Newsgroups: sci.med.aids Subject: CDC Summary 12/4/92 Message-ID: <1992Dec4.164821.23381@cs.ucla.edu> From: Billi Goldberg Date: Fri, 4 Dec 92 07:59:03 PST AIDS Daily Summary December 4, 1992 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. Copyright 1992, Information, Inc., Bethesda, MD *********************************************************************** * "Justices OK AIDS Tests for Inmates" Los Angeles Time--Washington Edition (12/04/92), P. B1 (Hager, Philip) The California Supreme Court ruled Thursday that HIV tests would be required under law for potentially thousands of sex offenders after their crimes occurred. The justices decided unanimously that mandatory HIV testing is not punishment--and therefore does not breach constitutional prohibitions against enacting new penalties for offenses already committed. The justices, who overturned an appeals court ruling, gave broad application to a law requiring HIV tests for people convicted of rape, sodomy, or oral copulation. Those who test HIV- positive may be sentenced to an extra three years in prison for any repeat crime. State officials said the ruling could permit testing of hundreds or even thousands of sex offenders for crimes committed before the law was enacted in January 1989. Christine May, a spokeswoman for the state Department of Corrections, said officials will examine the ruling and decide whether and how to proceed with expanded HIV tests. She noted that as of June 30, 3,176 prisoners were serving terms for rape, sodomy, and oral copulation. It is not known how many have not been tested for HIV, but the number is likely to be significant, she said. Richard Jay Moller, a lawyer for the defendant in the case, said, "People ought to be told in advance of the consequences of committing a crime. This is like saying 'If you've been convicted in the past for speeding, you now have to undergo a test for AIDS in addition to your $50 fine.'" "Council OK's Condom Machines at Most Businesses Serving Alcohol" Boston Globe (12/03/92), P. 38 (Walker, Adrian) The Boston City Council Wednesday voted to override Mayor Raymond Flynn's veto of a bill requiring most businesses that serve alcohol to sell condoms. In a council vote of 9-3, the bill was passed, although Flynn had vetoed it for the second time two weeks ago. The bill calls for condom vending machines to be displayed at most businesses selling alcohol with a capacity of more than 100 patrons. Following the first veto, some businesses were exempted, including smaller establishments, those with religious affiliations, and those with entertainment licenses primarily for offering video games or similar entertainment. Councilors who backed the bill admitted that it would have limited impact but considered it a symbolic effort to show concern for the AIDS epidemic. Adversaries argued that the council should not mandate what many businesses were already doing voluntarily, and some also based their opposition on religious grounds. Councilor David Scondras (Fenway), who sponsored the measure, applauded councilors Wednesday for making an effort to face the AIDS crisis. Flynn, who declined to comment in detail on the override, planned a meeting for tomorrow with Schools Superintendent Lois Harrison-Jones and AIDS activists to address AIDS education and condom distribution in the schools. The mayor strongly opposes school-based condom distribution programs. "Using Syringe, Abductor Threatens Man" Baltimore Sun (12/04/92), P. 1C (Langfitt, Frank) A Baltimore man was abducted by a man wielding a hypodermic needle which he claimed contained HIV-positive blood on Wednesday afternoon in Northwest Baltimore, police said. Brett Dieck was returning to Howard County after having picked up supplies at a warehouse for Golden Triangle Auto Parts in Ellicott City. A man carrying several shopping bags neared his truck and then entered through the unlocked passenger door, said Dieck. When Dieck told the stranger he could not give him a ride, the man pulled out a 3-inch syringe, put it behind Dieck's head, and threatened him. According to Dieck, the man said, "I have AIDS," and "Go! Man! I'll stick you, man, I swear to God I will." Baltimore police Sgt. John J. Parker said that right before the incident the man had run out of a nearby K-Mart store followed by security men who believed he might have shoplifted some items. While in the car, the man told Dieck that he was being chased by store security but that he had not taken anything. The man jumped out of the car after Dieck offered to drop him off at a 7-Eleven. Dieck said he could not determine if there was any blood in the syringe because the man had cupped his hand over it. "Brain Chemical Changes Might Predict Onset of AIDS" United Press International (12/03/92) Chicago--A sophisticated imaging procedure may be able to identify chemical changes in the brains of asymptomatic HIV-positive individuals, researchers reported Thursday at the 78th Scientific Assembly and Annual Meeting of the Radiological Society of North America. The changes may signal progression toward AIDS and may be helpful in evaluating and developing therapies for the disease, said Dr. Robert E. Lenkinski, associate professor of radiology at the University of Pennsylvania in Philadelphia. Lenkinski said, "Previous studies have shown that full- blown AIDS is accompanied by atrophy, or dying, of the gray matter in the brain. Our study shows early signs of biochemical changes in individuals who are positive for the HIV virus but have no clinical symptoms of AIDS." The technique, known as magnetic resonance spectroscopy, could then be used to track development of the disease, providing researchers with an approach to evaluate the efficacy of treatment, he said. "It is theorized that when neurons in the brain are destroyed, membranes are disrupted, leading to increased levels of [certain chemicals] in the brain," said Lenkinski. "It has been reported...that the first symptom of AIDS may be loss of neuro-cognitive function, such as short-term memory loss. Our findings suggest a biochemical basis for understanding these symptoms," concluded Lenkinski. "Study Calls Guantanamo 'HIV Prison Camp'" United Press International (12/02/92) Miami--Approximately 275 Haitian refugees are being held at what is considered an "HIV prison camp" at the U.S. Naval base at Guantanamo Bay, Cuba, according to a Yale Law School study. The report was issued Tuesday and was written by a group of Yale students, professors, and lawyers who were the first outsiders allowed into the camp since the federal government closed access last summer. The group is suing the government on behalf of the refugees. Those held at the camp are HIV- positive refugees and their dependents who the government says have plausible cases for political asylum. But they have not been admitted into the United States because of a law that prohibits HIV-positive foreigners from entering the country. The Yale group described the conditions at Guantanamo as deplorable. The Navy said it had not seen the report and did not comment in detail. However, it said improvements have been made in the past several months. Navy Lt. Commander Morgan Smith said, "The Department of Defense and the Joint Task Force have put forth a lot of effort and money in providing for the migrants. We're trying to make them as comfortable as possible under a difficult situation." The group describes overflowing latrines, clogged sinks, and showers. It also said that the facilities are so crowded that children have to sleep on floors. "Dual-Target Inhibition of HIV-1 in Vitro by Means of an Adeno- Associated Virus Antisense Vector" Science (11/27/92) Vol. 258, No. 5087, P. 1485 (Chatterjee, Saswati et al.) The adeno-associated virus (AAV) seems to be an ideal vector for use in antiretroviral gene therapy, write Saswati Chatterjee et al. of the National Institute of Allergy and Infectious Diseases in Rockville, Md. The researchers used an AAV vector encoding an antisense RNA to transduce stable intracellular resistance to HIV-1 in human hemopoietic and non-hemopoietic cell lines. The antisense targets are present in all HIV-1 transcripts and include the TAR sequence, which is critical for transcription and virus replication, and the polyadenylation signal. Cell lines expressing antisense RNA showed up to 95 percent inhibition of gene expression directed by the HIV-1 long terminal repeat and greater than 99 percent reduction in infectious HIV-1 production, with no detectable cellular toxicity. AAV does not prevent superinfection, a property that allows for infection with several different vectors or multiple rounds of infection with the same vector. Due to their efficient transcription and inability to recombine with HIV-1, AAV vectors represent a promising form of anti-retroviral gene therapy. For the treatment of human AIDS, it may be necessary to confer intracellular resistance to progenitor bone marrow cells that give rise to the renewable targets (T-lymphocytes, monocytes, and macrophages) of HIV-1 infection. Autologous AAV vector-transduced bone marrow stem cells could then be used to repopulate the immune system with HIV-resistant cells. If AAV vectors are safe and effective in animal models, the human trial may then be indicated, the researchers conclude. "Risk Reduction in Sexual Behavior: A Condom Giveaway Program in a Drug Abuse Treatment Clinic" American Journal of Public Health (11/92) Vol. 82, No. 11, P. 1536 (Calsyn, Donald A. et al.) Male clients attending a drug abuse treatment clinic will take, retain, and use condoms when various condoms are provided throughout the clinic, according to Donald A. Calsyn and colleagues from the Veterans Affairs Medical Center in Seattle, Wash. The researchers conducted a study to assess the effectiveness of a free condom distribution program in an outpatient drug abuse treatment clinic. All men receiving outpatient drug abuse treatment at the VA Medical Center during December 1989 and remaining in treatment until May 1990 were qualified for the study. Just before and four months after initiation of a condom giveaway program, a questionnaire regarding sexual behavior and condom acquisition was administered to 103 men at the clinic. Jars were filled with a variety of condoms and were displayed in every clinic room. Most condoms were taken from the men's rest room (47.8 percent), the dispensary waiting room (26.6 percent), the group therapy room (11.3 percent), and the women's rest room (4.4 percent). A total of 10.1 percent were taken from staff offices. A total of 56 patients (60 percent) of the clients reported taking condoms during the intervention. The