January 15, 1999
Volume XXXII No. 2


STD intervention successful in at-risk minority women

HSC study in Jan. 14 New England Journal finds reduced chlamydia,
gonorrhea incidence after risk-reduction training

Dr. Shain

Nine to 12 hours of culturally meaningful, risk-reduction training can dramatically lower minority women's chance of contracting chlamydial infection and gonorrhea, two sexually transmitted diseases (STDs).

That's the conclusion of a new Health Science Center study, conducted with the San Antonio Metropolitan Health District and released Thursday (Jan. 14) in The New England Journal of Medicine. The National Institute of Allergy and Infectious Diseases (NIAID) funded the project.

The study is the first to find significant STD risk reduction in Mexican- and African-American women using disease as the outcome variable.

The finding is critical as health care professionals, social scientists, and others scramble for ways to stem the rising tide of STDs, including HIV/AIDS. "Women with STD are more vulnerable to contracting HIV if exposed," said the study's principal investigator, Dr. Rochelle N. Shain, professor of obstetrics & gynecology. "Moreover, the same types of behavior that lead to STD can also lead to heterosexually acquired HIV infection."

Researchers in the Health Science Center's departments of obstetrics & gynecology and microbiology evaluated 424 Mexican-American women and 193 African-American women. Patients entering the study for one of four non-viral STDs--chlamydial infection, gonorrhea, syphilis or trichomoniasis. Unlike viral infections such as herpes, non-viral infections can be cured with a drug regimen.

The women studied were relatively young (most were 24 or younger) and were characterized by low levels of income and education.

Half of the women (the intervention group) were randomly selected to attend small-group sessions of three to four hours for three consecutive weeks. "These sessions were gender- and culture-specific," Dr. Shain said. The other half (the control group) underwent conventional STD risk counseling--a single session lasting approximately 15 minutes. "The small-group intervention significantly decreased chlamydial infection and gonorrhea among the women at six and 12 months' follow-up."

All participants underwent STD screening and interview at study entry, and again at six and 12 months. The study ended at 12 months. During the entire trial, 38 percent fewer women in the intervention group tested positive for either chlamydia or gonorrhea than did women in the control group.

The small-group sessions encouraged women to recognize their personal risk, make a commitment to reduce it, and carry through by taking preventive measures. These included having only one sex partner, avoiding unprotected sex, and not having sex with untreated or incompletely treated partners.

Extensive qualitative data were collected on target populations before patient enrollment. These data helped researchers to design effective intervention strategies for each ethnic group and identify barriers to change.

Co-authors from the Health Science Center are Drs. Jeanna M. Piper, associate professor of obstetrics & gynecology; Sondra T. Perdue, associate professor of microbiology; and Jane Dimmitt Champion, assistant professor of family nursing care and formerly from the microbiology department. Co-authors from other institutions are Drs. Edward R. Newton, chairman of obstetrics & gynecology at East Carolina University; Reyes Ramos, an independent consultant in San Antonio; and Fernando A. Guerra, M.D., M.P.H., director of the San Antonio Metro-politan Health District. Drs. Newton and Ramos are former Health Science Center faculty and Dr. Guerra is clinical professor of pediatrics.

Facts about STDs and minority women

  • Women are twice as likely as men to become infected with gonorrhea, chlamydia, hepatitis B and chancroid after a single exposure.1
  • The efficiency of male-to-female HIV transmission is about four times higher than female-to-male.2
  • In 1995, heterosexual contact emerged as the leading cause of AIDS in American women (ages 15 to 44).3
  • In 1996, 6 percent of men and 40 percent of women with AIDS were infected via heterosexual transmission.4
  • The rate of gonorrhea is substantially higher among Blacks and Hispanics than among Whites.5
  • AIDS incidence rates for Blacks and Hispanics are 6 and 3 times higher, respectively, than for Whites.6
  • In 1996, AIDS incidence rates for Black and Hispanic women were 17 and 6 times higher than for White women (Blacks, 61.7 cases per 100,000 people; Hispanics, 22.7; Whites 3.5).7
  • The risk of contracting HIV upon exposure is 3 to 50 times greater for individuals with sexually transmitted disease than for uninfected individuals.8

    1 Harlan S, Kost K, Forrest JD. Preventing pregnancy, protecting health: a new look at birth control choices in the United States. New York: the Alan Guttmacher Institute; 1991

    2 Aral SO. Heterosexual transmission of HIV: the role of other sexually transmitted infections and behavior in its epidemiology, prevention and control. Annual Review of Public Health 1993;14:451-467.

