Tuesday, August 11, 2015

License mislaid

It is 6 a.m. and the rats are twittering in the ducts of this basement, where I have taken refuge. Yesterday afternoon, I phoned the San Diego Police Department's outpost on Skyline Drive to speak to officer B. Downing, who arrested me July 31.

I asked him to cast his mind back to the events of that evening to see if he could shed any light on the whereabouts of my driver's license.

In the process of being ejaculated out of the county jail system in the wee small hours of Thursday, Aug. 6, the very last thing that happened, after handing back prison clothing and putting on the traditional shorts and wifebeater I had been arrested in, was the formal handing back of my personal property, which must be signed for without opening the sealed plastic bag in which it has been stored.

But, here's the thing, there are signs all over the room (at this final point of the labyrinthine path out of the belly of the beast) and those signs clearly state that it is forbidden to open the sealed bag before you are out of the building.

Looking back, I suppose there might have been a way for me to carefully verify (through the clear plastic) that all my cards were present in the little metal wallet thing I had bought, many years ago, from the shopping channel.

So I signed for my bag of wallets (I also carry a small leather wallet that holds such things as medical insurance IDs and the sort of cards that might qualify me for a free cup of coffee if sufficient holes are punched in it for all my cups of coffee that yearn to be free).

You know where this is going. It was only when I was standing under the street lights on the sidewalk of Front Street, enjoying the fresh night air, that I discovered my driver's license was not in the bag.

I had my bank debit card. And the first thing I did was stroll into a 7-Eleven for the biggest cup of black coffee and the most exotic pack of cigarettes. It turns out the 7 Eleven sells non-filtered Turkish cigarettes, which were fairly satisfying. And then I started walking to the downtown Police Station to lodge an official complaint.

I felt a little like Terence Stamp in The Limey (1999) as I strode past the huddled masses of homeless Americans. San Diego's main polices station was, at that time of night, still closed to the public. But I found my way into the employee parking lot and accosted a sergeant who was working in his car.

Why would I wish to lodge a formal complaint against my arresting officer? Well, a funny thing happened, back on July 31, on our way to the downtown police station. This was after I had been placed, handcuffed, in the back of his car. We left the rented townhouse that had been my home and we turned right into Imperial Avenue. I wondered, at the time, why he stopped opposite the main entrance to Greenwood Cemetery and then doubled back. He parked in the middle of the road, next to the median, opposite the 24-Hour Fitness. We were safe enough from passing traffic, because all those pretty lights on the roof were flashing, but without the siren. Officer Downing was rushing up and down the street with a flashlight, looking for something.

When, at last, he got into back into the car, I asked him what was up. He was quite embarrassed to tell me he had made a mistake. Most police officers are accustomed to using the hood of a police car as a convenient desk. And Downing had spread my belongings on the hood, before we set off, and then forgotten about them when we drove away. He told me he had seen my cards falling off as we accelerated along Imperial.

In the back seat, my hands locked behind my back, I had been unable to see much. He checked off that he had all the items that were loose in that metal wallet thing I had bought from QVC. He had my EBT card, my worthless Unemployment Insurance Card, my Fresh & Easy customer loyalty card, my bank debit card and MY DRIVER'S LICENSE. It was only when we were certain all those items were in his possession, that we drove to the downtown police station, in the basement garage of which, he finished off all his official report writing, prior to driving me to the UCSD Hospital, where my right hand was x-rayed for a suspected fracture of the pinky finger.

And, at that time, Downing who, in many ways, is a decent man and a considerate man, possibly also a brave man (ex USMC, two tours in Afghanistan and two in Iraq) confirmed to me that his report would have to include the whole embarrassing story of how he scattered my belongings along the highway after having left them on the hood of his police car.

Well, standing outside that basement garage of the downtown police station nearly a week after the fact, I told the story to several sergeants. And they all agreed there was no need to make a formal complaint, considering how simple it is to go to the DMV and be issued with a duplicate driver's license. Also, this was the wrong place to lodge such a complaint, because Officer Downing doesn't work out of that police station. He's based out on Skyline and we only dropped by the downtown location because that's what every cop does when he's taking a prisoner to the downtown county jail.

But I do recall there was a moment when Downing mentioned to me that he had my driver's license separate from my other property. I'm just not entirely sure whether that was in the car, at the police station, in the hospital waiting room or at the jail. At all of those junctures, he would have needed to look at it so he could enter my personal details into whatever part of the system he was committing me to at that point.

