| prevention-news-admin@cdcnpin.org 2004-08-03, 6:50 pm |
| CDC HIV/STD/TB Prevention News Update
Friday, February 06, 2004
The CDC National Center for HIV, STD and TB Prevention provides
the following information as a public service only. Providing
synopses of key scientific articles and lay media reports on
HIV/AIDS, other sexually transmitted diseases and tuberculosis
does not constitute CDC endorsement. The following summaries were
prepared without conducting any additional research or
investigation into the facts and statements made in the articles
being summarized, and therefore readers are expressly cautioned
against relying on the validity or invalidity of any statements
made in these summaries. This daily update also includes
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background on Morbidity and Mortality Weekly Report (MMWR)
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HIV/STD/TB Prevention News Update should be cited as the source
of the information. Contact the sources of the articles
abstracted below for full texts of the articles.
HEADLINES
NATIONAL NEWS
CALIFORNIA: "Governor Signs Leno's HIV Rapid Test Bill"
GEORGIA: "200 Atlanta Gays to Test Whether Pill Stops HIV"
UNITED STATES: "February 7: National Black HIV/AIDS Awareness and
Information Day"
MEDICAL NEWS
AFRICA: "Sex, Not Unsafe Injections, Fuels AIDS in Africa -
Study"
UNITED STATES: "Drug Effective for Resistant Hepatitis B"
LOCAL AND COMMUNITY NEWS
NEW YORK: "City Schoolbooks Badly Outdated on Sex Education"
TENNESSEE: "Downtown STD Rates Puzzle Health Officials"
NORTH CAROLINA: "Task Force Seeks Money, Condoms to Fight AIDS"
NEWS BRIEFS
SOUTH CAROLINA: "Free HIV Testing Offered Saturday"
OKLAHOMA: "About 100 People to Be Tested for TB"
NEW YORK: "Crystal Meth Forum this Sunday at Fashion Institute of
Technology"
UNITED STATES: "Stars Put a Good Face on MAC AIDS Fund"
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NATIONAL NEWS
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CALIFORNIA:
"Governor Signs Leno's HIV Rapid Test Bill"
Bay Area Reporter (01.29.04)::Matthew S. Bajko
Although AIDS activists are waging an intense battle against
Gov. Arnold Schwarzenegger's proposed budget cuts to AIDS
programs, they praised him for signing an HIV rapid testing bill
into law. The bill, AB685, reduces hurdles to training HIV
counselors and speeds deployment of a test that yields results in
less than an hour. An urgency bill, it became law the minute the
governor signed it on Jan. 21.
Introduced by Assemblymember Mark Leno (D-San Francisco),
the bill allows HIV counselors to become certified to administer
the rapid HIV test by passing a state-approved literacy protocol,
without requiring them to have a high school diploma or GED.
Health officials said the change allows HIV counseling by persons
such as former intravenous drug users and sex workers who may not
have finished formal schooling but are best-equipped to reach
underserved high-risk populations.
The bill also declares the intent of the Department of
Health Service's Office of AIDS to develop a less costly,
streamlined curriculum to train HIV counselors, paring training
days down from eight to four.
The rapid test allows patients to get their results on-site
in one visit, thereby eliminating the problem of people not
returning for their results. Statewide, an estimated 30 percent
of people who test positive for HIV never return to find out. In
San Francisco, roughly 15 percent of people do not return for
results.
Health officials estimate that in addition to the more than
15,000 individuals in the city under care for HIV, 10,000 more
are not receiving treatment. They estimate 5,000 San Franciscans
are HIV-positive but do not know it.
Steve Tierney, the city's director of HIV prevention, said
the Health Department hopes to have all eligible sites trained in
using the rapid test over the next five months.
GEORGIA:
"200 Atlanta Gays to Test Whether Pill Stops HIV"
Atlanta Journal-Constitution (02.05.04)::David Wahlberg
Approximately 200 gay men in Atlanta will be among the first
3,000 people in the world to test a new HIV/AIDS strategy: a pill
to prevent HIV infection. This spring, three studies - including
one funded by CDC - will examine whether the drug tenofovir
(Viread) can stop HIV from causing infection. Currently used to
treat HIV patients, tenofovir works by blocking reverse
transcriptase, an enzyme HIV needs for replication.
The $3.5 million CDC study will enroll men who have sex with
men, 200 at the AIDS Research Consortium of Atlanta and 200 in
San Francisco. A $6.5 million Bill and Melinda Gates Foundation
trial will involve 1,200 women in Cameroon, Ghana and Nigeria,
and 400 heterosexual men in Malawi. And a $2.1 million National
Institutes of Health trial will include 900 Cambodian women,
mostly sex workers.
