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AIDS Complicates the City's Pledge to House Homeless *
Los Angeles Times--Washington Edition (07/26/93), P. A7
Bearak, Barry

New York City spends $7.2 billion a year on social services,
and about $500 million of that money goes toward housing the
homeless. In 1981, New York became the first U.S city to
provide shelter on demand for the homeless. The AIDS epidemic,
however, has complicated the housing issue. People with
weakened immune systems cannot stay at group shelters. In the
1980s, the high number of infected drug addicts worsened the
housing problem. Because community groups refused to permit any
new AIDS housing, the city turned to single-room occupancy
hotels, or SROs. The hotels, however, have been at full
capacity for a year now, and the city transfers the overflow of
new AIDS clients to emergency assistance unit offices. Within
five years, New York's Division of AIDS Services has expanded
from five to 500 caseworkers, but it is still chronically
understaffed. "People get placed in the SROs and then get
forgotten about," said division head Stephen Fisher. Other
cities, such as Baltimore, Chicago, and Washington, D.C., also
have vast numbers of drug addicts who are infected with the
AIDS virus. Soon, these cities may face the same housing
dilemma as New York. Fortunately, AIDS activist groups and not-
for-profit organizations have opened some of their own housing,
and New York may pioneer some novel AIDS housing solutions.


Waiting to Die at the AIDS Hotel *
Los Angeles Times--Washington Edition (07/26/93), P. A1
Bearak, Barry

In New York City, homeless people with AIDS are entitled to
private rooms in one of the city's 34 single-room occupancy
hotels (SROs). To receive a room, however, an individual must
have an M11Q form signed by a doctor, proving that they have
full-blown AIDS. Although the city's homeless shelters are not
suitable for individuals with AIDS, it seems that SROs are no
better. Because most homeless people with AIDS are drug
addicts, SROs have become little more than government-
subsidized crack dens. "Put someone in an SRO and even if their
substance abuse is minimal, hands reach out in those dim
hallways day and night to sell them drugs," said Anita Vitale,
director of case management for the city's AIDS division.
Today, about 10 to 15 percent of Americans with AIDS are also
homeless, and that figure is rising. Housing solutions,
however, are only now starting to catch up. A small federal
program for AIDS housing began last year, and organizers are
only now planning the first national conference on housing
strategies.


Surgeon General Nominee Elders Ends Senate Hearing
in Stronger Position *
Wall Street Journal (07/26/93), P. A7A
Stout, Hilary

After her confirmation hearing, President Clinton's nominee for
surgeon general, Joycelyn Elders, was in a better position to
withstand attacks from conservatives. Elders, who previously
headed the Arkansas Department of Health, has been criticized
by conservatives and right-wing religious groups for her
support of condom distribution in schools, abortion rights, and
the inclusion of human sexuality lessons in elementary-school
curricula. Although Elders was also questioned about personal
finance matters, her explanations seemed to satisfy most
members of the Senate Labor and Human Resources Committee. A
vote is scheduled for Friday, and the committee is likely to
approve Elders' nomination. The full Senate could take action
on the matter before its summer recess. During the hearing,
Elders said she believes youths should be taught abstinence.
However, she added that because some youths also engage in
sexual intercourse, they must be taught responsible sexual
behavior, such as how to use condoms to protect against AIDS
and pregnancy. Elders also discussed an Arkansas school health
clinic system she had started, and noted that the school
districts themselves decided which services to provide, and
parents could also determine which services their children
received.


AIDS Patients Contest Utah Ban on Marriage *
New York Times (07/25/93), P. 28

Two Utah women with AIDS are suing to overturn a state law that
bars people with the disease from marrying. Upon learning of
the suit, Governor Mike Leavitt blocked enforcement of the law
until the legislature can reconsider it in January. Even
Stephen J. Rees, the state senator who sponsored the bill in
1987, now says, "I don't know what we were thinking." The
women, however, will continue with the case, in which they also
seek financial compensation. Plaintiff Cindy Kidd says,
"Prosecutors are not enforcing the law now. But what about
third parties? My insurance company may say, 'Oops! We won't
pay your health bill because you weren't legally married.' Then
what?"


Dangerous Liaisons *
Los Angeles Times Magazine (07/25/93), P. 10
Jones, Robert A.

"While HIV transmission among older men who have sex with men
is sharply reduced from the early '80s, transmission continues
at high levels in younger gay men," says a report by the
National Commission on AIDS. This finding simply confirmed what
researchers had suspected as early as two years ago: that the
younger the gay man, the more likely he is to engage in high-
risk sexual behavior. A 1991 study by the San Francisco
Department of Public Health found that among the men surveyed,
30 percent of those between 23 and 25 reported recently having
unprotected intercourse, compared to 43 percent of those
between 17 and 19. Eighty-two percent of the older group
reported having unprotected oral sex, compared to 90 percent of
the younger group. The study also found that 10.4 percent of
the 23- to 25-year-olds were HIV-positive, compared to 14.3
percent of the 17- to 19-year-olds. AIDS researchers have tried
to explain the findings by saying that younger people tend to
feel immortal and so take risks with their lives, or that young
gay men have not yet developed the social confidence to discuss
safe sex with their partners. These explanations imply that
when the older groups were between 17 and 19 they engaged in
the same risky behavior. However, the San Francisco study found
that today's youngest gay men are taking more risks than the
generation before them did at the same age.


Too Many Questions on Tainted Blood *
Toronto Globe and Mail (Canada) (07/26/93), P. A18

How 1,000 Canadians became infected with HIV before 1985
through tainted blood and blood products remains unclear, write
the editors of the Toronto Globe and Mail. There are many
indications that some of the cases could have been prevented.
Until the early 1980s, AIDS was poorly understood, and
consequently, largely unpreventible. By 1982, the link between
blood and the disease was made, and by Sept. 29, 1984, the
Lancet published a study proving the virus could be killed
through heat-treatment of blood. The Canadian Red Cross,
however, did not begin buying heat-treated blood products until
Dec. 12, 1984. Ottawa had apparently known that its blood
supply was contaminated, but did not know what action to take.
According to Greg Smith, the current director of Health and
Welfare Canada's assistance program, they knew much sooner than
July, 1984, about the contaminated blood supply, but "there was
nothing to replace [the blood] with. There wasn't enough of the
heat-treated product. You had to make some difficult medical
choices." It is unclear why there were shortages of heat-
treated blood products until late 1985 and why hemophiliacs
were not warned about potentially unsafe blood products and
informed about alternatives. Canada's implementation of a
screening program was also delayed until November 1985.
Ottawa's public inquiry into the nation's blood supply will
focus on the future safety of blood. Determining what happened
to the blood supply in the 1980s is vital to the national
interest, conclude the editors.


