January 30, 2009

CREDIT: Photo-Dan Toulgoet

Todd Jackman receives a rent subsidy from the McLaren Housing Society of B.C for his apartment on Jervis Street.

Todd Jackman is still getting over being diagnosed HIV-positive a dozen years ago, but having an affordable and comfortable apartment helps him cope.

"It's changed my life probably in a way I hadn't realized," said Jackman, who's faced a lifelong battle with depression. "I care about my home so much now that I don't really have parties like I used to when I was younger. It's like this is my home, my peace space."

Jackman, 42, receives a rent subsidy from the McLaren Housing Society of B.C., a non-profit that provides safe, affordable housing to financially needy men, women and families who live with HIV/AIDS and are in financial need. The subsidy combined with his provincial disability benefits helps him pay $962 in rent for a West End one-bedroom. Previously, he lived at Helmcken House, the society's renovated heritage house in Downtown South that provides 32 one-bedrooms and studios for people with HIV/AIDS. McLaren helps people live in 135 homes in three buildings and with rent subsidies. It's now poised to expand as it prepares to develop 110 more units on land occupied by the Odyssey Night Club on Howe Street near Davie. It's one of the city's 12-owned sites under development for social and supported housing.

Jackman says the need for housing is great. As a part-time employee of the society and a volunteer, he's spent the last year updating the society's 300-strong housing assistance waiting list. The typical individual or family waits for a space or subsidy for four years. "This new building is amazing," Jackman said. "All we need is four or five more of them, then we might be talking."

Three two-bedroom townhouses will form the base of the 12-storey structure to mesh with future developments, and the tower will include 96 studios, four fully accessible units and seven one-bedrooms for couples. "There's a huge undersupply of housing for couples," said Peter Regier, vice-president of McLaren's board.

Founded in 1987, the society's first clients were gay men. But in the last decade it has served more heterosexuals, people with a long history of poverty and those with addictions or mental health problems or both.

The society will provide supportive housing for half the tenants at the Howe Street location, filling the large gap between the unofficial help provided at Helmcken House and the assistance dying people receive at the nearby Dr. Peter Centre. That help will include 24-hour staffing, individualized plans and basic life skills training, including nutrition. The new building will feature a rooftop garden and raised beds for growing food. GBL Architects Group Inc. has received a commendation for its design which is to meet high environmental building, or LEED Gold, standards.

Most of the new residents will be West End residents at risk of becoming homeless. Some become homeless after a hospital stay, and a large number of McLaren's clients couch surf and live in overcrowded conditions until they find their own space.

Joel Leung, 41, lived with friends for six months until he received help from McLaren 10 years ago. "McLaren saved my life," he said.

Regier said stable housing is key to health and dignity for people who are HIV-positive. "For some people who are in a state of ill health, having the proper toilet facilities is really important," he said. "We've heard horror stories of people living in SROs with rats getting into their food."

The McLaren housing society evolved from the work of Ted McLaren, a social activist who died of AIDS in 1985. He opened up his five-bedroom home to those in need of affordable housing, and it became the first project of its kind in Canada.

In 1993, McLaren House closed as the society's work expanded. The McLaren Housing Society continues to meet around its namesake's dining room table in their Helmcken Housing boardroom today.

By Cheryl Rossi, http://www.canada.com/vancouvercourier

February 3, 2009

So, bits of Canada's medical marijuana rules were ruled unconstitutional yesterday, except Ottawa was given a year to fix them, and the Victoria guy charged with growing the dope was convicted, except he got off.

Huh?

Saying the B.C. Supreme Court decision makes Canada's medical marijuana laws clearer is like saying cowboy boots make Danny DeVito taller -- really, it's just a matter of degree.

Justice Marvyn Koenigsberg, sitting in Vancouver, struck down Health Canada regulations that say a licensed marijuana grower may only supply a single client and that bar more than three growers from pooling their resources. Her ruling echoed a 2008 federal court decision that tossed out the one-grower, one-client regulation; coincidentally, Ottawa lost its appeal of that decision yesterday.

At issue in Vancouver was a 2004 raid in which 900 pot plants were seized from what turned out to be the Vancouver Island Compassion Society's East Sooke production facility. The guy tending the operation, Mat Beren, was charged with possession and growing for the purpose of trafficking.

The judge convicted Beren yesterday, but gave him an absolute discharge, meaning he won't go to jail or have a record.

