HIV cases decline for black women, increase for gay men: CDC

Fewer black women in the United States are being infected with HIV, but the number of young gay and bisexual men infected is rising, the Centers for Disease Control and Prevention said on Wednesday.
Between 2008 and 2010, the number of newly infected black women dropped 21 percent, according to the CDC report. Yet despite the decline, they still accounted for 70 percent of all new HIV cases among women, the federal health agency said.
The rate of new infections for black women was 20 times higher than the rate for white women, the CDC said.
The number of new infections among young gay and bisexual men increased by 22 percent during that same two-year period, the CDC said.
The number of new HIV infections diagnosed annually in the overall U.S. population remained unchanged between 2008 and 2010 at about 47,500, according to health officials.
Public information campaigns on HIV prevention and testing seem to be working in lowering the number of new infections among African-American women, said Joseph Prejean, chief of the Behavioral and Clinical Surveillance Branch in the CDC's division of HIV/AIDS Prevention in Atlanta.
"We are encouraged to see some declines among African-American women," Prejean told Reuters. "They've been one of the most severely affected populations. We're cautiously optimistic that this could be part of a longer-term trend."
Among young gay and bisexual men, efforts to fight HIV have not been as effective, possibly because of advances in treatment for AIDS, the immune disorder caused by HIV, Prejean said.
"We do realize that many men who have sex with men do probably underestimate their personal risk and believe that treatment advances minimize the health threat," Prejean said.
Even though treatment can prolong the life of an AIDS patient, Prejean cautioned that "their life really does change. They then begin to take medication and will take medication for the rest of their lives," he said.
HIV is an incurable infection that costs $400,000 to treat over a lifetime, CDC Director Dr. Thomas Frieden said last month after another government report showed more than half of young Americans infected with HIV were not aware they had it.
Young people ages 13 to 24 account for 26 percent of all new HIV infections in the United States, the earlier CDC report said.
The report released on Wednesday said nearly two-thirds of new HIV infections in 2010 resulted from men having sex with other men. Young black men who have sex with men account for more new infections than any other subgroup, government health officials said.
"Because gay men account for 66 percent of all new infections, we must increase the focus of our prevention programs for gay men, particularly young and black gay men," said Michael Ruppal, executive director of The AIDS Institute.

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Ky. court upholds decision in penis removal case

A Kentucky man lost his bid Friday to force a doctor to pay damages for removing a cancer-riddled section of his penis during what was scheduled to be a simple circumcision.
The Kentucky Court of Appeals found that a jury correctly concluded that 66-year-old Phillip Seaton of Waddy consented to allow Dr. John Patterson to perform any procedure deemed necessary during the Oct. 19, 2007, surgery.
Patterson, a Kentucky-based urologist, maintains he found cancer in the man's penis during surgery and that it had to be removed. The patient claims the surgery was supposed to be a circumcision and he never authorized the amputation, nor was he given a chance to seek a second opinion.
"Additionally, there is uncontroverted testimony in the record that if Mr. Seaton were not treated for the penile cancer, it would prove fatal in the future," Judge Janet Stumbo wrote for the court.
Judge Michael Caperton dissented, but did not issue a written opinion.
Clay Robinson, a Lexington-based attorney for Patterson, said the opinion was "very well-reasoned" and fact-based.
"You always appreciate when you see judges at any level go into that amount of detail," Robinson said.
Seaton and his wife, Deborah, sued Patterson, a Kentucky-based urologist, in Shelby County Circuit Court in 2008. Seaton, now in his 60s, was having the procedure to better treat inflammation. The Seatons also sued Jewish Hospital, where the surgery took place. The hospital settled with the couple for an undisclosed amount.
Both sides agree that Seaton had squamous cell carcinoma, a type of skin cancer, in his penis. Patterson concluded that a tumor had overtaken much of the top of the organ, which made it impossible to insert a catheter.
"He also opined that serious complications and additional surgery could result if he did not insert the catheter," Stumbo wrote.
The main point of contention is whether Patterson acted reasonably in removing the organ immediately or if amputation could have been delayed to let Seaton seek other medical options.
Stumbo and Judge Donna Dixon concluded that, even though Seaton had limited ability to read and write, he never informed the doctor of that fact and signed the consent form in the presence of a witness. The Seatons claimed that the waiver didn't give Patterson authority to conduct an amputation without further consent.
"They maintain that no harm would have resulted if Dr. Patterson has consulted with either of them before proceeding, or if he had allowed them to consult with another physician to get a second opinion or other treatment options," Stumbo wrote.
Stumbo wrote that Patterson acted properly because the tumor had consumed such a large section of the organ.
"For this reason alone, the resection of the tumor was 'necessary and proper' in the context of inserting a catheter," Stumbo wrote.
Kevin George of Louisville, the attorney for Seaton, did not immediately return messages seeking comment.

