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Newsline

February 2001

The Newsline section recalls the pioneering HIV/AIDS publication of the same name produced by the People with AIDS Coalition of New York (PWAC-NY).


Kissing and Herpes Virus

New findings published in today's New England Journal of Medicine (2000;343:1369-1377) show that a form of herpes virus may be spread through kissing. Herpes virus 8 causes an AIDS-related skin cancer known as Kaposi's sarcoma. John Pauk and colleagues from the University of Washington tested 39 gay men who were infected with HIV but not Kaposi's sarcoma. They found the virus in 30 percent of saliva and mouth swabs, but only 1 percent of anal-genital samples. The research also indicated that "deep kissing" could place gay men at greater risk for the virus. (Washington Post (www.washingtonpost.com), 11/09/00; P. A8)


Group Roams Chat Rooms to Talk to Gay Men About AIDS

The Stop AIDS Project, a San Francisco-based nonprofit agency that has fought AIDS since the early 1980s, is now taking its campaign to Internet chat rooms that are popular with gay men. To that end, the city's Department of Public Health recently awarded the group $130,000 for the online project. Specifically, the researchers will train four disease-prevention counselors to go through gay and bisexual chat rooms and field questions about safe sex. Research indicates that gay men are more likely to go online to find a sex partner than lesbians and heterosexuals, and people who do use the Internet to set up sexual encounters are at greater risk for sexually transmitted diseases (STDs). Marcel Miranda, deputy director of outreach and organizing at Stop AIDS, works in chat rooms answering explicit questions about risky sex. The profile for his America Online moniker, StopAIDSMM, notes, "We're not the sex police. We just want to make sure you have the information to make informed choices." Chat rooms were associated with a syphilis outbreak among gay men in San Francisco last year. A cluster of six cases was traced back to a chat room, with some of the patients reporting that they only knew their partners by their screen names. Dr. Ronald Valdiserri, deputy director of the AIDS division at the Centers for Disease Control and Prevention, says that as technology evolves, methods of combating HIV and other STDs need to change as well. The Stop AIDS program, he notes, "is not, in practice, different from providing outreach services on a street corner where injecting drug users might hang out or in a public park after hours where sex takes place." (New York Times (www.nytimes.com), 11/09/00; P. E8; Gaither, Chris)


Antiretrovirals Do Not Independently Affect T-Cell Count in HIV-Negative Subjects

A study from Drs. Vincenzo Puro and Giuseppe Ippolito of the National Institute for Infectious Diseases in Rome notes that antiretroviral drugs do not have a direct effect on T-cell counts in HIV-negative patients. The research, published in the Journal of Acquired Immune Deficiency Syndromes (2000;24:440-443), goes against the proliferation hypotheses. The scientists looked at data from 448 healthcare workers who had been exposed to HIV-1, including 284 who received prophylaxis after HIV-1 exposure. Puro and Ippolito found that CD4 and CD8 cell counts rose slightly in both treated and untreated patients, increases that were not correlated with the length of postexposure prophylaxis, sex, or side effects. (Reuters Health Information Services (www.reutershealth.com), 11/07/00)

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Botswana President: AIDS May Be Responsible for Half of Natural Deaths

Botswana's president, Festus Mogae, claims that AIDS is responsible for at least half of the country's natural deaths. Mogae told Parliament that he wanted to review government AIDS strategies, noting that "the killer disease had raised the national human toll to nightmarish proportions." According to the United Nations, Botswana has the highest infection rate worldwide, with more than one-third of the country's adults infected with HIV. Mogae said he wants to discontinue any outdated prevention strategies, and he supports new international anti-AIDS programs, including efforts from Bill Gates' Foundation and U.S. Centers for Disease Control and Prevention. (CNN Online (www.cnn.com), 11/08/00)


