                      AIDS Daily Summary
                       August 15, 1996
     
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"Payments to Hemophiliacs With AIDS Are Cleared"
"New Treatments Put AIDS Programs in a Dilemma"
"Plan to Move Medicaid Recipients Into Managed Care Gains" 
"Across the USA: Kentucky"
"Tax Change Could Make Life Easier for Chronically Ill"
"UPI Science News: [Oral Sex Not Safe Sex, Researchers Warn]" 
"India--AIDS: Women Are Captive Partners"
"HIV Trends Reported for China"
"Changes in Sexual Behavior and a Decline in HIV Infection Among 
Young Men in Thailand"
"Blind in Rangoon"
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"Payments to Hemophiliacs With AIDS Are Cleared" 
Wall Street Journal (08/15/96) P. B5
     American hemophiliacs who were infected with HIV through
tainted blood products between 1978 and 1985 would receive $100,000
each under a settlement with four pharmaceutical companies. 
Federal District Judge John F. Grady tentatively approved the 
settlement between the patients and Bayer, Baxter International, 
Rhone-Poulenc Rorer's Armour Pharmaceutical, and Alpha Therapeutic,
a unit of Japan's Green Cross Corp.  Family members and survivors 
are eligible to participate in the settlement, which was originally
planned as a $640 million fund. The companies have now agreed, 
however, that if more than the expected number of people sign up 
for the settlement, the fund could increase.  Between 6,000 and 
10,000 U.S. hemophiliacs are estimated to have been infected with 
HIV through the contaminated blood products.
     
"New Treatments Put AIDS Programs in a Dilemma" 
Washington Post (08/15/96) P. A1; Goldstein, Amy
     AIDS patients in Washington, D.C., are being told they can no 
longer apply to receive drugs from the city's AIDS Drug 
Assistance Program (ADAP) due to the high demand for promising 
new treatments.  The problem is similar in states across the 
country, as funding for the federal program is being depleted.
ADAP provided AIDS drugs for 65,000 uninsured and poorly insured 
patients last year, about one out of ten people with HIV.  The 
number of drugs provided under the program has doubled since last 
year and more HIV-infected patients and their doctors are 
electing to start treatment sooner, often with a combination of 
drugs.  As a result, the programs are starting to restrict 
enrollment, the drugs they offer, or both.
     
"Plan to Move Medicaid Recipients Into Managed Care Gains" 
New York Times (08/15/96) P. B1; Rosenthal, Elisabeth
     A plan by New York State to move most of its 3.5 million
Medicaid recipients into managed care plans could be implemented by
the end of the year, officials said Wednesday.  The move was 
advanced by an announcement from the federal government of the 
terms under which it would approve the plan.  Under the new plan, 
all Medicaid recipients who are not in nursing homes would receive 
their care through health maintenance organizations.  The 
conditions set down by the Health Care Financing Administration 
would require the state to slow down the move to managed care and 
to create special plans for patients with serious illnesses like
AIDS.
     
"Across the USA: Kentucky"
USA Today (08/15/96) P. 15A
     In Kentucky, a program to be launched in September will
provide promising but costly new AIDS drugs to approximately 30 
indigent AIDS patients.  The drug combinations cost up to $15,000 
per year for each patient.
     
"Tax Change Could Make Life Easier for Chronically Ill" 
Wall Street Journal (08/15/96) P. C1; Asinof, Lynn
     Pending legislation could make it easier for people with
chronic or terminal illnesses to use payments from the sale of
their life insurance policies to meet their health care needs.  The
policy change would exempt from federal income tax both the
acceleration of death benefits and the money received from the sale
of those benefits.  To be eligible, patients must have a chronic
illness or be expected to live less than two years.  The practice
of selling one's life insurance, now used mostly by AIDS patients,
may become more popular.  The new policy is also expected to make
the viatical settlement industry more accepted.
     
