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National News
International News
Medical News
Local and Community News
News Briefs
Wednesday, May 11, 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
TEXAS: "Girls' Film on Teen Pregnancy Airing Nationally"
Associated Press (05.08.05):: Lynn Brezosky
When six of their classmates became pregnant, four girls at
Mission High School in the border region of south Texas - where the teen
pregnancy rate is among the highest in the nation - decided their peers
needed more information on safe sex. Two years later, their 16-minute
educational film promoting condom use, titled "Toothpaste" in reference
to teen slang for condoms, is available to public schools across Texas.
Schools across the country have ordered the film, which will also be
shown at film festivals and on Showtime, according to Scenarios USA, a
national organization that educates teens on STDs and pregnancy.
In 2003, Scenarios USA challenged teens in Miami, New York City,
and the border region of Texas - all areas with high rates of STDs and
teen pregnancy - to film their lives. While researching teen pregnancy,
the four girls were surprised to find out their region's rate was higher
than in Miami and New York City. They were even more shocked to discover
that students in other states learned about contraception in schools.
In Texas, the sex-education curriculum is abstinence-based.
While local districts can discuss contraception with students, the state
advises against it. Most south Texas school districts do not.
"Toothpaste" is a frank discussion about contraception and teen
sexuality in a region where 37 of 1,00 girls become pregnant by age 17.
It follows the lives of two girls and their decisions on whether to have
sex with their boyfriends. David Champion, a Texas education Agency
specialist in south Texas, said he sees value in the film. "If you want
to talk to these teenagers, it's information that they need to know and
they want to know," said Champion.
"Toothpaste" won the annual contest and Scenarios USA polished
the film by bringing on professional directors, producers, and camera
operators.
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International News
UNITED KINGDOM: "Doctors Call for Hepatitis B Jab for All
Children"
Guardian (London) (05.10.05):: James Meikle
British doctors have called for all UK children to be vaccinated
against hepatitis B virus (HBV). Currently, only babies deemed at risk
are vaccinated.
In 2003, there were 1,151 new cases of the virus in Britain - a
135 percent increase over 1992 figures - mostly among those ages 15-44.
The British Medical Association (BMA) said routine immunization of
babies could prevent "untold suffering" among patients and save the
National Health Service millions in treating people with HBV.
Britain is one of the few developed countries not to offer
routine HBV vaccination, according to BMA. "It makes sense to immunize
all children against hepatitis B," said Sam Everington, BMA's deputy
chair and an east London general practitioner. "The vaccine is extremely
safe and millions of babies have been immunized against a major cause of
cancer."
The Department of Health said government advisers were
considering whether hepatitis B immunization needed strengthening or
expanding. The department noted that the United Kingdom has one of the
lowest prevalences of chronic HBV in the world and that incidence of
acute HBV remains stable and low.
"Expert advice has been that we should seek to improve
immunization of groups most at risk of infection such as babies born to
mothers with hepatitis B, injecting drug users, and gay and bisexual
men, and this is what we have been doing," the department said.
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SWAZILAND: "Truckers Contribute to the Spread of AIDS"
Inter Press Service (05.03.05):: James Hall
Health surveys for years have noted that itinerant workers such
as truck drivers and seasonal agricultural workers are at greater risk
for contracting and spreading HIV/AIDS. At a gathering of local leaders
in the southern Shiselweni region, the prominent Chief Mzweleni Dlamini
recently blamed foreign truck drivers for spreading HIV/AIDS in
Swaziland. "They take advantage of the poverty in the country to entice
women into sex for money or a meal," he said.
"Truckers do contribute to the spread of the disease, but they
are not the principal cause of Swaziland's HIV prevalence rate, which at
about 40 percent of the adult population is currently the highest of any
country in the world," said AIDS activist Sempiwe Hlope. "But it is
unfair to single them out, and inaccurate to say truckers are a
principal cause of infection."
Local business leaders criticized the chief's remarks and said
that Swaziland should not be singled out in a health crisis that affects
all Southern African countries. "I am losing too many drivers [to AIDS]
but they are also South Africans, Botswanans, Zimbabweans," said Willie
Stuart, president of the trucking firm Speedy Overborder.
In what health officials denounce as a discriminatory policy,
Ezulwini, a wealthy suburb of Swaziland's capital Mbabane, banned
construction workers' hostels. Single-sex workers' hostels breed STDs,
said Gladys Simelane, an HIV/AIDS counselor, because men are forced to
live without female companions and often engage the services of
prostitutes. But she noted it was unfair to banish workers' hostels.