HIV Lipodystrophy with Exercise Works Best

A study from Nicholaos Bellos of Bellos Southwest Infectious Disease of Dallas shows that steroids, exercise, and diet changes are useful treatments for AIDS-related lipodystrophy. Patients who follow a regimen to fight fat redistribution can be helped by these treatments, according to Bellos. Interim data from his study found that the patients following this regimen experienced up to a 15 percent increase in lean body mass. Lipodystrophy is not to be confused with AIDS wasting, which reduces fat mass. Weight loss along with fat redistribution is a sign of lipodystrophy, which repositions fat in the abdomen and face. Bellos' study was an extension of a previous one from the University of California at Berkeley, published last year in the Journal of the American Medical Association. Patients treated with oxandrolone, an anabolic medication, showed an increase in lean body mass; however, their body fat did not change. Bellos' approach for treatment includes a dietitian's analysis and photographs to monitor appearance, along with a strict exercise program. (AIDS Alert (www.ahcpub.com), 10/00; Vol. 15, No. 10, P. 126)


A Few TB Patients Spread Contagion

States can quarantine or incarcerate individuals who pose public-health threats. In the case of tuberculosis (TB), the failure to complete treatment can result in multidrug-resistant disease, which can then be spread to others. While jail is an option for extremely difficult-to-treat patients, Dr. Robert Benjamin, medical director of the TB program in Alameda County, California, notes: "We take the abrogation of civil liberties very seriously, and we bend over backward on due process." Benjamin explains that some patients are instead ordered to stay in their houses and to not have visitors who have not been exposed. Such cases are relatively rare, but they can be especially worrisome in cities with high rates of infection. In San Francisco, the rate of TB among the homeless population is 200 to 400 cases per 100,000 people, according to Dr. Masae Kawamura, the city's chief TB control officer, while the overall city rate is approximately 30 per 100,000. (San Francisco Examiner (www.examiner.com), 11/07/00; P. A15; Winokur, Scott)


Clinton Signs Legislation for Third World Debt Relief

President Clinton signed a foreign aid bill on Monday that gives $435 million to forgive the debts of the poorest nations. "By lifting the weakest, poorest among us, we lift the rest of us as well," the president said. The money was included in a nearly $15 billion foreign aid measure that included $300 million to fight HIV worldwide and lifted restrictions for U.S. aid to overseas family planning organizations that support or are involved with abortions. (Washington Post (www.washingtonpost.com), 11/07/00; P. A13)


Program Helps Parents Discuss AIDS with Children

A program called Talking with Kids About HIV/AIDS helps parents reach their children before adolescence. The program involves six two-hour sessions that use role-playing and games to teach parents how to talk to their children about sex and AIDS. Dr. Jennifer Tiffany of Cornell University, where the program was created, said the goal is to save lives by preventing new HIV infections in young people. The curriculum for the program has been used throughout New York State, has been accepted by the World AIDS Foundation for use in Mexico City, and will be implemented soon in Miami. (Reuters Health Information Services (www.reutershealth.com), 11/07/00)


HIV Epidemic Among Homosexuals, Drug Users Probably Had Different Sources

A study from Dr. Carla Kuiken of Los Alamos National Laboratory in New Mexico suggests that the HIV epidemic among homosexuals and intravenous drug users in the West could have different sources. Kuiken and colleagues report in the American Journal of Epidemiology (2000;152:814-822) that they evaluated HIV-1 variants among homosexuals and drug users in Sweden, Norway, and Holland. The researchers discovered that the two groups had distinct HIV-1 variants, but the Swedish and Dutch drug users had common mutations and the sequences from homosexuals in Norway and Holland were virtually identical. Kuiken and colleagues theorize that HIV subtype B was carried from Africa to the Western homosexual community by one person, and the virus then spread to other risk groups and evolved independently. (Reuters Health Information Services (www.reutershealth.com),11/07/00)


