Export More Female Condoms, Not Abstinence Programs, Report Says

Penny Starr

Senior Staff Writer, crosswalk.com

(CNSNews.com) - The U.S. government must provide more funding for the worldwide distribution of female condoms while reducing the amount of money it spends on abstinence-until-marriage programs, according to Serra Sippel, executive director of the Center for Health and Gender Equity, or CHANGE.

"The Congressional earmark in PEPFAR (President's Emergency Plan for AIDS Relief) -- which we are in the process of trying to remove the earmark that (gives) money for abstinence and fidelity - what we've found from people we interviewed and from various studies is that the result of that is the stigmatization of condom use," Sippel said Tuesday at a briefing of the Global Health Council in Washington, D.C.

Sippel added that the goal of her advocacy group is to "really push the U.S. government to promote sexual and reproductive condom rights within U.S. foreign policy."

According to the United States Agency for International Development (USAID), the federally funded agency that distributes international aid, $457 million of its budget for FY 2008 is dedicated to family planning programs, including condom distribution.

The CHANGE briefing also marked the release of its "Saving Lives Now: Female Condoms and the Role of U.S. Foreign Aid" report. In it, the center states that the U.S. government supplied nearly 1.9 billion condoms worldwide between 2004 and 2007.

It also reports that the "the United States government plays an important role in shaping global trends in reproductive and sexual health supplies," with America providing 42 percent of "global donor support" for family planning, including the female condom.

But other advocacy groups say that U.S. foreign aid that promotes sexual activity is doing more harm than good around the world.

"Social radicals ... believe they must liberate Third World children from their benighted traditions and religions and to enlighten them in the way of the American teenager," Austin Ruse, president of the Catholic and Family Rights Institute, told Cybercast News Service. "That is, to be sophisticated about sex and riddled with STDs.

"These social radicals believe that young people not only can't, but shouldn't control themselves sexually," Ruse added. "They seek to tear down, rather than build up the human person."

The center's report also detailed strategies used to successfully distribute female condoms, including in Zimbabwe, where it credits Population Services International, another non-profit health advocacy group, for helping with the distribution of female condoms in that AIDS-stricken country.

"Because approximately 97 percent of Zimbabwean women visit a hair salon at least once a month, PSI also promoted female condoms to women in Zimbabwe using hair salons in low-income, urban areas," the report reads.

Wendy Wright, president of Concerned Women for America, cited another report to argue that abstinence programs, not condom distribution, can really help women at high risk for contracting AIDS.

A Feb. 2 article in National Geographic online, said a decline in AIDS rates in Zimbabwe was linked to "behavior changes," as first reported in the journal Science.

"Most important, researchers say, is the substantial decrease in casual sex partners reported by Manicaland residents," the National Geographic online article reported. "This, combined with increased abstinence by teenagers, may be contributing to the HIV decline."

"Our biggest problem is relying on methods that have had terrible failure rates," Wright told Cybercast News Service, "while denying them access to programs that have been proven effective."

Wright said groups with agendas like CHANGE are "trying to wipe out the competition by giving no federal funding for abstinence, even though the evidence shows that abstinence programs are effective in delaying sexual initiative and reducing HIV and AIDS rates."

Make media inquiries or request an interview about this article.

Export More Female Condoms, Not Abstinence Programs, Report Say

By: Penny Starr

Senior Staff Writer, crosswalk.com

(CNSNews.com) - The U.S. government must provide more funding for the worldwide distribution of female condoms while reducing the amount of money it spends on abstinence-until-marriage programs, according to Serra Sippel, executive director of the Center for Health and Gender Equity, or CHANGE.

"The Congressional earmark in PEPFAR (President's Emergency Plan for AIDS Relief) -- which we are in the process of trying to remove the earmark that (gives) money for abstinence and fidelity - what we've found from people we interviewed and from various studies is that the result of that is the stigmatization of condom use," Sippel said Tuesday at a briefing of the Global Health Council in Washington, D.C.

Sippel added that the goal of her advocacy group is to "really push the U.S. government to promote sexual and reproductive condom rights within U.S. foreign policy."

According to the United States Agency for International Development (USAID), the federally funded agency that distributes international aid, $457 million of its budget for FY 2008 is dedicated to family planning programs, including condom distribution.

The CHANGE briefing also marked the release of its "Saving Lives Now: Female Condoms and the Role of U.S. Foreign Aid" report. In it, the center states that the U.S. government supplied nearly 1.9 billion condoms worldwide between 2004 and 2007.

It also reports that the "the United States government plays an important role in shaping global trends in reproductive and sexual health supplies," with America providing 42 percent of "global donor support" for family planning, including the female condom.

But other advocacy groups say that U.S. foreign aid that promotes sexual activity is doing more harm than good around the world.

