-----===[[[ A I D S w i r e D I G E S T 03.22.93 ]]]===----- AIDS Case Numbers Rise Under New Federal Rules * New York Times (03/22/93), P. B3 Navarro, Mireya As a result of the new federal definition of AIDS, cases of the disease in New York increased 58 percent in the first two months of 1993, compared with the same period last year. Although the numbers of new AIDS cases were high, federal officials expected them to nearly double. New cases increased 63 percent nationwidein January and February, compared with the same period in 1992. Officials from the Centers for Disease Control said that the early 1993 figures are incomplete because states are still adjusting to the increased reporting workload under the expanded definition. New York City had a reported total of 47,185 AIDS cases by last month, which is the highest number in the nation. Officials from the city health department predict that they have yet to count more than half of the cases that meet the new AIDS definition because they are still hiring more staff. Dr. Pauline Thomas, director of the New York City Health Department's AIDS surveillance office, said even without the new, more-inclusive definition, AIDS cases in the city were increasing and rose 11 percent in 1992 over the previous year. Nationwide, there were 12,243 new AIDS cases reported in the first two months of the year. Among these, 4,996, or 41 percent, were reported under the new definition. About 95 percent of the cases that qualified under the new definition were reported because of low CD4 counts. Health officials in New York and other states are creating a system that would require the laboratories that conduct CD4 counts to report the cases directly to health departments, just as hospitals, doctors, and clinics currently do. This process would be faster and more accurate. Study Suggests Alcohol Affects Response to HIV * Washington Post (03/21/93), P. A5 Drinking alcohol may impair the body's ability to fight HIV, according to a new study published in the current Journal of Infectious Diseases. Omar Bagasra, lead author of the study, said, "Even casual consumption of alcohol stimulates replication of the AIDS virus in cell cultures." Bagasra said alcohol, which generally depresses the body's immune system, may increase the chance of infection in people who drink alcohol as many as 36 hours before being exposed to the virus. In a test tube, researchers from the Thomas Jefferson University combined white blood cells of 60 healthy people and HIV. The volunteers had been drinking up to 10 alcoholic beverages over the weekend. The scientists discovered that HIV quickly replicated and invaded the CD4 lymphocytes. It also prevented "killer" cells, the CD8 lymphocytes, from attacking infected cells and inhibiting the disease. The coauthor of the study, Roger Pomerantz, said earlier studies have demonstrated that alcohol affects all white blood cells, but that CD8 cells are especially vulnerable. He said, "CD8 is one of the factors that holds HIV at bay. Because alcohol suppresses the function of these cells, the AIDS virus appears to progress relatively unchallenged." Red Cross Urges Probe of Blood System * Toronto Globe and Mail (03/19/93), P. A2 The Canadian Red Cross has called for a public inquiry to renew confidence in the country's blood-management system. The Canadian blood supply is one of the safest in the world, but fears should be allayed by an impartial body of experts such as the Royal Society of Canada, Red Cross officials told a House of Commons committee. Stephen Vick, a Red Cross spokesman, denied that tainted blood products were knowingly administered to hemophiliacs in the 1980s, as has been alleged by some members of the Canadian Hemophilia Society. "No one would knowingly distribute something that was infected--not in the past, not in the present. I mean, there would be absolutely no reason for doing that," said Vick. He mentioned that the Red Cross' decisions were based on information available at the time. In April 1985, it was unclear whether heat treatment of HIV-tainted blood was effective. But it is now known that the process is effective in killing HIV, and the Red Cross is being condemned for failing to order heat-treated products earlier than it did in March 1985. Vick said, "Hindsight is marvelous. Unfortunately, people at the time were facing partial and sometimes incorrect information." He added that the proposed public inquiry should not review what happened in the 1980s because doing so could cause bias in court cases. Instead, the review should concentrate on how the current blood-management system can be enhanced, said Vick. U.S. Drafting Global Epidemic Battle Strategy * Los Angeles Times--Washington Edition (03/22/93), P. A1 Cimons, Marlene A major plan to combat future epidemics is being drafted by federal health officials who are concerned about growing reports of infectious disease outbreaks. Health officials from the Centers for Disease Control said they are also concerned about increasing evidence that many bacteria are manifesting a resistance to standard antibiotics because the drugs have been widely used in recent years. In a summary of the proposed plan, the CDC cautioned that "a new virus that emerges in the developing world is only a short airline flight from the United States." In addition, drug-resistant bacteria "can spread rapidly as a result of overcrowding, homelessness, and poor infection-control practices," said the summary. The CDC will conduct a special meeting today in Atlanta with infectious disease experts to address the proposals, which are still being developed, the agency said. The CDC plan said more resources on the state and federal levels will be needed to enhance surveillance efforts, both in the United States and abroad, to detect problems before they get out of control. The plan would entail a network of 15 locations worldwide, staffed with epidemiologists and laboratory personnel who would be responsible for studying and identifying infectious disease problems in those regions. Moreover, the plan said the CDC itself will need more infectious disease experts, citing a 12.5 percent decrease in such experts during the last decade (excluding AIDS specialists). The plan also advises that the CDC work with the National Institutes of Health to expand laboratory and research endeavors, so that researchers can better understand new or newly identified organisms. HHC's Ryan White AIDS Funds Come Up Short for New York City Newark * United Press International (03/19/93) Byron, Peg (New York) City health officials angrily denounced recent federal awards of millions of dollars in Ryan White AIDS funds Friday, claiming they slighted minorities and areas ridden with poverty, homelessness, and drug additions. New York City received less than half of the funds it requested through the Ryan White Comprehensive AIDS Resources Emergency Act of 1990-- for a total of about $15 million. Newark, N.J., was given no money at all. However, San Francisco received approximately the same size award as New York, although New York has about five times the number of AIDS cases. A total of $91 million was given to 25 different municipalities nationwide, without any public announcement, on March 5 by the Health Resources and Services Administration of the Department of Health and Human Services. An HRSA spokesman said that an outside consulting group decided on the award choices, based in part on whether an applicant had spent all its funds from the previous year. Mark Roebuck, the spokesman, said New York and Newark fared the worst among the grant recipients, even though he added that none got as much as requested. The money is designed to pay for AIDS drugs, services, housing, and prevention in a year when the new expanded AIDS definition is expected to add about 40 percent more qualified patients to AIDS caseloads in many cities. A high-ranking state health official in Albany, N.Y., said, "The bottom line is that this loss of funds will translate into deaths for individuals who will not get services they would otherwise have." House Weighs in on NIH AIDS Research * Science (03/05/93) Vol. 