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In This Issue:
CDC instructs states to start HIV reporting
PA Senate considers HIV transmission bill
HIV protein could be new drug target
Study says new resistance is effective
Gilead to end adefovir studies
Rates of OIs increase in SF hospital
New skin condition linked to starting HAART
AIDS Action: US gets 'F' for prevention efforts
Bisexual women said to be at higher HIV risk
TPAC announces funding increases
Anti-Giuliani protests continue in NYC
CLS to hold training on substance abuse and welfare reform
The U.S. Centers for Disease Control and Prevention (CDC), after several years of encouraging states to collect the names of people with HIV but stopping short of new regulations, has apparently decided that it's time for more direct pressure.
On December 8th, the CDC issued new guidelines instructing states to collect data on HIV cases with patient names or identifying codes attached - a measure that has alarmed many AIDS activists.
The CDC threatened to reduce or cut off federal funding for HIV counseling and testing and other AIDS prevention activities to states that do not comply with the new rules.
The guidelines are the latest step in an effort by the CDC to track where and how the HIV epidemic is spreading. The CDC estimates that up to 900,000 Americans are living with HIV, and about 297,000 of them actually have AIDS.
Pennsylvania is among the states which does not require HIV reporting. All states collect the names of people with AIDS.
The CDC began recommending in 1997 that states tally HIV cases as well AIDS cases. States had been reporting AIDS cases by patient name since 1981. The new guidelines released spell out how states should report HIV cases as well.
Testing sites would report HIV cases and patient names or identifying codes to state health departments, which would pass case data on to the CDC. Names and other identifying information would be kept at the state level.
States that don't comply with the guidelines risk losing federal funding for HIV surveillance - ranging from $50,000 for Wyoming to $3 million for New York City.
The guidelines, first proposed a year ago, will mainly affect people who request an HIV test during visits to their regular doctor or when having lab work done that goes on their medical record.
Most states have clinics that offer anonymous HIV tests, and home-testing kits can be bought over-the-counter at many drug stores.
The collecting of names of people who test positive for HIV worries some AIDS activists.
Even though all but 11 states have anonymous testing, some AIDS activists are afraid that people won't get tested for fear their names will be reported to the state.
"I see any disincentive to undergo HIV testing as a problem," said Daniel Zingale, executive director of AIDS Action, a Washington-based advocacy group. "Anything that's keeping people away from knowing their HIV status is a bad idea unless there's a compelling reason to do it."
Dr. Ronald Valdiserri, deputy director of the CDC's center for HIV prevention, said that reporting names is the best way to ensure HIV data is accurate and that the names will be well-protected.
One option is for states to keep names in a database that requires two passwords - one held by the state, the other by the CDC. And the CDC is urging states to pass laws making it a felony to release such names.
"The information tends to be more complete when names are used to track the data," Valdiserri said. "There tends to be less frequent duplication."
Thirty-four states already collect HIV cases with names attached. Four other states use identifying codes, and Washington state uses a combination of the two approaches. The remaining 11 states and the District of Columbia do not report HIV statistics. (Associated Press)
Apparently acting in response to the case of Nushawn Williams, the HIV-positive New York man who knowingly infected several partners with HIV and who was arrested in 1997, Pennsylvania Sen. Stewart Greenleaf (R), chair of the state Senate Judiciary Committee, has proposed legislation that would make it a crime for an HIV-positive individual to "engage in sexual intercourse or share a hypodermic needle without the other person's informed consent," the Associated Press reports.
The bill would make the intentional transmission of HIV a third-degree felony, punishable by a $15,000 fine and up to seven years in prison. "For someone who wants to engage in sexual intercourse with someone who has an HIV disease, fine, that's their decision to make. ... But this is a life-or-death issue," Greenleaf said, adding, "Certainly there should be some kind of informed consent."
However, AIDS activists said the bill was "a dangerous step toward criminalizing the disease."
Bruce Flannery of the Pennsylvania Coalition of AIDS Service Organizations, an umbrella group representing 35 AIDS-related organizations across the state, asked, "Is the transmission of any other disease a criminal act?" Activists also contend that existing laws already offer the proposed protections and such a measure could discourage people from revealing their HIV status.
