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HEADLINES

NATIONAL NEWS
UNITED STATES: "The HPV Debate: Majority of Pediatricians Recommend Vaccine, but Opponents Fear Its Use Could Lead to Promiscuity" CALIFORNIA: "Porn HIV Case Renews Concerns"

INTERNATIONAL NEWS
SOUTH AFRICA: "South Africa Leads Hunt for Killer TB Vaccine"

MEDICAL NEWS
UNITED STATES: "Determinants of Recent HIV Infection Among Seattle-Area Men Who Have Sex with Men" UNITED STATES: "AIDS Virus Raises Heart Disease Risk in HIV-Infected People"

LOCAL AND COMMUNITY NEWS
HAWAII: "HIV Case: Medical Privacy Violator Gets One Year"

NEWS BRIEFS
GLOBAL: "US Pledges to Put Women, Girls First in AIDS Fight" ZAMBIA: "Zambia Calls for Accelerated Efforts in HIV/AIDS Fight" MISSOURI: "Missouri University Health Care Worker Identified with Active Case of Tuberculosis"

NATIONAL NEWS

UNITED STATES:
"The HPV Debate: Majority of Pediatricians Recommend Vaccine, but Opponents Fear Its Use Could Lead to Promiscuity" Daily Gazette (Schenectady, N.Y.) (06.06.09)::Joanne E. McFadden

A 2006 American Academy of Pediatrics survey found 81 percent of pediatricians were likely to offer the vaccine against human papillomavirus (HPV) to their female patients. As of June 2008, Merck & Co. had distributed 18 million doses of its vaccine Gardasil in the United States. Yet while the health care community advocates for the vaccine, which protects against HPV strains linked to 70 percent of cervical cancer and 90 percent of genital wart cases, many parents are still not on board. Merck reported in August that about 60 percent of 11- to 12-year-old girls had yet to receive the vaccine. Gardasil is recommended for girls as young as nine, before possible exposure to HPV. According to CDC, more than 50 percent of sexually active men and women are infected with the STD at some point in their lives. And because most HPV cases are symptom-free, people often do not know they have been infected. In addition, HPV can be transmitted not only through sexual intercourse but also by skin-to-skin contact and oral sex. Pediatricians say some parents cringe at the thought of their child becoming sexually active. "A lot of parents of 11-year-old girls don't want to think about sexual activity and want to put it off a little longer," said Dr. Kevin Karpowicz of the Ellis Pediatric Health Center in Schenectady.

"[Vaccination] doesn't necessarily mean this is a passport for going and having sex," said Swatantra Mitta, a physician with Clifton Park Pediatrics in New York. Mitta said she counsels parents and patients on this point, noting that Gardasil does not protect against other STDs, including HIV, or pregnancy.

CALIFORNIA:
"Porn HIV Case Renews Concerns"
Los Angeles Times (06.11.09)::Rong-Gong Lin, II; Kimi Yoshino

State and local health officials said Wednesday they are launching investigations into a newly confirmed HIV case in an actress working in Southern California's pornography industry. According to the Adult Industry Medical Healthcare Foundation (AIMHF), the San Fernando clinic that serves adult-film stars and confirmed the positive test, the woman's partners have tested HIV-negative. Those partners are not being allowed to perform at this time and are being encouraged to get re-tested in 14 days, said Brooke Hunter, the clinic's administrator. However, public health officials said an official report has not been made at the state or county level. The new case, the first publicly confirmed case since an HIV outbreak shut down pornography production in 2004 for four weeks, is likely to reignite debate over whether the industry lacks sufficient safety measures to prevent transmission of HIV and other STDs. Dr. Jonathan Fielding, health officer for Los Angeles County, said he is concerned that condoms are not being broadly used. "You wouldn't send someone to work on a high-rise building without a hard-hat, so why are we allowing these performers to perform without condoms?" he asked. Deborah Gold, a senior safety engineer with the state Occupational Safety and Health Division, said numerous investigations of the industry have found that condoms are not used and that no training has been conducted to prevent unsafe contact. According to Fielding, the county receives AIMHF reports of 60 to 80 new cases of chlamydia and gonorrhea per month among adult performers. The clinic's protocol calls for performers to get tested for HIV every 30 days. Fielding, however, said this is inadequate since it takes nine to 11 days after exposure for the virus to be indicated by test results.

