In order to promote better sexual health around the globe, the Bill and Melinda Gates Foundation wants someone to create the next generation of safe — yet pleasure-enhancing — condoms. And the foundation is putting its money where its mouth is with its ongoing Grand Challenges Explorations grant competition. Successful applicants could win a $100,000 initial grant, as well as up to $1 million in continued funding, to put their new condom design into production.

The challenge was issued in light of the reality that, while condoms have been in use for the past four centuries, “they have undergone very little technological improvement in the past 50 years.” On its website, the global health advocacy organization specifies that stymied sexual pleasure is a significant factor contributing to inconsistent condom use, and condoms that heighten pleasure might help reverse the trend in at-risk communities:

The one major drawback to more universal use of male condoms is the lack of perceived incentive for consistent use. The primary drawback from the male perspective is that condoms decrease pleasure as compared to no condom, creating a trade-off that many men find unacceptable, particularly given that the decisions about use must be made just prior to intercourse. Is it possible to develop a product without this stigma, or better, one that is felt to enhance pleasure? If so, would such a product lead to substantial benefits for global health, both in terms of reducing the incidence of unplanned pregnancies and in prevention of infection with HIV or other STIs?

Likewise, female condoms can be an effective method for prevention of unplanned pregnancy or HIV infection, but suffer from some of the same liabilities as male condoms, require proper insertion training and are substantially more expensive than their male counterparts. While negotiating use of female condoms may be easier than male condoms, this need for negotiation precisely illustrates the barrier preventing greater use that we seek to address through this call. [...]

We are looking for a Next Generation Condom that significantly preserves or enhances pleasure, in order to improve uptake and regular use. Additional concepts that might increase uptake include attributes that increase ease-of-use for male and female condoms, for example better packaging or designs that are easier to properly apply. In addition, attributes that address and overcome cultural barriers are also desired.

While the idea that men don’t use condoms as a consequence of curtailed pleasure and satisfaction may induce some serious eye-rolling, study data on the subject shows that it is no laughing matter — particularly for low-income regions with medically vulnerable populations. In one qualitative study on inconsistent condom use among HIV-positive populations in India, interview participants cited a lack of “full satisfaction” and the desire for “greater sexual intimacy in the heat of the moment” as a major barrier to safe sex practices. And here in the U.S., another study of American men who have sex with men (MSM) — who are generally at much higher risk for HIV and syphilis transmission — found the trend to be even more pronounced, with the vast majority of respondents tying non-use of condoms to sensation and pleasure-related reasons.

Citing the constitutional supremacy of federal laws over state-level legislation, U.S. District Judge Audrey Fleissig has struck down a 2012 Missouri law that “required insurers to issue policies without contraception coverage if individuals or employers objected because of religious or moral beliefs.”

The law was meant to effectively nullify Obamacare provisions requiring all employers to provide contraceptive coverage without an additional co-pay. It was passed after the Missouri state legislature overrode Gov. Jay Nixon’s (D) veto of the measure.

In an effort to mollify concerns from conservative critics of the contraception mandate, the Obama Administration recently issued clarifying rules on which employers — specifically, religious organizations — will be exempt from the Obamacare provision. Still, that hasn’t stopped for-profit companies like the crafts chain Hobby Lobby from bending over backwards to avoid complying with the law and providing their workers with affordable birth control.

Legally speaking, however, such companies are reaching when they claim that the Obamacare mandate is invalid under current law, and judicial decisions that claim otherwise are simply incorrect. In fact, a Bush-appointed judge rejected a legal challenge to the reform law’s contraception requirement from a Missouri-based Catholic business owner late last year, writing that, federal religious freedom law “is a shield, not a sword” that “is not a means to force one’s religious practices upon others.” Ultimately, the issue will likely be settled by the Supreme Court.

The rising global demand for modern forms of contraception is outpacing women’s access to birth control, a new study finds. In fact, in just two years, an estimated 233 million women of reproductive age will lack access to the contraceptive services they would prefer to use — up from 221 million women in 2010.

Worldwide access to birth control has improved over the past two decades, and the percentage of women using at least one form of modern contraception with their regular sexual partner increased from 55 percent in 1990 to 63 percent in 2010. But according to new data published in The Lancet, there’s still a huge unmet need for family planning services in developing nations, partly because the demand for birth control services continues to rise. The researchers project that more than 80 percent of the unmet need will originate in the developing world, particularly in sub-Saharan Africa.

