From: Billi Goldberg <bigoldberg@igc.apc.org>
Subject: CDC Summary 9/9/92
Note: Copyright 1992, Dan R. Greening. Non-commercial reproduction allowed.
Archive-Number: 6146
Organization: unspecified
Date: Wed, 9 Sep 92 17:55:49 PDT

                         AIDS Daily Summary
                         September 9, 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 
************************************************************************
 "Personal Health: Patients Have Many Options for Safer Transfusions" 
New York Times (09/09/92), P. C13  (Brody, Jane E.)
     The AIDS epidemic has prompted an effort to make the blood supply 
safer and has spurred a sharper focus by blood specialists on the risks 
linked with blood transfusions.  About 90 percent of blood  transfusions 
involve blood donated by strangers.  Donors are  thoroughly screened for 
personal histories and risks for disease. Donated blood is tested 
through many sophisticated means to  prevent the chance of a 
contaminated transmission that could risk the patient's life.  Blood 
experts encourage autologous blood  transfusions--transfusions using the 
patient's own blood--before  elective surgery.  The procedure entails 
two or more donations,  usually a week apart, during the month before 
the scheduled  surgery, with the last donation being given three or more 
days  before it.  Children can even donate their own blood ahead of  
time, but amounts extracted at any one time from small children  may be 
less than a pint, whereas for an adult two to four pints  of blood are 
typically used per patient.  Blood specialists say  that directed 
donations, or those from friends or relatives, may  be less desirable 
than blood from strangers who donate  voluntarily.  Dr. Celso Bianco, 
medical director of the New York  Blood bank, said that directed donors 
may feel pressured to  donate and may be more inclined to lie about 
medical histories  that could make their blood unsafe. 

"Clean Needles Put Into War on AIDS" Los Angeles Times--Washington 
Edition (09/09/92), P. B1  (Pyle, Amy)
     The ACT-UP group called Clean Needles Now recently began  
conducting clean needle exchange programs in Los Angeles to  thwart the 
spread of HIV among addicts.  The program serves about 150 addicts 
weekly, and is Los Angeles' first effort to  discourage the practice of 
sharing syringes.  The program has  emerged late compared to similar 
efforts in many other large  American cities.  AIDS activists say that 
the slow pace of  acceptance for the exchange program in Los Angeles is 
the result  of health agencies' fear of losing local government funding,  
health-care workers' fear of being arrested, and the spread-out  
geography of the city, where most residents infrequently come in  
contact with addicts.  In California, as well as nine other  states, it 
is illegal for anyone to obtain needles without a  prescription, 
although the largest volunteer needle exchange in  the nation is running 
in San Francisco, and has been supported by the last two mayors and 
generally tolerated by police.  The Los  Angeles County government has 
continually opposed needle  exchanges, but the Board of Supervisors' 
political composition is changing, as is its position on needle 
exchanges.  State  legislation has been passed that would allow pilot 
needle  exchanges to take place, but still awaits consideration by Gov. 
Pete Wilson. 

"Two AIDS Groups Leave Damien Center" United Press International 
(09/05/92)
     Indianapolis--A conflict with the Catholic church has prompted  two 
AIDS programs of the Catholic-affiliated Damien center to  move.  
Project Outreach, which targets minorities for AIDS  education, moved 
last week to offices at the Indiana Community  AIDS Action Network, Inc.  
The Indiana HIV Advocacy Program is  planning to move to the same 
location by the first of October.   The government-funded groups were in 
a dispute with the Damien  Center over their support of condoms as a way 
to prevent the  transmission of HIV.  The Roman Catholic Church strongly  
discourages condoms and other forms of birth control.  John  Aleshire, 
the center's director of development and public  affairs, said the 
relocation of the two groups should not  influence services to AIDS 
patients.  The Damien Center has been  skeptical since the August board 
meeting about whether it can  keep its ties with the Catholic church due 
to the church's  position on the use of condoms.

