                     AIDS Daily Summary 
                       March 9, 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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"AIDS Virus Found to Form Hybrids"
"Fall in AIDS Cases Endangers Federal Funding"
"The City's Ailing Hospitals"
"Australian Safe Sex Cards Banned"
"Louganis's Big Splash"
"City Paramedic with HIV Placed on Paid Leave"
"AIDS Center Closes Due to Lack of Funds"
"U.S. Epidemiologist Witness at Canadian Inquiry"
"Increases in CD4 T Lymphocytes with Intermittent Courses of 
Interleukin-2 in Patients with Human Immunodeficiency Virus 
Infection"
"Beyond Condoms"
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"AIDS Virus Found to Form Hybrids"
Washington Times (03/09/95) P. A6
     Various strains of HIV coexist in people and produce hybrids more
often than scientists thought, reports a study in the journal 
Nature.  Researchers studied 114 strains of HIV-1 and discovered 
that at least 10 strains appeared to be hybrids, combining 
genetic material from different major subtypes of the virus.  The
finding raises the question of whether a vaccine that works 
against parental strains will also work against their hybrid 
offspring.
      
"Fall in AIDS Cases Endangers Federal Funding"
Washington Times (03/09/95) P. A10;  Roman, Nancy E.
     On Wednesday, Republican lawmakers criticized Health and Human 
Services (HHS) Secretary Donna Shalala for misleading Congress 
about the extent of the AIDS epidemic.  "Why are you telling this
committee about spread and increase when actually AIDS cases are 
decreasing?" asked Rep. Ernest Istook Jr. (R.-Okla.).  He cited a
Feb. 3 report from the Centers for Disease Control and Prevention
that found that AIDS cases decreased by about 20 percent from 
1993 to 1994.  Istook said the full Appropriations Committee may 
reconsider funding for AIDS treatment when it marks up the HHS 
budget in June.  Shalala was before the panel to justify the 
Clinton administration's 1996 budget for HHS, which includes a 
$91 million increase in funding for the Ryan White program.  She 
explained the statistics by noting that "Roughly 40 percent of 
the more than 440,000 cases reported since 1981 were reported in 
1993 and 1994."  Istook said the figure was misleading because 
the definition of AIDS was expanded in 1993 to accommodate women 
and children.
      
"The City's Ailing Hospitals"
New York Times (03/09/95) P. A24
     New York City Mayor Rudolph Guiliani is right to call for a 
fundamental reappraisal of the city's public hospital system, 
write the editors of the New York Times.  In addition to a 
declining quality of care, the hospitals are faced with rising 
costs, and falling state and city aid.  Mayor Guiliani is already
trying to sell three public hospitals and is wondering whether 
the city should sell them all.  His plan is worth exploring, 
write the editors, but only as part of a plan to improve health 
services for the poor--or at least insure that they do not become
worse.  The city may have overlooked the fact that some of the 
public hospitals' difficulties stem from their tradition of 
caring for a portion of the population that nobody else wants as 
patients.  Municipal hospitals have long been a resource for 
Medicaid and uninsured patients who do not feel they can turn to 
private hospitals.  For example, municipal hospitals bear the 
brunt of the care for the homeless, and for AIDS 
patients--particularly children with AIDS.  The people who depend
on the system are not the only ones who must insist that cuts, 
closings, and selling of city hospitals be conducted carefully, 
the editors conclude.
      
"Australian Safe Sex Cards Banned"
Reuters (03/09/95)
     In Sydney, Australia, trading cards issued by a local AIDS 
council depicting naked men performing homosexual acts have been 
ruled pornographic and banned.  Politicians had complained that 
the 24,000 cards--each of which contains a safe sex 
message--could be obtained by schoolchildren.  Queensland AIDS 
Council spokesman Geoff Woolcock said the cards were to be 
distributed only in homosexual nightclubs.  "The adult gay male 
population has very little to do with the school-going population
in this state and we don't believe there would have been any 
exchange of cards to be concerned about whatsoever," he added.  
Another series of 230,000 gay safe-sex trading cards, with 
explicit language but no pictures, will be issued in Victoria.  
Those cards will be distributed in sealed packages that carry 
warnings.
      
"Louganis's Big Splash"
Washington Post (03/09/95) P. D1;  Lichtenstein, Grace
     Greg Louganis' autobiography, "Breaking the Surface," describes a
distressingly callow young man who learned how to deal with his 
wonderful athletic talent, but never learned elementary ethics, 
writes Grace Lichtenstein in the Washington Post.  Although many 
of the diver's problems stem from society's prejudice against 
gays and the world's attitude toward AIDS, he caused many of the 
problems himself.  "It's not my intention to shock anyone, but 
looking objectively at some of what I've lived through, even I 
find parts of my life shocking," Louganis says.  A person's HIV 
status is no one else's business--as long as that person is not 
putting anyone else at risk.  Louganis did not know what the 
chance was of anyone else contracting HIV from his blood.  He 
said that his "denial" of his infection was so strong, and that 
he was so concerned about his career, that he kept silent.  The 
most valuable aspect of the book may be its significance for gay 
youths, says Lichtenstein.  Louganis' message is that you can be 
gay and still become the greatest athlete in your field.
      
