| prevention-news@cdcnpin.org 2005-05-18, 6:00 pm |
| CDC/NPIN Logo <http://www.cdcnpin.org/scripts/index.asp>
Wednesday, May 18, 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
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the articles abstracted below for full texts of the articles.
National News
"GLOBAL: US Backs Off Stipulation on AIDS Funds"
"GLOBAL: AIDS Researchers, Activists to Face Off over
Drug Studies"
"NEW JERSEY: Pascrell Joins Fight for Control of AIDS
Funding"
International News
"GLOBAL: Gates to Donate Extra $250 Million for Health
Grants"
"CANADA: Needle Exchange Came Too Late: Cushman"
Medical News
"UNITED KINGDOM; IRELAND: Late HIV Diagnosis 'A
Problem'"
Local and Community News
"LOUISIANA: Syphilis on Rise Among Gay Men"
News Briefs
"GLOBAL: Bush, Mandela Discuss Fighting AIDS, Debt
Relief for Poor Countries"
"MYANMAR: Myanmar Launches UN-Sponsored Program to
Prevent Mother-to-Child HIV/AIDS Transmission"
"FLORIDA: Freedom High Student Has TB: Peers Tested"
"OKLAHOMA: Tulsa Elementary Student Tests Positive for
TB"
"NORTH CAROLINA: Teen Health Earns Challenge Grant"
_____
National News
GLOBAL: "US Backs Off Stipulation on AIDS Funds"
Washington Post (05.18.05):: David Brown
On Tuesday, the Bush administration pulled back from a plan that
would have required grassroots AIDS organizations overseas partly funded
with US money to declare their opposition to prostitution and sex
trafficking. AIDS organizations that are directly funded by the US
government or a federally funded charity are currently required to make
the declaration.
A CDC document issued last week said grassroots HIV/AIDS groups
receiving money through the Global Fund to Fight AIDS, Tuberculosis and
Malaria must make the declaration. The Global Fund itself is exempt from
the requirement. The policy would have required 3,000 groups in 128
countries to make the pledge, which AIDS activists warned could engender
fear and resentment in some nations and make it harder to reach sex
workers.
Department of Health and Human Services spokesperson Kevin W.
Keane said Tuesday night that the posting of the CDC document, which
appeared in two "requests for applications" for contracts for AIDS
activities in Africa, was "a misunderstanding." The language "hadn't
been fully reviewed and cleared," Keane said. "We are removing that
language."
Randall L. Tobias, director of the President's Emergency Plan
for AIDS Relief (PEPFAR), learned of the CDC posting last week before a
visit to Africa. The policy "is not one I have seen and considered," he
noted. "It is something that I would want to sign off on one way or
another."
Keane said Tobias has rescinded the policy.
The anti-prostitution clause has been a part of PEPFAR since its
2003 inception, though it exempted multilateral organizations such as
the Global Fund and the World Health Organization. US charities working
overseas were initially exempt; they are now being asked to comply.
PEPFAR regulations state that nothing in the anti-prostitution
clause should be construed to preclude services to sex workers. But
Maurice I. Middleburg, acting president of Engender Health, a charity
working in 16 countries, said the declaration "risks further
stigmatization of a population [prostitutes] that is already very
difficult to reach."
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GLOBAL: "AIDS Researchers, Activists to Face Off over Drug
Studies"
Wall Street Journal (05.18.05):: Marilyn Chase
At a meeting Thursday in Seattle, drug research sponsors,
scientists, and activists will try to settle the ethics conflict of
expanding AIDS drug trials into poor nations in Africa and Asia.
Convened by the International AIDS Society, the forum will address the
study of Gilead Sciences Inc.'s Viread (tenofovir) for HIV prevention.
Originally, the study's sponsors - the Bill and Melinda Gates
Foundation, CDC, and the National Institutes of Health - had hoped they
could determine whether tenofovir prevented HIV as early as 2006. Now it
looks as if results may not be in before 2007.
Activists' protests have caused tenofovir studies to be
cancelled in Cambodia and suspended in Cameroon. The central issue is
the demand that volunteers who become infected during the study receive
developed-world standards of care and be provided lifelong AIDS drugs.
