New studies show HPV screening is less expensive and more efficient when offered at community health campaigns compared to health clinics in rural Kenya

New studies show HPV screening is less expensive and more efficient when offered at community health campaigns compared to health clinics in rural Kenya

Cost concerns now dominate considerations for the expanded use of HPV screening for cervical cancer prevention in high and low-resource settings. As part of a trial comparing two implementation strategies for HPV testing offered via self-collection, our team recently published innovative analyses of the material and time costs for each strategy. In the larger trial, the team showed that HPV-screening through community-health campaigns (CHCs) reached more women than testing in government-supported health facilities. These new papers show that HPV-screening through CHCs was also lower in cost and provided a quicker and more efficient experience for women compared to offering HPV screening at health clinics in rural Kenya. The next step is a cost-effectiveness analysis to compare alternative screening and treatment strategies using primary data from this study along with, published data to determine the cost per disability-adjusted life year (DALY). These results can be used to help policy-makers and funders make key decisions about how to implement cervical cancer prevention...
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Guttmacher-Lancer Commission on Sexual and Reproductive Health and Rights releases report in special Lancet edition

Guttmacher-Lancer Commission on Sexual and Reproductive Health and Rights releases report in special Lancet edition

Last week, the Lancet published a series of articles resulting from the Guttmacher-Lancet Commission on Sexual and Reproductive Health and Rights. This important commission highlighted the links between SRH and rights, and the crucial role that both play in sustainable development. The commission advocates for inclusion of SRH services into universal health coverage, as one step in making them accessible and affordable to all individuals, regardless of age, race, SES, sexual orientation or sexual identity. Finally, they extol countries to make crucial reforms to promote gender equality and give women greater control over their bodies.  This timely series of articles can be found at the Lancet website....
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Despite Government Policy, Cervical Cancer Progress Stalls in India

In what might have been a leap forward for reproductive health, the Indian government unveiled an national oral, breast and cervical cancer detection protocol in 2016.  At the time, the initiative was lauded by public health professionals.  However, with little progress to show, the Ministry of Health and Family Welfare is attracting criticism. India leads the world in cervical cancer mortality with over 70,000 deaths per year.  Yet, its women often can't access appropriate screenings, and the government immunization schedule fails to include the HPV vaccine.  This contradicts vaccination recommendations by the WHO and the country's own National Technical Advisory Group on Immunization. It seems India may suffer from misgivings similar to those driving the worldwide anti-vaxxing movement.  A 2009 HPV vaccination trial of 25,000 Indian girls was stopped after the unrelated deaths of seven participants sparked public outcry. Stigma and logistical challenges also complicate cervical cancer screening efforts.  Considering India's "burgeoning youth population that is sexually experimenting at a younger age," this might prove an...
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Harnessing Culture for Change

Harnessing Culture for Change

Today is International Day of Zero Tolerance for female genital mutilation (FGM). FGM is comprised of all procedures which alter or injure female genitalia for non-medical reasons. It is internationally recognized as a violation of human rights, and eliminating this practice is one of the Sustainable Development Goals and a key focus area for many governments around the world. It is estimated that at least 200 million women and girls have undergone FGM and almost 40% of girls between the ages of 15 and 19 are currently affected. In order to make lasting change on this issue, more is needed than national legislation. FGM is deeply rooted in culture and religion, and local traditions need to be taken into account and understood to advocate for change. Read the latest editorial from The Lancet addressing this issue, and offering solutions for how we can harness culture for change....
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Ireland to Vote on Abortion Law Reform

Ireland to Vote on Abortion Law Reform

At the end of May, the Irish government will hold a referendum to decide if their long-standing constitutional ban on abortion should be repealed. Currently, unborn fetuses have a right to life equal to living humans, which has been interpreted as a ban on abortion in almost every single circumstance. If the referendum passes, the Irish Parliament will have the power to enact laws regulating abortion. Read the New York Times article for more information on the potential new regulations and Christine Ryan's blog to learn more about abortion law reform. Photo courtesy of: Clodagh Kilcoyne/Reuters  ...
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HIV Interventions Effective in Uganda, New Study Says