"UPI Science News: [Oral Sex Not Safe Sex, Researchers Warn]" 
United Press International (08/14/96); Smith, Michael
     Even people who practice relatively safe sex are contracting
HIV, researchers reported Wednesday in the Annals of Internal 
Medicine.  Timothy Schacker of the University of Washington, and 
colleagues found that in a study of 46 people, almost half said 
they had sexual contact with only one partner in the month before 
their infection was detected.  Oral sex, widely thought to be 
less risky than other sexual contact, was the most common form of 
sex among the participants.  For four patients, the researchers 
were able to determine that oral sex was the route of 
transmission.  Researchers reported in June that rhesus monkeys 
could be orally infected with a virus similar to HIV and 
cautioned that oral sex is not necessarily safe sex.
     
"India--AIDS: Women Are Captive Partners" 
IPS Wire (08/14/96) 
     In India, where HIV is spreading rapidly, an increasing number
of women are infected by their husbands and passing the virus on to
their children.  A 1995 government study at J.J. Hospital found 
that 3.5 percent of pregnant women under the age of 20 were
HIV positive, while 2.5 percent over age 20 were also infected.  
At Mumbai's Wadia Maternity Hospital, 3,800 female homemakers 
have been tested for HIV in the last three years, and 1 percent 
have tested positive.  Infants are also tested and followed for 
15 months.  AZT is available to mothers who can afford the drug. 
According to the study, women in India are especially vulnerable 
to infection because they do not have the social standing to 
insist on protection.
     
"HIV Trends Reported for China"
Reuters (08/14/96) 
     HIV is spreading from the rural areas of the Yunnan Province
to urban cities, researchers report.  Elena S. H. Yu of San Diego 
State University and colleagues found that, from 1985 to 1994, 
intravenous drug use was the main route of HIV transmission in 
China.  The opium link between the Yunnan and neighboring 
Myanmar, Laos, and Vietnam--as well as the high level of drug use
and unprotected sex--was blamed.  The researchers say the virus
is expected to spread through heterosexual transmission in other
areas of China.

"Changes in Sexual Behavior and a Decline in HIV Infection Among
Young Men in Thailand"
New England Journal of Medicine (08/01/96) Vol. 335, No. 5; P.
297; Nelson, Kenrad E.; Celentano, David D.; Eiumtrakol, Sakol;
et al.
     To combat the spread of HIV in Thailand, where the virus has 
spread rapidly since it was first reported in 1988, the Ministry 
of Public Health implemented a program to promote condom use 
among sex workers in 1990 and 1991.  Dr. Kenrad E. Nelson, of 
Johns Hopkins University, and colleagues, studied the effect of 
this and other programs to curb the spread of the virus, testing 
and interviewing five groups of 21-year-old men who were 
conscripted into the army by a lottery in 1991, 1993, and 1995.  
The researchers report that the prevalence of HIV infection was 
10.4 percent in the 1991 group and 12.5 percent in the 1993 
group.  In 1995, the rate decreased to 6.7 percent.  For those 
men who did not have sexual relations with a sex worker before 
1992, the rate of infection was only 0.7 percent.  Throughout the 
study, the proportion of men who reported having sexual relations 
with a sex worker decreased from 81.4 percent to 63.8 percent, 
while the rate of condom use during commercial sexual contact 
increased from 61 percent to 92.5 percent.  The authors call the 
success of the condom campaign unprecedented and compare it to 
the change in behavior among homosexuals in the United States in
the early 1980s.
     
"Blind in Rangoon"
Far Eastern Economic Review (08/01/96) Vol. 159, No. 31; P. 21; 
Noung, Bertil; Noung, Hseng
     In northern Burma, where the estimated number of HIV
infections is between 350,000 and 400,000, many of the infected 
individuals are drug addicts and prostitutes returning from 
Thailand.  The disease is widespread in Burma's prisons, where 
heroin is available but disposable syringes are not, and 
homosexuality is common.  Furthermore, the military establishment
in Rangoon has failed to implement measures to curb the epidemic
and has not allowed foreign non-governmental organizations to help.
An estimated 60 percent to 70 percent of all intravenous drug users
in Burma are infected with HIV, according to the United Nations 
International Drug Control Program.  Heroin production in the 
country is increasing, and while most of the drug is exported, it
is also sold locally throughout the country.  The Southeast Asian 
Information Network blames the authorities for the spread of the 
disease, saying the government is either unable to control the
heroin market or is involved in making the drug available.  The
sex industry has also fueled the epidemic, and local officials
estimate that 80 percent of women entering the sex trade will
eventually become infected with HIV.
