The FDA on generic drugs

The FDA says that:

Generic drugs are safe, effective and FDA approved. Generic drugs account for about 50 percent of all prescription drug purchases in the United States, therefore, consumers should be well informed and confident when taking generic drug products.

To obtain printed copies of any of these materials, please email your request by title to: dpapubs@cder.fda.gov. You can also call 301-827-1243 or 1-888-INFO-FDA.

• "You know that question that goes through your mind when you take your generic drug? Here are the answers." This brochure provides five common questions and answers (Q&As) about generic drugs.
• En Español "¿Qué son las drogas genéricas y por qué son importantes para usted? Todo lo que necesita saber sobre las drogas genéricas." This brochure provides five common questions and answers (Q&As) about generic drugs.
• "Facts about Generic Drugs." This brochure provides plain language answers to the 9 most common questions about generic drugs.
• "Generic Drugs: Questions and Answers" This provides 9 common Q&As about generic drugs.
• En Español "Frecuentes Preguntas Acerca de las Drogas Genéricas." This provides 9 common Q&As about generic drugs.
• "Generic Drugs: What Everyone Should Know" This short article describes how FDA regulates generic drugs.
• "Savings From Generic Drugs Purchased at Retail Pharmacies" This analysis looks at the potential savings of buying generic drugs instead of brand name drugs.
• "FDA-Approved Bargain Drugs: Generic Products Must Meet High Standards" This one page "Just the Facts," from December of 2003, discusses the high standards that generic drugs must meet for approval.
• "Study: U.S. Generic Drugs Cost Less Than Canadian Drugs." This FDA Consumer article from July/August 2004 discusses the results of a study that compared the cost of U.S. drugs and Canadian drugs.
• "FDA Ensures Equivalence of Generic Drugs." This FDA Consumer reprint, updated August 2002, is about the safety and efficacy of generic drug products, and includes information on cost benefits. For reprints, e-mail papubs@cder.fda.gov, or call 301-827-1243 or 1-888-INFO-FDA.
• "Greater Access to Generic Drugs." This FDA Consumer article from Sept/Oct. 2003 describes new FDA initiatives to improve drug reviews and reduce legal loopholes. For reprints, e-mail dpapubs@cder.fda.gov, or call 301-827-1243 or 1-888-INFO-FDA.
• "Generic Drugs: What You Need to Know." This FDA Consumer article from Sept/Oct. 2002 provides information on the law that allows approval of generic products, Drug Price Competition and Patent Term Restoration Act of 1984. It also includes Q&As about generic drugs.
• "What You Want to Know About Generic Drugs: Generic Drugs: Safe. Effective. FDA-Approved." This 59-slide PowerPoint presentation is intended for consumer education.

For more information about generic drug products, visit the Office of Generic Drugs Web site .

Infection increases among young gay males

Thanks to JS for sending this link to an essay by Nate Lippens about the increase in infection among young gay males: "All that for nothing."

Gay men used to risk friendships, offend drinking buddies, and piss people off to stop the spread of HIV. Now the only thing we're willing to risk is our health.

FDA approves first generic drug for HIV/AIDS

On December 3, the Food and Drug Administration (FDA) approved a generic formulation of Didanosine (ddI) Delayed Release capsules, 200 mg, 250 mg, and 400 mg for use in combination with other antiretroviral agents in the treatment of HIV-1 infection in adults. The product, manufactured by Barr Laboratories, Inc. of Pomona, NY will be available for use within the United States and foreign countries.

It is the first approval in the United States of a generic antiretroviral product to treat HIV/AIDS.

Didanosine (ddI) is the a generic version of the already approved Videx EC Delayed-Release Capsules manufactured by Bristol Myers Squibb. It is a delayed-release capsule, taken once daily.

National Perinatal HIV Consultation and Referral Service

The National Perinatal HIV Consultation and Referral Service (Perinatal Hotline) at 888-448-8765, provides free 24-hour clinical consultation and advice on treating HIV-infected pregnant women and their infants as well as indications and interpretations of rapid and standard HIV testing in pregnancy.

The Perinatal Hotline is an expansion of the HRSA National HIV/AIDS Clinicians’ Consultation Center (NCCC) at San Francisco General Hospital, which currently operates the National HIV Telephone Consultation Service (Warmline) and the National Clinicians’ Post-Exposure Prophylaxis Hotline (PEPline).

The Perinatal Hotline (888-448-8765) and the PEPline (888-448-4911) are both available 24 hours, seven days per week. The Warmline (800-933-3413) is available 8 a.m. to 8 p.m. (EST) Monday through Friday. All consultations are free and confidential.

See the NCCC Web site for more information.

