                     AIDS Daily Summary 
                      August 19, 1996
     
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 National AIDS 
Clearinghouse, or any other organization. Reproduction of this 
text is encouraged; however, copies may not be sold, and the CDC 
National AIDS Clearinghouse should be cited as the source of this 
information. Copyright 1996, Information, Inc., Bethesda, MD
     
     
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"Across the USA: Indiana"
"Understanding the Kassebaum-Kennedy Health Coverage Bill" 
"AIDS Agency's Message Questioned Over Drug Use at Fire I. 
Fund-Raiser"
"D.C.'s Spreading Tuberculosis Problem" 
"A Step Toward 'Classism and Sexism'" 
"Patients in Britain Face AIDS Risk" 
"Life Expectancy Shortened in Uganda"
"Youths at High Risk for HIV Report Consistent Condom Use" 
"Montreal Needle-Exchange Surprise"
"Editorial: Time to End the Death Trials" 
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"Across the USA: Indiana"
USA Today (08/19/96) P. 8A
     More women have HIV or AIDS in northwestern Indiana than in
any other part of the state, the state Department of Health 
announced.  Lake County has the highest incidence, with 128 
cases, or 51.7 cases per 100,000 women.
     
"Understanding the Kassebaum-Kennedy Health Coverage Bill" 
Washington Post (08/19/96) P. A13; Skidmore, Dave
     In a question and answer format, the Washington Post details
provisions of the health insurance bill recently passed by 
Congress.  Among them is a change in policy for people who are 
chronically or terminally ill.  The new bill would allow such 
patients tax deductions for the cost of long-term care, at home 
or in a nursing home, and would allow penalty-free IRA 
withdrawals for medical expenses exceeding 7.5 percent of income. 
In addition, the revenue terminally ill patients receive for 
selling a life insurance policy would be tax-exempt, and 
chronically ill patients would be able to cash in or sell a 
policy to pay for long-term care.
     
"AIDS Agency's Message Questioned Over Drug Use at Fire I. 
Fund-Raiser"
New York Times (08/17/96) P. 22; Dunlap, David W.
     The Morning Party, an annual gay dance held at Fire Island
Pines on the Atlantic's edge, is a popular fundraising event 
which raises hundreds of thousands of dollars for the Gay Men's 
Health Crisis (GMHC).  Critics say the group, an important 
private AIDS service organization, should not be involved in the 
event because the rampant drug use at the party often leads to 
unsafe sex.  Leaders of the GMHC defend the organization's link 
to the party, and say some of the benefits of the fund-raiser 
even helped launch a substance-use counseling and education 
program. The group also said drug use at the party is not 
condoned.
     
"D.C.'s Spreading Tuberculosis Problem"
Washington Post (08/18/96) P. C8; Schiraldi, Vincent; May, Mary 
Elizabeth
     The conditions of Washington, D.C.'s prisons are conducive
to the spread of tuberculosis (TB) and pose a public health 
threat, claims Vincent Schiraldi, executive director of the 
District's Center on Juvenile and Criminal Justice, in a 
Washington Post letter to the editor.  Schiraldi argues that the 
negative impact of the city's high incarceration rate and the poor 
medical care of inmates outweighs any benefit of incarceration.  
In a second letter to the editor, Mary Elizabeth May, a student of 
public health at George Washington University, criticizes the 
District's public health system for its poor response to the 
city's TB crisis.  Most of the city's TB patients are prisoners 
and homeless people, she says, and the disease should therefore be 
monitored and treated through related channels.  She notes that 
the city's TB bureau must use creativity and flexibility to reach 
the homeless TB-infected population.
     
"A Step Toward 'Classism and Sexism'" 
Washington Post (08/17/96) P. A24; Lin, David
     In a letter to the editor of the Washington Post, David Lin 
argues that the mandatory HIV testing of newborns can lead to 
classism, sexism, and discrimination against mothers found to 
have HIV and AIDS.  He claims that the women who can afford to be 
denied health insurance and employment because they are found to 
have HIV will still be able to afford to support themselves, but 
poor mothers will face financial hardships.  Lin suggests that 
the fathers of newborns also be tested, as well as other members 
of the population who may be at risk.
     
