Date: Tue, 6 Aug 1996 09:56:41 -0400 From: "Flynn Mclean" Subject: CDC AIDS Daily Summary 08/06/96 AIDS Daily Summary August 6, 1996 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 National AIDS Clearinghouse, or any other organization. Reproduction of this text is encouraged; however, copies may not be sold, and the CDC National AIDS Clearinghouse should be cited as the source of this information. Copyright 1996, Information, Inc., Bethesda, MD ****************************************************** "Rising Health Costs Threaten Generous Benefits in Europe" "Stopping Bleeding With Biologic Glue" "Journal: Not If, But When" "AG Seeks Court Order Against Pot Club" "High Risk of HIV Infection Among Homeless in Denver" "Incidence of AIDS-Related Pneumocystis Carinii Pneumonia Down Significantly" "Insurer Goes to Court to Defend Refusal to Tell Man He Had AIDS" "Zimbabwean Army in Anti-AIDS Campaign" "HIV Prevention Helping, But Not Enough" "Drugs Policy: Give Them the Needle" ****************************************************** "Rising Health Costs Threaten Generous Benefits in Europe" New York Times (08/06/96) P. A1; Whitney, Craig R. European countries, long known for their generous health care benefits, are now starting to scale back on care and drugs provided. Health care managers are turning to market-oriented cost-control measures, such as encouraging competition between hospitals and limiting the tests doctors can order. In France, in the face of rising health care costs, the government is encouraging doctors to cut back on the amount and cost of drugs they prescribe. For example, Dr. Phillippe Perez, in the Paris suburb of Thiais, says he can save money by sending his AIDS patients to the hospital rather than prescribing costly drugs, but notes that is not necessarily in their best interest because they have to stop working. "Stopping Bleeding With Biologic Glue" Washington Post--Health (08/06/96) P. 8; Murphy, Caryle Fibrin sealant, a concentrated combination of blood-clotting agents, is used in surgery to form a seal that can stop bleeding and help wounds heal. The product is not commercially available in the United States but has been used for years in Europe and South America. Because the sealant is made from blood products, there is concern about the transmission of bloodborne viruses. In some cases, however, the patient's own blood is used to make the sealant, to avoid the risk of viral transmission. Moreover, at the University of Virginia's Health Sciences Center, Dr. William D. Spotnitz makes his own sealant for use in surgery. Currently, some U.S. drug companies are seeking Food and Drug Administration approval of the sealants, which have significant moneymaking potential. "Journal: Not If, But When" New York Times (08/03/96) P. 19; Rich, Frank While powerful new AIDS drugs promise to improve the health of people infected with HIV, the cost of the drugs makes them inaccessible to many, notes Frank Rich in an Op-Ed piece in the New York Times. Rich cites Jerome Groopman, director of New York's Mapplethorpe Laboratory for AIDS Research, who says that AIDS could be treated like a manageable disease within five to ten years. Until that time, Groopman warns, the health care system is not prepared to provide adequate care for AIDS patients, many of whom do not have health insurance. In conclusion, Rich points out that Groopman also cautions that the drugs must be taken according to a strict regimen and that AIDS cases may rise as more people become less careful because of the talk of a cure. "AG Seeks Court Order Against Pot Club" United Press International (08/05/96) California Attorney General Dan Lungren said Monday that he will seek a court order to stop the Cannabis Buyers' Club from continuing to sell or distribute marijuana. Justice Department agents raided the club Sunday and seized more than 150 pounds of marijuana, more than $60,000 in cash, and more than 400 growing marijuana plants. Club leaders say they sell marijuana only to members who prove they have AIDS, cancer or some other medical condition. Lungren, however, said undercover drug agents were able to buy as much as two pounds of marijuana and that videos show that the club sold the drug to teenagers. "High Risk of HIV Infection Among Homeless in Denver" Reuters (08/05/96) A survey of homeless people in Denver found a low rate of HIV infection, but a group of Colorado disease experts concluded that high risk behaviors are common among the population. Judith C. Shlay of the University of Colorado in Denver and colleagues found the overall HIV rate among people who attended a homeless clinic in Denver was 0.9 percent. Among the participants, 41 percent reported previous injection drug use and 22 percent said they had used injection drugs in the past 12 months. While most subjects said they currently used condoms more frequently than in the past and had fewer sex partners, 60 percent