| prevention-news@cdcnpin.org 2004-10-12, 7:10 pm |
| CDC HIV/STD/TB Prevention News Update
Tuesday, October 12, 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
TEXAS: =93Safe-Sex Activists Oppose Abstinence-Only Texts in Texas=94
INTERNATIONAL NEWS
SOUTH AFRICA: =93Private Clinics in South Africa Urge Drug Companies to L=
ower Prices for AIDS Treatment=94
AFRICA: =93HIV/AIDS Campaigns Overlook Rural Africa: Experts=94
CHINA: =93Peer education Makes Young Chinese Discuss Sex, AIDS More Easil=
y=94
CANADA: =93Hep-C Called 'Runaway' Problem Among City's Illegal Drug Users=
: Medical Officer Defends Expanded Paraphernalia Plan=94
MEDICAL NEWS
GLOBAL: =93Distance Communication Transfer of HIV Prevention Intervention=
s to Service Providers=94
NEWS BRIEFS
CHINA: =93Annan Lauds China's Efforts on Prevention and Treatment of AIDS=
=94
CHINA: =93Southern China Offers Gay Men Free HIV Tests: Report=94
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NATIONAL NEWS=09
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TEXAS:
=93Safe-Sex Activists Oppose Abstinence-Only Texts in Texas=94
Washington Times (10.12.04)::George Archibald
On Nov. 5, the Texas State Board of education will take a final vote=
on the adoption of new health textbooks for the state's 7,800 public sch=
ools. Texas, which spends more than $570 million a year on textbooks, is =
the nation's second-largest textbook market.=20
A state law enacted in 1995 states: =93Any course materials and inst=
ruction relating to human sexuality, [STDs], or [HIV/AIDS]=85 must presen=
t abstinence from sexual activity as the preferred choice of behavior in =
relationship to all sexual activity for unmarried persons of school age.=94=
=20
Texas Essential Knowledge and Skills, the state curriculum standard =
that predates the 1995 law, states that textbooks must =93analyze the eff=
ectiveness of barrier protection and other contraceptive methods includin=
g the prevention of [STDs], keeping in mind the effectiveness of remainin=
g abstinent until marriage.=94
=93Information on family planning and disease prevention is not in t=
he books,=94 Samantha Smoot, president of the Texas Freedom Network, said=
at a textbook hearing in September. Smoot, who leads the =93Protect Our =
Kids Campaign=94 with Planned Parenthood and other groups seeking compreh=
ensive sex-education information for Texas' textbooks, was one of more th=
an 315 people who testified before the state board.=20
To comply with state mandates, textbook publishers have produced sep=
arate ancillary materials for teachers that include information on condom=
s, birth control and STDs that is not in student versions of the books. C=
ritics say the supplemental materials do not comply with state law. These=
materials were not formally offered with the textbooks for state adoptio=
n; publishers say they will be provided to schools that purchase the book=
s.=20
Kyleen Wright, president of Texans for Life and an abstinence-educat=
ion advocate, said Texas has become =93one of the top three states=94 for=
reducing teen pregnancies, births and abortions since the Legislature ma=
de abstinence education =93the law and standard in classrooms.=94
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INTERNATIONAL NEWS=09
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SOUTH AFRICA:=20
=93Private Clinics in South Africa Urge Drug Companies to Lower Prices fo=
r AIDS Treatment=94
Associated Press (10.12.04)
New government drug-pricing regulations require that South Africa's =
state-associated AIDS treatment facilities receive the lowest drug prices=
.. However, the regulations also require drug firms to charge a higher =93=
single exit price=94 to nongovernmental AIDS organizations, including cha=
rities. AIDS groups today criticized the regulations for increasing the p=
rice manufacturers charge private groups, and they urged the firms not to=
raise their AIDS drug prices.
Some drug companies are increasing prices beyond the means of nongov=
ernmental groups to buy medicines, AIDS Healthcare Foundation said today =
in a statement. =93As a result, we are unable to treat the thousands of S=
outh Africans on our waiting list, many of whom will sadly die unless acc=
ess to low-priced drugs become a priority,=94 said Michael Weinstein, pre=
sident of AHF, which treats 500 patients with antiretrovirals at its Durb=
an center. There are 3,000 people in Durban on the center's waiting list =
for treatment, AHF said.
