In July 1992, the National Hemophilia Foundation and CDC received a report from a hemophilia-treatment center of a 19-year-old man with hemophilia (patient 2) who recently had seroconverted for antibody to human immunodeficiency virus (HIV). This report summarizes the findings of an investigation by CDC and state and local public health officials, which determined he was infected with a strain of HIV nearly identical to that in his previously infected older brother (patient 1).
"Time to Act" is the theme selected by the World Health Organization (WHO) for the sixth annual World AIDS Day, December 1, 1993. This year's theme focuses attention on the need for action against the pandemic of human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS). WHO estimates that 13 million men, women, and children worldwide have been infected with HIV.
During the 1980s, human immunodeficiency virus (HIV) infection emerged as a leading cause of death in the United States (1). In 1992, HIV infection became the number one cause of death among men aged 25-44 years. This report updates national trends in deaths caused by HIV infection for 1991 and 1992.
MMWR Weekly, November 19, 1993 / 42(45);873,879-880
Street outreach programs for human immunodeficiency virus (HIV) prevention are designed to deliver HIV prevention messages, materials, and referral services to high-risk persons outside of traditional health-care and drug-treatment clinics. The Acquired Immunodeficiency Syndrome (AIDS) Evaluation of Street Outreach Projects (AESOP) is an eight-site * study designed by CDC in collaboration with researchers in each of the sites to better understand client characteristics, service delivery, and the impact of street outreach programs . . . .
Human immunodeficiency virus (HIV) counseling and testing are important components of the public health effort to contain the acquired immunodeficiency syndrome (AIDS) epidemic. Project RESPECT is a multicenter randomized trial being conducted by CDC at five sexually transmitted disease (STD) clinics to evaluate the efficacy of HIV counseling interventions in preventing HIV and other STDs. Because consistent and proper use of latex condoms is one method to substantially reduce the risk for transmitting HIV and other STDs . . . .
The following map provides information on the reported number of acquired immunodeficiency syndrome (AIDS) cases per 100,000 population by state of residence for October 1992 through September 1993. The map appears quarterly in MMWR. More detailed information on AIDS cases is provided in the quarterly HIV/AIDS Surveillance Report . . . .
A Food and Drug Administration (FDA)/CDC educational packet on food safety for nursing home directors and food service workers, "Handle with Care" (stock no. PB92-780857), is available from the National Technical Information Service, telephone (800) 553-6847. A public information pamphlet on Salmonella enteritidis is available from CDC's Foodborne and Diarrheal Diseases Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Mailstop C-09, 1600 Clifton Road, NE, Atlanta, GA 30333.
Since 1985, the number of human immunodeficiency virus (HIV) tests provided annually through publicly funded counseling and testing (CT) programs has continued to increase, with more than 2 million tests provided in 1991 (1). However, the success of CT programs in reaching persons most at risk for infection and transmission of HIV is unclear. To ensure that resources are used as effectively as possible, CT programs must evaluate their ability to reach persons at highest risk.
In January 1993, the surveillance case definition for acquired immunodeficiency syndrome (AIDS) among adolescents (aged greater than or equal to 13 years) and adults was expanded to include human immunodeficiency virus (HIV)-infected persons who have less than 200 CD4+ T-lymphocytes per uL or a CD4+ T-lymphocyte percentage of total lymphocytes less than 14 (1) or pulmonary tuberculosis, recurrent pneumonia, or invasive cervical cancer.
These guidelines for the treatment of patients with sexually transmitted diseases (STDs) were developed by staff members of CDC after consultation with a group of invited experts who met in Atlanta on January 19-21, 1993. Included are new recommendations for single-dose oral therapy for gonococcal infections, chlamydial infections, and chancroid; new regimens for the treatment of bacterial vaginosis (BV) and outpatient management of pelvic inflammatory disease (PID); a new patient-applied medication for treatment of genital warts; and a revised approach to the management of victims of sexual assault.
Although refraining from intercourse with infected partners remains the most effective strategy for preventing human immunodeficiency virus (HIV) infection and other sexually transmitted diseases (STDs), the Public Health Service also has recommended condom use as part of its strategy. Since CDC summarized the effectiveness of condom use in preventing HIV infection and other STDs in 1988, additional information has become available, and the Food and Drug Administration has approved a polyurethane "female condom."
The following map provides information on the reported number of acquired immunodeficiency syndrome (AIDS) cases per 100,000 population by state of residence for July 1992 through June 1993. The map appears quarterly in MMWR. More detailed information on AIDS cases is provided in the quarterly HIV/AIDS Surveillance Report, . . . .
