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National News Briefs Across the Nation

November News Links and Briefly - Across the nation

NASTAD releases National HIV Prevention Blueprint and Policy Agenda
“Each year, tens of thousands of opportunities are missed, despite our relentless efforts. As long as the nation remains apathetic to prevention, our potential to be victorious in this fight diminishes,” says Dr. Andre Rawls, Chair of the National Alliance of State and Territorial AIDS Directors (NASTAD), the organization founded to be the voice of state AIDS directors. See NASTAD Press Release and documents.

NIH Announces 2007 World AIDS Day Award Recipients
On December 1, the National Institutes of Health (NIH) joins with people around the globe in commemorating World AIDS Day. More than 25 million men, women and children have already died, and an estimated 33.2 million people around the world are currently living with HIV infection. Last year alone, an estimated 2.5 million new HIV infections occurred worldwide, and 2.1 million people died from AIDS. NIH Press Release (11/29/07)

AIDS Service Organizations Nationwide Challenged
CLEVELAND, OH—a newly-released national study from the AIDS Taskforce of Greater Cleveland highlighted “serious signs of financial and operational vulnerability” among AIDS Service Organizations (ASOs) across the United States, due to a combination of government funding cuts and lags, larger patient loads, and the increasing complexity of tasks ASOs are being asked to undertake. See the Press Release.

Clinton To Release HIV/AIDS Policy
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=49051

Los Angeles Times Examines Efforts To Prevent Spread of HIV/AIDS Among U.S. Adults Ages 50, Older
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=49055

CDC's newest health disparities report entitled "Health Disparities in HIV/AIDS, Viral Hepatitis, Sexually Transmitted Diseases and Tuberculosis in the US: Issues, Burden and Response" is now available.

CMS Officials Investigate Case Involving Four Transplant Recipients Who Contracted HIV, Hepatitis C From High-Risk Organ Donor
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=48934

Baltimore Sun Profiles HIV Researcher Pauza
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=48932

AMA Recommends Routine HIV Testing While Protecting Patient Autonomy, Privacy
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=48905

Democratic Presidential Candidates Debate in Nevada; Clinton and Obama Clash over Health Care Proposals New York Times (Requires free, one-time registration)
http://www.kaisernetwork.org/fe.cfm?id=7638

Benefits of HIV/AIDS Programs in Workplace Outweigh Costs, Report Says
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=48876

Giuliani Says He Would Continue PEPFAR Program, Attempt To 'Dramatically' Increase Trade With Africa
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=48845

Four Transplant Recipients Contract HIV, Hepatitis C From High-Risk Organ Donor http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=48850

Former Chair of Presidential Advisory Council on HIV/AIDS Hitt Dies http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=48790

CDC Broadcast on Current Events in HIV Prevention among Hispanics
AIDSInfo At-A-Glance Volume 3 Issue 48
On November 15, 2007, the Centers for Disease Control and Prevention (CDC) and the Public Health Training Network will host a 2-hour satellite broadcast and Webcast, "Current Challenges and Successes in HIV Prevention with Hispanics/Latinos." http://www.cdcnpin-broadcast.org/

Federal Officials to Discuss State of HIV/AIDS Epidemic in Live Webcast
AIDSInfo At-A-Glance Volume 3 Issue 48
The Department of Health and Human Services (HHS) Web site AIDS.gov has announced that it will host a live Webcast to discuss the current state of the HIV/AIDS epidemic in the United States.

The Webcast will take place on Friday, November 16, and will feature four top Federal officials in the area of HIV/AIDS, including National Institute of Allergy and Infectious Diseases (NIAID) Director Anthony Fauci. HHS grantees and employees are invited to take part in this unique educational opportunity.

For more information about the Webcast, please visit the www.AIDS.gov . Webcast Information page or send an e-mail to contact@AIDS.gov .

