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News & Notes

January 1998

International Developments | Broadened Aspects to Sustiva
| Strides Made Towards AIDS Vaccine | HIV-Infected Newborns| The Superman Syndrome

According to a recent nationwide survey of more than 1200 people, Americans are unusually well-informed about AIDS.

The survey, conducted by the Princeton Survey Research Associates for the Kaiser Family Foundation, indicates that people believe AIDS is one of the two top major health problems facing the country, and that the government should spend more to fight it.

In response to whether the government should spend more to help the HIV-infected poor to pay for drugs, nearly three-quarters of those questioned responded affirmatively, while less than one-quarter were of the opinion that people should pay for their own drugs no matter what their income level. In a separate story in the Washington Post, it was recently reported that the Clinton administration abandoned as too expensive a plan to use Medicaid to get expensive drugs to low-income HIV-infected Americans.

Contrary to public belief, there was strong support expressed in the survey -- 95 percent -- for spending money on AIDS education and prevention. Among the approaches suggested were AIDS education in schools and ads for condoms, even commercials on network television. A majority favored controversial government-funded needle exchange programs, which the federal government has blocked in the past, claiming that to fund such programs would implicitly support illegal drug use.

"This isn't really the third rail that politicians say it is," said Tim Westmoreland of Georgetown University Medical School and a senior advisor on HIV to the Kaiser Family Foundation. "The public is not terrified of it."

Drew Altman, president of the foundation, noted the increase in public awareness. "People get it, and that's unusual -- we usually don't see that in these kinds of surveys."

Commenting on the survey, Dr. Sophia Chang, director of HIV research at the Kaiser Family Foundation, said, "We are also finding out that Americans are starting to learn how to live with AIDS." Compared to 2 percent in 1983, 35 percent knew someone who had AIDS or had died of it. Two-thirds said they would be very or somewhat comfortable working with someone who had AIDS.

The survey revealed most people still don't get tested -- only 38 percent ever have been -- but 52 percent of parents questioned said they were "very concerned" about the possibility of their children becoming infected.

International Developments

A United-Nations sponsored pilot program to make powerful new AIDS drugs available at subsidized prices in Ivory Coast, first greeted with optimism, has quickly caused frustration among patients and medical officials. The majority of the 1 million HIV-positive people in the Ivory Coast will be excluded because participants still face prohibitive costs for the drugs -- $15,000 a year for each patient in a country where the per capita income is only about $500 -- with the course of treatment lasting a lifetime. U.N. officials say the pilot program will run two to three years and then be evaluated, leading Nicole Doumatey, an AIDS counselor, to point out: "There are lifetime drugs. What happens after three years?" Monique Rokotomalala, chair of the Ivory Coast U.N. project, notes that the poverty of the majority of AIDS patients might block their participation in the project, but she still believes the challenges presented by the program will better enable Ivory Coast and other developing countries to deal with the needs of treating AIDS sufferers. . . . India, which has more HIV-infected people than any other country (3 to 5 million out of a population of over 1 billion), is now experiencing a rise in the disease among a group once thought to have a very low risk for AIDS: young married women. A study recently published in the Journal of the American Medical Association points to husbands who frequent prostitutes as the cause. Margaret Bentley, an associate professor of health at Johns Hopkins and one of the authors of the report points out, "The married women in our study represent a larger population of low-income women whose husbands have multiple sex partners." These same women, she added, are less likely to discuss risky sexual behavior with their husbands because their culture discourages discussion of sexual behavior which doesn't touch on birth control. Thomas Quinn, another of the study's authors, warns that given India's large population, there is a great potential for a dramatic, continued spread of infection.

Broadened Access To SustivaTM

Broadened access to Sustiva, a non-nucleoside transcriptase prohibitor that can significantly reduce viral load and increase CD4 cell count in combination therapy, was announced by the DuPont Merck Pharmaceutical Company. The drug is currently in development as a once-daily HIV treatment in combination with other retrovirals. Preliminary data reveal 88 percent of patients receiving combination therapy of Sustiva (increased to 600 mg once daily at 36 weeks from a 200 mg initial dose) and Crixivan (indinavir)(1,000 mg every eight hours) achieved HIV-RNA levels below the level of quantification (400 copies/mL) using the Amplicor assay. Clinical studies show Sustiva as generally well tolerated. There was no apparent increase in serious side effects for treatments containing Sustiva plus Crixivan over treatments not containing Sustiva. DuPont Merck plans to submit it's application for approval regarding Sustiva to the FDA in the second quarter of 1998.

Strides Made Toward AIDS Vaccine

Two studies presented at The 10th International Conference on AIDS and STDs in Africa have shown that an AIDS vaccine demonstrated protection against HIV infection in animals and causes humans to produce antibodies to recognize the most prevalent subtypes of the virus. Dr. Prem Sarin, vice president of research for the developer of the vaccine, CEL-SCI Corporation commented, "These exciting results bring us another crucial step closer to the development of a worldwide AIDS vaccine."

Dr. Margaret Johnston, scientific director of the International AIDS Initiative, stated that a vaccine was possible, but that it wasn't going to be easy. Scientists were not yet clear which immune response to stimulate to block development of HIV, and she added that vaccines take eight or more years from the first phase of testing to their use in the community. "The earliest we could have a vaccine is 2004 to 2005. It is unlikely that if they work they would be 100 percent effective so I don't think the answer is there yet."

However, she believes the obstacles can be overcome.

HIV-Infected Newborns

A recent controversial New York State law mandating HIV testing of all infants born after February 1, 1997 has revealed 82 infected infants whose similarly infected mothers did not know their children were in danger. The controversy stems from the fact that babies are required to be tested without their mother's consent. Women discover their own status through the results of the HIV test on their infants. Babies have been tested for the virus in New York for several years for research purposes, but before the new law, mothers could choose not to learn whether their infants tested positive for HIV antibodies. It was reported that infants who tested postive for the virus have received follow-up medical care.

The Superman Syndrome

A study performed by MTV and Yale University reveals that a startling 87 percent of young people believe they aren't vulnerable to the AIDS virus. Within that group, 98 percent of whites considered themselves invulnerable, while minorities -- 16 percent of Hispanics and 11 percent of blacks -- saw themselves as vulnerable. The study also demonstrated that information disseminated by the mass media isn't meeting young peoples' needs; just over half said there wasn't enough information about AIDS prevention. Dr. Michael Merson, Yale School of Medicine's Dean of Public Health, summed up the findings in this way: "It tells us that despite the information that's out there, young people have not internalized the dangers of AIDS, drugs, and alcohol, and other health-related risks."

Health concerns were not a priority item with young people. The issues of top concern to them were career, employment, personal development, and educational achievement. Only 3 percent of the individuals queried cited AIDS and sexually transmitted diseases as a top concern. Over half of them could not think of a way that they were at risk for becoming infected with the virus, although 20 percent said they had a friend or knew of an acquaintance who had died from AIDS.

Back to the January 98 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.