                     AIDS Daily Summary 
                      July 18, 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
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Copyright 1995, Information, Inc., Bethesda, MD

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"Efforts to Make Blood Products Safer Tied to Competitive 
 Pressures"
"Study Finds Americans, Europeans Ill Informed on STDs"
 Nurturing a New View on Prenatal AIDS Testing"
"Gays, AIDS and Oral-Sex Risk"
"UCSF Dentists Offer Free Services at the Nation's Biggest Health
 Fair"
"Tuberculosis Knowledge Among New York City Injection Drug Users"
"Treatment of HIV-Associated Kaposi's Sarcoma with Paclitaxel"
"New AIDS Prevention Volume Highlights Innovative Solutions Used 
 in Last Decade"
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"Efforts to Make Blood Products Safer Tied to Competitive 
Pressures"
Philadelphia Inquirer (07/18/95) P. A1;  Shaw, Donna
     According to company documents, executives of Baxter Healthcare 
Inc. decided in 1979 to expedite the company's virus-killing 
research for hemophilia blood-clotting products after they 
learned that a West German firm was close to introducing a 
clotting drug that was heat-treated to kill the hepatitis virus. 
The executives then chose to focus on obtaining regulatory 
approval for a safer product in Germany--where there were 6,000 
hemophiliacs, compared to the United State's 20,000.  The effort 
of designing federally approved products for American 
hemophiliacs should not "in any way slow down or retard 
progress...in the highest priority project of obtaining Germany 
registration," wrote David L. Castaldi, president of Baxter's 
Hyland Therapeutics Division, in a 1982 memo.  These documents 
are part of lawsuit filed in Chicago's U.S. District Court by 
American hemophiliacs against Baxter, three other drug makers, 
and the National Hemophilia Foundation.  The plaintiffs contend 
that the companies did not do enough to keep HIV out of their 
blood products, and that the foundation was too financially 
dependent on industry to be an effective voice.  Last week, the 
Institute of Medicine said that the companies could have 
inactivated viruses in blood products sooner, if there had been 
regulatory or competitive pressure.
      
"Study Finds Americans, Europeans Ill Informed on STDs"
Reuters (07/17/95);  Melnbardis, Robert
     According to a new study by the American Social Health 
Association, most adults in the United States and Europe know 
little about sexually transmitted diseases (STDs) other than 
AIDS.  The survey of nearly 5,000 adults showed that one-third 
could not name an STD besides HIV or AIDS.  "The public awareness
of these infections is very low, and this epidemic in STDs is 
just smoldering in all of these countries," said Peggy Clarke, 
association president.  Clarke said the survey shows that 
increasing public awareness of HIV and AIDS have not facilitated 
open discussions of STDs, noting that embarrassment is the 
largest factor.  Among those who could name an STD other than 
AIDS, the most frequently cited ones were traditional STDs such 
as syphilis and gonorrhea.
      
"Nurturing a New View on Prenatal AIDS Testing"
Boston Globe (07/16/95) P. 71;  Goodman, Ellen
     The federal study concluding that HIV-infected women who took AZT
during pregnancy reduced by two-thirds the risk of HIV 
transmission to their babies has not only changed the odds of 
having a healthy baby, but added weight to the importance of HIV 
testing, writes columnist Ellen Goodman in the Boston Globe.  The
discovery imposes a special moral obligation on a pregnant woman 
to be tested for HIV, Goodman contends.  However, there is still 
an ethical dilemma in requiring her to do so.  The Centers for 
Disease Control and Prevention's Dr. Martha Rogers notes that 
mandating tests only guarantees test results--it does not ensure 
treatment.  The first steps toward testing and treatment should 
be better counseling, reaching out to women, and getting them 
into a trusting relationship with medical care--and this is not a
relationship that can be built by adversaries or force, Goodman 
concludes.
      
"Gays, AIDS and Oral-Sex Risk"
Philadelphia Inquirer (07/15/95) P. A7;  Rotello, Gabriel
     In an article published in the June issue of Harper's magazine, 
Walt Odets, a Calif. psychologist and well-known critic of 
conventional AIDS prevention methods in the gay community, cited 
a study that appeared to support his claim that oral sex without 
condoms is "an extremely safe activity."  According to Odets, the
study followed a cohort of 6,704 gay men in San Francisco and 
found that "in five years there were precisely two infections 
that might be attributable to oral sex.  This represents a 0.0003
percent risk of HIV transmission over five years."  A letter to 
the editor published in the current issue of Harper's, however, 
notes that two out of 6,704 actually yields a 0.03 percent risk. 
Still, Odet's comments leave the impression that only two men 
became infected with HIV via oral sex in five years--a figure 
which is low and misleading.  The study followed only 675 gay 
men.  In addition, Alan Lifson--who published a study of two of 
the participants--said, "Our report was simply a case study of 
two men in whom oral transmission occurred, to indicate that it 
does, in fact, occur."  The best way to way to look at the data, 
notes cohort director Paul O'Malley, is that at least 3 of the 
675 men, or 0.5 percent, were orally infected with HIV.
      
