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HIV/AIDS Chronicles

March/April 2004

Global Coalition on Women and AIDS Launched

Actress Emma Thompson joined health experts and equal rights campaigners Monday, February 2, to launch the Global Coalition on Women and AIDS, a UN-initiated group of organizations that aims to improve HIV prevention and treatment for young women and girls with HIV/AIDS. The group also plans to address violence against women and legal and social inequalities that make women vulnerable to HIV. "AIDS is the greatest threat to face the human race ever," said Thompson at a London news conference. Thompson said she was inspired to join the coalition after witnessing the consequences of AIDS and seeing the bravery of women and activists during her trips to Uganda and Mozambique. "We are deeply concerned that women's issues are still very marginalized when it comes to the response to AIDS," said UNAIDS Executive Director Dr. Peter Piot. The need for the coalition became clear because prevention methods recommending abstinence, being faithful and using a condom are irrelevant for women infected by their husbands. "Marriage is no protection against AIDS," said Piot. Females are more vulnerable because HIV is more easily transmitted from men to women than vice versa, and women have sex earlier and generally with older partners. African women are nearly 1.2 times more likely to be infected with HIV than boys or men. For young women and girls, the figure is 2.5 times higher. Sexual violence increases the risk of infection. In South Africa, 20-48% of girls ages 10-25 report their first sexual encounter was forced. In addition, property and inheritance rights in many countries make it impossible for a woman to leave her husband even if she knows he may be HIV-positive, and widows lose part or all of their assets to relatives.

NIH Director Defends Government-Funded Research on AIDS, Sexual Practices

In a letter made public Thursday, January 29, National Institutes of Health Director Dr. Elias Zerhouni forcefully defended government funding of research on human sexuality. Writing to Rep. Billy Tauzin (R-LA), Zerhouni said he had reviewed studies of California prostitutes, sex and drug use among truckers, the sexual habits of older men, sexual arousal among gays and lesbians, and other projects Tauzin and other conservatives had complained about. "I fully support NIH's continued investment in research on human sexuality," Zerhouni wrote to Tauzin, who chairs the House Energy and Commerce Committee. Zerhouni said NIH could do a better job of explaining the projects to the public "so that they may understand the relevance of this research to public health." "One grant pays people to watch pornography and drink alcohol before watching pornography," Rep. Joseph Pitts (R-PA) told Zerhouni at an October hearing. In July, the House narrowly defeated an attempt by Pitts and others to block money for sexuality research grants. The Washington-based Traditional Values Coalition (TVC) gave lawmakers a list of 157 researchers with NIH grants; it called the grants "a total abuse of taxpayer dollars." Zerhouni said the study of sexual behavior, although distasteful to some, is important in combating disease. "Clearly, this has to be considered as one of our highest priorities in light of the enormous suffering and costs of illnesses associated with sexual behavior," he said. TVC Executive Director Andrea Lafferty said Zerhouni's argument was superficial and unconvincing. But Rep. Henry Waxman (D-CA) praised the letter. Last fall, he had criticized NIH and Health and Human Services Secretary Tommy Thompson for questioning researchers about their work. "I urge my colleagues in Congress and Secretary Thompson to respect Dr. Zerhouni's decision and disavow irresponsible attacks on science," Waxman said.

