(Credit: Queerty)

The County of Los Angeles Department of Public Health wants to help promote safer sex practices by passing out one million and one condoms by the end of this year. In order to accomplish that goal, city officials are hitting the road — in a 40-foot “condom mobile” featuring the images of professional athletes reminding people to “suit up.”

Last year, the county’s health department sponsored its first-ever condom contest to give residents the opportunity to design an official Los Angeles branded condom wrapper. And now, the new bus will be handing out free condoms packaged in the winning design. The county has also partnered with local LGBT intramural sports leagues that will help them distribute additional free condoms.

This isn’t the first creative initiative to address California’s rising STD rates by expanding access and exposure to prevention methods. A new state-sponsored initiative called the “Condom Access Project” makes it easier for California teens tp obtain sexual health resources by allowing them to order free condoms online. And Los Angeles voters recently endorsed a measure requiring adult film stars to wear condoms on screen.

Education campaigns about safer sex may be especially necessary since not all of California’s students are receiving that type of instruction in school. Last year, the ACLU sued a Fresno County school for failing to provide accurate sexual health education to students. Students there were taught that sexually transmitted infections can be prevented by going out in groups with friends and getting plenty of rest.

On Election Day 2012, Los Angeles County voters approved Measure B, an ordinance “requiring producers of adult films to obtain a County public health permit” and for “adult film performers to use condoms while engaged in sex acts.” Porn producers, who have consistently opposed the measure, vowed to fight it tooth and nail. But as it turns out, one group is ready to fight back.

On Monday, the AIDS Healthcare Foundation (AHF) — an advocacy and lobbying outfit that has pushed for cheaper HIV medications and greater public health protections for HIV-positive Americans — became the first group to call out the Los Angeles County Department of Public Health over its allegedly lax enforcement of Measure B since its passage. The foundation lodged an official complaint with the County “after receiving an anonymous letter with an accompanying videotape filmed by someone on an Immoral Productions set” depicting unsafe sex practices and reviewing material on the production company’s website that also depicted intercourse without a condom.

For the well-funded advocacy group, this is just the latest skirmish in a decade-long battle. AHF president Michael Weinstein has spearheaded efforts to instill the same workplace safety and public health standards on straight porn sets as are already enforced in most gay pornography productions. Under his leadership, the AHF filed suit — to no avail — to make Los Angeles-produced pornography a “condom-only” enterprise; pushed for a citywide L.A. ordinance to the same effect; and spent over $1.6 million in its ultimately successful 2012 campaign to pass the more expansive, countywide Measure B. As he told L.A. Weekly in 2010, “AHF doesn’t give up on an issue, and we’re not going to give up on this.”

It appears that Weinstein and his group plan to follow through on that promise in the face of a combative Los Angeles adult entertainment industry and concerns over the Public Health Department’s enforcement prowess. “We’re putting them to the test,” Weinstein told the Los Angeles Times. “If democracy means something in L.A. County — if porn producers and county supervisors are not above the law — then they will enforce it.”

AHF and fellow public health advocacy organizations certainly have their work cut out for them. Trade groups associated with the multibillion dollar L.A. porn industry have promised to litigate the measure, citing freedom of speech concerns. This argument could potentially stand up in court — but only if the industry’s claims that it sufficiently tests all of its performers for sexually transmitted infections are true. An independent study by AHF that was published in the December Journal of Sexually Transmitted Diseases presents plenty of evidence to suggest that they are not, as “roughly a third of the 168 adult film actors who participated in the research project were found to have a previously undiagnosed STD.”

Obamacare seeks to extend health coverage to millions of previously uninsured Americans, but that doesn’t include the nation’s estimated 12 million undocumented immigrants. And as Kaiser Health News reports, that oversight — along with the historical difficulty that undocumented immigrants face when trying to obtain coverage — has led to the proliferation of underground, cash-only “bodega clinicas” in Los Angeles migrant communities.

The clinicas aim to serve Latino immigrants who do not have public or private health insurance. Strictly speaking, they are closer to private primary care doctors’ offices than public clinics that are subject to much tighter regulations. But while the community clinics provide immigrants with a much needed service, their off-the-grid nature has some health officials worried about the quality of care that they provide.

Still, care providers also see in the clinicas the potential to ease the burden of America’s primary care doctor shortage:

Health officials see in the clinicas the tantalizing opportunity to fill persistent and profound gaps in the county’s strained safety net, including a chronic shortage of primary care physicians. By January 2014, up to 2 million currently uninsured Angelenos will need to enroll in Medicaid or buy insurance and find primary care. And the clinicas, public health officials note, are already well established in the county’s poorest neighborhoods where they are meeting the needs of Spanish-speaking residents. The clinicas also could continue to serve a market that the Affordable Care Act does not touch: undocumented immigrants who are prohibited from getting health insurance under the law.

Dr. Mark Ghaly, deputy director for Community Health at the Los Angeles County Department of Health Services, said bodega clinicas, a term he seems to have coined, that agree to some scrutiny could be a good way of addressing the physician shortage in these neighborhoods.

