NewsNight Minnesota; 3176; NewsNight Minnesota Episode from 07/08/1996

Tonight on NEWSNIGHT a snapshot of the fight against AIDS here and a broad look at successful prevention strategies in nations like Uganda. And we'll hear about drug therapies that have specialists at the World AIDS Conference talking about a cure. Plus in our Monday Page Break make Hunter went to the barber shop and came back with more than a haircut. It's all tonight on NEWSNIGHT. Tonight's broadcast of NEWSNIGHT Minnesota is presented in part by Norwest banks contributing to the growth of the Twin Cities through support and community service. BEMIS company a major supplier of Flexible Packaging and specialty coated products since 1858 and by the attorneys of Briggs and Morgan providing a broad range of legal services to businesses individuals and government entities. Good evening glad you could join us. We'll spend a lot of time tonight talking about developments in the fight against AIDS but we'll start with some today's headlines. Ken Stone is standing by with the rundown. Thanks. Despite a coordinated statewide efforts to encourage safe driving over the Fourth

16 people were killed on state roads over the long holiday weekend. State public safety commissioner Don Davis said today he continues to support overtime shifts during holidays but said quote we'll never have enough law enforcement officers to ensure that everyone buckles up drive sober and controls speed and quote 16 highway deaths compared with 20 during last year's July 4th holiday weekend. Minnesota's Civil Liberties Union is siding with former state lawmaker Ted Jews over an allegedly false campaign ad ahead of a county judge threw out an indictment against Jude over this ad it aired in 1994 during Judes unsuccessful campaign for the Sixth District congressional seat now held by Bill Luther. The state has argued that the ad violates Minnesota's fair campaign practices law and is taking the case to the state appeals court. The MCO use of the law has a chilling effect on free speech and should be declared unconstitutional. 3000 acre chunk of land in northeastern Minnesota could be come the next popular destination for nature

lovers Champion International selling some uninhabited land along the swamp river to the Nature Conservancy an environmental group plans to turn it over to the state which will keep the land undeveloped. The area will be open to the public 10 months after being diagnosed with a Becker boy has died from the rare disease year old Tyler Anderson died at his home yesterday hailed the subject of the movie Lorenzo's Oil strikes mostly boys and destroys nerves and muscles. And finally former Minnesota Governor Harold Stassen has run for president at least a half a dozen times. But this year he will not run for president. Noah Stassen said today he will run for vice president with Bob Dole. If Dole chooses to offer him the job. Stassen says one major reason he'd be good for the job is that he's 89 and he's still working and that would add support to Bill's view that Dole is young enough to be a successful president. Lol a spring chicken at the age of 72. And that's it in the headlines cafe back to you.

Thank you Ken. Since AIDS first became a part of our collective consciousness the only news we've had about it has been tragic increasing rates of infection. The chances for a vaccine slimmer and slimmer. A cure all but out of the question. But now the news out of Vancouver said of the bi annual World AIDS Conference is decidedly more optimistic for the first time a new treatment actually holds out some hope for AIDS patients. We'll get to the biology of this new treatment using something called protease inhibitors in just a few minutes. But first NEWSNIGHT it's time question went to the Minnesota AIDS line to see if the good news has spread to Minnesota's HIV affected community. Good afternoon. About 10000 phone calls every year begin just this way here an AIDS line. It's a hotline for people who want information on AIDS and HIV infection that would you feel comfortable talking a little bit more about what your risk was would that be helpful. OK. OK. Well and that certainly is something that can cause transmission.

But the surprisingly good news about protease inhibitors is not making these phones ringing off the hook. A few calls a week are from people investigating protease inhibitors wanting information wanting to find out what it's all about. I think that's stayed pretty consistent since stuff started happening in Vancouver I don't think there's been a lot of change in the volume of calls regarding protease inhibitors. But while protease inhibitors haven't yet had much of an impact on the work done here plenty has changed in the 10 years since AIDS line was started 10 years ago. HIV and AIDS affected mostly probably 90 percent the gay and bisexual male communities. Over the past 10 years injecting drug users have made increasingly larger percentage of the HIV cases every year about 250 to 300 Minnesotans find out they're either HIV positive or have AIDS which doesn't sound like a lot but it's still the leading cause of death for Minnesota men aged 25 to 44 and also one of the leading causes of death for women.