MGH Offers Apology for Error in AIDS Data *
Boston Globe (07/23/93), P. 6
Foreman, Judy

Officials from the Massachusetts General Hospital (MGH)
apologized last Thursday for an "unfortunate error" by
researchers who claimed to have discovered what could be "the
Achilles' heel" of HIV last February. Researchers said the
reported treatment had stopped replication of HIV in a test
tube. However, researchers later found that the MGH research
was seriously flawed. Nonetheless, said National Institute of
Allergy and Infectious Diseases director Anthony Fauci, the
findings do not mean that the researchers' results are useless
or that the federal government will stop its trial involving
400 people. The MGH research involved an idea called
combination therapy, which involves blasting AIDS with three
drugs. It is not likely that the virus would be able to adapt
to so many drugs at once and thus would not be able to
reproduce. The researchers used AZT and ddI along with
pyridinone or nevirapine. The researchers reported that the
combination of drugs prevented the virus from growing and
spreading in the test tube. However, the MGH researchers
reported recently that the virus does become resistant to all
three drugs eventually. The researchers erred in their third
experiment, in which they added four genes to the AIDS virus
known to cause drug resistance, and determined that because the
virus could not survive, their theory was supported. However,
the researchers did not know initially that their mutant
viruses contained a fifth mutation capable of killing the virus
on its own.



Peptide T Unavailable in Buyers' Clubs *
AIDS Treatment News (07/09/93) No. 178, P. 7
James, John S.

Because buyers' clubs throughout the United States have been
unable to obtain supplies of peptide T, approximately 3,000
AIDS patients have been denied access. Peptide T, which has
been in drug development for several years, is not federally
approved and therefore can only be sold in buyers' clubs or
through other underground sources. The drug is used to treat
AIDS-related neurological problems, especially painful
neuropathy and cognitive disorders, and it is believed to be
entirely safe. The immediate reason for the cutoff is that the
European supplier decided not to sell it any more to the U.S.
buyers' clubs. In January 1992, peptide T was cut off as a
result of a new round of clinical trials, which brought peptide
T under a different legal framework and under a different
bureaucracy within the Food and Drug Administration. It is
unknown exactly why the recent cutoff occurred. It may have
resulted from fear of the FDA, but without any specific action
by the federal agency. However, it appears that peptide T will
not be available in the near future.


July 27, 1993


Faith in Multiple-Drug AIDS Trial Shaken by Report
of Error in Lab *
New York Times (07/27/93), P. C3
Altman, Lawrence K.

Massachusetts General Hospital and Harvard Medical School
scientists admitted last week that they found a grave error in
a theory supporting a new type of drug therapy for HIV. The
error highlights the great pressures on AIDS scientists to work
rapidly while upholding scientific standards, as well as the
pressures on federal health officials to rush into clinical
trials for AIDS drugs. The Harvard trial was launched without
independent confirmation of preliminary research findings. The
research, carried out by a Harvard medical student, was also
found to be sloppy. The student published without repeating
important steps to verify vital data. In addition, the
student's team misread laboratory data and failed to detect a
fifth mutation in the virus used in the experiment. According
to experts, the flawed research has clouded hopes that the
trial could lead to an important advance in therapy. However,
volunteers are being asked to continue using a combination of
three drugs--the experiment's strategy. Some experts feel that
the desperate AIDS situation is grounds for testing drugs in a
variety of combinations. Other studies, they say, support such
therapy. Members of the AIDS community and researchers are now
at odds over the research, with AIDS activists claiming that
researchers intentionally manipulated the system to boost the
size of the trial, which the research's supervisor, Dr. Martin
S. Hirsch, denies. Volunteers have been sent letters explaining
the facts of the drug trial.



AIDS in California *
Business Wire

(Sacramento, CA) There were 8,513 AIDS cases reported in
California last year, in an increase of 4.3 percent from 1991.
About 72 percent of cases were reported by homosexual or
bisexual men, an increase of 0.8 percent over the previous
year. More than 10 percent of cases were due to injection drug
use, up 20 percent from last year, and compared to a slight
decrease nationally. Almost 500 women in California reported
having AIDS in 1992, up 17.6 percent from the previous year,
and compared to an increase of 9.8 percent nationally. While
new national statistics show that more women are developing
AIDS from heterosexual contact than injection drug use,
California statistics have shown the opposite since 1895. In
1992, 42 percent of California women with AIDS contracted the
disease through injection drug use, 35.3 percent from
heterosexual contact, 9.3 percent from contaminated blood
products, and 12.8 percent from unidentified sources.


City Health Chief Vows Help for AIDS Groups *
Philadelphia Inquirer (07/27/93), P. B5
Collins, Huntley

Philadelphia's city health commissioner has vowed to find city
and state funds for local AIDS organizations that were passed
over for federal funding. Robert K. Ross, speaking at a meeting
of The Philadelphia AIDS Consortium (TPAC), said that because
many local agencies had not been properly forewarned about new
competitive bidding techniques for federal funds, he would find
a way to give temporary financial support to several local
organizations. However, Ross warned that competitive bidding is
"the way government is going," and that this year's aid should
not be expected in the future. Before Ross' placating words,
some blacks had been angry over the dispersal of the Center for
Disease Control and Prevention's funds. Ross pointed out that
three of the five AIDS organizations that received funding were
"of color," and he stressed the importance of resolving the
city's problems concerning AIDS funds. He said that unless
problems within the fund distribution process were eradicated,
Philadelphia could lose millions of dollars in future federal
funding.


