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.
Journal of the American Medical Association (12/15/99) Vol. 282,
No. 23, P. 2220; Ledergerber, Bruno; Egger, Matthias; Erard,
Veronique; et al.
A Swiss HIV Cohort Study examined the incidence of opportunistic
infections (OIs) in patients taking potent antiretroviral therapy
and identified some risk factors. The study, which took place in
Switzerland, included 2,410 participants who were followed for at
least 15 months after beginning treatment. The results show that
143 of the patients developed 186 OIs after beginning potent
antiretroviral therapy. The incidence of any OI dropped from
15.1 per 100 person-years in the six months prior to treatment to
7.7 in the first three months of therapy, 2.6 in the next six
months, and 2.2 per 100 person-years between months nine and 15.
The authors concluded that the risk of developing an OI for a
patient taking antiretroviral therapy is greatest during the
first few months of therapy. They also noted that baseline CD4
cell count and immunologic and virologic response to treatment
were to strong predictors of disease progression in the patients
receiving the treatment.
Journal of the American Medical Association (12/15/99) Vol. 282,
No. 23, P. 2227; Ford, Carol A.; Bearman, Peter S.; Moody, James
A new study attempted to determine the numbers of adolescents who
think they need healthcare but do not receive it. The influence
of factors such as sociodemography, insurance status, past health
care, and health risks was analyzed using the National
Longitudinal Study of Adolescent Health from 1995. From grades
seven to 12, more than 20,000 adolescents completed a home
interview for the study, with an average of 18.7 percent
reporting foregone healthcare in the last year. Increased risks
for foregone care included factors like older age, minority,
single-parent home, and disability. In addition, children who
reported being sexually active, smoking cigarettes on a daily
basis, and drinking alcohol frequently were more likely to report
foregone care than those who did not report such behaviors.
According to the researchers, the findings suggest that
adolescents who forego health care are at greater risk for
physical and mental health problems.
New York Times (12/15/99) P. A16; Wilgoren, Jodi
Two new surveys conducted by the Kaiser Family Foundation and the
Alan Guttmacher Institute show that sex education in the nation's
schools is now focusing more on abstinence. The majority of
schools support the idea that students should delay sex until
marriage, but birth control and safe sex are necessary if they do
not wait. While over 95 percent of public school principals
reported that AIDS and other sexually transmitted diseases were
discussed in sex education classes, less than 50 percent provide
information on where to get birth control or how to use condoms.
The Guttmacher poll of superintendents reveals that most school
districts have changed their sex education programs over the last
10 years, with approximately one-third raising their emphasis on
abstinence. Money from Congress has helped the abstinence
message, as Gov. George W. Bush of Texas calls for more federal
spending on it. Regional differences show that schools in the
South report abstinence-only policies more often, with only 5
percent offering comprehensive sexuality education.
USA Today (12/15/99) P. 10A
Ohio's state school board has adopted a rule that requires
teachers to emphasize abstinence in sex education classes.
Critics have accused the Education Department of instituting
inappropriate sex education programs.
"Step Up the Fight Against AIDS, Panel Says"
Boston Globe Online (12/15/99) P. B3; Mullin, Rachel
Participants in a panel discussion on AIDS in Africa at Harvard's
Graduate School of Education are calling on the African-American
community and U.S. leaders to help fight the epidemic. The
topics of rape and promiscuity sparked discussion on sexual
behaviors that help spread HIV. Rev. Eugene Rivers, co-chairman
of the National Ten-Point Coalition, called for "a post-civil
rights freedom movement to free the women of the world from rape
and sexual exploitation." In addition, panelist Kevin Freeman of
Boston University's School of Public Health suggested that all
races should work together to help stop AIDS.
Boston Globe Online (12/14/99); Mcmillan, Jean
Massachusetts has received $99.7 million as its first of three
payments from a national tobacco settlement, but anti-tobacco
groups note that they will not let the arrival of the funds
distract them from their efforts to fight Big Tobacco. About $23
million will be spent on tobacco-cessation programs next year,
while $10 million has been budgeted to improve care for
HIV-infected individuals, another $10 million will be spent on a
catastrophic drug pharmacy program, $10 million for better care
for those with HIV, and $5 million will be used for community
health centers.
Reuters Health Information Services (12/14/99)
New findings show that shigellosis rates among HIV-infected
individuals living in San Francisco are increasing. The
researchers, who evaluated 228 and 140 confirmed cases of
shigellosis reported in San Francisco and Alameda Counties during
1996, found that the majority of the cases in both counties were
caused by the S. sonnei species. In addition, nearly 40 percent
of the patients in San Francisco were also infected with HIV.
The authors, who report their findings in the November/December
issue of Emerging Infectious Diseases (1999;5:e1-e7), suggest
that it may be necessary to rework public health prevention
efforts in regions with a large HIV-positive and homosexual male
population.
"Visions 21: The Spread of HIV"
Time (11/08/99) Vol. 154, No. 19, P. 84; Ho, David
AIDS will remain an epidemic well into the future, according to
Dr. David Ho, director of the Aaron Diamond AIDS Research Center.
HIV has become the most fatal microbe in the world, more deadly
than tuberculosis and malaria. Sub-Saharan Africa and Southeast
Asia have been particularly hard hit by the epidemic, and the
infection rates continue to rise. Fourteen AIDS drugs have been
created and are now used in the United States and Western Europe,
but treatments are scarce in less developed areas. Ho predicts
that AIDS will be the leading killer of young Africans by 2025,
but he notes that Asia "will have the biggest impact on the
global spread of AIDS." Depending on how the virus spreads in
India and China, 100 million to 1 billion people could be
affected, Ho says. The real hope for stopping HIV is a vaccine,
which will also require a huge effort on the part of government
leaders to help get it to the people who are most in need.