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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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OPINION

Trump Threatens to Violate Gag Order and Go to Jail: ‘I’ll Do That Sacrifice Any Day’

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16 hours ago

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May 6, 2024

By

Just hours after a New York State Supreme Court Justice held Donald Trump in criminal contempt of court for violating his gag order and threatened him with jail time, the ex-president attacked several of the judges overseeing his cases, and suggested he may violate the gag order for the good of the U.S. Constitution.

“Because this judge has given me a gag order and says you’ll go to jail if you violate it. And frankly, you know what, our Constitution is much more important than jail. It’s not even close. I’ll do that sacrifice any day,” Trump claimed.

Trump is on trial for 34 criminal felonies for falsification of business records, which experts describe as election interference after he paid “hush money” to an adult film actress in an effort to keep his alleged affair away from the public eye just before the 2016 presidential election.

The ex-president, who announced his 2024 run for the White House, insiders say, to escape prosecution for a wide variety of alleged crimes, began his Monday post-trial news conference with reporters by criticizing the prosecution’s announcement it expects to wrap up its portion of the trial in about two weeks.

READ MORE: ‘Israel Aid, Ukraine Aid, Kitchenaid’: Dem Mocks GOP’s ‘Hands Off Our Appliances’ Week

“The government just said that they want two to three more weeks,” Trump complained. “That means they want to get me off the [campaign] trail for two to three more weeks. Now, anybody in there would realize that there’s no case, they don’t have a case. Every legal scholar says they don’t have a case. This is just a political witch. It’s election interference. And this is really truly election interference, and it’s a disgrace. It’s a disgrace, and in every poll I’m leading by a lot.”

Those statements are false.

The New York Post reports, “Prosecutor Josh Steinglass estimated that the DA’s office would wrap up its case around May 21, two weeks from tomorrow. But he cautioned that’s a ‘rough estimate.'”

Concluding the District Attorney’s Office did have a case, a Manhattan grand jury indicted Trump on 34 felony counts.

A great many legal scholars say there is a case.

There is no evidence of a “political witch-hunt.”

Trump is not leading in all the polls, nor, in all the ones he is leading in, is he leading by “a lot.” Nor do political candidates get exempt from prosecution because they may be leading in a particular poll.

The ex-president went on to claim prosecutors “figure maybe they can do something here, maybe they can do, this case should be over, this case should have never been brought.”

“And then Alvin Bragg brought the case, as soon as, when I’m running and leading, that’s when they decided, let’s go bring a case. So it’s a disgrace. But we just heard two to three more weeks. I thought that we’re finished today and they are finished today. We look at what’s happening. I thought they were going to be finished today and then 2 to 3 more weeks,” he again complained, again saying prosecutors “all want to keep me off the campaign trail. That’s all this is about. This about election interference. How do we stop it? And it’s a disgrace.”

READ MORE: ‘I’m Not Talking About That Meeting’: Noem Implies She May Have Met With Kim Jong Un

Trump then brought up the gag order.

“Where I can basically, I have to watch every word I tell you people, you asked me a question, a simple question I’d like to give it but I can’t talk about it,” he claimed, falsely.

“Because this judge has given me a gag order and say you’ll go to jail if you violate it. And frankly, you know what, our Constitution is much more important than jail. It’s not even close. I’ll do that sacrifice any day.”

Trump attacked three of judges overseeing his case, excluding U.S. District Court Judge Aileen Cannon.

“But what’s happening here is a disgrace and the appellate courts ought to get involved. New York looks so bad, system of so called justice was so bad between this judge and [Judge Arthur] Engoron and [Judge Lewis] Kaplan the triple teamed with the corrupt judges is a disgrace to our nation. So I should be out there campaigning.”

Watch Trump’s remarks below or at this link.

READ MORE: Congressman Pummeled for Praising Students Mocking Black Protester With Monkey Sounds

 

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OPINION

‘Israel Aid, Ukraine Aid, Kitchenaid’: Dem Mocks GOP’s ‘Hands Off Our Appliances’ Week

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19 hours ago

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May 6, 2024

By

Last year in January, in the wake of a study that found 650,000 children have developed asthma because of gas stoves, Bloomberg News reported: “US Safety Agency to Consider Ban on Gas Stoves Amid Health Fears.”

There was no ban in the works or on the way, and the chair of the U.S. Consumer Product Safety Commission (CPSC) was forced to issue a statement promising, “I am not looking to ban gas stoves and the CPSC has no proceeding to do so.”

Republicans however, went on the attack, with some, like U.S. Rep. Ronny Jackson (R-TX), a physician, shouting on social media, “I’ll NEVER give up my gas stove. If the maniacs in the White House come for my stove, they can pry it from my cold dead hands. COME AND TAKE IT!!”

Congressman Jackson soon doubled-down, appearing on Newsmax.

One month later, West Virginia Democratic U.S. Senator Joe Manchin teamed up with several Republicans to protect Americans’ “right” to non-electric cooking.

READ MORE: ‘I’m Not Talking About That Meeting’: Noem Implies She May Have Met With Kim Jong Un

“Gas stoves have been in the news lately and I’ve come out strongly against the Consumer Product Safety Commission pursuing any ban of gas stoves,” Manchin declared, despite there being no possibility of that. “In fact, I’m introducing legislation today with Senator [Ted] Cruz that would ensure that they don’t and separately sending a letter to the commission with Senator [James] Lankford.”

For decades the scientific community has known about the health dangers of gas stoves, but Americans love them and there are no plans to have any federal government agency coming to take them away.

The Biden administration would like to help Americans buy new, energy-saving home appliances, but Republicans oppose those efforts as well.