Net Search for Sperm Brings High Risk Home

Women who seek artificial insemination often want to perform it at home. However, most very few sperm banks -- and none in Canada -- will ship directly to patients. Because of this, Jacqueline Beaudoin of Ontario started an Internet mailing list to match male donors with women looking for donors. The Web practice raises several medical concerns, since the semen may not be screened for HIV or other diseases. The Centers for Disease Control and Prevention recommended in 1994 that sperm banks freeze semen specimens for six months prior to use, a time period which allows for retesting of donors for antibodies to HIV, which may not show up immediately after infection. The CDC's Ronald Valdiserri said, "It does not surprise me to learn that people are using the Internet as a way to identify donors." However, Valdiserri warned the practice is dangerous, noting that it is "essentially like having sex with somebody you don't know anything about." (USA Today (www.usatoday.com), 11/07/00; P. 10D, Ruben, Rita)


Women Initiate Highly Active Antiretroviral Therapy Later than Men

Dr. A. Mocroft from University College London and colleagues analyzed treatments for patients at an HIV clinic in Southern Alberta, Canada. The researchers found that equal access to healthcare does not mean equal treatment occurs for men and women who have HIV. The study, published in the Journal of Acquired Immune Deficiency Syndromes (2000;24:475-482), involved 1,403 patients, including 126 women. The researchers concluded that women were much less likely to start highly active antiretroviral therapy than men in the study, and they tended to start treatment a few months later than the men. (Reuters Health Information Services (www.reutershealth.com), 11/06/00)


Concern Grows Over AIDS Rate Among Priests

The growing number of priests who have died from AIDS has been documented by the Kansas City Star, based on estimates from experts and priests. The Star has identified over 300 AIDS-related deaths among priests nationwide, using death certificates and interviews with family members and colleagues; however, the actual number is unknown. According to the Star, the AIDS death rate among priests in 14 states is more than two times that of adult males in those states. AIDS expert Richard Selik of the Centers for Disease Control and Prevention stated that data shows the HIV death rate is higher in priests than in men 25 years of age and over. Rev. Jim Walsh of the National Catholic Educational Association said he was surprised by the data, which he said reflect a "need to talk about celibacy and to do it in the sense of people witnessing how they're living it and where it's not working for them." The Star's state-by-state examination of the problem shows that hundreds of priests have died from AIDS, including a rector, seminary vocation directors, and college chaplains. However, there are signs of growing concern about sex and AIDS in the church. The National Federation of Priests' Councils is creating a new document concerning how dioceses should respond to priests with AIDS, and a study endorsed by the National Conference of Catholic Bishops will examine problems faced by priests in their first five years after ordination. According to Brother Bernard Stratman, director of the federation, more priests are needing treatment for chemical, alcohol abuse, personality problems, and sexuality dysfunctions. Earlier this year, the Church of England acknowledged that 25 of its priests had died from AIDS-related causes. More recently, spurred by the enormity of the AIDS epidemic in southern Africa, the church said that all Anglican bishops in the region would be tested for HIV. (Kansas City Star (www.kcstar.com), 11/05/00; P. A1; Thomas, Judy L.)


Latin America, Caribbean Not Confronting AIDS Crisis, Says U.N.

On Monday, UNAIDS director Peter Piot, speaking before a regional AIDS conference in Brazil, urged Latin America and the Caribbean to face their AIDS epidemics and take on issues like gay sex and condoms. Piot praised Brazil's response to the problem, but noted that other countries in Latin America are doing nothing to address AIDS. The Caribbean has the second highest HIV rate in the world. Most countries the region spend less than $50,000 a year on HIV prevention directed towards gay communities. Piot called that sum "a joke," noting that "it doesn't reflect the size of the epidemic in those communities." The influence of the Catholic Church has also hampered condom use and frank discussion of sex in Latin America. Brazil's HIV infection rate has steadied to about 0.5 percent to 0.6 percent of the country's adults, and it has challenged pharmaceutical giants by producing AIDS drugs at a fraction of their original price. (CNN Online (www.cnn.com), 11/06/00)


