HIV/AIDS Newsroom: November 30, 2000
The Cost-Effectiveness of Elective Cesarean Delivery for HIV-Infected Women With Detectable HIV RNA During Pregnancy
AIDS Online (www.aidsonline.com)
11/10/00; Vol. 14, No. 16, P. 2543; Mrus, Joseph M.; Goldie, Sue J.; Weinstein, Milton C.; et al.
The University of Cincinnati Medical Center evaluated the cost-effectiveness of Cesarean delivery for HIV-infected women during pregnancy. Comparing elective Cesarean section and vaginal delivery, the researchers used the HIV transmission rate, maternal death rate, and quality of life as factors during the study. The results showed that elective Cesarean section led to an HIV transmission rate of 34.9 per 1,000 births, compared to 62.3 per 1,000 vaginal deliveries. The elective C-section was more cost effective, but it also had increased risk of maternal mortality by 2.4 deaths per 100,000 deliveries. Overall, the researchers concluded that "in pregnant women with detectable HIV RNA, elective Cesarean section would reduce total costs and increase overall quality-adjusted life expectancy for the mother-child pair, albeit at a slight loss of quality-adjusted life expectancy to the mother."
Religious leaders from around the world will gather in Washington, D.C., today for the first World AIDS Day Summit, a four-day conference organized by the White House Office of National AIDS Policy to increase assistance for faith-based groups that are working to fight AIDS. Sandra L. Thurman, the office's director, explained that the meeting hopefully will encourage governments, businesses, and foundations to give more to faith-based organizations battling the epidemic. One of the leaders attending the conference, Anglican Archbishop of Capetown Njongonkulu Ndungane, said there is growing concern in South Africa about the AIDS epidemic's effect on economic growth. The archbishop called on his government to create "a war strategy" to fight the disease, including working to end the stigma surrounding AIDS. Summit participants will meet with President Clinton at a reception today, and then they will hold an open interfaith service "of healing, hope, and remembrance" at St. John's Episcopal Church in Lafayette Square.
Public Citizen, Union Urge Needle Ban
USA Today (www.usatoday.com)
11/30/00; P. 10D; Healy, Michelle
Public Citizen, a consumer group, and the Service Employees International Union called on the U.S. Food and Drug Administration Wednesday to ban some needles, catheters, and other sharp instruments that could injure health care workers. The two groups argued that the products could be replaced with safer alternatives. Each year, approximately 590,000 nurses, physicians, and other health workers in the United States are accidentally stuck by needles. Public Citizen's Sidney Wolfe noted that as a result of the needle sticks, thousands have contracted hepatitis C and at least 49 have contracted HIV.
A new report suggests that using traditional factors -- such as race, income, and family structure -- to forecast self-destructive behavior among adolescents is difficult. The survey of 10,000 students between the ages of 12 and 17 concluded that school performance and spending a lot of unsupervised time with friends is a better measure of whether teens will engage in such behaviors as smoking, drinking, having sex early, or attempting suicide. Using statistics from the National Longitudinal Study of Adolescent Health, which was funded by 18 federal agencies and analyzed by researchers at the University of Minnesota Medical School, investigators found a greater prevalence of violence than expected. The study also revealed that many young people have a drinking problem, with about 10 percent of youths reporting that they drink weekly. Fewer than one in five seventh and eighth grade students reported having had sex, compared to nearly two out of three juniors and seniors.
Researchers report in the Proceedings of the National Academy of Sciences that a new tuberculosis (TB) vaccine could be ready for human tests next year. According to Dr. Marcus Horwitz, a professor at the University of California at Los Angeles and the lead author of the study, the new vaccine is very potent and protected all the guinea pigs tested against TB; guinea pigs develop TB similarly to humans. The scientists genetically engineered the existing BCG vaccine so that it produced the major secretory protein of the organism that causes TB. Horwitz noted that the new vaccine would be inexpensive and easy to administer, and UCLA is in talks with drug manufacturers to produce and test the product in humans.
U.S. Surgeon General David Satcher stated Tuesday that the benefits of antiretroviral treatments outweigh any risks involved. Speaking at a press briefing in Pretoria, Satcher said the drugs have been especially useful in preventing mother-to-child HIV transmission in the United States, and also for treating people with AIDS. The price of the drugs is high, Satcher admitted, and he noted that South Africa and the United States are in very different situations regarding the affordability of the medicines. The surgeon general did say, however, that Brazil is in a very "similar [socioeconomic] place" to South Africa, and that country's government has established the necessary infrastructure to provide the drugs and also reduced the price of the treatments by manufacturing them locally. The briefing was for the Health Working Group of the US-SA Bi-National Commission's special meeting on HIV/AIDS, which was chaired by Health Minister Manto Tshabalala-Msimang and Satcher. The two officials signed a joint agreement for better financial and political cooperation on AIDS.
On Friday, World AIDS Day, 100 truck drivers will participate in a special procession to South Africa's Department of Transport, to highlight the spread of HIV infection among drivers in the country. According to Marlea Clarke, a University of Capetown researcher, three truck drivers die every day from AIDS-related conditions. There are concerns that the drivers could be one of the groups that have a key role on the spread of the virus in South Africa, as prostitutes line major highways. Clarke noted that the average truck driver spends three days or less at home every month, and "there is [a] flourishing commercial sex network along the freeway system in the region." Clarke said that mine workers, who also visit sex workers frequently, are at risk for HIV infection as well.
A new report from the Chinese Ministry of Health and the People's University of China indicates that only 3.8 percent of Chinese are aware of how HIV is transmitted. According to the Guangming Daily, the survey -- which involved more than 3,800 people between the ages of 20 and 64 -- found that more than 50 percent of respondents thought they could become infected if they used chopsticks and bowls that an AIDS patient had used. Many respondents also cited sneezing and hand-shaking as possible modes of transmission, and about 45 percent thought that using a condom would not help prevent HIV infection. Conservative attitudes have made promoting sex education difficult in China, and advertising condoms is thought to encourage promiscuity.
New statistics show that 787 cases of HIV and 50 cases of AIDS have been diagnosed in Kuwait since 1984. According to Dr. Rashid al-Owaish, the head of Kuwait's public health department, more than 3.6 million HIV tests have been administered, primarily on expatriates coming to work in the country. Owaish did not say how many nationals had been infected; however, recent figures indicate that over 20 Kuwaitis have died from AIDS and 70 have tested HIV-positive in the past 16 years.
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.