AIDS Daily Summary 
                       August 16, 1994

The Centers for Disease Control and Prevention (CDC) National AIDS
Clearinghouse makes available the following information 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, and the CDC Clearinghouse should be cited
as the source of this information.  Copyright 1994, Information,
Inc., Bethesda, MD

"Female Condom, Reality, Introduced to U.S. Drugstores"
Philadelphia Inquirer (08/16/94) P. A3;  Sakson, Steve
     Wisconsin Pharmacal Co. plans to put its female condom on sale
for the first time this month at drugstore counters nationwide.  
The condom, which is named Reality, comes in a small white box, 
with pages of instructions and 11 diagrams.  Wisconsin Pharmacal 
plans a $4 million ad campaign emphasizing the condom's role in 
preventing sexually transmitted diseases as well as pregnancy.  
The cost is approximately $2.75 each, compared to about a dollar 
for a male condom.  The FDA warns that about 25 percent of 
Reality's users could get pregnant during a year of use, compared
with a 15 to 17 percent rate for male condoms, diaphragms, or 
sponges.
      
"Counting the Cost of AIDS"
Washington Post (Health) (08/16/94) P. 8;  Brown, David
     Measuring the impact of AIDS worldwide is a difficult dilemma
for health economists.  While estimates of the large financial
impact of the epidemic helps coax people into greater action, these
huge numbers can obscure some of AIDS' most important effects.  For
example, while AIDS may not significantly reduce a nation's 
economic growth rate, it may greatly increase the number of 
citizens living in poverty.  AIDS patients may desire a goal such
as comfort during their illness and a pain-free death, a goal 
which can be overlooked when evaluating medical care in terms of 
years-of-life-gained-per-amount-spent.  Thus, health officials 
may not realize they can make inexpensive but highly useful 
investments in things like morphine and clean sheets.  Stefano 
Bertozzi, a World Health Organization economist, speculates that 
AIDS played in essential role in the Rwandan economy's 
destruction, "robbing many of the young men in the military 
[where the infection rate is believed to exceed 20 percent] of 
their dreams for a long-term future."
      
"D.C. AIDS Program Offers 3 New Drugs"
Washington Post (08/16/94) P. B6
     The District of Columbia has added diphenoxylate and atropine 
(Lomatil), dronabinol (Marinol), and megestrol acetate (Megace) 
to its list of free medications given to AIDS patients without 
medical insurance.  According to Peter Hawley, medical director 
of the Whitman-Walker Clinic, Lomatil is an appetite stimulant, 
Marinol is a diarrhea prevention treatment, and Megace is a 
steroid that helps patients to gain weight.
      
"The Unyielding AIDS Epidemic"
New York Times (08/13/94) P. A20
     The fight against AIDS will have to be fought for a very long 
time, warn the editors of the New York Times.  The international 
AIDS conference in Japan has highlighted the dangers of a major 
breakout of the disease in several Asian nations, including 
India, Thailand, and China.  Meanwhile, scientists report only 
slow and incremental gains in development of a vaccine and in 
treatment.  The editors compare the battle against AIDS to the 
fight against cancer, with victory occurring only after a long 
struggle.
      
"Pay Heed to Women, Say AIDS Activists"
Boston Globe (08/15/94) P. 25
     The inattention to special problems of AIDS among women and
the lack of research on important AIDS-related questions such as 
mother-child transmission has prompted greater demands for female
input in the battle against the deadly disease.  The female 
agenda includes demands for research into the effects on women of
the leading AIDS drugs, distribution of accurate information on 
childbearing by HIV-positive women, and studies of the effects of
taking birth-control pills and AIDS medications simultaneously.  
Karen Lee, a divorced mother from Australia, joined the growing 
number of activists from around the world trying to force the 
medical establishment to pay more attention to women, who now 
account for nearly half of all new infections, compared to just 
one in three a few years ago.  While waiting to discover if she 
had transmitted HIV to her son, Lee was subject to misinformation
on this subject and many others.
      
