-----===[[[ A I D S w i r e  D I G E S T  06.28.93 ]]]===-----


Man Infected With H.I.V. by Florida Dentist Dies *
New York Times (06/28/93), P. A8

A man who contracted HIV infection from his Florida dentist has
died of an AIDS-related illness at the age of 33. The man,
Richard Driskill, died of pancreatic failure on Saturday,
according to his lawyer, Robert Montgomery. Driskill was one of
six patients known to be infected by dentist Dr. David Acer,
who died of AIDS in 1990. Driskill worked as a foreman at a
citrus plant, and was referred to Dr. Acer by his insurance
company. Once another patient of Acer's, Kimberly Bergalis,
publicly disclosed her infection, Driskill underwent testing
for HIV infection. He tested positive and subsequently sued the
insurance company, CIGNA Dental Health Plan of Florida, for an
undisclosed amount. Even though Dr. Acer tested positive for
HIV in 1986 and developed AIDS-related symptoms, he continued
to treat patients. Researchers at the Centers for Disease
Control determined that the strain of HIV carried by the six
patients matched Acer's strain. Public health officials claim
that Dr. Acer is the only doctor or dentist known to have
infected a patient with the virus. Since Kimberly Bergalis died
in 1991 at the age of 23, 57 other health-care professionals
have told the authorities that they are HIV-positive, and
19,000 of their patients have been tested. Not one patient has
contracted HIV from being treated by an infected health-care
worker, aside from the Acer cases.

Related Stories: Washington Post (06/27) P. A14; Philadelphia
Inquirer (06/27) P. B5.


Panel Is Probing Early Abbott AIDS Test *
Wall Street Journal (06/28/93), P. B6C
Burton, Thomas M.

An HIV test made by Abbott Laboratories in 1985 has been found
to be inaccurate in detecting the virus in donated blood,
according to congressional investigators. As a result, dozens
of unsuspecting patients may have received HIV-contaminated
blood, say investigators for the House Subcommittee on
Oversight and Investigations. In addition, investigators are
critical of the American Red Cross' continued use of the test
for months throughout 1986 despite evidence that other recently
introduced tests were more accurate. The Red Cross says it was
faced with a dilemma. Although it was aware of the difficulties
in the Abbott blood test, it believed any switch to a different
test could have led to more problems. Staff members of the
House panel, headed by Rep. John Dingell (D-Mich.), have said
that the subcommittee hopes to publish a report on the HIV test
this fall that calls into question the roles of Abbott and the
Red Cross. Also, several lawsuits have been filed against
Abbott, and at least one against the Red Cross, by people who
allegedly contracted HIV through blood transfusions while the
Abbott test was in use. The congressional inquiry found
internal documents from Abbott and the Red Cross that show that
a fierce internal debate emerged in 1986 at the Red Cross over
the Abbott blood test, which the Red Cross later decided to
continue using. It was not until January of 1987 that Abbott
introduced a refined HIV test that detected early phases of
virus more effectively than had the old test. The Red Cross
immediately adopted that version of the test.


Experts Change Guides to Using Drugs for H.I.V. *
New York Times (06/27/93), P. 1
Altman, Lawrence K.

An independent panel of federal AIDS experts has recommended a
major shift in the strategy for treating people with HIV
infection. The new recommendations, released Friday night after
a three-day meeting at the National Institutes of Health, allow
for more flexibility than existing ones. While the new
guidelines are not official federal health policy, they are
expected to strongly influence doctors' decisions. The new
rules reflect recent research such as the Concorde study, and
stress that patients and doctors should decide together about
when and how to treat HIV by concentrating on the patients'
views of drug treatment, personal health, and other factors.
The guidelines acknowledge that individuals respond to AZT
differently and that before starting AZT therapy in each case
there should be a full discussion of benefits and risks. The
panel said that treatment with AZT is no longer necessarily
advised for people with a low count of CD4 immune cells.
Patients with CD4 counts between 200 and 500 should start
taking AZT, according to the panel. Careful monitoring without
drug therapy is also recommended, the new guidelines say, and
AZT treatment can begin if a patient's condition changes or
laboratory tests show a depletion of the immune system. The
panel said that AZT should be the first-line drug to attack
HIV. For AIDS patients who experience progression of the
disease despite AZT use, the panel recommended switching from
AZT to ddI. The experts also cautiously advocated the use of
more than one anti-HIV drug, either in combination or in
sequence.


Into the Maelstrom: New Chief of AIDS Policy Considers the
Political Pitfalls That Await Her *
New York Times (06/27/93), P. 23
Hilts, Philip J.

President Clinton appointed Kristine M. Gebbie to the
controversial post of AIDS czar on Friday. Gebbie knows her job
will not be easy. "AIDS politics are always difficult," she
said. "The subjects you must confront are sex and drugs and
death and money. I don't come into the job with any illusions
that it won't be difficult at every step. But my job is to look
forward," added Gebbie. She served as the secretary of the
Washington State Department of Health for four years, and was
administrator of the Oregon Division of Health for 11 years.
Gebbie was also a member of the first National Commission on
AIDS during the Reagan administration. Daniel T. Bross, the
executive director of the AIDS Action Council, a Washington,
D.C.-based lobbying group, said, "Her appointment is good news.
What is most pleasing is that she comes from the medical and
public health community. That is an indication that this
administration is going to address AIDS as a public health
problem and not as a moral or political issue." Gebbie said
that prevention and education programs could be one of her
first priorities. However, addressing such issues will draw
heavy political fire, she said, adding that she would not
apologize if she turned out to be a compromiser. Dr. David
Rogers, co-chairman of the current National Commission on AIDS,
said, "She is a consensus builder and can succeed, but it is
absolutely dependent on whether the President gives this job
the authority it needs."


National Association of People With AIDS Statement on White
House Appointment of AIDS Policy Coordinator *
PR Newswire (06/25/93)

(Washington, DC) The National Association of People with AIDS
said in a statement Friday that it is pleased with President
Clinton's appointment of Kristine Moore Gebbie as White House
AIDS policy coordinator. The statement read, "The National
Association of People with AIDS (NAPWA) applauds the
president's fulfillment of his campaign promise to appoint an
AIDS policy coordinator at the White House. We believe the
appointment of Kristine Moore Gebbie as the senior government
official coordinating our nation's response to the HIV epidemic
is a crucial step in the campaign against this epidemic." In
addition, it said, "With each passing day that our nation fails
to address this issue, more and more people with AIDS are
turned away from needed health care, victimized, unjustly
fired, evicted, refused service, left homeless, or without food
and medicines. And every hour of every day, someone dies of
this disease." The statement also said that Gebbie has "shown
herself to be a tireless champion of action against AIDS,"
while serving as secretary of the Washington State Department
of Health. NAPWA concluded, "We are optimistic that through his
trust and support, the president will move quickly to address
our concern that this office be given the political means and
will to affect an AIDS agenda that is bold and compassionate."


