Date: Thu, 03 Nov 1994 09:03:29 -0500 (EST) From: "JOHN FANNING, CDC NAC" AIDS Daily Summary November 3, 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 ************************************************************ "Discovery That AIDS Can Be Prevented in Babies Raises Debate on Mandatory Testing" "Across the USA: New Jersey" "Health Professionals, Inc. Announces Research Agreements" "Paris Bus Drivers Strike After AIDS Syringe Attack" "The Philadelphia AIDS Consortium Enlists Through Questionnaire the Advice of Consumers of HIV/AIDS Related Services" "British Stores Blackmailed with HIV Threat" "Autopsy Rates Among Patients Reported with AIDS" "Insurer Will Accept Wash. AIDS Patients" "Grantwatch: Taking Action on National Health Care Reform" "Bookshelf: Gardening in Clay" ************************************************************ "Discovery That AIDS Can Be Prevented in Babies Raises Debate on Mandatory Testing" New York Times (11/03/94) P. B14; Kolata, Gina A debate over mandatory AIDS testing has arisen from the discovery that many infant AIDS cases are preventable. In order to prevent HIV infection, the HIV-positive mother must take AZT while she is pregnant--which means that pregnant women who may or may not know they are infected would have to be identified. A federal study found that while 25.5 percent of babies born to women taking a dummy drug were HIV-positive, only 8.3 percent of babies born to HIV-infected pregnant women taking AZT contracted the virus. While many have said that mandatory testing violates peoples' civil rights, "these data do change the agenda," said Dr. Philip Pizzo, chief of pediatrics at the National Cancer Institute. Pizzo is one who says that testing should be mandatory so that no HIV-infected pregnant woman remains unidentified. Two editorials being published--along with the study--in the New England Journal of Medicine recommend that HIV testing of pregnant women be encouraged but should remain voluntary. Dr. Arthur Caplan, director of the Center for Bioethics at the University of Pennsylvania, said that the real debate is not over testing, but the confidentiality of testing. The solution, he said, is to address the confidentiality fears because "to give a kid a preventable case of AIDS in the name of civil rights seems wrong." Related Story: USA Today (11/03) P. 1D "Across the USA: New Jersey" USA Today (11/03/94) P. 10A Condoms distributed at AIDS testing and counseling sites in New Jersey are being recalled because they smell like dead fish. The odor could be an indication of poor quality or contamination. "Health Professionals, Inc. Announces Research Agreements" PR Newswire (11/02/94) Center for Special Immunology, Inc. (CSI), a subsidiary of Health Professionals, Inc., has signed agreements with Immunobiology Research Institute (IRI) and Boehringer Ingelheim to participate in HIV clinical trials with each company. Eight CSI centers will participate in IRI's two-year Phase III study of the safety and efficacy of thymopentin (TP5). CSI Chicago will participate in Boehringer's Phase II trial of the safety, efficacy, and tolerance of nevirapine--an antiretroviral--when administered with AZT. Health Professionals, Inc.'s operations include a multistate network of primary care and clinical research facilities that specialize in immune system disorders--primarily AIDS, HIV, and Chronic Fatigue Immune Dysfunction Syndrome. "Paris Bus Drivers Strike After AIDS Syringe Attack" Reuters (11/02/94) In protest for a colleague who was attacked with an HIV-infected syringe last Thursday, Paris bus drivers held a one-day strike on Wednesday. The drivers demanded more stringent security measures, including special cabins for drivers and a second transport official in buses. In the first eight months of the year, more than 254 Paris bus staff have been attacked. "The Philadelphia AIDS Consortium Enlists Through Questionnaire the Advice of Consumers of HIV/AIDS Related Services" PR Newswire (11/01/94) In an attempt to provide HIV-infected consumers with an opportunity to influence decision making with regard to the distribution of more than $10 million to be allocated through the Ryan White CARE Act, The Philadelphia AIDS Consortium (TPAC) has distributed more than 5,500 questionnaires to consumers and providers in nine countries. The questionnaires asks consumers to evaluate services such as primary health care, case management, and translation services. TPAC provides special services for those who need assistance in filling out the form including reasons due to language barrier, illiteracy, and hard-to-reach locations. Information from this questionnaire, public hearings, and small discussion groups will help