Friday, August 31, 2007

Drinkers & HIV

Keith Alcorn, reports for Aidsmap(August 31, 2007)

Heavy drinkers living with HIV have lower CD4 counts

HIV-positive people not taking antiretroviral treatment who are heavy drinkers have lower CD4 counts than moderate drinkers or those who never drink. However, the same difference isn’t true for people taking antiretrovirals, and alcohol consumption doesn’t affect viral load, according to a study by researchers from Boston reported in the Journal of Acquired Immune Deficiency Syndromes.

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
Russia or South Africa, the researchers say that the findings could have major public health consequences.

Reference

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)

Link to JAIDS abstract

Link to Aidsmap report

The Best Health Care system . . . .

Kevin Sack reports for the New York Times (August 31, 2007)

Cancer Society Focuses Its Ads on the Uninsured

in an unusual development the American Cancer Society plans to devote its entire $15 million advertising budget this year to highlighting the consequences of inadequate health coverage. The society has expressed frustration that cancer rates are not dropping as rapidly as anticipated and noted the of recent research linking a lack of insurance to delays in detecting malignancies.

Several other organizations, including the American Heart Association, the American Diabetes Association and the Alzheimers Association, said they applauded the campaign’s message that progress against chronic disease would be limited until the health care system is fixed

John R. Seffrin, the chief executive of the cancer society said his organization had concluded that advances in prevention and research would have little lasting impact if Americans could not afford cancer screening and treatment.

“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.


Link to NY Times report

American Medical Association - Voice for the Uninsured
Link to AMA (Uninsured)

Thursday, August 30, 2007

Jimmy Kimmel Explains

A bit of Fry and Laurie

CXCR4

David McLay, writing for Aidsmap (August 30, 2007) in

Emergence of CXCR4-tropic HIV raises risk of AIDS fourfold

reports more evidence of a link between the presence of HIV that uses the CXCR4 co-receptor and faster HIV disease progression has emerged in the findings of a study by researchers at the University of California–Los Angeles, reported in the September 1st issue of Clinical Infectious Diseases.

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.

Reference

Baseline HIV type 1 co-receptor tropism predicts disease progression
Eric S. Daar et al.

Clinical Infectious Diseases 45:643 – 649, 2007.


Link to CID abstract

Link to Aidsmap report

HIV self-testing

Reuters Health (August 28, 2997) reports in

HIV self-tests ineffective in high-risk individuals

that in a study conducted at two major HIV centers in Singapore, it was found rapid HIV self-tests were used improperly, or the results were interpreted incorrectly, by individuals at risk for HIV infection or those who were already infected.

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."

reference

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, August 1, 2007.


Link to JAIDS abstract


Link to Reuters Health report

Senator Craig - Tap Three Times

nasty bad naughty boy

Wednesday, August 29, 2007

A Bit of Fry and Laurie

CNN Out In The Open with Dan Savage

The best health care system in the world


Natasha Singer writing for New York Times: Health (August 29, 2007) in

Botox Appointments Faster Than for Moles, Study Finds

reports that patients seeking an appointment with a dermatologist to ask about a potentially cancerous mole have to wait substantially longer than those seeking Botox for wrinkles, according to a study published online by The Journal of the American Academy of Dermatology.

Dermatologists in 12 cities offered a typical wait of 8 days for a cosmetic patient wanting Botox to smooth wrinkles, compared with a typical wait of 26 days for a patient requesting evaluation of a changing mole, a possible indicator of skin cancer.

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.


Reference


Short wait times for patients seeking cosmetic botulinum toxin appointments with dermatologists
Jack S. Resneck et al
Journal of the American Academy of Dermatology doi:10.1016/j.jaad.2007.07.020

Link to JAAD article


Link to NY Times article


Meanwhile, an Editorial in the same New York Times (August 29, 2007) in


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.

Last year, the number of uninsured Americans increased by a daunting 2.2 million, from 44.8 million in 2005 to 47.0 million in 2006.

The one area where the nation had made progress — reducing the number of uninsured children — took a turn for the worse. The number of uninsured children under 18 dropped steadily and significantly from 1999 to 2004, Then last year the number of uninsured children jumped more than 600,000 to reach 8.6 million.


