The CDC HIV/Hepatitis/STD/TB Prevention News Update

MICHIGAN: "Sex and the Senior: What Older Adults Need to Know That Is Not Often Talked About"

REPUBLIC OF CONGO: "Mobile HIV Test Unit a Hit"

TANZANIA: "Alcohol Use Before Sex and HIV Risk: Situational Characteristics of Protected and Unprotected Encounters Among High-Risk African Women"

NEW YORK: "HIV Fighters Gain Speed"

IOWA: "WHO-AM Radio Says Host's Remarks Had 'Factual Errors'"

FLORIDA: "Virtual Game for Latinas Targets Real-World Issues"

UNITED KINGDOM: "Hepatitis C Liver Deaths Warning"

AUSTRALIA: "Health Service Plays Down Hepatitis Transmission Fears"

ILLINOIS: "Progress Made in Limiting Kane County TB Outbreak"

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MICHIGAN:
"Sex and the Senior: What Older Adults Need to Know That Is Not Often Talked About"   back to top
Grand Rapids Press , (08.09.2010)   Paul R. Kopenkoskey

Older adults comprise a small but growing population of residents in the Grand Rapids area with STDs.

“While the absolute numbers seem small, I worry about exponential growth,” said Dr. Russell Lampen, an infectious-disease specialist with Spectrum Health Medical Group.

In Kent County, chlamydia cases among those age 45 and older increased from 338 in 2002 to 527 in 2007. In that same age group, gonorrhea cases increased from 549 to 686 during those years.

Some researchers attribute the increase in STDs among older adults to the availability of Viagra and other erectile dysfunction (ED) drugs. At the same time, it is possible that people who choose to use such drugs also are less likely to engage in safe-sex practices.

Another explanation is generational. Those who came of age in the 1960s and 1970s may perceive STDs as curable and thus relatively insignificant.

“I think people sort of see these as diseases of adolescence, not something that would affect older people - something kids get, not adults,” Lampen said.

Lampen encouraged health officials to broach the issue of safe sex with older adults, particularly those who are single, and men who request ED drugs.

“Patients need to realize the only safe sex is when they protect [them]selves with a condom. You can’t predict which partner is safe by appearance,” Lampen said.

REPUBLIC OF CONGO:
"Mobile HIV Test Unit a Hit"   back to top
Inter Press Service , (08.26.2010)   Arsène Séverin

A mobile HIV screening van purchased by the National Council Against AIDS has drawn crowds consistently since its December 2009 launch. A telethon helped raise $215,000 to purchase the van and outfit it with a sampling chair, refrigerator, laboratory, and generator.

In public places such as markets and major intersections, the mobile unit had tested 5,275 people through April, returning 114 (2.2 percent) positive results. That compares favorably with the country’s two fixed testing centers, which have screened 40,085 people over five years, yielding 4,323 HIV-positive results (10.8 percent).

“We have already done over 50 tests, and there’s still a crowd waiting,” Dr. Wilfrid Hervé Poaty, manager of the mobile unit, said while parked in a south Brazzaville neighborhood. “There are usually 100 to 115 tests per outing. Amongst these, we often find two to three people with HIV.”

The National Council wants to boost serostatus awareness in the Congo from the current 10 percent of residents to 50 percent by 2013, said Poaty. According to the council, 3.2 percent of the population, or about 120,000 people, have HIV/AIDS. In the capital, 1,700 patients receive treatment at the Brazzaville Outpatient Treatment Center (OTC).

In June, HIV/AIDS patients receiving care demonstrated at the Ministry of Health, with some complaining of expired treatments as well as shortages. The director-general of health, Alexis Elira Dokekias, denied both claims. However, the van was sidelined from late May to the middle of June after it ran out of chemical reagents for lab testing, council officials acknowledge.

“The drugs are available,” according to the OTC’s Dr. Merlin Diafouka. “We always have a three month reserve in our supply to avoid shortages.”

