-----===[[[ A I D S w i r e  D I G E S T  04.19.93 ]]]===-----

A Community Reaches Out to a Teacher With AIDS *
Washington Post (04/19/93), P. B1
Buckley, Stephen

The first teacher in Montgomery County, Md., to publicly
disclose his AIDS-related condition has received widespread
support. Phil Campbell, a sociology teacher and student
government adviser at Paint Branch High School, says the
community's response has been "unbelievable." He receives cards
and letters offering prayers, encouragement, and sympathy every
week. Also, many former students, some of whom he taught 10
years ago, have returned to visit him. He said, "My greatest
fear was rejection. I thought people would say, 'Oh my God, I
don't want to have anything to do with you because you have
AIDS.' I thought I wouldn't be able to teach." Campbell, a
divorced father of two sons, learned he was infected with HIV
in June 1988. By 1990, he experienced a bout of pneumonia,
fought off a constant low-grade fever, lost his appetite and 20
pounds. Rumors began to spread. Last year at Paint Branch's
graduation, Campbell spoke indirectly about the hearsay. He
said, "Within a period of time, you all will know at least one
person who's been living with AIDS."  Campbell's doctors told
him in January that he had full-blown AIDS. At that point most
of the Paint Branch community already knew he was infected with
HIV.  Campbell answered all of the questions about his illness
directly, except for how he contracted the virus. He said,
"Through a sexual encounter," and left it at that. This year
will be Campbell's last at Paint Branch so he can take a trip
across the country.


Failure to Inform Man of HIV Shortened Life, MD Testifies *
Toronto Globe and Mail (04/16/93), P. A12
Downey, Donn

A Toronto man who died of AIDS could have lived longer had his
physician allowed him to make decisions on his own care,
according to a teacher of family medicine at the University of
Toronto. However, Dr. Stanley Bain did not tell Kenneth Pittman
that he might be infected with HIV, and Pittman was not tested
until a few days before his death at the age of 59. The test
proved to be positive for the virus. Since Pittman was not
aware of his HIV status, he could not decide to take AZT, a
treatment that may have prolonged his life by five years, said
Dr. Philip Hebert, an assistant professor of family and
community medicine at the university and a physician at
Sunnybrook Medical Center. Pittman's widow, Rochelle, and his
four children are suing Dr. Bain, the Toronto Hospital, and the
Canadian Red Cross Society for $2 million over Pittman's death,
caused by the receipt of HIV-positive blood in 1984 while he
was a hospital patient. Rochelle Pittman tested HIV-positive
five months after his death. Dr. Bain learned in 1989 that the
blood donor might have transmitted HIV to Pittman, but the
doctor decided not to inform his patient. Therefore, Pittman
continued to have unprotected sex with his wife, and Dr. Hebert
speculated that she probably contracted HIV during the last
year of her husband's life. But Dr. Bain believed that Pittman
would have been unable to deal with the news because he had a
history of anxiety and depression, said Dr. Hebert.
Nevertheless, "there is good evidence that Mr. Pittman would
have wanted to hear the bad news," Hebert said, referring to a
time when Pittman was hospitalized for a heart condition and
was concerned that information was withheld from him.


Children's Hospital to Issue HIV Alert *
Toronto Globe and Mail (04/16/93), P. A1
Hess, Henry

The Toronto-based Hospital for Sick Children expects to inform
the families of thousands of children who received blood
transfusions between 1980 and 1985 that they may have been
exposed to HIV. The hospital plans to send letters to the
family doctors of about 1,700 children who were administered
transfusions during heart surgery between January 1980 and
November 1985, according to hospital spokeswoman Dr. Susan
King. These children are among 17,000 others given transfusions
during surgery or other treatment at the hospital in the late
seventies and early eighties, before the Red Cross began
testing blood for HIV. Dr. King said the risk is "very low"--
between one in 1,400 and one in 14,000, depending on the number
of transfusions and the blood products used. Hospital officials
are aware of only 20 Sick Children's patients who contracted
HIV through tainted blood transfusions. However, Dr. King said
these children are reaching an age when they are likely to
become sexually active, and risk unknowingly transmitting the
virus to their partners. Dr. King said if this method of
contacting the 1,700 former heart patients is effective, it
will be extended to the other children. But until then, she
said, any parents who believe their children may have had blood
transfusions between 1980 and 1985 should contact their family
doctors. The effort at Sick Children's, Canada's premier
children's hospital, is the first in Canada and the first by a
pediatric hospital anywhere.


Japan Sets Gene Therapy Rules for AIDS and Cancer *
Reuters (04/16/93)

(Tokyo) Japan has established a first-time policy on clinical
research into gene therapy as a way of fighting AIDS and
cancer, a health ministry official announced on Friday. An
advisory committee to the Health and Welfare Minister said in
the guidelines, "Since 1990 when the United States first tried
gene therapy on lethal genes, there has been increasing work on
gene therapy." It added, "As gene therapy could become an
epoch-making technology in the 21st century, we have worked out
guidelines to promote appropriate research on the therapy." The
guidelines require the research to be restricted to lethal
genes and diseases for which gene therapy is more effective,
including AIDS and cancer. Gene therapy is a controlled,
experimental treatment intended to introduce new genes into the
body to correct an inherited or acquired condition. The
guidelines require a series of checks on procedures, including
informing patients of the risks involved and allowing the
treatment to cease at any time. In addition, the guidelines
indicate that an investigative council of legal and medical
experts should determine the safety of any procedures before
they are conducted. The health ministry has allotted $1.32
million in this fiscal year for basic research into gene
therapy.


AIDS Quilt: Blanket Statement *
Chicago Tribune (04/16/93), P. 1-7
Birge, Elizabeth

An 800-panel section of the AIDS Memorial quilt was displayed
last week at Loyola University in Chicago, drawing many people
who came to honor those who have died of AIDS. More than
171,000 people in the United States have died of the disease
since the Centers for Disease Control began reporting the
deaths 13 years ago. Since 1987, the AIDS Memorial quilt,
organized and sponsored by the San Francisco-based NAMES
Project, has provided friends and families with a means to cope
with their grief and preserve the memory of those who have
died. The quilt includes more than 22,000 panels that are shown
in clusters throughout the country. A few of the panels are
simple, listing only the individual's name and date of death,
while others are much more elaborate, including testaments to
the character and kindness of the individual. Sheldon Lewin, a
graduate student at Loyola, said, "The quilt is the antithesis
of the disease. It's color, it's love, it's meaning."


Commentary: the New Female Condom--
Item 1 on a Women's AIDS Prevention Agenda *
American Journal of Public Health
(04/93) Vol. 83, No. 4, P. 498
Gollub, Erica L. and Stein, Zena A.

The Food and Drug Administration should make research on
women's AIDS prevention methods high in its priorities, write
Erica L. Gollub and Zena A. Stein of Columbia University in New
York, N.Y. An advisory panel to the FDA has recommended that
the female condom Reality be approved for contraception and HIV
prevention. Final FDA approval will mark the first official
recognition of a woman-controlled method for protection against
sexually transmitted disease. The FDA's response to the female
condom used as a prophylactic against sexually transmitted
disease has been lagging compared to that of the male condom.
For example, in 1987 a new indication for the prevention of
STDs including HIV infection was added to the labeling for male
condoms. No actual data on HIV were available to support such a
claim, and the available data on other STDs did not all
consistently show protection. But the agency went ahead with
this action because of the critical need for an anti-AIDS
prophylactic. However, it is this kind of reasoning that the
FDA has found difficult to apply. The female condom can be
inserted before intercourse without interrupting the sexual
sequence, unlike the male condom. This way, it also prevents
against pre-ejaculate seminal fluid. In those instances where
the man refuses to wear a condom, the availability of a female
condom makes protection possible for the first time. While the
female condom has some advantages over the male condom, more
public exposure to the device is needed to achieve widespread
use and effectiveness at population levels, conclude Gollub and
Stein.