As it turns out, the DMV is not about to issue me with a duplicate license very easily. So I'll just hope the license turns up in a drawer at the jail or in the laundry of Officer Downing. Stranger things have happened.

Friday, August 07, 2015

When your own family sends you to jail...

Wow! What a week I've had. I don't suppose it occurred to anybody to check the San Diego County Jail.

Absolutely nobody bothered to check the San Diego County Jail. I'm out now, but it was a damned close run thing. It was a lost weekend that lasted from 8:30 p.m. Friday until 4 a.m. Thursday.

Fortunately, I have my Get Out Of Jail Free card. White privilege? I never leave home without it. What does not kill me seems to make me stronger. They let me out at 4 a.m. and liberty smells sweet in every way.

I owe some serious apologies to Sanns Dixon, because my incarceration prevented me from acting in the movie he had planned to shoot yesterday (Wednesday).

All last week, my stepdaughter told me she would buy groceries on Friday. Look at what she bought. Five boxes of Cheezits? Seriously? And my son-in-law's riposte was, "You don't have to eat it." Can you imagine a stupider remark? I was annoyed. But is that any reason to spend a week in jail? Who needs family like that? I've got to get out of here.

I never actually slapped anybody. Her husband (who has won cups for karate) twisted my pinky, causing a serious sprain. And, when I pulled it away, my fingers made the gentlest contact with her cheek. This was the "battery" that sent me to jail.

Those who expected me to remain in custody should be aware of the nickname bestowed upon me in 1992 by the national organizer of the Communist Party of Great Britain (Provisional Committee): The Teflon Bolshevik. Seriously, if I didn't have this white skin and a middle-class education, I'd be dead meat, by now.

Memorize the phone number of a reliable friend, just in case you ever find yourself in the lock up with no money and no chance of bail. They allow free phone calls, during the intake phase. But each call costs $5 once you're "housed." If you have no money on you, when you're arrested, your only hope is for an outsider to go to the jail website at sdsheriff.net and put some money on your "book."

During Friday night or the early hours of Saturday morning, I met a gentleman who had been arrested and taken to jail barefoot and wearing a hospital gown. His only crime was getting into an argument with his brother about an overdue debt. "So, he went for his shit and I went for my shit," was the way he put it. In other words, they attempted to settle the dispute with AR-15s. The brother didn't get off any rounds at all. About four shots were fired into a corner of their mother's home, which the prisoner assures me was completely harmless.

I also made the acquaintance of a young man who was arrested on Friday night after a high-speed police chase across the Coronado Bridge, while drunk and naked with a young woman sucking his wing-wang. That's a trick I mean to put on my bucket list.

One of the most interesting men I met in the jail was Lloyd Fink, who is 11 years older than me. He was a student at NYU, back in the 1960s, when his study partner showed him a mayonnaise jar full of smart pills that he'd got from his professor Timothy Leary. With the exam two days away, they decided to try the pills. Fink says he thought taking two pills would make him twice as smart. So they dropped the acid and very soon they were wrestling with paisley-patterned hallucinations. Neither of them made it to the exam hall. As soon as I was released, I made a couple of calls so that Lloyd got out on bail by 6 p.m. How he's going to get into his apartment is entirely his problem. The police who arrested him locked his keys in there when they slammed the front door shut.

So many times I have overheard one side of a telephone conversation that suddenly goes into:

"You're my boo and the reason I love you so much is because you're having my baby…"

I think I heard the same prisoner say those words in three different phone calls, probably to three different women.

Sometimes it goes like:

"I know we broke up and I know things were never right between us, but please be there for me while I'm in here. I really need someone."

Probably the most impressive character I met during the first 24 hours of incarceration was a drug dealer who bore an uncanny resemblance to Antonio Banderas. They pulled him over in North Park with a pound of meth in his car. Everybody in the tank looked to him for advice and guidance, because... Charisma? Intellect? At least we got each other's jokes. Heavy hitters like that get housed on the 5th floor of the jail. I was on the 4th with the punks and junkies.

Fifth-floor prisoners get access to the commissary, where you can buy food that is not sub-standard bologna and such luxuries as instant coffee. Down on the 4th floor, there are no luxuries. And they don't offer any hot drinks at all. It's the tap water in the cell, six ounces of apple juice per day, 12 ounces of milk. The nurse gave me Ibuprofen to help with the caffeine withdrawal. After a couple of days, I started passing my Ibuprofens to my celly, who was suffering severe pain from scoliosis.