Of broader interest were the constitutional arguments launched by the compassion society, which spent five years and $200,000 arguing that Health Canada's regulations stop many sufferers from getting marijuana. Yesterday's ruling left society founder Philippe Lucas, a Victoria city councillor, declaring a "partial victory."

Health Canada introduced its medical marijuana rules in 2001. Ottawa allows the use of pot to ease the pain of the dying and to alleviate the symptoms of multiple sclerosis, spinal cord conditions, cancer, HIV/AIDS, epilepsy, severe forms of arthritis and, on a physician's approval, afflictions that conventional treatment has failed to ease. Individuals are licensed to get marijuana in three ways: They can grow it themselves, designate someone to grow it for them, or buy it through Health Canada from a contractor that grows dope in a Manitoba mine shaft.

Not good enough, say critics who argue Ottawa has failed to provide the access and supply demanded by law. They say the mine shaft pot is of poor quality and it takes eight to 12 weeks for applicants to get Health Canada's approval -- an eternity for the terminally ill. Only 2,600 Canadians have received Ottawa's blessing, yet the trial was told that between 400,000 and a million of them use marijuana for medicinal purposes.

Sitting in the half-light are the compassion clubs, operating openly, sort-of-tolerated but still outside the law -- meaning they often make up their own rules. The nine-year-old Vancouver Island Compassion Society, with 850 members -- twice as many as at the time of the bust -- has stricter rules than does Victoria's Cannabis Buyers Club, which has more than 2,400 clients. Where the former group will only sell marijuana to someone on the recommendation of a physician (it says 300 local doctors have done so) the latter merely requires proof of diagnosis of a permanent disability or disease.

Compassion clubs typically pay growers $2,200 to $2,600 for a pound of marijuana. The clubs then sell for $7 to $12 a gram. That's more than the $5 charged by Health Canada, but usually 10 to 20 per cent less than pot goes for on the street.

What Monday's ruling means to all that, who knows? Lucas said the compassion society needs time to study a decision that took the judge two hours to read. He also said he wants to work co-operatively with Health Canada.

So does Eric Nash, who runs Island Harvest Organic B.C. Cannabis in Duncan. Yet he is still waiting for Health Canada to respond to his months-old application to grow pot for several hundred would-be clients. Koenigsberg gave Ottawa a year to change its one-grower, one-client rule, so Nash isn't sure where he stands. "Another shade of grey enters the picture."

By Jack Knox, Times Colonist

January 30, 2009

The abrupt departure of the State Department’s global AIDS coordinator has led to debate over who should run what may be President Bush’s most important achievement: his commitment of billions of dollars to fighting AIDS overseas.

Alex Wong/Getty Images Dr. Mark R. Dybul, the former coordinator of global policy on AIDS, during a news conference in Washington on Jan. 12.

The position — global AIDS coordinator and director of the President’s Emergency Plan for AIDS Relief, known as Pepfar — is a State Department post with ambassador’s rank that had been held by Dr. Mark R. Dybul, a Bush administration appointee.

On Jan. 9, Dr. Dybul circulated a memo saying he had been asked by President Obama’s transition team to stay on the job temporarily. But on Jan. 22, one day after Hillary Rodham Clinton was confirmed as secretary of state, her staff announced that Dr. Dybul had resigned.

The State Department said Friday that Dr. Dybul was required to submit his resignation and leave his post because he was a political appointee of the Bush administration. “And that’s all that was,” said the spokesman, Robert A. Wood. He noted that Dr. Dybul had been treated the same as other Bush appointees.

Dr. Dybul did not return phone messages, but he has told friends that he does not even know who decided his resignation should take effect, after he had been asked to stay temporarily.

“He deserved better,” said a friend who asked not to be identified for fear of jeopardizing his government job. “He didn’t want to stay, but he was asked to.”

The ambassador disburses Pepfar’s funds; Congress authorized $15 billion over five years in 2003, and the fund has since paid for AIDS drugs for about two million people, mostly in Africa. Last year, after a fight between liberal and conservative lawmakers over what the money could be spent on, the fund was renewed as part of a law authorizing $48 billion over five years for combating AIDS, tuberculosis and malaria.

The question of who should run the program seems to be a legacy of that fight. Several names have been discussed as possible candidates, but AIDS activists say they know of no one who has been seriously evaluated for the job by the Obama transition team since November.