"Forever on Call"
Los Angeles Times (08/14/94) P. E1;  Glionna, John
     Dr. Scott Hitt specializes in AIDS treatment as a partner in
the Pacific Oaks Medical Group, one of the country's largest
private health-care providers for HIV patients.  Hitt treats more
than 600 HIV-positive people and another 250 with full-blown AIDS. 
Hitt is also a gay activist and has recently been mentioned as a 
candidate for an appointment to the President's AIDS Commission, 
a policy-making advisory group.  On the mounting loss of life, 
Hitt claims that soon, "the toll from the disease will exceed the
number of Americans who died in all of our wars combined."
      
"Infections by Health Worker Spur Tuberculosis Warning"
Toronto Globe and Mail (08/12/94) P. A5;  Feschuck, Scott
     Tuberculosis is a growing concern in North America, with AIDS 
patients being among the most likely to contract it.  Health 
officials in Alberta, Canada, are searching for people who may 
have come into contact with a health-care worker diagnosed with 
tuberculosis.  The health-care worker, believed to be a doctor, 
has likely passed the tuberculosis on to dozens of others.  TB 
bacteria often sit dormant for years and become active when a 
person's immune system is weakened by AIDS.
      
"Firms Start to Focus on AIDS Education"
Nikkei Weekly (07/25/94) Vol. 32, No. 1630, P. 21;  Kurosaka, 
Yukinobu
     As the number of HIV/AIDS patients in Japan totaled 3,317 at
the end of April, more and more Japanese businesses discovered that
ignoring the disease will not make it disappear.  About two years
ago, a movement seeking to curb the spread of AIDS began in 
Japanese business circles.  Companies gave employees 
AIDS-prevention guidelines and attended seminars.  The surge of 
information appeared to create the perception that the Japanese 
had done enough, and many companies lost their aggressiveness in 
the battle against the disease.  Some groups, however, today 
continue to introduce new AIDS-prevention measures.  For example,
teachers in the greater Osaka region recently held a seminar on 
AIDS-related topics.  And the Japan International Cooperation 
Agency is now providing emergency medical kits to employees who 
are given overseas assignments.  The packs include sterilized 
syringes and instruments.  Much more must be done, however, to 
fight AIDS and install life-saving measures.
      
"HIV And Anal Cancer; Anal Pap Smears, Early Treatment, 
Recommended for High-Risk Men & Women"
AIDS Treatment News (07/22/94) P. 2;  Smith, Denny
     Joel Palefsky, M.D. and his staff at the University of
California has been surveying possible increases in precancerous
changes in anal tissue that might occur in people who have both the
human papilloma virus(HPV), which causes genital and anal warts,
and HIV.   His observations, boosted by other similar studies,
start from the idea that HPV may cause some abnormal anal cells,
called dysplasia; then those cells may later turn into actual
tumors, or neoplasia.  Some researchers think that co-infection
with HIV might increase the rate of dysplasia.  Dr. Palefksy's
staff looked at the cancer registry statistics for San Francisco,
and saw the rate of reported anal cancer was higher in communities 
that had a greater number of people who are HIV-positive.  Now, 
there are indications that HPV/HIV co-infection is strongly 
linked with neoplasia in the cervix(cervical intraepithelial 
neoplasia, or CIN), and in the anus(anal intraepithelial 
neoplasia, or AIN).  In one of Palefsky's AIN studies of men , he
discovered that 11 percent of the HIV-positive group had AIN, as 
compared to 2 percent of the control group.  AIN can be detected 
using Pap smears of anal cells.  Most AIDS care providers don't 
furnish this test, but data from studies might change this. Dr. 
Palefsky recommends annual AIN screens for all HIV-positive 
people with CD4 counts below 500, women with a history of 
virulent CIN, and all men who have a history of being the 
receptive partner in anal sex.