AIDS Daily Summary April 22, 1994 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 1994, Information, Inc., Bethesda, MD "Breastfeeding Can Act as Transmitter of H.I.V." New York Times (04/22/94) P. A26; Mathur-Wagh, Usha; Roche, Natalie; Taha-Cisse, Ashaki H. While generally in agreement that breastfeeding has its benefits, Roche et al. of Beth Israel Medical Center in New York warn that there is one circumstance in which the practice is potentially life-threatening. Although AIDS continues to be regarded as an almost exclusively male disease, Roche et al. say that the disease is now the leading cause of female mortality in New York City and New Jersey. As of 1991, they say, AIDS was the No. 1 killer of American women aged 15 to 44. The Beth Israel group cautions that it is crucial that women who are considering breastfeeding first undergo HIV testing. The virus is found in significant quantities in the breast milk of HIV-positive mothers. Like blood, semen, and vaginal fluids, breast milk is one of the bodily fluids through which HIV can be transmitted. Roche et al. realize that their recommendation may be viewed as an obstacle to encouraging women to breastfeed, yet feel that failure to issue such a warning would be a serious oversight from a public health perspective. Breastfeeding is best for babies whose mothers are HIV-negative, agree Roche et al., and every woman owes it to herself and her family to remain HIV-negative while breastfeeding, and beyond. "AIDS Czar Listens" Washington Times (04/22/94) P. C3; Neufeld, Matt At a forum at Howard University Hospital yesterday, national AIDS policy coordinator Kristine Gebbie disclosed that seven members of her staff are "living with the virus." She also said there has not been enough study of women and children with AIDS, and promised there will be more in the near future. There was little time for much else, for most of the 90-minute forum was monopolized by a discussion of the red tape surrounding AIDS-related programs. After the program, Gebbie said she had talked with District of Columbia Health Commissioner Mohammad Akhter about the problems he has encountered in dealing with city bureaucracy. "We can certainly make it plain to the people who work with him that they can't have our money unless they are delivering on the service they promised to deliver on," she said. "They need to know these grants don't flow indiscriminately." "Brazil Duty Cuts Include Beer and Condoms" Knight-Ridder/Tribune Business News (04/22/94); Bruce, James The Brazilian government this week issued a list of duty cuts on 19, items including condoms, which were made duty-free. The removal of duties on prophylactics followed the refusal to eliminate the excise on them by another government agency, which reasoned that other essential health products were still being taxed. Locally manufactured condoms, which cost about $1 each, are among the most expensive in the world, according to the Health Ministry. Eliminating the duty and all other taxes on such imports would lower the cost of Brazilian condoms by 53 percent, the ministry estimates. Promoting the use of condoms is key to the country's campaign against the spread of AIDS. "Fighting Infectious Diseases With Blood Products" Investor's Business Daily (04/21/94) P. A6; Lau, Gloria North American Biologics Inc. is leading the research effort into HIVIG, a product aimed at wiping out HIV infection in babies born to HIV-positive women. Mother-to-infant transmission of the virus can be interrupted by giving the newborn a dose of the blood component at birth to strengthen the immune system, says David Gury, the company's chairman, president, and chief executive. HIVIG is a preparation of antibodies called an immune globulin, taken from the blood of infected patients who remain healthy and still develop HIV antibodies. The compound is used to prevent and sometimes treat infectious diseases. "It takes a lot of antibody to make a product for an infant, but it takes a lot more product for an adult," says Gury, explaining why North American Biologics has not focused on perfecting the medication for adults. "Since this comes from people who already have AIDS, the availability of the product is very limited." "Researchers Confirm HIV Leads to AIDS Deaths" Reuters (04/21/94) Reporting in the Lancet medical journal, researchers in Africa say they have disproved claims that HIV does not cause AIDS. The scientists contend that a study of more than 9,000 Ugandans proves unequivocally that HIV causes AIDS, and the inevitable death that it brings to infected persons. According to the study, the death rate among adults not infected with HIV was less than eight in 1,000, compared to a death rate of 116 in 1,000 in HIV-positive adults. "Among adults, half of all deaths were attributable to HIV infection," wrote Daan Mulder and colleagues at the Medical Council's research program on AIDS in Uganda. In an accompanying commentary, officials from the Centers for Disease Control and Prevention said the study provided valuable data. The lack of data on HIV-related mortality encouraged some people to challenge the virus as the cause of deaths or even AIDS in Africa, wrote Timothy Dondero and James Curran, but "Mulder and colleagues now destroy that quaint notion. ...The overwhelming data on the impact of HIV in Africa should now reinforce