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HIV/AIDS Chronicles

August 2001

Twenty Years of AIDS in America

Twenty years after the first cases of AIDS were identified, the rate of HIV infection for Americans has stabilized at roughly 40,000 annually. That reduced overall HIV infection rate, however, is not reflected in the HIV rate for African-Americans. African-Americans now account for more than half of new infections, according to the Centers for Disease Control (CDC). One in 50 black men is believed to have HIV, with black women accounting for 64 percent of new HIV cases among adult females.

"It's unacceptable, in a rich nation like ours, to have 40,000 new infections of what is a preventable disease," said Dr. Helene Gayle, director of the CDC's AIDS prevention center.

The higher HIV rate for African-Americans is accounted for by enduring socioeconomic disparities, including lack of access to medical care. African-Americans are also more likely than whites to live in areas with high rates of sexually transmitted diseases (STDs).

"Clients I see rarely have just HIV," says Patricia Kelly, executive director of Movers Inc., an AIDS outreach program in Miami. "It's HIV and substance abuse, HIV and domestic violence, HIV and my kids are in foster care, HIV and my family won't have anything to do with me, HIV and I'm in jail."

Blacks are also disproportionately represented in US prisons, where HIV infection rates are six times higher than in the general population.

In addition, black men who have sex with men are less likely to identify as homosexual and so miss prevention messages targeting gays. According to Kevin McGruder, executive director of Gay Men of African Descent, a New York nonprofit organization, black men are less likely to be public about being gay because fewer institutional support systems and medical clinics understand their background.

Finally, mistrust of the medical establishment endures among poor, black Americans because of a history of abuse, like the government-sponsored Tuskegee syphilis study that left patients diagnosed with the disease untreated even after the development of penicillin. Surveys show that eight of ten people at risk for HIV believe at least one HIV conspiracy theory.

According to Dr. Beny Primm, executive director of the Addiction Research and Treatment Corp., the best way to counter the mistrust that leads to high-risk behavior is to use HIV-positive counselors in high-risk neighborhoods. "This way," he says, "the misinformation is refuted by people who are trusted by the community." Such focused intervention can increase HIV testing and may serve as a blueprint for broader efforts.

Landmarks in AIDS Epidemic

  • June 5, 1981: The CDC reports on five Los Angeles gay men suffering from a rare pneumonia found in patients with failing immune systems.

  • May 1983: Human T-cell leukemia virus is identified in patients with AIDS. Identified as the virus causing AIDS, it is later renamed human immunodeficiency virus, or HIV.

  • December 1984: Ryan White, 13, is diagnosed with AIDS contracted from a blood-clotting agent used to treat his hemophilia. He is barred from school the following year.

  • October 2, 1985: AIDS claims its first celebrity with the death of movie star Rock Hudson.

  • May 26, 1988: The government mails "Understanding AIDS," a booklet on how the disease is spread, to 110 million homes.

  • August 18, 1989: Reported US AIDS cases reach 100,000.

  • April 8, 1990: Ryan White dies.

  • June 1991: At the 10th anniversary of the epidemic, 250,000 Americans have AIDS and 1.5 million more have HIV.

  • November 7, 1991: Los Angeles Lakers star Magic Johnson announces he has HIV.

  • March 26, 1992: The government unveils advertising to remind the public that AIDS reaches beyond urban drug addicts and gays.

  • April 8, 1992: Tennis great Arthur Ashe announces he has AIDS.

  • February 6, 1993: Ashe, 49, dies of AIDS-related pneumonia.

  • December 7, 1995: The Food and Drug Administration approves the nation's first protease inhibitor, a new class of drugs that cripples an enzyme HIV needs to reproduce.

  • December 30, 1996: Protease inhibitor pioneer Dr. David Ho is named Time magazine's Man of the Year.

  • February 27, 1997: In the first significant drop in the epidemic's history, the government reports a 13 percent decline in AIDS deaths in the first half of 1996.

  • January 31, 1999: Researchers say they have convincing proof that the AIDS virus has spread three separate times from chimpanzees to people in Africa -- one of the transmissions starting the worldwide epidemic.

  • June 2001: At the 20th anniversary of AIDS, more than 700,000 Americans have been diagnosed with the disease. More than 420,000 have died. Worldwide, more than 36 million people have HIV and more than 16,000 new infections occur each day.

