by Kait Scalisi | May 2, 2014 | News
Last week, the FDA rocked the sexual and reproductive health world when it approved a new tool to be used in cervical cancer screening. The test, made by Roche Diagnostics, is a primary HPV test that detects the presence of the virus’ DNA in a cervical sample. This differs from a Pap smear which looks for abnormal, potentially cancerous cells.
Primary HPV testing is not actually a new tool. It has been used for years both as a follow-up test to resolve ambiguous Pap results and together with Pap smears as a primary screening tool in women over the age of 30. The FDA ruling allows it to now be used alone in women 25 years and older for primary screening. If it were to detect either HPV types 16 or 18, the two strains causing the majority of cervical cancers, patients would then be sent for a cervical biopsy. If, however, it detected any of the other strains, they would go for a Pap smear as a follow-up.
Proponents of the test, including the Society of Gynecologic Oncology (SGO), argue that this ruling simply offers health care providers another tool. They point to the fact that it is not completely replacing the tried-and-true Pap smear, but rather adding nuance to cervical cancer screening.
Some consumer groups and professional organizations, however, are worried about the impact of this ruling. There are concerns that this may turn into another PSA-screening debacle where large numbers of patients receive medical care—either additional screening procedures or cancer treatment—that do more harm than good. Simply having HPV does not automatically mean that a woman will develop cervical cancer. HPV infections are incredibly common—almost every sexually active individual will have the infection at some point—and usually cleared by the immune system. If the Roche test detects HPV, a patient will be referred for additional procedures that may be invasive, expensive, and ultimately unnecessary.
Those in favor of using the test for screening emphasize its potential to increase detection of precancerous and cancerous cells. It’s estimated that HPV causes 90% of cervical cancers. But only screening for the virus instead of looking for cancerous cells could delay diagnosis and treatment for the minority of patients in whom cancer of the cervix is not associated with HPV. Finally, the validity of the study used by Roche to test the product is being questioned. As the Patient, Consumer, and Public Health Coalition writes:
“The basis for approval of this indication is a flawed clinical trial. Flaws include the design of the comparator arm, participant age and HPV vaccination status, trial duration, and testing interval.”
For now, the Pap will remain the go-to test while medical societies and organizations like the SGO and the American College of Obstetricians and Gynecologists (ACOG) develop best practice standards for the use of the Roche test.
Other Sexual Health News This Week
Tennessee: Governor Signs Bill Targeting Drug Use During Pregnancy (New York Times)
White House Issues Report on Steps to Prevent Sexual Assault on College Campuses including a new PSA. (Washington Post)
Minn. HIV/AIDS Cases Drop Slightly in 2013 (Kare 11)
Maryland Lawmakers Launch Drive to Overturn Transgender ‘Bathroom Bill’ (Fox News)
Transgender Students Protected Under Title IX, DOE Says (MSNBC)
55 US Schools Face Federal Sex Assault Probes (AP)
by Kait Scalisi | Apr 25, 2014 | News
Tennessee may become the first state to prosecute new mothers for illegal drug use during pregnancy if such use results in either addiction or harm of their newborn. At first blush, SB 1391 does little more than amend the state’s current fetal homicide law. Yet this very amendment—one that allows women who have pregnancy complications after using drugs to be charged with crimes ranging from a misdemeanor to aggravated assault—could see new moms slammed with up to 15 years in prison. The proposal, which easily passed through both chambers of Tennessee’s legislature, now awaits the signature or veto of Gov. Bill Haslam.
Other states have sought similar legislation have abandoned it due to the scientific evidence showing that such interventions actually put babies in harm’s way. The American College of Obstetricians and Gynecologists (ACOG) is unequivocal on this issue, stating that, “Seeking obstetric–gynecologic care should not expose a woman to criminal or civil penalties.” Incarceration, or the threat of it, simply does not reduce drug or alcohol use. Instead, it can discourage pregnant women from seeking prenatal care. This, in turn, may deny these women the opportunity to receive evidence-based interventions via their healthcare provider.
Nevertheless, many states criminalize prenatal substance abuse to some degree; for example, by classifying it as a form of child abuse.
But before we examine all the ways this bill could go wrong, let’s put on our social justice hats and assume some good intentions. Why does this bill, and other statutes similar to it, even exist? Supporters of such legal interventions hope they will reduce the number of children born with neonatal abstinence syndrome (NAS), which is associated with numerous negative birth outcomes, including birth defects, low birth weight, and sudden infant death syndrome (SIDS). But the prevention by criminalization approach fails to take into account the complex nature of addiction, and the scarcity of addiction treatment options for pregnant drug users. A recent report from the Guttmacher Institute shows that few states have programs or protections in place for pregnant women seeking addiction treatment:
- 18 states have targeted programs
- 10 states give pregnant women priority access to state-funded programs
- 4 states protect pregnant women from discrimination in general programs.
SB 1391 offers clemency to pregnant addicts if they enroll in a recovery program before giving birth, remain in the program after delivery, and successfully complete it. Although Guttmacher lists Tennessee as one of the 10 states that give priority access to state-funded treatment programs, this alone does not guarantee that a woman seeking treatment can receive it, and thus even have a chance of being safe from prosecution.
