National News
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 KENTUCKY: "Bill Would Require School Girls Have Papillomavirus Vaccine"
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International News
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SOUTH AFRICA: "Winfrey Takes AIDS Test, Offers Them to New School's Students in South Africa"
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IRAN: "Sex and Shopping Bring HIV Crisis"
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THE PHILIPPINES: "Cervical Cancer Vaccine to Save Patients 500,000 Pesos"
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Medical News
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UNITED STATES: "HIV Test May Show Which Drugs Work Best"
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UNITED STATES: "Explaining Recent Declines in Adolescent Pregnancy in the United States: The Contribution of Abstinence and Improved Contraceptive Use"
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Local and Community News
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MARYLAND: "Sex-Ed Plan Could Revive 2005 Debate"
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News Briefs
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TEXAS: "Health Officials: 2,800 May Have Been Exposed to TB"
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NORTH CAROLINA: "Skipping Drugs Lands Man in Jail; Tuberculosis Treatment Is Mandatory"
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FLORIDA: "Hepatitis Diagnoses Reported: Three Cases Cited at Manatee Elementary over Last Three Months"
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The Prevention News Update
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National News
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KENTUCKY
"Bill Would Require School Girls Have Papillomavirus Vaccine"  back to top
Lexington Herald-Leader, (01.05.2007) Barbara Isaacs:
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On Jan. 2, state Rep. Kathy Stein's (D-Lexington) bill to require girls to be vaccinated against human papillomavirus (HPV) before entering middle school was sent to Kentucky's House Committee on Health and Welfare. "It is proactive," Stein said. Parents can still decline any vaccinations for religious or other reasons, allowing them to opt their children out of the immunization, "if need be," she said. HPV is an STD that causes most cases of cervical cancer.
The Family Foundation of Kentucky said it will lobby against Stein's bill, which would add the HPV vaccine Gardasil to polio, mumps, and measles shots already required. "There's no long-term track record yet" for Gardasil, said Martin Cothran, FFK's senior policy analyst.
A similar HPV bill is pending in the California Legislature, and another passed Michigan's Senate but was defeated in the House, said Joy Johnson Wilson, director for health policy for the National Conference of State Legislatures.
"Making this mandatory is going to be difficult," said state Sen. Tom Buford (R-Nicholasville). "I'm never in favor of forcing parents… But this use of this drug is a no-brainer. We need to get it out there." Buford favors making the vaccine free, as New Hampshire does for females ages 11-18.
"To me, it's unbelievable that some people think that by giving this vaccine, it's going to encourage young women to engage in sexual activity," said Stein. "I find that laughable."
"We cannot keep in the stuff," said Dr. W. David Hager, referring to Gardasil stock at his Lexington obstetrics office. "It has really caught on. It's an extremely popular vaccine," Hager said, though he added, "I also believe parents have the right to choose."
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International News
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SOUTH AFRICA
"Winfrey Takes AIDS Test, Offers Them to New School's Students in South Africa" back to top
Associated Press, (01.06.2007) Clare Nullis:
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On Saturday at her new Leadership Academy for Girls in South Africa, Oprah Winfrey underwent an HIV test to help persuade students to do the same. "To be a great leader, you must be of sound mind, body and spirit," Winfrey told the girls. "Part of leadership is having the courage to demonstrate true action. Today I have taken the test to demonstrate why it's so important."
Winfrey's test results will remain confidential, as will those of the students. A statement issued on behalf of the Oprah Winfrey Foundation said HIV tests will be voluntary, require parental consent, and the results will not affect students' standing at the school. Many of the girls come from families affected by HIV/AIDS.
Winfrey spoke to the families about the importance of routine health examinations for students. She stressed that no girl would be forced to undergo testing. In addition, she offered free testing and antiretroviral treatment to students' family members and caregivers.
Around 5.4 million South Africans have HIV/AIDS. A November report by the Actuarial Society of South Africa and the Medical Research Council found an estimated 950 people died each day from AIDS-related causes in 2006, while another 1,400 were infected daily for a total of 530,000 new infections last year.
Winfrey opened the academy last Tuesday at a star-studded ceremony that featured former South African President Nelson Mandela, who had encouraged her to start the school. More than 3,500 girls from across the country applied for the academy, which will eventually have 450 students. Admission requirements include both academic and leadership potential as well as a monthly household income of no more than 5,000 rand ($787 US).
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IRAN
"Sex and Shopping Bring HIV Crisis" back to top
The Guardian (London), (01.03.2007) Robert Tait:
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The phenomenon of prostitutes offering shopkeepers sex in return for free or discounted clothes is becoming more common in Tehran's shopping districts, undermining HIV/AIDS prevention efforts in a country where the virus is increasingly transmitted sexually.
