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CDC HIV/STD/TB Prevention News Update

Tuesday, March 7, 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

Metronidazole to Prevent Preterm Delivery in Pregnant Women With Asymptomatic Bacterial Vaginosis

New England Journal of Medicine (www.nejm.org) (02/24/00) Vol. 342, No. 8, P. 534; Carey, J. Christopher; Klebanoff, Mark A.; Hauth, John C.; et al.
Researchers for the National Institute of Child Health and Human Development Network of Maternal-Fetal Medicine Units investigated the effectiveness of metronidazole in preventing preterm delivery in women who have asymptomatic bacterial vaginosis, a condition that has been connected to preterm birth. The women participating in the study were given eight capsules of either 250 mg of metronidazole each or a lactose placebo, to be ingested in front of study personnel. The women received eight additional capsules to be taken 48 hours later. Two more doses were administered 24 to less than 30 weeks gestation. Information on delivery was available for 953 of the women treated with metronidazole and 966 women who were given the placebo. Of the women in the metronidazole group, 116 women had their babies early, compared to 121 women in the placebo group who experienced preterm delivery. In addition to not preventing delivery before 32 weeks, treatment with metronidazole did not reduce the occurrence of preterm deliveries caused by spontaneous labor or spontaneous rupture. Incidents of preterm labor, intraamniotic or postpartum infections, neonatal sepsis, or admission of the infant to the neonatal intensive care unit were also not reduced with treatment.


General Media

Rabies Virus Used in HIV Vaccine Test

USA Today (www.usatoday.com) (03/07/00) P. 9D
Researchers at Thomas Jefferson University in Philadelphia report that combining the rabies virus with a part of HIV makes an HIV vaccine that appears to work in mice. The findings are promising, although any possible human trials of such a technique are long off. The new approach, reported in the Proceedings of the National Academy of Sciences, should be more useful than killed or weakened virus vaccines, the authors said. They also noted that rabies does not seem able to mix with other viruses like HIV can.

India: Coping with TB

New York Times (www.nytimes.com) (03/07/00) P. A8
A new report reveals that an intensive treatment program for tuberculosis (TB) has saved over 40,000 lives in India, reaching cure rates of more than 80 percent. An estimated 2 million Indians develop TB every year.

Fast, Accurate Tuberculosis Test Well-Suited for Developing Nations

U.S. Newswire (03/03/00)
An international team of scientists has developed a new method for detecting tuberculosis (TB), called microscopic observation broth-drug susceptibility assay (MODS). The test is inexpensive and can detect small amounts of the Mycobacterium tuberculosis bacillus, according to a report in March's Journal of Clinical Microbiology (2000;38;1203-1208). The MODS assay is fast and specific, according to Robert Gilman, a professor at Johns Hopkins School of Public Health, and effective for use in rural, poor areas. Gilman also noted the test, which was studied in Peru, can identify drug-resistant strains of TB.

Nurse-to-Patient HIV Transmission Reported

Reuters Health Information Services (03/06/00); Stern, Penny
A new study details a case of apparent nurse-to-patient HIV transmission in France. A French-Belgian research team report that a female surgical patient in suburban Paris developed HIV after one of two night nurses unknowingly infected her. The woman had no known risk factors for HIV, but an analysis of HIV from the nurses showed one as the likely source. According to the report in the Journal of Virology (2000;74:2525-2532), it is not known how the nurse, who was unaware of her HIV status until just weeks before the patient returned to the hospital with symptoms of HIV, transmitted the virus to the patient.

Health: STD Levels in India/Bangladesh Point to AIDS Explosion

"Health: STD Levels in India/Bangladesh Point to AIDS Explosion" IPS Wire (03/06/00)
High levels of sexually transmitted diseases in India and Bangladesh could accelerate the pace of the expected HIV/AIDS explosion in South Asia, according to UNAIDS head Dr. Peter Piot. On Monday, Piot helped launch the "2000 World AIDS Campaign," which is focusing on the attitudes and behaviors of men. Piot said that India, with 3.7 million cases, has the most HIV infections in the world, out of a population of 1 billion. However, the low HIV prevalence is not expected to last because of low condom use among commercial sex workers and men's infidelity to their wives. The secrecy and stigma of HIV, related to extramarital affairs, has forced many men to keep the virus secret from their wives. Males in South Asia have great control over women, although Piot was careful not to blame all men for the spread of HIV in Asia. The new campaign, which carries the theme "Men Can Make a Difference," will urge men to have better sexual health and to take leadership in protecting their wives and daughters.

Of Sex, Smarts and the Teenage Mind

New York Times (www.nytimes.com) (03/07/00) P. D8
A new study led by Dr. Carolyn Halpern of the University of North Carolina at Chapel Hill shows that adolescents who score higher on intelligence tests are less likely to engage in sexual intercourse, kissing, or holding hands than other teens. However, among students over age 15, those who scored low on the test scale were just as likely as those in the upper percentile to abstain from sex. The study, published in the Journal of Adolescent Health (2000;26:213-225), used data from a national survey of 12,000 teenagers and more detailed information on 300 North Carolina teens.

A Disease Spread by Silence

San Francisco Chronicle Online (www.sfgate.com) (03/05/00) P. 1/Z1; Wright, Kai
In South Africa, HIV infects one in eight people, with an estimated 1,600 infections daily. Nearby Botswana, Namibia, Swaziland, and Zimbabwe also have high rates of infection. One obstacle to changing the HIV demographics in Africa is ending the stigma associated with the virus. The Clinton administration has proposed a boost in foreign assistance, from $112 million last year to $325 million in 2001, to help Africa start more AIDS programs. However, the money will not help without an attack on the stigma of HIV, which causes many people to keep their infection status secret. Because of this secrecy, the stigmatization cannot end and discourages testing for HIV. The 1998 murder of Gugu Dlamini, who openly announced she had HIV during a World AIDS Day event, has scared many South Africans into concealing their HIV infection. In KwaZulu-Natal, AIDS activist Mercy Makhalemele founded a group for people with AIDS, where people can come to confide their HIV status and publicly disclose it. Makhalemele, who halted the disclosure campaign following Dlamini's murder, is now focusing on the upcoming world AIDS conference in July, attempting to raise funding and forge global partnerships with HIV and AIDS patients.

Scope of Flood Disaster Grows Daily

"Scope of Flood Disaster Grows Daily" USA Today (www.usatoday.com) (03/07/00) P. 15A; Walt, Vivienne
The severe flooding in Mozambique is aggravating the spread of disease. In the country of about 19 million people, about 1.8 million are infected with HIV, and malaria and tuberculosis are also running rampant. According to Lindsay Davies, a spokeswoman for the World Food Program, "This is a hotbed for disease to grow and multiply," as the contaminated floodwaters and rising temperatures continue to take their toll.

State Survey: New Jersey

Infectious Diseases in Children (www.slackinc.com/idc.htm) (02/00) Vol. 13, No. 2, P. 66
A new law signed by New Jersey Gov. Christine Whitman requires the use of needle stick safety devices, joining California, Maryland, Texas, and Tennessee, which have similar measures. Both the Centers for Disease Control and Prevention and the Occupational Safety and Health Administration advise making needle stick safety devices mandatory in U.S. hospitals. Each year, needle stick injuries expose up to 1 million health workers to diseases like HIV and hepatitis B or C.

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