Sunday, December 31, 2006

Party Time

Religious Thoughts

Which reminds us of Stephen Fry's story of Yasa Arafat's decription of religious wars as two bullies fighting over whose imaginary friend is bigger.

2007? Tomorrow Belongs to Me --- Beware!




House Honors




House MD is House OBE.

Actor James Hugh Callum Laurie - Actor, Writer, Directo, was awared an OBE in the British New Year's Honors (Queen's List) for services to Drama. Congratulations.

Friday, December 29, 2006

The Disappearing Gentlemens' Lavatories of Old London

Flu could wipe out 62 million

BBC on line reports the prediction in the Lancet that a global flu pandemic could kill 62 million people. The 1918 pandemic claimed 50 million lives and it is anticipated that the toll today would be higher despite medical advances.

Once again, the world's poorest nations would be hardest hit fuelled by poverty, malaria and HIV. They, of course, are the least able to afford to prepare for a pandemic, The developed world continues to ignore the implications of rapid transit and the spread of infection. As with HIV etc. We do well to remember how small a world it is. That is enlightened self interest even if we ignore the moral imperatives as usual (Darfur, Zimbabwe, etc etc etc) epidemics have a way of reminding us how small the world has become.

Link to BBC on line story.

Just can't get e--nough




In the current edition of
New Scientist there
is a review by
Richard Fisher
of the whole range
of “dysfunctional
techno-habits
”.

Link to New Scientist article

Thursday, December 28, 2006

George W. Bush: What The Hell Is Going On?

Christmas Island Crabs



Primary HIV-1 Drug Resistance in Adolescents

Adolescents recently infected with HIV-1 have high rates of primary drug resistance, according to a report in the December 1st issue of The Journal of Infectious Diseases. Other studies have shown an increased prevalence of resistance resistance, the authors explain, but these most of them have been conducted with middle-aged white men.

Dr. Rolando M. Viani from University of California, San Diego School of Medicine, and his co-researchers investigated the prevalence of primary genotypic and phenotypic HIV-1 drug resistance patterns among 55 recently infected youth ranging in age from 12-to-24 years old.

They noted, “The rates of NNRTI-resistant HIV-1 that we report in these recently infected adolescents and young adults are among the highest ever reported in the United States, and the overall rates of drug resistance are concerning."

"These observations support the current guidelines for resistance testing in adults and adolescents recently infected with HIV-1 before initiating antiretroviral therapy."


Prevalence of Primary HIV-1 Drug Resistance among Recently Infected Adolescents: A Multicenter Adolescent Medicine Trials Network for HIV/AIDS Interventions Study
Rolando M. Viani et al

The Journal of Infectious Diseases 2006;194:1505-1509

Link to JID abstract.

Wednesday, December 27, 2006

Sex Lesson



Any Umbrellas? The Power of Urban Myths

It has been reported that men in London may be deterred from seeking sexual health screening because they believe that an "umbrella" like instrument will be inserted into their urethra to check for sexually transmitted infections.

Michael Carter writing for Aidsmap (December 22, 2006) notes that the British Medical Journal reports that the staff at the genitourinary medicine clinic at St Thomas's Hospital, London, found that the myth was so prevalent that they recommend "more informative advertising and media attention is needed to encourage people to attend clinics.

During the investigation, some men provided sketches showing what they believed the swab looked like --- these resembled an umbrella, an arrow, a hook, and a double-headed fishing hook.

Link to Aidsmap article

Reference

You’re not going to give me the umbrella, are you?
Bradbeer C et al

BMJ 333: 1287 – 1288, 2006.

Link to BMJ article


Tuesday, December 26, 2006

The Twelve Days of Christmas

On the thirteenth day of Christmas I returned:
Twelve drummers drumming,
Twenty-two pipers piping,
Thirty lords a-leaping,
Thirty-six ladies dancing,
Forty maids a-milking,
Forty-two swans a-swimming,
Forty-two geese a-laying,
Forty golden rings,
Thirty-six birds a calling,
Thirty French hens,
Twenty turtle doves,
Twelve partridges in pear trees!

And I was glad to be rid of all 364 gifts

But I did keep all 364 condoms!

