| prevention-news-admin@cdcnpin.org 2004-08-03, 6:51 pm |
| CDC HIV/STD/TB Prevention News Update
Wednesday, March 17, 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
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of the articles abstracted below for full texts of the articles.
HEADLINES
NATIONAL NEWS
ALABAMA:
"Alabama Prison Last that Still Completely Segregates HIV Inmates"
INTERNATIONAL NEWS
NETHERLANDS: "Drug-Resistant TB Found in Netherlands"
MEDICAL NEWS
UNITED STATES: "Study: HIV Patients Face Heart-Disease Risk"
LOCAL AND COMMUNITY NEWS
MARYLAND: "HIV Tests Spur Joint Inspection at Maryland General"
TEXAS: "Houston Hit Hard by Cuts in Funding for HIV/AIDS"
OHIO: "David's House Is Closing Its Doors"
FLORIDA: "Seder Offers Hope to HIV, AIDS Patients"
NEWS BRIEFS
TANZANIA: "Tanzania Is Running Out of Condoms: Official"
GEORGIA: "HIV/AIDS Problem Has New Focus"
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NATIONAL NEWS
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ALABAMA:
"Alabama Prison Last that Still Completely Segregates HIV Inmates"
Associated Press (03.13.04)::Samira Jafari
Alabama's Julia Tutwiler Prison in Wetumpka is the nation's last
prison that completely segregates HIV-positive inmates from other
prisoners. Its 13 HIV-infected women are confined to Dorm 8, where they
are barred from taking the vocational classes that are available to
thousands of other state prisoners.
With its TV, DVD player, telephones, microwave, books and
computer, Dorm 8 is a far cry from the deteriorating shanty on prison
grounds that used to house the HIV-positive inmates. The residents of
Dorm 8 have access to a range of classes, including courses on high
school equivalency, anger management and parenting. But they do not
know why they, unlike women in the general prison population, cannot
take cosmetology, welding, mechanics or other job-training classes
offered at a nearby vocational school.
In January, at the Limestone men's prison in Capshaw, Alabama
integrated its male HIV-positive inmates into regular education and
vocational programs. Department of Corrections Commissioner Donal
Campbell said he supports integrating the women with HIV into the
programs, but this is not a priority. Limestone's 200 HIV-positive
inmates were integrated into the programs first, he said, because that
prison's structure makes it easier to move inmates to classes safely.
Officials cited safety concerns about integrating the women, as
well as concerns about disease transmission. While some of the women in
Dorm 8 admit they have had sex with others in the unit, they say they
would never do so among the general population. They also said they do
not think harassment in the general population would be any worse that
what some suffered outside prison. The women of Dorm 8 have launched an
HIV/AIDS awareness newsletter to educate inmates outside their unit
about life with the virus.
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INTERNATIONAL NEWS
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NETHERLANDS:
"Drug-Resistant TB Found in Netherlands"
Associated Press (03.16.04)
The Netherlands is reporting its first outbreak of a strain of
multi-drug-resistant tuberculosis (MDRTB), prompting officials to
express concern about a wider outbreak once the European Union expands
eastward. An eastern European TB patient has infected six Dutch
citizens, two of whom have developed pulmonary TB, according to the
Dutch Tuberculosis Foundation.
The World Health Organization on Tuesday issued a report
estimating that 300,000 new cases of MDRTB are occurring globally each
year, with 79 percent of these showing resistance to three or more
drugs. WHO said the strain is most common in countries of the former
Soviet Union, particularly Kazakhstan, and in Israel.
The Dutch outbreak is under control "thanks to the swift action by
the regional municipal health services," said Jaap Broekmans, director
of the foundation, who expressed concern about the May 1 opening of
borders to people from eastern Europe, where the chance of developing
MDRTB is 10 times higher than elsewhere. Dutch authorities are
preparing for a more serious outbreak with the influx of infected
newcomers, Broekmans said.
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MEDICAL NEWS
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UNITED STATES:
"Study: HIV Patients Face Heart-Disease Risk"
Reuters (03.15.04)
Researchers reported Monday that HIV patients have a sharply
higher risk of atherosclerosis - clogging and hardening of arteries -
and the disease appears to progress quickly. "In the HIV patients, the
extent of atherosclerosis was associated with classic cardiac risk
factors such as age, cholesterol levels, cigarette smoking and high
blood pressure," said Dr. Priscilla Hsue, assistant professor of
medicine at university of California-San Francisco.
Hsue and colleagues studied 148 HIV patients, who were on average
45 years old, infected for 11 years, and undergoing treatment with drug
cocktails including protease inhibitors for 3.3 years. Researchers used
ultrasound to measure the thickness of the carotid arteries. Thickness
of this artery is an indication of atherosclerosis.
