-----===[[[ A I D S w i r e D I G E S T 04.12.93 ]]]===----- A Hollywood Dance for AIDS * New York Times (04/12/93), P. B5 Brozan, Nadine Because actress Rosie Perez has seen eight friends die of AIDS, she is determined take action against the disease. "I've got a big mouth," said Perez, who starred in "White Men Can't Jump" and "Untamed Heart." She added, "I'm going to put my drop in the bucket and go to AIDS dance-a-thons in as many cities as I possibly can." Perez and other celebrities such as Sharon Stone and musical group En Vogue are scheduled to attend the fifth annual Los Angeles AIDS Dance-A-Thon on Sunday. The proceeds from the five-hour dance party will go to AIDS Project Los Angeles and other AIDS-related groups. The benefit raised $1.1 million last year. Faulkner Hospital Nurses Rally, Demand HIV Policy * Boston Globe (04/09/93), P. 65 Lewis, Diane Registered nurses at a Boston-area hospital protested Thursday and demanded disability insurance, fair wages, and an agreement that will guarantee a special insurance payment to nurses who contract HIV while on the job. Approximately 200 nurses picketed and passed out leaflets in front of Faulkner Hospital in Jamaica Plain, Mass. Maureen McNamara, surgical day nurse at the hospital, said, "We're out here because we need protection against HIV, and we've offered a plan other hospitals have already put into effect, but Faulkner isn't willing to accept it." Many nurses emphasized that point by appearing on the picket line with children who carried signs that read, "If My Mom Gets HIV, Who Takes Care of Me?" Christopher Miller, director of community relations at Faulkner, said the hospital is reviewing the issue. "Every hospital has to deal with this [HIV infection of staff] in some way. It's a reality right now, and we are continuing to look at the options available to us for HIV insurance. But nothing has been decided as yet." Julie Pinkham, a union official from the Massachusetts Nurses Association, which represents more than 20,000 registered nurses in the state, said nurses at Faulkner want a contract patterned after one approved last year by nurses at Brigham and Women's Hospital in Boston. That agreement involved a guarantee of disability insurance for HIV- positive nurses in the course of their work. In addition, nurses would also obtain a percentage of their salary. France--AIDS Scandal * Associated Press (04/09/93) (Paris) A French legal panel on Friday extended by four months the period of the government's liability to AIDS patients who contracted HIV from tainted blood transfusions. The Council of State's order also said the government must pay $363,000 each to three hemophiliacs who tested HIV-positive after receiving infected blood between Nov. 22, 1984 and March 12, 1985. Previously, the government's liability had been limited to the period from March to October 1985. However, the constitutional panel decided that officials were liable beginning Nov. 22, 1984, when they received a report that blood transfusions were transmitting HIV. The Health Ministry said it could not immediately disclose how many people could qualify for compensation under the new ruling. Several people have already been awarded damages by courts. Among the 1,200 French hemophiliacs who contracted HIV from transfusions in 1985, more than 300 of them have died. French health officials refused to use a U.S.-developed HIV testing device, and chose instead to wait until a French testing system had been implemented. That decision allowed thousands of people to contract HIV in the meantime. A total of three former health officials have been sentenced to prison because of the scandal. Second Group of Ailing Haitians Flown to Miami * United Press International (04/09/93) (Miami) The second group of HIV-positive Haitian refugees from the U.S. Naval base at Guantanamo Bay, Cuba, arrived in Miami on Thursday following a court order requiring sufficient medical care to be provided for them. Ron Tomalis, a spokesman for the Justice Department's Community Relations Service in Washington, D.C., said Friday that eight of the 31 are being reunited with relatives in south Florida, while the others are being resettled in New York. Tomalis said 25 of the 31 qualify under the court order because they have the most seriously weakened immune systems. He added that the others had medical problems that required more specialized treatment than was available at the base or were dependents of others in the transport. On March 26, U.S. District Judge Sterling Johnson Jr. allowed the government 10 days to provide adequate medical treatment to the most seriously ill Haitians at Guantanamo Bay. Last Monday, 20 refugees--15 of them HIV-positive--were flown to Miami. Rayford Kytle, spokesman for the Public Health Service, said all of the refugees will qualify for Medicaid or other federal assistance to pay for their medical care for eight months. After that, he said, most are eligible for Supplemental Security Income, a program administered by the Social Security Administration. A total of 193 Haitians remained at the refugee camp as of Friday. All have been considered to have plausible claims for political asylum but have been banned from the United States because either they or their parents are HIV-positive. Manager With AIDS Sues Restaurant Chain for Discrimination * Reuters (04/08/93) (San Francisco) A restaurant employee has filed a lawsuit against a restaurant chain, claiming it withheld his long-term disability insurance coverage because he is gay and is infected with HIV, his attorney said Thursday. The action, filed by Michael Manrique, a kitchen manager, names Lyons restaurant chain and Sara Lee Corp., the food giant that owns Lyons. Manrique claims the company did not submit his long-term disability insurance form to its insurer because he was a homosexual and because he was HIV-positive. Manrique's attorney, Thomas Olszewski, said the suit, filed in San Mateo County Superior Court this week, seeks unspecified punitive damages against the companies. "It's a real shame that someone being so ill has to deal with an employer who, as I see, acted really callously and maliciously," said Olszewski, who added that Manrique tested positive for HIV in November 1989. "For many years, he worked for this company, and he feels like he's being just thrown away because they can't deal with his AIDS diagnosis and his sexual orientation," said the lawyer. The lawsuit alleges that Manrique was given the right to obtain long-term disability insurance in August 1989, and turned in his application in October. The suit claims deductions for the insurance were taken from his paychecks through 1991. According to the suit, his superior asked Manrique to re-submit the disability insurance application in March 1991, and in August he was notified that the company would not provide the insurance. His attorney said Manrique still works for Lyons, but is on disability leave for an unrelated work injury. NIH Set to Test Multiple AIDS Vaccines * Reuters (04/08/93) Frank, Jacqueline (Washington) The Clinton administration will permit the National Institutes of Health to test multiple AIDS vaccines instead of only allowing the Army to test a single vaccine, administration sources said Thursday. The decision ends the controversy between Army AIDS researchers who had hoped to test a vaccine made by MicroGeneSys Inc. and the National Institutes of Health, which contended that multiple vaccines should be tested. Health and Human Services Secretary Donna Shalala said a final announcement on the therapeutic vaccine trials was expected to be made last Friday. Companies including Genentech Inc., Chiron Corp., and Immuno AG have already told NIH that they are prepared to participate in the vaccine tests. The testing is intended to demonstrate whether AIDS vaccines are effective in thwarting the replication of HIV in patients already infected. Shalala refuted last week's reports that the Clinton administration had decided the Army's test of the MicroGeneSys VaxSyn should proceed without tests of others at the same time. "The report was inaccurate, and I expect there to be some announcement in the next 24 hours about that particular AIDS research project," said Shalala. Administration sources subsequently confirmed that NIH director Dr. Bernadine Healy and Food and Drug Administration Commissioner David Kessler had convinced the White House that multiple vaccines should be tested simultaneously. But MicroGeneSys president Frank Volvovitz said a test of multiple