Pediatric guidelines updated

The Guidelines for the Use of Antiretroviral Agents in Pediatric HIV Infection have been updated. The Pediatric Guidelines, developed by the Working Group on Antiretroviral Therapy and Medical Management of HIV-Infected Children, now include Supplement II, titled "Managing Complications of HIV Infection in HIV-Infected Children on Antiretroviral Therapy, "and Supplement III, titled "Adverse Drug Effects." Also included in the new version are updates to the atazanavir, indinavir, and enfuvirtide sections in Supplement I, "Pediatric Antiretroviral Drug Information."

All new information is highlighted in yellow in the main document. Supplements II and III are new to the guidelines and are highlighted in title only. The updated guidelines document is available in the Pediatric Guidelines section of the Guidelines page on the AIDSinfo Web site.

World AIDS Day

Abilene

Big Country AIDS Resources will sponsor a World AIDS Day community worship service at the First Baptist Church chapel, 1333 N. 3rd at Orange St. (use Orange St. entry) on Wednesday, December 1 at 7pm. Please call Larry Holmes at 325-691-1300 for more information.

Austin

The seventh annual Austin area World AIDS Day Interfaith Service of Rememberance and Hope will be held Wednesday, December 1 at 7pm at the Unity Center, 9600 Dessau Road. This service provides a vivid reminder of the need for renewed awareness of the extent of the HIV/AIDS pandemic in Central Texas. AIDS quilts will be displayed in memory of those who have died from AIDS complications. For more information, please contact Roger Temme, Interfaith Care Alliance, at 512-459-5883.

Beaumont

The P.A.L.M. Center will be at the Lamar University Student Center in Beaumont. They will have a booth for testing, education and pamphlets. There will also be a candle light ceremony starting around 6:30 that night for anyone who wishes to attend. Contact Carla Baker at CBaker@landmanor.org for details.

Dallas

Skillful Living Center, Inc. presents its fourth Teen Summit on Thursday, December 2, 2004 from 9:30am-2:30pm at the Oak Cliff Bible Fellowship Church, 1808 W. Camp Wisdom Rd., in Dallas. The Teen Summit 2004 theme is, "Empowering the Hip Hop Generation with Healthy Sexuality & Relationship Skills". Expected attendance is 600 teens from approximately four schools. Hip Hop Promoters will share the "History of Hip Hop." There will be food, fun, prizes, speakers and entertainment. Please contact Mary Tavares at 214-330-8468 or slc2mary@aol.com for more information.

AIDS Arms, Inc. will present a World AIDS Day musical memorial on Wednesday, December 1 at 7:30pm at the Sara Ellen & Samuel Weisfeld Center, 1508 Cadiz at Browder by Dallas City Hall. The musical will feature the Turtle Creek Chorale, the Women's Chorus, Beckles Dance Company, Denise Lee, and Gary Floyd. Call 972-530-9253 for tickets or additional information. Tickets can be purchased on behalf of clients to enjoy the event.

The Micheal Maddison Children's Fund will hold a silent auction benefiting children affected by HIV/AIDS that includes a gallery showing of artistic photo journalism by Malek entitled "A Celebration of Life". Food and drinks will be offered. Hosted by International fashion photographer, A O. Matesun (a.k.a. Malek), Myriam Guerrero and 97.9 The BEAT's Action Jaxon. For additional information, please visit www.mmcfund.org.

The Dallas County Health & Human Services Department Testing and Counseling Clinic will be offering free testing on Wednesday, December 1. Please contact Kay Caddell at KCaddell@dallascounty.org for more information.

Denton

ExHALE Services is having several free HIV testing sites on Wednesday, December 1. Sites include the University of North Texas Health Clinic from 10am-12pm, the Texas Women's University Wellness Clinic from 10:30am-2pm, and ExHALE Services, 405 S. Elm St., Ste. 102 in Denton, from 3-7pm. Please call 940-484-2617 or 817-781-0523 with any questions.

World AIDS Day will be recognized at the University of North Texas (UNT) on Tuesday, November 30 and Wednesday, December 1. The free events are open to the public and feature UNT faculty, staff and students as well as representatives from Metroplex AIDS organizations and UNT organizations, who will share program and educational information. UNT's University Union is located at 410 Avenue A in Denton. Participating organizations include various Metroplex AIDS organizations and UNT groups, including the Ally Program, Center for Psychosocial Health, Division of Equity and Diversity, University Union, Student Health and Wellness Center, Feminist Majority Leadership Alliance and Pan African Students' Association. On November 30 from 6-8pm in the University Union Golden Eagle Suite, UNT faculty and students will give presentations on HIV/AIDS research. There will also be a panel discussion with persons with HIV infection. On December 1 from 10am-2pm in the University Union Courtyard, there will be displays of community resources, as well as poster displays of faculty and student research. UNT faculty representing academic departments across campus have authored poster presentations on HIV and AIDS research. From 12-3pm, UNT's Center for Psychosocial Health will host an open house in Terrill Hall, room 284. The website for the Center is www.unt.edu/cph. HIV testing and results will be given at UNT Student Health and Wellness Center for UNT students on December 1st. An evening World AIDS Day candlelight vigil will begin at 6pm, with location to be announced by UNT's Feminist Majority Leadership Alliance (FMLA). For more information, contact Dr. Dan Emenheiser or Rebeca Perfecto, Division of Equity and Diversity, at 940-565-2456, or check www.unt.edu/ally.

