CDC HIV/STD/TB Prevention News Update

Myanmar, Laos: H.I.V. Spreading

"Myanmar, Laos: H.I.V. Spreading" New York Times (02/09/00) P. A6; Wren, Christopher S.
New research from the Johns Hopkins School of Public Health shows that HIV is spreading in the Asian region known as the Golden Triangle. According to the report, the virus is moving along heroin trafficking routes from Myanmar and Laos. Lead researcher Chris Beyrer said the data show "a clear and urgent need" for neighboring countries like China, India, and Vietnam, in addition to Myanmar, to focus more on HIV prevention.

Across the USA: Illinois

USA Today (02/09/00) P. 9A
In Illinois, the state Department of Public Health reported a 24 percent increase in new AIDS cases for 1999. The state has recorded a total of 23,094 cases of AIDS, including 1,557 new cases reported last year.

CDC Funds Diversion Is Probed

"CDC Funds Diversion Is Probed" Washington Post (02/09/00) P. A19; Strauss, Valerie; Stephens, Joe
The House Commerce Committee began an investigation Tuesday about how the Centers for Disease Control and Prevention diverted millions of dollars in federal funding. A letter to CDC Director Jeffrey Koplan from committee Chairman Thomas J. Bliley Jr. (R-Va.) questioned certain CDC statements made to Congress, following reports that the CDC told Congress it spent up to $7.5 million fighting hantavirus when much of the money actually went to study other diseases. Speaking before a House Appropriations subcommittee, Health and Human Services Secretary Donna Shalala called the CDC the "world's premier public health agency," but said the agency has lost the trust of the Congressional panel. Shalala said she is working with Koplan to fix the problems and has ordered the CDC's chief financial officer to review all agency expenditures.

State to Try to Get a Figure on Hepatitis C Infections

Houston Chronicle (02/08/00) P. A22; Snyder, Mike
Dr. Sharilyn Stanley, associate Texas health commissioner for disease control and prevention, announced that the state will launch a hepatitis C education and prevention initiative that will estimate the number of Texans infected with the virus. The seroprevalence study, to be done in two phases, will first collect 3,000 blood samples from clinics and test them. Because taking blood from a random group of the population just for this research would be too expensive, officials are searching for a group of blood samples already drawn that can be tested for hepatitis C, including random samples given for cholesterol screenings. The blood samples would remain anonymous, and the state could not contact those who test positive. The Texas plan, the most comprehensive one seen in the country, is based on a bill recently passed in the state Legislature, which has allocated $3.5 million for the effort.

Kazakhstan Faces Uphill Battle Against TB

Fox News Online (02/09/00)
Kazakhstan is struggling with an increasing rate of tuberculosis (TB), as poverty and crowded prisons help the bacterium to spread. Last year, the TB rate in the country was 18 percent higher than in 1998, according Shakhimurat Ismailov, director of the National Tuberculosis Center; although, the rate of growth between 1997 and 1998 was 30 percent. Ismailov said that small improvements were seen last year following the implementation of a new system to better diagnose and treat TB, although the central causes of the disease have yet to be addressed and the divide between the rich and poor continues to grow. He noted that the Aral Sea is shrinking and clean water is harder to find, while bulging prisons allow TB to breed rapidly, with 50 to 60 people in a cell meant for 15 to 20 inmates.

The Message of Risk

"The Message of Risk" Boston Globe (02/08/00) P. A22
An editorial in the Boston Globe raises the question about whether any type of sex may be considered safer than another. With an infected partner, no unprotected sex is safe, but new research shows that oral sex is much more a risk than previously thought. The study of 102 gay and bisexual men in San Francisco found that 8 percent contracted HIV through oral sex. In response, AIDS specialists in Massachusetts have announced plans to notify HIV prevention groups in the state about the risk of oral sex. The editors note that "the message about the risk of oral sex should especially be delivered by AIDS prevention groups and sex education instructors working with adolescents."

Officials Considering Needle Exchange

Washington Post--P.G. Extra (02/09/00) P. M3; Schwartzman, Paul
Prince George's County, Md., has a high enough AIDS caseload to prompt council member Thomas Hendershot (D-New Carrolton) to propose a needle exchange program for drug addicts. The proposal is opposed by several council members, who believe it will encourage drug use and may attract addicts from other parts of the state. Hendershot's plan, which would be run by the county's Board of Health, would cost $300,000 to $400,000 a year. Council Chairman Dorothy Bailey asked lawmakers for a three-week delay of a health committee review of the bill to allow for three public forums on the issue. Prince George's has the second highest number of AIDS cases after Baltimore, which has reduced its HIV caseload by 35 percent since it launched a needle exchange program in 1994.

Primary Care Center Harbors Risk of TB

"Primary Care Center Harbors Risk of TB" Sacramento Bee (02/08/00) P. B1; Davila, Robert D.
The Primary Care Center in Sacramento, California, has only one waiting room for primary care and chest patients, making it possible for someone with active tuberculosis (TB) to come into close contact with other patients. In a memo last November, Sacramento County health officer Dr. Gleenah Trochet called the situation "dangerous," after a guard working in the waiting area tested positive for the TB bacterium. County officials are recommending that a new clinic be built to help resolve problem. The clinic serves many low-income or uninsured individuals in the region, and early estimates for a new facility range between $18 million and $28 million.

Does Sex Ed Focused on Abstinence Work?

"Does Sex Ed Focused on Abstinence Work?" American Medical News (01/17/00) Vol. 43, No. 2, P. 21; Shelton, Deborah L.
Seven in 10 public school districts across the country require sexuality education, with 86 percent of them teaching abstinence-only as the preferred option or the only option of birth control outside of marriage, according to a survey by the Alan Guttmacher Institute. A second survey of 313 school principals showed that 94 percent of large secondary schools taught abstinence, but under 50 percent provided information about birth control and how to use it. Monica Rodriquez, director at the Sexuality Information and Education Council of the United States, is concerned that young people do not have access to information about sexuality that could be life-saving. The American Medical Association House of Delegates recently accepted a report by its Council on Scientific Affairs that called for comprehensive sex education, concluding that abstinence-only programs have limited value. About 23 percent of all school districts teach abstinence as the only birth control option, with southern states five times more likely than northeastern ones to have such a policy. However, the South also has some of the highest rates of sexually transmitted diseases and teen pregnancy. A 1997 Kaiser study found that, of 13- to 18-year-olds surveyed, 61 percent cited their peers as their primary source of sexual health information, 44 percent listed sex education classes, 39 percent said a teen magazine, and 32 percent listed their parents. Tina Hoff, director of public health information and communication for the Kaiser Foundation, noted that doctors were not even mentioned on that list. She said, "It's very important for physicians dealing with adolescents to know that young people are looking for accurate information about contraception, safe sex and HIV, in particular."

Initiative Targets Barriers to HIV Drug Adherence

AIDS Alert (02/00) Vol. 15, No. 2, P. 19
The failure of HIV patients to comply with their drug regimens can have serious consequences, because the rapidly mutating virus needs little encouragement to step up its attack. Massachusetts health officials are now attempting to determine which intervention programs work best in helping HIV patients follow their treatment regimens. To that end, the Community Research Initiative (CRI) of New England conducted a survey of 450 HIV patients in the state and 280 in a follow-up survey. According to CRI's Julie Marston, the top three reasons for not taking medications are forgetting, being too busy, and being away from home and not having the drugs. Other reasons cited include falling asleep, depression, being too sick from side effects, or having too many pills to take. The challenges to adherence programs fell into three categories: work burden, attitudes/beliefs, and confidentiality. These must be overcome for treatment success, according to the initiative.