vaccines could triple the cost of the trial and delay it by two years. The Limits of AZT's Impact on HIV * U.S. News & World Report (04/12/93) Vol. 114, No. 14, P. 18 AZT has become the most widely used drug to fight AIDS since it was approved by the Food and Drug Administration in 1987. Burroughs Wellcome, the manufacturer of AZT, made $338 million last year alone from sales of the drug. However, a team of European researchers recently reported that although HIV- positive patients taking AZT demonstrated a slightly lower risk of developing AIDS within the first year of treatment, that benefit disappeared two years later. The Lancet published preliminary findings of the three-year study, which could give more reason for critics to argue the drug's cost, side effects, and general efficacy. Even though U.S. researchers concede the study was more comprehensive than American trials, many argue the European researchers' suggestion that HIV-positive patients experience little improvement in their illness before the development of AIDS symptoms. In addition, researchers have long been familiar with the limits of AZT's efficacy and now suggest using the drug either sequentially with other drugs or in a kind of AIDS treatment "cocktail" combining a number of drugs to fight the virus all at once. "Treating people with AZT alone doesn't happen in the real world anymore," said Dr. Mark Jacobson of the University of California--San Francisco. Also, with recent findings indicating that HIV replicates rapidly in the lymph nodes after infection, physicians may begin pushing even harder for early treatment of HIV-infected patients. A Few Old-Fashioned Maladies * U.S. News & World Report (04/12/93) Vol. 114, No. 14, P. 18 Because AIDS has been in the media spotlight in recent years, other sexually transmitted diseases have not been as publicized. However, a new report by the Alan Guttmacher Institute shows that diseases such as gonorrhea, herpes, and syphilis, although treatable, have not been eradicated. In fact, syphilis is at its highest level in 40 years and gonorrhea is America's most commonly reported communicable disease. The report predicts that about 25 percent of Americans will become infected with an STD at some point in their lives. The study's author, Patricia Donovan, believes the increases in rates of STDs are a result of declining health care and increased sexual intercourse among the young. Donovan says federally funded clinics must emphasize more prevention. Burroughs Fights AZT Suit * American Medical News (04/05/93) Vol. 36, No. 13, P. 2 Burroughs Wellcome, the manufacturer of AZT, has said it is confident that it can succeed in defending the patent of the drug in a lawsuit. According to two generic drug makers, the U.S. government should be named as AZT's co-inventor because National Cancer Institute researchers were first to recognize the drug's ability to thwart the replication of HIV. However, Burroughs officials claim their researchers thought of using AZT to treat HIV. Because Burroughs' name is on the patent, the company has exclusive rights to AZT's use in HIV treatment. New Infectious Disease Push * American Medical News (04/05/93) Vol. 36, No. 13, P. 2 The Center for Disease Control will launch a worldwide network to track the spread of infectious diseases and detect drug- resistant or new strains in time to help prevent their spread. The network is expected to cost between $75 million and $125 million but is an essential part of the Clinton administration's health reform plan, according to the CDC and outside experts. The plan will require the CDC to enhance surveillance of disease in the United States and establish about 15 facilities across the world to track disease. Contraceptive Labels to Reflect Protection * Washington Post (Health) (04/13/93), P. 5 Rovner, Sandy The Food and Drug Administration recently announced that it will soon label contraceptives to reflect how well the product protects against sexually transmitted diseases (STDs) and unwanted pregnancy. FDA Commissioner David A. Kessler said the intent is to clearly tell teenagers that contraceptives such as the pill, IUDs, or Norplant may prevent pregnancy but provide no protection against HIV or any other STD. Kessler said, "Safe sex isn't just about preventing pregnancies. You don't hear people saying use Norplant plus a condom, or Depo Provera plus a condom, or oral contraceptives plus a condom. That's not being said, and it needs to be said." According to the FDA, letters were sent to manufacturers of oral, injectable, and implanted contraceptives as well as natural skin condoms (usually made of lambskin membrane, which is more permeable than latex), calling for packages to state that "the products are intended to prevent pregnancy and do not protect against HIV infection and other sexually transmitted diseases." The only contraceptive products allowed to claim efficacy against STDs like HIV, gonorrhea, chlamydia, syphilis, herpes, Hepatitis B, and others are latex condoms. Natural skin condoms will refer consumers to latex condoms for STD protection under the new FDA policy. Kessler said that the new labeling should be present on products in about six months. "This is in everyone's interest. It's a public health initiative. This is not a theoretical risk. The epidemic that kills is HIV," he said. Immune Response Stock Jumps as Study of Vaccine Evaluated * Wall Street Journal (04/13/93), P. C13 Immune Response Corp. said the results of its HIV vaccine's clinical trials are being reviewed by the company and its partner, but wouldn't elaborate on the findings. The clinical trials were completed in September. The company and its partner, Rhone-Poulenc Rorer Inc., recently permitted researchers to compare treated control groups, which "unblinded" the study. However, Immune Response said it wouldn't publicly disclose the findings of its HIV vaccine until analysis is complete. The company will present data at the international AIDS conference in Berlin in June. In addition, Immune Response and Rhone-Poulenc Rorer, a unit of the French pharmaceutical company Rhone-Poulenc SA, said their joint venture acquired additional rights to the vaccine in Europe, Africa, Central and South America. The venture already has U.S. rights to the vaccine. 'Healers' Adjust to AIDS Era * Los Angeles Times--Washington Edition (04/13/93), P. A1 Kraft, Scott Because millions of black South Africans go to traditional healers for their health problems, which often involve AIDS, a U.S.-sponsored program is educating the healers about the disease. Throughout South Africa, traditional healers--known in Alexandria as sangomas or inyangas--are changing their time- honored practices after taking AIDS education courses. The new practices of these healers, to whom 24 million of South Africa's 30 million blacks turn for treatment, are the newest front in the fight against AIDS on the southern tip of Africa. More than 200 traditional healers have learned valuable lessons from weeklong AIDS workshops across the country. The seminars are part of a $500,000 project sponsored by the U.S. Agency for International Development, and are designed to target an important, but often ignored, segment of the health care field in South Africa. Group leaders begin the seminars by refuting some of the myths about AIDS. In the classroom, the healers learn about HIV through various presentations, and in the evening the group breaks up into small focus groups to discuss AIDS. Approximately 300,000 South Africans, most of them black heterosexuals, are HIV-positive, and that figure is increasing by 300 a day. There have been about 5,000 cases of full-blown AIDS so far in the country. Traditional healers quickly discover that some of their practices, such as reusing razor blades, have the potential to transmit HIV from patient to patient. As a result of this risk, the healers will have to alter their practices. Not Me... * Washington Post (04/13/93), P. A17 Kamen, Al President Clinton's top choice for the AIDS czar position on Friday told administration officials she did not want the job. New York City Health Commissioner Margaret Hamburg, who is several months pregnant, said that because of uncertainties about the scope of the job and the timing of the opportunity, she had to decline. About Town: Hard Rocking for AIDS * Washington Times (04/13/93), P. E2 Baldrige, Letitia) Nearly 200 people went to the Hard Rock Cafe in Washington, D.C., Friday night after Elton John's concert at the Capital Center. The event at the Hard