HIV/AIDS Newsroom: November 8, 2000
Realistic Priorities for AIDS Control
10/28/00; Vol. 356, No. 9240s, P. 1525; Nandy, Shailen; Scott, Robert
A letter from two scientists at the School for Policy Studies at the University of Bristol in the United Kingdom, responds to Ainsworth and Teokul's report on the effectiveness of national AIDS control programs in undeveloped countries. Shailen Nandy and Robert Scott note that the report did not mention the World Bank's Structural Adjustment Policies (SAPs), which were made to help debt repayments. Research has shown a link between SAPs and malaria's return, so a link to HIV is also possible. Countries that continue spend on debt repayments will continue to struggle with forming AIDS prevention programs, the authors conclude.
A new study of a seaweed gel that researchers hope will prevent the sexual transmission of HIV involves 165 women in Chiang Rai, Thailand. Dr. Khanchit Limpkanjanawat, the co-director of the HIV/AIDS Collaboration, which is being conducted with the Population Council, said the study will assess the safety of "carraguard," which is also known as lambda-carrageenan or PC-515. While the gel would not destroy HIV, the researchers hope it will keep the virus from entering blood cells. Speaking at a press conference to mark a decade of collaboration between the Thai Health Ministry and the U.S. Centers for Disease Control and Prevention, Dr. Khanchit said the participants were married women over the age of 18 with low HIV risk and whose husbands do not have any sexually transmitted diseases. Half of the women will receive the seaweed gel, while the other half will be given a comparative product. Thus far, no side effects have been reported. According to the CDC's Dr. Helene Gayle, if the product works, it will be necessary to work out an agreement with the various partners involved to make sure the gel is available at a reasonable price in all nations.
Condom Machines to Be Fitted [in Thailand]
Bangkok Post Online (www.bangkokpost.com)
11/07/00; Assavanonda, Anjira
Provincial health officers in Phayao, Thailand, plan to install condom vending machines throughout the region to help reduce the risk of HIV infection among local residents. The machines would provide greater access to condoms for teens, farmers, and others. Phayao has the nation's highest HIV rate, with 95 percent of cases transmitted through sex. Provincial health chief Dr. Phetsri Siriniran cited low condom use and casual sex as factors in the AIDS epidemic. A vending machine would help distribute condoms and reduce embarrassment for students and others.
States can quarantine or incarcerate individuals who pose public-health threats. In the case of tuberculosis (TB), the failure to complete treatment can result in multidrug-resistant disease, which can then be spread to others. While jail is an option for extremely difficult-to-treat patients, Dr. Robert Benjamin, medical director of the TB program in Alameda County, California, notes: "We take the abrogation of civil liberties very seriously, and we bend over backward on due process." Benjamin explains that some patients are instead ordered to stay in their houses and to not have visitors who have not been exposed. Such cases are relatively rare, but they can be especially worrisome in cities with high rates of infection. In San Francisco, the rate of TB among the homeless population is 200 to 400 cases per 100,000 people, according to Dr. Masae Kawamura, the city's chief TB control officer, while the overall city rate is approximately 30 per 100,000.
A program called Talking with Kids About HIV/AIDS helps parents reach their children before adolescence. The program involves six two-hour sessions that use role-playing and games to teach parents how to talk to their children about sex and AIDS. Dr. Jennifer Tiffany of Cornell University, where the program was created, said the goal is to save lives by preventing new HIV infections in young people. The curriculum for the program has been used throughout New York State, has been accepted by the World AIDS Foundation for use in Mexico City, and will be implemented soon in Miami.
A study from Dr. Carla Kuiken of Los Alamos National Laboratory in New Mexico suggests that the HIV epidemic among homosexuals and intravenous drug users in the West could have different sources. Kuiken and colleagues report in the American Journal of Epidemiology (2000;152:814-822) that they evaluated HIV-1 variants among homosexuals and drug users in Sweden, Norway, and Holland. The researchers discovered that the two groups had distinct HIV-1 variants, but the Swedish and Dutch drug users had common mutations and the sequences from homosexuals in Norway and Holland were virtually identical. Kuiken and colleagues theorize that HIV subtype B was carried from Africa to the Western homosexual community by one person, and the virus then spread to other risk groups and evolved independently.
Vietnam's deputy head of the national AIDS committee estimates that 140,000 to 165,000 people will be infected with HIV by the end of 2000. Nguyen Chung A reported that more than 26,300 cases of HIV have been diagnosed, and 4,305 people have developed AIDS. While the statistics are much lower than what some experts had predicted in the early 1990s, prevention efforts have been hampered by a reluctance to discuss sex in public and a high number of drug users who return to their habits after receiving treatment. Insufficient condom production and poor quality condoms are also problems in Vietnam.
Experts at the Association of South East Asian Nations (ASEAN) have opened a four-day meeting in Hanoi to discuss how to control AIDS in their regions. Vietnamese Health Minister Do Nguyen Phuong stated that AIDS is rapidly growing in Asia, although HIV detection rates remain low among the general population. Risk groups like prostitutes and drug users must be addressed at once, as low condom use and a lack of clean needles puts others at risk. A study from the Philippines shows that condoms are rarely used by sex workers, as demonstrated by high rates of syphilis among the prostitutes. "The number of encounters between HIV-positive [people] and vulnerable persons hasn't reached a critical level which can trigger an explosion," the study said. However, it also noted that complacency is dangerous, since "behavioral data shows that most high-risk individuals fail to take proper protective measures."
The annual water festival in Phnom Penh, Cambodia, will be under close watch by police, who want to discourage thousands of visitors from entering brothels. Municipal police chief Suon Chheangly said police will stand outside brothels to prevent visitors and reduce the risks of HIV. Prime Minister Hun Sen urged visitors to be wary of AIDS, as an estimated 200,000 of the nation's citizens are infected with HIV. The government will hand out up to 50,000 free condoms during the three-day festival.
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.