TANZANIA:
"Alcohol Use Before Sex and HIV Risk: Situational Characteristics of Protected and Unprotected Encounters Among High-Risk African Women"   back to top
Sexually Transmitted Diseases Vol. 37; No. 9: P. 571-578, (09..2010)   Joseph C. Fisher; Peter A. Cook; Saidi H. Kapiga

The authors compared the situational characteristics of protected and unprotected sexual encounters that involved alcohol use two hours prior with ones that did not. The data were collected from December 2002 to December 2005 as part of enrollment in a prospective cohort study aimed at identifying HIV seroconversion risk factors among female bar and hotel workers in Northern Tanzania.

In all, 608 (37.3 percent) of the women who were inconsistent condom users were asked set-matched questions regarding situational characteristics surrounding their last protected and unprotected sex, including whether they had been drinking within the previous two hours. After controlling for time since the last type of encounter, the associations between drinking two hours before sex (yes/no), condom use (protected/unprotected), and their interaction with the situational descriptors were examined with a 2x2 model for paired categorical data.

Condom failure was five times more likely if someone (woman, man or both partners) had been drinking ahead of the encounter (odds ratio [OR], 5.19; 95 percent confidence interval [CI], 2.05-15.46) and was especially likely to occur if only the woman had been drinking before sex (OR, 14.05; 95 percent CI, 4.03-50.41). Alcohol use before sex was associated with sexual contacts where the woman was having sex with her partner for the first time; their relationship was casual or transitory or sex was transactional; the location was unfamiliar and less under her control; and the partner had been drinking or using drugs prior to sex. “Condom use was more frequent in precisely the same types of encounters,” the authors reported. The study found no significant interactions between alcohol use before sex and condom use, “suggesting that drinking before sex and use of condom are distinct and not contingent risk factors.”

“Alcohol use before sex is associated with an increased likelihood of condom failures and with high-risk sexual encounters, ones that have consistent situational characteristics regardless of whether condoms are used or not,” the researchers concluded.

NEW YORK:
"HIV Fighters Gain Speed"   back to top
Wall Street Journal , (08.30.2010)   Suzanne Sataline

In 2008, St. Barnabas Hospital in the Bronx began offering rapid HIV testing in its inpatient and outpatient units as well as through the emergency department. Since May, tests also have been given at its dental clinic, a natural place to perform the oral-swab screening, workers say. A grant allows the hospital to offer the test at no cost.

From 2008 to 2009, the hospital conducted 25,000 rapid and standard HIV tests, and it is on track to do 18,000 this year. “The more people who know their status, the more people we get into care. We decrease the community viral load and decrease the number of infections,” said Ralph Belloise, director of HIV services at St. Barnabas.

The Bronx is especially affected by HIV/AIDS, say New York City health department officials. The borough is home to nearly a quarter of the city’s HIV infections and a third of its annual AIDS deaths. Some 106,000 city residents were living with HIV/AIDS in 2008. This number has grown steadily for the past 10 years, officials note. One in five infected residents are unaware of their status.

The health department in 2008 launched “The Bronx Knows,” a borough-wide effort to boost voluntary HIV testing. Roughly 75 community organizations, including hospitals, had administered more than 375,000 HIV tests as of June. Of these, 1,275 tests were positive, according to the health department.

Testing rates are rising at other city hospitals and agencies, too. Health and Hospitals Corp., which operates city-owned hospitals, tested almost 190,000 people last year, said Terry Hamilton, director of HIV services, up from 50,000 tests in 2004. Almost 90 percent of the tests it performs this year will provide rapid results.

IOWA:
"WHO-AM Radio Says Host's Remarks Had 'Factual Errors'"   back to top
Des Moines Register , (08.27.2010)   Jason Clayworth

Clear Channel Communications broadcast on Aug. 26 a statement acknowledging that a commentator on its news radio station WHO-AM in Des Moines had made erroneous remarks about AIDS and homosexuality.

During a recent show broadcast from the Iowa State Fair, Jan Mickelson said some AIDS education efforts destigmatize the “stupid behavior” of homosexuals. Mickelson took issue with awareness messages from community leaders and others that HIV does not discriminate. Comparing HIV with lung disease, cirrhosis, and heart disease, he said that these diseases also do not discriminate but are linked with smoking, overeating, and problem drinking.

