| prevention-news@cdcnpin.org 2005-05-02, 5:52 pm |
| Web Bug
CDC/NPIN Logo <http://www.cdcnpin.org/scripts/index.asp>
National News
International News
Medical News
Local and Community News
News Briefs
Monday, May 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 relying 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 announcements. Reproduction of this text is encouraged; however,
copies may not be sold, and the CDC HIV/STD/TB Prevention News Update
should be cited as the source of the information. Contact the sources of
the articles abstracted below for full texts of the articles.
National News
NEW HAMPSHIRE: "Many Fear More HIV/AIDS Drug Coverage Cuts"
Associated Press (04.28.05):: Meg Heckman
The New Hampshire AIDS Drug Assistance Program's (ADAP) 331
clients received letters last fall stating that they would continue to
receive AIDS drugs, but expensive medications to fight side effects and
other complications would no longer be covered. Last year, the federal
government cut the state's ADAP grant by 5 percent, while drug costs
leapt by 47 percent, to some $9,300 per patient annually. By December,
New Hampshire's ADAP will be nearly $1.8 million in the red.
"That's a recipe for disaster," said Dr. William Kassler, state
medical director. With possible federal budget tightening and continued
drug price increases, things could get worse, said Kassler. Even some
drugs that have been on the market for years are suddenly more
expensive. "The drug companies feel that the market will bear this,"
said Kassler. "They can charge that, and people have no option but to
pay."
Kassler's most difficult decision was related to the expensive,
last-line AIDS drug Fuzeon, which the state can only afford for two
patients. There is already one patient on the Fuzeon waiting list. "It's
an ethical conundrum," said Kassler. "How can you look this guy in the
face and say we can't give you this medication? But how can you look at
other folks and say we can't give you your medication [because Fuzeon is
so expensive]?"
ADAP clients say lobbying lawmakers for more federal funds is
hard when the state contributes none of its own funds. However, Gov.
John Lynch has included $180,000 for ADAP in his proposed budget.
Additionally, state legislators are considering creating a committee to
assess the needs of state residents with AIDS.
Back to Top Back to Top
MONTANA: "State's Family Council Expires"
Billings Gazette (04.29.05):: Chelsi Moy
On Thursday, the head of the conservative nonprofit group
Montana Family Foundation (MFF) criticized Gov. Brian Schweitzer's
decision to suspend an ad campaign promoting abstinence and allow a
state-appointed family and marriage council to expire. "We have programs
that are working," said MFF President Jeff Laszloffy. "I would hate to
see them go away."
Laszloffy said abstinence ads usually begin running around prom
season and last until graduation. That is the time when young girls are
most likely to become pregnant, he said. Montana receives $172,000 in
federal funding to promote abstinence, $50,000 of which pays for
billboards, and radio and television advertisements, while $90,000 goes
toward cities for abstinence efforts. The program typically receives
$40,000 from the Temporary Assistance for Needy Families federal block
grant, but this year legislators took that money away and directed the
agency not to shift money to promote abstinence.
Schweitzer's family planning policy adviser, Anna Whiting
Sorrell, said the administration wants to take a more comprehensive
approach, viewing abstinence as only one component of sex and health
education. Laszloffy said such a move would undermine the abstinence
message and might jeopardize federal money for the program.
Schweitzer said his decision not to reauthorize the Governor's
Council on Families - one of 50 committees in the Department of Public
Health and Human Services involving more than 1,000 people - is part of
his pledge to make state government more efficient. "We want families to
have a better quality of life, but not by spending state and federal
money for people to sit on councils," said Schweitzer.
Whiting Sorrell added that the administration intends instead to
organize a council with a broader perspective but would not elaborate on
what that would encompass.
Back to Top Back to Top
International News
BRAZIL: "Brazil Refuses US AIDS Funds, Rejects Conditions"
Wall Street Journal (05.02.05):: Michael M. Phillips; Matt
Moffett
Last week, Brazilian authorities wrote the US Agency for
International Development (USAID) to reject the $40 million remaining
from a 2003-2008 $48 million USAID grant. Brazilians said the
requirement that recipient groups condemn prostitution would hamper
their work. Prostitution is not a crime in Brazil, and sex-worker
associations are among Brazil's most active constituents engaged in
prevention work.
