Date: Thu, 15 Aug 1996 10:43:35 -0400 From: "Sarah Araghi" Subject: CDC AIDS Daily Summary 8/15/96 AIDS Daily Summary August 15, 1996 ****************************************************** "Payments to Hemophiliacs With AIDS Are Cleared" "New Treatments Put AIDS Programs in a Dilemma" "Plan to Move Medicaid Recipients Into Managed Care Gains" "Across the USA: Kentucky" "Tax Change Could Make Life Easier for Chronically Ill" "UPI Science News: [Oral Sex Not Safe Sex, Researchers Warn]" "India--AIDS: Women Are Captive Partners" "HIV Trends Reported for China" "Changes in Sexual Behavior and a Decline in HIV Infection Among Young Men in Thailand" "Blind in Rangoon" ****************************************************** "Payments to Hemophiliacs With AIDS Are Cleared" Wall Street Journal (08/15/96) P. B5 American hemophiliacs who were infected with HIV through tainted blood products between 1978 and 1985 would receive $100,000 each under a settlement with four pharmaceutical companies. Federal District Judge John F. Grady tentatively approved the settlement between the patients and Bayer, Baxter International, Rhone-Poulenc Rorer's Armour Pharmaceutical, and Alpha Therapeutic, a unit of Japan's Green Cross Corp. Family members and survivors are eligible to participate in the settlement, which was originally planned as a $640 million fund. The companies have now agreed, however, that if more than the expected number of people sign up for the settlement, the fund could increase. Between 6,000 and 10,000 U.S. hemophiliacs are estimated to have been infected with HIV through the contaminated blood products. "New Treatments Put AIDS Programs in a Dilemma" Washington Post (08/15/96) P. A1; Goldstein, Amy AIDS patients in Washington, D.C., are being told they can no longer apply to receive drugs from the city's AIDS Drug Assistance Program (ADAP) due to the high demand for promising new treatments. The problem is similar in states across the country, as funding for the federal program is being depleted. ADAP provided AIDS drugs for 65,000 uninsured and poorly insured patients last year, about one out of ten people with HIV. The number of drugs provided under the program has doubled since last year and more HIV-infected patients and their doctors are electing to start treatment sooner, often with a combination of drugs. As a result, the programs are starting to restrict enrollment, the drugs they offer, or both. "Plan to Move Medicaid Recipients Into Managed Care Gains" New York Times (08/15/96) P. B1; Rosenthal, Elisabeth A plan by New York State to move most of its 3.5 million Medicaid recipients into managed care plans could be implemented by the end of the year, officials said Wednesday. The move was advanced by an announcement from the federal government of the terms under which it would approve the plan. Under the new plan, all Medicaid recipients who are not in nursing homes would receive their care through health maintenance organizations. The conditions set down by the Health Care Financing Administration would require the state to slow down the move to managed care and to create special plans for patients with serious illnesses like AIDS. "Across the USA: Kentucky" USA Today (08/15/96) P. 15A In Kentucky, a program to be launched in September will provide promising but costly new AIDS drugs to approximately 30 indigent AIDS patients. The drug combinations cost up to $15,000 per year for each patient. "Tax Change Could Make Life Easier for Chronically Ill" Wall Street Journal (08/15/96) P. C1; Asinof, Lynn Pending legislation could make it easier for people with chronic or terminal illnesses to use payments from the sale of their life insurance policies to meet their health care needs. The policy change would exempt from federal income tax both the acceleration of death benefits and the money received from the sale of those benefits. To be eligible, patients must have a chronic illness or be expected to live less than two years. The practice of selling one's life insurance, now used mostly by AIDS patients, may become more popular. The new policy is also expected to make the viatical settlement industry more accepted. "UPI Science News: [Oral Sex Not Safe Sex, Researchers Warn]" United Press International (08/14/96); Smith, Michael Even people who practice relatively safe sex are contracting HIV, researchers reported Wednesday in the Annals of Internal Medicine. Timothy Schacker of the University of Washington, and colleagues found that in a study of 46 people, almost half