Think the hardest part for me is talking with someone who's HIV infected and who's trying to find their way around the service delivery system is struggling because so much of their life has fallen apart because of HIV. You know I think the best part of my job is anytime I get done talking with someone on the phone or meeting with them when they say this has been so helpful. Thank you so much information and feel free to call again. Yeah. In Minneapolis I'm Tom Cushman for Newsnight Minnesota. The AIDS epidemic in the twin cities and across our country pales in comparison to countries in Central Africa and Uganda for example a staggering one in 10 persons is affected with HIV. Despite the shocking statistics Uganda has made progress in the fight against the disease both with prevention methods that were once unknown in that part of the world. These Nights last row has more. This door to door demonstration to introduce condoms to housewives is organized

by the Islamic Medical Society and it is indeed for many an introduction. The campaign has the blessings of religious leaders like Shaikh Ibrahim in Condi who is a cutie or priest and will drink or wear it your way to teach adultery and fornication are against the teaching of Islam. But we have to acknowledge that these practices happen outside of the teachings we have no choice but to accept that these things happened and tried to prevent it. The uh the issue of the air was the week. The information centers in Kampala offer confidential HIV testing along with counseling and what are called drama clubs. They are uniquely African form of therapy in a

land where anti HIV drugs like AZT are virtually unheard of. And with the progress from HIV infection to full blown AIDS happens in about half the time it does in western countries. If you are sick and then you lose you see. We see ice and drama acting. There over a visit by son of a disease which you have been somehow you know that you are not alone with other people. You see the problems of being a doctor going to St. John. This relieves you of his psychological and then it reduces the amount of stigma one person might have. Run the show and. Dance music and drama all forms of exercise. So some of the members would have us sick or not. We give them plenty of body exercises as they learn to dance as they sing and as they dramatize and then we take the music outside with other people. Dancers records regular road shows of past Uganda attracting audiences with

drama and dance and using the form of what is called the ABC radio page and that is abstinence. Be faithful. Condominiums. There is evidence of some dividends of changing behavior patterns recent surveys show a slight dip in the infection rate as with those already connected. Lieber says the challenge is to reinforce the idea of hope and purpose in their life. If I can believe another five yes. During this five years my daughter Kristen always. You never want to be 16. And she will be the much more capable often. Then if I died today and I'd want to Uganda's openness and innovations have won kudos from public health experts. But it is a measure of this nation's despair when people can hope only for more people who orphaned an even more sobering measure of that despair is Uganda's life

expectancy which is now the world's lowest at 37 years. Some critics of current AIDS research argue that too much of the drug development focuses on strains of the virus found here in the U.S. as opposed to the types found in places like Uganda where the disease runs rampant. Well here in the U.S. AIDS drugs have been put on a fast track for FDA approval. Meaning that patients who take them may be acting as human guinea pigs for the same last row visited with one such patient in Minneapolis who has access to cutting edge treatments. Maybe the reason he's kept in good health. Just. Like. Dan Osborne has been a part of the AIDS epidemic for as long as it's been an epidemic. His is one of its few happy stories. All right. Dr.. Osborne says he became infected with HIV the virus that leads to AIDS in 1983. And like many like himself he survived 12 years to feel the first rays of

real optimism that medicine may finally gain the upper hand over HIV session. That oral thrush and that was next to nothing. Exactly how much drugs have played a role in his good health isn't fully known. But Osborne has kept abreast and availed himself of all new drugs that have hit the market. So this venture to a CTD for a teen here. And you never intended to help. Dr. Frank Graeme has Osborne on a combination of two basic types and generations of so-called antivirals drugs that slow the HIV replication in the body. If it too is better than one which is I think it clearly is and 3 is better too which I think it probably is. Then by that logic you mean keep pushing. Just. Last December the federal government added to medicines arsenal against HIV. It

