Category: Reproductive Health

What you need to know about SESTA and the recent seizure of Backpage

Late last week, classified ad website Backpage.com went offline after being seized and disabled due to an “enforcement action by the Federal Bureau of Investigation, the U.S. Postal Inspection Service, and the Internal Revenue Service Criminal Investigation Division”. Backpage.com is known for personal ads, and was considered by many to be the dominant online platform for sex workers to advertise their services.

Various websites have been shutting down their personal ads section in response to the Stop Enabling Sex Trafficking Act (SESTA), which has taken aim at online platforms as a playing a perceived role in sex trafficking and prostitution. While many advocates have been fighting SESTA for a large part of the year, awareness seems to be low of the laws implications among the general population.

Advocates against SESTA argue that the act will do more harm than good in regards to the safety of sex workers. Online platforms for sex work have been viewed as safer than street based sex work, allowing for screening of potential clients. Others have argued that SESTA would limit online free speech, arguing that it would require platforms to put strong restrictions on users’ speech, extending beyond the space of personal ads. If you’re interested in seeing what you can do stop SESTA, check out https://stopsesta.org for more information on how to contact your elected officials.

 

Sources – Buzzfeed News: Backpage Has Been Taken Down By The US Government And Sex Workers Aren’t Happy – https://www.buzzfeed.com/blakemontgomery/backpage-service-disruption?utm_term=.mceyodXp#.bkjAQmNK

“The Angelina Effect”

In this day of age celebrities dominate our world. They hold elected office, they are activists, they are social media entrepreneurs, they are everywhere. Whether we like to believe it or not they have influence over our behaviors and how we make decisions. I’m guilty that most of the accounts I follow on Instagram are former Bachelor contestants and catch myself wanting to mimic their fashion and fitness routines. In fact, there has been research that has examined this phenomenon. Back in 2013, esteemed actress Angelina Jolie announced that she carries the a genetic mutation that greatly increases your risk of breast and ovarian cancer (BRCA1). In her New York Times opt ed piece, Jolie reveals that she lost her mom, aunt and grandmother to cancer and that influence her decision to undergo preventive surgery to remove both of her breasts (mastectomy) and ovaries. After this announcement, several researchers explored what came to be known as “The Angelina Effect” and how her decision influenced other women’s decisions about their own health. In a study published in Health Services Research journal, hospital data from both New York and the UK revealed that three months after Jolie’s announcement there was a significant increase in preventive mastectomies prior to the announcement. This trend has been seen with other celebrities after announcements of diagnoses and provides incentives for both public figures and healthcare providers to use these instances as teachable moments and bring awareness to employ preventive healthcare.

To learn more about the BRCA1 gene visit the following site: https://www.cancer.gov/about-cancer/causes-prevention/genetics/brca-fact-sheet#q1

 

 

 

Pollution and Pregnancy: A Match Made in Hell

A recent study in the journal Biological Psychiatry has found that mothers exposed to air pollution during pregnancy have children at higher risk of cognitive health problems, due to brain alteration during fetal development. Such abnormalities resulted in issues such as impulse control and behavioral problems. Researchers believe that long-term impacts could include high-risk activity, such as addiction, as well as mental health disorders and low academic achievement.

Previous research has associated high levels of pollution with poor development in the womb, but this study found that these risks occur even when pregnant mothers were living in places with air pollution levels deemed acceptable. This raises questions of whether our air quality measurement standards are adequate and accurate.

Researchers compare this troubling finding with the field’s existing knowledge of the dangers of smoking during pregnancy – Dr. John Krystal, editor of the journal that published the study, draws the parallel that both scenarios involve “inhaling toxins.” We already know that other environmental factors (like stress, lead exposure, and pesticides) can lead to adverse outcomes during pregnancy, but it seems that regulatory policies for some environmental risks fall short of others. Translating research findings to the public – and focusing on productive solutions instead of instilling fear in those with no choice of residence – are key roles for public health moving forward.

