From: bigoldberg@igc.apc.org (Billi Goldberg)
Newsgroups: sci.med.aids
Subject: CDC Summary 8/20/92
Date: 20 Aug 92 14:55:26 GMT
Article-I.D.: cs.1992Aug21.015204.22273
Organization: unspecified
Note: Copyright 1992, Dan R. Greening. Non-commercial reproduction allowed.
Archive-Number: 5943


                         AIDS Daily Summary
                           August 20, 1992 
 The Centers for Disease Control (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 
Clearinghouse, or any other organization.  Reproduction of this text is 
encouraged; however, copies may not be sold.  Copyright 1992, 
Information, Inc., Washington, DC 
************************************************************************
 "When Benefits Changes Leave Employees Vulnerable" Washington Post 
(08/20/92), P. A1  (Gladwell, Malcolm)
     The estate of a male AIDS patient is challenging his employer for 
changing its insurance policy to one that provided only limited  
reimbursement for AIDS patients.  John McGann, who died last  year, lost 
his insurance coverage seven months after he developed AIDS in late 
1987, when his policy changed.  His employer, H + H  Music Co. of 
Houston, decided to switch medical plans after  viewing the first of 
McGann's medical bills.  The policy that was abandoned promised to pay 
up to $1 million of lifetime AIDS  expenses per employee.  H + H took 
advantage of the protection of the federal law known as ERISA (the 
Employee Retirement Income  Security Act), which permits companies 
freedom over how they  structure their health plans if they act as their 
own insurers  instead of using an insurance company.  The new self-
insured plan only allowed $5,000 over the lifetime of an employee with 
AIDS--a limit McGann surpassed in a matter of months.  McGann's estate 
is not suing over the basic ERISA-guaranteed right of employers to  
change and structure self-insured plans in response to changing  work 
force conditions and economic circumstances.  Rather, the  case 
concentrates on H + H Music's decision to focus its  cost-saving effort 
at the expense of one person with a disease,  which violates the anti-
discrimination clause in the ERISA  statute, according to attorneys. 

"Securities Officials Warn About Scam Involving the Terminally Insured" 
Wall Street Journal (08/20/92), P. C18  (Salwen, Kevin G.)
     Unscrupulous businesses are allegedly using the plight of AIDS  
patients and other terminally ill patients in scam operations to  bilk 
investors, state insurance regulators warn.  The fraudulent  brokers 
promise investors "big bucks" with low risks by  purchasing the 
insurance policies on terminally ill individuals.  Officials from 
numerous states around the country have said the  scams violate 
securities laws.  "This form of marketing is  ghoulish, insensitive, 
possibly violative of confidentiality  rights, and flat out illegal," 
said Glenn Pomeroy, the North  Dakota securities commissioner.  
Regulators have named National  Insurance Marketing Inc. and Life 
Partners Inc. as two companies  involved in the insurance scams.  The 
companies offer investors  lists of terminally ill patients' initials, 
death benefits,  estimated life expectancies, and insurer ratings, and 
allow the  investors to select policies to purchase.  Experts say the  
fraudulent brokers exploit the legitimate practice that some  insurers 
have instituted of paying pre-death benefits of some  AIDS patients and 
other terminally ill people.  Related Stories:  New York Times (08/20) 
P. A1; Washington Post (08/20) P. A6;  Baltimore Sun (08/20) P. 1A; 
Washington Times (08/20) P. C1 

"School Board Toughens Chancellor's AIDS Pledge" New York Times 
(08/20/92), P. B2  (Berger, Joseph)
     The New York City Board of Education yesterday decided on a  
version of a new abstinence pledge for AIDS educators, despite  
objections of the board's president, H. Carl McCall, and Schools  
Chancellor Joseph A. Fernandez.  The board's move to approve a  broader 
pledge than the Chancellor had wanted was more  representative of the 
troubling relationship between the board  and Fernandez than of the 
pledge's substance.  In May, the board  approved a resolution mandating 
that all AIDS lessons on  prevention put greater emphasis on abstinence 
than any other  means of prevention.   Subsequently, Fernandez submitted 
a short  text for such a pledge.  Fernandez called the new pledge a  
"loyalty oath" that will call for outside groups to emphasize  their 
adherence to abstinence from sex as the best way to avoid  HIV 
infection, even if they do not really feel this method is  realistic.  
Yesterday, the board passed their own version of the  pledge that gave a 
comprehensive explanation of what is expected  of outside lecturers and 
offered a rationale for the policy.  The Chancellor's version basically 
repeated the resolution and said  outside lecturers may not implement 
AIDS education without a  signed agreement. 