"City Paramedic with HIV Placed on Paid Leave"
St. Louis Post-Dispatch (03/08/95) P. 2B
     A paramedic with St. Louis' ambulance service was placed on paid 
leave after it was discovered that he was HIV-positive and did 
not always wear protective gloves while attending patients on the
ambulances.  The paramedic said that whether or not he wore 
gloves depended on the situation.  The paramedic--who returned to
work on Monday after four days of paid leave--has promised to 
wear gloves whenever he tends to a patient.  He will dispatch 911
calls for the ambulance service for 30 days, and will then return
to ambulance duty.  Bob Hardy, EMS acting director, said that 
ambulance workers must wear gloves any time they have patients 
who are bleeding or who have contagious diseases.
      
"AIDS Center Closes Due to Lack of Funds"
Los Angeles Times--Washington Edition (03/08/95) P. B2;  Aubry, 
Erin J.
     Due to a lack of financial support and a shortage of donors, the 
Gathering Place, the only AIDS drop-in center serving the 
primarily black and Latino South-Central population of Los 
Angeles, closed last week.  Founded in 1990, the center was 
somewhat of an oasis for people with HIV or AIDS who also dealt 
with poverty, homelessness, prison records, and unemployment, 
said Director Graciela Morales.  The Sisters of St. Joseph 
Ministerial Services, which founded and operated the center, 
decided the Gathering Place was not receiving enough outside 
financial support to remain operational.  Morales said the 
decision was too sudden and insisted that there were healthy 
prospects of keeping the center open.  There were three private 
and state grants totaling $250,000 pending, and Morales said she 
was applying for more.  Morales plans to open as an independent 
nonprofit agency in the same location within a month.
      
"U.S. Epidemiologist Witness at Canadian Inquiry"
Toronto Globe and Mail (03/07/95) P. A4
     The first witness in the final stage of the $13.5 million 
judicial inquiry into Canada's blood system will be Dr. Donald 
Francis, a former epidemiologist at the U.S. Centers for Disease 
Control and Prevention.  Francis has been one of the most acerbic
critics of governments' slow response to the AIDS epidemic.  In 
his interim report last month, Mr. Justice Horace Krever, who is 
heading the commission of inquiry, warned that the tainted blood 
tragedy could be repeated with a new contaminating agent.  He 
said that changes are necessary to "minimize the likelihood of 
such a calamity."  The final report, to be completed by the end 
of the year, will examine the decisions that led to the infection
of more than 1,000 Canadian hemophiliacs and transfusion 
recipients with HIV during the early 1980s.  The commission's 
final report will also recommend a complete revamping of the 
blood system.
      
"Increases in CD4 T Lymphocytes with Intermittent Courses of 
Interleukin-2 in Patients with Human Immunodeficiency Virus 
Infection"
New England Journal of Medicine (03/02/95) Vol. 332, No. 9, P. 
567;  Kovacs, Joseph A.;  Baseler, Michael;  Dewar, Robin J. et 
al.
     To determine the value of intermittent courses of interleukin-2 
for the long-term management of HIV infection, Kovacs et al. 
focused on HIV-infected patients with a moderate suppression of 
the immune system.  Based on previous work, such patients are 
more likely to have a response to immunomodulators than patients 
with severely impaired immune function.  Twenty-five patients 
received interleukin-2 for five days every 8 weeks during a 
period of seven to 25 months.  In addition, all patients received
at least one antiviral agent.  Therapy with interleukin-2 was 
linked to at least a 50 percent increase in the number of CD4 
cells in six of the 10 patients with CD4 counts higher than 200. 
For the remaining 15 patients, who had CD4 counts of 200 or less,
interleukin-2 therapy was associated with increased viral 
activation, few immunologic improvements, and significant toxic 
effects.  Kovacs et al. concluded that intermittent interleukin-2
therapy can reverse some of the immunologic abnormalities 
associated with HIV infection in patients with CD4 counts above 
200.
      
"Beyond Condoms"
Advocate (02/21/95) No. 675, P. 80;  Rotello, Gabriel
     The Victorian AIDS Council/Gay Men's Health Centre of Australia 
has begun promoting the idea that gay couples can choose not to 
wear condoms if they observe specified guidelines.  The 
organization outlines eight steps a couple should follow to 
decide whether to use condoms.  The first step is to decide 
whether having sex without condoms is important to both members. 
The main body of the message is aimed at couples in which both 
partners test HIV-negative twice.  They proceed to step five, 
which involves both partners promising not to have unsafe sex 
outside the relationship.  The approach of either using a condom 
every time, with every partner, or adopting a more complex set of
rules that requires negotiation, honesty, trust, and maturity has
yet to be adopted officially by any AIDS group in the United 
States.  Critics note that many men who desire condomless sex 
lack the maturity, skills, or responsibility to follow such 
emotionally complex steps.
      
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