Tag Archives: hiv

The Clinton Foundation Sure Is a Great Charity

by CaseyYZQswynlze Posted on September 24, 2016

Mother Jones

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When it comes to charity, Dylan Matthews is pretty hardnosed. To earn his approval, a charity better focus on truly important problems and be damn good at it. So how about the Clinton Foundation? After starting out as a skeptic, he says, “I’ve come to the conclusion that the Clinton Foundation is a real charitable enterprise that did enormous good.” In particular, he praises the Clinton Health Access Initiative, which helped lower the cost of HIV drugs and saved untold lives. But there’s a catch:

And—perhaps uncomfortably for liberals and conservatives alike — it is exactly the kind of unsavory-seeming glad-handing and melding of business and politics for which Bill and Hillary Clinton have taken years of criticism that led to its greatest success….The deals made required buy-in from developing governments. The person tasked with getting that buy-in was a former US president with existing relationships with many of those people. Bill Clinton essentially used his chumminess with foreign politicians and pharmaceutical executives, the kind of thing about the Clinton Global Initiative that earns suspicious news coverage, to enlist their help in a scheme to expand access to HIV/AIDS drugs.

I don’t get it. Why should this make anyone feel uncomfortable? Lots of people have star power, but very few have star power with both rich people and foreign leaders. Bill Clinton is one of those few, so he chose a project that (a) could save a lot of lives, (b) required buy-in from both rich people and foreign leaders, and (c) was right at the cusp where an extra push could really make a difference.

I can’t even imagine why anyone would consider this unsavory, unless they’ve lived in a cave all their lives and don’t understand that glad-handing and chumminess are essential parts of how human societies operate. Matthews may be right that many people feel uneasy about this, but I can’t figure out why. It sounds like Clinton chose to do something that his particular mix of experience and character traits made him uncommonly good at. That’s pretty smart.

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The Clinton Foundation Sure Is a Great Charity

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Gay Men Wanted to Donate Blood in Orlando. They’re Still Not Allowed To.

by Volodyslav7uk Posted on June 19, 2016

Mother Jones

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By the early afternoon on June 12, hours after a gunman slaughtered 49 people at a gay nightclub in Orlando, hundreds of sympathizers had lined up to donate blood to the 53 young men and women who had survived the shooting. There were many gay men who would have liked to help but couldn’t. Last December, the Food and Drug Administration lifted its lifetime ban on blood donations by men who have sex with men (often referred to as MSM). Gay men could now give blood, the agency announced—but only if they’ve been celibate for a year beforehand. For gay men in America, it is still easier to purchase an assault rifle than to donate blood.

The lifetime ban was implemented during the early 1980s to help stem the spread of AIDS, which doctors had no way to diagnose or treat at the time. Three decades later, HIV/AIDS is a chronic condition, and advances in diagnostics have made it possible to detect infection within as few as nine days of exposure. But medical progress and political progress are asymmetrical. Despite years of criticism from the American Association of Blood Banks, the New York City Council, and the American Medical Association (AMA), the prohibition remained in place. “The lifetime ban on blood donation for men who have sex with men is discriminatory and not based on sound science,” the AMA declared in 2013.

So the FDA finally relented, somewhat, by reducing the lifetime ban to a yearlong moratorium on donations after the last male-to-male sexual encounter. “The 12-month deferral window is supported by the best available scientific evidence,” Dr. Peter Marks, head of the FDA branch that crafted the recommendation, said in a statement announcing the new policy.

Dan Bruner, the senior director of policy at Washington, DC’s premier HIV clinic, Whitman-Walker Health, was disappointed. “The updated policy is still discriminatory and not rooted in the reality of HIV testing today,” he wrote in response. “The deferral period should be no longer than 30 days.”

In the aftermath of Orlando, as a flurry of politicians, mourners, and activists have renewed their call for the FDA to rethink its 12-month policy, old arguments about public health and identity politics have re-emerged. Once again, health authorities, doctors, and LGBTQ advocates are looking at the same studies and clinical data and coming away with opposing conclusions on what constitutes the “best” scientific evidence.

There’s an emotional history here. By the time the FDA released the first reliable HIV test in 1985, more than 14,000 surgery patients and hemophiliacs were known to have been infected by blood transfusions—a veritable death sentence. Thousands of the fatal donations came from closeted gay men. Even with a test available, infected blood still snuck into the blood supply, because there is a window during which the virus is undetectable in the bloodstream of an infected person. The most common HIV test looks for antibodies against the virus rather than the virus itself. Just as there’s a lag between the intrusion of a burglar and the arrival of police, there’s a lag between pathogen and antibody. In the 1980s, the lag period was around a month. Today, every unit of blood collected in America must pass a nucleic acid test, which can detect HIV nine days after a person is infected.

