HIV/AIDS Newsroom: December 8, 2000
TB Surge in Japan Felt in High Places
Washington Post (www.washingtonpost.com)
12/08/00 P. A49; Coleman, Joseph
The per capita tuberculosis (TB) infection rate in Japan is 38.1 cases per 100,000 people, the highest rate among industrialized countries. In addition, the number of new TB infections in Japan increased last year for the third consecutive year, and the surge is forcing health officials to rush to update prevention programs and look for additional resources. The disease has made a comeback, and not even Japan's Imperial Household is immune from TB testing. Crown Prince Naruhito and Princess Masako were tested recently after an elderly attendant was diagnosed with TB. While the tests came back negative, another employee at the palace was hospitalized because of TB in mid-November. Some other countries fighting TB say their higher rates of infection are, in part, the result of the AIDS epidemic and a greater number of drug-resistant TB strains. In Japan, however, experts cite the country's increasingly elderly population as a key factor in the disease's surge. The number of Japanese age 65 or older accounts for some 17.3 percent of the population, and many survivors of the postwar days -- when TB was the No. 1 cause of death in Japan -- carry the tubercle bacillus. While most hosts will not develop the disease, it can become active and contagious as an aging individual's immune system weakens, thus putting other people at risk as well.
A new survey of more than 15,000 high school students from around the United States indicates that only 43 percent of teenage girls and 26 percent of teenage boys discuss pregnancy prevention or sexually transmitted diseases (STDs) with their doctors during routine exams. "Health care providers are missing very important opportunities," notes the Centers for Disease Control and Prevention's Dr. Judith Wasserheit. The CDC's survey also found that older teens and those who are sexually experienced are more likely to have discussed STDs and/or pregnancy with their physicians, compared to younger teens or those who have not yet had sex. The study was discussed Wednesday at the CDC and American Social Health Association's National STD Prevention Conference in Milwaukee. Dr. Sheldon Wasserman, a gynecologist in Milwaukee and a speaker at the conference, says he makes it a point to discuss sex with each of his teen patients, and he had found that most are relieved to have the subject brought up. "They want you to" begin the discussion, he notes. "They're there for a reason."
18 Percent of Women in U.S. Carry Cervical-Cancer Virus
Deseret News (www.deseretnews.com)
12/07/00; P. A9
The Centers for Disease Control and Prevention reported this week that almost 18 percent of women in the United States and 8 percent of American men carry the human papillomavirus (HPV). More than 95 percent of cervical cancer cases are caused by the virus, and the HPV-16 strain causes half of those cases. According to the research, the highest rates of HPV-16 infection were among African-American women between the ages of 20 and 29. In all, about 12.5 percent of whites and 19.1 percent of African-Americans carry HPV-16. Dr. Judith Wasserheit, director of the STD Prevention Program at the CDC, said that HPV is the most common sexually transmitted disease among young people who are sexually active.
In Denver, health officials and Planned Parenthood workers are distributing this week 1,775 silk purses filled with condoms in an effort to reduce teenage pregnancy and sexually transmitted diseases (STDs). The workers are attaching condom-use information to posters of steamed-up couples on the backs of restroom-stall doors at area teen dance clubs, coffeehouses, community clinics, and clothing stores. The fliers that contain the condom information also include coupons for a silk purse filled with three male and two female condoms. The coupons can be exchanged at a number of area sites. The program is part of a $180,000 Centers for Disease Control and Prevention-funded study that aims to prevent unintended pregnancies and STDs. "We don't expect with a campaign like this we can change actual behavior," explained Sheana Bull, a behavioral scientist for Denver public health. "But changing attitudes is the first step."
U.S. Secretary of State Madeleine Albright's trip to Africa this week is intended to draw attention to thriving economies, the AIDS epidemic, and women's rights on the continent. Today, Albright is slated to meet with Nobel Peace laureate Desmond Tutu, South African President Thabo Mbeki, and female political and business leaders. She is also expected to visit an HIV research unit. Albright will then fly to Mauritius and will end her trip in Botswana, which has been extremely hard-hit by AIDS.
More than 100 experts are gathering in Japan this week to participate in the Okinawa International Conference on Infectious Diseases. In an opening speech, Zambia's president, Frederick Chiluba, called for increased efforts, resources, and political will to fight infectious diseases. The meeting follows the Group of Eight (G-8) nations' pact made earlier this year in Okinawa to battle infectious diseases including HIV, tuberculosis (TB), malaria, and polio. At that meeting, the G-8 officials announced an objective to reduce the number of HIV and AIDS cases among 15- to 24-year-olds by 25 percent in 10 years, and they also set goals for reducing TB and malaria.
Toronto health officials report that nine high school students have tested positive for non-contagious tuberculosis (TB). The diagnoses follow the discovery of active TB in a 17-year-old North Toronto Collegiate Institute student. Nearly 200 students and staff members were tested for TB as a result, and these individuals will be retested in three months. Sharon Pollock, Toronto public health unit's TB manager, noted that "the nine individuals may not have contracted TB from this student, but could have contracted it in the past. These are not active cases."
A new report from Vietnam's Anti-Social Vices Department indicates that 21.6 percent of Hanoi prostitutes are infected with HIV. The Tuoi Tre (Youth) newspaper quoted the report as comparing this rate with an infection rate of 2.8 percent in 1998; however, no total figures were provided. Approximately 70 percent of the prostitutes in Ho Chi Minh City are between the ages of 18 and 25, up from 43 percent four years ago. The report also said that there are estimated 40,000 prostitutes in Vietnam, although the number could be much higher since many women who work as waitresses in the county are willing to provide sexual favors.
The AIDS epidemic in Africa faces many obstacles, but the chief one is finding affordable antiretroviral drugs to prevent HIV transmission to newborns and to treat those already infected. Most developed nations now routinely offer antiviral therapies to HIV-infected mothers; however, there are few clinics in Africa that can offer the drugs to these women. Cost is a determining factor, as the drugs often cost more than many Africans' salaries. Five companies have agreed to cut their drug prices to Africa by 80 percent, but that alone will not be a solution. According to David Bloom, a professor at Harvard University School of Public Health, AIDS is tied into poverty and a lack of health infrastructure. Lower drug costs must be accompanied by testing to measure the drugs' success in each patient. Rampant poverty in South Africa makes the drug AZT unattainable. With the help of a discounted price, AZT costs 40 cents for each 100-milligram pill. Nevirapine is another drug that offers hope to prevent HIV transmission to infants. It requires only three doses and has been shown to reduce transmission to 14 percent for a trial of 652 pregnant women. AZT, by contrast, requires months of treatment. South Africa has not accepted an offer of nevirapine from Boehringer Ingelheim, as Health Minister Manto Tshabalala-Msimang said they do not believe the only answer to AIDS is antiretroviral therapy. The government's plan to prevent HIV is to treat AIDS-related infections, and form home-based care, she said. Tshabalala-Msimang noted that even an 80 percent reduction in price would still not be affordable for the 4.2 million HIV-infected individuals in South Africa. If the issue of price is ever overcome, patients would then face the need for resistance testing. HIV's ability to mutate quickly requires careful monitoring of a patient's therapy. Testing CD4 cells and viral load is expensive, however, and not stressed in places like Thailand. Christopher Ouma, a worker for Doctors Without Borders in Nairobi, Kenya, believes Africa cannot wait for viral load testing to become the norm, since they need the drugs now. And even after antivirals become widely available to Africa, the trick will be adhering to the difficult therapy, which requires a strict timetable and food requirements.
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.