Absence of HIV Transmission From an Infected
Orthopedic Surgeon *
Journal of the American Medical Association
(04/14/93) Vol. 269, No. 14, P. 1807
von Reyn, C. Fordham

The risk of HIV transmission from an HIV-positive surgeon to
patient is extremely low, provided that the surgeon strictly
adheres to universal infection control procedures, write C.
Fordham von Reyn et al. of the Dartmouth-Hitchcock Medical
Center in Lebanon, N.H. The researchers contacted 2,317 former
patients on whom an HIV-positive orthopedic surgeon performed
invasive procedures between January 1, 1978 and June 30, 1992.
The orthopedic surgeon voluntarily withdrew from practice after
testing positive for HIV. A total of 1,174 former patients
underwent HIV testing, representing 50.7 ,K$\X:ients on
whom the orthopedic surgeon performed invasive procedures
during the 13.5-year period. Patients were tested from each
year and from each category of invasive procedure. All patients
were found to be negative for HIV by enzyme-linked-
immunosorbent assay. Two former patients reported known HIV
infection prior to surgery. The examination of AIDS case
registries and vital records neglected to detect cases of HIV
infection among former surgical patients. The estimated cost of
the initial patient notification and testing was $158,000, with
the single most expensive activity being counseling and
testing. This accounted for 37 percent of the total expense.
The patient notification and testing were conducted while
maintaining the confidentiality of the orthopedic surgeon who
was an active participant in the planning and execution of the
study. Notifying patients of the infected surgeon's HIV-status
is both disruptive and expensive and is not routinely
recommended, the researchers conclude.


Investigation of Potential HIV Transmission
to the Patients of an HIV-Infected Surgeon *
Journal of the American Medical Association
(04/14/93) Vol. 269, No. 14, P. 1795
Smith Rogers, Audrey et al.)

The risk of HIV transmission during surgery is so remote that
it will be quantified only by gathering data from multiple,
methodologically similar investigations, writes Audrey Smith
Rogers et al. of the Johns Hopkins University School of
Medicine in Baltimore, Md. The researchers identified a total
of 1,131 persons in hospital databases who underwent invasive
surgical procedures between 1984 and 1990 and for whom the HIV-
positive surgeon was listed as the operating surgeon. The AIDS
case registries were reviewed for all patients having undergone
invasive procedures and death certificates were obtained. Among
the 1,131 patients, 101 were dead, 119 had no address, 413 had
test results known, and 498 did not respond to the
questionnaire. No study patient name was found in reported AIDS
case registries. One newly detected, HIV-positive patient was
determined to have been most probably infected in 1985 during a
transfusion. There was no HIV transmission in 369 person-hours
of surgical exposure, suggesting that HIV transmission to
patients is unlikely to occur more frequently than once per
1000 person-hours of surgical exposure. The researchers
determined there is no evidence to suggest that the surgeon
failed to adhere to standard infection-control guidelines; over
50 percent of the patients with invasive procedures chose to be
tested, and of those whose results were revealed, only one
person was found to be infected with HIV. The study patient's
infection was probably the result of a tainted blood
transfusion received in 1985. As a result, there is no evidence
that the transmission of HIV from the HIV-positive surgeon to
any patient transpired, the researchers conclude.


Drug Concerns to Share AIDS Data *
New York Times (04/20/93), P. C10
Kolata, Gina

A total of 15 major pharmaceutical companies have decided, in a
highly unusual move, to share AIDS drugs and information while
the drugs are undergoing early clinical testing. Dr. Edward
Scolnick, president of the Merck Research Laboratory in Rahway,
N.J., arranged the collaboration. He said that cooperation
between companies seemed increasingly significant as it had
become clear that combinations of drugs were likely to be more
effective in fighting HIV than any drug used alone. The
researchers are hopeful that HIV, when faced with a combination
of several drugs requiring mutation at different sites for
resistance to develop, will be unable to evolve all the
mutations at the same time. Therefore, several drugs taken
together or one after the other could halt the spread of HIV.
Currently, the drug companies do not know what other drugs
their competitors are developing. The new agreement allows
companies to routinely exchange animal data and safety data on
new AIDS drugs. "An agreement like this will greatly facilitate
companies' ability to choose the best drug combinations much
faster and in a much more efficient way," said Scolnick. He
also said that the collaboration would not violate antitrust
laws. In creating the agreement, Merck spoke frequently to
members of AIDS advocacy groups, including ACT-UP. Dr. Daniel
Hoth, director of the division on AIDS at the National
Institute of Allergy and Infectious Disease said, "We're
delighted to see the pharmaceutical industry take this step
because we think that increasing the information flow will
likely accelerate the discovery of better compounds for AIDS."

Related Stories: Wall Street Journal (04/20) P. B1;
Philadelphia Inquirer (04/20) P. A3; USA Today (04/20) P. 1B


Schmoke to Ask U.S. for Help With Needle Plan *
Baltimore Sun (04/20/93), P. 1B
O'Donnelll, John B.

Baltimore Mayor Kurt L. Schmoke announced yesterday that the
city will ask the Clinton administration to bypass the state
law that currently forbids a clean needle exchange program. The
move comes after the Maryland General Assembly blocked the
program proposed by the mayor. Addressing a Washington
conference on urban policy, Schmoke said that the House
Judiciary Committee last month rejected the city's request for
an exemption to the state's drug paraphernalia law. This marked
the second year in a row that the General Assembly has impeded
the city's effort to launch a three-year program for up to 700
addicts at a cost of $50,000 a year. He said the city would try
other "innovative ways" to start a needle exchange program that
would curb the spread of HIV among IV-drug users. The mayor
subsequently said in an interview that Baltimore would ask Dr.
M. Jocelyn Elders, President Clinton's designee for surgeon
general, for a federal exemption that would allow the city to
establish the program. Federal law enables the surgeon general
to call for a "local health emergency" on AIDS that would
permit the city to begin the needle-exchange program despite
state law, said Schmoke. Dr. Elders, the director of the
Arkansas Health Department, whose confirmation hearings are
scheduled after June 1, supports such programs. But Dr. Peter
Bielenson, Baltimore's health commissioner, warned that
although the surgeon general could permit the use of federal
funds for a needle-exchange program, it is not clear that she
could override the Maryland drug paraphernalia law.


State of the Art AIDS Center Dedicated *
United Press International (04/19/93)
Wasowicz, Lidia

(San Francisco) The Gladstone Institute of Virology and
Immunology, the second largest research center in the United
States to be devoted exclusively to AIDS, was dedicated on
Monday. The institute--the largest concentrated American AIDS
research center outside the National Institutes of Health in
Bethesda, Md., is affiliated with the University of California-
-San Francisco, and located at the San Francisco General
Hospital. "We have an unprecedented opportunity to study HIV,
with five different research groups each complementing one
another. We are trying to understand in exquisite detail how
the AIDS virus works," said Dr. Warner Greene, director of the
institute. Dr. Anthony Fauci, a director at NIH, spoke at a
dedication luncheon and commended San Francisco for the
"humanistic, sensitive, and creative approaches to the public
health and societal challenges of the HIV epidemic." He said
that while education and behavioral modification are essential
to fight "this terrible plague," the fundamental scientific
method of understanding the virus and how it works on the
immune system "are the issues which will ultimately determine
our success or failure in the war on AIDS." The center will be
funded with $12 million from the state, $4 million from UCSF
and $28 million over a four-year period from the J. David
Gladstone Institutes, a charitable trust. The researchers will
use a multipronged approach to examine the mechanisms that
allow HIV to enter immune system cells, reproduce, and
interfere with specific proteins. They will also study how HIV
is incited in the immune system, and determine how to produce
effective vaccines.


