KAISER DAILY HIV/AIDS REPORT
A service of kaisernetwork.org
http://www.kaisernetwork.org/dailyreports/hiv
________________________________________



Monday, June 2, 2003

POLITICS AND POLICY
========================================
1. G8 Summit Sees 'Little Progress' in Boosting Contributions to
International Effort To Combat HIV/AIDS


ELECTION 2004
========================================
2. Democratic Presidential Candidate Kucinich Announces Support of Medical
Marijuana


DRUG ACCESS
========================================
3. Wall Street Journal Examines Stalled WTO Negotiations on Access To
Generic Medications, Including HIV/AIDS Drugs

4. Fast Company Profiles Mining Conglomerate Anglo American's Decision To
Provide Antiretrovirals to HIV-Positive Employees

5. North Carolina AIDS Program To Limit Fuzeon Access to 25 People


ACROSS THE NATION
========================================
6. U.S. News & World Report Profiles How Public Health Programs Are
Fighting Rise in Syphilis Cases


PUBLIC HEALTH & EDUCATION
========================================
7. More Than 10% of HIV-Positive Individuals Do Not Disclose Status Before
Engaging in Risky Sexual Behavior, Study Says

8. Youth Offenders Engage in HIV Risk Behaviors, Study Says

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

POLITICS AND POLICY

1. G8 Summit Sees 'Little Progress' in Boosting Contributions to
International Effort To Combat HIV/AIDS

Access this story and related links online:
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=18026

World leaders attending the G8 summit in Evian, France, which ends today,
met yesterday with the leaders of 12 developing countries but made "little
progress" in increasing contributions to the international effort to combat
HIV/AIDS, the New York Times reports. However, French President Jacques
Chirac announced an increase in France's contribution to the Global Fund to
Fight AIDS, Tuberculosis and Malaria (Tagliabue, New York Times, 6/2).
Chirac said he would increase France's contribution to the international
fight against the pandemic three-fold to $179 million (Roth, Houston
Chronicle, 6/1). Chirac, the host of the summit, also lauded President
Bush's signing of the global AIDS bill (HR 1298) (Curl, Washington Times,
6/2). Bush last week signed into law a bill that authorizes $15 billion
over five years to fight AIDS in Africa and the Caribbean. In addition, it
authorizes up to $1 billion in fiscal year 2004 for the Global Fund, but
the amount actually appropriated is contingent upon the contributions of
other countries. Under the measure, the United States can contribute up to
$1 billion to the fund but only if that amount totals no more than
one-third of the fund's total contributions. Therefore, in order for the
total $1 billion to be appropriated, other nations must contribute more
money (Kaiser Daily HIV/AIDS Report, 5/30). Chirac said, "Bush took a
decision in this area that I would not hesitate to call historic"
(Washington Times, 6/2). Chirac said he hoped his announcement would be
"followed by the other European countries and by the European Union," and
he added that he would "press" the European Commission, the E.U.'s
executive body, to release funds from the $10 billion European Development
Fund to fight HIV/AIDS worldwide. Chirac said, "I have the impression that
Europe will take up this challenge." Romano Prodi, president of the
European Commission, said he supported a European contribution of $1
billion to the Global Fund to match the U.S. authorization (New York Times,
6/2). Chirac said at a news conference that a decision by all 15 E.U.
members would have to wait until a meeting set for June 26 in Salonika,
Greece (Miami Herald, 6/2).

Other Contributions


Some advocates had expected Chirac to propose a matching commitment by the
European Union, according to the New York Times. Jennifer Brant, a trade
policy adviser for Oxfam America, said, "We hoped it would be a kind of
contest. But it didn't pan out." U.N. Secretary-General Kofi Annan said,
"The time for additional funding has arrived," adding that he hoped G8
leaders "who played such an important role in getting the [Global Fund] up
and running will now endow it with the further resources it needs to
achieve our shared goals" (New York Times, 6/2). Jamie Drummond, a
spokesperson for Debt, AIDS, Trade in Africa, said that Chirac's
announcement is a ''crucial step'' in garnering matching funds from other
European countries, adding, ''That's good news for Africa and the
developing world" (Miami Herald, 6/2).