"An AIDS Message to 'Nation at Risk'" Washington Post (08/20/92), P. A33  
(Schwartz, Maralee)
     An HIV-positive woman, daughter of renowned Republican  contributor 
Max Fisher, addressed the Republican National  Convention last night.  
Mary D. Fisher, speaking about the family values theme of last night's 
program, said, "We do the  president's cause no good if we praise the 
American family but  ignore a virus that destroys it."  Repeatedly, 
Fisher told the  delegates to view AIDS patients as part of their 
community.   "They are human.  They have not earned cruelty, and they do 
not  deserve meanness.  They don't benefit from being isolated or  
treated as outcasts.  Each of them is exactly what God made: a  
person...ready for support and worthy of compassion."  The tone  of the 
convention with its stress on family values is hostile to  gay issues 
and considers AIDS a homosexual epidemic.  Fisher, who became infected 
from her husband, said that she wanted to change  that perception of 
AIDS.  "Though I am female and contracted this disease in marriage and 
enjoy [the] warm support of my family, I  am one with the lonely gay man 
sheltering a flickering candle  from the cold wind of his family's 
rejection."  She encouraged  AIDS awareness and spoke of the nation's 
children.  "If you do  not see this killer stalking your children, look 
again.  There is no family or community, no race or religion, no place 
left in  America that is safe."  Related Story: USA Today (08/20) P. 6A 

"Gay Rights and AIDS Emerging as a Divisive Issue in Campaign" New York 
Times (08/20/92), P. A1  (Schmalz, Jeffrey)
     Homosexual issues have emerged as a controversy at the Republican 
National Convention and outside the Astrodome, where it is being  held.  
Beginning Monday night with a speech by Patrick J.  Buchanan and 
proceeding with remarks by other Republicans in the  past two days, the 
party has clarified its stance on opposition  to homosexual rights.  The 
party has portrayed Bill Clinton and  the Democrats as wanting to give 
preferential treatment to gay  men and lesbians.  The Republican 
comments, in opposition to the  Democratic position that supports gay 
rights, emphasize how the  presidential candidates are partaking in an 
open debate over  extremely different views on gay rights and AIDS.  The 
argument  has also surfaced because AIDS has made homosexuals a larger  
political presence as a result of additional funding and  organization.  
But some 2,000 ACT-UP members marched on the  convention hall Monday 
night, burning the president in effigy  before being broken up by police 
who clubbed a half dozen  demonstrators who were chanting, "We're here! 
We're queer!  We're  not gonna go!"  Yesterday, Bush was interrupted 
twice by ACT-UP  hecklers while speaking at a Republican National 
Committee event, and the Rev. Jerry Falwell was disrupted when speaking 
at another function. 

"Hospital Trying New Safe Needles" United Press International (08/19/92)
     Fort Lauderdale, Fla.--The North Broward Hospital District has  
implemented trial tests of new equipment designed to decrease the risk 
of HIV infection health-care workers encounter from  accidental needle 
sticks.  Health-care workers at the hospital  are using plastic-covered 
needles and IV bags with locks.  The  needles are encased in plastic and 
can be injected into a patient for intravenous feeding or medication, or 
into an IV medicine bag without ever being in the open.  Another device 
locks the needle  of an IV bag into a connecting tube, eliminating the 
chance the  needle could come loose or jab a health-care worker.  Within 
a  month, the district will start testing injection needles that  have 
their sharp points sheathed in plastic.  The district  hospitals and 
eight others nationwide will report which devices  are effective and 
which ones are not. 

"Getting Drugs to Market in Half the Time" Business Week (08/24/92) 
No.3280, P. 36  (Carey, John)
     For the past decade, the president and the Office of Management + 
Budget have proposed that a portion of taxpayer funding for the  Food 
and Drug Administration be replaced by fees levied on  pharmaceutical 
companies and other regulated businesses.   Congress and the industries 
commonly condemn the notion as a tax  on innovation.  However, this year 
Congress and the  pharmaceutical industry have decided to support "user" 
fees if  the money is used to increase the number of the FDA's drug  
reviewers and speed up the approval process for new products.   
Legislation is expected to go before Congress in September  mandating 
drug companies to forfeit $75 million a year in fees.   A panel convened 
in 1989 by Health and Human Services Secretary  Louis W. Sullivan 
decided that the FDA is unable to perform to its fundamental tasks of 
regulating so many drugs without appropriate funding.  Congressmen John 
D. Dingell (D-Mich.) and Henry A.  Waxman (D-Calif) focused their 
attention on a user-fee bill  earlier this year which calls for levying 
the fees only if  Congress boosts the agency's budget, eliminating the 
temptation  to skimp on regular taxpayer funds.  FDA chief Dr. David 
Kessler  has vowed to add 620 new drug reviewers and to try to reduce  
average approval time from over 2 years to 12 months. 