HIV/AIDS, TB Programs Must Cooperate To Save Lives, Health Officials Say
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=48785

Seattle Post-Intelligencer Examines Reactions of People Who Participated in Merck's Canceled HIV Vaccine Trial
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=48788

Senate Approves Labor-HHS-Education Spending Bill; President Bush Expected To Veto Measure AP/San Francisco Chronicle
http://www.kaisernetwork.org/fe.cfm?id=7556

Global Fund, Ryan White Program Would Receive Increases in Funding Under House-Passed FY 2008 Appropriations Bill
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=48697

"AIDS Conference to Focus on Social Services" - CDC Summary

Washington Post Examines Reaction to Study Tracking HIV's Arrival in U.S. From Haiti
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=48645

Concurrent Sexual Relationships Not Uncommon Among U.S. Men, Contributing to Spread of HIV, Study Says
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=48574

U.S. Residents Spend Double What People in Other Industrialized Nations Spend on Health Care But Have More Access Problems, Survey Finds Reuters
http://www.kaisernetwork.org/fe.cfm?id=7464

See October Archived News.

Across the nation

Washington, D.C., Mayor Fenty Pledges Increased HIV Testing, No-Cost Condom Distribution in Response to Report
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=49052

Palm Beach Post Examines HIV/AIDS in Florida
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=49053

University of Miami Project Outreach HIV/AIDS Clinic Closes
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=48727

Baltimore Sun Series Examines Link Between Commercial Sex Work, HIV Transmission in Baltimore
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=48671

Oregon Receives $1.2M Grant To Provide Rent, Support Services for HIV-Positive People Living With Mental Illnesses
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=48646

Ohio Not Applying for Federal Funds Aimed at Preventing HIV Among Teenagers
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=48575

Summaries

UNITED STATES:
"New Rules for HIV-Positive Travelers Raise Questions"
Bay Area Reporter (San Francisco), (11.29.2007) Heather Cassell
The Department of Homeland Security is proposing new travel rules for HIV-positive foreign nationals visiting the United States on a short-term basis. The proposal, released Nov. 5, is open to public comment until Dec. 6.

Current policy has for 20 years barred HIV-positive non-residents from traveling to or transitioning through the United States. Prospective travelers may apply for a 30-day exception for business or leisure from the Department of Homeland Security. There is also an exemption when it is proven the overall benefits outweigh the public health risk. Except in very limited circumstances, it prohibits infected non-residents from gaining legal status or immigrating to the country.

The proposed new rules would still allow 30-day visits, said Gay Men's Health Crisis (GMHC), although Border and Customs officials could stamp passports for a 60-day stay. But now non-residents would need to prove they know how HIV is transmitted; prove there would be no "anticipated medical care" during the stay; carry adequate supplies of medicine for the travel period; and show proof of US accepted medical insurance and sufficient assets to cover unanticipated care. In addition, immigration status and the length of stay could not be changed while here, leaving seekers of asylum or permanent residency in limbo, said Nancy Ordover, GMHC's assistant director of research and federal affairs.

"In its least troubling provisions it makes no changes and leaves intact a very bad policy," Ordover said. "In its most troubling provision it actually adds a burden to HIV-positive travelers and it actually requires people to forgo certain rights and opportunities."

Last year on World AIDS Day, the Bush administration announced it would issue an executive order to do away with the requirement of waivers for HIV-positive non-residents on short-term visits. But none materialized, said Kathy Drasky, spokesperson for Out 4 Immigration.

The United States is one of 13 countries that bar HIV-positive foreign nationals from visiting or immigrating, according to immigration advocates. For more information or to register a comment, go to www.regulations.gov, right-click "search for dockets" at the top, and submit the docket number USCBP-2007-0084.

