| prevention-news@cdcnpin.org 2005-03-26, 10:14 am |
| CDC HIV/STD/TB Prevention News Update
Thursday, March 24, 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
TEXAS: "Committee Approves Women's Health Bill"
LOUISIANA: "Judge to Hear ACLU Contempt Motion on State Abstinence Program"
INTERNATIONAL NEWS
AFRICA: "TB the Number One Killer Among AIDS Sufferers in Africa"
INDIA: "India Gets Pat from WHO for War on TB, Pledges to Step Up Campaign"
RUSSIA: "TB Incidence in Russia Increases by 3 Percent in 2004"
MEDICAL NEWS
UNITED STATES: "Teen Pledges Barely Cut STD Rates, Study Says"
LOCAL AND COMMUNITY NEWS
ILLINOIS: "Meth Use Adds to Ravages of AIDS"
NEWS BRIEFS
LIBYA: "Qaddafi Won't Free Nurses in HIV Case"
NEW YORK: "Manhattan: Tuberculosis Rates Continue to Fall"
GLOBAL: "Canada in Multi-Million Dollar TB Grant"
RUSSIA: "Death Rate from TB in Prisons Reduces 4-fold for 6 Years"
CALIFORNIA: "HIV Panel to Hold Forum"
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NATIONAL NEWS
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TEXAS:
"Committee Approves Women's Health Bill"
Associated Press (03.22.05)::Natalie Gott
On Tuesday, the Texas Senate Health and Human Services Committee approved a bill (SB 747) that will expand Pap smear, mammogram, STD and TB screening, among other services, to women 18 and older with an annual income no more than 185 percent of the f
ederal poverty level. Currently, women on Medicaid cannot access preventative health and family planning services if they make more than $3,300 per year in a family of four, said Sen. John Carona (R-Dallas), the bill's sponsor. That is 17 percent of the f
ederal poverty level. The bill would set the cut-off level at $34,800 for a family of four.
The Health and Human Services Commission will create a Medicaid waiver program for the expansion in services, which would include birth control but not abortion. Under the waiver, for every $1 Texas spent, the federal government would pay $9. The Leg
islative Budget Board estimated the waiver program would save Texas about $135 million in fiscal years 2006 and 2007.
"It's smart money, and it provides good preventive care," said Carona, adding that 21 other states have similar waivers. "It's preventive in nature. It will be enormously beneficial to women. If you look at what this legislation does, in its truest p
urpose and intent, it will actually reduce abortions."
LOUISIANA:
"Judge to Hear ACLU Contempt Motion on State Abstinence Program"
Associated Press (03.23.05)::Alan Sayre
On Thursday in New Orleans, a federal judge is to hear arguments in the American Civil Liberties Union's request that Louisiana be found in contempt of a 2002 court settlement dealing with religious content in the state's program promoting abstinence
until marriage.
US District Judge Thomas Porteous Jr. will conduct the hearing. In July 2002, he ruled that some grants under the Governor's Program on Abstinence (GPA) were being used by recipients to promote religion. Program officials contended they had stopped s
uch spending, but Porteous issued an order compelling the program to cut off funds to groups or persons conveying a religious message. Louisiana first appealed, then dropped its effort and settled with ACLU in November 2002, promising to monitor spending
more tightly and to conduct quarterly reviews of funded programs, denying renewal to those found promoting religion.
The current ACLU motion, filed in January, contends that GPA continues to feature religious materials on its Web site. ACLU filed the motion after Gov. Kathleen Blanco said in December that simply providing Web links to other abstinence-related sites
with religious content does not violate the settlement.
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INTERNATIONAL NEWS
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AFRICA:
"TB the Number One Killer Among AIDS Sufferers in Africa"
Agence France Presse (03.23.05)
TB is the top killer among HIV-infected Africans, and efforts to combat it have stalled in seven out of nine sub-Saharan African countries, according to the 29-page 2005 Global TB Control Report Card - released in conjunction with World TB Day on Thu
rsday. The report, based on figures from the World Health Organization, ranks countries according to their TB control efforts.
"TB is now the number one opportunistic infection for people who are HIV-positive and the leading killer of people with AIDS," said Joanne Carter, director of the Washington-based TB organization RESULTS International, who helped compile the report.
"In many African countries severely affected by HIV/AIDS, TB cases have more than tripled in the past decade," she added.
Nine of the 22 highest-burden countries are in Africa, said the report. Only South Africa and the Democratic Republic of Congo made the grade, with Ethiopia, Kenya, Mozambique, Nigeria, Uganda, Tanzania, and Zimbabwe all failing. "The overwhelming co
nclusion from the report card is that Africa is where we're facing the biggest challenge and the biggest trouble," said Don Enarson, a director at the International Union Against Tuberculosis and Lung Disease in Paris.
Nigeria and Uganda were cited for doing "conspicuously little" to control TB. Some 105,000 people died of TB last year in Nigeria, while Uganda posted a 10 percent drop in the TB detection and cure rate between 1999 and 2003.
