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Tied Up in Causes *
Baltimore Sun (05/03/93), P. 1
Shapiro, Stephanie

Celebrities wearing ribbons to promote a certain cause have
become a widespread practice on awards ceremonies. This surge
in ribbon-wearing stemmed from the red AIDS awareness ribbon
that was developed in 1991. Visual AIDS, a non-profit coalition
of new York artists and art professionals, created the ribbon
believing a simple red loop was a way to solidify and
strengthen the struggle against HIV. As a part of the Ribbon
Project, the it was introduced on the 1991 Tony Awards show.
The small red ribbon subsequently spurred an interest among the
politically correct. It soon became an indispensable accessory
on networks and cable awards programs. But it has also prompted
other ribbons: pink for breast cancer awareness; green against
tropical plywood for movie sets; purple signifies the toll of
urban violence; and blue is for crime victims' rights. But Anne
Kasper, director of the Campaign for Women's Health, a project
of the Older Women's League national advocacy group, says that
the different ribbons don't compete for the public's attention
and money. A Baltimore-area charity, Lifesongs for AIDS, has
raised $10,000 selling designer James Arpad's rhinestone ribbon
pins for $100 and $50. Arpad gives all of the proceeds from the
brooch to the Design Industries Foundation for AIDS. Nancy
Smith, executive editor of Self magazine, said, "I cannot
overstate how powerful the AIDS ribbon was in establishing this
sort of loop on your lapel as a statement about something."
She added that ribbons are unique because they're "so
understated and at some level it's a kind of secret message.
It's so subtle; it gives a sense of solidarity."


WHO Session Faces Political Battle *
United Press International (05/02/93)

(Geneva) The World Health Organization began its annual meeting
with continued debate over its Japanese director that
threatened to overshadow important discussions of AIDS,
tuberculosis, and other health problems. The United States and
some European countries oppose the re-election of Dr. Hiroshi
Nakajima as director-general of the United Nations' health
organization, but he will likely win because of the massive
support of Third World countries. The U.S.-led opposition has
alleged that Japan and Nakajima have given discretionary WHO
funds to Third World countries as a way of ensuring Nakajima's
re-election. However, the Japanese government denied the
accusations. The United States wants Nakajima replaced by his
Algerian deputy, Dr. Mohammed Abdelmoumene. As WHO sought
approval for its 185 member countries for a $1.8 billion budget
to combat illnesses and disease over the next two years, the
political controversy threatened to overshadow the crucial
health items on the agenda. Regarding AIDS, WHO predicts a
cumulative total of 12 million adults worldwide have contracted
HIV, and 1 million children have been born infected with the
virus. WHO said in its report to the Assembly that the world
needs to spend $2.5 billion a year on HIV prevention--20 times
what is actually being spent--just to significantly slow the
spread of HIV. Also, WHO declared a global emergency in the
fight against TB, whose spread is thought to be associated with
HIV, and which now kills some 3 million people a year.

"Florida Restaurant Has Modified Menu for AIDS Patients"
Reuters (05/02/93)

(Miami Beach, FL) A restaurant in Miami Beach now offers dishes
in its menu that are specially prepared to meet the nutritional
needs of AIDS patients. Chef Kathy Raffele of Falcon's Lair
said she decided on the menu after repeatedly being asked for
meals without dairy products, animal fats, refined sugar, and
fried foods. Those foods can be hard to digest in people with
depressed immune systems, and can trigger diarrhea. The menu
designates the dishes with a star stating "appropriate for
those persons with Compromised Immune Systems." Raffele said,
"I figured life would be easier for my customers and me if I
just had everything ready on the menu." She added that she
consulted with nutrition experts at StratoGen, a local AIDS
medical center, for suggestions on how to modify rich dishes.
For instance, a dinner at Falcon's Lair may begin with a seven-
onion soup or Ceasar salad without egg, and an entree of
steamed snapper in coconut sauce or ravioli stuffed with pureed
vegetables. Rafelle said she was currently working on deserts
that would be appropriate for AIDS patients to eat.


Built-In Viruses May Play Early Role in Cancer *
Reuters (05/03/93)
Mikkelsen, Randall

(Philadelphia, PA) A virus that resembles HIV that humans are
born with may be involved early in the onset of cancer,
according to a study published in the May 1 issue of the
journal Blood. The finding may lead to new ways to detect
people at risk of cancer or new ways of preventing its onset.
The study found active examples of a type of human endogenous
retrovirus (HERV) in the blood cells of leukemia patients.
Endogenous retroviruses such as HERV-K virus in the study are
contained within each human's genetic makeup and passed from
parent to child. Although HIV is a retrovirus, it is free-
standing and is transmitted through blood products. Researchers
believe retroviruses can cause human genes to jump from one
location on the chromosome to another, where they can incite
the development of cancer and other diseases. Dr. Isadore
Brodsky, director of the Institute for Cancer and Blood
Diseases at Philadelphia's Hahnemann University and head of the
study, said the findings of active endogenous retroviruses may
also result in a new understanding of the origins of AIDS. "I
think increasingly the thinking about AIDS...is that it may
have evolved from one of these endogenous [retroviruses] and
taken on a free-standing existence and that it may not be as
early in development as we think it is..."


New Program for Parents to Learn About Sex Education *
Reuters (04/29/93)
Sposato, William

(New York) A European pharmaceutical company has developed a
sex education program designed specifically for parents in
discussing the issue with their children. The program called
"Time...to talk," was developed by Organon Inc., a subsidiary
of the Dutch company Akzo, along with sex education experts. It
will be released in 24 cities this year, and designers hope to
avoid political disputes over the issue of sex education by
emphasizing that the kit is for parents, who can then make
their own decision about what to teach their children. "We're
not passing on our values or anyone else's values. What we do
in this workshop is to tell the parents 'you are the only ones
who should be communicating values to your children, especially
when it comes to sexuality,'" said Craig Rothenberg, a
spokesman for Organon.  Officials stressed there would be no
sales promotions involved in the program, which includes
seminars by sex education experts with parents. The program
says in a booklet that even though children are overwhelmed
with sexual images in the media, parents are still the most
powerful source of information on sexuality.  The program
encourages parents to be "askable," to respect their children's
privacy, and to acknowledge that discussing sex with children
will not make them more likely to become sexually active. In
addition, the program addresses AIDS. However, the experts said
that parents should not use concern about AIDS to try to scare
their children because such an approach could backfire. The
booklet says, "Remember, the question is not if your children
will engage in sexual activity, but when."


Calif. Licenses First 3 Viatical Settlement Firms *
National Underwriter (04/26/93) Vol. 97, No. 17, P. 13
Haggerty, Alfred G.

California has given three viatical settlement firms licenses
to specifically purchase life insurance policies from
terminally ill insureds at a percentage of their face value.
The three licenses were given to American Life Resources Corp.,
Miami Beach, Fla.; Neuma Inc., Chicago, Ill.; and Living
Benefits, Albuquerque, N.M. California Insurance Commissioner
John Garamendi said among the 45 companies which are devoted to
living benefits or viatical settlements, contracts nationally,
13 others are currently conducting business in the state and
have applied for licenses.  The living benefits companies buy
life insurance policies for a percentage of their face value--
usually from about 56 to 85 percent--from terminally ill
patients so that the patients may use the money while they're
still living. Rob Worley, president of Living Benefits, said 96
percent of his clients are AIDS patients. He said that the
company will not consider people who have just tested HIV-
positive because their life expectancy exceeds 24 months.
According to Worley, his company has paid out $80 million in
settlements on policies with face values ranging from $1,000 to
$4.5 million. Commissioner Garamendi imposed strict licensing
rules in January 1992 that require viatical settlement
companies to provide specific information on their plan of
operation, financial status, past experience in living benefits
contracts, and methods for obtaining information from medical
providers and policyholders. Such regulations are "absolutely
critical" to guarantee that AIDS patients and others with
terminal illnesses are not taken advantage of and that medical
records remain confidential, said Regina Aragon of the San
Francisco AIDS Foundation.


