From: Billi Goldberg <bigoldberg@igc.apc.org>
Subject: CDC Summary 12/28/92
Note: Copyright 1992, Dan R. Greening. Non-commercial reproduction allowed.
Archive-Number: 6681
Organization: unspecified
Date: Mon, 28 Dec 92 08:00:15 PST

                        AIDS Daily Summary
                         December 28, 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 

 "On a Scale of Sorrows" Washington Post (Business) (12/28/92), P. 1  
(McKee, Bradford)
     Many people in the Washington, D.C., area have experienced some  
sort of setback after their AIDS-infected status was discovered  by 
their employers, according to local legal and health care  experts who 
track the disease.  Dinah Wiley, legal services  director for the 
District's Whitman-Walker AIDS Clinic, said that instances of AIDS-
related bias emerge once or twice a week in the city, and virtually all 
cases are settled privately between the  employer and the employee.  
Approximately 2,500 people in the  Washington area have AIDS, while 
20,000 or more in the city alone may be infected with HIV.  Employees 
infected with HIV or AIDS  face pressure because employers experience a 
sharp rise in health care costs or have concerns, often misplaced, about 
health risks  to co-workers and customers, said experts.  Wiley said in 
most  cases, employers deny AIDS-related bias, and take steps against  
the employee because of worries about medical insurance costs.   In the 
past three years, 17 people in the District have filed  complaints with 
the Department of Human Rights alleging AIDS bias by employers.  
Regardless of AIDS education efforts, some  employers who act against 
employees are motivated more by fear of AIDS than by concern over health 
costs.  The Health Insurance  Association of America is encouraging 
insurers and policy-holders to deal with AIDS "like any other disease," 
said spokesman Donald White.  The group has supported a proposal 
requiring the overhaul of group insurance for smaller employers, in 
order to guarantee  health care to all Americans, despite their 
conditions.

"Scientists Test 'Cell Therapy' in Fight Against AIDS Tumors" Baltimore 
Sun (12/28/92), P. 3A
     A study investigating a procedure known as "cell therapy" will be 
conducted this month in San Francisco to test the procedure's  efficacy 
in fighting Kaposi's sarcoma.  The study will be the  third and most 
extensive trial of cell therapy.  The procedure  involves removing white 
blood cells, known as CD8 cells, from the patient's blood.  These are 
subsequently isolated and treated  with small doses of Interleuken sII, 
a cancer-fighting drug, and  phytohemaglutina, a soybean extract.  The 
cells are then  incubated for two to three weeks, during which time they 
multiply about tenfold.  Later they are reinfused by the billions into 
the patient's bloodstream.  The goal is to use a patient's own cells  to 
fight the tumors, and thus encourage the strengthening of an  immune 
system that has been weakened by HIV infection.  Applied  Immune 
Sciences, the small biotechnology firm in Santa Clara,  Calif., that 
developed the procedure, says it has shown good  results in two earlier 
tests, and no negative side effects.  The  company hopes the study will 
verify cell therapy's effectiveness  against Kaposi's sarcoma and help 
create a broad treatment for  AIDS and other immune-system diseases.  
Dr. James Kahn, associate director of the AIDS program at San Francisco 
General Hospital  and assistant professor of medicine at the University 
of  California--San Francisco, is directing the study, which will  test 
20 people.  He hopes to introduce preliminary findings from  the study 
at the international conference on AIDS in Berlin in  June. 

"Volunteers Fill Void for AIDS Patients" Los Angeles Times (12/27/92), 
P. B3  (Dennison, Mike)
     A program designed to provide "companion-advocates" for AIDS  
patients was started in Grand Junction, Colo.  Many AIDS patients are 
shunned by society because they are homosexual or because of  fears of 
transmission of the virus, and are often abandoned by  their families 
and left with little or no money.   Companion-advocates, such as those 
in the Colorado program,  provide friendship and help.  They take 
patients to doctor  appointments, help them take their medication, take 
them out for  meals, or even go camping with them.  Most importantly, a 
program volunteer will remain with a patient until he or she dies.   
Program training sessions to become a companion-advocate often  include 
listening to local attorneys explaining the legal  implications of AIDS 
and doctors fielding questions about the  disease.  Robert Barone, the 
program organizer, speaks to school  groups, churches, service clubs, or 
anyone who will listen.  He  frequently takes young HIV-positive 
patients with him when he  speaks.  Barone has organized four seminars 
that have trained 62  volunteers.  A total of 18 people in Grand 
Junction who are  infected with HIV have been assigned companion-
advocates, and  Barone wants to train enough volunteers so that at least 
three  advocates can be assigned to each AIDS patient who needs help.   
While Barone has no shortage of volunteers, he says he still  encounters 
ignorance and prejudice about the disease.  He said,  "There are still 
people I run into who have no idea we have an  AIDS problem." 

