Foreign Policy magazine recently published a list of the 10 worst ideas proposed or adopted by presidential candidates Sen. Barack Obama and Sen. John McCain.

There’s no overlap. Most of Obama’s ideas that came under fire have to do with trade agreements and energy solutions. McCain gets zinged for policies ranging from flip-flopping on immigration, to calling for 45 nuclear power plants, to balancing the budget through victory in the war on terror (um, seriously?).

But one of McCain’s not-so-bright ideas stands out, because it addresses both a domestic and global issue that women’s health advocates have been writing about forever, but which doesn’t receive all that much attention from policy wonks: supporting abstinence-only education and the global gag rule.

So kudos to FP editors for identifying McCain’s views on reproductive health as one of his 10 worst ideas:

What he said: Asked on the campaign trail if he thought grants for sex education should include instruction on contraception, McCain turned to an aide for help, saying, “Brian, would you find out what my position is on contraception—I’m sure I’m opposed to government spending on it, I’m sure I support the president’s policies on it.” The reporter asked, “Do you think contraceptives help stop the spread of HIV?” After a long pause, McCain replied, “You’ve stumped me.” —Town hall meeting, Iowa, Mar. 16, 2007

Why it’s a bad idea: A landmark, 10-year study sponsored by Congress found in 2007 that students in sexual-abstinence programs “were just as likely to have sex as those who did not, reported having similar numbers of sexual partners, and first had sex at about the same age,” the Chicago Tribune reported. Abstinence-only education is one of the core principles guiding the so-called global gag rule, an executive order passed by President George W. Bush in 2001 that prohibits giving foreign aid to NGOs that offer any kind of counseling on abortion as family planning. McCain voted against repealing the measure in 2005. Critics of the gag rule point to reports showing a shortage of contraceptives, clinic closings, loss of funds for HIV/AIDS education, and a rise in unsafe abortions since it was instituted.

That information is well-documented by the Global Gag Rule Impact Project (a collaborative research effort led by these groups), which has looked at the impact in nine countries since 2002. Most of the research has been done in Africa, but the analysis also includes Europe, Asia and the Caribbean.

First introduced in 1984, the Global Gag Rule, officially known as the Mexico City Policy, was rescinded by former President Bill Clinton in 1993 and reinstated by President George Bush in 2001 on his first day in office.

If McCain is elected, you can be sure he and running mate Sarah Palin won’t be “reforming” or “changing” that policy when they get to Washington.

McCain’s view on abstinence-only education and his failure to grasp the connection between contraception and HIV is something we need to make more noise about. Here’s another item — in a recent op-ed published in the Milwaukee Journal-Sentinel, Ellen Bravo wrote:

Recently, I conducted an informal poll among friends, all smart, politically aware people who keep up with the news. A dozen of the 15 people I asked had never seen the clip of a befuddled McCain stroking his chin when a reporter asked about his position on a proposal to require insurance companies that cover Viagra to cover contraceptive products, reminding him that he’d voted against it.

“I certainly do not want to discuss that issue,” McCain replied. “I don’t know enough about it to give you an informed answer because I don’t recall the vote.”

Had that clip — or any of numerous examples of McCain’s other extremist positions and slip-ups — been played more than 600 times in four days, as the “Dean scream” was, today’s polls would be very different.

So, folks, in an effort to amplify the message, please consider embedding this video on your own site (even if you’ve done so before), and spread the word that McCain’s views on abstinence-only education and the global gag rule rank as one of Foreign Policy’s 10 worst ideas.

FDA Report Says No Risk From BPA: I’ve written before about the dangers associated with bisphenol A, or BPA, a chemical used in hard, clear plastics, such as Nalgene and baby bottles, as well as in the linings of food cans and baby formula.

The chemical, which mimics a human hormone, has been linked to hormonal changes in animal studies. Canada recently banned polycarbonate infant bottles, and the U.S. National Toxicology Program earlier this year acknowledged “some concern” that BPA may affect neural and behavioral development “in fetuses, infants, and children at current human exposures.”

But according to a draft assessment released by the Food and Drug Administration yesterday, BPA does not pose a health hazard when used in food containers. From the Washington Post:

The report stands in contrast to more than 100 studies performed by government scientists and university laboratories that have found health concerns associated with bisphenol A (BPA). Some studies have linked the chemical to prostate and breast cancers, diabetes, behavioral disorders such as hyperactivity and reproductive problems in laboratory animals.

Exposure to the small amounts of BPA that migrate from the containers into the food they hold are not dangerous to infants or adults, the draft said.

Here’s the kicker:

The chemical industry and the agencies that regulate the use of BPA, the FDA and the Environmental Protection Agency, have deemed the chemical safe, largely on the strength of two industry-funded studies that found no problems. The American Chemistry Council welcomed the findings of the new report.

“Clearly, their effort was to minimize people being concerned about this,” Diana Zuckerman, president of the National Research Center for Women and Families, told the Post. “It just seems that whenever there is an opportunity to look at a new, important issue, they just seem to be siding with industry’s point of view.”

Wal-Mart and Toys R Us aren’t waiting around for the government to take action — as of January, both businesses will stop selling any childrens’ products made with BPA.

Marrying, or Divorcing, for Health Insurance: “In a country where insurance is out of reach for many, it is not uncommon for couples to marry, or even to divorce, at least partly so one spouse can obtain or maintain health coverage,” reports The New York Times. “There is no way to know how often it happens, but lawyers and patient advocacy groups say they see cases regularly.”

Here’s more on the Kaiser Family Foundation study mentioned in the story.

Report: “Failing Women, Withholding Protection”: The female condom first made its debut 15 years ago, but a lack of investment and marketing on the part of policymakers has limited the condom’s availability and marginalized its role in protecting women from HIV-infection and other sexually transmitted diseases, according to a new report issued by Oxfam International and the World Population Foundation. The report was presented at the International AIDS Conference in Mexico City. The full text is available here.

“This is a 15-year scandal born of ignorance and inertia. It has been made doubly worse as the HIV epidemic is now affecting women at a higher rate than men, especially in Sub-Saharan Africa. We now know that millions of women might have been spared HIV, unwanted pregnancies, and empowered themselves in the process, if they had access to this simple method,” said Oxfam spokeswoman Farah Karimi.

“The female condom is the only method that women have to protect themselves. It has been embraced in many countries and cultures, it works and it is cost-effective,” added Karimi. “Political leadership and funding are needed now. No more excuses.”

Plus: Here are some facts about the female condom from “Our Bodies, Ourselves,” and our previous coverage on the condom’s redesign and how U.S. global policy affects condom promotion.

APA Report: Abortion Not a Threat to Mental Health: “The best scientific evidence published indicates that among adult women who have an unplanned pregnancy the relative risk of mental health problems is no greater if they have a single elective first-trimester abortion than if they deliver that pregnancy.”

That’s one of the conclusions put forth by the American Psychological Association Task Force on Abortion and Mental Health, which just issued this comprehensive report (PDF), an evaluation of all English-language studies published in peer-reviewed journals post-1989 comparing the mental health of women who had an induced abortion to the mental health of comparison groups of women.

Plus: For a closer look, read Lynn Harris’ good analysis at Broadsheet.

