-----===[[[ A I D S w i r e   D I G E S T 05.17.93 ]]]===-----

Waking Up to a Death Threat *
Los Angeles Times--Washington Edition (05/17/93), P. B6
Stier, Ken

Due to the increasing prevalence of HIV infection in Thailand,
the country's business community has launched an anti-AIDS
campaign in the workplace and is contributing to government-
sponsored AIDS programs. Most Thai men have their first sexual
encounters with prostitutes who work in the nation's thousands
of brothels, coffee shops, massage parlors, and other fronts
for the sex trade. Thailand's economy is dependent on the
expensive executive clubs for business entertainment where sex
is prominent among the offerings, and therefore contributes to
the increase of HIV infections. Government statistics say that
about 2,000 people have full-blown AIDS, but other estimates
state that about 600,000 of nearly 57 million Thais are HIV-
positive. In addition, between 2 million and 6 million Thais--3
percent to 10 percent of the population--are expected to be
HIV-positive by the end of the decade. Approximately half a
million Thais are expected to have died of the disease by then.
Consequently, Thailand is expecting about a $9 billion expense
for dealing with the epidemic by the year 2000, including lost
wages, declining productivity, and the escalating cost of
health care. But Thailand is leading Asia in efforts to thwart
the spread of the disease. The Thai government is spending $48
million a year on AIDS education programs--including
instruction for primary school students--while the private
sector contributes mostly in-kind services of equal value.


AIDS Plan Under Fire as Shift Is Demanded *
New York Times (05/15/93), P. 2

The World Health Organization announced Friday that it would
reassess its global strategy against AIDS after major members
of the United Nations health agency demanded that other
agencies be given bigger roles. At the conclusion of a two-week
annual assembly meeting, WHO's member states unanimously passed
a resolution requesting that the agency examine whether closer
cooperation was needed in the United Nations to fight AIDS. The
move came after a war of words was ignited last week over the
re-election of Dr. Hiroshi Nakajima of Japan as Director
General of the World Health Organization. Western nations had
previously issued hints that future funds for the agency would
be threatened if Dr. Nakajima were re-elected. One expert at
WHO said the review was "a move to extricate the AIDS program
from the wounded WHO." Authorities, however, denied that it was
politically motivated and mentioned that Japan was one of the
more than 40 nations sponsoring the resolution.


Prescription Is Fun at Nation's First Playroom for AIDS-
Infected Kids *
Los Angeles Times (05/16/93), P. A5
Duff-Brown, Beth

A New York hospital has opened a treatment center to help young
AIDS patients combat depression and fear while a therapist
works with them in the hospital's playroom. The Magic Playroom
at the Bronx Municipal Hospital in New York City is the first
of its kind in the city and is believed to be unique in the
nation--a treatment center that encourages fun. Dr. Arye
Rubinstein, director of the Center for AIDS Research at the
Albert Einstein College of Medicine and a leading expert on
pediatric AIDS, said that in New York City, AIDS has become the
leading killer of Hispanic children and the second leading
cause of death among African-American children. Rubinstein had
previously attempted to build the playroom, but was
unsuccessful until Pepsi Co. donated $100,000. Health
authorities predict that about one in every 30 women of
childbearing age in the South Bronx is infected with HIV.
Rubinstein has observed children battle depression and fear
while a play therapist works with them, encouraging them to
climb and to slide, and talk about the parents they might have
lost and the sickness they are experiencing. Nearly 30 indigent
children with AIDS attend the free day-care center at the
Pediatric AIDS Center at Bronx Municipal, where they have the
opportunity to interact in the large sunny playroom. Other
playrooms of this kind are expected to be built in medical
centers in Los Angeles and San Francisco, with the help of
Pepsi.


Conference Told AIDS Among Drug Users Rising but Controllable *
Reuters (05/14/93)
Charles, Deborah

(Montreal) One of the fastest growing groups at risk of
contracting HIV infection is that of IV-drug users, but risk
reduction approaches could thwart the epidemic among them,
according to a conference on AIDS research in Montreal, Canada.
Researchers from Canada and the United States told the three-
day Canadian Conference on HIV/AIDS Research, which ends
Saturday, that levels of HIV infection among IV-drug users
appear to be increasing worldwide. However, Dr. Don Des
Jarlais, director of research at the Chemical Dependency
Institute at New York's Beth Israel Hospital, said needle
exchange programs and education can help reduce risk levels
among IV-drug users to control the spread of HIV infection. "It
is possible to change the rate of HIV-positive cases among
intravenous drug users. This is new ... it goes against all the
stereotypes that say it is not possible. If you start early
enough, it is easy," said Jarlais. He mentioned effective
programs in cities including Tacoma, Wash.; Sydney, Australia;
and Glasgow, Scotland, that prevented HIV infections among IV-
drug users. Dr. Catherine Hankins, chairwoman of the conference
and an epidemiologist at the Center for AIDS Studies in
Montreal, said that prevention programs are not instituted in
many cities and countries because of the stigma still linked
with AIDS and IV-drug users. Jarlais said that about one-third
of AIDS cases in the United States are among IV-drug users,
which is a sharp increase from 1982-83 when the figure was
about 10 percent. He said that with time and effort by
governments and health-care workers, AIDS could be limited or
stabilized among IV-drug users.


Baby Is First to Receive Revolutionary Gene Therapy *
Reuters (05/16/93)
Yablonka, Marc

(Los Angeles) Gene therapy was conducted for the first time on
a five-day-old baby with a weakened immune system, and doctors
hope the revolutionary procedure will save his life, according
to hospital officials. On Saturday, surgeons at the Children's
Hospital in Los Angeles inoculated the baby with a small amount
of gene altered cell material taken from blood extracted from
his mother's placenta soon after birth. A hospital spokeswoman
said the baby was in good condition after the experimental
operation. He will be placed in a germ-free plastic bubble for
three to six months, which is the amount of time it will take
doctors to determine whether the procedure was effective. Dr.
Donald Kohn, director of the hospital's gene therapy program,
said he was hopeful that the therapy would eventually be used
to treat other infants with genetic disorders that can be
diagnosed in the womb, including AIDS, hemophilia, and sickle
cell anemia. The baby was born with a type of severe combined
immunodeficiency (SCID) that if left untreated, kills most of
its victims before they turn one year old. The doctors drew
blood from the mother's placenta, and the "stem cells"--the
parent cells of other blood cells--were isolated. The stem
cells were combined with a mouse leukemia virus that had been
altered to contain the adenosine deaminase gene and "growth
factors" to help the cells replicate, the doctors said. The mix
was subsequently injected into the baby in a two-minute
procedure. A second baby is expected to undergo the treatment
Tuesday at the hospital at the University of California--San
Francisco, the doctors said.


AIDS Cases Rising in South Africa *
Reuters (05/14/93)

(Johannesburg, South Africa) The number of HIV-positive South
Africans has increased 60 percent over the past two years and
is expected to double this year, said the country's National
Health Department on Friday. A report based on a survey of
women attending health clinics calculated that the current
total number of people infected with HIV was about 322,000,
versus 202,000 in 1991. "The nationwide doubling time is 12
months," the report said. The number could escalate to 4
million by the year 2000 unless there is an dramatic change in
sexual activity, the report said. There was a significant rise
in the number of cases in black communities, and the regions
with the highest rate of HIV infection were Natal and the
nearby black homeland of KwaZulu. Although some nearby African
nations had high rates of HIV/AIDS, South Africa had been
virtually spared by the epidemic until recently.


Underground Needle Exchange Being Done;
Lawful Program Pondered *
United Press International (05/14/93)

(Indianapolis, IN) Members of the AIDS activist group ACT-UP
have started their own clean needle exchange program among IV-
drug users, even though a proposed pilot program is being
considered by an Indiana advisory committee. The group of ACT-
UP members called the AIDS Brigade has distributed about 1,500
clean needles to about 150 people since November, said Larry
Pasco, an ACT-UP member. Pasco said the AIDS Brigade has
collected and disposed of about 1,350 used needles. He said it
is "absolutely moral" to provide a clean needle to an addict.
In Indiana, it is illegal to possess syringes for use with
illegal drugs, and only doctors, pharmacists, and approved
researchers are allowed to distribute them. A state advisory
panel Thursday proposed limited testing of such needle exchange
programs for prevention of HIV infection. Indiana Health
Commissioner John Bailey said the needle exchange proposal will
be reviewed along with other programs, such as the distribution
of bleach to drug users for sterilizing their needles.