China Struggles to Cope with Explosion of Sex Diseases

The China Daily reported that over 8 million Chinese have sexually transmitted diseases (STDs), according to experts, but the country lacks the health training and facilities to control the infections. Official statistics show that there are 840,000 cases of STDs in China. Zhang Guocheng, deputy head of the health ministry's STD and Leprosy Control Center, noted, "China's medical services on the prevention of STDs and their control is trailing behind the swift spread of the diseases." The China Daily also said there were at least 500,000 HIV cases in the country, although government statistics show just over 17,300 as of year-end 1999. However, gonorrhea is the most widespread STD, with syphilis coming in second. Prostitution is fueling the spread of STDs, as are the millions of young women who make up part of China's "floating population" who travel the country in search of more money. The China Daily noted that many Chinese hospitals have no specialized hospitals or physicians, so service is often of poor quality and at a high price. The Health Ministry plans to fight the problem with a State Diseases Control Center. (Agence France Presse (www.afp.com), 11/06/00)


Millions Fail to Get Vital AIDS Medicines; UCSF Finds Medicaid Isn't Delivering in 4 Big States

A study conducted by the University of California at San Francisco's (UCSF's) AIDS Policy Research Center has found that millions of poor and uninsured AIDS patients are not receiving treatments through federal drug programs. Millions of low-income people covered by Medicaid in four major states are not receiving AIDS drugs, including residents of Texas, California, Florida, and New York. According to the report, the worst of the four states was Texas, where almost two-thirds of eligible AIDS patients did not receive proper treatment. The UCSF researchers noted that Texas places more barriers between poor AIDS patients and drug treatment than there are in other states, including a $5 copayment per prescription. AIDS advocates also note that Texas and Florida limit patients to three prescriptions per month. The report was slated for release in March; however, a copy of it was leaked to a wire service reporter on Friday. (San Francisco Chronicle (www.sfgate.com), 11/04/00; P. A1; Levy, Dan)


U.S. Surgeon General Calls for Global Efforts on AIDS

U.S. Surgeon General David Satcher urged for a global effort to fight HIV/AIDS, speaking at the international AIDS conference in Nashville, Tenn., over the weekend. Over 20 million of the 35 million people infected with HIV live in Africa, said Satcher, who asserted that the world has a responsibility to help with the problem. The United States has passed a bill to end racial disparities in health care, which is one step forward. The AIDS Marshall Plan for Africa should hopefully get support through former congressman Ronald Dellums, who is chairman of Clinton's advisory council on AIDS. Dellums also discussed the AIDS epidemic in developing nations, noting that it was a security threat to the United States, too. (Africa News Service (www.africanews.org), 11/05/00)


HIV Shown to Hide Out in the Kidneys

Researchers, led by Dr. Paul Klotman of the Mount Sinai School of Medicine in New York, have found that HIV can directly infect human kidney cells. Klotman and colleagues discovered the infected kidney cells in HIV-positive African Americans who had kidney disease related to their immunocompromised status. There was evidence of HIV activity in the patients' kidneys, even when the virus was suppressed to undetectable levels in the blood using antiretroviral therapy. If other cells besides T cells carry HIV, finding other treatments will be more difficult, the researchers reported in the Journal of the American Society of Nephrology (2000;11). (Reuters Health Information Services (www.reutershealth.com), 11/03/00; Mulvihill, Keith)


Communities: A Colorful Van Is the Bait to Reach Street Youth [in New York]

A colorful 32-foot van in Dobbs Ferry, New York, works as a street outreach center for young people. Luz Bovell is the outreach director for the Children's Village residential treatment center, which is a nonprofit youth home for children with severe needs. The Street Wise van teaches teens about contraception, disease prevention, and pregnancy. Bovell runs the van most nights and has met hundreds of youths while working. The workers hand out condoms, along with education about HIV and other sexually transmitted diseases. (New York Times -- Westchester Weekly (www.nytimes.com), 11/05/00; P. 5; Rowe, Claudia)


