If you’re online early tomorrow morning (Wednesday, March 14), head over to whitehouse.gov/live at 8:30 a.m. (EST) for a White House event commemorating National Women and Girls HIV/AIDS Awareness Day.

According to a blog post by the Office of National AIDS Policy, the multi-agency event “will discuss the intersection of HIV/AIDS, violence against women, and gender related health disparities. Speakers and panelists will examine the juncture of these three important issues that impact women’s lives both domestically and globally.” Join the conversation on Twitter by following @AIDSgov and @PEPFAR and by using this hashtag: #NWGHAAD

Here’s the full agenda:
* Welcome and Event Overview
* Global Announcement
* Framing the Data: A Presentation by the Centers for Disease Control and Prevention
* Research Update: A Brief Update on Ongoing Research by the National Institutes of Health
* Panel Discussion: Linkage between HIV/AIDS and violence against women; a discussion of these issues and gender related health disparities in the global/domestic context.
* Domestic Announcement
* Global and Domestic Synergy
* Closing Remarks

For more on how PEPFAR — the U.S. President’s Emergency Plan for AIDS Relief — is integrating the issue of gender-based violence in prevention and response programs, take a look at this detailed program guide. This introduction is an important statement:

There is growing consensus that HIV prevention programs must not only address the biomedical and behavioral factors involved in transmission, but also the underlying social and structural drivers that increase vulnerability. Social, political, and economic inequities fuel women’s and girls’ vulnerability to HIV and GBV. Likewise, stigma and discrimination, including against MARPs such as MSM, sex workers, transgender people, and people who inject drugs, make it impossible to prevent or treat HIV through biomedical and behavioral approaches alone. While the evidence base for both HIV structural prevention and GBV prevention are limited, strategies to empower women and girls, engage men and boys, and challenge harmful social norms show promise for addressing the underlying drivers of HIV and GBV, simultaneously reducing the risk and vulnerabilities to both.

Domestically, Kaiser Family Foundation last month released an updated fact sheet highlighting the impact of HIV/AIDS on women in the United States. The fact sheet provides current data and trends over time. In 2009 (most recent year), more than 290,000 women were among the approximately 1.2 million people living with HIV/AIDS in the United States. Women of color, particularly black women, are disproportionately affected, as are low-income women. And most women with HIV/AIDS receiving medical care have children under age 18.

Here’s a list of events around the country organized in connection with National Women and Girls HIV/AIDS Awareness Day. The Centers for Disease Control last week launched Take Charge. Take the Test – a HIV testing and awareness campaign from Act Against AIDS. The campaign ill include radio, billboard and transit advertising along with a website and community outreach efforts in 10 metro areas where African American women are most affected by HIV.

If you’ll in or around Pittsburgh, PA this weekend, we’d love to see you at the symposium on “Women, HIV, and the 40th Anniversary of Our Bodies, Ourselves,” featuring OBOS co-founder Judy Norsigian.

The symposium is part of Women and Girls Health Weekend coordinated by Educating Teens about HIV/AIDS, Inc. This Friday, there will be a screening of the breast implant documentary “Absolutely SAFE” with filmaker Carol Ciancutti-Leyva, then Judy will speak on Saturday. Registration is required.

Details on the Saturday event:

Saturday, March 10, 8:45 a.m.-2 p.m.
University Club, 123 University Place, Pittsburgh, PA 15213

“Women, HIV, and the 40th Anniversary of Our Bodies, Ourselves,” an inter-generational symposium featuring Judy Norsigian, executive director of Our Bodies, Ourselves; in observance of National Women and Girls HIV/AIDS Awareness Day and in celebration of the 40th anniversary of the book that inspired the women’s health movement. $35 registration includes luncheon.

Presented by Educating Teens About HIV/AIDS, Inc. Co-sponsored by the University of Pittsburgh Graduate School of Public Health and its Department of Infectious Diseases and Microbiology.

A recent study published in The Lancet Infectious Diseases drew attention and controversy this month because of its finding that women using injectable types of contraception (known by the brand name Depo Provera) had twice the risk of acquiring HIV from their infected partners.

Heterosexual couples in which one partner had HIV were studied in seven African countries. The participants were sexually active, not pregnant, and not on antiretroviral medicines. Women were HIV-tested quarterly and asked at those times about their contraceptive use.

The researchers found that unprotected sex and sex with other partners was more likely when women used a hormonal contraceptive, but even when they controlled for this, the risk of HIV infection was higher in women using injectable contraceptives compared to oral or no hormonal birth control. Risk of infection in uninfected men from their infected partners was also higher.