City Advisory Group OKs $250,000 to Keep AIDS
Nursing Home Open *
PR Newswire (04/16/93)

(Philadelphia) The Philadelphia area's only nursing and
personal care facility for AIDS patients should be kept open
with $250,000 of federal AIDS housing funds, according to an
official advisory group which helps the city allot AIDS housing
funding from Washington, D.C. David Fair, the chairperson of We
the People Living with AIDS/HIV in the Delaware Valley, Inc.,
said the funding should not be given to the Betak facility by
the city's Office of Housing until Gov. Casey carries out his
commitment to provide a similar amount of new funding. The
advisory group, mandated by federal law to advise City Hall on
AIDS housing matters, told city housing officials at a meeting
Thursday that the funding should be set aside from the Housing
Opportunities for People with AIDS Program, which has awarded
close to $2 million in AIDS housing money to the city this
year. The $250,000 had initially been part of a pool of money
set aside to assist with the rehabilitation of new housing
facilities. Fair said that after giving the money to Betak, the
program would still have more than $300,000 for rehab projects.
"The urgent need to assure the continued existence of Betak and
the care it provides to over 40 desperately ill people with
AIDS clearly outweighs the need to rehab buildings," said Fair.
Betak's daily costs for nursing care for an AIDS patient are
about $250, while the state will pay only $86 daily; its costs
for personal care are about $110 a day, but it only receives
$17 per day for that level of services.


United Biomedical, Inc. Begins First Test
of Multi-Component AIDS Vaccine *
Business Wire (04/15/93)

(Hauppage, NY) United Biomedical, Inc. (UBI) of Hauppage, N.Y.
has launched the first human trials of an experimental AIDS
vaccine involving several copies of a chemically synthesized
peptide from five distinct global variants of HIV. Dr. Wayne
Koff, vice-president for Vaccine Research and Development,
said, "This Phase I trial represents the next major step in the
UBI HIV vaccine development program which is focused on
developing a multi-component vaccine capable of inducing a
broad spectrum of immunologic responses with the goal of
providing protective immunity against worldwide strains of HIV.
These responses include neutralizing antibodies to protect
against globally divergent isolates of HIV, cytotoxic T cells
to destroy HIV-infected cells, and mucosal immunity to provide
a local secretory barrier to sexually transmitted HIV." The
Phase I trial will analyze the product's safety and immune-
stimulating capacity in 36 uninfected men and women at low risk
for HIV infection. The eight-month trial, to be conducted at
Long Island Jewish Medical Center in New Hyde Park, N.Y., is
currently recruiting volunteers between the ages of 18 and 50.
Recent studies suggest that HIV now exists in at least five
genetically distinguishable groups, and researchers have
expressed concerns that protecting people from HIV in different
parts of the world where different variants of HIV are
circulating would be difficult to accomplish with a vaccine
made from a single virus strain. The prototype UBI vaccine uses
peptides from five different strains of HIV and can produce
high levels of neutralizing antibodies against multiple strains
of HIV in small animals and lower primates.


Boxer--AIDS *
Associated Press (04/16/93)

(London) Boxer Ruben Palacio took 12 years to win a world
title, but on the eve of his first fight since the title, he
became the first champion to become infected with HIV. On
Friday, Palacio flew home to Columbia, after testing positive
for HIV during a routine pre-fight medical examination. He was
subsequently stripped of his WBO featherweight title. WBO
championship committee president Ed Levine said, "It took, him
a long time to get to this stage. He reaches the pinnacle of
his sport, he's defending his championship for the first time,
and he's stricken." Levine said the only thing to do was to bar
Palacio from the ring. "We can't risk the life of another boxer
by letting him fight. It's a kind of disease that can be spread
via blood contact, and boxing is a sport where that is likely
to happen," said Levine. Palacio was expected to defend his
title against Briton John Davidson on Saturday in Washington,
England. Levine said, "Instead of going home with the biggest
payday of his career, he's going home with a test result that
indicates his life is substantially shortened."


Risks and Realism: Teen Sex *
American Enterprise (03/93-04/93) Vol. 4, No. 2, P. 52
Besharov, Douglas J.

Because of the increasing rates of teenage pregnancies,
abortion, and sexually transmitted diseases (STDs), teenage
risky sexual behaviors must be curbed. Although most sexually
active teenagers engage in careful contraceptive practices most
of the time, large subgroups do not. Lorraine Klerman, director
of the Maternal and Child Health Program at the University of
Alabama, said that one reason teens give for not using condoms
is they "believe that they can tell who has AIDS from their
sick or emaciated condition." Also, the more risky the
teenager's overall behavior, the greater the chance that he or
she engages in unprotected sex. Donald Orr and colleagues from
the University of Indiana examined condom use among inner-city
female teenagers in Indianapolis and discovered that only about
50 percent of them reported that their partners ever used
condoms. The figure fell to an alarming 29 percent among "risk-
takers," defined as drug or alcohol users, school dropouts, and
those who commit minor delinquencies. Many Americans in general
do not think it is "right" to be prepared for casual sex.
Consequently, males and females of all ages are often without
contraception at the time of intercourse and end up having
unprotected sex. Also, while most American school districts
offer some sort of sex education, for many young people it
comes too late. About 30 to 50 percent of all teenagers receive
their first real sex education course after the tenth grade,
according to the Allan Guttmacher Institute.


The Next Step in AIDS Treatment *
Nature (04/08/93) Vol. 362, No. 6420, P. 493
Maddox, John

Although AZT was found to be ineffective in prolonging the
lives of people infected with HIV, the findings do not indicate
that AZT should not be administered in people with full-blown
AIDS, writes columnist John Maddox. AZT has been used in the
United States in asymptomatic HIV-positive people on the basis
that administration of the drug appeared to abate the decline
of T-cell counts. However, a report in the Lancet demonstrated
that AZT should not be used early in the course of disease.
While the CD4 counts of the 877 people given AZT were
consistently greater than those of patients receiving only
placebo, the first three years of follow-up have shown that the
proportions of people in the two groups progressing to overt
AIDS or even to death were not significantly different at
roughly 18 percent. The conclusions are that AZT is not an
effective AIDS drug in HIV-infected individuals, and that CD4
cell count may not be a reliable proxy for the progression to
AIDS in infected people. But nothing is implied by the study of
the utility of AZT in the treatment of those in whom symptoms
have already appeared--there is no case for abandoning that
treatment, at least on the evidence now available. It is much
more alarming that the CD4 count has proven to be an unreliable
mark of the efficacy of drug treatment in HIV infection. AIDS
researchers should acknowledge HIV is alive from the beginning
of infection and turn it into a workable assay of the progress
of disease. The general application of such an assay will
probably in itself provide a better understanding of the
pathogenesis of AIDS, concludes Maddox.


Infective and Anti-Infective Properties of Breastmilk
From HIV-1-Infected Women *
Lancet (04/10/93) Vol. 341, No. 8850, P. 914
Van de Perre, Philippe et al.

A vaccine preparation inducing a persistent immune response of
the IgM type in the mother's body fluids could be valuable to
prevent transmission of HIV-1 from mother to child, write
Philippe Van de Perre et al. of the National AIDS Control
Program in Kigali, Rwanda. The researchers hypothesized that
transmission of HIV-1 through breastmilk could be favored by
the presence of infected cells, by deficiency of anti-infective
substances in breastmilk, or both factors. A total of 215 HIV-
1-infected women were enrolled at delivery in Kigali, Rwanda;
milk samples were collected 15 days, 6 months, and 18 months
post partum. HIV-1 IgG, secretory IgA, and IgM were assayed by
western blot, for the latter two after removal of IgG with
protein G. In the 15-day and 6-month samples, the researchers
sought viral genome in milk cells by double polymerase chain
reaction with three sets of primers (gag, pol, and env). At 15
days, 6 months, and 18 months post partum, HIV-1 specific IgG
was detected in 95 percent, 98 percent, and 97 percent of
breastmilk samples; IgA in 23 percent, 28 percent, and 41
percent; and IgM in 66 percent, 78 percent, and 41 percent. In
children who survived longer than 18 months the risk of
infection was associated with lack of persistence of IgM and
IgA in their mothers' milk. The presence of HIV-1-infected
cells in the milk 15 days post partum was strongly predictive
of HIV-1 infection in the child by both univariate and
multivariate analysis. The combination of HIV-1 infected cells
in breastmilk and a defective IgM response was the strongest
predictor of infection. IgM and IgA anti-HIV-1 in breastmilk
may protect against postnatal transmission of HIV, the
researchers conclude.


