AIDS FAQ part 2/10
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Section 2. How to prevent infection.
 Q2.1 How is HIV transmitted?
 Q2.2 How effective are condoms?
 Q2.3 How do you minimize your odds of getting infected?
 Q2.4 How risky is a blood transfusion?
 Q2.5 Can mosquitoes or other insects transmit AIDS?
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Question 2.1. How is HIV transmitted?
The Human Immunodeficiency Virus and Its Transmission - CDC National
AIDS Clearinghouse
Research has revealed a great deal of valuable medical, scientific,
and public health information about the human immunodeficiency virus
(HIV) and acquired immmunodeficiency syndrome (AIDS). The ways in
which HIV can be transmitted have been clearly identified.
Unfortunately, some widely dispersed information does not reflect the
conclusions of scientific findings. The Centers for Disease Control
and Prevention (CDC) providest he following information to help
correct a few commonly held misperceptions about HIV.
Transmission
HIV is spread by sexual contact with an infected person, by
needle-sharing among injecting drug users, or, less commonly (and now
very rarely in countries where blood is screened for HIV antibodies),
through transfusions of infected blood or blood clotting factors.
Babies born to HIV-infected women may become infected before or during
birth, or through breast-feeding after birth.
In the health-care setting, workers have been infected with HIV after
being stuck with needles containing HIV-infected blood or, less
frequently, after infected blood gets into the worker's bloodstream
through an open cut or splashes into a mucous membrane (e.g., eyes or
inside of the nose). There has been only one demonstrated instance of
patients being infected by a health-care worker; this involved HIV
transmission from an infected dentist to five patients.
Investigations have been completed involving more than 15,000 patients
of 32 HIV-infected doctors and dentists, and no other cases of this
type of transmission have been identified.
Some people fear that HIV might be transmitted in other ways; however,
no scientific evidence to support any of these fears has been found.
If HIV were being transmitted through other routes (for example,
through air or insects), the pattern of reported AIDS cases would be
much different from what has been observed, and cases would be
occurring much more frequently in persons who report no identified
risk for infection. All reported cases suggesting new or potentially
unknown routes of transmission are promptly and thoroughly
investigated by state and local health departments with the
assistance, guidance, and laboratory support from CDC; no additional
routes of transmission have been recorded, despite a national sentinel
system designed to detect just such an occurrence.
The following paragraphs specifically address some of the more common
misperceptions about HIV transmission.
HIV in the Environment
Scientists and medical authorities agree that HIV does not survive
well in the environment, making the possibility of environmental
transmission remote. HIV is found in varying concentrations or
amounts in blood, semen, vaginal fluid, breast milk, saliva, and
tears. (See below, Saliva, Tears, and Sweat.) In order to obtain
data on the survival of HIV, laboratory studies have required the use
of artificially high concentrations of laboratory-grown virus.
Although these unnatural concentrations of HIV can be kept alive under
precisely controlled and limited laboratory conditions, CDC studies
have showned that drying of even these high concentrations of HIV
reduces the number of infectious viruses by 90 to 99 percent within
several hours. Since the HIV concentrations used in laboratory
studies are much higher than those actually found in blood or other
specimens, drying of HIV- infected human blood or other body fluids
reduces the theoretical risk of environmental transmission to that
which has been observed - essentially zero. Incorrect interpretation
of conclusions drawn from laboratory studies have alarmed people
unnecessarily. Results from laboratory studies should not be used to
determine specific personal risk of infection because 1) the amount of
virus studied is not found in human specimens or anyplace else in
nature, and 2) no one has been identified with HIV due to contact with
an environmental surface; Additionally, since HIV is unable to
reproduce outside its living host (unlike many bacteria or fungi,
which may do so under suitable conditions), except under laboratory
conditions, it does not spread or maintain infectiousness outside its
host.
Households, Offices, and Workplaces
Studies of thousands of households where families have lived with and
cared for AIDS patients have found no instances of nonsexual
transmission, despite the sharing of kitchen, laundry, and bathroom
facilities, meals, eating utensils, and drinking cups and glasses. If
HIV is not transmitted in these settings, where repeated and prolonged
contact occurs, transmission is even less likely in other settings,
such as schools and offices.
Similarly, there is no known risk of HIV transmission to co-workers,
clients, or consumers from contact in industries such as food service
establishments (see information on survival of HIV in the
environment). Food service workers known to be infected with HIV need
not be restricted from work unless they have other infections or
illinesses (such as diarrhea or hepatitis A) for which any food
service worker, regardless of HIV infection status, should be
restricted; The Public Health Service recommends that all food service
workers follow recommended standards and practices of good personal
hygiene and food sanitation.
Kissing
Casual contact through closed-mouth or "social" kissing is not a risk
for transmission of HIV. Because of the theoretical potential for
contact with blood during "French" or open-mouthed kissing, CDC
recommends against engaging in this activity with an infected
person. However, no case of AIDS reported to CDC can be attributed to
transmission through any kind of kissing.
Saliva, Tears, and Sweat
HIV has been found in saliva and tears in only minute quantities from
some AIDS patients. It is important to understand that finding a small
amount of HIV in a body fluid does not necessarily mean that HIV can
be transmitted by that body fluid. HIV has not been recovered from the
sweat of HIV-infected persons. Contact with saliva, tears, or sweat
has never been shown to result in transmission of HIV.
Insects - see Question 2.4 
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Question 2.2. How effective are condoms? 
The proper and consistent use of latex condoms when engaging in sexual
intercourse--vaginal, anal, or oral--can greatly reduce a person's
risk of acquiring or transmitting sexually transmitted diseases,
including HIV infection.
When condoms are used reliably, they have been shown to prevent
pregnancy up to 98 percent of the time among couples using them as
their only method of contraception. Similarly, numerous studies among
sexually active people have demonstrated that a properly used latex
condom provides a high degree of protection against a variety of
sexually transmitted diseases, including HIV infection.
Condoms are classified as medical devices and are regulated by the
Food and Drug Administration. Each latex condom manufactured in the
United States is tested for defects, including holes, before it is
packaged, and several studies clearly show that condom breakage rates
in this country are less than 2 percent. Even when condoms do break,
one study showed that more than half of such breaks occurred prior to
ejaculation.
Update: Barrier Protection against Sexual Diseases - CDC National AIDS
Clearinghouse
Although refraining from intercourse with infected partners remains
the most effective strategy for preventing human immunodeficiency
virus (HIV) infection and other sexually transmitted diseases (STDs),
the Public Health Service also has recommended condom use as part of
its strategy. Since CDC summarized the effectiveness of condom use in
preventing HIV infection and other STDs in 1988 (1), additional
information has become available, and the Food and Drug Administration
has approved a polyurethane "female condom." This report updates
laboratory and epidemiologic information regarding the effectiveness
of condoms in preventing HIV infection and other STDs and the role of
spermicides used adjunctively with condoms.*
Two reviews summarizing the use of latex condoms among serodiscordant
heterosexual couples (i.e., in which one partner is HIV positive and
the other HIV negative) indicated that using latex condoms
substantially reduces the risk for HIV transmission (2,3). In
addition, two subsequent studies of serodiscordant couples confirmed
this finding and emphasized the importance of consistent (i.e., use of
a condom with each act of intercourse) and correct condom use
(4,5). In one study of serodiscordant couples, none of 123 partners
who used condoms consistently seroconverted; in comparison, 12 (10%)
of 122 seronegative partners who used condoms inconsistently became
infected (4). In another study of serodiscordant couples (with
seronegative female partners of HIV-infected men), three (2%) of 171
consistent condom users seroconverted, compared with eight (15%) of 55
inconsistent condom users. When person-years at risk were considered,
the rate for HIV transmission among couples reporting consistent
condom use was 1.1 per 100 person-years of observation, compared with
9.7 among inconsistent users (5). Condom use reduces the risk for
gonorrhea, herpes simplex virus (HSV) infection, genital ulcers, and
pelvic inflammatory disease (2). In addition, intact latex condoms
provide a continuous mechanical barrier to HIV, HSV, hepatitis B virus
(HBV), Chlamydia trachomatis, and Neisseria gonorrhoeae (2). A recent
laboratory study (6) indicated that latex condoms are an effective
mechanical barrier to fluid containing HIV-sized particles. Three
prospective studies in developed countries indicated that condoms are
unlikely to break or slip during proper use. Reported breakage rates
in the studies were 2% or less for vaginal or anal intercourse
(2). One study reported complete slippage off the penis during
intercourse for one (0.4%) of 237 condoms and complete slippage off
the penis during withdrawal for one (0.4%) of 237 condoms
(7). Laboratory studies indicate that the female condom (Reality
(trademark) **) -- a lubricated polyurethane sheath with a ring on
each end that is inserted into the vagina -- is an effective
mechanical barrier to viruses, including HIV. No clinical studies have
been completed to define protection from HIV infection or other
STDs. However, an evaluation of the female condom's effectiveness in
pregnancy prevention was conducted during a 6-month period for 147
women in the United States. The estimated 12-month failure rate for
pregnancy prevention among the 147 women was 26%. Of the 86 women who
used this condom consistently and correctly, the estimated 12-month
failure rate was 11%. Laboratory studies indicate that nonoxynol-9, a
nonionic surfactant used as a spermicide, inactivates HIV and other
sexually transmitted pathogens. In a cohort study among women, vaginal
use of nonoxynol-9 without condoms reduced risk for gonorrhea by 89%;
in another cohort study among women, vaginal use of nonoxynol-9
without condoms reduced risk for gonorrhea by 24% and chlamydial
infection by 22% (2). No reports indicate that nonoxynol-9 used alone
without condoms is effective for preventing sexual transmission of
HIV. Furthermore, one randomized controlled trial among prostitutes in
Kenya found no protection against HIV infection with use of a vaginal
sponge containing a high dose of nonoxynol-9 (2). No studies have
shown that nonoxynol-9 used with a condom increases the protection
provided by condom use alone against HIV infection.
Reported by: Food and Drug Administration. Center for Population
Research, National Institute of Child Health and Human Development,
National Institutes of Health. Office of the Associate Director for
HIV/AIDS; Div of Reproductive Health, National Center for Chronic
Disease Prevention and Health Promotion; Div of Sexually Transmitted
Diseases and HIV Prevention, National Center for Prevention Svcs; Div
of HIV/AIDS, National Center for Infectious Diseases, CDC.
Editorial Note: This report indicates that latex condoms are highly
effective for preventing HIV infection and other STDs when used
consistently and correctly. Condom availability is essential in
assuring consistent use. Men and women relying on condoms for
prevention of HIV infection or other STDs should carry condoms or have
them readily available.
Correct use of a latex condom requires 1) using a new condom with each
act of intercourse; 2) carefully handling the condom to avoid damaging
it with fingernails, teeth, or other sharp objects; 3) putting on the
condom after the penis is erect and before any genital contact with
the partner; 4) ensuring no air is trapped in the tip of the condom;
5) ensuring adequate lubrication during intercourse, possibly
requiring use of exogenous lubricants; 6) using only water-based
lubricants (e.g., K-Y jelly (trademark) or glycerine) with latex
condoms (oil-based lubricants (e.g., petroleum jelly, shortening,
mineral oil, massage oils, body lotions, or cooking oil) that can
weaken latex should never be used); and 7) holding the condom firmly
against the base of the penis during withdrawal and withdrawing while
the penis is still erect to prevent slippage.
Condoms should be stored in a cool, dry place out of direct sunlight
and should not be used after the expiration date. Condoms in damaged
packages or condoms that show obvious signs of deterioration (e.g.,
brittleness, stickiness, or discoloration) should not be used
regardless of their expiration date.
Natural-membrane condoms may not offer the same level of protection
against sexually transmitted viruses as latex condoms. Unlike latex,
natural- membrane condoms have naturally occurring pores that are
small enough to prevent passage of sperm but large enough to allow
passage of viruses in laboratory studies (2).
The effectiveness of spermicides in preventing HIV transmission is
unknown. Spermicides used in the vagina may offer some protection
against cervical gonorrhea and chlamydia. No data exist to indicate
that condoms lubricated with spermicides are more effective than other
lubricated condoms in protecting against the transmission of HIV
infection and other STDs. Therefore, latex condoms with or without
spermicides are recommended.
The most effective way to prevent sexual transmission of HIV infection
and other STDs is to avoid sexual intercourse with an infected
partner. If a person chooses to have sexual intercourse with a partner
whose infection status is unknown or who is infected with HIV or other
STDs, men should use a new latex condom with each act of
intercourse. When a male condom cannot be used, couples should
consider using a female condom.
Data from the 1988 National Survey of Family Growth underscore the
importance of consistent and correct use of contraceptive methods in
pregnancy prevention (8). For example, the typical failure rate during
the first year of use was 8% for oral contraceptives, 15% for male
condoms, and 26% for periodic abstinence. In comparison, persons who
always abstain will have a zero failure rate, women who always use
oral contraceptives will have a near-zero (0.1%) failure rate, and
consistent male condom users will have a 2% failure rate (9). For
prevention of HIV infection and STDs, as with pregnancy prevention,
consistent and correct use is crucial.
The determinants of proper condom use are complex and incompletely
understood. Better understanding of both individual and societal
factors will contribute to prevention efforts that support persons in
reducing their risks for infection. Prevention messages must highlight
the importance of consistent and correct condom use (10).
References
1. CDC. Condoms for prevention of sexually transmitted diseases. MMWR
1988;37:133-7. 
2. Cates W, Stone KM. Family planning, sexually transmitted diseases,
and contraceptive choice: a literature update. Fam Plann Perspect
1992;24:75-84.
3. Weller SC. A meta-analysis of condom effectiveness in reducing
sexually transmitted HIV. Soc Sci Med 1993;1635-44.
 4. DeVincenzi I, European Study Group on Heterosexual Transmission of
HIV. Heterosexual transmission of HIV in a European cohort of couples
(Abstract no. WS-CO2-1). Vol 1. IXth International Conference on
AIDS/IVth STD World Congress. Berlin, June 9, 1993:83.
5. Saracco A, Musicco M, Nicolosi A, et al. Man-to-woman sexual
transmission of HIV: longitudinal study of 343 steady partners of
infected men. J Acquir Immune Defic Syndr 1993;6:497-502.
6. Carey RF, Herman WA, Retta SM, Rinaldi JE, Herman BA, Athey
TW. Effectiveness of latex condoms as a barrier to human
immunodeficiency virus- sized particles under conditions of simulated
use. Sex Transm Dis 1992;19:230- 4.
7. Trussell JE, Warner DL, Hatcher R. Condom performance during
vaginal intercourse: comparison of Trojan-Enz (trademark) and Tactylon
(trademark) condoms. Contraception 1992;45:11-9.
8. Jones EF, Forrest JD. Contraceptive failure rates based on the 1988
NSFG. Fam Plann Perspect 1992;24:12-9.
9. Trussell J, Hatcher RA, Cates W, Stewart FH, Kost K. Contraceptive
failure in the United States: an update. Stud Fam Plann 1990;21:51-4.
10. Roper WL, Peterson HB, Curran JW. Commentary: condoms and HIV/STD
prevention -- clarifying the message. Am J Public Health
1993;83:501-3.
* Single copies of this report will be available free until August 6,
1994, from the CDC National AIDS Clearinghouse, P.O. Box 6003,
Rockville, MD 20849- 6003; telephone (800) 458-5231.
** Use of trade names is for identification only and does not imply
endorsement by the Public Health Service or the U.S. Department of
Health and Human Services.
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Recent articles about Condoms (1993-1994)
Source: Michael Howe <hivinfo@itsa.ucsf.edu>, AIDS News Service, VAMC
 Condom Failure Rates
 (Arranged Chronologically - Reverse Order)
1
AU - Park JS ; Kim CK
TI - The effective prevention of HIV by female condom (Femidom).
AB - As part of a widely implemented prevention strategy, condom
use exemplifies the empowerment of individuals and interaction
between people who want to protect themselves and others against
HIV infection. The serious consequences of condom failure has

 
placed added emphasis on condom quality. Correct condom use can be
learned and practiced with the result being more condom use with
less breakage. The newest female barrier, Female Condom (Femidom)
could protect against HIV transmission. Female Condom is a
lubricated polyurethane bags with a soft ring. As sexually
transmitted diseases are a high risk factors in HIV transmission,
then the use of Female Condom has an obvious indirect value in HIV
control. Comparative studies have been initiated whether female
condom will be as good as better than male condom in directly
ffecting HIV transmission. Female Condom is a choice for HIV
prevention as well as a useful method of contraception.
SO - Int Conf AIDS. 1994 Aug 7-12;10(2):288 (abstract no. PC0531).
2
AU - Thompson JL ; Yager TJ ; Martin JL
TI - Estimated condom failure and frequency of condom use among
gay men.
AB - OBJECTIVES. Condoms are designed to bar transmission of the
human immunodeficiency virus (HIV), but they sometimes fail. This
paper explores the effect of experience with condoms on condom
failure among gay men. METHODS. Risk of condom failure (breakage
or slippage) on a single occasion is estimated for four sexual acts
reported over 12 months by a sample of gay New York City men (n =
741). The estimation procedure assumes that each episode in which
a condom is used is an independent event. Evidence is offered to
support this assumption. RESULTS. Risk of condom failure in a
single episode was fairly high, particularly in anal intercourse,
for men who had engaged in each act only a few times in the
previous year. It declined rapidly with experience (e.g., to below
1% for receptive anal intercourse after about 10 episodes in the
previous year). Condoms failed less often in oral than anal sex,
but estimated risk of failure also decreased with experience.
CONCLUSIONS. Gay men should be especially cautious the first few
times they use a condom; after moderate experience, however, they
may expect a low risk of condom failure.
SO - Am J Public Health. 1993 Oct;83(10):1409-13.
3
AU - Joffe A
TI - Adolescents and condom use.
AB - Increasing condom use among adolescents is an essential
component of a public health strategy aimed at decreasing rates
of sexually transmitted infections and the spread of human
immunodeficiency virus infection. This article reviews current data
about the contraceptive and prophylactic characteristics of
condoms. Data about current levels of use among adolescents and
factors demonstrated to affect such use are also summarized. Except
where data are scanty or nonexistent, the research studies are
limited to those focusing primarily on adolescents and,
occasionally, college students. Based on these data, suggestions
for increasing condom use among adolescents are presented.
SO - Am J Dis Child. 1993 Jul;147(7):746-54.
4
AU - Weller SC
TI - A meta-analysis of condom effectiveness in reducing sexually
transmitted HIV [see comments]
AB - Before condoms can be considered as a prophylaxis for
sexually transmitted human immunodeficiency virus (HIV), their
efficacy must be considered. This paper reviews evidence on condom
effectiveness in reducing the risk of heterosexually transmitted
human HIV. A meta-analysis conducted on data from in vivo studies
of HIV discordant sexual partners is used to estimate the
protective effect of condoms. Although contraceptive research
indicates that condoms are 87% effective in preventing pregnancy,
results of HIV transmission studies indicate that condoms may
reduce risk of HIV infection by approximately 69%. Thus, efficacy
may be much lower than commonly assumed, although results should
be viewed tentatively due to design limitations in the original
studies.
SO - Soc Sci Med. 1993 Jun;36(12):1635-44.
5
AU - de Wit JB ; Sandfort TG ; de Vroome EM ; van Griensven GJ ;
Kok GJ
TI - The effectiveness of condom use among homosexual men [letter]
SO - AIDS. 1993 May;7(5):751-2.
6
AU - Richters J ; Donovan B ; Gerofi J
TI - How often do condoms break or slip off in use?
AB - Men attending 3 sexually transmissible disease clinics and
a university health service in Sydney were given a questionnaire
asking how many condoms they had used in the past year and how many
broke during application or use or slipped off. Respondents were
544 men aged 18 to 54 years. Of these, 402 men reported using
13,691 condoms for vaginal or anal intercourse; 7.3% reportedly
broke during application or use and 4.4% slipped off. Men having
sex with men reported slightly higher slippage rates than those
having sex with women. Breakage and slippage were unevenly
distributed among the sample: a few men experienced very high
failure rates. A volunteer subsample reported 3 months later on
condoms supplied to them: 36 men used 529 condoms, of which 2.8%
broke during application or use and 3.4% slipped off. Many of these
failures pose no risk to the user, especially those occurring
during application, as long as they are noticed at the time, but
failure may discourage future use. Research is needed to identify
user behaviours related to breakage.
SO - Int J STD AIDS. 1993 Mar-Apr;4(2):90-4.
7
TI - HIV infection in European female sex workers: epidemiological
link with use of petroleum-based lubricants. European Working Group
on HIV Infection in Female Prostitutes.
AB - OBJECTIVES: To assess the prevalence of and risk factors
associated with HIV infection in European female sex workers,
particularly sexual risk factors. DESIGN: Multicentre
cross-sectional study performed in nine European countries.
METHODS: Female sex workers voluntarily enrolled between September
1990 and November 1991. Face-to-face interviews were conducted in
various settings (health care, prostitute organizations, outreach)
to collect information on over 150 behavioural, health and
sociodemographic variables. Enrollment of intravenous drug users
(IVDU) was limited to a maximum of 25% of the total sample. The
HIV-1 and HIV-2 antibody status of blood or saliva samples was
tested using enzyme-linked immunosorbent assay and confirmed by
Western blot. RESULTS: Eight hundred and sixty-six (91.6%) of the
945 interviewees provided blood (n = 824) or saliva (n = 42)
samples. HIV seroprevalence was 5.3% [44 HIV-1-positives and two
HIV-2-positives (from Lisbon)] overall, 31.8% (35 out of 110) in
IVDU and 1.5% (11 out of 756) in non-IVDU [odds ratio (OR), 31.6;
P < 0.001]. Lack of condom use (P = 0.002, test for trend) and
previous ulcerative sexually transmitted disease (OR, 3.6; P =
0.06) were associated (on logistic regression) with HIV infection
in both IVDU and non-IVDU. Previous hepatitis B (OR, 13.8; P =
0.02) and needle-sharing (OR, 4.1; P = 0.04) were associated with
HIV infection in IVDU, and low education level (P = 0.02, test for
trend), previous transfusion (OR, 9.1; P = 0.003), origin from
sub-Saharan Africa (OR, 5.4; P = 0.05) and use of petroleum-based
lubricants (OR, 15.2; P = 0.001) in non-IVDU. CONCLUSIONS: HIV
prevalence remains relatively low among non-IVDU prostitutes in
Europe. While intravenous drug use remains the most important risk
factor for HIV, petroleum-based lubricants (used by 10% of women
in this study) may be a risk factor for HIV among European female
sex workers; over 80% of those interviewed always used condoms with
clients.
SO - AIDS. 1993 Mar;7(3):401-8.
8
AU - de Graaf R ; Vanwesenbeeck I ; van Zessen G ; Straver CJ ;
Visser JH
TI - The effectiveness of condom use in heterosexual prostitution
in The Netherlands.
AB - OBJECTIVES: To assess the extent to which condoms are used
effectively in commercial heterosexual intercourse. Data on the
number of condoms that had broken or slipped off, the sexual
technique during which this had occurred and the perceived cause
of failure were collected. The use of non-water-soluble lubricants
and non-fortified condoms during anal intercourse, and the demand
for a greater variety of condom sizes were also examined. SUBJECTS
AND METHODS: One hundred and twenty-seven female prostitutes and
91 male clients from different parts of The Netherlands were
interviewed face-to-face between July 1990 and March 1991. RESULTS:
Of those who used condoms during vaginal intercourse, 49% of the
prostitutes had experienced condom breakage in the previous 6
months, and 16% of the clients in the previous 12 months. The
breakage rate was 0.8% for prostitutes and 1.5% for clients. Condom
quality was seldom reported as the cause; breakage was generally
attributed to human factors, such as rough or prolonged
intercourse, incorrect handling of the condom or the use of
insufficient lubricant. Prostitutes also identified penis size as
a cause. Condoms slipping off before or after ejaculation was
reported less frequently than breakage. Thirteen per cent of
clients and 36% of prostitutes expressed a need for either smaller
or larger condoms. Of the prostitutes, 9% used oil or vaseline as
a lubricant. CONCLUSIONS: In view of the low rate of condom failure
in heterosexual prostitution in The Netherlands, the potential
spread of HIV by this means is small. The use of a greater variety
of condom sizes may further reduce the failure rate. Few
prostitutes remain ignorant about the adverse effects of oil-based
lubricants on condoms.
SO - AIDS. 1993 Feb;7(2):265-9.
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Question 2.3. How do you minimize your odds of getting infected?
"Playing the AIDS Odds" (21 Oct 93)
Robert S. Walker, Ph.D. Phone: (210)224-9172
Emeritus professor Internet: rwalker@trinity.edu
Trinity University, Pol.Sci.
715 Stadium Drive office: 128 Main Plaza, No.310
San Antonio, TX 78212 San Antonio, TX, 78205
Everyone worries about the degree of transmission-risk involved in
various activities. Can you get infected from mutual masturbation?
From fisting? From using poppers? From this and from that? The real
question is, "Is it possible to provide answers with sufficient
precision to allow an individual confidently to assess risk and modify
behavior in specific situations?" The answer is "No." No one knows
enough about either sexual or drug behaviors, and their relation to
HIV sero- conversion, to speak with assurance. But this doesn't mean
that meaningful recommendations are out of the question.
Those interested in risk assessment might read two articles
representing different approaches. First: Michael Shernoff,
"Integrating Safer Sex Counseling into Social Work Practice, Social
Casework: The Journal of Contemporary Social Work, vol. 69 (1988),
pp. 334-339. The author offers a scaled list of 30 sexual behaviors
from abstinence through fisting to condomless, receptive anal
intercourse. The list is graded from "least likely" to transmit virus
to "most likely." Some of the relative rankings are arguable, but the
biggest problem is that the intervals of the "risk" scale are not
equal. For example, #29 is "vaginal intercourse to orgasm without
condoms," #30 is "anal inter- course to orgasm without condoms;" these
two are separated by the same scaler distance as abstinence (no.1) and
solitary masturbation (no.2). But everyone agrees that, anal
intercourse is many times more dangerous than vaginal for the
receptive partner, not just "one interval" more dangerous. Such lists
are not too useful; I doubt that any subscriber to this list needs to
be told that solitary masturbation is safer than receptive anal
intercourse. Further, until a lot more is known about the
relationships between specific behaviors and sero-conversion, the
intervals cannot be meaningfully quantified.
The second article is Norman Hearst and Stephen B. Hulley,
"Heterosexual AIDS," Journal of the American Medical Association,
April 22, 1988. The authors calculate probabilities for HIV
transmission for different parameters (such as: the area's
seroprevalence rate, the infectiousness of a partner, the
condom/spermicide failure rate, and the number of sexual
encounters). The "odds" of transmission with different parameters
(such as: 500 encounters, .01 condoms failure rate, area
seroprevalence of .0001, and so forth) are then projected. The
resulting odds range from a "low" of 1 chance in 5 billion to a "high"
of 1 transmission in 500 encounters. In the lowest risk example, there
is 1 in 5 billion chance that HIV will be transmitted when: (1) your
partner tests negative; (2) he/she has no history of high-risk
behavior; (3) condoms are used in intercourse, and the condom failure
rate is .01; (4) the area seroprevalence rate is 0.000001, (5) the
infectivity value is 0.002; and (6) there is only one sexual
encounter.
As behavioral guides, neither approach is very helpful. When the
possible sex or drug scenarios become as disparate as they are in
real-life situations, and when the odds resemble your chances of
winning a major lottery, then stating intervals or odds does not
provide much more than a illusion of knowledge and resulting security.
I suggest a different approach to thinking about risk. First, do not
worry about practices for which there is no documentation of
transmission (as distinct from speculation about it). If there is any
risk in kissing, masturbation, skinny-dipping or whatever, it is
probably much less than the chance of being hit by lightning - and few
people worry about that. Focus on those activities, like intercourse
and/or injecting drugs, which common sense tells you are risky, if for
no other reason than that they have a long history of transmitting
other diseases (like syphilis or hepatitis). Such behaviors would
clearly include injecting drug use within a group, condomless anal
and/or vaginal intercourse, and less clearly oral sex, fisting, or any
S&M practice that involved a possible blood exchange.
Second, take into account the overall setting within sexual or drug
activity is taking place. While it seems that we are all biologically
at equal risk, we do not face equal environmental risks. While HIV
theoretically can spread uniformly from the North to the South pole,
it has not in fact done so. It is one thing to pick up someone at a
bar in Brahma, Oklahoma and another in San Francisco, California. The
risk involved in employing a prostitute in Des Moines is much less
than in Newark, NJ or Washington D.C. where the seroprevalence rate
among prostitutes is very high. Similarly, patronizing a Newark
shooting gallery or crack house is like asking for AIDS, but the risk
of transmission within the West Coast drug scene is much less. For
area comparisons see the Centers for Disease Control's quarterly
HIV/AIDS Surveillance Report, and/or Jonathan Mann et al, AIDS in the
World, Harvard U. Press, 1993.
What I am suggesting is that some information plus common sense is a
better guide than current statistical or quasi-statistical statements
about relative risk. This will remain the case until a great deal more
empiric data is amassed about some of our most private behaviors. If
you are a person who does not feel comfortable without precise,
reliable, quantified guidelines, then your only course is to abstain
from activities wherein there is a possibility of transmission. There
are many mood-altering substances that do not require injection, and a
lot of sexual behavior that does not involve penetration and fluid
exchange.
With respect to non-sex or drug modes of transmission, all one can say
is that there have been no documented cases of transmission through
insect bites, shared utensils, shared occupational space or equipment,
food handling, and so on. Theoretical risks for an infinite number of
imagined scenarios can be computed, but in the actual world there are
no data supporting transmission in these scenarios. An excellent
survey of 14 principal articles searching for data on other routes of
transmission can be found in: Robyn R.N Gershon et al, "The Risk of
Transmission of HIV-1 Through Non-Percutaneous, Non-Sexual Modes: A
Review," Department of Environmental Health Sciences and Department of
Epidemiology, The Johns Hopkins University School of Hygiene and
Public Health, distribut- ed by New York City's Gay Men's Health
Crisis, AIDS Clinical Update, October 1, 1990. There have been cases
of transmission through transfusions /transplants of contaminated
whole blood, blood products, donor organs, and dental work. The only
thing one can do is to be aware of the possibility, and make sure that
those who treat you take all precautions.
Currently, the only way to load the dice in your favor is to use
common sense in any situation wherein someone else's body fluids might
be introduced into yours through sexual or drug behaviors. If one can
foresee that there would be opportunity for fluid exchange - blood,
semen, vaginal secretions - then a large measure of safety can be had
from the use of condoms (see: Condom Faq) and/or your own works for
injecting drugs. The only safer course - and it is an honorable and
intelligent one - would be to abstain from such activities altogether.
What must be kept in mind is that the risk of HIV transmission is
totally unlike the risk of losing at the races. Because you cannot
recoup the loss represented by infection, you ought not think of the
"odds" in the same way. In fact, it is better not to focus on the so-
called "odds" at all. Given that (1) infection almost always leads to
AIDS (estimates=95%), and (2) that AIDS almost always leads to death
(estimates=99%), people must now think of sex or injecting drug use as
an all-or-nothing game, . Each time you play, there are only two
possible outcomes. If you win you have, perhaps, enjoyed a pleasant
encounter; if you lose, you die. And each time you play without regard
to common sense evaluation and personal protection, you enhance the
possibility that you will lose. Its as simple as that.
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Question 2.4. How risky is a blood transfusion?
The following October 15, 1993 United Press International article, was
summarized in the CDC AIDS Daily News Summary.
"CDC Study Finds Five Transfusion-Related AIDS Cases Per Year" United
Press International (10/25/93)
Miami Beach, Fla.--Since screening for HIV began in 1985, very few
people have become infected with the virus via blood transfusions,
according to experts at the Centers for Disease Control and
Prevention. The rate of transfusion-related AIDS cases rose steadily
from 1978 to 1984, then fell dramatically when testing began in 1985,
said the CDC. Officials report that between 1986 and 1991, the number
of such cases may have been as low as five per year. "While the risk
of getting AIDS from a transfusion is not zero, this study
corroborates other CDC research and published data indicating that the
risk is extremely low," said Dr. Arthur J. Silvergleid, president of
the American Association of Blood Banks. A total of 4,619 individuals
are believed to have been infected through the blood supply. Each year
in the United States, about 4 million people receive blood
transfusions.
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Question 2.5. Can mosquitoes or other insects transmit AIDS?
From the onset of the HIV epidemic, there has been concern about
transmission of the virus by biting and blood-sucking
insects. However, studies conducted by researchers at CDC and
elsewhere have shown no evidence of HIV transmission through
insects--even in areas where there are many cases of AIDS and large
populations of insects such as mosquitoes. Lack of such outbreaks,
despite intense efforts to detect them, supports the conclusion that
HIV is not transmitted by insects.
The results of experiments and observations of insect biting behavior
indiciate that when an insect bites a person, it does not inject its
own or a previous victim's blood into the new victim. Rather, it
injects saliva. Such diseases as yellow fever and malaria are
transmitted through the saliva of specific species of
mosquitoes. However, HIV lives for only a short time inside an insect
and, unlike organisms that are transmitted via insect bites, HIV does
not reproduce (and, therefore, cannot survive) in insects. Thus, even

 
if the virus enters a mosquito or another sucking or biting insect,
the insect does not become infected and cannot transmit HIV to the
next human it feeds on or bites.
There is also no reason to fear that a biting or blood-sucking insect,
such as a mosquito, could transmit HIV from one person to another
through HIV-infected blood left on its mouth parts. Two factors
combine to make infection by this route extremely unlikely-- first,
infected people do not have constant, high levels of HIV in their
bloodstreams and, second, insect mouth parts do not retain large
amounts of blood on their surfaces. Further, scientists who study
insects have determined that biting insects normally do not travel
from one person to the next immediately after ingesting blood.
........................................
An interesting paper is:
Do Insects Transmit Aids?
by Lawrence Miike
Health Program; Office of Technology Assessment United States
Congress; Washington D.C. 20510-8025 September 1987 -- A Staff Paper
in OTA's Series on AIDS-Related Issues
For sale by the Superintendent of Documents U.S. Government Printing 
Office
Washington, D.C. 20402
This paper indicates that "The conditions necessary for successful
transmission of HIV through insect bites, and the probabilities of
their occurring, rule out the possiblility of insect transmission of
HIV infection as a significant factor in the way AIDS is spread. If
insect transmission is occurring at all, each case would be a rare and
unusual event."
 
