Increasing Condom Use, Reducing Sexually Transmitted Infections Through Behavioral Interventions

Main Category: Sexual Health / STDs
Also Included In: HIV / AIDS;  Preventive Medicine
Article Date: 19 Dec 2011 - 0:00 PST

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Behavioral interventions aimed at reducing sexual risk behaviors, such as unprotected sex, are effective at both promoting condom use and reducing sexually transmitted infections (STIs) long after the initial intervention, according to a new report in the Journal of Acquired Immune Deficiency Syndromes.

Lead author Lori A. J. Scott-Sheldon, Ph.D., of The Miriam Hospital's Centers for Behavioral and Preventive Medicine, and colleagues at the University of Connecticut conducted a meta-analysis of 42 studies evaluating the effectiveness of HIV-related behavioral interventions. The studies included in the meta-analysis assessed behavior changes, including increased condom use, and biological outcomes, such as a subsequent STI or HIV diagnosis. The studies were conducted worldwide and included a number of at-risk populations.

Researchers found that behavioral interventions - which included HIV education, motivation and skills-based training aimed at negotiating safer sex behaviors - were successful at improving condom use and reducing incident STIs, including HIV, for up to four years. This meta-analysis is believed to be the first to examine the incidence of HIV in a wide range of at-risk populations.

Scott-Sheldon says that while it may seem intuitive that behavioral changes, such as increased condom use, will result in fewer STIs, previous studies have been unable to support that assertion.

"The association between behavioral and biological outcomes is complex, since transmission of STIs depends on a number of factors, including partner type, characteristics, and perceptions of partner safety," she says. "Examining both outcomes, and factors associated with sexual risk behaviors, should be important in determining the efficacy of behavioral interventions."

The meta-analysis evaluated the findings of 67 behavioral interventions in 42 studies. While most studies were conducted in North America, 17 percent took place in Asia, 14 percent in Africa, 5 percent in Europe and 2 percent in South America. In most cases, participants were randomized to receive an HIV-related behavioral intervention or a control group. Interventions were provided in both group and individual settings.

Interventions were found to be more successful at improving condom use when social, cultural and economic barriers were addressed. Researchers also observed that, contrary to expectations, self-management training targeting risky sexual behavior did not significantly impact condom use one year after the initial intervention.

They also noted that participants were less likely to acquire STIs following the behavioral intervention if they were diagnosed with an STI or HIV at the time they entered the study. In addition, interventions were more successful at reducing the incidence of HIV when they sampled more Latinos. The authors note that, globally, Latinos are disproportionately affected by HIV and interventions targeting this group are urgently needed to prevent HIV infection in this population.

"HIV infections cost the United States billions of dollars annually," Scott-Sheldon says. "In the absence of an effective HIV vaccine, safer sexual practices and expanded prevention efforts are required to prevent new infections and reduce the burden of HIV. Translation and widespread dissemination of effective behavioral interventions within a wide range of population groups should be a high priority."

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our sexual health / stds section for the latest news on this subject. Co-authors include Michael P. Carey, Ph.D., director of The Miriam Hospital's Centers for Behavioral and Preventive Medicine; and Tania B. Huedo-Medina, Ph.D., Michelle R. Warren and Blair T. Johnson, Ph.D., of the University of Connecticut.
The principal affiliation of Lori A. J. Scott-Sheldon, Ph.D., is The Miriam Hospital (a member hospital of the Lifespan health system in Rhode Island). Dr. Scott-Sheldon also is an assistant professor of psychiatry & human behavior (research) at The Warren Alpert Medical School of Brown University.
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Pink Bibles Recalled, Linked To Planned Parenthood Funding

Editor's Choice
Main Category: Breast Cancer
Also Included In: Public Health;  Sexual Health / STDs
Article Date: 16 Dec 2011 - 7:00 PST

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Some pink Bibles, which were for sale in retail outlets since October 2011, have been recalled because it was discovered that part of their sales money went towards breast cancer screenings at Planned Parenthood, a US family planning organization which also provides abortions. The Southern Baptist Convention's publishing arm says it is recalling the Bibles.