number of clients possessing condoms increased from 61 (59.2 percent) to 71 (76.1 percent) at follow-up. Also, the mean use of condoms for vaginal intercourse activity increased from 20.3 percent of events initially to 33.7 percent at follow-up, conclude Calsyn et al. "The Reporting of HIV/AIDS Deaths in Women" American Journal of Public Health (11/92) Vol. 82, No. 11, P. 1500 (Buehler, James W. et al.) The wide ranges of underlying-cause-of-death vital records and AIDS surveillance among women reflect the potential role of both HIV infection and drug use in contributing to excess mortality, write James W. Buehler and colleagues from the Centers for Disease Control in Atlanta, Ga. The researchers conducted the study to assess the completeness of vital statistics and case reports of AIDS in measuring HIV-related mortality in women aged 15-44. They used vital records to reveal the number of deaths attributed to HIV infection and excess deaths due to causes that have increased along with the HIV epidemic. It was found in 1988 that in women aged 15-44 there were 1,365 deaths with HIV infection listed as the underlying cause, 202 deaths with HIV infection listed as an associate cause, and 149 excess deaths due to conditions highly related to HIV infection. Also, there were 780 excess deaths as a result of causes that may have been related to HIV infection or illicit drug use. Among the deaths that occurred in 1988, 1,532 were reported through AIDS surveillance. Consequently, underlying-cause-of- death vital records and AIDS surveillance identified 55 percent to 80 percent and 67 to 97 percent, respectively, of HIV-related deaths in women 15 through 44 years of age in 1988, conclude Buehler et al. "Survey Says Insurance Claims for AIDS Reached $1.3 Billion Last Year." Business + Health (11/92) Vol. 10, No. 13, P. 12 A survey by the Health Insurance Association of America found that insurers paid $1.3 million in claims as a result of AIDS or related illnesses in 1991. While the number of AIDS-related claims rose for individual and group life policies, individual and group accident and health claims remained about the same as last year. The findings were based on statistics from 387 companies that paid $989.3 million or 73 percent of all AIDS claims .An actuary estimated another 27 percent to bring the figure to $1.3 billion. The survey did not include self- insured companies or claims paid by Blue Cross or Blue Shield. The cumulative total of AIDS-related claims paid by the insurance industry since 1986 is $4.9 billion. Newsgroups: sci.med.aids Subject: CDC Summary 12/4/92 Message-ID: <1992Dec4.164821.23381@cs.ucla.edu> From: Billi Goldberg Date: Fri, 4 Dec 92 07:59:03 PST AIDS Daily Summary December 4, 1992 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. Copyright 1992, Information, Inc., Bethesda, MD *********************************************************************** * "Justices OK AIDS Tests for Inmates" Los Angeles Time--Washington Edition (12/04/92), P. B1 (Hager, Philip) The California Supreme Court ruled Thursday that HIV tests would be required under law for potentially thousands of sex offenders after their crimes occurred. The justices decided unanimously that mandatory HIV testing is not punishment--and therefore does not breach constitutional prohibitions against enacting new penalties for offenses already committed. The justices, who overturned an appeals court ruling, gave broad application to a law requiring HIV tests for people convicted of rape, sodomy, or oral copulation. Those who test HIV- positive may be sentenced to an extra three years in prison for any repeat crime. State officials said the ruling could permit testing of hundreds or even thousands of sex offenders for crimes committed before the law was enacted in January 1989. Christine May, a spokeswoman for the state Department of Corrections, said officials will examine the ruling and decide whether and how to proceed with expanded HIV tests. She noted that as of June 30, 3,176 prisoners were serving terms for rape, sodomy, and oral copulation. It is not known how many have not been tested for HIV, but the number is likely to be significant, she said. Richard Jay Moller, a lawyer for the defendant in the case, said, "People ought to be told in advance of the consequences of committing a crime. This is like saying 'If you've been convicted in the past for speeding, you now have to undergo a test for AIDS in addition to your $50 fine.'" "Council OK's Condom Machines at Most Businesses Serving Alcohol" Boston Globe (12/03/92), P. 38 (Walker, Adrian) The Boston City Council Wednesday voted to override Mayor Raymond Flynn's veto of a bill requiring most businesses that serve alcohol to sell condoms. In a council vote of 9-3, the bill was passed, although Flynn had vetoed it for the second time two weeks ago. The bill calls for condom vending machines to be displayed at most businesses selling alcohol with a capacity of more than 100 patrons. Following the first veto, some businesses were exempted, including smaller establishments, those with religious affiliations, and those with entertainment licenses primarily for offering video games or similar entertainment. Councilors who backed the bill admitted that it would have limited impact but considered it a symbolic effort to show concern for the AIDS epidemic. Adversaries argued that the council should not mandate what many businesses were already doing voluntarily, and some also based their opposition on religious grounds. Councilor David Scondras (Fenway), who sponsored the measure, applauded councilors Wednesday for making an effort to face the AIDS crisis. Flynn, who declined to comment in detail on the override, planned a meeting for tomorrow with Schools Superintendent Lois Harrison-Jones and AIDS activists to address AIDS education and condom distribution in the schools. The mayor strongly opposes school-based condom distribution programs. "Using Syringe, Abductor Threatens Man" Baltimore Sun (12/04/92), P. 1C (Langfitt, Frank) A Baltimore man was abducted by a man wielding a hypodermic needle which he claimed contained HIV-positive blood on Wednesday afternoon in Northwest Baltimore, police said. Brett Dieck was returning to Howard County after having picked up supplies at a warehouse for Golden Triangle Auto Parts in Ellicott City. A man carrying several shopping bags neared his truck and then entered through the unlocked passenger door, said Dieck. When Dieck told the stranger he could not give him a ride, the man pulled out a 3-inch syringe, put it behind Dieck's head, and threatened him. According to Dieck, the man said, "I have AIDS," and "Go! Man! I'll stick you, man, I swear to God I will." Baltimore police Sgt. John J. Parker said that right before the incident the man had run out of a nearby K-Mart store followed by security men who believed he might have shoplifted some items. While in the car, the man told Dieck that he was being chased by store security but that he had not taken anything. The man jumped out of the car after Dieck offered to drop him off at a 7-Eleven. Dieck said he could not determine if there was any blood in the syringe because the man had cupped his hand over it. "Brain Chemical Changes Might Predict Onset of AIDS" United Press International (12/03/92) Chicago--A sophisticated imaging procedure may be able to identify chemical changes in the brains of asymptomatic HIV-positive individuals, researchers reported Thursday at the 78th Scientific Assembly and Annual Meeting of the Radiological Society of North America. The changes may signal progression toward AIDS and may be helpful in evaluating and developing therapies for the disease, said Dr. Robert E. Lenkinski, associate professor of radiology at the University of Pennsylvania in Philadelphia. Lenkinski said, "Previous studies have shown that full- blown AIDS is accompanied by atrophy, or dying, of the gray matter in the brain. Our study shows early signs of biochemical changes in individuals who are positive for the HIV virus but have no clinical symptoms of AIDS." The technique, known as magnetic resonance spectroscopy, could then be used to track development of the disease, providing researchers with an approach to evaluate the efficacy of treatment, he said. "It is theorized that when neurons in the brain are destroyed, membranes are disrupted, leading to increased levels of [certain chemicals] in the brain," said Lenkinski. "It has been reported...that the first symptom of AIDS may be loss of neuro-cognitive function, such as short-term memory loss. Our findings suggest a biochemical basis for understanding these symptoms," concluded Lenkinski. "Study Calls Guantanamo 'HIV Prison Camp'" United Press International (12/02/92) Miami--Approximately 275 Haitian refugees are being held at what is considered an "HIV prison camp" at the U.S. Naval base at Guantanamo Bay, Cuba, according to a Yale Law School study. The report was issued Tuesday and was written by a group of Yale students, professors, and lawyers who were the first outsiders allowed into the camp since the federal government closed access last summer. The group is suing the government on behalf of the refugees. Those held at the camp are HIV- positive refugees and their dependents who the government says have plausible cases for political asylum. But they have not been admitted into the United States because of a law that prohibits HIV-positive foreigners from entering the country. The Yale group described the conditions at Guantanamo as deplorable. The Navy said it had not seen the report and did not comment in detail. However, it said improvements have been made in the past several months. Navy Lt. Commander Morgan Smith said, "The Department of Defense and the Joint Task Force have put forth a lot of effort and money in providing for the migrants. We're trying to make them as comfortable as possible under a difficult situation." The group describes overflowing latrines, clogged sinks, and showers. It also said that the facilities are so crowded that children have to sleep on floors. "Dual-Target Inhibition of HIV-1 in Vitro by Means of an Adeno- Associated Virus Antisense Vector" Science (11/27/92) Vol. 258, No. 5087, P. 1485 (Chatterjee, Saswati et al.) The adeno-associated virus (AAV) seems to be an ideal vector for use in antiretroviral gene therapy, write Saswati Chatterjee et al. of the National Institute of Allergy and Infectious Diseases in Rockville, Md. The researchers used an AAV vector encoding an antisense RNA to transduce stable intracellular resistance to HIV-1 in human hemopoietic and non-hemopoietic cell lines. The