=93As millions of people worldwide are dying from AIDS because they =
are unable to access [antiretroviral] treatment, it astonishes me that dr=
ug companies continue to have the audacity and hubris to increase the alr=
eady greatly inflated prices of drugs,=94 said Weinstein.
The Network of AIDS Communities in South Africa also called on drug =
companies to honor their pledge to bring the lowest possible prices to na=
tions in desperate need. =20
AFRICA:
=93HIV/AIDS Campaigns Overlook Rural Africa: Experts=94
Agence France Presse (10.12.04)
The majority of HIV/AIDS prevention and support efforts in Africa co=
ntinue to focus on major cities, while rural areas and communities are of=
ten overlooked, delegates at the UN's Commission on HIV/AIDS and Governan=
ce in Africa (CHGA) were told today. Politicians, including former Zambia=
n President Kenneth Kaunda, along with development workers and researcher=
s have gathered in Addis Ababa for CHGA's third session of open discussio=
ns and debates.=20
=93Earlier in the pandemic, HIV/AIDS was viewed merely as an urban p=
henomenon, and most of the response is still focused there,=94 said K.Y. =
Amoako, executive secretary of the UN's Economic Commission for Africa, a=
t the opening of the session. =93Now, however, we can see that the epidem=
ic has spread to our rural areas where the vast majority of Africans live=
.. Households are losing key productive members in their prime and communi=
ties are losing the main producers of food,=94 said Amoako. =93Crucial kn=
owledge is lost and the fabric of rural communities is being torn apart.=94
Joseph Tumushabe, of Uganda's Makerere University, said rural commun=
ities are more affected by HIV/AIDS in part because they are more vulnera=
ble to a range of social and economic ills, including conflict, famine an=
d floods. =93We are now coming to the point where we are going to get inf=
ormation and statistics and data with regard to what is happening to the =
population, particularly in rural areas. If we are going to confront HIV/=
AIDS, we have got to look at rural areas and communities,=94 he added.=20
Topics addressed at the conference will be included in CHGA's final =
report on the long-term impact of the HIV/AIDS pandemic in Africa, which =
is scheduled to be submitted to UN Secretary-General Kofi Annan in June 2=
005. Later this year, the commission will meet in Ghana to examine the im=
pact of HIV/AIDS on the workforce and again in Cameroon to discuss gender=
and AIDS orphans.=20
CHINA:
=93Peer education Makes Young Chinese Discuss Sex, AIDS More Easily=94
Xinhua News Agency (10.12.04)
In China, where sex is rarely discussed in public, peer education pr=
ograms are teaching people how to prevent HIV/AIDS, use contraception, re=
spond to sexual harassment, and reject unwanted sexual advances. Experts =
say the peer education concept, which was brought to China from Australia=
in 1996, is playing an increasing role in the sexual education of Chines=
e youth.
International nongovernmental groups like Maria Snopes China, a bran=
ch of a British noncommercial public service agency, have led programs in=
China. MSC has been offering peer education services on sexual and repro=
ductive health issues for students at eight Beijing universities since Se=
ptember 2003. So far, the group has trained 200 students as peer educator=
s.
With its interactive nature, peer education helps teenagers develop =
proper attitudes toward sex, sexual discrimination and drugs, said Cui Qi=
, MSC program officer. =93Young people should be given a chance to learn =
how to make rational and proper decisions on sexual relationships and rep=
roductive health,=94 said Cui, who described the experience as =93a game=94=
instead of a lecture or seminar.=20
Peng Zhu, a Beijing university freshman and a first-time peer educat=
ion participant, said, =93I feel quite relaxed instead of embarrassed whe=
n talking about sex. It is a good idea to be a sex and reproductive healt=
h trainer and to share my knowledge with classmates.=94=20
=93Teenagers have become sexually mature and active much earlier, bu=
t lack of sexual education will put them in a position that's very vulner=
able to HIV/AIDS,=94 said Liu Liqing, chief representative of Marie Snope=
s to its China office.=20
Experts have called for governments to train more sex education teac=
hers for primary and middle schools while cultivating more professionals =
by offering sexology majors at some universities.