Archive-name: aids-faq/part3
AIDS FAQ Part 3/10
Section 3. General Information on AIDS
Q3.1 Testing Information - Blood Banks
Q3.2 Testing Information - Elisa and Western Blot tests (Please 
Contribute)
Q3.3 Symptoms of HIV and AIDS (please contribute)
Q3.4 AIDS and Opportunistic Infections.
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Question 3.1. Testing Information - Blood Banks
All blood products in the U.S. are screened by ELISA assays for
several infectious agents, including: HIV 1/2, HTLV I/II, HBV, HCV,
Syphillis, Hepatitis B core, and a liver enzyme ALT, indicative of
hepatic infections. Some blood donations are also tested for CMV, a
more common virus that has devestating effects in immunocompromised
individuals, such as cancer patients and transplant recipients.
In addition to these laboratories, all donors are screened through
questionaires that meet or exceed FDA requirements.
What if a blood-bank finds out you are HIV positive? 
The Red Cross and other blood banks routinely test blood donations for
HIV antibodies.
The Red Cross has specifically asked that people not use blood
donation as a way of finding out if they are HIV+. If you think you
might be infected, go get a blood test. Many cities offer free
anonymous HIV testing. Contact your local public health service office
for details.
This is particularly important if you think you might have been
infected within the last six months, since there's the risk that you
are indeed infected, but do not yet have antibodies to HIV.
Blood donation is a fine thing to do--but how will you feel if you
donate, then a month later you find out through some other means that
you're HIV+? We're supposed to be making a gift of life, not death.
The following article discusses how blood banks use the information,
if you have tested positive for HIV antibodies. In addition to your
possible role in killing another person, donating blood to obtain a
free HIV test also risks your anonymity.
system. JAMA. 1993 May;269(17):2239-45.
"The coded identity of potential or actual blood donors who are found
to be unsuitable on the basis of medical history or laboratory testing
is entered into a donor referral registry (DDR). Before each donated
unit of blood is made available for use, the coded identity of the
donor is checked against the DDR to ensure that the donor has not been
found to be unsuitable during a previous donation. Although
potentially infectious donors are so informed and asked not to give
blood in the future, this DDR check is thought to improve the safety
of the blood supply by serving as an additional way of identifying
potentially infectious blood should these donors return. The American
Red Cross operates a single DDR with information from all of its 47
reginal centers. However, other blood banks' DDRs act only locally
since there is no requirement that different blood banks in the same
or neighboring communities exchange this DDR information. The
operation of these DDRs costs money, consumes experts' time, and has
the potential for many abuses such as failure to obtain informed
consent and breeches of confidentiality. The value of a DDR in
improving the safety of the blood supply has not been established. An
analysis of the value of thse DDRs should be conducted, and based on
the results, DDRs should be either eliminated or refined into an
appropriate system."
See also: Grossman BJ. Springer KM. Blood donor deferral registries:
highlights of a conference. Transfusion. 1992;32:868-72.
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Question 3.2. Testing information (please contribute)
 We need info for this section - Elisa and Western Blot
tests, anonymous, confidential and other testing, reportable states, 
etc.
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Question 3.3. Symptoms of HIV and AIDS (please contribute)
 We need a concise but complete descriptions of symptoms at all
stages of HIV infection and AIDS.
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Question 3.4. AIDS and Opportunistic Infections.
AIDS and Opportunistic Infections
NIAID BACKGROUNDER: Office of Communications, National Institute of
Allergy and Infectious Diseases, National Institutes of Health,
Bethesda, Maryland 20892 - September 1993 Opportunistic infections
(OIs) cause most of the illnesses and deaths among people infected
with HIV, the virus that causes AIDS. The National Institute of
Allergy and Infectious Diseases (NIAID) leads the way in U.S. research
on these life-threatening infections. As part of the NIAID effort,
investigators are defining the optimal therapies, alone and in
combination, to prevent and treat OIs. They seek ways to identify
infections earlier and recognize resistance to therapies more quickly.
What are OIs?
The immune systems of most people with HIV gradually deteriorate,
leaving them vulnerable to numerous viruses, fungi, bacteria and
protozoa that are held in check in people with healthy immune
systems. These microbes can become active in HIV-infected individuals,
causing frequent and severe disease.
NIAID uses a two-pronged approach to the prevention and treatment of
OIs: basic laboratory research to learn how these microbes cause
disease and clinical research to develop and evaluate promising
therapies.
Prevention and treatment of one such disease, Pneumocystis carinii
pneumonia or PCP, has been a major thrust of the NIAID program. Other
NIAID investigations include cytomegalovirus (CMV) infection,
Mycobacterium avium complex (MAC) and tuberculosis (TB). Institute
research focuses on these infections because, although they occur
repeatedly among HIV-infected people, they are rare in the general
population and few drugs are available now to prevent and treat them.
PCP: The Most Common OI
PCP remains the most common, life-threatening opportunistic infection
in people with HIV, occurring in up to 80 percent of individuals who
do not take preventive therapy.
The PCP organism, a microscopic parasite, appears to infect most
people during childhood. In people with healthy immune systems, the
parasite normally remains dormant, but it may cause disease in those
with damaged immune systems.
PCP infection is characterized by a dry cough and shortness of
breath. Individuals may experience other, less specific symptoms such
as fever, fatigue and weight loss for weeks or even months before
respiratory problems appear. As PCP infection progresses, the
functioning lung tissue becomes clogged, which decreases the transport
of oxygen from the inhaled air into the blood. At this point, the
oxygen in the blood may be lowered to dangerous or even fatal levels.
Without treatment, close to 100 percent of HIV-infected patients with
PCP die. During the 1980s, the development of effective therapies led
to better management of PCP. Drugs for preventing and treating PCP
include aerosolized pentamidine and oral trimethoprim-sulfamethoxazole
(TMP/SMX), but both can result in serious side effects that prevent
some patients from taking the drugs.
TMP/SMX is recommended more often than aerosolized pentamidine for
treating and preventing PCP because the combination is effective,
tolerated by about half of the patients who take it and may work
against other disease-causing organisms as well. In 1992, an
NIAID-supported trial proved that TMP/SMX is better than aerosolized
pentamidine at preventing a second episode of PCP in people with AIDS
who can tolerate either therapy.
Although definitive research data are lacking, other agents may be
considered in situations in which neither TMP/SMX nor aerosolized
pentamidine can be given. The drug atovaquone is approved for patients
with mild to moderate PCP who cannot tolerate TMP/SMX. One NIAID study
showed that primaquine, an antimalaria drug, with clindamycin is an
effective oral therapy for PCP. TMP with dapsone is an alternative
treatment.
The search for new, more effective, less toxic drugs and combinations
of drugs to fight PCP continues. NIAID studies play an important role
in this effort. One trial compares three drug regimens--TMP/dapsone,
primaquine/clindamycin and TMP/SMX--for oral treatment of mild to
moderate PCP. Another protocol looks at an 8-aminoquinoline, an
antimalaria drug, while a third trial considers two regimens of
TMP/SMX to prevent PCP.
CMV: A Herpesvirus
Infection with CMV, a virus in the herpes family, may occur throughout
life. By age 50, about half of the general population has been exposed
to this virus, yet most people do not become ill. After the original
infection, the virus may lie dormant and reactivate itself if the
immune system becomes suppressed.
For people with HIV infection, CMV is one of the most frequent and
serious OIs they face. CMV retinitis, an inflammation of the
light-sensitive inner layer of the eye, is the most common CMV
infection and leads to blindness if left untreated. Infections also
may occur in the gastrointestinal tract, lungs, brain, heart and other
organs.
Both intravenous ganciclovir and foscarnet are approved to treat CMV
retinitis. Lifelong maintenance on either treatment is required
because the drugs do not kill CMV, they merely slow down its ability
to grow. Even with therapy, the rate of relapse is high.
NIAID studies of CMV and other herpesviruses have shown that
intravenous foscarnet and ganciclovir are equally effective for CMV
retinitis, although foscarnet was associated with increased survival
for patients in the study. An ongoing trial is testing an oral form of
ganciclovir to prevent CMV disease. The oral form of the drug would be
much easier and safer for patients to take.
MAC: A Bacterial OI
Infection with MAC is diagnosed in up to 40 percent of people with
AIDS in the United States, making it the most common bacterial
OI. Usually, it affects people in advanced stages of HIV disease when
the immune system is severely suppressed.
The MAC organism is found widely in the environment and is thought to
be acquired most commonly through the mouth or gastrointestinal
tract. It can spread to the lungs, liver, spleen, lymph nodes, bone
marrow, intestines and blood. MAC causes chronic debilitating
symptoms--fever, night sweats, weight loss, fatigue, chronic diarrhea,
abdominal pain, liver dysfunction and severe anemia.
Rifabutin is the first drug to be approved for preventing MAC disease
in people with advanced HIV infection. The Food and Drug
administration based this approval on clinical studies showing that
patients who received rifabutin were one-third to one-half as likely
to develop MAC as were patients who received placebo.
To prevent MAC disease, a U.S. Public Health Service Task Force on
Prophylaxis and Therapy for MAC suggests that patients with HIV
infection and fewer than 100 CD4 + T cells receive oral rifabutin for
the rest of their lives unless disease develops. In the latter case,
multiple drug treatment is needed. CD4+ T cells are immune system
cells targeted and killed by HIV. No other drug regimen is recommended
currently to prevent MAC. Azithromycin and clarithromycin are
promising agents for prophylaxis, but studies of these agents have not
been completed.
Increasing evidence suggests that treatment can benefit patients with
disseminated MAC, especially multiple-drug regimens including either
clarithromycin or azithromycin. Therefore, the PHS task force suggests
that all regimens, outside of a clinical trial, should consist of at
least two drugs, including clarithromycin or azithromycin plus one
other agent such as clofazimine, rifabutin, rifampin, ciprofloxacin
and, in certain situations, amikacin. They recommend continued therapy
for the patient's lifetime, as long as clinical benefit and reduction
of mycobacteria are observed.
NIAID has several studies under way looking at the roles of
clarithromycin and azithromycin, and other drugs such as sparfloxacin,
alone and in combination, to prevent and treat this serious disease.
TB: An Airborne Disease
TB, a chronic bacterial infection, causes more deaths worldwide than
any other infectious disease. About one-third of the world's
population harbors the predominant TB organism, Mycobacterium
tuberculosis, and is at risk for developing the disease. The World
Health Organization (WHO) estimates that 4.4 million people worldwide
are coinfected with TB and HIV. WHO predicts that by the year 2000, TB
will take one million lives annually among the HIV-infected.
Because of their weakened immune systems, people with HIV are
vulnerable to reactivation of latent TB infections, as well as to new
TB infections. Transmission of this disease occurs most commonly in
crowded environments such as hospitals, prisons and shelters--where
HIV-infected individuals make up a growing proportion of the
population.
Active TB may occur early in the course of HIV infection, often months
or years before other OIs. TB most often affects the lungs, but it
also can cause disease in other parts of the body, particularly in
people with advanced HIV disease.
Of particular concern for people with AIDS is multi-drug-resistant TB
(MDR-TB). MDR-TB can occur when patients fail to take their TB
medicine for the prolonged periods necessary to destroy all TB
organisms, which then become resistant to the drugs. These resistant
organisms can be spread to other people. Even with treatment, for
individuals coinfected with HIV and MDR-TB, the death rate may be as
high as 80 percent, as opposed to 40 to 60 percent for people with
MDR-TB alone. The time from diagnosis to death may be only months for
some patients with HIV and MDR-TB, as they are sometimes left without
adequate treatment options.
The initial site of TB infection is in the balloon-like sacs at the
ends of the small air passages in the lungs. In these sacs, white
blood cells called macrophages ingest the inhaled TB organism. Some of
the organisms are killed immediately, while others remain and multiply
within the macrophages. If the organism breaks out of the sacs, TB can
become active disease. This spreading sometimes results in
life-threatening meningitis and other problems.
NIAID launched the first large U.S. study to assess TB treatment
strategies for people coinfected with HIV and TB. The study is aimed
at finding state-of-the-art treatment. NIAID is the lead institute for
TB research at the National Institutes of Health, supporting more than
50 research projects related to TB.
Other OIs
NIAID-supported scientists also study other OIs including fungal
infections, herpes simplex virus infections, toxoplasmosis and
cryptosporidium infections.
 
bedfellow.mit.edu
faqserv
Archive-name: aids-faq/part4
Section 4. Treatment options.
Q4.1 General treatment information.
Q4.2 What about "alternative" treatments for HIV/AIDS
Q4.2.2 OZONE
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Question 4.1. General treatment information. 
[This article was published in AIDSFILE, 1993 Sept, Vol. 7, No. 3,
p. 1-3. (Copyright 1993 The Regents of the University of
California). The Regents grant permission for material in AIDSFILE to
be reprinted for use by nonprofit educational institutions for
scholarly or instructional purposes only, provided that (1) the author
and AIDSFILE are identified; (2) proper notice of the copyright
appears on each copy; (3) copies are distributed at or below cost.]
Review of Clinical Guidelines - Antiretroviral Therapy 
Paul A. Volberding, MD
Introduction
A number of new observations have been made recently concerning
antiretroviral therapy for HIV infection. Although new data is always
welcome, lately it seems to cause as much confusion as
clarification. Caregivers for patients with HIV disease continue to
recognize the established benefits of antiretroviral therapy, but new
uncertainties have been introduced. These uncertainties mean that we
must consider the new information in order to make the best use of
available treatments at the same time that we appreciate their
limitations. Those who care for patients with HIV disease also
anticipate the introduction of new classes of drugs, and we are
beginning to determine how we might use these additional agents in our
patient care.
Review of Clinical Guidelines
Antiretroviral therapy clearly has shown activity in delaying the
progression and death of patients with HIV infection, especially when
therapy has been tested in patients with more advanced disease. But
even in asymptomatic HIV infection there is a general agreement of at
least a transient clinical benefit from the use of nucleoside analog
therapy. It is clear also that antiretroviral therapy improves various
laboratory markers of the disease, including immunologic and virologic
disease markers, such as CD4 cell counts and HIV p24 antigen
levels. Further evidence of the clinical activity of these drugs comes
from trials showing a second period of benefit when therapy is changed
to a non-cross-resistant agent, for example, switching from zidovudine
to ddI. In addition, we are encouraged by symptomatic improvement in
patients with advanced disease who are started on antiretroviral
drugs. Also, many retrospective epidemiology studies continue to show
a survival advantage in patients taking these drugs. Despite
continuing agreement on some of the benefits of antiretroviral
therapy, we also face growing uncertainties. Recent studies have shown
no survival advantage when antiretroviral drugs are used in
asymptomatic HIV infection, and any benefit in slowing clinical
progression seems to disappear when zidovudine monotherapy, at least,
is given for a prolonged period. Questions continue as well about the
degree of benefit of antiretroviral therapy for patients with advanced
HIV disease. Early clinical trials of zidovudine, for example, were
done before the routine used of PCP prophylaxis, which, by itself,
delays progression to that common indicator of AIDS. Questions about
the current status of antiretroviral therapy include: Which drug or
combination is superior as initial therapy? When should this initial
therapy begin? What is the duration of the benefit from initial
therapy? How long should it be continued before other drugs or
combinations are initiated? Finally it is important to consider: Which
drugs should be used following initial therapy? What might we
anticipate in the future from drugs in current clinical development?
Beginning Therapy -- What and When
Probably the easiest question at the moment in the field of HIV
therapy is which drug to use to begin treatment. Data from ACTG 116A
make it clear that zidovudine is superior to ddI as a monotherapy in
previously untreated patients, and data from other studies show the
superiority of zidovudine over ddC. An independent "State of the Art
Panel" recently convened by the National Institute of Allergy and
Infectious Diseases (NIAID) and chaired by Merle Sande, MD, UCSF chief
of the medical service at San Francisco General Hospital, found an
easy consensus that zidovudine monotherapy is the initial therapy of
choice. Even here, however, other opinions may be heard, especially
concerning the potential for initial use of combinations of nucleoside
analogs. For example, the recent ACTG 155 trial in much more advanced
disease tended to show a superiority of the combination of zidovudine
and ddC, which was limited to patients with the highest CD4 cells
(between 150 and 300). A large study, ACTG 175, is comparing initial
combination with monotherapy, but the results from this trial are not
anticipated before the end of 1995. In the meantime, combinations
including zidovudine with ddI or zidovudine with ddC as initial
therapy remain of interest. When best to initiate antiretroviral
therapy is probably the most controversial question in the field of
HIV management. Extended data from ACTG 019 demonstrate durable
clinical progression benefit with the use of 500 mg of zidovudine
daily in patients with asymptomatic HIV infection and with CD4 cell
counts between 300 and 500, but these data are in apparent conflict
with those from the recently completed Concorde Study. Concorde,
enrolling more than 1700 patients with any level of CD4 count,
compared the initial use of one gram of zidovudine daily with the same
therapy deferred until after the person developed AIDS or ARC. After a
median treatment duration of three years, and despite a clear and
sustained CD4 improvement with the immediate use of zidovudine, there
was no apparent benefit in the immediate treatment group either in
clinical progression or survival. When the investigators analyzed a
subset of the overall group with CD4 counts below 500 cells and after
one year of therapy, a benefit similar to that seen in ACTG 019 was
observed. Although Concorde was a powerful study, given the size and
duration of follow-up, concerns have been raised that the dosage at
one gram was excessively high and that the large number of patients
allowed to begin therapy before they became symptomatic complicates
the analysis. Also adding to the confusion are the recently published
results of the European-Australian cooperative Group trial, which
tended to find a clinical benefit with the use of zidovudine in
patients with CD4 counts up to 750 cells. The State of the Art Panel
recommended two broad options after considering the available
data--initiating therapy in asymptomatic individuals with CD4 counts
under 500 cells, or delaying this therapy until symptomatic HIV
disease intervened. Another option favored by many clinicians is to
follow patients, delaying therapy until evidence of more rapid disease
progression becomes apparent as manifested by rapid declines in CD4
count or by a rise in p24 antigen or, especially, a rise in beta-2
microglobulin. At any rate, the clinician must discuss the various
options with each patient, individualizing this decision according to
the clinical and laboratory status of the patient and according to the
patient's own desires.
Duration of Therapy
A second difficult question in the field of HIV management is how long
to continue initial zidovudine. Again, the ACTG 019 experience would
suggest that zidovudine monotherapy has a prolonged period of benefit,
especially in patients with higher CD4 cell counts (300-500) when
therapy is begun. On the other hand, ACTG 116A seemed to indicate that
the initial superiority of zidovudine was lost after as little as two
to four months of treatment with this drug prior to treatment with
didanosine. Here again, the State of the Art panel could find little
room for consensus. When therapy is begun in individuals with CD4
counts above 300, the panel suggested that it should be continued
until the CD4 cell count fell below 300. When zidovudine monotherapy
is begun in patients with CD4 counts under 300, the additional option
of switching to ddI monotherapy after a fixed interval was raised, but
again this interval was not defined. Once zidovudine monotherapy has
been used, and when it is no longer felt to be effective for an
individual, secondary therapy must be initiated. The choice of this
therapy, however, is also uncertain. In moderate disease, with CD4
cell counts below 300, switching to ddI was superior to continuing
with zidovudine in ACTG trials 116a and 116b/117, while switching to
ddC was not of benefit in ACTG 155. On the other hand, from data
gathered in CPCRA Trial 002, in patients with more advanced disease,
ddI and ddC were equivalent in secondary treatment of patients
previously treated with zidovudine who had progressed despite taking
that drug or who were intolerant of zidovudine toxicity. In fact, ddC
had a slight but significant superiority compared to ddI in terms of
survival in this trial. It was hoped that combination therapy
following zidovudine would be beneficial but questions have been
raised following the results of ACTG 155. In this study, patients
previously treated with zidovudine with CD4 cells below 300 were
randomized to stay on zidovudine, start ddC monotherapy, or begin
zidovudine and ddC combination therapy. Overall, there was no
difference in clinical progression or survival among the three study
arms. When the baseline CD4 counts are examined, however, it was found
that combination therapy was superior in patients with higher CD4 cell
counts, especially between 150 and 300. Therefore, it might seem
advisable not to delay the introduction of combination therapy until
patients have very advanced disease but rather to use such therapy
earlier in the disease course. Whether zidovudine and ddI would be as
good as zidovudine and ddC has not been investigated.
Newer Classes of Drugs
Along with new data on existing therapies, more information is
available now on newer classes of drugs. These include nucleoside
analogs, non-nucleoside reverse transcriptase inhibitors, protease
inhibitors, and the tat inhibitor.
Nucleoside Analogs. New nucleoside analogs in clinical investigation
include d4T (stavudine) and 3TC. d4T has been much more extensively
studied and appears effective in raising CD4 count and lowering HIV
p24 antigen in a number of Phase 1 trials. It appears safe. Although
cases of pancreatitis have been reported, they seem to be extremely
rare. Neuropathy is the main toxicity but, again, it appears to be
somewhat less than with ddI or ddC. d4T may not be suitable for
combination with zidovudine as the two drugs have a negative
interaction limiting their activation within the cell. On the other
hand, d4T is a well-tolerated drug and may prove to be an alternative
to one or more of the existing nucleosides. 3TC also appear safe and
may be able to help restore sensitivity to zidovudine when the
patient's HIV has become resistant.
Reverse Transcriptase Inhibitors. The non-nucleoside reverse
transcriptase inhibitors, including nevirapine and the Merck "L" drug,
were recently thought to have limited value because they induce
high-level drug resistance so rapidly. At the Berlin conference,
however, one report showed that by increasing the dosage of nevirapine
to 400 mg daily, a dose well above the level of resistance, prolonged
benefit might be achieved. Also, it was shown that combining
zidovudine with nevirapine delays the onset of nevirapine
resistance. Thus, these drugs may still find a place in clinical
medicine. At the same time, convergent therapy, using three drugs
together, was disappointing because of simultaneous resistance to
zidovudine, ddI and non-nucleoside reverse transcriptase inhibitors.
Protease Inhibitors. Protease inhibitors seem to be gaining some
ground. In Phase 1 trials, several of these compounds have evident
antiretroviral activity, which was reflected in decreasing HIV p24 and
increasing CD4 cell counts. Clinical benefits have not been
established nor has the activity of these drugs used in combination
with zidovudine been described. Because several structurally different
protease inhibitors are being developed by different drug companies,
it is hoped that at least one of these compounds will become more
widely available soon for clinical use. Tat. While the protease
inhibitors appear encouraging, tat inhibitors appear to be clinically
inactive. In Phase 1 trials of the Hoffman LaRoche tat inhibitor,
little or no antiretroviral activity was seen and it is probably that
this class of drugs will not be developed further.
Summary
Given this complex and seemingly confusing information, what
recommendations can be given to the clinician? Most important is to
individualize the decision-making and to consider the desires of the
patient even more than previously. Some patients gravitate easily to
more aggressive therapy, while others prefer a more conservative
therapeutic approach. With the former, initiating therapy at or even
above 500 CD4 counts, perhaps even with a combination of zidovudine
and ddI, may be considered. For more conservative patients, however,
following the recommendations of the Concorde study may in order. In
other words, defer the initiation of zidovudine monotherapy until the
onset of clinical symptoms. Once the choice of initial therapy has
been made, all other recommendations must also be individualized. No
firm data are available to guide the decision about how long to
continue a therapy or even about what to use next. Most of these
options have not been compared directly in clinical trials. It would
seem advisable to continue therapy longer in patients with relatively
earlier disease when therapy is initiated. On the other hand, if
patients have more advanced disease, for example, are symptomatic or
have CD4 cell counts below 300 when therapy is begun, then a more
rapid alteration of therapy to a non-cross-resistant drug or
combination should be considered. The goal in each patient is to
continue effective antiretroviral therapy for as long as possible,
discontinuing the therapy if further benefits appear
impossible. Although the results of recent clinical trials are
disappointing in some respects, it nevertheless is important to have
these data. Only then can we adjust our expectations and our patients'
expectations of antiretroviral treatment and learn how to make the
best use of the drugs that we have available. Recognizing the
increasing need for the development of new classes of more effective
drugs in combinations, we must still seek to maintain the optimism
that enables progress in our patients' care.
Dr. Volberding is a UC San Francisco professor of medicine and
Director, UCSF AIDS Program at San Francisco General Hospital.
References: ZDV and The AIDS Clinical Trials Group (1989-93): 
Aweeka FT. Gambertoglio JG. et al. Pharmacokinetics of concomitantly
administered foscarnet and zidovudine for treatment of human
immunodeficiency virus infection (AIDS Clinical Trials Group protocol
053). Antimicrobial Agents & Chemotherapy. 36(8):1773-8, 1992 Aug.
Fischl MA. Richman DD. et al. The safety and efficacy of zidovudine
(AZT) in the treatment of subjects with mildly symptomatic human
immunodeficiency virus type 1 (HIV) infection. A double-blind,
placebo-controlled trial. The AIDS Clinical Trials Group [see
comments]. Annals of Internal Medicine. 112(10):727-37, 1990 May
15. [Editor's Note: This article reports the results of ACTG 106.]
Fischl MA. Parker CB. et al. A randomized controlled trial of a
reduced daily dose of zidovudine in patients with the acquired
immunodeficiency syndrome. The AIDS Clinical Trials Group. New England
Journal of Medicine. 323(15): 1009-14, 1990 Oct 11.
Gelber RD. Lenderking WR. et al. Quality-of-life evaluation in a
clinical trial of zidovudine therapy in patients with mildly
symptomatic HIV infection. The AIDS Clinical Trials Group. Annals of
Internal Medicine. 116(12 Pt 1):961-6, 1992 Jun 15.
Hochster H. Dieterich D. et al. Toxicity of combined ganciclovir and
zidovudine for cytomegalovirus disease associated with AIDS. An AIDS
Clinical Trials Group Study. Annals of Internal
Medicine. 113(2):111-7, 1990 Jul 15.
Kahn JO. Lagakos SW. et al. A controlled trial comparing continued
zidovudine with didanosine in human immunodeficiency virus
infection. The NIAID AIDS Clinical Trials Group [see comments]. New
England Journal of Medicine. 327(9):581-7, 1992 Aug 27.
Koch MA. Volberding PA. et al. Toxic effects of zidovudine in
asymptomatic human immunodeficiency virus-infected individuals with
CD4+ cell counts of 0.50 x 10(9)/L or less. Detailed and updated
results from protocol 019 of the AIDS Clinical Trials Group. Archives
of Internal Medicine. 152(11):2286-92, 1992 Nov.
Krogstad DJ. Eveland MR. et al. Drug level monitoring in a
double-blind multicenter trial: false-positive zidovudine measurements
in AIDS clinical trials group protocol 019. Antimicrobial Agents &
Chemotherapy. 35(6): 1160-4, 1991 Jun.
Meng TC. Fischl MA. Richman DD. AIDS Clinical Trials Group: phase I/II
study of combination 2',3'-dideoxycytidine and zidovudine in patients
with acquired immunodeficiency syndrome (AIDS) and advanced
AIDS-related complex. American Journal of Medicine. 88(5B):27S-30S,
1990 May 21.
Sidtis JJ. Gatsonis C. et al. Zidovudine treatment of the AIDS
dementia complex: results of a placebo-controlled trial. AIDS Clinical
Trials Group. Annals of Neurology. 33(4):343-9, 1993 Apr.
Sperling RS. Stratton P. Treatment options for human immunodeficiency
virus-infected pregnant women. Obstetric- Gynecologic Working Group of
the AIDS Clinical Trials Group of the National Institute of Allergy
and Infectious Diseases. Obstetrics & Gynecology. 79(3):443-8, 1992
Mar.
Volberding PA. Lagakos SW. et al. Zidovudine in asymptomatic human
immunodeficiency virus infection. A controlled trial in persons with
fewer than 500 CD4-positive cells per cubic millimeter. The AIDS
Clinical Trials Group of the National Institute of Allergy and
Infectious Diseases [see comments]. New England Journal of
Medicine. 322(14):941-9, 1990 Apr 5. [Editor's Note: This article
reports the results of ACTG 109.]
See also:
Aboulker JP. Swart AM. Preliminary analysis of the Concorde
trial. Concorde Coordinating Committee [letter]. Lancet. 1993 Apr
3;341(8849):889-90. Comment in: Lancet 1993 Apr 17;341(8851): 1022-3;
Lancet 1993 Apr 17;341(8851):1023; Lancet 1993 May 15; 341(8855):1276;
Lancet 1993 May 15;341 (8855):1276-7; and Lancet 1993 May
15;341(8855):1277.
Cooper DA. Gatell M. et al. Zidovudine in persons with asymptomatic
HIV infection and CD4+ cell counts greater than 400 per cubic

