| prevention-news@cdcnpin.org 2004-10-04, 2:18 am |
| CDC HIV/STD/TB Prevention News Update
Monday, September 27, 2004
The CDC National Center for HIV, STD and TB Prevention provides the follo=
wing information as a public service only. Providing synopses of key scie=
ntific articles and lay media reports on HIV/AIDS, other sexually transmi=
tted diseases and tuberculosis does not constitute CDC endorsement. The f=
ollowing summaries were prepared without conducting any additional resear=
ch or investigation into the facts and statements made in the articles be=
ing summarized, and therefore readers are expressly cautioned against rel=
ying on the validity or invalidity of any statements made in these summar=
ies. This daily update also includes information from CDC and other gover=
nment agencies, such as background on Morbidity and Mortality Weekly Repo=
rt (MMWR) articles, fact sheets and announcements. Reproduction of this t=
ext is encouraged; however, copies may not be sold, and the CDC HIV/STD/T=
B Prevention News Update should be cited as the source of the=20
information. Contact the sources of the articles abstracted below for ful=
l texts of the articles.
HEADLINES
NATIONAL NEWS
WYOMING: =93Health Department Plans to End Enrollments for AIDS/HIV Progr=
am=94
INTERNATIONAL NEWS
KENYA: =93AIDS Awareness Thrust of Talk=94
AFRICA: =93Lewis Applauds Clinic=92s =91Great Accomplishment=92=94
AFRICA: =93Unable to Get Western Medicines, African Patients with HIV See=
k Out Herbal Remedies=94
MEDICAL NEWS
UNITED STATES: =93Human Immunodeficiency Virus Infection in a Rural Commu=
nity in the United States=94
LOCAL AND COMMUNITY NEWS
TEXAS: =93City Sues Prostitute to Get HIV Treatment=94
GEORGIA: =93Middle Georgia Teen Centers Don=92t Expect New Rules to Affec=
t Operations=94
NEWS BRIEFS
TEXAS: =93Fort Bend Health Officials to Test Students for TB=94
AFRICA: =93Nigeria Equips African Teachers with HIV/AIDS Combat Knowledge=
=94
LESOTHO: =93Lesotho Benefits from Prince Harry=92s AIDS Documentary=94
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NATIONAL NEWS=09
************************************************************
WYOMING:
=93Health Department Plans to End Enrollments for AIDS/HIV Program=94
Wyoming Tribune-Eagle (09.24.04)::Michelle Dynesrep
After Sept. 30, HIV/AIDS patients will no longer be able to enroll i=
n care and drug assistance programs with the Wyoming Department of Health=
.. Rising costs are to blame, said Kurt Galbraith, the department=92s HIV/=
AIDS coordinator.=20
Patients already in the system will continue to get service, althoug=
h some program offerings will be reduced, and mental health counseling an=
d transportation assistance have been eliminated. Patients will be referr=
ed to other sources for these needs. The state will maintain a waiting li=
st after Sept. 30, Galbraith said, and these patients will be connected w=
ith a case manager who will help them find additional resources in other =
parts of the state and through pharmaceutical companies.=20
Theresa Bush, coordinator for the Ryan White Title III Early Interve=
ntion Services program at the Community Health Center of Central Wyoming =
in Casper, said she learned Wednesday of the enrollment cap. She said tha=
t while the Casper program provides dental services, nutritional assistan=
ce, and mental health, substance abuse and adherence counseling, it has n=
o program for prescription assistance. An evaluation is underway to see i=
f prescription assistance can be added, she said.
Galbraith said the average monthly cost of care for the state program=
=92s 87 clients climbed from $771 per patient in 2003 to $1,190 per patie=
nt in 2004. The average number of drugs per program patient increased fro=
m three to four in the last year. No generic versions are available for a=
ny of the HIV/AIDS medications, Galbraith said. The federal government=92=
s contribution to the program has remained level since 2000.
