| prevention-news@cdcnpin.org 2004-10-26, 10:08 pm |
| CDC HIV/STD/TB Prevention News Update
Friday, October 22, 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
UNITED STATES: =93Syphilis Through Oral Sex on the Rise=94
NEW JERSEY: =93Graying HIV/AIDS Set Has Its Own Needs=94
INTERNATIONAL NEWS
SOUTH AFRICA: =93S. Africans Shun a Remedy for AIDS=94
UNITED KINGDOM: =93High Hopes for Fridge-Free Jabs=94
MEDICAL NEWS
UNITED KINGDOM: =93Investigating Ethnic Inequalities in the Incidence of =
Sexually Transmitted Infections: Mathematical Modeling Study=94
LOCAL AND COMMUNITY NEWS
MASSACHUSETTS: =93AIDS Relief Program Falls Behind Schedule=94
TEXAS: =93AIDS Foundation Aims to Equal Grant=94
NEW YORK: =93Needle Swap Makes Debut in Long Island City=94
NEWS BRIEFS
SOUTH AFRICA: =93Good News for Western Cape AIDS Patients=94
JAPAN: =93HIV Infections, AIDS Cases Hit Highest Quarterly Figures Ever=94
GEORGIA: =93Thousands Help Raise $1 Million for AIDS Walk=94
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NATIONAL NEWS=09
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UNITED STATES:
=93Syphilis Through Oral Sex on the Rise=94
Reuters Health (10.21.04)
Syphilis is increasingly being transmitted through oral sex, accordi=
ng to a new CDC report published Friday. Mistaken in the belief that oral=
sex is safe sex, many people are unaware they can readily catch or trans=
mit syphilis in this manner. Moreover, syphilitic sores in the mouth can =
increase the risk of HIV infection.
Over the period from 1998 to 2002, Dr. C. Ciesielski and colleagues =
from the Chicago Department of Public Health observed patterns of syphili=
s transmission change substantially. During the 1990s, syphilis occurred =
almost exclusively among heterosexuals, the researchers noted. But since =
2001, men who have sex with men account for nearly 60 percent of people w=
ith syphilis.=20
To explain these findings, the researchers interviewed people who we=
re infected with syphilis in 2000-2002. In nearly 14 percent of cases, or=
al sex was the subjects=92 only sexual exposure during the time they were=
infected; this mode was reported by 20 percent of MSM with syphilis, and=
6-7 percent of heterosexuals. These figures did not include possible inf=
ection through oral sex when sexual intercourse also occurred.=20
People with syphilis in the mouth may not show any symptoms, or the =
sores could be mistaken for herpes or aphthous ulcers, the researchers no=
ted. The syphilitic sores may carry high concentrations of the germ and b=
e highly infectious.
=93These data underscore the need for educating sexually active pers=
ons regarding the risk for syphilis transmission through oral sex,=94 the=
researchers concluded. =93Persons who are not in a long-term monogamous =
relationship and who engage in oral sex should use barrier protection (e.=
g., male condoms or other barrier methods) to reduce the risk for sexuall=
y transmitted disease (STD) transmission,=94 the researchers advised.
The full report, =93Transmission of Primary and Secondary Syphilis b=
y Oral Sex - Chicago, Illinois, 1998-2002,=94 was published in the Morbid=
ity and Mortality Weekly Report (2004;53(41):966-968).
NEW JERSEY:
=93Graying HIV/AIDS Set Has Its Own Needs=94
Newark Star-Ledger (10.21.04)::Angela Stewart
The New Jersey Summit on HIV/AIDS and Aging, held Wednesday in Woodb=
ridge, marked the first time that HIV experts joined with social scientis=
ts and gerontologists in the state to discuss the graying HIV epidemic. T=
he number of people age 50 or older with HIV/AIDS in New Jersey is five t=
imes what is was nearly a decade ago, but many older residents remain und=
iagnosed or untreated, conference officials said.
In 1992, there were just 1,051 people age 50 and older in New Jersey=
who had been diagnosed with HIV/AIDS, said Rose Marie Wright, a research=
scientist with the state Department of Health and Senior Services. By 20=
02, that number had risen to at least 6,534.
=93We know that this is only the tip of the iceberg of what=92s goin=
g on out there,=94 said Eliahu Bishburg, chief of infectious diseases at =
Newark Beth Israel Medical Center. The most recent state statistics show =
that two-thirds - or around 68 percent - of people age 50 and older livin=
g with HIV/AIDS reported being diagnosed before turning 50; the remainder=
were over age 50 when they were diagnosed. Intravenous drug use is how m=
ost New Jersey men over 50 report they were infected; having sex with oth=
er men was the second most common mode. In older women, the most common m=
ode of exposure was heterosexual sex. A large group of people report not =
knowing how they were infected.=20
Diagnosing HIV/AIDS in older people can be challenging as many are f=
ighting other diseases that have similar symptoms to HIV. In talking with=
their health-care provider, older people may find it more difficult to d=
iscuss their high-risk behaviors.=20
Since HIV/AIDS in people over 50 in New Jersey disproportionately af=
fects blacks and Latinos, advocates say prevention outreach must include =
specific initiatives geared toward this graying, minority population.
