-If -If -If THE : This Newsletter is published by the National OFFICIAL NEWSLETTER OF -If THE ...... Cbalition of Gay Sexually Transmitted Disease Services (NCGSTDS). Although efforts will be NATIONAL COALITION I... made to present accurate, factual information, . ... the NCGSTDS, as a volunteer, nonprofit organiza ...... tion, or its officers, members, friends, or OF ... agents, cannot assume liability for articles ... published or advice rendered. The Newsletter ...... provides a forum for communication among the GAY STD SERVICES ... nation's gay STD services & providers, and ...... encourages literary contributions, letters, * reviews, etc. The Editor/Chairperson reserves * VOLUME 8:4 ""INTER~ 1987 3* the right to edit as needed, unless specific ********************************. requests to the contrary are received. Articles for the Newsletter, or inquiries about membership or subscriptions may be addressed to Mark P. Behar, PA-C, Chairperson, NCGSTDS, PO Box 239, Milwaukee, WI 53201-0239 (414/277-7671). Please credit the NCGSTDS when reprinting items from the Newsletter. We're eager to hear from you, and will try to answer all correspondence! The NCGSTDS is the proud recipient of the National Lesbian/Gay Health Education Foundation's JANE ADDAMS-HOWARD BROWN AWARD, for outstanding effort and achievement in creating a healthier e~~!:~~;,~,~:,~,:~:,:<,!:::!::,~~<:::,~::~*,~,::,:<,~:,~::,:<,~:;~"::::;,~~<,:,,:<,:,, n:Di GAY AND LE~~~~~R~ASSOCIATION ************************************************************************************************************************************ TABlE a: romNTS (AllUm) CATALOO IWlKETIt«3 Fm AI00-28 (BE lYPE t()T RElATED-61 RANIX)1, ~ TESTIt«3 IN NY-11 1969 TEEN AIlE CASE ~D-9 CA1l«lICS PlAN RESIIBa-79 e4-CSF STIWTE 'lUTE CEUS-27 MILITARY IW6 TEST R6JLTS-13 RAPID IN-a:FlCE TEST-10 AFRIKN4 remT GAYS, AI00-82 CATTLE VIRJS LINKED TO AI00-61 ~ ~ AI!E-7 MILWNJKEE CABLECASTS: P.0.C.-86 REACTICtl MlXED:C(JItI11SSICtlERS-16 AIlS IDE IlJE TO AIoo-4 ~ a: EXPlICIT AIlE UT-73 HEAl..TIl DIRECT~ SOJIreOO<-2 MINI-SERIES P\.NMD: 9UlT5-66 REAIElS ~LD INVITE 1'i/A-13 AIlE & S10 1987 WP-UP-30 OiEMlCAL [£PEN AIlE ~29 HEPATITIS C(MlliCATEO: Al00-79 MINN. MEOlA CN4>AI~ a:F-69 AIlE & SYPH1LI5-65 'HEPATITIS AATES RISlt«3-77 Mlt«)RI1Y AIlE PIn! a:NIEO $$-86 REAGAN JR. '15. RENlAN SR.-7 AIlE .fCTI~ LINE ESTAS-28 0iEM [£PEN Rx: SAFER SEX-29 HEREDiTARY FACTOR IN Alt67-S2 Mlt«)RI1Y EtOC IN 8 CITIES-85 REITER'S S'rWD, ~I~I5-62 AIlE AWARENE$ & PREY 1OfTH-32 OilCAOO ILL-PREPARED-80 HERPES &llT-9 MISSILES FOO Aloo-6 REPORT: C()tI1ISS 'N &lRPRI5It«3-17 AIlE EPI/SlRVEIIJ...6l(;E UPDATE-21 OilCAOO UPDATES CXMII..NI1Y-20 HERPES 003AN TIWEPtJHT5-62 1M: 36:23-48, JUN-IE, -33-52 RESEAIOi RJNm IN OHCAOO-19 AIlE PROTEIN 'roRJTED'-58 Oi~IC VIRAl FATHIJE S'rWIlHO' aILE AIlE TESTlt«3-12 RISKY SEX STILL PR.tCTlCEO-72 ~ WEJ..C()fS PWAs-7 HISP~ICS SEEK INRr84 !OlE Ctl SYRULI5-65 Rx & EVAL ~ITS INVESTlGATEO-27 AIlE TIlE M.JSlCAL-7 Ctf.fCTMS SlUDlE0-63 HIV & SYPHILIS ~ECTICtH1 NAACP ADDRESSES AI00-86 ru SAFER SEX INSTR CERTlFlCATI~70 AIlE UPDATE: EXPANDIt«3 ~-31COLLEGE QKlHllS Pl.J*EO-73 HIV ANTIBXlY: NEW PREV00-11 NATICHIIIDE ACTI~ PI.J*EO-2 g:H(Xl Al IE ElltATlCtl: SI EOJS-70 AIlE, ETHICS, & :oorIlUTI~8COLORAOO AIlE PIn! GETS $$-23 HIV FlNOItm PRESENTEO-14 NATIVE NtfRICMS & AI00-87 ~IENTISTS IP.AW PROTESTS-S AIISIIALK RAISES $250,000-30 ca..awxl MANDATES RErorrlt«3-4 HIV INFEC AATE 00* IN SF-14 NAZI BARBIE RJa5 AIlE AmIH 5EROC(JMRT: AS POO TO NEGHO AIRLINE RERJSES TICKET: AI!E-9 C()tI1ISSI~ER NIA fQ.JARE a:F-16 HIV TESTIt«3 W/O COOENT 9.)IT-10 NEW ~ RETR(NIRJS-59 9iOPS ocmTE PEmT.A!r2 AL-721 TESTED BY I'i/A (MJP-22 CQIIII1SS'N: ciw..t.etaR wAII~HS Itm The National Lesbian and ~y Health Foundation is proud to announce the 2nd International Lesbian and Gay Health Conference and AIDS Forum, July 20-26, 1988 at Boston s Park Plaza Hotel and TO\IIers. The Conference is the ninth on gay/lesbian health, and the sixth AIDS Forum. The theme of the conference, which is expected to attract over 1500 registrants from around the \IKlrld, is 'OJr experience of the BO's OJr Mission for the 90' s. • This theme reflects the overall goal of the Conference- to constitute an international and· national health' care agenda for the next decade. An added feature of the conference is the annual medical rooeting of the American Association of Physicians for Human Rights (AAPHR) which will immediately follow, July 24-26th. Deadline for submitting proposals is January 15, 1988. Applicants will be notified by the prOijramming cClllllittee by March 15th. Copies of the Proposal Form are included with this News letter. Additiona 1 information may be obtained by contacting Michael \lleeks at the FOJndation (202/797-3708) or Greg Tlmas of GaTge \IIashingten University (202/994-4285). The Conference is being COSlXJ1sored by tl's FOJndation, AAPHR, and G\II University. 101 ********lI lOll! *Xi *** +~~ +lOll! ++ +l!l! lOll! +** HEALTH DIRECTORY SOURCEBOOK Requests for free listings of health related services for tl's 6th edition of TI's National Lesbian/Gay Health Directory are now being solicited by tl's directory's PJblisl'sr, tl's National Lesbian/Gay Health FOJndation, Inc. Types of services to be included: ·clinics, walk-in centers, cOJnSeling and referral agencies, gay sensitive practitioners or services, individual lesbian or gay health professionals in private practice, nutritienists, optometrists, dentists, AA, A1-Anon, and m rooetings for lesbians and gay men, help lines, etc. Request a copy of tl's listing form from: NLGiF/SaJrcelxlok, PO Box 65472, \IIashington, OC 20035. mJ\OI*'IUlilI lOll! **. +101 +lI 101 m +************ IOIlI • +1<101 W SHOPS DONATE PERCENTAGE by Mark Perigard, with thrills to ~ Wirmrs, 12/10/87 Eleven Back Bay shops in Basten will donate a percentage of their fu 11 day's proceeds to tl's city's AIDS Action cClllllittee (AAC) en December 17th. AAC is encOJraging supporters to patrcnize those participating businesses. In a press release fran AAC, Jam &xx:Ie, a.r.ner of Body Body stressed that "in the season of giving, the holiday sale provides an opportunity to give twice; a gift for someone special and a gist to tl's fight against AIDS.' m •••• ***"'** .********.**.t~*********** NATION~IDE AIDS ACTION PLANNED by Nadine fot:Gam, with thrlks to ~ OJtlines, 12/10/87 After meeting in \llashingten, OC in associatio with the March en Washingten for Lesbian and Gay Rights, AIDS activists thrOJghout the country have anna.JI'1Ced a IlaII natienal net\lKll"k of AIDS organizatiens involved in protests, lobbying efforts, civil disobedience, daoonstrations, and camunity organizing. TI's net\lKlrk is organizing nine days of naticnwide protests and actiens en April 29-May 7, the ·Spring AIDS Actien '88.' CaimJnities will coordinate their efforts on issues including gay men and Iurophobia; care and uncaring; AIDS in tt-e gt-etto, barrio, and on the reservation; AIDS en caffiPJs; AIDS behind bars; \\Omen and tt-e AIDS crisis; AIDS, a \IKlI"ld-wide crisis; and life withheld and life held back; the ninth day culminating in a National Day of Protest. Participants are encOJraged to unify behind the stated goals of tl's AIDS Action Pledge: To engage in nonviolent civil disobedience orott-er protests to demand massive AIDS funding. For more informatien: AtT UP, 337 E. 10th St., New York, NY 10004 (212/674-6520); or tt-e AIDS Action Pledge, 158-A Lexington St., San Francisco, CA 94110 (415/821- 9087) . ~********mJl~m m'****ll**** ** •• **** INTERNATIONAL AIDS CONGRESS Professor Robert Gallo of tl's U.S. National Institutes of fl.ea 1th (NIH) has been named chairman of tl's International Congress en AIDS which will be hosted by The RePJb1ic of San Marino, Iktober 10-14, 1988. The 4-day conference, by invitation only, will attract approximately 600 of tl's \\Or ld' s most renowned p/"tfsicians, researchers and other hea lthcare representatives. The spenser for the Congress is Renzo Ghiotti, Minister of Public Health for the Republic of San Marina. Other AIDS-related topics to be covered at the San Marino Internatiena 1 Symposia en AIDS are antiviral therapy, psychosocial aspects, healthcare and society and legal ramifications between citizens and society, in particular AIDS sufferers. Invitations for submitting abstracts on the various Congress themes will be sent out this winter. San Marino, surrOJnded by Italy, is located 12 miles fran tl's Adriatic Sea atop tl's 2300 foot Mt. Titana. It is considered tl's \IKlr1d's oldest dem:::cracy, fOJnded 1600 years ago. Today tl's country has a poPJlation of 28,000. Details abOJt tl's Congress are available by contacting one of tl's Congress' COS1XJ1S0rs: Det1ev Baurs-Krey, president, Tt-ermascan, Inc., 500 Fifth Av., New York, NY 10110. ***"'** ** **IO/OIJIOI**'I •• *m* ***'I *••••• *******.~ P~A CONFERENCE IN DALLAS by Lori Ks1schaft, with thrills to Bostal'S ~ Camtnity 1Bs, 11/22-28/87 Over 70 men and \IKlmen with AIDS from all parts of tt-e COJntry gatl'sred for a three-day ccnference of tl's National Association of POOp 1e With AIDS (NAP\IlA) in September. TI's ccnference offered \IKlI"kshops en such subjects as legal awareness, dealing with t~ media, cpl spiritua~ity. !nforma 1 discussions included talks on holistic healing, crystal meditatien, and 1atemative tl'srapies. According to, tt-e Ba ltlmore Alternative, participil1ts discussed tl'sir shared cencerns asP\llAs: discrimination, lack of canpassien fran sane ~ica1 prof~icna1s, a1d anger at the slow speed of legislatures and tl's FDA. Participants a1se explored how local differences in tl's dynamlcs of .tl's dlsease ~ffect how it should be handled in different areas. TI's Dallas P\IlA Coalition provided free housing in a recently PJrchased InJslng canplex wlth 22 apartments, while most of tt-e rooetings were t-e1d at a local Episcopal crurch. ***** THE OFFICIAL NBtlSLETTER OF THE NCGSTffi * VOLUME 8:4 * ~INTER, 1987 * PAGE 3 ***** ++:11+ ++ • ++ * + • **:II *+ + + + M ++ + + + + + + + •• *.... **** •* • + * * • + .... +:11+ ++ M +* "'+:11+ +lI*** +• +*:11+ • +**:11*** .. ++:II. W ********** "'*. +... +*:11+ ++ + + + "'* +• "'* "'* ••• **:II +•• +* POLICE UNION JOKES ABOUT GUNS by Lisa Kee'l and Rick Harding, with tt-anks to I~ ~..bi~rn El~, 7/31/87 A unirn representing roore than 21,000 law enforcerrent and correctioos officers througi"o.Jt the state of New York publ~shed an AIffi "joke" in the July issue of the unien's newsletter 'The Enforcer" suggesting that a Magnum 357 -caliber gun could be used to relp prevent the spread of AIDS. According to tre Albany daily newspaper, tre Knickerbocker News, tre "joke" appeared ~n a 7-qL:estioo AIffi quiz ent~t led "What's YOJr AIDS 107" The quiz was co-written by Katherine frank 1~n, an AfSCME health coordinator as part of an mB education effort. One of the 7 questims asks: "For trose who have to \IIOrk with or around AIffi victims who have open, bleeding sores or ot!-er b:ldy fluid discharges, sane of t!-e protective measures that may be used to prevent spreading are (pick all that apply): A. Gloves; 8. M357 [designat~en for a 357-caliber handgun]; C. Hardhats; D. Masks.' Franklin told the ~icker~~~ ~~ that jokes abrut guns are "an everyday tool· for law enforcerrent people and that the joke was "meant to provide some huroor to people who are very frightened en this subject." Virginia Apuzzo, gay Haisoo to New York ~rnor Mario Ctmo, said sre was "er.orroously dismayed" over the joke and said it was "stepping en tre sOJls" of people with AIffi. ************-************~+*+++**** QUARANTINE FOR 14 YEAR OLD BOY by Stephanie Poggi, with tt-anks to BcEtrn's ~ CarmJnl!:i News, 7/26-8/1/87 New informatien has arerged abrut tre quarantine of a 14 y ear old Miami boy who tested positive for antib:ldies to t!-e HIV virus. A florid.~ judge lifted t!-e quarantine order en June 16. According to Ben Schatz of Natiena 1 Gay Rights Advocates of San Francisco, who:ret with t!-e boy and the Florida Dept. of Health, 'The Dept. [of Health] had tried to justify quarantine by pointing to ruroors that t!-e boy was S8XJally active and stay9J out late at night in gay bars. Yet the Dept. did not seek to edL:cate t!-e boy abrut AlOO or safer sex. Instead, t!-ey quarantined him witl:nJt a hearing, and witln.:t notifying his family.' Schatz said !-e learne::l thrrugh conversatiens with t!-e quarantined boy and his roother, that authorities refused to al1D.II t!-e boy to :rest with a representat~ve of a local Alffi service organizatien or with a minister fran a Metropolitan CamlJnity Church. In additien, 1a'l.'fSrs for the Dept. told the boy's roother not to speak with reporters. Tre :rot:!-er also said s!-e was told by the Dept. that she and her soo had to be tested for HIV antib:ldies. Dept. attorneys refuse::l to discuss these and ot!-er allegatims with Schatz. T!-e boy, who unsuccessfully attempte::l suicide befo."S the quarantine order, is temporarily rospita lized 'for psychiatric eva luatim" and "assistance." +lI*** • "'* +:II "'* •**:11*:11:11 ********'***lI. "' •• ",**lI*lI+ **:11****** DENTIST IN TEXAS PRISON FI:RED by Jlmie rt:Knight, with tlwlks to BcEtrn's ~ Camt.ni!:i ~, 9/6-12/87 A prisen dentist who refused to treat prisoners with AIffi has been fire::l by the Texas Department of Correctiens. Or. David Spence was dismissed fran his positim at the Coffield prism unit near Palestine in northeast Texas after he said he wanted th optim to refuse "treatment for anycne suspecte::l of, or diagnose::l with Alffi, at any tine, 00II or in the future." Although Spence is not the en ly dentist in the Texas prism system (the natirn's third largest) to express crncern about the possibility of HIV exposure m the job, his open defiance violated department j:Xllicy that forbids nalica 1 staff fran withholding care, according to the ~as~ten Post. "'* **:11*** "'*. "'* *+:11:11:+*:11 "''''''''''* **:II *+. "'* **:II*lI*lI+. U*lI***M - --- - LA,\.II CASES I:NVOLVI:NG SEX •. AI:DS The American Civil Liberties Unim (ACW) Lesbian and Gay Rights Project's recently PJblishe::l Natienal lXx:ket Qf Alffi and Sexualit:i and ~ Law Cases, a canpilatirn of pending cases involving Alffi, sexual orientatim or crnsensua 1 sexual activity, crntains roore tt-an 100 cases of the AClU project and affiliates, gay and lesbian rights organizatims and private attorneys, including 20 cases of the ACLU of Sourthern Califomia, the largest caseload of any affiliate or organizatien. "Not enly does the ACLU of Southern Califomia have the largest caseload of AIffi, sexual orientatien or consensual sexual activity cases, it has sane of the roost significant cases in the natirn,' said ACLUSC gay and \IOIlen's rights attorney Susan fo'cGreivy. W/2£ cases crntaine::l in the lXx:ket inlcude Bean '!.:.. Count:i Qf Los tngeles, charging that the county has faile::l to design and irnplSlSlt an AIffi e::lucatim program directed at minority camunities; CUrran '!.:.. Mt. Diablo CaJncil Qf §Q'i Scouts, challenging the discriminatory j:Xllicy of the Boy Scouts not to permit participatim by tmJsexuals and the defendants' claim of immunity fran coverage of California's Unruh civil rights act base::l m privacy rights or a right not to associate; Doe '!.:.. Centinela Hospita 1, challenging the rospita l's discriminatory exPJ lsim of an AIffi antiOCdies carrier fran its alcoro 1 and drug rehabilitatim program; Hale v. Board of Trustees, charging plaintiffs were discriminate::l against m the basis of sex and sexual orientatim and dB'1ie::l dur process befo;; their ~a' fran a state university faculty; Leyland '!.:.. Orr, challenging the discriminatory dismissal of a transsexual fran the Air Force; bg}g Beach ~ and Lesbian Pride, Inc. '!.:. !:gJg Beach ~ Cwncil, challenging as discriminatory the council's refusal to issue a parade demonstration permit without charging fees for police protection thus violating California constituticnal prohibitions crncerning freedan of speech and discrimination based Up:J1 wealth; Stanley '!.:.. §is Erothers Qf ~ ~eles, challenging discriminatory exclusien of gays and bisexuals fran crnsideratirn as Eig Brothers solely l:a:ause of their sexual orientatien; Thomas '!.:.. Atascadero, challenging discriminatory exclusion of a kindergarten student fran his classroom l:a:ause he has AIDS. The 133 page lXx:ket includes case sunmaries which provide a detaile::l descriptien of the issues presented in the case, its status in court, and lists the none, address and telephone number of the organization and/or attorney handling the case. The sunmaries include citatiens for PJblishe::l opinims and the cwrt file nunbers. It also lists sample pleadings which are available fr'an the ACLU Lesbian & Gay Rights Project. The lXx:ket costs $10 per copy, plus $2 for postage and t-andling. For tobre Informatien: ACLU Literature Dept., 132 ~t 43rd St., New York, NY 10036. Checks should be made payable to the ACLU Foundatirn. ***** PAGE 4 * 'THE OFFICIAL NE\IISlETTER OF 'THE NCGSTOO * \OOK 8:4 * WINTER, 1987 ***** ~**"."*****""""'ICm""'*****""**'~"""'***'''''''''***''**'*'''' •••••••••••• **'**, •••••• ,., •••••••••• ***** A,I:DES, GONE DUE AI:DS with thanks to Detroit's CruiS!, 11/18/87 :he Nob~e School District in Norman, Oklahoma is ~eluctant to ca~~ an aide an aide. It announced that library aides and teacher aides will be sallee 'assistants' becacse of public anxiety over AIDS. Such is the price of paranoia. Does it portend a linguistic backlash? Will school nurses now cease administering "first aid" and switch to "first assistance?" wm first aid kits around the country now have to be recalled fran off factory walls and out of Scouts' backpacks for relabeling? What of drugstores with their beauty aids, cosmetic aids, and foot-care aids? Will corporate America turn on products like Kitchen-Aid dishwaters and Band-Aids? The Noble School District could have found a better sclution: Teach students that "aide" doesn't mean 'AIDS," and that even if it did, panic and fear would be inappropriate responses ~~'*************** COLORADO MANDATES AIDS REPORT"I:NG by Stephanie Poggi, with thanks to Bostoo's ~ ~ity News, 5/24-31/87 Abill trzt requires disclosure of the names of people who test HIV antibody positive and grants new quarantine powers to health officials has been approved in the State of Colorado. The Coalition for Political Respoosibility, the grrup that led the fight against the bill, is pla~'ing their own network of alternative anonymous counseling/testing sites. While a Colorado state regualatio instituted in October of :995 already mandates the reporting of names of people who test HIV antibody positive to the State Dept. of Public Health, the new law will solidify the regulation. Specifically, testing laboratories :TIJst give the health departllB'lt the names and addresses of individuals testing H!V antibody positive, and that private doctors :TIJst report the names and addresses of those with AIDS or HIV-related illnesses. Failure to de so will result in prosecution. Another provision of the bill allows local and state health authorities to inspect any medical records relevant to investigatioos of srurces of HIV infectioo. Officia~s are not required to inform the person whose records they are seeking. The bill also expands the state's powers to quarantine or "isolate' persoos who "endanger the pJblic !-ealth.' The bill allows for the issuance of orders to "cease and desist" behaviors believed to be "dangerrus" "::t public health officials. If an individual does not "cease and desist,' he or she can be taken into custody for 72 haJrs. Artrur Pa.o.oers of the Coa liticr. for Po litica 1 Responsibility said his grrup is urging anyor.e contacted by health authorities to "Just &3y No." Powers added, "They'll be saying 'yes' to civil liberties.' He added that gay/lesbia~ fears that the law wm "drive [people at risk] undergrrunds," have already been corne rut. since implenentatioo of the :985 reporting regulation, "clinica visits overall have dropped substantially-- people at highest risk have virtually boycotted the state's clinics.' He said, "AIDS will be spread even more rapidly because of this law .... It will cause more lives to be lost, not to be saved," State Health Chief Tan Vernon, who strongly backed the legislatill'1, has arguoo that the best way to stop AIDS is to change the behavior of these who have been exposoo to it. According to Vemon, reporting nal!eS will allow the health department to offer appropriate crunselling and education. The ~~ricar. Civil Liberties Unicr. and lambda Legal Defense a,d Educatior. Fund are currently studying the feasibility of a legal challenge to the new law. ~************"'** ••• *****",. ***lI~ NAZI BARBIE FUELS AIDS PHOBI:A by Kim Westheiner, with thanks to Bostoo's ~ Camwity~, 6/7-13/87 Racist, anti-Semitic and A!DS phobic sentiments have been fueled by the tria 1 of accusoo Nazi war criminal Klaus Barbie. According to the Boston Globe, cr. the eve of Barbie's trial, rightwing presidential candidate Jean~.arie Le Pen made a series of anti-Jewish statenents and attacked people with AlOO. In the past, Le Pen's bigotry ras been directed primarily towards North African Arab immigrants. Using the French initials fo:- AIDS (SIDA), le Pen coined the word "sidaique.· The new word is reniniscent of the French adjective for Jewisrness )udaiq~e. He also called for 'sidatoriums" --isolatill'1 centers for people with AIDS. According to numerous French commentators, Le Pen's rhetoric-- which focuses or. race, etmicity, cootagirus diseases and sex-- evokes the language of French writings used by the Nazis. Other events which have coincided with Barbie's trial include anti-Semetic demontrations in Lyll'1 and Marseilles, racist beatings in several areas of the cClJntry, and the painting of swastikas en war monuments in !zieu. Barbie is accused of having deported 44 Jewish children fran Izieu, where they had been hiding in a secret orphanage, to Ausc!lNitz. **~.*.***********~********ICm* DELAWARE HOSPITAL REFUSES T"REAT"MENT" by lru Chibbaro Jr., with thanks to !~ ~shil}9!~ §lade, 7/24/87 The civi 1 rights office of the ~ .S. Department of Health and Human Services began an investigatioo into whether a Lewes, Delaware, I-ospita ~ '/iolated the civil rights of a D.C. :nan when one of its doctors :-efused to treat the man because he feared the man harbored the AIDS virus. Alan 8:-ot:nan, an official with HHS's Philadelphia regional office, said HHS investigators are determining whether Dr. Robert Spicer, an ::lrthcpedic surgeon at Seebe Hospital, violated a federal law prohibiting discrimination against handicapped people by refusing ,to perform su:-ge:-y on vactione:- Rod Miller. The U.S. Suprare crurt ruled in March that a 1973 law protecting handicapped per'soos fran discriinination ~y institutions receiving federal funds, such as hospitals, applies to peep le who have AIDS or are suspected of having the diSease. Miller entered Beebe Hospita~ 's emergency roan on July 5 after he injured his foot on a jetty at a state park rutside Retl,both 8eac~, a polXllar '/acetior. a:-ea for Washington residents. Spicer told Miller he was concerned that Miller might have been exposed to the AIDS virus then said ~i~1e~ needed t~eatment which Spicer could not provide. The docto:- sent Miller to George Washington University Hospital in DC by helicopte: :::r.d sail:! ~me:- will be res;:x:r.s~ble for the $3100 cost of the helicopter if Miller's health insurance does not pay for it. Mauro r.b1toya, an ettorney for the Whitmar.-Walv2r clinic, said Miller is considering suing Beebe Hospital. ~:tlIoIoIJIoI:*******>ti::iottlkll<*:iott**************:iott:iott ***** THE OFFICIAL NEWSLETTER OF THE NroSTIl3 * \QUME 8:4 * 'ilINTER, 1987 * PAGE 5 ***** w ••••••• u.u •••• ~.****'.~****' ...... *****'+:+:m •• +:+~lI.m ..... +:+w+:lC*llllll.x. •• +:IC*lIlIx. •• +:++:+ •• +:+ •••••• +:+ •• x.. HOMOPHOBIA IN RESTAURANT by lori Ks1sct'aft, with tlBlks to Ib;tcn's ~ ~m~, 11/22-28/87 Larry and Seija Doolittle were forced to close their Hagerstown, Maryland restaurant because of homophobia and AIIl3 hysteria focused cn their maitre d', Steve Sobota. The Doolittle's believe the rUfTDrs that Sobota is gay and had AIOS started frOOl jealOJSY over his excellent performance and rapid prOOlOticn. !klris Martin, a kitchen expeditor, proclaimed at one JX)int, 'Either that fag goes, or I do." 'I doo't like that,' said Mrs. Doolittle. 'ilhen Sobota offered his resignatioo in an attempt to save the restaurant, she respooded, "Nobody's different in ~ Ixxlk. I \I01't take that [letter of resignatioo] frOOl yoJ.' According to the ~1~.i[Q~ Alt~!:Ntive, the NOClI'S assurre that cecause Sobota is gay he IIlISt have AIOS. 'I do not have AIOS,' Sobota emphasized. 'I doo't act effeminate, or stand OJt, and I do not broadcast ~ sexual preference to anyone. I have maintained a \I01derful relatiooshop of 7 years with ~ laver .... I just didn't understand their hatred.' Sobota moved back to his toretoo, HagerstQ\ll), in order 'to leave the crirre and filth of Sa ltiroore' after he was beaten by fOJr yoJtl'S OJtside a Sa ltillDre gay bar last spring . ... +...... +... ++ + + + WlblI+lIlI ...lIlI. +:+. ++:+.+:+:+lIlI +. m SCIENTISTS DRAW PROTESTS by .tme-cl'l'istine d'~ky, with thanks to New YQr..h ~tive, 10/19/87 Despite cold temperatures, 50 protesters picketed against Natiooa 1 Institutes of Health (NIH) scientists Robert Gallo and Anthooy Fauci at New York City's Marriott Marquis Hotel, October 4. The two health officials were speaking at the Interscience Cooference 00 Antimicrobial Agents and Chei1Dtherapy, a week-lcng meeting that focused 00 AIIl3, aI1Dn9 other medical issues. The protest was organized by the AIOS Coalitioo to Unleash Power (ACT UP), which criticized Gallo and Fauci for allegedly delaying federal approval of experimental treatments for illnesses associated with AIOS. Shouting, 'History 'ilill Recall, the NIH Did Nothing At All,' and 'Fauci, Fauci, Tell Us Why, YOJ Sit By, While Thousands Die,' the protesters demanded immediate access to experimental drugs which are ccnsidered prOOlising but which the NIH has not tested. Amain stake in the argument for immediate testing of experimental drugs (such as ampligen, AS 101, ribavirin, HPA-23, CSF, AL- 721 Antabuse and Illl.lthiol) is that NIH testing and approval of Retrovir (AlT, Azidothymine), manufactured by the BurrOJgI'S-\lle11cOO\8 COOlpay, a~rentlY was based cn flawed studies. The studies which demoostrated AlT's efficacy were riddled with irregularities, such as the whiting OJt of informatioo 00 pati9'lt's charts, lack of dOJble-blinding, incorrect data, and unspecified deatl'S, according to ACT UP. In :pite of these flaws, AlT has demoostrated important, clinical bB'lefits. 'ilhat then is holding up the testing ~f.other drugs, many of ~nch.have demoostrated effectiV91ess in European clinical trials? Some protestors expressed hope that a rec9'lt dec,s1oo by the State of Cal,fornla to begin its Q\II) drug testing and approval program WOJld p.Jt pressure 00 the NIH and FDA to speed up their Q\II) drug testing and approval programs. Michael Hirsch of ACT UP said that the New York State AIOS Institute has already begun funding its 00 research project into alternative treatments, and noted, "trbst states have the capacity to do the sarre thing as California.' But he cautiooed that "They aren't going to be able to test drugs the way NIH does." The protest did not appear to have Ill.lch impact 00 the coofer9'lce activities ...... +:+ ..... ++:+ ++:+ ... +:+:+lI. +:+lIlI+ ..... +:+ ••• m. ++. CALIFORNIA PLANS LAROUCHE ATTACK by Alex Mactmald, with tlBlks to the ~ Franciscg Saltinel, 11/6/87 Asmall grOJp of gay activists frOOl around California rret to brainstorm ideas for a strategy to meet the latest assault cn the gay cOO\lll.lnity by the far right. The meeting carre just after agents of ccnspiracist Lyndcn LaROJche filed petitions with California's Secretary of State to place another LaROJche quarantine initiative 00 the ballot. Right-wing Rep.Jblican U.S. Coogressman \IIilliam DannaTeyer submitted another ballot proJX)Sal to the California attorney g9'leral as a preliminary to a petition drive which would place Dannemeyer's initiative on the ba llot. Pau 1 Boneberg, wI'o attended the meeting repres9'lting tIobilization Against AIOS,described the flOOd of the meeting as angry and depressed. Boneberg says that a conS9'lSUS was reached 00 one ess9'ltial point: the gay cOOIlIJnity Ill.lst take the off9'lsive on AIOS and stop spending its resOJrces in fending off attacks. trbst of those att9'lding the meeting worked in the fight against the first LaROJche initiative, PrOJX)Sition 64. Like Proposition 64, LaROJche II WOJld mandate the enforcement of public health laws, which are now enforced at the discretion of public health officers. It declares that AIOS, which physicians regard as an infectious disese, is actually a cootagiOJS disease, a code word for 'transmissible by casual ccntact. H California voters voted ovef'ltlhelmingly to reject PrOJX)Sitioo 64 in November, 1986, 71% to 29%. The Oannemeyer initiative WOJld mandate tracking of sexual partners of persons wI'o prove to be HIV antibodY-JX)Sitive. It will also strip the p.Jb lic of SOO\8 of the medical confid9'ltia lity guaranteed by present state law. In submitting the initiate to the attorney g9'l8ral's office, Oannemeyer seeks ooly clarificaticn of its language so that it will be properly legal and 9'lforceable. A petitioo drive will follOrll. Giv9'l the ease with which LaROJche picked up over 700,000 signatures for ProJX)Sition 64, there is little reasoo to believe that the pres9'lt effort will fail. The initiative will appear cn the ballot in November, 1988 for the presidential electioo. Going on the offensive in opposition to hoIlDphobic and AIDS-hysteria-inducing legislators, Northern California activists Ralph Payne along with 8aneberg are discussing a set of AIDS initiatves under the spCJlsorship of the gay cOOlllJnity. Serre of the prOJX)Sals they are coosidering include a bood issue for facilities dedicated to research and treatment of AIOS, tax credits for any mooey dooated to AIDS research and increases of taxes 00 cigarettes and tobacco to help finance AIOS research. The tobacco tax appeals especially to gay and AIOS activists, apart frOOl any effect it might have in inhibiting the use of that toxic substance, because it strikes at the cigarette manufacturers and heavily S1,Jbsidized tobacco farrrers wI'o bankroll right winger Ca'1gressman Jesse Helms' JX)litical career. Boneberg believes that the cOO\lll.lnity's avera 11 respoose should C9'lter 00 demands for massive increases of research funding for treatment. "\lie can de-fang the bigots,' he says. 'Let us be for treatment; let them be for bigotry.' Other rreasures considered at the meeting included p.Jblic relations campaigns and civil disobedi9'lce, bJt no cons9'lSUS had be9'l reached. *****' +:+ tt ..... tt. m +tt .mutt •• m+:+ +... +:+:+lIu .. ***** PAGE 6 * '!HE OFFICIAL NE\!ISLETTER OF '!HE NCGSTOS * 'AlJE 8:4 * WINTER, 1987 ***** ••••••• I I ...... ** •• ** ••••••••••••••••••• I ...... I ...... 1 ...... I •••••••• ** ...... PUBLIC AIDS HOSPITAL canpiled by Johanna Stayva, with thanks to ~i~ Qdtlir.~, 7/2/87 The U.S. Ar~f agreed June 12 to turn over its Richmond District hospital faci~ity to make way for the first public AIOS hospital in the nat~cn, according to San Frar.c~sco's ~ Area Reporter. The 350-bed facility could open by summer, 1988. U.S. Senator Pete Wilson (R-GA) has bee:1 instrumental in the effort to get the Arrrry to re ~ inquish the hosp~ta 1. Arrrry Secretary John Marsh finally agreed to tum over the building to the federal ~Jblic Health Service, which will either lease or give the building to the city of San Francisco. Wilson said he will include a $15 mi~lion authorization for the physical conversion of the building in the amnibus AIOS bill he plans to introduce in the ~.s. Senate. ~**"*****************'**'**'** CORPORATIONS POLICIES ON AI:DS by Jocr\ Ihyle, with thanks to the btQ1'S ~ CamUlity NarIs, 10/4-10/87 Nationa 1 Gay Rights Advocates (HeRA) has released a study which identifies the policies of major U.S. corporatiCJlS 00 AI05-re lated issues. ~ican ~rat~ Poli~: AIOS and ~~ surveys 'Fortune 100' anployers. According to New Works News of Indiana, the areas surveyed inc luded mandatory HIV testing, medical benefits and anp loyrnent discriminatioo. Sixty-seven percent of the respoodents prohibit AIOS related discrimination. CorporatiCJlS that responded included: Citicorp, Chevron, Bank of .America, OJ Pont, Westinghouse, Trans_rica, and GTE. The 34 page report lists the individual responses as \11911 as a summary of the total. Cammts and excerpts of the policies of diffeent corporations are also included. Copies may be obtained for $15 per copy fran: NGRA, 540 Castro St., San Francisco, CA 94114. ***"*"* **'* ***** ••• **"*******"*"* ••• ** ...... **. u **. **. BROT'HELS, FREE OF A.NT·ISDDY with thanks to ~roit's ~i~, 11/11/87 After 18 mooths of required screening, not one woman \IIOrking in any of Nevada's 37 legal brothels has shown signs of infectioo with the AIDS virus, according to L.arry Mat!-eis, state health administrator. He said 8 wanen who appl ied for jobs as prostitutes showed signs of infection and were not hired. The state began requiring monthly blood tests in May, 1986. Most brothels forbid high-risk s~Jal activities such as ana~ intercourse and all require the use of condoms. ****"******** *. ****'** ******************************* MISSILES FOR AIDS by l.oJ Chibbaro Jr., with tlBlks to It! Washi~oo Blade, 12/11/87 Representatives of gay Jewish groups and a Miami gay activist who called for the United States and the Soviet Unioo to forego missiles for AIOS research pra;;rams \ll9re amoog the thousands of protestors who descended 00 Washington furing the visit of Soviet leader Mikhail &:lrbachev. Aspokesman for the War ld Calgress of Gay & Lesbian Jewish Organizations said at least 36 gay and lesbiam Jews joined the Dec. 6 march and rally for Soviet Jewry, which drew sane 200,000 people. While gay Jewish representatives joined in solidarity with Soviet refusniks, Miami gay rights leader Robert Kunst brought a giant banner to Lafayette Park across fran the White House, which declared, "Canmit 10 missiles each to cure AIOS nOlI, or else it's ;nfa~.' Kunst, one of the activists who battled hanophobe Anita Bryand in the 19705, said he sent letters to President Reagan and Soviet General Secretary &:lrbachev asking both leaders to eannark the cost of 10 missiles each to AIOS research pra;;rams. Each of those missiles- MXs or their Soviet equivalents cost an estimated $180 million. Kunst distributed copies of a letter he received fran the Soviet minister of health, which called 00 scientists and health agencies of both countries to ·unite to solve the main problems of mankind, suC;h as AIIX3 ... ." Ott'er nenbers of the protest included nenbers of gay Jewish congregatioos fran Washingtoo, New York, Philadelphia, Detroit, and Chicago. Participants carried bamers identifying tt'srselves as gay Jews and chanted and sang Hebrew songs, 'to great attention and applause." ...... *•• *...... II *••• ** 11 ••**"*"*"*"*"* *. ** ***** ** ••• AZT GOVrT PAYOFF DISCOVERED! by ClY'is 9.111, with tlBlks to btoo's ~ CamUli~ NarIs, 12/13-19/87 D.lring the course of filing suit against the government for failing to test and license nullel'OUS pranising AIOS drugs, National Gay Rights Advocates (NGRA) discovered evidence of what might be CCJlSidered a 'pay-off" to a government agent::'i by the makers of the ooe AIOS drug currently approved. According tothe HeRA, 9Jrroughs-\!/ellcane, the makers of fllT, recently 'donated' $55,000 to the Natioal Cancer Institute. The sane day the "dooation" was made, the FDA granted filrroughs the exclusive rights to market fllT for 7 years- even dwght he patent on the drug expired nearly 10 years ago. According to the NGRA, a doctor at the NCI, SaneJl Broder, claims to have asked 9.Irroughs for the $55,000 to support his II«lrk. A prescriptioo for m costs nearly $10,000 per year. AltOOJgh the canpany says it has spent roore than $80 million to develop the drug, many AIOS activists believe the drug is so highly priced because th eFOA has refused to license drugs manufactured by canpeting canpanies. According to NGRA legal director Leonard Graff, the filrrrughs 'donatioo' violates Executive Order 1122 "Standards of Ethical Conduct for (X)vernment Officers and Employees,· which prohibits g6lV9mment anployees fran accepting" anything of mooetary value' fran any persoo or corporation that is associated with the agency. AIOS activists told ~ Ccmruni~ News the filrroughs 'donatioo' is evidence of the systanatic exc lusioo of new drugs and treatments by the mainstream medical and scientific cOOlllJl1ities. Large drug canpanies such as filrroughs benefit fran 'favoritism" fran the FDA and NIH because they have high-level coonectioos there and because they have expertise inthe highly technical and canplicated drug testing-and licensing process. CCJlS~tly, pranising alternative drugs are relegated to the underground IIlOV9IOOI'lt. . :tJk**It**~ *t:jJk*************'"'''''''' ...... ***** THE OFFICIAL NOOLETTER OF THE NCGSTDS * VOLUME 8:4 * ItIINTER, 1987 lI< PAot::. -f ~'" +JI~+JIJIJI~~*,m**,*******~+JI*~~ PLAGUES AND PEOPLE with tlB'lks to ~IEOJS~, Sept.~., 1987 [The follOiling quotatien -fran ~ Magic &Jllet by Allan M. Brandt-- \liaS posted in large type en tre OJtside \llall of tre Judson MeIrorial Church in New York City, August, 1987.J " ... CAUGHT IN THE COMPLEX WEB OF SOCIAL AND SCIENTIFIC QUESTIONS SURROUNDING AIDS ... THE HIGH MORTALITY ASSOCIATED WITH AIDS AND THE GROWING NUMBER OF CASES COULD BECOME THE JUSTIFICATION FOR DRASTIC MEASURES. 'BETTER SAFE THAN SORRY~ COULD WELL BECOME A CATCH PHRASE TO JUSTIFY-DRAMATIC ABUSES OF HUMAN RIGHTS IN THE CONTEXT OF AN UNCERTAIN SCIENCE ... ITS ASSOCIATION IN MUCH OF THE PUBLIC EYE WITH VIOLATION OF THE MORAL CODE COULD CONTRIBUTE TO SPIRALING HYSTERIA AND ANGER WHICH HAS ALREADY LEO TO THE DOUBLE JEOPARDY OF LETHAL DISEASE AND SOCIAL OPPRESSION ... AIDS WILL BE A MEASURE UPON WHICH WE MAY CALIBRATE ... OUR CAPACITY FOR JUSTICE AND COMPASSION.- REAGAN J R __ VS. __ REAGAN SR __ with thris to The \!IashingtlJl B1ad!, 7/31/87 Ron Reagan, Jr., tre 29-year-old sen of President Reagan, told reporters in Los Ange les t~.at he thinks scxre of t!-e Reagan administratien' s policies on AIDS are 'foolish: and that re has given his fatrer 'a lot of flak" en tre subject. Reagan Jr., who recently appeared in an AIDS documentary entitled AIDS: Changing the ~Jles, criticized his fat!-er's administration's officials who favor limiting sex educatien in high schools and telling students not to have sex until trey are married, according to tre San Francisco ~ ~~~ Repor~~. Reagan Jr. said re will encOJrage the ~"esident to W6tch tre documentary and said re has had several discussiens with his father cencerning AIDS. ******+lIlI ++ *'* •*********** +*'* *'* *m ** ••• ***********" CO-OP WELCOMES PWAs canpiled by Johanna Stoyva, with thanks to Chi~ ~lines, 7/9/87 Acting on the advice of a gay man and his lover with AIDS, the Cambridge Food Cooperative has started offering free membership to peep 1e with AIDS, according to Boston's ~ \IIind~. Information and a free manbership card are sent to P\IIAs, for wt-ar. tre $5 membership fee is \llaived, as is a $150 investment requirenmt. P\IIAs srop at regular member prices-12% off the shelf price. _ The t\110 and a falf required mcnthly \IIOrk ho..trs are \llaived for members who are unable to \IIOrk. "\lie \llant to provide people with AIDS with heathful food and nutritional supplenmts at good value prices and also to offer them the less tangible, but very important, benefits of membership in a friendly, supportive organization,' explained tre co-opts general manager. *"***********'***********" ******************** *'**** GOVERNORS ON AIDS with thanks to Detroit's Cruise, 9/9/87 A task force of the Naticnal (1Jvernors Associatien unanil1O.lsly approved a policy staterrent call~ng AIDS "t!-e natioo's ~umber 1 illblic health problar.: The ccmnittee calledfor a "natienal educatioo and p~eventiOl1 program' with an emphasis en ca.:nseling ya.:ng peeple before they become old enOJgh to contract the disease, transmitted thra.:gh sexual contact and IV drug abJse. The federal government, the c:rrrnittee said, "must take the lead on a naticnal AIDS educatioo campaign" and federal assistance should go to state and local governments and ccmwnity organizatioos. "Although this an era of tight federal bJdgetary ccnstraints, the seria.:sness of the problem calls for an increased federal investrrent," t!-e statement said. "r.'.anyof the standard policies and canfortable W6ys with which we've dealt with other things just don't \IIOrk on this issue," said Gov. Thanas Kean (R-NJ). T!-e panel sidestep~ tre issue of whet!-e~ testing should be mandatory or voluntary, a tOJchy subject because of civil rights and privacy censideratior.s. ***" •• ~********** AI:DS. T-HE MUS.I:CA.L with thanks to New york Native, 7/27/87 I I Tt-eatergoers in London, who have in tre past seen hit musicals based en cats, trains, chess pieces, and Plantagenet trOJbadors, will find a new musical in too soon, entitled MDS: Tre r.tJsic~. Tre productien, under tre auspices of the Lenya Hobnoobs Theatre Canpany, pranises to be "a musical extravaganza with asta.:nding stage techniques, looking at the media treatment of the AIDS issue," according to The National ~ (T!lI), a British mcnth ly. The productien is reported to feature a cast of 40 performers, and a plot abo..tt th."ee protagonist~-;;ca~9htCp in the morass of moralism, political rivalry, and threats to civil liberties until one of them --a gay man-- begins to take actiQ1 to stop the trend." The theater canpany has been developing tre mus;ca 1 ;n \IIOrkshops over tre past few mcndlS, and says it is nO\ll ng;jotiating if,6 th larger theater venues to move tre shOll. According to TNG, tre Lenya Hobnoobs Theatre Canpany is named for the R.Jssian-born lesbian poet -3:',~ Playwirt-;;Jt who fled her native land when Soviet Premier Josef Stalin began his bloody purges of Soviet society. Prior to that, Hobnoobs ~ad written distinctly lesbian poems and plays, sane of which were published in the legendary revoluticnary ja.:rnal Noyy Lef. ,...... ".. , ... "" ...... "', .'! "'.".. ._._._._0_._._._._ ...... _._..... -- --- ***** PAGE B ~ lHt Urrl~lAl Nt~lt"tK Ur 'Nt N~I~ ~ VULU~t ~:4 ~ WiNTER, 1981 ~ ********************1I<***1I<***************1I<***********************"~:m •• :+JI:+:m*******,,,,*************.+JI:m.~***+:m~****,* EMPLOYMENT OPPORTUNITY: CL:I: N:I: C:I: AN Experimced, highly-rrotivated physician assistant or family nurse practitioner is wanted for a progressive, expanding AIDS team in major medical cmter in Brooklyn. Posiiton includes OJtpatimt care of poople with AIDS and AAC, patimt and realtrcare \tKJI'ker education, sara admiistration, and possibilities for research. Strong skills :n gmera 1 adult outpatimt medicine required. Experimce in assessment and/or treatnEnt of HIV disease, training or experience in educaiton, and organizational abilities preferred. MJst be able to obtain New York State registration prior to emp1oyrrmt. Salary is definetely canpetitive, with a full benefits package. Please send C.V. to: Sl-eldon Landesman, fttl, SJNY Health Scimce Ca1ter, 450 Clarkson Av., Box 56, Brooklyn, NY 11203 (718/735-1054), ask for Al Oppermam, Manager, or Peter Berge, PA-G. ***** .... ***~ .... m.**********'* •••••• CONTEST: RUMOR VS_ REALITY by Kim Westehirner, with thanks to &men's ~ ~ity News, 7/19-25/87 Acolor television, micrONave ovms, and Reebok sneakes are among the prizes that will go to tl-e wimers of "frutoor vs. Reality,' an AIDS risk-reduction contest. The contest is sponsored by Spectrum, an AIDS education organization for the Washington OC black camunity, and Alianza, an organization providing similar services in the city's Latino carmJnity. ~mor vs. Reality is the latest in "a series of innovative and successful projects by Spectrum and Alianza that take cultural considerations into accOJnt in providing AIDS education. These fact~~s include: black and Latino gay/bisexual males are not likely to idmtify with tl-e gay carmJnity; absmce of an idmtified black or Latino gay neighborhood; and the re1uctance of black and Latino IV drug users and prostitutes to use Washington, OC's primary OJtpatient AIDS clinic due to its designation as a 'gay" clinic. In addition to distributing AIDS education literature, tl-e organizations have produced television and radio pJblic service annOJncements for blacks and Latinos, coordinated safer sex Kfone party' programs, delivered "street-based,' person-to-person OJtreach and provided in-services, speeches and training sessions to governlOOl1tal agencies as well as civic grOJps. Participants in the ~mor vs. Reality contest enter into competition by correctly ansering basic questions abOJt tl-e illness qnd prevention. According to contest organizers, tl-e drawing will be I-eld in conjunction with "fun, games and up-to-date information on how AIDS is affecting the black and Latino cc:mrunities." ***+JI~~""'~"**'."* PETS FOR LOAN TO PWAs BY SF SPCA with thanks to ~ With AIDS ~ fran Shcrrt:i Project & SF AIts Fa.rdat;ien, ~, 1987 TI-e San Francisco Scx:iety for Prevention of Cruelty to Animals is offering to provide people with AIts the companionship of a variety of animals on a part-time basis for individuals who do not wish to CAtI1 or maintain an animal of tl-eir CAtI1. They will make tl-e animals available to interested indivicLals for a few InJrs per week or will bring tl-e animal to a person's fone for a short visit. Sara of tl-e animals available through this program are dogs, cats, chinchillas, rabbits and even a fighting cock (as in rooster)! All animals participating in this program are certified safe by tl-e SFSPCA veterinarian for handling by i~ised people. FOR m INFmlATI~: Ken 'llhite, Education OepartnEnt, SFSPCA, 415/554-3065 or 554-3000. EMERGENCY PATIENTS & HEALTH WORKERS Astudy of critically ill arergency room patients at Baltimore's TI-e Johns Hopkins Hospital shows that a significantly high proportioo are infected with the AIDS virus, ~tmtially increaing the exposure of the virus to rea1th care \tKJI'kers who may not fo11011 recOOllB1ded infection Cootrol tecmiques. Trauma patiE!'1ts aged 25 to 34 were seven times more likely to carry antibodies to HIV than the gmeral popJ1ation, according to the study. HIV infection in the U.S. is estimated at 0.8%, while the Hopkins team fW'lCl 6% of the trauma patients were infected. 'This higher rate may reflect the inner city 10ca 1e of the hospital and the socioeccronic characteristics of the patimts,' says James L. Baker, MD, instructor in emergency medicine at The H=Joms Hopkins Sctm1 of I's:!icine. 'Our results indicate that the risk of exposure to HIV may be greater than previcusly recognized during resuscitatioo of critically ill arergency patients." Baker cautions that tl-ese results do not necessarily apply to otl-er anergency patients eitl-er at Hopkins or elsewl-ere. Another study suggests that Baltimore may have a greater number of HIV infected poople in its popJlation than other comparable cities. for example, HIV antibody testing of U.S. military recruits through Oecanber, 1986, slDs that 0.48% of Baltimore's recruits were infected, while 0.37% of those in tl-e rest of Maryland and 0.15% in tl-e nation carried antibodies to HIV. 'Unsuspected infection with tl-e AIOO virus anmg emergmcy patimts may be nuch greater than realized and a nuch greater risk to perscmel than we t!nJght,' Baker says. "Those realth care profesionals who do not follOll infection control measures are increasing tl-eir risk of acquiring the infection.' Health care \IKlrkers may not fo llCAll infection CO'ltro1 recanmendatiO'ls, such as wearing gloves, goggles or other protective cothing, because they perceive the AIts risk as remote or may be unfamiliar with the precautiens, suggests Baker. He said that wI-en caring for bleeding patients, whether suspicioo of HIV infectioo exists or not, infection control precautions slnJld be used by all E!IIeI'QEIlCY department personnel and prelnspital care providers such as paramedics, ~lice officers and firefighters. TI-e AIts virus can be fCllnd in different concemtratiens in blcxxl, tears and saliva, which emergency personnel fr~t 1y encounter while caring for patimts. TI-ere are several doclllmted cases of rea lth care \tKJI'kers who have becara infected with HIV after sticking themselves with needles and otl-er cases were transmission \lias determined to have been "by repeated ungloved contact with infected blood, secretions for excretions. The Hopkins study-examined blood fran 203 anal;ms patients age 15 or older who required emergmcy care during a 100-day period in 1986. Twenty 910%) admitted or slnrled evidence of intravenOJS drug abuse, b.rt: "this inf~~tien did not prove statistically significant or clinica lly useful in determining which patiE!'1ts were more likely to be infected,· Baker says. Of the 203 patients, six (3%) were infected with HIV. All were trauma patients (approximately 6% of tl-e 107 trauma patients). Five had gunshot or stab \IOJnds. The sixth was injured iOn a traffic accidmt. Five were male and five were black. T\IKl had a history of intravenOJS drug abuse. TI-e study appears in tl-e May 15 JOJrnal 2f tl-e American Medical Association. ***** TIlE OFFICIAL NBrlSLETTER OF TIlE NCGSTffi * VOI..l.tE 8·4 * \l/INTER 1987 * PN;f. 9 ***** ** ...... U*** ...... ••• w*-••••• ; ...... ~*"~ •• w ... ~ ...... ~~ ...... *•• ~ HERPES SUI:T by Lori Ks1schaft, with t~ to btlJ'l'S ~ Camuli~ News, 12/13-19/87 A man wl-o allegedly transmitted geni ta 1 herpes to a \IIOman may be sued for llO"Ietary damages, a Ci rcui t Cwrt judge has ruled. The sui t c~tends that the man had a duty to abstain fran s8)QJal cmtact, to warn his partner a!:nJt his herpes, and to use a cmdan, according to the Ch1cago Sun-Times. The \IIOman is asking $1 million in damages. ************.*m.** .. ***** •• ~.********~* •• *. AIRLINE REFUSES TICKET DUE TOO AI:DS by Char les Linebarger, with thirlks to til! New Yor~ Native, 9/28/87, 10/5/87 Northwest Orient Airlines refused to sell a ticket to til! nation's capital fran San Francisco to Leonard Matlovich, a Vietnam war hero and person with AIffi wto wisl'ed to attend the ~tober March on \l/ashingotn for Lesbian and Gay Rights. Representatives of the local news media watcl'ed as ticket clerks and supervisors for the airlines explained to Mat10vich that it is til! airline's IXllicy not to fly ~p1e wro are believed infected with HIV, til! SCM:a lled 'AIffi virus.· Mat10vich went to San Francisco Intenationa 1 AirlXlrt to ruy a ticket aboard the airline after l'earing a!:nJt Northwest's discriminatory 1Xl1icies. A representative fran the airline said that Northwest's 1Xl1icy tOollard PWAs is that anyone with AIffi has to supply tl'em with a certificate filled out by a doctor stating that the PWA is medically allO\lled to fly .... and are non-infectious and [have] no malady which might cause distress or inconvenience to other passengers. According to Benjamin Schatz of til! National Gay rights Advocates, the airlines may be guilty of violating federal law, the Air Carriers Act of 1986, which bars discrimination against ~le with pIljsica1 handicaps. Northwest finally agreed to eliminate all special ~irements for passengers with AIffi, after consulting with attorneys. Jean O'leary, executive director of NGRA, said, "This is an imlXlrtant victory, especially since we were able to accanplish our goals witlnJt resorting to a lengthy lawsuit. It's unfortunate, tn..oever, that it took the threat of litigation to convince Northwest to adopt a IXllicy which slnJld have been obvious in the first place. Any airline which discriminates against passengers with AIffi is not only ignoring the medical facts, it is violating federal law, and NGRA is fully prepared to go to court to stop tl'em." North.olest's new guidelines state that, "based on advice fran our medical consultants, the HIV or AIffi virus is not contagious in casual cmtact. Norttllest will not dey passage to a person with AIffi." The guidelines stress, rowever, that passengers with AIffi wto also have other conditions such as tuberculosis, for which medical certificates are normally ~uired, will be treated in a manner identical to others with those conditions. *** ...... ~ ...... ** ...... *** ••••• ** ... ** MASSACHUSETTS INVESTIGATES GROUP abstracted fran an article by Mark Perigard, with thanks to btlJ'l'S ~ Wincbls, 12/3/87 The Massacrusetts Senate and House of Representatives both considered motions calling for investigations of allstate money spent on Alffi education materials and aimed at the \IIOrk of bton's AIffi Action Canmittee (Me), which has cane under fire for the production and distrirution of s8)QJa11y explicit brocrures. The House overwhelmingly favored creatilJ'l of a joint legislative cannittee for such an investigation. The Senate overwt-elmingly rejected a similar call, I-a.oIever rather than dying, the bill will go to the Senate's \l/ays & l'eans Ccmnittee Itotere it could either die, or be re!X)rted out favorably. For the current fiscal year, the state allocates a!:nJt a quarter of Me's bJdget, $712,000. MC did admit an error of $699 for the printing of an brocrure targeting men involved in s/m, rut reimbJrsed the state wI'en the mistake was discovered. Me Executive Director Larry Kessler predicted that if the legislature does order an audit of the agency, they will be pleased by what tt-e:/ discover. 'Tt-e:/'ll be astooisl'ed by the number of people we reach in terms of the services we provide. I'm not afraid of any investigation," Kessler statoo. Senator Michael Barrett, a supporter of Me, said tl-e braJrere over tl-e first brocrure "was an attempt to discredit the gay rights bill,· which was recently discussed. "TI-e issue was raised by people wI-o believe with their l'eart and soul that being gay is bad,' he added. Copies of the safer sex pamphlet were mailed to nearly every state legislator by Joseph Stanton, a physician seeking to kill the gay rights bill. Senator David Locke made the use of sexual1y-exp1icit pamphlets an issue on the Senate floor wI'en he stood up during the debate with a copy of the brocrure and claimed that passage of the bill \IIOU 1d only further the militant hanos8)QJal agenda. \l/aving the brocrure, he said, HIt nOlI appears the taxpayers are subsidizing in effect, the battle to promote hanoselQJa li ty . " *... ~~ .. *••• *.*w~ •• *...... w...... ~.**~ 1969 TEENAGER AIDS CASE FOUND by Lori Ks1schaft, with thanks to btlJ'l'S ~ Camulity News, 11/29-12/5/87 Evidence that a teenager died of AIffi in 1969 indicates AIffi may have sporadically existed in the U.S. before the current epidemic. According to the New York Times, the teenager, identified as Robert R., appeared at a clinic in 1968 with a variety of conditions, including S\IIOllen lymph nodes. for the next 15 months, he suffered fran exhaustion, weight loss, and severe chlallfidia until he died after a !:nJt of bralChia1 ~ia. U!X)n autopsy, he was found to have widespread internal Kaposi's sarcana. Dr. Mem:lry E1vin-Lewis, a ch1allfidia specialist, requested that tissue samples be frozen because sll! had been fascinated by his strange illness. These tissue samples have now been sOOotn to contain antibodies to the HIV virus and the P24 viral protein. Robert's doctors believe that he engaged in hanos8)QJal anal intercourse, a1tlnJgh Il! never cmfirmed or denied this fact. They also report that he had never travelled outside the St. Louis area. According to Richard Rothenberg, an epidemiologist at the COC, because the HIV virus is difficult to transmit, continued existence requires a large IXlJll1ation of susceptible individuals. Rothenberg said this case indicates that the virus may have been introduced into the U.S. several tines before it encountered a popJ1ation that could support it. *******.w •• *.~ ••• w~~.w************** ***** PAGE 10 * 'THE OFFICIAL NEWSLETTER OF 'THE NCGST~ * n1)E 8:4 * WINTER, 1987 ***** ***. m. m m •• ~ ••••••• " •••••••• " •••••• ~ •••••••••• t: •••••••••••• "~ •••••• "~~ t:m ••••••••••••••••••• 'JI~ •••••••••••• t:t** ••••••••••••••• ID FOR AIDS~ VICTIMS BLAMED with thanks to Chicago's ~ ~ TillES, 8/20/87 Sixty percent of Alrericans surveyed in a recent Gallup poll responded favorably to til! idea of persoos carrying til! "AI~ virus' being made to carry identificatioo crds, and 45% say that persoos with AI~ 'have ooly themselves to blame,' according to a report fran til! Alrerican Institute of Public Opinioo. TI'e poll asked if persoos with AI~ sl-oJld be treated with canpassioo: 7B% of til! reslXl1dents said, "yes,' and 7% said 'no.' lilt 60% said 'yes" \IIhen asked if persoos carrying til! AI~ virus sl-oJ ld carry an lO, as opposed to 40% who said 'no." Asked to respood to til! statellSlt, 'f\h;t people with AI~ have ooly themselves to blame,' 45% said 'yes' and 13% said 'no;" 42% said they tl-oJght AI~ \lias "llJI1istllSlt' for lIOI'al decline, while 43% said they did not. TI'e poll also asked if PWAs sl-oJld be allO\lled to live in til! carmJnity; 48% said "yes,' 29% said "no." en til! issue of whether employers sl-oJld have til! right to fire people because they have AI~, til! margin \lias 43% against such right and 33% in favor if it. 'Evangelicals and those with less than a high sctml diploma are far rore likely to blame victims for incurring til! ailment and to view til! epidsnic as llJI1istllSlt as pJnistllSlt for roora 1 dec line," til! Gallup report noted. ***t:t." •• ~"' •••• "JI *************. m"~. m m SEROCONVERSION=ANTIBODY P~S TO NEG! with thanks to tt-e Pasadena (Califomia) Star-News, 6/3/87 Five ~ally active men who tested antibody positive to til! AI~ virus inexplicably last all signs of infectioo 6 to 18 nmths later, til! director of tt-e MJltiCenter AI~ Cohort Study (M4CS) at tt-e Natiooal Institutes of Health reported. TI'e 'reverse serocooversioo" suggests t\110 possibilities: til! virus can run its crurse, or tt-e virus finds a way to hide in cells, Dr. Michael Polis said at tt-e 3rd Internationa 1 Cooference 00 AI~ in IrIashingtoo, OC ...... " ...... tt:t:...... m .. t:t .. . TESTING BY MAIL? by Marc Stein, with thanks to Ibstoo's ~ CamlIlity News, 9/27-10/3/87 Til! Septsnber issue of til! Saturday Evening Pas~ offers readers free HIV testing thraJgh til! mail, according to til! Advocate. Til! Past will not I-o,.,Iever, irmaliately give respoodents tll!ir results. People who take til! test will be asked to cootact a local doctor, pastor, or counselor me name will be sent to than. After contact is made, til! reslXl1dent will be given her or his test results. Officials at til! Centers for Disease Cootrol are reportedly coocemed because test results will be sent back thraJgh til! mail. TI'e Past urges readers to use false naRES when mailing in blcxxl samples. Past pJb lisher Cory Servas is a nsnber of tt-e president's Natiooa 1 AI~ Carmissioo. ** ...... ~ ...... +=+=+**. "**m m ANTIBODY-POSITIVE PLASMA STUDl:ED by Lisa Keen with thanks to The WashingtCJl Blade, 8/28/87 Researcll!rs in London and Bronx, New York, have begun clinical trials on a form of AI~ treatment which involves injecting people with AI~ with specially processed plasma fran people who test positive. Called 'passive immunity,' til! treatment is based on til! theory that til! antibodies against til! AI~ virus may be able to Il! lp fight til! virus in some people with AI~. Jack Snyder, senior vice president for Medicorp, Inc., a Canadian-based biomedical canpany which manufactures til! treatment, said that 35 people with AI~ are being tested with the treatment at the Bronx Veterans Admistration Hospital and another 35 at a London hospital . • "U.U •• ~~ ... UU .. U •• 4C ••~ .... U.~~ ••• H1V TEST1NG W1THOUT CONSENT SUIT by Lori UI'OI, with thirlks to Ibstm's ~ CamlIlity News, 10/18-24/87 ARe:lding, california man is suing Shasta General Hospital for illegal HIV testing, patient dumping, illegal disclosure of coofidential medical information, destruction of evidence, and infliction of snotiooal distress. Til! man, referred to as Join Doe, states that despite his objections, he was teste:! for HIV when Il! entered til! ha;pital for hemia treatment. Acording to til! 1984 AI~ Confidentiality Act, medical personnel are not permitted to test for HIV witl-oJt til! coosent of til! patient. Doe claims that Il! \lias refused treatment after Il! tested positive and then received no referrals fran his doctor. Doe's attorney, Alice Phillipson, blames California Attorney General Join Van de ! Til! Eastman Kcxiak Canpany will soon begin marketing til! first tests that will permit p/'r;sicians to test patients in tll!ir officies for expa;ure to AI~ and otll!r 5elQJa lly transmitted diesases, according to til! New York Times. The tests, marketed under til! name 'Sure Cell, • will be available early in 1988. Kodak officials said with til! new tests tll!re IrWld be no need to wait for lab reports. TI'e results of til! tests IrWld be knorn in 3 to 15 minutes. Til! tests cootainspecific proteins, and were developed in partnership with Cetus Corp., a biotechnology canpany that is based in Emeryville, California. . ! ...... ' " ! I ! , , I ...._ ... '-l-._._._ ...... _._._._._._._ ...... _... !. ***** THE (fFICIAL NEWSLETIER OF THE NCGSTffi * VOUJrtf 8:4 * \IIINTER 1987 * PAGE 11 ***** **** .... I I I III m I m +1m ••• *r ••• U.I<****** * •• mll ...... I IlIlIlI+. mi ...... lIlIlIlI ...... m****** MlIlIlI ...... ; ****lI .... lI. mm ..... rm+ +. +..... +********* TESTING ~ITHOUT PROFIT? by Joan !byle, with thanks to 8a;tCJl'S ~ ~i~ ~, 10/11-17/87 Tre ~atiCJla 1 Gay Rights Advocates (NGRA), a San Francisco-base:! pJb lic interest law firm, has amOJnce:i a prCYJram to combat rrmey-making HIV testlng centers. Since IlI:lny free testing clinics have waiting perioos of up to seven weeks, numb3rs of people have gCJle to private clinics ~ich offer. irnrediate service.. NGRA's prCYJram inc~udes passag: of legislatiCJl which \IIOJld expand tre number of not for profit testing S1t~ and WhlCh \IIOJld regulate prlvately-run centers. Those who wlsh to IlI:lke a fast-buck by exploiting pJblic fears and running shoddy testmg centers must be IlI:lde to understand that trere is a doo side risk to profiteering," said NGRA executive Director Jean 0' Leary. Sre cCJltinue:!, ·Those politicians who are clamoring for IlI:lndatory testing are conveniently over looking tre fact that we can't even handle tre delll:lnd arrmg those who wish to b3 teste:! va luntarily" . ******~~+lI***************+lI*** HIV ANTIBODY: NEW PREVENTION? by JEI'II'lie t'ct A pair of researcrers from HOJstCJl'S Baylor College of Medicine have discovere:! an antibody which trey say prevente:! transmissiCJl of tre AIDS virus from infecte:! cells to realtlTyr cells in tre test tub3. Drs. Nancy and Tse Wen Chang have develope:! a preparation calle:! a rrmoclCJlal antibody which, in tre test tub3, targets cells infecte:! with tre AIDS viruses and also appears to attack tre virus itself, according to tre Imtros~ Voice. This targeting ability is important, since PJ.T, tre only fe:!era lly-approve:i treatment for AIDS, also affects realtlTyr cells, causing side effects. .\IIe must emphasize that this cannot be calle:! a cure for AIDS and that any treatment of patients base:! on OJr findings is probably at least t\110 years away,· said Nancy Chang. ·My applicatiCJl for huIlI:ln treatment must be considere:! very preliminary.