A lawyer from the Center for Reproductive Rights fills us in on what’s going on with the last clinic in Mississippi. A new HIV prevention drug has limited uses and pregnancy testing in bars is a really bad idea.

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This is my body, not yours

A pill to prevent HIV

 Who should take Truvada for PREP?

Pregnancy testing in bars?

Satan is against selling your daughter into marriage. Go, Satan.

On this episode of Reality Cast, I’ll be talking to a lawyer from the Center for Reproductive Rights about what exactly is going on in Mississippi. An HIV prevention drug is approved by the FDA, but how useful is it? Also, pregnancy testing in bars is just the worst idea.

Care2 put out a great video about the relationship between reproductive health and bodily autonomy featuring a variety of women laying claim to their own bodies.

• my body *

It’s pretty great stuff. In a sense, it’s straightforward, but it’s so unusual still to hear women to stand up and say that we own our own damn bodies, and so it’s really moving.

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I’m a huge fan of technological innovation and of people not contracting HIV, so I really wanted to throw a party when I heard there was a pill approved by the FDA that you can take to prevent getting HIV. It’s called Truvada and the idea is you take it every day, like a birth control pill, and it helps prevent HIV transmission. But it’s not really time to whip out the balloons and noisemakers yet, because the whole thing seems like it has a whole lot of drawbacks that will keep it from really being a player in the war to eradicate HIV.

First of all, it’s not really like the birth control pill in one major aspect. For a lot of women, the birth control pill is the only safe sex precaution they need, because they’re in monogamous, tested relationships. But unfortunately, Truvada really isn’t supposed to be used that way.

• truvada 1 *

What struck me as odd about this is that if you use condoms every time you have sex and limit your number of partners, that’s usually enough to prevent getting HIV. Condoms work really well. Research on HIV-discordant couples, where one person is infected and the other isn’t, has shown that regular condom use works even without a pill as back-up. The problem is that people don’t use condoms, but in this NPR report, it was clear that this is absolutely not supposed to be a substitute for condoms. In fact, so much so that the  reason it got approved was research showed that people who use this drug don’t slack off on condom use. Truvada has side effects, and in some people they’re very serious, especially with regards to liver stuff. It seems on the surface like the risks way outweigh the benefits of using Truvada plus condoms, instead of just using condoms.

All that, plus, you know, drugs are expensive.

• truvada 2 *

I’m going to go out on a limb and say probably very few, especially in light of the fact that it’s not something that allows for behavioral changes. Since condoms alone are extremely effective, and since insurance companies are often loath to pay for the more expensive treatment when the cheaper one is just as effective, I just don’t really see it happening, except in rare cases. In fact, I was hard-pressed to think of exactly who could benefit from such a drug, but luckily NPR did another story explaining that aspect. Basically, the first answer is, “Very few people and it’s a total niche product.” But a few groups of people were discussed.

• truvada 3 *

For thirteen grand a year, it really doesn’t seem like a little extra insurance to help you sleep at night is going to be an option for anyone that’s not extremely wealthy. Particularly if you’re talking about couples like this one, who practice safe sex AND the HIV positive partner takes anti-virals that keep his viral load low. I’m not saying that it’s not good to be extra safe, but at a certain point, we all do things every day that are riskier than what these two have going on, and I’m a tad skeptical of the value-add of an extremely expensive pill.

Another group that had a little bit more reason to be interested is women who are in bad relationships with HIV positive men, where the women are abused and can’t insist on a condom every time and their partners might not be taking their anti-viral medications. They interviewed one doctor who had prescribed the drug under those circumstances, but again, I have to wonder about the cost. It just seems like pretty much all women in those situations aren’t going to be able to come up with $13,000 a year. It would be interesting to find out how her patients pay for it.

One last situation was mentioned that’s of interest.

• truvada 4 *

Of course, you’re still running a risk of getting HIV in those situations, so I really don’t think it’s advisable and imagine most doctors would just suggest that keeping HIV out of a woman’s system should be prioritized over baby-making. Still, it’s just part of medicine that you have to accept that some people are going to make their choices, and so I’m glad there’s a way to make what’s inherently a risky choice a somewhat safer one.