Fort Worth

Tarrant County AIDS Interfaith Network will have two significant activities on World AIDS Day. A Physician Lecture will take place Wednesday, December 1 from 12-2pm at Celebration Community Church, 908 Pennsylvania Av. in Fort Worth. This is a free program with catered lunch for persons living with HIV/AIDS, social workers and medical professionals, sponsored by Abbott Labs. Later that day, an Interfaith Commemorative Service will take place at 6:30pm at Texas Christian University's Carr Chapel, 2855 South University. For more information, please contact Curtis L. Smith at 817-923-2800, ext. 22.

Galveston

MotherLand, Inc. cast members will be presenting the HIV/AIDS awareness play, "That's Why We're Here" at the AIDS Coalition of Coastal Texas World AIDS day event at 1405 39th Street in Galveston. MotherLand will also be conducting testing on December 1 in collaboration with ELOES Center. For testing times and locations, please contact Victor Ndando-Ngoo or Ifeoma Adegun at 713-290-0001.

Planned Parenthood of Houston and Southeast Texas (PPHSET) will provide free HIV testing at the World AIDS Day event sponsored by the AIDS Coalition of Coastal Texas (ACCT) in Galveston on Wednesday, December 1. A memorial march begins at Galveston City Hall at 11am, ending at the Saengerfest Park on the Strand, where PPHSET will be offering HIV tests. Contact ACCT at 409-763-2437 for information.

Houston

The Harris County Hospital District's Thomas Street Health Center, in conjunction with the Houston Department of Health and Human Services, will host a day of recognition on Wednesday, December 1 from 12-4pm at 2015 Thomas St. The day of recognition will include this year's dedication of the Tree of Remembrance and a health and information fair. This will be an opportunity for the public to come to Thomas Street Health Center and honor a loved one who has passed away due to HIV/AIDS. They will also be able to attend a health and information fair highlighting HIV/AIDS services available in the Houston/Harris County area. For more information, please contact Jeff Benavides at 713-873-4026.

On December 1, 2004, the University of Houston will be commemorating World AIDS Day. Following is a list of activities:

• Two panels of the AIDS Quilt will be on display in the University Center.
• The Wall of Tears will be displayed in the UC Arbor, with an opportunity to write messages of support and comfort
• The UH AIDS Quilt will be on display. This quilt was made from messages students and employees contributed over the past three years. An opportunity to add messages to the next UH Quilt will be available.
• There will be music from 11:30am-1pm in the Arbor.
• A health fair will be held on the first level of the UC from 11am-1pm.
• Information and red ribbons will be available at the UC and in the Towers Commons.
• 10,000 red ribbons will have been distributed across campus the week preceding World AIDS Day.
• The UH Health Center will be doing free HIV testing all day.
• There will be a candlelight vigil held at 5pm in the UC Arbor.

For more information about these activities, please contact Gail Gillan, Director, UH Wellness, at 713-743-5461.

To observe World AIDS Day 2004, the Texas Children's Hospital Allergy and Immunology Department will set up a booth to offer HIV information/education for the staff, volunteers and families at the hospital. Up-to-date facts and information about HIV prevention, medical care and research for infants, children, adolescents and pregnant women will be available for everyone. The event will be held from 11:30am-1pm on the Clinical Care Center Bridge. For further information, contact Gloria Sierra or Sherri Henry at 832-824-1319.

Planned Parenthood of Houston and Southeast Texas (PPHSET) will be conducting free HIV testing in collaboration with Fundatión Latino Americana Contra El Sida (FLAS), Inc. at the Mexican Consulate's Office, 4506 Caroline Street, 1st Floor, in Houston, 10am-2pm. Contact FLAS at 713-772-2366 for additional information.

In honor of World AIDS Day, Rice University will host a display of the NAMES Project AIDS Memorial Quilt in the Grand Hall at Rice Memorial Center. Making up 10 quilts total, 80 panels will be on display at the following times: Wednesday, December 1, 11am-11pm; Thursday, December 2, 11am-11pm; Friday, December 3, 11am-5pm. In addition to the display, there will be a variety of educational, academic, and artistic programs. For a full schedule of events, visit www.rice.edu/service.

The Houston GLBT Community Center, 3400 Montrose Blvd., Ste. 207, will have a tree of remembrance, celebrating the annual tradition it took over from NAMES Project Houston in 2002. The center invites people to bring memorial ornaments throughout the month of December. For more information, call 713-524-3818.

