Report of the Second Public Health Service Aids Prevention and Control Conference

REPORT OF THE SECOND PUBLIC HEALTH SERVICE AIDS PREVENTION AND CONTROL CONFERENCE

Charlottesville, Virginia June 1-3, 1988 PHS Leadership on AIDS

Robert E. Windom, M.D. Assistant Secretaryfor Health

C. Everett Koop, M.D., Sc.D. Surgeon General

Ralph R. Reed, M.D. Deputy Assistant Secretaryfor Health

Frederick K. Goodwin, M.D. Administrator, Alcohol, Drug Abuse, and Mental Health Administration

James 0. Mason, M.D., Dr.P.H. Director, Centersfor Disease Control

Frank E. Young, M.D. Commissioner, Food and Drug Administration

Everett R. Rhoades, M.D. Director, Indian Health Service

James B. Wyngaarden, M.D., Ph.D. Director, National Institutes ofHealth

David N. Sundwall, M.D. Administrator, Health Resources and Services Administration

Peter J. Fischinger, M.D., Ph.D. Director, National AIDS Program Office

NOTICE

Please address all correspondence regarding this supplement to Public Health Reports to: National AIDS Program Office Office of the Assistant Secretary for Health Room 738-G, Hubert H. Humphrey Building 200 Independence Avenue, SW Washington, DC 20201

Public Health Reports is published bimonthly by the Office of the Assistant Secretary for Health, Rm. 725-H, Hubert Humphrey Bldg., 200 Independence Ave., SW, Washington, DC 20201. Second-class postage paid at Washington, DC, and additional mailing offices. POSTMASTER: Send address changes to Superintendent of Documents, U.S. Government Printing Office, Washington, DC 20402. WORKGROUP MEMBERS PREVENTION: INFORMATION, EDUCATION, AND BEHAVIOR CHANGE EPIDEMIOLOGY AND SURVEILLANCE

Co-Chairs Co-Chairs

William Blattner, M.D. Lyle Bivens, M.D. Chief, Family Studies Section Director, Division of Basic Sciences National Cancer Institute/NIH National Institute of Mental Health/ADAMHA James Curran, M.D. Gary Noble, M.D. Director, AIDS Program Deputy Director (AIDS)/CDC Center for Infectious Diseases/CDC Staff Staff Ms. Sandra Bart Mr. E. Thomas Starcher National AIDS Program Office/QASH Center for Infectious Diseases/CDC

Members Members

Ms. Wendy Baldwin Gerald Faich, M.D. National Institute of Child Health and Human Center for Drugs and Biologics/FDA Development/NIH Helene Gayle, M.D. G. Stephen Bowen, M.D. Center for Infectious Diseases/CDC Center for Prevention Services/CDC Harry Haverkos, M.D. Ms. Anita Eichler National Institute on Drug Abuse/ADAMHA National Institute of Mental Health/ADAMHA John Karon, Ph.D. Mr. Warren Hewitt Center for Infectious Diseases/CDC Office of Minority Health/OASH Mr. John Klemm Edward Hooper, M.D. Office of the Actuary/HCFA Office of the Director/IHS William Lassek, M.D. Charles Hostetter, M.D. Region III/OASH Office of Special Projects/HRSA Meade Morgan, Ph.D. Jan Howard, Ph.D. National Institute on Alcohol Abuse Center for Infectious Diseases/CDC and Alcoholism/ADAMHA Clifford Patrick, Ph.D. Marshall Kreuter, Ph.D. Office of Minority Health/OASH Center for Health Promotion and Education/CDC Mr. Harold Van Patten Ms. Susan Lachter Center for Infectious Diseases/CDC National Institute of Mental Health/ADAMHA William Winkenwerder, M.D. Ms. Susan Lockhart Office of the Administrator/HCFA Office of the Surgeon General/OASH

James 0. Mason, M.D., Dr.P.H. Director/CDC J. Michael McGinnis, M.D. Office of Disease Prevention and Health Promotion/ OASH