    3 Wortley PM, Fleming PL. AIDS in women in the United States. Journal of the American Medical Association 1997;278:911-916.

    4 Centers for Disease Control and Prevention (US). HIV/AIDS Surveillance Report. 1996;8(2).

    5 Donovan P. Testing positive: sexually transmitted disease and the public health response. New York: Alan Guttmacher Institute;1993.

    6 Centers for Disease Control and Prevention (US). HIV/AIDS Surveillance Report. 1994:6(2).

    7 Centers for Disease Control and Prevention (US). Focus on women and HIV. HIV/AIDS Prevention 1997;8:1-2. Also: Centers for Disease Control and Prevention (US). HIV/AIDS Surveillance Report. 1996;8(2)

    8 St. Louis ME, Wasserheit JN, Gayle HD. Editorial: Janus considers the HIV pandemicharnessing recent advances to enhance AIDS prevention. American Journal of Public Health 1997;87:10-12.

    (Facts and footnotes are from Shain RN, Piper JM, Newton ER; Perdue ST; Ramos R, Champion JD, Guerra FA. Behavioral intervention to prevent sexually transmitted disease among minority women: results of a controlled randomized trial. New England Journal of Medicine, Jan. 14, 1999.)

    NIAID scientists laud study

    Officials of the National Institute of Allergy and Infectious Diseases (NIAID) praised the behavioral intervention study conducted in San Antonio.

    "This study confirms that sexually transmitted diseases can be prevented through behavioral intervention," said Dr. Anthony S. Fauci, NIAID director. "In the absence of effective vaccines, this type of intervention is our best hope to control the STD/HIV epidemic today."

    "The culturally relevant intervention was designed to help women recognize that they are susceptible to sexually transmitted diseases, including AIDS, and can do something about it," said Dr. Penelope J. Hitchcock, chief of the sexually transmitted diseases branch in NIAID's Division of Microbiology and Infectious Diseases.

    The study was part of a four-year program project funded by NIAID. Dr. Joel Baseman, professor and chairman of microbiology, was the principal investigator of the "Cooperative Research Center for STDs" project. Dr. Rochelle Shain, an anthropologist who completed two years of postdoctoral study in reproductive physiology and contraception, was principal investigator for the behavioral component.

    More statistics on sexually transmitted diseases and HIV/AIDS are available on the NIAID Web site.



Media Report

Regional Academic Health Center,
AIDS research among 1998 headliners

National & international

French and German publications carried extensive articles about the Health Science Center's Research Imaging Center and quoted and pictured its director, Dr. Peter Fox.

Dr. Claudia Miller, family practice, was quoted in a Time magazine story on sick buildings.

The New York Times interviewed Dr. Sunil Ahuja, medicine and microbiology, about genetics developments in AIDS research.

Reuters carried a story about a Health Science Center research study, conducted with rats, that found aspirin use reduces production of two proteins which are colon cancer biomarkers.

Dr. Charles Mouton, family practice, was profiled in Minority Research & Training, a newsletter of the National Institute on Aging.

The international edition of Orthopaedics Today pictured and mentioned Dr. Nicolas Walsh, rehabilitation medicine, in conjunction with his membership on the Steering Committee of the Bone and Joint Decade.

Dr. Gordon

State

The Associated Press sent out a story about the new Regional Academic Health Center (RAHC) in the Rio Grande Valley, noting that the Health Science Center has responsibility for running parts of the center. Papers carrying the article included the Dallas Morning News, the Galveston Daily News and the Lubbock Avalanche-Journal.

