Jesse Kelly is an avowed anti-choice candidate and has received support from the National Right to Life Political Action Committee. Barber, when asked about his position on choice and women’s health care, said he has always been pro-choice and believes women’s health care decisions must be made between women and their doctors.

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Ron Barber is running to finish Gabrielle Giffords’ term in the June 12, 2012, special election. Early voting starts on May 17.

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“There has been too much political debate about limiting our freedoms,” he told us. “Women have the right to make their own choices about contraception and any interference from the government or employers is an affront to personal liberty.”

The debate on women’s health care used to center on abortion. It has now expanded to include the availability of contraception and the “right to refusal” –  so-called consciousness clauses that allow pharmacists to refuse to dispense emergency contraception, employers to opt out of providing insurance coverage for birth control, and health care providers to refuse emergency care for pregnant women. Barber, as do most Americans, believes that the “availability of contraception was an issue we settled 50 years ago” and employers, insurance companies, and pharmacists should not put themselves between a woman and her doctor.

Arizona's 8th Congressional District encompasses much of Pima and Santa Cruz counties, as well as Cochise County. To find out what district you live in, click here.

“I will be a strong voice to make sure that basic contraception continues to be available to women. I will vote against any proposal to defund Planned Parenthood,” Barber promises. Though many of the laws on this issue are being implemented at the state level, he says that he will oppose any restrictions on contraception and be a voice of support for access to contraception at home in Arizona.

In the last round of budget debates, Republicans made Planned Parenthood a bargaining chip. When asked how he would deal with this tactic as a congressman, Barber said he believes that while bipartisan solutions can be found to some of the issues, he “will not cave to any attempt to extract a vote against Planned Parenthood in exchange for movement on other important legislation. The American people deserve a Congress willing to vote on each issue – not have legislation held captive by an extreme part of the Republican caucus.”

Barber continued, “Our country – and certainly Southern Arizona – is facing enormous challenges: a disappearing middle class, unemployment and underemployment, aging infrastructure. To play partisan games with the budget – to risk programs that support our veterans, support our children, and support our seniors – is not business-as-usual, it is totally unacceptable. Our federal and state budgets should reflect our values and not the extreme positions of a few legislators.”

Defunding Planned Parenthood is a stated goal of the presumptive Republican presidential candidate. As a supporter of Planned Parenthood, Barber holds that Planned Parenthood “should not be held hostage in the debate about contraception and abortion rights.” He appreciates that Planned Parenthood has provided critical health services for nearly 100 years, and its cancer screenings, mammograms, and preventive care must continue to receive federal support. Barber has stated that when he is in Washington, he will “fight to ensure that Planned Parenthood receives the political and financial support to continue these essential services.”

Barber sees access to basic health care as a major issue that must be addressed in the remainder of this legislative term – and into the next term. He believes it will be important to ensure that Planned Parenthood and other providers continue to receive funds to provide basic health care, regardless of state laws on abortion or funding. He recognizes that low-income women and women in rural areas don’t have easy access to preventive care, and he wants to work to improve this access. Barber has said he “will put a high priority on this issue when I go to Congress.”

Ron Barber has lived in Southern Arizona most of his life. He went to high school in Tucson, and graduated from the University of Arizona. He married his high school sweetheart, Nancy, and they raised their two girls there. Together they ran a small business, Toy Traders/Stork’s Nest, where families could buy and trade used toys, clothing, and equipment. He also worked for 35 years as an advocate for people with disabilities. As his website tells us, he ran one of the five most cost-efficient, high-quality family-service programs in the country.

Wanting to continue his commitment to improving people’s lives and solving community problems, Barber headed up Congresswoman Gabrielle Giffords’ district operations in 2006. In that position, he got results by cutting through federal agency red tape for constituents. After the tragic shooting in Tucson in January 2011, Giffords stepped down from her position to focus on her recovery. Barber, less critically wounded in the shooting, recovered and was encouraged to run to fill the remainder of Giffords’ term, as well as to run for the next full term. With Gabrielle Giffords’ encouragement and endorsement, Barber accepted the opportunity to continue his commitment to public service.

