| prevention-news@cdcnpin.org 2004-10-04, 2:18 am |
| CDC HIV/STD/TB Prevention News Update
Wednesday, September 29, 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
GLOBAL: =93After 20 Years, AIDS Vaccine Still Seems a Distant Dream=94
UNITED STATES: =93Cost of AIDS Therapy Out of Reach for Many=94
INTERNATIONAL NEWS
ETHIOPIA: =93Abduction and Rape of Young Girls for Marriage Common in Rur=
al Ethiopia, Victims and Aid Workers Say=94
ETHIOPIA: =93Ethiopia Church Says Condoms Unchristian=94
MADAGASCAR: =93Madagascar to Distribute 15 Million Free Condoms=94
MEDICAL NEWS
AUSTRALIA: =93Sexually Transmitted Disease: Patients Prefer Website-Based=
Strategy for Sexual Partner Notification=94
LOCAL AND COMMUNITY NEWS
TEXAS: =93Prostitute May Agree to Treatment=94
NEW YORK: =93Effort Targets HIV/AIDS; university at Albany Conference Foc=
uses on Preventing Illness Among Minorities=94
NEWS BRIEFS
EUROPE: =93European Center for Disease Prevention and Control Opens in St=
ockholm=94
ARKANSAS: =93Health Department: Four Employees Inappropriately Received M=
oney=94
DELAWARE: =93Remembering AIDS Victims=94
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NATIONAL NEWS=09
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GLOBAL:
=93After 20 Years, AIDS Vaccine Still Seems a Distant Dream=94
USA Today (09.29.04)::Steve Sternberg
HIV vaccine research is at a crossroads, as once-promising approache=
s have proved disappointing and uncertainty lingers as to where to go nex=
t. This was reiterated by discouraging results announced this month at th=
e 2004 AIDS Vaccine Conference in Switzerland and in July at the 15th Int=
ernational AIDS Conference in Bangkok. =93We're dealing with a very formi=
dable scientific challenge,=94 said Anthony Fauci, director of the Nation=
al Institute of Allergy and Infectious Diseases. =93This is probably goin=
g to turn out to be the most difficult vaccine to develop in the history =
of vaccine research.=94=20
Nearly two-dozen prototype vaccines are in human trials, compared to=
just seven two years ago. Eleven of these are in the US government-spons=
ored HIV Vaccine Trials Network. Some now in trials include DNA vaccines,=
made up of bits of pure genetic HIV material stripped of the sections th=
at would allow the virus to become active and reproduce itself. Others ar=
e =93Trojan-horse=94 vaccines, created by packing other viruses with inac=
tivated HIV proteins that researchers hope will kick the immune system in=
to overdrive.=20
But many basic questions remain unanswered. For example, researchers=
do not know what immune responses best guard against HIV infection. And =
they cannot figure out how to develop a vaccine with neutralizing antibod=
ies =97 critical to the effectiveness of every other vaccine =97 capable =
of killing HIV before it establishes itself in the body.=20
=93Part of any investigation into the unknown is running into dead e=
nds. That's how science is done,=94 said Emilio Emini, director of vaccin=
e research at the International AIDS Vaccine Initiative.=20
Missteps are inevitable because monkey studies of HIV vaccines are u=
nable to predict how well the vaccines will work in humans. That has prom=
pted a profound shift in research strategy: Researchers must now rely on =
costlier, small-scale human trials, said Lawrence Corey, director of HVTN=
..
UNITED STATES:
=93Cost of AIDS Therapy Out of Reach for Many=94
Washington Blade (09.24.04)::Phil Lapadula
In August, the Food and Drug Administration approved Sculptra, a new=
treatment for the facial wasting that can be a side effect of HIV drugs.=
Its maker, Dermik Laboratories of Berwyn, Pa., set the US price at almos=
t four times the price in Europe, where it has been used since 1999. Scul=
ptra sells for $125 per bottle in Europe and South America but $480 in th=
e United States, said Dr. Peter Engelhard, director of Apex South Beach C=
linic, which specializes in treating HIV atrophy. Each treatment requires=
two to three bottles; each patient needs three to six treatments; and on=
e to two bottles are needed every one to years for maintenance treatments=
, Engelhard said.
