| prevention-news-admin@cdcnpin.org 2004-08-03, 6:51 pm |
| CDC HIV/STD/TB Prevention News Update
Thursday, March 18, 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 and announcements. Reproduction of this
text is encouraged; however, copies may not be sold, and the CDC
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
WISCONSIN: "Bill Would Let Wisconsin Educators Ask Students to
Take HIV Test"
NEW YORK: "Hepatitis C Treatment Rules Continue to Draw
Criticism"
INTERNATIONAL NEWS
GLOBAL: "Lack of Money Endangers UN Plan to Treat HIV/AIDS
Sufferers"
MEDICAL NEWS
UNITED STATES: "Cognitive Function: Alcohol Abuse History Could
Pose Problems for HIV Patients"
LOCAL AND COMMUNITY NEWS
LOUISIANA: "US Cuts May Limit Local HIV Services"
LOUISIANA: "Teen Temptation"
MICHIGAN: "Stopping the Spread of HIV: Two Break Through Silence
to Help Teach Gay Arabs"
NEWS BRIEFS
CALIFORNIA: "David Pasquarelli - AIDS Activist"
WASHINGTON: "Former Councilwoman to Lead AIDS Agency"
MISSOURI: "Saint Louis university Testing TB Vaccine"
NIGERIA: "Nigerian Leader Vouches for Polio Vaccine"
************************************************************
NATIONAL NEWS
************************************************************
WISCONSIN:
"Bill Would Let Wisconsin Educators Ask Students to Take HIV
Test"
Associated Press (03.18.04)
Gov. Jim Doyle is considering a bill that would allow
Wisconsin educators to request that a student take an HIV test if
they think they were exposed to the virus. The bill by Sen. Carol
Roessler (R-Oshkosh) has already passed through the Legislature;
it would let educators request testing only in cases where an
educator was significantly exposed to a student's blood. The bill
would add educators to a list of people - including health care,
emergency medical and corrections workers - currently allowed to
make such a request. Doyle has not decided whether to sign it.
Roessler was prompted to sponsor the bill after hearing that
teacher Cheryl Hartman was unable to request the testing of a
student who broke a window and spattered blood in her eye. "I had
no right to know what I had been contaminated with," said
Hartman, who eventually tested negative. Educators say the bill
is a necessary precaution for teachers who find themselves in
violent or emergency situations.
The measure would also include other school employees, such
as janitors and coaches. There is concern that school workers
could use the right to demand testing as a crutch for lax
protective measures and medical advice, said Chris Ahmuty,
executive director of the American Civil Liberties Union of
Wisconsin.
The bill requires that teachers must have initially used
precautions to prevent exposure. A doctor would certify that
exposure had occurred. Educators themselves would also have to
submit to an HIV test.
Stan Johnson, president of the Wisconsin Education
Association Council, dismisses the notion that educators would
abuse the right because they would have difficulty meeting those
standards. Health experts tell people not to rely on another
person's test result to learn their own HIV status, said Michael
Gifford, vice president and chief operating officer of the AIDS
Resource Center of Wisconsin.
NEW YORK:
"Hepatitis C Treatment Rules Continue to Draw Criticism"
Associated Press (03.15.04)::Joel Stashenko
New York state's refusal to treat hepatitis C-infected
inmates serving short sentences does not jeopardize their chances
of ultimately beating the virus, the prison system's top doctor
told skeptical state Assembly committee chairs Tuesday. "We just
don't feel it's wise to start something we can't finish," said
Dr. Lester Wright, chief medical officer for the state Department
of Correctional Services, adding that hepatitis C is unlike other
diseases in state prisons - such as HIV or TB - that compel
immediate treatment upon detection.
The Assembly's health committee chair, Richard Gottfried (D-
Manhattan), and Jeffrion Aubry (D-Queens), chair of the
Assembly's corrections committee, remained critical of the
prison's policy of treating HCV-infected inmates only if they are
incarcerated for the year needed to complete the drug regimen.