 
millimeter. New England Journal of Medicine. 329(5): 297-303, 1993 Jul
29.
Hamilton JD. Hartigan PM. et al. A controlled trial of early versus
late treatment with zidovudine in symptomatic human immunodeficiency
virus infection. Results of the Veterans Affairs Cooperative
Study. New England Journal of Medicine. 326(7):437- 43, 1992 Feb 13.
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Question 4.2. What about "alternative" treatments for HIV/AIDS?
DNCB FACT SHEET
Billi Goldberg
PURPOSE DNCB (1-chloro-2,4-dinitrobenzene or C(6)H(3)ClN(2)O(4)) is a
potent topical contact sensitizer. Studies have shown that, when used
regularly, DNCB will boost the cellular immune response resulting in
increased numbers of cytotoxic T lymphocytes (CTL) and natural killer
(NK) cells .
REFERENCES
Caulfield CR, Goldberg B. 1993. The Anarchist AIDS Medical Formulary. 
Berkeley: North Atlantic Books.
Gilden D. DNCB Treatment Today. AIDS Treatment News #182
1993:3-7. Hosein S. Immunomodulators. Treatment Update #43
1993;4(3):4-6. Mills LB. Stimulation of T-cellular immunity by
cutaneous application of dinitrochlorobenzene. J Am Acad Dermatol
1986;14(6):1089-1090. Stricker RB,
Elswood BF, Abrams DI. Dendritic cells and dinitrochlorobenzene
(DNCB): a new treatment approach to AIDS. Immunol Lett
1991;29:191-196.
Stricker RB, Elswood BF. Topical dinitrochlorobenzene in HIV disease.
J Am Acad Dermatol 1993;28(5):796-797.
Stricker RB et al. Pilot study of topical dinitrochlorobenzene (DNCB)
in human immunodeficiency virus infection. Immunol Lett 1993;36:1-6.
DNCB TREATMENT INSTRUCTIONS (Rev. 12/1/93) 
by Billi Goldberg
PURPOSE
DNCB is a potent topical contact sensitizer. Studies have shown that,
when used regularly, DNCB will boost the immune response resulting in
increased numbers of cytotoxic T-lymphocytes (CTL) and natural killer
(NK) cells. Articles and studies in The Anarchist AIDS Medical
Formulary,(1) AIDS Treatment News,(2) Treatment Update,(3) and
scientific journals(4) provide additional information on DNCB that may
be helpful.
ACTION
The mechanism of immunological action of DNCB is due to Delayed Type
Hypersensitivity (DTH) which involves the initiation of the Th1 or the
cell mediated immune response (CMI). The humoral or antibody system is
not directly involved in DTH. The primary infections in AIDS are of an
intracellular nature which can only be controlled by the cell mediated
immune response; the antibody system is ineffective in controlling
these opportunistic infections.
DRUGS AND IMMUNOSUPPRESSION
Antibiotics, nucleosides analogues and other drug treatments can
interfere with the cell-mediated immune response thus negating the
systemic action initiated by DNCB. Drugs required for the treatment of
infections must be continued until the infections are cleared or
controlled. Individuals with AIDS must use PCP prophylaxis; use of
other prophylaxis drugs is of questionable value (see Hoover DR et
al. 1993. Clinical manifestations of AIDS in the era of pneumocystis
prophylaxis. NEJM 329:1922-1926) especially in DNCB users. It is
extremely important to avoid all forms of ultraviolet radiation such
as sunlight (wear a hat and use sunblockers) and tanning salons. UV
light not only suppresses cellular immunity but can increase HIV
replication.
VITAMINS, MINERALS, AND IMMUNITY
Individuals with compromised immune systems fighting chronic
infections require supplements of basic vitamins and
minerals. Suggested supplements are Multi-mineral tab, Multi-vitamin
tab, Beta Carotene (25,000 I.U.), B-Complex, Vitamin C (1000 mg),
Vitamin E (400 I.U.), Odorless Garlic (270 mg), and Zinc (30
mg). These supplements should be taken only once a day; overuse of
supplements can be detrimental. Zinc can be toxic when over 100 mg per
day is used. There are studies that show that the optimal amount of
Vitamin C is one to three grams per day with amounts over that causing
interference with the immune response.(1) N-acetyl-L-cysteine (NAC)
and other anti-oxidants such as curcumin, interfere with lymphocyte
proliferation and immunological functions (i.e., IL-2 and IL-2R,
cellular adhesion molecules, lymphotoxin, and production of colony
stimulating factors) in infected and uninfected cells by inhibiting
Nuclear Factor-kappa B (NF-kB).(2)
Most herbs are polysaccharides that initiate a systemic antibody
response or Th2. Studies have shown that activation of this Th2
response will shutdown the cell-mediated immune response (Th1)
required to control the infections involved in AIDS. Herbs, therefore,
should not be used indiscriminately or on a regular basis unless it
can be shown that they initiate cellular immunity or delayed-type
hypersensitivity. If the immunological action of any herb is not
known, it should not be used.
INFORMATION AND AVAILABILITY
DNCB information and kits can be obtained from DNCB Now!, 2261 Market
Street, #499, San Francisco, CA 94114 or call (415) 954-8896. Starter
kits are available for a suggested donation of $25.00 which includes
postage and treatment instructions. Single vials of DNCB require a
$6.00 suggested donation which includes postage. For an additional
donation of $5.00, an information packet of literature on DNCB and
cell-mediated immunity will be sent.
DNCB kits, individual vials, and information packets will be supplied
free of charge to those unable to afford them.
INITIAL APPLICATION (if previous DNCB user, start with 0.2% solution) 
1. Using a Q-tip, apply the 10% SOLUTION to the inner LEFT forearm in
a 2" x 2"-square. (Do not use with thymic peptides or cytokines.)
2. After a few minutes, apply the Q-tip with the 10% SOLUTION a second
time on the same 2" x 2"-square location.
3. Let dry for a few minutes and cover with a large adhesive bandage,
making certain that the adhesive does not touch the application
site. Do not remove bandage or wash the application site for at least
ten hours.
4. Do not, under any conditions, apply DNCB again until two weeks has
elapsed even if there is no reaction at the application site.
AFTER TWO WEEKS
1. Using a Q-tip, apply the 2% SOLUTION to the inner RIGHT forearm in
a 2" x 2"-square.
2. After a few minutes, apply the Q-tip with the 2% SOLUTION a second
time on the same 2" x 2"-square location.
3. Let dry for a few minutes and cover with a large adhesive bandage,
making certain that the adhesive does not touch the application
site. Do not remove bandage or wash the application site for at least
ten hours.
4. In less than seventy-two hours, the skin at the application site
should be bright red, itchy, and slightly raised. If this happens,
start weekly applications as per the next section.
5. If there is no reaction, continue with weekly applications of the
10% SOLUTION (alternating arms each week) until there is an
appropriate response at the application site, then start weekly
applications.
AFTER ONE WEEK AND EACH WEEK THEREAFTER
1. Repeat numbers 1 to 4 above using the 2% SOLUTION, using a
different application site for each weekly application. Stinging at
the site within one hour after application is a sign of an appropriate
dose that will result in a good reaction, but this does not occur in
all individuals.
2. It is advisable to move the application site each month between the
inner arms, inner thighs, and trunk (stomach, rib cage, and chest). It
is especially important to apply DNCB on the upper and lower trunk
areas more often that other sites, since the lungs and
gastrointestinal tract are primary sources of opportunistic
infections. When applying to the trunk area, use a 3" x 3"-
square. Every six weeks or more often if there are infections, it is
advisable to use extra DNCB by applying the Q-tip one additional time
to the trunk area application site. To initate an increased immune
response, DNCB can be applied to more than one site during the weekly
application (such as two trunk sites, arm and trunk, thigh and trunk,
neck and trunk, etc.). It can also be applied at or near swollen lymph
nodes.
3. If the application site is not bright red and slightly raised in
twenty-four to seventy-two hours, the solution is too weak. For the
next application, either increase the solution strength or apply one
extra application with the Q-tip.
4. If the skin at the application site has raised blisters or open
sores, decrease the strength of the application by either applying
only once with the Q-tip, or using a weaker solution, such as 0.2% or
0.02%.
5. If the present application site becomes bright red in twenty-four
to seventy-two hours or any previous application site changes color,
you are considered sensitized and need only to continue applications
on a weekly basis.
6. Do not use DNCB more than once a week, no matter what conditions or
circumstances occur.
If severe contact dermatitis or itching occurs, apply calamine lotion,
aloe vera, cocoa butter, or Bactine directly to the rash. The use of
cortisone or hydrocortisone creams is not recommended, as they have
systemic immunosuppressing effects. An overly strong reaction
resulting in dermatitis is a sign of an excellent immune response and
is positive not negative. The dermatitis will heal in time and will
not leave a scar.
DNCB can be applied to Kaposi's sarcoma lesions at the same time as
the weekly application.
DNCB must be used weekly to be effective and to initiate appropriate
systemic immune responses.
REFERENCES
(1) Caulfield CR, Goldberg B. 1993. The Anarchist AIDS Medical 
Formulary. Berkeley, CA: North Atlantic Books. 
(2) Gilden D. 1993. DNCB Treatment Today. AIDS Treatment News 182:3-7. 
(3) Hosein S. 1993. Immunomodulators. Treatment Update 43 :4(3):4-6. 
(4) Mills LB. 1986. Stimulation of T-cellular immunity by cutaneous
application of dinitrochlorobenzene. J Amer Acad Dermatol
14:1089-1090; Stricker RB, Elswood BF, Abrams DI. 1991. Dendritic
cells and dinitrochlorobenzene (DNCB): a new treatment approach to
AIDS. Immunol Lett 29:191-196; Stricker RB, Zhu YS, Elswood BF. et
al. 1993. Pilot study of topical dinitrochlorobenzene (DNCB) in human
immunodeficiency virus infection. Immunol Lett 36:1-6; and Stricker
RB, Elswood BF. 1993. Topical dinitrochlorobenzene in HIV disease. J
Am Acad Dermatol 28:796-797.
(5) Hoover DR, Saah AF, Bacellar H., et al. 1993. Clinical
manifestations of AIDS in the era of pneumocytstis prophylaxis. NEJM
329:1922-1926; and Osmond D, Charlebois E, Lang W. et
al. 1994. Changes in AIDS survival time in two San Francisco cohorts
of homosexual men, 1983 to 1993. JAMA 271:1083-1087.
 
bedfellow.mit.edu
faqserv
Archive-name: aids-faq/part5
Sci.Med.AIDS FAQ Part 5/10
(6) Munster AM, Loadholdt CB, Leary AG, Barnes MA. 1977. The effect of
antibiotics on cell-mediated immunity. Surgery 81:692-695; Anderson R,
Oosthuizen R, Maritz R, et al. 1980. The effects of increasing weekly
doses of ascorbate on certain cellular and humoral immune functions in
normal volunteers. Am J Clin Nutr 33:71-76; and Ramirez I, Richie E,
Wang YM, van Eys J. 1980. Effect of ascorbic acid in vitro on
lymphocyte reactivity to mitogens. J Nutr 110:2207-2215.
(7) Aillet F, Gougerot-Pocidalo MA, Virelizier JL, Israel N. 1994.
Appraisal of potential therapeutic index of antioxidants on the basis
of their in vitro effects of HIV replication in monocytes and
interleukin 2-induced lymphocyte proliferation. AIDS Res Hum Retro
10(4):405-411; Staal FJT, Roederer M, Raju PA, et
al. 1993. Antioxidants inhibit stimulation of HIV transcription. AIDS
Res Hum Retro 9;299-306; Nabel GJ. 1993. The role of cellular
transcription factors in the regulation of human immunodeficiency
virus gene expression. In: Cullen BR, ed. 1993. Human Retroviruses,
New York: IRL Press, 61; Go C, Miller J. 1992. Differential induction
of transcription factors that regulate the interleukin 2 gene during
anergy induction and restimulation. J Exp Med 175:1327-1336; and
Baeuerle PA, Henkel T. 1994. Function and activiation of NF-kB in the
immune system. Ann Rev Immunol 12:141-179.
HOW DNCB WORKS
by Billi Goldberg
DNCB is applied weekly on the skin at various sites which initiates
contact sensitivity. The Langerhans cells in the skin at the
application site pick up the DNCB antigen, migrate from the skin,
change into veiled dendritic cells, continue their migration to the
nearest lymph node, change into interdigitating dendritic cells. Once
in the lymph nodes, they present the DNCB antigen to CD4 helper cells,
thus initiating a Th1 response or cell mediated immune response or
Type IV Delayed Type Hypersensitivity response (they can all be
considered the same thing).
The CD4 helper cells then proliferate forming more helper CD4 cells
which then circulate and activate effector cells (primarily
macrophages) to rid the sysem of the DNCB antigen. At the same time
CD4 memory cells are produced adding to the CD4 memory pool for the
DNCB antigen (hapten). Each time DNCB is applied, these memory cells
are activated thus initiating a systemic Th1 response to DNCB. The
longer DNCB is used, the response becomes faster, more potent, and
more effective because there are more circulating DNCB CD4 memory
cells to initiate the immune response.
The result of this specific systemic Th1 response to DNCB is the
non-specific activation of macrophages. Many of these macrophages are
infected with HIV and other intracellular pathogens that cause AIDS
but are unable to present these pathogen antigens due to
infection. The microbial pathogens of AIDS are of the facultative or
obligate intracellular type. The activation of these macrophages
result in phagocytosis of the pathogens which are then presented by
macrophages to CD4 and CD8 memory cells specific for the presented
pathogen. The activated helper and cytotoxic T lymphocytes initiate
specific systemic responses to destroy the presented pathogens. This
results in more activated macrophages, more pathogens presented, more
T memory cells activated, more infected cells destroyed, ad infinitum.
Since pathogens can be presented on both the Class I and Class II MHC
(major histocompatibility complex) of the antigen presenting cells,
cytotoxic T lymphocytes, natural killer cells, neutrophils, and killer
macrophages are also activated to accomplish the destruction. There is
also an excellent probability that dendritic cells (the most potent
antigen presenting cells in the immune system) are also activated in
the lymphoid tissues to present intracellular and extracellular
antigens thereby activating even more T lymphocyte memory, helper, and
effector cells thus increasing the Th1 response against the pathogens
involved in AIDS.
It is extremely important to remember that the antibody/Th2/humoral
response is not directly involved in fighting the infections of
AIDS. The denial of this fact is the primary reason that there has
been no progress in realistic treatments for AIDS. In point of fact,
there is research to show that activating the antibody or Th2 response
may suppress the Th1 response. This would allow the intracellular
pathogens to be uncontrolled since their control depends on the Th1 or
cell-mediated immune response. There is also research to show that
immune complexes (HIV + antibody) can be internalized through the
antibody receptor (Fc) of monocytes and macrophages thus spreading and
increasing HIV infection of these cells.
Delayed Type Hypersensitivity is an extremely effective and potent
immune modulator that forces priming and activation of macrophages
that are non-responsive due to infection. DNCB, then, acts like an
adjuvant or biological response modifier. These phenomena have been
researched in-depth and are considered a factual part of scientific
knowledge. On page 1292 of the recent edition of The Merck Manual is
the following: "Skin malignancies have regressed after induction of
delayed hypersensitivity to dinitrochlorobenzene (DNCB) and subsequent
direct application of DNCB to the tumor."
Below are the scientific explanations of what happens. This process
has been an integral part of the scientific literature for many
years. Meltzer and Nacy have explained it brilliantly. DNCB is not
new; it has been used for decades. But, since the cost of DNCB is
minimal and there is no profit to be made, it has been ignored.
The following is from Chapter 28 titled "Delayed-Type Hypersensitivity
and the Induction of Activated, Cytotoxic Macrophages" by Monte
S. Meltzer and Carol A. Nacy in Fundamental Immunology (1989), second
edition, published by Raven Press.
Page 775: "Contact sensitivity is a variant form of DTH in which
certain reactive chemicals (usually small molecular weight compounds
or metal ions that can diffuse into the epidermis) covalently bind to
skin proteins and create neoantigens. Such neoantigens prime or
sensitize the exposed animal to a second cutaneous application of the
reactive chemical (contactant). A portion of the neoantigen is host
derived. Thus an animal exposed to trinitrochlorobenzene (TNCB or
picryl chloride) solution epicutaneously responds to a repeated
cutaneous exposure with a vigorous DTH response. Intradermal injection
of TNCB covalently bound to an irrelevant protein such as albumin
fails to elicit this response. Neoantigens induced in the epidermis
are taken up by Langerhans cells. These highly efficient,
antigen-presenting dendritic cells migrate into the dermis, enter
lymphatics, and travel to the cortical region of the draining lymph
node where they present the antigen to CD4+ T cells. Application of
normally sensitizing chemicals to skin devoid of Langerhans cells
(skin treated with corticosteroids, UVB light, or cellophane adhesive
tape) does not induce contact sensitivity and may produce specific
immunologic tolerance to the contactant."
Pages 766-767: "Coincident with the development of DTH during
infection is a widespread activation of free and fixed mononuclear
phagocytes throughout the body. Tissue macrophages develop profound
alterations in morphology, cell proliferation, phagocytosis, and the
capacity to destroy intracellular and extracellular
microorganisms. Each of these changes is dependent on interactions
with sensitized lymphocytes. These systemic changes in the
antimicrobial activity of immunologically activated macrophages may
explain observations made as early as 1936 that animals responding to
reinfection with one microorganism (bacterium A) [ed. DNCB] acquire
the ability to resist nonspecifically infection with antigenically
unrelated pathogens (bacterium B, C, or D). Unlike the long-lived,
antigen specific, DTH response, this nonspecific element of acquired
resistance is short lived and can only be reexpressed by further
exposure to the original microbe (bacterium A) [ed. DNCB].
"Thus the DTH response to foreign antigens induces a series of immune
reactions whose ultimate purpose is the short-term accumulation of
nonspecifically cytotoxic, macrophage effector cells. Mononuclear
phagocytes rapidly and preferentially accumulate at sites of
infection. These inflammatory cells co-locate with antigen-reactive,
sensitized T cells and undergo dramatic changes in their functional
state. The activated macrophages that result are pleuripotent
cytotoxic effector cells which destroy viruses, bacteria, fungi,
single and multicellular parasites, allografts, and tumor cells. This
complex network of cell-mediated reactions is controlled by an even
more complex interaction of various cytokines, those released by the T
cell, the macrophage, and even the target cell. DTH reactions are not
self-destructive overreactions to foreign antigens, but rather tightly
controlled body defenses against tissue allografts, infection, and
neoplastic change."
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Question 4.2.2 OZONE
OZONE / OXYGEN
Prepared by Martin A. Majchrowicz
Spring 1994
Ozone, the fusion of three oxygen molecules to create O3, is an
incredibly unstable molecule that breaks down very easily into a
stable O2 molecule and an O1 charged molecule. In nature, oxygen more
frequently occurs in the O2 state which is far more stable. Ozone is
more commonly known as the layer of the atmosphere which protects
plants and animals from the damaging effects of ultraviolet radiation
from the sun. It is also known as a pollutant that builds up in the
lower part of the atmosphere on warm days as a result of chemical
reactions, driven by the heat of the sun, when nitrogen dioxide and
hydrocarbons from vehicle exhaust react with oxygen. In this form,
ozone can cause irritation and sometimes damage to the mucosal
membrane of the respiratory tract and the eyes.
Ozone can also be useful in the treatment of water. Known as a strong
oxidant, ozone can be used in the water purification process as a
method of killing bacteria and other microorganisms in the water
supply.
Due to its antibacterial, antifungal, and antiviral properties, some
believe that ozone can be used as a method of treating a variety of
diseases including HIV/AIDS. This practice has become quite
controversial. Most researchers believe ozone has no medical
use. However, ozone proponents claim that the Western medical
"establishment" wants to "crush" this cheap and effective method of
treating HIV/AIDS, cancer, and a variety of other acute and chronic
fatal diseases.
There arc several different forms of ozone therapy which are sometimes
referred to as superoxidation or hyperoxidation. Ozone therapy can be
administered in three different ways. One method is removing blood
from the patient, bubbling ozone through the blood, and infusing the
blood back into the patient. Another form is the rectal ozone machine
which generates ozone gas and blows it directly into the patients
rectum. The last and potentially most dangerous form of ozone therapy
is intravenous or intramuscular injections of ozone gas. This
literally entails injecting ozone gas directly into the vein or muscle
of the patient. Hydrogen peroxide injections are sometimes used as
part of, or independent of, ozone therapy. Those who recommend
hydrogen peroxide also recommend peroxide also recommend drinking and
bathing in it. The hydrogen peroxide used for such therapy is a
different strength than what can be purchased in a drug store.
MECHANISM OF ACTION As there are many different forms of ozone
therapy, there are as many different theories as to how ozone therapy
can be useful. The most simplistic of these theories is that since
disease-causing organisms, including viruses, die in the presence of
high concentrations of oxygen, by increasing the oxygen concentration
in the body with ozone, this will kill HIV and other viruses and
bacteria. This theory is also coupled with the fact that since we
breath oxygen everyday, it is "obviously" safe to be injected or
infused into the body with no toxicity or side effects.
When ozone is created, it quickly degrades from an O3 molecule to an
O2 and an O1 The first theory suggests that the O2 molecule will kill
free viruses, meaning viruses that are not hiding in CD4 cells. Since
there is very little free HIV in the blood, the real problem of HIV
infected cells and their ability to produce more HIV is not solved.
This theory can be taken one step further by claiming that the O1
molecule, an oxidant, is the useful aspect of ozone degradation
reaction, and this is what will kill free viruses as well as "diseased
cells" (cells infected with HIV). The rationale for this theory is
based on the fact that healthy human cells can protect themselves from
the oxidative stress of O1. However, viruses, microbes, and "diseased
cells" lack the ability to protect themselves from oxidants, therefore
they are destroyed by ozone. Healthy cells. those that are not
infected with HIV, will not be damaged by the ozone. As opposed to the
first theory, this second theory suggests that ozone is not only
effective against free virus but also against cells that are already
infected with HIV. However, neither of these theories has been proven
in any laboratory studies.
One laboratory study suggests that ozone may act directly on HIV by
inducing viral particle disruption, reverse transcriptase
inactivation, and/or perturbation of the ability of the virus to bind
to its receptor on target cells.
Bocci, a researcher in Italy, has put forth a very different theory of
how ozone may be effective against certain diseases. Bocci recognizes
that ozone decomposes very rapidly and very little virus is actually
free in the blood. He suggests that the benefit of ozone may be due to
its ability to enhance the functioning of the immune system and induce
the production of certain cytokines such as tumor necrosis factor
(TNF) and interferon (IFN).
STUDIES While laboratory studies that show ozone can kill HIV in vitro
(in the test tube) exists, there is little evidence to suggest that
ozone is an effective anti-HIV/AIDS therapy in humans.
Carpendale reports using ozone to treat diarrhea of unknown origin in
five men with a wide range of CD4 cells. Of the five men, the four
with the highest CD4 counts experienced a decrease in diarrhea. The
one patient with cryptosporidium and a CD4 cell count of 75 did not
respond to ozone and eventually died. The four men who responded had
relatively high CD4 counts (193, 130, 209, & 435) and may have
resolved regardless of therapy. Many times, diarrhea in people with
HIV can spontaneously resolve. Due to the small number of patients and
the nature of their symptoms, it is difficult to conclude that ozone
had a definite effect on their diarrhea.
Carpendale also reports on two asymptomatic patients who used ozone
for five years. One patient who began with 907 CD4 cells showed an
increase of CD4 cells to 1286 at the beginning of the third year and
an increase of the CD4/CD8 ratio. Although the follow-up supposedly
lasted five years, there is no data past this point.
The second patient began with 309 CD4 cells, increased to 831, but
then stabilized between 500-700. After six years, this patient
"suddenly" died of pneumonia and disseminated coccidiomycosis (a
fungal infection).
The CD4 cell trends mentioned in this report are nothing extraordinary
considering the final outcomes. Both patients experienced transient
increases in their CD4 cell counts and moderate increases in their
CD4/CD8 ratios. There was no mention of whether or not other
medications were used. This report does not provide a clear benefit of
ozone therapy.
In addition to these extremely limited studies, there are supposedly
hundreds of cases of people being "cured" with ozone including
complete alleviation of symptoms and becoming HIV negative (using
ELISA, Western Blot, and PCR). None of these reports has ever been
substantiated. Proponents of ozone claim that these reports cannot be
made public due to the fear that those doctors involved will have
their licenses revoked. However, nothing is preventing patients with
HIV/AIDS from coming forward and claiming that they have been "cured".
COMMENT Until recently, it was thought that ozone therapy was at least
a safe alternative, and attempts had not been made to discourage
people from seeking it as an option. However, after two reported cases
of death involved with ozone therapy, we at APLA strongly caution
people about the risks involved with ozone therapy. The three main
issues are safety, price, and effectiveness.
Proponents of ozone repeatedly make accusations that the "medical
establishment" is against ozone because it is an inexpensive approach
and that finding a cure using ozone will threaten pharmaceutical
companies. The average cost of a rectal ozone machine is $5000, while
some "underground" physicians charge as much as $30,000 for IV ozone
treatments. We have known of several people with HIV/AIDS who
purchased ozone machines and reported little to no benefit. One ozone
"doctor" in Mississippi claims to be doing a "super secret" study with
the government. This "doctor" said that "all the patients need to know
is it'll cost them about $1000 a week and they don't have to worry
about anything after that. They have to worry about their board and
room, but that's about all." If it wasn't for the study, this therapy
would cost $4000 a week. When questioned about which governmental
agency was sponsoring the study, he responded, "I'm not at liberty to
say who's doing it." The decision is yours to decide who is really
profiteering.
In an article by Ed McCabe in AIDS Patient Care (December 1992),
McCabe claims that "over 300 AIDS patients" have become HIV negative
through using ozone. In an attempt to verify this information, we
asked McCabe if we could speak with people who have become HIV
negative. We were provided with four names of people, two men who
became HIV PCR negative and two men who became p24 negative (which is
not incredibly significant). The protocol these men received included
hydrogen peroxide baths, chelation ("a method of removing toxins from
the blood"), nutritional supplements, hyperbaric oxygen chambers, and
a variety of other herbs and homeopathic substances. One of the men
who became p24 negative reported feeling better immediately afterwards
but no sustained benefit six months later. The other said he probably
felt better just because it was an opportunity for him to get away
from work and his home for a while. He also reported that the "doctor"

 
in Mississippi who administered the therapy was not a real doctor, and
that after being told he would be treated for free was charged $1000
for lab work.
Of the two men who were reported to become HIV PCR negative, one
reported that he was not PCR negative but feels ozone has been
beneficial in some way. The other man could not be contacted after
repeated phone calls and messages. All three men contacted mentioned
how upset they were that McCabee claims that people are being "cured"
and becoming HIV negative from using ozone therapy. Ed McCabe is a
journalist who lectures around the world promoting ozone therapy
through his books and videos.
Safety remains to be the most important issue. We have been told of
two deaths that were a direct result of intravenous ozone
therapy. These two people were receiving ozone therapy from a
particular "doctor" who practiced in San Francisco and Las Vegas. This
"doctor" is unable to be reached for an interview. One of these cases
is currently under investigation.
To date, there are no studies that can clearly demonstrate how ozone
works. In addition, there are no human studies that have shown that
ozone can be effective. Reports of people becoming HIV negative have
not been confirmed. With reports of two deaths as a result of IV ozone
therapy, the safety, as well as the trust of those who administer and
promote ozone therapy, remains questionable.
REFERENCES 
Bocci, V: Ozonization of blood for the therapy of viral diseases and
immunodeficiencies. A hypothesis. Medical Hypotheses. 39:30-34, 1992.
Carpendale, MT, Freeberg, JK: Ozone inactivates HIV at noncytotoxic
concentrations. Antiviral Research. 16(3): 281-292, 1991.
Carpendale, MT, Freeberg, J, Griffiss, JM: Does ozone alleviate AIDS
diarrhea? Journal of Clinical Gastroenterology. 17(2):142-145, 1993.
Carpendale, MT, Griffiss, J: Is there a role for medical ozone in the
treatment of HIV and associated infection? Proceedings of XI Ozone
World Congress, September 1993.
Fowkes, SW: Oxidative Medicine. Forefront Health Invest
McCabe, E: Ozone therapies for AIDS. AIDS Patient Care. December 1992. 
Wells, KH, Latino, J, Gavalchin, J, et al: Inactivation of human
immunodeficiency virus type 1 by ozone in
vitro. Blood. 78(7):1882-1890, 1991.
 
