| prevention-news@cdcnpin.org 2004-10-28, 7:10 pm |
| CDC HIV/STD/TB Prevention News Update
Thursday, October 28, 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: =93Science, Ideology Clash on AIDS Prevention=94
INTERNATIONAL NEWS
RUSSIA: =93Media Leaders Urge Governments to Commit to Combating AIDS in =
Former Soviet Union=94
CANADA: =93Needle Exchange Needed in Prisons to Combat Spread of Disease,=
Groups Say=94
UKRAINE: =93WHO Experts to Check on Possible Spread of Syphilis Through D=
onated Blood=94
ZAMBIA: =93AIDS-Hit Zambia Bans Condom Handouts to Students=94
MEDICAL NEWS
UNITED STATES: =93Co-occurring Hepatitis C, Substance Use, and Psychiatri=
c Illness: Treatment Issues and Developing Integrated Models of Care=94
LOCAL AND COMMUNITY NEWS
MASSACHUSETTS: =93Bishop Attacks School Condom Plan; Holyoke Tries to Ste=
m Teen Pregnancies=94
NEWS BRIEFS
MALAWI: =93UN AIDS Envoy Begins Working Visit to Malawi=94
JAMAICA: =93More Youngsters Getting HIV/AIDS=94
GEORGIA: =933 Teens Test Positive for TB Exposure=94
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NATIONAL NEWS=09
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UNITED STATES:
=93Science, Ideology Clash on AIDS Prevention=94
USA Today (10.28.04)::Steve Sternberg
The conflict between science and ideology is a central issue of the =
current US presidential campaign. Researchers say the science of HIV prev=
ention is clear. Studies show that when used consistently, latex condoms =
are 98 percent effective for preventing pregnancies, almost 90 percent ef=
fective for stopping HIV, highly effective against syphilis and gonorrhea=
, and can also block chlamydia and HPV. =93They've been effective for 50 =
years. They're not perfect, but they work,=94 said AIDS researcher James =
Curran, dean of Emory University's Rollins School of Public Health.=20
Research also shows that teenagers who pledge abstinence until marri=
age usually have sex later than those who don't pledge, but they are less=
likely to use condoms and as likely to contract STDs.
The Bush administration asserts that condoms cannot eliminate all ri=
sk from sex with multiple partners. President Bush and his congressional =
allies support abstinence. Last year, Bush promised $15 billion over five=
years for AIDS treatment and prevention in the 15 worst-affected countri=
es. But some AIDS experts are unhappy that one-third of the prevention mo=
ney is earmarked for abstinence-only programs, many of them faith-based.=20
=93We were buying condoms for STD prevention, and we haven't succeed=
ed,=94 said Megan Hauck, deputy policy director for the Bush-Cheney campa=
ign. =93There isn't any evidence comparing abstinence programs with compr=
ehensive sexual education,=94 Hauck said, adding that the administration =
has funded a study on the effectiveness of abstinence-only programs.
=93We are absolutely committed to making decisions on HIV-prevention=
policy on the basis of science,=94 said CDC Director Dr. Julie Gerberdin=
g. Last year, however, Gerberding made headlines when she presented a che=
ck for $363,935 to abstinence-only Metro Atlanta Youth for Christ.
Scientists say the issue is part of a larger debate, with science lo=
sing ground in the political arena in the past decade. =93If you look at =
what critics of science say =97 academic and religious critics alike =97 =
they converge on the same notion: Science is just one more way of looking=
at the world, and it shouldn't have the cultural authority it has been g=
ranted,=94 said Ronald Numbers, medical historian at the university of Wi=
sconsin-Madison.
=93When you take people's money and make decisions on what to fund w=
ith it, you have to consider morals and ethics in addition to science. It=
's a combined equation,=94 said Hauck.=20
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INTERNATIONAL NEWS=09
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RUSSIA:=20
=93Media Leaders Urge Governments to Commit to Combating AIDS in Former S=
oviet Union=94
Associated Press (10.27.04)::Maria Danilova
At a conference in Moscow Wednesday, US actor and AIDS activist Rich=
ard Gere joined television, radio, and publishing representatives from Ru=
ssia, Ukraine and other former Soviet Republics in a pledge to produce HI=
V/AIDS awareness campaigns. One campaign is set to begin Nov. 29 and cost=
about $30 million in the first year.=20
Participants acknowledged that media campaigns and celebrities alone=
could not solve the epidemic and urged governments to do more. =93School=
s must be open for public awareness campaigns.=85 This must be a state po=
licy,=94 said Rafael Akopov, head of Prof-Media publishing. Several Russi=
an television networks will broadcast HIV prevention messages during prim=
e time shows, said Alexander Dybal, chairperson of the Russian Media Part=
nership Against HIV/AIDS.=20
Gere said he plans a campaign with prominent Russian rock singer And=
rei Makarevich to form =93a creative task force=94 to promote safe sex. A=
IDS represents a global security problem, said the actor, who arrived in =
Moscow from India where he runs an AIDS program.