Coming Out as an Abortion Provider: Nell, who also blogs at Abortion Clinic Days, writes at the new Feministing Community site about her experience meeting her partner’s Republican grandparents and explaining what she does. Yes, there’s a happy ending.

Obesity Study Looks Thin: That’s the word from “The Numbers Guy,” aka Carl Bialik, who has a different take on a recently published study that projects 100 percent of American adults could be overweight by 2048.

What’s in a Midwife’s Bag?: Writing at Offsprung, Diane Dawson, a homebirth midwife, opens up her big black bag to reveal what she brings with her to deliver a baby. “I think that most people still think I show up with a smile and rabbit’s foot for luck. And maybe an herb or two in my purse. For the vast majority of pregnancies, this may well be enough, but I like to be a bit more prepared. …”

New State Law Calls for GPS Tracking on Abusers: “Gov. Rod Blagojevich signed a measure to create a new early warning system by allowing satellite tracking of people who violate orders of protection,” reports the Chicago Tribune. “Opponents of domestic violence and prosecutors say the Cindy Bischof Law will add teeth to the orders, which some deride as mere pieces of paper ineffective in protecting people from stalkers or abusers. Bischof was among at least four women in the Chicago area killed this year by men with orders of protection against them.”

The Centers for Disease Control and Prevention has issued a new report, published in the August 6 issue of JAMA, titled “Estimation of HIV Incidence in the United States.” The paper describes a revised model for estimating new HIV infections, which resulted in an estimate for 2006 that was considerably higher than the agency had previously believed.

According to the CDC:

“Using the new surveillance system, CDC estimates that 56,300 new HIV infections occurred in the United States in 2006. CDC previously estimated that approximately 40,000 new HIV infections occurred annually since the 1990s. The 2006 incidence estimate is about 40% higher than the previous estimates. The new system reveals that the epidemic is—and has been—worse than previously estimated and underscores the need to expand HIV prevention to reach those at greatest risk.”

Unfortunately, the article is not freely available to the public at this time, although the CDC is providing some related fact sheets and podcasts. The abstract can also be viewed at the JAMA website, and the New York Times and other news outlets have coverage of the report.

The report also indicates that the number of new infections each years seems to have been fairly stable since the late 1990s, and points to considerable disparities, noting that “gay and bisexual men of all races and ethnicities and African American men and women are the groups most affected by HIV.” Responding to the findings, Rep. Henry Waxman said in a statement:

As the total number of people with HIV in the United States has risen, so has the need for these programs. But unbelievably, in recent years the HIV prevention budget has gone down. Since fiscal year 2002, when adjusted for inflation, CDC’s prevention budget has actually shrunk by 19%. The President has recently requested decreases in funding for HIV prevention at CDC.

So, even as the agency’s experts have identified a growing list of interventions that work, they’ve had less and less money to actually get these programs to the communities that need them. And they’ve had less money for crucial research for some of the highest-risk populations, like minority men who have sex with men.

Waxman, Chair of the House Subcommittee on Oversight and Government Reform, plans to hold a hearing on this topic in September.

This week the Black AIDS Institute released a report, “Left Behind! Black America: A Neglected Priority in the Global AIDS Epidemic” [available as a PDF]. The authors explain:

“…as America lost interest in its own epidemic over the last decade, the disease became even more firmly implanted in Black America. Nearly 600,000 Black Americans are living with HIV, and as many as 30,000 become newly infected each year….Blacks living with HIV have an age-adjusted death rate more than twice as high as HIV-infected whites.”

Statistics from the CDC reveal that while Blacks are about 13% of the U.S. population, they are nearly half of those diagnosed with HIV/AIDS. Among women diagnosed with HIV in 2005, 64% were Black women.

The authors of “Left Behind!” describe a lacking national strategy, in contrast with international efforts (such as the recent PEPFAR reauthorization). Of 15 countries targeted for international HIV/AIDS relief, the raw number of HIV+ Black Americans is higher than that of seven of those countries, including Ethiopia, Vietnam, Haiti, and others. The authors explain further that if Black America were its own country, it would have the 16th largest HIV/AIDS epidemic in the world.

In an article in the New York Times, Dr. Kevin Fenton, director of the CDC’s HIV prevention efforts, calls the disparity “staggering” and calls the situation “a crisis that needs a new look at prevention.” Fenton also stated, however, that “the argument that government prevention efforts are not tailored to the black epidemic is mistaken,” according to the Washington Post. The agency’s own statistics reveal that:

“Since the beginning of the epidemic, blacks have accounted for 397,548 (42%) of the estimated 952,629 AIDS cases diagnosed in the 50 states and the District of Columbia” [emphasis added]

A new CDC report on HIV incidence is expected to be released on Sunday. The Southern AIDS Coalition has also been attempting to draw attention to geographic and racial disparities in the epidemic, and UNAIDS released a new report on the global AIDS epidemic.

See this website to find an HIV testing site near you.

White House Defines Contraception as Abortion: You know you’re counting down the remaining hours of the Bush presidency when you read that the administration “wants to require all recipients of aid under federal health programs to certify that they will not refuse to hire nurses and other providers who object to abortion and even certain types of birth control,” as reported in The New York Times.

Under the draft of a proposed rule, hospitals, clinics, researchers and medical schools would have to sign “written certifications” as a prerequisite to getting money under any program run by the Department of Health and Human Services. Such certification would also be required of state and local governments, forbidden to discriminate, in areas like grant-making, against hospitals and other institutions that have policies against providing abortion.

And the kicker:

The proposal defines abortion as follows: “any of the various procedures — including the prescription, dispensing and administration of any drug or the performance of any procedure or any other action — that results in the termination of the life of a human being in utero between conception and natural birth, whether before or after implantation.”

Check out the full memo (PDF). Reuters has reaction from family planning groups. NARAL created a letter you can send to members of Congress.

For more reading, see Allison Stevens; Susan Wood; and Christina Page, who notes:

Up until now, the federal government followed the definition of pregnancy accepted by the American Medical Association and our nation’s pregnancy experts, the American College of Obstetricians and Gynecologists, which is: pregnancy begins at implantation. With this proposal, however, HHS is dismissing medical experts and opting instead to accept a definition of pregnancy based on polling data. It now claims that pregnancy begins at some biologically unknowable moment (there’s no test to determine if a woman’s egg has been fertilized). Under these new standards there would be no way for a woman to prove she’s not pregnant. Thus, any woman could be denied contraception under HHS’ new science.

Senate Passes PEPFAR: Scott Swenson of RH Reality Check has the live blog on the 80-16 vote to reauthorize the President’s Emergency Plan for AIDS Relief (PEPFAR), a five-year, $50 billion global initiative to combat HIV/AIDS, tuberculosis and malaria.

SEICUS, International Women’s Health Coalition, and other groups issued a response to the vote, noting in part that “policymakers failed to address critical shortfalls in the bill that would have ensured effective use of scarce public funds and a sustainable response to the pandemic.” It continues:

One key change that should have been made in the PEPFAR bill was the abolishment of arbitrary funding guidelines that determine how money can be distributed on the ground. The Senate bill calls for spending at least fifty percent of prevention funds designed to halt the sexual transmission of HIV, in countries with generalized epidemics, only on abstinence and faithfulness programs. PEPFAR recipients that do not meet this requirement must justify their programmatic decisions through an onerous reporting requirement to Congress, potentially facing defunding. [...]