· Tre Changs must nO\ll test tre antibody's effectiveness on HIV-infecte:! rulll:ln blocxl cells in th etest tub3. If these tests, which are expecte:! to take several rrmths, are successful, tre research team wi 11 seek appprova 1 from tre FDA to test tre preparatiCJl on people who have AIDS. Dr. Joseph fl!elnick, who chairs Baylor's virolCYJY and epidemiolCYJY department, aid that Chan'gs discovery is 'perhaps 1000 times more potent, perhaps even more so, than any antibcxly that is krJa,.n abOJt until this time in being able to neutralize tre virus." u ...... I .....lI •••lI ...... +MlIlIlII I Ilrt...... 1JIlIlIlI mm RANDOM~ ANONYMOUS TESTING I: N NY by Rick Harding, with thanks to !!! Washi~ Blade, 8/7/87 New York State realth officials will test over 100,000 hospital patients for antibody to HIV without tre patient's knO\llle:!ge, annOJnce:! Governor Mario CUomo. Tre study will give rea lth officials a better understanding of how tre virus has spread and wretrer it is still confine:llll:linly to knoo high-risk grOJps- gays and IV drug abusers. According to State Health Commissioner Dr. David Axelroo, tre tests will be performe:l CJl blocxl specimens of hospital patients who will not b3 told that tre test is b3ing CCJlducte:! on treir blocxl or results of tre test. He said that performing the tests without informing the patients is not unethical because there is no effective long-term treatment for AIDS. According to realth department officials, the program, which is the largest study of its kind, will begin early in 1988 and take 6-12 rrmths to complete, and will cost $3.4 million. Asimilar study being conducte:! by the federal Centers for Disease Control is testing abOJt 3600 specimens per year. ORTHOPEDIC SURGEON WANTS. T·EST·I:NG by Nadine t'cGm, with thanks to Chi~ OJtlines, 12/10/87 Dr. Lorraine Day, the chief of orthope:!ics at San Francisco General Hospital, has annOJnce:! that a11 elective surgery patients in the pJblic hospital's orthope:!ics service will b3 asked to take an HIV antibcxly test, the ~ri~ Medical ~ reports. Day made her statement the day after hospital officials disclose:! that a realth care \IIOrker who accidentally pJnctured his or rer thumb with a nee:lle from an patient infecte:! with AIDS. San Francisco General is internationally knoo for its five year old AIDS unit. Its positim CJl antibcxly testing IlI:lY set an example for other hospitals; its decisiCJls are significant particularly because many of tre hospital's patients are indigent and may not be able to go elsewhere for a second opinion or care. Day, who has aske:! other department memb3rs to folb her policy, also believes plTyrsicians should take tre HIV antibcxly test, and stop performing surgery if trey test positive. sre says that patients who elect not to take tre test will still receive treatment, but possibly will not be given surgery. "On emergency patients, I'll operate .... On elective patients, I want tre hospital to come to grips· with deciding when and if it is appropriate to operate, sre said. • I want people to face tre fact that this is a new ethical problem for us. Yoo can't just tell us, 'YOJ took tre Hippocratic Oath and YOJ have to do this.' It's just not that simple. OJr lives are at risk. I want OJr rea lth and safety to be part of the ~uation in deciding whether a patient gets the operation." General surgeon \IIilliam Screchter, mD, chairman of the hospital subcommittee preparing guidelines on perioperative transmissim of HIV, who considers Day's decisioo pranature, said re "assumes every patient is infecte:!' in accordance with the hospital's infection control policy that urges \IIOrkers to take blood and bcxly fluid pr~autions on every patient. Screcter believes that liTre oottom line is that if YOJ dCJl't want to operate m HIV infecte:! patients, yru shouldn't \IIOI'k rere." Orthope:!ic surgeon Leonard Simpson, who practices at t\110 otrer San francisco hospitals and does not ask patients treir antibcxly status, note:! "Illhat's important is not whetrer a persm is HIV positive, but whether treir immune system is compromise:!. In patients with AIDS or~, there is no question that trere is a compromised ability to fignt infectioo, which plTyrsicians must always consider in deciding on an appropriate coorse of treatment." By taking a thoraJgh history and doing a complete physical, ~ said, any problems with tre immune system is likely to be discovere:! . ••••• •.•.• _._._._._._._'-._..... _.-.<',."",! 'oL ...... ~ ***** PAGE 12 * lHE (fFiCIAL NE\IISlETTER (f lHE NCGSTIS * VCl.lJ!E 8:4 * WINTER, 1987 ***** • ++ + + 401+ ++ + + + *lIll. ++ m 401+ *401 •• 401 •• +~ •••••• m** +•••• *** •••••• 401401 ••• *** m *. ********** 401 m II •• I ••• I I. 1••••••• 401 •••••••••••••••• 401* ••••• MOBILE AIDS TESTING by IhJg Hinckle, with tlalks to Ttl! \rIashi~al ID.~, 8/7/87 Cory Servass, a nanber of President Reagan's natirnal AIlS ccmissirn and forller editor of tt'e ~turday Evening Post, had tt'e Post's trailer outside tt'e U.S. Capitol acting as an 'AIlS ftlbileHoffering to provide tt'e antitxxly test to anyme win wanted it. Joining anti-gay Crngressman William DannelleY8r (R-Galifornia) at a press calference inside tt'e Capitol, Servass said AIlS antibody tests should be crnsidered as routine as a cl'olesterol test. Ratt'er than test people at obviously high risk, said Servass, win gave as examples pe:>ple win engage in Hfisting, rimming, and water sports," st-e seeks to test people wl'o are at relatively low risk and likely to drnate blood. Tt'e Dameneyer press cooference was intended to daTmstrate support for bills rn mandatory testing and crntact tracing, and ott-er activities, which DannelleY8r has introduced. Also at tt-e press calference was 74 year old tax activist Paul Gam of Sacramento, wro recently revealed that t'e has AIlS. Gann has also been involved in anti-1Jay activities, leading a failed effort to repeal a Sacramento gay rights bill in 1986. ~******** ****************m *1 *****" *. *•• FOOT'BA,LL PLA,YERS T'ES,T'ED with thanks to Detroit's Cruise, 9/2/87 The Houston Oilers and tt-e Dallas Cowboys are tt'e first National Football League teams to test players for AIDS al a voluntary basis durir~ t~ai:;i:;g ::am~. Coi..+:CfS s;:ckesman [}Jug Todd said the testing is confide:1tia 1 under California state law, and the results rrust go directly to ~ designated physician, which in this case is one of the team doctors. About 95% of the Cowboys veterans wl'o reported to camp agreed to be tested, and aba.:t 80% of the rookies have beer. tested, the Dallas Times Herald reported. Todd said the test requires a Calsent form signed by the player before tt'e training camp physical, [=D NOTE: -They agreed voluntarily, without duress, ehh??!!!j *",****************************IlIl4OII' I ~**IlIl4OI PREMARITAL TESTING with thiJlks to ~ Mlines, 10/8/87 Tt-e October 2 Journal of tt-e Ailerican Medical Associatirn states that mandatory premarital screening for tt-e HIV virus is a "relatively ineffective and inefficientuse ~ ~es· because of tt'e low prevalence of infectirn in tt-e populatial that \IO.Ild be tested. Ttl! study, reported by Paul D. Cleary, PhD of tt-e Harvard Scl'ool of Mlic l-ealth, and colleagues, also indicates that premarital screening in tt-e U.S. \IO.Ild cost rrore than 100 infectirn individuals \IO.Ild be told that they were probably not infected, and tt-ere \IO.Ild be rrore than 350 false positive results.' Tt-e authors \lll'ite that while detectirn may pranpt behavior changes in SOlIe cases, this benefit is deceptive because tt-e virus \IO.Ild already have been transmitted in serre couples during pre-marita 1 sex. Furtt-errrore, while detectial may reduce tt-e number of HIV-infected infants born to tt-ese COJples, screening \IO.Ild prevent rnly about half tt-e number of potential such births. Tt-e report notes that premarital syphilis testing. cited as a precedent for HIV testing, has "seldan identified previously undetected cases,' and tt-e autlYJrs coosider it an example of a universal screening policy 'abandaled primarily because [it has] not effectively served tt-e pJblic gcxxl.' Such testing accounted for about 1 percent of all positive syphilis tests in 1978, for example, and cost an estimated $800 millirn dollars. Tt-e autl'ors ca 11 tt-e widespread belief that mandatory testing is a way to stop tt'e spread of AIlS a 'mistnderstanding of tt-e epidemio 1OilY of HIV infectial and tt-e performance of diagnostic tests." They note that "tt-e rrore resrurces we devote to such marginally effective ventures, tt-e fewer resources we will have to develop truly effective pJblic l-ealth programs,' and that testing programs should "be motivated by an ana lysis of tt-e epidemiologic facts ratt-er than a resprnse to po litica 1 pressures, and such policies should be part of a I1IJ ltifaceted, natiCJ1\llide program to reduce" HIV transmissial. They suggest that 'pJblic educatirn, cameling of individuals, and discretialary testing can be important too 15 in reducing tte spread of HIV infection. ~ ...... ,. ... ** ..... m •••••••• ,. ••• ,. •• *4OI ...... 4OI.4OI BLOOD AIDS ANTIBODY TESTING EASI:ER Asafe, fast and inexpensive iletl'od of testing blood for presence of antibody to HIV has been developed by investigators at Sa ltirrore's JoI'ns Hopkins Scl'oo 1 of Public Health. Tt-e iletl'od offers an effective and efficient means of mass blood-testing in developing natials, tt-e developers say. The procedure uses drops of blood fran a pricked finger collected on filter paper as an alternative to blood drawn fran a vein in tt-e arm, greatly simplifying blood-testing in countries ....rere sterile equipment and properly outfitted laboratories are not readily available, says Hanayoo1 Farzadegan, PhD, assistant professor of epidemiolOilY at tt-e Scl'ool. Tt-e tecmique is also valuable for testing infants and intravenoos drug arusers in tt-e US from wt-om it may be difficult to get blood samples from tt-e arm. 'Collecting blood specimens rn filter paper generally is suitable for large-scale screening and for epidemiologic studies,' Farzadegan nots. 'Tt-e dried samples are light, easy to store or mail, and cannot be broken or spiled. They also take up little space.' Tt-e iletl'od curra1tly is not used in tt-e U.S. because of tt'e readily availalbe equipment and testing sites, t-e added. thee tt-e finger or heel is pricked, blood is collected al filter paper and dried. A I'ole pJl1ct-er is used to cut a disc from tt-e paper, which is placed in a solutial of p/mpl-orous and ,saline to recrnstitute tt-e blood, which is therl tested for presence of HIV antilxxlies. ELISA tests of blood and filter paper specimens sfn"led no difference in detecting antilxxly. lilly Amilitary judge has ruled that the Arnry's IXllicy of banning AIDS test results fran military proceedings takes precedence over current Department of Defense (000) IXllicy which all(lf.; the use of test results in sane cases. The ruling was made by Col. Raynmd Cole in court~rtial pr~eeding; of a soldier on trial for having unprotected sex while knO\llingly he carried the AIDS virus, according to the San Fra~clsS2 Examlner. The Dept. of the Arnry letter of February 1986 says that the results of the AIDS testing may not be used in military actlon," said Cole. 'This case is frozen, the situation is frozen. Any new regulation that canes doo the road will not apply to this case.' The Army charges that PFC Adrian tIorris, 27, shO\lled "wanton disregard for hJman life' by having sex with two wanen and a man without telling them he carried HIV. MEDICAL AIDS CURRICULUM NEEDED by Lisa Karl, with thanks to Th! Washingtm Blade, 11/13/87 Despite AIDS activists' pleas.to address the epidemic as strictly a medical problem, it can't be done, said nationally knoo AIDS expert Dr. June ~born .. Osborn, Speaklng to a conference of the Association of the American Medical Colleges, said that the multitude of ethical questlons whlCh. surroun~ AI~ .makes it . iffilXlSSib le to treach medial students only about the health issues of AIDS. Noting the ongoing deba:es over patlent confldentlahty, the rlght of sex partners to knO\II a patient's antibody status, and the refusal of sale doctors and hosPltals.to treat people with AI~, O:borne said i~ is iffilXlr~ant for medical schools to expand their curricula and their "teaching time" to help medlcal students deal nO\ll wlth lSsues they wl11 face flrst-hand later. 'Adding a couple of hours on retroviruses won't do it,' said Osborn. ** •••• *** ••••••• *•••• *•••••••• **.***.* •• **.*~ ...... ETHICAL STATEMENT BY AMA by Lori Ks\schaft, with thanks to Ibrtal's ~ <'mnuli~ News, 12/13-19/87 The American Medical Association (AMr\) has declared it is unethical for doctors to refuse to treat peep le who have tested positive for HIV. ;" This statement \lIaS made amid reports that a few doctors had turned away people with AIDS, according to the ~ Tribune. The statement i read in part: 'A person who is afflicted with AIDS needs canpetant, compassionate treatment. Neither those who have the disease nor those r~ ~ who have been infected with the virus should be subjected to discrimination based on fear or prejudice, least of all by members of the health care camllli~.' ******* .... *" *" •• *" **~. *" •• *" *"***** •••• *" *"~ DOCTORS STILL UNINFORMED ABOUT AIDS by Lisa ItWJllwgh, with thanks to lb! ~hingtm Blade, 11/6/87 Peep le with AIDS in Car lifornia may not be getting the right diagnosis because doctors there often do do not know the S)11lPtans of HIV infection. Investigators in the Dept. of Medicine and Scx::iology at the University of Ca lifomia at Los Angeles conducted a statewide survey of 1000 doctors and found that nore than falf their sample could not identify the signs of HIV infection, did not routinely take note of their patients' sexual histories, and \ll9re uncanfortable about counseling patients who are gay. These findings may reflect the situation nationwide, the survey said. The ~l' Area BeQQrter a San Francisco Gay newspaper, quoted Dr. Charles Lewis, lead author of the UCLA survey, as saying that 65% of the doctors in the sample did not inquire about their patients' sexual orientation, thJs failing to identify those at risk for HIV infection and losing a chance to counsel them about hO\II to reduce their risk. Q, ly 44% knew !lOre than three S)11lPtans of AIDS related canplex, Lewis said. He also found that only about half the doctors durveyed \ll9re willing to take steps to educate themselves more thoroughly about AIDS. Doctor's discanfort in treating gay patients 'constitutes a major barrier to the provision of optimal care,' Lewis concluded. Dr. Jeffrey Kelly at the University of Mississippi headed a similar survey of 500 doctors in tthree mid-sized cities representing urban areas that have noderate but increasing numbers of AIDS cases. Doctors were asked to read profiles of an AIDS patient and a leukemia patient; these diseases have similar medical characteristics. Kelly found that the AIDS patient elicited "much harsher attitudes' fran doctors than the leukemia patient. The doctors surveyed considered the AIDS patient more responsible for and deserving of his illness, nore deserving of quarantine, and less deserving of sympathy than the leukemia patient. ******** .... *" ••••• *" ~. **** *"*** ~~ u. **" READERS OF PEOPLE WOULD l:NV'l:T"E PWA. I by Rick Harding, with thanks to lb! ~shi~ ~lade, 7/24/87 I .~ lt~gh readers of Peoe le ~~zine cc:r.sider AIDS the natim's \IIOrst ;>rob lam, a !lI3jority ~ ld "at fear irwiti"g a person with AI~ to their !"one for dinner. ft.rocr.g 1000 peep 1e who responded to t!-e magazine's readers' survey, 28% said AIDS is the ":rost seria.:s national ;>rob 1em" ! with home lessness caning second with 26%. 85% of the reslXlndents said they do not know a person with A!~. A1though t!-e number of peep 1e ! who \llQUld invite a person with AIDS to dinner in their rare was da..n fran 60% in 1986, 51% of ~l~ readers stil: \lIQUId extsnd the invitatim; Readers under 25 and over 55 were least likely to invite a person with AIDS into t!-eir home aild peep1e with nore educatic:r. were :rore likely. 58% of tf!e readers said they do not believe that "AIDS is God's Illnishnent for imral behavior." 25% said t!-l3t it is. Again, those with nore education \119."9 mosre likely to discount t!-e pJnisrment theo.... y. The p:l 11, which was tabulated by Audits and Surveys" Inc., was Illblished in t!-e !lI3gazine's July 27 editim. ~ PAGE 14 * lHE OFFICIAl NOOLETTER OF THE NCGSTOO * IJCllJE 8:4 * WINTER, 1987 ***** +lIlI+.*lI** ••••• *lI ••••••••••••••• ~ *lit •••• t: •••••• 4c4:t:IlI ••• >1<*** ••••• *lI ••••••••••••• ++lI •• nll. W ••••••••••••••••••••••••••• *lIW ••••••••••• ** HIV INFECTION RATE DOWN I:N SF by Nadine MjJcm, with thlrlks to ~ Mlines, 12/3/87 David \fIerdegar, MD, San Francisco director of p.Jblic health aMOJI'1ced that over the past year, fewer than 1% of gay and bisexual men in three major San Fracisco study grrups have beca!e infected with the HIV virus, according to the A«erican Medical News. The department of health held a C01ferEYlce Nov. 4-7 caled 'Health Department Leadership and Camunity Response," attEYlded by 1500 nalical and health leaders. The conferEYlce was designed ·so the rest of the nation need not go thrrugh all we have, and that the lessons we learded can I:.e applied· in other camunities, said \fIerdegar. He called the department's II«lf'k a 'stll1lling success story.' At the same time, ~, an estimated 35,000 San Franciscans are ttnJght to I:.e infected with the virus. Therefore, while the rate of new infection has decreased dramatically, the number of new AlOO cases fran earlier infections is expected to renain at 1200 to 1300 each year throogh 1993. In addition, because it is still unclear how far and how fast the disease will spread into heterosexuals thrrugh IV drug users and female sexual partners of bisexual men, the runber of new infectios may C01tinue to rise anmg these grrups. ~*****",*****lIlI.' ** .... *...... u ••••• **u** HIV FINDINGS PRESENTED ccxnpiled by Johanna Stoyva, with thanks to Chi~ Mlines, 7/9/87 9r. KEYlneth Mayer, research director for the Fenway Ccmrunity Health Center reported recEYlt ly on the findings of a study funded by the Massachusetts Department of Public Health of HIV infection in gay and bisexual men involving rore than 300 subjects, according to Boston's ~ lI'indO\llS. According to Mayer, rectal trauma increases the efficiency of the virus. The study, which began in January 1985, has I:.eEYl ~nable to show whether drugs or sexually transmitted diseases make it easier for the virus to establish itself in a person's immune system, but Mayer refused to discrunt their role. "Everyone expresses themselves so differEYltly,· he said. "It's not like we are studying one ;~festyle. These factors are so variable." Thase with more than 11 partners who EYlgaged in receptive anal interCCllrse were 28 times rore 1ike ly to I:.e seropostive for the HIV than those who engaged in no anal intercrurse, he said. The data on seroconversion fran negative to positve for HIV due to receptive oral contact is inconclusive, he said. \\'hat IlXlSt motivates peep le to change their sexual I:.ehavior, he said, is their perceived susceptibility for AIDS. Other considerations the study has borne rut, include the perceived severity of AIDS, informational act~vities and peer pressure. "Crunseling for safer sex is the key, not [knO\lling] test results," he said. "Antibody testing by itself is not a meaningful aptitude changing tooL" *~~*********~********"'***** OLDER MEN WITH HIV by Stepllllie Poggi, with thlrlks to btoo's ~ ~i~ News, 8/2-8/87 Older men with HIV antibodies are likely to develop full-bloo AlOO mroe quickly than yoonger men with HIV, according to researct:e': a~ the University of California at Berkeley and at San Francisco. The new finding comes fran a study done of AlOO cases anmg gay men lmng.,n an area of high AlOO incidEYlCe in CEYltra 1 San Francisco. The team of researchers say that other factors such as use of poppers and a ~,story of sexually transmitted diseases also playa role in older men's development of the disease. As of Septeml:.er, 1986, 12.4~ of men \fI'th HIV antibodies in the high incidEYlce area had developed AlOO. &It only 5% of infected men aged 25-29 had full-bla.r.n AlOO, wh,le 20% of .those aged 35-44 had developed the disease. The scientists suspect that age at time of infection may partly determine tw well a ~n's ~mmune system can fight off AIOO. They also noted that the men aged 35-44 QEYl9rally had more extEYlSive use of ~ and a IlXlre extEYlSwe hlStOry of sexually transmitted diseases, specifically gonorrhea, syphilis, and amoebic dYSEYltery. The older men \filth AlOO had not cootracted HIV any earlier than the ywnger men. Researcher James \l/iley, co-director of the Survey Research Center at U.C. Berkeley, can I:.e reached at 415/642-3086 for more information . •••lIlI •••lIW ...... **lI .. *lIu*'...... *lIlIlI ...... u NUMBERS OF THOSE I:NFECTED with thanks to ~ Mlines, 11/19/87 The General AccOJl'1ting Office, a CIJlgressiooal watchdog aQSlCY, said based on estimates canpiled by the \!/orld Health Organizatioo, 5 to 10 million people have I:.eEYl infected with HIV, and the number CClIld reach 100 million in the next frur years, according to Asscx:iated Press. the (l4() said however that the future of the virus carro.rt: I:.e accurately predicted for reasoos including health officials' and sciEYltists' lack of knowledge abCXJt patterns of sexual I:.ehavior, as well as their uncertainty abCXJt the effectiVEYl8SS of prevsltioo programs. ~while, the Reagan Administratioo is reportedly attempting to scale da.r.n the estimated numbers of AIOO cases in the U.S., according to the Chi~ TribJne. The \!/hite HCXJse is \Io\Tking on a report that will revise oo..nward the runber of those people infected with HIV, previously predicted fran 1 to 2 million. The new nl.lllbers CClIld I:.e as 10\11 as 300,000 and as high as 1 millioo. The decrease is allegedly based onthe fact that the disease "is not spreading beymd the existing risk grrups and a small range just CXJtside-sex partners of intraVEYlous drug users and so forth,· said IJle Public Health Service officia 1. (), Cktober 30, the \!/or ld Health Organizatioo (W-tO) reported a 3.5% increase in AIOO over the previCXJS rrmth, reported United Press Internatiooa 1. The ClIIIJ lative total of reported cases as of Cktboer28 waS 62,784, up fran 60,653 00 Sept. 30. 126 countries reported cases. hjercy officials cautilJled that the actual total is probably twice the Mber of reported cases. Officials estimate that half of the cases CCXJnted since 1981 have resulted in'death. Thee were 48,591 cases in 41 countries in the Americas, 7477 cases in 27 European CClJIltries, 5830 cases in 36 African COJIltries, 678 cases in frur cMtries of (keania, and 208 cases in 18 nations of Asia. The U.S. accaJ1ted for 42,354 cases, or 67.5% of the total number of those reported. ~~**lI***lI~*W+lI"" THE OFFICIAL NE\l/SLETTER a= THE tmTIE * 'v'ClM 8:4 * \IIINTER,' 987 PAGE 15 ~ 1: N F ECT" I au S,N ES,S, OIF H 1: V' LES,S,EN ED with thanks to Detroit's Cru~, 11/11/87 !:XJtcn researchers have fOJnc a way to make the AIlE virus ~ess infectiOJs by the L:se of drugs, ~~!~~§ magazine !"epc!"tad. The g~itis~ monthly scientific magazine said it was sti~l unlear whether the process would be of use to AIDS sufferers OJ: it wa!"rantee further !"esearch. Laboratory tests at the University of A~tercam showed that certain chemica~s altered a protein produced by HIV prese1t in AIDS cases. Tests with two of the most effective inhibitor drugs-- narred as dNM and castanospermine -had i'esu~ted in HIV becaning less infectiOJs and had produced no side effects. T"EENAGERS WI:T"H HIV I:NFEC:T"I:ON .. with thanks to tl'e AIlE ~, May, 1987, a billalth ly pJb licatim of tl'e AIre Respmse PrctJram of Orange CoJnty, Ca hforma; thanks also to tl'e La; ~ Ti~, 4/26/87 tlere than 1300 California teenagers have tested \XlSitive for antibody to tl'e AIlE virus, according to state l-ealth officials.wOO warn that teenagers are a particularly vulnerable grClJp. TI'e Tines Trim of Palo Alto reported :hat Ra1 ~~lin, field services coordlnator for the Califomia [ept. of Health Services AIlE Testing Program, said 1317 teenagers were antlbcdy \XlSltlve between June, 1985 and January, 1987. Of trose, 19 have so far been diagnosed \tIith tl'e disease. ~ •• m•• m... ~.~ ...... m"'1"~**I**U':'** INSURANCE ANALYSIS BY" HA,RV'A,RD LA,W with thanks to Chicago's ~~ £i~ Tines, 6/25/87 Natiooal Gay Rights Advocates, a public interest law firm, has announced that Benjamin Schatz, director of its AIDS Civil Rights Prcject, has had an article pJblished in the ~arvard Law Review, the nati:n's most p~estigiOJs lega~ jOJrnal. The article :itled "The AIDS :nsur~nc~ Crisis: Underwriting or Overreaching," provides a legal and ethlcal analYSls of two approaches cammon~~ ~sed by ,nsurers to ~vold ~.DSl related expe1ses: sexual orientation discriminatioo and HIV-antibody testing. The article takes a crltlca 1 look at the ecooom,c and I ega , justifications for these practices, examines relevant medical and legal precedents, and concludes that both p~act~ces end~nger public health and increase discrimination against groups which are already ostracized. Reprints of the article can be obtalned by sendlng $5 to NGRA, 540 Costro St., San Francisco, CA 94114. '~"**"*)'~It:.m~~lI*'~*IlI)"lI'lI'~'~',*,* INSURERS EXISTANCE T'HREATENED with thanks to ~, 8/31/87 Tre cost of Alre-re1ated deaths to U.S. life insurance firl15 CClJ1d total $50 billim by tre end of tre century and threaten tl'e solvency of many companies, says tl'e first major study of tl'e disease's effect on tl'e industry. Tre study, ccmnissioned by tl'e Society of Acturaries, reports that annual costs for life insurance clail15 for AIre will rise to $7.5 billion by tre year 2000 and acCCJJnt for 14% of all individual and grCIJp c1ail15 filed. Projections are based on figures from tl'e federal COC, which suggest that 15% of tt-ose infected with HIV develop tre syndrtm! after 5 years, and up to 36% afte 7 years. last year tre inckJstry paid CIJt $200 million in such clail15, or 1% of the $20 billion total in clail15 settled. Tre nunber of c1ail15 for the disease tre industry is seeing nOlI/ is barely tre tip of an encrl\OJS iceberg, says Michael COIIIell, coautt-or of the study and vice-president of tre \IIorchester, /t1assacrusetts-based State Mua1 Life Assurance Co. of Anerica. To CCJJnter tl'e financial impact of tre c1ail15, says Calle", companies are likely to start increasing tl'eir reserves, which most probably will nEaI1 an increase in rates; re expects that IImt companies will absorb tre costs not coovered by tre increase. Callell warns, ~, that tre rurden is not falling lI1iformly on all companies and trose that see AIUS c1ail15 rise to nore than 20% of treir total CClJ1d face seriCIJS solvency problens. rre society will use tre study to lobby for tre right to test life insurance applicants for tre syndrome ...... m •• ~m.~.m~~~ ...... ~ ••• ~.~m INSURANCE COMPANY OFFER by Kim IrIestreiner, with thanks to bton's ~ Camuni~ ~, 7/26-8/1-87 \IIhy not let me insurance coopanies :-efuse to pay up in situations where a po ]icy t-o lder dies with MUS, ARC, or "coop lications of AIlE," asks Benjamin Lipson in a Bostoo Globe co1unn. Policyre1ders 'lire doo't want to fall under tre aoove exclusioo cCIJld just "su!:xnit to a blood test for the presence of the [HIV] antibody.' Lipson, wOO is an insurability coosultant, says his proposal cCIJld end the cootroversy brClJ9ht on by Massachusetts' new plan to allOll/ HIV testing of applicants for life and disability insurance. Lipson is sure his plan \llClJld be met with pleasure by the insurance industry: "Insurance companies then \llClJld return to their pre-AIUShysteria blood profile guidelines, These did not include testing for the AIDS antibody. Specific testing r~uirments varied from insurer to insurer and depe1ded on tre applicant's age, allOJnt of insurance applied for thad prior medical histories that may have included gClJt, diabetes, elevated crelesterol and otrer abnormal blood chemistries. Aform of competition \llClJld return to the life insurance industry as underwriters could waive or r~uest the different tests." Furtherroore, Lipson surmises, his pro\XlSal would help deter the spread of MUS: "\IIhat better deter rant could an individual have for avoi.c!ing tre type of behavior that CCIJ ld be responsible for cootracting AIDS than by knOll/ing that if he or she became infected, their life insurance \IICIJ ld be void upon death? \llhat better educational technique CCIJ ld the federal government develop with the minions of dollars at·its disposal than the knOll/ledge tre insurance pclicy!-older would have that acquiring ArCS would mean the loss of his or her life insurance coverage?" ~.~****~~.****** ***** PAGE 16 * THE OFFICIAL NBr/SlETIER OF THE NCGSTOO * nIlE 8:4 * WINTER, 1987 ***** ***'" 1 *lI1. 1 I I WI I *lI •• 1:*lI. ~ *lI1. ***' It m, 1:11 I •••• 1 •• 11 ••••• ' •• *lI1 1 1 I I. I ••• ***'. 1 •• 1 •••• I •• WI ••••••• *lI •• 1t ..1 I ••••••••••••••••••••••••••• WI REACTION MIXED TO NEW COMMISSIONERS I7y Peg &Jrm, with tllClllG to Tt-e Washi!Y;ltCn Blade, 11/13/87 Presidmt Reagan's strife-riddm AlOO ccxrmissien is backed up to 13 members with tl-e appointment of a drug abJse expert fran Brooklyon and a l-ealth official fran Oregen. Critics of tl-e beleaguered carrnissien, establisl'ed I7y Reagan last sunner, quickly pointEd rut that eva'1 thwgh tl-e new appointees' experimce with AlOO ;s above tl-e norm for tl-e grrup, tt-ey are at best "a mixEd bag." Dr. BB1y Primm, 59, is executive director of tl-e Addictien Research and Treatment Corp. which runs six Brooklyon drug treatment clinics. AUniversity of Ge1eva medical school graduate, Primm, a black is also l-ead of tl-e Urban Resrurce Institute. Primm has expressed ccncern abwt wlBt I-e calls "a great da1ial of tl-e [AIOO] problem in tl-e black and hispanic camu1ities,' and has also criticizEd whites, \111m I-e says are reluctcnt to disruss tl-e problem for fear of offmding minorities. &It some swrces criticizEd Primm. O'le activist expresse:l ccncern abwt Primm's endorsing tl-e sterilizatien of those infectEd with tl-e AIOO virus. Joan Gibbsd, a staff attorney for tl-e Ca1ter for Ccnstituticna 1 Rights, said sl-e hease Primm mdorse such a plan during a recmt meeting of tl-e Brooklyon AIOO Task Force. 'What I-e said during his presmtatien, and I asked him abwt it during a \IIOrkshop,' Gibbs recallEd, 'wasl-e understood some people \llaJld think this is ga1OCide, rut nevertl-eless, his feeling \IIS ... we have to start thinking abwt vasectanies and tubal ligations." Yolanda Cerano, presidmt of tl-e Associatien 'for Drug Ablse Preva'1tien and Treatment, wro has worked with Primm, said it was I-er understanding tl-e doctor opposed teaching addicts tw to sterilize hypodermic neEdles as a means of avoiding infectien. Primm, and tl-e otl-er new appointee, Christine Gebbie, cwld not be reacl'ed for camalt. both were in Florida with tl-e rest of tl-e ccxrmissien truring AIOO treatment facilities there. Gebbie, a nurse and part-time teacl-er at Oregcn Health Science University, is tl-e 44)1ear-old associate director for health at Oregcn's Department of Hunan Resrurces. 'SI-e's a real mixed bag," said Keesten la.riery, a gay activist and assistcnt to ene of Portland's frur city C A member of tl-e Presidmt's AIOO Carrnissien and tl-e chairman of tl-e .Anerican Medical Associatien debatEd at a ccxrmissien meeting whether tl-ere shwld be widespread testing for exposure to tl-e AIOO virus in tl-e gB1eral JX>IX.Ilatien, according to TI-e New York Times. Cory SerVaas, a member of tl-e ccxrmissien and tl-e Editor and IXlblisher of tl-e ~ Evening iUt, said tl-e /IWI. shwld urge doctors to test all of tl-eir patients for exposure to tl-e virus, eva'1 those not belcnging to high risk graJps. SerVaas participated in tre National CmferEnCe on HIV I-e ld in 'Nashingten in NovenI:er that critics charged was daninated by conservatives. art: Alan Nelson of tre /lIlA, said tre organizatien opposed widespread testing because tl-e testing \IIaJ ld be expensive and yield too many false positive results. ANew York Times Editorial against widespread testing notEd that in lOll-risk popJlatiCJls, 89 people rut of 100,000 \llaJld test HIV antibody positive-:-8VS1 ttnJght I-e real incidB1ce \llaJld be closer to 10 rut of 100,000. SerVaas notEd that tl-e testing program currmtly being ccnductEdI7y tl-e ~ense Dept. has had an extremely la,., rate of false positives, b.Jt Nelsen cwntere:l tl-e tests were dcne lI'lder strict ccnditions and that tl-e accuracy rate \llaJld vary widely anmg private laboratories ara.nd tl-e cwntry. Anotl-er member of tl-e ccxrmissien, Kristine Gebbie, criticizEd SerVaas for her ranarks, saying that members of tl-e ccxrmissien shwld not give misleading informatien. *** w, * II * ** **lI *lI ***1:1*** +***:I It+***:! t*t.***, W:I** CANDIDATES GET AIDS BRl:EFING Kl:TS with tllClllG to The Washingta1 Blade, 12/4/87 All 12 presidmtial candidates were g;vm a campaign briefing package in November to I-elp them develop a ·responsible and canpassienate strategy' for dealing with tl-e AIOO epidemic. TI-e package was deliverEd by tl-e AIOO Actien cruncil, a lobbying grwp canpose:l elf more than 300 grrups natienwide. Executive Director Ann ftt:Farrm said tl-e 71-pge package ccnsistEd of informatia1 en tl-e AIOO crisis fran educatien, socia 1, medical, hea lth-care, and po litica 1 standpoints. S/'e said tl-e Cwncil recante1Cls in tl-e package five steps tl-e next .ministratien shwld take, including more support for research programs, an extms;ve educational campaign and legislatien to ~re ccnfidentiality in tl-e use of tl-e AIOO antibody test and prevent discriminatien based en tl-e results of tl-e test. 'No presida1tial candidate shwld be electEd unless I-e or sl-e has a well-formulatEd, scientifically-basEd, respcnsible and canpassicnate strategy for dealing with wlBt is potmtially tl-e largest epidemic of modern times,' ftt:FarrB1 said. According to Norma .Arne Rotha1berg, a spokes\onan for tl-e Co..ncil, tl-ere have bea1 no inquiries or feEdback abwt tl-e packages fran any of tl-e candidates so far. ~*lI:I:I:I*lI*lI****lI:I:I:I*lI:I:I:I****"** ••• *lI ***** lHE OFFICIAL NE\I/SI..ETTER OF lHE NCGSTOO * VOlUME 8:4 * WINTER, 1987 * PAGE 17 ***** •••••••••••••••••••••••••••••••••••••••••••••••• :t:.** •••••••••••••••••• IC ••• ** ••••••••••• ++ •• +•• +••••• +•• +•• ** •••••• ~ ••••••• ** •••••••• **.~ •• ** SUIT AGAINST AIDS PANEL BY APHA with thanks to It! Natiat's Health, (TI-e Official Naepaper of tI-e /Izrer. Mlic Health Assn.), \8:ember, 1987 Tre American Public Health Associatiat (APHA) recB'ltly joina:l six otl-er organizatioos in suing tl-e Reagan Administration. saying tl-e controversial PresidB'ltia 1 Carmissiat at AIOO was i119Ja 11y biasa:! and inexpert. In mid-November, too PresidB'lt nama:! two new members with extensive experiB'lce with tl-e epidemic to tl-e panel which is mandata:! to be 13-manbers. The litigating groops are nO\l/ discussing wl-etl-er to contirue too suit. Patti !?oldman, an attorney with too Ralph Nadar-relata:! Public CitizB'l Health Research Group, which is also suing, said sl-e felt too 1ega 1 case definitely had been a major factor in rroving too Administratiat to appoint roore expert members. Too two new ccmnissiooers are Oregat Health Carmissiater Kristine Gebbie, wI'O has been a major spokespersat at AlOO through tl-e Association of State and Territorial Health Officials; and 8sly Prillm, ft1), a New York expert at drug abuse will has worka:! at too epidemic as it affects blacks and drug abusers. Too suit cita:! requirements of too Federal Advisory Carmittee Act that such ccmnittees 'be fairly balanced in terms of JXlints of view represB'lta:! and too functions to be perforrred.' Too groups' brief nota:! examples such as Carmissioner Dr. Tl-eresa Crenshaw's advocacy of quarantining all AlOO patiB'lts; and statemB'lts of Carmissiater Penny Pu 11B'l wro reporta:!ly accusa:I Imlsexua ls of practicing 'blood terrorism' by deliberately datating contaminata:! blood. Furtl-er, stata:! the brief, 'Hundreds of researcl-ers and tealth care providers have amassa:I a wealth of knowla:lge about AIOO and its effects at individuals and cannunities. Yet tl-ese people have been alut totally axe luded fran too Carmissiat.· Too panel was set up to advise too PresidB'lt 00 all aspe;:ts of too epidemic and is due to report next sumer, with a preliminary report due in December. TI-e Naticnal Acaderrr.j of Sc;B'\ces in its key report of tl-e crisis had calla:! for an advisory panel. TI-e almost continual storm over and batt ling within tl-e ccmnission since its inception this summer has so far resu lta:! in its executive director being forced to resi\7l; and in ~tober, tl-e resignation of too original chair of tl-e Carmission, \1/. Euga1e Mayberry, chief executive officer oftl-e Mayo Fa..ndation in Rocl-ester, Minnesota; and tl-e resignatiat of Dr. Woodrow I+Jers woo is too tea lth ccmnissioner of Indiana and had been spe;:ifically cita:! by the administratiat as giving too panel balance. Otl-er groops involva:! as co plaintiffs include New York's Gay MB'ls Health Crisis and too National Associatiat of People With AlOO, People With AIOO Coalition, National Minority AIOO Council, the Public CitizB'l Health Research Group, and Michael Ca llB'l, a New York City man with AlOO . .... *****" ...... ********* ... m +...... ** m ••• ut REPORT FROM COMMISSION "SURPRISING" by Lisa M. I TI-e White HoJse ccmnissiat at AlOO lavished CQ1Siderable praise at gay camunity groops for tl-eir quick and creative respatSeS to AlOO, and witl"aJt JXlinting a finger at any spe;:ific arEJ1a, CatCluda:! that 'too nuch time has elapsa:! and too many people have become afflicta:! while questions remain lI1BI'1S\tIeI'a:!." Speaking thrCllQh a 25-page "preliminary report," tl-e 13-member ccmnission said it intB'lda:i to fran a number of "review groops," including ate "with expert experiSlCa:!-basa:! information at minority camunities." Although tl-e report did not spe;:ify which minorities would be represB'lta:! at such a review group, ate AlOO activist, wt-o has met with all but one member of tl-e ccmnission personally, says sl-e believes tl-e I1¥JVe is an attanpt to address early harsh criticism of tl-e ccmnissiat's lack of representation fran gay and black camunities. OJrrB'ltly, tl-e 13-manber ccmnissiat includes atly one oPB'lly gay member, Dr. Frank Lilly, and one black member, Dr. 8sly Primm. TI-e preliminary report, which was releasa:l at a press conference at tl-e White liaJse, also at1I'I(lJ'lCa:\ tl-e ccmnission's intB'ltion to investigate 'new drug approval mechanisrrs" at tl-e FDA, as well as non-fa:lerally sJX)nSora:! camunity-basa:l drug trials. "TI-e Carmissiat is c:ateerned," said tl-e report, 'that after 8 years, tl-ere are so few drug tl"erapies available for AlOO and t«, patiB'lts." TI-e report said tl-e ccmnissiat would investigate claims fran people with AlOO that "access to drug development programs is not fast B'lough, that tl-e rmber of differB'lt drugs currB'ltly being testa:! is i~te, and that tl-e government agencies responsible for tl-ese programs have moved too slowly." 1m Itt:FarrB'l, executive director of tl-e AlOO Actiat Cruncil said, 'At tl-e first ccmnissiat tearing, many of tl-e ccmnission members were saying tw amaza:! tl-ey were about tw nuch tl-e government was doing. Now tl-ey're saying, we need more information. The report reflects eateem that not B'lClIQh is being date.' !It:FarrB'l, wro said sl-e has met personally with all but ate of tl-e ccmnission members and has plans to meet with tl-e last ate SOa1, said sl-e believes "many of tl-e carmission members are very aware of criticism" levela:! against tl-e presdiB'ltia 1 study group whB'l it was forma:! in September that tl-e panel lacka:! represB'ltation fran hard-hit groups and fran AlOO experts. !It:FarrB'l said sl-e believes tl-e I1¥JVe to form "review groups' of experts in a number of fields is an attempt to address this criticism and 'do a job that's cra:lible.' Jeff Levi, executive director of tl-e National Gay and Lesbian Task Force, said I-e does not believe tl-e ccmnission intends to p.Jt gays at tl-ose review groups and said I-e was concerned that by praising tl-e storng effort made by tl-e gay camJ..r\ity to address the AlOO epidemic, tl-e ccmnissiat was trying to justify a ra:luca:! government response. 'It's a pleasnat surprise in that tl-ey're stating what's true,' said Levi, 'but rrrt fear is that tl-ey'll say tl-e camunity is doing such a good job tl-e govertl1B1t doesn't nea:I to do anything.' Vic Basile, executive director of tl-e Human Rights Campaign Fund which along with tG.TF and otl-ers lobbies Capitol Hill for AlOO funding, said t-e too, was "ga1E!rally surprisa:i and pleasa:!" at tl-e cannissiat's remarks. "It's surprisingly positive language,' said Basile, a harsh critic of tt-e panel's early make-up. 'Where I thought there was little rope, something affirmative seems to be happB'ling." Basile said I-e was pleasa:l to tear during the White HoJse press conferB'lce that carmission Chairman Admiral James Watkins had added a person with AIOO to the ccmnission staff and anotl-er PWA as a consultant. Basile said, to!ever, that I-e was concerna:l that prevB'ltion was not one of tt-e ccmnission's four priorities. Irmediate attB'ltiat would be focusa:l at four areas, according to tl-e report: 1) determining tl-e incidB'lCS and prevalSlCe of AlOO; 2) finding out "wily tl-ese alternative care settings are unavailable in adequte numbers;" 3) investigating tt-e develO/lllB'lt of new drug tl"erapies; and 4) examining tl-e impact of AlOO among drug and alcoool abusers. In its CatClusiat, too ccmnission report stata:!,' • [b]ecause of too urgSlCy of IIllCh of its work, too Carmissio will not wait until its final reJXlrt to issue recamB1dations.' Instead, too panel intm to release rEmlllS idations through interim reJX)rts between now and when too final report is due next June. "ObviOJsly, tearings and recannB'ldatiats alate will not solve problems of this magnitude, problems which can only be resolva:! by a ~ive national response,' CatCluda:! too report. ***** PAGE 18 * lHE (fFICIAl NOOLETIER OF lHE NCGSTIE * IJ(llIE 8:4 * WINTER. 1987 ***** ...... **** •••• t ••• m ••••••••••••••••••••••• •••••••••••••••••• •••••••••••••••••••••••• PRESIDENTIAL COMMISSIONERS NAMED by lisa Kesl. with thanks to The \!/ashi!1!l!;CJl Blade. 7/24/87 'Nhat earlier looked 1ike a bright stx)t for gay'S in having tre President aptx)int an openly gay persCJl to his natiooa 1 AIlE tarmissiCJl quickly turned dark wher. the full membership of tre carmissiCJl was announced. In additiCJl to former Gay Men's Health Crisis board member Dr. Frank Lilly, the 13 member carmission will include Catholic Cardinal John O'Connor, who has actively opposed gay rights efforts in New York City for year; 111 inois State Rep. Pa-ny Pullen. whc has introduced numerous bills cal:;ng for contact tracing, mandatory testing, and tre removal of all health care workers- including psychologists- fran their jobs if they test positive; and sex trerapist Theresa Crenshaw, who has made a reputation with San Diego gays as being 'very anti-gay: Lilly was robbed by retx)rters follO\lling tre press conference that announced t!-e Carmission's membership. Asked repeatedly about his role as the CJlly openly gay person on tre body, Lilly stated that he ~ld "forcef~lly represent" roth the gay cCXll'llJnity and the bianedical research cCXll'llJnity. Most gay activists contacted about tre 3Ppointments were highly skeptical about what the carmission will be able to accanplish. According to a White House press release, tre carrr.issi:r. is mandated to review current AIlE education efforts and research; "review tre history of dealing with ccxmunicable disease epidemics in the U.S.;" "assess the extent to which AIlE has spread roth aroong specific risk groups and the tx)pulation as a whole;" and among other things, examine funding and drug release tx)licies. In addition to Lilly, O'Connor, and Pullen, tre AIlE carmissioners announced include: Theresa Crenshaw, 3 doctor and sex educator wlm San Diego gays describe as "alarmist" and "pro-testing." Sre was the driving force behind San Diego School Board officials adoption of a tx)licy banning teachers and students with AIlE fran schools. That tx)licy was later scratched. Richard De Va:., co-founder of tre ~y Corporation which sells household prooucts. De Va:. is best knO\IIn as a long-time financia 1 5uptx)rter of the Republican Party. \lkxx:trO\ll r+ters, Indiana State Health Carmissioner. !n testiroony before the Senate Carmittee on Veterans Affairs. Myers, representing the Association of State and Territorial Health Officials, said that antibOOy testing is not necessary for all patients who enter VA hospitals and that "shortfalls in our systems of confidentiality' require tre 'right of refusal" by any patient :lot to take the test. Myers is the only b~ack person on tre carmission. Colleen Con\IIay-Welch, dean of nursing at Vanderbilt Univeristy and a graduate of Georgetown and Catholic Universities in DC. John Creedon chief executive officer of the Metropolitan Life Insurance Canpany and general chairman of the Greater New York BloOO Program Campaign. 8.JrtCJl Lee III, a l*t:Isician at MemJria 1 Sloar. Kettering Cancer Center, specializing in the diagna:.is and treat!le1t of lymphomas. Cory Servass, former editor and pub lisrer of The Sat'~~ ~~~:iQg Pa:.t and current medical director of tre FOU:1dation for Preventive Medicine. William \!/a lsh founder of Project HOPE (Health Opportunity for People Eve~e) and a clinical professor of internal medicine at Georgetoo. Aa!liral James \!/atkins, retired Chief 0+ Naval Operations and former Canmande:" of the U.S. Pacific Fleet. Tre Carmission is chaired by Dr. Eugene Mayb!rry, chief executive officer of tre Mayo Cl inic. COMMISSIONS: CHALLENGER V_ AIDS? by ~ Blizard, with tl'Bllts to TIl! Washi~ Blade, 10/23/87 ANew York Times article contrasted tre resources made available to President Reagan's fla..ndering AIlE CarmissiCJl and those usaf by his highly actlaimed Carmission on the Space Shuttle Challenger actident. The article, written by \l/ashington staff writer Phillip Baffey, juxtapr:sed Space SIlrt:tle and AIlE carmission statistics, dalmstrating that tre AIlE carmission may not be equipped to achieve tre same success of its highly-touta'l predecessor. Noting that tre Challenger panel's task was "RlICh narrO\ll9r and easier, essentially a tecmical and managanent analYSis,' tre article goes on to point out theat tre AIlE carmission's task is roore canplex IxJt has fewer resources at its dispr:sal. Wt-ereas tre Challenger carmissiCJl had a staff of 49, tre AIlE carmission nO\II has only 6 anployees. Tre Challenger panel's bJdget was $3 million, canpared to tre AIlE carmission's projected bJdget of $950,000. Furthernore. tre Challenger carmissiCJl had tre p3rIer to order NASA to perform tests and conduct research; tre AIlE carmission has no such control over any federal agency ...... :t ...... m ...... ** ...... m CONGRESS PLANS O~N A l: DS COMM l: SS I ON with thlllits to ~ Mlines. 8/27/87 Tre U.S. House of Representatives voted 355-68 in favor of a bill introduced by Rep. J. Roy RO\IIland (D-GA) to establish a natiooal AIlE carmission separate fran tre one created by President Reagan. According to tre IrIashington Blade. tre bill stipulates that of tre proposed carmission's 15 members, at least 8 oust be "experts in tre scientific and medical camunities and CJl legal and ethical issues who are specifica lly qualified to serve- by reasCJl of treir educatiCJl. training. or experience." Members are to be appointed by three brancres of tre government: five by tre President, including tre Secretary of Health and Human Services and tre Administrator of Veteran Affairs; five by tre Speaker of tre House, including tlttO reccmJS1dai by the Hruse minority leader; and five by tre President Pro-TE!11\1XX'9 of tre Senate, including tlttO reccmJS1ded by tre Senate minority leader. They are to be chosen within 45 days after the bill is signed into law. The San Francisco Sentinel reports that tre carmission will have $2 million in 1988 to carry out its IlIrpr:se, which is similar to that of tre President's carmission -to make reccmJS1dations on natiooal AIlE policies. In addition to having a full staff for inves~igation and research, tre new panel will hold IlIblic hearings. Tre carmissiCJl's chair will be selected by tre IISIIbers thenselves; tre panel \l/ill be required to make periooic reports, with one full report at tre end of its first year of \IIOI'k and a final report at tre end of its secald. Tre proposed bill is sean by sane as a response to tre conservative orientation of may of tre IISIIbers of tre carmissionappaointed by President Reagan. Rep. RO\IIland's literature prepared in suptx)rt of his bill states that tre new carmission "lOJld not bE! hampered by phil a:.ophi ca 1 differences.' Executive director of tre Natiooa 1 Gay and Lesbian Task Force Jeff Levi said that while tre secalCl carmission \iIOUld be better than tre President's, re is not certain that eitrer \l/ill contrilxJte to tre fight against AIlE. Tre lfIhite House has released a statement opposing tre coomission proposa:! in tre House. ******************* ******. m *••••••• *••• *****" *. ** ***** THE OFFICIAL NE\IISlETIER OF THE NCGSTDS * VOl.IJoIE 8:4 * IrIINTER, 1987 * PAGE 19 ***** *UlI ••• **u.++ ••••• m.***+.+~++IC~+U."+ ••••• ICICICIC+ •••••••••• IC+***** •• *•• 1CICICICICIC**************.~mlC+**UlIIC+*UlI***.** RESEARCH FUNDS CONT'INUED IN C:H IC:AGO Chicago's Howard Brown Memorial Clinic (HBMC) has announced the extension of its largest AIDS research project for an additional four years, Anew contract, recently signed with the National Institutes of Health (NIH), will extend the clinic's participation in the federally funded rulti-ca1ter AIDS corort study (MACS) through the fall of 1991. 'OJr undertanding of HIV infection ahs been greatly enhanced by the contrirution of the participants in the study and the staff at HOC woo have worked so hard ave the past 4 years," said Dr. Jam Phair, principal investigator of the MACS and chief of infectious diseases of Nortl1olestern University foIe!iical School. "019 of the results of this productive collaboration (between HOC and Nortl1olestern] has been the funding by the NIH of a Clinical Studies Program at Nortl1olestem and ~sh Presbyterian which will enable AIDS patients and persons infected with HIV to received the roost advanced therapy,' Phair added. MACS is the largest epidemio logica 1 study in the war ld on gay lifest les and sexual practices and t'CNI they relate to transmission of the HIV virus. The study began in 1984 and has a1 ready yielded uh illljXlrtant data about the spread of AIDS. HOC is one of four health organizations conducting the MACS research, and the only non-university site. The other sites are: Balti!lOre's Jams Hopkins, University of of California at Berkeley, and the University of Pittsrurgh. ~e than 800 nen in the Chicago area participate in the study. They receive a canp lete history and physical examination and series of blood tests every 6 nmths. The MACS project is the largest of several AH~-related studies at HOC, yet a new study funded by the federal Centers for Disease Control has recently begun. Over a half of a million dollars was awarded to the clinic to cover the first year of a 5 year study to evaluate the health of 200 individuals to determine ~ sare individuals infected with the HIV virus eventually cootract the disease while others remain healthy. Participants in the study will be selected from a group of people wro have participated in an earlier HOC research project dating bact to 1978. Frozen blood samples and lledical information frcxn these individuals will provide iJlllXlrtant clues as to the history of HIV infection and AIDS in Chicago. 'Because of the availability of stored blood samples dating back to 1978, we have the opportunity to look for early evidence of many kinds of infections in individuals at risk for AIDS and t'CNI they may interact in triggering the disease,' said Gregory F. Shipman, MO, lledical director at HOC and principal investigator of the study. Chicago is one of three sites chosen for this national research project and is the only carm.mity-based, non-profit organizatioo awarded a grant. Other sites are in San Francisco and Denver. HOC is the largest AIDS research and resource facility in the Midwest. Additionally, the agency provides a variety of social services and support to nearly 60% of the people wOO have AIDS in Chicago. 'OJr ccxnmitnent to both the understanding of the causes of AIDS and the care of people affected by the illness is resolute,' said Jam Charles, president of HOC's board of directors. "\lie are pleased that the COC has allowed Howard Broo to expand our ability to learn !lOre about this disease,· he added. For Itlre Information: HOC, 945 1rI. GED-ge St., Chicago, IL 60657 (312/871-5777). 1CICIC4CIC+ .... +.mu.** ••• *.ut:m.U ..+ .. *IC++t:m+ •• * BALTIMORE HERO LOOSES $400.000 abstracted frcxn an article by Rick Harding, with thanks to ~ lrIasbfug~9} ~l~~~, 7/17/87 The Balti!lOre-based Health Education Resou~ce Organization (HERO) lost nearly $400,000-- or one-third of its annual budaet --in state anc ~ocal contracts, lost its axecutive director, and laid off the director and staff of its satellite office in Montgomery·County. On June 30, just one day before a $353,000 AIDS education contract was scheduled to expire with HERO, Maryland health officials a1nounced that the contract \IJOUld not be reewed rut that instead the education programs \IJOU1d be handled by the state's health departnent. T\IIO weeks earlier, the Montgarery County Health Departrrent declined to renew a $41,000 contract with the group for patient services for people with AIDS. Ir. :naking their anouncement, state officials praised HERO for the \IIOrk the group had done and attributed their decision not to rene\ll t!le contracts to a directive from Governor lrIilliam Donald Schaefer stating that the health departrrent should take a more prominent role inbattling the AIDS epidemic. But Montgomery County AIDS Coordinator Jim Band criticized the group's accounting and monitoring practices. '\lie just didn't know t'CNI OJr money was being spent," Bond said about t!le county's patient services contract with HERO. Several volunteers in HERO's Montgomery County office agreed that the office was extremely disorganized. According to sources at HERO and at the Montgomery County health departrrent, the final straw with HERO's Montgarery County office might have care when the group ordered $15,000 \IIOrth of M&M; brand candy for a fundraising project. Candy sales apparently went much slower than the group had expected and huge cases of M&Ms filled ruch of the goup's office space at the flb1tgomery County health departrrent. HERO board president Dr. Jom Bart lett acknowledged "inefficiency has been a problem" throughout the organization. Dr. Bernard Brar.soo, ~ERO's rredica 1 director who is acting as head of the g~oup's main office in Baltirrore, said he believes the state health department's decision not to renew HERO's education contract was not meant to punish HERO for any perceived inefficiencies in the organization but instead reflects the state's desires to completely reorganize its AIDS programs. Lynette David, a spokes\llOlllan for the state health department, said the state is in the process of creating a separate AIDS unit within the health departrrent and that it will be hiring an AIDS program administrator and a new deputy secretary of health to oversee the new unit. Before HERO was notified of the fuding cutbaCYS in June, 1987, the group appeared to be high on a wave of success. !t had sold thousands of its posters praroting condcxn use, a number of school systems were st'CNIing the group's AIDS education film The AIDS ~~ig, and at the Third International conference on AIDS in early June the group made five presentations ranging fran tecmiques to -edu;ate minorities about AIDS to an eva luatioo of using ex-drug addicts to educate IV drug arusers about AIDS prevention. HERO is now in a "~lding pattern" and is expected to c~ out of the experience strong as ever. Bartlett said the group will search for new sources of fundin;, including corporations, other cities, foundations, and private donations. HERO will try to capitalize on its national reputation he sa~c noting that the group is already doing \IIOrk for the cities of Newark and Chicago. ' , **ICm**lCm***************** **************** ***** PAGE 20 * 1HE OFFICIAL NOOlETTER OF 1HE NCGSTOO * IJ(ll)£ 8:4 * WINTER, 1987 ***** u ...... tct •• m ••• tu •••• u •• **** ...... tctu ••• ****>* ...... u ...... tct ...... A~ARDS TO RYAN & KRIM FROM AAPHR I7y lisa KeEn, with thcJ1ks to TI'S \llashingten Blade, 8/14/87 Caitlin Ryan, of tre National lesbian and Gay Health FOJndation, told tre American Association of ~icians for Human ~ights (AAPHR) that far too few lesbians are ~ognize::! for treir contrirutions to tre gay/lesbian novanent. Sre and Mathilde Krim of tre American FaJndation for AIOO Research (AmFAR) received awards at tre banquet of tre annual AAPHR neetings, a 475 rrember organization of gay/lesbian doctors and medica 1 students. Ryan also criticize::! tre gay camooity in general, saying 'we often attack OJr leaders instead of supporting and nurturing trem.... We fail to support OJr social and political institutions ... [and) ... fail to challenge OJr sexist and racist biases and fears.' Pierre ludington, executive director of tre San Francisco-based associatien which was fOJnde::! 8 years ago, said reaction to Ryan's speech was 'overwrelmingly pa;itive' and that sre received a standing ovatien from the 100 people attending the banquet in Minneapolis. Ryan was given an award by the association in recognition of her IIK)rk as an e::!ucator and professional trainer on gay health and Ami-re late::! concerns. Before joining tre staff of Whitman-Walker, Ryan heade::! the AID Atlanta service grOJp. She currently serves as a board rrember of tre National lesbian and Gay Health FOJndation and is ."o,.king on the final ana lysis of a nationwide survey of lesbian health nee::!s. Sre also serves as a consultant on the Intergovernmental Health Policy Project for state legislators . • • • • •****** ... ************** *. tct tct tct ****. *tct****+:**** CHICAGO UPDATES COMMUNITY Chicago's Howard Broo Me!lDrial Clinic spcnsore::! an 'AIOO Up:jate," a SUIlIllary of information from the Third International AIOO Ccnference in Washington, OC. Tre saninar was cospcnsore::! by Gay and lesbian AIOO Scientists (G!JS), and feature::! medical, scientific, and psychosocial developments. 'Tre purpa;e of the meeting was to share the information we learne::! in Washington with those in the caTIllJ1ity concerne::! with AIDS-relate::! issues,' said Bob Rybicki, HOC's director of social services and one of tre panelists. Other panelists include::!: larry Falk, PhD of Ab!xrt:t labs; Tom Klein, MD, forner medical director of the Clinic; and Greg Shipman, 1«), the Clinic's current medical director. tct •••• :u .. m ....**:t:tu ... **** ..... tct:t ....*** •• u,. LABOR AGREEMENT RATIFIED AT CLINIC with thcJ1ks to Tre Center News, of the los klgeles Gay & lesbian Carm..nity Services Center, July/~, 1987 After three days of exchanging proposals, neetings in caucuses and drinking lukewarm coffee, negotiations between tre GlCSC and the Hospital and Services Employees Union (local 399) came to a close. A tentative agrearSlt was reached en all issues, su~tly f'SlUiring ratification from Center anployees in the bargaining unit and Tre Center's Board of directors. In 1984, amidst low staff llDI'ale and ITlJltiple staff concerns, The Center negotiatie::! its first bargaining agrearSlt with a three-year duration. Harmering oot the first contract was a difficult process. This year, with the gramdl«lrk laid three years ago, 'negotiations were less difficult' according to Rose Hodges, loca 1 399 &Jsiness Agent. Tre ease in which negotiations occurred this time is attrirute::! partially to the streng ccntract that was negotiate::! the first time and also to the good relations that have remained between the Unien and Tre Center. Responding to the unique issues and needs of employees IIK)rking in an openly gay and lesbian agency, the new agrearSlt extends bereavement leave to include 'ena close personal friend per year' and increases the maxinum allowable acrurulation of sick leave and entitles employees to utilize sick leave for stress. In additioo, anployees in the bargaining unit may receive a medical leave of absence wIB1 adopting a child and will be eligible for parental leave of up to three nmtt-s for tt-e adoption or birth of a child. Constraints imposed I7y funding SOJrces were a major consideration when reviewing wages. However both parites were able to agree upcn a wage upgrade that was alllDSt lI1aIlillOJS ly accepted by bargaining unit employees. Skyrocketing health insurance costs forced The Center to negotiate a cap en insurance premiuns. If a premium increase exceeds this cap, GlCSC may give written notice to the Union reopening that particular article in the contract. GlCSC is trn first gay/lesbian agency to become unionized. \llhile times have chage::! c3nd IlDre fair practices have been adopted as a reult of unienization, Local 399 continues to have a strong presence. According to Deputy Director Chi Hughes, who serves as Tre Center's representative to tre lklion, 'the relationship between GlCSC and local 399 has been very good. Trere have been very few grievances and all have been resolved to the satisfaction of those involved. Tt-ere are currently 43 bargaining unit anp loyees oot of a staff of approximately 78. ************** *. *.******. tct m:+ •• *..... tct *** ... **. **. ** BALTIMORE~S HERO ANNOUNCES CHANGES With the discentinuation of nearly one third of its funding for the current fiscal year, the Health Education Resoorce Organization HERO) has undergone a major revision in its structure and delivery of AIDS-relate::! coom..nity services. In its revise::! structure, Jack Stein, LCSW, has r:cently been ~med Actin~ Executive Director and charged with ccntinuing the agency's missien. For the past 4 years, , HERO has played an lmportant ro 19 m respondlng to the supportive and eiJcationa 1 needs of Mary land residents affected by the AHS epidemic. Stein had preve~OJsly acted as HERO's program di~tor and had experience ccnducting AIDS traini~ to health care professionals., Stein has already lmplemente::! substantial changes in the agency's operations. He state::!, 'AIDS is a Ding target and requires a system flexible enOJgh to ~espond to unfor:een issu~: yet adaluately structure::! to effectively carry 0Jt its stated goals.' He cites cCJll1lllity collaboratlon and cooperatlon as crltlcal for an effective response. For More Informatien: HERO, 101 W. Read St., 5.!ite 812 Baltiroore !til 21201 (301/685-1180). ' , +::+.** ..... m'~. +** u *'* tct *** ..... +... *** .. tct •••• *** ***** lHE OFFICIAL NEWSLETTER OF lHE M::GSTOO * vot..M 8:4 * WINTER, 1987 * PAGE 21 ***** **** m ...... **** •+ •• M. +•• *+. *•• +•••• M•••••• t: •••••• m M•• *M** M. m**** ********** •• 4<*m *t:tt+** .****** *•••• M**. t:'* ++** •• ********* EDuCATIONAL AGENCIES GET GRANTS Tre Centers for Disease cCJltrol awarded cooperative agreanents to 15 natiCJla 1 organizatiCJls, 15 state educational agencies and 12 10ca 1 educatiCJl agencies to relp sct'OOls and otrer agencies that serve yaJth provide effective AIOO educatiCJl. In additiCJl, 3 training/datmstratiCJl projects were also funded. Tre awardees for tre School Health EducatiCJl to Prevent the Spread of AIOO (9-lEPSA) are listed belON to relp enable yaJ to CCJltact than and rmitor their projects. NATICNAL ORG.ANIZATICNS: .American Alliance for Health, Physica~ EducatiCJl, RecreatiCJl, and Dance (RestCJl, VA, 703/476-3(37); .American AssociatiCJl of s.;-r;;;iAdmi~~trators (Ar lingtCJl, VA, 703/528-0700); .American College Health AssociatiCJl (Rockville, MD, 301/963-1100); .American School Health AssociatiCJl (Kent, (}i, 216/678-1601); Center for PopulatiCJl OptiCJ1S (WashingtCJl, OC, 202/347-5700); Council of Chief State School Officers (WashingtCJl, OC, 202/393-8159); ETR Associates (Santa Cruz, CA 404/429-9823); National AssociatiCJl of State Boards of EducatiCJl (Alexandria, VA, 703/979-2823); NatiCJlal CoalitiCJl of Advocates for Students (BostCJl, MA, 617/357-8507); National Coa litiCJl of Hispanic Health and Human Services OrganizatiCJls (WashingtCJl, OC 202/371-2100); National Network of Runaway and Youth Services, Inc. (WashingtCJl, OC, 202/488-0739); National OrganizatiCJl of Black County Officials (WashingtCJl, OC, 202/488-0739); The NatiCJlal PTA (Chicago, IL 312/787-0977); National Rural and Small Schools Consortium (Bellingham, WA 206/676-3576); National School Boards AssociatiCJl (Alexandria, VA 703/838-6765). STATE E()JCATICN AGENCIES: California State Dept. of EducatiCJl (Sacramento, 916/322-5420); State of Colorado Dept. of EducatiCJl (Denver, 303/866-6783); Connecticut State Dept. of EducatiCJl (Hartford, 203/566-3(61); District of Columbia Public Schools (WashingtCJl, OC, 202/724-4926); Florida Dept. of EducatiCJl (Tallahassee, 904/488-1611); Louisiana State Dept. of EducatiCJl (BatCJl Rruge, 504/342-3(80); Maryland State Dept. of EducatiCJl (Baltimore, 301/333-2318); Massachusetts Dept. of EducatiCJl (Quincy, 617/770-7593); Michigan Dept. of EducatiCJl (Lansing, 517/373-1486); New Jersey State Dept. of EducatiCJl (TrentCJl, 609/984-1890); New York State EducatiCJl Dept. (Albany, 518/474-1491); Ohio Dept. of EducatiCJl (Columbus, 614/466-1298); Pennsylvania Dept. of EducatiCJl (Harrisrurg, 717/787-6749); Puerto Rico Dept. of EducatiCJl (Hato Ray, 809/756-5820); WashingtCJl State EducatiCJl Dept. (Olympia, 206/753-2744). LOCAL E!JJCATICN AGENCIES: Baltimore City Schools (301/396-1527); &>stCJl Public Schools (617/787-0177); Chicago Public Schools (312/890-8020); School Board of Dade County (Miami) (305/350-3124); Dallas Independent School District (214/426-3234); Denver Public Schools (303/837-1000 x2(89); Los Angeles Unified School District (213/625-6411); New York City Board of EducatiCJl (718/935-4144); Orleans Parrish School Board (504/286-2906); School District of Philadelphia (215/351-7131); San Francisco Unified School District (415/565-9267); Seattle Public Schools (206/281-6502). TRAINING/DEMONSTRATICN PROJECTS: Local: San Francisco. State: Michigan and New York. Ca1tact these programs for more informatiCJl. For more informatiCJl alxlJt 9-lEPSA, CCJltact Dennis Tolsma, Director, Center for Health PromotiCJl and EducatiCJl at the COC (404/329-3311). mu+ .. M**** m M. M. W M**** *************. ** •• * BOSTONtS AIDS ACTION RECOGN I:ZED with tlBlks to btCJl'S AIOO kt:ial Cannittee ~, Cktober, 1987 BostCJl's AIOO ActiCJl has been nanal the 1987 MassaclllSetts recipient of the "National Philanthropy Day Award," presented by the National Society of Fundraising Executives, a WashingtCJl, OC-based nonprofit professional society with local chapters nationwide. The award, which will be presented at a cerermy at &>ston City Hall, Novanber 12, cited AIOO Actial as "the charity which best exemplifies the very best of philanthropy in MassaclllSetts." AIOO ActiCJl was chosen to receive the award, according to the awards anna.ncement, for its 'strong Ixlard support, camunity involvement, and creative administrative leadership." The announcement also cited the group's 'high level of staff involvement, broad volunteer involvement, significant gift participatiCJl, and broad outreach in the community.' '\lie are hooored to be recognized in this way,' said AIDS Action Director of Finance and Administration Larry Killian, Rand [we] share that honor with all of our supporters. • MttM. *••• ***** **** ••• *+ • + ****** tt+** ttM m ttM •• AMFAR AWARDS $2_5 MILLION TN GRANT"S with tlBlks to T!