| prevention-news-admin@cdcnpin.org 2004-08-03, 6:50 pm |
| CDC HIV/STD/TB Prevention News Update
Monday, February 23, 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
information from CDC and other government agencies, such as background
on Morbidity and Mortality Weekly Report (MMWR) articles, fact sheets
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of the articles abstracted below for full texts of the articles.
HEADLINES
NATIONAL NEWS
UNITED STATES: "Teens 'Overexposed' to Media Sex"
UNITED STATES: "Abstinence Promise"
INTERNATIONAL NEWS
EUROPE, CENTRAL ASIA: "Leaders Urge Swift Action to Halt Spread of AIDS
in Europe, Central Asia"
INDIA: "Indian Media Targeting Stigma Surrounding AIDS: Population
Expert"
MEDICAL NEWS
UNITED STATES: "Concurrent Partnerships Among Rural African Americans
with Recently Reported Heterosexually Transmitted HIV Infection"
LOCAL AND COMMUNITY NEWS
VERMONT: "Group Wants Needle Exchange to Go Mobile"
NEW YORK: "A Scorned Plan Seeks to Undo Needles and the Damage Done"
MISSOURI: "Officials Urge Hundreds of Workers to Get Tuberculosis Test"
NEWS BRIEFS
NIGERIA: "Nigeria Boycotts Polio Vaccination Drive"
CHINA: "China Honors Leading AIDS Campaigner for First Time"
MARYLAND: "Gonorrhea Hits Low in City, but Syphilis Increases"
MONTANA: "STD Increase Troubles Officials"
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NATIONAL NEWS
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UNITED STATES:
"Teens 'Overexposed' to Media Sex"
Washington Times (02.20.04)::Joyce Howard Price
A federally funded research project found that children and teens
are constantly exposed to sexual images in the media, but found that no
conclusions could yet be drawn about effects on their sexual attitudes
and behavior. The report, "Impact of the Media on Adolescent Sexual
Attitudes and Behaviors," was released Feb. 19. It was funded by a
$241,200 grant from CDC, according to a CDC official.
"All we really know is that kids are overexposed to sex,"
according to Dr. Joe S. McIlhaney, Jr, whose Austin, Texas-based
Medical Institute for Sexual Health conducted the research.
Although several studies suggest a relationship between media
images and teens' sexual attitudes and practices, the studies are not
conclusive, according to the medical institute.
However, the current study found that mass media "have been shown to
affect a broad range of adolescents' attitudes and behaviors, including
[increasing] violence, eating disorders, and tobacco and alcohol use."
The study found that teens exposed to TV programming with sexual
content "are more likely than other adolescents" to have more
permissive attitudes toward premarital sex and "to think that having
sex is beneficial." The study said two-thirds of Hollywood movies
released each year are R-Rated and that teens generally see them before
they reach the required age of 16.
Adolescents listen to the radio more than 40 hours a week, the
study said, and more than one-fifth of teen-oriented radio segments
contain sexual content. The report noted that 42 percent of top-selling
CDs contain "pretty explicit" or "very explicit" sexual content.
On average, the study noted, children ages 9-17 use the Internet
four days a week and spend about two hours online at a time. Sixty-one
percent of computer-using teens "surf the net" and 14 percent "see
something they wouldn't want their parents to know about," the study
found.
UNITED STATES:
"Abstinence Promise"
Washington Times (02.19.04)::Cheryl Wetzstein
President Bush's proposed doubling of abstinence education funding
from $135 million to $270 million a year has angered some who believe
it is a waste of money but sparked hope among abstinence-education
proponents. Abstinence-friendly government officials could structure
grants so that good programs could be sustained and a network built to
match Planned Parenthood, said LeAnna Benn, director of Teen-Aid Inc.
in Spokane, Wash. "This is a president who's finally putting his money
where his mouth is," Benn said.