November 1988, Vol. 103, Supp. No. 1 - 99 KshitJ Mohan, Ph.D. Thomas Quinn, M.D. Office of Device Evaluation/FDA Johns Hopkins University Mr. Henry Montes Marvin Reitz, Ph.D. Office of Minority Health/OASH National Cancer Institute/NIH Mark Rosenberg, M.D. Zeda Rosenberg, Ph.D. Office of the Deputy Director (AIDS)/CDC National Institute ofAllergy and Infectious Diseases/NIH Ms. Beverly Schwartz Office of the Deputy Director (AIDS)/CDC Gerald Schochetman, Ph.D. Center for Infectious Diseases/CDC Ms. Paula Van Ness Office of the Deputy Director (AIDS)/CDC Allison Wichman, M.D. National Institute of Neurological and John Whitney. M.D. Communicative Disorders and Stroke/NIH Region IV/OASH Ann Willoughby, M.D. National Institute of Child Health and Human Development/NIH CLINICAL MANIFESTATIONS AND THERAPEUTICS PATHOGENESIS Co-Chairs Chair Samuel Broder, M.D. Anthony Fauci, M.D. Associate Director, Clinical Oncology Program Director National Cancer Institute/NIH National Institute of Allergy and Infectious Diseases/NIH Daniel Hoth, M.D. Director, AIDS Program National Institute of Allergy and Infectious Staff Diseases/NIH Staff Valerie Setlow, Ph.D. National AIDS Program Office/OASH Ms. Johanne Messore Members National AIDS Program Office/OASH

Henry Francis, M.D. National Institute of Allergy and Infectious Members Diseases/NIH Margaret Hamburg, M.D. James Bilstad, M.D. National Institute of Allergy and Infectious Office of Drug Evaluation II/FDA Diseases/NIH Bruce Burlington, M.D. Malcolm Martin, M.D. Office of Drug Evaluation II/FDA National Institute of Allergy and Infectious Diseases/NIH Bruce Chabner, M.D. National Cancer Institute/NIH Henry Masur, M.D. Ellen Cooper, M.D. Critical Care Medicine/NIH Division ofAnti-Viral Drug Products/FDA J. Steven McDougal, M.D. Susan Ellenberg, Ph.D. Center for Infectious Diseases/CDC National Institute of Allergy and Infectious Diseases/NIH Robert Purcell, M.D. National Institute of Allergy and Infectious Jack Killen, M.D. Diseases/NIH National Institute of Allergy and Infectious Diseases/NIH

100 - Public Health Reports John McGowan, Ph.D. Peter Nara, D.V.M., Ph.D. National Institute ofAllergy and Infectious National Cancer Institute, Frederick Cancer Diseases/NIH Research Facility/NIH Maureen Myers, Ph.D. Joan Porter, D.P.A. National Institute ofAllergy and Infectious Office for Protection from Research Risks/NIH Diseases/NIH Gerald Quinnan, M.D. Robert O'Neill, Ph.D. Center for Drugs and Biologics/FDA Division of Biometrics/FDA Philip Pizzo, M.D. National Cancer Institute/NIH William Robinson, M.D. BLOOD AND BLOOD PRODUCTS Office of the Administrator/HRSA Co-Chairs

VACCINES James Allen, M.D. Assistant Deputy Director for Science (AIDS)/CDC Co-Chairs Jay Epstein, M.D. Chief, Laboratory of Retrovirology Division of Blood and Blood Products/FDA Wayne Koff, Ph.D. Acting Chief, Prevention Branch National Institute of Allergy and Infectious Staff Diseases/NIH Paul Parkman, M.D. Mary Ann Danello, Ph.D. Director, Center for Biologics Evaluation and Office of the Commissioner/FDA Research/FDA Maryann Roper, M.D. Members Acting Deputy Director National Cancer Institute, NIH Ms. Sharon Barrett Bureau of Maternal and Child Health and Staff Resources Development/HRSA Harold Jaffe, M.D. Ms. Lorraine Fishback Center for Infectious Diseases/CDC Office of Health Planning and Evaluation/OASH Janine Jason, M.D. Walter Dowdle, Ph.D. Center for Infectious Diseases/CDC Office of the Deputy Director/CDC George Galasso, M.D. Harvey Klein, M.D. Extramural Affairs/NIH Clinical Center/NIH Ms. Debbie Henderson Joel Kuritsky, M.D. AIDS Coordination Staff/FDA Center for Biologics Evaluation and Research/FDA Werner Kirsten, D.V.M. Paul McCurdy, M.D. National Cancer Institute, Frederick Cancer National Heart, Lung, and Blood Institute/NIH Research Facility/NIH George Nemo, M.D. Clifford Lane, M.D. National Heart, Lung, and Blood Institute/NIH National Institute of Allergy and Infectious Diseases/NIH Darrell Liu, Ph.D. Division of Biochemistry and Biophysics/FDA Nancy Miller, Ph.D. National Cancer Institute/NIH November 1988, Vol. 103, Supp. No. 1 - 101 INTRAVENOUS DRUG ABUSE NEUROSCIENCE AND BEHAVIOR