"Ill Artists' Effort to Insure That Art Survives AIDS" Washington Post 
(12/27/92), P. 1  (Collins, Glenn)
     A New York City program helps artists deal with the painful  
question of the future of their works after they die.  Kevin  Oldham, an 
HIV-positive composer, said, "It seems to me that  whether you stay 
alive or not seems to be the trivial part.  It's your work itself that 
must have a life of its own.  If I can make sure that my music will 
continue to have life, that seems to be  the more important 
consideration."  Oldham has received  assistance from the Estate Project 
for Artists with AIDS, which  is encouraging those in every artistic 
discipline to catalogue  their works and prepare their estates.  
Alliance for the Arts, a  nonprofit arts service and educational 
organization based in  Manhattan, sponsors the project.  Patrick Moore, 
the project  director, said that while most people hesitate to make 
wills,  several artists don't think about their estates until they are  
seriously ill.  So far, the project has provided information to  more 
than a thousand artists with AIDS, telling them to plan  early while 
they are still well.  In addition, it tells them to  document and 
inventory works in their own or other's possession,  to execute a will, 
and to designate capable and knowledgeable  executors, trustees, and 
beneficiaries.  The project was started  in July 1991, and has 
disseminated 25,000 estate-planning  brochures to artists' groups, AIDS 
service groups, and public  libraries.  The Estate Project refers 
artists to various  information and legal resources, in addition to 
archives and  service groups like Safe House, a Manhattan-based 
repository for  the work of writers who have AIDS and other life-
threatening  illnesses. 

"Gay Episcopal Priest Dead of AIDS-Related Disease" United Press 
International (12/27/92)
     Boston--The first openly homosexual priest in the Episcopal  Church 
has died of AIDS.  After a fight against the disease for  several years, 
the Rev. J. Robert Williams succumbed to a  pulmonary infection 
Christmas Eve at Beth Israel Hospital in  Boston.  He was 37 years old.  
In 1989, Williams was ordained in  New Jersey by Bishop John Spong, the 
controversial head of the  church's Newark diocese.  Williams headed The 
Oasis, a Hoboken,  N.J., ministry to gay men and women.  He was asked to 
resign a  few weeks after his ordination because he said in a speech 
that  Mother Theresa, the Nobel-winning Catholic nun, should have sex  
and called monogamy as unnatural as celibacy.  Subsequently he  moved to 
Provincetown, Mass., where he joined a small  denomination, the Western 
Orthodox Catholic Church, and operated  a healing ministry.  He 
published one book, "Just As I Am: A  Practical Guide to Being Out, 
Proud, and Christian," and was  working on a second book at the time of 
his death. 

"Selected Behaviors That Increase Risk for HIV Infection, Other  
Sexually Transmitted Diseases, and Unintended Pregnancy Among  High 
School Students--United States, 1991" Morbidity and Mortality Weekly 
Report (12/18/92) Vol. 41, No. 50, P. 945
     A significant percentage of American students engage in behaviors 
that simultaneously put them at risk for HIV infection, sexually 
transmitted diseases, and unintended pregnancy, write the Centers for 
Disease Control.  Data were collected from two school-based components 
of the CDC's Youth Risk Behavior Surveillance System: state and local 
Youth Risk Behavior Surveys (YRBSs) conducted by departments of 
education in 23 states and 10 cities during  April-May 1991 and the 
national YRBS conducted during the same  period.  The survey obtained a 
sample of 12,272 students  representative of students in grades 9-12 in 
the 50 states and  the District of Columbia.  Risk behaviors addressed 
in the survey include having sexual intercourse, having sexual 
intercourse with multiple sex partners, IV-drug use, not practicing 
contraception, and not using condoms.  Among the participants in the 
state and  local surveys, 33-79 percent reported ever having had sexual  
intercourse; 54-78 percent reported being currently sexually  active; 
and 8-46 percent reported having had sexual intercourse  with four or 
more partners during their lifetime.  In 27 of the  28 sites, male 
students were more likely than female students to  report ever having 
had sexual intercourse and having had four or  more sex partners during 
their lifetime.  In 26 of 28 sites,  female students were more likely 
than male students to report  being currently sexually active.  In all 
sites, 5 percent or less of male and female students reported IV-drug 
use.  Also, 28-53  percent of participants reported they or their 
partner had used a condom at last sexual intercourse, the CDC concludes. 