The average cost of the program is about $61,000 per month. Capping =
enrollment will allow it to be paid for through March 31, Galbraith said.
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INTERNATIONAL NEWS=09
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KENYA:=20
=93AIDS Awareness Thrust of Talk=94
The Record (Kitchener-Waterloo, Ontario) (09.27.04)::Anne Kelly
About 50 community leaders in Matangwe, Kenya, watched a video about=
AIDS, received a free meal, and saw a condom demonstration recently duri=
ng the first of a series of AIDS awareness sessions at Kenya=92s Matangwe=
Community Health Centre. Participants - including village elders, member=
s of women=92s groups, traditional medicine men and church leaders - were=
encouraged to spread the word about HIV/AIDS and the clinic in this isol=
ated village, where stigma, denial and misunderstanding persist about the=
disease many locals call =93slim.=94 Within two weeks of the presentatio=
n, over 20 people came to the clinic for testing. All but one were HIV-po=
sitive.
Over 80 percent of patients treated at the center for pneumonia and =
TB likely have HIV/AIDS, estimated Sylvia Scott, who co-founded the clin=
ic with her husband Stephen. Posters at the clinic advise girls to =93get=
together and practise saying no to sex before marriage.=94 Some adults a=
nd teenagers began asking for condoms that the clinic provides free, nutr=
ition advice and how they could get AIDS treatment. =93Before, people wer=
en=92t willing to talk about it,=94 said Sylvia.=20
The clinic provides drugs for opportunistic infections, and Sylvia i=
s trying to obtain drugs to prevent mother-to-child transmission. It refe=
rs patients to the nearest hospital for AIDS treatment.
This summer, the clinic hired HIV/AIDS facilitator Julia Awiti to le=
ad awareness programs and provide counseling. She told community leaders =
that with polygamy and sex outside marriage common in Matangwe, HIV would=
continue to spread unless people changed their behavior. She also helped=
dispel common myths that help spread AIDS. =20
AFRICA:=20
=93Lewis Applauds Clinic=92s =91Great Accomplishment=92=94
The Record (Kitchener-Waterloo, Ontario) (09.24.04)::Anne Kelly
Pressure and momentum from the efforts of individuals, organizations=
and governments in Africa to finally treat people with HIV/AIDS provide =
glimmers of hope to Stephen Lewis, UN=92s special envoy on HIV/AIDS in Af=
rica. =20
Co-founded by Waterloo locals Stephen and Sylvia Scott, who grew up =
in Kenya, the Matangwe Community Health Centre opened in 2001 with over $=
500,000 in financial assistance from the Waterloo area. Grassroots effort=
s like the center - which treats people for opportunistic infections, del=
ivers babies, and provides critical health care - are laudable, and the c=
linic is a =93great accomplishment,=94 Lewis, a veteran Canadian diplomat=
, said in a telephone interview. =93We=92re not talking about huge amount=
s of money=94 that can provide hope, said Lewis, who urged local donors t=
o continue funding the center.
Lewis=92 own foundation is helping orphans, women dying with AIDS an=
d people living with HIV/AIDS, with the aim of helping organizations with=
no other available financing. =20
A consortium including the Clinton Foundation, UNICEF, the World Ban=
k and the Global Fund to Fight AIDS, TB and Malaria has negotiated a gene=
ric-drug deal that brought the cost of antiretroviral drugs down from $50=
0-$600 for brand-name drugs to $140 per person. Still, the need will outp=
ace supply for some time.=20
Treatment is reaching 1-5 percent of patients who have reached a cer=
tain stage of AIDS in Botswana, Uganda and Rwanda, Lewis said. Kenya=92s =
plan to provide free AIDS drugs =93provides real hope for Kenya because t=
he new government=92s pretty determined to overcome the pandemic,=94 he s=
aid.