While he is entitled to his opinion, Mickelson’s comments “confused strong opinion with medical fact and contained factual errors regarding HIV/AIDS, its spread, and current efforts to inform the public about the disease,” Clear Channel said.

“Jan Mickelson’s comments on HIV/AIDS are reprehensible,” said Carolyn Jenison, executive director of One Iowa. The state’s largest gay civil rights group, One Iowa, worked with the Gay and Lesbian Alliance Against Defamation to get Clear Channel to clarify the remarks.

“Stigma and discrimination surrounding the discussion of this epidemic are barriers to prevention and treatment of HIV/AIDS,” Jenison said. “Clear Channel did the appropriate thing in responding to and correcting this misinformation.”

FLORIDA:
"Virtual Game for Latinas Targets Real-World Issues"   back to top
Orlando Sentinel , (08.24.2010)   Victor Manuel Ramos

A University of Central Florida (UCF) social psychologist and nurse leads a team that is developing a virtual reality-based program using avatars to discourage young Latinas from engaging in risky sexual behaviors.

Unlike most abstinence programs, the team’s computer simulation game does not feature adult-to-teen discussions on how to say no to sex. Instead, avatars reinforce players’ self-esteem and help guide them through a maze of relationships.

Anne Norris came up with the idea after witnessing avatars used for teacher training at the university, thinking it could be a new way to reach teenagers. “This would be great for working with kids and giving them a chance to practice all the skills that we know are really important to help them avoid early sexual experiences and unsafe sex,” said Norris.

In July, the project received a $434,800 grant from the National Institute of Nursing Research at the National Institutes of Health. The team is hoping to reach Hispanic girls ages 10-14. Data from CDC show Latina teens have the highest birth rate of all groups.

Students from the summer “After-School All-Stars Program” at Stonewall Jackson Middle School in east Orlando have provided feedback on the game, which is still in development.

The project will continue to refine the game over the next two years. The goal is to teach without preaching. “I believe in the power of play,” said Jeff Wirth, director of the UCF Interactive Performance Lab. “That is how we learn as human beings, and this kind of experience allows someone to play, which is fun, and as a result to learn without feeling pressured.”

UNITED KINGDOM:
"Hepatitis C Liver Deaths Warning"   back to top
UK Press Association , (08.29.2010)   

Deaths from liver disease in the United Kingdom shot up 60 percent during the past decade, and hepatitis C was a major factor in the increase, according to a report from the All-Party Parliamentary Hepatology Group. The exact toll of the virus is difficult to calculate, the study says, because so many of the estimated 250,000 to 466,000 UK residents living with it remain undiagnosed. With the number of deaths attributed to liver disease rising by 8 percent a year, it is now the fifth-leading killer in the United Kingdom - following heart disease, cancer, stroke, and lung disorders.

AUSTRALIA:
"Health Service Plays Down Hepatitis Transmission Fears"   back to top
Australian Broadcasting Corporation News , (08.31.2010)   

Persons receiving care at Wollongong Hospital’s Renal Unit should not be alarmed about the diagnosis of hepatitis C in a patient there, according to the South East Sydney Illawarra Health Service. Although the hospital took four months to determine the patient had contracted the virus, the health service said the hospital has since taken appropriate action to reduce the risk of further infection. Patients “shouldn’t be concerned,” said Sue Browbank, a Southern Hospital Network spokesperson. “The unit has been in operation for many years, and this is the first occasion where there has been any concern expressed that hepatitis C may have been contracted in the unit.”

ILLINOIS:
"Progress Made in Limiting Kane County TB Outbreak"   back to top
Associated Press , (09.01.2010)   

In Kane County, west of Chicago, health authorities are reporting progress toward containing a TB outbreak. Seventeen active cases, most linked to an Aurora homeless shelter, have been diagnosed this year. No new active cases have been found since late June, however, and a mass screening of nearly 200 people in August found no new cases. Another large-scale screening is planned for October. Health workers have been aggressive in their efforts to bring TB screening and education to the residents of local homeless shelters, said Tom Schlueter, spokesperson for the Kane County Health Department.