NetNews Usenet Archive 1992 #27/NN_1992_27.iso/spool/sci/med/aids/2029

Text File | 1992-11-22 | 14.7 KB | 241 lines

Newsgroups: sci.med.aids
Path: sparky!uunet!elroy.jpl.nasa.gov!ucla-cs!usenet
From: Billi Goldberg <[e-mail]>
Subject: CDC Summary 11/23/92
Message-ID: <[e-mail]>
Note: Copyright 1992, Dan R. Greening. Non-commercial reproduction allowed.
Sender: [e-mail] (Mr Usenet)
Nntp-Posting-Host: sole.cs.ucla.edu
Archive-Number: 6485
Organization: unspecified
Date: Mon, 23 Nov 92 07:58:29 PST
Approved: [e-mail] (J. Philip Miller)
Lines: 226

                     AIDS Daily Summary
                     November 23, 1992
 The Centers for Disease Control (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. Copyright 1992,
Information, Inc., Bethesda, MD
**********************************************************************
 "As H.I.V. Patients Stay at Work, Problems, and Solutions, Emerge" New
York Times (11/23/92), P. A1  (Navarro, Mireya)
     As more and more HIV-positive people are living longer as a result
of new treatments, they are also trying to hold onto jobs. Some continue
working because they need the income or the health-insurance benefits.
However, many others work as long as they can for other reasons, such as
the fulfillment and camaraderie they receive through their jobs.  Some
companies have implemented policies that state that AIDS will be treated
like any other life-threatening disease.  These companies have also
accommodated employees with HIV with flexible work schedules and other
measures.  But at other companies, workers with HIV/AIDS have been
dismissed, although most states have laws that prohibit firing employees
simply because they have the disease. Consequently, many HIV-positive
employees believe they must hide their infection if they want to
continue working.  Several HIV-positive individuals are concerned about
being discriminated against or losing their jobs or chances of
promotion.  Many do not reveal their HIV-positive status until they
must, such as when they have to explain frequent absences.  Other AIDS
patients do not file claims for HIV-related treatments in order to hide
their condition or avoid being dropped from health plans. According to
employers, fear of transmission of HIV is still a worry for co-workers,
even this far into the AIDS epidemic. Business groups say that most
private or public employers have not prepared for the disruptions that
AIDS can prompt.  This situation is changing, however, due to laws like
the Americans With Disabilities Act.

"A Call for Explicit AIDS Education" USA Today (11/23/92), P. 1D
(Painter, Kim)
     AIDS education implemented in most states still does not give
students the information they need to prevent HIV infection, according
to a group that promotes a more explicit approach. Debra Haffner,
executive director of the Sex Information and Education Council of the
U.S., said, "We found that states have done a really terrific job of
putting programs in place, but they still are not meeting young people's
needs."  The council surveyed all state education agencies and did in-
depth analyses of programs in 34 states.  It revealed that all states
mandate or recommend AIDS education and most have developed curricula or
policies.  The group argues that although most programs promote
abstinence, they offer little advice for teenagers already having sex,
who account for 54 percent of high school students.  The council's
research found that five states say schools should provide practical
information on getting and using condoms.  A total of seven states
provide what the council considers an accurate definition of
homosexuality, and eleven offer what the council deems a sufficient
balance of information on abstinence and safer sex.  Haffner says she
expects that with the Clinton administration, "the 'just say no'
approach of the past few years will no longer be seen" in federal
policies and funding--and that will make a difference in state and local
programs.

"Spike Lee Sees AIDS as a Plot" Washington Times (11/23/92), P. D1
(Grenier, Cynthia)
     The Rolling Stone 25th anniversary special issue includes an
advertisement that features filmmaker Spike Lee.  The opening text of
the eight-page ad for United colors of Benetton reads, "We sought
another powerful voice in the realm of social commentary.  We could
think of no more qualified individual to break through the static of
mainstream media in the pursuit of change then filmmaker Spike Lee."  An
essay by Lee accompanies a portfolio of Benetton ad photos from the past
eight years.  Near the end of the essay, Lee says, "All of a sudden, a
disease appears out of nowhere that nobody has a cure for, and it's
specifically targeted at gays and minorities (i.e. Hispanics and
blacks).  The mystery disease, yeah, about as mysterious as genocide.
I'm convinced AIDS is a government-engineered disease."  Rolling Stone's
vice president for public relations, Lynn Tanzman, said the essay is
completely Lee's opinion and he is entitled to express it.  She said it
was not an editorial matter, but a question for the advertising
department and the publisher.