CANADA:=20
=93Hep-C Called 'Runaway' Problem Among City's Illegal Drug Users: Medica=
l Officer Defends Expanded Paraphernalia Plan=94
Ottawa Citizen (10.09.04)::Daniel Tencer
Ottawa's needle-exchange program now distributes such items as crack=
-pipe stems, as well as tourniquets and aluminum caps for IV drug users, =
in order to stem hepatitis C among the city's illegal drug users, said Dr=
.. Robert Cushman, Ottawa's chief medical officer. On Friday, Cushman said=
the =93runaway=94 hepatitis C problem is so severe it would be =93stupid=
=94 not to offer the items. His response followed concerns raised about t=
he new initiative, which the City Council's health and social services co=
mmittee backed Thursday.
Crack pipes get hot during use, burning and cracking the user's lips=
, and blood could then get passed to the next user, said Cushman. He said=
the city would not hand out crack pipes, but rather stems that can be fi=
tted onto pipes, through which users could inhale without transmitting bo=
dy fluids.=20
Hepatitis C virus (HCV) is much more transmittable than HIV, said Cu=
shman. A decade ago, virtually none of the city's drug users tested posit=
ive for hepatitis C, he said. HCV infected 56 percent two years ago; and =
now it infects 76 percent, he said. The needle-exchange program alone did=
not adequately address the HCV epidemic, said Cushman.=20
Preventative measures would save the health system money that could =
be used for other problems, said Cushman, whose report to the committee c=
ited research conducted by Health Canada and Lynne Leonard of the Univers=
ity of Ottawa's Department of Epidemiology and Community Medicine.=20
=93I can certainly understand their strategies for trying to prevent=
the spread of those diseases,=94 said Police Chief Vince Bevan, who offe=
red little resistance to the initiative. Cumberland Councilor Rob Jellett=
said he would rather focus on treating drug users than helping them use =
drugs.
Ottawa's needle-exchange program is 13 years old. New HIV cases amon=
g IV drug users decreased from 39 in 1995 to 12 in 2001, according to cit=
y health research.
=20
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MEDICAL NEWS=09
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GLOBAL:=20
=93Distance Communication Transfer of HIV Prevention Interventions to Ser=
vice Providers=94
Science (09.24.04) Vol. 305; No. 5692: P. 1953-1955::Jeffrey A. Kelly; An=
ton M. Somlai; Eric G. Benotsch; Timothy L. McAuliffe; Yuri A. Amirkhania=
n; Kevin D. Brown; L. Yvonne Stevenson; M. Isa Fernandez; Cheryl Sitzler;=
Cheryl Gore-Felton; Steven D. Pinkerton; Lance S. Weinhardt; Karen M. Op=
genorth=20
Most AIDS service organizations (ASOs) are located in nations with l=
ittle access to relevant scientific developments, and scholarly journal a=
rticles often provide insufficient detail for ASOs to implement preventio=
n approaches. In the current study, researchers assessed whether online a=
nd offline technologies could help AIDS nongovernmental organizations (NG=
Os) in poor countries implement a prevention program in their communities=
..
Participants were 86 AIDS NGOs in 78 countries, most having limited =
budgets and few staff. Researchers chose the popular opinion leader (POL)=
model of prevention outreach for dissemination.
Using telephone, Web site, e-mail and/or instant messaging, consulta=
nts who were from the region in which NGOs operated or familiar with its =
culture assessed the NGOs' needs and reasons for participation, which hel=
ped to personalize relations. NGOs were randomized into either a control =
condition or =93a technology transfer condition with an interactive dista=
nce learning computer training curriculum and individualized distance con=
sultation.=94
Control NGO directors attended a POL orientation and were told they w=
ould receive training in 18 months. NGOs received a computer, subsidized =
Internet, access to a study Web site to network with other NGOs on new pr=
ograms, and briefing papers on topics including grant writing, program an=
d needs assessment, and organizational management. Experimental NGOs addi=
tionally received a transfer program carried out using distance communica=
tion technologies.=20
Experimental NGOs received a self-paced POL intervention curriculum =
on compact disk (CD). The curriculum described intervention procedures, m=
odeled techniques, and used discussion points to encourage program implem=
entation. The CD had print, video and voice-over to explain critical area=
s and cover practical implementation issues, and included copies of all p=
rintable material needed for the intervention. Most NGOs requested, and r=
eceived, supplemental print curricula. The curriculum took an average thr=
ee to four weeks to complete. Consultations continued for six months.=20
At 15-months from baseline, interviewers who were unaware of an NGO'=
s condition asked directors whether a program had been initiated or modif=
ied based on the study interaction, and assessed the presence of core POL=
elements.