Consequently, just a few hundred of the estimated 9,200 inmates
who show signs of HCV infection are treated while incarcerated.
According to Wright, released inmates do not have
particularly good histories of follow-up with doctors and
sticking to health care routines. Prison officials have also had
difficulty in lining up HCV-treatment programs outside of prisons
for inmates released unexpectedly, prior to treatment conclusion.
"Treatment ends up with large gaps in it, which is not good
health care," said Wright. Discontinuing the treatment schedule
could make later attempts to treat HCV impossible, added Wright.
Gottfried said treatment for inmates is often delayed
because they cannot become immediately eligible for Medicaid upon
their release, and he urged for a plan allowing the paperwork for
Medicaid to be started well in advance of the end of inmates'
sentences. Dr. Guthrie Birkhead, director of New York's AIDS
Institute, said social service officials are hesitant to accept
Medicaid applications for people who do not apply in person and
who are not currently living in the local district.
************************************************************
INTERNATIONAL NEWS
************************************************************
GLOBAL:
"Lack of Money Endangers UN Plan to Treat HIV/AIDS Sufferers"
Associated Press (03.17.04)::Naomi Koppel
The World Health Organization's ambitious "3 by 5" campaign
- which aims to get 3 million people in developing countries onto
antiretroviral treatment by 2005 - is in danger because
governments have failed to fund an important part of the
operation, UN officials and campaigners said Wednesday. The
campaign has only received $65 million of the $218 million it
needs over the next two years, and most of those funds have been
spent, said Alex Ross, chief of staff of the UN-administered
Global Fund to Fight AIDS, Tuberculosis and Malaria.
To date, only the British government has publicly announced
a donation specifically for the 3 by 5 campaign - 3 million
pounds (US$5.6 million). The balance of funds raised so far has
come from general donations to WHO and UNAIDS and from WHO's own
coffers.
AIDS campaigners are worried that funding problems for the 3
by 5 campaign threaten the multibillion-dollar efforts of the
Global Fund, which provides money and medicines for treatment and
prevention programs in developing countries based on proposals
for projects put forth by governments.
However, just around 40 percent of proposals to the fund are
considered appropriate, and many governments say they need
assistance to develop the projects, in addition to setting up
health care and procurement systems to make them work. This help
is supposed to come from the 3 by 5 project. Last week, WHO put
$1 million into an "emergency deployment," sending 40 staffers to
21 countries to assist them in preparing proposals before the
April deadline for submissions to the Global Fund's next funding
round, Ross said.
************************************************************
MEDICAL NEWS
************************************************************
UNITED STATES:
"Cognitive Function: Alcohol Abuse History Could Pose Problems
for HIV Patients"
AIDS Weekly (03.01.04)
HIV patients with a history of alcohol abuse (HAA) may be at
higher risk for cognitive problems than HIV patients without HAA,
according to a recent study. HIV-negative people with HAA, but
who currently abstain, showed no significant loss of cognitive
function. That suggests HAA either adds to the problems HIV
infection can cause or has an interactive association with HIV's
neurological effects, said Dr. Robert Bornstein, a professor of
psychiatry, psychology and neurology in Ohio State's college of
Medicine and Public Health.
"This study suggests that previous alcohol abuse may create
a point of vulnerability that is exacerbated by the effects of
the virus on the brain," said Bornstein. "There appears to be
just enough alteration to cognitive function to make the brain
more susceptible to the damaging impact of a second, independent
process," he said. "Further studies would be required to
determine if this combined effect is specific to HIV."
Even in patients without reported HAA, deficits in memory
and learning, slower reaction time and decision-making are
commonly reported in HIV patient studies. The most severe
cognitive changes, including dementia, are almost always reported
in the latest stage of the infection, but research has shown that
even asymptomatic HIV patients can experience subtle cognitive
impairments that affect their daily activities. Given that risk
and the new findings, Bornstein said health care providers should
be aware that patients with HAA are likely at greater risk for
cognitive impairment.
