From: Billi Goldberg <bigoldberg@igc.apc.org>
Subject: CDC Summary 12/16/92
Note: Copyright 1992, Dan R. Greening. Non-commercial reproduction allowed.
Archive-Number: 6640
Organization: unspecified
Date: Wed, 16 Dec 92 08:03:51 PST

                           AIDS Daily Summary
                            December 16, 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 

 "Program in Africa Curbs Spread of AIDS" Baltimore Sun (12/16/92), P. 
8A
     Health-care workers in Rwanda are controlling the heterosexual  
spread of HIV by targeting young women with education and testing 
programs.  The effort could serve as a model for U.S. inner  cities.  
Rwanda has one of the world's highest rates of AIDS.   According to 
researchers from the University of California--San  Francisco, nine out 
of ten deaths are caused by AIDS, and almost  one third of urban adults 
are HIV-positive.  In the study  published in today's Journal of the 
American Medical Association, the researchers examined 1,458 women ages 
20 to 40 who enrolled  in  a prevention program in 1988 in the Rwandan 
capital, Kigali.  The program offered confidential HIV testing, viewing 
of a  35-minute educational video, and group discussions afterward.   
All of the subjects received regular physician examinations,  condoms 
and spermicides, and invitations for male partners to be  tested and 
counseled.  As a result, condom use rose from 7  percent to 22 percent 
in one year among all of the women's  partners. 

"Critics of Traveling AIDS Play Speak Out" Baltimore Sun (12/16/92), P. 
7B  (Ruhl, Sherrie)
     A controversial AIDS play performed in Harford County, Md.,  high 
schools is racist and encourages teenage sex, some critics  contend.  
Rev. Saint George Crosse of the St. James United  Methodist Church in 
Jarretsville said at Monday night's Board of  Education meeting that 
"Secrets," a sexually explicit play  performed by a national group of 
young actors, mocked problems  facing minority youths.  Crosse told the 
board, "A black girl,  using jive talk, explains condoms and 
contraceptives to her naive white girlfriend.  This play says that sex 
on a first date is  typical of black people."  Approximately 15 of the 
150 people  attending the meeting expressed opposition to the play.  The 
play is produced by Kaiser Permanente Health Systems and has been  
opposed by some parents since first shown to high school students last 
year.  At that time, the school board decided that 11th and  12th grade 
students could view the play, which includes frank  messages about AIDS 
and sexual behavior.  Board members said that the information about AIDS 
in the play outweighed all other  concerns.  The board also decided that 
students must have their  parents' permission to attend the play.  Nancy 
Jacobs, state  representative of the local chapter of Concerned Women of  
America, a conservative political group, said "Secrets" relays  
incorrect information regarding AIDS.  She added that the play  doesn't 
tell students that condoms can break. 

"France's Bloody Scandal" Chicago Tribune (12/15/92), P. 2-1  (Waxman, 
Sharon)
     About 5,000 French people contracted HIV through contaminated  
blood transfusions in the 1980s, and approximately 1,500 French  
hemophiliacs injected themselves with blood products that were  tainted.  
However, these cases could have been prevented if the  French government 
properly screened the blood, which it  completely neglected, experts 
report.  Already, 300 hemophiliacs  have died from AIDS as a result.  
The majority of HIV-positive  people did not discover they were infected 
until years afterward. Some who knew they were infected were unaware of 
the implications so they engaged in unprotected sex, didn't receive  
life-prolonging drugs, and didn't prepare themselves  psychologically 
for the ramifications of the disease.  In 1983,  France ignored offers 
from U.S. and Austrian companies for heated blood products.  
Subsequently, evidence was found that all of  France's blood products 
were contaminated with HIV, according to  a National Blood Transfusion 
Center study in early 1985.   Meanwhile, the French government held up 
approval during 1985 of  an American-made blood screening test to allow 
the Pasteur  Institute to come up with its own.  Also, the French blood 
donor  system continued to allow people at high risk of HIV infection to 
donate blood.  Consequently, thousands of people contracted HIV  in a 
scandalous tragedy that could have been prevented if the  French 
implemented the American-made blood screening test when it was first 
released. 

"Survey Details Risky Youth Behavior" United Press International 
(12/15/92)
     Charlottesville, Va.--A survey intended to reveal rates of risky  
behavior found that a majority of Virginia high school students  engaged 
in sexual relations, officials said Tuesday.  The survey  is the first 
of its kind in Virginia, and educators, health  officials, and law 
enforcement authorities hope it will elucidate the problems so specific 
solutions can be implemented.  Gov. L.  Douglas Wilder said the results 
reinforce the need for effective  school-based comprehensive health 
education programs to reduce  certain behaviors.  The study found that 
58 percent of high  school students said they'd had sex before, with 14 
percent  reporting their first experience before the age of 13.  About  
50.6 percent of the females and 59.5 percent of the males  surveyed said 
they used condoms.  The survey, conducted last  spring, involved 1,640 
students and questioned sexual activity,  drug and alcohol use, 
nutrition, exercise and other factors  relating to disease or death.  
The survey was created by the  state Department of Education, the 
governor's Drug Policy Office, and the Centers for Disease Control.  
Wilder said the findings  will be used to help determine funding and 
program priorities at  the state level.  The survey will be conducted 
again in 1993 and  every two years thereafter. 