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INTERNATIONAL NEWS=09
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SOUTH AFRICA:
=93S. Africans Shun a Remedy for AIDS=94
Washington Post (10.21.04)::Craig Timberg
After struggling to make antiretroviral drugs (ARVs) available in th=
e developing world, medical authorities have discovered many people in th=
e advanced stages of AIDS are reluctant to take them. Such reluctance con=
stitutes an unexpected barrier in countries like South Africa, where 600 =
people die of AIDS each day, according to analysts, and about 5 million h=
ave HIV.
Fear of the drugs=92 side effects, widespread skepticism of Western =
medicine, the reluctance of public figures to say positive things about A=
RVs, and reverence for traditional healers lead many patients to shun the=
drugs. Many activists blame the situation on President Thabo Mbeki and h=
is health minister, Manto Tshabalala-Msimang, who, instead of pushing ARV=
s, have repeatedly emphasized good nutrition and clean water as keys to t=
reating HIV/AIDS.
=93A very big part of the problem is the government is still in deni=
al,=94 said Zachie Achmat, head of South Africa=92s Treatment Action Camp=
aign.=20
=93Mbeki scared a lot of patients,=94 said Francois Venter, a doctor=
who treats people with AIDS with free ARVs at Johannesburg General Hospi=
tal. He estimated that one of three patients who need ARVs refuse them. =93=
They are just terrified of the side effects,=94 he explained.
Anglo American, a mining conglomerate, offers free ARVs to all 140,0=
00 of it is employees. Brian A. Brink, a physician overseeing the program=
, said 34,000 employees have HIV and at least 8,500 are at a point in the=
ir illness when they should be taking ARVs. But only about 2,050 have tak=
en advantage of the program, leaving 75 percent not having sought out the=
easily accessible ARVs. Brink attributes the gap to a combination of the=
stigma of HIV/AIDS, uncertainty about the ARVs=92 effectiveness, and fea=
r of side effects.
UNITED KINGDOM:
=93High Hopes for Fridge-Free Jabs=94
BBC News (10.19.04)
A new technology developed by Cambridge Biostability could eliminate=
the need for refrigerating vaccines, thus making vaccines more widely av=
ailable in the developing world. The technique is based on anhydrobiosis,=
a process that allows cells to be preserved in a dried-out state.=20
Normally, vaccines need to be refrigerated and remain in an unbroken=
=93cold chain=94 until administration in order to protect the vaccines f=
rom extreme temperatures. Keeping vaccines cold is difficult in some part=
s of the world; experts estimate that approximately half of all vaccinati=
ons are wasted annually due to contamination or exposure to extreme tempe=
ratures.
Cambridge Biostability spent five years trying to adapt anhydrobiosi=
s to vaccines. The process allows some organisms to survive dried-up by r=
eplacing water with a sugar solution that keeps cells in a state of suspe=
nded animation until rehydration occurs. In vaccines, the process can pro=
duce a dry vaccine that reactivates once it is injected into the body. Th=
e biotech firm is also working on producing vaccines for hepatitis B and =
meningitis. In theory, dry-vaccine technology could be used on any vaccin=
e, including live vaccines such as the one for measles. It could also pot=
entially be adapted to allow a vaccine=92s slow release, eliminating the =
need for boosters.
If the technique succeeds, official estimate as many as 10 million m=
ore children worldwide can be given vaccinations, within existing budgets=
.. Two million children die from vaccine-preventable illnesses each year.
After the World Health Organization assessed the dry-vaccine technol=
ogy, Britain=92s Department for International Development contributed =A3=
950,000 (US$1.7 million) in funds. =93The good health we take for granted=
in the UK is due in great part to our vaccination program. We want to ma=
ke this a reality for children and their parents in the developing world,=
=94 said Hilary Benn, International Development Secretary. =20
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MEDICAL NEWS=09
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UNITED KINGDOM:
=93Investigating Ethnic Inequalities in the Incidence of Sexually Transmi=
tted Infections: Mathematical Modeling Study=94
Sexually Transmitted Infections (10.04) Vol. 80; No. 5: P.379-385::K.M.E =
Turner; G.P. Garnett; A.C. Ghani; J.A.C. Sterne; N. Low
The authors investigated ethnic differences in rates of gonorrhea us=
ing empirical sexual behavior data in a simple mathematical model, and ex=
plored the impact of different intervention strategies in the simulated p=
opulation.