Karen Boyce, Dermik's manager of communications, said the company is=
developing a patient-access program for those who cannot afford Sculptra=
; details should be available in late October. She noted that Sculptra is=
sold not to patients but to doctors; she suggested physicians could set =
lower prices for patients with hardships.=20
Engelhard said he had 170 patients on a waiting list before Sculptra=
was approved, but after approval and the price hike, all but 30 said the=
y could not afford it. =93They're either getting a different product or n=
one at all. It's too bad because this is the best one,=94 he said.
Insurance companies are unlikely to cover Sculptra because they cons=
ider it a cosmetic treatment, like Botox for wrinkles, Engelhard said. He=
disagrees, comparing it instead to reconstructive procedures following b=
reast cancer surgery. =93People do things like stop taking their medicati=
ons because of atrophy, and that does change their longevity,=94 he said.
Jonathan Appelbaum of Boston's Fenway Community Health said coverage=
by state drug assistance programs is also unlikely because Sculptra is c=
onsidered a treatment or device, not a drug.
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INTERNATIONAL NEWS=09
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ETHIOPIA:=20
=93Abduction and Rape of Young Girls for Marriage Common in Rural Ethiopi=
a, Victims and Aid Workers Say=94
Associated Press (09.24.04)::Anthony Mitchell
UNICEF estimates that more than 70 percent of marriages in Ethiopia =
are initiated through the abduction of young girls, and male dominance an=
d stigma against the victims often allow the perpetrators to go unpunishe=
d. While such abductions in African countries are typically committed dur=
ing war, they have long been a marriage custom in Ethiopia. =20
Residents in Arsi say men frequently see the kidnappings as a bargai=
n, since virgin girls can command a $400 dowry. Abducted and raped, a gir=
l can then be obtained for $50 and a horse, since families assume no one =
but the abductor =97 often 10-15 years older =97 will marry her.
For Chaltu Jeylu, kidnapped at age 13 and raped by her suitor until =
she became pregnant, the trauma of assault is magnified by the fear of co=
ntracting HIV. Such victims =93may well be infected,=94 said Rahel Worku,=
a nurse at a government health center that helps girls. =93It is a very =
high risk, but we have no testing facilities, so we do not know,=94 she s=
aid.
Chaltu, now 14, ultimately fled her husband, but in doing so was ost=
racized by her village and most of her family. Her husband is free and fa=
ces no charges; his friends have threatened to break Chaltu's arm if she =
pursues a case against him. Chaltu's father said she brings shame upon th=
e family. Her mother alone supports Chaltu's escape. Village elders force=
d Chaltu's family to return the dowry and relinquish the couple's baby bo=
y. =93They say I broke the tradition of the community because I did not s=
tay with him,=94 said Chaltu.
Marriage via child abduction =93is not seen as serious here, it is p=
art of the culture,=94 said Ellen Alem, acting director of the Ethiopian =
Women's Lawyers Association. =20
ETHIOPIA:=20
=93Ethiopia Church Says Condoms Unchristian=94
Reuters (09.28.04)
A leaflet distributed this week by the Orthodox Church in Ethiopia s=
aid that condoms should not be used to fight HIV/AIDS because they are ne=
ither Christian nor reliable.=20
=93Our church does not condone the campaign to use condoms against H=
IV/AIDS because such practices are unchristian and are not permitted unde=
r the ethics of the Orthodox Church,=94 the leaflet said. =93We teach tha=
t a couple should be faithful to each other and avoid multiple partners, =
which is the major cause of [HIV] infection,=94 it continued. =93Furtherm=
ore, the use of artificial material such as condoms is not reliable,=94 t=
he religious missive purported, =93and could also undermine the campaign =
against HIV/AIDS.=94
Of Ethiopia's 68 million population, about 3 million are HIV-infecte=
d and another 1,000 people become infected every day. The Orthodox Church=
claims about 60 percent of the population as members.