INTERNATIONAL NEWS

SOUTH AFRICA:
"South Africa Leads Hunt for Killer TB Vaccine" Reuters (06.05.09)::Wendell Roelf

Researchers in South Africa next month will begin trials evaluating a vaccine for TB, a disease estimated to affect one in three people globally. "The world needs a new TB vaccine because the current one is not really effective in terms of preventing TB and that is manifest in the context of an increasing epidemic," said Gregory Hussey, director of the South African TB Vaccine Initiative. The most promising vaccine of nine candidates, MVA85A, will be tested among 2,874 children under the age of one. The goal is to register a new TB vaccine by 2015. "All of the clinical trials conducted to date with this vaccine have shown that it is safe and it stimulated high levels of the type of immune response we believe is protective against tuberculosis," said vaccine inventor Dr. Helen McShane of the University of Oxford. The current vaccine, Bacille Calmette-Guerin (BCG), was developed in the 1920s. The new vaccine, if found to be successful, will be used as a booster to the BCG shot. TB primarily is a lung disease but also can affect organs and bones. According to the Global Tuberculosis Institute at the New Jersey Medical School, it kills about 1.8 million people annually, with children and young adults the most vulnerable. The TB infection rate in South Africa is the highest in the world: 948 infections for every 100,000 people. Persons with HIV infection are particularly at risk, and the World Health Organization says TB is the leading cause of death among HIV-positive persons. Addressing TB has become a priority of several global health initiatives, including the World Bank and the Bill and Melinda Gates Foundation.

MEDICAL NEWS

UNITED STATES:
"Determinants of Recent HIV Infection Among Seattle-Area Men Who Have Sex with Men" American Journal of Public Health Vol. 99; No. S1: P. S157-S164 (04..09)::Hanne Thiede, DVM, MPH; Richard A. Jenkins, PhD; James W. Carey, PhD, MPH; Rebecca Hutcheson, MSW; Katherine K. Thomas, MS; Ronald D. Stall, PhD; Edward White, PhD, MPH; Iris Allen, MPH; Roberto Mejia, PhD; Matthew R. Golden, MD, MPH

The study authors sought to identify HIV infection risk factors related to partner selection and sexual behaviors with those partners among men who have sex with men (MSM) in King County, Wash. Participants were recruited from Seattle-area HIV testing sites. Recent HIV infection was assessed by the Serologic Testing Algorithm for Recent HIV Seroconversion (STARHS) or a self-reporting previous HIV-negative test. Computer-based self-interviews collected data on behaviors with three male partners. Generalized estimating equation models identified partnership factors associated with recent infection. Data from 32 HIV-positive MSM (58 partners) and 110 HIV-negative MSM (213 partners) were analyzed. Multivariate analysis showed recent infection was associated with meeting partners at bathhouses or sex clubs, bars or dance clubs, or online; use of methamphetamine during unprotected anal sex; and unprotected anal intercourse, except with HIV-negative primary partners. The authors concluded that improved efforts to promote condom use with casual partners - regardless of their partner's HIV status - are needed, as are new strategies to control methamphetamine use in MSM and to reduce risk behaviors related to meeting partners at high-risk venues.

UNITED STATES:
"AIDS Virus Raises Heart Disease Risk in HIV-Infected People" Bloomberg News (06.03.09)::Marilyn Chase

HIV infection poses a risk of cardiovascular disease similar to that of smoking, researchers recently reported. The thickening of the carotid artery associated with the increased risk is not caused by HIV medications, said the team headed by Carl Grunfeld, professor of medicine at the University of California-San Francisco and an endocrinologist at the San Francisco VA Medical Center. "The effect is so big that no drug or class of drugs stands out as being an effective contributor," Grunfeld said in a statement. The results have implications for the use of cholesterol-lowering drugs. For someone who has an intermediate risk of heart attack, a 10 to 20 percent chance of a heart attack with 10 years, the need for the drugs is a gray area. But an HIV-positive diagnosis moves a person who otherwise has an intermediate risk into the high-risk category, Grunfeld said, and treatment is indicated. "I am recommending that patients with HIV in the middle category be treated as if they were at high risk," Grunfeld said. It is not clear how HIV may contribute to atherosclerosis. Inflammation caused by HIV infection may be a factor, Grunfeld said. The research was funded by the National Institutes of Health and the National Heart, Lung and Blood Institute. The study, "Preclinical Atherosclerosis Due to HIV Infection: Carotid Intima-medial Thickness Measurements from the FRAM Study," was published in AIDS (2009; doi: 10.1097/QAD.obo13e32832d3b85.