Teen Pregnancy Ups Risk of Mother-to-Child HIV

Dr. Lynne Mofenson of the National Institute of Child Health and Human Development reported recently at the American Academy of Pediatrics meeting in Chicago that HIV infection in teenage girls in the United States has not been reduced and is contributing to mother-to-child transmission of the virus. In the United States, the mother-to-child HIV transmission rate has dropped from 25 percent to 3 percent, Mofenson said, but it can be reduced further with elective cesarean section delivery. According to Mofenson, sexually active teenagers are not likely to be tested for HIV. Some solutions to reducing the mother-to-child transmission rate are universal HIV testing for pregnant women, better prenatal care, and treatment with antiviral drugs during labor. (Reuters Health Information Services (www.reutershealth.com), 11/02/00)


IV Drug Use Fuelling Southeast Asia's HIV-AIDS Epidemic: World Bank

The rise in intravenous (IV) drug use is fueling an AIDS epidemic in southeast Asia, the World Bank said Friday. A cheap supply of heroin, growing poverty, and the effects of an economic crisis are contributing to the problem. Almost all south Asian countries except Cambodia have rising rates of drug use, said Chris Beyrer, director of Johns Hopkins University AIDS Training Program. In Bangkok, Thailand, HIV rates increased from 2 percent of IV drug users 10 years ago to more than 40 percent now. Rates of HIV are also increasing among IV drug users in Vietnam, Bangladesh, Malaysia, and Myanmar. World Bank Economist Martha Ainsworth noted that unless aggressive measures are taken, IV drugs users will continue to be "a reservoir for transmission [of HIV] to the rest of the population." Ainsworth asserted that drug addicts must be provided with clean needles, counseling, and education. (Agence France Presse (www.afp.com), 11/03/00; Kurlantzick, Joshua)


Changing Demographics in HIV Infections

The AIDS epidemic is slowing in the United States, but not among African Americans and Hispanics, who account for over two-thirds of new HIV infections. African Americans represent over 50 percent of new infections, while African-American and Hispanic women account for 78 percent of new cases for women. Surgeon General David Satcher explained that "the epidemic has evolved from one centered on white gay men to one increasingly impacting people of color, women, and the young." The Centers for Disease Control and Prevention has set new goals to focus on cities with at-risk minority groups. Some barriers to reducing the HIV rate are that many minorities feel they are not at risk, some people distrust federal programs and will not seek help, and the stigma surrounding homosexuality and AIDS. Satcher also noted that many HIV-infected young people are not aware of their infection. Earlier this summer, at the 13th International AIDS Conference in Durban, the CDC reported that 7 percent of young gay men are infected with HIV, and most had not previously been tested. Two new federal initiatives on AIDS, the Leadership Campaign on AIDS and the Crisis Response Team, will work to reduce the stigma surrounding the disease and develop prevention campaigns for high-risk communities. (American Medical News (www.amednews.com), 10/30/00; Vol. 43, No. 40, P. 26; Shelton, Deborah L.)


