From Cameroun to the Pope: Reality Check Please

Damaris Mounlom

If the Catholic Church wants to stem new HIV/AIDS infections in Africa, they must recognize that women and girls are more vulnerable to new infections than their male peers because the "liberation of women" has not yet been fully realized.

This
week, Pope Benedict XVI makes his inaugural trip to Africa after
nearly four years as the head of the Roman Catholic Church.  During
this trip, Pope Benedict will visit Cameroun and Angola to make
preparations for the upcoming Second Special Assembly for Africa of the
Synod of Bishops. 

"The what?" you ask.  We wondered the same thing and decided to do a little research.

The
first Special Assembly, held in 1994, brought together Catholic leaders
from throughout Africa to focus on some of the continent’s most
pressing issues.  Intended to be an "occasion of
hope and resurrection," the Assembly examined fundamental challenges to
the health and well-being of Africans, including poverty, international
debt, HIV/AIDS, ethnocentricity, and "the liberation of women."

At this point, we’d like to ask our readers to review the list.  See anything odd?  As
a group of Camerounian advocates working to protect the rights of women
and young people, we take umbrage with the Church’s statement that the
"liberation of women" is a pressing concern for Africa, on par with
some of the world’s most intractable problems. 

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Is
the Church suggesting women instead remain subjected to the entrenched
gender inequality rampant not only in Cameroun, but throughout the
world?  We ask Pope Benedict XVI to enlighten us on the Church’s position on this matter during his trip to Cameroun, if so inclined.

If
the bishops truly want to stem new HIV/AIDS infections in Africa, they
must recognize that women and girls are more vulnerable to new
infections than their male peers precisely because the "liberation of
women" has not yet been fully realized.  Young
women in Cameroun between the ages of 15 and 17 are more than three
times as likely to be infected with HIV compared to young men in the
same age category.  By the time these girls reach the ages of 23 and 24, they are more than five times more likely to be infected.

Girls
and women are more vulnerable to HIV/AIDS because they face violence
and sexual coercion; lack the power to negotiate sex or marriage; have
unequal earning power; and lack access to education, including
comprehensive sexuality education. More than half of all women in
Cameroun have been subjected to violence, and 43% have experienced violence by their spouse  further increasing their vulnerability. 

Throughout much of Sub-Saharan Africa, marriage has become a risk factor for HIV.  The Church’s preferred HIV/AIDS prevention program of "chastity" and "fidelity," reiterated by Pope Benedict yesterday,
unrealistic for the vast majority of women who are unable to negotiate
when they have sex or with whom, and is a dangerous prescription that
threatens to keep women and girls vulnerable while the world turns a
blind eye. 

Despite
the fact that abstinence-only education has been proven ineffective
time and time again, these policies and programs have continued at the
expense of women and young people.  Why? 

The
post-Assembly report states that "The concerns of the Synod Fathers
were all the more justified in that the preparatory document of a
United Nations Conference held in September 1994 in Cairo – on African
soil – clearly seemed to wish to adopt resolutions contradicting many
values of the African family." 

The conference referred to is the International Conference on Population and Development (ICPD), which took place shortly after the First Assembly.  Hailed
by sexual and reproductive health and rights advocates as a victory for
women around the world, the Conference’s Program of Action, agreed to
by 179 governments, asserts a woman’s right to control her body and
sets global goals for achieving gender equality and eliminating
violence against women. 

The
Program of Action also committed to reducing infant, child and maternal
mortality; and ensuring universal access to reproductive health care by
2015, including family planning, assisted childbirth and prevention of
sexually transmitted infections including HIV/AIDS.  ICPD
will celebrate its fifteenth anniversary this year, once again
coinciding with the Special Assembly for Africa of the Synod of Bishops.  Coincidence?  Perhaps.  But perhaps not. 

We
call on our fellow Camerounians, Africans and citizens of the world to
make it clear to Pope Benedict XVI, that we refuse to relinquish our
"African values" of ensuring every woman and girl’s right to
comprehensive sexuality education; sexual and reproductive health
services; and a life free from gender inequality, violence and sexual
abuse.