Monday, December 25, 2006

Season's Greetings

The Twelve Days of Christmas

On the twelfth day of Christmas, my true love sent to me
Twelve drummers drumming,
Eleven pipers piping,
Ten lords a-leaping,
Nine ladies dancing,
Eight maids a-milking,
Seven swans a-swimming,
Six geese a-laying,
Five golden rings,
Four calling birds,
Three French hens,
Two turtle doves,
A partridge in a pear tree.
And seventy-eight condoms.

Season's Greetings

Sunday, December 24, 2006

The Twelve Days of Christmas

On the tenth day of Christmas, my true love sent to me
Ten lords a-leaping,
Nine ladies dancing,
Eight maids a-milking,
Seven swans a-swimming,
Six geese a-laying,
Five golden rings,
Four calling birds,
Three French hens,
Two turtle doves,
A partridge in a pear tree.
And a fifty-five condoms


On the eleventh day of Christmas, my true love sent to me
Eleven pipers piping,
Ten lords a-leaping,
Nine ladies dancing,
Eight maids a-milking,
Seven swans a-swimming,
Six geese a-laying,
Five golden rings,
Four calling birds,
Three French hens,
Two turtle doves,
A partridge in a pear tree.
And sixty-six condoms

Season's Greetings

Saturday, December 23, 2006

The Twelve Days of Christmas

On the ninth day of Christmas,
my true love sent to me
Nine ladies dancing,
Eight maids a-milking,
Seven swans a-swimming,
Six geese a-laying,

Five golden rings,

Four calling birds,
Three French hens,
Two turtle doves,
A partridge in a pear tree.
And forty-five condoms

Fashion statement: Mon Dieu Moncler!

It may be too late for Gift hints but

this look could be yours for only $3,845

Moncler parka with a fur-trimmed hood, $1,125
and Zegna broadcloth shirt, $145
Boglioli cashmere jacket, $1,995
Incotex washed cotton-linen trousers, $285
Wool scarf, $275 at Etro.

Well I suppose it does include a vintage wool tie from eBay for only $20



Chris Shipman for the New York Times



Friday, December 22, 2006

The Twelve Days of Christmas



On the eighth day of Christmas,
my true love sent to me


Eight maids a-milking,
Seven swans a-swimming,
Six geese a-laying,
Five golden rings,
Four calling birds,
Three French hens,
Two turtle doves,
A partridge in a pear tree.
And thirty-six condoms

Dangerous Times



from The Times, London








You person of the year, you!

Thursday, December 21, 2006

A Christmas Carol


What excitement and anticipation as we await the seasonal production by the Seattle Prevention Players --- a traditional pantomime based on Mr. Charles Dicken's

A Christmas Carol
(or We Quite Like Living in the Past,

as the Prevention Players have sub-titled it)

The lead, Scrooge, is taken by Dr. Bob of Public Health, who convinces us that he will never change. Even Tiny Tim, little Beau the poster boy for HIV stops with me cannot melt this heart!


Not all is gloom. There is a comedy interlude with the guest appearance of Mayor Nickles as Mr. Bumble, the Beadle, who comes with measuring staff and tells us that he is there to make sure that no exotic dancers have been included in the program

Following the traditional story, Scrooge sees a face from the past appearing as a door knocker. No not Jacob Marley, this is Grey Lambert who asks why no one learns any lessons from the lives that have already gone. Having a house named after you is a poor consolation.

Then comes the first of the three Ghosts - The Ghost of Christmas Past played by the Director of Seattle Counseling Services (for Sexual Minorities) as it used to be called when it was a community resource rather than a glorified mental health agency.

During this act we are transported to the scene of Mr Fezziwig's Christmas Party robustly played by the Boys of Gay City.

The Ghost of Christmas Present follows and introduces us to the Cratchet Family’s Christmas Dinner. Here we see Mrs Cratchet played by the Director of Lifelong Aids, In such dire times, Tina as Mrs Cratchet puts on a wonderful Christmas spread despite the world of suffering around her. What a pudding --- enough to distract any one.

Tina incidentally would have liked to have provided Gay Bingo for the Intermission but there was not enough time. A spot by Seattle Gay Men's Chorus was also nixed because they are too close to real lives. But for those in need of diversion from the sorrow, we have an intermission display by the Dancing Waters (No! It's not that kind of thing)


The last visitor is the Ghost of Christmas Yet to Come. Here are some of the most tear jerking scenes.

