OHIO: "Experts Agre= e that Routine HIV Testing Is Positive, but Not Sure of Practicality"ILLINOIS: "Local Respo= nses to the HIV Testing Guidelines"
OHIO, MICHIGAN: "Jails, Prisons Test to Prevent Outbreak= of Tuberculosis"

INDIA: "Hateful' Anti-Gay Law Must= Go: Indian Government Agency"

IVORY COAST: "Cost-Effectiveness o= f HIV Treatment in Resource-Poor Settings: The Case of Côte d'Ivoire"<= BR>

FLORIDA: "Housing Worries Hit Some with HIV"
MISSOURI: "University to Dist= ribute Free Condoms in Campus Bathrooms"

UNITED STATES: "Black Doct= ors Endorse Routine HIV Testing"
= PENNSYLVANIA: "OraSure Begins Studies for its Home HIV Test= "
WISCONSIN: "HP= V Vaccine Now at University of Wisconsin Health Services"
ASIA-PACIFIC: "Methamphetamine, Ec= stasy Dominate Southeast Asia Drug Worries"
AUSTRALIA: "Many Australians Living with Undiagn= osed Hepatitis B"

O= HIO:   "Experts Agree that Routine HIV Testing Is Positiv= e, but Not Sure of Practicality"
Dayton Daily News   = ; (09.22.06):: Anthony Gottschlich

Ohio health official= s welcomed CDC's recommendations for routine HIV testing, but they expressed= reservations about funding. "I understand the philosophy of it," sa= id Bill Hardy, executive director of AIDS Resource Center (ARC) Ohio in Dayt= on. "But is it practical, will there be sufficient funds to pay for it, = and how will the public pay for it?"

The Combined Health District= of Montgomery County and some local doctors report charging $25 for a tradi= tional HIV test, with rapid-result swab tests costing more.

"It'= s a cost issue," said Health Commissioner Allene Mares. "We're not a= ble to offer HIV/AIDS testing to everyone."

"By identifying p= eople earlier through a screening program, we'll allow them to access life-e= xtending therapy, and also through prevention services, learn how to avoid t= ransmitting HIV infection to others," said Dr. Timothy Mastro, acting di= rector of CDC's division of HIV/AIDS prevention.

Dr. Robert L. Brandt= Jr., a Dayton-area HIV/AIDS specialist, said he thinks the guidelines will = help reduce stigma for testing. By putting HIV testing in the mainstream, he= said, it would become routine and most insurance companies would probably c= over it.

CDC's recommendations have been endorsed by the American Med= ical Association, which urged physicians to comply.

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ILLINOIS:   "Local Responses to the HIV Testin= g Guidelines"
Windy City Times (Chicago)    (09= .27.06):: Andrew Davis

Local HIV/AIDS leaders offered a mixe= d response to CDC's new HIV testing recommendations calling for routine volu= ntary, opt-out screening of people ages 13-64 in health care settings. Gener= ally, HIV agencies are in favor of expanded testing, but they are concerned = the recommendations may jeopardize patient consent and prevention counseling= .

Matt Sharp of Test Positive Aware Network has "mixed feelings&= #34; about the recommendations. "There [have] always been concerns with = a government HIV name-based reporting system," that patients' fear of di= sclosure could ultimately deter people from testing, he said. He acknowledge= d that name-based HIV reporting "is being implemented in order to ensure= government funding for services and care, getting people to take advantage = of current treatments." He expressed concern, however, about the role of= counseling under the new recommendations.

Jim Pickett, policy direc= tor of AIDS Foundation of Chicago (AFC), is against de-linking HIV screening= from specific consent. "Why do we think testing is going to stop this e= pidemic?" he asked. "Right now, we have over half a million who live= with HIV/AIDS who don't have regular access to health care." Illinois l= aw requires pre-test counseling, said Pickett: "That law was put into ef= fect for a reason; it's good public health."

"The very same l= aws that describe how testing's supposed to be in Illinois have critical saf= eguards regarding privacy and confidentiality," said David Munar, associ= ate director of AFC. Munar hopes state testing laws will proceed independent= ly with what works for Illinois. He feels pre-test counseling and informed c= onsent get short shrift in the new recommendations. "It doesn't make sen= se to encourage doctors and health care workers to have fewer conversations = about HIV."

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OHIO, MICHIGAN: &nb= sp; "Jails, Prisons Test to Prevent Outbreak of Tuberculosis" <= BR> The Blade (Toledo)    (09.25.06):: Christina Hall
In 2003, a disproportionate 3.2 percent of US TB cases were am= ong inmates in correctional facilities, according to CDC.

