World AIDS Day: Fighting the Stigma Is Half the Battle

RibbonThey say words can never hurt you, but in certain parts of the world, there are three letters that can take away everything dear to you: HIV.

Can you imagine having your family disown you? What if doctors refused to treat you, even with basic care? What would it feel like if you were not allowed to pursue any form of education? How about if you had no possibility of a future with a romantic partner?


We will never make strides in preventing HIV transmission until we confront the taboos that surround it.


This is reality for millions of men, women, and children in sub-Saharan Africa who have been diagnosed with HIV/AIDS. As of 2013, that number was 24.7 million, which accounts for the vast majority of the world’s total reported cases, which by 2014 approached 37 million people, 2.6 million of whom were children. In 2013 alone, 1.5 million sub-Saharan Africans were newly infected. Since the first case was reported in 1981, a certain stigma has always lingered around the disease. Many in the United States refer to it as the “gay disease” or accuse those infected of bestiality. They may say that someone who has been diagnosed should avoid intimacy, believing that a person with HIV is incapable of functional relationships without infecting their partner. In Africa, the implications are even more harsh. Often believed to be a “curse from God,” many regions exile an infected person from their community.

Worse, the stigma does not stop with individuals. It bleeds into the legal, political, and economic arenas as well. This is true worldwide. Some places have prosecuted women for transmitting the virus to their child, or have prosecuted individuals for not disclosing their positive status even if they have reached an undetectable viral load through antiretroviral therapy (ART). The discrimination surrounding a positive diagnosis is cited as the primary hurdle in addressing prevention and care. Continue reading

The Imaginarium of Doctor Delgado: The Make-Believe Medicine Behind SB 1318

pillDr. George Delgado, a gynecologist based in San Diego, is probably not likely to win the Nobel Prize in Medicine any time soon — or ever. Delgado’s dubious medical claims have been one of the driving forces behind a piece of legislation, Arizona Senate Bill 1318, that pushes what physician and state Rep. Randall Friese calls “fringe medicine.”

Delgado runs a website called Abortion Pill Reversal, offering 24-hour medical advice to women who have taken the abortion drug mifepristone and regret their decision. “There is an effective process for reversing the abortion pill, called ABORTION PILL REVERSAL, so call today!” the website cheers. Most people have probably never heard that a medication abortion — that is, an abortion performed by administering two pills — can be reversed. If this medical breakthrough sounds new, it’s because it doesn’t exist — at least not within any kind of evidence-based, established medical practice.


So-called abortion reversal is untested for safety or effectiveness.


Unsafe abortions have always been the consequence of the anti-abortion movement. Now unsafe abortion reversals can likely be added to that, thanks to the procedure Delgado has performed and promoted — in spite of scant evidence of its safety and effectiveness. In the two-step process of a medication abortion, a provider first administers a dose of mifepristone and then follows it with a dose of misoprostol. Delgado claims he can intervene in a medication abortion so that the patient’s pregnancy can continue. If patients change their minds after the first step, Delgado claims, they can counteract the initial drug with a dose of progesterone.

For published medical literature, Delgado can claim a 2012 article he co-wrote in the Annals of Pharmacotherapy. The article describes six abortion reversal patients, four of whom, he claims, remained pregnant. Though published in a legitimate medical journal, Delgado’s findings were from a small sample of patients, none of whom were compared in a controlled study to patients who did not undergo the progesterone treatment. Moreover, not everything that’s published in medical journals is well received by the medical community. Dr. David A. Grimes, a physician formerly with the Centers for Disease Control and Prevention, calls the article “an incompletely documented collection of anecdotes.” Continue reading

Sniping, Not Debating: The Center for Medical Progress Videos

The following guest post comes to us via a Planned Parenthood Arizona volunteer.

health care providersI watched or read the first few full-length videos and transcripts posted by the Center for Medical Progress (CMP) beginning July 25, 2015. No doubt, coming weeks will bring more videos, but I would be surprised if they stray from themes of this first batch. In a nutshell, the heavily edited videos assert that uncompassionate Planned Parenthood representatives violate laws against collecting and selling fetal tissue for profit, “haggle” over pricing, and discuss abortion procedures and tissue in a distasteful, chilling manner.