antisense targets are present in all HIV-1 transcripts and include the TAR sequence, which is critical for transcription and virus replication, and the polyadenylation signal. Cell lines expressing antisense RNA showed up to 95 percent inhibition of gene expression directed by the HIV-1 long terminal repeat and greater than 99 percent reduction in infectious HIV-1 production, with no detectable cellular toxicity. AAV does not prevent superinfection, a property that allows for infection with several different vectors or multiple rounds of infection with the same vector. Due to their efficient transcription and inability to recombine with HIV-1, AAV vectors represent a promising form of anti-retroviral gene therapy. For the treatment of human AIDS, it may be necessary to confer intracellular resistance to progenitor bone marrow cells that give rise to the renewable targets (T-lymphocytes, monocytes, and macrophages) of HIV-1 infection. Autologous AAV vector-transduced bone marrow stem cells could then be used to repopulate the immune system with HIV-resistant cells. If AAV vectors are safe and effective in animal models, the human trial may then be indicated, the researchers conclude. "Risk Reduction in Sexual Behavior: A Condom Giveaway Program in a Drug Abuse Treatment Clinic" American Journal of Public Health (11/92) Vol. 82, No. 11, P. 1536 (Calsyn, Donald A. et al.) Male clients attending a drug abuse treatment clinic will take, retain, and use condoms when various condoms are provided throughout the clinic, according to Donald A. Calsyn and colleagues from the Veterans Affairs Medical Center in Seattle, Wash. The researchers conducted a study to assess the effectiveness of a free condom distribution program in an outpatient drug abuse treatment clinic. All men receiving outpatient drug abuse treatment at the VA Medical Center during December 1989 and remaining in treatment until May 1990 were qualified for the study. Just before and four months after initiation of a condom giveaway program, a questionnaire regarding sexual behavior and condom acquisition was administered to 103 men at the clinic. Jars were filled with a variety of condoms and were displayed in every clinic room. Most condoms were taken from the men's rest room (47.8 percent), the dispensary waiting room (26.6 percent), the group therapy room (11.3 percent), and the women's rest room (4.4 percent). A total of 10.1 percent were taken from staff offices. A total of 56 patients (60 percent) of the clients reported taking condoms during the intervention. The number of clients possessing condoms increased from 61 (59.2 percent) to 71 (76.1 percent) at follow-up. Also, the mean use of condoms for vaginal intercourse activity increased from 20.3 percent of events initially to 33.7 percent at follow-up, conclude Calsyn et al. "The Reporting of HIV/AIDS Deaths in Women" American Journal of Public Health (11/92) Vol. 82, No. 11, P. 1500 (Buehler, James W. et al.) The wide ranges of underlying-cause-of-death vital records and AIDS surveillance among women reflect the potential role of both HIV infection and drug use in contributing to excess mortality, write James W. Buehler and colleagues from the Centers for Disease Control in Atlanta, Ga. The researchers conducted the study to assess the completeness of vital statistics and case reports of AIDS in measuring HIV-related mortality in women aged 15-44. They used vital records to reveal the number of deaths attributed to HIV infection and excess deaths due to causes that have increased along with the HIV epidemic. It was found in 1988 that in women aged 15-44 there were 1,365 deaths with HIV infection listed as the underlying cause, 202 deaths with HIV infection listed as an associate cause, and 149 excess deaths due to conditions highly related to HIV infection. Also, there were 780 excess deaths as a result of causes that may have been related to HIV infection or illicit drug use. Among the deaths that occurred in 1988, 1,532 were reported through AIDS surveillance. Consequently, underlying-cause-of- death vital records and AIDS surveillance identified 55 percent to 80 percent and 67 to 97 percent, respectively, of HIV-related deaths in women 15 through 44 years of age in 1988, conclude Buehler et al. "Survey Says Insurance Claims for AIDS Reached $1.3 Billion Last Year." Business + Health (11/92) Vol. 10, No. 13, P. 12 A survey by the Health Insurance Association of America found that insurers paid $1.3 million in claims as a result of AIDS or related illnesses in 1991. While the number of AIDS-related claims rose for individual and group life policies, individual and group accident and health claims remained about the same as last year. The findings were based on statistics from 387 companies that paid $989.3 million or 73 percent of all AIDS claims .An actuary estimated another 27 percent to bring the figure to $1.3 billion. The survey did not include self- insured companies or claims paid by Blue Cross or Blue Shield. The cumulative total of AIDS-related claims paid by the insurance industry since 1986 is $4.9 billion. Newsgroups: sci.med.aids Subject: CDC Summary 12/4/92 Message-ID: <1992Dec4.164821.23381@cs.ucla.edu> From: Billi Goldberg Date: Fri, 4 Dec 92 07:59:03 PST AIDS Daily Summary December 4, 1992 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. Copyright 1992, Information, Inc., Bethesda, MD *********************************************************************** * "Justices OK AIDS Tests for Inmates" Los Angeles Time--Washington Edition (12/04/92), P. B1 (Hager, Philip) The California Supreme Court ruled Thursday that HIV tests would be required under law for potentially thousands of sex offenders after their crimes occurred. The justices decided unanimously that mandatory HIV testing is not punishment--and therefore does not breach constitutional prohibitions against enacting new penalties for offenses already committed. The justices, who overturned an appeals court ruling, gave broad application to a law requiring HIV tests for people convicted of rape, sodomy, or oral copulation. Those who test HIV- positive may be sentenced to an extra three years in prison for any repeat crime. State officials said the ruling could permit testing of hundreds or even thousands of sex offenders for crimes committed before the law was enacted in January 1989. Christine May, a spokeswoman for the state Department of Corrections, said officials will examine the ruling and decide whether and how to proceed with expanded HIV tests. She noted that as of June 30, 3,176 prisoners were serving terms for rape, sodomy, and oral copulation. It is not known how many have not been tested for HIV, but the number is likely to be significant, she said. Richard Jay Moller, a lawyer for the defendant in the case, said, "People ought to be told in advance of the consequences of committing a crime. This is like saying 'If you've been convicted in the past for speeding, you now have to undergo a test for AIDS in addition to your $50 fine.'" "Council OK's Condom Machines at Most Businesses Serving Alcohol" Boston Globe (12/03/92), P. 38 (Walker, Adrian) The Boston City Council Wednesday voted to override Mayor Raymond Flynn's veto of a bill requiring most businesses that serve alcohol to sell condoms. In a council vote of 9-3, the bill was passed, although Flynn had vetoed it for the second time two weeks ago. The bill calls for condom vending machines to be displayed at most businesses selling alcohol with a capacity of more than 100 patrons. Following the first veto, some businesses were exempted, including smaller establishments, those with religious affiliations, and those with entertainment licenses primarily for offering video games or similar entertainment. Councilors who backed the bill admitted that it would have limited impact but considered it a symbolic effort to show concern for the AIDS epidemic. Adversaries argued that the council should not mandate what many businesses were already doing voluntarily, and some also based their opposition on religious grounds. Councilor David Scondras (Fenway), who sponsored the measure, applauded councilors Wednesday for making an effort to face the AIDS crisis. Flynn, who declined to comment in detail on the override, planned a meeting for tomorrow with Schools Superintendent Lois Harrison-Jones and AIDS activists to address AIDS education and condom distribution in the schools. The mayor strongly opposes school-based condom distribution programs. "Using Syringe, Abductor Threatens Man" Baltimore Sun (12/04/92), P. 1C (Langfitt, Frank) A Baltimore man was abducted by a man wielding a hypodermic needle which he claimed contained HIV-positive blood on Wednesday afternoon in Northwest Baltimore, police said. Brett Dieck was returning to Howard County after having picked up supplies at a warehouse for Golden Triangle Auto Parts in Ellicott City. A man carrying several shopping bags neared his truck and then entered through the unlocked passenger door, said Dieck. When Dieck told the stranger he could not give him a ride, the man pulled out a 3-inch syringe, put it behind Dieck's head, and threatened him. According to Dieck, the man said, "I have AIDS," and "Go! Man! I'll stick you, man, I swear to God I will." Baltimore police Sgt. John J. Parker said that right before the incident the man had run out of a nearby K-Mart store followed by security men who believed he might have shoplifted some items. While in the car, the man told Dieck that he was being chased by store security but that he had not taken anything. The man jumped out of the car after Dieck offered to drop him off at a 7-Eleven. Dieck said he could not determine if there was any blood in the syringe because the man had cupped his hand over it. "Brain Chemical Changes Might Predict Onset of AIDS" United Press International (12/03/92) Chicago--A sophisticated imaging procedure may be able to identify chemical changes in the brains of asymptomatic HIV-positive individuals, researchers reported Thursday at the 78th Scientific Assembly and Annual Meeting of the Radiological Society of North America. The changes may signal progression toward AIDS and may be helpful in evaluating and developing therapies for the disease, said Dr. Robert E. Lenkinski, associate professor of radiology at the University of Pennsylvania in Philadelphia. Lenkinski said, "Previous studies have shown that full- blown AIDS is accompanied by atrophy, or dying, of the gray matter in the brain. Our study shows early signs of biochemical changes in individuals who are positive for the HIV virus but have no clinical symptoms of AIDS." The technique, known