Every individual needs a range of services and information to protect him/herself and live healthy and happy lives. Local NGOs and public health experts on the ground must be able to determine the best programming for their own communities. For too long, local organizations were constricted by mandates from Washington. U.S. foreign assistance can be restructured to better empower local communities and save many lives in the process.
]]>It had been a long time since I was excited about something that the United States said at the UN. In fact, I couldn't recall a recent example of us actually engaging with the United Nations, much less making a strong statement about the importance of comprehensive sexuality education and reproductive health services on the floor of the UN. And, it couldn't possibly happen on the same day that we decided to seek a seat on the UN Human Rights Council, and in the same month that the United States formally joined the rest of the Western nations in calling for the worldwide decriminalization of homosexuality.
But it turned out that my skepticism
and disbelief was sooooo 2006. I opened the email to find that the US
stated its renewed and deep commitment to the goals and aspirations
included in the International Conference on Population Program of Action
and Development (ICPD) and the Key Actions of the Millennium Development
Goals (MDGs):
"Ladies and Gentlemen, our common task this week is vital. Five years remain in both the ICPD and the MDG mandates. We can, this week, commit to stronger actions to reach our common goals."
"We must do much more to provide comprehensive, accurate information and education on sexuality, sexual and reproductive health for women, men, girls, and boys as they age and their needs evolve. We must, as well, foster equal partnerships and sharing of responsibilities in all areas of family life, including in sexual and reproductive life, and promote frank discourse on sexuality, including in relation to sexual health and reproduction."
I read it five times. While there have been several moments since January 20 when I have found myself with a previously unfamiliar sense of pride to be from the United States, it still takes awhile to digest. Wait, we value science over ideology and recognize the importance of engaging with the international community? We have an Administration committed to equality and that deeply understands that we will not meet the challenges of the 21st century until human rights for all are ensured?
As startling as I initially found this sensation, the notion that the President not only cares about my health and rights, but the health and rights of women everywhere, is growing on me. I think I'm becoming an optimist. In fact, I just might leave my passport cover at home next time. ]]>"We are not part of the problem; we are the solution," said Alejandra Gil of Mexico. "Don't close your eyes; we are here: we are youth, men who have sex with men and women living with HIV. We are not going away."
Across cultures, sex workers have been historically cast as social deviants and victims. They have been further stigmatized and discriminated against as disease vectors in the HIV/AIDS epidemic. As a result, governments have enacted policies that criminalize and violate the health and human rights of sex workers.
While criminalization may have political appeal, there is no evidence that this is an effective strategy for protecting sex workers from violence and abuse. In fact, there is growing evidence from numerous countries, including Sweden, that criminalizing the sex worker or her/his client is likely to contribute to the abuse and marginalization of sex workers. Criminalization gives latitude to the police to abuse sex workers, and leads to other human rights violations.
Enacting bad policies is not going to improve the state of HIV/AIDS in the sex worker community. Changing the course of the epidemic requires measures that empower sex workers against HIV/AIDS. Policymakers and implementers need to end the conflation of trafficking, sex work and violence by recognizing that sex work is work, and that men, women and transgenders have the right to earn a living with dignity and respect. Sex workers need to be meaningfully involved in the design, implementation and evaluation of policies and research on sex work so that programs addressing the gender equality, violence and economic disparities among this population can be effectively implemented.
These changes are crucial to move the discussion beyond vice and victim hood and create concrete policy solutions that respect the rights of sex workers and provide HIV/AIDS services free of stigma and discrimination. ]]>The issue here should not be about being happy or providing comfort to politicians to skirt around real life issues that will determine if someone can protect themselves against HIV. Despite all the flowery language about bipartisanship and compromise, key issues that should have been addressed in PEPFAR fell prey to political sport, and people will lose not just a game, but their lives.
This game came at the expense of good public health policies. Why? Because policy makers would rather avoid fundamental issues like human sexual relations, even though they are central to confronting the HIV pandemic. Everyone knows you can't play sports unless you address sound fundamentals first.
The political sport ends up looking like this:
In the name of reducing HIV infections, the majority inbounds a consensus bill that includes support for voluntary contraceptive services for HIV positive women, in case a woman decides she doesn’t want to become pregnant again. The GOP ideologues then steal the issue with hyperbolic claims that abortion is being promoted as a way to prevent HIV. They shoot, they score, as Democrats (heavily favored to win due to their majority status) watch helplessly. Democrats tense up and start to play nervous.
From the stands public health experts are shouting that by enabling funds for HIV prevention education and services, including testing, to go to family planning providers, we can reach more people at risk of HIV – helping to slow the spread. Their shouts are backed up by facts that no one on the floor seems to care about.
The GOP takes the ball away from the Democrats and again asserts that providing HIV prevention through family planning services is really about expanding abortion. Like basketball before the shot clock, conservative ideologues just keep tossing the abortion issue back and forth even though it has nothing to do with PEPFAR, leaving Democratic leadership playing defense. Even some of the Democrats' fans, you know the types, the rock stars that always get court side seats, turn around to tell the public health experts from the stands to just be quiet and enjoy the game.