The study was limited in that it relied on women’s self-reporting of contraception use and methods. The way participants were selected could have biased the results, and condom use was also self-reported. The study did not randomize women to a birth control method, nor was it designed from the outset as a test of HIV risk and specific types of contraceptive use. It also could not clearly evaluate any risk associated with oral birth control, because there were not enough users of the pill in the study.

Despite these limitations, there is reason to be concerned about whether there is a link between Depo Provera or its generic forms and risk of HIV infection. There are several ideas about how the drugs could potentially increase risk, but the HIV question has been around since at least 1996. That year, researchers working with monkeys and implantable contraceptives published a study suggesting increased risk of a similar virus. Researchers involved with early work on this subject have responded:

How many years has it been that the non-human primate model, and other researchers, have been warning about this and being ignored? What, 15 years now? Shocking.
and
It’s not like we did our work and it was published in an obscure journal. There’s absolutely no excuse for people doing contraceptive work to not have known this, and not to have taken this forward in the late ’90s. We should have had this answered [in humans] ten years ago.

Global health programs often promote long-acting methods like Depo Provera for women in areas where access to regular medical care is difficult and maternal mortality is high. These same areas often have high rates of HIV. I find it unacceptable that the question of contraceptive use and HIV risk has been around for years, and we don’t appear to be much closer to a clear answer. As Charles Morrison wrote in an accompanying editorial:

The question of hormonal contraceptive use and risk of HIV acquisition remains unanswered after more than two decades. Active promotion of DMPA in areas with high HIV incidence could be contributing to the HIV epidemic in sub-Saharan Africa, which would be tragic. Conversely, limiting one of the most highly used effective methods of contraception in sub-Saharan Africa would probably contribute to increased maternal mortality and morbidity and more low birthweight babies and orphans—an equally tragic result. The time to provide a more definitive answer to this crucial public health question is now; the donor community should support a randomised trial of hormonal contraception and HIV acquisition.

Such a trial would require careful design in order to minimize any risk to participants and to stop as soon as any increased risk of one method is clear. It might be impossible to get funding for, but we owe it to women, who deserve clear and accurate information about the potential risks of injectable and all forms of contraception.

Today, the U.S. Department of Health and Human Services announced that it is adopting the Institute of Medicine’s recommendations for preventive care services for women. This will ensure that women have access to the following services under health insurance plans without having to pay a co-payment, co-insurance or deductible:

• well-woman visits
• screening for gestational diabetes
• HPV testing
• STI counseling
• HIV screening and counseling
• contraception methods and counseling
• breastfeeding support, supplies, and counseling
• screening and counseling for domestic and interpersonal violence

Coverage for these services is expected to begin Aug. 1, 2012.

There is one caveat for some women regarding access to contraception without a co-pay — a provision that “Group health plans sponsored by certain religious employers, and group health insurance coverage in connection with such plans, are exempt from the requirement to cover contraceptive services.”

An announcement at the HealthCare.gov site indicates that public comment is welcome on this provision. Although I haven’t yet been able to locate it on Regulations.gov, instructions for comment and more detail about the exemption is provided in this document.

Good news! You may remember that the health care reform legislation enacted last year included provisions for preventive health care services to be fully covered without requiring patients to have copayments.

It was not clear, however, whether birth control would be included as a preventive service. It seems obvious to us, but the Institute of Medicine was asked to make some recommendations about which preventive services for women should be included, and included birth control in those recommendations, released yesterday.

If they are adopted, preventive services including birth control could become much more affordable and accessible to women in the United States.

The Institute, after reviewing the rate and consequences of unintended pregnancy, effectiveness of birth control, and cost and access concerns, concluded:

The committee recommends for consideration as a preventive service for women: the full range of Food and Drug Administration-approved contraceptive methods, sterilization procedures, and patient education and counseling for all women with reproductive capacity.

In addition to copay-free coverage of birth control, the Institute recommended:

• screening for gestational diabetes
• human papillomavirus (HPV) testing as part of cervical cancer screening for women over 30
• counseling on sexually transmitted infections
• counseling and screening for HIV
• lactation counseling and equipment to promote breast-feeding
• screening and counseling to detect and prevent interpersonal and domestic violence
• yearly well-woman preventive care visits to obtain recommended preventive services

You can view the Institute’s press release, recommendations, report brief, and full report, “Clinical Preventive Services for Women: Closing the Gap,” online. The Department of Health and Human Services will still need to adopt this list of recommendations for the care to be covered under the Affordable Care Act.