"Study: Computers Better at Screening Blood Donors Than Humans" United 
Press International (09/08/92)
     Chicago--A computer is more effective at eliciting honest  
responses from blood donors about potential AIDS risk factors  than if a 
human asks the questions, a study revealed Tuesday.   Researchers from 
the Harvard Medical School in Boston and the  American Red Cross tested 
blood donor reactions to a computerized screening questionnaire and 
discovered that people answered more  easily with a computer.  The study 
involved 2,372 individuals who went through the normal screening process 
and the computerized  questionnaire.  A total of 12 reported possible 
AIDS risks only  to the computer.  But none of the 12 tested positive 
for HIV.   The conventional screening process involves a trained 
interviewer who asks a series of confidential questions, such as if the 
donor ever used IV-drugs or other high-risk activities.  The  
computerized method allowed donors to sit in front of the screen  and 
respond on the keyboard to the same set of questions.  The  authors of 
the study reported in the Journal of the American  Medical Association, 
"The computer interview was deemed more  private than the standard 
interview by 39 percent of the  subjects, whereas only 7 percent judged 
the standard method to be more private."  The authors also said, "This 
study demonstrates  that computer-based interviewing is considered 
acceptable and  indeed even superior to standard methods by blood donors 
themselves." 

"Perot's EDS Fired HIV-Positive Employee" United Press International 
(09/08/92)
     Dallas--An article due for publication in the October issue of  
Vanity Fair says ABC News had planned to air a story divulging  that 
Ross Perot's computer company, Electronic Data Systems,  fired a man 
with HIV infection.  The article said ABC never  released the report 
because Perot dropped out of the presidential race the same day the 
network expected to air the story.  Moreover, the magazine said that ABC 
claimed it had proof that  other employees of EDS, which Perot later 
sold, were fired  because they were ill or had dependents who were ill.  
Vanity  Fair did not indicate whether Perot was aware of the man who 
told a supervisor he was hospitalized with AIDS-related pneumonia.   
Perot's senior campaign aide, Tom Luce, said the various rumors  about 
Perot and his family "were all absolutely false."  Also,  Luce said he 
had never heard about an HIV-positive employee of  EDS who was fired.  
He said, "I told the reporter working on that [Vanity Fair] story that 
based upon the part she read me, the  story was totally inaccurate."

"Doctors Fear 15,000 in Bangladesh Might Have AIDS" United Press 
International (09/07/92)
     Dhaka, Bangladesh--Experts are extremely concerned that AIDS may  
be ravaging the population of Bangladesh, Dhaka's Daily Star  reported 
Monday.  The experts fear that there could be as many as 15,000 AIDS 
patients in Bangladesh, although doctors have only  detected nine cases 
so far.  "As there have been nine positive  cases out of 48,000 
tested... there could be at least 15,000  cases among the country's 
total population of 110 million," said  an official at the Bangladesh 
Institute of Epidemiology, Disease  Control and Research.  The official 
added, "Though it is largely  a guess, it cannot be brushed off as 
baseless."  The newspaper  indicated that even the 15,000 figure may be 
low, because  Bangladesh has insufficient facilities to test patients 
for HIV.  The government runs only four HIV testing centers, which have  
screened only 48,000 people thus far.  An additional 122,000  
Bangladeshis have been tested at private clinics, but such  results are 
not always reliable. 

"A New Frontier for Health Care Risk Management" (09/92) Vol. 39, No. 9, 
P. 16  (Challan, Barbara)
     Faced with a more sophisticated medical environment, and the  
increasingly litigious American society, risk managers in the  health 
care industry must deal with a broad array of perils.   Health care risk 
managers must spend much of their time on risk  control and risk 
financing activities related to medical  professional liability, 
specifically in such areas as  comprehensive general liability, 
directors' and officers'  liability, workers' compensation, pollution 
and hazardous wastes, business interruption, employee dishonesty, and 
coverage of  vehicles, property, boilers, and machinery.  Resources must 
be  appropriately allocated among the numerous clinical services in  
health care organizations.  Risk managers can also help public  affairs 
staffs with damage control of medical disasters, and must aid the 
organization in complying with the regulatory and  technological changes 
that are changing the medical field and  imposing difficult choices on 
patients, families and medical  personnel.  The threat of HIV infection 
among health care workers and patients requires health care risk 
managers to establish and  enforce precautions to minimize the chances 
of transmitting the  virus in the health care setting, and to address 
the issues of  mandated patient confidentiality and informed consent  
implications of blood transfusions. 

