Date: Mon, 11 Mar 1996 10:04:00 +0500 From: ghmcleaf{CONTRACTOR/ASPEN/ghmcleaf}%NAC-GATEWAY.ASPEN@ace.aspensys.com Subject: CDC AIDS Daily Summary 03/11/96 AIDS Daily Summary March 11, 1996 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 1996, Information, Inc., Bethesda, MD ************************************************************ "Lawyer's Family In Court Over 'Philadelphia'" "In the Loop: Courting Clinton's Reconsideration" "AIDS Data Not in Peril" "AIDS Clinical Trials Lack Data on Adolescents" "UNAIDS Highlights Women and AIDS in New Report" "Eight Causes Explain Most Cases of Fever in AIDS Patients" "Euthanasia and Physician-Assisted Suicide in Homosexual Men with AIDS" "Soldiers and AIDS: All of You, Out" "Blood, Sweat and Fears" ************************************************************ "Lawyer's Family In Court Over 'Philadelphia'" New York Times (03/11/96) P. D1; Pristin, Terry A lawsuit charging that Tri-Star Pictures misappropriated the story of Geoffrey Bowers, a New York lawyer with AIDS, in the film "Philadelphia" is set to go to trial Tuesday in Federal District Court in Manhattan. Bowers' family claims that the film company misrepresented the origins of the film's screenplay. The family is seeking an undisclosed amount in damages and public acknowledgment that the movie was based on Bowers' experience. Bowers died in 1987 before winning a discrimination suit against his former employer, Baker & McKenzie, the world's largest law firm. The 1993 movie was heralded by gay-rights groups for changing attitudes about AIDS. Tri-Star has promoted the screenplay, by Ron Nyswaner, as an original story developed after brainstorming with the director Jonathon Demme. The company holds that the story was derived from numerous discrimination cases, including Bowers'. The case may depend on whether the family's contributions to the film are seen as unique. Details of the Bowers case had been public information before the film was made, but the family contends that some details in the film could only have come from information provided by them. "In the Loop: Courting Clinton's Reconsideration" Washington Post (03/11/96) P. A17; Kamen, Al A controversy is brewing over President Clinton's appointment of Andrew S. Effron, minority counsel for Sen. Sam Nunn (D-Ga.), to the Court of Military Appeals. Some gay groups oppose the appointment because of Effron's participation in Nunn's anti-gay policy in the military and Clinton's signing of a measure to force HIV-positive people out of the military. Other gay groups are holding back their criticism, hoping that Nunn will support a bill to repeal the HIV-positive ban. Nunn had been undecided on the repeal, but is said to be leaning in its favor. He will announce his decision soon. "AIDS Data Not in Peril" New York Times (03/11/96) P. A16; Bereano, Philip L. In this letter to the editor appearing in the New York Times, Philip Bereano, a University of Washington engineering professor, says that a recent Times article misrepresented the impact a ban of HIV-positive military personnel would have on AIDS research. The article suggested AIDS research would be threatened by the ban, but Bereano says this would be "highly improbable." He says that the ban should be opposed because it is a result of homophobia and hysteria, but that AIDS research would not be affected by the ban because the 1,049 HIV-positive people do not represent a unique group of patients. Bereano argues that similar subjects could be studied by any medical institution. "AIDS Clinical Trials Lack Data on Adolescents" Reuters (03/08/96) A report by the Office on National AIDS Policy shows that adolescents are being overlooked in AIDS clinical trials. Patricia Fleming, the Office director, said that one-quarter of all new U.S. HIV infections are thought to occur in people between the ages of 13 and 20. The report suggests that the government, researchers, and clinicians work together to develop appropriate clinical practice guidelines for adolescents with HIV or AIDS. It also recommends that the National Institutes of Health develop dosage guidelines for treating HIV-positive adolescents. According to the report, adolescents have been on the "periphery" of AIDS research. "UNAIDS Highlights Women and AIDS in New Report" Reuters (03/08/96) The Joint United Nations Programme on HIV/AIDS (UNAIDS) has released a report, called "Reducing Women's Vulnerability to HIV Infection," which says that more than 10 million women are infected with HIV and that the number is increasing worldwide. The report gives the biological, social, and economic reasons as to why women are vulnerable to the virus. To lessen women's vulnerability, the report suggests such methods as combating ignorance, providing "women-friendly" services, developing prevention methods