Of 42 experimental NGO directors, 37 (88 percent) utilized the CD fo=
r an average 6.8 hours, viewing 69 percent of its content. All read print=
curriculum, averaging 15.6 hours and reading 93 percent of it. In additi=
on, an average 10.7 other staff and volunteers used the curriculum. Consu=
ltants communicated an average 5.9 times for 30 minutes each time. Thirty=
directors (72 percent) rated the CD as useful; 37 (88 percent) rated the=
print material as useful; and 28 (67 percent) rated the distance consult=
ations similarly. The majority (37) held staff meetings to develop new PO=
L-based programs; 34 identified target populations; and 31 determined ven=
ues. For support, 24 (57 percent) wrote grant proposals.=20
At follow-up, 18 of 42 technology transfer NGOs (43 percent) =97 com=
pared with 7 of 41 controls (17 percent) =97 developed a new POL-based HI=
V prevention program. Key POL elements were incorporated into an existing=
program by 23 (55 percent) experimental versus 11 (27 percent) control N=
GOs. By almost double (64 percent versus 34 percent), experimental NGOs e=
ither developed a new program or modified an existing one based on POL.=20
Twenty-three (55 percent) experimental NGOs passed curriculum materi=
al to other providers, with CD materials reaching 81 other organizations =
and print manuals passing to 143. Additionally, 12 NGOs (29 percent) held=
POL trainings with 73 other in-country agencies, and 19 (45 percent) dis=
cussed the model with their governments; 26 percent of governments incorp=
orated the model into their strategic HIV prevention plans.
Most experimental NGOs did not adopt the intervention wholly but use=
d core elements selectively; many (25/42; 60 percent) cited lack of fundi=
ng as an implementation barrier, with those core POL elements requiring n=
o additional staff and cost impact most often incorporated. Researchers c=
oncluded that =93advanced communication technologies can link service pro=
viders worldwide with training, technical assistance, and consultation in=
the use of new approaches originating in the research arena.=94 =20
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NEWS BRIEFS =09
************************************************************
CHINA:
=93Annan Lauds China's Efforts on Prevention and Treatment of AIDS=94
Xinhua News Agency (10.12.04)
In Beijing, UN Secretary-General Kofi Annan has praised China's AIDS=
prevention and control efforts and called for an end to discrimination a=
gainst people with AIDS. While visiting the Center for Disease Control an=
d Prevention in Chaoyang District, Annan inspected testing and monitoring=
facilities and met with HIV patients. Annan named AIDS education as a ma=
jor component in the fight to prevent and treat HIV infection. He further=
expressed hope that China will eliminate AIDS discrimination and will en=
courage HIV-infected persons to seek early treatment.
CHINA:
=93Southern China Offers Gay Men Free HIV Tests: Report=94
Agence France Presse (10.11.04)
The southern Chinese province of Guangdong is offering free HIV test=
s to homosexual men, the state-owned China Daily and the Guangdong-based =
Information Times reported Monday. The provincial Center for Disease Cont=
rol's AIDS institute began interviewing and testing gay men amid growing =
concern over the rapid rise of HIV/AIDS in China. He Qun, the center's de=
puty director, said HIV in Guangdong is believed to be spreading primaril=
y through heterosexual sex and, to a lesser degree, intravenous drug use.=
Along with prostitutes, gay men are considered a high-risk population. G=
uangdong, which had 9,000 syphilis patients last year, is also planning t=
o build a syphilis treatment center to handle the growing number of patie=
nts infected with the STD.
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ANNOUNCEMENT: National Latino HIV/AIDS Awareness Day (NLHAAD) is October =
15. In support of NLHAAD, the Department of Health and Human Services is =
hosting an Awareness Day=A0Web site that=A0offers information on preventi=
on, testing, and treatment, as well as information on local NLHAAD events=
.. The=A0Web site address is http://www.omhrc.gov/hivaidsobservances/nlhaa=
d/index.html.
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