Reproductive Rights Prof Blog

Study Shows What Happens When College Students Can't Obtain Subsidized Birth Control

Slate: The Aspirin Strategy: What happens to college sex when you stop subsidizing birth control?, by William Saletan:

Rush Limbaugh has a solution for women who have trouble affording contraception: Have less sex. Instead of asking your employer or college to provide insurance that covers birth control, pay for your birth control yourself. Or get your boyfriend to pay for it. Or just keep your knees together so you won’t have to worry about getting pregnant. . . .

[T]here’s evidence that many college women . . . have done what Limbaugh suggested. Faced with a contraceptive price hike in 2007, they cut back on sex. And yet, the rate of accidental pregnancy among college women didn’t decline. In fact, among those who were financially stressed, the rate increased, apparently because many of them responded to the higher cost of birth-control pills by shifting to cheaper, riskier methods, or to unprotected sex. . . .

Mary Fan on Decentralizing STD Surveillance

Mary D. Fan (University of Washington School of Law) has posted Decentralizing STD Surveillance: Toward Better Informed Sexual Consent on SSRN. Here is the abstract:

Historically, sexually transmitted diseases have been treated as an affliction of the morally degenerate Other and the consequence of deviation from the dominant sexual culture. Sexual culture and our national sexual health have, however, evolved. Sexually transmitted diseases (STDs, also referred to as STIs) are widespread and spreading. Transmission is facilitated by social, cultural and technological shifts. These social shifts strain our STD surveillance polices and laws, which remain strongly shaped by the inherited paradigm of the past. Information and power is centralized in the state, which receives, stores, and sometimes acts -- albeit with increasing infrequency in a time of severe budgetary strain -- on information reluctantly reported by health care providers. Because of targeted intervention and concentrated surveillance in low-income health settings, socially and economically marginalized groups continue to bear the heaviest burden of surveillance. Sexual culture shifts and the resulting health ramifications, however, cut across traditional social categories such as class, age, sexual orientation, and race.

This article explores how public health policies can respond to changing sexual culture and the need for more reliable information sharing by facilitating voluntary test results sharing and priority flagging of actors most in need of intervention. The Article advocates for utilizing the better vantage of doctors to identify potentially problematic actors based on reports by patients, in the privacy of the doctor’s office, about individuals who endangered their health. In a time when budget-strapped public health authorities are in triage mode and unable to engage in contact-tracing for all cases, a priority flag approach would be more efficient in identifying potentially problematic actors in need of stronger surveillance and educational intervention. This method of identification is also salutary because it relies on accounts of behavior warranting concern, rather than on heuristics about who is high-risk that may reinforce old stigmas and stereotypes.

Carissima Mathen and Michael Plaxton on HIV, Consent, and Criminal Culpability

Carissima Mathen (University of Ottawa) & Michael Plaxton (University of Saskatchewan) have posted HIV, Consent and Criminal Wrongs on SSRN. Here is the abstract:

Over a decade has elapsed since, in R. v. Cuerrier, the Supreme Court of Canada concluded that those who knowingly fail to disclose HIV positive status to their sexual partners are criminally culpable. Since then, the use of the criminal law in these circumstances has been criticized. It is suggested, in particular, that advances in the treatment of HIV-AIDS render several of Cuerrier’s key premises tenuous and in need of reconsideration. The Supreme Court has created an opportunity for such reconsideration in two appeals: R. v Mabior and R. v. DC. In this article we suggest that the Court should reconsider Cuerrier in a fundamentally different way, engaging more squarely with the boundaries of sexual assault. We believe that much of the criticism of Cuerrier, while thoughtful and important, proceeds from questionable premises of criminal responsibility that carry serious implications for the concept of consent to sexual activity.

Doctors Without Borders Warns that up to 15,000 AIDS Victims in Congo May Die Within 3 Years

Voice of America: Thousands of AIDS Victims Face Death in Congo:

A medical aid group has warned that up to 15,000 AIDS victims in Democratic Republic of Congo could die in the next three years because of difficulty getting life-saving drugs.