We visit the Exchange when there is discussion of attending the funeral. This group played by the Lifelong Board of Directors, provides the fine line, "I will attend if a luncheon is provided."



The final scene of the future yet to come has a novel twist. Scrooge, while sad at what has happened can see no real need for change. For him and the rest of the cast it will be business as usual.


They leave you to take comfort in the epilogue transformation scene when Tiny Tim transmutes from "HIV stops with me" into an angelic "I am the Cure"

The Twelve Days of Christmas

On the seventh day of Christmas, my true love sent to me
Seven swans a-swimming,
Six geese a-laying,
Five golden rings,
Four calling birds,
Three French hens,
Two turtle doves,
A partridge in a pear tree.
And twenty-eight condoms

Season's Greetings

The SNL Sketch Uncensored

Wednesday, December 20, 2006

The Twelve Days of Christmas


On the sixth day of Christmas, my true love sent to me
Six geese a-laying,
Five golden rings,
Four calling birds,
Three French hens,
Two turtle doves,
A partridge in a pear tree,
And twenty-one condoms

Ryan White Act Reauthorized

On Tuesday (December 19, 2006), President Bush signed into law the Ryan White CARE Act Reauthorization Bill (HR 6143). Keep in mind the provision which repeals the Ryan White program after three years. This means that Congress must write a new law and review the programs provisions before then.

Resistance Mutations

Derek Thaczuk's report for Aidsmap (December 20, 2006):

Emergence of resistance mutations: a comparison between drug classes

is too full and technical to reproduce or review here. It is worth following the Aidsmap link to read it in full.

Link to Aidsmap article


References:

Evolution of HIV Resistance Mutations in Patients Maintained on a Stable Treatment Regimen After Virologic Failure.
Goetz, Matthew Bidwell et al
JAIDS Journal of Acquired Immune Deficiency Syndromes. 43(5):541-549, December 15, 2006.
Link to JAIDS article abstract

Drug resistance at low viraemia in HIV-1-infected patients with antiretroviral combination therapy.
Aleman, S et al
AIDS. 16(7):1039-1044, May 3, 2002.
Link to Aidsonline abstract.

Incidence of resistance in a double-blind study comparing lopinavir/ritonavir plus stavudine and lamivudine to nelfinavir plus stavudine and lamivudine.
Kempf DJ et al.

The Journal of Infectious Diseases2004;189:51-60

Link to JID abstract

HIV-1 Drug Resistance Evolution Among Patients on Potent Combination Antiretroviral Therapy With Detectable Viremia.
Napravnik, Sonia et al

JAIDS Journal of Acquired Immune Deficiency Syndromes. 40(1):34-40,
September 1, 2005.
Link to JAIDS article abstract.


A scorpion in ya jeans!

The BBC on Line reports that a Japanese woman, on the southern island of Okinawa, trying on a pair of jeans in a shop got a shock when she was stung by a scorpion hidden inside. Local health officials captured the 2 inch scorpion, which was believed to be a Chinese bark scorpion. It probably traveled inside the jeans from China, where they were made. The woman felt a sudden pain in her right knee as she tried the jeans on. When she rubbed the area with her hand, the scorpion stung her right index finger. She ended up in hospital for five days as a result of the sting, which was not life-threatening.

Your worst nightmare and our excuse to reprise this:


Tuesday, December 19, 2006

The Twelve Days of Christmas

On the fifth day of Christmas, my true love sent to me
Five golden rings,
Four calling birds,
Three French hens,
Two turtle doves,
A partridge in a pear tree,
And fifteen condoms

HIV hates our guts

Peter Aldhous reports in the current issue of New Scientist (2582 16 December 2006)

HIV delivers a punch to the guts


Evidence is building that the virus deals a body blow to the immune system almost immediately after infection by destroying key cells in the gut lining. It used to be there is a steady battle throughout the course of infection. The new findings have important implications for the development of vaccines and for improving therapies.

HIV attacks CD4 cells, also known as "helper" T-cells, which help coordinate immune responses. In the blood of infected people, there is a steady fight between viral replication and the production of new CD4 cells to replace those that are lost to the virus. If left untreated, HIV eventually wins this battle, and the immune system collapses.

The most successful treatment for HIV is called highly active anti-retroviral therapy, or HAART, which uses cocktails of drugs that can tip the balance in the blood in the immune system's favor: people with HIV who have now been on the therapy for years seem to remain healthy.

