PATIENT COUNSELING Ne\N AIDS Effort Targets Business
information; benefits programs for HIV-infected employees and their families; and workplace discrimination. • Training for managers, supervisors, and union leaders to be sure they lmderstand the workplace policy and the way it will be implemented. • Educating employees and their families about ways to prevent HIV infection. Possible educational activities include seminars and speakers; distribution of payroll inserts and brochures; displaying informational posters; and presenting HIV/ AIDS prevention videos at company meetings or training programs. • Supporting commlmity involvement and volunteer efforts to respond to AIDS. Efforts may include offering local AIDS prevention groups access to equipment and facilities; sponsoring community activities; partici-
In December the Centers for Disease Control and Prevention (CDC) launched a workplace education program called "Business Responds to AIDS." The program, developed in consultation with experts from business, labor, health, government, and AIDS service organizations, offers resources to help workplaces meet the challenges of HIV infection on the job and in the community. "Business Responds to AIDS" recommends that businesses develop comprehensive programs that include these elements: • A written workplace policy that addresses state and federal laws; policies for hiring, promoting, transferring, and dismissing employees with HIV infection; confidentiality of employee records and medical
Yeast Infections May Be Sign of HI V In November, the U.S. Public Health Service released an
advisory to women noting that frequent or stubborn vaginal yeast infections may be an early sign of HIV infection. New labeling for products to treat vaginal candidiasis states: "In women with frequently recurrent vaginal yeast infections, especially infections that do not clear up easily with proper treatment, the vaginal yeast infections may also be the result of serious medical conditions, including infection with HIV, that can damage the body's normal defenses against infection."
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pating in educational programs at schools; and donating time or money. "Business Responds to AIDS" provides a centralized resource service at the CDC National AIDS Clearinghouse, which businesses can call for information and materials. The toll-free number is (800) 458-5231.
Messages About AIDS Reach Some, Not All Two recent reports suggest that messages about preventing AIDS are not reaching all groups that need to hear them. A nationwide telephone survey of more than 10,000 heterosexuals ages 18 to 75 found that 15-31% of respondents were at some risk for becoming infected with HIV in the past one to five years (Science. 1992: 258;1101-5). However, only 17% of heterosexuals with multiple sex partners reported using condoms all the time. Among those with "risky" sex partners-nonmonogamous, HIV-positive, abusers of intravenous drugs within the previous five years, transfusion recipients, or hemophiliacs-only 12.6% use condoms all the time, and only 10.8% of untested transfusion recipients use condoms all the time. Respondents reporting sex with multiple partners were most likely to be white or African American young AMERICAN PHARMACY
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male adults rather than Hispanic, unmarried, or highly educated. Women and lowincome individuals were most likely to report having risky sex partners. The researchers noted that public health messages about AIDS prevention seem to be reaching heterosexuals with multiple sex partners "to some extent," especially young adults, but are failing to reach middle-aged and elderly adults and people who have received blood transfusions. Another study, conducted by researchers at the Medical College of Wisconsin, Milwaukee, found that nearly one-third of some 1,800 gay men studied in 16 small cities engaged in unprotected anal intercourse an average of eight times in the past two months, usually outside of monogamous relationships. Although 90% of men who had protected anal intercourse described their HIV risk over the past two months as none or slight, 77% of men who did have unprotected anal intercourse incorrectly described their risk as none or slight. The fmdings show that education and prevention efforts are now "urgently needed for reaching gay men in smaller cities, who have been neglected ... relative to their urban counterparts," the researchers stated. On a brighter note, the AMERICAN PHARMACY
percentage of students who received high school instruction about HIV increased from 54% in 1989 to 83% in 1991, according to the Centers for Disease Control and Prevention. During the same time period, the percentage of students who discussed AIDS or HIV infection with parents or other adults in their families increased from 54% to 61 %. From 1989 to 1991 , declines occurred in the percentages of students who reported ever having had sexual intercourse (59% to 54%), having two or more sex partners during their lifetime (40% to 35%) and having four or more sex partners during their lifetime (24% to 19%). These fmdings are particularly positive in light of the trend of increasing sexual activity by many adolescents over the past 20 years. The percentage of students who reported using condoms went up only slightly between 1990 and 1991-from 46% to 48%but a significant increase was reported by students younger than age 15-from 46% to 57%.
from the Center for Tobacco Research and Intervention, University of Wisconsin Medical School (lAMA. 1992;268:2687 -94). The researchers reviewed all placebo-controlled, double-blind nicotine patch studies with at least six months of follow-up that have been published in English. They found that nicotine patches produced six-month abstinence rates of 22-42%, as compared with 5-28% for placebo. In one study that paired patch therapy with intensive group behavior therapy, the abstinence rate was 35% a year later. Nicotine patches appear to be more effective than nicotine gum, the researchers said. Reasons for this may be that the gum is often prescribed without clear instnlctions to stop smoking and without concomitant counseling. Also, patients have difficulty using the gum properly, which reduces compliance.
National Chronic Fatigue Syndrome Awareness Month. National Chronic Fatigue Syndrome Association, 3521 Broadway, Suite 222, Kansas City, MO 64111. (816) 931-4777. National Eye Donor Month. Eye Bank Association of America, Inc., 1001 Connecticut Ave., NW, Suite 601, Washington, DC 20036. (202) 775-4999. National Kidney Month. National Kidney Foundation, 30 East 33rd St. , New York, NY 10016. (800) 622-9010 or (212) 889-2210. 7-13, Save Your Vision Week. American Optometric ASSOciation, Communications Center, 243 N. Lindbergh Blvd., St. Louis, MO 63141. (314) 991-4100. 21-27, National Poison Prevention Week. Poison Prevention Week Council, P.O. Box 1543, Washington, DC 20013; (301) 504-0580. 23, American Diabetes Alert. American Diabetes ASSOciation, 1660 Duke St. , Alexandria, VA 22314. (800) 232-3472 or (703) 549-1500.
Health Dates Nicotine Patches Effective with Counseling Although nicotine patches can be effective aids in smoking cessation, proper counseling seems to be critical to the long-term success of patients who use them, according to a recent study
American Heart Month. American Heart Association, 7320 Greenville Ave., Dallas, TX 75231 . (800) AHA-USAI. 14-21, National Condom Week. Men's Support Center, P.O. Box 30564, Oakland, CA 94604. (510) 891-0455.
Fe bruary 1993
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