259, No. 5100, P. 1387 A bill that would dramatically restructure the way the National Institutes of Health (NIH) plans and funds AIDS projects ran into some difficulties last week. The bill did survive, however, and is close to coming on the House floor for a vote. The NIH-AIDS legislation gained momentum on February 18, when the Senate approved a bill that would move overarching control of AIDS research from separate NIH institutes to a stronger Office of AIDS Research (OAR) within NIH. On February 24, the House approved an amendment by Representative Henry Waxman (D- Calif.) that bestowed similar power to OAR, but the House bill differed significantly from the Senate's on a few major points. The Senate wants the discretionary fund to contain 25 percent of new AIDS money NIH collects each year, while the House proposed a hard figure of $100 million. The House version also insists that OAR must allocate money to various NIH institutes within 30 days of receiving the funds, in an attempt to reduce fears that OAR would slow the rate of research. As Science went to press, the NIH bill was up before a vote of Representative John Dingell's (D-Mich.) Committee on Energy and Commerce, in a prelude to a full vote by the House. The Future of Aids * Newsweek (03/22/93) Vol. 121, No. 12, P. 47 Cowley, Geoffrey Dr. Brett Tindall, an AIDS researcher at the University of New South Wales, says, "We know that HIV causes AIDS. We also know that a few patients remain well for long periods, but we've never known why. Is it the vitamins they take? Is it some gene they have in common? Work suggests it has more to do with the virus. I think we've found a harmless strain." Paul Ewald, an evolutionary biologist at Amherst College, argues in his upcoming book that HIV may have infected people for decades, even centuries, in a form that was benign. He follows its virulence to the social upheavals during the 1960s and 1970s which increased its range and aggressiveness within the body. Shifting conditions could drive a normally non-aggressive parasite towards virulence, or vice versa. There is evidence that HIV was not always so deadly. Rather, when people's sexual contacts expanded as a result of urbanization, fresh hosts were more available, and thus infected hosts became more dispensable. If Ewald is correct, the process can be reversed by decreasing the number of hosts available, namely through clean needles and condoms. Studies suggest that through safer sex, gay communities have decreased the number of new infections five- to tenfold. There are also indications that in the same population, during the same period, the virus has grown less noxious. By disturbing rain forests and other wilderness areas, however, new viruses might be stirred up and allowed to develop into epidemic killers. Two examples are the Ebola virus and HTLV. Position Statements Explore HIV Issues * American Nurse (03/93) Vol. 25, No. 3, P. 12 Because of the intricate issues associated with the AIDS epidemic, the American Nurses Association has issued new position statements that concentrate on women, correctional inmates, and the HIV-positive nurse's ethical obligations and disclosure. The ANA emphasizes that training is essential for clinicians and health-care workers to increase their knowledge in HIV risk assessment and gynecological developments of HIV infection and disease in women. The ANA endorses increased research in: HIV prevention for women; the etiology of HIV in women; the care and treatment of infected women; and the recruitment of women for clinical drug trials. The association acknowledges that the actions of nurses must be in compliance with the state and federal laws regulating AIDS/HIV and supports the strict adherence to the Centers for Disease Control Guidelines (July 1991) and the Occupational Safety and Health Administration Standard (1991) for patient and care giver protection from transmission of HIV infection. The ANA believes that nurses who carry a blood-borne infection should voluntarily avoid exposure-prone invasive procedures that have been epidemiologically associated with HIV. The ANA emphasizes that the HIV-positive nurse and nursing personnel have a right to have their HIV-status kept confidential. The ANA also believes there is no reason to isolate HIV-positive inmates from others based solely on their HIV status. The association recommends AIDS education be provided to all staff and inmates in jails, prisons, and juvenile confinement facilities. The ANA also stresses that HIV-positive inmates be protected by confidentiality rules. Putting It to the Test: Along With Romance, an HIV Awareness * Baltimore Sun (03/23/93), P. 1D Marbella, Jean Due to the spread of the AIDS epidemic, more and more couples are facing the issue of whether to get tested for HIV infection. Undergoing HIV testing has become an increasingly common rite of passage in modern relationships. The entire issue of AIDS forces most couples to confront things like HIV status, the use of condoms, and their sexual and drug-use histories. Although it is difficult to estimate how many people are getting tested for HIV because most tests go unreported, health professionals believe the number is rising as AIDS awareness increases. Dr. Alfred Saah, an epidemiologist with the Johns Hopkins School of Public Health who has been helping players from the National Basketball Association cope with the aftermath of Magic Johnson's disclosure that he is HIV- positive, said, "More people are getting tested these days. More and more physicians are recommending that their patients be tested, and people are becoming much less afraid of getting tested." Dr. Saah and other experts say that gays are several years ahead of heterosexuals in their AIDS awareness. Health professionals advise that couples address HIV status before engaging in sexual activity. Those who already know they are infected, however, are at risk of immediate rejection. Joe Jacques, an adult educator with HERO, an AIDS resource group in Baltimore, said, "We counsel them to bring it up right away if it's a new relationship before they become too emotionally involved." Patient to Test Own AIDS Treatment * Toronto Globe and Mail (03/22/93), P. A10 Palmer, Mark An AIDS patient from Mississauga, Canada, announced Saturday that he will test a treatment he has created to put cancer, leukemia, Lou Gehrig's disease, and AIDS into complete remission. Alan Quirt, an artist and entrepreneur, was diagnosed with AIDS in September of 1989 after testing positive for HIV in June 1988. He currently has cancer, which has been compounded by bouts of thrush and diarrhea. Quirt made his announcement at a news conference held at the Springbank Visual Arts Center in Mississauga. After he sent about 15,000 flyers throughout Mississauga and contacted three major Toronto media organizations, he was disappointed at the turnout of only about 20 people. "I was expecting a lot more people," Quirt said as he looked over 107 fluorescent works of art he was hoping to sell to help fund his treatment program. Quirt said he and a friend with AIDS will take the complicated treatment, which involves injection of HIV antibodies. They expect to have results available in six months. Quirt, who has no medical background, said that his physician, an AIDS expert, was "astonished I came up with it. But I did go to a university for seven years. I'm a very smart person." Quirt said regarding his attempt to cure AIDS and other diseases, "It is impossible to succeed without suffering. If you are successful and you have not suffered, someone has suffered for you. And if you are suffering without succeeding, it is so someone will succeed after you." All Communities Must Have H.I.V. Programs * New York Times (03/23/93), P. A22 (Sweeney, Timothy J.) Eliminating AIDS from society requires a three-step approach to lower infection rates by promoting behavior change among all sexually active people, providing care to all those who are ill, and conducting effective research to find treatments and a vaccine to prevent people from contracting HIV in the future, writes Timothy J. Sweeney, executive director of the Gay Men's