The first-of-its-kind rejection was made by Brazil's AIDS
commission, which includes cabinet members, scientists, church
representatives, and community advocates. Brazil provides about 90
percent of funding for its AIDS budget and the World Bank provides
another 7-8 percent. The remainder comes from the United States and
other governments.
US funding would have included $190,000 for eight sex-worker
groups across Brazil, according to Gabriela Leite, coordinator of the
Brazilian Network of Sex Professionals and a former sex worker. Leite
said she was involved in protracted discussions with USAID to ensure US
funds went only to AIDS education and prevention, and not to sex-worker
rights issues. But the resulting 50-page agreement broke down because
her organization refused to condemn prostitution.
Some public health experts and scientists consider Brazil's AIDS
strategy a model. In 1992, experts predicted Brazil would have 1.2
million people infected by 2002. It had instead 660,000 cases. The
Brazilian government encourages abstinence and monogamy, while
prevention efforts focus on condom education and distribution. Since
1996, the country has provided free antiretroviral drugs to those
infected.
"This is an evolving situation," said Roslyn Matthews, a USAID
spokesperson who said the agency was reviewing Brazil's decision. "We
are in the process of determining next steps." The anti-prostitution
requirement was created in 2003 by two US laws, one dealing with AIDS
and the other with forced prostitution or sex trafficking.
Back to Top Back to Top
Medical News
UGANDA: "Rates of HIV-1 Transmission Per Coital Act, by Stage
of HIV-1 Infection, in Rakai, Uganda"
Journal of Infectious Diseases 191(9):1403-9 (05.01.05)::
Maria J. Wawer; Ronald H. Gray; Nelson K. Sewankambo; David Serwadda;
Xianbin Li; Oliver Laeyendecker; Noah Kiwanuka; Godfrey Kigozi; Mohammed
Kiddugavu; Thomas Lutalo; Fred Nalugoda; Fred Wabwire-Mangen; Mary P.
Meehan; Thomas C. Quinn
In this retrospective study, researchers identified 235
monogamous HIV-discordant couples in a Rakai, Uganda, population-based
cohort to estimate rates of HIV transmission per coital act (PCA) and
stage of infection. Transmission within pairs was confirmed by sequence
analysis. Rates of transmission PCA were estimated by index partner's
stage of infection (recent seroconversion, prevalent or late-stage
infection). The adjusted rate ratio was estimated by multivariate
Poisson regression.
The average coital act frequency was 10.2/month (median=
8.3/month) among couples with an incident index partner and 10.0/month
among couples with a prevalent index partner. Coital frequency declined
from an average 8.7/month to 6.2/month before the death of an index
partner. Median viral load approximately five months after
seroconversion was 30,000 copies/mL; and a median 2,600 copies/mL by 15
months. Median viral load among prevalent partners increased from 10,300
copies/mL at baseline to 15,000 copies/mL after 30 months of follow-up.
Among late-stage partners, median viral load was 112,600 copies/mL at
the last test date, conducted an average five months before death.
Of the 235 couples, 68 (28.9 percent) index partners transmitted
HIV to their previously uninfected partners. Transmission was highest
among 23 incident partners, of whom 10 (43.4 percent) transmitted HIV to
their partners within approximately 2.5 months after seroconversion, and
13 (56.5 percent) had after approximately 35 months. Prevalent index
partners transmitted infection at a mean annual rate of 8.4 percent. And
of 51 late-stage partners, 19 (37.3 percent) transmitted HIV within
approximately 6-35 months before death.
The overall average rate of HIV transmission PCA was 0.0012;
0.0082 PCA within approximately 2.5 months after the index partner's
seroconversion; 0.0015 PCA 6-15 months after seroconversion; 0.0007 PCA
among HIV-prevalent index partners; and 0.0028 PCA 6-25 months before
the index partner's death.
Higher transmission rates were significantly associated with
early and late stage of HIV infection, viral load of 3.50 log10
copies/mL or more, genital ulcer disease, and younger age (15-29 years)
of index partner.