The PEPFAR bill passed by the Senate also failed to fully increase protection for women and young people, two groups increasingly vulnerable to new infections in nearly every region of the world. Women and young people are most likely to use family planning and other reproductive health services, and would benefit greatly from a strategy that integrated HIV prevention and treatment with family planning. Recent studies suggest that upwards of 90 percent of HIV-positive pregnant women in countries such as Uganda and South Africa have unmet need for integrated family planning and HIV services. However, the bill passed by the Senate fails to call for, or even acknowledge, the need to strengthen critical linkages between family planning and reproductive health services and HIV prevention efforts.

Regional “Hypersegregation” May Contribute to Racial Disparity in Preterm Births: Where a mother lives may account for some of the striking racial disparities in preterm birth, according to a new study described in this release and published in the American Journal of Epidemiology.

Written by Northeastern University professor Theresa Osypuk, the study found that regional hypersegregation (residential racial segregation across four or more dimensions*) may contribute to the higher rate of preterm births among black women. Prior research has shown that infants born to Black women in the U.S. are 50% more likely to be preterm than infants born to White women, although the causes remain poorly understood. [...]

“The complexity of residential segregation and its impact on preterm births and related health outcomes has been overlooked by health literature,” said Dr. Osypuk, Assistant Professor in Northeastern’s Bouve College of Health Sciences. “We believe that the association between residential segregation and higher risk of preterm birth is related to the neighborhood environments in which black women live, including neighborhoods characterized by high levels of poverty, violent crime, and worse housing stock.”

Are Breast Self-Exams Worth It?: Kate Harding breaks down a new study by the Cochrane Collaboration.

Blogging While Brown (and Female): “People consider me the 411 on what goes wrong with black women in America,” Gina McCauley, founder of www.whataboutourdaughters.blogspot.com,” tells Kristal Brent Zook in this article on how women bloggers of color are getting their messages out without having to first get approval through a male power structure.

Plus: The first ever “Blogging While Brown” conference takes place July 25-27 in Atlanta.

Return of the C-Word for Departing Trib Editor: From Romenesko: “In 2004, Ann Marie Lipinski had her Chicago Tribune staff manually pull 600,000 copies of the WomenNews section out of preprinted packages because of the headline, “You c_nt say that.” (The story explored usage of the vulgar term for a woman’s anatomy.) On Thursday, the departing editor showed the newsroom a reader’s e-mail that said, “You C_nt Leave.”

Dissecting the Diets: I caught a frustratingly superficial TV news segment on a long-term Atkins Foundation-funded study (published in the New England Journal of Medicine) that concluded participants on the Atkins Diet lost more weight compared to people on low-fat or Mediterranean diets. Tara Parker-Pope notes, however, that none of the diets resulted in much weight loss (though there were other health benefits), and she takes a closer look at what eating low-carb meant for the purpose of this study — while some commenters discuss whether the low-fat diet was low enough to be effective. Parker-Pope’s most concise critique of the study may be found here.

AIDS Conference Coverage: Kaisernetwork.org will provide daily coverage of AIDS 2008 from Mexico City, Aug. 3-8. Coverage will include live and tape-delayed webcasts and transcripts of each day’s sessions, including the opening and closing sessions, all plenary sessions, and selected other sessions and press conferences; English- and Spanish-language audio podcasts of select sessions; slide presentations from select conference sessions; a daily update email with links to the latest coverage; and more.

Plus: Here’s information on how you can syndicate Kaiser’s coverage on your own website.

Hot Flash Fan Heats Up Exhibit: Lucinda Marshall points to an exhibit at the Huff Gallery at Spalding University in Louisville: “The Hot Flash Fan, Then and Now: Celebrating 160 Years of Feminism.” The Hot Flash Fan, an 8’ x 16’ wall hanging, was created by Ann Stewart Anderson in collaboration with more than 50 women artists. From the exhibit website:

The Hot Flash Fan was created in 1985 and facilitated by renowned feminist artist, Judy Chicago. The Hot Flash Fan, an immense wall hanging, encompasses various media and materials including: elaborate knotting, roping, beading and stitching. In addition, the piece is swathed in vibrant colors, which enhances the viewer’s image of the realities and experiences of menopause.

This specific piece has particular historical significance because it was one of the first artworks to ever visualize the subject of menopause. Through its vivid colors and intricate detailing the Hot Flash Fan depicts the various myths, stereotypes, as well as lived experiences of women transitioning through the multiple phases of menopause. Though historically, representations of menopause have largely focused on the decaying of women’s bodies, as the piece indicates, there are also many reasons to celebrate menopause as one of the important phases in women’s lives.

Check it out:

Federal Agencies Can Now Offer Secret Input on EPA Chemical Reviews: The Washington Post reports on changes the Bush administration has made to Environmental Protection Agency reviews of chemicals — changes that officials with the Government Accountability Office say will delay scientific assessments of health risks and open the process to politicization.

Richard Wiles, executive director of the Environmental Working Group, called the EPA process a “bureaucratic quagmire,” adding, “With these rules in place, it’s now official: The Bush White House is where all good public health protections go to die.”

Death in Childbirth a Health Scourge for Afghanistan: Reuters takes a close look at the staggering maternal death rate in Afghanistan, where about 1,600 Afghan women die in childbirth out of every 100,000 live births.

“In some of the most remote areas, the death rate is as high as 6,500. In comparison, the average rate in developing countries is 450 and in developed countries it is 9,” writes Tan Ee Lyn. “Virtually everyone in Afghanistan can recount a story about a relative dying in childbirth, often from minor complications that can be easily treated with proper medical care.”

Plus: Read our previous posts on Afghanistan and maternal health — and how the United States has mismanaged funding and programs intended to improve hospital conditions.

The Disney Hyprocrisy: From Slate: Forget Miley Cyrus. Check out Disney’s Chinese underwear ad. Just go.

Plus: There’s a new book out on the sexualization of ‘tween girls: “The Lolita Effect,” by Gigi Durham, a University of Iowa journalism professor.

“I’m criticizing the unhealthy and damaging representations of girls’ sexuality, and how the media present girls’ sexuality in a way that’s tied to their profit motives,” said Durham in this release. “The body ideals presented in the media are virtually impossible to attain, but girls don’t always realize that, and they’ll buy an awful lot of products to try to achieve those bodies. There’s endless consumerism built around that.”

Divorce Leads to Job Loss: So imagine you’re a professor and you’re going through a divorce. Your college requires that you talk with a staff member to see whether the grounds for divorce meet Biblical standards. If you don’t, you’ll lose your job. Yep, that’s what happened to a popular English professor who has taught at Wheaton College in Illinois for 20 years. From the Chicago Tribune:

Many theological conservatives say the New Testament permits divorce only in cases of adultery or desertion. Wheaton requires faculty and staff to sign a faith statement and adhere to standards of conduct in areas including marriage, said Provost Stan Jones.