Canada Court Allows Wife to Sue Bisexual Husband
Over AIDS Risk *
United Press International (06/26/93)

(Toronto) An Ontario provincial court judge decided that a
suburban Toronto woman can sue her estranged husband for more
than $1 million for putting her at risk of contracting HIV
because he neglected to disclose his homosexual activities.
Justice Alvin Rosenberg on Friday refused to dismiss a suit
filed by Sophia Bell-Ginsburg of Missassagua against Norman
Myron Ginsburg. The husband sought dismissal, saying the suit
was frivolous. Sophia Bell-Ginsburg said her husband, whom she
married in 1986, deliberately hid his homosexual activities
from her. The judge said the husband "knew his sexual practices
put him in a high-risk category for contracting AIDS yet he
deliberately concealed the nature and extent of his sexual
practices from Sophia." The couple are currently involved in
divorce proceedings, and Sophia has tested negative for HIV.
Rosenberg said the actions of the husband may prevent Sophia
"from establishing a normal relationship for the rest of her
life." The husband was described by Rosenberg as "in ill
health, the particulars of which are known only to him."


HIV Overlooked in Women *
Health (07/93-08/93) Vol. 7, No. 4, P. 18

HIV is three times less likely to be detected in infected women
than in infected men who are admitted to an emergency ward,
according to a study conducted by researchers from the Albert
Einstein college of Medicine in New York, N.Y. In an attempt to
determine the rate of HIV infection in the emergency room at
North Central Bronx Hospital, Drs. Ellie Shoenbaum and Mayris
Webber tested blood from 852 patients during three weeks in
1989. A total of 90 of the patients were infected with HIV, but
only 27 were identified after being evaluated by medical staff.
About 40 percent of the infected men were detected, whereas
only 17.5 percent of the HIV-positive women were identified.
Dr. Shoenbaum said, "It was astonishing. For everything we
looked at, women were disadvantaged." Physicians were more apt
to identify HIV infection by the AIDS-related symptoms
exhibited, which mostly occurred in men. Men were more inclined
than women to be asked about risky drug use, even though most
patients weren't asked about risk factors at all. HIV infection
was detected in men of all ages, but in women, it was
identified only between the ages of 25-44, possibly because
most infected women in New York City fall within that range.
The study indicates that more than men, HIV-positive women may
not be recognized during emergency care unless they already
have full-blown AIDS. However, if they'd been detected sooner,
the symptoms could have been delayed by earlier drug therapy,
concluded Shoenbaum.


Tyranny of the Red Ribbon *
Newsweek (06/28/93) Vol. 121, No. 6, P. 61
Peyser, Marc

The ubiquitous red ribbon that symbolizes AIDS awareness has
prompted debate among AIDS organizations about its
effectiveness. The ribbon has been displayed at virtually every
entertainment awards ceremony since it was first introduced in
1991. Recently, the AIDS ribbon was even given a tribute at the
Council of Fashion Designers of America Awards. Natasha
Richardson, the director of Visual AIDS, which created the
ribbon, spoke at the awards ceremony about how much "compassion
and awareness" the ribbon has generated. But one AIDS patient
claimed, "It was revolting. I felt like I was being packaged
into a neat little cause for people to pander to." The ribbon
was first introduced at the Tony Awards in 1991 by Broadway
Cares/Equity Fights AIDS. Since then, the red ribbon has been
made out of enamel, silk, and rhinestones. There are ribbon
earrings, mugs, Christmas ornaments, and even greetings cards.
However, some AIDS activists claim that the ribbon has lost its
meaning, and that it has become empty and commercialized.
Although no one disputes the ribbon's original goal of raising
AIDS awareness, critics contend that it has never convinced
Congress to spend more money on AIDS, and never saved a single
life. Still, some people consider the ribbon a source of both
financial and moral support for AIDS patients. Tom Viola of
Broadway Cares, said, "A ribbon by itself is frivolous, even
silly. But when coupled with activism, it works. It gets people
on board."


Agenda: Something Rotten in the Air *
Advocate (06/29/93) No. 632, P. 17

American Airlines' employee health plan discriminates against
people infected with HIV, according to recent protests by AIDS
activists. The company's health plan denies coverage to any
employee hired after Dec. 1, 1986 who has a preexisting medical
condition or any illness arising from that condition. Activists
say that American's health policy intentionally excludes HIV-
positive individuals. "When you have a policy like American's,
it's tantamount to having no coverage for HIV infection," said
Mike Isbell, an attorney for the gay group Lambda Legal Defense
and Education Fund. Jacques Chambers, benefits program manager
for AIDS Project Los Angeles, said, "If an insurance company
tried this, it would be struck down by the regulatory
authorities, but American can get away with it" because it is
self-insured. Chambers said his organization has intervened on
behalf of at least one HIV-infected employee of American.
However, American's spokesman Gus Whitcomb said the policy is
not discriminatory because it applies to all preexisting
medical conditions, not only HIV infection. A Supreme Court
ruling last year mandated that self-insurers, such as American,
are permitted to alter or restrict their health coverage at
will.


June 29, 1993


AIDS Panel's Final Report Repeats Pleas for Action *
New York Times (06/29/93), P. B7
Hilts, Philip J.

The National Commission on AIDS issued its final report, after
four years of work, which reemphasizes its request for the
federal government to establish a national plan to combat the
AIDS epidemic. The commission ended its work yesterday and said
it hoped that the Clinton administration would do a better job
of handling the epidemic than previous administrations. It also
commended the appointment of Kristine M. Gebbie last Friday as
the White House AIDS Coordinator. In addition, the
commissioners mentioned that the administration had asked for
the most significant increase in funds to fight AIDS--to $2.7
billion from $2.1 billion. However, the report said, "To date,
no opportunity has yet been found to discuss recommendations
sent to President Clinton upon his taking office." It also
said, "Our nation has continued on its shortsighted course.
Sadly, we must continue to report that America is still doing
poorly." The report indicated that the panel is still
advocating recommendations it made two years ago. Most of the
recommendations have not been followed, with some exceptions:
the government has expanded the criteria for full-blown AIDS to
include people who were previously considered to only be HIV-
positive, and the White House has just appointed an "AIDS
czar." The commission advised the government two years ago to
devise a single plan for the nation to combat AIDS, provide
treatment for drug abuse to all who need it, abolish any laws
that prevent drug users from obtaining clean needles and
bleach, and provide medical coverage to all citizens with the
cost of prescription drugs included.

Related Stories: Washington Post (06/29) P. A4; Los Angeles
Times--Washington Edition (06/29) P. A4; Philadelphia Inquirer
(06/29) P. A3; Baltimore Sun (06/29) P. 1A; USA Today (06/29)
P. 1D.


