KAISER DAILY HIV/AIDS REPORT
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Monday, April 7, 2003

POLITICS AND POLICY
========================================
1. HHS Awards $3.8 Million in Grants for HIV/AIDS Health Services for
Medically Underserved Communities

2. New York HIV Planning Council To Investigate Reduction in Federal Ryan
White CARE Act Funding for New York City

3. Bush Administration, Prominent Republicans 'Pressure' Maryland Gov.
Ehrlich To Veto Medical Marijuana Bill


ACROSS THE NATION
========================================
4. Florida Health Department Recalls HIV/AIDS Brochure With Religious
Content


DRUG ACCESS
========================================
5. California Medicaid Program Enacts Tighter Controls on Drug Used To
Treat AIDS Wasting


GLOBAL CHALLENGES
========================================
6. Faith-Based Groups From United States, Africa Join To Combat HIV/AIDS

7. Population Losses Due to HIV/AIDS Means Famine in Africa 'Could Last for
Generations'


MEDIA & SOCIETY
========================================
8. Churches Employ Variety of Sexual Education Programs in Curricula,
Washington Post Reports


SCIENCE & MEDICINE
========================================
9. South African Medical School To Conduct Electromagnetic HIV Treatment
Clinical Trials


OPINION
========================================
10. Congressional Politics Hampering AIDS Legislation, Washington Post
Editorial States

11. Blacks Should Engage in More 'Straight Talk' About Sexuality To Prevent
HIV, USA Today Opinion Piece Says

****************************************

POLITICS AND POLICY

1. HHS Awards $3.8 Million in Grants for HIV/AIDS Health Services for
Medically Underserved Communities

Access this story and related links online:
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=17018

HHS Secretary Tommy Thompson on Thursday announced $3.8 million in grants
to help provide outpatient and primary care services to low-income people
who are either living with HIV/AIDS or are at risk of contracting the
virus, according to a Health Resources and Services Administration release.
The 12 grants, awarded under the Title III Early Intervention Services
program of the Ryan White CARE Act, will go to community-based clinics,
hospitals, public health departments and universities in nine states. The
grants will help fund testing and referral services, medical evaluations
and clinical care, oral health care, drug adherence and nutritional
counseling, outpatient mental health services and outpatient substance
abuse treatment. The funding will help "ensure that early HIV care is
targeted to needy communities" in inner cities and rural and remote areas,
according to HRSA. Thompson said, "Today's grants will help get people in
to be tested and see that they receive early treatment to slow progression
of the disease." HRSA Administrator Elizabeth Duke said that the grant
recipients -- all of which have received such funding for at least the past
three years -- "have a track record of providing outstanding services to
people living with HIV/AIDS who need it most" (HRSA release, 4/3).

2. New York HIV Planning Council To Investigate Reduction in Federal Ryan
White CARE Act Funding for New York City

Access this story and related links online:
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=17019

The HIV Health and Human Services Planning Council of New York on Thursday
voted to begin investigating the reasons behind a $14 million reduction in
New York City's allotment of federal Ryan White CARE Act funds, Long Island
Newsday reports (Ramirez, Long Island Newsday, 4/4). HHS this year awarded
New York City 12% less than last year in federal Ryan White CARE Act funds,
which was the largest reduction nationwide. Although the allocation of
funds based on the number of AIDS cases in New York City increased, the
allocation of supplemental funds based on severity of need decreased from
$48 million last year to $32 million this year (Kaiser Daily HIV/AIDS
Report, 4/3). The council, a 50-member panel that decides how to
distribute Ryan White funds, blamed the city's health department for the
cut. HIV/AIDS advocates and public officials have said that the
department's application for funding was "tardy and poorly prepared,"
according to Newsday. However, Health Commissioner Thomas Frieden defended
the application, saying, "If you find problems with the application, let's
use that to make sure next year's application is better. But my take is
that absolutely nothing in the application justifies this cut." He also
said that city officials are discussing with federal officials how to
restore the funds. Joe Pressley, a council member, said that Mayor Michael
Bloomberg (R) should "fix this hole that I think he created," adding, "New
York City lags woefully behind other cities in the proportion of tax
dollars devoted to AIDS." In a separate move, City Council Speaker Gifford
Miller (D) filed a formal complaint about the cut with the federal
government, Newsday reports (Long Island Newsday, 4/4).