"Social radicals ... believe they must liberate Third World children from their benighted traditions and religions and to enlighten them in the way of the American teenager," Austin Ruse, president of the Catholic and Family Rights Institute, told Cybercast News Service. "That is, to be sophisticated about sex and riddled with STDs.

"These social radicals believe that young people not only can't, but shouldn't control themselves sexually," Ruse added. "They seek to tear down, rather than build up the human person."

The center's report also detailed strategies used to successfully distribute female condoms, including in Zimbabwe, where it credits Population Services International, another non-profit health advocacy group, for helping with the distribution of female condoms in that AIDS-stricken country.

"Because approximately 97 percent of Zimbabwean women visit a hair salon at least once a month, PSI also promoted female condoms to women in Zimbabwe using hair salons in low-income, urban areas," the report reads.

Wendy Wright, president of Concerned Women for America, cited another report to argue that abstinence programs, not condom distribution, can really help women at high risk for contracting AIDS.

A Feb. 2 article in National Geographic online, said a decline in AIDS rates in Zimbabwe was linked to "behavior changes," as first reported in the journal Science.

"Most important, researchers say, is the substantial decrease in casual sex partners reported by Manicaland residents," the National Geographic online article reported. "This, combined with increased abstinence by teenagers, may be contributing to the HIV decline."

"Our biggest problem is relying on methods that have had terrible failure rates," Wright told Cybercast News Service, "while denying them access to programs that have been proven effective."

Wright said groups with agendas like CHANGE are "trying to wipe out the competition by giving no federal funding for abstinence, even though the evidence shows that abstinence programs are effective in delaying sexual initiative and reducing HIV and AIDS rates."

Export More Female Condoms, Not Abstinence Programs, Report Says

By: Penny Starr

Senior Staff Writer

(CNSNews.com) - The U.S. government must provide more funding for the worldwide distribution of female condoms while reducing the amount of money it spends on abstinence-until-marriage programs, according to Serra Sippel, executive director of the Center for Health and Gender Equity, or CHANGE.

"The Congressional earmark in PEPFAR (President's Emergency Plan for AIDS Relief) -- which we are in the process of trying to remove the earmark that (gives) money for abstinence and fidelity - what we've found from people we interviewed and from various studies is that the result of that is the stigmatization of condom use," Sippel said Tuesday at a briefing of the Global Health Council in Washington, D.C.

Sippel added that the goal of her advocacy group is to "really push the U.S. government to promote sexual and reproductive condom rights within U.S. foreign policy."

According to the United States Agency for International Development (USAID), the federally funded agency that distributes international aid, $457 million of its budget for FY 2008 is dedicated to family planning programs, including condom distribution.

The CHANGE briefing also marked the release of its "Saving Lives Now: Female Condoms and the Role of U.S. Foreign Aid" report. In it, the center states that the U.S. government supplied nearly 1.9 billion condoms worldwide between 2004 and 2007.

It also reports that the "the United States government plays an important role in shaping global trends in reproductive and sexual health supplies," with America providing 42 percent of "global donor support" for family planning, including the female condom.

But other advocacy groups say that U.S. foreign aid that promotes sexual activity is doing more harm than good around the world.

"Social radicals ... believe they must liberate Third World children from their benighted traditions and religions and to enlighten them in the way of the American teenager," Austin Ruse, president of the Catholic and Family Rights Institute, told Cybercast News Service. "That is, to be sophisticated about sex and riddled with STDs.

"These social radicals believe that young people not only can't, but shouldn't control themselves sexually," Ruse added. "They seek to tear down, rather than build up the human person."

The center's report also detailed strategies used to successfully distribute female condoms, including in Zimbabwe, where it credits Population Services International, another non-profit health advocacy group, for helping with the distribution of female condoms in that AIDS-stricken country.

"Because approximately 97 percent of Zimbabwean women visit a hair salon at least once a month, PSI also promoted female condoms to women in Zimbabwe using hair salons in low-income, urban areas," the report reads.

Wendy Wright, president of Concerned Women for America, cited another report to argue that abstinence programs, not condom distribution, can really help women at high risk for contracting AIDS.

A Feb. 2 article in National Geographic online, said a decline in AIDS rates in Zimbabwe was linked to "behavior changes," as first reported in the journal Science.

"Most important, researchers say, is the substantial decrease in casual sex partners reported by Manicaland residents," the National Geographic online article reported. "This, combined with increased abstinence by teenagers, may be contributing to the HIV decline."

"Our biggest problem is relying on methods that have had terrible failure rates," Wright told Cybercast News Service, "while denying them access to programs that have been proven effective."

Wright said groups with agendas like CHANGE are "trying to wipe out the competition by giving no federal funding for abstinence, even though the evidence shows that abstinence programs are effective in delaying sexual initiative and reducing HIV and AIDS rates."

House Panel Examining Federal Abstinence Programs

By Susan Jones
CNSNews.com Senior Editor
April 23, 2008

(CNSNews.com) - Rep. Stephanie Tubbs Jones (D-Ohio) has introduced a bill urging the House of Representatives to spend more taxpayer money on the prevention, screening and treatment of sexually transmitted diseases.

