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PubMed2002

[AIDS prevention among incarcerated teenagers, Brazil].

OBJECTIVES: To describe social and family support, drug use, and knowledge, practices and attitudes related to AIDS and its prevention among male teenagers. METHODS: Participants were 275 male teenagers interned in a youth detention center (FEBEM - State Foundation for Juvenile Well-Being) in São Paulo, Brazil. There were two segments. In segment 1, semi-structured interviews with 20 detainees took place. In segment 2, close-end self-administered questionnaires covering sociodemographic data, criminal records, sexual practices, drug use, attitudes, knowledge and AIDS-related practices were applied. RESULTS: Ninety percent of the detainees lived previously with their families. All of them had attended public schools, although 61% had already dropped out. Twelve percent had never used drugs, and 5.5% were intravenous drug users. Most (98%) were sexually active; 35% had had more than 15 sexual partners, 8% had homosexual experiences (inside or outside the center), 12% had exchanged sex for material return and 22% were fathers. Many said that getting HIV infected "that's life " and that they face greater risks in their lives, such as surviving on the streets. They think condoms are easily broken (83%) and interfere with sex (58%); 72% had used condoms but only 9% used them with all their partners. CONCLUSIONS: These teenagers have a very high risk of HIV infection. It is necessary to integrate AIDS prevention programs to their life ills and related problems such as racism, expectations for the future, criminality, drug use, basic rights including sexual and reproductive rights, and show them there are alternatives other than exposing themselves to HIV infection or dying as criminals.

Acquired Immunodeficiency Syndrome↗
PubMed1994

PrepCom III ends with no consensus on reproductive health and rights.

The third and final session of the Preparatory Committee (PrepCom III) for the International Conference on Population and Development (ICPD) came to a close on April 22 without agreement on the language of the draft Program of Action on Population and Development. Although PrepCom III was intended as a forum for reaching world consensus on the document, an intense campaign led by the Vatican has left key segments in dispute. The Vatican effort centered on attacking terms that it believed included the possibility of abortion. As a result, "reproductive health," "sexual health," "sexual and reproductive rights," "safe motherhood," "fertility regulation," and "family planning" now appear in brackets indicating that they are disputed terms. The Vatican and its allies also proposed replacing the term "individuals and couples" with "men and women" because the former could be interpreted to allow adolescents the right to reproductive and sexual health and to information about these issues. Finally, the Vatican opposed references to "condoms" in a segment addressing HIV transmission, contending that abstinence is the only effective method of preventing sexual transmission of the virus. The resulting lack of consensus on the document may force ICPD participants to focus more on abortion specifically than on the broader issues of population and development emphasized by the draft Program. Regarded as an enlightened document that departs from its predecessors, the draft focuses on the centrality of women to the issues of population and development. In addition to moving beyond traditional notions of family planning, the draft recommends the initiation of programs to promote gender equity in health, economic opportunity education, and property rights. CRLP's International Program is currently preparing a fact sheet on the politics of choice in preparation for the ICPD.

Condoms↗
PubMed1999

[What significance does "reproductive health" have for the dermatologist?].

"Reproductive rights embrace certain human rights that are already recognized in national laws, international human rights documents and other relevant UV consensus documents. These rights rest on the recognition of the basic right of all couples and individuals to decide freely and responsibly the number, spacing and timing of their children and to have the information and means to do so, and the right to attain the highest standard of sexual and reproductive health. They also include the right of all to make decisions concerning reproduction free of discrimination, coercion and violence. Full attention should be given to promoting mutually respectful and equitable gender relations and particularly to meeting the educational and service needs of adolescents to enable them to deal in a positive and responsible way with their sexuality." (The International Conference on Population and Development (ICPD), held in Cairo, Egypt, from 5 to 13 September 1994).

Diagnosis, Differential↗
PubMed2005

Assessing reproductive status of right whales (Eubalaena glacialis) using fecal hormone metabolites.

Long-term studies of the endangered North Atlantic right whale, Eubalaena glacialis, have revealed declining reproductive parameters over the past two decades, threatening recovery of this small population if current trends continue. Little is known about right whale reproductive physiology, and investigating this reproductive decline has been limited by a lack of non-lethal methods for assessing reproductive status (e.g., sexual maturation, ovarian activity, pregnancy, lactation, and reproductive senescence) in free-swimming whales. This paper describes validation of existing radioimmunoassay techniques to study reproduction in right whales by measuring estrogens, progestins, androgens, and their related metabolites in fecal samples. Over the past decade fecal steroid hormone assays have been used to assess reproductive status and function in a wide range of terrestrial wildlife species, but this is the first application of this methodology in wild cetaceans. Analysis of fecal hormone metabolite levels in combination with life history data from photographically identified whales shows that this non-invasive method can be used to determine gender, detect pregnancy and lactation, and to assess age at sexual maturity in right whales and potentially other endangered whale populations.

