Controversy over CDC’s 2006 HIV/AIDS Surveillance Report
CHAMP declares CDC’s HIV “Heightened National Response” for African Americans chaotic and underfunded
FDA to review the safety of abacavir and didanosine
Public health workers respond to CDC study regarding teenagers and STIs
Controversy over CDC’s 2006 HIV/AIDS Surveillance Report
The U.S. Centers for Disease Control and Prevention (CDC) released its annual HIV/AIDS Surveillance Report in late March, to much trepidation from the HIV/AIDS community.
The data shows an increase in the number of HIV/AIDS diagnoses occurring in the U.S. from 2005 to 2006 (by nearly 33%). However, this year’s figures include data from states such as California, Illinois, and Wisconsin, which were previously not included in the annual report because they had not yet made the transition to confidential name-based HIV reporting.
Up until 2005, there were only 38 states and 5 dependent territories using such a system. As of 2006, however, 45 states plus the dependent territories were reporting in this manner. For this reason, it is not possible to tell from this data whether or not there is any change in new HIV cases overall.
It is clear, however, that the number of new HIV diagnoses in the 38 states and 5 dependent territories that have been using this system for some time show a 2% decrease in new diagnoses from 2005 to 2006. Their reported cases of AIDS, however, have increased slightly from 35,634 in 2005 to 36,817 in 2006.
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CHAMP declares CDC’s HIV “Heightened National Response” for African Americans chaotic and underfunded
The Community HIV/AIDS Mobilization Project (CHAMP) released a statement following the release of the CDC’s 2006 HIV/AIDS Surveillance Report which details the progress, or lack thereof, of the Center’s Heightened National Response effort that was “launched with much fanfare in March 2007.”
According to CHAMP, the effort has been “marked by shifting leadership, lack of communication with local leaders and community organizations, and no new funding for any initiatives besides those restricted to HIV testing.”
The initiative is currently being headed up by Madeline Sutton, MD, MPH, CDC’s Acting Director of Partnerships in the Department of HIV/AIDS Prevention. Sutton is the latest in a series of individuals responsible for the Response, and it is believed that she will once again restructure the initiative in an effort to bring about results.
“The CDC released this report last March, and the only change we’ve seen is more HIV for African Americans, not less,” says Kenyon Farrow, Director of Communications at CHAMP. “This seems like another grand vision outlined in a glossy document that is, in fact, ill-equipped to make any real dent in new infections. We need real leadership, real funding, and a comprehensive strategy at the federal level if we’re going to do more than give lip service to HIV prevention in our country.”
“The U.S. requires countries applying for our global AIDS funding to have a national AIDS strategy, yet we don’t even have one of our own,” said Waheedah Shabazz-El of CHAMP. “Perhaps the CDC should be upfront about its own challenges to help Congress and the president recognize the need for a comprehensive national AIDS strategy, rather than rallying hardworking Black community leaders around grandiose plans almost guaranteed to fall short due to lack of resources and coordination.”
A representative from the CDC contends that the Heightened National Response remains a central priority for the agency, and argues that there is “lots of activity” in support of it. Aside from spending more than half of its $300 million HIV prevention budget in response to the HIV/AIDS crises among African Americans, the CDC has developed Partner Commitments with more than 100 African American leaders in response to the epidemic, faith-based forums that bring together African American faith leaders, new prevention interventions, and $35 million in new funds to expand HIV testing.
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FDA to review the safety of abacavir and didanosine
The Food and Drug Administration (FDA) recently announced that it will review the safety of two anti-HIV drugs, GSK’s Ziagen (abacavir) and BMS’s Videx (didanosine).
Recent data from a cohort study with more than 33,000 HIV-positive people found that these drugs were linked to an increased risk of heart attack among participants.
GSK and BMS evaluations of these drugs did not find an increased risk of heart attack, however, the FDA points out that people taking either drug “had a greater chance of developing a heart attack than patients taking other medications.” The risk did not increase over time and, according to the agency, seemed to diminish after people stopped taking the drugs.
Because researchers have not evaluated the risk of heart attacks associated with similar drugs (Gilead’s Viread and Emtriva, specifically), the FDA recommends that health care providers “evaluate the potential risks and benefits” of all the anti-HIV drugs that their patients are taking.
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Public health workers respond to CDC study regarding teenagers and STIs
In an op-ed piece published in the Washington Post, public health workers Robert E. Fullilove (Associate Dean at Columbia University’s Mailman School of Public Health), Adaora Adimora (Associate Professor of Medicine at University of North Carolina-Chapel Hill), and Peter Leone (North Carolina Division of Public Health) responded to a recent study from the CDC that estimates high rates of infection with sexually transmitted diseases (STDs) among teenage girls in the U.S.
The study found that 25% of young women between the ages of 14 and 19 have at least one of the four common STDs, and that number was twice as high among the African American girls and young women.
Fullilove and his colleagues refer to these data as “old news,” and express concern that “this study will have its 15 minutes in the spotlight” and “fade from view” as other studies indicating rising rates of STDs among this population have.
“Our national silence [regarding rising rates of STDs] may be related to our difficulty discussing the roles that race and poverty play in these trends,” the authors suggest. “These diseases cost tens of billions of dollars each year, but with the exception of HIV infection, STDs remain the elephant in the room when it comes to the national conversation about health and health care.”
The reasons for this, they contend, are obvious. “Conversations about sexual behavior, race, and sexually transmitted [diseases] remain taboo.” They also suggest that “the incidence of many STDs, particularly HIV, is concentrated in poor, segregated neighborhoods that are characterized by high rates of incarceration, which causes a shift in the patterns of marriage and courtship that result when so many men are removed from a community.”
“We can no longer have effective STD prevention campaigns in poor communities of color if they treat one person at a time or ignore the social condition underpinning high rates of HIV and other STDs. Where you live and choose sexual partners has an enormous impact on your risk, particularly if it is in a community with high incarceration rates.” They add that “if we are unable to engage in a national dialogue about the sexual health of our youths and the social dynamics that drive [STDs], this epidemic will go largely ignored, and many more lives will be lost.”
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