Firms to Share AIDS Rese!U}rch in Global Venture *
Journal of Commerce (04/21/93), P. 7A

A total of fifteen U.S. and European pharmaceutical companies
announced Tuesday they will swap drug supplies and information
on early-stage AIDS research to hasten the search for
combination therapies to fight HIV infection and AIDS. The
companies said the unusual move resulted primarily from the
increasing concentration of AIDS research on combination
therapies since realizing that HIV is likely to develop
resistance to every individual AIDS drug. Edward Scolnick,
president of Merck & Co. Research Laboratories, led the
collaborative effort that took a year of negotiations to come
together, said participants. In addition to Merck, the other
companies involved in the Inter-Company Collaboration for AIDS
Drug Development are Bristol-Myers Squibb Co., Burroughs
Wellcome, Glaxo Inc., Hoffman-La Roche, Eli Lilly & Co., Pfizer
Inc., Smithkline Beecham, AB Astra, Du Pont Merck, Syntex Inc.,
Boehringer Ingelheim, Miles Inc., and Sigma-Tau. The
participants said that all companies involved in AIDS drug
development they were aware of had joined the collaboration,
and that any company actively involved in HIV anti-viral
development may participate. Scolnick said the collaborators
would most likely meet every couple of months for a daylong
scientific meeting where they will review for one another their
preclinical and early clinical data. The American Foundation
for AIDS Research (AmFAR) was pleased with the news of the
collaboration, which it hopes will lead to the development of
drug combinations that will reduce viral resistance.

Related Story: Financial Times (04/21) P. 1


Bias Crimes Now Include the Disabled *
New York Times (04/21/93), P. B3
Hicks, Jonathan P.

New York City Mayor David N. Dinkins' administration yesterday
extended the definition of bias crimes to include attacks on
the disabled, including anyone who has or is perceived to have
AIDS. The new category of bias crimes will allow the disabled
to have their cases handled by police investigators assigned to
a bias crime unit, which gives such crimes a higher priority
but carries no higher penalty if convicted. It was pressure
from gay and lesbian organizations, rather than advocates for
the disabled, that prompted the change. Mayor Dinkins was
surrounded by representatives of several gay organizations, who
have pressed for more support for victims of violence targeted
at homosexuals, when making his announcement yesterday.
Although attacks against homosexuals are already covered by the
bias category of assaults motivated by sexual orientation,
advocates indicated that the broader definition of bias crimes
to cover AIDS patients would give more investigative weight to
even more cases. Attacks against people thought to have AIDS
have risen in the last few years, according to Matt Foreman,
executive director of the New York City Gay and Lesbian Anti-
Violence Project. The numbers of cases reported to the
organization show attacks on people with AIDS, or those
perceived to have AIDS, increased from 26 in 1990 and 86 in
1991 to 116 in 1992. "And we believe it might get worse because
even though people's understanding of AIDS is increasing, their
fear of it is not diminishing," said Foreman. With the
expansion of the definition of bias crimes, Dinkins has
provided New York City with one of the broadest definitions of
such crimes in the nation.


Court Told Women, Accused Share Rare Strain of HIV *
Toronto Globe and Mail (04/20/93), P. A5
Hess, Henry

Three HIV-positive women from London, Ontario, and the man who
allegedly infected them, all share the same strain of HIV,
which is seldom found in North America, according to a genetics
expert who testified Monday in court. Dr. Michael Montpetit,
head of the Canadian bureau of HIV/AIDS laboratories in Ottawa,
said his tests back the allegation that the women contracted
HIV from Charles Ssenyonga, who is being tried in the Ontario
Court's General Division on charges of aggravated sexual
assault and criminal negligence. Ssenyonga is accused of
infecting the women through unprotected sexual intercourse
after knowing he was infected with HIV. Montpetit testified
that the four share a single strain of virus known as subtype A
of HIV-1. "In a North American setting, that strain is
extremely rare," said Montpetit. He added that it is a strain
usually linked with Central African countries such as Uganda
and Zaire. Ssenyonga moved from Uganda to Canada in 1983, even
though the court has heard that he first tested positive for
HIV in 1989. Dr. Montpetit, who took several hours to explain
to the court the techniques used to compare the genetic makeup
of HIV strains, rejected suggestions that the test results
could be translated any other way. He acknowledged that he has
not compared the samples to any other HIV-positive person in
the London area, but said that it didn't matter. The chance of
finding such a rare type of virus in the North American
population "let alone specifically matching three viruses in
three victims with a common partner--I do not known how to
calculate them, but they would be astronomically low," he said.


Risk of HIV Infection 'Horrendous,' Court Told *
Toronto Globe and Mail (04/20/93), P. A12
Downey, Donn

The chance that Kenneth Pittman would contract HIV from blood
donated by an infected person was "horrendous," according to a
family doctor who testified in the Ontario Court's General
Division. But Dr. Stanley Bain never recommended to Pittman
that he should be tested for HIV, and Pittman subsequently died
of AIDS in March 1990. Pittman never knew he had the disease,
but a blood sample taken shortly before his death tested HIV-
positive. His widow, Rochelle, also tested positive five months
later. She and her four children are suing Dr. Bain, the
Canadian Red Cross, and the Toronto Hospital for $2 million in
damages for negligence. Dr. Bain first discovered that Pittman
might test HIV-positive when he was informed in April 1989 that
the man had received a blood product from an HIV-infected
donor. Dr. Bain saw Pittman the following month but was
reluctant to mention that the Toronto Hospital had told him the
unfortunate news. Dr. Philip Hebert, an assistant professor of
family and community medicine at the University of Toronto,
said that patients would test positive for HIV 37 percent of
the time under such circumstances. He added that Dr. Bain had
an obligation to inform his patient so he could decide if he
wanted to be tested. If Pittman had been tested early, it could
have prolonged his life by as much as five years, said Dr.
Hebert. Dr. Bain would have been allowed to withhold the bad
news from Pittman only if Pittman had specifically told him he
did not want to know if he was HIV positive, Dr. Hebert said.


People and Places: Comic Super Hero Will Have AIDS *
Baltimore Sun (04/21/93), P. 2

A new comic book superhero named Bloodfire will contract HIV,
despite his superhuman strength, speed, and endurance. Creator
Joe Zyskowski, founder of Lightning Comics, said he hopes
children will become more aware of the dangers of the deadly
disease. He said, "I was trying to come up with a character
that was going to have some impact and relevance with the real
world. Anyone can get AIDS--even a super hero." The first
edition of the series will be available in June nationwide.


Haitians Demand Closure of Guantanamo Internment Camp *
Reuters (04/19/93)

(New York, NY) More than 200 people protested in Manhattan at
the Immigration and Naturalization offices on Monday demanding
the closure of the military internment camp in Guantanamo Bay,
Cuba, which houses HIV-positive Haitian refugees. The
demonstrators chanted, "HIV is Not a Crime, Why are Haitians
doing Time," and carried placards reading, "Close Down the
Guantanamo Death Camp." AIDS activists and other protesters
called for the immediate release of 191 Haitian political
refugees at the naval base in Guantanamo Bay. "We are here to
protest the inhumane treatment that the Bush administration
started and to denounce its continued policy by President
Clinton," said Guy Victor, a well-known Haitian activist. He
added, "We are very disappointed in Clinton. Millions of
Americans voted for him because he said he was going to change
the policy of Guantanamo and be more humane. He is no better
than Bush." Among the protesters was 22-year-old Siliese
Success, who said she was recently released from the internment
camp after eight months. "We were mistreated by the American
police, the MPs. They put me in an underground prison because I
was constantly demanding to be let out of the base," she said.
Success said she "has no idea" why she was put in the HIV camp.