ELECTION 2004

2. Democratic Presidential Candidate Kucinich Announces Support of Medical
Marijuana

Access this story and related links online:
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=18027

Presidential candidate Rep. Dennis Kucinich (D-Ohio) on Thursday said that
if he were elected president he would issue an executive order legalizing
and facilitating the use of medical marijuana "as an act of compassion and
expression of humanity," the AP/Las Vegas Sun reports. Kucinich said,
"I've talked to too many people who have had family members suffering from
terminal illness who feel [medical marijuana] would provide them the most
relief from pain and suffering" (Fouhy, AP/Las Vegas Sun, 5/29). He added,
"Compassion requires that medical marijuana be available"
(Marinucci/Wildermuth, San Francisco Chronicle, 5/29). Although federal law
prohibits the use or possession of marijuana for any purpose, eight states,
including California -- where Kucinich was campaigning when he made the
announcement -- have legalized the use of medical marijuana for people with
chronic or life-threatening illnesses, such as HIV/AIDS and cancer.
Presidential candidate Sen. John Edwards (D-N.C.), also campaigning in
California, said on Wednesday that he would not overturn the existing
marijuana law but would establish a commission to study the medical effects
of the drug (AP/Las Vegas Sun, 5/29).

DRUG ACCESS

3. Wall Street Journal Examines Stalled WTO Negotiations on Access To
Generic Medications, Including HIV/AIDS Drugs

Access this story and related links online:
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=18028

The Wall Street Journal today examines the World Trade Organization's
negotiations on expanding access to generic drugs, including those used to
treat HIV/AIDS, in developing countries and the "clamor for action" that
has grown in recent days with the G8 summit in Evian, France
(Thurow/Miller, Wall Street Journal, 6/2). WTO talks in Geneva over
generic drug access have been stalled since members missed a Dec. 31, 2002,
deadline to reach an agreement. U.S. negotiators in February refused to
sign a deal under the Doha agreement to allow developing nations to
override patent protections to produce or import generic versions of drugs
to combat public health epidemics unless wording was included to specify
which diseases constitute a public health epidemic (Kaiser Daily HIV/AIDS
Report, 5/29). The Bush administration endorsed a list of 20 infectious
diseases, including HIV/AIDS, malaria and tuberculosis. However, doctors
and health advocates have said that many drugs used to treat public health
concerns such as heart-related problems, diabetes, cancer and chronic
respiratory diseases are not included on the U.S.-backed list despite being
common problems in developing countries. According to the Journal, the WTO
talks have "deteriorated into a major letdown for those it was supposed to
help" (Wall Street Journal, 6/2).
4. Fast Company Profiles Mining Conglomerate Anglo American's Decision To
Provide Antiretrovirals to HIV-Positive Employees

Access this story and related links online:
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=18029

Fast Company this month profiles mining comglomerate Anglo American,
which last year announced that it would cover the cost of antiretroviral
drugs for any of its 130,000 employees in South Africa who do not already
qualify for treatment under other medical aid programs (Fishman, Fast
Company, June 2003). An estimated 23% of its workforce -- or 18,000 people
-- is HIV-positive, company spokesperson Anne Dunn said (Kaiser Daily
HIV/AIDS Report, 8/6/02). Following Anglo's announcement, other companies
have announced or are preparing to announce their own plans to treat
HIV-positive employees, Fast Company reports (Fast Company, June 2003).
The article is available online.
5. North Carolina AIDS Program To Limit Fuzeon Access to 25 People

Access this story and related links online:
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=18030

While the North Carolina AIDS Drug Assistance Program will cover the cost
of Fuzeon, the group will restrict access to the treatment to 25 patients
because of the drug's high cost, the Charlotte Observer reports. The state
ADAP, which buys HIV medications for low-income patients, has an enrollment
of 2,820 people -- 15% of the state's residents known to have HIV -- and
has a budget of $24 million. The income ceiling used in part to determine
eligibility for the North Carolina ADAP is the lowest in the nation,
according to the Observer. Participation is limited to those who earn no
more than $11,225 annually for a single person, or $23,000 for a family of
four (Stobbe, Charlotte Observer, 5/31). The FDA in March approved Fuzeon,
which is designed for HIV/AIDS patients who have failed to respond to other
medications. The drug is costs about $20,000 per patient per year, double
the price of the most expensive HIV treatments currently on the market. In
addition, the total cost of treatment could reach between $30,000 and
$40,000 per patient per year because the drug must be taken in combination
with other medicines (Kaiser Daily HIV/AIDS Report, 5/15). The North
Carolina Medicaid program, along with a majority of private and public
insurance plans, said it will pay for the drug. But the North Carolina
ADAP will determine eligibility for the drug based on whether patients meet
medical criteria and the order in which they sign up for coverage
(Charlotte Observer, 5/31).

