| prevention-news@cdcnpin.org 2005-02-03, 11:04 am |
| CDC HIV/STD/TB Prevention News Update
Wednesday, February 02, 2005
The CDC National Center for HIV, STD and TB Prevention provides the following information as a public service only. Providing synopses of key scientific articles and lay media reports on HIV/AIDS, other sexually transmitted diseases and tuberculosis does
not constitute CDC endorsement. The following summaries were prepared without conducting any additional research or investigation into the facts and statements made in the articles being summarized, and therefore readers are expressly cautioned against re
lying on the validity or invalidity of any statements made in these summaries. This daily update also includes information from CDC and other government agencies, such as background on Morbidity and Mortality Weekly Report (MMWR) articles, fact sheets and
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tracted below for full texts of the articles.
HEADLINES
NATIONAL NEWS
UNITED STATES: "Report: AIDS on the Rise Among Blacks"
TEXAS: "Abstinence Programs Haven't Influenced Texas Teens, Study Finds"
MISSISSIPPI: "Mississippi Department of Corrections Integrates HIV Inmates into Community Work Centers"
INTERNATIONAL NEWS
HAITI: "US-Funded AIDS Clinic Opens in Remote Haitian Town"
AUSTRALIA: "Nationwide Hep C Study Launched"
MEDICAL NEWS
UNITED STATES: "Effective HIV Case Identification Through Routine HIV Screening at Urgent Care Centers in Massachusetts"
LOCAL AND COMMUNITY NEWS
NORTH CAROLINA: "Activists Ask County to Focus HIV Effort"
NEW YORK: "Officials to Warn of STD"
NEWS BRIEFS
NEBRASKA: "Group Strives for AIDS Awareness"
IRAN: "Recorded HIV/AIDS Cases Rise in Iran"
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NATIONAL NEWS
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UNITED STATES:
"Report: AIDS on the Rise Among Blacks"
Associated Press (02.01.05)
African Americans comprise more than half of new HIV cases each year and about two-thirds of new AIDS cases among teens, even though they represent less than 15 percent of the US population, according to a new report. The Black AIDS Institute, a Los
Angeles-based research and public policy group, released "The Time is Now!" to coincide with the start of Black History Month. The report is based on HIV/AIDS statistics culled from CDC, Congress, the Kaiser Family Foundation, and other sources.
The report found that black women made up 67 percent of US women diagnosed with AIDS in 2001. Its release follows that of a new Rand Corp. study indicating that a significant number of blacks believe HIV/AIDS was created by scientists conspiring to d
estroy their communities.
BAI noted that funding for the primary federal AIDS program has remained level during the last three years, and the number of media stories about the disease dropped 57 percent from 1997 to 2002.
The report urged Congress to increase funding for HIV/AIDS treatment, control the cost of medicines, provide more comprehensive sex education in schools, and push more states to adopt needle-exchange programs.
TEXAS:
"Abstinence Programs Haven't Influenced Texas Teens, Study Finds"
Associated Press (01.30.05)
In an ongoing study, Texas A&M university researchers found that students in nearly all high school grades throughout Texas were more sexually active after participating in abstinence-only sex education programs. The programs did not encourage teen s
ex; rather, researchers believe the abstinence messages did not interrupt expected adolescent sexual trends.
The study findings were based on 10-page questionnaires filled out anonymously by junior and high school students from more than two-dozen schools engaged in five different programs.
"We didn't find what many would like for us to find," said A&M researcher Buzz Pruitt, who met with state health officials recently to discuss the findings. Pruitt warned against making overreaching conclusions based on the study, which is incomplete
. There is no comparison group, so researchers cannot say whether teen sex rates would have been even higher without abstinence-only programs.
Of the ninth-grade girls studied, about 23 percent had already had sexual intercourse - a figure below the national average - prior to their abstinence-only program enrollment. After taking the abstinence courses, that rate grew to 28 percent, close
to the state average. Rates of sexual activity grew for 10th-grade boys, from 24 percent before program exposure to 39 percent after taking the course. No changes in rates of sexual activity were noted among ninth-grade boys in the programs.
