| prevention-news@cdcnpin.org 2004-10-16, 11:08 am |
| CDC HIV/STD/TB Prevention News Update
Wednesday, October 13, 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
MARYLAND: =93Schaefer Calls People with AIDS 'a Danger'=94
INTERNATIONAL NEWS
SOUTH AFRICA: =93HIV/AIDS Prompts South Africa Nurse Shortage=94
CHINA: =93China Launches Hunt for HIV-Infected Blood Sellers=94
GLOBAL: =93Vaccine Could Reduce Cervical Cancer by 70 Percent=94
MEDICAL NEWS
AUSTRALIA: =93Is Screening for Anal Cancer Warranted in Homosexual Men?=94
LOCAL AND COMMUNITY NEWS
CALIFORNIA: =93HIV/AIDS; Reported Los Angeles County AIDS Cases Up 89 Per=
cent over Past 2 Years=94
CALIFORNIA: =93Stop AIDS Project Searches for New Leader=94
NEWS BRIEFS
MARYLAND: =93Western Maryland News in Brief=94
SOUTH CAROLINA: =93Blood Screening Begins for Hepatitis B=94
RUSSIA: =93HIV-Positive Russians Detained During Protest in Western City=94
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NATIONAL NEWS=09
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MARYLAND:
=93Schaefer Calls People with AIDS 'a Danger'=94
Washington Post (10.13.04)::Matthew Mosk
On Tuesday, Maryland Comptroller William Donald Schaefer (D) called =
people with AIDS =93a danger=94 and said those with the disease =93brough=
t it on themselves.=94=20
Schaefer, 82, made the remarks during an interview when asked to exp=
lain comments he made last week at a Board of Public Works meeting. At th=
at time, he asked the state's AIDS administrator why she does not establi=
sh a public registry listing HIV-positive Maryland residents. In the 1990=
s, Schaefer's call for such a registry was defeated three times by the st=
ate Legislature.=20
=93As far as I'm concerned, people who have AIDS are a danger,=94 Sc=
haefer said. =93People should be able to know who has AIDS.=94
Activists decried the remarks by Schaefer, who is a former governor.=
=93That someone who holds his position could make such insensitive remar=
ks and advocate such draconian policies and show such a complete level of=
ignorance, and yet feel he is equipped to speak on the issue =97 I'm jus=
t dumbfounded,=94 said Dan Furmasky, executive director of Equality Maryl=
and, which advocates for gay, lesbian, bisexual and transgender residents=
..=20
On Tuesday, Schaefer made no apologies for his remarks; he dismissed=
as =93propaganda=94 the suggestion that a registry would deter those wit=
h HIV/AIDS from seeking treatment. =93They don't want to die,=94 he said.=
=20
Schaefer's position is vastly different from the view of most public=
-health officials, who reject the idea of such a registry. Maryland colle=
cts information on HIV-positive persons using codes; the patient's identi=
fy remains confidential. It collects the names of AIDS patients, but that=
list is not accessible to the public.=20
=93There are many reasons why it is not open to the public,=94 sand =
Naomi Tomoyasu, acting director of the Maryland AIDS Administration. =93T=
he most important is, we want to encourage people to come in and get test=
ed and get care.=94
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INTERNATIONAL NEWS=09
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SOUTH AFRICA:=20
=93HIV/AIDS Prompts South Africa Nurse Shortage=94
Associated Press (10.12.04)
On Tuesday, a study determining HIV/AIDS prevalence among South Afri=
can health workers warned the country needs more nurses. The study found =
a =93very high,=94 rising rate of HIV/AIDS among health workers, the Sout=
h African Press Association reported.=20
The authors examined both junior and professional staff at 5 percent=
of public and private health facilities in four of the nation's nine pro=
vinces. About 20 percent of workers ages 18-35 had HIV/AIDS, compared to =
13 percent of professionals. HIV was more prevalent among black health wo=
rkers and unmarried staff. Infection status was not tied to educational a=
ttainment.
