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News And Notes

by Valerie Michelle Hoskins
 From Body Positive

November 1997

Mandatory Reporting | AIDS Numbers | International Developments
It's About Race | States Get The Needle Point
Princess Di Fund | We Want a Vaccine

In an attempt to insure that people who are HIV-positive get early treatment, the New England Journal of Medicine is urging state health departments to require reporting of HIV infections. A majority of states now require reporting to alleged confindential registries. These states are Alabama, Arizona, Arkansas, Colorado, Idaho, Indiana, Louisiana, Michigan, Minnesota, Mississippi, Missouri, Nebraska, Nevada, New Jersey, New Mexico, North Carolina, North Dakota, Ohio, Oklahoma, South Carolina, South Dakota, Tennessee, Utah, Virginia, West Virginia, Wisconsin, and Wyoming. The states with the highest rates of HIV infection, New York and California, do not require reporting.

New treatments that increase an HIV-positive person's longevity were identified as a reason why keeping HIV infections private has decreased in popularity. Dr. Robert Steinbrook, an editor for the journal, believes that AIDS is now in the same league as other sexually transmittable diseases reportable diseases like tuberculosis, syphillis, gonorrhea with which people can live long and productive lives. It is believed that mandatory reporting will allow health officials to track people who were exposed to the virus, test them, and if they are HIV-positive, get them early treatment and counseling to help improve their chances of living long and successful lives with the virus. Unfortunately, this focus on mandatory reporting doesn't take into account the levels of ignorance and prejudice that still exist in our society when confidentiality is breeched.

A "News & Notes" brief in the October 1997 Body Positive recently exposed the results of these factors. "Why Go to Med School?" focused on HIV-positive health practitioners who are having problems with being restricted from performing their jobs. In the same issue, in an article titled, "Mixed-Status Couples: Navigating the Challenges of Everyday Life," a couple living in rural upstate New York stated, "Where we live, it's not common to be HIV-positive, and if someone is, it's often kept very quiet."

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CDC Statistics on AIDS

The Centers for Disease Control and Prevention (CDC) is encouraged by new statistics for 1996 that reflect the first-ever drop in the number of new AIDS cases in the United States. The new combination therapy treatments appear to be what's making this impact. According to the CDC report, approximately 56,730 people were diagnosed HIV-positive in 1996, a 6 percent reduction compared to 60,620 new cases in 1995. The states also indicated a drop in AIDS-related deaths: there were an estimated 50,140 deaths in 1995 and about 38,780 in 1996 -- a 23 percent decline.

In addition, AIDS is no longer the number one killer of young and middle-aged adults: It's now number two for people between 25 and 44 years of age. Accidents (car crashes and falls) are the number one cause of death for this age group, followed by cancer.

Yet, not all the figures are encouraging, especially for people of color and women. In 1996, AIDS cases among heterosexual black men rose 19 percent and cases rose to 12 percent among heterosexual black women. The number of women who contracted the virus through sex with infected men rose 7 percent last year. This transmission route is now the leading cause of infection for women -- a switch from the 1980s and early 1990s when needle sharing was the leading cause.


International Developments

Women are being used in ethically questionable experiments in developing countries, according to a recent editorial in the New England Journal of Medicine. The studies are intended to help stop mother-to-child transmission of HIV, but the ethics of the researchers are in question because AZT is being withheld from the participants even though it is available. Currently, 15 government-financed studies are being conducted in countries where the cost of AZT treatment (about $1,000 per pregnant woman) is totally out of range financially for these mothers. These studies are being compared to the Tuskegee study that occured in Alabama. Black men with syphilis were denied penicillin for 40 years so researchers could study the disease's progression. Journal editor Marsha Angell wrote, "Justifications are reminiscent of those for the Tuskegee study: Women in the Third World would not receive anti-retroviral treatment anyway, so the investigators are simply observing what would happen to the subjects' infants if there were no study." The countries in which these studies are occuring are Burkino Faso, Ethiopia, Ivory Coast, Kenya, Malawi, South Africa, Tanzania, Uganda, Zimbabwe, the Dominican Republic and Thailand... British AIDS charities are giving thumbs down to an HIV treatment lottery. According to Derek Bidell, director of the National AIDS Trust, "This situation amounts to a lottery of care for people with HIV." The lottery is geographical, so people who are HIV-positive but do not live in the lottery-winning towns will not have access to the combination therapies that they need. Ian Kramer of the U.K. Coalition of People Living with HIV and AIDS had this to say, "It means that hundreds of people will die much earlier than they need to. It is like condemning a small town to death. This kind of geographical lottery is totally unacceptable." At a recent British AIDS conference, people infected with the virus requsted that they be included in any future plans regarding their healthcare... Russia makes up for lost time with popular newspaper all about AIDS. SPID-Info means "AIDS-Info" in Russian (SPID is the Russian acronym for AIDS), and it's a hot, new publication that has advice about safer sex and other AIDS-related information mixed in with sex stories, advice columns, sci-fi articles about cloning and fratricide, a crossword puzzle and jokes. Here's what one reader had to say about it: "It is very useful. I guess the articles are disclosing a subject that we didn't discuss before."


