The Trump Effect on Sexual Health in Africa

By Robert Wyrod

As the Trump presidency enters its third month, we are beginning to see the implications for the U.S. role in promoting global sexual health. Trump’s reinstatement and expansion of the Mexico City Policy, aka the global gag rule, has rightfully received much attention. By prohibiting U.S. foreign aid from funding any organization providing or promoting abortions, it severely limits America’s ability to improve sexual health in the Global South. For the many health clinics across Africa that rely on U.S. funding for reproductive health and family-planning services, this may likely mean dramatically scaling back services or shuttering clinics.

Efforts are underway to challenge the reinstatement, most prominently the Global Health, Empowerment, and Rights (HER) Act led by Senator Jeanne Shaheen (D-NH). But there is another, less-discussed issue that could have an even greater impact on sexual health worldwide, especially in Africa. Will Trump defund the President’s Emergency Plan for AIDS Relief? The PEPFAR program, launched in 2004 during the George W. Bush administration, is the largest health initiative in history focused on fighting a single disease. To date, over $70 billion has been spent on PEPFAR programs, mostly in sub-Saharan Africa. This makes PEPFAR a tempting target for the current administration, especially given Trump’s deep skepticism of foreign aid. In mid-January, the Trump transition team sent a series of pointed questions to the State Department about U.S. aid to Africa, asking “Is PEPFAR becoming a massive, international entitlement program?” Continue reading “The Trump Effect on Sexual Health in Africa”

Reconsidering Gendered Sexualities in a Generalized AIDS Epidemic

By Christie Sennott and Nicole Angotti

In the rural area of Mpumalanga Province, South Africa that we study, HIV is estimated to infect 1 in 5 people. Many researchers have studied the social, biological, and behavioral factors that contribute to HIV infection and the consequences of high mortality from AIDS-related diseases. Yet, less attention has been paid to how people actually living in communities affected by HIV/AIDS talk about the epidemic in everyday life—a useful way for understanding how men and women experience a significant threat to their lives and the lives of those around them.

HIV/AIDS is a unique type of threat: it is transmitted sexually, potentially fatal, and therefore has wide-reaching consequences for men and women’s sexual lives. Whereas several studies have found that individuals work to “reaffirm” or recuperate long-standing norms governing gender and sexuality when those norms are threatened, we find that HIV/AIDS – which threatens not just individual lives, but also relationships, families and communities – provokes reconsideration of gendered sexualities at the community level. We define reconsideration as the processes through which men and women debate, challenge, make sense of, and attempt to come to terms with the social norms circumscribing gendered sexual practices. Our focus on reconsideration shows the multiple voices and commentaries on HIV/AIDS that are circulating in the community, and that ideas about masculinity and femininity are complex, contradictory, and evolving in everyday conversation and interaction.

Our data are ethnographic and collected by men and women from the community. Over several months in 2012, a local team of “insider ethnographers” wrote field notes capturing conversations about HIV/AIDS that they encountered in public settings, such as large community events like village meetings, and other venues where interaction is commonplace, such as at bus depots and at church. These data are ideal for understanding local ideas about threats like HIV/AIDS because they are captured in real time and show the multiple perspectives that come to bear on the social experience of living amid an HIV/AIDS epidemic.

Continue reading “Reconsidering Gendered Sexualities in a Generalized AIDS Epidemic”

G&S Blog Post – Weight Stigma, Gender & Medicine: A Tale of Two Times

By Natalie Ingraham

Recently, New York Times science journalist Gina Kolata wrote two stories about stigma related to fatness, often called weight stigma. These articles address that way fat people, and fat women in particular, are treated poorly by society because of body size. In her September 25th article, Kolata considers weight stigma specific to medical settings and the emotional and physical consequences of this stigma for fat patients. However, it’s important to note that she doesn’t  describe cases of medical neglect or mistreatment as a weight stigma. However, less than a week later on October 1st, she devotes and entire pieces to the “shame” of weight stigma and its negative outcomes for individuals who experience it. Here, she focuses heavily on the work of the Rudd Center, which works extensively on weight stigma and its impacts.