Jail routine is bizarre.

4 a.m. Breakfast (oatmeal or grits with waffles in a plastic-wrapped tv-dinner tray.


Noon Lunch is four slices of wheat bread, two slabs of the worst bologna imaginable, a slice of pretend cheese, a small sachet of coleslaw dressing. This comes in a plastic sack and they throw it at you three times a day, during the 24 hours it takes to be processed into the modules. Once housed, you get two sugar cookies, 6 ounces of orange juice and 6 ounces of fat-free milk with lunch. There's also soup that they ladel into your cardboard tray once you've scooped the sandwich makings out of it. Those cardboard trays come in handy, in the cell, for stashing the odd cookie for the long periods of lockdown.


4 p.m. Dinner, which is something hot in a tv-dinner-style box. Last night was maceroni with hamburger helper and quite tasty. I got a double helping, because, on that day, I was one of those entrusted to hand them out. There was also a small bag of chopped lettuce and a sachet of Italian dressing with that.

Lockdown. Sometimes, when this lockdown ends, I wake up from a deep sleep and think it's tomorrow. But it's only 8:30 p.m. the same day.

8:30 p.m. Potential free association with the television on. But you don't get to choose the channel and you might get locked down in the middle of an episode of... Friends? I laughed at a line in Friends, three days ago. I call that my Papillon moment.

10 p.m. Final lockdown.

2 a.m. Medication. They finally got around to finding me some HIV drugs, which are supposed to be taken with food. I took the option to hold onto them until breakfast rather than accept another gratuitous bag of bread and bologna. All that sodium is going to kill me.

The deputies brighten up an otherwise dull lockdown by dropping by and demanding to check identity wristbands. I hadn't planned a tunnel, because it would only lead me to the 3rd floor.

Nothing like incarceration to bring me back to reading The San Diego Union-Tribune, every section. The whole module agreed that George Varga's pre-gig interview with Bill Maher was lame as fuck. Everybody agrees with me Nick Canepa is the finest writer in the county. Last night, I completed both crosswords!

Deputy: So what brings you here?

Burgess: At 58 years old, I embarked upon a life of crime.

Kingsman was what they used to call me in jail. That's not all they called me. Sometimes it was "OG," sometimes "English." When they call me "English," I think of Col. Stok talking to Michael Caine in Funeral in Berlin (1966).

At 3 a.m. on Wednesday morning, they put two young junkies in my cell. Immediately, one of them asked me to give him my top bunk. Fuck no! They both banged around in the lower bunks for a while, but neither of them seemed able to cope with the confinement. The one who wanted my bunk ended up laying his bedding on the floor and sleeping next to the toilet. They both remained in the cell during breakfast (served every morning at 4 a.m.) and I happened to notice the cheeky bastard had climbed up into my bunk and was resting his head on my "pillow" (my sheet and blanket rolled up to serve as a bolster). My cartel-member buddy and I stormed into the cell to explain the facts of life to him, but he wouldn't move. So, on the advice of "Mafia For Life," I pulled my mattress out from under him and he fell like a rock onto the hard floor. He was like a zombie. Blank eyes. Didn't utter a sound. Just climbed back onto my bunk. So I appealed to the screws. Next thing I know, we're all on lockdown again. I moved my bedding into a nearby cell. The zombie must have made a wrong move. Something like 30 deputies turned up from nowhere and pinned him to the floor. Some were laughing. One was writing notes in a little book. One was punching the poor sod in the face. They took him out on a stretcher and I never saw him again. It was quite shocking. A man could easily die like that.

I was supposed to read the newspaper article about her to Mafia For Life, because he likes Amy Schumer. Well, that newspaper got tossed and, after the next lockdown, other things were going on in the module, so that never happened.

And there was a homeless man who told me he never pan handles or dumpster dives, because he's got eight hustles he can hook you up to. His favorite is to hang out in Starbucks and wait for you to go to the bathroom. Then he scoops up your phone, your iPad and your laptop and runs out the door before anybody gets out the second "Hey!" in "Hey! Hey! Hey!"

But the one who had two broken ribs from being wrestled to the floor by "loss prevention," was the Scotsman (Permanent Resident Alien Permit, lovely cross of St. Andrew deconstructed as a tattoo on his forearm. All he stole was a large bar of Hershey chocolate with almonds. So we, in the module, referred to him as the Hershey Bandit. Nobody in this country has heard of the Milky Bar Kid.