The vast majority of CD4 cells, however, some 98 per cent, are in mucosal tissues, such as those lining the vagina, airways and especially the gut - possibly because pathogens typically enter the body through such tissues. Only about 2 per cent of CD4 cells circulate in the blood.

This may explain why HAART doesn't fix all the damage that HIV causes. The virus hits immune cells in mucosal tissues hard and fast, usually before treatment with HAART even starts. Virologists have recently shown that the number of CD4 cells in the gut lining plummets by up to 6o per cent within the first few weeks of infection.

Researchers led by Martin Markowitz of the Aaron Diamond AIDS Research Center in New York have shown that HAART does little to reverse this damage, even in people who are treated very early after being infected. Despite being put on drugs within about three weeks, 70 per cent of Markowitz's patients lost more than half of the CD4 cells in their lower gut (Study 1 below).

Markowitz's team is now studying the mechanisms by which HIV causes distress in the gut. Not only does the virus kill gut CD4 cells directly but it gets the immune system to turn on itself: some CD4 cells self-destruct, and others seem to be killed by other T-cells (Study 2 below) The researchers believe this is linked to the way HIV activates the immune system abnormally.

This damage may also trigger further harmful immune activation throughout the body, says Daniel Douek of the Vaccine Research Center at the National Institute of Allergy and Infectious Diseases in Bethesda, Maryland. Douek's work suggests that damage to the gut enables molecules from microbes in the gut to enter the bloodstream. These molecules include some known as lipopolysaccharides, which are a component of bacterial cell walls and stimulate the immune system (Study 3 below).

A concern is that this will have a negative psychological impact on people. As Markowitz says, "We don't want to scare people.” The worry is that their damaged gut linings may eventually cause them to be laid low by HIV, despite the positive effects of HAART in the blood. Another possibility, however, is that HAART could keep enough gut CD4 cells alive to make a difference - enough to keep an infected person healthy for the rest of their life, even if the gut's immune system never returns to normal.

The most important implications may be for vaccine development. An effective AIDS vaccine will probably have to trigger "mucosal" immunity in the gut lining, in addition to immunity in the blood. Ideally, it would stimulate antibodies capable of knocking out the virus before it enters CD4 cells, as well as directing T-cells to destroy cells that do get infected.

Link to New Scientist preview (subscription required)

Keith Alcorn, writing for Aidsmap (December 19, 2006) also covers these studies.
Link to Aidsmap article

References:

(1)
Lack of Mucosal Immune Reconstitution during Prolonged Treatment of Acute and Early HIV-1 Infection
Saurabh Mehandru et al

PLoS Med 3(12): e484 DOI :
10.1371/journal.pmed.0030484

(2)
Mechanisms of Gastrointestinal CD4+ T Cell Depletion During Acute and Early HIV-1 Infection
Saurabh Mehandru et al

Journal of Virology. doi:10.1128/JVI.01739-06
Link to J. Virol abstract

(3)
Microbial translocation is a cause of systemic immune activation in chronic HIV infection
Jason M Brenchley et al

Nature Medicine - 12, 1365 - 1371 (2006)
Link to Nature abstract

Christmas Greetings

Monday, December 18, 2006

TheTwelve Days of Christmas

On the third day of Christmas,
my true love sent to me
Three French hens,Two turtle doves,
A partridge in a pear tree.
And six condoms





On the fourth day of Christmas, my true love sent to me
Four calling birds,
Three French hens,
Two turtle doves,
A partridge in a pear tree.
And ten condoms

AIDS-Malaria: The New York Times Spells It Out

The New York Times in its Editorial Published: December 18, 2006:

The AIDS-Malaria Connection

AIDS prevention has seen two breakthroughs this month. The big news is the protective value of circumcision. But there is another important finding: AIDS and malaria feed on each other, with disastrous effects.

In a paper published in the journal Science, researchers looked at health records from Kisumu, Kenya, a city of 200,000 with high levels of both diseases. They calculated that the interaction of the diseases increased AIDS cases by 8 percent and malaria by 13 percent. Over 25 years, that meant 8,500 additional AIDS cases and almost a million extra cases of malaria. The researchers drew on earlier findings that H.I.V.-positive people who get malaria experience a six- to eight-week spike in the level of the AIDS virus in their blood. During that spike, they are supercontagious, with double the usual chance of infecting a sexual partner. People with H.I.V. have also been proved more likely to catch malaria.