Bruner, who is gay, is frustrated by the disparity between the FDA’s new policy and modern HIV diagnostics. “I’m married and have been in a monogamous relationship for 33 years,” he says. “If the Red Cross had a blood drive and I wanted to give, I could hold off on sex for a month. I could understand that. But the one-year ban is illusory progress. It says, ‘You can’t donate if you have a sex life.'” Bruner compares the current situation to the exclusion of homosexuals from the military for the sake of troop cohesion. “Don’t Ask, Don’t Tell,” a policy enacted in 1994 under President Bill Clinton and eliminated in 2011, allowed homosexuals to serve only if they remained in the closet, putting gay sex at odds with civic duty. “Donating blood is something normal people do,” Bruner says. “The FDA’s policy treats MSM as if they’re not normal, as if they have an infection even when they don’t.”

Indeed, the FDA does not consider MSM normal when it comes to HIV. “A history of male-to-male sexual contact was associated with a 62-fold increased risk for being HIV positive,” Marks tells me. He adds that MSM comprise 2 percent of the population but account for two-thirds of new HIV infections. “If everyone was 100 percent truthful and never cheated, the current nucleic acid test would be able to take care of things,” he explains. “Say you and your partner always use condoms. That also has a failure rate. With anal receptive intercourse it’s 1 to 2 percent.” That adds up fast when your agency is responsible for the safety of millions of Americans.

The FDA relies on data to craft policy, and because American researchers have not thoroughly studied a shorter deferral period for MSM, the agency instead looked to Australia, whose HIV epidemiology and blood screening systems are similar to those in the United States, according to Marks. In 2000, Australia replaced its own indefinite ban on MSM blood donations with a 12-month deferral for sexually active gay men. Australian researchers then studied millions of blood donors from the mid-1990s to the mid-2000s and found no statistically significant increase in the number of HIV-positive donors under the new policy, much less transfusion-borne infections.

Health officials in Italy tried something different: They eliminated MSM deferrals entirely in 2001 and began assessing each donor’s risk with an extensive questionnaire. In 2013, Italian researchers concluded that this individual risk assessment was just as effective at screening out HIV-positive donors (regardless of sexuality) as their nation’s mandatory MSM deferral had been.

Preempting questions about these findings on C-SPAN, Marks said that heterosexuals account for a much larger proportion of new HIV infections in Italy than in the United States. He claimed that getting rid of deferrals and relying only on HIV testing would quadruple the rate of infection through the blood supply. In a subsequent interview, he also said it “wasn’t too big a leap” to make policy based on a six-year-old study of another country’s policy. “We want data we can hang our hat on,” he said.

Public health, of course, is not clinical medicine in aggregate. Doctors treat individuals and can see the result of a prescription in days, but public health officials deal in million-person trends and decade-long studies. It’s therefore not surprising that the FDA’s blood-donation policy lags a decade behind modern diagnostics. “For every letter we got saying we should advance the policy, we got one saying that we shouldn’t change the policy,” Marks says. Imagine the response had the FDA tried to end its MSM ban six years ago, when Australian researchers first published their study. In 2010, a majority of Americans opposed same-sex marriage, including President Barack Obama (publicly, at least). Today, we are more sympathetic to LGBTQ people, but the association of AIDS with gay men endures, in part because the latter still account for a staggering proportion of the US HIV-positive population—more than 40 percent as of 2011.

Dr. Gerald Friedland, an AIDS expert at Yale New Haven Hospital, can sympathize with both sides. “There is logic to the current policy because MSM are the highest-risk population, but there is a danger of stigmatizing,” he says. “Every epidemic is a mosaic of smaller epidemics. Risk is contextual.” For instance, African Americans make up 41 percent of the 1.2 million HIV-positive Americans despite being only 12 percent of the population. In 2014, roughly a quarter of the nation’s 45,000 new HIV infections were black MSM. Poverty, access to housing and education, and geography matter, too. The South is home to 37 percent of the population but 44 percent of Americans with HIV. Yet there are no special donor questions or deferrals for black people, poor people, or Southerners.

Friedland says the FDA may have crafted its policy in deference to the hierarchy of medical evidence. “When we make guidelines for antiretroviral therapy, for example,” he says, “a strong recommendation will receive an ‘A’ if it’s based on two double-blind randomized control trials”—experiments in which neither the researchers nor the subjects know who receives the medication and who receives a placebo. A recommendation receives a “B” if it relies on observational studies, which Friedland describes as “lots of evidence but not randomized evidence.” (The studies from Australia and Italy would probably receive a “B.”) The third threshold, a “C,” is based on a consensus of expert opinion in situations where there are no good studies. (The idea of shrinking the MSM deferral to 30 days would get a “C” because it hasn’t been studied.) “Many decisions are made on this basis,” Friedland says. “There might have been a difference of opinion within the FDA that led to a less-than-forceful recommendation.” The apparent unwillingness of the medical community to undertake clinically relevant studies of a 30-day deferral for sexually active gay men—research many experts say could be conducted without endangering any transfusion recipients—leaves in place a somewhat arbitrary policy that feels discriminatory to many Americans.

Earlier this spring, I went to a Red Cross blood drive in New Haven, Connecticut, and found that the nonprofit had yet to implement the FDA’s “less-than-forceful” recommendations. Its laminated donor handouts still told gay men they could not donate blood, period. Dr. Dominick Giovanniello, the American Red Cross’ medical director for Connecticut, explains that the policy change is more gradual and complicated than media reports made it seem back in December. The new policy, Giovanniello says, was issued as a “draft guidance” back in May of 2015, which gave blood banks time to absorb the changes and get donation centers up to speed, rewriting and reprinting donor manuals, creating new programming for computer-based questionnaires, and retraining phlebotomy staff.