"What Congress has to realize is that by denying youth critical
information about contraceptives and prevention in the era of AIDS,
they are placing the health and lives of young people in jeopardy,"
said James Waggoner, president of Advocates for Youth. "This is money -
hundreds of millions of dollars - that we could better spend on
children and people who need the help," Rep. Pete Stark (D-Calif.) told
Health and Human Services Secretary Tommy Thompson at a recent hearing
on the budget proposal.
Advocates for Youth is backing a "No New Money" campaign for
abstinence funding, citing a study indicating that one five-year,
federally funded Minnesota abstinence program could "negatively impact"
young people's sexual decisions, said Tamara Kreinin, President of
Sexuality Information and education Council of the United States, a No
New Money campaign backer. In that study of 413 students, the number
who said they had intercourse rose from 14 in 2001 to 21 in 2002.
However, the lack of a control group not taught abstinence means "there
is no way of knowing whether this number would have been larger absent
the abstinence education program," according to Wade Horn, assistant
secretary for children and families at HHS.
Under Bush's proposal, the Community-Based Abstinence Education
(CBAE) would be moved to Horn's agency in HHS. CBAE would receive $186
million a year, up from about $70 million. Thompson's office would
receive $10 million in abstinence funds. The Title XX Adolescent Family
Life Act's funding would be doubled to $26 million. The Title V
abstinence grant program in the welfare reform law would stay at $50
million annually.
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INTERNATIONAL NEWS
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EUROPE, CENTRAL ASIA:
"Leaders Urge Swift Action to Halt Spread of AIDS in Europe, Central
Asia"
Agence France Presse (02.23.04)
Irish Prime Minister Bertie Ahern told a 55-nation HIV/AIDS
conference in Dublin today that urgent action is necessary to stop the
increasingly fast spread of HIV through Europe and Central Asia. "We
must leave Dublin with an action plan to fight HIV/AIDS in our region,"
the minister, whose nation holds the rotating European Union
presidency, said in an opening address. Ahern warned that people must
not "delude themselves that HIV/AIDS was exclusively an African
problem," but recognize it as "a potent threat to our young people."
"Explosive rates of HIV/AIDS are also being recorded outside of
Africa, including in Europe and Central Asia," Ahern told the two-day
conference, entitled "Breaking the Barriers - A Partnership to Fight
HIV/AIDS in Europe and Central Asia."
Of those HIV-infected in Eastern Europe, 80 percent are young, UN
Secretary-General Kofi Annan told the conference. "No nation can afford
to see its future workers and leaders struck down by AIDS before they
reach maturity," he said.
Worldwide, AIDS is spreading at its most rapid rate in Eastern
Europe and Central Asia. In 1998, only 30,000 people were infected in
the regions compared to 1.5 million now, according to a report by
UNAIDS Executive Director Peter Piot. On May 1, the EU will expand to
include the Czech Republic, Estonia, Hungary, Latvia, Lithuania,
Poland, Slovakia, Slovenia, Cyprus and Malta. UNAIDS is calling on EU
governments to do more to help the 10 new members tackle the spread of
HIV.
INDIA:
"Indian Media Targeting Stigma Surrounding AIDS: Population Expert"
Agence France Presse (02.18.04)
Indian media have started an HIV/AIDS awareness campaign to combat
AIDS stigma, including the belief that the disease only affects
prostitutes and drug users, a population expert said Wednesday. "It is
still said today that HIV is only a problem in India among people who
don't behave themselves," said Carl Haub of the Population Reference
Bureau (PRB) in Washington.
Last June, PRB partnered with the Population Foundation of India
to begin an AIDS awareness media campaign in India. "There was a great
deal of denial about HIV," when PRB began an HIV study of India in
June, Haub said in a conference on HIV's extent in India.
The PRB study, funded by the Bill and Melinda Gates Foundation,
showed that pregnant women have tested positive for the disease, a sign
that married men who have sex with prostitutes "are acting like a
bridge and bringing the disease home," said Haub. Indian media are now
starting to dispel some of the myths surrounding the disease. "We're
seeing more and more of these [articles]," he said.