Commentators say the move will have no impact on abortions figures, but will hurt lower-income women who would have received free breast cancer screenings.

LifeWay Christian Resources, a seller of Christian publications and part of The Southern Baptist Convention, has stopped selling the pink Bibles. The pink-bound books are of the Holman Christian Standard Bible.

Part of the sales of these Bibles went to Susan G. Komen for the Cure, a breast cancer charity, which said all those donations were going towards breast cancer screening. The Komen Foundation says it is disappointed with the recall.

Apparently, LifeWay received "about three dozen complaints" that Komen affiliates were sponsoring mammographies at Planned Parenthood. Planned Parenthood offers abortions as part of its family planning services.

Many products and symbols are colored pink as a gesture of breast cancer awareness, such as pink shoes, mouse pads, ribbons, etc. There used to be a pink Holman Christian Standard Bible for sale; that is, until last Wednesday.

The Pink Bible that has been recalled (Photo: The Tennessean)

LifeWay Christian Resources is pulling the bibles because the Dallas-based Susan G. Komen for the Cure Foundation, which benefits from the pink Bibles' sales, has some links to Planned Parenthood. Thomas Rainer, president of LifeWay, said:

"Though we have assurances that Komen's funds are used only for breast cancer screening and awareness, it is not in keeping with LifeWay's core values to have even an indirect relationship with Planned Parenthood."

The Komen Foundation said all the bible money was going towards breast cancer programs only. The Foundation expressed "disappointment" at LifeWay's move. Apparently, LifeWay had pledged $25,000.

LifeWay says the Bibles will be rebound and re-used. Some blogs, such as Bound4Life and LifeNews, had accused the Komen Foundation of donating hundreds of thousands of dollars to Planned Parenthood.

The Komen Foundation has emphasized that the money which went to Planned Parenthood was exclusively for breast cancer screenings and achieved 139,000 breast exams as well as over 5,000 mammograms. 177 cases of breast cancer were identified.

Opinions on this move are divided. While some say Bible sales cannot be linked to abortions, others emphasize that the only result from this move will be fewer breast cancer screenings for lower income females, resulting in more cases of breast cancer developing undetected, and more suffering for women - it will have absolutely no impact on abortion rates.

Written by Christian Nordqvist
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

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posted by ramo on 16 Dec 2011 at 7:28 am

As a Christian I feel that doing good cannot be linked with such politically and emotionally charged actions. If we were to ensure that none of our money reached pro-choice groups we may as well do business only within churches. Helping breast cancer awareness and treatments is something on which we should not just cooperate but actively recruit every organization- of no faith or other faiths or of secular values- to accomplish.

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posted by lou on 16 Dec 2011 at 7:39 am

The concept that "poor" will not receive breast screening without planned parenthood is an absolute lie. Any "poor" woman can get medicaid or be seen at any major hospital in th US and cannot be turned away if they have a real problem. Planned Parenthood uses this money as a slush fund that ultimately subsidizes their abortion mill. The Koman fund has TOO MUCH MONEY to the point that they give funds to organizations that subsidize abortion. We are reaching the point where breast cancer funding employs more people than it cures. Pink is a color and no organization owns it. Enough is enough

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posted by John on 16 Dec 2011 at 7:44 am

Lifeway is clearly an agent of Satan and has no interest in understanding God. This is another example that proves religion is the root of all evil. What a disgusting group of people. You will be judged and you will be doomed to hell.

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posted by Brent on 16 Dec 2011 at 7:50 am

...here's yet another example of christians harming society in order to advance a backward way of thinking. Why someone would want to deny a woman the opportunity to be checked for breast cancer simply because she went to a place that provide an abortion is incomprehensible to me. One would think that a true christian would want to help those in need regardless of the location.

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posted by Jack on 16 Dec 2011 at 7:51 am

I am so sick and tired of these conservative right winged whack jobs: get over it! Abortion is not murder, it is legal and nothing wrong with it!

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posted by Alex Meyer on 16 Dec 2011 at 7:55 am

Facts don't matter to these people. The only thing that matters is their backwards lifestyle. They don't care who suffers from their actions, be it underprivileged people or their own children.