The AP also disseminated a story about a new device to keep human organs viable longer before transplants, quoting Leon Bunegin, anesthesiology.

A story in the McAllen Monitor chronicled the Fifth Biennial University of Texas System Texas-Mexico Border Health Symposium. The article quoted Selina Catala, project coordinator of La Frontera, a community outreach and education project of the Health Science Center.

Dr. C. Kent Osborne, medicine/medical oncology, discussed Faslodex, a promising new drug for breast cancer, in a story sent statewide by The Associated Press. Faslodex appears to bypass the resistance that breast cancer patients may build up to the widely used drug tamoxifen.

The Uvalde Leader-News mentioned the Health Science Center's role in administering a health professions scholarship named in honor of U.S. Rep. Henry Bonilla.

The Laredo Morning Times mentioned the 14th Annual Update in Medicine Conference, held in Laredo and co-sponsored by the Health Science Center.

The Memphis (Texas) Democrat and the Hearne Democrat both quoted Dr. Charles Bryan, medicine, in a story about flu season.

The Victoria Advocate mentioned the Health Science Center's South Texas Poison Center in a story about students and teachers being exposed to turpentine fumes at an elementary school. The Advocate also called the Poison Center for quotes on the danger of mercury after a spill in Victoria.

The Corpus Christi Caller-Times mentioned the appointment of Dr. Joseph Janosek to the general dentistry clinical faculty, noting Dr. Janosek will act as a preceptor for dental students.

The Austin American-Statesman carried a story about a new cancer drug, Hercepton, and quoted Dr. Richard Elledge, medicine/medical oncology.

The TSBR Reporter, published by the Texas Society for Biomedical Research, quoted Dr. Patricia Camacho, physiology, about her study on calcium's functions in muscles including the heart, and in non-muscle tissues.

The Dallas Morning News ran a story on saw palmetto vitamins, quoting Dr. Cynthia Mulrow, medicine/general medicine.

San Antonio Express-News

Several articles chronicled the ground breaking of the South Texas Centers for Biology in Medicine. The main story quoted Dr. Sanford A. Miller, dean of the Graduate School of Biomedical Sciences, and Dr. John P. Howe III, president.

In subsequent articles, Dr. Ralph DeFronzo, medicine/diabetes, discussed the facility's expected impact on type 2 diabetes research, and Dr. Arlan Richardson, Aging Research & Education Center/physiology, discussed impact on research of aging.

Dr. Daniel Hale, pediatrics, was quoted in a story about adult diabetes in children.

Medical student Charlene Brady was pictured with a story about her favorite pastime, ballet dancing.

Drs. Eric Kraus and Ronald Grimwood, dermatology, were quoted in articles about the sun's damaging effect on skin and skin care for baby boomers. Dr. Robert Brzyski, obstetrics & gynecology, commented on the Women's Health Initiative. Dr. Connie Mobley, community dentistry, discussed the pros and cons of caffeine.

Dr. Donna Taliaferro, acute nursing care, was interviewed about reiki, a hands-on therapy method. Dr. Ed Gruber, family nursing care, explained the role that nurse practitioners play in the medical field.

Dr. Colleen Keller, family nursing care, was interviewed about different body shapes.

A Susan Yerkes column focused on the 21st annual Breast Cancer Symposium sponsored by the Health Science Center and the Cancer Therapy & Research Center (CTRC). Drs. C. Kent Osborne; Charles Coltman, medicine/CTRC; and President Howe were mentioned.

Dr. Howe was quoted in a story about the burgeoning health of the medical industry in San Antonio.

December graduations of the School of Allied Health Sciences and the School of Nursing were included in a commencement roundup. A later article listed the nursing graduates and mentioned that the school had conferred its 6,000th degree.