Ugandan Men Turn to Young Women to Escape AIDS *
Reuters (05/13/93)
Massie, Meg

(Kampala, Uganda) Because one in every ten Uganda residents is
infected with HIV, Ugandan men are resorting to having sexual
relations with young girls. Health-care workers have seen
increasing numbers of reports of child abuse, rape, and sex
between young girls and much older men. Official statistics
report that five times as many females as males between the
ages of 15 and 19 are HIV-positive. Approximately 1.6 million
Ugandans--or one in five of the sexually active population--are
infected with HIV. Carol Jaenson, head of a multimillion dollar
UNICEF project to thwart the spread of HIV to five- to 15-year-
olds, said AIDS workers were particularly concerned about
adolescent girls. She said, "We want to give those girls the
strength to make the right decision at crucial times. No one is
going to be holding a young girls' hand when an older man is
coaxing her into sex." In order to help this population of
girls, embedded traditions, which have left Ugandans so
susceptible to AIDS, must be changed. These cultural practices
include polygamy, circumcision of both sexes with unsterilized
razors, and wife inheritance, the practice of assuming a dead
relative's widow. But social workers know that breaking
centuries-old traditions that have promoted the submissiveness
of women will not be easy. The young girls are being provided
with condoms as well as being encouraged to abstain from sex or
stay in a monogamous relationship. More than 30,000 AIDS cases
among Ugandans have been reported, although health officials
believe the actual number is at least 150,000. AIDS has
surpassed malaria in Uganda to become the country's leading
killer.


AIDSLINE Now Available on PaperChase *
Information Today (05/93) Vol. 10, No. 5, P. 4

The National Library of Medicine's database of clinical,
research, and health care policy information on AIDS is now
offered through PaperChase. The database, called AIDSLINE, uses
77,000 references, selected from 4,000 sources. References used
in AIDSLINE are taken from several National Library of Medicine
databases, including MEDLINE, Health Planning and
Administration (HEALTH), CANCERLIT, CATLINE, and AVLINE.
AIDSLINE also provides meeting abstracts from the Fifth through
the Eighth International Conferences on AIDS, the 90th and 91st
Symposium on Nonhuman Primate Models for AIDS, and, when
necessary, the 1990 and 1991 annual meetings of the American
Society for Microbiology. PaperChase integrates all references
from all years of MEDLINE, HEALTH, and AIDSLINE into a single
database. While all three databases are searched at once, the
search may be restricted to one database if needed. PaperChase
does not require a subscription fee or minimum monthly charge.


India: Introduction of Sex Education *
Lancet (05/08/93) Vol. 341, No. 8854, P. 1207
Anand, Annu

Due to the threat of AIDS in India, education officials are
seriously considering including sex education in the school
curriculum. The move would be a significant one because it is
still believed in the country that talking about sex is taboo.
The National Council of Educational Research and Training
(NCERT), which prepares textbooks for all levels of schooling,
has implemented a program to design lessons, relevant to India,
in "adolescence education"--the term the council prefers for
sex education. Adolescence education will be introduced as part
of education lessons such as sciences, social studies, and
psychology. Health and education experts meeting in New Delhi
to develop the program for the council suggested that the three
components on sex education--including the physical and social
aspects, sex roles, and sexually transmitted diseases--prepared
by UNESCO should be used as reference points for preparing
teaching material. The concentration will be on changes
occurring during adolescence, the reproduction process, sex-
related hygiene, negative effects of teenage pregnancies, HIV
infection and AIDS, and drug abuse. In order to make parents,
opinion leaders, teachers, and the community more comfortable
about introducing sex education, NCERT will soon implement an
awareness program. According to a survey of Indian
schoolchildren conducted by the Family Planning Association
last year, the chief sources of information on sex and related
matters were found to be television and magazines, not family,
friends, or school.

May 18, 1993


FDA Approves Antibiotic for Fighting Tuberculosis *
Wall Street Journal (05/18/93), P. B6

The Food and Drug Administration has granted approval to the
antibiotic streptomycin, a drug used in combating the
resurgence of tuberculosis, according to the drug's
manufacturer Pfizer Inc. of New York. The company said it is
planning to make its Streptomycin Sulfate Injection USP
available nationwide by mid-June. The drug would be used to
fight emerging multi-drug-resistant strains of TB, which are
fatal in 40 percent or more of all cases of the disease. Since
1991, there has been a shortage of streptomycin, when the main
ingredient of the medicine, sterile bulk streptomycin, which
was manufactured overseas, became unavailable in the U.S. In
order to provide more of the drug, Pfizer reformulated the
product, modified manufacturing processes, and worked with the
FDA to make the drug available domestically.


Thai Doctors Keep Quiet About AIDS Virus *
Reuters (05/18/93)

(Bangkok, Thailand) Thai physicians are neglecting to inform
HIV-positive pregnant women about their infected condition in
an attempt to thwart an epidemic of baby abandonment, according
to a report in Tuesday's issue of The Nation newspaper. Each
year in Thailand, more than 2,000 newborn babies are abandoned
in 17 northern provinces, which is the country's poorest area.
The newspaper quoted doctors as saying that children born with
HIV infection are the most likely to be deserted by their
mothers. The Nation reported that doctors at one Thai hospital
have been ordered to keep any diagnoses of HIV infection to
themselves in order to lessen the risk of babies being
abandoned. According to AIDS advocates, tens of thousands of
Thais are HIV-positive, especially in the north, where IV-drug
use is prevalent.


New TB Drug Resistance Test Developed *
Reuters (05/17/93)
Schwartz, Jerry

Atlanta--A new test that has been developed uses a glow-in-the-
dark feature to determine if a tuberculosis patient is infected
with a strain that is drug-resistant or one that is susceptible
to common anti-TB drugs. Dr. William Jacobs of the Howard
Hughes Medical Institute in New York told attendees at the
Monday meeting of the American Society for Microbiology that
cultures of the TB bacteria can be treated in a test tube so
that those which are drug resistant glow. "What we are
developing is a lights-out test that will be considerably
faster than the tests available now," said Jacobs. He mentioned
that it usually takes eight to 13 weeks to determine whether a
patient is infected with a strain of TB that can be treated
with current drugs. Physicians who treat large numbers of TB
patients say that delay can be fatal, because sometimes
patients can't be found once the test results are back. Jacobs
said that with the new test, the time to diagnose the type of
TB could be shortened to as little as a week. He said that
trials of the new test are being conducted, and commercial use
of the test could begin within two or three years. Jacobs said
that in New York City, approximately 85 percent of people with
multi-drug resistant TB who are co-infected with HIV are being
killed by TB. Multi-drug resistant TB kills 40 to 60 percent of
those with HIV infection. Officials from the Centers for
Disease Control have reported that TB develops resistance to
conventional treatments when the patient fails to complete the
full regimen of drugs--a process that can last for several
months.


AIDS Test Could Delay Immune System Destruction *
Reuters (05/17/93)

(Atlanta, GA) AIDS patients' lives could be extended if they
were regularly tested to determine whether the strain of HIV in
their bodies was in the process of mutating to become resistant
to conventional AIDS drugs like AZT, said a microbiologist on
Monday. Thomas Merigan, professor of medicine at Stanford
University, said an advanced test called polymerase chain
reaction (PCR) could enable doctors to switch drugs during AIDS
treatment before the disease has the opportunity to
considerably harm the patient's immune system. "Once that
mutation occurs, the virus is 16 times more resistant to AZT
that it was before," said Merigan. Doctors usually monitor the
number of white blood cells that have been attacked by HIV to
determine if an AIDS drug has become ineffective. However, long
before the blood cell counts decrease, signaling irreversible
destruction of the immune system, it is possible for laboratory
analysis to demonstrate whether the virus is changing to become
resistant to some AIDS drugs, Merigan said. "In some people who
are taking AZT, this happens after a month. In some people,
it's three or four years," he noted. The PCR test would permit
doctors to switch drugs or add another drug before the virus
can respond. Merigan said patients should be administered PCR
tests every two months. He said clinical trials of the
technique are already being conducted and soon will be
expanded.


New Jersey Dentist Sued Over Termination of HIV-Infected
Patient *
United Press International (05/17/93)

(Newark, NJ) A dentist allegedly refused to treat an HIV-
positive New Jersey man after learning of the patient's
condition, according to a lawsuit filed by the American Civil
Liberties Union. The suit was filed Friday in federal court on
behalf of the Camden County resident, known only as D.B. The
man incurred a cracked tooth in an automobile accident and was
being treated by Dr. Howard Bloom, who practices at the Madison
Dental Center in Pennsauken. After D.B. informed Bloom that he
was HIV-positive, the dentist allegedly terminated treatment,
informing the patient that he would not extract the tooth or
provide any additional dental treatment. The suit says that
Bloom breached the federal Americans With Disabilities Act and
the New Jersey Law Against Discrimination. The suit seeks a
court order prohibiting the Madison Dental Center and its
employees from discriminating against HIV-positive people and
compensatory and punitive damages for D.B. One ACLU lawyer
representing the case said, "It is tragic that D.B. was
mistreated based on a health condition. Since universal
precautions used in dentistry have virtually eliminated any
risk of transmission of HIV in a health care setting, the
discrimination and humiliation D.B. suffered was particularly
senseless."