According to the National Conference of State Legislatures, more than half the states have some form of mandate dealing with HIV exposure and transmission. At least 20 have specific bans against infection through sexual activity and 12 states prohibit the sharing of needles. (Kaiser Daily HIV/AIDS Report. This article is reprinted with permission from the Kaiser Daily HIV/AIDS Report. The Daily Report is published for The Henry J. Kaiser Family Foundation by National Journal Group Inc. Copyright 1999 by National Journal Group Inc., 1501 M St., N.W., Washington, DC 20005. All rights reserved. The Daily Report is available in its entirety free on the Kaiser Family Foundation's Web site, www.kff.org. You may also register for free e-mail delivery at www.kff.org/register.)
American scientists have identified two functions of a protein essential for the replication of HIV that could provide a new drug target to halt the spread of the disease.
A team of researchers at the University of Massachusetts Medical Center in Worcester said a molecule, called the HIV matrix protein, acts like a traffic signal controlling two vital but different functions in the HIV infection cycle.
"It is a new (drug) target," Dr Michael Green, of the University of Massachusetts Medical Center in Worcester, told Reuters.
"You think you understand this virus and then you find a new wrinkle, but the good thing here is that every time you find a new wrinkle it is a new function and that makes it a target for drug discovery," he said in a telephone interview.
Green and Dr. Mario Stevenson found the functions of the protein by studying normal and mutant forms of HIV.
In a report in the science journal Nature, researchers showed how the protein helps HIV invade the cell nucleus, where it hijacks the cell's genetic machinery and produces its own genetic material, or RNA, forming the basis of new HIV proteins.
Later in the infection cycle it makes a U-turn and directs new HIV proteins out of the cell nucleus into the surrounding cytoplasm where the new viruses are made.
"It gives you two shots at it (the virus). If you disrupt either function you'll inhibit the viral replication," Green said.
And unlike existing AIDS drugs that target reverse transcriptase in one class and protease in the other, the matrix protein provides the potential to attack the virus on completely different fronts.
"You can stop the replication in its tracks. You would stop it from coming out of the infected cell and keep it contained within a single infected cell," Green added.
It is still early days in terms of drug development, but Green said he and his colleagues have delineated a clear path on how to go about discovering a drug to target the protein.
As it is highly specific to the virus, unlike existing treatments any drug targeting it should not have side effects. It could also theoretically be used as a prophylactic.
"So if somebody is infected by the virus, as long as they are taking a drug (targeting the protein) the virus cannot spread," Green said. Leading AIDS expert Dr Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases (NIAID) that funded the research, said it helps fill in a missing piece of the HIV reproductive process.
"The findings suggest we may be able to devise therapies that subvert the order and timing of cellular events necessary for HIV replication," he said in statement.
So far more than 33 million people have died of AIDS. The latest figures released by UNAIDS, the UN agency leading the fight against the disease, showed that 2.6 million have died of the disease this year -- the highest number since the epidemic began in 1981.
A newly available drug resistance test can help doctors make better choices in treating HIV infection in patients for whom combination therapy has failed, according to results of a newly published study by Stanford researchers.
More than half of HIV patients treated with the new drug "cocktails" fail to do well because of drug resistance, said Andrew Zolopa, MD, assistant professor of medicine at Stanford University School of Medicine and lead author of the latest study.
Doctors typically have relied on standard clinical factors, such as a patient's T-cell count, viral load and treatment history, in deciding what follow-up treatment to pursue with these drug-resistant patients, Zolopa said.
But in the latest study, Zolopa and his colleagues found that use of new genotype tests are more helpful in predicting a patient's response to therapy than a traditional clinical evaluation, he said. The genotype tests reveal the specific mutations, or changes, in the genetic sequence of a virus that enable it to resist drug treatment.
"The study indicates that these tests can provide the clinician with valuable information in crafting new combinations of medications to better control HIV infection in patients with partially resistant virus. We feel the test adds to what doctors are doing currently," Zolopa said. "We obviously need new and better drugs to treat HIV infection for many patients in our care now, but short of new drugs, these resistance tests should help clinicians use the drugs we have more wisely," said Thomas Merigan, MD, the Becker Professor of Medicine and one of the study's senior authors.
The study was published in the December 7, 1999, issue of the Annals of Internal Medicine.
In the study, the researchers evaluated 54 HIV-infected patients being cared for at the Stanford Positive Care Clinic, which Zolopa directs. The patients had all received a combination of saquinavir and ritonavir -- two types of protease inhibitor drugs -- between October 1996 and February 1998. In addition, all of the patients had been previously treated with nucleoside analogs, the earlier class of AIDS drugs that include AZT and ddI.
