AIDS Daily Summary April 01, 1994 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 1994, Information, Inc., Bethesda, MD "City Stops Funds for AIDS Unit" Philadelphia Inquirer (04/01/94) P. B1; Collins, Huntly With the failure of the AIDS Task Force of Philadelphia to submit audited financial statements for the past two fiscal years, City Controller Jonathan Saidel yesterday ceased funding for the city's oldest AIDS service agency. According to a spokesperson, the controller will not issue any payments to the private, nonprofit group until he receives reports on investigations being conducted on the task force by the Health Department and an outside auditor. Loss of funding presents a threat to the organization's future, since government funding through the city accounts for nearly half of its $1 million budget. "We will probably have to vastly curtail operations," said Mark Blair, board treasurer of the task force, of the possibility that funding could be cut off permanently. The agency, regarded as a leader in the fight against AIDS, provides free HIV testing, social services, and food distribution for AIDS patients and prevention programs. However, it has been struggling since last fall to make up a $200,000 shortfall for fiscal year 1993. Group officials say the problems have been corrected and that new financial controls have been established, yet the task force still failed to submit the documentation required by Saidel. "Bill to Require H.I.V. Counseling for Pregnant Women Gains in Albany" New York Times (04/01/94) P. B5; Sack, Kevin Sen. Michael J. Tully and Assemblyman Richard N. Gottfried, the chairmen of the Health Committees of the New York State Assembly and the Senate, agreed on a bill that would require HIV counseling--but not mandatory testing--for expectant women and new mothers. The bill would require all pregnant women to be told that the state recommends testing, as well as counseling for the women on the benefits of testing. It is in competition with a bill proposing that mothers be notified of the results of HIV tests that are currently conducted on newborns. They are performed anonymously to track the prevalence of the virus, and state privacy laws dictate that parents cannot be notified of the results unless they ask to be, meaning that many infected babies will go untreated. While a positive result does not necessarily mean that the baby is infected, it always indicates infection in the mother. Whether to identify infected babies, and thus identify their mothers, has been one of the toughest questions put to the Legislature this year. Assemblywoman Nettie Mayersohn has launched a campaign for a bill that would require HIV notification without the consent of the mother--a proposal actively opposed by a coalition of civil liberties groups, women's organizations, and AIDS lobbyists who insist that such a measure would only prevent some women from seeking prenatal care. "Woman With HIV Sues for Denial of Surgery in Japan" Reuters (04/01/94) A 23-year-old Thai woman has filed suit against two Japanese hospitals and local authorities for refusing to perform her hip surgery after discovering that she is HIV-positive. The woman, who broke her hip after falling down some stairs, is now paralyzed in the lower half of her body after the two hospitals administered only cursory treatment, said her attorney. According to the lawyer, the unidentified woman was taken to the private Kyonan hospital, where blood samples were taken without her consent. She received only pain killers and minor treatment with no explanation and, after five days, was transferred to Kofu municipal hospital, north of Tokyo. Kofu officials initially authorized surgery, then canceled the procedure when they learned the patient's HIV status and transferred her to a third hospital which was notified of her condition. The last facility, which is not being sued, treated the woman, but failed to operate. The woman, who returned to Thailand in February, is seeking $145,000 from the Kofu city government, as well as the Kofu and Kyonan hospitals. "Gay Activists, Doctors Credited With Recognizing Blood Dangers" Toronto Globe and Mail (03/31/94) P. A4; Mickleburgh, Rod The effort of a group of gay activists and physicians in Vancouver to warn gays not to donate blood during the early 1980s saved lives, according to statistics released at the Krever inquiry into Canada's tainted-blood tragedy. At a time when nearly everyone else downplayed the danger of contracting AIDS through the blood stream, local activists spread the word in gay bars and bathhouses not to donate blood. Even earlier, Vancouver doctors with large practices of gay patients warned them to refrain from giving blood. Although British Columbia has the highest per-capita rate of AIDS in the country, its percentage of blood donors found to be infected with HIV is significantly lower than the national average. "I'd say these people were heroes," said lawyer Doug Elliott, representing the Canadian AIDS Society at the inquiry. "Very early on, they realized that AIDS provided a threat to everyone, through the blood supply." "Defendant in AIDS Suit Denies Squandering Cash" Houston Chronicle (03/31/94) P. 27A; Greene, Andrea D. A woman being sued for allegedly squandering $37,000 of $50,000 belonging to an AIDS patient testified on Wednesday that he was subjected to what his attorney called "terrible living conditions" only because he chose to move out of her home. Lawrence White testified a day earlier that he gave Clortis "C.C." Roberts access, through power of attorney, to the $50,000 so that she could pay his bills when he died. He said she spent most of the money on personal luxuries. Roberts countered that she never read the power of attorney granted her, believing it only allowed her to make White's medical decisions and not to maintain his finances to his benefit. She admitted to buying antiques and paying loans and rent with White's money, but claimed also to have purchased groceries and home furnishings that benefited White. Roberts insisted time after time that the money was a gift from White to be spent at her discretion. Based on similar complaints about Roberts, her Foundation for Women and Children with AIDS is being investigated for possible misuse of funds. "Race, Class, and AIDS Knowledge" Focus (02/94) Vol. 9, No. 3, P. 7; Peruga, Rivo M. Socioeconomic and sociodemographic differences have more influence on AIDS knowledge than do racial differences, finds a