CDC HIV/Hepatitis/STD/TB Prevention News Update (091103)

The CDC National Center for HIV, STD and TB Prevention provides the following information as a public service only. Providing synopses of key scientific articles and lay media reports on HIV/AIDS, other sexually transmitted diseases and tuberculosis does not constitute CDC endorsement. This daily update also includes information from CDC and other government agencies, such as background on Morbidity and Mortality Weekly Report (MMWR) articles, fact sheets, press releases and announcements. Reproduction of this text is encouraged; however, copies may not be sold, and the CDC NCHSTP Daily News Summary should be cited as the source of the information. Copyright © 2009, Information Inc., Bethesda, MD.

NATIONAL NEWS

UNITED STATES: US Lawmakers Push to Ramp Up Hepatitis Battle

Agence France Presse (11.02.09) - Tuesday, November 03, 2009

A bill introduced Thursday in the US House of Representatives would increase federal spending to prevent and treat hepatitis B and C. The diseases disproportionately affect Asian-Americans, and Asian-American lawmakers are pushing the new legislation.

HR 3974, whose short title is the "Viral Hepatitis and Liver Cancer Control and Prevention Act of 2009," was introduced by Rep. Mike Honda (D-Calif.). It would fund the fight through appropriations of $90 million in fiscal years 2010 and 2011, $110 million in FY 2012, $130 million in FY 2013 and $150 million in FY 2014. The bill's 11 cosponsors include four Republicans.

Rep. Bill Cassidy (R-La.), a physician, is a cosponsor. "As a hepatologist, I have witnessed firsthand the consequences hepatitis can inflict on a patient's health, their families and the nation's health care budget," he said.

Honda contends the nation's fight against hepatitis is underfunded: He points out that just $18.3 million is allocated to combat hepatitis in FY 2009, compared to $692 million for domestic HIV-fighting efforts.

"We have a wave of chronic liver disease that will crash like a tsunami on the United States health care system if we do not address this problem now," said Lorren Sandt, chair of the National Viral Hepatitis Roundtable. "This simple legislation will help identify the people who are chronically infected and get them into treatment, which can save millions in future health care costs."

The legislation was referred to the House Energy and Commerce Committee. Honda, who leads the Asian-American caucus in Congress, continues to seek additional supporters.

UTAH: The Birds, the Bees and the Basics

Salt Lake Tribune (10.28.09) - Tuesday, November 03, 2009

The curriculum, using materials from the Department of Health and Human Services' "Parents Speak Up" campaign, targets adults who will then instruct parents on the finer points of taking about sex with their children. About 20 people, including parents, local health department officials, and others, attended the first session in late October.

"The approach we want to take is instead of liberalizing the [school] curriculum and putting information in there a lot of parents don't feel comfortable with, we wanted to train the parents and let the parents teach the kids," said Utah PTA Health Commissioner Liz Zentner.

"I think parents should definitely be empowered to have this conversation with their children, said Melissa Bird, executive director of the Planned Parenthood council.

The PTA's campaign comes at a time when state lawmakers are considering legislation that would create two tracks for school-based sex education. Both would teach abstinence, but one also would include information about contraceptives and other issues. Attendance in either track would require parental permission.

"Even great kids from great families with strong moral values, [Latter Day Saints], Catholic, whatever, it can happen to any kid," said Michelle Brown, president of the Hillcrest High PTA. "If parents trick themselves into thinking it can't they're wrong."

INTERNATIONAL NEWS

GLOBAL: Experts Warn of Drastic AIDS Funding Shortfall

Agence France Presse (11.03.09) - Tuesday, November 03, 2009

When the global AIDS pandemic hits its 50th year, annual spending needed to fight the disease in developing countries could reach $35 billion, three times the current level, according to a new study. At the same time, more than 1 million people could be newly infected each year, estimated researchers for the AIDS 2031 project. The study is one of a series of articles about HIV/AIDS in the November/December issue of Health Affairs.

"The cost of fighting the epidemic for treatment and prevention is rising very rapidly around the world, especially in southeastern Africa," said study co-author Robert Hecht, managing director of the Washington-based Results for Development Institute. In the current global financial crunch, funding resources are becoming scarcer and other priorities more competitive, he said.

This is "a moment of opportunity, because it's a chance for government officials and external funders to take a hard look at what they have been doing and to find ways to spend the money that is available in a more efficient way to cut down on waste," said Hecht. Economizing strategies "need to be addressed as soon as possible if we are going to see a successful fight against AIDS over the next 10 to 20 years," he said.

One example of shifting to high-impact strategies would be to rely on nurses rather than doctors for treatment in some cases, said Hecht. For high-impact prevention, male circumcision has been shown to be very effective in reducing female-to-male HIV risk. Most young adult males are not circumcised in southeastern Africa, and infection rates there remain high, he said. In addition, antiretroviral drugs very effectively reduce mother-to-child HIV transmission risk, he noted.

INDIA: Uproar Against Changes to HIV Bill

The Telegraph (Kolkata) (10.26.09) - Tuesday, November 03, 2009

HIV/AIDS advocates are protesting changes made to an anti-discrimination bill, saying officials with the Ministry of Law and Justice have stripped away many crucial protections.

"The law ministry has gone beyond its mandate and deleted substantive provisions - the work of the law ministry was only to check whether the provisions of the bill are legally workable," said Anand Grover, an attorney with the Lawyers Collective's HIV/AIDS section. The non-governmental group helped draft the bill following consultations throughout India.