Recommendations for HIV Testing Services for Inpatients and
Outpatients in Acute-Care Hospital Settings *
Journal of the American Medical Association
(04/28/93) Vol. 269, No. 16, P. 2071

Because studies have shown the rate of HIV ranging from 0.3
percent to 6.0 percent among various hospital patient
populations, the Centers for Disease Control devised new
recommendations to control the spread of the disease. In
anonymous unlinked serologic surveys conducted by the CDC, 0.2
percent to 8.9 percent of persons receiving care in emergency
departments and 0.1 percent to 7.8 percent of persons admitted
to acute-care hospitals were HIV-positive. The CDC conducted
anonymous unlinked serologic surveys to evaluate 13 hospital-
specific variables as surrogate markers for hospital-specific
HIV seroprevalence. The diagnosis rate for AIDS was the only
hospital-specific characteristic associated with hospital-
specific seroprevalence. The CDC found that about 225,000 HIV-
positive patients were treated in the 5,558 acute-care U.S.
hospitals in 1990; 163,000 of these HIV-positive patients were
estimated to have a primary diagnosis other than HIV/AIDS.
Among these 163,000 patients, 125,000 (77 percent) were
admitted to the 593 (11 percent) hospitals with an AIDS
diagnosis rate of less than 1.0 per 1,000 discharges; 110,00
(88 percent) of the 125,000 patients were aged 15-54 years.
Therefore, HIV testing of patients in this age-range at these
hospitals would detect 68 percent of infected people
hospitalized in the United States for conditions other than
HIV/AIDS. By knowing their HIV status, infected persons and
their partners will be able to receive treatment earlier, thus
delaying the onset of AIDS. The CDC suggested that HIV
counseling and testing should not be used as a substitute for
universal precautions or other infection-control techniques.


Consumed With Fear *
Economist (04/24/93-04/30/93)
Vol. 327, No. 7808, P. 87

The incidence of tuberculosis has steadily increased since the
mid-1980s. World Health Organization members approximate that
1.7 billion people have contracted mycobacterium tuberculosis,
though some just carry the disease. Researchers attribute HIV
and multi-drug resistance (MDR) to the recent surge in TB
rates. When the problem of resistance arose after the first
antibiotics were introduced, physicians created a plan of using
multiple drugs to attack TB. However, the method doesn't
perform well if the drugs are administered sequentially instead
of simultaneously. This procedure allows the bacteria to
multiply and develop new drug resistance. Poor administration
of multi-drug treatments has produced the evolution of hundreds
of MDR forms of mycobacterium tuberculosis. The best treatment
appears to continue utilizing combinations correctly and to
search for new effective combinations. TB seems to cause the
most deaths among HIV-infected people. Approximately 3 percent
of TB cases occur in patients infected with HIV. Scientists
have begun to determine transmission of TB through genetic
"fingerprinting," tracing strains from one victim to another.


May 4, 1993


Viral Technologies Testing AIDS Vaccine *
Baltimore Sun (05/04/93), P. 11C
Bowie, Liz

Viral Technologies Inc., a joint venture of two biotechnology
companies based in Bethesda, Md., has announced that it will
apply to the U.S. Food and Drug Administration for permission
to test its AIDS vaccine, hgp-30, on humans. Preliminary
results from tests on mice have been positive. Cel-Sci Corp.
and Alpha 1 Biomedicals Inc. are joint owners of Viral
Technologies.

"Voice of the People: Chicago Recognized for Battling AIDS *
Chicago Tribune (05/03/93), P. 1-10
Lyne, Sheila

Chicago Department of Health Commissioner Sheila Lyne announced
that federal authorities have awarded the city the largest
proportional increase, among 25 eligible urban areas, in funds
to fight AIDS. Chicago will receive $2.7 million based on its
AIDS case rate, and $4.7 million based on its application,
which, according to Lyne, demonstrates "a strong understanding
of the AIDS epidemic in Chicago and ... a convincing plan to
fight the disease." More than 4,000 Chicago residents have died
from AIDS and thousands are currently living with the disease.


Vitamin Tested to Treat AIDS-Related Cancer *
United Press International (05/03/93)

(Seattle) VitaMed Inc., a biotechnology company based in
Seattle, Wash., said that it has signed an agreement with the
University of Washington to research a vitamin B-12 treatment
that could inhibit AIDS-related lymphoma. The company, a unit
of VitaMed Biopharmaceuticals Ltd. of Canada, said initial
tests show that tumor cells die when deprived of the vitamin,
while healthy cells may be kept alive with B-12.


Judge Order Arrest of Foreigners
for Alleged Unlicensed AIDS Clinic *
United Press International (05/02/93)

(Manila, Philippines) A regional trial court judged ruled that
three foreigners should be arrested for allegedly operating an
unlicensed clinic that treats AIDS patients in central
Philippines, official reports said Sunday. Executive Judge
Generoso Juaban of the regional court in Cebu, 350 miles south
of Manila, provided warrants for the arrest of U.S. national
Felip Dugrot and Australians Robert Graham and his wife
Rosanna, the state-run Philippine News Agency said Sunday.
Prosecutors, who filed the charges on Wednesday, said Dugrot
had worked at the unlicensed AIDS clinic as the chief
physician. The prosecutors alleged that the clinic attempted to
cure patients by using ozone treatment, an untested process of
blood purification. In March, local police and immigration
officials seized the facility and discovered that 17 foreign
nationals were seeking treatment for HIV infection. The
government said it believed Graham and his wife had left the
Philippines and returned to Australia, and that Dugrot was in
custody of immigration officials in Manila.


Dutch Study Shows HIV Strain Is Fast Track to AIDS *
Reuters (05/03/93)

(Amsterdam, Netherlands) A more virulent strain of HIV
discovered by Dutch researchers is believed to hasten the
development of full-blown AIDS. The presence of the strain of
HIV known as SI (Syncytium Inducing) makes it six or seven
times more likely that an HIV-positive patient will develop
full-blown AIDS within 2.5 years, says the study, published in
Saturday's edition of the journal Annals of Internal Medicine.
Roel Coutinho, one of the researchers in the study conducted by
the Central Laboratory for the Blood Transfusion Service and
the Amsterdam Municipal Health Service, said, "The SI virus is
a more aggressive virus which can be recognized in specific
laboratory tests. If a person has the aggressive virus variant,
the chance of getting AIDS is increased more strongly." People
are normally first infected with the less threatening NSI (Non
Syncytium Inducing) strain of HIV, said Coutinho. "It is very
rare that people have the SI strain from the beginning, but if
that happens, the prognosis is very bad," he said. Individuals
who have the NSI strain can also develop the SI strain. The
discovery may have indications for the treatment of HIV
patients, although this has not yet been fully determined. "The
therapy for SI and NSI may have to be different. There is some
evidence that, for example, AZT works better in NSI strains and
other medicines may have to be used for SI strains," said
Coutinho. The researchers believe that HIV slowly attacks the
immune system, but at a certain moment the virus dominates the
immune system and the more virulent strain emerges.