If you believe it is critical for the people of CD8 to have a strong proponent for women’s health care representing them in Washington, you might like to volunteer or contribute to his campaign. Please go to www.ronbarberforcongress.com to sign up to help. You can also join Planned Parenthood in Tucson on May 24 at 6 p.m. to call voters and encourage them to vote for Ron Barber — contact Michelle Steinberg to RSVP and receive details. If you are registered to vote in CD8, you can request an early ballot here.

Today, Arizona’s Asians and Pacific Islanders, or APIs, represent nations throughout Asia and the Pacific, with Indians and Filipinos constituting the two largest API ethnic groups in Arizona. Although APIs are a small percentage of Arizona’s total population — 2.8 percent — their population is now the fastest-growing in Arizona, increasing by 85,000 in the last decade. In this respect, Arizona mirrors a larger trend; nationally, the Asian and Pacific Islander population grew by 43.3 percent between 2000 and 2010.

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More than two-thirds of Asians and Pacific Islanders have never been tested for HIV.

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Asians and Pacific Islanders experience the same health problems as the population at large, but like other minority groups, their health needs are best met by understanding how health problems affect them uniquely, and by providing culturally competent health interventions and health care. There’s an increasing need for both as their population grows, especially when it comes to addressing HIV/AIDS in their population. Although APIs have low rates of officially reported HIV/AIDS compared to other racial and ethnic groups, their incidence of unreported HIV/AIDS most likely hides a larger problem. As Dr. C. N. Le of the Asian & Pacific Islander Coalition on HIV/AIDS explains, “The statistics say that the prevalence rate among Asians is relatively small, and much smaller than among the black community or the Latino community … But those are official statistics, and official statistics are notorious for undercounting minorities, and especially for undercounting immigrants.”

Lending credence to Dr. Le’s argument is the fact that more than two-thirds of APIs have never been tested for HIV. Even with that low rate of testing, APIs have the highest rate of increase in new HIV infections compared to other racial and ethnic groups. To raise awareness about HIV/AIDS among APIs — and to promote effective prevention and screening — May 19 is National Asian & Pacific Islander HIV/AIDS Awareness Day.

National Asian & Pacific Islander HIV/AIDS Awareness Day serves as a day to observe ongoing efforts of education, prevention, and screening, as well as to plan partnerships and capacity-building for the continuation and expansion of these efforts.

Activists and advocates have cited an assumption among health care providers that APIs are at a low risk for HIV/AIDS as one of the reasons APIs are undercounted in HIV/AIDS statistics. Among the issues addressed on this awareness day are the stigma of HIV/AIDS diagnosis in the API community and the promotion of HIV/AIDS screening by health care providers.

Although the rate of reported HIV/AIDS among APIs in Arizona has dropped somewhat in the last decade, it’s too soon to call a success, especially given the low rate of testing among APIs. Both here and nationally, we will need to confront HIV/AIDS in our many cultural communities to stop its spread. Along with many other services offered, Planned Parenthood health centers are a resource in confronting HIV/AIDS in Arizona’s diverse communities, with staff who can talk to individuals about STIs and help them get the testing or treatment they may need. The Planned Parenthood website also has an online tool called The Check that can help individuals decide if they should get tested for chlamydia, gonorrhea, or HIV.

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Bronski frames LGBTQ history as one that is woven into the fabric of U.S. history — not separate from or additional to it.

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Bronski explains in the introduction to his book that he is interested in providing something more than a history of “who might have been ‘gay’ in the past or had sexual relations with their own sex.” In fact, his mention of individuals is often pared down to the sheerest character sketches and profiles. Far from a collective biography of LGBTQ Americans, Bronski’s interest in individuals is often limited to a person’s role as agents in a process of evolving gender expectations, agents who sometimes shape those expectations and other times act independently of them. He explains that he doesn’t want to reduce history to “names, dates, political actions, political ideas, laws passed and repealed.” Instead, borrowing the words of Shulamith Firestone, he wants to present history “as process, a natural flux of action and reaction.”

