The CDC National Center for HIV, STD, and TB Prevention provides the following information as a public service only. Providing synopses of key scientific articles and lay media reports on HIV/AIDS, other sexually transmitted diseases and tuberculosis does not constitute CDC endorsement. This daily update also includes information from CDC and other government agencies, such as background on Morbidity and Mortality Weekly Report (MMWR) articles, fact sheets, press releases, and announcements. Reproduction of this text is encouraged; however, copies may not be sold, and the CDC HIV/STD/TB Prevention News Update should be cited as the source of the information. Contact the sources of the articles abstracted below for full texts of the articles.
St. Petersburg Times (www.sptimes.com) (03/27/00) P. 5A; Allison,
Wes
Researchers, led by Dr. Terri Pustilnik at the University of
Alabama at Birmingham, have created a vaccine that is designed to
help the body fight cervical cancer using its own immune system.
At the American Cancer Society's annual science writers
conference in Tampa, Pustilnik and colleagues reported that the
vaccine attacks the human papillomavirus (HPV)using genetically
altered immune system cells. The vaccine has proven effective in
mice, and a phase I trial this fall will test its safety in about
12 women. HPV has been linked to the development of cervical
cancer.
Miami Herald Online (www.herald.com) (03/26/00); Somaroo, Tanya
The South Beach AIDS Project, based in Miami Beach, has been
offering home HIV testing kits free of charge to residents since
January. Over 550 residents have tested themselves for the
virus. Jeff Wilkinson, director of the project, said the kits
allow anonymous, confidential testing to be done at home. The
Home Access HIV testing kit is the only at-home one approved by
the Food and Drug Administration. The kit includes a number that
patients use to access their results via a toll-free hotline, and
professional counselors are also available to discuss treatment
options on the phone. The free distribution of the kits is part
of a project to learn the cost effectiveness of the at-home HIV
test kit in identifying, counseling, and treating individuals who
do not know they are infected. Over 84,000 cases of HIV and AIDS
have been reported in Florida as of June 1999.
"Men's AIDS Prevention Counseling Is Subject of 3-Year NIH Study"
Denver Rocky Mountain News Online (www.insidedenver.com)
(03/25/00); Lowe, Peggy
A new study evaluating the effectiveness of HIV prevention
counseling is taking place in six cities, including Denver. For
the three-year, $20 million effort, Project Explore has recruited
4,400 gay men throughout the nation who have tested negative for
HIV. Project Explore aims to help gay men protect themselves
while "trying to have intimacy and learn about sexuality, wanting
to have satisfying lives," according to Thomas Coates, director
of the AIDS Research Institute at the University of California at
San Francisco. The program is working to get the men to ask why
they take sexual risks. Participants in the program will also
receive testing for sexually transmitted diseases and follow-up
for three years.
Honolulu Star-Bulletin Online (www.starbulletin.com) (03/24/00);
Altonn, Helen
Hawaii, which has had the highest rate of tuberculosis (TB) cases
nationally since 1992, has announced plans to begin a TB
screening and prevention program in communities at high risk for
the disease. Dr. Jessie Wing of the state Health Department's TB
Control Program notes that Hawaii's TB problem reflects in part
the high number of visitors and immigrants to the state. The
Health Department will receive $114,000 in supplemental funding
for five years from the Centers for Disease Control and
Prevention. These funds will be used to launch a targeted TB
screening program. The education and prevention effort will
focus on high-risk communities in Honolulu as well as on
communities in Maui and on the Big Island. Hawaii recorded 184
TB cases last year, with 147 in Oahu alone.
Salt Lake Tribune Online (www.sltrib.com) (03/24/00); Wagner,
Norma
Utah residents who travel internationally are at high risk for
contracting tuberculosis (TB), according to Teresa Garrett,
bureau director of the state health department's HIV, TB control,
and refugee program. Previously, health officials attributed the
state's higher-than-national averages to male prisoners, the
homeless, and drug addicts. Utah's TB rate was lower in 1999
than 1998, with 40 cases instead of 52; however, foreign-born
residents, women, and foreign travelers are now more likely to
contract the disease. Whereas the number of foreign-born
residents with TB was about 15 percent of all cases in Utah
between 1995 and 1999, that number has soared to about 55
percent. Garrett noted that TB is most common in the former
Soviet Union, Southeast Asia, Africa, and parts of South America.
