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110、Onions, garlic linked to lower cancer risks
Fri Dec 1, 2006 12:34pm ET

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NEW YORK (Reuters Health) - People who flavor their diets with plenty of onions and garlic might have lower odds of several types of cancer, a new study suggests.

In an analysis of eight studies from Italy and Switzerland, researchers found that older adults with the highest onion and garlic intakes had the lowest risks of a number of cancers -- including colon, ovarian and throat cancers.

The findings, which appear in the American Journal of Clinical Nutrition, are in line with some past research. But those studies were mainly conducted in China, and it is unclear if the results are different in Western countries.

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Dietary habits are substantially different in China, with garlic intake, in particular, being far higher, Dr. Carlotta Galeone, the lead author of the new study, told Reuters Health.

These latest findings suggest the anti-cancer benefit of these vegetables extend to Western populations, according to Galeone, a researcher at the Mario Negri Institute of Pharmacologic Research in Milan, Italy.

It's still not certain that onions and garlic have a direct effect on cancer risk. It's possible, for instance, that onion and garlic lovers also have an overall diet that protects against cancer, according to Galeone and her colleagues.

On the other hand, they note, animal studies and lab experiments with cancer cells have found that certain compounds in onions and garlic may inhibit the growth of tumors. Sulfur compounds found in garlic and antioxidant flavonoids in onions are among the potentially protective substances.

The current findings are based on results from eight studies conducted in Italy and Switzerland. Each study compared healthy older adults to patients with a particular form of cancer, asking participants for detailed information on their diets, physical activity and other lifestyle habits.   Continued...




When it came to colon cancer, Galeone's team found that men and women who ate seven or more servings of onions per week had less than half the risk of those who shunned the vegetable. Similarly, garlic lovers were a quarter less likely to develop the disease than people who maintained garlic-free diets.

The vegetables were also linked to lower risks of cancers of the mouth, throat, kidneys and ovaries.

Given what's known about the biological activity of some onion and garlic compounds, it wouldn't be a bad idea to spice up your diet with the vegetables, according to Galeone.

It's probably wise to mix them with plenty of other vegetables, however.

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Some research has found that garlic and tomatoes may have "synergistic" cancer-fighting effects, Galeone and her colleagues note. And, in general, experts recommend that people eat a variety of fruits and vegetables every day for overall health.

SOURCE: American Journal of Clinical Nutrition, November 2006.

© Reuters 2006. All Rights Reserved

111、 Prescription Labels Often Misunderstood By Ed Edelson
HealthDay Reporter
Fri Dec 1, 7:02 PM ET




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FRIDAY, Dec. 1 (HealthDay News) -- Many Americans, including those with college degrees, have trouble interpreting the instructions on prescription drug labels, a new study finds.


Indeed, only 34.7 percent of the people with lower literacy, grade level or below, interviewed for the study could determine the number of pills to take daily when faced with "take two tablets by mouth twice daily," according to the study report in Annals of Internal Medicine.


And 9 percent of all those interviewed had trouble with the instruction, "take one tablet by mouth once each day."


The problem is most common with the "two tablets twice daily," noted researcher Michael S. Wolf, assistant professor of medicine at Northwestern University's Feinberg School of Medicine. That is often misinterpreted to mean "two tablets a day," he said. But the number of misinterpretations rises with the amount of numbers included in the instructions, Wolf said. So, "take one teaspoon twice a day for seven days" is especially confusing, for example, he noted.


It's an important issue because more and more Americans are taking more and more medications, said lead researcher Terry C. Davis, professor of medicine and pediatrics at Louisiana State University Health Sciences Center in Shreveport.


"The topic resonates because most people are taking some medication and taking them safely is important," she said.


Important enough for the American Academy of Physicians Foundation to appoint a new advisory committee, headed by Wolf, to come up with better ways of making sure that people know how much of a drug they should be taking, and when.


"We're working to push for policy change, and we expect to report this month or early in January," Wolf said.


The problem can start in the doctor's office, Davis said. "Most doctors don't give any instructions on how to take the medicine" that they write prescriptions for, she said. "Doctors can be more precise -- saying when a drug should be taken, how many times a day and for how long," she said.