How to Get Information About AIDS in the Workplace *
Knight-Ridder (05/17/93)

(Miami, FL) A set of videos has been developed by the Greater
Miami Chapter of the American Red Cross to educate people in
the workplace about AIDS and HIV infection. The five videos
include America at Work: Living With HIV; Basic HIV Issues for
the Workplace; Rights and Responsibilities; Disclosure; and
Issues for Managers and Supervisors. Each video lasts about 30
minutes and involves the audience in discussion on the topic.
Also, a Red Cross expert can make a workplace presentation
using all or some of the videos. Love Carefully, a private
company formed to educate people in the workplace about AIDS,
also offers a chapter-by-chapter guide on how to use Dr. Fleur
Sack's book, Romance to Die for: The Startling Truth About
Women, Sex, and AIDS, as a presentation tool. The guide can be
used by the client's own wellness expert to prepare an in-house
presentation, or the company can arrange for an expert speaker
to make the presentation.


German Prostitutes Demand State Health Insurance *
Reuters (05/16/93)

(Kassel, Germany) German prostitutes demanded Sunday to be
covered under state health insurance, claiming they were no
more likely to contract HIV infection than anyone else.
Speakers said at a congress in the western city of Kassel that
investigations had shown no higher rate of HIV infection among
prostitutes than any other group of people. A spokeswoman told
journalists, "We aren't a risk group." Prostitutes, who have
previously demanded the right to government health programs,
can get health insurance only if they lie about their
occupation or insure themselves privately. Nearly 400,000
prostitutes are believed to be working in Germany.


Octamer Gains Critical Patent Approval *
Business Wire (05/14/93)

(Tiburon, CA) Octamer Inc., a privately held company in Mimi
Valley, Calif., announced Friday that it received official
acceptance of a third new chemical compound, which produces
selective cell death and inactivates the HIV-1 virus and
various cancer cells. The agent, 3-NOBA-Cysteine Sulfinic Acid
adduct, is a substance that releases free NOBA, and organic C-
nitroso compound, in water soluble form, binding and
inactivating the HIV-1 virion. The substance is also
tumoricidal for a variety of human cancers in vitro. Octamer's
family of novel agents can successfully target and alter the
course of HIV infection. The agents, known as C-nitroso
compounds, target and alter certain chemical structures on the
virus known as zinc fingers, rendering the virus noninfectious.
The design of zinc-ejecting agents that target retroviral zinc
fingers is a dramatically new technique in the chemotherapy of
AIDS. Both NOBA and NOBP were tested for their inhibitory
effect on HIV-1 infectivity in human lymphocytes. The HIV-1 was
inactivated, causing no changes in cell metabolism.


The Shadow That Defies Managing: AIDS Takes a Heavy Toll on
Victims and Coworkers *
Washington Post (05/16/93), P. H1
Banas, Gary E.

AIDS can raise distressing issues of fairness on the job,
writes Gary E. Banas, director of administration for the Office
of the Comptroller of the Currency in New York. For the first
time in early 1987, Banas had to deal with AIDS. Charles, a
capable mid-level manager with the disease, began losing weight
and missing work. Also, the quality of his work started to
suffer. Even though Charles asked to keep his condition a
secret, employees became suspicious when their questions would
be evaded by Banas, and they deduced that Charles had AIDS. No
matter how much AIDS education the employees received, they
still thought HIV could be transmitted casually. After Charles
couldn't perform his job effectively, he was reassigned to a
nonsupervisory position. Soon after, he died of the disease.
But after his death, Banas had to hire another manager, named
John. John had worked there about a year and a half and then
disclosed that he also was HIV-positive. John soon began to
lose weight and his work performance declined. His subordinates
noticed something was wrong and asked Banas what was happening.
They found that AIDS not only affected John's performance, but
also the performance of every one of his subordinates.
Nevertheless, John complained that his unit was not competent
and threatened to take corrective action against some of the
employees if their work did not improve. When it was later
discovered that John was not getting the job done, he was
reassigned to a new position. But even in his new position, he
could not perform well and was given disability retirement.
Banas concludes that he knows it may not have been morally
right to put John on retirement, but he had to do his job.


Congress May Hang Up on AIDS Hotline *
Science (04/30/93) Vol. 260, No. 5108, P. 611
Stone, Richard

When the House of Representatives passed the National
Institutes of Health reauthorization bill, it put an end to
Project Aries, a $1.2 million study on whether phone counseling
can persuade men to practice safe sex. A team of researchers
led by Roger Roffman, an associate professor at the University
of Washington, conducted Project Aries to advise gay and
bisexual men about safe-sex practices during a series of 14
conference calls. The men subsequently answered questionnaires
over the year that were intended to mark changes in their
sexual behavior. The project received little attention until
the New York Guardian featured an article criticizing the study
with the headline "Dial 1-800-SOD-OMY." The story claimed that
Project Aries "advocates a homosexual lifestyle." Using this as
support, Rep. Sam Johnson (R-Texas) proposed the amendment to
stop Project Aries in the middle of its fourth (and final)
year. Some AIDS researchers were enraged by the amendment's
passage. "As soon as Congress begins to interfere in the peer-
review system, we're dead in the water," said Thomas Coates,
director of the Center for AIDS Prevention Studies at the
University of California--San Francisco. However, some members
of Congress were hoping to make a deal in conference between
the House and the Senate on the reauthorization bill that would
allow Aries to finish its last year.

May 18, 1993


FDA Approves Antibiotic for Fighting Tuberculosis *
Wall Street Journal (05/18/93), P. B6

The Food and Drug Administration has granted approval to the
antibiotic streptomycin, a drug used in combating the
resurgence of tuberculosis, according to the drug's
manufacturer Pfizer Inc. of New York. The company said it is
planning to make its Streptomycin Sulfate Injection USP
available nationwide by mid-June. The drug would be used to
fight emerging multi-drug-resistant strains of TB, which are
fatal in 40 percent or more of all cases of the disease. Since
1991, there has been a shortage of streptomycin, when the main
ingredient of the medicine, sterile bulk streptomycin, which
was manufactured overseas, became unavailable in the U.S. In
order to provide more of the drug, Pfizer reformulated the
product, modified manufacturing processes, and worked with the
FDA to make the drug available domestically.


Thai Doctors Keep Quiet About AIDS Virus *
Reuters (05/18/93)

(Bangkok, Thailand) Thai physicians are neglecting to inform
HIV-positive pregnant women about their infected condition in
an attempt to thwart an epidemic of baby abandonment, according
to a report in Tuesday's issue of The Nation newspaper. Each
year in Thailand, more than 2,000 newborn babies are abandoned
in 17 northern provinces, which is the country's poorest area.
The newspaper quoted doctors as saying that children born with
HIV infection are the most likely to be deserted by their
mothers. The Nation reported that doctors at one Thai hospital
have been ordered to keep any diagnoses of HIV infection to
themselves in order to lessen the risk of babies being
abandoned. According to AIDS advocates, tens of thousands of
Thais are HIV-positive, especially in the north, where IV-drug
use is prevalent.


New TB Drug Resistance Test Developed *
Reuters (05/17/93)
Schwartz, Jerry

(Atlanta, GA) A new test that has been developed uses a glow-
in-the-dark feature to determine if a tuberculosis patient is
infected with a strain that is drug-resistant or one that is
susceptible to common anti-TB drugs. Dr. William Jacobs of the
Howard Hughes Medical Institute in New York told attendees at
the Monday meeting of the American Society for Microbiology
that cultures of the TB bacteria can be treated in a test tube
so that those which are drug resistant glow. "What we are
developing is a lights-out test that will be considerably
faster than the tests available now," said Jacobs. He mentioned
that it usually takes eight to 13 weeks to determine whether a
patient is infected with a strain of TB that can be treated
with current drugs. Physicians who treat large numbers of TB
patients say that delay can be fatal, because sometimes
patients can't be found once the test results are back. Jacobs
said that with the new test, the time to diagnose the type of
TB could be shortened to as little as a week. He said that
trials of the new test are being conducted, and commercial use
of the test could begin within two or three years. Jacobs said
that in New York City, approximately 85 percent of people with
multi-drug resistant TB who are co-infected with HIV are being
killed by TB. Multi-drug resistant TB kills 40 to 60 percent of
those with HIV infection. Officials from the Centers for
Disease Control have reported that TB develops resistance to
conventional treatments when the patient fails to complete the
full regimen of drugs--a process that can last for several
months.