Like other health officials, she believes the solution is to expand
HIV/AIDS prevention education, targeting itinerant workers and
commercial sex workers.
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Medical News
UNITED STATES: "Early Therapy Slows HIV Progression in Babies"
Reuters (05.11.05):: Karla Gale
Treating HIV-infected infants younger than 3 months old is
associated with better outcomes than delaying treatment, according to a
new study by Stanford university School of Medicine's Dr. Yvonne A.
Maldonado and colleagues at the California Pediatric HIV Study Group.
In the current issue of the Journal of the American Medical
Association (JAMA), the researchers described time trends in early
progression of HIV infection among 205 children born between 1988 and
2001 using clinic visit records through age 3. Around two-thirds of the
children were treated with some form of antiretroviral therapy (ART). By
age 3, 81 had progressed to an advanced disease stage. Absence of ART
was associated with increased risk of HIV progression.
Among the 23 children treated with three AIDS drugs, including
either protease inhibitors or a nonnucleoside reverse transcriptase
inhibitor, none progressed to advanced disease.
The authors found that even ART with one or two drugs, if
initiated by age 2 months rather than 3 to 4 months, was associated with
delayed and decreased progression to advanced stages. "Because there are
potential drawbacks of very early therapy. large, prospective clinical
trials defining the differences between very early versus delayed
institution of therapy are needed," the researchers noted.
A second study in this week's JAMA found that the likelihood of
needing to switch therapy - indicating treatment failure - is
significantly greater among children not treated with protease
inhibitors and those who start ART at advanced disease stages.
In that study, Dr. Susan Brogly of the Harvard School of Public
Health and colleagues examined change in pediatric HIV treatment in US
children from 1987 to 2003. The authors observed that since pediatric
guidelines were released in 1998, 22 percent of the 766 HIV-children in
their study were started on a regimen not recommended by the guidelines.
Of 753 children treated with ART, 606 were switched to a second regimen.
"Once our results were adjusted for age and year of calendar
start, we found that older regimens - those including one or two
nucleoside reverse transcriptase inhibitors - were associated with
shorter time to first regimen switch," said the authors.
"We also identified that children who start therapy when they
are severely immunosuppressed also had a shorter time to regimen
switch," Brogly said. This is key, because "more exposure to more drug
classes and specific drugs, the more it can lead to drug resistance if
not taken properly," she added. "Switching could also result in a
reduction of future treatment options."
In an accompanying editorial, Dr. Ram Yogev at Chicago's
Children's Memorial Hospital noted that "while it is possible to
celebrate the tremendous change in the outcomes of HIV-infected children
treated with HAART, it is even more important to continue to prioritize
research for the survivors who are now living with a chronic disease."
"Temporal Trends in Early Clinical Manifestations of Perinatal
HIV Infection in a Population-Based Cohort," "Antiretroviral Treatment
in Pediatric HIV Infection in the United States," and "Balancing the
Upside and Downside of Antiretroviral Therapy in Children" were
published in JAMA (2005;293(18):2221-2231, 2213-2220, and 2272-2274,
respectively).
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UNITED STATES: "Long-Lasting Gel Against Herpes"
BBC News (04.30.05)
Dr. Judy Lieberman and colleagues at Harvard Medical School have
developed a gel that could protect against genital herpes for up to 10
days without a reapplication. The gel, using an active ingredient called
small interfering RNAs, blocks herpes transmission by destroying the
virus. When applied to the vagina, the gel is absorbed and remains
active for at least 10 days. Studies in mice have shown the gel
completely blocks infection.
Lieberman said that if the gel works in people, too, the
long-lasting protection would be a great advantage. "The problem with
microbicides is that people don't remember to use them before they have
sex," she said. Experts said the gel could be useful in developing
countries where people may refuse to wear condoms.
Marion Nicholson, director of the Herpes Virus Association, said
that such a gel is very interesting, though it is still far from being
developed. She stressed that condom use is important to prevent a number
of STDs including HIV, and that herpes can also be contracted from oral
sex if one partner has an active cold sore.
The article, "Long-Lasting Gel Blocks Herpes," appeared in New
Scientist (2005;2946:17).
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UNITED STATES: "Columbia University, New York: Physical
Intimate Partner Violence Does Not Lead to Sexual HIV Risk"
AIDS Weekly & Law (04.28.05)
N. Elbassel and colleagues at Columbia university have published
research showing that physical violence between intimate male and female
partners does not lead to sexual HIV risk, as they had originally
hypothesized.