Rock was a post-concert charity party to benefit John's AIDS Foundation. Top Recording Industry of America executive and Washington insider Hilary Rosen commended John's AIDS efforts. "I think he's really helping to mainstream AIDS in the music industry. I think it's nice that even though he's British, the money [raised by the foundation] is staying in the U.S. for the most part," said Rosen. Hard Rock company President Art Levitt said the restaurant was sponsoring Elton John's current tour and would be hosting similar parties in every city on the tour that has a Hard Rock Cafe. The restaurant is selling limited-edition Elton John T-shirts, proceeds from which will be given to the musician's AIDS charity. Condoms in the Schools * Business Wire (04/12/93) (Menlo Park, CA) The controversial issue of condoms in the schools is reviewed in a new book published by the Henry J. Kaiser Family Foundation, an independent health care philanthropy that focuses on improved health care for the poor. The book, "Condoms in Schools," describes the health issues at risk, as well as the questions about morality that cannot be avoided in public education. The book includes five papers from researchers, educators, lawyers, and public opinion experts who reviewed the difficult questions involved at a two- day Kaiser Forum in Menlo Park. The chapters examine the state of condom programs in the nation's high schools, in addition to the attitudes of school and community leaders. Moreover, the book addressed legal matters and evaluates the criteria all condom distribution programs must meet. The authors hope the book will foster a more open, informed debate about the issue. Single copies of the book are available free of charge from the foundation. Garamendi Issues First Living Benefits Licenses in Nation * United Press International (04/12/93) (San Francisco) Supported by AIDS advocacy leaders, California Insurance Commissioner John Garamendi announced Monday the licensing of three companies specializing in "living benefits" contracts. The companies' contracts enable terminally ill policyholders to cash in their life insurance policies so that they may take the money and use it toward drugs and other services. Between 55 to 90 percent of the policy value is usually paid to the individuals under these plans. "We know this is a rapidly growing area. We also know that these people [the policyholders] are ripe to become victims because of their circumstances," said Garamendi. He added that he thought it was important to require the companies to be licensed to ensure that the terminally ill get "good value for their policies." The three companies that were licensed to provide such contracts in California are American Life Resources Corp. of Florida, Neuma Inc. of Illinois, and Living Benefits Inc. of New Mexico. Deaths: Richard C. Failla--Judge and AIDS Activist * Washington Post (04/13/93), P. C7 Richard C. Failla, vice president of the Gay Men's Health Crisis and the first openly homosexual man to be elected to the New York State Supreme Court, died of AIDS on April 11 at a hospital in New York. Judge Failla, a native of New York, was appointed to a Criminal Court judgeship by former New York Mayor Edward Koch. He subsequently won an uncontested election to the state Supreme Court, a trial court in New York state, in 1988. As the AIDS epidemic emerged, Judge Failla served on the board of directors of the Gay Men's Health Crisis, the world's first private AIDS agency. He later became its vice president. Surgeon Can't Collect for AIDS Phobia * American Medical News (04/05/93) Vol. 36, No. 13, P. 15 Even though a surgeon operated on a patient without knowing of the patient's HIV-positive status, he was found by a New York Appellate court to have no claim for emotional distress. The patient was brought to the emergency department by police, who arrested him for burglary. The surgeon conducted two operations without taking precautions such as using a face shield, special gown, and double gloves. After the operations, it was disclosed that the patient had previously tested HIV- positive. The physician claimed in the lawsuit that he and his family developed a serious emotional problem as a result of the potential of HIV infection. The physician sued the county, which employed the police officers, and the hospital. The court stated that there were no undisputed facts. Therefore, the only issue was the interpretation of law to determine whether the surgeon was entitled to a judgment based on the negligent infliction of emotional distress. In addition, the court discovered there was no specific incident in the two operations in which transmission of HIV might have occurred: no torn gloves, pierced skin, or body fluids splashed against a mucous membrane. The physician tested negative for HIV, and his claim was based on the potential of subsequent seroconversion. The court ruled that even if the surgeon did contract HIV from the patient, the police had no duty to tell the surgeon about the patient's HIV status. Since the patient did nothing threatening, he was entitled to the protection of the nondiscriminatory language of the statute that prohibits disclosure of HIV-related information solely to execute "infection-control precautions." NIH Plans to Begin AIDS Drug Trials at Earlier Stage * Nature (04/01/93) Vol. 362, No. 6419, P. 382 Macilwain, Colin The National Institutes of Health has announced it will start treating HIV-positive patients as soon as possible after seroconversion, resulting from recent findings that show HIV is active in the body in large numbers much earlier than was previously believed. Anthony Fauci, director of the U.S. National Institute of Allergy and Infectious Diseases (NIAID), said, "We must address the question of how to treat people as early as we possibly can with drugs that are safe enough to give people for years and that will get around microbial resistance." He said any delay would signify questions over safety and resistance rather than a lack of funds. Fauci, who co-authored one of the two papers published last week in Nature, rejects the argument by one of his co-authors, Cecil Fox, that the new discovery indicates that "$1 billion spent on vaccine trials" has been "a waste of time and money" because the trials were started too long after the patients were infected and were ended too quickly. John Tew of the Medical College of Virginia in Richmond claims that the new evidence strongly backs the argument for early treatment of HIV-infected patients. AIDS activists welcomed the new information but said the scientific community has been slow to understand the significance of infection of the lymph tissue. "We've known about this for five years, but we're glad it is now in the public domain," said Jesse Dobson of the California-based Project Inform. But Peter Duesberg, who believes that AIDS is independent of HIV and is a result of drug abuse in the West, said, "We are several paradoxes away from an explanation of AIDS--even if these papers are right." Arab Nations: Attitudes to AIDS * Lancet (04/03/93) Vol. 341, No. 8849, P. 884 Kandela, Peter After news broke that a Middle Eastern doctor had died of AIDS, the Arab world used the story as ammunition to settle old political scores. A Saudi-owned newspaper referred to the doctor as an Iraqi because he was born in Iraq, even though he grew up in Saudi Arabia. But other Arab newspapers considered him a Saudi. The death of the young doctor has prompted controversy in Arab medical communities despite the typically silent response to AIDS-related issues throughout the region. Dr. Jacques Mokhbaat, an AIDS expert in Beirut, said Lebanese society is characterized by "ignorant" hostility towards AIDS patients regardless of how they contracted the virus. Although some of the HIV-positive Arabs contracted the disease through tainted blood imported by their government, they are still considered to be "deviants" and are thus discouraged from seeking medical care. Some attitudes toward AIDS are so drastic that they threaten AIDS patients' livelihoods. Dr. Nabil Altia, a specialist at Abasa Fever Hospital in Egypt, has proposed the establishment of an AIDS colony for all HIV- positive individuals. There are no predictions of how many Arabs are HIV-positive, but official figures are believed by many doctors to be far from accurate. In addition, several doctors in the Arab world are becoming concerned about the secrecy in government circles about the importation of infected blood. According to rumors, countries