Showing posts with label public health. Show all posts
Showing posts with label public health. Show all posts

Tuesday, April 17, 2012

The Impact 'Harm Reduction Strategies' Has on Sex Workers

via The Jurist, by Elizabeth Hand

Shohagi was only fourteen when her father arranged her marriage. Sent away from her home, family and friends to marry an unknown man who was much older, she quickly discovered her partner's violent nature. The abuse sent her fleeing back home to a family that rejected her for disobeying her father, threatening her with death. No longer possessing any support system or income, she was shepherded into a brothel in Calcutta. Western perspectives on sex work require such a tale to be met with horror and sympathy. However, Shohagi describes her experience as a sex worker with hope and empowerment. Working in a brothel gives her the chance to earn an income and support herself. Distanced from the violence of both her husband and family, she prefers her life of autonomy.

Shohagi's story is far from unusual, yet it does not conform to the usual cautionary tale that accompanies debates about sex work. Too often the narrative is one of woe and misfortune that leaves a woman with no choice but to become a prostitute, and her life rapidly decays. Adopting this typical western, feminist criticism of prostitution leaves no room for the possibility that a person chooses sex work, and is also pursuing his or her best interests. While many second-wave academics, like Catharine MacKinnon in her article Prostitution and Civil Rights, draw a distinction between indentured servitude and sex work by making the argument that a condition entered into voluntarily, prostitution, is different than one entered into involuntarily, servitude. However, functionally they are both treated as a type of slavery. This approach fails to validate a person's choice to work as a sex worker. In the name of protecting women, MacKinnon fails to acknowledge the agency of women who choose sex work. A viewpoint like this highlights the shortcomings of western ideologies that tend to equate morality with legality. To the contrary, harm reduction strategies can offer protection to sex workers, who are at a high-risk of contracting HIV or facing sex-related violence. However, rather than focusing on harm reduction, generally criminalization is preferred, which strips sex workers of valuable protections and condemns them as immoral.

While no federal law exists that bans all prostitution across the board, Nevada is the only state that, in a few counties, has legalized some forms of prostitution. Many states enforce punishments exceeding a year in prison for this line of sex work. In essence, with the exception of a few counties in Nevada, prostitution is illegal in the US. The reasons cited for why prostitution should remain illegal range from the argument that it is degrading and base to the idea that it is a form of violence against women, or that banning it deters violence against women. Are these compelling enough reasons to justify the continued criminalization of many forms of sex work? Looking to other countries' approaches to monitoring sex work, the US has a lot to gain from legalizing prostitution as a means to ensure sex workers' safety, health and protection from abuse. If the US were to legalize prostitution, the government could more closely regulate it, implementing harm reduction strategies that could be pivotal in tackling HIV/AIDS, STIs, and violence towards sex workers.

The US has traditionally disfavored the implementation harm reduction strategies, preferring to take the moral high road. From needle exchanges to the regulation of sex work, the US chooses hardline stances against these activities at the cost of abandoning citizens that could be offered partial protection. Needless to say, HIV and AIDS are significant concerns when it comes to sex work, and US policy continually uses HIV/AIDS as a guise for providing a motive for eradicating sex work, specifically prostitution. However, when the government steps in to monitor and regulate commercial sex, as opposed to prohibiting it, HIV incidence is likely to go down. Without the government stepping in to police the sex trade, sex workers will continue to be at high risk of infection, while also lacking access to health care and prophylactic resources. Policies aimed at regulating brothels for public health reasons have had tremendous success in lowering not only the incidence of HIV infections in sex workers, but also the overall incidence in the population by altering behavior when it comes to practicing safer sex methods. A UNAIDS case study evaluated Thailand's 100 percent condom use program and found that the government's mandate of condom use within brothels, a policy aimed at combating rapidly rising HIV at the onset of the global AIDS epidemic, made sex work safer and altered cultural norms surrounding sexual practices for the entire nation.

Read the Rest.



[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

Saturday, August 6, 2011

Why the CIA's Vaccine Ruse Is A Setback for Global Health


Last week, the Guardian broke the news that in the run-up to the raid on Osama bin Laden's compound, the CIA used a vaccination campaign as a ruse to get DNA evidence from the al-Qaeda leader's kids. With help from a Pakistani doctor, Shakil Afridi, they set up clinics in two neighborhoods, delivering doses of the Hepatitis B vaccine to local children. The revelation drew a quick and angry response from health experts. Medecins Sans Frontieres called the operation "a dangerous abuse of medical care." In the Washington Post, Orin Levine and Laurie Garrett warned that the CIA's "reckless tactics could have catastrophic consequences."

