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HIV/AIDS Chronicles

May 2001

HIVMA Develops Qualifications for HIV Specialists. The Infectious Disease Society of America's HIV Medicine Association (HIVMA) has unveiled new requirements for doctors who want to become qualified as HIV specialists. The group has presented its proposal to officials in California, where an amendment to state law gives HIV-infected individuals the right to be treated by physicians qualified in the treatment of HIV. According to HIVMA Chair Dr. William Powderly, HIVMA is recommending that any credentialing process for HIV specialists focus on a combination of patient experience and ongoing education and training in HIV care, especially with antiretroviral drugs.

To Combat the Wily HIV, Newer and Safer Drugs are Necessary. Despite the development of at least 15 anti-HIV drugs since the mid-1980s, more and better medications are needed to effectively reduce the number of infections and deaths from AIDS. Current HIV patients continually fight the odds of viral resistance to the drugs, while treatment programs that do work may have to be taken for a lifetime which could be as long as 50 years or more for a young patient. Experts did not predict the majority of the toxicities currently plaguing the anti-HIV drug therapies today, nor do they completely understand why the resistances develop. There are dozens more drugs currently in the experimental and testing stages, but it is not known when or if the FDA will ever license a 16th drug. Even with all the obstacles they have encountered, researchers remain optimistic that new classes of drugs, along with immunologic therapies and other techniques, will ultimately eradicate HIV for good.

Interneuron Says Gel to Be Tested Against HIV. Interneuron Pharmaceuticals announced Wednesday, February 28, that it would conduct tests of its PRO 2000 vaginal gel in four countries that have high rates of HIV infection. The tests -- intended to assess the gel's efficacy against HIV -- will be conducted in Zimbabwe, Malawi, South Africa, and India. The Phase II/III study will be run by the National Institute of Health's HIV Prevention Trials Network later this year.

Roche AIDS Eye Drug Backed by U.S. Advisory Panel. A Food and Drug Administration (FDA) advisory committee unanimously voted in favor of Hoffmann-La Roche's new drug to treat cytomegalovirus (CMV) retinitis in AIDS patients. The drug, valganciclovir, is an oral formulation of Roche's intravenous CMV drug, ganciclovir. The FDA advisors recommended approval of the new drug based on tests showing its efficacy in the early stages of the disease; however, the panel did question valganciclovir's effectiveness over the long-term for the treatment of CMV retinitis in AIDS patients.

Merck Starts Human Trials of AIDS Vaccine. Although this certainly will not be the first AIDS vaccine to enter human trials, Merck's testing of a new vaccine appears promising. Dr. David Baltimore, the chair of the National Institute of Health's AIDS Vaccine Advisory Committee, suggested that members of the panel -- which heard details of the vaccine's progress during a closed-door session last month -- "were excited" about the prospects. Merck will combine the vaccine with one it had tested earlier in a new trial for healthy, uninfected patients to check the products' safety, a step in a long process that has impressed researchers because of the thoroughness with which Merck has performed its research to date. Details of animal trials have yet to be revealed, and while panelists who approved the human trials may not reveal any specific information about Merck's testing, they claim the data are impressive and the greater scientific community at large will learn of the vaccine at a forum in Colorado in April. While Merck chief of vaccine research Emilio Emini notes pointedly that the vaccine "might fail," the drug worked well in monkey trials, according to those close to the investigation, and will enter tests in HIV-positive patients in four months, if the present step is successful.

GlaxoSmithKline AIDS Drugs Show Promise. An AIDS vaccine developed by GlaxoSmithKline has been shown to stave off the disease in monkeys for over a year. Human Phase I clinical tests are expected to start later this year. If the product proves successful in human testing, Glaxo may combine the vaccine with a cocktail of its existing AIDS drugs. Merck, VaxGen, Aventis, and Chiron are among the other companies that have tested or are testing HIV vaccines.

Glaxo Cuts Price of HIV Medicine. Pharmaceutical giant GlaxoSmithKline (GSK) announced Wednesday, February 21, that it would reduce the prices of antiretroviral drugs by 90 percent to non-governmental organizations and employers that can efficiently distribute them in developing nations. GSK's chief executive officer, Jean-Pierre Garnier, noted that more must be done to help HIV patients in the developing world; however, he noted that patents are not the problem. "Even in countries where low-cost generics could be available, they aren't," he said. Garnier said the governments of Senegal, Rwanda, and Uganda have already accepted a previous drug-discount officer, while 31 others have expressed interest.