Anyone traveling to these places, including missionaries, should
be screened for the disease, she said. In addition to the
falling TB rate, Utah health officials also reported a decline in
drug-resistant strains of the disease.
Bergen Record Online (www.bergen.com) (03/24/00); Johnson, Linda
A.
For the third consecutive year, New Jersey has seen a decline in
tuberculosis (TB) cases, falling 11 percent to 571 cases in 1999.
Newark experienced a 43 percent drop in TB cases last year, for a
71 percent decline in the last five years. Dr. Lee Reichman,
head of the New Jersey Medical School National Tuberculosis
Center at the University of Medicine and Dentistry of New Jersey
in Newark attributed the decline in large part to directly
observed therapy (DOT), a program in which healthcare workers
observe TB patients taking their medications daily for six
months. The DOT program, which serves about three-quarters of
the state's TB patients, uses incentives to encourage patients,
including nutritional supplements and bus tickets for individuals
who do not want healthcare workers visiting their homes. New
York City officials also announced new TB statistics on Thursday,
reporting the seventh straight year of decreasing TB cases for
1999, with a 6 percent decline to 1,460 cases.
"Lobola, AIDS and Africa"
Washington Post (www.washingtonpost.com) (03/27/00) P. A27;
Mathabane, Mark
A commentary in the Washington Post draws attention to the
practice of lobola, in which African girls are bought as wives
for a cash or livestock dowry. Author Mark Mathabane cites this
practice as one reason why AIDS affects more women than men in
South Africa, which has 4 million people carrying HIV. Lobola,
rape, and older men taking advantage of younger girls are the
reasons for the spread of HIV among young women. The tale of
Florah, the author's sister, highlights the need for change.
Florah's husband was repeatedly unfaithful to her and put her at
risk of infection with HIV and other sexually transmitted
diseases. Florah could not leave her husband because he could
ask for his money back and she was told leaving would disgrace
the family. The author notes that many women stay in such
situations and, even when faced with the threat of disease, do
not mention condoms. According to Mathabane, while additional
funding certainly is needed for vaccine research, prevention
campaigns, and education, such "measures will be effective only
if issues such as the oppression of women are vigorously
addressed."
Bangkok Post (www.bangkokpost.com) (03/23/00); Thaitawat, Nusaru
The HIV infection rate among military conscripts in Thailand has
declined. The Armed Forces Research Institute of Medical
Sciences and Phra Mongkut Hospital found that 1 percent of the
25,738 conscripts last November who were screened for HIV tested
positive for the virus. That figure is down from 1.2 percent in
1998 and 1.6 percent in the previous year. The incidence among
May conscripts had dropped as well, falling to 1.6 percent in
1999, from 1.9 percent in 1998 and 2.2 percent in 1997. The
statistics show that last year, men aged 22 to 29 and those with
under nine years of formal education were more likely to have HIV
than those aged 21 and those over nine years of school.
AIDS Clinical Care (03/00) Vol. 12, No. 3, P. 23; Soloway, Bruce;
Friedland, Gerald
HIV patients who fail one or more antiretroviral regimens are
difficult to treat successfully, and physicians often must devise
salvage regimens. When switching a patient's failing therapy,
physicians should take into account that the success rates of
salvage regimens are lower than those of initial therapies and
that if a salvage regimen is not followed correctly, it could
lead to additional resistance mutations that make the virus
harder to treat. The success of an antiretroviral therapy
depends not only on viral loads, but also on the interactions of
behavioral factors and their effects on adherence. Viral factors
such as resistance to one or more medications must be treated
carefully. It is essential to obtain a complete history of prior
antiretroviral therapy from the patient. Adherence failure is
the largest factor contributing to treatment failure. The causes
of adherence failure must be addressed and discussed, including
supply of medications, depression, family crises, and other
factors. The clinician's job is to assess the patient's need for
therapy based on CD4 cell count and viral load. The patient's
lifestyle must be taken into account, including any substance
abuse, privacy needs, and mealtime schedules. Other factors
involved include the willingness of the patient for treatment and
the patient's relationship with his or her physician.