Date: Fri, 08 Jul 1994 09:17:47 -0400 (EDT) From: "ANNE WILSON, CDC NAC" AIDS Daily Summary July 08, 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 ************************************************************ "A 'Night Against AIDS': Mixing Acts and Advice" "Malaysia HIV Cases on the Rise" "China's Anti-AIDS Program" "Recent Reports: Cohesion and Group Therapy" "HIV-1 Newborns" "PCP Prophylaxis in Paediatric HIV Infection: Time for a Change" ************************************************************ "A 'Night Against AIDS': Mixing Acts and Advice" New York Times (07/08/94) P. D15; O'Connor, John J. In what has been dubbed a "National Night Against AIDS," ABC has teamed up with the Centers for Disease Control and AIDS groups to organize viewing parties and follow-up discussions for the 8 p.m. broadcast of "In a New Light '94" on Saturday night. Two previous "In a New Light" specials were remarkably successful in recruiting volunteers for AIDS service organizations throughout the nation. This year's special fuses celebrity entertainment from the likes of Gloria Estefan, Liza Minnelli, Chaka Khan, Kathy Mattea, Clint Black, Lou Reed, and Michael Feinstein with a series of mini-documentaries about AIDS patients, their parents, and those coping with the loss of a loved one to AIDS. Throughout the program, the toll-free number of the National AIDS Hotline of the Centers for Disease Control, which fields questions and recommends local resources, will be made available to viewers. "Malaysia HIV Cases on the Rise" Reuters (07/07/94) A total of 8,049 Malaysians were HIV-positive as of last April, according to Health Minister Lee Kim Sai. The annual infection rate for the virus increased from 0.005 percent per 100,000 people in 1985 to 0.09 percent last year, Lee reported. "China's Anti-AIDS Program" Lancet (07/02/94) Vol. 344, No. 8914, P. 51; Rich, Vera Health education, publicity, and monitoring of those at risk for infection are the cornerstones of China's new anti-AIDS campaign. While "small scope" statistics indicate that the country has 1361 HIV-infected people--40 of whom have developed AIDS and 22 of whom have died--health officials estimate that the actual number of HIV-positive people may be as high as 10,000. According to a health service official, Sun Xinhau, the epidemic is spreading, especially in Yunnan province, which accounts for 80 percent of all HIV cases. Xinhau stressed the need to bolster administrative measures and overcome prejudice. "Recent Reports: Cohesion and Group Therapy" Focus (06/94) Vol. 8, No. 7, P. 7; Tunnell, G. Short life expectancy, unpredictable course of illness, and social stigma are three HIV-related issues which jeopardize cohesion among support group members and threaten the facilitator's grasp on objectivity, according to an analysis of group therapy for HIV-positive individuals. Counselors should not interpret avoidance of discussions about death as denial, but should understand that the group needs time to develop the trust and compassion necessary for such discussion to take place. When the group is inevitably touched by death, therapists need to acknowledge the difficulty of mourning, discuss it, and remain sensitive to unexpressed anger among group members. Unpredictable course of illness may cause anxiety among members about their own or other people's health, and lead to irregular attendance. The emphasis that is then placed on the counselor is so strong that it often can undermine the very purpose of group therapy, which involves support and acceptance among peers. Finally, when societal stigma is internalized, some members may subconsciously distance themselves from the group by becoming a "container of self-hatred." They induce others to support their feelings of unworthiness, and validate their own feelings of unacceptability. Therapists also become caught up in the HIV-related factors and often lose the objectivity they have been trained to maintain. They rush to help the group members, thereby relaying the message that members are inadequate and helpless. "HIV-1 Newborns" New England Journal of Medicine (06/30/94) Vol. 330, No. 26, P. 1905; Speiser, Daniel E.; Wyler, Claire-Anne; Siegrist, Claire-Anne Speiser et al. acknowledge that Blanche et al.'s study confirms the bimodal pattern of AIDS in newborns, and clearly demonstrates the link between the infant's survival and the severity of disease in the mother. These findings, however, do not offer an explanation for how HIV-infected babies can progress to AIDS in a matter of months. Speiser et al. suggest that HIV-1-specific immunologic intolerance may directly lead to rapid disease progression. This condition occurs when antigens present in the fetal thymus during early development are viewed as self-antigens, and the immature immune systems learns not to respond against them. Advanced disease in the mother, then, could result in early transmission in utero--possibly of a larger viral inoculum or more virulent HIV strains--that could infect the fetal thymus and, therefore, induce immunologic intolerance. "PCP Prophylaxis in Paediatric HIV Infection: Time for a Change" Lancet (07/02/94) Vol. 344, No. 8914, P. 5; Kovacs, Joseph A.; Kovacs, Andrea A.S. Despite major breakthroughs in prevention of Pneumocystis carinii pneumonia (PCP), the Centers for Disease Control and Prevention in 1992 received reports of 239 cases involving children under age 12. CDC guidelines for PCP prevention, which dictate that prophylaxis should begin when the CD4 count drops below the 200 level, are generally accepted by experts as valid. Because the normal CD4 count in uninfected babies and children is significantly higher than in adults, CD4 counts decrease with age, and PCP often is diagnosed in HIV-infected infants with CD4 counts higher than 200, separate guidelines have been developed for children. These guidelines, which recommend initiation of prophylaxis according to age-specific CD4 thresholds, have of late come under some question by the European Collaborative Study, which suggested that existing thresholds will not result in timely initiation of prophylaxis for most babies who develop PCP. If these findings are confirmed, alternative approaches for PCP prophylaxis should be considered. "A National Night Against AIDS" CDC National AIDS Clearinghouse Special Notice (06/94) Join ABC Television, the Centers for Disease Control and Prevention, your local AIDS organizations, and others on Saturday, July 9, 1994, from 8:00-10:00 p.m., EDT, when the ABC Television Network will devote two hours of prime-time programming to "IN A NEW LIGHT '94," an AIDS entertainment and information special. The program, hosted by Barbara Walters, will feature special appearances by President Bill Clinton and National AIDS Policy Coordinator, Kristine Gebbie. The program will also feature leading film, television, theater, music, and sports personalities including Whoopi Goldberg, Bill Cosby, Rosie O'Donnell, Rosie Perez, Luke Perry, Susan Lucci, Dr. Ruth Westheimer, Christy Turlington, Patti LaBelle, Chaka Khan, Clint Black, Gloria Estefan, Kathy Mattea, Lou Reed, and Liza Minelli, among others. Using music and humor, "IN A NEW LIGHT '94" will present critical information to viewers on a variety of AIDS issues, including how individuals can protect themselves from HIV and how they can help fight AIDS in their communities. In connection with the program, communities across the country will join in a national AIDS awareness event called "A Night Against AIDS." On July 9, individuals and organizations nationwide will bring people together to view "IN A NEW LIGHT '94" and discuss issues raised by the program. If you are interested in organizing your own viewing event, call the CDC National AIDS Hotline at 1- 800-342-AIDS. An operator will send you a free packet of materials to help you plan such an event.