The warning comes from Doctors Without Borders, which says access to health care for HIV and AIDS patients in Congo is “horrific.” It says 85 percent of an estimated 350,000 people who could benefit from antiretroviral drugs are not receiving them. . . .

11th Circuit to Hear Case of HIV-Positive Man Denied a Job by Atlanta Police Department

GA Voice: HIV-positive man not hired by Atlanta Police Department to have case heard in federal appeals court, by Dyana Bagby:

The Eleventh Circuit Court of Appeals on Wednesday will hear the case of of a 37-year-old man who says the city of Atlanta called him a "direct threat" to others and he was denied a job with the Atlanta Police Department because he is HIV-positive.

Lambda Legal is representing the man, identified as "Richard Roe" in court documents to protect his identity.

A U.S. District Court ruled in favor of the city of Atlanta, saying the city did not discriminate against the HIV-positive man. Lambda Legal states that by calling Roe a "direct threat" the city did break federal law. . . .

Benjamin Meier and Alicia Yamin on Right to Health Litigation and HIV/AIDS Policy

Benjamin Mason Meier (UNC-Chapel Hill) and Alicia Ely Yamin have posted Right to Health Litigation and HIV/AIDS Policy on SSRN. Here is the abstract:

This article sketches the evolving interaction between human rights case law and HIV/AIDS policy. To clarify the need for such analysis, this article discusses the promise of human rights litigation in providing accountability for state public health commitments. Given the promise of this litigation in realizing public health outcomes, this article reviews the origins and development of human rights jurisprudence for HIV/AIDS. With this enforcement movement facing increasing criticism for distorting the global health governance agenda, the authors examine the backlash against this human rights jurisprudence in setting HIV/AIDS policy. This article concludes that scholars and practitioners must engage in comparative analyses of these rights-based litigation strategies and empirical research on their public health impacts. . . .

NYC Teen Sex Public Service Announcement Causes Stir

NY1 Online: Clinic CEO Defends Controversial Teen Sex Public Service Announcement:

After a new set of public service announcements from the Community Healthcare Network about sex caused a minor stir, Inside City Hall’s Errol Louis spoke with Catherine Abate, the CEO and president of the clinic, and Anthony Murray, a senior at University Heights High School who co-wrote and co-directed one of the PSAs.

New York Daily News: Safe sex web series launches using city teens speaking in slang using terms like 'Raw Dogging', by Simone Weichselbaum:

A new web series starring city teens talking racy street lingo about safe sex, STDs, and pregnancy will air Thursday.

“More Than Just Sex” features five public service announcement-styled videos on the popular site Vimeo.com where baby-faced actors use terms like “raw dogging” to describe not wearing a condom. . . .

Fighting HIV Stigma in the Rural South

CNN: Pastor fights HIV stigma in Southern town, by Jacque Wilson:

. . . It's a problem all across the Bible Belt. In 2007 -- the most recent data available from the Centers for Disease Control and Prevention -- the rate of diagnosed AIDS cases in the Southeastern United States was much higher than in other regions of the country: 9.2 per 100,000 people, versus 2.5 in the Midwest, 3.9 in the West and 5.6 in the Northeast.

Rural areas like this have it particularly bad. The CDC reports that while HIV diagnoses have slowly decreased in metropolitan areas since 1985, rural areas are still showing an increase because of stigma, poor education and a lack of funding. . . .

Man, Free of HIV After Bone Marrow Transplants, Offers Hope of Cure for AIDS

The New York Times: New Hope of a Cure for H.I.V., by Andrew Pollack:

Medical researchers are again in pursuit of a goal they had all but abandoned: curing AIDS.

Until recently, the possibility seemed little more than wishful thinking. But the experiences of two patients now suggest to many scientists that it may be achievable.

One man, the so-called Berlin patient, apparently has cleared his H.I.V. infection, albeit by arduous bone marrow transplants. . . .

