The FDA has recently approved two drugs that will have a huge impact to the desi woman community; a) earlier this summer, the approval of the cervical cancer vaccine (or known as the HPV vaccine) and b) last week the approval of Plan B, the emergency contraceptive, as an over the counter drug for anyone over the age of 18. I think that both of these are huge landmark moments for the advancement of reproductive justice in our community.
According to a policy brief distributed by the National Asian Pacific Women’s Forum (NAPAWF)…
The vaccine, Gardasil, is 100% effective in preventing the infection of human papillomavirus (HPV) which causes 70% of all cervical cancer cases worldwide. The FDA approved the vaccine for safe use among girls and women ages 9-26. Asian Pacific Islander (API) women will greatly benefit from this new HPV vaccine, given their high rates of cervical cancer, particularly among Vietnamese and Korean women.In fact, in the U.S. cervical cancer is relatively rare. For many API women, however, lack of health insurance, lack of knowledge about Pap smears and preventive care, and lack of culturally and linguistically appropriate services prevent them from equally accessing the health care system, contributing to their higher rates of cervical cancer.
Although abstinence or faithful lifelong monogamy are the only real full-proof ways to protect against HPV infection, these may not be realistic. Regular Pap smears are perhaps one of the most effective measures to protect oneself against developing cervical cancer. Because HPV is sexually transmitted, experts argue that the vaccine should be administered before adolescents have their first sexual encounter.
To me, it feels like an enormous injustice to know that a disproportionate amount of women in my community will have a higher chance of getting a preventable cancer because of the social stigmas attached to sex in our society, especially as a South Asian American female. When I ecstatically announced the FDAs approval to my mother and declared the need to get all the girls in our extended family here vaccinated, I was met with a, “Isn’t HPV sexually contracted? Why would we need to vaccinate then?” I didn’t really know how to respond to her. Social stigma of sexuality in our community as a form of birth control and cancer prevention will only take us so far.
As for the approval of the Plan B, emergency contraceptive this week (Abhi had blogged about it’s pending last month)…
“The FDA’s decision … is a critically important step in improving the overall health care of API women,” said Kiran Ahuja, Executive Director of NAPAWF. “For API women, timely access to EC cannot be understated, given the high number of unintended pregnancy and abortion rates in our community.”National data reveals that 35% of pregnancies end in abortion for API women, the second highest percentage for all racial and ethnic groups. In addition, between 1994-2000, abortion rates fell for all groups except API women. Another study found that over two-thirds of API women are sexually active, yet less than 40% regularly use contraception, increasing their risk of unintended pregnancy and abortion. It is estimated that wider access to EC could reduce the number of unintended pregnancies each year by as much as 50%.
Thirty-six percent of API women under age 65 lack health insurance and do not have a regular source of health care, which creates an enormous barrier to accessing health care services and prescription drugs. Making EC over the counter will now enable these women to have better access to this time-sensitive drug. [link]
I can’t imagine even broaching this topic with my mother…I know there is going to be a proportion of readers that think that the both the HPV vaccine and access to EC will only lead to promiscuity amongst our girls. But this is really about the safety of the health of our women, and, disproportionately, our youth. Our youth have rights that need to be protected. I’m glad to see the FDA has approved these drugs, and groups like NAPAWF are reaching out to educate our community. But we need your help too- reach out to a desi sister or even a brother, discuss these issues letting them know the drugs exist, and break down the social stigmas in our society. It’s fascinating to me that we’ve reached a stage where we can easily talk about the distribution of condoms to villagers in India, yet when it comes to discussions on the sexual health of our own South Asian American community, it is still approached with such taboo.
You can change that.Who knows? Maybe by having that discussion, you could be saving someone’s life.
it is a great advance in hopefully preventing cervical cancer for women around the globe, not just the desi’s..
the debate between promiscuity and HPV prevention is similar along with promoting condom usage and increasing sexual encounters among high schoolers… i tend to think education about prevention about cancer/hiv is more important… kids these days are smart..and will do things according to their own set of values/upbringing/whatever they may be/etc..
is the vaccine available in india? that is my question… women in 3rd world nations have less access to gyn care, and pap smears and hence there is a higher prevelance of advanced staged cervical cancer, as compared to here in the USA… earlier staged cancers are almost 90% curable.. hence there is a great discrepency…even when you get it…
what a lot of my non medical friends find hilarious, and somewhat unrealistic is the doctor chic chatting around a pool/cocktail party to her friends and trying to educated them in the TV commericials that are being strewn around the stations….
despite the possible higher levels of education/medical sophistication, sex ed is still far from what it should be in the s.asian US communities. i don’t have stats offhand..