BRF--AIDS Walk *
Associated Press (05/02/93)

(New York, NY) More than $5 million was raised on Sunday when
thousands of people participated in a walk designed to raise
money for AIDS causes. New York Mayor David N. Dinkins told the
marchers, "But if you think that this march ends in a few
hours, I've got news for you. Our march is not over until we
tackle this virus." Approximately 28,000 people participated in
the walk, which encompassed a 6.2 mile route through Manhattan,
said Craig Miller, an organizer of AIDS Walk New York. "We just
had the largest and most successful AIDS fund-raiser ever
held," he said, referring to the $5 million raised. Separately,
about 460 Rikers Island inmates conducted their own walk on the
prison grounds, raising $3,400, according to Vito Turso, a
Correction Department spokesman. Any pledges made by the
inmates and prison staff were collected and sent to AIDS Walk
organizers.


Real Danger in the Ring--HIV *
Philadelphia Inquirer (05/04/93), P. A1
Barra, Allen

In boxing, protecting yourself is vital, writes Allen Barra for
the Philadelphia Inquirer. However, boxers are being denied
that protection by the byzantine state rules regarding testing
for AIDS and by the state commissions that claim they don't
have the funding to support widespread testing. Blood is part
of the point of boxing, and if a fighter has HIV and enters the
ring, there is a good potential that he may pass the disease to
his opponent. In England, the Board of Control tests all boxers
before all fights, and the cost of the tests is taken from
gross proceeds. In America, state laws are complicated, and
testing raises the prospect of lawsuits. However, many of the
people involved in the sport, including boxers themselves,
favor testing. Cost, the second issue, is not a problem for
major fighters, but for others, the cost of testing is a large
part of their pay. State commissions say they don't have the
estimated $5,000 to $25,000 to pay for yearly testing, although
such a claim is outrageous considering that a heavyweight match
between Riddick Bowe and Lennox Lewis would gross $60 million
to $75 million. It may take the illness of a major boxing
figure to draw attention to the testing issue, but by that
point, the decline of the sport may have begun, concludes
Barra.


Case Tests State AIDS Law *
Philadelphia Inquirer (05/04/93), P. B
Robinson, Melissa B.

A lawyer told the Pennsylvania Supreme Court Monday that two
hospitals broke state law by informing doctors, reporters, and
patients that a physician had the AIDS virus. The case is the
first involving Pennsylvania's AIDS confidentiality law of
1991. The law states that the results of a person's AIDS test
cannot be revealed without a court order. A court can disclose
test results if it finds a "compelling need." In the case now
at the high court, a doctor voluntarily took a an HIV test two
years after being cut during surgery. The doctor, after testing
positive, told his superiors, and withdrew from his residency
in obstetrics and gynecology. Lawyers for the Harrisburg
Hospital and Pennsylvania State University's Hershey Medical
Center later sought permission from a local court to reveal his
HIV test results. Dauphin County Common Pleas Court Judge
Warren Morgan permitted the disclosure, and though the doctor
appealed, the state Superior Court upheld the decision. The
high court must now determine if the lower court was right in
deciding there was a compelling need to release the doctor's
test results. The hospitals, in disclosing the test results,
held a news conference, made a news release, mailed letters to
447 patients, and informed the doctor's colleagues.


Changes in HIV Rates and Sexual Behavior
Among Homosexual Men, 1984 to 1988/92 *
American Journal of Public Health
(04/93) Vol. 83, No. 4, P. 578
Silvestre, Anthony J. et al.

Present levels of behavioral change in the homosexual male
population are not adequate enough to slow, much less end, the
AIDS epidemic, write Anthony J. Silvestre et al. of the
University of Pittsburgh in Pittsburgh, Pa. The researchers
studied 1,614 homosexual and bisexual men between 1984 and 1985
and from 1988 to 1992 at the Pitt Men's study, a site of the
Multicenter AIDS Cohort Study. Among the men entering the study
since 1988, 16 percent reported engaging in unprotected anal
receptive intercourse with more than one partner during the six
months before their visit. About 7 percent of the younger men
and 18 percent of the men over 22 years of age in the recent
cohort were already HIV-positive, the same rates as those
described eight years ago. This was the most striking finding
of the study. Although there was a significant increase in
knowledge about HIV over this period, including the mode of
transmission, the infection rate of about 7 percent among gay
teenage males and young adults in this sample did not decrease.
Although it is promising that there have been widespread and
significant changes in sexual behaviors, a notable percentage
of gay and bisexual men in this cohort still continued to
engage in or have relapsed into unsafe sexual practices that
could result in HIV transmission. Further research needs to be
conducted to determine the current sexual behaviors and HIV
rates among gay men not currently involved in studies. The
research will need to consider cultural, geographic, racial,
and age-related differences in that population, the researchers
conclude.


Public Relations to AIDS in the United States:
A Second Decade of Stigma *
American Journal of Public Health
(04/93) Vol. 83, No. 4, P. 574
Herek, Gregory and Capitanio, John P.

AIDS-related stigma in the United States remains a serious
problem, despite the country entering its second decade of the
epidemic, write Gregory Herek and John P. Capitanio of the
University of California--Davis. The researchers assessed the
prevalence of stigma to AIDS via telephone interviews with a
general adult sample and an African-American sample. Most of
the study's participants exhibited some form of stigma. Also,
an alarmingly large percentage of respondents believed that HIV
can be transmitted through various kinds of casual contact
(18.5 percent). Several respondents seemed to not understand
the mechanisms through which HIV is transmitted; instead, they
seemed to equate male homosexual behavior or drug use with HIV
transmission, even in situations where such transmission would
be impossible. Blacks expressed more support for policies
separating persons with AIDS from others and a stronger desire
to avoid these persons, compared with whites, who expressed
more adverse feelings toward AIDS patients and a greater
willingness to blame them for their illness. The study also
found that men were significantly more likely than women to
support quarantine as a means to control the spread of HIV and
to report that they would avoid a neighborhood grocer with
AIDS. Moreover, the study discovered that white women were the
least likely of any group to anticipate that they would avoid
AIDS patients or to overestimate the risks of casual contact.
Reducing stigma and promoting compassion toward AIDS patients
should be key objectives of AIDS education and prevention
programs, the researchers conclude.


Depressive Symptoms in Blood Donors
Notified of HIV Infection *
American Journal of Public Health
(04/93) Vol. 83, No. 4, P. 534
Cleary, Paul D. et al.

Meeting the psychological needs of HIV-positive individuals may
be necessary if HIV screening programs are essential to the
success of HIV counseling and testing programs, write Paul D.
Cleary et al. of the Columbia University School of Public
Health in New York, N.Y. The researchers examined blood donors
who had been notified of HIV infection by the New York Blood
Center. A nurse elicited a medical history, performed a limited
medical examination, and asked the subjects to complete a
questionnaire that included questions about drug use, sexual
behavior, and psychological characteristics. The subjects
completed another questionnaire about two weeks later. The
study found that the average depressive symptom scores for both
men and women were substantially higher than scores typically
found in representative population samples. More than a quarter
of the men and more than a third of the women reported seeking
psychological or psychiatric services in the first few weeks
following notification. Depressive symptoms were evaluated
using the Center for Epidemiologic Studies Depression (CES-D)
scale.  The findings indicate that persons with high CES-D
scores, low self-esteem, less positive coping strategies, and
more social isolation may have more persistent symptoms of
depression and a greater need for professional services.
Anticipating such problems and helping persons to cope with
notification may increase the positive impact of HIV screening
programs, the researchers conclude.