In each study, half of participants will receive tenofovir
and half will receive a placebo. All participants will be advised
to practice safe sex and given condoms. Regimen adherence, side
effects, viral resistance and high-risk behaviors will all be
tracked.
Animal studies have suggested tenofovir might prevent HIV
infection. Some doctors have begun prescribing the drug, combined
with another medicine, as a "morning-after pill" when patients
report having risky sex. Physicians also note growing street use
of tenofovir among gay men as prevention before sex. That is one
reason CDC wants to study whether the drug is safe and effective
in HIV-negative people, said Kathryn Bina of CDC's National
Center for HIV, STD and TB Prevention.
Experts caution that tenofovir is no magic bullet. It has
side effects, and allowing large numbers of at-risk people to
take it intermittently could lead to drug resistance. Some worry
that the security of taking a pill that would not be 100 percent
effective could lead to more high-risk sex or drug use. Taken
daily, tenofovir costs about $4,600 a year - $12.67 a day.
UNITED STATES:
"February 7: National Black HIV/AIDS Awareness and Information
Day"
GayHealth.com (01.14.04)
Five national organizations founded National Black HIV/AIDS
Awareness and Information Day to mobilize African-American
communities in the fight against the epidemic. The campaign seeks
to encourage HIV prevention, education and testing. According to
CDC, while African Americans make up just 12 percent of the US
population, they accounted for half of all new HIV infections in
2001.
The five founding groups - Concerned Black Men Inc. of
Philadelphia; Jackson State University-Mississippi Urban Research
Center; Health Watch Information and Promotion Service; National
Black Alcoholism and Addiction Council; and National Black
Leadership Commission on AIDS - provide HIV/AIDS prevention
capacity-building assistance to community-based organizations and
stakeholders serving the African-American community. For more
information, visit www.blacksandhiv.org/index.htm.
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MEDICAL NEWS
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AFRICA:
"Sex, Not Unsafe Injections, Fuels AIDS in Africa - Study"
Reuters (02.05.04)
Unsafe sex is a far more common route of HIV transmission in
sub-Saharan Africa than unsterile medical injections and blood
transfusions, according to a review published in the Lancet
Friday by a team of experts largely from the World Health
Organization and UNAIDS. Rejecting the recent suggestion that the
epidemic is driven by unsafe health care practices, the article
reasserts the widely held view that heterosexual sex spreads HIV
in up to 90 percent of adult HIV/AIDS cases in Africa, and it
vindicates prevention programs that teach safe sex and condom
use.
A year ago, a Pennsylvania consultant, David Gisselquist,
led a group of researchers who a year ago blamed unsafe
injections for causing up to 40 percent of adult HIV/AIDS
infections in the region.
But George Schmid, of WHO's department of HIV/AIDS, and
colleagues rejected Gisselquist's unorthodox findings after
reviewing the same data and other studies. "We concluded that
epidemiological evidence indicates that sexual transmission
continues to be by far the major mode of spread of HIV-1 and that
unsafe injections, while important to eliminate, do not
contribute nearly the proportion of cases as has been suggested,"
Schmid told a news conference in Geneva.
Most injections in sub-Saharan Africa are given
intramuscularly, and blood contamination of needles after such
use is "infrequent," according to the team of 15 including
experts from Belgium, Britain, Uganda and the United States.
Schmid endorsed the WHO estimate that unsafe injections comprise
just 2.5 percent of HIV transmission cases in Africa.
"A lot of prevention programs that have been going on in
Africa should be continued,' said Peter Ghys of UNAIDS. "With
there being much more funding available, there is an opportunity
to expand those programs," he said. The full report,
"Transmission of HIV-1 Infection in Sub-Saharan Africa and Effect
of Elimination of Unsafe Injections," appeared in the Lancet
(2004;363(9407):482-488).
UNITED STATES:
"Drug Effective for Resistant Hepatitis B"
Reuters Health (01.29.04)::Will Boggs, MD
When chronic hepatitis B virus (HBV) becomes resistant to
the standard lamivudine (Epivir) treatment, the antiviral
adefovir (Preveon), alone or in combination with ongoing
lamivudine therapy, appears to be effective, according to a study
in the medical journal Gastroenterology. The rate of lamivudine
resistance can reach 69 percent after five years of treatment,
Dr. Marion G. Peters and colleagues from the university of
California-San Francisco explained in their report. Adefovir has
been shown in lab experiments to suppress lamivudine-resistant
HBV.