When my cell door opened and they called for me to roll up my bedding and walk to the gate, I could have screamed for joy.

Can you believe they still didn't wash the pan and throw away the teriyaki sauce from the chicken legs I barbecued for the kids last Friday night? So it's been sitting here a week with stuff dropping in off the trees. I would have washed it up, myself, but I was unavoidably detained.

Wednesday, March 14, 2012

Take a second look, before you endorse the KONY 2012 campaign

This may surprise you, but your enemy's enemy is not necessarily your friend. The terrible state of affairs in Uganda will offer you many permutations on that theme. But did you really think you were going to make a difference by watching a slick video and clicking on an internet link?

I'm not an expert, but here are a few angles you may want to examine before nailing your colors to the mast of the Invisible Children organization.

1. “Invisible Children is misusing funds, misrepresenting facts and possibly making the situation in Uganda worse”

2. Looks like the founder of the Kony 2012 campaign has an evangelical agenda: "...in a November 7, 2011 appearance at Liberty University, as part of Liberty's Fall Convocation speaker series, Invisible Children co-founder Jason Russell hinted that Invisible Children was also an evangelizing effort, and during his talk Russell coached Liberty University students on what could be characterized as extremely low-key, or stealth, evangelism."

3. Nationally, Ugandans are fighting to eject a U.S.-backed dictator, Gen. Yoweri K. Museveni, who has been in office for more than 26 years now and imposed his regime by brutal repression.

As you know, Gen. Museveni has stolen the last three elections, including last February's presidential election.

KONY 2012, Invisible Children's Pro-AFRICOM and Museveni Propaganda 

4. “The violence in Uganda, Congo, and South Sudan has been the most devastating — anywhere in the world — since the mid-1990s. Even conservative estimates place the death toll in the millions. And the LRA is, in fact, a relatively small player in all of this — as much a symptom as a cause of the endemic violence. If Kony is removed, LRA fighters will join other groups or act independently. Civilians will remain exposed to atrocities committed by other armed groups, including their own national armies.”

5. More about the LRA in Sudan.

6. Ugandans criticise Kony campaign

7. Social Media Scam Alert: Top Ten Ways to Tell Kony is Phony

8. Kony 2012 Hides US Support for Repressive Ugandan Regime

“Kony 2012” Director Arrested For Public Masturbation

Jason Russell, star and co-creator of viral phenomenon Kony 2012, was arrested in San Diego for public masturbation and vandalizing cars. NBC San Diego is reporting Russell was detained last night, with police describing his behavior as “very strange.” 

Sunday, September 18, 2011

Researchers Announce a Breakthrough on HIV/AIDS Treatment
A technique that alters T cells has been shown to reduce the amount of virus in infected people.

By Deborah Erickson 

For the first time, researchers have shown that a cell-based therapy for HIV/AIDS can reduce the amount of virus in infected people. The breakthrough — big news for researchers, who have struggled for decades to create vaccines and cell-based therapies for HIV — was announced on Sunday at the 51st Interscience Conference on Antimicrobial Agents and Chemotherapy in Chicago. To date, the sole treatment for HIV has been multidrug regimens that prolong life but never eliminate the virus.

Sangamo BioSciences of Richmond, California, says it has found a way to protect the T cells that HIV attacks first, so they can live to fight another day. The approach entails temporarily stopping a patient’s antiretroviral therapy and removing T cells carrying the CD4 receptor. This surface protein is the doorway by which the virus gains entry into the cell. The collected T cells are exposed to zinc finger nuclease, an enzyme designed to remove the gene for a coreceptor of CD4 called CCR5. The cells are then reinfused into the patient. Once they’re back in the body, the new study shows, the cells persist and travel in the body just like normal T cells.

Sangamo’s approach is based on the observation that some people have a naturally occurring mutation in the CCR5 gene that protects them against HIV. Ordinarily, humans have two copies of every gene. It turns out that individuals with a mutation in both copies of the CCR5 gene cannot be infected by the most common HIV strains. In people with the so-called Delta-32 mutation in just one copy of the gene, infection rarely progresses to AIDS. In the U.S., about 1 percent of the population is thought to carry the helpful mutation, which some researchers believe arose as protection against the Black Death.

Previous evidence existed showing that CCR5-negative cells could help AIDS patients. In 2007, an American man with AIDS and lymphoma received, as treatment for the cancer, a bone-marrow transplant from a person with the CCR5 mutation. The marrow recipient has been free of both AIDS and cancer since then. Sangamo’s method treats a patient’s own cells, with less risk than a marrow transplant.

