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CDC HIV/STD/TB Prevention News Update

Friday, January 14, 2000
The CDC National Center for HIV, STD, and TB Prevention provides the following information as a public service only. Providing synopses of key scientific articles and lay media reports on HIV/AIDS, other sexually transmitted diseases and tuberculosis does not constitute CDC endorsement. This daily update also includes information from CDC and other government agencies, such as background on Morbidity and Mortality Weekly Report (MMWR) articles, fact sheets, press releases, and announcements. Reproduction of this text is encouraged; however, copies may not be sold, and the CDC HIV/STD/TB Prevention News Update should be cited as the source of the information. Contact the sources of the articles abstracted below for full texts of the articles.

Peer-Review Headlines

General Meadia


Peer-Review Headlines

HPV DNA Testing of Self-Collected Vaginal Samples Compared With Cytologic Screening to Detect Cervical Cancer

Journal of American Medical Association (01/05/00) Vol. 283, No. 1, P. 81; Wright, Thomas C.; Denny, Lynette; Kuhn, Louise; et al.
A study of 1,415 South African women aged 35 to 65 years was performed to compare testing methods for cervical disease. The researchers wanted to determine whether testing with self-collected vaginal samples for human papillomavirus (HPV) DNA was effective. The women were screened with four different tests after a self-collected vaginal swab. They included a Pap smear, direct visual inspection of the cervix, cervicography, and HPV DNA testing with a sample obtained by the physician. Those women with abnormal results were referred for colposcopy for further testing. The results showed that 550 of the women had positive results for at least one of the screening tests, and 500 underwent colposcopic examination. Invasive cancer was found in nine of the 1,356 women who returned to be screened. The authors found that testing of self-collected vaginal samples for those at high risk for HPV was as effective as a conventional Pap smear. Therefore, in areas where cytologic screening is not available, self-collected tests could be used. This approach has advantages for women at high risk for cervical cancer, but the researchers note that it does not guarantee that women will return for further treatment or testing.


General Media

Researchers Test Intermittent HIV Therapy

Washington Post (01/21/00) P. A10; Brown, David
A team of researchers, led by Franco Lori and Julianna Lisziewicz of Georgetown University, has found that intermittently stopping triple-drug therapy boosted the immune systems of two HIV patients studied. The findings, which are published in The Lancet, suggest that taking breaks from drug treatment may actually benefit those with HIV or AIDS. Recent studies have shown that daily doses of antiviral drugs keep the virus at undetectable levels in the blood in most HIV-infected individuals; however, Lori and Lisziewicz suggest that by stopping treatment, the body is able to fight back against the virus. The study followed three HIV patients who were recently infected. One patient was able to control the virus for longer and longer periods after each therapy interruption; the last time he stopped treatment, he was able to go 150 days before starting again. The researchers warn, however, that further trials are needed, and patients and doctors should not attempt to replicate this or other similar research until more is known.

Groups Join to Criticize Ruling on HIV Inmates

"Groups Join to Criticize Ruling on HIV Inmates" Birmingham News Online (01/21/00); Brumas, Michael
Several AIDS activists and gay organizations are criticizing a recent Supreme Court ruling that supports Alabama's segregation of HIV-positive inmates. The original Circuit Court of Appeals ruling and the High Court's refusal to hear an appeal allow prisoners in Alabama to be excluded from educational and recreational activities since they pose a risk of HIV transmission to others. The Supreme Court last year asked the Clinton administration's opinion on the matter, and U.S. Solicitor General Seth Waxman said the 11th Circuit ruling should stand. A statement signed by several groups, including AIDS Alabama and the American Civil Liberties Union's National Prison Project, asserts that "their recommendation upholds stigmatization of people with HIV and sets a precedent for an unnecessary and unfair double standard regarding HIV-positive prisoners."

First National HPV Hotline Launched

Reuters Health Information Services (01/20/00); Rostler, Suzanne
The first national human papillomavirus (HPV) hotline is now available to counsel and refer individuals with questions or anxiety regarding the sexually transmitted disease. HPV is the most common cause of cervical cancer, which can be detected through the Pap test and is treatable if caught in time. According to the American Social Health Association, which launched the hotline, 5.5 million cases of HPV are detected each year. Trained counselors at the toll-free service, which can be reached at (877) HPV-5868, are available from 2 p.m. to 7 p.m. Eastern Standard Time Monday through Friday.