"Publicly Funded HIV Counseling and Testing--United States, 1991" 
Morbidity and Mortality Weekly Report (08/28/92) Vol.41, No.34, P.613
     Knowledge of HIV infection status and client-centered counseling  
can increase self-perception of risk and assist persons in  altering 
their behavior, thus decreasing their risk for infecting others or for 
becoming infected, writes the Centers for Disease  Control.  Of the 
2,090,635 HIV tests conducted in the 65 project  areas during 1991, 
57,879 (2.8 percent) tests were positive.  The highest rate of positive 
test results was found among  homosexual/bisexual male injecting-drug 
users (IDUs) (17.4  percent).  Among those homosexual/bisexual males who 
were not  IDUs, seroprevalence was 11.8 percent, and for heterosexual 
IDUs, 8.3 percent.  Client record data, representing a 60 percent  
subset of the aggregate counseling and testing (CT) data and  providing 
greater detail about persons receiving CT, suggested  that at least 74 
percent of the persons with HIV-positive test  results and 62.8 percent 
of those with negative test results  completed post-test counseling.  
Public health, to guarantee that persons with undetected HIV infection 
obtain appropriate CT,  should concentrate priorities on increasing 
testing of persons  engaging in risk behaviors and raising the number 
who receive the complete recommended CT, referral, and partner 
notification  services, the CDC concludes.

"Condom Use Among Male Injecting-Drug Users--New York City, 1987-1990" 
Morbidity and Mortality Weekly Report (08/28/92) Vol.41, No.34, P.17
     HIV transmission among heterosexuals continues to increase,  
especially among IV-drug users and their sex partners, write the  
Centers for Disease Control.  A study was conducted on condom use among 
450 male IV-drug users in New York City.  Participants were offered on-
site confidential HIV counseling and testing and were  paid $20 per 
interview.  They were also offered medical and  social services, 
including referrals for drug abuse treatment and "AIDS prevention kits."  
The majority (348--77 percent) of male  IV-drug users reported having 
"steady female sex partners, 21 (5  percent) reported only "casual 
partners, and 81 (18 percent)  reported having both "steady" and 
"casual" partners.  The largest  percentage of respondents reported 
never using condoms (193--43  percent), 139 (31 percent) reported always 
using condoms, and 118 (26 percent) reported using condoms occasionally.  
Respondents  with both steady and casual sex partners were more likely 
to use  condoms occasionally than were those with only steady or only  
casual sex partners.  Individual condom use was closely linked  with 
having peers who used condoms or safer sexual activities to  reduce 
risk.  Also, condom use was related to  cleaning needles  and other 
drug-injection HIV risk reduction activities, the CDC concludes
. 
"Women and AIDS" Maclean's (08/31/92) Vol.105, No.35, P.31 (Chisholm, 
Patricia)
     Statistics released last week in Canada demonstrated that in  
several parts of the country there has been an increase in the  number 
of women contracting HIV.  According to reports from  clinics in Ontario 
and British Columbia, about 10 percent of  those testing positive for 
HIV were women.  While some experts  considered the numbers to be less 
alarming than they seem,  citing technical reasons, others said the 
figures should serve  as a warning.  The increase could be partly 
attributable to the  recent growth in the number of Canadians seeking 
HIV tests.   Carol Major, head of the Ontario health ministry's HIV 
laboratory in Toronto, said that HIV testing has more than doubled since  
Magic Johnson revealed his infection.  Ministry officials said  that of 
32,000 women tested between Nov. 1, 1991 and the end of  April, 1992, 78 
were HIV positive, while out of 35,000 men  tested, 730 were positive.  
Approximately 10 percent of patients  testing positive in Ontario were 
women, compared with only 1.3  percent of those tested in the province 
in 1985, the first full  year of Canadian testing for HIV.  In British 
Columbia, the  number of women testing positive rose to more than 10 
percent in  the past year.  The majority of women who contracted HIV in 
both  provinces did so through heterosexual sex. 

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