Two years ago, many sick patients could barely make it to a northwes=
t Uganda hospital where Doctors Without Borders supplied AIDS drugs. Now,=
there are 1,100 receiving treatment, =93they=92re well,=94 and another 2=
,500 will soon start treatment, said Lewis. =93The availability of treatm=
ent resulted in so much hope, so much awareness, that all of the stigma, =
all of the inhibitions, were gone.=94
AFRICA:
=93Unable to Get Western Medicines, African Patients with HIV Seek Out He=
rbal Remedies=94
Associated Press (09.21.04)::Chris Tomlinson
Without access to AIDS drugs, increasing numbers of HIV-infected Afr=
icans are turning to traditional healers seeking treatment for everything=
from stomach aches to tuberculosis.=20
In rural Kenya, there are no indications that government and drug co=
mpany pledges to provide HIV treatment will soon result in improved care.=
While the expensive medications remain unavailable, about 600 Kenyans di=
e daily of AIDS-related illnesses. In Narok, 60 miles west of the capital=
of Nairobi, there is no laboratory capable of assessing the health of HI=
V patients.=20
The Kenyan government will certify traditional healers who demonstra=
te basic health-care skills and knowledge of their craft. But the country=
=92s physicians remain highly skeptical. Leander Otieno, professor of med=
icine at the university of Nairobi, said there is negligible evidence as =
to the efficacy of herbal treatments for HIV/AIDS. The healers=92 claims =
=93have not been counterchecked=94 by studies, Otieno cautioned.=20
Vincent ole Yiapan, a certified Masai traditional healer in Narok, d=
oes not claim to cure HIV but said the 234 plants he uses to create powde=
red treatments do help AIDS patients. The 62-year-old former teacher reti=
red four years ago after his daughter=92s death from AIDS and is now foll=
owing his parents=92 vocation. =93If I knew then what I know now, she wou=
ld have lived longer,=94 he said.=20
Yiapan lectures his patients on HIV prevention and explains that, in=
the absence of drugs, good nutrition and traditional herbs can help peop=
le live normal lives. He makes sure, however, that they understand he is =
not curing them. Unlike AIDS medicines, which can cost up to $2 a day in =
a country where most live on less than $1 a day, Yiapan=92s treatments co=
st one cent.=20
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MEDICAL NEWS=09
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UNITED STATES:=20
=93Human Immunodeficiency Virus Infection in a Rural Community in the Uni=
ted States=94
American Journal of Epidemiology (09.15.04) Vol. 160; No. 6: P. 582-588::=
Tedd V. Ellerbrock; Sandra Chamblee; Timothy J. Bush; Johnny W. Johnson; =
Bryan J. Marsh; Pam Lowell; Robert J. Trenschel; C. Fordham von Reyn; Lin=
da S. Johnson; C. Robert Horsburgh, Jr.
An increasing proportion of US persons with HIV live in the South, a=
nd the region accounts for most cases of AIDS among rural residents. In 1=
986, a population-based survey of HIV infection in Belle Glade, a rural c=
ommunity in western Palm Beach County, Fla., found HIV prevalence was 3.2=
percent (28/877). A history of STDs and sex with men were independent pr=
edictors of HIV infection in men, while predictors in women included a po=
sitive rapid plasma reagin test and microhemagglutination-Treponema palli=
dum test and having a male sex partner known to engage in sex with prosti=
tutes. In 1998-2000, researchers performed a second population-based stud=
y and case-control study to determine if prevalence and risk factors had =
changed.