AIDS Researcher Partly Retracts Study That Caused Stir

In a letter published on January 23 in Science, leading AIDS researcher Dr. David Ho and colleagues partly retracted a paper previously published in the journal, "Contributions of Human-Defensin 1, 2, and 3 to the Anti-HIV Activity of CD8 Antiviral Factor" (2002; 298:995-1000). In that report, they identified substances active against HIV -- alpha defensins -- as produced by CD8 cells. In their letter, "Retraction of an Interpretation" (2004; 303:467), Ho and colleagues said the substances the report identified were not produced by CD8 cells, but were introduced into the experiment by contamination. For years, scientists have been intrigued that a small percentage of people with HIV live for 10, 15 years or more with no progression to AIDS. Dr. Jay A. Levy, of the University of California-San Francisco and editor of the journal AIDS, observed in the 1980s that certain immune cells of those people, known as long-term nonprogressors, produced something that keeps the virus at bay. Since then, researchers have sought to identify this substance, called CD8 antiviral factor (CAF), after the type of immune cell that supposedly produces it. In their 2002 paper, Ho and colleagues said alpha-defensins -- small proteins the body produces to kill bacteria -- were "a major component of the long-sought-after CAF." But in the January 23 retraction, Ho and colleagues said alpha-defensins are not produced by CD8 cells. When the original paper was published, some scientists said a potential flaw in Ho's experiment was that he grew CD8 cells in cultures along with some other white blood cells that might have produced the defensins. In fact, that is what happened. Ho and Dr. Linqi Zhang, the lead author on the 2002 paper, noted in an interview that the cultures were supposed to contain only B and T cells but also contained a tiny amount of cells called neutrophils, which produce defensins. The scientists said they had used a common technique to prepare cultures, assuming neutrophils would be kept out. "What we have taken for granted in the field over the years is not necessarily correct," Zhang said.


200 Atlanta Gays to Test Whether Pill Stops HIV

Approximately 200 gay men in Atlanta will be among the first 3,000 people in the world to test a new HIV/AIDS strategy: a pill to prevent HIV infection. This spring, three studies -- including one funded by CDC -- will examine whether the drug tenofovir (Viread) can stop HIV from causing infection. Currently used to treat HIV patients, tenofovir works by blocking reverse transcriptase, an enzyme HIV needs for replication. The $3.5 million CDC study will enroll men who have sex with men, 200 at the AIDS Research Consortium of Atlanta and 200 in San Francisco. A $6.5 million Bill and Melinda Gates Foundation trial will involve 1,200 women in Cameroon, Ghana and Nigeria, and 400 heterosexual men in Malawi. And a $2.1 million National Institutes of Health trial will include 900 Cambodian women, mostly sex workers. In each study, half the participants will receive tenofovir and half will receive a placebo. All participants will be advised to practice safe sex and given condoms. Regimen adherence, side effects, viral resistance and high-risk behaviors will all be tracked. Animal studies have suggested tenofovir might prevent HIV infection. Some doctors have begun prescribing the drug, combined with another medicine, as a "morning-after pill" when patients report having risky sex. Physicians also note growing street use of tenofovir among gay men as prevention before sex. That is one reason CDC wants to study whether the drug is safe and effective in HIV-people, said Kathryn Bina of CDC's National Center for HIV, STD and TB Prevention. Experts caution that tenofovir is no magic bullet. It has side effects, and allowing large numbers of at-risk people to take it intermittently could lead to drug resistance. Some worry that the security of taking a pill that would not be 100% effective could lead to more high-risk sex or drug use. Taken daily, tenofovir costs about $4,600 a year -- $12.67 a day.

AIDS Panel Gives Immigrants a Voice

Grace C. Clark, public health program consultant for the HIV section of the Georgia Department of Human Resources Public Health Division, recently led a meeting of more than two dozen community and religious leaders to determine how to tackle the delicate issue of teaching immigrants and refugees about HIV/AIDS. The meeting led to the development of a community advisory council -- the HIV/AIDS Immigrant/Refugee Advisory Board of Georgia -- to serve as a liaison between the state's ethnic communities and the Public Health Division. Clark said refugees and immigrants living in Georgia are from different ethnic groups, experiences and backgrounds. Sometimes, beliefs and customs, coupled with fear, create barriers to getting medical treatment. The rate of HIV/AIDS among Georgia's immigrant/refugee population is unclear. States report AIDS cases to CDC, but not all submit HIV information, a CDC spokesperson said. Moreover, although reporting forms request information on country of origin, state and local practices vary on providing such information. Breaking down barriers for newcomers is urgent, given that half of the 50,000 refugees the U.S. government has agreed to accept for the budget year ending September 30 will come from Africa. In addition to other cultural barriers, the main reason people do not seek medical care is the stigma attached to HIV/AIDS. Nigerian-born Clark said the state's outreach endeavor has been positively received. The program is modeled after a Minnesota effort that was launched after health officials there determined that HIV among African immigrants and refugees helped fuel a 6% increase in new infections in 2002. The state formed an advisory group, sent African-born educators to community centers to talk about transmission and treatment and enlisted the aid of churches and mosques. The Minnesota program's Web site contains HIV/AIDS information in Amharic and Somali.