A 2006 CDC= report cited as reasons close, overcrowded living quarters; inadequate vent= ilation systems; and the high number of incarcerated people who do not acces= s standard public or nonemergency medical care. Correctional TB control can = be difficult, CDC said, because populations are diverse, include those from = other countries, and inmates are held in close proximity for varying duratio= ns.

CDC recommends early and follow-up TB screening; treatment; prope= r ventilation and respiratory precautions; planning for the inmate's release= ; working with local and state health departments; and screening employees f= or infection.

In Ohio and Michigan prisons, inmates are tested f= or TB infection by their second and seventh day of detention, respectively, = said state prison officials. In Michigan, prisoners are screened for symptom= s and asked intake questions to determine whether they may be at risk for TB= . In Ohio, prisoners are tested for TB annually on the same day. Michigan te= sts prisoners annually around their birthday.

In both states, inmates= with a positive skin test are often ordered to undergo an X-ray exam. Isola= tion at a hospital or on-site negative air pressure cell, which has separate= ventilation, is rare, said officials. Jails test inmates less frequently th= an state prisoners, since they are often detained for shorter periods and ma= y be released or transferred before a skin test could be read or treatment c= ompleted.

In October 2005, 132 of 42,965 inmates tested had positive= skin tests, but not active TB, said Annette Chambers, chief of Ohio's priso= n medical services bureau. Since 2003, Ohio has logged just two active TB ca= ses among inmates and no transmissions, she said. Michigan diagnosed one act= ive case recently, two cases last year, and a few cases in prior years, said= Dr. George Pramstaller, the Department of Corrections' chief medical office= r. Among active diagnoses, the prisoners either entered with the infection o= r were exposed in jail, he said.

The full CDC report, "Prevention= and Control of Tuberculosis in Correctional and Detention Facilities: Recom= mendations from CDC," was published in Morbidity and Mortality Weekly Re= port (2006;55(RR09):1-44).

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INDIA:   "Hatefu= l' Anti-Gay Law Must Go: Indian Government Agency"
Reuters &nb= sp;  (09.27.06):: Kamil Zaheer

On Tuesday, the chi= ef of India's National AIDS Control Organization (NACO) said India's law aga= inst homosexuality is "not acceptable" and abolishing it is "fun= damental" to the nation's AIDS fight. The British colonial-era law, Sect= ion 377 of the Penal Code, punishes men with up to 10 years in jail for havi= ng sex with men.

"This is not acceptable. Section 377 is quite an= anachronism," Sujatha Rao told delegates of a four-day Asia-Pacific con= ference on male sexual health and HIV. She called the 1861 law, which is bei= ng challenged in New Delhi's High Court by AIDS groups, "hateful." <= BR>
Activists say police use the threat of Section 377 to extort money fr= om gay men sitting in parks or lanes.

NACO estimates about 25 percent= of men who have sex with men (MSM) are infected with HIV. "It is import= ant to end this [Section 377], otherwise it would be very difficult to reach= out to MSM and end the spread of this infection," Rao said after the co= nference. Just 6-8 percent of gay men receive any HIV/AIDS outreach, includi= ng the distribution of condoms, she said.

While India's Ministry of H= ome Affairs has opposed abolishing the law, citing public opinion, Rao said = NACO was trying to reach a common position before the High Court hears the c= ase in October.

Rao's comments followed by 10 days an open letter wr= itten by leading Indian writers, lawyers, and artists asking the government = to remove the "monstrous" law. "With this law, MSM are scared to= come out in the open and we can't work with them [on HIV prevention]," = the authors said.

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IVORY COAST:   "Cost-Effectiveness of= HIV Treatment in Resource-Poor Settings: The Case of Côte d'Ivoire" <= BR> New England Journal of Medicine Vol. 355; No. 11: P. 1141-1153 &nbs= p;  (09.14.06):: Sue J. Goldie, MD, MPH; Yazdan Yazdanpanah, MD, P= hD; Elena Losina, PhD; Milton C. Weinstein, PhD; Xavier Anglaret, MD, PhD; R= ochelle P. Walensky, MD, MPH; Heather E. Hsu, AB; April Kimmel, MS; Charles = Holmes, MD, MPH; Jonathan E. Kaplan, MD; Kenneth A. Freedberg, MD

"As antiretroviral therapy is increasingly used in settings with l= imited resources, key questions about the timing of treatment and use of dia= gnostic tests to guide clinical decisions must be addressed," the author= s wrote.

