NetNews Usenet Archive 1992 #31/NN_1992_31.iso/spool/sci/med/aids/2166

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Subject: CDC Summary 12/28/92
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                        AIDS Daily Summary
                         December 28, 1992
 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. Copyright 1992, Information, Inc.,  Bethesda, MD

 "On a Scale of Sorrows" Washington Post (Business) (12/28/92), P. 1
(McKee, Bradford)
     Many people in the Washington, D.C., area have experienced some
sort of setback after their AIDS-infected status was discovered  by
their employers, according to local legal and health care  experts who
track the disease.  Dinah Wiley, legal services  director for the
District's Whitman-Walker AIDS Clinic, said that instances of AIDS-
related bias emerge once or twice a week in the city, and virtually all
cases are settled privately between the  employer and the employee.
Approximately 2,500 people in the  Washington area have AIDS, while
20,000 or more in the city alone may be infected with HIV.  Employees
infected with HIV or AIDS  face pressure because employers experience a
sharp rise in health care costs or have concerns, often misplaced, about
health risks  to co-workers and customers, said experts.  Wiley said in
most  cases, employers deny AIDS-related bias, and take steps against
the employee because of worries about medical insurance costs.   In the
past three years, 17 people in the District have filed  complaints with
the Department of Human Rights alleging AIDS bias by employers.
Regardless of AIDS education efforts, some  employers who act against
employees are motivated more by fear of AIDS than by concern over health
costs.  The Health Insurance  Association of America is encouraging
insurers and policy-holders to deal with AIDS "like any other disease,"
said spokesman Donald White.  The group has supported a proposal
requiring the overhaul of group insurance for smaller employers, in
order to guarantee  health care to all Americans, despite their
conditions.

"Scientists Test 'Cell Therapy' in Fight Against AIDS Tumors" Baltimore
Sun (12/28/92), P. 3A
     A study investigating a procedure known as "cell therapy" will be
conducted this month in San Francisco to test the procedure's  efficacy
in fighting Kaposi's sarcoma.  The study will be the  third and most
extensive trial of cell therapy.  The procedure  involves removing white
blood cells, known as CD8 cells, from the patient's blood.  These are
subsequently isolated and treated  with small doses of Interleuken sII,
a cancer-fighting drug, and  phytohemaglutina, a soybean extract.  The
cells are then  incubated for two to three weeks, during which time they
multiply about tenfold.  Later they are reinfused by the billions into
the patient's bloodstream.  The goal is to use a patient's own cells  to
fight the tumors, and thus encourage the strengthening of an  immune
system that has been weakened by HIV infection.  Applied  Immune
Sciences, the small biotechnology firm in Santa Clara,  Calif., that
developed the procedure, says it has shown good  results in two earlier
tests, and no negative side effects.  The  company hopes the study will
verify cell therapy's effectiveness  against Kaposi's sarcoma and help
create a broad treatment for  AIDS and other immune-system diseases.
Dr. James Kahn, associate director of the AIDS program at San Francisco
General Hospital  and assistant professor of medicine at the University
of  California--San Francisco, is directing the study, which will  test
20 people.  He hopes to introduce preliminary findings from  the study
at the international conference on AIDS in Berlin in  June.

"Volunteers Fill Void for AIDS Patients" Los Angeles Times (12/27/92),
P. B3  (Dennison, Mike)
     A program designed to provide "companion-advocates" for AIDS
patients was started in Grand Junction, Colo.  Many AIDS patients are
shunned by society because they are homosexual or because of  fears of
transmission of the virus, and are often abandoned by  their families
and left with little or no money.   Companion-advocates, such as those
in the Colorado program,  provide friendship and help.  They take
patients to doctor  appointments, help them take their medication, take
them out for  meals, or even go camping with them.  Most importantly, a
program volunteer will remain with a patient until he or she dies.
Program training sessions to become a companion-advocate often  include
listening to local attorneys explaining the legal  implications of AIDS
and doctors fielding questions about the  disease.  Robert Barone, the
program organizer, speaks to school  groups, churches, service clubs, or
anyone who will listen.  He  frequently takes young HIV-positive
patients with him when he  speaks.  Barone has organized four seminars
that have trained 62  volunteers.  A total of 18 people in Grand
Junction who are  infected with HIV have been assigned companion-
advocates, and  Barone wants to train enough volunteers so that at least
three  advocates can be assigned to each AIDS patient who needs help.
While Barone has no shortage of volunteers, he says he still  encounters
ignorance and prejudice about the disease.  He said,  "There are still
people I run into who have no idea we have an  AIDS problem."