-e Washingt;al Blade, 8/14/87 The .American FoundatiCJl for AIOO Research CJl July 24 awarded $2.5 million in AIOO research grants to 45 projects in the U.S. and other countries. The projects ranged from studies of !"OIl the AIOO virus attacks different parts of the txxly to the impact of AIOO CJl yruth and an analysis of public opinion concerning the epidemic. The organization makes grant awards every six months, and AmFAR Chairwoman Elizabeth Taylor said these most recent grants were more than druble what was awarded by the group six rmths earlier. Included in the $2.5 milliCJl was $400,000 raised by singer Madonna at a New York City AmFAR benefit concert in July. ~* m •* ****. m** M*. **********UM ttm M. m HO .... ARD BRO .... N MEMORIAL CLINTC MOVES Chicago's Howard BrONn Memorial Clinic began operations at its new facility located at 945 W. George Street. The not-far-profit health and human services organization.is Chicago's largest AIOO service provider, as well a major provider of services for sexually transmitted diseases. T!-e new facility occupies two floors of the former Niedermaier Displays warehouse, and will provide the Clinic with ITlJch needed space for its expanding AIDS services, including research, HIV antibody testing and counseling, support services and statewide AIDS hotline. For additional information, call 312/871-5777. . **** m ••• M* •••• **** MW,* ************** tt+:ttm. ***** PAGE 22 * 'THE OFFICIAL NEWSlmER (f 'THE NCGSTOO * \QlM: 8:4 * WINTER, 1987 ***** ...... 1II ... 1"11:11 11 I .... m ""'''''! m .IIM ..... M ...... M ..... M ...... m ...... M ...... M •••••• ikI ...... ikI."IkIJIJI ...... NEW AIDS R~ GREETED WITH C:AUTI:ON with tl"a'lks to ~ IrIashingtm Blade, 9/25/87 Anewly annrunced treatnent for AIOO which involves injecting patients with a series of typhoid vaccine d The Camunity Research Initiative (CRI), which is already mCl1itoring data m AL-721, charges teh federal research establislm!nt has dragged its feet in testing the egg-based anti-viral substacne, which preliminary f'eIXlI'ts of nearly a year ago sro,., i~ the cmditims of sane people with MOO. Federa lly-spcJ1SOl'ed studies of AL -721 were m hold lI'ltil micl-Nowmber, aid a spokesltlCman for the Natima 1 Institute for Allergy and Infectirus Diseases (NIAIO), until the marufacturer resolved prodJctim problems and a tangle of federal agEJlCies agreed to give a green light to waiting researchers. Although the substance cruld be cmsidered a food-product -and many desperate people have mixed up batches in their mnes or obtained supplies fran grrups like the PWA Coalitioo, NIAIO spokeslman Sandi Hecker said for testing purposes, AL-721 is classified as a drug, and must be manufactured uniformly and approved by the FDA. CRI's Michael Callen said his grrup is already gathering data fran CRI-affiliated physicians who have patients taking AL-721, which has not stoll any side effects. lilt NIAID-spmsored studied to be ~ormed at t\IIC New York hospitals that are designated AIOO Treatnent Evaluatioo Units, just got \IKlI'd they cruld begin. Mt. Sinai and Marorial-Sloan Kettering Cancer Center will run the study CalCUrrently, canparing the effects of variOJS dosages m volll'lteers with AIoo-related Canplex and Progressive Generalized Lymphadenopthy over a 12-week Il'!riod. The study will begin as SOal as the drug is made available by the Natima 1 Cancer Institute . •• ikI ••• ~ ...... Ik**IkI ••••• ikI. ,.U ••••••••••• PWAs PLAN SUIT FOR ACUPUNCTURE by WilliCID IlJrks, with tl"a'lks to ~ OJtlines, 11/19/87 Several poople with AIOO receiving acupuncture treatnents for their symptoms at AIoo Alternative Health Project (AAHP) are planning a 1altlSUit in order to guarantee they will be able to ca'1tinue to receive treatnent, according to Artrur Shattuck, codirector of the Chicago alternative clinic. The new Illinois ~ical Practices Act effectively makes the practice of acupuncture by anyooe except a licensed physician, osteopath, or chiropracter illega 1. Altlnlgh acupuncture is not nentimed by name in the law, the new act brings a11 drug less forms of therapy except faith healing under its purview, according to Shattuck. ThJs acupuncturists, naprapatl's, and possibly massage therapists cruld be prosecuted as unlicensed medical practitioners by the state Registration and Education Department. Six PWAs treated at AAHP have already determined to sue, bJt Shattuck said trey rope as many as six ot!-ers will join in the class action to guarantee that the treatment they believe is essential to their health will ~ontinue to be available. The American Civil Liberties Union of Illinois is coosidering taking 00 their case, altlnlgh they have frund other attorneys willing to do so slnlld the ACLU decline, Shattuck stated. Acupuncture has been used in treating AIoo and AIOS-re1ated cmditims such as night or day sweats, diarrhea, loss of aPll'ltite, and a sense of well-being, bJt it is not a cure for Aloo, Shattuck said. 'Sense of well-being may be hard to define in Western medical terms," he said, 'bJt we find that many ~ cane to the clinic to get a treatnent and find they feel better afterwards.' In addition, certain fungal infectioos and drug side effects fran such treatments as ArT or chemotherapy can be relieved with acupuncture. Although acupuncturists at AAHP have not been prosecuted to date, several cases were prosecuted under the old Medical Practices Act, according to \IIilliam I>Jnbar, director of the Midwest Center for the Study of Oriental Medicine. Dunbar said the state's Supreme Court ruled in ooe case that acupuncturists cruld be licensed under the other practices or systems of medicine provisioos of the old Medical Practices Act. That ruling was made after the new act was signed into law, OOriever, and the Illinois Department of Registratim and Educatioo will ooly license physicians, chiropracters, and osteopatl's to practice medicine under the new law. 'Acupuncture for diagnostic or treatment purposes is a medical practice, and anyooe practing medicine witlnlt a license will be referred to the State's Attorney General for prosecution,' said Mike Accettura, legal crunse1 for the Dept. of RegistratiC)) and Education. For OJnbar and Shattuck, the i~ant issue is who is qualified to perform acupuncture. "The irony is that a licensed chiropractor or MO can practice acupuncture witlnlt any training,' Dunbar said. 'All they have to do is go to Chinatoo and buy a set of needles and a IXXlk m ro,., to do it.' At the Midwest Center for the Study of Oriental f!4edicine noo-physicians must study acupuncture for 27-36 mCl1tl's and pass natima 1 board 'exams to be certified. Physicians wfo study at the center take a tltlC-year crurse, Dunbar said. In making referrals for acupuncture, IXInbar said he It«lJ 1d refer Il'!OP 1e to practitlmers who are national board certified or are licensed to practice acupuncture in other states. \llhether the acupuncturist is a physician 1t«lJ1d make little difference, he said, 'bJt if ScxnecJl9 wants a physician who is natimal1y board certified, there are very few poop1e to refer them to. " **Ikm1kl***************I. +* *. +. m +****JIJI iklikI"" **** ***** lHE OFFICIAl NEWSLETTER OF lHE NCGSTOO * vruJME 8:4 * WINTER. 1987 * PAGE 23 ***** U*~"U.**'U'******"'**"""~'**"""'U""'~****************,,"*"***>IOI~**.'m.'**":'>IOI4C$"'*****,,**'~"'" FROG SKIN MAY BE NEW SOURCE OF Rx: by Lisa Keel and Rick Harding. with tl-anks to ~ ~~b:!W~~ §l~~. 7/31/87 Medical researchers at the National Institutes of Health said that a newly discovered infection-fighting substance found int he skin of frogs is being studied as a possible treatment for AIDS. Leslie Fink. a spokeswoman for the National Institute of Chi1d Hea1th and Human Developnent. said that the substance called magainins has been sra...n in early ex!)3riments to kill many types of bacteria and fungi. Fink said testing has begun to see if magainins can ki1l or slow reproduction of the AIDS virus. but that no results are yet available. :0 obtain the eJ9S for study, researchers surgically removed them fran the frogs' abdanens ther, sewed up the incisions and returned the frogs to aquariums. After discovering that the frogs' incisions never became infected in the ITlJrky aquarium water, he analyzed the chemical canponents of the frog skin and found the substance he later named magainins. t.'I:U**** •• *•• ** .. Kt~~*'Ic*- TYLENOL & AZT BAD COMBINATION by JEmie It:lVlight. with tlalks to Ib;tCJ'l's ~ ~i~ ~. 9/13-19/87 The canbination of fall and acetaminophen (Tylenol) can be dangerous to anyone using the drugs. The canbination can increase the hematologic damage which is the \IIOrst side-effect of AIDS, according to New York Nati~. Apparently many peep le are unaware of the danger. despite many warnings printed on the package insert of Retovir (AlT). People using AlT should also know that other durgs may be dangerous in combinatio with the AIDS treatment and should consult their physicians about possible drug interactions. ***********~ •• ". u* **** •• ** .. **"1 n**u,***** TREATMENT HOPEFUL_ BA.T" 1 237 with tl-anks to Detroit's Cruise. 10/28/87 Asubstance that blocks the AIDS virus fran entering human cells in a test tube ::I"9J' sar:eday be able to do the same in the body. Researchers at Houston's Baylor College of Medicine said the substance, BAT123, appears te attack the virus directly. rendering it unable to infect cells. It also blocked transmission efthe virus frar. infected to noo-infected ce~1s in a test tuve. Dr. Nancy Change. who headed the team with her husband. Dr. Tse \lien Chang, stresses that the new substance Ncanr~ot be called a cure for AIDS," and says testing BAT123 as a t~eatment in pecple with AIDS is at least two years away. Other scientists also advise caution. ":here've been other monoclona~ antibodies that have been kO\ll1 to inhibit the AIDS virus in the test tube, Nsays Dr. Jeffrey Laurence of the Laboratory for AIrs Research at new York's Corne11 Medica1 Center. The next step is to de tests on blood ce~:s taken f~an P\IIAs which w~11 take several months. *****,,************#+**********)'(***~*:+:**:IC****m~ PINE CONE EXTRACT FOR T"REA,T"MENT"?· wi~~ ~h8nkl to tha New York Nat;~, 7/13/87 ~ihan Nonoyama, President of the Showa University Research Institute for Biomedicine in Japan, is negotiating with the University of South Florida (L~F) to set up an experimental treatment program for oersons with AIDS using an ancient folk medicine: pine cone extract. Nonoyama has announced the preliminary results from his own experiments on an a~tract from a certain white pine sone grown only in the southern region of Japan, saying the extract "sla..a:l the killing rate of the cells by the [HIVJ virus." According tothe Chicago------OJt~ine,----- Nonoyama said it is ony the whie pine cones which produced the results. "It seemes to provide a protective effect to the cells," Nonoyama said. "This study and other experiments in Japan, both in the test tube and in animals. cause us to be1ieve it may act as an irTmlnologic stilTlJlus." The researcher hopes to set up an experimenta~ treatment program at the Sd-ool of Medicine at USF in Tampa soar.. Nonoyama expects the program to conform to federal guidelines for experimental AIDS treatments. ***************** +#+ ************************ HOUST·ON Y· S, MONTROSE CL I: N I: C: GROWS, Houst(J1 's M:ntrose Clinic is a private. non-profit. medical and educaticrta 1 resource CB'lter specializing in the screening. diagnosis, treatment, and prevention of sexually transmitted diseases. To meet the demands of its increasing and varying clientele. the Clinic is relocating to 1200 Ricllrmd. a place that nore than doubles the old facility on Hawthorne. The Clinic has grown rapidly in its six year history. but roost dramatically in the last 18 nmths. The Clinic offers chlarrrydia screening routinely. a full range of female STO services. bilingual services. HIV antibody testing. irmune system evaluation. anmg nore traditional STO services. For tt'ore Information: The Itntrose Clinic. 1200 Ricmmd. HoustCJ'l. TX 70006 (713/528-5535). ********. '*************** ************* ~******* COLORADO AIDS PROJECT GET"S GRANT' with tlalks to ~ £olorado AIDS ~ect News, I\rt:lJ1I'l, 1987 In an unprecedented action. the Colorado Trust. the state's largest private funding source for health related prograll5, has granted the Denver-based Co lorado AIDS Project $50,000 to develop and execute training and intervention prograll5 in high risk fllPU lation groups. This is the Trust's largest ever AIDS related grant. "Their response to our proposal clearly indicates the confidence that CAP has generated." camented Executive Director Julian ItIsh, "and is an incredible compliment to trose who have supported and cCJ'ltinue to support the Project. Without them, we never \!OJ ld have developed the programs to qualify for this major grant which opens new opportunities for us to be of service." For More Information: Colorado Health Net\llOrk. P.O. Box 18529. Denver. CO 80218 (303/837-0166). ~ml""*"***********' •• I'."" •• '•• *'~ .... _.. r~ ,.. 1111... VII 4V4n\oo ... ~ ..... 1 ..... \ V, ...... -,....., wv_._ ...... , .-_. ++ +. +U MM. +, .. ++ M** M UUM *****++. +.. , lUI I:+lIM*=***, .... M' .lI ..... U +M I .. I HI I +I .**1 I +H m +III MliMMm ...... M ...... ALTERNATIVE TREATMENTS ASSESSED I7y Richard DiGioia, Kl, with thcrlks to The lllash:i!Yllt.CIJ Blade, 12/4/87 O1e of the Il'/JSt cootroversia 1 aspects of the AIlS crisis is the emerga1CE! of a groop of treatments that are calle:! •a ltemative' or 'nm approv9:l." This groop initially coosist9:l of ribivarin and isoprinosine, b.rt: has nC1ttl expanded to include egg lecithin lipids (AL-721), naltrexooe, DTC (Irruthiol), nooolaurin, and others. There are reasoos wily a veritable cottage in True AL-721 was develop9:l at the \lleizmam Institute of Science in Israel. It calSists of three lipids all derived from egg yolk: various naJtral lipids (70%); pl-osphatidycholene (20%); pI-osphatidylethanolamine (10%). The theory behind using AL-721 is that this mixture m:xlifies cell membranes, increasing the ratio of pI-ospholipids to cholesterol. There does exist laboratory evidence that in the test tube this change in cellllBllbranes blocks the infectioo of tunan T-lymphocytes I7y HIV. True AL-721 is not generally available in the U.S. The patent is held by Ethigen, formerly Praxis PharmacaJticals, which is seeking approval from the FDA to market it as a drug for AIlS rather than as a food. Coosequently this company has not releas9:l AL-721. This has le:! to a number of alternatives. There is a "home forrrula' that uses soy lecithin. There is a variety of AL-72Hike products, using all egg ingr9:lients, available throogh clubs or ccmnercial manufacturers. To avoid patent infringement, none has exactly the 7:2:1 mix of true AL-721. In this area ooe of these ccmercial products -EggsAct -is available throogh sane health food stores and by mail order. There are several dosgae schedules and methods of taking it. Unfortunately, no ooe has shoo that this product is absorb9:l from the gastrointestinal tract and gets into the bloodstream in the appropriate proportioos. It is not knoo whether AL-721 COJld interfere with the absorptioo of f1J.T if taken at abOJt the same tine. For more specific informatioo abOJt AL-721, cootact AIlS Treatment News (P.O. Box 411256, San Francisco, CA 94141, 415/282-0110). Naltrxooe is an opiate antagonist. Or. Bernard Bihari, a ~ychiatric researcher at Ikwlstate f1alical Center in Brookl~, NY, fWld that in lC1ttl ~-;; -rruch lower than use:! to counteract the effects of narcotics- naltrexone seenal to affect alpha-interferoo levels inthe blood. Since high alpha-interferoo levels are associate:! with AIlS, it seems desirable to be able to lower the level. Unfortunately, his work has not been publish9:l in any nalical joornal. Nor is there evidence that this treatment imporves the quality or duratioo of an AIlS patient's life. The dosage usually use:! is 3 rrg/day; taken as 4 ml of a liquid mix creat9:l by crushing a 50 rrg tablet of naltrexooe and putting it into 50 cc of cherry syrup. This is a simple prescriptioo to write, bJt I urge that the script be taken to a drugstore that is familiar with this practice. DTC (diethyldithiocarbamate) is also knoo I7y it's French trade nane, Irruthiol. Some researchers claim that it ;s an ilTlllJl'1e system booster that works by stirrulating the liver to produce a thymic-like hormone that speeds the maturatioo of T4 helper l~l-ocytes, tl1.ls increaing their total number. A few researchers also think that it may have a limit9:l degree of direct activity against HIV. Studies claiming to show effects with DTC have been cooduct9:l in France, bJt nothing has been publish9:l in the U.S. There are 4 optioos in getting DTC. 01e is to go to France to bJy Irruthiol. The secood is to bJy it as a raw chemical in the U.S. in the reagent grade tri-hydrate form. since the drug is destroy9:ll7y stomach acids, one rrust enterica lly coat the drug, naJtra lize the stomach acid, or give the drug rectally as a suppository or enema. the third optioo is to get it from an LndergraJl'ld SOJrce that has prepar9:l it in enteric-coat9:l capsules. The foorth is to have yoor doctor prescribe .AntabJse, the drug us9:l in the treatment ota1 coho lism. Alleg9:l1y, .AntabJse breaks 00,.", into DTC in the body. It seems to ne that the first three optioos are either extrerrely expensive or risky. If a patient is insistent 00 taking DTC despite lack of evidence for benefit, it seems Il'/JSt reasooable to prescribe .Antabuse. The dose suggest9:l is 750 rrg (3-250 rrg tablets) taken together once a week. No alcohol can be coosunal during this treatment. Certain drugs -aspirin, ibJprofen-type drugs (Advil, etc.), isoniazid (INH), and metronidazole (Flagyl, etc.) shoold be avoided. ' In sunry, I have serioos doobts abOJt the efficacy of these drugs. HC1ttIever, I WOJ ld, rather have my patients take than with my \tro.JIl9:lge than take them secretly. I can ooly hope that the nalica 1 research system WOJ ld move quickly to study these treatments and l'eso lye these questioos. (Or. DiGioia is co-chairrnan of the D.C. AIlS Advisory Ccmittee and a physician in private practice.] ***************m*",************m******. ***** THE OFFICIAL NE\I/Sl.ETTER OF THE NCffiTIl> * IJOI..M 8:4 * \!lINTER, 1987 * PAGE 25 ***** **· .. M**...... M* ...... *M •• MM ...... M.M ...... **.M** ..... " ...... M ...... W •• M ...... W ... UMW ... M •••• W URINE INJECTIONS DISPUTED canpiled by Johanna Stoyva, with thanks to ~~ MJjnes, 7/16/87 :e~s .Attornf!Y .Gene~a: Ji~ Mattox f:loc suit recently to prevent a HOUSt01 man fran treating pers01S with AIDS and allergy victims by 1nJectlng them w1th the,r ur,ne, accord1ng to HOUSt01'S Mant~~ Voice. William Hitt, who ope~ates cl~nics ~n Dallas as well as the microAllergy Clinic and Immunotherapy Clinic in HouSt01, claims the urine treatment can help pe~S01S with AIDS from contracting diseases they otherwise \tIOUld catch easily. The AG's office began investigating Hitt in March after receiving a canplaint fran the state health department. The suit, filed in a HoustCJ1 state court, said the investigation showed Hitt \liaS using a drug not approved by the Federal FDA or the state health ~pa~tment. Documents filed sh:J;i Hitt has been "treating" 119 people with AIDS. The suit see~.s to stop Hitt fran using t~ ~reatment unless.it 1S approved by the state, that he be ordered not to advertise that the treatment will provide protectiCJ1 for allergy Vlctlms and people wlth AIDS, and that he be barred fran presenting himself as a medical doctor. *****"****** ••• ****** •«« *'**** ••••• w************** DRUG RESEARCH TAKEN I:NT"O O .... N HANDS by Peg ~, with thrlks to The Washi¥a'! Blade, 11/20/87 Fed up with the lagging pace of AlOO research, people with AlOO in Ne\tI York City are taking things into their 0\Il1 hands and SOCJl will sp01SOl' their 0\Il1 experill81tal drug tests. The People with AlOO CoalitiCJ1 ~ its research program will becooe a nKXIe1 for the rest of the CMtry. The program, called tl-e Ccmwnity Research Initiative (CRI), is creating a net\IIDrk of pl'ljsicians to treat people with AlOO in experill81tal protocols that I1KlSt JlI¥;icicrlS CClJ1d not manage in individual practice. Sooe 10 to 20 local doctors are Il(]II affiliated with CRI. "The bottan line is we feel we can do it better, cheaper, faster, and nDre ethically," said Michael Callen, a persCJ1 with AlOO who 1-e1ped fCUld tl-e c:amtnity-based research program. CRI began one year ago art: of frustration with the sluggismess of federally sponsored research. fv1 indeps\dSlt subsidiary of tl-e P\I/A Coalition, it \lIaS founded by Dr. Mathilde Krim, co-cahir of the American FoundatiCJ1 for AIIl> Research (AmFAR), &1d Or. Joseph Scmabend, a veteran AlOO pl¥;ician. "I am pleased that people are waking up and realizing that tl-e govemll81t doesn't care etl-er we live or die and we have got to stop \llaiting for it to save ClJr lives," said Ca11Sl in a recSlt te1ep/me intervie\tl from his Manhattan apartll81t. "\!/e have the expertise (and] we have tl-e mooey within ClJr CX1 carmJnity," I-e OOltinued. "\!/e've got EOOJgh prominent researchers who are lesbian or QCfi or are on ClJr side for us to just do the trials ClJrselves- just ~ tt-em: Licensed to administer drug studies by the state of NeItI York, CRI has raised Lnder $100,000 and is awaiting \liard CJ1 grant re:jU9Sts to AmFAR and the Gay MSl's Health Crisis, both of which say they endorse CRI's efforts. After mootl-s of frantic fundraising, CRI \IIQn a CCJ1tract with a pharmacart:ical canpany to study aerosolized pentamidine for use in preventing pnamx:ystis carinii p-lElIlO1ia (PCP), a virulent infection associated with AlOO. CRI, in consultation with San Francisco General Hospital, plans to mooitor aboJt 200 volunteers in its study of aerosol pentamidine. Paul Van SaJder, executive director of tl-e PIIA Coa litiCJ1, criticized federal efforts for OOlcSltrating a1nmt exclusively on fllT, already liCSlsed as an anti-AlOO drug, in spite of the severe anemia ,,*,ich tl-e drug causes in aboJt half of trose with AlOO using the drug. kcording to doctmlts supplied by the National Institute of Allergies and Infectious Dieseases (NIAID), of 21 AlOO treatll81t studies underway at federally funded AlOO Treatll81t Evaluation Units around tl-e country, 15 focus CJ1 /llT. At NIAID's 0\Il1 laboratory, three art: of eight current AlOO protocols primarily OOlcern /llT. Future studies for CRI studies include Ampligen, an anti viral drug which may also I-e lp rebJild illlll.ll'lE! systerrs weakened by AlOO, and canbination tl-erapies, which are lIDf'e difficult to test IxJt have rEa!i~ little attention from federal researcl-ers. .Arotl'er anti-viral, has becare well \In DEXTRAN & HEPARIN INHI:SIT HIV? with thanks to Chicago's ~ ~ Times, 8/20/87 Dextran sulfate and heparin have been sro...n to inhibit HIV, according to an Arrerican-Japanese translator in the New York Native. An assistant professor of microbiology at the Fukushilll3 Meida 1 College in Japan, Masahiko Itch noticed the anti-vira iqua lities of this drug cCX!lbinaitoo when researching ways to ccxnbat herpes. Dexrian sulfate is used to treat atherosclerosis, and heparin is an anti-coagu 1ant. \IIhen canbined, the drugs \IKlr'k 'synergistica lly· to inhibit the replication of HIV in a test tube. According to Itoh, "these drugs are cheaper and have fewer side effects than AZT,' rut they are not yet proven effective outside the lab. Itoh I'oped that "this canbinatioo will be effective in prolonging life when used in conjunctioo with an irmune booster.' ...... ***"*** ••••••• 401401 ...... , ...... PREVENTING PNEUMOCYSTIS by Joseph A. ScmaIBld, I() , with thanks to the PWA CoalitiQ'l Nasline, J\Jle, 1987 [Note: The fo110\11ing is presented for informational PJrposes only and does not constitute an endorsement. P\IIAs and P\II~ are urged to CCJlSU1t with their 00 nalica1 care provider(s) for nalica1 advice before undertaking any treatllSlt.) Nobody slw1d get jM.JTOCystis carini; Jl"leuJO)ia (PCP) a second till'e. There are a variety of nalicines which will substantially reduce the probability that PCP will recur in a person who has once suffered fran this condition. \IIhi1e there are no canp 1eted studies anmg AIOO patients that definitively prove the efficacy of any treatllSlt to prevent pneurrocystis, observations that rave been made to date indicate trat a number of treatllSlts are very likely to be effective. Anmg the treatllSlts trat llI3y be useful in pcp prophylaxis are: 1. ~E. Adose of 100 ~ (25 ~ four times daily) has been administered for PCP propt-ty by IlI3ny p!-tysicians over many years. It is probably quite effective. There are sooe side effects, the mst frequent of which is anania. Ha.rever, with appropriate l101itoring, this is infrequently a significant problem. Dapsone contains sulfur and sooe people are allergic to it. 2. BACTRIItVSEPTRA. Published studies in pediatric non-AIOO patients at risk for pcp rave sro...n trat this drug can effectively prevent the Jl"leul101ia. One doub1e-strength tablet twice daily probably ras considerable efficacy in preventing pcp in adult AIOO patients. There are side effects with this drug, including a 10\11ered white blood count. It also is a su1p1-ur-containing drug and sooe people llI3y be allergic to it. HO\IIever, individuals who are allergic to the drug have frequently been able to take Dapsale. 3. FANSIOAR. This drug is also a su1p1-ur-containing preparation. It is administered once a ItI8ek by /IOJth and probably ras a high degree of efficacy. Allergic reactions llI3y develop and because the drug remains in the body for a week, these may be roore difficult to control. Many ptlysicians rave administered Fansidar with good results. 4. AEIml POOMIDINE. Trials are being CO'lducted at this till'e with the administration of pentamidine by aeroso11t18ek1y or biweekly to prevent PCP. The optilll31 dosage and freqlJ'ency of administration rave yet to be definitely established. This mode of prevention appears to be the mst benign and may well becooe the preferred mode of preventing PCP. It was pioneered by the Infectious Diseases Service of New York's rr\:ooria1-S1oan Kettering Cancer Center where the optilll31 conditions of administratiQ'l are nO\II being \IKlr'ked rut. AZT does not prevent PCP, a1tlnJgh it has been c1ainal to delay its onset and reduce its severity. The AZT protocol has recently been ch3nged to permit the use of Bactrim for PCP prophylaxis. Of course the issue of PCP preventioo should rave been addressed in the original study design and it is to be hoped trat in future studies, no ale will be left unprotected fran a recurrence of PCP. It is rard to be made to relinquish an interventiQ'l that will a1mst definitely prevent PCP in order to receive an experillSltal and toxic treatnmt whose beneficia 1 effects cannot yet be moo. The mst comnm objection to the use of PCP prophylaxis has been trat there is no established protocol at this till'e. HO\IIever, anyone who ras h3d Pcp Q'lC8 has a realistic probability of experiencing a second episode. It seems unconscionable to wait for the unequivocal denmstratioo trat a particular propt-tylactic Il'ethod will guarantee freedan fran recurrence. Considering the gravity of the Jl'lElUI1D'1ia, it should be sufficient that a therapy has a very good chance of effectively preventing a recurrence. Of course, studies on the efficacy of the agents IISltioned aoove must continue, ha.rever, even witl'nrt: the final results of such studies, prop/"rJ1axis slw1d be offered. P!-tysicians tend to respond to authoritative recClMS1dations regarding the rnanagerrmt of specific diseases. For example: the Public Health Service WOJ1d represent such an autl"oritative voice. \llhi1e no recamendations can be IlI3de in the absence of clear-cut data, suggestions may be certainly given while such data is being collected. Many p!-tysicians in New York City rave been administering PCP prop/"tylaxis for sooe years with good results. However. there are ptlysicians wlme practice is not to administer such pro~laxis. If this is true in New York. it is likely trat many more patients go witlwt prophylaxis in smaller camunities. It is surprising to us trat studies on experillSlta 1 treatllSlts for AlOO, particularly in time who rave rad PCP, do not include ll'eaSures for PCP propt-tylaxis since, as IISltioned, such Il'easures are available and likely to be effective. Aerosol pentamidine is probably the modality trat is least likely to interact with an experimental treatment and it is therefore of the greatest urgency that efficacy studies on this treatment be completed and published. \llhile individuals wt-o have h3d one episode of PCP 1I[lJ1d benefit from p~laxis, people with other manifestations of AIOO wro have not yet had Pcp could also usefully receive PCP propt-tylaxis. Ha.rever, precisely wrat criteria are used in determining wh,ether or·not an immune compromised individual should receive propt-tylaxis remain to be established. Studies designed to elucidate factors predictive of PCP are urgently needed. If the modality used for propt-tylaxis is not significantly toxic, as may be the case for aerosol pentamidine, then the se1ectioo of patients to propt-tylax can be broader, as the potential benefit 1I[lJ1d clearly rutweigh any pcssible harm. We urge yru to discuss the issue of prophylaxis for PCP with yrur ptlysician. ***** lHE OFFICIAL. NEWSLETTER OF lHE NCGSToo * VOI..IJt 8:4 * \!lINTER, 1987 * PAGE 27 ***** *** •• n· ...... n ••••• n ••••• m ...... m=* ••••••• n ... m.m ...... +:':.n+:m=*'=*=*~n.' .. +:m •• , ...... **.*** FUSIDIC ACID AS NEW TREATMENT? I7y Lori KII1ScI'aft, with thanks to btal's ~ ~~ Nas, 11/29-12/5/87 A 58 year old I113n with AIoo stn.led I113rked improverent after treatet with fusidic acid, sparking hopes that the anitbiotic l113y be helpful in treating P\IIAs. The British rredica 1 journal Lancet p.,Ib lisra:! his case history a1009 with researchers' discovery that 'fusidic acid inhibits HlV infection in the test tube." The researchers noted, ro...ever, that the "clinical improvement in our case may have been fortuitous, or associated with fusidic acid's anti bacteria 1 activity.' According to the New York Native, fusidic acid has been used for other ca1diitions for a long time, is relatively free of side effects, can be given orally, and is relatively inexpensive. The next step is to find out whether it really is effective as part of an AIoo treatet program. +:m" ••••• , ...... '.n.' ••• n~ ••••• ,=*+:m SIGHT VS_ LONGEVITY CHOICE FOR PWAs I7y Mark 9JlliVtll, with thanks to n-e \llashingtal Blade, 12/11/87 Many people with AIoo are being forced to cl-roie between a drug to preserve their eyesight and a drug to prolong their lives, according to the New York Times. CytaJe;lalovirus (CftToI) is very camm in the general pop.,llation, according to Dr. DJJglas Dietrich of the New York University School of fo'alicine. It is usually harmless rut can seriously damage the eyes, brain, and other organs of the body in Sanea1e \1100 has a suppressed ill'lllJf1e system. For people \IIith AIoo, Dietrich said, the 00 disease is f~tly fataL (he experieta1 drug, ganciclovir (DHPG, cytovene), has been sro,.." to arrest the spread of 00 in the eyes and other parts of the body. &It because the drug suppresses the ability of the bale I113rrow to produce blood cells, it cannot be taken at the same time as drugs that affect blood cell production. The drug PJ.T has been st-a..ll to prolong the lives of people with AIoo rut is one of the drugs that cannot be taken with ganciclovir. The FDA has not yet approved ganciclovir, which was developed in 1982 for I113rketing rut has allowed the drug to be supplied free to people with AIoo while studies are being conducted . • n*** ...... n.=* ...... 'm.**+***=* ...... ,. GM-CSF HELPS STIMULATE WHITE CELLS I7y Betsy Pisik, with thanks to n-e \llashingtal Bl~, 9/11/87 Researchers in Boston have been successful \IIith a rormone that stimulates the production of white blood cells and l113y help people with AIoo ward off some infections, according to The New York Times. Studies conducted at two hospitals with 16 AIoo patients revealed the oormone, tual grinJlcx:yte-macrophage colooy-stinulating factor (~), increased white blood cell production, rut had 0 impact on the number of helper T-cells, which are the prilll3ry target of HIV, the putative Aloo virus. According to Dr. Michael DeLeo, the t-ormones might be most helpful if given in conjunction with other drugs that fight the virus. These rredications often suppress the production of white blood cels, and G1-CSF \IIOUld help offset the effect. *...... n ... n ••• =* •••••• +:' ..... n'.n**.n'~***=* Rx & EVALUATION UNITS INVESTIGATED I7y Lori KII1ScI'aft, with thanks to btal's ~ ~ity~, 11/29-12/5/87 Rep. Nancy Pelosi (D-CA) has called for a Congressional Investigation of the National Institutes of Health Aloo Treatet Evaluation Units (ATBJs). Her action comes in response to complaints that the program, which is intended to identify and test effective therapies for AIoo, enrolls too few patients and creates long delays for peep le \Il1-o wish to try experieta1 treatets. Coming ~ explains that disagreeJlalt abOJt tt-e program reflects different perspectives al its p.,Irpose: "Many people \IIith AIoo and AIoo advocacy organizations put the stress on Aloo Treatet Evaluation Units, \IIhile researchers and scientists put the stress on AIlE Treatment Evaluation Units: Pelosi argues that treatet should not be sacrificed to research. "I have people wOO need t-elp. They need it soon and we need answers that this research and treatJlalt could lead to.... It's not fast enough for us.' She also criticizes the ATBJs for using Aloo in over 90% of their studies when other treatets l113y be IlXlre successful. If Pelosi's request is granted, the Helath and Human Resources Subcommittee \IIill open hearings in \llashington. *** ••• *...... *****.**.**~.******* •••• *~**** HOTLI:NE FOR T"REAT"MENTS PROJECT INFCRtI annoJ'1Ced the receipt of a grant from the Design and Inteior Fumishings Foundation for AIoo (DIFFA). The grant, totaling $8000 is supported by both the Northem California Chapter in San Francisco and the antional office in New york CIty. The grant \IIill support the operatial of the PROJECT INFOOtI toll-gree hotlines, which provide inforlll3iton on available experietal treatJlalts for AIoo, A~, and HIV seropositivity. 'The DIFFA grant I113kes it possible for us to continue to provide this ouch needed service,' stated PROJECT INfOO!lleaders Joe Brelt.er and Martin Delaney. 'Since our work was recognized on such programs as AOC's 20/20, imaM, and Nightline, and in I113gazines such as News\lleek, Time, and American Health, our Slll311 staff has been overwhelrred. The toll-free ootlines have been averaging 4000-5000 calls per mmth from AIlE affected individuals, health care professionals and other AIoo servie organizations. Over 1500 inforlll3iton packets are l113iled each month. PROJECT INFOOtI's long held contention that 'early intervention' can slow progression of the disease is now receiving wide" support in the rredica 1 community. "Unfortunate ly, only one treatJlalt-Retrovir (AlT) has been approved for limited distrirution, and it is not well suited for everyone. Other safe treatJlalts are available; trose in need have a right to know all their options and to be protected from possible exploitation,· stresses Brewer and Delaney. For I'ore Inforlll3tion: PROJECT INFO~, 25 Taylor St., Suite 618, San Francisco, CA 94102 (Nationally--800/822-7422, in California--800/334-7422, in San Francisco--415/928-0293) ...... n ...... mm ...... u ...... +:+:+:m+:m ***** PAGE 28 * lliE OFFICIAL NOOl.ETTER OF lliE NCGSTIE * \QlrE 8:4 * \IIINTER, 1987 ° ***** ..... "*+ ++ + + + + + + M+ I. M. +. *=IlIl ++ .... ++.M +...... +. +. +U ••• M***** ...... It ...... CATALOG MARKETING FOR A.IDS. with thanks to Detroit's Crui~, 12/23/87 Developmental Marketing Group, a syndicated cata~og marketer specializing in charitable causes, ras mailed an appeal for funds on behalf of the Nationa~ AIDS Network (NA"J). The year-old Oxnard, California based canpany sent to 2 million households what appears to be an average mai~-order catalog, offering merchandise that ranges fran cookware to attache cases to Mister Dew Drop, an automatic 'pet watering station." M the cover starkly IXlf'trays the catalog's pJrpose, with dramatic art and the headline, "AIlE: It's everyme's problem." The catalog solicits support for the \IIashingtoo, DC-based NAN, which describes itself as "a natiooa 1 clearinghouse, sorting and pJtting together this massive Jigsaw pJzzle" that is AIlE. NAN gets a percentage of merchandise sold anc all volu~tary contributions pledged by its mail-order :ustomers. Brian Fitzpatrick, chief operating officer and director of Developmental Marketing says, "The objective is to raise mooey for a charitable organizatioo. \IIhile the charitable organization does not pay to produce the catelog, each group has approval of the copy and the products offered in the catalog on its behalf. The group then gets royalties of 6-16% on every product sold in addition to 100% of all donations, and purchasers are entered on the organization's mailing list. The catelog offers about 64 items, ranging in price fran $8 for a telephone answering tape to a $289 5ewin~ machine. NAN formed in 1985, and consists of five major AIlE service organizations °in Baltimore, Boston, Los Angeles, New York and San . rancisco, ar.d over 300 camunity-based service providers. "NAN previously thought about a direct mail campaign but fcund it rruch too expensive," said Executive Director Paul Kawata. "Now, a five-year contract at Developmental Marketing Group, at no cost, gives us reach a~c op~"tunity to expand." ~********************** A. I: OS. A. C: TO I: ON L 1: N E ESTOABL1:SHED with thanks to The ~ ~la~, Septanber, 1987 The \IIashington, DC-based Fairness Fund has begun operating a new national Action Hotline to help facilitate the generation of mailgrams on AIDS and gay/lesbian-related issues to members of Congress. Callers will be able to dial the toll-free number 1 / BOO / 257 -4900 (day or night) and ask for Operator 9184, woo will read them three 50-word mailgram messages 01 AIlE issues that camunity lobbyists have identified as crucial for Congressional action. The messages will cost $4.50, and will be billed to the caller's personal telephone number. Acaller also has the option of canposing his or her 00 50-word message. The operators will be able to look up or verify the names of a caller's Senators and Representatives. The Project's primary goals are to accelerate !'esearch, increase drug availability, and provide the best care possible for people with AIDS. The project also supports efforts to promote an effective national AIDS education program, and the enactment of laws to protect the confidentiality of and prohibiting discrimination against pecple infected with the HIV virus. Because the prepared mailgrams can be changed on a regular basis, the Action Hotline ensures that individuals can ca~l it and be assured that the message t~f send to Congress is coordinated with current 'on the Hill· priorities, and t~at it ensures timely communication to address rapidly changing legislative situations. **********************' ~ ••• ********* CANADIAN A :1: OS RESEARC:H C:ON FERENCE The first CaMdi." AIlE Research Conference sponsored by New Biotech, Canada's moothly biotecmology magazine, will take place in Toronto, January 26-29, 198B. The ConferB1Ce will focus CJl the business and bioresearch canponents of AIlE and to examine currEnt research work that is taking place in Canada and further stinulate work in this area by bringing a nunber of internatiCJla1 experts to Canada for the pJrpose of interacting with Canadian researchers. The format of each of the ConferB1Ce will be a plenary lecture follCMed by parallel sessions on: roolecular biology, illlllJnology, pharmacology, diagnostics, epidemiology, and vaccines. There will also be poster exhibits as well as a camercial exhibition. The I 1\5 0f ~anuaryI 18., '988. , the Centers for Disease Control AIDS Activity reports a total of 51,361 adult and pediatric cases of AIDS in the U.S. (COC strict case definitioo; this includes 3143 patients who rreet only the 19B7 revised surveillance definition for AIlE). PATl.~ RISK GROJP: Homosexually active men account for 65% of all cases; 17% fran IV drug abusers; 8% fran homosexually active men and IV drug ;iiJsers;--1% fran hemophiliacs; 4% fran heterosexual cases; 2% fran transfusion, blood/components; ar.d 3% fran those in no apparent risk or unknown risk group due to incanp 1ete investigatioos. (The COC, finally reacting to the persistent criticism fo~ their un~ua 1 "hierarchica 1" 1isting- wherein if rorosexua lly active mer. are Q1so IV drug users or hemophiliacs, they were only counted 1n the top, 1.e., rorosex'JQ 1, category, therefore confusing and misrepresenting the data. COC statisticians have finally n reconstituted' the dat,a to make it ~re accurate.-ED] ~Q~ 21% of the cases are aged 29 or less; 46% from ages 30-39; 21% from ages 40-49; and 10% from ages over 49. RACIAL/ETHNIC BACKGRruND; 61% of the cases are white; 25% are black; 14% are hispanic/latino; 1% are other or unknoo. Note that 54% of the pediatri~ (exe ludi~- ado lesca1ts) cases are black, 23% hispanic, 22% white, and 1%'are unknoo. GEOORAPHICAL OISTRIBJTIGl: 54 states and territories, including the District of Columbia, Puerto Rico, Guam, and the Virgin Islands have reported cases to the CDC; New :ork & California have the most cases, with 25% & 22.4%, respectively; Florida, Texas, & New Jersey report 7.2%, 6.7% & 6.4%, respectwely; nlinois, Pennsylvania, Ge:Jrgia, & Massacrusetts, each report: 2.7%, 2.5%, 2.2%, & 2.1% respectively, of the cases; all other areas each ~eport less than 2%. OVERALL trtlRTALITY: 56%. ********,IlI.~,,***.*********,"*' ***** TIlE OFFICIAL NE\l/SLETTER OF TIlE NCGSTOO * VOI.l)1E 8:4 * \IIINTER, 1987 * PAGE 29 ***** .**.*~ ...... Mot.* •• Mot •• ~ ...... ~~ ... *...... Mot~ .... ~ ••• ~ ..... ~~ ..... +~++ .. m..... ** .. ~+:.. ~ .. *mmMot .. * CHEMICAL DEPENDENCY Rx: :: SAFER SEX with thanks to OJr Voi~, fran tte Pride Institute, volusn 1:2 Tre Pride Institute is tre natioo's first gay and lesbian affirmative center for alcol'n lism and chemical dependency treatment. Recovery fran chemical dependa1cy. ~overy fran chemical dependency is tre primary focus of 11 Pride Institute treatment strategies. \!/hile in treatment, all Pride patients -both ~ and men- receive extensive informaitoo 00 AIOO and tre coonectioos between AIOO and chemical dependency. Family nmbers, significant otrers, and friends attending tre family program also receive a lecture 00 AIOO. OJr It.O:,k with patients is not limitEd to giving strict clinica 1 and Educatiooa 1 informatioo 00 !'OIl to avoid AIOO, l'OIdver. Many chemically dependent gay men and lesbian ~ have been accustared to using alcol'nl and drugs during sexual activity. for sane, being sexual witl'oJt chemicals \IRIS a virtual impossibility. To relp all our patients learn safer, chemical-free sexual behavior, Pride offers "safer sex It.Orksl'nps." Males patiS1ts attS1d a It.Orksl'np IIOdelEd 00 Michael Shemoff's and Luis Palacio's highly successful training sessioo S1titlEd, 'Hot Horny, and Healthy." Both It.Orksl'nps are designed to re 1p male patinets discover new \IRIYS of being sxua 1, so that wren trey leave treatment, trey can have sober, safer sex. \IbJm wI'n are in high risk groups have a smaller workshop lead by female staff nmbers dealing with special issues relatEd to safer sex. Mel POOl, MO, Cochair of tre Pride Advisory Board, observEd that safer sex Educatioo is an important part of treatment. 'Many patiS1ts leave treatment scarEd to have sober sex and get panickEd at not Lnderstanding that safer sex can be fun too, all witl'nut chemicals,· re said. For more informatioo, cootact: Pride Institute, 14400 Martin Dr., Eden Prairie, MN 55344 (612/934-7554) . • +•• ****~.:t ...... ~ ••• ~~~.m*lt* ... :. ALCOHOLISM RESOURCES AVAILABLE Tre National Associatioo of Lesbian & Gay Alcol'nlism professiooals (NALGAP) has recS1tly publishEd M works of great importance to alcol'nlism and chemical depS1dS1cy professirnals. Tre 'NALGAP AnnotatEd Bibliograply: Alcol'nlism, &Jbstance AbJse, and Lesbian/Gay Men" by Steva'1 Berg, Dana Fimegan, and Emily M::Nally, is tre most complete listing of resources dealing with lesbian/gay alcol'nlics in existance. Including over 900 fully annotatEd citations, tre bibliography is fully indexe:l by autl'nr, title, and subject which makes it an extremely useful reference book. Annotatioos are descriptive and quickly summarize tre main points in tre article. Tre literature coveed int eh bibliography ranges from early psycl'n logical 1iterature to tre most recS1t studies intre field. Articles from professiooa 1 journals as well as tre small press are also includEd. Tre 'Natirnal Directory Qf Facilities and Servi~ for Lesbian and ~ Alcol'nlics· by Ren Vaclm lists over 300 facilities and services, both professirnal and peer level, for alcol'nlic and chemically dependS1t lesbians and gay men that state that trey provide lesbian/gay positive services. Listings are alphabetizEd by state and city and include informatien 00 types of services which are providEd, fees and I'oJrs, to whom services are providEd, and IJ.tet:rer tre staff is professiooal, paraprofessional, peer, or volunteer. Tre Directory is an excellS1t resource for anyooe working intre chemical dependency field. It is particularly useful for aftercare planning in camunities otrer than one's CW1 and for idS1tifying resources which are available in ooe's CW1 COIIIlU1ity. Tre Bibliography costs $25 plus $1.50 postage & handling per book (cost to NALGAP members is $21.25 each, plus $1.50 P&H); tre Directory costs $5 (includes postage and handling). Make checks payable to: NALGAP and send to: NALGAP, 1208 E. State Blvd., Ft. \IIayne, IN 46805. Pre paid orders 00 ly, please! .. u~.:t*'.'''*''.'''''''''''''I*lt~~~ ... m.Mot C:H EM I: C:AL DEPENDENCY & AIDS CONF_ T!-e Anerican MEdical Society en Alcol'n lism and Otrer Drug Dependencies (AMSAOOD) is sPCl'lsoring tre 2nd annual forum en •AI 00 and Chemical Dependency, February 18-20, at tre Hyatt Regency in PI'nS1ix, ftl. Practitiooers, nurses, program directors & administrators, counselors or anyone else associatEd with AIOO care or chemical dependS1cy care is invitEd to attend. 15.5 CME (category 1) for physicians and physician assistants will be grantEd; C8Js and otrer academic crEdits have been appliEd for. Cost of tre crnference is: $175 for AMSAOOO nmbers, $190 for nonmembers. For additiCJ'1al ;nformatioo: Conference RegistratiCJ'1, AMSAODD Forum 00 AIOO & CD, P.O. Box 81691, Atlanta, GA 30366. Sore of tre featurEd speakers include Melvin Poh1, MD (Las Vegas); Louise Hay, 00; Fatrer laJ Booth (Loog Beach, CA); Larry Siegel, MD (Key Illest); Peter Selwyn, MD, Ib1 DesJarlais, PhD, Stuart E. Nicl'nls, MO, LeClair Bissell, MD (New York); Gwge Solomon, MD (Los Angeles); Kenneth Fisrer, MD (Pl'nS1ix); Mary Jean Kreek, MD (New York); Enoch GJrdis, MD, C. Robert Scruster, PhD, Donald Ian Macdonald (\IIashingtoo, OC); \llilliam Hawtl'nrne, MO (Basten); Daniel E. Beauchamp, PhD (Chapel Hill, NC); Lori Karan, MD (Richmond, VA); Loretta Finnegan, MD (Philadelphia); Max Schneider, MO (Orange, CA); Joyce JacksCJ'1, MA (TrS1too, NJ); Mark Hochhauser, PhD (Minneapolis); Timothy Baker (Atlanta); and otrers. ," •••• *•••• m***** *m~ ...... ~"**IlI:t •••• ~ COUNSEL I: NG & EDUC:ATI:ON PROT"OC:OL ·Protocol for AIOO Educatien and Risk Reduction Copunseling in Chemical DependS1cy TreatlTS"lt Settings, n is tre title of a valuable pamphlet recS1t1y publishEd by tre ARC Research Foundatioo. .6JJt1'nrs Caitlin ~an, MS\II, and Melvin Pool, MO provide basic AIlE informatiCJ'1 for patiS1t lectures and discussicns as well as for staff training. In additioo, trey offer guidelines and a counseling protocol for It.Orking with patiS1ts wI'n may have receivEd a positive HIV antibody test. T!-e protocol is rece:mS1dEd for all chemical dependS1CY treatment programs and facilities. Fop ordering informatioo, centact: ARC Research Foundatien, 411 \f/aver1ey Oaks Road, \f/a1tham, MA 02154 (617/893- 0602). **.**~ ..... ~ .... ~~ •• *m •••••• ~ ***** PAGE 30 * '!liE OFFICIAL NEWSLETTER OF '!liE NCGSlm * \WJE 8:4 * WINTER, 1987 ***** •~ .** .lI.lI ..... ********lI ••••• *** ** ...... ** ...... AIDSWALK RAISES ALMOST $250 .. 000 I7t IhJg Hinc:kle with thcnks to TI-e Washi~m Blade, 8/28/87 The final total of nmey raised by the June 28 AHBWALK was $248,393.37. Organizers of the Washingtm, OC walk, which drew sooe 3000 walkers, distriruted the funds August 18. Whitman-\llalker Clinic and the Human Rights Campaign Fu1d each ~ived $50,000 (20% of total raised); the National AlOO Network recieved $46,088.22 (19%); the AlOO Action Council received $23,044.11 (9%), and the Regional Addictions Prevention (RAP) group received $9,698.70 (4%). TWS1ty-two percS1t of the nmey raised WS1t to covering the cost of p.rt:ting on the event: $54,400. Lois Reckitt, deputy executive director of the Campaign Fund and the day-to-day supervisor of the evS1t, said that anmg is considered 'very low· for rrrunting such benefits. Less than half of the rudget, said Reckitt, WS1t to salaries for three staffers; abaJt 20,000 paid for printing and postage to recruit walkers; and the remainder was SPS1t on advertising and praootion. Reckitt said the evS1t ac:ualy carle.in under the original rudget which had been set at $70,000. Reckitt said she was very pleased with how IIl.JCh "The Next Step. ralsed, notmg that abaJt 95% of the nmey pledged was collected. She said that $15,162.34 fran the nmey raised has been set aside as ·seed OO'ley. to help organize the walkathon for 1988. ***lI ...... ** •••• ** .. ** ...... ** ...... VACCINE #2 APPROVED FOR TESTI:NG I7i S. EiSBlberg, with thcnks to Sc;B'lCe News, 12/5/87 AsecO'ld potS1tial AlOO vaccine was approved by federal officials for lunan testing in the U.S. The vaccine was developed I7t Seattle-based 01c0gS1, a divisim of the Bristol-Myers Co. It will be giVS1 to 30 hea1tlly tnTmexual males beginning in JarYJary at Seattle's Pacific Medial Center, according to study coinvestigator Ann Collier of the University of Washingtm School of Medicine. Another group of 30 controls will be inVolved in this phase of the study which will exanine the vaccine's safety and how it might inf1uda1ce the illllllne response. Testing of the first peotS1tial AIOO vaccine, developed I7t MicrdleneSys, Inc., of West HaVS1, Canecticut, was approved by the FDA last SlIII'IIeI'. Inocu 1atim of human volunteers, who are predaninant ly homosE!)«Ja 1 males, began in Septanber at the National Institute of Allergy and Infectious Diseases in Bethesda. The my side effect so far has been redness near the inocu1atim site, which is typical for inoculations, says MicrdJsleSys PresidS1t Frank Volvovitz. Both vaccines will expose volunteers to similar viral proteins found in the ·S1ve10pe" structure surrounding HIV, which can lead to fully developed AlOO. The proteins will not cause HIV infectim, rut sfnlld stimulate an effective immune response that protects against future HIV infection. TI-e vaccines will intraiJce viral proteins differS1t1y to the 00dy. The Bristol-Myers experimS1tal vaccine, called HIVAC-1e, is made fran the vaccinia virus, which has been used to manufacture the smallpox vaccine. In the case of the potS1tial AlOO vaccine, researchers have altered the vaccinia virus I7t inserting a QS1e coding for the HIV viral protein gp120. The hope is that after the vaccine S1ters the body, the QS18 will use tl'e machinery of invaded cells to make gp120 proteins, which will thS1 appear on tl'e cell surface and be recognized I7t tl'e body's immune systan. To make tl'e Mic~ys vaccine, researcl'ers inserted a gn coding for gp160 into a virus that infects matts and rutterflies, placed tl'e virus into cultures cmtaining insect cells and produced a large quantity of tl'e viral protein, which is used as tl'e vaccine. TI'e studies of tl'ese and other vaccines will determine which triggers tl'e best illllllne response, says Gerald QJinnan, director of tl'e FDA's division of virology. In tl'e "insect· approach, tl'e protein will be floating feely in tissue fluids, while in tl'e vaccinia approach. it will be on cell surfaces. If tl'e vaccines' safety and irmune response are established, tl'eir ability to preVS1t HIV infectim will thS1 !:e studied . •...... +. ** ...... +*"*"*. tlIlIlI****. +...... +lI •••• ** AIDS &: STD 1987 ~RAP-UP with thcnks to SciB'lCe News, 12/19-26/87 The follOWing are the big AIDS &STO stories of 1987, according to the editors of Science News: >/ls sciS1tists struggled to develop AIOO vaccines, ethicists, la\l.'J8rs and policy-makers \IKlrried abaJt tl'e problems that will have to be faced during testing and distribution of candidate vaccines, particularly in the absence of a U.S. vaccine-liability program. >Although sexually tranmsitted AIOO attracted more attS1tion, certain VS18rea 1 diseases continued to thrive in the U.S. SciS1tists recanmS1ded that WOmS1 treated for gonorrhea be treated for ch lalT¥lia at tl'e same time. Tl'ere was a large increase in reported cases of syphilis, and sciS1tists reported that having AIOO accelerates tl'e CaJrse of a patiS1t's syphilis. >AIOO continued to capture headlines, claim lives and involve armies of sciS1tists, me research focused on both prevS1tion and cure. DeveloPmS1t of AIOO vaccines met grim obstacles, rut human testing of two potS1tial AIOO vaccines was approved I7t the FDA. Earlier, in the first reported human test of an AlOO vaccine, a FrS1ch researcl'er had injected himself and volunteers fran Zaire with anotl'er vaccine candidate. Azidotl'tymidine (AZT), later called zidovudine, became tl'e first AIOO treatmS1t approved for sale in tl'e U.S. Other drugs, such as ribavirin and ampligS1, stu".led pranise in early clinical trials using AlOO patiS1ts. Acrowd of otl'er potS1tia1 drugs, aimed at differS1t features of AIDS pathology, pJshed closer to extS1ded clinical trials: for example, granu1ocyte-macrophage colony-stimulating factor (a+csF) tx:osted tl'e number of white blood cells in patiS1ts, and drugs that stopped an AI!&re1ated S1Zyme reduced the cell-to-cell spread of the AIOO virus. &.It many specifics abaJt AIOO remained a mystery. Reports of "killer" cells in tl'e body that destroy AIOO infected cells, AIOO-re lated l'ereditary factors and causes of AIOO demS1tia provoked as, many questions as answers. SciS1tists also isolated t\fK) additional viruses that apparS1t ly cause AIOO. Despite increased anphasis on education and. prevention, AIDS threatS1ed to break aJtinto the U.S. heterosexua 1 canmunity, with intraVS1aJs drug use recognized by sciS1tists as being tl'e most likely conduit. While studies attempted to determine tl'e number of SE!)«Ja 1 contacts needed for virus exposure and possible routes of infection, new epidaniologic surveys reflected a steady rise in the projected medical and econanic effects of tl'e AlOO virus. *****lI~ •• **. *******lI *****'********* .****tlI ***** lHE OFFICIAL NE\IISLETTER OF lHE NCGSTOO * VOI.UME 8:4 * WINTER, 1987 * PAGE 31 ***** •** ••••••• ** ** ** •• ****. **. 101m m. **** ...... +l! ++ ...... ** toI:+. lOll! **. ** ** ••• toI:+ ••• ++ + •• ****"'li •• ** **. ***** NEW VIRUS~ GROWTH FAC:ToOR FOUND by D.O. Edwards, with ttalks to SciBlCe---- News, 6/6/87 Yet another virus that apparently casues AIOO -- along with a growth factor in the AIOO-associated Kaposi's sarcoma and a role for leukemia viruses in the AIOO scenario -were anmg the new findings presented by scientists during the Third IntematiCNl CooferenceCJ1 AIOO held in ItIashingtCX1, OC. According to Robert C. Gallo of the Natiooal Cancer Institute (NCI) in Bethesda, his research grOJp and other collaOOrators have recently fOJnd the follCY.lling: *In additiCX1 to the previOJSly described HIV-1 (previOJSly known as HTLV-III) and HIV-2 viruses, there appears to be a third, distinct retrovirus cabable of causing the fatal disease. The scientists frund the virus in blood samples fran 10 Nigerian patients with AIOO or AIOO-like syndrane. Tests using the patients' serum and knoo AIOO viruses shCY.lled that the newly isolated virus is a separate human retrovirus that causes AIOO, says Gallo, who expects roore such viruses will be fMd. He says the discovery increases the risk of infectiCX1 by an AIOO-causing virus, rut that 'we shOJldn't panic· since the virus seaTS to be less virulent than the other AIOO viruses. *AlthOJgh the bluish or reddish skin nodules of Kaposi's sarcana are fre::p.Jently associated with AIOO, NCI scientists have determined that the syndrone probably is not directly caused by the HIV virus, says Gallo. And, he says, his grOJp has regulated the grCY.llth of I AIDS UPDAToE:: TOHE EXPANDl:NG FRONT with thillks to SciBlCe NarIs, 5/16/87 Recent annOJncaoonts fran scientific and policy-making grOJps fighting the spread of AIlE have added to the canplex picture of the fatal disease. Til«> reports tie AIOO to an increased incida1ce of tubercula;is and to a seCCX1d virus, while others raise roore questiCX1s abaJt AIOO testing. *In an editorial note in the May 1 fIorbidit~ and fIorta lity Weekly Report, the COC in Atlanta suggests taht the unexpected rise in the number of tubercula;is patients in the US may be due to AIOO patie'lts infected with both the virus causing AI!:B and the bacterium causing tubercula;is. The 1986 total of 22,575 tuberOJla;is cases reported to the COC marked a 1.7% increase over tl'e 1985 figures. Until 1985, the incidence of TS had been declining steadily, and the 1986 increase is "the first substantia01 rise" in tubercula;is cases since natiCX1a 1 reporting of TB began in 1953, say authors of the report. They suggest that p.Jbic health departnents match AIOO and tubercu la;is registries, and offer AIOO testing to patients with TB. *A secCX1d retrovirus - cla;ely related to tl'e HIV-1 virus kna.t.n to cause AIOO --may also cause the disease and pranpt a secCX1d epidemic, say scie'ltists fran France and Portugal. Led by Luc IImtagnier of tl'e Institut Pasteur in Paris, tl'e research team reports in the May 7 New §}gland JOJmal Qf Medicine that the HIV-2 virus has been isolated fran 30 African AIOO patients treated in Lisba1. At a M:lrch nesting in San Francisco, IImtagnier had anrunced the genetic mapping of tl'e so-called HIV-2 virus, isolated fran patie'lts withOJt AIOO in West Africa. After finding the virus in two people with AIOO, the scientists began searching for it in others suffering fran the disease. The latest study frund that blood fran the 30 patients with HIV-2 infectiCX1 did not cra;s-react with the HIV-1 virus, suggesting HIV-2 \lIS in fact causing the disease. AlthOJgh the HIV-2 virus may not have I1YJVed beya1d Africa, the authores express CCX1C9m that OJrre'lt diagnostic tests used II«>rldwide to screen blood and patients fran the HIV-1 virus are incapable of detecting the ne\IIly described virus. Also, nethods being used to prepare antiviral vaccines do not include antigenic canpcM1ts fran HIV-2. f#a1tagnier and his coauthors CCX1Clude that 'it appears clear that HIV-2 .... is the cause of AIDS in sane West Africans and that a ne\II AIDS epidemic is pa;sib le (rut not yet documented) in West Africa." They call for large-scale epidemiologic studies to assess the spread of the virus to other areas. *.... 01 April 30, the Food & Drug AdministratiCX1 approved a new camercial test kit for AIOO based CX1 the 'Western Blot' illYflJnOa5say, which is CCX1sidered roore specific in detecting the AIOO virus than the currently used inm..noassay screening method. The new test shOJld eliminate the problsn of false pa;itive results sanetines seen with the current test. While AIOO testing tecmology advanced, goverr1l1S1t officials were arguing over Iw screening shOJld be impleme'lted. &Jrg9CX1 General C. Everett Koop restated his pa;itiCX1 that mandatory AIOO tests 'are unnecessary, while Secretary of EducatiCX1 William Ba1nett said he supports mandatory testing aroong sane grOJps, including inmigrants and priSCX1ers. ***** PAGE 32 * TIlE CfFICIAL NEWSLETTER OF TIlE NCffiToo * 'vruJt1E 8: 4 \IIINTER, 1987 ***** . ++ +. +... +...... ++, .. ~ .... ++ •• +lIU till" 1lI ...lIlI. t ••• , .... ++, ...... III III Ill ...... 1lI.lIlIlI* .... ' ...... +'lI!' ++ ..... Ill AIDS AWARENESS & PREVENTION MONT·H with thcrlks to Science News, 10/10/87 \IIith Ck:tober officially designated AIoo Awar9'1ess and Preva1ticrl ftmth, tl'e federal governnBlt has launct-ed its massive educaticrl campaign called 'Anerica Res\Xl1ds to AIoo.' TI'e goal is to 'blanket tl'e naticrl with accurate AIoo informatioo,' according to a stataTSlt fran tl'e US Dept. of Health and Human Services. While the educatioo effort presses 00, so do AIoo research and politics. *****Despite the justifiable fear of AIoo, the overall prevalEro! of infectioo in the general popJlaticrl ranains 1011. This, say scientists at Harvard University, makes the ccrltroversia 1 coocept of mandatory pranarita 1 screening for the AIoo virus "a relatively ineffective and inefficient use of resources.' Reporting in the Ck:tober 2 Jrurna 1 ~ the Anerican Medical Associatioo, the researcl'ers estimate the number of peep le who \IIaJ ld have to be tested under such a program, as well as the nlJIl'bers of infectioos that might be prevented. They ccrlclude that if mandatory premarital screening were in place with currently available tests --which can yield both false positives and false negatives -the program \IIaJ ld detect fS\ller than 0.1% of infected individuals and ca;t "substantially· roore' than $100 millioo annually. They also say that mandatory pranarital screening for syphilis -begun in the mid-193Os and cited by trose supporting an AIoo program - has been 'judged to be ineffective and IJ'YleceSSary.' Voluntary testing, EdJcatioo and ca.nseling are the best ways to stop AIoo in lOllI-prevalence POp.J latioos say the scientists. *****Impatient with the federal process used to evaluate new drugs for use in AIoo patients, the State of California has decided to create its OlIn system for testing AIoo drugs. The state legislature approved the plan, which officials there said \llaJld be based 00 the process follOlled by the Food & Drug Administratioo, rut \llaJld provide quicker results. The FDA annoonced in March that certain investigatiooal drugs -including those for AIoo -might be used in patients withoot passing ttroJgh the time-coosuming channels normally needed for approval. ~re p.Jb 1ic funding will be floong to groups engaged in AIoo research, with the recent annaJncaTSlt that under so-called cooperative agreaTSlts tl'e federal governnBlt has awarded $10 millioo to 11 research groups across the US. The cooperative agreaTSltS differ fran the standard funding process of cootracts and grnats by a1 lOlling the grrup receiving the funds tEl manage the research, and the govemrrent to coordinate exchange of informatioo anmg the scientists involved. Administered by the Natiooal Institute of Allergy and Infectioos Diseases in Bethesda, the Natiooal Cooperative Drug Discovery Group Program was created in 1986 to encaJrage joint AIoo research by academic and industrial partners. \IIith the latest award, expected funding for the program through 1992 totals $68 millicrl. t:+lI*~~+ '1lI'~"'IlI"*IlI.t'llI POLITICS~ SCIENCE~ PEOPLE & A.IDS by D.O. fdlerds, with than~ to Science News, 6/6/87 SaTe opening CamB'lts at tl'e Third Internatiooal Cooference 00 AIoo in June were met with jeers, others with a standing ovaticrl. There were words of dean and \!lOrds of hope. Ant there was a mix of emothioos, people and papers perhaps never before seen at a scientific meeting -as more than 6350 ccrlference attendees and 850 reporters crOllded in \IIashingtoo, DC to hear health and government officials begin the meeting. fIost cootroversial were stataTSlts by Vice President ~ &Jsh, who called the AIoo virus "an ~l opportunity rrerchant of death.' &Jsh, ecroing stataTSlts made the previoos day by President Reagan, said the fovernllS1t plans to require mandatory AIoo testing of priscrlers, inmigrants and aHenns seeking residency. &Jsh pointed rut that similar screening is already under way in the military and foreign service. 