Achieving Health Equity and Justice through the Reproductive Justice Framework: keynote by Monica Raye Simpson

This past Friday marked the 39th annual Minority Health Conference, which is the largest and longest run student-led health conference in the world. This year’s 20th annual William T. Small Jr. keynote speaker was Monica Raye Simpson, who is the executive director of SisterSong Women of Color Reproductive Justice Collective, gave a keynote address titled: “Achieving Health Equity and Justice through the Reproductive Justice Framework”. In the talk, Simpson gave an energetic and powerful where she gave a history of the Reproductive Justice framework, and how her own life experiences shaped how she approaches her work. One of her main points was how the Reproductive Justice Framework’s focus on centering those who are the most marginalized is critical for the field of Public Health, in order to overcome health inequities. In case you were not able to attend the event in person, the keynote speech is available for broadcast in the link below, moderated by yours truly.

Sources: https://sph.unc.edu/sph-webcast/2018-02-23_mhc/

A Queer Health Reading List

The following is a list of books and articles related to queer health that might be useful for some individuals interested in the topic. The list is by no means exhaustive.

HIV:

  1. Race, K. (2016). Reluctant Objects Sexual Pleasure as a Problem for HIV Biomedical Prevention. GLQ: A Journal of Lesbian and Gay Studies22(1), 1-31.
  2. Gonzalez, O. R. (2010). Tracking the bugchaser: Giving the gift of HIV/AIDS. Cultural Critique75(1), 82-113.

Research & Infrastructures:

  1. Nguyen, V. K. (2009). Government-by-exception: Enrolment and experimentality in mass HIV treatment programmes in Africa. Social Theory & Health7(3), 196-217.
  2. Murphy, M. (2017). The economization of life. Duke University Press.

Regarding MSM:

  1. Boellstorff, T. (2011). But do not identify as gay: A proleptic genealogy of the MSM category. Cultural Anthropology26(2), 287-312.
  2. Young, R. M., & Meyer, I. H. (2005). The trouble with “MSM” and “WSW”: Erasure of the sexual-minority person in public health discourse. American journal of public health95(7), 1144-1149.

Medical interventions:

  1. Epstein, Steven. 2010. “The great undiscussable: Anal cancer, HPV, and gay men’s health.” In Three shots at prevention: The HPV vaccine and the politics of medicine’s simple solutions, edited by Keith Wailoo, Julie Livingston, Steven Epstein, and Robert Aronowitz. Baltimore: Johns Hopkins University Press, pp. 61 -90.
  2. Blackwell, Courtney, Jeremy Birnholtz, and Charles Abbott. 2014. Seeing and being seen: Co-situation and impression formation using Grindr, a location-aware gay dating app. New Media & Society: 1461444814521595.

Precarity:

  1. Butler, J. (2006). Precarious life: The powers of mourning and violence. Verso.

PrEP:

  1. Fiereck, K. J. (2015). Cultural Conundrums: The Ethics of Epidemiology and the Problems of Population in Implementing Pre-Exposure Prophylaxis. Developing World Bioethics15(1), 27–39. http://doi.org/10.1111/dewb.12034
  2. Singh, J. A., & Mills, E. J. (2005). The Abandoned Trials of Pre-Exposure Prophylaxis for HIV: What Went Wrong? PLoS Medicine2(9), e234. http://doi.org/10.1371/journal.pmed.0020234
  3. Calabrese, S. K., Earnshaw, V. A., Underhill, K., Hansen, N. B., & Dovidio, J. F. (2014). The Impact of Patient Race on Clinical Decisions Related to Prescribing HIV Pre-Exposure Prophylaxis (PrEP): Assumptions About Sexual Risk Compensation and Implications for Access. AIDS Behav, 18(2), 226-240. doi:10.1007/s10461-013-0675-x
  4. Calabrese, S. K., Magnus, M., Mayer, K. H., Krakower, D. S., Eldahan, A. I., Hawkins, L. A. G., . . . Dovidio, J. F. (2017). “Support Your Client at the Space That They’re in”: HIV Pre-Exposure Prophylaxis (PrEP) Prescribers’ Perspectives on PrEP-Related Risk Compensation. AIDS Patient Care STDS, 31(4), 196-204. doi:10.1089/apc.2017.0002
  5. Calabrese, S. K., & Underhill, K. (2015). How Stigma Surrounding the Use of HIV Preexposure Prophylaxis Undermines Prevention and Pleasure: A Call to Destigmatize “Truvada Whores”. Am J Public Health, 105(10), 1960-1964. doi:10.2105/ajph.2015.302816
  6. Dumit, J. (2012). Drugs for life: how pharmaceutical companies define our health. Duke University Press.