In the current study, they addressed the cost-effectiveness = of treatment strategies for a cohort of HIV-positive adults in Ivory Coast. = Study subjects had a mean age of 33 years; CD4 cell count of 331 per cubic m= illimeter; and an HIV RNA level of 5.3 log copies per milliliter. Using a co= mputer-based simulation model incorporating CD4 cell count and HIV RNA level= as predictors of disease progression, they compared the long-term clinical = and economic outcomes of several strategies: no treatment; trimethoprim-sulf= amethoxazole prophylaxis alone; antiretroviral therapy alone; and prophylaxi= s with antiretroviral therapy.

The researchers found that undiscounte= d gains in life expectancy ranged from 10.7 months with antiretroviral thera= py and prophylaxis begun on the basis of clinical criteria to 45.9 months wi= th antiretroviral therapy and prophylaxis begun on the basis of CD4 testing = and clinical criteria as compared to trimethoprim-sulfamethoxazole prophylax= is alone. In 2002 US dollars, the incremental cost per year of life gained w= as $240 for prophylaxis only; $620 for antiretroviral therapy and prophylaxi= s without CD4 testing; and $1,180 for antiretroviral therapy and prophylaxis= with CD4 testing, each compared with the next least expensive strategy.
"None of the strategies that used antiretroviral therapy alone were= as cost-effective as those that also used trimethoprim-sulfamethoxazole pro= phylaxis," the researchers reported. "Life expectancy was increased = by 30% with use of a second line of antiretroviral therapy after failure of = the first-line regimen."

The prophylaxis plus antiretroviral ther= apy approach, with the use of clinical criteria alone or in combination with= CD4 testing to guide the timing of treatment, "is an economically attra= ctive health investment in settings with limited resources," the researc= hers concluded.

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=

FLORIDA:   "Housing Worries = Hit Some with HIV"
Palm Beach Post    (09.27.06= ):: Thomas R. Collins

Palm Beach City officials say most lan= dlords of 60 former Hope House clients are allowing the tenants to stay. In = August, the city cut federal grant funding to the rent and utility assistanc= e organization for HIV/AIDS patients. City officials say all former Hope Hou= se clients now have case managers with the nonprofit Comprehensive AIDS Prog= ram. However, one property manager of a suburban West Palm Beach apartment c= omplex wants former Hope House clients to move out.

"Everybody= is worried," said one former Hope House client. All tenants asked to re= main anonymous, fearing discrimination. Residents have received electric bil= ls, which used to be paid in Hope House's name, ranging from $648 to $1,119,= labeled "pay immediately." The city said it would investigate tenan= ts' claims about a family that has been without power for five days.

= If former clients notify the city, it will pay their bills, said Paula Ryan,= the city's economic and community development director. She said Hope House= had not been paying the bills, resulting in the current high balances due. = "The full amount has to be paid, so it's being paid," she said. The = city stopped disbursing funds to Hope House when city staff reported not rec= eiving proper financial records from the agency; questions of over-billing f= or rent also arose.

Electric bills began running high once the city = told Hope House clients to stop paying the agency their portion of rent, lea= ving the organization unable to cover utilities, said Hope House Director An= gela Rose. She said the city should stop trying to blame its own lack of ove= rsight on Hope House.

Some former clients report great difficulty in = securing other housing. One woman said she had contacted 200 landlords but a= lmost none would accept her rent voucher.

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MISSOURI:   "University to Distribute Free Condoms in Ca= mpus Bathrooms"
Associated Press    (09.23.06)<= /strong>
On Sept. 22, officials of the University of Missouri-Columbia an= nounced the school would become the first in the Big 12 Conference to offer = free condoms in residence hall bathrooms. The condoms will be placed in bask= ets with wallet-sized educational packets, according the Residential Life of= ficials.

"Since we are sexual-health advocates, we feel it is nec= essary to have the information along with the condoms," said Heather Mue= ller, a health educator at the Student Health Center. Mueller said the Colum= bia/Boone County Health Department will supply the condoms. A fraternity sug= gested the program, which is similar to a project at Harvard University.
=
The university already distributes condoms at the Student Health Center;= the Women's Center; and the Lesbian, Gay, Bisexual, and Transgender Resourc= e Center. Mueller said the Health Advocate Peer Education program, a group s= he coordinates, pushed for HIV awareness and wider contraception availabilit= y.

