Date: Fri, 21 Jul 1995 09:55:18 +0500 From: ghmcleaf{CONTRACTOR/ASPEN/ghmcleaf}%NAC-GATEWAY.ASPEN@ace.aspensys.com Subject: CDC AIDS Daily Summary 07/21/95 AIDS Daily Summary July 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 ************************************************************ "Survey Finds D.C. Is Rich in Small Nonprofit Groups" "Chronicle: Greg Louganis" "Red Cross Issues Another Recall of Blood Products" "AIDS Drop-In Center Draws" "State TB and AIDS Officials Knock Down Barriers" "Energy Expenditure and Wasting in Human Immunodeficiency Virus Infection" "The Cost-Effectiveness of Voluntary Counseling and Testing of Hospital Patients for HIV" "Money Talks" ************************************************************ "Survey Finds D.C. Is Rich in Small Nonprofit Groups" Washington Post (07/21/95) P. A2; Thompson, Tracy Washington, D.C., has a largely invisible, grass-roots network of more than 700 small nonprofit groups whose objectives range from delivering meals to homebound AIDS patients to constructing low-income housing, found a new survey by the Washington Regional Association of Grantmakers. According to the survey, these groups obtain about one-third of their funding from the government. Hope Gleicher, executive director of the association, says there is a need for this kind of accounting of organizations because it increases awareness of the city's dependence on nonprofits to deliver social services. As of May, the city owed its contractors, including nonprofit groups, $33 million. "Chronicle: Greg Louganis" New York Times (07/21/95) P. B6; Brozan, Nadine Four-time Olympic gold medalist Greg Louganis is preparing for the starring and only role in "The Only Thing Worse You Could Have Told Me," an off-Broadway play by Dan Butler. The play offers a view of contemporary gay life as seen through several characters in 14 vignettes. The play--which is currently being performed by Butler, who is leaving to return to the NBC comedy "Frasier"--is also largely autobiographical. Louganis has earned both praise and criticism for his disclosure earlier this year that he has AIDS, and that he participated in the 1988 Olympics while infected with HIV. He has performed in several stage productions, including "Jeffrey." "Red Cross Issues Another Recall of Blood Products" Toronto Globe and Mail (07/19/95) P. A3; Abbate, Gay The Canadian Red Cross Society has ordered the recall of additional blood products after learning that a donor has been diagnosed with possible Creutzfeldt-Jacob disease. This second withdrawal in two weeks comes after the agency discovered that the man had donated blood in August 1994. The only other time he donated blood was in 1985. Dr. Maung Aye, national director of blood services with the Canadian Red Cross, said that both recalls were precautionary moves and that there is no scientific data that show the disease is transmitted among humans via blood transfusions. Creutzfeldt-Jacob disease is very rare, with just one case per 1 million people diagnosed each year. It is thought to be cause by an infectious protein or virus. Recently, a physician testifying at an investigation into Canada's blood system cautioned that Creutzfeldt-Jacob disease could be the next AIDS-like epidemic. "AIDS Drop-In Center Draws" Boston Globe (07/20/95) P. 24; Ferdinand, Pamela A new Cambridge drop-in center for people with HIV and AIDS has become a popular place. As many as eight people a day come to the center, which is run by Cambridge Cares About AIDS, to have coffee, talk with peer leaders, find out about referral services, or watch movies provided by local merchants, says executive director Mark Gray. The center was created after agency workers realized that people were lingering at the office because they did not have anywhere else to go for support. "They really look forward to it and have found that it's a really safe space to be in," Gray notes. "State TB and AIDS Officials Knock Down Barriers" AIDS Alert (07/95) Vol. 10, No. 7, P. 88 Connecticut is a model of how AIDS and tuberculosis (TB) control programs share information, say officials at the Centers for Disease Control and Prevention (CDC). The CDC and its Advisory Council for the Elimination of Tuberculosis (ACET) have been working to establish better relationships between AIDS and TB registries, however, confidentiality laws in many states hinder such efforts. In New York City, for example, AIDS surveillance programs are barred from telling TB surveillance programs who their patients are. Theoretically, an HIV-positive patient whose AIDS-defining illness is TB may not be counted as a TB patient--although city health officials maintain this is not true. Connecticut has been sharing data since 1986, says Tom Marino of the state's TB control program, because "we thought it was mutually beneficial to better determine to what extent HIV and AIDS was contributing to TB incidence" in the state. The public health need for identifying co-infection cases is easily justified, but confidentiality matters are politically sensitive. One way to convince legislators is to provide them with data on the rates of co-infection in the state or in certain jurisdictions and settings, says Dr. Alicia Roach, Connecticut's acting chief of AIDS epidemiology. "Energy Expenditure and Wasting in Human Immunodeficiency Virus Infection" New England Journal of Medicine (07/12/95) Vol. 333, No. 2, P. 83; Macallan, Derek C.; Noble, Carole; Baldwin, Christine et al. To determine the contribution of total energy expenditure to weight changes in patients with HIV-related wasting, Macallan et al. performed more than 50 tests of energy metabolism in HIV-infected men at various stages of the disease. The results of the tests were compared with the rate of weight gain or loss. The average total energy expended was 2750 kilocalories (kcal) per day, give or take 650 kcal, which is no more than that expended by healthy men. The researchers observed a significant positive relation between total energy expenditure and the rate of weight change. During rapid weight loss, therefore, total energy expenditure fell to 2180 kcal per day, which is primarily the result of reduced exercise. In addition, they observed that in periods of rapid weight loss, people infected with HIV used less energy. The key determinant of weight loss in HIV-related wasting, the authors concluded, was reduced energy intake--not increased energy expenditure, as some have suggested. "The Cost-Effectiveness of Voluntary Counseling and Testing of Hospital Patients for HIV" Journal of the American Medical Association (07/12/95) Vol. 333, No. 2, P. 129; Lurie, Peter; Avins, Andrew L.; Phillips, Kathryn A. et al. In response to letters to the editor published in the Journal of the American Medical Association written by members of the Johns Hopkins University School of Medicine and the Centers for Disease Control and Prevention (CDC), Lurie et al. state that--contrary to the letters' assertion--they are aware of the existence of universal safety precautions. Their research concluded that inpatient HIV screening for the purpose of preventing health care worker infection was not cost-effective, but that it could be cost-effective in areas of 1 percent seroprevalence or more. The analyses were based in three diverse hospitals, and reflect the reality of adherence to universal safety measures, rather than an idealized version of compliance, Lurie et al. assert. It seems unlikely, they conclude, that the study will be interpreted as implying that the CDC endorses inpatient HIV testing for preventing the infection of health care professionals--particularly when it was stated that "the CDC has explicitly rejected this position." "Money Talks" Advocate (07/25/95) No. 686, P. 41; Gallagher, John As AIDS and homosexual groups revise their strategies to accommodate the Republican Congress, they are increasingly turning to GOP consultants for help. Proponents of the strategy claim that this is how the game is played, and that the use of PR firms and political consultants is a long-overdue step toward making the two movements more professional. "People involved in the different movements need to adapt the techniques that work, whether or not they view them as correct," says Andrew Barrer, a former senior advisor in the White House Office on AIDS Policy. But others argue that professional packaging is not a substitute for grassroots activism, and could even divert resources from the unglamorous work involved in AIDS and gay issues. The new tactics emphasize the general lack of contingency plans that left many groups struggling when the Republicans won last fall. "We had such strong relationships with key congressional offices under the old regime that we might not have done all the work we really needed to do to really forge new relationships with a wide range of offices," admits Mike Isbell of the Gay Men's Health Crisis.