"We can no longer be silent about this issue, Tubbs Jones said. "The abstinence-only education touted by the Bush Administration is simply not enough."

But a conservative group says a new study by the Heritage Foundation shows that abstinence programs work. Fifteen of the 21 programs reviewed by Heritage analysts showed positive behavioral results, including delay or reduction of sexual activity, said the Family Research Council.

On Wednesday, House Oversight and Government Reform Committee Chairman Henry Waxman (D-Calif.) was holding a hearing on abstinence programs.

Federally funded abstinence-only programs require the exclusive teaching of abstinence until marriage and prohibit teaching about condoms or other contraceptives -- other than to discuss failure rates. These programs have received over $1.3 billion in federal funding over the past decade, the Oversight and Government Reform Committee says on its Web site.

On Wednesday, medical and scientific experts, as well as youth educators, will testify before the committee on evidence of the effectiveness of abstinence-only programs and of "more comprehensive" programs -- those that include mentions of birth control.

The problem

Tubbs Jones says the United States has the highest rate of sexually transmitted infections in the industrialized world. Almost half occur in young people.

"The issue of sexually transmitted diseases has grown to epic proportions in this country," Tubbs Jones said in a news release. "What is most devastating is the toll that STD's are taking on our young women, particularly African American young women."

Pointing to numbers from the federal Centers for Disease Control and Prevention, Tubbs Jones noted that 48 percent of young African American women are infected with an STD compared to 20 percent of young white women.

That 2008 report from the CDC estimated that 1 in 4 young women between the ages of 14 and 19 in the United States, or 3.2 million teenage girls, are infected with at least one of the of the most common sexually transmitted diseases, including human papillomavirus (HPV), chlamydia, herpes simplex virus, and trichomoniasis. These infections can lead to long-term health risks including infertility and cervical cancer.

Tubbs Jones said direct medical costs associated with STDs are as high as $15.3 billion a year.

Studies show abstinence works

The Family Research Council is hailing The Heritage Foundation for its "careful" review of 21 abstinence education programs.

"The research by Christine C. Kim and Robert Rector provides valuable data about the benefits of abstinence education programs and, most importantly, that it is the teens who benefit most," said FRC President Tony Perkins. "This paper also shows that none of the programs had a negative impact, despite what opponents of abstinence claim."

The Heritage researchers said they reviewed at 21 studies of abstinence education. Fifteen of the studies examined programs that were primarily intended to teach abstinence. Of those 15 studies, 11 reported positive findings.

The other six studies analyzed virginity pledges, and of those six studies, five reported positive findings.

"Overall, 16 of the 21 studies reported statistically significant positive results, such as delayed sexual initiation and reduced levels of early sexual activity, among youths who have received abstinence education. Five studies did not report any significant positive results," the Heritage Foundation said on its Web site.

"All of the evidence shows that sexual abstinence is the healthiest behavior for youth," the FRC's Perkins said. "Teaching and equipping youth with the skills to practice this behavior is the goal of genuine abstinence education."

The FRC says the federal government should support "effective" abstinence education programs like those the Heritage Foundation has reviewed, and not promote programs that encourage teens to engage in physically and emotionally risky sexual behavior.

"The government does not promote drug use or underage drinking, and it should not promote risky sexual behavior either," Perkins said.

Continued Good News on Teen Pregnancy and Abortion

By Janice Shaw Crouse
townhall.com

In a study released this week, the Centers for Disease Control and Prevention (CDC) reports record declines in the rates of teen pregnancies and abortions. The drop in teenage pregnancy rates continues a long trend: the decline of 38 percent is a fall from an all-time high in 1990 to an historic low in 2004. Significantly, the CDC, the nation's largest public health agency, stated that their report is the most comprehensive study of this decade.

Teen pregnancies were only 12 percent of the total pregnancies in 2004, down from 15 percent in 1990. Teen abortions were at a historical high in 1990 at 1.61 million, but had declined by 24 percent (1.22 million) by 2004. Another way of looking at the data is to note that among 15- to 44-year-old women, abortions per 1,000 women declined from 30 per thousand in 1990 to only 19.7 per thousand in 2004.

Clearly, the only thing that has changed in the years under review is the increase in schools offering abstinence education. Contraception, especially the condom, is readily available, but that's nothing new; that availability has remained constant during the period of the decline. Over the past decade, though, abstinence programs have become far more widespread. In addition, they have been increasingly more effective as more money has been available to test the programs and provide research about best practices in teaching abstinence. The programs focus on increasing teen self-esteem and teaching delayed gratification, how to say "no" effectively, how to resist peer pressure, and how to plan and achieve goals for the future. Such programs provide legitimate means of teen empowerment.

