dmcanzi@watserv1.uwaterloo.ca (David Canzi) (04/15/91)
Medical News for March 18 to April 4, 1991
Copyright 1991: USA TODAY/Gannett National Information Network
Reproduced with Permission
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March 20, 1991
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AZT MAKER SUED BY GROUP:
An AIDS advocacy group, accusing the makers of the drug AZT of charging too
much, is suing the company in an attempt to nullify its patent. In their
lawsuit, two HIV-infected men and the People With AIDS Health Group, New York
City, say Burroughs Wellcome Co.'s patent should be invalid because the
company was not alone in developing AZT for treating AIDS in humans.
BURROUGHS SAYS SUIT UNFAIR:
Burroughs Wellcome says it has acknowledged other contributions in AZT's
development. In 1987, the Food and Drug Administration approved AZT as a
treatment for AIDS. Last year, Burroughs Wellcome sold $287 million of AZT
worldwide, under the brand name Retrovir. The company says since it began
marketing AZT it has lowered the cost by about 70 percent to $2,000 a year.
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April 3, 1991
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PREGNANT WITH AIDS:
Up to 80,000 U.S. women ages 15 to 44 may be infected with HIV, the virus
that causes AIDS, researchers say in Wednesday's Journal of the American
Medical Association. Government scientists looked at tests of newborns in 38
states and the District of Columbia. When infants test positive for HIV
antibodies it means their mothers are infected.
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April 4, 1991
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JOURNAL REPORTS ON AIDS:
The AIDS virus enters the body like a killer lion, but is quickly tamed by
powerful natural defense mechanisms, two new studies show. Identifying those
mechanisms - and understanding how the virus eventually escapes them - could
lead to vaccines and drugs that prevent HIV infection or stop it before it
causes AIDS, scientists report in The New England Journal of Medicine.
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Center for Disease Control Reports
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Morbidity and Mortality Weekly Report
Thursday March 28, 1991
Current Trends
Characteristics of, and HIV Infection among, Women Served by Publicly
Funded HIV Counseling and Testing Services -- United States, 1989-1990
In 1990, the number of reported acquired immunodeficiency syndrome (AIDS)
cases among women in the United States exceeded 15,000, an increase of 34%
from 1989 (1). Public health surveillance of the human immunodeficiency virus
(HIV)/AIDS epidemic has included monitoring of publicly funded voluntary
counseling and testing (CT) programs, such as the voluntary client record
system (representing 43% of all reported CT visits) that collects detailed
information for each CT visit. This report summarizes findings based on
information from the client record system for women who received public CT
services during 1989 and 1990.
During 1989 and 1990, women accounted for approximately 1 million (48%) of
the 2.2 million tests reported by all CT programs. Of these, 47% of tests were
from white women; 35%, black women; and 16%, Hispanic women; in comparison,
these groups account for 79%, 11%, and 6%, respectively, of the U.S. female
population (2). Approximately 20,000 (2%) tests were positive for HIV
antibody, including 0.9% among whites, 3.3% among blacks, and 3.7% among
Hispanics.
Nearly all CT visits by women occurred in either sexually transmitted
disease (STD) clinics (29%), HIV CT sites (29%), or women's (family planning
and prenatal) clinics (28%). Of seropositive tests, 40% were from CT sites,
29% from STD clinics, and 8% from women's clinics. Drug-treatment centers
accounted for 4% of all tests and 7% of all positive tests; however, the
seropositivity rate among tests from drug-treatment centers (3.7%) was higher
than tests from other sites (CT sites, 3.0%; STD clinics, 2.2%; and women's
clinics, 0.7%) (Table 1).
Most (80%) women who were tested did not report HIV risk behavior
(including 81% of blacks, 76% of Hispanics, and 69% of whites) (Figure 1, page
203). Of women who did not report HIV risk behavior, 1.0% were seropositive;
however, seropositivity varied by race and ethnicity (1.9%, 1.0%, and 0.3% in
black, Hispanic, and white women, respectively). Of seropositive women, 65%
reported a specific risk behavior; 35% reported no risk behavior (22% among
whites; 24%, Hispanics; and 44%, blacks).