This type of detailed information can be included if a patient asks for it, either in the physician's office or at the pharmacy, Davis said.


But there's a more basic problem, Wolf said. "We may need more explicit instructions," he said. "The current system is very bad at providing information on prescription drugs. Instructions can vary not only by pharmacy but also by physician."


The committee probably will recommend "some regulatory oversight to standardize dosage, of a kind we've never had before," Wolf said.


The issue of "how we can confuse patients less" about the drugs they take is of growing importance, Wolf said. He estimated that perhaps 500,000 adverse events occur each year in this country because people misread their drug instruction.


More information


There's more on prescription drugs at the U.S. Food and Drug Administration.

112、Private Plans Boost Medicare Spending Fri Dec 1, 7:02 PM ET




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FRIDAY, Dec. 1 (HealthDay News) -- Efforts to include more private insurers in Medicare may be costing the agency more money, new research shows.


On average, private Medicare Advantage (MA) plans were paid 12.4 percent more per enrollee in 2005 than what the same enrollees would have cost the traditional U.S. Medicare fee-for-service program, says a report released Thursday by the Commonwealth Fund, a private foundation that supports independent research on health and social issues.


"While encouraging enrollment in private plans was billed as a way to reduce costs for the program, Medicare Advantage, in fact, costs Medicare money because of the extra payments," report author Brian Biles, professor of health policy at George Washington University, said in a prepared statement.


The report authors estimated that extra payments to MA plans in 2005 totaled more than $5.2 billion over fee-for-service costs for about 5.6 million Medicare beneficiaries enrolled in MA plans. That works out to about $922 more per person.


Most of those extra payments were required under the Medicare Modernization Act of 2003, which was meant to expand the role of private plans in Medicare.


Eliminating extra payments to private plans could save Medicare about $30 billion over five years, the report authors estimated. These savings could be used in a number of ways, including:

filling in the coverage gap (the so-called doughnut hole) in the Part D drug benefit.
reducing the increase in the Part B premium in 2007 by about $10 per month for each beneficiary.

"If traditional Medicare and private plans are ever to compete fairly, they need to compete on a level playing field, which would require the elimination of these extra payments," Biles said.


More information


The American Academy of Family Physicians offers information about health insurance.

113、Probe urged on blood-clotting drug use Thu Nov 30, 6:02 PM ET



BALTIMORE - Two U.S. senators are calling for a military probe of the use of a blood-clotting drug on wounded troops in     Iraq, after reports of life-threatening clots following its use.

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The Defense Department should track all patients who receive the drug, Factor VII, on the battlefield to determine whether they are more prone to blood clots or other complications, Sen. Barbara Mikulski (news, bio, voting record), D-Md., said in a letter to Dr. William Winkenwerder Jr., Assistant Secretary of Defense for Health Affairs.

"We need to know if the long-term risks of this drug pose a greater danger to our service member's lives than can be justified by the short-term benefits," Mikulski said in a letter sent Wednesday.

Melissa Schwartz, a Mikulski spokeswoman, said the senator's office had not received a reply as of Thursday morning.

"I have no indication how fast we are going to hear," Schwartz said.

Senate Minority Whip Richard J. Durbin, D-Ill., said a series of articles by The (Baltimore) Sun on the military's use of the drug prompted him to seek answers from the     Pentagon.

"The safety of our troops is the top priority and my office is discussing the serious findings reported in The Baltimore Sun with the Defense Department," Durbin said in a statement.

The military has justified the use of the drug, originally designed to treat rare forms of hemophilia, by saying it gives front-line doctors a way to control often fatal bleeding. Wounded troops requiring transfusions of 10 or more units of blood have a 25 percent to 50 percent chance of dying from their injuries, they note.

Military doctors in Iraq have injected it into more than 1,000 patients, and doctors at military hospitals in Germany and the United States have reported unusual and sometimes fatal blood clots in soldiers from Iraq.

Lt. Gen. Kevin C. Kiley, the Army's surgeon general, sent a letter to The Sun saying the use of the drug has been mischaracterized.

"This product is used on a case-by-case basis, in specific circumstances as ordered by the physician, to control life-threatening bleeding," Kiley wrote. "It saves the lives of our most severely injured troops."

