Date: Fri, 27 Dec 96 09:25:40 EST From: "Flynn Mclean" Subject: CDC AIDS Daily Summary 12/27/96 AIDS Daily Summary December 27, 1996 The CDC National Center for HIV, STD, and TB Prevention makes available the following information as a public service only. Providing this information does not constitute endorsement by the CDC. 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 ****************************************************** "A New Regimen: Africa's AIDS Experts Turn to Antibiotics to Slow the Epidemic" "U.S. to Limit HMO Incentives Linked to Curbs on Medicare, Medicaid Treatment" "Health Aides Push Condoms for Prisons" "87 Ohio Counties Report AIDS Cases" "Russian Karelia's AIDS Toll Up From Zero to Ten" "Chronicle: For Steve Ross, Showtime Is Charity Time" "California's Agouron Pharmaceuticals Applies to Produce Anti-HIV Drug" "Coping With AIDS: Together, Online" "Medicine Men" ****************************************************** "A New Regimen: Africa's AIDS Experts Turn to Antibiotics to Slow the Epidemic" Wall Street Journal (12/27/97) P. A1; Bennett, Amanda In Africa, where the promising protease inhibitor combinations are far out of reach, health workers are putting new faith in a stalwart medicine--the antibiotic. Scientists have found that by using antibiotics to limit the proliferation of conventional sexually transmitted bacterial diseases, they can dramatically reduce the spread of HIV. Initial studies that reduced new HIV infections in specific regions around Lake Victoria by as much as 40 percent have inspired the U.S. Agency for International Development and the World Bank to spend some $16 million in efforts to expand the antibiotic treatments throughout Tanzania and Uganda. While experts believe the program could ultimately save thousands of lives, there are significant hurdles, including doubts about whether similar success rates can be achieved on a broader scale, the prohibitive cost of even-conventional medicines in Africa, and concerns regarding widespread antibiotic distribution and resistant strains of diseases. "U.S. to Limit HMO Incentives Linked to Curbs on Medicare, Medicaid Treatment" Washington Post (12/27/96); Baker, Peter New federal rules to be instituted next week address the health care industry's dilemma of trying to contain costs while also easing fears that patients will not receive necessary care. The new regulations from the Health Care Financing Administration will restrict the financial penalties which may be assessed against Medicare and Medicaid providers who order referrals or expensive procedures. Health maintenance organizations (HMOs) will still be able to link physicians' pay to their abilities to keep costs down, though financial losses for doctors who refer patients to specialists or prescribe elaborate tests and treatments more often than an HMO prefers will be limited. Industry leaders appear content with the new rules. Industry officials and federal officials both say they are not aware of any specific evidence of problems stemming from an HMO's financial incentives, but rather they note both the public's concern about the issue and the need to reassure it. "Health Aides Push Condoms for Prisons" Boston Globe (12/26/96) P. B9; Dowdy, Zachary R. Massachusetts public health officials and correctional officers are debating the state's longtime policy of prohibiting condom distribution inside prisons, where AIDS is six times more prevalent than in society at large. Health officials say that, despite rules to the contrary, sex and rape will continue to occur inside prisons, and that Massachusetts should follow the model of prisons in Canada, Vermont, and Mississippi, which already distribute condoms to inmates. Massachusetts prison officials say that condoms provide containers for contraband, and that they would encourage inmates to have sex, an activity that is illegal and punishable. To bolster their argument, AIDS experts cite a rising occurrence of disease in prisons: whereas roughly 3,430 U.S. inmates had AIDS in 1992, the figure rose to 5,279 in 1994. "87 Ohio Counties Report AIDS Cases" United Press International (12/26/96) According to a recently released report from the Ohio Department of Health, 87 of the state's 88 counties have reported at least one case of AIDS. Of the reported cases, 10 percent were among the 57 counties with fewer than 500,000 residents. Moreover, rural Ohio counties have an annual AIDS rate of 3.2 per 100,000 residents--just one-third of the annual rate in urban areas. Cuyahoga County has the greatest