This post first appeared on Akimbo.

Roundups Sexual Health

This Week in Sex: News From the HIV Epidemic

Martha Kempner

This week in sex: Scientists report the first case of HIV transmission to a patient adhering to PrEP protocols, two studies show a new vaginal ring can help women prevent HIV, and young people still aren't getting tested for the virus.

This Week in Sex is a weekly summary of news and research related to sexual behavior, sexuality education, contraception, STIs, and more.

With the death of Nancy Reagan, the 1980s AIDS crisis is back in the national spotlight. But, of course, HIV and AIDS are still ongoing problems that affect millions of people. This week in sex, we review scientists reporting the first case of HIV transmission to a patient adhering to PrEP protocols, two studies showing a new vaginal ring can help women prevent HIV, and evidence that young people still aren’t getting tested for the virus.

First Case of HIV Transmission While on Truvada

Last week, Canadian scientists reported on what they believe to be the first HIV infection in a patient who was following a PreP (Pre-Exposure Prophylaxis) regimen.

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PrEP is a method of HIV prevention. By taking a daily pill that contains two HIV medicines, sold under the name Truvada, individuals who are HIV-negative but considered to be at high risk of contracting the virus can prevent infection. Studies have found that PrEP is very effective—the Centers for Disease Control and Prevention estimates that people who take the medication every day can reduce their risk of infection by more than 90 percent from sex and by more than 70 percent from injection drug use. One study of men taking PrEP found no infections over a two-and-a-half-year period.

PrEP is less effective when not taken regularly, but the new case of reported PrEP failure involves a 43-year-old man who said that he took his medication daily. His pharmacy records back up that assertion. The man’s partner has HIV, but is on a drug regimen and has an undetectable viral load. The man did report other sexual encounters without condoms with casual partners in the weeks leading up to his diagnosis.

Dr. David Knox, the lead author of this case study, notes that it is difficult to know if a patient really did adhere to the drug regimen, but the evidence in this case suggests that he did. He concluded, “Failure of PrEP in this case was likely due to the transmission of a PrEP-resistant, multi-class resistant strain of HIV 1.”

Experts say, however, that they never expected PrEP to be infallible. As Richard Harrigan of the British Columbia Center for Excellence in HIV/AIDS told Pink News, “I certainly don’t think that this is a situation which calls for panic …. It is an example that demonstrates that PrEP can sometimes be ineffective in the face of drug resistant virus, in the same way that treatment itself can sometimes be ineffective in the face of drug resistant virus.”

Still, some fear that the new study will add to the ongoing debate and apathy that seem to surround PrEP. While some experts see it as a must-have prevention tool, others worry that it will encourage men who have sex with men to forgo using condoms and perhaps increase their risk for other sexually transmitted infections. Still, only 30,000 people in the United States are taking the drug—an estimated one-twentieth of those who could benefit from it.

A New Vaginal Ring Could Help Women Prevent HIV Infection

Researchers have announced promising results from two studies looking at new technology that could help women prevent HIV. The dapivirine ring, named after the drug it contains, was developed by the International Partnership for Microbicides. It looks like the contraceptive ring, Nuvaring, and is similarly inserted high up into the vagina for a month at a time. Instead of releasing hormones to prevent ovulation, however, this ring releases an antiretroviral drug to prevent HIV from reproducing in healthy cells. (A ring that could prevent both pregnancy and HIV is being developed.)

The two studies of the ring are being conducted in Africa. One study recruited about 2,600 women in Malawi, South Africa, Uganda, and Zimbabwe. It found that the ring reduced HIV infection by 27 percent overall and 61 percent for women over age 25. The other study, which is still underway, involves just under 2,000 women in seven sites in South Africa and Uganda. Early results suggest that the ring reduced infection by 31 percent overall when compared to the placebo.

Both studies found that the ring provided little protection to women ages 18-to-21. Researchers are now working to determine how adherence and other biological factors may have impacted such an outcome.