HIV Interventions Effective in Uganda, New Study Says

Recent research out of Uganda, described in a Nov. 30 HealthDay article, offers exciting insights into curbing HIV’s spread. The study, conducted by a team from Johns Hopkins University, offered 34,000 people in the country’s Rakai District free male circumcision, condoms and antiretroviral therapy. Interventions also included the “promotion of safe sex,” according to the article, which was reproduced by U.S. News & World Report. Researchers said the district’s HIV infection rate declined by 42 percent from 1999 until 2016. Unfortunately, however, they noted gender-based differences in impact; while there was a 50 percent reduction in new cases among males, females saw a less substantial 30 percent decrease. According to Dr. Mary Kate Grabowski, assistant professor at Johns Hopkins, "this difference may have been due to the direct risk-lowering effect of circumcision for men, plus the fact that infected women were more likely than men to use antiretroviral therapy and thus were less likely to transmit the virus to male partners.” As officials have...
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Latin America Sees Uptick in HIV Among Key Populations

Latin America Sees Uptick in HIV Among Key Populations

As public health advocates around the globe celebrate successful responses to HIV/AIDS this World AIDS Day, officials are sharing sobering news about the disease’s incidence in Latin America. Unfortunately, the region has seen a rise in new infections, catalyzed by societal abuse of women and men who have sex with men (MSM), according to a Nov. 24 article by the Agence France-Presse. “Our statistics clearly show that where there is violence there is HIV,” UNAIDS deputy director Luiz Lourdes said. Lourdes referred to evidence indicating female victims of violence are perhaps 30 to 50 percent more likely to contract HIV than their non-abused peers. Such data is unfortunately extremely pertinent in Latin America, which officials say is the most dangerous region for women. According to Lourdes and Agence France-Presse, “more than 30 percent of young women in Latin America said they have suffered physical or sexual violence.” As they face marginalization, women and MSM are less likely to participate in HIV/AIDS reduction campaigns....
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16 Days of Activism Against Gender-Based Violence

16 Days of Activism Against Gender-Based Violence

Cultural complexity is an integral dimension of health, forcing practitioners to strike a balance between being relativistic and intervening when social traditions threaten a population’s health and human rights. South Africa has been thrust into this tight spot, as a cultural practice called ukuthwala facilitates abduction and sex trafficking of adolescent girls, according to a Nov. 29 article by the Mail & Guardian.   Originally a stepping stone toward marriage for consenting couples, ukuthwala has now evolved to include “the abduction of a girl or a young woman by a man and his accomplices with the intention of forcing her family to agree to a marriage,” the media outlet said. This of course constitutes a grave denial of women’s rights to choose their partners and determine what happens to their bodies. According to Girls Not Brides, 1% of South African girls under 15 are married, as are 6% of those under 18. However, these figures do not account for differences between rural...
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Global Public Health Community Celebrates World AIDS Day

Global Public Health Community Celebrates World AIDS Day

The global health community is no stranger to intractable issues or creative ways to confront them, and World AIDS Day—observed each Dec.1—plays a valuable role in catalyzing conversations about ending “one of the most destructive pandemics in history." This year’s theme is “Increasing Impact Through Transparency, Accountability, and Partnerships,” Ambassador Deborah L. Birx, U.S. Global AIDS Coordinator & U.S. Special Representative for Global Health Diplomacy at the U.S. Department of State revealed in a Nov. 1 blog post on HIV.gov. Started in 1988, World AIDS Day offers “a time to honor those who have lost their lives to AIDS, communicate our ongoing commitment to assist those who are living with or at risk for HIV, and celebrate the caregivers, families, friends, and communities that support them,” Birx said. Indeed, the event is simultaneously retrospective and prospective. While innovative treatments and programs—including antiretroviral therapy, condom distributions and mother-to-child transmission (MTCT) reduction campaigns—have, in many ways, transformed HIV since it was discovered in 1984, there...
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Indonesian Military Continues Virginity Tests

Indonesian Military Continues Virginity Tests

In a concerning violation of female soldiers’ reproductive and human rights, Indonesia’s military reportedly continues to conduct invasive “virginity tests” on women recruits, despite a 2014 statement by the World Health Organization that such examinations have “no scientific validity.”  Human Rights Watch made the allegation in a Nov. 23 special report, citing “senior military and police officers with knowledge of the ‘virginity testing’ policy.” Indonesian officials purport a “two-finger test” that assesses a woman’s hymen can accurately indicate whether she is a virgin, if she is pregnant and how mentally sound she is.  As Fuad Basya, a spokesman for the military, said in 2015, “If they are no longer virgins, if they are naughty, it means their mentality is not good.” Such attitudes, which equate virginity with morality, may foster a toxic culture surrounding sexuality.  Indeed, an August editorial VICE editorial chronicles the challenges of obtaining emergency contraception as an unmarried woman in Indonesia, including “slut-shaming pharmacists, slow-a** clinics, and weird WhatsApp...
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