number of AIDS cases per 100,000 residents--18.2; Hamilton County has a 15.43 rate; and Franklin County's rate is 14.3 per 100,000. Noble County is the only Ohio region not report a case of AIDS since 1981, but officials note that some residents with AIDS may have moved into the county after being diagnosed. Some 65 percent of reported AIDS cases have resulted in death, and officials estimate that some 16,000 to 18,000 Ohio residents are HIV positive. The Department of Health based its report on HIV and AIDS data collected over a 15-year period. "Russian Karelia's AIDS Toll Up From Zero to Ten" Itar Wire Service (12/26/96) Karelia, an autonomy in Russia's European north, has reported 10 new cases of HIV in two months. Until November, the Karelia region was considered free of the virus. Karelia health care minister Anatoly Artyomiyev, who revealed the HIV data at a recent news conference, noted that the region lacks funds to maintain clinics or to pay the $4.3 million in wages it owes to medical personnel. Artyomiyev also noted that residents' vulnerability to diseases is on the rise. "Chronicle: For Steve Ross, Showtime Is Charity Time" New York Times (12/27/96) P. B6; Brozan, Nadine In an effort to raise money for the fight against AIDS, cabaret performer Steve Ross will perform songs by request before each show and during intermission for a donation of $100. Ross, who is making his Broadway debut in Noel Coward's "Present Laughter," explained that other charity work he does inspired him "to give music to the cause." If Ross plays just two requests during each performance of the show, $1,600 could be raised each week. "California's Agouron Pharmaceuticals Applies to Produce Anti-HIV Drug" Knight-Ridder/Tribune Business News (12/24/96); Aguilera, Mario C. Agouron Pharmaceuticals has filed a new drug application with the Food and Drug Administration for its Viracept anti-HIV drug, marking the first time a company has petitioned the FDA for a new class of protease inhibitor drugs for both adults and children. Analysts say the market potential for such a drug is tremendous. The FDA has already approved three drugs that fall under the same classification as Viracept: Merck & Co.'s Crixivan, Abbott's Norvir, and Roche Holding's Invirase. A price has not yet been set for the new Agouron drug. "Coping With AIDS: Together, Online" Yahoo! Internet Life (12/96) Vol. 2, No. 7, P. 24; Gensler, Howard Internet newsgroups provide an important means for the exchange of HIV and AIDS information, on topics ranging from research and treatment advances to political movements and service organizations. On sci.med.aids, users can access daily AIDS news updates, detailed scientific information about drug therapies, and debates about different AIDS drugs. Due to the occasional censorship of posts on sci.med.aids, James Scutero founded misc.health.aids which includes more controversial information. While the dialogue can become extreme, "whatever goes in is going to be tried by fire. It's going to be ground up, analyzed, and reanalyzed. And whatever's true is going to stick," Scutero says. At alt.hemp-tokers, the legalization of marijuana is advocated, especially for people with AIDS and other illnesses. Another group, rec.pets.dogs.rescue, posts information about organizations that help AIDS patients care for their pets. AIDS information can also be found on many web sites, including those developed by AEGIS (AIDS Education Global Information System) at www.aegis.com, the New York Academy of Medicine at www.nyam.org, and Medline at www.healthgate.com. "Medicine Men" Advocate (12/24/96) No. 723, P. 31; Gallagher, John The biotech company CytoDyn has produced a new HIV therapy called Cytolin. The company is dedicated primarily to treating HIV; financial concerns are secondary. Unlike any other HIV therapy, Cytolin is an antibody designed to bolster the immune system. Allen D. Allen, the Los Angeles physicist who developed the idea for Cytolin, explains that the drug is designed to block the region of the CD8 cell that is responsible for killing the body's infection-fighting CD4 cells. CytoDyn medical director David Hart says, "Most researchers and doctors practicing HIV medicine believe we will never poison the virus out of existence," but he notes that by targeting the mechanism that destroys the immune system, anti-viral treatments could be more effective. The Food and Drug Administration approved a preliminary clinical trial of the drug in October, and if it is successful, Cytolin could be on the market in two years.