Health Officials Express Concern Over Infection Rate of Young Gays, Bisexuals

Gay men too young to remember the earliest reports of AIDS are now spreading the disease at alarming rates that remind US health officials of the epidemic's explosive first years. According to a government survey released on May 31, 4.4 percent of gay and bisexual men ages 23 to 29 are newly infected each year with HIV. Among blacks in the same age group, 14.7 percent, or one in seven, become HIV-positive each year.

"The numbers we're publishing right now are more like the findings you see in the '80s than the findings you see in the '90s," said the CDC's Linda Valleroy, who led the survey in which 3,000 gay and bisexual men were tested anonymously between 1998 and 2000 in Baltimore, Dallas, Los Angeles, Miami, New York and Seattle. The survey, timed to mark the 20th anniversary of the discovery of AIDS, is the government's most sweeping evidence yet of a resurgence in the disease among young gay men. The one-in-seven infection rate for young black gays and bisexuals is roughly the same as the current rate in South Africa, Valleroy said.

"People don't perceive that you get infected and you die in two months anymore," said Phill Wilson, executive director of the African-American AIDS Policy and Training Institute at the University of Southern California. "There's all these posters around that say you can climb mountains and do whatever with HIV and AIDS. There's not enough messages about the price you have to pay."

"We have to stop and take a look at the devastation that potentially could occur among these young men," said Dr. Helene Gayle, the CDC's AIDS chief. "These are precious and important lives." The CDC wants to cut the number of new US infections from the current 40,000 annually to below 20,000 in five years, chiefly by improving prevention, targeting at-risk groups and urging more Americans to be tested for HIV.

Quilt's Message Endures

Two decades after the CDC first reported that a deadly new disease had begun circulating among young gay men in Los Angeles, the AIDS Memorial Quilt remains a powerful icon of the epidemic and a uniquely personal view of the social, political and cultural impact of AIDS. In his book Stitching a Revolution: The Making of an Activist (written with Jeff Dawson), Cleve Jones said he conceived the idea of the quilt on Nov. 27, 1985, as he and other demonstrators papered a wall of San Francisco's old Federal Building with cardboard sheets bearing the names of those who had died of AIDS. "It reminded me of a quilt, like the one made for me by my grandmother," he wrote.

Jones felt a quilt would be a "comfortable middle-class symbol" that most people could accept. As it grew, the quilt earned a reputation as "the battle flag in the war against AIDS." Thousands of panels honoring gay white men were soon joined by others memorializing hemophiliacs, African-Americans, Latinos, children and women. In 1996, when the quilt was displayed for the fifth time in Washington, D.C., its 50-ton expanse reached from the Washington Monument to the doors of Congress.

Jones, whose HIV is now controlled by drugs, has officially parted ways with the quilt but not with activism. On Friday, June 1, in Washington, volunteers began reading the names of people who have died of AIDS. They continued the roll call night and day until Sunday, June 3, when the community that Jones helped create marched on Washington to demand increased access to AIDS drugs worldwide.

Discrepancies in AIDS Sufferers May Be Linked to Gene Variation

Scientists have found a common genetic variation that may help solve the long-standing mystery of why HIV is rapidly lethal in some people yet takes decades to affect the health of others. The discovery, published in the May 31 issue of The New England Journal of Medicine (Volume 344; No 22: P 1668-1675), ultimately could help in developing a vaccine against the AIDS virus. The discovery could also allow physicians to design an individualized medical plan for each patient, with those most at risk of quick progression getting the strongest doses of drugs at an early stage.

The genetic variation, called "Px," is present in about 12 percent of the population. It is only slightly different from other versions of a gene that acts as a critical part of the body's defenses against foreign invaders, such as HIV. The variation is benign in people who aren't infected with the virus, and it may even help by boosting the body's defenses against malaria, said study senior author Mary Carrington, an immunologist at the National Institutes of Health.

However, in the study of 850 people, the presence of the Px gene variation appeared to accelerate the onset of full-blown AIDS by four to five years. In the study group, it took only about seven years after infection for half of those with Px to develop full-blown AIDS, compared with about 11 to 12 years for those with other versions of the gene. One theory for this difference holds that the Px gene is "just sitting there and not doing its job" in AIDS patients, Carrington said. Another holds that "it may be actively damaging" to the body's defenses against the disease, she added.