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Judge orders end to HIV prison segregation in Alabama

Judge orders end to HIV prison segregation in Alabama
BIRMINGHAM, Alabama (Reuters) - A U.S. federal judge ruled on Friday to end the segregation of prisoners with HIV in Alabama, agreeing that it violates the Americans with Disabilities Act (ADA).
"It is evident that, while the ... segregation policy has been an unnecessary tool for preventing the transmission of HIV, it has been an effective one for humiliating and isolating prisoners living with the disease," U. S. District Judge Myron Thompson wrote in his ruling.
South Carolina now remains the only state segregating HIV inmates from the general population. Mississippi ceased a similar practice in March 2010.
The ruling came in response to a lawsuit by the American Civil Liberties Union (ACLU) over what the group contended was a discriminatory practice that prevented most HIV-positive inmates from participating in rehabilitation and retraining programs, including mental health and substance abuse programs, important for their success after prison.
"We won on all counts. It is a total victory and a glorious day for everyone with HIV," said Margaret Winter, associate director of the ACLU National Prison Project and lead counsel for the plaintiffs.
Proponents of ending the policy sited an out-dated view of HIV/AIDS, which has become increasingly controllable. In the case of a virus transmitted by behavior, and not environment, preventing its spread is easier through proper medical treatment, rather than radical segregation of HIV positive inmates, according to Nancy Mahon, who chairs the Presidential Advisory Council on HIV/AIDS (PACHA).
"We now have ability to suppress the virus and reduce the possibility of transmission to four percent. Alabama and South Carolina have been in the dark ages about this public health sorrow," said Mahon, who also directs the MAC AIDS Fund, which is financing the ACLU challenges in both states.
"The last thing we want to do is send them back into the community without treatment," she added.
Two of Alabama's 29 prisons have dormitories specifically housing prisoners with HIV. A handful of prisoners had been allowed to live and work in non-segregated settings in work-release programs, Winter said.
Currently, the inmates with HIV live, eat and exercise apart from the general population, according to court documents filed by the ACLU. Male inmates in the HIV dormitories were given white armbands that signal their medical status.
"First, we are isolated ... like we are contagious animals," Dana Harley, another prisoner who was a plaintiff in the case, said in a letter included in the court file. "It is like punishment three times over."
Approximately 270 inmates out of the 26,400 in the state prison system have tested positive for the virus and none have developed AIDS, according to Alabama Department of Corrections spokesman Brian Corbett, who did not respond to inquiries about the ruling.
The judge plans to rule separately on the medical criteria for work release for HIV prisoners, according to his ruling.

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Venezuela VP in Cuba to visit ailing Chavez

