The difference may place some heavy drinkers at earlier risk of developing opportunistic illnesses, but the study was not designed to assess how quickly people developed clinical illnesses related to HIV infection.
Nevertheless, the findings imply that someone who consistently drinks heavily would be quicker to reach the point at which treatment is recommended than someone who is teetotal.
In settings where high alcohol consumption is common, such as
Alcohol consumption and HIV disease progression
Samet, Jeffrey H. et al
Journal of Acquired Immune Deficiency Syndromes (advance online publication), 2007. 10.1097/QAI.0b013e318142aabb (published ahead of print August 23, 2007)
Friday, August 31, 2007
“I believe, if we don’t fix the health care system, that lack of access will be a bigger cancer killer than tobacco,” Mr. Seffrin said in an interview. “The ultimate control of cancer is as much a public policy issue as it is a medical and scientific issue.”
The New York Times reports also notes that the American Medical Association has begun a three-year campaign called Voice for the Uninsured that will begin with $5 million in advertising in early primary states. AARP, in conjunction with the Business Roundtable and the Service Employees International Union recently began a similar effort called Divided We Fail.
American Medical Association - Voice for the Uninsured
Link to AMA (Uninsured)
Thursday, August 30, 2007
The findings suggest that a test which screens for HIV coreceptor usage may provide useful additional information about otherwise healthy patients who may be at high risk of HIV disease progression.
The development of a new group of anti-HIV drugs, the CCR5 antagonists, has sparked interest and work in co-receptor biology. The entry inhibitor maraviroc (Selzentry in the US, Celsentri in Europe) by Pfizer is the first to block HIV’s use of CCR5.
The drug has antiretroviral activity only in people carrying virus that uses CCR5, but not in those carrying virus that uses CXCR4. The drug recently received accelerated approval from US and European regulatory authorities and is expected on the US market this autumn.
There have been a series of small studies linking faster disease progression with CXCR4, but the study by Eric Daar and colleagues presents multi-year data from over 100 people with HIV who received minimal antiretroviral therapy.
To obtain their data, the research team used frozen blood samples collected during the Hemophilia Growth and Development study, a cohort that enrolled HIV-positive youth from several community-based sites in the US from 1989-1900. Daar and colleagues tested viral load in samples taken as close as possible to the participant’s enrolment in the study.
What is still unclear is whether emergence of CXCR4 is a cause or an effect of disease progression.
Baseline HIV type 1 co-receptor tropism predicts disease progression
Eric S. Daar et al.
Clinical Infectious Diseases 45:643 – 649, 2007.
HIV self-tests ineffective in high-risk individuals
that in a study conducted at two major HIV centers in
The major problem was collecting an adequate blood sample,
The study by Dr. Vernon J. Lee of Tan Took Seng Hospital in Singapore and co-investigators is reported in the Journal of Acquired Immune Deficiency Syndromes. It suggests a major problem is collecting an adequate blood sample. Also, a significant number of study subjects were unable to interpret results or interpreted them incorrectly. This despite the fact that before testing, 90 percent said the test steps were easy to understand and the instructions were easy to read and follow.
However, the study found that 85 percent of participants failed to perform all of the steps correctly or were unable to perform the test at all. As a result, invalid results occurred in 56 percent of cases.
The investigators found that "blood sampling via finger prick and collection via a capillary tube was difficult for participants." But subjects who were known to be HIV-positive correctly performed the test and interpreted the results more often, which might reflect their "exposure to and experience with blood tests."
Inconvenience and long waiting times were cited by 18 percent of participants as deterrents to being tested for HIV at health-care centers.
The researchers conclude that the "implementation of self-testing should be reconsidered until kit design and downstream issues have been adequately addressed."
User Acceptability and Feasibility of Self-Testing With HIV Rapid Tests.
Lee, Vernon J et al
Journal of Acquired Immune Deficiency Syndromes. 45(4):449-453,
Wednesday, August 29, 2007
Natasha Singer writing for New York Times: Health (
Some dermatologists said financial incentives to perform cosmetic treatments coupled with bureaucratic obstacles in obtaining insurance reimbursement for medical treatments might also have a role in the varying wait times.
Dr. Michael J. Franzblau, a dermatologist in San Francisco, said doctors typically charged $400 to $600 for a Botox antiwrinkle treatment, for which patients pay upfront because insurance does not cover it. Meanwhile, doctors have to wait for health insurance to reimburse them for mole examinations, for which they receive an average of $50 to $75, he said.
Short wait times for patients seeking cosmetic botulinum toxin appointments with dermatologists
Jack S. Resneck et al
Journal of the
Meanwhile, an Editorial in the same New York Times (
A Sobering Census Report: Bleak Findings on Health Insurance
notes the Census Bureau’s report on the state of American health insurance was as disturbing as its statistics on poverty and income. The bureau reported a large increase in the number of Americans who lack health insurance.
