Mexico to Offer Free HPV Vaccination in Federal District

Angela Castellanos

The Mexican State, the metropolitan area which surrounds the capital is implementing an HPV vaccination campaign aimed at students in the sixth grade.

Mexican
women have reasons to celebrate. In order to reduce the rate of cervical
cancer, the Mexican capital government has announced a free HPV vaccination
campaign for girls from the Federal District. 

Human
Papilloma Virus is one of the causes of cervical cancer. HPV infects 20 percent
of men and women in Latin America, but it does
not always result in cervical cancer. When it affects men, it can cause cancer
of the penis or anus. 

"There are
about 100 types of HPV, and just 30 or 40 of them attack the female and male
genitals. Moreover, there is an 80 percent chance of getting infected over the
lifespan," explained Nubia Muñoz Calero, Colombian pathologist and physician, a
member of the committee of scientists in charge of supervising the HPV vaccine
Gardasil’s clinic trials, and nominated for the Nobel Prize for Physiology and
Medicine 2008. 

According
to the Mexican governmental Subsecretaría
de Prevención y Promoción de la Salud
, the mortality rate due to cervical
cancer has decreased over the last 15 years. In fact, in 1990 there were 25.3
deaths for 100,000 women. In 2006, the rate was 14.6. However, this decrease
was not homogeneous within the country. Most of the Mexican victims are poor
women from states with a low human development index. 

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Nevertheless,
cervical cancer can be treated if it is detected early. According to the
National Survey on Reproductive Health (2003), just 70.7 percent of Mexican
women had a Pap smear in the last three years. 

The Pap
smear, a method used for early cancer detection, has a low detection rate, and often provides false
negative diagnosis, which is why the HPV vaccine is very important, pointed out
Muñoz. However, the Colombian scientist warned that the girls vaccinated
required early detection tests as well, since the vaccine is not 100 percent
effective, to prevent high grade damages and the cervical cancer associated to
HPV types 16 and 18. 

These HPV
types cause between 65 and 70 percent of the cervical cancer worldwide, and in Latin America respectively. 

In 2007,
the Mexican government launched the Programa de Acción Específico de Cáncer
Cérvico Uternino 2007-2012 (Specific Action Program on Cervical Cancer 2007-
2012), a comprehensive plan aimed "to reduce the mortality and morbidity rates
through the provision of excellent services for the promotion, prevention,
detection, diagnosis, treatment and suffering control, as well as the
responsible participation of the population on health care." 

Through the
program’s implementation, by 2012, the detection coverage will be 85 percent
every three years among women between 25 and 34 years old. Other goals are diminishing the mortality rate among women 25
years old or older by 27 percent, compared to the rate of 2006. Another goal is
to reduce the disparities of the mortality rate 50 percent. 

It is in
the framework of this program that the free distribution of the HPV vaccine was
considered. 

The Mexican
vaccination announcement came after Panama launched a national free HPV
vaccination campaign, last October. The Mexican vaccination will cover, so far,
the capital city, and will be provided to about 35,000 girls between 11 and 13
years old, in all the health care centers of Mexico City. 

As it is a
prophylactic vaccine, it has to be applied before the sexual life starts in
order to have better results, since the HPV is a sexually transmitted
infection. 

Last
December, thousands of girls received the first dose of the vaccine, as well as
a short information session, which included various sexuality topics and documentation
related to gender violence. 

The Mexican State, the metropolitan area which
surrounds the capital, announced that in 2009, it will implement a vaccination
campaign aimed at students in the sixth grade.

The HPV vaccine
has been sold in Mexico
since 2006, but it was only provided by the private health centers at a high
price of 600 US Dollars. The vaccine, in any of its marks, is one of the most
costly vaccines worldwide. Panama’s
budget for the vaccination of all 10-year-old girls is 5,6 million dollars. For
the implementation of the Mexican campaign, the government allocated about 10
million dollars. 

"The
governments should negotiate the prices with the pharmaceutical laboratories,
or work together at regional level in order to get lower cost prices through
PAHO’s Rotary Fund," recommended Muñoz.

