>From: "ANNE WILSON, CDC NAC" >Subject: CDC AIDS DAILY SUMMARY 12/29/93 >Date: Wed, 29 Dec 1993 13:44:00 GMT AIDS Daily Summary December 29, 1993 The Centers for Disease Control and Prevention (CDC) National AIDS Clearinghouse makes available the following information as a public service only. Providing this information does not constitute endorsement by the CDC, the CDC Clearinghouse, or any other organization. Reproduction of this text is encouraged; however, copies may not be sold, and the CDC Clearinghouse should be cited as the source of this information. Copyright 1993, Information, Inc., Bethesda, MD "Biaxin Listed as Treatment for AIDS-Related Infection" Wall Street Journal (12/29/93) P. B4 Abbott Laboratories Inc. of Abbott Park, Ill., has received approval from the Food and Drug Administration to offer its antibiotic Biaxin as a treatment for disseminated mycobacterium avium complex (MAC), an AIDS-related condition. Disseminated MAC is the most common systemic bacterial infection observed in AIDS patients. According to Abbott, Biaxin, the brand name for clarithromycin, is the first drug to receive FDA permission to treat the infection. The company reported study results indicating that Biaxin reduces the MAC organism in the blood. "Hope for Children of AIDS" Los Angeles Times--Washington Edition (12/29/93) P. B10 (Adams, Emily) Tanya Shaw, a single mother with AIDS, dedicated her final months to starting a service agency that would cater to others like herself. A small group of women responded to her call and helped her find an adoptive family for her two daughters. Upon Shaw's death last February, the women created Tanya's Children, a nonprofit organization, to continue her mission. Volunteers at the agency, which is located in South-Central Los Angeles, arrange child-care for ailing mothers. "The first thing we offer women is a reprieve from their children," says Sandy Scott, executive director of Tanya's Children. "That's what they need the most, for the days when child care is just too exhausting." The agency also provides legal aid and counseling, and leads mothers through the maze of government and private foundations that offer money, meals, and other support. In addition, Tanya's Children works as a referral service, screening prospective families to adopt the children of clients who will eventually die from AIDS. The organization has already arranged the adoptions of three children, and has seven more active clients. But as AIDS now ranks as the Number 4 killer of women aged 25 to 44, Scott and others at Tanya's Children expect many more mothers to seek their services. "Michael Callen, Singer and Expert on Coping With AIDS, Dies at 38" New York Times (12/29/93) P. D19 (Dunlap, David W.) Michael Callen, a writer and singer who spent the 12 years since his AIDS diagnosis telling the world how to deal with the virus, died of the disease on Monday night at the age of 38. After he learned in 1982 that he had AIDS, Callen thrust himself into political advocacy. He devoted the rest of his life to spreading the message of survival through magazines, newspapers, films, television appearances, and concerts. In addition, he authored "Surviving AIDS," and co-authored "How to Have Sex in an Epidemic." In 1983, Callen was a plaintiff in the nation's first AIDS discrimination case, in which his physician, Dr. Joseph A. Sonnabend, successfully challenged an eviction from a Greenwich Village co-op for treating AIDS patients. Callen was also a founding member of the People With AIDS Coalition and of the Community Research Initiative in New York, which conducted its own drug trials. He is survived by his companion, parents, a sister, and a brother. Related Story: Los Angeles Times--Washington Edition (12/29) B3 "TB and the Budget at AID" Washington Post (12/29/93) P. A18 Earlier in the year, the World Health Organization asked the United States to contribute to an international effort to combat the spread of tuberculosis in developing countries. Last week, the health office of the U.S. Agency for International Development (AID), citing the budget environment, declined to offer its $3-million share. The decision, say the editors of the Washington Post, is one that AID Administrator Brian Atwood should reconsider. The number of fatalities from AIDS and malaria, combined with other infectious diseases, still do not reach the number of adults who reportedly die each year from TB, cites the Post. As "the world's most neglected health crisis" by WHO standards, TB, left unchecked, will wipe out 30 million lives in the next ten years. It is most prominent in the Third World, but is sweeping Europe and America as well. Old environmental factors in the United States, such as crowded, unsanitary conditions, added to new ones like HIV, drug abuse, and homelessness, all add to the TB rebound. AID staff insist that TB already benefits from other programs, including a $35-million grant to WHO's AIDS-HIV program. That, however, declare the Post editors, does not alter the fact that a $3-million contribution from the United States, combined with the donations from other rich nations, is a necessary and inexpensive way to save many lives in developing countries. "Urgency Spurs AIDS Vaccine Testing" St. Louis Post-Dispatch (12/27/93) P. 1B (Signor, Roger) The urgency of testing new AIDS vaccines has heightened in recent months, primarily due to obstacles facing the first generation of candidate vaccines. After five years of preliminary trials, laboratories are finding that the vaccines are safe, but may be ineffective. The problem is that the vaccines are failing a final lab test that they must undergo before they can be used in large trials. In this test, the vaccine is mixed in a test tube with viruses taken from AIDS patients, as well as cells that can make antibodies to kill the virus at a cue from the