Joint Statement from Drs. Elias Zerhouni, Jack Whitescarver, and Anthony Fauci of the
National Institutes of Health on World AIDS Day
NIH Announces 2007 World AIDS Day Award Recipients

On December 1, the National Institutes of Health (NIH) joins with people around the globe in commemorating World AIDS Day. More than 25 million men, women and children have already died, and an estimated 33.2 million people around the world are currently living with HIV infection. Last year alone, an estimated 2.5 million new HIV infections occurred worldwide, and 2.1 million people died from AIDS.

Dr. Jack Whitescarver, NIH Associate Director for AIDS Research and director of the Office of AIDS Research (OAR), states, “On World AIDS Day, we confirm our commitment to the global fight against HIV/AIDS. This pandemic continues to wreak devastating consequences in every sector of society, affecting the stability of families and entire communities with profound economic and national security consequences.”

This year, the U.S. Department of Health and Human Services has adopted the World AIDS Day theme of “The Power of Partnerships” to remind us all—scientists, clinicians, policymakers, activists, communities, families, clinical study volunteers and individuals living with HIV—that only by working together can we bring an end to HIV/AIDS. NIH has established research partnerships with research institutions, non-governmental organizations, governments, industry, foundations, and representatives of affected communities in the United States and around the world.

“On World AIDS Day, we applaud the heroic efforts of researchers and clinical trial participants who have devoted their time and energy to helping us find effective ways to prevent HIV/AIDS and new treatments to help those already infected,” says National Institutes of Health (NIH) Director Elias Zerhouni, M.D. “Although much work remains to be done in the fight against HIV, we remain committed to developing new and improved strategies to control and defeat this virus.”

Since the first cases of what is now known as AIDS were first reported in the United States more than a quarter century ago, the NIH has established the largest and most significant AIDS research program in the world, a comprehensive trans-NIH research effort. NIH supports and conducts basic, clinical and behavioral research designed to better understand the biology of HIV and how it affects the body, develop effective new therapies to treat and control the virus, and design interventions aimed at preventing new infections.

“The world is at a pivotal stage in combating HIV/AIDS,” says Anthony S. Fauci, M.D., director of the National Institute of Allergy and Infectious Diseases (NIAID), a component of the NIH. “Although there have been substantial scientific advances in terms of effective HIV treatments and methods to prevent HIV transmission, the virus continues to spread, and many people still die needlessly.”

NIH-funded research established the foundation for the discovery and development of antiretroviral therapies and regimens that have resulted in improved quality of life and life expectancy for those with access to these drugs. In addition, NIH research has developed treatments for HIV-associated co-infections and co-morbidities, including malignancies, neurological complications, tuberculosis, and other clinical manifestations. NIH research has also made a number of advances in HIV prevention, including the demonstration that medically supervised circumcision of adult men can reduce risk of heterosexual HIV acquisition. Although HIV vaccine research experienced a recent setback with the failure of the Merck vaccine candidate in the STEP clinical study, NIH remains committed to developing a safe and effective HIV vaccine.

“Vaccines have always been the cornerstone in fighting infectious diseases,” says Dr. Fauci. “We will continue a vigorous vaccine research agenda despite the fact that a promising vaccine candidate recently did not work. Other vaccine strategies are in development, and we are learning from the STEP study and using those findings to move HIV vaccine research forward.”

In addition to a continued NIH commitment to finding an HIV vaccine, researchers are also examining new, evidence-based approaches to HIV prevention, including topical anti-HIV gels or creams that could be applied prior to sexual intercourse, as well as preventive regimens of antiretroviral medicines. The intent is to create a toolbox of effective HIV preventive measures, including a vaccine, which can stop the global scourge of HIV/AIDS.

NIH World AIDS Day Awards

To recognize the important contributions that NIH scientists have made to AIDS research, the OAR and NIAID established the NIH World AIDS Day Awards. The recipients of the second annual NIH World AIDS Day Awards were announced today. These scientists and managers have made exceptional contributions to the AIDS research efforts at NIH—either for original scientific research or for programmatic support for research. The individuals selected for the 2007 honor are:

Daniel Douek, M.D., Ph.D. and Richard Koup, M.D., of the Dale and Betty Bumpers Vaccine Research Center of the National Institute of Allergy and Infectious Diseases—a joint award for their original scientific research that significantly contributed to determining the mechanisms that control HIV pathogenesis and immune reconstitution. Their landmark findings have led the field in understanding the role of HIV-specific T cells in the control of HIV infection and helped to establish the immunological basis for the future development of an AIDS vaccine.

