Monthly Archives: May 2012

AIDS Researchers Sideline Women: An Example of Sex Bias in Drug Treatment Trials

Guest Blogger:  Elizabeth Wingfield, Former WLP Internred bow aids symbol

A recent Los Angeles Times  editorial revealed that women are underrepresented in clinical trials of ways to treat and prevent HIV infection. While men make up 75% of the U.S. population living with HIV, women make up far less than 25% of most clinical trials. For example, according to the editorial, “a recent report on the promising ‘Quad’ pill — a single daily tablet that combines several medications — noted that one trial had 700 participants. Just 10% were women.” This underrepresentation may have negative health consequences because women metabolize drugs differently from men and some side effects vary based on sex.

The reason for the disparity in clinical studies is thought to be due to the fact that most women who are HIV positive in the U.S. are poor and are either black or Latina. Poor HIV positive women have “less access to medical treatment at universities doing research, and are therefore less likely to be found when researchers are recruiting.”  Also, according to experts cited in the editorial, there “is a lingering mistrust of medical researchers in the black community… partly the legacy of exploitative experimentation on minorities. As a result, women and people of color have traditionally been underrepresented in clinical trials on numerous diseases and conditions.”

The editorial notes that some researchers are doing the right thing by making a greater effort to recruit women for clinical trials. More energy spent recruiting women helps to offset the reasons why poor women and women of color are less likely to participate in research. As an example, “the AIDS Clinical Trials Group has set a floor of 10% participation by women in studies, and it tries for 20%. In addition, it used grant money to hire community health ‘promoters’ at 10 research sites across the country whose job is to make people in minority communities aware of research projects.” Notably, two AIDS Clinical Trials group units run by UCLA last year managed to have a higher percentage of women participate in their studies than live with HIV in Los Angeles. The editorial ends by urging “community health providers… to be…aggressive about staying in touch with research institutions and keeping abreast of studies enrolling new participants [since] women should be encouraged to consider joining those studies.”

In Through the Lens of Equality: Eliminating Sex Bias to Improve the Health of Pennsylvania’s Women, the Women’s Law Project (WLP) discusses the ways in which sex bias in drug treatment trials negatively impacts women’s health.  This bias turns women “into guinea pigs at the medical provider’s office and pharmacy, taking medications with little or no information about their safety or possible side effects,” and the exclusion from clinical trials also denies women the opportunity to receive treatments available and affordable only through the trial.  WLP recommends several ways the Food and Drug Administration, other governmental officials, and pharmaceutical companies can address sex bias in clinical trials, including by offering solutions to practical barriers to participation in clinical trials (such as by providing childcare) and by requiring that the pool of participants in drug trials reflect the prevalence in groups with the condition the proposed drug aims to treat.

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Filed under Drug Trials, Gender Discrimination, Health Care, HIV/AIDS, People of Color, Sexually Transmitted Disease, Sexually Transmitted Infections, Women's health

A Lawsuit in Federal Court Seeks to Lift the Obama Administration’s Emergency Contraception Decision

A federal district court in New York is considering “whether to force the federal government to lift the age restrictions on over-the-counter sale of emergency contraceptives.” This lawsuit, brought by the Center for Reproductive Rights, alleges that the Food and Drug Administration (FDA) has denied women of all ages access to over-the-counter emergency contraception and has failed to follow procedural, statutory, and regulatory mandates in violation of the United States Constitution and the Administrative Procedure Act.  The plaintiffs originally filed this action in 2005, and re-opened the case in 2012, after Health and Human Services (HHS) Secretary Kathleen Sebelius made the unprecedented decision to overrule the FDA’s judgment to lift the age restriction on over-the-counter access to emergency contraception (Plan B).

We have blogged before  about the age restriction on emergency contraception access and why it is unwise to have such a restriction. In a letter sent to President Obama and Secretary Sebelius, WLP noted that

when our country faces approximately 3.1 million unintended pregnancies each year, unrestricted access to safe and effective contraception is vital…[and] also…there is simply no evidence to suggest that making emergency over-the-counter contraception available encourages young women to begin having sex at a younger age, or engage in sex with more partners.

According to Politico, Judge Korman “seems to be losing his patience with what he sees as the government’s disregard of scientific evidence saying the drug should be available over the counter. ‘Understand — the FDA has made a scientific judgment here,’ Korman told the government’s lawyer.”

But even if Judge Korman does decide to overrule the age restriction on emergency contraception, the government has argued that Korman does not actually have the power to make such a decision. However, the Center for Reproductive Rights (CRR) noted that Korman has already established a precedent for lowering the age limit on access to emergency contraception when he ordered the age restriction be lowered from 18 to 17 in 2009.