Still, every year, the college has dealt with several cases in which it must evaluate the divorce of a job applicant or a staff or faculty member and consider whether it matches the exceptions laid out in Matthew 19 and the writings of the Apostle Paul.

I admit I’m not up on Bible readings, but what about, say, domestic abuse — along with a host of other very good reasons?

Genetic Link to Osteoporosis: “Researchers have identified two common genetic mutations that increase the risk of osteoporosis and related bone fractures, according to a study released Tuesday,” reports Reuters.

U.S. Federal Funding for HIV/AIDS: The Kaiser Family Foundation has released a new fact sheet on federal funding for HIV/AIDS in the President’s Fiscal Year 2009 budget request, and comparisons over time, with key funding highlights for domestic and global HIV/AIDS programs. It also includes additional information on federal funding for global TB, malaria and other global health efforts.

Can I Get A May Day for Immigrant Women’s Health?: “May Day, May 1st, has come to hold the promise of rallies for immigrant rights staged across the United States. And this year is no different. But with McCain’s more-of-the-same health care plan having just been released, it’s a perfect time to focus on why women’s reproductive health care must be a crucial part of any discussion about immigration reform,” begins Amie Newman’s essay at RH Reality Check.

Rescue Us From Our Bodies: Here’s a nice round-up of responses to Midol’s new “Reverse the Curse” campaign.

Stop the Mommy Madness: Salon talks with feminist activist Amy Richards, whose new book is titled “Opting In: Having a Child Without Losing Yourself.”

Plus: Rachel Fudge reviews “Opting In” for Mother Jones.

More Mothers Breast-Feed, in First Months at Least: “About 77 percent of new mothers breast-feed their infants at least briefly, the highest rate seen in the United States in more than a decade, according to a government survey released on Wednesday,” reports The New York Times. Enthusiasm, however, was tempered.

Breast-feeding experts said that they were cheered by the report’s numbers but noted that rates of breast-feeding at 6 months of age have remained unchanged and are significantly lower than goals set by government agencies. The most recent C.D.C. survey did not report breast-feeding rates at 6 months because of a lack of data. [...]

In the most recent survey, breast-feeding rates increased among non-Hispanic black women to 65 percent from 36 percent in 1993 and 1994. Eighty percent of Mexican-American infants and 79 percent of non-Hispanic white infants had been breast-fed.

The age and income of mothers played important roles. Just 57 percent of poor mothers and only 43 percent of mothers under 20 breast-fed their infants, the survey found.

Dr. Barbara L. Philipp, associate professor of pediatrics at Boston University, said the C.D.C. survey had not asked mothers whether they breast-fed exclusively. “One sip was positive, so they set the bar very low,” Dr. Philipp said.

A new report commissioned by the Center for Health and Gender Equity (CHANGE) blames “bureaucratic obstacles, funding restrictions, and a lack of high level commitment to female condoms” for delaying the expansion of U.S.-funded female condom distribution efforts.

But the biggest deterrent — for both male and female condoms — lies within U.S. global policy concerning HIV prevention.

The report, “Saving Lives Now: Female Condoms and the Role of U.S. Foreign Aid,” takes to task the U.S. Office of the Global AIDS Coordinator, which prioritizes condom promotion programs under the President’s Emergency Plan for AIDS Relief (PEPFAR) only for “high-risk persons.”

Also damaging is the congressionally mandated requirement that PEPFAR spend 33 percent of all HIV prevention funds on abstinence-until-marriage programs, which funnel money toward programs that only promote abstinence and fidelity as means of preventing HIV.

Congress reauthorized PEPFAR earlier this month. Policy and news updates are available through PEPFAR Watch, also sponsored by CHANGE.

“Saving Lives Now” is available for free at PreventionNow.net (download PDF), a global campaign to expand access to female condoms. CHANGE and its U.S. partners work with existing female condom campaigns in other countries such as Argentina, Ghana, and Zambia.

Female condoms account for just 0.2 percent of total global condom supply. The report found that female condoms are available in 108 countries, but they are not readily accessible in most countries. The United States has supplied female condoms to 30 countries in the past decade and to 16 countries in 2007. Nearly 26 million female condoms were distributed worldwide in 2007, compared to 11 billion male condoms.

“It is distressing that women make up half of those infected by HIV and policy makers are refusing to provide women with the tools they need to negotiate safer sex,” said Serra Sippel, CHANGE executive director. “The U.S. and other donors must increase comprehensive funding for the purchase, distribution and programming of female condoms to ensure that women and men have access to female condoms and know how to use them.”

Based on interviews with health experts and a review of current literature on female condoms, the report’s executive summary (PDF) offers the following findings and common-sense recommendations:

FINDING: U.S. agencies responsible for female condom programming and procurement do not have polices that promote the integration of female condoms into HIV prevention and family planning programs. Whether the U.S. procures female condoms in a given country is highly dependent on the personal biases of USAID mission staff.

RECOMMENDATION: USAID and OGAC should issue policy guidance promoting female condom procurement and programming within U.S.-funded development programs, including PEPFAR. As a signatory of ICPD, the U.S. should promote female condoms as a vital tool to prevent both pregnancy and HIV infection.

FINDING: The U.S. excels at assisting countries in female condom logistics and procurement.

RECOMMENDATION: The U.S. should expand technical assistance for female condom logistics and procurement to additional countries to increase HIV prevention efforts.

FINDING: Sustained product availability and effective programming is limited to a few countries. Accurate estimates for female condom needs do not exist.

RECOMMENDATION: The U.S. should apply intensive programming efforts to an additional three countries for scale-up and replication. These efforts could be used to create a more realistic assessment of global female condom needs for scale-up.

Plus: Here’s a post from last year on efforts to redesign the female condom and problems with raising money in the United States for the clinical trials required for FDA approval.

Last-Minute Reminder: Judy Norsigian, executive director of Our Bodies Ourselves, will be at Women & Children First bookstore in Chicago Sunday, April 6, at 4:30 p.m. to discuss OBOS’ new book, “Pregnancy and Birth.”

Get event details here. Oh, and I’ll be there, too!

Judy has two events in Chicago on Monday — both of which are free and open to the public. Then it’s on to Austin, Texas. Check the OBOS events calendar for more cities and dates on the OBOS book tour.

Single Mothers in China Forge a Difficult Path: The New York Times reports on the plight of single mothers in China, some of whom lie about their marital status or enter into marriages solely to obtain basic identifications for their children to attend school or to receive other social services. Howard French writes:

In a society where until quite recently premarital sex was often punished, the issue of single motherhood has been slow to enter the public arena. But now, a new awareness of the issue is raising questions about the status of women in China. And the debate is also stretching to other areas of citizens’ rights, including the most basic societal tenets like the hukou, or residency permit, a central tool of population control passed down from the Maoist era that restricts movement by linking people to the towns of their birth.

The Chinese government has long maintained that the Communist Party liberated women in 1949 along with the rest of the country. But in an era of rapid modernization, China has lacked anything like a broad current of thought about women’s rights.

“When we argue that a woman owns the uterus, and it’s her right to decide whether to deliver the baby or not, people won’t buy it,” said Yuan Xin, director of psychology at the Consulting Center of Nankai University. “If you are a woman, your personal choice is monitored and supervised by a lot of others, and they expect you to do what everyone else does.”