Health Crisis in New York, N.Y. The front page article in the New York Times on March 7 stated that AIDS "can be all but stamped out even without a vaccine or wonder drug," if prevention programs were heavily focused in communities with high rates of HIV infection. But allowing the illness and deaths of more than a million and a half Americans infected with HIV is not the way a civilized society ends the epidemic, says Sweeney. Anti-AIDS efforts by and for the affected communities have always been the foundation on which successful prevention programs have been established. However, calling for programs to target the hardest-hit communities must not impede prevention efforts for less devastated communities, Sweeney notes. The Gay Men's Health Crisis has been providing HIV prevention and education to gay men in New York City since 1982. Such programs have contributed to a substantial decline in transmission rates among gay men. But HIV is now surging in smaller cities and in different populations. Therefore, varied approaches to HIV prevention education are needed for groups including women and adolescents, concludes Sweeney. New HIV Test Said to Track Virus in All Stages * Reuters (03/19/93) Ben-Itzak, Paul (San Francisco) On Friday, researchers the success in human trials of a new method to measure the spread of HIV in the body, a test which physicians say will facilitate the process of determining whether anti-AIDS drugs are effective. The test accurately tracked the spread of HIV in all 66 patients involved in the study at the University of Alabama--Birmingham. Jeffrey Lifson, an author of the study and an official at Genelabs Technologies Inc., the company that developed the test, said the researchers were able to detect and measure the presence of HIV even in its early stages, which has proven difficult in other tests. Lifson said the test "will be useful in assessing the effects of treatments and evaluating new treatments." Warner Greene, a leading AIDS physician and researcher at the University of California--San Francisco, considers the test a breakthrough and said, "It gives us tremendous ability to [quantify] the amount of virus in the body, for example, before and after the introduction of a drug" into the body. Greene said that rather than waiting to see the progression of disease in a patient to determine if the drug is working, doctors may be able to test a drug's efficacy by determining the presence of the virus. However, Greene warned that the test was highly technical and it is uncertain how soon it will be available for doctors to use. Next, the researchers will have to test the technique on larger groups. Does Drug Use Cause AIDS? * Nature (03/11/93) Vol. 362, No. 6416, P. 103 Ascher, M.S. et al. Although Peter Duesberg, a professor of molecular biology at the University of California--Berkeley, believes that AIDS and drug use are related, they are not, write M.S. Ascher et al. of the California Department of Health Services in Berkeley, Calif. Duesberg has maintained since 1987 that HIV is not the infectious aetiological agent for AIDS and has recently stated that either drug consumption or conventional clinical deficiencies and their treatments cause AIDS-related illnesses. However, the researchers found this untrue. They analyzed data from a unique population-based cohort study, the San Francisco Men's Health Study (SFMHS). It is based on a randomly selected cohort of 1,027 single men 25-54 years old. The researchers examined the cohort at 6-monthly intervals for 96 months, and obtained drug-use data and determined HIV serostatus a each examination. The researchers compared heavy drug use for the 25-months period before entry into the study among 215 heterosexual and 812 homosexual/bisexual cohort members. Except for amyl nitrate, with 18 percent heavy use in homosexuals versus no heavy use among heterosexuals, the percentage of subjects reporting heavy use of each drug was similar in both sexual preference groups: 36 versus 39 percent for marijuana; 7 versus 4 percent for cocaine; and 1 versus 5 percent for amphetamines, respectively. During the 96 months of follow-up, 215 cases of AIDS occurred among the homosexual/bisexual men compared with none among the heterosexuals. It was found that if heavy use of marijuana, cocaine or amphetamines is casually linked to AIDS, a cumulative incidence of 56 cases among the heterosexual subjects would be expected. HIV-1 and the Aetiology of AIDS * Lancet (03/13/93) Vol. 341, No. 8846, P. 658 Schechter, Martin T. et al. HIV-1 infection has an integral role in the CD4 depletion and progressive immune dysfunction that characterize AIDS, write Martin T. Schecter et al. of the University of British Columbia and St. Paul's Hospital in Vancouver, British Columbia, Canada. The question of whether HIV-1 infection causes AIDS has been raised, and the suggestion made that to know the correct cause of AIDS the incidence of disease in patients with and without risk behaviors and with and without antibody to HIV-1 must be known. The researchers found that in 715 homosexual men followed for a median of 8.6 years, all 136 AIDS cases occurred in the 365 individuals with pre-existing HIV-1 antibody. Most men negative for HIV-1 antibody reported risk behaviors but none developed any AIDS-defining conditions. CD4 counts declined in anti-HIV-1 positive men but remained stable in antibody-negative men, whether or not risk behaviors were present. The hypothesis that AIDS in homosexual men is caused not by HIV-1 infection but by drugs and sexual activity is rejected by these data. A central role for HIV-1 in the pathogenesis of AIDS does not discount a role for cofactors that might help to determine the clinical course in different hosts. Whether these cofactors involve other microorganisms, genetic susceptibility, autoimmune processes, or other phenomena is currently the subject of debate and investigation, the researchers conclude. India: Anti-AIDS Policies * Lancet (03/13/93) Vol. 341, No. 8846, P. 684 Mangla, Bhupesh India's National AIDS Committee decided at its first meeting that AIDS will not be a notifiable disease in order to protect the confidentiality of HIV-infected people. In addition, the committee decided that providing clean needles or syringes to IV-drug users would give wrong signals about government policy on drug abuse. Drug use is considered a criminal offense punishable by imprisonment. It is prevalent some northeastern states of India, particularly Manipur, where 54 percent of IV- drug users have been found to be infected with HIV. In other parts of the country, where IV-drug use is not as prevalent, the first priority is to prevent a shift towards drug injection. Advertising efforts that emphasize abstinence from injecting drugs might arouse curiosity, instead of discouraging IV-drug use--as happened in 1991 in Nepal, where after such a campaign, there was a rapid switch from oral to injecting drug use. The committee also called for physicians to educate themselves about the disease because of concerns about how hospitals have refused to treat AIDS patients. In early February, such a refusal led the government to instruct the All India Institute of Medical Sciences not to deny any AIDS/HIV patient treatment even if surgery were necessary. HIV Care Changes Prompt New Guidelines * American Medical News (03/15/93) Vol. 36, No. 11, P. 18 The American Medical Association has revised its five-year-old policies for physician-conducted HIV blood test counseling. The new guidelines were prompted by drastic changes in attitudes, knowledge, and treatment options during the last five years and since clinical testing for HIV antibodies began in 1985. There are special sections on testing and counseling women and adolescents in the new policies. In addition, some routine patient testing is emphasized in the guidelines. They will be published in the 03/22/93-03/29/93 issue of American Medical News. Drug Shown to Kill HIV to be Tested in Humans * Washington Post (03/24/93), P. A3 An AIDS drug that has proven its efficacy in killing HIV in the test tube will be tested in humans at the National Institutes of Health. On