U.S. Will Relax Disability Rules in H.I.V. Cases *
New York Times (06/29/93), P. A1
Pear, Robert

The Clinton administration will release new regulations this
week to facilitate the process in which HIV-positive people
receive federal disability benefits, contradicting a decade of
more restrictive policy. The rules, being distributed Tuesday
to Social Security offices nationwide, come partly in response
to a lawsuit filed three years ago by 19 New York state
residents. The suit is pending before Federal District Judge
Miriam G. Cedarbaum in Manhattan. The plaintiffs, who are
seeking class-action status to allow the suit to include
thousands of people, have complained that they had been
improperly denied benefits even though they were unable to work
because of HIV-related illnesses. The new rules would allow for
many people who were denied benefits in the past to be eligible
automatically. AIDS advocates predict that 10,000 more HIV-
positive people may qualify under the new standards. More than
55,000 people with HIV now receive monthly cash benefits, at a
cost of more than $300 million a year. The new criteria for
evaluating HIV infection look for many conditions specific to
women, like pelvic inflammatory disease and cervical cancer.
Also, under the rules, people infected with HIV will be able to
qualify for benefits if they are found to have serious
illnesses like bacterial pneumonia and tuberculosis. In
addition to the specific criteria, there is a new catchall
category for people who show "repeated manifestations of HIV
infection," as well as a significant restriction in routine
activities of daily living or difficulties in completing work
in a timely manner because of inability to concentrate on a
specific task.


Government Panel on HIV Finds the Prospect
for Treatment Bleak *
New York Times (06/29/93), P. C3
Altman, Lawrence K.

Because of new findings about the efficacy of AZT, the outlook
for treating AIDS is disheartening. At a meeting at the
National Institutes of Health last week, most experts agreed
with the European "Concorde" study's conclusion that AZT is not
effective in treating early HIV infection. Dr. Merle A. Sande,
the chairman of the meeting and an AIDS expert at the
University of California--San Francisco, said regarding beliefs
that AIDS would gradually become treatable like other chronic
diseases, "Somehow, it clearly hasn't happened." He added, "We
are still quite a ways back, in the infancy, I hope, of being
able to treat this disease effectively." AIDS experts said one
of the reasons the outlook for AIDS therapy is bleaker than
previously thought is that they have been hampered by too many
variables in evaluating studies of AZT and its pharmacological
cousins, ddI and ddC. The studies frequently have different
criteria for entry, test different amounts of drug for people
at different stages of HIV infection and AIDS, vary in the
lengths of follow-up of volunteers, and set different criteria
for stopping the trials. Dr. Douglas D. Richman, an infectious
disease expert at the University of California--San Diego,
said, "All the studies are right, and the problem is how to put
all the pieces together into a clear picture," which is
impossible, "because all the pieces do not exist."


UCSF Will Be One of First California Sites to Participate
in National Study of AIDS in Women *
Business Wire (06/28/93)

(San Francisco, CA) The University of California--San Francisco
is one of four sites announced Monday to take part in a
national study of the effect of HIV infection in women. The
Women's Interagency HIV Study will last four years and will
research signs and symptoms in HIV-positive women. It will also
investigate the pattern and rate of depletion of their immune
systems, and the potential co-factors that may affect HIV
disease progression. The research at UCSF will be conducted by
Dr. Ruth Greenplatt, assistant professor of medicine with the
AIDS clinic. The other study cites named on Monday also include
the University of Southern California, Bronx-Lebanon Hospital
Center, and Georgetown University. The National Institute of
Allergy and Infectious Disease will appropriate $5 million to
fund the project. Researchers involved in the study will
collect information from about 1,700 HIV-positive women and 375
women who are HIV-negative but at high risk of contracting the
disease. Health and Human Services Secretary Donna E. Shalala
made the announcement about the project on Monday. She said,
"AIDS is now the sixth leading cause of death for women aged 25
to 44 in the United States." Approximately 11.4 percent of the
U.S. AIDS cases reported by March 31 in people older than 13
were among women, according to the Centers for Disease Control.


New York Telephone Will Award Monetary Grants to 23
Organizations Involved in Providing Service to AIDS Victims *
Business Wire (06/28/93)

(New York, NY) New York Telephone will provide monetary grants
to 23 organizations statewide that are involved in providing
service and care to AIDS patients. The recipients of the grants
will be recognized on June 30 at New York Telephone's
headquarters in New York City. The money awarded ranges in
value from $5,000 to $25,000, for a total of $270,000. Dick
Jalkut, president of New York Telephone, said, "It has become
painfully clear that the AIDS virus is a problem that crosses
all lines in our society today. This special event and grant
program brings together the corporate and nonprofit communities
throughout New York State that provide services to the men,
women, and children infected with the HIV virus and AIDS." New
York Telephone's AIDS contribution program was implemented with
the intent to fund organizations most closely serving the
populations affected by the disease. "The program is designed
to make a positive difference and improve the quality of life
of AIDS victims," said Jalkut. One of the groups receiving a
grant is the Herbert G. Birch Services in Queens, which sent
children with the disease along with their families to the
Fresh Air Fund's Hidden Valley Camp in upstate Fishkill.
Complete medical facilities are provided at the camp. Other
organizations receiving grants provide food and shelter to
homeless AIDS patients, offer counseling on housing and legal
issues, and sponsor dependent-care programs.


HIV Prevention Through Case Management for HIV-Infected
Persons--Selected Sites, United States, 1989-1992 *
Morbidity and Mortality Weekly Report (06/18/93)
Vol. 42, No. 23, P. 448

The spread of HIV can be curbed by HIV-prevention case
management--a one-on-one client service intended to assist HIV-
positive persons in receiving services that will prevent or
reduce high-risk behaviors, write the Centers for Disease
Control. This method allows HIV-positive persons to enter a
stable, ongoing medical-care system and supports prevention
goals by giving multiple opportunities to provide risk-
reduction information and to reinforce safer behaviors. Between
October 1, 1989 and September 30, 1992, the CDC and the Health
Resources and Services Administration funded three community
health centers (CHCs) to provide HIV early intervention
services within existing primary health-care programs. The
sites involved in the effort included Miami; New York City; and
Newark, New Jersey. The risk-reduction programs of each of the
three CHCs comprised the same standard components: HIV
counseling and testing routinely offered to all persons and
case-management services offered to HIV-positive people. A
follow-up visit was scheduled for persons after they received
HIV-test results and posttest counseling. During this visit,
the case manager administered a standardized questionnaire
about drug and alcohol use and sexual behaviors, provided
additional risk-reduction counseling, and developed a care plan
for necessary medical psychosocial services. Four to six months
after the first follow-up visit, clients were scheduled to meet
with the case manager and the behavioral questionnaire was
administered again. The findings suggest that a sample of HIV-
positive persons who received ongoing HIV-prevention case
management adopted and sustained selected safer sexual
practices during the six-month follow-up period.


Trends in HIV Prevalence Among Disadvantaged Youth *
Journal of the American Medical Association (06/09/93)
Vol. 269, No. 22, P. 2887
Conway, George A.

