Reproductive Rights Prof Blog

Likely Houston Zika Outbreak Complicated by Texas's Conservative Position on Reproductive Rights

HoustonPress (Sept. 19, 2016): Texas's Conservatism on Reproductive Rights May Make Fighting Zika Harder, by Carter Sherman:

As Houston braces for an outbreak of Zika (the city's mosquito season will extend well into October), activists are taking note of the likelihood that Texas's ultra-conservative stance on reproductive rights will make it harder for the state to fight the virus.  The Population Institute, an international non-profit that aims to expand access to family planning resources, has reported that "Texas's especially dire track record on the issue makes the state 'particularly vulnerable."  The state received an F-, the lowest possible grade, in the Institute's 2015 Report on Reproductive Health and Rights. 

Despite the recent victory in Whole Woman's Health v. Hellerstedt, the fact that many abortion clinics in Texas remain closed means that "some women who contract Zika may have no choice but to carry a pregnancy to term."  And with the number of people traveling to Texas from other regions of the world, Zika will remain a year-round concern. 

Genevieve Cato of the Lilith Fund expressed her consternation: “I personally have found it almost maddening that we are seeing this potentially devastating possibility of a Zika outbreak at the same time that the state is doubling down on its willful inaction on expanding access to reproductive healthcare.”     

Obstacles to Zika Testing: The CDC Weighs In

New York Times (Sept. 19, 2016):  Want a Zika Test? It's Not Easy, by Roni Caryn Rabin:

Getting a Zika test is harder than you thought, even for people who have recently traveled to areas where Zika is a big problem and who are planning to have children.  People are discovering that you cannot simply show up at a public health department and be tested on demand. 

The difficulty stems from a Centers for Disease Control directive establishing strict guidelines for Zika testing.  The guidelines give priority to pregnant women with possible exposure to Zika and to people with Zika-like symptoms.  This leaves out people who have possibly been exposed to Zika and are trying to conceive.  The guidance for this population is that they engage in protected sexual intercourse for at least eight weeks after their fear exposure.   The World Health Organization recommends six months of protected sexual intercourse before trying to conceive.  These recommendations are meant to prevent an onslaught of requests for Zika testing that would swamp local public health authorities.  They also help define when insurers will cover Zika testing. 

Testing for Zika is a complex process that may require three tests for a conclusive result.  There is no test for detecting the infection in semen, however.

 

Denied Birth Control, Teens Around the World Still Have Sex — Unsafe Sex

Refinery 29 (June 16, 2016): Denied Birth Control, Teens Still Have Sex — Unsafe Sex, by Hayley MacMillen:

From the 2016 International Conference on Family Planning in Indonesia, Refinery 29 provides first hand accounts of young people denied safe sex options and education.  A recent Lancet study has identified unsafe sex as the fastest growing risk factor for ill health for  young people around the world.  At the conference, attendees stressed the importance of accurate, as well as widespread, sex ed to all adolescents.  Haley MacMillen writes:

Birth control fallacies are, of course, not limited to East Africa but crop up wherever medically accurate, comprehensive sex ed is withheld. When I ask Philippines-based journalist and sex columnist Ana Santos, another attendee of the International Conference on Family Planning, about    contraception myths in her country, she’s armed with some horrifying ones. People believe that "jumping after sex will prevent pregnancy" — although she notes, drily, that "a jump from what height is never mentioned" — and that "drinking coconut juice laced with bleach or Tide detergent will wash away the spermies." And since condoms can be hard to come by, people, especially young people, wrap Calypso plastic, a brand used to package iced candy, around their penises instead. "Totally ouchy, right?" Santos asks. Yes. And ineffective.

The article emphasizes the need for comprehensive sex ed  - both internationally and locally - in order to help young people around the world and around the corner. 

Phoenix School Board Votes to Remove Pages from Biology Textbook Discussing STDs, Contraception, and Abortion

The New York Times: In Arizona, a Textbook Fuels a Broader Dispute Over Sex Education, by Rick Rojas:

The textbook, the one with the wide-eyed lemur peering off the cover, has been handed out for years to students in honors biology classes at the high schools here, offering lessons on bread-and-butter subjects like mitosis and meiosis, photosynthesis and anatomy.

But now, the school board in this suburb of Phoenix has voted to excise or redact two pages deep inside the book — 544 and 545 — because they discuss sexually transmitted diseases and contraception, including mifepristone, a drug that can be used to prevent or halt a pregnancy. . . .

