NEWS 'n NOTES

Needle Exchange | AZT Flaw | Cunanan's Motive? | Morning-After |
| Bye, Bye Confide | AIDS Money | Positive Blood|

We Want Needle Exchange!

The needle exchange debate is heating up on the federal level in July with the American Medical Association and the U.S. Conference of Mayors both calling for the federal government to lift the ban on funding for needle exchange programs. "The federal ban on funding for needle exchange impedes states and local communities from implementing HIV prevention strategies that have been scientifically proven effective," a resolution sponsored by San Francisco Mayor Willie Brown and L.A. Mayor Richard Riordan, and passed by the mayor's group, said. Although the AMA had previously "encouraged" needle exchange programs, this decree was broader. The AMA's House of Delegates voted to work with Congress to develop legislation revoking the ban on federal funding of programs and to urge state medical groups to initiate state bills to relax drug paraphernalia laws. "There's more and more evidence that the advantages of needl exchanges outweigh the disadvantages," said Dr. Nancy Dickey, chair of the AMA's board of trustees and president-elect of the association. If the ban continues to the turn of the century, the AMA noted, the United States would have failed to prevent 11,000 cases of AIDS at a cost of $630 million for medical care. Despite the good sense exhibited by these two prestigioous organizations, we hear the Republicans on the House Labor-HHS-Education Appropriations Subcommittee want to pass legislation that would remove U.S. Secretary of Health and Human Services Donna Shalala's authoity to lift the federal ban. It's critical that you call Subcommittee members Dan Miller (R-FL) at (202) 225-5025 and Bill Young (R-FL) at (202) 225-5765, and tell them to protect the HHS Secretary's waiver authority over the federal ban on needle exhange programs. [News brief provided by New York Citizens AIDS Network, a grassroots advocacy project of the Public Policy Department of Gay Men's Health Crisis.]

AZT Loses Credibility

AZT is not as effective as was originally believed due to the discovery of a flaw in its chemical structure. According to research reported in the August issue of Nature Medicine and Nature Structural Biology, AZT is not as effectively metabolized in the body, so less of the drug is converted to a form that can aggressively attack the virus. Antiviral therapies such as AZT and d4T are drugs called thymidine analogs and in combination therapies are often combined with drugs like ddII, ddC and 3TC that are non-thymidine drugs. Researchers credit d4T as a more effective treatment then AZT because it was developed to more closely resemble the natural thymidine substance. According to Calvin J. Cohen, M.D., research director, Community Research Initiative of New England, "It is important that physicians and patients understand and consider the similarities and differences between the available thymidine anologs when making treatment decisions. It's no secret that AZT has not always been held in high esteem by people who have used the drug, still it was the first thymidine drug that offered hope for and an extended life to people suffering from AIDS.

Surprise, Surprise, No AIDS For Cunanan?

"Florida statutes do not permit me or my office, without a court order, to confirm or deny that an HIV test has been performed on any person, or to disclose any test results if they exist," said State Attorney Katherine Fernandez Edwards when asked to confirm a report printed in the Miami Herald that Andrew Cunanon did not have AIDS. According to the Herald, law enforcement personnel, under the condition of anonymity, revealed that the Dade County Medical Examiner's office concluded that Cunanan was not HIV-positive. Cunanan is believed to have begun a five person murder rampage when he learned he was HIV-positive. Gianni Versace, one of the fashion industry's most renowned designers, was allegedly killed by Cunanan on July 15 in Miami Beach. Cunanun, said to be a gay prostitiute, also allegedly murdered two of his former lovers and two other people before taking his own life. If the Herald's report is correct, the question of motive remains a mystery.

Feds Concerned about The Morning-After

The new "morning-after" treatment that was reported in use in San Francisco in Body Positive's June 1997 issue is being viewed with caution by U.S. Federal health officials. "It is not the morning-after pill" stated Dr. Robert Janssen, deputy director of the Centers for Disease Control and Prevention's Division of HIV/AIDS Prevention, Surveillance and Epidemiology. Federal officials are fearful that people will use "morning-after" treatment as an excuse to stop practicing safer sex and that the virus will become more resistant to the drugs when used almost instantaneous by injecting drug users, rape and child sexual abuse victims, people who are having sex and won't use condoms and prisoners. Janssen cautioned, "It's not a justification for turning the clock back on over a decade of behavior change. And it's not going to stop the HIV epidemic dead in its tracks." The cost for post-exposure drug therapy can run between $600 to $1,000, must be taken on a strict regimen for four weeks, and is typically not covered by insurance.