The current lawsuit seeks to remove a barrier to young women’s access to emergency contraception by making it available without a prescription, which takes time for women to procure and may cost money for the appointment.  In Through the Lens of Equality: Eliminating Sex Bias to Improve the Health of Pennsylvania’s Women, WLP discusses many of the barriers that impede women’s access to basic reproductive health care, including legal restrictions, high cost, misinformation, and violence and harassment against patients and providers.  These barriers have a deleterious effect on women’s health by, for example, increasing the likelihood of unintended pregnancies, which are correlated with a wide range of negative health outcomes for women and children.  Removing the age restriction on over-the-counter access to emergency contraception would improve the health and welfare of young women throughout the country.

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Filed under Contraception, Emergency Contraception, Family Planning, Federal Court, Health Care, Reproductive Rights, Women's health

Report: Female Farm Workers Face Sexual Violence, Harassment

On May 16, Human Rights Watch (HRW) published a report detailing the results of interviews with over 160 farmworkers, police, attorneys, and other members of the agricultural industry about sexual violence and harassment endured by female migrant farmworkers. Women make up 630,000 of the approximately 3 million people who perform migrant and seasonal farm work and 50% of the U.S. agricultural workforce is undocumented. Lily Kuo describes how “nearly all of 52 farmworkers interviewed said they had suffered sexual violence or harassment or knew others who had.” The report found that people in positions of power, such as “foremen, supervisors, farm labor contractors, and company owners were abusing multiple women and often over long periods of time.”

HRW found that most women and girls who work in the agricultural industry and suffer abuse do not report it because they are undocumented and do not want to risk getting deported if they do. Even the relatively small percentage of workers with guest worker visas are unlikely to report abuse because they are dependent on their employers in order to keep their legal status.

While there are U visas, which provide temporary legal status to victims of certain serious crimes if they suffer substantial physical or mental abuse and if they cooperate with the investigation, Huffington Post reports that

even this limited protection could soon be eviscerated. As Congress debates the reauthorization of the Violence Against Women Act, proposed provisions to strengthen the U visa have come under attack, while

Even if proposed provisions to strengthen U visas were passed there would still be significant obstacles to obtaining them, since “to apply for a U visa the victim must get a certification that he or she cooperated with a law enforcement investigation. But law enforcement officials vary widely in their willingness to certify victims, due to a mistaken belief that they are helping unauthorized immigrants ‘get green cards.’”

The HRW report, while detailing troubling realities of the abuse many migrant farmworkers face, does offer hope that their situations can be bettered; it lists ways to improve and expand victims’ access to justice. The report proposes, among other things, that the U.S. Congress pass the Senate version of the Violence Against Women Act (VAWA) reauthorization bill, enact immigration legislation that would reduce the incidence of serious abuse of immigrant workers’ rights, and that the exclusion of farmworkers from important laws providing labor protections like the National Labor Relations Act and the Fair Labor Standards Act be eliminated.

To learn more about this issue and what you can do to help, you can read the entire HRW report here. You can also watch a video that includes an interview with an HRW official as well as with farmworkers below.

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Filed under Immigrants, Sexual Assault, Sexual harassment, Uncategorized, Violence Against Women

Women’s Law Project Releases Through the Lens of Equality: Eliminating Sex Bias to Improve the Health of Pennsylvania’s Women

The Women’s Law Project (WLP) released today a major report, Through the Lens of Equality: Eliminating Sex Bias to Improve the Health of Pennsylvania’s Women, linking sex bias to adverse health outcomes in women.   The release of this report coincides with National Women’s Health Week (May 13-19th), during which time organizations around the country are raising awareness about the benefits of the health care law.

Inspired by the public debate on health care, WLP embarked on an examination of the relationship between the sex bias that women experience and their health, resulting in the publication of Through the Lens of Equality.  “As familiar as we were with ongoing bias and discrimination against women and with data on critical health measures for women, our in-depth examination of the linkage between the two truly shocked us,” said Carol Tracy, Executive Director of the Women’s Law Project.  “The focus is on Pennsylvania, however, the finding and recommendations have nationwide application,” she added.

“For all of the years that I have been involved in women’s rights and women’s health care, I have never seen the connections between health and equality more dramatically demonstrated that it is in this report,” said Kate Michelman, former President of NARAL Pro-Choice America and long-time Pennsylvania resident who served as a consultant to this project.

Through the Lens of Equality examines the health impact of sexual and intimate partner violence, caregiving responsibilities, poverty, and bias in the workplace, school, and health care.  The report delves into the politicization of women’s reproductive health care and shows how women are harmed by limited access to abortion, contraception, and maternity care.  It repeatedly points to the importance of implementation of the Patient Protection and Affordable Care Act (ACA) to expand access to better health care for women, while acknowledging the ACA’s serious gaps, including not mandating abortion coverage.