During 1992, state and territorial health departments reported 47,095 cases of acquired immunodeficiency syndrome (AIDS) to CDC, an increase of 3.5% over the 45,499 cases reported in 1991. As in previous years, most (50.8%) cases were attributable to transmission of human immunodeficiency virus (HIV) among homosexual/bisexual men (Table 1). This report summarizes the characteristics of persons reported with AIDS in 1992, compares them with data from 1991 (Table 1), and describes selected trends since 1988.
During the 1980s, human immunodeficiency virus (HIV) infection emerged as a leading cause of death in the United States (1). This report updates national trends in deaths caused by HIV infection during 1990 and 1991 and indicates that HIV infection/acquired immunodeficiency syndrome (AIDS) continues to cause an increasing proportion of all deaths.
Mycobacterium avium complex (MAC) causes disseminated disease in up to 40% of patients with advanced human immunodeficiency virus (HIV) disease in the United States. A U.S. Public Health Service Task Force convened to address the prophylaxis and therapy of MAC recommends that patients with HIV infection and less than 100 CD4+ T-lymphocytes/uL be administered prophylaxis against MAC. The recommended regimen is rifabutin, 300 mg by mouth daily, for the patient's lifetime.
MMWR Weekly, June 18, 1993 / 42(23);448-449,455-456
Transmission of human immunodeficiency virus (HIV) infection can be prevented through HIV-prevention case management -- a one-on-one client service specifically designed to assist HIV-infected persons in receiving services that will prevent or reduce behaviors that result in further spread of the virus, delay the onset of symptomatic HIV disease, and improve the client's health status. This approach enables HIV-infected persons to enter a stable, ongoing medical-care system and supports prevention goals by providing multiple opportunities . . . .
On April 19, 1993, the National Institute on Drug Abuse of the National Institutes of Health, the Center for Substance Abuse Treatment of the Substance Abuse and Mental Health Services Administration, and CDC issued a joint bulletin updating recommendations to prevent transmission of human immunodeficiency virus (HIV) through the use of bleach for disinfection of drug injection equipment. The bulletin particularly addresses persons who cannot or will not stop injecting drugs.
From 1980 through 1990, the cumulative incidence of acquired immunodeficiency syndrome (AIDS) in the District of Columbia (DC) (2713 cases per 100,000 persons) was approximately eight times that of the surrounding metropolitan area (340 per 100,000). From 1980 through 1986, the AIDS epidemic primarily involved men who had sex with men; since 1986, the incidence of AIDS has been increasing among injecting-drug users (IDUs) and their sex partners.
Previous reports have described transmission of human immunodeficiency virus (HIV) to five persons (patients A, B, C, E, and G) during receipt of care from an HIV-infected dentist in Florida (1-3) and other investigations of patients who were treated by HIV-infected health-care workers (HCWs) (4). This report updates these investigations and presents evidence that a sixth patient (patient I) became infected with HIV while receiving care at the Florida dental practice, the only practice in which HIV transmission from an infected HCW to patients has been documented. Investigation of Patients of HIV-Infected HCWs (Excludes Florida Dental Practice).
This document updates previously published CDC recommendations for infection-control practices in dentistry to reflect new data, materials, technology, and equipment.
MMWR Recommendations and Reports, May 21, 1993 / 42(RR-7);001
These recommendations update previous CDC/American Thoracic Society (ATS) recommendations for the treatment of tuberculosis (TB) among adults and children (1). The most notable changes are in response to the increasing prevalence of drug-resistant TB in the United States. These recommendations include the need for a) in vitro drug susceptibility testing of Mycobacterium tuberculosis isolates from all patients and reporting of these results to the health department, b) initial four-drug regimens for the treatment of TB, and c) initial directly observed therapy for persons with TB.
On January 1, 1993, the acquired immunodeficiency syndrome (AIDS) surveillance case definition for adolescents and adults was expanded beyond the surveillance definition published in 1987 (1) to include all human immunodeficiency virus (HIV)-infected persons with severe immunosuppression ( less than 200 CD4+ T-lymphocytes/uL or a CD4+ T-lymphocyte percentage of total lymphocytes of less than 14), pulmonary tuberculosis (TB), recurrent pneumonia, or invasive cervical cancer.
MMWR Recommendations and Reports, April 23, 1993 / 42(RR-5);001
Although 97%-98% of children in the United States are vaccinated before or shortly after starting school, the proportion of preschool children who have completed a full series for all recommended vaccines is considerably lower. Although low immunization coverage among preschoolers has been attributed to difficulties in reaching certain groups, such as the urban poor and racial and ethnic minorities, more recent evaluations suggest that the health-care delivery system itself bears much of the responsibility.
MMWR Recommendations and Reports, April 09, 1993 / 42(RR-4);001
This statement summarizes current recommendations by the Advisory Committee on Immunization Practices (ACIP) on the use of active and passive immunization for persons with altered immunocompetence. The purpose of this statement is to make ACIP recommendations more accessible for clinicians by consolidating them into a single document.
