Date: Wed, 02 Feb 1994 09:08:45 -0500 (EST) Subject: CDC AIDS DAILY SUMMARY 02/02/94 AIDS Daily Summary February 02, 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 1993, Information, Inc., Bethesda, MD "Researchers Pursue Gel to Kill HIV" Philadelphia Inquirer (02/02/94) P. A1 (Collins, Huntly) While health experts for years have been preaching condom use as a means of avoiding HIV infection, millions of poor and uneducated women in developing countries and poverty-stricken areas of the United States cannot seek protection in condoms, which require the knowledge and consent of their male partners. In hopes of finding an alternative protection for such women, scientists have launched a worldwide research effort to develop a vaginal microbicide that women could apply before intercourse to block HIV. Although some say the newly developed Reality female condom is a step in the right direction, they point out that it is noisy, ugly, expensive, and obvious to the male partner. "Ideally, this product would be odorless, colorless, and safe," says Victor Zonana, spokesman for Health and Human Services Secretary Donna E. Shalala, about possible microbicides. "Women would be able to use it in private so that men wouldn't have to know." Scientists are currently studying existing spermicides to find out how well they protect women from HIV. From there, says David M. Phillips of the Population Council's Center for Biomedical Research at Rockefeller University, there are other questions which must be answered before research can continue. Among those questions are whether the virus infects women through vaginal tears and sores or through the healthy vaginal membrane, whether HIV infects sperm, and exactly what cells or tissue it infects after entering the vaginal tract. "Roche Begins a Study on New AIDS Drug" Wall Street Journal (02/01/94) P. C23 Roche Holding Ltd. has started a significant global study of a novel experimental AIDS drug as a result of promising data from patients finished last year. The company tested R031-8959 in more than 3,000 patients with AIDS in the United States and worldwide. As a member of a new class of drugs, Roche's compound stops the AIDS virus by inhibiting protease, an enzyme that the disease needs for reproduction. Roche joins five other pharmaceutical companies interested in this class of compounds. "AIDS Mask" Associated Press (02/01/94) Chicago--A rare leukemia virus known as HTLV-1 can disguise an important indicator of HIV infection and cause those who have the virus to fall ill more quickly, according to a new study. Although relatively rare in the United States, researchers say HTLV-1 has a higher-than-average frequency in those infected with HIV--especially intravenous drug users. Researchers studied 27 men and women in Rio de Janeiro who were infected with both HIV and HTLV-1 and compared them with 99 men and women who had only HIV infections. The study found that those with both infections tended to have more white (CD4) blood cells than did those who had HIV only. Low CD4 counts have long been associated with worsening HIV infections. Dual-infected persons, however, have more severe symptoms, say the researchers. "This report suggests that the use of CD4 counts in persons co-infected with HIV and HTLV-1 ... may be more complicated than in persons with HIV alone," confirmed Dr. Stanley H. Weiss, director of infectious diseases epidemiology in the Department of Preventive Medicine at New Jersey Medical School in Newark. It could be misleading for doctors to use CD4 counts to determine the severity of HIV infection, he says, although the federal Centers for Disease Control and Prevention dictate that anyone with a CD4 count below 200 can be classified as having AIDS. "A Mixed Blessing of Bureaucracy" Washington Post (02/02/94) P. A9 (Morgan, Dan) Although Medicaid has meant salvation for many, its bureaucracy, high costs, and inconsistencies from state to state have left virtually no one satisfied and nearly everyone confused, especially AIDS patients. Once they have become permanently disabled and meet income criteria, people with AIDS theoretically are eligible for Medicaid. Still, AIDS patients say they run into a number of "catch-22s." For example, permanently disabled persons without resources can receive monthly cash payments under a program called Supplemental Security Income, and those receiving SSI support generally are automatically qualified for Medicaid. But the very definition of permanent disability is subject to dispute when concerning AIDS patients. While the federal Centers for Disease Control and Prevention says that anyone with a T-cell count under 200 has AIDS, the Social Security Administration--which rules on SSI eligibility--uses a more restrictive definition. In addition, early intervention with antiviral and prophylactic treatments is thought to prolong life without disability. By the time AIDS patients qualify for Medicaid due to permanent disability, however, it may be too late for drugs or medical intervention to help. "Harold Burris Dies; Minister, AIDS Activist" Washington Post (02/02/94) P. B4 The Rev. Harold Joseph Burris, a Methodist minister who founded a minority AIDS support group, died of AIDS on Jan. 28 at the age of 59. Burris began his involvement with AIDS in 1984, when he worked with the Whitman-Walker Clinic in Washington, D.C., locating housing for HIV-positive people. In 1989, he established the Intergroup Minority Project AIDS Consortium and Trust (IMPACT-DC). The organization collaborates with other AIDS service groups to help provide physical, social service, psychological, and educational needs to AIDS patients and their families and friends in the black and Hispanic communities. Burris is survived by his mother, a brother and sister, his son and daughter, and two grandchildren. "Researchers Urged to Address Ethical and Social Issues Before Initiating HIV Vaccine Trials" Business Wire (01/25/94) Led by