dmcanzi@watserv1.uwaterloo.ca (David Canzi) (04/23/91)
Medical News for Week April 5 to April 11, 1991
Copyright 1991: USA TODAY/Gannett National Information Network
Reproduced with Permission
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April 5-7, 1991
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AGOURON REPORTS ON HIV ENZYME:
Agouron Pharmaceuticals Inc. Thursday said its scientists have solved the
atomic structure of a protein which plays a critical role in infection by the
Human Immunodeficiency Virus. The discovery, reported in the Science, is
expected to contribute to the development of new drugs for treatment of AIDS.
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April 8, 1991
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CHILDREN MORE SUSCEPTIBLE TO PCP:
Young HIV-infected children who contract pneumocystis carnii pneumonia are
less likely to survive than adults with similar conditions, according to a
study in the Journal of the American Medical Association. PCP is a common
disease among HIV-1 patients.
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Center for Disease Control Reports
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Morbidity and Mortality Weekly Report
Thursday April 4, 1991
AIDS-Related Knowledge and Behaviors Among Teenagers -- Italy, 1990
As of December 31, 1990, the number of acquired immunodeficiency syndrome
(AIDS) cases in Italy exceeded 8000 (1). Although 67% of AIDS cases in Italy
occurred among intravenous (IV)-drug users, the role of transmission through
heterosexual contact with human immunodeficiency virus (HIV)-infected persons
has increased, accounting for 7% of cases in 1990, compared with 2% in 1985.
As part of an AIDS epidemiology course in Frascati for regional AIDS
epidemiologists (approximately 20 km (13 miles) south of Rome) in November
1990, course participants surveyed AIDS-related knowledge and behaviors among
students attending the five high schools in the local school district. This
report summarizes findings of the survey, which aimed to characterize AIDS-
related knowledge and behaviors of this population.
Survey participants were students attending the five high schools in the
district. Each school had five grade levels; ages of students range from 14 to
19 years. Of the 112 homeroom classrooms in the district, 27 classrooms were
randomly selected for the survey. A self-administered, anonymous
questionnaire, identical to that used to survey U.S. high school students (2),
was administered to all 547 students in the selected classrooms.
Fifty-two percent of the respondents were male. A greater percentage of
students were in the lower grade levels (range: 36% in grade level 1 to 10% in
grade level 5), reflecting the smaller number of classes and smaller class
sizes in the higher grade levels. Of the students sampled, 28% attended
classical or scientific high schools, and 72% attended technical high schools-
-a distribution similar to that of the district.
Overall, 98% of students correctly identified IV-drug use and 95%
correctly identified sexual intercourse without a condom as risk factors for
AIDS. In addition, 54% knew that AIDS cannot be contracted from using public
toilets; 51%, AIDS cannot be contracted by having a blood test; 48%, AIDS is
not transmitted through insect bites; and 41%, AIDS cannot be contracted
through blood donation. Although 92% identified condoms as protective, 64%
knew that oral contraceptives do not protect against AIDS. In general,
knowledge levels were higher in the upper grade levels and the classical and
scientific schools.
Sixty-two percent of students reported obtaining their information about
AIDS from television. Fifty-nine percent indicated they would ask medical
personnel for correct information about AIDS; 18%, their parents; and 6%,
their teachers.
One percent of students reported having used drugs intravenously (0.4% of
females and 1.7% of males); 0.4% of students reported having shared needles.
Twenty-three percent reported having had sexual intercourse, and 4% reported
having had four or more sex partners. In general, sexual activity was reported
more commonly by males, and males reported initiating sexual activity at an
earlier age than females (Figure 1). Ages of initiating sexual activity were
similar for students in all schools.
Although levels of knowledge concerning the protective effect of condoms
were high, reported use of condoms was low: among sexually active students,
14% of males and 41% of females reported never using condoms; 54% of males and
37% of females reported always using condoms.
Reported by: P Lorenzetti, MD, P Rossi, MD, Aosta; L Armignacco, MD, C De
Siefano, MD, P Ferrara, MD, Basilicata; G Iannicelli, MD, M Sangalli, DBiol, M
Zaccarelli, MD, Latium;A Belloni, MD, F Castelli, MD, A Parisi, MD, Lombardy;
N Morandi, MD, A Morando, MD, R Stagnaro, MD, Liguria; M Amati, DBiol, S
Battuci, MD, A Beretta, MD, Marches; G Paggi, MD, B Salassa, MD, Piedmont; C
Germinario, MD, O Iacobellis, MD, S Lo Caputo, MD, Apulia; C Aiazzi, MD, D
Milio, MD, M Rubino, MD, A Scasso, MD, Tuscany; G Gosetti, MD, TrentinoAlto
Adige; M Alongi, DEd, D Arpaia, DEd, G Cicconi, DEd, F De Zardo, DEd, E
Napolitani, DEd, 37th School District, Latium. D Greco, MD, P Pezzotti,
DStatistics, S Saimaso, DBiol, A Tozzi, MD, AIDS Task Force, Istituto
Superiore di Sanita, Rome, Italy. International Br, Div of Field
Epidemiology, Epidemiology Program Office, CDC.