ACROSS THE NATION

6. U.S. News & World Report Profiles How Public Health Programs Are
Fighting Rise in Syphilis Cases

Access this story and related links online:
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=18031

The June 2 issue of U.S. News & World Report profiles several public
health programs that are attempting to confront a nationwide rise in the
number of syphilis cases. Syphilis increases the chances of transmitting
or contracting HIV by up to five times. Therefore, a rise in the number of
syphilis cases "raises the frightening specter of a new AIDS epidemic" in
the United States, according to U.S. News. Although the actual increase in
syphilis cases is small -- there are currently just over 6,000 cases in the
United States -- the trend shows that people are slipping back into unsafe
sexual behavior and could become a "breeding ground" for HIV, according to
U.S. News. The trend is so disturbing to health officials that the CDC has
sent representatives throughout the country to research new intervention
strategies. In one such program, the Baltimore-based not-for-profit Health
Education Resource Organization, outreach workers run a syphilis screening
van that travels throughout the city offering free testing (Levine, U.S.
News & World Report, 6/2).

Microbicide Development


U.S. News also profiles the research challenges surrounding the development
of microbicides, which some say could be "as revolutionary as the [birth
control] pill in women's reproductive health" (Hobson, U.S. News & World
Report, 6/2). Microbicides include a range of products such as gels,
films, sponges and other products that could help prevent the sexual
transmission of HIV and other sexually transmitted diseases. The Bill &
Melinda Gates Foundation in March announced that it will award $60 million
to the International Partnership for Microbicides for research into the use
of microbicides to prevent HIV transmission (Kaiser Daily HIV/AIDS Report,
4/1). Researchers hope to have a product on the market by 2007 (U.S. News
& World Report, 6/2).

NPR's "Weekend Edition Sunday" reported on a public education campaign on
the Navajo Nation reservation in Arizona and New Mexico in which public
health officials discuss syphilis in local bars. According to Indian
Health Service physician John Erlu, there "seems to be a very clear link"
between syphilis transmission and alcohol use. As alcohol is illegal on
the Navajo reservation, drinking associated with the outbreak occurs in
border towns, NPR reports. The segment also includes comments from Navajo
Division of Health spokesperson George Joe and Lucy Lozano, manager of a
Gallup, N.M., bar that was the first to allow health workers to discuss
syphilis with patrons on the premises (Whitney, "Weekend Edition Sunday,"
NPR, 6/1). The full segment is available online in RealPlayer.

PUBLIC HEALTH & EDUCATION

7. More Than 10% of HIV-Positive Individuals Do Not Disclose Status Before
Engaging in Risky Sexual Behavior, Study Says

Access this story and related links online:
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=18032

Approximately 13% of HIV-positive individuals do not disclose their status
to sexual partners before engaging in risky behavior that could transmit
the virus, according to a study published in the June issue of the American
Journal of Public Health, the Los Angeles Times reports (Carey, Los Angeles
Times, 6/2). Daniel Ciccarone and colleagues at the University of
California-San Francisco interviewed about 1,400 HIV-positive individuals
-- 606 men who have sex with men, 287 heterosexual men and 504 heterosexual
women -- about their sexual behavior and disclosure of HIV status,
according to a UCSF release (UCSF release, 5/28). About half of the
sexually active individuals reported having sex with a partner whose HIV
status was either unknown or negative, and 13% of those individuals said
that they had had unprotected sex with a partner whose status was unknown
or negative, according to Reuters Health reports. The study also found
that most unprotected sex involved "mutual non-disclosure," in which
neither partner revealed his or her HIV status. Men who have sex with men
were more likely than heterosexual men and women to have sex -- whether
protected or unprotected -- without revealing their HIV status, according
to Reuters Health. According to the study, men who have sex with men were
less likely to disclose HIV status before sex in a casual relationship than
in a monogamous relationship. Heterosexual men and women were just as
likely to reveal their HIV status in a casual relationship as in a
monogamous relationship (Mozes, Reuters Health, 5/28).