Further, teens have access now to all the technological evidence, via high definition sonograms, that the babe in the womb is really a pre-born child with fingernails and sucking a thumb. These views of the baby inside the womb are having a profound impact on the future generation of mothers and fathers; they understand the seriousness of abortion - that it truly does kill an infant.

Equally important, today's teens have seen broken relationships up close and ugly; they've seen friends used and discarded. They want more; they want a future and hope for those things that now seem possible for everyone.

The culture is changing for the better.

Unsurprisingly, the battle is not over yet. The left is still behind the times and is still arguing the same old talking points. The Guttmacher Institute headed their press release about the decline in teen pregnancy and abortion with the improbable claim: Improved Contraceptive Use a Key Factor. We are supposed to believe that suddenly teens have become consistent and reliable about using a condom. In fact, an earlier analysis by Guttmacher reported that 86 percent of the decline in teen pregnancy between 1995 and 2002 was due to more teens using contraception and using it more effectively. Apparently unaware that they seemed to be trying to have it both ways, Guttmacher complained that "the proportion of U.S. teens receiving any formal instruction about birth control methods has declined sharply." Most of their press release promoted the "need" for comprehensive sex education instead of abstinence programs for teens. Further, they cited the need for increased funding for comprehensive sex education and recommended cutting all funding for abstinence (even though current funding shows an untenable disparity - $12 in comprehensive sex education funding for every $1 in abstinence education.) They want it all, even though their programs have proven ineffective.

There is still much to be done in changing attitudes and promoting the well-being of America's young people, but teen sexual activity is down, teen pregnancies are down and teen abortions are down. That is great news from the cultural battle fields.

Over the past decade, we have offered our nation's teens a bright future and expected the best from them. Not surprisingly, they have met the challenge and are seizing the opportunities to grasp all the possibilities available to their generation. Our national leadership needs to continue to keep faith with them by supporting abstinence education as clearly the best choice for their current and future well-being.

Janice Shaw Crouse, Ph.D., Senior Fellow at the Beverly LaHaye Institute, the think tank for Concerned Women for America, is a recognized authority on domestic issues, the United Nations, cultural and women’s concerns.

Canadian Prisons Contributing To Spread of HIV, Researchers Say

About 15% of incarcerated drug users at correctional facilities in the Canadian province of British Columbia reported using injection drugs during their incarceration, causing concern that prisons are contributing to the spread of HIV in Canada, according to one of two recently released studies conducted by researchers from the B.C. Centre for Excellence in HIV/AIDS, the CNS/Vancouver Sun reports.

The first study, published online in Oxford University's Journal of Public Health, followed 1,247 injection drug users for six years. Half of the IDUs were incarcerated at some point during the study. Nearly 15% of those who had been incarcerated reported using injection drugs while in prison, mostly with used needles.

The second study, published in Drug and Alcohol Review, followed 902 IDUs at Insite -- a supervised drug-injection facility in Vancouver, Canada -- over two years. About one-third of the IDUs reported having been incarcerated at each six-month follow-up, 5% of whom reported using injection drugs during their incarcerations.

The studies found that IDUs who have been incarcerated are "more likely to report syringe sharing" and to be living with HIV or hepatitis, the researchers wrote. Evan Wood, a researcher who worked on both studies, said the findings likely underestimate the number of IDUs who reuse needles while incarcerated because many people are unlikely to admit they use injection drugs or reuse needles.

The researchers are calling for needle-exchange programs in prisons to reduce the spread of HIV and hepatitis. Wood said a "coordinated public health response" is needed to address the issue and to protect inmates and their "home communities" from the spread of bloodborne diseases. The researchers added that the findings underline the "urgent need" to expand harm-reduction programs at correctional facilities across Canada.

Officials at Correctional Service of Canada said that "continuing risk behavior by inmates during incarceration presents a public health challenge." Guy Campeau, director of media relations at CSC, said that the department is implementing a "comprehensive" infectious disease program that includes methadone maintenance and the distribution of condoms, dental dams, water-based lubricant and bleach to help reduce the spread of HIV and other diseases. The department has "no plans to implement a needle-exchange program," Campeau said (Munro, CNS/Vancouver Sun, 4/6).

SOURCE: KAISERNETWORK.ORG

Mens' low libido no longer a secret

Waning sex drive, performance problems affecting more males in their 20s and 30s

By GAIL ROSENBLUM
Star Tribune (Minneapolis)

Michael Metz is growing less surprised by phone calls like the one he got a few weeks ago. A worried young wife said that the couple's sex life had taken a noticeable nosedive. "Is there something wrong with us?" she asked. Probably not, said Metz, a St. Paul, Minn.,-based marital and sex therapist. Any couple married for five years, with young children, should expect a dip in intimacy. Then came the punch line: She's starving for the hot sex they used to have. He's the one with the "headache."

A guy who doesn't want sex? We're kidding, right? Uh-uh.