Using the findings from cross-sectional studies of gonorrhea rates a=
nd sexual behavior in three ethnic groups in southeast London, the author=
s determined the parameters for a deterministic, mathematical model of go=
norrhea transmission dynamics in a population stratified by sex, sexual a=
ctivity (rate of partner change), and ethnic group (white, black African,=
black Caribbean). The researchers compared predicted and observed rates =
of infection and simulated the effects of targeted and population-wide in=
tervention strategies.
=93In model simulations the reported sexual behaviors and mixing pat=
terns generated major differences in the rates of gonorrhea experienced b=
y each subpopulation,=94 the researchers wrote. =93The fit of the model t=
o observed data was sensitive to assumptions about the degree of mixing b=
y level of sexual activity, the numbers of sexual partnerships reported b=
y men and women, and the degree to which observed data underestimate fema=
le infection rates,=94 they found, adding that interventions to reduce th=
e duration of chlamydia infection were most successful when targeted at b=
lack Caribbeans.
=93Average measures of sexual behavior in large populations are inad=
equate descriptors for the epidemiology of gonorrhea,=94 the authors conc=
luded. =93The consistency between the model results and empirical data sh=
ows that profound differences in gonorrhea rates between ethnic groups ca=
n be explained by modest differences in a limited number of sexual behavi=
ors and mixing patterns. Targeting effective services to particular ethni=
c groups can have a disproportionate influence on disease reduction in th=
e whole community.=94
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LOCAL AND COMMUNITY NEWS=09
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MASSACHUSETTS:
=93AIDS Relief Program Falls Behind Schedule=94
Harvard Crimson (10.20.04)::Jeffrey P. Amlin
Delays in the importation of AIDS drugs may cause a Harvard relief p=
rogram to miss its first-year targets, according to the program=92s inter=
im executive director. The Harvard School of Public Health (HSPH) is one =
of four institutions administering the President=92s Emergency Plan for A=
IDS Relief (PEPFAR). HSPH won a five-year $107-million grant in February =
to fund relief work in Botswana, Nigeria and Tanzania.
Harvard PEPFAR is behind schedule because Tanzania has not yet purch=
ased antiretrovirals for the Harvard-assisted HIV/AIDS clinics. Mark Barn=
es, interim executive director of the program, said it currently oversees=
hundreds of patients, and had hoped to enroll 3,000 before the end of it=
s first year.
In Nigeria, the program funds treatment for about 2,000 patients. It=
s one-year target was 7,000-9,000 patients.=20
Barnes said the program supervises treatment for more HIV/AIDS patients t=
han any other Nigerian program, and that Harvard PEPFAR=92s figures are n=
ot lower than those of other relief programs receiving government funding=
..
Explaining the shortfall in progress, HSPH spokesperson Robin Herman=
said that the careful planning and coordination among the four PEPFAR in=
stitutions and the government was also time-consuming.
Barnes said that, unlike other AIDS relief organizations with multi-=
year implementation plans, PEPFAR was put on the ground within months of =
the grant announcement. However, Sarika P. Bansal, president of the stude=
nt-run Harvard AIDS Coalition, while not specifically faulting the Harvar=
d program, criticized PEPFAR as a whole for its limited scope and lack of=
communication between donors and recipients.
TEXAS:
=93AIDS Foundation Aims to Equal Grant=94
Houston Chronicle (10.19.04)::Tom Manning
HIV prevention efforts in Houston got a major boost last month when =
AIDS Foundation Houston received a $25,000 grant through its partnership =
with the National AIDS Fund and the Elton John AIDS Foundation. AFH inten=
ds to match that grant by raising an additional $25,000, with the $50,000=
to be disbursed to AIDS service organizations throughout Houston.=20
=93The National AIDS Fund receives funding from the Elton John Found=
ation, then they leverage the funds they receive on an international leve=
l and funnel it to community partners,=94 said John Huckaby, AFH=92s vice=
president of planning and program development. For the last seven years,=
AFH has served as the local =93model=94 agency for the national fund. =93=
We competitively bid to receive the challenge grant,=94 Huckaby said.=20
=93Funding has been changing in some areas on the prevention side bu=
t the need definitely has not,=94 said David Mandel, COO of AFH. =93That=92=
s why we=92re so thankful for this grant. This money will go directly to =
groups that deal with outreach and prevention, which is where the need re=
ally is,=94 Mandel noted.=20
Texas ranks fourth in the nation for reported AIDS cases. And within=
the state, Harris County reports the largest number of HIV/AIDS cases, s=
aid Huckaby. =93Adolescents are a group that=92s seeing increased rates a=
t alarming numbers,=94 he noted. =93There=92s a consolidated effort here =
to get the word out about HIV prevention, but we have to really target th=
e most vulnerable people,=94 including sexual and racial minority youths,=
said Huckaby.