Researchers say such an offer could be construed as an undue inducement
to participate in a study. At a Thai study site, activists want IV drug
users to be provided with free needles in addition to the counseling,
condoms, and syringe-cleaning supplies already offered. CDC says such an
offer would clash with a congressional ban. A third study, in Nigeria,
was cancelled due to unrelated clinic problems.
Act Up Paris and other European advocates successfully shut down
trials of Pfizer Inc.'s experimental AIDS treatment maraviroc in France,
Germany and Spain over issues of volunteer recruitment criteria and
safety. Fabrice Pilorge of Act Up Paris said his group is focused on
publicizing the study volunteers' plight.
Helene Gayle of the Gates Foundation acknowledged that activists
are raising valid questions. But she worried, "Are we making this so
complicated that nobody will do research trials? If we stop tenofovir,
we may stop something that could prevent millions of infections."
Separately, UNAIDS is holding global talks on the ethics of
prevention studies.
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NEW JERSEY: "Pascrell Joins Fight for Control of AIDS Funding"
The Record (Bergen County, N.J.) (05.17.05):: Tom Meagher
On Monday in Washington, an aide to Rep. Bill Pascrell Jr.
(D-N.J.) met with representatives of AIDS organizations that have
proposed changes to the Ryan White CARE Act.
Communities Advocating Emergency AIDS Coalition and AIDS Action
have put forth a plan for the act, which is up for congressional renewal
in September, to follow new federal metropolitan boundaries. The
boundaries, which are already used to determine funding for housing and
health care programs, would give control of Ryan White funds for
Passaic, Bergen, and Hudson counties to New York City. The federal
Office of Management and Budget placed the three counties in the New
York City area for legislative and funding purposes after the 2000
census.
Pascrell will work to gain the support of the full New Jersey
congressional delegation for allowing the AIDS money for the three
counties to be exempt from the boundary change, according to Sabrina
Glavan, his spokesperson.
Members of New Jersey planning councils have launched a drive
for an exemption to allow the area to remain autonomous. The Paterson
City Council last week joined the effort by unanimously passing a
resolution calling on state and federal officials to exempt the Bergen
and Passaic planning council from the change.
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International News
GLOBAL: "Gates to Donate Extra $250 Million for Health Grants"
Wall Street Journal (05.17.05):: Marilyn Chase
On Tuesday in Geneva at the opening of the World Health
Assembly, Microsoft founder Bill Gates announced that the Bill and
Melinda Gates foundation has boosted its commitment to provide grants
for scientists developing inventions to improve global health from $200
million to $450 million.
The cash goes to Grand Challenges in Global Health, a program
the foundation started in 2003. It expects to award the first round of
grants this summer, drawing from more than 1,500 project ideas from
scientists in more than 70 countries addressing a variety of health
needs. Ideas include vaccines that are needle-free or do not require
refrigeration; drugs to minimize resistance; and new technologies that
allow health aides to make diagnoses in resource-poor settings.
Gates challenged rich and poor countries alike to devote more
resources to major health crises and to make market forces and delivery
systems function better for the poor.
"The world is failing billions of people," Gates said. He urged
wealthy governments to match their funding commitments to the scale of
international crises such at TB and malaria, and he called on poor
countries to boost the portion of their gross domestic product devoted
to health. Gates suggested research funds be redirected toward saving
the greatest number of lives. At present, 90 percent of research and
development targets diseases affecting 10 percent of the world's
population.
Gates proposed focusing "more thinking and funding" on delivery
of health inventions, such as an HIV/AIDS vaccine, once they are
discovered. He urged countries to adapt systems and market forces to
better serve the poor in the developing world.
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CANADA: "Needle Exchange Came Too Late: Cushman"
Ottawa Citizen (05.16.05):: Carly Weeks
Dr. Robert Cushman, city medical officer of health, said
Ottawa's reluctance to give intravenous drug users (IDUs) clean needles
and syringes in the late 1980s is the main reason the city has more IDUs
with HIV and hepatitis C than Toronto, which adopted needle exchange in
1989. Ottawa waited until 1991 to give out clean needles and syringes.
Cushman said the delay only partly explains the current high
levels of infectious disease among Ottawa IDUs, pointing to the early
program limitations: strict rules and a limited number of needles for
distribution.