Metz is one of many sex therapists noting a shifting dynamic in the bedroom, as women are finally talking about a problem many of their mates would rather shove under the mattress: erectile dysfunction and diminished libido in men under age 40, married and single. Studies suggest the problem is trickling down to younger, college-aged males; as many as one-fourth face performance problems.

Brian Zamboni, a therapist with the Program in Human Sexuality at the University of Minnesota, also has seen a "significant and steady stream" of new male clients, ages 20 to 35, in the past five years. One of several new books on the subject calls low sexual desire among men "America's best-kept secret." Some men, though, are sharing their frustration and confusion.

"Yes, I'm 25 and I have a sexual dysfunction already," posts "Z," seeking advice on a medical Web site. "I don't have erections in the morning anymore. I must sleep first to have sex later. Why is this happening to a healthy guy like me?"

There are lots of possible reasons. Too little sleep. Too much porn. Cigarette smoking and other unhealthy habits. Unresolved resentment toward one's mate. And it doesn't just affect the guys. Partners feel the impact, too.

"This morning, I was once more rejected and I started to cry because it's getting to me," writes a woman on the "Mismatched Libidos" message board, directed to people in their 20s and 30s. "I feel ugly, I feel fat."

Another writer shares similar frustration. "My husband would always say, 'You have an incredible sexual appetite. I hope you never lose that, especially when we have kids.' Well, two kids and 10 years later, I am not the one who has lost it. He has. There is always one excuse after another."

If there is good news here, it's that unleashing men from the myth that they always want sex allows women to silence the fiction that they never want sex. Metz, who has written three books on men's sexual health, believes that it is women's increased confidence in — and demand for — sexual pleasure and intimacy that is forcing this issue into the open. "Women are expressing more frequently that sex is important to them," he said.

For most men, sex is still very important, too, which makes the inability to perform difficult to face or fix.

So, what is going on?

Well, a lot. And this is part of the problem. "A good number of men, even young men, get exhausted," said Metz. "The competitive pace, the demands of work and kids, the decrease in leisure time — it has to show up somewhere." But therapists and doctors see many other factors playing a part. Among them:

· His health. Is he drinking? Smoking? Alcohol and cigarettes both inhibit erections. Is it his prescription medication? Some antidepressants and blood-pressure drugs can lower desire or delay orgasm for men and women. Obesity, diabetes, sleep apnea and thyroid imbalances can all hamper sexual success, too. And what about illicit drugs? "The research isn't definitive," Zamboni said, "but cocaine, marijuana and heroin use can inhibit erections." Low testosterone levels could also be a treatable factor.

· Psychological stresses. This is the "feelings" conversation many men just hate. But it's essential to draw them out if they hope to get to a solution. "A number of young men are lonely in their marriages," feeling like the third wheel when babies arrive, Zamboni said. Not just lonely. Some are silently fuming. Bob Berkowitz and Susan Yager-Berkowitz asked men why they stopped having sex with their wives for their new book, "He's Just Not Up for It Anymore." Forty-four percent answered, "I am angry at her." Men felt criticized and controlled, undervalued and insignificant, yet "many couldn't, or wouldn't, talk about it with their partners," they write. Thus begins a downward spiral. He loses his desire, starts having performance problems, starts to avoid sex.

· Her reaction. At this point, things may go from bad to worse. Women (and some gay partners, Metz said) aren't thinking, "Poor guy, he has performance anxiety. I need to be patient and affirming." She personalizes: "He doesn't love me anymore! He must be having an affair!" Not surprisingly, she pulls away. Sometimes, in fact, he is having an affair, or she is. Sometimes, though, women say his "affair" is with pornography.

· Pornography. Is pornography a culprit? Maybe yes, maybe no. There's certainly a risk, Zamboni said, that a man can become dependent on porn. "Instead of going to his partner, he goes to the computer." There's also a risk that his view of normal women's bodies and capabilities could become unrealistic.

Consider this blog entry on Cribsheet (startribune.com/cribsheet), a Star Tribune forum for new parents:

"I'm sorry to have to say this, because it must be painful for a woman to hear," writes a young father, "but I just don't find my wife as attractive as I used to. Pregnancy takes a toll on a woman's body and — I'm sorry — I'm just not turned on the way I used to be. If that makes me a cad or a superficial jerk, I'm sorry. But there it is." (Never mind that he, too, has likely put on a few, or more than a few pounds. Men don't tend to see that as a problem. Sorry, but there that is, too. This is probably a good conversation for couples to have when they're both feeling well-rested and collaborative.) But Metz also knows some couples "who use traditional porn for their own

sexual energy. Porn is about fantasy," he said. "Fantasy can be fine, if you know what you're doing." How can anyone be sure? Metz encourages couples to ask a very sensible question: Are your actions around pornography encouraging intimacy with your partner, or hindering it? "A man who masturbates four times a week to porn and is ignoring his wife," Metz said, is clearly compromising intimacy. "If he does it one time a week as a reaction to a high-pressure career and it's a tension release," the act may not have any ill effects on the couple's intimacy, he said.