Prostitution, Prejudice Fuel AIDS Epidemic in Honduras *
Los Angeles Times--Washington Edition (07/27/93), P. C1
Wilkinson, Tracy

Honduras now has Latin America's highest rate of AIDS cases. In
the country, where the disease is spread through an active
prostitution industry, AIDS patients are outcasts. Health care
workers, the poverty-stricken society, and worried government
officials are staggered by the epidemic. Honduras, with about
15 percent of Central America's population, has 60 percent of
the region's AIDS patients. While 2,700 cases of full-blown
AIDS have been reported in the country, the Health Ministry
estimates 50,000 Hondurans may be infected. But there is a
distinct shortage of care available for the patients. "There is
a lot of fear. People don't want to be around AIDS victims,
much less care for them. Most of them have nowhere to go," said
nurse Helen O'Connor. Most patients end up at shelters such as
the San Jose Hospice. Of the Hondurans infected with HIV or
suffering from AIDS, about two-thirds are heterosexual, and
slightly over half are women. Health officials in San Pedro
Sula are now discovering that almost 4 percent of pregnant
women with no risk factors are infected with HIV. The spread of
the disease is exacerbated by rampant prostitution and by the
reluctance of Honduran men to use condoms. The government is
now promoting condom use in extramarital sexual contacts.


State Seeks Comment on Use of AIDS Funds *
United Press International (07/26/93)

(Indianapolis) A public hearing will be held on August 4 at the
Indiana State Department of Health, for the purpose of getting
the public's views on the continued use of funds obtained
through the Ryan White Care Act. The Indiana State Department
of Health has received $753,940 from the program in 1993, with
much of the funding going towards a care consortium. The
consortium's main objectives, thus far, have been to coordinate
medical care, intervention programs, dental services, and
psychological care through various state agencies. Moreover,
the consortium has given financial support for medicine and/or
living expenses to those who have tested positive for HIV or
who have already acquired AIDS. Individuals interested in
commenting on the use of the funds should attend the meeting or
write to James Lollis Jr., assistant director of the Indiana
State Department of Health's Division of Acquired Diseases.


Illinois Company Set to Test Blood Substitute in U.S. *
Knight-Ridder (07/23/93)
Leung, Shirley

(Chicago) Baxter International has announced that it will
expand
clinical tests of its hemoglobin-based blood substitute to
hemorrhagic-shock victims at St. Francis Hospital in Tulsa,
Oklahoma. With a patented chemical cross-linking process,
Baxter
has stabilized a human hemoglobin molecule from outdated blood
so
that it can carry oxygen to tissues. Scientists currently
maintain blood volume with plasma and other artificial
materials,
but the hemoglobin solution, DCLHb, can also carry oxygen,
which
is important to trauma victims and heart-surgery patients. The
chemical process also kills all viruses that could have come
from
the hemoglobin, including HIV and hepatitis. However, "The
hemoglobin is not a red blood cell, and we don't know how the
body will react on a long-term basis," said Irving Miller, head
of the chemical engineering department at the University of
Illinois in Chicago.


Taking a Very Large Dose of Can-Do *
Financial Post 500 (Canada) (1993) No. 3070, P. 68
Levin, Martin

Francesco Bellini, chief executive officer of BioChem Pharma
Inc., hopes to propel the firm into the ranks of the world's
leading pharmaceutical companies. The Canadian company may
become a leader in AIDS research with its drug 3TC, according
to Bellini. BioChem has formed ventures with U.K., German, and
Swedish firms that pay 12 percent in royalties, a figure that
remains well above industry standards. Glaxo Canada Inc. signed
with BioChem to market 3TC in North America and holds
production rights for the rest of the world. In January, Glaxo
invested C$30.3 million in BioChem, raising its stake to C$72
million and its equity to 17 percent. BioChem's philosophy
stresses flexibility, with scientists and business managers
treated as equals. Everyone in the company receives stock
options. 3TC currently appears to be as effective or more
effective than AZT. Phase 1/2 clinical testing in North America
and Europe has indicated that patients gained weight, had an
increase in appetite, and had more energy. Also, the patients
did not have major side effects. BioChem anticipates the drug
will begin Phase 2/3 trials. Timothy Wilson, an analyst with
Hambrecht & Quist Inc., suggested investors buy BioChem stock
in January based on 3TC.


Wellcome's AZT Faces Attacks on Two Fronts *
Business Week (07/26/93) No. 3329, P. 36
Flynn, Julia et al.

Although Burroughs Wellcome has seen monetary success from its
anti-AIDS drug AZT since 1987, the company is now under attack
for its patent and clinical reputation. In a lawsuit currently
being tried in North Carolina, Burroughs Wellcome is seeking to
prevent generic drug makers Barr Laboratories Inc. and
Novopharm from producing cheaper versions of AZT. Barr and
Novopharm, supported by the National Institutes of Health,
claim Burroughs Wellcome's patents for AZT are invalid because
NIH researchers co-invented the drug. But even if Wellcome
maintains its patents, the role of AZT as the primary treatment
for HIV-positive patients is declining, according to Dr.
Anthony Fauci, director of the National Institute of Allergy &
Infectious Diseases. If Wellcome loses the suit, the lost
profits would be substantial. Novopharm and a Barr subsidiary
already sell generic versions of AZT in Canada, at about half
Burroughs Wellcome's treatment price of $2,100 per year and
claim that U.S. discounts would be similar. Not only are
Wellcome's patents threatened, but also its clinical
reputation. The European Concorde trial revealed that AZT is
not effective when taken early in the course of HIV disease.
Consequently, in late June, an NIH panel concluded that while
AZT should remain a first-line drug for HIV-positive people,
doctors may consider not using it for patients not yet
exhibiting symptoms. Only about 1 percent of infected people in
the United States currently receive AZT. And before the
Concorde trial revelations, asymptomatic patients were expected
to account for 20 percent of U.S. sales. However, now
Wellcome's market share is expected to stay at eight percent,
said analyst Jo Walton of Lehman Brothers.


Grim Reality: AIDS Is Cutting a Wide Swath Through
the Nation's Young Adults, A Federal Study Shows *
Advocate (07/24/93) No. 634, P. 24
Bull, Chris

Because of a recently released federal report showing that AIDS
has surpassed accidents, cancer, and heart disease as the
leading cause of death among young adults in five states and 64
cities, epidemiologists and policy makers have renewed their
demands for enhanced prevention efforts targeting the disease.
Susan Y. Chu, a Centers for Disease Control epidemiologist who
co-authored the report, said, "The study says that people are
dying all over the place, more so than we ever imagined. We're
hoping this will shock people out of their complacency." The
study revealed that AIDS is the second leading cause of death
among men ages 25 to 44, behind only unintentional injury.
Among women in the same age group, AIDS is the sixth leading
cause of death, ranking behind cancer, unintentional injury,
heart disease, suicide, and homicide. Chu said that the actual
number of people who died of AIDS-related complications that
year was probably even higher than the number indicated in the
report, since the study's authors predict that nationally,
AIDS-related deaths are underestimated by about 35 percent
because of poor reporting standards in state health
departments. Karen Wines, director of development for the
Hyacinth AIDS Foundation in New Brunswick, N.J., said that in
her state AIDS prevention efforts rarely target the predominant
AIDS population of IV-drug users because they tend to be
members of racial and ethnic minorities. She said, "The
question is 'Are we getting enough funding for prevention and
for treatment of people who are sick?'" She added, "The answer
is 'Absolutely not,' and the result is that more and more
people are going to die and the epidemic is going to get even
worse."


