Reproductive Rights Prof Blog

HPV Vaccine No Longer Mandatory for Immigrant Women

RH Reality Check: Eliminating HPV Vaccine Mandate For Immigrant Women: A Victory on the Road to Reproductive Justice, by Miriam Yueng (National Asian Pacific American Women's Forum) & Amanda Allen (Reproductive Justice Fellow/Georgetown Women’s Law and Public Policy Fellow):

This week the reproductive justice movement is celebrating a significant victory. Effective December 14, immigrant women and girls will no longer be forced to get Gardasil, a vaccine developed by Merck and Company to prevent transmission of the strains of human papillomavirus (HPV) linked to cervical cancer.  This marks the reversal of a harmful and discriminatory rule originally put in place in July 2008 by the U.S. Citizenship and Immigration Services (USCIS) that took away the ability of immigrant women and girls to make informed choices of whether or not to get the Gardasil injection. The National Asian Pacific American Women’s Forum (NAPAWF), along with other immigrant rights, reproductive justice, civil rights, public health and women’s rights advocacy groups, led the effort to reverse the rule. The successful outcome highlights the ways in which the reproductive justice framework is essential to achieving equitable results for historically marginalized communities. We believe this approach is also essential to securing accessible and affordable health care for all.

Male Prostitution Legalized in Nevada

Salon.com: Nevada legalizes male prostitution, by Kate Harding:

But a lobbyist fears equal opportunity will destroy the brothel industry 

On Friday, one of Nevada's most important industries took a big step toward gender equality. Unfortunately, that doesn't mean men in leotards will now be serving cocktails on casino floors at 9 a.m., but it does mean that people who like to have sex with men will legally be able to purchase an opportunity to do so.

Technically, male prostitution wasn't expressly prohibited before, but health codes required "that prostitutes must undergo 'cervical' testing for sexually transmitted diseases," leaving those without a cervix out of a job. Bobbi Davis, owner of the Shady Lady Ranch, hired an ACLU lawyer to ask that the language be changed, and the health board approved the request. Davis intends to have male prostitutes working for her in the new year. Like her female employees, they'll decide whether to accept men, women or both as clients.

Although Davis and other brothel owners will probably be happy to have a new revenue stream in tough economic times, you know that whenever the subject of men having sex with men comes up, somebody's going to A) be unhappy and B) say something remarkably stupid on the record. . . .

Study Finds Casual Sex Does not Cause Emotional Damage

StarTribune.com: Casual sex – and no emotional wreckage?, by Josephine Marcotty:

Results of a study on casual sex among young adults surprise U researchers. But they note the physical risks.

As most every parent knows, hooking up for casual sex is bad for young people because it causes emotional or psychological damage.

Right?

Well, actually, no. At least not for young adults between the ages of 18 and 24, according to a new study by University of Minnesota researchers.

Even they found the results startling.

Trinidad & Tobago to Begin HIV/AIDS Education in Primary Schools Next Year

Trinidad & Tobago Express: AIDS education for primary pupils from Jan, by Aabida Allaham:

THERE are more than 200 HIV-infected children attending public schools in Trinidad and Tobago and they are silently shouting out for something to be done about the discrimination they are faced with, chief education officer at the Ministry of Education Peter O’Neil says.

’There are approximately 204 children in our system [who] are currently accessing treatment for HIV/AIDS and that in itself suggests that children are not least affected by this,’ O’Neil said yesterday, while addressing a small gathering of teachers at the Ministry’s World AIDS Day 2009 symposium at the Crowne Plaza hotel in Port of Spain. The event was entitled Let’s talk HIV/AIDS.

O’Neil, who spoke on behalf of an absent Education Minister, Esther Le Gendre, said in addition to the stigma and discrimination these children are faced with on a daily basis, ’some 38 children die every day in the Caribbean from HIV/AIDS’.

As a result, he said, AIDS education will be a part of the primary school curriculum from January.

