"Visual Captchas are user unfriendly - its very hard to sign up if you are visually impaired, and to be honest I've got perfect vision and I sometimes have problems trying to decipher the jumbled mess offered up as letters."
Depending on the target audience, yes.
"...he still gets a good number of spam postings."
Nothing will stop a human. That's why I implemented a little thing with posts on my site(s). If the post id is less than a number I specify it does not ping external sites or get added to my site wide feed, and instead I get an email with the contents of the post.
It isn't perfect, but if one of those bastards does sit there and sign up then at least "the world" isn't notified.
Since implementation a couple months ago, it's been a nice work around. I can go in and delete the blog without any serious side effects, and still keep it out of the mainstream.
I guess you might say that a downside is that legitimate users don't have external pings for a few posts, but if they are serious about using the service then it doesn't matter in the long run. If they are only trying it out and make a post or two, then it actually works out better in the long run.
That being said, in what little time I've had for MU lately (been writing another open source project that's taken up a ton of time), I've come up with an alternative "math" type solution that I'm planning on putting together sometime soon. Granted it's only applicable to my corner of the audience, so it won't benefit any site other than mine, but it will still be an acceptable alternative.
Since with comments the "captcha" is pretty much a back-up to SK2, it probably won't make much of a difference. But, it will be a "cool" little deal for my site. :D