The Bushworld has been desperately trying to malign the lowly condom, trying to push false and misconstrued data which “questions” the supposed effectiveness of the condom in preventing the transmission of STDS. You know, like AIDS. I guess the philosophy on that is if we scare people into thinking that condoms are not all what they’re cracked up to be, abstinence will prevail–even after marriage.

I guess they never considered the fact that if they keep pushing this agenda, the vast majority of the target population will continue to have sex, only without condoms. I mean, why use them if they’re worthless?

Recipient of Pinhead Award

I would have to award former Rep. Tom Coburn, MD (R-OK), a belated Pinhead of the Year award for his work in trying to promote the transmission of STDs as well as unplanned pregnancies. Coburn was a staunch proabstinence opponent of government-funded family planning programs under the Clinton administration, and he, along with his other pinhead friends, were successful in attaching one of those noxious amendments to the House version of the Breast and Cervical Cancer Treatment Act. This particular one mandated that condom packages carry a cigarette-type warning that condoms offer “little or no protection” against an extremely common STD, human papillomavirus (HPV), which causes cervical cancer.

I can just see it now. Bob and Sue are out together, getting ready to screw in the backseat of Bob’s jalopy. Being a conscientious teenage couple, Bob pulls out the condom right as things get hot and heavy. And then…

“Oh, Sue, wait! Can you hand me the flashlight? I’ve got to read the warning on the label.”

And then, after reading that condoms offer little to no protection against HPV, our two teen heros decide to call it a night, and go home to separate cold showers.

Read the Label, Stupid

While this idiocy was ultimately removed from the bill, Coburn and the pinhead clan were able to secure a requirement that the FDA reexamine condom labels to determine whether they are medically accurate with respect to condoms’ “effectiveness or lack of effectiveness” in STD prevention. And now, since the political climate has changed in favor of detrimental and utterly dangerous public health ideology, the anti-condom campaign has begun full force.

The NIH held a workshop in 2000 where they examined the literature on the effectiveness of condoms, and reviewed its role in preventing the transmission of eight STDs: HIV, gonorrhea, chlamydia, syphilis, chancroid, trichomoniasis, genital herpes and HPV. Few of the studies were “Condom specific” so to speak, and they were only able to definitively conclude that condoms were effective in preventing the spread of HIV and gonorrhea (and of course, preventing pregnancy).

But this conclusion didn’t mean that condoms were not effective for other diseases. It was just that “the literature is insufficient to warrant definitive statements specific to the other six STDs considered by the panel.”
And the workshop report explicitly cautioned that the “inadequacies of the evidence available…should not be interpreted as proof of the adequacy or inadequacy of the condom.”

Yet don’t you know the old adage. Once a pinhead, always a pinhead. The anti-condom bandwagon got rolling, and the pinheads quickly dismissed the findings of NIH. Amazing as it may seem, Coburn issued a press release in July 2001, entitled, “Condoms Do Not Prevent Most STDs” and praised the NIH report for finally exposing “the ’safe’ sex myth for the lie that it is.” And this man is supposed to be a physician? But now, with Clinton gone and Bush in office, Coburn had a much more receptive atmosphere to carry on his anti-condom diatribes. Indeed, I think his goal is to fight STDs and teenage pregnancy with fire and brimstone.

So let’s see what this all means. Coburn thinks that by putting “warnings” on condoms, ie, that they do not protect against some STDs, Americans are going to put padlocks on their zippers. Are we orbiting cloud 9 yet? Are the Klingons marching on Washington?

Truth be known, most people don’t read labels. I mean, have you been to a drugstore lately and seen the condom aisles filled with people studiously reading the labels? Most people can’t even be bothered to read the labels on their prescription medicine bottles, or on an over the counter drug, for heaven’s sakes! And yet, Coburn truly believes that guys are going to stand there and read the fine print on a condom package, and then pause and reflect on the message.