AVES (Amigos Volunteers in Education and Services) has arranged a World AIDS Day Mass to be celebrated in Spanish at All Saints Catholic Church, 215 E. 10th St. in the Heights. The mass takes place Wednesday, December 1 at 7pm. People wishing to bring photos of loved ones are invited to do so, and they will be placed on a table near the altar during the Mass. For more information, call 713-626-2837.

The Illumination Project takes place Wednesday, December 1 at 7:30pm at the Hobby Center for Performing Arts, 800 Bagby. Presented by the Dominic Walsh Dance Theater, the Hobby Center, and Hope Stone, Inc., this performance benefits Baylor International Pediatric AIDS Initiative and Bering Omega Community Services. For tickets or more information, call 713-526-1907.

There will be a ecumenical, interfaith Community World AIDS Day service on Wednesday, December 1 at 7pm at the Grace Lutheran Church, 2515 Waugh Dr. A reception will follow. Please call the Rev. Todd Williams at 832-723-6948 for more information.

A World AIDS Day luncheon honoring Bracewell & Patterson, LLP and benefiting AIDS Foundation Houston will take place Thursday, December 2 at 11:30am at the Houstonian Hotel, 111 N. Post Oak Ln. Call Annisa Hill at 713-623-6796, ext. 224 for tickets and additional information.

The Living Water-Annual Mass of Remembrance will take place Friday, December 4 at 11am at St. Mary of the Purification Catholic Church, 3006 Rosedale. A reception will follow at the Parish Hall. For more information, call 713-626-2837.

Longview

Special Health Resources of Texas (SHRT) will host a candlelight service on Wednesday, December 1 at St. Andrews Presbyterian Church, McCann Rd. and Hampton St., 7-8pm. SHRT Board Chairman Griff Hubbard will emcee the event and State Representative Tommy Merritt will speak. For more information, please call 903-234-0776.

Lufkin

On December 1, World AIDS Day, Planned Parenthood of Houston and Southeast Texas (PPHSET) will be hosting a free HIV testing day at their Lufkin Clinic, 1404 Frank, from 1-7pm. The event will be announced on the four Clear Channel radio stations and on Lufkin's Spanish radio station. We will also be offering urine gonorrhea and chlamydia testing at a reduced rate. This free HIV testing day will follow the annual education program conducted by the Community Coalition for AIDS Education, of which PPHSET is a partner, at the Pitser Garrison Civic Center from 8:30a-11:30am. For more information please contact Bonnie Lee at 936-634-8446 ext. 223.

Plano

AIDS Services of North Texas will be hosting a World AIDS Day ceremony on Wednesday, December 1. The ceremony will be at the Plano Centre, Plano, Texas and will begin at 7:30pm. Mayor Pat Evans will be the guest speaker as well as Mr. Glenn Kopanski, Retired Naval Petty Officer. Kopanski is known to be one of the longest surviving AIDS patients in the country. AIDS Services of North Texas will be displaying 20 Quilts of the internationally acclaimed AIDS Memorial Quilt and will be dedicating over 20 new panels to the Memorial. Eighteen panels are for young South African children who have lost their lives to AIDS. Over 100 Plano students will be participating in the evening ceremony. Local youth from Collin County will perform in the ceremony. For more information, go to www.aidsntx.org and click on "upcoming events."

San Antonio

The San Antonio AIDS Foundation (SAAF) and the Partnership for Education, Empowerment, Resources and Support (PEERS) For Women are presenting an evening community activity for World AIDS Day. Featured speakers include:

• Ann Paddie, Bank of America - Topic: Women and Business
• Crystal Stone, ClearChannel Radio - Topic: Women and Radio Broadcasting -Linda Hook, RNC, MSHP, San Antonio Metropolitan Health District -
• Topic: Women and Health -Patti Radle, San Antonio Councilwoman
• Topic: Women and Community Activism -Patti Wetzel, MD - Topic: Women and AIDS

The evening program begins at 6pm on Wednesday, December 1 at the SAAF facility located at 818 E. Grayson. Speakers will present from 6-6:30pm followed by a few testimonials from women of PEERS. The community activity will end with a candlelight ceremony to remember those we have lost to AIDS. The program is open to the entire community. For more information regarding the speakers and/or program, please contact Ramiro Sanchez at 210-225-4715.

Moral Plunder

Kathy Pollitt's recent column for The Nation argues that a number of policies implemented by the current national administration represent a quid pro quo for the political support of the Religious Right. Her column begins:

Sitting alone in a classroom at a Catholic all-boys high school this weekend (don't ask), I passed the time by browsing through the health textbooks stacked on the window sill. Sure enough: no discussion of contraception (condoms are mentioned, but not described, in connection with people who have HIV); abortion, still legal here in the United States, isn't even listed in the glossary. Sex itself is discussed only in the vaguest terms, with emphasis on how to avoid it. This wasn't a special Catholic-boy textbook, either -- "Health: Skills for Wellness" is one of the bestselling health texts in the country.

