"Officials Link Man to at Least 10 Girls Infected With H.I.V."
New York Times (10/28/97) P. A1; Barron, James
Officials in Chautauqua County, NY, say one man has apparently infected at least 11 teenage girls in western New York state with HIV--six of them, including a 13-year-old, after he knew he carried the virus. Officials said Monday that the man and his partners may have infected as many as 50 other people, creating the worst health crisis ever to hit the community 70 miles south of Buffalo. County officials believe the virus was transmitted through heterosexual sex. "It appears that he did not warn his contacts about his seropositive status," said Dr. Berke. "Most of the cases demonstrate a significant number of sexual partners and a lack of concern for contraception." The county district attorney, James Subjack, said he plans to file statutory rape charges against the man. The county may also file assault and reckless endangerment charges. County Health Commissioner Robert Berke has identified the man as Nushawn Williams; Williams is believed to have used a number of different names, including that of Shyteek Johnson. Last month, Johnson pleaded guilty to selling crack to undercover agents and is now an inmate at Riker's Island in New York City. (Related Story: USA Today, P. 2A).
"Preventive Steps Remain Critical"
USA Today (10/29/97) P. 1D; Painter, Kim
Experts say that this week's report of an outbreak of HIV infection in western New York is an indication that recent treatment improvement and decreased death rates are not reasons to relax prevention efforts. "A lot of people want to say we're done with prevention, let's move on to treatment," said Ronald Valdiserri of the Centers for Disease Control and Prevention. "But here we have this very sad, very unfortunate situation. And what we need to do now is make sure it doesn't happen again." While the case of Nushawn Williams--who had unprotected sex with at least nine girls and young women in rural Chautauqua County but did not tell them he was infected--is unusual, the situation stresses the need for further education efforts. "We do know that it's possible to become infected after a single episode of unprotected heterosexual intercourse," Valdiserri said. Some people face a greater risk of infection than others. Experts stress that teenagers in particular need to know about sexual risks. Donna Futterman of Montefiore Medical Center in New York noted that teenagers must be aware that "you cannot rely on the person telling you they do or do not have HIV."
"Public Health Cited in Breaching H.I.V. Confidentiality"
New York Times (10/29/97) P. A30; Richardson, Linda
The official release of the name of a man accused of infecting at least nine young women in Chautauqua County, NY, with HIV was the first use of a state law provision allowing such a release in cases of "clear and imminent danger to the public health." The state law gives only a few exceptions to the requirement that the names of HIV-infected individuals be kept confidential, but since Nushawn Williams may have infected numerous women across the state, health officials were granted a court order to publicize his name broadly. The law--which was adopted in 1988--also allows, but does not require, physicians to notify the partners of an infected patient without the patient's consent. In county health departments, HIV-infected individuals have access to services to help them track down their past partners, but they do not have to use the services. County workers cannot reveal the person's name or contact the partners themselves.
"Elders Weighs in on N.Y. AIDS Spree"
Washington Times (10/30/97) P. A4; Price, Joyce Howard
Former Surgeon General Joycelyn M. Elders said inadequate sexual education allowed a New York man to infect at least nine teenagers and young women with HIV. "We deny our children are having sex and that our teen-age girls are having sex with adults," Elders said. However, Chautauqua County officials say the 28 young women who had sex with Nushawn Williams knew the risks they were taking. Sharon Linden, head of the Jamestown School District's health department, said the district's abstinence-based sexual education program begins in the fifth grade, but children are first introduced to information about HIV transmission as early as age seven. Chautauqua Lake Central School District Superintendent Don Belcer and other officials said that societal factors, such as drugs and alcohol, led the students to ignore what they had been taught. Speaking at a breakfast at the National Press Club, where she was recognized by contraceptive manufacturer Pharmacia & Upjohn, Elders stressed the need to make contraceptives accessible to teenagers and lambasted Congress for supporting abstinence-only sex education.
"N.Y. Case May Boost HIV Reporting"
USA Today (10/31/97) P. 3A; Findlay, Steven
The recent report that an HIV-positive New York man infected at least nine women with HIV may help an effort to create a national HIV reporting program. While health workers in every state are now required to report AIDS cases to the Centers for Disease Control and Prevention, only 26 states have mandatory HIV reporting. Some of the states that do not have the requirement also have the highest rates of HIV and AIDS, including New York, New Jersey, California, and Illinois. The CDC says that about 75 percent of the United States' 1.5 million HIV-infected inhabitants live in states without HIV reporting. In January, the federal agency plans to recommend formally that every state adopt a reporting system. Critics of such a plan fear HIV reporting would result in breaches of confidentiality and discrimination. In the recent New York case, officials identified Nushawn Williams as being HIV positive because his reported sexual contact with at least 28 girls and women throughout the state constituted a serious threat to public health.
"Sex, Privacy and Tracking H.I.V. Infections"
New York Times (11/04/97) P. C1; Altman, Lawrence K.
While contact tracing is a standard weapon in public health efforts against sexually transmitted diseases, the method's use for HIV infection has been the subject of debate since the epidemic began. With the advent of new treatments to hinder disease progression and prevent viral transmission, however, health officials are reconsidering the issue, so they may be able to reach the approximately 250,000 people in the United States who do not know they are infected. Contact tracing, a process that relies on the voluntary participation of infected individuals, most recently resulted in an HIV test for Nushawn Williams in New York State and enabled state workers to track down some of the women he infected with the virus. Although the health workers did not identify Williams while contacting the women he named, last week they sought and received a court order allowing his name to be broadcast because of concern he may have infected many women over a wide area. In spite of possible benefits, debate over contact tracing has centered around issues of privacy and discrimination. The federal Ryan White Care Act, for example, requires states to support programs that notify people who were married to an HIV-infected person up to 10 years before diagnosis. Some health workers, however, are concerned this practice could lead to spousal abuse.
"Is It Time to Treat HIV Like All Other STDs?"
Washington Post--Health (11/04/97) P. 23; Coburn, Tom A.; Mayer, Kenneth
Although the knowledge and resources exist to prevent the spread of HIV in the United States, the abandonment of public health procedures that have proven effective against other sexually transmitted diseases has hindered U.S. prevention efforts, claims Rep. Tom Coburn (R-Okla.). To facilitate HIV monitoring and early treatment applications, Coburn has introduced the HIV Prevention Act of 1997, which would require HIV notification and reporting. In a Washington Post forum, Coburn's argument is countered by Dr. Kenneth Mayer, a professor at Brown University Medical School. Mayer says that HIV prevention must be conducted differently from prevention efforts against other STDs because HIV is unique. HIV-infected patients face a real fear of discrimination in the workplace and at home, Mayer says, and the long incubation period of the virus and high cost of current treatments would make a contact-tracing program ineffective. However, Coburn maintains that partner notification is the only way to gain a better understanding of HIV, by monitoring the virus in the early stages of infection.
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