Meanwhile, a group of seven scientists and physicians who specialize in hematology and blood-clotting have written an editorial for an upcoming issue of the journal Applied and Clinical Thrombosis/Hemostasis saying there are "rightful concerns" about the use of the drug.

"Our soldiers are already in great danger and the availability of a lifesaving drug such as (Factor VII) is welcome," the editorial said. "It is, however, equally important to recognize and investigate the reported adverse reactions with its use to avoid additional risk to these Army personnel."

Rep. Roscoe G. Bartlett, R-Md., said he had confidence in the decision-making abilities of military doctors.

"It would be very nice to have some definitive study of the risks and benefits of using the drug prophylactically, and I hope that kind of research will be done," said Bartlett, a former professor of physiology at Howard University's College of Medicine. "But this war won't wait for that, and we have to let these doctors make their own judgment calls about what is necessary to save these soldiers."

114、Problem gamblers have poorer health
Fri Dec 1, 2006 1:34pm ET

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NEW YORK (Reuters Health) - People who can't control their gambling may have higher odds of physical health problems as well, a new study shows.

Researchers found that among more than 43,000 Americans in a national survey, problem gamblers had elevated rates of liver disease, high blood pressure, high heart rate and angina -- chest pain caused by blockages in the heart arteries.

Although gambling addiction often goes hand-in-hand with substance abuse, anxiety and other mental health disorders, the new study is the first to link it to specific medical conditions.

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There's no way to tell from the findings whether the physical health problems stemmed from the gambling problems, Dr. Nancy M. Petry, the study's senior author, told Reuters Health.

But the study shows that gamblers' problems extend beyond financial woes and mental health issues, and influence physical health, said Petry, a professor of psychiatry at the University of Connecticut Health Center in Farmington.

She and her colleagues report their findings in the journal Psychosomatic Medicine.

Using data from a federal survey on the prevalence of psychiatric disorders in the U.S., the researchers found that pathological gamblers were more than twice as likely as people without gambling problems to have angina and nearly three times more likely to have liver disease. They were also almost twice as likely to suffer from tachycardia, an excessively rapid heartbeat.

The subjects were at increased risk of developing these disorders even after other factors, including alcohol abuse and mental health disorders, were taken into account.   Continued...

115、Report sparks changes at pharmacy chains By ERIC TUCKER, Associated Press Writer
Fri Dec 1, 11:40 AM ET



PROVIDENCE, R.I. - The nation's largest drugstore chains say they are working to better protect patient privacy after an investigative TV report turned up sensitive information about hundreds of customers in trash bins in cities around the country.

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Indianapolis TV station WTHR inspected nearly 300 trash bins and found nearly 2,400 patient records, including pill bottles, customer refill lists and prescription labels. Most of the bins belonged to Walgreens Co., CVS Corp. or Rite Aid Corp. The inspections were done in more than a dozen cities ranging from Boston to Louisville, Ky., to Phoenix.

The station said its investigation began after a grandmother from Bloomington, Ind., was robbed at her front door by a thief authorities said found her address in a CVS trash bin. The man posed as a pharmacy employee to try to steal her prescription for the painkiller Oxycontin, the authorities said.

As part of its response, Deerfield, Ill.-based Walgreens Co. said it was now instructing staff to lock outdoor trash bins at all times and was reviewing the way it disposes of patient information.

In Woonsocket, R.I., where CVS is headquartered, 460 patient records were found in CVS trash bins, the station said. Responding to the findings, CVS sent a statement acknowledging it was unacceptable that patient information could be retrieved from the bins.

"Nothing is more central to our health care operations than maintaining the privacy of health information," the CVS statement said.

The report aired in multiple installments up through this month.

CVS, which operates about 6,200 stores nationwide, said it was now requiring all trash generated in its pharmacies ― and not just trash containing patient information ― to be placed in special bags which are then returned to CVS warehouses. It said it was also holding in-store training sessions to review proper procedures for handling of the pharmacy trash.

"Our policy, when it's followed correctly, is foolproof," said CVS spokesman Mike DeAngelis. "But if there's a lack of execution, that's where issues arise. So we've enhanced the policies and procedures in order to make sure that they are followed."