Link to NY Times editorial

HIV in semen

Michael Carter, writing for Aidsmap (August 28, 2007) in

HIV levels peak in semen 3 - 4 weeks after infection

reports HIV viral load is at its highest in semen three to four weeks after infection with HIV, according to a study published in the August 20th edition of AIDS. The study also revealed that individuals with late-stage HIV infection also have high viral loads in their semen, and the investigators believe that their findings confirm earlier suggestions that individuals recently infected with HIV as well as those with advanced HIV disease, are particularly infectious and are driving the spread of HIV.

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
US state of North Carolina, as well as in Malawi, South Africa, and Brazil.

Reference

Amplified transmission of HIV-1: comparison of HIV-1 concentrations in semen and blood during acute and chronic infection

Pilcher, Christopher D et al
AIDS. 21(13):1723-1730, August 20, 2007

Link to AIDS abstract

Link to Aidsmap report

International reputation

Peter Brookes - TheTimes

Organ donors wanted

Jane E. Brody writing for the New York Times: Personal Health (August 28, 2007) in

The Solvable Problem of Organ Shortages

draws attention to the shortfall in the number of donor organs needed in the United States. As of June, 97,000 people awaited lifesaving transplants, and each day the waiting list grows five times faster than the donation rate.

People typically wait three to five years for donated organs, and each day 17 of them die.

But, as the acting Surgeon General Dr. Moritsugu noted recently in The Journal of the American Dietetic Association, “The shortage of donor organs is a medical problem for which there is a cure.”

Brody looks at the whole picture, including addressing fears and celebrating the personal stories and illustrating the impact of donations.

She also suggests there are several ways to increase the supply of organs. But the success of any transplant program depends on the number of individuals who indicate in advance of their death their willingness to be donors. While most Americans say they approve of donation, only about one person in four has indicated that by signing forms. In Europe, where you are considered a potential donor unless you expressly declares that you do not want to be one, more than 90 percent of people are organ donors.

So, perhaps the most valuable impact of the article may be the link to organdonor.gov and the suggestion to download an organ donor card. Take a look!

Link to Organdonor.gov.


Link to NY Times article

Tuesday, August 28, 2007

Dedicated to: Toe-Tapping Larry: I'm Not Gay

Juvenile violence

Martin Rowson- The Guardian

Deadly virus & the fruit bat

Nicholas Bakalar writing in the New York Times: Health Section (August 28, 2007) in

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 Marburg virus in a non-primate species — bats. BBC News also covers the story.

The researchers, from the US Centers for Disease Control and Prevention and Centre International de Recherches Medicales de Franceville in Gabon, who are investigating the death of a gold miner from Marburg fever in western Uganda, found that the virus is common in only one species of fruit bat. Scientifically known as Rousettus aegypticus, the bat is found across sub-Saharan Africa. The researchers are trying to determine if bats harbor the disease between periodic outbreaks in southern Africa.

Marburg and the related Ebola virus have caused in the past large outbreaks with extremely high mortality rates, 80 to 90%, in humans and great apes.

The largest outbreak of the Marburg disease occurred in 2004-2005 in Angola and killed more than 300 people.

reference

Marburg Virus Infection Detected in a Common African Bat
Jonathan S. Towner et al
PLoS ONE 2(8): e764. doi:10.1371/journal.pone.0000764

Link to PLoS ONE article

Link to NY Times article

Link to BBC news report

PTSD: a treatment

Amanda Schaffer writing for New York Times: Health (August 28, 2007) in

Not a Game: Simulation to Lessen War Trauma

reports on Virtual Iraq, a computer simulation created to treat Iraq war veterans suffering from post-traumatic stress disorder (PTSD)

By repeatedly encountering sights, sounds, smells and rumblings that evoke painful memories, experts say, veterans with the disorder can begin to reprocess traumatic events and become desensitized to them.

The simulation is available to a small number of patients at sites including the Veterans Administration Medical Center in Manhattan, the Naval Medical Center in San Diego, the Emory University School of Medicine in Atlanta and Walter Reed Army Medical Center in Washington.

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.

In choosing which stimuli to introduce, the therapist’s goal is to evoke the conditions present when specific traumatic events occurred, as accurately as the simulation will allow. Smells like spices, burning garbage or body odor can be emitted in four-second puffs. And the scene can be set to day or night, sun or fog or even a sandstorm.

Dr. Albert Rizzo, the director of the Virtual Environments Lab at the University of Southern California who helped develop the simulator first created a simulation for Iraq veterans with the disorder in 2003, by modifying the Xbox game Full Spectrum Warrior. In 2004, he and Ken Graap, president and chief executive of Virtually Better in Decatur, Ga., received financing from the Office of Naval Research to develop the current simulation, with extensive feedback from veterans and active-duty members of the military.

