Date: Tue, 22 Oct 1996 09:49:32 -0400 From: "Flynn Mclean" Subject: CDC AIDS Daily Summary 10/22/96 AIDS Daily Summary October 22, 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 ****************************************************** "White House Waffles on HIV Asylum Policy" "FDA Panel Advises Against Approval of Contraceptive" "Concerns Grow That Doctor-Assisted Suicide Would Leave the Powerless Vulnerable" "USA Snapshots: Why Teens Use Drugs" "Making AIDS Vaccine" "Depression in Children with HIV-Infected Mothers May Be Overlooked" "Court Rejects Assisted Suicide Case" "Can HIV-1 Transmission be Prevented During Pregnancy and Labor?" "New Hemoglobin From Old Blood" "The Great Fellatio Debate: How Safe is Oral Sex?" ****************************************************** "White House Waffles on HIV Asylum Policy" Washington Times (10/22/96) P. A1; Larson, Ruth The White House has been criticized for being unclear on its policy of granting asylum to people with HIV. A spokesman for the White House Office of National AIDS Policy said a 1993 law barring the immigration of people with HIV still stands, but the Immigration and Naturalization Service (INS) has reported that, at the White House's instruction, HIV was added to the list of considerations for asylum candidates. However, while the Presidential Advisory Council on HIV/AIDS recommended reversing the ban on HIV-positive immigrants, INS rejected the proposal, saying that such a move would be counter to the statute and that it therefore could not change the class for HIV. The agency, though, did change the current policy to include HIV status is the factors to be considered in requests for asylum. Critics note that the White House's and INS' exchange of blame avoids the issue "of exposing taxpayers to the enormous costs of treating additional AIDS patients," according to Rep. Lamar K. Smith (R-Texas), head of the House Judiciary subcommittee on immigration. "FDA Panel Advises Against Approval of Contraceptive" Washington Post (10/22/96) P. A6 Approval of a new barrier contraceptive device was not recommended by a panel of the Food and Drug Administration on Monday, due to concerns about how well the device prevents pregnancy. Yama Inc. has sought the approval for a device similar to a cervical cap, called Lea's Shield. The company had tested the device on only 55 women, 9 percent of whom became pregnant during the six-month study period. The FDA panel said the size of the study was inadequate to accurately determine reliability. Women's advocates had urged approval of the device, contending that women are desperate for new contraceptive options. Lisa Cox, of the National Women's Health Network, said "the appropriate response to the public health needs of women in the '90s is to expedite barrier controls." Yama, however, was urged to study whether the new contraceptive provided any protection against sexually transmitted diseases, adding that currently there is no evidence of such an indication. "Concerns Grow That Doctor-Assisted Suicide Would Leave the Powerless Vulnerable" New York Times (10/20/96) P. 14; Kolata, Gina As assisted-suicide cases move rapidly through the court system, concerns are being raised about how society would be impacted if doctors are allowed to help patients die. Opponents of assisted-suicide say society's attitudes toward people who are poor, elderly, or physically and mentally ill would become less compassionate. Supporters, however, focus on how assisted-suicide would benefit the terminally ill individual. Two cases--both involving patients dying of cancer or AIDS who wanted their doctors to help them commit suicide--reached U.S. Circuit Courts of Appeals in Oregon and New York earlier this year. Both courts decided that each state's law banning assisted suicide was unconstitutional, sending a strong message in favor of the practice. "USA Snapshots: Why Teens Use Drugs" USA Today (10/22/96) P. 1D One-quarter of 17-year-olds surveyed by the National Center on Addiction and Substance Abuse say the main reason teens use drugs is because their friends do, while 49 percent of 12-year-olds said the main reason is "to be cool." Other popular reasons cited included "to feel good" and stress relief. Overall, about 4 percent of the 12-year-olds polled said it was "very likely" they would try drugs, while 20 percent of 17-year-olds said they would. "Making AIDS Vaccine" United Press International (10/22/96); Wasowicz, Lidia Researchers have found an antibody that may help protect people from contracting HIV through sexual contact. Scientists at the University of California Los Angeles, report