Researchers Predict Legalizing Prostitution Would Lower the Spread of HIV Infections

Jezebel: Legalizing Prostitution Could Lower the Spread of HIV by One-Third, by Hillary Crosley:

Here's a crazy thought; legalizing prostitution could reduce the number of international HIV infections for female sex workers by at least a third in several countries. Health experts presented this new research drawn from Canada, India and Kenya during the 20th International AIDS Conference in Melbourne, Australia on Tuesday. . . .

Ninth Circuit Case Addresses Constitutionality of Requiring Porn Actors to Wear Condoms

The National Law Journal: A Condom Conundrum: Can Los Angeles demand that porn actors wear them?, by Amanda Bronstad:

At first blush, a case now before the U.S. Court of Appeals for the Ninth Circuit appears downright raunchy, brought by a Los Angeles studio whose films have titles like "Bedside Brat," and "Sex in Dangerous Places."

But the appeal, by Vivid Entertain­ment LLC, raises an intriguing constitutional issue: How far does the First Amendment go in protecting the free-speech rights of actors who have sex with each other in movies? . . .

Arizona Willing to Sacrifice Pregnancy Prevention and Other Women's Health Services in Zeal to Attack Abortion

The American Prospect: Razing Arizona Women's Health Care, by Amelia Thomson-Deveaux:

Like Napoleon forging into the Russian winter, anti-choice politicians are loath to give up on abortion restrictions, however minor, until the Supreme Court forces them to. On Wednesday, Arizona Attorney General Tom Horne asked the Supreme Court to reinstate a law that would strip Medicaid funding from doctors and clinics who perform abortions. Poor women already can’t use federal dollars to cover abortion procedures—that’s been illegal since the late 1970s. The law, which was struck down by the Ninth Circuit Court of Appeals in August, instead would prevent the state’s abortion providers from being reimbursed by Medicaid for providing any kind of care to low-income women, whether it’s breast exams, cervical cancer screenings, or contraceptive services. . . .

Indiana made a similar bid for the Supreme Court’s attention after the 7^th Circuit Court of Appeals struck down its law, which prohibited Planned Parenthood from receiving state or federal funds. But the justices refused to hear the case. Caitlin Borgmann, a professor of law at the City University of New York, says it’s unlikely, given the justices’ unwillingness to hear Indiana’s appeal, that Arizona’s petition will be successful. “To read the statute as broadly as Arizona wants would allow the state to exclude providers for any reason,” says Borgmann. “Such a precedent ought to give the Supreme Court pause too, because its implications extend far beyond abortion.” . . .

It’s undeniable that without programs like Medicaid, which help low-income women afford contraception, the abortion rate in the country would be much higher. . . . “Laws like these reveal the anti-abortion rights movement for what it is,” Borgmann says. “Their goal is to be punitive and prevent access to abortion, not come up with solutions to help women make autonomous decisions about their health.” . . .

HPV Vaccination Rate Among Teenage Girls Remains Low

The New York Times: HPV Vaccine Not Reaching Enough Girls, C.D.C. Says, by Sabrina Tavernise:

The very low vaccination rate for teenage girls against the human papillomavirus — the most common sexually transmitted infection and a principal cause of cervical cancer — did not improve at all from 2011 to 2012, and health officials on Thursday said a survey found that doctors were often failing to bring it up or recommend it when girls came in for other reasons. . . .

Roger Magnusson on Australia's Legal Responses to HIV and other STIs

Roger Magnusson (University of Sydney) has posted Law's Role in Promoting Sexual Health in Australia on SSRN. Here is the abstract: 

This paper explains some of the principle ways in which public health laws seek to influence sexual behaviour and rates of transmission of STIs (sexually transmissible infections), with particular reference to HIV. It then presents two competing models for identifying, evaluating and debating the values inherent in legal and policy responses to STIs in Australia. These are, firstly, the “contain and control” model inherited from historical responses to contagious diseases, and secondly, a “human rights” model, which seeks to implement a harm minimization approach to STIs and assumes a happy alignment, in most circumstances, between the public health interest and individual rights and interests. Elements of both approaches are evident in Australian laws responding to HIV and other STIs. Despite the acknowledged success of Australia’s response to HIV, the rate of new infections is rising, contributing to debate about the appropriate limits of a human rights-focused approach. The paper evaluates, in particular, debates about the persistent criminalization of HIV and STI transmission as a public health tool; the policy challenges posed by risk-seeking behavior; and the challenge to “HIV exceptionalism” posed by the “test and treat” strategy in the United States, which emphasizes opt-out HIV testing and wider use of HIV test data.

Boston College Cracks Down on Safe Sex Group's Distribution of Condoms

The New York Times: Ban on Free Condoms Jeopardizes Group’s Work With Catholic College, by Jess Bidgood:

Chelsea Lennox, a junior at Boston College, the Gothic university overlooking this natty Boston suburb, picked up a bouquet of brightly colored condom packages and put them into the envelope that she views as a tiny beacon of sexual health resources at the deeply Catholic institution.