The American Red Cross, a private entity regulated by the FDA, is responsible for about 40 percent of the nation’s blood supply, more than 5 million pints every year, and it wants its policies and facilities to be “in sync” nationwide before it rolls out the changes. Donation facilities less strict than the FDA recommends can be cited or even shut down, so they err on the side of strictness. Yet more than a year has passed since the FDA issued the draft guidance, and the American Red Cross has yet to end the indefinite deferrals. “I’m a little surprised that it’s taken blood banks this much time,” Marks told me.

The ongoing deferral puzzles many LGBTQ advocates, given how vital blood is to the health care system. The Williams Institute, a think tank affiliated with the UCLA School of Law, found that the 12-month deferral forfeits as many as 300,000 pints of blood every year. Ending it, the institute wrote, could “help save the lives of more than a million people.”

Then again, the nation’s demand for blood is down significantly, falling by 27 percent from 2008 to 2013, due to the emergence of minimally invasive surgery and evidence that high-volume blood transfusion is risky and expensive. But the complex biology of blood means that even a slight expansion of the donor pool could save many lives. Although more than two-thirds of Americans have A-positive or O-positive blood, around 9 percent have O-negative and 3 percent have AB-positive, and these rarer types are highly versatile: You can transfuse any patient with O-negative blood cells, and AB plasma is accepted by any body. “There’s always a need for AB plasma and O-negative red blood cells,” Giovanniello says. Having these rare types on hand is especially important when time is short—say, in the aftermath of a mass shooting.

When I ask Marks about the Orlando attack and whether the FDA plans to respond to the renewed criticism of the 12-month deferral, he replies that the agency is “on a course to gather more data to move the policy forward” and that a new plan has “been in the works for weeks and weeks.” He and his staff would only hint about what such a plan might entail. Lorrie McNeill, Marks’ communications director, tells me that many in the LGBTQ community feel that any time-based deferral would be discriminatory. “The comments we heard back were overwhelmingly in favor of moving toward an individual risk assessment,” McNeil says.

Marks has previously said that the FDA hopes to better understand why HIV-positive people would donate blood, which requires thinking about how and why people lie when answering donor questionnaires. “Most donors answer questions as if they’re asking ‘Is my blood safe?’ rather than what they actually ask,” he tells me. “If people feel like we have a fair policy, then they’ll be more likely to comply. There are certain questions that make people so embarrassed that they won’t answer truthfully.”

Marks is cagey about what an improved donor questionnaire might include. “If I could ask you your favorite kind of ice cream bar, and that would predict with 99.9 percent accuracy that you were safe to donate,” he says, “then that would work.” In any case, an FDA study on the effectiveness of a less invasive, more holistic donor history questionnaire would show that the agency is seeking evidence that could support an effective individual risk assessment.

But even if the FDA takes this step, the research would take years to complete, could be cut short by a Republican administration, and might deliver inconclusive results. In the meantime, queer men who want to give blood have to re-enter the closet for an afternoon. The FDA has thought through its policies with care, but its circumspection is lost on millions of gay men and their allies who view the deferral as a symptom of the same phobia that apparently brought a man with an assault rifle to a gay club. The current policy suggests that the federal government is more concerned with preventing injury than insult. With better evidence, it won’t have to choose one or the other.

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Gay Men Wanted to Donate Blood in Orlando. They’re Still Not Allowed To.

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These Porn Stars Want the Government Off Their Backs

by Stanton2314 Posted on February 20, 2016

Mother Jones

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Dozens of porn stars—some in business casual, others more colorfully dressed—mingled outside the Elihu M. Harris State Building auditorium in Oakland, California, on Thursday morning, trading notes on the speeches they planned to make when they testified before California’s Occupational Safety and Health Standards Board (OSHA). After six years of advisory committees and meetings, the board was set to vote on a package of regulations they hoped would protect the actors against sexually transmitted infections—a measure publicized as a “condoms in porn” mandate. But workers in the porn industry opposed the rules, which they said did not account for the realities of their work or respect for their personal autonomy. The Free Speech Coalition, a porn industry trade group, brought porn stars from Los Angeles to join others from San Francisco’s kink- and gay-porn scenes in speaking out against the regulations.

“We’re not fighting safety,” Mickey Mod, a veteran porn performer and producer, told the panel. “These are our bodies, and we work with them every day. Every day, I trust the men and women who are on our side to be as safe as possible.”

Since the regulations were first proposed in 2009, some porn advocates and public-health academics have offered suggestions that they say make the rules more realistic for those in the multibillion-dollar industry. Many of them say they have felt ignored. On one draft of the regulations, the OSHA board dismissed all of the Free Speech Coalition’s 37 concerns, including objections that the measure failed to sufficiently protect workers’ medical privacy and ignored the possibility of using HIV-prevention drugs as an option for protection. “We understand that they feel it will affect their livelihood, but Cal/OSHA’s primary concern is the health and safety of workers,” an exasperated public information officer from the California Department of Industrial Relations, which includes OSHA, told me before the meeting.

