>Newsgroups: sci.med.aids >From: "ANNE WILSON, CDC NAC" >Subject: CDC AIDS DAILY SUMMARY 12/27/93 >Date: Mon, 27 Dec 1993 13:25:55 GMT AIDS Daily Summary December 27, 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 "All Four Kidnappers Apprehended With $10 Million Ransom" United Press International (12/27/93) Moscow--On Monday, Russian security forces apprehended four kidnappers and recovered the $10 million ransom they received from the government in exchange for the release of a group of schoolchildren they held hostage. Under interrogation, the head of the group told police that he was infected with the AIDS virus, according to the Interfax agency. The terrorist said he needed the ransom money to pay for medical treatment of the disease. "Baby Son of "AIDS Romeo" Escapes HIV Infection" Reuters (12/26/93) London--The infant son of an AIDS-infected man who invoked public fury by having unprotected sex with a succession of women has tested HIV-negative, according to a British tabloid. The paper reported that the 20-month-old baby, despite the fact that both his parents are infected, has been given a clean bill of health. Even when both mother and father are infected, a child will not necessarily contract the virus. Some infants are born with HIV antibodies from their mothers, but these disappear when their immune systems develop and fight off infection, which is what happened with baby Daniel. Doctors must wait at least 18 months to determine if full HIV is present. Daniel's doctors said that it is now very unlikely that the child will develop HIV. The baby's father, Roy Cornes, drew the wrath of health officials after admitting to having unsafe sex with several women after testing HIV-positive in 1985. Five of his former girlfriends were infected, and one died of AIDS. The case prompted calls for laws on HIV disclosure. "Health Worker Brings Bad News to the AIDS Infected" Los Angeles Times--Washington Edition (12/26/93) P. A6 (Daubenmier, Judy) Every state has an HIV-notification program of some sort, according to Janet Riessman, spokesperson for the AIDS Action Council of Washington. Some programs coach individuals in notifying partners themselves, some enlist the help of doctors or other professionals to help the patient conduct partner notifications, and some are a combination of both. In Michigan, doctors and local public health officers who diagnose an HIV-positive patient have a responsibility to warn persons who have shared needles or had unsafe sex with the infected individual. As a communicable-disease field representative for the health department in Ingham County, Mich., Patricia Villegas has the tough task of telling patients their HIV status, and helping the positive ones trace and contact partners who may have been exposed to the virus. This is sometimes dangerous work for Villegas, who finds herself at the fringe of the drug world and often needs a police escort. It is also frustrating work, for there are times when partners who may have been exposed to AIDS cannot be found. "A lot of the time they may be individuals who say they've had sexual contact with [people] in a very casual sense of the word. They don't know much about them; they had sexual contact while under the influence of alcohol or drugs," explains Villegas. When she does locate a partner, Villegas breaks the news, lets it sink in, then suggests testing. Confidentiality is guarded-- Villegas never discloses the name of the individual who listed the contact as a partner. Still, it is a difficult job. "I don't think it gets easier," she says. "I think what has happened is that I have learned a healthy detachment as a professional." "US Says It Can't Fund TB Fight" Boston Globe (12/24/93) P. 3 The United States cannot help finance the World Health Organization's $9-million fight against tuberculosis, despite a warning that a resurgence of the disease in America is being fueled by the global epidemic. WHO asked the U.S. government to contribute a third of the program's cost to combat TB in third world countries and to prevent its mutation into incurable strains. "It is a logical, simple, cheap thing for America to do to bring a halt to what otherwise will be an incurable plague in the 21st century," declared Richard Bumgarner, deputy director of WHO's TB program. But the U.S. Agency for International Development, which dispenses foreign aid, does not have $3 million to spare, according to the agency's global health chief, Dr. Ann Van Dusen. The agency's health funds are committed to AIDS and child health and family planning programs. The agency's decision illustrates the problem faced by health officials in this tight budget era: Which disease gets priority? WHO contends that attacking TB is important, for it kills 3 million people each year--more than all other infectious disease combined. About one-third of the world's population is infected and 8 million get sick each year. Doctors had hoped to wipe out the disease, but a resurgence has been in effect since 1985. Drug-resistant strains are developing so quickly that the Centers for Disease Control and Prevention last week called for forcibly committing patients who failed to take their medication properly. "Medical Briefs" Advocate (12/28/93) No. 635, P. 36 Upjohn Laboratories has produced a drug that has been