The international community recognizes that reproductive choice, and the ability to determine when and how to have a family, is a human right — particularly because family planning can save lives. An estimated 47,000 women die from unsafe abortions each year, and those deaths could be prevented by both expanded access to safe abortion services and wider availability of reliable contraception. But there’s still a long way to go before every woman around the world can realize her right to determine her own reproductive future.

Increased funding for international family planning programs is essential to continue delivering the preventative health resources that women need. But it’s also important to continue eliminating the pervasive societal stigma surrounding birth control, since some women are dissuaded from using contraception because their family or community doesn’t support it. That issue isn’t exclusive to the developing world, either. Here in the United States, enduring misinformation about certain types of contraception — particularly long-lasting forms of birth control and emergency contraception — also contributes to fewer numbers of women, and particularly young women, choosing the most effective forms of birth control.

Over the past year, Texas officials have attacked women’s health resources from all angles — slashing funding from family planning programs, cutting off funds to the Planned Parenthood affiliates in the state, and attempting to shut down dozens of abortion clinics. Those decisions have jeopardized thousands of low-income women’s access to affordable health care, and faith leaders are praying for Texas to reverse its course.

Religious leaders in Texas joined together last week to emphasize that women’s health is a religious issue. Jewish and Christian leaders prayed for increased access to preventative health services, like family planning programs and birth control, in a state that has become increasingly hostile to women’s health care:

Gathered in the rotunda of the Texas Capitol Extension, leaders from Christian and Jewish faiths voiced frustration with funding for women’s health care services. Their prayer included a plea to state lawmakers to restore the $73 million cut from family planning services during 2011 and to make contraception more readily available to low-income women.

“For us this is part of our faith commitment that cares for all of God’s creation, all of God’s people,” said Larry Bethune, pastor of University Baptist Church in Austin. “Particularly for the stability of families and for the care of women and their health.”

“We believe that women should have and families should have the opportunity to make choices about when they’re going to have children and how many children they’re going to have,” said Bethune. “Women need to have access to health care, to good counsel and to clinics that can provide that health care before, during and after pregnancy.”

The faith leaders criticized Texas officials for targeting Planned Parenthood in their ongoing crusade against abortion — a crusade that has had far-reaching implications for the poor women in the state who must now search for new doctors. Planned Parenthood is the state’s largest health care provider for low-income women, but Texas Republicans have been so focused on cutting ties with the national organization that they have forced the closure of dozens of unaffiliated health clinics and have ultimately eliminated $30 million in federal funding for women’s health services.

“I think the abortion issue, it’s just part of a continuing culture war,” Rabbi Neal Katz told a local ABC News affiliate. “But I do believe that it’s a distraction from the issue that we’re trying to focus on, which is women having access to good health care, to family planning, to birth control.”

Despite the Religious Right’s attempt to use abortion as a wedge issue, reproductive rights are not actually incompatible with faith communities. Most religious groups support women’s right to legal abortion services under Roe v. Wade, and many people of faith — including Catholics and evangelicals — support expanding women’s access to birth control.

In order to avert a government shutdown later this month, Congress and the Obama administration must negotiate a continuing resolution to maintain federal funding — and a group of House Republicans is suggesting that deal should also roll back Obamacare’s effort to expand women’s access to affordable contraception.

The automatic spending cuts that will take effect under sequestration will already compromise programs that disproportionately impact women, including slashing $86 million from critical family planning and reproductive health services. But that’s not enough for Republican lawmakers, who want to use the upcoming budget negotiations as yet another opportunity to keep attacking women’s health:

GOP lawmakers reintroduced a bill Tuesday to repeal the contraception mandate. They also pressed their party’s leaders to roll back the provision as part of a continuing resolution later this month to keep the federal government operating.

“This attack on religious freedom demands immediate congressional action,” the 14 lawmakers wrote. “Nothing short of a full exemption for both nonprofit and for-profit entities will satisfy the demands of the Constitution and common sense.”

The continuing resolution that House appropriators released Monday would not cut off funding for the Affordable Care Act, despite years of conservative pressure to defund the healthcare law. But Tuesday’s letter, led by Rep. Diane Black (R-Tenn.), indicates that fights over the health law could still roil the funding debate.

Obamacare’s birth control provision, which went into effect on August 1, helped eliminate the gender-based disparity in health costs by eliminating co-pays for women’s contraceptive services. Studies have proven that increasing access to cost-free birth control lowers the rates of unintended pregnancy and abortion, as well as provides women with greater economic autonomy to achieve their personal financial goals. Nevertheless, right-wing Obamacare opponents misconstrue the law as a threat to religious freedom, despite the fact that it already contains an exemption for faith-based organizations that oppose covering contraception.

