Tag Archives: reproductive health

Reviewing the Utilization of New Media in Sexual Health Promotion

Google Hangouts are increasingly being utilized by groups to present conversations with people in disparate locations to a wide audience. So it was exciting to be sitting front and center—so to speak—at last week’s YTH Live Google Hangout being hosted by one of my favorite organizations, ISIS (Internet Sexuality Information Services – if you don’t know them, check them out!), in preparation for the April YTH Live Conference, focusing on new and social media use and technology in the sexual health promotion space for teens.

The topic was using mobile technology, specifically text messaging, in the sexual health context. As someone who utilizes new media in all my projects, I was excited to hear what the panelists had to say, and see if my experiences were borne out in their work as well. The lineup was great, featuring Tom Subak from Planned Parenthood Federation of America, Dr. Pamela Johnson from Voxiva (developer of the great mobile maternal and newborn health program Text4Baby), Sam McKelvie from Mobile Commons, and Eric Leven from RipRoad. It was hosted by ISIS’s Executive Director and Founder, Deb Levine (who, incidentally was instrumental as the launcher of Go Ask Alice!, and as a former Alice! Health Promotion Office employee for a couple of years, I wanted to make sure to plug that).

The first question broached by Deb was around the key trends around people seeking out health information. Tom mentioned that young people are constantly and consistently surrounded by media and information sources—literally at the tip of their fingers, so finding the answers they need is way easier than it was before the advent of new media. In this vein—and luckily, I might add—it is pretty easy to ask what were historically difficult questions. Thoughts and questions about sexually transmitted infections, pregnancy and abortion don’t require the same mustering of public courage required in asking another person face-to-face about a pressing health issue.

Tom also noted something that I have definitely seen as a sexual health educator—people are usually seeking this information in moments of crisis and anxiety. It’s in these crisis moments that text messaging can play an important role. Waiting for an email response or waiting for someone to answer a question on Tumblr or Facebook—while still far quicker than waiting for an appointment with a healthcare professional—is not as quick as being able to text a worried query and getting an immediate response. One of the most fascinating things I heard in the entire Hangout was when Eric discussed his team’s Know HIV campaign, an integrated new media campaign encouraging people to get tested for HIV. He said that the busiest time for people accessing information about HIV was in the early morning hours—either it’s the time when people are mulling over the issue, or it’s the time right after they’ve had sex or potential exposure to HIV and are seeking out information immediately. Having that information easily accessible in those moments can be crucial, and can also help people plan their next steps.

The YTH Live Conference is in April, hosted by ISIS.

The YTH Live Conference is in April, hosted by ISIS. Click for details!

My favorite part of the Hangout was when the speakers were addressing two-way communication. In my own work as well as the projects on which I have advised digital strategy, I try to emphasize two major tenets: One, interactivity is key. New media truly embodies the idea of call and response, and for the conversation to be kept going you need to answer questions as well pose them, and engage followers in creative ways. I’ve done this with polls, questions, trivia that awards responders, and the solicitation of input from my most vocal network members.

Sam underscored how to address that issue, noting that two-way communication doesn’t necessarily mean organizations need someone dedicated to personal responses—great news for folks with small budgets and for people working on a consultant basis. The example given was if you text a client “Did you get a flu shot?” you can have a few answers set depending on the person’s response. If their text back is “Yes,” you can have automatic answers setup to push to the client saying, “Great, don’t forget to remind your friends!” If their text back is no, then automatic messages can be sent saying, “Here is where you can get a shot close to you,” sending a link to a nearby clinic based on their location or directing them to a site giving them more details.

The second point I generally emphasize is that you need to treat your social and new media networks similar to the way you treat your in-person networks—essentially, it’s just relationship building in another context. This is partly accomplished by the first tenet, interactivity, but it’s also accomplished by paying attention to the work of your followers and supporting it, as well as reaching out to build collaborations and coalitions with other like-minded groups, increasing the internet-based safe spaces. (The collaborations are not solely web-based, of course. Pamela emphasized that the public health departments and medical professionals who supported Text4Baby and encouraged their patients to sign up were key, and it’s always a good idea to increase the number of sources of information about sexual and reproductive health.)

There are few organizations who can thrive in new media spaces by just blasting their own content—the New York Times is the only one I can think of. For my work implementing HIV and sexual health programs on Facebook and Tumblr, paying attention to the work of my followers and voicing my appreciation and admiration of their own work made significant headway in how trusting my audience was. In terms of sexual health specifically, this is also meeting teens where they’re at—Sam mentioned this as being essential from a programmatic perspective, but it’s also essential in terms of a behavior change perspective. When I worked with teens and young adults on risk behavior change around sex and substance, the greatest indicator of their success was my ability to assess where they were in terms of thinking about changing their behavior, and help them dissect some of their ambivalence and tease out their true questions (motivational interviewing, for all you health behavior professionals!). New media is a great space in which to do this, because the conversation feels sustained and continuous, and it’s easy to see one’s progression over the course of time. And paying attention to where those conversations are happening is also key—Tumblr has been the busiest platform for my sexual health interventions, which speaks to its popularity among teens, followed by Facebook and Twitter, the latter of which people seem to use as reminders and the former being a good platform for asking questions.

Lastly, the question of how to select the right mobile media tool to implement your public health message was brought up. Eric’s response was that text message was king, since you can access people who are otherwise difficult to reach on other platforms. I tend to agree with this, since other platforms tend to require more initiation on the part of the individual, and populations have to do some seeking out on their own. Text message pushes allow your message to be sent to larger numbers of people across greater demographics, and with more frequency. Sam noted that teens of color and teens in lower-income communities who may not have full web access actually text the most, and information being sent via text can be even more helpful for these teens. That being said, I fully believe the integration of multiple new media platforms tends to ensure greatest success.

