Date: Fri, 23 Feb 1996 10:52:57 +0500 From: ghmcleaf{CONTRACTOR/ASPEN/ghmcleaf}%NAC-GATEWAY.ASPEN@ace.aspensys.com Subject: CDC AIDS Daily Summary 02/23/96 AIDS Daily Summary February 23, 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 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 1996, Information, Inc., Bethesda, MD ************************************************************ "Pa. Adds New AIDS Drug to Program" "Airing Ads on AIDS" "CDC Finds Some Drug Users Still Spreading AIDS" "Health and Welfare Ministry in Japan Knew of Risk of AIDS in 1983" "HHS Awards $80 Million in Ryan White Funding to 42 Cities" "Urine Therapy Devotees Flock to India" "Survey Finds Keys to Secondary Prevention of AIDS" "Serum Cortisol Levels Linked to Disease Progression in AIDS Patients" "CDC Wants More Input Before Updating Post-Exposure Guidelines" "Gay Physicians Group Offers Aid to HIV-Infected Doctors" "Continued Sexual Risk Behavior Among HIV Seropositive, Drug- Using Men: Atlanta, Washington D.C., San Juan, Puerto Rico" ************************************************************ "Pa. Adds New AIDS Drug to Program" Philadelphia Inquirer (02/23/96) P. B3; Collins, Huntly The Pennsylvania Welfare Department announced Thursday that uninsured people will have access to the first of the protease inhibitors, a promising new class of anti-HIV drugs. The state will add the drug saquinavir, or Invirase, to the AIDS medicines it already provides to uninsured residents. The drug, along with others expected to be approved this spring, has shown the most potential yet to suppress HIV. The state now pays for 56 AIDS drugs for low- and moderate-income residents. A year's supply of the saquinavir costs about $6,860. "Airing Ads on AIDS" Miami Herald (02/22/96) P. 1B; Smith, Stephen Health Crisis Network, Dade County, Fla.'s largest provider of AIDS services, has contracted with the advertising firm Beber Silverstein & Partners to give a louder voice to AIDS education. Already, there are plans for billboards that show a condom and read: "The airbag for your other drive." The new campaign is also supposed to include free television commercials, but currently TV stations are only willing to air the tamest ad. This commercial features a group of men, women, and children who obtain services from Health Crisis Network, along with the message: "Every 13 minutes, someone in the United States is infected with HIV." Officials at Health Crisis Network say they are frustrated by the TV station's reluctance to air more provocative ads. "If we're going to talk about the transmission of HIV, you have to talk about sex," said Cathy Lynch, the organization's director. "CDC Finds Some Drug Users Still Spreading AIDS" Reuters (02/22/96); Cooper, Mike A new study from the U.S. Centers for Disease Control and Prevention (CDC) shows that one third of HIV-infected men using illegal drugs continue to have unprotected sex, frequently with multiple partners. A total of 28 percent of the 116 men surveyed said they were having sex without a condom. The subjects reported an average of 4 sex partners and 14 sexual acts in the prior month, were more likely trade sex for money or drugs, and were less likely to inform their partners that they had HIV. Dr. Judith Greenberg of the CDC's Division of Sexually Transmitted Diseases says that the results indicate that the drug counseling programs from which the subjects were selected may be neglecting to stress the importance of practicing safer sex. "Health and Welfare Ministry in Japan Knew of Risk of AIDS in 1983" Reuters (02/22/96) As early as 1983, Japan's Health and Welfare Ministry considered a warning against the use of U.S.-produced blood products for hemophiliacs, but did nothing, according to documents disclosed Wednesday. Until recently, the Ministry said it could not confirm the existence of AIDS-related documents, in response to charges by hemophiliacs that it knew imported blood products were contaminated. A Ministry report in 1984 concluded that unheated products could continue to be used. More than 1,800 Japanese have been infected with HIV from the blood products so far. "HHS Awards $80 Million in Ryan White Funding to 42 Cities" Reuters (02/21/96) The Department of Health and Human Services (HHS) announced that it has released $80 million in Ryan White funding to 42 cities. HHS said that the cities received about half of the normal amount under the CARE Act, because Congress has not provided the full year's funding for the Ryan White Program, which provides medical and support services for HIV and AIDS patients "Urine Therapy Devotees Flock to India" Reuters (02/23/96); Graves, Nelson Hundreds of doctors and scientists from 17 countries are attending the first World Conference on Auto-Urine Therapy, a controversial treatment for many diseases including AIDS. The three-day meeting, being held in the western Indian state of Goa, brings together proponents of the 5,000-year-old therapy, which involves drinking one's own urine. Former Indian Prime Minister Moraji Desai, who died at 99 last year, surprised the world when he revealed that he drank his own urine every day. Some doctors say urine contains hormones, enzymes, vitamins, and minerals that can cure diseases, and lessen AIDS patients' symptoms. But many mainstream doctors say that while small