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Health: Prevention Of Spread Of HIV Feasible

Washington, 29 June 1998 (RFE/RL) -- At the top of this week's health file is news about an important but inexpensive weapon that's available for use in the struggle against the spread of the Human Immunodeficiency Virus (HIV), the virus responsible for the deadly disease known as AIDS (acquired immune deficiency syndrome).

Study Shows Behavioral Interventions Cut HIV-Related Risk Behavior

Washington -- U.S. government researchers say communication and education can dramatically reduce risky sexual behaviors and increase the adoption of precautionary measures, even among persons considered the hardest to reach.

HIV is spread by the transfer of infected bodily fluids from one person to another through unprotected sexual intercourse or the shared use of needles and syringes by drug abusers. In a report broadcast by RFE/RL last December, the World Health Organization noted "alarming rises of sexually transmitted diseases in Eastern Europe." The report said this pointed "to the potential for a much wider sexual spread of HIV, affecting larger parts of the population."

The World Health Organization says: "Sexually transmitted disease makes HIV (when present) spread much more easily from one partner to the other. It is also an important marker of potential HIV spread because it has the same transmission route -- unprotected sex."

However, just last week, the U.S. National Institute of Mental Health (NIMH) reported some encouraging results from the largest randomized, controlled, HIV behavioral intervention study conducted in the United States.

The trial enrolled 3,706 men and women in 37 urban clinics across the country. According to the government scientists, those who attended HIV prevention sessions that focused on motivation and skills to reduce high-risk sexual behaviors reported significant reductions across a range of sexual risk indicators over a one-year period.

The report said the seven-session intervention reduced the incidence of gonorrhea in men by half. Incidence of gonorrhea is an indicator of unprotected sexual behavior.

NIMH Director Steven Hyman said: "Reducing high risk behaviors is still the best way to prevent new HIV infections." He said the institute has identified an effective strategy that could be adopted by public health and community organizations all across America. Dr. Hyman contends that, "if these behavioral changes were maintained for even one year, there would be a profound, cost-effective, public health impact in the communities that adopted this program." Experts Urge Reconsideration Of Ban On Kidney Sales

Washington -- An international panel on medical ethics contends that a ban on the sale of human kidneys should be reconsidered because of a world-wide shortage of organ donors.

In an article published in last week's edition of The Lancet, a British medical and science journal, the panel says that "feelings of repugnance" are not a good enough reason for the fact that kidney sales from live vendors are illegal in most parts of the world.

The authors are members of the International Forum for Transplant Ethics. The forum includes doctors and professors from Britain, the United States, Canada, and Oman. They did not argue for lifting the kidney sale ban outright, but said the debate on the subject should be reopened.

The panelists wrote: "The well-known shortage of kidneys for transplantation causes much suffering and death. If we are to deny treatment to the suffering and dying, we need better reasons than our own feelings of disgust."

The Lancet article noted that in 1990, two British doctors lost their licenses after authorities uncovered a scheme in which Turkish men had been brought to Britain and paid more than 3,000 dollars each for their kidneys.

The Lancet article said this "aroused such horror" that nearly all professional associations denounced the sale of kidneys and nearly all countries have now made it illegal.

The authors suggested that kidney sales could be regulated to prevent abuses, rather than banned altogether. They said independent trusts could be set up to fix charges and handle accounts, as well as to ensure fair play and high standards.

The panel argued that: "If the rich are free to engage in dangerous sports for pleasure, or dangerous jobs for high pay, it is difficult to see why the poor who take the lesser risk of kidney selling for greater rewards, perhaps saving relatives' lives, or extricating themselves from poverty and debt -- should be thought so misguided as to need saving from themselves."