A day after Dr. Dybul’s resignation, word began to circulate among AIDS activists that the job had been offered to Dr. Eric Goosby, the director of AIDS policy in Bill Clinton’s administration, who now runs a San Francisco foundation devoted to fighting AIDS.

According to a member of an anti-AIDS group speaking on the condition of anonymity, Senator John Kerry, Democrat of Massachusetts, approached Mrs. Clinton, seeking the job for Dr. Jim Yong Kim, a Harvard medical school professor and former World Health Organization AIDS chief, and was told that she had offered it to Dr. Goosby.

Through a spokesman, Dr. Goosby declined to confirm or deny that he had been offered the job, and Dr. Kim did not return phone calls seeking comment. Senator Kerry’s spokesman said he would not discuss the senator’s personal conversations with Mrs. Clinton.

Both men had been discussed as possible candidates, along with Dr. Nils Daulaire, president of the Global Health Council; Dr. Wafaa El-Sadr, an epidemiologist at the Columbia School of Public Health; and Warren W. Buckingham III, Pepfar’s director in Kenya, who is openly gay and taking AIDS drugs himself.

Dr. Daulaire declined to be interviewed, Dr. El-Sadr said she had not heard that her name was among those being discussed, and Mr. Buckingham said he knew his name had been suggested by others but had not lobbied for the job and had not been contacted by either the Obama or Clinton teams.

The abruptness of Dr. Dybul’s departure and the secrecy of the process to replace him has upset some AIDS policy specialists.

On Monday, a coalition of 68 anti-AIDS groups sent a letter to Mrs. Clinton asking her not to fill Dr. Dybul’s post immediately but to convene a committee to identify top candidates and get many viewpoints, including theirs.

One of the letter’s authors, Brian Hennessey of the Vineeta Foundation, expressed his irritation at how the request was ignored. “Goosby is not bad,” he said. “There are plenty of people who want Goosby — but they’ll be damned if the job is filled this way. This isn’t the truth in advertising of the Obama campaign.”

Dr. Dybul’s departure was both celebrated and condemned.

Jodi Jacobson, a former head of the Center for Health and Gender Equity, which wants financing for all aspects of women’s reproductive health, including abortion, wrote a blog post titled “Dybul Out: Thank You Hillary!!!” It argued that he had worked too closely with the far right, and she accused him of lobbying to please the Roman Catholic Church by letting its relief groups refrain from distributing condoms.

Michael Gerson, a former Bush speechwriter and Washington Post columnist, shot back that “blogging extremists” like Ms. Jacobson had lied about Dr. Dybul’s record.

At the heart of the debate was the difficult bipartisan compromise behind Mr. Bush’s AIDS plan. It is the darling of two groups that normally oppose each other: foreign policy liberals who want to help Africa and evangelical Christians who support mission hospitals there.

Dr. Dybul was straddling some personal fences too: he was one of the Bush administration’s few openly gay officials, a doctor who had treated AIDS patients in San Francisco and Africa, and he had donated to Democratic causes.

His only predecessor, Randall L. Tobias, a former pharmaceutical executive, was promoted within the State Department, then resigned in 2007 after acknowledging that he had received massages from an escort service at the center of a Washington prostitution scandal — a development that led to derision over the fund’s abstinence policies.

Mr. Tobias and Dr. Dybul surprised many with two early decisions that activists had expected fights over: Pepfar has paid for millions of condoms, and it buys inexpensive generic drugs from India, despite the pharmaceutical lobby’s opposition.

But conservatives in Congress imposed other restrictions: a third of the money spent on prevention had to be used for teaching abstinence until marriage; groups getting funds, including those helping prostitutes, had to sign a pledge condemning prostitution; and no money could be spent on clean needles for drug addicts. In separate studies, the Government Accountability Office and the Institute of Medicine found that the abstinence earmark unnecessarily tied the hands of fund recipients, especially in countries where AIDS was concentrated among drug users and prostitutes.

By Donald G. McNeil Jr., http://www.nytimes.com

February 2, 2009

Gay and lesbian advocates last week at the annual Creating Change conference in Denver called on the Obama administration to create a domestic HIV/AIDS strategy, the Denver Post reports. Conference Director Sue Hyde said, "People will have a hard time choosing marriage if they are sick and dying," adding, "HIV and AIDS have never lost their grip" in the U.S.