bedfellow.mit.edu
faqserv
Archive-name: aids-faq/part6
AIDS FAQ Part 6/10
Section 5. Social Services Available
Q5.1 Guide to Social Security Benefits.
Q5.2 What if you can't afford AZT?
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Question 5.1. Guide to Social Security Benefits. 
U.S. Department of Health and Human Services Social Security 
Administration
SSA Publication No. 05-10020
September 1993
A Guide to Social Security and SSI Disability 
Benefits For People With HIV Infection
About This Booklet
Social Security can provide a lifeline of support to people with HIV
infection. That lifeline comes in the form of monthly Social Security
disability benefits and Supplemental Security Income payments,
Medicare and Medicaid coverage, and a variety of other services
available to people who receive disability benefits from Social
Security.
If you are disabled because of HIV infection, this booklet will help
you understand the kinds of disability or Supplemental Security Income
programs.
What's Inside
Part 1 -- Background Information The first section provides some brief
background information about HIV infection and Social Security.
Part 2 -- What Benefits Are You Eligible For? This section explains
the nonmedical rules and eligibility factors for Social Security
Disability Insurance benefits and Supplemental Security Income
Disability payments.
Part 3 -- How Does Social Security Define "Disability?" This section
explains Social Security's definition of "disability" and how it
relates to claimants with HIV infection.
Part 4 -- How Does Social Security Evaluate Your Disability This
section explains how Social Security evaluates disability claims
involving HIV diseases in general. And it includes up-to- date
information about the way we process claims, especially those
involving women and children with HIV infection.
Part 5 -- How Do You File For Disability Benefits? This section
includes information about when and how to apply for disability, what
steps we take to ensure that your claim is processed quickly and
accurately, and most important, what things you can do to help the
process along. Also included is information about situations when we
can presume a person is disabled and make immediate payments.
Part 6 -- Helping You Return To Work This section provides an overview
of special rules designed to help you return to work.
Part 7 -- What you Need To Know About Medicaid And Medicare This
section includes a brief overview of the kinds of benefits available
from the Medicaid and Medicare programs.
For More Information
***************************************************************** 
PART 1 -- BACKGROUND INFORMATION
Acquired immunodeficiency syndrome (AIDS) is characterized by the
inability of the body's natural immunity to fight infection. It is
caused by a retrovirus known as human immunodeficiency virus, or
HIV. Generally speaking, people with HIV infection fall into two broad
categories:
1) those with symptomatic HIV infection, including AIDS; and 2) those
with HIV infection but no symptoms.
Although thousands of people with HIV infection are receiving Social
Security or Supplemental Security Income disability benefits, we
believe there may be others who might be eligible for these
benefits. Social Security is committed to helping all men, women, and
children with HIV infection learn more about the disability programs
we administer. And if you qualify for benefits, we are just as
committed to ensuring that you receive them as soon as possible. You
should also be aware that the Social Security Administrations's
criteria for evaluating HIV infection are not linked to the Centers
for Disease Control's (CDC) definition of AIDS. This is because the
goals of the two agencies are different. CDC defines AIDS primarily
for surveillance purposes, not for the evaluation of disability.
PART 2 -- WHAT BENEFITS ARE YOU ELIGIBLE FOR?
We pay disability benefits under two programs: Social Security
Disability Insurance, sometimes referred to as SSDI, and Supplemental
Security Income, often called SSI. The medical requirements are the
same for both programs, and your disability is determined by the same
process. However, there are major differences in the nonmedical
factors, which are explained in the next two sections.
Social Security Disability Insurance Benefits: The Nonmedical Rules Of
Eligibility
Here are examples of how people qualify for SSDI: 
o Most people qualify for Social Security disability by working,
paying Social Security taxes, and in turn, earning "credits" toward
eventual benefits. The maximum number of credits you can earn each
year is 4. The number of credits you need to qualify for disability
depends on your age when you become disabled. Nobody needs more than
40 credits and young people can qualify with as few as 6 credits.
o Disabled widows and widowers age 50 or older could be eligible for a
disability benefit on the Social Security record of a deceased spouse.
o Disabled children age 18 or older could be eligible for dependent's
benefits on the Social Security record of a parent who is getting
retirement or disability benefits, or on the record of a parent who
has died. (The disability must have started before age 22.)
o Children under the age of 18 qualify for dependents benefits on the
record of a parent who is getting retirement or disability benefits,
or on the record of a parent who has died, merely because they are
under age 18.
For more information about Social Security disability benefits in
general, ask Social Security for a copy of the booklet, Disability
(Publication No. 05-10029).
How Much Will Your Benefits Be?
How much your Social Security benefit will be depends on your earnings
history. Generally, higher earnings translate into higher Social
Security benefits. You can find out how much you will get by
contacting Social Security and asking for an estimate of your
benefits. We'll give you a form you can use to send for a free
statement that contains a record of your earnings and an estimate of
your benefits. In addition to checking your benefit, we encourage you
to use this statement to verify that your earnings have been properly
recorded in our files. It's important that you do this because any
missing or unreported wages could lower your Social Security benefit
or even prevent you from qualifying for disability benefits. If you
find a problem, contact your local Social Security office right away,
show them proof of your actual wages, and the record will be
corrected. This can be particularly important for people who have
tested positive for HIV but have not developed symptoms, so that any
potential benefits will not be delayed by wage correction
efforts. Disabled widows, widowers, and children eligible for benefits
as a dependent on a spouse's or parent's Social Security record
receive an amount that is a percentage of the worker's Social Security
benefit.
Supplemental Security Income: The Nonmedical Rules Of Eligibility 
SSI is a program that pays monthly benefits to people with low incomes
and limited assets who are 65 or older, or blind, or disabled. As its
name implies, "Supplemental" Security Income "supplements" a person's
income up to a certain level that can go up every year based on
cost-of-living adjustments. The level varies from one state to
another, so check with your local Social Security office to find out
more about SSI benefit levels in your state. We don't count all the
income you have when we figure out if you qualify for SSI. And if you
work, there are special rules we use for counting your wages. Again,
check with Social Security to find out if you can get SSI. In addition
to rules about income, people on SSI must have limited
assets. Generally, individuals with assets under $2000, or couples
with assets under $3000, can qualify for SSI. However, when we figure
your assets, we don't count such items as your home, your car (unless
it's an expensive one), and most of your personal belongings. Your
Social Security office can tell you more about the income and asset
limits. For more general information, ask for a copy of the booklet,
SSI (Publication No. 05-11000).
PART 3 -- HOW DOES SOCIAL SECURITY DEFINE DISABILITY?
In this section, we'll explain the criteria you must meet in order to
be considered "disabled." First, we'll explain in general terms how
Social Security defines and determines disability. Then we'll discuss
how it applies to people with HIV infection.
The General Definition Of Disability
Disability under Social Security is based on your inability to work
because of a medical condition. You will be considered disabled if you
are unable to do any kind of "substantial" work for which you are
suited. (Usually, monthly earnings of $500 or more are considered
substantial.) Your ability to work must be expected to last at least a
year. Or, the condition that keeps you from working must be so severe
that you are not expected to live. For children, we decide how the
condition affects their ability to function--to do the things and
behave in the ways that other children of the same age normally would.
How This Definition Of Disability Applies To People With HIV Infection 
A person with symptomatic HIV infection is often severely limited in
his or her ability to work. In other words, if the evidence shows that
you have symptomatic HIV infection that severely limits your ability
to work, and if you meet the other eligibility factors, the chances
are very good that you will be able to receive Social Security or SSI
Benefits. On the other hand, some people with HIV infection may be
less impaired and able to work, so they may not be eligible for
disability.
PART 4 -- HOW DOES SOCIAL SECURITY EVALUATE YOUR DISABILITY? 
Social Security works with an agency in each state, usually called a
Disability Determination Service (DDS), to evaluate disability
claims. At the DDS, a disability evaluation specialist and a doctor
follow a step-by-step process that applies to all disability claims,
thus assuring a consistent approach to evaluating disability. First,
the DDS specialists decide whether your impairment is "severe." This
simply means the evidence must show that your disability interferes
with your ability to work. The next step in the process is deciding
whether the disability is included in a list of impairments. This list
describes, for each of the major body systems, impairments that are
considered severe enough to prevent an adult from doing any
substantial work or in the case of children under the age of 18,
impairments that are severe enough to prevent a child from functioning
in a manner similar to other children of the same age. Recently we
published a list of impairments for HIV infections. In this list, we
have included many conditions associated with symptomatic HIV
infection, including some that specifically apply to women and
children with HIV infection (See next two sections). Some of the
HIV-related conditions included in the HIV list of impairments are
shown below. The level of severity that an impairment must meet to be
found disabling are also specified in the regulations.
o Pulmonary tuberculosis resistant to treatment 
o Kaposi's sarcoma
o Pneumocystis carinii pneumonia (PCP)
o Carcinoma of the cervix
o Herpes Simplex
o Hodgkin's disease and all lymphomas
o HIV Wasting Syndrome
o Syphilis and Neurosyphilis
o Candidiasis
o Histoplasmosis
Remember: these are just a few examples. You can see a complete list
of HIV-related impairments at any Social Security office. The complete
list will also include the findings necessary for listed impairments
to be considered disabling by Social Security. If you have symptoms of
HIV infection that are not specifically included in (or equal in
severity to) the impairments on our list, then DDS disability
specialists will look at how frequently these conditions occur and how
they affect your ability to function. The DDS team will evaluate how
well you function in three general areas: daily activities; social
functioning; and the ability to complete tasks in a timely manner,
which requires the ability to maintain concentration, persistence, and
pace. If you have "marked limitations" in any one of these functional
areas and repeated manifestations of HIV meeting the criteria in the
listings, you may be found disabled. A marked limitation is one that
seriously interferes with your ability to function independently,
appropriately, and effectively. It does not mean that you must be
confined to bed, hospitalized, or in a nursing home. If the
specialists decide that you are not disabled at this point because you
do not have a condition that exactly matches or is equal in severity
to one on our list, then they will look to see if your condition
prevents you from doing the work you normally do. If it does not, then
we look to see if it prevents you from doing any other type of work
you're suited for, based on your age, education, and experience. If it
does, you may still be found disabled. Remember, at all steps in the
process, your impairment must be documented. Documentation includes
medical records from your doctors, as well as laboratory test results,
X-ray reports, etc. The HIV infection itself--that is, the presence of
the virus--must be documented as well as any HIV-related
manifestations. At all steps in the process it is important that we
have evidence of signs, symptoms, and laboratory findings associated
with HIV infection, as well as information on how well you are able to
function day-to-day. The signs and symptoms may include: repeated
infections; fevers/night sweats; enlarged lymph nodes, liver or
spleen; lower energy or generalized weakness; dyspnea on exertion;
persistent cough; depression/anxiety; headache; anorexia; nausea and
vomiting; and side effects of medication and/or treatment, as well as
how your treatment affects your daily activities.
Evaluation Of HIV Infection In Women
Statistics show that there is an increasing number of women with HIV
diseases. Social Security's guidelines for the immune system recognize
that HIV infection can show up differently in women than in men. In
addition to following the criteria outlined in the previous section,
DDS disability evaluators consider specific criteria for diseases
common in women. These include: vulvovaginal candidiasis (yeast
infection); genital herpes; pelvic inflammatory disease (PDI);
invasive cervical cancer; genital ulcerative disease; and condyloma
(genital warts caused by the human papillomavirus). Again, the level
of severity necessary for these impairments to be considered disabling
is included in the list of impairments.
Evaluation Of HIV Infection In Children
We also have separate listings for children with HIV infection. These
guidelines recognize the fact that the course of the disease in
children can differ from adults. As with adults, some children may not
appear to have the conditions specified in the guidelines, or may have
listed conditions that are not as severe as the guidelines
require. When this happens, a functional assessment is made using
criteria contained in the lists. A child may be disabled if the
HIV-related impairments substantially reduce his/her ability to grow,
develop, or engage in activities similar to children of the same
age. For more information about disability benefits for children, ask
Social Security for a copy of the booklet, Social Security And SSI
Benefits For Children With Disabilities (Publication No. 05- 10026).
PART 5 -- HOW DO YOU FILE FOR DISABILITY BENEFITS 
You apply for Social Security and SSI disability benefits by calling
or visiting any Social Security office. All Social Security files are
kept strictly confidential. It would help if you have certain
documents with you when you apply. But don't delay filing because you
don't have all the information you need. We'll help you get the rest
of it after you sign up. The information you'll need may include:
o your Social Security number and birth certificate; 
o the Social Security numbers and birth certificates for family
members signing up on your record; and
o a copy of your most recent W-2 form (or your tax return if you're
self-employed).
If you're signing up for SSI, you will need to provide records that
show that your income and assets are below the SSI limits. This might
include such things as bank statements, rent receipts, care
registration, etc.
You'll also need to give us information about how your condition
affects your daily activities, the names and addresses of your doctors
and clinics where you've received treatment, and a summary of the kind
of work you've done in the last 15 years. If you have medical evidence
such as reports of blood tests, laboratory work, or a physical, it
would be helpful if you brought them with you. In the section below
(What You Can Do to Expedite the Processing of Your Claim), we give
you some guidelines for providing us with medical and vocational
information that will help speed up your claim. But first, we want you
to know what Social Security does to make the process work as smoothly
as possible.
What Steps Has Social Security Taken To Ensure Prompt Processing And
Payment Of Disability Benefits?
All HIV infection claims are given prompt attention and priority
handling. For many people applying for SSI with a medical diagnosis of
symptomatic HIV infection, the law allows us to PRESUME they are
disabled. This permits us to pay up to 6 months of benefits pending a
final decision on the claim. You will qualify for this immediate
payment if:
o a medical source confirms that the HIV infection is severe enough to
meet SSA's criteria;
o you meet the other SSI nonmedical eligibility requirements; and 
o you are not doing "substantial" work (See section, "The General
Definition of Disability" in Part 3).
If you have symptomatic HIV infection but the local Social Security
office cannot provide immediate payment, a disability evaluation
specialist at the DDS may still make a "presumptive" disability

 
decision at any point in the process where the evidence suggests a
high likelihood that your claim will be approved. (If we later decide
you are not disabled, you will NOT have to pay back the money you
received.)
Special arrangements have been made with a number of AIDS service
organizations, advocacy groups, and medical facilities to help us get
the evidence we need to streamline the claims process. And many DDS's
have Medical/Professional Relations Officers who work directly with
these organizations to make this process work smoothly.
What You Can Do To Expedite The Processing Of Your Claim 
You can play an active and important role in ensuring that your claim
is processed accurately and quickly. The best advice we can give you
is to keep thorough records that document the symptoms of your illness
and how it affects your daily activities, and then to provide all of
this information to Social Security when you file your claim. Below
are some guidelines you can follow:
o Document the symptoms of your illness early and often 
Use a calendar to jot down brief notes about how you feel on each
day. Record any of your usual activities you could not do on any given
day. Be specific. And don't forget to include any psychological or
mental problems.
o Help your doctor help you
Not all doctors may be aware of all the kinds of information we need
to document your disability. Ask your doctor or other health care
professional to track the course of your symptoms in detail over time
and to keep a thorough record of any evidence of fatigue, depression,
forgetfulness, dizziness, and other hard-to-document symptoms.
o Keep records of how your illness affected you on the job 
If you were working, but lost your job because of your illness, make
notes that describe what it is about your condition that forced you to
stop working.
o Give us copies of all these records when you file 
In addition to these records, be sure to list the names, addresses,
and phone numbers of all the doctors, clinics, and hospitals you have
been to since your illness began. Include your patient or treatment
identification number if you know it. Also include the names,
addresses, and phone numbers of any other people who have information
about your illness.
PART 6 -- HELPING YOU RETURN TO WORK
If you return to work, Social Security has a number of special rules,
called "work incentives," that provide cash benefits and continued
Medicare or Medicaid coverage while you work. They are particularly
important to people with HIV disease who, because of the recurrent
nature of HIV-related illnesses, may be able to return to work
following periods o disability.
The rules are different for Social Security and SSI beneficiaries. For
people getting Social Security disability benefits, they include a
9-month "trial work period" during which earnings, no matter how much,
will not affect benefit payments; and a 3-year guarantee that, if
benefits have stopped because a person remains employed after the
trial work period, a Social Security check will be paid for any month
earnings are below the "substantial" level (generally $500). In
addition, Medicare coverage extends through the 3-year timeframe after
the trial work period, even if your earnings are substantial.
SSI work incentives include continuation of Medicaid coverage even if
earnings are too high for SSI payments to be made, help with setting
up a "plan to achieve self-support" (PASS), and special consideration
for pay received in a sheltered workshop so that SSI benefits may
continue even though the earnings might normally prevent payments.
These and other work incentives are explained in detail in the
publication, Working While Disabled...How Social Security Can Help
(Publication No. 05-10095). For a free copy, just call or visit your
nearest Social Security office.
PART 7 -- WHAT YOU NEED TO KNOW ABOUT MEDICAID AND MEDICARE 
Medicaid and Medicare are our country's two major government-run
health insurance programs. Generally, people on SSI and other people
with low incomes qualify for Medicaid, while Medicare coverage is
earned by working in jobs covered by Social Security, for a railroad,
or for the federal government. Many people qualify for both Medicare
and Medicaid.
Medicaid Coverage
In most states, Social Security's decision that you are eligible for
SSI also makes you eligible for Medicaid coverage. (Check with your
local Social Security or Medicaid office to verify the requirements in
your state.)
State Medicaid programs are required to cover certain services,
including inpatient and outpatient hospital care and physician
services. States have the option to include other services, such as
intermediate care, hospice care, private duty nursing, and prescribed
drugs.
For more information about Medicaid, contact your local Medicaid agency.
Medicare Coverage
If you get Social Security disability, you will qualify for Medicare
coverage 24 months after the month you became entitled to those
benefits. Medicare helps pay for:
o inpatient and outpatient hospital care; 
o doctor's services;
o diagnostic tests;
o skilled nursing care;
o home health visits;
o hospice care; and
o other medical services.
For more information about Medicare, call or visit your local Social
Security office to ask for the booklet Medicare (Publication
No. 05-10043).
FOR MORE INFORMATION
For more information or to apply for benefits, call or visit Social
Security. It's easiest to call Social Security's toll-free telephone
number. The number is 1-800-772-1213. You can speak to a
representative 7 a.m. to 7 p.m. each business day. The best times to
call are early in the morning, early in the evening, late in the week,
and toward the end of the month.
The Social Security Administration treats all calls
confidentially--whether they're made to our toll-free numbers or to
one of our local offices. We also want to ensure that you receive
accurate and courteous service. That's why we have a second Social
Security representative monitor some incoming and outgoing telephone
calls.
Note from the AIDS Information Center: This document reflects changes
in Social Security rules that took effect on July 2, 1993 and, also,
how SSA evaluates claims based on HIV/AIDS. Copies of this
publication, available in English and Spanish, can be ordered through
Social Security's toll-free number, 1-800-772-1213. The publication
numbers are 05-10020 (English) and 05-10920 (Spanish). For bulk
quantities call the Public Information Distribution Center at (410)
965-0945. The fax number for ordering publications is (410) 965-0696.
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Question 5.2. What if you can't afford AZT?
PATIENT ASSISTANCE PROGRAM AT BURROUGHS WELLCOME 
The Burroughs Wellcome Company has announced changes in its Patient
Assistance Program (PAP) to make access to its drugs easier for
disadvantaged patients. Physicians can now call a toll-free number,
once they have determined that a patient is in need, to receive
authorization to enroll the patient in the program. Upon
authorization, the physician will give the patient a prescription
benefit card from PCS Health Systems that can be used at any pharmacy.
To qualify, patients must meet the following guidelines: 
o be a resident of the United States or its territories; 
o be financially disadvantaged;
o have applied for and be awaiting reply from other prescription
funding sources; or
o not qualify for private or government assistance.
The primary patient groups expected to participate are those using
Burroughs Wellcome products for HIV and related infections, those with
herpesvirus infections, transplant recipients, and those with cancer
or congestive heart failure.
Enrollment in the PAP must be initiated by a physician. To find out if
an individual is eligible, patients should have their physicians call
(800) 722-9294.
 
rdue
Archive-name: aids-faq/part7
AIDS FAQ Part 7/10
Section 6. The common debates.
Q6.1 What are Strecker and Segal's theories that HIV is manmade?
Q6.2 Other conspiracy theories.
Q6.3 HIV the cause of AIDS?
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Question 6.1. What are Strecker and Segal's theories that HIV is 
manmade? 
Jakob Segal's theory is that HIV was formed from visna (a sheep virus)
and HTLV-I (Human T-cell Leukemia Virus) by US army biological
research labs in 1977 or 1978. The virus supposedly escaped
accidentally after being tested on prisoners.
Robert Strecker's theory is that HIV was formed from visna and BLV
(Bovine Leukemia Virus) by the US in the 1970's after 30-40 years of
work. The virus was supposedly tested on populations in Africa and was
deliberately introduced into the US homosexual community through the
hepatitis B vaccination program.
The alleged evidence to support this theory: 
* Visna is very similar to HIV. HIV can be formed by combining the
genes of visna and BLV or HTLV. HIV is not similar to primate
viruses. The government was interested in biological warfare and was
planning to make an immune-system destroying virus. In particular, the
DOD Appropriations for 1970 Hearings, 91st Congress, Part 6, p 129
states:
There are two things about the biological agent field I would like to
mention. One is the possibility of technological surprise. Molecular
biology is a field that is advancing very rapidly, and eminent
biologists believe that within a period of 5 to 10 years it would be
possible to produce a synthetic biological agent, an agent that does
not naturally exist and for which no natural immunity could have been
acquired.
Mr. Sikes. Are we doing any work in that field? 
Dr. MacArthur. We are not.
Mr. Sikes. Why not? Lack of money or lack of interest? 
Dr. MacArthur. Certainly not lack of interest. 
[MacArthur provides the following information:] 
The dramatic progress being made in the field of molecular biology led
us to investigate the relevance of this field of science to biological
warfare. A small group of experts considered this matter and provided
the following observations:
* All biological agents up to the present time are representatives of
naturally occurring disease, and are thus known by scientists
throughout the world. They are easily available to qualified
scientists for research, either for offensive or defensive purposes.
* Within the next 5 to 10 years, it would probably be possible to make
a new infective microorganism which could differ in certain important
aspects from any known disease-causing organisms. Most important of
these is that it might be refractory to the immunological and
therapeutic processes upon which we depend to maintain our relative
freedom from infectious disease.
* A research program to explore the feasibility of this could be
completed in approximately 5 years at a total cost of $10 million.''
* HIV is a new disease that appeared suddenly in the late 1970's without 
a 
natural source.
* HIV could have been easily synthesized in a laboratory in the 1970's. 
The evidence is overwhelmingly against these theories. The key problem
with these theories is they arose in the early 1980's, before SIV
(simian immunodeficiency virus) was discovered and before the relevant
viruses were sequenced. The genetic sequences clearly show:
* HIV is much closer to SIV (simian immunodeficiency virus) than HIV is 
to 
visna, BLV, HTLV or any other known virus. 
* HIV can't be formed from splicing together parts of other known 
viruses. 
Viral genetic sequences can be ftp'd from ncbi.nlm.nih.gov in
repository/aids-db.
To summarize the other arguments against Strecker and Segal's theories: 
* The military testimony described a future study to see if making a
new agents was feasible, not to actually produce it. More importantly,
they are looking for an agent refractory to immunological processes;
this means something resisting immunological processes. The quoted
testimony and other parts of the testimony state they are looking for
a new agent for which people do not have natural immunity; this is
entirely different from an agent that destroys the immune system. It
is also much easier than producing something like HIV.
* Most scientists believe HIV evolved from SIV or a close
relative. HIV did not suddenly appear in the late 1970's, but has been
found in preserved blood samples from the 1950's.
* Biotechnology was not sufficently advanced in the 1970's to produce
something like HIV, and it is debatable that it would be possible even
now. Since the details of HIV are not understood even now, it is
inconceivable that someone could have deliberately designed HIV in the
1970's.
Strecker's claim that HIV was introduced via hepatitis B vaccinations
is extremely doubtful. McDonald et al, Lancet, 1983 Oct 15,
2(8355):882-4 state the incidence of AIDS in unvaccinated sexually
active homosexual men was _higher_ than in vaccinated men, although
the rates were too low for statistical significance. Stevens et al,
JAMA, 1986 April 25, 255(16):2167-2172 tested blood samples from the
beginning of the vaccination program and found that 6.6% were already
HIV-positive. Therefore, HIV couldn't have been introduced via the
vaccinations.
While evaluating these theories, I recommend treating Segal's and
Strecker's literature citations with extreme skepticism, as they are
both rather casual about the connection between their claims and the
contents of the papers. In particular, Strecker provides quotes that
do not appear in the cited papers.
Finally, since both theories allege a coverup of the connection
between visna and HIV, a clear explanation of their relationships may
be helpful. The viruses described above are all
retroviruses. Retroviruses have three subfamilies: Oncoviruses,
Lentiviruses, and Spumaviruses. HTLV is a oncovirus, while the
remainder are lentiviruses. The analysis of genetic sequences gives
strong evidence for the evolution of lentiviruses. They apparently
branched into the primate lentiviruses (HIV-1, HIV-2, and SIV), and
the nonprimate lentiviruses (visna, BLV, EIAV, FIV, CAEV, etc.) Thus,
HIV and visna have many similarities since they are both lentiviruses,
but HIV and SIV are much more similar. (See Fields Virology for more
information on retrovirus classification and "The Emergence of Simian
Human Immunodeficiency Viruses", Myers et al, AIDS Research and Human
Retroviruses, 8(3), 1992 373-386 for more information on lentivirus
evolution.)
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Question 6.2. Other conspiracy theories.
One school of thought holds that the "AIDS was a U.S. biological
warfare experiment" myth was extensively spread as part of a
disinformation campaign by Department V of the Soviet KGB (their
`active measures' group). They may not have invented the premise
(Soviet disinformation doctrine favored legends originated by third
parties), but they added a number of signature details such as the
name of the supposed development site (usually Fort Meade in Maryland)
which still show up in most retellings.
According to a defector who was once the KGB chief resident in Great
Britain, the KGB promulgated this legend through controlled sources in
Europe and the Third World. The Third World version (only) included
the claim that HIV was the result of an attempt to build a "race
bomb", a plague that would kill only non-whites.
From the CDC AIDS Clearinghouse:
"Soviets Secretly Tried to Blame U.S. for AIDS--CIA" Reuters (09/30/93) 
Langley, Va.--For more than five years, the former Soviet Union
attempted to blame the AIDS virus on a plot by U.S. military
scientists, according to newly declassified CIA documents. The papers
reported that the Soviets launched a campaign in 1983 aiming to tie
the emergence of AIDS to American biological weapons research. The
disinformation was circulated in 25 different languages in over 200
publications, as well as in posters, leaflets, and radio broadcasts,
in more than 80 countries before the campaign was finally abandoned by
the Soviets, according to a study cited by the CIA in the
documents. The Soviets dropped the campaign in 1988 when the United
States refused to cooperate with them on a research program on AIDS,
which was by then spreading in the U.S.S.R., said the CIA article. The
Soviet campaign was apparently retaliation for the Reagan
administration's claims of Soviet-produced "yellow rain," or yellow
traces found on vegetation due to a Soviet biological weapon.
Reproduction of the above excerpt is encouraged; however, copies may
not be sold, and the CDC Clearinghouse should be cited as the source
of this information. Copyright 1993, Information, Inc., Bethesda, MD
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Question 6.3. Is HIV the cause of AIDS?
Q: What is AIDS?
by Robert Holzman and David Mertz
The immune system is responsible for defending the body against
bacteria, parasites, viruses and cells identified as foreign such as
virally infected, transplanted, and (many believe) malignant
cells. The Acquired Immune Deficiency Syndrome (AIDS) is a condition
in which a person's immune system is so weakened that s/he becomes
susceptible to conditions that occur rarely in those with intact
function. The formal case definition includes a large number of
indicator diseases deemed, in the words of the original: "at least
moderately predictive of cellular immune deficiency". This original
definition, free of assumptions regarding etiology, has been modified
in accordance with the general acceptance of HIV as the causal agent
responsible for the vast majority of AIDS cases. The revised
definition also includes certain conditions believed ascribable to
advanced HIV infection itself (e.g. wasting). A concise summary of the
1993 case definition may be found in the textbook, Scientific American
Medicine section 7, chapter XI, page 2.
Q: Why is HIV considered to be the cause of AIDS? 
The epidemic occurrence, in 1980, of Kaposi's Sarcoma in homosexual
men and, in 1981, of certain unusual infections in intravenous drug
users, were unprecedented events. While all of the initially
recognized diseases were previously known, and most were occasionally
seen in persons who were ostensibly immunologically normal, the risk
of developing them was strongly associated with the presence of an
immunosuppressed state, generally due to therapy for cancer or
suppression of graft rejection. In order to identify cases for study
and comparison with noncases, an operational definition was developed
(see the FAQ question What is AIDS?) The issue for investigators was
why so many homosexual men and intravenous drug users were developing
such severe immune suppression now, while previously only subtle
defects in immunity had been seen in such individuals.
Among the earliest suggestions of an infectious etiology was the
report (published in Am. J. Med. 1984;76:487-492, but presented orally
earlier) that cases of AIDS among homosexuals were not occurring
randomly but were clustered among sexual contacts. 40 persons were
identified who showed linked transmission over 3 generations of
infection. At the time there were four major theories of etiology
under investigation: (1) multiple and repeated infections with
Cytomegalovirus leading to immune suppression, (2) immunologic
exhaustion from multiple previous infections, (3) alloimmunization to
lymphocytes, due to intra-rectal injection of sperm, and (4) toxic
effects of components of inhalant drugs or genital
lubricants. Theories 2-4 were incompatible with the observed pattern
of transmission. No credible evidence for theory 1 was ever produced.
Three laboratories, Gallo's at NIH, Levy's at UCSF, and Montagnier's
at Institute Pasteur (listed alphabetically), almost simultaneously
identified a retrovirus in AIDS patients which was ultimately named
the Human Immunodeficiency Virus (HIV). The identification of
infection with this retrovirus in most (and with subsequent
improvements in technique, in almost all) persons with AIDS who were
tested raised the question whether this virus was a harmless infector,
an opportunistic pathogen, or the actual causal agent of the
progressive immunosuppression. Some of the evidence for the last role
is summarized below.
First, HIV causes a distinct acute illness (the "primary infection")
which has been characterized in otherwise healthy
(non-immunosuppressed) individuals known to have been or suspected of
having been infected at a particular time (e.g. in a laboratory
accident) or in whom the appearance of serum antibodies was detected,
indicating a recent infection. An causal role for HIV in subsequent
immune suppression is suggested by the fact that those whose symptoms
of primary infection last more than 14 days subsequently develop AIDS
more rapidly than persons who have briefer periods of
illness. (Br. Med J. 1989;299:154-157.)
Second, HIV infects cells with the CD4 receptor on their surface,
cells which are critical for immune function and which, in those with
AIDS, are abnormal in function, number, or both. (For a discussion of
current concepts of the pathogenesis of HIV-related immune suppression
see Science 1993; 262:1011-1018.)
Third, HIV infection antedates immune suppression and is the single
factor common to all AIDS risk groups. Studies of stored blood
indicate that HIV spread in the homosexual population of San Francisco
a few years before the epidemic of AIDS-indicative
conditions. Moreover, in cases where the date of infection is known
exactly or approximately, acquisition of HIV infection precedes the
development of immune suppression by substantial periods. Such
situations include, for example, transmission by transfusion to adults
having cardiac surgery or neonates with hemolytic disease, by breast
milk to neonates (including breast milk of a wet nurse to a child
without familial risk factors), by clotting factor concentrates to
hemophiliacs, by parenteral exposure of laboratory technicians or
physicians to blood or viral concentrates, and to spouses of HIV
infected persons via sexual transmission. Most telling is the
observation that among infants of HIV-infected mothers, only those
that acquire HIV infection develop progressive immune suppression and
AIDS defining illnesses.
Not all accept the causal association between HIV and the immune
suppression that leads to an AIDS indicative illness. Peter Duesberg,
a retrovirologist at the University of California at Berkeley has been
the most vocal scientific critic of this hypothesis. Few of those
actively engaged in research on AIDS agree with Duesberg's analysis,
and rebuttals may be found in Nature 1990; 345:659-660 and Science
1988; 241:514-517. At least one study (M.S.Ascher, Nature, 1993;
362:103) has been designed in response to his assertions that drug use
was a major cause of AIDS associated immune suppression. In that
study, cohorts of homosexual and heterosexual men were compared,
matched for use of marijuana, cocaine or amphetamines. There was no
association between the development of AIDS and use of these
drugs. The homosexual cohort used more nitrites than did the
heterosexual one, but development of AIDS was related to the presence
of HIV infection and not to use of drugs (M.S. Ascher, Lancet, 1993;
341:1223).
Those who believe that HIV causes AIDS look to the cases associated
with transfusion, congenital infection, or sexual transmission as
coming as close to Koch's postulates as is likely to be possible in
humans. In the absence of an animal model in which HIV induces immune
suppression, it is likely to be impossible to strictly fulfill Koch's
Postulates for HIV and AIDS.
As the reader studies the debate on the cause of AIDS and forms
his/her own conclusions it is important to focus clearly on the
arbitrary nature of the case definition as an operational way to
detect severe immune deficiency. Even the 1993 revision of the AIDS
case definition does not require the documented presence of HIV
infection. It is logically possible for there to be more than one
etiology, although published data (New Engl. J. Med, 1993;
328:373-379.) indicate that only 299 of 230,179 reported persons with
AIDS have been HIV-negative when testing was done (Evidence of HIV
infection was sought in approximately half the 230,179 (Duesberg,
Science, 1992;257:1848)).
In summary, to assert that HIV is the cause of AIDS is to assert that
HIV was the cause of the epidemic of immune suppression that appeared
in 1980-81. To ascribe this role to HIV it is not necessary to show
that HIV is the only cause of immunosuppression in those at risk, nor
that cofactors are unimportant in the development of AIDS, nor that
every patient who meets the case definition has HIV infection. It is
only necessary to show that HIV infection can result in immune
suppression and that HIV infection occurred in the appropriate
population at an appropriate time to account for the epidemic.
Q: What is the evidence against HIV as the cause of AIDS? (see also
Section 7.4: The Group for the Scientific Reappraisal of the HIV/AIDS
Hypothesis)
There are many PWA's and AIDS-activists, and many in the scientific
community who remain doubtful that HIV causes AIDS. These doubts arise
both from observers of the socio-political history of HIV/AIDS, and
from some scientists knowledgeable about retroviruses, epidemiology
and immunology.
DOUBTS RELATED TO THE SOCIAL HISTORY OF HIV/AIDS 
Some social critics raise questions about the circumstances in which
the HIV/AIDS hypothesis was made public: After a decade of a massively
funded, but predominantly unsuccessful, search for viral causes of
cancer, in 1984 then Secretary of Health and Welfare Margaret Heckler
declared to the national press that an *American* discovery of the
(probable) viral cause of AIDS had been made -- without a single peer
reviewed article on HIV having appeared. Quickly thereafter, the word
"probable" was dropped by the press, and virtually all scientific
monies for AIDS research were directed towards HIV. Continuing this
trend, suspicious dealings between the US government and Burroughs
Wellcome assured the approval and usage of the "anti-viral" drug
AZT. In an ad hoc manner, many HIV-scientists thereafter conveniently
rejected Koch's Postulates in defense of the HIV/AIDS
hypothesis. References: John Lauritsen's 1993 _The AIDS War_
(Asklepios, New York, ISBN 0-943742-08-0), Jad Adams' 1989 _AIDS: The
HIV Myth_ (St.Martin's Press, New York, ISBN 0-312-02859-8), and Jon
Rappoport's _AIDS Inc._ (Human Energy Press, San Bruno CA 94066.)
DOUBTS ABOUT THE SCIENTIFIC VALIDITY OF THE HIV/AIDS HYPOTHESIS 
Were the only doubts about HIV causation of AIDS those surrounding the
"context of discovery," these doubts would be of little interest to
anyone but historians of science. The main doubts raised by HIV-

