Victory for Free Speech and Public Health
Today, a Federal Appeals court in New York upheld a case brought by Pathfinder International and Alliance for Open Society International, which challenged a government rule commonly referred to as the "anti-prostitution loyalty oath." Under the rule, recipients of US global HIV and AIDS funds must formally pledge their opposition to prostitution in order to remain eligible for funding. The requirement forces organizations to censor even their privately-funded speech regarding the most effective ways to engage high-risk groups in HIV prevention.
The 2-to-1 ruling by the US 2nd Circuit Court of Appeals upheld the decision of the US District Court for the Southern District of New York, which has twice ruled that the anti-prostitution loyalty oath violates the First Amendment by restricting privately funded speech and forcing organizations to adopt the government's viewpoint. A preliminary injunction has prohibited USAID and the Department of Health and Human Services from enforcing the loyalty oath against the plaintiff organizations, including the US-based members of the Global Health Council and InterAction, who joined the case in 2008.
"Today's victory has profound implications not only for the rights of private, non-governmental organizations to operate without undue government interference, but for the health of vulnerable women, men, and adolescents in less developed countries," Pathfinder President Daniel E. Pellegrom, said. "Any organization that works to address the tragedy of HIV and AIDS must confront head on the need to serve sex workers, but the loyalty oath undermines our efforts by forcing us to stigmatize the very people we are trying to reach."
Pathfinder and Alliance for Open Society International originally brought the case to court in 2005.
Pathfinder commends the court's decision which upholds the rights of organizations to implement evidence-based programs to prevent HIV and AIDS without impediment.
"Pathfinder is committed to continuing to stand up for this right, as well as the health and rights of those we serve," President Pellegrom said. "We believe the court decision should stand, and the US government should take steps to immediately repeal this harmful policy."
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What's more, women in Ethiopia are having fewer children (the fertility rate fell from an average of 6.5 children per woman in 2000 to 4.6 currently), maternal deaths are in decline, and more women are staying in school longer. Plus, more women are opting for long-acting reversible contraceptives (LARCs) instead of more traditional short-term methods like birth control pills or condoms.
The Single-Visit Approach as a Cervical Cancer Prevention Strategy Among Women With HIV in Ethiopia: Successes and Lessons Learned
Cervical cancer is the second most common form of cancer for women in Ethiopia. Using a single-visit approach to prevent cervical cancer, the Addis Tesfa project tested women with HIV through visual inspection of the cervix with acetic acid wash and, if tests results were positive, offered immediate cryotherapy of the precancerous lesion or referral for loop electrosurgical excision procedure. The objective of this article is to review screening and treatment outcomes over nearly 4 years of project implementation and to identify lessons learned to improve cervical cancer prevention programs in Ethiopia and other resource-constrained settings.