Scientists hailed the study for providing data to a field lacking it. Texas and nearly a dozen states have evaluated their abstinence programs.
Interim data from a $4.5 million per-year federal study on abstinence programs were supposed to have been released previously but remain unpublished. A final report is due in 2006, said Harry Wilson, associate commissioner of the federal Family and Y
outh Services Bureau.
MISSISSIPPI:
"Mississippi Department of Corrections Integrates HIV Inmates into Community Work Centers"
Associated Press (01.31.05)::Holbrook Mohr
On Monday, the American Civil Liberties Union said the Mississippi Department of Corrections is in compliance with a federal court order to integrate HIV-positive prisoners into the department's community work programs. In June, US Magistrate Judge J
erry A. Davis ordered MDOC to change its policy following a lengthy court battle with ACLU.
"Our main concern now is that they are integrated in the same way as other prisoners," said ACLU National Prisons Project attorney Jessica Feirman. ACLU brought the suit on the grounds that HIV-infected prisoners were not receiving equal treatment be
cause they were denied access to the work programs. Under Davis' ruling, HIV-positive prisoners were made eligible to transfer to lower-security work centers.
According to Corrections Commissioner Chris Epps, the HIV status of prisoners no longer determines where they are housed or whether they are placed in work programs. "They are treated the same as other prisoners," said Epps. MDOC spokesperson Suzanne
Singletary said 10 HIV-positive prisoners are in community work programs.
Mississippi has 17 work centers, each housing around 75 inmates who work for cities, counties, state agencies, and charity organizations. In order to qualify for the programs, inmates must meet numerous criteria. Those who have a history of violent c
rimes or are considered a flight risk are not placed in the programs, said Epps. "It's a tough criteria," he said. "We expect you to work. You have to be able to work physically and mentally."
The state has about 250 HIV-positive prisoners who have generally been housed separately from the main prison population.
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INTERNATIONAL NEWS
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HAITI:
"US-Funded AIDS Clinic Opens in Remote Haitian Town"
Associated Press (02.01.05)::Amy Bracken
On Tuesday in Jeremie - a remote town about 100 miles southwest of the capital of Port-au-Prince - a clinic opened and began supplying free antiretroviral drugs for AIDS patients. The facility is the second to open in Haiti under President George W.
Bush's $15 billion international AIDS initiative. The new clinic is funded by the US State Department and run by the local Saint-Antoine Hospital. By March, an additional 12 US-funded clinics are scheduled to open in Haiti.
Randall Tobias, the director of the US international AIDS effort, spoke at the opening of the clinic, which is decorated with quilts made by AIDS patients. "HIV/AIDS no longer has to be a death sentence," he said.
Before the small clinic opened, local HIV patients had to suffer through a 12-hour bus ride to obtain treatment in Port-au-Prince.
Dr. Smith Francois, the clinic's director of internal medicine, said anti-HIV stigma often discourages people from seeking treatment. In addition, many people "who get sick go to a Voodoo priest instead of a doctor." Many AIDS patients in Haiti think
the disease is "something supernatural that someone did to them," Francois said.
AIDS kills about 30,000 people a year among Haiti's population of 8 million, according to UNAIDS. Jean-Robert Brutus of the US Agency for International Development said the United States spent about $20 million on AIDS treatment in Haiti over the las
t year. One-third of the money designated for prevention goes to abstinence-first programs. At present, the money can only buy brand-name drugs, not cheaper generics.
AUSTRALIA:
"Nationwide Hep C Study Launched"
Australian Associated Press (02.02.05)
Hepatitis C virus researchers are asking people with HCV to enroll in a large Australia-wide study to improve treatment of the disease. Eighty-five percent of people with hepatitis C could be cured if treatment were begun early enough, said Dr. Steph
en Pianko, a liver specialist at Melbourne's Alfred Hospital. However, people with genotype 3 tend to have higher viral concentrations, and only about 70 percent can be cured. About 38 percent of Australians with HCV have genotype 3.
