Date: Thu, 9 Mar 1995 09:35:29 +0500 From: ghmcleaf{CONTRACTOR/ASPEN/ghmcleaf}%NAC-GATEWAY.ASPEN@ace.aspensys.com AIDS Daily Summary March 9, 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 ************************************************************ "AIDS Virus Found to Form Hybrids" "Fall in AIDS Cases Endangers Federal Funding" "The City's Ailing Hospitals" "Australian Safe Sex Cards Banned" "Louganis's Big Splash" "City Paramedic with HIV Placed on Paid Leave" "AIDS Center Closes Due to Lack of Funds" "U.S. Epidemiologist Witness at Canadian Inquiry" "Increases in CD4 T Lymphocytes with Intermittent Courses of Interleukin-2 in Patients with Human Immunodeficiency Virus Infection" "Beyond Condoms" ************************************************************ "AIDS Virus Found to Form Hybrids" Washington Times (03/09/95) P. A6 Various strains of HIV coexist in people and produce hybrids more often than scientists thought, reports a study in the journal Nature. Researchers studied 114 strains of HIV-1 and discovered that at least 10 strains appeared to be hybrids, combining genetic material from different major subtypes of the virus. The finding raises the question of whether a vaccine that works against parental strains will also work against their hybrid offspring. "Fall in AIDS Cases Endangers Federal Funding" Washington Times (03/09/95) P. A10; Roman, Nancy E. On Wednesday, Republican lawmakers criticized Health and Human Services (HHS) Secretary Donna Shalala for misleading Congress about the extent of the AIDS epidemic. "Why are you telling this committee about spread and increase when actually AIDS cases are decreasing?" asked Rep. Ernest Istook Jr. (R.-Okla.). He cited a Feb. 3 report from the Centers for Disease Control and Prevention that found that AIDS cases decreased by about 20 percent from 1993 to 1994. Istook said the full Appropriations Committee may reconsider funding for AIDS treatment when it marks up the HHS budget in June. Shalala was before the panel to justify the Clinton administration's 1996 budget for HHS, which includes a $91 million increase in funding for the Ryan White program. She explained the statistics by noting that "Roughly 40 percent of the more than 440,000 cases reported since 1981 were reported in 1993 and 1994." Istook said the figure was misleading because the definition of AIDS was expanded in 1993 to accommodate women and children. "The City's Ailing Hospitals" New York Times (03/09/95) P. A24 New York City Mayor Rudolph Guiliani is right to call for a fundamental reappraisal of the city's public hospital system, write the editors of the New York Times. In addition to a declining quality of care, the hospitals are faced with rising costs, and falling state and city aid. Mayor Guiliani is already trying to sell three public hospitals and is wondering whether the city should sell them all. His plan is worth exploring, write the editors, but only as part of a plan to improve health services for the poor--or at least insure that they do not become worse. The city may have overlooked the fact that some of the public hospitals' difficulties stem from their tradition of caring for a portion of the population that nobody else wants as patients. Municipal hospitals have long been a resource for Medicaid and uninsured patients who do not feel they can turn to private hospitals. For example, municipal hospitals bear the brunt of the care for the homeless, and for AIDS patients--particularly children with AIDS. The people who depend on the system are not the only ones who must insist that cuts, closings, and selling of city hospitals be conducted carefully, the editors conclude. "Australian Safe Sex Cards Banned" Reuters (03/09/95) In Sydney, Australia, trading cards issued by a local AIDS council depicting naked men performing homosexual acts have been ruled pornographic and banned. Politicians had complained that the 24,000 cards--each of which contains a safe sex message--could be obtained by schoolchildren. Queensland AIDS Council spokesman Geoff Woolcock said the cards were to be distributed only in homosexual nightclubs. "The adult gay male population has very little to do with the school-going population in this state and we don't believe there would have been any exchange of cards to be concerned about whatsoever," he added. Another series of 230,000 gay safe-sex trading cards, with explicit language but no pictures, will be issued in Victoria. Those cards will be distributed in sealed packages that carry warnings. "Louganis's Big Splash" Washington Post (03/09/95) P. D1; Lichtenstein, Grace Greg Louganis' autobiography, "Breaking the Surface," describes a distressingly callow young man who learned how to deal with his wonderful athletic talent, but never learned elementary ethics, writes Grace Lichtenstein in the Washington Post. Although many of the diver's problems stem from society's prejudice against gays and the world's attitude toward AIDS, he caused many of the problems himself. "It's not my intention to shock anyone, but looking objectively at some of what I've lived through, even I find parts of my life shocking," Louganis says. A person's HIV status is no one else's business--as long as that person is not putting anyone else at risk. Louganis did not know what the chance was of anyone else contracting HIV from his blood. He said that his "denial" of his