Monday, officials from the National Institute of Allergy and Infectious Diseases (NIAID) said they will recruit up to 80 HIV-positive patients in clinical trials of a drug called U-90,152. The officials said U-90,152 has proven that it can sterilize cell cultures infected with HIV. In addition, studies have demonstrated that the way the new drug inhibits HIV is different from the AIDS drugs now licensed--AZT, ddI, and ddC. Anthony Fauci, director of the NIAID, said, "Toxicity and the fact that the virus can mutate and become resistant to these drugs within six to 12 months limit their usefulness as single-drug therapies." U-90,152 also works against reverse transcriptase, but it attacks the enzyme molecule at a different location. NIAID authorities said there is a possibility that using U-90,152 in combination with one of the other drugs would be more effective against HIV than any of the drugs alone. H. Clifford Lane of the NIAID said the combination could prevent drug resistance caused by the virus' ability to mutate. The clinical trials of U-90,152 will consist of two phases, each lasting 24 weeks and each enrolling up to 40 HIV- positive patients. In the first trial phase, patients will be randomly assigned to receive either a three-drug combination of U-90,152, AZT, and ddI, or a two-drug combination of AZT and ddI. The second phase of the study will involve 40 patients who will receive either U-90,152 alone or in combination with AZT. Related Story: Philadelphia Inquirer (03/24) P. A2 The AIDS Ribbons' Tangled Message: Why Some See Red * Los Angeles Times--Washington Edition (03/24/93), P. B8 Lazarus, Judith The symbolic red ribbon worn in support of AIDS care and research has become somewhat of an empty statement, according to AIDS activists. The ribbons have been virtually omnipresent at awards ceremonies, where they are worn by celebrities. However, now that the symbol has become common, some are saying that while they appreciate the intent, the ribbon has become a hollow, politically correct statement. James Hulse, a member of ACT-UP/LA, said he believes wearing a ribbon for many can be "a cop-out. Ask them if they've donated money. Ask them if they've written to their congresspeople." Some critics cite the significance of when first lady Barbara Bush appeared on camera at the Republican National Convention seated in the audience wearing a red ribbon, but subsequently took it off before joining her husband on the podium. Her office claimed she did not want "to distract from the President's big moment." Roger McFarlane, one of the original founders of the Ribbon Project, which brought the symbol to prominence, said, "It was the most cynical use of the ribbon I have yet to see." David Michaels, a Los Angeles-based producer and a governor of the Academy of Television Arts & Sciences, has worked to see that ribbons are distributed at just about every televised West Coast awards show. Nevertheless, the latest development in the ribbon controversy is that now red and pink striped ribbons are being distributed: the red for AIDS and the pink for breast cancer awareness. Although activists admire the intentions, they hope the funds raised will actually make it to the people who need it. Michaels said, "Rather than buying a ribbon, I'd like to see people making donations to AIDS organizations and making their own." Boston Condom Law Is Rejected * Boston Globe (03/23/93), P. 17 Wong, Doris Sue On Monday, a judge overrode a Boston ordinance mandating that most businesses that serve alcohol must have operating condom vending machines on their premises. Judge Harold Flannery, in a ruling from Suffolk Superior Court, ruled that the City Council exceeded its authority when it passed the law in December, over Mayor Flynn's veto. The City Council had declared that a public health emergency had existed when it passed the ordinance, and the law was intended to fight the spread of sexually transmitted diseases, including HIV. The measure required businesses with alcohol licenses and a capacity of more than 100 patrons to have condom vending machines installed, as a condition of obtaining or keeping their entertainment licenses. Flannery said in his eight-page decision that the state legislature has vested "exclusive power" in the mayor to issue and impose conditions on the entertainment licenses under state law. The measure has been challenged in a lawsuit brought by the Massachusetts Restaurant Association, initially against the mayor and the City Council. However, Flynn was permitted to switch sides and accompany the restaurant association in suing the council. Although Flannery refused to allow several AIDS activist groups to intervene in the case, he took into consideration their argument that the condom vending machine ordinance was justifiable on public health grounds. Blood Supply Issue Remains Unresolved * Toronto Globe and Mail (03/23/93), P. A8 Picard, Andre A $100-million blood fractionation plant proposed by the Red Cross has not been approved by the Canadian Blood Agency, officials have announced. The statement, which contradicts senior officials at the Canadian Red Cross Society, was released soon after one of Canada's biggest users of blood products said that building a plant would be irresponsible. The controversy between bureaucrats and blood collectors has emerged now that users such as hemophiliacs and transfusion patients are demanding an independent public inquiry into the administration of the blood system. They caution that political bickering and bureaucratic red tape contributed to Canada's tainted-blood scandal, in which more than 1,000 Canadians contracted HIV, and warn that the disaster could be repeated if the system is not corrected. However, last week, Steven Vick, assistant national director of blood services at the Red Cross, said the society's proposal to build a blood fractionation plant, which separates blood plasma into component parts, had been approved. He claimed the project would save provincial health plans more than $400-million and ensure Canadian self- sufficiency in blood products. But the Canadian Blood Agency's chief financial officer, Phil Dresch, said the agency had not even decided whether a domestic fractionation plant was a good idea or whether Canada would continue its policy of buying blood products from the United States and Europe. "We acknowledge that we have a number of proposals to build a blood fractionation plant in Canada. But media reports that we have reached a final decision, that the Red Cross has been awarded a contract, are not accurate," said Dresch. Dying Mother Finds Home for Little Girl Ill With AIDS * Baltimore Sun (03/24/93), P. 1B Hare, Mary Gail A mother dying of AIDS who has been seeking care for her HIV- positive four-year-old daughter has finally found the right family. Catherine Williams, a single mother, is planning to accept a Carrol County, Md., family's offer of a home and foster care for her only child, a 4-year-old. Williams said, "I want to have everything in writing so there is no question who will be responsible for my child." Williams has been spending her depleted strength and limited resources trying to find a home for her daughter. Her family members cannot take the child, partly because they are also in poor health. Williams, a former caseworker at the Maryland Department of Social Services, also discovered that the state foster care system is not capable of handling her daughter's special needs. Therefore, Williams started her own search in hopes of finding a family and developing a relationship with them before she dies. She spoke to several AIDS-support groups and churches, and told her story to the Baltimore Sun. Since her story was published on March 9, it has generated an influx of calls and letters offering everything from prayers to money for mother and child. Williams said that for financial reasons, foster care would be a better option than adoption for the family that takes the child. Her daughter now receives half of Williams' Social Security disability benefits. When Williams dies, the daughter will receive the full amount. The prospective foster parents