                     AIDS Daily Summary 
                      August 21, 1995

The Centers for Disease Control and Prevention (CDC) National AIDS
Clearinghouse makes available the following information as a public
service only. Providing this information does not constitute
endorsement by the CDC, the CDC Clearinghouse, or any other
organization. Reproduction
of this text is encouraged; however, copies may not be sold, and
the CDC Clearinghouse should be cited as the source of this
information. Copyright 1995, Information, Inc., Bethesda, MD

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"As Theater Turned Disco Faces Demolition, Gay Alumni Share 
 Memories"
"The Doctor Is in to Cure District's Jail"
"Ethiopian AIDS Victim Thrown Off Egyptian Flight"
"AIDS Fear in Niger Causes Blood Shortage"
"Bill Offers a Hope to Inmates with AIDS"
"Prostitution Could Lead to Vietnam AIDS Surge"
"Medicaid AIDS Coverage Unfair; Not Likely to Change"
"A Comparison of Immediate with Deferred Zidovudine Therapy for 
 Asymptomatic HIV-Infected Adults with CD4 Cell Counts of 500 or 
 More per Cubic Millimeter"
"Mixed Results with Octreotide for AIDS-Related Diarrhea"
"The Lady Is a Champ"
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"As Theater Turned Disco Faces Demolition, Gay Alumni Share 
Memories"
New York Times (08/21/95) P. B3;  Dunlap, David W.
     For some, the Saint discotheque--which is slated to be
demolished next month--represents the peak of gay life in New York
City during the early 1980s.  The Saint opened in September 1980
with a crowd of several thousands of men dancing on the 
4,800-square-foot oak floor.  Within months, however, many of 
them began to die from a disease, not yet called AIDS.  "People 
called it the 'Saint's disease' because everybody who got it 
seemed to be among the guys who danced all night at that popular 
disco," wrote Randy Shilts in his book "And the Band Played On." 
Now, 15 years later, the Saint's alumni are remembering not drugs
or the sex, but the refuge they took from a hostile world in this
fantasy place prior to the AIDS epidemic.  "We didn't know we 
were dancing on the edge of our graves," said Rodger McFarlane, 
who later became the executive director of the Gay Men's Health 
Crisis.  "It was the headiest experience I've ever had in my 
life."  The club closed in 1988, reopened briefly one year later,
and is now scheduled to be replaced by a seven-story apartment 
building.
      
"The Doctor Is in to Cure District's Jail"
Washington Post (08/21/95) P. B1;  Locy, Toni
     Dr. Richard M. Shansky is going to prison to better understand

the District of Columbia's jail.  Shansky is the newly appointed 
receiver for the much-criticized medical and mental health 
services for inmates.  He will earn $175 an hour, but his monthly
salary can reach no higher than $16,500.  U.S. District Court 
Judge William B. Bryant seized control of the services in July 
after a court-appointed monitor detailed the last hours of an 
imprisoned man who had AIDS.  The man died while tied to a 
wheelchair with a urine-soaked sheet.  He was so weak that he 
could not walk to the toilet on his own and was ignored for days 
by the jail staff, who did want to go to his cell because of the 
odor.  In addition to medical services, Shansky's other main task
is to investigate the issue of inmate suicides at the D.C. jail.
      
"Ethiopian AIDS Victim Thrown Off Egyptian Flight"
Reuters (08/20/95)
     A maid who was being deported by Egyptian authorities because
she was infected with HIV could not return home to Ethiopia because
her fellow passengers would not let her on the flight.  According
to airport officials, passengers on the EgyptAir flight to Addis 
Ababa recognized Mariam Mesaret because of the publicity she had 
received upon being arrested for being infected.  They refused to
sit near her, and the flight captain asked the authorities to 
take her off the plane.  The officials report that Mesaret was 
then returned to a hospital.
      
"AIDS Fear in Niger Causes Blood Shortage"
Reuters (08/19/95)
     In 1995, more than 20 women have died at Niger's largest 
maternity hospital because the fear of AIDS has caused a severe 
shortage at the blood bank.  "The maternity is still facing 
difficulties because it gets its supplies from the blood bank at 
the Niamey national hospital, which is also suffering from a 
serious shortage," said the hospital's chief doctor Zeinabou 
Moumouni.  She added that people are afraid to donate blood for 
fear of contracting HIV.  "There is a real need for information 
and greater public awareness," she noted.  Between 1987 and 1994,
there were nearly 1,700 cases of AIDS registered in Niger, which 
has more than 8 million citizens.  Some predict the total will 
rise to 8,700 by 1998.
      
"Bill Offers a Hope to Inmates with AIDS"
Boston Globe (08/18/95) P. 1;  Dowdy, Zachary R.
     Massachusetts legislators are considering a bill that would
grant medical parole to AIDS patients and other terminally ill 
individuals in state and county facilities.  The measure passed 
the state Senate, and is expected to reach the House this fall.  
A spokesman for the Massachusetts Department of Correction said 
that in 1994, 19 state inmates died of AIDS-related causes.  
Statistics on voluntary testing indicate there are at least 416 
HIV-infected inmates, but prisoner advocates say there are many 
more infected prisoners who do not want to be tested for fear of 
other inmates' reactions.  State Sen. James P. Jajuga 
(D-Methuen), who co-sponsored the bill, said it is designed to 
give parolees at least several days at home before their deaths. 
Inmates who are diagnosed with six months left to live may apply 
for early parole, although first-degree murderers may not.
      