Area Television

KABB-TV, Channel 29, interviewed Dr. Alice Gong, pediatrics, about the benefits of breast-feeding newborn infants, and Dr. Geoffrey Weiss, medicine/medical oncology, about a new drug treatment for melanoma.

Dr. Alexander Shepherd, pharmacology, discussed blood pressure levels.

KENS-TV, Channel 5, interviewed Dr. John Calhoon, surgery/thoracic, about the "keyhole" procedure performed on a 5-year-old boy to repair a faulty aortic valve.

KENS also interviewed Dr. Duane Proppe, physiology, about how and why the human body sweats; Dr. Sanford Miller about salt intake; Dr. Karen Diaz, obstetrics & gynecology, on treatment for urinary incontinence; Dr. Mark Pigno, prosthodontics, on his efforts in reconstructing a shooting victim's face; and Dr. Sunil Ahuja on AIDS research.

In other KENS segments, Dr. David Cochran, periodontics, described a new implant procedure; Dr. Cynthia Alford, family practice, explained a new course for first-year medical students involving visits to the elderly; and Dr. William Sponsel, ophthamology, commented about a new glaucoma detection device.

Also with KENS, Dr. Elmer Tu, ophthalmology, discussed the prevalence of cataracts; and Dr. Carlos Encarnacion, radiology, explained why type 2 diabetics are more susceptible to getting peripheral arterial disease.

KWEX-TV, Channel 41, interviewed Martha Baez about dietary supplements and Linda Pruski, Aging Research & Education Center, about exposing middle school students to all areas of science.

Dr. Karl Klose, microbiology, was interviewed about the harmful effects of anti-bacterial soaps, and Dr. Tomy Starck, ophthalmology, was interviewed about a new laser procedure, known as LASIK, that corrects nearsightedness.

Area Radio

KTSA-AM, 550, spoke with Dr. Robert Brzyski, obstetrics & gynecology, about the birth of the Houston octuplets, and with Dr. Donald Gordon, emergency medical technology, about the dangers of dehydration.

WOAI-AM, 1200, interviewed Dr. James Mellonig, periodontics, about a new oral medication for treating periodontal disease; Dr. Connie Mobley, community dentistry, about the holidays and diets; and Betty Razvillas, medicine/medical oncology, about a local candlelight vigil to support a national march on cancer. Dr. Laura Collins, medicine/cardiology, discussed the increased risk of women who have atrial fibrillation.

WOAI interviewed Dr. Mobley about caffeine and the heart; President Howe about the ground breaking of the South Texas Centers for Biology in Medicine; and Dr. William Beck, otolaryngology-head & neck surgery, about automobile airbags and hearing loss. Dr. Wichard A. J. van Heuven, ophthalmology, discussed strobismus (an eye muscle problem) in babies.

Area media

San Antonio Medicine mentioned the Health Science Center in an article about earning CME (continuing medical education) credits by taking part in interactive, virtual, educational events. The magazine also carried liver transplant articles written by Drs. Glenn Halff and Francisco Cigarroa, surgery/organ transplantation programs.

Dr. Rajam Ramamurthy, pediatrics, wrote an item printed in San Antonio Medicine about the Medical School Curriculum Review Committee and curriculum restructuring of the first two years of Medical School.

The Fort Sam Houston News Leader carried a story about the weeklong Science '98 exposition and noted that the Health Science Center is the primary coordinating agency for the program.

The San Antonio Business Journal reported that President Howe has been named chairman-elect for the Greater San Antonio Chamber of Commerce, effective in 2000.

The MedTones, the campus singing group, were pictured in the University Health System Infoline. The photo caption mentioned Gilbert Aldrete, the choir's longtime director.



Nursing students' visit sparks
children's curiosity about biology, education

Mary Mahoney members

"How do people go blind?" one child asked. "How do the eyes move?" asked another. The questions were flowing freely when members of the Mary Mahoney Nursing Students' Association in the School of Nursing visited fifth-graders at Bowden Elementary School.