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posted by Shannon on 16 Dec 2011 at 8:02 am

As someone who just this month lost their mother to breast cancer, I find it appalling that a Christian organization would withdraw support of a horrible disease because of where the test could be performed. Susan G Komen is one of the leading charity organizations for breast cancer. Will the publisher destroy the bibles, wasting a valuable resource in the process as well?

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posted by Mark on 16 Dec 2011 at 8:03 am

I also want to add that this author has no clue on economics and business finance. When Planned Parenthood receives money to do breast cancer screens, the money might be set aside specifically for that test. But, using the Komen money for breast cancer screens results in a freeing of money to be used elsewhere (primarily on abortions) at Planned Parenthood. To say the money from these bibles wasn't funding abortions is ludicrous and ill-informed.

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posted by Joe on 16 Dec 2011 at 8:13 am

I agree with the move, but they now need to find away to fund low cost or free screening to fill in the gap.

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posted by John on 16 Dec 2011 at 8:44 am

God doesn't exist so get real with your right wing conservatism. The real enemy to places like LifeWay is they might have to dig in their pocket to help someone that is not like them. If it went to help poor white Christians jump in wholeheartedly. If it goes to help a person on no or another religion they will try to convert you. Also if your not of the white race, too bad. Suffer and die from breast cancer if your poor.

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New Hope In Fight Against Global HIV/AIDS Pandemic

Main Category: HIV / AIDS
Also Included In: Sexual Health / STDs
Article Date: 16 Dec 2011 - 0:00 PST

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Scientists at the Gladstone Institutes have discovered new protein fragments in semen that enhance the ability of HIV, the virus that causes AIDS, to infect new cells - a discovery that one day could help curb the global spread of this deadly pathogen.

HIV/AIDS has killed more than 25 million people around the world since first being identified some 30 years ago. In the United States alone, more than one million people live with HIV/AIDS at an annual cost of $34 billion.

Previously, scientists in Germany discovered that HIV transmission is linked to the presence of an amyloid fibril in semen. This fibril - a small, positively charged structure derived from a larger protein - promotes HIV infection by helping the virus find and attach to its target: CD4 T white blood cells. In Cell Host & Microbe, researchers in the laboratory of Warner C. Greene, MD, PhD, who directs virology and immunology research at Gladstone, describe a second type of fibril that also has this ability.

These findings may spur efforts to slow the spread of HIV/AIDS. Prevention has recently focused on microbicides; chemical gels that, when used by women during sexual intercourse, block HIV infection. But while early microbicides had some success - reducing infection by an average of 39% - more recent trials have failed and devising a truly potent microbicide remains a top priority.

"Today's microbicides may be failing because, while they do target the virus itself, they don't block the virus from interacting with the natural infection-enhancing components of semen," said Nadia R. Roan, PhD, the paper's first author and a research scientist at Gladstone, an independent and nonprofit biomedical-research organization. "Now that we more fully understand how HIV hijacks these components to promote its own infection, we are one step closer to developing a microbicide that can more effectively stop HIV."

Sexual transmission accounts for the vast majority of HIV infections, and semen is the virus' key mode of transport. Earlier studies by Drs. Roan and Greene revealed the mechanism by which a positively charged fibril in semen - called SEVI - attracts HIV like a magnet, binding to the negatively charged HIV and helping to infect CD4 T cells. Here, they set out to investigate whether other components of semen also played a part.

In laboratory experiments on human semen samples, they identified a second set of fibrils - derived from larger proteins called semenogelins - that enhance HIV infection just as SEVI does. Removing these and other positively charged components from semen diminished HIV's ability to infect CD4 T white blood cells. Further confirming the role of these fibrils in promoting HIV infection, Drs. Roan and Greene found that semen samples from men who are naturally deficient in semenogelins - a disorder called ejaculatory-duct obstruction - also had a limited ability to enhance HIV infection.

"Our experiments suggest that fibrils derived from semenogelins - the major component of semen - are integral to enhancing HIV infection in semen," said Dr. Roan. "But we are intrigued by their natural, biological function as well. The fact that these fibrils are found in male reproductive organs could point to an evolutionary role in fostering fertilization - something we're currently exploring."

