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June 4, 2006

Death to Women. Long Live HIV and HPV.

In our current political world we tend to think of the war on drugs and the war on abortion as very distinct battlegrounds. While it is becoming increasingly clear that the war on abortion is also a war on contraception and sex itself (See Christina Page, How the Pro-choice Movement Saved America) it should be clear that both the war on drugs and the war on abortion are powerful tools for undermining women's health and evidence-based medicine overall.

Feminist writers, thinkers and leaders from Katha Pollitt in the Nation (Virginity or Death, May 30, 2005 issue) to bloggers across the ether-sphere are decrying Bush administration officials in the FDA who are opposing a new vaccine that eradicates the human pampilloma virus (HPV).

HPV causes genital warts and in its most deadly strains, it is the primary cause of cervical cancer which kills nearly five thousand American women every year. Why are Bush's appointees on the FDA trying to stop a medicine that will save thousands of women's lives?

According to Leslie Unruh, the founder and president of the Abstinence Clearinghouse (and a major force with her husband in promoting the recent South Dakota ban on abortions) says: "I personally object to vaccinating children when they don't need vaccinations, particularly against a disease that is one hundred per cent preventable with proper sexual behavior." Senator Tom Coburn, (R) Oklahoma (who also favors a ban on abortion, even in cases of rape and incest) has similarly said "Premarital sex is dangerous, even deadly. Let's not encourage it by vaccinating ten-year-olds so they think they're safe."

But while the FDA may block the vaccine and has already prevented the over the counter sale of Emergency Contraception, lets not overlook the equally dangerous and irrational ongoing opposition to needle exchange.

Today's New York Times features a story about how New Jersey leaders continue to oppose needle exchange that stems the spread of HIV. Making clean needles available through needle exchange programs and permitting their sale at pharmacies have proven highly effective in curtailing the transmission of HIV/AIDS and hepatitis. New Jersey, according to the Times story has the country's highest rate of H.I.V. infection among women, who make up 36 percent of the cases among New Jerseyans over 13, and the third highest among children. Over all, almost 33,000 people in New Jersey have AIDS, up from 26,000 at the end of 1998. Forty-one percent of all cases resulted from injection drug use, according to the state health department.

According to Sunday's paper, studies in New York City have shown that needle exchange programs have reduced the rate of new H.I.V. infections by roughly 75 percent since the 1990's. Malcolm Gladwell, the author of the best selling book The Tipping Point cites needle exchange as a classic and unquestionable example of a small action that makes a huge difference. Needle exchange has also been shown to be an important first step in helping drug users obtain drug information, treatment, detoxification, social services and primary health care.

Moreover, numerous public health groups including the American Medical Association, the National Institutes of Health, the Centers for Disease Control and Prevention, and the Institute of Medicine, have endorsed needle exchange programs. Despite the fact that government sponsored research has shown that such programs do not lead to increased drug use and does have numerous positive health effects, New Jersey official are seeking to stop such life-and cost-saving measures. Why?

According to the New York Times: "Ronald L. Rice, a Democrat, who has struck an alliance with Republican lawmakers, who are in the minority, to keep the legislation bottled up in committee along argue, along with other critics, including John P. Walters, the director of the White House Office of National Drug Control Policy, that "making needles more accessible suggests that government is condoning an illegal — and destructive — activity."

Mr. Rice, a former Newark police officer also asserts that "Needle exchange is a form of keeping people junkies the rest of their lives." US federal policy also prohibits use of its funds for life-and cost-saving needle exchange programs claiming that it will send the wrong message to youth and encourage drug use.

So needle exchange that prevents the spread of HIV will encourage young people to use drugs and eliminating the threat of HPV will encourage teenagers to have sex.

The truth though is that depriving people of needle exchange and the HPV vaccine will result in the preventable deaths of thousands of women as well as men. What this means is whether the issue is drugs or sex, and however nervous one or both of these issues may make us, we need to work across issues to ensure that health care policy is based on science and compassion not sexism and sadism.

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