Despite Republicans’ insistence that Obamacare is an affront to religious liberty, most Americans don’t agree. A diverse coalition in support of the health reform law’s expanded access to contraception — including religious groups like Catholics for Choice, Jewish Women International, the Religious Coalition for Reproductive Choice, the United Methodist Church, and the Unitarian Universalist Association — is already urging the U.S. House Committee on Appropriations to reject a deal that would restrict women’s access to birth control.

Unfortunately, Rep. Black is no stranger to targeting women’s health. So far this session, she has also introduced a measure to defund Planned Parenthood, as well as called for an unnecessary government study to justify her continued effort to strip funding from the women’s health organization.

So far, New York City’s campaign to prevent unintended teen pregnancy has been extremely successful. The public schools in the city have instituted a mandatory comprehensive sex ed curriculum, as well as a program to help expand teen’s access to contraception — both of which have directly contributed to the fact that the teen pregnancy rate in New York City has plummeted by 27 percent over the past decade.

The city’s Human Resources Administration is now expanding those efforts to a broader marketing campaign, rolling out a series of advertisements that intend to communicate the “real cost of teen pregnancy.” The ads, which will appear on subways and bus shelters across the city, are an attempt to frighten teens out of having a child at a young age:

This strategy may not be totally without precedent. Wonkblog’s Sarah Kliff points out that a similar type of advertising campaign in Milwaukee helped contribute to a drop in teen pregnancies. But the huge drop that New York City has already seen over the past 10 years belies a simple fact: edgy advertising isn’t nearly as important as actually equipping young people with the resources they need to understand their bodies and mitigate their sexual risk.

In fact, a recent study demonstrates that providing young adults with the support they need can be a more effective method of preventing unwanted pregnancies than shaming teens about their sexuality. Throughout the course of the study, the teens that participated in a program tailored to help young people make good sexual choices — including providing providing personal case management, youth leadership opportunities, and specialized counseling — were much more likely to make safe sexual choices, like using condoms, than the teens who weren’t in that program. And the healthy sexual behavior extended beyond simply using protection. The teens who received support and counseling were also more likely to be able to recognize unwanted sexual attention, and refute those type of advances — in other words, they became better aware of their physical boundaries and their ability to withhold consent.

Ultimately, the United States needs a huge overhaul when it comes to society’s approach to teen sexuality. Too often, teens aren’t given accurate information about their bodies, aren’t empowered to make their own decisions, don’t know what “consent” is and how to navigate it, and are ultimately too ashamed to ask for the resources they need. Young adults need to be trusted with information about sexuality — and those who are at a higher risk for unintended pregnancy need to be supported, not stigmatized for the “failures” that result from their sexual behavior.

Even though the copper intrauterine device (IUD) — a long-lasting, hormone-free form of birth control — is the most effective form of emergency contraception to prevent pregnancy after an unprotected sexual encounter, doctors typically don’t mention it to their patients.

When most women choose to take emergency contraception, they opt for what is commonly down as “Plan B,” a pill that acts much like daily birth control pills do to prevent ovulation and fertilization. Plan B is safe and effective, and leading physicians’ groups are calling for the Obama administration to change their current policy and make it available over the counter to young women of all ages. But copper IUDs are even more effective than the morning after pill.

Unfortunately, the fact that 85 percent of doctors never recommend copper IUDs as a form of emergency contraception falls in line with broader trends. Even though both copper and hormonal IUDs are the most effective type of birth control currently available — and the American College of Obstetrics and Gynecology now encourages doctors to give them to their young female patients — lingering stigma surrounding IUDs still prevents doctors from talking about them and women from using them. Despite all evidence to the contrary, parents still remain largely uncomfortable with the idea of doctors offering IUDs to their daughters.

The most effective forms of birth control are slowly gaining ground. IUD use in the U.S. jumped from 0.8 percent in 1995 to 5.6 percent a decade later. And IUDs — which can cost women as much as a thousand dollars upon insertion — are now covered under Obamacare, which could encourage more widespread use by eliminating potential cost prohibitions. But the education process is slow, and doctors may need to do more to make sure they’re effectively conveying their patients’ full range of contraceptive options.

(HT: RH Reality Check)

69-year-old Rebecca S. Tomczak suffers sarcoidosis, a condition that leads to lung scarring and can devolce into a terminal disease if left untreated. The doctors told her that without a full lung transplant, her prognosis would be dire — and while Tomczak could have qualified for transplant lists at several hospitals, she had to scour through several providers before finding one that would take up her case, since she’s a practicing Jehovah’s Witness. Her adherence to her faith prevents her from receiving blood transfusions, which are typically necessary for transplant surgeries.