the conscience for a worldwide prevention effort." "Study Finds Southern Europeans Die of AIDS Sooner" Reuters (04/21/94) AIDS patients in southern European nations died sooner than AIDS patients in the northern part of the continent, according to a study published in last Friday's issue of the British Medical Journal. Researchers studied 6,500 patients in 17 European countries who were diagnosed as HIV-positive between 1979 and 1989. "Survival of AIDS patients seemed to vary within Europe, being shorter in southern than central and northern Europe," the report concluded. Researchers did not determine what caused the regional differences, but speculated that the disparity may have been related to the "defining illnesses"--diseases common to AIDS patients--that first led doctors to diagnose AIDS. The report also found that patients treated with the antiviral drug AZT before being diagnosed with full-blown AIDS tended to die sooner. Researchers said this could be attributed to the fact that HIV infection was more advanced and the patients had a poor likelihood of survival anyway. In addition, older patients were found to have a lower survival rate. "Balladur Pledges $17 Million to Fight AIDS" Reuters (04/21/94) After seven French television networks this month raised $17 million for AIDS research, France's Prime Minister Edouard Balladur pledged that his government would make a donation to match that amount. On April 7, more than 33 million viewers tuned in for the joint broadcast of "All Against AIDS," an effort to curb the spread of the disease and battle public ignorance and prejudice. "The AIDS evening raised 100 million [francs] and I have decided that we will double that amount--the government will add 100 million," Balladur announced. AIDS kills 15 people each day in France, which has the highest number of AIDS cases in Europe. Since the onset of the epidemic, there have been 32,000 cases of AIDS, and an estimated 150,000 more people are thought to be HIV-positive. "Pill Manufacturers Promote Condom Use for Disease Protection" USA Today (04/21/94) P. 4D; Painter, Kim; Levy, Doug Birth control pill manufacturers Wyeth Ayerst Laboratories and Ortho Pharmaceutical Corp. are doing something that once would have been considered bizarre: promoting condoms. Wyeth Ayerst is sending kits including a sample condom, a brochure about condom use, and coupons for physicians to give to pill users, while Ortho is distributing a counseling kit including a video and audio tape, plus a condom sample. The two pill makers are not abandoning their product; rather, they are advocating the idea that, for sexually active women, a combination of both the pill and condoms is the best way to avoid pregnancy and disease. Authorities on AIDS and other sexually transmitted diseases have long expressed concern that many women who are on the pill do not realize that they are vulnerable to disease. "Study Finds AIDS Growing But Not Rampant Among U.S. Prisons" AIDS Alert (04/94) Vol. 9, No. 4, P. 57 AIDS continues to spread in American jails and prisons, but at a rate just slightly higher than that of the general population, according to a new study of the nation's correctional facilities. The study was sponsored by the Centers for Disease Control and Prevention, and conducted by Abt Associates of Cambridge, Mass. The study found that the cumulative number of AIDS cases in correctional facilities jumped 66 percent since Abt's 1990 study, while the number of cumulative cases in the overall population increased 64 percent. While the evidence points to a higher rate of HIV infection in correctional facilities, the number is difficult to determine because of inconsistent testing and tracking procedures in prisons and jails, cautions Theodore Hammett, one of the study's authors. The study also found that fewer correctional facilities segregate infected inmates; that a higher percentage of female than male inmates are HIV-positive; and that rates of HIV infection tend to be higher in jails rather than in prisons, especially in cities with a greater concentration of high-risk behavior. "Jazzman" Advocate (04/19/94) No. 653, P. 52; Deffaa, Chip Grammy-nominated pianist-composer Fred Hersch is the only world-class jazz musician who is both overtly gay and HIV-positive. The 38-year-old recording artist disclosed his health status, without consciously planning to, during an interview with a radio personality. Asked why he had decided to participate in a benefit concert featuring "The AIDS Quilt Songbook," a CD for which he is one of the composers, lyricists, and performers, Hersch told the truth: he was diagnosed with HIV in 1986. Public acknowledgment of his condition was liberating, Hersch found, and he decided to speak openly about it to educate others. When he received a lot of media attention for a major concert in his hometown of Cincinnati, Hersch grasped the moment to discuss AIDS. He also made the concert an AIDS benefit, which raised $30,000 in one evening. Today, Hersch continues to dedicate his talents to AIDS benefits. "I can't write big checks," he admits, "but I can play the piano." He is currently working on "Last Night When We Were Young: The Ballad Album," which he conceived and produced. As the first all-star jazz AIDS benefit album, it features Bobby Watson, Phil Woods, George Shearing, and other jazz heavyweights.