HAVANA (AP) — Venezuela's vice president arrived in Havana on Saturday in a sudden and unexpected trip to visit President Hugo Chavez as he recovers from cancer surgery.
Communist Party newspaper Granma published online a photo of a smiling Vice President Nicolas Maduro being greeted at the airport in the Cuban capital by the island's foreign minister, Bruno Rodriguez.
"From there, (Maduro) went directly to the hospital where President Hugo Chavez Frias is receiving treatment to greet his family members and Venezuelan Science and Technology Minister Jorge Arreaza Monserrat, and to discuss with doctors the adequate moment to visit the President the same day," the paper said.
Granma added that Maduro was accompanied by Venezuelan Attorney General Cilia Flores.
The previous night in Caracas, Venezuela, Maduro did not specify how long he would be away but said Energy Minister Hector Navarro would be in charge of government affairs in the meantime. Maduro's announcement came at the end of a long speech at the inauguration of a state governor, and he offered no information on the purpose of his visit beyond seeing Chavez.
In a speech Saturday, Venezuela's National Assembly President Diosdado Cabello said only that Maduro went to Cuba to visit with Chavez and urge him "to follow his treatment." Venezuelan press officials in Caracas said they had no additional information Saturday.
Maduro's trip comes amid growing uncertainty about Chavez's health.
The Venezuelan leader has not been seen or heard from since undergoing his fourth cancer-related surgery Dec. 11, and government officials have said he might not return in time for his scheduled Jan. 10 inauguration for a new six-year term. There have been no updates on Chavez's condition since Maduro announced Monday night that he had received a phone call from the president who was up and walking.
Venezuela's opposition criticized Maduro for what they said was a lack of transparency surrounding Chavez's health.
"What I still don't understand is who is president," Lawmaker Alfonso Marquina said. "Who is governing the country now? As for the purpose of this sudden and improvised trip, only the national government knows."
Maduro is the highest ranking Venezuelan official to visit Chavez since the surgery. Bolivian President Evo Morales traveled to Cuba last weekend in a quick trip that only added to the uncertainty surrounding Chavez's condition. Morales has not commented publicly on his visit or even confirmed that he saw Chavez while he was there.
Before leaving for Cuba, Chavez acknowledged the precariousness of his situation and designated Maduro as his successor, telling supporters they should vote for the vice president if a new presidential election was necessary. Although Chavez has delegated some administrative powers to Maduro, he did not leave the vice president officially in charge of the presidency.
Venezuela's Democratic Unity bloc of opposition parties suggested Saturday it was time for the government to declare the president temporarily absent from power.
"They are trying to hide what every day is a fact: The government does not want to recognize that there is a temporary absence of the president from his duties," the bloc said in a statement.
On Friday morning, Maduro read a New Year message from Chavez to Venezuelan troops, though it was unclear when the president composed it.
"I have had to battle again for my health," Chavez said in the message. He expressed "complete faith in the commitment and loyalty that the revolutionary armed forces are showing me in this very complicated and difficult moment."
A group of opposition candidates demanded Friday that Maduro provide an official medical report on Chavez's health. Lawmaker Dinorah Figuera said the country needs "a medical report from those who are responsible for the diagnosis, evaluation and treatment of the president."
"The Venezuelan people deserve official and institutional information," Figuera told Venezuelan media.
A legal fight is brewing over what should happen if Chavez, who was re-elected in October, cannot return in time for the inauguration before the National Assembly.
National Assembly Diosdado Cabello insisted Monday that Venezuela's constitution allows the president to take the oath before the Supreme Court at any time if he cannot do it before the legislature on Jan. 10.
Opposition leaders argue the constitution requires that new elections be held within 30 days if Chavez cannot take office Jan. 10. They have criticized the confusion over the inauguration as the latest example of the Chavez government's disdain for democratic rule of law and have demanded clarity on whether the president is fit to govern.

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AP's Honduras correspondent navigates violent land