approved the first of a new class of antiviral is called protease inhibitors. So far three such drugs have been approved. This is the protease inhibitor. I take three of these. Dan Osborne Like most patients uses protease inhibitors along with older drugs like AZT and the report card so far has been extremely positive. There's been a sharp drop in the amount of HIV present in the body and in some patients doctors have been unable to detect HIV at all. This does not necessarily mean a cure. But Dr. rame says HIV infection could now become a chronic condition instead of a fatal one. It's on average a 12 year almost from onset to death. Absent any therapy. So if you take a person who gets infected at age 30 that person is got 60 years left on the planet. On average anyway. So if you can slow this thing down by a factor of four and keep a saw done that's the key. Keep it because this resistance issue

you should have another lifespan I mean you don't have to cure people of it. But in AIDS there's been hope and let down before. Also more immediately protease inhibitors have proven difficult for many patients to tolerate especially patients on other non AIDS drugs like anti-histamines. So it takes careful fine tuning to find the right combination for individual patients. There's also no telling how long it will take HIV to develop a resistance to protease inhibitors. Now that of course is the key to this whole thing. Or are these improved results going to be sustained or not. So far the best we can do is say that. Through the first year or maybe even the first year have. We have sustained this approach just not really I don't want to have to know if it's going to stay beneficial for five years or more or less. And I plan to be around the fire you know one thing Dan Osborne must do to be

around is to stay on his medications without fail 20 pills a day for ever. It's a daunting regimen to which doctors fear many patients may not adhere. One worry I was born who is insured does not have is the $20000 a year tab for his medications for Newsnight Minnesota. This is Fred. Joining us to talk about where we are in the fight against HIV. Dr. Frank rein he's an HIV care specialist at Abbott Northwestern Hospital in Minneapolis. Ken epic is living with HIV and He's the co-chair of the state Hib Planning Council. Trish McTaggart is with us she's the Medicaid director for the State Department of Human Services. Welcome one and all. Well Dr. rame Let's talk about these proto protease inhibitors used in conjunction with some of the older HIV battling drugs like AZT there's a lot of optimism coming out of the World AIDS Conference surrounding these combinations of new and old drugs. We do think it's overly optimistic that we can expect a cure like everything a cure I think is.

Well first of all probably not necessary and it's still optimistic. My own. The expectation is that if you stop taking these drugs the virus will go back to work. But the hope is that if you keep on taking them and if the virus learns to become resistant to the group you're on we've got eight now we're going to have a couple more licensed pretty quickly. And there are many more in the pipeline that you can rotate them keep them going in combination whatever and keep the virus from doing anything. And that's tantamount to cure. That is the big question if you could do that or not. And as a piece we don't know what a quality of life issues here. I mean this is the gentleman that we talked to in his piece taking 20 20 pills a day and we don't know about the toxicity of these drugs yet. Do you think then. Well I'm on 20 prescriptions a day between medical doctor and a naturopath. I don't know what the number of pills that I don't count that is probably 70 or 80. The problem that I have is with the protease inhibitor the one that I'm on now cannot be taken with meals all the rest I take with meals which makes it fairly easy. This one I have to take

approximately 8 hours apart and away from meals which means I actually take the first one at 5 am the second in the afternoon and third before going to bed. If I remember to do it and you really have to make an effort to remember to do it what do you think Ken when you hear about these reports coming out the World AIDS Conference about the protease inhibitors and that this is a lot of optimism that many researchers have about these combinations of drugs that of course you've gone through. You see you used. What do you hear. What do you think when you hear these reports. Well I think what is showing up in the media is overly optimistic. I'm more concerned about resistance. I'm already on my second protease inhibitor the first one started show resistance and got switched to a second one. How long will that last before you go to the third or fourth or whatever. I don't know I mean we find out as it is the days go by. Do we have to emphasizing too much truth do you think. Drugs and new drugs and new treatments with drugs vs. other sorts of treatments.