have experience in caring for children with AIDS and have adopted two children through state agencies. Female Barrier Contraceptive * Lancet (03/13/93) Vol. 341, No. 8846, P. 696 Smith, Conamore et al. Although the female condom device, Femidom, claims to be as effective as the male condom at preventing HIV infection, it is not, write Conamore Smith et al. of the Parkside Health Trust in London, U.K. Direct comparisons must be done with proper epidemiological methods (randomized controlled trial) because there is no evidence to support recommending the use of Femidom instead of the male condom for contraception. In the advertisements by Chartex International, the manufacturer of Femidom, it is implied that the female condom is as effective a contraceptive as the male condom. These claims are based solely on one published study which followed-up 106 women who responded to an advertisement inviting volunteers to a U.K. family planning clinic. The overall use-efficacy was estimated to be 15 percent. The researchers stated that this was well within the rates reported worldwide for the male condom, a contention that is misleading because most of the reports referred to were about different populations than that of the Femidom. While the Femidom study was well-conducted, the reported drop-out rate of 56 percent together with the fact that 84 percent were using barrier methods at recruitment into the study, means that extrapolating the results to the sexually active population in general is faulty. Femidom was used with spermicidal lubricant. The version of Femidom currently marketed in the U.K does not contain a spermicide, which further undermines the evidence that Femidom is as effective as the male condom, or that the marketed version in the general sexually active population would reach a failure rate of 15 percent, conclude Smith et al. Viral Culture of HIV in Neonates * New England Journal of Medicine (03/18/93) Vol. 328, No. 11, P. 814 Lyman, William D. et al. Although Burgard et al. imply that maternal-fetal transmission of HIV-1 occurs at birth, neither in utero or peripartum transmission can be excluded on the basis of their data, write William D. Lyman et al. of the Albert Einstein College of Medicine of Yeshiva University in Bronx, N.Y. In the Oct. 22 issue of the Lancet, Burgard and colleagues state that the frequency of HIV transmission from infected mothers to their fetuses is not known and that there is an apparent lack of viral genome in fetal tissues. The authors take this as evidence that vertical transmission occurs at birth and not prenatally. In order to back their conclusions, they cite three papers. But other studies that do not substantiate their claims are not cited. Studies have demonstrated that the frequency of transmission during the first and second trimesters of pregnancy ranges from about 15 percent to 70 percent. While the exact number could be contested, to give the impression that nothing is known in this regard is not consistent with the evidence. The second claim by Burgard et al. that the HIV-1 genome is absent in fetal tissues is also not supported by studies. The researchers and other scientists have demonstrated that HIV-1 DNA can be detected in human fetal tissues before 24 weeks of gestation. The authors strongly suggest in their findings, along with other studies, that maternal-fetal transmission of HIV-1 transpires at birth. Until there is conclusive knowledge of when and how vertical transmission occurs, it is essential that all available evidence be considered for care and treatment strategies, the researchers conclude. Clinton AIDS Policies Hit Rough Waters * Advocate (03/23/93) No. 625, P. 18 Gallagher, John The Senate voted on Feb. 18 to prevent President Clinton from executing his plan to lift the federal government's policy of prohibiting HIV-positive foreigners from entering the United States, which may indicate a future trend in congressional reaction to Clinton's other AIDS policies. The Senate wrote the immigration ban, which previously had been a Bush administration policy, into law through an amendment included in an appropriations bill for the National Institutes of Health. The bill involved a provision to fund AIDS research through a single office rather than to several different agencies. The NIH funding bill passed 93-4, while the immigration amendment passed 76-23. Health and Human Services Secretary Donna Shalala previously appeared on CNN in an interview and said that the Clinton administration would fulfill the president's campaign promise to eliminate the immigration ban. Soon after her interview, congressional opposition to lifting the ban began to emerge. Within a day, Rep. Marge Roukema (R-N.J.) wrote Clinton a letter urging him to "rethink and reject this decision." However, Marvyn Silverman, president of the American Foundation for AIDS Research, said that current immigration law mandates that people entering the country prove that they are self-sufficient and unlikely to drain public health resources. He said, "The chance that a rush of people will come to a country without universal health coverage is slim." He added that the administration's decision not to lobby more aggressively may have made political sense because they are "hoping it will be killed" in the House. News in Brief: Ohio * Advocate (03/23/93) No. 625, P. 23 The Columbus AIDS Task Force in Ohio announced on Feb. 13 that demand for its services is outstripping the supply and that it may run out of money this year for the first time ever. "This is the first year that expenses have exceeded the income we had," said Janet Ferguson, the group's associate director. The task force is estimating a shortfall of about $23,000 by March 31 and will be forced to spend $157,000 from its cash reserves. The group has 15 staff members and makes counseling, education, and other services available to AIDS patients and their families. AIDS Virus Replicates on a 'Massive' Scale Soon After Infection * Washington Post (03/25/93), P. A3 Brown, David Two new studies published in today's Nature suggest that HIV replicates in lymph nodes on a "massive" scale shortly after infection, even though it was previously believed that the virus went into a "latent" stage. This latent stage was thought to last years, during which time it damaged relatively few cells and could not be detected in the blood. But the two articles say a patient's absence of symptoms or lab test abnormalities is a poor indication of what is actually transpiring. Dr. Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases and co-author of one of the studies, said, "Clinical latency does not mean disease latency." The new discoveries indicate that-- theoretically, at least--it might be useful to treat HIV patients much earlier than they are now. Fauci said if there were a perfect drug that never conferred resistance in the virus, such treatment would be practicable. However, he added, no antiretroviral drugs are now available for such long-term use, and current guidelines for drug treatment should still be followed. The two studies examined evidence of viral infection in lymph nodes of patients at various stages of HIV infection. It now seems that soon after HIV enters the bloodstream, it is transported to a nearby lymph node, at which point it is filtered out by a complex of cells that incite the immune system to attack HIV. Subsequently, the virus' genetic code, in the form of RNA, is displayed prominently on the surface of a particular kind of cell in the node. As a result, it is available to infect white blood cells that travel through the node and carry the virus to other areas. Related Stories: Wall Street Journal (03/25) P. B12; Washington Times (03/25) P. A5; USA Today (03/25) P. D1; Los Angeles Times--Washington Edition (03/25) P. A8; Philadelphia Inquirer (03/25) P. A4 Enzo Biochem's Test for HIV * Wall Street Journal (03/25/93), P. B12 A new test to detect HIV in the blood by finding viral genes instead of antibodies' reacting to the virus has been developed by a unit of Enzo Biochem Inc. BioChem to Test AIDS Drug * Toronto Globe and Mail (03/24/93), P. B12 Montreal