From: Billi Goldberg <bigoldberg@igc.apc.org>
Subject: CDC Summary 10/16/92
Note: Copyright 1992, Dan R. Greening. Non-commercial reproduction allowed.
Archive-Number: 6322
Organization: unspecified
Date: Fri, 16 Oct 92 08:02:03 PDT

                         AIDS Daily Summary
                          October 16, 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 CDC 
Clearinghouse, or any other organization.  Reproduction  of this text is 
encouraged; however, copies may not be sold.  Copyright 1992, 
Information, Inc., Bethesda, MD 
************************************************************************
 "U.S. Is to Argue Employers Can Cut Health Insurance" New York Times 
(10/16/92), P. A1  (Pear, Robert)
     The Bush administration has decided to support a federal court  
ruling that allows employers to cut the health insurance coverage of 
employees who develop costly illnesses such as AIDS.   Government 
lawyers said that Solicitor General Kenneth W. Starr  would propose the 
administration's position in a memorandum to be filed with the Supreme 
Court in the next few days.  The case  involves a Houston music store 
employee who watched his maximum  benefits fall from $1 million to 
$5,000 after he developed AIDS  and filed his first claims.  His 
employer served as its own  health insurer and so, unlike conventional 
providers of group  health insurance, was able to avoid state insurance 
regulations.  The Supreme Court asked the administration for its views 
on the  case in March.  Over the last few months, several groups lobbied  
the Justice Department, saying Starr should urge the High Court  to 
reverse the lower court ruling.  The ruling said that  employers may, 
under the 1974 Employee Retirement Income Security Act, significantly 
reduce insurance coverage for employees with  costly illnesses.  The 
opponents, including the Department of  Health and Human Services, said 
the appeals court ruling would  aggravate a major social problem by 
enabling employers to lessen  health benefits for people with serious 
illnesses, thereby adding to the 35 million Americans already without 
health insurance.   But the Labor Department argues that employers will 
be less  willing to offer health insurance if they cannot protect  
themselves against any future costs by reducing benefits.  The  
Solicitor General concluded that the appeals court decision was a 
correct interpretation of the 1974 law. 

"Wake Up Call on Threats of Disease" New York Times (10/16/92), P. A22  
(Altman, Lawrence K.)
     Public health surveillance systems lack the ability to adequately 
detect threats from new diseases and the reemergence of old ones, said 
the National Academy of Sciences in a report issued  yesterday.  The 
report said the sudden appearance of new diseases like AIDS and the 
reemergence of tuberculosis are inevitable  regardless of significant 
advances in medicine.  The report, from the academy's Institute of 
Medicine, provides what the academy  considers the first public policy 
strategy to deal with the  threat that comes from at least 50 viruses, 
bacteria, fungi and  parasites, in addition to an unknown number of 
microbes that have yet to be found.  The report warned researchers and 
health  officials to be better prepared for the possibility of  
devastating new epidemics caused by viruses and other microbes  for 
which there are no effective drugs.  Many scientists believe  that some 
of the world's epidemics might be controlled if they  were recognized 
sooner, when only a few cases exist.  But the  report added that earlier 
and more effective responses are not  likely unless the worldwide 
infectious-disease surveillance  system, a rudimentary network 
coordinated by the World Health  Organization, is upgraded.  The 
committee said it still was  skeptical whether an improved system, had 
it been operative in  the 1960s and 1970s, would have affected the 
impact of AIDS.   Committee co-chairman Dr. Joshua Lederberg said it 
would be  significant for researchers to learn how and where AIDS 
developed so they might be better able to identify a new disease as a 
small cluster and prevent it from developing into an epidemic.   Related 
Stories: Washington Post (10/16) P. A2; Los Angeles  Times--Washington 
Edition (10/16) P. A12

"Police Told to Halt Routine AIDS Tests in Prostitution Cases" New York 
Times (10/16/92), P. B18
     Police officers in Bensalem, Pa., have been directed to  
discontinue regular testing of prostitutes for HIV because the  practice 
breaches Pennsylvania state law.  The police had been  testing the 
arrested prostitutes for HIV infection and charging  those who were 
infected on the basis that they were knowingly  jeopardizing the lives 
of others.  However, Bucks County District Attorney Alan Rubenstein told 
the department Tuesday that the  state's Confidentiality of HIV-Related 
Information Act makes it  legal for police officers to test someone for 
HIV only if the  officer has been exposed to a bodily fluid.  The 
consent has to  be obtained in writing, and only the court can issue the 
results. The tests were started by the police officers last month, when  
for the third time detectives arrested a 22-year-old woman on  charges 
of prostitution.  According to detectives, the woman had  previously 
told them she was HIV-positive.  With her consent, the detectives tested 
her blood for the virus.  Subsequently, the  woman was indicted for 
reckless endangerment when the test's  results showed HIV infection.  
Jack Robinson, a Bensalem police  captain, said the department did not 
know that the state law had  been in effect since March 1991.  The 
police said that on  Rubenstein's orders they were dropping the reckless 
endangerment  charges against the 22-year-old woman.  Captain Robinson 
argued  against the order. "They are spreading this disease," he said,  
regarding infected prostitutes.  "They should be charged  especially if 
they know they have it." 