Some other coverage and discussion of this topic:

• NLIRH Applauds Panel’s Counsel to Cover Birth Control Under Health Reform – from the National Latina Institute for Reproductive Health
• Anti-Choicers Gear Up To Fight Guidelines on Preventive Care for Women – Jodi Jacobson at RHRealityCheck discusses the inevitable anti-choice backlash
• A Preventive Health Care Game-Changer for Women – at the Ms. Blog
• Statement from the March of Dimes commending the recommednations
• Doctors to HHS: Adopt Contraception Recommendations, Improve Women’s Health, Save Money – Press release from Physicians for Reproductive Choice and Health<
• Women’s Preventive Health Coverage Information Central – lots of news and resources on this topic from Raising Women’s Voices
• Women Should Get Free Birth Control, HHS-Backed Group Urges – at The Rundown, a PBS NewsHour blog

Seen other good links on this news? Leave ‘em in the comments!

From dorms at USF to justice for women around the world, here are a few items of interest:

The United Nations’s UN Women group released a report, “Progress of the World’s Women: In Pursuit of Justice,” which looks at the legal rights of women around the world, barriers to accessing and navigating the justice system, and the impact of war/conflict on women, among other issues. It also includes ten recommendations for making justice systems work for women.

The University of South Florida has begun offering students gender-neutral housing options in response to a transgender student who reported hostility and harassment in campus housing. The school is going to offer several housing options and allow students to indicate male, female, or transitioning on their campus housing applications.

NPR’s All Things Considered ran a piece yesterday on mother-to-child transmission of HIV in Mozambique; there is a related piece on breastfeeding and HIV in developing nations.

Childbirth Connection has launched the Transforming Maternity Care blog with Amy Romano, formerly of Science & Sensibility and part of the editorial team for the forthcoming edition of “Our Bodies, Ourselves.” It looks like the blog will focus on quality improvement, patient advocacy, and shared decision-making in maternity care.

Today is the 11th annual National Black HIV/AIDS Awareness Day, intended to promote testing, treatment and action in Black communities. As part of the day, many places throughout the United States offer free HIV testing, education and other community events; a state-by-state directory at http://www.blackaidsday.org/ for finding events and test sites near you.

Related resources:

• 2011 State of AIDS in Black America report, Deciding Moment – released today by the Black AIDS Institute
• Increasing HIV/AIDS Awareness among Blacks/African Americans – from the CDC; there are links to statistics at the bottom of the page
• HIV/AIDS Basics – from AIDS.gov

Researchers, advocates and public policy experts have gathered in Vienna, Austria to discuss the latest scientific developments and other issues related to HIV/AIDS at the 18th annual International AIDS Conference.

The biggest news focus coming out of the conference so far is about tenofovir gel, a vaginal microbicide. Tenovir has been part of the CAPRISA trial conducted in South Africa, and has shown some promise in preventing HIV transmission. According to a press release from the trial:

The microbicide containing 1% tenofovir—an antiretroviral drug widely used in the treatment of HIV—was found to be 39% effective in reducing a woman’s risk of becoming infected with HIV during sex and 51% effective in preventing genital herpes infections in the women participating in the trial. Should other studies of tenofovir gel confirm these results, widespread use of the gel, at this level of protection, could prevent over half a million new HIV infections in South Africa alone over the next decade.

The search for an effective microbicide has been ongoing for quite a few years now, as it could represent an important woman-controlled tool for reducing HIV infection, especially when women may not be able to insist on condom use. This is the first time a microbicide product has really been considered to show major promise for prevention.

As the New York Times explains, however, additional work will need to be done before this product becomes widely available to women who might benefit from it:

Broader trials are needed to confirm the results, and it will most likely be years before the product is publicly available, but if produced on a large scale the gel would cost less than 25 cents per application…Because the trial was relatively small and the gel was nowhere close to 100 percent effective, AIDS scientists and public health officials wanted to see another trial get similar results before they undertook the large fund-raising and public education efforts that would be needed to make billions of doses of the gel, as well as the applicators, which are more expensive, and then to persuade women to use them and governments of poor countries to adopt them.

Science magazine has made a paper with scientific details on the trial freely available to the public. The conference blog provides a number of relevant resources for those interested in learning more about this research.

Last night’s PBS Newshour had an interview with Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases (part of the NIH), which I think did a great job of explaining the findings; a transcript of the video below is available online.

