HIV/AIDS Newsroom: August 31, 2000
Public Health in Europe
08/19/00 Vol. 356, No. 9230, P. 665; McKee, Martin; Jacobson, Bobbie
Public health issues in Europe vary by country, but tuberculosis (TB) and AIDS continue to plague many areas, including Russia and Eastern Europe. In Russia, TB deaths have reached a level seen 20 years ago, due to the poor prison system and increasing rate of HIV. Russia's criminal justice system is near collapse, and the overcrowded conditions are ideal for the spread of TB. Those patients who receive drug treatments can remain infectious, and multidrug-resistant strains of TB have become common. Contributing to the problem are a struggling health budget and outdated technology. The World Bank has responded to Russia's needs with a loan to help control AIDS and TB; however, effective strategies must be in place to prevent infections that resist second-line drugs. TB rates are also increasing in a number of Western European cities, including London. In these cities, the incidence of the disease is strongly associated with indices of deprivation.
A member of parliament in England, Dr. Evan Harris, will on Thursday be the first human to receive a new experimental vaccine against AIDS. If the vaccine is found safe, it will be given to subjects in Nairobi, Kenya, in about three to six months. The experimental DNA vaccine, being tested by Britain's Medical Research Council, is designed to fight the type A strain of HIV seen in Africa. Dr. Andrew McMichael, who is leading the trials, said the researchers will first measure the immune response of healthy volunteers to the vaccine, and they ultimately hope to test it in people at high risk for HIV infection.
Council to Revisit Needle Exchange Plan
Washington Post--P.G. Extra (www.washingtonpost.com)
08/31/00 P. M3; Schwartzman, Paul
In Maryland, the Prince George's County Council will hold a public hearing in the next six weeks to discuss if the county should begin a needle exchange program. Six months ago, council member Peter Shapiro (D-Brentwood) and Thomas Hendershot (D-New Carrollton) proposed the idea to allow drug users to trade dirty needles for clean ones. Approximately one-third of the county's 1,400 AIDS cases are related to intravenous drug use. While critics of the proposal are concerned that the needle exchange may attract more addicts to the area, health experts assert that such programs can stem the spread of infectious diseases. In Baltimore, the number of new HIV infections has dropped by 35 percent since a needle exchange was launched there six years ago.
The Los Angeles Board of Supervisors has declared a public health emergency in Los Angeles County, clearing the way for a legal needle exchange program. The declaration is the first step required under state law to allow clean needles to be traded for used ones. Dr. Jonathan Fielding, the county's public health director, said the benefits of an exchange extend beyond HIV prevention. "Needle exchange programs attract the high-risk, hard-to-reach addicts. ... It's an opportunity to get them into treatment." While Republican supervisor Mike Antonovich claimed that needle exchanges are "reckless and destructive," medical experts testifying before the board on Tuesday asserted that is not true. Fielding cited studies that showed that needle exchanges in cities like Seattle and New York did not spread HIV or other blood-borne infections. In addition, Ferd Eggan, the city of Los Angeles' AIDS coordinator, said that over 5,000 people in the city used nonprofit needle exchanges in 1999, and 4,000 of them received treatment in addition to clean needles, ranging from receiving on-site medical check-ups to enrolling in drug addiction programs.
Health professionals and education experts are perplexed as to why today's informed teenagers are still having unprotected sex. According to Health Canada, the chlamydia rate for females ages 15 to 19 was six times that for males in 1996, and nine times above the national rate. Chlamydia and gonorrhea rates remain alarmingly high in Canada. The higher sexually transmitted disease (STD) rates among women could also be a result of better and more frequent testing of females. Dr. Barbara Romanowski, the acting medical consultant to Alberta Health's STD program, suspects that herpes and HIV are also being spread among teens. Researchers from the University of Alberta are forming a national survey on youth sexual health to question students about their sexual attitudes and behavior. A total of 35,000 students will take part, and the findings will be used to design sex education programs.
Patients in Canada's tainted blood scandal have reluctantly agreed to a C$79 million compensation deal that will clear the Canadian Red Cross Society of any liability. The individuals involved in this case were infected with hepatitis C or HIV either before 1986 or after 1990, thus making them ineligible for the federal-provincial compensation plan announced two years ago. The groups that voted on the package were creditors, hepatitis C and HIV patients, and government agencies with a claim against the Red Cross. According to Bob Rae, the chief negotiator for the Red Cross, because there are an estimated 5,000 to 7,000 eligible hepatitis C patients in Canada, they will receive less than C$12,000 each. The 75 eligible HIV-infected individuals will share C$14 million.
Researchers from the University of California at Los Angeles (UCLA) have found why HIV infection flourishes in the gut instead of in blood circulating in the body's periphery. Dr. Peter Anton, an associate professor of digestive diseases at UCLA, and colleagues report in the August issue of AIDS that immune system cells in the gut are more receptive to HIV, as T-cells there have six times the number of receptors compared with circulating blood cells. Dr. Anton noted that, based on monkey studies, wherever HIV enters the body, viral cells head to the gut. The scientists said this helps to explain why unsafe sex is so dangerous, because HIV can enter through a minute tear.
A survey by the Chinese University in Hong Kong interviewed 252 heterosexual men and 85 gay men ages 18 to 60 who visited prostitutes within the previous six months. The survey found that only 41 of the heterosexual men and 13 of the gay men had been tested for HIV. Nearly one-third of the men who had not yet been tested said they were afraid of receiving a positive result.
A major hospital staff deficit in Nyanza, Kenya, stems from the fact that four out of ever 30 nurses in the region have HIV-related illnesses, according to Provincial Medical Officer Dr. Ambrose Misore. Dr. Misore noted, "Every weekend we raise funds for staff funerals. Because there is an embargo on employment, we are forced to operate on an increasingly lean staff." The official also said that Kenya's falling sugar supply is related to the AIDS epidemic, as many young farmers in the sugar belt have died from the disease.
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.