AIDS Daily Summary September 09, 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 "Blacks Far More Likely Than Whites to Have AIDS, Agency Says" New York Times (09/09/94) P. A16 The Centers for Disease Control and Prevention announced Thursday that black women are almost 15 times more likely than white women to develop AIDS, and that black men are five times more likely than white men to have the disease. The agency said that 55 percent of the 106,949 reported cases of AIDS in the United States last year were among racial and ethnic minorities. Among 100,000 black women, 73 developed AIDS, while only 5 white women out of 100,000 had the disease. Forty-seven percent of minority AIDS cases were blamed on intravenous drug use and 37 percent were caused by HIV transmission during heterosexual intercourse. The research shows that complex social, economic and cultural factors complicate AIDS prevention efforts. "Slower AIDS Virus Traced" Washington Post (09/09/94) P. A20 Scientists studying prostitutes in Senegal have found that HIV-2 causes AIDS much less often than HIV-1, which is prevalent in the United States. Women registered as "commercial sex workers" were examined and treated for diseases twice a year over eight years. During a five-year period, four women out of 32 who had HIV-1 developed AIDS, while none of the 33 women who had HIV-2 advanced to the disease. Richard Marlink, executive director of the Harvard AIDS Institute, said his research traced more than 100 HIV-2 positive women and that after an average of four years, only one developed AIDS. Through blood testing, only several hundred cases of HIV-2 have been found in the United States and Europe. Marlink said that scientists want to learn whether a unique gene in HIV-2 can be used on HIV-1 patients as treatment. "AIDS Charity Sees Dangers to Third World Doctors" Reuters (09/09/94) Twenty-five percent of doctors who spend their lives in high-risk developing countries risk acquiring AIDS, says Patrick Dixon, of the British AIDS charity AIDS Care, Education and Training (ACET). Dixon bases his warning on the assumption that one quarter of hospital patients in countries like Uganda and Rwanda are HIV-positive, and that their blood and tissues carry the virus. Accidental facial cuts and blood spurts during operations are some of the ways that these doctors increase their risk of developing AIDS. His book "The Truth About AIDS" includes this warning and is being sent to missionary field stations and other charity hospitals in the Third World. The risk of infection, he says, can be reduced by basic precautions. "Some HIV Strains May Lead to AIDS Faster--Doctors" Reuters (09/09/94) Doctors from the University of New South Wales in Australia said that some HIV strains progress to AIDS much faster than others. The doctors reached this conclusion after studying 25 people who contracted HIV through transfusions of tainted blood on known dates. Those who received blood from donors who developed AIDS in less than five years took just over two years to develop it themselves. Transfusion recipients whose donors had been HIV-positive for 11 years and had not developed AIDS took more than 9 years on average to acquire it. "To Fight AIDS, California Cities Pointedly Skirt State Drug Laws" Washington Post (09/09/94) P. A24; Spolar, Christine Although California is one of 10 states in the nation that ban needle exchanges, many of its larger cities are declaring "emergencies" to circumvent the law. Earlier this week, Los Angeles followed the lead of other cities, such as Oakland and Berkeley, and asked its police to disregard state needle laws so that private exchange programs would be unhindered. During the past year and a half, three studies have found that needle-exchange programs are effective and do not lead to increased drug use. The National Academy of Sciences released its research and recommended that the federal ban on needle-exchange programs be lifted. Los Angeles Mayor Richard Riordan is trying to slow the spread of AIDS transmitted via intravenous drug use. Drug users say that they are happy with the programs and they will use them because they can keep their anonymity and receive the needles without problem. "AIDS...Again" Nature (09/01/94) Vol. 371, No.6492, P. 2 The younger generation of gay men is passing on AIDS with "negligent abandon," say the editors of Nature. Whereas the older generation of homosexual males modified their sexual habits because of AIDS, the young people continue to practice unsafe sex--even though they know they are at risk. Epidemiologists at the University of California at San Francisco have found that one in three homosexual or bisexual men will be HIV-positive by age 30. These findings confirm the lack of a connection between lectures and behavior. The editors ask whether it is only youth, or other factors that makes people take such risks. So far, they say, the answers have been little more than "pop-psychology," and that is not enough. "Major FDA Public Meeting on Early Access, Accelerated Approval, September 12-13" AIDS Treatment News (08/19/94) No. 205, P. 5 The FDA has scheduled a two-day public meeting of the Antiviral Advisory Committee to review its accelerated approval system. The meeting will be held Sept. 12-13, and will begin with a history of early availability of drugs--especially in regards to oncology, along with parallel track and treatment INDs in their applications for HIV drugs. The FDA plans for the meeting to then progress to a discussion of accelerated approval, including the evidence at the time of approval, confirmatory trials, and the lessons to be learned from the examples. The meeting will end with a call for recommendations on how to improve the approval system. The Advisory Committee will not, however, vote on any issue at this meeting. "The Invisible Lesbian Face of AIDS" Advocate (09/06/94) No. 633, P. 45; Guly, Christopher Activists complain that there is an absence of research on lesbians with AIDS. Nick Bollman of Funders Concerned About AIDS, says the "public face" of the AIDS epidemic is likely to concentrate only on homosexual men. "But AIDS is also a real threat to women, straight or lesbian," Bollman adds, "because HIV comes through sexual practices, not sexual identity." Indeed, Becky Trotter of the Calif.-based Women Organized to Respond to Life-Threatening Diseases, says that informing the women that unsafe oral sex and use of unsterilized sex toys can transmit HIV are just two avenues of infection between two women. Lesbians should use condoms or dental dams when having oral sex, advises Dr. Karen Raub. "Studies Uphold Antiviral Strategy: Better to Add Than Switch" AIDS Alert (09/94) Vol. 9, No. 9, P. 121 Findings presented at the 10th International AIDS Conference in Yokohama, Japan, show that use of AZT delays progression of AIDS no more than two years and offers no additional benefit for patients with CD4 counts above 500. These results add to recent data showing that a combination of drugs taken earlier may be the best protection against AIDS progression. The AIDS Clinical Trial Group 019 randomly divided participants into three groups receiving placebos, 500mg of AZT, or 1,500mg of AZT. The study found that those who had CD4 counts above 650 delayed the count from dropping to 400 by more than two years. The slow decrease in CD4 counts versus those who took AZT and had CD4 counts below 500, did not show an greater chance of survival or a delay of progression of AIDS. "Clinicians have known for a long time that AZT therapy loses benefit, but one of the big issues has been how long it lasts," said Paul Volberding, the study's main researcher and director of the AIDS program at San Francisco General Hospital.