Or maybe it would be from being deathly frightened of what our parents would do if we came home pregnant?
Yeah, I don’t know about that- I think that the perception of ‘high levels of education’ and that to be used as a correlation to the use of contraceptives is a stretch. I would guess that risks of HPV contraction and use of EC would happen at the “youth” stage of a desi- i.e. an age where there is high stigmas of talking about being sexually active.
As for education- here in LA County, the fourth largest desi city in the US, the percentage of only completed high school education or less is 49% for Bangladeshis, 58% for Sri Lankan, 40% for Pakistani, and 35% for Indians. (Source: APALC Demographics Profile, LA County) Personally, i think those percentages are pretty high to consider us to have high levels of education.
YAY!
education aside, these educated people dont act educated when it comes to their kids. Indian kids. no. they dont have sex….mass denial at its best.
i concur whole heartedly.
not all parents have
yes there is a huge double standard.. i’ve heard some fathers tell there sons to go ‘sow their oats’, whereas with indian females, you should remain chaste until marriage…
It’s a shame that desis tend to not get regular gyn checkups – even some extremely highly educated women I know in India (one of whom worked for the UNDP in a program for women, for crying out loud) have never been to a gyn except for pregnancy. They don’t go before or after. Many believe that BCPs make you fat and there’s no need to see a gyn for routine “maintenance.” I have a dear great-aunt (who has a masters degree!) who never married and presumably never was sexually active, and so she never went to a gyn, and so was clueless when cervical cancer hit her at age 70. The prissy old aunties need to give a serious think to this whole death-before-dishonour attitude to sexual health.
a convenient presumption.
This is something that I often hear thrown around in our community, and a lot of assumptions are often based on these figures. The sombering truth is that it is a very dichotomous community, we have the very rich and very poor. Bangladeshi’s and Pakistanis in LA County have big percentages that fall below 200% the poverty level (53% and 42%, respectively.) Even Asian Indians is at 25%. (Whites are at 20%)
Anyways, I challenge you gautham, and everyone actually, to talk to a teenage desi girl about their experience in having sex talks with their mothers. As posted above, even at the age of 27 this is a taboo topic with my mother. Also talking about sex is one thing, but getting into a scary situation where you need to go to a doctor and ask about EC or even an abortion is really, really scary as a young desi girl. And I’m sure the truth of how many south asian women who have had abortions, have STDs, or used EC is higher than perceived.
Posts 9–13:
Seems like a serious conflict of values/experiences between the first and second generation. What kind of support would the second generation like to receive from the first?
The “day after” pill has been available without prescription in India for quite some time. Birth control pills have been available super cheaply and over the counter without prescription for a long time too. Many religious aunties in India use them to delay a menstrual period that is due to come during a religous mahotsava (festival) so that they can fully partake of the temple rituals and goings on without being obstructed by a forbidden period.
What I’ve noticed in India and what scares me is that everything is available very cheaply and without prescription and without information regarding possible negative side effects. Almost without exception, everytime I have had to buy allopathic medicine from an Indian pharmacy to get over a flu, thyphoid, dysentary or something, the pills are cut with scissors from the pack, so you only buy as much as needed and rest can be conserved for the pharmacy, hence no sheet is given to you listing the ingredients of the pills or their possible side effects. Moreover, whenever I had asked pharmacists and even doctors or nurses what possible side effects a medicine might have, they have all said, “no side effects madam”. I think in many instances even the pharmacists, doctors, nurses or other administrators of these drugs are not well read up on what the drugs contain and what their side effects may be.
Poor, uneducated people attribute an almost God-like status to doctors and healers and I have seen them being dished out free government funded medicines, unable to read anything about them, and they don’t really ask the distributor anything about side effects and what not, thinking that whatever the “doctor sahib” gives them must be pure as gold and endowed with a miraculous healing power. They hence take the free drugs, go home in good faith, and Goddess only knows what reactions they get to these heavy chemical laced allopathic drugs. I myself have had serious reactions to quiet a few medicines that have supposedly had “no side effects, madam”.
So there are two sides to the coin of easily availabe drugs in India.
Personally I would be wary of “vaccines” anywhere – East or West.
Gautham, I think you are right. The attitude towards males is totally different from what females have to stand up to. My own mother had an issue with my school when they automatically put me in a list for paps. The fact that it could save lives didn’t matter because the almight ‘virginity’ couldn’t be compromised.