such as Iraq and Lebanon have been victims of the French blood scandal, but it is acknowledged that it would not be in the best interests of these governments to publicly disclose such information. Dr. Roper Leaves CDC, But Focus on Prevention Remains * American Medical News (04/05/93) Vol. 36, No. 13, P. 9 Voelker, Rebecca The June 30 departure of Dr. William Roper as head of the Centers for Disease Control will lead to even greater emphasis on health promotion and disease prevention at the agency, public health experts have predicted. Industry leaders claim Roper leaves the CDC strategically positioned to campaign for disease prevention as healthcare reforms come into existence. However, they also criticized him for underemphasizing and watering down the CDC's AIDS prevention and education materials. Although the CDC has touted its "America Responds to AIDS" campaign, "a lot of people have no idea it exists. And those who do are underwhelmed," said Mervyn Silverman of the American Foundation for AIDS Research. Roper, who began as director of the CDC in 1990, wants to find a health administration position in the private sector. At the beginning of his tenure, Roper set three goals. He wanted to strengthen the public health infrastructure, make prevention a reality, and improve children's health. "I feel very satisfied with the major things I wanted to do," Roper said. The agency's budget increased to $2 billion from $1.1 billion during his reign. Health officials said Roper concentrated on sound public health practices. Katherine McCarter, associate executive director of the American Public Health Association, hopes the new CDC director will publish clear, frank AIDS information that targets specific groups. Latest Skirmish Over Military AIDS Vaccine Test Leaves Key Issues Unresolved * Washington Post (04/14/93), P. A19 Squires, Sally The president and CEO of MicroGeneSys, along with the company's lobbyist, met with officials from the Defense Department and the National Institutes of Health to discuss the future of the controversial $20- million study of an experimental AIDS vaccine. Franklin Volvovitz, head of MicroGeneSys of Meriden, Conn., met yesterday afternoon with Edward P. Martin, acting assistant secretary of health affairs at the Defense Department, and Anthony Fauci, head of the NIH Office of AIDS Research. The two hour meeting, held at the Pentagon, reached "no conclusions," said Fauci, referring to the future of an unusual congressionally approved scientific study of VaxSyn, MicroGeneSys' AIDS vaccine. "We are trying to work out a situation that complies with the language of the law, but still meets scientific standards," said Fauci. Last fall, Congress bypassed the NIH in mandating a $20-million amendment to the Defense appropriations bill. It stated that only VaxSyn, which contains gp160, would be used in the trial. But scientific critics were outraged that congressional action mandating the study came after extensive lobbying by former Senator Russell Long (D-La.). In addition, the amendment stated that the trial must proceed unless the NIH director, the Food and Drug Administration commissioner, and the secretary of defense unanimously agreed within six months of the bill's passage not to go forward. The NIH established an expert panel to examine the data. Based on the panel's recommendations, NIH Director Bernadine P. Healy and FDA Commissioner David Kessler wrote to Defense Secretary Les Aspin, urging him to expand the trial to include other vaccines. Some critics, however, claim expanding the study will waste time. Risk of AIDS Virus From Doctors Found to Be Minimal * Washington Post (04/14/93), P. A9 The risk of HIV being transmitted from infected health-care professionals to patients is minimal, according to new research published in today's Journal of the American Medical Association (JAMA). This finding supports previous conclusions by health experts that the chance of contracting HIV from a health care worker is remote. Three studies in the JAMA demonstrate that thousands of patients were treated by two HIV- positive surgeons and dentists without becoming infected with the virus. The studies were conducted by separate research teams in New Hampshire, Maryland, and Florida. Each study started with an HIV-positive doctor or dentist and tested all patients willing to participate. The New Hampshire study found that none of the 1,174 patients who had undergone invasive procedures by an HIV-positive orthopedic surgeon contracted HIV. In Maryland, 413 of 1,131 patients operated on by a breast surgery specialist at Johns Hopkins Hospital were found to be HIV-negative. Similarly in Florida, 900 of 1,192 dental patients, who all had been treated by an HIV-positive general dentist, were tested and found to be negative for HIV. The Florida researchers, led by Gordon M. Dickinson of the University of Miami School of Medicine, said, "This study indicates that the risk for transmission of HIV from a general dentist to his patients is minimal in a setting in which universal precautions are strictly observed." Related Story: Philadelphia Inquirer (04/14) P. A6 Traversing the AIDS Highway * Toronto Globe and Mail (04/13/93), P. A10 Stackhouse, John Due to the scourge of AIDS in African countries like Uganda and Tanzania, many children become orphaned in areas where resources are scarce. At the beginning of Uganda's AIDS epidemic the extended family took care of the surviving children of parents who died of the disease. But a decade later, "the extended family is exhausted," said Fred Kalibwani, a field worker with the aid agency World Vision. By the year 2000, the AIDS orphan population may exceed five million in East and Central Africa. Near Kakuuto in Uganda's Rakai county, about 40,000 children--one in four--have already lost at least one parent to AIDS, according to a study by the Save the Children Fund. A recent study by Unicef found that about 60 percent of the orphaned children in Uganda had been sick in the previous two weeks. Also, approximately 15 percent had never attended school, which with fees, books, and mandatory uniforms can cost between $20 and $30 a year. Many extended family members become overwhelmed with the care these orphans need, and cannot adequately care for them. Some relatives now have become predators, selling the homes and farms of the deceased to pay medical and funeral bills or simply for profit. Some non-governmental groups help families cope by providing farming tools, seeds, and skills training for at least one orphan, and the Kamapala-based Association of Women Lawyers is attempting to educate widows about property rights and child rights. Other groups are teaching men how to write wills. However, few communities have the resources for more legal, social, and medical assistance. The typical 20-year-old man in a country like Uganda now only has a 50-50 chance of reaching age 40, according to the World Bank. Patent for HIV Contraceptive Agent Granted to Future Medical Products Inc. * Business Wire (04/13/93) (Hauppauge, NY) The U.S. Department of Commerce's Patent and Trademark office issued patent protection for an HIV inhibitor as a contraceptive agent, according to Future Medical Products Inc., a medical products company which manufactures the inhibitor. Butylurea (BU), the HIV inhibitor, is a member of the alkylurea group of chemicals. A Food and Drug Administration-approved laboratory conducted independent studies on BU as a spermicide and found it to be effective either alone or in combination with much lower concentrations of the current commercially used spermicide Nonoxinol 9. BU, which showed antiviral potency against HIV, inactivated free viral particles, in addition to HIV particles associated with the white blood cells, when used in HIV-infected blood. Also, toxicology studies of HIV inhibitor BU were successfully finished, including both acute and sub-acute topical sensitization and irritation studies. No side effects were found at an efficacious HIV killing dosage with intravaginal BU foam with or without Nonoxinol 9. Moreover, histologic tissue evaluation showed no apparent damage after exposure to BU with or without low dosages of Nonoxinol 9. Dr. Yair Devash, chairman of the board of Future Medical Products Inc., said that "the dual activity of BU as an HIV killer and sperm killer results in an attractive contraceptive reagent." Specialty Pharmacy in San Francisco Caters to AIDS Patients * Reuters (04/13/93) Davidson, Ros (San Francisco) An AIDS pharmacy that offers