| prevention-news@cdcnpin.org 2004-10-27, 10:10 pm |
| CDC HIV/STD/TB Prevention News Update
Thursday, October 21, 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
OKLAHOMA: =93Officials Monitor Resistant Gonorrhea in State=94
PENNSYLVANIA: =93After Delay, OraSure to Launch Saliva-Based HIV Test=94
INTERNATIONAL NEWS
UGANDA: =93US Firm Opens $15M Ugandan AIDS Clinic=94
ASIA-PACIFIC: =93Asia-Pacific Moving 'Too Late and Too Slow' in Fight Aga=
inst HIV/AIDS=94
MEDICAL NEWS
ESTONIA: =93Treatment of Sexually Transmitted Diseases in Estonia: Consis=
tency with the Evidence-Based Medicine Principles=94
LOCAL AND COMMUNITY NEWS
GEORGIA: =93Blacks Urged to Mobilize Against HIV/AIDS=94
NEW YORK: =93Start AIDS Charity at Home, Groups Say=94
NEWS BRIEFS
IOWA: =93Former Surgeon General Jocelyn Elders to Speak at UNI Health Con=
ference=94
DISTRICT OF COLUMBIA: =93AIDS Walk on the Rebound=94
NEW ZEALAND: =93HIV Test Trial for Pregnant Women Proposed=94
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NATIONAL NEWS=09
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OKLAHOMA:
=93Officials Monitor Resistant Gonorrhea in State=94
Daily Oklahoman (10.19.04)::Diane Clay
Oklahoma health officials are closely tracking a strain of fluoroqui=
nolone-resistant gonorrhea that first appeared in the state in July. Whil=
e gay and bisexual men are at greatest risk now, health experts said the =
strain will show up eventually in the heterosexual community.=20
=93This is a significant blow, because it takes out a whole class of=
antibiotics,=94 said Dr. Karen Wendel, an infectious disease expert with=
the Oklahoma City-County Health Department and the university of Oklahom=
a Health Sciences Center. =93When rates go higher, we will have to do wha=
t other states have done and abandon the drug altogether,=94 said Wendel,=
adding that many of the other antibiotics used to treat gonorrhea have s=
ignificant side effects.
Fluoroquinolone-resistant gonorrhea first appeared in Southeast Asia=
, where rates of resistance have reached near or above 50 percent in Japa=
n, Korea and the Philippines; China's rate of resistance is over 92 perce=
nt. While US states have rates nowhere near these levels, concern over an=
tibiotic-resistant gonorrhea prompted CDC in April to recommend that clin=
ics stop using fluoroquinolones for gay and bisexual men. CDC is currentl=
y gathering data from 30 sites across the country, including Oklahoma Cit=
y, to monitor the strain's spread.
In 2003, Oklahoma ranked 15th in the nation for its gonorrhea rate a=
nd Oklahoma City ranked 20th among other major cities. So far, the state =
has reported only two cases of drug-resistant gonorrhea but Wendel said m=
ore diagnoses are expected. She said clinicians need to watch for patient=
s who have resistance to antibiotics, particularly if they are in a high-=
risk group or have traveled to an area with high rates of resistance and =
were sexually active there.
PENNSYLVANIA:
=93After Delay, OraSure to Launch Saliva-Based HIV Test=94
Associated Press (10.20.04)::Daniel Rosenberg
Saying its saliva-based HIV test works properly, Bethlehem, Pa.-base=
d OraSure Technologies Inc. said Wednesday that it would start shipping t=
he tests early in November. The product launch was delayed after a clinic=
al trial of the OraQuick Advance Rapid HIV-1/2 Antibody Test showed a hig=
her rate of unconfirmed positive results than the company had found in it=
s own clinical data.=20
The company conducted another study that mirrored the field use of t=
he test, and reviewed more than 12,000 test readings. Results from that s=
tudy, in addition to data from several independent studies, =93clearly in=
dicate that the test is operating within its specifications,=94 the compa=
ny said.