LA County to Intensify Fight Against HIV, STDs in Gay Bathhouses

On Tuesday, February 3, the Los Angeles County Board of Supervisors ordered local health officials to review HIV/AIDS and STD prevention efforts in gay bathhouses and sex clubs. The board unanimously backed a motion instructing the Department of Health Services and other county workers to recommend improvements in a report within 90 days. The order also requires officials to look for ways cities and the county can coordinate licensing and permitting for the clubs. The motion, authored by County Supervisor Zev Yaroslavsky, cited a study showing 11% of patrons at two bathhouses in 2002 were HIV-infected despite counseling and testing efforts. This rate "suggests that our HIV/AIDS and STD prevention and treatment efforts must be strengthened to address the environment in which high-risk sexual behaviors occur," the motion stated. It also noted the risky behavior occurs at such venues as sex clubs frequented by gay men, with the potential for higher rates of HIV and other STDs at these sites as well. According to John Schunhoff, chief of operations for the public health division of Los Angeles County's health department, an estimated 50,000-60,000 people are infected with HIV in the county. Schunhoff said the motion was also prompted by a syphilis outbreak in 2000 among men going to bathhouses. CDC reports syphilis cases throughout the West soared 64.3% between 2001 and 2002. "We are glad that the county has taken these crucial first steps toward safeguarding public health and well-being by regulating these establishments," said AIDS Healthcare Foundation President Michael Weinstein.

Menino, Health Advocates Push for Needle Legislation

On Wednesday, January 28, Boston Mayor Tomas Menino told state legislators that drug addicts should not have to have a prescription to access clean needles. "It prevents the spread of AIDS. We've known that for years," the mayor told the Legislature's Health Care Committee. Massachusetts is one of just four states that require a doctor's prescription to obtain needles. Boston, Cambridge, Northampton and Provincetown operate needle exchange programs. "We know that clean needles work. We have to use them in the fight," said Jean Flatley McGuire, former director of the state's HIV/AIDS bureau, who now teaches public health at Northwestern University.

Montreal Police Alone in HIV Test: New Standards

On Monday, January 26, Montreal adopted hiring standards for its police force, stipulating that HIV-positive candidates will not be hired. A survey of other professions and trades whose members have close contact with the public revealed that they have no such rule. Robert Salois, president of the Quebec Order of Dentists, which regulates the practice of 4,000 professionals, said he is unaware of HIV testing as a condition of employment for dentists. "It doesn't exist in Quebec and would be illegal, contrary to the Charter of Rights and Freedoms," he said. The Quebec Human Rights Commission is investigating a complaint brought by AIDS rights groups against the Grand Seminaire de Montreal's demand for HIV testing of priesthood candidates. Commission spokesperson Ginette L'Heureux said such tests cannot be ordered unless they directly relate to the job, and the employer must prove an illness would interfere with a person's work. Urgences Sante, with 850 ambulance technicians, does not require HIV tests for new employees, according to spokesperson Eric Berry. "In our job, even if you have HIV, it doesn't mean you can't practice," he said. No trainers or swim instructors at downtown Montreal's YMCA are asked to take HIV tests, said Director Richard St-Yves. "When you teach phys ed or swimming, even if a person were HIV-positive, there is no danger of transmission," he said. Louise Cantin, secretary-general of the 65,000-member Quebec Order of Nurses, said hospitals and other health care centers in Quebec do not require HIV tests for nurses. Hans Brouillette, spokesperson for the Quebec Association of Restaurateurs, which represents 5,500 restaurants, said he knows of no cases where cooks or waiters must take HIV tests. "When you hire someone, you don't have the right even to ask those questions," he said.

From the Centers for Disease Control and Prevention's National Prevention Information Network for HIV/AIDS, STDs and TB.

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