To inform this view of history, Bronski draws on past literature and research on LGBTQ history, adds to it, and rethinks it to create his own retelling. His retelling begins with a glimpse of the Americas on the cusp of contact with Europe, looking briefly at the role of Two-Spirit people (individuals considered to have a mixed or third gender role) in indigenous societies. It moves forward chronologically to arrive in the 1990s (and then touches on the recent past and the present in an epilogue).

For many readers, Bronski’s book will add new dimensions to familiar history. For example, he argues that the institution of slavery had a significant impact on LGBTQ history, because “acceptance of slavery as a philosophical concept and political reality laid the groundwork for the justification of ‘othering’ — designating a group of people as ‘different,’ placing them outside of the legal, social, and moral framework granting full citizenship.” The introduction of the birth-control pill, on the other hand, had a more positive impact on LGBTQ history, because it undermined the argument that same-sex sexual activity, because it did not lead to reproduction, was unnatural; the introduction of the birth-control pill normalized “the separation between sex and reproduction.”

The interaction of phenomena that are known to general U.S. history and phenomena that are more specific to LGBTQ history is a theme throughout Bronski’s book, and it’s central to how he wants to write his chronicle. His book frames LGBTQ history as one woven into the fabric of U.S. history — not separate from or additional to it. His hope is “to give a secure and realistic sense of how the lives, thoughts, and actions of LGBT people have made this nation into the country it is today, and show all non-LGBT people how this history has affected them as well.” The influence of LGBTQ people on this country’s historical landscape is seen from their role in the earliest intentional communities to their political influence in the Roosevelt years and beyond.

Ambitious in its approach, at times Bronski’s book does seem to shortchange history a bit by focusing on processes first and the people in those processes second. While some readers might like to read about ideas rather than people, for others, the personal framework can give history a more meaningful and concrete narrative. Another shortcoming is Bronski’s occasional reliance on prose and poetry to reveal historical episodes of same-sex bonding and intimacy. This shortcoming is understandable, given that any scholar of LGBTQ history has to deal with a scarcity of frank and forthright documentary evidence of private behavior that was often shunned and persecuted by social purity movements. Bronski does make up for it by using very compelling evidence from literature — evidence that, while subject to interpretation, has obvious interpretations that are hard to ignore.

One of the first books of its kind, Bronski’s work won the American Library Association’s Stonewall Book Award after its hardcover release. Soon to be released in paperback, it should be a welcome resource for the LGBTQ community, as well as its allies (like this blogger).

Condoms offer fantastic protection against STIs and reduce pregnancy risk. Most are made from latex, to which some people are allergic.

Latex condoms are a well-rounded form of birth control: Not only are they great for preventing pregnancy, but they reduce the risk of passing on or receiving a sexually transmitted infection (STI). When used consistently and correctly, they offer fantastic protection. Although condoms have been around for centuries, their modern construction from latex is a vast improvement over the silk and viscera of yore. A product of the industrial age, they are manufactured by dipping a porcelain mold into natural rubber latex, a material that originates from a tree.

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Latex is tops, but polyurethane and polyisoprene condoms are good alternatives. Beware of lambskin: It isn’t effective in STI prevention.

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Because of latex’s many advantages, the majority of condoms are manufactured from this material. However, up to 6 percent of the population is allergic to latex. There is a range of symptoms associated with latex allergies. Most people with latex allergies experience only a localized reaction on the vulva or penis (contact dermatitis); systemic reactions (like asthma or anaphylaxis) are rare. Allergy tests can be performed on people who suspect they might be sensitive to latex.

Luckily, even if you have a latex allergy you can still find condoms to facilitate your safer-sex experiences, including condoms made out of polyurethane and polyisoprene. Not all condoms protect against pregnancy or STIs, so read the label carefully. In the United States, if the packaging doesn’t explicitly state that the condoms are made to prevent disease, they haven’t been approved by the FDA for that purpose.