as magnetic resonance spectroscopy, could then be used to track development of the disease, providing researchers with an approach to evaluate the efficacy of treatment, he said. "It is theorized that when neurons in the brain are destroyed, membranes are disrupted, leading to increased levels of [certain chemicals] in the brain," said Lenkinski. "It has been reported...that the first symptom of AIDS may be loss of neuro-cognitive function, such as short-term memory loss. Our findings suggest a biochemical basis for understanding these symptoms," concluded Lenkinski. "Study Calls Guantanamo 'HIV Prison Camp'" United Press International (12/02/92) Miami--Approximately 275 Haitian refugees are being held at what is considered an "HIV prison camp" at the U.S. Naval base at Guantanamo Bay, Cuba, according to a Yale Law School study. The report was issued Tuesday and was written by a group of Yale students, professors, and lawyers who were the first outsiders allowed into the camp since the federal government closed access last summer. The group is suing the government on behalf of the refugees. Those held at the camp are HIV- positive refugees and their dependents who the government says have plausible cases for political asylum. But they have not been admitted into the United States because of a law that prohibits HIV-positive foreigners from entering the country. The Yale group described the conditions at Guantanamo as deplorable. The Navy said it had not seen the report and did not comment in detail. However, it said improvements have been made in the past several months. Navy Lt. Commander Morgan Smith said, "The Department of Defense and the Joint Task Force have put forth a lot of effort and money in providing for the migrants. We're trying to make them as comfortable as possible under a difficult situation." The group describes overflowing latrines, clogged sinks, and showers. It also said that the facilities are so crowded that children have to sleep on floors. "Dual-Target Inhibition of HIV-1 in Vitro by Means of an Adeno- Associated Virus Antisense Vector" Science (11/27/92) Vol. 258, No. 5087, P. 1485 (Chatterjee, Saswati et al.) The adeno-associated virus (AAV) seems to be an ideal vector for use in antiretroviral gene therapy, write Saswati Chatterjee et al. of the National Institute of Allergy and Infectious Diseases in Rockville, Md. The researchers used an AAV vector encoding an antisense RNA to transduce stable intracellular resistance to HIV-1 in human hemopoietic and non-hemopoietic cell lines. The antisense targets are present in all HIV-1 transcripts and include the TAR sequence, which is critical for transcription and virus replication, and the polyadenylation signal. Cell lines expressing antisense RNA showed up to 95 percent inhibition of gene expression directed by the HIV-1 long terminal repeat and greater than 99 percent reduction in infectious HIV-1 production, with no detectable cellular toxicity. AAV does not prevent superinfection, a property that allows for infection with several different vectors or multiple rounds of infection with the same vector. Due to their efficient transcription and inability to recombine with HIV-1, AAV vectors represent a promising form of anti-retroviral gene therapy. For the treatment of human AIDS, it may be necessary to confer intracellular resistance to progenitor bone marrow cells that give rise to the renewable targets (T-lymphocytes, monocytes, and macrophages) of HIV-1 infection. Autologous AAV vector-transduced bone marrow stem cells could then be used to repopulate the immune system with HIV-resistant cells. If AAV vectors are safe and effective in animal models, the human trial may then be indicated, the researchers conclude. "Risk Reduction in Sexual Behavior: A Condom Giveaway Program in a Drug Abuse Treatment Clinic" American Journal of Public Health (11/92) Vol. 82, No. 11, P. 1536 (Calsyn, Donald A. et al.) Male clients attending a drug abuse treatment clinic will take, retain, and use condoms when various condoms are provided throughout the clinic, according to Donald A. Calsyn and colleagues from the Veterans Affairs Medical Center in Seattle, Wash. The researchers conducted a study to assess the effectiveness of a free condom distribution program in an outpatient drug abuse treatment clinic. All men receiving outpatient drug abuse treatment at the VA Medical Center during December 1989 and remaining in treatment until May 1990 were qualified for the study. Just before and four months after initiation of a condom giveaway program, a questionnaire regarding sexual behavior and condom acquisition was administered to 103 men at the clinic. Jars were filled with a variety of condoms and were displayed in every clinic room. Most condoms were taken from the men's rest room (47.8 percent), the dispensary waiting room (26.6 percent), the group therapy room (11.3 percent), and the women's rest room (4.4 percent). A total of 10.1 percent were taken from staff offices. A total of 56 patients (60 percent) of the clients reported taking condoms during the intervention. The number of clients possessing condoms increased from 61 (59.2 percent) to 71 (76.1 percent) at follow-up. Also, the mean use of condoms for vaginal intercourse activity increased from 20.3 percent of events initially to 33.7 percent at follow-up, conclude Calsyn et al. "The Reporting of HIV/AIDS Deaths in Women" American Journal of Public Health (11/92) Vol. 82, No. 11, P. 1500 (Buehler, James W. et al.) The wide ranges of underlying-cause-of-death vital records and AIDS surveillance among women reflect the potential role of both HIV infection and drug use in contributing to excess mortality, write James W. Buehler and colleagues from the Centers for Disease Control in Atlanta, Ga. The researchers conducted the study to assess the completeness of vital statistics and case reports of AIDS in measuring HIV-related mortality in women aged 15-44. They used vital records to reveal the number of deaths attributed to HIV infection and excess deaths due to causes that have increased along with the HIV epidemic. It was found in 1988 that in women aged 15-44 there were 1,365 deaths with HIV infection listed as the underlying cause, 202 deaths with HIV infection listed as an associate cause, and 149 excess deaths due to conditions highly related to HIV infection. Also, there were 780 excess deaths as a result of causes that may have been related to HIV infection or illicit drug use. Among the deaths that occurred in 1988, 1,532 were reported through AIDS surveillance. Consequently, underlying-cause-of- death vital records and AIDS surveillance identified 55 percent to 80 percent and 67 to 97 percent, respectively, of HIV-related deaths in women 15 through 44 years of age in 1988, conclude Buehler et al. "Survey Says Insurance Claims for AIDS Reached $1.3 Billion Last Year." Business + Health (11/92) Vol. 10, No. 13, P. 12 A survey by the Health Insurance Association of America found that insurers paid $1.3 million in claims as a result of AIDS or related illnesses in 1991. While the number of AIDS-related claims rose for individual and group life policies, individual and group accident and health claims remained about the same as last year. The findings were based on statistics from 387 companies that paid $989.3 million or 73 percent of all AIDS claims .An actuary estimated another 27 percent to bring the figure to $1.3 billion. The survey did not include self- insured companies or claims paid by Blue Cross or Blue Shield. The cumulative total of AIDS-related claims paid by the insurance industry since 1986 is $4.9 billion. Newsgroups: sci.med.aids Subject: CDC Summary 12/3/92 Message-ID: <1992Dec4.235116.5795@cs.ucla.edu> From: Billi Goldberg Date: Fri, 4 Dec 92 07:56:32 PST AIDS Daily Summary December 3, 1992 The Centers for Disease Control (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. Copyright 1992, Information, Inc., Bethesda, MD *********************************************************************** * "NIH Endorses Human Trials Hill Ordered for AIDS Drug" Washington Post (12/03/92), P. A4 An advisory panel to the National Institutes of Health yesterday ratified plans for national AIDS vaccine trials, but criticized a congressional move that mandates the trials. The advisory committee unanimously granted approval to a plan that will test the vaccine widely among HIV-positive people. The trials of the vaccine, called gp160, had not been endorsed through normal scientific evaluation at NIH. In October, Congress included funding of $20 million for testing the vaccine in the Defense Department appropriation bill. It passed after successful lobbying by the vaccine's manufacturer, MicroGeneSys Inc. of Meriden, Conn. The bill specifies that the trial could be stopped if the NIH, the Food and Drug Administration, and the Defense Department decided within six months that a trial of gp160 was not appropriate. A special committee selected by NIH Director Bernadine P. Healy met twice last month and finally decided to recommend to the director that she approve a trial that would include gp160 along with one or two other vaccines. The advisory committee vote yesterday supported that recommendation. Regardless of the decision, the advisory panel chastised the action of Congress in mandating a human drug trial, suggesting that testing of drugs should be based on science and not on a political process. Healy said it caused potential danger because political action based on lobbying was determining what drugs could be tested. She added that such testing should be based on scientific merit. Related Stories: New York Times (12/03) P. B12; Philadelphia Inquirer (12/03) P. A22 "AIDS Rally Presses Flynn on Condoms in Schools" Boston Globe (12/02/92), P. 55 (Dowdy, Zachary R.) Boston-area AIDS officials and activists argue that Mayor Raymond Flynn is sending mixed signals when he strongly supports legislation for a pilot needle-exchange program while opposing condom distribution in public schools. Michael Cronin, cochair of the Boston AIDS Consortium, said, "The mayor cannot pick and choose AIDS initiatives that he happens to be comfortable with while discarding those that bother him." Cronin believes Flynn is giving into pressure from the Catholic Church that he refuse to back condoms in schools. The activist joined AIDS experts and area teenagers at a World AIDS Day news conference in City Hall Plaza, where they pleaded with the mayor to make condoms available in the city's high schools. But Flynn released a two-page statement in which he mourned the thousands of deaths from AIDS but applauded Boston's actions