Washington, D.C., study. Researchers randomly interviewed 1,237 adults aged 18 to 65 about knowledge of natural history and transmission of the disease. They excluded whites and blacks of Hispanic origin, Asians, Pacific Islanders, and Native Americans. Knowledge about proven means of transmission was high in general, and did not vary by race or class. In terms of knowledge of prevention measures, blacks were twice as likely than whites to have low knowledge levels. When unemployment status was included in analysis, however, the racial difference became statistically insignificant. Similarly, blacks were more likely not to recognize the difference between people with AIDS and asymptomatic people, but this difference also decreased substantially when educational level was considered. Whites were more informed about unproved modes of transmission than were blacks, and these racial disparities remained even after adjusting for educational level. Peruga suggests, however, that racial disparities themselves may be an indication of socioeconomic differences, for blacks generally have had less access to education than whites. "Unsafe Sex and Drinking Often Go Together" Nation's Health (03/94) Vol. 24, No. 3, P. 15 Risky sexual behavior seems to account for a much-higher-than-anticipated rate of HIV infection among heterosexuals with drinking problems, reported a recent study published in the Journal of the American Medical Association. Researchers in San Francisco found that HIV infection rates among non-intravenous drug using clients of public alcohol treatment programs were "several times higher than published estimates from a similar community-based heterosexual sample." The rate of HIV infection was three percent for men and four percent for women among the 888 heterosexual, non-IV drug users participating in the study. Unsafe sex practices were common among the respondents, 54 percent of whom reported multiple sexual partners in the previous year. Of these non-monogamous respondents, 97 percent failed to use condoms during sexual activity, and few consistently questioned new partners about previous high-risk behavior. The study's authors concluded that "appropriate risk-reducing interventions could readily be incorporated in these treatment programs and are urgently needed." "HIV-2 Transmission: Implications for Spread of HIV-1" Journal of the American Medical Association (03/23/94-03/30/94) Vol. 271, No. 12, P. 903; O'Brien, Thomas De Cock et al. summarize data proposing that HIV-2 is less transmissible through sexual intercourse than is HIV-1, thus explaining the more limited global spread of the former. They speculate that the lesser infectivity of HIV-2 is the result of a relatively lower viral load in HIV-2 patients with high CD4 lymphocyte counts compared to HIV-1 infected patients with similar values. De Cock et al. also suggest that HIV-2 may be less transmissible because late-stage disease--involving increased viral burden--develops more slowly with HIV-2 infection. The natural history and transmissibility of the viruses, says Dr. Thomas R. O'Brien of the National Cancer Institute, may be linked by two additional factors. First, he notes, quantitative studies of people with HIV-1 show high viral levels during primary infection, which may be critical to the spread of HIV-1. Second, similar rates of positive qualitative viral culture results among HIV-1 and HIV-2 infected persons with low CD4 counts do not preclude lower quantitative viral levels among HIV-2 patients. O'Brien concludes that, in addition to the factors cited by De Cock et al., the disparity in HIV-1 and HIV-2 infectivity may be due to lower levels of HIV-2 during primary or late infection. "Retrospective Study of Transfusion-Associated HIV Infections in Switzerland" Lancet (03/26/94) Vol. 343, No. 8900, P. 797; Bosshard, Hanspeter; Zwahein, Marcel; Marti, Bernard et al. In response to increased public concern about the safety of blood transfusions and blood products, the Swiss Red Cross and Swiss Health Authorities investigated the HIV status of recipients of potentially HIV-tainted blood products donated between 1982 and 1993. The aim was to identify any blood recipients unaware of their HIV infection, and prevent them from spreading the disease to their sexual partners. Questionnaires about 301 blood products concerning their use, the recipient, and the recipient's sexual partners, were returned by 70 hospitals, then analyzed. Transfusion patients received 225 products, 17 were not transfused and, for 59, transfusion remained undocumented due to lost or incomplete medical records. Three infections were diagnosed as a result of this study. Fifty-two recipients were HIV-positive, 43 were HIV-negative, and, for 129 patients, HIV status could not be determined. Sexual contacts were confirmed and tested for half of the HIV-infected patients--eight of whom were also infected. However, no new partner infection was diagnosed as a result of this study. The researchers estimate that their study covered 60 percent of all HIV-contaminated blood products in Switzerland, yet only three recipients and not a single partner with previously unknown infection was diagnosed. This suggests, say the researchers, that systematic HIV screening of all recipients of labile blood products since 1982 is not justifiable in a country such as Switzerland. "Free Access to Electronic AIDS Information" Information Today (03/94) Vol. 11, No. 3, P. 9 The National Library of Medicine, part of the National Institutes of Health and the world's largest health sciences library, has discontinued all online fees imposed for searching three AIDS-related databases and an online directory of sources of information. Effective immediately, the 75,000 members of the NLM international online database network may now search AIDSLINE, AIDSDRUGS, AIDSTRIALS, and DIRLINE free of charge. AIDSLINE is an online database with more than 90,000 references to AIDS-related journal articles, books, audiovisuals, and conference abstracts. AIDSTRIALS, a joint effort of the Food and Drug Administration and NIH's National Institute of Allergy and Infectious Diseases, includes up-to-date information on more than 500 clinical trials of drugs and vaccines that have been or are currently being tested. The shift to free access followed recommendations made at a June conference last year, when members of community organizations demonstrated that the existing modest fees were a financial burden, and that the charges were inhibiting their access.