Also of interest is the Women ARISE coalition, consisting of international women’s groups and organizations whose stated mission is to:

…work together to galvanize and promote a common agenda on women and girls’ rights in the AIDS response and ensure that all women and women’s issues are central and visible in the objectives and program of the International AIDS Conference in Vienna.

The group’s founding document [PDF] outlines important principles and needs for addressing the concerns of women and girls in HIV/AIDS response efforts, including protecting and promoting the human rights (including reproductive and sexual rights) of women and girls, addressing violence against women as a cause and consequence of HIV, addressing sexual and reproductive health more broadly, developing the basic services needed by communities, including women’s leadership, and demanding accountability from the international community.

The International Women’s Health Coalition has also posted on the Women ARISE initiative in their post, Outspoken Women in Vienna Demand Rights and Inclusion, reporting directly from the conference on a demonstration at the conference plenary session intended to make it “clear that the only way to end this epidemic is through gender equality, empowering women, fulfilling our sexual and reproductive rights and health, and providing all young people with comprehensive sexuality education.”

Readers can get updates from the conference on Twitter (@aids2010), on Facebook, and on the conference blog.

View all Women’s Health Heroes. Voting closes May 14. Background info here.

Entrant: Steven Slosberg
Nominee: Betsy Ryan, RN

I’ve submitted a column I wrote about Betsy Ryan several years ago when I was a columnist for The Day, a daily newspaper in New London, Conn.

Betsy continues to work ardently as a nurse in the infectious diseases department at Lawrence & Memorial Hospital in New London, as well as in HIV/AIDS education and prevention in our community, and, as a breast cancer survivor, summons enviable energy in her commitment.

She is most deserving of this honor.

A reluctant hero on front lines of a long fight (originally published 10/01)

Knowing Betsy Ryan, I suspect the Alliance for Living first had to engrave and mail the invitations, post public notice in places beyond her reach and probably put a search party on standby before telling her she was going to be formally honored for her community service. There could be no way out of it.

Even then, says Peter Bowler, one of the Alliance for Living leaders, she tried to persuade the non-profit support group for people affected by HIV/AIDS in this region to give the award to more deserving folk or at least let them share it with her.

“I said, ‘Too late, Betsy,” said Bowler. “See you at the awards dinner.”

That would be next Wednesday night, at the Mystic Hilton, when Lizbeth Love Ryan, a registered nurse and longtime relentless advocate for HIV and AIDS education and prevention, is to receive the organization’s annual outstanding community service award as part of its Awards & Appreciation Night.

The thing is, Ryan, who works in Lawrence & Memorial Hospital’s infectious disease service, has yet to acknowledge that she will attend.

“If we have to track her down and hook her up to an ox and cart, she’ll be there,” said Bowler.

She is that modest, that reluctant to take a public bow, at least about her role in community HIV awareness, but absolutely not in her labors to make lives here better and safer.

There is Betsy Ryan, a slender figure, prim and proper might apply, standing in front of any group, demonstrating, step by step, the proper way to apply a condom, and candidly discussing spermicides and lubricants and why latex condoms are best because they’re man-made and the quality can be assured.

I saw her give such a demonstration for the first time before a roomful of politicians, educators, nurses and health care and human service agency workers at Ocean Beach one September day in 1989. She gave similarly straightforward demonstrations at Frank’s Place, a gay bar, in New London during the annual Celebration of Hope fund-raisers. She’s given hundreds and hundreds of them, all over the region.

She’s been admired as a caregiver and has served as an ad hoc spokeswoman for tracking HIV/AIDS here. Though not always the easiest person for a reporter to find at deadline, she has been consistently helpful in providing statistics, always protecting the confidentiality of those with the disease. She knows just what she can say and won’t be cajoled into saying more.

In her time here she’s coordinated the New London AIDS clinic, has been a mainstay of the AIDS care program at L&M and was president of the Women’s Center of Southeastern Connecticut. She moved here in 1972 and, except for a short time in Hawaii, has been a nurse at L&M. She started out in the emergency room. She’s in her early 50s, was raised in western Pennsylvania and for the last 15 years has lived with Ken Abrahms, who owns Art Unlimited in Ledyard. They have a home in Groton and one in Watch Hill.

Donna M. Greene, president of the Alliance for Living board, has known Ryan for nine years, since Greene was involved with Helping Our People Endure Foundation Inc. (HOPE), which, in April 1998, merged with the Southeastern Connecticut AIDS Project (SECAP) to form the Alliance for Living.

