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CDC HIV/STD/TB Prevention News Update

Tuesday, January 11, 2000
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.

Peer-Review Headlines

General Meadia


Peer-Review Headlines

Continued Risky Behavior in HIV-Infected Youth

American Journal of Public Health (01/00) Vol. 90, No. 1, P. 115; Diamond, Catherine; Buskin, Susan
New research indicates that both adolescents and adults continue to engage in risky activities even after they were diagnosed with HIV. Researchers from the University of Washington School of Public Health and the Seattle-King County Department of Public Health reviewed data for more than 3,000 HIV-infected youths and adults in an effort to describe and compared the risk behaviors of the two groups. The data was obtained from the Seattle-King County Adult/Adolescent Spectrum of HIV-Related Diseases Study, conducted between January 1990 and February 1998. The results show that both female and male youths were over two times as likely as adults to engage in risky behavior, including engaging in unsafe sex and sharing injection drug paraphernalia. The authors note, however, that both the youths and the adults participated in risky activities after HIV diagnosis, showing the need for public health campaigns targeting individuals infected with HIV as well as those at risk for HIV/AIDS.


General Media

Gore Vows AIDS Initiative

"Gore Vows AIDS Initiative" Washington Post (01/11/00) P. A11; Lynch, Colum
Vice President Al Gore pledged on Monday to seek $150 million from Congress to combat HIV and other infectious diseases in Africa and Asia, noting that AIDS is as significant a threat to global security as war. If approved, the new funds would raise the total for fighting AIDS overseas to $325 million. The funding would mostly go towards sub-Saharan Africa, where AIDS is the leading cause of death. At the meeting of the United Nations Security Council, Namibian health minister Libertine Amathila and others warned that AIDS is ruining national health budgets in Africa. Amathila noted, "Africa has the least access to drugs but the greatest access to arms." Vice President Gore also reported that the White House plans to request $50 million from Congress to finance research and to buy and distribute drugs that attack other major killers, including tuberculosis, hepatitis B, and yellow fever.

Clinton Wants Bigger Budget to Fight Diseases

Reuters (01/10/00)
President Clinton has proposed spending an extra $20 million in 2001 to battle infectious diseases and to form a national electronic disease surveillance network. The new network, which would allow for rapid transmission of information from doctors to state health departments, is being created by the Centers for Disease Control and Prevention. In a fact sheet detailing the plan, the White House noted that there has been substantial improvement in the United States' ability to identify outbreaks of infectious diseases, although diseases like AIDS and toxic shock syndrome still pose serious health threats. If approved by Congress, the additional funding would add to the CDC's existing budget of $44.3 million for the project.

Supreme Court Roundup: AIDS Insurance Cap

New York Times (01/11/00) P. A14; Greenhouse, Linda
The U.S. Supreme Court has refused to hear an appeal against an insurance company's cap on lifetime benefits for AIDS treatment. Policies from Mutual of Omaha give maximum benefits at $25,000 or $100,000, not $1 million or more as provided for non-AIDS-related conditions. The limit on benefits was challenged by two HIV-infected policyholders who had won a 1998 decision in Chicago that was overturned last summer. The appeals court ruled that while the Americans with Disabilities Act ensures access to insurance, it does not regulate the content of insurance policies.

Ailing Immigrants: New Era, New Rules

New York Times (01/11/00) P. D7; Chiles, Nick
In the early 1900s, immigrants entering the United States were inspected at places like Ellis Island for signs of coughing or other illness. If tuberculosis (TB) was suspected and the disease had not progressed too much, they were sent back home. X-rays were used after 1910 to be sure of a diagnosis during a time when tuberculosis was highly feared. Today, TB is once again causing fear among public health experts, as TB rates increase in developing nations and immigration rates from those countries has never been higher. While the circumstances now are different from the early 1900s, when officials had to make diagnoses in a matter of seconds and effective antibiotics and treatments were not available for many diseases, today there are other concerns, including AIDS and drug-resistant TB. Thousands of immigrants enter the country without medical screening, bringing TB, skin infections, and colds. Borders have become easier to cross, and TB rates among the foreign-born population are high. For individuals born in the United States, the rate of TB is about five cases per 100,000 people, compared to about 30 per 100,000 among foreign-born individuals in the country.

Influenza Virus Enhances CXCR4-Dependent HIV-1 Infection

Reuters Health Information Services (01/10/00)
Researchers, led by Dr. Ana Puri of the National Cancer Institute, have found that influenza infection raises the susceptibility of cells to infection by HIV-1 isolates that use the CXCR4 coreceptor. The team, which reported its findings in the January 1 issue of AIDS Research and Human Retroviruses (2000;16:19-25), conducted an in vitro study to determine the impact of the influenza strain A/PR/8 on HIV-1's replicative ability. The researchers conclude that the influenza virus increases CXCR4 expression and thus influences HIV-1 infection.

USAID Announces 12 African Nations to Receive Funding

Africa News Service (01/10/00)
Twelve African countries--including Ethiopia, Kenya, South Africa, and Uganda--will receive additional fiscal year 2000 funding under President Clinton's LIFE (Leadership and Investment Fighting an Epidemic) initiative, according to the U.S. Agency for International Development (USAID). The money is given based on the governments' commitment to stopping the spread of HIV and will be used for prevention efforts. The funds will also support those sick with AIDS, help children orphaned by the disease, treat pregnant women with HIV/AIDS, and help build health infrastructure in the countries. Since 1986, USAID has given over $1.2 billion to help fight AIDS in the developing world.

Health--Congo: AIDS the Number One Cause of Death

IPS Wire (01/10/00)
AIDS is the chief cause of death among Congolese Armed Forces servicemen, of whom 14 percent are infected with HIV, according to armed forces health officials. AIDS caused over 60 percent of army deaths between 1989 and 1993, according to Col. Prosper Kinzonzi, director of the First Military Zone's health service. The armed forces are at risk because they travel, are young, and are sexually active. Kinzonzi lists unsafe commercial sex is key cause of the rise in AIDS cases in the military. Rape is also a factor in the increase, as sexual violence becomes more common among soldiers.

AMA to Study Pap Smear Liability Issues

American Medical News (12/27/99) Vol. 42, No. 48, P. 29; Stapleton, Stephanie
The American Medical Association (AMA) House of Delegates has asked its Council on Scientific Affairs to study the use of the Pap smear, the limitations of the test, and the effects of false-negative test results. The action came in response to the request from numerous healthcare professionals that the AMA have guidelines to review Pap smears in terms of potential legal action. The AMA Board of Trustees reports that there has been a substantial increase in lawsuits filed based on false-negative Pap test results. In some areas, a false-negative result is considered proof of substandard care, ignoring the fact that no test is 100 percent accurate. While the AMA realizes Pap smears have decreased cervical cancer mortality rates, the group noted there are concerns about supporting the type of liability protection in question. Currently, no guidelines have been set.

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