The trial will enroll 624 participants from 30 sites across Australia. Its aim is to improve the cure rate among patients with HCV genotype 3 by increasing the treatment time from 24 weeks to 48 weeks, said Pianko. "We believe that by extending treat
ment we may be able to push those cure rates up from 70 percent back to that 85 percent that the overall group can expect," said Pianko.
"There is treatment and they really should seek it," said Pianko, encouraging people with HCV to volunteer for the study. "In the next 10 years we believe that the number of patients dying of liver failure and liver cancer is going to double and it's
a major public health problem," he said.
In Australia, 150,000 people have chronic HCV infections and 14,000 are newly infected each year.
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MEDICAL NEWS
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UNITED STATES:
"Effective HIV Case Identification Through Routine HIV Screening at Urgent Care Centers in Massachusetts"
American Journal of Public Health Vol. 95; No. 1: P. 71-73 (01..05)::Rochelle P. Walensky, MD, MPH; Elena Losina, PhD; Laureen Malatesta, MHP, PA-C; George E. Barton, BA; Catherine A. O'Connor, MSN, ACRN; Paul R. Skolnik, MD; Jonathan M. Hall, BA; Jean F.
McGuire, PhD; Kenneth A. Freedberg, MD, MSc
Despite CDC guidelines advising routine HIV counseling, testing, and referral in hospitals where HIV prevalence exceeds 1 percent, an estimated 180,000-280,000 people in the United States have undiagnosed HIV. In 2003, CDC began promoting "New Strate
gies for a Changing Epidemic" to make "HIV testing a routine part of medical care." The authors designed "Think HIV" to provide routine, voluntary HIV counseling, testing, and referral at 4 Massachusetts hospital-associated urgent care centers in high HIV
prevalence areas.
From January to September 2002, Think HIV offered routine HIV counseling, testing, and referral to 7,026 patients, 2,620 of whom accepted, and 2,444 of whom had completed HIV test results at the time of the report. During the same time, state-funded
counseling, testing, and referral sites within 10 miles of Think HIV sites (self-referral sites) completed 13,890 tests. The researchers compared Think HIV's positive diagnostic yield with that of the self-referral sites with chi-square tests. Think HIV i
dentified 48 new HIV diagnoses (2 percent undiagnosed HIV prevalence) compared to 262 new diagnoses at self-referral sites (1.9 percent undiagnosed HIV prevalence).
The authors also compared patient demographics using chi-square tests. "Gender, race/ethnicity, previous HIV testing, and risk behaviors of Think HIV patients differed significantly from those of self-referral patients but HIV prevalence stratified b
y these characteristics did not," the researchers wrote. "The distribution of patients who were HIV infected differed by risk of transmission between the 2 types of counseling, testing, and referral programs (P<.0001)."
Among infected Think HIV patients, 12.2 percent were men who had sex with men. None were injection drug users.
A total of 1,382 of the 2,444 patients (56.5 percent) tested by Think HIV returned for results, 56 percent among HIV-negative patients and 88 percent among patients with HIV. Of the 48 HIV-positive patients, 42 were told their results. All had docume
nted linkage to care, defined as at least 1 outpatient HIV primary-care visit.
The authors found that Think HIV reached a higher proportion of African Americans and risk behavior categories (except MSM) than self-referral screening. It also yielded a higher prevalence of HIV-positive MSM than self-referrals. Think HIV costs wer
e less than $5,000 per each newly identified HIV-positive patient and $5,500 for each patient linked to care.
"Programs such as Think HIV will be most efficient in areas of highest HIV prevalence," the researchers concluded. "An extension of routine HIV counseling, testing and referral programs similar to Think HIV in high HIV prevalence settings may have su
bstantially higher positive diagnosis yields than our already successful program."
