AIDS Daily Summary April 19, 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 "Clients Press to Keep AIDS Agency" New York Times (04/19/94) P. B3; Navarro, Mireya New York City's Division of AIDS Services has been criticized by clients and their advocates for inconsistent service and what they call a failure to cut through the bureaucracy enough to prevent delays in government benefits. Now that the agency is in danger of being severely cut or eliminated entirely under Mayor Rudolph Giuliani's budget, these clients and their advocates are rallying to preserve the services. In recent weeks, protesters have demonstrated in favor of continued funding for the organization. They contend that continued financing is critical because D.A.S. serves the sickest and most disenfranchised patients in the city's HIV population. Three-fourths of the clients are black or Hispanic, and all have either AIDS or advanced HIV disease. D.A.S. supporters also maintain that the city would save relatively little by cutting out the agency's 700 employees, since the majority of personnel costs are paid for with state and federal money. In fact, they say D.A.S. actually helps save the city money by keeping many clients from going to shelters or staying in the hospital longer than needed due to lack of housing or home care. Administration officials, however, say that the agency is one of only a few parts of the social service bureaucracy that can legally be cut, since it is not mandated by law, court decree, or out-of-court settlements. "Vietnam AIDS Death Toll Rises Sharply" Reuters (04/19/94) On Tuesday, Vietnam reported a sharp increase in AIDS mortality, with 15 new deaths from the disease confirmed within the past month. A total of 33 Vietnamese died from AIDS by the end of last week, up from a tally of just 18 in mid-March, reported a spokesman for the Vietnam National AIDS Protection Committee. The sudden surge was partially attributable to delayed information about earlier AIDS deaths, although some did die in the past four weeks, he said. The spokesman verified that 1,300 Vietnamese were HIV-infected, and 103 people had full-blown AIDS, up from 1,233 and 75 respectively in mid-March. The country discovered its first HIV case in December 1990 and its first AIDS case only last year. Since then, rising levels of commercial sex and drug abuse have contributed to the spread of the disease. "The Rise of 'In-Your-Face' Activism" Washington Post (Health) (04/19/94) P. 7; Boodman, Sandra G. AIDS activists have taught breast cancer activists how to translate rhetoric into effective political action. In the mid to late-1980s, AIDS patients--angered at the climbing death toll and what they perceived to be a slow and unresponsive medical establishment--demanded and were eventually granted a say in how AIDS funding would be spent and what kinds of research would be financed. Breast cancer activists have followed the example set for them by AIDS advocates. They have even come up with a pink ribbon to symbolize their movement, just as the red ribbon has come to be an emblem of the AIDS movement. "AIDS showed us it could be done and helped create an atmosphere that fostered our success," says Fran Visco, an attorney and breast cancer activist. "County Leads State in AIDS Increase" Washington Times (04/19/94) P. C10 With 244 new patients in 1993, Prince George's County experienced the highest percentage increase in the number of AIDS cases in the state of Maryland, finds a report. The large caseload in the county could be related to the its proximity to Washington, D.C.--which had 1,534 new cases in 1993--health officials speculate. Last year, Maryland had the nation's eighth-highest rate of AIDS cases, at 47.6 documented AIDS cases per 100,000 residents, according to the Centers for Disease Control and Prevention. "Unsafe Sex Resurging Among Young Gay Males" Boston Globe (04/18/94) P. 23; Pertman, Adam AIDS researchers and health care professionals are noticing an alarming trend among young gay and bisexual males who, fully aware of the risks, are engaging in sexual practices that could reverse progress against the spread of AIDS in gay communities. "Though they know enough about the subject to teach a course on it, they have not incorporated their knowledge into their practices ... so we've got the risk for a whole new epidemic," explains Steven Tierney, director of adolescent services for the Justice Resource Institute at the Sidney Borum Jr. Health Center in Boston. Although most of the evidence is anecdotal, several localized studies and the testimony of AIDS researchers and health care professionals countrywide support the finding. Some health care professionals concede that they have not done enough to deal with the problem because focus on the rising heterosexual spread of the disease has diverted media and professional attention. Scientists, psychologists, and young homosexual men offer explanations for the renewed risk behavior that comes after a decade of education and prevention campaigns. The two main explanations cited are contradictory: one depicts a growing sense of fatalism stemming from young men who have seen so many of their elders die from AIDS; the other expresses a common trait of youth--a