The nursing students brought along a skeleton; large models of body organs, including the heart, brain, ear, kidney and eye; and Choking Charlie, a doll for illustrating the Heimlich maneuver to help someone who is choking. The Mary Mahoney Association donated the organ models for permanent display in the school library.

Olusola Okuwobi Abedoyin, a December graduate of the School of Nursing, asked the children to guess what the brain does. "It helps you think in school," one said. "It helps your body move," another said. Abedoyin, a native of Lagos, Nigeria, told the children about stroke and about healthy eating habits to prevent vascular diseases that might cause stroke later in life.

Magalie Moore, president of the Mary Mahoney Students' Association and a December graduate, presented facts about kidneys. "Drink a lot of water," she advised, "and leave your Kool-Aid alone." Moore is from Cap-Haítien, Haiti.

The eye presentation prompted many questions. The nursing students replied that accidents and diseases can lead to blindness, that genes determine eye color, and that muscles and nerves in the eyes help control their movement.

"This presentation broadens the students' horizons," said Pam Burse, vice principal at Bowden Elementary. "This is an experience they may not have in their day-to-day lives, seeing people who are successful in a field such as this and who give them a goal to work toward. They may see doctors and nurses on TV, but they do not grasp that education is the key to becoming doctors and nurses."

testing reflexes

Several children read essays thanking the Mary Mahoney members for their visit. "I like the heart," said fifth-grader Andriana Martinez. "It's the most important thing in the body. I want to become a heart surgeon."

Bowden librarian Linda Russell reiterated the educational message. "The most important thing you are going to think about is going to college," she said to the children. "Who among you has someone in your house-hold who has been to college?"

Some hands went up in the room, but many others did not.

"Our goal," Russell continued, "is to one day have all or almost all of our students raise their hands."

Mary Mahoney members started visiting Bowden Elementary in 1995. Dr. Beverly Robinson, associate dean for the graduate nursing program in the School of Nursing, supervises the student association. Nurses from the Health Science Center also conduct teaching and mentoring projects at Bowden and volunteer to work in the nurse's office.

"It is making a difference in our kids," Russell said. "When we say nurses, they say, 'Are they here? What are they going to do?'"

The Mary Mahoney delegation included Cynthia McDonald-Jordan, a winter graduate; Lisa Ramsey and Mary Logan, first-year nursing students; and Diana Pirzada and Honoria Stewart, second-year nursing students.

Leanthony Mathews, a 1998 School of Nursing graduate who works in the University Hospital cardiac unit, snapped pictures of the Mary Mahoney members and the fifth-graders. "I am a past president of the Mary Mahoney Association and am here to show my support," he said. "Our visits here are important--they have a real impact."

Goals of the Mary Mahoney Nursing Students' Association

  • promoting academic and personal excellence;
  • serving as liaisons/advocates for ethnic nursing students;
  • networking with other nursing, campus, and community groups;
  • encouraging leadership opportunities for African-American students

Named for Mary Mahoney, the first African-American professional nurse in the United States



Young to retire from medical dean post

Dr. Young

Dr. James J. Young, dean of the Medical School for a decade, has announced his retirement, effective when a replacement is named.

A search committee has been appointed and is chaired by Dr. Celia Kaye, chairman of pediatrics.

Dr. Young came to the Health Science Center from West Virginia, where he was vice chancellor for health affairs for the West Virginia Board of Regents. The board is the governing body for that state's System of Higher Education.

In October 1987, he joined the Health Science Center as dean of the School of Allied Health Sciences. The following July, he was named interim dean of the Medical School.

Selected as the medical dean in May 1989, Dr. Young served in dual roles until a new allied health dean was appointed in November 1990.

A native of Fort Ringgold in the Rio Grande Valley, Dr. Young served more than 30 years in the U.S. Army Medical Department, achieving the grade of brigadier general and designation as chief of the Medical Service Corps. Among his many decorations is the Distinguished Service Medal.



University Police to sponsor 55-Alive class

A 55-Alive class taught by AARP and sponsored by the University Police Department will be offered from 8 a.m. to 5 p.m. Saturday, Jan. 23, in room 1.230 of the School of Nursing (original building).