Roundups Sexual Health

This Week in Sex: The Sexually Transmitted Infections Edition

Martha Kempner

A new Zika case suggests the virus can be transmitted from an infected woman to a male partner. And, in other news, HPV-related cancers are on the rise, and an experimental chlamydia vaccine shows signs of promise.

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

Zika May Have Been Sexually Transmitted From a Woman to Her Male Partner

A new case suggests that males may be infected with the Zika virus through unprotected sex with female partners. Researchers have known for a while that men can infect their partners through penetrative sexual intercourse, but this is the first suspected case of sexual transmission from a woman.

The case involves a New York City woman who is in her early 20s and traveled to a country with high rates of the mosquito-borne virus (her name and the specific country where she traveled have not been released). The woman, who experienced stomach cramps and a headache while waiting for her flight back to New York, reported one act of sexual intercourse without a condom the day she returned from her trip. The following day, her symptoms became worse and included fever, fatigue, a rash, and tingling in her hands and feet. Two days later, she visited her primary-care provider and tests confirmed she had the Zika virus.

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A few days after that (seven days after intercourse), her male partner, also in his 20s, began feeling similar symptoms. He had a rash, a fever, and also conjunctivitis (pink eye). He, too, was diagnosed with Zika. After meeting with him, public health officials in the New York City confirmed that he had not traveled out of the country nor had he been recently bit by a mosquito. This leaves sexual transmission from his partner as the most likely cause of his infection, though further tests are being done.

The Centers for Disease Control and Prevention (CDC)’s recommendations for preventing Zika have been based on the assumption that virus was spread from a male to a receptive partner. Therefore the recommendations had been that pregnant women whose male partners had traveled or lived in a place where Zika virus is spreading use condoms or abstain from sex during the pregnancy. For those couples for whom pregnancy is not an issue, the CDC recommended that men who had traveled to countries with Zika outbreaks and had symptoms of the virus, use condoms or abstain from sex for six months after their trip. It also suggested that men who traveled but don’t have symptoms use condoms for at least eight weeks.

Based on this case—the first to suggest female-to-male transmission—the CDC may extend these recommendations to couples in which a female traveled to a country with an outbreak.

More Signs of Gonorrhea’s Growing Antibiotic Resistance

Last week, the CDC released new data on gonorrhea and warned once again that the bacteria that causes this common sexually transmitted infection (STI) is becoming resistant to the antibiotics used to treat it.

There are about 350,000 cases of gonorrhea reported each year, but it is estimated that 800,000 cases really occur with many going undiagnosed and untreated. Once easily treatable with antibiotics, the bacteria Neisseria gonorrhoeae has steadily gained resistance to whole classes of antibiotics over the decades. By the 1980s, penicillin no longer worked to treat it, and in 2007 the CDC stopped recommending the use of fluoroquinolones. Now, cephalosporins are the only class of drugs that work. The recommended treatment involves a combination of ceftriaxone (an injectable cephalosporin) and azithromycin (an oral antibiotic).

Unfortunately, the data released last week—which comes from analysis of more than 5,000 samples of gonorrhea (called isolates) collected from STI clinics across the country—shows that the bacteria is developing resistance to these drugs as well. In fact, the percentage of gonorrhea isolates with decreased susceptibility to azithromycin increased more than 300 percent between 2013 and 2014 (from 0.6 percent to 2.5 percent).

Though no cases of treatment failure has been reported in the United States, this is a troubling sign of what may be coming. Dr. Gail Bolan, director of CDC’s Division of STD Prevention, said in a press release: “It is unclear how long the combination therapy of azithromycin and ceftriaxone will be effective if the increases in resistance persists. We need to push forward on multiple fronts to ensure we can continue offering successful treatment to those who need it.”

HPV-Related Cancers Up Despite Vaccine 

The CDC also released new data this month showing an increase in HPV-associated cancers between 2008 and 2012 compared with the previous five-year period. HPV or human papillomavirus is an extremely common sexually transmitted infection. In fact, HPV is so common that the CDC believes most sexually active adults will get it at some point in their lives. Many cases of HPV clear spontaneously with no medical intervention, but certain types of the virus cause cancer of the cervix, vulva, penis, anus, mouth, and neck.