OraQuick Advance is the only Food and Drug Administration-approved r=
apid HIV test available that uses saliva, the company said. Analyst David=
Lewis of Thomas Weisel Partners said he believes the less invasive, user=
-friendly oral test will expand the existing public-health HIV-testing ma=
rket of 3 million people by as much as 25 percent.
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INTERNATIONAL NEWS=09
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UGANDA:
=93US Firm Opens $15M Ugandan AIDS Clinic=94
Associated Press (10.20.04)::Henry Wasswa
On Wednesday, the largest training center in Africa for HIV/AIDS hea=
lth workers opened in Uganda. The $15 million Infectious Diseases Institu=
te at the university of Makerere will teach 250 health workers annually h=
ow to train other medical workers in the most modern HIV treatment method=
s. The center will treat 10,000 patients a year, according to Dr. Keith M=
cAdam, the institute's director. Since 2001, the university has treated 8=
,000 patients and trained 250 health workers.
Funded by the US drug firm Pfizer Inc., the institute comprises clin=
ics, laboratories and lecture rooms. It will provide free treatment to pa=
tients, using drugs provided by major drug companies, said McAdam, who is=
also a professor of clinical tropical medicine at the university of Lond=
on. The institute will train people to use all kinds of drugs, including =
generics, he said. The use of generic drugs in Africa =97 where most peop=
le live on less than $1 a day =97 has been a controversial issue.=20
Uganda's President Yoweri Museveni officially opened the institute a=
nd said he hoped the facility will help find a cure for HIV. He praised t=
he institute's approach of teaching prevention and offering treatment.
Pfizer officials said the company chose Uganda for the institute bec=
ause the country accepted the existence of HIV/AIDS 17 years ago and moun=
ted an aggressive program to control its spread. =93With this institute, =
we now have the capacity to train hundreds or thousands of people,=94 sai=
d Hank McKinnell, Pfizer chair and CEO. =93The purpose is to provide high=
-quality clinical care in Uganda and more widely in Africa.=94
More than a million people in Uganda have HIV. Over 900,000 Ugandans=
have died of AIDS-related illnesses since the disease was identified the=
re in the 1980s. Hundreds of thousands of children are AIDS orphans.
ASIA-PACIFIC:
=93Asia-Pacific Moving 'Too Late and Too Slow' in Fight Against HIV/AIDS=94
Agence France Presse (10.20.04)
Governments across the Asia-Pacific region should step up efforts to=
combat HIV/AIDS or risk a crisis similar in scale to Africa's, Kathleen =
Cravero, deputy executive director of UNAIDS, said Wednesday at a meeting=
in Manila. Cravero said the Association of Southeast Asian Nations (ASEA=
N) and the Asia-Pacific Economic Cooperation forum (APEC) =93need to get =
the action much accelerated.=94 She said the ASEAN region =93had made goo=
d progress in the last couple of years but like most of Asia, it is movin=
g too late and too slow.=94
=93The time is now for regional institutions to step up and accelera=
te their action at a regional level and with individual countries,=94 Cra=
vero said. Asian economic, political, and regional institutions have a wi=
ndow of opportunity to ensure that an epidemic of African proportions doe=
s not take hold, she said. Cravero urged such institutions to provide res=
ources to individual countries and for national leaders to take a role in=
combating the spread of the virus.
Cravero praised the Asian Development Bank (ADB) for allocating fund=
s to help control HIV/AIDS. A study by Manila-based ADB and UNAIDS said m=
ore than 7 million people in the region have HIV/AIDS and half a million =
die from the disease each year. The study estimated a total of 10 million=
people in the region would be newly HIV-infected between 2004-2010, with=
the annual death toll rising to more than 750,000 by 2010.
The Philippines, Cravero warned, should not be complacent despite it=
s current low AIDS prevalence. She cited factors that could contribute to=
the rapid spread of HIV/AIDS in the nation: low condom use, a broadly di=
spersed sex industry, high population mobility, high STD rates, risky you=
th behavior, needle sharing among drug users and low public awareness.