that have provided housing for AIDS patients and first-rate primary and secondary care. Flynn also praised a state proposal to develop a needle-exchange program, which would enable IV-drug users to receive clean hypodermic needles as a means to control the spread of HIV. Flynn also defended his position on condom distribution in the schools, claiming they are widely available from several other sources in every neighborhood. He addressed the criticism from activists calling for condom distribution, saying that such a decision will be left to the mayorally-appointed School Committee and Superintendent Lois Harrison-Jones. "8 Percent of State Inmates Estimated to be Infected With AIDS Virus" Boston Globe (12/02/92), P. 1 (Hernandez, Efrain) Approximately 800 prisoners in Massachusetts' correctional facilities are HIV-positive, with an especially alarming prevalence of infection among female inmates, according to the physician who monitors prison health care. A total of 2,200 inmates were tested earlier this year, which is more than 20 percent of the prison population. The tests revealed that 8.1 percent of the inmates are HIV-positive, a rate 15 times greater than the general population. But statistics show that women in the prison system tested positive for HIV at a rate almost twice that of men; one in every five inmates with a history of IV-drug use was found to be infected with HIV. Dr. Mark R. Prete, program medical director for the private company responsible for health care in prisons statewide, said nearly 300 inmates known to be infected with HIV are being treated, but based on the testing, hundreds more are probably infected. Prete said, "There may be a lot more who are HIV- positive who are not showing clinical symptoms." "Thailand's Sex Industry Spreads the HIV Virus" Chicago Tribune (12/02/92), P. 1-5 (Scmetzer, Uli) Thailand is experiencing a significant increase in AIDS cases as a result of its popular sex industry. The most recent Health Ministry estimate is that over the next two years 10,000 Thais will die of AIDS and that 1 in every 100 pregnant women is infected with HIV. "AIDS Free" signs are posted at the doors of many of Thailand's nightclubs, although the claim is often untrue. HIV tests were performed on all of the women at one southern city, revealing that all the female inhabitants were infected with the virus. The Thai government has finally established a five-year emergency plan and allotted $40 million and 750 permanent anti-AIDS officials to educate its people in the dangers of infections and the use of condoms. The effort has elicited some reaction. The latest Health Ministry survey found 84 percent of brothel customers insist on using condoms. The Red Cross conducted a survey among children between the age of 12 and 14 years. It discovered that 98 percent said they wanted prostitution to exist as a profession, and 4.5 percent of the young women surveyed conceded that they expected to end up as sex workers. Thailand's sex industry generates 25 percent of the country's national revenue. A Thai health ministry official estimated that at least 350,000 Thais are infected with HIV, that 10,000 will die over the next 24 months and at least 3,000 babies were born with the virus among the 90,000 births over the last year. Moreover, the Health Ministry reports that 23.8 percent of all prostitutes are infected, as well as 35 percent of drug addicts. "AIDS Day Observed Many Ways" Chicago Tribune (12/02/92), P. 1-5 World AIDS Day was recognized around the globe in various ways on Tuesday from light demonstrations to solemn vigils. Demonstrators in Santa Claus costumes danced around a giant condom in Town Hall Square in Copenhagen. In Russia, physicians conducted free consultations at the Moscow Satire Theater. Brazilian protesters demanded more government funds. The World Health Organization sponsors World AIDS Day and called attention to Asia, where it claims 2 million people could die of AIDS by the year 2000. India is at high risk because of its widespread illiteracy, poor health care, and contaminated blood banks, experts say. In Banjul, Gambia, hundreds of marchers gathered to hear speeches and pray for AIDS patients. The West African nation's health minister, Landing Jallow Sonko, cautioned that AIDS may boost child mortality by as much as 50 percent in much of sub-Saharan Africa in the 1990s. The Japanese baseball star Sadaharu Oh observed the occasion by joining other celebrities in distributing information packets at a rally in the Ginza shopping district. In Britain, protesters gathered outside the prime minister's office to request the appointment of a minister for AIDS. And in the United States, Health Secretary Louis Sullivan recognized the day by implementing a new program to help businesses keep employees infected with HIV working as long as possible. "High Rate of Condom Use in France, HIV Testing in Britain" United Press International (12/03/92) Washington--Approximately 80 percent of French 18- and 19-year- olds use condoms, but many people of all ages in Britain and France are still at risk for HIV infection, according to two surveys published in the British journal Nature. The two studies of sexual behavior in Britain and France were issued Wednesday. They found that many men and women at risk for HIV infection had altered their behavior because of the disease. The French researchers said, "Young people change partners more frequently than older people but are less likely to have more than one sexual partner at any one time." It was discovered also that younger French people were most likely to use condoms. A total of 18 percent of men and 11 percent of women reported using a condom during their last intercourse, and condom use was 2.5 times more frequent during sex with a casual partner, the study found. The researchers said that women were 3.1 times more likely to use a condom if they were having sex with a new partner. Of 18- and 19-year-olds, condom use was 79.8 percent among males and 48 percent among females. The survey of British sexual behavior found that 4 percent of men and 3 percent of women had been tested for HIV in the past five years. The report found that single people were reporting a larger number of sexual partners in the past year and younger people were reporting more partners. Dr. Anne Johnson of University College in London and her colleagues said, "Our study indicates many of those at high risk for HIV infection have perceived this risk and have already undergone HIV antibody testing, but that more than half remain untested." "Canada's Estimates of AIDS Cases Low" Toronto Globe and Mail (12/01/92), P. A1 (Mickleburgh, Rod) Canada's total number of AIDS cases has been underestimated by nearly 45 percent, according to the country's leading AIDS expert. Dr. Donald Sutherland, head of HIV-AIDS epidemiology for the Laboratory Center for Disease Control in Ottawa, said 1992 may witness the highest number of cases in a single year since the first case was recorded in Canada in 1980. Sutherland revealed new statistics emphasizing the spread of HIV in Canada, taking into consideration for the first time statistical estimates of delayed reporting of AIDS cases and cases that were never reported. His revised tally predicts there were actually 9,299 cases of AIDS in Canada by the end of 1991. The number is substantially higher than the Health and Welfare's most recent AIDS Update report of 6,477. The new statistics indicate that there will have been more than 11,000 cases of AIDS reported in Canada by the end of 1991, including a record 1,846 new cases during the current year. Sutherland stressed that his figures are estimates but insisted they are far more accurate than those listed in the Health and Welfare's quarterly reports, which count only reported AIDS cases. Sutherland's division conducted a complex statistical analysis, including viewing death certificates, to determine as accurately as possible how many AIDS cases are never reported and how many are seriously delayed in being reported. Dr. Sutherland said AIDS is not listed as the cause of death in about 15 percent of those who die of the disease, possibly because of the stigma associated with it. "AIDS Stalks Asia; Few Take Heed" Toronto Globe and Mail (12/01/92), P. A1 (Stackhouse, John) The AIDS epidemic is ravaging Asia, but few efforts have been implemented to thwart the disease's spread. John Dwyer, president of the AIDS Society of Asia and the Pacific, told a recent international congress of the society in New Delhi, "We anticipate an Africa-like situation developing here, only worse." The World Health Organization says there are approximately 1.5 million HIV infections in Asia and perhaps 20,000 full-blown cases of AIDS. By the year 2000, WHO predicts that Asia will be ahead of Africa in the number of HIV infections by adding a million new infections a year. At that time, the majority of the world's 40 million HIV infections and 10 million adult AIDS cases will be in Asia, according to estimates from the Asian Development Bank. The Foundation for Children states that in Thailand, 30,000 prostitutes in Bangkok alone have contracted HIV. If the projections are correct, however, no country will have more infections than India, where WHO predicts the number will reach five million. In addition, within India, Bombay is home to at least 100,000 HIV-positive prostitutes. Yet although there are commitments of foreign aid, there is no clear plan that has arisen on how to fight HIV in India, or even Asia. The World Bank has allotted a soft loan of $84-million--other donors have contributed $15 million more--to start up India's National AIDS Control Organization. But what is even more disconcerting is how to properly educate 850 million Indians, who are plagued with illiteracy and poverty or have religious or cultural traditions that prevent them from aggressively reacting to the epidemic. "Inhibition of Furin-Mediated Cleavage Activation of HIV-1 Glycoprotein gp160" Nature (11/26/92) Vol. 360, No. 6402, P. 358 (Hallenberger, Sabine et al.) HIV inhibitors reduce the infectivity of the virus and may therefore have the potential to stop the spread of infection in an organism, write Sabine Hallenberger et al. of the Phillips-Universitat Marburg in Marburg, Germany. The envelope glycoprotein of HIV initiates infection by mediating fusion of the viral envelope with the cell membrane. Fusion activity entails proteolytic cleavage of the gp160 protein into gp120 and gp41 at a site containing several arginine and lysine residues. Activation at basic cleavage sites is observed with many membrane proteins of cellular and