pharmaceutical company BioChem Pharma Inc. has announced it will start PhaseII/III clinical trials of its AIDS drug 3TC next month. This phase of testing is the last before the company applies for regulatory approval of the drug. The company claims the drug causes fewer adverse effects than other AIDS treatments. The tests will be conducted on 320 HIV- positive patients in Europe and about 500 subjects in North America, including Montreal. The trials will use 3TC alone or in combination with other HIV therapies, including AZT. BioChem expects to have a complete analysis of the trial findings before the end of the year. Metro Firms: Viral Technologies Lands Vaccine Patent * Washington Times (03/25/93), P. C3 Viral Technologies Inc., the jointly-owned subsidiary of CEL- SCI Corp. of Alexandria and Alpha 1 Biomedicals Inc. of Washington, D.C., has been awarded a European patent for an AIDS vaccine, the companies have announced. Viral Technologies developed the HGP-30 vaccine, which is unique because it is a synthetic copy of part of the core protein of HIV. House Panel Rejects Needle Exchange Plan * Baltimore Sun (03/25/93), P. 1B Bowman, Tom A proposal to implement a pilot needle exchange program in Baltimore, Md., as a way to thwart the spread of HIV among IV- drug users was rejected yesterday by a state House panel. The House Judiciary Committee voted 11 to 13 against the legislation, which Baltimore Mayor Kurt L. Schmoke and other proponents patterned after effective programs in U.S. and European cities. The majority of those who opposed the bill said they did not approve of the concept of allowing IV-drug users to turn in dirty hypodermic syringes in exchange for clean ones. The panel's decision signifies the second time in two years such a proposal has been rejected. Advocates of the needle exchange program said that needle exchanges have proven effective in the seven states and eight foreign nations that have established such programs. A study at Yale University discovered that the New Haven needle exchange program reduced HIV infections by one-third without evidence of increased drug use. State Attorney General J. Joseph Curran Jr. and Health Secretary Nelson J. Sabatini supported the program even though Gov. William Donald Schaefer opposed it. The governor believes such a program would result in more drug use. The three-year pilot would have cost $50,000 in city funds and donations. The proposed program would have involved up to 700 addicts, who would have been offered anti-drug and AIDS counseling in addition to clean needles. Also, the city Health Department was expected to monitor and evaluate the program. The measure required approval by the General Assembly because an exemption was needed from the state's drug paraphernalia law, which prohibits unauthorized ownership of hypodermic syringes. Kentucky Dentist Plans to Bring Self-Sheathing Needle Invention to Market * Knight-Ridder (03/23/93) Johnson, Darragh (Lexington, KY) Because the threat of AIDS is an everyday occurrence for some health-care professionals, a needle has been developed that automatically re-covers itself. Dentist Dr. Bart McFarland invented SafeMate, the self-sheathing device, and hopes that it will be on the market and selling to doctors nationwide within a couple of months. Before McFarland's invention, doctors had to implement several sloppy and slow methods for re-covering the fronts of their needles. These methods diverted attention away from the patient the health- care worker had just pricked. Also, these techniques were not foolproof--they only covered the fronts of the needles, leaving the backs open. McFarland's needle comes with a plastic case that fits over the needle and locks into place. The physician screws the needle into the syringe before injection, then unhooks the case and slides it back onto the syringe. After the needle has been used, the doctor slides the case back over the needle. This device covers the needle from behind, so it can never prick the doctor's skin. The SafeMate self-sheathing needle also covers the back of the needle. McFarland was granted a patent in 1987 and has been working with designers and business professionals to ensure that the cover will lock into place in order to obtain Food and Drug Administration approval. Governor Tucker Announces Conference on 'Business Responds to [AIDS]' * PR Newswire (03/23/93) (Little Rock, AR) Arkansas Gov. Jim Guy Tucker announced Tuesday that a Conference on "Business Responds to [AIDS]" will be held on April 23 at the Statehouse Convention Center in Little Rock. The governor's office, in conjunction with the Arkansas business community and the Centers for Disease Control will conduct the meeting. At the conference, health professionals, business owners, and managers will address better ways to prepare the business community to cope with major health problems created by HIV infection. Information will be discussed candidly and advice will be given on dealing with the crisis within personnel systems. Topics addressed will include prevention education, workplace policies, volunteerism, and community support. Gov. Tucker said, "Educating the workforce about this disease is the best way to stem the tide of AIDS-related illness." He added, "Arkansas currently ranks fifteenth in the nation in incidence of HIV/AIDS per capita. Business must act now in decisive ways to prevent the spread of the disease among the state's workforce and to protect our social and economic health." Most people who are infected with HIV throughout the nation fall within the age group of 25-44 year olds. Tucker said that half the nation's workforce falls within this category and that AIDS is the third leading cause of death in this age group. The Prevention Game * Science (03/12/93) Vol. 259, No. 5101, P. 1537 Flam, Faye A new HIV/AIDS educational game has been developed specifically for classroom use. "AIDS Is No Game" teaches teenagers about HIV and AIDS by asking questions like, "Can HIV be spread by sharing eye make-up?" or "A drop below what number of T-4 helper cells usually marks the early stages of AIDS?" The game separates the class into two teams, which are then questioned about AIDS research, medicine, prevention strategies, and social issues. The game is designed and marketed by Programming Concepts Inc. of San Antonio, Texas. The "AIDS is No Game" features buttons with pictures of HIV, an "Epidemic Watch" poster that lets students follow track the spread of HIV throughout the United States, dice playing cards, and pre- and post-game tests. The game, which costs $300, is being promoted as an "educational vaccine," on the basis that education is the best means to avoid HIV infection. Phosphorodithioate DNA as a Potential Therapeutic Drug * Science (03/12/93) Vol. 269, No. 5101, P. 1564 Marshall, W.S. and Caruthers, M.H. A deoxyoligonucleotide inhibitor, which binds strongly to the primer-template active site of HIV-1 reverse transcriptase (RT), provides another type of potential therapeutic agent against HIV-1, write W.S. Marshall and M.H. Caruthers of the University of Colorado--Boulder. Mechanistic studies suggest that phosphorodithioate DNA oligomers interfere with enzyme function by binding tightly to the active site for primer- template, which results in low or subanomolar inhibitory constants. While many of these studies have used deoxyoligocytidine analogs, a rationally designed approach has led to the discovery of a very active phosphorodithioate deoxyoligonucleotide inhibitor. Since HIV-1 RT is a bireactant enzyme, in order to complete the kinetic analysis the pattern of inhibition with respect to deoxynucleotide triphosphates (dNTPs) was determined for dithioate tetradecadeoxycytidine by using a similar analysis. The results of kinetic analysis suggest that both thioate and dithioate deoxyoligocytidine inhibit HIV-1 RT by specifically binding to the active site for primertemplate, thereby precluding the binding of the natural substarate and subsequent polymerization. Phosphorodithioate- containing deoxyoligonucleotides should be further explored as DNA therapeutic drugs, the researchers conclude. USA: Reorganization