The authors warn that South Africa's health system could face more s=
ick workers who stay at home increasing the workload on others, leading t=
o burnout and a decrease in morale. In addition, workers with HIV are mor=
e at risk of being co-infected with opportunistic diseases such as TB. Th=
e report said the risk of workers transmitting HIV to patients was =93les=
s likely=94 than being infected by HIV patients. =20
=93Given the high prevalence of HIV =97 15.7 percent =97 in the youn=
ger population of health workers, it is critical to increase the numbers =
of nurses to be trained, particularly if one considers that from 1997 to =
2001 the country experienced a 6.86 percent decline in the number of nurs=
es registering with the South African Nursing Council,=94 the journal sai=
d. The authors recommended that the Department of Health train more nurse=
s and determine the reasons for nurse attrition.
The full report, =93HIV/AIDS Prevalence Among South African Health W=
orkers,=94 was published in the South African Medical Journal (2004;94(10=
):846-850).
CHINA:
=93China Launches Hunt for HIV-Infected Blood Sellers=94
Deutsche Presse-Agentur (10.13.04)
Today in Beijing, China's Ministry of Health launched a drive to fin=
d tens of thousands of rural residents who became infected with HIV by se=
lling their blood in the 1990s. A circular posted on the ministry's Web s=
ite ordered local officials to locate lists of blood sellers and use heal=
th reports, death registers, local newspapers and other sources to identi=
fy areas where HIV infection may have occurred.
In =93key provinces and areas=94 where infection through blood selli=
ng is already known to be a problem, officials were told to find everyone=
who sold blood. Individual test results must be kept confidential. Healt=
h workers were told to test the family members of HIV-infected persons an=
d to conduct secondary CD4 tests.
April 2005 is the deadline by which all provinces and regions must r=
eport their findings to the ministry. Provinces can apply to the central =
government for serum supplies needed to carry out the tests based on the =
estimated number of blood sellers but must bear all other costs, the mini=
stry said.
UN experts estimate that about 1.5 million Chinese are already HIV-i=
nfected and say the number could climb to 10 million by 2010 if the gover=
nment fails to expand education, prevention and anti-discrimination campa=
igns. The Chinese government says a lower number of people =97 840,000 =97=
now have HIV. The new testing initiative is likely to result in a large =
increase in China's official count of those with HIV/AIDS.
GLOBAL:
=93Vaccine Could Reduce Cervical Cancer by 70 Percent=94
Australian Associated Press (10.13.04)::Holly Nott
Research trials underway in 14 countries have shown promising result=
s in the search for a vaccine to prevent human papillomavirus (HPV). The =
13,000 research participants taking part in the trials include hundreds o=
f women, ages 17-25, from Western Australia, New South Wales, South Austr=
alia and Tasmania.
The vaccine targets HPV types 16 and 18, which cause more than 70 pe=
rcent of cervical cancers, said Dr. Rachel Skinner, who is leading the tr=
ial at Perth's Telethon Institute for Child Health Research. =93Therefore=
, if this vaccine does prove to be effective in preventing infection with=
these two types of virus, it has the potential of reducing cervical canc=
er rates by more than 70 percent,=94 she said.=20
Globally each year, 471,000 cervical cancer cases are diagnosed, and=
the disease kills 200,000 women. Cervical cancer rates have been dramati=
cally reduced in Australia by a two-yearly Pap smear program. =93But, nev=
ertheless, there are still 600 new cases of cervical cancer in Australia =
per year and 250 deaths from cervical cancer,=94 Skinner said. =93A vacci=
ne would have the greatest impact, certainly, in countries which don't ha=
ve effective screening, like those in the developing world.=94
Dr. Peter Richmond, chief of the Telethon Institute's vaccine trials=
group, said there is presently no vaccine to prevent cervical cancer. =93=
This vaccine=85 has already been successfully tested in hundreds of women=
worldwide. The vaccine has been well tolerated, and this study will exam=
ine how well it prevents infection and stops cancer.=94
The vaccine, if proven effective in the four-year trial, will be rec=
ommended for use in young women prior to HPV exposure.