May 5, 1993


Drug Concern Hopes Its AZT Formula Ends Single Brand
for AIDS Treatment *
Wall Street Journal (05/05/93), P. B10
Waldholz, Michael

A Colorado pharmaceutical company has developed a version of
the AIDS drug AZT that may be more effective than the only
brand of the drug currently available. Burroughs Wellcome Co.
is the only company that has its brand of AZT, known as
Retrovir, on the market. Verex Laboratories of Englewood,
Colo., told its shareholders yesterday that preliminary human
trials suggest its formulation of AZT, known as Aztec, may be
more potent, longer-lasting, and less toxic than Retrovir.
Verex said if Aztec is approved by the Food and Drug
Administration for sale, it hopes to sell it for less than
Retrovir, which costs AIDS patients about $2,500 to $3,000 a
year. Retrovir is known to have the potential to cause severe
anemia, and HIV has often developed resistance to Retrovir
after a year or so of treatment. But James M. Dunn, the
founder, chairman and chief executive officer of Verex, said
his company's version of AZT may not produce similar adverse
effects because it may be effective at lower doses. Dunn said
that initial tests of Aztec demonstrated that 100 milligrams of
the formula provided the same amount of AZT in the bloodstream
as 300 milligrams of Retrovir. Dunn added that the FDA has told
Verex to conduct a study comparing how patients fare when given
both versions of the drug. Even if Verex receives FDA approval,
however, it remains unclear whether it could sell its version
of the drug without violating Burroughs Wellcome's patent.


French Doctor Jailed in Scandal of AIDS-Tainted Blood
Begins His Appeals Process *
Boston Globe (05/04/93), P. 2
Echikson, William

The former head of the French National Blood Transfusion Center
and three other former health officials appeared in court on
Monday at the Palais de Justice in Paris to begin an appeals
process that could lead to a retrial in one of the country's
most devastating scandals. Last October, Dr. Michel Garretta
was sentenced to four years in prison on charges of fraud and
criminal negligence for allowing nearly 1,200 hemophiliacs to
contract HIV from contaminated blood products. The court stated
that he could have used available methods to decontaminate the
blood or replace it with untainted stocks. In addition,
Garretta was prohibited for life from practicing medicine and
was ordered to pay $1.84 million in damages. Attorneys for the
hemophiliacs had portrayed Garretta as a greedy bureaucrat who
purposely made the infected blood available to unknowing
victims. His actions are believed to have been motivated by
high prices for blood stocks. In 1985, France's National
Transfusion Center had stocks worth nearly $40 million and
Garretta did not want to incur the losses. In the first ruling
in October, the court labeled Garretta as "the instigator and
chief executor of policy." The retrial is expected to last
several weeks, and will involve an effort by the hemophiliacs'
lawyers to launch a new, tougher charge of poisoning against
the defendants. Sabine Paguine, the chief lawyer for the
hemophiliacs, said, "He didn't actually give the hemophiliacs
poison, but he engaged in a conspiracy to poison them."


Study Ties Time in Jail to Risk of TB Infection *
New York Times (05/05/93), P. B5
Navarro, Mireya

The longer an inmate is incarcerated, the greater are his or
her chances of contracting tuberculosis, according to a new
study published in this week's Journal of the American Medical
Association. The authors of the study said their research
confirmed for the first time the widely held belief that New
York City jails are regularly contributing to the city's TB
epidemic by spreading the germ that causes the disease. The
researchers, two doctors and an epidemiologist from the
Montefiore Medical Center who work for the Rikers Island Health
Service, discovered that 60 of 2,636 inmates who tested
negative to the TB skin test in 1985 had developed the disease
by 1992. Also, the researchers said those with TB had spent an
average of 6.5 months in jail, compared with 5.2 months for the
others, and had gone to jail at least one more time. Inmates
who spent more than one year in jail were more than twice as
likely to have developed TB than those who spent less time in
jail, the researchers found. City health officials said that
poor ventilation and overcrowding in the system contribute to
the high risk of infection. Moreover, the inmate population
includes a disproportionate number of people who are indigent,
homeless, addicted to drugs, or HIV-positive, all of which are
high risk factors for TB.  Overall, the study revealed that the
rate of TB among inmates was far greater than that of the rest
of the city--152 to 500 cases per 100,000 people, compared to
50.2 for the city as a whole.  What is most alarming is that
half of the 15,000 inmates at Rikers are discharged within a
week, leading to the spread of TB among the public.


The Fight to Save Phila. From an Epidemic of TB *
Philadelphia Inquirer (05/05/93), P. B1
Collins, Huntly

Due to the resurgence of tuberculosis in Philadelphia, the City
Council will hold hearings on TB today with an emphasis on
ensuring that TB patients take their medicine. According to
critics, even four months after appointing a TB czar, the city
has yet to approve, much less establish, an extensive plan for
fighting the disease. Dr. Bruce Davidson, a pulmonary
specialist who was appointed director of TB control in January,
said he would offer a preliminary TB plan today. He said last
week that the plan will include measures such as screening
those in homeless shelters and jails, and the forced isolation
of TB patients who are reluctant to take their medication. He
said his first priority will be to make sure that
Philadelphians with active TB complete their regimen of drugs.
Failure to finish a course of treatment over 6 to 12 months
leads to the proliferation of deadly drug-resistant strains.
About 30 percent of the 308 Philadelphians reported to have
active TB in 1991 did not complete their treatment, said
Davidson. The number of active TB cases in the city has
increased more than 40 percent during the last four years. In
1992, the figure was up to 339 cases. Some community groups
that expected to send representatives to testify at today's
hearings claim Davidson has failed to work with them. David
Fair, director of We the People Living with AIDS/HIV, said,
"His office is right across the street from ours, and we've
never seen him. And we have a major TB epidemic among our
members."


Teens Knowledgeable About Sexually Transmitted Diseases but
Still Reluctant to Use Condoms, UCSF Study *
Business Wire (05/04/93)

(Washington) High school students understand that unprotected
sex can lead to a sexually transmitted disease (STD) or even
HIV infection, but they still fail to use condoms, according to
a new study released yesterday at the joint meeting of the
American Pediatric Society and Society for Pediatric Research.
The study, conducted by researchers from the University of
California--San Francisco, involved 278 sexually experienced
ninth-graders at public high schools. The group was ethnically
mixed and had equal distributions of boys and girls. The
students answered a survey that addressed their attitudes,
beliefs, and behavior regarding STDs and HIV infection. The
researchers discovered that slightly more than half of the
students did not consistently use condoms. Groups including
girls, Asians, and those who felt they had little control over
the sexual activity of their partners used condoms the least.
Also, ten percent of the students had already contracted an
STD, but this did not seem to affect their attitudes about
condom use. Dr. Jonathan Ellen, a fellow in the UCSF Division
of Adolescent Medicine, presented the findings and said, "Our
results show teenagers are knowledgeable and realistic about
sexually transmitted diseases, which contradicts a widespread
belief that they view themselves as invulnerable to the world
around them and are difficult to educate about the risk." He
added, "The finding is important because it establishes
adolescents as a rational group about STDs, and with this as a
baseline, we can develop informational programs that are more
effective in encouraging condom use."


Changes in HIV Rates and Sexual Behavior Among
Homosexual Men, 1984 to 1988/92 *
American Journal of Public Health
(04/93) Vol. 83, No. 4, P. 578
Silvestre, Anthony J. et al.

Present levels of behavioral change in the homosexual male
population are not adequate enough to slow, much less end, the
AIDS epidemic, write Anthony J. Silvestre et al. of the
University of Pittsburgh in Pittsburgh, Pa. The researchers
studied 1,614 homosexual and bisexual men between 1984 and 1985
and from 1988 to 1992 at the Pitt Men's study, a site of the
Multicenter AIDS Cohort Study. Among the men entering the study
since 1988, 16 percent reported engaging in unprotected anal
receptive intercourse with more than one partner during the six
months before their visit. About 7 percent of the younger men
and 18 percent of the men over 22 years of age in the recent
cohort were already HIV-positive, the same rates as those
described eight years ago. This was the most striking finding
of the study. Although there was a significant increase in
knowledge about HIV over this period, including the mode of
transmission, the infection rate of about 7 percent among gay
teenage males and young adults in this sample did not decrease.
Although it is promising that there have been widespread and
significant changes in sexual behaviors, a notable percentage
of gay and bisexual men in this cohort still continued to
engage in or have relapsed into unsafe sexual practices that
could result in HIV transmission. Further research needs to be
conducted to determine the current sexual behaviors and HIV
rates among gay men not currently involved in studies. The
research will need to consider cultural, geographic, racial,
and age-related differences in that population, the researchers
conclude.