"One Step Toward Stopping the New Tuberculosis" Business Week (08/24/92) 
No. 3280, P. 77  (Smith, Emily T.)
     Although scientists once thought they had tuberculosis under  
control, a new drug-resistant form has emerged and cases are  
increasing.  Researchers at London's Hammersmith Hospital, along  with 
colleagues in France, have determined how the tuberculosis  bacterium 
escapes drugs.  The researchers report in the Aug. 13  issue of Nature 
that a single inoperative gene is the secret  behind the microbe.  An 
enzyme that alters an antibiotic is  activated by the gene, transforming 
it from innocuous to lethal.  But the drug remains harmless without the 
enzyme.  The findings  may facilitate the development of new drug 
therapies, including  one which would duplicate the enzyme's impact by 
administering a  converted form of the antibiotic rather than the 
original drug.   A second approach calls for using the new information 
to  determine how the enzyme-altered agents actually kill microbes,  
then developing drugs that attack the same targets.  The findings offer 
"hope that molecular genetics may be one way to tackle the  emerging 
problem of drug-resistant tuberculosis," said Dr. Barry  R. Bloom of the 
Albert Einstein College of Medicine.  

"Targeting Hospital Screening for HIV" Science News (08/15/92) Vol. 142, 
No. 7, P. 103  (Raloff, J.)
     Among the estimated 1 million HIV-positive individuals in the  
United States, about one-fifth entered a hospital in 1990--most  of whom 
probably did not know they were infected, according to a  report 
featured in the Aug. 13 issue of the New England Journal  of Medicine.  
Robert S. Janssen of the Centers for Disease  Control led the study, 
which found that if most areas with high  rates of AIDS were to offer 
voluntary and confidential HIV  testing to all patients age 15 to 54, in 
only one year they might detect up to 110,000 persons who unknowingly 
carry HIV.  The  researchers reported that this method would direct many 
newly  infected and still asymptomatic people into treatment, extending  
their lives, and helping to control the spread of the virus.  In  the 
study, HIV assays were performed on 196,000 anonymous but  
systematically collected blood samples.  Janssen and colleagues  
reported that "two-thirds of the HIV-positive patients in the 20  
hospitals studied [entered] with conditions other than  symptomatic HIV 
infection or AIDS." Janssen calls the most  important finding the 
"identification that the AIDS diagnosis  rate for a hospital can serve 
as a surrogate marker" for rates of HIV, which differ by region.  
Currently, hospitals don't compile  AIDS diagnosis rates, even though 
the process would "probably  take only 5 minutes," Janssen said. 

"Screening for HIV Infection--Benefits and Costs" New England Journal of 
Medicine (08/13/92) Vol. 327, No. 7,  P. 487  (Quinn, Thomas C.)
     Many HIV-positive individuals are not aware of their condition,  
and often learn they are infected only after becoming ill with an HIV-
related disease, writes Thomas C. Quinn of the National  Institute of 
Allergy and Infectious Diseases.  Testing for HIV  based on risk 
behavior or clinical suspicion only identifies 30  to 40 percent of HIV-
infected individuals.  Janssen and  colleagues, writing in the August 13 
New England Journal of  Medicine, recommend that current routine testing 
of all hospital  and clinic patients be replaced with routine voluntary 
testing in all clinics and hospitals.  Under routine testing, the test 
is  provided unless the patient refuses; under routine voluntary  
testing all patients are offered the test.  Janssen et al. claim  
routine voluntary testing would find 68 percent of all  HIV-infected 
patients, while routine testing would find 20  percent more HIV-infected 
patients but would require testing five times as many people.  Of 
course, the implementation of voluntary routine testing requires that 
physicians and legislators  cooperate to ensure the privacy of HIV-
infected individuals and,  more important, provide the funds necessary 
to care for all  people with HIV, not just those with AIDS.  If 
implemented with  sufficient physician and government support, Quinn 
concludes,  voluntary routine testing could be of tremendous benefit to  
patients and health-care providers. 

"News in Brief: New Jersey" Advocate (08/13/92) No. 609, P. 22
     In opposition to New Jersey's newly announced focus on  
confidential, not anonymous, HIV testing, about 40 AIDS activists 
protested at the state capitol in Trenton on June 25.  Though  testing 
for HIV antibodies is offered at 16 sites operated by the state, the 
four newest sites offer only confidential testing;  individuals who test 
positive for HIV at one of those locations  are listed in a confidential 
registry.  Health department  officials claim that confidential testing 
helps HIV-infected  patients, enabling the department to offer them 
special services. However, AIDS activist John Macklin said the change in 
emphasis  will discourage people from being tested for the virus. 
Newsgroups: sci.med.aids