3. Bush Administration, Prominent Republicans 'Pressure' Maryland Gov.
Ehrlich To Veto Medical Marijuana Bill

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http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=17020

Bush administration officials and other prominent Republicans are "heavily
pressuring" Maryland Gov. Robert Ehrlich (R) to veto a bill that lessens
penalties for seriously ill patients who use marijuana as medicine, the
Baltimore Sun reports. Ehrlich is a "longtime" supporter of medical
marijuana, and he has said he is willing to consider signing the
legislation, according to the Sun (Craig, Baltimore Sun, 4/4). The
Maryland Senate last month approved the measure (S 502), which would reduce
penalties for people who use marijuana for medical purposes, including
people with HIV/AIDS. Marijuana can be used to ease nausea, pain and other
symptoms commonly associated with terminal or chronic illnesses. The bill
(HB 702), which was passed in the state House last month, would set a fine
of up to $100 for using marijuana due to "medical necessity." In other
circumstances, marijuana possession carries a maximum penalty of up to one
year in jail and a $1,000 fine (Kaiser Daily Reproductive Health Report,
3/27). Ehrlich, who co-sponsored medical marijuana legislation when he was
in Congress, said he can "take some pressure" from national party leaders,
according to the Sun. "I think most people can discern a clear difference
between legalizing substances that wreck lives as opposed to a life
situation where someone is doing something because of severe pain," Ehrlich
said. Although Ehrlich is "inching" towards signing the bill, members of
his administration said that it is "by no means a certainty" that he will
sign the bill, according to the Sun. John Walters, director of the White
House Office of National Drug Control Policy, said in a Baltimore speech
that the General Assembly had been "conned" by medical marijuana proponents
into supporting the bill (Baltimore Sun, 4/4). Walters said that modern
medicine is more effective than marijuana at alleviating terminally ill
patients' pain, the Associated Press reports. "We have the most
sophisticated medical institutions in the history of man," Walters said,
adding, "We don't use smoked weeds" (Witte, Associated Press, 4/3). Eight
other states -- Alaska, California, Colorado, Hawaii, Maine, Nevada, Oregon
and Washington -- have laws allowing the use of marijuana for medical
purposes (Kaiser Daily HIV/AIDS Report, 3/27).


ACROSS THE NATION

4. Florida Health Department Recalls HIV/AIDS Brochure With Religious
Content

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http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=17021

The Florida Department of Health on Friday pulled an HIV/AIDS educational
booklet following complaints by civil liberties groups about the booklet's
religious content, the Miami Herald reports (Weaver, Miami Herald, 4/5).
The American Civil Liberties Union of Florida had demanded that the state
remove from its inventory an HIV/AIDS booklet called "A Christian Response
to AIDS," which includes quotes from the Bible and a picture of Jesus.
Howard Simon, executive director of the Florida ACLU, said that the purpose
of the brochure was to promote a particular religious viewpoint rather than
to educate people about HIV/AIDS. The ACLU sent a letter to Dr. John
Agwunobi, secretary of the state health department, and Beth Swisher of the
Florida Bureau of AIDS expressing its concerns and requesting that the
brochure be pulled. Simon said that about 13,500 copies of the 16-page
brochure were bought by the health department in 2001 and 2002. Health
department officials said that the brochure was on a list of state-approved
HIV/AIDS education materials. Tom Liberti, director of the Florida Bureau
of AIDS, said that the department purchased the pamphlets after they were
requested by faith-based organizations -- particularly black groups -- that
were involved in prevention programs (Kaiser Daily HIV/AIDS Report, 4/4).
After the decision to pull the booklets was made, Simon said that he
thought the state had little choice in the matter, according to the
AP/Bradenton Herald. "The mistake in judgment was there for everybody to
see," Simon said, adding, "I'm glad they responded so quickly." Liberti
wrote to local health agencies and groups to inform them that "effective
immediately no state or federal money is to be spent on the purchase and/or
distribution of this brochure" (Royse, AP/Bradenton Herald, 4/6).