Walgreens, the nation's biggest drugstore chain by revenue, said it had e-mailed all of its stores to reiterate its policy for handling patient information.

The company also said it was now requiring that patient vials be returned to pharmacy warehouses to be thrown out. Previously, staff had been instructed to either black out patient information or remove the label from the vial before putting it in the trash. Outside trash bins are also to be locked at all times, the company said.

Walgreens spokeswoman Carol Hively said Thursday the company was concerned certain employees were not following proper procedures and was trying to reinforce the rules. But she said other TV stations that have conducted similar investigations have not found privacy problems.

"We feel that having seen these other reports from around the country where other TV stations randomly selected Walgreens stores and there was a good outcome makes us feel that these efforts were successful," she said.

Camp Hill, Pa.-based Rite Aid Corp., the nation's third-largest drugstore chain, is enforcing current policies and has not made changes, said spokeswoman Jody Cook. She said company policy calls for pharmacies to shred confidential patient information, such as prescription labels. If the store is not set up to do that, then the information is to be sent back to pharmacy warehouses to be destroyed.

"We have policies in place to protect patient information, so really it was more of a retraining," Cook said.

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Sleep Problems Can Strike Preschoolers, Too By Kathleen Doheny
HealthDay Reporter
Thu Nov 30, 11:47 PM ET



THURSDAY, Nov. 30 (HealthDay News) -- Sleep problems don't just plague teenagers who burn the candle at both ends or adults anxious about paying their bills.

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Even preschoolers can have trouble sleeping, and experts suspect the main difficulty for kids ages 1 to 5 is simply a lack of restful slumber.


"Twelve to 15 hours a night is recommended based on best guesses," said Christine Acebo, an assistant professor of psychiatry and human behavior at Brown University Medical School. Part of the problem, she explained, is that no rigorous studies have been done to test the effects of various amounts of sleep on young children. "We don't really know how much sleep they need."


However, in a recent study published in the journal Sleep, Acebo found that few young children get the recommended 12 to 15 hours of sleep. When she tracked 169 children, ages 1 to 5, she found that the older kids got less than 9.5 hours of sleep in a 24-hour period, including naps. And the 1- and 2-year-olds got 10.5 to 11 hours in each 24-hour period.


Acebo, who's also assistant director of the Bradley Hospital Sleep and Chronobiology Research Laboratory in Providence, R.I., also found that children in lower-income families spent more time in bed at night, but woke up more frequently during the night than children from higher-income families. The children from low-income families also tended to have variable bedtimes, which can trigger sleep problems, the researchers found. She suspects the variable bedtimes could be due to the parents' changing work schedules. They may have to work alternating shifts, for instance.


Besides a lack of sleep, young children often struggle with other conditions, Acebo said, such as restless leg syndrome, a neurological disorder that typically affects older adults. Restless legs syndrome is characterized by unpleasant sensations in the legs. Or, children, like adults, can suffer from sleep apnea, in which they have episodes of upper airway obstruction, interrupting breathing and compromising sleep.


"There are a fair number of kids who have sleep problems such as sleep apnea from enlarged tonsils and adenoids," Acebo said.


Some sleep problems may be traced to feelings of insecurity in a child, said another sleep expert, Dr. Rafael Pelayo, a pediatric neurologist and assistant professor at the Stanford University Sleep Disorders Clinic. "We want children to go to bed feeling safe, comfortable and loved," he said. If they don't feel that way, it's understandable they may have trouble falling or staying asleep.


Sufficient sleep is crucial not only for proper growth and development, but for a child's behavior, too, as any parent of a crabby preschooler already knows. On a more scientific level, researchers from Northwestern University Medical School studied the link between adequate sleep and behavior. They evaluated 510 children, ages 2 to 5, asking parents to report the amount of sleep their child got and then to describe the youngster's behavior the next day. The result: A lack of sleep during the night or naps translated into next-day behavior problems.


So, what's the experts' advice for parents of preschoolers?


"Keep regularly scheduled bedtimes and have good routines for bedtime," Acebo said. Those routines might include a bedtime story or anything else that is relaxing, she said. The point is to ease them to sleep in a relaxed manner.