Adverse Effects of Antiretroviral Therapy

HIV-infected individuals who begin highly active antiretroviral therapy (HAART) should be aware of the drugs' potential adverse effects and toxicities. AIDS patients are now using combination therapy for longer periods of time, which means more complications are being seen. Mitochondrial toxicity may start gradually, or right away. Two features of this condition are peripheral neuropathy and renal tubular acidosis. Diagnosing of such a toxicity is hard if the patient is taking other similar drugs. Drug hypersensitivity, which typically shows as a rash and fever, is nearly 100 times more common in HIV patients than in the general public. However, about half of the cases of antiviral hypersensitivity resolve themselves without treatment. The lipodystrophy syndrome is an adverse effect first identified two years ago. Features of the condition include fat loss in the arms, legs, face, and buttocks, with accumulated fat in the abdomen, breasts, and "buffalo hump" area on the back. The syndrome has not been associated with differences in testosterone levels. Diabetes is also more frequent in HAART-taking patients, and 15 percent have glucose tolerance that is hindered. It is not known why lipodystrophy occurs, but there are several theories, including the possible inhibition of lipid proteins. The metabolic effects of lipodystrophy can lead to cardiovascular disease and heart attacks in a previously not at-risk group. The only way to stop fat accumulation, in theory, is to stop therapy, but increased exercise can stop the accumulation. Anabolic steroids can only partly help hide fat loss in the legs or face. Specific adverse effects exist for each drug. Zidovudine has risks of anemia, headache, nausea, and fatigue, as do most of the drugs. The most common complaint, nausea, is frequent with zidovudine and didanosine. Diarrhea and vomiting are frequently seen effects of the protease inhibitors. (Lancet (www.thelancet.com), 10/21/00; Vol. 356, No. 9239, P. 1423; Carr, Andrew; Cooper, David A. )


Scientists Report Bid to Block Publication of an AIDS Study

Immune Response Corp., a California biotechnology company, reportedly tried to stop publication of an AIDS study by Dr. James Kahn of the University of California at San Francisco that discusses the use of Remune therapeutic HIV vaccine. The study is published in today's Journal of the American Medical Association, whose deputy editor Drummond Rennie, said patients have the right to know about the vaccine trial. The $30 million study tested the vaccine for two years on people with HIV infection. The results indicate that the number of people with declining health was the same for both groups: those who received the vaccine and those who received placebo shots. Immune Response contends that detailed data from 250 patients in the study of 2,527 should be included in the report. The company says those 250 patients, who had their blood tested more often, had a better immune response to the vaccine than the control group. Because combination antiviral therapy came out during the study, fewer people got sick during the study than the researchers had initially predicted. After two years in the study, a total of 53 people in each group had worsened or died. Kahn and colleagues determined there was no benefit to the vaccine in terms of survival or health improvement rates, and their report did mention the 250 people with better responses. The report did not, however, say the patients taking Remune had a greater drop in viral load compared to the placebo group. (Washington Post (www.washingtonpost.com), 11/01/00; P. A10; Brown, David)


Few Drugs for the Needy: Profile of AIDS in Malawi

In the African country of Malawi, AIDS treatment consists of a hospital bed to lie in, for those who are lucky. For those who can afford better conditions, Mwaiwathu Private Hospital in Blantyre offers a clean bed, comfortable sheets, and for those who can afford it, dual-drug therapy for AIDS. The total number of Malawian patients who receive America's standard triple-drug therapy is estimated to be 30, compared to the over 1 million people in Malawi who are infected with HIV. Many patients know only little about these drugs, the cost of which is prohibitive for most anyhow. Malawi has about 10 million people and last year lost 70,000 to AIDS. Those who can afford Mwaiwathu Private Hospital are typically businessmen, who do not live in huts but in houses. Yasaya is a patient at the hospital and had been sick for a year before being diagnosed with HIV. The public hospital in Malawi, meanwhile, is overcrowded and lacks resources; patients often sleep on the floor. The difference between the hospitals is not only comfort, but opportunity. Yasaya is offered the chance for antiretroviral medications, which have been available for nearly 13 years, but are unknown to most of the patients. One month of the drug Crixivan, a protease inhibitor, costs $500, which is Yasaya's monthly salary. Malawi's government has at least produced a framework for dealing with AIDS, which includes more testing, education, and hope, but not treatment. Dr. Cooper Nyirenda offers Yasaya AZT and 3TC, two drugs for AIDS treatment, but neither one being a protease inhibitor. The drugs are kept at Queen Elizabeth Central Hospital and are sold at a reduced price to those who can afford them. The drugs were obtained in a deal made with Glaxo Wellcome in 1998, which offered a 25 percent discount. In May of this year, Glaxo and four other companies offered discounts of up to 85 percent for poor countries; however, Malawi's deal was already made. The difference between Mwaiwathu Hospital and Queens hospital is stark. At Queens, over 70 percent of the patients have HIV/AIDS or related illnesses, compared to 30 percent at Mwaiwathu. Family members often do the job of nurses, because of a shortage of help. Dr. Nyirenda comes up with a plan for Yasaya to take Combivir and Crixivan for three months, the point at which his employer may refuse to continue paying for the drugs. Then Yasaya will start the dual therapy. A problem with the drug supply at the pharmacy makes Yasaya receive Viracept instead of Crixivan, as he becomes the 31st person in Malawi to start triple-drug therapy against AIDS. (Washington Post (www.washingtonpost.com), 11/01/00; P. A1; Finkel, David)