'Reascrlab le nen and \IIOIIS1 may differ [crl the testing issue]," he said. 'Ultimate ly, we IlllSt protect the healthy.' The administratioo also has decided to encoorage states to require mandatory premarital testing for AIoo, according to &.Ish. He net with roore positive audience response wI'S1 he said the coofidentia 1 testing program IIlJst not turn into a "witch runt,' and that everyooe shares a 'CDnma'l responsibility' to remain understainding and compassiooate tOllard all AIoo 'victims.' ll'eanwhile, rutside the meeting, protesters carrying 'AIDSgate' signs rallied against the administraticrl's AIoo policies. Surgea'l General C. Everett Koop, who supports the use of ccndans and sex educaticrl to l'elp slOll the spread of AIoo, was applauded for his CamB'lts calling for coorage rather than fear. "[AIoo] is disdainful of age ... and it spitefully remains a mystery,' he said. "\lie dare not res\Xl1d with less than rur very best effort.' Part of that effort must be \!IOrldwide cooperatioo in p.Jblic health, said Koop, pointing rut that to date, 51,000 cases of the syndrome have been reported in 112 ca.ntries. And that number, he said, may be ooly half the actual cases because of incanplete reporting. Since last year's intematiooal AIoo meeting in Paris, there has been a ·global mobilizatioo to canbat AIoo,· said Carlyle !lJerra de Macedo, director of the \llashingtoo, DC-based Pan Anerican Health Organizatioo. He said nearly 80% of the \!lOr lds AIoo cases reported tt-us far have been in the \!/estern hemisphere, with nearly all of those in Brazil, the U.S., Canada, and Haiti. It was obvioos to all present that since the first AIoo cases was reported int he US in 1981, battles rave been \IIa'1 and lost. 'The tarulatio of the dead grOllS looger and looger,' US Assistant Secretary of Health Robert ~indan said during the meeting's opening sessioo. 'Looking backward is so easy. It \llaJld have been Italderful 6 years ago if we'd been able to say these [first cases] are enoogh to pranpt a \!IOrldwide respoose." Late as it may be, the response has been substantial "- at least in terms of dollars. Nearly $1 billicrl in US federal funds have been spent tt-us far 00 AIoo research, patient care, educatioo and preventioo, said Windan, adding that the states probably have spent the sane amoont. OJrrent ,projectioos by the RAND Gorp. of Santa Iblica, California, estimates that the natioo's medical costs for AIoo from mid-1986 to mid-199l coold exceed $37 billioo. The Public Health Service predicts that the umber of cases coold swell to 250,000 by 1990. Yet among the grim statistics 'there is DlJCh to give us rope,' said LOIIell Harmisoo U.S. dep.Jty assistant secretary for health. He calls the isolatioo and coog of AIoo viruses, early successes in vaccine research, and the introductioo of AIoo drugs 'major points of achievaTSlt.' Still, he says, 'we are all at risk, and we IlllSt •.. becare energized and carmitted to an urgent solutioo [for the AIoo problem].' between 49% and 68% of hospitals had established HB vaccination programs and that CENTERSFOR DISEASECONTROL June 19, 1987 1 Vol. 361 No. 23 the number has increased steadily each year (CDC, unpublished data). large hospitals 353 ACIP: Update on Hepatitis B (>500 beds) were most likely to establish programs (90%). However, by June 1985, Prevention 60% of hospitals with fewer than 100 beds also had begun vaccination programs. In I 75% of the programs, vaccination was recommended for high-risk health-care workers (as defined by the hospital), and, in 77%, the hospital paid for these vaccinations. In addition, 70% of states had established programs for vaccinating health-care workers under state jurisdiction (CDC, unpublished data). :i! In spite of these programs, the actual use of vaccine in high-risk health-care m professions has been modest. One statewide survey showed that, in hospitals with MORBIDITYAND MORTALITYWEEKLY REPORT ~.... HB vaccine programs, only 36% of persons at high risk had actually received vaccine n (CDC, unpublished data). In on~survey in three large cities, only 24% of physicians ~ Recommendations of the Immunization had received vaccine (CDC, unpublished data). National surveys have shown higher rates of vaccination among dentists (44% in early 1986) and hemodialysis staff (an Practices Advisory Committee estimated 44% in 1985); however, even these rates fall well short of optimal coverage (CDC, unpublished data). ' I Update on Hepatitis B Prevention ~ Development of vaccination programs has also progressed for several other :i! groups at high risk of HBV infection. By mid-1985, 94% of states had established m INTRODUCTION vaccination programs for the developmentally disabled in institutions under state Hepatitis B virus (HBV) infection is a major cause of acute and chronic hepatitis, jurisdiction, and 75% had programs for staff of such facilities (CDC, unpublished m cirrhosis, and primary hepatocellular carcinoma in the United States and worldwide. ~ data). By 1986, an estimated 27% of the developmentally disabled had received HB Since 1982, a safe and effective hepatitis B (HB) vaccine manufactured from human vaccine (Merck Sharp & Dohme, unpublished data). In addition, wide-scale programs .. plasma has been available in the United States. This vaccine has been recommended directed at vaccinating all susceptible persons were established in 1981 for Alaskan as preexposure p'rophylaxis for persons at high or moderate risk of HBV infection (1 ). Natives and in 1985 for the population of American Samoa. In addition, the combination of HB vaccine and hepatitis B immunoglobulin (HBIG) Nevertheless, there has been little progress in developing vaccination programs has been recommended for postexposure prophylaxis in susceptible persons who for other major risk groups, including parenteral drug abusers, homosexual men, and ~ have perinatal or needle-stick exposure to known HBV-positive persons or their co heterosexually active persons with multiple sexual partners. Few states have estab :.;. blood. lished programs for offering vaccine to any of these groups, and private usage of This statement provides an update on HB vaccine usage and on its impact on vaccine among these groups is believed to be limited. . disease incidence in the 5 years following its licensure. In addition, it provides both Impact on Disease Incidence recommendations for using a new HB vaccine produced in yeast by recombinant DNA The incidence of reported hepatitis B has increased steadily over the last decade. .. technology and an assessment of the need for HB vaccine booster doses for persons Hepatitis B is now the most commonly reported type of hepatitis in the United States. who have received the initial three-dose regimen. Basic recommendations on :IE In 1978, 15,000 cases of clinical hepatitis B were reported to CDC, for an incidence rate preexposure and postexposure usage of HB vaccine and on prevaccination serologic of 6.9/100,000 population. At that time, CDC estimated that there were actually testing for susceptibility to hepatitis B are unchanged. Previous recommendations J 200,000 persons with HBV infection and that 50,000 of these had clinically confirmed should be consulted for a complete discussion of the usage of HB vaccine (1 ). co cases with jaundice. The incidence rate of reported disease increased 33%, to ....."" PLASMA-DERIVED HB VACCINE 9.21100,000, in 1981, the year prior to vaccine availability. It continued to increase Patterns of Usage to Date during the initial 4 years of vaccine availability, reaching a rate of 11.5/100,000 in .. Since the plasma-derived HB vaccine became available in June 1982, 4AOO,000 1985 (2). Based on a comparison with the overall infection rate estimated in 1978, the doses have been distributed in the United States, and an estimated 1AOO,OOO persons incidence of HBV infection in the United States is now estimated at over 300,000 cases have completed the three-dose series (Merck Sharp & Dohme, unpublished data). per year. During this 5-year period, vaccination programs and overall vaccine usage have The apparent lack of impact of HB vaccine on the incidence of hepatitis B is ~ focused primarily on three risk groups- persons who work in health-care professions attributable to several factors. First, the majority of acute hepatitis B cases now occur c..> and have exposure to blood, staff and clients of institutions for the developmentally c..> in three groups: homosexual men, parenteral drug abusers, and persons acquiring disabled, and staff and patients in hemodialysis units. Although no precise figures are disease through heterosexual exposure (3). None of these groups is being reached available, is estimated than 85% distributed vaccine has been used it that more of for effectively by current HB vaccine programs. In contrast, fewer than 10% of cases I these groups. occur in health-care workers, the institutionalized developmentally disabled, and Development of vaccination programs for health-care workers has progressed other groups currently accounting for the bulk of vaccine usage. Finally, up to 30% of steadily since vaccine licensure. Several surveys of hospitals in 1985 showed that patients deny any of the recognized risk factors, even after careful questioning. No healthy adults. For example; in one study using three 40-fL9 doses of recombinant HB effective strategy has been devised to prevent disease among this group, although vaccine, only 64% of vaccine recipients developed protective levels of antibodies. some are probably undisclosed members of the three major risk groups. The recombinant HB vaccine has been shown to prevent HBV infection of A reduction in the incidence of hepatitis B can be expected only if significant vaccinated chimpanzees challenged intravenously with HBV of either adw or ayr proportions of persons at high risk receive vaccine. Increased efforts are needed to subtypes. In studies of infants born to HBsAg- and HBeAg-positive mothers, the I develop programs to vaccinate persons in all high-risk groups and to increase combination of HBIG (0.5 cc at birth) and recombinant HB vaccine (5fL9 in each of compliance among those who are susceptible in areas where programs are estab three doses) protected 94% of infants from developing the chronic carrier state, an ~ lished. To have any effect on the incidence of hepatitis B, use of HB vaccine in the efficacy equalling that of HBIG plus plasma-derived HB vaccine (6). The simultaneous ~ United States must extend beyond the current groups of recipients. administration of HBIG did not interfere with induction of anti-HBs antibody response NEW RECOMBINANT DNA HB VACCINE by the recombinant HB vaccine. Formulation There have been no large-scale efficacy trials of recombinant vaccine in adults. In July 1986, a new, genetically engineered HB vaccine (Recombivax HB®; Merck Nevertheless, the immunogenicity studies, the challenge studies using chimpanzees, Sharp & Dohme) was licensed by the U.S. Food and Drug Administration. This and the efficacy trials of the He vaccine and HBIG in infants born to mothers who are * vaccine, as formulated, has an immunogenicity comparable to that of the currently carriers of HBV strongly suggest that the efficacy of recombinant HB vaccine in adults available plasma-derived vaccine (Heptavax B®; Merck Sharp & Dohme). The two is comparable to that of the plasma-derived product. vaccines are also comparably effective when given with HBIG to prevent perinatal Safety HBV transmission. The new vaccine provides an alternative to the plasma-derived HB Because only the portion of the HBV viral genome that codes for the surface coat ~ vaccine for almost all groups at risk of HBV infection. ofthe virus (HBsAg) is present in the recombinant yeast cells, no potentially infectious ~ The recombinant vaccine is produced by Saccharomyces cerevisiae (common viral DNA or complete viral particles can be produced. No human or animal plasma (=) baker's yeast) into which a plasmid containing the gene for the Hepatitis B surface or other blood derivative is used in the preparation of recombinant HB vaccine. ~ antigen (HBsAg) subtype adw has been inserted (4 ). HBsAg is harvested by lysing the During prelicensure trials, approximately 4,500 persons received at least one dose, yeast cells and is separated from yeast components by hydrophobic interaction and and 2,700 persons completed the vaccine series (5). Reported side effects were size-exclusion chromatography. The purified HBsAg protein undergoes sterile filtra similar in extent and variety to those following administration of the plasma-derived ; tion and treatment with formalin prior to packaging. The vaccine is packaged to vaccine. Seventeen percent of those vaccinated experienced soreness at the injection contain 10fL9 HBsAg protein per ml, adsorbed with 0.5 mg/ml aluminum hydroxide; site, and 15% experienced mild systemic symptoms (fever, headache, fatigue, and Sf: a 1 :20,000 concentration of thimerosal is added as a preservative. nausea). To date, no severe side effects have been observed, nor have significant ~ The recombinant HBsAg takes the form of 17-25 nm spherical particles, similar in allergic reactions been reported. Although yeast-derived proteins may constitute up appearance to human plasma-derived HBsAg. The recombinant particles differ in that to 4% of the protein in the vaccine, no adverse reactions that could be related to m the HBsAg is not glycosylated, whereas up to 25% of plasma-derived HBsAg is changes in titers of antibodies to yeast-derived antigens occurred during clinical ~ glycosylated. The vaccine contains more than 95% HBsAg protein. Yeast-derived trials. * protein can constitute up to 4% of the final product, but no yeast DNA is detectable in Early concerns about safety of plasma-derived HB vaccine, especially the concern the vaccine. that infectious agents such as human immunodeficiency virus (HIV) present in donor Immunogenicity and Efficacy plasma pools might contaminate the final product, have pro'{en to be unfounded (7 ). The immunogenicity of the recombinant HB vaccine is comparable to that of the There are no data to indicate that the recombinant vaccine is potentially or actually ~ plasma-derived product (5). When given in a three-dose series (10fL9 per dose), safer than the currently licensed plasma-derived product. co recombinant HB vaccine induces protective antibodies (anti-HBs*) in over 95% of Dosage and Schedule • healthy adults 20-39 years of age. Studies comparing antibody responses of healthy The recombinant HB vaccine is given in a series of three doses over a 6-month adults show equal rates of seroconversion following the three doses of either the period. The second dose is administered 1 month after the first, and the third dose, 5 recombinant vaccine (10fL9 per dose) or the plasma-derived vaccine (20fL9 per dose). months after the second. For normal adults and children>10 years of age, the * However, the'geometric mean titers (GMT) of antibodies developed by recipients of recommended dose is 10fL9 (1, ml) intramuscularly in each of the three inoculations. the recombinant vaccine have ranged from equal to to 30% as high as those Children<11 years of age should receive a 5-,fLg dose (0.5 ml) by the same schedule. developed by recipients of the plasma-derived vaccine. The recombinant vaccine, like Newborns of mothers who are carriers of HBsAg should receive the three-dose series the plasma-flel'ived vaccine, produces a somewhat lower antibody response in older (5fL9 per dose) by the same schedule; however, the first dose, which is given at birth, adults than in younger adults (5). should be combined with a single dose of HBIG (0.5 ml) given intramuscularly at .~ another site. In studies using three 5-fL9 doses of recombinant vaccine for children<12 years of TABLE 1. States and metropolitan areas reporting increases of ;;020 cases of I After a 5-year trend of decreasing incidence of primary and secondary syphilis in ~ the United States, 8,274 cases were reported during the first 3 months of 1987. This primary and secondary syphilis - United States, January-March 1986 and January- :i! is an increase of 1,549 cases (23%) over the 6,725 cases reported during the first 3 March 1987 "' months of 1986. The estimated annual rate per 100,000 population rose from 10.9 Number of Cases cases to 13.3 cases (Figure 1). An increase of this magnitude has not been observed January-March 1987 Change (%) i in over 10 years. Reporting Area January-March 1986 Increases of 20 or more cases over the number reported during the first 3 months California * of 1986 were observed in eight states, four major metropolitan areas, and the Los Angeles 508 970 (91) Commonwealth of Puerto Rico (Table 1). The three areas reporting the largest Other 784 847 (8) numerical increases were California, Florida, and New York City. In California, Total 1,292 1,817 (41) (92) ~ increases of 10 or more cases occurred in Los Angeles, Long Beach, and seven Florida 877 1,679 00 New York FIGURE 1. Incidence rates of primary and secondary syphilis, by quarter - United 510 875 (72) - States and selected areas, 1977-1st quarter 1987 New York City Other 55 90 (64) 60 565 965 (71) Total * Georgia 383 417 (9) :E: a 50 Commonwealth of 3 Puerto Rico 207 229 (11) J 40 Pennsylvania <0 2 00 Philadelphia 118 187 (58) ..... ~ (15) g ~ vJjWV// Other 33 38 225 (49) * 6o • .' "\ .... / ' New York City Total 151 Mississippi 131 162 (24) ~ 20 .Jf;;'~J'\:::: V'/f'.....·A/ - ~Ifomla.-/' - Maryland III - I (70) ~ 10 , ...... ::;;;;;.~;;;~= ...... Baltimore 56 95 ~ 40 53 (33) (A> Other ..... Total 96 148 (54) o I Arizona 63 95 (51) 1977 1983' 1984' 198'5' 1986 '1987* D Oregon 27 48 (78) YEAR Nevada 20 41 (105) *1987 data are estimated. As with two smaller outbreaks in the 1980s (3,4), the current increases appear to be Reported by: MH Wilder, MD, Acting State Epidemiologist, Florida Dept of Health and Rehabilitative Svcs. S Schultz, MD, New York City Health Dept. 5 Fannin, MD, County of Los largely among heterosexuals. Angeles Dept of Health Svcs; K Acree, MDCM, MPH, JD, Acting State Epidemiologist, California The increases in primary and secondary syphilis have prompted two major Dept of Health Svcs. Div of Sexually Transmitted Diseases, Center for Prevention Svcs, CDC. concerns. First, this trend is likely to have a severe adverse effect on efforts to control Editorial Note: Although primary and secondary syphilis had been declining since congenital syphilis. While sexually acquired syphilis that is diagnosed in its early 1982 (1 ), they now appear to be on the upsurge in some areas. While 70% of cases stages can be effectively treated with long-acting penicillin preparations, congenitally I among males occurred among homosexual and bisexual men during the 1970s (2), acquired syphilis is responsible for high rates of infant morbidity and mortality (5). cases among these groups now appear to be on the decline in some areas (Table 2). After an 8-year decline, the incidence of congenital syphilis among infants began ~ ...00 TABLE 2. Cases of primary and secondary syphilis, by patient characteristics rising in 1983 (6). The areas with the largest increases in primary and secondary United States, January-March 1986 and January-March 1987 syphilis already have some of the highest rates of congenital syphilis in the nation (6). Any increases in acquired syphilis among heterosexual adults in these Number of Cases Reporting Areal Change areas are certain to be followed by further increases in congenital syphilis. Patient Characteristic* January-March 1986 January-March 1987 (%) Second, a history of sexually transmitted disease is associated with increased risk * Florida for human immunodeficiency virus (HIV) infection and acquired immunodeficiency Sex syndrome (AIDS) among both homosexuals (7,8) and heterosexuals (9). New York Female 314 595 (90) City and Florida have increased incidences of syphilis as well as high rates of AIDS Male 565 1,078 (91 ) among heterosexuals, particularly among those who abuse intravenous drugs (10). ~ Race Because genital ulceration is associated with higher rates of HIV infection (11,12), the ~ Black 694 1,331 (92) increases in primary and secondary syphilis in these areas may be the forerunner of c=; White and other 185 342 (85) future increases in HIV-related morbidity and mortality. Moreover, on the basis of :; Sexual preference (male)t case reports of treatment failures (13) and an atypical course in one patient (14), Heterosexual 347 521 (50) concerns have been raised about the effects of HIV-infection on the natural history and response to treatment of syphilis. These reports suggest the potential for Homosexual/bisexual 38 79 (108) problems in the management of patients with both infections. I California !:fl Sex References 1. CDC. Annual summary 1984. MMWR 1986;33(54):57-9. ~ Female 260 507 (95) 2. Fichtner RR, Aral SO, Blount JH, Zaidi AA, Reynolds GH, Darrow WW. Syphilis in the United Male 953 1,296 (36) States: 1968-1979. Sex Transm Dis 1983;10:77-80. ~ Race 3. CDC. Early syphilis-Broward County, Florida. MMWR 1987;36:221-4. ~ 4. Lee CB, Brunham RC, Sherman E, Harding GKM. Epidemiology an outbreak infectious 849 (131) of of Black 368 syphilis in Manitoba. Am J Epidemiol 1987;125:277-83. * White and other 845 954 (13) 5. Murphy K, Patamasucon P. Congenital syphilis. In: Holmes KK, Mardh PA, Sparling PF, Sexual preference (male)t Weisner PJ, eds. Sexually transmitted diseases. New York: McGraw Hill Co, 1984:352. 6. CDC. Congenital syphilis-United States, 1983-1985. MMWR 1986;35:625-9. 643 1130 (76) Heterosexual 7. Jaffe HW, Choi K, Thomas PA, et af. National case-control study of Kaposi's sarcoma and Homosexualibisexual 277 148 (-47) Pneumocystis carinii pneumonia in homosexual men: part 1, epidemiologic results. Ann ~ co New York City Intern Med 1983;99:145-51. :,;. 8. Moss AR, Osmond 0, Bacchetti P, Chermann J, Barre-Sinoussi F, Carlson J. Risk factors for Sex AIDS and HIV seropositivity in homosexual men. Am J Epidemiol 1987;125:1035-47. Female 158 290 (84) 9. Castro KG, Fischl MA, Landesman SH, et al. Risk factors for AIDS among Haitians in the Male 349 585 (68) United States. Atlanta, Georgia: International Conference on AIDS, April 14-17, 1985: 45. 10. CDC. Update: acquired immunodeficiency syndrome-United States. MMWR 1986;35;757- Race 60,765-6. * Black 246 475 (93) 11. Cameron OW, Plummer FA, Simonsen IN, et al. Female to male heterosexual transmission White and other 261 400 (53) of HIV infection in Nairobi. Washington, DC: III International Conference on AIDS, June 1-5, 1987. Abstract MP91 :25. Sexual prefer'ence (male)t- 12. Greenblatt RM, Lukehart SL, Plummer FA, et al. Geonital ulceration as a risk factor for human Heterosexual 125 250 (100) immunodeficiency virus infection in Kenya. Washington, DC: III International Conference on j Homosexual/bisexual 45 22 (-51 ) AIDS, June 1-5, 1987. Abstract ThP68:174. 13. Berry CD, Hooten TM, ColJier AC, Lukehart SA. Neurologic relapse after benzathine penicillin .....~ *Demographic data were available for 99% of patients with reported cases. therapy for secondary syphilis in a patient with HIV infection. N Engl J Med 1987;316: 1587-9. tExcludes men whose sexual preference was not determined. These comprised 2% of men with syphilis in California, 40% in Florida, and 53% in New York City. 14. Johns DR, Tierney M, Selsenstein D. Alteration in the natural history of neurosyphilis by concurrent infection with the human immunodeficiency virus. N Engl J Med 1987;316: I 1569-72. CENTERSFOR DISEASECONTROL August 14, 1987/ Vol. 36/ No. 31 Priorities for public health counseling and testing should be based upon 509 PHS Guidelines for Counseling and Antibody Testing to Prevent HIV providing ready access to persons who are most likely to be infected or who Infection and AIDS practice high-risk behaviors, thereby helping to reduce further spread of infection. There are other considerations for determining testing priorities, 522 Update: AIDS '- United States including the likely effectiveness of preventing the spread of infection among i 526 Publication of Revised Case Definition persons otherwise realize that are risk. Knowledge for AIDS Surveillance who would not they at of MtlWR the prevalence of HIV infection in different populations is useful in determin MORBIDllY AND MORTALIlY WEEKLYREPORT ing the most efficient and effective locations providing such services. For example, programs that offer counseling and testing to homosexual men, :i! IV-drug abusers, persons with hemophilia, sexual and/or needle-sharing ITI Perspectives in Disease Prevention and Health Promotion partners of these persons, and patients of sexually transmitted disease n~ clinics may be most effective since persons in these groups are at high risk ~ Public Health Service Guidelines for Counseling and for infection. After counseling and testing are effectively implemented in Antibody Testing to Prevent HIV Infection and AIDS settings of high and moderate prevalence, consideration should be given to establishing programs in settings of lower prevalence. These guidelines are the outgrowth of the 1986 recommendations pub Interpretation of HIV-Antibody Test Results I lished in the MMWR (1 ); the report on the February 24-25,1987, Conference ~ on Counseling and Testing (2); and a series of meetings with representatives A test for HIV antibody is considered positive when a sequence of tests, ~ from the Association of State and Territorial Health Officials, the Association starting with a repeatedly reactive enzyme immunoassay (EIA) and including of State and Territorial Public Health Laboratory Directors, the Council of an additional, more specific assay, such as a Western blot, are consistently State and Territorial Epidemiologists, the National Association of County reactive. i The sensitivity of the currently licensed EIA tests is 99% or greater when Health Officials, the United States Conference of Local Health Officers, and * the National Association of State Alcohol and Drug Abuse Directors. performed under optimal laboratory conditions. Given this performance, the Human immunodeficiency virus (HIV), the causative agent of acquired probability of a false-negative test result is remote, except during the first immunodeficiency syndrome (AIDS) and related clinical manifestations, has weeks after infection, before antibody is detectable. been shown to be spread by sexual contact; by parenteral exposure to blood The specificity of the currently licensed EIA tests is approximately 99% ~, 00 (most often through intravenous [IV] drug abuse) and, rarely, by other when repeatedly reactive tests are considered. Repeat testing of specimens ~ exposures to blood; and from an infected woman to her fetus or infant. initially reactive by EIA is required to reduce the likelihood of false-positive Persons exposed to HIV usually develop detectable levels of antibody test results due to laboratory error. To further increase the specificity of the against the virus within 6-12 weeks of infection. The presence of antibody testing process, laboratories must use a supplemental test- most often the indicates current infection, though many infected persons may have minimal Western blot test-to validate repeatedly reactive EIA results. The sensitivity * or no clinical evidence of disease for years. Counseling and testing persons of the licensed Western blot test is comparable to that of the EIA, and it is :IE who are infected or at risk for acquiring HIV infection is an important highly specific when strict criteria are used for interpretation. Under ideal component of prevention strategy (1). Most of the estimated 1.0 to 1.5 circumstances, the probability that a testing sequence will be falsely positive J coto million infected persons in the United States are unaware that they are in a population with a low rate of infection ranges from less than 1 in 100,000 ...... infected with HIV. The primary public health purposes of counseling and (Minnesota Department of Health, unpublished data) to an estimated 5 in testing are to help uninfected individuals initiate and sustain behavioral 100,000 (3,4). Laboratories using different Western blot reagents or other * changes that reduce their risk of becoming infected and to assist infected tests or using less stringent interpretive criteria may experience higher rates individuals in avoiding infecting others. of false-positive results. Along with the potential personal, medical, and public health benefits of Laboratories should carefully guard against human errors, which are likely to be the most common source of false-positive test results., All laboratories ~ testing for HIV antibody, public health agencies must be concerned about (.0.) actions that will discourage the use of counseling and testing facilities, most should anticipate the need for assuring quality performance of tests for HIV <.0 notably the unauthorized disclosure of personal information and the possi antibody by training personnel, establishing quality controls, and participat bility of inappropriate discrimination. ing in performance evaluation systems. Health department laboratories i should facilitate the quality assurance of the performance of laboratories in U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES I PUBLIC HEALTH SERVICE their jurisdiction. Guidelines for Counseling and Testing for HIV Antibody 4. Women of childbearing age. All women of childbearing age with identifi These guidelines are based on public health considerations for HIV testing, able risks for HIV infection should be routinely counseled and tested for including the principles of counseling before and after testing, confidentiality HIV antibody, regardless of the health-care setting. Each encounter be of personal information, and the understanding that a person may decline to tween a health-care provider and a woman at risk and/or her sexual be tested without being denied health care or other services, except where partners is an opportunity to reach them with information and education I testing is required by law (5). Counseling before testing may not be practical about AIDS and prevention of HIV infection. Women are at risk for HIV -0 when screening for HIV antibody is required. This is true for donors of blood, infection if they: ~ organs, and tissue; prisoners; and immigrants for whom testing is a Federal • Have used IV drugs. =- requirement as well as for persons admitted to state correctional institutions • Have engaged in prostitution. in states that require testing. When there is no counseling before testing, • Have had sexual partners who are infected or are at risk for infection persons should be informed that testing for HIV antibody will be performed, because they are bisexual or are IV-drug abusers or hemophiliacs. that individual results will be kept confidential to the extent permitted by law, • Are living in communities or were born in countries where there is a * and that appropriate counseling will be offered. Individual counseling of known or suspected high prevalence of infection among women. those who are either HIV-antibody positive or at continuing risk for HIV infection is critical for reducing further transmission and for ensuring timely • Received a transfusion before blood was being screened for HIV antibody but after HIV infection occurred in the United States (e.g., ~ medical care. m between 1978 and 1985). Specific recommendations follow: ~ Educating and testing these women before they become pregnant allows (=) 1. Persons who may have sexually transmitted disease. All persons seeking ~ them to avoid pregnancy and subsequent intrauterine perinatal infection :z treatment for a sexually transmitted disease, in all health-care settings of .their infants (30%-50% of the infants born to HIV-infected women will including the offices of private physicians, shou~dbe routinely* counseled also be infected). and tp-sted for HIV antibody. All pregnant women at risk for HIV infection should be routinely I 2. IV-drug abusers. All persons seeking treatment for IV-drug abuse or counseled and tested for HIV antibody. Identifying pregnant women with ~ having a history IV-drug abuse should be routinely counseled and ~ of HIV infection as early in pregnancy as possible is important for ensuring m tested for HIV antibody. Medical professionals in all health-care settings, appropriate medical care for these women; for planning medical care for including prison clinics, should seek a history of IV-drug abuse from their infants; and for providing counseling on family planning, future patients and should be aware of its implications for HIV infection. In pregnancies, and the risk of sexual transmission of HIV to others. i addition"state and local health policy makers should address the follow All women who seek family planning services and who are at risk for HIV * ing issues: infection should be routinely counseled about AIDS and HIV infection and • Treatment programs for IV-drug abusers should be sufficiently avail tested for HIV antibody. Decisions about the need for counseling and able to allow persons seeking assistance to enter promptly and be testing programs in a community should be based on the best available estimates of the prevalence of HIV infection and the demographic vari ~ encouraged to alter the behavior that places them and others at risk for co HIV infection. ables of infection. ~ • Outreach programs for IV-drug abusers should be undertaken to 5. Persons planning marriage. All persons considering marriage should be increase their knowledge of AIDS and of ways to prevent HIV infection, given information about AIDS, HIV infection, and the availability of to encourage them to obtain counseling and testing for HIV antibody, counseling and testing for HIV antibody. Decisions about instituting and to persuade them to be treated for substance abuse. routine or mandatory premarital testing for HIV antibody should take into * 3. Persons who consider themselves at risk. All persons who consider account the prevalence of HIV infection in the area and/or population themselv,es at risk for HIV infection should be counseled and offered group as well as other factors and should be based upon the likely testing" for HIV-antibody. cost-effectiveness of such testing in preventing further spread of infection. Premarital testing in an area with a prevalence HIV infection as low as j *"Routine counseling and testing" is defined as a policy to provide these services to of 0.1% may be justified if reaching an infected person through testing can <0 all clients after informing them that testing will be done. Except where testing is ....co required by law, individuals have the right to decline to be tested without being prevent subsequent transmission to the spouse or prevent pregnancy in a denied health care or other services. woman who is infected. I 6. Persons undergoing medical evaluation or treatment. Testing for HIV Confidentiality and Antidiscrimination Considerations antibody is a useful diagnostic tool for evaluating patients with selected The ability of health departments, hospitals, and other health-care provid clinical signs and symptoms such as generalized lymphadenopathy; ers and institutions to assure confidentiality of patient information and the unexplained dementia; chronic, unexplained fever or diarrhea; unex public's confidence in that ability are crucial to efforts to increase the number plained weight loss; or diseases such as tuberculosis as well as sexually of persons being counseled and tested for HIV infection. Moreover, to assure I transmitted diseases, generalized herpes, and chronic candidiasis. broad participation in the counseling and testing programs, it is of equal or greater importance that the public perceive that persons found to be positive Since persons infected with both HIV and the tubercle bacillus are at will not be subject to inappropriate discrimination. high risk for severe clinical tuberculosis, all patients with tuberculosis Every reasonable effort should be made to improve confidentiality of test should be routinely counseled and tested for HIV antibody (6). Guidelines results. The confidentiality of related records can be improved by a careful managing patients with both HIV and tuberculous infection have been ~ 'for review of actual record-keeping practices and by assessing the degree to published (7). which these records can be protected under applicable state laws. State laws ~ The risk of HIV infection from transfusions of blood or blood compo ~ should be examined and strengthened when found necessary. Because of 7I= nents from 1978-1985 was greatest for persons receiving large numbers of the wide scope of "need-to-know" situations, because of the possibility of units of blood collected from areas with high incidences of AIDS. Persons inappropriate disclosures, and because of established authorization proce who have this increased risk should be counseled about the potential risk dures for releasing records, it is recognized that there is no perfect solution of HIV infection and should be offered antibody testing (8). I to confidentiality problems in all situations. Whether disclosures of HIV ~ 7. Persons admitted to hospitals. Hospitals, in conjunction with state and testing information are deliberate, inadvertent, or simply unavoidable, public ~ local health departments, should periodically determine the prevalence of health policy needs to carefully consider ways to reduce the harmful impact . HIV infections in the age groups at highest risk for infection. Consideration of such disclosures. should be given to routine testing in those age groups deemed to have a Public health prevention policy to reduce the transmission of HIV infection i high prevalence of HIV infection. can be furthered by an expanded program of counseling and testing for HIV * 8. Persons in correctional systems. Correctional systems should study the antibody, but the extent to which these programs are successful depends on best means of implementing programs for counseling inmates about HIV the level of participation. Persons are more likely to participate in counseling infection and for testing them for such infection at admission and and testing programs if they believe that they will not experience negative discharge from the system. In particular, they should examine the useful consequences in areas such as employment, school admission, housing, and ; CD ness of these programs in preventing further transmission of HIV infection medical services should they test positive. There is no known medical reason .. and the impact of the testing programs on both the inmates and the to avoid an infected person in these and ordinary social situations since the correctional system (9). Federal prisons have been instructed to test all cumulative evidence is strong that HIV infection is not spread through casual prisoners when they enter and leave the prison system. contact. It is essential to the success of counseling and testing programs that 9. Prostitutes. Male and female prostitutes should be counseled and tested persons who are tested for HIV are not subjected to inappropriate discrimi * and made aware of the risks of HIV infection to themselves and others. nation. Particularly prostitutes who are HIV-antibody positive should be in References j structed to discontinue the practice of prostitution. Local or state jurisdic 1. CDC. Additional recommendations to reduce sexual and drug abuse-related ~ tions should adopt procedures to assure that these instructions are transmission of human T-Iymphotropic virus type III/lymphadenopathy l§ followed. associated virus. MMWR 1986;35:152-5. 2. CDC. Recommended additional guidelines for HIV antibody counseling and * Partner Notification/Contact Tracing testing in the prevention of HIV infection and AIDS. Atlanta, Georgia: US Sexual partners and those who share needles with HIV-infected persons Department of Health and Human Services, Public Health Service, 1987. are at risk for HIV infection and should be routinely counseled and tested for 3. Burke OS, Brandt BL, Redfield RR, et al. Diagnosis of human immunodeficiency virus infection by immunoassay using a molecularly cloned and expressed virus HIV antibody. Persons who are HIV-antibody positive should be instructed in envelope polypeptide. Ann Intern Med 1987;106:671-6. ~ how to notify their partners and to refer them for counseling and testing. If 4. Meyer KB, Pauker SG. Screening for HIV: can we afford the false positive rate? N ~ they are unwilling to notify their par,N'lrS or if it cannot be assured that their Engl J Med 1987;317:238-41. partners will seek counseling, physicians or health department personnel 5. Bayer R, Levine C, Wolf SM. HIV antibody screening: an ethical framework for should use confidential procedures to assure that the partners are notified. evaluating proposed programs. JAMA 1986;256:1768-74. I 6. CDC. Tuberculosis provisional data - United States, 1986. MMWR 1987;36:254-5. As described in the MMWR supplement being released this week, CDC, in 7. CDC. Diagnosis and management of mycobacterial infection and disease in consultation with state and local public health officials and clinical special persons with human T-Iymphotropic virus type III/lymphadenopathy-associated ists, has revised the case definition for national reporting of AIDS (8). With virus infection. MMWR 1986;35:448-52. this revision, AIDS cases involving patients with presumptively diagnosed 8. CDC. Human immunodeficiency virus infection in transfusion recipients and their indicator diseases, which were previously not reportable because they lacked family members. MMWR 1987;36:137-40. i 9. Hammett TM. AIDS in correctional facilities: issues and options. 2nd ed. Wash biopsy or other specific confirmation required by the former surveillance ·0 ington, DC: U.S. Department of Justice, National Institute of Justice, 1987. case definition, will now be reportable. Inclusion of this category will allow rn~ Epidemiologic Notes and Reports for national reporting of an estimated 10% to 15% of patients not previously eligible for reporting (4). Because, historically, most health departments -'" Update: Acquired Immunodeficiency Syndrome - United States have not required reporting of the additional manifestations of human immunodeficiency virus (HIV) infection included in the expanded case As of August 10, 1987, physicians and health departments in the United definition (HIV dementia complex, chronic wasting syndrome, etc.), the States had reported 40,051 patients (39,493 adults and 558 children) meeting number of cases that will be added to existing case counts as a result of this * the current case definition for national reporting of the acquired immunode revision is unknown. Since most patients with the wasting syndrome and HIV ficiency syndrome (AIDS) (1-3). Of these patients, 23,165 (58% of the adults dementia develop the opportunistic diseases included in the previous AIDS and 65% of the children) are known to have died. The number of AIDS cases case definition, addition of these conditions to the case definition may result ~rn reported per year continues to increase in all patient groups (Table 1). AIDS in earlier reporting adding substantially to the ultimate case count. without Sfi cases have been reported from all 50 states, the District of Columbia, and To evaluate the impact of the revised case definition on long-term trends -n n.- four U.S. territories. of overall reporting, future data analyses will include separate tallies for f!! AIDS surveillance is conducted by health departments in each state, cases meeting the previous and the revised case definitions. z territory, and the District of Columbia. Most areas employ multifaceted active Targeted epidemiologic surveys and serologic studies as well as prompt surveillance programs that include four major sources of AIDS information: and complete reporting are essential for effectively monitoring the HIV ~:;0 hospitals and hospital-based physicians, physicians in nonhospital practices, epidemic. They are also necessary for projecting trends and health-care ~ public and private clinics, and medical records systems (death certificates, costs; for identifying patterns of infection; for formulating and targeting ~rn tumor registries, hospital discharge abstracts, and communicable disease prevention strategies; and for providing timely guidelines for risk-reduction z reports). Epidemiologic and clinical AIDS patient information is reported and other information to the public, the scientific and public health commu ~ through state and local health departments to CDC on a standard, confiden nities, and members of high-risk groups. ~ tial case report form. The median interval between diagnosis of an AIDS case References and notificption of CDC is 2 months. At present, an estimated 6,000 to 8,000 1. CDC. Update: acquired immunodeficiency syndrome (AIDS) - United States. * AIDS cases (15% to 20% of the total number of cases) have been diagnosed MMWR 1983;32:688-91. and will be reported soon to CDC. 2. Selik RM, Haverkos HW, Curran JW. Acquired immune deficiency syndrome (AIDS) C§ trends in the United States, 1978-1982. Am J Med 1984;76:493-500. ~ In late 1985, a 3-month review of death certificates was conducted in four rn 3. CDC. Revision of the case definition of acquired immunodeficiency syndrome for co :.;. major U.S. cities to assess the completeness of AIDS case reporting (4 ). Data national reporting - United States. MMWR 1985;34:373-5. from this review suggest that 11% of AIDS cases are not reported to state and 4. Hardy AH, Starcher ET, Morgan WM, et al. Review of death certificates to assess local public health departments, primarily because of breakdowns in estab- completeness of AIDS case reporting. Public Health Rep 1987;1.02:3~6-91. ·lished reporting procedures (e.g., absence of the individual responsible for 5. Marier R. The reporting of communicable diseases. Am J Epldemlol 1977;105: !'i87-90. b OF S ., * reporting when the case was diagnosed). 6. Rauch KJ, Rutherford GW, Badran C, Neal DP, ~ayerNM, E.chen erg : urvel- lance of acquired immunodeficiency syndrome In San FranCISco: evaluation of the Reported by: State and Territorial Epidemiologists. AIDS Program, Center for Infec completeness of reporting [Abstract]. Paris, France: International Conference on tious Diseases, CDC. >E AIDS, June 23-25,1986. . f . Editorial-Note:. In comparison to many reportable diseases, the reporting 7. Chamberland ME, Allen JR, Monroe JMi et al. Acquir~dImmunode IClency J level for AIDS has been high (5). Previous AIDS validation studies conducted syndrome in New York City: evaluation of an active surveillance system. JAMA co ICalifornia, four cases; Nebraska, Florida, Tennessee, Michigan, and Thailand one case each. 534 Multiple Strain Outbreak of PPNG - Denver, Colorado, 1986 I MtlWR FIGURE 1. Isolates of penicillinase-producing Neisseria gonorrhoeae in the Denver ~ MORBIDITYAND MORTALITYWEEKLY REPORT 545 Notices to Readers Metro Health Clinic - Colorado, 1986 ifi 10 Epidemiologic Notes and Reports m ~ Multiple Strain Outbreak of Penicillinase-Producing * ·Neisseria gonorrhoeae - Denver, Colorado, 1986 8 In 1986, the Denver Metro Health Clinic (DMHC) detected 40 cases of infection with strains of penicillinase-producing Neisseria gonorrhoeae (PPNG). This was a marked 6 i increase over the nine cases* found during the preceding 5 years. The increase in 00 :,;. cases began during the last 2 months of 1985, when three cases were detected. From ~ January through May 1986, seven additional cases were identified.t Beginning on ~ 4 June 2,1986, all isolates were routinely screened for 13-lactamase, and, over the next 7 months, 33 of 1,358 isolates (2%) were identified as PPNG strains. Four of these * occurred among persons referred to the clinic as known sexual contacts of PPNG positive patients. One was from a patient with possible treatment failure, and 28 were 2 from patients not suspected infection with PPNG. of :IE The epidemic peaked during the period from August through November (Figure 1). Since the DMHC treats over 50% of all reported cases of gonorrhea in the city and o fULf.rq«?H?AI t'/'VV%j'V~~~ ~ county of Denver, trends among patients in these clinics are considered representa Jan reb Mar Apr May Jun* Jul Aug Sep Oct Nov Dec ~ ~ tive of trends in the greater Denver metropolitan area. On August 18, 1986, the MONTH Colorado Department of Health issued an advisory requesting other Denver metro- *Routine screening of all isolates for j3-lactamase began on June 2. *These nine strains were found among 549 isolates from patients with treatment failures. No I strains of PPNG were found among the 789 isolates from systematically selected patients. tFive were found by routine screening of systematically selected isolates, and two were from patients referred to DMHC as sexual contacts of patients with confirmed cases of PPNG infection. References were culture-positive, and 14 (88%) of these had PPNG strains. The other 33 (67%) of 1. CDC. Penicillinase-producing Neisseria gonorrhoeae - United States, 1986. MMWR 1987; the 49 contacts were culture-negative for N. gonorrhoeae and received treatment 36:107-8. 2. Perine PL, Schall a W, Siegel MS, et al. Evidence for two distinct types of penicillinase with either spectinomycin or ceftriaxone. producing Neisseria gonorrhoeae. Lancet 1977;2:993-5. The minimum inhibitory concentrations (MICs) of penicillin, tetracycline, and 3. Siegel MS, Thornsberry C, Biddle JW, O'Mara PR, Perine PL, Wiesner PJ. Penicillinase spectinomycin were determined for 38 of 40 isolates by an agar dilution method. The producing Neisseria gonorrhoeae: results of surveillance in the United States. J Infect Dis geometric mean MICs for tetracycline and spectinomycin in the 1986 PPNG isolates 1978;137: 170-5. 4. Jaffe HW, Biddle JW, Johnson SR, Wiesner PJ. Infections due to penicillinase-producing i were similar to those for isolates from systematically selected patients seen from Neisseria gonorrhoeae in the United States: 1976-1980. J Infect Dis 1981;144:191-7. 1981 through 1986. However, the 1986 PPNG isolates had lower geometric mean 5. CDC. 1985 STD treatment guidelines. MMWR 1985;34(4S). MICs for tetracycline than did isolates from patients with treatment failure from 1981 through 1986 (0.67 compared with 3.03I-lg/ml). All isolates tested were susceptible to Notices to Readers spectinomycin (MIC <64I-lg/ml). Auxotype/serovar and plasmid analysis of 36 of the 40 PPNG isolates from 1986 Publication of Recommendations for Prevention of fi: HIV Transmission in Health-Care Settings has been completed. Eight auxotype/serovar classes were involved in the outbreak. ~ Four auxotype/serovar classes were represented by isolates from at least five n On August 21,1987, CDC is releasing an MMWR supplement entitled "Recommen ~ individuals. Plasmid analysis indicates that all isolates contained either the 3.2 (44%) dations for Prevention of HIV Transmission in Health-Care Settings". This document or 4.4 (56%) Mdal plasmid for fj-Iactamase production, but only those from one class consolidates and updates previous recommendations. Copies of the supplement (Proto/I B-3) contained the 24.5 Mdal conjugative plasmid. (MMWR Vol. 36, Supplement no. 2S) may be purchased from the Superintendent of Reported by: J Douglas, MD, F Judson, MD, Denver Disease Control Svc, Denver; N Spencer, R Documents, U.S. Government Printing Office, Washington, D.C. 20402, telephone Hoffman, MD, State Epidemiologist, Colorado Dept of Health. Sexually Transmitted Diseases I (202)783-3238, or from MMS Publications, C.S.P.O. Box 9120, Waltham, Massachu ~ Laboratory Program, Center for Infectious Diseases; Div of Sexually Transmitted Diseases, setts 02254, telephone (617)893-3800. ~ Center for Prevention Svcs, CDC. m Editorial Note: Although the incidence of PPNG has been concentrated in New York, California, and Florida, outbreaks in other parts of the country are occurring fre ~ ~ quently (1 ). The absence of PPNG strains among the systematically selected isolates August 28, 1987/ Vol. 36/ No. 33 CENTERSFOR DISEASECONTROL screened in the previous 5 years at the DMHC suggests that the increase in cases * reflected a new problem and was not due solely to screening. A high proportion of patients in the Denver outbreak gave histories suggesting that they may have become infected outside of Colorado and/or may have been involved in prostitution-related activities. These histories, along with the diversity of auxotype/serovar classes ; co involved and the presence of both the 3.2 Mdal and 4.4 Mdal fj-Iactamase plasm ids :.;... among the isolates, strongly suggest that this outbreak is in reality a series of 561 Cryptosporidiosis - New Mexico. "mini-outbreaks" caused by different strains of PPNG. Mtl'lR 1986 * MORBIDITYAND MORTALITYWEEKLY REPORT In contrast to previously reported experiences in the United States (2-4), the Denver PPNG isolates were relatively susceptible to tetracycline. This pattern reflects :IE the high proportion of strains with the 3.2 Mdal plasmid, which is characteristically Epidemiologic Notes and Reports associated with increased tetracycline susceptibility. The DMHC's routine use of ~ Cryptosporidiosis - New Mexico, 1986 ~ tetracycline in treating heterosexuals with gonorrhea probably delayed recognition of co<0 the onset of the outbreak, as evidenced by the increase in incidence of PPNG cases ..... after the institution of routine screening of all pretreatment isolates for fj-Iactamase. Between July 1 and October 1,1986,78 laboratory-confirmed cases of cryptospo CDC currently recommends that all gonococcal isolates be tested for fj-Iactamase ridiosis were reported to the Office of Epidemiology at the New Mexico Health and production. In areas where the proportion of gonococcal disease caused by PPNG Environment Department. Because the source of infection in these cases was unclear, * strains is greater than 1%, all patients diagnosed with gonorrhea should be treated investigators conducted a case-control study to establish risk factors for infection. with a regimen effective for antimicrobial-resistant gonorrhea (e.g., ceftriaxone, For study purposes, a patient was defined as a Bernalillo County resident with 250 mg, intramuscularly). In addition, patients treated for gonorrhea should receive laboratory-confirmed cryptosporidiosis reported to the Office of Epidemiology from 1 week of tetracycline or erythromycin therapy for the cotreatment of chlamydial July 1 through October 1, 1986. If more than one laboratory-confirmed case occurred ~ in a household or day-care group, only the person with the earliest onset of infection (5 ). Detailed guidelines for the diagnosis, therapy, and recommended public ~ health interventions for antimicrobial-resistant gonococcal infections will be pub symptoms was included in the study. lished as an MMWR supplement in September. Fifty-eight (74%) of the 78 patients with cryptosporidiosis lived in Bernalillo County, which includes the city of Albuquerque. Twenty-four of these patients were I Previous outbreaks of cryptosporidiosis have occurred among animal handlers, included in the study. Thirty-two of the remalnmg patients were household or through direct contact with animal feces (1), and in day-care centers, through day-care contacts of these patients, and two were lost to follow-up. person-to-person contact (2,3). An outbreak has also been reported from a Texas The 24 patients included in the study were matched with 46 controls by age, sex, community where a common water well became contaminated (4 ). and neighborhood of residence. Using a questionnaire administered by telephone to Although surface water has not been previously recognized as a source of infection both patients and controls, investigators gathered information on household size; with Cryptosporidium, this study demonstrates that it may be. Further evidence was day-care-center attendance, employment, or other principal sources of contact; provided in January 1987 when a major waterborne outbreak of cryptosporidiosis in I travel; surface-water exposure; pet and domestic animal exposure; and the source of Georgia was traced to a river serving as the municipal water supply (CDC, unpub water to the home. lished data). Cryptosporidium sp. has been isolated from a broad variety of animals, ~ Patients' dates of onset of symptoms ranged from May 28 through September 2, including cattle, sheep, dogs, cats, deer, mice, rabbits, and snakes. Cryptosporidium en 1986. Symptoms lasted from 5 to 60 days, with a median of 21 days. Ninety-six sp. found in cattle have been shown to be transmitted to humans (1 ). Surface water - percent of the patients reported watery, nonbloody diarrhea; 79% reported flatu might become contaminated through direct deposit of feces into water or by surface lence; 67%, abdominal pain; 58%, nausea; and 54%, low-grade fever. runoff that washes feces into water. The seasonal distribution of cryptosporidiosis, Patients ranged in age from 4 months to 44 years, with a median age of 3 years. which occurs primarily in the summer and early fall (1,5). could be partially explained Seventeen (71%) were <10 years of age. Seventeen 01%) of the patients were by the increased outdoor activity during that time of year. * female, and seven (29%) were male. Thirteen (77%) of the patients <10 years of age Cryptosporidium species are known to be resistant to most chemical disinfectants, and four (57%) of those >10 were female. such as chlorine and iodine. Physicians should consider cryptosporidiosis in the Univariate analysis suggested that drinking untreated surface water and attending differential diagnosis of persons with diarrhea who have a history of drinking surface a day-care center where other children were ill with diarrhea were possible risk water that is untreated or treated by chemical means alone. ~ factors for this infection. There was a strong statistical association between drinking References ~ surface water and illness (odds ratio [OR) incalculable, p = 0.0016). None of the five 1. Current WL. Cryptosporidiosis. J Am Vet Med Assoc 191:15;187: 1334-8. B 2. CDC. Cryptosporidiosis among children attending day-care centers - Georgia, Pennsylvania, ~ patients who drank surface water had treated it in any way. One of these five patients Michigan, California, New Mexico. MMWR 1984;33:599-601. attended a day-care center, the others had no other risk factors for cryptosporidiosis. 3. Stehr-Green JK, McCaig L, Remsen HM, Rains CS, Fox M, Juranek DO. Shedding of oocysts None of the 46 controls had drunk surface water. in immunocompetent individuals infected with Cryptosporidium. Am J Trop Med Hyg 1987; ~ There may have been an increased risk of illness among those who had swum in 36:338-42. 4. D'Antonio RG, Winn RE, Taylor JP, et al. A waterborne outbreak of cryptosporidiosis in ~ surface water (OR = 3.7; 95% confidence interval [CI), 0.71 to 12.6). Exposure to normal hosts. Ann Int Med 1985;103:886-8. ~ surface water (either through drinking or swimming) had occurred in New Mexico, 5. Mata L. Cryptosporidium and other protozoa in diarrheal disease in less developed countries. southern Colorado, and Mexico. If the two patients exposed to surface water in Pediatr Infect Dis 1986;5:5117-30. ~ Mexico and their controls are eliminated from the analysis, drinking surface water is CENTERSFOR DISEASECONTROL September 11, 1987Nol. 36/No. 35 still associated illness (OR incalculable, p = The time ~ significantly with 0.014). ~ between exposure to surface water and illness ranged from 4 to 21 days, with a median of 7 days. The average incubation period of cryptosporidiosis is 2 to 10 days. 585 Sentinel Surveillance System for * Fourteen (820/0) ofthe 17 household members with exposures to surface water similar Antimicrobial Resistance in Clinical Isolates of Neisseria gonorrho6ae to the patients' became ill with diarrhea within 2 to 7 days. 593 HIV Infection and Pregnancies in There was no statistically significant difference between patients and controls in Sexual Partners of HIV-Seropositive attendance at day-care centers or in employment. However, patients were more likely Hemophilic Men - United States ~ than controls to attend a day-care center reported by a parent as having other children Mtl'lR co MORBIDITYAND MORTALITYWEEKLY REPORT ~ ill with diarrhea (OR = 5; 95% CI, 1.4 to 26.3). A patient was also more likely to be a household contact of a day-care-center attendee or employee, but this did not reach statistical significance (OR = 3.7,95% CI, 0.95 to 14.2). Epidemiologic Notes and Reports Reported by: DJ Grabowski, MS, Albuquerque Environmental Health; KM Powers, JA Knott, MV * Tanuz, LJ Nims, MS, MI Savitt-Kring, CM Lauren, 81 Stevenson, HF Hull, MD, State Epidemiol Sentinel Surveillance System for Antimicrobial Resistance in Clinical ogist, New Mexico Health and Environment Dept. Div of Field Svcs, Epidemiology Program Isolates of Neisseria gonorrhoeae Office; Div of Parasitic Diseases, Center for Infectious Diseases, CDC. Editorial Note: Cryptosporidium sp. was recognized as a human pathogen in 1976. Infections caused by strains of Neisseria gonorrhoeae that 'are resistant to The illness is ass06ated with significant morbidity, including diarrhea, which is often recommended antimicrobials continue to be a growing public health problem. Over j prolonged and which can be accompanied by severe weight loss. In immunodeficient the past 3 years, the incidence of plasmid-mediated, penicillinase-producing N. ~ persons, cryptosporidiosis can cause life-threatening dehydration. There is no known gonorrhoeae (PPNG) has increased, and it now accounts for 2% of all reported !§ effective therapy. gonococcal infections in the United States (1 ). However, the proportions of infections caused by organisms with chromosomally mediated resistance to penicillin, tetracy cline, and spectinomycin and by gonococci with plasmid-mediated tetracycline I resistance (TRNG) have been determined for only a limited number of localities (2,3). The procedures for laboratory diagnosis and reporting of PPNG have been standardized, and over 90% of public health laboratories routinely test every gono- coccal .isolate for production of f3-Iactamase (CDC, unpublished data). However, studies in Seattle and Vancouver (2,3 ). Although no organisms in our sample were ~scert~lnmentand reporting of other types of antimicrobial resistance have been resistant to ceftriaxone, 27 (2%) of the isolates had MICs of 0.06-0.25 ....g/ml and met ,~cons,s.tent.Whereas PPNG can be detected by a rapid diagnostic test, laboratory the criteria for intermediate susceptibility. Trends in ceftriaxone susceptibility will dlagno~lsof ~h~omo.somally ~e?