Public Relations to AIDS in the United States:
A Second Decade of Stigma
American Journal of Public Health
(04/93) Vol. 83, No. 4, P. 574
Herek, Gregory and Capitanio, John P.

AIDS-related stigma in the United States remains a serious
problem, despite the country entering its second decade of the
epidemic, write Gregory Herek and John P. Capitanio of the
University of California--Davis. The researchers assessed the
prevalence of stigma to AIDS via telephone interviews with a
general adult sample and an African-American sample. Most of
the study's participants exhibited some form of stigma. Also,
an alarmingly large percentage of respondents believed that HIV
can be transmitted through various kinds of casual contact
(18.5 percent). Several respondents seemed to not understand
the mechanisms through which HIV is transmitted; instead, they
seemed to equate male homosexual behavior or drug use with HIV
transmission, even in situations where such transmission would
be impossible. Blacks expressed more support for policies
separating persons with AIDS from others and a stronger desire
to avoid these persons, compared with whites, who expressed
more adverse feelings toward AIDS patients and a greater
willingness to blame them for their illness. The study also
found that men were significantly more likely than women to
support quarantine as a means to control the spread of HIV and
to report that they would avoid a neighborhood grocer with
AIDS. Moreover, the study discovered that white women were the
least likely of any group to anticipate that they would avoid
AIDS patients or to overestimate the risks of casual contact.
Reducing stigma and promoting compassion toward AIDS patients
should be key objectives of AIDS education and prevention
programs, the researchers conclude.


Technical Guidance on HIV Counseling *
Journal of the American Medical Association
(04/28/93) Vol. 269, No. 16, P. 2072

While it is unlikely that a single HIV counseling session will
yield immediate and permanent adoption of safer behaviors,
client-centered HIV counseling and attendant prevention
services such as referral and partner notification do
contribute to the initiation and maintenance of safer
behaviors, write the Centers for Disease Control. Publicly
funded HIV counseling and testing services (HIV-CTS) are a key
factor in the national AIDS prevention program. The CDC issued
recommendations, in addition to existing guidelines, that focus
on the counseling portion of the HIV-CTS process--a cooperative
effort that involves giving information and assisting the
client in identifying his/her HIV prevention needs, and in
developing a strategy to address those needs. The guidelines
emphasize the importance of ensuring that HIV counseling is
empathic, a quality known to be important in other clinical
encounters. By guaranteeing that counseling is empathic and
"client-centered," counselors will be able to develop a
realistic appraisal of the client's level of risk and assess
which stage the client has reached in the behavior change
process. Determining the client's state of behavior change is
essential in reducing or modifying risky behavior and will vary
among clients. The CDC developed the "Stages of Behavior
Change" model that recognizes that persons usually pass through
a series of steps before accomplishing consistently safe
behavior. These include: precontemplation (no intention to
change one's behavior); contemplation (long-range intentions to
change); ready for action (short-term intentions to change);
action (attempts to change); maintenance (long-term consistent
behavior change); and relapse.


May 6, 1993


Pregnant Women Will Get a Trial Vaccine for AIDS *
Philadelphia Inquirer (05/06/93), P. A4
Recer, Paul

AIDS vaccines will be tested in HIV-positive pregnant women to
determine whether the drugs are safe and whether newborns can
be protected from contracting the disease, federal health
officials announced yesterday. Secretary of Health and Human
Services Donna E. Shalala said the experimental vaccines were
being used for their ability to stimulate an antivirus response
in women infected with HIV and to determine whether this
response is transmitted to the babies. The health officials
said there would be two vaccine trials conducted at eight
university research hospitals. Both of the trials will involve
women between the ages of 16 and 40 who are HIV-positive but
asymptomatic. In one trial, 24 women will participate. Among
the 24 participants, 16 will receive an experimental vaccine
and eight will be administered a placebo. In the other trial,
which will be smaller, nine women will receive another vaccine
and three will receive a placebo. The trials entail four to
five immunizations in the women. The first will be between the
16th and 24th week of pregnancy. These will be followed by
monthly booster shots until the end of pregnancy. The infants
will be examined at birth, at six weeks, and then every three
months thereafter.  Approximately 75 percent of babies born to
HIV-positive mothers never contract the virus. It is unclear
why some babies become infected and others do not. However,
government researchers said HIV is believed to be transmitted
late in pregnancy or during birth.


AIDS Activists Say City Is Too Slow in Its Response to TB *
Philadelphia Inquirer (05/06/93), P. B3
Collins, Huntly

Approximately 30,000 residents of Philadelphia are at risk of
contracting tuberculosis because they are infected with HIV. At
a daylong hearing conducted by the City Council health
committee yesterday, AIDS activists criticized the city for
dragging its feet in combating the spread of TB.  Health
Department officials highlighted a preliminary plan to fight
the increasing number of active TB cases. It calls for various
measures, including court orders that would force people to
take their TB drugs if they are repeatedly reluctant to do so
on their own. In Philadelphia, there were 339 TB cases reported
in 1992--up 43 percent from 1989. Although some doctors
commended the city's anti-TB plan as an important first step,
AIDS activists and some Council members said it was ambiguous
and insufficient. Councilwoman Joan Specter said the Health
Department officials' plan fell far short of matching the TB
threat facing the city. She mentioned a lack of proper
ventilation and ultraviolet lighting in the city's own health
clinics, where thousands of ill people, including more than 900
HIV-positive patients, wait for hours in closed quarters to see
a doctor. Some AIDS activists heckled the officials by holding
placards and coughing in unison to emphasize their concerns
about TB. Kiyoshi Kuromiya, an HIV-positive man who edits a
scholarly newsletter about medical treatments for AIDS, held up
a placard that read, "Where are the TB guidelines?" He said he
had been asking the Health Department for information regarding
TB since November 1991.


Death May Renew Focus on AIDS Ban *
USA Today (05/06/93), P. 4A
Nichols, Bill

The recent death of one of the Haitian refugees with AIDS may
highlight President Clinton's broken campaign promise to
overturn the ban against HIV-positive immigrants. AIDS
activists hope the death of Joel Saintil, one of the 240 HIV-
positive Haitians held at the U.S. Naval Base at Guantanamo
Bay, will force President Clinton to act. Saintil was one of 53
Haitians ordered paroled in late March by a federal judge, over
administration objections. Even though President Clinton, who
relied on gay political support, promised repeatedly to lift
the ban, so far the White House will only say that it is
examining the issue. But one of the lawyers for the Haitians,
Michael Ratner, said, "I've gotten notes that mass suicides
might happen. The people who are coming out, we talk to their
counselors and they say ... they're coming out with what
amounts to a concentration camp mentality." U.S. District Judge
Sterling Johnson previously ordered the sickest of the Haitians
to receive humanitarian parole in March, and Clinton still
faces a more extensive ruling by Johnson on the legal status of
health conditions at the camp. However, activists are hopeful
that if Johnson rules to close the camp, the Clinton
administration will not appeal and use the order as a way out
of political controversy.