feeling of invulnerability. In response to the problem, the division of Adolescent and School Health of the Centers for Disease Control and Prevention has called a meeting of health care workers and educators in Atlanta next week to discuss the topic. "Man Starts AIDS-Awareness Crusade" St.Louis Post-Dispatch (04/18/94) P. 5B; Signor, Roger Emzy Smith, a 40-year-old black man from St. Louis, is on a mission to educate his people about AIDS. Smith says he will "go anywhere at any time" to discuss AIDS because many blacks believe they are somehow immune to the disease, or that those who are infected are being punished by God. He speaks on the subject at public meetings sponsored by the St. Louis Regional Medical Center's Ryan White AIDS Program. "Many African-Americans have their heads in the sand about the threat of AIDS," Smith explains. Health officials confirm that this indifference contributes to the increase in new HIV infections among blacks in St. Louis and St. Louis County, where they account for 35 percent of the AIDS cases. The disproportionate number of blacks with AIDS will rise sharply in a few years, predicts William Dotson of the St. Louis Metropolitan AIDS Program. One reason is the number of new HIV infections among blacks. Last year saw 290 black males and 54 black females diagnosed for HIV infection--more than double the totals for each group a year earlier, Dotson says. Even more cases will occur among blacks in the wake of an explosion of syphilis cases in 1992-93, in which nearly 2,000 infections occurred--93 percent of whom were blacks. "In those infected by syphilis, we know that their chance of developing AIDS in years ahead is very strong," says Dotson. "Avant-Garde Actor Ron Vawter Dead at Age 45" United Press International (04/18/94) Ron Vawter, an actor in the experimental theater, died Saturday after experiencing what was believed to be an AIDS-related heart attack. The 45-year-old actor was asleep on a flight from Zurich to New York City when he died, according to his agent. Vawter earned praise for his dual portrayal in "Roy Cohn/Jack Smith," in which he linked the right-wing lawyer and transvestite performer, both of whom died of AIDS. He also had minor roles in "Philadelphia," "The Silence of the Lambs," and "Sex, Lies and Videotape." Vawter is survived by his companion, director Greg Mehrten, his mother, and two sisters. "AIDS Complaints Up" National Law Journal (04/18/94) Vol. 16, No. 33, P. A8 Allegations of AIDS discrimination at work are increasing in the office of the Indiana HIV Advocacy Program, several of which have made their way into the court system. The program has received about 1,000 telephone calls and documented 248 cases of AIDS discrimination since March 1992, reports director Paul Chase. Approximately 43 percent of those cases involve employment discrimination through termination, harassment, or denial of benefits to infected employees. "Injecting Drugs and AIDS" Lancet (04/09/94) Vol. 343, No. 8902, P. 911; McCarthy, Michael Intravenous drug users who stopped sharing needles significantly lowered their risk of HIV infection, report researchers in Bangkok, Thailand. The study examined the seroconversion of individual IV drug users instead of depending upon community-wide infection rates. Intravenous drug users who had previously tested negative for HIV were interviewed, then retested. One of the questions asked was, "Since you first heard about AIDS have you done anything to avoid catching the virus yourself, or to prevent someone else from getting it from you?" Of 173 respondents, 111 fell into the "stopped sharing" needles category. The finding that drug users will accurately report their behavior changes should boost efforts to implement politically unpopular prevention programs--including needle exchanges--and should make evaluation of such programs easier, says the study's lead author, Dr. Don Des Jarlais of Beth Israel Medical Center in New York City. "Comparison of Long-Term Prognosis of Patients With AIDS Treated and Not Treated With Zidovudine" Journal of the American Medical Association (04/13/94) Vol. 271, No. 14, P. 1088; Lundgren, Jens D.; Phillips, Andrew N.; Pedersen, Court et al. To determine the connection between time elapsed since beginning treatment with zidovudine and survival in AIDS patients, Lundgren et al. of the AIDS in Europe Study Group studied 4,484 AIDS patients at 51 centers in 17 European nations. All of the participants had been diagnosed with AIDS between 1979 and 1989, had survived their initial AIDS-defining event, and had not started taking zidovudine before AIDS diagnosis. For those being treated with zidovudine, the death rate was significantly lower than for untreated patients who had developed AIDS at the same time. For longer times since beginning treatment with zidovudine, the association with a reduced mortality rate diminished. For patients who survived for more than two years after initiating zidovudine therapy, the mortality rate was higher than for untreated patients who had developed the disease at the same time. Lundgren et al. concluded that zidovudine, when initiated after an AIDS diagnosis, was linked to improved prognosis, but for no more than two years after beginning therapy.