I’m pretty weary of (though never surprised by) folks who oppose a woman’s right to make her own child-bearing decisions. Why? In this case, opponents refuse to stand and fight on the merits of their arguments. Instead, they use sniping tactics that trigger emotions and ignore facts.

CMP selected snippets of their hidden-camera videos to concoct a narrative not supported by the unedited videos. Consider these snippets they left out.

Planned Parenthood affiliates help WOMEN donate THEIR fetal tissue for medical research.

Dr. Deborah Nucatola, Planned Parenthood Federation of America’s senior director of medical services, spoke of the demand for fetal tissue donation programs:

“Patients will call up, make an appointment, and say, ‘I would like to donate my tissue.’ And the affiliates are really feeling like, ‘Oh, wow, I really need to figure out a way to get this done.’ Because patients are talking about — you know, in general, in health care, a provider is not going to offer a service unless there’s demand. And there is a demand now, I mean, women know that this is something that they can do.”

Continue reading

STD Awareness: Which STDs Are Vaccine Preventable?

scientistWouldn’t it be great if we could wipe sexually transmitted diseases off the face of the earth? If vaccinologists have a big “to-do” list out there, probably every single infectious disease is on it, including every STD. But some STDs have a higher priority than others, while other pathogens, unfortunately, don’t yield to our efforts quite as easily as other vaccine-preventable diseases.

Celebrate National Immunization Awareness Month by taking a look at a vaccinologist’s hypothetical “to-do” list below. While we already have a couple of STDs checked off that list, there is still more progress to be made!

check boxHuman papillomavirus: Gardasil, the most widely used HPV vaccine, introduced a new-and-improved version earlier this year. Gardasil 9 protects against seven strains of HPV that collectively cause 90 percent of cervical cancers and anal cancers, plus the two HPV strains that are jointly responsible for 90 percent of genital warts. Not only that, but vaccination against HPV will also reduce the frequency of “pre-cancers,” which are cellular abnormalities that can be treated before progressing into full-fledged cancer — meaning less time, money, and anxiety spent dealing with follow-up procedures and treatments. In fact, Australia is already seeing a huge nosedive in genital warts and pre-cancers — all thanks to their sky-high HPV vaccination rates.

check boxHepatitis A and B: Hepatitis, a disease of the liver, can be caused by several types of viruses, including hepatitis A virus and hepatitis B virus. Both can be transmitted sexually, but thanks to the vaccines, you can ask to be protected against them using a combination vaccine, meaning you’ll only have to get three shots over a six-month period rather than the five shots you’d receive if you were vaccinated for the two viruses separately. Continue reading

Pro-Choice Friday News Rundown

  • ribbonsThe imbeciles in the state of Kentucky are trying to say that a ban on gay marriage isn’t discriminatory because it bars both gay and straight people from same-sex unions. To me, this is akin to saying you’re going to ban breastfeeding in public places, but you’re going to ban both men and women from breastfeeding, and thus, it’s not discrimination against women! See, magical thinking! No logic necessary!! (ABC News)
  • Arizona Republicans are such big fans of lying that they’ve passed a law that requires doctors to lie to women about abortions being reversible. (The Guardian)
  • Tampons may one day help detect endometrial cancer. (Smithsonian Mag)
  • Why settle for No. 3 when you can strive for No. 1? Apparently, Texas isn’t satisfied having *only* the third highest HIV infection rate in the country, so they’ve cut funding for HIV screenings in favor of abstinence education. Makes all the sense in the world, doesn’t it? #CompassionateConservatism (RH Reality Check)
  • Looks like the fate of Texas will soon be very similar to that of Scott County, Indiana. Planned Parenthood was the county’s sole provider of HIV testing, but the state cut funding and several clinics were forced to close. They’re now suffering an HIV outbreak that its governor has called “an epidemic.” (HuffPo)
  • Speaking of Indiana, their ”religious freedom” bill caused a huge ruckus this week. But instead of just repealing the stupid thing, they’ve “revised it” to ban businesses from denying services to people on the basis of sexual orientation and gender identity. (IndyStar)
  • Wow, so Indiana just keeps on delivering the worst of the worst, don’t they? Purvi Patel has been sentenced to 20 years in prison for feticide and “neglect of a dependent” for having a miscarriage that may have been caused by an abortion pill. She’s not the first woman to face such charges, and these predatory, intrusive laws pretty much guarantee she won’t be the last. (MSNBC)
  • We often hear about what miscarriages cost women emotionally, but what about the financial cost? It’s pretty steep. One woman’s miscarriage cost her tens of thousands of dollars in medical bills. (Slate)
  • Maryland has opened an abortion clinic that’s being compared to a “spa.” Naturally, women being able to receive kindness and comfort while undergoing a completely legal medical procedure has some people outraged. (WaPo)
  • The Navajo Nation is being referred to as a “condom desert.” (Al Jazeera America)
  • Hard to express how heartbreaking a read this last piece is — women in abusive relationships suffer in ways many people just can’t fully grasp. They are more likely to contract HIV and less likely to use birth control. And when they do use birth control, it often has to be done via “secret” methods. (Jezebel)