AIDS Test Could Delay Immune System Destruction *
Reuters (05/17/93)

(Atlanta, GA) AIDS patients' lives could be extended if they
were regularly tested to determine whether the strain of HIV in
their bodies was in the process of mutating to become resistant
to conventional AIDS drugs like AZT, said a microbiologist on
Monday. Thomas Merigan, professor of medicine at Stanford
University, said an advanced test called polymerase chain
reaction (PCR) could enable doctors to switch drugs during AIDS
treatment before the disease has the opportunity to
considerably harm the patient's immune system. "Once that
mutation occurs, the virus is 16 times more resistant to AZT
that it was before," said Merigan. Doctors usually monitor the
number of white blood cells that have been attacked by HIV to
determine if an AIDS drug has become ineffective. However, long
before the blood cell counts decrease, signaling irreversible
destruction of the immune system, it is possible for laboratory
analysis to demonstrate whether the virus is changing to become
resistant to some AIDS drugs, Merigan said. "In some people who
are taking AZT, this happens after a month. In some people,
it's three or four years," he noted. The PCR test would permit
doctors to switch drugs or add another drug before the virus
can respond. Merigan said patients should be administered PCR
tests every two months. He said clinical trials of the
technique are already being conducted and soon will be
expanded.


New Jersey Dentist Sued Over Termination of HIV-Infected
Patient *
United Press International (05/17/93)

(Newark, NJ) A dentist allegedly refused to treat an HIV-
positive New Jersey man after learning of the patient's
condition, according to a lawsuit filed by the American Civil
Liberties Union. The suit was filed Friday in federal court on
behalf of the Camden County resident, known only as D.B. The
man incurred a cracked tooth in an automobile accident and was
being treated by Dr. Howard Bloom, who practices at the Madison
Dental Center in Pennsauken. After D.B. informed Bloom that he
was HIV-positive, the dentist allegedly terminated treatment,
informing the patient that he would not extract the tooth or
provide any additional dental treatment. The suit says that
Bloom breached the federal Americans With Disabilities Act and
the New Jersey Law Against Discrimination. The suit seeks a
court order prohibiting the Madison Dental Center and its
employees from discriminating against HIV-positive people and
compensatory and punitive damages for D.B. One ACLU lawyer
representing the case said, "It is tragic that D.B. was
mistreated based on a health condition. Since universal
precautions used in dentistry have virtually eliminated any
risk of transmission of HIV in a health care setting, the
discrimination and humiliation D.B. suffered was particularly
senseless."


How to Get Information About AIDS in the Workplace *
Knight-Ridder (05/17/93)

(Miami, FL) A set of videos has been developed by the Greater
Miami Chapter of the American Red Cross to educate people in
the workplace about AIDS and HIV infection. The five videos
include America at Work: Living With HIV; Basic HIV Issues for
the Workplace; Rights and Responsibilities; Disclosure; and
Issues for Managers and Supervisors. Each video lasts about 30
minutes and involves the audience in discussion on the topic.
Also, a Red Cross expert can make a workplace presentation
using all or some of the videos. Love Carefully, a private
company formed to educate people in the workplace about AIDS,
also offers a chapter-by-chapter guide on how to use Dr. Fleur
Sack's book, Romance to Die for: The Startling Truth About
Women, Sex, and AIDS, as a presentation tool. The guide can be
used by the client's own wellness expert to prepare an in-house
presentation, or the company can arrange for an expert speaker
to make the presentation.


German Prostitutes Demand State Health Insurance *
Reuters (05/16/93)

(Kassel, Germany) German prostitutes demanded Sunday to be
covered under state health insurance, claiming they were no
more likely to contract HIV infection than anyone else.
Speakers said at a congress in the western city of Kassel that
investigations had shown no higher rate of HIV infection among
prostitutes than any other group of people. A spokeswoman told
journalists, "We aren't a risk group." Prostitutes, who have
previously demanded the right to government health programs,
can get health insurance only if they lie about their
occupation or insure themselves privately. Nearly 400,000
prostitutes are believed to be working in Germany.


Octamer Gains Critical Patent Approval *
Business Wire (05/14/93)

(Tiburon, CA) Octamer Inc., a privately held company in Mimi
Valley, Calif., announced Friday that it received official
acceptance of a third new chemical compound, which produces
selective cell death and inactivates the HIV-1 virus and
various cancer cells. The agent, 3-NOBA-Cysteine Sulfinic Acid
adduct, is a substance that releases free NOBA, and organic C-
nitroso compound, in water soluble form, binding and
inactivating the HIV-1 virion. The substance is also
tumoricidal for a variety of human cancers in vitro. Octamer's
family of novel agents can successfully target and alter the
course of HIV infection. The agents, known as C-nitroso
compounds, target and alter certain chemical structures on the
virus known as zinc fingers, rendering the virus noninfectious.
The design of zinc-ejecting agents that target retroviral zinc
fingers is a dramatically new technique in the chemotherapy of
AIDS. Both NOBA and NOBP were tested for their inhibitory
effect on HIV-1 infectivity in human lymphocytes. The HIV-1 was
inactivated, causing no changes in cell metabolism.


The Shadow That Defies Managing: AIDS Takes a Heavy Toll on
Victims and Coworkers *
Washington Post (05/16/93), P. H1
Banas, Gary E.

AIDS can raise distressing issues of fairness on the job,
writes Gary E. Banas, director of administration for the Office
of the Comptroller of the Currency in New York. For the first
time in early 1987, Banas had to deal with AIDS. Charles, a
capable mid-level manager with the disease, began losing weight
and missing work. Also, the quality of his work started to
suffer. Even though Charles asked to keep his condition a
secret, employees became suspicious when their questions would
be evaded by Banas, and they deduced that Charles had AIDS. No
matter how much AIDS education the employees received, they
still thought HIV could be transmitted casually. After Charles
couldn't perform his job effectively, he was reassigned to a
nonsupervisory position. Soon after, he died of the disease.
But after his death, Banas had to hire another manager, named
John. John had worked there about a year and a half and then
disclosed that he also was HIV-positive. John soon began to
lose weight and his work performance declined. His subordinates
noticed something was wrong and asked Banas what was happening.
They found that AIDS not only affected John's performance, but
also the performance of every one of his subordinates.
Nevertheless, John complained that his unit was not competent
and threatened to take corrective action against some of the
employees if their work did not improve. When it was later
discovered that John was not getting the job done, he was
reassigned to a new position. But even in his new position, he
could not perform well and was given disability retirement.
Banas concludes that he knows it may not have been morally
right to put John on retirement, but he had to do his job.


Congress May Hang Up on AIDS Hotline *
Science (04/30/93) Vol. 260, No. 5108, P. 611
Stone, Richard

When the House of Representatives passed the National
Institutes of Health reauthorization bill, it put an end to
Project Aries, a $1.2 million study on whether phone counseling
can persuade men to practice safe sex. A team of researchers
led by Roger Roffman, an associate professor at the University
of Washington, conducted Project Aries to advise gay and
bisexual men about safe-sex practices during a series of 14
conference calls. The men subsequently answered questionnaires
over the year that were intended to mark changes in their
sexual behavior. The project received little attention until
the New York Guardian featured an article criticizing the study
with the headline "Dial 1-800-SOD-OMY." The story claimed that
Project Aries "advocates a homosexual lifestyle." Using this as
support, Rep. Sam Johnson (R-Texas) proposed the amendment to
stop Project Aries in the middle of its fourth (and final)
year. Some AIDS researchers were enraged by the amendment's
passage. "As soon as Congress begins to interfere in the peer-
review system, we're dead in the water," said Thomas Coates,
director of the Center for AIDS Prevention Studies at the
University of California--San Francisco. However, some members
of Congress were hoping to make a deal in conference between
the House and the Senate on the reauthorization bill that would
allow Aries to finish its last year.

May 19, 1993


Lawmaker May Be Tapped as 'AIDS Czar' *
Washington Post (05/19/93), P. A17
Kamen, Al

The federal AIDS coordinator position may be filled by Rep. Jim
McDermott (D-Wash.), who is a prominent congressional advocate
of health care reform. McDermott, a popular legislator from
Seattle, is also a medical doctor who once served as a Navy
psychiatrist and Peace Corps Physician in Africa. He currently
chairs the House ethics committee and serves on the Ways and
Means subcommittee on health. After the initial candidate for
the "AIDS Czar" position, New York City health commissioner
Margaret Hamburg, withdrew, McDermott emerged as the front-
runner. However, the Clinton administration is still
formulating the AIDS czar position itself, and its exact
responsibilities and authority. The AIDS czar's office will be
located in the White House. According to McDermott's press
secretary, Barry E. Piatt, the congressman was invited to the
White House last week to give his views on AIDS, and "was not
offered the job, did not ask for it, and is not pursuing it."
White House officials say that McDermott is "not a done deal,"
but might be getting close.