state-of-the-art service for HIV-positive or AIDS patients has been quite successful in the four months since it first opened its doors in the heart of San Francisco's gay district. The Castro Village Pharmacy allows prescriptions to be faxed in by physicians, and pills are dispensed by a computer. Also, doctors can log on to the pharmacy system, in which there are automatic print-outs of information about each treatment for AIDS patients. The pharmacy will deliver drugs to those too ill to leave home, and does not require up-front payment on expensive medications. In addition, the store has a full-time counselor who refers people to medical or financial services, and an AIDS specialist who is at the store two days a week for free consultations. Paul Morabito, owner of the pharmacy and a former investment banker who specialized in health care, said, "This is much more than a normal pharmacy because AIDS is much more than a normal disease." Morabito said half of the profits from the store are given to a non-profit AIDS foundation and for research into the disease. Another store is expected to be opened in San Francisco, as well as two stores in outside cities. The cities being considered include New York, Los Angeles, and Chicago. The financial backing for the chain comes from McKesson Corp., the world's largest pharmaceuticals distributor. The company gives the pharmacy significantly longer than the usual 15 days to pay for the drugs, which allows the store and its patients time to negotiate with insurance companies about payment for expensive drugs. Alternative Medicine Advocates Divided Over New NIH Research Program * AIDS Treatment News (04/02/93) No. 172, P. 6 Gilden, Dave The new Office of Alternative Medicine at the National Institutes of Health has raised questions about the NIH's commitment to an effort that uses unorthodox or holistic therapeutic methods. The OAM is a small division of the NIH, with its budget only at $2 million dollars compared to more than $10 billion for the NIH as a whole. In addition, the money for available research grants is even smaller. About $500,000 to $600,000 total will be available this year for 10 or 20 grants. Kaiya Montaocean, of the Center for Natural and Traditional Medicine in Washington, D.C., says the OAM is afraid to become involved in AIDS. "They have to look successful and there is no easy answer in AIDS," she said. There is also a common perception that the OAM will focus on fields the NIH establishment will find non-threatening, such as relaxation techniques and acupuncture. When the OAM called for an advisory committee conference of about 120 people last year, the AIDS community was largely missing from the meeting. In addition, activists' general lack of contact with the Office has added suspicion that the epidemic will be ignored. Jon Greenberg, of ACT-UP/New York, said, "The OAM advisory panel is composed of practitioners without real research experience. It will take them several years to accept the nature of research." Nevertheless, Dr. Leanna Standish, research director and AIDS investigator at the Bastyr College of Naturopathic Medicine in Seattle, said, "Here is a wonderful opportunity to fund AIDS research. It's only fair to give the Office time to gel, but it's up to the public to insist that it's much, much more [than public relations]." Herpesvirus Decimates Immune-cell Soldiers * Science News (04/03/93) Vol. 143, No. 14, P. 215 Fackelmann, Kathy A. Scientists conducting test tube experiments have found that herpesvirus-6 can attack the human immune system's natural killer cells. This attack causes the killer cells to malfunction, diminishing an important component in the immune system's fight against diseases. Also, the herpesvirus-6 may be a factor in immune diseases, such as AIDS. In 1989, Paolo Lusso's research found that herpesvirus-6 attacks another white cell, the CD4 T-lymphocyte, which is the primary target of HIV. Lusso also found that herpesvirus-6 can kill natural killer cells. Scientists previously knew that the natural killer cells of patients infected with HIV do not work correctly. Lusso's research represents the first time scientists have indicated that natural killer cells are vulnerable to any kind of viral attack, according to Anthony L. Komaroff, a researcher with Harvard Medical School. Despite the test-tube findings, scientists are uncertain whether the same result occurs in the body. Lusso's team also found that herpesvirus-6 produces the CD4 receptor molecule that provides access for HIV. CD4 T- lymphocytes express this surface receptor, making them vulnerable to HIV's attack. Researchers concluded that herpesvirus-6 cells can exacerbate the affects of HIV. I Want A New Drug * Nature (04/01/93) Vol. 362, No. 6419, P. 396 The best and most informed care for AIDS patients comes from research at the San Francisco General Hospital. During the past decade, the distinctions between researchers, physicians, patients, and activists have lessened, leaving a network of people performing myriad tasks in the effort to fight AIDS. Brook Byers, a venture capitalist, encourages the efforts of companies like Genentech, which has had a long involvement in AIDS research. SyStemix researcher Mike McCune is making a strain of SCID mouse with a transplanted human immune system and hopes to provide researchers with another tool to bring to bear against HIV. McCune has joined Immune Restoration Think- Tank, an independent study group organized by Martin Delaney's pressure group Project Inform. PI is one of the oldest AIDS awareness groups. Delaney began alternative trials of an experimental drug GLQ223, a chemical taken from Chinese herbal remedies and popularly called Compound Q. He wanted to subvert the usual testing and approval process, which takes so long it is often to do current patients no good. The drug is currently in Phase II trials. Larry Waites, a doctor who participated in the trials and a member of the think-tank, has worked with the FDA, pharmaceutical companies, and hospitals in community-based clinical trials. News in Brief: CDC Backs Hospital Tests * Advocate (04/06/93) No. 626, P. 28 The Centers for Disease Control said on Feb. 23 that confidential HIV testing and counseling should be conducted regularly for patients at nearly 600 hospitals nationwide, where 1 percent or more of the patients are infected with HIV. CDC officials predicted that the implementation of the routine- testing procedure could detect 80,000 HIV-positive people who would not otherwise know their infected status. Clinton Retains Bush FDA Head * Advocate (04/06/93) No. 626, P. 23 Bull, Chris The Clinton administration has decided to keep David Kessler as the director of the Food and Drug Administration and dismiss Bernadine Healy as director of the National Institutes of Health, a move which was commended by AIDS activists. Peter Staley, a member of the Treatment Action Group, a direct-action AIDS organization based in New York City, said, "Kessler has been very responsive to our concerns for a long time but Healy only began to show an interest when it became apparent that the political climate was about to change." In announcing the final decisions, Health and Human Services Secretary Donna Shalala mentioned Kessler's attempts to hasten the FDA's drug- approval process as one of the reasons she decided to retain him. Even though Healy was known for her efforts in increasing public awareness of women's health issues and establishing an NIH research office on women's health, she denounced women's rights groups last May by rejecting legislation that would have required all federally funded research projects to include women and racial minorities in their clinical trials. Kessler has been supported by AIDS activists for launching a program that makes experimental drugs for AIDS treatment and other life-threatening illnesses available before they have obtained full governmental approval. During his tenure, two AIDS drugs- -ddI and ddC--have been made available under the program. Activists are also hopeful the Clinton administration will follow through in improving the federal government's AIDS efforts by increasing research funding, appointing a federal official to coordinate AIDS programs, and forming an NIH office of AIDS Research. AIDS Daily Summary April 15, 1993 Sex Survey: What Men Want and Think They Might Get * Washington Post (04/15/93), P. A1 Rensberger, Boyce Nearly three quarters of men agreed with the statement that using a condom "shows you are a caring person," while 15 