“The data are very encouraging,” says Edward Lanphier, Sangamo’s founding CEO. “We are seeing a statistically significant correlation between our treatment and viral load reduction. This is a big step forward toward our goal of developing a functional cure for the disease.” Lanphier envisions that someday AIDS patients will not need to be on aggressive antiretroviral therapies because their virus will be well-controlled—or even undetectable, as happened with one subject with a mutation in one CCR5 gene.

Experts unaffiliated with Sangamo and its clinical trials agree that the scientific achievement is impressive, but they question the notion that it could yield a functional cure. Gerhard Bauer, assistant professor in the Stem Cell Program at the University of California, Davis, and director of that school’s Good Manufacturing Practice laboratory at the Institute for Regenerative Cures, says, “this is a great move forward, to demonstrate reduction of viral load by pushing in modified T cells. It has never been done before by any company, and I congratulate them 100 percent.”

However, Bauer says, he is “not so sure” the company will be able to create a functional cure. T cells don’t live forever, he points out.

“This is encouraging,” says Ellen Feigal, vice president of R&D at the California Institute for Regenerative Medicine, “and it provides supporting evidence for a study we funded that would take the work to the next step.” This study, by researchers at City of Hope, a cancer center in Duarte, California, aims to provide patients with a permanent supply of HIV-resistant T cells. The strategy calls for modifying patients’ blood-forming stem cells, which produce all future T cells as well as the macrophages and dendritic cells that can also be HIV targets.

Sangamo is also exploring the potential of stem-cell modification with City of Hope researchers, but the company does not concede that modified stem cells will be necessary or any better than T cells. “Yes, T cells turn over,” says Geoff Nichol, who joined Sangamo as executive vice president of R&D a few months ago to commercialize the platform, “but there are some very long-lasting subsets that can live for years and years and remember the epitope they came up against. We are feeling bullish about T cells because of our data.”

Sangamo’s news is “certainly scientifically interesting,” observes Warner Greene, director of the Gladstone Institute at the University of California, San Francisco. But, he points out, no cell therapy, whether it involves T cells or stem cells, is a practical approach to treating HIV/AIDS throughout the developing world, where seven out of 10 new infections are occurring. “We really need to be looking for therapies that can benefit the millions of individuals with HIV, not just a select few who might be able to afford cellular therapies.”

Copyright TechnologyReview.Com 2011

Tuesday, July 26, 2011

Kaletra Plus Selzentry Yields Faster Response And Better Immune Recovery Than Kaletra Plus Truvada (IAS 2011)
By Courtney McQueen and April Clayton 

Preliminary results from a small 48 week clinical trial indicate that previously untreated HIV-positive adults taking Kaletra plus Selzentry have better immune recovery and faster virologic response compared to participants taking the more standard regimen of Kaletra plus Truvada.

Based on their results, the researchers recommended further research into treatment regimens that do not contain nucleoside reverse transcriptase inhibitors (NRTIs) – such as Truvada – which currently form the backbone of antiretroviral therapy. They also noted that longer trials with more participants would be needed to confirm the long-term safety and efficacy of non-NRTI-based regimens.

The results were presented last week at the 6th International AIDS Society Conference on HIV Pathogenesis, Treatment, and Prevention (IAS 2011).

Traditional combination antiretroviral therapy regimens consist of two NRTIs plus at least one additional anti-HIV drug from a different class. However, due to side effects associated with NRTIs and the fact that some patients cannot take them due to allergies or other conditions, researchers have begun exploring alternative “NRTI-sparing” regimens (see related AIDS Beacon news).

In this study, researchers examined the efficacy of the non-NRTI-based regimen of Kaletra (lopinavir/ritonavir) plus Selzentry (maraviroc) versus the more traditional regimen of Kaletra plus Truvada (emtricitabine/tenofovir). Truvada is a combination of two NRTIs, while Kaletra is a protease inhibitor and Selzentry is a CCR5 inhibitor, which is a relatively new type of antiretroviral.

The trial included 38 HIV-positive adults who had not previously been treated for HIV. Half the participants were randomly assigned to receive Kaletra plus Selzentry, and the other half were assigned to take Kaletra plus Truvada. The researchers then assessed participants’ CD4 (white blood cell) counts and viral loads (amount of HIV in the blood) at 4, 12, 24, 36, and 48 weeks after starting treatment.

