Presenting with Lenhart was Kicesie Drew, who provides sex ed information via YouTube; Sally Swanson from the Adolescent Pregnancy Prevention Campaign of North Carolina, a group that usess texting to answer questions about sexual health; and Cornelis Rietmeijer, director of the Sexually Transmitted Disease Control Program/Denver Public Health.

More health professionals are turning to innovative techniques and technologies to reach young and at-risk populations. I recently took part in a symposium, sponsored by Chicago Department of Public Health and the National LGBT Tobacco Control Network, on how public health workers can use social media to reach the LGBT community. We looked at some of the promises and obstacles that new communciation tools present. One of the most important lessons: Know how your audience uses technology, and go where they go.

I was honored to be on a panel with Lovette Ajayi, a superstar at Community Media Workshop and co-founder of the Red Pump Project, which raises awareness about the impact of HIV/AIDS on women and girls. And that brings me to the second point of this post: March 10 was National Women and Girls HIV/AIDS Awareness Day.

The Red Pump Project presents statistics about HIV/AIDS  and women — and the great disparities. Though black and Latina women represent 24 percent of all U.S. women combined, they account for 82 percent of the estimated total of AIDS diagnoses for women in 2005.  Consider that HIV is the:

* Leading cause of death for black women (including African American women) aged 25–34 years.
* 3rd leading cause of death for black women aged 35–44 years.
* 4th leading cause of death for black women aged 45–54 years.
* 4th leading cause of death for Latina women aged 35–44 years.
* The only diseases causing more deaths of women are cancer and heart disease.
* The rate of AIDS diagnosis for black women was approximately 23 times the rate for white women and 4 times the rate for Latina women.

These numbers illustrate the need for massive improvements in education, prevention and treatment — all topics the National STD Prevention Conference aims to address. High-priority issues are identified for each biennial conference, and this year’s top three issues couldn’t be more  relevant or directly worded.

The last point is a great reminder of how change is both incredibly simple and complex: “It is essential to find ways to move beyond our longstanding societal reticence to openly discuss sexual health issues and to normalize conversations around STD prevention.”

Plus: In related news, Washington, D.C. will make 500,000 female condoms available — for free. The condoms will be available in beauty salons, convenience stores and high schools in parts of the city with high HIV rates, reports the Washington Post. The project is funded through a $500,000 grant from the MAC AIDS Fund, a subsidiary of MAC Cosmetics.

In contrast to a lot of the hype and stereotypes about “hooking up,” Corinna is looking for what’s real, both in sexual attitudes and experiences among a diverse array of ages, genders and sexual identities, races and sexual ideologies/constructions. The only requirements for participating in this study are being over the age of 16, and having had some kind of sexual partnership before, even if none has been casual. The study takes around twenty minutes.

Corinna would like the study to show as diverse an array of people as possible, especially since so often media representations or cultural conversations about casual sex are usually only about heterosexual white women or about gay men. She particularly wants to be sure LGBT people, people of color, those over 45 and social conservatives are adequately represented, so please share this link with your networks after you take the survey yourself, especially if your networks include people in any or all of those groups.

To take the survey, visit http://www.surveymonkey.com/s/S97WR6H.

A free live webcast (with captioning) of the conference is being made available for those who can’t attend the Bethesda, MD event. (You may need to download an appropriate media player to watch it.)

Various experts are discussing the medical evidence on VBAC (audience discussion has been lively already!), including the following key questions:

• What are the rates and patterns of utilization of trial of labor after prior cesarean, vaginal birth after cesarean, and repeat cesarean delivery in the United States?
• Among women who attempt a trial of labor after prior cesarean, what is the vaginal delivery rate and the factors that influence it?
• What are the short- and long-term benefits and harms to the mother of attempting trial of labor after prior cesarean versus elective repeat cesarean delivery, and what factors influence benefits and harms?
• What are the short- and long-term benefits and harms to the baby of maternal attempt at trial of labor after prior cesarean versus elective repeat cesarean delivery, and what factors influence benefits and harms?
• What are the nonmedical factors that influence the patterns and utilization of trial of labor after prior cesarean?
• What are the critical gaps in the evidence for decision-making, and what are the priority investigations needed to address these gaps?

They are also expected to discuss a systematic literature review on the topic prepared under contract with the Agency for Healthcare Research and Quality (AHRQ) which will be completed and released this year and will address these same key questions. The previous AHRQ review on the topic was completed in 2003, and identified significant gaps in the literature and the problems those gaps pose for informed decision-making. A full agenda with listed presenters and sponsors is available online.