"We hope that this research paves the way for the next-generation of microbicides that can both neutralize these fibrils and attack the virus," said Dr. Greene, who is also a professor of medicine, microbiology and immunology at the University of California, San Francisco, with which Gladstone is affiliated. "This type of one-two punch in a microbicide - what current products lack - could finally give women real protection against HIV's deadly attack."

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our hiv / aids section for the latest news on this subject. Gladstone Research Associate Simon Chu also participated in this research, which was made possible by a research grant that was awarded and administered by the U.S. Army Medical Research and Material Command and the Telemedicine & Advanced Technology Research Center at Fort Detrick, MD, under Contract Number W81XWH-11-1-0562. Additional support came from the Giannini Foundation, the National Institutes of Health and the German Ministry of Science.
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Researcher Studies The Globalization Of Sex Trafficking And The Organizations That Work To Stop It

Main Category: Women's Health / Gynecology
Also Included In: Sexual Health / STDs;  Public Health
Article Date: 14 Dec 2011 - 1:00 PST

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In today's world, human trafficking is not an isolated problem, but a growing global issue. A Kansas State University professor is studying ways that anti-trafficking groups are fighting back.

"The focus of my research is not just to say how much sex trafficking is occurring, but how forms of it are changing," said Nadia Shapkina, assistant professor of sociology, who is looking at the geography, history and economic impact of trafficking. "The sex trade has been a global industry for a long time. But now, with the globalization of technology and transportation, it is becoming even more transnationalized."

One form of the sex trade that has evolved in recent years is sex tourism, which combines aspects of tourism with the purchase of sexual services, particularly of young women. About 95 percent of sex tourists are men from wealthy countries who come to tourist destinations - such as Greece, Thailand or Australia - for both entertainment and sex.

"Sex trafficking delivers women to customers, but sex tourism delivers customers to the place of consumption," Shapkina said. "Sex tourism becomes a very lucrative business. Technology, communication and transportation all allow that and they enable the trafficking of women as well."

Sex tourism operations are often led by skilled businessmen who know how to appeal and advertise to middle- and upper-class men with money and resources to travel and consume sexual services. Their messages have spread worldwide, Shapkina said, pointing to the United States, where multiple cases of labor and sex trafficking have been investigated.

"It doesn't necessarily mean that the market has increased, but it might mean that authorities have started detecting this criminal practice," Shapkina said. "It is hard to estimate the size of the sex trade because it is so underground. But what we can say is that it is very transnationalized and even the U.S. is affected by this negative aspect of globalization."

The globalization of human trafficking has also led to a rise in anti-trafficking activism. Shapkina is looking at how governments, international organizations, nongovernmental organizations and celebrity activists are collaborating to combat trafficking. She is mapping out organizations to understand what kind of resources they have, how successful they are and what they can achieve.

In the process, she has noticed challenges that many activist groups face. It is often difficult to coordinate actions across national borders because legal systems and cultures vary across countries. For instance, some countries such as Saudi Arabia penalize female victims of human trafficking, while countries such as Germany take a more humanistic approach by providing services for the victims.

Similarly, Shapkina is finding that many activist organizations turn to the government for help. Sometimes the governments respond and sometimes they don't, especially if the country has a strong sex tourism presence and governments benefit from the revenues from the sex trade.

Allegiances also play a role in a country's willingness to criminalize human trafficking. For instance, Turkey had no presence of active anti-trafficking organizations, but when the country wanted to join the European Union it began involving nonprofit organizations to work on the problem. A similar situation is happening in Ukraine as it tries to join the European Union and has to satisfy human rights and gender equality standard policies of the union.

"I have focused on Eastern Europe because the trafficking of women has become a problem in the region," said Shapkina, who is originally from Russia. "Many nongovernmental organizations have been forming in that area, and they want to focus on human trafficking. That is very new and we need to explain what is going on there."