“We have S.T.I. facts, birth control choices, how to choose one, and then Planned Parenthood locations and resources,” Ms. Lennox said of the contents, ready for distribution. . . .

NGOs Challenge Speech-Related Conditions Placed on Federal Funds for Global HIV/AIDS Prevention

SCOTUSblog - SCOTUS for law students: SCOTUS for law students: Prostitution and Free Speech, by Stephen Wermiel:

Prostitution seems like an unlikely topic for a battle over freedom of speech, but that is precisely the focus of an important case to be argued in late April that tests the limits of the federal government’s ability to attach conditions to federal spending.

The case is Agency for International Development v. Alliance for Open Society International, Inc., to be argued on April 22.

The dispute involves a challenge by nongovernmental organizations (NGOs) to regulations implementing a federal law that provides funds to help combat the spread of HIV and AIDS throughout the world. . . .

Atli Stannard on Criminalization of Failure to Disclose HIV-Positive Status in Canada

Atli Stannard has posted When Failure to Disclose HIV-Positive Status Vitiates Consent to Sex in Canada on SSRN. Here is the abstract:

A number of jurisdictions have grappled with a particularly difficult question in respect of the Human Immunodeficiency Virus (HIV): when does failure to disclose that one is HIV-positive, combined with engaging in otherwise consensual sexual relations, make that act of engagement in sex a criminal offence?

In two recent cases, the Supreme Court of Canada examined this question. The cases ultimately turned on rather different matters, but were heard in tandem. This case note focuses first on Mabior, then outlines its “sister case” of D.C. Together, they provide a good understanding of the current Canadian approach to the criminalisation of exposure to HIV without disclosure – treating it as a sexual offence, rather than an offence against the person. The case note draws out the "Williams Paradox" and the use of statistics in the cases. It compares the Canadian approach to that in England and Wales, Australia, and New Zealand. . . .

Medical Groups Encourage Screening for Reproductive Coercion

Medical News Today:  Reproductive Coercion Common in Abusive Relationships, by Kelly Fitzgerald:

Adolescent girls and women should now be screened for reproductive coercion, a form of abuse that occurs when male partners sabotage their contraception intentionally.

This form of abuse, known as reproductive coercion, can manifest in several ways, such as deliberately giving a partner a sexually transmitted disease (STIs), forcing a partner to have an undesired abortion or pregnancy, or seizing control of a woman's contraceptive pills. . . .

Guttmacher Institute Releases 2012 State Policy Review on Reproductive Health and Rights

Guttmacher Institute:  Laws Affecting Reproductive Health and Rights:  2012 State Policy Review:

                      

Reproductive health and rights was once again the subject of extensive debate in state capitols in 2012. Over the course of the year, 42 states and the District of Columbia enacted 122 provisions related to reproductive health and rights. One-third of these new provisions, 43 in 19 states, sought to restrict access to abortion services. Although this is a sharp decrease from the record-breaking 92 abortion restrictions enacted in 2011, it is the second highest annual number of new abortion restrictions. . . .

Federal Court Ruling Expected on Alabama Policy Isolating Inmates with H.I.V.

The New York Times: Ruling Soon on Isolation of Inmates With H.I.V., by Robbie Brown:

ATLANTA — In his first week in prison in Alabama, Albert Knox, a former pimp convicted of cocaine possession, tested positive for H.I.V.

Afterward, he says, guards called out “dead man walking” as he passed through the halls. He was banned from eating in the cafeteria, working around food or visiting with classmates in his substance-abuse program. . . .

Benjamin Meier, Kristen Brugh, and Yasmin Halima on Human Rights Based Approach to Global HIV/AIDS Policy

Benjamin Mason Meier (University of North Carolina at Chapel Hill), Kristen Nicole Brugh (University of North Carolina at Chapel Hill), & Yasmin Halima have posted Conceptualizing a Human Right to Prevention in Global HIV/AIDS Policy on SSRN. Here is the abstract:

Given current constraints on universal treatment campaigns, recent advances in public health prevention initiatives have revitalized efforts to stem the tide of HIV transmission. Yet despite a growing imperative for prevention — supported by the promise of behavioral, structural, and biomedical approaches to lower the incidence of HIV — human rights frameworks remain limited in addressing collective prevention policy through global health governance. Assessing the evolution of rights-based approaches to global HIV/AIDS policy, this review finds human rights to have shifted from collective public health to individual treatment access. While the advent of the HIV/AIDS pandemic gave meaning to rights in framing global health policy, the application of rights in treatment access litigation came at the expense of public health prevention efforts. Where the human rights framework remains limited to individual rights enforced against a state duty bearer, such rights have faced constrained application in framing population-level policy to realize the public good of HIV prevention. Concluding that human rights frameworks must be developed to reflect the complementarity of individual treatment and collective prevention, this article conceptualizes collective rights to public health, structuring collective combination prevention to alleviate limitations on individual rights frameworks and frame rights-based global HIV/AIDS policy to assure research expansion, prevention access, and health system integration.