viral origin. The researchers recently discovered that the enzyme activating the haemagglutinin of fowl plague virus (FPV), an avian influenza virus, is furin. Furin, a subtilisin-like eukaryotic endoprotease has a substrate specificity for the consensus amino-acid sequence Arg-X-Lys/Arg-Arg at the cleavage site. Here, the researchers demonstrate that the glycoprotein of HIV-1, which has the same protease recognition motif as the FPV haemagglutinin, is also activated by furin. In addition, the researchers present evidence that peptidyl-chloromethyl ketones that have the Arg-X-Lys/Arg-Arg motif and which are specific inhibitors of furin interfere with cleavage of the HIV glycoprotein and hence its activation and formation of infectious virus particles. Furthermore, the inhibitors prevent shedding of gp120 from the surface of infected cells, which is also suspected to play a role in viral pathogenesis, the researchers conclude. "The Stalled Response to AIDS" Issues in Science and Technology (Fall 1992) Vol. 9, No. 1, P. 24 (Gellin, Bruce G. and Rogers, David E.) The AIDS epidemic has become more devastating since its start as a result of public ignorance, write Bruce G. Gellin and David E. Rogers in an article in Issues in Science and Technology. The epidemic has been advanced by three factors of modern society: the sexual revolution, the ease of international travel, and the invention and wide use of the hollow-bore needle. But there is also a fourth factor: lack of adequate knowledge or the collective national will to educate people to change the behaviors that put them at risk of infecting themselves or others. A recent study of urban black teenagers by the Robert Wood Johnson Foundation shows that anti-AIDS messages are being heard, but they are reaching the wrong audiences with the wrong information. In addition, there is evidence that moralistic contentions such as appeals to abstinence do not work. The Johnson Foundation also found that black, urban teenagers regularly ignore the messages of all celebrity spokespersons, believing that they are merely performing one of the obligations that accompanies celebrity status. Also, the National Research Council's 1987 report, "Risking the Future," demonstrated that access to contraceptive services does not influence adolescents' decisions to become sexually active. The authors emphasize that we must speed the development of explicit, culturally appropriate educational programs for AIDS prevention. Society should also broadcast information on how HIV is not spread. Most importantly, those in leadership positions must recognize that we have a devastating epidemic to deal with, the authors conclude. otal of $180,447 on AIDS programs. By fiscal year 1991-1992, the amount had soared to $73.3 million. "AIDS Activists Prepare Plea" Los Angeles Times--Washington Edition (12/02/92), P. B3 (Boxall, Bettina) A 7-foot by 50-foot giant card will be shipped to President-elect Bill Clinton this week in observance of World AIDS Day. On the card are brightly colored children's handprints, a family snapshot, words of loss and humor, and most importantly, messages to Bill Clinton to keep his campaign promises regarding the AIDS epidemic. One of the several thousand people in Los Angeles and West Hollywood who signed the card said, "We have lost too many lives, too many years to AIDS while the White House has sat and done nothing. You are our hope." During his campaign, Clinton promised accelerated research and funding for AIDS. The activists made it clear that they are not going to let Clinton forget this vow. One message shouted, "Help!" "More $ for research," demanded another. Younger AIDS patients left handprints and footprints next to their names and ages. Separately, "Captain Condom" dressed the part and distributed condoms throughout Los Angeles to promote AIDS prevention as part of World AIDS day, sponsored by the World Health Organization. AIDS Project Los Angeles joined AIDS agencies in other parts of the nation in launching a bilingual effort in Spanish and English to promote HIV testing and early treatment. "More Ohio Black and Female Citizens Are Getting AIDS" United Press International (12/01/92) Ohio health officials said the number of women and African- Americans with AIDS in the state is growing significantly. State officials, in a report released Tuesday to coincide with World AIDS Day, said that the perception still remains that AIDS is a disease that affects only homosexuals and drug users. However, Ohio Health Director Dr. Peter Somani cautioned that AIDS does not discriminate against any group of people. The health officials said that women with AIDS are expected to account for 9 percent of all AIDS cases in Ohio this year-- up from 7 percent in 1991 and 6 percent in 1990. African-Americans who have AIDS are expected to comprise 31 percent of all such cases in Ohio this year, which marks an increase from 29 percent last year and 26 percent during 1990. Since the disease was diagnosed in the early 1980s, there have been 3,562 AIDS cases reported in Ohio through Oct. 31, including 241 women and 906 African-Americans. Officials emphasized that their statistics only reflect people diagnosed with AIDS, not HIV infection. Dr. Victoria Cargill, a Cleveland AIDS expert and founder of the group Stopping AIDS is My Mission or SAMM, said, "Science, medicine, epidemiology reported on what we saw first, and education was aimed at that population who had the disease. That [education] was effective." She added, "These other groups thought we weren't talking to them; they thought it was a gay male disease. But they were getting infected. We were behind." Medical researchers say AIDS educators may still be lagging behind in targeting the next at-risk group--adolescents. "Immunologic Aspects of Diseases of the Eye: Acquired Immunodeficiency Syndrome" Journal of the American Medical Association (11/25/92) Vol. 268, No. 20, P. 2869 (Friedlaender, Mitchell H.) AIDS is commonly linked with ocular disorders, writes Mitchell H. Friedlaender in a primer on Allergic and Immunologic Diseases in the Journal of the American Medical Association. Cotton-wool exudates are the most common ocular symptoms, but they may be seen in eye conditions other than AIDS. They have the same appearance as those seen in lupus erythematosus, but it is not known whether the cotton-wool spots of AIDS have a similar pathogenesis. AIDS patients may develop Kaposi's sarcoma of the conjunctiva or lids in addition to cotton-wool spots, as well as chorioretinitis associated with any one of a number of different opportunistic pathogens. Optic manifestation of infections with cytomegalovirus are the most important, but those associated with Cryptococcus, Toxoplasma, or Candida may also occur. Because cotton- wool spots and cytomegalovirus retinitis are early signs of AIDS, the ophthalmologist may be the first physician to alert the patient to the existence of this serious disorder, concludes Friedlaender. "HIV Instruction and Selected HIV-Risk Behaviors Among High School Students--United States, 1989-1991" Morbidity and Mortality Weekly Report (11/20/92) Vol. 41, No. 46, P. 866 A growing percentage of American high school students are receiving AIDS education and discussing the related issues with their parents, according to a study by the Centers for Disease Control. The CDC conducted three national school-based surveys among high school students that addressed HIV-risk behavior and school-based AIDS education. The three surveys were the 1989 Secondary School Student Health Risk Survey (SSSHRS), which covered HIV-related knowledge, beliefs, and behaviors, and 1990 and 1991 Youth Risk Behavior Surveys (YRBS) that addressed HIV- related issues and other selected risk behaviors. Since the 1989 survey did not include questions about condom use and injecting drug use (IDU), these behaviors were compared only for 1990 and 1991. The percentage of students who received HIV education in school increased substantially during 1989-1991 (from 54 to 83 percent), as did the percentage of students who discussed AIDS with parents or adults in their families. In addition, in each year, students who reported receiving HIV education in school were substantially more inclined than those who did not receive instruction to report discussing AIDS with their parents or other adults in their families. Between 1989-1991, significant declines occurred in the percentages of students who reported ever having had sexual intercourse (59 to 54 percent), having two or more sex partners during their lifetime (40 to 35 percent), and having four or more sex partners during their lifetime (24 to 19 percent). The rate of condom use did not change substantially, and rates of IDU did not change. "AIDS Community Demonstration Projects: Implementation of Volunteer Networks for HIV-Prevention Programs--Selected Sites, 1991-1992" HIV-positive refugees and their dependents who the government says have plausible cases for political asylum. But they have not been admitted into the United States because of a law that prohibits HIV-positive foreigners from entering the country. The Yale group described the conditions at Guantanamo as deplorable. The Navy said it had not seen the report and did not comment in detail. However, it said improvements have been made in the past several months. Navy Lt. Commander Morgan Smith said, "The Department of Defense and the Joint Task Force have put forth a lot of effort and money in providing for the migrants. We're trying to make them as comfortable as possible under a difficult situation." The group describes overflowing latrines, clogged sinks, and showers. It also said that the facilities are so crowded that children have to sleep on floors. "Dual-Target Inhibition of HIV-1 in Vitro by Means of an Adeno- Associated Virus Antisense Vector" Science (11/27/92) Vol. 258, No. 5087, P. 1485 (Chatterjee, Saswati et al.) The adeno-associated virus (AAV) seems to be an ideal vector for use in antiretroviral gene therapy, write Saswati Chatterjee et al. of the National Institute of Allergy and Infectious Diseases in Rockville, Md. The researchers used an AAV vector encoding an antisense RNA to transduce stable intracellular resistance to HIV-1 in human hemopoietic and non-hemopoietic cell lines. The antisense targets are present in all HIV-1 transcripts and include the TAR sequence, which is critical for transcription and virus replication, and the polyadenylation signal. Cell lines expressing antisense RNA showed up to 95 percent inhibition of gene expression directed by the HIV-1 long terminal repeat and greater than 99 percent reduction in