The conference, which is sponsored by the National Gay and Lesbian Task Force, was expected to attract about 2,000 participants, and its leaders hope to begin lobbying federal policymakers to create a national plan to address HIV/AIDS, including a strategist in the White House who reports directly to President Obama. Marjorie Hill, chief executive of Gay Men's Health Crisis, said that the U.S. "does not have a coordinated plan," despite the presence of HIV/AIDS for the past 27 years, and that a plan must be driven by science. Ideas from Gay Men's Health Crisis include federal funding for needle exchange programs, condom availability in prisons and schools, and advertisements targeting same-sex couples that say safer sex "is a healthy part of the adult experience." In addition, the Post reports that the conference aimed to address the stigma associated with HIV/AIDS, which Hill said can prevent people from seeking treatment or discussing their HIV-positive status. Hill also said that many young people are complacent about HIV/AIDS because they did not experience the epidemic in the 1980s, when men who have sex with men were "dropping like flies." She said, "People are still dying, but at a much slower rate" because of advances in antiretroviral therapy.

Advocates also addressed HIV/AIDS in minority populations. David Munar, vice president for policy and communications at the AIDS Foundation of Chicago, said that HIV/AIDS is "dramatically impacting people of color at a disproportionate rate." Munar added that there is a "new sense of optimism that the new president and Congress will act on these data and refocus attention nationally on the epidemic at home," which "has not gone away" (Brown, Denver Post, 1/30).

http://www.kaisernetwork.org

The Sixteenth Conference on Retroviruses and Opportunistic Infections (CROI) takes place from Sunday February 8th to Wednesday February 11th in Montreal, Canada. CROI is one of the major HIV scientific meetings of the year, and aidsmap.com will be publishing daily news reports and a daily round-up bulletin from the conference.

What should I expect from this year's conference?

• A major microbicide trial, HPTN 035, comparing two products, BufferGel and PRO 2000, will report its results.

• Further information to inform the debate about when to start treatment: is a CD4 count of 350 too low a starting point?

• Further exploration of the links between HIV, antiretroviral drugs and cardiovascular disease. Does HIV itself raise the risk of heart disease?

• What's the risk of HIV transmission when an individual has an undetectable viral load on treatment? This will be a hot topic at CROI 2009, following the recent controversy over the declaration by Swiss doctors that heterosexuals with HIV cannot transmit HIV to regular partners if they have undetectable viral load.

• Are people with HIV continuing to suffer neurocognitive problems such as memory loss and lack of concentration due to HIV in the brain, despite antiretroviral treatment? Several major studies will report their findings.

• New studies of treatment options for mothers who have been exposed to single-dose nevirapine to prevent mother-to-child transmission. Are there better options than using nevirapine-based ART when mothers need treatment for their own health?

• What are the best ways of increasing the uptake of HIV testing in resource-limited settings? Studies from several African countries will provide new insights.

Where can I find out what's being discussed?

News reports will appear on www.aidsmap.com from Monday February 9th, and daily bulletins from Tuesday February 10th.

As a regular subscriber, you will automatically receive these round-ups of the latest news. They will also be available, along with translated versions in French, Spanish, Portuguese and Russian, on the CROI pages of aidsmap.com.

Webcasts of many conference sessions, including all the main presentations and symposia, will be available from Monday February 9th at the official
 CROI website.

Also:  The Clinical Care Options website

Expert commentary podcasts on all the major topics from the conference will also be available to download from Monday February 9th at the

Clinical Care Options website.

www.aidsmap.com

February 3, 2009

A promising treatment that keeps CD4 cells from producing a key receptor on their surface, thus potentially blocking viral infection, is set to begin early safety studies in humans according to an announcement by the treatment’s developer, Sangamo BioSciences, Inc.

HIV typically uses the CCR5 receptor on the surface of CD4 cells in order to infect the cells and reproduce. When cells lack CCR5, or have had their receptors blocked by a drug such as Selzentry (maraviroc), HIV typically can’t infect them. While a small percentage of people are born with a genetic mutation that keeps their cells from making CCR5 receptors, most people with HIV don’t have this mutation. Scientists have long wondered whether it might be possible to genetically reprogram people’s CD4 cells to stop producing CCR5 receptors.

Zinc finger DNA-binding protein nuclease (ZFN), a technology developed by Sangamo, blocks the production of CCR5 on CD4 cells. It reportedly worked in animal studies, and Sangamo is partnering with the University of Pennsylvania to conduct its first human clinical trial.