Co-Chairs Co-Chairs Herbert Nickens, M.D. Director Clarence Gibbs, Ph.D. Office of Minority Health/OASH Deputy Chief, Laboratory of Central Nervous System Studies Roy Pickens, Ph.D. National Institute of Neurological Associate Director for AIDS and Communicative Disorders and Stroke/NIH National Institute on Drug Abuse/ADAMHA Frederick Goodwin, M.D. Staff Administrator Alcohol, Drug Abuse, and Mental Health Administration Ms. Winnie Mitchell-Frable National AIDS Program Office/OASH Staff Members Ms. Anne Guthrie Zili Amsel, Ph.D. Office of Health Planning and Evaluation/OASH National Institute on Drug Abuse/ADAMHA Robert BattJes, D.S.W. Members National Institute on Drug Abuse/ADAMHA Mr. Richard Chambers Peter Bridge, M.D. Office of Intergovernmental Affairs/HCFA National Institute of Mental Health/ADAMHA T. Stephen Jones, M.D. Sandy Genser, M.D. Center for Prevention Services/CDC National Institute on Drug Abuse/ADAMHA Joseph Kelaghan, M.D. Loringngraham, Ph.D. National Institute of Child Health and Human National Institute of Mental Health/ADAMHA Development/NIH Robert Janssen, M.D. Stuart Nightingale, M.D. Center for Infectious Diseases/CDC Office of the Commissioner/FDA Stephen Koslow, Ph.D. Juan Ramos, D.S.W. National Institute of Mental Health/ADAMHA National Institute of Mental Health/ADAMHA Stan Schneider, Ph.D. National Institute of Mental Health/ADAMHA Charles Schuster, Ph.D. National Institute on Drug Abuse/ADAMHA Ellen Stover, Ph.D. National Institute of Mental Health/ADAMHA Ernestine Vanderveen, Ph.D. National Institute on Drug Abuse/ADAMHA Andrew Sumner, M.D. Office of the Assistant Secretary for Planning and John West, M.D. Evaluation/OS Region IX/OASH Daniel Whiteside, D.D.S. Bureau of Maternal and Child Health and Resources Development/HRSA

102 - Public Health Reports Ms. Gilda Martoglio PATIENT CARE/HEALTH CARE NEEDS Office of the Surgeon General/OASH Antonia Novello, M.D. Co-Chairs National Institute of Child Health and Human Development/NIH J. Michael Fitzmaurice, Ph.D. Director Ms. Penelope Pine National Center for Health Services Office of Research and Demonstrations/HCFA Research/OASH Samuel Matheny, M.D. Karen Rudzinski, Ph.D. Director, AIDS Services Program National Center for Health Services Research/ Bureau of Maternal and Chfld Health and OASH Resources Development/HRSA David Smith, M.D. Bureau of Health Care Delivery and Assistance/ Staff HRSA Mr. Elmer Smith Morgan Jackson, M.D. Bureau of Eligibflity and Reimbursement National AIDS Program Office/OASH Coverage/HCFA Members Joyce Young, M.D. Bureau of Health Care Delivery and Assistance/ HRSA Ms. Cheryl Austein Office of the Assistant Secretary for Planning and Evaluation/OS PARTICIPANTS AT LARGE Mr. James Bloom Office of the Director (AIDS)/CDC Mr. James Brown Jacqueline Bowles, M.D. Office of Public Affairs/OASH Office of Minority Health/OASH Agnes Donahue, D.D.S. Ms. Barbara Brady National Institute of General Medical Sciences/NIH PHS Executive Secretariat/OASH Peter Fischinger, M.D., Ph.D. Ms. Judith Braslow National AIDS Program Office/OASH Bureau of Maternal and Child Health and Resources Development/HRSA Mr. Wilford Forbush Office of Management/OASH Vivian Chang, M.D. Region II/OASH Robert Gallo, M.D. National Cancer Institute/NIH Ms. Iris Gelberg National AIDS Program Office/OASH Ms. Kathleen Holcombe Office of the Administrator/HRSA Mr. Steven Grossman Office of Health Planning and Evaluation/OASH C. Everett Koop, M.D., Sc.D. Surgeon General, U.S. Public Health Service 0. Marie Henry, DNSc. Office of the Surgeon General/OASH Arthur Lawrence, Ph.D. National AIDS Program Office/OASH Rudolph Jackson, M.D. Office of the Deputy Director (AIDS)/CDC Mr. W. Harell Little Office of Management/OASH Stephen King, M.D. Reimbursement Policy Office/HCFA Mr. Joel Mangel Office of General Counsel/PHS Matthew Kinnard, D.D.S. National Institute of Dental Research/NIH Charles McCarthy, Ph.D. Office of the Director/NIH Carl Leukefeld, D.S.W. National Institute on Drug Abuse/NIH Charles MacKay, Ph.D. Office of the Director/NIH November 1988, Vol. 103, Supp. No. 1 - 103 John Petricciani, M.D. National AIDS Program Office/QASH Ralph Reed, M.D. Deputy Assistant Secretary for Health Everett Rhoades, M.D. Director/IHS Mr. Richard Riseberg Office of General Counsel/PHS Mr. Ronald Wilson National Center for Health Statistics/CDC Robert Windom, M.D. Assistant Secretary for Health Gooloo Wunderlich, Ph.D. National AIDS Program Office/OASH James Wyngaarden, M.D. Director/NIH Frank Young, M.D. Commissioner/FDA

