Rare and Aggressive H.I.V.

Reported in New York

1. Why is this strain of H.I.V. so alarming to health officials?
It was the first time a strain of H.I.V. had been found that both showed resistance
to multiple drugs and led to AIDS so quickly
2. How is crystal meth linked to an increased spread of H.I.V.?
the drug's stimulating effect and erasure of inhibitions contributes to sex
marathons that have
increased the spread of H.I.V.
3. How many partners has this specific man had?
The man, whose name was not released to protect his privacy, is believed to have
had unprotected sex with hundreds of partners
4. Dr. Frieden believes this is a wake up call to who?
to men who have sex with men, particularly those who may use crystal
methamphetamine
5. The viral strain in the unnamed patient was resistant to how many of the four
classes of drugs used to treat H.I.V. from the start of treatment?
The viral strain in the unnamed patient was resistant to three of the four classes of
drugs used to treat H.I.V. from the start of treatment.
6. When does drug resistance typically occur and why?
Drug resistance usually occurs after a patient is treated with retroviral drugs, often
because the patient veers from the prescribed course
7. The limited epidemiological investigation in this case shows that the patient
could have developed AIDS in what amount of time? On average, it takes how
long from the time a person is first infected with H.I.V. for AIDS to develop?
Shows that the patient could have developed AIDS in as little as 2 months, but that
it might have taken as long as 10. On average, it takes 10 years from the time a
person is first infected with H.I.V. for AIDS to develop
8. Why do health officials believe NY city residents are growing lax in their
attitudes about sex practices?
Because in the past four years, the number of new syphilis cases in the city has
slowly increased, with gay men accounting for most of them. Only 45 percent of
gay men surveyed by the Health Department in 2003 said they used a condom
during sex.

A Public Health Quandary: When Should the Public Be Told?

1. What is the quandary that public health officials face when warning the public
about a potential health threat?
how much information is enough to warn the public about a potential health
threat?
2. Why have some AIDS experts criticized Dr. Friedens decision to publicize one
case before all the tests have been completed?
Some AIDS experts have criticized Dr. Frieden's decision to publicize one case
before all the tests have been completed as too hasty, alarmist and unscientific.
3. Dr. Frieden pointed out that he was announcing what?
a public health phenomenon that required intervention, not a scientific discovery
4. It may turn out the man is the only case and represents a coincidence of what
two rare events?
drug resistance, and rapid progression occurring together.
5. Why hasnt AIDS and H.I.V. been treated as if it were an epidemic?
because of the population and the political context in which it arose.
6. Why is so important for more infected people to be detected in the early stages
of H.I.V. infection?
is at that time when the risk of transmission of the virus is extremely great
because there are large amounts of H.I.V. in the blood. Also, Dr. Frieden said, most
people change their risk behavior upon learning that they are infected.
7. What is the process of contact tracing?
Its the process of interviewing the persons sexual contacts and so on, so that they
could stop further transmission
8. Why do the epidemiologists in this case face a harder problem than the
laboratory scientists?
They face a harder problem because the man does not know all of his sex
partners information.
Alarm Over Single AIDS Case Is Challenged by Questioners
1. What were the complaints of the some of the scientists concerning the
announcement made by New York City's health commissioner, Thomas R.
Frieden, on Feb. 11?

scientists said not enough research had been done to warrant a public health
announcement, and accused Dr. Frieden of excessive haste.
2. What was the concern of gay activists?
Gay activists worried that Dr. Frieden's use of the announcement to emphasize
safe-sex practices would set up gay men as culprits, reviving a concern as old
as the disease
3. What else has resurfaced among top AIDS researchers?
Longstanding rivalries among top AIDS researchers resurfaced
4. Why is competition so intense among scientists and their institutions to
communicate new findings and get credit?
It is important so they could get more money and further expand their research
5. What is the basic role difference between scientists and public health officials?
Scientists have to take emergency measure to try and stop the disease from
spreading.
6. The Community H.I.V./AIDS Mobilization Project, based in New York,
said the link between the spread of the possible new strain and the use of crystal
methamphetamine was unproven, and suggested that the city had ignored the
''underlying issues'' of what?
The issues are, discrimination, poor housing, and unemployment
7. Do you think Dr. Frieden did the correct thing in making his announcement?
Why?
Yes I think he did right. it might have brought up some needless alarms, but it also
opened up peoples eyes and brought out similar cases.
How to Get Those at Risk To Avoid Risky Sex?
1. If nothing else, the AIDS case that alarmed health officials in New York last
week illustrates what?
illustrates the enormous difficulty of promoting and sustaining changes in
sexual behavior
2. Over the last decade, AIDS activists and health officials have mounted public
awareness campaigns, distributed pamphlets at medical clinics and conducted
large-scale studies aimed at increasing what and reducing what?

activists and health officials have mounted public awareness campaigns,

distributed pamphlets at medical clinics and conducted large-scale studies aimed at
increasing condom use and reducing anonymous sexual encounters.
3. Almost every effort has fallen short in high risk groups, experts say: a result of
what? a result of social and political factors, the increasing prominence of Internet
liaisons and drug use and dynamics of disease transmission that
researchers have only begun to understand
4. Some researchers and AIDS advocates also cite as obstacles what?
Less federal financing to stress abstinence for prevention effort over other
methods of reducing sexual risk.
5. What were the results of the Explore project after a year and after two years?
results were 18% lower in the group that had counseling, and 20% less likely to
have intercourse without knowing the H.I.V status of the partner. After 2 years, the
differences disappeared.
6. How have the antiretroviral drugs that have extended
the lives of so many people with AIDS made public efforts harder than ever?
They have tempered the dread of catching the virus. Also, its outside of the
researchers control.
7. Why is first studying the social network in a given high-risk population
important?
Health officials can begin to prepare their efforts. This can be done by informing
and advertising the people.