Date: Fri, 31 May 1996 10:22:47 -0400 From: "Flynn Mclean" Subject: CDC AIDS Daily Summary 05/31/96 AIDS Daily Summary May 31, 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 ************************************************************ "Hemophiliacs Willing to Take Modified Plan" "Fairness of Sentence for Rape Questioned" "Health Risk" "Japanese Lax in Terms of HIV Prevention" "Zimbabwe: AIDS Orphans on Farms" "Untested" "AIDS Associated With Injecting-Drug Use--United States, 1995" "Wonder Drug?" "World Medicine and Western Medicine: The Missing Dialog--Interview, Kaiya Montaocean, Co-Director, Center for Natural and Traditional Medicines" ************************************************************ "Hemophiliacs Willing to Take Modified Plan" Los Angeles Times--Washington Edition (05/31/96) P. B6; Groves, Martha Thousands of hemophiliacs who contracted HIV from contaminated blood products will accept the revised $640 million settlement offered by four drug companies, representatives of the plaintiffs said Thursday. The companies--Bayer, Rhone-Poulenc Rorer, Baxter International, and Alpha Therapeutic--eliminated on Wednesday an earlier restriction on the number of people who could reject the offer and pursue individual lawsuits but did not admit liability in the case. Representatives of the hemophiliacs said that while the $100,000 proposed payment to each plaintiff was inadequate, it would at least help alleviate the burden felt by many families. "Fairness of Sentence for Rape Questioned" Baltimore Sun (05/31/96) P. 1B; O'Brien, Dennis Maryland's Supreme Court will consider today whether the attempted murder conviction of an HIV-positive rapist in 1994 was justified. Dwight R. Smallwood was convicted of attempted murder as a result of his raping three women in 1993, when he knew he was infected with HIV. His lawyers will argue that his conviction sets a dangerous precedent for the estimated 15,000 HIV-positive people living in Maryland, who could face similar charges for having unprotected sex. Gary E. Bair, of the attorney general's office, said the charge is appropriate if a prosecutor can prove that a rapist had an intent to kill. Smallwood was sentenced to life in prison in 1994 for rape and attempted murder. AIDS activists say that increased criminal penalties for people who know they have HIV could discourage those at risk from being tested. Smallwood's lawyer said he should have been charged under a Maryland law for knowingly transmitting HIV and that if he had intent to kill, Smallwood would have used his gun. "Health Risk" St. Louis Post-Dispatch (05/30/96) P. 1B; Schieszer, John While the number of tuberculosis (TB) cases in the United States has decreased over the last three years, doctors are concerned that cuts in funding could now reverse this trend. Curbing funding for research and treatment could result in more drug-resistant strains of TB and a repeat of the resurgence seen in the 1980s. TB kills more people worldwide each year than AIDS, malaria, and all tropical diseases combined, but in the United States, the number of TB cases declined about 6 percent last year. Most of the TB cases reported in St. Louis were in immigrants from countries where the disease is common. Those considered at the greatest risk for TB are the homeless, intravenous drug users, and people with compromised immunity, including AIDS and cancer patients. In the United States, treatment for a TB patient costs about $2,000, but treating a drug-resistant strain can cost $250,000. "Japanese Lax in Terms of HIV Prevention" Reuters (05/30/96) Japanese adults' HIV risk behaviors may cause a dramatic increase in the number of new HIV infections, a researcher at the University of Tsukuba warns in the current issue of AIDS Education and Prevention. Tsunetsugu Munakata reports that two behavioral surveys of more than 10,000 adults show that most do not regard AIDS as a major threat and that one in five males and one in 12.5 females who are married or who have a regular sex partner had sex with another sex partner within the last year. Three-quarters of them, especially those between the ages of 20 and 24, said they do not always use condoms. Munakata also said there was a strong reluctance to be tested for HIV and to notify sex partners of the test results. More AIDS education, especially the promotion of condom use, is needed, Munakata said. "Zimbabwe: AIDS Orphans on Farms" AIA/GIN News Service (05/29/96) In response to the rising death toll from AIDS in rural Zimbabwe, farmers have started foster homes for the orphaned children. Two million people, half of them children, live on Zimbabwe's large-scale commercial farms. At the current rate of HIV infection in this population, at least 200,000 children could be orphaned in the next ten years. The farming community is especially vulnerable to AIDS because of its social and geographical isolation, lack of education and economic security, and because large groups of people move from farm to farm. Recreation in the community depends on bars, where unprotected commercial sex is common. Many farm workers lose contact with their extended families, leaving children in need of foster care. Currently, many farms are already taking in children, and 65 percent of farmers interviewed said they are in favor of foster care for orphaned children, though they are concerned about the high cost of providing this care. "Untested" Economist (05/18/96) Vol. 