Britons Ill Informed About Sexual Diseases

Reuters (01/20/00)
A recent survey of 163 young people in Britain indicates that young people lack information about sexually transmitted diseases (STDs) and their consequences. Few of the respondents, whose average age was 26, knew much about STDs like gonorrhea and chlamydia. Specifically, less than half of the men and women knew about chlamydia, and many also could not answer questions regarding fertility. The study, conducted by Dr. Brian Clark of University College in London, is published in the journal Sexually Transmitted Infections.

AIDS Changes Cancer Profile in Sub-Saharan Africa

Reuters Health Information Services (01/20/00)
Two recent studies show that the AIDS epidemic has caused increased incidence of cancer in sub-Saharan Africa, with trends in Uganda and Zimbabwe showing more cases of Kaposi's sarcoma (KS), squamous cell carcinomas of the conjunctiva, and non-Hodgkin's lymphoma. Dr. D. Maxwell Parkin of the International Agency for Research on Cancer in France found that the incidence of KS in Uganda has increased significantly since the 1960s and been stable since 1990s. Meanwhile, Dr. Eric Chokunonga of Parirenyatwa Hospital in Harare found that KS rates doubled in men and women from 1990 to 1995, and there was a dramatic increase in squamous cell tumors of the conjunctiva. The studies, both published in the journal AIDS (1999;13:2563-2570, 2583-2590), reveal the primary HIV-related cancers in Africa.

Children Living With HIV Have Better Chance of Long Life

Detroit Free Press Online (01/21/00)
New HIV treatments are allowing infected children to live longer lives. Statistics show that whereas as many as three children with AIDS died per week at Children's Hospital of Michigan in Detroit five years ago, only one about child dies per year now. Children's Hospital employs social workers and psychologists to help its young patients, aiding them with such issues as school and dating as they grow older. According to statistics, there are more than 100 children 12 years of age and younger living with HIV or AIDS in Michigan.

Going the Extra Mile for Children in Need

"Going the Extra Mile for Children in Need" Washington Post (01/21/00) P. C11; Mann, Judy
Georgetown University students Thor Cheston and Stephen Sobhani began volunteering to help children with HIV/AIDS in December 1998 at a hospital Christmas party. After the party, they decided to do more to help children in the HIV/AIDS pediatric unit, and decided to raise money for it by biking across the country. The bike ride, called "It's for the Kids," now has a Web site and the backing of the department of pediatrics, along with the support of the National AIDS Policy director. The students also began pen-pal programs and other activities that bring college students and HIV-infected children together. The Georgetown basketball team has also volunteered its time and free tickets for kids to go to games. In all, 12 Georgetown students will make the bike ride from San Francisco to D.C., hoping to raise $100,000 for Metro Teen AIDS, Grandma's House, and Georgetown's pediatric infectious disease unit.

Despite Gains in Treatment, Number of HIV Infections Continues to Rise

Infectious Diseases in Children (12/99) Vol. 12, No. 12, P. 22; Rosenthal, Marie
At the end of 1999, global estimates for AIDS rates were not a positive indication for the future. New statistics from UNAIDS and the World Health Organization show that the number of AIDS deaths reached 2.6 million this year, the highest total since the epidemic began. Nearly all the infections and deaths occurred in the developing world, primarily among young adults. About 50 percent of those who contract HIV are infected before age 25, and African girls between the ages of 15 and 19 are at least five times more likely to have HIV than boys the same age. HIV is also leaving behind thousands of orphans whose parents have died from the disease. The former Soviet Union has seen a sharp increase in cases, caused mainly by intravenous drug use with infected needles. In India and China, AIDS is becoming a more serious concern, as an increasing number of women and commercial sex workers become infected. There are an estimated 4 million prostitutes in China, and surveys show that only half have ever used a condom. Thailand has seen improvement through a HIV prevention program, though, and the Philippines' testing of registered sex workers is also helping to contain the spread of the deadly virus.

Most Girls in Best Friends Program Avoid Sex, Drugs, Booze, Survey Finds

Washington Times (11/27/99) P. A2; Wetzstein, Cheryl
A recent survey of girls participating in the Best Friends abstinence program found that 97 percent of more than 2,600 girls did not have sex during the 1998-1999 school year. National studies show that 48 percent of high school students have had sex. The Best Friends programs teaches girls in 26 cities, the District of Columbia, and the Virgin Islands about self-respect and success, using a holistic approach. According to the report, girls in the program are less likely to have sex, drink alcohol, become pregnant, or use drugs. Founded in 1987, the program uses classroom time, dance and exercise classes, and meetings with mentors to help teens reach their goals.