· Unreasonable expectations. We live in a world where erections are considered problematic only if they last more than four hours, and women feel inadequate if they don't own several lacy thongs. No wonder people are shell-shocked. We also think everybody's doing it with more frequency and flair than we are. Probably not. Still, everybody's anxious. That's doubly true, Metz said, for other cultural groups. He's counseled couples and men in the Muslim community, for example, for whom talking about sexuality is "a shy, cautious experience. I see it as a double edge," he said, "... the deep respect for the body and private intimacy, (coupled) with an anxiety, especially for men, who commonly have premature ejaculation. The difficulty of talking about sex is similar to other couples."

Metz wishes that everyone would follow a "good-enough sex" approach,

where pleasure becomes as important as performance. That means relaxing and touching. It means taking the pressure off by finding other ways to enjoy intimacy. It also means getting real about what's reasonable.

The woman who called Metz eventually revealed that, while their sex life had diminished, they were still making love once a week. That, according to many studies, is about average and certainly no cause for alarm. "You're not going to be having college sex when you're raising kids and working your butt off," Metz said. "The crucial issue is being realistic about expectations. How sad it is that this pursuit of 'perfect' sex becomes a cause of sexual problems."

More Contraception Choices for Women 40

ATLANTA (AP) - Birth control options are growing for women 40 and older - a group that once viewed its choices as pretty much limited to tube-tying surgery and condoms.

For them, the pill is back. So is the IUD. The reason is that both are safer. There's even a nonsurgical method of tube-tying.

Such options have long been needed, experts say, because 40- and 50-somethings are a complex group. Some have had several children and are willing to have sterilization surgery. Others may want children, but not right now.

Traditionally, women 40 and older are the least likely to use birth control. Along with adolescents, they have the highest rates of abortion. At the same time, these women are more experienced at using contraception and follow instructions better.

When it comes to contraceptives for women 40 and older, "one size definitely does not fit all," said Dr. Vanessa Cullins, vice president for medical affairs of the Planned Parenthood Federation of America.

A review of the current science of contraception and women 40 and older was published recently in the New England Journal of Medicine. The author, University of Florida gynecologist Dr. Andrew Kaunitz, noted that the risk of dangerous blood clots rises sharply at age 40 for women who take birth control pills containing estrogen.

The risk is even greater for overweight women, who also are more likely to have high blood pressure and diabetes.

But the dosage of estrogen in current birth control pills has been dramatically reduced. The pill is now considered a safe alternative for lean, healthy, older women Kaunitz and other experts said.

"It may not be well known that the current low-dose formulations are a reasonable option for healthy women in their 40s," said Dr. JoAnn Manson, a Harvard endocrinologist who wrote a book on menopausal hormone therapy.

The pill may be preferable for some women, because it can help control irregular menstrual bleeding and hot flashes and has been shown to reduce hip fractures and ovarian cancer, wrote Kaunitz. He has received fees or grants from several companies that make oral contraceptives.

But middle-aged women who are obese, smoke, have migraines, high blood pressure or certain other risk factors should be steered toward IUDs or progestin-only treatments like "mini-pills," experts said.

Higher breast cancer rates have been reported in older women who took estrogen-progestin pills for menopause. However, studies did not find an increased breast cancer risk in women 35 and older who took oral contraceptives.

The most common form of contraception for women 40 and older continues to be sterilization — a category that counts tubal ligations (tube-tying) in women as well as vasectomies in their male partners.

Increasingly, gynecologists are offering a newer type of tubal ligation that is nonsurgical. The procedure, called Essure, was approved by the government in 2002. Instead of cutting through the abdomen to cut and tie the fallopian tubes, a doctor works through the cervix, using a thin tube to thread small devices into each fallopian tube. These cause scarring, which in about three months plugs the tubes, stopping eggs from the ovaries from reaching the uterus.

Also relatively new is a product called Implanon, approved by the government in 2006. It's a matchstick-sized plastic rod, placed under the skin of the upper arm, that is a more modern cousin of Norplant and can last about three years.

"Things have definitely changed. There are a lot more options for older women than there used to be," said Dr. Erika Banks, director of gynecology at New York City's Montefiore Medical Center.

Choosing the right contraception can be a bit of an odyssey, said Lisa Riley, a 44-year-old who works in Banks' medical practice. Last week, Riley got a new IUD.

When she was younger, she took the pill. It worked, but she stopped it to have kids — twins — in 1993. She was nervous about returning to the pill because of worries about a possible cancer risk. For about a year, she and her husband used condoms, but he got tired of that, Riley said.

She had friends on IUDs so she chose that option. It worked well for several years until it began to cause heavy menstrual bleeding. After Banks advised her to get a new one, she chose Mirena, a version that releases hormones and should last for five years.

