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CDC HIV/STD/TB Prevention News Update

Thursday, March 16, 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

Vaccination Strategies for Targeted and Difficult-to-Access Groups

American Journal of Public Health (www.apha.org/news/publications/journal) (03/00) Vol. 90, No. 3, P. 447; Trubatch, Beth N.; Fisher, Dennis G.; Cagle, Henry H.; et al.
Researchers from the Intravenous Drug User Project in Anchorage, Alaska, describe in a letter to the editor how they successfully vaccinated high-risk, difficult-to-access groups like injection drug users (IDUs) against hepatitis B. The authors street-recruited IDUs and referred them for vaccination to either the Department of Health, Alaska Native Medical Center, or to the patient's Medicaid or private physician. At first, only 7 percent of 140 users received the first hepatitis B shot; however, after a $10 incentive was offered for proof of vaccination, 48 percent of 172 users received their first hepatitis B shot. According to the researchers, the results show that there are successful strategies for vaccinating such high-risk groups, who were even willing to travel off-site for the inoculation.

Ireland's Largest Drug-Abuse Project Still Under Fire

"Ireland's Largest Drug-Abuse Project Still Under Fire" Lancet (www.thelancet.com) (03/11/00) Vol. 355, No. 9207, P. 910; Birchard, Karen
Grainne Kenny, the head of Europe Against Drugs (EURAD) is calling for the resignation of the director of Ireland's largest needle-exchange program after the Irish media quoted him as advocating giving heroin to some addicts. In response, Director Tony Geoghagen said his comments had been misinterpreted and explained that he merely suggested that all possible options be considered. One proposal was that some addicts might be given heroin in a controlled situation as part of an effort to get the individuals to stop using the drug. Geoghagen said, "Ireland has the highest rate of drug deaths in the [European Union] ... . There are many different ways of dealing with drug use in Europe." The "harm-reduction approach," which involves free needle exchange and long-term methadone distribution, is opposed by EURAD and other groups.


General Media

Genes Are Patentable; Less Clear Is if Finder Must Know Their Role

Wall Street Journal (www.wsj.com) (03/16/00) P. A1; Waldholz, Michael
Human Genome Sciences (HGS) received in February a U.S. patent on a gene, CCR5, that HIV uses to infect cells. This announcement sent HGS shares flying, and has sparked a debate regarding the value of the patent. Scientists fear that the patent could block important AIDS research, and drug companies hope that HGS cannot demand money that arises from marketed drugs that block HIV's access to the gene. The larger question of who owns the human genome continues as well. Some drug makers and intellectual property lawyers note that HGS' patent does not mention AIDS; HGS asserts, however, that its press release regarding the new patent was correct. HGS discovered the gene and filed for a patent five years ago, but the gene's role as biochemical gateway for HIV when infecting cells was not learned until several months later, by four independent research teams who then applied for their own patents. Many researchers believe that HGS CEO William Haseltine is unfairly claiming a gene whose specific role and value in HIV was identified by other researchers.

Fined Doctor's Patients Offered Tests

Washington Post (www.washingtonpost.com) (03/16/00) P. B4; Glod, Maria
Loudoun Hospital Center in Loudoun County, Virginia, is offering free blood tests for HIV and other diseases to 160 patients treated by a doctor suspected of stealing and using their painkillers. Gastroenterologist Joseph Shaw Jones is under investigation, and patients treated by the doctor between August and November 1998 will be tested. Hospital officials say the risk of infection is very low, but the testing is being conducted as a precaution. The state Board of Medicine concluded in late 1998 that Jones stole painkillers from used syringes, injected Demerol and saline into a vial for his own use, and then returned a fraction of that solution to the patient's intravenous line. The board fined Jones $10,000, and now federal authorities are working with county prosecutors and Virginia State Police in a criminal inquiry.