~atedresis.tance and TRNG requires relatively require continued monitoring as this and other third-generation cephalosporins are eX'penslv~antlmlcro~lal susceptibility determination procedures on subcultures of used more frequently in the treatment of gonorrhea. These results, when compared pnm~ryIsolat~s. Until recently, surveillance of these strains had been based on a with those from the NGTMS, show a marked decrease in susceptibility to penicillin pas~'v.e.reporting system; consequently, geographical areas performing more sus and tetracycline. Limited GISP trend data suggest that the incidence of chromosom I cep~lblhtytests than other areas may appear to have higher incidences of these ally mediated resistant organisms will continue to increase. strains. In localities where the proportion of gonococcal strains meeting CDC surveillance Because recommendations for therapy should be based on accurate and timely definitions of antimicrobial resistance is ;;?:1%for 2 consecutive months, treatment surveillance of antimicrobial resistance in N. gonorrhoeae, the Division of Sexually and disease-intervention protocols may require modification. Management and Transmitted Diseases, Center for Prevention Services, CDC, in cooperation with the treatment guidelines for infections caused by antimicrobial-resistant N. gonorrhoeae ~ Sexually Transmitted Diseases Laboratory Program, Center for Infectious Diseases, are being published as an MMWR supplement and will be available later this month. CDC, an'd state and local health departments, has organized the Gonococcal Isolate References Surveillance Project (GISP). ~ 1. CDC. Penicillinase-producing Neisseria gonorrhoeae-United States, 1986. MMWR 1987; ~ In this project, each of four regionally based laboratories chosen for their expertise 36:107-8. in performing antimicrobial susceptibility determinations processes a prospective 2. Bowie WR, Shaw CE, Chan DGW, Jones HD, Black WA. In-vitro susceptibility of 400 isolates consecutive sample of isolates from five sexually transmitted disease clinics. Each of Neisseria gonorrhoeae in Vancouver, 1982-84. Can Med Assoc J 1986;135:489-93. month, the first 25 urethral isolates from male patients in each clinic are submitted to 3. Hook EW, Knapp JS, Handsfield HH, et al. Characterization and prevalence of chromosomally mediated resistance to penicillin G and tetracycline in Neisseria gonorrhoeae from Seattle, I the regional laboratories where a test for f3-lactamase is performed and minimum Washington. In: Schoolnik GK, ed. The pathogenic Neisseriae: proceedings of the fourth ~ inhibitory concentrations (MICs) to penicillin, tetracycline, spectinomycin, cefoxitin, international symposium, Asilomar, California, 21-25 October 1984. Washington, DC: Amer ~ and ceftriaxone are determined. Classification of the isolates is based on the CDC ican Society for Microbioloav. 1985:96-100. surveillance definitions of plasmid-mediated resistance (PPNG, TRNG) and chromo 4. CDC. Antibiotic-resistant strains of Neisseria gonorrhoeae: policy guidelines for detection, somally mediated resistance (4). This report summarizes the results from the first 15 management, and control. MMWR 1987;36(5S):[In press]. i participating clinics. 5. Jaffe HW, Biddle JW, Thornsberry C, et al. National gonorrhea therapy monitoring study: in-vitro antibiotic susceptibility and correlation with treatment results. N Engl J Med 1976; * Between August 1986 and July 1987, 1,420 gonococcal isolates were evaluated. 294:5-9. Nineteen isolates (1 %) were PPNG, and 64 (5%) were TRNG (Table 1). Forty-five ofthe 6. Reynolds GH, Zaidi AA, Thornsberry C, et al. The national gonorrhea therapy monitoring TRNG isolates were reported from Baltimore, where TRNG accounted for 15% study: II. trends and seasonality of antibiotic resistance of Neisseria gonorrhoeae. Sex (45/300) of gonococcal isolates. For the 1,337 non-PPNG, non-TRNG isolates, the Transm Dis 1979;6:103-11. ~ geometric mean MIC to penicillin was 0.19J.Lg/ml; to tetracycline, it was 0.66J.Lg/ml; to 00 ... cefoxitin, 0.33J.Lg/ml; to spectinomycin, 16.5J.Lg/ml; and to ceftriaxone, 0.003J.Lg/ml. TABLE 1. Results of the initial phase of the Gonococcal Isolate Surveillance Project, Thirteen percent of the isolates without plasmid-mediated resistance were chromo by city - United States, August 1986-July 1987 somally resistant to penicillin, and 48% of them were chromosomally resistant to * Number of isolates tetracycline (Figure 1). No isolates were resistant to spectinomycin or ceftriaxone. Without Plasmid- Reported by: Gonococcal Isolate Surveillance Project participants. Regional Laboratories. eity PPNG TRNG Mediated Resistance Total JE Sexually Transmitted Diseases Laboratory Program, Center for Infectious Diseases; Div of Albuquerque 3 1 69 73 Sexually Transmitted Diseases, Center for Prevention Svcs, CDC. Atlanta 0 2 63 65 ~ Editorial Note: This is the first nationally based prospective survey of antimicrobial u; Baltimore 0 45 255 resistance in N. gonorrhoeae in the United States since the National Gonorrhea 300 ~ Therapy Monitoring Study (NGTMS) was conducted from 1972 to 1977 (5,6). Birmingham 0 5 58 63 Previous nationally based reports of chromosomally mediated resistance and TRNG Boston 1 4 120 125 have been limited to summaries of outbreaks and the passive reporting of sporadi Cincinnati 0 0 74 74 * cally occurring cases (7,8). Denver 5 0 172 177 The preliminary GISP survey data underestimate the proportion of infections Honolulu 3 0 64 67 caused by PPNG strains because New York and Florida, which accounted for 58% of Long Beach, CA 0 0 95 95 ~ PPNG reported in 1986 (1 ), are not represented in the initial GISP survey results. The New Orleans 0 5 99 .... 104 ~ distribution of TRNG reflects a high prevalence of disease in Baltimore, as previously Phoenix 0 0 23 23 reported (9). Excluding the Baltimore cases, TRNG represents 2% (19/1,120) of the San Diego 7 2 138 147 national sample. San Francisco 0 0 45 45 I The high incidence of gonococci with chromosomally mediated resistance to St. Louis 0 0 20 20 penicillin and tetracycline confirms published reports of geographically limited San Antonio 0 0 42 42 Total 19 14 1,337 1,420 7. Rice RJ, Biddle JW, Jeanlouis VA, DeWitt WE, Blount JH, Morse SA. Chromosomally HIV (11,12). mediated resistance in Neisseria gonorrhoeae in the United States: results of surveillance Questionnaires were sent to 246 HTCs and physicians. Two hundred and thirty and reporting, 1983-1984. J Infect Dis 1986;153:340-5. seven (96%) responded, either in writing (123) or to follow-up telephone inquiries 8. Knapp JS, Zenilman JM, Biddle JW, et al. Frequency and distribution in the United States of strains of Neisseria gonorrhoeae with plasmid-mediated, high-level resistance to tetracy (114). Nine addressees (4%) either could not be reached or chose not to provide the cline. J Infect Dis 1987;155:819-22. requested in~Q.rrTlation. 9. Brewer F, Matuszak Dl, Libonati JP, Jackman NER, Israel E. Tetracycline-resistant Neisseria I [letter). New Engl J Med 1986;315:1548-9. The 237 respondents provided information concerning 2,276 spouses/sexual partners of a comparable number of HIV seropositive hemophilic patientst (Table 1). Seven hundred and seventy-two (34%) of the spouses/sexual partners were known to ~ FIGURE 1. Distribution of minimum inhibitory concentrations of chromosomally have been serologically tested for HIV antibody. Of those tested, 77 (10%) were co mediated resistance - Gonorrhea Isolate Surveillance Project, August 1986.July - 1987 reported to be seropositive. Among all spouses/sexual partners, 280 (12%) were PENICILLIN TETRACYCUNE reported to have been pregnant during the period January 1985 through March 1987 CDC Su,.,eillance (Table 1). One hundred and seventy (61%) of these women had been tested for HIV Definition antibody; 22 (13%) of those tested were seropositive for HIV prior to pregnancy, Resistance * ~ during pregnancy, or at delivery. § Six hundred and two (30%) nonpregnant spouses Imermadiate were tested; 55 (9%) were seropositive. (/) ~ (/) Twenty children had been born to these 22 seropositive women, two of whom Susceptible w rz:zJ were pregnant twice. One of these 24 pregnancies was therapeutically aborted, and ~ ~ ~ !!l the outcomes of three others were not reported. Thirteen (65%) of the children born ~ l5 l5 to HIV-seropositive women had been tested for HIV antibody. Four (31%) were c=; a: a: w seronegative, and nine (69%) were seropositive. Because the infants' ages at the time ~ ~ ~ ::;) of antibody testing were not given, it was not possible to determine whether the Z i positive results reflect passively transferred maternal antibody or infection of the infant. None of the 20 children born to seropositive mothers have yet been diagnosed as having AIDS. I Reported by: Hemophilia Treatment Centers. National Hemophilia Foundation. Div of Host ~ Factors, Center for Infectious Diseases, CDC. ~ MINIMUM iNHIBITORY CONCENTRATION {JlgIml) MINIMUM INHIBITORY CONCENTRATION \ilQlmi) Editorial Note: The reported rate of HIV seropositivity among spouses/sexual part • ., - 0.19 . _ -0.66 act., - .250 _:11.,- 1.0 ners of seropositive hemophilic men in this survey is consistent with findings in Epidemiologic Notes and Reports earlier studies (9,10). However, these rates should not be generalized to all U.S. i hemophilic households because a number of limitations must be taken into account HIV Infection and Pregnancies in Sexual Partners when interpreting the findings of this survey: * of HIV-Seropositive Hemophilic Men - United States • The survey dealt only with spouses/sexual partners of known HIV-seropositive hemophilic patients. (NHF recommends voluntary HIV-antibody testing of hemo Seroprevalence rates for antibody to human immunodeficiency virus (HIV) have philic patients, along with appropriate pre- and post-test counseling.) been reported to range from 33% to 92% for patients in the United States with i • A higher proportion of pregnant women than nonpregnant women had been tested ex> hemophilia A and from 14% to 52% for those with hemophilia B (1-7). The cumulative (61 % compared with 30%, p<0.0001). This finding suggests that some women may .. incidence of AIDS is currently estimated at 3% (345 cases) for U.S. patients with hemophilia A and at 1% (23 cases) for those with hemophilia B. The cumulative AIDS tThe vast majority of hemophilic men are reported to be monogamous. Respondents were not asked to indicate the number of HIV-seropositive hemophilic male partners represented by this incidence for seropositive patients varies from region to region and is reported to be survey . .as high as 18% in one hemophilia treatment center (HTC) in Pennsylvania (8). 'Respondents were not asked to indicate at what stage during pregnancy testing was performed * Because sexual partners of infected men are also at risk for HIV infection (9,10), the or why these women were tested for HIV antibody. National Hemophilia Foundation (NHF) has developed extensive educational pro grams to inform patients with hemophilia and their sexual partners about the risks of TABLE 1. HIV antibody testing of spouses/sexual partners of HIV serQPositive hemophilic men, by pregnancy status of spouse/sexual partner - survey of U.S. HIV transmission. hemophilia treatment centers and physicians, 1987 The Division of Host Factors, Center for Infectious Diseases, CDC, and NHF j conducted' a surVey of all U.S. HTCs and physicians known to treat patients with Pregnancy Status· - hemophilia. NHF estimates that those surveyed provide medical care for at least 75% Pregnant Not pregnant Total ~ of the hemophilic men in the United States. The purpose of the survey was to Test Results No. 1%) No. 1%) No. 1%) determine 1) whether sexual partners of known HIV-seropositive hemophilic men Seropositive 22 (8) 55 (3) 77 (3) I were being tested for HIV antibody*, 2) the HIV seroprevalence rate among those Seronegative 148 (53) 547 (27) 695 (31) partners who had been tested, and 3) the extent of compliance with NHF and Public Not tested* 110 (39) 1,394 (70) 1,504 (66) Health Service recommendations for preventing sexual and perinatal transmission of Total 280 (100) 1,996 (100) 2,276 (100) *The issue of counseling was not addressed. *Unknowns not included. CENTERSFOR DISEASECONTROL September 18, 1987Nol. 36/No. 36 have been tested because they were pregnant or wished to become pregnant. • HTCs and physicians have routine interaction with their hemophilic patients, but they may not interact as frequently or as closely with their patients' families or sexual partners. Therefore, HTCs and physicians may not be aware of the health status of their patients' family members/sexual partners. They may also be i unaware of testing performed at other locations, e.g., by obstetricians. 614 Performance Evaluation Program: Abstention from sexual intercourse would eliminate any risk of sexually transmit- R Testing for HIV Infection ted HIV infection (13). The use of condoms, and possibly condoms in conjunction MORBIDITYAND MORTALITYWEEKLY REPORT with spermicides, will reduce the risk of HIV transmission. However, even when condoms are properly used for each act of sexual intercourse, infected patients and Notice to Readers ~ their sexual partners should fully understand that some risk remains (14). In ~ (=) accordan'ce with PHS guidelines, health-care personnel should provide hemophilic Performance Evaluation Program: Testing for ~ patients and their sexual partners with thorough, confidential, and individualized Human Immunodeficiency Virus Infection counseling (12). References CDC's Training and Laboratory Program Office (TLPO) is implementing a 1. Jason J, Holman RC, Kennedy MS, Evatt BL. Longitudinal assessment of hemophiliacs program to evaluate the quality and effectiveness of testing for human exposed to HTLV-""LAV [Abstract). In: Program and abstracts of the 26th Interscience I Conference on Antimicrobial Agents and Chemotherapy. New Orleans, Louisiana: 26th immunodeficiency virus (HIV) infection. This program is designed to serve as ~ Interscience Conference on Antimicrobial Agents and Chemotherapy, 1986:97. a model for the assessment of emerging laboratory technologies. rn~ 2. Jason J, McDougal JS, Holman RC, et al. Human T-Iymphotropic retrovirus type-"" The major objectives the HIV Testing Performance Evaluation Program lymphadenopathy-associated virus antibody: association with hemophiliacs' immune sta of tus and blood component usage. JAMA 1985;253:3409-15. are 1) to build a database of information that describes the testing practices ~ @ 3. Ragni MV, Tegtmeier GE, Levy JA, et al. AIDS retrovirus antibodies in hemophiliacs treated and the physical and technical characteristics of HIV testing laboratories, 2) to with factor VIII or factor IX concentrates, cryoprecipitate, or fresh frozen plasma: prevalence, evaluate the quality HIV testing, 3) to establish an information exchange seroconversion rate, and clinical correlations. Blood 1986;67:592-5. of * 4. Goedert JJ, Sarngadharan MG, Eyster ME, et al. Antibodies reactive with human T cell network, 4) to identify and define problems in HIV testing, and 5) to improve leukemia viruses in the serum of hemophiliacs receiving factor VIII concentrate. Blood and maintain the quality of HIV testing. 1985;65:492-5. To initiate the program, TLPO is sending an enrollment form to laborato 5. Kreiss JK, Kitchen LW, Prince HE, et al. Human T cell leukemia virus type III antibody, ~ lymphadenopathy, and acquired immune deficiency syndrome in hemophiliac subjects: ries that participated in CDC's earlier proficiency testing program. However, co results of a prospective study. Am J Med 1986;80:345-50. enrollment in the program is open to all those that perform HIV testing and ~ 6. Gjerset GF, McGrady G, Counts RB, et al. Lymphadenopathy-associated virus antibodies and to manufacturers of HIV testing products. Participation in the program, which T cells in hemophiliacs treated with cryoprecipitate or concentrate. Blood 1985;66:718-20. * 7. Waskin H, Smith KJ, Simon TL, Gribble TJ, Mertz GJ. Prevalence of HTLV-"I antibody among is not intended to satisfy regulatory requirements, is voluntary. To request an New Mexico residents with hemophilia. West J Med 1986;145:477-80. enrollment form and additional information, interested laboratories and 8. Eyster ME, Gail MH, Ba"ard JO, AI-Mondhiry H, Goedert JJ. Natural history of human manufacturers may telephone TLPO at (404) 329-1967 or write to Centers for immunodeficiency virus infections in hemophiliacs: effects ofT-ceIl subsets, platelet counts, :E and age. Ann Intern Med 1987;107:1-6. Disease Control, Attention: Ms. Fern Lavinder, Training and Laboratory 9. Jason JM, McDougal JS, Dixon G, et al. HTLV-""LAV antibody and immune status of Program Office, DAMC, 24 Executive Park, E20, 1600 Clifton Road, NE, ~ household contacts and sexual partners of persons with hemophilia. JAMA 1986;255:212-5. Atlanta, GA 30333. <.0 10. Kreiss JK, Kitchen LW, Prince HE, Kasper CK, Essex M. Antibody to human T-Iymphotropic co..... virus type "I in wives of hemophiliacs: evidence for heterosexual transmission. Ann Intern Reported by: Div of Assessment and Management Consultation, Training and Med 1985;102:623-6. Laboratory Program Office, CDC. 11. National Hemophilia Foundation. Hemophilia and acquired immunodeficiency syndrome * (AIDS): intimacy and sexual behavior. In: AIDS update, September 1985. New York: National CENTERSFOR DISEASECONTROL November 13, 1987Nol. 36/No. 44 Hemophilia Foundation, 1985:3-4. 12. CDC. Public Health Service guidelines for counseling and antibody testing to prevent HIV infection and AIDS. MMWR 1987;36:509-15. ~ 13. CDC. Additional recommendations to reduce sexual and drug abuse-related transmission of 728 Lack of Transmission of HIV Through human T-Iymphotropic virus type ""lymphadenopathy-associated virus. MMWR 1986; Rho(D) Immune Globulin (Human) <.0 35:152-5. - 14. Fischl MA, Dickinson GM, Scott GB, Klimas N, Fletcher MA, Parks W. Evaluation of heterosexual partners, children, and household contacts of adults with AIDS. JAMA i 1987;257:640-4. Mtl'lR MORBIDITYAND MORTALITYWEEKLY REPORT and the lack of evidence of HIV infection associated with Rh-IG despite receipt of these products by more than 350,000 women annually, there is no evidence to implicate this Lack of Transmission of Human Immunodeficiency Virus product as a source of HIV infection nor to change current recommendations for its Through Rho(D) Immune Globulin (Human) use and administration. On September 18, 1987, the Armed Forces Medical Logistical Office issued References 1. Cohn EJ, Strong LE, Hughes WL Jr, et al. Preparation and properties of serum and plasma instructions to temporarily suspend from distribution and use in military hospitals proteins. IV: A system for the separation into fractions of the protein and lipoprotein I one lot (RHG 636) of RhoGAM* Rho(D) Immune Globulin (human) (Rh-IG), manufac components of biological tissues and fluids. J Am Chem Soc 1946;68:459-75. tured by Ortho Diagnostic Systems, Inc. This action was taken because a woman on 2. Oncley JL, Melin M, Richert DA, Cameron JW, Gross PM Jr. The separation of the antibodies, ~ isoagglutinins, prothrombin, plasminogen and beta,-lipoprotein into subfractions of human active duty who had received an injection from the lot was subsequently found to be <.TI <=> infected with human immunodeficiency virus (HIV). The woman received RhoGAM lot plasma. J Am Chem Soc 1949;71 :541-50. 3. Wells MA, Wittek AE, Epstein JS, et al. Inactivation and partition of human T-cell Iymphotro RHG 636 in September 1986, prior to the birth of her second child in December 1986. phic virus, type III, during ethanol fractionation of plasma. Transfusion 1986;26:210-3. In addition, she had received an earlier injection of Rh-IG from a different lot in May 4. Centers for Disease Control. Safety of therapeutic immune globulin preparations with respect 1985, prior to the birth of her first child. to transmission of human T-Iymphotropic [sic) virus type III/lymphadenopathy-associated The woman was first tested for HIV in November 1986 as part of the military virus infection. MMWR 1986;35:231-3. 5. Tedder RS, Uttley A, Cheingsong-Popov R. Safety of immunoglobulin preparation .containing * screening program and was found to be seropositive for HIV antibodies at that time. anti-HTLV-III [Letter). Lancet 1985; 1:815. At present, she remains seropositive with evidence of severe immunodeficiency but has not developed AIDS. Her first child, born in July 1985, was negative for HIV CENTERSFOR DISEASECONTROl November 20, 1987Nol. 36/No. 45 ~ antibodies when tested in January 1987. Her second child tested positive for HIV FT1 antibodies at birth, but subsequent serologic testing performed at 9 months of age ~ was negative, reflecting the loss of passively derived maternal antibody and the (=) 744 Hepatitis B in an Extended Family - absence of infection. Alabama ~ An epidemiologic investigation determined that this woman very likely had a behavioral risk factor for infection with HIV. Samples of both Rh-IG lots from which the woman had received treatment have been studied by the U.S. Food and Drug Administration. They have been found to be free of anti-HIV antibodies. Lot RHG 636 MtlWR I MORBIDITY MORTALITYWEEKLY REPORT ~ was also tested and found to be free of HIV antigen. In addition, review of the AND manufacturer's records for Rho GAM lot RHG 636 confirmed that all plasma used for ~ that lot had been screened for antibodies to HIV and found negative and that all steps Epidemiologic Notes and Reports in its manufacture were in accordance with good manufacturing practices. i@ Reported by: Center for Drugs and Biologics, Food and Drug Administration. Office of the Hepatitis B in an Extended Family - Alabama Surgeon General, US Army. AIDS Program, Center for Infectious Diseases, CDC. * In July 1986, a case of clinical hepatitis B in a 3-year-old boy was reported to the Editorial Note: Approximately 500,000 doses of Rh-IG are administered annually to health department in Houston County, Alabama. During the subsequent investiga an estimatea350,000 women in the United States. Rh-IG and other immune globulins tion, the public health nurse found no obvious risk factors for the child's illness and used in the United States are produced by several manufacturers using one of the decided to screen other family members for hepatitis B surface antigen (HBsAg), modifications of the Cohn-Oncley fractionation process (1,2 ), which has been shown ~ hepatitis B core antibody (anti-HBc), and hepatitis B surface antibody (anti-HBs) in an to be effective in removing HIV by partitioning and inactivation (3). Since late April co attempt to determine whether any other household members were infected...... 1985, all units of plasma for production of Rh-IG have been screened for antibodies to Thirty-two family members or sexual partners of family members were identified; HIV, and all repeatedly reactive units have been discarded. Several epidemiologic and approximately half of these persons lived in or frequently visited the same dwelling. laboratory studies have shown that recipients of hepatitis B immune globulin (HBIG) Three were not available for testing. Ten (34%) of the 29 persons tested (including the and immune globulin (lG). including recipients of lots manufactured before April index patient) showed evidence of hepatitis B virus (HBV) infection, and seven were * 1985, have not developed either antibody responses indicative of HIV infection or positive for HBsAg. Nine of the 16 persons who lived in or frequently visited the clinical illness associated with HIV infection (4 ). Low levels of passively acquired HIV dwelling were seropositive; one of the 13 who infrequently visited was seropositive antibody from some preparations of HBIG that were known to contain high levels of (p<0.01). HIV antibody have been reported, but this passively transferred HIV antibody has not Only the index patient had a history of illness consistent with hepatitis, and none j persisted longer than 6 months (5 ). of the persons with HBV infection knew of previous exposure to persons known to Based on the history of the safety of IG products, the investigation of this case ~ have hepatitis. None worked in a medical or dental field or had previously injected (which strongly suggests that the woman was exposed to HIV through other means), ~ illegal drugs. One seropositive 21-year-old female had had a blood transfusion in *Use of trade names is for identification only and does not imply endorsement by the U.S. June 1986. She had lived in the same dwelling as the index patient for the 6 months Department of Health and Human Services or the Public Health Service. prior to diagnosis of his illness. Three persons with HBV infection had self I administered tattoos that had been applied 3 years earlier. However, two of the nonfamily members who were tattooed during the same session with the same applicator were seronegative. Four toothbrushes were shared by nine immediate patient (4,6,7): Finally, since perinatal transmission of HBV is highly efficient and. leads to death from primary liver cancer or cirrhosis in a high proportion of cases, it family members; one toothbrush was used by the index patient and two of his is imperative that women at high risk for HBV infection be screened for HBsAg and HBsAg-positive uncles. One 16-year-old male HBsAg carrier has muscular dystrophy that infants of infected mothers be treated at birth with HBIG and HB vaccine (4 ). and requires assistance in motor activities, although he has never been institution References alized. The younger children reportedly have frequent contact with him. 1. Centers for Disease Control. Hepatitis surveillance report no. 50. Atlanta: US Department of I All HBsAg-positive persons, except the index patient and his half-sister, have been Health and Human Services, Public Health Service, 1986:16-25. retested and confirmed as chronic HBV carriers because they were anti-HBc-lgM 2. Szmuness W, Harley EJ, Prince AM. Intrafamilial spread of asymptomatic hepatitis B. Am J negative on initial testing and have remained HBsAg positive for more than 6 months. Med Sci 1975;270:293-304. 3. Bernier RH, Sampliner R, Gerety R, Tabor E, Hamilton F, Nathanson N. Hepatitis B infection All HBsAg-positive carriers who were tested were also HBeAg positive. The index in households of chronic carriers of hepatitis B surface antigen: factors associated with patient was positive for anti-HBe when his illness was diagnosed. HB vaccine was :z! prevalence of infection. Am J EpidemioI1982;116:199-211. m given. to susceptible family members who continued to reside in the household, and 4. Immunization Practices Advisory Committee. Recommendations for protection against viral persons found to be seropositive received follow-up care. In addition, health officials hepatitis. MMWR 1985;34:313-24,329-35. ~ ~ counseled'the persons involved on the risk factors for HBV infection. 5. Redeker AG, Mosley JW, Gocke OJ, McKee AP, Pollack W. Hepatitis B immune globulin as a prophylactic measure for spouses exposed to acute type B hepatitis. N Engl J Med ~ Reported by: MA Price, RN, ME Crumpton, MD, Houston County Health Dept; WE Birch, DVM, 1975; 293: 1055-9. CH Woernle, MD, State Epidemiologist, Alabama Dept of Public Health. Hepatitis Br, Div of Viral 6. Koff RS, Slavin MM, Connelly LJD, Rosen DR. Contagiousness of acute hepatitis B: secondary Diseases, Center for Infectious Diseases, CDC. attack rates in household contacts. Gastroenterology 1977;72:297-300. Editorial Note: In the United States, acute hepatitis B is primarily a disease of adults 7. Aldershvile J, Orholm M, Tage-Jensen U, Hardt F, Nielson 0, Copenhagen Hepatitis Acuta Programme. Hepatitis B virus infection among household contacts of patients with acute I and often occurs among members of high-risk groups. Less than 3% of acute hepatitis ~ HBsAg positive hepatitis. Infection 1981 ;9: 164-6. B cases occur among persons under 14 years of age. Fewer than 10% of children ~ infected with HBV have well-described risk factors such as prior blood transfusion, hemophilia, hemodialysis, drug abuse, and institutionalization in facilities for the CENTERSFOR DISEASECONTROL November 27, 1987/ Vol. 36/ No.46 retarded. In contrast, 28% of these children have had contact with a person with 757 Outbreak of a Distinct Strain of i Penicillinase-Producing Neisseria hepatitis B, and 63% indicate no apparent source of infection when interviewed (1 ). gonorrhoeae - King County, In the latter instance, the most likely source of infection is a household member who Washington * is an HBV carrier or has an acute case of hepatitis B. When a child is found to have acute or chronic hepatitis B infection, an investiga tion of the circumstances surrounding transmission is warranted. In some instances, ~ as in this family, the child may signal a more extensive pattern of HBV transmission. M R co Previous studies have shown that persons living in the same household as an HBV MORBIDITYAND MORTALITYWEEKLY REPORT .. carrier have a 40% or higher likelihood of current or prior HBV infection (2,3). Serologic testing of household members may detect other infected persons who * require medical evaluation and counseling and will identify susceptible persons who may require prophylaxis. Epidemiologic Notes and Reports This investigation illustrates a number of possible modes of HBV transmission that contribute to the intrafamilial spread of this virus. The 21 -year-old woman who was j Outbreak of a Distinct Strain of Penicillinase-Producing a carrier probably transmitted the virus perinatally to her three children. Other ~ Neisseria gonorrhoeae - King County, Washington To control this outbreak, the Seattle-King County Department of Public Health has _ Epidemic PPNG intensified its case finding, interviewing, and partner-tracing efforts and has advised Itralnl * 6 rz2 Other PPNG all clinical facilities to increase their screening efforts. The health department, in stralno cooperation with the King County Medical Society and local media, has advised all health providers to use only ceftriaxone or spectinomycin as initial therapy for all ~ W ~ persons suspected or proven to have gonorrhea (3). In accordance with CDC U 4 a: ~ w (=) treatment guidelines (3,4 ), a 7-day course of tetracycline or doxycycline for possible 11. coexistent chlamydial infection continues to be recommended for all patients with ~ gonorrhea. Providers have also been advised to confirm all suspected cases by culture to allow screening for j3-lactamase production and to immediately report all confirmed PPNG infections by telephone to the health department. Reported by: RJ Rice, MD, HH Handsfield, MD, R Tulloch, Seattle-King County Dept of Public I Health and University of Washington, Seattle; L Klopfenstein, M Donnelly, JM Kobayashi, MD, Sf! 2 3 State Epidemiologist, Washington Dept of Social and Health Svcs. Sexually Transmitted 3 4 :x!rn Diseases Laboratory Program, Center for Infectious Diseases; Div of Sexually Transmitted 1985 1986 Diseases, Center for Prevention Svcs, CDC. YEAR (QUARTERS) Editorial Note: PPNG outbreaks caused by organisms belonging to a single AlS class i are uncommon. Recent reported outbreaks from Denver (5), Miami (6), and Amster December 11, 1987 I Vol. 36 I No. 48 dam (7) have all implicated multiple strains in endemic transmission. It is unclear CENTERSFOR DISEASECONTROL * whether multiple-strain outbreaks arise because of importation of different PPNG 785 Tuberculosis and Acquired strains into a' community or through the conjugal transfer of plasm ids that code for Immunodeficiency Syndrome - New j3-lactamase from native PPNG strains to non-PPNG gonococci.* York City Single-strain PPNG epidemics in the United States were suspected in 1980 (2) in ~ co Seattle and in Shreveport, Louisiana. At that time, complete AlS classification was not ~ possible. In single-strain epidemics, eradication of PPNG from a community may be feasible. In the United States (2) and in Sweden (8), eradication efforts have been Mtl'lR more successful in areas where single-strain PPNG has been suspected. AlS classi MORBIDITYAND MORTALITYWEEKLY REPORT fication may be useful as an adjunct to the management guidelines for the control of * antibiotic-resistant strains of N. gonorrhoeae recently published by CDC (3). References Epidemiologic Notes and Reports 1. Centers for Disease Control. Penicillinase-producing Neisseria gonorrhoeae- United States, :IE 1986. MMWR 1987;36:107-8. 2. Handsfield I:;IH, Sandstrom EG, Knapp JS, et al. Epidemiology of penicillinase-producing Tuberculosis and Acquired Immunodeficiency Syndrome - New York City .~ Neisseria"gonorrhoeae infections: analysis by auxotyping and serogrouping. N Engl J Med 1982; 306: 950-4. In recent years, reported tuberculosis (TB) cases in New York City (NYC) have ~ 3. Centers for Disease Control. Antibiotic-resistant strains of Neisseria gonorrhoeae: policy increased substantially, in large part related to coexisting human immunodeficiency guidelines for detection, management, and control. MMWR 1987;36(suppl 5S). virus (HIV) and Mycobacterium tuberculosis infection. From 1984 to 1986, reported TB 4. Centers for Disease Control. 1985 STD treatment guidelines. MMWR 1985;34(suppl 4S). .: 5. Centers for Disease Control. Multiple strain outbreak of penicillinase-producing Neisseria cases increased by 36%, or 593 cases (from 1,630 to 2,223 cases) (Figure 1), a I gonorrhoeae-Denver, Colorado, 1986. MMWR 1987;36:534-6,542-3. numerical increase greater than that for any state or any other city in the nation. By comparison, during the same period, reported cases for the entire nation increased ·Scientists hypothesize that conjugal transfer of j3-lactamase plasmids may occur when an 2%, infection consists of PPNG and non-PPNG strains (a mixed infection). or 513 (from 22,255 to 22,768). · Because. t~eincreased TB in NYC was concurrent with the acquired morbidity FIGURE 1. Reported tuberculosis cases, by year - New York City, 1981·1986 '""!mun~deflc,encysyndrome (AIDS) epidemic and was concentrated in the group wIth 80Ya of all NYC AIDS patients (males 20-49 years of age), a special study was 2.500 conducted to evaluate the hypothesis that increased TB morbidity might be related to AIDS. The NYC TB registry for 1979 through 1985 and the NYC AIDS registry for 1981 2.000 throu~h1985 were ""!atched. * To determine differences in clinical, demographic, and I behavIoral characteristics of persons with one or both diseases, patients with both TB an~AIDS .(TB/AIDS) were compared with AIDS patients without TB and with TB patl~ntswl.thout AIDS. Only adults and adolescents (persons 13 years of age or older ~tdl~~nosls) were compared because no pediatric patients with both diseases were Identified. (: ~ TBI AIDS Patients ~ The 261 patient~common to both registries constituted 2% of the 11,231 adult and c:; 500 adolescent TB patients reported to the NYC TB registry from 1979 through 1985 and i!= 5% of the 4,892 adult and adolescent AIDS patients reported to the NYC AIDS registry from 1981 through 1985. Eighty-seven percent (226) of these 261 patients were male; o I ~9% 19% (49) 52% (136! were black; (76) were Hispanic; and were non-Hispanic white. 1981 1982 1983 1984 1985 1986 The median age for diagnosis of both TB and AIDS was 34 years. I YEAR ~ The date on which the first M. tuberculosis-positive specimen was taken was available for 258 TB/AIDS patients. For these patients, TB had been diagnosed a ~ TABLE 1. Adult and adolescent AIDS patients with TB (TB/AIDS) and without TB, ~ median of 2 months before AIDS diagnosis (range: 94 months before AIDS diagnosis' byi race/ethnicity and AIDS risk factor - New York City, 1981-1985 i ~ to 28 months after AIDS diagnosis). For 65% of the patients, TB was diagnosed within 6 months before or after AIDS diagnosis. TB/AIDS AIDS Only (n =261) (n =4,631) Adult and Adolescent AIDS Patients With and Without TB * TB/AIDS patients and AIDS patients without TB were similar in median age at AIDS Characteristics No. (%) No. (%) diagnosis (34 compared with 36 years) and in gender. However, TB/AIDS patients Race/Ethnicity Black, Non-Haitian 107 (41) were more likely to be non-Haitian black, Haitian, and Hispanic than AIDS patients 1,279 (28) ~ without TB (Table 1). In addition, TB/AIDS patients reported intravenous (IV) drug Haitian 29 (11 ) 119 (3) I abuse more frequently and homosexual/bisexual activity alone less frequently than Hispanic 76 (29) 1,077 (23) :: patients with AIDS alone. Among non-Haitian-black IV drug abusers, the percentage White, Non-Hispanic 49 (19) 2,113 (46) of TB/AIDS patients (10%) was more than twice that among both those with a his Other/Unknown 0 43 (1) * tory of homosexual/bisexual behavior (4%) and those with neither risk factor (4%) Risk Factor (Table 2). Among non-Hispanic-white IV drug abusers, the percentage of TB/AIDS IV Drug Abuse 127 (49) 1,303 patients (5%) was more than twice that among both those. with a history of (28) Homosexuality/Bisexuality 81 (31) 2.709 (58) Ii homosexual/bisexual behavior (2%) and those with neither risk factor (0%). Among Both of Above 22 (8) 265 (6) ~ Hispanic IV drug abusers, the percentage of TB/AIDS patients (8%) was higher than <0 Other 31 (12) 354 (8) ~ that among those with a history of homosexual/bisexual behavior (5%) and more than twice that among those with neither risk factor (3%). Thus, when the data on AIDS patients was adjusted for race/ethnicity, those AIDS patients who were IV drug TABLE 2. Intravenous (IV) drug abuse and homosexuality/bisexuality among adult * abusers were significantly more likely to develop tuberculosis than those who were and adolescent AIDS patients* with TB (TB/AIDS) and without TB, by race/ethnicity * not (Mantel-Haenszel X2 = 18.7, P <0.0001). and AIDS risk factor - New York City, 1981-1985 Adult and Adolescent TB Patients With and Without AIDS IV Drug Abuse Homo/Bisexuality Both Factors Neither Factor TB/AIDS patients were younger (median age at TB diagnosis: 34 years compared TB/AIDS TB/AIDS TB/AIDS with 44 years) and more likely to be male than TB patients without AIDS. In addition, Cases Cases Cases ~fAl~Cases ~ AIDS AIDS AIDS AIDS they were more likely at TB diagnosis to have mre than one site of disease, Race/Ethnicity Cases No. (%) Cases No. (%) Cases No. (%) Cases No. (%) It3 extrapulmonary TB, and a nonreactive tuberculin skin test (Table 3). TB/AIDS patients Black, with a pulmonary site of disease were less likely to have cavitary disease. Non-Haitian 669 70 (10) 509 21 (4) 101 12 (12) 107 4 (4) I White, Non-Hispanic 191 9 (5) 1,803 36 (2) 107 4 (4) 61 0 (0) *These time intervals were chosen because AIDS was first recognized nationally in 1981 and Hispanic 555 44 (8) 436 23 (5) 74 6 (8) 88 3 (3) because it was noted that the diagnosis of tuberculosis often preceded the diagnosis of AIDS by (9) months or years. Total 1,415 123 2,748 80 (3) 282 22 (8) 256 7 (3) *Excludes 148 Haitian AIDS patients, 29 of whom also had TB, and 43 patients with other or unknown race/ethnicity, none of whom also had TB. Reported by: RL Stoneburner, MD, MPH, MM Ruiz, MD, JA Milberg, MPH, S Schultz, MD, A The registry match indicates that TB/AIDS patients in NYC are predominantly IV Vennema, MD, New York City Dept of Health; DL Morse, MD, MS, State Epidemiologist, New York State Dept of Health. AIDS Program, Center for Infectious Diseases; Div of Tuberculosis drug abusers. Fifty-seven percent of the TB/AIDS patients in this study were IV drug Control, Center for Prevention Svcs, CDC. abusers, whereas 34% of AIDS patients without TB had this risk factor. The number of Editorial Note: The data from this study, as well as other evidence presented below, reported TB patients in NYC who are IV drug abusers is currently unknown. There are suggest that human immunodeficiency virus (HIV) infection is causing a resurgence an estimated 200,000 IV drug abusers in NYC, 30,000 of whom are enrolled in of TB in NYC. Three findings from this study support the hypothesis that AIDS is methadone treatment programs. These estimates, along with the fact that 12 TB cases I associated with the observed increase in TB morbidity. First, the increase in TB cases developed in a cohort of 5191V drug abusers, that IV drug abuse is the most common was concentrated in the sex and age group containing the majority of NYC AIDS risk factor among TB/AIDS patients, and that NYC had 600 more cases in 1986 than it ~ patients (males 20-49 years of age). Second, a relatively high proportion of AIDS had in 1984, suggest that many unreported or unidentified TB cases may be occurring ~ patients (5%) also had clinically active TB. Third, among patients with both diseases, annually among HIV-positive IV drug abusers. Identifying tuberculin-positive IV drug TB diagnoses clustered in time around the AIDS diagnoses. abusers and giving them isoniazid preventive therapy, regardless of their age, may Perhaps the strongest evidence to date for a causal association between TB and prevent TB among this group. HIV infection comes from a study among a cohort of 519 IV drug abusers in NYC who The registry match also indicates that most TB/AIDS patients in NYC are members of racial and ethnic minorities. Eighty-one percent of the TB/AIDS patients were black * were followed from 1984 through 1986 (1). In this group, 12 of the 279 persons with (including Haitian) or Hispanic, whereas 53% of AIDS patients without TB and .68% of serologic evidence of HIV infection or clinical AIDS developed TB, whereas none of TB patients without AIDS (50% black and 18% Hispanic) belonged to these groups. the 240 HIV-negative persons developed TB (p = 0.0005, Fischer's exact test). Patients with AIDS or HIV infection who also develop TB often have clinical Other evidence that HIV infection and AIDS may be responsible for the resurgence findings§ that are different from those of TB patients without immunodeficiency (2-8), ~ of TB in NYC includes the fact that NYC, the area with the largest increase in TB in the and a high index of suspicion and special diagnostic studies are often needed to ~ c=; nation, has also reported more AIDS cases than any other area in the nation. The establish the diagnosis of TB in these patients (9). HIV-infected persons who have nearly 600 additional TB cases in 1986 (compared with 1984) exceeds the increase in active TB should be treated in accordance with recently published guidelines (9 ). ~ the entire nation as a whole. Through 1986, 7,891 patients with AIDS, or 27% of the nation's cumulative reported cases (29,121), were NYC residents. Data also indicate §Multiple disease sites, extrapulmonary involvement, loss of tuberculin skin reactivity, and, that the greatest increases in TB in NYC occurred in areas of the city with a high among patients with pulmonary disease, noncavitary chest X-rays. incidence of AIDS. . I ~ Data suggest that HIV infection in the absence of AIDS is associated with increased TABLE 3. Adult and adolescent TB patients with AIDS (TB/AIDS) and without AIDS, :i! TB mc;>rbidity (New York City Department of Health, unpublished data). In this study, by demographic group and clinical characteristics of TB - New York City, 1979·1985 m 58 males who were 25-44 years of age and did not have AIDS but were hospitalized TB/AIDS TB Only for suspected TBt consented to HIV antibody testing. Thirty-one (53%) of them were (n=261) (n = 10,970) ~ HIV positive. ~ Characteristics at TB Diagnosis No. (%) No. (%) Previously published studies have linked TB to AIDS in Florida (2-3), Newark (4 ), Sex * Connecticut (5). and San Francisco (6). Increased TB morbidity has been associated Male 226 (87) 7,351 (67) with HIV infection in Dade County, Florida (7). Of 71 consecutive TB patients seen at Female 35 (13) 3,619 (33) Age 20-49 Years the Dade County Public Health Department, 31% (22) were HIV positive. Two of these ~ 22 patients met the former CDC surveillance criteria for AIDS; ten (45%) of the 22 had 244 (93) 6,219 (57) co Y"s :p. extrapulmonary TB and would thus meet the revised CDC surveillance case definition No 17 (7) 4,751 (43) for AIDS (8). Disease Sites There are two possible mechanisms by which the immunodeficiency caused by Multiple· 62 (24) 415 (4) HIV infection may increase the risk of tuberculosis. HIV-related immunodeficiency One, Extrapulmonary 58 (22) 1,741 (16) could increase susceptibility infection and permit that infection to rapidly * to new One, Pulmonary 141 (54) 8,814 (80) progress to clinically apparent disease, or it may allow a previously latent tuberculous Tuberculin Skin Test~ infection to progress to clinically apparent disease. Although the clinical and radio Nonreactive 50 (58) 792 (18) graphic evidence of tuberculosis in AIDS patients is often similar to the pattern (42) 3,686 (82) observed in nonimmunodeficient patients with primary or recently acquired infection, Reactive 36 j the clustering of TB di_agnoses around the time of the AIDS diagnoses suggests that Chest X-rayl <0 most tuberculosis in patients with AIDS results from reactivation of a previously Normal 13 (8) 269 (3) ....co acquired latent infection. The present annual risk of new tuberculous infection in the Abnormal, Noncavitary 131 (80) 5,410 (66) United States is too low to account-for the high incidence of tuberculosis among AIDS Abnormal, Cavitary 20 (12) 2,576 (31) patients. Thus, most tuberculosis in AIDS patients is probably due to the reactivation ·'nc'udes at least one extrapulmonary site. I of latent infections. tlncludes only patients with known tuberculin skin test results. llncludes only those with pulmonary disease and known chest X-ray results. ~All 58 patients were later found positive for M. tuberculosis. :.:' ...... J ... :~~~~~~~~~~~~~~~~~~~~~~ HIV testing of all TB patients should be considered because of the implications of . HIV seropositivity for patient management (10). There is some evidence that TB :: I:MPORTA.NT· NOT·ES.!. ::" : .. by MarkBehar, PA-C,Editor :: patients with HIV infection do not respond to standard therapies as well as patients ...... without HIV infection. Some reports have suggested a higher incidence of adverse ...... drug reactions (6) and a higher treatment-failure rate during therapy (4). Therefore, ::: \llelCCJ1Eto tre first issue of SEXUAL~LTH I3EPORTS{THE OFFICIAL NBIISLETIER QE :. I CDC and the American Thoracic Society have recommended a more aggressive ::: THENCGSTOO. f>s \119 begin ClJr 9th year of ~blicatim,readers mayhave :1 approach to treatment of TB in HIV-infected patients (9,11 ). Treatment should initially ::: re::C7Jrlizedan annoying irregularity of tre ~blicatim.AlttnJgh \lie are :. include at least t~eeof the drugs available for treatment of TB, should continue for ::: attemptingto ralSdy this situatim, readers maywish to be appraised of sane of :: a minimum of 9 months, and should last for at least 6 months after the patient ::: tre reaSCl'lSfor tre Newsletter's ncn-regularity. Tre &JrgeCl'lGa1era l's Report : becomes negative for M. tuberculosis. HIV-infected patients with tuberculosis should :: to tre AmericanPoople in 1986 unfortunately refel'S1ced tre NCGSTOOin its : ~ appa'ldix,and this resulted in Iu1dredsof requests for 'informatim abClJtAlOO' receive frequent and careful monitoring for adverse drug effects during therapy and ::! ! ~ (=) should be periodically evaluated for signs of relapse after therapy is complete. To ::: fran peqlle fran all over tre 1«lI'1d. AlttnJgh \119SS'ICf a 'form' letter in reply, : prevent the transmission of HIV, persons being tested for HIV infection should be :: this precess is very tine-consuming, and takes uh neededresClJrces away fran ! ~ counseled in accordance with current recommendations (12). ::: prociJctimof tre presB'lt issue. \liealso are attemptingto uP3radeClJr canpJter : Increases in TB morbidity may occur in other areas as the prevalence of HIV f: systen to desktop~blishing, a feat that may very \llell cost up to $10,000 in : increases in these areas. Health departments should conduct surveys of the preva !: hard- and software, and are negotiating with a natima1 organizatim to assist : i lence of HIV infection among TB patients in their jurisdictions. CDC is currently I us in this VB'lture. OJr intB'lt and hopeis to improve the appei!lranceand : , working with health departments in 30 metropolitan areas to plan and implement :: Sf: of ~blicatimso be yoor valued :i! such surveys. :: regularity tre that it will cmtinue to : t m resClJrce. In orderto expedite this issue's delivery to yoo, tre usually very ::; References :! 1. Stoneburner RL, Des Jarlais D, Milberg J, Friedman SR, Sotheran JL. Evidence for a causal ::: tine cmsuming 'spelling che::k' for each of tre over 15 files for this : : association between HIV infection and increasing tuberculosis incidence in New York City. ::: Newsletterwas anitted . Typos and spelli ng errors may tl-erefore be I1'Ore : = i Presented at the third international conference on acquired immunodeficiency syndrome ::: noticeable. YClJrunderstanding and patiB'\C9 are greatly appre::iated, and 'y'ClJr : : (AIDS), Washington, DC, June 1-5, 1987. * 2. Pitchenik AE, Cole C, Russell BW, Fischl MA, Spira TJ, Snider DE Jr. Tuberculosis, atypical '::: cannentsare always apprciated. Finally, due to tre incredible velune of : = mycobacteriosis, and the acquired immunodeficiency syndrome among Haitian and non :! II\:Iterialand to reducecosts, \119have de::ided to '~ll·over 80 (yes, eighty!) :: Haitian patients in south Florida. Ann Intern Med 1984;101 :641-5. ::: articles-over 27 pages\I/Orth-and hold then for tre Spring, 1988issue (9:1). !: 3. Centers for Disease Control. Tuberculosis and acquired immunodeficiency syndrome ; Manyof those articles are m internatimal newsevalts and CO'ldans,as \llell as Florida. MMWR 1986;35:587-90. :: :: co 4. Sunderam G, McDonald RJ, Maniatis T, Gieske J, Kapila R, Reichman LB. Tuberculosis as a :: manyother diverse topics. \lie sincerely apologize for this anissim, but : : :,;.. manifestation of the acquired immunodeficiency syndrome (AIDS). JAMA 1986;256:362-6. believe that tre renainder of the Newsletterwill keepyoo busy til the next 5. :! :: Centers for Disease Control. Tuberculosis and AIDS-Connecticut. MMWR 1987;36:133-5. 4IiI' . 4r * 6. Chaisson RE, Schecter GF, Theuer CP, Rutherford GW, Echenberg DF, Hopewell PC. • iI 1ssue arrwes. : • Tuberculosis in patients with the acquired immunodeficiency syndrome: clinical features, ~iI.iI ••... response to therapy, and survival. Am Rev Respir Dis 1987;136:570-4. : ~ttigi~~~~~~li~~ ~l~ ~EQ~~ {~Jcoverage is inclusive thrClJgh ! : 7. Pitchenik AE, Burr J, Suarez M, Fertel D, Gonzalez G, Moas C. Human T-cell Iymphotropic j virus-III (HTLV-III) seropositivity and related disease among 71 consecutive patients in whom i.: ~enber11, 1987. Three ~ suppletlB'lts ~ll~ ~ ~~~ due to treir : t tuberculosis was diagnosed: a prospective study. Am Rev Respir Dis 1987;135:875-9. t: size, tn.ewr: :: ~ 8. Centers for Disease Control. Revision of the CDC surveillance case definition for acquired ..... : : >Revisimof the COC&Jrveillance Case [)efinitim for AIOO.36: 15, ::. immunodeficiency syndrome. MMWR 1987;36(suppl 1S). 9. Centers for Disease Control. Diagnosis and management of mycobacterial infection and :: 8/14/87, 15 pages. : i disease in persons with human T-Iymphotropic virus type III/lymphadenopathy-associated : : >Recannendati(]'lSfor PrevB'ltim of HIVTransmissim in Health Care .. : virus infection. MMWR 1986;35:448-52. Settings. 36:25, 8/21/87, 18 pages. : : * 10. Centers for Disease Control. Public Health Service guidelines for counseling and antibody :: testing to prevent HIV infection and AIDS. MMWR 1987;36:509-15. :: >/lntibiotic-Resistant Strains of Neisseria &norrhoeae: Policy : i 11. American Thoracic Society, Centers for Disease Control. Mycobacterioses and the acquired GJidelines for ~te::tim,ManagetlB'lt, and Cmtrol. 36:55, 9/11/87, 18 pages. iI ::4IiI iI immunodeficiency syndrome. Am Rev Respir Dis 1987;136:492-6. iI 12. Centers for Disease Control. Additional recommendations to reduce sexual and drug •• ~ abuse-related transmission of human T-Iymphotropic virus type III/lymphadenopathy :: To re::eive copies of these suppletlB'ltscmtact 'y'ClJrnearest nedical, hospital, :. g:: associated virus. MMWR 1986;35:152-5. :: or Micipa 1 library, or cmtact tre CB'lters for disease CmtroT dire::t ly : : ::._ (404/639-3311). !iI: : I .. ~ • : *:*:*:*:*:*:*:*:*:*:*:*:*:*:*:*:*:*:*:*: :. . : ;iI ...... *...... : :. ***** PAGE 56 * ltIE OFFICIAL NEWSLETTER OF ltIE mTOO * \WJI1E 8:4 * WINTER. 1981 ***** *m •• ++:*** +. *•• lI*" 101 ***"*" •• 1.1 *.1101.101 ••••• *••• 1. *•• 1••••• mll •••••••••••••••••••••••••••••••••• lei ••• 101 ...... *•••••••• It ••••• *. +ICI*'I ** WORRIED SICK: HASSLES AND HERPES try Rick Neiss. with thanks to SciSlCe ~. 12/5/81 Agrowing number of studies are finding links betwea1 Il5VCl"Ological states- particularly stress -and immune functioo. Tre emerging facts have given birth to a new discipline, psycttnaJroimmunology. which seeks to understCK'ld tre links betwea1 Il5VCl"Ological status, central nervClJS system activity. endocrine functioo and immune respcJlSe. In trying to understand this canplex relatiooship. naJrobiologists and physicinas have foond it useful to study ~le with herpesvirus inf~tioos. Tre virus spends ITOSt of its time in a latent. or inactive. phase. residing in tre cell bcx!ies of certain peript-eral nerves. (kcassiooally it ~ares active. reproduces and is transported down tre nerve-cell axcr\s to tre skin. wrere it may cause tre formatioo of blisters or 'cold sores." ftnecdotal evidence has linked herpes reactivatioo to ll5ycl"Ological stress. bJt ooly r~tly have cootrolled studies coofirmed that link. New research by &..!san Kennedy and rer colleagues at Ohio State University's College of ~:!icine in Columbus took Il5vcl"Ologica1 and immunological data frClll married men and cClllpared trem to separated or divorced men matct-ed for age and educatiooi all tre subj~ts had rerpes. Separated and divorced men were more anxiClJS. depressed and looely than treir married OOJnterparts -and had higrer levels of rerpesvirus antibcx!ies. Since antibcxly levels go up during pericxls of viral reactivatioo. higrer antibcx!y levels are believed to refl~t a depressed inm.mesystem incapable of keeping tre viral inf~tioo under cootrol. ~ married men. marital quality had its correlates with ilTrl'lJne functioo as well. Poorer marital quality was related to higrer viral antibcx!y levels. and lower ratias of relper T cells to suppressor cells -another measure of immune suppressioo. Other researchers are finding that immune functioo may be linked not ooly to persooa 1 stress. but also to the perceptioo that otrers neartry are experiencing stress. Jill Irwin at QJeen's University in Kingstoo. Canada. and her colleagues at tre University of Rocrester in New York measured tre activity of natural killer cells in mice expa;ed to foot st-ocks. and cmpared thase measures to unstressed mice. Unstressed mice not in the vicinity of the stressed mice st-owed no suppressioo of normal immunity as measured try killer cell activity. But unstressed mice kept in cages clase enrugh to !"ear and smell their stressed neighbors st-owed significant dr'OjE in killer cell activity. The researchers suggest that cues associated with a nearby stressful experience may provoke changes in ilTrl'lJne flnCtioo. perhall5 as a result of an increase in s)11lllatretic nervous activity. Such activity-- tre S Taking into aCOOJnt new informatioo 00 the ways in which AIOO can attack the bcxly. eoc epidemiologists have released CK'l expanded c!efinitioo of medical cooditiQ1S that coostitute a case of AlOO. The official definitioo. devised to help determine which cases stnlld be reported to health officials. includes for the first time AlOO-associated degenerative disease of tre brain and wasting S)ofIdrome (emaciatioo). Publist-ed in a supplement to tre Aug. 14 !'orbidity and !'orality ItIeekly~. tre definitioo also broadens the number of CO'lditiQ1S CQ1Sidered 'AIOO-indicative.· which are viewed as strong evidence for AIOO - even if the patient tests negative for antibcx!ies against the AlOO virus. State and local !"ea lth departments are expected to begin tabulating cases 00 the basis of this definitioo try Sept. 1. 1OI •• IOI ••• *** •• *••••••••• IOIIlI ••••• lI •••••••••• m •••• HSV LATENCY MAKES - ANTI-"SENSE·" try D.O. Edwards. with thCK'lks to SciSlCe NarIs. 12/5/87 A backwards genetic message may be tre reasO'1 wily rerpes simplex viruses lie formant betwea1 occasiooa 1 attacks 00 treir Man hasts. scientists I'eIXlrted. Because such latency pericxls are characteristic of gEnital t-erpes and cold sores. as well as some ott-er viral diseases like AU5 and shingles (herpes zaster). the researchers say that further studies 00 the unusual gene may suggest a way to keep inactive thase viruses that persist in tre Iunan bcxly. It is well establisrsl that Q'1C9 a persa1 is inf~ted ItIith herpes simplex 1 viruses. the viruses 'rest' - or at ITOSt grow very slowly -sCX1Stlhere in the nerves thrrugtnlt life. waiting to reactivate and ambush tre hast with painful attacks. WI"ry and !-ow the viruses remain inactive is of coosiderable interest in terms of pJblic !"ealth: Between 65 and 80% of the general U.S. JlOpJlatioo has been expa;ed to these rerpes viruses. Scientists at the Natiooal Institue of Allergy & Inf~iClJS Diseases (NIAID) in Bethesda. h.Jnted for donnant herpes simplex viruses in facial nerve tissue taken frClll cadavers taht did not have signs of active herpes inf~tions. The NIAID group found large amounts of RNA similar in structure to a previously identified viral gene that forces inf~ted hast cells to produce a viral protein called ICPO and relll5 regulate subsequent stBlS in viral replicatioo. But tt-ere \lias a twist: Tre new RNA \lias a mirror image of the ICPO gene. and therefore is what geneticists call 'anti-sense" RNA. Tt-e NIAID researcrers. with collaborators front he Office of the Chief r.B:!ical Examiner in Baltimore. say in tre Dec. 3 New England Joornal Qf r.B:!icine that tre anti sense RNA may cause latency by either blocking activity of the normal viral RNA. or coding for a protein that interferes with virus growth. Kenneth Croen of NIAID said that tre current results may suggest 'the ideal trereapy' for tre millioos wl"O suffer frClll rerpes inf~tiQ1S. 'It really depends 00 wretrer tre anti-sense [RNA] is a regulatory [message] itself. or whether tt-ere is a regulatory protein projuced.' he explains. "In either case. one coold devise therapeutic approaches" that essentially duplicate either actioo. If the RNA turns 0Jt: to be a regulatory, it \IIOUld be the first time such a Ehanism \IIOUld be demO'1strated OJt:side bacteria. The current study is an extensia, of IIKX'k in laboratory mice reported earlier in 1987 by University of California researcrers in La; Angeles and Irvine. Results frClll-1unan tissues. t-owever. stnlld accelerate rerpes research by providing 'a uniform nodel of herpes simplex latency,' says Croen. 'in tre animal models for herpes. it's less clear what latency is.' re says. "It is not moo whether the viral [genetic machinery] is slllt off in animals.' !'ore experiments IIlJSt be tb1e. says Croen. to prove whether the anti-sense RNA is relly the key factor in establishing and maintaining latecny. and whether it cares frClll the virus. Tt-e approach also may be useful "in studying factors like stress. which is moo to reactivate the herpes virus and in studying latency in other viral inf~tions. ******lkltlt1tlI<************************* ...... lHE OFFICIAL NBllSLElTER OF lHE NCGSTIS * VClI.M: 8: 4 * WINTER, 1987 * PAGE 57 ***** *** •• *****. +I •••••• I•••••••• ~ I+ + u •••• I. I. I. I••• +I" +, I. **+. *~ ******' ******* .. ~**' .*" IMil. I. ****** •• ~. I••••• ~. '** I..... II. I~ I'** BALASCOPY PROVIDES COMPUTER AID D~ Bal ascopy , in which a computer program provides accurate, early diagnosis of the actual disease quickly and at a cost of just a few dollars, was annOJnced at the Balascopy Research Institute. Date fran rOJtine blood sample results is ooterOO into the Balascopy CClnpJter which is able to identify and differentially diagnosed ARC (AIlS related condition) in two distinct forms-- AIlS in it's earliest stages, and can identify those ~le who have been tested lXEitive for AIlS antilxxlies rut are not clinically ill. Untill1CNl, diagnosis has been limited to the HIV antilxxly tests, frequently in conjunction with other laboratory and blood tests and biopsy reports. The Balascopy program canpares up to 55 variables fOJnd in the blood sample, and translates it's findings into 16 OJtpJt presaltations in the f{)rm of circular polar diagrams. According to the manufacturer, 12 different studies daTmstrated that the technique distinguished AIlS, ARC, and uninfected individua ls. 'Given enOJgh data,' said Peter To los, president of the Ba lascopy Research Institute, "Ba lascopy can determine when a patient canes datn with ARC or AIlS, what the specific condition is, and what the most likely OJtcanes are. In addition, it can determine drug effectiveness in a few days and measure improvement or decline in a patient's condition.' The test is expected to be available nationally by late Spring, 1988. For additional information, contact: Balascopy Research Institute, 50 Fremont Street, 31st Floor, San Francisco, CA 94105 (415/777-9759). COMPETITION CAUSE OF AIDS DEMENT"IA? by D.O. &Mrds, with tlBlks to Sciax:e NarIs, 9/5/87 Structural similarities between AI!S-causing viruses and a protein that stimulates nerve cells may ccntrirute to the demential common in AIlS patients, and tM may provide a W3¥ to reverse that dem:ntia, scientists said. The researchers suggest that the similarities create a canpetition between virus and protein for binding sites on naJrons- leading to inhibition of nerve function by the viruses, and in turn causing symptans associated with dem:ntia. Since the AIIS-causing HIV-l virus wsa first isolated fran brain tissue in 1985, there have been multiple reports of the virus fOJnd in the nerVOJS systan of people with AIlS. (Ner teh same period of time, clinicians began rOJtinely observing P\IIAs for signs of dementia, including merrory impairment, apathy, and poor concentration. NG.II recognized in at least 2/3 of AIlS patients, signs of dementia recently were added to a revised definition of the deadly disease. rut the actual cause of AIlS danentia has been l.nmoo, despite the fact that the anoJI1t of HIV-1 in the spinal fluid is related to the severity of danentia. 'Even tlnJgh there is this dementia in AIlS, it is clear that HIV-1 does not infect the naJrons t!mselves, 'Mark GJrney of the University of Chicag told Science News. GJrney, co-'AOI'ker Mark Lee and David Ho of the Cedas-Sinai ll'alica 1 Center in Los k1ge les studied the interaction between HIV-1 and factors that are moo to control naJronal grllllth and function. What they found, says GJrney, COJld help explain what is causing AI!& related danentia. • [The HIV-1 virus] infects the rrmocyt:e cells in the brain." says GJrney. 'So I'o.tI does an infected monocyte, which isn't a nerve cell, cause danentia? There must be an indirect mechanism: That mechanism, GJrney and his coautrors report in the August 28 Science, may be the CCJ11)etition between the virus and a protein called naJrolaJkin. First described by GJrney and others in 1986, naJrolaJkin is secreted by l~l'ocyte cells, stimulates antibody production by other blood cells and influences the grllllth of naJrons in enbryos. In the recent study, the sceintists fOJnd that a segment of naJrolaJkin is very similar in structure to the HIV-l c:anpalS1t called gp120. Experiments using 10-day old chick anbryos sl-oled that the addition of either whole HIV-1 or gp120 suppressed the activity of naJrolaJkin. According to GJrney, the cause of the dementia in AIlS apparently differs fran that of other dem:ntias: 'In Alzheimer's, yOJ have actual death of nerve cells, and yru don't in AIlS.... It's as if the [AIlS-related danentia] is a by-product, and the brain is an inncx:alt bystander.' The absence of cell death directly due to viruses may mean that the dementia COJld be reversed, he says. This pranise is supported by results fran a recently reported study, in which a small number of AIlS patients treated with the drug zidcMJdine (AlT) sl-oled improvement of dem:ntia. That success, suggests GJmey, may have been due to reciJced canpetition: 'It yru control the infection, YOJ reduce the gp120 and the naJrolaJkin can start acting again." BJt GJrney admits there are many questions witlnJt answers. CUrrent research results are derivOO fran embryonic, rather than adult nerve tisse. NaJrolaJkin's role in the adult brain remains unclear. That discrepancy, he says, creates a "weak part in generalizing OJr results to dementia in adult AIlS patients.' He and his c:o-It«lI'kers are planing to inject gp120 into the brains of adult laboratory animals, and watch for signs of dementia. Another question the researchers nust be an5werOO is whether gp120 also interferes with the immune-systan functions of naJrolaJkin. I'.~I •• II"~.I~ •• '.' ••• ~~~.~I'.I.'II'.*.I.'.