TEGUCIGALPA, Honduras (AP) — Every Saturday morning, one of my taxi drivers pays about $12 for the right to park his cab near a hospital, about two blocks from a police station.
But it's not the government that's charging.
An unidentified man pulls up in a large SUV, usually brandishing an AK-47, and accepts an envelope of cash without saying a word. Jose and nine other drivers who pay the extortionists estimate that it amounts to more than $500 a year to park on public property. During Christmas, the cabbies dish out another $500 each in holiday "bonuses."
Meanwhile, Jose pays the city $30 a year for his taxi license.
"Who do you think is really in charge here?" Jose asked me.
It is an interesting question, one I have been trying to answer since I arrived here a year ago as a correspondent for The Associated Press. Is the government in charge? The drug traffickers? The gangs? This curious capital of 1.3 million people is a lawless place, but it does seem to have its own set of unwritten rules for living with the daily dangers.
Jose, who did not want his last name used for fear of reprisals, says his extortionists are from "18th Street," a powerful gang that started in U.S. prisons. The taxi drivers don't bother to report the crime, he says, because they suspect police are involved in the racket. In the first six months of 2012, 51 taxi drivers were killed in Tegucigalpa — most of them, Jose's colleagues believe, for failing to pay extortionists.
When I moved to Tegucigalpa last March several friends back home in Spain wanted to know why. The big story was in Egypt, Libya and Syria; what was I planning to do on the other side of the globe? "Bear witness," I said, "to the most violent place in the world, to a country in crisis."
I am the only foreign correspondent here, with no press pack to consult on questions of security, or to rely on for safety in numbers. I fall back on instincts honed in war zones, but they are not always sufficient when you are covering a failing state.
When you are in the trenches of Libya, you generally know where the shooting comes from. But in Honduras, you never know where danger lurks.
Three weeks after I arrived, I attended a ceremony in the capital where U.S. Assistant Secretary of State William Brownfield delivered 30 motorcycles to President Porfirio Lobo to help Honduras fight crime. A neighborhood leader, however, had complained to me that the narcos had bribed some police officers to look the other way. I asked the officials if they weren't afraid the motorcycles would end up in the hands of the bad guys.
I got no answer. Instead a Honduran reporter wrapped his arm around my shoulder and whispered, "We don't ask questions like that here." If I wanted to survive in Honduras, he said, "Keep a low profile."
More than two dozen Honduran journalists have been killed in the last two years. Some reporters carry weapons to protect themselves, others use the armed guards that President Lobo offered after a prominent Honduran radio journalist was assassinated last May — reportedly in retaliation for a government crackdown on cartels.
It is not hard to become a fatality. A few months ago, I interviewed a lawyer, Antonio Trejo, who was defending the peasants of Aguan Valley in a land dispute against agribusiness tycoon Miguel Facusse, one of the most powerful men in the country. Trejo had warned repeatedly that he would be killed for helping the campesinos. Two days after I interviewed him, he was shot six times as he was leaving church by two men on a motorcycle.
In August, I took a walk on a Sunday with a couple of friends in a sad dilapidated park — one of only two in the city. I got a call on my iPhone. I stepped away from friends and began to walk as I talked, as you would in a normal city, a normal park. Suddenly two teenagers approached me, asking first for a cigarette, then for the phone. I hung up, put the phone in my pocket and shouted over to my friends, who helped me chase the young men away — once we realized they weren't armed.
But I learned my lesson. Unwritten rule: Do not walk around talking on an iPhone, which costs about three times a monthly salary in Honduras. And forget the park.
Like most Hondurans who can afford it, my family and I live behind high gated walls with a guard out front. After the park episode, I gave up my morning ritual of newspapers and espresso at an outdoor cafe. I don't go out at night.
In the daytime, I use trusted drivers like Jose to guide me through Tegucigalpa's chaotic streets, past its barbed-wire fences, mounds of garbage and packs of dogs. I keep the tinted windows up, the doors locked, and we don't stop at the lights, so we won't get carjacked.
I vary my routes. I try not to fall victim to the permanent sense of danger that hangs over the capital, where the conversation is invariably about whose relative was just killed, or what atrocity happened on the corner. Yet I constantly check the rear and side mirrors of Jose's car for approaching motorcycles. Honduras has the world's highest murder rate, and paid gunmen almost always travel by motorcycle to make a quick getaway through impossible traffic.
The violence is a stark contrast to the friendly feel of a land where many have a Caribbean attitude about life, happy and easygoing. Once you leave the cities, the landscape is amazing — wild, healthy, and savage, from the waterfalls of La Tigra National park, just half an hour from the capital, to the islands of the Caribbean and the world's second largest coral reef.
___
Our babysitter, Wendy, sells Avon products door-to-door to make extra money after her child's father disappeared on his clandestine journey to the U.S. to find work.
Last month, she was on her way to deposit her Avon earnings in the bank when a robber pointed a knife at her waist and told her to hand over the cash. He took 5,000 lempiras — about $250 — which was everything she had earned, including the money she owed Avon.
Again last week, Wendy encountered thieves, this time as she left my house about 7:30 p.m. Half a block away, she passed a group of basketball players just as three gunmen threw them up against a wall, stealing their money and phones. "They looked like police," she said of the gunmen.
Two days later, a neighbor in her poor barrio of ramshackle huts and dirt roads was robbed by an armed drug addict. The neighbor escaped, went home for his own gun and returned to kill the drug addict. "Police thanked him for the favor," Wendy said.
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My best friend here is a man named German who studied art and opened a tattoo parlor with a business partner. They were talented and developed a good clientele, particularly among youths looking to leave the street gangs and get rid of the signature tattoos. German learned how to convert numbers such as 18 into pirate ships, and to turn other gang symbols into random designs. He saw this as a kind of social service, removing a stigma from the skin of a gangster who wanted to return to civilian life, and he asked to borrow a camera of mine to take pictures of their work.
Some days later, German's partner was walking home when a black car drew near. He tried to run until the front-seat passenger screamed at him to halt. "Get in and put this on," the man said, handing him a black hood.
They took him to a dark room where they removed the hood and claimed he spied on them. They tortured him for several hours before letting him go, with a broken rib.
My friend closed his shop and moved to a new house. He knows they are looking for him.
German comes from a family of means. Here, violence is democratic.
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Honduran officials receive aid from the U.S. to fight the trafficking of cocaine headed for the U.S. market. The country has 640 kilometers (400 miles) of northern Caribbean coastline, with plenty of tree cover and great uninhabited stretches for moving drugs. It is flanked by the port town of Puerto Lempira in the east and San Pedro Sula in the west.
While Hondurans blame their police for much of the crime, police say they are overwhelmed and outgunned by the drug traffickers and criminals. AP photographer Esteban Felix and I decided to see this for ourselves, and rode with police in San Pedro Sula, the country's largest and wealthiest city.
In one night, we saw the bodies of two bus drivers who had been killed for refusing to pay a cut to gangs, a police officer executed on a highway with a single shot to the head, and three people shot dead in a pool hall for what was described as "a settling of accounts."
The hospital emergency room looked like a scene out of a civil war, with mop-wielding orderlies failing to keep up with the blood pooling on the floor.
The owner of the bus company urged his employees to remove the drivers' bodies and collect the fares from the bloodied bus before police did. Once again, I made the mistake of asking a question, this time of the owner of the bus company. He turned in anger and ordered me not to publish what I had seen, while asking me repeatedly, "Where are you staying?"
Needless to say, I did not stay the night in San Pedro Sula.
I returned to the capital, which, despite the violence, has become my home. My two-year-old daughter can say Tegucigalpa — which is not easy. And every time she sees the flag, she waves and says "Honduras," as she was taught in her preschool.
Somehow, we already belong to this country. After 10 months living here, I have learned the rules of survival. If Jose pays his weekly extortion fee, chances are he'll survive.
And since I'm usually sitting in the passenger seat, chances are so will I.

