Tag Archives: contraception

How the Female Condom Can Help the Women of Chile

Huge strides have been made in the understanding of how behavior drives HIV-infection. Notably, much of the coverage of how social constructs (and contexts!) contribute to the epidemic revolves around prevention education in the scope of proper – male – condom use. No doubt, comprehensive interventions in this arena have been instrumental in curbing infections. But it’s worth noting the limitations of this approach given the changing face of the virus.

Chile, a country with a prevalence of 28,963 notified people living with HIV (and an estimation of about twice that actually living with the virus), like many countries, is seeing an increasingly feminized epidemic.

Unfortunately (and perhaps unsurprisingly), most prevention and education frameworks neglect to take into consideration why this is.

In many cases, and specifically in Chile’s, women are contracting the virus via their husbands in relationships presumed to be safe and monogamous, and in which the negotiation of condom use on the part of the woman immediately presumes she is adulterous.

More nuanced approaches to prevention need to be undertaken with the understanding of how relationship dynamics – and the social climate in terms of perceptions of HIV+ individuals – contribute to the spread of the virus.

The International Community of Women Living with HIV/AIDS Chile is doing just that.

ICW Chile primarily works with women who contracted HIV from their husbands, have been subsequently widowed due to the illness, and are now attempting to forge their own way. This is difficult in a place where the stigma of HIV weighs heavily enough for most women to expect job termination if they disclose their status. While treatment is readily accessible – the Ministry of Health provides ARTs for all those in need, an initiative not to be understated – the social ramifications prompt many women to remain silent.

An organization dedicated to education, awareness raising, commemorations, and training in areas of women’s sexual and reproductive health and empowerment (and, importantly, with a board made up entirely of HIV+ women), they are embarking on an undertaking addressing the need for women to be able to protect themselves – by providing them with female condoms.

Female condoms aren’t entirely absent in Chile – but they can hardly be considered accessible when only one organization in Santiago is selling them – at $6 a piece. Of importance to note, they are desired – one organization that represents 2,000 sex workers in Santiago has shared that of the approximately 70 women a week coming to them for contraceptives and protection, female condoms are consistently requested.

The reason? They are often able to negotiate male condoms with clients, but not with their partners or husbands, putting both parties at risk. Female condoms can be inserted before sex by the woman herself, which precludes a negotiation conversation that comes with the use of the male condom (and is often ultimately refused).

This is where ICW Chile comes in.

Female Condom

The ICW Chile has already forged some of the essential partnerships to get this initiative off the ground. Groups like Fundacion Margen (a sex workers’ rights and advocacy group), in addition to their own five sub-regional teams around the country are prepared to help with raising awareness for the campaign as well as actually distributing the female condoms. Two HIV/AIDS organizations and two transgender health groups are also supporting ICW Chile’s efforts, and the Santiago Chapter of the National Women’s Service (SERNAM) has also offered their assistance. Creating a robust community of like-minded organizations, with resources and ties to mobilize is no doubt important here – but without the product, these connections run the risk of withering.

Luckily, one gift that’s helping them get off the ground is from the Female Health Company, one of the two primary female condom manufacturers, which recently pledged to donate 1,000 female condoms to the campaign, an instrumental and desperately needed move.

But it’s not enough.

When you reflect on the numbers above, it’s clear that ICW Chile needs our help in procuring the goods – and we’re going to make it as easy as possible to assist!

The goal is to distribute 30,000-35,000 female condoms in the next six months, and reach out to 60,000 people educationally. Showing a dedicated interest to the Chilean government, by region, and indicating how many people would utilize the female condoms if they were accessible (financially as well as physically!), could help prompt a firmer commitment from the Ministry of Health to provide female condoms on the scale of male condoms.

They’ve set up an Indiegogo page that details what your gift can provide, what you’ll get in return, and some of the important facts we’ve highlighted here. (I’m donating in the name of my mom for Mother’s Day!) They’ve gotten some buzz already, and this is a bandwagon worth jumping on.

I urge you to check out their Twitter and Facebook pages as well, and share widely with your networks. We’ve all seen what social media networks and crowd-funded projects can achieve, and I can think of no better project right now needing our crucial support.