HIV prevention strategies should be targeted at the hard-to-
reach group of adolescents who are out of school and indigent,
write George A. Conway et al. of the Centers for Disease
Control in Atlanta, Ga. The researchers conducted an analysis
of demographic and geographic trends of HIV infection among Job
Corps students aged 16 to 21 years from January 1988 through
December 1992. Among the 269,956 Job Corps students screened,
812 (0.3 percent) tested HIV-positive. Seroprevalence of HIV
for young men decreased from 3.6 per 1,000 in 1988 to 2.2 per
1,000 in 1992. The rate of HIV among young women increased from
2.1 per 1,000 in 1988 to 4.2 per 1,000 in 1990, with
seroprevalence remaining stable from 1990 through 1992. The
decreasing trends in the rate of HIV among men and increasing
trends among women were primarily a result of changes in the
seroprevalence in African-American students. The substantial
rise in HIV rates among female Job Corps students provides
proof of the increasing risk of infection for socioeconomically
disadvantaged young women. Reasons for the declining trend in
the rate of HIV among male Job Corps students are unclear.
Anti-HIV interventions that increase access to HIV counseling
and testing, drug counseling and treatment, and employment
opportunities will be essential in reducing the impact of HIV
on high risk adolescents in the United States, the researchers
conclude.


The Completeness of AIDS Case Reporting in New York City *
Journal of the American Medical Association (06/16/93)
Vol. 269, No. 23, P. 2995
Greenberg, Alan E. et al.

The New York City AIDS surveillance system was effective in
tracking the epidemic's spread during its first decade, write
Alan E. Greenberg et al. of the Centers for Disease Control in
Atlanta, Ga. The researchers identified adults and adolescents
with AIDS or with illnesses suggestive of AIDS using both
population-based and nonrandom sampling techniques. These
people were matched with the NYC AIDS case registry and the
medical records of nonmatching persons were reviewed to
determine whether they met the 1987 CDC's AIDS surveillance
case definition. Among the 7,015 persons with AIDS identified
in the five projects, 5,912 (84 percent) had been previously
reported. The completeness of reporting ranged from 81 percent
to 87 percent in all major gender, race/ethnicity, risk,
borough of residence, and age subgroups. The study found that
the odds of being unreported were substantially higher among
outpatients in hospital clinics, out-of-state residents,
persons with diagnosis other than Pneumocystis carinii
pneumonia, and persons recently diagnosed with AIDS.
Completeness of reporting studies is an essential part of AIDS
surveillance, providing data that are critical for determining
the validity of the AIDS surveillance database, the researchers
conclude.


June 30, 1993


Rules Are Set for Granting Benefits on AIDS Virus *
Wall Street Journal (06/30/93), P. B

The Social Security Administration disclosed rules that are
aimed at expediting the procedure in which benefits are given
to people infected with the HIV virus. As with the interim
regulations issued by the outgoing Bush administration, the new
rules list symptoms connected with aids that will automatically
qualify individuals for disability benefits. Included in the
list are several gynecological conditions and serious
infections like tuberculosis. In addition, the rules add a new
category that qualifies people who suffer from "functional
limitations" from HIV that restrict their day-to-day activities
at home and at work.

Related Story: Baltimore Sun (06/30) P. 12A.


Don't Ask to Be on AIDS Coordinator's Staff *
Washington Post (06/30/93), P. A19

The nation's new AIDS coordinator, Kristine M. Gebbie, formerly
Washington state's health official, revealed to the Fox network
on Tuesday that her staff will be "very small, four or five
people at the maximum." Gebbie also said that she approved of
needle exchanges for drug addicts as a means of stemming the
spread of the disease, but did not encourage condom
distribution in schools. She explained that condoms should be
accessible to "anybody who is sexually active," but that the
question of school distribution is a local decision.

Related Story: Baltimore Sun (06/30) P. 12A.


Victims Reject Blood Deal *
Toronto Globe and Mail (Canada) (06/29/93), P. A7
Picard, Andre

People in Quebec who were infected with the AIDS virus because
of Canada's tainted-blood scandal have strongly rejected a $10-
million provincial compensation plan. Claire Desrosiers,
executive director of the Quebec division of the Canadian
Hemophilia Society, announced yesterday that 95 percent of the
172 people who responded to a questionnaire rejected the
proposal earlier in June. Over 1,000 people became infected
with the HIV virus through blood and blood products before
compulsory testing of donated blood began in 1985, following an
eight-month delay. Approximately 100 of those people are now
deceased. So far, only Quebec and Nova Scotia have implemented
compensation programs. But whereas the Nova Scotia plan
provides victims with $30,000 tax-free each year, as well as
reimbursement for AIDS drugs not covered under the provincial
health plan, the Quebec plan will give victims and their
families less than $13,000 per year, and will be provided only
if the victims are deemed in "desperate need."


North American Biologicals to Supply HIVIG For... *
PR Newswire (06/29/93)

(Miami, FL) North American Biologicals Inc. (NABI) announced
Tuesday that its Immunotherapy Division has won a contract to
supply the National Heart, Lung, and Blood Institute of the
National Institutes of Health with HIVIG. The institute will
use HIV Immune Globulin in a clinical trial to test its
efficacy in preventing the transmission of HIV from HIV-
positive mothers to their unborn infants. NABI will be the only
supplier of the hyperimmune globulin in the Phase II trial, and
the company may use data from the trial in its Product License
Application for HIVIG, which has received FDA's Orphan Drug
status. The National Heart, Lung, and Blood Institute, the
National Institute for Child Health and Human Development, and
the National Institute of Allergy and Infectious Diseases are
collaborating on the clinical trial, which will be held at more
than 40 centers across the country. NABI Chairman, President,
and CEO David J. Gury noted, "There are strong indications that
the antibodies produced naturally by HIV-positive donors, when
properly isolated and prepared from their plasma, will be
effective in preventing HIV infection in newborns." NABI owns
all rights to HIVIG, which is derived from the plasma of HIV-
antibody-positive donors who have strong immune systems and
response to HIV. The plasma is treated to inactivate the virus,
and the plasma antibodies are purified and concentrated.


Nation Editorial Sampler: What Newspapers Are Saying *
United Press International (06/30/93)

President Clinton's willingness to support the politically
touchy recommendations from his AIDS-policy coordinator,
Kristine Gebbie, will determine her success in the position,
write the editors of the Seattle Times. While Gebbie will
encounter a number of obstacles, she has the training,
experience, and personality for the job. Gebbie, trained as a
nurse, was Washington state and Oregon's top public-health
officer, and served on the Reagan administration's national
AIDS commissions. In order to succeed in her present position,
Gebbie needs more than Clinton's general support for greater
AIDS research funding. Clinton, in order to support Gebbie and
make headway against the disease, must prepare for
controversies over spending, research, needle exchanges, and
advertising campaigns. Clinton's commitment to fighting AIDS
will determine Gebbie's success, the editors conclude.