Comments on AIDS Weaken Mbeki

South African President Thabo Mbeki's comments regarding AIDS have caused his approval rating to fall from 70 percent to 50 percent in the past year. Mbeki has questioned the link between HIV and AIDS -- one that most scientists accept -- and has suggested that poverty is a direct factor behind the disease. His frequent statements about poverty causing AIDS have hurt his image as a competent leader, and the government now working on damage control by creating an advertising campaign stressing condoms and abstinence. The government has also formed an international marketing council to reduce perceptions about crime and AIDS. While some analysts say Mbeki is losing popularity because of a fall in the economy, AIDS workers report that some people now believe risky sex is okay, since the president and scientists he backs have minimized HIV's role and suggested that poverty contributes more to AIDS. (New York Times (www.nytimes.com), 11/01/00; P. A10; Swarns, Rachel L.)


Evaluation of HIV-1 Immunogen, an Immunologic Modifier

A study of HIV-infected investigated whether the addition of HIV-1 Immunogen would reduce disease progression. A total of 2,527 adults without previous AIDS-related conditions were divided into two groups: approximately half of whom received HIV-1 Immunogen, while the rest received a placebo. A total of 57 percent of the subjects were receiving combination antiretroviral therapy (ART). About 70 percent of the subjects changed his or her type of ART during the trial, and 40 percent added or ended a protease inhibitor during the 48 weeks. During the study, the overall event rate was 1.8 per 100 person years of follow-up. A total of 106 subjects reached an endpoint stage of AIDS-related disease, including 35 who died prior to clinical progression. The most common disease seen was oropharyngeal candidiasis, which occurred in 13 participants. Overall, 42 subjects died: 23 in the HIV-1 Immunogen group and 19 in the control group. The authors note that there were no statistically significant differences between the two groups in terms of changes in HIV RNA, CD4 percentage, or body weight. The researchers concluded that HIV-1 Immunogen with unrestricted ART did not increase HIV progression-free survival rates relative to the use of antiviral therapy alone. (Journal of the American Medical Association (www.jama.com), 11/01/00; Vol. 284, No. 17, P. 2193; Kahn, James O.; Cherng, Deborah Weng; Mayer, Kenneth; et al.)


More Teens Visiting Peer Clinic for Sex Issues

The Teen Clinic at Planned Parenthood in Providence, Rhode Island, has a growing number of visitors. The clinic provides sex education, contraceptives, and tests for sexually transmitteddiseases, including HIV. Each peer educator specializes in one subject to help talk to other teens knowledgeably. Most of the visitors are female. The number of teens who come per month has reached about 100, up from about 12 a month when the center first opened in 1996, according to director Miriam Inocencio. (Providence Journal-Bulletin (www.projo.com), 11/13/00; P. 3C; Pina, Tatiana)


Effective HIV Vaccine Trials Need Randomized Placebo-Controlled Design

Dr. Jared Baeten of the International AIDS Research and Training Program at the University of Washington in Seattle reports that HIV researchers should perform randomized trials to keep nonvaccine factors that affect HIV-1 incidence separate from the effects of the vaccine. Dr. Baeten studied HIV-1 incidence among 953 prostitutes in Kenya, and found a decline in HIV risk over time. The researchers' ideas for vaccine trials were published in the Journal of Acquired Immune Deficiency Syndromes (2000;24:458-464). (Reuters Health Information Services (www.reutershealth.com), 11/10/00; Hendry, Joene)


