HIV/AIDS Newsroom: January 16, 2000
The Context of HIV/AIDS Surveillance
Journal of Acquired Immune Deficiency Syndromes (www.jaids.com)
12/15/00; Vol. 25, No. 2, P. S97; Valdiserri, Ronald O.; Janssen, Robert S.; Buehler, James W.; et al.
Researchers from the National Center for HIV, STD, and TB Prevention at the Centers for Disease Control and Prevention discuss the context of HIV/AIDS surveillance, including how it has changed in response to increased understanding of HIV-related disease, the diagnosis and clinical management of infection, and the groups affected by the disease. Surveillance is the oversight for an entire population and is used to design and implement national policies; direct resources; and plan, focus, and assess prevention and healthcare programs. The information accumulated through surveillance shapes public awareness and response to the AIDS epidemic in the United States, but must continually keep abreast of the characteristics and trends attributable to the rapidly spreading disease. One key aspect of HIV/AIDS surveillance is the confidentiality of the data. The authors note that in response to confidentiality concerns, "the CDC has required that state/local health departments strengthen their security standards, supported additional efforts to strengthen privacy protections to public health data, and made strong public policy statements about the necessity of maintaining anonymous testing options."
Researchers studied maternal and cord samples from HIV-seropositive women and their infants in Zimbabwe to assess the frequency of HIV RNA and DNA detection. The authors used nested envelope PCR and a quantitative method using an Amplicor HIV DNA assay to study 27 maternal and 28 cord samples. According to the report, HIV RNA was detected in 90 percent of maternal and nearly 40 percent of cord plasma at levels of at least 25 percent of maternal plasma. Testing confirmed that the samples were all most closely related to HIV-1 subtype C in the envelope. The researcher suggest that "studies of [cord blood] with measurement of maternal and infant plasma viremia and characterization of maternal and infant virus may clarify the timing of transmission among infants who are infected despite treatment and the mechanism(s) by which antiretroviral drug treatments reduce mother to child transmission."
AIDS-Drug Makers Sue in South Africa Over Patent Law
Wall Street Journal
01/16/01; P. B12
The South African pharmaceutical manufacturers association is suing the government over legislation that allows cheap versions of patented AIDS drugs to be imported or produced locally. Phil Thomson, spokesman for GlaxoSmithKline, says that his company is specifically opposed to the South African law that allows patents to be ignored by the health minister. The government maintains that the nation relies on inexpensive drugs to fight the growing AIDS epidemic within its borders. Few of the 25 million people in sub-Saharan Africa infected by the AIDS virus have access to antiretroviral drugs.
Chengdu, the capital of Sichuan province in China, has adopted a new legislature that directly effects people who are HIV-positive. The recent Chengdu City AIDS Prevention and Management Regulation, slated to begin in May, will ban HIV patients and people who have tested positive for the virus to marry. In addition, the new law requires police to test all arrestees of high-risks groups for HIV and those that test positive must be incarcerated separately from the others. The new law also mandates HIV testing for Chinese citizens who have been residing abroad for more than one year, and furthermore encourages HIV-positive women who become pregnant to have an abortion if treatment for the prevention of transmission of HIV to the infant is not available. Despite the fact that China is well known for promoting "genetically superior" births, the strict new legislature has created a public stir.
In an effort to appease protesting church groups who felt the advertisements were too offensive, Zambian officials recently suspended health infomercials regarding HIV and safe sex. This action has caused concern among foreign aid donors who are in doubt now as to whether Zambia is truly committed to fighting the spread of HIV. The nation currently cares for 520,000 children orphaned by HIV to date, with the number predicted to increase to 974,000 by the year 2014.
GlaxoSmithKline has developed a new drug treatment for HIV, which will be available this Tuesday. The drug called Trizivir combines three standard therapies of zidovudine, lamivudine and abacavir into one dosage. The combination pill is more suitable for a long-term commitment to the treatment of HIV, eliminating the need for taking as many as seventeen pills per day at certain times. Current HIV patients of the old regiment of multiple pills per day say that they are more likely to maintain their therapy with only having to take one pill per day.
An HIV-positive man recently spent 39 days in a Boca Raton jail until the woman he had sex with months ago was pronounced HIV-negative. If the woman had been found HIV-positive, Jose Pagan could have been facing attempted murder charges, based on a 1996 Florida legislature act that contends that uninformed HIV-infected sexual intercourse is a third degree felony.
Atlanta school districts are reacting cautiously to the findings of recent studies regarding teenager abstinence with a careful review of possible additions to their new curriculums. Proponents of the True Love Waits program which proposes sexual abstinence believe the program is effective in that recent figures from the Centers for Disease Control and Prevention indicate that between 1991 and 1997 the number of sexually active teens decreased from 54 percent to 48 percent, while the use of condoms increased to 57 percent, up from 46 percent. While some parents are encouraging the addition of abstinence pledges into the normal curriculum, CEO and President of Planned Parenthood of Georgia, Kay Scott, feels that more comprehensive sex education programs, ones that teach prevention against sexually transmitted diseases (STDs) and pregnancy, are by far, the most overall effective. The CDC reports that HIV remains the primary killer among teens and young adults, as 3 million cases of STDs and 1 million pregnancies among teens continue to occur each year.
South Africa exemplifies the AIDS plight facing most of sub-Saharan Africa, where 25 million of the world's 34 million AIDS-infected people live, yet just 25,000 receive any kind of antiretroviral drug -- one hundredth of one percent. In an attempt to relieve some of the suffering, Zackie Achmat, an HIV patient himself, openly flew to Thailand, purchased some 5,000 doses of Pfizer's drug Biozole for the treatment of AIDS-related fungal infections, and brought them back to the country, giving them to the South African government to treat a few more patients for just 15 pence apiece, compared to the set price of 9 pounds per pill. Achmat made the journey not only to bring the medicines into South Africa at a cheaper price but also to bring awareness to the prohibitively high prices associated with AIDS drugs: "I think it's immoral that people are dying just because they're poor," he whispered from his own sickbed at home. Yet instead of showing compassion, major pharmaceutical companies like GlaxoSmithKline and Pfizer will be suing South Africa on March 5 for violation of their intellectual property rights, rights that prevent other companies or countries from producing the same drugs for a period of time and that the companies claim have been violated by South Africa's laws that allow such production and importation, providing drugs at a much lower price and undercutting the profits of the multinational firms.
Delegates present at the American Medical Association (AMA) Interim Meeting in December agreed to support the decision of the Food and Drug Administration if it decides to allow drug manufacturers to distribute emergency contraception (ECP) over the counter. If taken within 72 hours of unprotected intercourse, the ECP will inhibit or delay ovulation or induce changes in the endometrium that will in turn weaken implantation. Some critics, however, voiced concern that over-the-counter access would not ensure that recipients understand that the pill does not prevent sexually transmitted diseases.
This article was provided by CDC National Prevention Information Network. It is a part of the publication CDC HIV/Hepatitis/STD/TB Prevention News Update.