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March 2000 Treatment Chronicles

From the CDC National AIDS Clearinghouse

March 2000

Agency's Leader Takes the Subway to the Front of the AIDS Battle. Ana Oliveira is the first woman to serve as executive director of the Gay Men's Health Crisis (GMHC), the first and largest AIDS service agency in America. A native of Brazil, a lesbian and an acupuncturist, Oliveira started working for the agency in 1996 in the women's department. Oliveira explains that her first ties to the agency began in 1981, when she took the subway to the South Bronx to study acupuncture at a school associated with Lincoln Hospital's substance abuse program. Paul Popham, a founder of GMHC, turned to the clinic she worked for in an effort to find a solution for the then-unnamed AIDS. Although Oliveira had originally planned to return to Sao Paulo, she now says she will not leave until "we have the same impact on the prevention side of the epidemic [that] we've had on quality of life."

AIDS-Related Opportunistic Illnesses Occurring After Initiation of Potent Antiretroviral Therapy. A Swiss HIV Cohort Study examined the incidence of opportunistic infections (OIs) in patients taking potent antiretroviral therapy and identified some risk factors. The study, which took place in Switzerland, included 2,410 participants who were followed for at least 15 months after beginning treatment. The results show that 143 of the patients developed 186 OIs after beginning potent antiretroviral therapy. The incidence of any OI dropped from 15.1 per 100 person-years in the six months prior to treatment to 7.7 in the first three months of therapy, 2.6 in the next six months and 2.2 per 100 person-years between months nine and 15. The authors concluded that the risk of developing an OI for a patient taking antiretroviral therapy is greatest during the first few months of therapy. They also noted that baseline CD4 cell count and immunologic and virologic response to treatment were to strong predictors of disease progression in the patients receiving the treatment.

Help for Web Pharmacy Users. The Food and Drug Administration (FDA) has launched a new Web site, accessible via www.fda.gov, intended to help patients buy drugs and medical products over the Internet. The site warns of the dangers of buying illegal products online and also includes instructions on how to report suspicious sites or when one experiences serious side effects from products purchased on the Internet. The FDA recently reported that illegal home HIV tests being sold online did not work correctly. According to the agency, patients can verify the legitimacy of an online pharmacy by checking the National Association of Boards of Pharmacy Web site, located at www.nabp.net.

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Visions 21: The Spread of HIV. AIDS will remain an epidemic well into the future, according to Dr. David Ho, director of the Aaron Diamond AIDS Research Center. HIV has become the most fatal microbe in the world, more deadly than tuberculosis and malaria. Sub-Saharan Africa and Southeast Asia have been particularly hard hit by the epidemic, and the infection rates continue to rise. Fourteen AIDS drugs have been created and are now used in the United States and Western Europe, but treatments are scarce in less developed areas. Ho predicts that AIDS will be the leading killer of young Africans by 2025, but he notes that Asia "will have the biggest impact on the global spread of AIDS." Depending on how the virus spreads in India and China, 100 million to 1 billion people could be affected, Ho says. The real hope for stopping HIV is a vaccine, which will require a huge effort on the part of government leaders to help get it to the people who are most in need.

Step Up the Fight Against AIDS, Panel Says. Participants in a panel discussion on AIDS in Africa at Harvard's Graduate School of Education are calling on the African-American community and U.S. leaders to help fight the epidemic. The topics of rape and promiscuity sparked discussion on sexual behaviors that help spread HIV. Rev. Eugene Rivers, co-chairman of the National Ten-Point Coalition, called for "a post-civil rights freedom movement to free the women of the world from rape and sexual exploitation." In addition, panelist Kevin Freeman of Boston University's School of Public Health suggested that all races should work together to help stop AIDS.

Hospices Are Succumbing to Falling AIDS Mortality. The decline in the number of deaths from AIDS in the past few years has affected hospices in the Los Angeles area and throughout the United States, causing some to close their doors because patients are living longer and healthier lives. Richard Bettger was once near death because of AIDS, and had gone to a hospice to die. However, new drug treatments helped him recover within a year and he was able to return to his old life. AIDS mortality in Los Angeles County fell 52 percent in 1997 from 1996, and then by 34 percent in the following year.

Doctor with HIV Files Suit Over Job. Arkansas pediatrician Dr. Thomas Jefferson was fired in July 1998 from his children's clinic after revealing he was infected with HIV. He has sued the clinic in a federal court, claiming he is legally disabled and was wrongfully fired. Jefferson alleges that by firing him, the Little Rock Children's Clinic violated the Americans with Disabilities Act. Jefferson reported his condition to the Arkansas State Medical Board as part of a safety protocol; however, because of his and others' experiences, many HIV-positive doctors and nurses will try to keep their HIV status private. According to a 1996 report in the Journal of the International Association of Physicians in AIDS Care, many doctors hide their HIV status and go out of state for treatment.

West Hollywood Rejects Mandatory Condom Distribution Measure. A proposal in West Hollywood to make handing out condoms mandatory in bars and nightclubs with high-risk customers has been unanimously rejected by the city council. A voluntary distribution program remains in place to help those at risk for HIV. Health advocates supported the proposal for the California city, but some business owners found the idea biased. In addition, West Hollywood Councilman Steve Martin noted that "mandatory condom distribution does not adequately address the issue of safe sex."

Condoms Reduce Heterosexual HIV Transmission Risk Substantially. Researchers from the University of Texas Medical Branch at Galveston have found that consistent use of condoms reduces the risk of heterosexual HIV transmission by about 87 percent. The meta-analysis of 25 studies on condom efficacy showed that proper condom use prevents the transmission of HIV with anywhere from 60 percent to 96 percent effectiveness. According to the researchers, the incidence of transmission among individuals who always used condoms was 0.9 per 100 person-years, compared to 6.7 per 100 person-years for those who never used the prophylactics. The study was published in the November/December issue of Family Planning Perspectives.



  
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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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