"More Needs Than Funds" American Medical News (10/05/92) Vol. 35, No. 
37, P. 19
     While more money than ever is being spent on AIDS services in  
Arizona, the money is not enough to meet the growing demands of  the 
disease, health-care providers say.  Arizona will have  $686,616 in 
federal funds diverted statewide through the Ryan  White Care Act.  The 
state's share was $653,285 last year.  The  state alone provides almost 
no money for AIDS services.   Approximately 4,000 people in Arizona are 
HIV-positive, report  the latest statistics from the state Department of 
Health  Services.  There have been 1,011 AIDS deaths in the state since  
the beginning of the epidemic. 

"No Rate Hike for HIV Claims, but Insurers Urge Caution" American 
Medical News (10/12/92) Vol. 35, No. 38, P. 16  (Clements, Bill)
     Insurance premiums for doctors have not been substantially  
influenced by fears that professional liability rates would  escalate 
after a Florida dentist infected several patients with  HIV last year.  
But insurers say physicians are exposed to  several areas of liability 
if a patient becomes infected with  HIV.  Some insurers may institute 
educational programs to help  doctors prevent HIV-related risks.  
Timothy Morse, vice president with St. Paul Fire and Marine Insurance 
Co., the nation's largest liability insurer for physicians, said, "Now 
we have no reason to expect that AIDS or HIV will be a significant 
driver of the cost  of physician's professional insurance."  So far, 
there has been  no substantiated case of a physician transmitting HIV to 
a  patient, according to federal health officials.  There are  
approximately 7,000 HIV-positive physicians in the United States. 
Statistics released by St. Paul show that physicians were  involved with 
72 of 356 claims related to AIDS or HIV infection  it has seen filed 
over the past six years.  Morse said that,  overall, the company has 
paid out $21 million in indemnity and  legal expenses for the 356 
claims.  Physicians may face  allegations relating to testing for HIV 
without consent.  Also,  they may experience a conflict of 
confidentiality and the  obligation to warn others of the presence of 
the disease when  placing a patient in a hospital, said Morse.  Insurers 
recommend  that physicians follow the infection control guidelines  
established by the Centers for Disease Control to avoid the  greatest 
danger of infecting a patient with HIV. 

"HIV Counseling and Testing Services From Public and Private  Providers-
-United States, 1990" Morbidity and Mortality Weekly Report (10/09/92) 
Vol. 41, No. 40, P. 743
     HIV counseling and testing (CT) services are key factors of the  
national HIV-prevention strategy, and these services must be  continued 
by public programs, write the Centers for Disease  Control.  The 1990 
National Health Interview Survey AIDS  Supplement obtained information 
on HIV/AIDS-related knowledge and attitudes and testing from a sample of 
40,513 respondents, based  on nationally representative samples of the 
U.S. civilian,  noninstitutionalized population 18 years or older.  The 
NHIS  began collecting information in 1990 on sources of HIV tests for  
all tests reported by respondents, enabling comparison of persons 
reporting voluntary tests from public and private providers.   About one 
fourth of respondents (23 percent) reported having been tested for HIV 
at least once.  Among all of the respondents, 4.8  percent had 
voluntarily tested for HIV to determine infection  status.  The survey 
discovered that private-sector providers were twice as likely to have 
been the source of the most recent  voluntary test.  Public health 
departments and AIDS clinic/CT  sites were the most frequent public 
sources reported.  A higher  percentage of persons who were at increased 
risk for HIV used  public programs for voluntary HIV testing than did 
those at no  increased risk.  Among all persons receiving voluntary 
tests,  45.4 percent reported receiving pre-test counseling and 30.8  
percent reported receiving post-test counseling.  Pre- and  post-test 
counseling rates were higher among public sources, the  CDC concludes. 

"Hospital Patients Tested" American Medical News (10/12/92) Vol. 35, No. 
38, P. 28
     A total of six out of every 1,000 Alabama hospital patients  tested 
positive for HIV infection, according to a study conducted by the state 
Department of Public Health.  The prevalence of  infection among blacks 
was more than three times that for whites, and the rate for men was six 
times greater than for women, said  the report.  The rates of infection 
were elucidated in a blind  study of blood samples from 11,372 patients 
between the ages of  15 and 54.  A state official indicated that 26.7 of 
every 1,000  black men tested HIV-positive.  The statistics for black 
men  between 25 and 34 years of age were even more alarming--47.3 per 
1,000.

"Cash Infusion for Hospitals" American Medical News (10/12/92) Vol. 35, 
No. 38, P. 28
     A total of $23.3 million in Louisiana state money is expected to  
be given to hospitals and other groups that are helping combat  the 
state's increasing AIDS crisis.  Approximately $20 million  will be 
allocated to hospitals in New Orleans, Shreveport,  Alexandria, Baton 
Rouge, Lafayette, and Houma.  The remainder  will be given to early 
intervention programs and continuing AIDS  research at Tulane and 
Louisiana State universities.  There were  3,413 reported AIDS cases in 
the state as of June, 1, and about  26,000 people are estimated to be 
HIV-positive. 

"AIDS Tops Deadly List" American Medical News (10/12/92) Vol. 35, No. 
38, P. 28
     AIDS has become the leading cause of death for Orange County,  
Calif., adults aged 25-44 years--surpassing heart disease and car 
accidents, according to health officials.  Although the disease  was 
once uncommon in the suburban county east of Los Angeles, it  has became 
the number one killer for people in that age group in  1990, said 
officials.  Within the last 11 years, a total of 1,240 Orange County 
residents have died of AIDS. 

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