Date: Mon, 21 Aug 1995 10:03:37 +0500 From: ghfostel{CONTRACTOR/ASPEN/ghfostel}%NAC-GATEWAY.ASPEN@ace.aspensys.com Subject: CDC AIDS Daily Summary 08/21/95 AIDS Daily Summary August 21, 1995 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 1995, Information, Inc., Bethesda, MD ************************************************************ "As Theater Turned Disco Faces Demolition, Gay Alumni Share Memories" "The Doctor Is in to Cure District's Jail" "Ethiopian AIDS Victim Thrown Off Egyptian Flight" "AIDS Fear in Niger Causes Blood Shortage" "Bill Offers a Hope to Inmates with AIDS" "Prostitution Could Lead to Vietnam AIDS Surge" "Medicaid AIDS Coverage Unfair; Not Likely to Change" "A Comparison of Immediate with Deferred Zidovudine Therapy for Asymptomatic HIV-Infected Adults with CD4 Cell Counts of 500 or More per Cubic Millimeter" "Mixed Results with Octreotide for AIDS-Related Diarrhea" "The Lady Is a Champ" ************************************************************ "As Theater Turned Disco Faces Demolition, Gay Alumni Share Memories" New York Times (08/21/95) P. B3; Dunlap, David W. For some, the Saint discotheque--which is slated to be demolished next month--represents the peak of gay life in New York City during the early 1980s. The Saint opened in September 1980 with a crowd of several thousands of men dancing on the 4,800-square-foot oak floor. Within months, however, many of them began to die from a disease, not yet called AIDS. "People called it the 'Saint's disease' because everybody who got it seemed to be among the guys who danced all night at that popular disco," wrote Randy Shilts in his book "And the Band Played On." Now, 15 years later, the Saint's alumni are remembering not drugs or the sex, but the refuge they took from a hostile world in this fantasy place prior to the AIDS epidemic. "We didn't know we were dancing on the edge of our graves," said Rodger McFarlane, who later became the executive director of the Gay Men's Health Crisis. "It was the headiest experience I've ever had in my life." The club closed in 1988, reopened briefly one year later, and is now scheduled to be replaced by a seven-story apartment building. "The Doctor Is in to Cure District's Jail" Washington Post (08/21/95) P. B1; Locy, Toni Dr. Richard M. Shansky is going to prison to better understand the District of Columbia's jail. Shansky is the newly appointed receiver for the much-criticized medical and mental health services for inmates. He will earn $175 an hour, but his monthly salary can reach no higher than $16,500. U.S. District Court Judge William B. Bryant seized control of the services in July after a court-appointed monitor detailed the last hours of an imprisoned man who had AIDS. The man died while tied to a wheelchair with a urine-soaked sheet. He was so weak that he could not walk to the toilet on his own and was ignored for days by the jail staff, who did want to go to his cell because of the odor. In addition to medical services, Shansky's other main task is to investigate the issue of inmate suicides at the D.C. jail. "Ethiopian AIDS Victim Thrown Off Egyptian Flight" Reuters (08/20/95) A maid who was being deported by Egyptian authorities because she was infected with HIV could not return home to Ethiopia because her fellow passengers would not let her on the flight. According to airport officials, passengers on the EgyptAir flight to Addis Ababa recognized Mariam Mesaret because of the publicity she had received upon being arrested for being infected. They refused to sit near her, and the flight captain asked the authorities to take her off the plane. The officials report that Mesaret was then returned to a hospital. "AIDS Fear in Niger Causes Blood Shortage" Reuters (08/19/95) In 1995, more than 20 women have died at Niger's largest maternity hospital because the fear of AIDS has caused a severe shortage at the blood bank. "The maternity is still facing difficulties because it gets its supplies from the blood bank at the Niamey national hospital, which is also suffering from a serious shortage," said the hospital's chief doctor Zeinabou Moumouni. She added that people are afraid to donate blood for fear of contracting HIV. "There is a real need for information and greater public awareness," she noted. Between 1987 and 1994, there were nearly 1,700 cases of AIDS registered in Niger, which has more than 8 million citizens. Some predict the total will rise to 8,700 by 1998. "Bill Offers a Hope to Inmates with AIDS" Boston Globe (08/18/95) P. 1; Dowdy, Zachary R. Massachusetts legislators are considering a bill that would grant medical parole to AIDS patients and other terminally ill individuals in state and county facilities. The measure passed the state Senate, and is expected to reach the House this fall. A spokesman for the Massachusetts Department of Correction said that in 1994, 19 state inmates died of AIDS-related causes. Statistics on voluntary testing indicate there are at least 416 HIV-infected inmates, but prisoner advocates say there are many more infected prisoners who do not want to be tested for fear of other inmates' reactions. State Sen. James P. Jajuga (D-Methuen), who co-sponsored the bill, said it is designed to give parolees at least several days at home before their deaths. Inmates who are diagnosed with six months left to live may apply for early parole, although first-degree murderers may not. "Prostitution Could Lead to Vietnam AIDS Surge" Reuters (08/18/95) A Vietnamese official said on Friday that increasing prostitution could result in a surge of AIDS cases in the country. "It is not sure that we will be able to control the situation," said the official, a member of the National AIDS Protection Committee. The official said that although 80 percent of