SmithKline and Adria Labs to Promote AIDS-Related Drug *
United Press International (05/05/93)

(Philadelphia, PA) SmithKline Beecham in Philadelphia and Adria
Laboratories in Dublin, Ohio, announced a joint effort
Wednesday to co-promote Adria's recently approved drug,
Mycobutin, to be used in AIDS patients with mycobacterium avium
complex (MAC).  Mycobutin is the only approved antibiotic to be
used for the prevention of a life-threatening bacterial
infection common in AIDS patients in the late stages of
disease. MAC results in drastic weight loss, anemia, and poor
absorption of nutrients.  SmithKline spokesman Jeremy Heymsfeld
said the agreement calls for SmithKline and Adria to co-promote
the drug using Adria's trademark Mycobutin in the United
States. SmithKline's 230-person hospital sales force will
promote Mycobutin. About 20 to 25 percent of AIDS patients
experience MAC. There are about 190,000 cases of AIDS in the
United States, with MAC being the fastest growing opportunistic
infection among them.


People in 20s Say They Are Not Happy With Sex Life,
Survey Says *
Reuters (05/03/93)

(New York, NY) The Americans who are now in their 20s are not
content with their sex lives, according to a magazine survey
released Monday. Details and Mademoiselle magazines conducted
the survey, which involved 2,500 respondents, and found that
two-thirds of men have altered their sexual activity because of
AIDS, but that only 37 percent of women have done so. The
survey revealed that 63 percent of men and 50 percent of women
are having sex less frequently than they want to. Although most
of the respondents believed that they should be using condoms,
usage is still not prevalent. At total of 39 percent of women
and 27 percent of men said they have never used condoms during
sexual intercourse. The respondents appear to respect marriage-
-81 percent of the women and 56 percent of the men believe
marriage is "the ultimate expression of love." Moreover, the
majority of both sexes claim they are in a monogamous
relationship.


TB and the Workplace: COG Plans Session on Resurgent Disease *
Washington Post (05/06/93), P. D.C. 2

The Metropolitan Washington Council of Governments will conduct
a seminar Tuesday to discuss the effects of tuberculosis in the
workplace. The one-day session, to be held at the COG Training
Center in Washington, D.C., will involve a look at the history
of TB and why it has re-emerged, the difference between TB
infection and the active disease, the effect of HIV infection
on TB diagnosis and treatment, how it affects health-care
workers, and how to improve control of the disease.


3TC: New Treatment Enters Major Trials *
AIDS Treatment News (04/23/93) No. 173, P. 7
Tate, Larry

Two large studies were expected to begin recruiting patients
last month for efficacy trials of the AIDS drug 3TC, the latest
antiviral drug in the class of nucleoside analogs that include
AZT, DDI, DDC, and d4T. In prior dosage and safety trials
involving 202 patients--in the U.S., Canada, and Europe, at
varying levels of immune health--received varying doses of 3TC.
Definitive data from these early studies is not available, but
it was found that the drug does have anti-HIV activity by
reductions in common markers of viral activity, and some
reductions in viral burden. However, any T-cell increases were
not large and did not last very long. These increases were less
than those seen in AZT, DDI, and d4T. There was some apparent
stabilization of T-cells, and the drug did seem to have a
positive safety profile. Side effects like headache, fatigue,
and diarrhea were observed, but only to the extent those
symptoms are normally seen in people with fairly advanced HIV
disease. Also, some evidence of drug resistance was seen in
some patients at doses below the ones to be used in future
trials. The two planned 3TC trials will last only 32 weeks and
will mainly use the drug in combination with AZT because of the
limited T-cell increases previously observed. The first study
will involve 320 AIDS patients in four arms. The different arms
will test single drugs against different doses of 3TC in
combination. The patients must have 200-500 T-cells and no past
history of using AZT, DDI, or DDC.  The second study will
involve 225 patients in three arms, and will also be blinded.
To be eligible, patients must have taken AZT for at least 24
weeks but never taken DDC or DDI, and have 100-300 T-cells.


High Plasma Lipoprotein in HIV-Positive Patients *
Lancet (04/24/93) Vol. 341, No. 8852, P. 1099
Constans, J. et al.

The link between lipoprotein and thrombosis in HIV-positive
patients remains undetermined, write J. Constans et al. of the
Hopital Saint-Andre in Bordeaux, France. In two issues of the
Lancet last year, Tabib et al. and Capron et al. reported
arterial thrombosis in HIV-positive patients. Since lipoprotein
is probably involved in the development of atherosclerosis and
thrombosis, the researchers examined lipoprotein in HIV-
positive individuals. The total of 95 HIV-positive patients
enrolled in the study between June and September 1992 were
divided into four groups according to CD4 count: 32 had less
than 50 CD4 cells per uL, 25 had 50-200/uL, 23 had 200-400/uL,
and 15 had over 400/uL. Risk behavior for HIV infection
included IV-drug use in 32, homosexuality or bisexuality in 38,
blood transfusions in 10, multipartner heterosexuality in 14,
and was unknown in 1.  Lipoprotein was measured by
nephelemetry. The average lipoprotein was 0.48g/L in group A,
0.35 g/L in B, 0.46 g/L in C and 0.34 g/L in D. There was no
significant difference between the groups, but there was a
significant difference between controls and groups A, B and C.
Lipoprotein was above 0.30 g/L in 13 group A (41 percent), 13
group B (52 percent), 9 group C (39 percent), and 5 group D (33
percent) patients. Overall 40 (42 percent) of the 95 HIV-
positive patients had lipoprotein over 0.30 g/L. Among the 95
HIV-positive patients, 14 had active opportunistic infection.
Plasma lipoprotein is genetically determined but may be
sensitive to nutritional or inflammatory events. The
researchers conclude that opportunistic infections may be
involved in risk of arterial thrombosis because they are
associated with high lipoprotein.


Drug Companies Join Forces in Search for AIDS Therapy *
Science (04/23/93) Vol. 260, No. 5107, P. 482
Cohen, Jon

A total of 15 pharmaceutical companies decided on April 19 that
they would participate in a collaborative effort in finding an
effective AIDS treatment. The companies hope they can thwart
HIV by bombarding it with several agents at once, a strategy
they think may increase the efficacy of individual drugs,
reduce toxicity, and prevent HIV from developing resistance as
quickly as it would otherwise. P. Roy Vagelos, chief executive
officer of Merck & Co., led the effort known as the
InterCompany Collaboration for AIDS Drug Development. The move
is intended to foster a "new synergy" among drug makers through
sharing of information and experimental compounds shortly after
completion of "phase one" safety tests in small numbers of
infected people. "The sooner we learn about the other people's
compounds that are safe and effective, the sooner we'll want to
do combination trials with them," said Vagelos. Participating
companies expect to standardize their assays so that data from
different studies can be compared. But there are limits to this
new cooperation: no commercial ties are to be formed and
companies will continue to pursue independent research and
development. Dan Hoth, who heads the National Institute of
Allergy and Infectious Diseases' (NIAID) Division of AIDS said,
"If all of these companies are willing to share information
about what they're doing in phase one trials and what they're
getting out of them, that could speed things up significantly."


