A workshop about the criminalisation of HIV transmission was never going to be a cheerful event, but it was surprising to me how enthused everyone was in discussing this issue. Even though the day was murky, a selection of our office sacrificed an hour spent in a warm cafe with a bowl of soup, to attend an optional lunchtime session called Behind the Bars that explored the reason behind the criminalisation of HIV in various countries.

Instead of delving through facts and statistics we were to be focussing on fictional but realistic situation. The story we were given went as follows: a young man named Bill goes to the pub one night, and after a few drinks he ends up going home with a woman and having sex. He wakes up with a shocking hangover and remembers that he hadn’t used a condom.

After a visit to his local clinic where a number of tests are carried out on him, he receives the news that he is HIV positive. During his post test session, the counsellor asks him if he is in contact with the person he slept with that night. Bill remembers her first name and the college she says she went to, but nothing else. Bill had never previously been tested for HIV, but has not previously had unprotected sex with many other people.

During the session, when discussing Bill’s options the counsellor mentions that if the woman was aware that she was HIV positive then she could be criminally liable under the ‘Offenses Against the Persons Act’ from 1861 since she didn’t disclose her status. Bill decides to phone the police. At this point, the story is over to us. The email I received over a week ago, inviting me to the session, read: ‘Can you handle the truth? Can the evidence of HIV transmission ever be crystal clear?’ I was about to find out.

Divided into 4 groups (one for each of the characters: Bill, the girl, the counsellor and the police officer) and armed with fat felt tip pens in garish colours, we began discussing our roles. What were each of these characters thinking? How would they feel about the situation and what would they want to do? How would our actions alter the course of this story?

It was agreed upon that Bill would feel frightened and angry about the situation and may want to place the blame on someone else. This is the basis for the law that exists regarding HIV transmission in many countries around the world. But what would Bill have to gain from placing the woman in prison? No one could say for sure what Bill would do. On one hand, he could feel sympathetic towards the woman because she may have the virus unknowingly. Or, he could feel guilt for giving the virus to her if he had it previously. Or he could just be plain angry.

The other group then spoke about the woman – who was she and did she know her HIV status at all? If she was to be prosecuted, how would evidence be found against her? Maybe if she was arrested she would be asked to do a HIV test, and if she was found to be positive would she immediately go to prison? ‘It’s just one person’s word against another,’ said one participant.

The counsellor had a lot of responsibility too, as it would be up to them to advise Bill and help the police find evidence if the woman was to be put on trial. A lot of other questions cropped up – if evidence was required for the case (such as the HIV status of Bill and the woman and their sexual history) could they be obtained without infringing the human rights of the people in question? Would any of us want our private records leaked during an investigation? Should the information be released if that could potentially secure someone’s freedom or should it remain sealed? With our power came a huge responsibility and it was up to us to decide.

Finally, the police would be responsible for carrying out the investigation. They would of course be obliged to search for evidence and find records that pointed to the ‘criminal’ who passed this virus on to Bill. ‘But isn’t this just another form of discrimination?’ said another participant. ‘Are all the people with HIV just going to end up in prison?’ Our final task was to discuss what measures should be taken to change this law – we had to think about how we could protect people from this virus in a way that doesn’t alienate and stigmatize a group in our society. But then we all realised that it was 1:30 and so packed up our pens and slowly filed out of the door, chatting noisily as we headed for lunch.

In truth, criminalising HIV is just another tool with which to frighten us and encourage safe practices. But does scaring us really work? I once received a card from the NHS on St. Valentine’s Day that said: ‘Roses are red, violets are blue, one in 10 have Chlamydia, don’t let it be you!’ in big horrific lettering. In all honesty, most of the people I knew just laughed at this when they got one themselves. You need to work with the people you want to help (whether it’s people with HIV or young people) not try to frighten them with the threat of STIs or HIV. In the future, we should all skip lunch and try to work out this issue, because until we campaign for a change in the law there won’t be one.

