Articles in the Newsline section were abstracted by the National Prevention Information Network (NPIN) of the U.S. Centers for Disease Control and Prevention (CDC).
An estimated 15 million Americans contract sexually transmitted diseases (STDs) every year. Pharmacists talking to patients with STDs should make sure to address preventing infection and also reach them about prevention. The patient should be assured of the confidentiality of the discussion as well as have confidence in the counselor's professional skills. Some suggested steps for the pharmacist-turned-counselor to follow are to identify individuals at risk or in need of counseling; stress preventative options; note the symptoms of STDs; encourage testing and/or other diagnostic processes; and address the patient's disease, treatment and prognosis. Because patients possibly infected with an STD may need more counseling than most pharmacists can provide, pharmacists should also be prepared with referrals, if necessary. (Pharmacy Times (www.pharmacytimes.com) (12/00) Vol. 66, No. 13, P. 55; Shaw, L. Kendall)
A new report from Housing Works, an AIDS service group in New York, claims that 70 percent of the money the state spends on the disease goes to organizations run by non-Hispanic white people, even though over 80 percent of New York residents with HIV or AIDS are minorities. Housing Works analyzed the funding contracts that New York awards to various groups for AIDS prevention and services for HIV-infected individuals. The analysis revealed that just 30 percent of the funds statewide are given to minority-run organizations. State officials and HIV service group leaders deny that the funding is discriminatory, noting that gay men, most of them white, were the hardest hit by AIDS at the beginning of the epidemic, and they established the first groups to help fight HIV and AIDS. Those groups, therefore, are now older and more politically powerful than newer groups. (New York Times (www.nytimes.com) (01/23/01) P. B6; Perez-Pena, Richard)
During the last two decades, the number of American prison inmates has increased by nearly 400 percent, for a total of over 2 million inmates, and the social costs are beginning to add up. Diseases like AIDS, hepatitis, and drug-resistant tuberculosis (TB) are common in prisons, according to psychiatrist Terry Kupers, and as many as 20 percent of inmates have some form of mental illness. In New York City, for example, the majority of the drug-resistant TB cases that started appearing in the late 1980s were linked to individuals who contracted the infection while incarcerated. (Reuters (www.reuters.com) (01/23/01); Elsner, Alan)
According to a study published in the February 1st issue of the Journal of Infectious Diseases (2001;183:401-408), long term HIV-1 suppression is better predicted by phenotypic drug susceptibility testing than treatment history. Researchers from the University of Alabama at Birmingham School of Medicine studied plasma samples from 86 HIV-infected individuals who were starting new antiretroviral regimens after experiencing treatment failure. The authors discovered that the length of time until failure on the new treatment program was not related to drug susceptibility predicted on the basis of treatment history. (Reuters Health Information Services (www.reutershealth.com), 01/23/01)
A new report in the Journal of Infectious Diseases (2001;183:383-391) indicates that anal human papillomavirus (HPV) appears to be common in HIV-positive and HIV-negative women who are at high risk for infection. Researchers from the University of California at San Francisco studied 251 HIV-positive women and 68 women who had similar risk factors but were not infected with HIV. Approximately three-quarters of the women with HIV and two-fifths of the HIV-negative women had anal HPV DNA. The researchers also discovered that in a subset of 200 women for whom cervical HPV information was also available, anal HPV was much more common. (Reuters Health Information Services (www.reutershealth.com), 01/24/01)
One key reason for clinicians to help their HIV-infected patients with planned pregnancies is so they can help reduce the risks with detailed counseling. "I just think the most important thing is to prepare HIV-positive women for the fact that there is always the potential for the child to become HIV-positive," explains Dr. Rani Lewis of Vanderbilt University in Nashville, Tennessee. Experts suggest that HIV-positive women who have a desire to become pregnant should, among other things, consider increasing their insurance coverage; discontinue risky activities, such as drug use; and prepare to accept the realities of a child infected with HIV. Another reality is that if the child is born HIV negative, the parents may have to confront their own mortality, possibly not surviving long enough to see the child grow up. HIV management and counseling are two essential measures that clinicians need to take when advising HIV-positive women about possible pregnancy. Other key issues that need to be discussed include delivery and breast-feeding. (AIDS Alert (www.ahcpub.com/online.html) (01/01) Vol. 16, No. 1, P. 6)
