Friday, March 21, 2008

On the critical use of clear, accurate language in our work

by Jim Pickett
Chair, IRMA

As you all know, IRMA has been engaging in a discussion over the last days regarding the accurate use of language in our field. Many of you have written to me on this issue, and I want to make a brief comment on where I stand, and where I believe IRMA should take a firm stand.

Regardless of any organization’s focus or mission, a definition is a definition is a definition, it does not change to suit one or another’s interests.

Let’s think about an apple. If I use apples to make apple pies, apple sauce, or I use apples to throw at my neighbors house, an apple is still “the fleshy usually rounded red, yellow, or green edible pome fruit of a usually cultivated tree.”

The definition of an apple is not strictly confined to the apple user’s focus or mission. An apple is not only “something used to make apple pie,” even if that is the only way you engage with an apple.

Similarly, let’s say my HIV prevention work focuses specifically and solely on engaging gay men with interventions to reduce their risk and avert new infections. Despite my focus, it would not be accurate or honest to define “HIV prevention work” as something that is exclusively conducted with gay men. This is not the case. HIV prevention work is conducted with a variety of at-risk populations and its broad definition has nothing to do with any specific focus.

In this vein, the imprecise definition of microbicides as “products, such as gels or films that could be applied vaginally to prevent HIV transmission during vaginal intercourse” is not only imprecise; it is not correct and is misleading.

As we all know, microbicides are not just “products that could be applied vaginally to prevent HIV transmission during vaginal intercourse.” In fact, microbicides are products in development that could be applied topically, either vaginally or rectally, through a variety of means to prevent HIV transmission during vaginal or anal intercourse. That definition should stand regardless of where my interest/focus/mission/research lies…

And as for who will use microbicides… Receptive partners of both sexes are potential end-users of microbicides; end-users will not be women exclusively. Gay men and MSM will also be end-users. Women will be end-users of rectal microbicides as well as vaginal microbicides. And the heterosexual male partners of women who use microbicides, vaginally and/or rectally, should also be considered end-users as well.

It is absolutely critical that we continue to call out misleading and inaccurate language – among ourselves, the broader microbicide field, and the world at large. When any of us perpetuates the denial of a population through our silence, or negates an important realm of research and development by narrow definitions that only serve our organizational mission and self-interest, we sow misunderstanding and do harm – real damage – to vulnerable women and men in every region of the world. I think it is in our interest to stay vigilant on this issue.

I am interested to hear your comments on this.


Anne Davis said...

This was interesting to read because I’m new to this exciting area of HIV prevention. The way microbicides were explained by Ian McGowan, MD during my interviews enabled me to accurately tell interested family, friends, and advocates, of its great potential impact – on women and men, or men and women, worldwide.

No matter what point along a timeline one jumps in to any field, it’s important to stay abreast of new language and changing definitions. With regard to microbicide development, aren’t we responsible for teaching medical editors at periodicals, television stations and newspapers globally? They disseminate information to broad audiences and it seems to me the accuracy of our news content could favorably impact advocacy, funding and recruitment of research participants.

Diego said...

But I don't know that this is "new" language insomuch as a call for accurate, correct language.

Microbicides in the context we are discussing here are topical agents - very generically. They are not limited to "topical agents to be used vaginally."\

Our leaders in the field should be held accountable. Misleading info is picked up and circulated all over the place - leading people to have a skewed understanding of the issues.

Do we want this? Hmmmm, perhaps some of us in microbicides field do...


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