Date: Tue, 22 Feb 1994 09:10:03 -0500 (EST) From: "ANNE WILSON, CDC NAC" Subject: CDC AIDS DAILY SUMMARY 02/22/94 To: aids@cs.ucla.edu, david@stat.com, gopher-mail@niaid.nih.gov, AIDS Daily Summary February 22, 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 "AZT Found to Sharply Reduce Passage of AIDS From Mothers to Their Infants" Wall Street Journal (02/22/94) P. B2 (Thomas, Emory Jr.) The risk of mothers transmitting HIV to their newborns can be significantly reduced by the drug AZT, according to a new study by the National Institutes of Health. Studies conducted in 50 American and nine French clinics gave 477 HIV-positive pregnant women either AZT or a placebo during pregnancy and labor. The babies were given the same drug as their mothers for six weeks following birth. The results showed that infants born to HIV-infected mothers were only one-third as likely to contract the virus if they and their mothers received AZT during and after pregnancy. NIH has embarked on a national campaign to inform physicians about the study, and the doctors are expected to immediately begin taking the results into consideration when caring for HIV-positive pregnant women. The study also has implications for HIV testing, as NIH and other health agencies currently recommend testing, but do not mandate it. While the results of the study are promising, NIH director Dr. Anthony S. Fauci cautions that the newborns must be studied further to determine whether AZT causes any long-term side effects. Related Stories: Washington Post (02/21) P. A12; Chicago Tribune (02/21) P. 1-8; St. Louis Post-Dispatch (02/21) P. 1. "Hundreds of Convicts in Thai Prison AIDS Zone" Reuters (02/22/94) Bangkok, Thailand--Some 200 HIV-positive Thai convicts have volunteered to isolate themselves at the new three-story AIDS center in Bangkok's main correctional facility, reports prison physician Jorn Luerwitvorapong. "Patients who wish to separate themselves from other convicts are permitted to live in the AIDS zone if they want to," says Luerwitvorapong. He adds that Klongprem Prison is also treating about 80 other inmates who have already developed AIDS. The AIDS zone, which is equipped with facilities to sterilize laundry and utensils, can house as many as 500 people, according to Luerwitvorapong. He says that 300 of the prison's 5,000 inmates have tested positive for HIV, and 200 have opted to live in the AIDS zone. "AIDS Plan for Poor Seen as a Model for Other Ills" New York Times (02/22/94) P. A1 (Navarro, Mireya) While AIDS patients in the past were rejected by a medical establishment that either feared them or lacked the expertise to treat them, many AIDS patients in New York state are currently enrolled in hospital programs for poor people that offer what experts call a model for the kind of comprehensive care that all chronically ill patients should receive. The program at New York Hospital is part of a network of AIDS programs at 27 private and public hospitals, which receive more funding from Medicaid because they offer extensive services to AIDS patients. Experts say the network is a result of the initial reluctance to treat AIDS patients, as well as a patient population whose social and psychological problems often require as much attention as their physical ones. The programs center around the requirement that they provide or arrange for services to address needs at every stage of disease, as well as coordinate specialized services such as pediatric care or drug rehabilitation. Despite concerns over the expense of running the programs, officials contend that they will actually save money in the long run by keeping patients healthier longer and stressing preventive care. Other critics say the programs underscore the inequities of the nation's health care system by giving special attention to the disease. Still, AIDS patients enrolled in the programs praise the high quality care they are finally receiving. "Quest for AIDS Vaccine Raises Ethical Questions on Tests" Boston Globe (02/21/94) P. 3 (Saltus, Richard) Bioethicists are concerned about pressure to begin further testing of experimental AIDS vaccines in developing countries, despite discord over how to conduct the trials in an ethical manner. The bioethicists are also worried about recent reports that vaccines which appeared promising in lab settings may not be as effective outside the lab. This could present problems if a vaccine initially tested in America is administered to patients in other countries, since there are differences among the various strains of the virus, said members of the bioethical panel that spoke at the annual meeting of the American Association for the Advancement of Science. In addition, because vaccines have the potential to be only about 50 to 60 percent effective, it is crucial that volunteers realize risks and benefits, says Dr. Bernard Lo, head of AIDS prevention at the University of California at San Francisco. "People may not understand that an HIV vaccine is not like the ones we and our kids receive for mumps, measles, or polio," which are closer to 100 percent effective, warns Lo. "It's possible that some people would think they can go out and safely engage in all sorts of high-risk