Friday, October 17, 2003

That was then:
Army Gen. John P. Abizaid, in his first Pentagon briefing since taking charge of the U.S. Central Command last week [...] said that soldiers quoted yesterday on ABC News' "Good Morning America" questioning their mission in Iraq and calling for Rumsfeld's resignation were wrong and could be disciplined.
And also:
Soldiers' families are also being advised not to complain to the media, according to news reports.

After being told that 3rd ID soldiers would be staying in Iraq longer than expected, families received an e-mail message from a rear-detachment commander warning against contacting the press "in a negative manner regarding the military and this deployment."

This is now:
Army Lt. Gen. William G. Boykin has made several speeches — some in uniform — at evangelical Christian churches in which he cast the war on terrorism in religious terms. Boykin said of a 1993 battle with a Muslim militia leader in Somalia: "I knew that my God was bigger than his. I knew that my God was a real God, and his was an idol."

The defense secretary said he could not prevent military officials from making controversial statements.

"We're a free people. And that's the wonderful thing about our country," Rumsfeld said. "I think that for anyone to run around and think that that can be managed and controlled is probably wrong. Saddam Hussein could do it pretty well, because he'd go around killing people if they said things he didn't like."

Thursday, October 16, 2003

The online Museum of Menstruation (and I can't even begin to tell you how relieved I am to find that it's just a clever name for an informational website, and not a real museum) has been collecting responses to the question, "Would you stop menstruating if you could?" The breadth and range of the responses are utterly fascinating.
it's embarrassing. When suddenly you can't go somewhere you were supposed to and are asked why, if you excuse yourself from a commitment and it is a woman, perhaps she doesn't get as severe a period as you, so she assumes you are just being a hypochondriac/sissy who shouldn't let such things interfere with life and activities.

Have fantasized swapping my very fertile system with some poor female who is dying to have crying, money-eating, life-goals killing children, but cannot.

Bleeding once a month lets me know there's nothing wrong. Examples: if I'm stressed, I don't get my period. I didn't get my period once due to precancerous cells on my cervix, or from a very bad infection.

Please don't come up with that stuff about feeling more creative and better connected to Mother Earth and all that bullshit. Sorry for all women that define their relation to nature and spiritual things by bleeding.

Menstruation is a reminder to me that I am an organic creature, a child of Mother Earth. Menstruation is a sign of a healthy womb/healthy body. Menstruation is an emotional and spiritual thing for me. During my period, I am aware of the power I have as a woman to reproduce life and to become a living environment for the growth and development of a human being. To me, menstruation is sacred.

In my world, there were four things that qualified you as an adult; being able to wear makeup, having pierced ears, being baptized, and of course, having a period. I just wanted to feel like a grown woman, and I also wanted the responsibility.

I don't hate my period (usually), or think it's shameful or wrong; I'm fairly open about it, really. I just find it generally useless and pretty irritating. It doesn't have any "effect" on me - I'm not more emotional, more artistic, more connected to femininity. I'm just bleeding from the crotch for seven days.

Why, God? Why does God favor men? Why do women have to deal with all the pain, bloating, moodiness, odor, etc. Men have nothing they have to deal with.

Paging Connie Willis to the red courtesy phone.

More seriously, I'm struck by how few of the responses are as matter-of-fact as the second to last one. Women seem to project all kinds of things onto menstruation, and the factual correctness of the interpretation (no, there's no connection between lunar cycles and menstruation, and certainly menstruating doesn't mean that "nothing's wrong," as the third quote suggests) doesn't even seem to enter into it.

Monday, October 13, 2003

Some companies are designing their workplaces to force employees to exercise.
"It's, if you will, a forced wellness program," said Dan Jeakins, an architect in Dallas who has designed office buildings that encourage walking and stair-climbing. "We've had fitness centers, but that varies on who really uses those things."
As a health psychologist, I strongly approve of lifestyle modifications to promote healthy behavior, rather than short-term diets or "exercise programs." Most people, realistically, can't or won't take up high-intensity exercise in a gym, whereas most people can probably increase the amount of walking they do in their daily lives.

But as a disabled person, I have to wonder when the first ADA challenge will be brought against one of these companies. How are their employees with orthopedic disabilities, arthritis, asthma, emphysema, or severe seasonal allergies doing with all the required extra walking and time outdoors? What about female employees who are nine months pregnant? It's all very well to argue that the average employee is sedentary but nondisabled and could benefit from extra exercise, but public design is supposed to accomodate the needs of the entire population, not just the needs of the modal person. The ability to walk a half-mile to one's desk should not be a requirement for an office job. Period.

And as a woman, I wonder whether these new walking-intensive company campuses have dress codes for female employees which permit them to wear comfortable walking shoes, or whether women are expected to walk these "wellness-promoting" extra half-miles in the high heels typically required with women's formal office wear.

Thursday, October 09, 2003

The National Center for Biodefense at GMU has announced that smallpox vaccination might protect against HIV infection.
The study was conducted using blood cells from 10 vaccinated and 10 unvaccinated subjects. Despite the small number of subjects involved, there was a statistically significant difference in resistance to HIV infection between the blood cells from the vaccinated and the unvaccinated subjects. HIV failed to grow or grew at substantially reduced levels in the cells from the vaccinated group when compared to the unvaccinated group.
The researchers say they got the idea because HIV emerged in Africa at about the same time that smallpox vaccinations stopped there. The International AIDS Vaccine Initiative is apparently dubious, pointing out that we've had a lot of exciting early findings that have failed to pan out.