In the study, 33 participants (12 HIV-negative, 21 HIV-
positive) with HAA were compared to 47 people (18 HIV-negative,
29 HIV-positive) reporting no HAA or dependence. HIV-positive
participants with HAA showed significant impairments in verbal IQ
(7.7 percent lower), verbal reasoning (5.2 percent lower) and
reaction time (about 10 percent slower with each hand) compared
to HIV patients without HAA.
All participants with HAA had reduced their current alcohol
intake, regardless of HIV-status, and had significantly reduced
consumption compared to patients without HAA, said Bornstein.
"The findings related to abuse history cannot be attributed to
current use of alcohol," he said. "But the findings also show
that even if patients with HIV infection and a history of alcohol
abuse make a significant lifestyle change by abstaining from
alcohol, they are not protected from the apparent adverse effects
of alcohol abuse when combined with HIV infection.
"Our data suggest that the time at which alcohol consumption
is stopped in HIV-positive patients could serve as an important
predictor of their brain function in later stages of the
illness," said Bornstein.
The full study, "The Effect of Previous Alcohol Abuse on
Cognitive Function in HIV Infection," appeared in American
Journal of Psychiatry (2004;161(2):249-54).
************************************************************
LOCAL AND COMMUNITY NEWS
************************************************************
LOUISIANA:
"US Cuts May Limit Local HIV Services"
Times-Picayune (03.17.04)::John Pope
New Orleans' share of Ryan White CARE Act funds is about
$6.8 million this year, nearly $539,000 less than last year. The
city is one of 40 nationwide receiving less money after federal
Ryan White funding declined by about $4.2 million in the fiscal
year that began March 1. The New Orleans Regional AIDS Planning
Committee Council will meet Thursday to determine local
disbursements, and the full planning council will make final
decisions March 29.
"We don't feel happy about it," said Douglas Morgan, who is
responsible for administering the nationwide grant program.
"Individual metropolitan areas will have to make decisions - not
welcome decisions - about how they use their dollars."
The cuts might mean the closure, possibly by month's end, of
the Charity Hospital outpatient dental clinic that serves about
700 regional HIV patients, according to Kathleen Lincoln, manager
of the HIV outpatient program. If the center is forced to close,
patients could seek treatment at the city clinic or Louisiana
State University's dental school, but the waiting lists are long.
Because HIV attacks the immune system, warts, ulcers and the
fungal infection thrush can erupt in the mouth. If the mouth
hurts, patients might not be able to eat even though HIV
medication times are often tied to mealtimes, said Dr. Janet
Leigh, Charity Hospital's clinical coordinator.
NO/AIDS Task Force may have to scale back or cut services
including its food bank, home-delivered meals, substance-abuse
programs, and emergency funds used for clients' rent or
utilities, said Executive Director Noel Twilbeck. "There's a
commitment to fund primary care, case management and
prescriptions," he said. "After you fund that, everything else is
up for grabs." Anticipating a leaner budget, NO/AIDS stopped
accepting new clients four months ago, even though demand is
growing, said Twilbeck.
According to state data, there are about 7,145 HIV-infected
people in metro New Orleans, of whom 3,578 have AIDS - a 9.4
percent increase from the cumulative 6,533 HIV cases in 2001.
LOUISIANA:
"Teen Temptation"
Times-Picayune (03.15.04)::Barri Bronston
Parents may not feel comfortable talking about sex with
their middle school-age kids, much less about oral sex. But it is
an important discussion in an era when middle schoolers' sexual
activity often involves oral sex, which girls consider safe
despite the STD risks. This will be the focus of Thursday's
annual spring program sponsored by the Parents Council of New
Orleans (PCNO). "Our goal is to get parents talking about it in
ways that they feel comfortable with it," said PCNO President
Lynda Warshauer.