Health officials and experts say they believe the practice in part stems from loosening sexual mores among Iran's predominantly young population. They worry that many young people in the country are uninformed about HIV transmission risks.
Iran Positive Life, a volunteer group funded in part by UNICEF, is working to raise HIV/AIDS awareness among shopkeepers. In three months, volunteers have spoken to an estimated 5,000 young Iranians in shopping malls, parks and coffee shops. "I don't think [the prostitutes] are HIV/AIDS-aware," said IPL volunteer Amir Fattahi. "If they are infected and have sex with three or four shopkeepers a day, you can imagine the danger."
But awareness of HIV/AIDS does not always translate into safer behaviors. "I think most of the shopkeepers know the risk but they can't resist the temptation," said Fattahi. "We have found that while people know about HIV, their information is not necessarily enough for them to use precautionary methods when engaging in sex," said IPL Managing Director Amir Reza Moradi.
"At the same time, it's hard for us to reach sex workers, so our education workers go to malls and speak to shopkeepers…. If shopkeepers become educated and change their attitudes, hopefully the sex workers will notice and change their own ways," said Moradi.
Recent figures show Iran has 13,704 registered HIV cases. However, World Health Organization and Iranian Health Ministry estimate a more accurate figure would be between 70,000 and 120,000. Experts believe many infected young people do not seek testing due to ignorance about the virus or because of fear of their parents' finding out.
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THE PHILIPPINES
"Cervical Cancer Vaccine to Save Patients 500,000 Pesos" back to top
Philippine Daily Inquirer, (12.30.2006) Tessa R. Salazar:
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Thanks to the Philippine's Bureau of Food and Drug's recent approval of the human papillomavirus vaccine Gardasil, some 3,800 Filipino women each year may be spared the consequences of cervical cancer. Gardasil, produced for the Philippines by Merck, Sharp and Dohme (MSD), protects against four HPV types that cause 70 percent of cervical cancer and 90 percent of genital warts. BFD approved the vaccine for females and males ages 9-26.
A Phase III study of Gardasil among men ages 26-44 is ongoing, said Dr. Efren J. Domingo, president of the Society of Gynecologic Oncologists of the Philippines, Inc. If the vaccine is found efficacious in that age group, BFD might approve its use for these men by 2008-2009, said Domingo, who is also a University of Philippines College of Medicine professor.
The relative cost of the vaccine, 15,000-21,000 pesos ($307-$430 US) depending on the physician, should be weighed against the exorbitant cost of treating cervical cancer, as much as P500,000 ($10,244 US) per patient, said Domingo. Nonetheless, at P5,100-P7,000 ($105-$143 US) per dose, the three-series immunization might be too expensive for the middle classes, he acknowledged.
Whether Gardasil confers lifetime immunity or a booster shot will be required in the future has not been determined, said Domingo. However, five-year follow-up of the initial trial patients found the geometric mean titers of neutralizing antibodies were still very high, according to MSD.
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Medical News
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UNITED STATES
"HIV Test May Show Which Drugs Work Best" back to top
Orlando Sentinel, (01.08.2007) Jean P. Fisher:
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An experimental HIV drug-resistance test can detect even very small amounts of resistant HIV strains, ones that could eventually cause treatment complications or failure, a new study suggests. Such a test could help physicians predict the best treatment option from the outset, reduce treatment costs, and potentially curb a patient's infectiousness.
Current analyses are able to detect resistant strains only if they represent a significant proportion circulating in the patient's blood.
Dr. Feng Gao and Duke University colleagues helped to develop the test and publish proof of its accuracy and sensitivity. Duke is currently seeking to patent and, ultimately, market the test. But the test still needs proof it positively affects treatment outcomes.
"A lot of questions are still unanswered, but it's an important step forward," said Dr. Peter Leone, a physician at University of North Carolina-Chapel Hill and medical director of the state's HIV prevention branch. If successful, a more sensitive resistance test could "improve the odds that the first course of treatment is going to be successful," he said.
The documentation of drug-resistant HIV strains infecting treatment-naïve patients has garnered federal government support for making routine viral-resistance testing a standard of care. The government's recommendation, effective last year, means most private and public health insurers will cover resistance testing. The tests can cost from several hundred dollars to $1,000 or more.
The full report, "Detection of Minor Drug-Resistant Populations by Parallel Allele-Specific Sequencing," was published in the advance online Nature Methods (2007;doi:10.1038/nmeth995).
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UNITED STATES
"Explaining Recent Declines in Adolescent Pregnancy in the United States: The Contribution of Abstinence and Improved Contraceptive Use" back to top
American Journal of Public Health Vol. 97; No. 1: P. 150-156, (01..2007) John S. Santelli, MD, MPH; Laura Duberstein Lindberg, PhD; Lawrence B. Finer, PhD; Susheela Singh, PhD:
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In the current study, the researchers examined the relative contributions of declining sexual activity and improved contraceptive use to the recent decline in US adolescent pregnancy rates.