of AIDS Research * Lancet (03/20/93) Vol. 341, No. 8847, P. 747 Rowe, Paul M. Significant changes in the management of AIDS research at the National Institutes of Health will occur as a result of the NIH Revitalization Act of 1993, which has neared completion in Congress. The Senate passed its version of the act last month, and the House passed a very similar bill last week. The two versions will be incorporated into one, which will be on President Clinton's desk within weeks. The Senate bill, sponsored by Sen. Edward Kennedy (D-Mass.) and written along with scientists and AIDS activists, extends the power of the Office of AIDS Research (OAR), and upgrades its directorship to a full-time position. The new director of OAR will be under the authority of the NIH director. The OAR will be in charge of evaluating the AIDS research that is currently conducted by 21 of the institutes, centers, and divisions (ICDs) of NIH, both intramural (in Bethesda, Md.) and extramural (most NIH dollars go to universities via grants), and to identify redundancies and deficiencies in current programs. The OAR will develop a plan, which includes work in pathogenesis and basic science, natural history, and epidemiology, vaccine development, clinical research, and social and behavioral research. The director of the OAR will have the authority to encourage the ICDs to collaborate wherever duplicated efforts waste resources. Also, within two years, the OAR is scheduled to develop an overall AIDS budget to accompany the strategic plan. This budget will be formulated earlier than the rest of the NIH budget, and goes to the President separately. All objectives of the final bill except those dealing with future budgets will be enacted as soon as the bill is signed. Weld, Flaherty Pledge to Increase Funds for AIDS Prevention, Treatment * Boston Globe (03/25/93), P. 27 Locy, Toni Massachusetts Gov. William Weld and House Speaker Charles F. Flaherty signed a pledge Wednesday to increase spending for AIDS prevention and treatment. Project ABLE--the AIDS Budget Legislative Effort--conducted a State House news conference during which Weld said, "We wish to do more to ensure that AIDS and HIV treatment are given the public attention and funding they so obviously need." According to Weld, government officials are responsible for doing "everything we can to support the battle against this...hideous disease." In addition, Weld encouraged state residents to use the checkoff on Massachusetts tax returns to contribute to AIDS research funding. Michael Savage, vice chairman of Project ABLE, said AIDS funding has been lacking compared with the increase in the number of people with HIV or AIDS over the past four years. The number of AIDS cases has grown 115 percent over the past four years, even though funding for prevention and treatment has increased only 35 percent, says Project ABLE. The state Department of Public Health projects there are nearly 33,000 HIV-positive people living in Massachusetts. Savage said that because funding has not paralleled the number of cases, AIDS treatment providers have had to cut back on programs and have established waiting lists for AIDS-related services. The proposed fiscal 1994 budget includes a $5.5 million increase in AIDS prevention and treatment funding. Red Cross Feared Losing Donors, Man Says * Toronto Globe and Mail (03/25/93), P. A6 Downey, Donn The Canadian Red Cross was reluctant to implement a high- profile effort in 1985 to safeguard its blood supply because it was afraid of discouraging people from donating blood, said a former Ontario director of the Canadian Hemophilia Society. Robert O'Neill, who testified Wednesday in a civil action against the Red Cross, The Toronto Hospital, and Dr. Stanley Bain, said that in mid-1985 he told the national director of donor recruitment for the Red Cross that high-risk donors should be warned that they could be HIV-positive. But, said O'Neill, the Red Cross gave the impression it did not want a high-profile campaign to scare away high-risk donors, and it did not want to prompt "public hysteria." The case involves Kenneth Pittman, who died of AIDS in March 1990 after receiving an HIV-infected blood transfusion in 1984 at the hospital. His widow, Rochelle, subsequently tested HIV-positive about five months after Pittman died. The three parties have been named as defendants in the $2 million lawsuit initiated by the family of Kenneth Pittman. O'Neill said that in 1985 he encouraged the Red Cross to provide its brochure on AIDS to potential donors before they gave blood. He said he first saw the brochure in May of 1985 after he donated blood at the Manulife Center in Toronto. O'Neill said he always read a donor questionnaire before giving blood, but in 1985 none of the eight questions it asked referred to AIDS, HIV, or high-risk donors. A second witness, only known as Mr. E., testified that he discovered his HIV-infection after his blood donation was rejected in December 1985. He testified that he had donated blood many times and had between 200 and 300 homosexual partners, but did not recall ever seeing the brochure. "City Criticized for Not Housing People With AIDS" United Press International (03/25/93) (New York) Nearly 150 AIDS patients recently had to stay in city welfare offices overnight, according to a group of AIDS activists and city officials. They criticized the city for not using the available subsidies even when apartments are identified, and for increasingly using the offices known as Emergency Assistance Units. Virginia Shubert of the AIDS advocacy group Housing Works said at a news conference in the City Hall rotunda that she and other advocates met earlier with city officials and were told they expected too much from the city. However, Ellen Alpert, director of AIDS housing for the city who also attended the meeting, said the city is trying to cope with an overwhelming amount of new AIDS cases. "We are always working on that issue and they should not get frustrated, certainly with this mayor's office," she said, conceding that about 150 AIDS patients each week are referred to EAUs for assistance, while only a few end up spending the night in the offices. In addition, she said about 1,700 AIDS patients must now live in SRO housing, many without private kitchen and bathroom facilities, but the city was developing a plan that would provide housing for 300 AIDS patients within several years. Manhattan Borough president Ruth Messinger said, "It is unconscionable that the city is now sending homeless persons with HIV and AIDS to spend nights sleeping on plastic chairs in crowded and often filthy Emergency Assistance Units." Shubert also said that her agency did not expect to take legal action against the city. Magic Johnson Urges Japan to Fight AIDS * United Press International (03/25/93) (Tokyo) Former basketball star Magic Johnson spoke at an international symposium at which he urged Japan to join in the fight against AIDS with increased research and education, in addition to more compassion for those who have the disease. Johnson, who retired from the Los Angeles Lakers in 1991 after testing HIV-positive, addressed the symposium called "Living Together in the Age of HIV and AIDS." He said he was widely supported when the public learned of his condition, but that was a result of his celebrity status. "It is important to treat people the same way as before they were diagnosed as HIV- positive," said Johnson. He called for Japan to be more supportive of HIV-infected people and emphasized the significance of candid discussion about AIDS and safe sex with teenagers. He said, "Prevention is the key. You have to have safe sex. You can put on a condom just like you've put on that Lakers jersey," he said to a high school student wearing a Lakers shirt. All of the speakers at the symposium said that people with AIDS/HIV fight two battles: one against the tragic disease and the other against the social stigma attached to it. FDA Grants Permission for Independent Clinical Study of Experimental Treatment for HIV Infection * Business Wire (03/24/93) (Houston) The Burzynski Research Institute (BRI) has announced that the