I'm dubious myself. I notice that Medscape doesn't have anything about this on their HIV home page (although if you search the Medscape site you'll find a Reuters article that's essentially the same as the GMU press release), and nothing about it appears to have been presented at the Interscience Conference on Antimicrobial Agents and Chemotherapy or at the AIDS Vaccine 2003 conference. We've seen miraculous advances released to the popular press but not for scientific peer review before, and it hasn't typically boded well for the ultimate scientific value of the research.

There must be more to this theory than temporal correlation, but without anything to go on but the press release, there's no way I can tell what else there might be. In the United States, routine smallpox vaccination was halted in 1972 and the first cases of AIDS were identified in 1982. So virtually every adult infected with HIV in the early days of the epidemic would have been immunized for smallpox. Moreover, genetic analysis of HIV suggests that it's much older than smallpox eradication, and it appears that AIDS had already reached epidemic proportions in parts of Africa by the 1960s.

In short, I'm not expecting anything to come of this - although it would be nice to be pleasantly surprised a few years down the line.

Monday, October 06, 2003

Sweet suffering Jesus.
What I saw: A young family of five — father, mother, three young children, well-dressed, well-behaved, enjoying their night out, too. Except for the well-behaved children — mythical creatures with which we have no personal experience with — the family was unremarkable.

But they were black. And my husband whispered that in a nation where 70 percent of black children are born into homes without fathers, it was great to see a picture-perfect black family dining together. "I almost want to go give the guy a high five," he said, somewhat sheepishly.
I thought we were at least thirty years past the concept of "a credit to their race." What chills me most is that I'm dead certain that Graham thought she was being nice.

(Via Atrios.)

Friday, October 03, 2003

Because our church still hasn't gotten around to sending us a subscription to the UU World after two years of membership, I initially missed the July/August feature on Unitarian-Universalists and the military. The lead article, "Embattled Faith," does an excellent job of exploring historical and current conflicts within the denomination regarding war and peace. Unitarian-Universalism isn't pacifist either by creed (because there is no creed) or by history (Unitarians were strong promoters, for example, of the American Civil War), but pacifist viewpoints certainly dominate modern UU thinking to the extent that it can be uncomfortable to disagree. I credit the UU World for printing a sidebar piece by an Air Force wife who had to remind her church not to reject members of the military. It's not a very attractive view of Unitarian-Universalism, but I think it's important that practitioners of liberal religion be prepared to address our own hidden intolerances. Sure, it's more comfortable to focus on the beam in the other guy's eye, but UUs are supposed to believe in the inherent worth and dignity of all human beings, whether they're holding a peace sign at a rally or an M-16 in Iraq. No one ever said it was going to be easy.

Thursday, October 02, 2003

Monday, I heard Sten Vermund speak about the history of HIV epidemiology at the 2003 International Meeting of the Institute of Human Virology. Dr. Vermund mentioned, parenthetically, that bleach does not effectively remove virions from injection drug equipment, and thus is not recommended as a prevention technique.

I hadn't heard that. Given that I do HIV prevention work with my patients, 80% of whom have injection drug use histories, I thought it was a bit odd that I hadn't heard that - so I went researching. After several minutes of digging, I found a set of 1997 CDC recommendations for IV drug users emphasizing the importance of new, sterile syringes, with bleach mentioned as a backup option. The CDC's HIV FAQ also pushes the use of new syringes and mentions bleach as a less satisfactory alternative. Neither CDC site provided details of how needles should be cleaned with bleach, although established guidelines do exist.

An older CDC fact sheet presents a 1991 finding that addicts who reported always cleaning needles with bleach had the same seroconversion rates as addicts who didn't report using bleach. (I have to wonder about the accuracy of addicts' reports on their injecting behavior, though, given the typical state of mind immediately pre-injection.) Other studies have found that addicts often think they've rinsed their needle for a full 30 seconds when they haven't. These seem to be the results which led to the de-emphasis of bleach. But another recent study suggests that the recommendation might've been changed too soon:
"What we found is that for the type of syringe usually used by drug injectors, even a one-tenth diluted solution of bleach successfully disinfects the syringe if the solution is drawn in and squirted back out," Heimer says. "Even when we stacked the deck and left 10 times more blood in the syringe than is usually found, full strength bleach was effective in 152 of 153 attempts. We even found that rinsing three times with clean water reduced the likelihood of recovering live virus by 99%."

Most of the patients I see in my research don't share needles - Baltimore has an effective needle exchange program - and none of my therapy clients currently inject drugs. But damn it, it shouldn't take an hour of research for me to find out the latest evidence-based prevention recommendations. I should be drowning in the latest recommendations. But for some reason, that doesn't happen - especially when the latest recommendations contradict previous recommendations.

The best example of this is the spermicide nonoxynol-9. It used to be recommended because it was found to kill HIV in vitro, but in real life it actually increases the risk of HIV infection in both women and in gay men. Many AIDS service organizations still distribute condoms treated with n-9 - even the Institute of Human Virology, one of the premier HIV research institutions in the world. Information dissemination on this topic has just been poor. You shouldn't be able to get within ten feet of a condom without being exposed to full information about n-9. They should have warning labels on displays in stores. At a minimum, everyone working in the field should have had it hammered into their heads by now. I don't know why that hasn't happened.