percent said it "makes your partner think you have AIDS," according to a study published today in the journal Family Planning Perspectives. The study was conducted by researchers and demographers from the Battelle Human Affairs Research Centers in Seattle, and involved face-to-face interviews of 3,321 American men aged 20-39 during 1991. The study found that only 2.3 percent of the men--far less than the 10 percent figure usually cited--said they had ever had sex with another man, and less than half of these (1.1 percent) reported being exclusively homosexual. Approximately 71 percent of the respondents believed the risk of contracting HIV from a single act of intercourse with an HIV-positive woman was about 500 times higher than medical research suggests. The median number of female sex partners was 7.3. Slightly more than 23 percent of the men said they had 20 or more partners during their lifetimes, and 28 percent said they had one, two, or three partners. The report also revealed that almost all (96 percent) were aware that AIDS destroys the immune system and has no cure, but only 58 percent believed AIDS was painful. In addition, 41 percent of the men said they had been tested for HIV--half of them voluntarily tested and the rest tested for other reasons. Men who said they used a condom in the four weeks before the interview accounted for 27 percent. The study also discovered that about half of the men preferred condoms that are "easy to put on," "stay on," and have "the right amount of lubrication." Related Story: New York Times (04/15) P. A1 Bowing to Pressure, Defense Dept. Agrees to Drop AIDS Vaccine Test * Washington Post (04/15/93), P. A4 Squires, Sally The U.S. Defense Department revealed Wednesday night that it will abandon a controversial $20-million clinical trail of an experimental AIDS vaccine made by MicroGeneSys. The move comes after federal health officials, top AIDS researchers, and AIDS activists pressured the Defense Department to end the trial, because it was approved by Congress last fall but not by the National Institutes of Health, which typically approves trials. Defense Department spokeswoman Susan Hansen said the money will be diverted to the Department of Health and Human Services, where it will be used for a clinical trial involving 6,000 to 12,000 HIV-positive people at the NIH. The trial will test several types of therapeutic vaccines and will be led by Dr. Anthony Fauci, director of the NIH Office of AIDS Research, said an HHS spokeswoman. Fauci said Wednesday night, "It's too early to say which vaccines will be tested." He added that in order for the study to be scientifically complete and stay within the $20-million budget, it will need to follow guidelines developed last year by an NIH committee. The study would be restricted to HIV-positive people with white blood cell counts between 200 and 500, and require pharmaceutical companies to provide vaccine free. All vaccines involved will be provided free except VaxSyn, made by MicroGeneSys. "If we have to buy the vaccine, that would chew up most of if not all of the $20 million," said Fauci. MicroGeneSys Spokesman Jody Powell said the company is concerned that the responsibility was diverted from the Army, believed to be the leader in therapeutic vaccine research, to the NIH, which has made it clear that AIDS vaccine research is a low priority. Midwest Report: Schools' AIDS Programs Canceled Over Gay Speaker" Chicago Tribune (04/14/93), P. 1-3 AIDS education programs were canceled by officials from two high schools in the Upper Peninsula of Michigan after parents strongly objected to the appearance of a homosexual speaker, according to a lecture organizer. The lectures by educators from the Midwest AIDS Prevention Project (MAPP) were canceled last week as a result of program coordinator Steven Wood's sexual orientation, said Nancy Byers Sprague, who organized Wood's schedule. "I was very taken aback. I'm not used to that much anger. It made me realize just how strong the feelings and the fears about homosexuality are here," said Sprague, the director of affirmative action programs at Michigan Technological University in Houghton. Sprague and officials of the Ferndale-based MAPP said they received calls from angry parents claiming they did not want "queers" or "deviants" in schools. Vertex and Kissei Pharmaceutical Sign $20 Million Agreement to Develop Novel Drugs to Treat HIV Infection and AIDS * PR Newswire (04/13/93) (Cambridge, MA) Vertex Pharmaceuticals Inc. and Kissei Pharmaceutical Co. of Japan, have announced that they have signed a contract to collaborate on the development of orally active drugs to treat HIV infection and AIDS. The agreement calls for Kissei to contribute technical assistance and provide funding over three years to support Vertex's program to design and develop compounds that target an enzyme called HIV protease, which is essential in viral replication. Vertex is developing orally active compounds to inhibit the enzyme based on its three-dimensional atomic structure. Vertex believes that oral delivery represents the most practical method of treating HIV infection. Kissei will develop and commercialize these compounds in Japan and China and will pay Vertex a royalty on product sales in the two countries. Dr. Joshua Boger, president and CEO of Vertex, said, "Our agreement with Kissei, one of Japan's most progressive pharmaceutical companies, is an endorsement of our structure-based design efforts and, in particular, our progress in the HIV field. They recognize the potential of our program to design and develop drugs to treat HIV infection and AIDS." He added, "Kissei brings this collaboration an excellent R&D organization and a strong marketing presence in the Far East." Galaxy of Stars for Mercury * Washington Post (04/15/93), P. C7 Spain, Tom The most widely seen AIDS-related fundraiser, an all-star tribute to the late Freddie Mercury of the rock group Queen, took place one year ago next week. The event was held at London's 72,000-capacity Wembly Stadium and featured music superstars who joined the surviving Queen members to perform 20 of the songs popularized by the band. The tribute raised money for global AIDS charities and, at the same time, promoted AIDS awareness and education. "The Freddie Mercury Tribute Concert" produced by Hollywood Records, the Disney owned record label, will reach video stores next week. All proceeds from the sales of the video will be donated to the Mercury Phoenix Trust, a nonprofit foundation established by Queen to provide funds to AIDS charities around the world. Because this is Disney's second AIDS-related music video--the first being the children's music concert "For Our Children"--it is a definite indicator that Disney is not afraid of putting its power to work for a good cause. Needles and AIDS * Washington Post (04/15/93), P. A28 A Baltimore-based needle exchange program designed to thwart the spread of HIV among IV-drug users should be implemented, write the editors of the Washington Post. Baltimore Mayor Kurt Schmoke wants to begin a 30-month needle exchange program to control the spread of HIV. But Schmoke needs state approval to do so, if participants are to be protected from prosecution under Maryland's drug paraphernalia law. However, the legislature adjourned this week without approving the program. Since Schmoke believes this measure is critical to curbing the epidemic in the city, he is consulting legal experts about other options. About one-third of all AIDS cases now stem from drugs used by injection. In Baltimore, that statistic is 42 percent. But some legislators expressed opposition to the program, claiming the act of giving needles to drug addicts is immoral, impractical, and even "frightening." Nevertheless, the same type of program has been successfully executed in other cities and countries. In New Haven, Conn., new HIV infections among IV-drug users were reduced by a third after a needle exchange program was implemented. Also, there was no evidence of increased drug use after the program was initiated, and drug treatment enrollments increased. Although this approach to AIDS fosters an impression that government is condoning illegal behavior, the end result could be a reduction in HIV infection and drug use if initiated under controlled conditions, the editors conclude. How to Cope With the Burden * Economist (04/03/93-04/09/93) Vol. 327, No. 7805, P. 7 Trials of drugs that offer minimal benefits often provide conflicting results. The Concorde trial, which addresses AZT and