those who are infected with HIV are drug addicts and just 3.7 percent are prostitutes, the number of prostitutes is increasing. However, under new rules, the committee can only take blood from volunteers, so it will be more difficult to have exact figures. Authorities report that there have been 70 AIDS-related deaths in Vietnam. A total of 231 people have been diagnosed with AIDS, and nearly 3,000 others in the country are HIV-positive. "Medicaid AIDS Coverage Unfair; Not Likely to Change" AIDS Alert (08/95) Vol. 10, No. 8, P. 103 According to two new studies published in the journal Health Care Financing Review, many state Medicaid programs should end their unjust limitations on health care coverage for the approximately one out of two AIDS patients who rely on the program. Congress is preparing to shift the $90 billion federal part of the $158 billion total projected for this year's program into block grants to the states. "Payment methods that establish predetermined, fixed payments can discourage hospitals from admitting Medicaid recipients needing expensive care, such as patients with AIDS, said the authors of one study. The study determined that in 1992, 12 out of the 42 states that responded to the authors' questionnaire had some kind of yearly utilization cap on Medicaid patients' inpatient hospital care. A second study found that "utilization limits, copayments, and off-label-use and prior-authorization policies in many states weaken the drug benefit available." As a solution, the authors propose creating a national advisory panel of AIDS medical experts that would help the programs determine what drugs are considered standard treatment for HIV and AIDS care. In the meantime, the AIDS Healthcare Foundation of Los Angeles has established the first full-service, managed care program for Medicaid recipients who have AIDS, and recently signed a $26 million contract with California to provide care for 1,000 AIDS patients on the California Medicaid Program. "A Comparison of Immediate with Deferred Zidovudine Therapy for Asymptomatic HIV-Infected Adults with CD4 Cell Counts of 500 or More per Cubic Millimeter" New England Journal of Medicine (08/17/95) Vol. 333, No. 7, P. 401; Volberding, Paul A.; Lagakos, Stephen W.; Grimes, Janet M. et al. To assess the clinical benefits of zidovudine in asymptomatic HIV patients who have CD4 counts greater than 500, Volberding et al. compared immediate zidovudine therapy to deferred therapy in such patients. The participants were randomly assigned either zidovudine or a placebo, though the study was modified with open-label treatment two years later for those people whose CD4 levels fell below 500. After 6.5 years, there was no significant difference in AIDS-free survival or overall survival in the deferred-therapy group, compared to the low-dose or high-dose group of zidovudine. However, the two immediate therapy groups did experience a slower decrease of CD4 cells than the deferred group. Although side effects were rare, the high-dose zidovudine group experienced more severe anemia and granulocytopenia than the deferred group. The researchers concluded that zidovudine slows the decline of CD4 cells in symptom-free, HIV-infected adults with more than 500 CD4 cells, but does not extend either AIDS-free or overall survival. The results, therefore, do not necessarily justify the standard use of zidovudine monotherapy in this group. "Mixed Results with Octreotide for AIDS-Related Diarrhea" AIDS Clinical Care (08/95) Vol. 7, No. 8, P. 68 A multicenter study of the somatostatin analogue octreotide for the treatment of diarrhea produced mixed results. Nearly 130 AIDS patients were given octreotide or a placebo subcutaneously three times a day. After 21 days, 46 percent of the octreotide group had achieved the goal of a 30 percent decrease in stool weight, compared to 36 percent of the placebo group. The two groups had similar reductions in bowel-movement frequency. Although patients with idiopathic diarrhea--diarrhea lasting more than 13 weeks, body weight under 60 kg, or CD4 levels below 50--showed a better response to the treatment, the differences between the two groups remained nonsignificant. During the open-label phase, the octreotide dose was increased, and after eight weeks, both stool weight and bowel-movement frequency decreased significantly. Even though the results of the controlled study were disappointing, the open-label results indicate that longer-term treatment at higher doses could be effective. "The Lady Is a Champ" POZ (08/95-09/95) No. 9, P. 44; Mason, Kiki Actress, lawyer, and activist Ilka Tanya Payan bears little resemblance to the spitfire who captured the media's attention in October 1993, when she announced that she had AIDS. The star of a popular telenovela, or Spanish-language soap opera, Payan has been described as Latin America's Susan Lucci. She also had been a successful immigration attorney who wrote a weekly column on immigration issues in El Diario/La Prensa, the largest Spanish-language daily in the United States, and had established a program at Gay Men's Health Crisis to help immigrants with AIDS. Today, Payan is quiet and restrained, the result of repeated infections that have taken their toll. Payan keeps busy, though, with such activities as appearing in a closed circuit television program in the New York City school system and raising funds for an AIDS hospice in Puerto Rico. Her thoughts also turn to Ilka's Angels, a group of young Latina women who have formed an activist group about women's health issues. Payan refuses to direct the group, explaining, "My role is to try and activate people's heads, and the way that I do that is by saying health is a political issue. Then it's up to them to do whatever with the information."