South Africa Announces Plan to Expand Treatment for HIV-Positive Babies

Wash. Post: South Africa to treat all HIV-positive babies, by Donna Bryson:

PRETORIA, South Africa -- South Africa announced ambitious new plans Tuesday for earlier and expanded treatment for HIV-positive babies and pregnant women, a change that could save hundreds of thousands of lives in the nation hardest hit by the virus that causes AIDS.

President Jacob Zuma - once ridiculed for saying a shower could prevent AIDS - was cheered as he outlined the measures on World AIDS Day. The new policy marks a dramatic shift from former President Thabo Mbeki, whose health minister distrusted drugs developed to keep AIDS patients alive and instead promoted garlic and beet treatments. Those policies led to more than 300,000 premature deaths, a Harvard study concluded.

The changes are in line with new guidelines issued a day earlier by the World Health Organization that call for HIV-infected pregnant women to be given drugs earlier and while breast-feeding. By treating all HIV-infected babies, survival rates should also improve for the youngest citizens in South Africa, one of only 12 countries where child mortality has worsened since 1990, in part due to AIDS. . . .

World AIDS Day: U.S. Policies Still Lag

 Guttmacher Institute news release: World AIDS Day-- U.S. Policies Still Not Where They Need to Be:

World AIDS Day presents an opportunity to examine where we stand in the struggle against HIV/AIDS. One clear area of progress is the high degree of consensus at the global level that better linkages between HIV and reproductive health services are key both in meeting the needs of HIV-positive women and men and in preventing HIV transmission.

A solid body of evidence now demonstrates that these linkages are especially important in countries with high HIV prevalence and weak health infrastructures. It makes eminent sense to offer sexually active women the services they need—whether related to HIV or to reproductive health—in settings they already frequent. Women should be able to receive HIV testing, counseling and referrals at sites that they visit regularly to obtain family planning services. In turn, they should be able to obtain family planning counseling and services to help them to avert pregnancies they don’t want at places they visit to receive HIV services.

But while the global community recognizes the crucial role of linking these services, U.S. policy lags. Unaccountably, the law that guides the U.S. global AIDS program (PEPFAR), although revised and reauthorized little more than a year ago, fails to mention these linkages at all.

In fact, U.S. policy—unquestionably strong in the AIDS treatment area—lags generally in terms of HIV prevention. In no area is this more so than in its failure to adequately meet the needs of young people. PEPFAR still overemphasizes abstinence as the officially preferred strategy to prevent sexual transmission of HIV among all unmarried people, and imposes many restrictions on young people’s ability to receive comprehensive sex education and to obtain condoms. . . .

Health Officials Report that STD Rates Continue to Rise

Time Magazine: STDs Continued Record Increase in 2008:

(ATLANTA) — Sexually spread diseases continue to rise, with reported chlamydia cases setting yet another record in 2008, government health officials said Monday.

Last year there were 1.2 million new cases of chlamydia, a sometimes symptomless infection that can lead to infertility in women. It was the most ever reported, up from the old record of 1.1 million cases in 2007. See The Wellness Blog.

Better screening is the most likely reason, said Dr. John M. Douglas Jr. of the U.S. Centers for Disease Control and Prevention.

Syphilis, on the verge of being eliminated in the United States about 10 years ago, also has been increasing lately. About 13,500 cases of the most contagious form of the disease were reported in 2008, up from about 11,500 the year before.

Unlike chlamydia, health officials think syphilis cases actually are increasing. . . . 

China Lacks Sex Education Despite One-Child Policy

Slate Magazine: Everything You Always Wanted To Know About Sex (But Didn't Learn Because You Grew Up in China), by Michelle Tsai:

BEIJING—The first time Hu Jing tried to have sex with her college boyfriend, there was a technical difficulty. "We knew we had to use a condom," she said. "But we didn't know how."