And if they do read the label, and it says anything at all about condoms not being effective against STDs, well, do you think they’re not going to have sex? Do smokers stop smoking because of labels on cigarette cartons? Does “just say no,” work in stopping people from using illegal drugs? Do all of the millions of other health related warnings which inundate the public day after day have any effect at all? If they did, we’d be a nation of slim, fit folks, who didn’t smoke, limited caffeine intake to one cup of coffee a day, and where heart disease was a rare occurrence. There might be one lone McDonald’s on the landscape, and perhaps one tiny outlet for Kentucky Fried Chicken.

What is most dangerous is if someone actually does read a warning on a condom label, and decides what the hell? If it doesn’t protect against STDs (and the vast majority of the public hasn’t a clue what HPV is–they may well assume that it means AIDS) then why bother wrapping my dick in a plastic bag? No, Tom Coburn, it doesn’t mean that they will wait until holy matrimony and ’til death do us part. It means that they will have sex, and maybe if they’re smart, the girl will use some sort of contraceptive, but no protection against STDs. In other words, Tom, your campaign to malign the condom is the beginning of a public health nightmare like you never dreamed of.

Sex between unmarried people is very common, in the US and all over the world. It always has been common, even during the days of the Pilgrims and Puritans. It even occurs in nations where a person can face prison, be stoned to death, or be lashed to a pulp for even thinking about sex. The idea that we’re going to “scare” the population into abstinence is stupid beyond comprehension. And yet, these are the people who are now at the reins of public health.

The Big Blow Job

The recent news from Uganda was not good news for the pinhead crowd. It seems that condoms work afterall, regardless of their attempts to demonize that poor little bubble of latex.

From the SF Chronicle:

Uganda’s HIV rate drops, but not from abstinence
Study concludes basis of Bush policy apparently irrelevant

Boston — Abstinence and fidelity – cornerstones of the Bush administration’s overseas AIDS prevention programs — may be playing less of a role than previously thought in driving down HIV infection rates in Uganda, where the idea first gained credence, according to new findings presented here Wednesday.

Research from the heavily studied Rakai district in southern Uganda suggests that increased condom use, coupled with premature death among those infected more than a decade ago with the AIDS virus, are primarily responsible for the steady decline in HIV infections in that area.

Truth be known, the researchers found that that abstinence and fidelity have actually been declining, and yet the incidence of HIV has dropped. Could it be, the lowly condom? Could it be that it works?????

“Condom use may be offsetting other high-risk behaviors,” said Maria Wawer, a professor at Columbia University’s Mailman School of Public Health, who presented the study at a session of the 12th Annual Retrovirus Conference in Boston.

The single greatest factor in lowering the infection rate in Rakai was the premature deaths of those who were infected earlier with HIV and subsequently died of AIDS. The number who remained infected or became newly infected decreased in the late 1990s.

Dr. Ronald Gray of Johns Hopkins University, co-author of the Rakai study, said that much of Uganda’s early bout with high rates of HIV infection coincided with a period of war in the 1980s. By the 1990s, the country was settling down to a period of relative peace and a return to normal sexual behaviors.

The push for abstinence until marriage, and the so-called “zero-grazing” policy discouraging sex with multiple partners, does not appear in the Rakai study to have made an impact, according to Gray.

“Over the past decade, we’re just not seeing it,” he said.

The Rakai findings are based on an extensive and continuing process of interviewing 10,000 adults each year — a so-called population-based survey that is considered the gold standard for this kind of epidemiological research.

The rate of HIV infection is declining, despite the fact that the percentage of men aged 15 to 49 having sex outside of marriage in 2002, nearly doubled from the rate in 1995. Half of all men in this age group are screwing around, basically, up from 30% in 1995. Sexual activity has also risen among teenagers, and they’re starting at a younger age.

