Feminization of HIV & Macroeconomic Policies

The Appignani Bioethics Center, Guttmacher Institute and Population Council are co-sponsoring a panel discussion on "Feminization of HIV & Macroeconomic Policies." under the auspices of the fifty-third session of the Commission on the Status of Women, at the United Nations headquarters in New York, from 2 to 13 March 2009.

Date & Place: Tuesday, March 10, 2009, 6.00-8.00 PM, 777 UN Plaza, 10th floor - Conference Room, NY 10017

The feminization of HIV relates to gender discrimination and social restrictions. These result in women's lacking access to education and employment as well as decision-making power. Victims of gender violence, women are deprived of sexual and reproductive rights. International agreements and decisions on gender equality must be translated into national legal frameworks and action plans. The focus of this panel is the social, economic, cultural and legal aspects of the epidemic, but to truly understand its feminization we need to consider how macroeconomic policies might improve women's access to resources and political influence.

Our very own Sean Philpott (blogger extraordinaire and Science and Ethics Officer for the Global Campaign for Microbicides, based at PATH) will be presenting on a panel with Helen Epstein (author of the recent book AIDS in Africa: The Invisible Cure), Heather Boonstra (our colleague from the Guttmacher Institute), and Anrudh Jain (from the Population Council).

He'll be talking about research and development of new user-controlled HIV prevention technologies that women can use to protect themselves, focusing on the need for sustained economic investment and ways to increase private industry involvement through novel licensing agreements, priority review vouchers, and advance market commitments. Kudos and thanks!

Gay ban on blood donations

As I drive to or from work at the University of Vermont each day, I am reminded that there is an “urgent need for blood” by the local chapter of the Red Cross, which happens to have their building a block down from the campus. Years ago, these messages really got me concerned and would get me to the blood drives to donate blood. But then I found out about the ban on donations from gay men I have been boycotting the Red Cross ever since. Part of me feels bad about not helping the blood supply, but I feel the need for a boycott to put more pressure on the Red Cross and thus put pressure on the FDA to revisit their policy and stop denying donations based on sexual orientation rather than risky behavior.

The ban stems from 1983, when the FDA decided to protect the blood supply –and thus protect transplant patients- from the HIV virus. At the time, HIV/AIDS was a new epidemic, and the majority of cases in this country were gay men. We also didn’t have accurate HIV tests in place. The epidemic has changed dramatically since then. Worldwide, heterosexual (man to woman or vice versa) transmission of HIV/AIDS is the main way in which people contract HIV. In the U.S., the fastest-growing population infected with HIV is heterosexual women of color.[1] Not only is the “face” of the HIV/AIDS epidemic no longer gay men, but we have also now much more accurate HIV tests that can detect the virus in donated blood within 10 to 21 days of infection[2].

The way that the blood donation services screen out gay men is by asking each man if they have ever had sex, even once, with another man since 1977[3]. Those who say they have are permanently banned from donating. So even men who do not identify as gay but who have had sex with men get banned. What seems horribly troubling to me is that, nowadays, this is a ban based completely on sexual orientation, rather than risky behavior. Yes, unprotected anal sex is the “riskiest” of all sexual activities because of the nature of the cells in the anal region and how sensitive they are to small cuts & bleeding that normally happen during sex (and especially during “rough” sex). But plenty of heterosexual people engage in this activity as well. And we shouldn’t assume that all gay men engage in that activity anyway. Also, just because you are a gay man or a man who has sex with men, it doesn’t mean anything about the safety of your sexual practices (unprotected vs. protected sex) or about the number of partners you have, or about your risky behaviors in general. A heterosexual man or woman could easily have multiple partners and engage in risky sexual activities like unprotected anal or vaginal sex, therefore being more “at risk” for HIV than a gay man who practices safer sex and is monogamous. But the heterosexual man or woman would be able to donate blood and the gay man wouldn’t.

I hope that the FDA changes this policy soon because from an ethical and a medical standpoint it seems discriminatory. And I’m sure there are plenty of healthy, HIV-free gay men or men who have sex with men who would be more than happy to donate blood if they could, and plenty of people like me who would stop boycotting the blood banks if they changed the policy, thus easing this “urgent need” for blood donations.

---

[1] HIV InSite Website: http://hivinsite.ucsf.edu/InSite?page=kb-03-01-12

[2] CDC Website: http://www.cdc.gov/hiv/topics/testing/resources/journal_article/J_Lab_Med_20031.htm

[3] FDA Website: Blood Donation Guidelines: http://www.fda.gov/cber/dhq/dhq11/dhq11d.htm

Birth Control to Reduce HIV in Africa

I don't know which to be more horrified about in this article entitled the 'Best-Kept Secret' for HIV-Free Africa:

- that researchers realize that birth control can have a great impact on reducing the number of children born with HIV in Africa, but they can't do anything about it, because of the PEPFAR's ban on distribution of contraceptives or family planning;

or the sentence where women are treated like a piece of property: "The man who, in accordance with local tradition, inherited her after her husband died refused to use condoms";

or the comments to the article that say that this is not 'our' (read 'America's') problem. As if we lived in a bubble.

It is a painful reminder of just how far we still have to go when it comes to basic human rights and mankind's inhumanity to man (and woman).

Not a 'Good News' Day

This morning's news has two disturbing items:

First, from the Washington Post: Researchers have had to shut a South African AIDS vaccine trial developed by Merck & Co; they started warning hundreds of clinical trial volunteers that a highly touted experimental vaccine they received in recent months might make them more, not less, likely to contract HIV. The full article here.

Secondly, another reason to become a vegetarian -- from Wired, the inside scoop on how cloned meat (and milk) is filtering its way into the food chain and onto on your dinner table. The author talks to one of the farmers about the health problems that his cloned pig offspring have suffered: "Within weeks of delivery in September 2002, the first piglet got sick and died. Another dropped dead two months later. A few days before Christmas, Earnhart walked into his heated barn at feeding time and spotted his last two piglets belly-up in the straw. The cause of death was apparently their identical, adult- size ulcers...[The demise] may have resulted from a well-known, poorly understood side effect of somatic-cell nuclear transfer called sudden death syndrome." Access the rest of the article here.

Let's hope the rest of the week brings better news.