The researchers will take CD4 cells from 12 HIV-positive patients, genetically modify the cells with the Sangamo technology and then reinfuse the cells back into each patient. Patients will be treated one at a time with a delay of at least 21 days between each patient to ensure the highest degree of safety.

“This is the first time that we have had the ability to make a patient’s [CD4 cells] permanently resistant to infection by CCR5-specific strains of HIV, and we are very excited to begin a clinical trial of this novel ZFN-based therapy,” said Carl June, MD, one of the lead investigators from the University of Pennsylvania School of Medicine.

Even if the technology is proved safe, it is possible that the therapy may only work in people who have not developed sufficient quantities of HIV that use a different receptor, CXCR4, as is the case with Selzentry.

http://www.aidsmeds.com

Scientists at Harvard Medical School have succeeded in protecting mice against herpes infection for one week using a single application of a microbicide based on a new technology called RNA interference.

The technology, still in its infancy as a therapeutic tool, could have a powerful impact as an HIV prevention tool, according to Professor Judy Lieberman, lead investigator.

What is RNA interference?

Silencing RNAs, or RNA interference (siRNA), are short strands of RNA that target particular genes and `silence` the activity of messenger RNA generated by those genes.

They do so, in the main, by disrupting the production of the proteins assembled according to instructions carried in RNA. The very short sequences of short interfering RNA – less than 30 base pairs – bind to identical sequences in the RNA produced by the gene whose activity needs to be blocked.

The development of siRNAs as therapeutics stems from the discovery that cells generate siRNAs of their own, to protect against aberrant messenger RNAs, to protect against viruses and to modulate gene expression pathways within a cell.

However, delivering therapeutic siRNAs from outside the cell to the right place and ensuring that they do not have any unwanted effects on the cell are still proving challenging. The potential for viral resistance to the SiRNAs is also uncharted.

In the case of HIV, the most promising approach appears to be the development of siRNAs that can target sequences of HIV RNA that will not vary from one virus to another.

SiRNAs are also being investigated in many other disease areas, for both therapeutic and preventive purposes. The results published in January in the journal Cell Host and Microbe, for example, show the potential application of siRNAs in microbicides, topical agents that can be used to prevent vaginal transmission of sexually transmitted infections.

Although much emphasis has been devoted to microbicides that can protect against HIV, protection against HSV-2 (the virus that causes genital herpes) is also a priority, especially because HSV-2 infection increases an individual’s chances of becoming infected with HIV.

The study carried out at the Immune Disease Institute at Harvard Medical School sought to silence two genes in mice, using silencing RNAs that targeted a receptor for HSV-2 (nectin-1) and an HSV-2 gene essential for replication (UL29). When these genes are silenced, the receptor should not be expressed on the cell surface, and replication should be interrupted.

The research team found that when conjugated with cholesterol, the siRNAs were able to protect against HSV-2 for up to a week after one application by silencing the nectin-1 gene. However, protection was not evident immediately; it took at least one day for protection to become apparent, as measured by a sequence of viral challenges before, at the same time as and up to 7 days after administration of the microbicide containing the siRNAs.

SiRNAs may indice inflammatory or interferon responses, but there was no evidence of inflammation in the vaginal tissue of mice that received the microbicide

"People have been trying to make a topical agent that can prevent transmission, a microbicide, for many years," said Professor Judy Lieberman of Harvard Medical School. "But one of the main obstacles for this is compliance. One of the attractive features of the compound we developed is that it creates in the tissue a state that's resistant to infection, even if applied up to a week before sexual exposure. This aspect has a real practicality to it. If we can reproduce these results in people, this could have a powerful impact on preventing transmission."

The researchers also see potential for siRNAs to be used to suppress herpes reactivation in women who have already contracted HSV-2.

Lieberman was recently awarded a grant from the Massachusetts Life Science Center to collaborate with a corporate partner to build on these results to develop a topical microbicide that might be suitable for human use.

In addition, she is investigating how the same approach might be used to treat HIV in a multi-institutional programme funded by the National Institutes of Health that includes researchers at the Tulane National Primate Research Center, St. George's Hospital in London, and Alnylam Pharmaceuticals in Cambridge, Massachusetts.

Reference

Wu Y et al. Durable protection from herpes simplex virus-2 transmission following intravaginal application of siRNAs trageting both a viral and host gene. Cell Host & Microbe 5, 1-11, 2009.