High HIV prevalence is causing problems even in African countries that were praised by the report, such as South Africa, where an estimated one in five adults is living with HIV/AIDS. More than half of the South Africans infected with TB are also co-
infected with HIV. "People infected with the TB bacteria are 50 times more likely to become ill with TB once their immune systems are weakened by HIV," said Carter.
INDIA:
"India Gets Pat from WHO for War on TB, Pledges to Step Up Campaign"
Agence France Presse (03.24.05)
An estimated 4.5 million Indians have TB, according to the World Health Organization's annual report prepared for World TB Day today. However, the report praised India for its progress against the disease, especially the expansion of DOTS (Directly O
bserved Treatment Short-course). The country has achieved a TB case detection rate of 72 percent and an 86 percent treatment success rate, the report noted.
"TB is curable and yet over 1,000 Indians die of this disease every day," said Anbumani Ramdoss, India's health minister. "We must ensure the entire country is covered under [DOTS] by June 2005."
"India's DOTS program is the fastest expanding program and the largest in the world in terms of patients initiated on treatment," said S. Sahu of WHO's India office. "More than 100,000 patients are put on treatment every month."
Disease-related stigma and discrimination still deter people infected with TB from seeking treatment, health workers warned. "Workers are scared to get TB treatment because they fear their offices will ask them not to come to work as the disease is i
nfectious," said S. Sarla, a former TB patient who runs the TB support group Saahasee (Brave). "It's a poor man's disease and poor people cannot afford to lose their jobs," she said.
Indians with HIV/AIDS urged their government to use the DOTS model to distribute antiretroviral drugs. "With TB being the major cause of death among poor people living with AIDS, it is good news for us to know that free TB treatment is available out
there," said Elango Ramachander of the Indian Network of People Living with HIV/AIDS. "We hope that the TB program will serve as a model for the national AIDS control program and make antiretroviral drugs more easily available."
RUSSIA:
"TB Incidence in Russia Increases by 3 Percent in 2004"
ITAR-TASS (03.24.05)
Last year, 102,887 new TB cases were registered in Russia, an increase in incidence of 3 percent over 2003, according to the Federal Consumer Rights and Human Wellbeing Supervision Service. "The rate of the disease reached 71.7 cases per 100,000 of t
he population," the agency reported.
"In 27 constituents of the Russian Federation TB incidence is considerably higher than in the country in general," reported the service. "The highest sickness rate is in the Siberian federal district where the incidence exceeds the general Russian TB
occurrence 1.5-3.5 times."
Through the past year, the "TB mortality rate reduced inconsiderably and was 21.3 cases per 100,000 of the population," according to the medical aid development and resort treatment department of the Russian Ministry of Health and Social Development.
The high TB incidence and mortality among otherwise able-bodied Russians means the disease is responsible for serious economic damage to the country. Some 80 percent of cases can be linked to socio-economic factors, said Dr. Mikhail Perelman, directo
r of the Sechenov Research Institute of Physiopulmonology. "Tuberculosis recedes where there are no wars, the people are provided with [normal] housing and food and experience minimum stresses," he said.
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MEDICAL NEWS
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UNITED STATES:
"Teen Pledges Barely Cut STD Rates, Study Says"
Washington Post (03.19.05)::Ceci Connolly
Teenagers who pledge to abstain from sex until marriage are almost as likely to become infected with an STD as their non-pledging peers, according to an eight-year study by researchers from Yale and Columbia universities. While teens who take virgini
ty pledges delay the initiation of sexual activity, have fewer sex partners, and marry at younger ages, they are also more likely to engage in oral and anal sex and not use condoms, the researchers found.
"The sad story is that kids who are trying to preserve their technical virginity, are, in some cases, engaging in much riskier behavior," said study author Peter S. Bearman, a professor at Columbia's Institute for Social and Economic Research and Pol
icy. "From a public health point of view, an abstinence movement that encourages no vaginal sex may inadvertently encourage other forms of alternative sex that are at higher risk of STDs."
The study's findings are based on the federally funded National Longitudinal Study of Adolescent Health, which began in 1995 and tracked 20,000 young people from high school to adulthood. At the start of the study, the students, ages 12-18, agreed t
o detailed, sexually explicit interviews. Researchers re-interviewed the students in 1997 and again in 2002, when 11,550 also provided urine samples.
Twenty percent of the adolescents said they had taken a virginity pledge. The researchers then divided the pledgers into two categories - "inconsistent" and "consistent" - to reflect that some teens changed their status or their responses between int
erviews. Sixty-one percent of the consistent pledgers and 79 percent of the inconsistent pledgers reported having intercourse before marrying or prior to the 2002 interviews.
Nearly 7 percent of nonpledgers were diagnosed with an STD, compared with 6.4 percent of inconsistent pledgers and 4.6 percent of consistent pledgers. While major geographic differences were not detected, the study found that minorities were far more
likely to have an STD. About 25 percent of African-American girls in the survey tested positive for at least one STD in 2002.
While the raw numbers for high-risk behavior were small, the gap was statistically significant, said Bearman. Just 2 percent of teens who never took a pledge reported anal or oral sex but not intercourse, compared with 13 percent of consistent pledge
rs.