 
skeptics are on the actual scientific evidence for the HIV/AIDS
hypothesis. HIV-skeptics consider this evidence to be either weak or
non-existent. Beyond the generic concern which HIV-skeptics have that
no mechanism for the alleged action of HIV has been demonstrated, the
skeptics raise several more specific problems concerning the HIV/AIDS
hypothesis. These problems fall into two major categories:
Epidemiological and Immunological/Biochemical. Two general starting
references to HIV-skeptics are: Robert Root-Bernstein's 1993,
_Rethinking AIDS_ (Free Press, New York, ISBN 0-02-926905-9), and
Peter Duesberg's article "AIDS Acquired by Drug Consumption and Other
Noncontagious Risk Factors", _Pharmoc Ther_ v.55 p.201-277, 1992.
DOUBTS BASED ON EPIDEMIOLOGICAL DATA
First, HIV and HIV-antibodies are undetectable in a significant
percentage of AIDS cases. The exact number of such cases is
disputable, and many AIDS cases are simply never tested for HIV or
HIV-antibodies: estimates of HIV-negative AIDS cases generally range
between 2% and 10% of AIDS cases. Furthermore, Duesberg and others
argue that AIDS-defining diseases themselves occur in a large number
of people who are not defined as AIDS-cases because of their HIV-
negative status. From a philosophical point-of-view it doesn't matter
what the exact percentages are: If both AIDS itself, and AIDS-
defining diseases, occur without HIV, then HIV cannot be the sole
cause of AIDS, though it is possibly one among many contributing
causes in those who are HIV+.
Second, virtually all, if not all, of those who suffer from AIDS have
been exposed to MANY immunosuppressive risks besides HIV, even if most
have, indeed, also been exposed to HIV. Many pathogens such as
Hepatitis viruses, Herpes viruses including Cytomegalovirus, Herpes
simplex, Treponema pallidum, the cause of Syphilis, Epstein-Barr
Virus, Mycobacteria, and others, are just as prevalent in AIDS-
patients as is HIV. Further, simultaneous infection with a broad
spectrum of these pathogens occurs only in those populations at high-
risk for AIDS. HIV-skeptics do not believe that any epidemiological
evidence exists to single out HIV from the other pathogens
characteristic of AIDS. It is likely, they argue, that AIDS-defining
immune-suppression is caused by the cumulative effect, or by specific
synergistic interactions, of these other pathogens. In addition,
virtually all AIDS-patients have been exposed to drugs with known
immunosuppressive effects, whether medically indicated, recreational,
or both. These exposures include the usage of opiates (medically and
recreationally), nitrites, cocaine, chronic high-dosage antibiotics,
and chemotherapeutic agents. Finally, virtually all AIDS-patients have
been exposed to large amounts of foreign antigenic tissue, whether
blood products, lymphocytes or semen. Such exposure is known to
trigger auto-immunities similar to those present in AIDS.
DOUBTS BASED ON IMMUNOLOGICAL AND VIROLOGICAL DATA 
First, HIV is non-viremic and chemically inactive in those infected,
even those suffering acute immune-suppression. Skeptics argue that the
rate of infection of T-cells by HIV is so low that even were HIV to
kill every cell it infects, the human body would have no difficulty
replenishing those cells. Even so, retroviruses, including HIV which
has been continuously grown in the same cell-line since 1984, have
never been shown consistently to kill host-cells. Estimates of the
exact rate and location of T-cell infection vary, but no estimates
place the rate of infection high enough to suggest a serious HIV
threat to the immune system, even in the lymphatic system where HIV
may be present in higher numbers than in blood.
Second, in response to skeptics' objections about rates of T-cell
infection, HIV-scientists have proposed a pathogenesis of AIDS in HIV
triggered auto-immunities, caused by the similarity of HIV surface
proteins to those of immune system cells. However, CD4 homologies by
which HIV is alleged to cause auto-immunity or immune-system
malfunction also exist for many other pathogens/foreign tissue than
HIV -- including many pathogens common in AIDS-patients. No basis has
been demonstrated, nor plausibly hypothesized, which singles out
HIV/T-cell homologies from other homologies as a mechanism of auto-
immune reactions.
Third, the long "latency period" between HIV infection and the
development of AIDS is unlike the behavior of all other viruses, and
contradicts established retrovirology. To skeptics, this latency is
little more than an article of faith by HIV/AIDS hypothesizers. Put
simply, viruses don't cause disease after long latencies, except when
reactivation of a latent virus is triggered by external immune-
suppression. In all known viruses, production of antibodies
neutralizes the action of the virus, and the virus is eliminated or
brought into remission. Exactly the opposite is postulated for HIV;
but since no mechanism has been plausibly described for this, little
can be argued about it than one's prior convictions about HIV/AIDS
causation.
 
rdue
Archive-name: aids-faq/part8
AIDS FAQ Part 8/10
Section 7. Information Sources. 
Q7.1 Phone Information about AIDS. 
Q7.2 Phone Information about AIDS drug trials. 
Q7.3 Phone Information about AIDS treatments
Q7.4 US Social Security: Information for Organizations
Q7.5 Reappraisal of the HIV-AIDS Hypothesis. 
Q7.6 American Academy of Allergy & Immunology Physician's
 Referral and Information Line
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Question 7.1. Phone Information about AIDS. 
For general information about AIDS and referrals to other AIDS
information sources, call
CDC National AIDS Hotline: 1-800-342-AIDS 
Spanish:1-800-344-7432
Deaf: 1-800-243-7889
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Question 7.2. Phone Information about AIDS drug trials. 
You can obtain information about ongoing AIDS drug trials in the
United States by calling the AIDS Trials hotline at
1-800-TRIALSA
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Question 7.3. Phone Information about AIDS Treatments
PHS' AIDS TREATMENT INFORMATION SERVICE BEGINS 
HHS Secretary Donna E. Shalala today announced the start of the first
800-number service which provides federally approved treatment
information by phone or computer for people living with HIV/AIDS and
health care professionals.
Secretary Shalala said, "As of today, HIV/AIDS patients and those
caring for them can call ATIS, the AIDS Treatment Information Service
at 1-800-HIV-0440 and speak to a trained health information expert
about up-to-date HIV/AIDS treatments."
Interim national AIDS policy coordinator Patsy Fleming said, "ATIS
represents the kind of innovative, coordinated effort among government
agencies -- working together to provide a service that does not fall
under the mandate of any individual agency -- that is vital to meeting
the continuing challenges of AIDS."
Philip R. Lee, M.D., HHS assistant secretary for health and director
of the U.S. Public Health Service, said, "In addition to assisting
health care providers, the AIDS Treatment Information Service will
help people living with HIV/AIDS extend and improve the quality of
their lives by helping them make informed decisions about their health
care with their providers."
Surgeon General M. Joycelyn Elders, M.D., speaking in Atlanta at the
National Skills-Building Conference for community based organizations,
sponsored by the National Minority AIDS Council, the National
Association of People with AIDS and the AIDS National Interfaith
Network, said, "Community-based organizations and AIDS service
organizations all over America need to help get the work out about
ATIS. It provides an invaluable additional resource to people living
with HIV/AIDS."
The Public Health Service National AIDS Program Office has coordinated
development of the service. Six PHS agencies have contributed to its
formation and will be funding its operation. These agencies are the
Agency for Health Care Policy and Research, the Centers for Disease
Control and Prevention, the Indian Health Service, the Health
Resources and Services Administration, the National Institutes of
Health and the Substance Abuse and Mental Health Services
Administration. Project officers from each of the participating PHS
agencies will be responsible for oversight of the program.
Representatives from AIDS communities across the country have also
participated in designing the service.
The data-base for ATIS, which is housed at the National Library of
Medicine, part of NIH, will be continually up-dated to include all
federally approved HIV/AIDS treatment information. The data base can
be accessed free via computer.
ATIS also can provide access to other, related PHS information
services, including: the CDC National AIDS Hotline, providing basic
HIV/AIDS information; the CDC National AIDS Clearinghouse, providing
HIV/AIDS print and video materials; the AIDS Clinical Trials
Information Service, providing information on clinical trials for
treatments for HIV/AIDS and associated opportunistic infections; the
HRSA-sponsored Warmline, which provides HIV/AIDS treatment information
to physicians only; the SAMHSA National Drug Information, Treatment
and Referral Hotline, which provides information on drug treatment and
community resources; and the SAMHSA National Clearinghouse for Alcohol
and Drug Information, which provides information on alcohol and drug
abuse treatment and prevention.
ATIS staff will not provide treatment advice, but will provide
information and advise patients that they need to discuss their
treatment options with their physicians.
The service is staffed by highly trained health information
specialists who are fluent in English and Spanish. Deaf access (TDD)
in included. The service is provided Monday through Friday, 9 a.m. to
7 p.m. EST. All calls are completely confidential.
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Question 7.4. US Social Security: Information for Organizations 
SSA is committed to disseminating information about its benefit
programs to as wide an audience as possible. If your organization has
a newsletter, electronic bulletin board, informational database, or
other system for housing and disseminating information to people
living with AIDS and their caregivers, SSA would like to know about
it. SSA wants to work with you to share information about Social
Security benefit programs and eligibility criteria. SSA will share or
exhibit public information materials if you will inform them of any
meetings/conferences. Also, if you believe your staff could benefit
from an in-service training program covering SSDI/SSI, Medicare,
Medicaid, and other topics, please inform SSA.
SSA looks forward to a continuing partnership with your organization
to inform the thousands of men, women and children living with
HIV/AIDS about the benefits available through Social Security. If you
have any questions, or have any additional public information needs,
contact Robert G. Goldstraw, Social Insurance Affairs Specialist (AIDS
Outreach), Social Security Administration, Baltimore MD
21235. Telephone: (410) 965-4064.
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Question 7.5. Reappraisal of the HIV-AIDS Hypothesis.
Please see Q5.3 `HIV the cause of AIDS?' for introductory information
on this question.
The Group for the Scientific Reappraisal of the HIV/AIDS Hypothesis
(hereafter just 'Group' for short) is an organization of scientists,
AIDS-activists and educators, and other concerned persons, currently
numbering around four hundred. As their name indicates, the Group
wishes for the scientific community to reexamine an hypothesis which
they believe to have been prematurely, dogmatically, and even
dangerously, accepted. Many or most of the best known AIDS-skeptics
are members of the Group, including Peter Duesberg, Robert
Root-Bernstein, John Lauritsen, Eleni Eleopoulos, Michael Callen, Jad
Adams and Kary Mullis. The Group may be contacted at 2040 Polk
St. Suite 321, San Francisco, CA 94109 USA; Fax: 415-775-1379. The
Group publishes a newsletter entitled Rethinking AIDS, for which a
$25/year donation is requested.
The Group came into existence as a result of efforts to get the
following four sentence letter published in a number of prominent
scientific journals, including Nature, Science, JAMA, The New England
Journal of Medicine, and Lancet. As of October 1993, all have refused
to do so.
"It is widely believed by the general public that a retrovirus called
HIV causes the group of diseases called AIDS. Many biomedical
scientists now question this hypothesis. We propose that a thorough
reappraisal of the existing evidence for and against this hypothesis
be conducted by a suitable independent group. We further propose that
critical epidemiological studies be devised and undertaken."
The members of the Group do not necessarily agree with each other on
the precise nature and causes of "AIDS;" all they automatically have
in common is disbelief that HIV (sole) causation of AIDS has been
scientifically established.
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Question 7.6 American Academy of Allergy & Immunology Physician's
 Referral and Information Line
American Academy of Allergy & Immunology
Physician's Referral and Information Line
800/822-2762
The American Academy of Allergy & Immunology (AAAI) is the largest
national professional medical society representing allergists,
immunologists, and related allied health professionals. It is comprised
of 4600 clinicians, academicians, research scientists and allied
health professionals from the United States, Canada, and more than
40 foreign countries.
The purpose of the AAAI is to advance the knowledge and practice of
allergy and immunology through discussion at meetings; to foster the
education of both students and the public; to promote and stimulate
allergy and immunology research study; and to encourage the unity of
and cooperation among those engaged in the field of allergy and
immunology.
For more information about the AAAI, including membership information,
please contact:
Audrey Mudek
American Academy of Allergy & Immunology
611 E. Wells Street
Milwaukee, WI 53202
414/272-6071
If sending mail, please include a note that you heard about the AAAI
through a posting on the Internet.
To contact the AAAI via Internet, send e-mail to: paulr@execpc.com
Please include your name and mailing address.
========================================================================
======
=
Section 8. Internet resources.
Q8.1 Ben Gardiner's Gopher AIDS Database
Q8.2 CDC CDC National AIDS Clearinghouse Internet Services
Q8.3 WHO AIDS Cases Information
Q8.4 CDC AIDS Public Information Dataset.
Q8.5 World Wide Web site on AIDS (French and English)
Q8.6 Information about HIV and AIDS related patents
Q8.7 Art-AIDS Link
Q8.8 HIVNET/AEGIS Gateway (BETA VERSION) - Need update
Q8.9 Other USENET newsgroups.
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Question 8.1. Ben Gardiner's Gopher AIDS Database 
The 'gopher' system provides convenient menu-driven access to a wealth
of arcana--and valuable information--on the Internet. Daily, more and
more resources are made available in gopherspace. Generally, your
local gopher client (if one is installed) will be available by typing
'gopher' at your system prompt; your local system administrator should
be able to provide further details. Local gopher clients in turn allow
convenient access to other remote gopher clients throughout the
Internet.
One of the most valuable gopher resources for AIDS-related information
is the mirror of Ben Gardiner's AIDS-Info BBS database (also available
by direct modem dialup -- see below section). This database exists on
the University of California at San Francisco Experimental Gopher. It
may be reached either, (1) through the menu system of your local
gopher:
 
--> More Gophers and Other Internet Services/ --> All Registered 
Gophers/
--> North America/
--> USA/
--> california/
--> University of California - San Francisco, UCSFYI/
--> Computers and Networking Guide to Services at UCSF/
--> Questions, Answers and Information about Everything/ 
--> Databases (including Ben Gardiner's AIDS BBS database)/
or, (2) by typing 'gopher itsa.ucsf.edu', and going through the final
three menus. However, these particular menus are subject to change.
The most convenient means of reaching the database is by adding the
below information to your '.gopherrc' file. This will set a bookmark
in your personal gopher for the AIDS-Info BBS, which may be reached by
typing 'v' from anywhere within the gopher system. The information to
add, using your favorite system editor, is:
Type=1
Name=Databases (including Ben Gardiner's AIDS BBS database) 
Path=1/.i/.q/.d
Host=itsa.ucsf.edu
Port=70
The University of California at San Francisco Experimental Gopher also
provides gopher gateways to a wide variety of Biology and Medical
resource gophers. The UCSF gopher may be reached as described above
('gopher itsa.ucsf.edu'), or most simply by adding the following to
your '.gopherrc' file:
Type=1 
Name=Bio and Medical Gophers and Info. Sites Path=1/Bio and
Medical Gophers and Info. 
Sites Host=itsa.ucsf.edu Port=70
-------------------------------------------------------------------------
-----
Question 8.2 CDC National AIDS Clearinghouse Internet Services
 CDC National AIDS Clearinghouse
 Internet Services
The CDC National AIDS Clearinghouse is pleased to announce our new
Internet services, including a listserv of AIDS-related news, an
anonymous FTP site, and a gopher server. The CDC Clearinghouse
also maintains an Internet mailbox to which users may send
questions about Clearinghouse services, orders for free publications
and general inquiries. To correspond with the Clearinghouse, send
email to "aidsinfo@cdcnac.aspensys.com".
AIDS News Listserv
Address: listserv@cdcnac.aspensys.com
 A listserv (short for "listserver," the computer server that
runs the list) is an automated mailing list that sends electronic
mail messages to a large group of users who subscribe by sending
signup messages to the listserv. The CDC National AIDS
Clearinghouse maintains a read-only mailing list for individuals
who wish to receive AIDS-related documents from CDC, including the
AIDS Daily Summary, selected Morbidity and Mortality Weekly Report
articles, CDC National AIDS Hotline Training Bulletins, and
factsheets. The listserv also distributes press releases from
other Public Health Service agencies such as the National
Institutes of Health. To subscribe, Internet users should send the
message
 "subscribe aidsnews firstname lastname"
to the address above, where your real first and last names are
substituted for "firstname" and "lastname." Anyone with email
access to the Internet, including members of such networks as
America Online and CompuServe, can subscribe to the AIDS News
Listserv.
File Transfer Protocol (FTP) Site
Address: cdcnac.aspensys.com
 FTP allows users to download files from host computer sites
all over the world. An "anonymous FTP" site means that users do
not have to have an individual ID or password to connect to the
host. The CDC Clearinghouse's anonymous FTP site contains files of
documents such as the current HIV/AIDS Surveillance Report, AHCPR's
clinical practice guidelines, pathfinder guides to AIDS
information, and in the future, the Clearinghouse's Standard Search
Series. To obtain files:
 1) FTP to the address "cdcnac.aspensys.com"
 2) Type "anonymous" when asked to login.
 3) Enter your complete Internet address (e.g.,
 "johndoe@delphi.com") when asked for password.
 4) Change to the public directory and the CDC NAC
 subdirectory with the command "cd /pub/cdcnac".
 5) To download the file with basic information about CDC
 NAC's FTP site and the available files, type the command "get
 readme".
 6) To download other files, type the command "get filename",
 where "filename" is the name of the file. If downloading a
 binary (non-text) file, such as WordPerfect files ending in
 ".wp5" or compressed files ending in ".exe" or ".zip", be sure
 to type the command "binary" and press [Enter] before using
 the "get" command.
If using Mosaic or similar Internet software, the universal
resource locator address is "ftp://cdcnac.aspensys.com/pub/cdcnac".
Gopher Server
Address: cdcnac.aspensys.com
 A gopher server is a host computer with a simple menu
interface leading to text files of documents and other options. A
gopher is structured in a hierarchical or outline format with menus
and submenus leading to different levels of choices, like folders
or directories. The CDC Clearinghouse's gopher site contains the
AIDS Daily Summary, AIDS-related Morbidity and Mortality Weekly
Report articles, tables from the HIV/AIDS Surveillance Report, and
other CDC documents. Basic HIV/AIDS-related information is
available, as well as information about prevention, treatment, and

 
living with HIV. To reach the CDC Clearinghouse gopher, point your
gopher client to the address:
 "cdcnac.aspensys.com"
Select CDC NAC from the first menu. To point directly to the CDC
NAC gopher, point to the address "cdcnac.aspensys.com 72" (port
72). If using Mosaic or similar Internet software, the URL is
"gopher://cdcnac.aspensys.com:72".
-------------------------------------------------------------------------
-----
Question 8.3. WHO AIDS Cases Information
The latest figures on the The Current Global Situation of the HIV/AIDS
Pandemic are now available on the web using the URL:
 http://gpawww.who.ch/gpahome.htm
There also is a gopher version available at
 gpagopher.who.ch
For those with email only, the figures can be obtained by sending an 
email
message to gpadoc@who.ch with the command
 GET EMSERVE AIDSCASE
in the message text. A complete list of documents available from this
service can be retreived using the GET EMSERVE INDEX command.
These servers also contain additional publications and documents
developed by the Global Programme on AIDS, World Health Organization.
-------------------------------------------------------------------------
-----
Question 8.4. CDC AIDS Public Information Dataset. 
You can get the CDC AIDS public information Dataset via anonymous
ftp. Michelle Murrain has set up a small AIDS ftp site, which has the
most recent dataset (data through 1992). She gets each year's version
(usually in June-July) and puts it there. It contains a line of data
on each individual, including transmission category, OIs diagnosed,
date of diagnosis, etc.
The ftp site is:
family.hampshire.edu
directory, /pub/aids
The name of the file is PIDS92Q4.DAT (BEWARE the file is 16 MB!!)
There is also a Women and AIDS bibliography there. If anyone has
resources they would like to share with folks via FTP let her know and
she'll be glad to add them. Contact Michelle Murrain via
mmurrain@HAMP.HAMPSHIRE.EDU
-------------------------------------------------------------------------
----
Question 8.5 World Wide Web Site on AIDS (French and English)
 I'd like to inform you of (part of) a WWW server on AIDS and HIV in
french and partly in english. It contains extensive lists of ressources
in France, and also pointers to many other ressources on the Internet.
 The entry point in english is
 http://www.ircam.fr/solidarites/sida/index-e.html
-------------------------------------------------------------------------
-----
Question 8.6. Information on AIDS and HIV related patents
The US Patent and Trademark Office recently made available to the
Internet all AIDS and HIV-related U.S. Patents. The patents include
detailed research information.
http://patents.cnidr.org
or send e-mail with the word "help" in the message body to 
ezgate@cnidr.org
-------------------------------------------------------------------------
-----
Question 8.7.. ArtAIDS Link
The ArtAIDS LINK URL http://artaids.dcs.qmw.ac.uk:8001/
================
 
The ArtAIDS LINK is a collaborative art project and Internet event
open to all digital artists. The ArtAIDS LINK is located on the World
Wide Web, to commemorate and celebrate the fight against AIDS. The
LINK starts with original digital image files commissioned from
international artists, to enable an infinite chain of images (and soon
other digital media) to be created by modification and/or development
of the originals. New work can also be added to the LINK, in response
to the theme or aspects of the contributed images. Not all the
artists involved work on AIDS issues, but its theme is that *WE ARE
ALL INVOLVED*. The LINK symbolizes that involvement.
Participants can browse the ArtAIDS gallery and information pages,
which are regularly updated to reflect the submission of modified
digital art. Anyone can register to give notification of
participation, and to identify their contributions.
Initial contributions are expected to be single image files; no
restrictions are placed on file size, although the preferred formats
are:
 * 24-bit TIFF (RGB), 640x480 pixels, IBM PC byte order,
 with LZW compression.
 * Adobe Photoshop (2.5), 640x480 pixels
Other file types are welcome, but please check with the technical
coordinator first. Animation, multi-media, audio, MIDI and font files
are welcome, and you should contact the technical coordinator for
further information. Files created on an Apple Macintosh should be
binhex'd before contributing. The ArtAIDS LINK will become active on
World AIDS Day, 1st December 1994, hosted by Queen Mary and Westfield
College, University of London. This was preceded by an Internet video
conference launch, using the MBONE, on 28th December and hosted by
University College London. The LINK will close in March 1995, and
re-open in November 1995, prior to World AIDS Day 1995. We are
seeking sponsorship to help maintain the LINK; please contact Andrew
Nimmo if you are interested.
Project Coordinator: Q Love (Roarke Associates)
Technical Coordinator: Andrew Nimmo (email A.D.Nimmo@dcs.qmw.ac.uk)
Project Curator: Peter Ride (Cambridge Darkroom Gallery)
ArtAIDS LINK: http://artaids.dcs.qmw.ac.uk:8001/ 
ArtAIDS Email:ArtAIDS@dcs.qmw.ac.uk>
=====================================================================
ArtAIDS is a collaborative project for CRUSAID, a leading UK AIDS
fund-raising charity, with the Cambridge Darkroom Gallery, Queen Mary
and Westfield College (University of London), University College
London, Roarke Associates and the BBC Networking Club.
The ArtAIDS LINK is supported by funding from the Arts Council of 
England.
-------------------------------------------------------------------------
-----
Question 8.8. HIVNET/AEGIS Gateway
 Frequently Asked Questions About AEGIS 
What is AEGIS?
 AEGIS--AIDS Education Global Information System--is a global 
 freeway to a world of people, knowledge, and resources. A
 non-profit bulletin board service (BBS), AEGIS is the world's
 largest non-government database on HIV (the human
 immunodeficiency virus) and AIDS (acquired immune deficiency
 syndrome).
 The AEGIS database contains nearly 2 gigabytes of information,
 stored in over 158,000 files of information, with about several
 hundred new files added monthly. Users can read and download
 more than 26 different full-text publications, the National
 Library of Medicine's CLINICAL ALERTS, AIDS DRUGS, AIDS TRIALS,
 and AIDSLINE databases (more than 100,000 files), the National
 AIDS Clearinghouse's recourse data (more than 15,000 files), Law
 Library containing dozens of full-text AIDS-related judicial
 decisions and legal commentaries, a FUNDING RESOURCE database and
 global events calendar.
 Users also can connect directly to the White House (ONAP/OASH)
 BBS, FDA BBS, and NIH BBS in Rockville, MD. Additionally, AEGIS
 provides gateways to a number of AIDS-related conferences or
 "electronic town-halls" in English, Dutch, German, and Spanish,
 where users can seek and share information.
 AEGIS is the cornerstone of the Global Electronic Network for
 AIDS, an international consortium of electronic bulletin boards,
 and regularly uploads information to more than 150 BBSs in North
 America, Europe, Africa, Asia, and Australia.
 While there are no formal agreements or obligations between AEGIS
 and its affiliates, AEGIS asks and expects affiliates to share the
 information it provides without charge.
Who can use AEGIS?
 Anyone with a computer and a modem can use AEGIS at any time from
 almost any place in the world. Typically, users include persons
 with HIV/AIDS and their friends and families, health care
 providers and AIDS service organizations, educators and
 researchers, and affiliated bulletin board systems that download
 AEGIS files for toll-free use by their members.
 AEGIS is as user-friendly as it is powerful. AEGIS screens are
 straightforward and easy to understand even by computer novices.
 AEGIS is "keyword searchable", so topics can be found by typing in
 a few simple instructions. Ease of use will be further enhanced
 in 1995, when AEGIS introduces a point-and-click graphical user
 interface.
Is AEGIS a free service?
 Since 1990, AEGIS has been free to the user and has depended
 entirely upon donations to operate. A serious system crash in
 December of 1994, demonstrated the danger of trying to operate a
 service as important as AEGIS on an annual budget well under
 $20,000.
 In 1995, AEGIS is reorganizing to establish the fiscal strength it
 needs to secure the service and continue its growth. AEGIS will
 institute user fees designed to cover half its operating costs.
 However, it is integral to its mission "to find and operate AEGIS
 in ways that minimize economic barriers to its use." As a matter
 of policy, AEGIS will continue to make free access available to
 people with HIV/AIDS and the organizations that support them.
What is the purpose of AEGIS?
 1) To develop, maintain, and enhance a global online network
 where people can confer, seek, and exchange information on
 HIV and AIDS.
 2) To develop, maintain, and enhance a comprehensive,
 up-to-date database of information related to HIV and AIDS.
 3) To increase local, national, and global awareness of the
 AEGIS among persons with HIV and AIDS, researchers, health
 care providers, educators and others affected by HIV/AIDS.
 4) To fund and operate AEGIS in ways that do not create economic
 barriers to its use.
Why is AEGIS needed?
 - As of July, 1994, there have been 3,430 persons with AIDS in
 Orange County, 72,433 in California, and 388,365 in the
 United States. A quarter million Americans have been lost
 to this epidemic.
 - In some parts of the world, new infections have soared
 ten-fold in four years.
 - 17 million people worldwide are infected with HIV, the human
 immunodeficiency virus. By the year 2,000, between 40 and
 110 million people will be HIV-infected.
 - The 'magic bullet' to cure or prevent HIV disease has not
 been found, and AIDS cannot yet be considered a manageable
 chronic disease.
 - People with or affected by HIV/AIDS often are isolated by
 cultural, geographic, and economic barriers.
 In these times, the question is how must we fight AIDS and
 relieve the human suffering it causes? We believe the answer
 will be found in the transformation of information into
 knowledge. For that to happen, information must be freely
 available, easily accessed, and widely disseminated. It must be
 used.
 AEGIS employs the latest telecommunications tools to make
 information about HIV/AIDS available to anyone who needs it. In
 this way, we seek to relieve some of the suffering and isolation
 caused by HIV/AIDS, and foster the understanding and knowledge
 that will lead to better care, prevention, and a cure.
What is the history of AEGIS?
 AEGIS is a classic grassroots success story. In the mid-1980s,
 Orange County resident Jamie Jemison saw the potential of an
 online bulletin board service devoted to HIV/AIDS. The BBS he
 called AEGIS, however, was ahead of its time. The cost and
 limitations of computers and modems at that time for both a BBS
 and individuals were substantial barriers to their use. AEGIS
 remained a dream until he and Sister Mary Elizabeth connected in
 mid-1991.
 In 1990, she had launched the "HIV/AIDS Info BBS", motivated by a
 stay in a small Midwest farm community where she met several
 persons living with AIDS. They were profoundly isolated by
 illness, small town fears, and geography. In their need, she saw
 a way to put her technical skills to a spiritual use.
 Sr. Mary Elizabeth suggested joining forces with Mr. Jemison.
 However, he had gone on to other pursuits and ceded the use of
 the name AEGIS to Mary Elizabeth. Ever since, she has made AEGIS
 her life's work, building AEGIS into a service the Centers for
 Disease Control calls "the best of its kind."
Is AEGIS a religious organization?
 Since 1990, AEGIS has been a service of the Sisters of St.
 Elizabeth, a 501c(3) religious community. As such, AEGIS is
 spiritually motivated. But it has no religious agenda and makes
 no religious statement beyond the belief that "a virus has no
 morals."
 The community was organized in accordance with the precepts of
 the Episcopal Church, but it has not met the requirements for
 formal recognition at this time. AEGIS is now the primary
 community service activity of the Sisters of St. Elizabeth, and
 is operated solely by its founder.
 AEGIS is now in the process of reorganizing as a 501(c)3
 charitable and educational nonprofit organization, with bylaws
 and a Board of Directors. This step is intended to clarify the
 mission of AEGIS, and to involve more people in protecting and
 enhancing its viability and effectiveness. How well known is
 AEGIS?
 AEGIS is widely recognized by those involved in AIDS/HIV issues
 and familiar with bulletin board services. Feature articles have
 been written about AEGIS in the Los Angeles Times, the San
 Francisco Examiner, and the Computer Shopper, as well as several
 AIDS service organization newsletters. However, AEGIS needs to
 become better known in the HIV/AIDS community, particularly among
 AIDS service organizations and people with HIV/AIDS who are
 novice computers users.
What are the barriers to using AEGIS?
 1) Lack of awareness is the biggest barrier. AEGIS has never
 had the resources to engage in any formal marketing and has
 relied on word-of-mouth and occasional articles to increase
 awareness.
 2) Resistance to technology ("modem phobia") is another
 barrier. Even among computer users, there is the perception
 that modems are difficult to understand, install, and use.
 For the average computer user, e-mail, the Internet,
 cyberspace, etc. are still esoteric concepts, not practical
 tools.
 3) Cost of equipment and/or phone carrier charges is a third
 factor. The cost of computers and modems drop each year,
 the equipment still represents a substantial investment for
 many individuals.
Is AEGIS a start-up service?
 No! AEGIS is a mature, robust, fully operational service with a
 global network of users.
Is AEGIS unique?
 The "Guide to Selected AIDS-Related Electronic Bulletin Boards
 and Internet Resources," published by the CDC National AIDS
 Clearinghouse, contains information on dozens of computerized
 AIDS-related services.
 Only AEGIS is given a separate appendix, which contains an
 overview of AEGIS and a 10-page list of over 150 AEGIS affiliates
 in North America, Europe, Africa, Asia, and Australia. It says
 of AEGIS: "This comprehensive information collection is current
 and easily accessible; simply stated, this is one of the best."
 There are few significant alternatives to AEGIS. One of the
 newest is the AIDS/HIV Forum, a product of HandsNet, a nonprofit
 company whose clients are human services agencies. Its AIDS/HIV
 forum has received a two-year establishing grant from the Henry
 J. Kaiser Family Foundation.
 AEGIS is different from HandsNet in three ways. HandsNet targets
 only AIDS service organizations in this country. AEGIS is
 available to anyone and any organization, and is global in reach.
 HandsNet has a graphical interface. AEGIS does not, although it
 is praised for its ease of use. HandsNet charges fees that will
 average about $400 a year per agency. AEGIS is free to the user
 and seeks contributions from those who believe in its mission.
 In California, CAIN--the Computerized AIDS Information
 Network--is sponsored by the State Office of AIDS. Like AEGIS,
 CAIN includes e-mail, an interactive bulletin board forum, and
 databases of AIDS information. CAIN is far less comprehensive and
 up-to-date than AEGIS. CAIN also resides on the Delphi network
 and is available by subscription only.
 What makes AEGIS unique is that it is a single, all-inclusive
 AIDS/HIV resource with a global reach that is free to the user.
 You can access AEGIS by having your computer dial 714.248.2836.
 Communications protocols are 8N1/Full Duplex. AEGIS supports
 v.34 (28,800 bps) on all lines.
How does AEGIS operate?
 Since its inception, AEGIS has been managed by Sister Mary
 Elizabeth, its founder and system operator (sysop). Like many
 founders of grassroots organizations, she is a singular person
 doing the work of many people. AEGIS is now her life's work and
 she is on the job nearly every waking hour.
 Since 1990, Sister Mary Elizabeth has operated AEGIS on an annual
 budget considerably less than $20,000. AEGIS has received no
 government or foundation support, and has depended solely on
 contributions of money, equipment, and space from individuals who
 believe in its mission. In addition, its founder has worked as a
 consultant, with those fees going to maintain the service.
 In 1994, Sister Mary began to be more direct in asking users for
 contributions. This effort has had, at best, a modest success.
 A recent system crash, which kept AEGIS down from Sunday, December
 4, to Wednesday, December 7, 1994, resulted in a number of
 donations and offers of assistance. If this was a "blessing in