Link to Virtually Better site


Link to NY Times story

Monday, August 27, 2007

With all due respect . . . .

Camilla is not going to attend the Diana Memorial Service on Friday

Moorland - The Times

Disease 'games'

BBC News on line (August 21, 2007) reported last week in

Virtual game is a 'disease model'

An outbreak of a deadly disease in a virtual world can offer insights into real life epidemics, scientists suggest. The "corrupted blood" disease spreads rapidly within the popular online World of Warcraft game, killing off thousands of players in an uncontrolled plague. The infection rages, wreaking social chaos, despite quarantine measures. The experience provides essential clues to how people behave in such crises, Lancet Infectious Diseases reports.

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.

reference

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

Link to Lancet ID abstract


Link to BBC news report

The Gonzales Legacy

Sunday, August 26, 2007

Ooh, Vicar!

Last month the steering committee for the Global South Primates, (the Southern Comfort) made up of churches mainly in the developing world and the most conservative in the worldwide Anglican Communion, said its bishops will boycott the once a decade meeting of the Church – the Lambeth Conference - because the US Episcopal Church, is allowed to participate.

Now it seems, New Hampshire's Episcopal Bishop, Gene Robinson, told the BBC that he and his partner of 18 years, Mark Andrew, 53, will have a civil union shortly after the state's civil union law goes into effect next year. The Southern Comforts fume!

The Dark Lord, their leader Peter Akinola theArchbishop of Nigeria issued a statement saying the "the moment of decision is almost upon us" about whether Anglican conservatives and liberals can stay together.

The statement went on to say that theological conservatives cannot stand by as the U.S. Episcopal Church - the Anglican body in the U.S. - and the Anglican Church of Canada move toward full acceptance of gay relationships.

"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."

I recently heard of President Jimmy Carter saying that the problem with fundamentalists is that they can never admit that they might be wrong because if they are mistaken then so is God.

Meanwhile, remember the 18 men in northern Nigeria accused of homosexuality and awaiting sentencing on morals charges that we spoke of not long ago? A mob attempted to break into their prison on Saturday and lynch them. Doesn’t Nigeria need some moral leadership --- let alone some Christ-like charity --- but then the Archbishop is busy elsewhere?

*New Rules* Aug 24, 2007

Saturday, August 25, 2007

Lady Constance's culture corner


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 (August 28, 2007)


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 Hollywood to play himself. Then last month they ran off together to Malawi. So what exactly is going on between these two?

The Advocate answered with an ‘interview’ -

John August talks to Ryan Reynolds

On Religion

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 United States of America. Now, I have no concrete idea as to what the state of religion is or what it should be, nor am I qualified to even speculate on that, but I did nonetheless. I was driving home and I thought, He asked some really good great questions, especially that one about religion—oh, shit. That’s when you call your publicist and you say “Look, I might have said, ‘Religion poisons everything good in this world,’ uh…that might be a problem.”

On Paparazzi

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.

On Outing

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

Out of Africa

Describing John August and Ryan Reynolds travels to Africa to help build an orphanage in Malawi. It also features August’s “candid” shots of their journey. As well as his personal observation:

It’s tempting to try to equate what’s happening in Africa with 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 Malawi 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 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.

Link to The Advocate: Out of Africa

Friday, August 24, 2007

Pass the liquid antacid ---- please!

Corita R. Grudzen and Peter R.Kerndt have published a study (posted 08/06/2007) in the journal PLoS Medicine

The Adult Film Industry: Time to Regulate?

They remind us that the United States adult film industry produces 4,000-11,000 films and earns an estimated $9-$13 billion in gross revenues annually. An estimated 200 production companies employ 1,200-1,500 performers.Performers typically earn $400-$1,000 per shoot and are not compensated based on distribution or sales.

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

Even so, it is hard to dismiss their contentions about participants safety especially when compared with other industries:

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.[16] 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 America, portrayals of condom use onscreen could increase condom use among viewers, thereby promoting public health.

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.

Perhaps it is for this reason that Vivid felt they could get away with changing their policy

Vivid Entertainment Group, one of the largest producers of adult film in the US, 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.

They also remind us that there are situations where this work;

There are numerous other international models for condom enforcement in sex work, from Mexico City to Amsterdam. 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


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 US example of "now you see it now you don't". Where the condom seem be have magically appeared and is only accidentally glimpsed.

