HIV/AIDS Newsroom: January 17, 2001
Physician-Patient Communication in HIV Disease: The Importance of Patient, Physician, and Visit Characteristics
Journal of Acquired Immune Deficiency Syndromes (www.jaids.com)
12/15/00; Vol. 25, No. 5, P. 417; Wilson, Ira B; Kaplan, Sherrie
Researchers from the New England Medical Center and Tufts University School of Medicine recently evaluated patient-to-doctor communication regarding HIV. The study involved 264 male and female patients and their physicians in eastern Massachusetts, measuring communication based on a five-item general communications scale and a four-item HIV-specific communication scale that discussed alcohol, drug use, and sexual behaviors. According to the authors, HIV-specific communication was at a higher level between the female patient and homosexual physician, than between the male patient and heterosexual physician. The researchers concluded that better quality HIV-specific communication was provided by female and homosexual physicians than by male and heterosexual physicians. They note that understanding how female and homosexual doctors communicate better may help other doctors be more effective.
Visible Genetics, a Toronto-based company, has created a test that sequences HIV genes, helping doctors to identify which drug therapy will be best for a specific patient's infection. The company has also developed a desk-top sized gene sequencing machine, that company CEO Richard Daly would like to see in every doctor's office. Daly, who hopes to receive U.S. Food and Drug Administration approval of the machines this year, plans to give away the small sequencers to clinical labs, hospitals, and doctor's offices, selling only the test kits that run on the sequencing machines. Whether a particular type or several different types of gene testing will ever become a lucrative business and appropriately effective in the fight against the spread of HIV has yet to be determined. But proponents of the gene testing systems are beginning to see supporting documentation coming in from clinical trials. Doctors have attested to the effectiveness of gene testing when trying to choose the appropriate and most effective drug therapy program for their HIV patients. This type of gene testing is also considered a model of the future for fighting other diseases as well.
Cases Settled Against Two AIDS Test Makers
USA Today (www.usatoday.com)
01/17/01; P. 6D; Healy, Michael
A settlement was reached on Tuesday with Chembio Diagnostic Systems and Alfa Scientific Designs, two manufacturers of unapproved HIV test kits retailed via the Internet, and the U.S. government. Two years ago, the Federal Trade Commission -- which regulates health product advertising -- launched a crackdown of unapproved home HIV tests, warning that such tests sold over the Internet could provide false results. Thus far, six marketers have been cited by the agency for selling unapproved home HIV tests. The Food and Drug Administration has given approval to only one home HIV test kit, Home Access Health Corp.'s Home Access Express HIV Test System.
New findings from the Institute of Medicine (IOM) indicate that healthcare workers and others are not as likely to contract active tuberculosis (TB) while on the job due to falling TB rates throughout the United States and improved infection control measures. The IOM's Committee on Regulating Occupational Exposure to Tuberculosis said that active TB rates among health care workers were similar to those reported for other workers. The Centers for Disease Control and Prevention updated its guidelines for TB prevention in health care facilities in 1994, following a resurgence of TB cases in the late 1980s and early 1990s that cause outbreaks in hospitals and prisons. The IOM's report noted, however, that workers are not risk-free and that it is important to be vigilant in the fight against TB, even while rates are falling.
A recent study in the journal AIDS (2000;14:2769-2779) found that training health care workers and providing patients with educational packets can improve sexually transmitted disease (STD) case management in rural parts of South Africa. Investigators from South Africa's Medical Research Council randomly assigned five clinics to an intervention group and five to provide standard care. As part of the intervention, health care workers were taught about a comprehensive approach to STD management, including the distribution of an informational packet that contained a list of recommended treatments for each condition, condoms, partner information cards, and patient information. The researchers found that 83 percent of the simulated patients (associated trained to act as patients) in the intervention group were properly managed and 68 percent received sufficient counseling, while only 12 percent of the simulated patients in the control clinics were correctly managed and less than half received adequate counseling.
In an effort to fight the spread of HIV and tuberculosis (TB) in northwest Russia and the Baltic states, Norwegian officials have called for financial assistance from wealthy Nordic nations and Germany. Prime Minister Jens Stoltenberg reported that the number of HIV cases in some Baltic states and around St. Petersburg have increased significantly since early last year, while the number of drug-resistant TB cases is also on the rise. Stoltenberg said that fighting poverty was a key factor in the battles against both AIDS and TB.
Clinical trials are set to begin in the United States for a new HIV drug developed by Zeria, a Japanese drug maker. Originally, the drug -- sold as "Ancer 20 Injection" in Japan -- was developed to maintain white blood cell levels in patients receiving radiation treatments, but more recent studies indicate that it may also be effective in the treatment of HIV, apparently blocking the virus from entering healthy cells.
Britain's Cancer Research Campaign (CRC) has announced plans to initiate human trials of a new vaccine against cervical cancer. The vaccine is intended to boost the body's immune system against human papillomavirus (HPV), which is associated with 95 percent of cervical cancer cases. In the initial trial, 24 women will receive different doses of the vaccine to see how their immune systems respond. Results of study will be available in mid-2002, and, if successful, the CRC and the Imperial Cancer Research Fund will launch a larger trial to see if the optimum dose helps prevent HPV infection.
Researchers from the University of Maryland Biotechnology Institute announced that an AIDS vaccine is now in the pre-clinical trial stage of animal testing. The experimental vaccine was developed from pieces of HIV subtypes found in Nigeria and then combined with a non-toxic form of Salmonella bacteria, according to lead researcher Simon Agwale.
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.