A few minutes before the meeting, Eric Paul Leue, the Free Speech Coalition’s executive director, spoke privately to the workers, urging them to stay optimistic and reminding them that the OSHA board was in a difficult position. “Usually, workers and the board are fighting employers,” he said. “In this case, the workers and employers are fighting together.”

After nearly five hours of testimony, in which about 100 performers, directors, and production staff members spoke against the package of regulations—and a few former performers expressed support for it—the OSHA board struggled with the apparent contradiction of workers who were actively opposed to the OSHA protections. “I’m a labor representative. I work with working people for a living,” Dave Harrison, an OSHA board member, said. When he first heard about the regulations, “it was almost like, ‘Oh, okay, the porn industry’s coming out for an issue. What’s going to happen here?'” He chuckled. “But as the rule-making process works through, I’m actually more torn over this than I could ever explain.”

For the measure to succeed, four votes were needed, but it failed in a final vote when three board members voted for the regulations and two opposed it.

Here’s what you need to know about the proposed rules and the conflict that surrounds them:

What did OSHA propose? Some regulations already exist, but the ones that were proposed would have added a section to the OSHA code that specifically described the actions porn producers needed to take to protect workers from STIs. The regulations would have required the use of condoms, plastic barriers (known as “dental dams”) for oral sex, gloves, goggles, and other gear to block contact with bodily fluids that can carry infection. Similar requirements for all industries already exist under federal and state regulations, but they’re not well enforced. Since 2004, when OSHA began enforcing STI regulations at porn companies, they’ve only issued a handful of citations. Proponents argued that new regulations were needed to clarify the responsibilities of adult-film producers.

If condoms are already required, why is this a big deal? Because the porn industry ignores the condom requirement. Many industry workers argue that porn viewers do not “want to see dental dams, they don’t want to see gloves, they don’t want to see kissing with something in between,” explains Kevin Quintero, a cameraman for Treasure Island Media, a San Francisco-based gay-porn production studio. “That ruins their suspension of disbelief.” But if the proposal resulted in more aggressive enforcement, producers and performers say they would be forced to move away from California or to find work “underground.” Quintero says that would mean working for producers “who promote drug use, promote unsafe situations, who don’t care about their performers’ safety, usually only care about the ‘money shot’ or getting what they need. Oftentimes, it can be exploitative…I fought really hard to get out.”

What other regulations would the industry face? The proposal also would have put new testing regulations in place, requiring vaccinations and STI testing every three months. The requirements would have been less stringent than unofficial regulations that already exist in the porn industry under a system known as PASS, in which actors must pass a blood test every two weeks or they are not permitted to work. Repeatedly, performers have stressed that they feel safer having sex with other porn stars in the PASS system than they do with “civilians” outside of work. Some have also raised concerns about the possibility of confidential medical information being shared with their employers.

What’s the opposing position? OSHA argues that frequent testing isn’t the same as prevention. Several performers testified Thursday that they’d gone entire careers without contracting an STI, but past research has indicated a high rate of gonorrhea and chlamydia among performers. Earlier this month, the Centers for Disease Control and Prevention published a report documenting an incident involving male adult-film actors, in which an actor received a false-negative result on an HIV test in 2014 and then went on to infect two other people before his next testing date. Newly HIV-positive performers have forced the industry to declare periodic shutdowns, during which production is suspended for a few days while all the actors receive testing. Advocates have maintained that most infected performers do not contract HIV on set.

That’s no comfort to Sofia Delgado, one of the few performers who supported the regulations at the OSHA meeting. Delgado told me that she had been working in porn for just months when she tested positive for HIV in 2013, at age 20. Afterward, she couldn’t work, and now she says she’s saddled with thousands of dollars in medical expenses each month. “I felt so safe,” Delgado told me. “Everybody I was with was tested, but it didn’t matter.” If her partners had been using condoms, she says, she would at least be sure she didn’t contract HIV while working. Back then, PASS required testing once a month. “You’re having sex every day, so for 30 days you’re exposing God knows how many people to disease,” she said.

Additionally, the new regulations would have required producers, not actors, to pay for tests, saving employees hundreds of dollars per month—a point that none of the workers brought up in their anti-regulation presentations.

What does this mean for porn? The failure of the regulations will likely keep producers from moving out-of-state to avoid fines and hassle. After Los Angeles County passed a law in 2012 that required porn actors to wear condoms and companies to pay a fee to the county’s department of public health, the county saw a 95 percent drop-off in film production permits, which means companies either left, went “underground,” or filmed without permits.

What’s next? The fight over safe-sex precautions in porn will continue despite the defeat of the OSHA proposal. The next time it will be in the form of a proposition appearing on the 2016 California ballot. In the meantime, the OSHA regulators will go back to the drawing board—only this time, members of the board noted, they will listen more closely to the concerns of those in the industry.