Find Tainted-Blood Victims, Ottawa Told *
Toronto Globe and Mail (Canada) (05/18/93), P. A1
Picard, Andre

The Canadian government must immediately detect and inform
hundreds of Canadians who may have contracted HIV from tainted
blood transfusions and blood products, according to a group of
parliamentarians. "The tracing of persons infected with HIV-
contaminated blood is still incomplete," says an 88-page draft
report by the House of Commons subcommittee on health issues.
"The possibility that there are still HIV-infected persons who
contracted the virus from the blood system, and who are unaware
of their seropositive status, is extremely serious," said the
paper. The report, which is to be released to the public next
Tuesday, said that 200 people in Ontario alone may have
contracted HIV through transfusions and could be unaware of
their health condition. The report recommends that a program at
the Toronto Hospital for Sick Children, which contacts all
patients who received blood before mandatory testing for HIV in
November 1985, should be implemented in all hospitals in the
country. The draft report by the four-person subcommittee
advises the federal government to launch a sweeping public
inquiry into Canada's tainted-blood scandal, ensure that
compensation paid to victims be significantly increased, and
restore the complete blood system to give it a strong federal
presence. In addition, the report by the Commons subcommittee
condemned both the Canadian Blood Agency and the Canadian Red
Cross Society for not taking an active role in tracing
potentially infected blood recipients.


Cambridge Priest Reveals He Has AIDS *
Boston Globe (05/18/93), P. 21
Hart, Jordana

A Catholic priest from Boston, Mass., has disclosed that he is
HIV-positive, and has received the support of most of his
parishioners. Father William Cummings, 52, of St. John the
Evangelist parish, told his parishioners on April 25 in a
letter read by Bishop John Boles that he was diagnosed as HIV-
positive in 1985 and has developed AIDS. He added that he is
now fighting the disease but would most likely not be able to
return to the church. In the letter, Father Cummings did not
indicate how he contracted HIV. The Rev. Harold Lawson said
that while the church does not expect to offer any formal
program on AIDS, parishioners are being told that they can
speak with priests at the church about their fears and the need
for more knowledge about the disease. The Boston Archdiocese
disclosed in March 1992 that it has required HIV testing for
aspiring priests and nuns since 1989. But Larry Kessler of the
Boston-based AIDS Action Committee said the testing was
"borderline hysteria, homophobic, and outright discrimination."
Archdiocese spokesman John Walsh said at the time that the
testing was based on health concerns "and has nothing to do
with a stigma attached to homosexuality." It is unknown how
many priests are HIV-positive nationwide, but some researchers
have said the number is growing and signifies the number of
priests who stray from the church's insistence on celibacy.


Man Armed With Syringe Robs Stores *
Washington Post (05/19/93), P. C3
Castaneda, Ruben

Police in Washington, D.C., are searching for a man who has
held up six Safeway supermarkets in the city and has threatened
cashiers with a syringe that he claimed contained HIV-infected
blood. Police Lt. Alton Bigelow called the case "very unusual."
"I can't recall that happening in my four years in robbery,"
the lieutenant added. Investigators say they are uncertain
whether the red liquid witnesses reported seeing inside the
syringe is actually blood. All of the holdups, the first of
which occurred on April 20, took place between 11:22 a.m. and
10:30 p.m. Police refused to say how much money the robber has
stolen.


High Level of HIV Infection Found Among Young Gay Men *
United Press International (05/18/93)

(San Francisco) A disproportionate number of young homosexual
men in San Francisco are infected with HIV, according to a
study released Tuesday by health officials. Dr. Mitchell Katz,
head of the San Francisco Health Department's AIDS office, said
the findings demonstrated that a lot of effort needed to be put
forth to halt the spread of the disease. "The high rates of
HIV-infection, especially among African-American youth, and the
high rate of risk behaviors among young men having sex with men
in all ethnic groups indicates that the department needs
increased prevention campaigns aimed at youth," said Katz. "The
results are alarmingly high," he added. The survey involved 474
young men aged 17 to 22, and was conducted at dance clubs,
bars, and parks throughout the city and in Berkeley, Calif. The
study revealed that 9.4 percent of the homosexual young men who
participated were HIV-positive. Among the young gay men
infected, 21.2 percent were black, 9.5 percent were Hispanic,
8.3 percent were Native Americans, and 8.1 percent were white.
In addition, 33 percent said they had engaged in unprotected
sex. The San Francisco Health Department also estimated that
about 880 boys and men between the ages of 12 and 25 were
currently living with HIV in the city, but only 17 percent were
currently seeking treatment for the disease.


United Biomedical Approved to Begin International AIDS Vaccine
Trial *
Business Wire (05/18/93)

(Hauppauge, NY) United Biomedical Inc. (UBI) has been granted
approval by the Ministry of Health in the People's Republic of
China to launch clinical trials of its prototype synthetic AIDS
vaccine. The move makes UBI the first U.S. commercial
manufacturer to receive approval to conduct AIDS vaccine trials
internationally in HIV-negative volunteers. UBI began initial
Phase I safety trials of a synthetic vaccine representing a
highly immunogenic region of HIV with the National Institutes
of Health in February 1993. Due to the proven safety of the
vaccine, UBI has now extended its clinical trials to the Yunnan
Province of China, to examine small numbers of volunteers. Dr.
Wayne Koff, vice president for Vaccine Research and Development
at UBI, said, "UBI is committed to developing an effective AIDS
vaccine capable of protecting against globally diverse strains
of HIV and also capable of preventing against differential
modes of HIV transmission e.g. sexual, intravenous, and
maternal-fetal. The initiation of international trials
represents a major step in the clinical development of the UBI
synthetic AIDS vaccine, by enabling the company to obtain
significant safety and immunogenicity data in genetically
diverse populations where distinct global isolates of HIV are
known to be circulating." The UBI study in China and other
planned international trials provide the foundation for a
future large-scale, multi-national UBI trial targeted at
determining the efficacy of its candidate vaccine for
prevention of HIV infection and AIDS.


Liposome Encapsulated Cancer Drug Shows Enhanced Delivery in
AIDS-KS Patients; Significant Efficacy Demonstrated by Novel
Lesion Measurement Technique *
Business Wire (05/18/93)

(Orlando, FL) A new liposomal compound of the well-known anti-
cancer agent doxorubicin hydrochloride has been found to
deliver more drug to the disease site than standard therapy in
treating AIDS patients with Kaposi's Sarcoma (KS), according to
findings presented yesterday at the 29th annual meeting of the
American Society of Clinical Oncology (ASCO). The liposome-
encapsulated drug, called Doxil, showed significant efficacy in
KS patients as determined by the AIDS Clinical Trials Group
(ACTG) response criteria and, in some, by the use of ultrasound
volume measurements. Dr. Donald W. Northfelt and colleagues at
the University of California--San Francisco reported that
Doxil, Liposome Technology Inc.'s (LTI) proprietary long-
circulating Stealth liposome formulation of doxorubicin,
delivered five to eleven times more drug than single doses of
Adriamycin, which is free, unencapsulated doxorubicin. The
study, which involved 18 KS patients, demonstrated that Doxil
was well-tolerated by all subjects and had a safety profile
similar to that of Adriamycin at comparable doses. Stealth is a
second-generation drug delivery technology being developed by
LTI using a patented polyethylene glycol coating that enables
liposomes to circulate in the bloodstream much longer than free
drug. The longer circulation facilitates the delivery of higher
concentrations of the drug to specific disease targets. The
technology allows liposomes to remain relatively invisible to
the immune system, which often recognizes and destroys
conventional liposomes.


Sex Surveys Come Out of the Closet *
Science (05/13/93) Vol. 260, No. 5108, P. 615
Watson, Traci

The recently released survey on sexual behavior by Battelle
Human Affairs Research Center in Seattle has drawn a lot of
attention for its efforts in understanding human sexual habits.
The survey provided key figures about the numbers of sexual
partners and the prevalence of homosexuality. Because of the
conservative politics of the Bush administration, large studies
of this kind were stalled. But the Clinton administration seems
to have "a much more positive attitude towards this kind of
work," according to Joseph Catania, a psychologist at the
Center for AIDS Prevention Studies (CAPS) of the University of
San Francisco. Sevgi Aral, a sociologist at the Centers for
Disease Control, said the need to learn more about the
prevalence of various sexual behaviors in the United States and
about how it varies with age, ethnic group, and other factors
has profound scientific significance. Researchers say that by
studying sexual behavior, they hope to understand sexual
transmission of HIV. However, two large projects that might
have helped researchers were canceled in the past few years. In
1989, the pilot study for a survey of sexual behavior among
adults was ended when the Office of Management and Budget
refused to grant routine approval of the survey questions.
Also, a similar study of teenage sexual behavior was canceled
in 1991, in response to opposition from conservative lawmakers.
An extensive study involving 10,000-25,000 people would cost
about $15 million to $20 million, and since the National
Institutes of Health will divert only 13 percent of its $1.08
billion AIDS budget for prevention this year, it might be years
before researchers know enough about the sexual habits of
Americans.