Bush AIDS Initiative Gets Bipartisan Renewal: “A bipartisan coalition in the House voted Wednesday to significantly expand a popular program aimed at combating HIV and AIDS around the world, renewing the President’s Emergency Plan for AIDS Relief by authorizing $50 billion — $20 billion more than the White House requested — over five years,” reports the L.A. Times. The story also notes the political compromises over PEPFAR:

Conservatives gave up a demand that abstinence be the centerpiece of efforts to fight AIDS; when the program began five years ago, the Republican majority then in control of Congress included language requiring that one-third of all funds spent on prevention go toward abstinence-related initiatives. The legislation approved Wednesday mandated “balanced funding” to support a so-called A-B-C strategy: abstain from sex until marriage; be faithful; and use condoms.

Liberals agreed to accept some restrictions on activities by family planning organizations. Under the bill, funding may go to family planning clinics to pay for HIV/AIDS testing and education but not abortions. Faith-based organizations will also continue to receive funding.

Read more on PEPFAR at RH Reality Check, including this post by Kelly Castagnaro on PEPFAR as political sport.

Health Database Was Set Up to Ignore “Abortion”: The New York Times today caught up with the controversy over the restrictions on the word “abortion” in the world’s largest database on reproductive health. Known as POPLINE, the database is managed by Johns Hopkins University and receives funds from the U.S. Agency for International Development.

Rachel has an excellent report on how it all went down — including tons of links to more coverage — and how it turned out. Kudos to medical librarians and all activists who protested the restrictions and got the word out quickly and effectively.

Global Health Summit: The 2nd Annual GlobeMed Global Health Summit took place this week at Northwestern University. It’s mission: to mobilize and unite university students “to think critically about global health issues, develop personal and professional skills for building a sustained commitment to social justice, and share ideas about the role of students in catalyzing a movement to improve global health.”

I learned about the summit listening to a Worldview radio interview on Thursday with Catherine Quinn, coordinator of field program operations at Concern America, an international development and refugee organization. Quinn discussed maternal health and public health training in Latin America.

Public Masturbation as Teachable Moment: Courtney Martin raises a good question: What do you call it when a man publicly masturbates in your presence? “When I brought up this experience to friends, just about every one of them had a similar story, but we all realized there’s no real name for this kind of violation,” writes Martin. More than 100 readers weigh in.

Birth Control Options: “Birth control options are growing for women 40 and older — a group that once viewed its choices as pretty much limited to tube-tying surgery and condoms,” reports the AP. The story covers a safer birth control pill, the IUD and a nonsurgical method of tube-tying.

“Exile” Turns 15: This isn’t really health related — unless you think of feminist music as necessary for mental health — but Kate Harding has a great post at Broadsheet titled “The Album That Made Me a Feminist.” Take a guess what it is … OK, I’ll spill: Liz Phair’s “Exile in Guyville,” which Harding notes will be re-released on June 24, marking the album’s 15th anniversary.

The only thing I’d add to Harding’s post is that Phair’s third album, “Whitechocolatespaceegg,” is every bit as good. Really.

E-Mail Discussed Unapproved Use of Drug: “John C. Lechleiter, an Eli Lilly official who is about to become the company’s top executive, wrote an e-mail message in 2003 that appears to have encouraged Lilly to promote its schizophrenia medicine Zyprexa for a use not approved by federal drug regulators,” reports today’s New York Times. Why is this an issue?

The e-mail message was discussed this week in an Anchorage courtroom in a lawsuit against Lilly by the State of Alaska. The suit seeks reimbursement for the medical costs of Medicaid patients who developed diabetes while taking Zyprexa.

The drug causes severe weight gain and cholesterol problems in many patients and has been linked to diabetes.

Zyprexa is federally approved only for use by adults diagnosed with schizophrenia or bipolar disorder. While doctors are free to prescribe it “off label” for any patients for any use, it would be a violation of federal law for Lilly to actively encourage off-label use of the drug.

Bed Rest: Writing at Feminist Law Professors, David S. Cohen describes his wife being prescribed bed rest for preeclampsia and the questions it raises about medical logic and stereotypes.

Online Records: The Washington Post looks at the pros and cons of trusting your health records to online technology. There are now more than 100 websites offering management of personal health records.

Foes of Sex Trade Stung by Eliot Spitzer’s Fall: Until he was linked to a prostitution ring, the about-to-be-former New York governor was a strong ally of human rights groups, “which credit him with what they call the toughest and most comprehensive anti-sex-trade law in the nation,” reports The New York Times. The Times talked with Taina Bien-Aimé, executive director of Equality Now:

Too often, Ms. Bien-Aimé maintained, the public imagines a huge divide between the kind of glamorous call girl depicted in a movie like “Pretty Woman,” and the lurid, violent world of trafficked women in a film like “Eastern Promises.” But they are all part of a commercial sex industry that buys women’s bodies, she said, citing studies that put the average age of entry into prostitution in the United States at 14.

“There’s no sliding scale in the exploitation of women,” she said. “Either you exploit a woman in the commercial sex trade or you don’t.”

Because Mr. Spitzer seemed to agree, she said, “he was our hero.”

Silence Will Not Protect You: “On this day, National Women and Girls HIV/AIDS Awareness Day, AIDS now bears a black female face,” writes Diary of an Anxious Black Woman. “Unlike gay men in the ’80s, however, we are conspicuously silent (or rather “silenced”) in mainstream media and within the national conscience.” She continues:

Unlike gay men in the ’80s, who broke the silences surrounding their sexuality – promoting condom use through newsletters and even in gay porn (even though gay porn and personal relationships of late have dangerously resorted back to “bareback sex”) – black women, who now comprise 70% of new AIDS cases and, if aged between 19 and 44, will most likely die by this disease, have not rallied publicly through collective rage (I’m very angry to see such high statistics among my sisters, aren’t you?). We have not promoted, in TLC fashion (remember when they used to sport those condoms in their clothing?), condom use among women and girls through our erotic fiction, music, and videos (I know at least one porn star who gave out “goodies” at the Harlem Book Fair last summer but didn’t bother to distribute condoms) nor have we staged walkouts at various church services when they promote violent homophobia and “wives submit” type sermons. We have not stormed through the Stock Exchange to demand affordable drugs for black women here and overseas, nor have we staged sit-ins at various corrections facilities and hospitals and schools, which have all colluded in the silent devastation of our communities through the spread of HIV/AIDS.

We have not figured out, as the gay men of the ’80s did, that there is an insidious agenda to let us die.

Expert Hired to Guide Title IX Effort: “The University of Colorado appointed one of its staunchest critics Monday to advise the school on women’s safety issues, fulfilling the final requirement of a $2.85 million settlement with two former students,” reports the Denver Post. “Nancy Hogshead-Makar, an educator and 1984 Olympian, will independently oversee Title IX compliance, including matters regarding sexual harassment, sexual assault and gender discrimination.”

CU, you may remember, made headlines after a former student was raped during a high school recruitment party. The school overhauled its athletic program and several school officials were ousted. Best quote: “The best way to prevent a sex harassment or a sex assault claim is to prevent sexual harassment and sexual assault,” said Hogshead-Makar.