Meanwhile, the AIDS Healthcare Foundation, which submitted the original petition to OSHA to amend the regulations in 2009, has also pledged to file a new petition. The foundation, which is controversial among AIDS activists for its objection to HIV-prevention medication, is also behind the statewide ballot initiative as well as several lawsuits attempting to compel condom use in porn.

“I always expect the establishment to not hear us, not respect us, not listen to us, not pay attention to our lived experience,” says Nina Hartley, a longtime performer and outspoken porn advocate. “This shows that some people are open to hearing challenging ideas and maybe changing their opinion. I don’t know if anybody on the board likes porn, but they are clearly seeing us as humans, as actual people, and not just as a projection and not a stereotype, and that’s huge.”

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These Porn Stars Want the Government Off Their Backs

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GOP Candidate Asks Residents to Mail Him Their Pee

by MatthiaSwinburn Posted on August 20, 2014

Mother Jones

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In the run-up to this fall’s rematch against Rep. Pete DeFazio (D-Ore.), Republican Art Robinson is making an unusual ask.

“My name is Art Robinson,” read one of the mailers he sent to 500,000 Oregon residents in March. “I am a scientist who has lived and worked in Josephine County for 34 years. My colleagues and I are developing improved methods for the measurement of human health. Please consider giving us a sample of your urine.”

Robinson is a scientist, and that’s part of the problem. For the last three decades, when he’s not running for office, the Caltech-educated chemist has run a research nonprofit out of a family compound in the mountain town of Cave Junction, near the California border. In a monthly newsletter called Access to Energy, Robinson has used his academic credentials to float theories on everything from AIDS to public schooling to climate change (which he believes is a myth). In perhaps his most famous missive, Robinson once proposed using airplanes to disperse radioactive waste on Oregon homes, in the hopes of building up resistance to degenerative illnesses.

“All we need do with nuclear waste is dilute it to a low radiation level and sprinkle it over the ocean—or even over America after hormesis is better understood and verified with respect to more diseases,” Robinson wrote in 1997. He added, “If we could use it to enhance our own drinking water here in Oregon, where background radiation is low, it would hormetically enhance our resistance to degenerative diseases. Alas, this would be against the law.” (Robinson has since clarified that such proposals would be politically untenable.)

In another essay, he called public education “the most widespread and devastating form of child abuse and racism in the United States,” leaving people “so mentally handicapped that they cannot be responsible custodians of the energy technology base or other advanced accomplishments of our civilization.”

Robinson theorized that the government had overhyped the AIDS epidemic in order to force social engineering experiments on those aforementioned public school students. The truth, he contended, was far more complex:

There is a possibility that the entire ‘war’ on HIV and AIDS is in error. U.S. government AIDS programs are now receiving $6 billion per year and are based entirely upon the hypothesis that HIV virus causes AIDS. Yet, the articles referenced above and numerous additional publications by scientists who have become involved in this controversy state that: attempts to cause AIDS experimentally with HIV have completely failed; thousands of AIDS victims are HIV-free; and HIV shows none of the classical characteristics of a disease-producing organism. Moreover, AIDS is not a unique disease—it is an increased susceptibility to many ordinary diseases presumably as a result of depressed immune response. This depressed immunity can result from many other factors including those especially prevalent in the AIDS afflicted population—drug abuse and unhygienic exposure to very large numbers of different disease vectors. Moreover, large numbers of HIV carriers who are symptom-free are being treated by powerful life-threatening drugs that kill people in ways very similar to AIDS.

Those writings have become an albatross in his repeated challenges to DeFazio, who has publicized Robinson’s work. Robinson lost by 10 points in 2010, and then by 20 two years later in a district that had become more Democratic after redistricting. Last year, he entered the GOP primary yet again (on a whim one day while driving past the clerk’s office), and won the nomination by default in May when no other candidates materialized. Adding to the uphill odds is the fact that Robinson now has a second job: Since last August, he’s served as the chair of the Oregon Republican Party.

As for the urine samples, Robinson told the Roseburg (Ore.) News-Review he received 1,000 in response, which will go toward a study on aging. His campaign might not be worth a bucket of warm piss. But at least he’ll have plenty of it to fall back on.

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GOP Candidate Asks Residents to Mail Him Their Pee

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This Is Why You Have No Business Challenging Scientific Experts