In Ethiopia, condoms are widespread and cheap, costing 0.25 Ethiopia=
n Birr (0.03 of a US cent) for a pack of three. Analysts say the governme=
nt's recent media campaigns and promotion of testing centers have not yet=
decreased HIV infections. =20
MADAGASCAR:=20
=93Madagascar to Distribute 15 Million Free Condoms=94
Reuters (09.28.04)
A senior official with Madagascar's national AIDS committee said Tue=
sday the large island nation plans to distribute 15 million free condoms =
next year as part of a campaign to promote safe sex and control the sprea=
d of HIV/AIDS. The cheapest accessible condoms are the Protector brand, b=
ut at a cost of 500 Fmg (five US cents) they are still far too expensive =
for many, said Fenosoa Ratsimanetrimanana, the committee's executive secr=
etary. Madagascar has promoted condoms before, but this will be its first=
-ever purchase for free condom distribution. =20
Antenatal clinic surveys suggest that about 1.1 percent of the poor =
nation's 17 million population are HIV-infected, according to the World H=
ealth Organization. That is an increase from the 0.16 percent prevalence =
in 2000. =93The figures we have are not exact, but it is clear rates of i=
nfection are steadily increasing,=94 said Dr. Andre Ndikuyeze, WHO's coun=
try representative.
Madagascar invited bids from condom producers, said Ratsimanetrimana=
na, who hopes the purchase will help make condoms familiar to the populac=
e as a weapon against AIDS. When the condom supply runs out, the governme=
nt may buy more if financial resources are available, he said.
It can be difficult to discuss condoms and sexual issues in conserva=
tive Madagascar, aid workers say. Catholic Archbishop Cardinal Gaetan Raz=
afindatrandra has stated publicly that condoms are not effective against =
HIV. =20
************************************************************
MEDICAL NEWS=09
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AUSTRALIA:
=93Sexually Transmitted Disease: Patients Prefer Website-Based Strategy f=
or Sexual Partner Notification=94
AIDS Weekly (09.06.04)
In the current study, the authors sought to determine the =93estimat=
ed proportion of contactable sexual partners, the most common types of co=
ntact information available and the most acceptable contact tracing strat=
egies for our clients.=94
According to J.E. Tomnay and coauthors, 500 walk-in clients filled o=
ut a questionnaire regarding their total number of sexual partners, the p=
roportion of contactable partners and available contact information. =93W=
omen had the highest estimated number of contactable partners (89-94 perc=
ent), men who have sex with men had the lowest (51-73 percent),=94 they r=
eported.=20
Providing partners a Web site address was the most preferred contact=
tracing strategy (76 percent), while provider referral was the least pre=
ferred (33 percent). =93There was a difference in the type of information=
available for contacting sexual partners (p<.001); most commonly clients=
reported partners contactable by phone or face to face and least commonl=
y through a third person,=94 reported the authors.=20
=93The currently used method (doctor's letter) is not the preferred =
choice of these clients and more innovative methods using recent technolo=
gy may prove more effective,=94 the authors concluded.
The full report, =93Partner Notification: Preferences of Melbourne C=
lients and the Estimated Proportion of Sexual Partners They Can Contact,=94=
was published in the International Journal of STD & AIDS (2004;15(6):415=
-418).=20
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LOCAL AND COMMUNITY NEWS=09
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TEXAS:
=93Prostitute May Agree to Treatment=94
Amarillo Globe News (09.28.04)::Greg Cunningham
On Monday, Amarillo City Attorney Marcus Norris said an HIV-positive=
prostitute may be willing to voluntarily undergo treatment and counselin=
g to prevent her from spreading the virus.=20
Following the recommendation of health officials, Norris' office last wee=
k filed a suit asking a civil court to order the woman, identified only a=
s T.T., to enter a residential facility for HIV treatment. Court document=
s describe the woman as a cocaine addict.
=93We chose not to go criminal because we didn't feel like she would=
get the treatment she needs for her other problems,=94 Norris said. =93I=
f we can get her into treatment for these other problems, she won't feel =
compelled to prostitute herself, and the situation will be resolved.=94=20
The woman is alleged to have infected another person with HIV. Texas=
Department of Health spokesperson Doug McBride said department lawyers d=
o not think there is a law in Texas specifically making it a crime to exp=
ose someone to HIV. Jennifer Bard, a public-health law expert and an asso=
ciate professor at Texas Tech university School of Law, said there appear=
s to have been such a law at one time, but the Legislature repealed it in=
1993 =97 probably because a person alleged to have exposed someone to HI=
V could be charged under standard assault statutes.