Kenneth Bridbord, M.D., M.P.H., of the Fogarty International Center for his efforts to develop innovative programs to build a cadre of international research scientists and clinicians trained to join the global fight against the AIDS pandemic. These programs have played a significant role in building research infrastructure and capacity for the conduct of basic and clinical biomedical and behavioral AIDS research in more than 100 nations around the world.

“These awards demonstrate the NIH commitment to supporting a multifaceted research effort in HIV/AIDS, with the goal of fostering the best minds to work together as partners to develop new medical tools to stop the devastating effects of the disease around the world,” says Dr. Zerhouni.

NIAID is a component of the National Institutes of Health. NIAID supports basic and applied research to prevent, diagnose and treat infectious diseases such as HIV/AIDS and other sexually transmitted infections, influenza, tuberculosis, malaria and illness from potential agents of bioterrorism. NIAID also supports research on basic immunology, transplantation and immune-related disorders, including autoimmune diseases, asthma and allergies.

The Office of the Director, the central office at NIH, is responsible for setting policy for NIH, which includes 27 Institutes and Centers. This involves planning, managing, and coordinating the programs and activities of all NIH components. The Office of the Director also includes program offices, which are responsible for stimulating specific areas of research throughout NIH. Additional information is available at http://www.nih.gov/icd/od/. The Office of AIDS Research, part of the Office of the Director, is responsible for coordinating the scientific, budgetary and policy elements of the NIH AIDS program.

The National Institutes of Health (NIH)—The Nation's Medical Research Agency—includes 27 Institutes and Centers and is a component of the U. S. Department of Health and Human Services. It is the primary federal agency for conducting and supporting basic, clinical and translational medical research, and it investigates the causes, treatments and cures for both common and rare diseases. For more information about NIH and its programs, visit http://www.nih.gov.

Federal HIV/AIDS treatment and prevention guidelines and clinical trials information can be found at <http://aidsinfo.nih.gov/>. Additional information about AIDS research can be found at <http://aids.gov/research/index.html>. AIDS.gov <http://aids.gov/> is the information gateway to federal domestic HIV/AIDS information and resources.

###

UNITED STATES:
"Silence on HIV/AIDS Tied to Epidemic’s Rise"
Washington Times, (11.28.2007) Cheryl Wetzstein
In a commentary in today's Journal of the American Medical Association, three top public health experts expressed concern over a 13 percent rise in new HIV/AIDS cases among US men who have sex with men (MSM) between 2001 and 2005. In the 33 US states and dependent areas with name-based HIV reporting systems in place during the period, new cases by year increased from 16,167 to 18,296. In response, the authors - the University of Oxford's Dr. Harold W. Jaffe, Dr. Kevin M. De Cock of the World Health Organization, and Dr. Ronald O. Valdiserri of the US Department of Veterans Affairs - said health and community leaders must increase calls for responsible sexual behavior and HIV testing among MSM.

"The silence on this subject is nearly pervasive," the experts wrote. Surveys "document high rates of unsafe sex" among MSM, and a 10-fold increase in syphilis in this population could help boost HIV transmission, they warned.

During the early days of the epidemic, community leaders encouraged MSM to take precautions with slogans like "Silence equals death." But now, "AIDS is simply not as frightening as it was," the researchers said. Antiretrovirals allow HIV-positive men to live reasonably healthy lives, and "younger MSM have largely been spared the visible devastation of untreated HIV infection," they said. This is leading to a return to sexual risk-taking behaviors, they said.