The program for parents of 5th- to 9th-graders is "Straight
Talk About Sex in Our City: Getting the Conversation Going,"
sponsored by the Parenting Center at Children's Hospital, the
National Council of Jewish Women and the Junior League of New
Orleans.
The program features certified sex therapist and marriage
counselor Anne Gonsoulin, who will provide guidance on talking
with teens about sexuality, understanding healthy adolescent
sexuality and imparting sexual values. She will cover the stages
of sexual development from pre-adolescence to the late teen
years, providing parents with an understanding of what is and
what is not appropriate behavior. Following Gonsoulin's talk, a
Q&A session with three local guidance counselors will help assess
the local situation.
"One way to make it less embarrassing is to talk about what
the other kids are doing, what the peer group is doing," said
Gonsoulin. "If they know you're comfortable talking about it,
they'll be more comfortable talking about it." Parents can
initiate conversations about sexual references and images during
"teachable moments," for example, such as enjoying music or TV
together.
The free program is March 18, 7-8:30 p.m., at the Junior
League of New Orleans Headquarters, 4319 Carondelet St. For more
information, telephone 504-896-9591.
MICHIGAN:
"Stopping the Spread of HIV: Two Break Through Silence to Help
Teach Gay Arabs"
Detroit Free Press (03.16.04)::Bill Laitner
Three years ago, HIV experts in Michigan began to fear that
Arab Americans were an underserved group increasingly impacted by
HIV, said Craig Covey, CEO of the Midwest AIDS Prevention Project
(MAPP). MAPP had previously identified and educated subgroups
including gay Latinos and African Americans about HIV. But in
southeast Michigan, which has a large Mid-Eastern immigrant
population, "Arab Americans were the last group of gay men anyone
had tried to reach," said Covey.
"These people leave countries where there are still laws on
the books making homosexuality a capital crime," said Covey.
Using a $55,000 annual state grant administered by the nonprofit
Dearborn health center ACCESS (Arab Community Center for Economic
and Social Services), MAPP employs outreach workers to bring
HIV/AIDS prevention messages to one of Detroit's most secretive
groups.
Lured by an Arabian Nights party at a Ferndale nightclub,
young participants can pick up sex-education booklets printed in
Arabic and take an on-the-spot HIV oral swab test. "I tell them,
'Listen, I'm gay. I'm in a gay bar with you. I'm not going to
tell anyone I found you here," said Chris Ayoub, who does
outreach work along with David Ponsart. "A lot of them are
married. Their family asks them to. If not, it's a shame on the
family," said Ayoub. "They think if they only sleep with Arab
men, they won't get infected. They think God will protect them,"
he said.
"We have to reach the population at risk," even if that
means sending educators to "nightclubs dressed in tank tops,"
said Eve Mokotoff, HIV/AIDS epidemiology manager for the Michigan
Department of Health. Otherwise, more men could contract HIV and
the state could spend more money to treat them as they endure
years of fear and suffering, she said.
************************************************************
NEWS BRIEFS
************************************************************
CALIFORNIA:
"David Pasquarelli - AIDS Activist"
San Francisco Chronicle (03.18.04)::Nanette Asimov
AIDS activist David Pasquarelli, who challenged medical
findings that HIV causes AIDS and opposed increased funding to
fight the epidemic, died March 8 from complications of HIV. He
was 36. After his 1995 diagnosis with HIV, he "committed his life
to solving the mystery behind a compromised immune system,"
according to a written tribute from his partner of seven years,
Steve Huggins. A 1990 graduate of Penn State, Pasquarelli co-
founded ACT UP-Tampa Bay while a resident counselor at St. Leo
College in Florida. After moving to San Francisco, he became
affiliated with ACT UP-San Francisco, which favors
confrontational protests and is unaffiliated with other ACT UP
chapters. In August, Pasquarelli was sentenced to three years of
probation for making threatening phone calls to public health
officials and reporters in 2001. A memorial service will be held
Saturday at 4 p.m. at San Francisco's Palace of Fine Arts.
