| prevention-news@cdcnpin.org 2005-03-23, 5:35 pm |
| CDC HIV/STD/TB Prevention News Update
Monday, March 21, 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
MASSACHUSETTS: "Officials: Cuts May Spur TB Outbreak"
CONNECTICUT: "Connecticut Doctor Sees State Link to Drug-Resistant HIV"
WEST VIRGINIA: "Department of Health and Human Resources Project to Promote Abstinence Among Teens"
INTERNATIONAL NEWS
GLOBAL: "African AIDS Sufferers Plea for India to Drop Patents Bill"
CHINA: "China Plans National Database of HIV/AIDS Victims as Epidemic Looms"
MEDICAL NEWS
UNITED STATES: "Social Support and Sexually Transmitted Disease Related Healthcare Utilisation in Sexually Experienced African-American Adolescents"
LOCAL AND COMMUNITY NEWS
CALIFORNIA: "Surge in TB Cases Beyond West County"
NEWS BRIEFS
CHINA: "TB Still Major Public Health Problem: Hong Kong Health Secretary"
INDIANA: "Purdue Graduate Student Diagnosed with Tuberculosis"
CHINA: "East China Province Tests Previous Blood Sellers for HIV"
SOUTH AFRICA: "Twenty Thousand Rock at Mandela AIDS Gig"
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NATIONAL NEWS
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MASSACHUSETTS:
"Officials: Cuts May Spur TB Outbreak"
Boston Herald (03.17.05)::Jessica Heslam
State and federal budget cuts are forcing the cancellation of some Massachusetts TB clinics, a move that officials say could lead to an outbreak of the disease.
The number of TB clinics - visits by doctors and nurses to monitor active and latent TB - has dropped from 24 to 19. Last year, TB cases in Massachusetts were up by 9 percent to 284 cases, the largest increase the state has recorded in 14 years, and
officials say the numbers are still rising. State funding for the State Laboratory Institute in Jamaica Plain, which monitors TB and other infectious diseases, has gone down every year since 1999, falling from $11.2 million to $9.7 million in 2004.
"Although this is not an epidemic, it is definitely a warning," said Dr. Tom Garvey of Cambridge Health, who co-chairs the Medical Advisory Council on the Elimination of Tuberculosis. "The frightening thing about these numbers is it seems to be takin
g place across the board. There is no one population that is at the center of the increase. It does leave one to wonder whether cutbacks have already lent to a change in our tuberculosis rate."
Garvey encouraged citizens to ask lawmakers to restore funding to the lab, which faces a $400,000 shortfall for basic supplies. And even as the facility's funding has been cut, its mission has been expanded to include bioterrorism. "It's a tiny amoun
t of money to prevent an enormous problem," said Garvey, who said it is "certainly conceivable" that a TB outbreak could take place in Massachusetts.
CONNECTICUT:
"Connecticut Doctor Sees State Link to Drug-Resistant HIV"
Associated Press (03.18.05)
A preliminary study suggests a genetic and epidemiological link between an HIV-positive Connecticut patient and the widely reported case of a New York City man with virulent multi-drug-resistant HIV. Dr. Gary Blick, the Connecticut patient's physicia
n, announced the case Thursday.
The two men had unsafe sex together "during a night of sex and drugs last fall at a club in Manhattan," Blick, an AIDS specialist, told the Connecticut Post. However, that "does not by any means confirm direct person-to-person transmission" of HIV be
tween them, he said. His patient's virus is resistant to 19 of the 21 HIV drugs on the market, Blick said.
Blick noted that he is releasing information about the Connecticut patient with MDR-HIV quickly in order to prevent its spread. Blick is the founder of the Connecticut HIV/AIDS/STD Task Force and the Norwalk-based Global Health Organization.
A spokesperson for the New York City Department of Health and Mental Hygiene refused to comment on any potential link between Blick's patient and the New York City case. "Our investigation is continuing and progressing," said Sandra Mullen.
WEST VIRGINIA:
"Department of Health and Human Resources Project to Promote Abstinence Among Teens"
Associated Press (03.17.05)
In a bid to stem the spread of STDs and reduce pregnancies among young people in West Virginia, state health officials have proposed a program to encourage them to delay sex until marriage. Developed by the state Department of Health and Human Resour
ces' Office of Maternal, Child and Family Health (OMCFH), the West Virginia Abstinence education Project targets youth ages 10-14.
"It is imperative that prevention efforts begin prior to the age of 13 in order to successfully reduce high-risk behaviors," states the proposal, on which OMCFH is accepting public comment.