 
 disguise", it was in demonstrating that AEGIS is not secure at the
 present level of funding.
 To protect AEGIS, the organization has entered a second
 evolutionary stage. As an initial step, AEGIS is reorganizing as a
 501(c)3 nonprofit educational and charitable organization with a
 Board of Directors.
 A Business Plan is under development which will set goals and
 explore a variety of funding options, including foundation
 grants, government grants, and user fees. Some of the goals that
 have been identified are:
 - To have a salaried, full-time system operator
 (sysop)/coordinator. At this time, this position is being
 filled without pay by Sister Mary Elizabeth.
 - To train a half-time technical assistant in all aspects of
 maintaining the system, so that AEGIS is not fully dependent
 on its founder. This position is new and remains vacant.
 - To hire an executive director with primary responsibility
 for development and marketing. This position is new and
 currently is being filled by Christopher Quilter on a
 volunteer basis.
 - To become a node on the INTERNET.
 - To develop and maintain a more redundant and robust system
 better protected from crashes and better able to recover
 when they occur, and to acquire the technology that will
 augment the system's power and features.
 - To find and implement telecommunication options that make
 access to AEGIS easier and more affordable for the user.
 Christopher Quilter
 January 12, 1995
-------------------------------------------------------------------------
-----
Question 8.9. Other USENET newsgroups.
at your site--it discusses technical issues related to the molecular
should read these for a few days before posting, to see if your
question has been answered already, and to get a feel for the tone of
the group.
Misc.health.aids, a new unmoderated newsgroups is available for open
dialogue about AIDS and HIV, and often focuses on alternative 
treatments.
 
rdue
Archive-name: aids-faq/part9
AIDS FAQ Part 9/10
=============================================================
Section 9. Other Electronic Information Sources. 
Q9.1 List of AIDS BBSes.
Q9.2 National AIDS Clearinghouse Guide to AIDS BBSes.
Q9.3 National Library of Medicine AIDSLINE (please contribute)
Q9.4 Commercial Bulletin Boards
Q9.5 Reappraisal of the HIV-AIDS Hypothesis.
Q9.6 Lesbian/Gay Scholars Directory.
-------------------------------------------------------------------------
-----
Question 9.1. List of AIDS BBSes. 
Norman Brown's Consolidated List of aids/hiv Bulletin Boards 
Compiled For All People Affected By hiv/arc/aids
ABBS9310.DOC - 1993 Revision #9 - Updated to 1 October 1993
Compiled by Norman R. Brown - Copyright (c) 1993
CORRECTIONS Send NetMail to Norman Brown at FidoNet 1:104/909, GayCom
207:1/104, 94:3130/0 on ADAnet, N.BROWN1 on GEnie,
norman.brown@tde.com -OR- n.brown1@genie.geis.com on Internet
The acronyms "aids/hiv/arc" are in lower case in this document in order
to lessen their appearance of importance for the reader. Check with
your sysop as to whether it should be in upper or lower case on your
| particular bulletin board when making reference to particular echoes. 
This list is published and available for FREQ'ing as ABBS on or near the 
1st
of each month from:
Phone Number Fidonet ADAnet GayCom
Black Bag 302-994-3772 1:150/140 94:3020/1 -------
Denver Exchange 303-623-4965 1:104/909 --------- 207:1/104
Doc In The Box 314-893-6099 1:289/8 94:3140/1 -------
Erie Canal 315-445-4710 1:2608/31 --------- -------
hiv/aids Info 714-248-2836 1:103/927 --------- -------
hivNET-Amsterdam 31-20-6647461 2:280/413 --------- ------- 
SCHWUBS 49-71-5256330 2:244/52 --------- -------
Southmed Sydney 61-2583-1027 3:712/700 --------- -------
LambdaConn 203-877-6667 1:141/215 --------- -------
The shareware program FONDIR*.ZIP is also available from the same
bulletin boards.
Both files are available on GEnie, as well, in the Medical Forum, Page
745;3 as well as LiveWire, Page 400;7. They are also available on a
new network called NVN (National Videotex Network) on the aids
Forum. They are also available on the Internet. To receive them
through the Internet mailing list, please see further instructions on
page 16 of this document.
Copyright 1993 by Norman R. Brown for all people affected by
hiv/arc/aids. All rights reserved. For individual use only. Permission
is granted for posting this list in the file areas of public bulletin
boards, provided no charge is made for access. Bulletin board users
may print or copy this list for their own use or for limited sharing
with others in their hiv/aids or computer-user organizations, or for
posting in such places as public libraries. Please do not place in a
BBS message area other than in brief response to a specific
question. Unauthorized publication, in whole or in part, in any other
form or any commercial use of the material contained herein is
expressly forbidden.
Norman Brown's Consolidated List of aids Bulletin Board Systems
Primarily, this list includes all of the known BBS's which participate
in the aids/hiv-related ADAnet, FidoNet, GayCom, MetroLink, RBBS-NET,
RelayNet and TNet conferences marked with an asterisk in the footnote
column below. This list is compiled from ORIGIN lines in messages
reaching San Francisco, CA; Denver, CO; and Washington, DC; plus
information learned from other sources. Please remember when using
information from it that much of it changes each month.
Available aids-Related Conferences (Echoes) 
ECHO NAME TOPIC MODERATOR Z:NET/NODE FN
-------------------------------------------------------------------------
-----
act up ACT UP discussion Bearded Crewman 1:141/107 *
aids.data aids data. No discussion Mary Elizabeth 1:103/927 *
aids.dialogue aids-related support disc. Jeffrey Lizotte 1:141/215 * 
aids.hiv aids-related discussion Bert Sainz 1:123/316 F*
aids.spirit spiritual discussion/aids Kenny Teel 1:141/650 *
aids.women aids discussion for women Angie Kersnick 1:129/228 *
aids/arc aids-related discussion Mary Elizabeth 1:103/927 F*
taa aids-related discussion Johnny Chased 207:1/1 G*
hiv dateline hiv+ persons Randy Dodson 1:379/24
hiv/arc/aids aids-related discussion Hans Braun 1:125/572 S*
" " Jay Lightner S*
Living w/hiv aids-related discussion White Eagle 1:125/572 S*
-------------------------------------------------------------------------
-----
F Available on FidoNet "Backbone" in most Fido regions. G Available
only to GayCom subscribers. L Local BBS S Available only to StudsNet
subscribers. * Participants included in this list.
**********
ST U.S. State or Canadian Province
SYSOP System Operator
Z: FidoNet Zone, or other network, as follows: 
n: FidoNet (where n is: Zone 1 - North America; 
Zone 2 - Europe, etc.;
Zone 3 - Oceania;
Zone 4 - Latin America;
Zone 5 - Africa; or
Zone 6 - Asia.
A: ADAnet
207: GayCom private gay network
L: Local only; primarily aids/hiv, but does not carry echoes R: RBBS-NET
Relaying Networks:
MetroLink
RelayNet
TNet
Conversion to a Dialing Directory
You can convert ABBSyymm.DOC into a dialing directory for most major
communications programs by using a shareware program called FONDIR,
available on many BBS's. To use ABBSyymm.DOC together with FONDIR
simply enter this command at theDOS prompt:
FONDIR ABBSyymm.DOC /O:? /L:nnn- /A:1- /M:x
where: "ABBSyymm.DOC" is the name of the file; "?" is the code for
your software:
+ = ProComm+ 1.1 K = K9 Express 8.8 3
2 = ProComm+ 2.0 L = Ultiterm 2.0 3
A = PCanywhere 3.11 M = Telemate 3.01 - see FONDIR.DOC 3
B = Boyan 5.0 O = Mirror 3 1.01 3
C = PC Talk 1.39 P = Procomm 2.4.3 3
D = A Dialer 2.0 Q = Qmodem 4.5/5.0 3
E = Pilot 2.0 R = Rcomm 2.1 3
F = Commo 5.0 T = Telix 3.15 3
G = GT Powercomm 17.00 U = Unicom 3.0 3
I = Pibterm 4.1 Y = Carbon Copy Plus 4.01 3
"nnn" is your local Area Code;
"A:1-" adds the long-distance access code. 3
"x" is the maximum speed of your modem:
1 = 1200;
2 = 2400;
4 = 4800; and
9 = 9600.
ST City Bulletin Board/SYSOP Z:Net/Node Phone # (1+)
United States (FidoNet Zone 1)
AL Birmingham ADAnet Zone Coord/Bill Freeman A:94:94/0 205-854-5863 
AL Birmingham Int.Tech.Coord/Marlin Johnson A:94:94/97 205-254-3344 
AL Birmingham Torch Song/Festus S: 205-328-1517
AL Pinson ADAnet One Hub/Bill Freeman 1:3602/24 205-854-9074
AR N LittleRockGrapeVine/Ferret Face RelayNet 501-753-8121
AZ Phoenix Cade/William Richards 1:114/113 602-931-3468
AZ Phoenix Cloud 9/Tom Thurston 1:114/184 602-225-0512
AZ Phoenix Meat Rack/Rick Haubert 1:114/188 602-273-6956
AZ Phoenix Messenger/Howard Marshall 1:114/183 602-547-9513
AZ Phoenix Shadow Keep/Jandar 1:114/188 602-395-0500
AZ Tucson Western Connection L: 602-881-8283
CA Anaheim Meditation, etc./Bob Johnstone 1:10/227 714-952-2110
CA Benicia Task Force/Don Morse 1:161/513 707-747-5738
CA Claremont Intermania/Rick Walker 1:218/502 909-624-2246
CA Clovis Clovis Co of Fresno/Rod Jessen 1:205/48 209-323-7583
CA Clovis Clovis Co of Fresno/Rod Jessen R:8:910/512209-323-7583
CA Concord DVMCC/Drew Blanchard 1:161/203 510-827-0804
CA Concord Grateful Med/T.C. Dufresne 1:161/63 510-689-0347
CA Concord Grateful Med/T.C. Dufresne A:94:5100/3510-689-0347
CA Danville Dear Theophilus/Mark Spaulding 1:200/703 510-831-8436 
CA El Cajon Camelot 619-447-7869
CA El Cajon El Cajon Network Central 1:202/1522 619-447-7869
CA FountainVal Ye Olde BBS/Dallas Jones 1:103/552 714-968-1899
CA Fresno LightHouse/Danny Davis R:8:910/524209-252-7968
CA Gardena Gardena/Mark Bishop 1:102/255 310-555-1212
CA Hayward New Big Board/Cliff Wilson 1:204/10 510-670-2940
CA Irvine Wellspring/Steve Clancy 714-725-2700
CA Irvine Wellspring/Steve Clancy 714-856-5087
CA Irvine Wellspring/Steve Clancy 714-856-7996
CA Los Angeles Empty Bed Pan/Stu Carlson 1:102/733 310-478-0451
CA Monterey Nitelog/ RelayNet 408-655-1096
CA No.Highland Silverado Express/Rod Abbott 1:203/1102 916-344-8146 
CA N.Hollywood L.A.ValleyCollege/Tom Klemesrud 1:102/837 818-985-7150 
CA Northridge Silent Partner/Jim Schooler 1:102/910 818-832-4585
CA Pacifica Chemist'sComPort/Larry McGee 1:125/190 415-359-6036 
CA Sacramento Omar's Corner/Brian Greendahl 1:203/164 916-641-2413 
CA San Diego Hillcrest Community/MichaelBlair1:202/703 619-291-0544 
CA San Diego Mushin/Brad Chesbro 1:202/604 619-535-9580
CA San Diego Patient Advocate 1:202/742 619-546-4334
CA San Diego Telesis/ 1:202/740 619-497-0288
CA San Diego West Coast Connection/ RelayNet 619-449-8333
CA San Francis aids Info/Ben Gardiner L: 415-626-1246
CA San Francis Breath of Fresh Air hiv/aids 1:125/120 415-488-1461 
CA San Francis Fog City/Bill Essex 1:125/100 415-863-9697
CA San Francis Fog City/Bill Essex 207:1/5 415-863-9697
CA San Francis Fog City/Bill Essex 207:1/5 Members Only
CA San Francis Recovery/Rick Gorin 1:125/9 415-255-2188
CA San Francis STUDS!/Hans Braun 1:125/572 415-495-2929
CA San Francis STUDS!/Hans Braun S: 415-495-2929
CA San Mateo HTG/Outreach/Allan Hurst 1:204/462 415-572-9594
CA San Mateo PCBL/Les Kooyman 1:204/501 415-572-9563
CA SanJuanCapi hiv/aids Info/Sr.Mary Elizabeth 1:103/927 714-248-2836 
CA SantaFeSprngHelping Hands/Rick Venuto 1:102/433 310-948-5919
CA Santa Rosa Sonoma Online/Don Kulha 1:125/7 707-545-0746
CA Simi Valley Library/Gary Vedvik 1:102/1006 818-999-4391
CA Torrance Art Gallery-South/Mike Reeves 310-791-7278
CA Tujunga Mysteria/Phil Hansford 1:102/943 818-353-8891
CA Vacaville Net/Don Morse 1:161/611 707-746-6091
CA Vallejo Power Station/Joe Martin 1:161/123 707-552-0462
CO Bailey BaileyInfoExchange/Chris Stone 1:104/825 303-674-0147
CO Col.Springs Socialism OnLine/Randy Edwards 1:128/105 719-392-7781 
CO Col.Springs FireNet Leader/Wood/Sanders 1:128/16 719-591-7415
CO Denver Denver Exchange/James Craig 1:104/909 303-623-4965
CO Denver Denver Exchange/Sex Pistol 207:1/0 303-623-4965
CO Denver Denver Exchange/Sex Pistol 207:1/104 Members Only
CO Denver Denver Exchange/Sex Pistol S: 303-623-4965
CO Denver Max Manlove's/Max Manlove 1:104/431 303-863-0227
CO Denver Welcome Home/Dave Wilson 1:104/433 303-839-8665
CO Ft. Collins EMCC #2/Mike Coppock 1:306/31 303-484-6663
CO Littleton GC Fido/Steve Raymond 1:104/19 303-795-1215
CO WestAdamsCo Telepeople/Marshall Barry 1:104/69 303-426-1866
CT Rainbow View/Bill Hausler 1:141/991 203-744-0179
CT Branford Lifestyles (Gay)/Rick Sande 1:141/107 203-481-4836
CT Meriden Nusing Network/Michael Rostock 1:141/896 203-237-1131
CT Milford LambdaConn/Jeffrey Lizotte 1:141/215 203-877-6667
CT New Haven NHGCS Network/Kenny Teel 1:141/650 203-624-8990
CT Newington First Impressions/Corey Keaton 1:142/667 203-667-9666 
CT No.Branford Hippocampus/Aaron Waxman 1:141/205 203-484-4621
CT Wallingford Vampire Connection/John Melillo 1:141/808 203-269-8313 
CT W.Jordan Lake Wobegon/Robert Klaproth 1:311/19 801-568-3866 
CT Yalesville Emerogronican/Steven Ambrosini 1:141/666 203-949-0189 
DC Washington COCKpit 1:109/196 202-862-5497
DC Washington DC Information Exchange MetroLink 703-836-0748
DC Washington GLIB/Jon 207:1/3 703-578-4542
DC Washington GLIB/Jon 207:1/3 Members Only
DC Washington OASH/Ted Foor 1:109/166 202-690-5423
DE Bear Obsession/Bob Chalmers 1:150/135 302-836-7145
DE Wilmington Black Bag Medical/Ed DelGrosso 1:150/140 302-994-3772 
DE Newark Black Bag/Edward DelGrosso A:94:3020/1302-994-3772
FL Stetson University Legal L: 800-624-9091
FL Boynton College Board/Charles Bell 1:3638/13 407-731-1675
FL Davie Samurai Palace/ 305-587-018
FL DeLand Colosseum/Robert Gary 1:3618/28 904-734-9951
FL Hialeah LatinConnection/AdrianaFernandez1:135/323 305-826-0778
FL Hollywood Dracula's Castle/Robert Fonner 1:369/24 305-964-2696 
FL JacksonvilleCharlie's/Charles Deskin 1:112/69 904-396-4931
FL LifeLine 1:112/73 904-276-4724
FL Miami Tech-80/Bert Sainz 1:135/55 305-264-8155
FL Miami Lakes Telcom Central/Ray Vaughan 1:135/23 305-828-7909
FL Miami ShoresTown Crier/Orville Bullitt 1:135/36 305-785-0912
FL NewPtRichey Ground Zero/Sean Fleeman 1:3619/25 813-849-4034
FL NewPtRichey Special Place/Bob Dipalma 1:3619/19 813-372-7525
FL No. Miami Jailhouse/Kenny Star 1:135/34 305-944-6271
FL Orange Park OverbytesIndustries/Jaime Gibson1:112/92 904-278-0771
FL Orlando Compu-Link/Bill Wenzel 1:363/1571 407-240-7864
FL Orlando Nurse Corner/Pat & Jim Keller 1:363/15 407-299-4762
FL Palm Beach Adonis/Hung+ S: 407-881-8641
FL PalmBchGard Custom Computers/John Skakandy 1:3646/1 407-743-1112 
FL PampanoBeac Backstreet/Bob Kecskemety 207:1/17 305-941-0216
FL Port Richey Special Place/Bob Dipalma 1:3619/19 813-372-7525
FL Raiford MedLink Node 1/Bill Matthews 1:3600/3 904-431-1913
FL StPetersbur #1 Computers/Robert Dempsey 1:3603/260 813-521-3149
FL StPetersbur #1 Computers/Robert Dempsey 1:3603/260 813-527-1556
FL StPetersbur Mercury Opus/Emery Mandel 1:3603/20 813-321-0734
FL Sarasota Courts of Chaos/Lanier Kingsley 1:137/124 813-923-1055 
FL Cocoa MOTSS/Don Wilcox 1:374/41 407-779-0058
FL Talahassee Dreamland/David Barfield 1:3605/900 904-224-3545
FL St.PetersburAfterMidnite/Dell Edwards 1:3603/103 813-823-3163
FL Tampa AlternativeJames Floyd 1:377/51 813-882-8939
FL Tampa PrideNET USA!/Tony Myers 1:377/24 813-837-5463
FL Tampa T.A.B.B. 1:377/6 813-961-6242
FL Tampa Talen/Don Hardy 1:3603/410 813-895-0364
FL Venice Venice Recovery/John Grossberg 1:137/408 813-492-9592
GA Atlanta CDC aids Info Line/ L: 404-377-9563
GA Atlanta CDC aids Lab Info/ L: 800-522-6388
GA Atlanta hivNET Atlanta/David Coobs 1:133/606 404-622-2070
GA Atlanta Medical Forum/ L: 404-351-9757
GA Atlanta Meet Factory/ S: 404-350-0308
GA Atlanta PC Connect/Louis Kahn 1:133/620 404-565-8250
GA Atlanta Trash Shack/Dennis Dore 1:133/518 404-320-0026
GA Atlanta Trash Shack/Dennis Dore S: 404-320-0026
GA Centerville Mother's Kitchen/Mike Tucker 1:3611/19 912-953-2708
GA Conyers Atlanta Connection/Bill Noel 1:133/205 404-929-0800
GA Lawrencevil Retreat/Andria Duncan 1:133/618 404-339-3660
GA Macon Middle GA Medical/Doug Dozier 1:3611/5 912-477-8741
GA Norcross Pharmacy/Mike Mayer 1:133/601 404-729-1766
GA Smyrna No Frills/ 404-435-9608
GA Valdosta HOT South/Aulton White 1:3645/30 912-242-0496
GA Woodstock Index System/Rodney Aloia 1:133/201 404-924-8472
HI Honolulu GQ Link 1:345/3 808-526-9042
HI Honolulu Homeboy Shopping/David Roberts 1:345/23 808-624-1294 
HI Kahalui Modem Mania/Sue Kamalo 1:345/18 808-871-5891
IA Des Moines Silver Xpress/Brad Meyers 1:290/6 515-288-7793
ID BonnersFerr King Morpheous/Jeff Burns 1:346/16 208-257-5801
IL Champaign LawBoard Fido/Fred Grosser 1:233/1 217-352-6118
IL Chicago I Can!/Bogie Bugsalewicz 1:115/738 312-736-7434
IL Chicago I Can!/Bogie Bugsalewicz A:94:3120/2312-736-7434
IL Chicago Lambda Zone/Toby Schneiter 207:1/106 708-696-4298
IL Danville Grapevine/Danny Keele 1:233/30 217-431-8555
IL Moline Rampage/John Buckwalter 1:232/49 309-764-9794
IN Evansville Digital Dreams/Dave Worley 1:2310/220 812-421-8011
IN Evansville TGC Adult/ TNet 812-284-5465
IN IndianapolisPortalToInfinity/Anthony Besisi 1:231/540 317-887-6043 
IN Whiting ADAnet EList Coord/Rick Catania A:94:94/98 219-659-0112
KS OverlandPar South of the River/John Schmake 1:280/9 913-642-7907 
KS Winfield 9th & Main/Benn Gibson 1:291/21 316-221-3276
KS Witchita Land of Awes/Rex Rivers 1:291/9 316-269-3172
KS Witchita Land of Awes/Rex Rivers 207:1/10 316-269-4208
KS Wichita Q Continuum/Mike Randolph 1:291/1701 316-721-8466
KY Erlander DataNet/Rich Ashworth 1:108/90 606-727-3638
KY Louisville Code III/Ken Murray 1:2320/210 502-368-6908
KY Louisville LiveWire Online/Allen Prunty 1:2320/110 502-933-4725 
LA Lafayette Spinal Tap/Ryan Brooks 1:3803/4 318-233-0363
LA New Iberia Circle of Support/ 1:3803/7 318-367-9916
LA New Orleans Leather Connection/RobertGoslin 207:1/111 504-947-2627 
LA New Orleans Tulane Med. Ctr. L: 504-584-1654
MA Billerica Chicken Coop/Daniel Shapiro 1:324/295 508-667-7234
MA Billerica Vision/Joseph Oliveira 1:324/279 508-670-0934
MA Boston Five Point/Isaac Obie 1:101/625 617-859-7398
MA Boston StarBase/Ric Giguere 1:101/165 617-739-9246
MA Leicester Lighthouse/George Lafreniere 1:322/605 508-892-8857 
MA Leicester Lighthouse/George Lafreniere A:94:6021/5508-892-8857 
MA Melrose Den/Ray Gouin 1:101/225 617-662-6969
MA Needham Weed Garden/Holt Lipman 1:101/295 617-444-4061
MA Westminster DarkSide/David Place 1:322/247 508-874-6334
MA Worcester Foundation/Phil Collins 1:322/732 508-797-9563
MD Baltimore Harbor Bytes/ 207:1/15 301-235-4651
MD Baltimoore John's BBS 1:261/1083 410-566-1336
MD Baltimore Writer's Block/Ed Lawyer 1:261/1056 410-945-1540
MD Chevy Chase WorldComm/Matt Clement 1:109/466 301-657-8313
MD Frederick Chipin Block/ MetroLink 301-698-1486
MD GaithersburgNational hiv/aids/Joie Clarke 1:109/727 301-869-6808 
MD Wheaton Honey Board/Heather James 1:109/543 301-933-1467
MD Rockville FDA/ L: 800-222-0185
MD Rockville FDA/ L: 301-227-6849
MD Waldorf Brodmann's Place/Dave Brodmann 1:109/806 301-843-5732
MD Waldorf Brodmann's Place/Dave Brodmann S: 301-843-5732
MI Birmingham Alternate One/Ronald Miotke 1:2202/1 313-644-1260
MI Detroit Legend of Roseville RelayNet 313-776-1975
MI Highland Jim's Coffee House/Jim Pesola 1:2202/4 313-887-4330 
MI Lansing Flaming Dragon/Jim Knauer 1:159/675 517-336-7846
MI Monroe Fast Eddie's/Ed Dobie A:94:3130/2313-243-0944
MI Mt. Clemens Boat Town USA/Dan Dalton 1:2202/0 313-468-3572
MI Mt. Clemens Boat Town USA/Dan Dalton 1:2202/0 313-468-6982
MI Mt. Clemens Boat Town USA/Dan Dalton 1:2202/18 313-468-0912
MI Mt. Clemens Boat Town USA/Dan Dalton A:94:3130/0313-468-0912
MI Mt. Clemens JADA Editor/Peggy McBride A:94:94/94 313-468-0912
MI Pontiac Fire & IceBill Sims 1:2202/9 313-373-8608
MI Roseville Lyme Light/Anne Bussell A:94:3130/4313-774-5038
MI SterlingHts New Life/Julia Sidebottom 1:2202/2 313-795-5829
MN Andover DRAGnet/Gordon Gillesby 1:282/1007 612-753-1943
MN Andover DRAGnet/Gordon Gillesby A:94:6120/1612-753-1943
MN AppleValley Carolyn's Closet/Carson Kimble 1:282/3015 612-891-1225 
MO JeffersonCy Doc In The Box/Mark D. Winton 1:289/8 314-893-6099 
MO JeffersonCy Doc In The Box/Mark D. Winton A:94:3140/1314-893-6099 
MO Kansas City Shrouded Realm/Terry Goodlett 1:280/27 816-483-7018 
MO Kansas City KC aids InfoLink/Scott Cohan 1:280/14 816-561-1186 
MO Kansas City GCOMM/Scott Cohan 207:1/110 816-561-1187
MO Springfield ARCAngelExpress/SterlingMunhollo1:284/7 417-864-4573 
MO Springfield Art's Toy/Art Rainey 1:284/55 417-866-2284
MO St. Louis Hotflash/Rhett Butler 207:1/105 314-771-6272
MO St. Louis Hotflash/Rhett Butler 207:1/105 800-245-2601
MS Coldwater Coldwater/Rogert Martin 1:123/421 601-562-9385
MS Jackson Kudzu Konnection 601-957-1259
NC Charlotte Exchange/Ron Alspaugh 1:379/24 704-339-0333
NC Charlotte Exchange/Ron Alspaugh S: 704-342-2333
NC Charlotte MetroLink II/Matthew Irvin 1:379/20 704-567-6124
NC Charlotte MetroLink II/Matthew Irvin 207:1/8 704-567-6124