Indeed, they may. Here are three reasons why this is bad news for public health:

1. Broken Trust
When people don't trust medical personnel, they're less likely to participate in legitimate public health campaigns. Eight years ago, rumors spread that an anti-polio campaign in Nigeria was an American plot to sterilize Muslim girls, causing many families to refuse the vaccine. The subsequent outbreak spread to eight countries.

Read the rest here.

[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

Saturday, May 21, 2011

CDC Provides Recommendations for Zombie Apocalypse

via The Seattle Times

Pity poor Tom Skinner, a top spokesman for the Centers for Disease Control and Prevention (CDC) who has been valiantly trying to interest reporters in a new study in the agency's Morbidity and Mortality Weekly Report trumpeting "10 Great Public Health Achievements."

Unfortunately for Skinner, over at his agency's public-health blog, his colleagues were posting something that really got to the beating heart of morbidity and mortality: the first official CDC instructions on coping with a zombie apocalypse.

Yes, that's right. With a straight face, the normally staid health agency had posted a primer on how to prepare for an invasion of the brain-eating undead.

"So what do you need before zombies ... or hurricanes or pandemics, for example, actually happen?" the post said. "First of all, you should have an emergency kit in your house. This includes things like water, food and other supplies to get you through the first couple of days before you can locate a zombie-free refugee camp."

Read the rest.

[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

Thursday, April 14, 2011

Kenya: Counselling, not alarm device, had best effect on ART adherence

Via aidsmap, by Carole Leach-Lemens

Patients in Nairobi, Kenya getting intensive early adherence counselling when starting antiretroviral therapy were 29% less likely to have poor adherence and 59% less likely to have virological failure compared to those getting no counselling Michael H Chung and colleagues reported in a randomised, controlled trial published in the March issue of PLoS Medicine.

The positive effects of counselling on adherence were seen immediately after starting antiretroviral therapy and maintained throughout the18 month follow-up period. Use of an alarm device had no effect on adherence or virological outcomes. Public health concerns that scale-up of antiretroviral treatment in sub-Saharan Africa would lead to poor adherence and widespread drug resistance have been proven wrong, note the authors.

The authors conclude “as antiretroviral treatment clinics expand to meet an increasing demand for HIV care in sub-Saharan Africa, adherence counselling should be implemented to decrease the development of treatment failure and spread of resistant HIV.”

Read the rest

[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

Wednesday, March 23, 2011

HIV/AIDS: UNAIDS, activists urge countries to get clever with TRIPS

Via PlusNews

UNAIDS has released a new policy brief to help countries make intellectual property rights work for them, amid growing concern that an impending free trade agreement between the European Union (EU) and India could threaten the world's supply of generic antiretroviral (ARV) drugs.


The World Trade Organization's Trade Related Aspects of Intellectual Property Rights (TRIPS) allows countries to override patents - for public health purposes - by issuing "compulsory licenses" that enable the generic manufacture of drugs still under patent.

The UNAIDS brief, published on 15 March, noted that few developing countries had exercised this right and cited a lack of capacity to deal with the complicated legal paperwork required. Nevertheless, the flexibility afforded by TRIPS has brought increased competition, helping to lower the cost of first-line generic ARVs by as much as 99 percent in the last decade.

Recent changes in World Health Organization (WHO) HIV treatment guidelines substituted stavudine, a cheaper ARV, for tenofovir, a more expensive one, making it even more important for countries to take advantage of TRIPS to keep treatment costs low and extend coverage.

The UNAIDS paper - co-authored by UNAIDS, WHO and the United Nations Development Programme (UNDP) - aims to help countries improve their access to generic ARVs by using TRIPS. It also provides successful case studies from countries like Thailand, Brazil and Rwanda, which have used TRIPS to negotiate lower ARV prices, and recommends that governments adapt their national legislative frameworks and develop a domestic pharmaceutical production capability.

African activists speak out

According to UNITAID, an international facility for purchasing ARVs, India manufacturers most of the generic ARVs used in low-and middle-income countries, but African activists maintain that ongoing free trade talks between the EU and India will limit access to these drugs.

Read the rest

[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

Wednesday, May 19, 2010

Eradication of smallpox may have set the stage for HIV pandemic, study says

via Los Angeles Times, by Thomas H. Maugh II

"While these results are very interesting and hopefully may lead to a new weapon against the HIV pandemic, they are very preliminary and it is far too soon to recommend the general use of vaccinia immunization for fighting HIV," Weinstein said in a statement. Given the great difficulties researchers have encountered in trying to develop an HIV vaccine, the ironic fact is that we may once have had a vaccine that is more effective against the virus than anything that has since been developed, and we threw it away.


Laboratory tests suggest that immunity to smallpox triggered by the vaccinia (smallpox) vaccine can inhibit the replication of the AIDS virus. Such vaccination could have kept HIV transmission partially under control in the early days of the outbreak, but withdrawal of the smallpox vaccine in the 1950s would have freed it to spread unfettered, the researchers said.