The average carotid was significantly thicker in HIV patients than
among the 63 age- and gender-matched healthy HIV-negative patients.
Buildup of fatty plaque was found in 45 percent of HIV patients
compared with 24 percent of non-infected patients. A year later, the
arteries of some HIV patients had grown thicker, and the rate of
thickening was more rapid than in HIV-negative patients.
Drug cocktails used to treat HIV can have side effects including
raised cholesterol and changes to metabolism. HIV infection itself
could be a cause, said Hsue, because those patients with the most
damaged immune systems had the worst atherosclerosis.
"Our finding suggests that it would be reasonable to consider HIV
infection a cardiac risk factor," Hsue said. "Other risk factors, such
as high cholesterol and high blood pressure, need to be aggressively
treated in HIV patients - even if it means changes in their HIV
medications to control cholesterol levels," she said.
The full study, "Progression of Atherosclerosis as Assessed by
Carotid Intima-Media Thickness in Patients with HIV Infection,"
appeared in the American Heart Association's journal Circulation (2004;
doi:10.1161/01.CIR.0000124480.32233.8A).
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LOCAL AND COMMUNITY NEWS
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MARYLAND:
"HIV Tests Spur Joint Inspection at Maryland General"
Baltimore Sun (03.17.04)::Walter F. Roche Jr.
Yesterday, state and federal inspectors and hospital accreditation
officials responding to reports of suspect HIV lab tests launched an
on-site survey of Baltimore's Maryland General Hospital. Though
unscheduled, the visit by nine government inspectors and the Joint
Commission for the Accreditation of Healthcare was not a surprise: "We
expected them to do a survey once we reported the incident," said Lee
Kennedy, a spokesperson for the 245-bed facility. He did not know how
long the inspection would last. Timothy D. Miller, the hospital's
president, said its officials are cooperating fully.
The inspection came a week after the disclosure that Maryland
General's lab had sent HIV and hepatitis C test results to more than
400 patients despite indications that those results might not be
accurate. A complaint from a former worker alerted state officials to
the problem. The hospital has launched an effort to locate and retest
the affected patients. So far, Kennedy said, 36 patients have been
retested; all got the same negative results they originally received.
The hospital expects to have completed 100 tests by week's end.
The disclosure prompted Rep. Elijah E. Cummings (D-Md.) to call
for a public hearing by a congressional subcommittee. The testing
problem took place during a 14-month period that ended in August, about
the time the hospital stopped using testing equipment manufactured by
Adaltis USA Inc. During that time, state investigators found that lab
personnel manipulated and eliminated data showing the tests might be
wrong. The questionable results were sent to patients even though
guidelines called for a retest. Former lab worker Kristin S. Turner,
who said she became infected with HIV and hepatitis C as a result of
faulty testing equipment, last week filed a lawsuit against the
hospital, Adaltis, and her boss, James Stewart. Turner alleges she
repeatedly warned hospital officials that the machine's results were
unreliable.
TEXAS:
"Houston Hit Hard by Cuts in Funding for HIV/AIDS"
Houston Voice (03.12.04)::Binnie Fisher
HIV/AIDS service providers in Houston are facing the painful
realities of the federal Ryan White CARE Act funding cuts recently
announced. The overall cut to the Houston area was about 6.8 percent,
said Ken Malone, executive director of the Assistance Fund, which
provides medication help for HIV/AIDS patients. Ryan White funds are
emergency aid to urban areas disproportionately affected by HIV/AIDS,
and on that list Houston is number five, he said.
"We've been preparing for it," Katy Caldwell, executive director
of the Montrose Clinic, said about the funding cut. "We've made some
staff reductions, and we're not replacing certain vacant positions."
"It feels awful when you have to say to someone who needs services,
'Come back in a month,'" said Caldwell.
Now that the federal government has allocated the funds to
Houston, the region's Ryan White Planning Council (RWPC) takes over to
decide their local distribution, said Caldwell. RWPC has already
decided to decrease funding for the Montrose Clinic by 7 percent, she
said.
Cuts to the Assistance Fund were less harsh, at 3 percent, though
Malone said there would be some service reductions. This could mean
serving fewer clients or not providing clients with all the medication
they need, he said.
Congress is now deciding what future funding cuts will be made,
and Houston care providers said it looks as though the federal
government plans to slash another 19 percent from the Ryan White CARE
Act by 2009. Caldwell said, "The clients don't stop coming just because
the money stops." Said Malone: "This is the worst I've ever seen coming
down from Washington. At some point, there will have to be a
consolidation of service agencies. Nobody wants to hear that," he said.