The Long-Term Cost of Childhood Abuse: Middle-aged women who suffered physical or sexual abuse as children spend up to one-third more than average in health care costs, according to a long-term study of more than 3,000 women (mean age: 47 years) that appears in the March issue of the Journal of General Internal Medicine.

After accounting for women’s age and education, the health care costs for women who were sexually abused were 16 percent higher than non-abused women; physically abused women’s costs were 22 percent higher. For women who suffered both types of abuse, their costs rose 36 percent above average.

“What’s remarkable is that women with an average age in their late 40s still suffer consequences from abuse that occurred decades ago,” said Amy Bonomi, associate professor of human development and family science at Ohio State University, who led the study at Group Health in Seattle. “No other study has found that before.”

Pre-schoolers Discuss Body Image, Diversity: Because it’s never too soon.

The Big Push for Midwives: Great post by Amy G. about the campaign for the regulation and licensure of certified professional midwives. Amy mentions a number of blog posts on the issue, including ours.

Metabolic Syndrome Is Tied to Diet Soda: “This is interesting,” said Lyn M. Steffen, an associate professor of epidemiology at the University of Minnesota and a co-author of the paper, which was posted online in the journal Circulation on Jan. 22. “Why is it happening? Is it some kind of chemical in the diet soda, or something about the behavior of diet soda drinkers?”

I don’t know, but it makes me see red ….

Feeling Bad?: Those susceptible to Seasonal Affective Disorder, take note: Chicago had 11 — count ‘em — 11 minutes of sunshine during the first eight days of February. Chicago Tribune health columnist Julie Deardorff writes that she is going to try a sauna that that “uses infrared energy to warm the body and release toxins.” Readers, if you have suggestions for coping with a long gray winter, please leave them in the comments.

Why I am an Abortion Doctor: “I can take an anxious woman, who is in the biggest trouble she has ever experiences in her life, and by performing a five-minute operation, in comfort and dignity, I can give her back her life.” — Canadian abortion doctor Garson Romalis, who has survived being shot and stabbed because of his work.

NYT Op-Ed on Same-Sex Marriage Ruling: “In a decision at once common-sensical and profound, a New York State appeals court ruled Friday that same-sex marriages validly performed in other jurisdictions are entitled to recognition in New York. It was common sense because it simply accorded same-sex marriages the same legal status as other marriages. It was profound because of the way it could transform the lives of gay people.” Continue reading …

A Health Law With Holes: “This idea of an individual mandate absent comprehensive reform – how to say this politely? – is nuts. It makes a social failure the problem of the individual,” writes Robert Kuttner in an op-ed published in the Boston Globe about health care in Massachusetts.

Health Cuts Trigger Crisis in Chicago: In a front-page story on Friday, the Chicago Tribune reported on what doctors are calling “an emerging health crisis” in the city, with “hundreds of women with abnormal Pap smears, unusual bleeding, pelvic masses and other worrisome symptoms are waiting for weeks or months to see gynecologists in the Cook County health system.”

“The longer women wait for care, gynecological experts warn, the more likely it is that untreated medical problems could worsen, exposing the women to severe pain, cancers that are harder to treat or even life-threatening emergencies.”

Breastfeeding and HIV-Infected Mothers: “An antiretroviral drug already in widespread use in the developing world to prevent the transmission of HIV from infected mothers to their newborns during childbirth has also been found to substantially cut the risk of subsequent HIV transmission during breast-feeding,” according to this release from the John Hopkins Center for Clinical Global Health Education. Approximately 150,000 infants are infected through breastfeeding each year.

The findings were made public during the 15th Conference on Retroviruses and and Opportunistic Infections held in Boston this past week.

Another study presented at the conference found that the risk of HIV transmission decreased by 90 percent within couples in which one person is HIV-positive and the other is HIV-negative — if the HIV-positive person took antiretrovirals, which drive down the level of HIV in the blood.

“Getting an early diagnosis, and getting treatment to drive down viral load, is going to be good for prevention,” said Dr. Rebecca Bunnell, a researcher for the CDC in Kampala, Uganda, told the San Francisco Chronicle.

SF Chronicle writer Sabin Russel described the study as “one of the few rays of hope” to come out of the conference, “a meeting that has been dominated by discussions of setbacks, such as the failure of a major AIDS vaccine trial that was abruptly ended in September.”

And The New York Times reports on yet another study that was discussed, one that showed that male circumcision did not result in a lower risk of transmission for female partners. “Although the findings did not reach statistical significance, they still underscore the need for more effective education among men who undergo circumcision and their female partners, the authors of the study said,” reports the Times.

The Pill’s Long-Running Health Saga: “Last week, British researchers published decisively good news about birth control pills: They lower the risk of ovarian cancer — substantially,” writes Amanda Schaffer at Slate. “The new analysis pooled large amounts of data. It was elegantly done. And it’s worth celebrating, partly because health claims about the pill are often much harder to parse.”

New Insights Into Genital Pain: “For decades, women suffering from vulvodynia have been told that nothing seems to be wrong with them — nothing, that is, that the examining physician can discern — or that the condition may be real but that nothing can be done,” writes Jane Brody in The New York Times. According to recent study, vulvodynia (chronic discomfort of the vulva) affects as many as one woman in six, or 13 million American women. Attitudes are now changing, and the article looks at some very real potential causes and treatments.

Rape in the U.S. Military: “[I]n many cases, the military seems more intent on intimidating and harassing the victims than investigating and prosecuting the charges,” writes Lucinda Marshall in this L.A. Times opinion piece.

Consider the statistics cited: 2,947 reports of sexual assaults in the military in 2006, an increase of 24 percent over 2005. According to a March 2007 Pentagon report, more than half of the investigations dating back to 2004 resulted in no action. And when action was taken, only one-third of the cases resulted in courts-martial.

Plus: Also see Marshall’s diligent coverage of gender-based violence, both domestically and globally.

Rape Charges Dropped Over “Fraud”: “Prosecutors say they cannot press rape charges against a pharmacist who allegedly posed as a gynecologist and examined two women because of a half-century old state law that says an assault can’t be considered rape if consent is obtained through fraud or deceit,” reports the AP via the Boston Globe. Denise Lavoie writes:

Justices of the Supreme Judicial Court urged lawmakers to close that loophole in the law in a 2007 case in which they found a man could not be prosecuted for rape for duping his brother’s girlfriend into having sex. The court said state law currently defines rape as sexual intercourse compelled by force and against the will of the victim. Fraud cannot be allowed to replace the force required under the law, the court found.

Iraqi Women Face Greater Danger, Fewer Rights: “Most everyone in Iraq has suffered because of violence, but the lives of women have been, perhaps, affected the most,” reports NPR. “Women’s rights groups report that in the past six months, more than 100 women have been killed in the city of Basra for wearing make-up or what is deemed Western clothing. Those who dare to defend them have also been attacked and, in some cases, killed.”

The Sex of Your Surgeon May Matter: Tara Parker-Pope covers a study by researchers at Columbia University that found the likelihood of whether a woman receives radiation treatment after breast cancer surgery may be influenced by the gender of her surgeon. The study appears in The Journal of the National Cancer Institute (abstract available here). Parker-Pope writes:

About one in four women were not treated with radiation after surgery. Older women, black women, unmarried women and those living outside urban areas were less likely to receive radiation. But after controlling for those factors as well as characteristics of each woman’s cancer, the Columbia researchers spotted other trends.