Weight Stigma & Medicine

fat-pic
Photo by Parker Knight (CC) 

Kolata reviews important evidence by social scientists and public health professionals (Drury and Louis 2002; Puhl, Peterson, and Luedicke 2012; Teachman and Brownell 2001; Teixeira and Budd 2010) about the various types of discrimination fat patient’s face. Such discrimination includes hostile language about a lack of willpower to lose weight, shaming from medical staff about weight gain, or increased costs for medical services based on BMI. The stigma becomes medical neglect when misdiagnosis of a problem or medical equipment is unsafe or inaccurate for larger patients (e.g. a small blood pressure cuff causing both pain to the patient and an inaccurate higher blood pressure). The stories from patients in this article reflect both empirical work and personal narratives about weight-based medical mistreatment. Continue reading “G&S Blog Post – Weight Stigma, Gender & Medicine: A Tale of Two Times”

Menstrual Hygiene Explored Keeping Our Eye On The Wider Context

By Chris Bobel. Originally posted on the Society for Menstrual Cycle Research Blog re:Cycling (here).

Editors Note: This piece is being cross-posted in response to the recent media campaign #JustATampon.

This summer, I bought a new camera. I needed it to snap pictures during a research trip to India where I explored diverse approaches to what’s called in the development sector, Menstrual Hygiene Management (MHM). I chose a sleek, high tech device with a powerful, intuitive zoom.

Continue reading “Menstrual Hygiene Explored Keeping Our Eye On The Wider Context”

Slaves to Beauty

by Steven Vallas  Originally posted at Work In Progress (here). The piece is cross-posted with permission.
Credit: The New York Times
Credit: The New York Times

LAST WEEK The New York Times ran a set of stories that illustrate just how vital investigative journalism is, especially in an era in which savage capitalism seizes upon vulnerable groups-–immigrant women in powerless positions—and exploits them with impunity, knowing that governmental institutions lack the power, authority, or will to intervene. Written by Sarah Maslin Nir, the stories showed us that the outposts of bourgeois femininity—nail salons–we see in virtually all in commercial areas, have a dark side to them that is often quite hidden, even to the customers: rampant the wage theft and health hazards that are common practices within nail salons. Continue reading “Slaves to Beauty”

Why Are so Many U.S. Babies Born via Cesarean?

By Christine Morton

When I gave birth to my first child in 1995, the U.S. cesarean birth rate was 21%. By 2013, the total cesarean rate had risen to 33%, a nearly 60% increase! What has happened in the 18 years since I had my first baby to reach a point where 1 in 3 women give birth through major abdominal surgery?

A recent article in the Huffington Post highlights the risks of cesarean birth for both mother and baby and asks why the U.S. cesarean rate is more than double the World Health Organization recommended rate.

  • Are there medical factors that explain this increase?
  • Have women’s bodies become less capable of vaginal birth due to age or health issues?
    Are women choosing surgical birth because it’s less painful, or as safe as vaginal birth?
  • Are cesareans being done because women and babies are getting bigger?
    Is the increase due to more women having twins, triplets and so on?
    Has the increase in cesareans resulted in better health outcomes for women and babies?

The short answer to all these questions is NO. Continue reading “Why Are so Many U.S. Babies Born via Cesarean?”

Ebola, Women, and the Risk of Care

by Robert Wyrod

Wyrod_imageWatching the Ebola crisis unfold, I’ve found myself both fascinated and horrified by the differences in the fates of those infected. Here in the United States, the story has been the seemingly miraculous recovery of infected patients, with the tragic exceptions of Thomas Eric Duncan, the Liberian who died in Texas in October, and Martin Salia, the Sierra Leonean who died in Nebraska in November. While in West Africa, even as treatment improves, we are still seeing images of men, women, and children left to die alone on clinic floors and city streets. Continue reading “Ebola, Women, and the Risk of Care”