The Hollyfield Foundation, another Houston area nonprofit, will assi=
st AFH in raising the matching funds. =93We give to [AFH] every year,=94 =
said Wendy Harsbarger, executive director of Hollyfield. =93It=92s the fo=
undation that raises the most money citywide and reaches the most people.=
=94
AFH anticipates disbursing $25,000 to various organizations by Janua=
ry 1, 2005, and the remainder by July 1.
NEW YORK:
=93Needle Swap Makes Debut in Long Island City=94
Newsday (10.19.04)::Kate O=92Mara
Queens=92 first needle-exchange program, slated for a December openi=
ng, will operate out of the AIDS Center of Queens County at 42-57 Hunter =
St. in Long Island City. The exchange was originally planned to set up in=
a mobile unit parked near Vernon Boulevard and Queens Plaza South, but c=
ommunity leaders opposed placing the site near public housing and the pro=
gram has now moved to a more industrial area.
=93Syringe exchange will be a needed component of our harm reduction=
program, which deals with people where they=92re at, not where society w=
ants them to be,=94 said Philip Glotzer, executive director of the nonpro=
fit AIDS Center of Queens County. In the 11101 ZIP code, the rate of IV d=
rug users living with HIV/AIDS is nearly four times higher than in the su=
rrounding western-Queens areas, according to the New York City Department=
of Health and Mental Hygiene.=20
The exchange will initially be open on Tuesday and Friday nights fro=
m 6-10 p.m. Clients will get a unique number and an identification card, =
as well as an initial consultation to asses needs such as housing, food a=
nd clothing. =93We need only as much information as clients feel comforta=
ble giving us,=94 said Glotzer. =93We=92ll keep everything confidential.=94=
Prior to opening, staff will distribute informational =93palm cards=94 w=
ithin a 10- to 12-block radius.
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NEWS BRIEFS =09
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SOUTH AFRICA:
=93Good News for Western Cape AIDS Patients=94
Cape Argus (10.21.04)::Di Caelers and Candice Bailey
The Global Fund to Fight AIDS, TB and Malaria has given an R430 mill=
ion (US$70 million) grant to Western Cape province to accelerate its HIV/=
AIDS programs and to ensure that everyone needing antiretrovirals (ARVs) =
receives them by the end of next year. The new funding means the estimate=
d 12,000 people who need the drugs can be treated by the end of 2005, sai=
d Dr. Fareed Abdullah, head of Western Cape=92s HIV/AIDS program. Two-thi=
rds of the grant will go to treatment. To date, 5,000 Western Cape reside=
nts have received ARVs. The funding will also provide peer education prog=
rams in schools, more hospice beds, and money to municipalities to fund c=
ommunity-based and nongovernmental organizations=92 initiatives. The gran=
t is the first unconditional one the Global Fund has awarded to any of 12=
0 countries, said Abdullah.
JAPAN:
=93HIV Infections, AIDS Cases Hit Highest Quarterly Figures Ever=94
Mainichi Daily News (10.21.04)
From the end of June to the end of September, a record 209 people we=
re recorded as having HIV, Japan=92s Ministry of Health, Labor and Welfar=
e announced Thursday. The previous highest HIV-infection number over a th=
ree-month period was 199, posted in this year=92s second quarter. The min=
istry=92s AIDS monitoring office recommended that local government provid=
e testing services that give quick results. Officials said 120 of the 209=
patients contracted HIV homosexually, followed by 58 people who acquired=
HIV heterosexually. Of those infected during the period, 126 patients sh=
owed symptoms of AIDS, a record for a quarter, officials said.
GEORGIA:
=93Thousands Help Raise $1 Million for AIDS Walk=94
Southern Voice (10.22.04)::Dyana Bagby
Some 14,000 participants helped raise about $1 million at AIDS Walk =
Atlanta, held Oct. 17, according to preliminary results announced by walk=
officials. This year, AIDS Atlanta opted to produce the walk itself in o=
rder to cut expenses. =93We beat our $1 million goal=85 and [with product=
ion costs down] this means we netted more for the community,=94 said Tom =
Roeck, who was recently named president of AID Atlanta=92s board of direc=
tors. Net proceeds should reach about $740,000, which will be distributed=
between AID Atlanta and 15 other agencies, said Keith Fenton, manager of=
the AIDS walk.
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