Important note: Information in this article was accurate in 1998. The state of the art may have changed since the publication date.
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The San Francisco Examiner; Wednesday, Jan. 7, 1998 - Page A 4
Lisa M. Krieger of the Examiner Staff
An estimated 100 recommendations for specific policy changes are expected to come out of the conference, based on a written report to be presented there. The report summarizes the findings of seven separate committees of local AIDS experts who have been meeting in advance of the event, said summit coordinator Dick Pabich.
Although perhaps not as flashy as some previous mayoral summit conferences, the AIDS summit is likely to be among the most substantive.
"There is a commitment to shepherd through (these recommendations) and implement them," said Pabich. "There are very specific things that can be undertaken."
The summit is triggered by three recent trends in the epidemic: improvements in anti-viral treatment, changing demographics and the increasingly tough challenge of prevention.
San Francisco has been a longtime leader in compassionate and comprehensive treatment of the disease. But times have changed. Newly infected people are living longer - but are also struggling with competing issues of substance abuse, mental illness and homelessness. The old model of treatment, where HIV services were isolated from services for social ills no longer fits, according to summit experts.
"The overarching theme of the AIDS summit is the degree to which HIV services can be integrated with other health and social services - particularly as the epidemic shifts to people with multiple health problems, substance abuse, mental disorders, or homelessness," Pabich said.
"How can the city health department better integrate all of the responses to these problems?" he asked. "We can do it by improving consultation between agencies, cross-training (service providers), and doing better training of doctors."
For instance, if drug-addicted San Franciscans get treatment, they are at lower risk of HIV infection. If they have a home, they are more likely to stick to their anti-viral medication regimen. News of yet another AIDS conference has produced predictable cynicism, admitted Pabich.
"But it will be extremely substantial - perhaps even boring to listen to. And there will be a huge constituency of people breathing down the mayor's neck . . . exerting political pressure on him to solve these issues."
Drs. Marcus Conant and Thomas Coates are directing summit committees tackling access and adherence to treatments, prevention, workplace entry and re-entry, testing and reporting, insurance, housing and funding. The summit will be at Masonic Auditorium on Nob Hill at 1111 California St. Continental breakfast and lunch will be provided. The meeting will begin at 8:30 a.m., with registration starting at 7:30 a.m., and will adjourn by 5 p.m.
The conference is free but registration is required. To register, call (415) 554-6657.
Clinton's plan for drug fund
President Clinton is preparing to ask Congress for a $100million increase for a program that buys life-prolonging medicine for poor AIDS patients who don't qualify for Medicaid, according to the Associated Press.
The request, in Clinton's 1999 fiscal budget, represents a 35 percent increase for the cash-strapped AIDS Drug Assistance Programs (ADAP), an administration official confirmed.
ADAP programs in many states had to cut patients or restrict their access to therapy this year.
Clinton's fiscal 1999 budget request would increase spending for the AIDS drug program to $385million, up from the $285million this year and $167million last year.
Clinton did not request an increase in AIDS drug spending in his last budget, prompting criticism from AIDS activists until Congress allotted the additional money.
Genetic mutation
A second hereditary genetic mutation appears to help provide resistance to the AIDS virus, even in cases of frequent unprotected sex with infected partners, according to a report in the British medical journal Lancet.
For more than a year, U.S. and European researchers have been pursuing indications that genetic mutations can naturally provide protection against HIV.
A French team - headed by Dr. Alberto Beretta of St. Joseph's hospital in Paris and Dr. Luc Montagnier of the prestigious Pasteur Institute - studied the gene that creates the protein receptors on human cells. It is through these protein receptors that HIV enters and infects the cells.
Researchers have previously noted that some individuals with unusual resistance to AIDS have two copies of a gene mutation - called Delta 32 - in the two copies of the gene that makes the protein receptor called CCR5.
According to the Lancet article, the researchers learned that people also can be resistant if they have the new mutation, named m303, in one CCR5 gene copy and Delta 32 in the second CCR5 gene copy, despite frequent unprotected sex with infected partners.
In the study, one man who had both mutations and had been repeatedly exposed to the AIDS virus displayed a natural resistance. His father and sister also had the same m303 mutation, which appears to be inherited. They tested 209 healthy blood donors and found that three had the m303 mutation, indicating it was not unique to one family. Scientists believe the presence of the m303 mutation in Western European countries is "appreciable."
The toll
Garrett Marshall Stack III, 49, a chef, waiter, bartender and artist remembered for his primitive costumes on Halloween and Gay Pride Day.
. . . . . .Date . . . . . .reported. . Cases. . Deaths S.F.. . . .1/1 . . . . 24,881. 16,974 Calif.. . .1/1 . . . .104,638 . 66,263 U.S.. . . .1/1 . . . .612,078 .379,258 WHO(rprtd) 1/1 . . .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 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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