"This study, based on data from a random sample of 322 men on
methadone, examines whether traditional male gender role beliefs, male
substance use, and couple drug-involvement lead to male psychological
dominance, which in turn leads to perpetration of intimate partner
violence (IPV) and sexual HIV risk behavior," the scientists wrote.
"Structural equation modeling indicated that male psychological
dominance is directly associated with perpetrating both physical IPV and
sexual HIV risk; however, physical IPV did not lead to sexual HIV risk
as predicted originally," the investigators reported.
"Stronger endorsement of traditional male gender role beliefs
was associated with male psychological dominance," the researchers
found.
"Couple drug-involvement was also directly associated with male
psychological dominance as well as sexual HIV risk. Male substance use
led to couple drug-involvement, but not to physical or sexual HIV risk
as hypothesized," the scientists wrote.
"Study findings highlight the significance of couple
drug-involvement and male psychological dominance as pathways leading to
physical IPV and sexual HIV risk behavior," the authors concluded. The
study has implications for HIV prevention efforts targeting men involved
in drug use and their sexual partners, they wrote.
The report, "Deconstructing the Relationship Between Intimate
Partner Violence and Sexual HIV Risk Among Drug-Involved Men and Their
Female Partners," appeared in AIDS and Behavior (2004;8(4):429-439).
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Local and Community News
VIRGINIA: "New Leaders Working to Change Problem-Plagued AIDS
Program"
The Virginian-Pilot (05.10.05):: Katrice Hardy
A new director and management council appointed in Norfolk in
the past year have raised hopes that its Ryan White Title I Program's
service and management problems will improve. Norfolk was chosen to
administer the program for more than 2,100 HIV/AIDS patients living
between Currituck County, N.C., and Williamsburg because it has the
highest local concentration of patients. About $4.7 million in federal
funds provides for local care under a one-year grant continuing through
February.
However, Bayview pharmacies, Eastern Virginia Medical School,
and other health organizations had complained for years about lack of
guidance and oversight from the city of Norfolk. Between 1990-2003, the
city left unspent an annual average of $1 million in Ryan White funds,
though officials had identified hundreds of patients who were eligible
for the program but not receiving care. Federal auditors criticized the
local operation.
LaVerne Parker Diggs, a new assistant city manager, took over
managing the program about a year ago and recruited a management council
of community volunteers to oversee the program. Christine Carroll, hired
a few months ago to direct the program, is working with a team of health
planners to find other people in the region who should be receiving help
from the Ryan White grant. In addition to the more than 2,100 being
served, management council officials said they know of another 3,000
HIV/AIDS patients in the region, some of whom may not be receiving
services from other sources.
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News Briefs
MASSACHUSETTS: "New Guide for Those Living with AIDS"
Boston Globe (05.10.05):: Stephen Smith
Each year, about 1,000 people in Massachusetts are diagnosed
with HIV. The state Department of Public Health has released a guide
called "Now That You Know: A Guide to Living with HIV," designed to help
newly infected patients find a doctor, locate support groups, and enlist
specialists who can work with patients to manage their care. The 28-page
guide is available in English, Spanish, Portuguese, and French and can
be ordered free at www.maclearinghouse.com or by telephoning
1-800-952-6637.
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NEW MEXICO: "New Mexico Counties Cut Teen Births"
Albuquerque Journal (05.07.05):: Debra Dominguez
On Friday, the state Department of Health Family Planning
Program and the New Mexico Teen Pregnancy Coalition announced that a
challenge made in 2000 to reduce teen births in New Mexico counties is
being met. Between 1998 and 2003, teen births in the state declined 11
percent, lower than the national average of 16 percent. "We asked them
to bring them down by 20 percent by the year 2005. And 14 of them have.
Seven of them have reduced teen births by at least 10 percent," said
coalition Executive Director Sylvia Ruiz. "I attribute the decrease in
teen births to good comprehensive sex education programs, available
clinic services for adolescents, and various other after-school programs
for teens," said Ruiz.
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NORTH CAROLINA: "AIDS Walk Raises $106,000"
Charlotte Observer (05.08.05)
More than $106,000 was raised at Saturday's AIDS Walk Charlotte,
organizers of the event announced. Now in its ninth year, the two-mile
walk is the largest HIV/AIDS fundraising event in the Carolinas and
includes thousands of walkers, volunteers, and supporters. The money
raised will benefit the Regional AIDS Interfaith Network.
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