Results showed that after 48 weeks, participants in the non-NRTI Kaletra plus Selzentry group had significantly higher increases in CD4 counts than participants in the Kaletra plus Truvada group. The average increase in CD4 count for the Kaletra/Selzentry group was 226 cells per microliter, compared to 125 cells per microliter in the Kaletra/Truvada group.

Additionally, most participants in the non-NRTI group (83 percent) achieved undetectable viral loads by week 12, compared to less than half of patients in the Truvada group. By 48 weeks, 95 percent of participants in the Kaletra/Selzentry group had undetectable viral loads, compared to 83 percent of participants in the Kaletra/Truvada group.

The researchers also noted that three participants taking Kaletra plus Truvada had to interrupt treatment due to diarrhea. Overall one person in the Kaletra/Truvada group discontinued treatment, compared to none in the Kaletra/Selzentry group.

For more information, please see the study abstract and presentation (pdf) on the IAS 2011 conference website.

Copyright © 2011 AidsBeacon.com

Monday, July 25, 2011

NanoViricides announces anti-HIV therapy could lead to functional cure
by Deborah Sterescu 

NanoViricides (OTCBB:NNVC) reported Monday that its lead anti-HIV candidate achieved an efficacy level equivalent to a highly active anti-retroviral triple (HAART) drug cocktail in a recent animal study.

Treatment with the drug reduced HIV levels and protected human immune T-cells to the same extent as treatment with the cocktail did in a study of mice, said the company. The three drug-combination used for comparison is one of the current therapies recommended for patients with HIV.

NanoViricides, which uses special purpose nanomaterials to design viral therapies, also said that no evidence of drug toxicity was observed during the study, and that the investigational drug will now undergo further optimization.
The latest study verifies the company’s previous results, which found that nanoviricides had a significant therapeutic effect, equal or superior to the same three-drug cocktail in a mouse study.

The company’s nanoviricide therapy works to mimick cellular structures to which the virus binds, specifically attacking and dismantling them.  By working differently than many combination therapies, the drug developer believes that the nanoviral treatment, or HIVCide, could compliment current standard-of-care, possibly achieving a “functional cure” of HIV/AIDS, NanoViricides said.

Although a functional cure is not a complete cure, it would allow an infected person to continue normal life even after discontinuation of therapy, maintaining undetectable viral load until a recurrence.

“Creating an adjunct drug that acts by a novel mechanism complementing the current HAART therapy is becoming extremely important,” said CEO, Eugene Seymour.

“The HIV virus mutates constantly resulting in failure of HAART therapy regimens. In some countries, it has now mutated to such an extent that in up to 40% of patients the standard HAART therapy has become ineffective.”

The company’s nanoviricide class of drugs are being developed against a number of viral diseases, including H1N1 swine flu, H5N1 bird flu, seasonal Influenza, oral and genital Herpes, viral Hepatitis C, and Ebola virus, among others.

A recent study of anti-flu treatment FluCide showed that the drug was better than oseltamivir, or Tamiflu, with a 1,000-fold greater viral load reduction than the standard flu therapy, after optimization.

“The results of the current study have provided important insight to guide the next cycle of chemical optimization. We clearly know now that we are on the right path,” said president Anil R. Diwan.

Copyright © 2011 Proactive Investors USA & Canada

Friday, July 15, 2011

Got HPV and HIV? Don't panic

Human papillomavirus (HPV) is currently the most common sexually transmitted infection (STI), perhaps because it is so easy to spread through skin-on-skin contact. For this reason, condoms can decrease, but not preclude, transmission of the virus during sex.

Various strains of the virus may cause genital warts on your penis or your ass. Generally painless, they can be occasionally itchy. They are almost always benign, the obvious exception being the strains that cause anal cancer.

The chemical you used to burn off the warts was probably liquid nitrogen. Even with this treatment, warts can reoccur. Depending on your age, you may choose to be vaccinated with Gardasil, but it works best if received prior to exposure to the virus.

Health Canada has approved the vaccine for young men from nine to 26, but oddly, they must pay for this particular preventive medicine, at a cost of up to $300, and it is not always easy to find a dispensing source. Hopefully, one day both boys and girls will be vaccinated for HPV just as they receive polio and measles vaccines, but we are far from that state now.