Given the science showing both that penalizing women doesn’t work, and that addiction is a physiological, psychological, and genetic phenomenon, it would make more sense to focus on making drug treatment more available to pregnant women.
It is worth mentioning here, of course, that drug use does not occur within a bubble. The ecological factors associated with drug use virtually guarantees that the law would disproportionately affect minorities and the poor. RH Reality Check provides a fantastic in-depth analysis of how SB 1391 would affect black women the most:
“Certainly SB 1391 does not target Black women specifically, just as none of the laws that were enacted in states across the country in the wake of the ‘crack baby’ media hysteria did. However, history tells us that laws that do not specifically target people of color nevertheless tend to disparately affect people of color.”
Because of its wording, SB 1391 could subject any women with a poor pregnancy outcome to an investigation. Given that such outcomes occur disproportionately among poor women and minorities, the law essentially becomes a form of legal discrimination. For example, only two of Tennessee’s addiction recovery centers offer on-site prenatal care. For women without reliable transportation, even acceptance into this program would not necessarily be their saving grace.
Gov. Haslam has a few more days to decide whether he’ll sign this bill into law. In the meantime, civil liberties, health, and women’s rights groups are actively campaigning against it. Be sure to check back next week for more details on the outcome.
Other Sexual Health News This Week
A federal judge in Oregon will hear arguments about the state’s voter-approved ban on same-sex marriage. (Huffington Post)
Brown University is being criticized for its handling of an on-campus rape case. (Brown Daily Herald)
The Y chromosome may be more important than originally thought. (New York Times)
One Virginia county may be losing its sex education teachers. (Washington Post)
Mississippi’s governor signed a law that bans abortion after 18 weeks gestation (20 weeks from a woman’s last period). (Washington Times)
A national infertility association graded each state on the availability of infertility care. (RH Reality Check)
A new study takes a more nuanced look at sex trafficking. (Slate)
by Kait Scalisi | Apr 4, 2014 | News
Sexual Health Rankings™ presents Sex Stories, a weekly roundup of sexual health news from around the country.
Mississippi Passes Controversial Religious Freedom Law (Time)
Mississippi residents may soon be able to sue over laws that “impinge on their religious freedoms.” Opponents of the law worry it will be used to discriminate against LGBTQ individuals. The Governor, a supporter of the bill has yet to sign it. The bill also adds the phrase, “In God We Trust” to the state flag.
Mississippi Governor to Sign Bill Banning Abortion at 20 Weeks (Fox News)
Mississippi will soon join a number of states that ban abortion at 20 weeks. The law, which the Governor expressed eagerness to sign, makes an exception for women who face death or injury and in cases of severe fetal abnormality. It is expected that someone will file a legal challenge. Opponents feel that the ban will affect poor women while supporters argue the unborn child is of higher concern.
Utah Bans ‘Revenge Porn’ (Daily Mail)
Utah is the sixth state to pass laws criminalizing “revenge porn” or sexually explicit images published with intent to cause emotional stress or harm. The law has been criticized because its requirement for harmful intent leaves leaves a loophole for webmasters and others who post such content for other reasons such as income.
Statins Found to Improve Erectile Function (Fox News)
A new review of 11 randomized control trials examining erectile dysfunction (ED) and statin use found that such medications may have benefits beyond treating heart disease. Statins were associated with significantly higher scores on the International Inventory of Erectile Function. Such results further suggest the connection between overall health and sexual function.
Marriage May Help Keep Your Heart Healthy: Large US Study Links Vows to Lower Risk of Cardiovascular Illness (National Post)
A study of over 3.5 million people in the US found that married individuals have a lower risk of any type of heart or blood vessel problem. Such results were true regardless of age, gender, and other risk factors. This may be the result of having a spouse who encourages them to take care of themselves. It is important to note that most participants were white and female which can skew the results.
Harvard Student Who Claims On-Campus Assault Slams University Policies (ABC News)
Old policies have once again put Harvard at the center of the college sexual assault controversy. A survivor recently wrote an op-ed in the school’s newspaper accusing college officials of not providing an adequate response to the assault. The case speaks to the larger issues of rape culture and a lack of training for college officials on how to deal with sexual violence.
SC House: Sex-ed Classes Should be Medically Accurate, Not Just Focusing on Abstinence (The State)
As part of an effort to update South Carolina’s health and sex education laws, a House committee voted that all health information taught in schools must be medically accurate. The bill also requires sex-ed teachers to be certified in health and enforces stricter reporting to both the state and parents. Compromises, including removing language on sex outside of marriage, were removed in an effort to get the bill through.
by Kait Scalisi | Mar 28, 2014 | News
Sexual Health Rankings™ presents Sex Stories, a weekly roundup of sexual health news from around the country.