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Filed under Epidemiology and Population Health, Feminism, Health Behavior, Health Education, International, Public Health, Reproductive and Sexual Health, Women's Health

Is This Real Life? The Reproductive Rights Version

My support of a woman’s right to choose has been well-documented. I champion a woman’s freedom to make a decision about whether or not she should be carrying a fetus, and the availability of resources for her to safely and quickly terminate a pregnancy if she sees fit.

We are in troubled, troubled times. Ceaseless efforts to deny women these rights are abound, and I could link to hundreds of articles that document this, but the handful I’ve chosen certainly upset me enough. I, along with scores of women’s health advocates, have tried any number of measurable ways to fight back – raising more money; drafting opposing legislation and striking down initiatives; testifying before hearings; writing op-ed pieces that detail our positions and rationally lay out the reasons why these reproductive rights are essential to women’s health, well-being, and even economic prospects; explaining that abortions and contraception are also necessary for reasons far beyond prevention pregnancy, and that all reasons are valid and worthwhile.

We’ve been insulted, condescended to, systematically stripped of essential healthcare resources.

I’m tired. I’m tired of the hypocrisy of the anti-choice wing. Tired of the false rhetoric. Tired of their offensively misguided and false claims to care about women as much as they care about fetuses, tired of the aggressive push to force women to maintain pregnancies that they are unprepared for and do not want, and further impact their educational and economic statuses. Tired of the trumpeting of false information about contraception that is subsequently followed up by happily taking money from the very creators of products that prompted their supposed moral outrage. Tired of their total disregard of the reality of many of these women who make the decision to have an abortion. Tired of total disregard of the statistics that undermine their arguments about the United States valuing children and their yet-to-be-realized lives. Tired of the total disregard and dismissal of real ways that abortions could be prevented – complete and comprehensive sexual health education and easy access to a variety of contraceptives. Tired of the complete disdain for women as sexually independent beings, tired of their disgust of the sexual lives of women while giving men and their sperm an unlimited free pass and the ability to impregnate and take off without even a slap on the wrist. Tired of the inability to empathize and simultaneously mete out punishments to the half of the population they deem fit the ostensible crime of engaging in sexual activity. If you want to harp on the issue of responsibility, then it is essential to ensure that both parties are equally responsible in every way – and as about half of the links I have put in this post show, that simply does not happen. Women are disproportionately – vastly so – shouldered with the entire burden of and the entire blame. That’s the reality, and it can’t be separated from the issue.

I’m tired but not worn out. I remain entirely committed to this cause, and won’t be sidetracked by opponents who use everything from personal insults to false science to shaky numbers to try to distract me. Nancy Keenan, the president of NARAL, recently announced that she is stepping down – largely due to the fact that she feels millennials need to begin steering the abortion rights ship, to combat the intense dedication of anti-abortion activists. Over 50% of anti-choicers maintain that abortion is a primary issue for them in elections, while only about a quarter of pro-choicers say the same. Well, I’m here. This remains my number one issue. Are you with me?

A friend recently sent me yet another HuffPo article, that I certainly enjoyed, but that for some reason was the straw that broke my camel’s back in many ways, as I saw her argument struggling mightily to encompass all of the above reasons why we should protect contraceptive access for all women. I’m so tired, in fact, that my response to these attacks has been harrowingly brought down to the essential core that I never thought I would need to stray from when I first realized what being pro-choice was; stripped of the attempts to rationalize (issues of medical necessity outside of pregnancy prevention aside, issues of risk to the mother aside, issues of childcare concerns and education concerns aside) with those who are, in fact, irrational about these issues. What happens in my uterus is my business alone. If you want the babies that these fetuses become, that women made the decision they cannot care for, then there should be no difficulty in deciding that you should take them. Take them all. Take them lovingly and fully, not cynically or begrudgingly. Cultivate them for 9 months, care for the baby when it’s born, love her, feed him, clothe her, educate him, without any help from me. If your goal is to punish women who you think have made flagrantly immoral mistakes, let us air all of your dirty laundry as well, and dissect every single decision you in your life made, and force you to pay for it as we see fit. And by all means, find a way to keep the men who didn’t use condoms, or bullied their partners into not using contraception and subsequently fled, or who threatened or coerced their partner, sitting firmly next to a baby’s crib. Come up with solutions to the myriad of complex social and economic issues that contribute to reasons women get abortions. Re-educate yourself on the fundamental fact that it is not your right to dictate the decisions of another person, and while that lack of control may infuriate you, it’s the way it is.  What happens in my uterus is my business alone. Wherever I go, the uterus goes. You don’t get to stake your judgment flag in my sex organs selectively at will, running “protectively” towards it when it suits you, and fleeing from it (and from what it carries) when it doesn’t. You don’t get to be there at all!