1992-97 AIDS Projections for England and Wales *
Lancet (06/19/93) Vol. 341, No. 8860, P. 1589
Horton, Richard

While a plateau is expected in the overall incidence of AIDS in
England and Wales, there are varying predictions for each
exposure category. Prof. N.E. Day and colleagues estimate there
will be between 1,945 and 3,215 new AIDS cases by 1997.
Projected annual numbers of AIDS cases for 1997 in each of the
main exposure categories are: homosexual males--1,350; IV-drug
users--165; and heterosexuals--770. Day et al. estimated that
there were about 23,400 HIV-positive people living in England
and Wales by the end of 1991. The annual incidence of AIDS
among homosexual males is expected to plateau in 1994 in line
with a peak annual incidence of HIV-infection in 1983-84. Of
IV-drug users, the peak in HIV prevalence took place in 1985;
consequently, the increase in AIDS cases is still occurring.
For heterosexuals up to 1991, the peak of HIV infection had not
yet been reached, so it can expected that a continued rise in
the annual incidence of AIDS cases will occur for some time.
The population of those with HIV who acquired it heterosexually
from a partner who had also been infected heterosexually is
slowly growing. The United Kingdom Department of Health says
that its AIDS prevention policy is responsible both for the
reduction in projected new cases among IV-drug users and the
additional knowledge about heterosexual exposure. But Day et
al. attribute the changes to more detailed and reliable data
collection, along with better statistical methods.


Researchers Debate Timing of AZT Treatment *
American Medical News (06/21/93) Vol. 36, No. 23, P. 4
Staver, Sari

Even though there is new evidence indicating that early AZT
treatment does not prolong the onset of full-blown AIDS, two
leading AIDS researchers claim that it may be preferable to
start treatment with the drug even earlier than previously
recommended. At a recent American Medical Association symposium
on early HIV intervention, physicians debated the clinical
implications of the new data, which come from two of the
longest trials comparing early AZT treatment with delayed
monotherapy. The controversial trials were the "Concorde," a
collaborative effort between researchers in the United Kingdom
and in France, and the U.S. Veterans Administration's Study
298. Both studies compared early and delayed AZT treatment, but
the Concorde study researched asymptomatic patients at all CD4
levels, while the VA study included only symptomatic patients
with CD4 levels of 200 to 500. But Dr. Robert Walker, of the
National Institute of Allergy and Infectious Diseases, said he
personally believes HIV-positive patients should consider
beginning therapy immediately upon diagnosis. He mentioned
several recent laboratory studies that show active HIV
replication takes place from the earliest stages of infection.
In addition, Dr. Paul M. Volberding, director of the AIDS
program at San Francisco General Hospital and a principal
investigator of a large trial of early AZT treatment, said he
would "be tempted" to begin antiviral therapy in a patient with
an acute HIV infection. He said the benefits of early treatment
include lower toxicity rates, less chance of developing
resistant virus, and longer duration of benefit from the
antiviral drugs.


Surge in First-Quarter AIDS Cases Not Expected to Continue *
AIDS Alert (06/93) Vol. 8, No. 6, P. 81

Although there was a 204 percent increase in AIDS cases
reported since the implementation of the new federal AIDS
surveillance definition, it is not expected to continue, say
health experts. The number of AIDS cases reported in the United
States during the first quarter of 1993 rose to 35,779, a 204
percent increase from the 11,770 cases reported for the same
period last year. But health experts say the large and sudden
increase was anticipated and should have little effect on
clinical care. The CDC implemented the new definition on Jan.
1, 1993. It added CD4 counts of less than 200 and three
diseases: pulmonary tuberculosis, recurrent pneumonia, and
cervical cancer, to the list of criteria. The CDC estimated a
total of 85,000 to 90,000 new cases in 1993, or a 75 percent
overall increase over 1992, dropping to 10 percent to 20
percent in 1993. The agency estimated that about 50 percent of
the new cases reported in 1993 would come from the expanded
definition. If the rate of cases reported in the first quarter
were sustained throughout the year, about 140,000 new cases
would be reported, increasing the cumulative number of AIDS
cases reported since 1981 by 50 percent. But Dr. John Ward,
director of AIDS surveillance for the Centers for Disease
Control, says the rate will decrease substantially, and the 75
percent annual projection will be more out of line.


July 1, 1993


Researchers on AIDS Find a Use for Thalidomide *
New York Times (07/01/93), P. A13
Altman, Lawrence K.

The once-banned sedative thalidomide is now being investigated
for use in treating AIDS, tuberculosis, and other maladies.
Thalidomide was banned in the early 1960s after it was found to
cause deformed limbs in the children of women who took it early
in pregnancy. But in a report published today in the
Proceedings of the National Academy of Sciences, researchers
said that thalidomide could inhibit the growth of HIV in test
tubes and that in very limited tests of humans it seemed to
alleviate some of the severe symptoms of AIDS. The researchers
reported that thalidomide works in laboratory experiments
against HIV by selectively suppressing a natural substance
produced in the body. The substance, tumor necrosis factor,
also called cachectin, defends against infection, and is
believed to play a key role in inciting the progression to
full-blown AIDS. Cachectin is released by white cells during
infection and serves as a hormone in the immune system by
acting on other cells to combat an invading organism. Dr. Gilla
Kaplan, who headed the team of researchers from Rockefeller
University and New York Hospital-Cornell Medical Center, said
that in the laboratory, thalidomide significantly slowed the
growth of HIV when added to cultures of the virus taken from
patients at Bellevue Hospital and New York Hospital. The
patients did not take thalidomide. In another study, the drug
was given to patients with TB, some of whom had HIV infection.
Due to the apparent relief of AIDS-related wasting symptoms,
Dr. Kaplan said her team had started another study to give
patients thalidomide for two weeks, then stop for a period, and
later resume treatment.

Related Story: Philadelphia Inquirer (07/01) P. A8.


Novello Satisfied With Fight She Waged Against AIDS *
Washington Times (07/01/93), P. A4
Price, Joyce

Dr. Antonia Novello, who resigned Wednesday as U.S. surgeon
general, claims that she made significant steps in controlling
the AIDS epidemic, and becomes irritable when anyone indicates
that she was not as aggressive as her predecessor, C. Everett
Koop. "We were counting patients with AIDS when Dr. Koop was
surgeon general, and there were 29,000," said Dr. Novello. "As
of today, there have been 289,000 people with AIDS, and we're
caring for many patients. There's much more treatment today,"
she added. In 1989, President Bush appointed Dr. Novello, a
pediatrician, to a four-year post as surgeon general. At the
time she was nominated, she served as deputy director of the
National Institute of Child Health and Human Development. While
in that position, one of Dr. Novello's biggest concerns was
AIDS. In addition, she said that the disease was fast becoming
one of the leading killers of children. However, she left after
three years and three months to take a job with UNICEF and to
allow Dr. Joycelyn Elders, another pediatrician, to take over.
Dr. Novello released what she considers a "timely, accurate,
and sensible" report on AIDS three weeks ago, which was
presented at the Ninth International Conference on AIDS in
Berlin. It recognizes that "sex and drugs are facts of life,"
and provides instructions on condom use and the need for
intravenous drug users to keep their needles clean. Regarding
her AIDS report--the first by a surgeon general in seven years-
-Dr. Novello said, "I must prevent if I cannot cure. And in
1993 there is no magic bullet, no magic cure for AIDS. But what
I can do is to prevent the [HIV] infections of the 130 people
who are becoming infected each day" in the United States.