 
NC Durham Isolated Pawn/David Myers 1:3641/281 919-471-1440
NC Goldsboro Blues' Image/Jim Henry 1:151/808 919-751-2746
NC Goldsboro Swamp Ward/Mike Whatley 1:151/814 919-751-2324
NC Greensboro NC Triad/Richard Epson-Nelms 1:151/2325 919-854-7952 
NE Beatrice S.E. Community/Dick Douglass 1:285/115 402-223-2889 
NE GrandIsland Central Community/Fred Roeser 1:285/116 308-389-6495 
NE Lincoln Medicine Cabinet/Tom Hoover 1:285/207 402-435-0797
NE Lincoln NE EducationHub/Merle Rudebusch 1:285/100 402-471-0897
NE Lincoln TC Forum Univ. Neb./Ed Nemeth 1:285/110 402-472-3338
NE Lincoln TC Forum Univ. Neb./Ed Nemeth 1:285/110 402-472-5370
NE Lincoln TC Forum Univ. Neb./Ed Nemeth R:8:963/2 402-472-3365
NE Omaha Omaha Pub.School/Rich Molettier 1:285/113 402-554-6181
NE Wayne Wayne St.College/Dennis Linster 1:285/111 402-375-7564
NJ Bricktown Underground/David Brian 1:107/425 908-262-9666
NJ Cape May Inferno/Glenn Laws 1:266/72 609-886-6818
NJ Cape May Inferno/Glenn Laws 207:1/11 609-886-6818
NJ Dayton Altered Illusions/Lou Braconi 1:107/345 908-329-3216
NJ FranklinPrk Digital Abyss/Glen Panniche 1:107/398 908-422-4130
NJ Howell File Exchange/Walter Kuzma 1:107/449 908-905-3029
NJ Madison Strand/Gerhard Bartsch 1:107/915 201-822-3658
NJ Metuchen Micro-Fone/John Kelley 1:107/331 908-494-8666
NJ Parlin Central Jersey/Fred Seibal 1:107/600 908-525-9440
NJ Parlin RC's Place/R. C. Mann 1:107/82 908-721-4204
NJ Piscataway gLiTcH/JOD 1:2605/633 908-968-7883
NJ Piscataway gLiTcH/JOD 207:1/4 908-968-7883
NM Albuquerque Route 66 Solutions/Jon Jacob 1:301/28 505-294-4543 
NM White Rock ExplodoModeM 1:15/28 505-672-0427
NV Las Vegas Southern NV C.H.A.I.N./M.T.Swift1:209/238 702-656-7654 
NV Las Vegas SpiritKnife*LV/aids/hiv/M.Swift A:94:7020/2702-656-7654 
NV Reno Advanced System/Richard Dias 1:213/900 702-334-3308
NY CCMC-aids L: 518-783-7251
NY Albany Lower Albany/Phil Losacco 1:267/140 518-465-1072
NY BallstonSpa Access/Maureen Allen 1:267/136 518-885-4192
NY Brooklyn Blacknet/Idette Vaughan 1:278/618 718-692-0943
NY Brooklyn Brooklyn College/Howie Ducat 1:278/0 718-951-4631 
NY Brooklyn Brooklyn College/Howie Ducat 1:278/600 718-951-4631 
NY Brooklyn KinQuest/Bill Gage 1:278/611 718-998-6303
NY Brooklyn Pier/Michael Stewart 1:278/6969 718-531-9475
NY Clifton Prk Fantasy Land Adult/Tony Manino 1:267/106 518-383-2282 
NY Farmingdale SUNY/Gary Glueckert 1:107/270 516-420-0818
NY Great Neck Sacred Palace/Bill Athineos 1:107/256 516-829-8701
NY Hicksville Temporal Odyssey/Matt Faccenda 1:107/266 516-579-0098 
NY Merrick Pride/ 1:2619/102 516-785-1557
NY New York Backroom/Tiger Tom 207:1/1 718-951-8256
NY New York Backroom/Tiger Tom S: 718-951-8256
NY New York City People/Barry Weiser 1:278/720 212-255-6656
NY New York Comm Specialties/Howie Ducat 1:278/99 212-951-4631 
NY New York Dorsai Mission/Skip Mac-Stoker 1:278/706 718-729-6101
NY New York Utopian Quest L: 212-686-5248
NY New York Utopian Quest L: 516-842-7518
NY No. Babylon LastPlaceOnEarth/KennethOransky 1:107/247 516-243-1949
NY Rochester Cat's Meow #1/Bob Rathke 1:2613/140 716-473-2017
NY Rochester Frog Pond/Nick Francesco 1:260/270 716-461-1924
NY Rochester Recovery Room/Patrick Daugherty 1:2613/207 716-461-5201 
NY Scotia Critics Choice/Tim Koral 1:267/135 518-377-7009
NY Syracuse Erie Canal/Ray Bucko 1:2608/31 315-445-4710
NY Waterford Biologicalnightmare/RobLevine 1:267/139 518-233-9529 
NY Whitestone Corner Deli/Mike Schiffman 1:278/777 718-352-0821
OH Columbus Black Bag II/Paul Prior 1:226/320 614-293-8810
OH Columbus Mystic Life/Michael Kelly 1:226/520 614-279-7709
OH Dayton Levee/Jim Koz S: 513-222-6107
OH Dayton Olman/James Hale 1:110/247 513-427-9473
OH Dayton Olman/James Hale A:94:5130/ 513-427-9473
OH Galloway Information Exchange/Dan Styers 1:226/210 614-878-0161 
OK MidwestCity Sandbox/John Burton 1:147/34 405-737-9540
OK MidwestCity Torii Station/Jim Oxford 1:147/20 405-737-7565
OK OklahomaCit Huggy Bears/Donald Burch 1:147/30 405-949-2090
OK OklahomaCit OK NORML/Michael Pearson 1:147/3 405-282-8777
OK Ponca City Wordshop #2/Wayne Majors 1:3810/1 405-765-0951
OK Tulsa Looking Glass/Arnie Holder 1:170/706 918-838-7575
OR Eugene Paradox/Ryan Shaw 1:152/38 503-485-1988
OR Portland Busker's Boneyard/Hal Nevis 1:105/14 503-771-4773
OR Portland Club/Gary Seid 1:105/98 503-232-0332
OR Portland GayNet/Michael Hile 1:105/76 503-295-0877
OR Portland Land of the Gypsy's/Nancy Porter1:105/18 503-297-0626 
OR Portland Land Of The Gypsys/NancyPorter 1:105/18 503-297-0626 
OR Portland Medical Education/Jerry Donais 1:105/35 503-256-7758 
PA Hatboro Anterra Nework/Steve Ferguson 1:273/736 215-675-3851
PA Kittaning TechnoweenieParadyz/JoAnnKaraffa1:129/196 412-543-6580
PA MechanicsburConnections! BBS --------- 717-795-9925
PA Milford Omega/Gordon Craig 1:268/18 717-296-8560
PA Philadelphi Critical Path/Kiyoshi Kuromiya L: 215-463-7162
PA Philadelphi Club Philadelphia/Matt Zarkos 1:273/904 215-626-7398 
PA Philadelphi East Co Bear/John D. Steele 1:273/910 215-755-1917
PA Philadelphi La Dolce Vita/ L: 215-463-7888
PA Pittsburgh Meeting Place/Marc Shannon 1:129/45 412-482-7057
PA Pittsburgh PARIS BBS (RIP)/Doug Segur 1:129/228 412-381-6878
PA Wyndmoor WyndowIntoReality/Jeff Nonken 1:273/715 215-242-4485 
RI Providence Eagles Nest/Mike Labbe 1:323/126 401-732-5290
RI West Warwic AdvantageVoice&Data/Joe Caparco 1:323/113 401-885-5695 
RI Warwick GAYtway/Blind Faith 1:323/121 401-435-6544
RI Warwick GAYtway/Blind Faith 207:1/20 401-739-1380
SC Central Spawl/David Scott 1:3639/18 803-653-4536
SC Charleston Big Dog's/Dan Folk 1:372/62 803-769-6131
SC Columbia Dog Alley/Maddog 207:1/16 803-926-9110
SC Goose Creek Medical Forum/Shelley Crawford 1:372/106 803-824-0317 
SC Greensville Evolution/John Hames 1:3639/17 803-244-9556
TN Brighton Unbridled Desires/Ken McCleaft 1:123/415 901-476-3097 
TN Chattanooga Cove/Joel Davenport 1:362/960 615-855-9956
TN Chattanooga Cove/Joel Davenport A:94:6151/1615-855-9956
TN East Ridge TEL(Medical BBS)/Oliver Jenkins 1:362/621 615-622-6099 
TN Memphis Personals/John Heizer 1:123/22 901-274-6713
TN Memphis Personals/Lucky Ernie 207:1/12 901-274-6713
TN Bartlett Riverside/Gary Wilkerson 1:123/424 901-452-6832
TN Bartlett Riverside/Gary Wilkerson S: 901-452-6832
TN Nashville Meharry Medical College RelayNet 615-327-6175
TN Red Bank Eternal Flame/Jack Whaley 1:362/940 615-875-0290
TX Amarillo Town Crier/Matt Montgomery 1:3816/126 806-358-7032
TX Austin Health-Link/Bruce Baskett 1:382/5 512-444-9908
TX Austin Lambda Link/Joshua 1:382/25 512-873-8299
TX Austin Lambda Link/Joshua 207:1/109 512-873-8299
TX Austin RiverCityExchange/George Sharpe 1:382/4 512-327-5376
TX Beaumont Super Collider/Pat Presley 1:3811/320 409-833-8583
TX Bedford Metroplex Mailbox/Kyle Hearn 1:130/1008 817-268-1422
TX Bryan Lazy Jane's 1:117/128 409-268-1181
TX CorpusChristBlueWater/Tony Honaker 1:160/260 512-883-7839
TX Dallas DaBBS Dallas/Dale Becker 1:124/2126 214-821-7732
TX Dallas Dallas Mandate/Mark Taylor 1:124/6503 214-528-1816
TX Denton ComputerGeeksAnon/George Toon 1:393/42 817-380-0186
TX Fort Hood Serving with God's Love/D.Wright1:395/22 
TX Fort Worth Crystal Palace/Lisa Mashburn 1:130/1005 817-370-9591 
TX Fort Worth Stallions Coral/Stallion 207:1/107 817-545-7317
TX Irving aids Chat Line/John Pfeifer 1:130/55 214-256-5586
TX GrandPrairi Puss N Boots/Aaron Davis 1:124/3103 214-641-1822
TX Houston A Womyn's Line/Anna Mayes 1:106/8160 713-647-9057
TX Houston Beehive/Brad Wartman 1:106/41 713-974-6995
TX Houston Last Call/Doug Sutherland 1:106/8366 713-523-8366
TX Houston Medico/Dave Ray 1:106/595 713-895-7945
TX Houston Murphy's Law/Gregg Holland 1:106/365 713-584-0348
TX Houston PIC of the MID Town/Geo. Worley 1:106/31 713-961-5817
TX Houston Pink Triangle/Dereck Thomas 1:106/3802 713-630-0764
TX Houston Private Line/Larry Mers 1:106/5000 713-933-0499
TX Houston Turkey's Roost/Keven Turk 1:106/6235 713-530-6235
TX Port Neches StarGate Seven/Timothy Wilson 1:3811/110 409-727-8141 
TX San Antonio ETC MedNet/Bob Jackson 1:387/801 210-829-0346
TX San Antonio Gardens of Avalon/Ed Tillman 1:387/57 210-308-9579 
UT West Jordan Midnight Express/ L: 801-565-8330
UT W.Jordan Lake Wobegon/Robert Klaproth 1:311/19 801-568-3866 
VA Arlington NAPWA-Link/Richard Smith L: 703-998-3144
VA Norfolk Christian Resources/Mike Olah 1:275/36 804-543-3459
VA VirginiaBch ADAnet File Dist/Warren King A:94:94/99 804-496-3320 
VA VirginiaBch Pleasure Dome/Tom Terrific S: 804-490-5878
WA Ellensburg Joe's Oasis/Ben Roth 1:344/92 509-962-3536
WA FederalWay Big Easy/Danny Stephens 1:343/85 206-661-1457
WA Olympia Radio Point/Jay Andrews 1:352/111 206-943-1513
WA Seattle Seattle aids Info/Steve Brown L: 206-323-4420
WA Seattle Stage Seattle/Randy 207:1/102 206-286-1850
WA Seattle U. of Wash. HHS/Cindy Riche 1:343/35 206-543-3719
WA Tumwater Elder's Council/Daniel Smerken 1:352/458 206-357-8992 
WA Tumwater Elder's Council/Daniel Smerken A:94:2061/2206-357-8992 
WI Milwaukee Back Door/Paul Parkinson 1:154/700 414-744-9385
WI Milwaukee Back Door/Paul Parkinson 207:1/108 414-744-9385
MI Milwaukee Back Door/Paul S: 414-744-9385
WI Milwaukee Starcom/Rick Gardner 1:154/69 414-445-6969
Canada (FidoNet Zone 1)
AB Calgary Message-Line [K-12] 403-244-4724
AB Calgary Rainbow Connection/Brent Rector 1:134/172 403-244-0794
AB Edmonton Ten Forward/Tom Hall 1:342/1 403-424-3258
AB Edmonton Toys For Boys/Alex Solski 1:342/24 403-497-7816
AB Lethbridge Lost Planet/Terry Fleming 1:358/16 403-381-3185
AB Lethbridge Terminal/Laz Gottli 1:358/17 403-327-9731
BC Kelowna Dementia 9.4 1:353/294 604-765-5746
BC Nanaimo ADAnet Canada/Celia Corriveau A:94:94/10 604-756-3177
BC Vancouver Lambda Speaks/Warren Cox 1:153/756 604-681-3667
BC Vancouver PC-WorkShop/Ervin Jay 1:153/767 604-682-0914
BC Vancouver PC-WorkShop/Ervin Jay 1:153/797 604-687-0913
BC Vancouver PC-WorkShop/Ervin Jay 1:153/798 604-689-0437
BC Vancouver Phaonica * aids/hiv/Ed Parker 1:153/732 604-683-2144 
ON Gloucester Coven's Den/Sorceress 1:163/436 613-746-5559
ON Hamilton Villa Gryphus/Kelly Ryan 1:244/106 416-545-5789
ON Mississauga Canada Remote System/Rich Munro 1:229/15 416-579-6302 
ON Ottawa AlterNet/Paul Hannon 1:163/113 613-230-9519
ON Hull Cookie Jar 1:243/40 819-778-7956
ON Ottawa Chaos Central/Neal Bouffard 1:243/50 613-228-7268
ON Ottawa Echo Valley/Michelle Chartrand 1:243/26 613-749-4550
ON Ottawa Mother's Board/Perry Davis 1:243/38 613-728-4122
ON Ottawa Mother's Board/Perry Davis 207:1/203 613-728-4122
ON Richmond Abacus-I/John Gyulasi 1:153/968 604-272-4311
ON Richmond Ultimate/Steve Allan 1:243/52 613-838-4812
ON Toronto ADAnet Ability OnLine/ A: 416-650-5411
ON Toronto Dungeon/Trojan Horse S: 416-926-8734
ON Toronto Dungeon/Trojan Horse S: 416-926-8739
ON Toronto Gay Blade/Phil Dermott 1:250/214 905-882-4800
ON Toronto Gay Blade/Jock Strap S: 905-882-4800
ON Toronto Gay Blade/Phil Dermott 207:1/202 905-882-4800
ON Toronto Kaikatsu na Sakaba/Phillip Catt 1:250/470 416-778-7334
ON Toronto LeftoverHippies/Lesley-Dee Dyla 1:250/824 416-466-8195
ON Toronto QNet3/ A: 416-745-8133
PQ Montreal S-TEK/Eric Blair 207:1/201 514-597-2409
PQ Montreal S-TEK/Eric Blair S: 514-597-2409
PQ BellefeuilleEchoMailCoordinator/Ray Beriau 1:242/90 514-433-1105 
Latin America (FidoNet Zone 4)
PA Panama City Century XXI 4:920/50 011507638075
Overseas - Africa (FidoNet Zone 5)
Senegal Edna/Kate White 5:7711/1.25011221217627
Overseas - Asia (FidoNet Zone 6)
HK Island /T.K.Kang A:94:94/6 852-855-0569
Overseas - Australia (FidoNet Zone 3)
Armadale AlternativeAccess/Michael Bates 3:632/502 61-3-5000067
Burwood, NSW Eagle One/Terry Harvey 3:712/704 61-2-7453500
Cairns Far Northern News/Noel Roberts 3:640/531 61-7033-1553
Canterbury Pride/Addam Stubbs 3:632/353 61-3836-6782
Carnegie Orion/Peter Fortey 3:632/338 61-3885-0002
Carnegie Orion/The Phoenix S: 61-3885-0002
Fitzroy Big Tedd's #2/Robbie Bates 3:634/381 61-3417-1669
Greensborough Cool World/Gary Greer 3:635/564 61-3-4320716
Sandgate Soft-Tech/Alwyn Smith 3:640/201 61-7269-6355
Overseas - Belgium (FidoNet Zone 2)
Marchienne CarrefourSante/PhilippeRasquinet2:293/3211011-32-71518162
Overseas - France (FidoNet Zone 2)
Paris hivNET/Jean-Luc Dalous 2:320/303 33-1-42544519
 
rdue
Archive-name: aids-faq/part10
AIDS FAQ Part 10/10
Overseas - Germany (FidoNet Zone 2) (Cont'd.) 
Berlin A&M Soft/Michael Vogt 2:2403/34 49-30-3915186
Berlin hivNET/Joerg Schulze 2:242/1205 49-304542605
Berlin Kumpelnest/Matthias Ganick 2:2403/43.349-30-4026340
Rutesheim SCHWUBBS GAyBBS/Roland Teich 2:246/1603 49-7152-56330
Haar OASE/Wolfgang Roth 2:246/25 49-89-6883262
Hamburg SGBB/Thomas Blaesing 2:2403/43.549-40-8505958
Muenchen Medical System/Arnulf Bultmann 2:246/63 49-89-295223
Muenchen Tadzio Gay/Daniel Schroeder 2:246/75 49-89-657447
Nuremberg Mustang/Ralf Ulbrich 2:246/8 49-91-1505669
Seeheim MoonBeam/Christoph Vaessen 2:2405/11 49-62-5786308
Velbert Oganpipe/Michael Smetten 2:243/7011 49-2051-56866
Overseas - Italy (FidoNet Zone 2)
Roma sidanet/Massimiliano Fiorenzi 39-6-86801371
Overseas - Netherlands (FidoNet Zone 2)
Paradise! 2:280/712 31-36-5314728
Aalten BIB/Freek Kempink 2:500/279 31-5437-74203
Amsterdam ArtNet/Martin Cleaver 2:280/204 31-20-6163698
Amsterdam Black Box/Stefan de Droog 2:280/403 31-20-6255563
Amsterdam Broomcupboard/Jochem Broers 2:500/296 31-20-6362575
Amsterdam Cyberspace/Sico Bruins 2:280/404 31-20-6754650
Amsterdam hivNET Testlab/Matthew Lewis 2:280/419 31-20-6125918
Amsterdam hivNET/Tjerk Zweers 2:280/413 31-20-6647461
Amsterdam PCN/John Kessel 2:280/415 31-20-6962860
Amsterdam Utopia/Felipe Rodriquez 2:280/308 31-20-6273860
Apeldoorn Dutch Health/Ruud vd Linden 2:500/211 31-55-337951
Breda Pro Deo/Marco Blaauw 2:285/201 31-76-223378
Breugel MadCat's/Lodewijk Otto,MD 2:284/120 31-4990-60548
Den Haag Gay-Biseks CRUISING/Ben Fama 2:281/532 31-0703450380
Diemen FsFan/Hans Hoekstra 2:280/304 31-20-6958426
Heerlen hivNET-Limburg/Lucas Vermaat 2:284/306 31-45-231754
Leiden CommPoort/Dennis Hammerstein 2:281/403 31-71-124350
Pijnacker Gaypalace/Andre Degenhart 2:285/163 31-1736-99126
Rijswijk Interface/Ron Huiskes 2:281/506 31-70-3361380
Rotterdam hivNET/Simon Bignell 2:285/818 31-10-2130501
Schiedam Bommel's/Nitz Neder-Helman 2:285/800 31-10-4700939
Waddinxveen Monade/Olaf Boezelijn 2:281/709 31-1828-11894
Overseas - Oceania (FidoNet Zone 3)
Burwood, NSW Eagles/Terry Harvey A:94:8610/161-274535006
Stanmore NSW /Colin Lean A:94:94/8 61-2569-5130
Overseas - Sweden (FidoNet Zone 2)
Stockholm Gay Telegraph/Bengt Ericsson 207:1/301 46-8-6530808
Overseas - United Kingdom (FidoNet Zone 2) 
Spartacus/Barry Kingston-Wyatt 2:255/27 03-273-509152
Flaversham DataServeSystems/GrahamJenkins 2:440/23 44-795590170
Locksheath United Europe/George Cordner A:94:94/9 44-489-577514
London Gnfido/Karen Banks 2:254/70 44-71-6081899
London hivNET/Ron Dixon 2:25/555 44-81-6956113
London Out/Damien Marcus 2:441/55 44-71-4908493
London POS+NET/Ron Dixon 2:25/555 44-81-6956113
London Quadris Technics/Michael Pereira2:441/99 44-81-6499408
-------------------------------------------------------------------------
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Question 9.2. National AIDS Clearinghouse Guide to AIDS BBSes. 
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Public Health Service
Centers for Disease Control and Prevention CDC National AIDS 
Clearinghouse
A SELECTED GUIDE TO AIDS-RELATED
ELECTRONIC BULLETIN BOARDS
INTRODUCTION
This is a guide to representative electronic bulletin boards
containing information about HIV infection and AIDS. This guide is not
a complete listing of all AIDS-related electronic bulletin boards, but
has been prepared as an introduction to the subject and can be used as
a starting point to locate information. This document was prepared by
the CDC National AIDS Clearinghouse; please notify the CDC
Clearinghouse with any updates or additions. Inclusion of a service
does not imply endorsement by the Centers for Disease Control and
Prevention, the CDC Clearinghouse, or any other organization.
Electronic bulletin board systems, often called BBS's or bulletin
boards, are computerized information services that are accessed by
using a computer, modem, and telephone line. BBS's meet today's
demands for current news on HIV infection and AIDS and provide a
convenient means for information exchange among professionals,
volunteers, and individuals involved in the fight against AIDS.
BBS's can consist of any of the following features: electronic mail,
bulletin board forums, searchable databases, and transferrable
information files. Electronic mail is a convenient way of sending
private messages to others using the same system. Bulletin board
forums, sometimes called conferences, are interactive systems for
posting public messages to groups of users connected to the same
system. Searchable databases can sometimes be accessed through BBSs,
providing a quick means of obtaining specific information such as
bibliographic references, full-text articles, and information about
organizations. Text files of information can be downloaded from most
BBS's, then later edited and/or printed at the user's computer.
Many BBS's provide gateways to national forums. Messages posted on
these forums are "echoed" on networks linking BBS's throughout the
country. Some examples of these forums include the FidoNet AIDS/ARC
forum, the UseNet SCI.MED.AIDS newsgroup (available on all Internet
nodes as the AIDS listserv), the GayComm Talk About AIDS forum, and
the AIDS Education and General Information Service (AEGIS) network's
AIDS.DATA and AIDS.DIALOG.
To access a BBS, your computer (IBM-compatible or Macintosh) must be
equipped with a modem (external or internal; 2400+ baud recommended)
and communications software (such as ProComm, CrossTalk, or Red
Ryder). The modem must be connected to the computer and to a phone
line. It is preferable, but not necessary, to use a phone jack
separate from any telephones; the phone and the modem can use the same
phone line, but not simultaneously.
CDC NAC ONLINE
CDC NAC ONLINE is the computerized information network of the CDC
National AIDS Clearinghouse and gives AIDS-related organizations
direct computerized access to the CDC Clearinghouse and its
information and bulletin board services. It contains the latest news
and announcements about many critical AIDS- and HIV-related issues,
including prevention and education campaigns, treatment and clinical
trials, legislation and regulation, and upcoming events. CDC NAC
ONLINE provides direct access to CDC Clearinghouse databases such as
the Resources and Services Database of organizations providing
AIDS-related services. The system also features electronic mail,
interactive bulletin board forums, and is the original source of the
AIDS Daily Summary newsclipping service.
CDC NAC ONLINE users include U.S. Public Health Service agencies,
universities, health administrators, community-based organizations,
and other professionals working in the fight against AIDS. CDC NAC
ONLINE is a free service for qualified non-profit organizations and
can be accessed by dialing a toll-free number. For a registration form
or more information, call the CDC Clearinghouse at (800) 458-5231.
OTHER SERVICES
Unless otherwise stated, services are free. The phone number listed at
the top right of each record is the data-line that can be dialed with
a modem.
AIDS Info BBS San Francisco, CA; (415) 626-1246 
AIDS Info BBS is a long-established comprehensive electronic bulletin
board targeted primarily to HIV-positive individuals, persons with
AIDS, and others concerned about HIV infection. It contains hundreds
of articles including AIDS Treatment News, electronic mail, and an
open forum. Anyone can access AIDS Info BBS free. For more
information, contact Ben Gardiner, AIDS Info BBS, P.O. Box 1528, San
Francisco, CA 94101.
AIDSQUEST Atlanta, GA; (404) 377-9563 
AIDSQUEST is an electronic bulletin board provided by AIDS Weekly
publishers for AIDS Weekly newsletter subscribers. AIDSQUEST replaces
AIDS Weekly Infoline, an electronic bulletin board that was previously
available to any caller. AIDSQUEST includes DAITA, the Database of
Antiviral and Immunomodulatory Therapies for AIDS, articles from AIDS
Weekly, statistics from CDC, an interactive forum, and the UseNet echo
of SCI.MED.AIDS. Anyone can obtain information about AIDSQUEST by
connecting online to the above number. For more information, contact
AIDS Weekly, P.O. Box 5528, Atlanta, GA 30307-0528, (404) 377-8895.
Black Bag BBS Wilmington, DE; (302) 994-3772 
Black Bag BBS, a member of the AEGIS network, is an electronic
bulletin board containing information about many medical topics
including HIV/AIDS. The Black Bag Medical BBS List is a comprehensive
list of medical-related electronic bulletin boards in the United
States and abroad. Black Bag BBS also includes AIDS Treatment News,
AIDS statistics and the FidoNet echo of the AIDS National
Discussion. Donations are encouraged, but anyone can access Black Bag
BBS free. For more information, contact Edward Del Grosso, MD, 1 Ball
Farm Way, Wilmington, DE 19808.
Boston AIDS Consortium SPIN Boston, MA; (617) 432-2511 
SPIN, or Service Provider Information Network, is maintained by the
Boston AIDS Consortium. It includes AIDS Treatment News, statistics
from CDC, and other AIDS-related information. Anyone can access SPIN
by connecting online to and typing the username "spin." For more
information, contact Harvard School of Public Health, 677 Huntington
Ave., Boston, MA 02112, (617) 432-0885.
Breaking Walls; Building Bridges Concord, CA; (510) 827-0804 
Breaking Walls; Building Bridges is sponsored by the Diablo Valley
Metropolitan Community Church and includes general MCC information as
well as AIDS dialog and files, including the AIDS Daily Summary. It
serves the Oakland/East San Francisco Bay area and is a member of the
AEGIS network. For more information, contact Breaking Walls; Building
Bridges, Diablo Balley Metropolitan Community Church, P.O. Box 139,
Concord, CA 94522- 0139.
CAIN By Subscription Only 
CAIN is the Computerized AIDS Information Network sponsored by the
state of California. CAIN contains electronic mail, an interactive
bulletin board forum, and databases of upcoming events, educational
materials, organizations, and articles. It resides on the Delphi
network; charges for connect time are billed by Delphi. For more
information, contact CAIN, 1625 N. Hudson Ave., Los Angeles, CA
90028-9998, (213) 993-7416.
Can We Talk - Chicago Chicago, IL; (312) 588-0587 
Can We Talk - Chicago (CWT) is a publicly accessible, privately
operated system. It contains many newsletters, government information,
and articles. It offers connections up to 9600 baud. For more
information, contact Eddie V, Sysop, Can We Talk - Chicago, 3943
N. Whipple St., Chicago, IL 60618-3519.
CESAR Board Washington, DC; (301) 403-8343 
Administered by the Center for Substance Abuse Research, University of
Maryland, College Park and supported by Governor Schaefer's Drug and
Alcohol Abuse Commission. Includes Maryland AIDS statistics. Within
Maryland, call (800) 84-CESAR. For more information, contact Center
for Substance Abuse Research, 4321 Hartwick Road, Suite 501, College
Park, MD 20740, (301) 403-8329.
CHEN By Subscription Only 
CHEN is the Comprehensive Health Education Network sponsored by the
Council of Chief State School Officers. It contains general
information about HIV issues related to schools. It includes the
biweekly HIV/AIDS Education Bulletin Board newsletter. Use of CHEN is
free to qualified organizations; however, the purchase of IBM PSINet
software is necessary. For more information, contact Council of Chief
State School Officers, One Massachusetts Avenue, NW, Suite 700,
Washington, DC 20001-1431, (202) 408-5505.
Critical Path AIDS Project BBS Philadelphia, PA; (215) 563-7160 
The Critical Path AIDS Project has developed an electronic bulletin
board for persons with AIDS, researchers, health-care providers, and
others. It includes an extensive series of forums, downloadable files
including primarily resource and treatment information. Anyone can
access the system free by typing "BBS" when first connecting to the
system. A 9600-baud connection can be made by dialing (215)
463-7162. A user's manual is available. For more information, contact
Critical Path AIDS Project, 2062 Lombard St., Philadelphia, PA 19146,
(215) 545-2212.
FDA Electronic Bulletin Board Toll-free; (800) 222-0185
 
