NetNews Usenet Archive 1993 #3

home *** CD-ROM | disk | FTP | other *** search

/ NetNews Usenet Archive 1993 #3 / NN_1993_3.iso / spool / sci / med / aids / 2250 < prev next >

Wrap

Text File | 1993-01-24 | 15.1 KB | 232 lines

Newsgroups: sci.med.aids Path: sparky!uunet!paladin.american.edu!howland.reston.ans.net!usc!news.service.uci.edu!ucivax!ucla-cs!usenet From: Billi Goldberg <bigoldberg@igc.apc.org> Subject: CDC Summary 1/20/93 Message-ID: <1993Jan23.140018.3878@cs.ucla.edu> Note: Copyright 1992, Dan R. Greening. Non-commercial reproduction allowed. Sender: usenet@cs.ucla.edu (Mr Usenet) Nntp-Posting-Host: sole.cs.ucla.edu Archive-Number: 13 Organization: unspecified Date: Fri, 22 Jan 93 22:02:12 PST Approved: phil@wubios.wustl.edu (J. Philip Miller) Lines: 217 AIDS Daily Summary January 20, 1993 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. Copyright 1992, Information, Inc., Bethesda, MD ------------------------------------------------------------------------ "AIDS Enters the Office" Financial Times (01/20/93), P. 8 (Harrison, Barbara) Although a few American companies have instituted AIDS education campaigns, most firms lag behind in establishing any anti-AIDS efforts. Approximately 1 million Americans are HIV-positive, making AIDS the second leading cause of death for men aged 25-44 and the sixth leading cause for women aged 25-44. This age group accounts for more than 50 percent of the U.S. workforce. More than two-thirds of companies with between 2,500-5,000 employees and about one in 12 companies with fewer than 500 employees have had a worker with HIV or AIDS. Therefore, the Centers for Disease Control has established a "Business Responds to AIDS " program. The agency has prepared a manager's kit and a labor leader's kit to give step-by-step guidelines on how to develop an HIV/AIDS policy and an education program. The kits make recommendations regarding health insurance issues, in addition to counseling and educational services. It also includes a section on what the Americans with Disabilities Act means to companies. It says that companies cannot deny an HIV-positive individual a job because insurance costs may increase. Also, job applicants cannot be forced to undergo an HIV test. And firms cannot release workers with HIV or AIDS if they are able to perform the "essential functions" of a job given "reasonable accommodation" to their disability. Digital Equipment Corporation was one of the corporate pioneers which established an AIDS education program in 1987. Paul Ross, Digital's manager of its HIV/AIDS program, feels that allaying the fears of infected and uninfected alike is crucial to avoid workplace problems. ------------------------------------------------------------------------ "Europe Starts to Face HIV Issue" Financial Times (01/20/93), P. 8 (Abrahams, Paul et al.) European-based companies have been slow to deal with AIDS in the workplace, as opposed to their U.S. counterparts. A primary reason is that the disease has spread more slowly in Europe than North America. For example, 3,995 people in the U.K. have died of AIDS since 1982. Most of the firms that have addressed the problem early have been branches of U.S. multinationals or U.K.-based groups with subsidiaries in Africa and Asia. Glenys Rowe, an independent consultant on HIV and AIDS implications for businesses, says that more businesses are now beginning to face the issue. Approximately half of the companies that contemplate adopting an anti-HIV policy do not do so, but incorporate the issue into existing health policies. They fear that a specific policy would lead to discrimination. Rowe said that one of the most promising programs is the launch of the U.K. Corporate HIV + AIDS Project. It's goal is to produce a number of briefing sheets on various policy issues when considering the impact of HIV and AIDS on businesses. The French Agency for the Fight against AIDS recently surveyed more than 1,000 company personnel directors and found that one in 10 firms had HIV-positive workers. A total of one in four companies had implemented prevention programs. However, the 80 percent of companies which had not already established any program said they saw no reason to do so in the future. Evidence suggests that the risk are minimal for heterosexuals who do not inject drugs, do not visit brothels, and do not holiday in Thailand and other "sex-tourist" hot- spots. Recent figures state that homosexual/bisexual men comprise 65 percent of new AIDS cases and IV-drug users account for 15 percent. ------------------------------------------------------------------------ "Young Men Dominate AIDS Victims in Singapore" Reuters (01/16/93) Singapore--Most new AIDS cases in Singapore occur among young men who had sex with prostitutes, and an additional 55 people were found to be infected with HIV last year, the Health Ministry