard for the judicial process." More than 1,000 Canadians who got the AIDS virus from tainted blood between 1978 and 1989 will receive details of the $151-million provincial-territorial package, which includes an immediate $22,000 payment followed by $30,000 annually for life. Spouses and dependent children receive $20,000 and $4,000 a year, respectively, for up to five years. There are currently more than 100 outstanding lawsuits against the provinces, the Canadian Red Cross, and pharmaceutical companies. Some plaintiffs with cases before the court are considering a legal challenge of the waiver of the right to litigate. What appears to upset the AIDS patients most, however, is the mid-March deadline. The findings of the judicial commission of inquiry are not due in until the end of next year, and the patients feel they should have at least that long to consider the offer. "Disease Scares Fuel Interest in Blood Substitutes" Reuters (12/07/93) (Johnson, Cynthia) London--The German scandal over HIV-tainted blood products is sparking interest in the development of blood substitutes for transfusions. Because of the increasing incidence of blood-borne diseases like AIDS and hepatitis, as well as recurring shortages of donated blood, industry sources say there is a potential market in surgical and trauma uses that is worth $5 billion a year. "With advanced screening methods, the nation's blood supply is safer today than ever before, but it can never be 100 percent safe," acknowledged Dr. Harvey Klein, chief of the Department of Transfusion Medicine at the National Institutes of Health. "The risk of infection remains a major concern among medical and scientific communities, not to mention the general public." Scientists say the ideal blood substitute would be a stable oxygen-carrying solution that would eliminate the risks of blood matching and contamination. Research has primarily focused on hemoglobin-based products, including those using genetically manipulated forms of human hemoglobin or hemoglobin taken from pigs, cows, or donated human blood that is too old to use. "Texas Researchers Block HIV Infection in Cell" Reuters (12/06/93) (Gilardi, John) Houston--A drug made from an HIV protein segment that attaches to healthy cells appears to effectively block the virus from expanding in tests on healthy cells outside of the body, according to a study by researchers at the University of Texas M.D. Anderson Cancer Center. The research focused on the part of HIV known as the "V3 loop," which is thought to be key in binding to cell surfaces. The Anderson scientists synthetically reproduced the protein fragment and tested it on cultures of human cells outside the body. Six different protein segments have been developed, which lab tests suggest should block most HIV strains. Researchers are not certain how the drug actually blocks HIV infection in healthy cells, but they speculate that it occupies all of the slots on a cell surface that would otherwise be used by the AIDS virus to penetrate the cell. It also prevents HIV transmission by halting the fusion process between infected and non-infected cells. Researchers say the study may be indicative of an effective AIDS treatment. "Our discovery may lead to a more effective therapy because it blocks HIV from ever entering the cell and prevents it from spreading," explains Dr. Jagan Sastry, an assistant professor at the cancer center, and the head of the study. The full implications of the study, however, will remain unknown until human tests are conducted to test the drug's effect on AIDS. "A Resistance to Reason" Newsweek (11/29/93) Vol. 122, No. 22, P. 79 (Gelman, David) Despite an intense campaign to educate the public on how the AIDS virus can and cannot be transmitted, there still remains some uneasiness--even among physicians--about casual contact with AIDS patients. Psychologists believe there is a greater force at work than just a simple fear of infection. "People don't want to touch people with AIDS or share their dishes" even though they know that they are being irrational, says Carol Nemeroff, a clinical psychologist who headed a study of college students to evaluate how they would feel about using silverware previously used by AIDS patients, then washed. John Pryor, who co-edited a chapter in the 1993 book, "The Social Psychology of HIV Infection," thinks the average person has a profound negative bias against AIDS, which has been stigmatized by its victims, the majority of whom are believed to be gay or intravenous drug users. Therefore, AIDS is a "bad" disease carried by "bad" people. According to a study by psychologists Gregory Herek and Eric Glunt, many Americans are not convinced that the chances of contracting the virus through casual contact are minimal. Rather, they focus on what likelihood there is. The irony is that, amid all this anxiety, the public is not being more wary. Outside of high-risk groups like homosexuals and drug addicts, there have been few modifications in sexual behavior. "What we're seeing is a combination of extreme overreactions to casual contact side by side with serious underreactions to actual risk," explain researchers at Arizona State University. The only solution psychologists can offer is more and better education. "Heart Strings" Advocate (11/30/93) No. 643, P. 60 (Greenberg, Steve) Hearts and Voices is a group that performs weekly cabaret shows for AIDS patients at seven New York City hospitals. The organization was born three years ago when Nancy Sondag and friends performed a hospital, bedside revue of music written by her roommate Josef Gregory, who was ill with AIDS. While spending time in the hospital with Gregory, Sondag noticed "so many AIDS patients who had no family or friends visiting them." Other patients, as well as the hospital staff, asked Sondag to do shows on a regular basis. The shows grew from once weekly to six times a week. There are plans to expand the group to several cities nationwide, but first it must address the 14 additional NYC hospitals that want to be part of the program. The money is still tight, but Hearts and Voices has a gold mine of volunteers, including performers from Cats and Les Miserables, cabaret singers, and performers from the Metropolitan Opera. "At Last, a Promise Kept?" Advocate (11/16/93) No. 643, P. 24 (Gallagher, John) After lean times during the Reagan and Bush years, AIDS organizations eagerly anticipated a record increase in federal AIDS funds. Lobbyists fear, though, that a funding ceiling is near, one that will lessen the chances of similar funding increases in the future. A funding bill approved by the House is expected to be approved by the Senate and will be sent along to the president. If Clinton signs the bill into law, the federal AIDS budget would skyrocket to $2.58 billion--the largest amount of federal money ever allocated to fight a disease. The proposed budget includes an additional $210.5 million for the Ryan White Comprehensive AIDS Resources Emergency Act, and a significant increase in federal research funds. The large infusion of money for AIDS services should also eliminate interagency fighting for federal funding. "A Journal From the Plague Years: Life in an AIDS Clinic" Destination Discovery (11/93) Vol. 9, No. 8, P. 27 (Parker, Gary) The Whitman-Walker Clinic started 20 years ago as a VD clinic for white, homosexual men operating out of a church cellar on Saturdays. Relocated to a three-story building and adapted in response to a strange new virus that no longer affects gays only, the pioneering center has become one of the most noted AIDS clinics in the world. While it is the leading AIDS clinic in Washington, D.C., Whitman-Walker is actually only the third largest in the nation. With a 180-member staff, it falls behind only the Gay Men's Health Crisis in New York and AIDS Project Los Angeles in California. Nonetheless, it offers the widest array of services of any such clinic in the world. In fact, short of a hospital bed, Whitman-Walker can provide nearly every basic need. Over the years the clinic has launched such programs as free HIV testing, a pharmacy that sells medicine at cost, a dental clinic, and a food bank. The clinic operates the D.C. AIDS Information Line, as well as group houses for AIDS patients. Outreach staffers work the street corners, passing out free condoms and safe sex pamphlets to passerbys, as well as the prostitutes that are also working the street corners. In addition, this year alone the clinic will represent about 1,000 clients with some 1,700 legal problems. With 5,000 District residents sick with AIDS, and 21,000 more infected with HIV, the rate of infection in the city is nearly six times the national average.