We have the most safety information on condoms made from latex, which has been shown to be a very reliable material. The FDA recommends latex condoms above all others, though it has approved polyurethane condoms as well. Polyurethane and polyisoprene condoms are relatively new to the market — introduced in 1994 and 2008 respectively — and there have not been as many studies of their relative safety and performance. The FDA’s information about condoms is, for the most part, not up to date. Having said that, polyurethane and polyisoprene seem to be good materials, though they haven’t withstood the test of time as can be boasted by the latex condom.

Polyurethane

Although latex condoms are a relatively new advancement in contraceptive technology, they’ve been around since the 1920s, before most of you were born! It wasn’t until 1994 that the polyurethane condom, the first good alternative to latex, was produced. They are more expensive than latex, but are also thinner and better able to conduct heat. Whereas oil-based lubricants will destroy latex, they are fine to use in combination with polyurethane condoms. While polyurethane has its advantages, it is, unfortunately, not as effective a material as latex.

A 2003 study found that polyurethane condoms were more likely to break during sexual intercourse than their latex counterparts. However, despite being less effective than latex condoms, polyurethane condoms were still found to be in the same range of effectiveness as other barrier methods of birth control. A 2000 study also found that polyurethane broke and slipped more than latex, but these results were not found to be statistically significant. This study also found that both male and female participants found latex condoms easier to use than polyurethane condoms. A Guttmacher Institute study reached similar conclusions, also finding that polyurethane condoms lost their shape or bunched up more than latex condoms.

When used in combination with other contraceptive methods, such as the Pill or the IUD, polyurethane condoms should provide excellent protection against pregnancy.

Polyisoprene

Polyisoprene is a heavily refined, synthetic form of latex from which the allergenic latex proteins have been removed. Condoms made from polyisoprene are suitable for most people with latex allergies, though it’s possible that people who are highly sensitive to latex could experience delayed allergic contact dermatitis.

There are several brands of polyisoprene condoms on the market, though they may be more difficult to find than their latex and polyurethane counterparts. Like polyurethane condoms, they are said to do a better job of transmitting body heat. Unlike polyurethane condoms, they cannot be used with an oil-based lubricant — as they are a hypoallergenic but ultimately latex-derived material, oil-based lubricants will damage polyisoprene just as they damage latex condoms.

They are shown to protect against both pregnancy and the transmission of viruses, bacteria, and other pathogens.

One study suggested that polyisoprene condoms take longer to break than latex condoms. However, the researchers were not investigating condom durability but rather a new kind of machine that testers can use to determine condom durability.

Lambskin condoms are made from the intestines of sheep.

What about lambskin condoms?

When it comes to protecting against STIs, there really aren’t a lot of benefits to using a lambskin condom (also called a sheepskin condom). Some people use them because they think they are more “natural,” which may offer an appealing aesthetic.

It’s true that lambskin is natural — “skin” is a euphemism for intestines. Yup, this condom is made from the digestive tract of a sheep. The intestines are the site of the majority of digestion — it is here that foods are blasted with enzymes and broken down into small pieces. When the pieces are small enough, they are absorbed through tiny holes in the intestine’s porous membrane. Intestines, by their very nature, must be permeable — otherwise, malnutrition and starvation would result. So, yes, lambskin condoms are “natural” — and so are the holes through which viruses (also “natural”!) can pass.

According to the FDA, lambskin condoms have not been shown to protect against the passage of viruses, such as HIV, herpes, or human papillomavirus (HPV). In the early 1990s, Trojan-brand lambskin condoms were recalled en masse by the FDA because they didn’t contain adequate labeling. There were reports from customers who had used these condoms and, despite believing they were practicing safer sex, contracted HIV.