Well I think you have to look at the total picture but that's why the experts in the field as say a Medicaid director are responsibility is making sure that those drugs that are available to the consumer to the beneficiary are indeed things that we cover for the publicly funded enrollees. And quite frankly as long as FDA approves it we try to cover them. Are all patients who need these drugs covered. Are there are there certain drugs that are not covered that you can't give patients under the Medicaid program in the state funded programs which are both Minnesota care and on assistance medical care. We fund all FDA approved drugs as soon as they are approved by FDA. And quite frankly it becomes a transition as are approved they could add it however and are each funded prescription drug program because again that's Ryan White funded drugs and addition that we had to get state legislative funding for the program. We were only able to add drugs as we had finances to add the drugs. How does a person live HIV make their way through this maze in attempt to pay for their care and to pay for their drugs.

Very complex Let me say I think it is probably true in our state you know it's not true in every state that people get these drugs if they really work at it. But many times they have to go through considerable deprivation in order to get them they may have to spend down what available resources they might have they may have to spend quite a bit in terms of partial payments and so forth so it's hard but I think most everybody gets it sooner or later if they work at it. You and me understand eventually that it's possible that there is coverage particular within the state more than in the places that it can be covered. And they do pick it up the state does pick it up pretty quickly. But you have to meet certain requirements income requirements and that type of thing. But it basically it's available for people who need it and willing to take it. Asked this question to Tricia maybe Dr. ream can take a shot at this question. It was a question about are we emphasizing the guests so much that I want to jump in everybody. Yeah well I mean I think that we are at a point where where we really are trying very hard to persuade patients that

balance of the evidence is in favor of these complex regimens and they're very complex as Ken pointed out you have to take some minutes twice a day some three times a day some with meals some without meals. You can you really have to be very very compulsive to do this well and many people aren't motivated even to take one this and. And sometimes the medicines produce nausea vomiting. Some of them produce funny sensations in your mouth or so there. These are not altogether pleasant and even if we could say that we are able to bring people to a normal lifespan which I don't think we can say it's still with many people it's a price just in terms of what in these regiments are overwhelmed them. Put them in considerable financial disadvantage situations and just make them not feel good all the time so we have a long way to go before we really solve this problem. Ken do you have concerns. That is we talk about new and improved drugs for HIV positive people that we might get away from messages of prevention

and might even maybe cause some people to think well because go back to unsafe behaviors because you figure well there are drugs for this now right. And unfortunately that's the message that you get out of what's been showing up in media. If there is no you know if we have a cure which is what the media's been saying and you listen to it yesterday on television you get people saying oh well you know it all just kind of missile of pills here in there and if I get a little bit worse I'll just take some more later on. I'm cured. Or people who don't have it in are practicing unsafe sex because they think oh I'll just take a pill. Wrong. It's not easy it's not easy at all. You're talking about a time of potentially decades. I mean if it if we had the perfect solution it would still be decades of taking pills. And I don't know how long the government's really going to be able to manage this. So far they're doing it at twenty thousand per. Who knows what's going to happen on the way. The question this there was a participant in the conferences said yesterday that he was worried that with all these breakthroughs coming in treatment for