its effect against the progression of AIDS, is one such trial. More people developed AIDS and died during the Concorde trial than on all the other trials of the early use of AZT combined. This factor gives the trial some credibility. Although a number of trials have indicated benefits of taking AZT early in terms of the rate of progression of AIDS, few trials have found information about survival rates. A trial conducted in American veterans' hospitals studied survival rates and discovered similar results as the Concorde study. However, the American trial found that AZT did delay the onset of AIDS while the Concorde study did not reveal any correlation. Understanding the disease can provide clues to the discrepancies of the trials. The virus will produce a resistance to AZT in test tubes. People who receive treatment will also develop resistance. However, AZT may not lose its effectiveness although this has not been conclusively proven. AZT may only provide a limited relief in the progression of AIDS whenever taken. Although AZT does not provide an overall survival benefit, it may still be worth taking. AIDS and Priorities in the Global Village: To the Editor * Journal of the American Medical Association (04/07/93) Vol. 269, No. 13, P. 1636 Gellert, George and Nordenberg, Dale F. All health-care workers are obligated and responsible for not only ensuring that politicians understand the dimensions of certain health problems, but also to be committed to related policies, write George Gellert and Dale F. Nordenberg of the Orange County Health Care Agency, Santa Ana, Calif., and the Emory University School of Public Health in Atlanta, Ga., respectively. Dr. Berkley's editorial on why American doctors should care about the AIDS epidemic beyond the United States details several reasons for the concerted interest that all countries share in combating AIDS. It should be noted that while AIDS leads in hastening global health interdependence, it is not the only illness doing so. Diseases such as malaria and many respiratory and intestinal pathogens have similarly inhibited the economic development of most of humanity and acted to marginalize large populations. Berkley mentions the enormous social and economic impact that AIDS will have on many developing countries, and the increased need for international assistance that will result. Berkley also cites the lack of political aggressiveness toward the AIDS epidemic in its first decade. But now there is a new administration with a promise of substantial differences in approach to international health and development in general, and HIV/AIDS in particular. Vice President Al Gore proposes in his book "Earth in the Balance" a major environmental initiative that includes sustainable international development, with programs to promote literacy, improve child survival, and disseminate contraceptive technology and access throughout the developing world. If enacted, this change in policy could drastically change the future of worldwide health. AIDS and Priorities in the Global Village: In Reply * Journal of the American Medical Association (04/07/93) Vol. 269, No. 13, P. 1636 Berkley, Seth Every nation should tackle HIV as early and aggressively as possible before the disease reaches an endemic state, even at a cost of diverting less attention to some other illnesses, writes Seth Berkley of the Rockefeller Foundation in New York, N.Y., in reply to a letter by Drs. Gellert and Nordenberg. Although it is true that diseases other than AIDS, such as malaria and respiratory and intestinal illnesses, have similarly inhibited economic development in developing countries and deserve much more attention than they are getting, Berkley disagrees with the contention that AIDS is receiving too much attention. HIV differs from other diseases, in most developing countries because it is continuing to spread. For most endemic diseases, the outcome of neglecting interventions for one year is another year of about the same level of needless disease and death. But with AIDS and its increasing spread, the cost of neglect, not only in disease burden but financially, is much greater. Interventions in the early part of a rampantly spreading epidemic like HIV are highly cost-effective because each individual infection prevented significantly interrupts transmission. Berkley says he agrees with Gellert and Nordenberg about the gigantic social and economic effects of AIDS and about the need for political leadership. But he concludes that not only is assertive political leadership needed in the United States for the AIDS epidemic, but even more so in developing countries with high rates of HIV infection and where complacency about the epidemic has been the rule. Biotech Blood Money * Worth (04/93) Vol. 2, No. 3, P. 17 Henricks, Mark Several publicly traded biotech companies have ventured into the blood-substitute market. These companies have found that reproducing hemoglobin is a challenge because the protein, which carries oxygen to the body's tissues, is complex. Baxter International, the first blood-substitute developer to win FDA approval for emergency-room-hospital trials, makes its product from the molecule taken from outdated American Red Cross supplies. Alliance Pharmaceuticals develops its substitute from synthetic chemicals. The company was supposed to begin clinical trials in 1992 but complication caused a delay. Somatogen Inc. uses genetically engineered bacteria to form its version. BioTime Inc. doesn't claim to make a blood substitute but rather artificial plasma, which uses a simpler mix of common chemicals that don't use a specific oxygen-carrying agent. The company designed its substance to replace only one to three units of blood. Also, the FDA may grant approval more quickly to the plasma than the other products. Blood- substitute makers have had trouble with toxicity and instability problems. However, they continue to their research, despite costs that can reach up to $4 million per month. Japanese Firms Polled on AIDS * Wall Street Journal (04/16/93), P. A12 One third of Japanese companies believe that HIV-positive employees should be isolated from other workers, according to a new survey. The Yokohama Chamber of Commerce, which conducted the survey, said it was the first on Japanese corporate attitudes about AIDS. Among the 4,200 respondents, 10 percent would encourage HIV-infected workers to resign and 20 percent would attempt to have them confined to a hospital. Companies fear that HIV-positive employees can infect other workers and damage a company's image. The Japanese government is launching an advertising campaign to fight what it considers widespread ignorance in the country about AIDS and related issues. N.S. to Compensate Victims of AIDS-Tainted Blood * Toronto Globe and Mail (04/15/93), P. A4 Mickleburgh, Rod The Canadian province of Nova Scotia has independently decided to be the first province to compensate its residents who were infected by HIV-positive blood during the first half of the 1980s. Health Minister George Moody revealed Wednesday that he did not feel bound by an agreement the provinces reached in 1990 to not take unilateral action on the compensation issue. He said, "This isn't an issue of legal liability. It's an issue of compassion. These people should be able to live without having to beg to survive." Moody said that he has directed senior health officials to begin discussions immediately with representatives of the Nova Scotia branch of the Canadian Hemophilia Society to determine how much money should be given to the 15 people in the province believed to have contracted HIV through tainted blood or blood products. The infected hemophiliacs, who account for about 75 percent of the more than 1,000 Canadians who contracted HIV through contaminated blood, said they were ecstatic about Nova Scotia's decision. In 1989, the Canadian government agreed to provide $120,000 each in compensation to the individuals who contracted HIV and their families. Ottawa requested that the provinces contribute as well. Although there is a growing controversy over the role of provincial and Red Cross officials in neglecting to protect Canada's blood system from HIV before adequate methods were finally introduced in 1985, the provinces have been reluctant to offer any comprehensive aid package. Around the NFL: Survey Says... * Washington Post (04/16/93), P. C3 The National Football League should exclude HIV-positive players from the league, according to more than half of the top prospects for the NFL draft. Ralph Cindrich, the sports agent who commissioned the survey of 100 college players, said, "There aren't many Libertarians in that group." Campos Market Research conducted the survey in December, interviewing by telephone half of the 200 top-ranked players in the April 25 draft. The survey found that 52 percent of the players said HIV-infected players should not be allowed to play. However, 43 percent opposed such a ban and 5 percent were unsure. 