So don’t tell me that we have a collective duty to care for these unborn babies when what you are actually doing is attempting to control the freedom of women while doing everything you can to make sure that no true collectivism actually does benefit women or their babies.

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Filed under Feminism, Health Education, Politics, Public Health, Reproductive and Sexual Health, Women's Health

Reader Roundup (It’s Been a While…)

I am currently very guilty of completely falling behind on my (totally self-prescribed) schedule of at least weekly, hopefully twice weekly, original writings. I’m in a major data analysis crunch in my dissertation, and the stats interpretation is taking up a healthy number of my hours everyday. That being said, I’ve tried to keep up with my reading schedule, and with that in mind, I’ve done a little round up of some great articles I’ve read in the past couple weeks that I think some of my readers might enjoy. Without further ado:

For those of you interested in adolescent development, the Wall Street Journal had a great article about how the teen brain works, and how it’s changed: What’s Wrong With the Teenage Mind?

ESPN had a section on their website specifically devoted to viewers being able to comment on how much they hated female commentators. So, there’s that: ESPN Allowed People to Complain About ‘Female Commentators.’

Great details from the Huffington Post about what is at stake in an election year for women’s health, and how women’s health is used as fodder for politicos: What Does an Election Year Mean for Women’s Health and Rights?

Gail Collins, who I am a huge fan of, takes this to task as well, questioning how the allowance for employers who oppose birth control to deny coverage for female employees can be seen as a risky precedent: Tales From the Kitchen Table

Mother Jones, with excellent reporting as always, details The Republican War on Contraception – it’s even more frightening when all the facts are compressed into one terrifying testimony.

The International Center for Research on Women has a new series: HIV and AIDS: Are We Turning the Tide for Women and Girls? The chronicle case studies of women driven efforts to prevent HIV infection, projects that adapt to the need of the communities they work in (I’m always amazed that this essential element of global development remains sometimes misunderstood and underestimated), and innovative new endeavors is some great coverage on current global health initiatives aimed at reducing HIV infections and AIDS progression.

What interesting pieces have you read lately?

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Filed under Child Development and Child Health, Education, Feminism, Health Education, International, Politics, Public Health, Sexism

Bill O’Reilly, You So Crazy

Oh, Bill. I never cease to be amazed by some of the things you teach me. For example, how the brutal and horrifying rampage in Norway was not committed by a Christian (despite the rambling Christianity-soaked manifesto, and your O’Reilly-esque insistence that all terrorist attacks are carried out by Muslims regardless of any indication of their Islamic faith), simply because you don’t think a Christian would do that. Or like how your three visits to Africa assured you that you just can’t “bring Western reasoning into the culture.” Oh, and that the ACLU is second only to Al-Qaeda in how dangerous and threatening it is. And that poverty is a result being lazy and irresponsible, and if you just work hard and go to school, then, you know, you’ll make bags and bags of money and be just fine regardless of anything else or circumstance. Which sounds totally on point, since you also taught me that conservatives “see things in black and white, and liberals see gray.” Which sounds like nuance, and uh-oh, you’ve made me see that nuance makes things complicated…

And this past week, O’Reilly taught me this: “Many women who get pregnant are blasted out of their minds when they have sex and [are] not going to use birth control anyway.”

(First of all, if the women O’Reilly and the men he knows are having sex with are blasted out of their mind, I’d be interested in hearing how that consent discussion went. Perhaps his definition of consent is a little hazy. Recall – if she’s too drunk to consent, it’s not consensual sex.) 