Faced with this conundrum, Hu and her boyfriend went looking for answers—he from his more experienced friends, she from the university library, where she combed through Dream of the Red Chamber, a literary classic from the Qing Dynasty.

The following week, they reconvened for a second try. This time, they managed to roll on the condom but then … well, where was the penis supposed to go? It took another week of research before they succeeded in doing the deed.

After three decades of the one-child policy, you'd expect people here to know how to have sex without getting pregnant. And you'd be wrong. In July, Chinese health officials said that 13 million abortions are performed in registered medical institutions each year, largely because people lack sex education. The number of unwanted pregnancies is even higher when you take into account abortions at unregistered medical clinics, not to mention the 10 million abortion-inducing pills sold each year. . . . 

HPV Vaccine Approved for Boys but Not Recommended for Routine Use

LA Times: CDC panel OKs use of Cervarix HPV vaccine in girls, Gardasil in boys, by Thomas H. Maugh II:

The Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices voted today to recommend the use of the Cervarix human papilloma virus (HPV) vaccine in girls age 11 and 12. Cervarix was approved by the Food and Drug Administration on Oct. 16 and acceptance by the ACIP is the next step toward widespread use of the vaccine. The panel had initially recommended that the guidelines say that Gardasil, previously approved by the FDA, and Cervarix were interchangeable. But the final approval noted that Cervarix protects against only two strains of HPV that cause cervical cancer, while Gardasil protects against those two strains plus two other strains that cause genital warts.

The panel also voted that Gardasil "may be given to males aged 9 through 26 years to reduce their likelihood of acquiring genital warts." That statement stopped short of recommending it for boys and men and some experts think that, as a result, insurance companies will not pay for the vaccine for males.

See also: Reuters: U.S. advisers decline to push Gardasil vaccine for boys

The Huffington Post: Cervix Not Required: An Interview with Dr. Adina Nack, by Abby L. Ferber:

Last Friday, the FDA approved the Gardasil vaccine for use in boys and men ages 9 to 26 years old. When I heard this news, I was surprised. My daughter received the vaccine from her physician, and I had always thought of this as a "cervical cancer vaccine." The reality, however, is that this is a HPV vaccine, to guard against the sexually transmitted Human Papillomavirus. Why, however, is it only now being approved for males, when it was approved three years ago for females?

I turned to Adina Nack, Ph.D., professor of medical sociology and sexuality studies at California Lutheran University, for answers. She is the author of the book Damaged Goods? Women Living with Incurable Sexually Transmitted Diseases (Temple Univ. Press, 2008), and her research on STI stigma provides insight into the negative health consequences of Merck's original campaign for developing and marketing a female-only Gardasil. In my email interview with her, she reflects on the recent news.

The Pros and Cons of Circumcision

A recent issue of New York Magazine focuses on the debate over circumcision: For and Against Foreskin: A comprehensive investigation into the pros, cons, and controversies of circumcision.

The feature includes:

• Would You Circumcise This Baby?

• The Case Against the Case Against Circumcision

• What Your Sex Partners Think

• What About Cancer and AIDS?

and more.

Second-Generation Female Condoms Now Available in United States

Female Health Company Press Release: 

Second-Generation Female Condom Is Now Available in the United States:
FC2 Female Condom Will Cost 30 Percent Less than Predecessor

Company Makes Announcement at a Meeting of Southeastern Reproductive Health Organizations: FHC Makes Special Commitment to Expand Access in U.S. Regions with Highest AIDS Case Rates

CHICAGO, IL--October 1, 2009--The Female Health Company (FHC) (NASDAQ: FHCO) announced today that its second-generation FC2 Female Condom®, which received regulatory approval from the Food and Drug Administration in March as an HIV prevention method, is now available for purchase in the United States. 

The company made the announcement in Atlanta at a meeting of the Southeastern Urban Initiative for Reproductive Health, a coalition of reproductive health advocates from Southern states that is advocating for increased federal funding for HIV prevention.