The Food and Drug Administration operates a publicly accessible
electronic bulletin board. Included are press releases related to
AIDS, such as those announcing new drug approvals. To access, dial the
above modem and enter "BBS" at the "Login" prompt. Local users in the
Washington DC metro area should call (301) 227-6849. Those on an
FTS2000 line should dial FTS-394-6849 or 394-5657. There is no charge
and users can connect at up to 9600 baud. A users manual and technical
support are also available. For more information contact the FDA Press
Office, Parklawn Building, 5600 Fishers Lane, Rockville, MD, 20857.
Fog City BBS San Francisco, CA; (415) 863-9697 
Fog City BBS, a member of the AEGIS network, includes many articles,
general information, and the GayComm Talk About AIDS forum. Although a
subscription fee is charged for full membership, anyone can call Fog
City BBS for free AIDS information by connecting online to and logging
on as "AIDS INFO" when prompted for first and last name. For more
information, contact Fog City BBS, 584 Castro Street #184, San
Francisco, CA 94114-2588, Fax: (415) 863-9718.
GLIB Washington, DC; (703) 578-GLIB 
GLIB, the Gay & Lesbian Information Bureau, is maintained by the
Community Educational Services Foundation. It includes treatment
information and the GayComm Talk About AIDS echo. Subscription fees
vary and may not be required in some cases. GLIB is also available
through Bell Atlantic's IntelliGate Service. Anyone can obtain
information about GLIB by connecting online as a visitor. For more
information, contact Community Educational Services Foundation,
P.O. Box 636, Arlington, VA 22216, (703) 379-4568.
HEEF Kenney, LA; (504) 443-5546 
HEEF is the Health Education Electronic Forum, which replaces the
Tulane Medical Center's BBS. A $2.00 subscription fee is
requested. Anyone can register on HEEF by connecting and logging on as
a visitor. For more information, contact Lifestyle and Health
Promotion, 59 Monterey Dr., Kenner, LA 70065-3142.
HIV/AIDS Information BBS San Juan Capistrano, CA; (714) 248-2836 
HIV/AIDS Information BBS is the hub of the AIDS Education and General
Information System (AEGIS), a growing network of HIV-related
electronic bulletin boards (see last page). It includes many
newsletters and hundreds of files that can be downloaded. It also
echoes FidoNet and other networks, and is available via PC
Pursuit. Anyone can access HIV/AIDS Information BBS free at
connections up to 9600 baud. For more information, contact Sister Mary
Elizabeth, Sisters of St. Elizabeth of Hungary, P.O. Box 184, San Juan
Capistrano, CA 92693-0184.
HNS HIV-NET Tollfree; (800) 788-4118 
HNS HIV-NET, sponsored by Home Nutrition Services, is an electronic
bulletin board for physicians and other health-care professionals
treating HIV-positive patients and those with AIDS. It contains
hundreds of files of newsletter articles, bibliographies, and graphics
files of pictures of opportunistic infections. There are also a number
of different forums, corresponding to different health-care
professions. Interested users should dial the data line to
register. After being validated or registered by the sysop, they can
call back. For more information, contact John Owens, MD, HNS HIV-NET
BBS, 9037 Kirby Drive, Houston, TX 77054.
The Houston Exchange Houston, TX; (713) 521-2191 
The Houston Exchange, a member of the AEGIS network, contains
information from the Houston Clinical Research Network, an affiliate
of the Montrose Clinic. Anyone can access the Houston Exchange
free. For more information, contact Houston Clinical Research Network,
4211 Graustark, Houston, TX 77006, (713) 528-5554.
LEGALNET Petersburg, FL; (813) 343-0797 
The Stetson University College of Law's Legal Information Network
sponsors an online discussion area and a selection of files relating
to legal HIV issues. Anyone can access LEGALNET free with connections
up to 9600 baud. For more information, contact Stetson University
College of Law, 1401 61st Street South, St. Petersburg, FL, (813)
343-0797.
LPIES By Subscription Only 
LPIES is the Laboratory Performance Information Exchange System
sponsored by CDC's Public Health Program Practice Office and is
available free to HIV testing laboratories and related
organizations. Qualified users can register by connecting online to
(800) 522-6388. For more information, contact Program Resources, Inc.,
P.O. Box 12794, Research Triangle Park, NC 27709, (800) 322-4383.
NAPWA-Link Washington, DC; (703) 998-3144 
NAPWA-Link is the electronic bulletin board of the National
Association of People With AIDS and is part of the network maintained
by the Community Educational Services Foundation (see
GLIB). NAPWA-Link contains electronic mail, announcements, and
databases of news articles, drug interactions, and
organizations. Users must pay a fee; several membership plans are
available. Anyone can connect for online information about NAPWA and
NAPWA-Link by logging on as a visitor. For more information, contact
the National Association of People with AIDS, P.O. Box 34056,
Washington, DC 20043, (202) 898-0414.
NCJRS BBS Washington, DC; (301) 738-8895 
The NCJRS BBS is the electronic bulletin board of the National
Criminal Justice Reference Service. It includes information about
publications and services available from the National Institute of
Justice AIDS Clearinghouse, such as information about HIV and
incarceration. Anyone can access NCJRS BBS free. For more information,
contact National Criminal Justice Reference Service, P.O. Box 6000,
Rockville, MD 20849- 6000, (800) 851-3420.
OASH BBS Washington, DC; (202) 690-5423 

 
OASH BBS is the free and publicly accessible electronic bulletin board
of the U.S. Public Health Service, Office of the Assistant Secretary
for Health, National AIDS Program Office. It distributes many files of
AIDS- related information from the federal government, including the
AIDS Daily Summary, Federal Register announcements for funding, and
the National Library of Medicine's AIDS Bibliography. OASH BBS has
electronic mail, public forums, and file transfer. Anyone can access
OASH BBS free; connections up to 9600 baud are available. For more
information, contact National AIDS Program Office, Hubert Humphrey
Bldg. Room 729-H, 200 Independence Ave., SW, Washington, DC 20201,
(202) 690-6248.
Ohio AIDS/HIV BBS Columbus, OH; (614) 279-7709 
Ohio AIDS/HIV BBS is a relatively new system that branched off from
the Mystic Christian & Recovery BBS. It is a member of the AEGIS
network. Connections up to 9600 baud are available. For more
information, contact Michael Kelly, Sysop, Ohio AIDS/HIV Info BBS,
P.O. Box 2970, Columbus, OH 43216.
Public Health Network By Subscription Only 
The Public Health Network is produced for public health administrators
by the Public Health Foundation and contains information posted by a
number of U.S. Public Health Service agencies including CDC, the
National Institute for Drug Abuse, and the Health Resources and
Services Administration. A subscription is required and connect fees
are charged. For more information, contact Chris Frank, Public Health
Foundation, 1220 L St., NW, Suite 350, Washington, DC 20005, (202)
898-5600.
Questor British Columbia, Canada; (604) 681-0670 
Questor is UseNet system (for Unix users) that echoes the UseNet
SCI.MED.AIDS discussion. Anyone can access Questor free by connecting
online to the above number.
Seattle AIDS Information BBS Seattle, WA; (206) 323-4420 
Seattle AIDS Information BBS, a member of the AEGIS network, is
targeted to persons with AIDS and HIV infection. It contains
electronic mail, bulletin board forums, and hundreds of articles
available for viewing and file transfer. Donations are encouraged, but
anyone can access Seattle AIDS Information BBS free. For more
information, contact Seattle AIDS Information BBS, 1202 E. Pike, Suite
658, Seattle, WA 98122-3918.
888 Online Richmond, VA; (804) 266-0212 
888 Online is a member of the AEGIS network and includes all AEGIS
files as well as interactive forums. Files can be searched by words in
their text. 888 Online also includes information related to
alternative lifestyles and recovery. For more information, contact
Bill Smith, 888 Online BBS, P.O. Box 15885, Richmond, VA 23227-5885.
AEGIS
Listed below are the network affiliates of the AIDS Education and
General Information System (AEGIS). These BBSs echo messages and
exchange files of HIV/AIDS information, including the AIDS Daily
Summary. The AEGIS network is also linked to a similar network in
Europe called HIVNET. Anyone can log on anonymously to an AEGIS BBS
for free. Other BBS services interested in joining AEGIS should
contact Sister Mary Elizabeth of the HIV/AIDS Information BBS (which
see).
AEGIS NETWORK AFFILIATES
State BBS Name Fidonet Node Phone Number
Arizona The Meat Rack BBS 1:114/188 602.273.6956
California Breaking Walls; Building Bridges 1:161/203 510.827.0804
California The Task Force 1:161/513 707.746.6091
California Fog City BBS 1:125/100 415.863.9697
California The Clovis Co of Fresno 1:205/48 209.323.7583
California HIV/AIDS Info BBS 1:103/927 714.248.2836
Colorado Telepeople 1:104/69 303.426.1866
Colorado The Denver Exchange 1:104/909 303.623.4965
Delaware Black Bag Medical BBS 1:150/140 302.994.3772
Florida MOTSS BBS of Satellite Beach 1:374/41 407.779.0058
Florida Aftermidnite BBS / Tampa 1:377/43 813.831.7587
Massachusetts The Den 1:101/225 617.662.6969
Minnesota Drag-Net / Andover 1:282/1007 612.753.1943
Missouri Doc in the Box 1:289/8 314.893.6099
Missouri KC AIDS InfoLink 1:280/14 816.561.1187
Nevada Las Vegas AIDS Info BBS 1:209/238 702.658.3591
New York Brooklyn College ONLINE! 1:278/0 718.951.4631
New York The Erie Canal BBS 1:2608/31 315.445.4710
North Carolina The Isolated Pawn / Durham 1:3641/281 919.471.1440
Ohio The Mystic Christian 1:226/520 614.279.7709
Oklahoma The Looking Glass BBS / Tulsa 1:170/706 918.743.1268
Tennessee Riverside BBS 1:123/424 901.452.6832
Texas The Houston Exchange 1:106/20 713.521.2191
Texas Puss-N-Boots / Grand Prairie 1:124/3103 214.641.1822
Texas AIDS Chat Line / Grand Prairie 1:130/55 214.256.5586
Texas Loaves & Fishes BBS 8:3000/7 512.444.8790
Virginia 888 Online 1:264/190 804.266.0212
Washington Seattle AIDS Info BBS 206.323.4420
Ontario Mother's Board / Ottawa 1:243/38 613.728.4122
Quebec EC / Bellefeuille, Pq 1:242/90 514.433.1105
Australia SouthMed of Sydney Net 3:712/700 61.2.583.1027
NOTES
Several publicly accessible commercial networks have AIDS-related
forums, such as The Well [Whole Earth 'Lectronic Network, online
registration: (415) 322-7398]; GEnie [the General Electric Network for
Information Exchange, voice phone: (800) 638-9636]; and CompuServe
[voice phone: (800) 848-8990].
There are also several database vendors that provide gateway access to
AIDS-related databases, including the National Library of Medicine
[voice phone: (800) 638-8480]; BRS Search Services [(a division of
Maxwell Online; voice phone: (800) 456-7248]; and DIALOG [voice phone:
(800) 334-2564]. More information about AIDS-related databases can be
obtained by calling a Reference Specialist at the CDC Clearinghouse,
(800) 458-5231.
-------------------------------------------------------------------------
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-
Question 9.3. National Library of Medicine AIDSLINE (please
contribute)
If you know how to obtain access to this service, please contribute
instructions to the FAQ (e-mail to aids-faq@family.hampshire.edu).
-------------------------------------------------------------------------
-----
Question 9.4. Commercial Bulletin Boards (please contribute) 
There are AIDS-related areas on Compuserve and America Online. (we
need details: how to contact Compuserve and America Online, what the
newsgroups are called, etc.)
-------------------------------------------------------------------------
-----
Question 9.5. Lesbian/Gay Scholars Directory. 
11:06:05 EST
I have compiled an E-Mail Directory of Lesbigay Scholars, with now
more than 195 persons listed. To be included, fill out the form below
and return it to me:
lcrew@andromeda.rutgers.edu
Do NOT send by snail mail.
The E-Directory helps lesbigay scholars connect regarding on-going
manuscripts, conferences, and other scholarly projects. I send the
Directory to all who agree to be listed, with updates individual by
individual.
I also make available to one e-mail address by which those listed can
post announcements of interest to the entire group. But this is not a
discussion list per se--rather, a resource list.
Please share this announcement with any friends who might be
interested and with any other e-networks where forthright lesbigay
scholars might assemble qua scholars.
Thank you.
Louie Crew
Author/editor of _The Gay Academic_ and 950+ others Co-founder of the
Lesgay Caucus of the National Council of Teachers of English Founder
of Integrity, the lesgay justice ministry of the Episcopal Church
Academic Foundations Department, Rutgers University/Newark (Snail
mail: P. O. Box 30, Newark, NJ 07101)
========================================================================
====
Entry Form for E-Directory of Lesbigay Scholars Name:
Institutional affiliation:
Department:
Position:
E-mail address(es):
Snail mail:
Phone(s)
FAX:
Citations of a sample of yr. previous lesbigay scholarly projects: 
List/description of yr. on-going lesbigay scholarly projects: 
 
rdue
Archive-name: aids-faq/part1
AIDS FAQ part 1/10
for more details).
You may find something new here.
gaping holes. Send suggested changes to aids-faq@family.hampshire.edu.
You don't have to format it: just send it.
Disclaimer: Much of the information here is quoted from other
sources. We try to keep things as up to date and accurate as
possible. Understand however, that there may be individual parts of
this FAQ that you may not agree with, or may not feel is
accurate. Feel free to point this out to us, but we reserve the right
to leave it as it is.
You can skip to a particular question by searching for `Question
n.n'. See Q1.13 `Formats in which this FAQ is available' for details
of where to get the PostScript and Emacs Info versions of this
document.
=============================================================
Contents of Entire FAQ
(Contained in Part 1 of 10):
Section 1. Introduction, General Information, and FAQ Administrative 
Details
 Q1.2 Discussion topics.
 Q1.3 Sci.med.aids distribution.
 Q1.6 What is a moderated newsgroup?
 Q1.7 Editorial guidelines.
 Q1.8 How do I submit a posting?
 Q1.9 The moderators.
 Q1.10 Cooperative moderation - and voting on posts.
 Q1.11 If a post gets rejected.
 Q1.13 Feedback is invited
 Q1.14 Formats in which this FAQ is available
 Q1.15 Authorship and acknowledgements
(Contained in Part 2 of 10):
Section 2. How to prevent infection.
 Q2.1 How is AIDS transmitted?
 Q2.2 How effective are condoms?
 Q2.3 How do you minimize your odds of getting infected?
 Q2.4 How risky is a blood transfusion?
 Q2.5 Can mosquitoes or other insects transmit AIDS?
(Contained in Part 3 of 10):
 
Section 3. General HIV/AIDS info
 Q3.1 Testing Information.
 Q3.2 Testing Information - Elisa and Western Blot tests 
 (Please Contribute)
 Q3.3 Symptoms of HIV infection and AIDS (please contribute)
 Q3.4 AIDS and Opportunistic Infections.
(Contained in Part 4 of 10):
Section 4. Treatment options.
 Q4.1 General treatment information.
 Q4.2 What about "alternative" treatments for HIV/AIDS
 Q4.2.1 DNCB
(Contained in Part 5 of 10):
 Q4.2.2 OZONE
(Contained in Part 6 of 10):
Section 5. Social Services Available.
 Q5.1 Guide to Social Security Benefits.
 Q5.2 What if you can't afford AZT?
(Contained in Part 7 of 10):
Section 6. The common debates.
 Q6.1 What are Strecker and Segal's theories that HIV is manmade?
 Q6.2 Other conspiracy theories.
 Q6.3 Is HIV the cause of AIDS?
(Contained in Part 8 of 10):
 
Section 7. Information Sources.
 Q7.1 Phone Information about AIDS.
 Q7.2 Phone Information about AIDS drug trials.
 Q7.3 Phone Information about AIDS treatments
 Q7.4 US Social Security: Information for Organizations
 Q7.5 Reappraisal of the HIV-AIDS Hypothesis.
 Q7.6 American Academy of Allergy & Immunology Physician's
 Referral and Information Line
Section 8. Internet resources.
 Q8.1 Ben Gardiner's Gopher AIDS Database
 Q8.2 CDC CDC National AIDS Clearinghouse Internet Services
 Q8.3 WHO AIDS Cases Information
 Q8.4 CDC AIDS Public Information Dataset.
 Q8.5 World Wide Web site on AIDS (French and English)
 Q8.6 Information about HIV and AIDS related patents
 Q8.7 ArtAIDS Link
 Q8.8 HIVNET/AEGIS Gateway (BETA VERSION) - Need update
 Q8.9 Other USENET newsgroups. 
(Contained in Part 9 of 10):
Section 9. Other Electronic Information Sources.
 Q9.1 List of AIDS BBSes.
 Q9.2 National AIDS Clearinghouse Guide to AIDS BBSes.
 Q9.3 National Library of Medicine AIDSLINE (please contribute)
 Q9.4 Commercial Bulletin Boards
 Q9.5 Lesbian/Gay Scholars Directory.
 =============================================================
Section 1. Introduction and General Information
 Q1.2 Discussion topics.
 Q1.3 Sci.med.aids distribution.
 Q1.6 What is a moderated newsgroup?
 Q1.7 Editorial guidelines.
 Q1.8 How do I submit a posting?
 Q1.9 The moderators.
 Q1.10 Cooperative moderation - and voting on posts.
 Q1.11 If a post is rejected.
 Q1.13 Feedback is invited
 Q1.14 Formats in which this FAQ is available
 Q1.15 Authorship and acknowledgements
-------------------------------------------------------------------------
-----
-
mailing list called AIDS.
published authors, researchers, public health officials, and
interested individuals. It is carried in several countries,
particularly in the Americas and Europe.
Sci.med.aids is moderated by a team. When you submit an article to
-------------------------------------------------------------------------
-----
-
Question 1.2. Discussion topics.
Sci.med.aids covers topics of interest to people with AIDS (Acquired
Immune Deficiency Syndrome), their friends, relatives, and loved ones,
AIDS service providers, educators and researchers, and the general
public.
Some common topics are
 Causes of AIDS and opportunistic infections.
 Vaccines for AIDS.
 Treatments or cures for AIDS and opportunistic infections.
 AIDS prevention and education.
Sci.med.aids carries some regular magazines. Here's a current list:
 CDC AIDS Daily Summary
 AIDS Treatment News
 The Veterans Administration AIDS Info Newsletter
If you have the time to add to this list, we invite you to contribute
(if you obtain copyright permission, of course).
-------------------------------------------------------------------------
-----
-
Question 1.3. Sci.med.aids distribution.
Sci.med.aids is distributed as a USENET newsgroup, where it has
approximately 40,000 readers. At one time USENET was carried
primarily at research and educational institutions, but that is
changing; a number of commercial services now carry USENET.
Here is a breakdown of comparable newsgroups, for the month of
June 1994. You can obtain a full list of network traffic by
anonymous ftp from
 +-- Estimated total number of people who read the group, 
worldwide.
 | +-- Actual number of readers in sampled population
 | | +-- Propagation: how many sites receive this group 
at all
 | | | +-- Recent traffic (messages per month)
 | | | | +-- Recent traffic (megabytes per 
month)
 | | | | | +-- Crossposting percentage
 | | | | | | +-- Cost ratio: 
$US/month/rdr
 | | | | | | | +-- Share: % of 
newsrders
 | | | | | | | | who read this 
group.
 V V V V V V V V
 
 156 89000 870 78% 1282 1.7 37% 0.02 1.8% 
 243 75000 862 67% 4057 9.4 15% 0.11 1.7% talk.abortion 
-------------------------------------------------------------------------
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-------------------------------------------------------------------------
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-
 553 49000 487 77% 135 0.3 17% 0.01 1.0% 
 657 43000 506 65% 770 1.3 56% 0.03 1.0% 
talk.politics.drugs
 791 36000 602 46% - - - - 1.2% 
 885 33000 363 69% 553 0.7 54% 0.02 0.7% 
 981 30000 323 70% 680 1.0 9% 0.03 0.7% 
1746 11000 210 38% 53 0.1 6% 0.01 0.4% 
1821 10000 153 50% 205 0.3 6% 0.02 0.3% 
1847 9700 198 37% 158 0.2 7% 0.01 0.4% 
1870 9400 142 50% 136 0.2 20% 0.01 0.3% 
Sci.med.aids is also distributed as electronic mail by the AIDS
newgroup, but mail is available at more sites (including Compuserve,
America Online, MCImail, ATTmail and many institutions which have
Internet gateways).
redistributed by various bulletin boards and mail gateways.
-------------------------------------------------------------------------
-----
-
Various individuals and organizations have graciously posted thier
o The CDC AIDS Daily Summary
"The AIDS Daily Summary has been produced for nearly seven years by
Information Inc., a publisher who produces similar electronic
newsletters for other topics. Until 1992, the AIDS Daily Summary was
a subscription- based service which individuals and organizations were
able to receive for a fee. Since 1992, the CDC National AIDS
Clearinghouse has contracted with Information Inc. so that the AIDS
Daily Summary can be provided free of charge to all interested
readers. We encourage duplication and redistribution so that as many
people as possible benefit. It is posted daily on CDC NAC ONLINE, the
Clearinghouse's online information system and on the AIDSNEWS
listserv, which redirects it to Sci.med.aids...
Information Inc. is responsible for collecting and editing the
information in the AIDS Daily Summary. The titles you see listed
are taken verbatim from the original article. Although the editors
try earnestly to make the summaries scientifically accurate, this
is often difficult because of ambiguous language in the original
article. For example, references to the term "infected with AIDS"
are sometimes unchanged from article to summary because the editors
can not tell from the original whether "HIV-infected" or "person
with AIDS" is correct. In general, the editors aim to follow the
language and "spirit" of the original article, because an important
purpose of the AIDS Daily Summary is to reflect *how* HIV/AIDS is
represented in the press.
We are always happy to get feedback from readers of the AIDS Daily
Summary. We pass on comments about the scope and quality of the
coverage to the editors. Comments should be emailed to John Fanning at
`aidsinfo@cdcnac.aspensys.com' or `clearinghous@delphi.com'. Anyone
interested in being on the AIDSNEWS listserv to receive the AIDS
Daily Summary and other news from CDC and the Federal government
can send a `subscribe aidsnews' message to
`listserv@cdcnac.aspensys.com'. Note that we also have a gopher server
at `cdcnac.aspensys.com'."
o NAPWA Medical Alert
o Kairos House Caregivers Newsletter
o VAMC Newsletter
The AIDS Information Newsletter is one of several electronic
services provided to librarians and health care professionals
within the U.S. Department of Veterans Affairs. The newsletter is
transmitted from the AIDS Information Center located in San
Francisco on alternate Fridays to all VA Medical Centers,
server (gopher.niaid.nih.gov). The Center takes full responsiblity
for all material; the content does not necessarily reflect the
viewpoints or policies of the U.S. Department of Veterans Affairs.
o AIDS Treatment News
o After All
What is "After All?"
 "After All" is a newly created newsletter directed to those who have 
lost or are losing a loved one to AIDS. As of March '95 the issues will 
be monthly. We also hope to get those suffering from this disease to 
pitch in and help others to better understand the unending suffering 
this situation is causing . . . for so many!
 There will be three formats available:
 Printed
 family.hampshire.edu/pub/aids/afterall
 A full version created with Adobe Acrobat that will include 
text, graphics and color. You will need the Adobe Reader to view this 
format. It will be available at 
 family.hampshire.edu/pub/aids/afterall/reader.exe
 (a self-extracting .zip file). 
 
 The Premier Issue will be available in January as "angels1". Future 
issues will be monthly as "Angels2", "Angels3", etc.
 We need your help. If you like the issue let us know.
o (others - please contribute)
-------------------------------------------------------------------------
-----
-
The answer to this question depends on your system. You may have to
ask your local system administrator. Here are some guidelines valid
on many systems:
* You may have USENET on your system, especially if you run UNIX or
VMS. Here are some commands to try: "rn", "trn", "xrn", "nn", "tin".
That might not work, since some sites limit the newsgroups they
a mail message to listserv@rutvm1.rutgers.edu. The message body
should contain just the following command: subscribe aids <yourname>
Type in your real name (not your e-mail address) instead of <yourname>.
A complete message might look like this:
 To: listserv@rutvm1.rutgers.edu
 subscribe aids Joe Smith
To unsubscribe, send a message to listserv@rutvm1.rutgers.edu
containing the text
 unsubscribe aids
Please unsubscribe before your account expires. The moderators get
all sorts of junk mail if you don't.

 
-------------------------------------------------------------------------
-----
-
Question 1.6. What is a moderated newsgroup?
A moderated newsgroup is one in which all postings must be approved by
the moderators before being distributed. The purpose of moderation is
to restrict what can appear. Postings which do not adhere to the
guidelines for the group will be rejected.
-------------------------------------------------------------------------
-----
-
Question 1.7. Editorial guidelines.
posting, to see if your question has been answered already, and to get
a feel for the tone of the group.
* Write on topics directly relevant to AIDS, HIV, or related topics.
* Unconventional medical/research claims must be accompanied by
references to the popular press (i.e., major newspaper, magazine,
etc.) or scientific press (i.e., Science, Nature, Lancet, Scientific
American, Cell, Brain Research, etc.).
We require references for unconventional medical/research claims,
because some therapies carry with them potential danger. Some
unconventional medical/research claims are fallacious. Without this
undocumented therapies by now.
* Political, sociological opinion/analysis articles are acceptable.
The interpretation, and even the existence, of this particular policy
continues to be the subject of internal debate among the moderators.
However, in the past we have printed articles holding both popular and
unpopular opinions on topics like "Quarantining HIV Positives" or "who
did Clinton appoint to the AIDS Task Force."
* Refrain from personally attacking other participants. For example,
do not call someone an 'idiot' or say they are 'biased'. Instead,
point out the flaws in their argument. If you find yourself getting
angry at a poster, and construct a reply, please try to remember this
rule.
It is often useful to wait a day to see what other reactions have been
posted before sending something off in anger.
* Send one line "quips" as personal mail to the original submitter,
rather than posting.
* When posing a question to a previous poster, reconsider whether the
question needs to be posted. Perhaps you could ask the question by
e-mail and request a posted response.
* Do not invoke religion.
* Do not break copyright laws. Reprints of articles from other
sources must include a statement of permission to reprint. An
exception is made for abstracts of articles from scientific journals,
which are not usually restricted. If you can't get reprint
permission, excerpt or summarize the article.
* Do not construct an article with more than 20% text from a previous
article, unless it is very old (i.e., months old). The best approach
when constructing a response is to tersely summarize the article to
which you respond, in square brackets. For example,
 > [reasons to not include too much of a prior article]
Also, don't forget that many people get this stuff by mail, so huge
inclusions clog hundreds of mailboxes, including mine. Thanks.
* Do not duplicate something which has recently appeared.
The moderators don't always agree on what's acceptable and what's not.
If an article is rejected, you should receive a note from the
moderators saying why. These notes, and other discussions about the
-------------------------------------------------------------------------
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-
Question 1.8. How do I submit a posting?
This depends on the software you are using. On many USENET systems,
you can use the command postnews
You can also post by sending your article as e-mail to aids@cs.ucla.edu.
immediately. Sometimes the delay is very short; often it may be 24
hours or more. It depends on network delays and how busy the
moderators are. A tickler program reminds us of postings older than
48 hours.
IMPORTANT: Whether you use postnews or e-mail, please format your
article exactly the way you want it to appear in the newsgroup.
Because our moderation software is somewhat unpolished, editing out
notes to the moderators in a posting is quite tedious. If you must
communicate directly with the moderators, send a note to
aids-faq@family.hampshire.edu.
-------------------------------------------------------------------------
-----
-
Question 1.9. The moderators.
 Phil Miller Professor, Biostatistics, Washington University
 Jack Hamilton Health Care analyst
 Jeff Rizzo Interested hemophiliac with AIDS
 Lauren Fergusen Librarian 
Phil, Jack, Lauren and Jeff do most of the moderation. Dan repairs
the moderation software. Phil is probably the most liberal moderator,
Dan the most restrictive.
Various individuals have been moderators in the past, including:
 David Dodell Founder, Grand Rounds fidonet echo, Dentist
 Steve Dyer Writer, Gay Community News, Software Consultant
 Alan Wexelblat Freelance writer, ethicist
 Tom Lincoln Informatics Director, USC Medical Center
 Craig Werner MD/PhD Student, Albert Einstein School of Medicine
 Will Doherty Gay Activist, technical writer Sun Microsystems
 Michelle Murrain Health researcher and professor, Hampshire College
-------------------------------------------------------------------------
-----
-
Question 1.10. Cooperative moderation - and voting on posts.
Cooperative moderation seeks to limit the burn-out associated with
newsgroup moderation, by sharing the workload among several
moderators. In addition, it provides a more balanced treatment of
contentious issues.
D.R. Greening and A.D. Wexelblat, Experiences with Cooperative
Moderation of a USENET Newsgroup, Proceedings of the 1989 ACM/IEEE
Workshop on Applied Computing.
available by FTP from cs.ucla.edu:pub/aids.paper.ps.Z
This paper is also available from the UCLA Computer Science Department
as a technical report.
At present, a voting system has been added to the moderation
process. When you submit an article, moderators vote. 2 yes votes
post an article, while 2 no votes reject an article. The first
threshold to be exceeded determines the result.
-------------------------------------------------------------------------
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Question 1.11. If a post is rejected.
We reject many articles because of formatting problems, other
mechanical problems, or our own confusion, and those articles can be
revised quickly (by you) and resubmitted.
alone. Articles posted here are distributed in many forms. We share
information with AEGIS, an AIDS bulletin-board network. We have a
and provide them to their local library. Activists have even printed
with AIDS.
If you have important information, we urge you to spend the time to
revise your article and resubmit: it will be read. On the other hand,
these 73,000 readers are why we are so cautious about posting. Respect
your huge audience by spending the time to write a readable and
informative article. If you carefully investigate and share important
a little healthier, or reassure someone. All of these are valuable.
-------------------------------------------------------------------------
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A separate mailing list, aids-d, has been set up for the moderators
readers will not be interested in aids-d; its purpose is internal
discussion rather than information dissemination, and most articles on
aids-d are examples of what moderation has filtered out. If you want
to subscribe, send email to aids-d-request@sti.com.
-------------------------------------------------------------------------
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Question 1.13. Feedback is invited
Please send us your comments on this FAQ. 
We accept submissions for the FAQ in any format; All contributions
comments and corrections are gratefully received.
Please send them to aids-faq@family.hampshire.edu 
-------------------------------------------------------------------------
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Question 1.14. Formats in which this FAQ is available 
This document is available as ASCII text. We are working on
postcript, Emacs Info, and HTML) will be stored.
-------------------------------------------------------------------------
-----
Question 1.15. Authorship and acknowledgements 
The following people contributed to this FAQ: 
Dan Greening originally assembled and edited this document. Jack
Hamilton wrote the introduction and first section. Phil Miller offered
periodic edits. Michelle Murrain updated and edited this document in
August, 1994, and continues to update and maintain it. Anne Wilson
forwarded many valuable articles from the CDC National AIDS
Clearinghouse.
Robert Walker wrote the section on minimizing the risk of HIV
is reproduced here. Paul M. Karagianis <KARYPM@SJUVM.BITNET>
contributed archives answering question about mosquito
transmission. Iain Nicholson, who works on Plasmodium falciparum,
wrote the section on malaria. Vince Hammer wrote the review of ``Do
Insects Transmit AIDS?''
Michael Howe provided references for the question "Does HIV cause
AIDS?", and has scanned several documents for this FAQ. Ken Shirriff
<shirriff@sprite.berkeley.edu) wrote the sections on Peter Duesberg,
and on Strecker and Segal's theories that HIV is synthetic. Eric
Raymond <esr@snark.thyrsus.com> wrote about the USSR disinformation
campaign.
Rob James wrote a description of the US blood testing process. David
Wright wrote the reasons why we should not donate blood to get a free
HIV test.
David Mertz wrote the section on internet access to the gopher
database. Michelle Murrain wrote the section on the CDC patient data
FTP site.
 