For now, Riley doesn't plan any more children. But she wasn't ready for sterilization. "It's too permanent for me," she said.

SOURCE: MIKE STOBBE, ASSOCIATED PRESS, AP.GOOGLE.COM

Sex ed bill proposes more than abstinence-only

TALLAHASSEE, Fla. (AP) - Some Florida teens believe drinking Mountain Dew or smoking marijuana will prevent pregnancy and that swallowing a capful of bleach will prevent HIV/AIDS. One reason those dangerous myths have spread is the state's reliance on abstinence-only sex education, say advocates of a bill to require a more comprehensive approach in Florida's schools.

The measure narrowly won approval from a Sentate committee Tuesday. Under the proposed legislation, schools would still be required to teach abstinence as the only sure way to prevent unwanted pregnancies and sexually transmitted diseasese, but they would have to teach more about sex. It would require, for example, teaching about condoms and other methods of birth control and disease prevention.

The bill's chances, though, remain slim with the annual 60-day legislative session nearly half over. The bill would have to clear three more committees before getting a Senate floor vote. The House version has yet to get a committee hearing.

"Young people are getting too little information too late,'' said Jenna Cawley, director of education for Planned Parenthood of Greater Orlando.

Cawley urged the bill's approval as she told the Senate Education Pre-kindergarten-12th Grade Committee about the Mountain Dew, marijuana and bleach myths.

Opponents, including anti-abortion activists, claimed the bill's requirements would result in more, not fewer teen pregnancies as supporters argue.

"The only healthy, 100-percent effective way to prevent disease and pregnancy is abstinence,'' said Alison Lambrechts, a field coordinator for Project Reality, which provides sexual, alcohol and drug abstinence materials for schools.

The bill's sponsor, Sen. Ted Deutch, D-Boca Raton, said Florida's current approach isn't working because the state has the sixth-highest teen pregnancy rate nationally.

He cited a recent University of Florida study showing the state's sex education programs vary widely in content, get little class time and that some students miss out entirely. Half of the middle schools and a third of high schools teach abstinence-only courses, according to the Florida Department of Education.

The committee voted 4-3 for the bill (SB 848). One Republican, Senate President Pro Tempore Lisa Carlton of Osprey joined the panel's three Democrats in favor of the bill. The other three Republicans voted no.

Source: The Associated Press, www.nwfdailynews.com

Use a Condom - You'll Live Longer

At the 2008 National STD Prevention Conference held in Chicago in early March, Dr. Sara Forhan released an alarming set of data referring to a study of Sexually Transmitted Diseases in female teenagers.

Forhan studied 838 participants in the 2003-2004 National Health and Nutrition Examination survey, all of whom were female teenagers between the ages of 14 and 19. The study showed that approximately one in four teens had one of the four most common STDs found in women-HPV (Human papillomavirus,) Chlamydia, HSV-2 (Herpes simplex virus type 2), or Trichomoniasis.

That is 3.2 million members of America’s female population that have STDs that can cause lifelong damages such as genital cancers, genital herpes, and infertility, among other symptoms. Out of those 3.2 million, 15 percent have more than one of the four major STDs.

While there is no comparable data for male teenagers or young adults between the ages of 20 and 24, it is no secret that STDs in teen and young adults are on the rise. Quite often, it is more difficult to detect STDs that are generally symptom-free, such as HPV and Chlamydia in men, who typically do not undergo regular STD screening tests such as those for women. While the diseases are more prevalent in certain genders and backgrounds, it’s time for every one of us to take to step back to see what we’re up against and how we can fix this ever-growing problem.

Of the four STDs targeted in this study, the most prevalent STD found in teen girls was HPV, which affected 18 percent of the study's participants. According to the Center for Disease Control, over 25 percent of women aged 20 to 24 also have the disease at any given time. The majority of the American population will come in contact with one of the many strains of HPV before their 50th birthday. This is especially unfortunate because there is a strong link between HPV and cervical, penile, and anal cancers, as well as the occasional case of genital warts.

Next comes Chlamydia, a disease with little to no detectable symptoms. The rate of Chlamydia has gone up 36% in men and 16% in women from 2002 to 2006, the CDC says. Still, the disease is more than three times more common in women than men. Unfortunately for these women, Chlamydia is an extremely destructive force if left untreated and can lead to damage of the reproductive organs and infertility.

One out of five adolescents has genital herpes, the catalyst of which is primarily HSV-2, according to the CDC. Apart from genital herpes outbreaks, which do not occur right away and may be mistaken for another condition such as skin irritation in the early stages, there is no way to track HSV-2.

"Genital HSV-2 infection is more common in women (approximately one out of four women) than in men (almost one out of eight),” the CDC website states. "This may be due to male-to-female transmission being more likely than female-to-male transmission."