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Insert interview

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There’s a lot of places where I expect to get concern trolled for no other reason than I’m a lady. You get accustomed, when you’re female, to having people put on a concerned face so they can insinuate that being female means you’re stupid or to butt into your business, especially with regards to your sexual or reproductive choices. I expect it at family-oriented gatherings,  the internet, places like that. But not in bars! Not that bars are some kind of wonderland without problems, but one that they’re usually free  of is people trying to make you feel like you’re nothing more than a two-legged life support system for a uterus, and to express feigned concern that your stupid ladybrain is conflicting with your sole function as a baby factory. Bars, by virtue of being a place for adults to congregate, are usually free by and large of the pregnancy and childbirth obsession in our culture, and of using that obsession to bully women and make them feel like they’re bad for all their non-baby-making-related behaviors. But now there’s pressure to change all that, starting with a bar in Minneapolis. 

• test 1 *

Great, so this bar wants to be testing grounds for a widespread expansion of the uterine contents police state. Naturally, it’s not just the bar owner who approved this who is a man, but also the guy who asked to have the pregnancy test machine put in. I say naturally, because they seem to have a poor idea of how the actual process of learning you’re pregnant goes. As a person with a uterus, I can assure you it’s not really related to the bar-going experience in any way. The fact that the vending machine piously recommends women pregnancy-test every two weeks really drives home how little these guys know about how women’s bodies actually work. But of course, a lot of this is exploiting anxieties about women drinking alcohol. The possibility of pregnancy just gives that urge to moralize a form and an excuse.

• test 2 *

Lately, when I hear the words “informed choice” being tossed around regarding pregnancy, I grab my wallet. Informed decision-making is a great thing, but the phrase has been co-opted by misogynist elements, such as crisis pregnancy centers, to imply that women are really stupid and can’t make a good decision without having someone, preferably an older white man, holding their hand and exerting pressure. What we know is these things escalate. The first ultrasound laws justified with this “informed decision” making just required doctors to offer the option. Now you have to have the ultrasound and have to listen to a badgering script and have to hear the heartbeat and have to endure a vaginal probe. Which is why this all makes me uneasy. Right now, it’s being introduced as a soft thing, like “Oh, we’re giving you the totally voluntary option to just know, all up to you!” But the groundwork being laid here could be used to create a situation where women feel they have to go through a humiliating process of peeing on a stick in order to do something as simple as order a drink in a bar.

I suspect the reporters doing this soft, feel-good story may have suspected that the whole thing isn’t as sunshine and rainbows as they’re pretending, if only because the whole thing is a matter of two men exerting pressure on women to feel we have to pregnancy test before every damn drink we have. So, in order to make the whole thing feel less creepy and intrusive, they got some women on tape supporting it. But I am not fooled.

• test 3 *

The “discreet” thing is particularly thoughtless. Few places are more discreet than a bar bathroom. Drugstores are way more discreet. Plus, I can’t think of a worse place to go through the stress of pregnancy testing than a frigging bar. That’s an occasion where both you and the people around you need to be clear-headed and serious, not goofing off and getting tipsy. To make things even more alarming, a not insignificant number of couples going to bars are involved in abusive relationships. I can’t think of a more combustible combination than an abusive man, alcohol, and a pregnancy test, especially a positive one. Fetal alcohol syndrome is a real problem, but treating women like morons and increasing the uterus surveillance isn’t the answer. The real answer is better access to birth control and better access to substance abuse resources, so women can choose to get pregnant when they feel capable of being sober during their pregnancies.

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And now for the Wisdom of Wingnuts, at least they’re getting more upfront about it edition. Cal Beisner of the Cornwall Alliance was on Bryan Fischer’s radio program, and they got to talking about Pixar’s new girl-centered movie “Brave”. I’m sure you’ll be shocked to know that they strongly disapprove of girls having movies where they get to be real protagonists instead of passive princesses.

• brave *

Of course, if you see the movie, you know she never says she’s against marriage. She just doesn’t want to be sold by her father to a prince who “won” her in a contest. So I guess if you’re against arranged marriage, you’re anti-procreation and anti-marriage generally. Good to know.