Of an estimated 3,000 to 5,000 IDUs in Ottawa, 21 percent have
HIV and 76 percent have hepatitis C, according to Dr. Lynne Leonard,
professor and research scientist at the university of Ottawa.
Paul Lavigne, coordinator of Ottawa Public Health's harm
reduction program, said Ottawa's late start with needle exchange and the
program's limitations helped make the city second only to Vancouver in
the number of IDUs with hepatitis C and HIV.
Although the needle-exchange program eventually expanded and
provided more needles, Cushman said treatment and rehabilitation options
for IDUs are still underfunded. He said the ongoing effort to secure
resources to fight Ottawa's drug problem reflects the fact that
downtown, where most of the problem is centered, is under-represented in
the council chamber.
Ottawa adopted an integrated drug strategy last week, aiming to
bring city officials, the police, public health, and other community
leaders together to combat the problem with a unified approach. The
strategy followed an intense debate between Ottawa Police Chief Vince
Bevan and Cushman regarding the city's crack pipe distribution program,
which began giving out crack pipes and other paraphernalia April 1 to
stem the spread of disease among users who share pipes.
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Medical News
UNITED KINGDOM; IRELAND: "Late HIV Diagnosis 'A Problem'"
BBC News (05.13.05)
A new study found that one-third of nearly 1,000 patients
learned they had HIV only when their CD4 cell count was low. The study
reported that 168 patients in the United Kingdom and Ireland had been to
a hospital with HIV symptoms a year before being diagnosed. Late
diagnosis, the study said, meant patients were missing out on drug
therapy.
Investigators who surveyed more than 100 HIV centers in the
United Kingdom and Ireland found that of 977 patients diagnosed with
HIV, 301 had CD4 counts below the threshold for starting drug therapy.
Black Africans and the elderly were more likely to have late diagnoses,
they found.
Lead author Ann Sullivan said people at risk of HIV should be
encouraged to be tested and that health care professionals need to be
more proactive. "To improve this situation, the proportion of people
diagnosed as having HIV as part of routine screening needs to increase,
with people at risk being encouraged to have an HIV test," Sullivan
wrote. "Health care professionals' awareness of factors associated with
late presentation of HIV infection and conditions likely to be related
to HIV also needs to increase."
Socioeconomic issues were cited by a spokesperson for the
Terence Higgins Trust: "HIV is well understood by the gay community. HIV
is stigmatized within the black African population, it is not really
talked about. And when you think about the more disadvantaged groups and
asylum seekers that may be having trouble with social care, housing or
immigration, HIV may not be such a priority." A Department of Health
spokesperson said attempts are underway to encourage early diagnosis.
The study, "Newly Diagnosed HIV Infections: Review in UK and
Ireland" appeared in the British Medical Journal (2005;
doi:10.1136/bmj.38398.590602.E0).
Back to Top Back to Top
Local and Community News
LOUISIANA: "Syphilis on Rise Among Gay Men"
Times-Picayune (New Orleans) (05.12.05):: John Pope
On May 11, state health officials met with community leaders to
discuss the sudden spike in syphilis cases among gay and bisexual men in
Louisiana. Cases in this group rose from three in 2002 to 88 last year.
Officials are worried about HIV/AIDS as well, since syphilis patients
are much more vulnerable to HIV.
In 2003, 465 Louisianans died from AIDS, according to Dr. Jason
Reed, supervisor of the state Office of Public Health's HIV surveillance
program. AIDS kills roughly 20,000 annually nationwide.
Meeting participants said AIDS mortality is an aspect of the
illness often disregarded by young gay and bisexual men - the people
most likely to contract STDs because of their tendency to ignore safe
sex practices. Attendees said young people think they are invulnerable,
and they are not old enough to have lost friends in the early years of
the AIDS epidemic.
"I'm seeing more and more HIV-positive gay men 19 to 30 years
old," said James Swire, coordinator of the NO/AIDS Task Force's
community outreach programs. "They need to be talked to."
CDC figures show that nationwide, gay and bisexual men accounted
for 5 percent of syphilis cases in 1999 and 60 percent in 2003.