The researchers checked the patients' response to therapy three times over a six-month period, testing their viral loads, or the amount of virus circulating in the blood. About one-third of the patients had a good response, one-third had a partial response, and one-third had no response at all to the treatment, Zolopa said.
The researchers then compared these results with the results of genotyping tests done on viral samples stored at the start of the study. The genotyping test results were not known at the outset and were not used as a criteria for selecting patients, Zolopa said.
The researchers found a direct correlation between the patients' response to the new drug regimen and the genotyping test. They also found a link between the patients' response to treatment and the standard clinical evaluation, but the connection wasn't nearly as strong, Zolopa said.
With both pieces of information available -- the genotype test and the clinical assessment -- doctors could make best the treatment predictions, he said. "We believe the results of this study support the use of resistance testing in the care of HIV-infected patients who are experiencing less-than-optimal response to the medications," he said.
Zolopa noted that interpreting the results of genotype tests can be difficult and requires special training even for highly experienced HIV clinicians.
Stanford faculty are currently developing educational programs for doctors from around the country to learn how to better use these resistance tests, he said. "These tests should help us to better manage drug treatments for HIV-infected patients, but we have a lot yet to learn about them," Zolopa cautioned. (Company press release)
In early November, an U.S. Food and Drug Administration advisory committee recommended that the agency reject Gilead Sciences' request for accelerated approval of adefovir, an experimental drug that had shown some promise against HIV infection and hepatitis B.
According to the committee, the data submitted by the company were insufficient to conclude that the drug is safe and effective in patients with HIV. Based on the recommendations of the advisory committee, the FDA recently informed Gilead of its intention to deny approval of the drug, stating that further data would be required in order to so. As a result of this setback, Gilead has announced that it would halt development of adefovir for the treatment of HIV.
Gilead plans to put an end to clinical trials currently under way in the United States. The company has however indicated that all clinical trial subjects who wish to remain on adefovir will be offered the drug through its expanded access program. Patients already enrolled in the expanded access program will continue to receive the drug as long as they and their physician believe it is of use.
Adefovir will continue to be studied in clinical trials as a treatment for chronic hepatitis B infection (HBV). The dose of adefovir used in HBV trials is significantly lower than that studied in HIV-positive patients, a fact which may translate into less severe kidney toxicity for those taking the drug.
The widespread usage of HAART (highly active antiretroviral therapy) in 1996 led to significant reductions in numbers of life-threatening AIDS-opportunistic infections (OIs) and death rates in San Francisco.
However, that decline has reversed somewhat in 1998-1999 at San Francisco General Hospital (SFGH) for three of the major OIs. They include: Pneumocystis carinii pneumonia (PCP, lung infection); Mycobacterium avium complex (MAC); and cytomegalovirus (CMV, the cause of retinitis, a cause of blindness). There has not been an increase in cryptococcosis (meningitis, infection of membranes around the brain and spinal cord). The report was presented by Judith A. Aberg, MD, formerly at SFGH, now at Washington University in St. Louis, Missouri.
For each of the following five years, the numbers of PCP cases at SFGH were: 1995 (163), 1996 (119), 1997 (63), 1998 (80), and 1999 (first half only, approximately 40). Note that the number of cases was lowest in 1997, with a mild increase in 1998 and approximately the same for the first half of 1999.
For each of the following five years, the numbers of MAC cases at SFGH were: 1995 (142), 1996 (76), 1997 (27), 1998 (57), and 1999 (first half, slightly increased from 1998). Similar to PCP above, note that the lowest number of MAC cases occurred in 1997, with an increase in 1998. However, it is noteworthy that 23 of the 57 cases (40%) in 1997 had negative blood cultures for MAC, unlike the other 60% and essentially all of the earlier cases.
For each of the following five years, the numbers of CMV cases at SFGH were: 1995 (46), 1996 (30), 1997 (4), 1998 (10), and 1999 (first half only, approximately five). A similar pattern also occurs for CMV, as for PCP and MAC, with the lowest number of cases in 1997, and an increase in 1998. In the first half of 1999, the number has stabilized. Dr. Aberg commented that five of the ten (50%) patients with CMV in 1998 were taking HAART, but had not had a CD4 cell count increase.
For each of the following five years, the number of cases of cryptococcal disease at SFGH were: 1995 (57), 1996 (37), 1997 (26), 1998 (26), and 1999 (first half only, approximately 13). In contrast to the three OI cases above, the number of cryptococcal disease cases reached the lowest level in 1997 and has remained there through the first half of 1999.