NATIONAL AIDS PROGRAM OFFICE

Peter Fischinger, M.D., Ph.D. Director John Petricianni, M.D. Deputy Director Ms. Iris Gelberg Charlottesville Conference Coordinator

Staff

Sandra Bart Mary Ann Danello, Ph.D. Morgan Jackson, M.D. Sally Jones Arthur Lawrence, Ph.D. Melanie Lott Johanne Messore Winnie Mitchell-Frable Valerie Setlow, Ph.D. Warren Shaver E. Thomas Starcher, II

104 - Public Health Reports Outside Consultants to Workgroups Charles Konigsberg, M.D. Broward County Public Health Unit EPIDEMIOLOGY AND SURVEILLANCE Peter Lee National AIDS Network Charles Turner, Ph.D. Woodrow Myers, M.D. National Research Council Indiana State Board of Health Ira Longini, Ph.D. Harvey Makadon, M.D. Emory University Beth Israel Hospital Jim Glimm, Ph.D. Beny Primm, M.D. Courant Institute, New York University Addiction Research and Treatment Corporation Jim Koopman, M.D. University of Michigan Steve Rabin Ogilvy & Mather Public Affairs David Kanouse, Ph.D. The RAND Corporation Gloria Rodriuez New Jersey Department of Health Linda Bilheimer, Ph.D. Mathematica, Inc. Ricky Takal, Ph.D. Department of Education Mac Hyman, Ph.D. Los Alamos National Laboratory Charles Turner, Ph.D. National Research Council Ann Stanley, Ph.D. Los Alamos National Laboratory Richard Vogt, M.D. Vermont Department of Health Robin Weiss, M.D. Institute of Medicine Bailus Walker, Ph.D. State University of New York at Albany Lynn Levin, Ph.D. Institute of Medicine Fred Wolf Colorado Department of Health Stephen Lagakos, Ph.D. Harvard University CLINICAL MANIFESTATIONS AND PATHOGENESIS Jeffrey Harris, M.D., Ph.D. Massachusetts Institute of Technology David Baltimore, Ph.D. John Brundage, M.D. Massachusetts Institute ofTechnology Walter Reed Army Institute of Research Ronald Desrosiers, Ph.D. Ron Brookmeyer, Ph.D. Harvard Medical School Johns Hopkins University Richard Digioia, M.D. Andre Manitius, Ph.D. Private Practitioner - Washington, DC National Science Foundation William Haseltine, M.D. PREVENTION: INFORMATION, EDUCATION AND Harvard Medical School BEHAVIOR CHANGE James Hoxie, M.D. University of Pennsylvania Don DesJarlais, Ph.D. Martin Hirsch, M.D. New York State Division of Substance Abuse Massachusetts General Hospital Anke Ehrhardt, Ph.D. Richard Price, M.D. New York Psychiatric Institute Memorial Sloan-Kettering Cancer Center Martin Fishbein, Ph.D. Bian Safai, M.D. University of Illinois Memorial Sloan-Kettering Cancer Center John Henning, M.D. Gwendolyn Scott, M.D. American Medical Association University of Miami Wanda Jubb, Ed.D. Bruce Walker, M.D. Michigan Department of Education Massachusetts General Hospital November 1988, Vol. 103, Supp. No. 1 - 105 David Henderson, M.D. Irving Weissman, M.D. Johns Hopkins University, School of Public Stanford University Health John Ziegler, M.D. Maurice Hilleman, Ph.D., Sc.D. Veterans Administration Medical Center - Merck Institute for Therapeutic Research San Francisco Edward Hoover, Ph.D. Colorado State University THERAPEUTICS Lany Lasky, Ph.D. Genentech, Inc. John Bartlett, M.D. Duke University Medical Center Carol Levine Citizens Commission on AIDS David Barry, M.D. Burroughs-Wellcome Company Wendy Mariner, J.D. Boston University, School of Public Health Ronald Desrosiers, Ph.D. Harvard Medical School Thomas Matthews, Ph.D. Duke University Medical Center William Haseltine, M.D. Harvard University Michael Murphy-Corb, Ph.D. Delta Primate Research Center Rebecca Cole ACT-UP Gerald Myers, Ph.D. Los Alamos National Laboratory Lawrence