LOCAL AND COMMUNITY NEWS

HAWAII:
"HIV Case: Medical Privacy Violator Gets One Year" Honolulu Advertiser (06.10.09)::Jim Dooley

On Tuesday, Circuit Judge Randal Lee sentenced a woman to one year in prison for posting online the medical records of a person with HIV/AIDS. Rhonda Wong-Fernandez, 22, was also given five years of probation and 200 hours of community service. In passing sentence, Lee said Wong-Fernandez accessed the records while working at Straub Clinic and Hospital and passed them on to the victim's sister-in-law. Wong-Fernandez pleaded no contest to a felony charge of unauthorized computer access to confidential records. Court testimony showed Straub officials began an investigation after the victim notified them that her records had been improperly accessed. The woman died earlier this year. Michael Green, an attorney who represents the victim's estate, said the postings, which were uploaded to a MySpace page several times from late 2007 to early 2008, were "vile, hurtful, and disgusting." Lee declined a request by Wong-Fernandez's attorney, Deputy Public Defender Alan Komogome, that the sentence be delayed for one year to give the defendant time to arrange care for her three children, including a nursing infant. The prosecutor had recommended a 30-day sentence plus probation. The judge called the act "egregious," saying Wong-Fernandez's sentence should serve as a deterrent to others "that this kind of conduct will not be tolerated." "Young people in this society have to realize that the Internet is not something that can be taken advantage of," he said. "You can't use the Internet to do unlawful conduct." Clair Tong, a spokesperson for the facility, said, "We take patient confidentiality very seriously. Rhonda Wong-Fernandez is a former employee who was dismissed when we confirmed what she had done." Green said he plans to file a civil suit against Wong-Fernandez, Straub, and others defendants.

NEWS BRIEFS

GLOBAL:
"US Pledges to Put Women, Girls First in AIDS Fight" Associated Press (06.10.09)

The Obama administration will put women and girls first in the fight against HIV/AIDS, Secretary of State Hillary Rodham Clinton said Wednesday in a video address to an international AIDS conference in Namibia. The US government will prioritize the prevention of mother-to-child HIV transmission, she said, and it will work to protect girls from being coerced into prostitution or early marriage.

ZAMBIA:
"Zambia Calls for Accelerated Efforts in HIV/AIDS Fight" Xinhua News Agency (06.06.09)

Despite an increase in the number of people presenting for HIV testing and counseling, Zambia must work harder to fight AIDS, the minister of health said Friday at a meeting of senior cabinet officials. Kapembwa Simbao said condom use remains low, at 40 percent, as does the level of knowledge about HIV among youths. Referencing the Millennium Development Goals, Simbao called for a renewed commitment to providing universal access to HIV/AIDS prevention, treatment, care and support, and to halting and reversing the spread of the epidemic by 2015.

MISSOURI:
"Missouri University Health Care Worker Identified with Active Case of Tuberculosis" Columbia Missourian (06.08.09)::Emily David

A health care worker at Missouri University Health Care diagnosed with active TB has been removed from clinical duty and is undergoing treatment, Les Hall, MUHC's chief medical officer, told a news conference Monday. MUHC comprises nine sites; officials declined to identify the one where the man worked. The hospital is notifying persons who may have been exposed to the worker; so far, fewer than 20 have been contacted. All MUHC workers undergo regular TB tests; the patient's most recent test, in fall 2008, was negative. He had recently sought treatment for a cough he believed was related to allergies. "Although the risk to most in this case is low, patients with significant risk will be contacted to arrange for appropriate testing," Hall said. "By taking this proactive approach, we are confident that we can identify and manage the risks to patients and staff who may have come in contact with this worker."

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