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MEDICAL NEWS=09
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AUSTRALIA:
=93Is Screening for Anal Cancer Warranted in Homosexual Men?=94
Sexual Health (09.04) Vol. 1; No. 3: P. 137-140::Jonathan StC. Anderson; =
Claire Vajdic; Andrew E. Grulich
Anal cancer is at least 20 times more common in homosexual men than =
in heterosexual men. Some data suggest it is even more common in HIV-infe=
cted homosexual men. Some scientists have suggested screening of all men =
who have sex with men (MSM), particularly those with HIV, for anal cancer=
and its likely precursor, high-grade anal intraepithelial neoplasia (AIN=
). Exfoliate anal cytology can identify men with high-grade AIN, allowing=
further diagnostic assessment with high-resolution anoscopy and biopsy a=
nd ablative therapy if high-grade changes are identified. Reducing anal c=
ancer-related morbidity and mortality in MSM would be the goal of such sc=
reening.=20
In the present study, the researchers used widely accepted criteria =
for the introduction of screening programs to review the current evidence=
for screening MSM. The natural history of anal cancer and its precise re=
lationship with AIN is not clearly understood, they reported. While AIN i=
s very highly prevalent among homosexual men, little is known about what =
predicts its progression to invasive disease.=20
Exfoliate cytology and high-resolution anoscopy have sensitivity of =
between 45 percent and 70 percent. AIN treatment options are limited by m=
orbidity and high recurrence rates. There are no randomized controlled tr=
ials studying the efficacy of therapeutic agents or surgery for high-grad=
e AIN; however, early immunotherapies show very early promise. In theory,=
early detection may lead to better treatment outcomes, but studies of th=
e potential negative consequences of screening programs on the MSM popula=
tion are needed.=20
=93The currently available evidence does not support the implementat=
ion of a screening programme for AIN and anal cancer in homosexual men in=
Australia,=94 the researchers concluded. =93Screening for AIN and anal c=
ancer should be restricted to epidemiological protocols at least until an=
evidence-based therapeutic option for high-grade AIN is available. Furth=
er Australian and international research on the prevalence, incidence and=
natural history of AIN, risk factors for progression and regression of A=
IN, and risk-benefit assessments with regard to current and new treatment=
modalities are required to help fill gaps in the established criteria re=
quired before the widespread implementation of a screening test.=94
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LOCAL AND COMMUNITY NEWS=09
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CALIFORNIA:
=93HIV/AIDS; Reported Los Angeles County AIDS Cases Up 89 Percent over Pa=
st 2 Years=94
AIDS Weekly (10.11.04)=20
Reported AIDS cases in Los Angeles County have soared 89 percent ove=
r the past two years, according to the county's =93HIV/AIDS Semi-annual S=
urveillance Summary,=94 released in July. However, =93=85 no firm conclus=
ions about whether the number of new AIDS diagnoses is increasing or decr=
easing can be made at this time,=94 cautioned Douglas Frye, MD, medical d=
irector and Gordon Bunch, director of the county's HIV Epidemiology Progr=
am, in a cover letter accompanying the report.
Reported AIDS cases for Los Angeles County increased from 1,337 case=
s in 2001 to 2,532 cases by 2003. The reported AIDS increase may, in part=
, reflect previous underreporting during years in which the county was on=
ly required to report AIDS, not HIV cases.
Thirty-eight states track HIV incidence by a names-based HIV reporti=
ng system, while California opted for the unique identifier code system. =
In July 2002, the county began tracking HIV cases using unique identifier=
s, which many county health officials and AIDS advocates find cumbersome =
and flawed.=20
The reported AIDS increase turned up during a more aggressive county=
investigation of 11,000 of the 23,000 HIV cases reported since July 2002=
, so the 89 percent increase may go higher, said county officials.
=93While the dramatic spike in the numbers of reported AIDS cases in=
Los Angeles may be due in part to flaws in the new reporting system for =
HIV, it underscores the fact that the current reporting system is broken =
and needs to be fixed,=94 said Michael Weinstein, president of AIDS Healt=
hcare Foundation. =93Because it's more accurate, a names-based HIV report=
ing system would help us get more and better information so that we may u=
ltimately be able to make such critical conclusions about AIDS in Los Ang=
eles,=94 said Weinstein, referring to the surveillance report's cover let=
ter statement.