"After seroconversion of the index partner, the rate of
transmission (0.0082/coital act) within the first 2.5 months was almost
12-fold higher than that observed in prevalent index couples
(0.0007/coital act)," concluded authors. The authors acknowledged that
they were unable to determine the magnitude or duration of peak viremia
or HIV transmission PCA during the weeks immediately following
seroconversion, but viral loads were consistent with levels seen
approximately five months after incident partners' seroconversion. They
noted that a recent Malawi study suggested a peak HIV load of 6.10 log10
copies/mL (more than 1 million RNA copies/mL) shortly after HIV
acquisition. For Rakai couples, if the length of exposure between
incident infection and transmission was only 1 month (approximately 10
coital acts) instead of the study's estimated 2.5 months, the rate of
transmission could possibly be very high, as much as 0.02/coital act
among incident partners, they said.
"The highest rate of transmission per coital act, as well as the
highest proportion of transmissions, occurred during early-stage
infection in index partners, a time when few seroconverters know their
HIV status or receive ART," noted the authors. The overall contribution
of late-stage infection to the heterosexual epidemic "is likely to be
limited, because individuals with advanced HIV infection report less
sexual intercourse and have fewer partners, and only a minority of
couples remain discordant by this stage." Initiating ART to late-stage
patients, under current guidelines, "may have only a modest impact on
HIV transmission." "Measures that prevent primary HIV infection or
reduce early viremia (as may occur with HIV vaccines) are likely to have
a greater effect than ART on the spread of HIV. Increased efforts to
identify persons with early-stage HIV infection are also warranted, to
promote safe behaviors, and, where appropriate, to provide ART."
Back to Top Back to Top
Local and Community News
PENNSYLVANIA: "Children Given Strong Drugs After Needle Pricks
Cause HIV Scare"
Associated Press (04.30.05)
Nineteen pupils who were pricked with a needle wielded by a
third-grader at Bayard Taylor Elementary School in Philadelphia are
taking antiretrovirals to fend off HIV infection. One of the 19 students
tested positive for HIV. The incident began when a girl brought her
mother's blood-testing device from home and used it to prick the
children.
With the post-exposure drug therapy, "[HIV] may be in there, but
it never gets a chance to set up cells in your body," said Roger J.
Pomerantz, director of the infectious-disease division at Jefferson
Medical College. The drugs' possible side effects include headaches,
muscle aches, fatigue, nausea, and diarrhea. Cecilia Cummings,
spokesperson for the School District of Philadelphia, said the district
is paying for the children's medical care.
The odds of acquiring HIV from the incident are very small,
authorities said. The infection risk with a hollow needle, as is found
on a hypodermic, is very low - less than once in 200 cases - said Neil
O. Fishman, director of hospital epidemiology and infection control for
the university of Pennsylvania Health System. The needle in this case
was not hollow. "Transmission of HIV with a solid needle is very, very
rare and extremely unlikely," Fishman said.
Back to Top Back to Top
NEW JERSEY: "Atlantic City, Camden Volunteer for Needle
Exchange Program"
Associated Press (04.30.05)
Atlantic City and Camden have met a state deadline to apply for
a needle-exchange program Gov. James E. McGreevey created via an
executive order last October. The order, which declared a public health
emergency, permits three cities to participate in the program. Nine
cities were encouraged to submit applications but only Camden and
Atlantic City adopted the required local ordinances to create needle
exchanges within their jurisdictions.
Both cities could soon have their programs up and running if
health officials act by May 6 on their applications, which include plans
for program funding, operation, and outreach. Camden would set up a
mobile exchange through a nonprofit agency. Atlantic City would set up
mobile and fixed locations via a community AIDS organization.
Health officials view the needle-exchange program as a way to
curb the spread of HIV/AIDS in New Jersey. IV drug users account for
more than half of the state's 62,000 HIV/AIDS cases. In Atlantic City,
one in every 40 residents is HIV-infected, according to health
officials. The 1,340 HIV/AIDS cases in the city of Camden account for
more than half of Camden County's total caseload.
"This is not going away by happenstance," Anthony Lingo, of the
Camden County health department, said Saturday. "We have to take
definitive action."
An obstacle, however, remains for both cities: A lawsuit filed
in December challenging McGreevey's order continues to travel through
the courts.
Back to Top Back to Top
MASSACHUSETTS: "Westport Selectmen Rescind Needle-Exchange
Program"
Associated Press (04.29.05)
On Thursday, the Westport Board of Selectmen voted 3-2 to
overturn its own decision to set up a needle-exchange program for
intravenous drug users. This reversal came just three days after the
board's unanimous vote to allow the program.