Though it is true that your risk of developing anal cancer increases if you have HPV and HIV, that risk is actually fairly minimal. That said, you are wise to remain vigilant regarding your anal health. If you notice changes to your ass in the form of bleeding, significant growth of the warts or other lesions in the first inch inside your anal opening — or anything else unusual — get to your doctor. If you can access the Lower Mainland, you can go to the infectious disease clinic at St Paul’s Hospital to get an anal PAP test.

Is there a need to alter your sexual behaviour now that your serological status has changed? Not necessarily. Because condoms cover only your penis, and because HPV rarely limits itself only to this area, they are not entirely protective. However, you want to minimize transmission as much as possible, so if you are with new or multiple partners, glove up.

Because of the incomplete protection condoms afford, you will need to advise new sexual partners of your potentially infectious status even if you engage in protected sex. You may wish to forgo anal sex with casual partners when your CD4 count is less than optimal. You will learn to read your body’s cues and can act accordingly.

If you are in a sexually exclusive relationship, you probably share strains of viruses, so you can relax regarding barrier protection, but, of course, use your best judgment and continue to talk openly about your health. The strains of HPV you have may not be oncogenic (cancer-producing), and you want to keep it that way. Your goal is to prevent transmission and reception of new strains while still enjoying great sex.

If your health is good, your CD4 count is robust and you are doing well on HAART (highly active anti-retroviral therapy), your chances of developing anal cancer are reduced. As horrible as it sounds, anal cancer is less deadly and metastatic (easily spreading) than its sister cervical cancer, which women have learned to manage through routine PAP tests for years now. You guys must now be vocal and persistent in demanding the same good medical care.

HPV is primarily a cosmetic problem, providing you monitor your body for changes. Since it has become ubiquitous in the community, you needn’t fear rejection or embarrassment because of it.

So all in all, though having HIV and HPV is not good news, it is not terrible news, either. Several decades ago, these diagnoses would have threatened far more serious consequences. Now they signal a need for continued vigilance and monitoring of your health status — not such a bad thing, really.

The point is that this is not a death sentence. It is not even news about which you need to panic. You have illnesses that compromise your immune system, and luckily, medicine is catching up with necessary treatments, although, alas, cures are still unavailable.

Political pressure is needed to make Gardasil available for young men. Those in non-urban areas often still lack access to anal PAP tests and dignified treatment. We do not yet live in the world we hope for or deserve.

Still, you can have a long and satisfying life. I encourage you to do so. This is a situation where you can happily celebrate your half-full glass.

Got a question for Dr Ren? asktheexpert@xtra.ca

Copyright 2011 Xtra! Canada's Gay & Lesbian News
Ultrasound May Determine Heart Attack Risk in HIV Patients

Risk 10 times higher in HIV patients with abnormal results compared with general population: study

People with HIV are at increased risk for blood vessel blockages, and new research shows heart ultrasounds can help determine if these patients are more likely to suffer a serious or fatal heart attack.

A report from the American Heart Association revealed that the risk for heart attack among people with HIV who have abnormal heart ultrasound tests or "stress echoes" is 10 times greater than in the general population and more than three times higher than in people without HIV who have abnormal heart ultrasounds.

"We looked at whether stress echo can help predict risk in a high-risk group — HIV patients with known or suspected heart disease — and determine whether they have a high or low risk of heart attack and death in the future," the study's senior author, Dr. Farooq A. Chaudhry, associate professor of medicine at Columbia University College of Physicians and Surgeons and associate chief of cardiology and director of echocardiography at St. Luke's Roosevelt Hospital Center in New York City, said in an American Heart Association news release.

In conducting stress echoes on 311 HIV patients averaging 52 years of age with known or suspected heart disease, researchers found that 26 percent had abnormal ultrasounds. Within an average of about three years, there were 14 cardiac deaths and 17 nonfatal heart attacks.

The study authors concluded that the HIV patients who had normal stress echo tests had on average a less than 1 percent per year risk for serious or fatal heart attack -- the same risk as in the general healthy population. In sharp contrast, the risk of heart attack among the HIV patients with abnormal stress echo test results was almost 12 percent per year.

The study, published in the current issue of Circulation: Cardiovascular Imaging, found that 100 percent of HIV patients with normal heart ultrasounds survived in the year following the test and 98 percent were alive at four years. Those survival rates dropped to 92 percent at one year and 62 percent at four years for people with HIV that had abnormal stress echoes, the report indicated.

"Although we did not study which treatments are most effective for these patients, HIV patients who have abnormal stress echocardiography should probably be monitored and treated more aggressively to prevent heart attack and death," said Chaudhry. "Conversely, patients with a normal stress echo might not need such aggressive interventions."