Shapkina is also following human trafficking in the United States, where many initial anti-trafficking campaigns focused on foreign-born populations and immigrants as victims. That led to a realization of domestic exploitation, and prompted activists to focus on domestic trafficking, especially of minors.

"Clearly, the sex trade is a social problem, especially a gender inequality problem," Shapkina said. "This is what makes this trade possible, which involves the economic disempowerment of women. That's why we need to empower women economically and politically."

Shapkina recently gave a presentation about the global sex trade at the Gendered Commodity Chains: Bringing Households and Women into Global Commodity Chain Analysis international conference at Binghamton University, which is part of the State University of New York. An article based on the conference presentation will be published in 2012. Shapkina has also written a chapter about sex tourism in Ukraine. The chapter will be published in 2012 in the book "Sex Tourism in Ukraine: A Social Problem."

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
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Missed Opportunity To Transform Global HIV/AIDS Fight Reported By Tropical Disease Experts

Main Category: Tropical Diseases
Also Included In: HIV / AIDS;  Infectious Diseases / Bacteria / Viruses;  Sexual Health / STDs
Article Date: 12 Dec 2011 - 1:00 PST

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Global HIV/AIDS prevention and treatment efforts are missing a major opportunity to significantly improve health conditions in poor countries by simply adding low-cost care for the many other chronic and disabling diseases routinely afflicting and often killing these same patients, according to a panel of disease experts who spoke at the annual meeting of the American Society of Tropical Medicine and Hygiene (ASTMH).

"People want better health; they do not understand why we silo diseases," said Judd Walson, a global health and infectious disease expert at the University of Washington. "If you die from malaria, you don't care that your HIV was treated. Communities want us to leverage the resources we have to treat and prevent disease as effectively as possible."

Walson and his colleagues on the panel noted that many victims of HIV/AIDS also typically suffer from one or more of about 17 neglected, but burdensome, tropical diseases often called "diseases of poverty" because they prey on the "bottom billion" - the world's poorest people. They include ailments such as trachoma, schistosomiasis, lymphatic filariasis, leishmaniasis, Chagas disease and onchocerciasis, all of which are either insect-borne disease, bacterial infections, or caused by parasitic worms.

Despite the illness and deaths attributable to these diseases, proposed US funding for fighting them was only about $155 million in 2011, or about 3 percent of the $5.6 billion invested in HIV/AIDS efforts. Moreover, the programs often exist in isolation from one another with, for example, many programs restricting support only to antiretroviral drugs to treat AIDS.

Yet tropical disease experts note that in places like sub-Saharan Africa, where neglected diseases affect 1.4 billion people, co-infections with HIV are common. And they see mounting evidence that dealing with multiple diseases at the same time and in the same place is more cost-effective and clinically beneficial.

Walson pointed to a program in Western Kenya that focused on a community suspected of having high levels of HIV but whose remote location made it hard to reach to conduct testing. The program promised access to free bed nets and water filters to those residents who came in for a test. In just six days, some 10,000 residents turned out for the free nets and filters. The result: 1181 people were found to be HIV positive and referred to care while thousands of people gained new tools for preventing malaria and water-borne diseases.

In another example of the potential benefits of targeting multiple problems in a single intervention, a study initially focusing on treatment for onchocerciasis, a parasitic disease also known as river blindness, was broadened to offer insecticide-treated bed nets (ITNs), malaria drugs and vitamin A. The study, which covered an area with 2.35 million people, increased bed net coverage by nine-fold.

Sten Vermund, Professor of Pediatrics and Director of the Vanderbilt Institute for Global Health, noted the need to address any co-infections that might increase HIV viral load. He pointed to studies linking higher viral load with a higher likelihood of transmitting HIV, and a low load with reduced disease progression and HIV transmission risk. He said a review of a wide number of studies revealed that treating a variety of co-infections, including TB, malaria, schistosomiasis, filariasis, herpes, gonorrhea and syphilis decreased viral load to varying degrees.

"If de-worming efforts for neglected diseases reduces the viral load even just a little, then you could expect some benefit for preventing or slowing HIV transmission," said Vermund. "But it's also helpful to keep in mind that a majority of people don't know they have HIV. An effective mass de-worming campaign could have huge effects without even knowing the community's HIV status."