DRUG ACCESS

5. California Medicaid Program Enacts Tighter Controls on Drug Used To
Treat AIDS Wasting

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http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=17022

In an effort to combat the black market sale of Serostim among
bodybuilders and other people, California officials on Thursday announced
the enactment of tighter restrictions on the drug Serostim, which is used
to treat AIDS wasting and which officials say has cost the state's Medicaid
program $175 million in the past four years, the Los Angeles Times reports.
Beginning June 1, Medi-Cal will limit initial prescriptions of the drug,
which helps to build muscle mass, to four weeks and will require
pre-approval before reimbursing new prescriptions for the drug. Currently,
Medi-Cal beneficiaries are allowed to receive up to three months worth of
the drug with a doctor's prescription and no prior state approval. Similar
restrictions are already in place in the state's AIDS Drug Assistance
Program, which provides antiretroviral drugs and other treatment to people
who do not qualify for Medi-Cal. Officials predict that the new
restrictions will save the state $7.5 million a year. Officials previously
resisted adopting prior-authorization restrictions because they feared the
rules would prevent AIDS patients from accessing the drug, the Times
reports. Recent reports of counterfeiting and fraud, including reports of
abuses by bodybuilders and others who buy the drug through the black
market, and budgetary concerns prompted officials to make the change, Stan
Rosenstein, state deputy health director for medical care services, said.
Officials estimate that black market sales of the drug have cost the state
tens of millions of dollars, according to the Times. One statewide black
market ring involved the sale of more than $3.5 million in Serostim,
obtained through Medi-Cal and then sold at gyms and spas. Michael
Weinstein, president of the AIDS Healthcare Foundation, estimated that the
new restrictions will reduce usage of the drug by approximately 80% and
will reduce Medi-Cal reimbursement for the drug from $33.2 million last
year to between $6 million and $7 million next year. David Pieribone, the
associate director for education at AIDS Project Los Angeles urged
officials to moniter whether the new restrictions were preventing deserving
patients from receiving the drug. "If it's saving money, great. ... But
maybe they're saving money at the expense of patient lives or disease
progression. That is important too." State officials also said that the
same requirements will apply to oxandrolone, an anabolic steroid used to
prevent AIDS wasting, amid fears that Serostim users may try to switch to
oxandrolone because of the new restrictions. In a separate effort to
contain spending, officials announced prior-approval requirements for the
new antiretroviral drug Fuzeon, which costs more than $20,000 per patient
per year (Reiterman, Los Angeles Times, 4/4).


GLOBAL CHALLENGES

6. Faith-Based Groups From United States, Africa Join To Combat HIV/AIDS

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http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=17023

Twenty-two representatives of churches and mosques in several countries in
Africa are attending a six-week AIDS education and advocacy training course
organized by the Balm in Gilead, a U.S. coalition of more than 12,000
predominantly African-American churches, Long Island Newsday reports. In
what is reportedly the first program of its kind, the Balm in Gilead has
brought together counselors, health educators, clergy members and
researchers to train delegates from Cote d'Ivoire, Kenya, Nigeria, Tanzania
and Zimbabwe -- countries that are among those "hardest hit" by the
disease. The organization is conducting the program under an agreement
with the CDC, according to Newsday. Participating U.S. institutions
include the CDC, Columbia University's Mailman School of Public Health, the
Black Church HIV/AIDS Training Institute and other organizations. The
training course, for which the Balm in Gilead and the Bill and Melinda
Gates Foundation have contributed $2 million, is part of the African
HIV/AIDS Faith Initiative, a larger Gilead effort to build the capacity of
churches and faith-based groups to combat the epidemic in the five targeted
countries. The Balm in Gilead has established offices in each of the
countries to provide technical support for AIDS education and outreach
efforts. The representatives who are currently undergoing training will
return to their home countries to train clergy to educate their
congregations about AIDS. "This is the first time an African-American
organization has gone to Africa to say we want to partner with you,"
Pernessa Seele, founder and CEO of the Balm in Gilead, said, adding, "HIV
intervention must come from African people. Only Africans understand
African traditions." The initiative is modeled on AIDS programs in Uganda,
including the "ABC" prevention model -- abstain, be faithful and use
condoms "as a last resort," Seele said. "I see a bright future for the
faith community in addressing the AIDS problem in Nigeria. This is the
first time Christians and Muslims are coming together. What is binding us
is the issue of AIDS," Rev. Kaine Nwashili, national director of the
Interfaith HIV/AIDS Council of Nigeria and a trainee, said (English, Long
Island Newsday, 4/6).