As the New York Times reports, Tomczak was finally able to track down Dr. Scott A. Scheinin of the Houston-based Methodist Hospital, who agreed to treat her on her own terms. The hospital had conducted several successful bloodless lung transplants before — specifically tailored towards Jehovah’s Witnesses — and had developed an innovative, seemingly safe medical approach to treating these patients while also respecting their closely-held tenets. As Dr. Scheinin put it, “At the end of the day, if you agree to take care of these patients, you agree to do it on their terms.”

Critics might balk that tailoring medical procedures towards a patient’s religious beliefs is impractical and costly. But the new system that the doctors at Methodist developed was more cost-effective than regular transplant procedures — and arguably more safe, as there has been some evidence that blood transfusions may actually be risky in certain cases:

The economy is also helping the blood management movement. Processing and transfusing a single unit of blood can cost as much as $1,200, and many hospitals are trying to cut back. Administrators at Methodist said their bloodless lung transplants typically cost 30 percent less than other lung transplants, partly because careful management of hemoglobin levels before surgery has resulted in fewer complications and shorter stays.

Experts say they are beginning to see a measurable impact on blood usage, although the data to support it are not yet available. Dr. Richard J. Benjamin, the chief medical officer of the American Red Cross, predicted that the numbers would show the first decline in use since the AIDS scare began in the 1980s, perhaps by one million units.

“We’re changing this culture, this knee-jerk transfusion reaction,” Dr. Scheinin said. “And I think that’s been a good thing for all our patients.”

While Tomczak’s story is intriguing for its implications on medical innovation and reducing health care costs, it also highlights a positive way to reconcile the tensions between modern medical technology and religious dogma. Rather than being a case in which a doctor imposes his or her conscientious biases on a patient — such as the Irish medical team that incited global outrage after denying a life-saving abortion to a woman who later passed away — Tomczak’s experiences are an example of a doctor keeping his patient’s health at the forefront while also respecting that patient’s ethical choices through creativity and innovation. That may not be achievable in every single case — but this particular story shows that it certainly is possible.

Oklahoma already prevents women from using their insurance plans to help cover abortion services, but Republicans aren’t stopping there. One state lawmaker wants to continue stripping insurance coverage for reproductive health services, advancing a measure that would allow employers to refuse to cover birth control for any reason — based solely on the fact that one of his constituents believes it “poisons women’s bodies.”

Under State Sen. Clark Jolley (R)’s measure, “no employer shall be required to provide or pay for any benefit or service related to abortion or contraception through the provision of health insurance to his or her employees.” According to the Tulsa World, Jolley’s inspiration for his bill came from one of his male constituents who is morally opposed to birth control, and wanted to find a small group insurance plan for himself and his family that didn’t include coverage for those services:

Jolley said the measure is the result of a request from a constituent, Dr. Dominic Pedulla, an Oklahoma City cardiologist who describes himself as a natural family planning medical consultant and women’s health researcher. [...]

Women are worse off with contraception because it suppresses and disables who they are, Pedulla said.

“Part of their identity is the potential to be a mother,” Pedulla said. “They are being asked to suppress and radically contradict part of their own identity, and if that wasn’t bad enough, they are being asked to poison their bodies.”

The bill has already cleared a Senate Health committee and now makes it way to Oklahoma’s full Senate. It is unlikely that either Jolley and Pedulla themselves rely on insurance coverage for hormonal contraceptive services — but if the measure becomes law, the two men could limit the health insurance options for the nearly two million women who live in Oklahoma.

Of course, contraception does not actually poison women. The FDA approved the first oral birth control pill in 1960, and that type of contraception is so safe that the American College of Obstetricians and Gynecologists recommends making it available without a prescription, as it is in most other countries around the world. Furthermore, considering that over 99 percent of women of reproductive age have used some form of birth control, the Oklahoma women who rely on insurance coverage for their contraception would likely disagree with Pedulla’s assertion that it “suppresses and radically contradicts part of their own identity.”

In reality, access to affordable birth control is a critical economic issue for women. When women have control over their reproductive choices, it allows them to achieve economic goals like completing their education, becoming financially independent, or keeping a job. But birth control can carry high out-of-pocket costs, and over half of young women say they haven’t used their contraceptive method as directed because of cost prohibitions. Nonetheless, Republican lawmakers have repeatedly pushed measures to allow employers to drop coverage for birth control.