Using data from 1995 and 2002 for women ages 15-19, the authors developed two indexes: the contraceptive risk index, which summarized the overall effectiveness of contraceptive use (and nonuse) among sexually active adolescents; and the overall pregnancy risk index, which was calculated according to the contraceptive risk index score and the percentage of adolescents reporting sexual activity.
The contraceptive risk index declined 34 percent overall and 46 percent among subjects ages 15-17. Improvements in contraceptive use included increases in condom use, birth control pills, withdrawal, and multiple methods and a decline in nonuse. The overall pregnancy risk index dropped 38 percent, with 83 percent of the decline attributed to improved contraceptive use. For adolescents ages 15-17, improved contraceptive use contributed to 77 percent of the decline in pregnancy risk.
"The decline in US adolescent pregnancy rates appears to be following the patterns observed in other developed countries, where improved contraceptive use has been the primary determinant of declining rates," the researchers concluded.
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Local and Community News
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MARYLAND
"Sex-Ed Plan Could Revive 2005 Debate" back to top
Washington Post, (01.05.2007) Daniel de Vise:
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On Tuesday, Montgomery County School Board officials will consider a compromise middle- and high-school sex education curriculum that attempts to balance how much teenagers in the county need to know about premarital sex and homosexuality.
In fall 2004, a board-approved curriculum introduced sexual orientation topics to eighth- and 10th-graders and correct condom use to 10th-graders. Board members then decided to add a discussion of homosexuality, which singled out some religions for intolerance of gays. A curriculum video featured a young female health educator unrolling a condom onto a cucumber. Community groups then sued, arguing the lessons tacitly encouraged premarital sex and homosexuality.
In May 2005, US District Judge Alexander Williams Jr. halted the school system's lessons. An agreement was reached in June 2005, and the school board agreed not to address religious beliefs in the revised curriculum.
Other topics of potential controversy are addressed in the proposed new lessons as follows:
*The disputed condom video has been replaced by one that is purely instructive and features a wooden phallus.
*Despite protests from the groups, sexual orientation is introduced to eighth-graders. However, committee member recommendations of including emphatic statements that homosexuality is not a disease or mental illness — beliefs supported by mainstream medical groups — were not included.
*Anal and oral sex are discussed in the lessons, although anal sex is not singled out for potential health risks as the citizens groups had wanted.
*The viewpoints of former homosexuals, who maintain that sexuality is a choice, are not voiced, contrary to the groups' wishes.
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News Briefs
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TEXAS
"Health Officials: 2,800 May Have Been Exposed to TB" back to top
Associated Press, (01.06.2007) :
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State health officials have sent letters urging TB testing for about 2,800 people who may have been exposed to the disease at University Medical Center in Lubbock. The potential exposures would have taken place between September and November 2006; however, the hospital only learned of the problem in December. Only people who received one of the letters should be tested, the Texas Department of State Health Services said. It is doubtful anyone exposed at UMC would be showing symptoms yet, said Dr. Richard Lampe, the facility's chairperson of infection control.
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NORTH CAROLINA
"Skipping Drugs Lands Man in Jail; Tuberculosis Treatment Is Mandatory" back to top
News & Observer (Raleigh), (01.08.2007) Matt Dees:
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A man detained Sunday by the Durham Police Department turned out not to be the armed robbery suspect officers were seeking; however, when they ran a background check, they found an outstanding warrant against him for skipping, since November, his mandatory TB treatments. Brian Letourneau, health department director, said chances were "extraordinarily slim" that someone had caught TB from the man, but he said all those who had been in close contact with him will be tested. The man is being held alone in a cell at the Durham County Jail; bail is set at $50,000.
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FLORIDA
"Hepatitis Diagnoses Reported: Three Cases Cited at Manatee Elementary over Last Three Months" back to top
Bradenton Herald, (01.06.2007) Donna Wright:
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Three people at Manatee Elementary School have been diagnosed with hepatitis A during the past three months, according to Manatee County Health Department officials. All three have recovered and are no longer infectious," said John Burns, department spokesperson. This is the second incidence of hepatitis A in the county this school year: Between August and October, four people at Tillman Elementary School in Palmetto were diagnosed with the disease. For more information, telephone Ron Cox or Darlyn Hughes at Manatee County Health Department at 941-748-0747, ext. 1272 or 1211.
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The Prevention News Update
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The CDC National Center for HIV, STD, and TB Prevention provides this 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 HIV/STD/TB Prevention News Update should be cited as the source of the information. Contact the sources of the articles abstracted for full texts of the articles.
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