Following the conference, a panel will prepare a consensus statement addressing the key questions; you can sign up to be notified when the draft and final statements are available online and/or to receive a mailed copy of the final statement.

The Feminist Breeder is planning to have coverage of the conference on her blog and radio show, and the International Cesarean Awareness Network is planning a blog carnival on the topic of why VBAC is a viable option [hat tip to Jill at The Unnecesarean]. The hashtag #nihvbac is being used for discussion on Twitter.

The full conference will be archived at the NIH website, so if you can’t watch this week, you can view the proceedings later.

Visit www.blogtalkradio.com/joykeys to listen to the show online, and call (646) 929-0368 to ask questions. You can also go to the site now to sign up to receive a reminder via email or text message.

We mentioned the bill in a post last week, after it passed the House and was referred to the state Senate’s Public Health and Welfare committee. Committee chair Hob Bryan has now indicated that he will not bring the bill up for a vote, saying that “This is something there’s a good bit of concern about. Several people in the committee said they had gotten calls to oppose it.”

The Big Push for Midwives, mentioned in the story, led the campaign to mobilize against this bill and issued action alerts last week encouraging midwifery supporters  to contact their State Senators regarding the bill. Campaign manager Katherine Prown explained that their opposition was not opposition to regulation of midwifery, but to the limitation of midwifery practice solely to CNMs (who typically do not provide home birth support).

“At least 26 states have laws authorizing CPMs and there’s an effort under way to get more states to license them so the practice of out-of-hospital midwifery is regulated nationwide,” Prown said. Without those laws “you end up with this buyer beware kind of climate and anyone can claim to be a midwife,” said Prown.

The Big Push campaign works to expand access to Certified Professional Midwives and out-of-hospital maternity care, including work to regulate and license CPMs in all 50 states.

The bill would make it illegal for Certified Professional Midwives — midwives who who are specially trained to deliver babies in out-of-hospital settings– to practice.

Right now, the Midwives Alliance of North America (MANA) categorizes the current situation in Mississippi for non-nurse midwives as “Legal by Judicial Interpretation or Statutory Inference” – in other words, interpreted to be legal but not explicitly provided for in the current law.

The organization provides some documentation from the previous MS Attorney General who concluded in 1991 that, “By its express terms, the practice of medicine as defined in Miss. Code Ann. Section 73-25-33 specifically excludes the practice of midwifery. Thus, it is the opinion of this office that those persons otherwise not licensed as nurses may engage in the practice of midwifery without licensure as a physician and for compensation.”

The current bill, which would add language to explicitly make non-CNM midwives illegal, passed the state House on February 9th and has been referred to Public Health and Welfare committee in the state Senate, whose members bill opponents are contacting. That committee consists of: Hob Bryan, Chairman; Alan Nunnelee, Vice-Chairman; Terry C. Burton; Eugene S. Clarke;Bob M. Dearing; Joey Fillingane; Hillman Terome Frazier; Billy Hewes; W. Briggs Hopson III; John Horhn; Cindy Hyde-Smith; Gary Jackson; Kenneth Wayne Jones; Tom King; Chris McDaniel; Nolan Mettetal; Willie Simmons; Bennie L. Turner; Lee Yancey. Contact information for each Senator is linked from this Senate roster.

MANA is encouraging supporters of Certified Professional Midwives who live in Mississippi to contact their state Senators. Tell them that you do NOT support making Certified Professional Midwives illegal, and ask them to vote NO on HB 695.

In other birth-related legislative news, the American Association of Birth Centers is asking supporters to contact their Senators and Representatives to support the Medicaid Birth Center Reimbursement Act (H.R. 2358 / S. 1423). For further information, see our previous post and information provided by AABC.

Thursday’s bipartisan meeting at the White House (which you can follow live) promises to kick-start what may be the final descent toward healthcare reform. An overview:

Does healthcare reform have a chance? Is bipartisanship a real possibility? David Leonhardt of The New York Times provides some provisional answers.

Igor Volsky over at the Wonk Room brings us up to speed by providing a nice, clear comparison of the House bill, the Senate bill and President Obama’s new proposal.

As far as questions women should be asking about their stake and status in the debate, Lisa Codispoti and Brigette Courtot at the National Women’s Law Center remind us of the “8 Questions” they have been asking all along — and how Obama’s proposal addresses (or fails to address) the issues.