102.7 KIIS-FM and Sega Present KIIS & Unite Charity Concert Revue Premiering 'KIISVISION' and Silent Auction to Benefit Pediatric AIDS * PR Newswire (04/14/93) (Los Angeles) The Los Angeles radio station 102.7 KIIS-FM and Sega of America will host an all-star event to benefit the Pediatric AIDS Foundation on Saturday, April 24, at the Irvine Meadows Amphitheater. The celebrities involved include Jon Secada, Patty Smyth, Joey Lawrence, Portrait, Neneh Cherry, Jeremy Jordan, and Toad the Wet Sprocket. In addition, there will be a silent auction of celebrity and rock 'n' roll memorabilia, including an electric guitar played and signed by members of U2, a basketball autographed by Magic Johnson, a framed and bronzed stage costume from the group Yes, and a soccer ball signed by Rod Stewart. Also, those who wish to make a credit card pledge for the Pediatric AIDS Foundation can do so until April 24 by calling 1-800-800-2900. The concert will also have rides for children and strolling performers from the Los Angeles Circus. Lecture on Clinical Depression for AIDS Education Workers to be Held Friday at Philadelphia Health Management Corporation * PR Newswire (04/14/93) (Philadelphia) Because clinical depression is often a symptom of AIDS, a lecture for AIDS education workers will be held on the topic today at the Philadelphia Health Management Corporation. A woman living with clinical depression, a psychologist, and a homeless outreach worker will discuss how to identify clinical depression and other mental illnesses in AIDS patients. HIV-positive individuals are at serious risk for mental illness, including clinical depression, which affects more than 1 million men and women in the Philadelphia area. The event is part of a public education campaign on clinical depression sponsored by the Mental Health Association of Southeastern Pennsylvania in collaboration with the National Mental Health Association through a grant from the Eli Lilly company. AIDS Activist Says Water Problem May Have Killed Three * Reuters (04/14/93) (Milwaukee) Three AIDS patients may have died as a result of the parasitic contamination of Milwaukee's drinking water supply, a health activist announced Wednesday. Doug Nelson, executive director of the Milwaukee AIDS Project, said the three died last Friday after experiencing severe dehydration, nausea, fever, and diarrhea--symptoms common to healthy residents who became ill last week. According to city health officials, there was no direct evidence that the deaths were caused by the parasite cryptosporidium, a microorganism found in cattle waste. Nelson said the illness has a more severe effect on AIDS patients because of their weakened immune systems. Nearly 800,000 people live in the area served by the municipal water system, and an unknown percentage became ill last week. AIDS Administrators Plan Crisis Meeting Over Future of AZT * Nature (04/08/93) Vol. 362, No. 6420, P. 483 Dickson, David and Macilwain, Colin Top AIDS researchers from Europe and the United States are planning to meet before the end of the month to discuss the implications of a recent Anglo-French study that raised questions about the efficacy of AZT in treating HIV infection. The three-year study, organized jointly by Britain's Medical Research Council and the French National AIDS Research Agency, has demonstrated no proof that treatment with AZT postpones the onset of AIDS in patients known to be HIV-positive. European and American researchers have said that the so-called "Concorde" trial confirms what many have believed for a long time--basically that AZT taken on its own is likely to be restricted in delaying AIDS symptoms. However, some European researchers have criticized the decision of the U.S. Food and Drug Administration, following pressure from AIDS activists, to approve the widespread use of AZT in asymptomatic HIV-positive patients. Tony Pinching, professor of immunology at St. Bartholomew's Hospital Medical College in London, concedes that U.S. studies demonstrated a "possible benefit" to those infected with HIV. But he contends that the benefits were "too small and too short-term for us to know what they meant in the long-term." Daniel Hoth, AIDS director of the National Institute of Allergy and Infectious Diseases (NIAID), said, "The results need not be consistent with other trials. In the end we all agree that AZT is an effective drug, but only for a short period." One issue to be addressed at the upcoming meeting will be the Concorde trial's demonstration that the level of CD4 cells increased significantly in patients who had taken AZT, even though there was no resulting clinical advantage. CDC Pushes Ahead With Routine AIDS Testing * Nation's Health (04/93) Vol. 23, No. 4, P. 2 Hospitals and clinics with high rates of HIV infection should establish a policy of routine testing and counseling to determine the rate of infection and to intervene as soon as possible in diagnosing those with the disease, federal health officials announced in March. The Public Health Service says the results of voluntary testing, with counseling, would help newly diagnosed patients from spreading HIV and get them early, life-prolonging treatment. The new regulation encourages hospitals and clinics to regularly ask patients in nonemergency settings about their risks for HIV infection. Those patients found to be at risk would be offered HIV testing and counseling with informed consent. The federal officials recommend that high-risk hospitals--those with a rate of HIV infection of at least 1 percent or an AIDS diagnosis rate of at least 1.0 per 1,000 discharges--would implement a routing HIV testing and counseling policy to patients aged 15-54 years. The new guidelines should be based on confidential, voluntary patient participation and provide for pre- and post-test counseling, in addition to referral for complete medical evaluation. The Centers for Disease Control's Dr. John Ward said few hospitals, if any, are testing patients routinely for HIV. He added that the new policy should not encourage hospitals to replace universal precautions with universal testing. But AIDS advocates claim the new guidelines do not make sense because public hospitals are so underfunded to begin with that counseling could end up being the lowest funding priority. Senate: Give Me Your Tired, Your Poor, But Not Your HIV-Infected * Nation's Health (04/93) Vol. 23, No. 4, P. 4 The possibility of lifting a ban on HIV-positive foreigners seems somewhat unlikely. A Senate-passed bill reauthorizing the National Institutes of Health would strengthen the existing ban, preventing HIV-positive people from moving permanently to the United States. Health leaders in the House are doubtful they can eliminate the measure. However, Rep. Henry Waxman (D- Calif.) is optimistic that the final bill, to be negotiated in conference, will allow for exemptions for temporary visitors, refugees, and HIV-positive immigrants who are already in the United States. The American Public Health Association voiced strong opposition against the ban on Feb. 11 in a letter to all U.S. Senators. "We cannot afford to send mixed messages about such a serious disease as HIV infection. The public is not at risk of HIV from casual contact with individuals with HIV infection or AIDS. As physicians and scientists concerned with the health of Americans, we must say so," said the letter. Grapevine: The Most Dangerous Game * Time (04/19/93) Vol. 141, No. 16, P. 15 Farley, Christopher John A popular Japanese video game made by an Osaka-based software company simulates the experience of AIDS from HIV infection until death. The game is entitled "Jinai Seijin," which means "Saint of Godly Love." The game depicts a 25-year-old man who has sex with a prostitute and subsequently suspects he has contracted HIV. Players then have several options, including promiscuity, suicide, or life with a girlfriend who also has AIDS. A former medical student developed the game with the intent of it being educational and entertaining. 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 04.12.93 ]]]===----- .