Appelate Court Reverses Adoption by AIDS Victims *
United Press International (04/20/93)

(Indianapolis, IN) A couple from Shelby, Ind., who have been
diagnosed with AIDS, have lost their legal battle to keep an
adopted baby girl. The Indiana Supreme Court ruled 2-1 Monday
that Shelby Superior Judge Jack A. Tandy did not make a mistake
in permitting the natural mother, Gretchen Johnson, to change
her mind about the adoption. According to the appellate court
ruling, the court empathizes with the couple, but it must
concur with the welfare caseworker who says the child's best
interests must prevail. The caseworker didn't make a
recommendation, but said that it could be psychologically
detrimental for the child to be adopted and then potentially
orphaned. Following the May 20, 1992, final adoption hearing,
the child was placed in foster care by Tandy. The court records
state that Johnson, who was pregnant in October 1991,
approached the couple about adopting her child because the
father did not wish to support the baby. The girl was born in
late December 1991, and was given to the couple. Johnson signed
an adoption consent form in January 1992 and the couple then
petitioned the court for adoption in late February 1992. Before
the final hearing, Johnson wrote to Tandy, claiming she did not
want the adoption finalized, because she feared the baby would
eventually be orphaned as a result of the couple's medical
condition. Appellate Judge John T. Sharpnack, who issued the
opposing argument, said the court's records lacked any proof
concerning the couple's future ability to care for the child.


Guidance Over HIV-Infected Health-Care Workers *
Lancet (04/10/93) Vol. 341, No. 8850, P. 952
Horton, Richard

The United Kingdom's Department of Health recently followed the
advice of AIDS experts that there is no scientific reason for
routine HIV testing among health-care workers. Following recent
highly publicized reports of health professionals who
contracted HIV, the department issued revised guidelines on the
management of such cases. Dr. Kenneth Calman, Chief Medical
Officer, said doctors, dentists, nurses, and other health-care
workers have an ethical duty to seek advice if they have been
exposed to HIV infection, including, if appropriate, diagnostic
HIV testing. He said, "Infected health care workers should not
perform invasive procedures that carry even a remote risk of
exposing patients to the virus." The guidelines call for
employers to keep information about the HIV status of health-
care workers confidential. But doctors who know of an HIV-
positive colleague who has not sought advice must inform the
employing authority and the appropriate professional regulatory
body. The guidelines also emphasize the significance of
notifying all patients on whom an invasive procedure has been
done by an infected health-care worker. A model letter to
patients who have come into contact with such an individual is
provided, along with suggestions for health officials on how to
deal with the media. In addition, a U.K. advisory panel on HIV
infection in health-care workers has been formed to provide
specific occupational recommendations to those treating such
patients.


Properties of an HIV 'Vaccine' *
Nature (04/08/93) Vol. 362, No. 6420, P. 504
Volvovitz, Franklin and Smith, Gale

The questions raised by Moore et al. about recombinant gp160
envelope glycoprotein precursor from HIV-1 produced by
MicroGeneSys are advantages rather than disadvantages, write
Franklin Volvovitz and Gale Smith of MicroGeneSys in Meriden,
Conn. Moore et al. says that gp160 in a baculovirus expression
system does not bind strongly to the CD4 receptor, and that
this recombinant gp160 does not stimulate the same antibodies
as the HIV-1 virus does in natural infection. But vaccination
with recombinant gp160 in patients infected with HIV-1 broadens
HIV-1 specific envelope-directed immune responses, including
crossreactive antibodies to gp160 epitopes and CD4 and CD8
cytotoxic T-cell responses. Volvovitz and Smith claim that they
never intended their gp160 molecule to be identical to the
native protein. Antibody responses against native HIV-1
proteins, including the types described by Moore et al., exist
in nearly all AIDS patients but do not prevent progression of
HIV disease. In addition, the binding of gp120 or gp120-
antibody complexes to CD4 has been shown to interfere with
antigen specific activation of CD4 cells and trigger programmed
cell death in vitro, which may contribute to the pathogenesis
of HIV infection. The absence of CD4 binding by the
MicroGeneSys gp160 vaccine may therefore be viewed as an added
safety feature. Phase I studies have demonstrated stable CD4
counts, stimulation of cytotoxic T cells, and the suggestion of
restoration of immune function. Based on these and other
clinical results, MicroGeneSys gp160 was chosen by researchers
at the Karolinska Institute in Sweden for the first phase III
vaccine therapy studies, conclude Volvovitz and Smith.


HIV-1 Infection: Breast Milk and HIV-1 Transmission *
Lancet (04/10/93) Vol. 341, No. 8850, P. 930
Mok, Jacqueline

There are still more questions than answers regarding HIV-1-
positive women breastfeeding their babies, writes Jacqueline
Mok of the Lancet. The anti-infective properties of milk are
well documented. While the numbers of leukocytes,
concentrations of lactoferrin and IgA, and lymphocyte mitogenic
activity decline sharply during the first two to three months
of lactation to barely detectable levels, lactoferrin and IgA
then increase from three to twelve months, with 90 percent of
total IgA in milk being secretory IgA. Breastfeeding protects
infants against gastrointestinal and respiratory illnesses, in
both normal and uninfected children born to HIV-positive
mothers. The Italian National Registry of AIDS discovered that
breastfed HIV-1 infected children had a longer median
incubation time (19 months) than bottlefed infants (9.7
months). Breastfed children also had a slower progression to
AIDS. There is no agreement on which antibodies offer
protection against HIV-1 infection. Studies of the biological
properties of milk from 15 HIV-1 infected women showed the
presence of IgG and IgA antibodies against envelope
glycoproteins, as well as IgA antibodies against core antigens.
Binding of HIV-1 to the CD4 receptor can be inhibited by a
human milk factor. In the developing world, where infectious
disease and malnutrition contribute significantly to infant
mortality, breast milk is still the best food for infants,
regardless of the mother's HIV status. Transmission might be
restricted by breastfeeding after colostrum and early milk have
been expressed and discarded. The possibility remains that
breast milk could protect the infant who is already infected
with HIV at birth and may even delay progression to AIDS,
concludes Mok.


Absence of HIV Transmission From an Infected Dentist
to His Patients *
Journal of the American Medical Association
(04/14/93) Vol. 269, No. 14, P. 1802
Dickinson, Gordon M. et al.

If universal precautions are practiced, the risk of HIV
transmission from dentist to patient appears to be
infinitesimal, write Gordon M. Dickinson et al. of the
University of Miami School of Medicine in Miami, Fla. The
researchers contacted all patients treated by a dentist with
AIDS and attempts were made to contact all patients for HIV
testing. Living patients with newly detected HIV infection were
interviewed, and DNA sequence analysis was performed to compare
genetic relatedness of their HIV to that of the dentist. Death
certificates were obtained for deceased patients, and the
medical records of those with diagnoses suggestive of HIV
disease or drug abuse and those dying under the age of 50 years
were examined in detail. There were 1,192 patients who had
undergone 9,267 procedures, of whom 124 were deceased. An
examination of the death certificates of patients identified
five who had died with HIV infection, all of whom were either
homosexuals or IV-drug users. The researchers were able to
detect 962 of the remaining 1,048 patients, and 900 agreed to
be tested. HIV infection was reported in five of the 900
patients, including four who had clear evidence of risk factors
for the disease. One patient who had only a single evaluation
by the dentist denied high-risk behavior. Comparative DNA
sequence analysis showed that the viruses from the dentists and
these five patients were not closely related. The study
suggests the potential for HIV transmission from a general
dentist to his patients is minimal in a setting in which
universal precautions are strictly observed, conclude Dickinson
et al.