WASHINGTON:
"Former Councilwoman to Lead AIDS Agency"
Seattle Times (03.12.04)::Warren King
Former Seattle City Councilmember Tina Podlodowski has been
named executive director of the Lifelong AIDS Alliance, the
region's leading AIDS service agency. Though contributions to the
agency have declined in recent years, it continues to serve some
2,500 clients. "We really need to expand giving - corporate,
private, individual and through events," said Podlodowski, who
has also been a board member of the Human Rights Campaign, the
nation's largest gay political organization. "I think it's good
they chose someone locally who knows the community. And she's a
no-nonsense leader with the chutzpah to take the organization
where it needs to go," said John Leonard, former director of Gay
City Health Network and now a city official. Podlodowski succeeds
Chuck Kuehn, who leaves after three years as alliance director to
serve in the Peace Corps in Africa.
MISSOURI:
"Saint Louis university Testing TB Vaccine"
Associated Press (03.16.04)
The genetically engineered TB candidate vaccine rBCG30 was
administered to 15 volunteers at St. Louis university Tuesday in
the first test of the vaccine in humans. After receiving rBCG30,
volunteers will be observed over nine months and, if the vaccine
proves safe, it will advance to trials in larger numbers of
people. The project is funded by the nonprofit Aeras Global TB
Vaccine Foundation, a group funded by the Bill and Melinda Gates
Foundation. Dr. Jerald Sadoff, president of Aeras, said the aim
is to develop a more effective TB vaccine within 10 years; an
existing vaccine is useful for protecting infants, but its
effectiveness declines as people age.
NIGERIA:
"Nigerian Leader Vouches for Polio Vaccine"
Associated Press (03.17.04)::Gilbert Da Costa
Nigerian President Olusegun Obasanjo told reporters
Wednesday that independent test results "categorically attest to
the safety of the oral polio vaccine and clears it of
contamination by HIV, cancerous agents and anti-fertility
agents." The results of the tests, which were carried out in
South Africa, India and Indonesia, were consistent with those of
similar tests conducted earlier in Nigeria. Many Muslims in
northern Nigeria had boycotted polio vaccination campaigns
because radical Islamic leaders said the vaccines were tainted
with HIV, cancer-causing agents and sterilizing chemicals in an
alleged US plot to decimate Muslim populations. A 16-year, $3
billion global campaign has reduced polio cases from 350,000 in
1988 to fewer than 1,000 in 2003. The boycott is blamed for
polio's recent spread from northern Nigeria to eight other
African nations where the disease had previously been eliminated.
************************************************************
The Prevention News Mailing List is maintained by the National
Prevention Information Network (NPIN), part of the Centers for
Disease Control and Prevention's National Center for HIV, STD and
TB Prevention. Regular postings include the Prevention News
Update, conference announcements, current funding opportunities,
select articles from the Morbidity and Mortality Weekly Report
series and announcements about new NPIN products and services.
To join the PreventioNews listserv, send a blank e-mail to
prevention-news-subscribe@cdcnpin.org. For instructions on
how to remove yourself from the listserv, send a blank e-mail
to prevention-news-unsubscribe@cdcnpin.org.
You can also join or leave the PreventioNews listserv from the
NPIN Web site at
http://lists.cdcnpin.org/mailman/li...revention-news.
Back issues of the CDC HIV/STD/TB Prevention News Update can be
found at ftp://ftp.cdcnpin.org/PrevNews. You can search for back
issues in the Prevention News Update Database at
http://www.cdcnpin.org/news/.
We'd like to know what you think of the Prevention News Update.
Please take a minute to send an e-mail with your comments to
update-feedback@cdcnpin.org. With your help, we will continue to
improve this service to better meet your information needs.
Please send all other e-mail inquiries to info@cdcnpin.org.
**This message may be copied and distributed; however, it may not
be distributed for profit.**
************************************************************
|