I speak very candidly to my niece (16 years old)about protection even though she’s barely dating. As a female, it’s VERY important to me that she knows what’s out there. Thankfully, I talk to her with her mother’s blessings. The smart woman that she is, she knows that telling her daughter this stuff is better then her finding out from elsewhere.
ChickPea, I was shocked when I went to Kenya and found that the only time women went to OB/Gyn’s was when they were pregnant. There were no mandated yearly check ups etc. This is a sore spot for me because I know of women who had cancer and they didn’t know it because of the slack attitudes.
Taz is right, we owe it to our generation to spread the word around. Why guess whether your kid is out having a good time or not? Why not assume that he/she is a normal human being with urges and educate him/her instead?
Why? Vaccinations for the most part have served mankind very well. Smallpox, Polio, and a host of others.
I believe Pardesi Gori said that we should be wary of vaccines given without prescriptions. Unregulated chemicals can cause more havoc then the disease or condition they are supposed to treat. If a doctor prescribes them, it’s all good.
I’ve got friends who are parents who are dead set against vaccinating their children and they have all sorts of data regarding the extremely negative side effects of them. I’ve merely scanned over the info they sent me and I’ve not done any in-depth research on it, but their wariness has made me a bit wary and if I am ever to become a mother, one of my main priorities would be to research the topic in and out. There’s lots on the web about it.
I applaud both these advancements but, quite frankly, I’m amazed that they got through at all, especially given the current administration. With respect to the vaccine, I see several issues that might arise. First, when do you give the vaccine? As stated in the article, the vaccine will be most effective when administered prior to the female’s first sexual encounter. This means that it will be most effective when given to women before they reach the age of consent. Ergo, parental notice and consent is a requirement. Even with FDA approval, I see this being a HUGE problem in the overall effectiveness of the vaccine, and let’s not just single out desi parents here. I think this presents a problem no matter the cultural background. Even if parents accept that their kids are sexually active, my experience has been that such activity is kept on the DL…a sort of “don’t ask, don’t tell” policy, if you will.
Second, I’m not a doctor but when I think of vaccines I think of drugs that are designed to prevent diseases whose contractions aren’t necessarily rooted in voluntary activity. Leaving aside the important issue of rape or incest, I think there is a definite distinction that can be drawn between HPV and, e.g., the measles or polio. I’m sure that opponents to the vaccine will challenge the FDA approval in court and it would not surprise me at all if they raised this distinction in their challenge.
Third, how much does the vaccine cost? Just by the nature of the drug it seems to me that it will be most helpful to the poor and disenfranchised. If it is expensive, will insurance companies pay for it? More importantly, will Medicare/Medicaid pay for it. Just because it has FDA approval, Congress can still easily restrict its use by denying government health care subsidies to the use of the drug.
Most data actually shows vaccinations are very effective. Yes, the ‘web’ has some great information and cases listed as side effects to vaccinations. But they are exceptions to the case rather than the norm. Unless you’re a medical professional/researcher, I would take whatever information you find with a big grain of salt and not make a decision such as vaccinating your child based upon information garnered through the web via personal study. A professional has the right scientific skills to translate whatever information for you.
The source and technique of study that suggest vaccinations are bad should also be thoroughly researched. There are plenty of ‘studies’ out there that look great, but aren’t from a credible researchers.
Last thing you want is people stop vaccinating, like the Nigerians, who stopped Polio vaccinations because they thought it was an American ploy and anti-islamic.
just FYI for those women out there:
Pap smears/gyn exams should start at the age of 18, or at the time of first sexual intercourse..paps should be done yearly, or every 2-3 years if you’re with the same partner in a monogomous relationship…if caught early, it can be cured… pap smears are done by internists/family practice docs as well as gynecologists..so you can do it during your yearly physical…
more info on the vaccine from Wiki:
here is some info via the NCI website:
via the NCI website, some info from the study that was reviewed about the vaccine:
chick pea, my GYN recently told me that they’ve (whoever is in charge of these guidelines) upped the age of first smear to 21, unless the patient is sexually active.
yeah, age 21 is correct per the NCCN guidelines. here is more info on that:
yes, 21 is the age it should begin if not yet sexually active if sexually active, you should have a pap within 3 years..