Young People Not Getting Tested for HIV

A study in the February issue of Pediatrics found that HIV testing rates among young people have not increased in the last decade. The researchers looked at data from the Youth Risk Behavior Survey (YRBS), which asks current high school students about sexual behaviors in addition to questions about drugs and alcohol, violence, nutrition, and personal safety (such as using bike helmets and seat belts). Specifically, the YRBS asks students if they’ve ever been tested for HIV.

Using YRBS data collected between 2005 and 2013, the researchers estimated that 22 percent of teens who had ever had sex had been tested for HIV. The percent who had received HIV tests was higher (34 percent) among those who reported four or more lifetime partners. Overall, male teens (17 percent) were less likely than their female peers (27 percent) to have been tested.

Researchers also looked at data from the Behavioral Risk Factor Surveillance System, which asks similar questions to young adults ages 18 to 24. Among people in this age group, between the years of 2011 to 2013, an average of 33 percent had ever been tested. This review of data also found that the percentage of young women who get tested for HIV has been decreasing in recent years—from 42.4 percent in 2011 to 39.5 percent in 2013.

The authors simply conclude, “HIV testing programs do not appear to be successfully reaching high school students and young adults.” They go on to suggest, “Multipronged testing strategies, including provider education, system-level interventions in clinical settings, adolescent-friendly testing services, and sexual health education will likely be needed to increase testing and reduce the percentage of adolescents and young adults living with HIV infection.”

Analysis Politics

Campaign Fact-Check: Ted Cruz Falsely Claims the Affordable Care Act Pushed Single Moms to Part-Time Work

Ally Boguhn

Sen. Ted Cruz (R-TX) falsely blamed the Affordable Care Act for keeping “single moms” in part-time jobs, ignoring his own opposition to policies that could actually help single parents living in poverty.

Sen. Ted Cruz (R-TX) falsely blamed the Affordable Care Act (ACA) this week for keeping “single moms” in part-time jobs, ignoring his own opposition to policies that could actually help single parents living in poverty.

Speaking at a campaign rally Monday in Las Vegas, Nevada, ahead of the state’s Republican primary, Cruz suggested that the ACA has worked as a barrier to keep single mothers from working full-time because they are instead forced to work multiple part-time jobs:

You know, the media tries to tell us that the Obama-Clinton economy is the new normal. That stagnation is what we should come to expect. That there’s nothing better. We have the lowest percentage of Americans working today since 1977. Wages have been frozen for 20 years. Median wages today are the same as they are, as they were in 1996. Now that has been driven by illegal immigration that Washington refuses to solve, and that has been driven by economic policies that hammer the living daylights out of small businesses …. Single moms, struggling to feed their kids, working two, three, four part-time jobs because Obamacare doesn’t let them work full-time. Seeing their wages held stagnant, driven down—all of that can turn around. And if we do the two major legislative initiatives I’m campaigning on—if we repeal Obamacare and pass a flat tax—we will see millions and millions of high-paying jobs for people struggling to achieve the American dream.  

But this assessment was utterly wrong. Not only did Cruz get the basic facts about the ACA’s effects on jobs incorrect, he also failed to take into account the policies that could actually help improve the lives of single mothers—many of which he has actively opposed. 

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A January study in policy journal Health Affairs found “little evidence” to support some lawmakers fears that the ACA’s employer mandate, which requires those with more than 50 full-time employees to offer health insurance, would shift many full-time workers to part-time as employers attempted to side-step the law. Although the study found small changes to part-time work among some groups, CNBC reported, this “could not be attributed to the Obamacare employer mandate.”

A September 2015 survey from the Kaiser Family Foundation and the Health Research & Educational Trust similarly found that between January and June 2015, the vast majority of employers did not push employees to part-time work or reduce the number of people they hired because of the ACA:

The percentage of firms that offer health benefits to at least some of their employees (57 percent) and the percentage of workers covered at those firms (63 percent) are statistically unchanged from 2014. Relatively small percentages of employers with 50 or more full-time equivalent employees reported switching full-time employees to part time status (4 percent), changing part-time workers to full-time workers (10 percent), reducing the number of full-time employees they intended to hire (5 percent) or increasing waiting periods (2 percent) in response to the law.

