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Biotech / Medical : Procept (PRCT): 50% rise on high volume. Why? -- Ignore unavailable to you. Want to Upgrade?

To: Douglas who wrote (280)	11/4/1997 12:41:00 PM
From: Douglas	Read Replies (1) \| Respond to of 455

HIV Prevention is getting more emphasis: AIDS Study Emphasizes Prevention Worldwide Researchers Estimate Effects of Past Programs, Benefits of Future Ones in Developing Nations By David Brown Washington Post Staff Writer Tuesday, November 4, 1997; Page A13 The Washington Post About 2.3 billion people, roughly half the population of the developing world, live in places where the AIDS epidemic has barely begun and even mildly successful prevention programs could have enormous benefits, according to a new study. The 353-page World Bank study, released yesterday in Washington after 18 months of preparation, attempts to describe the effects AIDS already has had on the developing world, and to predict what might happen under various future scenarios. It also evaluates numerous countries' responses to the epidemic and makes general policy recommendations. One of the clearest lessons the authors of the report draw is that AIDS prevention campaigns can have large benefits at any stage of a country's epidemic -- provided the campaigns are targeted at the right people. Early interventions also are far more potent than late ones. For example, statisticians and epidemiologists on the World Bank's research team looked at what might happen to a country where, three years after the arrival of the virus, 5 percent of the adult population is infected. If condoms are used 5 percent of the time by men, with commercial and casual sex partners, prevalence of human immunodeficiency virus (HIV) infection would top out at 30 percent 30 years into the epidemic. However, if an AIDS prevention campaign commenced after 15 years and successfully increased condom use among the high-risk men to 20 percent of their sexual encounters, the peak prevalence would be lowered to 22 percent of the population. Such a program started three years into an epidemic would lower HIV prevalence further, to 20 percent, and by 30 years would have prevented more than twice as many infections -- and three times as many deaths -- as the latest intervention. In places where heterosexual transmission of HIV is common, high-risk individuals such as truckers or military personnel often are the bridges that carry infection into low-risk groups, where prevention strategies are harder to implement and less cost-effective. Furthermore, HIV is more easily passed when a person's infection is relatively recent. That makes the early years of a country's epidemic -- when most infections are new -- the biologically "hottest" phase. Such strategies are most needed now in China, India, Bangladesh, Indonesia, Russia and the former Soviet republics, according to the report. The AIDS epidemic is nascent in all of China except Yunnan Province, on the border with Burma, where male drug users account for nearly 80 percent of all of China's cases of infection. Central and eastern India also are relatively untouched, but the disease is spreading rapidly from the southern and western parts of that country. In the city of Nikolayev, Ukraine, one-half of intravenous drug users recently became infected over the course of 13 months. A tenfold increase in the number of syphilis cases in that country between 1991 and 1995 is laying the groundwork for possible heterosexual transmission of HIV, which is much more likely when a person has concurrent venereal infections. When it comes to the epidemic's demographic and economic effect, the World Bank researchers found that things often are not straightforward and intuitive. For example, the predictions that AIDS would decimate families in sub-Saharan Africa generally have not been borne out. A survey done in Kagera, Tanzania, specifically for this report found there was no change in household size in the two years after a member died of AIDS. That is because, in nearly all cases, new adults arrive to help the bereaved family cope. Similarly, the loss of a parent did not have a profound effect on either a child's nutrition or likelihood of going to school, in part because the level of each was low even in intact families. AIDS' effect on the economies of many African nations has been even less noticeable, in large part because there is a surplus of labor in most of Africa, and forces more powerful than the epidemic are driving economic development. At the same time, the epidemic's human toll cannot readily be seen in measures of gross domestic product, the report says. In just one dramatic measure of how the disease has touched people, life expectancy in Ivory Coast, Zimbabwe and Burkina Faso is now 10 years shorter than what it would have been if the disease had never appeared. "AIDS is reversing decades of progress in improving the quality of life in developing countries," said Martha Ainsworth, an economist and one of the two principal authors of the report. A summary of the report can be obtained through the World Bank's Internet site at www.worldbank.org/html/extpb/confaids/htm.