So obviously, it is not abstinence, fidelity and monogamy that has caused the rate of AIDS to drop. Rather, it would appear that consistant condom use has been the savior. Reports of consistent condom use by men rose to more than 50% by 2002, compared with 10% a decade earlier. Among women, reports of condom use rose from virtually zero to 25%.

ABC, Easy as 1,2,3

Uganda’s ABC strategy — Abstinence,Be faithful” and (use) Condoms” — has been widely touted as the reason for the dramatic decrease in HIV infection. In fact, it is on the verge of being exported to neighboring countries with the blessing and financial support of Bush. However, the “C” component of the triad is the one that has been de-emphasized in the Bush plan. In fact, the Bush administration’s $15 billion global AIDS plan is built around the two themes of abstinence and fidelity.

So what is the moral of the story? First, we should congratulate the Ugandans for being so proactive in using condoms to not only prevent the spread of AIDS but also an unwanted pregnancy. Second, as I am sure that the Rakai researchers are well aware of, that abstinence and fidelity do not come about just because someone like Bush tells them so. In order to change sexual mores, one has to begin at the core–and that is in addressing the lowly position of women in many of these cultures, as well as the dire poverty.

I don’t know the specifics for Rakai, but in many many parts of Africa and elsewhere, a woman just can’t say no to her husband–even if she knows that he’s been screwing around with half the neighborhood. If she can get him to wear a condom, that is progress. Many young girls are lured into sex in exchange for money and presents, which helps keep their families from starvation.

Yes, for rich Republicans sitting comfortably in their plushy dining room chairs, the idea of selling oneself may certainly sound repugnant. Well, come spend some time with an African family. Live as they do. Feel hunger pains. Feel the hopelessness. And maybe soon, you’ll be out there selling the only thing that you have to sell–your body.

So until cultures begin to change, we should be thankful that the Ugandans have at least caught onto the idea of using a condom. But I am sure that this report will have no effect on the Bush plan.

The FDA received more than 422,500 reports of drug side effects last year, which is a record high, according to an AP report.

The final figures aren’t out, but the preliminary ones report that these numbers top the 2003 figures of 370,887. But wouldn’t you know, the FDA immediately jumps to the conclusion that it can’t be the drugs that are at fault.

Agency officials attribute the rise to increased use of prescription drugs rather than an increase in risk from the drugs.

Uh, so the fact that maybe 100,000 people died from using Vioxx is just because of an overall increase in the use of prescription drugs? That the drugs that we are putting on the market have nothing to do with this?

That reminds me of some of the reaons given for the rise in breast cancer rates. Not that the cancer can possibly have anything to do with heavy pesticide usage, environmental pollutants, carcinogens in food, overall diet, etc., but that the rising rates are “due to more women getting mammograms.” So in other words, if you believe that, rates of breast cancer were exactly the same in 1900 as they are now, only women just didn’t know they were dying of it.

I need a drink.

And there was no room at the inn….

Reading about how thousands of students are being turned away from nursing programs in the midst of a shortage always reminds me of the Christmas story. No room at the inn. A nation in dire need of nurses is actually keeping students out of its classroom, forbidding the future saviors from getting an education.

Do I sound sarcastic? Well, I am. Surprise, this talk of the “thousands being turned away” is just one more nugget that the media has grabbed hold of, and is milking for all its worth. Now read this sob story from the US Newswire, and then I will fill in the blanks–which are always left out.

Though interest in baccalaureate and graduate nursing education programs is high, not all qualified applications are being accepted at four-year colleges and universities. In fact, AACN’s survey found that 32,797 qualified applicants were not accepted at schools of nursing last year due primarily to a shortage of faculty and resource constraints. Within this total, applicants turned away include 29,425 from entry-level baccalaureate programs; 422 from RN-to-Baccalaureate programs; 2,748 from master’s programs; and 202 from doctoral programs.