Peter Hotez, ASTMH President and founding dean of the National School of Tropical Medicine at Baylor College of Medicine, and Alan Fenwick, Professor of Tropical Parasitology and Director of Schistosomiasis Control Initiative at the Department of Infectious Diseases Epidemiology at Imperial College of London, offered a presentation focused on improved treatment for schistosomiasis. Schistosomiasis is a preventable, chronic, inflammatory condition caused by a parasite infection that is found in approximately 220 million people, most of whom live in sub-Saharan Africa. The parasite swims in water and burrows into human skin on contact. It is linked to an estimated 280,000 deaths each year. In women, the disease often affects the cervix and vagina where it can cause infertility, painful intercourse, and post-coital bleeding. One type of schistosomiasis known as female urogenital schistosomiasis affects girls and young women and is associated with HIV infection.

"These women are at highest risk of HIV infection and should be the focus of public health interventions," said Fenwick.

The high prevalence of urogenital schistosomiasis appears to be associated with higher rates of HIV and the genital lesions seen with this type of schistosomiasis may contribute to the acquisition of HIV in women. The researchers believe schistosomiasis interventions can be seen as a type of HIV/AIDS control, with mass treatment in girls aimed at preventing the onset of genital lesions.

In his President's address to the ASTMH meeting, Hotez challenged his colleagues to move beyond a focus on individual conditions to embrace a concerted campaign against the totality of tropical diseases. Referencing Bill Gates' call for adopting an "audacious goal" of eradicating malaria, Hotez called for expanding the "audacious goal" to ridding the world of all its neglected tropical diseases.

He portrayed neglected diseases as everyday manifestations of the Four Horsemen of the Apocalypse in that they cause pestilence, death, underlie famine and worsen the conditions of war. Hotez noted the importance of fighting disease to the success of international anti-poverty initiatives. "These diseases don't just occur in a setting of poverty; these diseases are a stealth cause of poverty in low and middle income countries," he said.

He quoted John Gardner, the Secretary of Health under President Lyndon Johnson, who said: "There are no better grounds on which we can meet other nations and demonstrate our own concern for peace and the betterment of mankind than in a common battle against disease.

In a separate presentation at ASTMH, Paul Farmer, founder of Partners in Health, also underscored the importance of attaching the fight against neglected diseases to a broader agenda.

"We need to understand the impact we can have when we link our understanding of improvements in people's lives to policy endeavors that can changes the lives of millions," he said. "Often this does not happen. The question is how can we build consensus in the scientific community and among our allies; how can we build coalitions to pull those policy levers more effectively? All of the diseases that affect the poor are neglected."

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
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Unpleasant Smell Linked To Gonorrhea In Men

Editor's Choice
Academic Journal
Main Category: Sexual Health / STDs
Also Included In: Men's health
Article Date: 09 Dec 2011 - 18:00 PST

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A much higher percentage of men with an unpleasant smell were found to have gonorrhea compared to other men, researchers from the Institute of Cytology and Genetics in Novosibirsk, Russia revealed in the Journal of Sexual Medicine. The authors explained that adult males with gonorrhea had a putrid smell, as far as many adult females were concerned.

As background information, the authors explained that animal research had demonstrated that rats and mice pick up on chemical signals to avoid sexual contact with infected potential mates. However, studies into body odor in humans have so far been limited to medical diagnostics. No studies had ever looked into smell modifications in humans, due to infection, and what impact that might have in choosing a sexual partner.

As STDs or STIs (sexually transmitted infections) have no clear visible external signs, the researchers wondered whether odor might be a sign that has been overlooked.

Mikhail Moshkin and team set out to determine whether odor unpleasantness in young adult males might be linked to infection with Neisseria gonorrhoeae (gonorrhea).

The researchers collected saliva and armpit samples from 16 healthy, 13 gonorrhea infected, and 5 other men who had recovered from gonorrhea after medical treatment. Healthy young female volunteers then assessed the sweat samples for odor (smell). With the saliva samples, the researchers measured for concentrations of testosterone, cortisol, immunoglobulin G (IgG), and immunoglobulin A (IgA). All the male participants were aged from 17 to 25 years and the female ones from 17 to 20.