The number of uninsured Americans has been rising inexorably over the past six years as soaring health care costs have driven up premiums, employers have scaled back or eliminated health benefits and hard-pressed families have found themselves unable to purchase insurance at a reasonable price.
It is estimated that 80% of all HIV infections are acquired sexually. The transmission of HIV depends upon the infectiousness of the host and the susceptibility of the sexual partner, and both infectiousness and susceptibility can vary significantly over time.
Infectiousness can be directly correlated with viral load in blood, and blood viral load can serve as a surrogate marker of shedding of HIV in genital secretions.
Investigators have recently developed a surveillance strategy that allows for the identification of individuals with primary HIV infection even before antibodies to HIV have developed. This has enabled clinicians to detect a significant number of patients with acute HIV infection in the
Amplified transmission of HIV-1: comparison of HIV-1 concentrations in semen and blood during acute and chronic infection
Pilcher, Christopher D et al
Tuesday, August 28, 2007
Venturing Into the Mines of Uganda, in Search of the Marburg Virus
reports on the study published Aug. 22 in the online journal PloS ONE which indicates that researchers have found the
The researchers, from the US Centers for Disease Control and Prevention and Centre International de Recherches Medicales de Franceville in
The largest outbreak of the
Jonathan S. Towner et al
PLoS ONE 2(8): e764. doi:10.1371/journal.pone.0000764
Not a Game: Simulation to Lessen War Trauma
Virtual Iraq features two scenarios. In one, patients navigate the streets of a generic Iraqi city, walking past buildings, cars, civilians and markets. With the touch of a therapist’s keypad, a little boy might appear on a street corner and wave, apparently in friendship, or a man might stumble down the middle of the street calling for help, a sight that provokes anxiety in some veterans who have come to fear ruses. In the other scene, veterans ride in a Humvee. Other vehicles might slow down in front of them, and strangers might open fire. Enemy combatants might appear under bridges. Objects dotting the roadside might explode as the Humvee passes.
The patient cannot shoot back at the insurgents and also cannot die or be wounded in the simulation.
Monday, August 27, 2007
In the game, there was a real diversity of response from the players to the threat of infection, similar to those seen in real life. Some acted selflessly, rushing to the aid of other characters even though that meant they risked infection themselves. Others fled infected cities in an attempt to save themselves. And some who were sick made it their mission to deliberately infect others.
Researcher Professor Nina Fefferman, from Tufts University School of Medicine, said: "Human behavior has a big impact on disease spread. And virtual worlds offer an excellent platform for studying human behavior.
She said a major constraint for epidemiologists studying disease dynamics at the moment was that they were limited to observational and retrospective studies. It would be unethical to release an infectious disease in real life in order to study what the consequences might be.
The untapped potential of virtual game worlds to shed light on real world epidemics
Eric T Lofgren & Nina H Fefferman
The Lancet Infectious Diseases: Volume 7, Issue 9, September 2007, Pages 625-629
Sunday, August 26, 2007
Now it seems,
"We earnestly desire the healing of our beloved communion but not at the cost of rewriting the Bible to accommodate the latest cultural trend," Akinola said. "We cannot turn away from the source of life and love for a temporary truce."
Saturday, August 25, 2007
This video is to convince 'the fan' of Ryan Reynolds that he certainly was in a TV sitcom, I suppose it is a fun clip and at least it’s not from Waiting!
What brought all this on? The cover story in the August issue of The Advocate (
Man in the mirror
which describes how (as they put it), in his new movie The Nines, the queer writer John August behind Go and Charlie and the Chocolate Factory cast one of the hottest straight movie stars in
The Advocate answered with an ‘interview’ -
John August talks to Ryan Reynolds
JA:But in real life, do you have to get your publicist involved in things?
RR:Yes, recently. [Laughs] I did an interview also for this movie for another magazine. The subject of religion came up, and I said some things that might have been somewhat provocative for certain groups in the
JA:There’s this need to create narrative. They have all these little snapshot images of this celebrity with that celebrity, and it becomes a process of creating an elaborate scenario that would explain why she was with him on that day and another guy on a different day. And why she would look unhappy taking groceries out of her car.
RR:Yeah, they’d never assume that it’s because the paparazzi is taking a picture and opening up their life with a jackhammer. They’re taking 140 shots a minute, and then they choose the one where you look like you’re frowning or a little bit upset or a little bit anything. Suddenly that becomes the story, which turns into “fact” shortly afterwards. It’s crazy. It’s stressful for the people who are under this microscope, and it’s stressful for the people around them as well. Because if you’re dating a girl, and you’re photographed with another girl who happens to be famous, and they’re cropping out the eight people around you—suddenly you’re in hot water for no reason at all.