by ukiczp43 Posted on June 5, 2014

green4us

Harry Collins, a founder of the field of “science studies,” explains why we should listen to scientists on climate change, vaccines, and HIV-AIDS. Jenny McCarthy, who once remarked that she began her autism research at the “University of Google.” Scott Roth/Invision/AP Remember “Climategate“? It was the 2009 nonscandal scandal in which a trove of climate scientists’ emails, pilfered from the University of East Anglia in the UK, were used to call all of modern climate research into question. Why? Largely because a cursory reading of those emails—showing, for example, climate scientists frankly discussing how to respond to burdensome data requests and attacks on their work—revealed a side of researchers that most people aren’t really used to seeing. Suddenly, these “experts” looked more like ordinary human beings who speak their minds, who sometimes have emotions and rivalries with one another, and (shocker) don’t really like people who question the validity of their knowledge. In other words, Climategate demonstrated something that sociologists of science have know for some time—that scientists are mortals, just like all the rest of us. “What was being exposed was not something special and local but ‘business as usual’ across the whole scientific world,” writes Cardiff University scholar Harry Collins, one of the original founders of the field of “science studies,” in his masterful new book, Are We All Scientific Experts Now? But that means that Climategate didn’t undermine the case for human-caused global warming at all, says Collins. Rather, it demonstrated why it is so hard for ordinary citizens to understand what is going on inside the scientific community—much less to snipe and criticize it from the outside. They simply don’t grasp how researchers work on a day-to-day basis, or what kind of shared knowledge exists within the group. That’s a case that Collins makes not only about the climate issue, but also to rebut vaccine deniers, HIV-AIDS skeptics, and all manner of scientific cranks and mavericks. All of them, he argues, are failing to understand what’s so important and powerful about a group of experts coming to a scientific consensus. “If we devalue scientific attitudes and scientific values, we’re going to find ourselves living in an unpleasant society,” explains Collins on the latest episode of the Inquiring Minds podcast. Defenses of scientific expertise have been published before—but the source of this particular defense is what is likely to surprise a lot of people. There was a time, after all, when people like Collins—sociologists, anthropologists, historians, and other scholars studying science itself—were deemed to be researchers’ worst enemies, rather than their staunchest defenders. The so-called “science wars” between these two camps peaked with the 1996 “Sokal Hoax,” in which one New York University physicist, Alan Sokal, got so fed up with so-called “postmodern” critics of scientific knowledge that he spoofed them by submitting a gibberish-laden article, entitled “Transgressing the Boundaries: Towards a Transformative Hermeneutics of Quantum Gravity,” to one of their own journals. The paper got published, to Sokal’s delight. Harry Collins. For hard scientists like Sokal, science studies scholars were wrongly asserting that since it occurs in a cultural context and is heavily influenced by many nonscientific factors (the gender and race of researchers, for instance), science doesn’t really have any special claim to objective knowledge. Rather, scientific expertise was deemed to be just as contingent, just as sociologically determined, as anyone else’s belief system. That’s why it’s so significant to find Collins, in his new book, laying out a robust defense of scientific expertise and arguing, as he puts it, that “scientists are a special group of people…in terms of the values that drive their lives and their aspirations in respect of how they live their lives.” That’s not to say that Collins thinks the sociological study of science, which he and his colleagues pioneered, was a worthless endeavor. Coming out of the 1950s heyday, he argues, scientists were treated as almost mythic luminaries and geniuses who couldn’t be questioned. And that just wasn’t accurate. “What we were doing was saying things like, ‘Let’s get away from the mythological picture of science, the myth of what goes on in the lab, and let’s go and talk to scientists,’” explains Collins. In Collins’ case, he embedded for over a decade with the community of gravitational wave physicists, becoming so familiar with their culture that he was actually able, in an experiment, to trick expert physicists into thinking he was really one of them. Through such careful investigations, Collins and his colleagues were able to debunk a variety of myths about science, including the idea that it is full of instantaneous strokes of genius or “eureka moments”—as well as the myth that scientists always follow the data where it leads, rather than clinging to older but established paradigms in the face of new evidence. A book that played a major role in kicking off the science studies wave, after all, was Thomas Kuhn’s 1962 classic The Structure of Scientific Revolutions, which showed how older communities of scientists initially resisted new knowledge, from the Copernican revolution all the way to the Einsteinian one. The upshot is that while the scientific process works in the long run, in the shorter term it is very messy—full of foibles, errors, confusions, and personalities. So it’s not that Collins now repudiates his older research. He just thinks some scholars took it all too far, winding up in radically postmodernist positions that really did seem to devalue expertise and scientific knowledge. “It just seemed to me that we were moving into a position where, at least in the narrow academic world of my colleagues, it was ceasing to be possible to talk about experts,” says Collins. “If you said, ‘So and so is an expert,’ you were accused of being an elitist.” Collins’ new book is, in essence, a thorough answer to this objection. Based in significant part on the so-called “Periodic Table of Expertises” that he and his colleagues at Cardiff developed, Collins carefully delineates between different types of claims to knowledge. And in the process, he rescues the idea that there’s something very special about being a member of an expert, scientific community, which cannot be duplicated by people like vaccine critic Jenny McCarthy, who told Time magazine in 2009 that “I do believe sadly it’s going to take some diseases coming back to realize that we need to change and develop vaccines that are safe.” And why would McCarthy think, in the face of scientific consensus, that the current ones aren’t? Well, she once remarked that she began her autism research at the “University of Google.” Read all the online stuff you want, Collins argues—or even read the professional scientific literature from the perspective of an outsider or amateur. You’ll absorb a lot of information, but you’ll still never have what he terms “interactional expertise,” which is the sort of expertise developed by getting to know a community of scientists intimately, and getting a feeling for what they think. “If you get your information only from the journals, you can’t tell whether a paper is being taken seriously by the scientific community or not,” says Collins. “You cannot get a good picture of what is going on in science from the literature,” he continues. And of course, biased and ideological internet commentaries on that literature are more dangerous still. That’s why we can’t listen to climate change skeptics or creationists. It’s why vaccine deniers don’t have a leg to stand on. And, in a somewhat older example, that’s why what happened in South Africa, when president Thabo Mbeki rejected the scientific consensus on what causes HIV-AIDS and opted to base government policies on the views of a few scientific outliers, is so troubling. To justify the decision not to distribute anti-retroviral AIDS drugs, says Collins, Mbeki “told his parliamentary colleagues to read the internet, and they’d see that there was a controversy about the safety of anti-retroviral drugs. There was no controversy. There was a controversy on the internet, but there was no controversy in mainstream science any longer. It had long, long, long passed its sell-by date.” Interactional scientific expertise, says Collins, is what allows you to know that—and if you don’t have it, you are really not in any position to call into question mainstream knowledge. The same goes for Climategate. For instance, one of the most attacked emails was one that was simply misunderstood by its attackers. The email referred to ”Mike’s Nature trick…to hide the decline,” and it was assumed on this basis that scientists were doing something underhanded to suppress the fact that temperatures were supposedly declining. But that’s just incorrect, as you would have known if you were part of the community of scientists doing the research. The “decline” being referred to wasn’t even about global temperatures at all, but rather, a decline in the growth of certain trees whose rings were being used to infer past temperatures. “What the scientists meant by ‘trick’ was ‘a neat trick’—’Hey, that was a really good piece of science,’” explains Collins. “Whereas the public were interpreting it as something tricky, disreputable, and underhand. So you’ve got to know the context in order to interpret what the very words mean, and you can only know the context by once again, being part of the oral culture of science.” And then, finally, there is the vaccine issue. Here, Collins is perhaps at his strongest. Once again, there are smatterings of science that vaccine skeptics can cite, most of all, the now-retracted 1998 Lancet study that ignited the modern anti-vaccine furor. But that doesn’t put them in a position to judge the state of scientific expertise about vaccines, or to call into question an existing consensus about their safety. And in this case, ignoring or attacking expertise can be downright deadly. “We still have the measles epidemic in this country,” Collins says, “which was the result of people rebelling against injecting their children with MMR, on the basis of what’s, again, a complete piece of scientific trash.” So can Collins’ new book, and his notion of “interactional expertise,” help reunite two communities of scholars who have been at loggerheads for too long—scientists and those in the humanities who study them? Collins certainly hopes so. “What I’m trying to do in the book is to find…a way of revaluing science,” he says, “of putting science back into the center of our society—but without rejecting all the great work that was done from the ’70s onward, and without going back to the mythical 1950′s picture of science.” To listen to the full Inquiring Minds interview with Harry Collins, you can stream here: This episode of Inquiring Minds, a podcast hosted by neuroscientist and musician Indre Viskontas and best-selling author Chris Mooney, also features a discussion of thescientifically problematic exclusion of the elderly from clinical trials for new drugs, and abizarre viral spoof article claiming that solar panels are draining the sun’s energy (seriously). To catch future shows right when they are released, subscribe to Inquiring Minds via iTunesor RSS. We are also available on Stitcher and on Swell. You can follow the show on Twitter at @inquiringshow and like us on Facebook. Inquiring Minds was also recently singled out as one of the “Best of 2013″ on iTunes—you can learn more here.