"Patients in Britain Face AIDS Risk" 
Xinhua News Agency (08/18/96) 
     Thousands of British patients are at risk of contracting HIV
and hepatitis from tainted blood products, the government's 
Medicines Control Agency reported following a spot-check of the 
country's blood centers.  The agency said that equipment for 
screening blood for the viruses is not being properly maintained, 
blood is not being properly labeled, and blood packs are neither 
being kept sterile nor being stored at the correct temperature. 
Simon Hughes, the Liberal Democrat health spokesman, called for 
an inquiry into the National Blood Authority, calling the 
situation "a life or death issue."
     
"Life Expectancy Shortened in Uganda" 
Xinhua News Agency (08/18/96) 
     AIDS has caused the life expectancy in Uganda to decrease
from 45 years in 1993 to 37 years now, Popcare's Sam Ruteikara 
reports.  The increase in HIV infections, he said, caused the 
average age at death to be 27 for women and 30 for men, he said. 
In his report, titled "AIDS: A Challenge to Church Ministry and 
National Development," Ruteikara said that the lower average 
dying age, combined with the higher number of infants being born 
with HIV, resulted in the life expectancy of 37 years.  The total 
number of Ugandans infected with HIV is estimated at 2 million, 
representing 10 percent of the population.
     
"Youths at High Risk for HIV Report Consistent Condom Use" 
Reuters (08/16/96) 
     A survey of African-Americans aged 12 to 21 found that a
sizable proportion reported consistent condom use for at least a 
six-month period, and many for a one year period.  Ralph J. 
DiClemente, of the University of Alabama at Birmingham, and 
colleagues concluded that youths "who perceived peer norms as 
supporting condom use...had greater impulse control...were 
male... and were younger...were more likely to report consistent 
condom use."  DiClemente suggested that HIV and sexually 
transmitted disease prevention programs be timed to precede the 
development of high-risk behaviors.
     
"Montreal Needle-Exchange Surprise"
Lancet (08/03/96) Vol. 348, No. 9023; P. 324
     A study of nearly 1,600 injection drug users in Montreal
found that those who participated in the city's needle exchange 
program had a greater chance of becoming infected with HIV than 
those who did not participate.  According to researchers at McGill 
and Montreal universities, the drug users who took part in the 
needle exchange had a 33 percent cumulative probability of HIV 
seroconversion, versus 13 percent for drug users who did not 
participate.  There was no known explanation for the unusual 
findings, which according to researcher Julie Bruneau, were 
"substantial and consistent...despite extensive adjustment for 
confounders."
     
"Editorial: Time to End the Death Trials"
AIDS Treatment News (08/02/96) No. 252; P. 1; James, John S.
     In an editorial, John S. James, editor of AIDS Treatment 
News, argues that the Food and Drug Administration's standards 
for clinical trials to test new antiretroviral drugs should be 
changed in light of the greater credibility of viral load tests.  
James says that the clinical trial system does not give 
physicians useful data for treating their patients.  Currently, 
drugs can be approved under "accelerated approval" based on 
easily observed evidence of disease status, provided the drug 
company agrees to complete larger and longer trials which assess 
a drug's efficacy based on "clinical endpoints" such as death or 
disease progression.  This standard requires unnecessary 
financial cost and a high number of deaths to prove that a 
treatment, which is already being used widely, is effective, 
James contends.  He also points out the ethical conflicts 
inherent in the system, in which trials are designed with the 
assumption that one drug will probably work better than another.  
James suggests that several smaller trials would be more useful 
to doctors, by providing information, for example, about the 
drug's endurance, how combinations affect effectiveness, and the 
safety of the drug for people with medical complications, 
children, or other populations.
     