"Ill Artists' Effort to Insure That Art Survives AIDS" Washington Post
(12/27/92), P. 1  (Collins, Glenn)
     A New York City program helps artists deal with the painful
question of the future of their works after they die.  Kevin  Oldham, an
HIV-positive composer, said, "It seems to me that  whether you stay
alive or not seems to be the trivial part.  It's your work itself that
must have a life of its own.  If I can make sure that my music will
continue to have life, that seems to be  the more important
consideration."  Oldham has received  assistance from the Estate Project
for Artists with AIDS, which  is encouraging those in every artistic
discipline to catalogue  their works and prepare their estates.
Alliance for the Arts, a  nonprofit arts service and educational
organization based in  Manhattan, sponsors the project.  Patrick Moore,
the project  director, said that while most people hesitate to make
wills,  several artists don't think about their estates until they are
seriously ill.  So far, the project has provided information to  more
than a thousand artists with AIDS, telling them to plan  early while
they are still well.  In addition, it tells them to  document and
inventory works in their own or other's possession,  to execute a will,
and to designate capable and knowledgeable  executors, trustees, and
beneficiaries.  The project was started  in July 1991, and has
disseminated 25,000 estate-planning  brochures to artists' groups, AIDS
service groups, and public  libraries.  The Estate Project refers
artists to various  information and legal resources, in addition to
archives and  service groups like Safe House, a Manhattan-based
repository for  the work of writers who have AIDS and other life-
threatening  illnesses.

"Gay Episcopal Priest Dead of AIDS-Related Disease" United Press
International (12/27/92)
     Boston--The first openly homosexual priest in the Episcopal  Church
has died of AIDS.  After a fight against the disease for  several years,
the Rev. J. Robert Williams succumbed to a  pulmonary infection
Christmas Eve at Beth Israel Hospital in  Boston.  He was 37 years old.
In 1989, Williams was ordained in  New Jersey by Bishop John Spong, the
controversial head of the  church's Newark diocese.  Williams headed The
Oasis, a Hoboken,  N.J., ministry to gay men and women.  He was asked to
resign a  few weeks after his ordination because he said in a speech
that  Mother Theresa, the Nobel-winning Catholic nun, should have sex
and called monogamy as unnatural as celibacy.  Subsequently he  moved to
Provincetown, Mass., where he joined a small  denomination, the Western
Orthodox Catholic Church, and operated  a healing ministry.  He
published one book, "Just As I Am: A  Practical Guide to Being Out,
Proud, and Christian," and was  working on a second book at the time of
his death.

"Selected Behaviors That Increase Risk for HIV Infection, Other
Sexually Transmitted Diseases, and Unintended Pregnancy Among  High
School Students--United States, 1991" Morbidity and Mortality Weekly
Report (12/18/92) Vol. 41, No. 50, P. 945
     A significant percentage of American students engage in behaviors
that simultaneously put them at risk for HIV infection, sexually
transmitted diseases, and unintended pregnancy, write the Centers for
Disease Control.  Data were collected from two school-based components
of the CDC's Youth Risk Behavior Surveillance System: state and local
Youth Risk Behavior Surveys (YRBSs) conducted by departments of
education in 23 states and 10 cities during  April-May 1991 and the
national YRBS conducted during the same  period.  The survey obtained a
sample of 12,272 students  representative of students in grades 9-12 in
the 50 states and  the District of Columbia.  Risk behaviors addressed
in the survey include having sexual intercourse, having sexual
intercourse with multiple sex partners, IV-drug use, not practicing
contraception, and not using condoms.  Among the participants in the
state and  local surveys, 33-79 percent reported ever having had sexual
intercourse; 54-78 percent reported being currently sexually  active;
and 8-46 percent reported having had sexual intercourse  with four or
more partners during their lifetime.  In 27 of the  28 sites, male
students were more likely than female students to  report ever having
had sexual intercourse and having had four or  more sex partners during
their lifetime.  In 26 of 28 sites,  female students were more likely
than male students to report  being currently sexually active.  In all
sites, 5 percent or less of male and female students reported IV-drug
use.  Also, 28-53  percent of participants reported they or their
partner had used a condom at last sexual intercourse, the CDC concludes.