Medical Savings Account and Medicare

The federal budget reconciliation process includes a provision that would introduce medical savings accounts (MSAs) into the Medicare market. This would expose people with HIV and other disabilites to high out-of-pocket costs, erode quality for people with traditional Medicare coverage and drain dollars from the Treasury. The Senate Fiance Committee, however, adopted an amendment to minimize the impact of MSAs by reducing the demonstration siz, lowering deductibles and capping out-of-pocket expenses. [News brief provided by New York Citizens AIDS Network, a grassroots advocacy project of the Public Policy Department of Gay Men's Health Crisis.]

Confide Died

Johnson and Johnson maintains that it pulled its home HIV test, Confide, off the market because of poor sales. A New York Times article, however, revealed that the Federal Drug Adminstration had given strong warnings to the company to enforce stricter quality control measures. In any event, those who tested positive and were told by J&J that they'd have up to two years of free phone counseling had only until August 29th before all they get is a message telling them to call the federal Centers for Disease Control and Prevention in Atlanta. Home Access is the sole remaining home HIV test on the market. [News brief provided by New York Citizens AIDS Network, a grassroots advocacy project of the Public Policy Department of Gay Men's Health Crisis.]

FY98 AIDS Funding

The House Labor/HHS Subcommittee passed a FY98 funding bill that calls for a $250 million increase for AIDS care, prevention and research programs, including a 79% hike for the AIDS Drug Assistance Program (ADAP). The Ryan White CARE Act would receive a $172 million increase over last year's funding of $996.3 million, $132 million of which would go to ADAP. AIDS research through the National Institutes of Health would receive a $63 million, or 4.8% increase over over the FY97 level of .5 billion. HIV prevention programs through the Centers for Disease Control and Prevention (CDC) would get $5 million, or .8% increase over the FY97 funding level of $617 million (the President has asked for $17 million more). In the Senate an appropriations subcommittee followed a House subcommittee's lead, proposing an $8 million increase for the Housing Opportunities for People with AIDS (HOPWA) program. The subcommittee's recommendation matches President Clinton's budget request for HOPWA. [News brief provided by New York Citizens AIDS Network, a grassroots advocacy project of the Public Policy Department of Gay Men's Health Crisis.]

AIDS in Asia

Government officials in China are in shock over an AIDS epidemic fueled by herion use that is occuring along an ancient carvan route that links China's Southeast Asian border to its remote frontier with Central Asia. According to an Associated Press report, Chinese officials would rather not deal with the effects of the epidemic, especially due to the scope and identity of those affected . . . . The Vietnam News reported new figures for the number of Vietnamese people infected by the HIV virus. The number of people now known to be infected has risen to 6,469 people (compared to 3,375 people at the beginning of 1996) of which 860 developed full-blown AIDS and 471 died . . . . The Thai government has announced new measures to attempt to control HIV from spreading and to provide financial support to those who are suffering from AIDS disease, according to a United Press International report. Some of the new measures include developing public education and prostitutionreduction campaigns , expanding child care efforts for children whose parents have died from AIDS, and implementing civil rights protection for people with AIDS who are employed.

Positive and Donating Blood

HIV-positive individuals who donate blood plasma may actually be helping themselves and the people who receive their plasma. Reuters North America reported that a controversial new potential treatment called Passive Immune Therapy (PIT) has slowed progession to full-blown AIDS in people who are HIV-positive and healthy, and that people with AIDS who receive the plasma exhibit "significant" benefits, including weight gain. Abraham Karpas, a blood specialist at Cambridge University said, "You are passing immunity from people who have it to people who don't." According to the researchers, people who donated plasma increased their T-cell count. Plasma comes from taking a person's blood and filtering out the white (immune fighting) and red blood cells, and then returning those cells back to the donor. Karpas and his research colleagues think that when plasma is returned to a donor's body it may contain small particles like antibodies that help white blood cells fight infection, or that temporarily removing the white blood cells causes a person's remaining T-cells to reproduce.