most girls we used to see in clinic while on my ob/gyn rotation started around 18.. thanks for the clarification 🙂
as long as we’re talking about preventative measures, i just want to add these few cents for those who are in this age group, or those who can coerce their parents who are (since prevention is better than cure!)–because i know a TON of desi parents who are horrible at getting regular checkups and all that…most don’t take care of themselves like they should (like mine) and need to be dragged to appointments for mammograms, PSA levels being checked, and colonoscopy procedures…. this is just a briefing…
women: annual mammogram needed starting at age 40 (although this is controversial right now of when to begin along with MRI’s of the breast) and then yearly. if have a strong famiy history of breast cancer, mammograms need to be done earlier.. (at what age is also controversial), and as usual, self breast exams monthly after your monthly periods are recommended…
pap smears: age 21 or after become sexually active, and done yearly…after age 70 and 3 negative paps in a row, likely can decrease the frequency of getting them
men: PSA levels should be checked on an annual basis (prostatic specific antigen–a blood test), starting at age 40, along with digital rectal exams..
both: colonoscopies should be done at age 50 and repeated every 10 years if negative, and followed up if have polyps or other suspicious lesions…
colonoscopy aren’t that bad… compared to watching that and a person have a face lift (omg, that is the worst procedure ever! also liposuctions are horrific), colonoscopies can save your life…
Dont worry. We are almost all 1st generation American’s and with each generation to follow the stigma of sex will be forgotten. Its only a matter of time before we hear our children having sex in there bedrooms and we knock only to tell them to keep it down.
Thankfully my mum and dad are not above talking about sex with us, their teenage daughters…although my mum found it difficult initially since she’s def not a doctor and has grown up in a fairly conservative enviroment. But it’s important and the best thing when the parents are in denial is to broach the topic forcefully…only that will get them to talk. Sex really shouldn’t be such a taboo – because there’s really no big deal to it, it’s the most normal activity in the world and a primary need for (almost) all human beings.
it’s possible that no parents are eager to discuss sex with their children – but i think there is a certain increased repression when it comes to desi families. my own parents who are fairly liberal, sent me out of the room when movies played sex scenes, never explained where babies came from or what sex actually was (figured it out on my own, amazingly), and didn’t give me a safe sex talk until well after i was already sexually active (and safe.) While my other (non-desi) friends had horribly embarassing talks with their parents but despite the umcomfort of the situation – had that talk anyway. i’m lucky to have had a comphrensive sex education in my public school but others (especially nowadays), not so much.
yay for plan B, VICTORY!
Its about time but still they had to put it at “over 18”. A couple of months back, I dont know if it was dateline or 60 minutes, they showed different pharmacies actually declining to fill out prescription for Plan B. Their reasoning? “its not birth control, its abortion”. Well all i have to say to them is, IN YOUR FACE!
I hear ya, i am scared 🙁
Just a couple of clarifications on the clarification:
Pap guidelines have changed recently and are still changing. Ask your Gyn what’s currnet! But as of now… Women should have their first pap within 3 years of becoming sexually active or at age 21, whichever comes first. Women over 30 who’ve had 3 sequential normal annual paps can increase the pap interval to every 2-3 years. Women age 70 or older may stop having paps if they have a history of 3 normal paps. Women who’ve had a hysterectomy for non-malignant disease don’t need paps anymore.
The vaccine will be most effective if given before the time of first intercourse, whether that’s at 12 or 21. Getting the vaccine at, say, 11 would protect in both these instances.
I’d be curious to know if the vaccine could be given to women who are sexually active, but don’t test positive for HPV….
or for that matter older girls who aren’t sexually active, I know people keep saying, vaccinate girls, but the truth is there are a number of women still virgins at 18, 19, 20, 30 whatever.
And the third or sencond part of the eqation is why the hell no one is talking about vaccinating the boys…
Good call, Kenyandesi. I’m ashamed to admit that question didn’t even occur to me until you mentioned it.
Because the vaccine is for CERVICAL cancer and boys don’t have a CERVIX.
Some type of vaccine has been linked to autism in children, if my memory serves me correctly.
I now reveal my total ignorance of all things medical, but I have a question. Men infect women w/ HPV because they can carry the virus, correct? Then why wouldn’t vaccinating the men prevent them from being carriers and therefore infecting women?
“Does HPV pose a cancer risk to men who contract the virus?”
Experts donÂ’t believe so. The HPV that causes these types of cancers have not been shown to pose a significant cancer risk to men. However, if you have repeatedly had unprotected sex with a woman with HPV the likelihood that you are a carrier is probably great and you would pose a potential risk to a future partner, no only of passing the virus on to her but by placing her at increased risk for cancer and possibly death.
There are even some tests out there for men called the “HPV man test”. It isn’t pleasant but if it would bring you some peace of mind you might inquire about it to your physician. The HPV man test is generally a penile swab to find abnormal cellular changes – a kind of “pap test”, if you want to look at it that way, for men. Your physician may not be capable of doing this type of test and you may have to see a specialist or enter some study in order to get it because HPV testing among men is rarely done except for research.