One important lesson of the study is that protecting H.I.V.-positive people from malaria would also limit the spread of AIDS. They need insecticide-treated bed nets to sleep under, and should take a daily dose of the antibiotic cotrimoxazole. Combining bed nets and cotrimoxazole with antiretroviral therapy reduced malaria cases in H.I.V.-positive people by 95 percent in one study. Cotrimoxazole is cheap, but is not yet widely used in poor countries.

The findings should add extra urgency to the fight against malaria, which has always lagged far behind AIDS in both money and attention. Last week President Bush convened a forum on malaria, but the fact that more than a million people — most of them under 5 — die each year from a disease that is easily preventable and curable speaks volumes.

The study also sheds new light on why Africa’s AIDS rates are so much higher than elsewhere: Africans’ health is poor, and they are more likely to suffer from diseases — malaria, genital herpes and others — that make H.I.V. more transmissible.

Donors eager to fight AIDS have shown less interest in improving Africa’s health systems, training health workers and equipping clinics. The biggest lesson of the new study is that it is all one fight.


We hope the guys at Seattle Lifelong will be able to get past the idea that this is "de-gaying" the struggle!

Sunday, December 17, 2006

Ooh, Vicar!

Yes we know the Twelve Days of Christmas are not the twelve days before Christmas, but the days from Christmas until Epiphany (January 6th) or the old Twelfth Night. Incidentally, it was thought to be bad luck to remove your decorations (tree included) until then). But the politically correct brigade’s attempt to designate the Christmas tree as a “religious symbol” cannot disguise that we have all made adaptations to the pagan winter festivals (who doesn’t need something to cheer up these bleak days?) And we think it's a lot more fun this way



On the first day of Christmas, my true love sent to me
A partridge in a pear tree.
And a condom



On the second day of Christmas, my true love sent to me
Two turtle doves,
A partridge in a pear tree.
And three condoms

Seasons Greetings



Greg Lake recalls the making of I Remember Father Christmas


Saturday, December 16, 2006

Size Matters

Sex Workers Speak Out

Sex workers, male and female, from across the world have been writing to the BBC News website about their lives following the murders of five prostitutes in eastern England. The BBC has published some of these. The site also links to a report of how the Dutch protect their sex workers.

Link to BBC News

Hard to swallow


In the New Scientist's special report Lone Voices (9 December 2006) Alison George writes about Barry Marshall, who was so sure the medical establishment was wrong about the cause of stomach ulcers that he swallowed the bacteria he believed were to blame. It still took years to convince everyone - but it did win him a share in the Nobel Prize in physiology or medicine in 2005.

As he says, conventional wisdom was that ulcers were caused by stress, bad diet, smoking, alcohol and susceptible genes -- no bacteria could survive in the stomach. Together with pathologist Robin Warren, he found a bacterium called Helicobacter pylori in all duodenal ulcer patients and in 77% of patients with gastric ulcers.

Link to New Scientist article (registration required)


Link to Nobel Prize Report

Thursday, December 14, 2006

Bye Rumsfeld!

POP QUIZ: Philosophy



What is the Categorical Imperative?





HIV antiretroviral resistance?

Michael Carter, writing for Aidsmap (December 13, 2006) under the title

Why did HIV therapy have some benefits for a man with resistance to nearly every antiretroviral?

tells of a French gay men infected with a strain of HIV that was resistant to virtually every antiretroviral drug nevertheless derived immunological benefit from therapy, remained asymptomatic and experienced some reduction in viral suppression of HIV, according to a case report in the January 2, 2007 edition of AIDS. The case has some similarities with a case in New York.

French investigators have, however, adopted a much more measured approach to this case than that of public health officials in New York, who summoned the world’s media to a press conference and sparked panic about “untreatable HIV”. The French doctors also emphasize in their paper that this appears to be an isolated case, possibly of co-infection or superinfection at seroconversion with different strains of HIV.

Link to Aidsmap article

Virological characterization of an infection with a dual-tropic, multidrug-resistant HIV-1 and further evolution on antiretroviral therapy.
Masquelier, Bernard et al
AIDS. 21(1):103-106, January 2, 2007.
Link to AIDS Journal abstract