Dr. Aberg merely speculated why there have been increases in PCP, MAC and CMV cases in 1998-1999, since the reason is not known definitively. However, the increases may be partly due to an increase in the number of patients who had not been taking HAART or had not yet even been diagnosed with HIV infection. Another proportion may represent those who have had HIV viral rebound and CD4 count decreases due to HAART drug resistance. However, whatever the reason, the trend is not in the direction that would be preferred by both physicians and patients. Hopefully, the pattern will not continue to worsen in the future. The reason(s) for a lack of increase in cryptococcal disease is (are) unknown. (HIVandHepatitis.com)
New skin condition linked to starting HAART
The range of skin conditions associated with HIV/AIDS continues to evolve three years after the introduction of HAART (highly active antiretroviral therapy). Toby Maurer, MD, Chief of Dermatology at San Francisco General Hospital (SFGH) presented an update on skin conditions in HIV/AIDS at the 14th Annual Medical Management of AIDS Conference sponsored by the University of California at San Francisco (UCSF).
Dr. Maurer described a new skin condition associated with starting HAART. The rash is red, confluent, and flat and sometimes with bumps ("maculopapular") that begins shortly after starting HAART. It usually lasts for approximately one month. It may or may not be itchy, and it can be easily treated with standard antihistamine therapy. Dr. Maurer said the rash is not serious and that HAART and other medications do not need to be stopped when the rash occurs. (When starting HAART, many people are also taking prophylactic or preventive antibiotics to help prevent opportunistic infections or OIs.) Dr. Maurer believes that the skin rash may be a mild allergic reaction or may be a part of the spectrum of "immune reconstitution" conditions that occur after HAART leads to partial improved function of the immune system. (HIVandHepatitis.com)
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AIDS Action, the nation's leading AIDS lobbying group, issued a World AIDS Day report card on the federal government's response to the AIDS epidemic with grades in four areas: an "A-" for research, a "B" for care and treatment, a "C" for the fight against global AIDS and an "F" for HIV prevention. The release of the report card was accompanied by a full-page ad in the Dec. 1 edition of USA Today.
At a time of increasing HIV infection rates and evidence of laxity around safer sex, official Washington has tragically short-changed domestic prevention efforts and has failed to launch new initiatives around HIV prevention and education. Young people now comprise half of the estimated 40,000 new U.S. HIV infections every year. Last year's "D" on prevention decreased to an "F" this year.
"We've spent more money teaching our kids about the fantasy world of Pokemon than about the real dangers of HIV," said AIDS Action Executive Director Daniel Zingale. "President Clinton and Congress need to untie the hands of public health forces trying to educate a new generation at risk for HIV."
With continued investments in AIDS research and maintenance of funding under the Ryan White CARE Act, this year's research and care and treatment grades are the same as last year's. Last year's failing grade on global AIDS was raised to a "C" after the Clinton Administration launched a global AIDS initiative that was the first step toward addressing an epidemic that threatens to bring down entire nations.
The 1999 Until It's Over Report Card was agreed to by a panel of AIDS experts and advocates including Mary Fisher, person living with HIV; Steve Gunderson, former member of Congress (R-WI); Julia Ormond, actor; Kate Shindle, Miss America 1998; Tavis Smiley, host, BET Tonight; Jeanne White, the mother of Ryan White and AIDS Action's Daniel Zingale.
Mary Fisher provided the only dissent on the panel, disagreeing with the research grade because of her concern about the government's failure to adequately address women's health. HIV disease is now the third leading cause of death among women age 25 to 44.
As part of its own efforts to reinvigorate prevention, AIDS Action is also unveiling several HIV testing public service announcements. "Take the Test" was designed and produced by DDB Needham, one of the world's largest advertising agencies. The ads feature Rae Lewis Thornton, an HIV-positive educator, talking to groups of young people about the need to be tested for HIV.
AIDS Action also released the results of an online poll at gay.com where users provided their own grades of a "B" for research, a "C" for care and treatment, an "F" for global AIDS and an "F" for prevention.
Women with a history of bisexual activity appear to be more likely to engage in risk behaviors that put them at risk for HIV-1 infection and other sexually transmitted diseases (STD) than women who have only had sex with men, according to a report in the December issue of the American Journal of Public Health.
Dr Virginia Gonzales and colleagues at the Center for Health Education and Research at the University of Washington in Seattle evaluated risk factors among women participating in a multisite randomized HIV-STD prevention program.