infectious HIV-1 production, with no detectable cellular toxicity. AAV does not prevent superinfection, a property that allows for infection with several different vectors or multiple rounds of infection with the same vector. Due to their efficient transcription and inability to recombine with HIV-1, AAV vectors represent a promising form of anti-retroviral gene therapy. For the treatment of human AIDS, it may be necessary to confer intracellular resistance to progenitor bone marrow cells that give rise to the renewable targets (T-lymphocytes, monocytes, and macrophages) of HIV-1 infection. Autologous AAV vector-transduced bone marrow stem cells could then be used to repopulate the immune system with HIV-resistant cells. If AAV vectors are safe and effective in animal models, the human trial may then be indicated, the researchers conclude. "Risk Reduction in Sexual Behavior: A Condom Giveaway Program in a Drug Abuse Treatment Clinic" American Journal of Public Health (11/92) Vol. 82, No. 11, P. 1536 (Calsyn, Donald A. et al.) Male clients attending a drug abuse treatment clinic will take, retain, and use condoms when various condoms are provided throughout the clinic, according to Donald A. Calsyn and colleagues from the Veterans Affairs Medical Center in Seattle, Wash. The researchers conducted a study to assess the effectiveness of a free condom distribution program in an outpatient drug abuse treatment clinic. All men receiving outpatient drug abuse treatment at the VA Medical Center during December 1989 and remaining in treatment until May 1990 were qualified for the study. Just before and four months after initiation of a condom giveaway program, a questionnaire regarding sexual behavior and condom acquisition was administered to 103 men at the clinic. Jars were filled with a variety of condoms and were displayed in every clinic room. Most condoms were taken from the men's rest room (47.8 percent), the dispensary waiting room (26.6 percent), the group therapy room (11.3 percent), and the women's rest room (4.4 percent). A total of 10.1 percent were taken from staff offices. A total of 56 patients (60 percent) of the clients reported taking condoms during the intervention. The number of clients possessing condoms increased from 61 (59.2 percent) to 71 (76.1 percent) at follow-up. Also, the mean use of condoms for vaginal intercourse activity increased from 20.3 percent of events initially to 33.7 percent at follow-up, conclude Calsyn et al. "The Reporting of HIV/AIDS Deaths in Women" American Journal of Public Health (11/92) Vol. 82, No. 11, P. 1500 (Buehler, James W. et al.) The wide ranges of underlying-cause-of-death vital records and AIDS surveillance among women reflect the potential role of both HIV infection and drug use in contributing to excess mortality, write James W. Buehler and colleagues from the Centers for Disease Control in Atlanta, Ga. The researchers conducted the study to assess the completeness of vital statistics and case reports of AIDS in measuring HIV-related mortality in women aged 15-44. They used vital records to reveal the number of deaths attributed to HIV infection and excess deaths due to causes that have increased along with the HIV epidemic. It was found in 1988 that in women aged 15-44 there were 1,365 deaths with HIV infection listed as the underlying cause, 202 deaths with HIV infection listed as an associate cause, and 149 excess deaths due to conditions highly related to HIV infection. Also, there were 780 excess deaths as a result of causes that may have been related to HIV infection or illicit drug use. Among the deaths that occurred in 1988, 1,532 were reported through AIDS surveillance. Consequently, underlying-cause-of- death vital records and AIDS surveillance identified 55 percent to 80 percent and 67 to 97 percent, respectively, of HIV-related deaths in women 15 through 44 years of age in 1988, conclude Buehler et al. "Survey Says Insurance Claims for AIDS Reached $1.3 Billion Last Year." Business + Health (11/92) Vol. 10, No. 13, P. 12 A survey by the Health Insurance Association of America found that insurers paid $1.3 million in claims as a result of AIDS or related illnesses in 1991. While the number of AIDS-related claims rose for individual and group life policies, individual and group accident and health claims remained about the same as last year. The findings were based on statistics from 387 companies that paid $989.3 million or 73 percent of all AIDS claims .An actuary estimated another 27 percent to bring the figure to $1.3 billion. The survey did not include self- insured companies or claims paid by Blue Cross or Blue Shield. The in Copenhagen. In Russia, physicians conducted free consultations at the Moscow Satire Theater. Brazilian protesters demanded more government funds. The World Health Organization sponsors World AIDS Day and called attention to Asia, where it claims 2 million people could die of AIDS by the year 2000. India is at high risk because of its widespread illiteracy, poor health care, and contaminated blood banks, experts say. In Banjul, Gambia, hundreds of marchers gathered to hear speeches and pray for AIDS patients. The West African nation's health minister, Landing Jallow Sonko, cautioned that AIDS may boost child mortality by as much as 50 percent in much of sub-Saharan Africa in the 1990s. The Japanese baseball star Sadaharu Oh observed the occasion by joining other celebrities in distributing information packets at a rally in the Ginza shopping district. In Britain, protesters gathered outside the prime minister's office to request the appointment of a minister for AIDS. And in the United States, Health Secretary Louis Sullivan recognized the day by implementing a new program to help businesses keep employees infected with HIV working as long as possible. "High Rate of Condom Use in France, HIV Testing in Britain" United Press International (12/03/92) Washington--Approximately 80 percent of French 18- and 19-year- olds use condoms, but many people of all ages in Britain and France are still at risk for HIV infection, according to two surveys published in the British journal Nature. The two studies of sexual behavior in Britain and France were issued Wednesday. They found that many men and women at risk for HIV infection had altered their behavior because of the disease. The French researchers said, "Young people change partners more frequently than older people but are less likely to have more than one sexual partner at any one time." It was discovered also that younger French people were most likely to use condoms. A total of 18 percent of men and 11 percent of women reported using a condom during their last intercourse, and condom use was 2.5 times more frequent during sex with a casual partner, the study found. The researchers said that women were 3.1 times more likely to use a condom if they were having sex with a new partner. Of 18- and 19-year-olds, condom use was 79.8 percent among males and 48 percent among females. The survey of British sexual behavior found that 4 percent of men and 3 percent of women had been tested for HIV in the past five years. The report found that single people were reporting a larger number of sexual partners in the past year and younger people were reporting more partners. Dr. Anne Johnson of University College in London and her colleagues said, "Our study indicates many of those at high risk for HIV infection have perceived this risk and have already undergone HIV antibody testing, but that more than half remain untested." "Canada's Estimates of AIDS Cases Low" Toronto Globe and Mail (12/01/92), P. A1 (Mickleburgh, Rod) Canada's total number of AIDS cases has been underestimated by nearly 45 percent, according to the country's leading AIDS expert. Dr. Donald Sutherland, head of HIV-AIDS epidemiology for the Laboratory Center for Disease Control in Ottawa, said 1992 may witness the highest number of cases in a single year since the first case was recorded in Canada in 1980. Sutherland revealed new statistics emphasizing the spread of HIV in Canada, taking into consideration for the first time statistical estimates of delayed reporting of AIDS cases and cases that were never reported. His revised tally predicts there were actually 9,299 cases of AIDS in Canada by the end of 1991. The number is substantially higher than the Health and Welfare's most recent AIDS Update report of 6,477. The new statistics indicate that there will have been more than 11,000 cases of AIDS reported in Canada by the end of 1991, including a record 1,846 new cases during the current year. Sutherland stressed that his figures are estimates but insisted they are far more accurate than those listed in the Health and Welfare's quarterly reports, which count only reported AIDS cases. Sutherland's division conducted a complex statistical analysis, including viewing death certificates, to determine as accurately as possible how many AIDS cases are never reported and how many are seriously delayed in being reported. Dr. Sutherland said AIDS is not listed as the cause of death in about 15 percent of those who die of the disease, possibly because of the stigma associated with it. "AIDS Stalks Asia; Few Take Heed" Toronto Globe and Mail (12/01/92), P. A1 (Stackhouse, John) The AIDS epidemic is ravaging Asia, but few efforts have been implemented to thwart the disease's spread. John Dwyer, president of the AIDS Society of Asia and the Pacific, told a recent international congress of the society in New Delhi, "We anticipate an Africa-like situation developing here, only worse." The World Health Organization says there are approximately 1.5 million HIV infections in Asia and perhaps 20,000 full-blown cases of AIDS. By the year 2000, WHO predicts that Asia will be ahead of Africa in the number of HIV infections by adding a million new infections a year. At that time, the majority of the world's 40 million HIV infections and 10 million adult AIDS cases will be in Asia, according to estimates from the Asian Development Bank. The Foundation for Children states that in Thailand, 30,000 prostitutes in Bangkok alone have contracted HIV. If the projections are correct, however, no country will have more infections than India, where WHO predicts the number will reach five million. In addition, within India, Bombay is home to at least 100,000 HIV-positive prostitutes. Yet although there are commitments of foreign aid, there is no clear plan that has arisen on how to fight HIV in India, or even Asia. The World Bank has allotted a soft loan of $84-million--other donors have contributed $15 million more--to start up India's National AIDS Control