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MEDICAL NEWS=09
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ESTONIA:
=93Treatment of Sexually Transmitted Diseases in Estonia: Consistency wit=
h the Evidence-Based Medicine Principles=94
Sexually Transmitted Diseases (10.04) Vol. 31; No. 10: P. 631-635::Anneli=
Uuskula, MD, PhD; Louise Anne McNutt, PhD; Jack Dehovitz, MD, MPH
Estonia is one of several Eastern European countries undergoing an e=
xplosive IV drug use-driven HIV epidemic. Early diagnosis and appropriate=
treatment of sexually transmitted disease (STD) is critical in preventin=
g an STD-driven HIV epidemic. In the current study, the researchers sough=
t to define the schedule of antibiotic treatment doctors in Estonia used =
to treat STDs and to determine if the treatments given corresponded to ev=
idence-based medicine treatment principles.
=93Using an administrative database of the Estonian Health Insurance=
Fund on pharmaceuticals reimbursement, we obtained information on: drug =
(ATC 1998) prescribed with an STD diagnosis (International Classification=
of Diseases and Related Health Problems, syphilis, gonorrhea, genital Ch=
lamydia trachomatis and Trichomonas vaginalis infections, and genital her=
pes), prescribing physician specialty, and patient demographics (date of =
birth, gender),=94 the researchers wrote. Therapeutic regimens prescribed=
were compared with recommendations from the European Sexually Transmitte=
d Infections Management Guidelines to evaluate the correspondence of STD =
treatment to evidence-based medicine principles.=20
In 2001 and 2002, doctors ordered 17,077 prescriptions for systemic =
antibacterial medications to treat STDs in 12,823 discrete individuals (2=
,942 men, mean age=3D31.8 years; 9,880 women, mean age=3D29.5 years). The=
majority of treatments were prescribed by gynecologists (60 percent) or =
dermatovenerologists (29 percent), while general practitioners treated ju=
st 8 percent of STDs. In 11 percent of treatment instances, the drug pres=
cribed was inconsistent with guideline recommendations; in 9 percent of e=
pisodes, the recommended drug was chosen but the dosage prescribed was to=
o low. Therefore, at least 20 percent of all treatment episodes could be =
considered inappropriate.
Educational efforts to increase physician awareness of evidence-base=
d approaches to STD management and treatment are needed to assure effecti=
ve STD care, the researchers concluded.
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LOCAL AND COMMUNITY NEWS=09
************************************************************
GEORGIA:
=93Blacks Urged to Mobilize Against HIV/AIDS=94
Atlanta Daily World (10.20.04)::Makebra M. Anderson
Georgia Representative and civil rights leader John L. Lewis urged a=
town hall meeting on curbing the spread of HIV/AIDS among blacks to borr=
ow from the playbook of the civil rights movement. =93You have to fortify=
, organize and be prepared to mobilize against this deadly disease,=94 Le=
wis told the recent gathering of students and professional journalists at=
the Morehouse School of Medicine. =93My generation believed in drama. Yo=
u must get in the way and get in trouble to do something about HIV/AIDS.=94
The meeting that featured Lewis, former US Surgeon General David Sat=
cher and various health professionals was part of a weekend of events org=
anized by the Black AIDS Institute of Los Angeles; the Black Leadership C=
ommission on AIDS; Balm in Gilead outreach to Africa; the Magic Johnson F=
oundation and Outreach Inc., an HIV and drug abuse prevention group.
