AIDS Daily Summary December 31, 1996 The CDC National Center for HIV, STD, and TB Prevention makes available the following information as a public service only. Providing this information does not constitute endorsement by the CDC. 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 ****************************************************** "U.S. Will Issue Warnings on Medical Marijuana Laws" "Doctors Criticize Move Against State Measures" "AIDS Alert Posted for Nicaragua" "Straight Talk for Survival" "AIDS and Comfort" "Across the USA: Missouri, Vermont" "With New Drugs, Hope Finally Dawns" "Health Notes: Controversial AIDS Vaccine" "Cambodian Blood Supply Tainted by Demand" "Health Emergency 1997: The Spread of Drug-Related AIDS Among African Americans and Latinos" ****************************************************** "U.S. Will Issue Warnings on Medical Marijuana Laws" Washington Post (12/31/96); Suro, Roberto Letters warning of sanctions will be sent to doctors, federal contractors, and others who invoke new laws in California and Arizona that permit the use of marijuana for medical purposes, the Clinton administration announced Monday. The plan calls for publicizing federal drug laws but does not propose any new legislation, deployments of law enforcement officers, or a legal challenge of the new laws. The administration warned that doctors who prescribe the drug risk losing their federal registration that allows them to write prescriptions. The administration contends that no scientific evidence has shown the benefit of marijuana, but Secretary of Health and Human Services Donna E. Shalala said, "The National Institutes of Health will continue to review the claims about the possible benefit of smoke marijuana for a small number of indications." The AIDS advocacy group ACT-UP has filed a ballot initiative in Washington, D.C., that is similar to the California measure. "Doctors Criticize Move Against State Measures" New York Times (12/31/96) P. D18; Wren, Christopher S. The Clinton administration's decision to target doctors who prescribe marijuana under two new state laws brought criticism from several doctors who say the action violates their right to decide what is best for their patients. "Now the federal government is entering the practice of medicine, placing itself in the physician's office between the doctor and patient," said David C. Lewis, director of the Center for Alcohol and Addiction Studies at Brown University. Other physicians say the administration's actions block any hope for research into the medical benefits of marijuana. White House drug chief Gen. Barry R. McCaffrey, however, said that "without question, the door is open to examine any drug" including marijuana, that would benefit American medicine. He added that such research must meet scientific standards. "AIDS Alert Posted for Nicaragua" Miami Herald (12/30/96) P. A13 The relatively low rate of AIDS in Nicaragua may be increasing, as prostitution rises amid widespread ignorance about the disease, AIDS activists warn. "Nobody here thinks of AIDS prevention, and that is dangerous. The numbers could rise very soon, very rapidly," said Dr. Alejandro Sanchez of the United Nations Development Program in Nicaragua. "Straight Talk for Survival" Financial Times (12/31/96) P. 8; Wrong, Michela In Uganda, where an estimated one in 10 people are infected with HIV, a campaign of openness against the disease has led to dramatic declines in new infections. Condoms are distributed freely and testing is available at no charge. Sex and AIDS are discussed in newspapers, on billboards, and in other media. The decline in HIV first became evident in 1993, and has continued. The HIV rate among women aged 15 to 19, for example, fell from 16.9 percent in 1991-1992 to 11.3 percent in 1993-1995. Studies show a radical change in sexual behavior, with people having fewer casual partners, using condoms, and delaying the start of sexual activity. "AIDS and Comfort" Miami Herald (12/30/96) P. 3B; Ifateyo, Ajowa In Broward County, Fla, grandmothers who are called on to care for their grandchildren after their children die of AIDS have formed the Family CARES Network. Members meet once a month for support, as well as to share food, clothing, and medical supplies. They also organize picnics, trips to the zoo, and other events for the children. Moreover, some of the group members take in children of members who have died. "I really consider them crusaders, taking on this incredible challenge," commented Stormy Schevis, coordinator at the Children's Diagnostic Center of the North Broward Hospital District. "Across the USA: Missouri, Vermont" USA Today (12/31/96) P. 6A The first bloodless surgery program in the St. Louis, Mo. area will open next spring at Barnes-Jewish Hospital. The majority of patients are expected to be Jehovah's Witnesses, who do not believe in transfusions. In Vermont, meanwhile, despite criticism of a condom distribution program for prison inmates in the state, officials say the policy helps reduce the rate of AIDS. "With New Drugs, Hope Finally Dawns" Philadelphia Inquirer (12/29/96) P. A1; Collins, Huntly While powerful new anti-HIV drugs have given many patients renewed health and hope, most people with HIV cannot benefit from the advanced treatment. The drugs are too costly for people in Third World countries and too complex for Americans with unstable lives. For David L. McColgin, a Philadelphia lawyer who has been fighting HIV for 15 years, the new medicines are covered by his health insurance. He started therapy with the protease inhibitor Crixivan last April, following a strict regimen which increased his annual drug costs $10,000, to about $22,000. By September, McColgin's viral load had decreased to the point where no virus could be detected in his blood. "Health Notes: Controversial AIDS Vaccine" United Press International (12/31/96) An experimental AIDS vaccine that had been shelved merits further study, says Harvard Medical School researcher Ronald Desrosiers. A weakened live virus was used in a monkey version of the vaccine that had failed to protect newborns. The vaccine worked well in older monkeys, however, and upon closer scrutiny, was found to cause disease in newborns only in extreme cases. "Cambodian Blood Supply Tainted by Demand" Nature Medicine (12/96) Vol. 2, No. 12, P. 1289; Marcus, Adam Due to an aversion among Cambodians to the practice of donating blood, donors in Phnom Penh are sometimes paid by desperate blood centers--despite a law against it. The practice concerns health officials who fear that paid donors are threatening the safety of the blood supply. A pint of blood sells for between $50 and $200, which is several times more than the average monthly salary. Workers at the blood center are paid off to protect the center from prosecution. The people who sell blood, often prostitutes or intravenous drug users, are 10 times more likely to have HIV, syphilis, and other sexually transmitted diseases than other donors, according to Dr. Monique Gue Guen, who operates the National Transfusion Center in Cambodia. About 6.5 percent of blood donations at the center tested positive for HIV last year, a higher rate than any other Asian country has reported. In Thailand, where screening procedures are especially good, the rate of HIV-positive donations was 0.3 percent. An estimated 30 percent of the blood units collected at the Cambodian center come from paid donors. Health officials are seeking safer donors, but the need for paid donors is expected to continue. "Health Emergency 1997: The Spread of Drug-Related AIDS Among African Americans and Latinos" The Dogwood Center, Princeton, NJ (11/5/96); Day, Dawn HIV is a serious risk for injection-drug users and could be reduced with government-supported needle-exchange programs, claims Dawn Day, director of Dogwood Center, a New Jersey-based independent research organization, in a new report. Among injection drug users (IDUs), African-Americans and Latinos are especially vulnerable to AIDS, with African-American IDUs four times as likely to have AIDS as white IDUs, and Latinos at least one and a half times as likely. African-Americans have more than four times the risk of getting AIDS than of dying from an overdose, Day reports. Moreover, the risk of AIDS among Latinos is more than three times greater than the risk of dying from an overdose. Over the past five years, 70 percent of all injection-drug related AIDS cases among African-Americans and Latinos were reported. To curb injection-related HIV infections, Day concludes, all levels of government must support needle-exchange programs, including allowing the possession of sterile needles, the sale of syringes without prescriptions, and the operation of needle-exchange programs. The AIDS Daily News will not publish on Wednesday, January 1, 1997, in observance of the New Year's Day Holiday. Publication will resume on Thursday, January 2.