behaviors" that contribute to the spread of AIDS. Given these and other concerns, as well as the relative ineffectiveness of current vaccines, the panelists questioned whether it is ethical to proceed with the trials under such circumstances. "CDC Reports Controversial Ads Working" United Press International (02/19/94) San Francisco--A recent poll of 1,000 adults suggests that the federal government's public service announcements--which promote abstinence and condom use for avoiding HIV infection--are having a favorable impact. Officials at the Centers for Disease Control and Prevention reported that nearly half of American adults have heard of the ads, and 15,000 people called for more information within 48 hours following their release. The survey also found that 86 percent of those polled said AIDS information should be aired on television, 73 percent said information about condoms for AIDS prevention should be broadcast on television, and 23 percent felt that condoms were very effective in preventing AIDS transmission. "Australia--AIDS Surgeon" Associated Press (02/19/94) Sydney, Australia--An Australian surgeon accused of accidentally transmitting HIV from one infected patient to four uninfected women has been given permission to continue working, report health officials. The New South Wales state Health Department said in December that the physician had voluntarily ceased to practice after the case was publicized. Four female patients contracted HIV following minor operations at the surgeon's Sydney clinic on the same day in 1989. An investigation concluded that the source of the virus was a male patient who was also treated that day, and died soon thereafter. Investigators have not been able to determine precisely how the virus was transmitted, but they theorize that the surgeon may have failed to adhere to strict anti-AIDS precautions, such as instrument sterilization. One of the three women died of an AIDS-related illness last month, and the surviving patients are suing the doctor for negligence. The surgeon has tested negative for HIV, and an investigation is continuing. "3 Students Suspended for Condom Giveaway" Chicago Tribune (02/21/94) P. 1-3 Three students at Penn High School in Mishawaka, Ind., said they were each suspended from school for three days for passing out lollipops with condoms attached to them in commemoration of National Condom Week. The 17-year-olds, who said they distributed about 300 condoms before school and between classes on Thursday and Friday, wanted to raise awareness of AIDS. One of the students said he was told by a school official that he was disrupting the educational environment. "British Film Director Jarman Dies of AIDS" Reuters (02/20/94) London--British filmmaker Derek Jarman died of AIDS Sunday at the age of 52, report officials at a London hospital. Jarman discovered in 1986 that he was infected with HIV, and spent his life campaigning for gay rights. "Database" U.S. News & World Report (02/14/94) Vol. 116, No. 6, P. 4 The vulcanized rubber condom was first introduced to the market in 1865, and has experienced monumental growth since the onslaught of HIV. In 1983, seven U.S. patents for condoms were approved, and condom sales in America reached $131 million. Following Surgeon General C. Everett Koop's 1987 endorsement of condom use as a means of preventing transmission of HIV and AIDS, condom sales that year increased by 50 percent. Then, in 1991, NBA legend Magic Johnson announced that he was infected with HIV. Following this shock, an increase of 5 percent occurred in the price per share of stock in Carter-Wallace, the seller of 60 percent of American-made condoms. By 1993, there were 60 U.S. patents approved for condoms, and domestic sales zoomed to between $265 and $270 million. "Legal Activity Has Employers Wary of Capping AIDS-Related Benefits" Employee Benefit Plan Review (01/94) No. 7, P. 33 The Americans With Disabilities Act (ADA) has had a definite impact in the workplace, as evidenced by the number of related charges filed with the Equal Employment Opportunity Commission. The EEOC, handed the responsibility of enforcing Title I of the ADA prohibiting job discrimination against disabled persons, received tens of thousands of ADA-related charges by the end of 1993--many of them dealing with AIDS. Only a handful of ADA cases have made it to the courts, but employers hope that the outcomes of these cases will establish legal precedents to help define their role in treating disabled employees and job applicants. The most nettlesome of the issues seems to be that of caps placed on AIDS-related benefits in health insurance plans. The debate is clear in two court cases. In McGann v. H&H Music, the appellate court ruled that an employer's adoption of a lower limit on AIDS-related benefits did not qualify as discrimination under ERISA. In a second case, Owens v. Storehouse, Inc., the court held that an employer could adjust its self-funded health plan under ERISA to include a cap of $25,000 for AIDS-related benefits. The ERISA cases provided the background for several other cases filed by health plan beneficiaries who say they were discriminated against through caps on AIDS-related benefits.