Safety of Anti-AIDS Drug Questioned in South Africa

New York Times (11/25/99) P. A14; Swarns, Rachel L.
Officials in South Africa have raised concerns that the AIDS drug AZT may be toxic and could cause cancer. Health Minister Manto Tshabalala-Msimang recently announced her suspicions in a speech to the National Assembly. Doctors are protesting the statements, hoping that the drug will not be banned in a country with one of the highest HIV infection rates in the world. While others have raised safety questions about AZT, the U.S. National Institutes of Health concluded in 1997 that the drug's benefits are much greater than any possible side effects. Physicians, AIDS advocates, and officials at Glaxo Wellcome, which manufactures AZT, have called on the South African government to review scientific literature about the drug; however, even while the government has agreed to conduct such a review, Tshabalala-Msimang said that AZT is still too costly. The South African government is researching a new AIDS drug called nevirapine, which is much less expensive than AZT.

AIDS Prevention Losing Out to Cures, Doctor Warns

PA News (11/28/99); Raven, Nell
Some AIDS prevention programs in Britain are being stopped as funding for expensive drugs increases, according to Dr. George Kinghorn of the Royal Hallamshire Hospital in Sheffield. Kinghorn has been forced to reduce his workforce by 5 percent as the demand for costly drugs grows. He fears the lack of prevention programs will cause an increase in sexually transmitted diseases, including HIV. Kinghorn also noted that reducing support for AIDS patients taking antiretroviral drugs means that it is less likely that they will follow their medication regimen correctly, possibly developing resistance as a result.

Where $609 Billion in Federal Spending Will Go: HHS

"Where $609 Billion in Federal Spending Will Go: HHS" Washington Post (11/26/99) P. A43; Eilperin, Juliet
Congress has reached a plan for federal spending, with $4.65 billion allocated for the Department of Health and Human Services. The National Institutes of Health received a 15 percent budget increase, to $17.9 billion, including a $3 billion delay to keep the Social Security surplus. The plan also includes $1.6 billion for Ryan White AIDS programs and $3 billion for the Centers for Disease Control and Prevention.

Across the USA: Illinois

USA Today (11/26/99) P. 10A
In Illinois, fewer people died from AIDS in 1998 than any year in the last decade. The falling number of deaths is slowing, though. There was a 52 percent decrease in deaths for 1997, but only a 10 percent decline last year.

Hepatitis B Vaccination Safe, Effective in Patients With Chronic Hepatitis C

Reuters Health Information Services (11/26/99)
Findings published by Taiwanese researchers in the Journal of Medical Virology show that hepatitis B virus (HBV) vaccination is safe and effective in individuals with chronic hepatitis C virus (HCV) infection. Three groups of patients were studied: patients with chronic HCV who received the vaccine, patients with chronic HCV who did not receive the vaccine, and healthy subjects who were vaccinated against HBC. According to the report, nearly two-thirds of those with chronic hepatitis C gained effective immunity to HBV. Researchers found the vaccination as safe for HCV patients as it was for healthy patients.

HIV on Rise in Vietnam, 600 New Cases Each Month

Reuters (11/25/99)
HIV cases in Vietnam are rising, as 16,175 people have been recorded as having the virus. Figures from the Vietnam News Agency show that 2,907 people have full-blown AIDS. Widespread prostitution and drug use are two factors cited in the spread of HIV in the country.

Almost Half S. African Mine Workers HIV Positive

Reuters (11/24/99); Sithole, Emelia
South Africa's deputy Minerals and Energy Minister, Susan Shabangu, recently reported that about 45 percent of mine workers in the country are infected with HIV. A high incidence of tuberculosis is also a problem. Shabangu asked that mining firms set up safe sex education at their mines to reduce the spread of HIV. The AIDS epidemic could kill up to 10 percent of the miners per year, according to a report presented recently at a mining seminar.

AIDS Mortality Rates Lower at Sites With HIV Experience

AIDS Alert (11/99) Vol. 14, No. 11, P. 129
A recent study of 7.000 AIDS patients admitted to one of 333 hospitals in California shows that AIDS mortality at hospitals with more experience in treating HIV/AIDS was 30 percent lower than the rate at the least experienced hospitals. The study also found that public hospitals had higher death rates than for-profit and nonprofit hospitals. The California researchers believe that consistent provider education needs to take place in order to give equal treatment.

