AIDS Daily Summary November 17, 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 ************************************************************ "Drug Is Found to Bar Infection by an AIDS-Type Virus" "Study: Medicaid, AIDS Deaths Linked" "HIV Patients Warned About D.C.'s Water" "AIDS on Rise in Latin America--Experts" "Bone Implant Infection Risk Combated" "Patient of Dentist with AIDS May Get Economic Damages" "Reducing the Risk of HIV Infection Among South African Sex Workers: Socioeconomic and Gender Barriers" ************************************************************ "Drug Is Found to Bar Infection by an AIDS-Type Virus" New York Times (11/17/95) P. A25; Kolata, Gina Researchers report in the journal Science that a drug called PMPA completely prevented one group of monkeys from becoming infected with the simian immunodeficiency virus, or SIV. In the study, none of the 25 monkeys who were given Gilead Sciences' experimental drug before or up to 24 hours after they were inoculated became SIV-infected, while all ten of the monkeys injected with salt water before inoculation with SIV contracted the disease. The scientists--led by Dr. Che-Chung Tsai of the Regional Primate Research Center at the University of Washington in Seattle--caution about jumping to conclusions about preventing HIV-infection or treating individuals who are already infected, but say they are greatly encouraged by the findings. Human studies, which are tentatively scheduled for 1996, would be required to determine PMPA's safety and efficacy in people. Related Stories: Philadelphia Inquirer (11/17) P. A2; USA Today (11/17) P. 1D; Washington Times (11/17) P. A3 "Study: Medicaid, AIDS Deaths Linked" Philadelphia Inquirer (11/17/95) P. A2; Ritter, Malcolm People with AIDS who are hospitalized for what appears to be Pneumocystis carinii pneumonia (PCP) are 73 percent more likely to die in the hospital if they are covered by Medicaid instead of private insurance, a new study claims. Researcher Charles Bennett noted that if planned Medicaid budget cuts are enacted, "this [problem] will only get worse." The study of nearly 900 patients in 56 hospitals in Chicago, Miami, and Los Angeles also revealed that Medicaid recipients are about 40 percent less likely to get a definitive test to diagnose the common HIV-related pneumonia. These people therefore have a greater risk of being treated for PCP while actually having a different illness, such as tuberculosis or viral and bacterial infections. Bennett said that this failure to treat the true disease could explain the higher death rates. "HIV Patients Warned About D.C.'s Water" Washington Post (11/17/95) P. A15; Kyriakos, Marianne The Whitman-Walker Clinic, the largest AIDS clinic in the Washington, D.C. area, and the National Association of People With AIDS warned AIDS patients on Thursday not to drink the city's tap water for fear of bacterial infections. A spokesman for the two groups said that people with weakened immune systems should drink bottled water or boiled tap water. The alert was prompted by continuing problems with bacteria in the District's aging drinking-water pipes. In October, standard tests of tap water throughout the city found unusually high levels of bacteria. But officials from both the Environmental Protection Agency (EPA) and the city claim there is no reason for panic. W. Michael McCabe, the EPA's regional administrator, said, "I want to emphasize that at the present time, we don't feel there is a public health threat." "AIDS on Rise in Latin America--Experts" Reuters (11/16/95) Health experts predict that an estimated 1 million Latin Americans could have AIDS by the turn of the century and that more effective campaigns must therefore be developed to prevent the spread of HIV. "Most people in the region know about AIDS and how to prevent it, but we need to convert this into action," explained Fernando Zacarias, coordinator of the Pan American Health Organization's regional program on AIDS. The group said that HIV infection is increasing among women, particularly those in the Caribbean and Central America, and that it is expected to increase rapidly in other areas, such as those regions where injection drug abuse is rising. According to the organization's statistics, there are currently 2 million HIV-infected people in Latin America and the Caribbean. "Bone Implant Infection Risk Combated" Richmond Times-Dispatch (11/16/95) P. E1; Orndorff, Beverly LifeNet, the organ procurement agency that serves central and eastern Virginia, has developed and implemented a new bone cleansing technology that attempts to eliminate the risk of disease transmission from processed cadaver bone implants. The process, called Allowash, uses a mixture of biological detergents to lower the amounts of bone marrow and fatty components of processed bones; these two factors are thought to be harbors for any viruses that the donor may have had. LifeNet says that such disease transmission is rare, about one in nearly 3 billion, but that it has happened. Four years ago, three patients who received bone tissue via LifeNet subsequently tested HIV-positive. The fresh-frozen tissue came from a donor who had apparently become infected with weeks of his death, and not enough time had yet passed for the infection to be detected by tests. "Patient of Dentist with AIDS May Get Economic Damages" National Law Journal (10/30/95) Vol. 18, No. 9, P. B21 The Supreme Court of Delaware ruled in September that although a patient could not collect damages for treatment by a healthcare professional who had AIDS without evidence of ensuing injury or HIV-exposure, economic damages could be recovered for misrepresentation. Brzoska v. Olsen involved 38 people who sued the estate of their late dentist for negligence, battery, and misrepresentation. The Supreme Court affirmed in part the decision of the superior court, ruling that there could be no recovery for fear of becoming infected with the disease absent any evidence of physical harm. Furthermore, the court concluded that the plaintiffs could not recover damages under battery as a matter of law. Recovery of economic damages was possible, however, for those plaintiffs to whom the defendant had made a direct claim that he did not have AIDS and subsequently provided treatment. "Reducing the Risk of HIV Infection Among South African Sex Workers: Socioeconomic and Gender Barriers" American Journal of Public Health (11/95) Vol. 85, No. 11, P. 1521; Karim, Quarraisha Abdool; Karim, Salim S. Abdool; Soldan, Kate; et al. Karim et al. undertook a study of female sex workers at a truck stop in South Africa to determine the social context that places them at high risk for infection with HIV, and how this context influences their risk-reduction capabilities. Ten in-depth interviews and 12 questionnaires revealed that the 12 respondents, whose mean age was 25.9, had a total of 266 clients each week. There was a high degree of knowledge concerning HIV etiology, modes of transmission, prognosis, and prevention methods among the sex workers, indicating previous educational efforts by one of the authors. But seven of the women said they were not using any form of contraception. Government clinics provided condoms; however, three women with an average of 84 clients per week never asked clients to use them. Of the remaining nine respondents, seven claimed that most clients would not accept their use, and only three of those seven denied those clients sex. These women also faced a high degree of violence, and several reported that clients were more likely to be aggressive when condoms were either used or suggested. To reduce the sex workers' HIV risk, the authors suggest the use of negotiation and communication skills, information and access to barrier methods they can use and control, and improved access to health care.