Officials are concerned T.T. may have infected others, and they say =
the case should raise concerns for those engaged in high-risk activities.=
=93One thing that can come out of this is that people will know you need=
to protect yourself,=94 said Hector Mendoza, STD/HIV program manager for=
the Department of Health in Amarillo.=20
Norris said T.T. =93seems to want some help now=94 and =93has been s=
omewhat cooperative since this suit was filed. I think she sees this as a=
n opportunity for her to make some positive changes in her life.=94=20
NEW YORK:=20
=93Effort Targets HIV/AIDS; university at Albany Conference Focuses on Pr=
eventing Illness Among Minorities=94
Times-Union (09.28.04)::Breea Willingham
A two-day conference on HIV/AIDS prevention in the black and Hispani=
c communities is scheduled to begin Wednesday at the university at Albany=
.. =93The aim is to get a handle on the disconnect of faith-based organiza=
tions, health-care providers and the HIV/AIDS community to see how these =
players network and how they facilitate or impede the effectiveness of HI=
V/AIDS prevention,=94 said Hayward Derrick Horton, a university at Albany=
associate professor of sociology. Capitalize on Community, a group Horto=
n founded last year, organized the conference.
According to the state Health Department, of Albany residents ages 2=
5-29 with AIDS, more than 40 percent are black. Half of Albany's AIDS cas=
es ages 30-39 are black. However, blacks comprise just 28 percent of Alba=
ny's population. Comparable statistics are unavailable for Hispanics, but=
the department's most recent quarterly report said 103 Hispanic Albany r=
esidents had HIV/AIDS.
Too many people continue to engage in unsafe sex, said Johanne Morne=
, director of an HIV prevention program at the Whitney Young Jr. Health C=
enter. People need to become comfortable having conversations about HIV/A=
IDS, =93then we can get comfortable with adopting those [safe] behaviors =
in our lives,=94 she said.
The first day of the conference will focus on student awareness. On =
Thursday, the conference will feature workshops and keynote speaker Debra=
Frazer-Howze, president and founder of the National Black Leadership Com=
mission on AIDS.=20
The conference also launches the Capitalize on Community campaign, a=
five-year research and outreach project intended to improve HIV/AIDS pre=
vention efforts in the Capital Region. =20
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NEWS BRIEFS =09
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EUROPE:
=93European Center for Disease Prevention and Control Opens in Stockholm=94
Agence France Presse (09.27.04)
On Monday, European Commissioner for Health and Consumer Protection =
David Byrne opened the European Centre for Disease Prevention and Control=
in Stockholm. =93Infectious diseases can pose a deadly threat and they d=
o not respect national borders,=94 Byrne said in a statement. =93This new=
EU agency will enable Europe to be better prepared for whatever new epid=
emics the 21st century has in store. It also has a crucial role to play i=
n helping us contain the alarming resurgence of HIV/AIDS we are beginning=
to see in Europe and enabling us to better understand a whole range of l=
ethal diseases,=94 Byrne added. The center will be funded with =804.8 mil=
lion (US$5.91 million) in 2005, rising to =8029 million ($35.7 million) i=
n 2007. The agency, which will not have regulatory powers, will focus on =
disease tracing and informing the public about risks.=20
ARKANSAS:
=93Health Department: Four Employees Inappropriately Received Money=94
Associated Press (09.29.04)
An Arkansas Department of Health audit has determined that four empl=
oyees were inappropriately paid a total of $17,566.66 through an AIDS div=
ision travel expense account. The nonprofit Fort Smith Fights AIDS, which=
receives federal money via the Health Department, had access to the acco=
unt. But the account was designed for FSFA and similar organizations, not=
for Health Department employees. According to the audit, the outstanding=
money was used to pay for travel costs for which FSFA had no receipts. R=
ick Hogan, chief counsel for the Health Department, said it appears as th=
ough the four employees circumvented the department's system to access th=
e money. =93It's not that the process was necessarily flawed,=94 said Hog=
an. =93It's that the process wasn't followed.=94
DELAWARE:
=93Remembering AIDS Victims=94
Wilmington News Journal (09.27.04)::Robin Brown
More than 2,000 walkers participated in Sunday's 18th annual Delawar=
e AIDS Walk. The 5K event began in Rockford Park. When donations are tall=
ied this week, said AIDS Delaware Executive Director John Baker, the walk=
is expected to have met its goal of raising $100,000 for local HIV/AIDS =
programs and services.=20
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