HHS Fumbles Ball on AIDS Vaccine Trial *
Science (07/09/93) Vol. 261, No. 5118, P. 151

The Department of Defense and the Department of Health and
Human Services have been at odds for the past several months
over which agency will conduct a $20 million AIDS vaccine
trial. Since last fall, the two agencies have been trying to
decide how to proceed with a congressionally mandated clinical
trial of a therapeutic AIDS vaccine made by MicroGeneSys Inc.
of Connecticut. The DOD decided in April to give the money to
the HHS following prolonged negotiations. The talks over the
vaccine trial started last October, when Congress bypassed the
peer-review process and appropriated $20 million to be given to
DOD to test MicroGeneSys' AIDS vaccine. But this spring a panel
of the National Institutes of Health decided that the money
would best be spent comparing several vaccines. Therefore, the
DOD agreed on April 7 to hand over the money to HHS for the
trial. But HHS now wants to return the funds to the DOD because
the agency's policy prohibits HHS from paying for experimental
products. HHS general counsel Harriet Rabb wrote to a DOD
lawyer on June 21 saying "a high-level member of HHS' staff"
had tried--but failed--to "persuade" MicroGeneSys to donate
vaccine. Nevertheless, now that DOD has the vaccine, it also
says it will not proceed with a trial unless MicroGeneSys
donates the vaccine. If the biotech company refuses, the $20
million would go to DOD's AIDS general research budget.


July 28, 1993


Confirm Dr. Elders *
Minneapolis Star Tribune (07/28/93)

(Minneapolis, MN) The editors of the Minneapolis Star Tribune
contend
that Dr. Joycelyn Elders, President Clinton's choice for top
health official, is hardly a "white-bread" candidate. As
director of the Arkansas Health Department, Elders supported
both
condom distribution and sex education in public schools,
arguing,
"We've taught them what to do in the front seat of the car, but
not what to do in the back seat." Elders detractors have
attacked her on these points, insisting that public-health
efforts should be geared toward promoting sexual abstinence.
But
the editors of the Minneapolis Star Tribune argue that the
opponents' anger is as irrational as it is extreme. The editors
agree with Elders' point that no sensible public-health
professional can depend on sermonizing as a cure-all for the
pressures today's teenagers face. In fact, they point out that
Elders' views differ little from former surgeon general and
Reagan-appointee C. Everett Koop, who advocated condom use as a
shield again AIDS and teen pregnancy. The editors contend that
Elders should not be punished for wanting to take matters a few
steps further.


China-AIDS *
Associated Press (07/27/93)

(Hong Kong) China's Cabinet has announced that it will restrict
the work, home, and school lives of residents within its
Guangdong province who are infected with AIDS. The number of
reported HIV cases within the province has risen from zero
three years ago to 63 at present. Although no indications have
been given to suggest similar measures elsewhere, HIV carriers
in Guangdong will now be subject to the government's will in
marriage, employment, and movements abroad. The Ta Kung Pao
newspaper has reported that, in an effort to counteract the
province's booming drug use and prostitution, Chinese officials
are promoting condom use and disposable needles.


It's Time for Ontario to Pay Blood Money *
Toronto Globe and Mail (Canada) (07/27/93), P. A17
Crozier, Karen L.

According to Toronto-based lawyer Karen Crozier, those in
Ontario who have been infected with the HIV virus through
tainted blood should receive financial retribution most
expeditiously. Crozier says there is no need for a set payment
program to be in place before victims get much needed funds,
and that Health Minister Ruth Grier should immediately begin
assistance. Crozier alludes to insurance programs that often
begin payment as soon as liability is established as evidence
that payment details can be worked out later. Crozier warns
that a failure to begin retribution for those infected would
place Ontario in a position of hypocrisy, and reveal the
health-care system to be void of human compassion. Crozier goes
on the urge for more controls within the health-care industry,
and says that everyone should share in the guilt, because
complacency within Ontario's population, in regards to medical
standards, was a contributing factor to this tragedy. Finally,
Crozier urges concrete action now, so that in the future,
companies will expect monitoring and, when needed,
intervention.


AIDS & Country Caring *
Washington Post (07/28/93), P. C7
Harrington, Richard

The country music industry is gearing up to join the battle
against AIDS. Country singer Mary-Chapin Carpenter has been
named chairman, along with fellow singer Mark Chestnutt, of the
"Country Music AIDS Awareness Campaign Nashville," which will
feature a series of public service announcements from a variety
of stars. Among the more well-known participants are Garth
Brooks, Wynonna Judd, and Willie Nelson. The campaign will
break nationally in January and reach an estimated 50 million
people. In addition, Nashville's Opry House will host a benefit
concert for Nashville CARES, the local AIDS support
organization, near the end of the year. Also, next March will
see the new compilation album "Red Hot + Country" hit stores,
with proceeds going to AIDS organizations. Recent reports have
shown that AIDS is growing fastest in the South and in rural
areas in general.


Eyeing Buyers Clubs *
American Druggist (07/93) Vol. 208, No. 2, P. 11
Ostrowidszki, Victor

The Food and Drug Administration is taking a tougher stance on
the underground businesses known as AIDS "buyers clubs." The
FDA cautioned the clubs that extreme promotion of their
merchandise could constitute health fraud. In addition, the
agency ordered the clubs conduct their operations under the
supervision of a physician and warned them against distributing
potentially harmful products. In a letter to the 12 recognized
buyers clubs, the policy was outlined by Dr. Randolph F.
Wykoff, director of the FDA's office of AIDS coordination. The
"FDA has become increasingly concerned about certain potential
threats to the health of people with AIDS and advanced HIV
disease posed by the activities of some groups," said Wykoff.
"These include: The lack of physician involvement in the
medical care of their clients; the sale of injectable products
of unknown purity, sterility, and strength; the sale of
products with unknown sources of manufacture; and the
promotion, distribution, and commercialization of unproven and
potentially dangerous products." The FDA has permitted HIV-
positive patients to import unapproved treatments under a
"personal use" policy. As a result of this demand, buyers clubs
have emerged to serve as information clearinghouses for
treatment alternatives. Buyers for the underground operations
obtain the drugs abroad that either are not available in the
United States or are available only at much higher prices and
subsequently distribute them to patients.