Greene, who works at Pfizer, has not always agreed with Ryan’s positions, notably Ryan’s opposition to needle exchange programs. But Greene admires Ryan’s courage of her convictions.

“She’s a very firm believer in what she stands up for,” says Greene. “She’s got all the facts. She really knows her business.”

She and Bowler and Michael Rosenkrantz, the executive director of Allliance for Living, decided it was time for Ryan to face facts, and receive the recognition.

“She’s one of the few people, out there in daily contact, in the front lines, who never loses her sunny disposition and always has her client’s best interest at heart,” said Greene.

Others will be honored at the dinner for volunteer work and Dr. Frederick Altice, an HIV specialist at Yale-New Haven Hospital, will be the keynote speaker.

Betsy Ryan will be recognized for her abiding dedication, and maybe the only way to assure her being there is the opportunity, with all those people gathered in one room, for her to unroll one more condom and deliver her unflinching AIDS 101 presentation, once again.

View all Women’s Health Heroes. Voting closes May 14. Background info here.

Entrant: Maureen Reinsel
Nominee: John Varallo, MD, MPH, Senior Technical Advisor

Obstetricians and gynecologists choose to dedicate themselves to women’s health, but that alone does not qualify them as a Women’s Health Hero. A hero humbly exceeds the average expectations to create true and lasting positive change. Dr. John Varallo, through his selfless and untiring contributions to women’s health in the United States, Guyana, Tanzania, Uganda, Belize, Guatemala, and Australia, is a Women’s Health Hero.

While I know him through his work on cervical cancer prevention and treatment in Guyana, it is far from his only contribution to women’s health globally. Dr. Varallo works with the most vulnerable women, and inspires others to join him through education and collaboration.

Dr. Varallo has contributed to improved prevention and treatment of cervical cancer, particularly among HIV positive women. Cervical cancer, caused by the sexually transmitted Human Papilloma Virus (HPV), is a preventable disease that kills an estimated 253,500 women worldwide annually (National Cervical Cancer Coalition, www.nccc-online.org). The burden of disease is particularly onerous among HIV positive women, who have a more difficult time clearing the virus from their system and in whom the cancer moves significantly more quickly.

Dr. Varallo’s efforts have led to a considerable expansion in coverage of cervical cancer prevention, detection, and treatment. In Guyana alone, he has trained 23 physicians, advance practice nurses, and registered nurses in one year to detect and treat pre-cancerous lesions. His work in Guyana has led to the Ministry of Health instituting a national cervical cancer prevention and treatment program, and he was the principle author of the country’s cervical cancer prevention and treatment policy and guidelines.

Providers trained by Dr. Varallo have screened more than 5,000 women in one year, providing approximately 800 women with preventative treatment. In addition to his work in Guyana, Dr. Varallo has trained health care providers in cervical cancer prevention and treatment in five other countries, including the United States.

Read the rest of this entry »

Amanda Lenhart, senior research specialist at Pew Research Center’s Internet & American Life Project, has posted her presentation on social media and young adults that was delivered this week at the National STD Prevention Conference in Atlanta. The slideshow covers the latest data on electronic and digital communciation, including cell phone usage and sexting.

Presenting with Lenhart was Kicesie Drew, who provides sex ed information via YouTube; Sally Swanson from the Adolescent Pregnancy Prevention Campaign of North Carolina, a group that usess texting to answer questions about sexual health; and Cornelis Rietmeijer, director of the Sexually Transmitted Disease Control Program/Denver Public Health.

More health professionals are turning to innovative techniques and technologies to reach young and at-risk populations. I recently took part in a symposium, sponsored by Chicago Department of Public Health and the National LGBT Tobacco Control Network, on how public health workers can use social media to reach the LGBT community. We looked at some of the promises and obstacles that new communciation tools present. One of the most important lessons: Know how your audience uses technology, and go where they go.

I was honored to be on a panel with Lovette Ajayi, a superstar at Community Media Workshop and co-founder of the Red Pump Project, which raises awareness about the impact of HIV/AIDS on women and girls. And that brings me to the second point of this post: March 10 was National Women and Girls HIV/AIDS Awareness Day.

