AIDS Daily Summary June 14, 1994 The Centers for Disease Control and Prevention (CDC) National AIDS Clearinghouse makes available the following information as a public service only. Providing this information does not constitute endorsement by the CDC, the CDC Clearinghouse, or any other organization. Reproduction of this text is encouraged; however, copies may not be sold, and the CDC Clearinghouse should be cited as the source of this information. Copyright 1994, Information, Inc., Bethesda, MD "AIDS Patients Seek Solace in Suicide but Many Find Pain and Uncertainty" New York Times (06/14/94) P. C1; Kolata, Gina Several studies have concurred that AIDS patients commit suicide at a rate much higher than that of other terminally ill people, and that the rate of suicide among AIDS patients is 10 to 20 greater than that of the general public. According to Dr. Peter M. Marzuk, a New York psychiatrist who has studied suicide rates among people with AIDS, there are several reasons why this group is prone to euthanasia. The disease is debilitating and, eventually, fatal. The infections that grip AIDS patients and the side effects of the medications they take may include dementia and depression--either of which can trigger suicidal thoughts, Marzuk notes. But patients and doctors say that while suicide is discussed bravely, it is not done quite so easily. Timing and method must be considered and, according to Marzuk, many people change their minds. "Vancouver AIDS Suicides Botched" New York Times (06/14/94) P. C12; Farbsworth, Clyde H. After 13 months of interviews with members of Vancouver's AIDS community, Canadian researcher Russel D. Ogden documented 34 cases of assisted suicide--and found that half were badly botched. While the goal was to alleviate the patients' pain, the bungled acts of euthanasia often took several hours longer to be finished, thus increasing the agony. The extended suffering stemmed from the lack of medical knowledge on the part of those who assisted in the suicides, as well as from the unavailability of appropriate drugs, Ogden concluded. "Southeast Asia Mulls Anti-AIDS Programme" Reuters (06/14/94) A coalition of Southeast Asian countries, fearful that AIDS could jeopardize their economic wealth, are considering a five-year program to combat the epidemic. The Association of Southeast Asian Nations (ASEAN)--which includes Malaysia, Brunei, Indonesia, Singapore, Thailand, and the Philippines--is holding a week-long meeting in the Malaysian capital of Kuala Lumpur to discuss proposals. The United States, Japan, and Australia will help finance the final AIDS program. "Two Teams Bring AIDS Awareness to Young People" Business Wire (06/13/94) June 30 marks the first date on the "Winning Against AIDS" tour, an HIV prevention and education program that teams young people with current and retired professional basketball players, as well as health educators. The program, sponsored by the National Basketball Players Association (NBPA) and the Johns Hopkins School of Hygiene and Public Health, will travel to cities throughout the country this summer dispensing information on AIDS to America's youth. Because the basketball players are credible and influential role models, their part in HIV prevention and education is logical, according to Alex English, director of player programs for the NBPA and spokesperson for "Winning Against AIDS." "Toledo Jury Deliberations Continue" United Press International (06/13/94) A federal jury continued deliberations yesterday into whether a Fremont, Ohio, hospital violated the Americans with Disabilities Act when the physician in charge denied admittance to AIDS patient Fred Charon. The admitting doctor insists that he based his decision to transfer Charon to a bigger facility on sound medical judgment, and not prejudice. Charon died of AIDS-related complications last year, but the case is being executed by the American Civil Liberties Union on his behalf. In the landmark trial, jurors last week found themselves at an impasse but were ordered by the judge to continue deliberations. "Clinic Wins Grant to Expand Trials Program" Washington Blade (06/10/94) Vol. 25, No. 24, P. 31; van Hertum, Aras The American Foundation for AIDS Research (AmFAR) and the Kresge Foundation recently awarded the Whitman-Walker Clinic $56,000 to expand its clinical trials program. The grant will be used to buy new medical equipment, install a computer networking system, and open a waiting room for patients' children. "AIDSLine: Is International Travel Possible for Me?" Advocate (05/31/94) No. 657, P. 31; Cohan, Gary R. Properly prepared, most HIV/AIDS patients can travel safely, but they should find out crucial information before booking their flight. The first consideration is whether or not the country being visited bars the entry of infected people. HIV/AIDS patients should then consult their primary physicians about which vaccinations they need, and which ones should be avoided. It is always advisable to obtain an "official" list of medications and supplies, and to identify a specific doctor, clinic, or other emergency facility at each destination of the trip in the event that the patient becomes ill. "Reality" Across the Board (05/94) Vol. 31, No. 5, P. 38 Awaiting only Food and Drug Administration approval of the London factory that will mass-produce the female condom, Wisconsin Pharmacal Co. Inc. is ready to begin manufacturing the product for national distribution. According to Mary Ann Leeper, president of the firm's female health division, female condoms eventually will be available in most places where male condoms are sold. They will, however, be marketed in a very different manner. "It's going to be a very straight-ahead approach," she says. "It's going to discuss negotiating its use and the expectations." Leeper estimates that 75,000 condoms have been distributed and women that have used tried them indicate their appreciation of the greater control the female condom gives them when dealing with sex. "It definitely gives women some control," says Leeper. "If the man won't wear one, the woman can." The condom, to be sold under the brand name Reality, is a large, polyurethane version of the male condom designed primarily for prevention of sexually transmitted diseases, even though it can be used as a contraceptive. Early research shows that loss of sensation--a primary initial concern, was not a cause for concern at all. About 80 percent of the men liked the female condom, while more than 60 couples said they would use it again. "Preventing HIV: Have We Lost Our Way?" Lancet (05/28/94) Vol. 343, No. 8909, P. 1306; Lifson, Alan R. With an estimated 13 million HIV-infected people worldwide, response to the epidemic is crucial. Alan R. Lifson of the University of Minnesota's School of Public Health suggests that priorities and control efforts be reevaluated, with five guiding principles in mind. First, he says, it is time to use the term "advanced HIV disease" in place of "AIDS." This will direct attention to the fact that progression towards illness and death begins not with the development of AIDS symptoms, but when HIV infection first occurs. Second, says Lifson, the No. 1 priority must be prevention of sexually transmitted HIV through better strategies for STD treatment and ways of empowering women to have greater control over barrier methods and risk-reduction techniques. Third, adequate opportunities for drug treatment and innovative strategies to avoid exposure to contaminated needles must be available to avoid HIV among intravenous drug users, says Lifson. Fourth, he continues, prevention programs should be based on, evaluated, and revised according to studies and surveillance data. Finally, Lifson notes the need for comprehensive and aggressive leadership in the second decade of the HIV/AIDS epidemic.