News Sexual Health

New Report from CDC Finds Drop in Risky Sexual Behavior

Martha Kempner

This week the CDC released a report that suggests that Americans are practicing fewer risky behaviors when it comes to HIV transmission.

This week the CDC released a report that suggests that Americans are practicing fewer risky behaviors when it comes to HIV transmission. Researchers analyzed data from the National Survey of Family Growth (NSFG) collected between 2006 and 2010 and compared it to data collected in for the same survey in 2002.  The NSFG measures HIV-risk with questions that ask about oral, vaginal, and anal intercourse, same-sex sexual behavior, condom use, and drug use. 

The report found that in 2006–2010 approximately 10 percent of men and 8 percent of women reported at least one of the HIV risk-related behavioral measures examined.  This represents a decline from 13 percent of men and 11 percent of women who reported one or more of these measures in 2002.  Researchers believe that the decline appears to be due to a decrease in sexual risk-taking behaviors.   For example:

  • In 2006‒2010, 3.9 percent of males and 1.8 percent of females had five or more sexual partners compared to 4.6 percent of males and 2.4 percent of females in 2002.
  • In 2006‒2010, 0.7 percent of males and 0.8 percent of females had a partner who injects illicit drugs compared to 2.3 percent of females and 2.9 of males in 2002.  
  • In 2006‒2010, 1.4 percent of females had a male partner who had sex with other men compared to 2.3 percent in 2002.  

According to Anjani Chandra, the report’s lead author, the reasons for the decline in risk behaviors is not clear. She notes that “some of the public health messages might be getting through. It also could be that people are reluctant to disclose that they engage in risky behaviors.  But, it could be real and reflect actual changes in behavior.”

Chandra also points out that the improvements are not the same across all demographics.  For example, 16 percent of young black men ages 15 to 24 reported at least one HIV risk-related sexual behavior, compared with 8.7 percent of Hispanic men and 6.5 percent of young white men. In addition, men who had served time in prison were far more likely (27 percent) to engage in at least one HIV risk-related sexual behavior than men who had not (7 percent) been in prison. 

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Approximately 1.2 million people in the United States are living with HIV and new cases have leveled off at about 50,000 per year though it estimated that 20 percent of HIV-positive individuals do not know their status.  

Chandra explained that this study was valuable because it looked at behaviors on a “household level” rather than just looking at high-risk populations as HIV research has often done.  Not everyone, however, agreed that this was a new or beneficial approach.  Philip Alcabes, an associate professor in the School of Health Sciences at Hunter College/City University of New York, told USA Today that he thought this report was still looking at ADS through the “moralizing lens” of 1981: “Having failed to advocate for structural changes that would actually reduce risk of HIV acquisition and having failed to implement widespread, easily accessible syringe exchange programs, federal agencies instead spend their time studying personal behavior.”

Roundups Sexual Health

This Week in Sex: A Reason to Celebrate on Tax Day?

Martha Kempner

Same-sex married couples get a long-awaited policy change (but maybe not a tax break), there’s encouraging news about the development of a male contraceptive method, and the month of April brings some much-needed attention to sexually transmitted diseases.

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

Tax Day 2016: A Reason to Celebrate for Same-Sex Couples

Many in the United States dread this time of year because it means dealing with the Internal Revenue Service (IRS). But there is something to celebrate this time around: 2016 is the first year that every married same-sex couple can file both federal and state taxes together.

After the U.S. Supreme Court ruling striking down part of the Defense of Marriage Act in 2013, the IRS changed its rules to allow legally married same-sex couples to be treated as married for federal tax purposes. While this was a step forward for equality, it actually made tax filing far more complicated for some couples, as NPR explains. Those who lived in a state where same-sex marriage was not recognized would have to file federal taxes as a married couple, but state taxes as individuals. To make matters trickier, state taxes are often based on your federal tax return; some couples had to create mock individual federal returns just to figure out what they owed their state.

This all changed in June 2015, when the Supreme Court ruled in Obergefell v. Hodges that no state can prevent same-sex couples from marrying and all must recognize their unions, effectively legalizing marriage equality nationwide. So this makes Tax Day 2016 the first day that all married couples—regardless of gender—will be treated equally.