Trans health:

  1. Plemons, E. D. (2014). It is as it does: Genital form and function in sex reassignment surgery. Journal of Medical Humanities35(1), 37-55.
  2. Preciado, Paul Beatriz. 2013. Testo junkie: Sex, drugs, and biopolitics in the pharmacopornographic era. New York: The Feminist Press at CUNY. (End of “The Micropolitics of Gender,” pp. 365 – 398).
  3. Spade, Dean. 2006. “Mutilating Gender.” In The Transgender Studies Reader, edited by Susan Stryker and Stephen Wittle. New York: Routledge, 315-32.
  4. Currah, Paisley. 2008. Expecting bodies: the pregnant man and transgender exclusion from the Employment Non-Discrimination Act. Women’s Studies Quarterly, 36(3&4).
  5. Crawford, Lucas Cassidy. 2008. Transgender without organs? Mobilizing a geo-affective theory of gender modification. WSQ: Women’s Studies Quarterly, 36(3&4): 127-43.
  6. Butler, J. (2001). Doing justice to someone: Sex reassignment and allegories of transsexuality. GLQ: A Journal of Lesbian and Gay Studies7(4), 621-636.
  7. Karaian, Lara. 2013. Pregnant men: Repronormativity, critical trans theory and the re (conceive)ing of sex and pregnancy in law. Social & Legal Studies: 0964663912474862.

Critical Disability Studies:

  1. McRuer, R., & Wilkerson, A. L. (Eds.). (2003). Desiring disability: Queer theory meets disability studies. Duke University Press.
  2. Cheslack-Postava, Keely, and Rebecca M. Jordan-Young. 2012. Autism spectrum disorders: toward a gendered embodiment model. Social science & medicine 74(11): 1667-1674.
  3. Jack, Jordynn. 2011. The Extreme Male Brain? Incrementum and the Rhetorical Gendering of Autism. Disability Studies Quarterly 31(3). http://dsq-sds.org/article/view/1672/1599
  4. Garland-Thomson, R. (2005). Feminist disability studies. Signs: Journal of Women in Culture and Society30(2), 1557-1587.
  5. Shakespeare, T. (2006). The social model of disability. The disability studies reader2, 197-204.
  6. Breckenridge, C. A., & Vogler, C. A. (2001). The critical limits of embodiment: Disability’s criticism. Public Culture13(3), 349-357.

Masculinity & health:

  1. MacLeish, Kenneth T. 2012. Armor and anesthesia: exposure, feeling, and the soldier’s body. Medical anthropology quarterly 26(1): 49-68.
  2. Oudshoorn, Nelly. 2000. “Imagined men: Representations of masculinities in discourses on male contraceptive technology.” In Bodies of technology: Women’s involvement with reproductive medicine, edited by Ann Rudinow Saetnan, Nelly Oudshoorn, and Marta Kirejczyk. Columbus: Ohio State University Press, 123-45.
  3. Serlin, David. 2006. “Disability, masculinity, and the prosthetics of war, 1945 to 2005.” In The prosthetic impulse: From a posthuman present to a biocultural future, edited by Marquard Smith and Joanne Mora. Cambridge: The MIT Press, 155-86.
  4. Shakespeare, T. (1999). The sexual politics of disabled masculinity. Sexuality and disability17(1), 53-64.