Russia has registered 1,030 AIDS cases and 283,000 HIV cases. But th=
e actual number of HIV cases is probably three times higher than the offi=
cial figures, and AIDS cases could quadruple to 5,000 within two years, s=
ay experts and activists. Some 68,000 people are registered as HIV-positi=
ve in Ukraine, where experts estimate that in fact more than 1 percent of=
the population =97 or 500,000 people =97 are infected. The epidemics in =
Central Asia and Eastern Europe are driven by intravenous drug use, activ=
ists say. =20
CANADA:=20
=93Needle Exchange Needed in Prisons to Combat Spread of Disease, Groups =
Say=94
Canadian Press (10.27.04)::Greg Bonnell
On Wednesday, the Ontario Medical Association and the Canadian HIV/A=
IDS Legal Network urged Canada to adopt prison-based needle exchange prog=
rams to stem the prevalence of HIV and hepatitis C virus (HCV) among inma=
tes. Nearly one in 50 federal inmates have HIV/AIDS =97 a rate 10 times h=
igher than in the general population. Almost a quarter of inmates test po=
sitive for HCV.
=93These are transmissible diseases which are being spread within th=
e prison and have the potential to spread when people come out of the pri=
son,=94 said Dr. Peter Ford of OMA. Once released, many prisoners return =
to the community =93unaware that they're infected with the potential to s=
pread the infection,=94 thus multiplying the problem as a public health t=
hreat, said Ford.=20
The network asked federal provincial and territorial governments to =
begin pilot programs in their correctional facilities within 18 months. B=
ut OMA's director of health policy, Dr. Ted Boadway, advocated for a more=
immediate date. =93They need to be started right now so the institutions=
can learn how to do this and protect everyone,=94 he said.
=93We're aware that it's an issue and we want to talk to the stakeho=
lders,=94 Correctional Services Minister Monte Kwinter said in Ontario. =93=
I want to find out what the ramifications of [needle-exchange programs] a=
re,=94 said Kwinter. Federal Public Safety Minister Anne McLellan said th=
e issue warrants study.
=93Needles can be used as weapons,=94 said Don Ford of Ontario Publi=
c Service Employees Union, which represents some 6,000 jail guards and op=
poses jail-based exchanges. =93How many [prisoners] are actually contract=
ing the disease once they're incarcerated?=94 asked Ford, who said there =
is no evidence on the matter.
However, in six countries the legal network studied, not one needle =
from an exchange has been used as a weapon, said Glenn Betteridge, HIV/AI=
DS Legal Network's spokesperson. Switzerland and Iran already have such p=
rograms, Boadway noted. =20
UKRAINE:=20
=93WHO Experts to Check on Possible Spread of Syphilis Through Donated Bl=
ood=94
Associated Press (10.28.04)
The World Health Organization is sending an expert from Britain's na=
tional Center for Blood to Croatia Thursday to investigate whether thousa=
nds of patients could have contracted syphilis through transfusions three=
years ago. Croatian Health Minister Andrija Hebrang invited WHO to study=
the case, even as he dismissed reports of a possible outbreak as unfound=
ed.=20
WHO's Alan Kitchen plans to spend two days at Croatia's Institute fo=
r Transfusional Medicine, which oversees donor blood collection, preserva=
tion and hospital delivery. Kitchen will issue a report on his findings i=
n about two weeks.=20
A former institute lab expert, Dr. Dubravka Pirc-Tiljak, told a maga=
zine this summer that in 2001 she was double-checking blood cleared of in=
fections when she discovered many donors tested positive for syphilis. In=
stitute head Irena Jukic rejected the claims as =93totally unfounded.=94 =
Blood donors are tested for syphilis, hepatitis B and C and HIV, said Juk=
ic, who added that syphilis had not been transmitted through transfusion =
in Croatia for decades.=20
Two Croatian independent commissions investigated the initial reports=
in 2001 and cleared the institute of any wrongdoing. But Hebrang wanted =
an international investigation to =93put an end to that story=85 and rest=
ore trust=94 in blood donors and transfusion recipients. =20
ZAMBIA:
=93AIDS-Hit Zambia Bans Condom Handouts to Students=94
Reuters (10.26.04)::Shapi Shacinda
The Zambian government banned the free distribution of condoms in pr=
imary and secondary schools on Tuesday =97 the same day the United States=
released $24 million to the country for HIV/AIDS programs that feature c=
ondom distribution as a key element.=20
According to a senior Zambian health official who declined to give h=
is name, a circular went out to schools instructing that condom programs =
=97 run mostly by nongovernmental organizations =97 be halted. =93The gov=
ernment's view is that distributing condoms in schools is like encouragin=
g sex among the youth and also contradicts Christian values,=94 the offic=
ial said.=20
Rosemary Musonda, who heads Zambia's National AIDS Council, said, =93=
It is not right to allow condoms in schools. It is going against the teac=
hing of good morals.=94 Influential church leaders have been publicly pre=
ssing the government to stop condom distribution in schools in favor of e=
ncouraging sexual abstinence among young people.