AIDS Pill Lowers HIV Levels in Clinical Trials. Gilead Sciences, a biotech firm in Foster City, Calif., reported that early results of a Phase III test of its once-a-day HIV drug, tenofovir DF, showed a significant drop in HIV levels in the bloodstreams of AIDS patients who were developing resistance to existing drugs. The study involved 552 AIDS patients who were divided into two groups: one that received tenofovir in addition to the standard AIDS drug cocktail, and another that was given the AIDS drug cocktail and a placebo. Gilead reported Tuesday, February 20, that halfway in to the 48-week study, patients in the tenofovir group saw an average 75 percent decrease in HIV levels, while the HIV levels of the patients in the placebo group remained essentially flat.

Bugs Keep HIV at Bay. Two new HIV vaccine compounds, nicknamed "Trojan horse" vaccines, consist of manipulated versions of live bacteria from other diseases. The vaccines are being developed and researched by David Hone and colleagues at the University of Maryland Biotechnology Institute in Baltimore and also by Yvonne Paterson and colleagues from the University of Pennsylvania Medical School in Philadelphia. Hone's vaccine is based on a weakened strain of Salmonella typhi, the bacterium that causes typhoid fever. Animal tests have conclusively demonstrated its effectiveness in protecting the mucosal surfaces in the rectum, vagina, and cervix. Hone hopes to begin clinical testing in Nigeria and Uganda later this year. Paterson's compound, meanwhile, is based on a weakened strain of Listeria moncytogenes. The vaccine has tested effectively on mice, and Paterson hopes to begin testing on monkeys soon.

Study: HAART Less Costly Than Treatment for AIDS. Caro Research, a health care consulting firm in Concord, Massachusetts, has studied and compared the costs of healthcare for persons with HIV/AIDS and found that it is significantly less expensive to maintain a program of highly active antiretroviral therapy (HAART) for a person with HIV, than it is to care for a person with AIDS. Judith O'Brien, senior researcher with Caro, says the important point is that HAART will always remain expensive, but the cost must be looked at from the larger context of treating HIV-positive persons in order to prevent them from progressing to AIDS. The study found that of 13,100 hospital discharges of HIV patients and 49,000 AIDS patients, the average annual cost per HIV patient without AIDS was $17,600, compared to $24,900 for individuals with AIDS. Between 1995 and 1998, the number of reported AIDS cases in Massachusetts increased 78 percent, while the rate of hospitalization dropped from 85 percent to 31 percent.

Virologic and Immunologic Consequences of Discontinued Combination Antiretroviral Drug Therapy in HIV-Infected Patients With Detectable Viremia. Researchers evaluated 23 HIV patients in an effort to determine the effect of discontinued HIV-drug therapy in patients taking antiretroviral drugs. Sixteen patients who had plasma HIV RNA Levels greater than 2,500 copies per milliliter while taking the combination drug treatments were chosen to participate in the randomized portion of the study. Eleven of the patients were selected to cease drug therapy, and five patients stayed on the drugs. The remaining seven patients non-randomized portion of the study were also taken off drug therapy. Therapy was discontinued for a period of 12 weeks, during which time plasma HIV RNA levels, CD4 cell counts and drug susceptibility was noted and recorded. Baseline measurements were taken of viral replicative capacities at the beginning of the study and again at the end. The researchers concluded that antiretroviral drug therapy remains a benefit for patients with persistent viremia, reflecting an association between continued therapy and maintaining a lower viral replication rate. The long-term implications of the findings are as yet undetermined, and the authors recommend continued therapy with combination drugs containing protease inhibitors for patients with limited therapeutic options.