"America's HIV epidemic isn't going away. In fact, it's getting worse, and African American and Latino women are disproportionately impacted," said Dazon Dixon Diallo, Founder and President of SisterLove, a grassroots service organization that supports HIV/AIDS prevention and reproductive health programs for women in the Atlanta, Georgia region.  "It's time to provide women in heavily impacted communities with expanded access to affordable women-controlled options, and the female condom becomes that choice. Women will use it if they have it." . . .

FC2 may be purchased from the Company's two public sector distributors: 

Total Access Group, Inc.  www.totalaccessgroup.com 

Global Protection Corporation, www.globalprotection.com/store

In addition, FHC has launched a website, www.fc2femalecondom.com, which includes tiered pricing information for ordering a minimum quantity of 25,000 units directly from the Company. 

Conservative Groups Oppose United Nations Sex Ed Guide

NY Times: U.N. Guide for Sex Ed Generates Opposition, by Steven Erlanger:

PARIS — A set of proposed international sex education guidelines aimed at reducing H.I.V. infections among young people has provoked criticism from conservative groups that say the program would be too explicit for young children and promote access to legal abortion as a right.

The guidelines, scheduled to be released by Unesco in a new draft next week, would be distributed to education ministries, school systems and teachers around the world to help guide teachers in what to teach young people about their bodies, sex, relationships and sexually transmitted diseases. They would address four different age groups. . . .

But the conservative criticism has already caused one of the key participating and donor agencies, the United Nations Population Fund, to pull back from the project and ask that its name be edited out of the published material. . . .

Uganda's Plan to Distribute Female Condoms Encounters Resistance from Funders Including PEPFAR

Time Magazine (8/30): The Battle in Uganda Over Female Condoms, by Nick Wadhams:

On the surface, it seems like a fine idea; reproductive rights groups certainly think so. In July, the Ugandan government announced that, using cash from the U.N. Population Fund, it would distribute 100,000 female condoms in a bid to stop a resurgence of HIV/AIDS. Advocates cheered the initiative, saying it would give women more control over their own bodies. But in the weeks since, major funders of anti-HIV/AIDS programs have shown far less enthusiasm, with many deciding not to back the plan. Instead of serving as a surefire weapon against the spread of HIV, Uganda's female condoms initiative has become the latest example of the limitations faced by governments, advocacy groups and donors in the fight against the virus....

Effort to Mandate Protected Sex in Porn Industry Faces Resistance

Broadsheet (Salon.com): Porn's last taboo: Protected sex, by Tracy Clark-Flory:

The industry is resisting a push for condom-only smut and not just because it makes far less money

You won't find "Debbie Does Condoms" or "Jenna Loves Prophylactics" on offer from any of the major porn studios, but that could all change thanks to an ongoing campaign to require rubbers in hardcore flicks. From the outside, it seems a rather admirable way to protect porn actors from the consumer push for risky bareback porn, as I wrote a couple months back. The approach seems basically humanist – or even feminist, considering that female porn actors are most at risk for contracting HIV in straight porn. But, I'm finding that there are actually some Magnum-sized issues with such legislation. Late last week, the AIDS Healthcare Foundation filed an official complaint against 16 pornographers for producing films featuring unprotected sex and promised to raise hell until condoms are mandated throughout the industry. . . .

CDC Considers Promoting Circumcision to Fight Risk of H.I.V.

NY Times: Officials Weigh Circumcision to Fight H.I.V. Risk, by Roni Caryn Rabin:

Public health officials are considering promoting routine circumcision for all baby boys born in the United States to reduce the spread of H.I.V., the virus that causes AIDS.

The topic is a delicate one that has already generated controversy, even though a formal draft of the proposed recommendations, due out from the Centers for Disease Control and Prevention by the end of the year, has yet to be released.

Experts are also considering whether the surgery should be offered to adult heterosexual men whose sexual practices put them at high risk of infection. . . . 