vaccine. The failure of a vaccine to kill the "wild" viruses is a warning to researchers that it may be ineffective. Scientists are checking to determine whether the test or the vaccine is flawed. A conclusion that the vaccines are ineffective could jeopardize a large, $10-million nationwide field trial of the first-generation vaccines by the National Institutes of Health. While some AIDS authorities say that the first generation of vaccines still may work, others believe that throwing out the vaccines and starting over may be best. "The virus strain used to make the first generation of vaccines is probably not the major strain of virus now involved in infecting people," said Dr. William G. Powderly, director of the AIDS Clinical Trial Unit at Washington University's School of Medicine. "If you want to prevent AIDS you have to hit the virus that's predominant in the early stages of infection." Dr. Margaret Johnston, director of the division of AIDS research at NIH says that, after more tests, her agency will decide whether or not to abandon the trial. "Blessed With Resistance" Discover (01/94) Vol. 15, No. 1, P. 46 (Caldwell, Mark) Last June's international AIDS conference in Berlin yielded at best a grim outlook on the AIDS epidemic. In the absence of therapies and 100 percent effective preventive measures, the disease continues to spiral out of control and the World Health Organization predicts that some 40 million people will have AIDS by the turn of the century. Despite this gloomy forecast, the conference brought to light some glimmer of hope. A study of more than 1,500 female prostitutes in the slum area of Pumwani in Africa shows that a handful have demonstrated an apparent immunity to the AIDS virus despite innumerable exposures. Statistically, they should be infected, but are not. This study parallels U.S. studies of gay men who, despite high-risk sexual behavior, have remained virus-free and of infected patients who have managed to stave off illness for unusually long periods of time. These studies suggest that the immune systems of certain people are able to resist the virus, either by warding off infection completely or sharply curbing the progress of the disease. At a time when research on antiviral drugs and vaccines has failed, more researchers think perhaps it is time to explore what is most likely the nature of the immunity of HIV survivors: a hidden part of the immune system that is generally ignored. "Kneeling at the Crystal Cathedral" Genre (12/93-01/94) No. 15, P. 41 (Sadownick, Doug) Despite an intense campaign to curb the spread of AIDS in the gay community, the 90s have seen an increase in promiscuity. Accompanying this trend is an increase in drug use, particularly of a refined type of speed labeled metamphetamine. Known on the street as crystal, it is inexpensive, long-lasting, and easily accessible, and is quickly becoming the drug of choice in gay urban centers. The appeal of crystal, says one user, is the effect of the drug on the libido. "Sex plus crystal equals Nirvana," he says. But health experts say sex plus crystal adds up to addiction, psychosis, and AIDS. Stephan Korsia, executive director of a French AIDS foundation, believes that "in addition to injection drug use, stimulant use is also now suspected as a high-risk vector for exposure to and transmission of HIV." Sam Minsky, administrative director of a Los Angeles outpatient drug treatment center, agrees. "The drug blurs the safer-sex boundaries, big time," he says. In addition, continues Korsia, "There is ample evidence to suggest that crystal accelerates premature progression to full-blown AIDS in people dealing with HIV infection. Studies have shown that crystal eats T-cells for breakfast, lunch, and dinner." To complicate matters, renewed interest in the multifactorial vein of AIDS theory suggests that powerful cofactors such as malnutrition, a history of sexually transmitted diseases, or drug abuse increases a person's susceptibility to AIDS. Says Richard Root-Bernstein in his book, Rethinking AIDS, "to control AIDS, we may have to learn how to get millions of addicts off drugs." "Skills for Teen Assessment Unique but Not Complex" AIDS Alert (12/93) Vol. 8, No. 12, P. 184 As the AIDS epidemic spreads among young people, health care workers must learn the unique skills necessary for successful assessment and risk reduction, says the nation's top expert in adolescent AIDS. Acquiring these skills, according to Dr. Karen Hein, director of the AIDS adolescent program at the Montefiore Medical Center in New York, is not difficult. They are, however, specific to adolescents and very necessary if health care workers are to help teens evaluate their risks and modify their behaviors. Because of the unique psychological and social features of adolescents, agrees Kim Miller, a research sociologist at the Centers for Disease Control, health care workers need to go the extra mile. "Handing them a pamphlet just won't work," she claims, "because they're not going to read it." Health care workers must also realize that certain other messages will not be effective with adolescent patients. For example, successful risk reduction requires a basic understanding of how HIV is transmitted, including the risk levels of different sexual behaviors. But some popular messages, such as abstinence, monogamy, and questioning partners about high-risk behaviors are simply unrealistic when applied to some adolescents, as are messages that attempt to induce fear. When handling the vulnerability and sensitivity that characterizes adolescence, health care workers should make teens feel welcome. In fact, establishing a rapport is critical, and avoiding a judgmental attitude is crucial. "Watch out for a tendency to blame adolescents, saying they are noncompliant," warns Miller. "A judgmental attitude in a provider will scare them away."