Independent Introduction of Two Major HIV-1 Genotypes Into
Distinct High-Risk Populations In Thailand *
Lancet (Great Britain) (05/13/93) Vol. 341, No. 8854
Ou, Chin-Yih et al.

The waves of HIV-1 infection in Thailand among IV-drug users
and sexually infected patients may not be epidemiologically
connected, write Chin-Yih Ou et al. of the Centers for Disease
Control in Atlanta, Ga. The researchers sought to find the
genetic heterogeneity and epidemiological distribution of HIV-1
in Thailand, and determined proviral sequences for 63 HIV-1
infected patients in various risk groups from across the
country between April and July 1991. Two specific genotypes of
HIV-1, A and B, were found to segregate by mode of
transmission. Among 29 sexually infected patients, 25 (86
percent) had HIV-1 of genotype A and 4 (14 percent) had
genotype B. Of the 29 IV-drug users, probably parenterally
infected, only 7 (24 percent) had genotype A and 22 (76
percent) had genotype B. This segregation is unlikely to have
developed by chance. No patient was found to be dually
infected. Nucleotide divergence averaged 3.4 percent among
genotype-A-infected patients and 3.5 percent among genotype-B-
infected patients, but 22 percent between the genotypes. A
total of 37 of the 40 isolates (both genotypes) had GPGQ
tetrapeptide at the tip of the V3 loop, which is common in
African HIV-1 strains but rare in North American and European
strains, where the GPGR motif prevails. The presence of two
major distinct HIV-1 genotypes in Thailand provides a unique
opportunity to follow the natural history of infection by two
viral strains, to find out potential differences in progression
of disease, pathogenicity, clinical manifestations, and
transmission efficiency. The researchers conclude that
additional studies in Thailand and neighboring countries will
be useful in the design and selection of candidate AIDS
vaccines.


Worker Wins Fear of AIDS Suit *
Business Insurance (05/10/93) Vol. 27, No. 20, P. 62

For the first time, a federal court has held a company
responsible for causing an employee to fear that he has
contracted AIDS. Last week, a jury found the Long Island
Railroad liable for the unsafe working conditions that led John
Marchica to prick his finger on a used hypodermic needle in
1989. But the jury also held the plaintiff 55 percent liable,
stating that he should not have touched the garbage that
contained the needle. The railroad is appealing the $126,000
damage award.


May 20, 1993


TB Rates Kept Rising Last Year, Report Says *
Baltimore Sun (05/20/93), P. 15A

The prevalence of tuberculosis in the United States increased
for the fourth year in a row in 1992 for a total of 26,673
cases, says a report issued yesterday by the American Lung
Association. As reported to the Centers for Disease Control,
active cases of TB, in which people exhibit symptoms of the
potentially deadly disease, increased 1.5 percent in 1992 from
26,283 cases in 1991, said the report. During the American Lung
Association's annual conference, its president, Lee Reichman,
said, "TB is still the largest cause of death from any
infectious disease in the world." Following a 30-year decline,
active TB cases began to resurge in 1985.


People Still Fear AIDS From Blood Transfusions: Poll *
Reuters (05/19/93)

(Washington) Despite the extremely small chances of contracting
HIV through blood transfusions, about half of all Americans
fear they can become infected this way, according to a new
Gallup poll released Wednesday. The survey was conducted for
the American Association of Blood Banks and involved 1,002
adults. It found that fear of HIV continues even though about
eight out of ten respondents say the blood supply is safe. In
1985, the first poll taken for the association showed that only
44 percent of people said the blood supply was safer than it
had been in the preceding five years. The new poll found that
this statistic had increased to 78 percent. Although 79 percent
felt blood banks cautiously screen blood donors and test each
donation for HIV, as they do, 50 percent believed it is still
possible to contract HIV from a transfusion. Another 49 percent
believed this mode of transmission would be unlikely. Those who
believed one could contract HIV by donating blood accounted for
25 percent of respondents, whereas 75 percent believed it
unlikely. Arthur Silvergleid, president of the blood bank
group, and June Osborn, chairperson of the National Commission
on AIDS, told a news conference that the blood supply is the
world's safest but more HIV education is still needed for
potential donors. According to Silvergleid, the chance of
contracting HIV from a transfusion is only about one in
225,000. He added that there is not enough blood in the
nation's supply, and there are fewer donors than there were 10
years ago.


Hundreds Unknowingly Infected, HIV Experts Say *
Toronto Globe and Mail (Canada) (05/19/93), P. A6
Picard, Andre

Among the 1.5 million Canadians who received blood transfusions
between 1980 and 1985, several hundred could be infected with
HIV but unaware of their status, according to Canadian
activists and public health officials. Robert St-Pierre,
coordinator of the HIV-T program at the Canadian Hemophilia
Society, said there could be as many as 1,200 transfusion
recipients who are unknowingly infected with HIV. However, Dr.
Robert Remis, medical epidemiologist at the Montreal-based
Center for AIDS Studies, said the figure is probably between
200 and 400. The men agree, however, that there is an imminent
need for formal government guidelines on testing and that there
are probably tens of thousands of Canadians who received blood
prior to 1986 who should be getting tested for HIV to ensure
they get early treatment for the disease and do not transmit it
to sexual partners. The Commons subcommittee on health issues
is expected to recommend next Tuesday that the federal
government, "as a matter of urgency," establish a federal-
provincial committee to decide on the best way to inform
thousands of Canadians that they were been exposed to the
deadly disease through transfusions before the mandatory
testing of blood began in November 1985. Although a report by
the Commons subcommittee on health issues states that 1,395
Canadian blood-transfusion recipients may have been infected, a
Canadian Red Cross Society study shows that only one in 5,750
blood donations were tainted with HIV in the first year of
mandatory testing.


Some Doctors Lack Knowledge of Tuberculosis, Survey Finds *
Reuters (05/18/93)

(San Francisco) Despite the alarming resurgence of tuberculosis
in the United States, many doctors are unaware of the proper
procedures for diagnosing, preventing, and treating the
disease, according to a survey released on Tuesday at a
conference of the American Lung Association in San Francisco.
The survey involved 2,034 doctors from areas nationwide with
the highest rates of TB. Esther Sumartojo, a research
psychologist with the Centers for Disease Control, said that
approximately two-thirds of doctors who responded had current
patients with TB and 80 percent had treated at least one TB
patient at some time. About 75 percent of the doctors
responding to the survey were aware that there are official
recommendations for TB treatment and control, said Sumartojo,
but only 58 percent knew a recommended course of treatment when
questioned about their usual handling of the disease. In
addition, 7 percent of the respondents were not aware that TB
must be reported to the local health department. The study
found that 81 percent of the doctors surveyed said they would
prescribe preventive therapy for people at risk of TB. However,
65 percent of respondents would incorrectly interpret the
results of a skin test for TB, 15 percent would use incorrect
and unnecessary laboratory tests before starting preventive
therapy, and 5 percent prescribed an incorrect course of
preventive therapy. Moreover, only 47 percent of the physicians
said they consulted American Lung Association publications and
only 43 percent consulted CDC materials.


STD Clinic, AIDS Testing Face Closure at Beth Israel *
Boston Globe (05/19/93), P. 17
Knox, Richard A.

Due to a $250,000 yearly loss, a Boston hospital will close its
clinic for treatment of sexually transmitted diseases (STDs)
and a program providing anonymous HIV testing. Beth Israel
Hospital's decision has enraged some hospital workers,
patients, and public health advocates. Larry Kessler of the
Massachusetts AIDS Action Committee said, "This is a sign of
the times. We're probably going to see more of this kind of
thing all over the place as hospitals get more cautious." On
Tuesday night, Beth Israel officials emphasized that patients
with STDs will still undergo treatment at the hospital, but
their care will be dispersed among several clinics and a wide
range of doctors and nurses instead of being dealt with by
staff specializing in STD treatment. Those patients seeking
anonymous HIV testing will be referred to other health
facilities and state programs. People who are tested for HIV at
Beth Israel will have the results entered into their medical
records. Approximately 1,400 patients seeking HIV testing were
seen by the clinic last year. Michael Savage, director of the
Fenway health center, said his facility has a two-week waiting
list for anonymous HIV tests. "If we're seeing the private
hospitals back away from programming that is not profitable, it
really puts an inordinate amount of pressure on organizations
like us and we then have to turn to the state," said Savage. In
1990, Beth Israel lost its state funding but continued to
operate with a hospital subsidy, which its administrators
recently decided not to continue.