About 4.6 million Indians had HIV/AIDS in 2002, compared to 1.75
million in 1994, according to figures from the Indian National AIDS
Control Organization. About 0.8 percent of people ages 15-49 have
HIV/AIDS, the highest figure for South Asia. It has steadily increased
since 1994.
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MEDICAL NEWS
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UNITED STATES:
"Concurrent Partnerships Among Rural African Americans with Recently
Reported Heterosexually Transmitted HIV Infection"
Journal of Acquired Immune Deficiency Syndromes (12.01.03) Vol. 34; No.
4: P.423-429::Adaora A. Adimora, MD, MPH; Victor J. Schoenbach, PhD;
Francis E. A. Martinson, MB, ChB, MPH, PhD; Kathryn H. Donaldson, MPH;
Tonya R. Stancil, MS, PhD; Robert E. Fullilove, EdD
The authors studied 206 African Americans in rural North Carolina
to determine the nature of sexual networks that might explain why rates
of heterosexually transmitted HIV are dramatically higher among African
Americans, especially in the rural Southeast. The subjects were men and
women between 18-59 who had been reported to the state health
department within the preceding six months as having heterosexually
transmitted HIV and who denied injecting drugs and male same-sex
activity. Researchers interviewed them about sexual and other risk
behaviors, and analyzed dates of sexual partnerships to identify
concurrency among their 3 most recent partnerships.
"The concept of sexual networks refers to a group of people linked
directly or indirectly through sexual contact," according to the study.
"Sexual networks play a critical role in the population spread of
sexually transmitted infections (STIs). African Americans and whites
appear to have largely separate and substantially different sexual
networks. One important difference in networks is the extent of
participation in concurrent sexual partnerships (partnerships that
overlap in time), as this pattern permits more rapid spread of
infection through a connected population than does a pattern of serial
monogamy with the same rate of formation of new partnerships, a key
determinant of the reproductive number for new cases."
Subjects in the study were mostly female, unmarried and poor.
Fifty-nine percent of subjects were high school graduates or had
equivalency degrees; only 4 percent had finished college. More than
half of the men (64 percent) and one-quarter of the women had a history
of incarceration for >24 hours.
The median number of lifetime partners was higher for men (20)
than women (8.5). More than half (54 percent) of participants reported
having more than 1 sexual partner during the preceding year. About 25
percent of women and men, respectively, had at least 3 and 4 partners
during the previous year. Some had a partner who had exchanged sex for
drugs or money (32 percent) or had done so themselves (31 percent).
Nearly half (48 percent) believed at least one of their last three
partners had smoked crack cocaine, and 31 percent had smoked it
themselves. Forty-four percent of those interviewed had more than 5
alcoholic drinks in 1 day during the past 10 years. Eighty-six percent
had sex without a condom on more than 10 occasions with at least 1 of
their last 3 partners.
Forty percent reported concurrent partnerships during the past
year and 60 percent reported overlapping partnership dates during the
past 5 years. Women were nearly as likely to report concurrent
partnerships as men. Eighty-two percent of men and 89 percent of women
believed it likely that at least 1 of their last 3 partners had sex
with others while in a sexual relationship with them.
Unmarried men were most likely to have concurrent partnerships,
and respondents with concurrent partnerships were slightly younger
(median age 35 for men, 30 for women). Participants with a history of
incarceration or a partner who had been incarcerated were more likely
to have concurrency prevalence. Use of crack cocaine was strongly
associated with concurrent partnerships.
"Concurrent partnerships likely accelerate heterosexual HIV
transmission among blacks in the rural southeastern United States," the
authors concluded. "Future research should examine the socioeconomic
context that supports this network pattern."