Burroughs, Rivals Clash as AZT Trial Opens *
Investor's Business Daily (07/01/93), P. 35

The role of government researchers in the development of the
anti-AIDS drug AZT was disputed yesterday by attorneys for
Burroughs Wellcome and two companies fighting to enter the
market for the drug. The debate emerged after opening
statements in a patent-infringement lawsuit that could lead to
less-expensive generic version of the drug that Burroughs
Wellcome now sells exclusively. Thomas Curnin, lead attorney
for Burroughs, told a federal jury that researchers from the
National Institutes of Health did little under the authority of
company scientists. But Dan Webb, representing Barr
Laboratories Inc., said Burroughs researchers would not have
known that their research on AZT was successful without the
help of NIH scientists. Tests on mouse viruses yielded clues
that would have led to a dead end if doctors Samuel Broder and
Hiroaki Mitsuya of the NIH hadn't risked infection and tested
AZT on live samples of HIV, said Webb. Determining when a
"definite and permanent" concept of using AZT against HIV
emerged and who developed the concept is crucial to deciding
the legitimate inventors. Burroughs filed a lawsuit against
Barr and Novopharm Ltd. after the two generic drug companies
applied for federal permission to manufacture AZT. The generic
drug firms allege that AZT was developed with the assistance of
public funds and research, while Burroughs contends that its
patents give it a monopoly on the drug until the year 2005.


AIDS Coordinator *
Associated Press (06/29/93)
Vernaci, Richard L.

(Washington, DC) The newly appointed federal AIDS coordinator
indicated that she supports needle-exchange programs but shied
away from endorsing condom distribution in schools. Kristine
Gebbie, appointed by President Clinton last week as the "AIDS
czar", said she has been given "clear authority to work across
the Cabinet" on federal efforts to deal with the epidemic.
Gebbie said her staff will be small, but it didn't bother her
because her job "isn't about building bureaucracy." She also
said she expects to concentrate the government's efforts by
getting different parts of the bureaucracy to work with each
other. "A lot of people within agencies are concerned about our
failures to be truly coordinated and to move as aggressively as
we should have," she said. Gebbie suggested that the government
planned to take a more liberal approach concerning education
and needle exchanges. "They do work in some communities," she
said about needle exchanges. "We're looking forward to a major
review of needle exchange programs due out in a very short
period of time," Gebbie added. "Anybody who is sexually active
should have ready access to means of protection, which includes
condoms," she noted, although she added that the decision to
distribute condoms in schools should be made locally. Shortly
after Gebbie was appointed, the National Commission on AIDS
issued a report criticizing the administration for its slow
action in dealing with the epidemic. Administration officials
now say that new action on the AIDS front will be taken soon.


'Dr. Peter' Shows Nobility in the Face of AIDS *
USA Today (07/01/93), P. 3D

Tonight HBO will air one of four of "The Broadcast Tapes of Dr.
Peter," an informative first-hand chronicle of the devastation
that AIDS causes. Dr. Peter Jepson-Young, a gay physician,
received much praise in Canada for his televised video diary
that chronicled his progressively intense battle with AIDS.
Four years into treatment when his TV experiment starts, Dr.
Peter lets the audience know that he is starting to lose his
sight. By the second video tape, he has lost his vision. He
recounts his plight calmly, and without anger or self-pity.
When he shows a few Kaposi's sarcoma (KS) lesions on his legs,
he says, "AIDS is not a focus in my life. It tends to be a bit
of a nuisance." Aside from his loss sight and the KS,
"Generally, I'm pretty healthy," he said. Dr. Peter presented
his non-preachy updates on AIDS--aired in Canada from July 1990
through November 1992--with dry humor. He always displays a
positive attitude in the tapes, and the audience must search
for clues of his depleting physical health. Even when he
discusses how other friends who have fallen seriously ill in a
short period of time, he emphasizes that it's "difficult not to
be pessimistic sometimes." Although Dr. Peter tells more about
AIDS than he shows, his intention was to humanize the disease
for the masses.


Studies on Male Sexual Behavior: Safe Sex Not
an Accepted Practice *
AIDS Alert (06/93) Vol. 8, No. 6, P. 88

Anti-HIV messages are not being heeded by Americans, especially
men, according to three studies recently released. The most
significant of the three studies is the National Survey of Men,
published in the March/April issue of Family Planning
Perspectives. The study involved 3,321 men ages 20-39 who
participated in face-to-face anonymous interviews throughout
1991. The findings show that although most men know of the
devastation that AIDS causes, awareness about the disease has
had little effect on sexual behavior. Most of the respondents
(55 percent) believed that the rate of AIDS in their community
was lower than the national average. The majority (60 percent)
also believed they had no chance of contracting HIV. And while
several men agreed that using a condom exhibits one's concern
about AIDS, they also agreed that using a condom makes a
partner think they are more likely to have AIDS. Another survey
of 458 Boston University students found that 72 percent failed
to use a condom during sexual intercourse. But the students
stated that they would use condoms if they were more available
on campus. The AIDS Action Committee of Massachusetts conducted
the study, which also revealed that despite a high level of
knowledge about HIV, nearly eight of 10 sexually active
students said they did not use a condom regularly. A survey
conducted by researchers from the University of California--Los
Angeles found that among the 5,153 juveniles incarcerated in
the city, 68 percent of the teens said they did not use
condoms. Teenagers who used condoms were more likely to carry
them all the time, and those who drank hard liquor used them
less frequently.


Fort Lauderdale Hospitals Help AIDS Patients Shift
to Home Care *
AIDS Alert (06/93) Vol. 8, No. 6, P. 92

A hospital district in Fort Lauderdale, Fla., has reduced the
average length of a hospital stay for its AIDS patients by
seven days. The North Broward Hospital District has used a
creative mixture of 10 case managers, Ryan White funding, an
AIDS Medicaid waiver program, and various community services to
help AIDS patients have shorter stays at its hospitals. Sharon
Barnwell, RN, HIV supervisor for the four hospitals that
comprise the district, said that the home case management
department has quadrupled in size in three years. This is due
to increased pressure from taxpayers to become more efficient
in treating its AIDS patients, most of whom are poor or have
used up all of their benefits. Consequently, the average length
of stay for AIDS patients has dropped from 21 to 14 days as the
district's 10 AIDS case managers help the patients make the
transition from hospital to home. And as community-based
services have improved and several AIDS groups have begun
working together, the options for AIDS patients have increased
substantially. Approximately 200 patients treated at the
district's hospitals last year received alternative care at
home. About 140 of those patients were eligible for the state's
"Project AIDS Care," an AIDS waiver program that allows home-
treated AIDS patients to be covered by Medicaid. The AIDS
waiver program can provide up to $1,300 a month for various
home care services. However, case managers frequently have to
search for other funding sources to meet costs, which can be as
high as $3,000 a month. Barnwell said that as a response to the
increase in home care, the district also opened a comprehensive
outpatient clinic in April specifically for AIDS patients.