Forhan's study also found a disparity in the race of infected teenagers in her study. While 20 percent of non-Hispanic whites and Mexican females were infected with one of the main four STDs, a shocking 48 percent of African-American females were affected.

"Factors contributing to the severe STD impact among African Americans include limited access to quality health care, as well as poverty. Additionally, a higher prevalence of STDs in this population may translate into a greater risk of being exposed. Finally, misperceptions of personal or partner risk may also be factors in increased risk for STDs among African American women," says Nikki Kay of the Center of Disease Control.

However, Dr. John Douglas, Director of the STD Prevention Division at the CDC, assures that the minority trend is not exclusive to African-Americans. “When compared to whites, the Chlamydia rate among Hispanics is three times higher and the gonorrhea rate is twice as high. Hispanics also have the second highest rate of syphilis in the nation, followed closely by Native American/Alaska Natives, who also have the second highest rate of gonorrhea and Chlamydia in the U.S."

Overall, young females have more STDs than young males. Young African-Americans have more STDs than other races. Now we must consider that statement and ask ourselves why this is happening.

"We are seriously overdue to re-invent 'sex education' - to ensure that adolescents gain understanding about the underlying gender norms that actually shape much of their sexual health and well-being. Specifically, policies and programs need to emphasize young people’s critical thinking skills and their awareness of gender issues," Nicole Haberland and Debbie Rogow say in an editorial reacting to Forhan's study. The two authors wrote the article on behalf of the Population Council, a program which seeks to improve programs and policies for HIV/AIDS; poverty, gender, and youth; and reproductive health.

Haberland and Rogow suggest that the rise in STDs is directly linked to America’s perception of the traditional gender roles men and women play out in a sexual relationship.

"Girls who are submissive to male partners, or who agree that males should 'have more power in the relationship' are less able and less likely to negotiate condom use or to refuse unwanted sex. Boys who are socialized to equate masculinity with physical strength, emotional toughness, and aggressive behavior; with proving their heterosexuality; and with having multiple sexual partners are also at greater risk."

According to the authors, the only way to fix the problem is to develop a stronger focus on gender dynamics among teens. This focus is absent in most sexual education programs, whether they are abstinence or prevention-based.

"Unfortunately, sex educators in the US are busy battling right wing opposition and have had little time or space to heed this call,” Haberland and Rogow explain. "Indeed, most sex education programs ignore gender issues, or touch on them at best superficially."

The call for education on gender relations and stereotypes also offer a solution to the controversial call for "sex education" to be taught at a younger age since many students drop out of school before high school, when sexual education is usually taught. The authors discuss this in a November 2005 article entitled Sexuality and Relationships Education: toward a Social Studies Approach:

"Unfortunately, in some cases, implementing this shift boils focusing only on negative aspects of sexuality (protection against abuse) or on lessons about intercourse and contraception for children who are not prepared for such information. In contrast, a culturally appropriate focus on social norms related to gender might also be considerably more appropriate for under-12 children than focusing predominantly on sexuality per se."

Even when taught to teens, Haberland and Rogow have found that the few gender-based sexual education programs that exist have had their success. In Latin America, the Project H program for young males targets gender awareness issues. An evaluation of the program showed more condom use and less STD symptoms among its participants.

In the US, where there is also a great concern about the growing levels of STDs in youth, the authors have also found a program that’s got the attention of teens. "Another example, closer to home, is the Brooklyn-based nonprofit Scenarios USA. Scenarios sponsors a critical thinking and creative writing program through public school districts in New York City, Cleveland, South Texas, and Miami, as well as through Planned Parenthood and through Black Entertainment Television."

Scenarios USA presents a new theme based around issues of love, sex, and gender every year. This year’s theme is "What’s the real deal about masculinity?" The theme was discussed through a story, play, and scriptwriting contest, which will be translated into publications, performances, and films that will be displayed throughout high schools and via television.

The data released by Dr. Sara Forhan at the National STD Prevention Conference only supports a pattern that America has been trying to deter for years though health and education programs. STDs have a significant prevalence in teens between age 14 and 19, as well as young adults between age 20 and 24. This is especially true for women and minorities, who are as much affected by society’s social constructs as they are sexually transmitted diseases.

It is only through gaining a greater understanding of our own strengths and, perhaps more importantly, vulnerabilities that teens can conquer the norms of sex as we know it. We need to recognize the faults of traditional gender roles and utilize that knowledge to protect ourselves from undesirable sexual situations and consequences.

Those who see themselves as being in a favorable sexual situation must still be aware of both contraceptive and STD screening services available to them, both of which are crucial to STD prevention and treatment. According to a study by Sherry Farr and her colleagues at the CDC, it shows that only 39% of women are actually taking advantage of both services, thus putting themselves at unnecessary risk.

The old cliché "knowledge is power" has never been more relevant than in a case such as the struggles of teens and young adults against sexually transmitted diseases, so get educated and get involved!

SOURCE: Kait Silva, acedmagazine.com