While many are celebrating the symbolic victory, some couples may be shocked to find out that they actually owe more taxes as a married couple.

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Another Step Toward Male Contraception

Over the last few decades, researchers have developed numerous ways to prevent pregnancy, from hormonal pills that block ovulation to IUDs that slow the movement of sperm through the reproductive tract. Up until now, male contraception has been limited to one barrier method, condoms, and one permanent one, vasectomies. Now, a new study lends some proof of concept for possible reversible male contraception methods.

As Rewire has reported, one method in development, known as Vasalgel, is intended to be injected into the vas deferens and create a physical barrier preventing sperm from leaving the testicles. Scientists behind Vasalgel say they intend for it to be reversible with another injection. This could be on the market as soon as 2018. But scientists are still looking for other ways to temporarily render males infertile—possibly ones that do not involve an injection into the testicles.

A new study suggests new chances for one such method. University of Virginia researchers are focused on an enzyme known as TSSK2, which helps make sperm motile. They think this enzyme could be the key to a contraceptive method because it is only found in the testicles and only involved in the very last state of sperm production. In theory, this means that blocking this enzyme could produce nonswimming sperm without causing side effects in the rest of the body. They have found a way to mass produce this enzyme in a laboratory, and their next step is to test existing drugs to see if any can bond only to TSSK2 in the testicles without affecting the rest of the body.

Clearly, they are years away from an actual male birth control pill based on this concept. But this is not the only idea for a male birth control pill under development. As Rewire reported last year, other scientists are working with existing drugs to block a protein called calcineurin and have successfully rendered mice infertile by doing so.

While men wait—though it’s still unclear if many are really interested in their own pill—we should all remember that between condoms, pills, patches, rings, and IUDs, there are many methods couple can rely on for preventing pregnancy.

April is STD Awareness Month

With so many months and even weeks dedicated to disease, causes, or remembrances, it can be easy to let them pass unrecognized. But we here at Rewire thought it was important to remind our readers that April is STD Awareness Month, because the epidemic in this country is growing out of control. For the first time in a decade, cases of chlamydia, gonorrhea, and syphilis are all on the rise.

Syphilis—a disease that not long ago, we thought could be eradicated—has increased by 40 percent between 2010 and 2014. While much of this increase is seen in men who have sex with men, rates among women are increasing as well. There has also been an increase in cases of ocular syphilis, which infects the eyes and can cause permanent blindness.

Along with this, we have seen a rise in the rate of congenital syphilis, which occurs when an infected woman passes the bacteria to her infant. As Rewire reported, the rate of congenital syphilis increased 38 percent between 2012 and 2014. Congenital syphilis can cause miscarriage, stillbirth, severe illness in the infant, and even early infant death. There were 438 nationwide cases of congenital syphilis in 2014, which led to 25 stillbirths and eight deaths within 30 days of birth.

Rewire has also been reporting on the possibility of antibiotic-resistant strains of gonorrhea that could turn a once easy-to-treat bacterial infection into a very dangerous disease.

We really do need to be aware of STDs and take steps to prevent them in ourselves and our communities. The CDC has given us all three easy tasks for this month—Talk, Test, Treat. So, for April, let’s talk openly about STDs with our friends, relatives, and partners; get tested if we’ve been exposed to any risk; and of course, seek treatment if necessary.

News Human Rights

Louisiana Is ‘Ground Zero’ for HIV, Incarceration Crises, Report Says

Kanya D’Almeida

Both of these epidemics disproportionately harm Black people, who account for 70 percent of new HIV infections in Louisiana and 66 percent of the state’s prisoners.

Thousands of prisoners in Louisiana’s county jails are routinely denied access to HIV testing and treatment, with five of the state’s 104 jails offering regular tests to inmates upon entry, according to a new Human Rights Watch (HRW) report.

The same people who are at the highest risk of HIV—people of color, sex workers, and low-income communities, for instance—face disproportionate incarceration rates in Louisiana, meaning that low-income people of color, and especially Black people, are bearing the lion’s share of the burden of inadequate HIV care in county jails, called “parish” jails in Louisiana.