For now, the focus of public health officials in this country appears to be on making recommendations for newborns, a prevention strategy that would only pay off many years from now. Critics say it subjects baby boys to medically unnecessary surgery without their consent. . . .

Gov't Study Shows Benefits of Gardasil, and Some Potential Complications

NY Times: Study on Vaccine for Cervical Cancer Finds Benefits Despite Some Risks, by Roni Caryn Rabin:

The new vaccine designed to protect girls and young women from cervical cancer has a safety record that appears to be in line with that of other vaccines, a government report has found. Some serious complications occurred, including at least 20 deaths and two cases of Lou Gehrig’s disease, but they were not necessarily caused by the vaccine, the study said.

The most common serious complications after vaccination with Gardasil were fainting episodes and an increased risk for potentially fatal blood clots, possibly related to oral contraceptive use and obesity, the study found.

The vaccine has been given to more than seven million girls and young women nationwide and there is no way to prove that complications came from the vaccine. . . .

Study Shows Young People Need Better HIV Education

Lesbian & Gay Foundation: Research reveals need for better HIV education for young people:

Over half the world's teenagers ignorant to HIV risks

A study by the international student organisation AIESEC has revealed that half of the world's teenagers admit to being ignorant about HIV risks.

The research, involved 1,566 young people from 99 countries, and showed that one in three youngsters apparently do not believe using protection stops the spread of sexually transmitted infections.

The results of the study highlight the need for improved health messages and sex education targeted at all young people from governments, parents and teachers.

Jonathan Klick, et al., on Abortion Liberalization and Sexual Behavior

Jonathan Klick (Penn Law), Sven Neelsen (Center for Economic Studies and Ifo Institute for Economic Research), and Thomas Stratmann (George Mason University) have posted The Effect of Abortion Liberalization on Sexual Behavior: International Evidence on SSRN.  Here is the abstract:

Most industrialized countries have increased access to abortion over the past 30 years. Economic theory predicts that abortion laws affect sexual behavior since they change the marginal cost of having risky sex. We use gonorrhea incidence as a metric of risky sexual behavior. Using a panel of 41 North American, European and Central Asian countries over the period 1980-2000, we estimate the impact of abortion law reform on risky sex. Compared to the most restrictive legislation that permits abortion only to save the pregnant woman’s life or her physical health, more liberal abortion laws are associated with at least thirty additional gonorrhea cases per 100,000 individuals. The marginal effect of laws which make abortion available on request is larger than the effect of laws which allow abortion on socioeconomic and mental health grounds. Our results are robust against a set of alternative sample constructions and model specifications.

International Guidelines for Mothers Taking Antiretrovirals May Change

Reuters: WHO may change ARV guidelines for pregnant mothers, by Wendell Roelf:

CAPE TOWN (Reuters) - International guidelines for mothers taking antiretrovirals (ARVs) may change, a senior WHO official said, with new evidence showing HIV infection rates among babies are significantly cut when mothers are given prolonged ARV treatment during breastfeeding.

The World Health Organization is reviewing its 2006 recommendations on the use of ARVs in pregnant women, including during the breastfeeding period. New guidelines are expected to be published by the end of 2009 and will take into account emerging data.

South African Government Fails To Support Circumcision To Help in HIV/AIDS Prevention

NY Times: South Africa Is Seen to Lag in H.I.V. Fight, by Celia W. Dugger:

ORANGE FARM, South Africa — ...Circumcision has been proven to reduce a man’s risk of contracting H.I.V. by more than half. Yet two years after the World Health Organization recommended the surgery, the government here still does not provide it to help fight the disease or educate the public about its benefits.

Some other African nations are championing the procedure and bringing it to thousands. But in South Africa, the powerhouse country at the heart of the epidemic, the government has been notably silent, despite the withering international criticism the country has endured for its previous foot-dragging in fighting and treating AIDS.