AIDS Daily Summary February 21, 1995 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 1995, Information, Inc., Bethesda, MD ************************************************************ "Immature Immune Cells May Sustain Brunt of H.I.V. Attack" "Thailand Starts Testing Anti-AIDS Vaccine" "D.C. Service Agencies, Clients Fear for Future" "Leaders of Gay Blacks Emphasize Local Issues" "Indonesia's Streetwise War on AIDS Has the World Watching" "HIV Revenge Killer Dies of Disease" "Sex Getting Safer in the Age of AIDS" "Apoptosis Occurs Predominantly in Bystander Cells and Not in Productively Infected Cells of HIV- and SIV-Infected Lymph Nodes" "Drug Abuse Treatment Experience and HIV Risk Behaviors among Active Drug Injectors in Ohio" "Global HIV/AIDS: A Strategy for U.S. Leadership" ************************************************************ "Immature Immune Cells May Sustain Brunt of H.I.V. Attack" New York Times (02/21/95) P. C3; Angier, Natalie Researchers at the Stanford University School of Medicine have announced that the population of the body's immune cells most ravaged by HIV is a group called naive T cells. The scientists found that naive T cells are extremely vulnerable to the impact of HIV and that their numbers decline significantly during the course of disease progression from infection to full-blown AIDS. The loss of naive cells might explain why HIV-infected individuals become increasingly vulnerable to new opportunistic diseases--they have lost the immune cells most capable of learning new tricks. If confirmed, the new findings could influence decisions of what sort of experimental therapies may work best for various subgroups of patients. "We'd predict that those individuals with few or no naive T cells won't respond to vaccination," said Dr. Mario Roederer, an immunologist at Stanford. Roederer also said that the results suggest that most of the immune anomalies and disturbances observed during the course of AIDS infection may be the result of the shifting ratio of cell types. "Thailand Starts Testing Anti-AIDS Vaccine" Reuters (02/21/95) The Thai Ministry of Public Health, working with Mahidol University, injected 30 recovering intravenous drug users with the experimental vaccine GP-120 on Tuesday to see if it protected them against AIDS. Sricharoen Migasena, head of research at Mahidol's Department of Clinical Tropical Medicine, said she thought the vaccine from Genentech Inc. would be "suitable" and "beneficial to our country." She explained that the study used recovering drug users because they were believed to be at "low risk" for HIV infection. She also said that although the strain of HIV treated by the vaccine is not the most common in Thailand, it is "the predominant strain" in intravenous drug users. "D.C. Service Agencies, Clients Fear for Future" Washington Post (02/20/95) P. D1; Constable, Pamela With city officials still deciding which programs to cut and by how much, many nonprofit agencies in Washington, D.C., have no idea whether they will be saved or spared. The District's Department of Human Services must cut $68 million from its billion-dollar budget, and aides to Mayor Marion Barry said last week that they will eliminate funding for many independent groups that serve the needy. Three nonprofit service areas being affected by the city's budget crisis are programs for the homeless, facilities for people with AIDS, and programs for minority or disadvantaged youth. "At this point, the city owes us $1.4 million, including $688,000 that is 45 days past due," said James Graham, director of the Whitman-Walker Clinic, which provides medical care, counseling, and housing for thousands of people who are HIV-positive or who have AIDS. Graham said that city officials promised to send the clinic a check for $250,000 this week, and that nonprofit organizations realize that they cannot be exempt from cutbacks. "But this is money we have already spent, and in effect we have been loaning it to the city. We need it back," he added. "Leaders of Gay Blacks Emphasize Local Issues" New York Times (02/20/95) P. A13; Dunlap, David W. Organizers who are gay and black often find the most challenging arena to be their own neighborhoods, where pastors condemn homosexuality and youths seem beyond the reach of AIDS-prevention messages. Neighborhood concerns predominated this past weekend at a three-day conference, which was sponsored by the Black Gay and Lesbian Leadership Forum. Members also discussed how to communicate more effectively with younger people who are at risk of HIV-infection. "The attitude is that it can't happen to me or to anyone I know," said Latoris Jordan, a medical assistant and physical therapist from Chicago. Black gay leaders acknowledged the involvement of many churches in the fight against AIDS, but said that conservative pastors who preached against homosexuality still posed a considerable hurdle. "This whole community is going to be dead by the time you get them all away from 'it's an abomination,'" said Mayor Kenneth E. Reeves of Cambridge, Mass. "Indonesia's Streetwise War on AIDS Has the World Watching" Washington Post (02/20/95) P. A3; Stevens, Jane E. Tuti Parwati, an Indonesian physician and AIDS researcher, is trying to slow the spread of AIDS in her country. With a population of 185 million, Indonesia is the fourth most