Important note: Information in this article was accurate in 1997. The state of the art may have changed since the publication date.
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The San Francisco Examiner - Wednesday, July 16, 1997
Lisa M. Krieger of the Examiner Staff
The funding debate in the House Appropriations Subcommittee comes on the heels of federal statistics that show the sharpest decrease in AIDS deaths is among white men, while the number of deaths fell less among women, minorities and poor people, who may lack access to a powerful and expensive new generation of anti-viral drugs.
The statistics suggest the need for a national effort to remedy the inequities that exist in access to health care services.
"It appears that we will win a significant increase in the AIDS Drugs Assistance Program (ADAP)," which serves the poor, predicted Daniel Zingale of AIDS Action in Washington, D.C. "So far, we're off to a strong start."
AIDS activists pushed for at least $100 million more in funding than was included in President Clinton's original budget proposal.
Anecdotal reports from cities across the United States reflect a need for more help. For instance, the San Francisco AIDS Foundation reports that nearly half the people it serves are homeless or in imminent danger of becoming homeless. Many also have addiction or mental health issues, which also require expensive treatment.
In Los Angeles, a survey of 6,000 HIV-infected people found that African Americans and Latinos are much less likely to know about combination drug therapy, much less likely to be on it and much less likely to be offered it than their Caucasian counterparts.
Heinnie Fairchild of Washington, D.C., who spoke at the AIDS Action-sponsored "State of AIDS Forum" this week said that a doctor recently tried to stop her prescription for a protease inhibitor. She said the doctor maintained "it was not his policy" to provide expensive drugs to Medicaid patients.
Many experts worry that changes to state welfare programs will further limit access to financial assistance for low-income individuals. Already, Milwaukee's health programs that serve the indigent have closed.
HIV-gonorrhea link
When men are infected with HIV and another sexually transmitted disease, like gonorrhea, their semen contains about eight times as much HIV as found in semen of men who who do not have dual infections, a new study has found.
The study, reported in the medical journal Lancet, was carried out in Malawi, a country in southern Africa where an estimated 15 percent of sexually active adults are infected with HIV.
The findings are relevant for the United States and other developed countries, said Dr. Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases.
"The study has important economic and public health implications because if you can treat a sexually transmitted disease with a few doses of relatively inexpensive antibiotics, you may prevent a number of HIV infections that would cost a lot more to treat," Fauci said.
Scientists believe that cells infected by sexually transmitted diseases produce natural infection-fighting substances known as chemokines. One explanation for the increased risk of HIV infection or transmission is that chemokines could ease the entry of HIV-infected cells into semen and speed the rate of viral replication there.
The study looked at 135 HIV-infected men with and without other infections. After a week of treatment, the amount of HIV dropped significantly in the semen of men with other sexually transmitted diseases. After two weeks of treatment, the amount of HIV was similar to the levels seen in men without sexually transmitted diseases.
Drug side effect
People who take indinavir (Crixivan), the most widely prescribed protease inhibitor in the U.S., may experience urinary tract disease and temporary kidney dysfunction, according to an NIH study published in the latest issue of the Annals of Internal Medicine.
"Indinavir is an excellent drug," said Dr. Jeffrey Kopp of NIH. However, if kidney or urinary symptoms become severe or recur, or if kidney problems develop, doctors may want to consider switching to another protease inhibitor, he said.
The problems are thought to be caused by indinavir crystals that form in the urinary tract. The drug is poorly soluble and more than 10 percent of a dose is excreted, unchanged, in the urine.
Infection through kiss
A woman apparently became infected with HIV from a deep kiss with a man who had bleeding gums and canker sores -- the first reported case of HIV transmission through a kiss, the government says.
The U.S. Centers for Disease Control and Prevention emphasized that the virus was transmitted via the man's blood, not his saliva. There are no reported cases of people becoming infected with the AIDS virus through saliva.
The couple said they always used a condom during sex. But both the man and woman had gum disease and poor oral hygiene. Her gum disease had weakened and thinned her gums, making it easier for the virus to get into her blood, the CDC said.
The toll
Brett Zeigler, 9, a Texas boy with AIDS, who moved with his father to Santa Cruz last summer to escape prejudice against the disease. They arrived with little money and moved into a local hotel. But within two weeks of hearing of their plight, more than 100 Santa Cruz residents offered money, new clothes and toys. The two were able to move into a home and Brett became a devoted Power Rangers fan ... R. Scott Thomas, 45, a graphic designer with Pacific Telesis who cycled Europe and South America, toured Australia by train and rafted the entire length of the Grand Canyon ... Harry "Dale" Weitemier, 47, a bon vivant who was also an accountant in the law office of the late Melvin Belli ... Wilmer Weiss, 71, a noted fashion retail executive for more than 50 years, most recently with I. Magnin in San Francisco.
Date
reported Cases Deaths
S.F. 7/1 24,371 16,803
Calif. 7/1 100,912 64,832
U.S. 7/1 548,102 343,000
WHO(estimated) 7/1 8,400,000 6,400,000
Figures are cumulative since June 1981. Government officials now compile and release statistics quarterly, not monthly. To contribute to AIDSweek, call
(415) 777-7867. AIDSweek columns are available on the Internet at www.examiner.com/aidsweek/ aidsweek.html
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