Clinical Trial Shows Ineffectiveness of Gel Intended to Reduce HIV Infection

Boston.com: HIV trial scrapped after gel found to be ineffective:

In a major setback for AIDS prevention research, a clinical trial of a new vaginal gel supposed to reduce HIV infections has been suspended after studies showed it to be ineffective.

Researchers from the Microbicide Trials Network, set up by the US National Institutes of Health (NIH), expressed surprise at the outcome as a previous study on a gel containing the drug tenofovir had shown encouraging results. . . .

Policy Guidances From Obama Administration Encourage Linkages Between HIV and Family Planning Programs

Guttmacher Institute: More Work Needed to Bridge the Gap Between HIV and Family Planning Services Worldwide, by Rebecca Wind:

A series of policy guidances recently issued by the Obama administration strongly endorse linkages between HIV and family planning programs in developing countries, but a failure to ensure that women in HIV treatment programs have access to contraceptives is undermining efforts to integrate these two critical health services, according to “Linkages Between HIV and Family Planning Services Under PEPFAR: Room for Improvement,” by Heather Boonstra.

The new guidances fully endorse the provision by family planning programs of HIV counseling and testing, as well as referrals for HIV care and treatment, and they recommend the use of President’s Emergency Fund for AIDS Relief (PEPFAR) funds for these purposes. The guidances also specifically acknowledge that preventing unintended pregnancy is vital to lowering the rate of new HIV infections. Therefore, they state, women in HIV programs should have access to family planning counseling and referrals for contraceptives.

However, PEPFAR funding for contraceptives themselves is prohibited, even in places where there is no corresponding family planning program available to which women can be referred. A substantial number of PEPFAR-funded countries that do not receive U.S. funding for family planning—including Botswana, Namibia and Swaziland—have HIV-prevalence rates that are among the highest in the world. . . .

Panel Recommends Routine HPV Vaccinations for Boys and Young Men

The New York Times: Panel Endorses HPV Vaccine for Boys of 11, by Gardiner Harris:

Boys and young men should be vaccinated against human papillomavirus, or HPV, to protect against anal and throat cancers that can result from sexual activity, a federal advisory committee said Tuesday.

The recommendation by the panel, the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention, is likely to transform the use of the HPV vaccine, since most private insurers pay for vaccines once the committee recommends them for routine use. . . .

Abortion Opponents Condemn Proposed Illinois Sex Ed Bill

The American Independent: Illinois anti-abortion-rights group condemn sex-ed bill, by Sofia Resnick:

The Illinois General Assembly will address a proposed state education bill mandating more comprehensive sex education in its fall veto session, which begins today. Anti-abortion-rights groups, such as the Illinois Family Institute and the Illinois Right to Life, have condemned the bill on morality charges and are trying to thwart its passage.

HB 3027 would amend the state school code and require that each class that teaches sex education and/or discusses sexual intercourse in sixth through 12th grades must include instruction on both abstinence and contraception as preventative methods against pregnancy and sexually transmitted diseases (STDs). Additionally, the sex-ed instruction would need to be evidenced-based and medically accurate; however, school districts that do not currently provide sex education will not be required to teach it.

In districts that do provide classes or courses on sex ed, teachers will have to teach students abstaining from sexual intercourse ”is a responsible and positive decision and is the only protection that is 100% effective against unwanted teenage pregnancy, sexually transmitted diseases, and acquired immune deficiency syndrome (AIDS) when transmitted sexually.” This is a departure from current sex-ed instruction, which emphasizes that “abstinence until marriage” is the “expected norm” and gives no information on contraception. . . .

Study Finds Contraceptive Popular in Africa May Increase Risk of H.I.V.

The New York Times: Contraceptive Used in Africa May Double Risk of H.I.V., by Pam Belluck:

The most popular contraceptive for women in eastern and southern Africa, a hormone shot given every three months, appears to double the risk the women will become infected with H.I.V., according to a large study published Monday. And when it is used by H.I.V.-positive women, their male partners are twice as likely to become infected than if the women had used no contraception.