Androgens↗
PubMed2004

Abortion: the legal right has been won, but not the moral right.

In 1978 the abortion law was liberalised in Norway. It permits abortion on request up to 12 weeks of pregnancy, and after that with the agreement of a medical commission, taking the woman's own views into consideration. In 2003, 96% of abortions took place before 12 weeks of pregnancy. There is considerable support among the population for the current law, and the right to abortion does not seem to be under threat, yet opponents of abortion attack the law frequently. Debates on recent biotechnology laws and difficulties introducing the abortion pill, on the spurious grounds that it would make abortion too easy, imply continuing moral qualms about abortion. While abortion among young, unmarried women is more accepted, many married women feel they have to justify their decision. Women are expected to feel sorrow, shame and guilt because of their sexual conduct for many reasons, but especially if the result is an unwanted pregnancy. It is easier to protect the law when there is recognition of the moral right to choose abortion. The legal battle has been won, but winning the moral battle is important in Norway now. I believe that until having an abortion is considered as acceptable morally as using contraception, women will not have gained their full reproductive rights.

Abortion, Induced↗
PubMed2003

Therapeutic versus genuine cloning: what are the real moral issues?

In order to answer the question raised in the title of my paper, I first put forward a general ethical theory, which is based on the traditional maxim neminem laedere. Second, I show how this principle in conjunction with certain assumptions concerning the value of life entails certain fundamental bioethical principles. Thus killing a living being Y is morally wrong whenever the intrinsic value of the life that Y would otherwise live is positive. But procreating a living being Y is prima facie (i.e., with regard to the interests of Y) morally neutral, i.e. neither bad nor good. Third I will argue that the question of moral rights should always be reduced to the question of the morality of certain corresponding actions. In particular, granting Y a right to life should be taken to mean that it would be morally wrong if someone else were to put an end to Y's life. In a similar vein, I suggest answers to some other questions of the reproductive rights issue. Fourth, with respect to the controversial issue of genuine cloning, I do not see any compelling moral reasons against this utopian way of procreating full-grown individuals. Nevertheless, I think there are a lot of other good (pragmatic, rational) reasons not to try to produce a human Dolly. Finally, as regards the use or abuse of human embryos as potential suppliers of stem-cells for the cure of other people's diseases, it seems morally safe to perform experiments at least with those embryos which, like spare embryos that remained from measures of in vitro fertilization, would not have a life anyway. It's more difficult to decide, however, whether it would be morally safe to produce embryos (for instance through cloning) only for the sake of using them in the aforementioned way.

Abortion, Induced↗
PubMed2006

Sex, life and the female condom: some views of HIV positive women.

This article offers some insights into the experiences of HIV positive women with the female condom, drawing on my own personal experience and responses of 18 members of the International Community of Women Living with HIV/AIDS to an e-mail survey conducted in 2005. Major barriers reported to female condom use were cost and sporadic or very limited access. All respondents talked about needing to negotiate the use of female condoms with their male sex partners. Most felt more in control and more confident during sex when using the female condom than with the male condom or unprotected sex. Concerns about female condoms appear to be common, especially among women who have never used one; those who had used the female condom for long periods of time said good things about it. Women reclaiming our bodies is a central part of the joy and the challenge of promoting the female condom. For HIV positive women and girls, using a condom is more than protection against pregnancy, but a matter of life and death greater than the risks pregnancy can bring. Female condoms could make a critically important contribution to protecting HIV positive women's sexuality and continued sexual activity, as a fundamental part of our sexual and reproductive rights, if only they were more widely available and affordable.

Attitude to Health↗
PubMed2004

Advocacy for legal reform for safe abortion.

In Ethiopia, violation of women's reproductive rights is both a cause and a manifestation of women's disempowerment. Obstacles to full realisation of Ethiopian women's reproductive health and rights include the persistence of harmful traditional practices such as female genital mutilation, early marriage and abduction, as well as the disturbing prevalence of rape and HIV/AIDS. Unsafe abortion represents a particularly serious threat to women's health and lives. Ethiopia's status as a signatory to the Convention to Eliminate all Forms of Discrimination Against Women (CEDAW) and its constitutional guarantee of women's equality demand more aggressive action to eradicate such practices and inequities. After years of lobbying by women's organisations, parliamentarians are now reviewing a draft of the 1957 penal code, which includes numerous provisions addressing some of these practices and other conditions that underlie women's poor social and health status.

Abortion, Legal↗
PubMed2004

"Yes" to abortion but "no" to sexual rights: the paradoxical reality of married women in rural Tamil Nadu, India.