said they had sexual contact with only one partner in the month before their infection was detected. Oral sex, widely thought to be less risky than other sexual contact, was the most common form of sex among the participants. For four patients, the researchers were able to determine that oral sex was the route of transmission. Researchers reported in June that rhesus monkeys could be orally infected with a virus similar to HIV and cautioned that oral sex is not necessarily safe sex. "India--AIDS: Women Are Captive Partners" IPS Wire (08/14/96) In India, where HIV is spreading rapidly, an increasing number of women are infected by their husbands and passing the virus on to their children. A 1995 government study at J.J. Hospital found that 3.5 percent of pregnant women under the age of 20 were HIV positive, while 2.5 percent over age 20 were also infected. At Mumbai's Wadia Maternity Hospital, 3,800 female homemakers have been tested for HIV in the last three years, and 1 percent have tested positive. Infants are also tested and followed for 15 months. AZT is available to mothers who can afford the drug. According to the study, women in India are especially vulnerable to infection because they do not have the social standing to insist on protection. "HIV Trends Reported for China" Reuters (08/14/96) HIV is spreading from the rural areas of the Yunnan Province to urban cities, researchers report. Elena S. H. Yu of San Diego State University and colleagues found that, from 1985 to 1994, intravenous drug use was the main route of HIV transmission in China. The opium link between the Yunnan and neighboring Myanmar, Laos, and Vietnam--as well as the high level of drug use and unprotected sex--was blamed. The researchers say the virus is expected to spread through heterosexual transmission in other areas of China. "Changes in Sexual Behavior and a Decline in HIV Infection Among Young Men in Thailand" New England Journal of Medicine (08/01/96) Vol. 335, No. 5; P. 297; Nelson, Kenrad E.; Celentano, David D.; Eiumtrakol, Sakol; et al. To combat the spread of HIV in Thailand, where the virus has spread rapidly since it was first reported in 1988, the Ministry of Public Health implemented a program to promote condom use among sex workers in 1990 and 1991. Dr. Kenrad E. Nelson, of Johns Hopkins University, and colleagues, studied the effect of this and other programs to curb the spread of the virus, testing and interviewing five groups of 21-year-old men who were conscripted into the army by a lottery in 1991, 1993, and 1995. The researchers report that the prevalence of HIV infection was 10.4 percent in the 1991 group and 12.5 percent in the 1993 group. In 1995, the rate decreased to 6.7 percent. For those men who did not have sexual relations with a sex worker before 1992, the rate of infection was only 0.7 percent. Throughout the study, the proportion of men who reported having sexual relations with a sex worker decreased from 81.4 percent to 63.8 percent, while the rate of condom use during commercial sexual contact increased from 61 percent to 92.5 percent. The authors call the success of the condom campaign unprecedented and compare it to the change in behavior among homosexuals in the United States in the early 1980s. "Blind in Rangoon" Far Eastern Economic Review (08/01/96) Vol. 159, No. 31; P. 21; Noung, Bertil; Noung, Hseng In northern Burma, where the estimated number of HIV infections is between 350,000 and 400,000, many of the infected individuals are drug addicts and prostitutes returning from Thailand. The disease is widespread in Burma's prisons, where heroin is available but disposable syringes are not, and homosexuality is common. Furthermore, the military establishment in Rangoon has failed to implement measures to curb the epidemic and has not allowed foreign non-governmental organizations to help. An estimated 60 percent to 70 percent of all intravenous drug users in Burma are infected with HIV, according to the United Nations International Drug Control Program. Heroin production in the country is increasing, and while most of the drug is exported, it is also sold locally throughout the country. The Southeast Asian Information Network blames the authorities for the spread of the disease, saying the government is either unable to control the heroin market or is involved in making the drug available. The sex industry has also fueled the epidemic, and local officials estimate that 80 percent of women entering the sex trade will eventually become infected with HIV.