Nearly sixteen months later, Republicans are still working to protect Americans from what some have suggested will be the federal government knocking on the doors of U.S. citizens to take away their gas stoves.

Last month, Republican Speaker Mike Johnson was all set to revive the House’s focus on ensuring Americans can continue to grill baby grill – indoors – childhood asthma-be-damned, and nearly put HR 6192, the Hands Off Our Home Appliances Act, and several others on the floor for votes, including:

The “Liberty in Laundry Act” (HR 7673), the “Clothes Dryers Reliability Act (HR 7645), the “Refrigerator Freedom Act” (HR 7637), the “Affordable Air Conditioning Act” (HR 7626), and the “Stop Unaffordable Dishwasher Standards Act” (HR 7700).

But at the last minute he changed the schedule after aid to Ukraine and Israel became the national focus.

READ MORE: Judge Hands Trump ‘Incarceration’ Threat as Experts Say Next Time He’ll Toss Him in Jail

MSNBC’s Steve Benen reports Monday, “the ‘Hands Off Our Home Appliances Act’ … will likely reach the floor this week, possibly as early as tomorrow.”

One year ago this month, U.S. Rep. Jared Moskowitz (D-FL) delivered amusing remarks during a House hearing.

“I want to apologize on behalf of the Democratic Party that we have decided to put kids’ safety, in their neighborhoods from getting gunned down, in movie theaters, or grocery stores, or school churches, or synagogues – we as Democrats have clearly lost our way that we are not focused on appliances,” Moskowitz said sarcastically in a viral video.

Now he’s back, along with the House Republicans’ renewed focus on the false fear-mongering the federal government is coming for your home appliances, or is going to ban them.

In response to Axios’ Andrew Solender reporting, “Appliance Week is BACK in the House!” Congressman Moskowitz replied, “Israel aid, Ukraine aid, Humanitarian aid, Kitchenaid.”

He then grew even more sarcastically excited:

Watch the videos above or at this link.

READ MORE: Congressman Pummeled for Praising Students Mocking Black Protester With Monkey Sounds

 

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News

‘I’m Not Talking About That Meeting’: Noem Implies She May Have Met With Kim Jong Un

Published

22 hours ago

on

May 6, 2024

By

Republican South Dakota Governor Kristi Noem continues to make media appearances promoting her new book, which has received massive attention for the story about her shooting to death her 14-month old dog, Cricket, and a goat, and her reportedly false claim she met with North Korean dictator Kim Jong Un.

But in discussing that apparent lie that appears in her book, Noem appeared to tell a few more – and seemed to suggest she may have actually met with Kim Jong Un but should not have put that meeting in her memoir. Experts have said it’s unlikely she did meet with him.

“The book is called, ‘No Going Back,’ but it sounds like the publisher, Center Street, is going back on a couple of the details in the book,” CBS Mornings told Noem.

“Well, I don’t believe so,” Noem replied.

After hearing the apparently false details of her alleged meeting with Kim Jong Un being read on-air straight from her book, Noem explained, “when I became aware of that we changed the content, and the future editions will be adjusted.”

READ MORE: Judge Hands Trump ‘Incarceration’ Threat as Experts Say Next Time He’ll Toss Him in Jail

Noem also said she’s “met with many, many world leaders, I’ve traveled around the world. I should not have put that anecdote in the book, and at my request they have removed it.”

She was then asked, “That specifically didn’t happen?” but Noem appeared to brush off the question.

“What I’m saying is I’m not talking about that meeting, I’m not talking about my meetings with world leaders, there are some that are in the book and there’s some that are not in the book.”

Asked, “Did you tell your ghost writer to write that?” Noem refused to answer the question.

“I specifically have worked on policy for over 30 years, and over that time I have traveled around the world and met with leaders around the world. And that anecdote, I’ve asked them to change the content, and it will be removed.”

“It’s a simple question, did you or did you not meet with Kim Jong Un?”

“That’s the answer that I have for you,” Noem replied.

READ MORE: Congressman Pummeled for Praising Students Mocking Black Protester With Monkey Sounds

She also did not tell CBS why she chose to put it in the book at all, if she knew it was false.

Noem does not mention that she recorded the audio book version for “No Going Back,” and would have read those words about meeting with the North Korean dictator aloud, yet apparently did not ask her publisher to remove it until a local newspaper, The Dakota Scout, published a report starting her account of the event was “in doubt.”

On Sunday, Noem first began to suggest the meeting might have taken place. Speaking with CBS’s “Face the Nation,” Axios reported, “Noem declined to talk about specific meetings she had with various world leaders, and never outright said she didn’t meet with Kim during the interview.”

A CBS News transcript of that interview shows “Face the Nation” moderator Margaret Brennan saying, “you released video of your recording of the audio book. you didn’t catch these errors when you were recording it?”

“Well, Margaret, as soon as it was brought to my attention, I took action to make sure that it was reflected,” Noem responded, before leaping into an attack on the media.

Also on Sunday, The Independent reported, “North Korea experts say it’s highly unlikely Ms Noem ever met the North Korean leader.”

“From 2011 to 2018, Mr Kim did not leave North Korea, according to University of Notre Dame professor and North Korea expert George Lopez.” The Independent added, “Benjamin Young, a professor at Virginia Commonwealth University and an expert on North Korea, told The Dakota Scout that Ms Noem’s account of meeting Kim was ‘dubious.'”

“I cover North Korea very closely, and I have never heard of Kim Jong Un meeting congressmen or congresswomen,” Young said.

Watch Noem’s full CBS interview from Monday below or at this link.

READ MORE: RFK Jr., Embracing Far-Right, Spoke at Fundraiser for Anti-Government Group With J6 Ties

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