AIDS Drug Mix Tied to Disfigurement. A new study suggests that extended use of AIDS drug cocktails, not a single drug, is likely the reason why some AIDS patients developed lipodystrophy. The condition causes pot bellies and fat deposits on the upper back. According to the researchers, who studied nearly 500 HIV patients between 1996 and 1999, lipodystrophy increases with age and use of AIDS drug cocktails. "Our study suggests that the risk of lipodystrophy is mainly related to the total exposure" to the combination drug therapy and "only to a lesser degree to specific antiretroviral drugs," said Dr. Esteban Martinez, who conducted the research with his colleagues at the Infectious Disease Unit at the Hospital Clinic in Barcelona. The findings are published in the journal The Lancet (2001; 357:592-598).

AIDS Drugs Help Even When Virus Resistant -- Study. A study of 16 male volunteers infected with drug-resistant HIV investigated the effects of stopping treatment in ten of the patients for 12 weeks. The researchers found that when treatment was discontinued, the amount of HIV in the blood increased faster, proving that the drugs -- despite the resistance -- helped to keep virus levels lower. It was also discovered that the number of disease-fighting CD4 cells declined more rapidly in the group for whom medication was discontinued. The researchers, who report their findings in the New England Journal of Medicine (2001; 344: 472-480), suggest that these findings mean that when drug therapy is interrupted, non-resistant virus particles spark into action, grow more rapidly, and kill more immune cells than the drug-resistant particles.

Many HIV Patients Report Use of Alternative Meds. A new study into the insight of patients' perception of their illness and medication regimen found that many HIV-positive individuals take alternative therapies in addition to their prescribed HIV medications. Alternative therapies micro-nutrients, vitamins, herbal supplements, teas, massage, protein supplements, and anabolic steroids. According to the study, almost 60 percent of the patients who said they used alternative medicines said they had informed their doctors about the therapies, although the data was not generally recorded in the patient's chart; the patients were more likely to tell their physicians only about their use of anabolic steroids or protein supplements. Because of the possible toxicity or negative interactions, the researchers advise patients to inform their physicians of all alternative medicines they are using.

Health Care: Abbott Recalls One Lot of HIV-Testing Kits. The Food and Drug Administration (FDA) announced that Abbott Laboratories has recalled one lot of its HIV-testing kits, in part because a manufacturing problem could affect the results of the tests. According to the FDA, an incorrect amount of liquid reagent was used in the tests, so the tests could fail to show whether a person is infected with HIV.

Fear of Disclosure and Popular Stigmas Contribute to Bad Outcomes. Some recent surveys demonstrate the very real stigma and misinformation associated with the causes and transmission of HIV. In one study, the Centers for Disease Control and Prevention found that 18.7 percent of 5,671 people surveyed believed that, "People who got AIDS through sex or drug use have gotten what they deserve." The same survey found that at least one of every four persons who stigmatized HIV and some 40 percent of all the survey participants believed that HIV could be transmitted by sharing a drink with an infected person, or by someone coughing or sneezing. The stigmatizing responses were more prevalent among white males, individuals aged 55 or older, people with an annual income under $30,000, people with only a high school diploma, and individuals in bad health. The CDC researchers concluded that early diagnosis and treatment are essential to the HIV-patients' overall health and well being, reduces hospital costs, and reduces the risks of active, uninformed transmission of the disease. The study noted, however, that "HIV-infected persons who fear being stigmatized are typically reluctant to acknowledge risk behaviors, avoid seeking prevention information, and may experience real or perceived barriers to prevention and healthcare services."

[Pennsylvania] Health Dept. Proposes HIV Disclosure. The Pennsylvania Health Department unveiled in late February a plan that would require physicians to report the names of HIV patients to state health officials. Under the new plan, HIV would be added to the list of 52 diseases and conditions now being reported to the state. According to State Health Secretary Robert Zimmerman, "Confidential reporting by name of patients with HIV is the most effective and efficient way to advance Pennsylvania's public health, and to help ensure those who are infected with HIV have timely access to education, medical care, and social services." Some AIDS activists expressed concern about the plan to use patients' names, suggesting that the proposal could make some people reluctant to be tested if they know the results will be reported to the government. The proposal must still go through several months of public review; however, if it is approved, Pennsylvania health officials hope the new rules could go into effect next year.