Gender theory, race, and reproductive health:

  1. Waggoner, Miranda R. 2015. Cultivating the maternal future: Public health and the prepregnant self.” Signs 40(4): 939-962.
  2. Franklin, Sarah. 2013. Biological Relatives: IVF, Stem Cells, and the Future of Kinship. Durham: Duke University Press. (“Miracle Babies” and “Reproductive Technologies,” pp. 31 – 67 and 150 – 84).
  3. Murphy, M. (2012). Seizing the means of reproduction: Entanglements of feminism, health, and technoscience. Duke University Press.
  4. Roberts, Dorothy E. Killing the black body: Race, reproduction, and the meaning of liberty. Vintage Books, 1999.
  5. Bridges, Khiara. 2011. Reproducing race: An ethnography of pregnancy as a site of racialization. Berkeley: The University of California Press. (“The Production of Unruly Bodies” and “The ‘primitive pelvis,’ racial folklore, and atavism in contemporary forms of medical disenfranchisement,” pp. 74 – 100 and 103-43).

The Super Bowl and sex trafficking: An unlikely pair

As a true Minnesotan I’m still saddened that our Vikings will not be playing in their home stadium this Sunday for Super Bowl 52, but I’m still ecstatic for the overindulgence in buffalo chicken dip and watching Justin Timberlake serenade America during the halftime show. For me, the Super Bowl has always been something I’ve associated with good food, company and football but recently learned that it the there is a much darker side as well; it is one of the largest incidents of sex trafficking in the country. Why is this? Experts suggest that this event attracts men who have higher disposable incomes and are a group that are more likely to purchase sex. Additionally, the sheer number of people at this event makes it easier for these incidents to go undetected. The unfolding of this trend came to light by Texas Attorney General in 2011 Greg Abbot when he declared the super bowl is “single largest human trafficking incident in the U.S.”. In the past two decades more efforts to prevent this have been implemented by the host city/state, federal agents and an NFL sponsored committee.

Efforts for this year’s super bowl been ongoing for the past two years with the Super Bowl Anti-Sex Trafficking Committee and Minnesota authorities. It’s included training thousands of volunteers to identify victims, campaigns, trainings for airport staff, transportation workers, and hotel staff and increasing space at local shelters.

Hopefully through these collaborations this will not be a story our children will be telling and instead we will be about the game.

 

 

America’s Mothers Dying

By Young Kim-Parker

Baby announcements are generally considered a joyous occasion. Culturally, we celebrate motherhood with baby showers, offering well-wishes and gifts to welcome the arrival of a new life. However, perhaps we should also start exhibiting more concern because in America the number of mothers dying from complications due to pregnancy and childbirth is on the rise.

On November 18th, CNN placed a spotlight on maternal mortality with guest reporter Christy Turlington Burns (yes, the former supermodel) to bring attention to America’s glaring lack of support for mothers [1]. Christy Turlington Burns nearly died after childbirth due to complications during the third stage of labor – after the child is born, women continue to labor to deliver the placenta. Her experience propelled her to form the non-profit, Every Mother Counts, to bring greater awareness to maternal health issues. CNN is airing their newest documentary mini-series, “Giving Birth in America,” to bring greater attention to a very real concern of the growing number of mothers at risk of dying from pregnancy and childbirth despite all of the technological advances of the 21st century [1].

The U.S. has the highest maternal mortality rate among industrialized countries, and maternal deaths cut across socioeconomic status – even those with graduate education and high incomes are at risk [2]. Consider the sudden death of a neo-natal nurse, Lauren Bloomstein, who died within 24 hours of giving birth at the regional health center where she worked (she died from severe pre-eclampsia – pregnancy-related high blood pressure – that was diagnosed too late) [3]. The tragedy lies in how many of these deaths are preventable. Globally, a United Nations commitment to reduce maternal mortality resulted in nearly 30-45% reduction in maternal deaths from 1990 – 2015 [2]. For the U.S., maternal deaths rose an estimated 60% during that period [2].