A Basis of HIV Resistance Suggests New Vaccine Strategy

A few people remain HIV-negative despite continuous exposure to the virus. Findings from an ongoing study by a team of researchers headed by Dr. Rupert Kaul of the Weatherall Institute of Molecular Medicine, Oxford, United Kingdom, reveal that the cause may be that their immune response involves cytotoxic T lymphocytes (CTL) against the surface region of antigens -- called epitopes -- not recognized by most infected people. "The fact that infected and protected women focus their CTL response on different HIV epitopes could be a significant finding for vaccine development," Kaul said.

Kaul and colleagues studied the immune responses of sex workers in Nairobi, Kenya: women who have more than 60 unprotected sexual encounters with HIV-positive men annually. Women new to the group show high rates of seroconversion in the first year, yet some remain HIV-negative for three years and longer. Researchers compared the immune responses of 91 HIV-negative sex workers from the cohort with those of 87 HIV-positive sex workers. The two groups of women both mounted HIV-1 specific CTL responses -- but often against a completely different set of epitopes. A few women who remained HIV negative for several years before seroconverting showed a switch in response from one set of epitopes to the other, according to a study by the same team published in the Journal of Clinical Investigation (2001; 107: 341-49).

According to Kaul, "the only way to demonstrate a true causal relationship between CTL responses and HIV protection is to induce these CTL in the setting of a vaccine trial." Phase I testing of a vaccine developed by Andrew Michael of the Weatherall Institute is underway in Oxford and Nairobi. "The vaccine in this trial does include the seronegative-specific epitopes, as well as epitopes known to induce a strong CTL response in HIV-positive workers."

Previous attempts to develop CTL-inducing vaccines have assumed that any CTL response could be protective, according to Jose Esparza, coordinator of the World Health Organization-UNAIDS HIV Vaccine Initiative. Future research should attempt to elicit protective CTL responses by taking into account the clade of HIV prevalent in the area to be targeted, and also should include epitopes tailored to the distribution of HLA types in the population, Kaul said. "The HLA types in Kenya have not been extensively studied but we are finding them to be quite different to those mapped elsewhere," said Kaul. Esparza agrees but cautions that "this would be particularly challenging in Africa, where both the genetic variability of the virus and of the host population is the largest."

Esparza expects interim results in one to two years from the first HIV-vaccine phase III efficacy trial -- the rgp120 HIV vaccine -- being tested in the United States and Thailand. "We do not know how effective that vaccine will be, or whether it will be effective at all. It may be prudent to prepare for the worst and to consider the use of a low efficacy vaccine while research continues to develop more effective products," he said.

Three Fake Drugs Are Found in Pharmacies

The Food and Drug Administration (FDA) is investigating four cases of counterfeit prescription drugs making their way to pharmacy shelves, and, in some cases, being sold to patients. To date no one has been seriously harmed by the fake drugs, but some patients have had adverse reactions. FDA officials say they have made the investigation a high priority, but that they cannot discuss many aspects of the cases because of the ongoing investigation. In the meantime, FDA officials and the brand name drug manufacturers have sent letters to pharmacies, doctors and distributors to warn them about the counterfeit drugs.

The medications involved are three injectable drugs: Serostim, a growth hormone sold by Serono and used by AIDS patients; Nutropin, a growth hormone sold by Genentech; and Neupogen, a cancer drug sold by Amgen. All the brand name drugs carry a high price, which could be why the counterfeiters selected them. A 12-week course of Serostim, for instance, costs $21,000. The counterfeiters may have been able to find an easy market for their drugs since Serostim and Nutropin are sought by people who believe the drugs will help them lose weight, build muscle and smooth wrinkles.

Serono first realized that someone was counterfeiting Serostim late last year when patients in at least seven states began to complain that they had suffered a slight swelling or a skin rash after being injected. And last month, the FDA reported three more cases of counterfeit drugs involving Neupogen, Nutropin and a second fake batch of Serostim. In each case, the counterfeit drug looked nearly identical to the real product. For Serostim, the lot number, which is used to trace drugs, was a real number; only the expiration date had been changed from August 2001 to August 2002.