Pelayo prefered to give a broader recommendation to parents. "I don't get caught up in details [such as have your child go to bed at the same time very night] on purpose," he said. Instead, he emphasizes that parents should make a child feel safe and comfortable and that the household shouldn't be too chaotic. A child will fall asleep more easily if the environment is conducive, he said.


Pelayo does caution parents not to tell a child she can stay up later and use a later bedtime as a reward for good behavior. That sends the wrong message, he said -- that sleep or having to go to bed is punishment. Another habit that some parents get into is to establish too early a bedtime for the age of the child. "Sometimes the kids have inappropriate [too early] bedtimes because the parent wants a break, they want earlier bedtimes," Pelayo said.


Occasional lack or sleep or sleep problems are probably nothing to worry about, Acebo said. However, if a child aged one to five seems sleepy during the day, outside of his or her regular nap time, then that is "something to tend to," she said. In these cases, a call or a visit to your pediatrician may be in order, the expert said.


More information


To learn more about children and sleep, visit the National Sleep Foundation.

117、Study Unearths Clues on How Body Absorbs Folate Fri Dec 1, 7:02 PM ET



FRIDAY, Dec. 1 (HealthDay News) -- U.S. researchers say they've identified the mechanism by which the intestinal tract absorbs the B vitamin folate from food.

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A team at the Albert Einstein College of Medicine, Yeshiva University, found that a protein called PCFT/HCP1 transports folate molecules from matter in the small intestine into intestinal cells.


They also found that a mutation in the PCFT/HCP1 gene causes hereditary folate malabsorption, a rare but potentially fatal disorder. Infants born with this disorder must be given high doses of folate in order to prevent severe anemia and neurological problems.


The study is published in the Dec. 1 issue of the journal Cell.


The researchers said their findings solve the mystery of how the body absorbs folate from foods and pave the way to a genetic test to quickly identify and treat infants who are unable to absorb folate, which is also called folic acid.


"We can't live without folate," study senior author Dr. I. David Goldman, director of the Albert Einstein Cancer Center, said in a prepared statement.


"Adequate folate in our diet -- and our small intestine's ability to absorb it -- is crucial for synthesizing DNA and other important constituents of our bodies. Folate deficiency in the developing embryo can cause developmental nervous-system defects such as spina bifida. After birth, infants with folate deficiency can experience anemia, immune deficiency with severe infections, and neurological defects such as seizures and mental retardation. And in adults, folate deficiency has been associated with an increased risk of certain cancers," Goldman said.


More information


The U.S. National Library of Medicine has more about folate.

118、 U.S. AIDS program revolutionizes Kenya By CHRIS TOMLINSON, Associated Press Writer
Fri Dec 1, 7:37 AM ET



NAIROBI, Kenya - Every day hundreds of Kenyans from every walk of life visit the Hope Center at the Coptic Hospital in Kenya's capital to meet with doctors and receive life-prolonging     HIV drugs, compliments of the United States.

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Before     President Bush started his signature HIV program, the people at Hope Center would have died within a few years because the drugs were either too expensive, unavailable or doctors didn't know how to prescribe them. Since 2003, the number of Kenyans on antiretrovirals provided by the U.S. has risen from 343 to 70,000, providing them with a chance to work, raise their children and fight the epidemic.

The U.S. program known as the President's Emergency Plan for     AIDS Relief "was a new experience and in Kenya it expands quickly and strongly, it was beyond the expectation of anyone," said Dr. Aida Samir, chief executive officer at the missionary hospital.

Kenya is the second largest recipient of funds from the program, best known as Pepfar, which has promised to spend $15 billion between 2003 and 2008 to fight AIDS. Out of the 19 countries with Pepfar programs, Kenya's $200 million program is widely considered the most successful and sophisticated.

Pepfar provides funding, advice and monitoring to 275 treatment sites in Kenya, where in 2001, according to the most recent figures available, 700 people a day were dying from AIDS or HIV-related diseases. In addition to providing treatment, Pepfar also funds care and support services, as well as prevention programs in coordination with the Kenyan government.

"It shows that with goodwill and adequate resources, there is practically no limit to how much a developing country can do to take care of its citizens," said Warren Buckingham III, the Pepfar director in Kenya.