AIDSFront: Medical Briefs *
Advocate (07/27/93) No. 634, P. 39
Delaney, Martin

The South West Community Based AIDS Treatment (ComBAT) Group
has launched a clinical trial of the anti-AIDS drug 3TC for
HIV-positive volunteers. The drug is a reverse transcriptase
inhibitor that interferes with the enzyme that HIV uses to copy
its genetic material. According to laboratory reports, 3TC is
active against strains of HIV that are resistant to AZT. ComBAT
and 19 other locations nationwide are sponsoring the 3TC
trials, which will last for about a year. The organization is
seeking 100 HIV-infected men and women as volunteers.


Viral Quasispecies *
Scientific American (07/93) Vol. 269, No. 1, P. 42
Eigen, Manfred

Using a combination of mathematics, chemistry, and biology,
Manfred Eigen has classified the nature of viruses, including
HIV, as a "quasispecies." He defines quasispecies as a group
where all members help to continue the stable population.
Fitness of the whole matters more than fitness of the
individual. Eigen notes that viruses are listed in three
different ways--a single strand of ribonucleic acid (RNA),
encoders of their messages as minus strands of RNA, and
retroviruses. The primary function of viruses is self-
preservation through mutagenesis, reproduction, proliferation,
and adaptation to a steadily changing environments. HIV, for
example, has 10,000 nucleotides, but each nucleotide has one of
four possible bases--adenine, uracil, guanine, or cytosine.
Because the quasispecies functions as a whole, it relies on its
error rate, or the probability that an error will occur when
one nucleotide is duplicated, to set its size and integrity.
Eigen's group determined the incidence of constant, variable,
and hypervariable sites in HIV and several other viruses. About
20 percent of the positions are constant and 70 percent of the
positions are variable with a lifespan of about 1,000 years,
suggesting the virus has survived for 600 to 1,200 years.


Insurance Status Among People With AIDS: Relationships
With Sociodemographic Characteristics and Service Use *
Inquiry (Summer 1993) Vol. 30, No. 2, P. 180
Fleishman, John A. and Mor, Vincent

AIDS patients without insurance were admitted to hospitals as
inpatients less frequently than those with private insurance,
and they had fewer inpatient nights, write John A. Fleishman
and Vincent Mor of Brown University in Providence, R.I. The
researchers interviewed 937 AIDS patients who were recruited
from outpatient HIV clinics and community-based AIDS service
organizations in nine communities nationwide. They found that
30 percent of the patients had private insurance, 29 percent
had no insurance, and 41 percent were covered by some form of
public health insurance. The study revealed that respondents
who were nonwhite, IV-drug users, unemployed, and had incomes
of less than $500 per month were more likely than their
respective counterparts to have no insurance or to have
publicly funded insurance. There were significant regional
variations in insurance status, with the South having the
highest rate of uninsured and the lowest proportion receiving
Medicaid. Approximately 95 percent of the uninsured and the
publicly insured, compared to 47 percent of those with private
insurance, used clinics as their source of medical care. As the
AIDS epidemic spreads to more second-wave or third-wave
communities, the number of affected people will increase in
states with restrictive Medicaid policies. The pattern
discovered in the South of a lack of both private and public
insurance may become more common. The researchers conclude that
further research on cost, financing, and utilization of care,
by AIDS patients was well as by the population in general, will
provide a necessary basis for informed formulation of health
policy.


Needles and Race *
Atlantic (07/93) Vol. 272, No. 1, P. 38
Kirp, David L. and Bayer, Ronald

Due to the reluctance by many politicians to implement needle-
exchange programs, the AIDS epidemic will continue to ravage
the IV-drug-using population. Several American politicians
dismiss the idea of providing clean needles to drug users as
"sending the wrong message" in the midst of the war on drugs.
But much less attention has been given to the widespread
discord within the black community, where many politicians and
ministers whose constituencies have been destroyed by drugs and
AIDS have been vocal opponents. It is this opposition that
could be why cities most affected by the epidemic have resisted
needle exchange. Stephen B. Thomas and Sandra Crouse Quinn from
the University of Maryland conducted an investigation of public
opinion among blacks on questions involving the AIDS epidemic.
Thomas and Quinn found that among black churchgoers, one in
five trusts government reports on AIDS, and two thirds
entertain the possibility that "AIDS is a form of genocide
against the Black race." Needle-exchange programs are viewed by
those who speculate about conspiracies against blacks as a
cheap and cynical substitute for the drug-treatment programs
for which the government continues to refuse to pay. Black
Americans and conservative politicians who oppose needle-
exchange programs, proven to thwart the spread of HIV among IV-
drug users, are becoming unwitting allies in exacerbating the
problem of AIDS prevalence.


July 29, 1993


Australian Study Says AZT Slows Progression
to Full-Blown AIDS *
New York Times (07/29/93), P. A20
Angier, Natalie

A new study has revealed that by taking the anti-AIDS drug AZT
early in the course of disease the progression toward full-
blown AIDS may be substantially slowed. The study, conducted by
Dr. David A. Cooper of St. Vincent's Hospital at the University
of New South Wales in Syndey, Australia, along with colleagues
from Europe and Australia, appears to contradict the renowned
Concorde study released in the spring that showed that HIV-
positive people did not receive a notable benefit by taking AZT
early. However, researchers familiar with all the clinical
trials of AZT said the data revealed the same basic message:
AZT is a moderately useful drug that can slow the course of
AIDS in some patients for a limited period of time, and it is
the patient and doctor's decision whether to use the drug early
or even to take AZT at all. The Australian study, published in
Thursday's New England Journal of Medicine, found that in a
group of 993 asymptomatic HIV-positive patients who had a CD4
count above 400 cells per cubic millimeter, those administered
AZT for three years were only half as likely to progress toward
AIDS as those given a placebo. The patients were identified as
having crossed the line from being asymptomatic to having the
disease when they began exhibiting symptoms of a suppressed
immune system. Although the Concorde study detected no
statistical benefit in beginning AZT therapy early to thwart
disease progression, researchers pointed out that the two large
trials used different parameters for determining disease
progression, different follow-up periods, and different "end
points" on which their conclusions were based.