The CDC’s new data suggests that an average of 38,793 HPV-associated cancers were diagnosed each year between 2008 and 2012. This is a 17 percent increase from about 33,000 each year between 2004 and 2008. This is a particularly unfortunate trend given that the newest available vaccine—Gardasil 9—can prevent the types of HPV most often linked to cancer. In fact, researchers estimated that the majority of cancers found in the recent data (about 28,000 each year) were caused by types of the virus that could be prevented by the vaccine.

Unfortunately, as Rewire has reported, the vaccine is often mired in controversy and far fewer young people have received it than get most other recommended vaccines. In 2014, only 40 percent of girls and 22 percent of boys ages 13 to 17 had received all three recommended doses of the vaccine. In comparison, nearly 80 percent of young people in this age group had received the vaccine that protects against meningitis.

In response to the newest data, Dr. Electra Paskett, co-director of the Cancer Control Research Program at the Ohio State University Comprehensive Cancer Center, told HealthDay:

In order to increase HPV vaccination rates, we must change the perception of the HPV vaccine from something that prevents a sexually transmitted disease to a vaccine that prevents cancer. Every parent should ask the question: If there was a vaccine I could give my child that would prevent them from developing six different cancers, would I give it to them? The answer would be a resounding yes—and we would have a dramatic decrease in HPV-related cancers across the globe.

Making Inroads Toward a Chlamydia Vaccine

An article published in the journal Vaccine shows that researchers have made progress with a new vaccine to prevent chlamydia. According to lead researcher David Bulir of the M. G. DeGroote Institute for Infectious Disease Research at Canada’s McMaster University, efforts to create a vaccine have been underway for decades, but this is the first formulation to show success.

In 2014, there were 1.4 million reported cases of chlamydia in the United States. While this bacterial infection can be easily treated with antibiotics, it often goes undiagnosed because many people show no symptoms. Untreated chlamydia can lead to pelvic inflammatory disease, which can leave scar tissue in the fallopian tubes or uterus and ultimately result in infertility.

The experimental vaccine was created by Canadian researchers who used pieces of the bacteria that causes chlamydia to form an antigen they called BD584. The hope was that the antigen could prompt the body’s immune system to fight the chlamydia bacteria if exposed to it.

Researchers gave BD584 to mice using a nasal spray, and then exposed them to chlamydia. The results were very promising. The mice who received the spray cleared the infection faster than the mice who did not. Moreover, the mice given the nasal spray were less likely to show symptoms of infection, such as bacterial shedding from the vagina or fluid blockages of the fallopian tubes.

There are many steps to go before this vaccine could become available. The researchers need to test it on other strains of the bacteria and in other animals before testing it in humans. And, of course, experience with the HPV vaccine shows that there’s work to be done to make sure people get vaccines that prevent STIs even after they’re invented. Nonetheless, a vaccine to prevent chlamydia would be a great victory in our ongoing fight against STIs and their health consequences, and we here at This Week in Sex are happy to end on a bit of a positive note.

Commentary Race

Black Lives Matter Belongs in Canada, Despite What Responses to Its Pride Action Suggest

Katherine Cross

Privileging the voices of white LGBTQ Canadians who claim racism is not a part of Canada's history or present ignores the struggles of Canadians of color, including those who are LGBTQ.

As I walked the streets of Toronto last month, it occurred to me that Pride Week had become something of a national holiday there, where rainbow flags and the Maple Leaf banners flying in honor of Canada Day on July 1 were equally ubiquitous. For the first time in my many years visiting the city—the place where I myself came out—the juxtaposition of Pride and the anniversary of Confederation felt appropriate and natural.