"ADA May Widen HIV Coverage" National Law Journal (12/21/92) Vol. 15,
No. 16, P. 26   (Rumeld, Myron D. and Brook, Richard)
     Health plan sponsors and fiduciaries have resorted to provisions
limiting coverage for certain types of illnesses or treatments in an
effort to control rising costs.  Caps or restrictions on  coverage for
the treatment of AIDS or HIV have become  particularly common despite
the dramatic increase in claims for  HIV-related care and the potential
effect of such claims on the  financial stability of many health plans.
The Americans with  Disabilities Act, designed to prohibit
discrimination against  employees with disabilities, will give claimants
a more effective legal weapon.  But the Employee Retirement Income
Security Act of 1974 (ERISA) gives broad discretion to plan sponsors and
fiduciaries to determine how best to control plan costs.  Plan
fiduciaries may cite policies and considerations that are not  cost-
based when defending plan rules limiting coverage for HIV  treatment.
For instance, some plans deny coverage for the  treatment of drug abuse,
and on that basis might deny coverage  for HIV patients when the
evidence indicates that the virus was  contracted through drug abuse.
The exact impact of the ADA on  rules capping coverage will depend,
however, on the construction  of vague and conflicting provisions of the
statute and its  underlying legislative history.  The ADA does not
directly  prohibit restrictions on HIV coverage, but it may indirectly
do  so by opening the door for state law challenges that until now  have
been considered pre-empted by ERISA.  Until the  uncertainties prompted
by passage of the ADA are resolved by the  courts and the Equal
Employment Opportunity Commission, many  plans are likely to choose
other means of controlling costs.

"Trials Set in High-Risk Populations" Science (12/11/92) Vol. 258, No.
5089, P. 1729  (Cohen, Jon)
     The National Institute of Allergy and Infectious Diseases  recently
announced that it is launching a trial of two preventive HIV vaccines
that will be administered to people considered to be at high risk of HIV
infection in addition to those at low risk.   Small-scale tests of
preventive vaccines, conducted over the past six years, have included
only volunteers from low-risk groups.   The placebo-controlled, Phase II
trial will involve 330  uninfected volunteers at five different
university medical  centers.  The volunteers will include drug users,
people with  sexually transmitted diseases, and minorities.  The test
will  assess whether people at high risk and minorities have different
responses from the healthy whites who dominated the earlier  trials.
NIAID's Patricia Fast, a trial coordinator, said that  some high-risk
uninfected subjects may already have been exposed  to HIV, an exposure
that might have altered their immune systems. Because the new trial will
enroll hundreds instead of dozens of  people, safety problems with the
vaccines are also more likely to emerge.  Both vaccines in the trial are
genetically engineered  versions of the HIV surface protein called
gp120.  It is still  undetermined when a Phase III trial in thousands of
people at  high-risk, which is the most conclusive test of AIDS vaccine
efficacy, will take place.

"New TB Research Facility" Science (12/11/92) Vol. 258, No. 5089, P.
1734   (Holden, Constance)
     A new research center at the Public Health Research Institute, a
private research group in New York City, has been opened to  research
tuberculosis.  The center's president, Lewis Weinstein,  said,
"Multidrug-resistant TB is reaching epidemic proportions."  In fact, in
only 2 years, the number of cases has escalated from  a few dozen to an
estimated 1,000.  What's worse is the disease  is now primarily
affecting HIV-infected individuals who have  depleting immune systems.
Also, it affects these patients  because they often fail to comply with
the full 6 to 9 months of  treatment, the disease often recurs in even
more drug-resistant  forms.  Barry Kreiswirth, a molecular biologist, is
expected to  head the TB center, which will serve as a lab in the
institute's  existing facility.  Private sources will fund the center
with a  budget of $2.5 million over the next three years.  The new
facility hopes to DNA fingerprint TB cultures with the intention  of
developing a large database that will facilitate quick  diagnosis of
different strains and their reactions to different  drugs.  Using
conventional methods, it can take weeks to grow TB  cultures and test
drugs on them.  Weinstein said another goal is  to test different drugs
in the lab, including many currently on  the shelves at pharmaceutical
companies.  In addition, various TB diagnostics will be tested,
including polymerase chain reaction.  The budget of the new program
signifies a sharp increase for TB  research, even though the federal TB
budget this fiscal year is  only $5.4 million.