The full study, "After the Promise: the STD Consequences of Adolescent Virginity Pledges," was published in the Journal of Adolescent Health (2005;36:271-278).
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LOCAL AND COMMUNITY NEWS
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ILLINOIS:
"Meth Use Adds to Ravages of AIDS"
Chicago Tribune (03.13.05)::Judith Graham; Johnathon Briggs
The growing popularity of crystal methamphetamine in Chicago's gay community has AIDS advocates worried that long-standing efforts to fight the spread of STDs, including HIV, could suffer a significant setback. "It's the biggest challenge we've faced
in two decades," said AIDS Foundation of Chicago Executive Director Mark Ishaug.
"When men with HIV take meth, they're not taking [AIDS] medications as prescribed. and [are] transmitting the virus to others who are not infected," said Dr. Dan Berger, medical director at North Star Health Care, Chicago's largest private HIV treatm
ent center.
That danger was highlighted last month when New York City health authorities reported the case of a meth-using gay man with a rare, virulent, and highly drug-resistant strain of HIV who had unprotected sex with more than 100 partners.
"We are very concerned," said Ron Stall, chief of prevention research for HIV/AIDS at CDC. In January, CDC held its first national forum on meth abuse and HIV. CDC is also testing an intervention to reduce high-risk sex among meth users in four citie
s, including Chicago.
According to Berkeley, Calif.-based psychologist Walter Odets, meth "is a drug that can make men who feel socially awkward or unattractive believe they're in the swing of things." "It's a terrific self-esteem enhancer" for a largely depressed gay com
munity "living in the midst of a deadly epidemic and a society that's still, for the most part, unapproving," said Odets.
Chicago-area AIDS and gay groups are now forming coalitions to respond to the crisis. "It's time to get the word out: We all need to focus attention on how to stop the use of this drug," said Robbin Burr, executive director at the Center on Halsted,
a gay and lesbian community center.
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NEWS BRIEFS
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LIBYA:
"Qaddafi Won't Free Nurses in HIV Case"
New York Times (03.24.05)::Reuters
Despite strong protests from the United States and the European Union, Libya's Col. Muammar el-Qaddafi will not release the five Bulgarian nurses who were convicted and sentenced to death for allegedly infecting children at a Benghazi hospital with H
IV in 1998. "I swear to God I will not release them," Qaddafi told an Arab League summit conference in Algiers. The verdicts were based on confessions that the nurses say were extracted under torture. Late last year, Tripoli suggested it would release the
medics in exchange for financial payments, but Bulgaria balked, saying any compensation would be an admission of guilt.
NEW YORK:
"Manhattan: Tuberculosis Rates Continue to Fall"
New York Times (03.24.05)::Marc Santora
TB cases in New York City reached an all-time low in 2004 - a critical turnaround in a disease that was epidemic just 15 years ago, the city's Department of Health and Mental Hygiene said today. Last year, 1,039 new TB cases were reported, a 9 percen
t drop from 2003 and a 73 percent fall from the epidemic's peak in 1992, when 3,800 cases were reported. "While tremendous overall strides have been made, TB continues to largely affect immigrant groups, particularly of Asian and Hispanic descent," said D
r. Sonal Munsiff, assistant commissioner for TB control.
That the number of cases in some areas of the city has not changed significantly in recent years reflects "the presence of large immigrant communities from countries with high rates of TB," Munsiff said
GLOBAL:
"Canada in Multi-Million Dollar TB Grant"
Agence France Presse (03.23.05)
On Wednesday, Canada said it will give an additional $38 million Canadian (US$31 million) to the global fight against TB this year. The money - to be divided among agencies including the Global Drug Facility, the International Union Against Tuberculo
sis and Lung Disease, and the World Health Organization - will be used to supply and monitor TB drugs, improve health care access, and launch programs. The effort's goal is to cure nearly 1 million TB cases. Previously this year, Canada had committed $12.
8 million Canadian (US$10.5 million) to fight TB globally. Since 1997, Canada has spent $160 million Canadian (US$131 million) on TB programs in 22 countries.
RUSSIA:
"Death Rate from TB in Prisons Reduces 4-fold for 6 Years"
ITAR-TASS (03.24.05)
Among federal prisoners in Russia, deaths from TB have declined four-fold and sickness by 2.5 times in six years, according to Svetlana Sidorova, chief TB specialist for Russia's Federal Penitentiary Service. "Meanwhile, the number of active tubercul
osis cases in prisons reduced two times," she added. Every year, prisons receive about 20,000 people infected with TB, or more than 15 percent of total cases in Russia, the medical department said. Prisoners have two mandatory TB examinations each year, s
aid the department. About 80 percent of prisoners diagnosed learn of their infection only while in detention, according to statistics.
CALIFORNIA:
"HIV Panel to Hold Forum"
Bay Area Reporter (03.17.05)
On Thursday, March 24, the council that prioritizes San Francisco's federal Ryan White CARE Act funds is scheduled to hold a community forum meeting. The San Francisco HIV Health Services Planning Council meeting is at 5 p.m. in the Rainbow Room at t
he LGBT Community Center, 1800 Market St. For more information, telephone Leah Crask at 415-674-4768.
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