Writing at Raising Women’s Voices, Amy Allina identifies ways in which Obama’s proposal builds on the Senate bill but also notes that it  “does not include the changes that Raising Women’s Voices has been urging Congress to make to the restrictive abortion provisions in [the Senate] bill” — namely by eliminating the requirement that policyholders make two separate monthly payments if they want a policy that includes abortion coverage.

It’s also worth taking a look at The National Partnership for Women and Families’ “The Top Ten Best Kept Secrets About Health Insurance Reform and Why Congress Should Pass It Without Delay” [pdf].

Finally, this is politics, and political agendas and expediency can often trump what’s right. Brian Beutler and Christina Bellantoni at Talking Points Memo dissect each party’s strategies, and Ezra Klein at the Washington Post provides a viewer’s guide.

All of this may come down to an arcane Senate procedure known as reconciliation. David M. Herszenhorn at The New York Times offers a primer.

When you feel yourself getting tired of all the red tape, get a pep talk from Ellen Schaffer and Joe Brenner at EQUAL/Center for Policy Analysis, whose PowerPoint — “The Truth About Health Reform: It’s Up to Us” — helps to put priorities in order.

“It is the position of the American College of Nurse‐Midwives that women should have access to a variety of measures to assist them in coping with the challenges of labor.”

The ACNM notes that a blend of inhaled nitrous oxide and oxygen is used for pain relief in labor in many other countries, but it not typically available in the United States, where epidural anesthesia and systemic opioids are more common.

Potential benefits of nitrous oxide are outlined in the document, including the ability for a woman to self-administer via face mask, the ability to quickly administer or discontinue the gas, and the lack of known adverse effects on the woman, fetus, or progress of labor.

Concerns about potential adverse effects, especially from occupational exposure to the gas for health workers, are also detailed and addressed in the document.

ACNM concludes:

While nitrous oxide is not without side effects and will not be agreeable to or effective for every laboring woman, it is an inexpensive, simple, reasonably safe and effective analgesic. It is important that midwives know about nitrous oxide analgesia and be able to offer it to women during labor.

See our previous related posts and companion content on the topic for more information and discussion, as well as this archived chat with the author of “Birth Day: A Pediatrician Explores the Science, the History, and the Wonder of Childbirth.”

OBOS is committed to expanding our audience and in this spirit we’ve asked former board member Moises Russo to translate into Spanish several of our blog entries. We hope to translate more entries in the coming year.

En OBOS estamos comprometidos a expandir nuestra audiencia de lector@s  y en este espíritu le hemos solicitado a Moisés Russo, ex-miembro de la Junta de OBOS, que traduzca al español varios de los blogs que tenemos en la página electrónica. Esperamos continuar con dichas traducciones durante este año.

Una segunda vacuna diseñada para proteger contra el cáncer cervicouterino estará disponible pronto en Estados Unidos.

La semana pasada, un panel de la de Food and Drug Administración (FDA) dio su aprobación a la vacuna Cervarix de GlaxoSmithKline PLC*, esencialmente recomendando que la FDA apruebe la vacuna para el uso en mujeres de 10 a 25 años de edad. La recomendación no es obligatoria; la FDA puede rechazar la decisión, pero ésta generalmente acepta la opinión de paneles externos de expertos.

La vacuna protege contra dos tipos de virus papiloma humano (VPH), asociados al 70% de los cánceres cervicouterinos.

Escribiendo en el Wall Street Journal, Jennifer Corbett Dooren resumió las preocupaciones con respecto a la seguridad que la FDA levantó acerca de Cervarix, incluyendo “una mayor tasa de abortos entre las mujeres que recibieron Cervarix”. La FDA refirió además “no se puede excluir un ‘pequeño efecto’ sobre los embarazos”. (La vacuna no está aprobada para su uso en mujeres embarazadas).

GlaxoSmithKline intentó por primera vez conseguir la aprobación el año 2007, pero la FDA solicitó más información luego de que algunos reportes sugirieron una tasa más alta de abortos en mujeres embarazadas. Dooren escribe:

La agencia dijo que se requeriría de un estudio de seguridad post- marketing para monitorizar los resultados de embarazos en mujeres que pudiesen recibir Cervarix, junto con otras potenciales preocupaciones sobre su seguridad incluyendo el desarrollo de enfermedades autoinmunes como Artritis Reumatoide y Esclerosis Múltiple. En su revisión del año 2007 de Cervarix, la FDA indicó que tenía preocupaciones sobre un “desequilibrio” en posibles desordenes autoinmunes visto en algunos estudios clínicos. Sin embargo, la agencia ha dicho que revisiones adicionales de los datos realizadas por sus propios equipos y por un reumatólogo externo concluyeron que las diferencias no eran estadísticamente significativas.