Individual states have taken action to pay more attention to mothers’ health needs. In the case of California, have successfully reduced their mortality rates by 55% [2]. Four states, Kentucky, Minnesota, Mississippi, and Oregon, have expanded Medicaid perinatal services to cover doulas, individuals uniquely trained to support expecting mothers throughout their pregnancy and after birth [4]. Increasing the training of doulas and insurance coverage of their services could save lives – cities such as Baltimore, New York, Chicago and Tampa have already begun doula training programs for the dual purposes of supporting mothers to have healthier pregnancies and to reduce infant mortality [5]. While doula training may not be sufficient, it seems to be an immediate opportunity to save lives. In time, one can only hope that more states and insurance companies will begin to cover doula services. In the meantime, instead of buying onesies and rattles for the next friend that is expecting, I’ll be contributing to doula services.

References:

[1] Burns, C. T. (2017, November 18). Maternal mortality is the shame of US health care. Retrieved from http://www.cnn.com/2017/11/15/opinions/op-ed-christy-turlington-burns-every-mother-counts-2017/index.html

[2] Merelli, A. (2017, October 29). What’s killing America’s new mothers? Retrieved from QUARTZ: https://qz.com/1108193/whats-killing-americas-new-mothers/

[3] Martin, N., & Montagne, R. (2017, May 12). Focus on Infants During Childbirth Leaves U.S. Moms in Danger. Retrieved from National Public Radio, Inc.: https://www.npr.org/2017/05/12/527806002/focus-on-infants-during-childbirth-leaves-u-s-moms-in-danger

[4] Gifford, K., Walls, J., Ranji, U., Salganicoff, A., & Gomez, I. (2017, April 27). Medicaid Coverage of Pregnancy and Perinatal Benefits: Results from a State Survey. Retrieved from Kaiser Family Foundation: https://www.kff.org/womens-health-policy/report/medicaid-coverage-of-pregnancy-and-perinatal-benefits-results-from-a-state-survey/

[5] Ollove, M. (2017, September 25). Cities turn to doulas to give black babies a better chance at survival. Retrieved from The Washington Post: https://www.washingtonpost.com/national/health-science/cities-turn-to-doulas-to-give-black-babies-a-better-chance-at-survival/2017/09/22/07420956-8363-11e7-ab27-1a21a8e006ab_story.html?utm_term=.8d953053d40c

#FreeCyntoiaBrown

“If I can keep one child from going down the path that I went down, it will be worth it.” Words spoken by twenty-nine-year-old Cyntoia Brown. The path she embarked on as a child was not one she chose. Brown was forced into prostitution as a child during which time she was abused and raped until the age of 16 when she was arrested for murdering one of her solicitors.

Brown’s story has garnered a lot of media attention recently with a number of high profile celebrities including Rihanna and Kim Kardashian sharing her story on social media outlets and calling for her release from a life prison sentence. Brown has served 13 years thus far and is ineligible for until she has served at least 53 years.

Cyntoia Brown’s story brings to light both the legal and health-related problems associated with sex trafficking. After having their human rights violated, victims who comply with their abusers’ demands are often jailed for prostitution. Those who fight back against their violators often face legal prosecution and serve jail sentences. Is this how we should treat victims of human trafficking?

Not only do victims face legal ramifications they also endure health consequences of their physical and emotional abuse. Women are often subjected to unwanted, unplanned pregnancies because they do not have access to birth control methods including condoms (1). This also places them at risk for gynecological problems including sexually transmitted diseases and infections. According to Stop Violence Against Women, rates of abortion, infertility, and sterilization are higher among female prostitutes. Victims are also subject to long-term mental health issues including depression, suicidal ideation, substance abuse and post-traumatic stress disorder.