Pollit's discussion continues through a long list of changes that she attributes to political payback for the Religious Right. Her conclusion is basically that "this, too, shall pass," and reason and enlightenment will eventually return to the land of the free and the home of the brave. Until then, however, she asks:

How many young people will suffer STDs and HIV and pregnancy because they learned in school that condoms "don't work" -- or didn't hear about them at all?

One may agree with her conclusion or disagree with her thesis, but Pollit still points to troubling examples of disinformation which seem likely to have some effect on HIV prevention. When effective prevention information is withheld from those at high risk to engage in high risk activities, then their likelihood for exposure to HIV increases simply because they will not have the information they need to avoid such exposure. Giving incorrect information is at least just as bad.

It's true. Condoms don't make a very good sandwich wrap. They are useless for holding the trunk closed when you want to haul an oversized load. They simply don't work as a hotpad. But condoms are effective at preventing the transmission of HIV.

The Short End of the Stick

Roy Appleton, Dallas Morning News, has written an interesting profile/update about Retractable Technologies, the manufacturer of retractable syringes which were specifically designed by Texan Thomas Shaw to eliminate needle stick injuries and reduce the spread of HIV and other infectious diseases in the health care setting. Appleton's article details the legal battles and financial struggles that resulted from Shaw's attempt to break into the closed world of medical suppliers.

Interestingly, Appleton makes no mention of current Texas law, which requires public entities whose employees are at risk of exposure to bloodborne pathogens through sharps injuries, including needle stick injuries, to provide safety engineered medical devices for their employees' use. This would be the Health and Safety Code, Chapter 81, Subchapter H: Bloodborne Pathogen Control (paragraphs 81.301-307).

This section of the law has a more or less interesting legislative history. In the 76th Regular Session (1999), Rep. Harryette Ehrhardt (D-Dallas) introduced HB 1646, which successfully passed through the Public Health Committee and was sent to the House floor as part of the Local & Consent Calendar. The companion bill, SB 905, by Sen. David Bernsen (D-Beaumont), moved similarly smoothly through the Senate. Both bills, however, ran up against the end of session crunch. Rather than lose them entirely, the authors decided to append them to another bill (HB 2085), the reauthorization of the Texas Department of Health, which was sure to pass.

As a result of this legislation, the then Texas Department of Health produced its Bloodborne Pathogen Exposure Control Plan, which includes the following procedures:

All publicly owned or financed institutions that provide health services, even if health services are not their primary purpose, shall comply with the state and federal laws concerning bloodborne pathogen exposure. Providers such as public hospitals, school clinics, home health agencies, local agencies (LAs), EMS providers etc are covered by these laws. Under the law, these providers are required to:
A. Use needleless systems and sharps with engineered sharps injury protection for all venous/arterial access, body fluid withdrawal, and all fluid administrations and injections.
B. Develop an Bloodborne Exposure Control Plan, modeled after and equal to the plan mandated by TDH, that monitors employee exposure determinations, addresses training and education, establishes safer work practices and procedures, provides employee vaccination, specifies use of personal protective equipment, and addresses housekeeping and laundry safety, post-exposure evaluation, followup and documentation. The BPECP shall be submitted to the state agency (SA) for approval prior to each fiscal contract period.
C. Record and report employee bloodborne exposure incidents to TDH. Keep a sharps injury log to record date, time, and related incident information as mandated by law. Sharps injuries shall be reported to TDH within 10 working days of the end of the calendar month in which the exposure occurred.
D. Employee medical records regarding vaccination, needlestick exposures, and treatment shall be retained for the term of employment plus 30 years. (Hard copy records may be converted to electronic storage formats.) Additionally, training records shall be retained for 3 years from the date of the training.
E. Review and update the exposure control plan - at least annually, or more frequently if safer work practices or devices are available or if further workplace guidelines, rules or regulations are issued.

Although early analysis of the legislation predicted that up to 25 safety-engineered devices would be registered with the state in any given year, only three are on the current list. Two of them are manufactured by Retractable Technologies.

Texas headed the wrong way

Mitch Mitchell, Fort Worth Star Telegram, writes about the decline in health-related rankings for the state. Texans are worse off in number of uninsured, child poverty, infant mortality, and infectious disease, among other things. There was one bit of good news, according to Mitchell:

Infectious disease was another category that depressed the state's health rankings, which saw the state drop from 39th in the nation to 43rd.

But some good news about HIV and AIDS was hidden in the numbers.

"About a decade ago, every year we had about 40,000 new AIDS cases and about 20,000 deaths," said Elvin Adams, the health authority for Tarrant County Public Health. "Now, people don't die from AIDS because we've found ways to treat them. We're doing such a good job treating people that our infectious disease rates are going up."

I guess that's one way of looking at it.