Facts Are Best Weapon vs. AIDS: Cable TV Program Promotes Awareness, Compassion

Since 1993, Leominster, Mass.-based Common Sensitivity has produced "AIDS and the Issues." The cable TV program is an outreach effort of the all-volunteer HIV/AIDS organization, whose mission is to promote HIV/AIDS awareness, understanding and prevention. The show won first place in educational programs at the 1998 New England Cable Television Awards and was a finalist for the 1999 Cable Positive award in the category of outstanding HIV and AIDS local programming. Volunteers have traveled around the country to produce the shows, sometimes doing multiple ones in one city. Recently, in San Diego, 100 individuals and organizations produced 16 shows.

Shows focus on specific topics arranged in a series. A five-program series, for example, focused on names reporting and partner notification. "Nothing like this on the topic of names reporting-partner notification has been done before on television because we dealt with personal perspectives of people who are living with HIV-AIDS, what they feel about this topic and how it impacted them," said Barry Ansin, founder of Common Sensitivity.

The programs are scheduled to air before 13 million viewers across the United States this summer over local cable stations. "People mistakenly believe that AIDS can be treated as a chronic infection, and therefore prevention efforts have fallen by the wayside. That's unfortunate because the latest information from researchers is that drug therapies aren't what everyone thought they were going to be," said Ansin. That is why the show is so important. Education and information "are the best weapon that we have in the fight against HIV-AIDS," he added.

Hospital Makes HIV Drugs Available for Morning After

Beth Israel Medical Center in Manhattan is making HIV drugs available as morning-after antidote for people who think they might have been exposed to the virus. The four-week course of powerful drugs is believed to reduce the likelihood of infection if taken within 72 hours of exposure to the virus. The treatment, called post-exposure prophylaxis, has been made available to the public in other cities, but Beth Israel claims to be the first New York City hospital to offer it. The drugs often have serious side effects, however, and experts do not know the long-term health risks for healthy individuals who undergo the treatment.

HIV Screening for Dentists

The American Dental Association (ADA) will now offer voluntary HIV screening to dental professionals every three years, instead of annually, at its national convention. In announcing the new policy, the ADA cited a lack of significant changes in HIV transmission risks associated with dentistry. Since 1987, the ADA's Health Screening Program has tested more than 17,666 dentists. To date, only one HIV-infected dentist has been identified who reported having no risk factors for non-occupational exposure to HIV.

Living with HIV Can Be Harder in Rural Areas

Three years into a four-year, $1.3 million project funded by the National Institutes of Mental Health, Timothy Heckman and his fellow researchers in 10 states have found alarming rates of depression and suicidal thoughts among people living with AIDS in rural areas. Preliminary results of the study of 201 people show that while AIDS continues to spread to rural areas, too few resources are available to help patients in those areas cope mentally and physically with the disease. Most subjects said they feel cut off from services, have limited access to care and are living in poverty, and 38 percent said they had thought about committing suicide.

Heckman, an assistant psychology professor at Ohio University in Athens, said that some patients report being the only person in their community with the disease. "We hear from people who are severely discriminated against. And that, more than anything else, affects their overall quality of life," he said. One element of his study, called Project Connect, aims to break that isolation: The eight-week project linked HIV-positive people from around the nation on conference calls with mental health researchers. This forum enabled participants to offer advice and encouragement and share their experiences, Heckman said. Tim Parr, 43, a dairy farmer in Ohio, said that since learning he has HIV he has been deserted by his best friend; his AIDS-related mail from the health department has been tampered with; and he has been run off the road by men wearing white capes and driving pickup trucks. Even though "they told me to take my disease and move out," Parr said, "I'm much more of a fighter than that. I have just as much right to be here as anyone else."

Barriers Hinder Treatment of HIV Among Immigrants Who Live Here Illegally

An untold number of the 7 million to 9 million undocumented immigrants in the United States are infected with HIV, and the secretive existence they live out of fear of deportation is adding to their health risks, according to medical experts. In the worst cases, immigrants are dying because they cannot access health care, or they are spreading the disease because they do not know they are infected. Undocumented persons with HIV may be getting a patchwork of inconsistent care, turning to emergency rooms for treatment of opportunistic infections and then returning to the shadows, afraid that deportation to a homeland without medicines or health care is a certain death sentence.