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Brazil debates treatment options in crack epidemic

RIO DE JANEIRO (AP) — Bobo has a method: Cocaine gets him through the day, when he cruises with a wheelbarrow around a slum on Rio's west side, sorting through trash for recyclables to sell. At night, he turns the day's profit into crack.
"Sometimes I don't sleep at all; I'm up 24 hours," says Bobo, a former soldier who doesn't use his given name for safety reasons. "I work to support my addiction, but I only use crack at night. That drug takes my mind away. I lose all notion of what I'm doing."
Bobo says balancing crack with cocaine keeps him working and sane. On the shantytown's streets, life can be hell: Addicts unable to strike Bobo's precarious balance use crack day and night, begging, stealing, prostituting themselves, and picking through trash to make enough for the next hit. For them, there's no going home, no job, nothing but the drug.
With a boom in crack use over the past decade, Brazilian authorities are struggling to stop the drug's spread, sparking a debate over the legality and efficiency of forcibly interning users. Brazil today is the world's largest consumer of both cocaine and its crack derivative, according to the Federal University of Sao Paolo. About 6 million adults, or 3 percent of Brazilians, have tried cocaine in some form.
Rio de Janeiro has taken the lead in trying to help the burgeoning number of users with an approach that city leaders call proactive, but critics pan as unnecessarily aggressive. As of May 2011, users living in the streets have been scooped up in pre-dawn raids by teams led by the city's welfare department in conjunction with police and health care workers. By Dec. 5, 582 people had been picked up, including 734 children.
The sight is gut-wrenching. While some people go meekly, many fight, cry, scream out in desperation in their altered states. Once they're gone, their ratty mattresses, pans, sweaters and few other possessions are swept up by a garbage removal company.
Adults can't be forced to stay in treatment, and most leave the shelters within three days. But children are kept in treatment against their will or returned to parents if they have a family. In December, 119 children were being held in specialized treatment units.
Demand for crack has boomed in recent years and open-air "cracolandias," or "crack lands," popped up in the urban centers of Rio and Sao Paulo, with hundreds of users gathering to smoke the drug. The federal government announced in early 2012 that more than $2 billion would be spent to fight the epidemic, allotting money to train health care workers, buy thousands of hospital and shelter beds, and create transitional centers for recovering users.
Mobile street units stationed near cracolandias are among the most important and visible aspects of the government's approach. The units, housed in metal containers, bring doctors, nurses, therapists and social workers to the areas where users concentrate. Slowly, by offering health care and other help, the units' workers gain the trust of users and refer them to treatment centers.
Studies suggest the approach can work: 47 percent of the crack users surveyed in Sao Paulo said they'd welcome treatment, according to the Federal University of Sao Paulo study.
Ethel Vieira, a psychologist on the raid team, thinks their persistence is paying off.
"Initially, they'd run away, react aggressively, throw rocks," she said of users. "Now most of them understand our intention is to help, to give them a chance to leave the street and to connect with the public health network."
Human rights groups object to the forced commitment of children, saying treatment delivered against the will of patients is ineffective. They also oppose the sweeps, which they describe as violent.
"There are legal procedures that must be followed and that are not being followed. This goes against the law and is unconstitutional," Margarida Pressburguer, head of the Human Rights Commission for Brazil's Association of Attorneys, said during a debate last year.
Rio Mayor Eduardo Paes suggested in October that the city would start forcing adults into treatment. "A crack addict isn't capable of making decisions," Paes said from the Jacarezinho shantytown in the week after police stormed the area and seized control of what was then Rio's largest cracolandia.
The Rio state Attorney General's Office responded by telling city officials "the compulsory removal of adults living in the streets has no legal foundation." It said adults can be committed only when they become a danger to themselves or others and outpatient treatment options have run out.
"They give us a place to sleep, food, clothes, everything," said Bobo. "I've been picked up by the city and I liked it. They are doing this for our good."
But even as Bobo endorsed the city's approach, a friend was stepping over to the drug stand for more cocaine. Bobo asked for $5 worth of drugs — cocaine for now, crack for later. Then he rolled up a bill and dumped a small mound of white powder in his palm for snorting.
With a nose full of cocaine, he set off, ready for another day.