Buckingham said in 2007, Pepfar plans to ensure that, for the first time, all 1 million pregnant women in Kenya who visit a clinic before giving birth will be tested for HIV. Whoever tests positive will be given drugs to protect the child from the virus, he said.

"It has changed my life, I can live healthy and I don't fall sick," said one patient who now works at Coptic Hospital, but asked not to be named to avoid being shunned. "Now I give back."

But while the treatment program is widely praised, critics of Pepfar complain that not enough is being done to prevent people from contracting HIV.

Richard Holbrooke, former U.S. ambassador to the     United Nations who now leads the Global Business Coalition on HIV/AIDS, added that the treatment program might not be sustainable, because the number of people with HIV continues to grow. According to the U.N. agency on AIDS, there will be 4.3 million new infections in 2006.

"If the number of people who need antiretrovirals increases every year, it becomes a bottomless pit," he said Thursday during a visit to Nairobi, where he publicly received an HIV test. "We have to turn the corner, the actual number of people with the disease needs to go down."

Rep. Barbara Lee (news, bio, voting record), D.-Calif., condemned a provision in Pepfar that requires that 33 percent of all money committed to prevention programs be spent to promote abstinence. She told reporters Wednesday that she would introduce the Pathway Act, which would eliminate the restriction she said had more to do with conservative ideology than scientifically proven successful programs.

"The Pathway Act seeks to correct these policies and ensure we fund the strategies that work," she said.

Two methods of prevention, which will likely receive scientific backing in 2007, are male circumcision and microbicide gels. Buckingham said that under the current legislation, Pepfar money could not be spent on either.

"This epidemic keeps changing," he said. "We need to tweak the legislation to reflect the changing environment."

Pepfar officials argue a three-pronged HIV prevention strategy, emphasizing abstinence, fidelity and condom use, offers people the best options in how to protect themselves from AIDS.

Back at Coptic Hospital, Samir and her senior HIV project manager, Nadia Kist, have put up tents to deal with the overflow of HIV patients under their care.

"It doesn't seem real, the transformation," said Kist, who has worked with the Coptic program since it began in 2004 with 300 people, but now serves 5,300. "It was almost people banging down the doors, coming by the thousands, it's really miraculous."

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U.S. Blacks Seek Answers to AIDS Epidemic By E.J. Mundell
HealthDay Reporter
Fri Dec 1, 7:02 PM ET



FRIDAY, Dec. 1 (HealthDay News) -- By now, most Americans know the drill: Practice safer sex, and     HIV should leave you and your community alone.

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Except that it's not really working out that way for America's blacks. Study after study shows that HIV infections continue to escalate among this community -- especially among gay and bisexual black men -- even though they practice safe sex at rates that equal or exceed those of whites.


For example, a study published in time for World     AIDS Day on Friday in the American Journal of Public Health found that young black adults who had engaged in no sex over the past year, didn't drink, and didn't abuse drugs were still 25 times more likely to test positive for a sexually transmitted disease or HIV than whites who practiced similar behaviors.


According to the U.S. Centers for Disease Control and Prevention, fully half of the nation's new HIV infections occur among blacks, who make up just 13 percent of the population. That rate continues to soar, despite the fact that condom use among blacks now tops 50 percent, compared to just one-third for young whites. According to the     CDC, black women have 21 times the risk of white women of contracting HIV, while black males are eight times as likely to become infected as white men.


And, according to a recent five-city study conducted by the CDC, a staggering 46 percent of young gay black men in America now carry HIV -- a rate that equals or exceeds that of most nations in sub-Saharan Africa. By comparison, the infection rate among gay American white men hovers around 21 percent.


"However, black men who have sex with men (MSM) do not engage in higher rates of unsafe sexual behaviors compared to other MSM -- we found that in about 30 studies," said CDC HIV/AIDS investigator Gregorio Millet. He spoke at a Foundation for AIDS Research (amfAR) summit on the issue held earlier this week in New York City.


Millet noted that studies also show that gay and bisexual black men use illicit drugs at roughly the same rate as their white peers.


So, if black Americans are doing so much that is right, what is going wrong? Twenty-five years into the AIDS epidemic, no one really knows for sure.