The special meeting Thursday drew so many angry residents it had
to be held outdoors in the rain. Opponents of the exchange fear it would
bring drug addicts and crime to the town of 14,000.
"I want to begin my statement by apologizing to the residents of
the town for not appreciating in advance the firestorm that my vote
would create," board Chairperson Elizabeth Collins said. Boos and calls
to resign interrupted the statements of board members who sought to
explain their earlier vote for the program. Collins and Selectman David
Dionne stuck with their initial decisions to back the exchange. During
the meeting, a petition calling for the board's recall circulated
through the crowd of 300.
Westport's neighboring towns, Fall River and New Bedford, have
both rejected needle-exchange programs in spite of having epidemics of
HIV and drug use. Only four Massachusetts communities - Boston,
Cambridge, Northampton, and Provincetown - operate needle exchanges.
Back to Top Back to Top
News Briefs
UKRAINE: "Ukrainian Health Authorities Record Increase in
Number of HIV-Infected People"
Associated Press (04.29.05)
Ukraine registered 12,490 HIV infections in 2004, a 25 percent
increase over the previous year, Tetyana Yurchenko, a Ukrainian Health
Ministry spokesperson, said Friday. She declined to speculate about the
causes of the increase. Since the nation recorded its first HIV case in
1987, a total of 76,875 people have been officially registered with the
disease by the Ukrainian government. Earlier this year, President Viktor
Yushenko's government said fighting AIDS would be among its priorities,
and it recently formed the National Coordination Council to help
organize public and private anti-AIDS efforts. By some estimates, as
many as 500,000 Ukrainians - 1 percent of the population - have HIV, and
the UN has said HIV infection rates are growing faster in Ukraine than
in Africa.
Back to Top Back to Top
OHIO: "League Addresses HIV/AIDS, Women"
Plain Dealer (04.28.05)
On Thursday, May 12, the League of Women Voters-Cuyahoga
Regional Area (LWV-CRA) will host a public forum titled "The
Feminization of HIV/AIDS" from 7 to 9 p.m. at Trinity Commons, 2230
Euclid Ave. Co-sponsored by the LWV-CRA education Fund, the free event
will include a panel of local and international experts discussing the
disease's impact on women. The meeting is part of a series of national
forums on "Women Engaging Globally," a program of the National League of
Women Voters education Fund, the Center for Women Policy Studies and the
Women's Environment and Development Organization. For more information,
telephone 216-781-0555.
Back to Top Back to Top
_____
The Prevention News Mailing List is maintained by the National
Prevention Information Network (NPIN), part of the Centers for Disease
Control and Prevention's National Center for HIV, STD and TB Prevention.
Regular postings include the Prevention News Update, conference
announcements, current funding opportunities, select articles from the
Morbidity and Mortality Weekly Report series and announcements about new
NPIN products and services.
To join the PreventioNews listserv, send a blank e-mail to
prevention-news-subscribe@cdcnpin.org
<mailto:prevention-news-subscribe@cdcnpin.org> . For instructions on how
to remove yourself from the listserv, send a blank e-mail to
prevention-news-unsubscribe@cdcnpin.org
<mailto:prevention-news-unsubscribe@cdcnpin.org> .
You can also join or leave the PreventioNews listserv from the
NPIN Web site at: http://www.cdcnpin.org/scripts/prevention_news.asp.
Back issues of the CDC HIV/STD/TB Prevention News Update can be
found at http://www.cdcnpin.org/scripts/locates/LocateNews.asp. You can
search for back issues in the Prevention News Update Database at
http://www.cdcnpin.org/news/.
We'd like to know what you think of the Prevention News Update.
Please take a minute to send an e-mail with your comments to
update-feedback@cdcnpin.org <mailto:update-feedback@cdcnpin.org> . With
your help, we will continue to improve this service to better meet your
information needs.
Please send all other e-mail inquiries to info@cdcnpin.org
<mailto:info@cdcnpin.org> .
**This message may be copied and distributed; however, it may
not be distributed for profit.**
---
You are currently subscribed to prevention-news as: ssah-submit@ezmort.com
To unsubscribe send a blank email to leave-prevention-news-1356515G@listmanager.aspensys.com
|