Brown’s story is not unique. According to the Human Trafficking Hotline, in 2015 over 5,500 cases of human trafficking were reported (2). This number rose in the following year. Over 7,600 cases were reported in 2016. The challenges that victims of human trafficking face need our attention. Their struggles with physical and emotional abuse do not belong only to themselves. They are public health issues that affect us all.

(1) http://www.stopvaw.org/health_consequences_of_trafficking

(2) https://humantraffickinghotline.org/states

Image: https://www.fbi.gov/news/stories/human-trafficking-prevention-month-raising-awareness-of-a-devastating-crime

 

Kyla Garrett Wagner: First Amendment and Health

First amendment, media law, health communication and sexual health advocate describe Kyla Garrett Wagner’s research in a nut shell. Her spunk and passion make her the perfect storm to facilitate the way we should communicate about women’s health options and fighting the regulations through informing through social science research.

Her story starts from her hometown in rural Indiana (think Parks and Recreation and Leslie Knope). Her academic journey began at Purdue University where she earned her B.A. in Communications and Women’s Studies. After receiving her bachelor’s degree, she continued her academic journey to the University of North Carolina’s School of Media and Journalism to pursue a MA in Health Communication. During her time at UNC she fostered her interest in communication of emergency contraception to college students but stumbled on to regulations that restricted her ability to develop a campaign to do so. From this setback made her reconsider her career path into health communication which ultimately led her to pursue her Ph.D. in First Amendment Law. Her research interests now intersect at how law intersects with health communication and public health. Keep your eye out for her name since we are definitely will hear more about her research and passion in the future!

PrEP for HIV Prevention? Here’s what you need to know

Pre-Exposure Prophylaxis, or PrEP, has changed the way in which we talk about HIV Prevention. After being approved for preventive use by the FDA in 2012, there has been a sharp increase in PrEP prescriptions in the U.S. over the past several years. Currently, the only prescription available for PrEP is Truvada, which also serves as a treatment drug for those who are HIV positive.

Truvada is a nucleoside reverse transcriptase inhibitor, or an NRTI. When exposed to HIV, a NRTI works by masking itself as a building block of the virus’s genetic structure. While our own cells are able to recognize and correct for this coding mistake, HIV cannot, and as a result is unable to replicate and mount a widespread infection.

A quick distinction: Truvada as a drug is a form of PrEP, PrEP is a general class of preventive measures. Birth control can be thought of as a form of PrEP, preventing a pregnancy before it occurs. Even sunscreen is a form for PrEP. You apply lotion to prevent sunburn before it occurs.

But PrEP only works if you take it. According to recent findings from the Centers for Disease Control and Prevention, the majority of uptake of PrEP in the United States has been among middle-aged, white, gay men. But the HIV epidemic has shifted, with the CDC noting continuous inequalities in the southern states and among young African Americans.

More concentrated efforts need to happen to ensure that those who can benefit from PrEP are able to access and receive it. Gilead, the company that produces Truvada, has a copay card available, where they pay up to $3600 a year in copays for those living under 500% of the national poverty level. For more information on PrEP, UNC campus health also serves as a great resource on campus, and students can get more information by making a free appointment with Student Wellness by emailing LetsTalkAboutIt@unc.edu or by calling (919) 962-WELL(9355).

For additional Resources on what to know about PrEP, and how to have a conversation with your provider, please see the resources below for information from the CDC. For those looking for a PrEP friendly provider, here is a list of providers in the State of North Carolina who actively prescribe PrEP.

Sources –

Gilead Copay Card: https://www.gileadadvancingaccess.com/copay-coupon-card

Centers for Disease Control and Prevention PrEP Resources: https://www.cdc.gov/hiv/risk/prep/index.html

Centers for Disease Control and Prevention PrEP Information: https://www.cdc.gov/hiv/basics/prep.html

List of PrEP Providers: https://www.med.unc.edu/ncaidstraining/files/PrEPProvidersforDownload.pdf/view