AIDS Patients are Susceptible to Recurrences
of TB, Study Says *
Washington Post (04/22/93), P. A13

Tuberculosis can strike AIDS patients more than once, which
makes the resurging health hazard harqrK.       R,,,KVmng
to a study published in today's New England Journal of
Medicine. People who contract TB usually develop an immunity
that protects them if they are exposed to the bacteria again.
But a person whose immune system is depleted may not be able to
fight off a new TB infection, doctors found. Peter M. Small of
the Howard Hughes Medical Institute at Stanford University,
director of the study, said that in order to protect against
reinfection, it may be necessary for some people to use TB
medicines permanently. The study examined the genetic makeup of
TB bacteria and how the germs changed over time in 17 patients
at Kings County Hospital in New York.


AIDS Patient Resistant to AZT From Outset *
Journal of Commerce (04/22/93), P. 9A

People can become infected with strains of HIV already
resistant to AZT, according to a study conducted by
Minneapolis, Minn., researchers. Dr. Alejo Erice at the
University of Minnesota Medical School found that an HIV-
positive man in the study was infected with a strain of HIV
resistant to AZT. The case calls into question whether using
AZT treatments early in the course of HIV infection increases
the chances of developing and spreading drug-resistant strains.
Although it has been known for some time that a person with HIV
infection can become gradually resistant to AZT, the 20-year-
old homosexual man in the study was resistant to AZT from the
start.

Related Story: New York Times (04/22) P. B11.


Fanfare: AIDS Testing on Upswing *
Washington Post (04/22/93), P. B2

Due to the situation of Ruben Palacio, the World Boxing
Organization featherweight champion who tested HIV-positive
last week in England, many boxers will undergo HIV testing.
Palacio, who was subsequently stripped of his title, had to
undergo HIV testing when he was in England because of the
country's mandatory testing policy. Colin McMillan, a British
boxer who lost a bloody fight to Palacio in England last
September, tested HIV-negative this week. Boxing trainers
George Benton and Ronnie Shields will be tested for HIV in a
Houston hospital Friday. Lou Duva, their colleague and a
longtime manager, pressured them and his entire camp to get
tested for the virus. Jimmy Binns, the legal counsel of the
World Boxing Association, said Tuesday that his organization
would immediately start HIV testing for all championship
fights, beginning with a May 22 title fight between heavyweight
champion Riddick Bowe and Jesse Ferguson in Washington. Bob
Lee, president of the International Boxing Federation, said his
group could possibly institute a testing policy when it holds
its annual convention in June. The World Boxing Council has
discussed a similar measure.


Laboratory Errors Kill Thousands, U.N. Agency Says *
Reuters (04/20/93)

(Geneva) Hundreds of thousands of people worldwide are dying or
becoming seriously ill as a result of laboratory mistakes, the
World Health Organization said Tuesday. The U.N agency demanded
tighter controls, adding that it expected 90 international
experts to recommend new guidelines to clinical laboratory
workers during a three-day meeting opening in Geneva yesterday.
WHO said in a statement, "Hundreds of thousands of people die
or become seriously ill every year because of errors and
inaccuracies in clinical and public health service laboratories
in many countries." WHO called for developing countries, in
particular, to establish external monitoring to improve
standards at their blood transfusion services and other public
health laboratories. WHO said inaccurate or wrong
interpretations have been made in tests for HIV, malaria,
cervical cancer, and typhoid fever. Dr. Nigel Gibbs, head of
WHO's Health Laboratory Technology and Blood Safety Unit, said,
"Serious mistakes happen in the laboratories of some of the
world's most industrialized countries as well as in developing
countries." He added, "Such mistakes are preventable."


Publishing Company Promotes Safe Sex & AIDS Awareness *
Business Wire (04/20/93)

(Chicago, IL) A comic book designed to address problems of
today's youth will discuss safe sex and AIDS awareness. The
comic book Hip Hop Heaven, published by Boomtown Productions,
will have a story in its May issue entitled "No Love Without a
Glove." The story will tell of four young people and their
experiences during a night out on the town. Craig "Rex" Perry,
president of Boomtown and creator of Hip Hop Heaven, said,
"Within the community we've got to be aware of the AIDS
reality." Hip Hop Heaven emphasizes messages of peace,
educational excellence, and pride in heritage and multicultural
awareness. The comic book is available from Afrocentric
bookstores, comic book stores, and college campus bookstores.


HIV-1 Infection: Breast Milk and HIV-1 Transmission *
Lancet (04/10/93) Vol. 341, No. 8850, P. 930
Mok, Jacqueline

There are still more questions than answers regarding HIV-1-
positive women breastfeeding their babies, writes Jacqueline
Mok of the Lancet. The anti-infective properties of milk are
well documented. While the numbers of leukocytes,
concentrations of lactoferrin and IgA, and lymphocyte mitogenic
activity decline sharply during the first two to three months
of lactation to barely detectable levels, lactoferrin and IgA
then increase from three to twelve months, with 90 percent of
total IgA in milk being secretory IgA. Breastfeeding protects
infants against gastrointestinal and respiratory illnesses, in
both normal and uninfected children born to HIV-positive
mothers. The Italian National Registry of AIDS discovered that
breastfed HIV-1 infected children had a longer median
incubation time (19 months) than bottlefed infants (9.7
months). Breastfed children also had a slower progression to
AIDS. There is no agreement on which antibodies offer
protection against HIV-1 infection. Studies of the biological
properties of milk from 15 HIV-1 infected women showed the
presence of IgG and IgA antibodies against envelope
glycoproteins, as well as IgA antibodies against core antigens.
Binding of HIV-1 to the CD4 receptor can be inhibited by a
human milk factor. In the developing world, where infectious
disease and malnutrition contribute significantly to infant
mortality, breast milk is still the best food for infants,
regardless of the mother's HIV status. Transmission might be
restricted by breastfeeding after colostrum and early milk have
been expressed and discarded. The possibility remains that
breast milk could protect the infant who is already infected
with HIV at birth and may even delay progression to AIDS,
concludes Mok.


HIV and the Aetiology of AIDS *
Lancet (04/10/93) Vol. 341, No. 8850, P. 957
Duesberg, Peter

Because there is no proof that HIV is the cause of AIDS, the
hypothesis that drug use leads to AIDS will hopefully become a
hindrance to the physiologically (AZT) and psychologically
(positive AIDS test) toxic public health initiatives, writes
Peter Duesberg of the University of California--Berkeley. In
the
Lancet's March 13 issue, Schechter et al. call Duesberg's
hypothesis that injected and orally used recreational drugs and
AZT lead to AIDS, "a hindrance to public health initiatives."
However, their hypothesis that HIV is the cause of AIDS has not
attained any public health benefits. The U.S. government spends
$4 billion annually, but no vaccine, no therapy, no prevention,
and no AIDS control have resulted from work on this hypothesis.
Schechter et al. conclude that HIV has a key role in CD4
depletion and AIDS based on epidemiological correlations with
antibodies against HIV and with self reported recreational drug
use among homosexuals from Vancouver. However, their survey
neglects to disprove Duesberg's drug-AIDS hypothesis, because
it does not provide controls--i.e., confirmed drug-free AIDS
cases--and because it does not quantify drug use and ignores
AZT use altogether. To refute Duesberg's hypothesis Schechter
would have to produce a controlled study demonstrating that
over a period of up to 10 years HIV-positive patients who use
recreational drugs or AZT or both have the same AIDS risks as
positives who do not do so. The 10 year period is claimed by
proponents of the HIV hypothesis to be the time needed for HIV
to
cause AIDS. Alternatively, they could show that HIV-free
individuals who have used drugs for 10 years never get AIDS-
defining illnesses, concludes Duesberg.


Rapid Decline of CD4+ Cells After IFNa Treatment
in HIV-1 Infection *
Lancet (04/10/93) Vol. 341, No. 8850, P. 959
Vento, Sandro et al.