Update on Amarillo case

I was looking for more information about what the final outcome might have been in the case of the alleged prostitute in Amarillo, who is HIV positive and who was being sued by the City of Amarillo under the "recalcitrant transmission" policy of the Department of State Health Services. While I still haven't found more recent news (see the link above), I did run across an editorial written by the Amarillo Globe News and published in the midst of things on September 30 (there were other developments a few days later).

The editorial begins by pointing out:

Well, Amarillo city officials appear to have gotten someone's attention with the threat of a lawsuit.

Whatever it takes.

The editorial includes a stern shaking of fingers:

The city's get-tough initiative against T.T. should send a wakeup call to those who fail to heed all the warning signals associated with high-risk behavior. It should warn the men who seek sexual gratification from women who might be infected with the virus. It should warn women who put themselves at risk by engaging in sex with men who themselves are infected. It should warn young people who believe mistakenly that they are invincible, that they cannot possibly fall victim to the tragic consequences of unsafe sex.

My only question is: Warn them about what?

The best information in this vague and threatening paragraph is the acknowledgement of "the tragic consequences of unsafe sex" on which they might have said a bit more. However, there is no "get tough" policy going on in Texas or Amarillo that works as effective prevention for broad groups of people. The lawsuit tool is available for specific individual situations where counseling has failed. When there is no counseling--or adequate funding for prevention messages to convince the broader public that HIV is an equal opportunity virus for men and women both--"get tough" just may get in the way.

Still looking for more current information . . .

Mandatory testing for Texas inmates

Representative Yvonne Davis (D-Dallas-District 111) has pre-filed HB 43, "relating to requiring the Texas Department of Criminal Justice to conduct a mandatory human immunodeficiency virus test on certain inmates and jail felons." Current law allows for this testing (using "may test"), but Davis bill requires that the institutional division of TDCJ "must test" an inmate who is eligible for release prior to release. In addition, the bill mandates that the state jail division "shall test" in the same manner and subject to the same conditions as apply to the institutional division.

Representative Norma Chavez (D-El Paso-District 76) filed a similar bill in the 77th legislative session (2001). Chavez' bill (HB 2583) required education and testing for both Hepatitis C and HIV, but restricted the requirement to inmates aged 22 or over and who had been sentenced for a term of at least two years. Chavez' bill was not related to release from incarceration. Chavez' bill was scheduled for a hearing but was pulled from the schedule at the last minute. The high fiscal note was a likely problem as well as the fact that Chavez' staff was unaware that HIV testing was not already mandatory in the prison system.

The Network is now reviewing Davis' bill and will contact her office for more background information.

Note that Chavez' bill was referred to the House Corrections Committee (not Public Health). It's a fair bet that Davis' bill will also be referred to that committee.

Texas legislature begins pre-filing bills

Shortly after elections for members of the Texas legislature, members of both houses can begin "pre"-filing bills. These are bills that legislators have been working on over the interim between sessions. They are not technically filed until the legislature comes into session in January, but pre-filing gets the bills through Legislative Council (for legal review) and acquires a bill number. This means that bills stand a better chance of getting quickly referred to committees and potentially having hearings. In other words, the early bird gets the worm.

Today was the first day for pre-filing legislation. House and Senate members filed a total of 135 bills and resolutions.

To see a list of all the bills filed on a particular day, Texas Legislature Online provides this resource. Just click on the date for which you wish to see all of the filings. To search for a particular phrase in the text of all of the bills filed, use this link.

When you see a bill number highlighted as a web link, you can click on the link to find out more about the bill. You can also click on the author's name to find out more about him or her and the other bills that he/she has filed.

World AIDS Day Memorial

This year, the international theme for World AIDS Day (December 1) is "Women, Girls, HIV and AIDS." Googling "World AIDS Day" will net a large number of web sites, some with current information. Today's mailbox, however, brought a message about an annual memorial event in which all of us can participate:

World AIDS Day is fast approaching. In Los Angeles on the Adelphia cable system we will once again present AIDS Watch. In this 24 hour program, midnight to midnight, we computer generate names of people that have died from HIV/AIDS. Every name, every person is treated equally. Rock Hudson and Freddy Mercury are on screen the same scant three and a half seconds that David Cartwright and Chris Blauman are. The names fade in and fade out. Black screen, white letters. This is very pointedly an awareness project, no funds are solicited. We hope only to touch people and remind them of this plague. In the 24 hours we have space for over 26,000 names.
26,000 memories. But yet in our best year (this will be the ninth time we have done this) only 14,000 names have been submitted. We need more memories, we need more names. In order for the names to reach the roster they must be submitted through the website. That's how the computer works, I didn't write the program. PLEASE visit the website and submit names for the memorial. AND please send this along to everyone you know that might have someone they want remembered. There is no cost involved. Just a moment of your time. Remember your friends. www.aidswatch.org

The interface is simple to use. I added three names, two of them members of my family. Doing so made me think about others who have been lost along the way--people who fought hard for AIDS funding and progressive policy, who didn't die of AIDS but gave their lives to it. I added three names to the World AIDS Day memorial, but I also thought of David and Sharon.

