The Food and Drug Administration, after numerous delays that many felt were politically motivated, has approved Barr Laboratory's Plan B contraceptive for over the counter sales to women over the age of 18 years old. Read the full article here. The age restriction is in line with remarks made by President Bush at a recent news conference whereby he suggested he was in favor of approval so long as minors were excluded. Thought Theater has previously discussed the rancor over the approval as well as the opposition expressed by numerous religious groups based upon the contention that the over the counter sales would lead to promiscuity here and here.
The Food and Drug Administration today said Barr could begin selling the drug, called Plan B, over the counter to those 18 and older. Plan B is designed to prevent pregnancy when taken within 72 hours of sex.
The decision capped a prolonged fight over whether the pill should be available without a doctor's permission, and which age group should get access. Some doctors' groups and Barr called for over-the-counter sales without an age limit. Some social conservatives said easy availability could increase promiscuity among teenagers.
Under the FDA's decision, Plan B will be kept behind pharmacy counters and can be dispensed only after customers provide proof of their age. The drug has been available with a prescription since 1999.
The FDA has been considering Barr's over-the-counter bid since 2003. An agency advisory panel recommended approval of Barr's application to sell the drug without a prescription to all age groups. The FDA rejected that approach, saying there wasn't enough evidence young teens could safely use Plan B without a doctor's supervision.
While the approval is long overdue but a welcome decision, I personally feel the decision to limit the sale to women over the age of 18 to be an absurd accommodation of those who insist upon viewing sex as an evil. At the same time, these same groups and individuals are living in full denial of the fact that preventing minors from purchasing the product will simply place underage women at risk for unwanted pregnancies as well as potential abortions. Further, the notion that a 16 or 17 year old woman would be unable to safely use the product is nothing more than irrational babble used to impose moral judgments and religious values...it has no scientific basis.
Anyone that believes 16 and 17 year old women haven't the ability to use the product properly must be oblivious to the fact that many of these same women are experimenting with alcohol, drugs, and cigarettes...all products that have detrimental health implications but because they are not associated with religious and moral judgments, they are often overlooked or condoned by the same parents that oppose the availability of Plan B. Additionally, should there be any doubt that 16 and 17 year old women will find the means to obtain the drug if they find themselves in need? Isn't it time this country have an honest discussion about sex and begin to approach it with maturity and reasonability instead of making it a divisive subject that simply serves to alienate children from parents?
How a parent can decide that they would prefer to place sexually active children at risk rather than provide them the means to prevent a pregnancy is beyond my comprehension. I understand that parents may prefer that their children not engage in sex prior to marriage but that desire is simply not founded in reality. If parents would simply accept that their children are apt to engage in sex just like they did, they might find the courage to set aside their antiquated moralistic judgments and begin to deal with sex in a proactive and positive manner. Why sex must be vilified in a world that is filled with divorce, crime, violence, wars, and numerous other clearly negative behaviors is unfathomable to me and it fully demonstrates the hypocrisy that permeates the entire debate about sex, contraception, and abortion.
Daniel DiRito | August 24, 2006 | 7:49 AM |
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The Ryan White Act has been a mainstay in providing HIV/AIDS funding for a number of years having been originated in 1990. In this year’s effort to reauthorize the funding, a conflict has emerged that is generating some interesting political spin. As I understand the issue, the current reauthorization proposes to change the way in which funding is apportioned to the individual states such that some of the larger states that initially suffered the greatest incidence of HIV/AIDS would potentially lose some funding.
Basically, the prior definitional guidelines provided funding based upon the incidence of AIDS...a definitional term that indicates an individual's disease progression as opposed to merely looking at the occurrence of HIV infections. Under the new guidelines, funding would be weighted towards the number of infections within a state as opposed to the number of individuals identified to have AIDS.
Senator Clinton has become the focal point of the political spin surrounding the funding changes. She has indicated a willingness to block the passage of the bill if the guidelines are in fact altered. The bottom line is her concern that New York may lose funding if the appropriation method is altered. California, Florida, and Illinois would also stand to lose funding. Clinton detractors have asserted that the Senator is merely looking at the 2008 political implications in her opposition to the funding changes...they assert that the new funding would shift money to southern states...a region the Senator isn't likely to win should she run for President in 2008. Read the full article here.
From The Washington Post:
This year's fight has pitted the states in which the AIDS epidemic began -- those with large cities that now have large populations of people with AIDS -- against smaller states in which the incidence of HIV infections, but not full-blown AIDS, has soared. The current law's formula is based on the number of patients with AIDS; the new funding formula would, in effect, distribute funding based on the number of patients with HIV or AIDS.
Some of the largest AIDS organization side with Clinton. Gay Men's Health Crisis, for example, "fully supports Senator Clinton's position on the current bill," a spokeswoman said.
On the other hand, Christopher M. Hamlin, chaplain for an outpatient clinic at the University of Alabama at Birmingham, favors the new formula. "The money needs to follow the virus," he said. "More funds need to be directed to the part of the community that has seen the numbers increase so much, especially rural communities."
Some critics see electoral motives behind Clinton's position. "If you look at the states she has to carry to become president -- California, New York, Illinois, Florida -- those would be the hardest hit if the formula were changed," said Charles Grant, founder of AbsoluteCare Medical Center Inc., the largest private HIV/AIDS medical center in Georgia.