Suspect's HIV-Status Privacy Upheld. In Massachusetts, Supreme Judicial Court Justice Martha Sosman in mid-February ruled that a bleeding suspect's HIV status would be protected, despite the risk to arresting police officers. In the case, the suspect allegedly attacked Springfield police with a butcher knife after they responded to a domestic violence call at the individual's home. The suspect, who was shot by one officer, was bleeding at the time of the incident. As a result of the HIV risk, one officer has reportedly started treatment with AIDS drugs to help prevent infection in case he was exposed to the virus.

D.C. Flier on AIDS Cites Bible. During a recent health fair in Washington, D.C., HIV/AIDS pamphlets containing citations from the Bible were distributed to participants. Printed on the cover of the booklet, called "A Christian Response to AIDS," was the D.C. Health Department Administration for HIV/AIDS logo, prompting concern among activists and civil libertarians that tax dollars were used in the purchase of the booklets. Arthur Spitzer, legal director of the area chapter of the American Civil Liberties Union, feels it is unconstitutional for the city to be spending tax dollars to promote religion. Officials from the D.C. health department admitted that it was a mistake to have ordered them at department expense and another mistake to have the department logo printed on them. A health department spokesperson said the original order was placed five years ago for a church program and was received without complaint; however, any remaining copies of the booklet will not be distributed.

Study Shows Injection Drug Users at Needle Exchange Program Share Few Syringes -- and Those Who Do, Share With Friends. Public health researchers at the Keck School of Medicine of the University of Southern California (USC) and the New York Academy of Medicine report that most injection drug users who take part in community needle exchange programs do not share their needles. The researchers note in the March issue of the American Journal of Public Health that because the results of the two-year study indicated that some drug users continue to share needles, despite the risks of contracting HIV and hepatitis B and C, "programs need to renew efforts to discourage further sharing of syringes obtained from the program." The authors studied nearly 1,200 injection drug users who participated in a Baltimore needle exchange between 1995 and 1997, and they found that about 17 percent of the addicts reported recently sharing a syringe, usually with a friend. Study co-author Thomas W. Valente, an associate professor at the Keck School at USC, said, "People working in HIV prevention need to get the message out that sharing with friends might seem natural and safe, but that isn't necessarily so. It is safer to use your own needle, and even safer to stop injecting altogether."

HIV-Infected Nurse Wants Safer Needles. Massachusetts nurse Karen Daley is behind a new legislative bill in Colorado that would require public employers to use a new, more protective type of needle for administering intravenous medications or drawing blood. An emergency room nurse, Daley became infected with HIV and hepatitis C after being accidentally stuck with a needle. She has urged other states and Congress to mandate that public institutions adopt measures to prevent accidental needle sticks. Under the Colorado bill, HB 1333, employers would be able to decide how to reduce needle sticks using special needles, for example, or a needle-less system. According to the Centers of Disease Control and Prevention, using safety needle devices could reduce needle sticks by as much as 76 percent.

Activists Decry Response to Black AIDS Toll. Valerie Papaya Mann, director of the D.C. Care Consortium, asserted Friday, February 23, that immediate and extensive action is needed to fight the high rate of HIV infection and mortality rate among African Americans. The activists noted that Washington, D.C., has the highest rate of HIV infection of any city in the United States, and they said that not enough effort is being made to reach the communities where African Americans live. "The challenge for those of us who are committed to reducing and eliminating HIV infection in the African-American community is to get our community to understand the severity of the current crises and the devastating impact this epidemic can have in the future," said Ron Simmons, executive director of Us Helping Us. Some activists said that Mayor Anthony Williams has been too silent on the issue, noting that the D.C. HIV Advisory Committee has not met in over two years and that there are no city-funded programs or conferences to encourage citizens to openly discuss issues surrounding the disease.