"Winning Designs for Living With AIDS" Boston Globe (11/20/92), P. 33
(Campbell, Robert)
     An AIDS exhibit was featured at "Build Boston", the array of
exhibits and talks about architecture and construction that was held
last week at the World Trade Center.  The AIDS exhibit consisted of
winners of a national competition, in which architects were asked to
design housing for AIDS patients.  Along with being a personal and
medical tragedy, AIDS is also an architectural crisis.  About 80 percent
of AIDS patients will need special housing at some time.  The
contestants were asked to come up with designs to convert a half a block
of Boston into apartments for AIDS patients.  The intention was to
create a model community that could be used as a standard for the rest
of the country.  The winning design, by David Kaplan and George Nakatami
of Santa Monica, Calif., incorporates housing thoughtfully into the
neighborhood.  David Lee, the current president of the Boston Society of
Architects, said, "Nobody could undertake this design task without
realizing the devastating physical challenges produced by AIDS.  But the
result shows that you can have an architecture of social concern without
sacrificing quality of design, or even joyousness.  As competitors were
told, this is a competition about people living with AIDS, not dying."
Interviewed AIDS patients indicated that they wanted to live in places
that could support their needs without feeling like nursing homes.

"Who Will Get the AIDS Blame Now?" Washington Times (11/23/92), P. E1
(Charen, Mona)
     Avoidable risky behavior, not the lack of federal funding, is the
reason for the spread of the AIDS epidemic, writes columnist Mona
Charen.  Since the AIDS epidemic began in the early 1980s, Republican
presidents have been blamed by homosexuals for its spread.  But now that
there is a Democrat in the White House, the claims against the
Republicans will come back to haunt them, says Charen.  It became a
point of pride to support increased funding for AIDS research and care,
even when the federal dollars for AIDS drastically exceeded funding for
other more prevalent conditions like cancer.  It also became
conventional wisdom that AIDS patients were dying unnecessarily and that
a more focused government effort could halt the progress of the disease.
Some even felt that AIDS was affecting homosexuals, blacks, and drug
addicts disproportionately because Republican presidents were
unsympathetic to these people.  A new study discovered that in small
towns, almost one-third of gay men said they engage unprotected anal
intercourse on a regular basis.  Nine percent said they are already HIV-
positive.  Several of those who admitted to this behavior said they
believed that their risk of getting the disease was slight or nil.  It
seems hard to believe that anyone living in a small town could be
ignorant of the way HIV is transmitted.  The media continually relay
facts about AIDS everyday.  If a person is still having unprotected anal
intercourse in 1992, it is not because the government has been reluctant
to explain the facts to him, but because the person chooses not to know
the truth, concludes Charen.

"City Scenes: AIDS Group has No Buddy for Joe" Boston Globe (11/20/92),
P. 25  (Cullen, Kevin)
     A Boston AIDS patient is angry with an area AIDS organization for
neglecting him.  Joe Scarantino, who was diagnosed with HIV years ago,
became sick last December and requested a "buddy," a volunteer who
provides companionship and help around the house, last spring from the
AIDS Action Committee.  He says that when he continued to request a
buddy he was considered a troublemaker by AIDS Action workers.  "They
tell me the reason I can't have a buddy is I'm too angry and I say the
reason I'm so angry is I'm being treated like a child.  Dealing with
AIDS Action is not the only thing going on in my life.  I have to deal
with my illness, with rejection by friends and family."  He added, "AIDS
Action started out with all the right ideas, but in many ways it's
become a huge bureaucracy, filled with bureaucrats.  I keep asking,
'Where's the compassion?'"  AIDS Action spokesman Tom McNaught said
individual cases cannot be discussed due to confidentiality rules, even
if someone waives confidentiality. McNaught said, "Last year we served
1,696 people with AIDS and HIV.  We have 201 trained buddies.  Clearly,
there's not enough.  Not everybody who wants a buddy gets one.  We don't
put them in a situation where they're at risk.  Sometimes people want a
buddy   because they need therapy or a boyfriend or girlfriend."