The law ministry deleted some provisions relating to a health ombudsman, an office that would ensure health care is not denied to HIV-positive people. Under the draft finalized by the health ministry, the ombudsman could order that services be provided within 24 hours in emergency cases. The law ministry has deleted this emergency power.

"Denial of health care services is a continuous problem - it happens routinely with HIV-infected persons," said Anushree Kini, an advocacy officer with the Lawyers Collective. "This 24-hour provision would be crucial in emergencies."

The Ministry of Law also has cut provisions for civil penalties if health workers violate the ombudsman's orders. And legal officials reversed the Ministry of Health's language that would have let health care providers decide whether to reveal a patient's HIV serostatus to his or her partner. Instead of "may," providers "shall" disclose a client's HIV status, making it mandatory.

In addition, the law ministry cut a provision that would allow older siblings to serve as guardians, even when still a minor, to safeguard the property rights of children of HIV-infected parents. Another deleted provision spelled out the need for an open and transparent market for HIV/AIDS treatments and diagnostics.

MEDICAL NEWS

UNITED STATES: Study Links Girls' Body Size to Sexual Behavior

Pittsburgh Post-Gazette (10.31.09) - Tuesday, November 03, 2009

Sexually active high school girls who were either overweight or who believed they were, as well as girls who were underweight, tended to use condoms less than girls of normal weight in a new study. Race and ethnicity played a role in the relationships between body and sexual behavior, though how exactly is not clear, according to lead author Dr. Aletha Akers of the University of Pittsburgh School of Medicine and colleagues.

Among 7,193 high school girls who completed the 2005 Youth Risk Behavior Surveillance survey, half reported having had sex. Caucasian girls who believed they were underweight, accurately or not, were more likely to be sexually experienced and to have had four or more sex partners. Overweight Caucasian girls were less likely to use condoms. Among African-American girls, those who were underweight were less likely to use condoms, while overweight girls were likelier to report four or more sex partners.

Regardless of weight or perception, Latina high school students were more likely to report sexual risks, including pre-teen sex and four or more sex partners. However, the sample size was small and the girls came from diverse nations and cultures, so researchers cautioned against drawing any broad conclusions.

Thin African-American girls and overweight Caucasian girls may feel less desirable in terms of cultural norms of attractiveness, and thus might be less willing to use condoms or capable of negotiating their use, Akers hypothesized.

"The goal is to point out that race is an important context of how girls think about their body image, and those variations influence how they negotiate sexual behavior," Akers said. She said she will ask for National Institutes of Health funding for a follow-up study.

LOCAL AND COMMUNITY NEWS

NORTH CAROLINA: STD Rates Increase in Iredell

McDowell News (Marion) (10.29.09) - Tuesday, November 03, 2009

Syphilis cases in Mecklenburg, Forsyth, Wake, and Wayne counties are at least twice the number they were at this time last year, according to the "North Carolina HIV/STD Quarterly Surveillance Report: Vol. 2009, No. 3."

In Iredell County, gonorrhea cases through the first nine months of the year totaled 187, compared to 163 during the same period in 2007. Chlamydia cases for the first nine months of 2009 and 2007 numbered 385 and 233, respectively.

Free testing for STDs is being planned through a statewide partnership between the Division of Public Health and health departments across North Carolina.

"Sexually transmitted diseases are not affecting one specific group of people," Evelyn Foust, director of the North Carolina Communicable Disease Branch, said in a release.

"It is important that anyone who is sexually active know their HIV and STD status in order to protect their health and the health of their partner," Foust said.

NEWS BRIEFS

TENNESSEE: State AIDS Drug Assistance Reaches Enrollment Capacity

Memphis Daily News (11.03.09) - Tuesday, November 03, 2009

The state AIDS Drug Assistance Program has reached its enrollment capacity, the Tennessee Department of Health announced Monday. Going forward, new patients seeking ADAP's assistance will be put on a waiting list. Persons on the waiting list will receive help accessing HIV drugs through patient assistance programs sponsored by drug makers. ADAP, which has $25.3 million in funding, had enrolled 3,367 Tennessee patients as of June, compared to 2,706 at the same time in 2008. The heightened demand for services is said to be the result of increased HIV testing efforts, rising unemployment among those living with the virus, and the swelling ranks of the uninsured. For more information, visit http://health.state.tn.us/STD/ryanwhite.htm or telephone 800-525-2437.

AUSTRALIA: Health Chief Sounds Tomato Warning

Australian Associated Press (11.02.09) - Tuesday, November 03, 2009

Reacting to the news that 23 cases of hepatitis A were diagnosed in the previous week, health authorities in Victoria have renewed their warnings about eating semi-dried tomatoes. More than two-thirds of those recently diagnosed reported having eaten the tomatoes, said Dr. John Carnie, the state's chief medical officer. Victoria has logged 200 hepatitis A notifications so far this year, compared to 74 during the comparable period in 2008, Carnie said. The greatest risk appears linked to semi-dried tomatoes found in restaurants, where they are typically served in salads and sandwiches. Bottled semi-dried tomatoes sold in supermarkets were pasteurized and are thus considered safe, as are foods containing cooked semi-dried tomatoes.

CDC HIV/Hepatitis/STD/TB Prevention News Update

For Tuesday, November 03, 2009