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President's brother speaks out on Colombia talks

BOGOTA, Colombia (AP) — A brother of Colombian President Juan Manuel Santos has revealed that the country's largest guerrilla group had initially proposed to hold peace talks within Colombia or in neighboring Venezuela, rather than in Cuba.
Enrique Santos said in an article published in the newspaper El Espectador on Sunday that the government's team had insisted that the talks not be held in Colombia.
"We decided on Cuba for security and above all because it guaranteed confidentiality," Santos wrote in the article.
Representatives of the Colombian government and the Revolutionary Armed Forces of Colombia, or FARC, began discussions in Havana on Nov. 19 seeking a deal to end the country's decades-old conflict. They currently are taking a holiday break and are to resume talks on Jan. 14.
Santos, a journalist and former director of the Colombian newspaper El Tiempo, is not a member of the team involved in the current talks, though he has acted as an adviser to the government negotiators.
He revealed details of earlier discussions with the rebels starting in February 2011. He said he has been involved "in an irreversible way in this process."
Santos said that one especially complicated matter was getting one of the rebel leaders, Jaime Alberto Parra Rodriguez, to make the trip to Cuba for those initial discussions. Santos said the rebels were distrustful of the plans to shuttle away Parra, who is better known by the nom-de-guerre Mauricio Jaramillo or the nickname "El Medico."
"It was very hard to convince the FARC to ... accept putting (Parra) on a helicopter supplied by the state," Santos wrote. "At the time of picking him up, he appeared guarded by more than 50 men armed to the teeth. In the end there was crying by women guerrillas and a farewell ceremony. That was the first big achievement: getting Jaramillo to Havana. That process lasted nearly a year."
Santos said he and others arrived in Havana on Feb. 23, 2011, ahead of their first contacts with the guerrillas, and that after sitting together about 70 times, they finally signed a preliminary accord in August 2012 to launch the peace talks. Until they reached that point, Santos said, "various times we were on the verge of breaking off" the discussions.

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Venezuela's official statement on Chavez's health

