Date: Tue, 20 Jun 1995 09:29:10 +0500 From: ghmcleaf{CONTRACTOR/ASPEN/ghmcleaf}%NAC-GATEWAY.ASPEN@ace.aspensys.com AIDS Daily Summary June 20, 1995 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 1995, Information, Inc., Bethesda, MD ************************************************************ "Living for Today" "Artists with AIDS Race Time to Preserve Work for All Time" "D.C. Averts Court Takeover of Mental Health Services" "Endangering Public Health" "AIDS Toll on Increase in Cambodia" "S. Africa Buys 97 Million Condoms to Fight AIDS" "Gay Olympics Kick Off on Rio's Copacabana Beach" "'Bypass' Budget Reveals AIDS Research Funding Priorities" "Outcome of Patients with HIV Infection and Decreased Consciousness or Recurrent Seizures" "Cheaper Test for Tracking AIDS" ************************************************************ "Living for Today" Los Angeles Times--Washington Edition (06/20/95) P. B5; Kristof, Kathy M. A growing number of terminally ill patients--most of whom have AIDS or are in the final stages of cancer--have opted to make viatical settlements. By selling their life insurance policies, policyholders get cash today for the benefits that would normally go to their beneficiaries after death. Some insurance companies now offer similar terms within policies called "accelerated benefits," which often include easy ways to cash in on only part of a policy while leaving the rest for heirs. Viatical settlement companies pay terminally ill individuals between 50 cents and 95 cents on the dollar for valid life insurance policies. The percentage depends on the viatical settlement company and on how long the policyholder has to live. The shorter the expected remaining lifetime, the larger the payout. The viatical settlement industry, however, is highly controversial--with some calling such companies "ghoulish" and others defending them as "angels of mercy." Increasingly, states are regulating viatical settlement companies or setting minimum standards. "Artists with AIDS Race Time to Preserve Work for All Time" New York Times (06/20/95) P. C15; Blumenthal, Ralph To alleviate HIV-positive artists' fear about their creations, an alliance of arts groups has been advising artists, musicians, dancers, and writers with HIV and AIDS on how to prepare their estates and preserve their work so it is not just thrown away when they die. The Estate Project for Artists with AIDS recently experienced significant expansion with the first presentation of grants for legal services and the documentation of creative work. The Alliance for the Arts, which devised the estate project in 1991, has distributed more than 50,000 copies of a planning guide called "Future Safe." However, the group's president, Randall Bourscheidt, said that it had stopped trying to offer all possible services itself. Instead, it now awards $200,000 to 12 specialized programs including free lawyer consultations, artist stipends, the videotaping and photographing of artwork, and the choreographic notation of dances "D.C. Averts Court Takeover of Mental Health Services" Washington Post (06/20/95) P. B4; Goldstein, Amy On Monday, Washington, D.C., Mayor Marion Barry announced that the city has avoided a complete court takeover of its mental health system by promising a four-month campaign to provide more services. If the District does not meet its obligations, the plaintiffs in a 20-year-old lawsuit against the city's psychiatric system say they will request a court-appointed receiver. Mayor Barry also appointed Melvin H. Wilson--a social worker and a longtime advocate for the homeless, the mentally ill, and people with AIDS--as the new director of the D.C. Agency for HIV/AIDS. "Endangering Public Health" Washington Post (06/19/95) P. A18 Budget problems have impaired the District of Columbia's efforts to find and control tuberculosis (TB) and AIDS--two of the city's most dangerous public health threats--write the editors of the Washington Post. While making budget cuts in an effort to keep the District afloat, officials have had to stop giving TB X-rays on several occasions because of shortages of film and developing solutions. The city's primary medical laboratory stopped testing blood samples for HIV for two months last winter because it had run out of the necessary chemicals. The shortages are due to finance officials' decision to reduce city buying to stave off insolvency. However, declare the Post editors, these people must realize that all city purchases are not of the same importance. The District's tormented public health system is under an enormous strain--almost half of its residents receive Medicaid or have no insurance at all. Undercutting the system's search to find and control such costly diseases as TB and HIV does not make sense, the editors conclude. "AIDS Toll on Increase in Cambodia" Reuters (06/19/95); Wallengren, Maja A senior health official in Cambodia said that as many as 10 Cambodians have already died from AIDS this year. Dr. Tia Phalla, head of the Cambodian Health Ministry's National AIDS Committee, warned that in five years the country would face a very serious problem with the disease. Phalla estimated that there were "at least 7,000" HIV-infected persons in the Southeast Asian country, but said his AIDS committee expected the number to almost double by the