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Health Activists Warn Lack Of Lube Hurts HIV Prevention

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Safer-sex messaging on condoms is universal but the generally poor availability of lubricants, and awareness of them, is hindering HIV prevention, health activists warn.

Some personal lubricant – or “lube”- has been shown to lower the risk of HIV transmission by decreasing the risk of condoms breaking.

Despite preliminary proof of lube’s efficacy, far less of the product is procured and distributed than condoms, leading people to use alternative, sometimes harmful, substances during intercourse such as butter or petroleum jelly; oil-based lubricants weaken latex, making the condom more likely to break.

Activists say, however, that a blind spot in research on lubricants as a part of HIV prevention programmes means not enough is known about their impact on HIV risk.

Availability

A 2012 survey by The Global Forum on MSM & HIV (MSMGF), a US-based coalition focused on men who have sex with men (MSM), found that barely a quarter of the 5,000 people from 165 countries surveyed reported easy access to free lubricant. A full 25 percent said free lubricant was completely unavailable. Less than 10 percent of people living in low-income countries reported easy access.

While condoms have been part of family planning and HIV prevention work for decades, safe personal lubricant has only recently emerged as a donor priority. For example, the US government began distributing condoms in the 1970s through its aid and diplomatic missions, but its aid arm, the US Agency for International Development, only began distributing lubricant in 2008.

“Where health systems are less developed, it is critical to help establish and maintain supply chains and distribution systems, as well as support efforts to build and accurately forecast demand [for lube],” explained a representative from the US President’s Emergency Plan for AIDS Relief (PEPFAR):

Acknowledging the importance of using personal lubricants with condoms, especially during anal sex, the UN Population Fund (UNFPA) decided in 2012 to include water-based lubricants in the procurement list of commodities available to governmental and non-governmental clients in low and middle-income countries.

However, outside of community-care settings, the real demand for lubricant remains largely misunderstood.

Research in Burundi found that health care providers sometimes do not provide lube to patients because they consider it to be “promoting homosexual behaviour”, highly-stigmatized there. With lube requests stymied in formal health care settings, NGOs can become the sole method of access.

“Key populations – such as MSM and sex workers – who need the lubricant the most, often get their health-related services from local NGOs, which are not often included in [HIV/AIDS] policies or broader [health] programmes,” explained Bidia Deperthes, a senior HIV adviser with UNFPA’s Comprehensive Condom Programming division in New York.

With these NGOs frequently absent from meetings with donors, lube demand can appear falsely low.

UNFPA, a global leader in the purchase and distribution of contraceptives, spent more than 18 percent of its 2011 budget on male condoms, but less than 0.5 percent on personal lubricants, citing donors’ and decision-makers’ lack of understanding of the true demand for the latter as one reason.

Alternatives

“Before there was lube from the outreach workers, I would use butter,” said Lucky, a transgender sex worker in Kathmandu, Nepal, who said she still uses non-lube products as lubricants when NGOs run out of money to fund free lubricant.

“The condoms would break sometimes, but at least it didn’t hurt as much,” she said.

Silicon and water-based lubricants are “condom compatible” and do not corrode latex. Other types of lubricant, including commercially-produced petroleum-based products like Vaseline, can destroy condoms and put users at risk of HIV and other sexually transmitted diseases.

The World Health Organization (WHO) has published a list of substances commonly used as alternatives to condom-compatible lubricant that may boost the risk of condom failure.

According to an International Rectal Microbicide Advocates (IRMA) 2009 study, most MSM throughout Africa are not using condom-compatible lubricant, a trend also seen in other regions facing a high burden of HIV.

A microbicide is a cream, gel, douche or an enema that may help reduce a person’s risk of HIV infection vaginally or rectally.Medical studies have shown rectal microbicides can offer protection in the absence of condoms and back-up protection if a condom breaks or slips off during anal intercourse.

Distribution and access

The American Foundation for AIDS Research and the US-based Johns Hopkins School of Public Health have identified availability of water-based lubricant and its cost as significant barriers to lubricant access in several countries including Guyana, Ukraine and China.

Lubricant is commercially categorized differently across countries – ranging from a medical device to a cosmetic product – meaning its manufacture, import and export can encounter legal and bureaucratic cross-border delays before reaching users.

Studies have found that even assuming high costs for lubricant production and distribution, “condom-compatible” lube prevention packages that include a condom plus a safe lubricant would only amount to about 1 percent of the global HIV/AIDS budget for 2011 (US$134 million).

Call for more research

Scientists have noted that even in places where lubricant is readily available and widely used,little comprehensive research has been conducted on its safety.

A 2007 global survey revealed more than 100 different types of lubricants are used worldwide during intercourse. WHO has outlined how vaginal and anal intercourse may require different types of lubricant.

“Most importantly, we need to determine the safety of sexual lubricants that are on the market already,” said Jim Pickett, chair of IRMA.