Intravenous (IV)-drug use was reported by 8% of all women, compared with
31% of those who were seropositive. Among black, Hispanic, and white women who
identified themselves as IV-drug users, seropositivity was 16.7%, 15.0%, and
3.8%, respectively. Of seropositive women, IV-drug use was reported by 43% and
32% of white and Hispanic women, respectively, compared with 26% of black
women.
Women who were sex partners of persons at risk accounted for 13% of those
tested, but 27% of all seropositive tests (20%, 30%, and 40% of all
seropositive black, white, and Hispanic women, respectively). The overall
seropositivity among women who were sex partners of persons at risk was 4.3%
(1.5%, 8.2%, and 3.6% for whites, blacks, and Hispanics, respectively).
Reported by: HIV prevention programs of state and local health depts. Program
Development/Technical Support Section, Div of STD/HIV Prevention and Office of
the Deputy Director (HIV), Center for Prevention Svcs, CDC.
Editorial Note: This assessment of findings at CT sites underscores the
disproportionate impact of the HIV epidemic on minority populations in the
United States (1). However, because these data reflect characteristics of
women who receive services at public clinics (Table 1), they cannot be
considered representative of all U.S. women. In addition, because these data
are collected in service delivery settings, data regarding risk may be less
reliable than those obtained during epidemiologic investigations, particularly
for persons who initially report no HIV risk behavior.
Nearly half the HIV tests reported by publicly funded CT programs are from
women, among whom blacks and Hispanics are disproportionately represented.
Although 17% of all women in the United States are black or Hispanic (2),
blacks and Hispanics accounted for 73% (52% and 21%, respectively) of reported
AIDS cases among women (1). Because of the high prevalence of HIV infection
and AIDS among these groups, community-based outreach programs should actively
encourage women--especially minority women--to seek HIV-prevention services.
Sexual transmission of HIV is associated with certain STDs. In the United
States, syphilis incidence is 50-fold greater among black women and 10-fold
greater among Hispanic women than among white women (3). HIV infection and
transmission have been epidemiologically linked with genital ulcer disease,
including syphilis (3-5), suggesting that genital ulcer disease facilitates
HIV transmission.
Previous documentation of the association between syphilis and
transmission of HIV (3-5) suggests that syphilis contributes to heterosexual
transmission of HIV in selected U.S. populations. However, because many women
at risk for syphilis may not be aware of the associated risk for HIV, they may
have reported no risk behaviors during pretest counseling. Accordingly, STD
and HIV control programs should direct efforts to diagnosing and treating
women who have syphilis or who are reported as sex partners of syphilis
patients (6) and should ensure that these persons receive HIV CT.
STD and HIV prevention programs need to maximize the proportion of high-
risk women who receive comprehensive HIV risk assessment, accept pretest
counseling, accept HIV testing, return for their test results, and receive
posttest counseling. Based on the data in this report, a substantial
proportion of women who seek HIV CT services at selected public sites may be
at risk for HIV infection; however, many of these women may be unaware of, or
unwilling to report, a specific risk behavior. Therefore, CT sites that serve
women in areas with high prevalence of HIV seropositivity should routinely
offer all clients HIV counseling and testing. In areas with low prevalence of
HIV seropositivity, standardized, thorough risk assessments may assist in
identifying a person's risks for HIV infection, and recommendations for HIV
testing can be made based on the results of each assessment.
References
1. CDC. HIV/AIDS surveillance. Atlanta: US Department of Health and Human
Services, Public Health Service, January 1991:9-14.
2. Department of Commerce. Census of population, general population
characteristics, United States summary. Washington, DC: US Department of
Commerce, Bureau of the Census, May 1983:1-21.
3. Rolfs RT, Nakashima AK. Epidemiology of primary and secondary syphilis in
the United States, 1981 through 1989. JAMA;264:1432-7.
4. Cameron DW, Simonsen JN, D'Costa LJ, et al. Female to male transmission of
human immunodeficiency virus type I: risk factor for seroconversion in men.
Lancet 1989;2:403-7.
5. Quinn TC, Cannon RO, Glasser D, et al. The association of syphilis with
risk of human immunodeficiency virus infection in patients attending sexually
transmitted disease clinics. Arch Intern Med 1990;150:1297-302.
6. Toomey KE, Cates W Jr. Partner notification for the prevention of HIV
infection. AIDS 1989;3(suppl 1):S57-62.
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Volume 4, Number 7 April 5, 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.