CARACAS, Venezuela (AP) — Hugo Chavez has suffered "new complications" following his cancer surgery in Cuba, his vice president said Sunday, describing the Venezuelan leader's condition as delicate.
Vice President Nicolas Maduro spoke with a solemn expression in a televised address from Havana, saying he had spoken with Chavez and that the president sent greetings to his homeland. Maduro did not give details about the complications, which he said came amid a respiratory infection.
"Several minutes ago we were with President Chavez. We greeted each other and he himself referred to these complications," Maduro said, reading from a prepared statement. The vice president was seated alongside Chavez's eldest daughter, Rosa, and son-in-law Jorge Arreaza, as well as Attorney General Cilia Flores.
Maduro's comments suggest an increasingly difficult fight for the ailing president. The Venezuelan leader has not been seen or heard from since undergoing his fourth cancer-related surgery Dec. 11, and government officials have said he might not return in time for his scheduled Jan. 10 inauguration for a new six-year term.
"The president gave us precise instructions so that, after finishing the visit, we would tell the (Venezuelan) people about his current health condition," Maduro said. "President Chavez's state of health continues to be delicate, with complications that are being attended to, in a process not without risks."
Maduro held up a copy of a newspaper confirming that his message was recorded on Sunday.
"Thanks to his physical and spiritual strength, Comandante Chavez is facing this difficult situation," Maduro said.
Maduro said he had met various times with Chavez's medical team and relatives. He said he would remain in Havana "for the coming hours" but didn't specify how long.
Maduro, who arrived in Havana on Saturday for a sudden and unexpected trip, is the highest-ranking Venezuelan official to see Chavez since the surgery in Cuba, where the president's mentor Fidel Castro has reportedly made regular visits to check on him.
Before flying to Cuba, Maduro said that Energy Minister Hector Navarro would be in charge of government affairs in the meantime.
"The situation does not look good. The fact that Maduro himself would go to Cuba, leaving Hector Navarro in charge only seems understandable if Chavez's health is precarious," said David Smilde, a University of Georgia sociologist and analyst for the Washington Office on Latin America think tank.
Smilde said that Maduro probably made the trip "to be able to talk to Chavez himself and perhaps to talk to the Castros and other Cuban advisers about how to navigate the possibility of Chavez not being able to be sworn in on Jan. 10."
"Mentioning twice in his nationally televised speech that Chavez has suffered new complications only reinforces the appearance that the situation is serious," Smilde said.
Before his operation, Chavez acknowledged he faced risks and designated Maduro as his successor, telling supporters they should vote for the vice president if a new presidential election were necessary.
Chavez said at the time that his cancer had come back despite previous surgeries, chemotherapy and radiation treatment. He has been fighting an undisclosed type of pelvic cancer since June 2011.
Medical experts say that it's common for patients who have undergone major surgeries to suffer respiratory infections and that how a patient fares can vary widely from a quick recovery in a couple of days to a fight for life on a respirator.
Maduro's latest update differed markedly from last Monday, when he had said he received a phone call from the president and that Chavez was up and walking.
The vice president spoke on Sunday below a picture of 19th century independence hero Simon Bolivar, the inspiration of Chavez's leftist Bolivarian Revolution movement.
Maduro expressed faith that Chavez's "immense will to live and the care of the best medical specialists will help our president successfully fight this new battle." He concluded his message saying: "Long live Chavez."
Chavez has been in office since 1999 and was re-elected in October, three months after he had announced that his latest tests showed he was cancer-free.
Opposition politicians have criticized a lack of detailed information about Chavez's condition, and last week repeated their demands for a full medical report.
Information Minister Ernesto Villegas defended the government's handling of the situation, saying during a televised panel discussion on Sunday night that Chavez "has told the truth in his worst moments" throughout his presidency.
Villegas said a government-organized New Year's Eve concert in a downtown Caracas plaza had been canceled, and he urged Venezuelans to pray for Chavez.
Chavez's daughter Maria, who has been with the president since his surgery, said in a message on her Twitter account: "Thank you people of Venezuela. Thank you people of the world. You and your love have always been our greatest strength! God is with us! We love you!"
Allies of the president also responded on Twitter, repeating the phrase: "Chavez lives and will triumph."

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Home market being held back by wary first-timers