For some, however, this crescendo of inclusive celebration was threatened by the Black Lives Matter Toronto (BLMTO) protest at the city’s Pride March, often nicknamed PrideTO. The group’s 30-minute, parade-stopping sit-in has since come in for predictable condemnation. The Globe and Mail’s Margaret Wente dubbed BLMTO “bullies,” sniffed that its tactics and concerns belonged to the United States, and asked why it didn’t care about Black-on-Black crime in Canada. The Toronto Sun’s Sue-Ann Levy, meanwhile, called BLMTO “Nobody Else Matters,” also saying it “bullied” Pride’s organizers and suggesting we all focus on the real object of exclusion within the LGBTQ community: gay members of the recently ousted Conservative Party.

There is a lot to learn from this Torontonian incident, particularly around managing polite liberal racism—an especially important civics lesson in light of the past month’s tragedies in the United States. Privileging the voices of white LGBTQ Canadians who claim racism is not a part of Canada’s history or present means ignoring the struggles of hundreds of thousands, many of whom are LGTBQ themselves.

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Pride has always been a thoroughly political affair. It is, thus, hardly an “inappropriate time and place” for such a protest. It began as, and remains, a public forum for the unapologetic airing of our political concerns as a community in all its diversity. We may have reached a new phase of acceptance—the presence of Prime Minister Trudeau at Pride was a beautiful milestone in both Canadian and LGBTQ history—but Pride as a civic holiday must not obscure the challenges that remain. It is not a coincidence that the majority of transgender people murdered worldwide by the hundreds every year are Black and Latina, and that many of them are sex workers. That is part of the reality that BLMTO was responding to—the fact that racism amplifies homophobia and transphobia. In so doing, it was not just speaking for Black people, as many falsely contended, but advocating for queer and trans people of many ethnicities.

Even so, one parade-goer told the Globe and Mail: “It’s not about them. It’s gay pride, not black pride.” The very fact that Black LGBTQ people are asked to “choose” validates BLMTO’s complaint about Pride’s anti-Blackness, suggesting a culture where Black people will be thinly tolerated so long as they do not actually talk about or organize around being Black.

Indeed, BLMTO’s much-criticized list of demands seems not to have been read, much less understood. While drawing attention to the Black Lives Matter collective, it also advocated for South Asian LGBTQ people and those in First Nations communities, whose sense of not-entirely-belonging at an increasingly apolitical PrideTO it shares.

In each paint-by-numbers editorial, there was lip service paid to the “concerns” BLMTO has about Canadian police forces and racial discrimination, but the inconvenience of a briefly immobilized parade generated more coverage. Throughout, there has been a sense that Black Lives Matter didn’t belong in Canada, that the nation is somehow immune to racist law enforcement and, in fact, racism in general.

Yet to listen to the accounts of Black Canadians, the reality is rather different.

Janaya Khan, one of the co-founders of BLMTO, recently spoke to Canadian national magazine MacLean’s about the activist’s views on structural racism in the country. As a native of Toronto, they were able to speak quite forthrightly about growing up with racism in the city—up to and including being “carded” (a Canadian version of stop-and-frisk, wherein officers have the right to demand ID from random citizens) at Pride itself. And last year in Toronto Life, journalist and writer Desmond Cole talked about his experiences being raised throughout Ontario. He told a story of a traffic stop, none too different from the sort that killed Philando Castile earlier this month, after a passenger in his father’s car, Sana, had tossed a tissue out the window onto the highway. The officer made the young man walk back onto the highway and pick it up.

Cole wrote, “After Sana returned, the officer let us go. We drove off, overcome with silence until my father finally exploded. ‘You realize everyone in this car is Black, right?’ he thundered at Sana. ‘Yes, Uncle,’ Sana whispered, his head down and shoulders slumped. That afternoon, my imposing father and cocky cousin had trembled in fear over a discarded Kleenex.”

This story, of narrowly escaping the wrath of a white officer on the side of a motorway, could have come from any state in the Union. While Canada has many things to be proud of, it cannot claim that scouring racism from within its borders is among them. Those of us who have lived and worked within the country have an obligation to believe people like Cole and Khan when they describe what life has been like for them—and to do something about it rather than wring our hands in denial.