This study in rural Tamil Nadu, India, explored the reasons why many married women in India undergo induced abortions rather than use reversible contraception to space or limit births in terms of women's sexual and reproductive rights within marriage, and in the context of gender relations between couples more generally. It is based on in-depth interviews with two generations of ever-married women, some of whom had had abortions and others who had not, from 98 rural hamlets. The respondents were 66 women and 44 of their husbands. Non-consensual sex, sexual violence and women's inability to refuse their husband's sexual demands appeared to underlie the need for abortion in both younger and older women. Many men seemed to believe that sex within marriage was their right, and that women had no say in the matter. The findings raise questions about the presumed association between legal abortion and the enjoyment of reproductive and sexual rights. A large number of women who had abortions in this study were denied their sexual rights but were permitted, even forced, to terminate their pregnancies for reasons unrelated to their right to choose abortion. The study brings home the need for activism to promote women's sexual rights and a campaign against sexual violence in marriage.

Abortion, Induced↗
PubMed2004

Family planning in the balance.

Family planning has long been acknowledged as an effective public health intervention. In recent years, however, family planning has come under increased scrutiny from conservative politicians and constituents. National US policies instituted since 2001 are resulting in cutbacks in family planning programs worldwide. In the long run, these conservative initiatives may set back several decades of progress in reproductive health and reproductive rights. In promoting an ideologically driven approach to sexual and reproductive health, the recent policy developments threaten to subvert ethical standards of medical care and the principle of evidence-based policy.

Abortion, Induced↗
PubMed2005

[Current situation with abortion in Colombia: between illegality and reality].

This article discusses the illegality of abortion in Colombia, situating this country within the 0.4% of the world population where abortion is completely banned. Absolute criminalization of abortion turns it into a public health matter and produces social inequality. The Colombian legislation has always disregarded women as individuals and as persons in full possession of their legal rights. In contrast to a comprehensive conceptualization of sexual and reproductive rights, the various abortion bills merely refer either to "morally unacceptable" situations such as pregnancy resulting from rape or to therapeutic motives. Contradictions between illegality and reality give rise to a public discourse that features rejection of abortion practices, in keeping with the prevailing stance of the ecclesiastic hierarchy, while in practice, and at the private level, people resort to voluntary interruption of pregnancy under conditions of safety and confidentiality, at least for women from the higher socioeconomic strata. This situation not only causes social inequality but also reflects how laws lose meaning and create the collective impression of being useless or unnecessary, thus undermining the state's governing role.

Abortion, Illegal↗
PubMed1997

Moral and policy issues in long-acting contraception.

The advent of reversible long-acting contraceptives-IUDs, injectables and implants-has provided women throughout the world with valuable new fertility regulation options. These highly effective methods, together with male and female sterilization, have proven to be enormously popular and are now used by the majority of women and men who are currently contracepting worldwide. Despite their remarkable popularity, long-acting contraceptives have engendered considerable controversy. Political, ethical, and safety questions have emerged, stemming from the ways in which these contraceptives have been developed and used over the course of this century. At the heart of the concern is the issue of reproductive rights and freedom. This paper reviews the history of the development of long-acting contraceptives, including the prospect of new methods that will likely emerge from ongoing research and development. It also examines the history, in the United States and in developing countries, of the use and abuse of long-acting methods, including sterilization, in the context of eugenics and population control policies. It then describes a new paradigm of reproductive health and rights that has emerged from the International Conference on Population Development in Cairo, and which offers an enlightened approach to future policies and programs. In light of the wide variety of ways in which long-acting contraceptives have been provided, the paper examines the rights and responsibilities of governments, family planning providers, and individuals. An ethical framework for the use of long-acting methods is discussed, and public policies for the future are proposed.

Contraception↗
PubMed2004

Bangkok 2004. Young women living with HIV/AIDS have rights too: a personal testimonial.

Many women living with HIV/AIDS continue to be treated as second-class citizens. In this presentation prepared for "Acting on rights: women, HIV/AIDS and the Barcelona Bill of Rights," a satellite meeting held on 11 July 2004, Promise Mthembu poignantly describes the stigma, discrimination, and abuse that she has faced as a young HIV-positive woman in Africa. The presentation discusses the issues of violence, disclosure, power imbalances in relationships, reproductive rights, safer sex, and access to health care. The presentation concludes with a series of specific recommendations for helping women living with HIV/AIDS realize their rights. Because Ms Mthembu was unable to attend the meeting in person, her presentation was read by Kanjoo Mbaindjikua, who told the delegates at the meeting that she shares many of Ms Mthembu's circumstances and experiences.

Female↗