The San Francisco Examiner; March 11, 1998
Lisa M. Krieger of the Examiner Staff

There were about 10 new AIDS cases per 100,000 Native Americans and native Alaskans in 1996, compared with 11 new cases per 100,000 whites.

"These populations are not typically thought of as those who need HIV services and programs," said Dr. John Ward, CDC chief of surveillance for AIDS. "But because the rate is as high as whites - the majority of the population - it shows this is an important public health problem."

The CDC said the groups have high rates of sexually transmitted diseases and drug use, which in turn raise their risk of AIDS. They also lack access to diagnosis and treatment.

Gay men and drug users run the highest risk of AIDS among Native Americans and Alaskan natives, just as they do among whites.

French research stumbling?

French scientists once were at the forefront of AIDS research. Now they are struggling to keep up.

During the early days of the AIDS epidemic, it seemed France could do no wrong. It was its team of researchers, including Dr. Luc Montagnier of the Pasteur Institute, that raced America's Dr. Robert Gallo to isolate HIV. It was French scientists who were first to publish the sequence of HIV's genome. French scientists first isolated HIV-2, a viral strain common in West Africa.

There is a widespread perception among scientists in France and abroad that the country is no longer on the cutting edge, reports Michael Balter in the journal Science.

"What major AIDS discovery has France made in the last 10 years?" asked immunologist David Klatzmann of the Pitie-Salpetriere Hospital in Paris. In 1996, for instance, French scientists were on the sidelines when one of the most important breakthroughs of the past decade was announced: the discovery, by several American-led teams, that receptors for immune-system signaling molecules called cytokines act along with the CD4 molecule as co-receptors for HIV.

Furthermore, Montagnier has been unsuccessful in proving his long-running assertion that "mycoplasma," a type of microbe, works together with HIV to cause AIDS. Montagnier also has been criticized for associating himself with the claim that a molecule called CD26 was a long-sought co-receptor for HIV - a finding that was quickly discredited.

The journal identifies a number of possible reasons France has lagged after its fast start. Some cite competition with the United States, which outspends France on AIDS research by more than 30 to 1.

But many blame France's highly centralized research system, which, they say, lacks the flexibility and dynamism that have characterized U.S. research. Some researchers who spoke with Science agreed that the French system stifles creativity, rewards mediocrity, and - perhaps the greatest sin of all - prevents young scientists from seeking an independent career.

"If a young scientist wants to take risks, the system will not let him do much . . . 35-year-old scientists are still considered young wolves, rather than equals," said Dr. Simon Wain-Hobson, a prominent AIDS researcher at the Pasteur Institute. "In the United States, 35 is getting on."

Drug price reduction

The manufacturer of AZT has announced it will cut the drug's price by as much as 75 percent to make it affordable for preventing mother-to-child transmission of HIV in developing nations.

But, AIDS authorities warned, it still will require subsidies from rich nations to make AZT available to the estimated 3 million women worldwide who carry the human immunodeficiency virus, or HIV, and become pregnant in a given year.

Many African nations where AIDS is rampant spend less than $10 per person for all health care, so mounting a major campaign to give AZT to pregnant HIV-infected women will require wealthy nations and international agencies to kick in substantial amounts. But the AZT price cut puts the enterprise within reach, according to public health experts and Glaxo Wellcome.

Women: Look for experience

Women treated for HIV-infection at outpatient clinics had an improved overall survival rate if those medical facilities were experienced at treating AIDS, researchers said.

A study of 887 women covered under Medicaid found that 71 percent of patients who sought treatment at facilities with the highest volume of AIDS patients were alive 21 months after diagnosis. That compares with 53 percent for women who went to facilities with less experience in treating the deadly disease.

The study, published in the March issue of the journal AIDS, was the first to look only at women, especially poor women.

Events

*Project Inform has moved. Its new address is 205 13th St., Suite 2001, San Francisco, 94103. The phone number remains (415) 558-8669; fax, (415) 558-0684; Web site, www.projinf.org.

*Maitri offers 15 new beds for HIV patients at its just-completed facility at 401 Duboce St. Once exclusively a hospice, Maitri has expanded its mission from hospice care to a broad range of residential HIV care for the homeless. Call (415) 863-7330.

*The National AIDS Memorial Grove in Golden Gate Park has finished construction. Only final landscaping details remain to be done over the next two years. The grove's new mission is to complete an endowment so the site can remain in perpetuity. Already, $600,000 has been raised toward an endowment goal of $1.7 million - but more is needed. To contribute, call (415) 750-8340.

. . . . . .Date . . . . . .reported. . Cases. . Deaths S.F.. . . .2/1 . . . . 25,148. .17,049 Calif.. . .2/1 . . . .105,121 . 66,450 U.S.. . . .2/1 . . . .612,078 .379,258 WHO(rprtd) 2/1 . . .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 http://www.examiner.com/aidsweek/aidsweek.html

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