form TPAC's recommendations to the federal and state governments for the distribution of the region's AIDS funds. "British Stores Blackmailed with HIV Threat" Reuters (11/01/94) Blackmailers threatened to inject HIV-infected fluid into food in three major British supermarkets unless they were paid US$20 million, a court was told Tuesday. The attempt was prevented by undercover police officers disguised as representatives from the Sainsbury, Safeway, and Tesco supermarket chains. Alexander Taylor denied conspiracy to blackmail, but the jury was told that the second man accused, Michael Norman, had admitted to blackmail. He will be sentenced at the end of Taylor's trial. "Autopsy Rates Among Patients Reported with AIDS" American Journal of Public Health (10/94) Vol. 84, No. 10, P. 1695; Schable, Barbara; Chu, Susan Y. Researchers studied autopsy rates of people in the United States who died of AIDS to determine if there was a decline similar to that found in the general population of the country. The general autopsy rate in the United States from World War II to 1991 dropped from about 50 percent to 11 percent of deaths. Data was taken from 16 states and local health departments whose combined AIDS deaths account for 43 percent of all AIDS deaths nationwide. The autopsy rate for people with AIDS fell from 57 percent in 1983 to 10 percent in 1991. While the autopsy rate for adults with AIDS declined by 82 percent, the autopsy rate in pediatric AIDS cases declined by 57 percent. Autopsies are more likely to be performed on persons with AIDS whose mode of HIV exposure is hard to determine. The authors attribute the substantial decline in autopsy rates among AIDS patients to improved diagnostic techniques, increased workload for pathologists, the cost of the procedure, and safety issues. Critical evaluation of the decline is suggested because of the usefulness of autopsies in confirming diagnoses both antemortem and in death certificates. "Insurer Will Accept Wash. AIDS Patients" American Medical News (10/17/94) Vol. 37, No. 39, P. 32 Principal Mutual Life Insurance Co. has agreed to accept approximately two dozen applications from AIDS patients. The applications were submitted during a state-mandated "open window" period from July 1 to Sept. 30 requiring insurance companies to accept all applicants--even those with pre-existing conditions. Applications received after the period face the usual three-month waiting period for coverage. Two agents--who were trying to help sick people get insurance--took advantage of the "open window" by writing up many policies for AIDS patients. Old Northwest Agents, Principal's brokerage firm, stopped them when it discovered their actions, though ONA district manager Dennis Warren claims the allegations of wrongdoing were "totally incorrect, unfounded and distorted." Principal also denies any allegations of improper actions. "We would never encourage or condone the idea of instructing any agents or marketers to only select or deliver to us business that is good business," said Rod Karsten, a director in Principal's national office in Des Moines, Iowa. The insurance commissioner's office, however, maintains that Principal is responsible for the actions of its brokerage agents. "Grantwatch: Taking Action on National Health Care Reform" Health Affairs (Fall 1994) Vol. 13, No. 4, P. 178 In July, Funders Concerned About AIDS released a report entitled "Taking Action on National Health Care Reform," which urges FCAA members and others to "join the struggle" for health care reform. One of the report's suggestions is funding for research of "how various approaches to managed care affect people living with HIV/AIDS." Other suggestions include continued financial support of HIV/AIDS programs and services, as well as endorsement of aggressive public health campaigns aimed at HIV prevention. The AIDS Action Foundation, in consultation with FCAA, prepared the report. "Bookshelf: Gardening in Clay" Lancet (10/15/94) Vol. 344, No. 8929, P. 1072; Volberding, Paul A. In "Gardening in Clay," author Ronald O. Valdiserri--a pathologist engaged in HIV prevention research at the Centers for Disease Control and Prevention--addresses HIV and AIDS as it affects society. Some recurrent themes are the author's choice of career, the difficulty of HIV prevention, the science and politics of prevention, and the loss of his twin brother, Edwin who died of AIDS. In one essay, "Down there", he directly addresses the often ineffective methods by which parents teach their children about sex. Another essay, "Icebergs," addresses society's faith in technology and pleads for tolerance and understanding in addressing the complex social issues raised by HIV.