found in the laboratory to be an effective HIV-inhibiting protease during the late stages of viral replication. The drug, U-75875, dramatically decreased HIV replication in both monocytes and chronically infected cells. Other drugs tested were only effective in newly infected cells. A report on the study proposes that the use of protease inhibitors alone or with another drug is important for HIV therapy. "New APHA Report: Access to Care for HIV Disease" Nation's Health (12/93) Vol. 23, No. 10, P. 16 The Special Initiative on AIDS recently released "Access to Care for HIV Disease," the 10th in a series of reports about AIDS. The report, prepared by the AIDS Working Group, identifies the clinical manifestations of HIV and the services needed by infected persons. The structure of the American health care delivery and financing system prevents many HIV patients from gaining access to health and social services. To improve access, comprehensive long-term financing and delivery solutions are crucial. "Access to Care for HIV Disease" examines barriers to care and addresses tactics to improve access. "Pharmacists' Role in Preventing and Treating HIV Infection" American Pharmacy (12/93) Vol. NS33, No. 12, P. 38 (Noormohamed, Saleem and Ferguson, Kristi) Pharmacists are among the most accessible and most respected of health care professionals. Because they are knowledgeable about drugs and educated to endorse health and prevent disease, pharmacists are perfectly poised to have a positive influence on the AIDS epidemic. They do, in fact, have several roles in the fight against the disease. First and foremost, pharmacists must provide accurate and up-to-date information. In addition, they need to monitor drug therapy in both hospital and outpatient environments, including agents that are obtained on the black market, vitamins and minerals, and other unsubstantiated cures and treatments that a patient might be taking. It is also critical that pharmacists counsel HIV patients on proper condom use, as well as educate the public on how the virus is transmitted and what behaviors are risky. It is equally imperative that pharmacists encourage AIDS testing for all individuals who may be at risk for the virus. Finally, ethical guidelines that apply to other health care professionals also apply to pharmacists, who must keep all patient information completely confidential. In general, pharmacists must promote the best possible health care for infected patients. "Counseling Adolescents for HIV Testing Takes Time, Insight" AIDS Alert (12/93) Vol. 8, No. 12, P. 186 More and more adolescents are voluntarily seeking HIV testing. Denial and an inability to fully comprehend the consequences of an HIV test may demonstrate the need for several counseling sessions. Topics of discussion should include the differences between HIV and AIDS, how the virus affects the immune system, how appearance does not reflect infection, the difference between confidential and anonymous testing, state testing and reporting laws, and how unprotected intercourse is the primary means of transmission. The main goal of counseling is to develop a rapport with the adolescent, who may be discussing these issues with an adult for the first time, and to eliminate myths that adolescents may have, the most common of which are that an HIV-positive test result means immediate death and that only "bad" people become infected. Counselors must also assess a patient's frame of mind and support system. If there is a risk of the adolescent becoming suicidal, then it is better to wait. Delivering positive test results requires straghtforward communication--although supportive and caring--and the counselor should be prepared to help the patient verbalize feelings and avoid destructive ways of acting out anger, fear, and helplessness.J Grief, coping, risk reduction, and empowerment are the main issues faced after the test. "HIV Transmission: Women's Risk from Bisexual Men" American Journal of Public Health (12/93) Vol. 83, No. 12, P. 1757 (Wood, Robert W. et al.) A recent analysis of AIDS surveillance data by the AIDS Prevention Project of the Seattle-King County Department of Public Health in Washington state found that men identifying themselves as bisexuals and men identifying themselves homosexuals differed in several ways. The study, which involved 5480 men who reported having sex with another man since 1977, found that self-reported sexual identity was an important indicator of sexual encounters with women and HIV positive status. Of the sample, 77 percent said they were gay and reported almost no sex with females in the past year. Thirteen percent said they were bisexual, and 8.4 percent identified themselves as straight. Self-described gays had the highest rate of HIV seroprevalence. Straight-identified men reported the highest number of female partners and were less likely to be infected, although the seroprevalence was still disturbingly high. Men calling themselves bisexuals, however, posed the most risk of HIV infection to women, while gays and straights exposed equal numbers of women. Bisexual men and straight men were also more likely to inject drugs, a contributing element to the AIDS epidemic. The study suggests that increased attention should focus on men who have sex with men and use intravenous drugs.