Stopping Needle-Sticks

In a letter to the editor of the Boston Globe, Karen Daley, president of the Massachusetts Nurses Association, discusses the risks involved with needle stick injuries. Daley -- who contracted HIV and hepatitis C from an accidental needle stick in 1998 -- points out that over 600,000 of the injuries occur every year, with 1,000 resulting in life-threatening infections. Earlier this month, President Clinton signed into law the Needlestick Safety and Prevention Act -- a move which Daley asserts "will help make needle stick injuries a thing of the past." (Boston Globe (www.boston.com/globe), 11/18/00; p. A16; Daley, Karen)


Mentally Ill Patients at Risk for HIV, TB, and Hepatitis

New research presented at the annual meeting of the Academy of Psychosomatic Medicine in Palm Springs, California, indicates that patients in mental hospitals are at greater risk for HIV, tuberculosis (TB), and hepatitis compared to individuals in the general population. Scientists studied more than 650 men and women admitted to psychiatric facilities between 1997 and 1999.

The researchers discovered that the patients were four to five times more likely to be infected with hepatitis B and 12 times as likely to have hepatitis C, while 20 percent tested positive for TB, and the estimated rate of HIV infection was 3 percent. Lead author Dr. W.F. Pirl of Harvard Medical School and the Eric Lindemann Mental Health Center in Boston, said the high infection rates were surprising, but better testing and treatment could help. (Reuters Health Information Services (www.reutershealth.com), 11/17/00; Mozes, Alan)


Nuceloside Analogues Should Be Switched when Protease Inhibitor Is Added

New findings published in the journal Clinical Infectious Diseases (2000;31: 987-994) show that HIV patients who receive new nucleoside analogues (NAs) benefit from protease therapy. Dr. Pierre-Marie Girard of Hopital Rothschild in Paris and colleagues studied 608 HIV-positive individuals to assess the long-term effects of antiretroviral therapy on treatment-naive and NA-experienced patients. The researchers found that after 22 months, 88 percent of the treatment-naive and 57 percent of the previously treated subjects had undetectable viral loads. The authors concluded, therefore, that treatment failure in therapy-naive patients should be low. (Reuters Health Information Services (www.reutershealth.com), 11/13/00)


Study Shows Why Teens Have Sex Early

A study from Drs. Rick Zimmerman and Katharine Attwood of the University of Kentucky has found that high school students in a relationship or who think their friends are having sex frequently are more likely to have sex earlier in high school, as are teens who drink alcohol. The four-year survey of 950 ninth grade students showed that 47 percent of teens in a relationship had already had sex in the ninth grade, compared to 23 percent of those not in a relationship who had sex. Attwood reported at the American Public Health Association meeting in Boston that it necessary to understand that students form two groups: those who have sex earlier and those who wait. Those students who postponed sex until they were older were more likely to have higher grades or were involved with religious activities. (Reuters Health Information Services (www.reutershealth.com) 11/14/00; Mulvihill, Keith)


Young Lack the Facts About AIDS

A new poll conducted by MTV shows that many young people are misinformed about HIV and AIDS. According to the survey, which questioned over 4,100 teenagers and young adults in 16 nations across the world, 60 percent of the 16- to 24-year-olds said they should be concerned about AIDS. However, only about one-quarter of the viewers said they know much about the disease and only about half of the sexually active respondents said they would never have unprotected sex. (USA Today (www.usatoday.com), 11/29/00; P. 9D; Healy, Michelle)

Articles in this section were abstracted by the National Prevention Information Network (NPIN) of the U.S. Centers for Disease Control and Prevention.


Back to the February 2001 Issue of Body Positive Magazine.


  
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