reported not using a condom in the past 12 months. "Incidence of AIDS-Related Pneumocystis Carinii Pneumonia Down Significantly" Reuters (08/05/96) The number of AIDS-related Pneumocystis carinii pneumonia cases in the United States has declined 36 percent since 1991, researchers told meeting participants at the "Care of the AIDS Patient" summer seminar, sponsored by the University of California at San Francisco. The university's Sharon Safrin reported that 95 percent of PCP cases occur in patients with CD4 counts below 200, that the risk of contracting the disease is four times higher in whites than in blacks, and that men have double the risk of women. "Insurer Goes to Court to Defend Refusal to Tell Man He Had AIDS" Houston Chronicle (08/05/96) P. 10A; Schwartz, John In 1988, Mississippi lawyer Frank Deramus was refused a request to transfer a policy from one life insurance company to another, but he was not told the reason was "confidential medical information." Medical tests ordered by Jackson National Life Insurance showed that Deramus had HIV, but he did not learn of HIV-positive status until he became sick and was diagnosed with AIDS. Deramus died in June 1991, nine days after the company finally gave him the information he requested. In response to a lawsuit brought by Frank's wife, Jody Deramus, the company contends that it had no legal obligation to release the test results. A federal district judge agreed with the company, but Jody Deramus' appeal began Monday in the Fifth U.S. Circuit Court of Appeals in New Orleans. "Zimbabwean Army in Anti-AIDS Campaign" Xinhua News Agency (08/05/96) In Zimbabwe, where an estimated 10 percent of the population has HIV and 300 people die of AIDS-related causes per week, the National Army is launching an HIV/AIDS awareness campaign for its senior officials. The workshop is designed to educate high-ranking service people and thus to improve cooperation with the lower ranks. A recent survey within the army showed that service members and their families were widely aware of the impact of the disease. Medical Services Director Lieutenant-Colonel Alexander Musoko said that despite the knowledge, however, there is no positive change in behavior--either in the army or other sectors of society. "HIV Prevention Helping, But Not Enough" American Medical News (07/22/96) Vol. 39, No. 17, P. 1; Shelton, Deborah L. HIV prevention efforts that emphasize safer sexual and drug-related behaviors are helping to curb the spread of HIV, researchers announced at the 11th International Conference on AIDS. From 1990 to 1995, for example, several cities in Uganda reported a decrease in the number of pregnant women found to be infected with HIV. Dr. Peter Piot, director of the Joint United Nations Program on HIV/AIDS, attributed the decline to increased condom use, a decrease in the average number of sex partners, and a delay in first sexual intercourse. Also, in Thailand, which has reported a four-fold decrease in new infections since 1990, the percentage of men frequenting prostitutes was 10 percent in 1993, down from 23 percent in 1990. In the United States, meanwhile, the level of new AIDS cases has fallen from 85 percent in the mid-1980s, to less than 5 percent, according to the U.S. Centers for Disease Control and Prevention. The CDC's Dr. Helene Gayle noted that behavior changes among gay white men are starting to have an impact on the rate of HIV infection. The number of AIDS cases is increasing for some groups in the United States, however, and Gayle suggested that prevention programs be targeted at women as well as young and minority gay and bisexual men. "Drugs Policy: Give Them the Needle" Economist (07/20/96) Vol. 340, No. 7975, P. 26 Almost half of all new HIV infections occur in intravenous drug users, and infections in their partners and children account for another 20 percent of new cases. Drug users often share needles or use discarded ones because laws against syringe sales in most states create a scarcity of clean needles. Needle exchange programs provide drug users with new needles in exchange for used ones and also offer water, bleach, and condoms. Such programs have curbed the spread of HIV among drug users and attracted some to counseling. Needle exchanges are limited and underfunded, however. Only about 10 percent of the addicts in New York City are serviced by the programs, and Washington, D.C. has no needle exchanges. A ban prevents federal funds from being used to support the programs for fear that they will increase drug use. But studies from the University of California, the Centers for Disease Control and Prevention, the General Accounting Office, and the National Academy of Sciences have disproved this fear and shown that needle exchanges do in fact reduce HIV transmission. The programs are a political issue, however, and will likely not be supported by President Clinton out of fear of criticism from conservative groups.