Their aim was to determine whether the females could distinguish pleasant and unpleasant armpit sweat smells, and whether the differences might be linked to gonorrhea infection, no infection, or recent infection.

They found that: The women described the odor from infected individuals as less pleasant compared to the healthy and recently recovered men. A very high proportion of samples from the infected men were rated as putrid (rotten, rancid).There was a negative correlation between odor pleasantness and concentrations of nonspecific salivary IgA and IgC.In an Abstract in the journal, the authors wrote:

"Perhaps, the immune-dependent reduction of the scent pleasantness in the acute phase of STI is part of an evolutionary mechanism ensuring, unconsciously, avoidance of a risky romantic partner."

Written by Christian Nordqvist
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

Visit our sexual health / stds section for the latest news on this subject. "Scent Recognition of Infected Status in Humans"
Mikhail Moshkin DrSci, Nadezhda Litvinova DrSci, Ekaterina A. Litvinova PhD, Alena Bedareva PhD, Andrey Lutsyuk MD, and Ludmila Gerlinskaya DrSci
The Journal of Sexual Medicine 6 DEC 2011. DOI: 10.1111/j.1743-6109.2011.02562.x Please use one of the following formats to cite this article in your essay, paper or report:

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Morning After Pill - Politics Slaps Science Down, And Wins

Editor's Choice
Main Category: Sexual Health / STDs
Also Included In: Women's Health / Gynecology;  Pediatrics / Children's Health
Article Date: 09 Dec 2011 - 10:00 PST

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Even though America has, by far, the highest rates of unwanted and unplanned teenage pregnancies in the developed world, and the FDA wanted to make the Morning-After-Pill, otherwise known as Plan B One-Step, available as an over-the-counter (OTC) drug to all females of reproductive age, HHS Secretary Kathleen Sebelius slapped them down and said "No". So, the drug continues as an OTC for females aged 17 years or more, and a prescription-only one for females below 17.

The outcry is growing. Many say this is another example of politics doing things for the sake of politics, rather than responding to sound science and acting in the public good. In America, there are presidential elections next year and many niche votes to win - at times like this, politics is king, say hundreds of Americans who have been writing in with their comments.

Assistant commissioner for women's health at the FDA in 2005, Susan Wood, resigned after frustration at political foot-dragging in approving the emergency contraceptive as an OTC medication. When President Barack Obama came into power four years later, Wood was overjoyed, because the new President emphasized that his administration would base its decisions on sound science, on facts, rather than politics.

Kathleen Sebelius can try to argue that the evidence before her regarding younger females being able to use the medication according to its labeled instructions is not convincing. Most people believe the truth to be different, that had the FDA proposed this status change for Plan B One-Step at the beginning of an Administration's four-year term, she would probably not have intervened.

A doctor (who wished to remain anonymous) wrote in, saying:

"So, because of politics, thousands and thousands more American teenage girls will go on to have unwanted pregnancies."

Asked whether she is now disappointed, Susan Wood said she is far beyond that. Experts say that no presidential administration has ever before publicly overruled the FDA in this manner.

Susan Wood said:

"This is contrary to the scientific integrity memo signed by Obama. It's contrary to the whole principal of making decisions based on science and evidence. (The decision sets) a terrible precedent for the whole breadth and depth of the FDA"

FDA Commissioner, Margaret Hamburg M.D., responded to Sebelius' move in a letter of protest, which was posted on the FDA's website.

Hamburg wrote (part of the letter is quoted):

""I reviewed and thoughtfully considered the data, clinical information, and analysis provided by CDER, and I agree with the Center that there is adequate and reasonable, well-supported, and science-based evidence that Plan B One-Step is safe and effective and should be approved for nonprescription use for all females of child-bearing potential.

However, this morning I received a memorandum from the Secretary of Health and Human Services invoking her authority under the Federal Food, Drug, and Cosmetic Act to execute its provisions and stating that she does not agree with the Agency's decision to allow the marketing of Plan B One-Step nonprescription for all females of child-bearing potential.