Experts see the lack of research as a disappointment 30 years into the AIDS epidemic, and as a mandate for more studies on lubricant.

 

A version of this article first appeared at IRIN Plus News, the humanitarian news and analysis service of the UN Office for the Coordination of Humanitarian Affairs, and is used by permission.

Image: Natalie Bailey/IRIN

Kyle Knight is a Fulbright Scholar in Nepal where his research focuses on the LGBTI rights movement. He previously worked at Human Rights Watch, where he focused on children’s rights issue. For three years, he worked as a suicide prevention counselor for LGBTQ youth at the Trevor Project in New York City. He currently sits on the Trevor Project’s Advocacy and Public Policy Committee, is the president of the Duke University LGBT Network, and a is lecturer in Gender Studies at Tribhuvan University, Nepal’s state-run university in Kathmandu. You can follow him on Twitter @knightktm.

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News

Stephen Miller’s Latest Rant Prompts Priest to Cite Goebbels Propaganda

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July 11, 2025

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Stephen Miller’s latest anti-immigrant rant is drawing attention, including from a well-known Catholic Jesuit priest, who appeared to liken the White House Deputy Chief of Staff’s remarks to those made by Hitler’s notorious Reich Minister of Propaganda, Joseph Goebbels, in 1941.

Miller, one of the most powerful members of the Trump administration, is seen as the principal architect of the President’s anti-immigration and deportation policies.

“U.S. Marines on the streets of Los Angeles. Masked immigration officers at courthouses and popular restaurants. Bans on travelers from more than a dozen countries,” Reuters reported on Friday. “For senior White House aide Stephen Miller, the architect of President Donald Trump’s immigration crackdown, things were going according to plan.”

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Denouncing the city government of Los Angeles as “waging a campaign of insurrection against the federal government,” Miller on Friday painted a scenario without undocumented immigrants in remarks made to Fox News.

“Let’s be very clear,” he said. “What would Los Angeles look like without illegal aliens?”

“Here’s what it would look like: You would be able to see a doctor in the emergency room right away, no wait time, no problem. Your kids would go to a public school that had more money than they know what to do with. Classrooms would be half the size. Students who had special needs would get all the attention that they needed.”

“There would be no violent transnational gangs. There would be no cartels. There would be no Mexican Mafia. There would be no Sureños. There would be no MS-13 There would be no TdA.”

“You would be living in a city that would be safe, that would be clean, there would be no fentanyl, there would be no drug dens,” he alleged. “That could be the future Los Angeles could have, but the leaders in Los Angeles have formed an alliance with the cartels and their criminal aliens.”

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Some of Miller’s claims are incorrect. For example, public schools often receive state funding in part based on the number of students and their attendance rate. Fewer students in classrooms means fewer dollars. And federal funding is tied to the number of low-income students and students with disabilities.

Miller’s claims about fentanyl and “drug dens” also don’t hold up. Most fentanyl comes into the U.S. via U.S. citizens, according to the Cato Institute.

Father James Martin, editor-at-large for America Magazine, which is published by the Jesuits, responded to Miller’s remarks by posting a quote from Goebbels:

“The enemy is in our midst. What makes more sense than to at least make this plainly visible to our citizens?”

It’s not the first time Father Martin has responded to Miller’s anti-immigrant rants with a quote.

In April, he quoted the Bible:

“‘I was a stranger and you did not welcome me’ (Matthew 25).”

See Martin’s post and video of Miller’s remarks below or at this link.

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Image via Shutterstock

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Record Majority of Americans Support Immigration in Massive Blow to Trump Agenda

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July 11, 2025

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A record-high majority—nearly eight in ten Americans—now view immigration positively, with similarly strong support for a path to citizenship for undocumented immigrants—particularly those brought to the U.S. as children. The Gallup poll also found that most Americans favor maintaining or increasing current immigration levels.

Meanwhile, large segments of the public oppose expanding the number of immigration enforcement agents—a cornerstone of President Donald Trump’s immigration agenda. Overall, just 35% of Americans approve of Trump’s immigration policies, while 65% disapprove.

Gallup’s report deals a major blow to the very core of President Donald Trump’s agenda, and his “One Big, Beautiful Bill” that dramatically increases spending on immigration enforcement, including detention camps, deportations, and removal, even to third-party countries.

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“Americans have grown markedly more positive toward immigration over the past year, with the share wanting immigration reduced dropping from 55% in 2024 to 30% today,” Gallup reported on Friday. “At the same time, a record-high 79% of U.S. adults say immigration is a good thing for the country.”

“These shifts reverse a four-year trend of rising concern about immigration that began in 2021 and reflect changes among all major party groups,” the top-rated pollster also reported.

Now, just 38% of Americans support deporting all undocumented immigrants, in vast contrast to the stated Trump agenda. That’s down from 47% last year.