RR Hence the witch hunt. That’s what frustrates me about some of the celebrity blogs in particular. They’re so obsessed with outing certain celebrities or punishing the people they think should be out that it turns into sort of this new McCarthyism.
If I were a gay man, I’d like to believe that it would be my choice if I were to publicize that or not.
There is much more substance in the section
Describing John August and Ryan Reynolds travels to
It’s tempting to try to equate what’s happening in
Africawith the American experience, but it’s a mistake. Our poor people don’t forage for roots in a famine. The African AIDS crisis is of a completely different scale and time line. After a church service, the orphans—my orphans—got pamphlets in Chichewa with a red AIDS ribbon on the front. I was excited until I realized there were only Bible verses printed inside. Cultures move at their own speed, and my frustration can’t change that.
If there’s a commonality I saw, it was the way the orphans of
have banded together. Lacking parents and traditional families, they take care of each other. That’s long been part of the queer experience. For generations, gays and lesbians were virtual orphans, disowned by their families. That’s changing, quickly. My hope for Malawi , for Malawi Africa, is that this upcoming generation can be the last of its kind. If this generation of orphans begets another generation of orphans, we’ll have all failed.
Friday, August 24, 2007
The Adult Film Industry: Time to Regulate?
Their thorough analysis will be helpful to anyone who has an interest in this influential field. Not least, is their list of references which also includes active links.
The primary concern and their reason for suggesting more regulation is the welfare of those who work in the industry. It is certainly refreshing to see a case being presented without a hidden "moral" agenda. But we do have a nagging concern that may creep into the equation if politicians and bureaucrats the arbiters of the potential policy changes they highlight
Potential Policy Changes
- National legislation that includes regulation of internet-based adult films
- Mandatory condom use with condom seal of approval
- Film rating system based on set safety criteria
- Licensure of performers
- STD testing paid for by the industry
- Vaccinations against human papillomavirus and hepatitis B and post-exposure prophylaxis paid for by the industry
- Education and training of all workers and employees
- Legal age of performers raised from 18 to 21 years old
- Drug testing of performers
In the health care setting, it is hard to imagine a clinic or hospital not providing and requiring its employees to wear gloves or other personal protective equipment. If a health care worker has a needle stick or other potentially infectious fluid exposure on the job, systems are in place to rapidly and effectively treat the employee to prevent transmission of HIV and other infectious diseases. Although a legal industry, adult film has allowed consistent exposure of its employees to HIV, hepatitis, human papillomavirus, herpes simplex virus, chlamydia, gonorrhea, and other diseases without liability or worker recourse.
They also raise other issues
The portrayal of unsafe sex in adult films may also influence viewer behavior. In the same way that images of smoking in films romanticize tobacco use, viewers of these adult films may idealize unprotected sex. The increasingly high-risk sexual behavior viewed by large audiences on television and the Internet could decrease condom use. Requiring condoms may influence viewers to see them as normative or even sexually appealing, and devalue unsafe sex. With the growing accessibility of adult film to mainstream
, portrayals of condom use onscreen could increase condom use among viewers, thereby promoting public health. America
In contrast to heterosexual adult films, homosexual-targeted productions more consistently require condoms. Due to the large number of HIV-positive performers, there is no requirement for HIV testing and condom use is the norm. Despite the ubiquitous use of condoms, homosexual adult movies are popular and profitable for production companies. In fact, there is some evidence that homosexual male audiences would not tolerate movies with unsafe sex, likely due to their proximity to many with HIV in the homosexual community. Some homosexual audiences regard watching sex without condoms as "watching death on the screen".
We wholeheartedly agree with the value of modeling the use of condoms. Unfortunately, the conclusion that barebacking is taboo is more wishful thinking than fact.
Vivid Entertainment Group, one of the largest producers of adult film in the
, temporarily implemented a condom-only policy after the HIV outbreak in 2004 but has since reversed this company policy. Although some companies may voluntarily decide to be condom-only, it is unlikely that this industry will establish safer working conditions for employees without external regulation. A state or national mandate would level the playing field for all companies and not give an unfair advantage to those who decide to produce films without condoms. US
There are numerous other international models for condom enforcement in sex work, from
to Mexico City . While there is no clear model for mandatory condom use in adult film, Brazil boasts an 80% condom usage rate in their adult films, while still maintaining a large share of the international market as the world's second largest adult film industry Amsterdam
But they seem to ignore the issue that the Brazilians like the French, gave attempted to eroticize the condom, overtly -- if not blatantly -- incorporating it into sexual activity. Rather than the
It is also possible to use filming techniques to reduce the visual effect of condoms, by using flesh tone-colored condoms or by digitally removing them post-production. Facial ejaculations could be simulated through the use of inert materials such as liquid antacids combined with filming techniques, which would eliminate any health risk to the performer.