Dr. Kevin Fenton, chief of CDC's syphilis elimination effort,
said in a telephone interview that use of illegal drugs such as crystal
methamphetamine is a factor contributing to the rise in syphilis cases.
"It has such a strong disinhibiting effect on sexual behavior that men
who normally would want to practice safe sex end up not caring," he
said. Fenton said the Internet "speeds up the process of meeting
partners and acquiring sexually transmitted diseases."
Meeting participants all agreed on the need for more aggressive
outreach and better access to treatment for STDs.
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News Briefs
GLOBAL: "Bush, Mandela Discuss Fighting AIDS, Debt Relief for
Poor Countries"
Associated Press (05.17.05)
Tuesday in Washington, President George W. Bush met with former
South African President and Nobel Peace Prize laureate Nelson Mandela to
discuss AIDS in Africa and debt relief for poor countries. According to
spokesperson Scott McClellan, Bush welcomed Mandela back to the White
House for a 20-minute talk. Bush told Mandela the United States is
committed to debt relief and said the issue will be addressed at July's
Group of Eight summit. At a brief speech Monday at the Brookings
Institution, a Washington-based think tank, Mandela said democracy is
spreading in Africa, but "true democracy cannot be imposed. It must be
homegrown and the product of consensus," said Mandela, who is in the
United States to seek support for the Nelson Mandela Legacy Trust, which
supports his Africa-based charities.
Back to Top Back to Top
MYANMAR: "Myanmar Launches UN-Sponsored Program to Prevent
Mother-to-Child HIV/AIDS Transmission"
Associated Press (05.17.05)
On Tuesday, UNICEF announced that the UN and the government of
Myanmar have launched a program to prevent mother-to-child HIV/AIDS
transmission. The program started at the country's 10 largest hospitals
and will gradually be extended throughout the nation, where HIV
infections continue to rise. HIV-positive women give birth to at least
3,000-4,000 HIV-positive children in the country every year, UNICEF
representative Carroll Long said in a statement. While Myanmar's
government says more than 300,000 of the country's 54 million people
have HIV/AIDS, UNAIDS estimates that more than 600,000 people ages 15-49
in the country have HIV. UNICEF spends an average of $2 million annually
to support HIV/AIDS prevention and care programs in Myanmar.
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FLORIDA: "Freedom High Student Has TB: Peers Tested"
Orlando Sentinel (05.18.05)
A Freedom High School student in Orange County has been
diagnosed with TB. Health officials will test some of the student's
classmates today for TB exposure. Bill Toth, an epidemiologist with the
Orange County health department, said the student has only been in the
United States for eight months; therefore, health investigators suspect
the disease transmission occurred abroad. Toth said about 85 students
who had close, regular contact with the teen have been identified for
testing. The students took home permissions slips and informational
material for their parents to sign and review. The infected student's
family is also being tested.
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OKLAHOMA: "Tulsa Elementary Student Tests Positive for TB"
Associated Press (05.18.05)
About 125 students and staff members of Mitchell Elementary
School will receive free TB skin tests from employees of the Tulsa
City-County Health Department on May 24. One student at the school has
tested positive for the disease. Following a health department protocol,
students and staff who were in enclosed classroom spaces with the
student, and those who rode the bus with the student, will be tested,
according to Pam Butler, director of health services for Tulsa Public
Schools. Anyone else who wants a test can request one at the health
department. Students identified for testing were sent home with consent
forms for their parents or guardians to sign. The TB case is the third
in Tulsa Public Schools in the last year.
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NORTH CAROLINA: "Teen Health Earns Challenge Grant"
Charlotte Observer (05.15.05)
The nonprofit Teen Health Inc. received a $15,000 challenge
grant from the Regional HIV/AIDS Consortium to implement its Focus on
Minorities prevention programs for adolescents in Iredell County. The
grant is funded through the consortium's partnership with the National
AIDS Fund and by the Elton John AIDS Foundation. The grant will help
fund Teen Health's Responsible Attitudes and Latino Outreach programs,
in which eight groups of teens meet at least once a week for classes and
activities. Since the organization began in 1996, the teen pregnancy
rate among 15- to 19-year-old girls in the county has dropped by 42.1
percent, the agency said. For information about Teen Health programs,
telephone 704-872-1023.
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_____
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