OHIO:
"David's House Is Closing Its Doors"
Toledo Blade (03.16.04)::Luke Shockman
David's House Compassion, a nonprofit organization that has
provided AIDS case management services in the Toledo area since 1989,
is closing April 1 due dwindling funding resources. Eight staff workers
will be laid off initially, with five others let go by the end of
April. Its headquarters at Detroit and Nebraska avenues will be sold to
pay off debt.
David's House had relied on funding through grants and private
donations, but in the past few years donations lagged and client demand
began exceeding resources. The organization stopped providing inpatient
care last year, but it continued other services including assistance
with medications, food, home visits and rent. The group's $847,000
annual budget was projected to end about $200,000 in the red in the
fiscal year ending June 30.
"Our private money donations simply dried up, and to continue
operations would mean digging a deeper and deeper hole," said David
Arnold, David's House president. "Our case load has risen every month
and every year for the past five years. But most people think the AIDS
epidemic is over," said Arnold.
David's House serves about 500 HIV/AIDS patients and 900 affected
family members. Arnold said the agency's officials hope another area
organization will continue its programming, but for now its clients are
being told to contact their case workers for more details. Monday
marked the 15th anniversary of David's House.
FLORIDA:
"Seder Offers Hope to HIV, AIDS Patients"
Miami Herald (03.14.04)::Beth Feinstein-Bartl
Marc Paige and Andrew Katzen, who moved last year from Rhode
Island to Fort Lauderdale, wanted to continue their tradition of
holding a Passover Seder for people with HIV/AIDS. Their idea resonated
with Rabbi Cheryl Jacobs, director of the Jewish Healing Center (JHC),
which oversees the nonprofit Jewish AIDS Network where both men
volunteer.
As a result, JHC is organizing the Seder of Hope with an
interfaith team of community religious leaders. The Seder celebrates
freedom from slavery, a message that Jacobs said is linked to freedom
from HIV/AIDS.
For Paige, who first came up with the idea of a special service 10
years ago, the ritual of the Seder is another reminder that AIDS is
still a threat. "There's a lot of complacency around AIDS today because
we have drugs that are keeping people alive longer," he said. "People
need to realize that it's a very serious illness and the drugs have
very serious and unpleasant side effects. People are still dying.
Prevention is still very important." The men are also helping organize
a similar event in Providence, R.I., on March 28.
A specially created Haggadah, a book that tells the story of the
Jews' flight from bondage in ancient Egypt, will be used for the
service, incorporating the words of well-known people who have died of
AIDS, Paige said. Panels from the South Florida Names Project AIDS
quilt will also be on display.
The Seder of Hope, which is expected to draw about 100
participants, will be held at 6 p.m. March 21 at the Soref Jewish
Community Center, 6501 W. Sunrise Blvd., in Plantation. Reservations
are required; telephone 954-370-2140.
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NEWS BRIEFS
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TANZANIA:
"Tanzania Is Running Out of Condoms: Official"
Agence France Presse (03.17.04)
A looming shortage of condoms could adversely affect the campaign
against HIV/AIDS, said Tanzania's National AIDS Control Program (NACP),
which has called for increased donor assistance to replenish supplies.
"We are worried that we may experience a crisis next year because not a
single donor has so far pledged to fund importation of condoms," NACP
Director Roland Swai said today. The nation needs 45 million to 50
million condoms annually, costing about $14 million. According to
official government records, 8-10 percent of Tanzania's 34.5 million
people are HIV-positive.
GEORGIA:
"HIV/AIDS Problem Has New Focus"
Atlanta Journal-Constitution (03.17.04)
Joan Liverpool and Gloria Fredricks, who were born in Guyana, have
recently formed the Georgia Coalition Against HIV/AIDS in Georgia, the
Caribbean and Guyana in order to raise awareness of the disease among
people of Caribbean and Guyanese descent. The coalition is holding a
training session in Atlanta for volunteers March 27-28 at St. Timothy's
Episcopal Church, 2833 Flat Shoals Rd. For more information, telephone
404-284-9026 or 770-498-2152.
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CORRECTION: The PNU's March 10 summary of the Boston Globe's March 10
article "Resistant Form of Gonorrhea Gains Foothold" omitted the
information that gonorrhea first became resistant to penicillin, then
to tetracycline. Physicians next turned to fluoroquinolones, chiefly
ciprofloxacin and ofloxacin. Now, clinics with a high volume of
gonorrhea patients have largely stopped prescribing drugs such as
ciprofloxacin and ofloxacin and are instead treating gonorrhea with
ceftriaxone. On March 11, the Boston Globe issued a correction to the
original article, noting that "in explaining why gonorrhea patients are
more likely to transmit or contract HIV, the story did not make clear
that there are inflammatory lesions inside sexual organs, not external
sores."
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