"It's part of a bigger problem among the undocumented: As long as we don't acknowledge that they are here, we don't have to take care of them," said Pamela Donnelly, associate executive director for the AIDS Outreach Center in Fort Worth, Texas. Language is often a major barrier. In New York City, workers at the African Services Committee are often asked to relay a diagnosis in French or various African languages. Some HIV-positive people shun support groups, fearing they could be spotted by a native of their homeland who would tell relatives they are sick.

Unless an infected person is related to an American citizen or is coming for a short stay, US authorities may exclude him or her from getting a green card, as legal immigration status is not granted to those who may need public health or welfare benefits. "This is a medical problem," said Dallas immigration attorney John Wheat Gibson. "To the extent that it is an immigration problem, it is the same immigration problem anyone else who is illegally present faces -- fear of the consequences of seeking health care."

Senate Democrats Tell Kofi Annan HIV/AIDS Will Be a Priority

On Thursday, May 24, Sen. Tom Daschle (D-S.D.) told UN Secretary-General Kofi Annan he would "make the international fight against HIV/AIDS a priority for the Senate." Daschle is set to become the Senate's new majority leader in the shake-up following Sen. James Jeffords' (Vt.) announcement that he would quit the Republican party and become an independent.

"The American people and the international community expect as much from the United States," Daschle said in a statement. "With more than 36 million people already living with HIV/AIDS, and 14,000 more contracting the virus every day, the secretary-general is right to call for a coordinated response. Governments, foundations and corporations throughout the world must work together to confront this humanitarian, economic and security crisis." The UN has called for global action on AIDS and is organizing a June special conference on the epidemic.

Annan visited legislators in Washington, D.C., just weeks after the United States was voted off the UN Human Rights Commission. Earlier Thursday Annan met with House of Representatives Minority Leader Richard Gephardt (D-Mo.) and Rep. Henry Hyde (R-Ill.), the chair of the House Committee on International Relations and an opponent of the UN.

International AIDS Fund Should Be Working by End of Year, Conference Says

A global fund to fight AIDS and other diseases in developing countries should be ready to begin supporting projects by the end of the year, a UN conference agreed on Sunday, June 3. More than 200 people who took part in consulting on the AIDS and Health Fund agreed the fund should concentrate on AIDS, malaria and TB. "Participants called for transparency in the way funds are allocated and spent, for those who use funds to demonstrate their impact, and for an emphasis on the prevention of illness as well as treatment," said the UN statement.

First Corporate Pledge Made to Global AIDS Fund

With a $1 million contribution announced on Friday, June 8, Winterthur, the Swiss-based insurance subsidiary of the Credit Suisse financial services group, became the first corporate contributor to the new global HIV/AIDS fund. The company hoped the contribution will be "the icebreaker" that encourages other private sector donations, according to a company source. UN Secretary-General Kofi Annan proposed the fund in April, calling on developed countries, private foundations and corporations to give $7 billion to $10 billion annually to fight AIDS, malaria and TB in the developing world. His spokesperson called Winterthur's donation "a very positive thing that should get the ball rolling."

Current spending on the three diseases is about $1.8 billion, according to Peter Piot, executive director of UNAIDS. The bulk of any new money will be spent on the AIDS epidemic in sub-Saharan Africa, home to 70 percent of the estimated 36-million HIV-infected persons worldwide. Contributions to the fund have been slow to materialize, however. The announced US donation of $200 million was criticized by AIDS activists as far too small. France has pledged about $127 million over the next three years, and Britain has promised an unspecified amount. No major foundation has offered money. There has been no US corporate response to Annan's personal appeal to the US Chamber of Commerce earlier in June. But UN officials insist they are not discouraged and that they still anticipate the money will be committed by mid-summer, following the UN General Assembly's special session on HIV/AIDS and the Group of Eight industrialized countries meeting in July. "I'm pretty sure that it's going to happen, and it's going to be a serious thing," World Health Organization Executive Director David Nabarro said on Thursday, June 7.