=93Contributing to the fight against AIDS, condoms will be marketed =
to priority high-risk groups for prevention,=94 the US embassy said in a =
statement announcing the $24 million in funding.=20
Analysts say sex is not openly discussed in Zambian families: It is =
considered taboo for parents to talk about sex with their children. Yet h=
ealth experts say teaching young people about safe sex is critical to slo=
wing the epidemic in Zambia, where one in five people =97 in a country of=
about 10 million =97 are HIV-positive.=20
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MEDICAL NEWS=09
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UNITED STATES:
=93Co-occurring Hepatitis C, Substance Use, and Psychiatric Illness: Trea=
tment Issues and Developing Integrated Models of Care=94
Journal of Urban Health (12.04) Vol. 81; No. 4: P.719-734::Diana L. Sylve=
stre; Jennifer M. Loftis; Peter Hauser; Sander Genser; Helen Cesari; Nico=
lette Borek; Thomas F. Kresina; Leonard Seeff; Henry Francis
Hepatitis C virus (HCV) infection is transmitted by injection drug u=
se and is associated with psychiatric conditions. =93Patients with drug u=
se or significant psychiatric illness have typically been excluded from H=
CV treatment trials noting the 1997 National Institutes of Health Consens=
us Statement on HCV that indicated active drug use and major depressive i=
llness were contraindications to treatment of HCV infection,=94 the autho=
rs wrote. =93However, the 2002 NIH Consensus Statement recognized that th=
ese patients could be effectively treated for HCV infection and recommend=
ed that treatment be considered on a case-by-case basis.=94
The investigators noted that treating HCV infection in such patients=
is challenging, since drug use relapse could potentially lead to psychos=
ocial instability, poor adherence and HCV reinfection. In addition, inter=
feron therapy might exacerbate preexisting psychiatric symptoms, accordin=
g to the report.
Co-occurring HIV or hepatitis B provide additional challenges, the a=
uthors said, and access to ancillary medical and psychiatric services may=
be limited. =93Patients with co-occurring HCV infection, substance use, =
and psychiatric illness can complete interferon treatment with careful mo=
nitoring and aggressive intervention,=94 the investigators wrote. =93Clin=
icians must integrate early intervention for psychiatric conditions and d=
rug use into their treatment algorithm.=94
Since few programs or treatment models address management of co-occu=
rring substance use, psychiatric illness, and HCV infection and therapy, =
the National Institute on Drug Abuse convened a panel of experts to addre=
ss the current status and long-range needs through a two-day workshop, =93=
Co-occurring Hepatitis C, Substance Abuse, and Psychiatric Illness: Addre=
ssing the Issues and Developing Integrated Models of Care.=94 The confere=
nce report summarizes the current data, medical management issues, and st=
rategies discussed at the meeting.