The Red Pump Project presents statistics about HIV/AIDS  and women — and the great disparities. Though black and Latina women represent 24 percent of all U.S. women combined, they account for 82 percent of the estimated total of AIDS diagnoses for women in 2005.  Consider that HIV is the:

* Leading cause of death for black women (including African American women) aged 25–34 years.
* 3rd leading cause of death for black women aged 35–44 years.
* 4th leading cause of death for black women aged 45–54 years.
* 4th leading cause of death for Latina women aged 35–44 years.
* The only diseases causing more deaths of women are cancer and heart disease.
* The rate of AIDS diagnosis for black women was approximately 23 times the rate for white women and 4 times the rate for Latina women.

These numbers illustrate the need for massive improvements in education, prevention and treatment — all topics the National STD Prevention Conference aims to address. High-priority issues are identified for each biennial conference, and this year’s top three issues couldn’t be more  relevant or directly worded.

The last point is a great reminder of how change is both incredibly simple and complex: “It is essential to find ways to move beyond our longstanding societal reticence to openly discuss sexual health issues and to normalize conversations around STD prevention.”

Plus: In related news, Washington, D.C. will make 500,000 female condoms available — for free. The condoms will be available in beauty salons, convenience stores and high schools in parts of the city with high HIV rates, reports the Washington Post. The project is funded through a $500,000 grant from the MAC AIDS Fund, a subsidiary of MAC Cosmetics.

Almost six months after receiving FDA approval as an HIV-prevention method, the FC2 female condom is now available in the United States.

The formal announcement was made in Atlanta last week at the Southeastern Urban Initiative for Reproductive Health Summit, a coalition of reproductive health advocates. The summit was hosted by SisterSong Women of Color Reproductive Health Collective.

The FC2 female condom is a second generation product developed by the Chicago-based Female Health Company. Currently available only to state health agencies and nonprofit organizations, the FC2 will be sold in CVS stores in the Washington, D.C. area starting in December, FHC’s senior strategic adviser Mary Ann Leeper told Reuters.

Washington, D.C. health officials released a report in March showing that at least 3 percent of District residents have HIV or AIDS — a rate that is on par with Uganda and some parts of Kenya.

Female Health Company is looking for a marketing partner to help promote FC2 directly to consumers.

“We need the other company to really make a dent into the consumer market,” said Leeper.

According to the Centers for Disease Control and Prevention (CDC), over the past two decades, the percentage of women among all people living with HIV in the United States has increased from 8 percent to 27 percent. African American women account for 66 percent of new AIDS cases among American women; they are 21 times more likely to contract HIV than white women, while Latino women are five times more likely.

“America’s HIV epidemic isn’t going away. In fact, it’s getting worse, and African American and Latino women are disproportionately impacted,” said Dazon Dixon Diallo, founder and president of SisterLove, a grassroots service organization that supports HIV/AIDS prevention and reproductive health programs for women in the Atlanta area. “It’s time to provide women in heavily impacted communities with expanded access to affordable women-controlled options, and the female condom becomes that choice. Women will use it if they have it.”

Female Health Company says the FC2 is thinner and quieter than its predecessor, the FC1 female condom. The FC2 is made of synthetic nitrile, a latex alternative, so it’s safe to use with both oil and water-based lubricants. Here’s information (pdf) about how to insert the condom. There’s also an animated video demonstration. More resources from FCH are available here.

FC2 may be purchased from the company’s two public sector distributors: Total Access Group, Inc. and Global Protection Corporation.

FHC has also launched a new site, www.fc2femalecondom.com, which includes tiered pricing information for ordering female condoms directly (minimum of 25,000). The maximum price of 82 cents per condom is 30 percent less than the price paid for FC1. A retail price has not been determined.

Though female condoms are not popular in the United States, the FC2 has been available in other countries since 2006. The U.S. Agency for International Development had lobbied for the FDA’s approval — a lengthy and expensive process – so it could be purchased for U.S.-funded global HIV-prevention programs.

Earlier this year, Audacia Ray, program officer for online communications and campaigns at the International Women’s Health Coalition, described other female condom prototypes that are being actively tested and promoted outside of the United States, especially in Africa.

We’ve written about the female condom – including the recently approved FC2 – several times in the past. Serra Sippel of the Center for Health and Gender Equity has an update on this topic at RH Reality Check, noting that Uganda is working on plans to reintroduce female condoms, with that nation’s government planning to promote the device beginning this fall.

Sippel explains that the Center for Health and Gender Equity and the Global Campaign for Microbicides recently met with:

…local leaders from HIV/AIDS, reproductive health, domestic violence, human rights and women’s rights groups in Kampala for an advocacy training targeted at donors and national government to ensure successful reintroduction of female condoms in Uganda. As part of the training, participants met with members of the Health Development Partnership Group, which USAID heads; with UNFPA and the Ministry of Health, demonstrating civil society support for the prevention method. Participants also learned about the history of the female condom in Uganda and how to move forward with advocacy efforts beyond the training.