Because of her disagreement with FDA's determination, the Secretary has directed me to issue a complete response letter, which means that the supplement for nonprescription use in females under the age of 17 is not approved."

President Obama said that this was Sebelius' decision and he had not been involved in it. Susan Wood said that she is glad Hamburg responded as she did - FDA employees are demoralized by this move; Hamburg's letter will help somewhat.

Some experts are now wondering whether this very public overruling will undermine people's faith in the FDA. Will companies decide not to bother submitting some new compounds for approval for fear of political bullying? Will this uncertainty result in fewer effective therapies for illnesses and conditions?

Economics is classed as a science in most countries around the world. Several European economists criticized the Euro during its formation, saying that it was being created by politicians, rather than experts who would be guided by scientific (economic) facts. Today the Euro is in trouble, precisely for the reasons expressed many years ago - and Europe is now paying a big price.

Teenage pregnancy rates in America are considerably higher than in Western Europe, Canada and Australasia. Changing the status of a morning-after-pill to OTC for all ages would have meant that a girl, say of 16 would have been able to simply go to a pharmacy and have the pill within a day or two of having unprotected sex. Now, as before, she will have to go to a doctor and get a prescription. A sizeable percentage of these girls will not see a doctor, for various reasons, perhaps money, procrastination, embarrassment, etc., some of whom will become evidently pregnant. Most girls of reproductive age in other developed nations are not face by such hurdles.

In most other developed nations where restrictions exist, either they have a teenage pregnancy rate which is a fraction of America's, or the restrictions are less severe. For example, in the UK, since 2005, the morning-after-pill is available OTC for any female aged 16+. In France, school nurses are allowed to dispense them free of charge. In Canada, emergency contraception (morning after pill) is available OTC in most provinces and territories.

The USA has the highest teenage pregnancy rate in the developed world. Access to emergency contraception is easier in most of the other developed countries

One can argue until one is blue in the face about the rights and wrongs of any issue - a good advocate, lawyer or politician can argue either way effectively, depending on what side of the fence he/she represents.

Science however, does not lie, it is based on facts. And the fact is, as seen in the map above - America has a serious teenage pregnancy problem; the statistics speak for themselves. It is also a fact that a higher percentage of younger girls in other developed nations are given scientifically based sex education, and have better access to sexual health services and medications.

Written by Christian Nordqvist
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

Visit our sexual health / stds section for the latest news on this subject. Medical News Today archives, HHS, FDA. Please use one of the following formats to cite this article in your essay, paper or report:

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Christian Nordqvist. "Morning After Pill - Politics Slaps Science Down, And Wins." Medical News Today. MediLexicon, Intl., 9 Dec. 2011. Web.
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posted by Seth on 9 Dec 2011 at 10:39 am

THIS IS STILL A VICTORY! Remember that most girls aged 17 and under will be able to find someone to buy Plan-B One-Step for them if needed. We must continue to fight against those who want to impose their religious values on others or we risk turning into backward country like the church-states of the past and present.

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posted by william on 9 Dec 2011 at 10:58 am

This isn't about religion to me, it's about responsibility. If kids are going to be havintg sex, then they need to be taught responsbility but they are not. The easy way out or welfare is becoming the answer. This pill should be available but not to kids without the parents consent. How did I make it to my age with out kids? Luck, pills,oh wait responsibility ! Minors are their parents responsibility, as well as their health. Teenage pregnancies and unwanted children are a problem in the US because it's so easy to get on welfare have the government support them.

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posted by David Morgan on 9 Dec 2011 at 11:02 am

In America we teach our girls abstention - and follow Bible teachings. This means they do not have sexual intercourse until they are married, or at least adults. Unlike the other countries mentioned in this text. I praise the HHS Secretary for upholding American values. And may God protect you all.

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posted by Harry Emblem on 9 Dec 2011 at 11:05 am

Most single parent mothers in Western Europe have much better welfare help than in the USA. So, saying welfare is why US girls get pregnant more than in W Europe is stupid!

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