Of 609 randomly chosen addresses selected for the study, 516 residen=
ts (85 percent) were enrolled and 447 (73 percent) were tested for HIV. T=
he 69 who were interviewed but not tested were similar to testers in term=
s of sex, age, current employment, annual income, and Haitian origin, as =
well as history of transfusion, crack use, any STD, and exchanging sex fo=
r money or drugs. However, non-testers had more lifetime sex partners and=
were more likely to be black but not Haitian. Participants were less lik=
ely to be male and children under 12 years of age than the local US Censu=
s population. =20
Seven total HIV infections were identified in the sample, for an HIV=
prevalence of 1.6 percent (7/447) in western Palm Beach County and 1.7 p=
ercent (5/286) in Belle Glade. Age- and gender-adjusted HIV prevalence wa=
s 1.5 percent each for Belle Glade and West Palm Beach County. Those test=
ing positive were ages 28-64 (median=3D46); five were male; all were blac=
k; and three were Haitian. The decline in prevalence in Belle Glade was m=
ore pronounced among women (12/436 in 1986 vs. 1/161 in 1998-2000) than a=
mong men (16/441 vs. 4/124), though this was of borderline statistical si=
gnificance. =20
Independent predictors of HIV infection in both 1986 and 1998-2000 w=
ere having a history of STDs, number of sex partners, and exchanging mone=
y or drugs for sex. A history of having sex with men was a risk factor fo=
r males in 1986 but not in 1998-2000; residence in specific neighborhoods=
was a risk factor in 1998-2000 but not in 1986. =20
HIV prevalence did not increase between study periods and probably d=
ecreased, the authors concluded, but =93remained a heterosexually transmi=
tted infection in this community, facilitated by other sexually transmitt=
ed infections and crack cocaine use.=94 Heterosexually acquired HIV infec=
tion did not spread throughout the community between 1986 and 1998 but pe=
rsisted at low levels in discrete neighborhoods. =93Further reduction in =
HIV prevalence may require a better understanding of the social networks =
that exist in these endemic neighborhoods and ethnographic studies focusi=
ng on the identification of factors affecting heterosexual HIV transmissi=
on,=94 the authors concluded.=20
=20
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LOCAL AND COMMUNITY NEWS=09
************************************************************
TEXAS:
=93City Sues Prostitute to Get HIV Treatment=94
Amarillo Globe-News (09.25.04)::Greg Cunningham
On Wednesday, the office of Amarillo City Attorney Marcus Norris fil=
ed a civil suit to compel an HIV-positive woman to seek treatment and sto=
p spreading the virus. =93We believe that by her conduct, she poses a hea=
lth threat to the community, and so we=92re going to have to try to get t=
he court to intervene and help,=94 said Norris.=20
=93We would not be doing this if we had been able to get this woman =
to behave responsibly with regard to sexual activity any other way,=94 sa=
id Dr. J. Rush Pierce, public health authority for the Bi-City-County Hea=
lth Department.=20
According to documents filed with the lawsuit, T.T. was diagnosed wi=
th HIV in January 2000 and counseled on how to avoid spreading the virus.=
A case of HIV was traced to T.T. in 2001; the patient told officials the=
woman had not disclosed her HIV status prior to sexual contact. Early in=
2003, upon learning T.T. was engaged in prostitution to support her coca=
ine habit, Health Department officials issued a letter ordering her to en=
roll in treatment. After several months of counseling, T.T. dropped out i=
n 2004 and returned to prostitution and her drug habit. T.T. met with Pie=
rce on June 15 but has since refused to meet with officials, enter a drug=
program, or receive HIV treatment.=20
Pierce said he wants to stress that the case is extraordinary and th=
at other HIV-positive persons seeking help from the department would not =
be subject to the same actions. =93This particular person just continues =
to put people at risk. You reach a point where you say, =91I don=92t know=
what else I can do.=92=94=20
Local officials say the case, if it goes to trial, would be the firs=
t of its kind in Texas. A judge will have the responsibility of determini=
ng the length of treatment and the facility for it. Norris said the suit =
seeks 12 months of confinement.