The subjects included 264 women who reported at least 1 risk factor in the previous year and who had sex with a man in the previous 3 months. Of these 264 women, 38% also reported ever having sex with another woman.
Overall, women who had sex with both men and women were more likely to "...report drug use in the 3 months before the study, a greater lifetime number of male partners, a sex partner who had had sex with a prostitute, an earlier age at sexual debut, and forced sexual contact."
Dr Gonzales' team found that women who had sex with men only had a mean of 2.1 risk factors, while women with a history of bisexual sex had a mean of 3.2 risk factors.
Based on these findings, they conclude that "it is essential not to make assumptions about women's sexual behaviors on the basis of their perceived or stated sexual identity, especially when tailoring prevention messages."
Women with a bisexual history "may represent on overlooked or hidden subset." Health care professionals therefore need to be aware that these women may have multiple HIV and STD risk-related behaviors. (Reuters)
The United Nations has launched an initiative to lower HIV infections among young people in Africa, with Secretary-General Kofi Annan calling for a response to the epidemic "that makes humanity live up to its name."
The United Nations kicked off a two-day meeting, attended by officials from Africa and U.N. agencies, non-governmental organizations and the private sector.
The aim of the meeting was to draw up a plan to reduce infection rates by 25 percent before 2005 among Africans aged 14 to 25.
"Our response so far has failed Africa," Annan said in an opening statement to the closed-door meeting. "From now on, let us resolve that failure is not an option."
Africa has been hardest hit by the AIDS epidemic, with 60 percent of the world's AIDS-related deaths occurring on the continent.
Less than five percent of the world's population lives in Africa, yet it is home to more than 50 percent of HIV-infected people.
Annan said the toll was devastating African economies, with the country losing much of its work force and governments unable to care for the victims or their survivors.
Annan said the international community had to break the "conspiracy of silence" and stigma that surrounds the virus. He also said it was important to speed up vaccine development and make treatment affordable for Africans.
He applauded initiatives launched by Africans themselves, such as Lesotho's decision to double its AIDS budget, Namibia's cabinet approval for a national AIDS program, and Uganda's success in stabilizing levels of the infection with a massive information campaign.
But Annan said Africans alone cannot be held responsible for fighting the epidemic.
"This unprecedented crisis requires an unprecedented response," Annan said, "a response that makes humanity live up to its name."
The initiative was launched after the General Assembly in June set 2005 as the target to reduce infection rates by 25 percent among young Africans.
The Philadelphia AIDS Consortium (TPAC) has announced it was increasing its overall allocations to 51 community-based organizations by over $400,000. The increase for additional direct services to persons living with HIV/AIDS represents a 10% across-the-board hike to service providers.
TPAC is responsible for setting priorities for Title II Ryan White CARE Act funds as well as funding provided by the state of Pennsylvania for AIDS care and prevention services.
Luciano Orsini, TPAC Board President, said, "We are always seeking new dollars to continue our fight to adequately fund needed services for those living with HIV/AIDS. We are proud of this recent success in obtaining new monies and take pride in distributing all of it directly to our community providers."
The targeted populations to be served are communities of color with special emphasis on helping women and children in these communities. In addition, small funding grants totaling over $73,000 were announced for: 1) underwriting a detailed needs assessment to better understand the barriers to dental care in the Latino and African-American communities; 2) developing a curriculum for faith-based communities in prevention and care; 3) designing standards for interpretation for case management training; and 4) funding specific support services to women and children. Award letters were sent to all agencies on December 3rd.
Bill Nason, Treasurer of the Board, stated, "TPAC will continue to cut costs and increase service dollars to consumers in the most efficient way we can." (TPAC)
Twenty people were arrested on Dec. 7th after they stormed the executive offices of New York City's Human Resources Administration to protest what they called the agency's harsh and inhumane policies toward poor and disabled New Yorkers with drug and alcohol problems.
Housing Works Inc., one of the protest organizers, said the agency's new welfare drug screening program has kicked more people off public assistance and medical care than it has helped get drug treatment. The not-for-profit group provides housing, health care, job training and support services to homeless and poor residents with HIV or AIDS.
"We need to bring attention to the horrible practices of this administration that criminalizes poverty and addiction," said Lisa Edwards, a staff attorney for Housing Works.
Housing Works, together with the New York City AIDS Housing Network, the Urban Justice Center, and Act-Up New York, was protesting a recent city policy that withholds benefits from welfare recipients who test positive after one month of treatment in drug and alcohol programs.