What Role Does Alcohol Play in Men’s Sexual Aggression? (Kinsey Confidential)
A new study examining the relationship between rape culture and alcohol consumption found that most acts of sexual aggression in bars are committed by men towards women and the acts are intentiona to some degree. Men become more aggressive as women drank more, although their own alcohol intake did not affect their behaviors. Finally, the study found that neither staff nor friends regukarky intervened and the latter group actually encouraged the aggressor.
Women with Heart Disease Benefit More from Exercise than Men (Headlines and Global News)
A study of over 2300 patients with heart failure found that there are gender differences in the effect of exercise on reducing bith mortality and hospitalizations. Females had significantly reduced risks of both outcomes as compared to make participants. The differences may be related to other new research which provides evidence that peak heart rates need to be calculated differently for men and women.
Michigan Won’t Recognize Same-Sex Marriages (USA Today)
Over 300 Michigan same-sex couples who married Saturday will not be receiving any legal benefits anytime soon. An appeals court put a stay on a ruling that struck down the state’s amendment defining marriage as between a man and a woman. The marriages are being reocgnized as legal but it could take months, and maybe a trip to the Supreme Court, before the couples will know for sure if their marriages will be recognized.
World Vision Reverses Decision to Allow Same-Sex Marriages (The Wire)
Faced with lots of criticism and the threat of lost funding, World Vision, one of the biggest Christian charities in the US has decided it will not allow employees to marry someone of the same gender. In its letter to donors, the charity claimed their original decision to allow same-sex marriage was a break from their Statement of Faith and commitment to the bible.
DOJ Trains Cops to Work with Transgender People (ABC News)
In response to the disproportionate rates of violence against trans* people as well as severe underreporting of crimes against them, the DOJ has launched a training program to teach local cops how to work with and build trust among the community. The policy director of the National Center for Transgender Equality helped design the training. Advocates see the program as a good first step to respond to this problem.
Hobby Lobby Contraceptive Case Goes Before Supreme Court (NPR)
The Supreme Court began hearing arguments this week about the constitutionality of requiring businnes to provide all FDA-approved forms of birth control services covered by health plans. The fight is led by arts and crafts chain Hobby Lobby whose owners are conservative Christians and feel for-profit organizations who dssire to opt out of this mandate should be able just as religious non-profits can. Important aspects of the case include the public health impact and the Religious Freedom Restoration Act. Justices initial arguments were split along gender lines. The decision is expected to be made in June.
by Kait Scalisi | Mar 21, 2014 | News
Sexual Health Rankings™ presents Sex Stories, a weekly roundup of sexual health news from around the country.
Army General Reaches Deal on Sex Counts (New York Times)
A senior Army officer has agreed to plead guilty to minor charges in exchange for prosecuters dropping more serious ones including forcing a captain to perform oral sex on him. The General’s punishment will not be determined until the hearing ends but similar cases involved the guilty receiving no jail time and retiring at a lower rank.
Episcopal Bishop in Michigan Backs Same-Sex Marriage (USA Today)
The head of southereastern Michigan’s Episcopal Church has come out in support of same-sex marriage. Reverend Wendell Gibbs feels that it is unjust to pick whose rights are protected and that such law promote segregation and dehumanization. Despite these views, same sex marriage is still illegal in Michigan so no unions will be held just yet.
Kentucky Same-Sex Marriage Recognition Put on Hold (ABC News)
A ruling that recognized same sex couples who were married in other states is on hold in Kentucky. The district judge who filed for the stay feels that it is better to wait until a final decision is made by the higher court. Regardless of the outcome, same sex marriages will still not be legal in the state.
Kids with ADHD, Autism More Likely to Have Gender Identity Issues (Psych Central News)
A chart review study of over 1,000 children found that those with autism or ADHD were more likely to express gender variance than their peers without the condition. Furthermore, those with ADHD who expressed gender variance also had higher rates of depression and anxiety. There was no differences for children with a medical neurodevelopment disorder such as epilepsy. Gender variance occurred equally in both males and females.
In other gender identity news, polls show support for the recently passed inclusion of a gender identity clause in Maryland’s non discrimination laws while a similar law in Kansas was put on hold until next session.
You’re Not Alone: Medical Conspiracies Believed by Many (Reuters)
A survey of over 1,300 U.S. adults determined that nearly half agree with at least one medical conspiracy theory . The theories ranged in popularity with the belief that the CIA infected blacks with HIV being the least believed. The study also suggests those believing in such theories were more likely to utilize complementary and alternative medicine.
Federal Agents Arrest More Than a Dozen in Internet Child Porn Sting (KCEN TV)
Fourteen individuals were arrested as apart of a massive child porn sting that involved over 200 victims throughout the U.S. and four other countries. Most of the victims were male and in their teens. The U.S. Immigration and Customs Enforcement Homeland Security Investigations reports this is their biggest operation yet.
Teen Pregnancy Campaign Turns Cell Phones Into Crying Babies; Reminds Teens That Sex Has Consequences (Medical Daily)
A new campaign by DoSomething.org uses text messages to simulate the needs of a newborn. The goal of the campaign, on its third iteration, is to engage with teens and start the conversation about safe sex and teen pregnancy. Each “parenting session” last for 12 hours and is meant to be interactive and witty but not shameful.