"ADA May Widen HIV Coverage" National Law Journal (12/21/92) Vol. 15, 
No. 16, P. 26   (Rumeld, Myron D. and Brook, Richard)
     Health plan sponsors and fiduciaries have resorted to provisions 
limiting coverage for certain types of illnesses or treatments in an 
effort to control rising costs.  Caps or restrictions on  coverage for 
the treatment of AIDS or HIV have become  particularly common despite 
the dramatic increase in claims for  HIV-related care and the potential 
effect of such claims on the  financial stability of many health plans.  
The Americans with  Disabilities Act, designed to prohibit 
discrimination against  employees with disabilities, will give claimants 
a more effective legal weapon.  But the Employee Retirement Income 
Security Act of 1974 (ERISA) gives broad discretion to plan sponsors and  
fiduciaries to determine how best to control plan costs.  Plan  
fiduciaries may cite policies and considerations that are not  cost-
based when defending plan rules limiting coverage for HIV  treatment.  
For instance, some plans deny coverage for the  treatment of drug abuse, 
and on that basis might deny coverage  for HIV patients when the 
evidence indicates that the virus was  contracted through drug abuse.  
The exact impact of the ADA on  rules capping coverage will depend, 
however, on the construction  of vague and conflicting provisions of the 
statute and its  underlying legislative history.  The ADA does not 
directly  prohibit restrictions on HIV coverage, but it may indirectly 
do  so by opening the door for state law challenges that until now  have 
been considered pre-empted by ERISA.  Until the  uncertainties prompted 
by passage of the ADA are resolved by the  courts and the Equal 
Employment Opportunity Commission, many  plans are likely to choose 
other means of controlling costs. 

"Trials Set in High-Risk Populations" Science (12/11/92) Vol. 258, No. 
5089, P. 1729  (Cohen, Jon)
     The National Institute of Allergy and Infectious Diseases  recently 
announced that it is launching a trial of two preventive HIV vaccines 
that will be administered to people considered to be at high risk of HIV 
infection in addition to those at low risk.   Small-scale tests of 
preventive vaccines, conducted over the past six years, have included 
only volunteers from low-risk groups.   The placebo-controlled, Phase II 
trial will involve 330  uninfected volunteers at five different 
university medical  centers.  The volunteers will include drug users, 
people with  sexually transmitted diseases, and minorities.  The test 
will  assess whether people at high risk and minorities have different  
responses from the healthy whites who dominated the earlier  trials.  
NIAID's Patricia Fast, a trial coordinator, said that  some high-risk 
uninfected subjects may already have been exposed  to HIV, an exposure 
that might have altered their immune systems. Because the new trial will 
enroll hundreds instead of dozens of  people, safety problems with the 
vaccines are also more likely to emerge.  Both vaccines in the trial are 
genetically engineered  versions of the HIV surface protein called 
gp120.  It is still  undetermined when a Phase III trial in thousands of 
people at  high-risk, which is the most conclusive test of AIDS vaccine  
efficacy, will take place.

"New TB Research Facility" Science (12/11/92) Vol. 258, No. 5089, P. 
1734   (Holden, Constance)
     A new research center at the Public Health Research Institute, a 
private research group in New York City, has been opened to  research 
tuberculosis.  The center's president, Lewis Weinstein,  said, 
"Multidrug-resistant TB is reaching epidemic proportions."  In fact, in 
only 2 years, the number of cases has escalated from  a few dozen to an 
estimated 1,000.  What's worse is the disease  is now primarily 
affecting HIV-infected individuals who have  depleting immune systems.  
Also, it affects these patients  because they often fail to comply with 
the full 6 to 9 months of  treatment, the disease often recurs in even 
more drug-resistant  forms.  Barry Kreiswirth, a molecular biologist, is 
expected to  head the TB center, which will serve as a lab in the 
institute's  existing facility.  Private sources will fund the center 
with a  budget of $2.5 million over the next three years.  The new  
facility hopes to DNA fingerprint TB cultures with the intention  of 
developing a large database that will facilitate quick  diagnosis of 
different strains and their reactions to different  drugs.  Using 
conventional methods, it can take weeks to grow TB  cultures and test 
drugs on them.  Weinstein said another goal is  to test different drugs 
in the lab, including many currently on  the shelves at pharmaceutical 
companies.  In addition, various TB diagnostics will be tested, 
including polymerase chain reaction.  The budget of the new program 
signifies a sharp increase for TB  research, even though the federal TB 
budget this fiscal year is  only $5.4 million. 

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