Transmission of Drug-Resistant Virus Raises More Questions *
AIDS Alert (06/93) Vol. 8, No. 6, P. 84

Researchers have reported a sexually transmitted case of drug-
resistant HIV infection for the first time. Even though it is
too early to know whether this is a common occurrence, the new
finding intensifies the debate over early antiretroviral
treatment and emphasizes the virulence of the mutated virus,
say researchers. The case was reported in the New England
Journal of Medicine in April by University of Minnesota--
Minneapolis researchers who describe a 20-year-old homosexual
man infected by an HIV-positive partner. He soon developed a
three-month, acute retroviral infection that did not respond to
AZT treatment. Alejo Erice, lead author of the study and
associate professor of medicine at the University of Minnesota-
-Minneapolis, said, "This confirms that resistant viruses are
pathogenic--that is, they are able to produce disease." Keith
Henry, director of the HIV program at St. Paul-Ramsey Medical
Center in Minnesota, said, "So far it seems safe to say it
doesn't appear to be real common," adding that most HIV-
infected Americans were infected before AZT became available in
1987. The virus isolated from the patient after he was
administered AZT had a significantly higher level of resistance
than the virus obtained before he was given the drug. That led
researchers to speculate that AZT may have selected drug-
resistant viruses and hastened progression of the disease. Both
Erice and Henry agree that their findings will incite
additional study. The Minnesota researchers have already
requested that a nationwide study be conducted by the AIDS
Clinical Trials Group.


July 2, 1993


FDA Moves to Strengthen Blood Bank Quality Control *
Washington Post (07/02/93), P. A2
Schwartz, John

The Food and Drug Administration announced yesterday that it
will implement new regulations to ensure the safety of the
blood supply. The rules are designed to enhance quality control
for blood banks and to set new standards for record keeping so
that potential HIV-positive donations can be tracked and
identified more easily. The guidelines call for blood banks and
other suppliers of blood and blood products to develop strong
quality assurance programs and employee training and competency
evaluation programs. A new requirement that the guidelines
incorporate is that blood centers must use a consistent "look
back" policy. Blood centers currently have to retrieve and
quarantine all blood from repeat donors found to be HIV-
positive. The new regulations would facilitate communication
between different institutions about problem donors. The rules
would lso force hospitals to inform patients who received blood
from donors who subsequently tested HIV-positive. Food and Drug
Commissioner David A. Kessler said the new rules are designed
to provide enough layers of protection to make the system safer
than it already was. He said, "The days are long gone when
collecting and providing blood was a simple operation. The
bottom line is a safer product and better assurances of
quality." After the guidelines are published in the Federal
Register, there will be a 60-day period for evaluation and
public comment. If the FDA does not take any additional action,
the rules will be put into effect in September.

Related Stories: New York Times (07/02) P. A11; Baltimore Sun
(07/02) P. 10A.


AIDS is Claiming More Young Lives *
Baltimore Sun (07/02/93), P. 10A

AIDS has become the second-leading killer of young men in the
United States, surpassing heart disease and cancer, according
to a report released Thursday by the Centers for Disease
Control. The federal agency said in its weekly report that AIDS
is also closing in on unintentional injuries, such as car
accidents, as the leading cause of death in men ages 25 to 44.
Last month, the CDC reported in the Journal of the American
Medical Association that AIDS was the No. 1 killer of young men
in 64 American cities and five states. The CDC said yesterday
that in 1991, the most recent year for which data are
available, young black men died at three times the rate of
whites as a result of AIDS. The death rates among Hispanics was
twice that for whites. Dr. Peter Drotman, assistant director of
public health in the CDC's AIDS division, said the agency is
not sure whether the death rate among ethnic minorities
indicates significantly higher infection rates, lack of access
to health care, or both. "This study is based on data taken
from death certificates, which doesn't tell us much about
socioeconomic status," said Dr. Drotman. "I'm sure if we had a
study that measured ability to obtain insurance and access to
medicine, we'd have better measures of that," he added. The CDC
reported that AIDS deaths were drastically increasing during
1990 and 1991, even though most leading causes of death among
young men and women remained relatively constant. Moreover,
among women, it seems AIDS will move from the sixth-leading
cause of death in 1990 to the fourth in 1991, surpassing
suicides and homicides and trailing behind only cancer,
unintentional injuries and heart disease.


Protesters Hold Capitol Funeral With Corpse of AIDS Victim *
Washington Post (07/02/93), P. C2
Kovaleski, Serge F.

Members of ACT-UP convened yesterday outside of the Capitol to
conduct a "political funeral" for a fellow activist who died of
AIDS. One of Tim Bailey's last wishes, those who knew him say,
was to have his dead body thrown onto the White House lawn in
protest of the lack of aggressive federal action against the
AIDS epidemic. But officials of ACT-UP, which organized the
funeral, said it would be too disrespectful to Bailey to throw
his body onto the lawn. Therefore, friends and colleagues paid
homage to Bailey in front of the White House while his body lay
in a coffin in a nearby van after being driven to the District
from New York. Police predicated that about 60 protesters
attended the afternoon funeral, but organizers said more than
100 people were present. Bailey's brother, Randall Bailey, and
another man were arrested after allegedly arguing with police
officers, who prevented them from pulling the coffin out of the
van, said authorities. Sgt. Dan Nichols said that ACT-UP had
planned to conduct a funeral procession from the Capitol to the
White House, but had not gotten the necessary permits.
Following a long standoff with police, the demonstrators were
told they would be able to conduct a procession, but not until
after the rush hour ended at about 6:30 p.m. Nichols added that
the activists gave a few speeches eulogizing Bailey, but did
not conduct the procession.


Calling Attention to the Need for AIDS Prevention and a Cure *
PR Newswire (07/01/93)

(New York, NY) The nine-member team of Princeton University
students who began a climb of Alaska's Mt. McKinley on June 17
as a means of raising AIDS awareness is making steady progress
to the summit of 20,320 feet. The "Climb for The Cure" was
delayed for two days after there was a shift in weather
patterns. But the effort has already achieved one of its goals-
-drawing attention to the need for AIDS prevention among 13- to
24-year-olds. In the past two years, the U.S. government has
reported a 62 percent increase in HIV transmission among this
age group. The climb is sponsored in conjunction with the
American Foundation for AIDS Research (AmFAR). Participants had
set their sights on raising $250,000 for AIDS research and
education, and so far more than $200,000 has been raised. The
team set up base camp June 14 on the Cahiltnah Glacier, and by
June 21 had reached 11,000 ft. despite light snow, dense fog,
and freezing temperatures. They reached 17,000 ft. by June 29,
and expect to make the summit any day. In addition to the
"Climb for The Cure," a symbolic movement called "Hopes and
Prayers for The Cure to AIDS" has been initiated. Personal
letters from Elizabeth Taylor, founding national chairman of
AmFAR, and Dr. Mathilde Krim, AmFAR's chairman, were sent to
hundreds of world leaders, asking for their "Hopes and Prayers
for The Cure." Once the climbers return, other "Hopes and
Prayers" that have been received will be encoded onto laser
disks over the year, placed in a time capsule, and buried
within the shadow of Mt. McKinley during a special dedication
ceremony scheduled for the spring of 1994.