Impact of the Expanded AIDS Surveillance Case Definition on
AIDS
Case Reporting--United States, First Quarter, 1993 *
Morbidity and Mortality Weekly Report
(04/30/93) Vol. 42, No. 16, P. 308

There was a 204 percent increase in the number of AIDS cases
reported between January 1 and March 31 this year as compared
with the same period in 1992, according to the Centers for
Disease Control. The new AIDS definition that was put into
effect on January 1, 1993, was the reason for the additional
cases. The definition added pulmonary tuberculosis, recurrent
pneumonia, or invasive cervical cancer, to the list of
qualifiers for AIDS. A T-cell count of fewer than 200 cells
also constitutes AIDS under the new definition. Between January
1 and March 31, a total of 35,779 AIDS cases--13 percent of the
cumulative total of 284,840 AIDS cases reported since 1981--
were reported to the CDC, a 204 percent increase from last
year.  Among the 35,779 AIDS cases, 21,582 (60 percent) were
reported based on the conditions added in 1993, and 14,197 (40
percent) were reported based on pre-1993 defined conditions--a
21 percent increase in reporting of pre-1993 defined cases over
the number reported for the same period in 1992. Among the
cases reported with only 1993-added conditions, 19,284 persons
(89 percent) had severe HIV-related immunosuppression only;
2,021 (9 percent) had pulmonary TB; 245 (1 percent), recurrent
pneumonia; and 41 (<1 percent), invasive cervical cancer. The
CDC does not expect the increase in the first quarter of 1993
to be sustained because the rise in cases during this period
signifies the reporting of the accumulated number of persons
who could not be reported as AIDS cases until January 1, 1993.


May 7, 1993


Dentist's Patient Is 6th With HIV *
New York Times (05/07/93), P. A16

Another patient of the Florida dentist who died of AIDS has
tested HIV-positive, which makes her the sixth, according to
federal health officials who said yesterday they were still
unsure how the virus had been transmitted. The reason the
patient, a teenage girl, was not tested until late 1992 was
because it was then that she was seeking admittance into the
military, said officials from the Centers for Disease Control.
"There were people who were notified in 1990 to get tested, and
they made a conscious decision not to get tested, said Thomas
Liverti, administrator of the Florida AIDS program and chief
investigator in the case of the dentist, Dr. David Acer. He
added, "We are urging them to get tested." The girl was treated
in Dr. Acer's office in Stuart, Fla., in 1987, 1988, and 1989.
However, her case differs from the five others because she did
not undergo highly invasive procedures like extractions and
root canal treatment that would make viral transmission
simpler.  After she and her family were questioned by health
officials, the authorities failed to identify any other way she
could have become infected with HIV than from Dr. Acer. Since
1990, health officials have investigated the case on and off,
but have neglected to elucidate how the dentist might have
infected his patients. The new case did not elicit any new
leads.  Approximately 1,100 of Acer's patients have told health
officials they have been tested for HIV. Dr. Acer had a total
of about 2,500 patients, said Stephen Kindland, a spokesman for
the Florida AIDS program.

Related Stories: Washington Post (05/07) P. A4; Wall Street
Journal (05/07) P. B6; Philadelphia Inquirer (05/07) P. A8;
Baltimore Sun (05/07) P. 2A


Glow of Firefly Is Used in New Test to Detect TB *
New York Times (05/07/93), P. A17
Altman, Lawrence K.

Drug-resistant strains of tuberculosis can be detected by a
transformation of the glow of the firefly, according to new
research reported in today's issue of the journal Science. This
process is much faster than conventional tests, and experts are
touting the development as a potentially important advance in
combating the resurgence of the disease, in which the death
rate in some outbreaks across the country has been as high as
50 percent. The firefly test reduces by several weeks the time
it can take to detect a drug-resistant strain of the bacterium
that causes TB. The test has been effective when used in
hundreds of experiments conducted with various strains of the
tubercle bacteria in the laboratory. Dr. William R. Jacobs and
Dr. Barry R. Bloom are the microbiologists who developed the
test at the Albert Einstein College of Medicine in the Bronx.
The team genetically engineered a phage, or virus that infects
bacteria, for the TB bacterium so that it carried the gene for
luciferase, the enzyme that makes fireflies glow. The virus was
used to infect the bacterium in the laboratory. Since the DNA
from the phage was easily merged into the bacterium's genes,
the bacteria could produce luciferase. The phage-infected
tubercule bacteria gave off light within two hours. Standard
anti-TB drugs were used to test bacteria cultured from
patients. If a glow was present, it signaled an impotent
antibiotic because the bacterium was able to produce luciferase
and light. However, if no light appeared, it meant that the
antibiotic was effective in killing or weakening the bacteria.

Related Story: Wall Street Journal (05/07) P. B6


Hospitals to Test AIDS Vaccine to Protect Babies *
St. Louis Post-Dispatch (05/06/93), P. 15A

As part of a nationwide effort announced Wednesday by federal
health officials, St. Louis and Washington universities'
medical schools will conduct a trial of an AIDS vaccine on
pregnant HIV-positive women in an attempt to protect their
newborns from contracting the virus. Robert B. Belshe, director
of the Center for Vaccine Development at St. Louis University's
School of Medicine, said mother-to-fetus transmission of HIV is
one of the fastest growing routes in which the virus is spread.
Approximately one-third of the babies born to HIV-positive
women will become infected as well, said Belshe. Researchers
are hopeful that the vaccine will incite production of
antibodies against HIV and protect both mothers and infants.
Dr. William G. Powderly, director of Washington University's
medical school's AIDS Clinical Trials Unit, said, "The
partnership involves St. Louis University enrolling pregnant
women and administering the vaccine. Once the baby is born,
Washington University will evaluate and care for both mom and
baby." The vaccine trial will last two years.


AIDS Action Committee Opens Mass. Toll-Free Hot Line
for Teen-agers *
Boston Globe (05/06/93), P. 35
Atkinson, Lisa

The AIDS Action Committee of Massachusetts has launched its
first AIDS hotline for teenagers as a response to the
widespread misinformation that these teens receive. The Youth
Only AIDS Line--or YO Line--is the first tollfree hotline of
its kind in the nation that provides information to
Massachusetts teenagers about sex and AIDS. "There's a lot of
evidence that teenagers are more comfortable talking to their
peers and they are more comfortable asking people their own age
questions," said Larry Kessler, director of the AIDS Action
Committee. Each year in the state, one in seven teenagers
contracts a sexually transmitted disease (STD), reports the
committee. The rate of infection with an STD has doubled among
teenagers since 1985. Kessler thought of the idea for the
hotline after attending AIDS conferences throughout the
country. "I kept hearing over and over again that for
teenagers, there weren't enough resources for them. I thought
if hotlines work so well for adults, why wouldn't they work for
teenagers?" The hotline will be open for Massachusetts
teenagers to access between 3 and 9 p.m., Monday through
Friday. The staffers had to go through a minimum of 35 hours of
training. During these training sessions, the staffers were
educated about HIV transmission, safer sex, sexual involvement,
condom use, substance use, cultural diversity, postponing
sexual involvement, and homophobia.


Canada Gays Still Practicing Unsafe Sex, Says Report *
Reuters (05/06/93)

(Ottawa) Nearly 40 percent of Canadian gay men still engage in
unprotected anal sex, even though there is the threat of HIV
infection, according to a Canadian government-funded study of
sexual practices of gay men in the country. The survey of about
5,000 men was conducted last year in 35 Canadian cities by the
Canadian AIDS Society, the University of Toronto, and Laval
University in Quebec. It was funded by the Canadian Department
of Health and Welfare. The study discovered that younger men
and those living in smaller communities were more likely to
practice unprotected sex. "The highest level of unprotected
anal intercourse in the past three months was reported by men
age 20 and younger," the study said. In addition, about 12
percent of the respondents said they knew they were HIV-
positive. About a quarter of the respondents who were infected
with HIV said they felt uneasy about having sex, the study
found. It revealed that 61.8 percent of the respondents had
recently participated in anal intercourse, with about 40
percent of them not using a condom.  Ted Myers, a professor in
the faculty of medicine with the University of Toronto, said,
"The survey confirms what we had known but it points to major
discrepancies in the practice of safe sex and in access to AIDS
testing." He added, "New approaches need to be taken to
education and there is a need to focus on youth." In Canada
there were roughly 11,000 confirmed cases of HIV infection and
AIDS by the end of 1992, but community leaders say about 30,000
people may actually be HIV-positive.