The Hidden Epidemic

Slate writer, Jon Cohen, provides more follow up on Gwen Ifill's question for the vice presidential candidates regarding the devastating effect of AIDS on black women in America. He recapitulates the non-answers of both candidates and then explores reasons why HIV so disproportionately affects black women in the U.S. He ends with quotes from Ifill about her own reaction to the candidates' lack of knowledge.

As Cohen lists the possible reasons for this situation, he adds a more fulsome response from Phill Wilson, executive director of the Black AIDS Institute in Los Angeles:

And there's one more factor to consider, says Wilson: Politicians ignore this population. "It's both a cause and a symptom of the problem that our government really is not interested in the health and well-being of black people and in particular black women," says Wilson. "How is it that Dick Cheney can tell you how many machine guns are in Baghdad, but doesn't have a clue about issues that are killing black women a stone's throw from his office?"

I have often opined that the AIDS epidemic casts a harsh light on the cracks that divide our society showing us, among other things, that HIV most affects those that our society is most willing to "throw away." Whether such neglect is willful or not, it remains a lasting condemnation that policy makers can continue to turn their backs on this situation.

ICAAC news

The 44th International Conference on Antomicrobial Agents and Chemotherapy concludes today in Washington, DC. AIDSmap provides an update on research reported at the conference.

The Puzzling Origins of AIDS

Red Nova, which appears to be a popular science website, presents an article by Jim Moore, an anthropologist on the faculty of the University of California at San Diego, who has done some research on the question of where/how AIDS might have originated. The article, which may first have been published in Scientific American, outlines four competing theories of the origin of AIDS:

• Tainted polio vaccine - chimpanzee or monkey tissue used to cultivate early polio vaccines in Africa may have allowed species crossover;
• Cut hunter - indigenous hunters of various primates, especially chimpanzees, may have been exposed to a virus that crossed species;
• Contaminated needles - inadequate health facilities may have spread a crossover virus in local populations;
• Heart of darkness - labor and health practices in the former Belgian Congo may have spread a debilitating virus in forced labor camps.

Moore's conclusions do not point to the greater validity of one theory over another. Rather, he looks at the "lessons" to be drawn from them:

Given the precarious status of each of the current theories, it seems more reasonable to try to keep an open mind until better evidence emerges and, in the meantime, to consider the literature on each of these origin stories as representing a highly refined simulation scenario. Insofar as there is any material benefit to come from understanding the origin of HIV in terms of cautionary tales, each model can and should be considered plausible-and worrisome. After all, unsterile needles do transmit diseases, contaminated polio vaccine did spread a simian virus (one called SV40) to millions of people, doctors do sometimes conduct risky research, colonial policies did have major health consequences, and contact with wild animals can introduce pathogens into humans.

An obvious general lesson can be drawn from all four theories: For some very puzzling reason, the origin of HFV was not fundamentally natural, given that humans apparently failed to acquire an immunodeficiency virus from simians during thousands of years of exposure. Instead, the emergence of HIV involved social change in one form or another: the abuses carried out at the hand of an invading foreign power; abrupt urbanization overwhelming the ability of medical and political authorities to manage the process; the undersupervised transfer of medical technology and half- measures in development programs; doctors taking liberties in distributing medicines without adequate precautions. It is worth noting that three of the four theories postulate an origin for AIDS that involves the inadvertent results of medical efforts, with what were then state-of-the-art health programs and technologies carrying with them unforeseen dangers.

Whether understanding the origin of HIV and AIDS is useful for evaluating risks associated with present-day concerns (say, the consumption of wildlife that might be the natural reservoir for emerging diseases like SARS, or evaluating the likelihood that the transplantation of animal organs into people will unleash a dangerous new virus) is a matter of opinion. My own view is that a firmer grasp of what happened in the past-and what might easily have happened had circumstances been slightly different-helps society to understand these dangers and to minimize the risk of sparking the next global scourge. [Emphasis added.]

The article itself is interesting reading. Its conclusions might prod us into thinking more about the ways in which social and healthcare practices in the current environment promote the spread of HIV in the U.S.

Cholesterol Pills and Grapefruit Don't Mix

. . . especially in combination with protease inhibitors, it would appear.

Catching up is hard to do

That's the new song I've started singing. Just back from a wee bit of sick leave with a bunch things to blog. Here goes:

* Innovative Health Solutions is offering a health insurance policy and life insurance for people who are HIV positive. There's no information about rates in the press release. The life insurance policy can be issued up to $10,000 in coverage.

* One Earth Foundation has announced that:

their national HIV/AIDS prevention initiatives will include the launch of Living for a Cure® Wristbands. The red Living for a Cure® Wristband symbolizes awareness among humankind in promoting a consciousness about the devastating AIDS disease. The foundation’s mission is to reduce the number of individuals infected daily by raising the nation’s level of awareness of the HIV/AIDS epidemic.