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LOCAL AND COMMUNITY NEWS
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VERMONT:
"Group Wants Needle Exchange to Go Mobile"
Associated Press (02.20.04)
On Feb. 20, the St. Johnsbury Vermont CARES Community Advisory
Board met to review an amendment to the statewide Organized Community-
Based Needle Exchange Program operating guidelines. The group hopes to
get the state health commissioner to approve a plan for a mobile
exchange program in which peer outreach workers would give out needles
in the community rather than just at approved clinics. The Health
Department approved the concept of a mobile exchange program last year,
but rules need to be established before it can begin, according to
Kendall Farrell, executive director of Vermont CARES.
Under the terms of the current proposal, peer outreach workers
would receive a stipend and follow a lengthy list of guidelines before
distributing needles. The well-trained workers would provide drug users
with a safe means of using intravenous drugs while educating them on
health and safety issues such as safe sex. Farrell said there are many
barriers to getting people into a site-based program; a mobile outreach
would bring prevention materials and education to people who need the
service.
St. Johnsbury is one of three Vermont towns that host exchange
clinics. The others are Burlington and Brattleboro. Farrell said there
are already six trained outreach workers in the St. Johnsbury area
ready to bring needles and education to the streets. The next step is
getting the health commissioner's approval.
NEW YORK:
"A Scorned Plan Seeks to Undo Needles and the Damage Done"
New York Times (02.15.04)::Jim O'Grady
After recently looking at a map of New York City neighborhoods
with high HIV infection and drug use rates, the city's health
commissioner, Dr. Thomas R. Frieden, found that all but three
communities - all of them in Queens - have needle exchange programs. As
a result, Frieden has proposed programs in the three areas of Queens:
Jamaica, the eastern end of the Rockaways, and from Long Island City to
Elmhurst.
But Frieden's proposal will be challenging. Because it is illegal
in New York to dispense syringes without a prescription, each program
requires a waiver from the state Department of Health. The AIDS Center
of Queens County, a medical and social service agency, is applying for
the waivers. However, an applying agency must demonstrate local support
for the programs - potentially creating the rare situation in which a
community board can go beyond its customary advisory role and approve
or veto a program.
And for Jonathan L. Gaska, district manager of Community Board 12
in the Rockaways, that means answering questions like, "'What are the
locations?' and 'Is there a need?'"
Frieden points out that in the early 90s, when needle exchanges
were few, needle sharing accounted for 50 percent of HIV transmissions.
Today it accounts for 12 percent.
Frieden envisions that an exchange van would visit the
neighborhoods at set times and at locations away from schools, churches
and commercial districts. But that plan does not appeal to Jerry Walsh,
who lives near Queensboro Plaza in Long Island City, a potential stop
for the program. "It's just been rezoned for business. But who would
want to start a business with a needle exchange nearby?" he asked.
Meetings will be held in the upcoming weeks to address such
concerns. The commissioner acknowledges that it is impossible to "find
some magical place that everyone agrees on." But he hopes open dialogue
will allow the exchanges to be minimally disruptive to the
neighborhoods.
MISSOURI:
"Officials Urge Hundreds of Workers to Get Tuberculosis Test"
Associated Press (02.21.04)
Hundreds of workers and visitors at the Traders on Grand office
building in downtown Kansas City are being encouraged by health
officials to get tested for TB after an infectious person spent time
there. About 220 people work in the building, and the Kansas City
Health Department said anyone who spent more than eight consecutive
hours inside between November 2003 and Feb. 13, 2004, should get
tested. The department will provide a free TB screening for workers on
Tuesday.
"The spread of tuberculosis requires a prolonged exposure.
Although we feel the risk to the occupants of this building is low, we
feel this clinic is the prudent thing to do," said Ron Griffin, manager
of the Health Department's communicable disease control division.
"There may be individuals out there who aren't employees who may have
been exposed," Griffin said of the decision to publicize the testing.
The infected person, now being treated with antibiotics, had
visited the building for extended periods of time prior to being
diagnosed with TB.