After having received FDA approval to market the device in March, the FC2 female condom is expected to be available in the United States this September. PreventionNow! has additional resources on the topic of female condoms, including news and global promotion efforts.

Woman Shackled During Labor Sues State: A former inmate at the Washington Corrections Center for Women who was shackled while in labor is suing the state of Washington for violating her constitutional rights. Read the full complaint here (pdf).

The Seattle-based women’s rights organization Legal Voice filed the federal lawsuit last week on behalf of Casandra Brawley. According to the complaint, Brawley, who was serving a 14-month sentence for shoplifting, was shackled by a metal chain around her belly during transportation to the hospital. At the hospital, she was shackled to her hospital bed during several hours of labor. A physician demanded the leg iron be removed while he performed an emergency c-section. The shackles were replaced after the baby was born.

“It defies common sense – and the Constitution – to risk any pregnant woman’s health, safety, and dignity by shackling her while she is in the process of giving birth,” Sara Ainsworth, senior counsel at Legal Voice and co-counsel for Brawley, said in a release.

“Like Ms. Brawley, the majority of women incarcerated in Washington State are serving sentences for non-violent crimes. And the idea that labor presents an escape opportunity is absurd. There is simply no justification that outweighs the medical risks of this inhumane, demeaning practice.”

Extra Sentence for Pregnant, HIV-Positive Woman: Rachel Mehlsak, a legal intern at the National Women’s Law Center, wrote a good summary of a court case involving a 28-year-old pregnant woman from Cameroon. A judge in Maine had sentenced the woman — who pleaded guilty to possessing false immigration documents — to a prison term longer than the maximum suggested under federal sentencing guidlines to ensure she would deliver her baby in prison. Why? Because she is HIV-positive, and the judge rationalized that she would receive better care behind bars, thus reducing the risk of HIV transmission. No joke.

The woman was recently released while her appeal to the 1st U.S. Circuit Court of Appeals is pending in Boston. Margo Kaplan of the Center for HIV Law and Policy has more.

New Push for Fetal Homicide Law: Another example of an ill-conceived attempt to protect the fetus comes by way of New Mexico, where the murder of a 22-year-old pregnant woman has led to talk of a fetal homicide law.

“Most crimes of this nature are prosecuted under state law, and according to the National Conference of State Legislatures, at least 36 states have fetal homicide laws (variously known as the Fetal Protection Act, the Preborn Victims of Violence Act and the Unborn Victim of Violence Act). Some laws apply to the killing of a fetus at any time after conception, while others only apply to a fetus that is capable of surviving outside the womb,” writes Gwyneth Doland of the New Mexico Independent.

There are, of course, hefty consequences:

“What we’ve discovered is that the minute one of these laws passes, the first people who are prosecuted are not batterers, but pregnant women themselves,” says Lynn Paltrow of National Advocates for Pregnant Women, a women’s rights organization that has fought against fetal homicide laws.

“These cases are always presented as a response to violence against women. But not a single state has ever looked at whether these laws have done anything to decrease the epidemic of violence against women. And no state should pass another law like this until that research is done,” Paltrow says.

Paltrow says that similar laws in other states are used to prosecute pregnant women who suffer from substance abuse problems.

In particular, she points to South Carolina, where a fetal homicide law has been used to prosecute dozens of pregnant women struggling with substance abuse. In one case, a 22-year-old homeless woman whose pregnancy resulted in a stillbirth was convicted of murder and sentenced to 12 years in prison, even though health experts said there was no evidence her drug problem caused the stillbirth.

A Model Program: I recently learned about the work of Women’s Equity in Access to Care and Treatment (WE-ACTx), which began working in Rwanda in early 2004 to help genocide rape survivors, many of whom had contracted HIV from their attackers. Today, WE-ACTx focuses on increasing women’s and children’s access to comprehensive HIV/AIDS care and services, education and training.

Earlier this month, WE-ACTx held its 4th annual celebration of Day of the African Child (commemoration of the 1976 child uprising in Soweto against apartheid) with more than 400 children with HIV and their families.

In addition to running several medical clinics, the organization educates people affected by HIV/AIDS  about their legal rights, and empowers them to take action to resolve legal problems they may face. Here’s the English version of the WE-ACTx Community Handbook on Health-Care Rights and Other Laws (pdf). If you’re looking for an organization to support, take a look at WE-ACTx.