Group Seeks Forest Park Site to Remember AIDS Victims *
St. Louis Post-Dispatch (05/19/93), P. 3A
Yearwood, Lori Teresa

A memorial to AIDS patients has been proposed by St. Louis AIDS
Memorial Inc. to provide a place for people to come and
remember those who died of the disease. The nonprofit group
wants to spend as much as $40,000 to transform Forest Park in
St. Louis, Mo., into a memorial for local people who have died
of the disease. If the Board of Public Service and the city's
Heritage and Urban Design agency approve the project, activists
say, it would be the first AIDS memorial in the country
designed as a place for contemplation. Pending a review this
week of the final architectural design, the St. Louis parks
department has approved the project. If officials endorse the
design plan on Thursday, and the city follows, a ground-
breaking ceremony for the memorial could take place by July.
The memorial would consist of eight-inch slabs of granite with
the names and ages of St. Louisans who have died of AIDS. The
granite would be inlaid into walkways and the concrete plaza
where the gateway stands in the center. Austin Tao, the
architect who is donating his services to develop the memorial,
said that walkways would circle the gateway, each set apart by
small, grassy hills. Benches would be placed between the hills,
white oaks, and cherry trees. The outermost circle of trees
would represent the end of the AIDS epidemic. The St. Louis
Metro AIDS project reports that 1,740 AIDS cases have been
reported in the city since 1981, and half have died.


HIV in Europe *
Lancet (05/01/93) Vol. 341, No. 8853, P. 1146
Horton, Richard

The effect of the AIDS epidemic on the European community was
recently discussed at a conference in London, U.K., organized
by the British All-party Parliamentary Group on AIDS. Professor
Roy Anderson of London noted that nearly 95,000 cases of AIDS
have been reported across Europe since the epidemic began, and
over half of the AIDS patients have died. While a rise in AIDS
cases has been evident in all countries--an annual increase of
16 percent in 1992--France, Spain, Italy, and Germany have been
especially affected. The means of HIV transmission varies
greatly in these countries. For example, Spain and Italy have
large numbers of IV-drug users, while France and Germany have
significant homosexual and bisexual populations. Also, France
has the fastest growing heterosexual epidemic. Anderson
reported that there has been an extended median survival rate
from 10.4 months for 1979-80 to currently between 18 and 24
months. It is expected that the epidemic in Europe will be
multiwaved. Death among higher risk groups will increase soon;
deaths in low-risk populations will possibly peak in another
30-40 years. These predictions assume that messages about
condom use will be effectively disseminated in at-risk
populations. But data presented by Prof. Roel Coutinho
(Amsterdam, Netherlands) displayed a significant rise in rectal
gonorrhea, which indicates that safe sex messages are not being
heeded by newer generations of gay men. More information from
HIV screening studies is necessary to improve the accuracy of
these predictions about the epidemic's subsequent spread.


Tat Drug: Parallel-Track Negotiations Status *
AIDS Treatment News (05/07/93) No. 174, P. 4
Peck, David

Although Hoffman-La Roche is the only company with a tat-
inhibitor drug in human trials, it will not agree to a
compassionate release program for AIDS patients with Kaposi's
Sarcoma (KS) who have exhausted all other treatment options.
The tat-inhibitor drug prevents the HIV tat gene and the tat
protein it produces from replicating. Within the past five
months, ACT-UP/Boston has been negotiating with Hoffman-La
Roche to get the company to establish a compassionate release
program and develop a parallel-track program (to go into effect
if the trial results are promising), to enable some patients to
get the drug, RO 24-7429, before it is approved for marketing.
While the company realizes the tremendous need for access to
the tat drug, on April 16 Hoffman-La Roche stated that parallel
track cannot be implemented until fall 1993 at the soonest.
Gail Levinson of Hoffman-La Roche addressed the KS issue to
ACT-UP/Boston: "Currently there are no data available which
show the tat antagonist to be effective against Kaposi's
sarcoma. As you know, we will shortly be initiating a KS
protocol which will evaluate the drug's effectiveness against
the disease. The prospect of making the drug available on a
compassionate plea basis is unwise at this time given the lack
of data on the drug." She also addressed the parallel-track
issue, "As we reviewed in detail, the interim analysis of ACTG
213 showed no undue safety problems. However, we will not know
activity nor dosage information until this stage of the study
is complete and the data analyzed. We anticipate this activity
to be completed during the summer months." But the activists
complain that if activity data will be provided in June, there
is no reason to wait until the fall.


Children: NIH Begins First Pediatric Trial of Therapeutic
Vaccine *
AIDS Treatment News (05/07/93) No. 174, P. 7

The first trial of an HIV therapeutic vaccine for children is
currently being conducted by the U.S. National Institutes of
Health. The research is intended to determine if an HIV vaccine
can prevent children already infected with HIV from developing
full-blown AIDS. The study will involve children between the
age of one month and 12 years. The participants must have well-
documented HIV infection because many infants who test HIV-
positive are not actually infected. However, the children must
not exhibit any symptoms of HIV disease. Three vaccines will be
used: a gp160 vaccine by MicroGeneSys, a gp120 vaccine by
Genentech, and another gp120 vaccine (with a different
adjuvant) by Biocine, a joint venture of Chiron and CIBA-Geigy.
An adjuvant is a substance added to a vaccine to make it more
effective. In both groups of 15 children, 12 will be randomly
assigned to receive vaccine and three will receive a placebo
(the adjuvant only). If the vaccine is well-tolerated, a higher
dose will be administered to the next group of 15 children.
This trial is looking mostly for safety and immunological
information because it is too small to tell if one vaccine is
more effective than another. The research will be conducted at
12 locations in the United States with a total of 90 children
participating. Each participant will receive six immunizations-
-one a month for six months--and will then be followed up for
24 months after the last inoculation.


May 21, 1993


Liz Orbits Cannes: A Day of Hopeful Stargazing at Film Fest *
Washington Post (05/21/93), P. B1
Waxman, Sharon

A benefit for AIDS was held at the Cannes film festival
yesterday and was attended by actress and AIDS activist
Elizabeth Taylor. The Cinema Against AIDS event consisted of a
$2,500-a-plate dinner with proceeds going to help AIDS research
and prevention, and a special screening of Sylvester Stallone's
new movie, "Cliffhanger." Those attending the event included
Sylvester Stallone, Michael Douglas, Sir Ian McKellen, Phil
Collins, and Prince Albert of Monaco. In a press conference
before the event, Taylor urged the world to wake up to the
ongoing tragedy of what she called the AIDS "pandemic." She
said the money raised by the dinner would go to Nairobi and
Argentina through the American Foundation for AIDS Research
(AmFAR). The event was initially scheduled to feature a
screening of the new HBO film "And the Band Played On," based
on Randy Shilts' best-selling book about the history and
politics of AIDS. But the film, which features dozens of
celebrities, was not ready in time. It will, however, be aired
in the fall on HBO.


New Insight Into Flu Virus *
United Press International (05/20/93)

(Cambridge, MA) New discoveries into how the flu virus attacks
human cells may help scientists who are attempting to fight
other viruses, including HIV. Researchers from the Whitehead
Institutes for Biomedical Research in Cambridge, Mass.,
reported Thursday that the flu virus has a "spring-loaded" coil
that propels a key protein from the virus molecule to a
position where it can bind with human cell membranes. The key
protein, hemagglutinin, carries a segment of material--called a
"fusion peptide"--that fuses with the membrane of uninfected
cells. How it emerges from inside the virus to the infected
cells is still unknown. "The piece of [hemagglutinin] that
carries the fusion peptide is like a bent spring," said Chavela
Carr of the Massachusetts Institute of Technology, a co-author
of the report published in the journal Cell. "Two forces seem
to hold the spring in the bent position: the fusion peptide
itself, which acts as a hook at one end of the spring, and
another subunit of the [hemagglutinin] molecule that acts as a
clamp," said Carr. As the acidity level of the targeted cell
membrane declines, the spring straightens out, enabling the flu
virus to join it. Therefore, drugs that could prevent the
acidity level from changing might inhibit infection.
"Ultimately, this model could help in the design of new
antiviral drugs," said Dr. Peter S. Kim of the Whitehead
Institute, MIT, and the Howard Hughes Medical Institute. The
researchers are currently finding proof of similar patterns in
other viruses including HIV. "We're just beginning studies to
assess how general the process really is," said Carr.