GEORGIA:
=93Middle Georgia Teen Centers Don=92t Expect New Rules to Affect Operati=
ons=94
Macon Telegraph (09.25.04)::Andy Peters
It appears unlikely that teens accessing state-funded centers in Mac=
on, Warner Robbins, Dublin and Sparta will notice many operational change=
s after Georgia=92s recent approval of new rules for the centers. On Wedn=
esday, the state Board of Human Resources ruled that the centers - which =
were founded in 1997 as a way to reduce teen pregnancy - must teach absti=
nence as the =93expected standard for all school-age children; abstinence=
must be taught as the =93only certain way to eliminate the risk of pregn=
ancy=94 and STDs; and condoms may only be distributed =93in a clinical se=
tting by a health-care professional.=94
Linda Holland, head nurse at Macon=92s teen center, said the new sta=
tewide emphasis on abstinence has always been the policy at her center. =93=
We might need to do fine tuning here and there, but we were already on tr=
ack,=94 Holland said of the new rules. The Macon center serves around 300=
teens each year, she added.=20
=93I=92m fine with [the new rules] as long as it keeps the centers o=
pen,=94 said Tiena Fletcher, a board member from Warner Robbins, referrin=
g to an earlier suggestion to close the centers altogether as part of sta=
tewide spending cuts. Fletcher said she supports a compromise reached by =
the board to allow some centers to hand out condoms while others do not. =
Some board members had wanted to ban all the centers from handing out con=
doms and require an exclusive focus on abstinence to prevent pregnancy.
The Warner Robbins center, one of 10 statewide that does not give ou=
t condoms, has not had teens returning with repeat pregnancies, Fletcher =
noted. =93They preach abstinence and they don=92t hand out condoms, so I =
know it can be done,=94 Fletcher said.
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NEWS BRIEFS =09
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TEXAS:
=93Fort Bend Health Officials to Test Students for TB=94
Houston Chronicle (09.25.04)::La Monica Everett-Haynes
After learning that a student at Austin High School has been diagnos=
ed with TB, Fort Bend County Health and Human Services will test students=
and faculty Tuesday for exposure to the disease. Results from those skin=
tests should be available in about two days. The health department notif=
ied parents of Austin High students in a letter dated Sept. 23. The Fort =
Bend case marks the second student TB diagnosis this month in the metropo=
litan Houston area. More than 350 Dobie High School students and staff re=
cently underwent testing after a 16-year-old was diagnosed with TB. Offic=
ials are awaiting results of that testing.=20
AFRICA:=20
=93Nigeria Equips African Teachers with HIV/AIDS Combat Knowledge=94
Xinhua News Agency (09.23.04)
The UN Educational, Scientific and Cultural Organization, Nigeria=92=
s government, and the National Universities Commission have partnered in =
a pilot training of university teachers to educate students about HIV/AID=
S, NUC=92s Executive Secretary Peter Okebukola said Thursday in Lagos. Th=
e first pilot in Nigeria enrolled 5,020 local teachers. The program will =
next month reach another 12,000 teachers from across Africa, Okebukola sa=
id. He expects 20,000 teachers to participate in a third training in Dece=
mber. Teachers are examined to gauge whether they learned the training in=
formation, he said. The program=92s impact will be assessed in a report i=
n two years. =20
LESOTHO:=20
=93Lesotho Benefits from Prince Harry=92s AIDS Documentary=94
Agence France Presse (09.23.04)
The United Kingdom=92s deputy high commissioner to Lesotho, Mark Wat=
chorn, announced that the British Red Cross has set up a fund for people =
in Lesotho who have AIDS. The fund=92s creation comes concurrently with I=
TV=92s screening of Prince Harry=92s documentary about AIDS in the Africa=
n kingdom. The fund was created the request of Prince Harry, 19, who spen=
t eight weeks in Lesotho helping build a clinic and bridges while filming=
=93The Forgotten Kingdom: Prince Harry in Lesotho.=94 =93The generous re=
sponse to the Red Cross appeal so far shows that [Harry] can help inform =
and motivate the public about a subject like HIV/AIDS,=94 the Red Cross s=
aid in a statement. AIDS has been declared a national emergency in Lesoth=
o, where HIV infects some 31 percent of the 1.8 million population and ha=
s cut life expectancy to 36 years. =20
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