This is not the first time Ted Cruz has falsely claimed the ACA pushed people to part-time work. During a January GOP debate, Cruz said that the health-care law “is the biggest job-killer in this country, millions of Americans have lost their jobs, have been forced into part-time work.”

Fact-checkers and media outlets quickly called out the statement as a falsehood. Politifact gave Cruz’s assertion a “pants on fire” designation, writing, “By every measure, millions more people are working and millions fewer are stuck unwillingly in part-time work since the time the Affordable Care Act became law. The law might have affected part-time work for certain kinds of people, but that didn’t change the improvement in the overall numbers.”

There is one thing Cruz was right about, however: Wage stagnation is a huge problem for Americans. But according to economic experts, it isn’t health-care reform or “illegal immigration,” as Cruz suggested, that is primarily at fault.

Instead, the real culprits responsible for wage stagnation, which continues to fuel economic inequality in the United States, are policymakers who have prioritized raising the incomes of the top 1 percent of earners. Lawrence Mishel, Elise Gould, and Josh Bivens explained in a January 2015 report for the Economic Policy Institute that “wages were suppressed by policy choices made on behalf of those with the most income, wealth, and power.”

Among those policy changes listed by Mishel, Gould, and Bivens has been the failure to raise the minimum wage, which they write “had especially adverse effects on women” and people of color.

“Less than half of all workers are women, but they account for 75 percent of workers in the 10 lowest-paid occupations and about 60 percent of minimum wage workers,” explained Laura D’Andrea Tyson, the former head of the Council of Economic Advisers and the National Economic Council, in a 2014 article for the New York Times.

“And most women earning the minimum wage are not teenagers, or wives who can rely on a spouse’s income. About three-quarters of female minimum wage workers are above the age of 20, and about three-quarters of these women are on their own. Many, of course, are working and taking care of children,” Tyson continued.

In other words, many of the single mothers Cruz expresses such concern for would disproportionately benefit from increasing the minimum wage.

Yet Cruz has steadfastly opposed doing so. Speaking at a private donor event in January 2015, the Texas senator claimed that the existence of a minimum wage at all “hurts the most vulnerable.”

Cruz also voted against raising the minimum wage during his time in Congress. In 2014, he voted against the Minimum Wage Fairness Act, and in 2015 he voted against a budget amendment introduced by Sen. Bernie Sanders (I-VT), which would have established “a deficit-neutral reserve fund relating to promoting a substantial increase in the minimum wage.”

The worry Cruz showed for single mothers and their children also seems to fall short when it comes to other policies advocates say could make a difference in the lives of that group. Take paid leave, for example, which would provide paid time off to care for a new child or sick family member. Single parents face a greater risk that “caregiving will conflict with work,” according to the Center for American Progress.

A 2015 study of low-income mothers in New York City conducted by the Community Service Society found that, lacking paid family leave, many women with a new child experienced “financial hardships and anxiety about holding on to their jobs, forcing them to return to work quickly, some when their infants were just two or three weeks old.” Many were also forced to leave the workforce altogether because of lack of accommodations and job security.

“Because most of these women quickly exhausted their accumulated sick leave or few vacation days, and because they received no other form of compensation, they soon fell behind in their ability to pay their bills—even if they returned to work only a few weeks after having given birth,” the study found. “When employed, these women had lived very close to the edge, so the absence of a regular paycheck, even for only a short time, was enough to put them over the brink.”

Yet Ted Cruz does not support federal mandates for paid family leave that could help relieve some of the financial pressures parents face that force some out of the workforce altogether. Last September, Cruz told a representative of Make It Work Iowa that while he thinks “maternity leave and paternity leave are wonderful things” that he supports “personally,” he nevertheless doesn’t “think the federal government should be in the business of mandating them.”

Although Cruz may feign concern for “single moms, struggling to feed their kids,” his policy positions show a clear lack of desire to enact changes that would actually help those families.