You can watch the whole Google Hangout here on the YTH Live page.

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Filed under Health Behavior, Health Education, Media, Reproductive and Sexual Health, Technology

Lots of Rest Can Prevent STD Transmission! At Least, That’s What Fresno is Telling Kids

In case you wanted to read something today that will make make you fume, check out ThinkProgress’ report about an abstinence-only education program in Fresno (for shame, California). It is massively, massively irresponsible.

Did you know that getting a lot of rest can prevent you from getting STDs? And that HIV can be spread by kissing? Let that marinate for a bit, because that’s what kids in Clovis, CA, are going to come out of school thinking.

Condoms? Not addressed. Contraception? Not covered.

This curriculum is actually against California law, which requires medically accurate sexual health education to be delivered to students. The ACLU is suing.

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Filed under Child Development and Child Health, Education, Health Education, Public Health, Reproductive and Sexual Health

Integrating Family Planning and HIV Services Benefits All

Some pretty great research is cropping up at the 2012 International AIDS Conference, and it’s hard to pick just one finding to reference, but I do love infographics and I do love family planning – so I found something that combines the two! Population Action International, a truly fantastic research and advocacy organization focused on women’s reproductive health access and care, and they make a great point about the advantages and importance of providing both family planning and HIV services at the same time and in the same place. They point out that mother-to-child HIV transmission can be reduced, stigma may decrease, and both time and money are save. Take a look:

Combining HIV and family planning services (courtesy of Population Action International).

Another issue at hand is that of the relationship between a provider and a patient or client. Family planning clinics have a better chance of establishing long-term relationships with women – particularly if women have multiple children – given that they also sometimes aid in pre- and post-natal care or help connect women to those services, which increases the likelihood of women who test HIV+ to getting the treatment they need. Again, all in one place!

Follow along at #AIDS2012 on Twitter to stay abreast of everything going on in D.C.

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Filed under 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

Senator Boxer’s Excellent Response to Attacks on Women’s Health

I’m sure most of you saw the photo of the all-male women’s health panel this past week in Congress:

Sure.

So, I wanted to spread the response of Senator Barbara Boxer, long time fighter for women’s health, and senator from my home state of California. It’s spot on:

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Filed under Feminism, Health Education, Politics, Public Health, Women's Health

I’m Rarely Speechless.

But I was reminded of an instance this past fall when I was. You know what’s one of my least favorite things to witness? People in positions of power, authority or supposed trust mocking those who come to them for help, advice, guidance, or wisdom. Last year, there was a pretty striking example of this in Spain, which got a fair amount of attention abroad but received minimal coverage here in the States. It was brought to my attention by Stephanie, and I’d shelved it for a few months since I had a lineup of things to chat about, but it most definitely deserves attention. I will say that this is old news, and I usually try to only post about current events – but it’s only old news in the world of Internet, as it happened a few months ago (September-October 2011). I think the issues it brings up are obviously still relevant and the fact remains that it never should have occurred to begin with.

The Spanish Society of Obstetricians and Gynecologists published a comic strip in their newsletter depicting images of physicians mocking patients – the physicians are always male gynecologists, and the patients are always female, and always drawn as unattractive with exaggerated features and shown with enlargement of their reproductive organs and functions. The comics mock women for uterine prolapses, for being informed about the birth process, for wanting to following non-interventionist labor procedures, imply that sexual interest is behind a doctor pap-smearing a patient every three months, mock elderly women and portray women with questions as insufferable. The link to the images is here (you will have to select that you want to see the pdf in the upper right corner of the page) – but I want to give warning that the images are graphic and can be extremely insulting. The words are in Spanish, but even if you don’t have elementary skills in the language the images do a pretty sufficient job of getting the message across.

There was obvious outcry, and petitions passed by many, to denounce the comics and ask them to be removed. But I remain absolutely flabbergasted that these were ever drawn at all, much less published by an organization that ostensibly commits itself to women’s and maternal health. Communicating with one’s physician is difficult enough for many people (men and women alike), and by publishing this, the SSOG has confirmed what are the worst fears of many – that their doctor doesn’t respect them, thinks they are foolish, thinks that their reproductive health needs are disgusting or gross, assumes sexual activity equals promiscuity, dismisses them if they have questions or are informed, that their doctor finds alternative therapies laughable and unsound, and that they as patients do not deserve to be treated with dignity – not to mention reinforcing the age-old stereotype of male gynecologists being driven by sexual interest instead of scientific, medicinal inquiry (and in this instance, the woman on the receiving end of a doctor’s inappropriate pursuits lauds HPV as a virus community comprised of an elite ‘club’ of women who are sexually active). It is particularly trying that the implications of the  gender binary here was so clear – the males were the physicians, in charge, in the know, firmly in the power position, and the females were weak, uninformed, unaware, and their reproductive health was repellent and the stuff of slapstick humor. It’s just an egregious example of an abusive power dyad.

This kind of impression can completely shut down any channels of communication, limiting the physician-patient relationship in its ability to be a health education opportunity, an encouraging behavior change environment, and most importantly, a place of trust and confidence. I wanted to highlight this issue mainly because of these points – that the physician-patient relationship has always had real promise, but that it cannot be effective if it isn’t mutually respectful and the patients aren’t seen as worthy of having dignity. That this was published in 2011 is to me a devastating indication of how in some areas, this seems very far off.

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Filed under Defining Gender, Feminism, Gender Stereotyping, International, 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