doses of urine are not harmful, they offer no therapeutic benefit. "Survey Finds Keys to Secondary Prevention of AIDS" Reuters (02/22/96) A survey of more than 2,500 homosexual and bisexual men shows that when they recognize the importance of testing, therapy, and secondary prevention behaviors, HIV-infected patients tend to follow medical recommendations for treatment. Dr. Ron Stall and others at the University of California at San Francisco analyzed the surveys, which asked about preventive health habits, antiviral treatments, and perceptions about such treatment including benefits and toxicity, and use of alternative therapies. While one-third of the men did not know their HIV-status, three-quarters of the ones that knew they had HIV adhered to secondary prevention recommendations. According to Stall, prevention efforts can help guard against both primary infection and secondary problems related to treatment and disease progression. "Serum Cortisol Levels Linked to Disease Progression in AIDS Patients" Reuters (02/22/96) A prospective study of adrenal function in 51 AIDS patients indicates that serum cortisol concentrations are negatively correlated with CD4 cell counts. In the Journal of Clinical Endocrinology and Metabolism, Dr. Loic Guillevin of Universite Paris-Nord speculated that either glucocorticoids can influence the immune system, or, that as the disease progresses, changes in the immune system influence cortisol concentrations. Guillevin also suggested that adrenal insufficiency may be increasing among AIDS patients. "CDC Wants More Input Before Updating Post-Exposure Guidelines" AIDS Alert (02/96) Vol.11, No.2, P. 13 The Centers for Disease Control and Prevention will gather health experts for a meeting this spring to consider whether to recommend the use of zidovudine for health care workers exposed to HIV. A case-control study, published recently in Morbidity and Mortality Weekly Report, showed that the drug, used in a prophylactic capacity, was beneficial to such workers. The current Public Health Service (PHS) recommendations, published in 1990, say there is not enough evidence to merit recommending post-exposure prophylaxis, although health care workers are to be informed of the option and left to make the decision themselves. The new study analyzed data from 31 health care workers that had been infected with HIV on the job and 679 others who were exposed to HIV between 1988 and 1994. Workers who took AZT after exposure were significantly less likely to become infected. If the PHS were to recommend AZT use for post-exposure prophylaxis, the Food and Drug Administration might expand its approved indication for the treatment. This could allow workers to receive insurance coverage for the drug. Also, workers who are not offered AZT might have legal standing. Worker interest in prophylaxis has increased since the study results were reported. "Gay Physicians Group Offers Aid to HIV-Infected Doctors" American Medical News (02/05/96) Vol.39, No.5, P. 22; Kent, Christina San Francisco's Gay and Lesbian Medical Association (GLMA) created the Medical Expertise Retention Program in 1990 to assist HIV-infected health care workers. The group offers legal assistance, support groups, job counseling, psychiatric referrals, updated policy information, and advocacy services. The organization has provided services for family practice, psychiatric, and ophthalmology residents who were dismissed based on hospital lawyers' advice. The group has also helped an emergency doctor whose professional liability coverage was dropped, thus forcing him to stop practicing. In a 1991 survey of 200 HIV-positive or "high risk" health care workers, the GLMA found that 75 percent feared losing their jobs because of their HIV status. The majority of those who were not tested, but considered high-risk, said they would be less likely to get tested, because of the potential job-related conflicts. "Continued Sexual Risk Behavior Among HIV Seropositive, Drug- Using Men: Atlanta, Washington D.C., San Juan, Puerto Rico" Morbidity and Mortality Weekly Report (02/23/96) Vol. 45, No. 7; Centers for Disease Control and Prevention A new study looking at sexual practices of male drug-users who are infected with HIV underscores the need for intensified prevention efforts for this risk group. Previous research reveals that a number of infected men who use drugs continue to practice high-risk sexual behaviors. To look at factors that may contribute to these behaviors, this report compares two groups of HIV-positive, drug-using men--those who report unprotected sex and those who abstain or practice safer sex. The study found no significant differences in demographic characteristics, health status, or drug use behavior, but did identify an opportunity for improved prevention. Most of these men are linked to ongoing community programs which provide drug treatment, mental services, health care, and psychological support. The challenge is to ensure that these programs also address the critical need for these individuals to reduce risky sexual behaviors. This article will be available tomorrow, February 23, from the Centers for Disease Control and Prevention National AIDS Clearinghouse World Wide Web page, http://cdcnac.aspensys.com:86, the CDC National AIDS Clearinghouse listserv, and CDC NAC ONLINE.