“This is not a publication about diseases, but instead an exposition of how biased environments in which women live, work, study, and receive health services are infected with outdated notions about women’s role in society which in turn have negative health consequences for them,” said Amal Bass, staff attorney at the Women’s Law Project.

The publication also provides a series of recommendations tailored to both overcoming sex bias and improving women’s health.  “Numerous targeted interventions well beyond improving access to insurance through the ACA — are necessary to cure institutional and individual prejudices about women,” said Terry Fromson, Managing Attorney of the WLP.  “Failure to do so will result in significant inequitable and avoidable health problems for women,” she added.

Through the Lens of Equality acknowledges the impressive strides that have been made in women’s rights over the past fifty years, but shows that past victories are not enough.  “Looking to the future requires insistence on equal treatment, equal access, and equal opportunity to achieve not just healthy women, but a healthy society,” said Susan Frietsche, Senior Staff Attorney

The Women’s Law Project is a legal advocacy organization based in Pennsylvania.  Founded   in 1974, its mission is to create a more just and equitable society by advancing the rights and status of all women throughout their lives.  The Law Project engages in high impact litigation, public policy advocacy and community education.   Through the Lens of Equality is available at http://www.womenslawproject.org/NewPages/wkTLE_Base.html.

 

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Filed under Domestic violence, Economic Justice, Education, Employment, Equality, Family Planning, Family Violence, Gender Discrimination, Health Care, Reproductive Rights, Sex Discrimination, Sexual Assault, Sexual harassment, Violence Against Women, Women's health

The Pennsylvania General Assembly Should Hold Public Hearings on SB 1063 and HB 1957 to Insure Motherhood

Pennsylvania’s women deserve to have maternity coverage in their health insurance.  Individual health insurance policies often do not cover maternity care, leaving many women at risk of having inadequate or no insurance when they become pregnant.  Furthermore, pregnant women applying for health insurance are denied maternity coverage because pregnancy is considered a “pre-existing condition.”  Currently, there is no law ensuring maternity benefits to women in Pennsylvania who purchase an individual policy of insurance.  The Affordable Care Act, which will not be fully implemented until 2014, assuming the United States Supreme Court does not overturn the law, may address these gaps in the law, but women need coverage now.  SB 1063 and HB 1957 would ensure that coverage.

It is important for the Pennsylvania General Assembly to hold public hearings on these bills.  Please urge Senator White and Representative Micozzie to move forward with these pieces of legislation:

Chair, House Insurance Committee: Nicholas Micozzie, 717-783-8808
Chair, Senate Baking & Insurance Committee: Donald White, 717-772-1589

For more information, see our post, Pennsylvania: Stop Insurers from Denying Essential Maternity Coverage to Women.

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Filed under Health Care, Health insurance, Maternity Coverage, Pregnancy, Reproductive Rights, Women's health

Urge Your Representative in Congress to Oppose H.R. 4970 to Protect the Safety of Domestic and Sexual Violence Victims

As Congress debates the reauthorization of the Violence Against Women Act (VAWA), domestic and sexual violence victims are in danger of losing important protections under the law.   Unlike previous reauthorizations of VAWA, a law originally passed in 1994 and reauthorized in 2000 and 2005, reauthorization this year has been a largely partisan process in both the Senate and the House.  As we have written previously, the Senate’s bill to reauthorize VAWA had bipartisan sponsorship, but passed the Senate Judiciary Committee on only a party-line vote of 10-8 without a single committee Republican voting in favor of reauthorization.  The bill ultimately passed the Senate in a 68-31 vote, with several Republicans supporting it. 

In the House, partisanship has resulted in a maneuver by Republicans that will undermine previously enacted protections under VAWA.  On May 8, 2012, the House Judiciary Committee approved a marked up version of H.R. 4970 introduced by House Republicans to reauthorize VAWA and to reduce protections for victims.  It passed out of committee in a 17-15 vote, with only one Republican voting against the harmful bill. 

Among its harmful provisions, H.R. 4970 targets immigrant domestic and sexual violence victims, who are among the most vulnerable victims because of language and cultural barriers to accessing services and, for some, undocumented status.  Sections 802 and 806 of the bill are particularly harmful.  Section 802 would limit the circumstances under which a victim qualifies for a “U” Visa, which provides an opportunity for undocumented victims of serious crimes to gain lawful status if they meet certain criteria.  Congress created the “U” Visa in 2000 to encourage immigrant victims to report crime and to strengthen the ability of law enforcement agencies to investigate and prosecute crimes.  Section 802 of the bill would undermine these purposes of the “U” Visa in several ways, including by requiring that victims report the crime within 60 days, a burdensome obstacle for immigrant crime victims who have difficulty accessing services.  It would also require that the “U” Visa applicant provide information that assists in identifying the perpetrator of the crime, even though it is sometimes difficult for victims to be able to identify a perpetrator accurately.  Section 806 of the bill would further undermine the purpose behind “U” Visas by terminating the visa recipient’s eligibility for permanent residence.  