Up to 95 Percent of HIV-Positive Probably Ignorant of Fact -- UNAIDS

According to UNAIDS Executive Director Peter Piot, up to 95 percent of people with the HIV virus in developing countries probably do not know that are infected, making investments in prevention programs crucial. Lack of testing resources, stigma and official denial contribute to the figure, Piot said at a news briefing on Thursday, May 31. "That's why it is so important that one of the priority investments is to develop, on a large scale, testing and counseling services, which certainly do not exist at the moment," Piot said from Geneva, where, in early June, representatives of developed and developing governments, international organizations, the private sector and non-governmental agencies discussed the global fund to fight AIDS, TB and malaria.

Over 100 Countries Debate Tough New Targets to Combat Global AIDS

Delegates from more than 100 countries began debating a plan on Sunday, May 20, calling for new targets to combat AIDS worldwide, including spending up to $10 billion a year by 2005 to stem the disease in developing countries. The Monday, May 21 meeting opened five days of negotiations on a declaration that UN members are expected to approve at the General Assembly special session on HIV/AIDS in New York in June. The draft declaration endorses the goal set last September by 150 world leaders at the UN Millennium Summit, which is to halt and begin reversing the HIV/AIDS epidemic by 2015.

If adopted, the declaration would commit UN members to meeting a series of interim targets over the next 15 years. Among these are: development of national strategies and financing plans to combat HIV/AIDS by 2003, including businesses, grassroots groups and people with HIV/AIDS; adoption by 2003 of a set of time targets to achieve the goal of reducing HIV prevalence among youth by 25 percent by 2005; making prevention measures, including information and education, available in all countries while taking into account "local circumstances, ethnic and cultural values"; reducing the number of infants born with HIV by 20 percent by 2005 and by 50 percent by 2010 by providing treatment to HIV-positive pregnant women; and development of national programs to increase drug availability by 2003, and by 2005 demonstrating progress in implementing comprehensive health care programs. The proposed draft also calls for countries to initiate programs identifying groups most at risk for HIV infection by 2003; to implement programs for AIDS orphans by 2005; and to adopt legislation by 2005 that protects the rights of people living with HIV/AIDS.

Brundtland Asks Health Ministers to Build on Health Care Advances

According to the Director-General of the World Health Organization (WHO), Gro Harlem Brundtland, the opportunity to boost global health through new drugs and cheaper access to existing medicines is greater than ever before-"but the price tag of tackling leading killer diseases, such as HIV/AIDS, malaria and tuberculosis is about $10 billion per year."

In a keynote address to the World Health Assembly on May 14, Brundtland said, "The move towards wider access to life-saving health care is now unstoppable." Improvements in understanding the real global threat of tobacco use; high level recognition of the "dire consequences of malaria and tuberculosis in the poorest communities"; and the visibility of the "extreme damage caused by HIV" all point to great opportunities, she said.

But the challenges are great, and include a lack of funds. Brundtland proposed a slight increase in WHO's regular budget for 2002-3 to $842 million. While the voluntary budget rose by 40 percent last year, she said, the funds were short-term and WHO acted quickly to use them. The Global Alliance for Vaccines and Immunization had attracted $375 million since 74 developing countries submitted proposals last year for national vaccination campaigns, with vaccines being delivered since the beginning of this year.

But there is still great urgency. "We cannot wait another decade while HIV/AIDS affects more and more of the people from Africa, China, India, the former Soviet Union and Eastern Europe," Brundtland told the World Health Assembly. "If we do not act now, drug-resistant tuberculosis will have become far more widespread, requiring costly treatment that is difficult to provide. Malaria treatments will have lost their potency due to the increase in drug resistant strains."

African First Ladies Vow to Fight Spread of AIDS

In a statement issued at the end of a three-day summit in Kigali, the wives of 11 African heads of state vowed to "advocate and support interventions that facilitate the adoption of safer sex practices and the development of life skills that will help youth to understand their sexuality and to protect themselves from HIV infection." They also called for increased access to antiretroviral drugs and said they would encourage their governments to "ensure that policies and institutions that seek to address the impact of the pandemic on children, youth and women are given priority." "We must treat this crisis as we would when confronted with an armed invasion," Organization of African Unity Secretary General Salim Ahmend Salim said in a speech read at the summit.