“Where are we going to find those providers?” he said. “One logical place to consider looking is these clinics.”

The clinicas are obviously not a perfect solution. While the clinicas could make for an effective source of cost-effective primary care, their cash-only model does pose some risks for the people who may need more specialized and expensive care — after all, paying $120 in cash for antibiotics is one thing, but $5,000 for a surgery is another story entirely. For more extensive care, these immigrants will require some sort of public or private insurance coverage.

But barring comprehensive immigration reform or additional measures to extend health benefits to America’s undocumented immigrants, Los Angeles’ clinicas are many people’s realities.

New York City and Los Angeles, along with a string of smaller cities, are finally seeing their childhood obesity rates drop for the first time. The decline, though modest, has shocked researchers who have watched the obesity rate in children steadily climb for 30 years. Los Angeles’ rate has dropped 3 percent, while New York and Philadelphia both reported declines around 5 percent.

About 12.5 million children under 20 are obese, and the rate has tripled since 1980. Childhood obesity problems are usually concentrated in metropolitan areas, prompting several cities to launch anti-obesity advertising campaigns. Others have gone farther; Mayor Michael Bloomberg (I-NY) recently banned the sale of sugary drinks above 16 ounces. First Lady Michelle Obama has made childhood obesity her personal cause, coming under fire from Republicans and conservative commentators for her efforts to reform school lunch programs and promote healthy eating habits. Along with city policies, nonprofit groups have been working to get more fresh produce in urban corner stores and promote urban agriculture initiatives.

It is not clear why the rate is dropping or which, if any, of these measures have had an impact. However, all of the cities that are now seeing declines enacted anti-obesity policies several years ago. The most promising data comes from Philadelphia, which has introduced snack guidelines as well as removed sugary drinks and deep fryers from school cafeterias over the past decade:

Individual efforts like one-time exercise programs have rarely produced results. Researchers say that it will take a broad set of policies applied systematically to effectively reverse the trend, a conclusion underscored by an Institute of Medicine report released in May.[...]

Some experts note that the current declines, concentrated among higher income, mostly white populations, are still not benefiting many minority children. For example, when New York City measured children in kindergarten through eighth grade from 2007 to 2011, the number of white children who were obese dropped by 12.5 percent, while the number of obese black children dropped by 1.9 percent.

But Philadelphia, which has the biggest share of residents living in poverty of the nation’s 10 largest cities, stands out because its decline was most pronounced among minorities. Obesity among 120,000 public school students measured between 2006 and 2010 declined by 8 percent among black boys and by 7 percent among Hispanic girls, compared with a 0.8 percent decline for white girls and a 6.8 percent decline for white boys.

Philadelphia’s measured success could inspire other cities to start experimenting with obesity reduction policies. These policies could help shift the currently untenable status quo. If the state of American health remains the same, the number of children with type 2 diabetes is projected to rise 50 percent by 2050, while children who are already struggling with weight problems are far more likely to suffer from heart disease and stroke as adults.

Tomorrow, voters in California will decide whether or not to pass Proposition B, which would require adult film stars throughout Los Angeles county to wear condoms during porn shoots. If Proposition B goes into effect, it will also allow the Los Angeles County Department of Public Health to enforce sexual health in the industry by conducting inspections to ensure that actors are adhering to the regulation.

Michael Weinstein, the executive director of the AIDS Healthcare Foundation, is the primary proponent of the measure, which he says will help safeguard public health among a population that tends to lack health insurance coverage:

Weinstein has said the adult film industry’s current testing methods have contributed to an epidemic of sexually transmitted diseases. He has also said that performers are not medically insured, which means tax payers front the bills for their healthcare. [...]

An independent study released by AHF last week found undiagnosed sexually transmitted diseases may be more common in the adult film industry than previously reported. The study, to be published in December in the Journal of Sexually Transmitted Diseases, found that roughly a third of the 168 adult film actors who participated in the research project were found to have a previously undiagnosed STD.

“I would call that an epidemic,” Weinstein said. “We’re in the business of promoting condoms. I’ve been called a condom Nazi and it doesn’t faze me.”

But members of the adult film industry say that Weinstein is mischaracterizing the issue, and claim the measure represents unnecessary government interference that infringes on their artistic expression. Adult film stars already get tested for sexually transmitted infections about once a month, which they say is a more effective method of maintaining their sexual health. They believe their industry will be threatened if they are forced to use condoms because “it’s just not what viewers want to see.”

The entertainment industry in general has typically failed to accurately depict safer sex practices — such as showing characters using contraception or condoms on screen — although some sexual health advocacy groups are working with television executives to try to change that. Adult films represent another area where the media could model safe sexual practices for consumers.

Condom use on porn sets is actually already required under both state and city law. Proposition B would expand an existing city ordinance in Los Angeles — the first city in the nation to institute a condom requirement for adult film stars — to the broader Los Angeles county.