>From: "ANNE WILSON, CDC NAC" >Date: Tue, 23 Aug 1994 09:27:36 -0400 (EDT) AIDS Daily Summary August 23, 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 ************************************************************ "Where Teens Can Learn About AIDS" "Live Music Concert to Benefit LIFEbeat, the Music Industry's Organization to Fight AIDS" "HIV-Positive Reservist May Be Restricted" "The Ever-Expanding Plague" "AIDSWatch: Employer Medical Bills Disputed" "Chubb Fosters AIDS Awareness With Education" "HIV Home Testing Fraught With Potential Problems" "Zidovudine and the Quality of Life" "AIDS Prevention Programs Do Work" ************************************************************ "Where Teens Can Learn About AIDS" Washington Post--Health (08/23/94) P. 13; Jordan, Fran "What About AIDS" is an exhibit on display until Sept. 12 at the National Museum of Health and Medicine. It combines scientific data and personal accounts in a special education program that includes a history of AIDS and photos documenting one woman's struggle with the disease. Also featured is a bilingual video on AIDS transmission "Live Music Concert to Benefit LIFEbeat, the Music Industry's Organization to Fight AIDS" Business Wire (08/22/94) Music video channel VH-1 will this Saturday premiere a 90-minute special entitled "VH-1 Presents the Beat Goes On -- The LIFEbeat Benefit 1994." The live music concert will benefit LIFEbeat, the music industry's organization to fight AIDS, which provides grants to individuals and AIDS service producers. Featured performers include Seal, k.d. lang, Jon Secada, and Sarah McLachlan. "HIV-Positive Reservist May Be Restricted" National Law Journal (08/22/94) Vol. 16, No. 51, P. B21 The National Guard acted appropriately when it restricted an HIV-positive reservist to a non-deployable position, the 1st U.S. Circuit Court of Appeals ruled on July 14. In Charles v. Rice, Oscar Charles--who tested positive for the virus after serving more than two decades in the Puerto Rico Air National Guard and being employed as a National Guard technician--was discharged. The Guard acted under Regulation 39-10, which dictates that members of the Guard infected with HIV shall be transferred to the stand-by reserve, unless a non-deployment position becomes available. Charles argued that the rule was invalid, and that the discharge violated his due process and equal protection rights. The district court ruled for the defendants, noting that there was ample support for the finding that HIV-infected persons, though asymptomatic, are not deployable because of their limited ability to be immunized, their inability to donate blood, and the unpredictability of the onset of symptoms. "The Ever-Expanding Plague" Newsweek (08/22/94) Vol. 124, No. 8, P. 37; Cowley, Geoffrey; Hager, Mary One of the main concerns to emerge from the 10th International Conference on AIDS, the first ever hosted by an Asian nation, is the ever-widening scope of the disease, especially in Asia. "HIV infections in some parts of Asia are now increasing more rapidly than anywhere else in the world," said Dr. Michael Merson of the World Health Organization and, without prompt action, the epidemic will soon overwhelm the world's most densely populated countries. HIV is still relatively rare in Japan, where condoms are widely available and intravenous drug use is near unheard-of. But the virus is becoming more and more prevalent in Thailand, India, Burma, Cambodia, Vietnam, Indonesia, and Malaysia. Ironically, as evident in China, economic expansion could actually exacerbate matters. New commerce there has disrupted traditional village life and sparked large population shifts. Although the epidemic still hasn't gotten a foothold in China, experts predict that when it does, the growth will be explosive. "AIDSWatch: Employer Medical Bills Disputed" Men's Fitness (08/94) Vol. 10, No. 8, P. 108 Contrary to popular belief, employers' costs are not being stifled by the cost of their workers' AIDS care, according to a report by the Centers for Disease Control and Prevention. An AIDS patient's medical bills average between $85,000 and $120,000 over five years; however, a typical large employer only pays about $17,000 of that total. Because AIDS patients incur the greatest expenses during the final months of their lives--generally after they've left their jobs and no longer carry insurance--the rest of the total is covered by taxpayers. One employer trade group argues against this rationalization, saying that the $17,000 figure is understated because it only includes costs incurred during a limited time frame. "Chubb Fosters AIDS Awareness With Education" National Underwriter (08/08/94) No. 32, P. 6; Cox, Brian Since implementing its mandatory employee AIDS education and awareness program in 1987, Warren, N.J.