Oficiales de Glaxo dijeron que estaban planeando un estudio de post-marketing que enrolaría a 100.000 mujeres en los EEUU, el cual incluiría un registro de embarazos. La compañía también se encuentra realizando otro estudio de post-marketing de grandes proporciones en Finlandia.

Gardasil, la popular vacuna contra el VPH fabricada por Merck y & CO. Fue aprobada por la FDA el 2006. Uno de los principales investigadores para la vacuna recientemente ha comenzado a denunciar preocupaciones con respecto a sus riesgos, beneficios y agresivas estrategias de marketing – principalmente que la protección puede no durar más allá de los 5 años, por lo que las niñas que sean vacunadas a una edad temprana pudiesen en el futuro aún encontrarse en riesgo.

El mes pasado, Rachel apuntó a una editorial del Journal de la Asociación Médica Americana sobre los riesgos y beneficios de la vacunación contra el VPH y analizó un comentario en la misma edición de JAMA (sólo resumen) sobre el marketing de Gardasil. Describiendo los hallazgos de los autores, Rachel escribió: “ La táctica de la compañía fue fomentar que todas las mujeres dentro de un cierto grupo de edad se vacunaran como una medida para evitar el cáncer, en vez de trabajar con oficiales de la salud pública para enfocarse en aquellas niñas que tienen un riesgo más elevado”.

Los Centros para el Control y Prevención de las Enfermedades (CDC por sus siglas en inglés) recomienda la vacuna para niñas de 11 y 12 años, y niñas y mujeres entre las edades de 13 y 26 años que aún no hayan sido vacunadas. Esa recomendación sin embargo se convierte en un mandato para las mujeres inmigrantes entre 11 y 26 años que buscan la ciudadanía Estadounidense. Gardasil fue agregada a la lista de vacunas requeridas el año 2008.

Simona Davis, una niña de 17 años en Florida que nació en el Reino Unido está buscando la ciudadanía Estadounidense pero se rehúsa a vacunarse. El noticiario ABC News tiene un reportaje completo sobre su rechazo a la vacuna. Davis, que es una cristiana devota que dice no tener intención de iniciar relaciones sexuales en el futuro cercano (menciona su promesa de virginidad como una prueba), está buscando una exención por razones morales y religiosas. Los Servicios de Ciudadanía e Inmigración de los EEUU han rechazado su solicitud.

“La decisión de incluir el VPH como una vacuna requerida fue hecha por el CDC”, ha dicho la vocera de los Servicios de Ciudadanía e Inmigración de los EEUU Chris Rhatigan a ABC News. “Nosotros seguimos la ley….La objeción a una exención debiese ser a todas las vacunas, no solamente a Gardasil”.

Un vocero del CDC ha dicho que se espera que el CDC publique nuevos criterios dentro de aproximadamente un mes para determinar que vacunas debiesen ser recomendadas a inmigrantes a los EEUU.

While that might not sound like the most appealing way to spend a Monday night, consider these three reasons to attend

Panelist #1: Sarah Haskins created, wrote and performed in the “Target Women” series on Current TV, where she spoofed advertiser’s and marketer’s ridiculous ways of selling women products, entertainment and ideas. She now writes screenplays. Funny ones.

Panelist #2: Susan Kim is a playwright, TV writer and author. She co-wrote “Flow: the Cultural Story of Menstruation” with Elissa Stein, and she has two graphic novels, “City of Spies” and “Brain Camp” (co-written with Laurence Klavan) due out from First Second Books this year. Her plays include the stage adaptation of Amy Tan’s “The Joy Luck Club” and numerous one-acts.

Panelist #3: Allison Silverman launched “The Colbert Report” as co-head writer and later helmed the show as executive producer. She was awarded a Peabody, an Emmy for Outstanding Writing, a Writers Guild Award and three Producers Guild Awards. Her previous writing credits include “Late Night with Conan O’Brien” and “The Daily Show with Jon Stewart,” for which she won a Peabody and an Emmy. Silverman was recently a recipient of New York Women In Film and Television’s Muse Award.

The moderator is Hanna Rosin, co-editor of Slate’s DoubleX and contributing editor at The Atlantic Monthly.

Bonus: 100 percent of the profits at this cultural center go to Housing Works, Inc., which provides housing, healthcare, job training and advocacy for New Yorkers living with HIV/AIDS. Now go with the flow.