"News in Brief: District of Columbia" Advocate (11/17/92) No. 616, P. 26
     Acting on a request by the Centers for Disease Control,
Washington, D.C., health officials announced on Oct. 13 that they would
improve attempts to find people who tested HIV-positive at  district-
funded clinics but did not return to obtain their test  results.  About
70 percent of those who tested HIV-positive at  district-funded clinics
since 1990 had not returned to learn  their results, according to an
article in The Washington Post.

"News in Brief: Utah" Advocate (11/17/92) No. 616, P. 27
     A senior Mormon church official who said AIDS is a "plague  abetted
by the immoral" has been chastised by AIDS activists and  religious
leaders.  Dr. Russell Nelson, a member of the Council  of the Twelve of
the Church of Jesus Christ of Latter-day Saints, made the statement at a
church general conference Oct. 4.  Nelson told the conference that "an
epidemic has been forecast--a plague fueled by a vocal few who exhibit
greater concern for civil  rights than for public health."  LaDonna
Moore, executive  director of the Utah AIDS Foundation, said Nelson's
remarks were  a "saddening display of judgment and indifference coming
from a  representative of a church which espouses Christian ideals."
She added, "It is so ironic that these statements should come during
AIDS Awareness Month."  Rev. Peter Eaton, association rector at  St.
Paul's Episcopal Church in Salt Lake City, said, "AIDS is a  disease,
not a disgrace."  In addition, St. Paul's rector Rev.  Caryl Marsh said,
"Do we question the morals of a person with  leukemia, cancer or heart
disease?"  Joseph Walker, spokesman for the Mormon Church, said Nelson
would not respond to the censure.  "He has said what he wanted to say,"
Walker remarked.

"The Relation Between Hospital Experience and Mortality for  Patients
With AIDS" Journal of the American Medical Association (11/18/92) Vol.
268,  No. 19, P. 2655  (Stone, Valerie E. et al.)
     AIDS patients attending hospitals with more experience dealing with
the disease are more likely to live longer than those who  are admitted
to less-experienced hospitals, write Valerie E.  Stone et al. of the
Boston City Hospital in Boston, Mass.  The  researchers studied 151
women and male IV drug users and a random sample of 149 all male non-IV
drug users diagnosed with AIDS  during 1987 in Massachusetts.  In 806
hospitalizations at 40  hospitals, inpatient mortality was 13.2 percent.
Relative risk  of mortality at low AIDS experience hospitals was 2.16
times that of high AIDS experience hospitals.  Using logistic regression
to  control for age, sex, race, HIV transmission mode, severity,  payer,
admission type, hospital ownership, and teaching status,  low hospital
experience with AIDS remained a significant  predictor of inpatient
mortality.  Comparisons of 30-day  mortality by hospital AIDS experience
showed similar results.  In addition, length of stay and intensive care
unit use were  substantially higher at low-experience hospitals after
controlling for severity of illness.  Moreover, the better  outcomes in
high-experience hospitals do not seem to be the  result of more
intensive use of resources as measured by  admission to the intensive
care unit, length of stay, or cost,  the researchers conclude.

"Immunodeficiency and the Risk of Death in HIV Infection" Journal of the
American Medical Association (11/18/92) Vol. 268,  No. 19, P. 2662
(Phillips, Andrew N. et al.)
     HIV-positive patients who are closely followed-up seldom die
before the CD4 cell count has fallen to 50 ul, which is a count  many
patients remain above for up to 12 years after  seroconversion, write
Dr. Andrew Phillips and colleagues from the University College and
Middlesex School of Medicine in London,  England.  The researchers
studied 111 patients with hemophilia  who seroconverted to HIV-1 between
1979 and 1985.  Kaplan-Meier  estimates were used to calculate the risk
of death and indicated  that almost half of patients alive 12 years
after seroconversion  will have a CD4 cell count that is above 50 ul.
About 35 percent remain above 200 ul.  A total of 37 patients died of
HIV-related  illnesses, and there was a 52 percent probability of HIV-
related  mortality by 12 years from seroconversion.  Mortality risk was
closely related to severe immunodeficiency.  There was only a 15
percent chance of HIV-related death occurring before a CD4 count  of
below 50 ul had been reached.  There was an average of one  HIV-related
death per 96.7 patient-years of observation before  the CD4 count had
fallen below 50 ul, as compared with one death  per 2.5 patient-years of
observation after the CD4 count had  fallen below this level.  The risk
of HIV-related death is small  before the CD4 cell count reaches a level
of 50 ul but rises  rapidly thereafter, the researchers conclude.