Asked why Clinton might countenance lower funding for Southern and rural states, Michael Weinstein, president of the AIDS Healthcare Foundation, the nation's largest community-based HIV/AIDS medical provider, said, "I don't think she expects to carry the South."
I personally think it is unfortunate that it is being suggested that the Senator is making a political calculation. In fact, Senator Schumer of New York is also opposed to the new funding guidelines. Clearly, whatever the Senator does is now believed to be motivated by her political aspirations despite the fact that she may simply be working in the best interest of her New York constituents. It seems like a case of damned if you do and damned if you don't. Unfortunately it points out how much partisan attention the Senator seems to attract regardless of her actions. With regards to the Ryan White Act, I simply don't buy the political spin.
Given the topic, I thought I would include the following AIDS awareness video. Thought Theater has previously posted AIDS awareness videos from France here and here. While it is unfair to make direct comparisons of the following video to the French videos, it should be obvious to the viewer that the French perspective would be met with criticism here in the U.S. despite being focused on individual empowerment and a clearly more positive awareness message.
Daniel DiRito | August 23, 2006 | 10:21 AM |
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The Bush administration's ABC program...a plan to combat HIV that promotes abstinence until marriage, being faithful, and condoms if necessary is being met with mixed reviews at the XVI International AIDS Conference in Toronto. Thought Theater previously reported on the programs negative implications in Uganda and it appears that other African countries are expressing concerns about the program. The full Washington Post article can be found here.
More important, the evidence that ABC is changing behavior is quite spotty, with condom use appearing to be the most acceptable of the three forms of advice.
ABC is a centerpiece of the Bush administration's $15 billion, five-year plan to fight AIDS in 15 target countries, most of them in Africa.
The Bush program stipulates that one-third of the money spent on preventing sexual transmission of the virus must go for "abstinence until marriage" messages.
The interim evaluation of efforts in Botswana, supported by the U.S. Centers for Disease Control and Prevention, found that much of the ABC message was getting through, but that it was not making much of a difference.
While I'm not opposed to abstinence messages, I simply don't see such programs as an answer to HIV. Abstinence programs require 100% compliance to be successful...an unrealistic objective when it comes to sex. All too often such programs convey a moral judgment which makes the objective use of condoms more difficult. People often make poor decisions when they equate their behavior with a morally unacceptable activity. Instead of being thoughtful and deliberate, they often act impulsively...which is a dangerous way to confront HIV. Condom use has to be promoted without moral judgment in order to be effective...if using a condom is seen to be part of an immoral act; it is less likely to be employed. The reporting seems to support this argument.
The people who had been counseled were also twice as likely to have been tested for HIV in the previous year, and to have discussed that possibility with a sex partner. However, they were just as likely to have a partner outside marriage as the people who had not gotten a visit from a counselor, and they were no more likely to be using a condom in those liaisons.
"People who were exposed to the program had greater knowledge but were no more likely to be practicing ABCs," said Margarett K. Davis, director of the "BOTUSA" collaboration between the two countries.
A survey of 1,400 Kenyan teenagers found a fair amount of confusion about ABC's messages. About 15 percent of the girls and slightly less than half the boys had had intercourse.
Half of the teenagers could correctly define abstinence and explain why it was important. Only 23 percent could explain what being faithful meant and why it was important. Some thought it meant being honest, and some thought it meant having faith in the fidelity of one's partner. Only 13 percent could correctly explain the importance of a condom in preventing HIV infection. About half spontaneously offered negative opinions about condoms, saying they were unreliable, immoral and, in some cases, were designed to let HIV be transmitted.
Some studies in the U.S. suggest that the comprehensive ABC education has reduced the likelihood that sixth and seventh grade students would engage in sexual intercourse. The study data covers a two year period and the data suggested that only 48 percent of those given abstinence only messaging engaged in sexual intercourse compared with 61 percent of those given a comprehensive message that included condoms. Missing from the data I reviewed is how many of those who did engage in sexual intercourse practiced safer sex with the use of a condom. I contend that it is possible to use fear and moral judgments to reduce sexual activity (or the willingness to report having engaged in such activity)...but for how long and at what risk are the essential questions that are seemingly being ignored.
If the majority of the 48 percent abstinence only group that engaged in sexual intercourse did so without condoms while a majority of the 61 percent comprehensive message group (including condom education) that engaged in sexual intercourse did so with condoms, then clearly the latter group was better served and the likelihood of transmitting HIV or other sexually transmitted diseases...as well as the potential to become pregnant...were diminished in this group.
One of the prevailing problems with much of the current statistical data being generated is that it is conducted with bias by groups that are the beneficiaries of this type of government funding. Further, proving the outcome desired by the Bush administration assures that the programs continue regardless of the actual realities. Unless the research fully extracts all the facts, it is impossible to objectively evaluate the benefits or the shortcomings of these programs. In fact, to actually ascertain the benefits of an abstinence only program, one would need to track these children until they were married. At the same time, one single failure during the years until that happens may well prove deadly.
Ironically, the Bush administration understands and likes to say that the U.S. has to be right 100 percent of the time to prevent a terrorist success. They tout that fact to demonstrate the daunting task of protecting America and yet they are employing the same model...by choice...to protect America's youth. We may have to live with that reality when it comes to terrorism but with regards to the health and wellbeing of young Americans such a concession is unconscionable.
Daniel DiRito | August 15, 2006 | 9:43 AM |
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