The size of a virus compared to a sperm. Viruses are small enough to pass through the pores in lambskin condoms. Illustration: FDA

The pores in lambskin condoms, while big enough to allow viruses to pass through, should be small enough to keep sperm out. They might be a suitable barrier method for a monogamous heterosexual couple, who have both been previously screened for STIs, wishing to decrease risk of pregnancy. (Though it bears pointing out that there aren’t good tests for HPV, so one partner could unknowingly be infected with HPV and pass that virus to the other through the pores in the lambskin condom.)

Condoms are available at all Planned Parenthood health centers. In addition, you can make an appointment with a clinician to discuss the pros and cons of various birth-control and barrier methods and find which one is appropriate for you.

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Income inequality is the most significant cause of racial and ethnic health disparities.

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The term health disparity is a broad term that refers to preventable differences in health between segments of society as a result of unequal access to health care, underfunded schools (which result in lower health literacy), discrimination, or other disadvantages. Racial and ethnic minorities, LGBTQ individuals, and low-income socioeconomic groups are typically the focus of health disparities research. It’s a broad area of study, but to stay within the focus of this blog, a look at reproductive health among Arizona’s racial and ethnic minorities can be a good place to start.

As previously discussed, Arizona’s teen pregnancy rate is one of the highest in the United States, underscoring the need for better sex education. That high rate of teen pregnancy is seen especially among Arizona’s Latina, Native American, and black populations. Among Latinas, 43.5 per 1,000 become pregnant at age 19 or younger. For Native Americans, the rate is 34.7, and for blacks, the rate is 33.3 per 1,000. That’s compared to a rate for all racial and ethnic groups of 28 per 1,000.

Among pregnant women, both teen and adult, lower maternal health disproportionately affects Arizona’s racial and ethnic minorities. For example, pregnancy-associated hypertension and weight gain of less than 21 pounds during pregnancy are more common among blacks and Native Americans in Arizona. There is also significantly lower use of prenatal care among Latinas and Native Americans.

Black, Native American, and Latino/Latina Arizonans are disproportionately affected by sexually transmitted infections (STIs) as well, with higher rates of early syphilis, gonorrhea, chlamydia, genital herpes, and HIV/AIDS than white Arizonans. The most significant difference is seen in the rate of chlamydia, which affects blacks at a rate of 926.9 per 100,000, Native Americans at a rate of 679.3, and Latinas/Latinos at a rate of 471.5. The rate for all racial and ethnic groups is 394.2 per 100,000, and for whites, it’s 156.3 per 100,000.

Although racial and ethnic health disparities have a number of causes, income inequality has been shown to be the most significant. In a state where 35 percent of the population belongs to a racial or ethnic minority group, and at a time when the wealth gap between whites and minorities has widened in the midst of an economic recession, addressing health disparities is critical. National Minority Health Month marks a time set aside to empower communities to address those disparities through education, prevention, and intervention. Planned Parenthood health centers are a resource for Arizona’s diverse communities, with staff available to talk about health matters and help individuals get the screening and treatment they may need.

A computer model of the surface of HPV-11, a leading cause of genital warts. Image: Scripps Research Institute

Human papillomavirus (HPV) is a hot topic these days thanks to the advent — and attendant controversy — of Gardasil, the vaccine that protects against four strains of this sexually transmitted virus. Discourse centers around HPV-16 and HPV-18, the two HPV strains that together are responsible for 70 percent of cervical cancers and 90 percent of anal cancers. However, Gardasil also protects against HPV-6 and HPV-11, two HPV strains that aren’t associated with cancer but rather with 90 percent of genital warts. While genital warts don’t have the potential to cause cancer and death, they can be very upsetting to the people who develop them.

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Every year in the United States, about $200 million is spent to treat genital warts.

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Many strains of human papillomavirus can cause warts, and not all of them are sexually transmitted. For instance, HPV-1, HPV-2, and HPV-4 cause warts on the hands and feet and are spread by skin-to-skin contact. About 40 strains of HPV can be transmitted sexually – they are called “mucosal” strains because of their affinity for mucous membranes such as the skin found in the genital, anal, and oral regions. Ninety percent of cases of genital warts are caused by two strains of HPV: HPV-6 and HPV-11. Genital warts are highly contagious and can be transmitted by any type of sexual activity.