Corey, M.D. University of Washington Medical School Bijan Safai, M.D. Memorial Sloan-Kettering Cancer Donald Edwards Center National Minority AIDS Council Roy Widdus, Ph.D. Mathilde Krim, M.D. World Health Organization American Foundation for AIDS Research Joyce Zarling, Ph.D, Sandra Lehrman, M.D. Oncogen Burroughs-Wel Icome Company Alexandra Levine, M.D. BLOOD AND BLOOD PRODUCTS University of Southern California- Los Angeles James Oleske, M.D. Celso Bianco, M.D. University of Medicine and Dentistry of Greater New York Blood Center New Jersey CDR Gerald Baker Fred Sattler, M.D. Armed Services Blood Program University of Southern California- Los Angeles Patricia Bonness Stephen Sherwin, M.D. Ortho Diagnostic Systems Genentech, Inc. Ritchard Cable, M.D. Paul Volberding, M.D. American Red Cross (Farmington Region) San Francisco General Hospital Margaret Castro Manfred Weigele, Ph.D. Becton Dickenson Microbiology Systems Hoffman-LaRoche, Inc. Amoz Chernoff, M.D. American Association of Blood Banks VACCINES Tom Clement Biotech Research Labs, Inc. Ronald Desrosiers, Ph.D. Harvard Medical School Karen Darcy Electro-Nucleonics, Inc Raphael Dolin, M.D. University of Rochester Medical Center Joyce Davis Medical Marketing Consultants Jorg Eichberg, D.V.M., Ph.D. Southwest Regional Primate Center Ross Eckert, Ph.D. Claremont McKenna College 106 - Public Health Reports David Mactas F. Carl Grumet, M.D. Marathon House, Inc., Therapeutic Stanford University Communitites of America J. Mehsen Joseph, Ph.D. James Maddux, M.D. Maryland Department of Health and University of Texas Health Science Mental Hygeine Center at San Antonio Sheldon Mazursky Floyd Martinez, Ph.D. Organon Teknlika Corp. La Frontera Center, Inc. Richard Montagna, Ph.D. Janet Mitchell, M.D. Cellular Products Harlem Hospital Center Alvin Novick, M.D. Andrew Moss, Ph.D. Yale University University of California - San Francisco Sergio Piomelli, M.D. Richard Russo Cooley's Anemia Foundation New Jersey Department of Health Robert Reilly Maxine Stitzer, Ph.D. American Blood Resources Association Francis Scott Key Medical Center Frederick Rickles, M.D. Jose Szapocznik, Ph.D. National Heart Foundation University of Miami Patrick Roche, Ph.D. E.I. Du Pont de Nemours and Co., Inc. NEUROSCIENCE AND BEHAVIOR William Sherwood American Red Cross (Penn-Jersey Region) Albert Bandura, Ph.D. Stanford University Marijane Sidote Abbott Laboratories, Inc. Kenneth Beck, Ph.D. University of Maryland Cladd Stevens, M.D. Greater New York Blood Center Rosalind Cartwright, Ph.D. Rush University Girish Vyas, Ph.D. University of California - San Francisco Thomas Coates, Ph.D. University of California, San Francisco INTRAVENOUS DRUG ABUSE Brian Flay, Ph.D. University of Illinois Karst Besteman, D.S.W. Jill Joseph, Ph.D. Alcohol and Drug Problems Association University of Michigan William Butynski, Ph.D. Joanne Mantell, Ph.D. National Association of State Alcohol Gay Men's Health Crisis and Drug Abuse Directors William McGuire, Ph.D. Don DesJarlais, Ph.D. Yale University Division of Substance Abuse Services, State of New York Susan Middlestadt, Ph.D. University of Illinois Loretta Finnegan, M.D. Thomas Jefferson University Dorothy Nelkin, Ph.D. University of New York David Hamburg, M.D. Carnagie Corporation of New York Richard Price, Ph.D. University of Michigan David Kerr Integrity House, Inc., Therapeutic Communities G. Terence Wilson, Ph.D. of America Rutgers University Mary Jeanne Kreek, M.D. The Rockefeller University