populous country in the world and has one of the lowest rates of HIV. By the end of November 1994, 266 people were reported to be HIV-infected and 66 of those had AIDS. Parwati heads the Citra Usadha Indonesian Foundation, under which 40 employees and volunteers work with those at highest risk--such as prostitutes, homosexuals, and students in tourist academies. Parwati's street workers distribute condoms, referral cards for medications for sexually transmitted diseases and for a test for HIV. She created her program to work through existing structures and mobilized their leaders to make HIV prevention a priority. "Parwati's program model is among the most innovative in the world," said Tom Coates, chairman of the steering committee for social and behavioral studies at the World Health Organization's Global Program on AIDS. Programs based on her models have been expanded to more than 30 communities across the country that work with other high-risk groups such as truckers, sailors, and oil workers. "HIV Revenge Killer Dies of Disease" Chicago Tribune (02/18/95) P. 1-16 Michael Lupo, the serial killer who strangled four homosexuals in revenge for contracting HIV, has died in prison from an AIDS-related illness, said prison officials in the northern English county of Durham. In 1986, Lupo, who was also a homosexual, went on an eight-week killing spree after learning he was HIV-positive. He was jailed for life after admitting to the murders and two other attempted killings. "Sex Getting Safer in the Age of AIDS" Philadelphia Inquirer (02/18/95) P. A2; Vedantam, Shankar Sexual encounters are becoming safer in the United States, reported the authors of the "Sex in America" study at the annual meeting of the American Association for the Advancement of Science. "People are responding the fact that sex can be a life-and-death question," said Joel A. Feinleib, research associate at the Harris School of Public Policy Studies at the University of Chicago. Promiscuous people who are at the highest risk of acquiring sexually transmitted diseases, such as AIDS, have tripled their condom use, the researchers report. The fact that sexually promiscuous people were cutting back on their prowling, selecting partners more carefully, and practicing safer sex reflects how the AIDS epidemic has changed America's sexual mores. Of those people with the riskiest behavior--between 11 and 20 partners in the last year--78 percent reported making changes in their sexual practices. "Apoptosis Occurs Predominantly in Bystander Cells and Not in Productively Infected Cells of HIV- and SIV-Infected Lymph Nodes" Nature Medicine (02/95) Vol. 1, No. 2, P. 129; Finkel, T.H.; Tudor-Williams, G.; Banda, N.K. et al. Finkel et al. found an increase in the percentage of apoptotic cells among circulating CD4 and CD8 T cells of HIV-positive individuals. There was also an increase in frequency of apoptosis with disease progression. Apoptosis, or programmed cell death, is a regulated mechanism of cell suicide that is critical to many physiological processes, including T-cell development and normal immune function. Using in situ labeling of lymph nodes from HIV-infected children and SIV-infected macaques, the researchers determined that apoptosis occurs mainly in bystander cells--not in the productively infected cells themselves. The therapeutic implications of the findings are that rational drug therapy may involve a combination of agents targeting viral replication in infected cells and apoptosis of uninfected cells. "Drug Abuse Treatment Experience and HIV Risk Behaviors among Active Drug Injectors in Ohio" American Journal of Public Health (01/95) Vol. 85, No. 1, P. 105; Siegal, Harvey A.; Carlson, Robert G.; Falck, Russel S. et al. Siegal et al. compared the sociodemographic characteristics and HIV risk behaviors of intravenous drug users who had undergone drug abuse treatment during the past five years and those who had not been treated. They studied 2001 active injection drug users who participated in the National Institute on Drug Abuse's National AIDS Demonstration Research projects in Cleveland, Columbus, Cincinnati, and Dayton, Ohio. Almost 43 percent reported having been treated during the previous five years. The length of involvement with drugs, higher injection frequencies, increased legal problems, and higher levels of HIV risk behaviors are factors associated with a history of drug treatment. The researchers concluded that effective HIV risk reduction education is an urgent priority in drug abuse treatment programs. "Global HIV/AIDS: A Strategy for U.S. Leadership" Health Affairs (Winter 1994) Vol. 13, No. 5, P. 256 In August 1994, the Center for Strategic and International Studies (CSIS) released "Global HIV/AIDS: A Strategy for U.S. Leadership." The report emphasized that the country "has a vital stake in slowing...the spread of HIV/AIDS in the world." The main barriers to effective strategies against the epidemic are stigmatization and discrimination, the CSIS wrote. The report concluded that the United States should lead the fight against AIDS "by example," for example by monitoring HIV/AIDS-related human rights violations "committed in the name of prevention," targeting HIV/AIDS prevention programs at various ages and populations, and refitting prevention strategies to address the special needs of women.