The researchers assessed the safety and effectiveness of
adefovir in 59 lamivudine-resistant patients. They found that
levels of the virus in blood specimens declined significantly in
patients given adefovir alone or in combination with lamivudine,
but not in patients taking lamivudine alone.
Sixteen percent of patients taking adefovir alone and 11
percent of patients taking adefovir and lamivudine cleared the
virus within 48 weeks. None on lamivudine alone did so.
Peters said there appears to be no reason to continue
lamivudine after beginning adefovir therapy in most cases.
However, combination therapy should be continued in patients with
cirrhosis. The article, "Adefovir Dipivoxil Alone or in
Combination with Lamivudine in Patients with Lamivudine-Resistant
Chronic Hepatitis B," appeared in Gastroenterology
(2004;126(1):91-101).
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LOCAL AND COMMUNITY NEWS
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NEW YORK:
"City Schoolbooks Badly Outdated on Sex Education"
New York Sun (02.06.04)::Kathleen Lucadamo
Yesterday at a state Assembly hearing, school officials said
sex education lessons in New York City schools have not been
updated in twenty years, and material for teens on HIV/AIDS are
nearly ten years old. Teachers are either following an outdated
curriculum or skipping sex education altogether.
Officials are working on the curriculum but have offered no
timeline on its availability to students. According to Roger
Platt, director of the Office of School Health, in 2002, nearly
10,000 city women under age 18 were pregnant, and 3,000 became
mothers. Teenagers accounted for 114 new HIV cases.
State law requires schools to teach HIV/AIDS education to
all students. High school health courses, though required, are
often haphazard. Platt said a shortage of health teachers - 196
for 1,200 schools - makes it hard to offer quality classes. It is
also difficult to get elementary teachers to sign up for the
required 30 hours of training for sex education. "It's pretty
hard to justify people investing 30 hours of their time to learn
a 20-year-old curriculum," Platt said.
At least 75 percent of school districts violate government
mandates for health education, including sex education and
HIV/AIDS instruction, according to Assemblymember Scott Stringer,
whose report, "Failing Grade: Health education in New York City
Schools," examined the issue.
Assemblymember Steven Sanders said, "For too long people
have relegated health education courses as the stepchild of the
academic programs. It should be approached with a sense of
urgency."
Planned Parenthood representatives said the primary focus of
sex education had been abstinence. "We support abstinence," said
spokesperson Carla Goldstein. "But should it be only abstinence?"
In 1993, Schools Chancellor Joseph Fernandez suggested the
Rainbow Curriculum, which promoted tolerance for homosexuality
and condom distribution in the schools. Mayor Rudolph Giuliani
and the Christian Coalition objected strongly.
TENNESSEE:
"Downtown STD Rates Puzzle Health Officials"
Chattanooga Times Free Press (02.01.04)::Ashley M. Heher
New Health Department data show STDs up to five times higher
in downtown Chattanooga's 37403 ZIP code than in any other area
of Hamilton County. The county ranks fourth-highest in the state
for chlamydia, fifth for gonorrhea and 17th for syphilis,
according to Tennessee Department of Health figures. Health
officials do not understand why the 37403 postal zone has rates
as high as 28.5 percent for chlamydia alone. Chlamydia infections
in the neighborhood are 104 times the state rate; gonorrhea rates
are about 87 times higher. Nearly 46 percent of 34703's chlamydia
infections occurred in 19- to 24-year-olds, 68 percent of whom
were African Americans.
The 37403 area has most of the city's homeless shelters and
a mix of inner-city poverty and urban revitalization. It is home
to the university of Tennessee-Chattanooga, the Health
Department, and the Chattanooga Times Free Press. The county's
highest syphilis rate is just to the south, in the 37408 zone,
where nearly half the population lives below the federal poverty
level and median household income is less than $10,000 a year.
Local shelter workers refer homeless persons to the Health
Department-run Homeless Health Care Clinic in the 34703 area.
Many homeless people use shelters as their mailing address, which
may be reflected in the data. Ron Berryman, a chaplain at the
Chattanooga Rescue Mission, said the numbers may also reflect
high prostitution rates downtown.
Pam Pitts, STD/HIV field services director for the state
Health Department, said Hamilton County disease rates are not
surprising. The challenge to health officials is how to reach out
to those most at risk. Pitts said African Americans and gay white
men are most at risk for syphilis and that people ages 15-19 are
most likely to contract gonorrhea and chlamydia.
NORTH CAROLINA:
"Task Force Seeks Money, Condoms to Fight AIDS"
Charlotte Observer (01.30.04)::Earnest Winston; Christina Breen
Bolling
On Jan. 29, a Mecklenburg County task force laid out a plan
to reduce the number of HIV/AIDS cases in the area. Plans include
condom distribution, syringe exchange, and outreach to high-risk
groups. The task force called for the county to increase funding
by $650,000 in fiscal 2004-05. The group also wants to create an
HIV/AIDS council.