When AIDS Hospice Closes, a Man Falls Through Cracks *
Philadelphia Inquirer (05/07/93), P. A1
Collins, Huntly

Because the city of Philadelphia had closed its group homes for
AIDS patients in order to save $600,000, one AIDS patient died
without a home. City health officials found housing for about
15 people, all of whom were poor and were displaced by the
March closing of Marian Homes in West Philadelphia. But John
Dempkowski died because he could not live alone like the
others. He suffered from depression and dementia. After the
city neglected to find an immediate opening in an AIDS nursing
home, it sent Dempkowski to a private boarding home in
Germantown on March 19. The home provided meals and a bed, but
no supervision. Dempkowski spent most of his time in a small
bedroom on the second floor experiencing delusions and
depressions. Two days after he arrived at the home, Dempkowski
told workers he didn't like it there and was leaving. On March
25, his body was found by schoolchildren on the floor of an
abandoned recreation center. The Medical Examiner's office said
Dempkowski died of complications from AIDS, possibly on the
night of March 24.  Dempkowski had wandered the neighborhood
for four days before anyone in authority attempted to find him.
His sister said she came to look for him a few days before he
died, but the boarding home told her it had never heard of
Dempkowski. When she and a social worker attempted to file a
missing person report on two occasions, Philadelphia police
refused to take the report. The police said they did not search
for Dempkowski because no one told them he was mentally ill
until four days after he was missing. His death highlights the
gaping holes in the city's medical system, its social service
network, and law enforcement procedures.


False Positive Tests for HIV in a Woman
With Lupus and Renal Failure *
New England Journal of Medicine
(04/29/93) Vol. 328, No. 17, P. 1281
(Jindal, R. et al.)

Patients with systemic lupus erythematosus and end-stage renal
disease who test HIV-positive on enzyme-linked immunosorbent
assay (ELISA) and Western blotting should undergo additional
study, including polymerase chain reaction (PCR) and culture
for HIV-1, write R. Jindal et al. of the Mount Sinai School of
Medicine in New York, N.Y. The researchers recently observed
the uncommon situation of a false positive test for HIV-1
during the pretransplantation evaluation of a 32-year-old
Haitian woman with systemic lupus erythematosus and end-stage
renal disease. She did not exhibit any AIDS-related conditions.
Screening for HIV-1 demonstrated strongly seropositive results
by ELISA, which was performed three times at six-week
intervals, and by Western blotting for the following
antibodies: p17, p24, p31, gp41, p51, p55, p66, gp120, and
gp160. The patient's CD4 cell counts were 130 per cubic
millimeter; the total T-cell and CD8 counts were normal. She
denied any high risk factors for HIV and heard at a lupus
support group that she could test positive for HIV-1 as a
result of a "universal antibody." Because the patient wanted a
renal transplant, the testing was extended to include p24
antigen testing, PCR, and viral culture, all of which were
negative. The researchers believe that the false positive test
may have been the result of the presence of autoantibodies
related to the systemic lupus erythematosus. The patient is
currently awaiting a kidney transplant. Autoantibodies are
often found in patients with systemic lupus erythematosus. Such
autoantibodies often lead to false positive results on syphilis
tests or to abnormal results on a coagulation test because of
the presence of serum cardiolipin, the researchers conclude.

Pneumococcal Appendicitis in a Man With HIV Infection *
New England Journal of Medicine
(04/29/93) Vol. 328, No. 17, P. 1282
Clark, Jennifer A. and Keroack, Mark A.

HIV-positive patients are at high risk of infection with
streptococcus pneumoniae, write Jennifer A. Clark and Mark A.
Keroack of the University of Massachusetts Medical Center in
Worcester, Mass. The researchers observed a 28-year-old man
with hemophilia A who was recently admitted to the medical
center with a two-day history of malaise, sweats, and pain in
the right lower quadrant. He was HIV-positive and had a CD4
cell count of 390 per cubic millimeter. He received one dose of
clindamycin and gentamicin before being taken to the operating
room, where a gangrenous appendix measuring 6 by 3 cm was
removed. A probable contaminant, propionibacterium species, was
isolated only from a broth culture. Pathological examination
revealed acute appendicitis with a necrotic appendiceal wall.
HIV-positive patients have an increased susceptibility for
pneumococcal pneumonia and pneumococcal bacteremia. The
majority of HIV-positive patients with pneumococcal bacteremia
present with pneumonia (89 percent). But there have been
reports of pneumococcal meningitis, sinusitis, pericarditis,
endocarditis, brain abscess, and mediastinitis. Multiple
defects in immunity have been shown in these patients,
including low base-line levels of IgG to pneumococcal
polysaccharide. It has been recommended that patients with
pneumococcal bacteremia be evaluated for HIV infection,
especially in the absence of other underlying diseases.


Prevalence of HIV Infection Among Psychiatric Patients
in a New York City Men's Shelter *
American Journal of Public Health
(04/93) Vol. 83, No. 4, P. 568
Susser, Ezra et al.

The development of specially-designed anti-AIDS programs for
psychiatric patients should be done immediately, write Ezra
Susser et al. of the Columbia University Department of
Psychiatry in New York, N.Y. The researchers examined the rate
of HIV infection among psychiatric patients in a New York City
shelter for homeless men. The records of all 90 men discharged
from the shelter psychiatry program to community housing over a
two-year period were analyzed. HIV status was known for 62 of
the 90 men. Among these 62 men, 12 (19.4 percent) were infected
with HIV.  There were 28 men whose serostatus was not recorded.
But even if all of the 28 men were negative for HIV, the rate
of the virus among this population would still be a high 13.3
percent. Since many of these patients are sexually active with
women, it is essential to encourage safer sex behaviors with
women as well as in sex with men and in drug use. Risk
reduction methods implemented elsewhere may not be effective
among these men.  Extreme psychiatric and cognitive impairments
affect their ability to adopt new behaviors; severe social
deprivations constrain their options for sex and influence
patterns of drug use; and sensitive outreach is required to
guarantee their participation in any formal program. The high
rate of HIV among these men suggests a need for quick
intervention among psychiatric patients in men's shelters in
New York City, the researchers conclude.


A Woman's Way to Make Sex Safer *
Time (05/10/93) Vol. 141, No. 19, P. 58
Gorman, Christine

The Food and Drug Administration recently announced that it was
preparing to approve a female condom in order to prevent both
pregnancy and the spread of HIV as well as other sexually
transmitted diseases. Wisconsin Pharmacal, the U.S.
manufacturer of the condom, says its product is designed with
the same purpose as the male condom. However, the female
condom, known as Reality, is not as effective as the male
condom, and will be more expensive--with a price of up to
$2.50. It consists of a 7 inch-long polyurethane sheath with a
ring on each end. The inner ring is inserted into the vagina,
like a diaphragm, while the other ring remains outside. But
before the FDA will approve Reality, it asked that two
statements be printed in the labeling. The first one should
assert that male condoms are still the best protection against
the disease. Even though Wisconsin Pharmacal believes the
polyurethane used in the female condom may be more effective
against viruses than the latex of male condoms, not enough
studies have been conducted to know for certain. The second
demand of the FDA is that the label compare the efficacy of
female condoms with that of the other barrier methods of birth
control. The FDA said that among 150 women who used the Reality
condom for six months, 26 percent became pregnant. But the
manufacturer argues that the pregnancy rate was 21 percent--and
only because many women didn't use the female condom every time
they had sex. Wisconsin Pharmacal said that with "perfect use"
the rate is 5 percent, in contrast to 2 percent for male
condoms. Resolving the debate over what failure rate to put on
the label has delayed the product's approval.


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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