3rd Health Officer Will Help County Tackle TB

Huntsville Times Online (www.al.com/news/huntsville) (03/16/00); Windsor, Shawn
An inmate in the Madison County, Alabama, jail tested positive for active tuberculosis (TB) last month. TB cases are not declining in Madison County, as in the rest of Alabama, and this has local public health officials concerned. The Huntsville area has the third-highest TB rate statewide, according to Dr. Larry Robey, director of the county health department. Two full-time TB control officers work in Madison county, and a third will be hired soon to test high-risk jail and shelter populations for the lung infection. Dr. Charles Woernle, assistant health officer in Alabama, believes TB will flourish again if more effort is not given. Multidrug-resistant strains of TB are also becoming more common as patients do not complete their full regimen of antibiotics.

High School Students Bring Condom Issue to Legislature

CNN Online (www.cnn.com) (03/15/00); Wiese, Kelly
Students from Frankfort High School in Frankfort, Kansas, have created in their government class a bill that would distribute condoms in public high schools. The students were instructed to find an issue of importance to them, investigate it, and then develop legislation to help solve the problem. The measure, which has upset some parents and church leaders in this small, rural community, would require schools to hand out condoms to students over age 13 who have completed a sex education course. Local Rep. Bruce Larkin says he opposes the idea, but he agreed to introduce the students' bill to the state Legislature to further their civics education.

Suit Filed Against School Board in Tuberculosis Case

Miami Herald Online (www.herald.com) (03/15/00); Weaver, Jay
The parents of a 10-year-old girl infected with tuberculosis (TB) at an elementary school in Miami Beach have gone to court in a proposed class-action lawsuit against the Miami-Dade School Board. Henna and Steven Haynes claim their daughter was exposed to TB because of an infected cafeteria worker who was not screened for the disease. Henna Haynes believes the school should pay damages and adopt a TB screening policy. A proposal for such a screening policy was withdrawn by board member Demetrio Perez Jr. in 1999 because of practicality issues for testing thousands of workers. Although none of the children or adults who skin-tested positive for TB have symptoms of the disease, they must still take medication and have follow-up exams.

High-Risk Behaviors Persist in HIV-Infected Primary Care Patients

Reuters Health Information Services (03/15/00)
Dr. Emily Erbelding and colleagues from Johns Hopkins University have found that HIV-infected patients being treated in primary care settings have a high prevalence of asymptomatic sexually transmitted diseases (STDs) and often exhibit high-risk sexual behavior, confirming the need for routine STD screening. The 10-month study of 691 HIV-infected patients revealed that heterosexual sex and injection drug use were the most common sources of HIV transmission among the women, while homosexual sex and injection drug use were the most common modes of transmission for the male participants. Nearly 58 percent of the subjects were sexually active within the last 90 days, and over 7 percent had multiple sexual partners in the past month. The report, published in the February 18 issue of AIDS (2000;14:297-301), also found that the overall prevalence for having either chlamydia or gonorrhea within the past 12 months was 7.5 percent.

Doctor Errors Common in TB Therapy

United Press International (03/15/00); Christensen, Damaris
A new report from researchers at the Johns Hopkins School of Medicine in Baltimore suggests that private doctors who do not treat many patients for tuberculosis (TB) make repeated errors in providing TB therapy. This could lead to increased drug resistance and longer hospital stays. The study of 110 people with active TB found that 17 received inadequate therapy, including 13 treated by private doctors. Dr. Richard E. Chaisson and colleagues report their findings in the March issue of Chest (2000;117:734-737).

Interview: Confused Myanmar AIDS Signals Alarm UN

Reuters (03/16/00); Brunnstrom, David
Myanmar is sending conflicting signals regarding its AIDS crisis, according to UNICEF regional director Kul Gautam. The official noted the government is not diverting sufficient resources to health programs and often does not cite AIDS as a significant problem. Gautam said Myanmar has severely underestimated its number of HIV infections, which are on the rise. Lieutenant-General Khin Nyunt reported earlier this year that the military is improving the health sector; however, a recent World Bank study showed that much more funding is going towards defense.

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