"UCSF Dentists Offer Free Services at the Nation's Biggest Health
Fair"
Business Wire (07/17/95)
     "Su Salud" ("Your Health"), the nation's largest all-volunteer 
health fair, will be held in Stockton, Calif., on July 23.  Among
the participants will be over 50 members of the University of 
California's San Francisco (UCSF) Medical School of Dentistry, 
who will offer free screenings for such conditions as AIDS, oral 
cancer, tuberculosis, and diabetes.  Nelson Artiga, one of the 
fair's coordinators, said that the UCSF volunteers will donate 
about $10,000 worth of services this year, providing dental and 
oral health services.  Other volunteer hospitals, universities, 
and community groups will offer services ranging from cholesterol
screenings to pre-natal exams.
      
"Tuberculosis Knowledge Among New York City Injection Drug Users"
American Journal of Public Health (07/95) Vol. 85, No. 7, P. 985;
Wolfe, Hannah;  Marmor, Michael;  Maslansky, Robert et al.
     Between November 1992 and February 1993, as part of a cohort 
study of HIV infection among injection drug users, Wolfe et al. 
recruited nearly 500 members of New York City methadone 
maintenance treatment programs to assess their knowledge of 
tuberculosis (TB).  More than 30 percent of this group reported 
having tested positive to a tuberculin skin test in the past.  
Almost all subjects identified TB as an airborne infection, and 
more than 50 percent also identified possible indirect methods of
transmission.  Seventy-five percent did not understand the 
difference between infection and active disease, but those who 
reported a history of skin test reactivity were two times more 
likely to comprehend the distinction.  A total of 40 percent of 
those surveyed did not understand the necessity of medication 
adherence.  The majority, however, did understand that TB is 
potentially fatal, and realized that HIV-infected persons are 
more susceptible to it.  The study's authors concluded that these
misunderstandings--which could be the result of faulty TB 
education and overgeneralization of knowledge about HIV--may 
contribute to the fear and confusion that hamper TB control 
efforts
      
"Treatment of HIV-Associated Kaposi's Sarcoma with Paclitaxel"
Lancet (07/01/95) Vol. 346, No. 8966, P. 26;  Saville, M. Wayne; 
Lietzau, Jill;  Pluda, James M.
     Saville et al. conducted a phase II trial to determine whether 
the drug paclitaxel (Taxol), which is active against various 
carcinomas, is effective against AIDS-related Kaposi's sarcoma 
(KS).  The drug's cellular target is similar to that of vinca 
alkaloids, which are active against KS.  Although none of the 20 
patients achieved a complete response, 13 had a partial response.
All six of the patients who had received prior systemic treatment
responded, as did the five with pulmonary Kaposi's sarcoma.  The 
other six remained stable, while just one progressed.  The most 
common dose-limiting toxic effect was neutropenia.  Novel toxic 
effects included late fevers, rash, and eosinophilia.  The 
authors say their findings suggest that paclitaxel is active 
against HIV-associated KS, including in those patients with 
aggressive disease, advanced AIDS, and previous receipt of 
systemic therapy.
      
"New AIDS Prevention Volume Highlights Innovative Solutions Used 
in Last Decade"
Nation's Health (07/95) Vol. 25, No. 6, P. 24
     "AIDS Prevention in the Community: Lessons from the First 
Decade," edited by Nicholas Freudenberg and Mark Zimmerman, 
offers case studies on more than 50 AIDS prevention and service 
programs funded by the Robert Wood Johnson Foundation.  
Freudenberg says the programs were selected based on the 
populations they served and on the innovative community-based 
interventions they provided.  The book offers cases studies of 
such programs as the Hartford Hispanic Health Council, the Los 
Angeles County Public Health Foundation Condom Promotion and 
Distribution Project, and the Southeast Network for Youth and 
Family Services AIDS Prevention for Runaway Youth.  The most 
significant lessons learned, according to Freudenberg, were "the 
importance of tailoring interventions to particular populations;"
including community members in planning and implementing 
programs; and the need to address life circumstances--such as 
drug use and poverty--that affect HIV risk.
      
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