                     AIDS Daily Summary 
                       August 30, 1994

The Centers for Disease Control and Prevention (CDC) National AIDS
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Copyright 1994, Information, Inc., Bethesda, MD

"Thai Parents Force Children Into Prostitution"
United Press International (08/30/94);  Ehrlich, Richard S.
     Saisuree Chutikul, Thailand's top women's rights activist, says 
that Thai parents often force their children to become 
prostitutes and don't care if they contract AIDS.  More than 
700,000 Thais already are infected with HIV.  United Nations 
officials report that Thailand's increasing infection rate is 
among the fastest in the world.  While Thai Prime Minister Chuan 
Leekpai admits that prostitution is too difficult to control in 
Thailand, he has made a commitment to attempt to stop children 
from being sexually exploited by both natives and foreigners.
      
"The Condom King Curbs Population Growth"
United Press International (08/30/94);  Hail, John
     Meechai Viravaidya, founder and board chairman of the private 
Population and Community Development Association, has been 
credited with making substantial gains in slowing Thailand's 
population growth through the promotion of condoms and other 
family planning methods.  Viravaidya estimates that the 
widespread use of condoms has resulted in a 77 percent decline in
sexually transmitted diseases from 1991 to 1993.  Bangkok, known 
for its sex industry, has seen business decline as much as 60 
percent because of fears resulting from the AIDS epidemic.  
Public health officials estimate that approximately 600,000 Thais
are currently infected with HIV.  Viravaidya says that number 
would have reached between 2 million and 4 million by the year 
2000 if Thailand had done nothing to raise the awareness of the 
disease.  Since the mid-1980s, Viravaidya and his group have been
Thai's leading promoters of AIDS awareness, distributing safe sex
pamphlets throughout the country's red light districts.
      
"Celgene Announces Financial Results for Second Quarter; Chiral Product Revenues Increased for Fifth Consecutive Quarter"
Business Wire (08/29/94)
     Despite the announcement that revenues for the second quarter 
ended June 30 were down from the same period last year, Celgene 
Corp. has made some advances.  For example, the company is poised
to initiate Phase II clinical trials of Synovir, its 
thalidomide-based treatment for cachexia in AIDS patients.  
Findings presented at the Tenth International Conference on AIDS 
in Yokohama, Japan indicated that thalidomide has a positive 
effect on AIDS patients' weight loss.
      
"Mexican Homosexual Granted U.S. Asylum Dies of AIDS"
Reuters (08/30/94)
     The San Francisco law firm of Marc van der Hout announced on 
Monday that Ariel Da Silva, a Mexican native previously known by 
the pseudonym of Jose Garcia, died of AIDS at the age of 36.  Da 
Silva was the first immigrant granted political asylum based on 
persecution due to his homosexuality.  His lawyers said that Da 
Silva's case pushed the American government to review its 
position on persecution of homosexuals.  Attorney General Janet 
Reno has issued a ruling that persecution for sexual orientation 
is grounds for political asylum.
      
"AIDS Chief Promises a Shift Towards Basic Research"
Nature (08/18/94) Vol. 370, No. 6490, P. 494;  Swinbanks, David
     Describing basic research as "the engine that will drive the 
entire AIDS research enterprise forward," William E. 
Paul--director of the Office of AIDS Research at NIH--announced 
that the United States will realign its fight against the disease
to focus on such broad-based research.  He reaffirmed NIH's 
commitment to clinical research, but said it will be redesigned 
to make it "more complete, coherent, and cost-effective."  He 
also appealed to the pharmaceutical industry to help assume the 
financial burden of large phase III clinical trials.  According 
to Paul, the inadequacy of current treatments that target the 
virus itself--such as AZT--are the result of a lack of 
understanding of the virus itself.  A broader approach would be 
adopted to develop new agents that intervene in the 
immunopathogenesis of HIV, as well as to discover new 
methods--like gene therapy--to attack the virus.
      
"U.S. Teens Know the Score, But Take Risks"
Insight (09/05/94) Vol. 10, No. 36, P. 29;  Wetzstein, Cheryl
     High-risk sexual activity between males represents the greatest 
number of AIDS cases among Americans between the ages of 13 and 
21, according to a study by the University of Minnesota Hospital 
and Clinics.  Despite scoring high awareness of AIDS, more than 
60 percent of the 239 young men surveyed continue to participate 
in risky behavior and are at "extreme risk" for exposure to HIV. 
Some teens have a fatalistic view about AIDS, explains Gary 
Remafedi, the study's lead researcher.  They believe they will 
get AIDS, regardless, because they are gay--it is therefore 
useless to struggle against it, he elaborates.  Those who have 
intercourse most frequently are also most likely to use condoms 
inconsistently.  However, it is in the longer-term relationships 
that HIV transmissions take place.  In this situation, partners 
can assume that their lovers are not infected when, in fact, they
are.  Young men, Remafedi adds, also may be hesitant to ask 
partners to use condoms because they are shy, or because they 
don't want to "spoil the mood."
      
"Stavudine (d4T) for HIV"
American Pharmacy (08/94) Vol. 34, No. 8, P. 9
     The FDA has granted approval to Bristol-Myers Squibb's anti-HIV 
drug Stavudine because it was shown to be effective on a 
surrogate endpoint and satisfied an unmet medical need.  Like the
other three approved HIV antivirals, stavudine is a nucleoside 
analog thought to slow the progression of the virus by blocking 
replication.  It is indicated for patients with advanced HIV who 
cannot tolerate or do not benefit from other drugs.  In October 
1992, the FDA made stavudine the first drug to receive "parallel 
track" status, meaning that it became available before approval. 
The predominant side effect reported was peripheral neuropathy 
with symptoms including numbness, tingling, or pain in the hands 
or feet.  The safety of stavudine use has not been investigated 
in elderly patients, children, pregnant women, or women who are 
breast-feeding.
      
"Aiming at AIDS"
American Druggist (08/94) Vol. 210, No. 4, P. 35;  Shannon, 
Jacqueline
     Pharmacists Paul Stephan, Greg Aspacher, Steven Chang, David 
Zeiger, and Steve Bryant were all disturbed by the poor quality 
of pharmacy care received by AIDS patients, and each responded 
separately by developing pharmacies specializing in AIDS 
treatment.  All of these pharmacies maintain information sources 
specifically for AIDS patients.  Some advertise via gay and 
community newspapers or use telemarketing and personal visits to 
doctors, but they all agree that participation in local HIV/AIDS 
service organizations is the best form of promotion.  Specializing 
in AIDS treatment requires a lot of time to sort outside effects 
and potential interactions of the myriad drugs taken by AIDS 
patients.  Stephan points out that the pharmacist of an 
AIDS-specialty practice must be able to put personal prejudices 
aside when dealing with patients.  Profits are not easy, with the
insurance difficulties and reimbursement problems associated with
AIDS cases.  Bryant recommends that no one enter this field with 
the sole intention of making money.  One of the primary benefits 
of pharmacies specializing in AIDS is that because the pharmacist
sees the patients much more frequently than the doctor, he can 
notice both gradual and sudden changes.  The pharmacists are then
able to alert doctors.
      