339, No. 7966, P. 29 The recent passage of the Ryan White Care Act demonstrates the United States' reluctance to treat AIDS as a public health issue. An amendment that would have made HIV tests mandatory for newborns was too controversial and was altered to encourage states to implement such tests instead, carrying the threat of losing federal AIDS funds if infant AIDS cases do not decline. Identifying pregnant women with HIV, and treating them and their children, can reduce the chance of transmission by two-thirds. The Centers for Disease Control and Prevention, however, claims that requiring HIV tests for pregnant women could be harmful to the doctor-patient relationship. Such HIV testing has also been criticized by AIDS activists, who advocate instead education and voluntary testing. A public health approach was successfully taken to deal with the post-World War II rise in venereal disease, and many states still require couples take a VD test to get a marriage license. A public health approach for AIDS, however, would have to address the issue of needle exchange programs, which are controversial because they are seen as helping drug addicts, even though they have been shown to be effective at reducing HIV transmission. "AIDS Associated With Injecting-Drug Use--United States, 1995" Morbidity and Mortality Weekly Report (05/17/96) Vol. 45, No. 19, P. 392 Injection-drug use is the second most common risk factor for HIV infection, responsible for 36 percent of all AIDS cases reported to the Centers for Disease Control and Prevention as of December 31, 1995. These cases include injection drug users (IDUs), their heterosexual partners, and children of mothers who are drug users or partners of drug users. The CDC's Division of HIV/AIDS Prevention reported trends in IDU-associated AIDS cases through 1995 in the United States. Of the IDU-associated AIDS cases reported in 1995, 54 percent were heterosexual males, 20 percent were female, 13 percent were men who have sex with men, and 11 percent were heterosexual partners of IDUs. Of all the AIDS cases in women, 66 percent were associated with injection drug use, as were 85 percent of AIDS cases among heterosexual men. An editorial accompanying the article points out that while the rate of IDU-associated AIDS cases is slowing, it is increasing among heterosexual partners of IDUs and among heterosexual minorities, especially African Americans. To reduce the rate of IDU-associated AIDS, efforts should focus on preventing the initiation of injection drug use, placing more IDUs in treatment programs, and encouraging safer injecting drug practices and sexual practices, the editors said. "Wonder Drug?" Barron's (05/20/96) Vol. 126, No. 21, P. 24; Savitz, Eric J. The recent release of a study showing the promise of Reticulose, an AIDS drug made by Advanced Viral Research, sparked investor interest in the company. Reticulose, Advanced Viral's only drug, has not been approved in any country, and the Food and Drug Administration has refused to let the drug be tested in human trials. The study found that Reticulose inhibited HIV replication in the laboratory and stimulated the production of gamma interferon. Although Advanced Viral is optimistic about the drug's potential, Reticulose has a problematic history. It was marketed in the 1940s as a treatment for a variety of illnesses but was banned in 1962 when new FDA laws required proof of a drug's efficacy not just its harmlessness. The FDA also rejected in 1984 the company's request to test the drug in AIDS patients. Other difficulties include two additional rejected bids for human trials in 1992 and 1995 and a Securities and Exchange Commission civil suit alleging that unrealistic claims were made about the drug. A distributor in the Cayman Islands currently markets the treatment on the Internet, claiming the drug is effective against a range of infectious diseases, including AIDS, but AIDS experts remain skeptical of Reticulose's potential. "World Medicine and Western Medicine: The Missing Dialog--Interview, Kaiya Montaocean, Co-Director, Center for Natural and Traditional Medicines" AIDS Treatment News (05/17/96) No. 247, P. 1; James, John S. Traditional medicine, although the basic form of health care for 80 percent of the world's population, receives little research funding and attention from the scientific community. Through the Center for Natural and Traditional Medicines (CNTM) in Washington, D.C., Kaiya Montaocean and John Rutayuga have been working to bring more support to traditional medicines. CNTM organizes collaborations between traditional medicine practitioners in Senegal, South Africa, the Caribbean, Brazil, and India. In an interview, Montaocean said that more collaboration between biomedical professionals and practitioners of natural and traditional medicine is needed. He sees Western medicine as suitable for short-term interventions, but not useful for treating the global population. Because most people with HIV live in countries where traditional medicine dominates, its solutions should be considered, Montaocean says. Practitioners of traditional medicine feel unwelcome and have become unwilling to work with the Western biomedical community. Montaocean claims that most people participating in the meetings are more interested in hearing about Western medical advances than traditional medicine, noting that as Western treatments fail, many people turn to traditional therapies.