Organization. But what is even more disconcerting is how to properly educate 850 million Indians, who are plagued with illiteracy and poverty or have religious or cultural traditions that prevent them from aggressively reacting to the epidemic. Newsgroups: sci.med.aids Subject: CMI and NIH Message-ID: <1992Dec6.014424.19028@cs.ucla.edu> From: Billi Goldberg Date: Sat, 5 Dec 92 17:09:05 PST I received the following letter on Saturday, December 5, 1992 in response to a letter that I had sent to Alan Sher previously. *********************************************************************** * DEPARTMENT OF HEALTH & HUMAN SERVICES Public Health Service National Institutes of Health November 30, 1992 Billi Goldberg AIDS Activist 2261 Market Street #436 San Francisco, Ca. 94114 Dear Billi: Thank you for your extremely kind comments concerning our work on T cell subset regulation in infectious disease and for the reprints you enclosed. You are correct in assuming that we firmly support the induction of CMI as a general strategy for combating AIDS as well as other infections. Unfortunately, in AIDS this concept remains highly controversial and much more work is needed to obtain the data necessary for convincing the general scientific and clinical community of it validity. Dr. Meltzer is a close colleague and friend and you can be assured that we are in close contact about our AIDS related research. Dr. Gene Shearer (NIH) is the true champion of the CMI-AIDS hypothesis and you and your colleagues should focus your efforts in making sure that his viewpoint is taken seriously. I thank you once again for your support. Sincerely yours, Alan Sher, Ph.D. Head, Immunology & Cell Biology Section Laboratory of Parasitic National Institute of Allergy and Infectious Diseases Newsgroups: sci.med.aids Subject: reverse demographics Message-ID: <1992Dec4.175706.25142@cs.ucla.edu> From: stgprao@st.unocal.COM (Richard Ottolini) Date: Fri, 4 Dec 1992 16:42:11 GMT With the apparent flattening of the AIDS incidence curves in certain sub-populations (e.g. 1992 gay number == 1991 gay number), have the demographers made projects as to (1) better estimates of the totally infected population or of sub-populations, (2) the likely size of the national infected gay population? I haven't read the proceedings of the international AIDS conference, so perhaps it was studied there. The numbers quaoted from #1 and #2 have generally been fuzzy in my view. This is partly due that short of a totallitarian survey, one can't really collect those numbers; partly due to politics in the US that prevents certain kinds of surveys. I've heard a fairly constant estimate quoted for HIV+ people in the US over the past 8 or so years (1.0-1.5 million). The CDC data along with the demographic model can now firm this number. Ditto for the size of the infected gay sub-population and the size of the entire gay sub-population. Since some the earlier demographic projections were predicting higher AIDS incidences than are occuring now, one hypothesis is the number of infected people is smaller than originally anticipated. Newsgroups: sci.med.aids Subject: Sentinel Article on Chinese Medicine Message-ID: <1992Dec5.174244.9790@cs.ucla.edu> From: Billi Goldberg Date: Sat, 5 Dec 92 07:34:01 PST The following article was printed in the San Francisco Sentinel on Thursday, December 3, 1992. It is being posted with the permission of the author, Charles R. Caulfield. *********************************************************************** * CHINESE MEDICINE AND HIV DISEASE by Charles R. Caulfield The use of acupuncture and Chinese herbal medications has become one of the most commonly used alternative therapies for AIDS in the Bay Area. Its use has become so widely accepted, that two Chinese Medicine Clinics in San Francisco have been awarded contracts through the S.F. Health Department ,AIDS Office, to provide Chinese Medical treatment to people with HIV. The contracts are funded by the Ryan White CARE Act allocations. This article in two parts will outline some factors relevant to Chinese Medicine's application to HIV. This first essay will discuss some rudimentary background and philosophy of this discipline. Part 2, which will appear next week will discuss certain distinguishing aspects of practices of some of the Chinese Medicine providers specializing in HIV treatment San Francisco, in order to assist consumers to make the most informed choices in selecting practitioners most suited to their needs. Most people with HIV who use acupuncture and Chinese herbs do so in conjunction with western medicine. There are, however, some who use it as their principal form of medical treatment. It is strongly suggested that it be used under the supervision of a licensed practitioner. The practice of Traditional Chinese Medicine (TCM), is considered a primary care medical modality in California, and it practitioners physicians. Certain components of its practice are reimbursable by private insurance companies. Acupuncture is covered by Medi-CAL at a rate of two treatments per month. Practitioners of Chinese Medicine use the title Licensed Acupuncturists, or L.Ac., and are licensed by the State Board of Medical Quality Assurance. The training required to qualify to sit for the licensing examination is quite rigorous. Candidates are required to have completed three years of post-graduate training in Chinese Medicine, which includes a good deal of western based training in anatomy, physiology and biology. According to Dr. Hong-yen Hsu, PhD, in Natural Healing with Chinese Herbs, the systematic practice of Chinese Medicine dates back over two thousand years, making it the oldest medical system in the world. The first known medical book on the subject is The Yellow Emperor's Classic of Internal Medicine, which was written during the Han dynasty around 200 A.D. The first systematic compendium of collected knowledge, the Treatise on Febrile Diseases, appeared at approximately the same time. The author was Chang Chung-ching, who is considered historically to be among China's greatest physicians, and is revered in China as Hippocrates is in the West. From its very origin, Chinese Medicine combined empirical experience with a clear philosophical theory. Many people erroneously view Chinese herbal medicine as an equivalent of taking a western drug for the alleviation of symptoms. But the differences between the two schools of thought are profound. Where western medicine is derived solely from scientific method as a means of treating disease, Chinese medicine is intertwined with a philosophy of life, and is based on a holistic view of supporting of the mind-body's innate ability to maintain health, and to heal itself should illness occur. This approach is the result of many thousands of years of accumulated experience. Chinese philosophy views the universe as a living organism, and sees the human body as a microcosm of that greater organism. Western medicine tends to view the human body as a machine and has evolved its practice based on this assumption. Rather than dealing with mechanistic components of the human organism, as western science advocates, the TCM approach is one of aligning the functions of the organs and systems as a whole, promoting the dynamic balance of energy polarities which maintains health and well-being. Central to the philosophy of Chinese Medicine is the concept of ch'i, or qi, which can loosely be defined as the vital energy of the universe, of which all things are made. Ch'i patterns fluctuate between the polarities of what are called yin and yang, the active and passive sides of the life force. Illnesses can crudely be viewed as either excesses or deficiencies in either the yin or yang components of ch'i. Ch'i is believed to vitalize the body by its movements along the pathways which are known as meridians. The 'meridian theory" of Chinese Medicine is not accepted in western medicine, because they have never been objectively identified anatomically. The circumstantial evidence of their existence, however, is undeniable to Chinese doctors, since points along the meridians have been used successfully as the sites for acupuncture needling for thousands of years. The use of herbs is also thought to facilitate the normal movement of ch'i along the meridians. The Japanese refer to illness as "bioki" which translates as "injured ch'i." Dr. Gonzon Goto, a leading Japanese authority on Chinese Medicine contends that the obstruction of ch'i along the meridians is the cause of all disease. Chinese medicine was popularized as a treatment for AIDS in San Francisco by Misha Cohen, a Doctor of Oriental Medicine, in 1984. A good deal of western type research on certain aspects of Chinese Medicine have since been conducted. Many of the herbs have been found to inhibit HIV and other viruses in laboratory experiments. Other herbs have been shown to act as biological response modifiers, enhancing certain immune responses. In addition, a small, strictly controlled study using acupuncture to treat HIV infected individuals was conducted at Lincoln Hospital in Bronx, NY, a few years back. It was reported that individuals receiving correctly applied acupuncture needling had notable increases in their CD4 counts after only a brief course of therapy. This pilot study certainly demonstrated the need for further research. A most attractive feature of Chinese Medicine is the lack of toxicity when utilized by trained professionals. It is generally thought to be ill-advised for an individual to use Chinese herbal formulations without the supervision of a licensed practitioner of TCM. Acupuncture is reimbursable by Medi-CAL and some private insurance. The herbs, which are not covered can be obtained in various forms, and are relatively inexpensive. Some human efficacy studies of Chinese medicine for HIV disease are currently underway or enrolling participants under the supervision of the FDA. Chinese herbs may be a rich source of therapeutic agents for AIDS and its related illnesses. Part two of this article in next week's edition will discuss the availability of Chinese medical treatment in San Francisco, its cost, and the various schools of thought employed in treating HIV with this discipline. We will also discuss available avenues of financial assistance with the cost of treatment for those who could benefit from treatment but would have difficulty affording. It is essential that people with HIV to have all the information they need to select the treatment options most suited to their own needs and dispositions. Chinese Medicine is a promising option which is safe, appears to be somewhat effective, and is affordable to most.