Denise Hallfors, the author of the American Journal of Public Health paper, said that for too long, the CDC and other public health entities have looked upon HIV/AIDS from a solidly white perspective.


Since the beginning of the AIDS epidemic, most infections among whites were largely contained within specific groups, such as gay men and intravenous drug users. "The thinking was, you have to go after those very high-risk populations," said Hallfors, who is senior research scientist at the Pacific Institute for Research and Evaluation in Chapel Hill, N.C.


"So, those are the populations that the CDC focused on and did outreach with. And if you look at the data from our study, that makes perfect sense -- whites have very low rates of STDs if they are not in those risk categories. As soon as they enter those risk categories, their rates triple."


But the black community appears to work differently, with the borders between low- and high-risk groups much more blurred. "High-risk individuals can and often do cross over into low-risk groups," Hallfors said. "Once they cross over into the low-risk group, then they spread infection to the much larger community."


Because of the higher death and incarceration rate of black men, black women -- who tend to partner with black men -- have a smaller pool of potential mates to pick from compared to whites, Hallfors added.


"So, if you are a young black female adult and you go to church every Sunday, you have a pretty conservative lifestyle, you don't drink, smoke or do drugs, and you have even one or two partners in your lifetime, if one of them happens to be infected, you're sitting there with an STD," Hallfors said. And since this woman's apparently low-risk, church-going partner may have unknowingly contracted his infection from a prior high-risk contact, she believes she is "safe" and thus doesn't get tested for HIV, or gets tested far too late.


The same may hold true among gay black men, Millet said. "Black MSM are also less likely than other MSM to be tested for HIV," at least on a regular basis, he said. That leaves them more open to unknowingly pass the virus on to other partners.


There could be many other reasons for the virulent spread of HIV among gay black men, but the data just isn't out there, he said. Gay black men may be at higher risk because of their genetics, their lower rate of circumcision (circumcision reduces infectivity), reduced access to health care, their pattern of sexual partners, and their higher rates of incarceration -- one in four black men will serve jail time vs. one in 24 whites. "Unfortunately, there are all these hypotheses where we just don't have sufficient data," Millet said.


Until recently, there's also been little outreach to this hard-hit community, Millet added. "This epidemic has been raging among black MSM for well over 20 years and for some reason there have not been enough HIV prevention programs directed at blacks," Millet said.


Damon Dozier, director of government relations and public policy at the National Minority AIDS Council, said it's taken the recent release of shocking statistics to wake policymakers from their focus on whites.

"I think that no one really paid attention to what was going on, but that 46 percent infection rate is a huge number," he said. "Because of that, the wool has been pulled from people's eyes."

But Dozier said that the CDC, especially, is less able to tackle these issues now than it was in the past. "The CDC prevention budget has been slashed over the past few years," he said. "It would take a number of dollars just to get them back to baseline. Our hope is that with this new Congress, with Ms. Pelosi [incoming House Majority Leader Nancy Pelosi, a California Democrat] as leader, that we can devote more money to prevention and direct those prevention dollars to that 46 percent demographic."

There are signs of a real turnaround at the CDC. Late in 2005, the agency's head, Dr. Julie Gerberding, met with black activists who had pasted signs reading 46% is Unacceptable to the front of their desks. As reported by The Advocate at the time, Gerberding told them that, "Whatever we are doing right now, it is not enough."

Since then, the agency has launched a flotilla of HIV/AIDS education and prevention programs aimed at specific black communities -- many with proven track records in turning attitudes and behaviors around.

And, on Thursday, Gerderding issued a statement noting that the CDC has "recently issued new recommendations to make HIV screening a routine part of medical care for all patients between the ages of 13 and 64." Most experts who deal with minority communities say getting individuals acquainted with their HIV status is key to helping them get treated, protect their partners, and slow the epidemic.

CDC investigator Millet said he believes the situation "is getting better, in that we are now asking the right questions -- there are more people from these affected populations who are doing the needed research."

Hallfors agreed. She said that papers like hers, and new data coming out of the CDC and elsewhere, "is really important, because policymakers can start to think differently. Whites and blacks are different, the dynamics are different, and you can't just treat these diseases the same for both groups."

More information

Find out more about HIV/AIDS from the U.S. Department of Health and Human Services.