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This Is Why You Have No Business Challenging Scientific Experts

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What’s It Like To Run a Condom Company?

by MollyDruitt Posted on May 17, 2014

Mother Jones

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During her time documenting natural disasters as a Red Cross photojournalist, Talia Frenkel saw first-hand the devastating effects of HIV and AIDS in Africa. She wanted to help combat this preventable disease, so in 2010, she created a women’s health company with a mission: For every L. Condom purchased in the United States, the company donates one condom to a person in the developing world. L. also employs HIV-positive women in Swaziland—they design wrappers for the condoms and package them. Meanwhile, business in the United States is booming: L. has rolled out bike delivery service in San Francisco, Los Angeles and Manhattan. Next up: an app that offers foreplay tips while you wait for your condoms to arrive, and expanding into other women’s healthcare products. I spoke with Frenkel about weird condom additives, being perceived as “shady” because of her job, and how L. distributes condoms to women who need them most.

Mother Jones: What’s the most surprising thing that you’ve learned working in the condom business?

Talia Frenkel, founder of the condom company L. Image courtesy of Talia Frenkel

Talia Frenkel: Most packaged consumer goods companies are actually owned by men, so there are very few women who are involved in the manufacturing and branding of products that women are predominantly purchasing. I think there’s something really broken about that, when women aren’t being included in the thought process. And the condom industry even more so, right? Me going into the manufacturing facility, I’m like “I’m the CEO, I promise!” It was really hard to be taken seriously at first.

MJ: Would you say that was one of the biggest challenges of starting the company? Being a woman?