The wristbands will sell for $2.00. Proceeds will be used for HIV/AIDS prevention and research programs.

The Austin American Statesman provides another take on wristbands as a marketing tool.

* The Houston Chronicle added Disease Intervention Specialist to the list of "worst jobs" in the Houston area. While the article may have been a tongue-in-cheek attempt to localize the recent Popular Science "Ten Worst Jobs" list, but it makes the worthy point that:

The annual list is an important reminder that improving public health or adding to scientific understanding is not always easy or glamorous.

An interview with a Houston DIS provides some background on the necessary but neither easy nor glamorous work performed on behalf of public health.

* The National Latino AIDS Awareness Day (October 15) marked the beginning of a national push to increase awareness and boost HIV prevention in the Latino community. The U.S. Department of Health and Human Services has been sponsoring health fairs with a tie-in to NLAAD. A fair was held in McAllen on October 24. Fairs will also be held in Dallas (November 14) and Houston (November 21).

More catching up when I catch up!

Comic book tackles HIV

Mia, a teenage runaway featured in the Green Arrow comic book series, discovers that she has HIV. She wants to become a crime-fighter, too, so Green Arrow allows her to become his new sidekick, with the new name, Speedy.

One-on-One counseling stems spread of AIDS

This article is a week or so old, but I have had some technical difficulties in getting a working link. It comes from HealthDayNews regarding an HIV prevention study for young HIV-positive drug users. While this particular version of the report was published in the Atlanta Journal Constitution on October 8, several other news outlets carried this and other HealthDayNews stories. Links to those articles were difficult to include here, for some reason I don't quite understand.

One other problem is that the article is based on a study that was published in "the Journal of Acquired Immune Disorders." When I find a news story like this, I like to link to the original study, if possible. In this case, I spent quite a bit of time looking for the journal cited in the article to no avail. Either the name of the journal is misidentified, or the journal is not available on the web, or my search skills need some improvement.

To make matters worse, I couldn't find any other news stories about this research that weren't a repetition of the HealthDayNews article.

All of that being said, the article does report some interesting research:

Convincing HIV-positive young adults to avoid infecting others is one of the biggest challenges in the fight against AIDS.

But in a new study, American researchers contend the solution may lie in one-on-one counseling that encourages people to make better decisions by understanding their own personal values.

The rates of one kind of unprotected sex dropped by more than 30 percent among HIV-positive drug users who underwent an intensive counseling program. "You shore up a person's ability to control their life and change their behavior," said Lee Klosinski, director of programs at AIDS Project Los Angeles, which hopes to replicate the study's findings. The counseling "equips them to make healthy choices in their life."

An estimated 110,000 Americans under the age of 23 are infected with the AIDS virus. Studies suggest that many of them aren't aware they're sick; those who know they're infected don't always take the expensive drugs that have revolutionized the treatment of AIDS over the past eight years.

Researchers offered a choice of three infection-prevention programs to 175 HIV-positive young people in Los Angeles, San Francisco, and New York City. The subjects, aged 16 to 29, were regular users of methamphetamine or intravenous drugs; more than two-thirds were gay men.

The participants, for the most part, had been very sexually active before the study: They reported a median of 50 sexual partners over their lifetime, and 21 said they'd had sex with 1,000 or more people. The risk is that they will continue to have unprotected sex and infect others.

Some of the subjects had as many as 18 sessions with a counselor over the phone. Another group attended one-on-one sessions, while a third group was assigned to get counseling at a later date. All participants received $20 to $25 for attending each of four meetings with counselors to measure their progress.

The goal of the counseling was to bring out an inner sense of responsibility in the participants, said study co-author Mary Jane Rotheram, director of the Center for Community Health at the University of California at Los Angeles. "Most people want to be good people," she said. "Our program helps people remember what's joyful and happy in their lives, and helps them figure out how to maintain that on a daily basis."
The findings appear in the October issue of the Journal of Acquired Immune Disorders.

The study suggested the one-on-one counseling convinced more than a third of participants to cut down on unprotected sex with partners whose HIV status -- positive or negative -- was unknown. "They had the same amount of sex, but it was either protected or they went to HIV-positive people," Rotheram said.

The telephone counseling wasn't as successful.

The findings are encouraging because they show that the federal emphasis on counseling is a good idea, said Steve Morin, director of the AIDS Policy Research Center at the University of California at San Francisco. "What this study illustrates is that it works."

Previous research has suggested that the counseling approach works in groups. But counseling several young people at once isn't feasible in many parts of the country, such as rural areas, Rotheram said. "This showed that you could also work with kids individually."

The next step is to expand the counseling program, Rotheram said. "We're being funded by the CDC [U.S. Centers for Disease Control and Prevention] to train providers so we can make this a routine part of medical care."

It almost makes you wish that news stories had footnotes, doesn't it. ;)