Related Stories: Washington Post (07/29) P. A14; Wall Street
Journal (07/29) P. B6.


AIDS Spreads Fastest Among Young Women *
Washington Post (07/29/93), P. A1
Rensberger, Boyce

Young women worldwide have the highest rate of HIV
transmission, according to a report released Wednesday by the
United Nations Development Program (UNDP). The findings
revealed in the report can be traced to various causes, from
social and behavioral factors to anatomy. As women grow older,
they become less inclined to contract HIV, even though, on
average, their number of sex partners increases. But men do not
encounter their peak risk for HIV until they are in their late
twenties and early thirties. The study found that women between
the ages of 15 and 25 account for 70 percent of the 3,000 women
a day who contract HIV and the 500 women a day who die of AIDS.
The report discovered that men and women differ greatly on when
they are at highest risk for HIV. In women, the tissue that
lines the vagina and can be injured during sexual intercourse
is very thin in preadolescent girls. It begins to thicken with
the onset of puberty and reaches its maximum about two years
after the first menstrual period. This risk for infection is
most relevant for girls between the ages of 10 and 18. Another
factor that puts young women at risk involves a special type of
cell that rings the opening of the cervix in women in their
later teens and early twenties. It is these cells that the
human papilloma virus infects to cause cervical cancer and that
researchers suspect HIV infects. Women are also at risk when
giving birth at young ages because it makes them more exposed
to microbes that can enter the vagina. The UNDP urges the
development of ways to convince young women to delay the time
of the first episode of sexual intercourse, to postpone the
first pregnancy, and to help girls control situations in which
they have sex.


Red Cross Offers Courses on Care of AIDS Patients *
Philadelphia Inquirer (07/29/93), P. B2

The Red Cross of Southeastern Pennsylvania is implementing a
series of AIDS courses designed to reach 1,200 people who
provide care to AIDS patients. The three-day courses, called
"AIDS Home Care," will begin today and will be repeated
throughout the year with three or four new classes each month.
The courses will give friends and families of AIDS patients the
information and skills to help handle the physical,
psychological, and spiritual challenges of the disease. Issues
covered in the courses will include nutrition, medications,
legal problems, and loss and grief. The program is funded by a
two-year grant from the Pew Charitable Trusts and also
supported by the We the People With AIDS/HIV, Ross
Laboratories, Episcopal Hospital, Misericordia Hospital, and
Thomas Jefferson University Hospital.


Average Cost of Treating AIDS Patients Declining *
Reuters (07/27/93)

(Chicago) The cost of treating AIDS patients has declined
significantly over the past few years, and can be attributed to
improvements in diagnosing and treating AIDS-related
conditions, according to a report in Tuesday's Journal of the
American Medical Association. The cost of treatment from
initial HIV infection to death from a collapse of the patient's
immune system is $119,274, according to the report, completed
in 1992 by Fred Hellinger, an economist at the U.S. Public
Health Service. He said the costs incurred by AIDS patients
from the time the disease was diagnosed fell by nearly 32
percent during the period the study was performed--to $69,000
in late 1992 from $102,000 in early 1991. Hellinger said the
average number of days AIDS patients spent in hospitals fell
from 52 days to 35 days. In the report, Hellinger examined the
average monthly medical costs of 1,164 HIV-positive
individuals, 784 of whom had AIDS. The patients had an
estimated lifespan of 25 months from the time of diagnosis of
HIV infection. But a patient with end-stage renal disease might
live five years and incur $175,000 in costs, said Hellinger,
citing Medicare statistics. He concluded, "If improvements in
the preventive and therapeutic care continue to slow the rate
of progression from HIV infection to serious complications and
reduce the intensity of treatment for (patients with AIDS), HIV
may be viewed in the future as a moderately expensive, chronic
illness, and not as a catastrophically expensive, fatal
illness."


France--AIDS *
Associated Press (07/28/93)
Burns, Christopher

(Paris) AIDS hotlines were inundated with calls from concerned
people Wednesday after the French government ordered nine tests
for HIV to be taken off the market because they were less
effective than newer tests. AIDS Info Service, the main
nationwide toll-free line, was answering up to 400 inquiries an
hour in the Paris region alone. ACT-UP demanded in a statement
today that the French government launch an emergency public
effort to test for HIV. The group said the authorities should
urge laboratories to destroy the banned tests. The Health
Ministry on Tuesday prohibited nine of the 31 HIV tests used in
France, claiming they were less accurate than more modern
methods. The majority of the tests were made by French
companies and belong to an early generation of tests developed
around 1985 to identify the presence of HIV antibodies.
"There's no need to be dramatic. It's simply a way of updating
the tests used," said Deputy Health Minister Philippe Douste-
Blazy. He added, "The withdrawn tests aren't bad, but they're
less effective." The tests that are prohibited include
Vironostika and Vironostika Anti HTLV3 LAV, made by Organon;
Elavia, Rapid Elavia, and Genie HIV1-HIV2 by Diagnostics
Pasteur; Cobas Core by Roche; Enzynum Test by Boehringer;
ImmunoComb PBS by Organics; and Rapid by Clonatec. Also, six
other tests made by Diagnostics Pasteur, Behring, Coultronics,
and Sorin-France are now limited to use by blood banks and only
when a back-up test is used. The withdrawal order involves only
France and its overseas territories. Other countries that might
be using the tests could not be identified by a Health Ministry
spokeswoman.


State of Denial *
Advocate (07/27/93) No. 634, P. 44
Gallagher, John

Alabama state laws regarding HIV are among the worst
nationwide. Doctors in the state may test for HIV without the
patient's permission, and Alabama state prisoners are tested
automatically for the virus and HIV-positive inmates are
separated from the general population. Sex-education
instructors are required to emphasize abstinence and to inform
their classes Alabama law forbids homosexuality. In addition,
an amendment to a 1975 Alabama state law permits health
authorities to disclose HIV status to a number of people,
including education superintendents, funeral directors, and
health care workers. The amendment was scaled down from the law
originally proposed, which would have allowed HIV status to be
disclosed to any individual.


Active AIDS Surveillance: Hospital-Based Case Finding
in a Metropolitan California County *
American Journal of Public Health (07/93)
Vol. 83, No. 7, P. 1,002
Elcock, Maryellen; Simon, Tamara; Gilbert, Bradley P.; Copello,
Gene; and Kelzer, Pauline J.