November 1988, Vol. 103, Supp. No. 1 - 107 NEUROPSYCHOLOGICAL ASSESSMENT AND Barton Pakull, M.D. PERFORMANCE Federal Aviation Administration Elizabeth Parker, Ph.D. Pim Brouwers, Ph.D. Veterans Administration Georgetown University Medical Center LTC Michael Peterson Lany Byrd, Ph.D. Department of Defense Emory University Richard Price, M.D. Richard Campbell, Ph.D. Memorial Sloan Kettering Cancer University of Illinois Center Diane Lynn Damos, Ph.D. Paul Satz, Ph.D. University of Southern California University of California, Los Angeles Clete DiGiovanni, M.D. Andrew Saykin, Psy.D. U.S. Naval Medical Center-Bethesda University of Pennsylvania Carl Eisdorfer, M.D., Ph.D. Fred Schmidt, Ph.D. University of Miami University of Kentucky Everett Ellinwood, M.D. Ola Selnes, Ph.D. Duke University Medical Center Johns Hopkins University Hospital Norman Garmezy, Ph.D. LTC Rufus Sessions, Ph.D. University of Minnesota Walter Reed Army Institute of Research Candace Gibbin, M.D. Fredric Solomon, M.D. Office of the Chief of Naval Operations National Academy of Sciences Katherine Goethe, Ph.D. Yaakov Stern, Ph.D. Wilford Hall, U.S. Air Force Medical Center Columbia University Wilfred Van Gorp, Ph.D. Elkhonon Goldberg, Ph.D. West Los Angeles Veterans Medical College of Pennsylvania Administration Medical Center Robert Heaton, Ph.D. University of California, San Diego PATIENT CARE/HEALTH CARE NEEDS Fred Hegge, Ph.D. Walter Reed Army Institute of Research Elaine Abrams, M.D. Russell Hibler, Ph.D. Harlem Hospital Center Department of Defense Kathryn Addenbrook Jerry Hordinsky, M.D. Wilson Health Care Center Federal Aviation Administration Linda Bilheimer, Ph.D. John House, Ph.D. Mathematica, Incorporated U.S. Naval Medical Center - Bethesda Gary Clarke, J.D. Kenneth Karols, M.D. Florida Department of Health Department of Defense Maxy Cline Glen Larrabee, Ph.D. Palo Alto Medical Foundation Research Institute Memory Assessment Clinics, Inc. Eunice Diaz Richard Letz, Ph.D. White Memorial Hospital Mount Sinai School of Medicine Don Edwards Alex Martin, Ph.D. National Minority AIDS Council Walter Reed Army Medical Center Jesse Green, Ph.D. Justin McArthur, M.D. New York University Medical Center Johns Hopkins University Hospital Joel Hay Eric Miller, Ph.D. Stanford University University of California, Los Angeles John Holloman, M.D. William F. Ryan Community Health Center 108 - Public Health Reports Robert Hummel New York State Department of Health Lisa Kaplowitz, M.D. Medical College of Virginia Paul Kawata National AIDS Network Andrew Kruzich King County Department of Health Michael Merdian Dallas Persons With AIDS Coalition Cliff Morrison AIDS Health Service Program - San Francisco Mervyn Silverman, M.D. AIDS Health Services Program David Werdegar, M.D. San Francisco Department of Health Albert Williams The RAND Corporation

November 1988, Vol. 103, Supp. No. 1 - 109 * U.S. GOVERNMENT PRINTING OFFICE: 1989 0 - 228-084 U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Second-Class Mail Public Health Service Postage and Fees Paid PHS-OASH Room 1 3C-26 Parklawn Bldg. ISSN 0033-3549 5600 Fishers Lane Rockville, MD 20857

OFFICIAL BUSINESS PENALTY FOR PRIVATE USE, $300

PUBLIC HEALTH REPORTS PHS 89-50193 (USPS 324-990)