Rep. Betty McCollum (D-MN) gets the ball and moves it up the court, working through the legislative process to enable HIV/AIDS education, counseling and testing activities to be provided by a larger group of health care providers, particularly because part of the mission of the reauthorization is to expand services. Her shot is blocked by those claiming that to maintain the delicate compromise, we cannot talk about the issue on the House floor, and she, and her good efforts, are sidelined. Another last minute shot on the floor comes from Rep. Joe Crowley (D-NY), suggesting we shouldn’t limit access to HIV prevention services by enacting a strangle hold where individuals can receive these services. Again, his shot is blocked by those who say, in the name of compromise, nothing can be changed.
The slam dunk would have been to simply, honestly and straightforwardly acknowledge that HIV is primarily a sexually transmitted infection. To slow the spread of the infection, we need to reach people where we can – to encourage testing and to provide the range of tools to protect themselves from HIV.
The obsessed anti-choice Republicans who are supporting this bill spent a lot of time on the House floor indicating there is a moral obligation for the US to continue leadership in this area. Agreed. The moral obligation they didn’t discuss – and don’t support – is that to be truly pro life is to take every action available to prevent the spread of HIV – not only the ones that fit into their personal definition of morality, but in the public health framework of what works. That includes better access to prevention, education and contraception for women through integrated HIV/family planning services.
No doubt PEPFAR will continue to do good – but the question remains, why add constraints that make it impossible to do more, prevent more infections, and protect more lives with the resources available?
As Rep. Hoyer said, PEPFAR shouldn't have fallen prey to political sport. What he didn't say was that it had before the game even got started. The fix was in. The public health experts in the cheap seats left the stadium hoping the team can do better next time and vowing to keep cheering them on with evidence, stats and real world experience that supports their case. The celebrity fans left unconcerned about the outcome of the game so long as they keep getting those cool front row seats.
Fighting AIDS is About More Than Money ... Read RHRealityCheck's extensive PEPFAR coverage.
]]>Trojan Condoms recently launched a new series of ads. "Evolve. Use a condom every time," is the tagline for the campaign, which includes a website with information about safe sex and STIs, as well as advertisements on two networks, nine cable channels and eleven magazines. But, according to The New York Times, you won't see the ad on CBS or Fox.
The ad features women in a bar surrounded by talking, beer-swilling pigs. The pigs' advances are spurned left and right. After hobbling off to the restroom and purchasing a condom from a vending machine, one of the pigs is transformed into a good-looking man who then finally receives the attention of an attractive woman at the bar. It's an interesting take on the typical definition of "pig," and a much-needed and accessible statement about sexual responsibility and respect.
In a written statement, Fox said it had rejected the spot because "contraceptive advertising must stress health-related uses rather than the prevention of pregnancy." CBS declined, stating that it would not be "appropriate" for the network "even with late-night-only restrictions."
It's unclear what CBS found offensive about the advertisement, which, as a media critic rightly points out, is undeniably tamer than most prime time programming. Particularly for CBS, home to the Victoria Secret Fashion Show, the infamous 2004 Superbowl "wardrobe malfunction," and its new fall series "Swingtown," which brings viewers into the sexually liberated suburban key parties of the 1970s. The sexy two minute trailer opens with the tagline: "the year was 1976 and everything about America was changing." Apparently, while its programming is changing, the network has yet to evolve from that AIDS-free American era where skin was "in" and contraceptive advertising was taboo.
While CBS' criticism of the advertisement is pure hypocrisy, Fox's statement is nonsensical. There is nothing about the ad that implies that condoms should be used for pregnancy prevention and not health reasons. Nor is it clear when Fox became medically qualified to decide that pregnancy is no longer a health-related issue. The transformation of the pig into the handsome and clean man in itself illustrates a shift from poor to good health, from a slovenly existence to a responsible one.
The campaign's mission is about helping America evolve to a sexually healthy and responsible nation:
Sex itself isn't an unhealthy thing that needs to be policed or demonized; it's a natural expression of our humanity. Using protection consistently and correctly is a critical component to managing one's sexual health.
Citing the number of sexually transmitted infections and unintended pregnancies occurring in the United States each year, the campaign effectively argues that the use of condoms symbolizes respect, both for ourselves and our partners. The desire to forge positive and healthy sex lives is commonly capitalized on in television advertisements for erectile dysfunction drugs and personal lubricants, and it's time that we allow this desire to be personified through women, youth and a much broader audience than middle-aged men.
Trojan is right: we need to evolve to a sexually healthier nation. We need to teach young women to insist that men wear condoms and we need to teach young men that wearing a condom every time is the right thing to do. In a television world where casual sex abounds, the promotion of safe sex should never be censored.
Watch the Trojan ad below.
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