Disease Detection International Inc. (DDI) Announces Brasilian
Approval to Sell Rapid, On-Site, AIDS Test *
PR Newswire (06/30/93)

(Irvine, CA) Disease Detection International (DDI) recently
received preliminary approval and specific recommendation from
Sao Paulo, Brazil, to sell its SeroCard HIV-1 rapid whole-blood
HIV test. In laboratory research performed at the Adolpho Lutz
Institute in Sao Paulo, the SeroCard HIV-1 test was found
"suitable for use as a screening test to detect the presence of
antibodies to the AIDS virus." Other tests performed within the
state prison system incited similar enthusiasm for DDI's
patented format, which uses whole blood from a simple prick of
the finger to perform the world's first "whole-blood ELISA test
in under eight minutes." DDI's president and CEO, H. Thad
Morris, said, "This enthusiastic endorsement was particularly
significant in light of the fact that the state of Sao Paulo,
with a population of more than 33 million people, has more than
three times the rate of infection than the nation of 150
million people as a whole." DDI will also formulate a joint
venture that will be named Disease Detection International do
Brazil and will be headed by Joao Carlos S. Bento, a Brazilian
businessman who has been working with the company and Brazilian
health officials to obtain approval of SeroCard. Bento said,
"The possibility of having such a rapid and convenient test
available within our health care system will be a true asset
for our state and country, where recent studies report up to 30
percent of donated blood may go untested for AIDS due to the
lack of sophisticated, expensive instrumentation and highly
trained personnel in satellite regions."


On Stage and Off: Anthem Against AIDS *
New York Times (07/02/93), P. C2
Collins, Glenn

The American Foundation for AIDS Research (AmFAR) has
established as its official anthem the song "The Day After
That" from the musical "Kiss of the Spider Woman." In the play,
the song, performed by Anthony Crivello, tells of a political
revolution. However, when Liza Minnelli saw the show, she
believed the song was "about a lot more than revolution." She
added, "It's about hope, about fighting despair." With the
approval of AmFAR and the song's authors, Minnelli will record
"The Day After That" for a video to be presented on World AIDS
Day on Dec. 1.


Walking Wounded *
Los Angeles Times--Washington Edition (07/01/93), P. B10
Natale, Richard

A neglected group of people affected by the AIDS epidemic are
the HIV-negative friends, families, or lovers of those who have
died of the disease. These people witness successive deaths of
friends and loved ones which can lead to grief, guilt, and
subsequently to bouts of hypochondria, clinical depression,
anxiety, insomnia, patterns of self-destructive behavior and
anhedonia, an inability to derive a sense of pleasure from
life. Dr. Mark Katz, an HIV specialist and member of the Los
Angeles County AIDS Commission, says there is a significant
other, friend, or family member for each of the approximately
40,000 HIV cases in Los Angeles to date. The emotions felt by
these people have been compared to the guilt experienced by
survivors of the Holocaust, to the post-traumatic stress
disorder that affects those who endure natural catastrophes
like earthquakes and tornadoes, and to the battle fatigue
syndrome soldiers withstand. The difference with AIDS is that
the epidemic continues to ravage through society, leaving no
delay to complete the normal grieving process. "It's like
suffering post-traumatic stress but without the post," said Los
Angeles therapist Don Alonz Survivors of the AIDS epidemic
often think of suicide or self-harm and frequently attempt to
suppress their feelings with alcohol and drugs. Moreover, it's
a behavior that can lead to unprotected sex. Peter Nardi, a
sociologist at Pitzer College in Claremont, Calif., said a
pattern of unsafe sex among survivors may have less to do with
fatalism than with feelings of monumental powerlessness. Dr.
Mark Katz said, "Safe-sex education is not enough. We must
encourage them to feel grief and pain and to find things to
rejoice about."


HIV Also Kills Developing White Blood Cells *
Science News (06/26/93), P. 406
Pennisi, E.

Not only does HIV kill mature white blood cells, but two
research teams have found that the virus also eradicates young
immune-system cells before they have a chance to develop. The
reports were published in the June 24 issue of Nature and
support the belief that HIV is most destructive in lymphoid
tissues. Grace M. Aldrovandl and colleagues from the University
of California--Los Angeles School of Medicine treated a dozen
SCID-hu mice with either no virus, inactivated virus, HIV from
children with AIDS, or HIV cultured in the laboratory. They
subsequently evaluated the T-cells in each thymus implant by
staining and sorting through these cells. In the mice that
received no active virus, 80 percent of the stained T cells
demonstrated both CD4 and CD8 receptors, indicating immature
cells. Mice with HIV from children had lost most of the CD4
cells, the researchers reported. The scientists next injected a
much lower dose of different viral strains into additional
mice. The T cells disappeared more slowly, and it seems the
immature cells were destroyed first, followed by CD4 cells,
says Jerome A. Zack, who heads the UCLA group. He said that
analyses of viral genetic material in these different cell
types showed that the immature cells were between five to 10
times more likely to harbor as much virus per cell as other
cells. The other research group from Systemix Inc., in Palo
Alto, Calif., found that HIV infection spread through the
thymus destroying most CD4 and immature cells within five
weeks. Both research teams agree that the findings may help in
studying HIV in living organisms and may help scientists
understand how HIV destroys the immune system.


Legions of Life Scientists Will Be Called to the Front,
as War on AIDS Intensifies *
Scientist (06/28/93) Vol. 7, No. 13, P. 1
Lewis, Ricki

Although the AIDS epidemic continues to spread, a growing
amount of skilled AIDS researchers is expected, according to
experts. While gauging the current exact amount of AIDS
researchers is nearly impossible, the number is probably in the
tens of thousands, according to several estimates and
predictions. Many offices contacted at the Centers for Disease
Control in Atlanta could not provide precise numbers of AIDS
researchers at the CDC. But a recent issue of the agency's
Morbidity and Mortality Weekly Report indicated that CDC
researchers are indeed hard at work on AIDS issues and problems
in the fields of behavioral studies, public health, and
epidemiology. Scientists say that after considering the number
of AIDS researchers working in government agencies, academia,
and industry, the AIDS research work force is enormous.
However, right now most new hiring of scientists for AIDS-
related research is in academia and government. Nevertheless,
once the epidemic is eradicated there will still be a need for
legions of AIDS researchers. Kenneth Bridbord, a pediatrician
who is chief of the international studies branch of the Fogarty
International Center at the National Institutes of Health,
where he coordinates the training of foreign AIDS researchers
in the United States, said, "The skills [for studying AIDS] are
easily transferred to biomedical and public health issues that
are emerging, and also to reemerging microbes and diseases." He
adds, "A glut of scientists with a broad spectrum of skills?
I'd be glad to face that dilemma!"


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
1993, Information, Inc., Bethesda, MD.

-----===[[[ A I D S w i r e  D I G E S T  06.28.93 ]]]===-----
.