We part company with them when they appear to embrace even more subliminal safe sex

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.

reference

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]

Transsexuality "cosmetic"

365Gay.com Newscenter Staff report (August 24, 2007) in

Gov't Witness: Transsexuality Not Medical

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."

Attorneys were given a Nov. 6 deadline to file briefs to Judge Joseph Gale. He did not indicate when he would issue a ruling.

The IRS itself has issued at least two separate rulings in other cases. In a 2005 case, the IRS ruled the costs of a woman's gender reassignment surgery and related treatments were not deductible as medical expenses. They cited the section of the tax code that says cosmetic surgery or similar procedures are deductible only when they are needed to improve a congenital abnormality, an accident or trauma, or a disfiguring disease. In a 1983 case, however, the IRS allowed a father to deduct his transportation costs when he accompanied his college-age son to a clinic where he received a sex-change operation.

An estimated 1,600 to 2,000 people a year undergo sex-change surgery in the United States, according to the Gay and Lesbian Medical Association.


Link to 365gay.com news story

America To The Rescue

Thursday, August 23, 2007

Beetroot rejected

Keith Alcorn writing forAugust 23, 2007) in

Food cannot replace medicine for HIV/AIDS and TB, South African experts say

reports an extensive analysis of all scientific research on the links between improved nutrition and the treatment of both HIV/AIDS and tuberculosis has found no evidence that healthier eating is any substitute for correctly-used medication.

The analysis was carried out by an expert panel appointed by South Africa’s Academy of Science of South Africa (ASSAf), an independent statutory body that advises the government.

Professor of nutrition Esté Vorster, director of the Africa Unit for Transdisciplinary Health Research at North-West University, said that malnutrition and poverty remained a contributing factor in many infections, including HIV/AIDS and tuberculosis. ''Neither poverty nor malnutrition is the cause of HIV/AIDS or tuberculosis,'' she emphasized.

The analysis was necessary because of widespread beliefs in South Africa that antiretroviral treatment was unnecessary if a person eats a healthy diet and that AIDS is caused, in part, by malnutrition. These beliefs have been promoted by Health Minister Manto Tshbalala Msimang, who has become notorious for her promotion of garlic, African potato and beetroot as vegetables that can delay the onset of AIDS.

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.

Link to assaf report


Link to aidsmap report


Global risks

BBC News on line (August 23, 2007) reports

WHO warns of global epidemic risk

World Health Organization experts, in its report "A Safer Future", highlighted several major threats to health in the 21st century claiming new killer diseases are emerging faster than ever across the world.

One of the biggest worries for those looking at global health is the sudden rise of a new and deadly illness. Air travel and a worldwide market in live animals means that a virus could sweep across continents in just a few months.

We already have some experience of this. In 2003, the SARS virus caused an unprecedented panic: A contagious illness, with a week's delay before the emergence of symptoms, and a very high death rate - potentially a very dangerous cocktail.

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.

The 1990s, saw the nightmare illnesses, predicted by some to be capable of spreading like wildfire due to modern travel habits. Viruses such as Marburg and Ebola have some of the highest fatality rates of all, and can kill within just a few days. Tropical Africa is the hotbed for haemorrhagic fevers, and victims develop a high temperature, diarrhoea, and then severe bleeding, and are highly contagious. Ironically, it is the swift and deadly nature of these infections which offers some protection for the rest of the world, as infected people quickly become too ill to travel.

It is not only the threat of new diseases that is worrying The WHO also worries that many of the world's best known diseases have been given a fresh "licence to kill".

A million people die from malaria every year worldwide, and the WHO says that not enough is being spent to stop this number increasing.This means that malaria is emerging in new areas, or coming back in areas where it was thought to be eradicated and the parasite that causes the disease is becoming more resistant to some of the most common treatments.

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.


Link to WHO report

Link to BBC news report

Wednesday, August 22, 2007

Condoms

Mummy Says Yes

Doubting Thomas

The Advocate on line reports (August 22, 2007) in

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 Wheaton College, a conservative university, according to Truth Wins Out.

The five-year study centers on Exodus International clients and will include handpicked testimonials from "ex-gay" lobbyists and ministry leaders. According to Truth Wins Out, there is no physical, scientific evidence to support the study, and no sign of physical verification such as an MRI.

Link to The Advocate news report

Link to Truth Wins Out

Link to Stanton Jones page at Wheaton

AIDS Vaccine: Resetting the Clock


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.

Link to AVAC reports