Faith-Based Approach to AIDS Initiative Needed, Opinion States


A faith-based approach to fighting HIV/AIDS internationally, including the
ABC approach, has a "scientifically supported base" and is also "the right
thing to do," Anne Peterson, assistant administrator for global health for
USAID, writes in a Washington Times opinion piece. Partnerships between
USAID, host-country governments and faith- and community-based groups are
crucial in fighting AIDS, because such groups provide "cultural sensitivity
and cohesiveness with their communities," Peterson states, adding that for
international and donor organizations to accept this approach, they must be
"sensitized to our scientifically proven methods." Peterson concludes that
"conservatives must become vigorous and constructive participants in the
public policy debate," voicing their support for the international fight
against AIDS (Peterson, Washington Times, 4/6).

7. Population Losses Due to HIV/AIDS Means Famine in Africa 'Could Last for
Generations'

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http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=17024

Combined with the effects of poverty, war, governmental problems,
corruption and "erratic" weather, the "devastation" of the HIV/AIDS
epidemic could "cripple the ability of societies in sub-Saharan Africa to
recover from famine," which some observers say "could last for
generations," the AP/Philadelphia Inquirer reports. According to the
United Nations, the situation in sub-Saharan Africa is considered a "new
variant famine" in which the population losses due to AIDS-related causes
are destroying economies and agriculture and health systems, the
AP/Inquirer reports. Currently, 29 million people in sub-Saharan Africa
are HIV-positive -- 70% of the world's total HIV cases. AIDS-related
conditions have killed more than eight million farm workers on the
continent. In addition, the disease is responsible for killing the primary
breadwinner in "millions of families," has "devastated poor rural villages"
and has orphaned 4.2 million children on the continent, according to the
AP/Inquirer. Brenda Barton, World Food Programme spokesperson in Nairobi,
Kenya, said, "The stark message is, this crisis is not going to go away.
We have a perpetual crisis. We are seeing a redefinition of famine, of
humanitarian crises as we know them." Although humanitarian groups have
worked to establish food aid and agricultural improvement programs, such
efforts "are like spitting in the wind," Renny Nancholas, the Southern
Africa food security coordinator for the International Red Cross and Red
Crescent Societies, said, adding, "No one organization is ever going to
dent such a huge crisis. It is really getting out of control." Richard
Ragan, the World Food Programme's country director in Zambia, said that the
"single biggest factor" in the food crisis is the AIDS epidemic, according
to the AP/Inquirer (Leonard, AP/Philadelphia Inquirer, 4/7). According to
Ragan, HIV/AIDS lowers agricultural production, increases poverty and curbs
the ability of agencies to "react to crises" (Leonard, AP/Minneapolis Star
Tribune, 4/6). He added, "It permeates everything you do in this part of
the world." Ragan said that in order to defeat the famine, the United
Nations and African governments have to "wage an all-out, coordinated
campaign" against HIV/AIDS. "If they don't, it is going to decimate the
entire continent," Ragan said (AP/Philadelphia Inquirer, 4/7).


MEDIA & SOCIETY

8. Churches Employ Variety of Sexual Education Programs in Curricula,
Washington Post Reports

Access this story and related links online:
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=17025

The Washington Post yesterday examined the growing number of churches and
synagogues that are including sex education in their religious instruction
curricula. While abstinence from sex is a "staple" in most faith-based sex
education courses, many programs offer information on a wide variety of
other topics. Some programs offer information on homosexuality, sexually
transmitted diseases, masturbation and oral sex, while others, such as the
Southern Baptist Convention's "True Love Waits," require participants to
pledge to abstain from sexual activity until marriage (Murphy, Washington
Post, 4/6). The complete article is available online.


