Mr. and Mrs. “Magic” team up for HIV message

As the most prominent African-American face of AIDS, NBA superstar-turned-entrepreneur Earvin “Magic” Johnson has long used his fame to raise public awareness about the deadly disease. But now his usually camera-shy wife, Cookie, is appearing in the public-service announcements that have begun airing on cable TV and YouTube that sound the alarm about the disproportionately high HIV rates in the African-American community. HIV is the virus that causes AIDS. “We’ve got to get the word out about HIV and AIDS to minority communities,” Johnson said during taping at the Beverly Hilton earlier this year. “Cookie’s taken on the battle.” Local activists have worked for decades to draw attention to the toll of HIV in the Black community. Now they are being joined by a growing number of African-American celebrities and leaders nationwide. The numbers provide ample reason for alarm. According to the Centers for Disease Control and Prevention, Blacks, who represent only 13 percent of the U.S. population, comprise almost half of the estimated 1.2 million Americans living with HIV today. Nearly 17 years after Johnson announced, with his wife at his side, that he had AIDS, Blacks account for most of the country’s new cases of HIV and AIDS, and AIDS-related deaths. Blacks resist getting tested because they fear being outcasts in their community, Johnson said. Or they get tested and “run scared,” often not telling their families. “We African Americans can be homophobic,” said moviemaker Spike Lee, who directed the public service ads. “There’s a whole lot of re-education that needs to get started.” The “I Stand With Magic” campaign, a five-year, $60-million project financed by the drug firm Abbott urges Blacks to be tested for HIV. The company, which says its goal is to halve the rate of new infections among U.S. Blacks, produces AIDS drugs. “There’s still a small part of our community that thinks, ‘It can’t happen to me,’ ” Cookie Johnson said. That’s why she has teamed with her husband in the new effort to reach out to a new generation of young people in hopes that they will get tested, find out their status and help stop the spread of HIV/AIDS.
The Feds ramp up childhood obesity fight
This aggressive new recommendation for warding off heart disease in some children has stirred a furious debate among pediatricians since the American Academy of Pediatrics issued it on Monday. Because of the urgent need to address the childhood obesity epidemic, the American Academy of Pediatrics is revising its 10 year old policy statement on cholesterol in childhood and recommending that overweight children receive cholesterol screening and treatment regardless of family history or other risk factors. The AAP policy review is published as an article in the 1st July issue of Pediatrics. The 1998 policy will be updated to recommend that all overweight children, starting as early as 8 years old, and regardless of their other risk factors, be included in cardiovascular prevention programmes, which apart from cholesterol screening includes following dietary guidelines, increasing physical activity and the use of cholesterol busting medication (statins), where appropriate. While some doctors applauded the idea, others were incredulous, reports The New York Times. In particular, these doctors called attention to a lack of evidence that the use of the cholesterol-lowering drugs, called statins, in children would prevent heart attacks later in life. “What are the data that show this is helpful preventing heart attacks?” asked Dr. Darshak Sanghavi, a pediatric cardiologist and assistant professor at the University of Massachusetts Medical School. “How many heart attacks do we hope to prevent this way? There’s no data regarding that.” Nor, Dr. Sanghavi added, are there data on the possible side effects of taking statins for 40 or 50 years, the Times notes. Other doctors said the recommendation would distract from common-sense changes in diet and exercise, which are also part of the new guidelines. “Treatment with medications in the absence of any clear data? I hope they’re ready for the public backlash,” Dr. Lawrence Rosen of Hackensack University Medical Center in New Jersey, vice chairman of an academy panel on traditional and alternative medicine, told the times. Doctors who sat on the academy’s committee on nutrition, which issued the guidelines, agree there are no long-term data on statin use in children. But they say there are adequate safety data to justify the recommendations. One statin, Pravachol, has already been approved by the Food and Drug Administration for use in children as young as 8. “We extrapolate from the information we have in adults,” said a member of the panel, Dr. Nicolas Stettler, an assistant professor of pediatric epidemiology at the Children’s Hospital of Philadelphia. “We know that in adults, decreasing cholesterol and giving some of those drugs decreases risk of heart disease or death. So there’s really no reason to think that would be any different in children.” The recomendation signals a more aggressive approach to treating cardiovascular disease at a young age using drugs that have been studied primarily in adults. . Some childhood obesity experts said they understood the need for the new guidelines, but added that there needed to be more focus on public health changes to address childhood obesity. “When you have a kid whose cholesterol looks like an overweight 65-year-old, what do you do?” said Dr. David Ludwig, director of the childhood obesity program at Children’s Hospital in Boston. “The committee had to balance the risks of treating children with powerful drugs, about which there is limited long-term data, with the risks of not treating children with unprecedented cardiovascular disease risk factors.” Even at that, there is concern about the turn to drugs as a solution. “My concern is what this is saying about society when we are so quick to prescribe drugs for these conditions before having systematically attacked the problem from the public health perspective,” said Dr. David Ludwig, director of the childhood obesity program at Children’s Hospital in Boston.
Teen sex doesn’t predict future HPV infection
Should an adolescent’s sexual behavior– or lack thereof – determine whether or not she gets human papillomavirus? No, say researchers at the University of Michigan C.S. Mott Children’s Hospital’s Child Health Evaluation and Research (CHEAR) Unit. Their study finds that sexually active teens are just as likely to get the HPV in adulthood as those adolescents who are not sexually active. “Using risk factors as a means to determine who should get the HPV vaccine is not a good strategy. In our study, all women who eventually became sexually active at some point had an equivalent risk of getting HPV,” says study lead author Amanda F. Dempsey. These findings, Dempsey says, support the Centers for Disease Control and Prevention’s Advisory Committee on Immunizations Practices recommendation for universal vaccination for all women ages 11 to 26, regardless of sexual experience. Much of the confusion over whether or not to vaccinate a patient stems from conflicting recommendations. While the advisory committee advocates universal vaccination, the American Cancer Society recommends vaccinating all females younger than 18, and selectively vaccinating women ages 19 to 26, based on an informed discussion between the patient and her doctor about sexual history. However, recent reports about problems that teens and other women have after getting vaccinated have caused more concern. (For more on the issue see Vital Signs.) The price of the vaccine is also a factor. With each dose costing approximately $120 – along with high up-front costs to stock the vaccine, inconsistent coverage from government programs and low levels of reimbursement from private insurance – many states are struggling to provide the vaccine to all eligible girls and women. For those reasons, many clinicians are targeting the HPV catch-up vaccination to only girls and women they deem to be at the greatest risk for acquiring HPV. Previous studies of sexually active adolescents and young adults identified specific sexual partnerships, behavioral and sociodemogrpahic characteristics associated with increased risk for HPV infection. HPV infection generally occurs shortly after a woman becomes sexually active. Most women never know they have the virus because it usually goes away on its own and may not cause any symptoms. There are more than 100 types of HPV, but only some types of HPV lead to cervical cancer or genital warts. The vaccine guards against four types of HPV: two that cause 70 out of 100 cases of cervical cancer and two that cause 90 out of 100 cases of genital warts.