That figures. Put the owness on the FEMALE. Shoot, maybe if men had to do this rarely done test then they would be more careful with making sure they practiced safe sex. And when they get tested for STDs and they get marked as “Clean”, they could still be carrying HPV? Which will give me cancer? And then they say, “baby, you’re on birth control, how about we not use a condom tonight? I’m tested and clean.” That is just messed up.
men are not regularly tested for hpv..it is placed as a woman’s responsibility… not saying it’s fair, but that is the way it is.. hopefully most people are informed and aware of the possible consequences…nobody is immune to anything these days..whether it be hiv, hpv, other std’s, cancer, etc…
It’s not just desi parents with backward/ludicrous attitudes about STD prevention, read this in the San Fran Chronicle about FDA’s own Janet Woodcock’s reasoning for barring OTC access to Plan B:
Screwed and Chick Pea, I have noticed in every country I’ve gone to, the onus is on women much more than men. Is it perhaps because men have proven themselves consistently less open than women are to things like testing and getting examined? Are women more open towards using contraceptives then men are? I just got my answer here…
http://www.alternet.org/story/17432/
… talks about RISUG, birth control injection for men…
“The injection is called Reversible Inhibition of Sperm Under Guidance (RISUG, pronounced RICE-ugh). It was developed by professor Sujoy K. Guha, an Indian researcher of biomedical engineering at the Indian Institute of Technology. Guha has tested RISUG on men for more than 25 years with successful results. His research has drawn praise from the World Health Organization, as well as doctors from around the world. Pharmaceutical companies in India and Egypt are vying to buy RISUG, and, if all continues well with Guha’s research, RISUG will be available on the Indian market sometime within the next few years.”
I always wondered why a male birth control pill had not been invented and mass marketed all these years. Why is the onus always on the woman, up until recently (still the future)?
Birth control pills and injections targeted towards women have side effects. Why in this day and age are women still targets, while men are not?
More over, in India it has been reported that social workers do mass propaganda towards poor uneducated village women regarding birth control measures like pills or injections and they do not inform them of the possible grave side effects. All of the possible side effects of the current injection for women are not even known. Again, these women partake of these things in full faith. In a way it’s kind of taking advantage of their innocence.
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for your interest a nyt article about the vaccine.
michigan may REQUIRE girls in 6th grade to get the vaccine… disucss…
I think like all vaccinations, all children (boys and girls) should be required to get the shot. because it is the only way the virus will eventually be wiped out, just like polio etc is virtually nonexistant in the western world 🙂
Pardesi Gori on August 28, 2006 06:30 PM · Direct link Some type of vaccine has been linked to autism in children, if my memory serves me correctly.
I feel compelled to correct this misconception. The MMR vaccine was touted as the evil cause of autism for a while, but overwhelming evidence is against this theory. Futher information is available at the CDC where the studies are all summarized. This misconception leads to people not vaccinating their children against measles, mumps and rubella, at least one of which (measles) is potentially deadly. The people who insist on not vaccinating their kids because they are suspicious about the government or the health industry in general are relying on the fact that everyone else is vaccinating their kids to protect their unvaccinated children, i.e. herd immunity.
This is just irresponsible and selfish.
If no one vaccinated their kids, they could die of measles or end up deaf, blind or severely disabled. Because the overwhelming majority are vaccinated, the dissenters can stick to their guns with very minimal health risks to their own children. I just don’t think this is fair and I can’t let that kind of misinformation go uncorrected. I think parents have a responsibility not just to their own kids but to society at large to vaccinate their children. Yes, new medical treatments sometimes have side effects that are unanticipated. But the MMR is not a new vaccine, and this issue has been extensively studied.
The prison inmates arent useless any more. They should each be given a ‘miraculas vial’, they have the ability to talk to Angels and to ask them to materialize a small speck of healthy medication in the empty vial you give them. The prisoners will look closely inside their vials every morning to determine if they accummulated a tiny bit of chemical drug given to them by the Christian Angels. Give them a list of different types of drugs to request for, let them choose wich one drug type they will get manifested inside their vials. Then when it works you have a new drug to study and mass produce.
Develop a small chip thats meant to be the spot where one molecule would be able to appear. First make a nano-box or nano-hole in the center of the chip where the single magic molecule might be found. Once this is done give one chip to each prisoner to put in the vile they each have.
You can You can the see that Jimmy J Farnham from 2008 and 1971 was taken 51,216 years in the past the time girls scout cookies who said he stole the bioengeneered 28, mill is the death wooze rot ogf corupton that a an Air force gov of Alibama your misusing time travel.