Monday, April 20, 2009

Sexual tolerance and inclusion must not forget anal sex/health


Acknowledging anal sex
via The Michigan Daily, by Rose Afriyie

[thanks for this important piece Rose!]

Excerpt:

The vision of sexual tolerance we must adopt is one where everyday people acknowledge differences in sexual relations while promoting public health provisions that accommodate our sexual diversity. We need a sexually tolerant healthcare system that accounts for the various kinds of activities that occur in our sexual lives.

And although anal sex is here to stay, it seems that people who practice anal sex, both occasionally or exclusively do not have access to the same kinds of care as people who practice vaginal sex.

Read the whole item.

Wednesday, March 25, 2009

You have til March 31 to Submit to the 2009 National LGBTI Health Summit


Beep beep, heyyyy, TWEET TWEET.
Follow the Summit on Twitter!

Join the Summit group on Facebook!


Have you sent in your workshop proposal?


The 2009 National LGBTI Health Summit is currently accepting workshop proposals for the upcoming gathering, to be held in Chicago, IL August14-18, 2009. Proposals will be accepted through March 31, 2009. We have received a lot of great submissions already - is yours among them?

The 2009 National Lesbian, Gay, Bisexual, Transgender, Intersex Health Summit and Bi Health Summit will focus on “Health Through the Life Course.”

Individuals and groups are invited to submit workshop proposals that address wellness issues (emotional, physical, spiritual, psychological, environmental, social, and/or sexual health) of LGBTI people.


Applicants are encouraged to address the Summit's theme of"Health Through the Life Course" by focusing on specific age groups within the LGBTI community, specific topics that may impact several age groups, or issues that impact LGBTIs over time. Proposals that seek to bridge generations and populations for the sharing of new and worldly wisdom are welcome.

Creative and traditional formats are accepted. Sessions will last one and a half hours – interested parties should consider collaboratingwith friends and colleagues.

The proposal format and instructions, as well as complete
information about the Health Summit is available at www.2009lgbtihealth.org. Interested parties are invited to engage in planning activities already underway on the site.

Beep beep, heyyyy, TWEET TWEET.
Follow the Summit on Twitter!

Join the Summit group on Facebook!


Monday, May 5, 2008

A Spade is a Spade - "Anal Sex is a Public Health Risk"

[IRMA received permission to re-print this e-mail correspondence from Dr. Ruben F. del Prado, the UNAIDS Country Coordinator for Guyana and Suriname (left), calling on his global colleagues to address unprotected anal sex as a public health risk.]


Dear UNAIDS colleagues, members of the Global Forum on MSM and HIV, The Johns Hopkins Bloomberg School of Public Health, and The Royal Tropical Institute colleagues… fellow workers towards universal access for all,

Seizing the opportunity to reiterate my appeal to ‘call a spade a spade,’ please check this out.

More than ever before, UNAIDS and its partners must strongly advocate for establishing unprotected anal sex as high risk behaviour and a public health risk, and not as conduct that typifies ‘marginalised’ groups and ‘sexual minorities.’ This would make good public health sense, and immensely benefit HIV prevention through broader community prevention messages that might more usefully fit overall HIV prevention objectives.

By continuing to use euphemisms in the HIV arena such as ‘MSM’ and ‘gender’ we actually undermine gay and transgender rights activism by further stereotyping men who have sex with men and transgender people.

There continues to be an urgent need for activism, for instance by demanding medical and nursing training colleges and HIV counseling and prevention programmes to address sexual health related pathology and psychology of sexual minorities in their curriculums and training programmes. There is no doubt about that!

I hold and intensify my firm stand on the importance of identifying unprotected anal sex as a public health risk.

It is not without reason and common sense that extensive consultations throughout India have resulted in the key recommendation to address male-to-male sexual transmission of HIV by "Mainstreaming ‘unprotected anal sex’ as a public health risk: As a key public health measure, advocate for and put emphasis on unprotected anal sex as a mode of HIV transmission in all relevant health programmes; not just those for MSM or Hijras but also for other populations."

[Click here for the full report, organized by NACO, supported by the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the Resource Centre for Sexual Health and HIV/AIDS (RCSHA), June 21st – July 5th 2006]

I am an advocate and international civil servant working towards HIV prevention, treatment care and support for all, but first and foremost I am a public health professional. If we want to make an impact in our time and be seen by the next generation as successfully establishing solid HIV prevention practice, we must address unprotected anal sex head on with full force as a public health and sexual health issue of great concern. Religious, cultural and societal dogma notwithstanding, we can and we must.

Regards,
r
Uniting the world against AIDS
Dr. Ruben F. del Prado
UNAIDS Country Coordinator for Guyana and Suriname


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