This accepts notions of risk reduction which are not necessarily valid and, even entrenches them. More significantly, it undermines the proposition of eroticizing the condom. As we have always done, we maintain that safe sex can and should be vibrant, erotic, and overt.
Sanitization, morally or practically will undermine this whole process --- as we have already seen in the "politicizing" of sex and prevention.
The Adult Film Industry: Time to Regulate?
Grudzen CR, Kerndt PR
(2007) PLoS Med 4(6): e126 doi:10.1371/journal.pmed.0040126
Link to PLoS article [open access]
In a Boston, Massachusetts court case that could have far-reaching consequences for transsexuals a government witness testified Thursday that transsexuality has no medical basis.
Rhiannon O'Donnabhain is suing the IRS after it refused to allow her to deduct the $25,000 cost of her sex reassignment surgery. The IRS maintains the surgery is cosmetic and not medically necessary.
On the witness stand Thursday, testifying for the government , 'forensic psychiatrist Dr. Park Dietz claimed that to be classified as a disease all disorders, including transsexuality, must have "an underlying pathological process." "There are variations in human nature, and these variations are not diseases," Dietz said on the stand.
On cross examination O'Donnabhain's attorney, Bennett Klein, from the Gay and Lesbian Advocates and Defenders disputed his claim and called into question his credibility as a witness.
Klein questioned Dietz about his testimony in the 2002 trial of Andrea Yates, the Texas woman who drowned her five children. In that trial Yates had pleaded not guilty by reason on insanity. She was found guilty of murder after Dietz testified she may have seen an episode of Law & Order just prior to the children's drownings in which a woman was acquitted by reason of insanity after drowning her children. After her conviction it was learned that no such episode existed, and the conviction was overturned. In federal court in Boston on Thursday Dietz denied Klein's assertion that he had given "false testimony" in the Yates case. Dietz acknowledged that he had made a "mistake," but said his testimony was "erroneous, not knowingly false."
GLAD attorney Karen Loewy told the court that there is medical consensus that gender identity disorder is a "legitimate serious medical condition."
Thursday, August 23, 2007
The analysis was carried out by an expert panel appointed by
Professor of nutrition Esté Vorster, director of the Africa Unit for Transdisciplinary Health Research at
The analysis was necessary because of widespread beliefs in
She attracted ridicule at last year’s International AIDS Conference for requiring the South African government’s stand at the conference to display these vegetables, and has become widely known in the South African press as Dr Beetroot
''The panel has concluded that no food, no component made from food, and no food supplement has been identified in any credible study as an effective alternative to appropriate medication,'' said Wits professor and National Health Laboratory Services pathologist Barry Mendelow, a specialist in blood disorders who chaired the study.
Scientists believe that an outbreak of pandemic influenza, could be a far greater threat, and governments across the world have been asked to plan for its arrival. A completely new strain of pandemic flu, however, is likely to be virulent because humans do not have any resistance to it. The focus in recent years has been the H5N1 virus in birds, which can infect - and kill - humans, but only those in close contact with affected poultry. At the moment, the virus cannot be spread from human to human - the fear is that it will mutate and achieve this possibility.
Cholera has also made a comeback in the last 25 years, says the WHO, which wants to see renewed efforts to control it. Apart from conflicts and natural disasters, the WHO says that the increasing urbanisation of many countries means thousands living in poor accommodation on the outskirts of major cities, with cholera the inevitable result.
Tuberculosis, now one of the major killers of people with AIDS, accounts for approximately 1.5 million deaths worldwide a year. Antibiotic therapies do exist, but many patients do not have access to them. The WHO expresses major concern for increasing resistance of the bacterium which causes TB to these antibiotics.
Wednesday, August 22, 2007
Watchdog group warns of faulty "ex-gay" study
a gay rights advocacy group has contacted several news outlets to warn of a fallacious report being released this year citing the supposed success of "ex-gay" therapy. The report, titled "The Thomas Project," is being published by Dr. Stanton Jones Provost and psychology professor of
New AVAC Report Examines State of the AIDS Vaccine Field and Calls for New, Ambitious Deadlines for Vaccine Development
The non-profit AIDS Vaccine Advocacy Coalition (AVAC) founded in 1995 has released its annual report examining the state of the AIDS vaccine field at the AIDS Vaccine 2007 Conference. The new report, entitled Resetting the Clock, outlines the specific deadlines and challenges facing the field in the arenas of AIDS vaccine scientific strategy, clinical trials, and the broader prevention field and provides recommendations for action by researchers, policymakers, industry, funders, civil society, and advocates, including AVAC.