CALIFORNIA:=20
=93Stop AIDS Project Searches for New Leader=94
Bay Area Reporter (09.30.04)::Matthew S. Bajko
After announcing her decision in August, Stop AIDS Project's executi=
ve director stepped down Sept. 30. The project's board of directors had a=
nticipated hiring a replacement, whose term was to have overlapped by 30 =
days the tenure of outgoing director Darlene Weide, but by Sept. 28 the b=
oard had failed to either name an interim director or hire a full-time re=
placement.=20
The board has hired the search firm Compass Point to help in a natio=
nwide search for qualified candidates, said Stop AIDS officials. =93We ar=
e interviewing finalists and expect to have an interim [executive directo=
r] in place very quickly,=94 said agency spokesperson Jason Riggs. Compas=
s Point will also help Stop AIDS determine what it seeks from a new leade=
r, said Riggs, who did not know how much the search firm's services cost.=
Meanwhile, a management team including the board of directors and board =
president will manage day-to-day operations, said Riggs.
Being a good fundraiser is expected to be among the qualities requir=
ed of the project's new executive director. The agency's budget for fisca=
l 2004 is $1.4 million.=20
Weide was with Stop AIDS for six years, three of them as its executi=
ve director. Weide shared management duties with Steve Gibson, the agency=
's former program director who left to run the Castro-based health center=
Magnet, before she was given the official position.
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NEWS BRIEFS =09
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MARYLAND:
=93Western Maryland News in Brief=94
Associated Press (10.12.04)
Frederick County infectious-disease specialist Dr. Paul G. Rausch wi=
ll stop treating HIV/AIDS patients as of Nov. 30 to limit his exposure to=
lawsuits and higher malpractice insurance premiums. =93I can no longer a=
ssume the additional liability of caring for complex and complicated infe=
ctious-disease patients,=94 Rausch wrote in a letter to patients at the e=
nd of September. On Sept. 14, the Maryland Insurance Administration appro=
ved a 33 percent rate hike for Medical Mutual Liability Insurance Society=
of Maryland, the state's largest insurer of doctors. Rausch said his pre=
mium will go from $19,000 this year to $28,500 next year. His decision wi=
ll not immediately cut his rates but will help him avoid lawsuits and fur=
ther rate increases, he said. Rausch and colleagues at Oncology Care Cons=
ultants will continue to treat cancer and hematology patients. The end of=
his infectious-disease practice will leave only one private physician in=
the county to treat about 130 HIV patients.
SOUTH CAROLINA:
=93Blood Screening Begins for Hepatitis B=94
Greenville News (10.08.04)::Liv Osby
The Blood Connection =97 which provides blood to all the hospitals i=
n Greenville, Greenwood, Pickens, Oconee, Abbeville, Laurens and Newberry=
counties =97 earlier this year participated in a study to find whether t=
he same test used to detect HIV, hepatitis C and West Nile virus could al=
so find hepatitis B. The Nucleic Acid Amplification Test found hepatitis =
B in one of every 340,000 samples that were negative by current testing m=
ethods, said lab Director Melanie Porter. The test is not required by the=
US Food and Drug Administration or the American Association of Blood Ban=
ks, but the Blood Connection opted to add it. =93A core element of our mi=
ssion is to provide a safe blood supply, and knowing the results of the s=
tudy we felt strongly we needed to being using the more sensitive [test] =
in addition to our other Hepatitive B virus testing,=94 Porter said in a =
release.
RUSSIA:
=93HIV-Positive Russians Detained During Protest in Western City=94
Associated Press (10.12.04)
On Tuesday in the western city of Kaliningrad, 13 HIV-positive Russi=
ans were detained after chaining themselves to the city hall building to =
protest the state's alleged failure to provide them with adequate medical=
care. The protesters were taken into custody after the unsanctioned rall=
y, at which some held signs reading, =93Our Death is Your Shame=94 and =93=
HIV is not a sentence =97 we need medicine.=94 =93Seven hundred people ha=
ve died in Kaliningrad, and the authorities pay no attention,=94 said act=
ivist Alexander Rumyantsev of the Delo foundation. =93We are here because=
people are dying,=94 he said in coverage broadcast on NTV. One woman tol=
d NTV, =93My doctor said, 'Why treat you? You could die on some stairwell=
in a week anyway and medicine is being wasted on you.'=94 HIV/AIDS is sp=
reading rapidly in Russia and particularly in Kaliningrad, a Baltic port =
where drug use is high.
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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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