In addition to advocating more testing and safer sex practices, leaders "must call for the end of stigma toward MSM, which may mitigate the internalization of homophobia leading to sexual risk behavior" and "advocate for legal domestic partnerships as a way to promote stable, longer term MSM relationships," the experts said.

The commentary, "The Reemerging HIV/AIDS Epidemic in Men Who Have Sex with Men," is published in the Journal of the American Medical Association (2007;298(20):2412-2414).

AIDS Service Organizations Nationwide Challenged
AIDS Taskforce of Greater Cleveland Press Release (11/27/07)
CLEVELAND, OH—a newly-released national study from the AIDS Taskforce of Greater Cleveland highlighted “serious signs of financial and operational vulnerability” among AIDS Service Organizations (ASOs) across the United States, due to a combination of government funding cuts and lags, larger patient loads, and the increasing complexity of tasks ASOs are being asked to undertake. The study, primarily authored by Krissy Ferris, was publicly released today by the AIDS Taskforce in a national teleconference sponsored by the NY-based organization Funders Concerned About AIDS. Funding entities from across the U.S. participated in the conference call. The complete report is available on-line at www.aidstaskforce.org . The report examined IRS financial records from a representative sample of 100 ASOs in the U.S. over a five-year period from 2001-2005, and conducted follow-up interviews with executive directors. Participating organizations represented each region of the country, organizations with small and large budgets, and both general and more specialized (such as faith-based or women’s) agencies.

Among some of the key findings:

Over the five-year period, most organizations experienced increasing financial difficulties. In the entire sample, only nine organizations reported a budget surplus—that is, not “losing money”—in all five of the reporting years. The other 91% reported a loss in at least one of the years between 2001-2005. Half of the organizations in the sample had a budget deficit in 3, 4, or all 5 of the years analyzed.
Regionally, organizations in the southern United Stated reported the greatest difficulties, and organizations in the Northeast were more likely to report “breaking even” or having small budget surpluses.
When asked about programming, 72% of ASOs responded that they had cut or restricted programs in the last five years.
Nearly all organizations reported being deeply concerned about the uncertainty of future government funding, and only seven percent said they thought the current method of funding ASOs is sustainable. As one executive director wrote about sustainability of government funding: "It is absolutely not [sustainable]. We need 2 things—funds for general operating expenses, and capacity building support to help us get through these changes! We want to come through this as a stronger organization, and not just an organization that is always in REACTION mode!"

A significant number of those participating in the survey expressed a sense of what can only be called “relief” to realize that theirs was not the only organization facing challenges—that in fact, the problems were fairly common. Here in Ohio, the challenges are similar. In 2007, AIDS Resource Center Ohio, the primary ASO for 35 Ohio counties, will have assisted 2,100 people living with HIV/AIDS and their loved ones—a 32% increase over 2006, according to executive director Bill Hardy.

“Needless to say,” says Hardy, “support for programs is nowhere near keeping pace. Our situation is further complicated because we serve so many counties without large population centers, where resources are already spread thin. In addition, for many of these regions, HIV/AIDS was never a ‘real’ issue, or one that received community assistance. Meeting the needs of thousands of clients, while weighing financial ‘solvency’ considerations, has become a never-ending tug-of-war.”

The report clearly points to opportunities as well as challenges. It applauds the work of ASOs: “That ASOs have managed so well to grow, adapt, and evolve is a testament to the thousands of professionals and volunteers who staff them.” And it recognizes that increased collaboration and strategic partnerships can help strengthen the system of HIV/AIDS care and treatment, thus ensuring greater stability in the future. As Kevin Sullivan, executive director of the Ohio AIDS Coalition, noted, “What this study tells me is that Ohio’s HIV/AIDS organizations must become more aggressive in reducing our operating costs.