Drug companies Trimeris and Roche Holding, both of which are working on a new class of AIDS drugs designed to help patients who develop resistance or intolerance to the disease's standard treatment, are reporting that six small studies have shown patients to respond favorably to their products. The companies' new drugs, called T-20 and T-1249, bind to the AIDS virus outside the cell and prevent it from ever entering the cell and infecting it. Current AIDS treatment involves a cocktail of antiretrovirals, three classes of drugs that use different means of preventing the virus from reproducing once inside the cell. According to Dani Bolgnesi, chief executive of Trimeris, 300,000 patients worldwide will probably have developed a resistance or intolerance to the cocktail by 2002. The results for all six studies will be released in a week at a major medical conference. Two 500-patient, Phase III trials of T-20 are also being conducted both in Europe and the United States, the results of which should be available next year. Phase III trials are necessary for the drugs to receive federal approval. (Wall Street Journal (www.wsj.com) (01/30/01) P. B5; Harris, Gardiner)
Drugmaker Merck announced Jan. 29 that the U.S. Food and Drug Administration has approved its experimental drug Cancidas, promising people with weakened immune systems a treatment for invasive Aspergillosis. Cancidas, which is the first member of a new class of medicines that are meant to stem the growing onslaught of deadly fungal diseases becoming common in people with weakened immune systems, is intended for extremely ill individuals who have not benefited from other therapies. When contracted by cancer patients, organ and bone marrow transplant recipients, patients with HIV/AIDS, and others with weakened immune systems, Aspergillosis can infect the lungs and spread throughout the body to damage the heart, brain, kidneys, and eyes. Because the drug is designed for patients with no other hope, pharmaceutical analysts expect most doctors will helve it for emergency use, rather than prescribe it as a first-use treatment. Merck is expected to achieve peak annual sales between $300 million and $500 million on the product. (Reuters (www.reuters.com) (01/29/01)
Japanese scientists recently concluded that methods currently being used to extract HIV from infected sperm are not significantly effective enough to consider using the sperm in artificial insemination. The scientists, headed by Shinichi Oka, section chief of the International Medical Center of Japan's AIDS Clinical Center in Shinjuku Ward, Tokyo, began to examine the two current techniques being used -- one method being the separation of healthy sperm from infected sperm, and the other, isolating the sperm from the virus and the lymphocytes, which are particularly susceptible to infection. Tests showed that even when using a combination of both techniques, at least four of nine samples remained HIV-positive afterward. (Daily Yomiuri (www.yomiuri.co.jp) (01/30/01) P. 1)
HIV infection rates appear to have decreased among injecting drug users (IDUs), although they remain in the high risk category for HIV infection. Researchers from the University of Illinois at Chicago found that of the nearly 800 IDUs they interviewed and tested for the study, baseline HIV seroprevalence was 18 percent or below those levels usually found on the East Coast, but higher than the rate found in the western and southern regions. In comparing the current incidence rate of seroconversions in over six hundred of the IDUs, which was at 1.1 per 100 person-years of risk, to the 1992 rate of 2.4 in a similar population, researchers concluded that the rate of infection among Chicago's IDUs has declined. It was noted that other researchers have found that newer IDUs seroconvert more frequently than do long-term IDUs. (Reuters Health Information Services (www.reutershealth.com), 01/29/01)
Researchers from Vanderbilt University School of Medicine, Nashville, recently concluded a study of the effects of efavirenz in several hundred nucleoside analogue reverse transcriptase inhibitor (NRTI) experienced patients. They discovered that the addition of indinavir plus the non-nucleoside reverse transcriptase inhibitor (NNRTI) efavirenz, results in a significantly lower viral count after more than 24 weeks as compared to strictly the indinavir alone. The positive response was maintained for another 24 weeks. In the final study published in the February 1st issue of the Journal of Infectious Diseases (2001; 183:392-400), Dr. David W. Haas and associates concluded that NRTI experience patients should be treated with efavirenz, indinavir, and two NRTIs as a standard by which alternative treatments should be compared. (Reuters Health Information Services (www.reutershealth.com), 01/29/01)
Back to the June 2001 Issue of Body Positive Magazine.
This article was provided by Body Positive. It is a part of the publication Body Positive.