HIV and AIDS that governments might become indifferent to paying for monies for prevention efforts and that sort of thing. What do you think of that. That quote government indifference. I certainly don't think that's something you find in the state of Minnesota. I mean I certainly can't speak for other states but I think there's a whole feeling of people versus programs in Minnesota and I need to really care for individuals both on a preventative and a maintenance kind of approach. So it may be true in other areas. I don't know who you're speaking to but. I don't think that's something you see in the US How do governments always had a lot of trouble with the maximum kind of preventive effort because it requires candor about gayness it requires candor about drug use or of course canot about heterosexual sex outside of marriage. And those are the kinds of things that it requires candor about the specific kind of sex acts and the relative hazard of each one. Governments always have a lot of trouble all that kind of stuff so I don't know where you get the maximum preventive benefit out of our government have about a minute left I

know you've been on the internet keeping track what's been happening at the conference. What's the best news to come out. Well I wish I when I went out about 5:30 and nothing was posted yet there's going to daily posting. But you've got to remember it's two hours later out there in Vancouver so at 5:30 when I looked it was 3:30 out there so I'll be on it. So they go home and see what's up. OK what do you hope to hear at this conference. A continuation of new drugs coming out I think beyond just these there are some others that are in the pipeline that I'm actually the one I'm looking at starting as soon as I get in the program. I think that there are other things that are coming up and other possibilities beyond just using drugs that are really important. I mean other lifestyle holistic very holistic. Those kinds of issues that people need to be aware of and implement bring them into their life. All right there is one new element very quickly and that's that we have this this quantity that they we can measure the amount of HIV in people's blood now conveniently and reliably and that gives us a new handle for how well we're doing with individuals with respect to their

drug regimen. And that's an important point which is also come Wong in the last year at least come along in a way that we can use it conveniently lots of things to talk about. Thank you very much appreciate your coming on. What I was doing was was entering a culture and for a while I I didn't know how to do it because I hadn't been going to barbershops I'd been going to hear salons because they had long hair. And once I learned the language. And how to get in and it was easy people wanted me to take their photograph. Fourteen years ago Saint Paul author Mick Hunter decided he wanted to buy an antique barber chair so he started visiting barber shops and talking to barbers. It didn't take him long to find a barber chair but that didn't stop him from visiting more barber shops. The result is a book of pictures and prose called at the American barbershop a closer look at a disappearing place and that's the subject of tonight's page break. When I first started out 14 years ago if people didn't understand the reason I would want to take photographs of barbershops they were kind of suspicious they thought it was some kind of a business deal and I was

up to something. But. The longer I went the more people started saying well yeah there is a disappearance of barber shops and they started to appreciate that I was interested in in something in the culture that was getting smaller and smaller because half the barber shops in America closed in. And the amount of time when I was out there photographing you know. My favorite photograph is the barber shop where there were. There was an 80 year old barber. He had on the place and he had sold it to a guy who was now 60 and the 80 year old guy still kept coming in because that's where he'd meet his friends and they'd hang out he'd cut a couple of heads of hair but he said that wasn't his office anymore it was more like his living room and then there was another guy. They kept calling him the new guy. He was 40 and he'd been there 20 years and they had one more chair and they were trying to fill that up with a 20 year old. For. The difference between a barber shop and unisex hair salon is that a

barber shop is more of a social event and then they're going to a hair salon for one thing most of them don't take appointments because then you have an excuse to sit there and talk and wait. Whereas if you have an appointment you show up five minutes before your claim and to get your hair cut and you have a whole series of photographs of beauty salons that are right next door even sharing the wall with a barber shop and. That people celebrate their gender by separating for a period of time that that's not that doesn't mean it's sexist as the same ones better than the other it's just saying you know it's a good idea for us to separate periodical IE so we can figure out who we are. Well I watched one barber stand there coming nearer and some of his friends go with him and we all graduated from high school the same time you know I'm overweight then you know all this it went around and we all look old you look young boys and this is because I'm a

barber because I get that interact with people all the time every 15 minutes I get a job well done because it's a great life. I know exactly what I'm going to do every day we're going to do it. And I'm happy. The book is called the American barbershop the author Hunter lives in St. Paul where he makes his living as a psychotherapist. Well now we're just about out of time but we know some of you won't sleep without visions of our weather map dancing in your head. Tomorrow's weather partly sunny and cool for July anyway. Highs will linger in the 60s and 70s. Thanks for watching our program. We'll be back again tomorrow night. Hope you can join us then.