But back to what he’s taught me. With this latest statement, I’ve learned that women – regardless of their sobriety level – are exclusively the ones who need to be concerned with contraception and infection (and that, in fact, they do a terrible job of this). Only one person in a two-person sexual encounter is responsible for ensuring the woman doesn’t get pregnant (hint – it is not the man). He’s also informed me that contraception is something only considered the exact moment before a sexual encounter occurs – not hours or days or months before – just in that whisper of a moment before the magic happens. If O’Reilly had actually engaged in sexual activity with the woman he harassed, maybe he would have just crossed his fingers that she was both sober and using birth control and not have give it a second passing thought or considered it his concern. So let’s all just do the same moving forward.

More seriously now – it’s unconscionable that someone supposes men should be able to have sex with a woman (a drunk or sober one) whenever they want and also not have to worry about or share the burden of responsibility to avoid pregnancy. We need to utilize as many tools as we can to prevent pregnancy, and that prevention should be shared equally between the two partners engaging in sexual activity. It would be great if health insurance took the lead and incorporated 50% (or 100%, if they were so inclined) of the cost of a partner’s contraception of choice into a man’s health insurance plan. I think that would be even more of a fighting point than co-pays being covered under plans.

Nancy Northrup, CEO of the Center for Reproductive Rights, did a great job and broke it down over at CBS News about why the hysteria over insurers now eliminating co-pays for women with contraceptive prescriptions that is bubbling over is not actually all that hysterical. In fact, it’s something that 28 states require to be covered by health insurance, something already covered (with those pesky co-pays) by government health insurance, and something that 99% of all women have used, regardless of religious affiliation.

Additionally, under the Affordable Care Act, virtually all of us will be required to have or purchase health insurance (a contentious point, still, largely among Republicans, but others as well). With what will be an added cost to the personal budget of many Americans, let’s take a snapshot of what the cost of birth control is: the pill is up to $50 a month (over $500/year), the NuvaRing is up to $70 a month (over $800/year) $500 – $1,000 for an IUD; even the morning after pill, used if other birth control methods failed or were forgotten, costs up to $70.  If you are currently one of the millions without healthcare and one of the millions without a job and an income, these costs are likely to be the first that are cut as you struggle to keep you and your family afloat. However. Pre-natal care costs, the cost of delivery, well visits for a newborn – and, you know, the food and clothing needs of a baby – are not going to be cheaper than the contraception options. Bottom line – prevention can be costly, and beneficial to all. Absence of prevention is even more costly, and frequently puts a lot of burden on all parties involved.

Remember how in O’Reilly’s world everyone is super wasted when they’re having sex – too wasted to worry about a condom? All these methods – the IUD, the birth control pill, the NuvaRing – can be taken or inserted well before sex. Some don’t ever come out, some devices like the NuvaRing are changed monthly. This is why these are called preventive measures. You are utilizing them well before you engage in sexual activity, so when you’re in O’Reilly’s alcohol-soaked sex fiesta and about to engage in consensual sexual activity, pregnancy is already well on the way of being stopped in its tracks. (Not STIs, let’s not forget. None of these protect against sexually transmitted diseases.) His excuse that they aren’t thinking about using contraception holds no water in the argument of preventive techniques like these that take the worry about pregnancy prevention out of the immediate sexual encounter (not 100%, though – no method is 100% effective, and I actually recommend using one of these birth control methods as well as condoms). I’d also add here that many women when drunk are still concerned with pregnancy prevention, so that weasle-y move of trying to make intoxicated women look like reckless players shooting for a fertilized egg is also inaccurate.

Bill’s “black and white” take on the issue of contraception seems to boil down to: women need to pay for their birth control, they need to pay for their pre-natal care costs and gynecological exams, they need to pay for the cost of having the baby. But the fetus was not put there by her alone. The desire to not get pregnant is not hers alone. Communicative partnerships and cost coverage in these areas leading to happy, healthy mothers and children would benefit everyone.

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Filed under Defining Gender, Feminism, Health Education, Media, Politics, Pop Culture, Public Health, Sexism, Women's Health