~.I.' STRESS AND IMMUNITY by Bruce ber, with tlBlks to Sciax:e NarIs, 9/12/87 Tending to a relative with Alzheimer's disease is not just psychologically stressful- over the long run, say researchers at Ohio State Univesity Colleae of Medicine in Columb.Js, it can undermine a caregiver's immune responses. Janice Kiecolt-Glaser and her colleagues canpared 11 men and 23 women caring for family rrenbers with Alzheimer's disease with controls matched for age, sex and education. An average of roore than five years had passed since the caregivers had noticed the first ~tans of the disease. Subjects caring for an Alzl-eimer victim reported roore distress and jXlOrer mental health than individuals with no such responsibilities. Careaivers, whose average age was 59 years, also had indications of poor irrm..ne function: 10ttler percentages of T l~es and helper T l~es than controls, as well as a lC7ller ratio of antilxxly-stimulating cells to antibody suppressing cells. In addition, there was evidence of jXlOrer inm.me systan control of the latent Epstein-Barr virus among careaivers. There were, tnr.oever, no graJP differences in number of physician visits or sick days in the prior six months. The most important health consequences of the observed immune changes may occur among older adults wro already have age-related drops in inm.me hfi:tion, say the researchers. They hope to test this suggestion with long-term studies of middle-aged and elderly caregivers. [EO NOTE: What ~ld be interesting and roore meaningful would be to measure inm.me systan responses in those caretakers after ~he saJrce of their stress was rarovec!-i.e., no longer caring for their relatives. If inm.me systan functirn rebOJnds after the stressor is relieved, this would be a roore patlE!rful indication of the role of stress. This has obviOJS implications for any caregivers of progressively, chronically ill patients.] ***** PAGE 58 * THE OFFICIAL NBtlSLETTER OF THE NCGSTOO * nlJE 8:4 * WINTER, 1987 ***** *I*tc+ ••••••••••••••• ~~m.~ ••• ~ ...... t: ••• ~ ...... ~ ...... AIDS PROT·EIN - COMPUT·ED·· with thrlks to Science News, 9/26/87 Scia1tists in Eng land have used a canpJter to coostruct tl-e probable three-diroonsima 1 structure of a protein that may. prove significant in developing new drugs against tl-e virus causing MOO. In tl-e Sept 24 Nature, Laurence Pearl of tl-e Institute of Cancer Research in Surrey and William Taylor of tl-e University of l.ondal re~t tl-eir canpJted structure for tl-e prtease a1~ produced by tl-e AIOO-causing HIV virus. Part of tl-e HIV protease - esSa1tial for the productiCJ1 of proteins that make up the virus core - structurally resembles the aspartic class of proteases fround in tl-e blcxxl and digestive systan. After canparing tl-e amino-acid patterns fran both 9roJIS, Pearland Taylor found that tl-e HIV protease is very similar to half of tl-e aspartic protease's structure. Based CJ1 this observatiCJ1, they suggest that HIV protease may in fact be active CJ11y when t\lKl of tl-ese smaller proteases unite. Tl-eir canp.rt:er nxxlel of this 'daub le' form and its binding sites may point to tl-e design of drugs that inhibit HIV protease activity, and therefore viral infectiCJ1, say tl-e scia1tists. *******-'4c!c+ ...... m ...... u ... I*tc+ ENZYME BLOCKERS SLAY AIDS - GIANT·S·· by D.O. Ea.erds, with th:rlks to Science NarIs, 11n/87 Drugs that block a 'sugar-trinming" a1zyne i~tant in tl-e progressiCJ1 of AIOO can reduce the virus's ability to infect Man blcxxl cells and may provide a OO1toxic therapy for tl-e disease, scia1tists said. !r;{ inhibiting an a1zyne called glucosidase, tl-e durgs appara1tly reduce tl-e cell-to-cell spread of HIV, as well as inhibit tl-e formatiCJ1 of 'giant' cells made when uninfected blcxxl cells attach to an HIV infected cell. Researcl-ers fromt I-e University of krsterdam and TI-e Netherlands Cancer Institute report in tl-e Nov. 5 Nature that tl-e drugs castancspermine and l-deox)'nojirimycin (dNM) hinder HIV's ability to infect nmx:ytes and l~es in cell cultures by at least 10o-fold. TI-e drugs are knoo to block glucosidase, which trims sugars fran the HIV catljXMlt gp120 during virus prodJctiCJ1 in host cells. Astudy last year at Stanford Univesity had shoo that gp120 joins with receptors CJ1 cell surfaces, leading to infectiCJ1 of the cell by tl-e virus. Subs~ua1t research indicated that at least sane of the gp120 sugars inflUa1ce this receptor binding. Receptor binding by gp120 is also ttnJght to be important in tl-e formatiCJ1 of large cells that develop ItIhen lXlinfected cells are mixed in vitro with HIV-infected cells and tl-eir nenbranes fuse together. Although researcl-ers have not detected tl-ese fragile giant cells in fresh tissues fran AIOO patia1ts, they suspect they may be important in tl-e spread of tl-e virus. TI-e cells could explain, for example, I'nrI HIV - which is faJnd in lC7ollE!l'-than expected numbers in AlOO patia1ts - may maximize its effect by infecting a cluster of cells at teh sarre tirre. In tl-e lastest research, castanospermine adn dNM 'completely inhibited' giant-cell formatiCJ1 for 6 hours after the drugs were mixed with cells, and tha1 great1ey decreased it for several days after tl-e mixing, say the scia1tists. TI-e drugs. 1'nrIever. dod not stop virus productiCJ1 inside already infected cells. The latter observatiCJ1 is of interest because it indicates that tl-e virus needs tl-e proper arrangems1t of gp120's sugars to bind to cells. b.rt: not to replicate. says Thanas Folks of the Naticnal Institute of Allergy and Infectious Diseases in Betl-esda. Folks. who does similar experiroonts with other a1~blocking aga1ts. told Scia1ce News that tl-e 10\11 toxicity of dtf1 and castanospermine also is i~tant. TI-e Mch researcl-ers note that tl-e t\lKl aga1ts have been used in Europe to caltro1 blcxxl glucose in Iunans. **m** ...... ** ...... m ...... EYE~ SKIN DISORDERS & HIV I:NFECT"ION by S. EiSEr\berg. with tlBlks to SciB'lCe News. 11/14/87 Certain eye lesioos or skin CCJ1ditioos may be early pi¥;ical signs that people are infected with tl-e h.Jman inmunodeficiSlCY virus (HIV). A1ttnJgh tl-ese indicators have been associated with fully developed AIOO for several years, tl-e new reports are tl-e first large-scale studies associating them with early stages of HIV infectiCJ1. which eva1tually can lead to AIOO. TI-e findings will I-elp increase practitioner awareness, leading to earlier diagnosis and treatrrent. researcl-ers say. In a study presBlted at tl-e Anerican kadeJri of Optha 1110 logy's lreeting in Dallas. 5 patimts with retinal disease. rut wro otl-erwise appeared hea ltlly. were diagnosed with HIV infectiCJ1, says William R. Freeman. an assistant professor of opthalroology at tl-e University of California at San Diego. who led tl-e study. Of those 5. t\lKl had cytomegalovirus (00) retinitis. or inflanmatiCJ1 of tl-e retina, t\lKl had a bacterial infectiCJ1 of tl-e retina. and one had "cottCJ1 \Il001 spots,' which are small white areas of retinal thicka1ing. Freeman also studied 13 patia1ts with ~. which can develop into AlOO and which typically is characterized by fatigue. weight loss, and s\lKllla1 glands. He frund that nine had 00 retinitis and frur had cottCJ1 \Il001 spots. Previously, researcl-ers had thought that eye lesioos. which are associated with about: 75% of AIOO cases. developed CJ11y later in the course of disease. In fact. 00 retinitis is coosidered CJ1e of tl-e various opportunistic infections defining tl-e onset of fully developed AIOO. This characterizatiCJ1 may lead optha 1100 logists to misdiagnose 00 retinitis in patia1ts who sean otherwise hea ltlly. They tha1 may incorrectly prescribe rredicatioos. such as steroids. and find that tl-e infectiCJ1 CJ11y \IKlrSa1s. flean\l/hile. tl-e diagnosis of possible HIV infectiCJ1 may have been missed. Freeman roontiCJ1S anotl-er possible scenario: 'If SQI!'eCJ1e with weight loss or fatigue cares to a [practitiCJ1er's] office, the pi¥;ician should check tl-e eye for any lesiCJ1s." Before coosidering tl-e possibility of HIV infectiCJ1. hO\IIever. tl-e clinician should rule out diabetes. hyperta1siCJ1 and otl-er ailroonts that can cause eye lesiCJ1s. Asimilar process of eliminatiCJ1 should be used by pi¥;icians dealing with certain skin disorders that may indicate HIV infectiCJ1. says Sirkka-Liisa Vale, a dermatology researcher at Aurora Hospital in Helsinki, Finland. In a study involving 237 tmosexuallyactive rren. to appear in tl-e Decanber Journal Qf tl-e Arrerican Academy Qf !Bmato logy. Valle shO\lled that three skin disorders were found il) tl-e 11 subjects with as~omatic HIV infectiCJ1 and in tl-e three subjects with ARC: an overgrooh of Candida yeast in tl-e nwth; scaling of tl-e face, sea lp and skin; and drying of tl-e skin. tl-e severity depended Up:Jl tl-e HIV infectiCJ1's stage. Says Marcus CCJ1ant. chairman of tl-e California State Departroont of Health Task Force CJ1 AIOO and clinical professor of dermatology at tl-e University of California Medical Sclml at San Francisco: "We need to let dermatologists knO\II that AlOO is· spreading aJtside tl-e high-risk groJlS and tl-ese disorders should make pi¥;icians think twice." (NCGSTOS ED Note: Not just dermatologists and other physicians. rut all primary care clinicians!!] ~, •• "*.******************************************* ***** lHE OFFICIAL NE\IISlETTER OF lHE NCGSTIE * VCXlJE 8:4 * ItIINTER, 1987 * PAGE 59 ***** ** •4C+ +4C+. ++ + + + + + m ++ + +. ++ + + t:+ ++** •• **** ++ + + •• +•• +. ++ • +. +••• ** •• ++ •• ++ t:. +. m **. +•• +••• +•••• +•• t:m~ • +• +. +**** ++ •••••• +••• ** •••• ****** ****** NEW HUMAN RETROVIRUS with tlB'lks to Sci~ NellIs, 12/19-26/87 Sci~tists have discovered anotn:r ~n retrovirus related to-- but distinct from-- those already associated with AIDS and certain cancers. Itallan researcrers at tn: Unlver:lty of Rome ~ t~ Univ:rsity of L'Aquila found tre virus in 7 patients with a relatively rare form of lymp~ cancer called mycOS1S fungoldes, after flrst lsolatlng it from a cell line derived from anotrer mycosis fungoides t' t Tentatlvely called HTLV-V in treir report in tre Ce::. 11 Science, tre virus joins otrer members of tre HTLV (IlJman T-l ..."""t h' ~ len )' "etrovirus family all 'd tTed' 1980 TI.... I"""'''' rap lC vlruses I .' 1 en 1 1 smce . II~ previously described HTLV viruses include tre AIDS-virus (HIV-l) as well as HTLV-1 d H~LV-II, WhlCh apparently c~n cause some leukanias a~d lymplmas. Afourth HTLV virus, nOtl known as HIV-2, is t~ght by researcrers ~o a,so ~e AIDS or an.AIDS-11ke syndrome. Tre new Vlrus differs from tre otrer 00 'cancer" retroviruses in that tre cancer cells from HTLV-V lnfected patlents do not have two .specific surf~ce receptors found on cancer cells from patients infected with HTLV-I and -II, say tre authors. They also report that tre wlfe of one patlent had antiOO:Jies against HTLV-V, suggesting possible sexual transmission of tL.- virus. I~ **** ••••••••• u****************** •• ++ •• ++. m +**. ** TIME FROM INFECTION COMPUT"ED with tlB'lks to Science Nas, 8/29/87 Based CJ1 data from patients wro acquired AIDS from blood transfusions, British scientists reported that children under tre age of 5 at tre tine of infection developed treir first symptoms of AIlE abaJt two years after transfusioo - IIXlre than 4 tines earlier than tre average eight-year "incubatiCJ1 tine" seen in patients between tre ages of 5 and 59. Tre statistical analysis, based CJ1 figures from 297 U.S. cases, also fan:! that patients 60 years and older develop AIDS at an average of 5.5 years after transfusiCJ1. Researcrers at tre University of lCJ1dCJ1 analyzed data provided by tre federal COC in Atlanta to determine tre average tine from infectiCJ1 to developoont of AIlE. Tre scientists point out in tre Aug. 20 Nature that, alttnJgh these incubatiCJ1 tines may not prove to be identical to those seen anmg other groups of AIDS patinets, knOtling tre exact date of infectiCJ1 from transfusiCJ1 makes such studies a unique and valuable resource in in t.nderstanding AIDS. David Cox of tre LCJ1dCJ1 group told Science News that tre data from tre lI1der-5 age group are tl-srost conelusvie, and incubatiCJ1 tines for older patients may have to be updated as rrore data become available. COC epidaniologist Harold Jaffe, wro did not take part in tre current study, said in an interview that "it looks like tre rate of disease progressiCJ1 in AIlE from transfusions is rrore or less the sane as in (AIlE from other sources].' Knowledge of average incubatiCJ1 tines, tn..ever, does not mean SomeCJ1e at high risk can relax after a certain number of years folloong probable exposure to the AIDS virus, says Jaffe. "I think we (scientists] all believe that there is no such thing as a maxiM incubatiCJ1 period (after which you are safe]," re says. m.+·+ •• +•• +••• ****.******.******.m++4C++.*~ WHITE BLOOD CELLS INCREASED hy D.O. Edwards, with tIB'lks to Science Nas, 9/12%1 AgrOtlth I-orwle that stirrulates certain cells in the bone marrOtl can increase the number of white blood cells circulating inthe blood, and perhaps give AIDS patients wro had decreased white cell ca..nts I a research group from New Eng land DeaCCJ1ess Hospital and Harvard r.B:Iica 1 Sclml in BostCJ1, Sandoz Research Institute in East Hanover, NJ, and the University of California at Los Angeles tested the toxicity and effectiveness of granu locyte-macrophage co long-stirru lating factor «(JI1-CSF). Tha scientists cone lude in the Sept. 3 New Eng land Journal Qf Medicine that (}1-CSF is both nootoxic and capable of boosting the runber of white cells in the body, suggesting a possible treatne'lt for disorders with depressed white cell counts. The scientists used a genetically engineered form of the naturally occurring \-ornme, which is thought to activate bone marrOtl precursor cells that eventually become various types of white blood cells. a major canpCJ1a'1t of the inmJnE! systan, white cells can be drastically decreased in irmune disorders like AIDS, as well as by irradiatiCJ1 and cancer chaootherapy. Too few white cells (leukopenia) makes the patient defenseless against a variety of opportunistic, often fatal infectiCJ1s like lMJf101ia. In the recent study, the autl-ors report that intravenous infusiCJ1 with !* returned to their previous lOtI levels after the treatnnet was discootinued. "[The report] doesn't say we're curing AIDS with (JI1-CSF, H Jerome Gr()()fl1lan of New England DeaCCJ1ess told Science News. "9Jt CJ1e could see using it in combinatiCJ1 with drugs like AlT.' Recently renaned zidovudine, AlT slOt/S viral replicatioo and currently is the ooly federally approved AIDS treatnent. Future experinents will test such drug combinations, says Groo!Jnan. He and his c:o-\IIOI'kers also are planning clinical studies to determine whet:rer increased white cell counts will in fact alter the nOtI-fata 1 course of AIDS. Because preliminary studies sto/ that the I'vrnme-boosted cells are functional, Groopnan says that (}I-CSF "has a potentially important role to play in treating AIDS.' Tha reported research offers no guarantees and ll\3y be off target, says David Nathan of BostCJ1's Children's Hospital in an accompanying editorial. He points out that the primary blood-cell prob lan in AIDS ;s the relative absence of T cell l~es, not the lack of those cell types affected by !l+CSF therapy. He therefore suggests that it may be llXlI'e appropriate to consider the I'vrnme as a possible treatnent for bone marrOtl diseases, not AIDS. 9Jt Groopman disagrees, saying in an interview that infectiCJ1 with the AIDS virus is dealt with by lymphocytes and rrooocytes "in concert," and that b::lth are a target of the virus. 9Jpporting the I'vrrme as a potential AIDS treatllS1t, says Groopman, are yet-tlnpJblished data suggesting that (}1-CSF rrif.J "potently enhance" the microbe-killing capacity of l101OCytes, as well as actually inhibit the replicatioo of the AIDS virus. He cautiCJ1s, ~ver, that trese results come from studies CJ1 cell cultures, not animal studies. m~~:+lI***.m:+ll~ ••• +••• t:m •••:+lI~.+~ ***** PAGE 60 * THE OFFICIAL NEWSLETTER OF THE NCGSTOO * vaJ.IE 8:4 * \!lINTER, 1987 ***** *...... m •• m** .... ~ ...... uu •• *** ...... m ...... u.*.** ...... u** ..... «***m .. **** .... u ...... **** HYBRID PARTICLE MIMICS HIV by D.O. Ederds, with thcrlks to SciEnCe News, 9/5/87 By exploiting peripatetic pieces of yeast's genetic material called retrotransposons, British scientists are hoping to hasten the develo\llS1t of effective AIIlS vaccines. ·Transposable elene'lts· -[tlA segrrmts that readily roove fran cne locatiat at clrooosare to another - were first discovered in maize /l()re than 30 years ago, and later in fruit flies and bacteria. ~ researchers fa..nd several years ago that these restless crunks of 00. can transfer traits like antibiotic resistance between bacteria, they began using tim as carriers of foreign 00 in genetic experiments. Scientists at the Oxford-based British Bio-Tecmo loy Ltd., the University of Oxford and the University of Canterrury used similar tecmo1oy in their experiments with yeast retrotransposons, reported in the Sept. 3 Nature. The retrotransposoos code for a grrup of yeast proteins that assenb1e tlmse1ves into harmless "virus-like particles," which the -;;es;rchers have tricked into accepting Segne1ts form the HIV viruses causing AIIlS. These hybrid faux-virus particles may be useful in developing both AIIlS vaccines and diagnostic tests to detect the HIV viruses, say the scientists. Oxford's SJsan Kingsman told Science News that 100 copies of the HIV Segne1ts can be incorporated into each "ball of protein· that forms the custan;rade particles. The presence~ sO many repeated units of HIV antigen is likely to elicit better il1lllJnity when injected into an animal, she says. Yet unlllblished tak by the British researchers suggests that a wide range of proteins, including time fran viruses other than HIV, COJ1d be inserted into the retrotransposats, says Kingsman. Noting that the hybrid particles are simple to CatStruct and then Illrify, the authors also report that rabb~ts inject~ with the recanbinant particles develop antibodies against the HIV canpooent of the particles, suggesting a "new approach to vaCClne produCtl00.· ***** *•• :+ U *. u ttt+:+* ...:t +.. +: .....:+ ... m *****u.:+ .... CHRONIC VIRAL FATIGUE SYNDROME by Charles Ortleb, with thanks to New York ~tivet 7/27/87 Is AICG actually an acute form of chrooic Epstein-Barr virus (CEBV) disease? That is OOJnd to be the most urgent questioo to be settled by scientists in the rrcnths at-ead. rut other questioos arise. [Xl CEBV and ArllS have the same cause, rut different ootcares? !kles every person who has AIIlS have CEBV disease and not vice-versa? Is the presence of a retrovirus or of syphilis the ooly way to distinguish between AIDS and CEBV disease? And is the cause of CESV disease Dr. Robert Gallo's virus, HBLV, or perhaps in the newly discovered [tlA virus of Dr. Shyh-Ching La? In the May 30 issue of Hospital Practice magazine, Dr. Anthony Komaroff, director of the Divisiat of General Medicine and Primary Care at the medical departments of Brigham and \!/aren's Hospital, Harvard Medical School, gave ooe of the most complete descriptioos of the sj'T1drare called CEBV disease to date. Komaroff chooses to call the disorder Chrenic Viral Fatique Sj'T1drare (CVFS). His report summarizes research performed en/l()re than 300 patients from varioos parts of the coontry who have chratic moooouc 1eosis. According to Komaroff, poople with CVFS "do not have an illness that began as acute infectiCXJ5 l!()nCJ1uc1eosis. Different symptoms may be predominant in different patients, rut the commoo denominator is fatigue.... Typically, the patient is a yoong adult, althCXJgh we and others have seen the i11ness develop in children less then ten years old and in adults over 50. \!/aren seem to be affected abCXJt twice as often as men. In rur experience, the average patient has been m for /l()re than a year, and sare have been ill for as leng as 15 years. A minority of the patients are totally disabled." Komaroff coocludes that CVFS (CEBV) is a real organic disease because of "recurrent pharj'T1gitis and other symptoms of upper respiratory infectien, recurrent cervical adenopathy [s\llOllen neck glands], and la,tIQrade fevers (up to 101.4)." There are also striking neurological symptoms that occur in the first weeks of the illness. The symptoms imrpove, rut do not disappear. According to Komaroff, the patients generally describe the ooset of symptoms in the same way. They were fine until ooe day 'they developed wrat seemed to be a simple 'cold' or 'flu' with sore throat, ceervical adenopathy, rrryalgia (saretimes). gastrointestinal symptoms, fever, and profoond fatigue. But unlike any previOJS cold or flu, the illness never went away." Komaroff cencludes that "commoo exposure to some external agent, infectioos o~ envircnmental, seems to be an unavoidable cenc1usioo' because his reasrch team foond ·clusters of cases of affected persens who lived with ene another and developed the illness at abCXJt the same time." AlthCXJgh it has been assumed that elevated titers of antibodies to EBV may be a symptom of CVFS (CEBV), Komaroff's research team fCXJnd serological testing "less usefu 1 in a general medica 1 practice." In some patients with the sj'T1drare there are no detectable antibodies to EBV, which is why Komaroff prefers to ca 11 the sj'T1drome Chrooic Viral Fatigue Sj'T1drare, rather than Chrenic Epstein-Barr Virus disease. Komaroff admits that until the agent or agents which cause the disease are identified, diagnosis may be difficult. Because the cause of AIIlS has not yet been established, the search for the cause of CVFS (CEBV) may also offer clues as to what causes AIDS, because AIDS is so closely related to the syndrome. The symptoms and clinica1 findings of people with CVFS (CEBV) are shared with people with AIDS. One scientist I talked to said that A!n'3-Re lated Canp lex (ARC) is very rruch like CVFS (CEBV). Another referred to the SJf1drare as "closet AIDS." Even the Institute of Medicine of the Natiena 1 Acader.ry of Sciences, in thei r book £onfrenting AIIlS. noted the importance of B-ce 11 deregu latien and Epstein-Barr virus in AIDS. As readers of the New York Nati,!§ \llCXJld 1ike this writer to note, the questioo of the cause of CVFS (CEBV) may lead back to the same virus which has been implicated by some scientists as the cause of AIDS: African Swine Fever Virus. In pigs, African Swine Fever Virus can cause acute disease (AIDS?) or chrooic disease (CVFS/CEBV?). In the March 8, 1986 issue of The Lancet, three researchers reported that they "frund evidence coosistent with African Swine Fever virus in the plasma of U.S. patients with AIDS." The Cslters for Disease Centrol later performed research which centradicted these findings. Further research'done by the New York State Health Department showed that 4% of blood from the New York City Blood Cslter that was positive for antibodies to African Swine Fever Virus. The'city and state still are not screening blood to prevent people from getting blood that may be infected with African Swine Fever Virus. Both the cause of AIDS and CVFS (CEBV) may be resolved in the next few mooths when Dr. $hy-Ching Lo presents his data at a new 00 virus which he has isolated fran AIDS patients. He has used the virus to create fatal AIDS-like illness in mookeys. At the time of the animals' deaths, they were relXlrtedly free of HIV, the so-called 'AIDS-virus." ~ ...... "" ...... "...... ''' ... ''' .. "...... THE OFFICIAL NEWSLETTER OF THE NCGST~ * VOLUME 8:4 * \!lINTER, 1987 * PAGE 61 ***** ...... ***** m ...... +••• **'**l4OIlj:~"""''''''' ~ ...... *...... GENE TYPE NOT RELATED TO AIDS by lori Ks1schaft, with tllillks to I.b;tm's !!:i ~itx News, 12/13-19/87 ~ear~hers report th3t a gene type previOJSly suggested to increase susceptibility to AI~ does not seem to h3ve any infludence Cl1 mfectlCl1rates or the disease's progressiCl1. British researchers h3d suggested th3t an inherited variant in a blood protein th3t carries vitamin D might account for some of the differences in people's susceptibility to AI~. But researchers at the University of California h3ve fCUld no evidence for this effect. Research cCl1tinues Cl1 the factors th3t cause sane people to be exposed to the virus witlwt h3rm while others suffer from ARC or die of AI~. Genetic factors are suspected, altlwgh so far none h3ve been cCl1firned to influence either an individua ls 's susceptibility to infectim or the subsequent level of disease ...... 4C*M ... m ..... mu1 ...... ** ... m* HODGKIN~S DISEASE ASSOCIATED by ImEH:tristine d'ldesky with tllillks to New YCI'k Native, 11/23/87 A recent medical report suggests th3t Hodgkin's disease is yet another neoplastic disorder whcih may occur in sane people at risk for AI~. The (ktober, 1987 New York State Journal Qf Medicine reported the case of a 43-year-old gay man who died of l~pOO::yte-depleted Hodgkin's disease nine days after being Impita lized with fever, jaundice, and mental cCl1fusim. The patient had no other infectiCl1S such as Epstein Barr virus or cyt Jeremy Rifkin, an outspoken critic of genetic engineering and other biotec!m logies, hs asked three federa ~ agencies to determine whether cattle viruses playa role in causing AI~, according to The ~ ~~~ Iimes. In a petitiCl1 submitted to the Agriculture Dept., the COC, and the NIH, Rifkin termed the cattle viruses "an extraordinary potential threat to public health: He speculated th3t the virus which causes AIDS may have evolved from cattle viruses, or th3t the cattle viruses may themselves playa role in the development of AIOO. The petitiCl1 cited scientific papers indicating a ·c lose corre latiCl1" between HIV and a virus found ir. cattle called bovine visna-like virus (bovine inmmodeficiency-like virus, BIV). The petitiCl1 warned th3t a rar.ge of viruses "exist in domestic animal herds in the U.S. and trus could pose a potential health hazard.' Rifkin also speculated that the cattle vius, BIV, may have infected cell cultures used to make sane ruman vaccines, thereby cCl1tributing to the global spread of AIOO. HO!IIever t!110 of the scientists whose papers \l!ere cited by Rifkin expressed doubt th3t the cattle viruses played any role in causeing AIDS. "It's not sanething that somebody should be afraid will jump into humans or th3t slw ld make people fear COllIS." 4C*m ...... ~ BOOSTING AIDS VACCINES by D.O. Edlrerds, with tllillks to SciEnCe News, 12/19-26/87 To ensure adequate immunity against disease, vaccinations frequently are follO!lled by booster shots to stimulate an individual's "immunologic memory.' T!IIO studies- Cl1e in the first lunans ~ to be injected with an experimental AIOO vaccine,. the other in chimpanzees- are suggesting th3t this so-called anamnestic respCl1Se could be a viable part of AIOO vaccinatiCl1. In March, 1987 Daniel Zaguryof the Pierre and Marie OJrie Institute in Paris and his cQ-ltKJrkers annoonced th3t they had injected small group of volunteers in Zaire (including Zagury) with a potential AI~ vaccine. Tt-e new vaccine- made by inserting a gene for the AIOO virus (HIV) envelope into vaccinia virus used to make smallpox vaccine- caused antibody productiCl1 and activated immune cells. After the initial immunizatiCl1S, 12 of the volunteers each received one of four possible "booster" preparatioos: the recombinant vaccinia vaccine itself, a portiCl1 of the HIV envelope segment used to make the vaccine, woole cells taken from an immunized subject and infected in vitro with the recombinant vaccinia before being injected back into the sanE persm (autologous cells) or just the membranes from the vaccinia-infected autologOJS cells. The researchers h3d 'fixed' whole cells with paraformaldehyde to maintain to maintain their surface structures, recognized by an immune system already primed by vaccinatiCl1. en Dec. 11th, Zagury discussed the results at the Fourth IntematiCl1al S~ium Cl1 Cancer Research, held t the NatiCl1a 1 Institutes of Health in Bethesda, and organized by the French AssociatiCl1 for Cancer Research. Ten days after booster soots were given, the IOClSt 'marked respCl1Ses' of both antibody productiCl1 and cellular immunity were seen with blood samples from Zagury himself, woo !lIaS the Cl11y Cl1e to receive the whole auto logous cells. Subs9:1uent tests shO!lled th3t the boosting treatment caused no side effects, and Zagury CCl1cludes that this treatment should be CCl1sidered a possible ·prototype of candidate vaccines." ANatiooal Cancer Institute study in chimpanzees could give the booster-soot issue added insight: Unlike the hJman volunteers, laboratory animals can be ·ch311enged" with actual HIV infectiCl1. Peter Fischinger, nOlll at Health and Human Services headquarters in \!IashingtCl1, OC, said at the s~ium th3t yet unpublislBl data indicate th3t -after several boosting immunizatiCl1S with the vaccine follO!lled by ch311enges with HIV- chimps shO!lled an immune respCl1Se not Cl1ly against the HIV strain used to make the vaccine, but also against additiCl1a 1 strains. This is encouraging for scientists who !IIOrry that HIV's high rate of mutatioo !llQUld make it difficult for a single vaccine to protect against multiple strains. Zagury's group plans to add substances called adjuvants to the vaccine to heighten immune respCl1ses, in order to "mimic" the boosting protocol in a way more praCtical for larger groups, says Zagury. In another study looking for cell cultures th3t might produce ffiCl1oclonal antibodies against HIV, the group has isolated 42 antibody-producing clCl1es out of 400 tested thus far. They oope to use these genetically engineered antibodies to protect developing fetuses in pregnant, HIV-infected !IIOemn in Africa, says Zagury. m4<+1m.**M ... u .. ** ...... m~ .... *•• 4C*M. ***** PAGE 62 * '!HE OFFICIAL NEWSLETTER OF '!HE NCGSTOO * IJ(lI)f 8:4 '" WINltK, l!ltl/ 'fJfVfJfJf. ~ ...... u ... tlIc4C$JI *** **** ** * * ** ** ••••• +•••••• +••• *••••• t***I+ *•• *•••• *•••• *. ** m:t. ******* •• ~ ****. m** •••••••••••••••••••••••• 4C$ •. HEREDITARY FACTOR I:N AIDS"? with tlBlks to SciErlCe News, 5/16/87 Apersen's relative susceptiblityto inf~tien with tre AIOO virus, as well as t'OII rapidly tre fatal diseases PNYJresses in tre Ixxly, may be associated with genetic differences in a particular protein fOJ'1d in bloo:l and en cell surfaces, say scientists at St. Mary's Hospital Medical Sd'OOl in Lcnden. Trey I'eIXlrt treir preliminary study in tre May 2 Lancet, saying that t-aoosexual men with a particular variatien of tre protein called grOJp specific canpcnent (ec) were I1DI'9 vulnerable to both inf~tien with tre AIOO virus and suil;equent appearance of tre disease. For example, in tre study of 203 t-aooselQJals at risk of inf~tien or inf~ted with tre AIOO virus, plus 172 healtl'ti f'eterosexual and t-aoosexual centrols, 30% of tre patients with AIOO had inrerited fran both parents genes for tre protein's ec 1f form, canpared with enly 0.8% of tre centrols. Tre autl"ors suggest that tre ec protein, which binds vitamin 0 and transports calcium, relps regulate viral entry into Imt cells, in a process that may be aff~ted byt re ofrm of protein fOJnd in an individual. ** •• +4C$ ****m +1Cm .. 4C$' ++ + + ••• ++ *. +•• *4C$lI. 4C$ ++ **** REITER~S SYNDROME~ PSORIASIS LINKS by Mark 9Jl1iVCl1, with tlBlks to Tte Washi~al Blade, 11/20/87 Tre high number of people inf~ted witht re AIOO virus that get Reiter's syndrane and psoriasis has led researcrers in New York to believe that tre diseases are both caused by amorma lities in tre illl1lJl'1e systsn, according to Tre New York Times. Reiter's syndrane, disovered by a German doctor in 1916, is an arthritis associated with ncnbacterial urethritis and cenjunctivitis and sanetimes diarrhea, and may be associated with shigella, sexually transmitted agents such as chlanrydia, and a certain genetic susceptibility (people having HLA-B27). Psoriasis is a skin disorder characterized by rOJgh, scaly patcres en tre scalp, elbaNs, mees, and otrer areas. Altl"ough tre cause of psoriasis is not knoo, sane researcrers now believe that psoriasis is a less severe manifestatial of Reiter's syrorane. IXx:tor's at New York University's Hospital for Joint Disease have fOJnd that sane people with AIOO developed cases of severe psoriasis almg with joint stiffness. Tre rea$(]') why tre diseases strike people inf~ted with AIOO has not yet been dtermined, b.rt: sane resercrers think it may be due to interferen, a cremical that is produced in tre Ixxly in respcnse to certain viral inf~tiens. P& are knO\IIn to have hight levels of interferen. \f/hen cancer patients are given high levels of interfercn to fight tre disease trey often develop psoriasis, doctors say. ** **. 4C$" 4C$' 4C$ 4C$' m•• m+ +lIlIlI:4t+ ******. m+ tlIc4C$JI m ANAL CANCER LINKED TO ANAL SEX by Charles-Gene ft:Oaniel, with tlBlks to ~ OJtlines, 11/19/87 (mTOO ED NOTE: This article brings to mind articles of warning publisred several years ago in this Newsletter. If yOJ recall, we spoke of tre role of ruman papillanavirus (HPV) en tre anor~tum, since it has been positively related to cervical cancer in wanen. 'lie proposed a study for dalmstrating tre early detectien of anor~tal coodylana (VS1ef'eal warts, caused by HPV), with acetic acid 5% (table vinegar) and colposcopic t~miques. Trere! 'IIe've made tre suggestien ence again! Na.tI read en .... ] Ahistory of receptive anal intercOJrse ammg gay men has been fOJnd to be streng ly related to development of a rapidly spreading type of anal cancer. Tre study, calducted in liIashingten State and British Columbia, also fOJnd that a history of genital wards predisposes both men and \IO!S1, rut especially gay men, to squanntS-cell carcinana. Janet Oaling, PhD, and a grOJp of researcrers fran tre University of liIashingtm Scl"ool of public Health and Camunity ft'edicine, Seattle, and tre Cancer Caltrol Agency of British Columbia, VancOJver, reported this study in a recent issue of Tre Ne\tI ~ land JOJma 1 Qf I'e:!icine. Trey canpared 58 men and 90 wanen with anal cancer with a grOJp of 64 men and 102 wanen with colen cancer wlme disease was diagnosed between 1978 and 1985. Tre average age of both grOJPS was abOJt 57. Tte researchers fOJnd that in gay men a history of receptive anal intercOJrse \lias strengly associated with occurrence of anal cancer b.rt: en ly weakly linked to tre risk of anal cancer in wanen, anmg wI"om anal interCOJrse is roore camm than tm1g men in general. Eight of 20 gay men with anal cancer had a history of syphilis. Tre gay men also had a high incidence of repatitis Band cyt:anegalovirus. In patients witl'aJt a history of genital warts, anal cancer \lias associated with a history of gmorrhea in heteosexual men and in wanen with !Xl5itive bloo:l tests for rerpes simplex type II and ch 1anrtdi a traclmatis. Cigarette SII'Oking at tre time of diagnosis a150 was fOJnd to be a substantial risk factor in both wanen and men. Tre researcrers said anal intercOJrse may predispose to anal cancer tlroJgh transmissien of roman papillanavirus. This is suggested, trey said, by tre strmg asscx:iatial of anal cancer with a history of genital warts. Ttey point 0Jt that roman papillanavirus inf~tim also has been fOJnd to be a risk factor in causing cervical and otrer genital cancers. ktotrer explanatial, trey suggest, is tre eff~t of prostaglandins, a canprnent of semen, which has been st'Olln to enhance development of tUfOOrs. *u.,. 4C$ *•• u**. +•• +. +lI ****lI **********. m 4C$. +lI+ m HERPES V1RUS & ORGAN TRANSPLANTS by Din Ea.erds, with tlBlks to SciErlCe News, 10/17/87 The virus causing genital herpes appraently can be trasferred to transplant r~ipients fran contaminated dalor organs and tissues, say scientists fran tre University of Minnesota Hospital in Minneapolis. Jesse L. G:xxlman reports that altlwgh tre stress of organ trasplantatien has been knO\IIn to reactivate latent rerpes viruses in a previOJSly inf~ted patient, disssninated rerpes inf~tioos seen in two transplant ~;p;ents at tre Minnesota Impital were caused by viruses in tre dalated organs. Tre transplanted reart and pancreas were suspected after tre t\110 patients- previOJsly uninf~ted with rerpes simplex virus type 2 -developed severe rerpes inf~tialS fo tre bloo:l and 1iver. O1e of tre patients eventually died fran tre inf~tial. 9Jil;9:IIJerlt testing of bloo:l SCI1lP les fran tre donors sIDled a previOJS inf~tien suggesting that this virus may I1DV9 fran tre genital site and. becane latent in otrer areas like tre dalated organs, says ~man. Ear 1ier this year, similar transmissien occurred in two kidney ~ipients in Pittsrurgh. Altlwgh G:xxlman anphasixes that this type of viral transmissial is very rare in tre transplant field, re says care sl'aJld be taken wren organs or tissues fran infected dcnors are used. ***** TIlE OFFICIAL NOOLETTER OF TIlE NCGSTOO * VOI..M 8:4 * \!lINTER, 1987 * PAGE 63 ***** ~~~ 4CI I ~~ 4Ct. I' • I •••• m 4Ct 4C+*:t 4Ct~ I ++ • 4Ct ++ • +•••••• +•••••••••••••••••• 4Ct •••••••••••••~ *•••••••••••••••••••••• 4Ct •• +I •• 4Ct ••• 1"+ 1'1 I 4Ct ** NEWS BLACKOUT: SMALLPOX-AIDS LINK abstracted fran an article by Joo RaPp:l!l)l't, with thanks to the ~ y~~ ~~~, 6/29/87 The question of an enormaJs U.S. media blackOJt instigated by the 'fIor ld Health Orga:1ization is !:eing cha~ged. No U.S. television, radio o~ :1ewspaper reported that on M3y 11, 1987, the Lmdoo Tirres ran a front-page story with the headline, "Smallpox Vaccine 'Tr~ggered AIDS Virus. "' The story's sOJrce was an OJtside consultant to the 'I.1-!O, wl-o told the Iirres, "1 believe the smallpox vaccine theory is the explanatioo for the explosion of AICB." He was referring to the agency's 13-year campaign to eradicate smallpox in the third world. Iimes writer and science editor Pierce \t/right wrote, 'T!-e smallpox vaccine theory 'IIIJJ ld accOJnt for the positioo of each of the seven Central African states which top the league table of roost-affected cOJtnries; why Brazil became the rrost amicted Latin American cOJntry; and !-ow Haiti became the rOJte for the spread of AICB to the U.S." According to \t/right, 'The greatest spread of HIV infection coincides witht he intense irtmJnizatioo programs .. : He then lists Zaire, with 36 millioo smallpox vaccinatioos, at the top of the list of African states; then Zambia, with 19 million; Tanzania with 14 millicr.; and so 00. "Brazil,' he writes, "the ooly SOJth American cOJntry covered in the eradicatioo campaign [of smallpox], has the highest incidence of A!OO in that regioo." Haiti had 14,000 citizens living in Central Africa; they picked up smallpox inoculatioos there and eventually returned !-orne. 'After a meeting of 50 experts near Geneval [in June], it was revea led that up to 75 :nillioo, one third the POpJ laticr. [of sOJthern Africa). COJ ld have the disease within the next five years," according to the article. Robert M3tthews, tectl"1ica 1 correspondent at the ~9.}doo Ti~, explained row the story developed. "The ['I.1-!OJ, which had been running their 13 year smallpox eradicatioo program in the third world until 1980, began to \IICX'lder if the caccinations were connected to the AIOO pandemic." 'I.1-!O hired a corsultant w!-o agreed that there was a coonectioo, rut the report was bJried by the agency. \!/hen the entire affair was brOJght to the attention of Paul RaybJrn of the Associated Press, 00 said that 00 checked OJt the story with too AP's London desk, wl-o sOJght confirmatioo fran 'I.1-!O's Jonathan M3nn. Mann, said RaybJrn, resrarked that the ~don Ti~ story "was unproven, speculative, and cOJld cause confusirn,' and for trose reasons, the story was killed. \!/hile 6500 people including 850 reporters gathered in \t/ashingtoo for too Third International Crnference on AIDS, not one word abOJt hte May 11 ~~ limes piece managed to escape fromt he buzzing, erotional gathering and make it to a newspaper, wire service, TV or radio staion. ~or was me lOJd protest voiced by any of the African de legates. Globa 1 ignorance or cover"1Jp? The Lrndcr. Ti~, in its M3y ~ 1 piece, further states that \t/HO is ·studying further evidence suggesting immunization with the smallpox vaccine Vaccinia (immunizing agent] awakened the unsuspected, formant h..Jman irtmJno defense virus infectirn (HIV).· In recent IlO'1ths, we have seen suggestions that inocu1atirns cOJ1d trigger a dorma:1t HIV, bJt toore is also informed speculatirn that too smallpox vaccine cOJ1d be crntaminated with other harmful viruses. for 30 years, variOJs doctors have claimed that we have been playing with a time bcxnb called vaccir.es, and there are examples to point to: too 1976 swine flu vaccine, which paralyzed a number of people ar.d was discootinued; the oral polio vaccine, which M3x Essex of Harvard's Schoc1 of Public Health warned abOJt in 1985, stating that, since STLV-3, a mild AIDS-like virus, had been found in green monkeys, and since IlIJch of the world's oral polio vaccine used green nmkeys in its manufacture, we cOJ1d be in trOJble. Dr. Robert Gallo of too Natiooa~ Cancer Institute was quoted as saying that using live vaccines such as that used for smallpox, can activate a dormant infectirn of HIV. Such informatirn seriOJs1y questirns the use of 1ive vaccines such as smallpox, ru!:ella, measles, diptheria, etc. when a persrn may be H!V infected, since these immunizatirns may accelerated the progress of HIV disease. So, altl-ough exp lainatirns are being given, nothing will be explained. So, altl-ough authorities and public officials will be doing damage-control, they will not be controlling any damage. And of course, they will be representing organizations and agencies who want to buy a little time to come up with a really good ~ie about what didn't happen. No me will ask the simple questioos: ·\t/here did the smallpox vaccines used in the third world come from?" "Are they 8rntaminated?" "\t/ith which viruses?" "\!/hat are too names of too manufacturers?" Ar.d U.S. AICB researcoors, in their ~abs, wm begin to \IICX'lder, as they discover and analyze IIOre "AICB viruses,' woore the 0011 too microbes are coming fraT:. They will begin to \IICX'lder if they themsleves are merely dupes, working to correct what another part of the medical establishment rzs wrOJght in its vaccines. &Jt they will keep their IlnJths sh..Jt, because they're paid to. *********************************************** COFACTORS ROLE IN AIDS STUDIED abrtracted fran an article I7t .Ame-christine d'Adesky with thanks to New York Native, 12/7/87 Amid the lIB'ly ~teries surrrunding AIOO and its debated etio logica 1 agent, HIV, is the questioo of why sane peep 1e develop symptoms and others do not. In a recent review, two researchers propose that IlIJltiple exposures to alloantigms (self-produced proteins) or to sexually transmitted diseases may trigger l~e activatio and conversioo of latent or dormant HIV in cells to beccxne infectiOJS and patrogS1ic. David tla::k and Norbert Roberts, Jr., of the Univesity of Rochester Schocl of Medicine present their analysis of cofactors in the deve10pnent of AlOO in the N ••• T~ Tuskegee Experiment was undertaken [by t~ Centers for Disease Cootro1] to study t~ loog-term effects of untreated syphilis 00 399 blck men in Tuskegee, Alabama. T~ discovery of syphilis as a major factor in "AlOO: and t~ high percSltage of blacks wro have "AlOO: force (t~ New York ~tive] to ask O'le questioo: Is t~ Tuskegee Experiment being Caltinuec! trader t~ guise of 'AIIm' T~ level of racism at the U.S. Public Health Service in t~ past, and toropI'obia at t~ COC at present, are staggering. I have no problen believing that the characters I've talked to at t~ COC over t~ last seven years \IoOJldn't think t\tIice aba.rt: using syphilis to Caltrol Anerican behavior. I especially want to make an appeal to t~ black gay men and lesbians wro read thjs paper to lead t~ way in mnding an il11!lOOiate investigatioo into t~ possible link bet\tleen t~ Tuskegee Experiment and 'AIOO.' \lie IllJSt educate every 1lWl, 1Ollan, and child in this CWltry abOJt what t~ US Public Health Service did to t~ black carm.Jnity for forty years. It may be t~ key to every American's "AIOO" educatioo. In James H. Jooes's Bad Blood: The ~ S~ilis Experiment, ~ ~ Qf Race and Medicine (Free Press), t~ author describes IDI t~ Public Health Service reacted wI-s1 Tuskegee \liaS exposed: 'Had t~ subjects of t~ Tuskegee Study been taken advantage of? T~ Public Health Service officiers wro had been directly involved int ~ experiment tl'OJght not. There was nothing in t~ir pJblic statements to indicate E!VS'\ an CJJI1ce of cootritioo. No apologies were tSlClered; no O'le admitted arrt perSO'lal \tI'oogdoing. en t~ Caltrary, t~ health officials wro had exercised direct respoosibi1ity for t~ experiet made it clear that t~ had acted in good CO'lSciE!1ce. If anything, tt-ey probably felt maligned and ab.Jsed by t~ pJblic's reactioo and betrayed by t~ governl1S1t's failure to defSlCl t~ study. Had tt-ey been giVE!1 an opportlnity to retrace t~ir st~, t~re is little doubt t~ \IoOJld have CO'lducted t~ experiet again.' Not ooly \IoOJ1Q tt-ey, it's possible that tt-ey did, and that t~ experiment is still U1derway. In t~ nME of all of t~ innocent black and white victins, let's resolve this matter as SOO'l as possible ..... • ut:t t:t. u ...... II II ... +** *,,**u .. I<:u:t:t +••• t:t ...... PREHISTORIC SYPHILIS with th:rlks to SciBlCS tes, 9/'l6/87 Syphilis-causing organisns, called trepooenes, have loog plagued certain sciE!1tists, rut not in t~ usual SE!1Se. Rather, historians of disease are \IlSUre IDI and wt-ere trepooenes originated. Noting that the earliest reports of syphilis and related diseases did not appear in t~ Old World until after 1500, many sciE!1tists have suggested that Coll.lllbJs's crew and other voyagers might have carried trepooenes back with them whE!1 tt-ey returned from t~ New World. Several decades ago, t~is theory received support fromt he discovery of 3000 year-old Iunan bales from the New World that seemed to slDl signs of trepooenal disease. fia"lever, in t~ last 20 years, medical historians have suggested that syphilis did indeed affect Europeans in the Middle Ages, rut was misdiagnosed as leprosy at the time. Before 1500, ~ t~ researchers, people believed that leprosy spread by sexual Caltact, \liaS highly cootagious and respooded to mercurial cCllllXlllds. Yet all of these factors fit syphilis more than leprosy. NaN, inmmlogical tests 00 bO'les from a PleistClCSlEHlpoCh bear prove that trepcnemal infectialS in t~ Ne\tI War ld date back at least 11,000 years. In the Sept. 3 Nature, sciE!1tists report that, using antibodies specific to trepO'lBlles, tt-ey successfully identified trepooenal material 00 the bear's bO'les. This is t~ first successful use of il1'llUlOlogy to detect an ancient disease-causing organism, says Bruce Rothschild of St. Elizabeth Hospita 1 Medical Center Hospital in YWlgStCWl, Ohio, wro ItIOrked with William TMrull of the Field ft\JsaJn of Natural History in Chicago. According to Rothschild, this finding "flJShes back the history of any identifiable trepooenal disease substantially." Although the ne\tI finding does not resolve the debate about the origin of treponemal infectiO'lS, the il1JllJl'lOlogical tecmique will help sciE!1tists trace t~ history of t~ and other infectiO'lS. While pat1eopathologists could previously ooly diagnose ancient infectiQ'lS, this ne\tI tecmique al1011S a direct idE!1tifcatioo of the infectious organism itself. Using the appropriate antibodies, says Rothschild, sciE!1tists might apply this tecmique to the history of smallpox or tuberculosis. *u .. t:t .. ***u******.t:t ...... t:t** ...... t:t SYPHILIS CASES ON THE RI:SE by D.O. Ed.erds, with thanks to SciBlCS NarIs, 7/11/87 Itbre than 8200 ne\tI cases of syphil is \tIere reported in the U.S. during the first three mO'lths of 1987, an increase of 23% over the nunber of cases seen during the same period in 1986, scientists at the COC in Atlanta arYlCU1Ced. The recent j~ in the venereal disease is the largest in more than a decade and reverses a five-year trend of decreasing incidence, according to the July 3 ItJrbidit' and rtrtality \lleek1y ~. The latest figures also expose a ne\tI profile of infectioo, says coauthor Peter Crippen. D..Iring the 1970s, at ewith early stage syphilis \tIere either homosexually or bisexually active; !nEver, the latest figures indicate a decrease of cases anmg these groups, offset by relatively large increases anmg heterosexuals. "The fear of AIOO anmg homosexuals and bisexuals has changed their [sexual) behavior substantially,· CripPEJ1 told SciE!1Ce News. Altl'OJgh the reasQ'lS for higher heterosexual incidence are unlMla1, scientists suspect increased drug use leading to prostitutioo, as \tIel1 as scarcity of local medical and educatiooa1 resources, whicb have been stretched thin by AIOO patients and drug addicts. Whatever the reasO'lS, ~ Crippen, 'the CalSEqJenCeS are still very real, especially in CalQS1ital syphilis [which mot~rs give their unborn children].· Health officials also are CalCemed abOJt evime that people with syphilis or other sexually transmitted diseases may be more likely to develop AIOO. Infectioo with the AIOO virus appal'8'ltly also alters the course of syphilis. . *. ** ** *. **** ***** *. ***lI **** *********** **""* •••• +* *** :QlICIOIC THE Off'lt;lAL Nl:::W:iLtlltK ur INt Nl.Il:)IUJ ~ VI..'LU'E: 0;1+ JlllI''';''', .;ou. ******" ...... u*"." .... u...... *"* .... *"~.*" ... "m .. ".. ".*" •• *"*"~ .. ""m** ... m*"* •• u*"*".~"u ..... m+::.~*.*"*".**"* •• m SYPHILIS & AIDS CONNECTION? al:stracted fran a letter by Steplsl Caiazza, M:l, with thanks to New york Native, 9/14/87 There are two types of tests for blood tests for syphilis: specific and nonspecific. Nonspecific blood tests for syphilis (e.g .• RPR. VORl. ART) detect antib:xJy pNXluced against a normal constitlJe'1t of the ruman b:xJy, not an antigao "created" by infection. Cecil'§ Iext~ of Medicine. one of whose editors is James ~gaarden. MD. the present director of the National Institutes of Health, states this openly: ~ .. the VORl detects antibody against a normal tissue canpoent ... .' \lie call this normal canponent of the ruman body cardiolipin. It is a phospholipid fOJnd in abJndance in many tissues. especially the liver and heart. kltibodies against cardiolipin useful in the diagnosis of syphilis were first described by wassermann in 1907 (hence the origin of the Wassermann test). Today we use a more purified cardiolipin antigen canprised of phospholipid. cholesterol and lecithin. (Is this beginning to sound like AL 721?) That antibodies to cardiolipin do nothing to 'fight" syphilis ought to be obvioos. For. as cardiolipin is a normal constituent of the ruman !xxJy and not produced by the infecting organism, then if antibodies which result in response to cardiolipin were toxic or 'fighters: syphilis \IIOJ ld be a lethal autoimmune disease. The point here is that the nonspecific tests for syphilis do not detect antibody directed against anything produced by the syphilis organism. T. pallidum. and are, therefore, not protective. They fight nothing. This is important. \try then, do we produce tim? Again quoting fran Cecil; 'As yet there is no convincing explanation for why patients infected with T. pallidum develop increasing titers of antibody against a normal tissue canponent.' The specific. or treponema 1 tests for syphilis include the FTA-ABS and tflA-TP. According to the COC, the FTA-ABS is reactive in. at most. 91% of patients with just primary syphilis. Further. any physician who has treated a significant number of syphilitics is well aware that a negative specific test for syphilis does not mean the patient has never had the disease. Indeed, in HIV-infected patients fran rrry practice with a docUllalted history of past syphilis. only 68% retain a reactive Treponemal antibody test. Finally. as long ago as 1968, Dr. J. lawton ~ith published a seminal paper in which he reported being able to visualize, isolate, and S\.JCC9Ssfully transfer to animals live Treponemes fran patients with central nervoos system (i .e.. late) syphilis and who had nonreactive FTA-ABS tests and who had, furthermore, been treated for syphilis. If a person's specific test for syphilis is negative and the nonspecific test is also negative, this does not necessarily mean that a person has never had syphilis. [According to Syphilis: ~~. published by the Public Health Service (January, 1968). syphilis tests may be classified by the type of antigen used. Nontreponemal or reagin (nonspecific) tests are performed with extracts fran normal tissue or other soorces. Treponemal (specific) tests employ treponemes or treponemal extracts to detect antibody. The reaction of antib:xJy with antigen may be detected by various laboratory nethods; the indicator system used a1100 a further classification of the treponema 1 and nontreponema 1 tests. For example, the antib:xJy (reagin) that reacts with purified beef heart extract (cardio-lipin-lecithin) binds canp lement and prevents heme lysis of sensitized red blood cells (the indicator) in the nonspecific tests. Acute false-positive reactions are foond in persons suffering fran many viral and bacterial infections or who have had certain vaccinations and immunizations, or certain "autoimmune' diseases. According to King Ho lITeS in Harrison's Principles Qf Internal Medicine-9th edition, in nonspecific tests, antibodies produced in syphilis contain immunoglobulins directed against a lipoidal antigen that results fran the interaction of T. pallidum with host tissues. ED NOTE: I have been unable to find very little aboot false negatives, therefore I have included the next article.] *"*" ••• **"~.u ...... *"* •• **"*" •• m.. ** MORE ON SYPHl:LIS al:stracted fran a letter by Craig JoInsal, with thanks to New York Native, 9/14/87 Blood tests mayor may not reveal antibodies to the germ causing syphilis. The tests may be falsely negative in early as well as late syphilis. In a study of 241 neurosyphilitics done in Virginia in 1965-70. nearly half (47.8%) had never been diagnosed as having any kind of syphil is. False negatives in the usual kinds of tests used range fran 3-75%, depending on which study ¥OJ go by. Primary and secondary, as well as tertiary or late syphilis can affect tre central nervOJS systan. Trus it's misleading to suggest that neurosyphilis is sanething to ItIOrry aboot only in longstanding cases. Neurosyphilis may appear within \llE!eks of initial infection. Not always will antibodies be detected in spinal fluid, even in active neurosyphilis. After treatment of syphil is, the antib:xJy titer usually becanes nonreactive. however this does not always mean that a person is cured. Tests may be negative in the face of active syphilis. O1ce positive. treponema 1 tests \IIill not always remain positive for the life of the patient. There are many reported instances of tests retuming to nonreactive. especiallyis the disease was treated in a very early stage. Many renooed syphiologists insist that the tflA-TP (or the FTA-ABS) shoold always be done. plus a RPR. ~m**"*.*"**,,.**,,.~~ AIDS & SYPHl:LIS LINK? Does syphilis cause AIDS? Astartling new theory suggests that syphilis may be the underlying cause of AIDS. Author and medical historian Harris L. Coo lter posits that syphilis and the extensive use of medicinal and recreational drugs weaken the body's illJllJl1e system, allONing the AIDS virus to develop. Evidence stDtIs that intensive treatment of AIDS patients \IIith penicillin may be effective in curing or arresting the disease. The book contains two startling interviews with Joan fttKenna and Dr. Stephen Caiazza, who independently arrived at this theory. Caiazza tested positive for AIDS-virus infection but was in good health, then deliberately infected himself with syphilis and started to develop typical AIDS ~ans. \tel he treated himself with penicillin, he recovered. 'The AIDS virus is probably little more than another 'opportunistic' infectim of an already destroyed immune system-at the most a 'co-factor' which may possibly give rise to AIDS when canbined with other factors ... the search shoold be for factors which undermine the immune system and trus predispose to infection with ... the.AIDS virus and otherS which may ordinarily be quite innocuous ... • according to an advertisement from author Coolter. Coolter argues that AIDS can be ~evented and treated if the syphilis link is perceived and diagnosed. The book brings together a large b:xJy of data on syphilis and medicinal drugs as AIDS co-factors. and discusses new and pranising lines of research and treatment in the struggle against the AIDS epidemic. For more information: North Atlantic Books. 2320 Blake St., Berkeley, CA 94704. * '!liE OFfICIAl Noo..ETTER (l" 111t: ~Ilb ~ ¥~ 0." n...... " ."y. ***** PAGE 66 ...... lI ...... u ...... ** ...... IOI*IOI .... ** ...... *******I u ...... '.Ull ...... ** .... **.** ... •.... •.. •...... ** .. • MAYOR PRESSURES TV STATIONS by Lisa ft:QjllCl1Qh, with thds to 1l'e Washi~ Blade, 11/13/87 New York City Mayor Ed Koch, . has called for p.Jblic and federal regulatory support to p.Jt pressure on local televisioo staims to air city paid advertisarents directed tONard prev9'1tion of AICS. Tre New York Times reported that Koch, frustated by local television stations' refua ls to air tre AICS preva1tion ads, aca.JSed tre station rnanagarents ;;t-;;censorship' that a1dangers lives and urged tre Federal Camunications CaTmission to force tre stations to run tre ads free of chare. Koch made these statarents at a conference re called to address tre AICS epidemic. ItInicipal officials fran arrund tre nation, including tre mayors of Kansas City, Hruston, and San Juan, att81ded tre conference and adopted a resolution in support of Koch's position. Tre city, rowever, does not have tre authority to force broadcasters to air p.Jblic service annCA.JnCarents. according to City Assistant Chief of Enforcarent Mary Catherine Kilday, only a congressional act can do so. It!mbers of tre conference also discussed tre need for increased federal funds to deal with tre AICS crisis. \IIitlwt that support, said Koch, nunicipalities will be unable to provide ada1uate rea1th and social welfare services to people with AICS. IXlrotlly Keams, a represenatitive of tre National Association of Counties, said at tre conference that tre AICS epidemic "is grOtt/ing even in tre at rural crunties. Tre funding prob lens are staggering.' Conference manbers also adopted a number of other resolutions, inc luding several aimed at getting tre federal government to fund AICS preva1tion programs in minority-grrup areas and AICS-education programs in p.Jblic schools . ••• ************" ••• ** *•• ** ...... I • **Ill **** •• ******Ie AND THE BAND PLAYED ON: REVIEW by Mark Perigard, with thcr1ks to Ba;tm's ~ WiI'ldcMs, 11/12/87 Imagine yrurself strapped into a roller coaster descending straight to Hell. That's hOttI San Francisco reporter Randy Shilts' new book reads. Shilts relentlessly documents tre murder of tlnlsands of people, atly gay, as the federal government looks 00, uncaring; tre media looks My, uninterested; and gay leaders squabble, more ccncerned with sexual liberatioo than lives. It's hard to imagine a situatioo \IIOrse than tre one which re describes rere. Shilts presents an international scientific cannunity gifted with tremendous teclTlO logy bJt totally unprepared for tre nightmarish AICS epidemic. Researchers fight in vain for funds, against a backdrop of po litica 1 intrigue. Dr. Robert Gallo, a retrovirologist with tre National Cancer Institute, appears as tre kind of nmster yru'd be advised to avoid in dark alleys. Shilts proves hOttI Gallo brazenly canmitted tre scientific fraud of tre century by using his connections to rob French researcrers of tre credit for discovering tre AICS virus. 'Patient Zero,' tre handsane Canadian flight attendant to \111m doctors traced many of tre first reported AICS cases in North America, appears only as a minor player here, despite tre ballyhoo in tre mainstream media. 0'1 tre otrer hand, Larry Kramer, author of Tre Normal Heart and fiery co-fa.tnder of New York's Gay Men's Health Crisis, SJerges as ooe of tre first reroes of tre epidemic, ooe of tre few to realize tre severity of what lay ahead for everya19. In startling vignettes, institutional villainy canpetes with tre crurage and heroism of ordinary people joined in tre seaningly hopeless struggle against massive suffering and death. Ckcasionally tre book lapes into melodrama, particularly in tre last 100 pages or so, bJt overall, Shilts' restraint is remarkable. \!/hile Shilts is arguably a sexual conservative, re makes a solid case for all his points. His book slwld be required reading for all freshmen congressmen, joornalists, and those interested in learning hOttI Ronald Reagan's admiistration gave a deadly disease free rein. O'1ce yru finish this book yru may find yrurself \IIOndering hOttI any of us have managed to survive this horrible epidemic. Shilts' book rings as a savage indictment of the genocide still occurring across the country. ********" III ** +lI •• Ill •• ****** I ••• I ** ***. I •• 401 •• ** +• 401 MINI-SERIES PLANNED_ SH 1 LTS·· BOOK by Lisa M. KeBl, with thris to 1l'e Washingtm Blade, 11/20/87 Gay reporter Randy Shilts confirmed that he has sold the film rights to his widely acclaimed book on the AIDS epidemic to be made into a television mini-series during tre 1988-89 seasoo. Shilts' book, And ~ Band ~!!!, traces the federal government's response, or lack of respoose, to tre AICS epidemic. Tre book was number nine 00 Tre \llashingtm Post best sellers' list and will reportedly be 00 Tre New York Times best sellers' list. Tre book has also gotten widespread media attentioo, particularly for identifying ·Patient Zero,' tre man believed to be responsible for allegedly initially spreading the AIDS virus to the the nation's gay male canmunity. Shilts said 30 film producers and studios contacted him abrut film rights to tre book, "bJt half of them wanted to do tre 'Patient Zero' story.· Shilts said re and his p.Jblisrers, St. Martin's Press, declined to c(JlSider offers fran those producers. Altlwgh Shilts declined to divulge hOttI much money re eamed for tre film rights, re said it wasn't as much as \IIashington eost reporter Bob \IIoodward got for tre rights to his bestseller alx:ut tre CIA. 'Bob got a millioo [dollars] upfroot,' said Shilts. 'I didn't get that. I was offered a million, bJt I wanted to make sure it got done right." Shilts sold tre rights to Edgar Screrick and Associates, producers of ~ Shoot Horses, !XJl't Jl!t1, and otrers. Shilts said re trusts Screrick will ·maintain tre integrity" of tre po litica 1 nature of tre book, fOCUSing m its 'broader political theme of \llashington." Shilts said casting for ht emini-series, which will be frur to six Iwrs loog over t\110 or three nights 00 NOC-TV, is still far off. Asked to speculate on who might play him in tre drama, re mused: 'I doo't m ... Sally Field or IS1nis QJaid." *******lI*****mm****************** +. *******. **** MEDIA COVERAGE WITHOUT HYSTERIA by Lisa ft:Qj llCllQh, with tlBlks to 1l'e ~hill!l!m Blade, 10/9/87 Tre National Leadership Goal itioo 00 AICS (NLCOA), a \llashingtoo-based clearinghouse for nOre than 10 grrups that focus 00 AICS educatioo, held a seminar to discuss media coverage of AIDS. The seminar was held at the Natiooal Press Club and attended by joornalists from major newspapers, magazines, and televisioo news programs fran arrund tre country. Tre prevailing topic was hOttI to present accurate and unambiguoos information to the public without pranoting 'AIDS I'tysteria.' The NLCOA plans to publish the cootents of that discussion to distribJte to newspaper editors and tre general public as part of its AICS educatioo efforts. ***** lliE OFFICIAL NBtlSLETTER OF lliE NCGSTOO * \WJE 8:4 * WINTER, 1987 * PAGE 67 ***** **u ...... ~ ..... *** ...... ~.u ...... ~ •••• *** ... , ...... MM ..... +.**".**"**"' ...... *** ... M.~M++M BANANA RIGHTS: PBS RESPONSIBLE ~iled I7t Nadine 1t:Gann, with tlS1ks to ~~ OJtli~, 10/22/87 Robert fIoore, the president of the Internaticna 1 Banana Association, \IIrote a letter to the I\Jb 1ic Broadcasting service protesting the use of a banana:o dEm1stra;e t"O\II to.p.lt on a condan in the docullel1tary call~ "A:OO: Changing the ~les," according to the The Washington Blade. fIoore wrltes y~t the :holce of a banana rat~ than sane other, lnammate prop, constitutes arbitrary and r~k less disr9;lard for the unsavory assoclatlon that \11,11 be dra\ltl'1 by the p.lbl,c and the damage to our industry that \IIill result therefran." ft'oore states that the lBA, \IIhich represents ei~h: U.S. banana importing canpanies, will hold PBS "responsible for any and all damages' to the banana industry that may result fran the amng of the docullS1tary. 