The top reasons reported by nursing schools for not accepting all qualified students into entry-level baccalaureate programs, include insufficient faculty (76.1 percent), admissions seats filled (75 percent), and insufficient clinical teaching space (54.5 percent). In the 2004-2005 academic year, 122,194 completed applications were received at schools of nursing with 84,002 meeting admission criteria and 54,577 applications accepted. The application acceptance rate was 44.7 percent.

Tragic, huh. It makes it seem that just because someone wants to be a nurse, then the gates of heaven should open and accomodate them. But the reality is that not everyone is accepted into the program of their dreams, whether it be nursing, medicine, art, linguistics, or advanced study of Indigo children. Not everyone gets into the school that they want to, or is hired for the job that they know is “perfect.”

First, the faculty shortage. I will go into that further in another post, but let’s just say that everyone is good at whining about the great faculty shortage but rather dim on coming up with a viable solution. And there are solutions, should anyone wish to actually convince more nurses to seek out a teaching career. But I think that those who whine and moan are waiting for heaven to intervene, and send a divine solution. And on the sixth day, God created 10,000 PhD prepared nursing instructors who were willing to work for less money than the dishwasher who scrubs pots at the local greasy spoon…

Second, nursing programs, even if there were more teachers, cannot be expanded indefinitely. A minor detail is finding sufficient clinical space. Nursing students put in two to three full days of clinical a week, and they have to find a facility ready and willing to deal with it. What this boils down to is if staff nurses are willing to watch over students. A clinical instructor generally has about 8 in a group, and it is impossible for her to watch over all 8 at all times. Thus, students are paired with nurses who are actually working on the floor, and this may or may not be welcomed. There are only so many students that one hospital can accomodate, and several schools of nursing may be competing for the same space.

In a large city like New York or Los Angeles, there are many hospitals to choose from. The downside is that there are also many nursing programs. So it all evens out. The moral to this story is that there are only so many nurses that can train at one time. The 54.5% who were rejected due to lack of clinical space is not going to change. It’s not like being able to stick 1,000 students into a huge auditorium to teach English 101. You just can’t keep stuffing them into nursing programs if they have nowhere to go to hone their skills. Unless, of course, someone decides that nursing students really don’t require an actual clinical rotation–you know, they can practice on eachother, or on the teacher, or maybe pick up some homeless folks lying around on the street.

The third tragic event, admission seats filled, ties in nicely with #1 and #2. You can only have so many seats if you have a limited number of teachers (which no one wants to do anything about) and a limited number of clinical slots (which will not change). Doesn’t take a genius to figure this out.

The Myth of the Turned Away Student

When I was in nursing school in the early 1980s, during a time of great nursing shortages, one of my classmates had first tried to get into a program at a state school. This particular university had a point system which the prospective students had to meet (do tricks, cartwheels, sell your body and soul, etc) and if you had below a certain amount, you were toast. No way were you getting into the program. They had many more applicants than slots, and finally, my classmate just gave up waiting and switched schools.

There was no wait at my school even though it was a prestigious university. The reason? Money. State schools=cheap. Private schools=expensive. There was room at my school for nursing students, and she came right in. And that is a situation which seems to be occuring right now.

Apparently, other nurses and would-be nurses are asking the same questions, and about 6 months ago, the topic came up on a bulletin board. A number of nursing students reported on schools where there was no waiting list, and where you could get in provided you met the requirements for acceptance into the university, and met the requirements for the nursing program. It seemed, from reading this long dialogue, that the situation of 20 years ago still held true. State schools were overloaded, but many private ones had space.

So why is this phenomena never mentioned? Perhaps someone should ask the multitudes who cannot enter the program of their choice if they are applying elsewhere? If not, then why? Obviously, some people cannot relocate or cannot afford a private school (don’t feel like selling their soul, first and last born to the devil), and so, the wait to be a nurse may be a long one. But the fact is, according to the responses posted on the board, is that all programs are not bursting at the seems, and that there is, room at the inn.