In what could be seen as a warning to the GOP, Gallup notes that “the desire for less immigration has fallen among all party groups, but it is most pronounced among Republicans, down 40 percentage points over the past year to 48%.”

Just this week, several top Trump administration officials have continued to promote his anti-immigrant policies.

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U.S. Secretary of Agriculture Brooke Rollins this week told reporters there will be “no amnesty” for undocumented farm workers while insisting adults on Medicaid could replace them.

“There will be no amnesty, the mass deportations continue, but in a strategic way, and we move the workforce towards automation and 100% American participation,” Secretary Rollins said.

Republican Senators have been promoting the Trump anti-immigrant agenda as well. On Thursday, U.S. Senator Ashley Moody (R-FL) called Democrats who oppose the often warrantless raids and tactics used by the DHS’s frequently masked ICE agents, “ignorant pawns of a subversive anarchist agenda.”

President Donald Trump’s and the Republican Party’s budget, which Trump signed into law last weekend, is tremendously unpopular, including his exponential expansion of immigration enforcement budgets, as well as aspects that gut vital social safety net programs like Medicaid and Medicare.

Critics praised Gallup’s findings.

“Nativism had its 6 months and now it’s clear that it’s not the answer,” wrote Cato Institute Director of Immigration Studies David J. Bier.

NBC News senior national political reporter Sahil Kapur, pointing to the Gallup statistics, called it “backlash politics.”

“Turns out, mass kidnappings and deportations are deeply unpopular when put into practice,” observed New York State Democratic Assemblywoman Emily Gallagher.

See the social media post above or at this link.

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Image via Reuters

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‘Racial Profiling’: Border Czar Blasted for Claim ICE Can Detain for ‘Personal Appearance’

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3 days ago

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July 11, 2025

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President Donald Trump’s hand-picked border czar, Tom Homan, is facing backlash from legal and political experts after asserting that Immigration and Customs Enforcement agents do not need “probable cause” to detain individuals—and can do so based on factors like “personal appearance.”

“Look, people need to understand,” Homan told Fox News on Friday. ICE officers “don’t need probable cause to walk up to somebody, briefly detain and question them.”

“They just need to tally the circumstances, right?” he claimed. “They just go through their observation, you know, get out typical facts based on the location, the occupation, their physical appearance, their actions.”

“A uniformed border police officer walks up to them, for instance, at a Home Depot. And they got all these … facts, plus the person walks away or runs away,” Homan said, offering one scenario. “Agents are trained. What they need to detain somebody temporarily and question them.”

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“It’s not probable cause,” he insisted. “It’s reasonable suspicion.”

“We’re trained on that. Every agent, every six months, gets Fourth Amendment training over and over again,” Homan said.

Legal experts blasted Homan’s remarks.

Professor of Law, former U.S. Attorney and MSNBC/NBC News legal analyst Joyce Vance summed up Homan’s remarks: “Racial profiling.”

“This is patently false,” declared U.S. Rep. Daniel Goldman (D-NY), also an attorney, “DHS has authority to question and search people coming into the country at points of entry. But ICE may not detain and question anyone without reasonable suspicion — and certainly not based on their physical appearance alone. This lawlessness must stop.”

Attorney and California Democratic state Senator Scott Wiener charged, “This is literally the definition of a white nationalist police state.”

U.S. Rep. Yvette Clark (D-NY) warned, “Trump’s thugs will racially profile you, then go on national television to brag about getting away with it.”

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Attorney and CNN legal analyst Jeffrey Evan Gold explained, “Walking up to people (without threatening) is legal. But ‘detaining’ people without ‘reasonable suspicion’ of criminal or quasi-criminal activity is illegal. Racial profiling is not cause for the required reasonable suspicion. ‘Let me see your papers’ is un-American.”

U.S. Senator Alex Padilla (D-CA), who, in a highly-publicized incident was forcibly removed and handcuffed by federal agents at a DHS press conference, wrote: “And there you have it. Under the Trump Administration, ICE and Border Patrol are being empowered to stop and question you based solely on how you look. No probable cause. No real reason. Just your ‘physical appearance.’ That’s not justice—it’s profiling.”

“They’re saying the quiet part out loud now,” wrote New York Democratic State Senator Gustavo Rivera. “Don’t get it twisted: if we let them keep doing this, they’ll find a reason to come for ANY ONE OF US soon enough.”

“THEY ARE ADMITTING IT,” wrote David J. Bier, Cato Institute Director of Immigration Studies and an expert on legal immigration, border security, and interior enforcement. “Homan is admitting to participating in a criminal conspiracy against the Constitution of the United States,” he alleged.

Max Flugrath, communications director for Fair Fight Action, wrote: “Trump’s Border Czar and Project 2025 contributor says ICE can detain anyone based on ‘suspicion’ and physical ‘appearance.’ That’s not immigration policy, it’s fascism.”

Watch the video below or at this link:

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