Health departments that rely solely on passive surveillance are
not guaranteed their reported level of AIDS cases will be
correct. Therefore, the authors attempted to create an example
of active AIDS cases reporting that use resources available to
county workers. To achieve the model, the authors conducted a
validation study of AIDS cases reporting. The study was used to
determine the level of underreporting. The authors then created

hospital-specific protocols for use in active surveillance. The
study indicated 24 percent of AIDS cases in all hospitals
together were not identified through passive surveillance in
1990. In addition, nine unreported cases, or 69 percent of the
total reported cases, were discovered through active
surveillance in the first three months of 1991. The Centers for
Disease Control estimates underreporting rates nationwide to be
15 percent.


Commission Report: 'AIDS: An Expanding Tragedy' *
Journal of the American Medical Association (07/21/93)
Vol. 270, No. 3, P. 298
Marwick, Charles

The National Commission on Acquired Immune Deficiency Syndrome
has concluded the current indifference and fear to AIDS must be
stopped, or else the virus will be responsible for an
unprecedented number of deaths among young Americans. The
projection was included in a recent commission report written
by Dr. David E. Rogers and Dr. June E. Osborn. Currently, AIDS
is the leading cause of death for men age 25 to 44 in more than
60 U.S. cities. AIDS commission officials say their previous
warnings and recommendations have been ignored or underfunded
to date. "The human immunodeficiency virus (HIV) has profoundly
changed life on our planet. America has not done well in
acknowledging this fact or in mobilizing its vast resources to
address it appropriately," the report states. The authors offer
two recommendations in the report. First, all leaders must
discuss AIDS with their constituents. Second, a national plan
for dealing with AIDS must be developed.


Pneumocystis Carinii Pneumonia Among US Children with
Perinatally Acquired HIV Infection *
Journal of the American Medical Association (07/28/93)
Vol. 270, No. 4, P. 470
Simonds, R. J.; Oxtoby, Margaret J.; Caldwell, M. Blake; et.
al.

R. J. Simonds and associates have monitored children ages zero
to 12 years and women of childbearing years to determine
epidemiologic traits of pneumocystis carinii pneumonia (PCP)
among children with perinatally acquired HIV. The scientists
obtained data from surveillance done by state and local health
departments and submitted to the Centers for Disease Control
and Prevention from 1982 to 1992. Of the 3,665 perinatally AIDS
cases reported, 1,374 listed PCP. More than 50 percent of these
cases happened in babies three and six months old. The
researchers concluded that PCP is widespread in young children
with HIV.


July 30, 1993



AIDS Drug Might Use 'Buckyballs' *
Los Angeles Times--Washington Edition (07/30/93), P. B1
Stolberg, Sheryl

What started as a joke treatment for HIV may actually be
effective in stopping the virus from multiplying in the test
tube. Simon Friedman, a 27-year-old graduate student in
pharmaceutical chemistry at the University of California--San
Francisco, was recently discussing with his colleague, Diane
Roe, ways in which researchers were trying to thwart HIV in the
test tube. Then Roe quipped, "What are they gonna try next?
Buckyballs?" But the joke turned out to be a potential method
of inhibiting HIV's spread in the test tube. Friedman says that

buckyballs--recently discovered molecules so nicknamed because
their shape resembles the late R. Buckminster Fuller's multi-
sided geodesic domes--do indeed stop HIV from multiplying. The
finding is published in this week's Journal of the American
Chemical Society and seems to be the first biological
application of buckyballs. The molecules function by inhibiting
a crucial enzyme. Friedman hopes buckyballs can be the first
step toward creating a successful protease inhibitor.
Buckyballs, also known as fullerenes or C-60, are hollow,
soccer-ball shaped molecules composed of 60 carbon atoms. They
comprise a third, newfound type of pure carbon. Friedman said
the thought occurred to him that their unique shape might
enable buckyballs to fit into the space that protease normally
uses to attach to a crucial protein. The computer model was
encouraging so he later checked his findings in the test tube.
Because the development of a protease inhibitor using
buckyballs is a long way off, Friedman said, "we have to be
willing to accept lesser goals--i.e. that we are moving in the
right direction."


African Nations Brace for Economic Impact of AIDS *
Christian Science Monitor (07/30/93), P. 8
Press, Robert

Africa has more than half of the world's AIDS cases, which will
eventually affect developing nations' economies, according to
two recent studies by the World Bank on AIDS in Africa.
Officials from Kenya said that the AIDS epidemic in Africa has
both a personal dimension for individuals and an economic one
for the whole population. Michael Merson, director of the AIDS
program for the World Health Organization, said that the
current problems affecting Africa may also soon be felt in
Asia. By the year 2000, Asia may have a higher annual rate of
HIV infection than Africa, said Merson. He is requesting $3
billion for an AIDS prevention program in developing countries,
which he says could halve the expected deaths from AIDS by the
end of the decade. World Bank economist Dean Jamison says the
$3 billion is only a fraction of the $170 billion spent on
health care each year in the developing world. Jamison claims
that significant steps have been taken in extending life
expectancy in the developing nations. However, without an
aggressive AIDS prevention program, these gains could be lost,
he added. According to Gilbert Jimbo, manager of Kenya's
National AIDS Control Program, AIDS patients occupy up to 60
percent of the nation's hospital beds in some areas. "The
impact of AIDS on the economy in Kenya will be the loss of 22
years of the patients' lives, which will cause a shortfall of
between 6 percent and 15 percent in gross domestic product by
the year 2000," said Jimbo.


AIDS Dilemma Remains Despite Positive AZT Study *
Reuters (07/29/93)
Johnson, Cynthia

(London) Decisions on whether to use AZT early in the course of
HIV infection should not be based on findings from a single
report, analysts said Thursday. The European-Australian study
featured in the New England Journal of Medicine concurred with
earlier research that showed that early treatment of HIV-
positive patients with AZT slowed the progression to full-blown
AIDS. Nick Partridge, chief executive of Britain's leading AIDS
charity The Terrence Higgins Trust, said, "This trial should
not be looked at on its own but together with the 13 other
studies already available about the use of AZT." One of the
studies is the Concorde study, which found that early use of
AZT may not be very effective in staving off full-blown AIDS.
The European-Australian study was led by Dr. David Cooper of
the University of New South Wales in Sydney and involved 1,000
patients, all of whom had CD4 cell counts of 400 or higher. The
Concorde trial also discovered that patients taking AZT before
the onset of AIDS symptoms had higher numbers of CD4 cells, but
determined that this had no noticeable impact on the eventual
course of the disease. "The main finding of the [Cooper] study
is something we have known for a long time, that zidovudine
[AZT] increases the CD4 cell count," said Ian Weller, the
British coordinator for Concorde. Analysts noted that the
Cooper study involved only people with fairly high CD4 counts,
whereas those in Concorde ranged from very high to very low.
They said that even in Concorde, among the 710 patients with
CD4s above 500 before entry, there was a trend toward some
benefit of early AZT treatment.