In a tight budget year, some task-force members said it
might be difficult to fund the entire amount. Others doubted the
recommendations would lead to any meaningful change. The task
force's suggestions would likely be implemented through the
county Health Department, but could also be carried out by
community-based nonprofits.
Reported HIV cases in Mecklenburg County have risen every
year since 2000. Through part of 2003, there were 332 new cases,
a 52 percent increase from 218 cases in 2000. Task force figures
show that 458 Mecklenburg residents died from HIV/AIDS between
1998-2002. HIV is the leading cause of death in the county for
people ages 25-44.
Gwen Curry, co-chair of the task force, said the money would
be used to hire two outreach workers, two HIV counselors, a
disease intervention specialist, a marketer, six case managers
and a nurse practitioner. The new employees would work toward the
goal of eliminating all new Mecklenburg County HIV cases by 2015.
The group estimates more than 3,000 county residents have HIV.
"We are in an epidemic stage right now," Curry said. "The
numbers will come down when we introduce science-based
intervention that is culturally relevant, peer-led, empowering
and community based and proven."
Mecklenburg County funded about $2.7 million in fiscal 2003-
04 for communicable illness and disease prevention and treatment
- including more than $141,000 specifically for HIV prevention,
outreach, counseling and testing.
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NEWS BRIEFS
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SOUTH CAROLINA:
"Free HIV Testing Offered Saturday"
The State (02.06.04)
Free, confidential HIV tests will be offered in South
Carolina and around the country Saturday as part of National
Black HIV/AIDS Awareness and Information Day. Three out of every
four South Carolinians living with HIV are black, even though
African Americans comprise only one-third of the state's
population. For information about events and testing locations
Saturday, telephone the South Carolina HIV/AIDS Hotline at 800-
322-AIDS.
OKLAHOMA:
"About 100 People to Be Tested for TB"
Associated Press (02.05.04)
In Oklahoma City, about 100 people at the university of
Oklahoma college of Pharmacy will be tested for TB exposure after
a student was found to have an active case of the disease. Skin
tests are being given to students, faculty and staff. Two
pharmacy students recently had positive reactions to the TB skin
test and will receive preventive therapy, but officials do not
know if they were exposed by the student with the active case.
The pharmacy college routinely screens foreign-born students for
TB exposure, health authorities said. The student, who is from
Vietnam, tested for TB in mid-2003 and received a chest X-ray to
screen for the disease. The results were negative. But by
January, she had symptoms and tested positive for active TB. "The
student is being treated and is doing well" at her home, Doug
Voth, pharmacy college dean, said Wednesday. Last year, Oklahoma
reported 163 cases of TB.
NEW YORK:
"Crystal Meth Forum this Sunday at Fashion Institute of
Technology"
Gay City News (02.05.04)::Duncan Osborne
This Sunday, actor Harvey Fierstein will moderate "The
Crystal Meth-HIV Connection," the second in a series of town
meetings on HIV and gay men. The forum will include a discussion
with Dr. Steven Tierney of the San Francisco Health Department,
psychologist Steven Lee, and recovering meth addict and longtime
AIDS advocate Peter Staley, as well as audience member comments
and questions. CDC and New York City Health Department officials
will also be present. Hundreds of people attended the first town
meeting in the series, "Challenging the Culture of Disease: A
Panel Discussion with Harvey Fierstein" on Nov. 16.
Sunday's event takes place at the Haft Auditorium of the Fashion
Institute of Technology, 7th Ave. and 27th St. in Manhattan.
UNITED STATES:
"Stars Put a Good Face on MAC AIDS Fund"
USA Today (02.06.04)::Csar G. Soriano
Christina Aguilera, Chloe Sevigny, Boy George, Missy Elliott
and Linda Evangelista are the new faces of MAC cosmetics' Viva
Glam campaign, marking the tenth anniversary of the MAC AIDS
Fund, which began in 1994 with spokesperson RuPaul. The fund has
raised more than $32 million for HIV/AIDS patients. All proceeds
from Viva Glam V pink lipstick ($14) and lip gloss ($13.50) go to
the fund. Print ads featuring the celebrities will appear next
week. Boy George said he was thrilled to take part in the
campaign. "I've been wearing makeup since I was 14 years old," he
said. "I feel it was about time I was rewarded." George added
that the combination of an AIDS benefit and glamour is a natural
one: "AIDS has affected the fashion industry probably more than
any other industry."
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