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The Guttmacher Institute held a media launch in London yesterday, in which they discussed the new data they have gathered regarding the number of global legal and clandestine abortions.

As part of my two week internship with IPPF I was asked to cover the event and so I waited nervously, as seasoned members of the British press descended upon the launch to hear Dr Sharon L.Camp (President of Guttmacher), Dr Akinrinola Bankole (Director of International Research for Guttmacher) and Dr Kelly Culwell (Senior Advisor on Abortion for IPPF) as they spoke about the falling rate of abortion.

However, not everything is looking good. Even someone like me, who has never attended a press conference on this issue or read up on it in great detail, could see that the statistics that emerged on illegal abortions demanded attention.

For instance, while the number of legal abortions have fallen (from 46 million in 1995 to 42 million in 2003), the number of women resorting to clandestine abortions is static. Also the report has uncovered that for every one legal abortion, two illegal and possibly dangerous abortions take place.
In the developed world, progress is rapid in making abortions safer and easier to access, but this is not so in many parts of Africa and Latin America. Limited services and restrictive laws mean that most women have few alternatives.

Annually, 20 million unsafe abortions take place, resulting in over 70,000 deaths. The report finds that liberalising abortion laws could help reduce this figure. In South Africa, once restrictive laws against abortion were lifted in 1996, there was a 50% decline in deaths due to abortion.
Dr Culwell agrees that liberalizing laws could lower the need for dangerous abortions, but says that ‘the law is not enough. ‘In order to lower unintended pregnancies which could lead to unsafe abortions, there is a pressing need for ‘new contraceptive technology and family planning services,’ says Dr Camp.

The Netherlands, a country in which the abortion rate is relatively low (10 per 1000 women) is an example of what can be achieved with good access to contraception and health care. The ‘Double Dutch’ system recommends the use of two contraceptives at a time.

The figures on clandestine abortions in the developing world were described as ’significant and tragic’, though Dr Camp did say that ‘it is not impossible to lower international rates of illegal abortions substantially.’

Women are paying the ultimate price because of inadequate pregnancy and birth services, according to the World Health Organisation. Please sign the petition that calls on governments to meet their commitments on sexual and reproductive health.

The HIV/Aids pandemic is claiming hundreds of thousands of lives each year. Over 200 million women, mainly in the less developed countries, do not have access to contraceptives. Unsafe abortions cost the lives of 67,000 women every year while millions of others suffer from injury, illness or disability.

Those shameful statistics came under the spotlight at a recent forum on sexual and reproductive health and development in Berlin (2-4 September 2009).

The forum, attended by over 400 representatives of NGOs from 131 countries, was held to mark the 15th anniversary of the International Conference on Population and Development (ICPD) held in Cairo.

According to Laura Villa Torres of the Mexican Youth Network for Sexual and Reproductive Rights, the ICPD was a “groundbreaking moment in birth and sexual policy and family planning”.

“Until then,” she explained, “demographic policies both at the national and international level were characterised by undemocratic and sometimes even racist rules, such as forced sterilisations in determined ethnic groups.”

The ICPD underlined the importance of gender equality and of improving the status of women, and called for family planning to be made universally available by 2015, providing estimates of the national resources and international assistance that would be required.

However, those goals are still a long way from being achieved.

Gill Greer of the London-based International Planned Parenthood Federation said: “No doubt there has been progress, but it has been uneven and selective.

“The right to the highest attainable standard of health, particularly sexual and reproductive health, continues to elude millions of people, especially the poor and marginalised. Nobody should be dying for having sex. And yet, it happens every day.”

The fall in funding for sexual health highlights the failure of governments to address the problems.

Greer explained: “Between 1994 and 2008, funding for reproductive health as a proportion of health aid dropped from 30 to 12 per cent.”

According to Greer, the Vatican’s condemnation of sexual education and the conservative approach of former US president George W. Bush helped “political opposition to the ICPD programme to resurface, facilitating worldwide attacks against programmes for sexual and reproductive health”.