reports. The Sunday Times newspaper quoted ministry figures as demonstrating that three out of four of all Singaporean AIDS patients were single and four out of five were between the ages of 20 and 39. Among the 55 new HIV- positive individuals--49 men and six women--about 70 percent contracted HIV through heterosexual relations with prostitutes and 96 percent through sexual contact. In 1991, there were 42 newly detected HIV cases, and 17 in 1990. According to the Health Ministry, 37 Singaporeans died of AIDS as of January 1 and there were 158 other people found to be infected with HIV. The number of foreigners infected with HIV increased from 28 in 1991 to 61 in 1992. ------------------------------------------------------------------------ "AIDS Prevention" Associated Press (01/16/93) (Kennedy, Dana) New York--After the federal government announced that it would cut state funds for AIDS prevention, a New York outreach worker began to worry about where teenage prostitutes in Times Square will get condoms. Ines Robledo, who works with Streetwork, a drop-in center that provides AIDS counseling to homeless teenagers and some adults, said, "They're going to give up hope without us." She said they are more concerned about where they are going to sleep and eat, rather than whether they are going to infect others or themselves. Federal officials recently revealed that Congress has allotted only $129 million for grants to states for AIDS prevention this year, compared with $143.7 million last year and $159 million in 1991. Terri Lewis, director of the AIDS and Adolescent Network, said, "This is the most appalling thing the government has done in the history of this epidemic. Many centers are going to close down, which means people won't get the services they need and more and more people will get infected." One prostitute said that many men won't use condoms and a lot of prostitutes won't dispute it. Monay Johnson, a 24-year-old transvestite prostitute, said he tries to use condoms with customers but often is to tired. He added that when he is using crack he usually forgets about it altogether. Streetwork is part of Victim Services Agency, and its budget for fiscal year 1993 is just over $1 million--including about $170,000 from the federal government, said Marin Gazzaniga, a Victims Services spokeswoman. The remainder comes from a combination of state, city, and private funds. ------------------------------------------------------------------------ "One of Six in Zimbabwe has AIDS Virus--Study" Reuters (01/18/93) Harare--Nearly 1.5 million residents of Zimbabwe, a sixth of the country's population, have contracted HIV, according to a survey published on Monday. The survey, commissioned by the Commercial Farmers' Union, said Zimbabwe's economy could experience a lack of skilled labor if infection rates continued at present levels. Zimbabwe has 40,000 confirmed AIDS cases reported in a population of 10.2 million. ------------------------------------------------------------------------ "AIDS Education" Associated Press (01/18/93) (Neergaard, Lauran) Atlanta--Parents and school systems nationwide are debating about how to educate students about AIDS and at what age. John Kappers of the National Association of People with AIDS, said, "This has polarized people because they think it's a morality issue. If they could see someone dying of this disease, they would see the immorality in not teaching about it." The debate has occurred in New York regarding what to teach in each grade which stalled the state from implementing AIDS education in the nation's largest school district until five years after lawmakers mandated it in 1987. Also, the Michigan Board of Education rejected a proposed wait-until-marriage approach. In South Carolina, some parents are requesting that lawmakers stop the Education Department from using "AIDS-Buster" kits--equipped with a rubber model of a penis for condom demonstrations--with high risk teens in pregnancy clinics and juvenile shelters. But the most recent controversy has emerged in Georgia, where hundreds of parents are protesting a state plan to increase sex and AIDS education. Georgia students get anywhere from two days to a few weeks of sex education in high school; the class is often an elective. The governor vetoed a bill last year that would have curbed the courses and asked the state Board of Education to strengthen the curriculum. The school board suggested that fifth- graders be taught "some of the ways to prevent the spread of communicable diseases." Critics say that suggests that students would get explicit lessons on anal and oral sex and condoms--educators vehemently deny it. Georgia has about 6,000 AIDS cases--ranking seventh in the nation--along with at least 16,400 HIV infections. ------------------------------------------------------------------------ "TMP/SMX Prophylaxis