Dr. Peter Lurie of the University of California at San Francisco Center for AIDS Prevention Studies, a group of researchers from Africa, Asia, South America, and North America has proposed guidelines for HIV vaccine testing in developing nations. The rules aim to make vaccine trials not only effective, but acceptable to host countries and conducted in accord with international ethical guidelines for the protection of human participants. A key recommendation was to conduct vaccine trials in developing countries only for vaccines that have a demonstrable effect against HIV strains found in those countries. While there are more than a dozen vaccines currently being evaluated for toxicity and optimal dosage, none were developed using HIV strains predominant in Third World nations, noted Lurie. Because trial participants, believing they are protected from HIV, may increase risky behaviors, the researchers also recommended frequent counseling and education for all volunteers. Lurie and the other experts also recommended that vaccine makers provide the labs and technology for research so that the host country will not have to pay, that researchers ensure the confidentiality of participants, that minorities and women receive adequate representation in trials, and that results are interpreted without bias, among other recommendations. "Fitness Leader Greg Salem Leads the Sixth Annual Workout for Hope April 9 Nationwide; Film/TV Actress and Former Pro Athlete Cathy Lee Crosby Joins as Celebrity Spokeswoman" Business Wire (01/31/94) Los Angeles--International fitness expert Greg Salem will act as National Chairman of the Sixth Annual Workout for Hope--Against AIDS, a three-hour exercise event to raise money for AIDS. On April 9, some 30,000 health buffs in more than 120 cities nationwide will work out simultaneously. Participants will perform aerobics, dance, and circuit training in hopes of achieving the $1.5 million goal. Salem is a 15-year fitness veteran who has designed more than 60 programs for worksite fitness promotions and starred in seven instructor training videos. "Workout for Hope is the only nationwide fitness industry-supported event to raise funds for AIDS research," said Salem. "It's essential that we invest in AIDS research now to save lives in the future." Proceeds benefit HIV/AIDS research being conducted at the City of Hope National Medical Center in Duarte, Calif. Last year's event raised $1.3 million. Film and television actress and former professional athlete Cathy Lee Crosby will promote the event in nationwide public service announcements. "Informative as Possible--Without Getting Reckless" Los Angeles Times (01/30/94) P. M4 The World Health Organization estimates that between 8 million and 10 million people worldwide are infected with the virus that causes AIDS. Part of the tragedy, according to the editors of the Los Angeles Times, is that one of the strategies by which the HIV/AIDS epidemic can be stemmed involves guaranteeing the confidentiality of the tests that detect it. Because the disease can incubate in the body for a decade or more without exhibiting symptoms, it is crucial for people to be tested if they have been exposed, says the Times. If not, asymptomatic individuals can unknowingly transmit the virus to others. However, it has been shown that large numbers of people will venture forward to be tested only if their confidentiality is ensured. Without this promise of secrecy, many people who are infected refuse to be tested. This confidentiality clause has come under attack in the case of a serial rapist. While encouraging people to seek HIV tests, the confidentiality laws make it illegal to disclose the results of such tests without authorization--in this case, protecting the suspect. However, say the editors of the Times, the laws do not expressly forbid notifying alleged rape victims. They can be informed that they have had sexual contact with an infected person, so long as a name is not revealed. And although the confidentiality laws are a barrier to knowing whether an alleged rapist has HIV, they are not a barrier to self-knowledge, which is most important, conclude the editors. "HIV Complainant Loses" National Law Journal (01/24/94) Vol. 16, No. 21, P. 6 A woman who sued her surgeon's office for disclosing her HIV status has lost her lawsuit. Identified only as "Jane Doe," the plaintiff alleged in her complaint that Doris Marselle, office manager at the office of Dr. Dionisio Flores, told at least four people that Doe was HIV-positive. Jane Doe has already filed a notice of appeal in the case. "Will Attention Bring Action?" American Medical News (01/17/94) Vol. 37, No. 3, P. 1 (Jones, Laurie) The president and his administration face an HIV epidemic that is larger and more diverse than ever before. As Clinton begins his second term, AIDS experts observe that his first was marked by a gratifying measure of symbolism and substance. To begin with, Clinton was the first U.S. president to make HIV/AIDS a priority of his administration. He demonstrated this commitment by increasing funding for AIDS research and treatment, launching an initiative to spur drug development, and naming a federal AIDS czar. Finally, Clinton is credited with acting to ensure that all Americans, including those with HIV and AIDS, are covered by universal insurance coverage under his health care reform. While his efforts are praiseworthy, and certainly more than any other president has accomplished in the past, AIDS experts say it is not enough. They hope for more funding for prevention and education, as well as continued funding increases for research and treatment. But just as important as money, they say, is the need to put in motion a sweeping action in the form of a national plan by a high-profile AIDS policy coordinator. Clinton has delivered Kristine Gebbie, but the AIDS experts are still waiting for the president to fulfill his campaign promise of a Manhattan Project for AIDS.