This refresher course is offered to motorists 50 and older. It is designed to meet the needs of older drivers and covers age-related physical changes, declining perceptual skills, rules of the road, local driving problems, and license renewal requirements.

Those who complete the course may obtain 10 percent off their car insurance premiums.

To register or for more information, call Larry Garrison at 479-9067 or Officer Karen Tucker, ext. 1787. Tucker is one of the University Police Department's community policing officers.



Briefly

Roger Perales and Joan Engelhardt, family practice, presented at the annual meeting of the American Public Health Association in Washington, D.C.

Perales described the Health Science Center's South Texas Environmental Education and Research (STEER) program, which offers medical students and residents, public health students and nursing students chances to learn about environmental medicine and public health along the U.S.-Mexico border. The hands-on approach helps students understand environmental contributors to illness and cultural factors affecting patients' health.

Engelhardt outlined the first year of "Agua Para Beber." Funded by the U.S. Environmental Protection Agency and conducted by STEER, this program provides a low-cost hygiene education and safe drinking water program to residents of the underdeveloped residential subdivisions along the U.S.-Mexico border in Laredo and Nuevo Laredo, Mexico.

Engelhardt described the scope of the public health needs in the area with respect to the provision of safe drinking water and sanitation, discussed the essentials of the program, and identified potential strategies to overcome obstacles associated with a community-based personal hygiene and sanitation program.



Restrict notices to bulletin boards

Physical plant asks that notices not be placed on walls and doors at the Health Science Center.

Notices and other items such as grade listings should be posted on bulletin boards provided throughout the institution. Individuals and departments should post their own materials and remove them when appropriate.

Here are the locations for posting your information.

Medical School Bulletin Boards
Floors 1-7 (Near middle elevator on C corridor hallway)
3rd Floor (At the end of the F corridor on the way to University Hospital)
3rd Floor (Across from the Bursar's window)
3rd Floor (Near glass elevator)

Dental School Bulletin Boards
1St Floor S Corridor on the way to Dental School cafeteria
2nd Floor U Corridor by bookstore
3rd Floor U Corridor by elevator

Guideline: 3x5 (for sale items) and 8x10 (seminars) flyers should stay up for no more than 30 days.



Revised NIH PHS forms available

PHS 398 and 259--two sets of newly revised application instructions and forms from the National Institutes of Health (NIH)--now are available in the Office of Grants Management. While NIH encourages the use of these forms for the January/February 1999 application receipt dates, the new forms are required for receipt dates of May 10, 1999 and thereafter.

For a copy, stop by the grants office or contact Liz Buel, ext. 2330, <buele@uthscsa.edu>. The revised instructions and forms are available from the NIH Web site.



For Sale to Any Department

Serviceable intra-oral x-ray equipment (10 machines) and a QUINT 200 Sectograph are available for viewing. Prices are negotiable. Call Dr. Marden Alder, dental diagnostic science, at ext. 3365 to view the Quint machine or Bill Angell at pager number 230-1409 to view the intra-oral x-ray machines.



Scraping up asphalt

asphalt

The first weeks of the dual parking garage project have gone smoothly and bulldozers already have demolished the surfaces of Lots 4 and 8 to prepare for the garages. A portable sign placed by university police near the Floyd Curl entry control station counts down the days until the garages are estimated to be ready.


Index of issues



THE NEWS is published Fridays by the Office of Public Affairs for faculty and staff of The University of Texas Health Science Center at San Antonio.
Vice President for University Relations.....Judy Petty Wolf
Director of Public Affairs.....Dr. Charles Rodriguez
Editor.....Will Sansom
Writers.....Myong Covert, Catherine Duncan, Joanne Shaw
Photographers.....Lee Bennack, Lester Rosebrock
Designer.....Kris Doyle
Production.....Printing Services


Office of Public Affairs, 7703 Floyd Curl Drive, San Antonio, Texas 78284-7768
(210) 567-2570