Uganda Provides Free AIDS Drugs to Pregnant Women

The New Vision newspaper in Uganda reported on Monday, May 21, that the Ugandan government will soon start providing free antiretroviral drugs to pregnant women. Health Minister Crispus Kiyonga was quoted as saying that the provisions are expected to reduce the mother-to-child HIV infection rate by about 32 percent in about 35,000 infants born with HIV annually. More mothers will now be expected to take advantage of the free service and submit to voluntary HIV testing, said Kiyonga.

UK HIV Cases At All-Time High

The number of newly diagnosed HIV cases in the United Kingdom has reached an all-time high, according to figures published on Friday, June 1 by the Public Health Laboratory Service (PHLS). The UK had 3,435 new HIV cases in 2000, a 14 percent increase over the previous year's figures. The PHLS said the number of newly diagnosed cases in 2000 was the highest in one year since testing became widely available in 1985. Health experts said that sex between men is the predominant route of HIV transmission in the UK.

Asia Steps Up Awareness of AIDS as Epidemic Completes Second Decade

Countries in Asia have begun to step up public awareness about HIV and AIDS, which has struck 6.3 million people there. Cambodia and Thailand, both notorious for their sex trade industries, reportedly have the worst rate of AIDS in Asia but seem to be making progress in public awareness. In Thailand, the Thai Working Group on HIV/AIDS has estimated that the number of people infected with HIV will drop to about 200,000 by 2015 from 770,000 in 2000. In Cambodia, the World Health Organization (WHO) has said that 2.8 percent of the adult population was infected by last year, down from 3.9 percent in 1997. While in the West AIDS has disproportionately affected the gay community, HIV in Asia primarily has been spread through heterosexual contact. Some Asian governments have taken steps to target high-risk groups, such as prostitutes and intravenous drug users (IDUs), while also educating the public about the disease.

But not all countries in Asia have approached the epidemic as openly. Malaysia doesn't have an anonymous HIV-testing program; rather, the government registers the names of anyone who tests positive for HIV and informs their sexual partners if they do not do so themselves within 48 hours. Such reporting, combined with the social stigma associated with AIDS, has made people leery of testing. Treatment for the country's 42,000 HIV-positive residents is difficult to find and costly. Although most AIDS drugs are available to them, many HIV-positive Malaysians cannot afford the $526 a month for treatment.

India already accounts for half of Asia's HIV-positive population with 3.9 million cases. China has about 600,000 cases, mostly among IDUs in interior provinces. But increasing overlap among IDUs and sex workers in China has made the problem particularly acute, as sexual activity could spread the disease to more populous coastal regions.

In Japan, where hemophiliacs comprised most of the early cases of HIV, men infected by prostitutes in foreign countries account for a growing percentage of the HIV-positive population, which the WHO has estimated to be about 8,100.

Babies at Risk from Late HIV Diagnosis

The number of local women infected with HIV/AIDS is on the rise in Hong Kong, and many discovered they were infected only when their babies were born, health officials said. Of the 44 new cases of HIV reported this quarter, women comprised 34 percent -- a significant rise from the last quarter and from the same quarter last year. One perinatal infection -- occurring three months before to up to one month after a birth -- was reported this quarter, bringing the number of mother-to-child transmissions to thirteen.

AIDS Activists Hold Special Event

A transvestite performed a traditional jaipong dance to open the AIDS memorial event held Saturday night, May 19, in South Jakarta, Indonesia. In the ceremony, participants lit candles, shared memories, prayed and recited poems, then boarded a bus to the Hotel Indonesia traffic circle, where they joined other activists at a similar event, the Jakarta Post reported. Since the country's first case was discovered in 1987, 1,887 HIV infections have been recorded in the nation, according to the Ministry of Health and Social Welfare.

Obituary: Robert B. Hays

Robert B. Hays, 46, a research psychologist at the University of California San Francisco Center for AIDS Prevention Studies, died Saturday, June 2, of AIDS. A Bay Area native who graduated from Vassar College and earned a doctorate in social psychology at the University of Oregon, Hays was alarmed by the spread of AIDS in the gay community and returned to San Francisco in 1988. With Susan Kegeles, he developed Mpowerment Project, an HIV prevention program that stresses the importance of a community of peers to reinforce safer sexual behavior. The program has been adopted in more than six US cities.

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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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