women can control, building safer norms, and reinforcing women's economic independence. "Eight Causes Explain Most Cases of Fever in AIDS Patients" Reuters (03/08/96) Eighty percent of fevers in HIV patients have one of eight possible diagnoses, reported Dr. Frederick Hecht of the San Francisco General Hospital. Hecht explained that an evidence-based approach is best to evaluate fever in AIDS patients. Pneumocystis carinii pneumonia and Mycobacterium avium complex are two of the most common causes of fever in AIDS patients, but others include catheter infection, bacterial pneumonia, and lymphoma. Hecht suggested that clinicians treating AIDS patients first look for the symptoms that characterize the eight most common causes of fever, focusing on the lungs, the lymph nodes, and the skin. "Euthanasia and Physician-Assisted Suicide in Homosexual Men with AIDS" Lancet (02/24/96) Vol.347, No.9000, P. 499; Bindels, Patrick J.E.; Krol, Anneke; Van Ameijden, Erik; et al. A study in the Netherlands found that 38 percent of deaths there involve medical decisions concerning the end of life (MEDL), and that 2.1 percent are the result of euthanasia or physician-assisted suicide (PAS). Bindels et al. studied the rate of MEDL among 131 homosexual men with AIDS by analyzing the mode of death information in both doctor and hospital records. The researchers found that 22 percent of the men died by euthanasia or PAS and in 13 percent another MEDL had been made. Seventy-two percent of those in the PAS/euthanasia group were age 40 or older, compared to 38 percent in the natural death group. The likelihood of euthanasia/PAS increased the longer patients survived after AIDS diagnosis. Analysis of CD4 and CD8 cell counts and phytohaemagglutinin responses two years before death and at the time of death showed that most of the patients would have died naturally within one month of the time euthanasia or PAS was induced. The authors suggest that the high rate of MEDL in the study group was due to the patients' high level of knowledge about AIDS acquired through long-term awareness of HIV infection. Furthermore, the higher rate of euthanasia in long-time survivors could be the result of additional suffering or the greater opportunity to discuss the option with friends and doctors. According to the researchers, euthanasia and other MEDL did little to shorten life. "Soldiers and AIDS: All of You, Out" Economist (02/17/96) Vol.338, No.7953, P. 26 HIV-infected people in the military have not been allowed in combat since 1986, a logical rule since the virus is transmitted through blood. However, a new policy would force the discharge of anyone with HIV, regardless of position, service record, or medical condition. The Pentagon opposed the provision, noting that the military would lose serviceman and officers with considerable skill. Republican Congressman Robert Dornan (R-Calif.) added the measure to the defense authorization bill, saying people with HIV are "drug dealers, people who visited whorehouses, or homosexuals." Dornan is said to have offered the provision on the grounds that people with HIV cannot serve overseas, and thereby weaken the military's strength in combat. People with diabetes, cancer, heart disease, and asthma are allowed to serve, however, even when they are kept from being deployed. Repeal efforts are currently underway, but they would either have to pass through Dornan's House subcommittee on servicemen, or House Speaker Newt Gingrich (R-Ga.) would have to act on the issue. "Blood, Sweat and Fears" Time (02/26/96) Vol.147, No.9, P. 59; Gorman, Christine With boxer Tommy Morrison's announcement that he has HIV, the risk of transmitting the virus in the boxing ring has been reconsidered. For many reasons, researchers say the chance of getting HIV during a fight are small. The skin provides a good barrier of the virus, the flow of blood out of a cut would make it difficult for another person's blood to flow in, and healthy athletes have only a small amount of the virus in their blood. The Centers for Disease Control and Prevention studied 11 National Football League teams and found 575 bleeding injuries occurred in 155 games among 538 players. The researchers estimated that the risk of getting HIV from playing football was 1 in 85 million, and no such transmissions have been reported. Boxing, however, involves exposing mucous membranes in the nose and eyes. One of the rare known cases of transmission through nonsexual physical contact was between two brothers, one infected, one not, who fought, and bled profusely into each other's eyes and open wounds. Shortly after that fight, the previously uninfected brother tested positive for HIV. In the wake of Morrison's announcement, meanwhile, New York has become the fifth state to require HIV testing for boxers.