'The banana's continued image in the minds of the consumer as a hea lthfu 1 and nutritious product is critically impor:ant to the indust~y's continued .ability to be held in such high r9;lard by the p.lblic,· he \IIrites. PBS's general counsel responded to fIoore ,n a letter, stat,ng that PBS f,nds the banana S9JlleI1t appropriate and \IIill not remove it fran the docullS1tary. A spokesperson for the lBA maintains that PBS released M:lore's letter as a 'p.lblicity stunt,' and that the group's president never intended to make a p.lblic issue out of his canplaint. The docUllel1tary features Ron Reagan, Jr. as host and narrator; co-narrator New York salsa artist ~ben Blades will appear in the banana segnslt, placing the condan over the unpeeled fruit. *******. *••• Ilk •••• '** ***+. II M M *+. '** ... *M. M~ FACES OF AIDS ACCORDING TO NE~S~EEK I7t tee~, with tlBlks to ~ ~li~, 9/3/87 News\ll88k magazine devoted its August 10th issue to 'The Faces of AlOO.' Inside were photographs of 302 persons who have died. Under the photo of each gay man was one sentence about his live, personality, or accanplishllS\ts, such things as: ·Produced a 'safe sex' calendar to help fu1d an AIOO clinic;' 'Enjoyed volleyball, soccer, chess, and science fiction;' 'Designed the faces of Elizabeth Taylor, Raquel Welch, and Cher;' , 'A Dreangirls assistant, he was 'going places'.' Under the photo of each non-gay person was a sentence, too, bJt we soon realized these sentences were all the same. They told us t"O\II the person had contracted AIOO: 'A hemophiliac, he was planning to becane a doctor;' 'He was an IV drug user; still his wife says: 'Ed loved life and his family;" "Se got AIOO in a 1982 blood transfusion. Her son, nO\ll t\flO, tests n9;lative;' 'Sanders was an intravenous drug user;' 'Contracted AIOO fran blood transfusion during 1981 surgery.' The implication is clear: a person who happens to have been heterosexual is dead, and the single most important thing to be said in surrming up his or her life is that he or she wasn't Q3!i. This tells us sanething about the progress of gay liberation in the United States. 01 the one hand, of course, we oust admit that more and more people tolerate us, a few even accept us, and sane can actually be counted upon to voice politically-cor~t opinions about our civil rights. 01 the other hand, tlnJgh, Newsweek has nicely driven rane the reality that when you're dealing in the mainstream, being gay is still a horrible thing. It is so horrible that if you have bJt one sentence for a eJlogy, you must clear up any possible confusion about sexual orientation. This is nothing short of blatant heterosexism fran smack in the middle of the liberal-leaning U.S. media. In preparation for 'The Faces of AIOO" issue, News~ contacted the Champaign-tlrbana Gay Canmunity AIOO Proj~t, a group I \lrlJl'k \IIith. Because we saw it as an intrusion into the lives of families who had been thjrough enough, we ~lined to participate int he gathering of 'victims." Had we I \\hile News\ll88k's homophobia is certainly appalling, it is sadly, not uncamm. For years the media has been banbarding us with the distinction between "innocent victims" of AIDS (everyone but homosexuals and drug users) and guilty victims (guess \llho?). Here in Urbana, a hospita 1 once asked alr AIOO proj~t if we had copies of our safer-sex pamphlets wit root our 'gay name" on trem. kld the check-out counter tabloids (the truest baraneters of what will play in Proria) continue to single out homosexuality as the final taOOo. Even when Rock Hudson admitted he \lIaS gay, these newspapers didn't. Instead we read endless articles on Rock's miserable dual life and anguished unhappiness. It was even suggested that he'd been merely an innocent roy corrupted by evi 1 PO\II9rfu 1 IlS1 ~essary to his career. The tabloid \fIOr ld (and thus Peoria) continues to lack the concept of a happy and proud 'se If-aVO\lled homosexual.' This makes it a little easier to understand such things as our families never bringing up the topic unless \lie force it. It helps me to understand the silence in nry office a few \ll88ks ago after I appeared on TV, on three radio stations, and in t\flO newspapers regarding an AIOO issue. I knO\ll that if anybo::ly else in the office \IIOUld have saturated the media with sane non-gay story, it \IIOUld have been the office topic for three days running. Such, troogh, is the current state of our liberation rnoverrslt. At least we're out of the closet, and that is no smal thing. &it we still have work before us. The current "tolerance' is only going to five way to 'acceptace" if we continue reminding our families, office mates, and newsmagazines that our gayness is not a secret. So far, we've sanet"O\ll failed in canmunicating our genuine pride and happiness. This fai lure, oddly, coexists with strong feelings (in many of us) that if we had been heterosexual, our lives \IIOUld have been irmeasurably less rewarding. "Being gay." Christopher Isher\llOOd's lover Il:o Barchardy said recently in ~hristopher Street, 'is one of the very best things that could have happened to me, and if nry parents were responsible then they have nry undying gratitude. My life witroot nry gayness \IIOUld have been intolerable." This is the message Proria hasn't yet heard. Getting it to play there is one of the most crucial tasks be before us as \tIS keep fighting for our freedan. ***** PAGE 68 * lHE OFFICIAl NE\1/SLETTER OF lHE NCGSTIS * va.tIE 8:4 * WINTER. 1987 ***** .~*.~**.*:t* ••••••• +*" •••••• *" ••••••••••••••• m ••••• **** ••• tm:+ •• m •• ~:+*" •••• +••••••• lI.~ •••• ""~ ••••• ~ ••••••• ~ •••••• ~." ...... tm COMPUTERIZED HIGH TECH AIDS INFO by Nancy De \..uca. with tl'alks to &lstm's ~ Camuli!y News. 12/13-19/87 Students at tre Lmg Beach California CampJS of California State University can access AIlS informatim 24 I'nIrs a day using tre university's canpJter system. Tre program. called AIlS Info O1-Line, is available witl'nlt charge fran tre university's AIlS Informatim Project. Tre program provides basic informaitm alnrt: AIlS. abstracts of journal articles. and tre addresses and pIme oonbers of local AIlS organizatims. This informatim can be easily updated or custanized to neet a particular organizatim's needs. In additim. tre program alla.r.s users to test treir ~owledge and keeps an ancnynws record of treir scores for health ItKlI'kers who can determine tre areas in which AIlS ~ow ledge is weakest. Users can also post questios m an electrmic bulletin board which will be answered by tre project staff. Tre pro;Jram, which can run m micrcx:anpJters or mainframes. was designed by Richard Wolitski, a graduate student in psychology. for more information or a copy of the program, wite to Richard Wolitski, AIlS Education Project. Psychology Dept •• California State University. Long Beach, CA 90840. m .... *.~~ .. ~* .. ~~ ...... BOGUS SAFE SEX PAMPHLETS CIRCULATED by Rick Harding. with thanks to !~ ~shi~ ~~. 7/17/87 :he Sexua ~ M~r.or~ty Youth Assistance League together with the 'l/hitman..JNa lker C~inic ~ssued a press statement decrying bogus "safe sex" leaflets whic~, a::c:)~ding to the g~oups, were distributed in parts of netropolitan 'IIashington, OC. The leaflets contained a sexually exp~icit phltograph of t\110 wanen engag~ng in sex and was tit~ed "You !m't Have tc Set AIDS to Have (?()()d Sex." Underneith the phltograph was written, "For further information onhow a purely Lesbian lifestyle can greatly reduce your risk of AIDS infection, just call or write:" and listed the phone n:.:mbers of the C~inic and SMYAL. In addition, the pamphlet listed tre name and number of a 'IIhitman..JNalker Clinic volunteer. The statement said tre groups viewed the pamphlet as "harassment" and an indication of tre 'fear and hostility around both AIDS 3nc sexua ~ minority peep le partic:.: lar ~y Lesbians." A spokesman for SMYAL said the group learned of the pamphlet after it received telephone calls from area citizens, concerned about the document, including a call fran tre office of tre mayor of tre City of New Carrollton, a suburb, whl said the ;Jamph lets had been left on a street. ~+:t***~~~~ AIDS~ ETHICS~ & THE CONSTITUTION with tl'alks to Lifelines. Newsletter of the Life Fa..ndatim, !ktober. 1987 Q, November 19th. Fred'll. Friendly. tre Edward R. fIlJrrow Professor Emeritus of Broadcast Journalism at Co ll.ll1lbia !kliversity's Graduate School of Jou~lism. will rralerate a panel di~ssion of 'AIlS. Ethics and tre Cmstitution,' as part of Hawaii's Cmstitutitnal Bicentemial Celebrat'tQ1. SysAtna~ed la;turer ,and organlzer.of cCl1fertrl(;e5 on media. law,,_ and p,lblic policy. Friax!ly i5 also the cri!Cltor ¢ tre Public Broadcas mg em s ser,es, Ire (;Q'\st,tut,on: ll"at Del,cate Balance. ne and tl"e panel melilbers \liill explore, through rwotreticalfact situations, tre constitutional implications of tre AIlS crisis and otrer contemporary events. with special emphasis m right of privacy issues. Tre pJblic forum will be co-sponsored by tre Hawaii State Bar Association and tre state's Cmstitutional Bicentemial Ccmnission. Panelists include several judges. journalists, medical and legal authorities, and praninent representatives fran government. 1~:t+m"'~*"*"'I""I ...... :t"~"":t ••• ~ MEDIA PSAs FOCUS ON ., DREAMS" with tlwlks to Southem california CAR§ Nat;, editim 3 Southern California CARES recently introduced an entirely new multi-media public education campaign designed to educate and inform the genera 1 pJblic about tre risks associated with AIlS. •AIlS. P!\QTECT YOJRSELF. STOP lHE EPIDEMIC.' is tre ttsTe of tre Lnique campaign. which contains television and radio public service announcements and print ads. According to Judy Spiegel. director of education and training at tre AIlS Project Los Mgeles (APLA) and director of Southern California CARES, and Vermica Timpson. a camunity outreach educator for hte black cOOlTUnity at APLA. tre 1987 campaign targets segments of the popJlation who have generally been ignored by past educational campaigns --especially tre area's black and latina camunities. An integral ttsTe of tre campaign is dreams -tre realization and fulfillment of our hopes and aspirations. Dreams transcend all barriers- ethnic, ecmanic, and social. 'If it hasn't already. AIlS will tough all our lives in sane way -a friend. a motrer, a child. a CO'"'loOf'ker- perhaps even more directly,' Spiegel said. "If we don't take ~rsona 1 steps to prevent its transmissim tod~. it will destroy our dreams tanorrow." +m l:t +~ ~***** •• ~*"*". ********** I*"*" ~ **"*" ASPECTS TV MOVI: ES. EXPLORE EMOTOI:ONAL Q, October 15, LIFETIME Cable Television Net\tKlrk debuted "INing for Love: Tre Impact of AIlS on the American Woman. I a sensiti'f9 documentary which looks at tre tl.Jm3n stories behind these frightening figures. Tre hone I'nIr program offers viewers a rare. intimate glimpse of tre day-to-day lives of four \IICl1S'l with AIlS. It also presents a heartwrenching and provocative examinatim of the stigma. ostracism, discrimination and vilence which shadow tre disease and its victims. lifetime is a vEnture of Hearst/AOC Viacan Entertaii11Slt Services and is available ~ more than 3400 cable systems throughout the nation. "Right to Die' is a fact~based drama about a courageouS terminally ill \llQman Whl decides to negotiate rer CW1 death. It was presented October 12 on NOC television. Tre movie explores many of the medical. 1ega 1. and ethical isues surrounding tre care of anyone wro is terminally ill. For r.bre Information about eitrer of tre movies: OJ ltura 1 Information Service. P.O. Box 786, Madison Square Station, New York. NY 10159. ***~*~ •• t*+ •••• ~m ••• :.-. ••• ~****** ***** lHE CfFICIAl NEWSlETTER OF lHE t«:GSTlE * VCll)£ 8:4 * WINTER, 1987 * PAGE 69 ***** *** •••••••••••••••••••••••••••• *** •••••••••••••••••••••••• *** •••• ,•• *** •••••••••••••••••• **.** ••••••••••••••••••••••••••••••• ** •••••• ~ •• **~ MINNESOTAN MEDIA CAMPAIGN KICKS OFF by Patricia Ohnans, with thanks to tt-e Mimesota AIlE ~jEct Narlsletter, Spring/a.m!r, 1987 Ninety perCE!\t of Minnesotans see tt-e mass me:lia as their primary SOJrce of informatien, Ane\II me:lia ~ampaign deve lopa:j by the Minnesota AIlE Project and nine ott-er agencies will use tt-e mass me:lia to inform tt-e Q8"19ral pJblic as well as time at risk alnrt: AIlE. Unveiled en May 27, tt-e Minnesota AIlE Media Campaign is tt-e focal pcsint of a statewide AIlE preventien effort. The carrpaign's objectives are: *To disseminate basic and current informatien alnrt: HIV infectien and AIlE. *To suggest and reinforce appropriate behaviors that reduce risk for HIV infectien and AIlE. *To praoote respcnsib le attitudes anmg nenbers of the Q8"19ra 1 pJb lic tOlt/ard peep 1e with AIlE and related illnesses. *To pJblicize services and srurces of informatien alnlt HIV infectien and AIlE. Tt-e AIlE Media Campaign is tt-e result of nine W1ti-s of plaming by the AIlE Media Ccnsortium. a locse coa litien of local organizatiens en tt-e frent lines of tt-e fight against AIlE in Minnesota. rrenbers of the Ccnsortium include: tt-e Minnesota~. of Health, the Minnesota Medica 1 Associatien, tt-e Minnesota AIlE Project, the Anerican Red Cross-St. Pau 1 CI'ilpter, tt-e Minnesota Insurance Informatien Center, the Henepin Co..nty Camulity Health Dept.. the Minneapolis Health Dept .• the Ramsey Co..nty Health Dept., at St. Paul Divisien of Public Health, and tt-e Minnesota Dept. of Hl.IllaI'l Services. The campaign the1e. "Anya1e Can Get AIlE - Everycne Can Prevent It,· stresses tt-e illlXlrtance of prev8'ltien eOJcatien in canbating AIlE. Aserices of advertisenents ccnvey direct, straightforward informatien alnrt: preventien, ccndan use, safer sex, and the avoidance of needle sharing. The advetisenents will be distributed to newspapers, radio stations and billboard canpanies ttroJglnJt Minnesota. Planning for the me:lia campaign include a large flJ'1draising effort as well. $70,000 form the Centers for Disease Centrol, administered by the Minnesota Dept. of Health, has already been raised for the campaign. That total will be matched by the Censortium rrsnbership. Ac!ditienal funding has been requested of the state Legislature, and will also be solicited fran corporate dcnors. ~ ...... ** ...... ** .. ** ...... POLIT"IC:S OF AIDS We are pleased to iIfVlO,JnCe the seccnd Pl'intiog of "The Politics of AI!s~" a Frent line IlClmoh let that provides an in~epth exp lanatien of the facts abO.Jt this epidanic and situates tt'e AIlE crisis in today's soclal and pohtical centext. The pamphlet expcses the Reagan administratien's negligent and repressive AIlE policies, and locates the AIlE epidemic at the CE!\ter of a national health care crisis. It details the disproportienate impact of the disease en minority group;, and describes tuN the New Right is using the AIlE issue to inflane anti-gay prejudices and pranote its reactionary agenda. The authors have extensive experience in the battle against AICS. Nancy Krieger is a pJb lic hea lth epidemiologist wIme \I/Ork focuses en the health status of \I/Orking peep le, with an emphasis en U.S. minority group;. Rose Appleman \IIl'ites en lesbian/gay issues for Frcntline and other newspapers. For additional informatien, ccntact: P.O. Box 2809, Oakland, CA 94609 (415/843-7495) . •••••••••••• **~.*** •••• ~ •• **** ...... EROTIC FILMS WORK BES,T" with thanks to Detroit's Crui~, 11/11/87 StuNing explicit, erotic films of safer sex practices is more effective than other techniques of encouraging gay men to avoid sexual behavior that places them at high risk for infectioo with the AIDS virus, according to a new study, spcnsored by the Gay Mel's Health Crisis and cooducted by Dr. Michael QJadland, a professor of psychiatry at Mt. Sinai Sdml of Medicine. QJadland, who has studied ruman sexuality for 20 years, said that until nOoll, 'there has been no attempt to systeratically evaluate the effectiveness of sex educatien prOJrams 00 changing sexual behavior.' Instead, he said, "a ot of assumpt~ons are wade.' The study involved 519 gay an db~sexual New York men wOOse attitudes and sexual behavior were first assessed with an extensive, anenyrro.Js questiennaire. Although virtua lly an \q)ew that the AIDS virus is carried in SerTe1, alnlt half had engaged in risky sexual behavior within the previous 50 days. QJadland dividied the men into four group;. Three of the group; spent a \l/eekend learning about and discussing safer sex, altlnJgh each group received different educational materia ls. The men in ene group saw and discussed the erotic ~ilm depicting safer sex'Ja 1 practices. Those in the second groop were given erotic printed materials describing safer sex to read and discuss. The men in the third group heard a man with AIDS speak about his disease and were provided with safer sex guidelines. The men in the fourth group were given written guidelines for safer sex and sent ~ with no oPPTotunity to participate in discussiens. T\I/C rocnths after the educatienal programs, QJadland gave the men the sarre questiens. The men who had seen the erotic film had made the greatest cranges in their behavior. Although they centinued to have unsafe sex, they reduced by nearly a third the number of times they had intercourse without coodoms. The safe sex guidelines were ineffective. Some men who received t!-em gave up sex canpletely for a tirre, !:xJt did not change their sexual behavior when they resurred having relatirns, Q,ladland saaid. ~e stated he was not surprised by the findings. "\lie knOoll that in trying to get people to change risky behavior, stopping smoking, for example, or wearing seat belts, that fear is effective,' he said. "&:t sex is different. ~eople cannot just give sex up. H ~~ ... ~~~~~~~ PILLOW HAS MINT AND CONDOM with thanks to Detroit's Cruise, 9/2/87 ~or anyone who has stayed at a luxur.y hotel recently, it comes as no surprise to find your bed rolled down and a chocolate mint rn, ~~ pi1lOoll. ACanadian hotel is going ene step beyond, however. Le ShangriLa Hotel in Canada is nOoll placing discreetl~ \IIrap~ c~doms 1n+~;; 156 of its roans to 'srow it cares' about its guests. The rctel, nO\ll operating at 60% capacity, admits the prCT.Ct1rn was ,,€S1gned to ,:, its rooms as well as to prevent the spread of AICS. ** .. ~*~ •• ~** ••• *...... "*w •• ~.***** .QlQlI: PAGE 70 * lHE OFfICIAL NElr/SLETTER (f lHE NCGSTOO * nLft 8:4 .. Wll'4lt1\, 1:10""" *u u+ +I.,,,,, .... n****.lt ...... m ...... mlt ...... mlt ...... Imlt II mlt ...... lI ...... iIOI •• U." u** TAXI DRIVERS MAY GIVE OUT AIDS L I:T by Peg 9yra1, ItIith thanks to I~ ~hi~ Blade, 7/3/87 Agroup of New York City taxi drivers want to join the fight against AIDS by distributing educational pamphlets in their cabs, Al Zeff, executive director of the 5000 rrenber Independent Taxi Q...ners CaJncil, said his group has asked the city's Dept-, of Health to supply 1iterature for distribution, "Despite what some people think, cab drivers are as socially conscious as everyone else," said Zeff. "It \IKlUld be something to read [a pamphlet) while yoo're stuck in traffic that might keep you alive." ***~****~m"lm*'l******* SC:HOOL AIDS EDUCAT I: ON .' SIEC:US The July-.AugJst, 1987 SIEOJS ~ features several articles abaJt sctm1 AIOO education. "Sctm1 AIIll Education: Politics, Issues and ResJXJ1Ses," by William Yarber, and "AIIll and the College Student: The NeBl for Sex Education," by Sandra Caron, banarie Bertran, and Tan rt:MJllen address in detail some of the ,pressing questions abaJt ec!ucaticrral programs targeting studa1ts. M amotated bibliogra~ of print and audio-visual materials 00 AIIll and safer sex education is also included, aloog with an article on curricula reviews 00 AIOO educatioo, book and audio-visual reviews. For additicrral inforniation abaJt the SIEOJS ~, ltII'ite: SIEOJS, New York University, 32 \tIashingtoo Place, New York, NY 10003 (212/673-3850). l*'I*lIOI' ...... II•••• ~ mlt***+l+*'I mlt. ***+l+ EDUCATIONAL POSTERS A chart and videotapes abaJt AIIll developed by Baltil1'Ol"e Jams Hopkins for its employees 1"01 are being offered to other organizaitcns. Designed to help health care ItIOrkers at all levels understand safety precauticns against AIOO in l'a;pitals, laboratories and lJI¥;icians' offices, the material already is in use tl'V'a.Jg!nJt the Joins Hopkins Health Systsn. Laminated for 1alg-term use, the 11x14" chart, "Universal Precautioos for Care of All Patients,· is an illustrated version of the Centers for Disease Control guidelines on proper clothing and EQJilJlS1t needed while performing different proceciJres. At the Jams Hopkins Hospital, the chart is posted 00 MrY ursing lIlit. The chart costs $5 each, plus postage. Videotapes, "AIIll and the Health Care \tIorker" and MAIIll and the Laboratory \laker" ItIere recorded during a series of lectures by Hopkins AIIll experts. Presented in a straightforward format, these include an introductory lecture follated by answers to workers' questicns. The one-!nJr videos cost $250 each plus $5 postage and handling, and are available in VtiS and 3/4" format. Copies of the chart and videotapes can be ordered fran the Jams Hopkins Office of ~blic Affairs, 550 N. Broact.ey, 11th Floor, Baltil1'Ol"e, MO 21205 (301/955-6680). Checks s!nJ1d be made payable to the Joins Hopkins Health Systsn ...... ltnlt ..... ~+n ..n ..... ltlt+n SAFER SEX INSTRUCTI:ON CERT'IFICATION \!/hile sex-pOObic and pJI1itive nsnbers of society call for extrare sexual oppression and proclaim that abstinence is the only form of AIIll preventioo, time ItIOI"king in the AIIll field know that making safer sex fun, erotic and appealing is a nuch more effective ItIirI to help people stop high-risk behavior. In this repsect, there is strong agreellSlt between the intuitive understanding and practical kI"OI1edge of grassroots AIIll preventioo programs, and the research, theory and practice pf professicrra1 sex therapists and ecb:ators. Unfortunately, AIOO educators have often had to work wit!nJt the benefit of sexological training ltIhi1e professicrral sexologists have been unable to adEQJate ly share their strategies, materials, and tecll1iques. NOfi there is a solution. The Institute for Mvanced Study of IUnan Sexuality, an internationally rena"ned, State of California approved graduate sclm1, is offering an intnive program to train and certify qualified applicants in the sexology of AIIll. This is the first certificate program in professicrra1 sexology and AIOO prevention in the natia1. TIme who canplete the progrcrn will be awarded a California state approved certificate as an Instructor/Mvisoryof Safer Sex. The coorse r'allJires 20 !nJrs "at toTe" preparation and successful canp1etion of a 7 day, 60!nJr coorse at the Institute. Cost for the coorse is $600. FOR MORE INFORMATION: Registrar, IASHS, 1523 Franklin St., San Francisco, CA 94109, 415/928-1133. ***** ••• ******+*lI •• ~ •• ** ••••••••• m u**** AUDIO T'APE ON SAFER SEX AVAILABLE "60 Minutes to Smart Sex," an audio tape produced Audio Renaissance Tapes of Los angeles, and narrated by Dr. Dean Edell, offers ways to enjoy full and safe intimacy while providing straight facts and sane surprising insights into STOs. It is the first informaticrral audio tape available a1 these topics. Edell, a well known medical authority and host of nationally syndicated radio and television ~ram:' discusses AIIll,'ch1allrldia, pelvic inf1anmatory diseases ~ other STOs. ~tans, 100g-term effec:s and t~tments a~ all rev~ewed In detail to provide listeners with a canprehensive understandlng of the prob1sn so they can better appreclate the smart sex alternatwes and solutions that are offered oot he tape and in the accanpanying booklet. Edell presents this critical topic in a positive light, with statenents such as, "Look at smart sex as a challenging, exciting adventure into intimacy and camunication." According to Edell, "the great thing abaJt smart sex is that it inspires yaJ to take activities yaJ might nOfI ccnsider ~ and non~a 1 and transform then into OOysseys for new sexual pleasure." Edell also addressed the fears and discanfort people experlence when confrontlng a sexu?: partner abaJt the use of ccndans and othe rnetroos of protection. Edell offers encwraging advice 00 incorporating safer sex tecmiques lnto norma11ove play. 'This can be that excuse yoo secretly may have been looking for to open up yaJr sex lifeto discussion and camLII'lication ltIhich ma~ have been lacking inthe past," says Edell. "Ywr goal is to open yaJr mind up to heN possibilities and new avenues to Smart sex pleasure. Tt-e !o.tr-100g cassette tape, along with a 32-page Smart Sex Manual, is available nationally tl'V'a.Jgh bookstores, record/tape stores and some 'drugstores. Also included is a Mentor Corrdan, the only one tnarlJfactured with a patented safety-sea1 adhesive and an "applicator hocxI" t~ protects the rubber fran tears and pJI'1ctures during application. for more information: Audio Renaissance Tapes, 9110 fulset Blvd., ante 240, Los Mge1es, CA 90069 (213/273-9755). ~****l+ ...... m ...... ***** THE OFFICIAL NE\IISLETIER OF THE NCGSTDS * VOLUME 8:4 * ItIINTER, 1987 * PAGE 71 ***** *********** +••• +*1 •• 1*. *********1*************** +. ++ II ++ + *************************************:1:1********************************** STREET WORKERS REACH ALIENATED atstracted fran CIl article by Hetsy Pisik, with thCllks to The Washirgtal Blade, 9/18/87 Take a walk thrOJgh certain well-defined areas of nortlltlest ItIashingtal, OC, and a self-described 'circus' of nightlife will unfold. Regular visitors to these areas cane for the staggering assortmslt of sex available men, \IIOmen, crossdressers, and transsexuals in nearly every guise. &.It as nuch variety as there is on the streets, one CO'lStanct has energed: the fear of AIDS. r.tJltiple sexual encamters are ClJt of vogue for nmt of the gay camunity, rut they are a way of life and an eccronic necessity for the estimated 500 prostitutes and rustlers who It«lI'k city streets each rmth. This figJre does not escorts, lOCXlels, dating services, and similar operations. ~ile so IlllCh effort has been directed t(7,llf'ard closing the baths and making the pJblic aware of safer sex guidelines, many of those involved in the street-sex industry have been imperviOJS to the message and it is ally recently that cmdans have becare a regular accessory of the job. The AORTA PROJECT (AIDS"1!CIucation Out Reach to the Alientated) is a program of the \!Ihitman-'llalker Clinic and one of its rore daring efforts. One aspect of the AORTA project is to educate incarcerated populations in the District, Virginia, and Maryland, &.It they also reach the people in the streets. A. Billy S. Jones, AORTA codirector, says the project seeks rut the "people who don't fit into yaJr mainstream grClJps. YClJ've got to appeal to these people as IV drug users, hispanics, cross dressors, whatever. Sale of these people are especially difficult to reach," says Jones. "YClJ're dealing with a subculture within a subculture within a subculture." According to AORTA statistics, many in the street sex industry are drug users, al the streets to support a habit. \!Ihitman-\llalke considers nearly all men on the streets to be gay or bisexuals, at least 7% of the prostitutes are lesbians, and rClJ9h ly 83% are racial or ethnic minorities. Sale men wear dresses. Add to all this the inherent stigma of the profession, and 'subculture' seems alnmt superficial. AORTA was developed to reach the fringe groops and subcultures throoghout the city. This includes alce-residential areas far fran gentrification, shooting galleries and dark side streets. AORTA ClJtreach \IO"kers travel the streets in pairs, armed with a ~itman-'llalker 10 badge (to protect them fran frequent police 'herds' or sweeps), dozens of condans, and a special savvy that canes fran having been on the streets once themselves. They distrirute literature on safer sex and drug abuse, and talk to nearly anyone who will listen. According to George Swales, the Clinic's director of education programs, $165,000 - the rulk of AORTA's operating rudget - canes fran an education Caltract fran the D.C. Canmission of Public Health. The clinic also charges for-profit organizations for setting up educaticnal programs. Additional IIKl'1E!Y is raised throogh jazz-a-thals, fundraising nights at area night clubs, and similar efforts. The biggest share of AORTA's expenses gores for salaries and condoms. Purchased in rulk, by the way, condoms are pretty cheap; $55 for a thOJSand. One of the rutreacher's priorities is to sensitize the police officers who \IIOI'k in these areas. One ClJtreach !l[)rker was chastised by police for "contributing to the delinquency of a minor" for handing a yrung girl a condan at her request, at 11:30 one night. "Everybody wants a condan!" says &.nshine, a lesbian who has been an AORTA \IIOI'ker for several rmths. IIbrkers may give away as many as 200 condoms apiece. &lnshine (street nanes are adopted by all ClJtreach \IIOI'kers) says that having been on the streets once themselves makes a big difference in the way the ClJtreach It«lI'kers are recieved. Sane \IIOI'kers say it helps that they are renembered fran 'before." '\lie dO'l't preach and we don't judge," Sunshine says. "\lie help. If anybody wants these condans, we'll give them a few." 'The people in the camercial sex industry \q)a,rI what's going on,and it's only reascnable that nost of them will do sanething to protect themselves and their custaners,' Billy Jones says. 'They read of CClJrse, and ltIhitman-\llalker contact has been important. .trtd by 00rt/, many of them are having to deal with the death of friends." Jones estimates the majority of those selling sex on the streets have 'a lay awareness of AIDS, and that's enoogh for nmt people.' Francis, a soft-spoken transvestite originally fran Canecticut, has been !l[)rking the streets for abClJt 4 years. He is usually ClJt on weekends, dalning a CO'lServative black skirt and blazer for the job. The 21-year-old wears his grandll'Other's pin thrClJgh the lapel, and ~ratively little make-up. "I always use CO'ldoms," he volunteers. 'If a client is reluctant, I say 'yClJ have no respect for yaJr health, and none for mine.' Usually I \IIO'l't go withaJt one,' Francis says, admitting, thaJgh, that sanetimes the IIKl'1E!Y is too important or it is un\IIise to resist. According to Francis, conversation anmg the District's transperscns, \III'S1 there is any, is abcut AIDS. \IIho has it, who's sharing \IIOI'ks (kits used to shoot drugs], and who is or isn't using condoms. 'ftbst will use the condoms \III'S1 they've got them," he says. 'A lot of the girls just don't care.' (The Clinic uses the m 'transpers(J1S' as an inclusive term for cross-dressers and pre- or post-operative transsexuals.] Billy JO'les CO'lCurs: 'The Il'OSt dangerOJS people rut there are the ones who say 'I'm positive. I'm gonna die anyey." The Clinic estimates that 7-17% of female prostitutes are lesbians, a figure that is probably la.rl. '\lie can't get a real accurate reading on that one,' says Jones. It is simply a fact that \IIOmen do not bJy sex: the rare exceptions are likely to be heterosexual and always thrClJgh a discreet "escort" service. &.It lesbians do \IO"k the streets, accepting male custaners ClJt of econanic necessity. Male rustlers acca..nt for approximately 10% of the city's sexual !l[)rkforce. 'Scoob," a baby-faced black man who has been on the streetss since he arrived fran New York earlier in the year, is very particular abcut what he will or \IIO'l't do with a custaner. 'I got ~ rules," he says, 'and I use condoms.' Insisting rustling is temporary, he wants to becare a restaurant manager, where he presently \IIOrks. His plans also include marriage, and his girlfriend has no idea what he does at night, because 'it !l[)Uld just crush her.' Giving just that reason, many street !l[)rkers don't use condoms \III'S1 sex is for pleasure, and this places their partners at risk. There are stories abcut police harassment, roogh treatmslt while in custody, offers to trade se>OJal favors for a rErlJced or dropped charge, and assorted other infractions. Many of these stories, however, are told abClJt Co-\llOl'kers or are third-hand aCCClJnts. &.It one story is a constant: there are police officers who CO'lfiscate Caldoms and return thern--p..nctured. Many peep le in the camercia 1 sex industry are drug abusers -43% by AORTA statistics -supporting a habit. Others, such as transsexuals, have little choice. Asex-change is expensive, and sexual identify clinics stipJlate that before surgery, candidates IIIJSt live as a \I[)nlan for at least a year. both conditions severely limit empl~t options. And the rest? Many !l[)rk the streets for extra pocket 1IDneY, or just when it's time to cane up with next rmth's rent. Currently, six former prostitutes and ruslters, nmt of them recovering addicts, have fa..nd satisfaction \IO"king with the ClJtreach program for $7.50 an haJr. They are the enbodiment of the AOOTA Project's unofficial Il'Otto: 'Let each one teach one.' ***** ..... ********** UI" ** ...... ******* ** •• +• ** ***** PAGE 72 * 'THE OFFICIAL NBISLETTER OF 'THE ~ * IJ(llJE 8:4 * WINTER. 1981 --- ..:t ...... ~ .... ~w ..... ~ ..... ~ .. ~.u •••••• w ...... u ..u ...... ~ .... u ...... u.l*t.uuu ..u.m ...... **** RISKY SEX STILL PRACTICED BY SOME by Rick Harding. with tt-anks to ~ WashingtgJ ~lade. 6/5/87 Although many gay men have stoPped engaging in sexual activity believed to transmit AIDS. studies show that from 23-44% of gay men in major U.S. cities continue to enga~e in sane form of unsafe sex. University of Michigan epidemiology professor Jill Joseph. wro p."8Sented research rest.: lts at the Internat100a 1 Conference 00 AIDS in OCt said that 23% of a study grrup of 435 gay men in Chicago ccr.tinue to p."actice unsafe sex. Joseph said those most likely to coninue practicing high-risk sex include men wro have never knO\lln someone with AIDS, those who rave little knO\llledge a~t AIDS, and those who do not identify \IIit~ t!-e gay camunity. Researchers from San Antcr.io, Texas, reported trat 24.9% of a study grrup of gay men t!-ere continue to engage in receptive a~l intercrurse without condoms-- t!-e practice AIDS experts say is most likely to transmit t!-e infecticr.. The researc!-ers r.oted, tn..ever. that t!-e number was dO\lln sharply from 46.2% of t!-e grrup who p!"acticed receptive anal intercrurse without condoms one year ago. San Francisco psycrologist Tromas Coates said that 28.9% of gay men in his study are continuing to have :Jnprotected anal sex. &.it!-e added that many of the men sti 11 engaging in unsafe sex are in monogamOJs !"91ationships in which !xlth partners knO\II t!-eir AIDS antilxxly status. Ot!-ers, !-e said, have tested positive for t!-e AIDS antibcCy and are having sex only with ot!-ers who have tested positive. Jeff r.bJlton, a psychologist at t!-e University of Ca)ifornia at San Francisco, reported that 44% of gay men in his study said they have unprotected anal sex. fIhIlton said !-e thinks his nunbers are hig!-er than in sane other studies becallse the participants, wro were recruited from sexually transmitted disease clinics in San Francisco in April, 1ge7, srught testing relatively late in t!-e AIDS epidemic indicating that they may have been reac!-ed with AIDS education relatively late. Met.: ltcr., who recent ly completed two studies on gay men's sexual behavior, said the primary reason given for continuing to engage in unsafe sexual practices was "loneliness." Other researchers said denial of the danger of contracting AIDS and t!-e influence of drugs and alcohol are also reasons w~ sane men continue to have unsafe sex. Severa 1 of t!-e researchers said that a percentage of t!-e population wm probably always ccr.tinue to practice unsafe sex. Coates noted that a large portion of the population continues to smoke despite years of war:'1i:'1gs from the Surgeon General and nUl!errus studies which show that smoking leads to lung cancer. The researc!-ers also said they be Heve that many pejple still have not beer. reac!-ed with adequate safe-sex information. ~***II::III::I*II::I*"II::I'II::I •••••• *.**tJklIdaI A.NAT·OM I CALLY CORRECT' T'EACH ING DOLLS Teach-A-Bcxlies were originally designal for t!-e professional use in child sexual aruse cases. crurt room testinmy. and with t!-e develOjl1lentally disabled. NO\II the dolls are available to parents and t!-eir children, as well as to !-ealth Educators. TI'e naturalness of anatomical Ixxly parts produces a more relaxed and teachable setting for children and adults. Anatomically correct hand puppets with three dimensional genitals, are also available. Male adults have I10Jth and anal openings, I1OJStac!-e, Ixxly hair, cirCUlCised penis (exchangeable uncircum::ised penis available for $1 extra), optional fingers. and washable clothes. Female adults have vaginal. I1OJth. and anal openings. Ixxly changes, sanitary napkin and belt. tafOlXl'l, baby with unbilical cord. optional fingers, and clothes. MIlt dolls are 22'. Child. toddler. and baby dolls are also available. All dolls come in white. black. or rre:lium fabric (for latino. native anerican. or ori9'ltal). A pair of adults. with fingers and with an extra uncirclJl1'Cised penis. costs less than $100. For more information: 817/923-2380. or write to Teach-A-Bcxlies, 2544 Boyd St .• Ft. \IIorth, TX 76109. *~ ••••• n.m~~.tm .. ~ ••••••• w.w~1Ot*** ST·A.T·E A. I: OS A.D CAMPAI:GNS with thanks to Detroit's Cruise, 7/22/87 State AIDS-awareness ad campaigns are not off to a rousing start. ~any are !xlgged down by limited ad production budgets and most have reservations about whether the campaigns will be accepted. Designed primarily to educate the public and stress prevention of AIDS, ad campaigns have started or are being planned in at least six states. !11inois, Hawaii and Minnesota have begun public service campaigns. Connecticut, Michigan and Oregon are planning blitzes, with Connecticut and Michigan planning to buy TV time or ad space instead of relying cr1 free ;x.:blic service placement. m the states have considered the possibility that their ads will not be accepted by the media. The Illinois Dept. of Public Health broke the first state-s~sored AIDS-preventia1 campaign. The 1IIJ1timedia public service effort is t!-emed 'Facts for Life." The $450,000 campaign includes a 30-sec TV spot and radio spots with Chicago Bears wide receiver Willie Gault. T!-e campaign also in:ludes transit a~d outdoor boards and posters that include a toll-free information number. Illinois' ads are supplemented by TV spots, posters and broch..:res created by the Arrerican Foundation for AIDS Research (AmFAR). The MirJ'lesota AIDS ~ia Consortium has ~'i1veiled its radio, p!"int and oltdoor campaign tl"ered ".Anyone can get AIm, everyone can prevent it.' Two consortium print ads. headlined "Don't leave har:e witho.;t it," pictures :ondoms. Another ad sl'Dws a man with AIDSlying in a t'mpital bed under the !-eadline '~ce yOJ have AIDS, you have it till the day yOJ die." The consortium feared rural Min.'1esota newspapers \IIOU ld not print graphic anti-AIDS ads and produced two sets of ads-- a more graphic metropclitan set and a toned-dO\lln outstate series. 80th Connecticut and Michigan plan to buy media time to assure their campaigns will be seen. Connecticut officials are more uncertain about when their spcts will run than if they ~il1 ~un. uPJb1~c serv~ce advertisanents can go Cli at three in the rroming, It said Dr. Peter Galbraith, chief of tt-e Connecticut 9Jreau of Health Promotix. "We've got to look beycr.d [public service) to paid advertising.' Tre Connecticut Legislature appropriated '$2 millicr. for an AIDS-awareness campaign st~ll in the planning stages, Gilbraith said. The state hired Expand Associates. a Washington-based consulting company, to help plan Connecticut's campaign. In Michigan, advertising agencies had'a June 17 proposal deadline .for the state's $1 million :rultimedia campaign, scheduled to break betweer. December and February. 1988. Cdy Norkin,services buyer for the Michigan Dept. of Management & &Jdge~, said the campaign w~ll have three phases. each with a separate advertising agency in charge. the first agency will design t!-e media plan, including heavy TV and radio buys. !M Norkin said th:jt agency won't be eligible to pitch the second phase, ad production. or the third, media placement. Altrrugh Michigan will Illy broadcast airtime, Norkin said the state wm solicit publi service placement by s:atians to make the campaign last longer. ***** lliE OFFICIAL NE\IISl.ETTER OF lliE t«:GSTOO * 14M 8:4 * WINTER, 1987 * PAGE 73 ***** *** ...... " ...... " ...... " ...... **** ••••• *** ...... *** **** •••••••• CENSOR OF EXPLICIT AIDS LIT alstractal fran articles by l.aJ Chibbaro Jr. & Lisa Kesl, with thanks to Tt-e ~hingta'l Blade, 10/16/87 & 10/23/87 AlOO service organizati Tt-e American College Health Associatial (ACHA) is finalizing plans to sponsor a series of regional AlOO educatial workshops. Under a cooperative agreanent with the COC, ACHA will schedule the first faJr of an ongoing series of workshops fran February thraJgh May, 1988 at tlEt campJSes aroJnd the country. The $90,000 agreanent is renewable for up to five years and will ultimately enable ACHA and its Task Force a'l AlOO to reach the faculty, staff and students of tt-me colleges and \J1iversities which have not yet estabished AIOO educatial programs. Atotal of 200 ~ -50 schools locatal in each of the faJr regi Bostoo's Fenway CamtJnity Health Center is pleased to amaJnce receipt of a $10,000 grant fran tt-e Chicago ResaJrce Center to fund a Natiooal Lesbian Health Study~ Tt-e study, to be named tt-e Bostoo Lesbian Health Project, has been developed by staff and board manbers at Fenway Carrrunity Health Center who are concerned al:oJt tt-e lack of accurate infanration in tt-e literature on lesbian health status and health care. This lack of information has made health care services and health educatioo difficult and has left lesbians without vital information al:oJ tt-eir health. Tt-e questicmaire utilized in tt-e study deals with health practices and history, stress in persooa 1 and I1.Ork lives, sexual practices, and family history. Tt-e questionnaires are in tt-e final stages of preparation. Tt-e plan is to distrirute 5000 copies in tt-e fall of 1987 to a broad netl1.Ork of lesbians across tt-e country. Right na.o/ a list of contracts is being developed. These contacts will distrirute questionnaires to lesbians eitt-er individually or at locations ue tl'ey will reach a grOJp. This OJtreach will attempt to reach a large and diverse network of wanen while maintaining confidentiality. If yo \IDJ ld be interested in being in tt-e study, being a contact, or have a suggestion of a place or graJP wt-ere distrirution \lDJ1d be t-elpful, please write: Boston Lesbian Health Project, Fenway CamtJnity Health Center, 16 Haviland Street, Boston, MA 02115. **"'*"'~* ••• m .....lIlI ...... m.u... mlIlIlIu ...... m NEW YORK OFFICE OF G/L HEALTH New York City's Office of Gay & Lesbian Health Coocerns (OOLHC), in seeking to make a paiitive impact on tt-e quality of health care provided to lesbians and gay rren, continue to target tlTee areas of great need: alcoholism, AIDS, and Gay & Lesbian YOJth. ~king with ott-er city agencies, ott-er ~pt. of Health offices and camunity organizatioos, OOLHC has provided expert consultation, initiated research and created lines of CCXlI1lJI1ication in these and ott-er areas. Tt-e foloong are sane highlights of OJr II«lrk in recent monti's: *Managing tt-e ~pt. of Health's cootracts with Gay Men's Health Crisis, ~pt. of Educaton, and Hetrick-Martin Institute (formerly the Institute for tt-e Protection of Lesbian and Gay YOJth, IPLGY). *Irnplementing an AIDS OJtreach & Education Program that targets gay and bisexualrren of color. Public Health Educator Harold Robinsoo's primary task is to visit bars, batl's and cruising areas frequented by rren of color, offering printed information on AIDS prevention and tt-e opportunity to discuss personal risk reduction one-to-one. This OJtreach includes those who accept tt-e labels of "gay" or 'bisexual,' or those rren who have sex with other rren rut coosider themselves 'straight." *Contracting with ~ Cable Netl1.Ork for tt-e production and cablecasting of Lavender Health, OJr cable sha.o/ 00 health/tunan service issues. Tt-e program includes news, interviews and canmentary 00 health issues that effect lesbians and gay rren, and is viewed lllIrsdays, 10: 30-11 IJlI on Manhattan Cable channa 1 J. *Opening an OOLHC office at tt-e Lesbian ~ ~ CamtJnity Services Center to hOJse OJr OJtreach and education staff. *Plaming and implementing training sessioos co-spoosored with tt-e New York City YOJth &Jreaus for tt-e staff of their graJP hones and st-e 1ters for adolescents. *Working closely with ~ ~ Lesbian Alcoholism Services (GLAS) and tt-e National Association Qf Lesbian ~ ~ Alcoholism Professionals (NALGAP) in publishing directories and bibliographies. Write to OO\..HC for a list of free publicatioos available. *Ongoing liai500 work with lesbian and gay community organizatioos, linking them with public and private assistance. The City Health Oepartrrent's Hepatitis B Preventioo lklit, in association with tt-e tt-e CamLnity Health Project at tt-e Lesbian & Gay Carrrunity Services Center are offering free vaccinatioos to gay rren under 26 years of age. Contact tt-e Unit: 212/285-4603. For nore information: OOLHC, 125 \IIorth St., Box 67, New York, NY 10013 (212/566-4995) . •••••• **u ...... w ...... ~ MAT·ERNAL AIDS TRANSMISSION ST·UD:I:ED Investigoators at Baltimore's Johns Hopkins Medical Institutions are planning three studies to investigate the transmission of HIV fran pregnant mothers to tt-eir \I1born children. Tt-e series of 3-year studies will explore ha.o/ often and when OJring pregnancy tt-e virus travels across tl'e placenta franmother to fetus. Tt-e investigators will a1so examine tt-e risk of transmission OJring birth where tt-e newborn infant is exposed to maternal blood and genital secretioos. 'All children born to HIV-infected mothers have antibodies, rut only 30 to 50% actually develop HIV infection," said John rtxllin, MO, associate professor of pediatrics and principal investigator of tt-e studies. "Right na.o/, we can't tell if a newborn's antibodies are those made by tt-e mother and passed on to the fetus or made by tt-e child, making it difficult to determine if tt-e child is truly infected.' Tt-e first study will look for evidence of HIV and its antibodies in fetal tissue fran aborted pregnancies among HIV-infected \IOIlB'1 who attend tt-e High-Risk Obstetrics Clinic at Hopkins and tt-e Planned Parenthood of Maryland Clinic. Tt-e second study will screen infants born to 190 HIV-infected wanen at Hopkins for HIV and HIV antibodies. Tt-e third study will canpare tt-e relationship between HIV infection and plTysical and rrental develOlJ1lent in children bam in tt-e second study to children born of uninfected. Infected children often sha.o/ syrnptans between 5 and 8 montt-s, with 90% developing symptans within tt-e first 2 years of life, r-txllin says. Often, infected children will develop at a normal 'rate during tt-eir first monti's, rut then fail to gra.o/ and decline in health. Although pediatric AIDS patients share sane adult patients' sympt:ans, such as diarrhea, oollen' lymph glands and ~tis carini; P1eumonia, tl'ey are mosre likely to ~evelop bacterial infectioos and often have lymphoid interstitial j:l19.Ilmia, a lung infection unique to children. ******. u ** *...... +lIlIlIlI .... ~. ""'. mlIlIlI ...... ** '!HE OFFICIAL NE\tISLETTER OF '!HE NCGSTt:G * VOI..lIt\E 8: 4 * WINTER, 1987 * PAGE 75 ***** *••••••••••••••••••••••• *••••• ~ •••••••••••••••••••••••••••••• ~~.** •••• ~~ •••••• ~ ••••• ~~ ••••••••• ****** •••• *••••••••••••• ~ ••••••••••• SUICIDE: THE FINAL RISK by Jim Dickey, with thanks to New Yor~ Native, 7/27/87 and tt-e ~ ~ose ~_~!:Y ~ O1e night in eary May, 1987, a 23 year old gay man- apparently in a sudden fit of despair. left his rOOll 00 the fOJrth floor of a San Jose hospital, iIIe'1t up to tt-e 7th floor, and jumped. His !:x:x:ly, partly hidden by air-cooditiooing equipma1t, was fOJnd 00 the hospital grrunds the next afternOCX1. He was tt-e first knoo AIt:G patient in the San Jose area to ccmnit suicide, st-eriff's investigators said. &It local mental health officials fear he \IICX1't be tt-e last. Natiooally, suicides of people with AIt:G appear to be increasing dramatically as tt-e number of cases of tt-e disease mrunts. Recent AI!:B-re lated suicides have included a 32 year old man wI-o jumped fran a sixth floor windO\ll of a Dallas hospital; t\tJO men 43 and 44, who tied themselves together and leaped fran the 35th floor of a luxury high-rise in New York; and a 26 year old Army private wI-o hanged himself at Walter Reed Army Medical Center in Washingtoo, DC. In Miami in April, five yrung people, including a 16 year old b::>y, ccmnitted suicide after testing lXlSitive for antibodies to HIV, tt-e so-called "AI!:B virus." Nooe had sholt.r. symptans of tt-e syndraTe itself. 'Tt-e pain and suffering which accanpany tt-e disease are of epidemic proportioos,' said Peter Goldblum, a clinical psychologist at tt-e AI!:B Health Project of tt-e University of California at San Francisco. Asuicide crisis line in San Francisco a1 ready receives 60 to 100 AIt:G-re lated ph::ne calls a rocoth. Goldblum predicted that, if tt-ere is ever widespread testing and large numbers of people find tt-ey have been exlXlSed to HIV, there will be a "psychological disaster" of 'Widespread depressioo and anxiety disorders.' Even before the AIt:G crisis, homosexual men- who, according to the federal Centers for Disease Cootrol, make up a majority of of people with AIt:G -attempted suicide at an astrundingly high rate, becallse of what psychologists call the "pariah syndrooe." Their sexual orientatioo, psychologists say, can cause family, friends, and employers to srun them, and this can cause severe depressioo and self-hatred. Studies show that c:ne of every five gay men has made at least ooe attempt 00 his 00 life, usually by the time he is 20, Goldblum said. That attempted suicide rate, the psychologist said, ccxnpares with ooe persoo in every 500 in the general popJlatioo. Precise informatioo 00 the number of AIt:G suicides is hard to find, partly because of coofidentiality la\llS involving the disease and partly because many suicides are reported as natural deaths, experts 00 suicide say. Suicide statistics that are available point to the enorlTO.lsness of the problem. Of the 1630 AIt:G patients in San Francisco in 1985, 12 are knoo to have ccmnitted suicide, Goldblum said. That translates to a rate of 736 suicides for gvery 100,000 people, ccxnpared with 51 per 100,000 fo." the grop with the secood-highest rate, the elderly, and 40 per 100,000 for tt-e third-highest, white men, Goldblum said. In cootrast, according to Goldblum, tt-e suicide rate for terminally ill cancer patients is believed to be la...oer than tt-e rate for tt-e general popJlatioo. Many gay men have been forced to grapple with the questioo of AIt:G suicide ~ if tt-ey aren't PWAs themselves, said Mary Viles, chair of the Berkeley, California, chapter of the Hemlock Society, an organizatioo that defends the right of terminally ill people to kill themselves in a nooviolent way. Viles said st-e spoke recently to a grOJp of 65 gay men O\IIVer the age of 40, rost of whcxn indicated tt-ey had coosidered suicide to such an extent that tt-ey already had determined how they \IIOJld do it. St-e said the men appeared knO\IIledgeable abaJt what kind of drugs to take if they wanted to die. 'Tt-ey all felt tt-ey were vulnerable [to AI!:B] because, by (the CDC's] definitioo, tt-ey had all exlXlSed themselves [thrOJgh their sexual activities)." Viles said. O1e 28 year old California man whose lover of 8 years died of ccxnplicatioos fran AI!:B in February, told a reporter t-e has "Illndreds of sleeping pills' in his home. If he were to cootract AIt:G, the man said, there \IIOJld be 'no way I \IIOJld go thrOJgh" what his lover had gooe thrOJgh. Menta 1 health professionals who treat P\IIAs are asking whether anything can be dooe to prevent suicides- and, in SaTe cases, whether anything shOJld be dooe if suicide is the result of a rational decisioo. Indeed, the AI!:B crisis has reawakened age-cld questioos involving the morality of suicide and euthanasia for terminally ill patients. Psychologists have pinpointed three main causes of suicidal t!nJghts in PWAs. O1e is depressioo caused by thoughts of what must be faced as the disease progresses. The sElCood is depressirn caused by Alt:G densltia ~raJe, which is beligved to occr in sane PWAs when HIV enters the brain. Tt-e third is a rational desire of tt-e patiS1t to end his 00 suffering and tt-e suffering of those he loves who must watch him deteriorate. Help with tt-e mental suffering which can accanpany AIt:G is readily available in San Francisco, where there is a large gay and lesbian POpJ latioo which is recognized by the city government and the general POpJ latioo alike. Tt-ere is help not ooly in dealing with emotioos, l:XJt in the practical aspects of living with Alt:G, said Dr. Thomas Waddell, a former Olympic athlete who has AIDS. San Francisco has the Shanti Project, and San Jose has the ARIS Project, both of which offer noo-professiooa 1 cOJse ling to PWAs. AFter the young man threw himse 1f off the roof of the San Jose f-ospita 1 00 May 2, the state Health Services Department investigated his death and CCX1Cluded that no ooe cOJld have knoo t-e was cootemplating suicide. According to tt-e hospital staff, he had ooce told doctors and nurses to "do everything you can to keep me alive." Severa 1 hOJrs before he jumped, he had an anxiety attack, and a nurse told him to lie doo and relax. That was the last time anyooe saw him alive. After his suicide, one friS1d of the youn man's said, 'He kept hoping [AIDS] was a bad dream. 'If I pretend it isn't true, God will save me, and I will go on and be like everybody else' [he said]. But when he faced the reality of it, his dream just popped.' As a result of the young man's death, investigator Jacqueline DavidSCX1 reccmnended that the f-ospital begin coosidering all AW3 patients to be potS1tial suicides. The staff is coosidering the reccmner.datioo. Tt-e hospital's present policy 00 people beligved to be suicidal is to p,lt them under observation by medical personnel 24 hours a day, and to remove any possible suicide instruments, including the glass and metal utensils norma lly used for eating. HO\II suicide precautioos \IIOJ ld apply to AIDS patients \IIOJ ld have to be determined by tt-e medical staff. 'Any persoo wI-o has a terminal illness of that nature is a very high risk," said Peg Shemaria, coordinator of the Alt:G Project in San Jose, who supports tt-e recamle'1datioo. s.1-e and hospital officials point OJt, ra...ever, that precautions have to be taken to ensure that AIDS patients' civil rights are not violated. '01e of the main reasons in the suicide of gay people, whether tt-ey have AIDS or not, is internalized homoph:lbia, wt-ere they take 00 the vi8\llS of the aggressor,' observed Gary Goldberg, a therapist with the Santa Clara COJnty Mental Health Department in San Jose, who has 25 gay clients. "I've had clients who have been disinherited by their families, ostracized by their crurches, fired fran their jobs, or dishonorably discharged fran the service because they were gay,' he added. Goldberg spoke of ooe American soldier in Vietnam wf.o received "a medal for killing t\tJO men and a discharge for loving ooe." !n tt-e past year, Goldberg said, a:~ of his tS1 clients with AIDS have contemplated suicide. San Francisco psychologist Goldblum noted that the pariah syndrome is intensified COOIMJED ***** Pia 76 * lllE CflICIAL NEWSLETTER OF lllE NCGSTOO * \W.ME 8:4 * WINTER. 1987 ***** *** ••• ~.**** •• ~ •••• *••• ** •••••••••••••• ***.** ••••• ** ••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••• 99n~1nu~d~ S~ICID~~ ~HE ~INA~ RISK when a gaJ' roan has AIDS. "There is a great deal of fear of AIDS patients arrong health care workers," he said, adding, "This fear can easily be translated into less-than-involved care." According to Goldblum, such fear can only canpaJnd the depressiO'] of AIDS patients. He emphas~zed, ~er, that depression ~n IlDSt cases does not lead to suicide. Former Olympian Waddell spoke of his 0\111 occassional depression. rut said he didn't consider it "a bad thing ... the ebb and flO\ll of one's psyche are natural.' Waddell said he has not rejected the idea of suic~de for hirrself. "If I'm suffering a great deal and everybody arOJnd me is suffering and there is no way oot, I \IIOOld consider taking my 0\IIn life,' Waddell admitted, saying he \IIOOld probably take a 'Brompton cocktail" (a combination of certain drugs and alcohol which allO\115 a person to "just go to sleep and never wake up"). One man who recently committed suicide in a way his friends considered gentle and responsible was the first coosing of an official of an AIDS support group. The official, who did not wish to name hirrself or his !"'elative, said the 42-year old college English teacher took an overdose of barbiturates. rut that his death was not listed officially as a suicide because it was not investigated. "It was a very loving thing for him to do," the official said. "He was not at all a person who had given in, in any sense. He felt the quality of his life [had] dec lined so l1IJch that his p!'tisica 1 body was a rurden to him. . . . Suicide was the final gesture of his rumanness- if you can define that as individuality, the abil ity to control one's destiny." Goldblum said that sometimes, 'Even the person who does choose intelligently to end his life, his suffering, needs assistance in the decision-rraking, to do it in a way that he can feel good about and which is responsible to the peqlle who care about him.' But Go ldb lum added, helping A!DS patients to kill themselves is "a complicated diler.ma, given that the la\llS clearly prohibit aiding and abetting suicides, and that the clinician is regulated ~i specific 13\115 and professional obligations to intervene in suicide." Fortunately, he said, "Overwhelmingly people with A!DS are able to find meaning in their lives and do not choose suicide. \!Ie see so many people who fight ::ou~ageously, and it \IIOOld be unfair to think that for everyone AIDS is a hopeless endeavor." ~** ••••• ~**~ ••• ~ LESBI:AN RISK STUDY OF AIDS "In order to believe that lesbians are not at risk for AIDS. or that those Ito have already been infected are merely incidental victims, \tQJld have to \ BREAST CANCER_ LESBIAN CONCERN with thanks to TI! Newsletter Qf the North Carolina LesbiCll CIld ~ Health Project. JIJle 1987 k5 breast cancer rates continue to rise, lesbians' lives will be deeply affected. Many lesbians may be at higher risk for breat cancer because they do not bear children. Estimates suggest that women Ito never have children may be at two to three tines the risk of developing this cancer than women who do bear children. Lesbians who have a history of breast cancer in their families are also at higher risk. Lowering the fat content of ya..rr diet may play a role in decreasing your chances of getting breat cancer; tnever, roore than any other suggestion to date, examining ya..rr breasts once a nmth is considered an essential ingredient of good health behavior. Many women within oor society get their breasts examined for lumps during rootine visits to a health practitioner. Many lesbians find these ,visits stressful and overwhelming. H Each year in tre United States, approximately 300,000 people becare infected with tre repatitis B virus - a major cause of acute and chrooic repatitis, cirrrosis of tre liver and liver cancer. In tre Third War ld, repatitis B is even oore prevalent, despite tre availability of effective repatitis vaccinatioos since 1982. Why haven't oore people opted for immunizatioo? Widespread U.S. immunizatioo has b3en hampered by tre high cost of tre vaccine (about $115 for tre r~ired three shot re;jimen) and an apparent unwillingness, even arrong high-risk individuals such as realth care professiooals and drug abusers [and homosexually active men] to undergo tre injectioo series. Internatioolly, these problens are exacerbated by tre shortage of sterile syringes and tre need to keep tre vaccine refrigerated. Na.tI, l'a.tlever, researcrers r6!Xlrt significant progress tC7.tlard developing an oral vaccine against repatitis B --cJ'le that \IOlld require no special handling or parap/"ernalia and may be creaper to produce. Paul P. Hung and his colleagues at \lYeth La!xlratories in Philadelphia Illblished tre results of treir I«lrk in tre July Proceedings ~!..~ Natiooal Acadany ~ Sciences (vol. 84:!3). Tre research team started with a live ade'lovirus vaccine, which in tablet form has proved effective in inducing immunity against adenovirus respiratory disease in humans. Trey tren spliced into tre adenovirus genare tre coding sequence for repatitis B surface antigoen- a oolecular cooformatioo that, wren recognized by tre bJdy's immune systan, triggers tre productioo of antibodies against repatitis B. In tre ~riments, hamsters \ll6re inoculated thrwght reir noses with tre repatitis B spliced viruses, which subsequently replicated in tre animals' lungs. Within 33 days, allof tre hamsters had produced antibodies to both adenovirus and repatitis B. "OJr results danoostrate tre potential utility of recanbinant ada'loviruses as live oral vaccines," tre authors write. .And although trey are U1\IIilling to predict when tre ~iments may progress to IlJman clinical trials, trey say that '01 tre wI'old, these data indicate a good prospect for developing recombinant adenovirus vaccines that will effectively immunize humans against [repatitis B]" 'It's certainly an unusual approach,' says Stephen Hadler, chief of epidaniologic activities at tre COC's repatitis branch. Because repatitis is not normally cootrcted by oral or nasal routes, 'CJl6 \IOlld anticipate major difficulties' in inducing high levels of repatitis antibodies in tre blood follOiling oral inoculatioo. If effective, l'a.tlever, 'an affordable oral repatitis vaccine \IOlld have major potential advantages, especially in tre Third \1Iorld, wrere it is most needed," re said. In compariSCX'l to intramuscular injectioos, oral vaccinatioos are IlllCh oore likely to gain wide acceptance, and trey cut out tre potential for inadvertently transmitting other diseases with syringes, Hadler says. 'Tre market \IOlld be huge.' Exactly hOIIlIllCh such a vaccine \IOlld cost is still a matter of coojecture, 1'a.tIever. AspokesperSCX1 for Wyeth says tre oral vaccine \IOlld 'probably be creaper' than tre current vaccinatioos, but ooe repatitis specialist at lferck Sharp & IXlhne - makers of tre ooly HBV currently sold in tre U.S. - says re IroNs of no data to support that claim. lfeanwhile, otre fruits may erge from Hung's research. For example, tre team may have relped settle a loog-standing questioo about tre functioo of a particular gene sequence in tre adenovirus genome. That sequence, knO\ll'l as tre E3 re;jioo, indirectly blocks the expressioo of illl1YJfl6'"C611-attracting antigens 00 adenovirus-infected cell surfaces, leading scientists to ITtpothesize that the E3 regioo is part of the mechanism by which an adenovirus avoids detectioo by the bJdy's immune systan. In accordance with this view, IUlg fa..nd that ade'loviruses wt-ose E3 re;jioos \II6re excised in order to make room for the hepatitis B splice did not survive as loog as did adenoviruses whose hepatitis splices \ll6re placed elsewhere, leaving the E3 regioo intact. ******::Ill ...... It ** It.. lIl ****~ *'** ...... It •• HEPATITIS RATES RISING by Rick Harding, with thanks to The ~hingtoo ~~, 7/3/87 :ven though an effective vaccine against hepatitis B became available in 1982, prevalence of the disease has continued to rise steadily. According to epidaniologists at the COC, a major reason for tre cootinued increase is tht f8\ll members of knO\ll'l high-risk groups, including gay men, have sought vaccinatioo. According to a rep:Jrt released by the agency June 19, aOOJt 210,000 people in high-risk groups, which include gay men, IV drug users, and heterosexuals with multiple sexual partners, have been vaccinated for hepatitis Bsince the vaccine became available five years ago. Members of trose high-risk grrups, ho\II6ver, !1\3ke up nearly 90% of repatitis B cases which currently are estimated at over 300,000 per year. Dr. Steve Hadler, chief of epidaniology in the repatitis branch of tre COC, said that the AlOO epidemic has "dwarfed the image of hepatitis B as sarething to fear." Coosequent ly, re said, many at high-risk are not being vaccinated. Dr. Jack Killen of Washingtoo, OC's Whitman-\lla lker Clinic, noted that men who are strictly practicing safer sex to prevent AIDS transmissioo should also be relatively safe from repatitis B infectioo. But re stressed that research has sl"oor1 the repatitis B virus to be much :rore easily transmitted than the AIDS virus. Studies shOll that hepatitis B can be transmitted easily during oral sex through sanen and pre-seminal fluid, Killen said. No cases of AICG, however, have yet been attributed to oral sex. Both Hadler and Killen also said that many people have b3en reluctant to seek repatitis B vaccination because of tre vaccine's relatively high cost. Tre required series of three doses costs around $125 and, according to Hadler, f8\ll health plans cover the cost of the inoculatioos. ANovember, 1985 Wasbingtoo ~l~Q~ survey of loca 1 re lath plans found that most health maintenance organizatioos and other "pre-payment" plans covered repatitis Bvaccinatioo, but most traditiooa 1 "fee-for-service" plans did not. Hadler said that as safer sex practices becane oore commoo he expects tre incidence of hepatitis cases to level off. He said that sane cities, including San Francisco and N8\II York City, have recently reported dramatic drops in the numbers of repatitis 8 cases. The eoc report stated that a new genetica lly-engineered vaccine appears to be as effective in :rost people as the original vaccine which is derived f."Om human blood plasma. Both vaccines require a series of three injectioos and the cost of both is approximately equal. People who have tested positive for the AICG virus and who wish to be vaccinated for hepatitis B should use the plasma-derived vaccine, Hadler said, which has b3en sl"oor1 to be oore effective in people with suppressed immune systens. Ear ly fea:'s that tre plas!1\3-derived vaccine might harbor infectious agents such as the AICG virus have proven unfrunded, according to the COC report. T~ report also states that, cootrary to manufacturers' recommendatioos, mter doses of the vaccine appear to be unnecessary. ********************lI**~**.