Blogs Comment On PEPFAR Administrator, Managing Herpes, Male Contraceptives

Main Category: HIV / AIDS
Also Included In: Women's Health / Gynecology;  Sexual Health / STDs;  Men's health
Article Date: 18 Feb 2009 - 5:00 PDT

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The following summarizes recent women's health-related blog entries.

~ "Ending the Compromise Era on AIDS," Michelle Goldberg, American Prospect blog: The firing of former head of the President's Emergency Plan for AIDS Relief Mark Dybul was a "stark manifestation of the different styles that" President Obama and Secretary of State Hillary Rodham Clinton "bring to governing," Goldberg writes, adding that Clinton is "more of a political pugilist" than Obama. Goldberg writes that Clinton "has a long, close history with the international reproductive rights movement that battled Dybul for years," adding that advocates within the movement felt that Dybul’s efforts to forge alliances with the religious right marginalized women’s reproductive rights and stymied efforts to promote linkages between HIV and reproductive health services. According to Goldberg, reproductive rights advocates made their "objections known to those close to Clinton shortly after inauguration." Although it is "not clear whether Clinton directly ordered his firing," some "people in the field believe that either she or someone who worked for her was behind it," according to Goldberg. Although a "fierce debate is underway about whether Dybul was unfairly treated," what is "at stake is more than just the reputation of one man, because the argument is really about America's AIDS policies and the future of PEPFAR," Goldberg writes. "Should Clinton push forward with more effective prevention policies, the consensus that has sustained the massive American commitment to AIDS relief could fray," Goldberg continues, adding, "So far, though, keeping that consensus together has come at the cost of some women's lives" (Goldberg, American Prospect blog, 2/13).

~ "Guidelines on Herpes in Pregnancy," Our Bodies Our Blog: The Society of Obstetricians and Gynaecologists of Canada in June 2008 released new guidelines on the "management of herpes simplex virus (HSV) in pregnancy," the blog post says, adding that herpes in pregnancy is "of concern because of the potential to pass the virus to the fetus during or near delivery, especially when the woman is newly infected late in pregnancy." According to SOGC's guidelines, "women's history of genital herpes" should be "evaluated early in pregnancy," and women with a history of genital herpes outbreaks should be "counseled about the risk of transmission at delivery," according to the blog. In addition, the guidelines say, "At delivery, women with recurrent HSV should be offered a caesarean section if there are prodromal symptoms or in the presence of a lesion suggestive of HSV." The American College of Obstetricians and Gynecologists published guidelines on the same topic in 2007, and they "reach similar conclusions that c-section 'is indicated in women with active genital lesions or prodromal symptoms' but that c-section is 'not recommended for women with a history of HSV but no active genital disease during labor.'" According to the post, neither "guideline suggests that c-section is necessary for all HSV-infected women or even all women with outbreaks of the virus at delivery" (Our Bodies Our Blog, 2/16).

~ "The Real Male Pill Part 2," Soumya Vemuganti, RH Reality Check: Although "most people" think of a male version of the female birth control pill when they think about "male birth control," the "most likely candidates for male contraception are not in a pill form," Vemuganti writes. Several mechanisms have been shown to be more successful than pill compounds, including methods to interfere with sperm-egg binding and prevent sperm from successfully entering the female reproductive tract. According to Vemuganti, "one of the most promising avenues for research is to arrest sperm production," known as spermatogenesis. Vemuganti writes that several experimental approaches to spermatogenesis include altering male testosterone levels, and newer studies involving combinations of testosterone and progestin have reduced problems related to injection frequency and side effects found in earlier studies. Vemuganti also discusses targeted non-hormonal methods, which "are advantageous due to the promise of fewer side effects." One such method involves a heat-based application to the testes . The technique has not been studied extensively, but it has an "ease of reversibility" and a "dramatic 100% success rate," according to Vemuganti. She adds, "The private sector is uninterested in pursuing heat-based contraceptives since administration is simple and cheap, therefore not profitable." Vemuganti continues that a pharmaceutical approach that may "spark interest" in the private sector is the use of an analog of an anti-cancer drug called Adjudin" (Vemuganti, RH Reality Check, 2/17).

Reprinted with kind permission from http://www.nationalpartnership.org. You can view the entire Daily Women's Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women's Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.

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