Food and Drug Administration on March 19 released from clinical hold Burzynski's Investigational New Drug Application (IND) for Antineoplaston AS2-1 capsules. The release means the drug can be tested in a phase I clinical study called "Treatment of Asymptomatic HIV Infection With Antineoplaston AS2-1." Burzynski's research shows that antineoplastons are naturally occurring peptides and amino acid derivatives that are components of a biochemical defense system which parallels our immune system. Burzynski suspects that the biochemical defense system protects us by reprogramming, or normalizing, defective cells, unlike the immune system, which protects us by eradicating invaders or defective cells. As a result of errors in cell programming, diverse conditions such as cancer, AIDS, autoimmune diseases, benign tumors, certain skin diseases, and Parkinson's disease may develop. According to Burzynski, without this corrective system, our immune systems would soon submit to damaging forces, such as viruses and dangerous environmental factors that are continually inciting abnormal cell development. Recommendations for Prophylaxis Against Pneumocystis Carinii Pneumonia * Lancet (03/20/93) Vol. 341, No. 8847, P. 758 Veugelers, Paul J. The number of men at risk of pneumocystis carinii pneumonia (PCP), who are not treated according to current recommendations, can be reduced by adding CD4 cells below 20 percent of total circulating lymphocytes to the eligibility criteria, write Paul J. Veugelers et al. of the Department of Public Health in Amsterdam, Netherlands. Since October 1984, 513 HIV seropositive homosexual men have participated in the researchers' cohort study in Amsterdam. CD4 cells were examined every three months and, since February 1990, primary prophylaxis against PCP was recommended when CD4 cells fell below 200/uL. A total of 150 participants progressed to AIDS by January 1993, of whom 49 had PCP as their primary index diagnosis. When reviewing these cases, in 11 men the number of CD4 cells never dropped below 200/uL up to 14 days before PCP diagnosis. The researchers examined CD4 cells as a percentage of total circulating lymphocytes in these 11 cases. In seven, the percentage had decreased below 20 percent preceding their PCP diagnosis. These seven cases would have received PCP prophylaxis when this percentage was part of the eligibility criteria. Kaplan-Meier analysis among the 184 men who ever had a CD4 count less than 20 percent while their absolute number of CD4 cells was still above 200/uL showed that the median time from the date of their first CD4 count less than 20 percent to eligibility for treatment according to the current criteria (less than 200 CD4 cells per uL) was 21 months. When two assessments below 20 percent was taken as a criterion, the median time to treatment was 17 months. The researchers conclude that in some cases the criteria for primary prophylaxis against PCP are not effective. Mycoplasmas in HIV-1 Seropositive Patients * Lancet (03/20/93) Vol. 341, No. 8847, P. 758 Bebear, Christiane et al. Mycoplasma fermentans DNA is present in different specimens from HIV-positive patients, write Christiane Bebear of the Centre Hospitalier Regional de Bordeaux in Bordeaux, France. In the Jan. 30 issue of the Lancet Dr. Katseni and colleagues report the detection of M. fermentans by a semi-nested polymerase chain reaction (PCR) in peripheral-blood mononuclear cells (PBMC), throat swabs, and urine samples, in similar proportions from HIV-1 seropositive or seronegative patients recruited from a sexually transmitted diseases clinic. Bebear et al. studied the detection of several mycoplasma species by culture and PCR in different specimens of 105 HIV-1 seropositive inpatients and outpatients recruited from two infectious diseases departments. Throat swabs, urethral or endocervical swabs, urine samples, and PBMC were cultured in media adapted to the growth of all mycoplasma species. All PBMC cultures were negative. No M. fermentans strain was isolated by culture from any specimen. PCR assay was performed on all lysed throat and genital samples, and on DNA extracted from PBMC, for the detection of M. fermentans, M. genitalium, and M. pneumoniae. Out of 105 patients, 28 (26.7 percent) had M. fermentans DNA detectable in at least one site. No difference was found between patients with or without M. fermentans DNA according to sex, age, source of contamination, antibiotic therapy, or stage of disease. Katseni et al. reported similar observations in blood in a smaller number of patients, and in blood, throat, and urine specimens. But the absence of positive cultures can be explained by the insensitivity of the approach for this microorganism, the researchers conclude. News in Brief: California * Advocate (03/23/93) No. 625, P. 25 An AIDS patient who on Feb. 8 shot three doctors at the Los Angeles County-University of Southern California Medical Center in Los Angeles told television interviewers that he was irate over the inadequate AIDS treatment he received while at the hospital. The man, Damacio Ybarra Torres, was arraigned Feb. 10 after allegedly shooting the doctors and holding two staff members hostage during a four-hour standoff with police. Torres pleaded not guilty to attempted-murder and kidnapping charges during the arraignment. He told television station KABC in Los Angeles, "I was the victim of a medical conspiracy. They refused me treatment for ten years. I'm in ill health, and they don't give a damn. Where can I go?" AIDS activists have long claimed that AIDS care at the hospital is poor and blame the Los Angeles County board of supervisors with neglecting to earmark enough funds for AIDS programs. Screening Blood Donors by Computer Interview * Journal of the American Medical Association (03/24/93-03/31/93) Vol. 269, No. 12, P. 1505 Wright, Michael P. and Silberstein, Fred B. The sensitivity of Locke et al.'s study in the Journal of the American Medical Association on screening blood donors by computer interview is questionable, write Michael P. Wright and Fred B. Silberstein of the Scientific Social Research in Norman, Okla. and the University of Oklahoma--Norman, respectively. Locke et al. show that potential blood donors are more apt to disclose personal risk factors for HIV infection in private computer interviews than they do in response to written questionnaires and face-to-face encounters. Locke et al. claim that their computer interview is "more sensitive" than the conventional method. But a case of error could be declared for any subject who was assessed not at risk by the computer interview process. Using a computer interview incorporating a refined probability analysis, this experimental method has been demonstrated using a group of HIV-positive subjects who reported personal behavior experience prior to their antibody tests. Locke et al. reported that 96 percent of their subjects were without HIV risk factors. They did not say for certain that no members of this group were infected. All subjects were HIV-negative, but because of the latency period, it is unknown that they were all uninfected. Unless this question is discussed, comments about sensitivity seem premature. A complete assessment of sensitivity would involve HIV-positive subjects in order to measure the success rate of the computer interview procedure in recognizing risk factors from those who were obviously at risk, conclude Wright and Silberstein. NOTE: Compilation by Michael Tidmus : AIDSwire. All rights reserved. Permission is granted to republish on electronic media for which no fee is charged, provided the complete text of this notice is attached to any republished portion or portions. * From the AIDS Daily Summary. The Centers for Disease Control and Prevention (CDC) National AIDS Clearinghouse has made this information available as a public service only. Providing this information does not constitute endorsement by the CDC, the CDC Clearinghouse, or any other organization. Reproduction of this text is encouraged; however, copies may not be sold. Copyright 1992, Information, Inc., Bethesda, MD. -----===[[[ A I D S w i r e D I G E S T 03.22.93 ]]]===----- .