Undeterred by a Monster; Secrecy and Stigma Keep AIDS Risk High for Gay Black Men. A study of 529 young men who have sex with men in New York City revealed that one-third of the African-American participants were infected with HIV, compared to 16 percent of all the men and 2 percent of the white men. African Americans made up just over 25 percent of the total group. The findings have researchers questioning how -- after years of news, political protests, and educational efforts -- some people do not understand the dangers of high-risk sexual practices. The reasons for this are many, and they include how a man perceives his homosexuality and how that affects where and when he decides to engage in intercourse. Other factors include how funds are directed to fight AIDS, poverty, drug abuse, and youth. Under conditions of homelessness and poverty, for example, some individuals use sex as a way to make money or find temporary housing. The social distress is so great in some communities that sex is used as a means to gain self-esteem, especially among young participants. Some health care workers assert that larger AIDS organizations have failed to properly address the specific issues of African-American homosexuality, in contrast to the same issue that mobilized white gay men infected during the first years of HIV. However, many have also noted the failure of some African-American AIDS groups to discuss or talk to homosexual men.

[Florida] County's New AIDS Cases Rank 5th in U.S. Metro Areas. Palm Beach County, Florida, now ranks fifth among 101 large metropolitan statistical areas in the United States for the highest rates of new AIDS cases. The country ranked eighth in 1999 and sixth the previous year. New statistics reveal an increase in new AIDS cases last year that terminated what had been a four-year decline in cases per 100,000 people in the county. Countywide, HIV cases dropped 24 percent, even as newly reported AIDS cases among adults increased 16 percent. The U.S. Department of Health and Human Services recently gave Palm Beach County $20,000 to support the establishment of a health team focused on identifying four "hot spots" where HIV transmission occurs frequently. The Rapid Assessment and Response Evaluation project will include resident volunteers to nightly patrol the streets of the targeted areas, identifying people who might be at risk or appear to be spreading HIV, and getting them in for testing and treatment.

Lamivudine Accumulates in Amniotic Fluid. According to new research from Dr. Laurent Mandelbrot and associates at the Service de Gynecologie-Obstetrique in Paris, lamivudine seems to collect in the amniotic fluid of HIV-positive pregnant women. The researchers measured levels of lamivudine in the amniotic fluid, maternal blood, and cord blood of 57 mother-infant pairs, and found that maternal and fetal concentrations of the drug were highly correlated. The authors noted that while the high concentrations of the drug may prove to be beneficial in post-exposure prophylaxis against vertical HIV transmission, they are concerned about mucosal toxicity in infants. Their findings are published in the January issue of the American Journal of Obstetrics and Gynecology (2001;184:153-158).

Protein in Placentas Said to Block AIDS. Researchers have discovered that a small protein found in the human placenta may be a natural protector against HIV. The protein, called leukemia inhibitory factor, or LIF, may naturally protect many fetuses from contracting HIV from their mothers. The findings were presented by Dr. Bruce Patterson of Children's Memorial Hospital in Chicago, and colleagues at the Eighth Annual Conference on Retroviruses and Opportunistic Infections in early February.

Bush to Keep Intact Clinton AIDS Policy Despite Criticism by Some Drug Firms. The office of the U.S. Trade Representative announced Tuesday, February 20, that President George W. Bush will maintain the existing U.S. AIDS policy. The pharmaceutical industry had hoped that Bush would implement changes because it feels that the current system allows some poor African countries to circumvent its intellectual property rights. The industry is especially against South Africa's proposals to reduce the cost of AIDS drugs through parallel importing and compulsory licensing. A Pretoria court will soon hear a legal challenge to the government action by the country's pharmaceutical manufacturers association. According to the U.S. Trade Representative's statement, "Consistent with our overall effort to protect America's investment in intellectual property, [the Bush administration will] work with countries that develop serious programs to prevent and treat this horrible disease."

Federal AIDS Treatment Money Will Go for HIV Prevention. In an effort to reduce by half the number of new HIV infections in the United States by 2004, government-funded health clinics that care for poor AIDS patients will emphasize prevention among their patients to keep them from spreading the virus. The Centers for Disease Control and Prevention's Dr. Helene Gayle, head of the National Center for HIV, STD, and TB Prevention, notes that the move aims to address the gap between AIDS care and prevention. Last fall, Congress allowed AIDS clinics to access federal monies through the Ryan White Care Act, in an effort to reach infected individuals into prevention and primary care programs. New language has been added to the law requiring that states and cities that are applying for grants must now report local HIV infection rates, in addition to AIDS cases, as part of an effort to help health officials reach the estimated 300,000 people who are unaware of their HIV infection.

