Insights & Updates – Page 35 – Global Reproductive Health at Duke

New study shows low, declining HPV vaccine follow-through in U.S.

June 14, 2018November 12, 2024 by Anna KatzNo Comments

Human papillomavirus (HPV) is one of the most common sexually transmitted infections, and causes about 31,500 cancers in the United States each year. It also has a vaccine--but many Americans aren't being vaccinated. The HPV vaccine is already underutilized in the United States, and a new study by researchers at the University of North Carolina found that HPV vaccine follow-through is declining over time. The vaccine, which is highly effective at preventing the development of abnormal cells that can progress to cervical cancer, is delivered in a series of doses. The Centers for Disease Control and Prevention (CDC) recommends that all children ages 11-12 should get two doses of the vaccine six to twelve months apart; adolescents older than 14 should get three shots over four months. Yet the survey of more than a million privately-insured Americans showed that vaccine follow-through declined from 2006 to 2014. The decrease was especially prominent among female patients, from 67% in 2006 to 38%...

RTI team provides key advice to Duke Big Data for Reproductive Health Team

June 13, 2018November 12, 2024 by Megan HuchkoNo Comments

On Monday afternoon, the Big Data for Reproductive Health Data+ Team met with Alex Pavluck and Alison Mitchell LeFew from RTI to describe their project and get direction in how to develop a “minimally viable product.” The meeting represents one of the first educational engagements of the Duke-RTI Collaboration. The goal for the 10-week Data+ project is to build a web-based application that will allow users to visualize and analyze contraceptive calendar data from the DHS. Students presented their research on currently available tools, identifying core elements they liked and key areas a new tool could improve. Pavluck, a senior manager for information and communication development for the Global Health Division of the International Development Group at RTI, shared his experience and provided advice on how to develop an MVP for user testing. The active discussion ranged from big picture needs to the technical details necessary to move the project forward. The meeting was a great example of key stakeholder...

LGBTQ Rights are Reproductive Rights

June 11, 2018November 12, 2024 by kb330@duke.eduNo Comments

If April showers bring May flowers, what do May flowers bring? June rainbows! Each June in the United States, individuals across the nation join in celebrating LGBTQ Pride Month, a time marked by celebration, protest, activism, and, of course, the bright rainbow Pride flag. The tradition was born out of the 1970 Gay Pride March, which took place in New York City to commemorate the Stonewall uprising. As the LGBTQ movement grew, so did Pride marches and within a few years, this form of political protest had spread across the United States, eventually expanding from a single march to a month of events for all LGBTQ people. Over the years, Pride has shifted from primarily a political protest, to a more celebratory occasion. The increasing sociocultural acceptance of LGBTQ people and same-sex relationships has played a role in this shift, and the recent Supreme Court decision in favor of marriage equality is undoubtedly worth celebrating. Yet queer communities certainly remain marginalized...

Australia establishes abortion clinic protections

June 11, 2018November 12, 2024 by kb330@duke.eduNo Comments

Australian state New South Wales (NSW) has passed a law establishing 150-meter “safe access zones” around abortion clinics. Protesters who intimidate or harass patients within 150 meters of the clinic could face jail time and other punishments. The bill also makes it illegal to film any person within the safe access zone without their consent. NSW is the fifth Australian jurisdiction to establish safe access zones and prohibit harassment of people seeking reproductive services. The bill’s passage marks an important stride toward reproductive freedom in Australia and a victory for reproductive health advocates around the globe. Photo credit: Peter Rae/AAP...

U.S. Supreme Court refuses to hear challenge of restrictive Arkansas abortion law

June 8, 2018November 12, 2024 by kb330@duke.eduNo Comments

The U.S. Supreme Court recently turned down a challenge to a restrictive Arkansas abortion law that ends the use of medication abortion in the state. The law would require physicians providing medication abortions--a series of two medications that safely terminate a pregnancy--to have a contract with a second doctor who has hospital admitting privileges. Though the state claims the law protects women’s safety, it effectively reduces the number of Arkansas abortion clinics from three to one and creates additional barriers for women to access care. This harmful law makes Arkansas the first state to effectively ban medication abortion. Photo Credit: Ricky Carioti/The Washington Post...

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

May 29, 2018November 12, 2024 by Megan HuchkoNo Comments

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...

Director’s Blog: May 2018

May 29, 2018November 12, 2024 by Megan HuchkoNo Comments

I’m excited to introduce a new monthly feature in which we reflect on current Center activities, upcoming events, and important reproductive health topics in the news. For my first blog, I want to reflect a little on why we wanted to create a Center for Global Reproductive Health at Duke, and what we are planning to do. We created this Center to help catalyze new relationships, research ideas and advocacy that will address the reproductive and sexual health disparities we see around the world. These stark disparities in health outcomes and human rights disproportionately impact women, and have remained present in the face of phenomenal expansions in technology, financing and health systems. They are driven by poverty, gender disparities, restrictive policies, and failure to recognize or implement effective, evidence-based solutions. We’ve all heard about the World Bank report that says more people have access to cell phones than toilets—well, certainly cell phone access is substantially greater than access to cervical cancer...

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

May 25, 2018November 12, 2024 by Megan HuchkoNo Comments

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....

Advocacy for Reproductive Justice

May 25, 2018November 12, 2024 by kb330@duke.eduNo Comments

Earlier this week, Willie Parker challenged members of the Duke Ob/Gyn Department to remember their role as patient advocates in an inspiring grand rounds lecture, “Advocacy for Reproductive Justice: How Much Fight is there in the Dog?” Dr. Parker, author of Life’s Work: A Moral Argument for Choice, a memoir of how his evangelical upbringing influenced his decision to become an abortion provider, talked about racial and ethnic disparities in unwanted pregnancies, and how the Reproductive Justice movement evolved to address these and broader inequities in sexual and reproductive health. He described how limitations in Medicaid coverage for pregnancy and childcare services disproportionately impact the same groups of women at highest risk for unplanned pregnancy. When access to abortion services is limited, as has been steadily happening for the past 15 years, it is these women who are most vulnerable to not be able to exercise their own choice in determining when and how they want to raise their family. Dr....

Bringing Multi-Purpose Prevention Technology Development into the Global Spotlight

May 14, 2018November 12, 2024 by kb330@duke.eduNo Comments

Multi-purpose prevention technologies (MPTs) are the future for female-driven sexually transmitted infection (STI) and unplanned pregnancy prevention. Although dozens of products are in the MPT development pipeline, including several at the final stages of clinical trials, progress in development has been slow, and investment paltry. In my last post, I discussed the technical and scientific barriers that are slowing down MPT research. Today I will highlight the comparable societal barriers, namely: lack of government willpower, widespread poor understanding of the depth and breadth of these health issues, and funding troubles. First, though HIV and unplanned pregnancies receive substantial attention in the fields of global health and development, other STIs tend to be much more overlooked. Fewer global health organizations conduct regular surveillance of non-HIV STIs, preventing more funding from going to their prevention. For instance, the World Health Organization’s (WHO) 2015 Report on global sexually transmitted infection surveillance reported an estimated 357.4 million new infections worldwide (roughly 1 million per...

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