Race Important Factor In Knowledge About HIV

Both African-Americans and Latinos with HIV are over twice as likely as Caucasians not to know their T-cell counts (14% and 10% vs. 4% for Caucasians). Forty percent of African-Americans and 50% of Latinos with HIV do not know their viral load, while only 17% of Caucasians reported not knowing. Further, 11% of African-Americans and 9% of Latinos do not understand the meaning of viral load, versus only 3% of Caucasians. These statistics were revealed at the U.S. Conference on AIDS organized by the National Minority AIDS Council and the Philadelphia EMA HIV Commission, an advisory board to the Philadelphia Department of Health. According to Pat Bass, co-director of the Philadelphia AIDS Activities Coordinating Office, "The statistics indicate that many people of color, in particular, are not only infected with HIV, but also affected by a lack of information."


Don't Know Why You Feds Say Goodbye to Needle Exchange

Ir's the same old story: We say "yes" to needle exchange and the government says "no!" The Clinton Administration is still holding fast against repealing the funding ban against approving federal funding for needle exchange programs despite the fact that transmission through the use of contaminated needles continues to grow in communities of color, poor communities, and among women.

There is encouraging news on the state level as Maine, Minnesota, New Mexico, and Rhode Island consider moving ahead to institute programs while the federal government looks the other way while more and more people become infected each day. Paul G. Loberti, Chief Administrator of the Rhode Island Dept. of Health had this to say: "States should not wait for the federal government to support needle exchange. States without needle exchange should begin the step-by-step process of introducing the important public health significance of creating access to clean injecting equipment." According to Loberti, injecting drug use in his state accounts for approximately 50% of all AIDS cases.

In Maine, traditionally a conservative state, Assistant State Epidemiologist Geoff Beckett offered this perspective: "When the issues are brought into the light of day, in an open discussion, many individuals who would not be expected to support these programs actually do. Maine's sterile syringe program has the support of the Maine Chiefs of Police and the state pharmacists association."


Princess Di Fund Goes To Pediatric AIDS

The Pediatric AIDS Foundation was the recipient of the Princess Diana Fund" by People Magazine. According to Susie Zeegan, co-founder of the Pediatric AIDS Foundation, the money will be used to inspire "the best and the brightest researchers to join together and bring an end to pediatric HIV/AIDS."


Heavy Volunteer Response to Possible Experimental Vaccine

A weakened version of HIV is being considered by a group of international volunteer physicians for experimental use as a vaccine against the virus. According to The International Association of Physicians in AIDS Care, there are about 50 volunteers eager to participate in the study and calls, e-mails, and faxes keep coming in from other interested parties.

Joe Zuniga, deputy director of the Chicago-based group, stated, "Considering that there are 8,000 new infections of HIV per day, we think that bold steps should be taken while observing good science. We are not calling for a trial tomorrow, or even the next day. We want there to be enough safety protocols in place for this not to harm anybody."

One reason why vaccine development has been slow is the fear that use of the live HIV virus (even a weakened mutant strain) might cause AIDS or other health complications. Some reseachers feel that there should be more testing using animals before human subjects are introduced.

Proponents counter by citing a rather chilling statistic: Even though combination therapy treatments are having a positive impact on people with HIV who are using the drugs on a regular consistent basis, only 6 percent of the population can afford to purchase the new treatments and not everyone can keep up with the dosage schedule required.


Back to the November 97 Issue of Body Positive Magazine



  
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This article was provided by Body Positive. It is a part of the publication Body Positive.
 
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