UCLA Study Shows AIDS-Intervention Programs Curb Risky Sex and Drug Use by HIV-Positive Youth. A recent study from the University of California at Los Angeles found that HIV-infected youths participating in an AIDS-intervention program voluntarily decreased their high-risk sexual behavior by 82 percent and their drug use by one-third. The findings, reported in the March edition of the American Journal of Public Health, offer some encouragement in the effort to curtail the spread of HIV among young people. During the study, researchers worked to assist participants in maintaining emotional wellness, take responsibility for their health, and reduce their high-risk behaviors. The "Stay Healthy" part of the program involved 12 sessions aimed at helping participants change their behaviors. The teens were introduced to modified behavior routines designed to keep them healthy, and they were educated about how to cope with their HIV status, disclosure issues, and medical decision-making. The second section, called "Act Safe," targeted the prevention of disease transmission to others.

Oxfam Joins Campaign to Cut Drug Prices for Poor Nations. Oxfam, a British charity, has begun a campaign to force drug companies to reduce the prices of lifesaving drugs to poor nations, by joining forces with Doctors Without Borders, ACT-UP, and others who have been of similar mind-set. The group plans to concentrate primarily on the world's largest pharmaceutical company, GlaxoSmithKline. Oxfam and advocates plan to attack the drug company through addressing audiences of its major financial backers on Wall Street and in London. "Our message to the big financial house will be that unless the big drug companies do something dramatic soon, they run a serious reputation risk," said Sophia Tickell, head of the campaign. Oxfam is also calling for a $5 billion fund to subsidize drug research for diseases like malaria, elephantiasis, tuberculosis, and sleeping sickness, all of which exist in epidemic proportions in poorer nations. The charity has requested that drug firms contribute part of their royalties from drug sales surpassing $1 billion to the effort. In response to Oxfam's announcement, Glaxo Chairman Sir Richard Sykes called it, "political rhetoric to point the finger somewhere else from where it should be."

Annan Urges More Spending to Stem AIDS. In a 29-page report released Tuesday, February 20, United Nations Secretary-General Kofi Annan called the AIDS epidemic "the most formidable development challenge of our time." The report, part of an effort to encourage foreign governments to increase their funding to fight the disease, is expected to set the pace of the first special AIDS session being held by the General Assembly in June. Annan urged governments to fund vaccine research, direct resources to high-risk groups, and determine goals regarding the overall reduction of the spread of infection. He also called on drug companies to provide more affordable medicines.

In India and Africa, Women's Low Status Worsens Their Risk of AIDS. A combination of poverty and powerlessness is putting women in Africa and Asia increasingly at risk for HIV infection. A recent report from United Nations Secretary-General Kofi Annan noted, "The gender dynamics of the epidemic are far-reaching due to women's weaker ability to negotiate safe sex, and their generally lower social and economic status." Despite years of international family planning efforts and education regarding women's rights, some countries still have practices in which a widow is married to her late husband's brother; however, if the husband died of AIDS, the widow might be infected, and might then pass HIV on to her new husband. In order to fight AIDS, Noeleen Heyzer, executive director of the U. N. Development Program for Women, asserted that governments and international agencies must focus on women. In addition, Adrienne Germain, president of the International Women's Health Coalition in New York, called for increased education in sexual behavior that "emphasizes gender equality and power relations more broadly, not just biologically."

China Admits Having More Than 22,000 HIV Cases. There were 22,517 known HIV patients in China as of year-end 2000, but a new report indicates that the actual number could be substantially higher. State television quoted experts from the health ministry as saying the country could have over 600,000 cases of HIV infection. Unless aggressive measures are taken, the United Nations has predicted that China could have at least 10 million cases of HIV/AIDS by 2010. According to the television report, about 70 percent of China's HIV cases are among drug users, two-thirds live in rural communities, and nearly 90 percent are between the ages of 20 and 50.

HIV Virus Infects Vietnamese Prostitutes. A new report reveals that over one-fifth of commercial sex workers in Vietnam are infected with HIV, up significantly from just two years ago. The findings are based on a survey conducted late last year by the Vietnamese ministry of labor and social affairs on 13,600 prostitutes.