Anna Carpenter on Women and HIV/AIDS Prevention

Anna E. Carpenter (Georgetown University Law Center) has posted Women and HIV/AIDS: Towards a Jurisprudence of Social and Economic Rights on SSRN. Here is the abstract:

This article argues that traditional HIV/AIDS prevention efforts focused on addressing individual risk factors are not sufficient to end the spread of the disease among women. Rather, systemic factors rooted in economic and gender inequality are the primary drivers of the HIV epidemic among women. As a result, the U.S. response to HIV/AIDS must address these factors, namely poverty and violence. The article then argues for a commitment to a social and economic rights framework as a key part of efforts to end the HIV epidemic. The social and economic rights critical to ending the HIV epidemic are those that would lift women and their families out of poverty, help them secure stable housing, give them the economic means to leave violent relationships, and give them access to health care. These rights include a right to a minimum level of economic support, a right to housing, and a right to health. The article finally articulates how a positive rights framework would offer descriptive, practical, and aspirational benefits necessary to eradicate the HIV epidemic among U.S. women.

Scott Burris and Matthew Weait on Criminalization and Moral Responsibility for Knowing Sexual Transmission of HIV

Scott Burris (Temple University – James E. Beasley School of Law) and Matthew Weait (University of London – Birkbeck College, School of Law) have posted Criminalisation and Moral Responsibility for the Sexual Transmission of HIV on SSRN. Here is the abstract:

The essay that follows is an effort to take on a narrow but important question in a serious, though limited, way. The question is whether there is a MORAL case for lifting primary responsibility for Human immunodeficiency virus (HIV) prevention from the shoulders of those who know they are infected. The question is important because, for many people, it feels so obviously right to require those with HIV to accept this responsibility that punishing them as criminals if they fail to do so seems a natural, logical and entirely fair next step. As far as we can tell, objections to HIV exposure or transmission laws to date have rested on practical, rather than moral concerns. We will ask whether there is a good moral case to be made against criminalisation.

There are two important things we will not do. We will not address the use of criminal law to deter or punish people who deliberately expose others to HIV with the aim of causing harm or with callous disregard of a significant risk of transmission. Like other commentators, we regard trying to harm others as wrongful and subject to prosecution regardless of the weapon used; our only concern in such a case, from the HIV perspective, is that a defendant not be punished more harshly only because the chosen weapon was the virus3 The second thing we will not do is attempt a moral analysis that is culturally comprehensive. The people of the world have developed many powerful systems of moral thought. We investigate our moral question within just one, the Western tradition of deontological ethics and liberal political philosophy. Our purpose is not, ultimately, to define for all people and all places a morality of HIV exposure, but to test whether the case for assigning primary moral responsibility for HIV to the person infected is as strong as it is assumed to be.

WHO and CDC Warn Gonorrhea Could Become Uncurable

U.S. News and World Report: World Health Organization warns Gonorrhea Could Join HIV as 'Uncurable', by Jason Koebler:

Both the WHO and the CDC say it's time to "sound the alarm" on the increase in drug-resistant gonorrhea

First, it was the Centers for Disease Control—now, the World Health Organization is warning that Gonorrhea could join herpes and HIV/AIDS as "uncurable" sexually-transmitted diseases.

"We're sitting on the edge of a worldwide crisis," says Manjula Lusti-Narasimhan, of WHO's department of reproductive health and research. "There's a general complacency around sexually transmitted infections in general, and this doesn't have the same political or social pressure as HIV. That's because gonorrhea has been so easily curable so far, but in the future, that won't be the case.". . .

The New York Times Posts Query About NYC's New Sex Education Classes

The New York Times - Schoolbook: Is New Sex Education Course Too Much or Just Enough?:

Last summer the Department of Education decided that for the first time in nearly two decades, students in New York City’s public middle and high schools would be required to take sex-education classes beginning this school year, using a curriculum that includes lessons on how to use a condom and the appropriate age for sexual activity. At East Side High Community School, the school newspaper, The East Sider, wrote about the new course in its January issue, before the course had started. The article, below, has been lightly edited.What do you think about the new sex education classes? Do you think they go too far? How are they being introduced in your school? Respond to our query below. . . .