year's end. A senior foreign health expert, however, said that based on national blood-screening tests, 100,000 people could be infected with the virus that causes AIDS. The World Health Organization estimates that there are at least 6,000 HIV-infected Cambodians. Phalla blamed a lack of funding on his committee's inability to adequately publicize the danger of AIDS in remote areas. "S. Africa Buys 97 Million Condoms to Fight AIDS" Reuters (06/19/95) South Africa has purchased 97 million male condoms and 90,000 female condoms for free distribution to stem the spread of HIV. Health Minister Nkosazana Zuma told parliament that the skyrocketing HIV infection rate could defeat post-apartheid gains in healthcare, welfare services, economic development, and education. "In the near future, 300 billboards with AIDS prevention messages will be in place throughout the country," Zuma added, noting that the government was spending $23.4 million on AIDS prevention during 1995. Antenatal tests on 18,000 South African women in November 1994 showed a 7.6 percent HIV infection rate, up from 4.25 percent one year before. According to the country's department of health, more than 600,000 of South Africa's 39 million people are infected with HIV. "Gay Olympics Kick Off on Rio's Copacabana Beach" Reuters (06/19/95) On Sunday, pairs of men, women, and transsexuals participated in Brazil's first gay olympics. The event combines off-beat contests and traditional sports, such as soccer and volleyball, on Rio de Janeiro's famous Copacabana Beach. The event coincides with the International Lesbian and Gay Association's 17th world conference, also in Rio de Janeiro, and concludes June 25 with a marathon along Copacabana Beach. The conference unites delegates from around the world to discuss human rights issues, AIDS, and legislation on gay marriages. "'Bypass' Budget Reveals AIDS Research Funding Priorities" Nature Medicine (06/95) Vol. 1, No. 6, P. 499; Steele, Fintan R. In 1993, Congress passed the U.S. National Institutes of Health (NIH) Revitalization Act, which established an Office of AIDS Research (OAR) at NIH and gave the new office the power to plan the budget for the whole NIH HIV/AIDS-related research program. The bill, however, also required OAR to prepare two budgets--one to include with the NIH budget and a second "bypass" budget, which would be submitted to the House Appropriations/Health and Human Services (HHS) Subcommittee without going through HHS first. Because the first budget is subject to the standard approval process, some feel that the second marks the real opportunities now available in HIV/AIDS research. "This is the first budget we [OAR] have been responsible for from the beginning of the budget process," said OAR director William E. Paul, who maintains that the $1.7 million sought in the bypass budget is "what we could spend wisely now, without any waste." If approved, the funds will be divided across eight "areas of emphasis," including vaccines and behavioral research. "Outcome of Patients with HIV Infection and Decreased Consciousness or Recurrent Seizures" Journal of the American Medical Association (06/14/95) Vol. 273, No. 22, P. 1738; Bedos, Jean-Pierre In response to a letter to the editor of the Journal of the American Medical Association, Jean-Pierre Bedos asserts that "neurological failure" is the correct term for his study, which involved HIV-infected patients treated in an intensive care unit (ICU). Although the phrase is imprecise and simplistic in a diagnostic setting, Bedos believes that his inclusion criteria were logical and well-suited to the patients in whom altered consciousness and convulsions were the two primary neurological reasons for hospital admission. Patients with isolated neurological disorders--such as aphasia, hemiparesis, and hemianopsia--who were not part of the group of patients admitted to the ICU with altered consciousness were not the focus of the study. Bedos concludes that, while nonspecific, the term "neurological failure" can be appropriate inclusion criterion for prognostic studies of HIV-positive patients admitted to ICUs. "Cheaper Test for Tracking AIDS" Science (06/02/95) Vol. 268, No. 5215, P. 1281 In May, the U.S. Food and Drug Administration approved for marketing an inexpensive and easy test that measures the level of CD4 cells in persons infected with HIV. The key difference between the current technique, known as flow cytometry, and T Cell Sciences' new TRAx CD4 system is that flow cytometry measures CD4 levels by scattering laser light through live blood cells. TRAx CD4, however, passes killed blood cells over a plate coated with antibodies to the CD4 receptor. AIDS researcher Thomas Quinn of the National Institute of Allergy and Infectious Diseases and Johns Hopkins University calls the TRAx CD4 "an excellent method for determining CD4 cell counts." Quinn would like to see the test used in countries such as Haiti and Uganda, which lack flow cytometry equipment. A spokesperson for T Cell Sciences said the company is not currently targeting such countries. Instead, the first users will be in labs in developed countries that cannot afford a flow cytometer and pay a reference lab at least $50 for each test. The TRAx CD4 system will use machines most labs already own and will cost about $18 per test.