The findings potentially present an alarming quandary for women in Africa. Hundreds of thousands of them suffer injuries, bleeding, infections and even death in childbirth from unintended pregnancies. Finding affordable and convenient contraceptives is a pressing goal for international health authorities. . . .

Gov. Perry’s Wife May Have Influenced His HPV Vaccination Order

The New York Times: A Political Wife's Influence on an Issue, by Susan Saulny:

Four years after Gov. Rick Perry issued an executive order that would have made Texas the first state to require that sixth-grade girls be vaccinated against a sexually transmitted disease linked to cervical cancer, its genesis remains a mystery. Opponents, including Representative Michele Bachmann, suggest the governor was influenced by close ties to lobbyists for the vaccine maker, Merck, or donations from the drug company.

One potential explanation that has received far less attention is the influence exerted on Mr. Perry by a close confidante with expertise in women’s health: his wife, Anita Thigpen Perry, a nurse, country doctor’s daughter, and career-long advocate for victims of sexual assault who has been a vocal proponent of immunizations. . . .

Condoms4Life Campaign Overcomes Censorship to Advocate Condom Use

Catholics for Choice: Censored Condoms4Life Campaign Is Beamed Around the World:

This week, The Condoms4Life Campaign brought the message that good Catholics use condoms and condoms save lives to the pilgrims of World Youth Day and the people of Madrid. Despite attempts by the local authorities to ban our ads, hundreds of thousands of people saw them via the materials we handed out, our nightly projections on buildings throughout central Madrid, and the thousands of clings and posters that were put up around the city.

After the local authorities censored our ads, we targeted their offices and other key players with our projections: the offices of Publimedia—who initially accepted and then rejected our ads for buses and bus shelters; the office of city council member Ana Botella who was reported to be behind the decision to ban the ad and the residence of Archbishop Antonio María Rouco Varela of Madrid, the local prelate, among other high-profile venues. . . .

New York City to Require Public Schools to Teach Sex Education

ABC News: New York City to Mandate Sex Education in Public Schools, by Katie Moisse:

For the first time in nearly 20 years, New York City's public middle and high schools will be required to teach students about sex.

In an email to principals last night, Chancellor Dennis M. Walcott said mandatory sex education will start in the second semester of the 2011-2012 school year. The curriculum will be flexible but will include lessons on how to use condoms, how to avoid unwanted sexual encounters and how to respect relationship partners. . . .

The mandate applies strictly to the New York City public school system. New York State currently requires one semester of health education in both middle and high school, but does not mandate sex education. Only 20 states and the District of Columbia mandate sex education, according to a recent report by the Guttmacher Institute, which studies sexual health. . . .

U.S. Institute of Medicine Recommends Free Contraception and Other Reproductive Health Services as Part of Healthcare Overhaul

Los Angeles Times/Reuters: U.S. health body backs free birth control for women, by Andrew Seaman:

WASHINGTON (Reuters) - The U.S. Institute of Medicine recommended providing women free birth control and other preventive health services under the country's healthcare overhaul.

The IOM report, commissioned by the Obama administration, recommended that all U.S.-approved birth control methods -- including the "morning after pill," taken shortly after intercourse to forestall pregnancy -- be added to the federal government's list of preventive health services.

Courts Play Vital Role in Blocking New Anti-Abortion Laws

New York Times Editorial: The Courts Step In:  

In three new rulings, federal judges in different states have acted to block immediate enforcement of measures that restrict abortion rights and women’s access to affordable contraception, lifesaving cancer screenings and treatment for sexually transmitted diseases. These rulings are important victories for women’s health and reproductive rights. .  . .

Studies Show AIDS Drugs Can Prevent HIV Infection

New York Times: Two Studies Show Pills Can Prevent H.I.V. Infection, by Donald G. McNeil, Jr.:

Two new studies released on Wednesday add to the growing body of evidence that taking a daily pill containing one or two AIDS drugs can keep an uninfected person from catching the fatal human immunodeficiency virus.

The studies were the first to show protection in heterosexuals; the only earlier one with similarly encouraging results involved gay men. . . .