Let’s start with a quick overview of genital warts. While it’s quite possible for someone infected with a wart-causing strain of HPV to be completely asymptomatic, the physical appearance of warts can take several forms. They can appear in the genital area, in or around the anus, and (very rarely) in the mouth, lips, palate, or throat. They can also rarely be found on the cervix and vaginal walls. They are soft to the touch and can be raised, flat, or bumpy. They may or may not be itchy or painful. Genital warts can be small or quite large. As you can see, there are a wide variety of ways they can manifest themselves, despite being caused by one type of virus. There are four types:

• condylomata acuminata, which have a “cauliflower-like” appearance
• papular warts, which are dome-shaped papules 1-4 millimeters in diameter
• keratotic warts, which have a thick, “crust-like” layer
• flat-topped papules, which can look like a freckle or might be slightly raised from the surface of the skin

Genital warts usually develop within six weeks to six months after exposure, but could take longer to appear. If our immune systems are healthy, our bodies may be able to fight off the virus — our immune systems are normally able to clear 90 percent of genital-wart infections within two years of exposure. Unfortunately, if the immune system can’t fight off the virus, the infection will become chronic, in which case warts can resurface throughout one’s lifetime. The warts can be removed by a doctor, but you could still transmit the virus to others and you might experience a recurrence of the warts. Smokers’ immune systems are less likely to be able to fight off the infection, and in the case of a chronic infection, smokers’ warts are more likely to return even after being removed by a health care provider.

You can reduce your risk of acquiring HPV by consistently and correctly using condoms and dental dams. The female condom (also known as the receptive condom or the insertive condom) is more effective in protecting against HPV transmission because it covers more surface area than regular condoms. However, barrier methods are limited by how much of the skin’s surface they can cover. Because the virus can reside in skill cells that aren’t covered by a condom or dental dam, HPV can still be spread even when safer-sex methods are used. Aside from total abstinence, the best protection against genital warts is to be vaccinated with Gardasil before becoming sexually active. (If you are already sexually active, you still could benefit from the vaccine, unless you have been chronically infected by all four strains of HPV against which the vaccine protects. Talk to a health care provider for advice.)

Genital warts by themselves are not life-threatening, though they can cause bleeding; when open wounds are present, the risk for the transmission of other STIs increases. Warts can also cause emotional distress, so most people who have them want to find ways to get rid of them. Old folk remedies included strategies such as rubbing a dead toad on the warts; these days there are many effective ways of getting rid of them, including surgical and nonsurgical methods. Talk to a health care provider to find out which option is best for you. They are easier to treat if therapy is sought within the first year of their appearance. Unfortunately, each treatment can cost several hundred dollars and the warts could return in the future (annually, about $200 million is spent to treat genital warts in the United States alone). Furthermore, evidence shows that warts can still be transmitted even when they have been removed because viruses can lurk in the surrounding skin cells. It is possible, however, that the removal of warts makes transmission less likely — but right now researchers don’t know for sure.

Genital warts could pose a problem during pregnancy. Hormonal changes can induce the warts to grow in size, and transmission to the infant during childbirth is possible, though rare. A congenital infection can lead to the growth of warts in the respiratory tract. This infection is called recurrent respiratory papillomatosis, and it can cause breathing problems. The warts can be removed, but they will usually keep growing back. This is a rare condition – only 1 in 200,000 children develops it – but it’s one more reason to consider Gardasil and always to use barrier methods during sexual activity.

Planned Parenthood health centers, as well as other clinics and health-care providers, can diagnose and treat genital warts. Additionally, Planned Parenthood carries Gardasil, the vaccine that protects against the strains of HPV responsible for 90 percent of genital warts.

Click here to check out other installments of our monthly STI Awareness series!