South African AIDS Campaign Targets Pre-Teen Sex. In an effort to stem the spread of HIV among young people, AIDS activists in South Africa are focusing on the risks of starting sexual activity too early. On average, South African children begin engaging in sexual activity at age 12, although the official age of consent is 16. South Africa is also plagued by high rates of rape, and some people believe the myth that having sex with a virgin can cure a man with AIDS. LoveLife -- an AIDS organization established two years ago with funding from the Kaiser Family Foundation, the Bill and Melinda Gates Foundation, UNICEF, and others -- is working to halve the incidence of HIV infection among 15- to 20-year-olds within five years, targeting 12- to 17-year-olds with aggressive television advertisements and education and awareness programs.

AIDS Knowledge, Attitudes, and Behaviour in Russia: Results of a Population-Based, Random-Digit Telephone Survey in St. Petersburg. Researchers conducting a population-based, random-digit telephone survey in St. Petersburg, Russia, identified a number of factors associated with high HIV risk. Just 6 percent of the participants reported consistent condom use, while more than 13 percent reported having three or more sexual partners in the past 12 months. In addition, 13 percent reported occasional or frequent anal sex. While approximately 66 percent of the subjects admitted they were at risk for contracting HIV, less than one-quarter said they had taken risk reduction measures. Many of the respondents also had mistaken beliefs about how HIV could be transmitted, such as through mosquito bites or by sharing cigarettes. The researchers note that more HIV/AIDS prevention efforts are needed in Russia, both for the general public and for high-risk groups.

Brazil's Unconventional AIDS Fight. Brazil has an unusual leader in its fight against AIDS. Jacqueline Rocha, a transsexual who is infected with HIV, has been credited for being the spirit behind the also unusual AIDS program the nation has undertaken. Part of the program involves the free distribution of generic AIDS drugs for the patented versions. Brazil's program is acclaimed for its unconventional combination of powerful advocates, including Rocha, Roman Catholic priests, and government officials. International health officials, who are used to seeing conflicts between governments and advocacy groups, say they are impressed with the progress that Brazil has made and the nation's ability to use diversity as a tool for success. Rocha is a member of the National AIDS Commission, which discusses prevention, care and how to control the epidemic. The commission also includes prostitutes and drug users, and all members must be consulted before any ad campaign is launched. Rocha has worked to fight a shortage of drugs for AIDS-related infections; demanded assurances from the government that locally produced AIDS medications will meet the standards of those made in more developed countries; and has also tried to combat rights violations, such as workplace discrimination of HIV-positive individuals.

HIV-Related Viruses Still Cross Species. Most researchers concur that the simian viruses that most closely resemble HIV started with chimpanzees and sooty mangabeys and was eventually contracted by humans. Variations of the simian immunodeficiency virus (SIV) exist in other nonhuman primates and continue to infect the human population in Africa. In an effort to discern how prevalent the virus is among wild nonhuman primates, researchers performed blood tests on 17 different species of 384 baboons and monkeys from Cameroon and found that 18 percent of the animals possess SIV antibodies that bind strongly to HIV antibodies. According to Eric Delaporte of the University of Alabama in Birmingham, another 14 percent of the animals had antibodies that bind less strongly to HIV, and several of the SIV subtypes identified had not been seen before. The findings were presented recently at the Eighth Conference on Retroviruses and Opportunistic Infections in Chicago.

Money's Not the Only Problem; Fears and Leadership Flaws Hinder the Search for AIDS Vaccine. In his new book, Shots in the Dark: The Wayward Search for an AIDS Vaccine, author Jon Cohen writes that the search for an AIDS vaccine has been fraught with egos, institutional politics, and rogue scientists. Cohen, a contributing correspondent for Science magazine, argues that the goal should be to develop a vaccine that works even if the reasons why it works are not immediately understandable and even if it is not perfect. Cohen notes, "A mediocre vaccine today would do the world more good than a 100 percent vaccine 10 years from now." There are several key obstacles to vaccine research, Cohen asserts, including funding, a reluctance by some to participate in testing, the ability of HIV to rapidly mutate, a lack of political support from world leaders, and a lack of interest from major drug companies.

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This article was provided by AIDS Survival Project. It is a part of the publication Survival News.
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