Resources on HIV Testing: National HIV Testing Day was June 27, and the Kaiser Family Foundation has released new and updated materials on attitudes toward HIV testing. First, take a look at the 2009 Survey of Americans on HIV/AIDS, the Foundation’s seventh major survey of the American public’s attitudes, knowledge and experiences related to HIV/AIDS.

Two new survey briefs were prepared as a follow-up: The first, on views and experiences with HIV Testing, looks at the U.S. public’s attitudes about experiences with HIV testing, including which groups are most likely to report being tested for HIV, reasons for being tested/not being tested, communication with doctors and partners about HIV/AIDS and more. The second brief examines more closely African American’s views and experiences with HIV testing.

Finding “Common Ground” on Abortion – How’s That Working?:  “President Obama has accomplished a lot in his first 100 days in office, but one campaign promise he’s been unable to keep is a vow to make peace in one of the most polarizing issues in all of American politics: abortion,” reports NPR.

Lines in the Sand: Speaking of the elusive common ground, On the Issues magazine chose “lines in the sand” as the theme for its current issue.

An email to readers said the choice was “provoked by today’s too-prevalent sentiment to compromise principles in the interests of seeking ‘common ground’ and reconciliation with opposing views. In these articles we explore the feminist and progressive values that must be held tightly, the ‘lines in the sand’ that we refuse to erase.”

Publisher and Editor-in-Chief Merle Hoffman says reproductive freedom is “the front line, the bottom line and the everlasting line in the sand,” in her editorial “Higher Ground, Not Common Ground.”

Also look for essays by Gloria Feldt, Loretta Ross and many more writers and artists.

Economics, Race and Pollution: A study by researchers at the University of Massachusetts and the University of Southern California tracking toxic emissions from factories confirms what we already know: poor, minority communities are disproportionately affected by harmful pollution. The Milwaukee Journal Sentinel reports on the findings. View the full report (PDF) here.

Public Attitudes Toward HIV/AIDS as a Health Issue: Kaiser Family Foundation has released its 2009 Survey of Americans on HIV/AIDS. In the United States, the sense of urgency about HIV/AIDS as a national health issue has decreased significantly. Residents’ concerns about the disease as a personal risk also has declined, even among some high-risk groups. This press release summarizes the findings. The study comes less than a year after the CDC  announced that there were 40 percent more new HIV infections each year than previously believed.

Egypt’s FGM Ban, One Year Later: In the year since Egypt outlawed female genital mutilation, the government hasn’t prosecuted a single case, Iman Azzi writes at Women’s eNews. Still, some activists say the law is a tool, among others, for gradually dismantling an ancient tradition.

Legalization – The “X” Factor: On May 1, thousands of activists took to the streets in favor of expanding immigrants rights. Suman Raghunathan, an immigration and public policy analyst, describes what immigrant women, particularly those who are undocumented, need: “A legalization program that’s broad, fair and workable for both immigrants and immigration officials.”

Raghunathan goes on to note that current federal immigration policy leaves it up to states to decide whether to provide free or low-cost health care to their undocumented residents. Several states, including New York, have expanded prenatal and neonatal care to undocumented women and children.

“Legal status,” she writes, “would mean that undocumented women are no longer left to the mercy of state legislatures and no longer denied appropriate nursing and doctoring.”

Plus: The L.A. Times reports on how some California counties are eliminating non-emergency health services for undocumented immigrants.

“We are mortgaging the future to scrape through the present,” said David Hayes-Bautista, professor of medicine and director of UCLA’s Center for the Study of Latino Health and Culture.

HRT and Heart Health: A study in the May issue of the journal Medical Care (abstract) looks at whether the decreased use of HRT has affected the rate of cardiovascular health outcomes, according to this release. The number of heart attacks in menopausal women has decreased, though it’s not conclusive that there’s a link. Researchers did not find a difference in the rate of strokes.

Before 2002, physicians believed HRT reduced the risk of coronary heart disease by up to 50 percent in menopausal women. As a result, physicians prescribed it broadly to treat many of the symptoms of menopause, as well as to protect women against cardiovascular disease. However, a report by the Women’s Health Initiative in 2002 revealed that HRT actually had the opposite effect — it increased the risk of heart attack in these women.

“After the 2002 report, the use of HRT in women aged 50 to 69 declined from more than 30 percent to less than 15 percent,” said lead study author Kanaka Shetty, M.D.