for Toxoplasmic Encephalitis" American Pharmacy (01/93) Vol. NS33, NO. 1, P. 87 (Covington, Timothy R. and Hurd, Peter D.) Low doses of trimethoprim-sulfamethoxazole (TMP-SMX) appear to be more effective prophylaxis against toxoplasmic encephalitis when compared to pentamidine in AIDS patients with a history of Pneumocystis carinii pneumonia (PCP), according to a study conducted by A. Carr et al. published in the Annals of Internal Medicine. Toxoplasmic encephalitis is a frequently occurring neurologic complication of HIV infection with early mortality as high as 16 percent and residual neurological impairment of 40-50 percent. The study analyzes the efficacy of low-dose TMP-SMX as primary prophylaxis against toxoplasmic encephalitis versus pentamidine in HIV-positive patients with a history of PCP. A total of 60 patients received TMP-SMX during the three-year study period, and 95 received pentamidine as secondary prophylaxis against PCP. None of the 60 patients in the TMP-SMX group and no patients in the seronegative for Toxoplasma gondii developed toxoplasmic encephalitis. In the pentamidine-treated group, 12 of 36 seropositive patients developed toxoplasmic encephalitis. No cases of toxoplasmic encephalitis developed during the observation period. The median time to develop PCP in the 12 seropositive patients in the pentamidine-treated group was 460 days. Low-dose TMP-SMX offers the advantage of being simple, convenient, and safe and it may protect an AIDS patient from developing both toxoplasmic encephalitis and PCP, the researchers conclude. ------------------------------------------------------------------------ "Corticosteroids for HIV Esophageal Ulcerations" American Pharmacy (01/93) Vol. NS33, No. 1, P. 87 (Covington, Timothy R. and Hurd, Peter D.) Oral corticosteroid therapy is effective when used to treat HIV- related esophageal ulcerations, write C.M. Wilcox and D.A. Schwartz in a study featured in the American Journal of Medicine. The study assesses the safety and efficacy of oral prednisone therapy in managing HIV- associated idiopathic esophageal ulcerations. Esophageal ulceration was confirmed by clinical, endoscopic, and pathologic criteria in HIV- positive individuals. Prednisone was administered to 12 patients at an oral dose of 40 mg per day, tapering 10 mg per week, for a total of one month of therapy. Endoscopy was performed within one week of completion of therapy. The mean duration of esophageal symptoms was found to be 2.9 weeks. A total of 10 of the 12 patients receiving the steroid had AIDS. Also, 11 of the 12 patients had complete relief of symptoms, usually in the first week of therapy. The study revealed that the oral steroid regimen was well-tolerated. Mild asymptomatic Candida esophagitis was detected in the patients on follow-up endoscopy. No systemic opportunistic infections were documented during or within one month of the completion of therapy. The researchers conclude that controlled studies should be conducted to determine optimal dose and duration of therapy and ultimate safety and efficacy. ------------------------------------------------------------------------ "Noticeboard: Didanosine and ACTG 116A" Lancet (01/09/93) Vol. 341, No. 8837, P. 109 The National Institutes of Allergy and Infectious Diseases has released findings from a study by the AIDS Clinical Trials group that addresses whether duration of previous AZT therapy influences the efficacy of didanosine. The trial (ACTG 116A) comprised the second part of a study that analyzed the efficacy and toxicity of didanosine in patients with AIDS, AIDS-related complex, or asymptomatic HIV infection. Of the patients who had not taken AZT before, didanosine was less effective than AZT at preventing progression of HIV disease to a new AIDS-related illness. In patients who had received 8-16 weeks of AZT, didanosine was the more effective drug. A total of 119 patients who took 8 or fewer weeks of AZT had inconclusive data. Patients receiving low-dose didanosine had fewer episodes of pancreatitis, the most serious side-effect of didanosine therapy, than those receiving the higher dose. Last year, the results from the first part (ACTG 116B/117) of the study protocol were published. Kahn et al. discovered that low-dose didanosine postponed progression of HIV disease in patients with ARC and asymptomatic HIV infection who had received AZT for at least 16 weeks. The subjects in the ACTG trial differed from those in the Alpha trial, in which patients were intolerant of AZT. The results that show 500 mg/day didanosine (400 mg/day in tablet form) is safer than the higher dose, and that it is more effective than AZT in patients who have received 8-16 weeks of AZT, support its use in urgently needed studies of alternating vs. simultaneous nucleoside analog regimens and in trials combining nucleosides with other drug categories.