Financial rescue packages have further squeezed resources for human and development programmes, and environmental causes are taking precedence over sexual health issues.

However, Thoraya Ahmed Obaid, executive director of the United Nations Population Fund (UNFPA), believes money is being lost as a result.

The UNFPA sponsored the Berlin forum along with the German government, and Obaid told media representatives: “An additional dollar invested in voluntary family planning comes back at least four times in saved expenses.”

She added: “It would cost the world $23 billion a year to stop women from having unintended pregnancies and dying in childbirth, and to save millions of newborns.” The figure, she said, is equivalent to the sum that governments spend on military funding in just ten days.

Heidemarie Wieczorek-Zeul, German minister for economic cooperation and development, made a called for governments of industrialised countries to set aside one percent of their economic emergency stimulus funds and put it towards development needs.

Wieczorek-Zeul said the theme for global policies must be: “It is not the market, stupid, it is the people who matter.”

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A new contraceptive that promises to make long-term birth control more acceptable to men is to be tested in Scotland.

Previous attempts at popularising the male ‘pill’ have foundered because, although effective, they have involved weekly injections. But a new combination of hormones means that the jabs now only have to be administered once every two months.

Scottish couples are now being urged to come forward to help researchers trial the new method, which stops sperm production. The bi-monthly jab combines testosterone and progesterone. The addition of the progesterone hormone makes it possible to use less testosterone and also helps make the effects last longer than previous versions.

The team are now searching for 20 couples in south-east Scotland to take part in a one-year international trial involving 200 couples, run by the World Health Organization.

Professor Richard Anderson, from Edinburgh University’s reproductive and developmental sciences division, said a previous study in Scotland with the weekly male jab had shown that such a method worked.

“That was extremely successful and proved the concept that an injectable hormone could stop men’s sperm production to very good contraceptive levels and be fully reversible,” he said. “It was a proof of concept rather than anything that was ever going to be used, but it did prove that it could be done.

“What we are doing now is a substantial refinement of that, using the same theoretical approach of hormone injections that temporarily stop men producing sperm. The idea is to check that it really is a good contraceptive.”

The new study will recruit men under the age of 45 with female partners under 37, with regular periods and no medical reason preventing pregnancy.

Tests have shown that the injection reduces a man’s sperm count down from above 20 million sperm per millilitre to zero in most men, and to less than one million in others.

Such as result would provide better contraceptive protection than condoms, and a similar success rate to the female pill.

“Many of the couples we see for this type of study will be those with existing contraceptive problems who recognise that although theoretically there are a lot of options, you can run out quickly,” Anderson explained.

But would men want the jab even if it were available in a more usable form? Anderson said he was in no doubt that there would be market for the male jab. “The surveys we have done have been very positive and particularly positive from women as much as men.

“You are in a stable relationship. You have had a baby or two. You have taken the reproductive burden on throughout. Maybe it’s about time someone else took a turn.”

Anderson said it was too early to talk about side-effects, but no serious problems were expected. Other hormone related treatments, such as the pill and hormone replacement therapy (HRT) have been linked to certain cancers.

“The risks with things like HRT and the pill are emerging after tens of millions of women have taken them for decades,” he said. “These have shown that the risks, while real, are very small and take a vast amount of exposure to come to light.”

A spokesman from the Family Planning Association said: “It is important that research continues to try to give men more contraceptive choice. But it is crucial that any new contraceptive is rigorously tested to make sure it is incredibly safe and effective.”

Source: Scotsman.com, 4 October 2009

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Sex education doesn’t have to make you cringe – it can make you laugh, like these videos featuring Monty Python, Ali G and more.

Ali G Sex Ed Video

Ali G discusses Sex Education

Breast Education: 1950’s Sex Ed Parody

Monty Python’s sex-ed

SEX EDUCATION