We need to think seriously about mergers and alliances as a means of continuing to provide services and advocacy for the HIV+ population.” The report ends with a series of recommendations, including a call to “seek out every opportunity to consolidate, build bilateral resource- and program-based partnerships, or merge with other ASOs.” The report also recommended that funders support short- and long-term investments in consolidations; that service consumers continue funding and supporting human rights advocacy; and that researchers investigate “best practices” and “model programs” in the development of sustainable networks that can provide comprehensive services. “It’s clear that many, many ASOs across the U.S. have done an extraordinary job in mobilizing professional and volunteer talents to provide services and prevent new infections,” Pike concluded. “But we also have to stop thinking about what we do in the context of a ‘state of emergency,’ and start thinking about the long haul.”

"Four Organ Patients Get HIV"
Chicago Tribune, (11.13.2007) Jeremy Manier
Four transplant recipients have contracted HIV in the first documented case of transmission via organ donation since 1985. The transplants took place in January at three Chicago hospitals: Northwestern Memorial Hospital, Rush University Medical Center, and the University of Chicago (UC) Medical Center. However, the patients did not learn until late last month that they are infected with HIV and hepatitis C.

A screening questionnaire by the agency that tested and approved the organs found the donor had engaged in high-risk behavior, said officials at Gift of Hope Organ & Tissue Donation (GHOTD). But tests for HIV, hepatitis, and other conditions were negative.

Alison Smith, vice president for operations at GHOTD, said the failure to detect the blood-borne infections stems from an inherent limitation of the standard test used to screen for them, ELISA. People who contract HIV up to 22 days prior to being tested turn up negative because their immune system has not yet made the antibodies ELISA is designed to detect. For hepatitis, the latent window can be even longer. GHOTD "followed the right procedures," Smith said.

The newer NAAT test reduces that window of time in which HIV goes undetected, said Dr. Michael Millis, chief of the transplant program at UC. "The organ supply is extraordinarily safe, but this has demonstrated that it's not 100 percent safe and it is never going to be 100 percent safe, at least with the technology we have today," he said.

CDC is conducting an epidemiological investigation into the cases. Its guidelines call for excluding high-risk patients from organ and tissue donation, "unless the risk to the recipient of not performing the transplant is deemed greater than the risk of HIV transmission and disease."

UC officials disclosed the problem on Monday, saying they wanted to explain how the infections occurred and assure potential organ recipients that the system remains safe. Since the last known case in 1985, more than 400,000 organs have been transplanted in the United States without a reported case of HIV transmission.

"AIDS Conference to Focus on Social Services"
Desert Sun (Palm Springs, Calif.), (11.06.2007)
Some 5,000 experts, patients, and health care workers are heading to Palm Springs for the 11th annual US Conference on AIDS, which runs Wednesday through Saturday at the Palm Springs Convention Center.

Chief among concerns at the event, whose theme is "One Family, One Voice, One Spirit," will be how service providers can use newly restricted federal funding to meet the needs of a patient population that is growing in number and living longer.

"It's very challenging with dwindling funds," said host committee co-chair Joe Acosta. "But it's also wonderful to hear that despite all those odds, we're trying to make ends meet."

The Ryan White program, reauthorized by Congress in 2006, now specifies that 75 percent of funds be spent on core medical services, said Peter DeMartino, public policy coordinator at the Desert AIDS Project. This leaves only 25 percent of the money to support the activities of social service providers. "People are feeling the crunch," he said. "The impact is being felt all over the country." The change has forced DAP to halt its food assistance program, which had helped 2,300 people.

A further challenge for communities, like Palm Springs, with large numbers of older people is that funds are distributed based on the number of patients diagnosed with HIV in a given community. Those who were diagnosed in one location but retired to another do not count toward the second community's patient tally.

The National Minority AIDS Council is sponsoring the meeting, which is being staged for the first time in a non-metropolitan area. In conjunction with the conference, local officials are holding a town hall meeting Thursday at 6:45 p.m. at the Wyndham Palm Springs; the public is welcome. For information on the conference, visit www.2007usca.org.

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