AIDS Cases Decline in 1998

Oregonian Online (01/14/00); McCall, William
After peaking in 1993 at 766 cases, the number of reported AIDS cases in Oregon dropped 32 percent in 1998 from the previous year, for a total of 199 new cases. Dr. Mark Loveless of the Oregon Health Division attributes the decline to better antiviral drugs, prevention efforts, and increased access to medical care. The dramatic decrease is encouraging, but minorities remain disproportionately affected. Minorities made up 18 percent of the AIDS cases in Oregon, with 16 cases per 100,000 population among African Americans and 10 cases per 100,000 for Hispanics. Comparatively, the incidence of AIDS among Whites in the state is five cases per 100,000 population. The statistics show that the number of AIDS-related deaths in Oregon also declined substantially, dropping 74 percent between 1996 and 1998.

More Blacks, Latinos, Women Seeking Help

Arizona Republic Online (01/14/00); Snyder, Jodie
In Arizona, an increasing number of African Americans, Hispanics, and women are becoming infected with HIV, which has taken the lives of some 4,000 people in the state in the past 20 years. Phoenix Body Positive, an AIDS support group, is helping minorities and women find treatment for HIV/AIDS. The group--which is trying to help more than the gay, White men who began the organization over 10 years ago--is working with churches, doctors, and testing centers to spread its message. Phoenix Body Positive offers HIV prevention counseling, support services like day care, and respite services. The agency's 1,200 clients include approximately 400 women, 380 Hispanics, and 330 African Americans.

Supreme Court Reinstates Suit Over STD Transmission

"Supreme Court Reinstates Suit Over STD Transmission" Las Vegas Sun Online (01/13/00); Ryan, Cy
A $15 million suit in which a woman sued her ex-boyfriend for battery, negligence, and emotional distress after she contracted two sexually transmitted diseases (STDs) has been reinstated by the Nevada Supreme Court. Mary Wilson was diagnosed with herpes simplex virus and human papillomavirus (HPV) four months after the relationship ended. Wilson claims she had no sexual contact with anyone else while she was dating Ronald Radcliffe or in the three years prior to that relationship, and she says Radcliffe lied to her about not being infected with an STD. While Radcliffe's attorneys noted that millions of Americans contract herpes or HPV during their lifetimes, the court said Wilson "does not bear the burden of completely eliminating the possibility that the defendant's conduct did not cause her injury. ... In short, a plaintiff does not need to prove her case beyond a reasonable doubt."

County Gets More Money to Treat AIDS

Houston Chronicle Online (01/13/00); Zuniga, Jo Ann
Texas' Harris County has received more funding for the Ryan White Planning Council, which administers money to organizations serving HIV-infected people in the metropolitan Houston area. The organization saw a 14 percent increase in funding, from $15.5 million to $17.6 million. That sum includes a significant increase in funds for African Americans, after new statistics showed that more than half of the new HIV cases reported in Houston and Harris County during the first six months of 1999 were among African Americans. Kathy Burton of the Houston's Health and Human Services Department noted that prevention efforts remain a priority for the city.

HAART Adherence Suboptimal in Inner-City Population

Reuters Health Information Services (01/13/00)
New research shows that up to 39 percent of HIV-infected patients in an inner-city population did not adhere to their antiretroviral regimens. The study, led by Dr. Paul Weidel of the Centers for Disease Control and Prevention, used a confidential interview and a self-administered anonymous survey to determine antiretroviral drug adherence among 173 people in the South Bronx. Common reasons for not adhering to treatment were forgetfulness and lack of access to medications. The researchers, who report their findings in the December 15 issue of the Journal of Acquired Immune Deficiency Syndromes (1999;22:498-502), called for interventions that help to make dosages easier to remember and that ensure a continued supply of medications.

AIDS Dooms 1 in 4 in Tiny Swaziland

San Francisco Examiner Online (01/13/00); Matthews, Christopher
Swaziland has a population of slightly less than 1 million, and statistics show that 25 percent of those people are infected with HIV. Long in denial, the country has started to realize the AIDS epidemic is continuing to pound southern Africa. Ambassador Mary Kanya explains that while the denial has not completely ended, an increasing number of people are realizing the horror of AIDS, as life expectancy has dropped significantly. Also, while U.S. Vice President Al Gore pledged $150 million in new U.S. funding in the fight against AIDS this week, Kanya and others fear the money may never reach their small country.

AIDS Epidemic Threatens Nakhodka in Russian Far East

Itar Wire Service (01/14/00)
The Russian city of Nakhodka has recorded 62 new HIV infections in the last two months, causing alarm about an epidemic. Anna Kalinina, spokeswoman for the Primorye AIDS Prevention Center, notes that many of the city's HIV patients are either drug addicts or the children of addicts. Vladivostok will soon open three new anonymous testing centers, a project being financed by the Soros Fund.

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