-based Chubb Corp. has been exemplary in its efforts to mitigate the impact of the disease on business. The program, which includes a two-hour seminar, as well as distribution of a video and educational pamphlets, is based on the insurer's philosophy that business must share the responsibility for fighting the spread of AIDS. "From a corporate standpoint AIDS is the largest killer of employees so it's going to effect most companies," says Janice Tomlinson, Chubb's senior vice president. The goal of the program is to allay employee fears concerning AIDS and to provide outside resources. In addition, Chubb offers infected workers counseling and workplace accommodations--including shortened hours and leaves of absence--which are tailored to the needs of the employee. Chubb's AIDS education program is not only smart, but good business, since the cost of treating infected employees can exceed the expense of proactive awareness programs, Tomlinson adds. "HIV Home Testing Fraught With Potential Problems" AIDS Alert (08/94) Vol. 9, No. 8, P. 107 As the Food and Drug Administration contemplates approval of HIV home testing kits, it must grapple with not only safety and reliability issues, but also with a number of public health concerns. The agency is worried, for example, that other members of a household may be exposed to contaminated blood or kit materials. In addition, users may not collect blood adequately, which could compromise the quality of the test. Another concern arises when consumers call to retrieve their results. The FDA is concerned that telephone counseling may obstruct a counselor's ability to gauge a tester's reaction to test results, and that a negative experience with a home test may deter them from seeking professional testing. Officials also find themselves in a quandary regarding anonymity. Not only do conflicts arise in states that require name HIV reporting and partner notification, but anonymous testing would effectively prohibit follow-up testing if the test was performed improperly, or if a user received a false test result and the laboratory could not contact them. Finally, there are concerns that home testing could foster nonconsensual testing, such as a parent forcing a child to undergo testing. "Zidovudine and the Quality of Life" New England Journal of Medicine (08/04/94) Vol. 331, No. 5, P. 332; Berman, Daniel S.; Wenglin, Barry D.; Lenderking, William R. et al. Drs. Daniel S. Berman and Barry D. Wenglin challenge Lenderking et al.'s conclusions that the side effects of zidovudine make its use questionable in treating HIV patients. They contend that "zidovudine alone or combined with other therapy, with proper monitoring and dosages, has an important role in the treatment of HIV disease." Lenderking and colleagues agree with that statement, but note that Berman and Wenglin's affinity for early initiation of zidovudine treatment is based upon their belief that adverse reactions to the drug are unimportant compared with disease progression. If a patient assigns full value to the period after an adverse event and no value to the time after disease progression, then Lenderking et al. say it is likely that zidovudine therapy provides more quality, symptom-free time. They add, however, that media reports suggest duration of side effects outweighs the benefits of delaying disease progression. Lenderking et al. appreciate the chance to clarify their conclusion, which is that neither extreme reflects the proper course of action for every patient, but that physicians should consider patients' preferences about side effects and quality of life when contemplating zidovudine therapy. "AIDS Prevention Programs Do Work" Issues in Science and Technology (Summer 1994) Vol. 10, No. 4, P. 16; Curran, James W.; Holtgrave, David R.; Guinan, Mary E. Curran et al. refute the contentions of Philipson et al. that HIV prevention programs are ineffective. Philipson et al.'s economic model, say Curran and colleagues, is based on faulty reasoning. In their article, "Why AIDS Prevention Programs Don't Work," the authors argue that humans learn about the risks of HIV infection, and respond by altering their own behavior in a timely fashion. Studies indicate, however, that HIV counseling and testing reduces high-risk behavior among HIV-positive individuals, but has little measurable effect among uninfected persons. This is the opposite of what Philipson et al.'s economic model predicts. Additional studies show that well-designed HIV prevention programs can modify HIV-related risk behaviors in homosexual men, intravenous drug users, serodiscordant couples, and minority urban male youth. This experimental evidence, concludes Curran et al., demonstrates the effectiveness of HIV prevention programs, while Philipson et al.'s economic model is not supported by existing empirical data.