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LOCAL AND COMMUNITY NEWS=09
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MASSACHUSETTS:=20
=93Bishop Attacks School Condom Plan; Holyoke Tries to Stem Teen Pregnanc=
ies=94
Boston Globe (10.26.04)::David Abel
Holyoke School Committee members recently approved an advisory counc=
il's recommendation to pilot a program to give high school students acces=
s to condoms. Before receiving the condoms, students would have to speak =
with a nurse, who would discuss pregnancy, AIDS, abstinence and the effic=
acy of condoms, said Michael J. Moriarty, vice chairperson of the committ=
ee. If the pilot were successful, the school would extend the program to =
sixth through eighth grades, said Moriarty,
The Roman Catholic bishop of Springfield, Timothy A. McDonnell, spok=
e against the decision, contending that the school system is =93an endors=
er and an enabler of early adolescent sex.=94 The bishop called the decis=
ion =93in effect, a millstone around the necks of parents.=94
School health officials said the number of teen births is the same n=
ow as two years ago. In September, 29 high school students were pregnant,=
four middle school pupils were pregnant; and one sixth grader was pregna=
nt. Massachusetts' teen birth rate is 23 per 1,000, and Holyoke has the s=
tate's highest teen birth rate, at 82 births per 1,000 teens. The city ra=
nks second in the state for AIDS cases. =93We had to do something to comb=
at what we were seeing,=94 said Dr. Robert Abrams, a school physician and=
interim director of health education for Holyoke schools.
The committee's approval was not unanimous. Moriarty voted to limit =
condom access to high school students only. =93I think the younger the st=
udent, the more concerned parents become,=94 he said. =93I'm in favor of =
sex education, but we don't have to give them condoms,=94 said member Wil=
liam Collamore. Member Linda Fitzell, a nurse, hoped her senior son and f=
reshman daughter would have no use for them. =93But I know a lot of kids =
don't listen to what parents say, so, in that case, I want to make sure t=
hey have protection.=94 =20
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NEWS BRIEFS =09
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MALAWI:
=93UN AIDS Envoy Begins Working Visit to Malawi=94
Agence France Presse (10.27.04)
On Wednesday, Stephen Lewis, UN special envoy for AIDS in Africa, be=
gan a tour of Malawi to assess a program distributing free antiretroviral=
s. =93The visit will help us scale up the antiretroviral treatment becaus=
e the program is lacking drugs and we have shortages of personnel, especi=
ally nurses,=94 said Mary Shaba, permanent secretary for nutrition, HIV a=
nd AIDS in Malawi's health ministry. Since its February launch, the progr=
am has reached 8,000 patients, Shaba said. It seeks to treat 40,000 by ne=
xt year. Shaba said the sourcing of cheaper drugs from the Global Fund to=
Fight AIDS, TB and Malaria had been impeded by logistical problems. The =
Global Fund has devoted $3 million to the plan.=20
JAMAICA:
=93More Youngsters Getting HIV/AIDS=94
Jamaica Observer (10.21.04)
At a recent conference in Kingston, Dr. Yitades Gebre, a senior medi=
cal officer at the Ministry of Health, reported that most HIV/AIDS cases =
are occurring among 15- to 24-year-olds. Three times more females than ma=
les are infected, possibly due to younger girls having sex with older men=
.. Fifty to 60 percent of the estimated 22,000 HIV-positive Jamaicans do n=
ot know they are infected, Gebre said.=20
GEORGIA:=20
=933 Teens Test Positive for TB Exposure=94
Atlanta Journal-Constitution (10.28.04)::Laura Diamond
Three students at Peachtree Ridge High School who tested positive fo=
r TB exposure will undergo chest X-rays and, if necessary, lab tests to d=
etermine if they have active cases, Gwinnett County school officials anno=
unced Wednesday. On Monday, county health officials tested a total of 107=
students and eight teachers at the Suwanee school as a precaution after =
a ninth-grader was diagnosed with an active TB case earlier this month. S=
tudents who test positive will receive antibiotics, said Vernon Goins, sp=
okesperson for the county health department. =20
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ANNOUNCEMENT: The 2005 National HIV Prevention Conference will be convene=
d by the Centers for Disease Control and Prevention (CDC) and many other =
national and community partners June 12-15 in Atlanta, Ga. The conference=
, which is held every two years, is noted for bringing together preventio=
n programs and science and for its exclusive focus on HIV prevention. Att=
endees include local, regional and national decision makers, researchers,=
policy makers, community leaders and practitioners working to prevent th=
e spread of HIV/AIDS. In 2003, this conference attracted over 3,000 parti=
cipants from across the country.
Abstract Submission Information: Online submission is available through t=
he conference Web site. Abstracts submitted on paper or diskette must be =
postmarked by Jan. 10, 2005. Abstracts submitted electronically must be r=
eceived by Jan. 17, 2005. For more information about abstract submission =
and other conference information, visit the conference Web site at http:/=
/www.2005HIVPrevConf.org, or telephone the conference hotline at 866-277-=
6313.
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