'Do Ask, Do Tell'


The study results suggest that current HIV prevention strategies to promote
openness about the disease are not helping everyone change their behaviors.
However, "the message that people ought to act responsibly has gotten out
well; only a minority is having risky sex without disclosing," Ciccarone,
the study's lead author, said (Los Angeles Times, 6/2). Ciccarone said
that the best way to encourage disclosure is to promote a community norm of
"do ask, do tell," adding, "While the vast majority of HIV-positive
individuals either abstain, disclose or attempt to minimize risk, the
worrisome number of HIV-positive people, both gay and straight, who 'don't
tell' and who 'aren't asked' while engaging in risky behavior, does call
for new approaches" (UCSF release, 5/28). Antony Stately, director of
client services at AIDS Project Los Angeles, said that public health
officials need to focus on reducing the social stigma attached to HIV/AIDS
and target their efforts on people who are engaging in risky behavior (Los
Angeles Times, 6/2).
8. Youth Offenders Engage in HIV Risk Behaviors, Study Says

Access this story and related links online:
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=18033

A majority of the children and teenagers in the U.S. juvenile justice
system say that they have engaged in behaviors that put them at risk of
contracting HIV, including having sex without a condom or receiving tattoos
with "potentially" dirty needles, according to a survey published in the
June issue of the American Journal of Public Heath, Reuters Health
reports. Dr. Linda Teplin, a legal health expert at Northwestern
University, and colleagues interviewed 800 youth offenders between the ages
of 10 and 18 who were detained at the Cook County Temporary Detention
Center in Chicago about their sexual experiences and drug use. Researchers
found that 95 of the juvenile detainees said that they had "at some point"
engaged in at least three HIV risk behaviors, and about 66% said they had
engaged in 10 or more risk behaviors. The survey also found that "very
few" participants reported using injection drugs or sharing needles,
Reuters Health reports. Teplin said that while most of the survey
responses were not "surpris[ing]," they were still somewhat "alarming,"
adding, "Once these kids are back in the community they may continue with
behavior that causes the disease to spread. They do not stay in jail for
very long." Teplin and colleagues called for corrections officials to pay
increased attention to HIV/AIDS prevention education. Teplin said, "These
kids may be too busy skipping school to learn about HIV, and they don't
have much parental support in their lives. The best chance to educate
these kids may actually be in prison" (Sabo, Reuters Health, 5/29).

Women in Prison


HIV prevalence among women in prisons is almost four times higher than it
is in the general population, according to a new guide released by the AIDS
Alliance for Children, Youth and Families. The report, "Serving Women in
the Corrections System Through Ryan White CARE Act Programs," states that
3.6% of women in federal or state correctional systems are HIV-positive,
compared with 2% of male prisoners. David Harvey, executive director of
the AIDS Alliance, said, "Reaching women in prison can help end the cycle
of addiction and HIV transmission," adding, "Prison provides a critical
time in which we can get women diagnosed and/or connected to care. Because
many women come out of the correctional system, there is a significant
benefit for public health when these women know their status and are in
treatment" (AACYF release, 5/29).

________________________________________

-------------------------------------------------------
CONTACT DAILY REPORTS EDITORIAL STAFF
http://www.kaisernetwork.org/contact/contact.cfm
EDITORIAL PHONE: 202-672-5952 FAX: 202-672-5767
EDITORIAL E-MAIL: dailyreports@...
E-MAIL REGISTRATION: www.kaisernetwork.org/email

The Kaiser Daily HIV/AIDS Report is published for kaisernetwork.org, a
service of The Henry J. Kaiser Family Foundation, by The Advisory Board
Company. © 2003 by The Advisory Board and Kaiser Family Foundation. All
rights reserved.
-------------------------------------------------------
kaisernetwork.org Editorial Contacts:
For editorial questions about kaisernetwork or the Kaiser Daily HIV/AIDS
Report, please contact Larry Levitt, Kaiser Family Foundation vice
president, editor-in-chief, kaisernetwork.org; Jill Braden Balderas,
Editor, kaisernetwork.org; Regina Davis, Senior Web Producer, HealthCast;
Tina Murrow, Online Production Manager, HealthCast; Joshua Perin,
editor-in-chief, Daily Reports; Alyson Browett, editor, Kaiser Daily
HIV/AIDS Report; or Susannah Hunter, associate editor, at
dailyreports@....
-------------------------------------------------------
kaisernetwork.org Contacts:
Marla Bolotsky, Vice President; Director, Online Communications and
Publishing
Robin Sidel, Manager, Online Communications
Dana Greil, Coordinator
For questions and further information about kaisernetwork.org, please
contact us at info@... or at 202-347-5270.
--------------------------------------------------------
Manage Your Email Subscription at http://www.kaisernetwork.org/email .
SUBSCRIBE by choosing "Create a new subscription."
CHANGE your subscription by logging in and choosing "Update your Report
Preferences."
UNSUBSCRIBE by logging in and choosing "Please delete my profile."
-------------------------------------------------------
kaisernetwork.org is a free service of the Kaiser Family Foundation. For
access to the Foundation's policy research, analyses, reports and fact
sheets, and media partnerships, visit the Foundation's main website at
www.kff.org.