Interferon (IFN), which induces autoantibodies and autoimmune
diseases in some settings, may hasten CD4 T-cell loss in some
HIV-1 infected individuals through the amplification of harmful
"autoimmune" reactions, write Sandro Vento et al. of the A.
Pugliese Hospital in Catanzaro, Italy. The researchers report
three asymptomatic HIV-1 infected individuals with hepatitis C
Virus related chronic active hepatitis (CAH) who had a rapid,
profound decline of CD4 cells after IFN. All three patients
throughout the observation were consistently negative for serum
HIV p24 antigen and had circulating antibodies to p24. Sera
from
all three patients, obtained at the end of IFN treatment and
testing in enzyme-linked immunosorbent assay, contained high
titres of antibodies reacting to a sequence located in the
aminoterminal of the beta chain of all human HLA class II
antigens, homologous to a sequence located in the carboxy
terminus of HIV-1 gp41. These autoantibodies, which also
recognize "native" class II molecules and may contribute to the
elimination of CD4 T cells "in vivo", were at low tires (50-
100) in all three patients six months after stopping IFN. Such
autoantibodies were not detected in 28 other patients with HIV
infection and HCV related CAH treated with IFN and who did not
experience CD4 T-cell loss in some HIV-1 infected individuals
through the amplification of harmful "autoimmune" reactions.
The
subjects had A1; B8; DR3; and B35, DR1 HLA antigen combinations
which are linked with a more rapid fall in CD4 cell counts and
clinical progression of HIV-1 disease. IFN can induce a very
rapid decline of CD4 cells and should be used cautiously in
patients with these HLA haplotypes, the researchers conclude.


Absence of HIV Transmission From an Infected Dentist
to His Patients *
Journal of the American Medical Association
(04/14/93) Vol. 269, No. 14, P. 1802
Dickinson, Gordon M. et al.

If universal precautions are practiced, the risk of HIV
transmission from dentist to patient appears to be
infinitesimal, write Gordon M. Dickinson et al. of the
University of Miami School of Medicine in Miami, Fla. The
researchers contacted all patients treated by a dentist with
AIDS and attempts were made to contact all patients for HIV
testing. Living patients with newly detected HIV infection were
interviewed, and DNA sequence analysis was performed to compare
genetic relatedness of their HIV to that of the dentist. Death
certificates were obtained for deceased patients, and the
medical records of those with diagnoses suggestive of HIV
disease or drug abuse and those dying under the age of 50 years
were examined in detail. There were 1,192 patients who had
undergone 9,267 procedures, of whom 124 were deceased. An
examination of the death certificates of patients identified
five who had died with HIV infection, all of whom were either
homosexuals or IV-drug users. The researchers were able to
detect 962 of the remaining 1,048 patients, and 900 agreed to
be tested. HIV infection was reported in five of the 900
patients, including four who had clear evidence of risk factors
for the disease. One patient who had only a single evaluation
by the dentist denied high-risk behavior. Comparative DNA
sequence analysis showed that the viruses from the dentists and
these five patients were not closely related. The study
suggests the potential for HIV transmission from a general
dentist to his patients is minimal in a setting in which
universal precautions are strictly observed, conclude Dickinson
et al.


CDC's Roper is Dismissed *
Advocate (04/20/93) No. 627, P. 23
Bull, Chris

The recent dismissal of Centers for Disease Control director
William Roper is an indicator of the kind of aggressive anti-
AIDS action the Clinton administration is expected to execute.
Roper strongly opposed sexually explicit content in federally
funded AIDS education campaigns. Health and Human Services
Secretary Donna Shalala asked for Roper's resignation on March
10. Two days later, Shalala revealed that Roper would be
replaced by Philip Lee, an advocate of unconventional AIDS
education approaches who has directed the Institute for Health
Policy Studies at the medical school of the University of
California--San Francisco since 1972. Lee also served as a
member of the board of directors of the American Foundation for
AIDS Research from 1985 to 1991. Bob Hattoy, a White House
special assistant who also is one of President Clinton's chief
AIDS advisers, said Lee's appointment suggests that the
administration will not support relatively nonspecific AIDS
prevention messages targeted at the general public. Roper has
been criticized by AIDS activists for developing weak education
campaigns. Also, educators were enraged when the CDC refused to
promote condom use in America Responds to AIDS, a multi-million
dollar television, radio, and print advertising campaign. Last
October, a 30-page review of CDC AIDS prevention programs by
the House of Representatives government operations committee
found that Roper fostered a political tone in materials and not
one based on medical concerns. What is currently at issue is
whether prevention efforts should now be targeted toward cities
with high rates of HIV or those where HIV is currently emerging
such as the South and Midwest.


Senior Role Is Seen for AIDS Adviser *
Washington Post (04/23/93), P. A21
Kamen, Al

President Clinton's AIDS policy coordinator "will work inside
the White House," will serve as an "integral part of the senior
staff," and will be "a named member of the Domestic Policy
Council," announced Health and Human Services Secretary Donna
Shalala last night at the National Minority AIDS Council
Congressional Dinner. She added, "The president insists on
having the right person. We'll make our choice soon--count on
that." The Domestic Policy Council is comprised of the
president, the vice president, some Cabinet members, senior
members of the White House staff, and others named to address
domestic issues. At this point, leading candidates for the AIDS
"czar" position include San Francisco business executive Lee
Smith and former Washington state health official Kristine M.
Gebbie.


Housing Is Tight, but Protesters Are Already in Action *
Washington Post (04/23/93), P. B1
Wheeler, Linda and Sanchez, Rene

The march for homosexual rights scheduled for Sunday in
Washington, D.C., is expected to draw as many as 1 million
people and address several issues including more federal action
to fight AIDS. Yesterday the first protest in connection with
the march was held in the city in the predominantly gay area of
Dupont Circle. ACT-UP conducted the demonstration that included
more than 300 people and disrupted downtown traffic for about a
half an hour and startled police. The marchers protested what
they consider as President Clinton's reluctance to deliver on
promises he made to combat AIDS. They walked from Dupont Circle
to the White House without a permit or police escort and had to
stop traffic on their own. Several city police officers rushed
to the scene and attempted to convince them to move to the
sidewalk, but they refused. As downtown lunch crowds observed,
the protesters blew whistles and chanted for the government to
give more attention to AIDS. "We're already 100 days into the
Clinton presidency, thousands more have died of AIDS, and he
has done nothing," said Tracy Gordon, an AIDS activist from
Seattle. The protesters marched toward the White House but were
re-routed by police. ACT-UP is expected to hold other AIDS
demonstrations today outside the Health and Human Services
Department headquarters and the Pharmaceutical Manufacturers
Association. While the protesters were at Dupont circle
yesterday, ACT-UP leaders encouraged the crowd to engage in a
"die-in" during the march by lying down in the street at 2 p.m.
Sunday as a symbolic statement of the lack of action against
AIDS.


India Launches $72 Million Plan to Control AIDS *
United Press International (04/23/93)

(New Delhi, India) The government of India has implemented an
extensive program to prevent the spread of HIV in the world's
second most populous country, officials announced today. Health
Minister B. Shankaranand told the Indian parliament that the
effort would concentrate on curbing "high-risk behavior,
promotion of blood safety, control of sexually-transmitted
diseases and better clinical treatment of AIDS cases." The
initiative would cost $72 million, said health ministry
spokesman Raman Prasad. India has reported 310 cases of full-
blown AIDS, said Dr. Brij Bhushan Thakur, a senior official at
the National AIDS Organization. "We are just starting to do
research on the extent of high-risk behavior prevalent in India
because we don't have that information yet," added Thakur.
India is home to 850 million people, where health services are
inadequate and the government has been reluctant to support
programs for HIV prevention and testing or AIDS medical care.
The World Health Organization has recently named India and
Thailand as the nations in the Asia-Pacific region most
threatened by major AIDS epidemics.