According to 2003 West Virginia Youth Risk Behavior Survey figures cited by the proposal, 52 percent of students in grades 9-12 have had sex, down from 63 percent in 1993. The state Bureau of Public Health reports 925 chlamydia cases were recorded am
ong 15- to 19-year-olds in 2003, as well as 176 cases of gonorrhea, and one syphilis case.
In 2002, 735 babies were born to state girls ages 15-17, down from 1,419 in 1985, according to West Virginia Vital Statistics.
Project priorities include funding community-based abstinence programs in addition to providing information and materials to encourage parents to discuss abstinence and STDs with their teens. The proposal notes that 2003 research by the National Camp
aign to Prevent Teen Pregnancy showed 53 percent of youth surveyed said parents and their own values and religious beliefs most influenced teens' decisions about sex.
Besides promoting abstinence, the project also focuses on reducing risk behaviors like drug, alcohol, and tobacco use among teens.
The proposal can be accessed online at http://www.wvdhhr.org/mcfh/ or at the Secretary of State's Office at the Capitol in Charleston.
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INTERNATIONAL NEWS
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GLOBAL:
"African AIDS Sufferers Plea for India to Drop Patents Bill"
Agence France Presse (03.18.05)
On Friday, AIDS activists in Africa, home to nearly two-thirds of the world's HIV infections, appealed to the Indian government to either drop or significantly amend a controversial bill that could prevent Indian drug firms from producing cheap copie
s of brand name drugs. Until now, Indian pharmaceutical companies have been able to make inexpensive versions of patented drugs because current law protects the manufacturing process and not the medicines themselves.
Indian officials have given assurances that the bill would not prevent pharmaceutical makers in the country from making and supplying generic AIDS drugs to developing nations.
But the Nairobi, Kenya-based Network of African People Living with HIV/AIDS said it is deeply concerned the measure could severely affect millions of Africans living with HIV/AIDS. "We fear the proposed patent bill might have a negative impact in Afr
ica, as millions of lives hang in the balance," it said in a letter delivered to the Indian High Commission in Kenya.
The group's chief concern is that the law could bar Indian firms from producing the three-in-one, fixed-dose antiretroviral combination. The Indian-made cocktail has "revolutionized AIDS treatment in Africa, and providing this user-friendly form of t
reatment has only been possible because there are no patent constraints in India on putting these medicines together in one tablet," the group noted. "These generic medications are a lifeline for [people with HIV/AIDS] in Kenya and the rest of Africa."
A similar plea was also presented to the Indian High Commission in Kampala, Uganda. "We wanted to pass on a message to India that they should not pass the bill on patents," said Dr. Lydia Mungherera, a Ugandan AIDS activist. "Passing this bill will b
e sentencing millions of Africans to death because they cannot afford any other means," Mungherera added.
CHINA:
"China Plans National Database of HIV/AIDS Victims as Epidemic Looms"
Agence France Presse (03.20.05)
On Sunday, Xinhua News Agency reported that China's Health Ministry will establish a national database of HIV/AIDS patients to better track the epidemic.
"We are still blind about some vital aspects of HIV/AIDS control," said Wang Longde, vice minister of health.
China's official estimate of HIV patients - 840,000 - is disputed by many independent observers. The government has precise information about only a small percent of the 840,000. Only 12.7 percent are registered with health authorities, and disease c
ontrol centers have detailed records for only 4.2 percent.
China's first HIV/AIDS prevention and control regulation is being drafted and will be given to the State Council for discussion in May. The regulation is expected to define the rights and duties of residents and regional governments in fighting the d
isease.
This year, each province will offer free, voluntary HIV tests in the hope of identifying more cases, Wang said. Testing was recently completed on 410,000 high-risk people in Yunnan province, one of the hardest-hit areas.
Yet much more remains to be done. Hao Yang, vice director of the health ministry's Disease Control Department, said only about 200 health professionals are engaged in HIV treatment and prevention at the present time, and many doctors who are working
in the specialty lack appropriate training.
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MEDICAL NEWS
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UNITED STATES:
"Social Support and Sexually Transmitted Disease Related Healthcare Utilisation in Sexually Experienced African-American Adolescents"
Sexually Transmitted Infections Vol. 81; No. 1: P. 63-66 (02.05)::L.M. Lowery; S. Chung; J.M. Ellen
In the current study, the researchers' set out to determine whether African-American adolescents' perceived social support predicted future utilization of STD-related health care.
"A longitudinal study of African-American adolescents ages 12-18 recruited from a random sample of households in the San Francisco Bay area in which baseline data were collected by telephone and follow up data were collected by telephone or in-home a
udio computer assisted self interview," the authors wrote. At baseline, the researchers asked participants about their sexual behaviors, STD history, and social support. At follow up 14-18 months later, participants were asked whether they, while asymptom
atic, had sought STD-related medical care within the past year.