Housing Works counselor Michael Kelly said the city does not consider medical evidence that relapses should be considered part of the recovery process.
"Some people who are dropped from their programs don't have anywhere to go but the street," he said.
Twenty protesters staged a 90-minute sit-in on the 25th floor of HRA's office building in lower Manhattan. Some handcuffed themselves to desks and other heavy objects while others commandeered the fax machine to send press releases to various news organizations. Another 20 people demonstrated outside.
HRA spokeswoman Debra Sproles did not return several telephone calls seeking comment. But the agency released a statement that said: "Once again, Housing Works demonstrated their willingness to engage in criminal activity. It is a disgrace that they oppose the city's efforts to help poor people gain access to needed support services that will ultimately help them to move from dependency to self-sufficiency."
Protesters told organizers outside the building that HRA Commissioner Jason A. Turner was in his office when they entered, but that could not be confirmed.
Meanwhile, more than three thousand New Yorkers gathered in Union Square Park on Dec. 5th to fight to save the 20-year-old right to emergency shelter for homeless New Yorkers. The group assembled to demonstrate their opposition to Mayor Giuliani's plan to eject homeless families and individuals from city shelters if they fail to meet his new requirements. An array of religious, political and social service leaders joined homeless individuals in addressing the afternoon crowd as all condemned the Mayor''s cold-hearted proposal to require work for emergency shelter from people who have fallen through every available safety net only to find themselves homeless.
"We do not want the homeless being forced to sleep on the streets, but that is exactly what will happen if Mayor Giuliani succeeds in denying homeless people emergency shelter. Families will be painfully separated. Children will be forced into foster care. Our streets will once again become the unfortunate destination of our homeless neighbors. All because the Mayor wants to ignore 20 years of proven experience about how to help the homeless," said Mary Brosnahan, Executive Director of the Coalition for the Homeless.
"This rally is not about people having the right to freeze to death on the streets of New York. It is about saving the right to emergency shelter and funding permanent solutions that we know work, like temporary rental assistance and affordable, permanent and supportive housing," added Brosnahan.
Among the 16 rally speakers were Reverend Luis Barrios of St. Mary''s Episcopal Church; Maria Cuomo Cole, President of Help USA (and wife of US housing secretary Andrew Cuomo); Brian McLaughlin, a working homeless graphic designer; Sister Mary Scullion, a nationally known homeless advocate from Philadelphia; NYC Councilmember Margarita Lopez, and Manhattan Borough President C. Virginia Fields.
"How far have we fallen from our moral obligation to help those less fortunate if this policy is allowed to stand? Food, shelter, and compassion are basic human needs and most of all should not be denied to the homeless," said Rabbi Robert Levine, who spoke at the rally and is Vice President of the New York Board of Rabbis.
Bianca Garcia, a Brooklyn Technical High School honors student who was once homeless also addressed the rally. "All kids need their parents. If it wasn't for the love and support of my Mom, I wouldn't have accomplished what I have. Mayor Giuliani should keep families together," said Garcia.
The rally was held on the 20-year anniversary of the historic court decision that paved the way for the creation of the right to shelter. In response to a lawsuit brought by Robert Callahan, a homeless man who slept on the streets of New York, the State Supreme Court ruled on December 5, 1979 that under the State Constitution the City and State have the obligation to provide emergency shelter to homeless men. Mayor Giuliani is in court fighting to absolve the City from its obligation to provide emergency shelter as is required under the terms of a 1981 consent decree. In addition to fighting in Court to preserve the right to shelter, the Coalition is part of the citywide Campaign to Save the Right to Shelter, organized by over 125 social service organizations, religious leaders, unions, elected officials, and homeless advocates.
More than 100 people stayed after the rally for the all-night sleep-out to protest Giuliani's inhumane policies. (Boston Globe and Housing Works)
On Tuesday, December 14 2:30-4:30 pm, Community Legal Services, Inc. will be presenting a training entitled "Substance Abuse and Welfare Reform: What You Should Know About the New Rules." The training will take place at the Philadelphia Bar Association, 1101 Market Street, 11th Floor Conference Center.
The training is free and open to anyone interested. If you plan to come, please call the Training Registration Voice Mail Box at 215-227-2400, ext 2475 and leave your name, the name of the organization you are affiliated with (if any), and your phone number.
This is the second presentation of a training CLS did on Thursday, October 28. The organization got such a large response to the first training that it decided to present it again. If you attended the training in October, there is no need to come to one next week.