Women who received radiation were more likely to have a female surgeon. Women who were treated by more experienced surgeons were also more likely to receive radiation treatment, as were women treated by doctors trained in the United States.

Chile Battles Access to Morning-After Pill: “Since assuming office in March 2006, President Bachelet and Health Minister Maria Soledad Barria have instructed public health authorities to work aggressively to ensure the pill’s availability not just at public clinics — where it is distributed for free to women 14 and over — but at all major pharmacies, enabling its availability to women from all social strata,” writes Matt Malinowski at Women’s eNews. But the plan is running into resistance.

The One To Take the Lead: “Although stories about reproductive health and politicization of science have made headlines recently, stories of how these problems are solved are less often told,” begins this essay at RH Reality Check by Susan Wood, who resigned her FDA position in 2005 as the FDA repeatedly delayed approval of over-the-counter emergency contraception. Wood credits Sen. Hillary Clinton for stepping up to the FDA.

“Stigma: The Silent Killer”: BET Networks will air a half-hour news special on Thursday, Feb. 7 at 8 p.m. ET/PT that examines the role that stigmas have played in the spread of HIV/AIDS among people of color in both the United States and the Caribbean. The special coincides with Black HIV/AIDS Awareness Day and is part of a public education partnership with the Kaiser Family Foundation, the BET Rap-It-Up Campaign.

On Dec. 26, New Jersey Gov. Richard Cody signed into law a provision requiring that pregnant women be tested for HIV, and that newborns be tested if the mother’s status is not known.

The purpose of the legislation is to prevent transmission of HIV from mother to fetus. It allows women to opt out of testing, and requires healthcare providers to provide information about “the benefits of being tested, the medical treatment available to treat HIV infection, and the reduced rate of transmission to a fetus if an HIV-infected pregnant woman receives treatment.”

The law has generated mixed reactions. An RH Reality Check blogger noted issues such as the forced nature of the intervention on the woman for the sake of the fetus, and the possibility that women will feel that they are not able to refuse the test. While the N.J. law does not include any criminal penalties for refusing the test, the refusal will be noted in the woman’s medical record.

On privacy and choice, Women’s Bioethics Blog asks, “Does a woman cede certain personal rights when she decides to carry a pregnancy to term?”

Others have pointed out that a better strategy may be expanding access to prenatal care in general, rather than focusing specifically on mandatory HIV testing. Another blogger believes the test is not an invasion of privacy, but notes that a stigma of blame still exists with regards to HIV/AIDS that must be addressed.

Some have asked how New Jersey plans to care for those women who find that they are HIV positive. It appears that the N.J. Department of Health and Senior Services does provide drugs to those with HIV and AIDS who meet certain income caps and lack other means of covering the expensive prescriptions.

What do you think? Was it necessary or useful to move from an opt-in to an opt-out strategy for HIV testing? What does it mean when an intervention is forced for the sake of the fetus? Does the benefit to the woman of knowing her status and being able to seek care outweigh the lack of choice? These are complicated questions, and I’d love to hear your thoughts.

By now you may have heard that Presidential candidate Mike Huckabee, in a 1992 Associated Press questionnaire completed while he was running for the Senate, advocated for the isolation of HIV positive individuals, stating:

“If the federal government is truly serious about doing something with the AIDS virus, we need to take steps that would isolate the carriers of this plague. It is difficult to understand the public policy towards AIDS. It is the first time in the history of civilization in which the carriers of a genuine plague have not been isolated from the general population, and in which this deadly disease for which there is no cure is being treated as a civil rights issue instead of the true health crisis it represents.”

He also seemed to tie his thinking on HIV/AIDS solely to homosexuality, stating, “I feel homosexuality is an aberrant, unnatural, and sinful lifestyle, and we now know it can pose a dangerous public health risk.”

Huckabee has since refused to recant or retract the statement, insisting that he didn’t mean HIV/AIDS patients should be locked up, but not indicating how he thought they otherwise would have been “isolated.”

Is Huckabee’s “it was 1992″ rhetoric implying that he didn’t know better at the time and that there was still confusion about HIV transmission valid? As Salon notes, a report from the Surgeon General [PDF] in 1986 clearly stated, “AIDS is not spread by common everyday contact but by sexual contact…We would know by now if AIDS were passed by casual, non-sexual contact.” The report went on to assert, “Quarantine has no role in the management of AIDS because
AIDS is not spread by casual contact.” This report pre-dates Huckabee’s statement by six years. Personally, I expect a candidate to find out the facts before advocating for the isolation of Americans.

Meanwhile, critics are reacting to a proposed change in travel restrictions for those with HIV/AIDS. Current law makes any individual inadmissable to the United States “who is determined (in accordance with regulations prescribed by the Secretary of Health and Human Services) to have a communicable disease of public health significance, which shall include infection with the etiologic agent for acquired immune deficiency syndrome.” This provision has been criticized given the issue we reviewed above – that HIV/AIDS is known to not be spread by casual contact.

On World Aids Day 2006, President Bush called for the Department of Homeland Security to revisit HIV-related travel restrictions to allow for “short visits.” A DHS document released on November 6, 2007 described the newly proposed rule, which has been criticized by Democratic House members and other organizations. It would require an HIV-positive visa applicant to demonstrate that there is no anticipated need for medical care while in the United States, has been counseled on the condition, understands transmission routes, and “establish that he or she possesses sufficient assets or insurance, that is accepted in the United States, that would cover any medical care that the applicant might require in the event of illness at any time while in the United States,” among other restrictions

As a representative for Physicians for Human Rights notes, “The travel ban is nothing more than a continuation of misunderstood, and offensive, practices that violate human rights and contribute to the stigma that fuels this pandemic.” With regards to the need to demonstrate that the individual will not use the healthcare system, PHR points out, “Such stipulations are not placed on visitors with heart conditions and other costly medical problems.” Failure to comply with the requirement could result in the individual being permanently banned from accessing the U.S.

Likewise, a 2004 joint statement from UNAIDS and the Institute of Medicine recommends against blanket travel restrictions, concluding that “HIV-related travel restrictions are an ineffective and discriminatory anachronism of a by-gone era.” The document [PDF] presents a compelling case against these restrictions, and is well worth a read given the current Dept. of Homeland Security consideration of the topic.

Dr. Drug Rep: In a confessional essay published in last Sunday’s New York Times Magazine, Dr. Daniel Carlat writes about his awakening after making $30,000 in one year (on top of the $140,000 he took home from his private practice) by recommending Wyeth’s antidepressant Effexor XR to other doctors. It’s a great read.

Today Carlat is an assistant clinical professor of psychiatry at Tufts University School of Medicine and publishes The Carlat Psychiatry Report, a peer-reviewed medical-education newsletter for psychiatrists that is not financed by the pharmaceutical industry. He also has a blog; read here how he plans to part with his “dirty thirty.”