A campus survey of 100 black students this year showed support for= increased access to condoms, said Christopher Keller, president of Phi Beta= Sigma, a traditionally black fraternity. Mueller said her research showed s= ome students were embarrassed to ask for a condom, and that the STD rate was= higher among blacks. "Let's face the facts: People are having sex, and = let's do something about it," said Keller, a senior.

Mueller said= campus staff would restock supplies in the 200 residential hall bathrooms t= hroughout the semester. No one has registered a complaint about the program,= which will be evaluated in an online survey at the end of term.

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UNITED STAT= ES:   "Black Doctors Endorse Routine HIV Testing" United Press International    (09.27.06)
T= he National Medical Association, the nation's largest association of African= -American physicians, has announced its endorsement of CDC's call for routin= e voluntary HIV testing in medical settings. "One of the reasons for suc= h high HIV mortality in the African-American community is the disease is dia= gnosed so late in the course of the illness," said Albert Morris, the or= ganization's newly installed president, noting that "routine testing is = critical in the fight against this disease." Morris said NMA is also ask= ing that CDC's recommendations be expanded to include mandatory HIV testing = of persons entering the correctional system. NMA represents some 30,000 blac= k doctors.

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PENNSYLVANIA:  &nb= sp;"OraSure Begins Studies for its Home HIV Test"
Linda Loyd&nb= sp;   (09.27.06):: Philadelphia Inquirer

OraS= ure Technologies announced Wednesday it has launched studies of its rapid-re= sult HIV test for in-home use by consumers. The company is conducting lab-ba= sed research and plans further clinical studies under an investigational dev= ice exemption filed with the Food and Drug Administration to use the device = in safety and effectiveness studies to support regulatory approval. An FDA p= anel met in November to discuss home HIV testing. OraSure's rapid-result HIV= test has been used in clinical settings since 2002. The test uses saliva or= blood and delivers results in 20 minutes.

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WISCONSIN:   "HPV Vaccine Now at University of Wisconsi= n Health Services"
University Wire    (09.21.06= ):: Amanda Hoffstrom, Daily Cardinal

On Sept. 20, University= of Wisconsin-Madison's Health Services department became one of the few are= a clinics to offer the human papillomavirus vaccine Gardasil. The three-seri= es vaccine, administered over six months, protects against four high-risk HP= V types that cause most cases of cervical cancer and genital warts, said Lyn= n Sterud, the university's clinical instructor of cytology. Each shot costs = $122, said Mary Landry, doctor of obstetrics and gynecology at UHS' women's = clinic. "Most insurance companies are covering it," she said. The be= st time to be vaccinated is before becoming sexually active and thus at risk= of acquiring the common STD. "However, if you are sexually active or if= you've had a past history of HPV disease, which is genital warts or cervica= l dysphasia, you're still a candidate and it's still recommended by [CDC's a= dvisory panel on immunizations]," said Landry.

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ASIA-PACIFIC:   "Methamphetamine, Ecstasy Domin= ate Southeast Asia Drug Worries"
Australian Associated Press &= nbsp;  (09.27.06)
Two new reports document the drug th= reats facing the Asia-Pacific Region, including Australia. Most of the 13 co= untries studied by the Australian National Council on Drugs indicated growin= g abuse of methamphetamine and ecstasy. And a report by the UN Office on Dru= gs and Crime warns more potent forms of meth are showing up on Australia's s= treets. The ANCD study says 80 percent of HIV infections in Indonesia are li= nked to injection drug use, and 25,000 Thais begin using drugs each year. Me= th is now the chief illicit drug used in the Philippines, according to the A= NCD study. Australia's first conference on amphetamines begins Thursday in S= ydney.

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AUSTRALIA:   "M= any Australians Living with Undiagnosed Hepatitis B"
Australian Ass= ociated Press    (09.27.06)
Ahead of World H= epatitis Awareness Day on Sunday, the Australian Hepatitis Council has revea= led new data indicating that more than 30 percent of the estimated 90,000 Au= stralians with hepatitis B do not know they are infected. Helen Tyrrell, the= council's CEO, said she welcomes the government's decision to include the h= epatitis drug Pegasys in the Pharmaceutical Benefits Scheme. "Given the = high incidence and alarmingly low rate of diagnosis and treatment, we believ= e easier access to therapy via the PBS will encourage more effective managem= ent and better diagnosis of hepatitis B," she said.

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