Germany--AIDS--Hemophiliacs *
Associated Press (07/28/93)
Allen, Arthur

Bonn, Germany--Prompted by the outcome of the tainted blood
scandal in France, HIV-positive German hemophiliacs have
demanded
compensation and an investigation into the country's blood
supply. In a statement from the Hemophiliacs Society, German
hemophiliacs, who consist of about 7,500 people, are calling
for
compensation for the 25 percent who contracted HIV and 300 who
subsequently died. Approximately 50 people protested at the
Health Ministry Monday and requested up to $216,000 for each
individual infected through the blood supply. While four French
officials were convicted and the reputation of the Socialist
government was destroyed last year because of charges of the
distribution of tainted blood through federal blood banks, the
blood banks in Germany are private. Health Ministry official
Franz-Josef Bindert said, "Officials acted within the
constraints
of what was scientifically known. In hindsight, they could have
done better, but they aren't liable." The Hemophiliacs Society
prepared a study that criticized the German government for
neglect and cited a slow reaction time by health authorities,
which contributed to the infection of many hemophiliacs between
1983 and 1985. Although a test for the presence of HIV in blood
only became available in 1985, tests for hepatitis antibodies,
carried by more than 80 percent of HIV-positive blood donors,
were available by 1981. There was no general recall of blood
products, and tainted blood products continued to be used in
some
cases into 1986.


Canada Watch: Activists Fight Deportation *
Toronto Globe and Mail (Canada) (07/29/93), P. A4

Canadian AIDS activists carried two imitation coffins to
federal immigration offices on Wednesday to protest against the
deportation of a Salvadorean woman, who is being ordered out of
the country solely because she is infected with HIV. Clara
Palacios must leave Canada on Saturday along with her 10-month-
old son. Approximately 50 members of ACT-UP carried the coffins
to represent what they believe will be the imminent death of
the two in El Salvador.


The Long Shot *
Discover (08/93) Vol. 14, No. 8, P. 6 *
Caldwell, Mark

When researchers discovered that AIDS was a virus in 1984, they
believed that a vaccine could be developed in as little as two
years. But although many prototype vaccines are now beginning
to reach the human testing stage, researchers have become wary
of claiming to have found a cure for AIDS. Over the past decade
they have learned more, more quickly, than was ever known about
other types of viral infections for which cures were
discovered. But what they have found is that the AIDS virus
doesn't follow the usual rules. It is a retrovirus, meaning
that it can go undetected for a long time, and when it finally
strikes, it attacks the very thing that is supposed to help the
body fight disease: the immune system. Another problem
hindering the discovery of a cure is that there are dozens of
different known strains of HIV, and the virus can mutate within
one patient.


Dental Treatment and HIV Positivity *
Lancet (07/10/93) Vol. 342, No. 8863, P. 119
Zakrzeweska, J.; Robinson, P.; and Croucher, R.

People with HIV have special needs for dental care because,
along with typical oral diseases, they may have particular oral
conditions caused by the infection. Yet, HIV patients have
difficulties getting proper dental care. One study found that
of 146 HIV-infected men, 30 percent stopped going to their
dentist because they feared refusal or negative attitudes. Of
those who did visit their dentist, only 50 percent revealed
their condition, and half of that group were refused treatment.


Laboratory Methods for Diagnosing and Monitoring HIV Infection
*
Journal of the Association of Nurses in AIDS Care
(04/93-06/93) Vol. 4, No. 2, P. 11
Grady, Christine)

The four types of laboratory tests relating to HIV include:
tests for antibody to HIV; tests for quantifying the presence
of HIV; tests to monitor the progression of the disease; and
tests to monitor immune status. The most common antibody test
is the enzyme-linked immunosorbent assay (ELISA). Others are
Western blot, immunofluorescence, radioimmunoprecipitation, and

hemagglutination. Although these tests only measure the
antibody to HIV -- not the presence of the virus -- any person
found to have antibody to HIV is considered infected, according
to the Centers for Disease Control and Prevention's definition
of AIDS. The only test approved by the Food and Drug
Administration to determine the presence of the virus is the
p24 antigen capture assay. Unfortunately, p24 assay identifies
as few as four percent of asymptomatic infected individuals and
70 percent of AIDS patients. Due to its lack of sensitivity,
the p24 assay is not recommended as a screening test. Other
tests for the presence or amount of the virus are HIV
culture/coculture and polymerase chain reaction. Tests for
monitoring the progression of HIV disease are often called
surrogate markers or prognostic indicators. Researchers have
not reached a consensus on which surrogate markers are best,
although many say a combination of tests yields the most
accurate results. Beta-2 microglobin and serum neopterin are
popular surrogate markers because they are inexpensive, easy to
measure, and widely available. Since HIV causes changes in the
immune function, patients' immunosuppression should be tested
by evaluations of white blood cells, lymphocytes, T4 cell
number, T-cell function, and B cells.


The Lifetime Cost of Treating a Person with HIV *
Journal of the American Medical Association (07/28/93)
Vol. 270, No. 4, P. 474
Hellinger, Fred J.

Fred J. Hellinger has used information from the AIDS Cost and
Service Utilization Survey to determine the estimated expense
of medical care for people with HIV from the time of infection
until death. Hellinger studied information from interviews
conducted during the spring and early summer of 1992 with 1,164
HIV patients. San Francisco Men's Health Study provided
estimates of the mean occupancy time in each of the four
disease phases, and then these numbers were multiplied by the
monthly cost in each stage. After that, Hellinger added the
figures to come up with a synthetic estimate of the lifetime
medical care costs of treating a person with HIV. Hellinger
concluded that the lifetime cost of treating a person with AIDS
has declined as a result of a decrease in using inpatient
hospital services, costing approximately $119,000.


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.

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