"Man Convicted of Transmitting AIDS Virus" United Press International 
(12/15/92)
     Houma, La.--Lawyers defending a man who was given a 10-year  prison 
sentence for allegedly transmitting HIV to his sexual  partner, are 
expected to appeal the conviction.  On Monday, State District Judge 
Baron Bourg sentenced Salvadore Gamberella, 28, to the maximum penalty 
allowed under law.  A jury convicted  Gamberella Nov. 18 on charges of 
having sex with his girlfriend  without disclosing his HIV-positive 
status.  The American Civil  Liberties Union waged a major attack on the 
prosecution of  Gamberella, filing a motion in the case contending that 
the 1987  state law forming the basis of his prosecution is  
unconstitutionally vague.  But Bourg rejected the argument.   District 
Attorney Doug Greenburg defended the constitutionality  of the law, 
claiming it is necessary to protect the public  safety.  Gamberella 
testified that he did tell his girlfriend  about his condition shortly 
after he tested HIV-positive.  The  21-year-old woman, who is the mother 
of their 2-year-old son, is  identified in court documents only as D.T.  
She testified that  Gamberella never told her he was infected with HIV.  
She  subsequently discovered she also was infected, but the child  
Gamberella fathered has not yet been found to be infected.   Defense 
attorney Cleveland Marcel Jr. said the ruling would be  appealed. 

"AIDS Home Target of Medicaid Cuts" United Press International 
(12/15/92)
     Indianapolis--Indiana's only nursing home specifically for AIDS  
patients is debating with the state over how much money it uses  to 
provide care to the patients.  Parkview Manor, is a 36-bed  nursing 
home, and is thought to be one of just five such nursing  homes in the 
country.  The state is requesting that Parkview  justify its rates as 
part of state government's search for ways  to slow Medicaid spending, 
said James Verdier, state Medicaid  director.  AIDS advocates have 
expressed fear that a cut in  Medicaid funding for Parkview would come 
at a time when other  nursing homes are reluctant to accept people 
infected with HIV.   Parkview administrator Marlene Roberts said AIDS 
patients  frequently require more medical care than most elderly nursing  
home patients.  She said that Parkview's costs are often lower  per 
patient than those of hospitals.  In addition, she said that  almost all 
of the Parkview patients are covered by Medicaid, not  private 
insurance.  Indiana law mandated for two years that the  state Medicaid 
program reimburse Parkview at a higher rate than  other nursing homes, 
but that provision was repealed this year.   Roberts said that Parkview 
and its parent company, Britwill Co.  of Dallas, have started collecting 
cost information from other  AIDS nursing homes and are performing 
detailed time studies of  activities at Parkview.  The state set Jan. 10 
as its deadline  for the information, she said.  New Medicaid rates are 
enacted  April 1. 

"Heterosexually Transmitted Human Immunodeficiency Virus  Infection 
Among Pregnant Women in a Rural Florida Community" New England Journal 
of Medicine (12/10/92) Vol. 327, No. 24,  P. 1704  (Ellerbrock, Tedd V. 
et al.)
     An alarmingly high rate of HIV that most likely resulted from  
heterosexual transmission was found among several pregnant women  in a 
rural Florida community, write Tedd V. Ellerbrock et al. of  the Centers 
for Disease Control in Atlanta, Ga.  The researchers  interviewed and 
tested 1,082 of 1,084 consecutive pregnant women  who registered for 
prenatal care at a public health clinic in  western Palm Beach County, 
Fla.  The rate of HIV infection was  5.1 percent (52 of 1,011 women).  
Black women who were neither  Haitian nor Hispanic had the highest rate 
of infection.  Only 4  of 1,009 women (0.4 percent) reported ever 
injecting drugs, and  all 4 were HIV-negative.  But 14 of 43 users of 
"crack" cocaine  (33 percent) had HIV infection.  A total of 131 of 983 
women (13  percent) tested positive for gonorrhea, chlamydial infection, 
or  syphilis at prenatal registration.  Mulivariate  logistic-regression 
analysis found HIV infection to be  independently associated with having 
used crack cocaine, having  had more than two sexual partners, being 
black but neither  Hispanic nor Haitian, having had sexual intercourse 
with a  high-risk partner, and testing positive for syphilis.  But 11 of  
the 52 HIV-positive women (21 percent) reported a total of only  two to 
five sexual partners and no known high-risk partners, had  never used 
crack cocaine, and had no positive tests for sexually  transmitted 
diseases.  The increasing rate of HIV and the  increasing prevalence of 
syphilis and use of crack cocaine  indicate that other women may be at 
similar risk of contracting  heterosexually transmitted HIV, the 
researchers conclude.