Lewis, whose bloody beating in Selma, Ala., captured the attention o=
f the nation and helped pass the 1965 Voting Rights Act, said the media i=
s as critical in the fight against HIV/AIDS as it was in the civil rights=
movement. =93The black media has to get out in front on HIV/AIDS. Withou=
t the media, the civil rights movement would be a bird without wings,=94 =
he said. =93We organized a movement with no Web site, fax or cell phones,=
but we used what we had and that was the media.=94
According to the US Census Bureau, African Americans represent just =
12 percent of the population, but account for 54 percent of all new US AI=
DS cases. Of new HIV cases in women, around 64 percent are black, 18 perc=
ent are white and 18 percent are Hispanic.=20
NEW YORK:
=93Start AIDS Charity at Home, Groups Say=94
New York Times (10.19.04)::David Gonzalez
Marie St. Cyr, who run Iris House, a one-stop support center in Harl=
em for women with HIV/AIDS, said her 11-year-old organization provides Af=
rican-American and Hispanic women and their families with services rangin=
g from counseling and housing to medical help and custody planning.
According to the United Nations, North America had the world's large=
st increase in HIV infections among women from 2001-2003. Federal data sh=
ow that while African-American and Hispanic women comprise less than 25 p=
ercent of the US female population, they account for nearly 80 percent of=
all female AIDS cases reported to date.
Ten people affiliated with St. Cyr's group have died since summer. I=
ris House serves 441 women, with at least one new client arriving per wee=
k. The agency offers nutritional counseling, support groups, a psychologi=
st, help negotiating the medical system and after-school activities for c=
lients' children. Currently, St. Cyr is attempting to jump-start a preven=
tion program that has lost federal funding. In her efforts to spare a fut=
ure generation from the disease, St. Cyr has to deal with the government'=
s stress on abstinence over condom use.
Having grown up in homes in crisis, AIDS orphans present an imperile=
d generation, advocates say =97 a peril that increases when they reach ad=
olescence and become sexually active. =93We are now into 20 years of kids=
losing their parents to AIDS and there is virtually no coherent support =
system for them in the city or the nation,=94 said Chris Norwood, executi=
ve director of Health People, a community health group in the Bronx that =
has been dealing with HIV/AIDS since the 1980s. =93So they inevitably bec=
ome the next group with a large level of infection.=94
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NEWS BRIEFS =09
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IOWA:
=93Former Surgeon General Jocelyn Elders to Speak at UNI Health Conferenc=
e=94
Associated Press (10.08.04)
Jocelyn Elders, who served as US Surgeon General under President Cli=
nton, is scheduled to deliver the keynote speech at a university of North=
ern Iowa multicultural health conference on Oct. 21. The two-day conferen=
ce will address racial differences in HIV/AIDS, breast cancer treatment a=
nd health care reform. Elders is a winner of the National Institutes of H=
ealth development award and is a professor of pediatrics at the Universit=
y of Arkansas Medical Center.
DISTRICT OF COLUMBIA:
=93AIDS Walk on the Rebound=94
Metro Weekly (10.21.04)::Sean Bugg
After years of decreased attendance and fundraising, organizers of W=
ashington's 18th annual AIDS Walk, scheduled for Oct. 23, said strong int=
erest this year could revive the event. =93We're seeing a lot of interest=
.. We're really hoping that the momentum continues,=94 said AIDS Walk Dire=
ctor Robert York. Proceeds from the walk go to the Whitman-Walker Clinic,=
which provides medical and support services for people living with HIV/A=
IDS. Last year's event raised $575,000, and the goal this year is $580,00=
0, according to the clinic.
NEW ZEALAND:
=93HIV Test Trial for Pregnant Women Proposed=94
New Zealand Herald (10.19.04)
In a report to the New Zealand Minister of Health released Tuesday, t=
he National Health Committee recommended that a pilot study offering an o=
ptional HIV test to all pregnant women be conducted in Auckland. Currentl=
y, only mothers considered to be at risk for having HIV are tested in New=
Zealand. Last year, there were five cases of mother-to-child HIV transmi=
ssion =97 the most ever recorded in the country; three have been diagnose=
d so far this year. With national testing, NHC estimated HIV would be det=
ected in an additional 4-18 women each year, preventing transmission to 1=
-4 infants.
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