“The Business of Being Born”: A couple of weeks ago I mentioned this new documentary on childbirth practices directed by Abby Epstein and produced by Ricki Lake (and what a hit it’s become in Australia!). Rachel has seen it and wrote a terrific review over at Women’s Health News in which she comments on the film’s two biggest strengths:

The first is that important information about the cascade of interventions in managed birth, U.S. practices vs. other countries and the resulting outcomes, drugs, c-section rates, and medical evidence is presented in a way that is accessible and informative even to those who are taking their first look at birth issues. [...]

The second major strength is that the film clearly locates birth issues inside feminism and choice, noting the power disparities of the traditional hospital birth system, the often misguided focus on outcomes and potential litigation that ignores women’s needs and experiences, and the empowerment that many women feel when able to give birth on their own terms.

Check out the full review. A list of upcoming screenings is available here.

Abortion Splits Hollywood: Ready for another look at “the A-word” — or lack thereof — in films? Of course you are.

Imaging Exams/Radiation Exposure Increasing: Pregnant women are receiving more high-tech imaging exams than a decade ago, according to a study presented Nov. 27 at the annual meeting of the Radiological Society of North America.

“Through medical imaging examinations, we are exposing pregnant women to twice the amount of radiation as we did 10 years ago,” said Elizabeth Lazarus, M.D., assistant professor of diagnostic imaging at the Warren Alpert School of Medicine at Brown University in Providence, R.I. “Overall, the levels of radiation to which we are exposing pregnant women are low, but they do carry a slight risk of harm to the developing fetus.”

Dora’s Scary Makeover: Why is it that doll versions of spunky role models end up passive and super-feminine? To wit: Dora the Explorer’s new “tool” is a comb. Great post over at Hoyden About Town, and Ampersand delivers on the visual.

Girls You Should Know: These two teenagers, finalists in the Siemens Competition in Math, Science & Technology, are researching why some breast cancer patients develop resistance to the cancer drug Herceptin. This story made me feel a little better about the world.

Jane Addams Day: The first annual Jane Addams Day will be celebrated Dec. 10, 2007. The first woman first American woman to win the Nobel Peace Prize, Addams co-founded the social settlement Hull-House in Chicago in 1889. She went on to campaign for suffrage and supported the founding of the NAACP and the ACLU. Check out the Jane Addams Hull-House Museum for more information.

The Outsiders: John Tierney tries to restart a debate about criticism of female genital mutilation being an issue of cultural imperialism. Fortunately, many of Tierney’s commenters aren’t buying it.

Missing, however, is a look at what local health advocates and community-based organizations such as Tostan are doing to raise awareness and to stop this brutality. The New York Times reported on community-based efforts in Egypt earlier this year.

Hysterectomies by the Numbers: “Hysterectomy, the second most frequent major operation performed on women in the United States, has long been criticized as being over performed, especially for benign conditions,” writes Linda Steinberg at the Women’s Media Center. “In the late sixties, the women’s health movement tried to bring national focus to this issue, but still today, some experts say, most of the 600,000 hysterectomies performed annually in this country may be unnecessary.”

World AIDS Day: For World AIDS Day (Dec. 2, 2007 marks the 20th World AIDS Day, if you’re keeping count), Kaiser Family Foundation has updated several resources with new data from UNAIDS on the global HIV/AIDS pandemic. From KFF:

The updates reflect major revisions based on refinements in methodology, increased data availability, and growing knowledge about the natural history of HIV disease. An updated fact sheet provides data on the global impact of HIV/AIDS by region, on women and young people, and data on the global response. Several indicators on globalhealthfacts.org have been updated, including the total number of men, women and children living with HIV/AIDS, and the total number of AIDS deaths worldwide. Both the HIV/AIDS Overview and Facts at a Glance sections on GlobalHealthReporting.org have also been revised.

In addition, there are many new developments in Kaiser’s public education campaigns designed to raise awareness about HIV/AIDS in the U.S. and around the World. The campaigns include the Global Media AIDS Initiative, the Caribbean Broadcast Media Partnership on HIV/AIDS, the African Broadcast Media Partnership Against HIV/AIDS, Rap-It-Up with BET, It’s Your (Sex) Life with MTV and ¡Entérate! with Univision.

Plus: Worldview, an excellent public radio program, on Friday broadcast an interview recorded earlier this year with Stephen Lewis, UN special envoy for AIDS in Africa from 2001 to 2006. He now co-directs AIDS-Free World and is chair of a foundation that funds grassroots projects addressing HIV/AIDS in Africa.

So what is it about the female condom that — pardon the pun — creates a barrier to widespread acceptance and use, both in the United States and in other countries?

Scientists and health advocates are trying to figure out the answer to that question.

Part of the problem is that in 15 years, there’s never been a second-generation product produced that improved upon the original version. Michael J. Free, head of technology at PATH, a nonprofit group based in Seattle that has redesigned the female condom, commented on the lack of competition in the development. “There’s no lack of interest, but we’ve been stalled,” he told The New York Times.

PATH is now seeking FDA approval for its version (more info on it here), which is supposed to offer improved ease of use and a more natural feeling sexual experience, but the process could be lengthy:

While the F.D.A. designates male condoms as Class 2 medical devices — meaning that a new maker has to pass tests only for leakage and bursting — it puts female condoms in Class 3, the same category as pacemakers, heart valves and silicone breast implants.

That decision was made in 1999 — after much debate, and well after the condom was in use overseas — because there was no clinical data on the effectiveness of female condoms, and failure could be life-threatening if the woman’s partner had AIDS. An advisory panel suggested not even calling it a “condom” and instead labeled it an “intravaginal pouch,” but the agency rejected that advice.

Names notwithstanding, the Class 3 listing means that any new design must pass clinical trials, which would cost $3 million to $6 million.

“That’s a huge, huge impediment, close to a 100 percent block, because no one’s willing to put up that sort of money,” Dr. Free said.

Design costs and prototype development have been covered by a combination of public and private funds, but no one is putting up money for the clinical trials or factory costs. Some investors cite the smaller-than-predicted American and European markets that never warmed to the original design.

There are some issues that even an abundance of development funds and a redesigned product can’t fix: the female condom can’t be used with discretion.

For that reason, married women, now one of the highest risk groups for AIDS in poor countries, rarely use it.

“I don’t want my husband to know that I am wearing a condom,” said Lois B. Chingandu, the director of SAfaids, an anti-AIDS organization in Zimbabwe.

“Condoms are almost undiscussable within a marriage” in Africa, she added. “It is something associated with casual sex. If a wife uses a condom, the message is that you have been unfaithful. If she even initiates the discussion, it tips the power scale. Men resist quite a lot, and it can result in violence.”

The female condom has developed a following among sex workers, however. And supporters say the condom’s failure in some countries was due more to poor marketing and inconsistent availability.

“People said, ‘Oh, it failed,’” said Mitchell Warren, former director of international affairs for the Female Health Company. “Well, it didn’t fail. It just wasn’t available, or its introduction was a bad program. People need to practice with it before it catches on.”

Plus: In 2005, health experts attended the Global Consultation on the Female Condom in Baltimore to review evidence of the female condom’s effectiveness in preventing pregnancy and sexually transmitted infections and to learn about countries’ program experiences. Slide presentations and panels from that conference are available online.