If passed into law, these provisions of H.R. 4970 will harm immigrant domestic and sexual violence victims, making it harder for these women to report and escape from violence in their lives.  The safety of these women should not be subject to partisan politics. 

Please tell your representative in the House that all domestic and sexual violence victims deserve protection.  Urge him or her to oppose H.R. 4970.  To call your representative, dial 202-224-3121 and tell the operator the name of your representative.

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Filed under Congress, Domestic violence, Immigrants, Sexual Assault, Violence Against Women

The Pregnant Workers Fairness Act Offers Hope for Women in the Workplace, If Congress Passes It

“Tina,” who is pregnant and works as a health aide in a nursing home, is told by her doctor that she should not lift more than 35 pounds.  Her job description requires lifting 40 pounds regularly, but lighter duty jobs, such as answering the phone and working at the reception desk, are available.  Nevertheless, her employer stops scheduling her for shifts and tells her she must take unpaid Family Medical Leave, which would run out before the delivery of her baby and leave her without the income she needs to pay the 50% of her medical insurance her employer does not cover.  Left with no choice, Tina loses her job.

“Jessica,” who is pregnant and works as a pharmacist’s assistant, needs to sit down occasionally throughout her day.  Chairs are available for customers, but the pharmacy does not permit the staff to use them.  As a result, Jessica loses her job.

For women like Tina and Jessica, whose stories are based on the experiences of real women who have called the Women’s Law Project, current anti-discrimination laws often do not go far enough.

Title VII of the Civil Rights Act of 1964, as amended by the Pregnancy Discrimination Act (PDA), prevents an employer from treating a pregnant woman differently from how that employer treats non-pregnant employees who are similar in their ability or inability to work.  Some courts, however, have limited the protections of this federal law by requiring pregnant employees to identify a non-pregnant employee who works in the same role and has almost identical limitations but is treated better by the employer in order to succeed with a lawsuit.  Some courts even permit employers to refuse to accommodate pregnant employees when they accommodate non-pregnant employees because pregnancy is not a work-related condition.  In short, despite the PDA, pregnant women are often treated differently from other employees with similar limitations.

Other laws do not provide better protections for pregnant women. Courts interpret the Pennsylvania Human Relations Act (PHRA) similarly to Title VII/PDA.  In addition, the Americans with Disabilities Act (ADA), which requires employers to provide reasonable accommodations to disabled employees, usually does not apply to women experiencing ordinary pregnancy.

A handful of states have laws that prevent employers from terminating women from employment or forcing them to take paid or unpaid leave when a reasonable accommodation is available, but Pennsylvania is not one of those states.  As a result of this gap in the law, many pregnant women in Pennsylvania, like Tina and Jessica, find themselves unemployed suddenly, without economic security and often without health insurance at a time when access to health care is crucial.

For Pennsylvania’s pregnant women and for women in many other states, the proposed federal Pregnant Workers Fairness Act would offer important workplace protections.  Introduced on May 8, 2012 by Representative Jerrold Nadler (D-NY) and other representatives in the House, the Pregnant Workers Fairness Act would:

  • Require employers to make reasonable accommodations to employees who have limitations on the job related to their pregnancy, childbirth, or related medical condition, unless the accommodation would impose an undue hardship on the employer.
  • Prohibit employers from retaliating against employees who need an accommodation.
  • Prohibit employers from forcing a pregnant employee to accept an accommodation she does not want.
  • Prohibit employers from forcing a pregnant employee to take unpaid or paid leave if a reasonable accommodation is available.

The Pregnant Workers Fairness Act is modeled after the Americans with Disabilities Act, which has been in effect for over two decades.  Thus, the Pregnant Workers Fairness Act employs a familiar framework that simply requires that employers provide reasonable accommodations that do not present an “undue burden.”  If passed, this law would help pregnant women stay employed and maintain their economic security and benefits, promoting the health of mothers and their families, while imposing only a minimal, temporary burden on employers.

Please contact your representative and tell them that they should support the Pregnant Workers Fairness Act.  To call your representative, dial 202-224-3121 and tell the operator the name of your representative.

For more information on this bill, take a look at the National Women’s Law Center’s Fact Sheet.

To learn more about the effects of sex bias and discrimination in the workplace on women’s health, stay tuned for WLP’s forthcoming report, Through the Lens of Equality: Eliminating Sex Bias to Improve the Health of Pennsylvania’s Women, which will be available online the week of May 14, 2012.

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Filed under Conress, Employment, Pregnancy, Reproductive Rights, Women's health