Editorial Note: Although the proportion of incorrect responses among the
students in this survey was higher than that reported in the United States
(2), these findings are consistent with those from other urban high schools in
Italy (3,4). Incorrect knowledge about means of transmission can lead to
unnecessary fears and stigmatization of HIV-infected persons and may limit the
effect of public health messages concerning the risks associated with IV-drug
use and high-risk sexual practices. In addition, the incorrect belief that
oral contraceptives protect against HIV infection may prevent persons from
taking appropriate precautions to protect themselves. These findings indicate
the need for educational efforts that promote correct knowledge and
understanding of risk factors associated with HIV infection.
Previous surveys of students in Italy did not address IV-drug use. The
prevalence of reported IV-drug use in this survey was lower than that of U.S.
students, although differences may be accounted for in part by the relatively
younger ages of the students in Italy and by cultural differences in the
acceptability of reporting IV-drug-use behaviors. The findings of this survey
are also consistent with previous reports that most IV-drug users in Italy
share needles, and virtually all begin doing so within a year of beginning IV-
drug use (5). In view of both these findings and the young age (mean: 28.5
years) of Italians diagnosed with AIDS (1) (which suggests that most became
infected as teenagers), more effective IV-drug education is urgently needed.
In this survey, the percentage of students who reported having had sexual
intercourse was considerably lower than that reported in other European
countries and in the United States (6-8), although it is consistent with
findings of other studies in Italy (9). The frequency of multiple sex partners
also was lower than that reported in the United States. Although lower than in
some countries, the proportion of sexually active teenagers nonetheless
underscores the need for additional sex education.
Although a high percentage of students knew that condoms may protect
against AIDS, routine use of condoms among sexually active teenagers was
relatively low--a finding of particular concern for females. In view of the
greater risk for heterosexual transmission from males to females than from
females to males (10), levels of awareness about risk for HIV infection must
be increased among females.
Only a small percentage of students reported having obtained AIDS
information from school. However, attempts have been initiated to increase the
role of schools in education about HIV infection and AIDS. In several regions
in Italy, innovative HIV/AIDS education programs have begun in the schools. In
addition, under the auspices of the Ministry of Education and the National
AIDS Committee National Training Program for HIV Infection at the Istituto
Superiore di Sanita, week-long workshops that involve participation of local
authorities in the development of appropriate teaching materials and curricula
are being held throughout Italy.
References
1. AIDS Task Force. Summary of AIDS cases notified in Italy as of December
31, 1990. Rome, Italy: Istituto Superiore di Sanita, 1991.
2. CDC. HIV-related knowledge and behaviors among high school students--
selected U.S. sites, 1989. MMWR 1990;39:385-9,395-7.
3. Signorelli C, Antelitano M, Fara GH. Evaluation of knowledge about AIDS in
a group of young people in Milan. Fedeerazione Medica 1990;XLIII(2):159-63.
4. Marin V, Moretti G, Carlotto A. How much do young people know about AIDS?
Medico Epaziente 1990;1:12-7.
5. Salmaso S, Conti S, Sasse H, and the Second Multicenter Study Group. Drug
use and HIV-1 infection: report from the second Italian multicenter study. J
Acquir Immune Defic Syndr 1991 (in press).
6. Fustenberg FF, Moore KA, Peterson JL. Sex education and sexual experience
among adolescents. Am J Public Health 1985;75:1331-2.
7. O'Reilly KR, Azol SO. Adolescence and sexual behavior: trends and
implications for STD. J Adolesc Health Care 1985;6:262-72.
8. Misfeldt JC, Werdelin L, Senderovitz F, Melbye M, Olsen V. The sexual
habits of young Greenlanders and their knowledge of AIDS: a study done among
students in vocational schools in Greenland in 1989. Ugeskr-Laeger
1990;22;152(4):237-9.
9. National AIDS Committee. Survey on the sexual behaviors of young people.
PRAGMA: Rome, September 1989.
10. Padian N, Shiboski S, Jewell N. The relative efficiency of female-to-male
HIV sexual trans mission (Abstract). VI International Conference on AIDS. Vol
1. San Francisco, June 20-24, 1990:159.
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Volume 4, Number 8 April 18, 1991
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Editor: David Dodell, D.M.D.
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--
David Canzi "Do not let superstition inhibit your actions."
-- Jeane Dixon, horoscope for Virgo, May 17, 1990.