"AIDS and Sexual Behavior in France" Nature (12/03/92) Vol. 360, No. 
6403, P. 407  (Spira, Alfred)
     A massive telephone survey in France helped distinguish which  
people protect themselves against sexually transmitted diseases  (STDs) 
and HIV infection and which do not.  The French government asked the 
Agence Nationale de Recherches sur le Sida (ANRS) to  perform a survey 
of sexual behavior and AIDS in the general  population (called ACSF for 
Analyse des Comportements Sexuels en  France).  The survey involved a 
total of 20,055 people aged 18-69 years and was conducted between 
September 1991 and February 1992. It was found that the median age at 
the time of first sexual  intercourse was 20 years for men and 22 years 
for women born  1922-26, and 17 and 18 years respectively for those born 
in  1972-74.  No increase of age at first sexual intercourse was  
apparent in younger people who began their sexually active life  after 
the emergence of the AIDS epidemic.  The study discovered  that young 
people change partners more frequently than older  people but are less 
likely to have more than one sexual partner  at one time.  The 
percentage of subjects saying they had used a  condom during intercourse 
at least once in their lifetime was  56.5 percent for men and 43.7 
percent for women.  These rates  decreased significantly with age, 
suggesting most widespread use  among the youngest subjects.  The condom 
usage rates were 79.8  percent of men aged 18-19 years and 48 percent 
for women in the  same age group.  In addition, the study found that 
condom use is  more prevalent in subjects most exposed to the risk of 
STDs or  AIDS, that is, those with several homosexual or heterosexual  
partners. 

"A Safer Sell" Supermarket News (12/07/92) Vol. 42, No. 49, P. 27   
(Muirhead, Greg)
     Condom sales are increasing as the products win more widespread  
acceptance from supermarkets.  Some stores are beginning to sell  
condoms for the first time, while others are experimenting with  
creative ideas.  Among these ideas are placing condoms in the  feminine 
hygiene section to obtain sales from female shoppers or  creating 
"family planning centers," where condoms are sold with  other birth 
control products.  Still, other stores are  considering leasing space 
for condoms to manufacturers.  Mark  Caldwell, pharmacy coordinator, 
Haggen, Olympia, Wash., said,  "We've seen an increase in condom sales 
in recent months and  we're still seeing that."  In addition, he said, 
the increasing  public awareness of the need for protection from HIV and 
other  sexually transmitted diseases has contributed to the growth of  
sales.  One buyer for a major East Coast chain also said that  AIDS was 
a reason for the growth in sales and that the long-time  conservative 
approach in supermarket condom sales is now  changing.  Moreover, Towne-
Oiler + Associates, a division of  Information Resources, Chicago, 
confirm that supermarkets are  experiencing sharp increases in condom 
sales.  For the three  months ended in October of this year, supermarket 
dollar sales  for condoms increased 26 percent, while drug store sales  
increased 16 percent.  Retailers said most of the sales growth is among 
condoms made by Carter-Wallace and Schmid. 

"Heterosexual Transmission of HIV--Puerto Rico, 1981-1991" Morbidity and 
Mortality Weekly Report (12/04/92) Vol. 41, No. 48, P. 899
     Efforts to prevent the spread of HIV infection in Puerto Rico  
should continue to target IV-drug users and their sex partners,  
according to the Centers for Disease Control.  Puerto Rico has  the 
second highest overall rate of AIDS cases among states and  territories 
in the United States and the second highest rate  among women.  The 
territory also has the highest number of AIDS  cases attributed to 
heterosexual transmission.  Between 1981 and  1991, 7,080 AIDS cases 
were reported in Puerto Ricans older than  13, including 1,266 AIDS 
cases diagnosed and reported in 1991,  for an annual incidence rate of 
50.9 cases per 100,000  population.  A total of 5,782 of the cases 
occurred among males.  The main route of transmission of HIV in Puerto 
Rico was IV-drug  use, which was reported in 4,639 (66 percent) of all 
cases among  adults reported since 1981; 546 (8 percent) cases among 
adults  resulted from heterosexual contact with an IV-drug user.   
Heterosexual transmission comprised 11 percent of all AIDS cases  among 
adults and male-to-male transmission accounted for 18  percent.  The 
percentage of AIDS cases resulting from IV-drug use decreased from 70 
percent before 1988 to 59 percent in 1991, and  the proportion of cases 
attributed to heterosexual transmission  increased from 5 to 18 percent.  
Also, 546 of the 798 cases of  AIDS attributed to heterosexual 
transmission since 1981 occurred  among persons who reported 
heterosexual contact with an IV-drug  user.  Moreover, a significant 
percentage of IV-drug users  reported high-risk sexual behavior.  Since 
1981, 16 percent of  all men with AIDS who reported IV-drug use also 
reported having  had sex with men. 
Newsgroups: sci.med.aids