Asymptomatic sexually experienced adolescents who spoke almost daily with their closest friend were more likely to have accessed STD-related health care in the past year (odds ratio (OR)=1.38; 95 percent confidence interval (CI) 1.09, 1.76). Closenes
s to female and male parents/guardians and participation in extracurricular activities were not associated with STD-related care utilization within that same period. "After controlling for age and sex, sexually experienced adolescents who talked to or saw
their closest friend almost every day were more likely to have had STD related health care within the past year (OR=1.35; 95 percent CI=1.08 to 1.70)," the study found.
"These findings suggest that friends have an impact on the seeking of confidential healthcare services, such as care for STDs," concluded the researchers.
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LOCAL AND COMMUNITY NEWS
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CALIFORNIA:
"Surge in TB Cases Beyond West County"
San Francisco Chronicle (03.18.05)::Leslie Fulbright
A new report released by the Contra Costa County Health Department ahead of World TB Day shows that while outreach helped reduce TB cases in some parts of Richmond and San Pablo last year, cases were up in some other parts of the county.
In 2001, some ZIP codes in Richmond and San Pablo saw a spike in TB, and health officials boosted their response in those communities. An advisory board formed and worked throughout western districts of the county to help doctors' and hospitals' diag
nosis and communication efforts. The result: a 78 percent decline in new cases in those communities in the past three years. Only 13 new cases were logged in 2004, down from 28 in 2003, said Dr. Charles Crane, medical director of Contra Costa's TB program
. However, new cases increased throughout the central and eastern sectors, even as the countywide total dropped from 82 cases in 2003 to 64 last year. "We must now increasingly turn our attention to those other areas," said Crane.
Particularly vulnerable are areas that are home to immigrants who visit relatives in Asia, Mexico, and Central America. These residents may acquire TB in other countries, then infect family members upon their return to the United States, officials sa
id.
Stepped-up outreach was credited with a decrease in TB cases in other parts of the Bay Area. Alameda County cases dropped from 175 in 2003 to 144 in 2004. San Francisco, which has the Bay Area's highest TB burden, experienced its lowest TB rate ever
in 2004 - 135 cases, down from 162 in 2003, said Jennifer Grinsdale, an epidemiologist and program manager with the city's TB control section. The homeless population saw the biggest decline, she said, crediting accelerated screening efforts in the Tender
loin satellite clinic.
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NEWS BRIEFS
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CHINA:
"TB Still Major Public Health Problem: Hong Kong Health Secretary"
Xinhua News Agency (03.19.05)
At a Saturday ceremony marking World TB Day on March 24, York Chow, Hong Kong's secretary for health, said the disease continues to be a major public health problem. Hong Kong has averaged about 6,000 TB cases annually in recent years. Director of He
alth Dr. Lam Ping-yan noted Hong Kong's TB notification rate was 10 times higher than that of Western nations. Hong Kong's Department of Health has adopted a set of long-term, effective measures to combat TB, including Directly Observed Treatment, contact
tracing, and enhanced case detection, said Lam. In addition, the department works closely with the World Health Organization and the International Union Against Tuberculosis and Lung Disease, Lam said.
INDIANA:
"Purdue Graduate Student Diagnosed with Tuberculosis"
Associated Press (03.18.05)
A Purdue university graduate student has been diagnosed with active TB, prompting health officials to test those who might have come into contact with the student, school officials said Friday. The student, who lives off campus, is undergoing treatme
nt and has been in isolation since March 11, said James Westman, director of Purdue's Student Health Center. The last confirmed case of active TB among the university's 38,000 students was in 1996, school officials said.
CHINA:
"East China Province Tests Previous Blood Sellers for HIV"
Xinhua News Agency (03.21.05)
The Jiangsu province in eastern China is conducting HIV testing among people who have sold blood since the 1990s, the provincial disease control center said today. According to a senior official at the center, some people infected with HIV have yet t
o be traced since infections from blood selling were first detected. Jiangsu has also ordered testing for the spouses and children of previous blood sellers who were found to be HIV-positive. Municipal governments will conduct the testing of local residen
ts, while migrant workers can be tested at the disease control center of the city or county where the work.
SOUTH AFRICA:
"Twenty Thousand Rock at Mandela AIDS Gig"
Agence France Presse (03.19.05)
About 20,000 people attended Saturday's AIDS benefit concert organized by former South African President Nelson Mandela. Held in George, the concert sought to highlight the plight of women living with HIV/AIDS in South Africa, where one in five adult
s are infected. The concert was the second event organized by Mandela's organization 46664, named for the former president's prison number during his incarceration at the Robben Island prison.
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