CDC has published Draft USPHS Guidelines for Prevention of Transmission of HIV through Transplantation of Human Tissue and Organs. The draft document is available for public comment from the CDC National AIDS Clearinghouse, P.O. Box 6003, Rockville, MD 20849-6003; telephone (800) 458-5231. Written comments should be sent by May 17, 1993, to the Technical Information Activity, Division of HIV/AIDS, National Center for Infectious Diseases, CDC, Mailstop E-49, 1600 Clifton Road, NE, Atlanta, GA 30333; fax (404) 639-2029.
CDC has published revised recommendations for human immunodeficiency virus (HIV) counseling and testing of patients in acute-care hospital settings (1).* These recommendations update previous CDC guidelines published in 1987 (2) and strengthen the recommendation for hospitals to assess the rate of HIV infection among their patient populations and to develop HIV-testing programs that assist infected patients in obtaining HIV-related treatment and prevention services.
MMWR Recommendations and Reports, February 12, 1993 / 42(05);95,101
Of all acquired immunodeficiency syndrome (AIDS) cases reported through 1991 in the United States, 76% occurred among persons aged 25-44 years; persons aged 15-44 years comprise approximately 50% of the United States workforce. On December 1, 1992, CDC introduced "Business Responds to AIDS" (BRTA) -- a new program for the primary prevention of human immunodeficiency virus (HIV)/AIDS. BRTA, which was introduced by satellite teleconference, encourages business and labor leaders in U.S. communities to develop comprehensive workplace HIV-prevention education programs.
During the human immunodeficiency virus (HIV) epidemic, media and public interest have been captured periodically by accounts of persons infected with HIV. However, the effect of these stories on HIV/acquired immunodeficiency syndrome (AIDS) awareness and sexual behaviors is largely unknown. On November 7, 1991, Earvin "Magic" Johnson announced at a press conference he was infected with HIV and would be retiring from professional basketball.
Human immunodeficiency virus (HIV) counseling and testing is a major component of the public health effort to contain the HIV/acquired immunodeficiency syndrome (AIDS) epidemic. However, persons may avoid HIV testing in part because they fear discrimination and legal sanctions if their drug use, sexual behavior, or test results became public. Anonymous testing has been offered to address these fears, but it is not clear whether anonymous testing, compared with confidential testing, actually results in testing more persons at risk for or infected with HIV.
The following map provides information on the reported number of acquired immunodeficiency syndrome (AIDS) cases per 100,000 population by state of residence for January 1992 through December 1992. The map appears quarterly in MMWR. More detailed information on AIDS cases is provided in the quarterly HIV/AIDS Surveillance Report, single copies of which are available free from the CDC National AIDS Clearinghouse, P.O. Box 6003, Rockville, MD 20849-6003; telephone (800) 458-5231.
Safer sex practices intended to reduce the risk for human immunodeficiency virus (HIV) infection have been vigorously promoted among men who are homosexual or bisexual (i.e., men who have sex with men). Such efforts have emphasized personal responsibility and protection of partners, and many of these men appear to have adopted risk-reducing behaviors. However, it is unknown whether these safer sex practices and norms have been adopted by men who have sex with men but conceal their sexual orientations or do not self-identify as homosexual or bisexual.
CDC recently published new projections of the number of persons in the United States who will initially be diagnosed with a condition included in the 1987 acquired immunodeficiency syndrome (AIDS) surveillance case definition during 1992-1994. The report also presents estimates of the number of persons with human immunodeficiency virus (HIV)-related severe immunosuppression (defined as HIV-infected persons with CD4+ T-lymphocyte counts less than 200 cells/uL whose illnesses have not been diagnosed as conditions included in the 1987 surveillance definition) as well as estimates on the effect of adding this measure of immunosuppression to the 1993 expanded AIDS surveillance case definition.
MMWR Recommendations and Reports, January 15, 1993 / 42(RR-02);1
These recommendations update previous recommendations regarding human immunodeficiency virus (HIV) counseling and testing of patients in acute-care hospital settings. The revision was prompted by additional information regarding both the rates at which patients admitted to some acute-care hospitals have unrecognized HIV infection and the potential medical and public health benefits of recognizing HIV infection in persons who have not developed acquired immunodeficiency syndrome.
MMWR Recommendations and Reports, January 15, 1993 / 42(RR-02);11
Human immunodeficiency virus counseling and testing services (HIV-CTS) have been recommended by CDC since 1985, when serologic tests became available to detect antibodies to HIV (1,2). In August 1987, CDC published the Public Health Service Guidelines for Counseling and Antibody Testing to Prevent HIV Infection and AIDS (3). These guidelines remain in effect today.
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