New Yorkers With AIDS Number More than 50,000 *
United Press International (05/20/93)
Byron, Peg

(New York) New York City has become the first city in the
United States to be home to more than 50,000 persons with full-
blown AIDS, according to a report released Thursday by the city
Health Department. The official number of AIDS cases at the end
of April was 50,274. The disease was the leading cause of death
for both women and men between the ages of 25 and 44, with
33,743 deaths in the city attributed to the epidemic since
1981, said Health Department spokesman Steven Matthews. "That
is more than 100 deaths each week," he added. The numbers
represent a 53 percent increase in official cases as a result
of the expanded definition of AIDS implemented on Jan. 1, said
Matthews. Also, some cities may have greater increases because
they use lab-based reports on CD4 cell counts and infection
with HIV. AIDS cases in New York outstripped the number in
other leading cities by the end of 1992, when Los Angeles had
16,518 and San Francisco had 13,473, said Matthews.

Self Editor Proposes New Condom Etiquette *
Reuters (05/20/93)

(New York) The editor of Self magazine has written her own book
to help women address the issue of condom use during sex.
Alexandra Penney, editor of the health magazine, wrote the book
"How to Make Love to a Man (Safely)," which appeared in
bookstores this week. She said, "I propose a new condom
etiquette. I make the modest proposal to say 'Hey, women buy
your own condoms.' New etiquette. Women have 'em, guys." Penney
said women cannot depend on men to carry condoms in their
wallets and it is a woman's responsibility to have condoms in
her cosmetic case. "There are going to be discussions about
using them and there are graceful, charming, artful ways
without being aggressive or overly pushy," she said.
Approximately 100 men were interviewed as a part of Penney's
research on the book, and most of the men preferred that women
bring up the topic. "You have to bring it up in a non-sexual
situation. Otherwise it can be a real show stopper," said
Penney. When asked why she wrote the book, Penny said, "There
was no single place where information on healthy sex had been
put together in an acceptable, upbeat way. Everything sounded
like a clinical, scary physician's pamphlet ... I felt it was
something I had to do." In addition, she said, "There is no
option about condoms. You buy them and you use them. And you
make it fun."


Sodomy Suspect Claims to Have AIDS *
United Press International (05/20/93

(St. Louis) A suspect in a string of sex attacks on men in a
St. Louis, MO. park has told authorities he has AIDS. The
suspect was arrested about 1:00 a.m. Wednesday in O'Fallon
Park, where three incidents occurred over the weekend. Melvin
Johnson, of Washington Park, Ill., was charged with sodomy,
attempted sodomy, first-degree and second-degree robbery, and
stealing. According to police, Johnson denied the sex attack
charges but told them he was diagnosed as HIV-positive in 1985,
and now only has a year to live because he has full-blown AIDS.
Johnson's claims were being investigated by police on Thursday.
Authorities said they publicly disclosed Johnson's story
because they feared other victims might have been attacked but
too embarrassed to come forward. The police said any other
victims of such incidents should know about the chance that
Johnson has AIDS.


KS: DaunoXome Study Recruiting, Compassionate Use Also
available *
AIDS Treatment News (05/07/93) No. 174, P. 7

An experimental treatment for Kaposi's Sarcoma (KS) will be
used in clinical trials at nine U.S. locations. The phase III
trial will randomize patients to receive either liposomal
daunorubicin (brand name DaunoXome and made by Vestar Inc.), or
the conventional treatment ABV (adriamycin, bleomycin, and
vincristine). In order for a volunteer to be eligible, he or
she must have five or more KS lesions, but have never had
systemic chemotherapy. Liposomal daunorubicin is daunorubicin
encapsulated in liposomes--microscopic balls of fat. Liposomes
are key to targeted drug delivery because they can be designed
to be absorbed differently by various tissues. Liposomal
daunorubicin has been shown to deliver a higher concentration
of the drug to tumors or to KS lesions than free daunorubicin
with less toxicity, especially to the heart. The clinical
trials will be held in Chicago, Houston, Los Angeles, New York,
Palm Springs, Portland, San Francisco, Tucson, and Washington,
D.C. In addition, a compassionate use program of DaunoXome is
being started in Boston, Los Angeles, New York, and San
Francisco. Those who qualify for the compassionate use program
for advanced KS must have failed at conventional therapy and
have 25 or more lesions. Patients who participate are
responsible for paying the cost of laboratory and other tests
and drug administration. However, the drug itself is free of
charge.


Rapid Assessment of Drug Susceptibilities of Mycobacterium
Tuberculosis by Means of Luciferase Reporter Phages *
Science (05/07/93) Vol. 260, No. 5109, P. 819
Jacobs, William R. et al.

Luciferase phages or Mycobacterium tuberculosis strains
expressing luciferase genes may enable rapid screening of drugs
for anti-TB activity, write William R. Jacobs et al. of the
Howard Hughes Medical Institute in Bronx, N.Y. Due to the
emergence of multi-drug-resistant strains, it has become
increasingly important to rapidly detect patterns of drug
susceptibility. Drug susceptibility was examined by a simple
method based on the efficient production of photons by viable
mycobacteria infected with specific reporter phages expressing
the firefly luciferase gene. Light production was dependent on
phage infection, expression of the luciferase gene, and the
level of cellular adenosine triphosphate. Signals could be
detected within minutes after infection of virulent M.
tuberculosis with reporter phages. Culture of conventional
strains with anti-TB drugs, including isoniazid or rifampicin,
resulted in extinction of light production. But the light
signals continued to be produced after luciferase reporter
phage were infected with drug-resistant strains of TB.
Luciferase reporter phages may help to reduce the time needed
for establishing antibiotic sensitivity of TB strains from
weeks to days and to hasten screening for new anti-TB drugs,
the researchers conclude.


Ethnic Conflicts, Poverty, and AIDS in Ethiopia *
Lancet (05/08/93) Vol. 341, No. 8854, P. 1219
Eshete, Hailegnaw et al

War and poverty in Ethiopia, Somalia, and the Sudan has
contributed directly to the AIDS epidemic by creating
conditions that foster its spread and by impeding the necessary
attempts for its control, write Hailegnaw Eshete et al. of the
National Research Institute of Health in Addis Ababa, Ethiopia.
Ethiopia's longest war was in the northern part of the country
beginning in 1962 and lasting for 30 years, affecting the lives
of thousands of civilians, including women and children.
Ethiopia has had one of the largest armies of African
countries--about 250,000 personnel. Organized AIDS intervention
has not been possible especially in the war zone areas. The war
might have incited the spread of HIV in these areas, mainly
because military troops were vulnerable to HIV infection and
potentially capable of transmitting the virus from place to
place. Troops frequently did not adopt safe sex practices and
could have been exposed to HIV infection during emergency blood
transfusion without screening. Following the overthrow of the
government in June 1991, several troops were repatriated. Blood
screening was not performed before repatriation mainly because
of the large number of troops. Therefore, HIV infection is no
longer confined to urban areas. The rate of HIV infection and
AIDS in Ethiopia is growing at a disturbing rate. A total of
4,861 AIDS cases were reported by Dec. 31, 1992. Not enough
attention has been paid to AIDS education, with only slight
behavioral and attitudinal change. Anti-AIDS efforts in the
region also need to deal with the broader issues of war and
poverty, the researchers conclude.


Shedding Light on AIDS-Related Costs *
Business Insurance (05/10/93) Vol. 27, No. 20, P. 33
Johnson, Nancy

More than two-thirds of companies with 2,500 to 5,000 workers
and nearly one in 12 small companies have employed a person
with HIV or AIDS, according to Paul G. Farnham, a health
economist for the National AIDS Information and Education
Program at the Centers for Disease Control and Prevention. Drug
research and increasingly expensive health care drove up the
cost of treatment for one person with AIDS from $85,000 in 1991
to $102,000 in 1992, and the cost of treating one HIV-positive
individual from $5,100 to $10,000. Only 20 percent of the $67
billion the country spent on AIDS and HIV in 1991 went to
easily measurable, direct expenses such as insurance, short-
and long-term disability, premature life insurance payouts, and
businesses' recruiting, hiring, and training costs. The other
80 percent went to partially measurable expenses such as the
impact of the Americans With Disabilities Act, legal defense
against discrimination and privacy suits, and HIV/AIDS
education programs; as well as perception-based costs including
reduced productivity of coworkers of infected employees, lost
business due to customer concerns, reduced productivity from
workers caring for relatives with AIDS, and managers' lost
productivity due to dealing with AIDS-related issues.

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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