STD Awareness: HIV Testing

HIV testIt’s often been said that young people view HIV as a chronic disease rather than the “life sentence” it was before there were effective treatments. The fact that an HIV infection can be managed with antiretroviral drugs is a boon from modern medicine, and there are hopes for better treatments on the horizon.

But HIV is only a manageable infection if you, well, manage it, and most Americans with HIV aren’t being treated with the medications we have in our arsenal. Only 3 out of 10 Americans who are infected with HIV are controlling the virus with medication — but when you zoom in on that population and look specifically at young people, the numbers are even more dismal, with only 13 percent of youth, ages 18 to 24, receiving treatment.


Knowing your HIV status is easier than it’s ever been.


Much of this problem is due to a lack of access — without adequate health coverage, these medications can be out of reach for many. But that’s not the whole story — it’s estimated that nearly half of 18- to 24-year-olds with HIV don’t know it. If they haven’t been diagnosed, they can’t know to seek treatment; if they don’t seek treatment, they can’t manage their infection; if they can’t manage their infection, their risk of health problems and early death increases — as do the chances of transmitting the virus to someone else.

So, if a 20-year-old tests positive for HIV and begins antiretroviral treatment right away, he or she can expect to live another five decades — to age 71, not bad compared to the average life expectancy of 79. But if that 20-year-old does not take antiretorvirals, he or she can only expect to live another dozen years — to age 32.

That’s why it’s so important to get tested and know your status. Continue reading

Toward Improved Care for LGBTQ Patients: New Guidelines Shine Spotlight on Addressing Health Disparities

doctorsOn January 5, Florida became the 36th state in the nation to legalize same-sex marriage, joining a movement that is sweeping across the United States. With federal judges striking down same-sex marriage bans left and right, it seems inevitable that we will soon live in a country that recognizes the freedom to marry. Yet, although more Americans than ever support marriage equality, the fight for the full inclusion of lesbian, gay, bisexual, and transgender individuals in our society is not over, as they continue to face significant barriers to quality medical services.


Full equality includes access to high-quality medical care, regardless of sexual orientation or gender identity.


The obstacles that have historically prevented LGBTQ patients from obtaining medical care continue to plague our modern health care system. Sure, the American Psychiatric Association no longer considers homosexuality a mental illness. But a concerning number of health care providers still refuse to serve LGBTQ individuals, and until the passage of the Affordable Care Act, insurance companies were not required to extend domestic partner benefits to same-sex couples. Moreover, the stigma that surrounds homosexuality prevents many patients from disclosing their sexual orientation to doctors. Because the LGBTQ community faces higher rates of certain conditions, including depression and substance abuse, failing to discuss sexual activity can lead to inadequate treatment.

One of the U.S. health care system’s most serious shortcomings is its failure to prepare doctors to work with LGBTQ patients. Young doctors are emerging from medical school ill-equipped to deal with the specific needs of the LGBTQ community. A 2006 study published in Family Medicine surveyed 248 medical students, finding that the vast majority of students held positive attitudes toward LGBTQ patients and hoped to provide them top-tier care. Unfortunately, the same group of students failed spectacularly when tested on LGBTQ-specific health concerns. Another study revealed that most medical schools throughout the United States and Canada devote minimal (if any) instructional time to LGBTQ issues, and that the quality of such instruction varies drastically across institutions. And significantly, many doctors report that they feel uncomfortable discussing sexual behavior with LGBTQ patients. Continue reading