WASHINGTON (AP) — This should be a great time to buy a first home. Prices have sunk to 2002 levels. Sellers are waiting anxiously as homes languish on the market. Mortgage rates are their lowest ever.
Yet the most likely first-time homeowners, especially young professionals and couples starting families, won't buy these days. Or they can't. Or they already did, during the housing boom. And their absence helps explain why the housing industry is still depressed.
The obstacles range from higher down payments to heavy debt from credit cards and student loans. But even many of those who could afford to buy no longer see it as a wise investment. Prices have sunk 15 percent in three years.
"I've looked for a home, but the places we can afford with the money we have are not that great," says Seth Herter, 23, a store manager in suburban St. Louis. "It also doesn't seem smart anymore to buy with prices falling. Buying a home just doesn't make sense to us."
The proportion of U.S. households that own homes is at 65.1 percent, its lowest point since 1996, the Census Bureau says. That marks a shift after nearly two decades in which homeownership grew before peaking at 70 percent during the housing boom.
The housing bubble lured so many young buyers that it reduced the pool of potential first-timers to below-normal levels. That's contributed to the decline in new buyers in recent years.
In 2005, at the height of the boom, about 2.8 million first-timers bought homes, according to the National Association of Realtors. By contrast, for each of the four years preceding the boom, the number of first-timers averaged fewer than 2 million.
Still, the bigger factors are the struggling economy, shaky job security, tougher credit rules and lack of cash to put down, said Dan McCue, research manager at Harvard University's Joint Center for Housing Studies. The unemployment rate among typical first-timers, those ages 25 to 34, is 9.8 percent, compared with 9 percent for all adults.
"The obstacles facing first-time buyers are big, and it's changing the way they look at home ownership," McCue says. "It's no longer the American Dream for the younger generation."
First-timers usually account for up to half of all sales. Over the past year, they've accounted for only about a third.
A big reason is tougher lending standards.
Lenders are demanding more money up front. In 2002, the median down payment for a single-family home in nine major U.S. cities was 4 percent, according to real estate website Zillow.com. Today, it's 22 percent.
And one-third of households have credit scores too low to qualify for a mortgage. The median required credit score from FICO Inc., the industry leader in credit ratings, has risen from 720 in 2007, when the market went bust, to 760 today.
Homes in many places are the most affordable in a generation. In the past year, the national median sale price has sunk 3.5 percent. Half the homes listed in the Tampa Bay area are priced below $100,000.
The average mortgage rate for a 30-year fixed loan is 4 percent, barely above an all-time low. Five years ago, it was near 6.5 percent. In 2000, it exceeded 8 percent.
When the economy eventually strengthens, the housing market will, too. More people will be hired. Confidence will rise. Down payments won't be so hard to produce.
The question is whether first-time buyers will then start flowing into the housing market. That will depend mainly on whether they think prices will rise, said Mark Vitner, senior U.S. economist at Wells Fargo.
"It's a guessing game as to when things will turn around," Vitner said. "But until they do, you won't see young people buying homes.

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First Person: I Repaid My Student Loans While Still in College

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The first two years of my college experience was spent at a community college. My tuition was covered, but I took out a loan for $20,000 to cover living expenses. Upon transferring to a costly four-year university I received a hefty scholarship, which covered most of my expenses. Still, my loans were at $11,500 per year. The day of my graduation, I received the coveted diploma and a not-so-coveted array of bills for my student loans.
However, the difference between other students and myself was the large sum of money lingering my savings account that I started four years prior. Let me explain how I managed to pay off my bills on the same day that I graduated from college:
Federal Loans Only
The first goal during my college career was to stay away from private student loans because they are nightmares. Trust me, I know. I took out a $5,000 private student loan in my first year of college and watched it as it was passed around from lender to lender and the interest rate jumped around, ranging from 8% to 20%. Not to mention the compounding of interest that increased the loan nearly $1,500 in eight months. Needless to say, I paid that off with every dime that I had to give to it by taking on a job. Please, if you can avoid them, do not take out alternative loans.
The government offers student loans at wonderful interest rates and the government will pay the interest of the loan while you are pursuing your education.
Monthly Payments While in School
Let's evaluate my loans. During years one and two, I took out $7,500 for each year. My plan was to get a job that I could take the money that I would need to pay off the loan in one year and pay it into a high-interest savings account. That meant that for years one and two, I paid $625 into my savings account each month. During years three and four, I took out $11,500 per year, which meant that I had to contribute $960 each month to the savings account. This may seem like a lot of money, but at the time I was single and still didn't have my daughter (until the fourth year), so it was easy to have all of my expenses paid, get a job on the side and contribute all of that money into a savings account.
At the end of the four years, I had contributed $43,000 to my savings account and earned about $1,000 in interest on the money.
On the day of my graduation I was able to pay off my student loans and never had to pay a cent of interest. If you are financially capable to do this, then I suggest that you do it. All it takes is finding extra income through a part time job or funding. You will save thousands of dollars in interest if you can manage this. If you cannot afford to pay the monthly payment, then pay half of it or pay what the interest would be on the loan. That way you can make a lump sum payment at the end of your college education.

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