** •• ******** ***** PAGE 78 * llIE CfFICIAL NEWSLETTER OF llIE NCGSTOO * Vll.l)£ 8:4 * WINTER, 1987 ***** toI+ toI+ +••• m ••• toI •• toI ••~ m +:toI+ •• +:m toI ••••••••••••~ ...... +...... ~ ...... • •••• • •••••••••• toI toI VATICAN DECLARES AIDS .1 SAN CT' I ON .. by Phil Zwickler, with tlwlks to de New York Native, 9/28/87 Tre San Francisco Examiner relX)rted Septem~r 9 that a Vatican official had declared Aloo to ~ a form of "natural saction" against rarosexual activity. Archbist'llp Jom Foley, read of tre Vatican Office of Social CcmJnication, said that while re does not ~lieve that Aloo is a "punisment by (b:j for any individual, yaJ do have a natural sanction for certain types of activities .... SaTe diseases or p/'I;,'5ical conditicns are tre direct result of perscnal acticns, like a hangover or venereal disease." Tre Vatican also announced that, while re is in tre U.S., tre Pope will address tre Aloo issue in a num~r of different ccntexts, incuding a talk with realth care II«X'kers in Arizala and speecres atnJt tre 'moral background of this disease," wren re visits California. "8a1eath ccntempt!" gay activist Andy HumIn exclaimed wren re reard atnJt Foley's remarks. AslX)kesperson for tre coalition for Lesbian and Gay Rights, HumIn said, 'They think Aloo is tre justification for treir recent prcnouncement on rarosexuality. Remember, it was last (£to~r that they called raoosexuality 'an intrinsic moral evil.' ... Safe sex does not put yaJ at any risk for Aloo. kid what atnJt lesbians? .. .' Aloo activists and gay activists alike have raised tre issue that, since Jam Cardinal 0'Ccnnor, tre Archbist'llp of New York, is a mem~r of tre Presidential Commission on tre HIV Epidemic, re must eitrer repudiate Foley's statements or relinquish his position on tre Commission. Within 48 hours'of tre Vatican statement, a story was released to tre press on tre Pope's view. It was relX)rted that Pope Jam Paul II "made a strong plea to raoosexuals to ccnsider tl-emselves 'in tre reart of tre cl-urch.' Tre interview also included tre Pope's reslXln58 totre question of whetrer Aloo is a form of divine punisment. ·It is not easy to knOll tre intentions of (b:j himself ,. said tre Pontiff. "He is a great ITtjStery. We knOll that He is justice. He is mercy and He is love.' OJring a September 16 visit to sick children in a PtYJenix, Arizala I"ospita 1, tre Pope told realth care \IIOrkers and doctors that, as it relates to tre ministry and care of people with Aloo, "As yaJ courageously affirm and implement yaJr moral obligation and social responsiblity to relp tt'Dse wt'll suffer, yaJ are individually and collectively, living out tre parable of tre ta:xI Samaritan. " **** ... +toI. +.. toIU. u ••••• m,******. toI+ ...... ~ FALWELL SUPPORTS KOOP .' S REPORT' with tlwlks to Chicago's M ~ Times, 8/20/87 While repeating his ~lief that rarosexuality is a "moral perversion,' tre Rev. Jerry Falwell nonetreless reaffirmed his SUplX)rt for U.S. Surgro1 General C. Everett Koop's call for safer sex education and tre use of condoms. According to tre ~ Area~, Falwell, in San Francisco August 7 to address a private club, admitted that 'If we canot stop sex outside of marriage, we certainly have got to stop sex that spreads this disease." Furtrer, Falwell called for 'an understanding and a sensitivity and a love for persons with AIoo, I although re also asserted that IX)liticians are afraid to del are Im:lsexuality wrong ~ "they're thinking more atnJt tre next election than tre next generation .' ********~ +... "****** •••• u***"toI ••• U .. ***" l:NT'ERFAl:TH CONFERENCE PROC:EED I NGS A proceedings book on tre "Interfaith Conference 00 Aloo and ARC' reld in San Francisco, March 21-22, is nOlI available for $10. Tre book is an 81/2 x 11' canb bound volume laser printed 00 quality 200# stock. SlX)nsored by Rabbi Robert Kirscrner of tre Congregation Emanu-El, Bishop William Swing of tre Episcopal Diocese of California, and Archbishop Jom Q.Jim, of tre Ranan Catt'lllic Archdiocese of San Francisco, tre Proceedings covers 4 major topic areas: History and Planning; Spiritual Responses: Plenaries (including Glenda Hope; tie spirituality of suffering, death and life transitioos; and a theolCJJY of AIoo); Spiritual Res\Xl1ses: Itklrkshops (including spiritual coonseling & support; grief & bereavement cameling; religion's role in prevention educatioo; refl~tions on Ronan Catllllic Teaching in tre AH~ epidemic; I"ospital, pisoo & military chaplains; meditations, prayers, & realing services; spiritual aspects of love, touch & realing; mobilizing religious institutialal resources; ccngregations' responses to members with Aloo); and Practicalities: Itklrkshops (including: Aloo-a primer; \IIOmen and Aloo; IV drug users & AIIB; children & Aloo; Aloo education in religious sctYJols; vi sua lising death & dying; Asian, Black, Latino, &Native .AJrerican Peoples; Civil Legislation; and &Jrn Out). For rtlre InfOl'fMticn: AIoo/ARC Conference Proceedings, c/o Shanti Project, 525 HCAllard St., San Francisco, CA 94105. *m.. u.u .. utolUuu .. toIU"ltoI~II,,**,,*~ JEWISH PROJECT GRANTS $$ by Lisa ~llwgh, with tlwlks to TIe IrIashingttn ~ade, 11/6/87 Tre Naticna 1 Jewish AIoo Project announced that it is distributing $10, 000 in grant nmey to three AIoo social and eductala 1 prCJJrams in tre Washington area. Tre Jewish Social Service Agency, which runs I"ospice and m rea lth care services for Jewish and pediatriC Aloo patients, will receive $3000 to develop Aloo educational services for tre local Jewish camJJnity. Tre National Associationof Peep le with Aloo will receive $2000 for its natiala 1 Aloo SUplX)rt netlllOrk and lobbying projects for govemrenta 1 funding of Aloo research. Tre largest grant, $5000, went to tre \!Iashington DC Whitman-'llalker Clinic's Aloo Foundatioo for 'direct financial assistance to people'with Aloo. Jim Graham, Administrator of Whitman-'llalker, said tie clinic's AIIB FOundatioo distributes nmey to people with AIIB to lelp them pay tleir rent and utility bills, to buy groceries, to defray travel and funeral expenses, and otler costs. Graham said that tre Clinic Foundaticn has distributed more than $200,000 since they received tleir first grant ,in ~r 1983; with monthly disbursements running between $7-8000. ****"*"*********************** *********. toI ******* * IJCLlK 8:4 * WINTER, 1987 * PNr. 79 ~ ***** THE OFFICIAL NE\IISlETTER OF THE NCGSTOO **lI ** .... ** +. +umm* +•••• m **+ **'*'*" **,*,,**m .. u**** **m *** ••• *** *. *. *.. *•••• Mot +. +.. ** ** •• ***** ** ... +** •• *•••• +...... **'*.4(+. +. ++. mm PROFIT FROM AIDS with tl-alks to Q!~ 0Jt]j~, 9/3/87 HOoII YOJ Can Profit f~ t!-e Panic Qf 1,g~, says that "AIDS An adverti5alS1t in Investor's Oai~ for a txxlk pJblished by JalleS U. Blanchard, ad, San Diego's Bravo! reports, includes t!-e follOolling: has bEm Dr. JoITl Phair. principal investigator of tl'e NIH Inm.me Functioo Study. a major AI~ research projE(;t. annoJf1C9d that Chicago's Ha.tlard 8ro,J,n Meroorial Clinic (HOC) is inviting 200 new participants- healthy gay or bisexual active black IlBl between the ages of 18-60 years to join the study. Aco llaboratioo bet\ll9B1 Howard Broo and NortllEstern University Medical Scroo 1. tl'e study is funded by a grant fran tl'e Natiooa 1 Institutes of Health. TI-e Chicago study is part of a larger projE(;t knOltl1 as tl'e r.tJ lti-ca,ter AI~ Corort Study (MACS). Other study Ca1ters are located at tl'e Johns Hopkins University (Sa ltinore). University of PittsbJrgh, and the University of California at Los Angeles. The ga1eral PJrlXlS9 of tl'e study is to describe tl'e natural history of tl'e develOjl1lB1t of tl'e disease. It is hoped that tl'e informatioo gained fran tl'e research will lead to tl'e ida1tificatioo of risk factors cootriMing to AIlS and eventually to tl'e preventioo and/or earlier diagnosis. fIore than 1,100 gay IlBl originally a1rolled in tl'e study tl'V'ge years ago at Ha.tlard 8ro,J,n and Nortl'Mest:ern. Study participants are S9a1 at 6 month intervals for 4 or nore years. During each visit. participants have blood drawn and are given a physical examinatioo. Aquestionnaire is also administered to obtain medical and sexual history data. This is not an experillBltal drug treatllBlt study. Gay or bisexual black IlBl wro want to join tl'e study may call Ha.tlard BrOltl1 (312/871-5695), for more informatioo. FOJnded in 1974, tl'e Clinic is a not-for-profit health and I1.nnan services organizatioo and ooe of tl'e Midwest's primary AI~ research and resoJrce Ca1ters. TI'e Clinic also operates tl'e statewide AI~ hotline (in Illinois, 1/800/AID-AI~) under a grant fran tl'e state's /)3partllBlt of Public Health. W~tw""ttw~~'11"""'UI"I* CHICAGO ILL-PREPARED FOR A I: DS COSTS by Albert Willians, with tlmks to Chicago's M ffiy TiE, 8/20/87 Chicago's health care camIJIlity is ill-prepared for tl'e financial implicatiCl'lS of tl'e AI~ crisis in tl'e city, according to a report titled. ·Policymaking for AI~ Care in Chicago." TI'e report projE(;ts total inpatia1ts costs for AI~ treatllBlt of nearly $265 mi1lioo by 1991 and estimates that tl'e number of AI~ cases will reach 7000 by that time. with 4000 deaths. f'eet:ing tl'e challa1Q9 of tl'e AI~ crisis will require "significant financing and structural changes" in tl'e way health care is now de livered in Illinois. Produced by tl'e University of Chicago's Ca1ter for Urban Research and Policy Studies in coojunctioo with tl'e highly regarded f'etropolitan Plaming COJncil, the study includes data compiled through interviews with health providers and policy-makers in Chicago, New York, and San Francisco. In trying to cootrol the cost of AI~ care in the city, the researchers say, "Chicago shold attempt to emulate San Francisco's utilizatioo of canmunity resOJrces and minimizatioo of inpatia1t hospital care." Other s~ific ~ommendatiCl'lS fran tl'e report: >/)3signing several Chicago hospitals as "core" treatllBlt facilities, with Cook County Hospital as a Ca1tral canpona1t. The report discourages against the developllBlt of a separate facility solely dedicated to AI~ treatllBlt. "To isolate AI~ patia1ts in separate facilities .... will play into the larger soc i eta 1 climate of fear and avoidance of AI~" the report said. >/)3velopllBlt of an innovative bB'lefit package for Medicaid ~ipia1ts that \IIOUld provide a range of services including counseling. in-patia1t care, medicatiCl'lS, and hospice services. >Establishing a state coordinating aga1cy chaged with addressing s~ific problems intl'e delivery of care to AI~ patia1ts. including "regulatory issues, financing. health faciliites planning and camunicatioo with the nursing !me industry' in the state. Due to the projE(;ted increased numbers of cases by 1991, the report predicts "an extraordinary increase in suffering inthe city' that will call for "sensitive and careful respooses fran PJblic officials .... The reCa1t cootroversy abOJt PJblic policy for preventing the spread of AI~ has obscured an ~ally important PJblic policy issue: the develoPllBlt of a systen of care for individuals wro already have cootracted AI~ .... &i 1991. AI~ \IIill ~ome the leading cause of death for young adults in Chicago .... • the report says. "Caring for individuals with AI~ presa1ts the City, the COJnty. and the State with an enormous challenge for resources. intelligence. and canpassioo," the report cootinues. •As the number of cases nounts, the informal and' ad hoc arrangarents that have served AIlS patia1ts to date will be increasingly taxed. Significant financing and structural changes. over and above those that have bea1 recanmended for care of the medically indiga1t. will be required. There is not a stroog CCJlStitUa1cy for the develoPllBlt of a systen of care for AI~ patia1ts; noving the systen will require political leadership and the cooperation of several layers of governllBlt." •••••• WW1*'****'****'*'*n •••• W "1" I. I*'***" BILL OF RIGHTS IN BOSTON? by Kim lllestl'eimer. with tlmks to &stoo's ~ CamUlity News. 10/11-17/87 "TI'e AIlS "Bill of Rights." a cootroversia 1 proposal by the New Alliance Party (NAP) may be introduced to tl'e 8eston City Council. At a Septenber 30 press cooference. Mary Fridley, the national coordinator of the lesbian and gay caucus of NAP. said the bill \IIOU ld "prohibit all forms of discriminatioo against people with AIlS. with ARC. and people who test positive to tl'e HIV virus. It \IIOUld also OJtlaw any form of mandatory HIV virus testing. Fridley acknO\llledged the bill had "Qa1erated considerable cootroversy" in New York. TI'e New York Native. me of the country's largest gay newspapers. printed a froot page attack this week 00 the Lesbian Md Gay Caucus and ootl'e AIlS Bill of Rights." Fridley \lIS referring to a news story in the Native in which the bill \lIS criticized by members of the New York State "Division of Human Rights, the Gay Men's Health Crisis, the Minority AI~ ProjE(;t and the Hispanic AIlS Forun. tl'e bill was a~ed of duplicating existing legislatioo, stigmatizing people with AIlS and giving tl'e perceptioo that discriminatioo against people with AI~,is not illegal under curra1t law. Fridley da1ied these claims. asserting. "To argue \119 doo't need as many rights as \119 can get doesn't make sa1se." According to Fridley, NAP. which has circulated petitioos in BOstoo bars for approximately three weeks, has collE(;ted abOJt 800 signatures in favor of the Bill of Rights. NAP is planning to ask gay City COJncilor David Scoodras to sponsor the bill. ****.tW1IU"~~"W***,,~"':'''~U~'Ut4C ***** THE OFFICIAL NOO..ETTER OF THE NCGSTIS * IJ(lllE 8:4 * \!lINTER, 1987 * PAGE 81 ***** ** ...... 1OIJ1 ...... 101 101 ..... 'JlJlJlICIOIlI*lI""~'''' ++. U***.:IJIIOIJIIOIJIJIIOIJI.IOIJIIOIJII ...... +::101+. I •••• ' .JIJI .... 101 ...... *' ++ llOI.IOIJ11 .IOIJI BLACK LEADERS ADDRESS AIDS FUNDI:NG by Craig Harris, with tlslks to btm's ~ CamlIlity~, 11/8-14/87 AbaJt 20 represa'ltatives of black civic, professicna 1, and re ligirus organizatioos met at \llashingtrn, OC's IboIard University Hospital October 29 for a black leadership forum rn AIlS. The forum was crnducted by the U.S. Department of Health and HlUllan Services, thrOJQh the Public Health Service and the Ca'lters for Disease Crntro 1. This neeting, me in a series of 10 held thrOJghOJt the natirn during the m:J1th of !X:tober, was designed to provide the COC with effective tecmiques for reaching the black camlJnity with accurate and curra'lt informatirn abaJt AIlS transmissirn and preva'ltirn. In her Dpa'1ing remarks, Stephanie Lee-Miller, Assistant Secretary for Public Affairs for the U.S. Dept. of Health and HlUllan Services, presa'lted an overview of topics to be discussed. These included the federal governnent's resprnse to the AIlS crisis in cammities of color, discriminatirn and funding crncems, and the black CCll1Il.tnity's perceived readiness to receive AIlS risk reductirn!hea lth praootirn messages. Lee-Miller assured the participants, who represa'lted such grrulE as teh Naticna 1 Urban league, the NAACP, the National Ca.ncil of ~ro \IIooal, and the African Metl'r:xlist Episcopal Church, that 9Jrg9l'l Ga1eral C. Everett Koop, Secretary of Health anc) HlUllan Services Otis R. bien and COC Director Jmes Masrn are aware of the particular AIlS educatirn and service de livery needs of blacks and latinos. ~ federal rutreach activities cited by Lee-miller were three press breakfasts attended by members of the mainstream and black press where "the issue of the minority dimensirn was addressed.' Lee-Miller also spoke of a neeting crnva'led !X:tober 28 in Nashville, at which Secretary bien addressed the students and faculty of Maharry, Fisk, and Vanderbilt Colleges. Anotherexample of federa 1 support for HIV infectirn interva1tioo in ccmrunities of color was the funing of a rne-hOJr te levisirn documentary a'ltit led •AIlS in the Black Ccmrunity' and produced by Black Entertainna1t Televisirn. Lee-Miller told forum participants that BET was selected because it dSlO1Strated expertise in reaching a large black cable audia'1ce, especially yaJnQ people who need to receive culturally sensitive informatirn rn how to protect themselves fran hiv infectioo. Lee-Miller applauded BET's lak, noting the Public Health Service had deferred to the CCfltractor's judgement despite fears that producers were being "too daring" in Hallowing the gay and bisexual black ccmrunity's views to be aired.' She added that there is 'a higher incidence of harosexual men and \Jm9I1 than we may want to acl«l.rlledge.' Referring to the numbes of black gay men as a tragedy which COJld be remedied in the future, she said, "\lie have to go rut there, get these yaJng boys and try to deal with it.' Lee-Miller's statana'lts raised the questirn of wily Rev. Renee~, Executive Director of the National Coalitirn of Black Lesbians and Gays, had not bea'1 notified of the leadership forum. Val sin Marmillirn of Hunt Marmillirn Associates, a Los Angeles firm which had bea'1 CCfltracted to facilitate the neeting, CCflfessed that the oversight was due to his ~y's lack of awareness of the organizatioo, despite the fact that NCBLG has \IIOrked closedly with staff members of both the COC and the Office of Minority Health in the past. Lee-Mi11er spoke also of what she terned "the minoritizatirn of AIlS,' referring to possible fll'\ding cuts as a result of the perceptioo that AIlS is becoming an illness affecting people of co lor. Citing future funding losses as a major fear in the black ccmrunity, she explained to participants that she is "not cmcemed that the rrr:rey will dry up if the minority issue is lOOI'e emphasized." According to Lee-Mi11er, 'the Black CCll1Il.tnity is much more prepared to deal with AIlS I'1OtII than 20 or eva'1 ta'l years ago.' She reasooed, however, that the slC7.11 resprnse of the Black CCll1Il.tnity to AIlS COJ1d be attriruted to feeling that "the Black CCll1Il.tnity has enaJQh problems, em't lay AIlS rn us." \!/hile she did not cite any risk-reductirn interva1tirn models for black gay/bisexual men, Lee-Mi11er did inform participants that the National Institute of Drug AbJse (NlOA) is abaJt to launch an AIlS preva1tirn media canpaign targeting IV drug users, their partners, and teenagers. This campaign will emphasize the use of billboards, posters, radio, and point-of-llJrchase locatioos to reach alia'lated popJ latirns. Lee-Miller a150 stated that "using and involving former IV drug users is an essa'ltia 1 part of reaching this pollJlatirn." Regarding preva1tirn interva1tioos for heterosexual fena1es, Lee-Miller asked "HC7.11 do we get black \Jm9I1 to ask questiCJ1S before they go to bed with a man?" She stressed this point more than the issue of promoting widespread CCJldom usage anmg sexually active \10181. Herbert Nicka'1s, I«l, Director of the Office of Minority Health of the Dept. of Health and HlUllan Services, spoke abaJt the creatirn of that office nearly tllK) years ago, at a time when six major causes of death (including cancer, heart disease, and homicide) am:J1Q blacks were the officer IS primary areas of cCJ1Ca'1tratioo. He explained that because of the disproportionate incida'lCe of AlOO amrng peep le of color, it becaae obviOJS that the Office of Minority Health \IO.Ild have to increase efforts to control the spread of HIV infectirn in these communities. Nicka'ls cited tllK) meetings as pivotal in a move tC7.llard collaborative efforts bet\llea'1 the federal health aga1Cies and minority camunity-based organizatiCJ1S. The first of these was the minority leadership Forun rn AIlS whcih was atta'lded by abaJt 40 represa'1tatives of black, latino, Asian, and Native American CClllll.inities in metro \!Iashingtrn, OC rn June 8-9. The other was the "AIlS in Minority PopJ1atioos' CCflfera'1C9 in Atlanta, .August 8-9 and atta'lded by over 1200 participants. The overwhelming turnout at this CCflfera'lce, which was originally planned for 400, indicated according to Nickens, that people of color are ready to deal with the issue of AIlS. Nicka'ls also said the media coverage of the CCflfera1ce was a signal to mainstream print and elecrCJ1ic media that it is okay to cover the issue of AIlS in communities of color. Nicka'1s stated that his office is CCflcentrating on expanding funding of community-based organizations, saying that such grrups have a 'critical role' because they 'm their people." Finally, he stressed the 'need for greater research of minority pollJ1ations in the areas of under-reporting, srorta'led survival time, and service delivery systems.' Laurie Sherman, Director of the COC Naticna 1 AIlS Informatioo Campaign, presa'lted an overview of the 'America Resprnds to AIlS" campaign which includes llJblic service annOJnCana'lts for te1evisioo, radio, newspapers, and magazines produced by ~i1vy and Mather, the frurth largest advertising agency in the \IIOr ld. F\Jb lic service annoJCana'lts targeting the black and 1atino communities were sub-cmtracted to minority-ooed advertising aga'lCies Lockhart and Pettus (New York City) and Sosa and Associates (San ~trnio). "\!/hat we're trying to do,' said Sherman, 'is to talk to 240 million Americans individually. The communicatioo challenge is a'lorf1OJS because we're trying to effect varied behavior change. Sane need just to be compassionate while others need to change their sexual or drug use behaviors." Forum particiPants were able to view the PSAs produced by the ttv-ee ad aga'lCies. ~i1by and Mather took the approach of using real peep le in variOJS American cities delievering risk reductirn messages. Several people of color appear in these, including Sally Jue, anA AIDS COOlt{)EO ***** PAGE 82 * lliE OFFICIAL NEWSLETTER OF lliE NCGSTre * nt)1E 8:4 * WINTER, 1997 ***** *** ••••• ***"* ••••••• *••• ***** ****+* ** ...... ****** ** ** ...... **** •••••••• m •••••••••• u ••••••••••• ** ••••• ,****+* •••••••• m ** C~n~1Qu~d.~ BL~C~ L~ADER§ cOJl1selor fran Los Angeles, Suki Ports, farner dir~tor of the Minority Alre Task Force of New York City, and Dr. Adaora Adirrora. Several participants expressed ccncern over the message delivered by Adaor<-; • ... if yoo're sexually active make sure that yoo're in a relatiooship in which yoo're having sex with ooe persoo who is having sex with ooly yo. kid make sure that the persal is not inf~ted with the Alre virus.' Roo Harris of Lockart & Pettus wtlined the approach his canpany took. "We wanted to soo,., that Alre is preva'1tble, not n~sarily 00,., to prevent it." He said that while Lockhart &Pettus \IIilI'\ted its product to look sanehwat similar to that of ~ilvy & Mather, 'the theme, 'America Resp Forum participants resturctured the afternoon sessioo to discuss issues of funding rather than problem identificatioo and educational strategies. Many of the participatns QJe5tiCl'1ed the usefulness of the originally scheduled topics in light of the I«lefully i~te allocatioos for the support of camJJnity based Alts educatoo. Edward Pitt, Oir~or of Health and EnvirCl'1mental Services of the National Urban League, complained to COC representatives that, 'The problem has been identified. YOJr facilitating a meeting of all of us does not get us any closer [to a solutioo]. The federal government can mobilize us by giving resOJrces, not be giving up pep talks." Gil Gerald, Oi~tor of Minority Affairs for the National Alre NetlrDrk, noted that the U.S. C AFRIKAN DESCENT GAY MEN & AIDS by Ell81 Steinbaun, with thanks to The VollJlteer, New York's Gay Mal's Health Crisis Narsletter, July/kqJst, 1997 Gay Men of Afrikan Descent (~), barely a year old, \lIaS bom 0Jt of the need for an organizatioo that COJld s~ifically address the C A $200 millial minority AIoo bill, hailed as tre first federal recognitiCX1 of tre AIoo epidemic amrng ccmrunities of co lor, has been received with 9Jarded optimism I1i Al[~ educators. Tre bill, which will be introduced by RepJblican Sa1ator Arlen Sj:ECtor of Ptmsylvania as an additiCX1 to Sa1ator Edward Kennedy's (D-M6ssachusetts) $946 milliCX1 comprehensive AIoo bill, would provide direct funding to ccmrunity based minority AIoo educatio projects clmen by tre Health and Human Services Department's (fffi) Office of Minority Health. Although Aloo eclK:ators generally support tre bill, some expressed CCX1cern that !tIS \IOJ ld censor tre cCX1tent of AIoo material as a result of a recent amendment to a $126 billial fffi appropriatialS package. Tt-e amendment, SJXl1Sored by right wing RepJblican Sa1ator Jesse Helms or North Carolina and right wing Rep.!blican Representative Robert Damemeyer of California, prohibits tre use of federal funds for educational projects or materials that 'promote or encourage, directly or indirectly, homosexual sexual activity or IV drug use." Regarded by gay activists ° as one of tre most I-aooprobic acts by CCX1gress in recent memory, tre legislatiCX1 will restrict tre ability of AIoo educators to reach POp.! latiCX1s that engage in high-risk drug use and/or homosexual activity. Tre amendment passed overwhelmingly by a 94-2 margin in tre Senate, and 368-47 in tre House. Tre $200 milliCX1 minority AIoo funding in Sj:ECter's proposal is intended for ccmrunity-based organizatiCX1s to do educational rutreach tailered to tre sj:ECific needs of treir calStituents. Tre bill promotes, 'coordinatial, tecmica 1 assistance, deve 10lJlSlt of educatio mateia ls and promotional strategies" between national and local AIoo and camlJnity organizations. According to Eartha Isaac, legis lative assistant to Sj:ECter, tre bill is tre first federally funded neasure to recognize tre severity of AIoo among black, latino, native american and asian camlJnities. Sj:ECter's office cooperated with tre National Urban Coalition, tre National Minority AIoo Crulcil (~C), tre National Black leadership Rwndtable, tre National AIoo Netll«ll'k and tre National Urban League in writing tre legislation. CarmJnity-based AIoo organizatialS have consistently lacked funding, resources, and tecmical assistance for minority AIoo educatial and risk-railctiCX1 outreach. (), March 18, 1987 a grrup of national minorityorganizatialS, including tre National Associatial fo rht Advancanent of colored People and NMAC, filed suit against tre Los Angeles Coonty Board of Supervisors for racial discrimination in tre allocatial of AIoo education fu1ding. Specter's bill bypasses city and state govemnents in order to fund grassroots organizatials directly. Ernest Andrews, Executive Director of tre M..Ilti-cultural Alliance for tre Prevention of AIoo, stressed tre importance of camunity-based educatioa 1 efforts. He said re fears AIoo may becane epidemic in rural area, esj:ECia 11y in tre Sooth, where mainstream AIoo organizations have little or no CCX1tact. 'Nobody ~ at tre extent of tre problem in trese areas. People die of unknown diseases and are ruried before AIoo is mentia'led. Trese areas have treir 0IIIn problems which we have yet to address,' Andrews stated. Isaac emphasized camunity-based organization's responsiVS1eSs to camunity needs, saying "You can't run the AIoo education srow from a downtOllln office.' According to Isaac, Sj:ECter envisions a roore efficient utilization of resrurces and funds. Coalitions of camunity-based groups can apply for support in cooperatial with existing institutialS such as crurches and universities, wich provide access to a wide range of people and resources. Groups of Baptist crurches and tre Sootrem Christian Leadership Council are examples of organizations that will reach many people outside urban centers. AIoo educators agreed with tre intent of Sj:ECter's bill, tre Helms alllS'1dns1t might make effective education all bJt impossible. They argue that the success of educatial in tre gay white male camunity, where tre rate of HIV infection has 1eve led off, is at least in part due to explicit safer sex education. Without tre freedom to develop and use explicit educational materials, ailcators may never reach many people win engage in high-risk activity. Educators are particularly calcemed that minority camunities, where IV drug use accounts for about half of all reported cases, will not respond to literature that promotes abstinence for drug addicts. Damaneyer's press secretary, Paul Mere, told ~ Camu1it~ News, that Helms and Damaneyer would fight efforts to 'misinterpret' tre amendment by liberals in CCX1gress. ''lie feel that uh of tre AIoo education material does not address tre t.nderlying problems which we are trying to get at-what causes t-aoosexuality and drug use. As long as these things are around trere \IIi 11 be diseases spread." "I am concemed that there \IIill be not IllJch left from tre Specter bill if people are really equating educatiCX1 with promoting t-aoosexuality and drug use,' said Craig Harris, Chairman of the Lesbian &Gay Caucus of the American Public Health Association. Forcing minority communities to fund treir 0IIIn explicit sex and drug educational material is equivalent to abandoning educatio all togehter, said Harris. 'llhite AIoo organizations have access to money, while minorities have less and are reluctant to p.!t money into what is perceived to be a gay issue. If Helms and Damaneyer succeOO, said Harris, 'people of color will be left with tit«) people in an office \IIith a typewriter, trying to get a fundi ng proposal out.' til ••••••••• II ••••• :t:t II .:tllt t:t ** ** t ...... *** ... .. BLACK CONFERENCE ON AIDS I1i Marc Stein, with t~ to btal'S ~ CamlIlity News, 8/2-8/87 The Southern Christian Leadership Conference (SOLC) has urged blacks to accept greater responsibility for containing AIDS, according to the New York Times. Tre appeal carre at the opening of an SCLC conference at Washington, DC's Howard University 00 AIoo among black people. Tre SCLC -i;s attempted to roobilize black people thrrughout tre U.S. by sJXl1Soring a series of state conferences 00 Aloo and its impact 00 tre black CamlJnity. SOLC Presidnet Dr. Joseph Lowery told calference-goers, 'The concept of AIoo in the black camJJnity is that it is a gay, white, male perSal disease... 'lie in tre black CamlJnity IllJst face up to tre fact that Aloo is a threat to tre tota 1 black ccmrunity. Blacks make up 12% of the US pop.!latial rut aCCOJl1t for 25% of AIoo cases. 8903 blacks are reported to have AIoo. Lowery called for strengthened family values, and freedom from sexual promiscuity, substance aruse, (and] perverted priorities." Norman Nickens, an AIoo discriminatiCX1 representative from tre San Francisco Human Rights Commissial, answered arguments that activists are p.!tting civil rights above p.!b lic eha lth Calcerns.. • If individuals are afraid of being discriminated against for ac\ San Antenio's Hispanic AIDS Carmittee for Educatien and Resources (HACER) is a private, ncngovernnental, nenprofit organizatien of volunteer professienals in the Hispanic community to address the problen of AIDS. HACER also hopes to help !OOdify behavior and to curtail the spread of disease within the community. Since its organizatien in June, 1987, HADER produced five 30-seccnd televisen public service announcenents in Spanish, starring /l'exican actor &:ma 10 Vega, and several other TV and radio PSAs in Spanish and English, featuring area celebrities, including Mayor Henry Cisneros. In additien, HACER produced five half hour video presS'ltations of interviews with local experts dealing with different aspects of the AIDS crisis. Three specific posters targeting specific elenents of San Antenio's Hispanic populatien have also been developed- a poster directed at sexually active nen bet\lleE!l1 the ages of 18-33, and was designed for placenent in nen's restroors in bars; a second poster targets wonen, and will be placed in beauty shops, laundromats, and clinic waiting rOOTS; the third poster in Spanish and English, sttes that AIlE is not spread by casual centact. In additien, various flyers and brocllJres have been developed including ene en "AIDS and \IIaJs1,' and 'AIDS and Food Handlers.' HACER is deeply ccmitted to collaboratien with other agencies and organizatien throughout San Antenio, Texas, and the rest of the natien. Copies of the above PSAsa, te levisien progralf5, and posters have already been sent to public health departnents, clinics, and service agencies in Texas and other states. HADER seeks to share informatien with other AIDS service organizatiens. Please write: Gabriel Cervera, MO, HAGER, 600 Henisfair Plaza \!lay, San Antenio, TX 78205. **.U*JI~.~ •• wu~:t ..~~ ...... ~.~ ..** PUERTO RICAN GROUP SUPPORTS FIGHT' by Bob Lederer, with tlBlks to btm's ~ CamU'\ity News, 10/25-31/87 APuerto Rican independS'\ce group based in the U.S. has become the first Latin .Alrerican liberatien organizatim to publicly support the fight against gay oppression. At its First Congress July 3-5 in Chicago, the Puerto Rican Natienal Liberatien bement, knoo by its Spanish initials-MLN, also adopted progressive resolutions on AIDS, sexism, reproductive choice and racism in Puerto Rico. These lJ1precedented stands will likely prove cmtroversial anmg the people of this Catholic area, and within the independe1ce IIDVfm'lt. The Congress marked ten years of existS'\ce for the MlN, which is organized in major U.S. cities where over half the Puerto Rican populatien no\II lives, after high lJ1employrrEl1t and political repressien forced tim to leave their U.S.-occupied island. The MLN resolved to cmtinue its public support for all neans of obtaining independence for their colmized nation. The folN's ne\IIly-adopted constitution 'forbids racism, sexism, and horrophobia in all their forlfS.' Another provisien rejects 'the imposition of conditions en social relations amcng the people: be they sexual preferS'\ceS, marriage, tenporary relations anmg or bet\lleE!l1 the sexes or of any other nnte.' In separate resolutions on 'revolutionary IlIJrals,' in which the organization notes it is 'the first to make sexuality part of a political program,' the folN declares. '\!Ie RUSt develop a positive visien of sexuality in all of its aspects, and as an organization, guarantee that each individual feels likewise.' In another resolutien, the MlN criticizes the perceptim of AIDS as a 'gay' disease and says AIDS is 'being used as a new justification for the oppression of l'amexuality.' The statenent adds, 'AIDS is attacking the Puerto Rican natien in dispt'O\Xll'tionately high numbers and we RUSt not let prejudice stand in the way of seeking a solution to the problan or supporting our brothers and sisters who are suffering fran it.' The resolution accuses the U.S. government of using AIDS 'as a way to canbat sexual liberatim and h.Jman liberaion gains over the last two decades •••• lt is up to all of us to expose this policy, separate the facts fran the lies, and oppose a retum to bourgeois llIJI'ality and repression.' *******.It •• *********.*.* •• ~ ••• w.~ •• ************ VENTioN US POIS,T·A.GiE S,T'AMP GIN A.1: OS?'? R by Jean Anne Hlavacek, ~ E u S This cOJntry has a great untapped resCIJrce for AIDS educatien in its Pesta 1 Service. I \OJ ld like to C E propose that we create a postage stamp to foster S'lharcid awarS'\9SS of the crisis due to AIlE. OJr A A currB'lt postage stamps den the images of seashells, a picture of a dog and the word 'LeNE: the flag, -r R and during Christmas tine, a madcnna or a decorated tree. I do not find any of these images I C trCIJb lesane, rut rather, I feel we as ccncemed Anericans can take the first step forward in facing the 0 problen of AIDS head en, by adding an AIDS educaticnal stamp to our currS'lt repertoire. I \OJld like to N see the AIDS informaticnal stamp in Imes, en teachers' desks, in !xJsiness establist1lS1ts and ultimately COM pAS S 1 0 N all corners of the world! The represS'\taticna 1 drawing of the proposed stanp design (accanpanying this artic le) can be !OOdified, with differS'lt colors or fents. Direct your camSlts to: The CitizS'l Stamp Advisory Carmittee, 475 L'Enfant Plaza, 5\11, 5800, \llashingten, OC 20260-6352. Send copies to Jean Arne Hlavacek, R-I, 701 West Lakeside St., Madiscn, \!II 53715 ...... +:o+ .... u.u ...... u.~.u •• w ...... NEXT NEWSLETTER_SHR As this Newsletter is being prepared, articles for tre Spring. 1988 issue of the ~~ Heal~ ~~rts, volune 9:1, are,being collecta:!. (YOJ sh::tJ ld see tre pile 00 my desk!). Ho;:efu 1 (!) pub 1icatioo and l1la"fl ing will be this Srping. HQ\II8V8r, due to unforeseeable :ir::umstances, publication may be delaya:!. Address inquiries and articles to: NCGSTDS, P.O. Box 239, Milwaukee, \!II 53201. Thanks for your understanding! *.~~~~~~~~~~~~~*** ***** lliE OFFICIAL NOOLmER OF lliE NCGSTCS * VOI..l.M: 8:4 * \IIINTER, 1987 * PAGE 85 ***** ** ...... ** ... m•••• ** ...... m.** ...... ** ...... **u ..... u...... ** •• m... **. **'*'111."" ....11 ..... ** MINORITY EDUCATION I: N B C:I:T"I:ES The U.S. Cooference of Mayors annaJnced that prograrrs targeting AICS information and education to minority popJlations in 8 cities have been selected to share in a total of $156,800 in grant funds in 1988. The camunity-based groops receiving the grants \tIere crosen from among the 105 that subnitted p~ ls to the Cooference in its foorth round of funding AICS prevS1tion efforts in cities. *****In Cantlridge (WI). the Cambridge Haitian /lJrerican Associatim 'IIill use Cralle, French and English to reach the high-risk PIJIl.llatim 'IIhich includes individuals 'IIith multiple sex partners, needle sharers and prostitutes. Culturally sensitive safer-sex information 'IIi 11 be PresS1ted in the differS1t languages thrOJgh posters, flyers and other media. *****In Chicago, the PilsS1 Catrolic Yooth Calter 'IIill develop a cartOO'1 series and poster using "Spanglish," a form of English popJlar anmg first QS19ration Hispanic imnigrants. Culturally specific language will also be used in safer-sex talks and forums for teenagers and their parents. *****!n Los Angeles, El Caltro Human Services Corporation will provide AICS educatim to approximately 500 \IICl1la'l wIme children attS1d either Head Start proJrarrs or local elBlS'ltary sctmls in predominantly-Hispanic East Lost Angeles. *****In New York, Health \IIatch of Brooklyn is developing culturally sensitive materials m AICS based m evaluatiQ'lS of pre-existing attitudes and beliefs in the black and minority comnunities. "Rap" and focus groops for both yOJth and adults will cover high risk behavior and AICS risk reduction. *****In Philadelphia, Blacks Educating Blacks AbOJt Sexual Health Issues wil wk with older teenagers living in imer-city neighbortmds. Brocrures and pJblic service ama.II'ICeIlS'Its m AICS transmission and risk reductim will be produced, and efforts will be made to foster positive attitudes about the use of condorrs. *****In San Francisco, KPOO-FM radio will provide AICS educatim to black and Hispanic comnunities ttroJgh English and Spanish Illblic service ama.JnCE!1lE!Ots m safer sex and intravenous drug abuse. The statim 'IIill distrirute AICS informatim at crurches, ccrduct on-air interviews with AICS experts, and present m-air dramas m AICS in both English and Spanish. *****In Santa Cruz (CA). the Santa Cruz AICS Project will initiate an "Alarma SIDA" ca~ign aimed at increasing use of 1OR-I'isk , protective sexual practi~anmg Latino ffiS1 and \IICl1la'l in the agriculture producti(J1 sector. ASpanish language slide-tape show illustrating high risk behavior and protective practices will be used in groops talks to be held in farm workers' camps. *****In Seattle, the People of Color Against AICS Network, an affiliate of the ~rican Frim Services Ccmittee, is targeting AICS educatim for Latino, black, Asian/Pacific Islander and Native ~rican audiS1Ces. The groop win produce a "black comnunity forum," Spanish language videotapes, radio and televisi(J1 Illblic service annaJncBlS'lts, an "Hispanic comnunity forum: and other tools to address the AICS threat to minority poIlJlatiQ'lS. 1te grant award winners \llBre selected by an indepsldS1t advisory board canprised of respresntatives of the /lJrerican Public Health Associatim, National Institute of Drug AbJse, National Coalitim of Hispanic Health and t+..man Services OrganizatiQ'lS, National AICS Network MInority Affairs Office, and National Institute (J1 lfental Health. Funds for the grants are provided to the Cooference of Mayors by the federal Calters for Disease Cootrol. The Cooference of Mayors ama.nced their fifth rani of Mding for camIJIlity-based groops and camunity service organizati(J1S having established ties with netr,aks of racial and ethnic minorities, gay and bisexual ffiS1, intravenOJS dr\lQ users and rnsOOers of other groops at high risk of CO'ltracting AICS. Approximately 18 grants of up to $20,000 each will be a\II3rded. Novanber 17 was the deadline for subnissim. For additional informatim: U.S. CooferS1Ce of Mayors, 1620 Eye Street, NIII, lllashingtm, DC 20006 (202/293-7330) ...... +1111 ...... LATINO EDUCATION IN CHICAGO by Rachel Pepper, with thirlks to ~ OJtlines, 10/22/87 The need to reach hispanics in their CWl language and culture (J1 the prevS1tim and care for AICS was the focus of "AICS in the Hispanic camu1ities: a forun spalSored by the Chicago Area AICS Task Force. The forum, secmd in a two IIO'lth series (J1 the impact of .AICS . in Chicago's minority camunities, featured a latino alderman, Luis Mierrez, and an impressive panel of hispanic health \IIOrkers lncludlng Pojelio Cadena, Chairman of the 23 organizatim Hispanic AICS Network, and Raul lopez, health educator and COJn5elor at tt-e P~lsen Litt~e Village lfenatl Health Calter. Ezekiel Mendez, coordinator of the Hispanic Health Alliance, spoke of t he need for Alts m.;terlal to be .1n both Spanish and English to reach as many poople as possible. He stressed the need for bicultural \IIOI'kers to ~k \II~t~ .the ~atl~ comnunity, saying that a white PhD in black studies IIIOJld not necessarily be qualified to deal with the black camunty. Blhnguallsm ~s not biculturalism: Mendez said. "It's life experiS1C9 that IjOJ must have." CadS1a said that since hispanics receive most of the,r informatim from televisim and radio, a change in programning is required to S1sure that the ctl1'lllJnity receives a nessage beyald soap opera life which currently dominate m hispanic carITU1ity television statiO'lS. Lopez said, "If 1jOJ' re talking about dS1ia 1 whS1 YOJ' re talking a~ AICS, then YOJ're talking about 9VS1 rrore dS1ial in the hispanic comnunity." There are many reasons r,rh; AICS is spreading at a disproportionate rate in the Hispanic comnunity, according to Lopez, citing lack of nmey for medical insurance, lack of \rortIledge about the disease, and especially cultural barriers that prevS1t the ctl1'lllJnity from effectively dealing 'IIith the disea~e. Some of t~e cultural barriers include a traditional reluctance to discuss sexuality and seek Impital based medical services of any k,nd. Male machlsmo, and the corresponding submissive role of hispanic women are also barriers to ctl1'lllJnication abOJt sex and sexuality bet\lleS1 mS1 and women, s~nce ffiS1 ~ not volunteer to use cmdars and the \IICl1la'l ~ be afreaid to I'9:lUe5t that they do. Lopez said that hispanics as a groop are l1fely to be Im:>probic, largely liue to their Catrolicism. "Hispanics do not accept I-arosexua lity,' he said, tel~ing:he s:ory of one.yrung man wt:o had cmtracted AICS rut rather than tell anyme or seek help, died alone in his apartmB1t. He d,ed w,trrut ta lklng (about hlS I-arosexua lity)," Lopez said. Maria Ortega, a cOJnSe 11 or wro \IIOrks with Lopez in worksl'ops and ootreach, said they have becare ·educators and advocates" for the latino carITU1ity. She said that the camu1ity is "very scared" of AICS to the point that wI'ole families are not going ootside their !mesO for fear of catching the disease. "\lie must tell them what AICS really is, and in their own language," she said. For ue informatim <1311: 312/744-0660 . ••••••••••••••••••••••••••••••••••••••••••••••••••• ***** P.AGE 86 * 1HE OFFICIAL NEWSLETTER OF 1HE NmSTOO * VClllE 8:4 * WINTER, 1987 ***** ...... IeI: ...... •••••• •• m .... . NAACP ADDRESSES AIDS by Bill Bahlman with thanks to ~ York ~ti~, 8/3/87 Tt-e 78th.Annual NAACP NatiCl'lal Cooference t-eld in New York July 5-7, 1987, passa:! a strCl'lgly worded resolutiCl'l carrniting tt-e organizatiCl'l to actiCl'l in dealing with tt-e AIDS crisis. The resolutiCl'l states that: AIOO shllld be treatd as a disease entity, withllt social stiQll\3; that the NAACP ca11s upcn Coogress and tt-e Reagan administratiCl'l to enact and sign laws to fund AIOO research and provide ~blic financial assistance to AIDS patients ;n need of financial t-elp; and that tt-e NAACP will embark Cl'l an a:!ucational campaign to ensure that nmbers of the black cCJrI1l.:nity receive accurate informatiCl'l abaJt AIDS and ID it is spread. The reso lutiCl'l was passa:! with little debate and was seen as an important step fOl'\tlard for tt-e NAAC? and tt-e black camunity at large in dealing with tt-e AIDS epidenic. U.S. &Jrgan General C. Everett Koop, ::r.e of the main speakers at tt-e cCl'lference, paved tt-e way for tt-e reso lutiCl'l when t-e inferned tt-e approximately 3000 NAACP manbers attending the cooference of tt-e high incidence of AlOO in tt-e black camunity, tt-e speed with which tt-e syfIdrare is spreading, and the deadly nature of the virus believa:! to cause AlOO. Many of tt-e assembla:! throog appeara:! st-a:ka:! by Koop's renarks. Also in attendance at tt-e cCl'lference was tt-e militant activist grOJp, tt-e Lavendar Hill fIOO, wre distributa:! leaflets entitla:! "AlOO: Politics and Prejudice." The leaflet was prepared by the tfob to inform nsnbers of tt-e black camunity Cl'l row tt-e federal goverrme'lt is using AlOO as a po 1itica 1 weapcn, and row little is currently being done to find a cure ard/or a vaccine. Tt-e IIob was generally well received for its OJtreach efforts. Tt-e NAACP caJTe OJt strCl'lgly against President Reagan's nominatiCl'l of Robert Bork to replace retired Justice Lewis Powell Jr. cl'l tt-e &Jprerre COJrt. The Rev. Jesse Jacksoo, wre was hailed as tt-e next President, was tt-e keyoote speaker. JacksCl'l noted that, instead of fighting for lXlSitive changes to make OJr Hves better, we're fighting off legis latiCl'l which takes away tt-e rights we've worka:! so hard to achieve in tt-e past . ••••••••••••••••••••••••••••••••••••••••••••••••••• MINORITY AIDS PROJECT/LA DENI:ED $$ by Chris &Jll, with thanks to Bosten's ~ CamU'lity NellIs, 7/26-8/1-87 Minority AHB Project of Los .A.'1geles famder Carl Bean has accused tt-e Los Angeles COJnty Soard of &Jpervisors of "J1.II1ishing" local black ar.d Latino crnr.l..:nities for a suit he filed against tt-e !xlard in March. Tt-e suit charged discriminatien in AIOO educatiCl'l funding. In an Apri 1 28 sp 1it vote the supe~isors denia:! a $20, 000 grant to tt-e Project en tt-e grOJl'lds Bean was involved in tt-e suit against tt-e !xlard. The !xlard had previOJsly awarda:! the Minority AIOS Project tt-e grant, aleng with grants to ott-er agencies. Tt-e nmey was intended to fund a series of 8 forums cl'l AIOS. Bean, wre is a black gay miister, said "Carl Beam, tt-e perscl'l, is a plaintiff in tt-e suit, not tt-e Minority A!OO Project. I was always under the impression, since I was a yo.Jng boy, that under tt-e CCl'lstitutiCl'l people 1 cOJld speak OJt cl'l issues that coocerned them witOOJt being penalized." Bean is joined in tt-e suit by tt-e National Associatioo for tt-e Advancenent of Colored Ptq>le, tt-e So.Jtt-ern Christian Leadership Cooference, and tt-e Hispanic AIOS EdtlcatiCJl FoundatiCl'l. Tt-e grOJPS seek to force tt-e Board of &Jpervisors and tt-e CoJnty Health OepartJTent to step up AlOO educatiCl'l for peep le of co lor. The suit specifically claims that a black man with AlOO, Greg Baker, ccu ld have avoided the disease had tt-e cOJnty dCJle Irore to educate black and Latino camunities. Tt-e plaintiffs repe the suit will focus attentiCl'l cl'l tt-e needs of urban minority camunities across tt-e COJI'1try. AlOO educators are alna;t unanil10JS in prcmting grass roots campaigns as the most effective JTeans of ~~ating the hard to reach black and Latino camunities. According to Craig Harris of the Natiooa 1 Mino."ity AI[B COJncil, AIOS funding has by and large faila:! to address tt-e specific needs of people of color. He said 00 ly grOJPS like Bean's serve to bridge tt-e gap between the :r.ainstream press and l-ealth professiCl'l and minority camunities. Eric Rafes, executive director of tt-e Los Angeles Gay and Lesbian Camunity Services Center, said that tt-e board's actioo raises critcal issues abOJt rpivate socia 1 service agencies. "fJoOII po litica 1 can we be witOOJt being Jl.lnist-ed for OJr views?" Rofes asked. Tt-e !xlard of supervisors is taking revenge on Bean for daring to ~blicize the issue nation-wide thrOJgh his suit, he said . •••••••••••••••••••••••••••••••••••••••••• (lIeI ••• t* STUDY ON AIDS IN BLACK COMMUNITY by Stephanie Poggi, with thanks to Bostoo's ~ CamlIlity News, 8/2-8/87 Researct-ers Vickie Mays and &!san Cochran have been f~ by tt-e Natiena 1 Institute of t'slta 1 Health to CXl'lCluct a national study of "mledge, attitudes and behaviors of black gay JTen or black males will have ever been sexually active with anott-er man." Pilycne wishing rrore informatiCl'l abaJt tt-e study or wishing to participate in it shll ld caltact Mays at tt-e Dept. of Psycre logy, lXliversity of California at Los Angeles, 1283 Franz Hall, Los Angeles, CA 90024-1563 (213/825-9858). **. t lei ••• t tiel •• ****** ....*IeI. m ...... lei ...... Ulel MILWAUKEE CABLECASTS TO Anovel ccxnbinatiCl'l of camunity ~blic access cable producers and volunteers fran tt-e Minority Advisory Co.r\cil of tt-e Milwaukee AlOO Project produced tt-e area's first live studio program en AlOO arrmg people of color in Milwaukee, 'AI~ Qf ~ Different Color." Local televisiCl'l reporter and celebrity Denise Callaway lrCderated a panel of local autrorities- Latina IIaria ib:IrigJeZ of Planned Parentlmd, Native .AIrerican Pat Ribbich of tt-e Indian Health Center, and Black camunity leader Dr. Cassandra \lie lch of Nortl"4JOint !'slica 1 Group. Tt-e project was speart-eaded by tt-e vollilteer prOOJetien crew fran tt-e Milwaukee Gay/Lesbian Cable Neoork, a subcarrnittee oHt-e area's Crtm City FOJndatiCl'l, a noo-profit gay/lesbian philantli'opic agency. Tt-e Netl«>rk also prOOJces tt-e IImth ly TRI-cab le tenight, a half Inlr magazine-style format program 00 tt-e Milwaukee Gay & Lesbian camunity. The program was cablec:ast en tt-e city's camunity access statien channel 14- which has a large black and latino viewership. A live studio audisx:e of abOJt 25 people t-elped to electrify tt-e panel and stifllJ lated discussien by audience rrenbers. Each of the rrenbers of tt-e program planning carrnittee was respalSib le for bringing several audience IlSIlbers to tt-e studio. Plans are underway to sct-edule additional programs in 1988. ***** THE OFFICIAL NBBLETTER OF THE NCGSTOO * VO\..lI4E 8: 4 * 'IIINTER, 1987 * PAGE 87 ***** ****"*.:+~ ••• ****,,,****** ••• +•••• **.** •• t.t"***~ ••••• **.~ •••• ***.:+.m •••• ~ •• :+.~.~ •• **+:+:+:+.***** PRISONER CONVICTED FOR BIT"I:NGi by RoIl!rt Halfhill, with tt-anks to Boston's ~ Camu1i~ ~, 7/19-25/87 A prisoner who is HIV antibody positive was convicted June 24 in a Minneapo1is Federal dist~ict Court of assau1ting two federal prison gJards witha deadly weapon: his teeth. No other H!V antibody positive person has been found guilty of intentionally t~iing to infect ar.other pe~son. In an unrelated case, a man in the Twin Cities sururb of ~.aple\llCJOd was ordered to take the HIV antibody test after police and firefighters became covered with his blood and saliva while trying to restrain him during a suicide attempt. In January, 198?, guard TillOthy Voight and Lt. Rona1d !r'cCullough attempted to take 44 year old prisoner James Moore to a "secluded area" after he r.ad refused to talk when questioned about sllOking in an unauthorized area. Moore resisted and during the ensuing fight, inflicted a 2 em gash in Voight's right thigh with his teeth. He also bit McCu110ugh twice but neither bite broke the skin. Both guards later tested negative for HIV antibody. rtxlre was serving a 7 year sentence for credit card fraud and had beer. a heroin llser since the age of 18. He had previously beer. tested positive for both HIV and hepatitis B antibodies. Moore's attorney, Kevin Lund, presented expert testimony at the trial tr.at the HIV virus could not be transmitted by biting, ra..eve~, the jury found rtxlre guilty due to statements made by Moore about his intention to harm the guards. The verdict is \110rrisaTe because only the verdict, not the juror's carments wm be raoombered, according to Harlan Daltor., an associate Yale Law Sdm1 professor who is co-editing a boJk on AIOO. In the Maple\llCJOd case, police were ca11ed by one of the man's parents on June 5 after he had locked himself in the bathroom threatening suicide. Officers later found the man in his backyard with two stab wounds to the abdomen. He reportedly tried to bite and smear his blood on them. Later at the St. Paul-Ramsey Medical Center, an officer stated that he had learned that the man might be gay, and therefore might have AIOO. 'Nhen the man refused to be tested, Ramsey County Oistrict Judge Margaret tr'.arrinan ordered a test. The results were negative. tr'.aplewood Police Chief Kenneth Collins said the man would have been charged with assault if he had tested positive. [ED NOTE: !!!!!!!!!J Test results for the officers are not available. ~I II ************~ I tIm •• **********'********* JAIL NEWSLETTER FEATURES AIDS I:NFO with thanks to the Bethlel-em, Pennsylvania Globe Times, 8/18/87 Amonthly newsletter targeted at 300 inmates in the Northampton Camty prison has \IlOl1 a national award for papers in its class. Although editors and reporters change frequently when parole is granted or sentences are canpleted, the inmate publication continues to meet its monthly deadline. Til! current 32-page Insider, described also as a newsletter, devotes 13 pages to AlOO, a particular concern among inmates because of til! potential for rarosexua 1 contact and subs9;luent AlOO risks that are involved. It was written by a former Lehigh University adjll1ct professor who is doing time for a series of tll!fts in Bethlel-em and nOlI is co-editor of the paper. In earlier editions, til! pages were crafTllSd primarily with poems by inmates spilling their guts to proclaim sadness and everlasting love to girlfriends on til! outside. Since censorship has virtually disapj:6i3red fran til! pages of inmate pJblications, til! new volumes nOlI reflect political concerns and a public consciousness anmg til! inmates. ~ ttl I I I .... ~~ 1***:+ ••••• ~~ ..**u**: ...... NATIVE AMERICANS & AIDS by I01lbr1ell, with tlBlks to til! ~ a I am writing to introduce you to til! National Native American AIDS Prevention Center project which has been formed to meet the need for a focused national American Indian/Alaskan Native resJXl1se to til! threat of AlOO. Til! m::dels for NNAAPC are programs which were developed in San Francisco, such as til! San Francisco AlOO Foundation, the Shanti Project, the Stop Alt:5 Project, and others. Trese programs are notable for tl'eir compassionate, non-judga1a1tal approach and tt-eir success at public education, achieving risk-behavioral changes, and toobilizing the camunity-at-large to lend a hand to people with AIOO. As of August 24, 1987, tl'e COC had received reports of 41 cases of AlOO among Native Americans nationwide. Cases have been reported both i urban areas and on reservations. Risk categories for Indian people follOll the non-Indian profile, with gay and bisexual males tl'e principle victims. If, as sane epidemiolCYJists have estimated, tll!re are 100 HIV seropositive individuals to each case of fu ll-b1O\tn AIOO, it is clear that we have a problem in Indian Country. According to the COC, Indian rates for gonorrhea and syphilis are significantly higll!r than for non-Indians, and in sane states, astronanical. 'lie llllst begin nOlI to inform and educate, and prepare to care for our O\tn. ~AAPC is operated on a wing and a prayer at this time. Although it has applied for funding through Indian Health Service, no funds have yet been received. Tl'erefore, tl'e only way we can let people knOll we exist is to write to papers in the hope that others may leam of our existance, and contact us at 415/654-2093. Thanks! NATIVE AMER1CANS AFFECTED ADV'ERSELY' by Stephanie Poggi, with thanks to bton's ~ Camu1ity ~, 7/29-25/87 The incidence of AIm in Native Americans has increased 44% since Deceml:er 1986, according to the ~::i~ ~owards News ~~ice via Chicago's Outlines. Some health officials fear the increasing rate of illness may have genocidal impact for sane Native American tribes. 'IIhile figures compiled by the Centers for Disease Control show only 36 confirmed cases of AIDS among the 1.4 mi1lion Native Americans and Inuits (Alaskan Natives), officials fran the Federal Indian Health Service suspect that AIDS may be drastically under-reported. 'IIhile testing is available at clinics on Indian reservations, confidentiality is a problem in small close-knit communities. In addition, death from AIDS among Indians may be 'listed as ·other· in many cases if doctors or coroners do not know the person's background. Indian Health 52rvice officials met recently with the CDC and with representatives of various Indian organizations to discuss responses to the disease. ***** PAGE 88 * THE OFFICIAL NEWSLETTER OF THE NCGSTOS * IJ(llJE 8:4 * WINTER, 1987 ***** •••••••••••••••••••••• ~ ••••••••••• ~ ••• +•••••• +••••••••••••••••••••••••••••••••••••••••••••••• , ••• , ••••••••••••••••••••••••••••••••••••••••• CONDOMS~ NOT CONTRAS I: N N IC:ARAGiUA with thanks to tt-e ~~ york Nati~, 6/29/87 ~~caraguan ~ea~th Min~ster Dora Maria Tellez has anounced a new policy by the Sandinista government to provide five million condoms to preven~ the spread of AIDS in Nicarag~a. 'Even t!-oJgh there have teen no reported cases in Nicaragua,' said a full-page advertisaoont which r;,n ~n ~ewspapers around the country, "our country ,'linS high risks in relation to this sickness." The ad, which appeared May 24, listed the symptars of AIDS, ways to prevent it, and a list of groups which have historically been at highest risk of contracting it. "Trere are no ':acci~aticns, ~o treat:nents-- ca1dcms are the only alternative," said Tellez. United Press International reports tre government is awaiting the first shipment of condoms, which are not manufactured in Nicaragua. lktlti*********~~**"*II**,, PRI:S,ONERS, DEMAND A,I: OS, E DU C:A,T' I: ON by Kim \rIest:t-einer, with thanks to btoo's ~ ~ity News, 5/24-31/87 Lack of AIDS edL!cation \\'as arrmg a number of coocerns leading to a protest at a Norfolk, ftlassacrusetts prisoo, Tt-e protest at tt-e Norfolk MassachJsetts Correctional Institution (r.tI) was initially spar!~ed by allegatioos that a prisooer's arm had been broken by a guard. 01 ftlay 13. approximately sa black inmates dgronstrated in the prisoo yeard. They dispersed after less than two hours and were denied a r~est to speak with prison officials. ~ater that day, the protest resurred with 250 demonstrators. Officials net with serre prisoners late that day, ~eso 1\,1rlg many o~ the inmates's concerns. Fear of AIDS is widespread within the Prism, and two inmates, Robert Land and Alvin Love, have f~led SL!it against ~assachusetts Gcverrlor Michael Dukak~s and a number of state off~cials charging them with failure to inst~tute mandatory H!V testing in prisons. Land and Love maintain that "the Defendants, in failing to provide mandatory AIDS testing fo." all inmates, seriously endanger the physical and rrer.tal well-being of the Plaintiffs." Qie of the protesters, Ahmad Rashad, suggested that Land's and ~ove's concern is ma~r.ly for education, "Howeveryou have to do serrething to get .. ,the Dept. of Correction to act in serre way.' Mandatory ':esting and ;:css~b le disc lost;re of test !"esu lts to the prison pop.llatioo could p.lt people with AIDS under 'physical threat." acknOtolledged Rashad. &:to he added, the prism will no':: even admiister the HIV test to people who r9:lUest it. Dept. of Corrections spokes\lOOan Gail Darnell maintains that AIDS pamphlets have been distributed for a number of years to all prisoners during orientation, and that heatlh service staff rrembers d~scuss AIDS more thoroughly during orientation. ~lk************",**~********,,** PRISON RA.PE by JOCI'l Iktile, with tt-anks to [b;too's ~ CamUlity News, 11/22-28/87 'People Organizing to Stop Rape of Imprisoned Persoos' is looking for people who fear trey cootracted AIDS thrrugh sexual assault while in confinement, The ruman rights organization fMded in 1979 by a prismer, ~se1 D. Smith, is gatt-ering IMteria 1 for a class actioo suit. The suit IttOJld be based 00 a canbination of two previOJS cases- \IIood1'us Y.:. Cams1wealth Qf Virginia (1973) involving prism rape, and laRocca y.:. Dalsreim (New York, 1983) pertaining to AIDS in prism. People Organized to Stop Rape of Imprisooed Poople can be reached at P,O, Box 246, Napa, CA 94559, (415/227-5639), PRISONERS PROPOSE AIDS EDUC:AT'I:ON by Mike Riegle, with thanks to BcstCJ1'S ~ ~;!y News, 7/26-8/1-87 The great majority of prisoners remain uneducated ab::ut the nature of AIDS and how it is spread. Q, the one hand there is a periodic panic over forms of Ca1tact that don't transmit the disease; on the other hand, high risk practices continue. Agroup of prisoners from the Auburn prism in New York have proposed an education P."oject focusing 00 prisoner-peer education. Sane s~ific goals of the program are: ~) have a nt;mber of prisoners trained as AIDS education counselors; 2) set up discussion grops using prisoner clubs and other inside grrupings; 3) Develop a presentation as part of the orientation program; 4) Sponsor s~ial programs such as movies, skits and speaka"S; 5) Write update articles in the prison rag; 6) Work with pre-release people to encourage a sense of responsibility &safety; and 7) Coordinate AHE educatim with current substance abuse programs. The prisoners have proposed the project to tre authorities ar.d feel that serre rutside s~pport in the form of letters would :rake a big difference. They ask that letters of support !:e sent to: Superintendent Robert Henderson, 135 State St., Auburn, NY 13021; and to Carlnissicner Thomas Crughlin, BJilding 2, State CampJS, Albany, NY 12226. Cammts and suggestions for the proposed project may be sent to David Gilbert, 83A 6158, Box 618, 135 State St" Auburn, NY 13024. ~ **""'**"** IIJic I I. ***** **1 * ******Jic I leU. I 1t:*Jic • ~ ***** PRISON AIDS PROJECT by Mike Riegel, with tt-anks to [b;t(J\'s ~ Camulity News, 10/11-17/87 bton's Ga~ Camunity News's Prisooer Project is looking for a way to coonect prisooers with AIDS/ARC, or who have t~ted HIV:::i~~ ~ are being treated (isolated) as if trey had AIDS, with people on tt-e outside (es~ially P\!IAs). 'lie IttOJld also"~ to f1 t ~,r """"'r/expertise to p.lt together updates of 1ega 1 decisions and rredica l/housing ;nfort'l\3tion that IttOJ ld be useful for pr1sooerS ~trugg 1119 1"""- he d . \ of thO 'f t'rn or if \)"1 are mterested with ignorance and hysteria in prisons. If you are in a position to gat ran summar1z e any lS ln ~ lUI, ,J-- Pro'ect 62 in being a penpa 1, please sa'ld us a note and as we get our act togett-er, we' 11 IMke serre of these caYlE!Ct10'lS, 00'l pr15(J\er J , Berkeley St., btoo, MA 02116. ~~ ...... *****lkXiclcj:ti I I II*' II I. ~ '***
N:Di GAY and LE