Spain to Compensate Hemophiliacs With HIV *
Reuters (04/21/93)

(Madrid) The Spanish government will compensate more than 1,000
hemophiliacs who contracted HIV through tainted blood and
plasma transfusions in the 1980s, the Health Ministry said on
Wednesday. Under-secretary of State for Health Angeles Amador
said that 1,147 people who contracted HIV would receive a lump
sum of $86,000 each. However, more than 400 of the hemophiliacs
have already died of AIDS, so the government will pass on the
compensation to their families, said Amador. "The rate at which
infected hemophiliacs are now dying is dramatic," he added. The
HIV-positive hemophiliacs would receive a pension of up to
$1,000 a month. According to the Spanish Federation of
Hemophiliacs, its members had a much higher rate of infection
than hemophiliacs elsewhere in Europe, with 43 percent
acquiring HIV through transfusions. Spanish Health Minister
Jose Antonia Grinan acknowledges the figure, but denies that
the hemophiliacs were infected through negligence. "They
themselves say the greater incidence of AIDS is because of a
certain treatment they received in Spain which was aimed at
giving them a better quality of life," Grinan told reporters
last month. The treatment used several doses of Factor VIII
blood clotting agent, which increased the risk of infection.
The majority of hemophiliacs were infected between 1983 and
1985, but the hardship they encountered was only disclosed
earlier this year when the federation began pressing for
compensation.


News in Brief: Pennsylvania *
Advocate (04/20/93) No. 627, P. 24

Pennsylvania AIDS programs and other social programs are in
jeopardy of losing funds unless the state legislature ends its
budget stalemate wUARobert Casey, the Pennsylvania
Coalition for Human Services said on March 8. Individuals
representing the group's member agencies organized a bake sale
in the rotunda of the state capitol to magnify their situation.
They said the coalition cannot receive the $550 million in
federal funds until the deadlock is settled. "It is ridiculous
that I am standing here in an apron in the capitol rotunda
selling baked goods for AIDS services," said Molly Wirick, a
member of the South Central Pennsylvania AIDS Planning
Coalition. "How much longer will it take? How many more pies
will we have to sell?" she added. In a separate issue, the AIDS
Law Project of Pennsylvania, a Philadelphia group, said on
March 11 that it will establish a program to urge lawyers to
donate their services to AIDS patients. The law project said
the attorneys will be encouraged to draft living wills and help
fight AIDS-based discrimination and illegal evictions.


News in Brief: Illinois *
Advocate (04/20/93) No. 627, P. 25

Illinois Gov. Jim Edgar's proposal to double AIDS spending is
an improvement but is still inadequate, according to leaders of
AIDS service groups. "It's a good beginning, but that's all it
is," said Mark Ishaug, a director of the AIDS Foundation of
Chicago. Edgar requested the allotment of $7.1 million for AIDS
education and treatment in a budget presented on March 3.
During the previous three years, state spending for the
programs had remained constant at about $3.6 million. In
addition, the budget recommends loosening the qualifications
for the state AIDS Drug Reimbursement Program and boosting the
number of drugs it subsidizes from five to ten. Tom Schafer, a
spokesman for Edgar, said the recommendations demonstrate that
the governor "understands the concerns of people with AIDS.
It's a growing problem, and the state has to deal with it now."


Rock Against AIDS, 1993 *
Rolling Stone (04/29/93) No. 655, P. 15
Herczog, Mary and Hochman, Steve

The music industry is increasingly diverting its attention to
AIDS causes. The Red Hot Organization, the group that developed
the 1989 album Red Hot + Blue and 1992's Red Hot + Dance, has
four recording projects and a television series planned to
benefit AIDS. Artists involved for an alternative-oriented
collection titled "No Alternative" include Red Hot Chili
Peppers, Nirvana, Sonic Youth, Soul Asylum, Matthew Sweet, and
Bob Mould. The collection will be released this fall by the
AIDS Music Project in conjunction with Red Hot. Also, Public
Enemy, Gang Starr, and Arrested Development head the cast for
an album of songs about AIDS issues called "Safe," which is
another co-venture with Red Hot. John Carlin, founder and
executive director of the Red Hot Organization, said, "From our
first two albums, we've given away more than $7 million to AIDS
groups, and the albums we have planned for this year are far
more commercial than the first two." LIFEbeat, a New York
organization founded last year, will host Counter Aid in New
York, Los Angeles, and Nashville on May 22nd. Celebrities will
raise money by working as salesclerks at record stores in the
three cities. All proceeds will go to LIFEbeat's efforts to
support people with AIDS or those who are HIV-positive within
the music business. Clean Needles Now, a clean needle exchange
group, will host a series of West Coast concerts benefiting
AIDS. But despite all of the fundraising efforts, AIDS
activists claim that it is not enough to turn the pop-music
world around as an industry fully addressing the issue. Scott
Sawyer, spokesperson of ACT-UP/New York, said, "Red ribbons are
not enough. We need frank, forthright lyrics about safe sex."


TB Makes a Comeback *
State Government News (04/93) Vol. 36, No. 4, P. 6
Voit, William and Knapp, Elaine S.

Although tuberculosis was once believed to be eliminated in the
United States, it is emerging again among the homeless, AIDS
patients, immigrants, minorities, and prisoners. Dr. Lee B.
Reichman, professor of medicine at the University of New Jersey
Medical School and president of the American Lung Association,
said, "Right now, it's a big city problem, but potentially it's
everyone's problem." The ALA predicts that 10 million Americans
are infected with TB, and about 10 percent of them will develop
the disease because their immune systems are depressed,
especially those with AIDS or HIV. Gene Tammes, a Centers for
Disease Control expert, said that is why the CDC has issued
guidelines warning hospitals and institutions not to mix AIDS
with TB patients. State health officials believe the TB is also
spreading because those who are most susceptible are the least
likely to follow through with treatment. In addition, the
increase is attributed to a shortage of public health services.
In New York City, TB is an epidemic "because the number of
cases is increasing faster than we can treat people," said Dr.
George Diferdinando, director of the New York State TB Control.
According to Diferdinando, curbing the spread of TB entails
keeping 85 percent or more of diagnosed TB cases in treatment.
About 40 percent of infected New York City residents don't
complete therapy. When TB patients don't finish taking their
medication, multi-drug resistant TB can develop, which requires
taking more expensive drugs and can take two years instead of
the normal six months to treat.


Increasing Frequency of Heterosexually Transmitted AIDS
in Southern Florida: Artifact or Reality? *
American Journal of Public Health
(04/93) Vol. 83, No. 4, P. 571
Nwanyanwu, Okey C. et al.

The alarmingly high rate of heterosexually acquired AIDS cases
in southern Florida was partially related to misclassification
of risk, write Okey C. Nwanyanwu et al. of the Centers for
Disease Control in Atlanta, Ga. The researchers investigated
168 such AIDS cases from Broward and coastal Palm Beach
counties. All of these cases attributed to heterosexual
transmission reported sexual contact with bisexual men,
injecting drug users, or persons born in countries where
heterosexual contact is the primary route of HIV transmission.
Medical records of patients, in addition to records from social
services, HIV counseling and testing centers, and sexually
transmitted disease (STD) clinics were reviewed. If no other
HIV risk factor was found from medical record review, patients
were interviewed using a standardized questionnaire. Once STD
clinic and other medical records were reviewed, 29 men and 7
women were reclassified into other HIV transmission categories.
After adjustments were made for the reclassification, the
percentage of AIDS cases reported from Palm Beach and Broward
counties between January 1, 1989, and March 31, 1990, that was
attributed to heterosexual transmission decreased from 10
percent to 6 percent among men and from 33 percent to 28
percent among women. While the percentage of heterosexually
transmitted AIDS cases in southern Florida decreased after
adjustment was made for reclassified cases, it still remained
above the national average, the researchers conclude.


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.

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