that, in a study of 252 homosexuals, those with high levels of the antibody VH3 were more resistant to HIV infection through sexual contact than those with low levels. "Depression in Children With HIV-Infected Mothers May Be Overlooked" Reuters (10/21/96) Depression is a serious threat in the HIV-negative children of HIV-positive mothers, and one that is often overlooked, report researchers at Yale University medical school. Dr. Brian W.C. Forsyth and colleagues found that children with HIV-positive mothers were significantly more withdrawn, had more attention problems, and were depressed more often than other children. "Court Rejects Assisted Suicide Case" United Press International (10/21/96); Kirkland, Michael California's request to the Supreme Court to speed up a review of a lower-court ruling that favors assisted suicide was rejected Monday. The Court may, however, still review the case, brought by an unidentified man with AIDS. The Court has already decided to hear similar cases from Washington state and New York. "Can HIV-1 Transmission be Prevented During Pregnancy and Labor?" Lancet (10/12/96) Vol. 348, No. 9033, P. 1021; McCarthy, Michael Caregivers have little control over the majority of the factors that increase the risk of mother-to-infant HIV transmission during pregnancy and delivery, according to French researchers. Laurent Mandelbrot and colleagues analyzed the pregnancy and delivery history, and the HIV-1 status at 18 months, of more than 1,600 children born to HIV-1 infected mothers. The study preceded the introduction of zidovudine use for the prevention of mother-to-child transmission, some 19 percent of the infants were found to be seropositive at 18 months. Factors that the researchers identified as increasing the risk of transmission included: invasive procedures, such as amniocentesis and amnioscopy; sexually transmitted diseases during pregnancy; preterm delivery; premature membrane rupture; hemorrhage during labor; and blood in the amniotic fluid. Except for the use of invasive procedures, caregivers have little control over these factors, the researchers said. Moreover, factors that the caregiver could control--such as protracted labor and skin abrasions--were found to have little influence on transmission. The researchers recommend that invasive procedures be avoided during pregnancy and that vaginal infections be quickly diagnosed and treated. "New Hemoglobin From Old Blood" Business Week (10/14/96) No. 3497, P. 88; Stodghill, Ron, II A substitute for hemoglobin--the component of red blood cells that carries oxygen--could help relieve the high demand for donated blood. Several companies have been developing potential blood substitutes, and Baxter International received Food and Drug Administration approval in June to start Phase III trials of its product, HemAssist, in surgery patients. The product could be approved for trauma patients within months. To create the product, Baxter collects millions of hemoglobin molecules from the red blood cells of outdated donated blood. The cells are purified to eliminate any disease agents and cross-linked for stability before they can be used. Analysts estimate that a viable blood substitute could be worth $2.5 billion a year. "The Great Fellatio Debate: How Safe is Oral Sex?" Village Voice (10/15/96) Vol. 41, No. 42, P. 25; Schoofs, Mark As the level of HIV risk involved in oral sex is debated by researchers and health experts and contradicting studies are reported, the public is left in confusion. It is known that oral sex is less risky than anal or vaginal sex; however, no one can say what that risk level is. At the International Conference on AIDS held this summer, researcher Timothy Schacker reported that, while the risk linked to a single act of fellatio is much lower than that for anal sex, the higher frequency of oral sex among gay men could attribute to significant cumulative risk. Although case reports show that few people have contracted HIV from fellatio, but a survey of 40 AIDS doctors across the country indicates that many such cases are not identified. The estimated HIV risk for fellatio varies widely, in part because of the degrees of infectiousness among HIV patients and susceptibility among uninfected persons. Among the 80 percent to 90 percent of gay men who engage in oral sex, only 3 percent to 6 percent use condoms. One study of heterosexuals found that about 75 percent did not use condoms while performing fellatio. Other precautions that can be taken in addition to condoms include avoiding oral sex with strangers and not performing fellatio while mouth cuts or sores are apparent.