"Prostitution Could Lead to Vietnam AIDS Surge"
Reuters (08/18/95)
     A Vietnamese official said on Friday that increasing
prostitution could result in a surge of AIDS cases in the country. 
"It is not sure that we will be able to control the situation,"
said the official, a member of the National AIDS Protection
Committee. The official said that although 80 percent of those who
are infected with HIV are drug addicts and just 3.7 percent are 
prostitutes, the number of prostitutes is increasing.  However, 
under new rules, the committee can only take blood from 
volunteers, so it will be more difficult to have exact figures.  
Authorities report that there have been 70 AIDS-related deaths in
Vietnam.  A total of 231 people have been diagnosed with AIDS, 
and nearly 3,000 others in the country are HIV-positive.
      
"Medicaid AIDS Coverage Unfair; Not Likely to Change"
AIDS Alert (08/95) Vol. 10, No. 8, P. 103
     According to two new studies published in the journal Health
Care Financing Review, many state Medicaid programs should end
their unjust limitations on health care coverage for the
approximately one out of two AIDS patients who rely on the program.

Congress is preparing to shift the $90 billion federal part of the
$158 billion total projected for this year's program into block
grants to the states.  "Payment methods that establish
predetermined, fixed payments can discourage hospitals from
admitting Medicaid recipients needing expensive care, such as
patients with AIDS, said the authors of one study.  The study
determined that in 1992, 12 out of the 42 states that responded to
the authors' questionnaire had some kind of yearly utilization cap
on Medicaid patients' inpatient hospital care.  A second study
found that "utilization limits, copayments, and off-label-use and 
prior-authorization policies in many states weaken the drug 
benefit available."  As a solution, the authors propose creating 
a national advisory panel of AIDS medical experts that would help
the programs determine what drugs are considered standard 
treatment for HIV and AIDS care.  In the meantime, the AIDS 
Healthcare Foundation of Los Angeles has established the first 
full-service, managed care program for Medicaid recipients who 
have AIDS, and recently signed a $26 million contract with 
California to provide care for 1,000 AIDS patients on the 
California Medicaid Program.
      
"A Comparison of Immediate with Deferred Zidovudine Therapy for 
Asymptomatic HIV-Infected Adults with CD4 Cell Counts of 500 or 
More per Cubic Millimeter"
New England Journal of Medicine (08/17/95) Vol. 333, No. 7, P. 
401;  Volberding, Paul A.;  Lagakos, Stephen W.;  Grimes, Janet 
M. et al.
     To assess the clinical benefits of zidovudine in asymptomatic
HIV patients who have CD4 counts greater than 500, Volberding et
al. compared immediate zidovudine therapy to deferred therapy in
such patients.  The participants were randomly assigned either 
zidovudine or a placebo, though the study was modified with 
open-label treatment two years later for those people whose CD4 
levels fell below 500.  After 6.5 years, there was no significant
difference in AIDS-free survival or overall survival in the 
deferred-therapy group, compared to the low-dose or high-dose 
group of zidovudine.  However, the two immediate therapy groups 
did experience a slower decrease of CD4 cells than the deferred 
group.  Although side effects were rare, the high-dose zidovudine
group experienced more severe anemia and granulocytopenia than 
the deferred group.  The researchers concluded that zidovudine 
slows the decline of CD4 cells in symptom-free, HIV-infected 
adults with more than 500 CD4 cells, but does not extend either 
AIDS-free or overall survival.  The results, therefore, do not 
necessarily justify the standard use of zidovudine monotherapy in
this group.
      
"Mixed Results with Octreotide for AIDS-Related Diarrhea"
AIDS Clinical Care (08/95) Vol. 7, No. 8, P. 68
     A multicenter study of the somatostatin analogue octreotide
for the treatment of diarrhea produced mixed results.  Nearly 130 
AIDS patients were given octreotide or a placebo subcutaneously 
three times a day.  After 21 days, 46 percent of the octreotide 
group had achieved the goal of a 30 percent decrease in stool 
weight, compared to 36 percent of the placebo group.  The two 
groups had similar reductions in bowel-movement frequency.  
Although patients with idiopathic diarrhea--diarrhea lasting more
than 13 weeks, body weight under 60 kg, or CD4 levels below 
50--showed a better response to the treatment, the differences 
between the two groups remained nonsignificant.  During the 
open-label phase, the octreotide dose was increased, and after 
eight weeks, both stool weight and bowel-movement frequency 
decreased significantly.  Even though the results of the 
controlled study were disappointing, the open-label results 
indicate that longer-term treatment at higher doses could be 
effective.
      
"The Lady Is a Champ"
POZ (08/95-09/95) No. 9, P. 44;  Mason, Kiki
     Actress, lawyer, and activist Ilka Tanya Payan bears little 
resemblance to the spitfire who captured the media's attention in
October 1993, when she announced that she had AIDS.  The star of 
a popular telenovela, or Spanish-language soap opera, Payan has 
been described as Latin America's Susan Lucci.  She also had been
a successful immigration attorney who wrote a weekly column on 
immigration issues in El Diario/La Prensa, the largest 
Spanish-language daily in the United States, and had established 
a program at Gay Men's Health Crisis to help immigrants with 
AIDS.  Today, Payan is quiet and restrained, the result of 
repeated infections that have taken their toll.  Payan keeps 
busy, though, with such activities as appearing in a closed 
circuit television program in the New York City school system and
raising funds for an AIDS hospice in Puerto Rico.  Her thoughts 
also turn to Ilka's Angels, a group of young Latina women who 
have formed an activist group about women's health issues.  Payan
refuses to direct the group, explaining, "My role is to try and 
activate people's heads, and the way that I do that is by saying 
health is a political issue.  Then it's up to them to do whatever
with the information."
      
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