infection was so strong, and that he was so concerned about his career, that he kept silent. The most valuable aspect of the book may be its significance for gay youths, says Lichtenstein. Louganis' message is that you can be gay and still become the greatest athlete in your field. "City Paramedic with HIV Placed on Paid Leave" St. Louis Post-Dispatch (03/08/95) P. 2B A paramedic with St. Louis' ambulance service was placed on paid leave after it was discovered that he was HIV-positive and did not always wear protective gloves while attending patients on the ambulances. The paramedic said that whether or not he wore gloves depended on the situation. The paramedic--who returned to work on Monday after four days of paid leave--has promised to wear gloves whenever he tends to a patient. He will dispatch 911 calls for the ambulance service for 30 days, and will then return to ambulance duty. Bob Hardy, EMS acting director, said that ambulance workers must wear gloves any time they have patients who are bleeding or who have contagious diseases. "AIDS Center Closes Due to Lack of Funds" Los Angeles Times--Washington Edition (03/08/95) P. B2; Aubry, Erin J. Due to a lack of financial support and a shortage of donors, the Gathering Place, the only AIDS drop-in center serving the primarily black and Latino South-Central population of Los Angeles, closed last week. Founded in 1990, the center was somewhat of an oasis for people with HIV or AIDS who also dealt with poverty, homelessness, prison records, and unemployment, said Director Graciela Morales. The Sisters of St. Joseph Ministerial Services, which founded and operated the center, decided the Gathering Place was not receiving enough outside financial support to remain operational. Morales said the decision was too sudden and insisted that there were healthy prospects of keeping the center open. There were three private and state grants totaling $250,000 pending, and Morales said she was applying for more. Morales plans to open as an independent nonprofit agency in the same location within a month. "U.S. Epidemiologist Witness at Canadian Inquiry" Toronto Globe and Mail (03/07/95) P. A4 The first witness in the final stage of the $13.5 million judicial inquiry into Canada's blood system will be Dr. Donald Francis, a former epidemiologist at the U.S. Centers for Disease Control and Prevention. Francis has been one of the most acerbic critics of governments' slow response to the AIDS epidemic. In his interim report last month, Mr. Justice Horace Krever, who is heading the commission of inquiry, warned that the tainted blood tragedy could be repeated with a new contaminating agent. He said that changes are necessary to "minimize the likelihood of such a calamity." The final report, to be completed by the end of the year, will examine the decisions that led to the infection of more than 1,000 Canadian hemophiliacs and transfusion recipients with HIV during the early 1980s. The commission's final report will also recommend a complete revamping of the blood system. "Increases in CD4 T Lymphocytes with Intermittent Courses of Interleukin-2 in Patients with Human Immunodeficiency Virus Infection" New England Journal of Medicine (03/02/95) Vol. 332, No. 9, P. 567; Kovacs, Joseph A.; Baseler, Michael; Dewar, Robin J. et al. To determine the value of intermittent courses of interleukin-2 for the long-term management of HIV infection, Kovacs et al. focused on HIV-infected patients with a moderate suppression of the immune system. Based on previous work, such patients are more likely to have a response to immunomodulators than patients with severely impaired immune function. Twenty-five patients received interleukin-2 for five days every 8 weeks during a period of seven to 25 months. In addition, all patients received at least one antiviral agent. Therapy with interleukin-2 was linked to at least a 50 percent increase in the number of CD4 cells in six of the 10 patients with CD4 counts higher than 200. For the remaining 15 patients, who had CD4 counts of 200 or less, interleukin-2 therapy was associated with increased viral activation, few immunologic improvements, and significant toxic effects. Kovacs et al. concluded that intermittent interleukin-2 therapy can reverse some of the immunologic abnormalities associated with HIV infection in patients with CD4 counts above 200. "Beyond Condoms" Advocate (02/21/95) No. 675, P. 80; Rotello, Gabriel The Victorian AIDS Council/Gay Men's Health Centre of Australia has begun promoting the idea that gay couples can choose not to wear condoms if they observe specified guidelines. The organization outlines eight steps a couple should follow to decide whether to use condoms. The first step is to decide whether having sex without condoms is important to both members. The main body of the message is aimed at couples in which both partners test HIV-negative twice. They proceed to step five, which involves both partners promising not to have unsafe sex outside the relationship. The approach of either using a condom every time, with every partner, or adopting a more complex set of rules that requires negotiation, honesty, trust, and maturity has yet to be adopted officially by any AIDS group in the United States. Critics note that many men who desire condomless sex lack the maturity, skills, or responsibility to follow such emotionally complex steps.