Building Manager Greg Norris said the Health Department alerted
him Friday about the case. "We're working hand in hand with them to
make sure there aren't any problems," said Norris.
The Health Department will provide a free, nine-month course of
antibiotics to anyone testing positive for TB.
Last year, 28 cases of active TB were reported in Kansas City, and
four of those people died, said Griffin.
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NEWS BRIEFS
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NIGERIA:
"Nigeria Boycotts Polio Vaccination Drive"
Associated Press (02.22.04)::Glenn McKenzie
The Islamic state Kano in Nigeria is at the heart of a spreading
polio outbreak, but on Sunday the government there refused to end its
boycott of a mass vaccination program that it charges is a US plot to
spread AIDS and infertility among Muslims. UN aid agencies say the
door-to-door drive, which begins Monday, to inoculate 63 million
children in 10 west and central African countries is critical to
stopping a polio epidemic that is spreading from Nigeria's
predominantly Muslim north. Kano, along with Zamfara and Kaduna states,
entirely blocked a house-to-house effort to administer the oral vaccine
in October after Kano officials said their lab tests found estrogen and
other female sex hormones in the polio vaccine. Last year, Nigeria
accounted for nearly half of the 700 polio cases documented worldwide.
The outbreak has now expanded to seven African countries where the
disease had been thought eradicated. The World Health Organization's
16-year fight against polio has reduced cases from 350,000 worldwide in
1988.
CHINA:
"China Honors Leading AIDS Campaigner for First Time"
Agence France Presse (02.20.04)
On Friday, Gao Yaojie, China's leading AIDS campaigner, was among
10 recipients of the "Touching China" award presented by the state-run
China Central Television (CCTV) station. The award is one of the
highest-profile honors, and its presentation to the 77-year-old doctor
signifies a shift in the government's attitude toward HIV/AIDS. Gao was
one of the first volunteers to help AIDS patients in China. Since 1996,
Gao has spent 80,000 yuan (US $9,665) of her own money to help 164
AIDS-orphaned children, visited more than 100 villages, and seen more
than 1,000 AIDS patients. Gao said that despite the government's paying
more attention to the problem of HIV/AIDS, much more work needs to be
done. In another unusual move, CCTV broadcast images of AIDS-stricken
farmers lying in makeshift clinics in villages. Such images are rarely
shown on Chinese television.
MARYLAND:
"Gonorrhea Hits Low in City, but Syphilis Increases"
Baltimore Sun (02.14.04)::Jonathan Bor
In Baltimore last year, gonorrhea cases hit a historic low, but
syphilis cases rebounded slightly after a four-year decline, according
to Dr. Peter L. Beilenson, city health commissioner. The gonorrhea
decline, he said, is due to increased testing and treatment efforts,
and to increased condom use among teens and young adults. But syphilis
is rising among teenage girls who have sex with older men, and among
men who, though often married, have sex with men. Gonorrhea cases were
down 16 percent from the previous year and 33 percent from 1999.
Syphilis was up about 10 percent - from 121 cases in 2002 to some 135
last year. In the 1990s, Baltimore typically reported more than 600
syphilis cases annually.
MONTANA:
"STD Increase Troubles Officials"
Billings Gazette (02.12.04)
Gonorrhea and chlamydia cases have increased in Yellowstone
County, the Yellowstone City-County Health Department recently
announced. The cases are not limited to illicit activities such as
trading sex for illegal drugs or money, said Tamalee Eberle, preventive
health services nurse with the department. Instead, the cases are
appearing among college and high school singles, ages 16-25, who are
experimenting with sex. Gonorrhea cases increased by 50 percent from
2002-2003, and chlamydia cases increased by 33 percent during the same
time, according to the latest county health department data. The
situation is also a concern because it could be an indicator of
HIV/AIDS risk, Eberle said. The best ways to stay safe, Eberle said,
are abstinence, maintaining a monogamous relationship, and using
condoms.
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