We should hardly be surprised that the United States and Canada, with parallel histories of violent colonial usurpation of Native land, should be plagued by many of the same racist diseases. There are many that Canada has shared with its southern neighbor—Canada had a number of anti-Chinese exclusion laws in the 19th and early 20th centuries, and it too had Japanese internment camps during the Second World War—but other racisms are distinctly homegrown.

The Quebecois sovereignty movement, for instance, veered into anti-Semitic fascism in the 1930s and ’40s. In later years, despite tacking to the left, it retained something of a xenophobic character because of its implicit vision of an independent Quebec dominated by white francophones who could trace their ancestry back to France. In a blind fury after narrowly losing the 1995 referendum on Quebecois independence, Premier Jacques Parizeau, the then-leader of the independence movement, infamously blamed “money and ethnic votes” for the loss. More recently, the provincial sovereigntist party, the Parti Quebecois, tried to impose a “Values Charter” on the province aimed at criminalizing the wearing of hijab and niqab in certain public spaces and functions. Ask Black francophones if they feel welcome in the province and you’ll get mixed answers at best, often related to racist policing from Quebec’s forces.

Speaking of policing and the character of public safety institutions, matters remain stark.

A 2015 Toronto Star special investigation found hundreds of Greater Toronto Area officers internally disciplined for “serious misconduct”—including the physical abuse of homeless people and committing domestic violence—remained on the force. In 2012, the same outlet documented the excessive rate at which Black and brown Torontonians were stopped and “carded.” The data is staggering: The number of stops of Black men actually exceeded the number of young Black men who live in certain policing districts. And according to the Star, despite making up less than 10 percent of Toronto’s population, Black Torontonians comprised at least 35 percent of those individuals shot to death by police since 1990. Between 2000 and 2006, they made up two-thirds.

Meanwhile, LGBTQ and Native Ontario corrections officers have routinely complained of poisonous workplace environments; a recent survey found anti-Muslim attitudes prevail among a majority of Ontarians.

Especially poignant for me as a Latina who loves Canada is the case of former Vancouver firefighter Luis Gonzales. Gonzales, who is of Salvadoran descent, is now filing a human rights complaint against Vancouver Fire and Rescue Services for what he deemed a racist work environment that included anti-Black racism, like shining a fire engine floodlight on Black women in the street and joking about how one still couldn’t see them.

One could go on; the disparate nature of these abuses points to the intersectional character of prejudice in Canada, something that BLM Toronto was quite explicit about in its protest. While anti-Black racism is distinct, the coalition perspective envisaged by Black Lives Matter, which builds community with LGBTQ, Muslim, South Asian, and First Nations groups, reflects an understanding of Canadian racism that is quite intelligible to U.S. observers.

It is here that we should return again to Margaret Wente’s slyly nationalistic claim that BLMTO is a foreign import, insensitive to progressive Canadian reality. In this, as in so many other areas, we must dispense with the use of Canadian civic liberalism as a shield against criticism; the nation got this far because of sometimes intemperate, often loud protest. Protests against anti-LGBTQ police brutality in the 1980s and ’90s, for example, set the stage for a Toronto where the CN Tower would be lit up in rainbow colors. And any number of Native rights actions in Canada have forced the nation to recognize both its colonial history and the racism of the present; from Idle No More and the Oka Crisis to the 2014 VIA Rail blockade, that movement is alive and well. Indeed, the blockade was part of a long movement to make the government acknowledge that thousands of missing and murdered Indigenous women constituted a crisis.

If we must wrap ourselves in the Maple Leaf flag, then let us at least acknowledge that peaceful protest is a very Canadian thing indeed, instead of redoubling racist insults by insinuating that Black Lives Matter is somehow foreign or that institutional racism is confined to the United States. Canada has achieved little of worth by merely chanting “but we’re not as bad as the United States!” like a mantra.

Far from being a movement in search of a crisis, Black Lives Matter and its intersectional analysis is just as well-suited to Canada as it is to the United States. In the end, it is not, per the national anthem, God who keeps this land “glorious and free,” but its people.