Louisiana has the nation’s second highest rate of new HIV infections, and the country’s third highest rate of adults and adolescents living with AIDS, according to the report. The state has the highest incarceration rate in the nation, locking up an estimated 847 people per 100,000 residents, compared to the national average of 478 prisoners per 100,000 people. On any given day, there are roughly 30,000 people in Louisiana’s parish jails, contributing to an incarceration rate that is 150 percent of the national average.

Many of those whose treatment has been interrupted while in jail were arrested for minor, non-violent crimes, per HRW.

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Both of these epidemics disproportionately harm Black people, who account for 70 percent of new HIV infections in Louisiana (compared to 24 percent for white people), and 66 percent of the state’s prisoners—even though Black people account for 32 percent of Louisiana’s 4.6 million residents.

“This is not a coincidence,” Megan McLemore, a senior researcher at HRW and author of the report, told Rewire. “The history of the state of Louisiana has been, to say the least, disturbing in relation to African Americans.”

HRW interviewed more than 100 people for the report, from formerly incarcerated people to medical staff in parish jails to HIV service providers. What they found was a pattern of rights violations, including the failure of most parish jails to comply with recommendations by the Centers for Disease Control and Prevention that all inmates be tested for HIV upon entry at a corrections facility.

Jail officials reportedly told HRW that they avoid testing because they can’t afford to treat those who test positive: a course of medication for a single patient can fall in the range of $23,000-$50,000 per year. But the HRW report claims that failing to conduct proper testing, interrupting patients’ treatment plans, and neglecting to provide linkages to treatment centers for people leaving jails could end up costing the state much more in the long run.

Strict adherence to antiretroviral medication regimes has been found to greatly enhance successful management of HIV, the report said, by strengthening a person’s immune system and decreasing the amount of virus in the body, thereby reducing the risk of transmission. By denying inmates access to their medications, Louisiana’s parish jails are contributing to an already grave epidemic: the state is home to more than 20,272 people living with HIV, with half of them diagnosed with AIDS, according to the report.

Jail officials’ behavior heightens the stigma around HIV, advocates said. McLemore told Rewire that Louisiana’s inmate population represents some of the country’s most vulnerable and heavily policed communities.

“These are people who are already stigmatized—add HIV, and the situation becomes almost unbearable. So when jail officials intentionally avoid or neglect testing and treatment, they are not only adding to that stigma, they are actually being discriminatory,” McLemore said, adding that some caseworkers claimed their HIV-positive clients avoided disclosing their status to jail staff because they had no assurance that it would guarantee care.

Darren Stanley, a case manager at the Philadelphia Center in Shreveport, told HRW that half his clients have spent time in jail, and the majority of them are denied their medications on the inside. One of his clients, who spent three weeks in the Caddo Parish Prison in 2013, paid the ultimate price.

“I tried to get in touch with him but he was very sick without his medications,” Stanley told HRW. “He died of AIDS two weeks after he got out.”

A formerly incarcerated woman named Joyce Tosten who spoke to HRW claimed parish jail officers informed her that she would need to have her mother deliver any necessary HIV medications to the jail. But she couldn’t call her mother because she didn’t have phone privileges at the time. Other sources alleged that even when family or friends brought medications to the jail, they were never delivered.

The problem does not stop at incarceration. According to HRW, “release from parish jail is often a haphazard process consisting of whatever is left of their medication package, a list of local HIV clinics, or nothing at all.”

The report includes a series of recommendations such as setting aside adequate funding for HIV testing and care, training jail staff on effective treatment and management options, and strengthening links with local care providers and community-based centers for returning citizens.

Deon Haywood, executive director of Women With A Vision (WWAV), a New Orleans-based grassroots health collective responding to the HIV epidemic in communities of color, told Rewire that HRW’s recommendations were “spot on.”

“They speak to the conditions we have seen in the community for the past 26 years,” she said. “Through my work at WWAV and other New Orleans agencies, I’ve witnessed the failure of incarceration to better the community. We urge Louisiana to invest in education rather than criminalization, and shift the state’s resources and policies towards solutions that address the systematic inequalities that poor communities of color face on a daily basis.”

HRW’s report adds to a list of woes that Louisiana residents confront on a daily basis. The state recently ranked last on a nationwide index measuring social justice issues like poverty and racial disparities.

CORRECTION: This story has been updated to reflect Louisiana’s correct incarceration rate.

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