The American Heart Association provides more information on HIV and the heart.

Copyright © 2011 HealthDay. All rights reserved
Pills found to be highly effective in preventing HIV transmission
By Thomas H. Maugh II, Los Angeles Times

Experts hail a pair of trials involving heterosexual couples in Africa as a breakthrough in AIDS prevention. The studies show that taking a pill containing one or two drugs each day can decrease transmission of HIV by as much as three-quarters.

Taking a daily pill containing either one or two anti-HIV drugs can reduce transmission of the virus by as much as three-quarters among heterosexual couples, two studies in Africa have shown — a breakthrough finding that promises to intensify a new focus on AIDS prevention.

The results were so compelling that the larger study was halted early and the drugs given to all the participants, researchers said Wednesday.

In the absence of a vaccine to protect against the virus, this new approach, termed pre-exposure prophylaxis, may be the best hope for slowing or even halting the spread of the deadly plague throughout the developing world. U.S. health officials are beginning to prepare guidelines for how the drugs could be used in this country to prevent new infections.

The findings "are two more nails in the coffin of HIV," said Mitchell Warren, executive director of the New York-based AIDS Vaccine Advocacy Coalition. "We are seeing similar results in different populations, and that gives us more certainty that these results are real."

A study of gay men reported in November showed that one of the drugs in the new trial could reduce the spread of HIV by as much as 70% when taken regularly by uninfected individuals. But a study released this year found that the drugs did not show a similar benefit among uninfected heterosexual women.

The strength of the new findings suggests that the study involving women may have been flawed.

"Our results provide clear evidence that this works in heterosexuals," said Dr. Jared Baeten of the University of Washington, co-chair of the new study.

The last year has brought several breakthroughs in AIDS prevention research, said Kevin Frost, chief executive of amfAR, the Foundation for AIDS Research. In addition to this latest finding and the study involving gay men, a study released last July found that microbicides could sharply reduce HIV transmission in women and a study in HIV-positive people showed that treating the infected person intensively could reduce transmission by as much as 96%.

Given those and other developments, "we find ourselves in a place where we have an extraordinary opportunity to radically alter the trajectory of the epidemic," Frost said. "The science is in place. We could do it with the tools we have available. It's no longer a question of, can we do this? The question is, will we do it?"

The new results are scheduled to be presented next week at the International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention in Rome, but were released early.

One trial enrolled 4,758 couples in Kenya and Uganda in which one partner was HIV-positive and the other was not. A third of the uninfected participants received a daily pill containing tenofovir, a third received a daily pill containing tenofovir in combination with emtricitabine, and a third received a placebo.

Tenofovir is marketed as Viread and the two-drug combination as Truvada by Gilead Sciences Inc. of Foster City, Calif. They are available generically in many countries for as little as 25 cents per pill, according to the World Health Organization

All couples also received condoms and counseling about how to prevent infection.

By the end of May, researchers had identified 18 new infections among the group receiving Viread, 13 among those receiving Truvada and 47 among those receiving the placebo. That corresponds to a 62% reduction in transmission among those receiving Viread and a 73% reduction among those receiving Truvada.

The second trial, sponsored by the U.S. Centers for Disease Control and Prevention, studied 1,200 healthy, sexually active males and females in Botswana. About half received Truvada and half a placebo. Among the 601 participants who took Truvada, there were nine new infections, compared with 24 among the 599 who received placebo. That amounts to a 62.6% reduction in new infections.

Among those participants who took the drugs regularly, researchers observed an even greater reduction — 77.9% — in new infections.

No significant side effects were observed in either trial. "The perception is that these drugs are really toxic," said Dr. Thomas J. Coates, an infectious diseases specialist at UCLA's Geffen School of Medicine. "They are not. The current generation is really quite safe."

Dr. Jonathan Mermin, director of the CDC's Division of HIV/AIDS Prevention, said the agency would immediately begin working with other public health groups to establish guidelines for using the drugs prophylactically in this country. Physicians should await those guidelines before prescribing the drugs, he said, but if they believe it is imperative to do it, they should adhere to the guidelines previously announced for using them in gay men.

Dr. Robert M. Grant of UC San Francisco's Gladstone Institute of Virology and Immunology speculated that the drugs might work even better in the United States than they did in Africa. People in this country "are more accustomed to using pills for prevention," he noted, and thus more likely to take the drugs regularly.

Copyright © 2011, Los Angeles Times