By Keith Alcorn, www.aidsmap.com

Gay men should have rectal tests for chlamydia as part of their routine sexual health care, investigators recommend in an article published in the online edition of Sexually Transmitted Infections. Researchers found that more gay men had rectal infection with chlamydia than had urethral chlamydia or rectal gonorrhoea. Furthermore, the majority of rectal chlamydia infections were asymptomatic and would therefore have been missed without routine testing.

They also found that over a third of the men with rectal chlamydia were HIV-positive.

Chlamydia is the most common bacterial sexually transmitted infection in the UK. Testing for urethral chlamydia is routinely offered to all men attending sexual health clinics. However, rectal testing for the infection is not offered to gay men attending most UK sexual health clinics. Nor is such screening recommended in the sexual health testing guidelines of the British Association for Sexual Health and HIV (BASHH).

Previous studies have found that between 7%-9% of gay man attending sexual health clinics have rectal infection with chlamydia, and that such infections are often without symptoms. Chlamydia, like all sexually transmitted infections, can cause changes to the genital mucosa that increase the risk of HIV transmission. Therefore the investigators reasoned that a benefit of detecting and treating rectal chlamydia would be a reduction in onward HIV transmission.

In recent years outbreaks of the sexually transmitted infection lymphogranuloma venereum (LGV) have been observed in gay men in the UK and several other industrialised countries. LGV is caused by certain strains of chlamydia. Most of the cases have involved rectal infection. In response to the outbreak of LGV, staff at London’s Chelsea and Westminster Hospital’s sexual health clinics started screening gay men for rectal chlamydia infection.

A study was designed by researchers from the hospital with three aims:

• To determine the prevalence of rectal chlamydia amongst gay men.
  

• To find out how many of these infections were asymptomatic.
  

• To establish the number of infections that would have remained undiagnosed had routine screening not been introduced.

The study was conducted between 2005 and 2006 and included a total of 3076 men. All these men had urethral screens for chlamydia and 3017 had rectal swabs for the infection.

Results showed that 8% of men had rectal chlamydia with 5% having urethral chlamydia. The prevalence of chlamydia was higher than any other infection, with tests showing that 4% of men had rectal gonorrhoea, 5% had urethral gonorrhoea and 3% syphilis.

The investigators then looked at the cases of chlamydia in more detail. Of the 397 men diagnosed with chlamydia, 62% (247) were infected rectally, 42% (165) had urethral infection and 4% (15) had the infection in both sites.

Rectal infection with chlamydia was asymptomatic in 69% (171) men and would therefore have been missed without routine screening. Only 8% of asymptomatic men also had urethral infection.

Rectal LGV was diagnosed in 14% (35) of the men with rectal chlamydia. There was also one case of urethral LGV. The vast majority of rectal LGV cases (82%) were symptomatic.

There was a high prevalence of HIV infection in men with rectal chlamydia (38%, 94 individuals). The investigators also note that twelve men were first diagnosed with HIV at the same time as rectal infection with chlamydia was detected.

Factors significantly associated with rectal chlamydia were HIV infection (p < 0.01), rectal gonorrhoea (p = 0.0002) and genital warts (p = 0.016). The investigators excluded men with LGV from their statistical analysis, but they still found a significant association between rectal chlamydia and HIV (p = o.004) and rectal chlamydia with rectal gonorrhoea (p = 0.002).

“Our data shows a higher rate of rectal chlamydia infection compared to gonorrhoea, a significant proportion of which were asymptomatic”, write the investigators.

They conclude, “current STI guidelines in the UK only recommend routine screening for rectal gonorrhoea but not rectal chlamydia and our data support the need to revisit these guidelines. We recommend routine screening for rectal chlamydia in men who have sex with men at risk of acquiring this infection.”

Reference

Annan, N.T. et al. Rectal chlamydia – a reservoir of undiagnosed infection in MSM. Sex Transm Inf (online edition), 2009.

By Michael Carter, www.aidsmap.com

Longtime HIVer Mark King has come a long way since the 1980s and early 1990s. As a gay man living in a wild time, he didn't hold back when it came to sex: "I didn't care what their status was," he recalls. "I didn't care about anything other than my own pleasure." In his latest video blog, Mark bares it all -- literally (well, almost) and figuratively. But this time, he's got HIV prevention in mind when he talks about barebacking, glory holes and his outlook on sex. "It means something more to me than it did before," Mark explains. "It's about respecting the other person, and it's about respecting me." (Blog from TheBody.com)

The Sex Pig is Dead