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LOCAL AND COMMUNITY NEWS
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NORTH CAROLINA:
"Activists Ask County to Focus HIV Effort"
Charlotte Observer (02.01.05)::Carrie Levine
Mecklenburg County's HIV incidence rate is more than double that of North Carolina's, prompting AIDS activists to call on county commissioners for more money and a stronger prevention focus.
In 2003, there were 437 new HIV cases in the county - a 43 percent increase over 2002. Though the number of new cases dropped to 344 in 2004, it still was 40 more than was reported in 2002, leading officials to say the trend over time is rising. AIDS
also replaced accidents as the top killer for people ages 25-44 in Mecklenburg in 2002.
Eloise Hicks, director of the Regional HIV/AIDS Consortium, served on a task force appointed by the county board to recommend strategies for dealing with the increase. "The county commission, which operates as a board of health, is looking at this mo
re as a political issue than as a medical emergency," she said.
Last year, the commissioners adopted the task force's long-term goal of no new HIV/AIDS cases by 2015, but backed off from recommendations for syringe exchanges, more outreach to high-risk groups, and an advisory panel of experts to focus on HIV/AIDS
in Mecklenburg. The board agreed to hire six of the 12 new requested health workers recommended by the task force. Those health workers have only recently been hired, said county health department spokesperson Andy Fair. The department is monitoring thei
r caseloads before deciding whether to hire more people.
County Manager Harry Jones said Mecklenburg's HIV/AIDS rates are cause for considerable alarm, and priorities must be weighed carefully. "And it gets right back to the question of, what role should government play in the modification of behaviors. An
d that's the policy issue I think we've got to discuss," Jones noted.
NEW YORK:
"Officials to Warn of STD"
Newsday (02.02.05)::Curtis L. Taylor
Today, New York City health officials are expected to issue a warning about lymphogranuloma venereum (LGV), a form of chlamydia infecting mostly gay and bisexual men. The STD used to be rarely seen outside of poor, tropical nations, but it has been i
ncreasingly diagnosed in Europe, San Francisco, and now, New York City.
LGV can cause genital ulcers, influenza-like symptoms, and bleeding of the rectum. Health officials believe it can also increase the risk of contracting hepatitis C and other STDs. If caught in time, patients with LGV can take a three-week course of
antibiotics to treat the disease. A single dose is used to treat common chlamydia strains, according to reports.
City health officials are expected to issue the warning because LGV is often misdiagnosed. "Contracting LGV, unfortunately, is just another health risk that people who engage in unsafe sex are in danger of," said Christine Quinn (D-Chelsea), who chai
rs the City Council's health committee. "If you engage in unsafe sex the reality is that there are many health conditions that you are at risk of contracting. Now there is another: LGV."
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NEWS BRIEFS
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NEBRASKA:
"Group Strives for AIDS Awareness"
Omaha World-Herald (02.01.05)::Kristin Zagurski
On Monday in Omaha, health officials said black Nebraskans' disproportionate share of state HIV/AIDS cases calls for a greater emphasis on testing and prevention. Though they make up only 4 percent of the state's population, black people account for
20 percent of its AIDS cases and 24 percent of HIV infections, according to the Nebraska Health and Human Services System. Representatives of several area HIV/AIDS groups met at the Urban League Family Resource Center to kick off Omaha's fifth-annual obse
rvance of National Black HIV/AIDS Awareness and Information Day on Feb. 7. For information about free and reduced-cost STD testing in Omaha, visit www.stdomaha.com.
IRAN:
"Recorded HIV/AIDS Cases Rise in Iran"
Agence France Presse (02.02.05)
Today in Tehran, the health ministry said the number of recorded HIV/AIDS cases in Iran has risen to 9,800 - up sharply from the 5,780 cases reported in December 2003. The rise was attributed in large part to increased testing. Intravenous drug users
accounted for 52 percent of cases. Since the diagnosis of Iran's first case 18 years ago, 1,041 people have died of AIDS-related illnesses. Experts estimate that as many as 40,000 Iranians are HIV-positive.
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