SCIENCE & MEDICINE

9. South African Medical School To Conduct Electromagnetic HIV Treatment
Clinical Trials

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http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=17026

The University of Natal's Nelson Mandela Medical School in Durbin, South
Africa, on Thursday announced the start of clinical trials for a new
non-invasive HIV treatment that uses electromagnetic technology to disrupt
the replication of the virus, the South African Press Association reports.
The treatment will use a device that emits radio frequency similar to that
of cell phone emissions. The patient would sit in a room "for some time"
to absorb the emissions, Umesh Lalloo, head of the department of medicine,
said (South African Press Association, 4/3). Although the electromagnetic
field device has existed for 14 years, no scientifically controlled studies
have been conducted to prove its efficacy in HIV treatment (SABCnews.com,
4/3). The school, which plans to recruit 360 HIV-positive people over the
next few weeks, expects the trials to be completed by the end of the year.
The treatment, which was invented by Russian scientists and refined in
South Africa, was prepared for clinical trials by Hivex Ltd., a South
African medical technology company (Reuters, 4/3). The trials, which will
be funded by a $3 million grant from British defense company BAE Systems,
will be monitored by a panel of international medical experts from
Canadian, Hungarian, South African and U.S. universities (Reuters, 4/3).


OPINION

10. Congressional Politics Hampering AIDS Legislation, Washington Post
Editorial States

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http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=17027

The delay in Congress' passage of legislation to fund the international
fight against AIDS is a result of "myopic domestic obsessions" that do not
concern Africa, a Washington Post editorial states (Washington Post, 4/5).
Congressional legislation was initiated after President Bush in his State
of the Union address on Jan. 28 proposed spending $15 billion over five
years to fight HIV/AIDS in Africa and the Caribbean (Kaiser Daily HIV/AIDS
Report, 4/3). The Post states that the House International Relations
Committee last week approved an amended bill to fund the AIDS fight "thanks
to the persistence and patience" of committee Chair Henry Hyde (R-Ill.),
who had "the pro-life credentials" to forge a compromise despite concerns
over condom distribution. However, the editorial continues, the "larger
picture is this: While members of Congress continue to seek and score
minor political victories, people in Africa continue to die of AIDS." In
the Senate, talks "broke down" over how to divide money between the Global
Fund to Fight AIDS, Tuberculosis and Malaria and U.S. organizations,
according to the Post. "Another fight" in the Senate is how to balance
funding between improving sanitary conditions in hospitals and promoting
"safer sex," the Post says. The editorial concludes, "U.S. senators
shouldn't be fine-tuning the strategies in any case. Appropriate the money
and let people in Africa go to work" (Washington Post, 4/5).

11. Blacks Should Engage in More 'Straight Talk' About Sexuality To Prevent
HIV, USA Today Opinion Piece Says

Access this story and related links online:
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=17028

Black men and women should engage in "straight talk" about sexuality
because "among other things, it could save lives," Laura Hall (D), a member
of the Alabama Legislature and board member of the Black AIDS Institute,
writes in a USA Today opinion piece. The result of the "culture of
silence" that currently surrounds sexuality -- especially among young,
African-American women -- is that half of the 40,000 people infected with
HIV each year in the United States are under age 25, and 64% of newly
infected women are black, Hall states. She says that the silence among
women exists for a number of reasons: "We learn it's not ladylike. We may
be economically dependent. We fear our men will leave us or become violent
if we mention 'condom' or 'AIDS.'" Hall states that men "have their own
reasons" for remaining silent about sexuality, including that some gay,
African-American men feel that they have to "choose between being black and
being gay." Hall concludes, "For an African-American community that is
being devastated by AIDS, there can be no greater service right now than
empowering young women -- and men -- to talk frankly about sex" (Hall, USA
Today, 4/4).


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