TF: Not only not being taken seriously, but being perceived as shady. You tell someone you own a women’s health company and they ask what your product is and you say, “Oh, it’s condoms.” They look at you like you’re a porn star or something. This is a basic woman’s health product that I think every woman should have in her purse. It’s not taboo to carry a birth control pill case, but it is with a condom, so I don’t understand why we act like condoms cause promiscuity. Condoms don’t cause promiscuity anymore than umbrellas cause it to rain.

MJ: How did you come up with the idea of one-hour condom delivery via bike messengers?

TF: Condom aisles can be uncomfortable. It’s like you have to make an announcement to the entire store, “Aisle 6, I’m having sex!” They’re not always that easily accessible. We started talking to these messenger groups, and the bike messengers themselves are really ecstatic about it. They like knowing that what they’re doing is involved with a cause. It truly is in line with our values of sustainability by having a low carbon footprint.

MJ: Why is it important to have environmentally friendly and chemical-free condoms?

TF: Our shampoos and conditioners have “paraben-free” on them but our condoms don’t. It’s just crazy. A lot of people have really negative experiences with condoms not knowing why. When you look at it, the complaints about condoms are they smell bad, they taste disgusting, they dry out, they’re physically irritating. All of these issues can actually be addressed in the materials that are being sourced, and then in the manufacturing process. If you look at an L. condom it’s a lot clearer than other products, and has a lower latex odor and taste. We made sure that the products are glycerin- and paraben-free, and don’t contain any potentially harmful additives.

MJ: What makes latex sustainable?

TF: Condoms are typically made from polyurethane or natural rubber latex. Polyurethane is a plastic so it has the environmental issues that all plastics have. But natural latex doesn’t have those issues.

MJ: How do you make sure your condoms get to the people who need them most?

TF: The international development NGO BRAC is one of my favorite organizations because it employs so many women on the ground. They train women as health care providers and they educate them, and they teach them how to teach their peers about basic health products. And then these women go out from community to community, and they sell products like condoms at the low market cost. By doing that, they are making a living wage for themselves, they become breadwinners in their families and their communities, and they have more of a say in making decisions, such as negotiating condom use.

MJ: The one-for-one model has its critics: Some people say that well-meaning businesses don’t do their research about what people in the developing world actually need.

TF: Every community needs access to contraception, and in Africa this is the most basic tool for fighting the HIV epidemic. Something that was important for me coming into this was speaking to the local program officers, asking them where their needs were, and telling them we’re not coming in and dropping off our product without communication. For example, in Haiti they wanted a new condom because they had tried different condoms and weren’t happy with the brands they were distributing, so they wanted to try L. They also wanted the packaging and art from HIV-positive women to help with removing the stigma. But in Uganda, they said “we’ve been socially marketing a product, we’ve had good momentum and progress, we don’t want to start distributing a new brand of condoms right now.” I said okay, tell me which brand you want to distribute, let’s identify it, and we’ll support the purchase of that product. We’re not Coca-Cola here trying to get our brand into Africa. We’re here to support their work. We’re not disrupting the local condom seller.

MJ: Have you encountered any type of resistance in the countries where you distribute condoms? Is any part of your distributing condoms perceived as controversial?

TF: We’ve obviously encountered some of the stigma and taboo, hearing comments like using a condom is eating candy with the wrapper on. You also hear things like that in America. We talk about how we can overcome those barriers to condom usage, but for the most part we’ve been really overwhelmed with how incredible these programs have been, and how eager the women are to educate their peers. That has been inspiring and humbling.

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What’s It Like To Run a Condom Company?

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New Photobook Documents the Travails of Transgender Cubans

by WilhemiBanniste Posted on May 8, 2014

Mother Jones

Malu with her parents and sister, in front of their home. Mariette Pathy Allen

Of all the allies in the global fight for LGBT equality, Cuba may be the most unlikely. For decades, the island was notorious for its crackdown on “social deviants”—an underclass that included homosexuals, transgender people, Jehovah’s Witnesses, Seventh Day Adventists, and anyone critical of the Castro regime. The 1960’s were especially bleak. Deemed unfit for the revolution, gay Cubans were banned from joining the military or becoming teachers. Thousands were confined to isolated labor camps. Conditions deteriorated further in the ’80s and ’90s as Cuba quarantined HIV-positive citizens, many of whom were gay.

Mariette Pathy Allen’s new photobook, TransCuba (Daylight Books), captures a country slowly outgrowing its history of persecution. Shot in 2012 and 2013, the book is haunted by the trauma inflicted by Fidel Castro’s government. But it is optimistic about life under his brother, Raúl, who assumed the presidency in 2008. Since the change in power, Cuba’s Ministry of Public Health has approved state-funded sex reassignment surgery, and the government has relaxed many discriminatory policies targeting sexual orientation and gender. In 2012, Adela Hernandez became the country’s first openly transgender person elected to public office. Perhaps most shockingly, in a 2010 interview with the Mexican newspaper La Jornada, Fidel Castro called his decision to imprison homosexuals in the 1960’s “a great injustice….I’m not going to place the blame on others,” Castro said, “We had so many and such terrible problems, problems of life or death.”

Despite its progressive reforms, Cuba continues to have serious problems, particularly with transgender rights. “I see transgender Cubans as a metaphor for Cuba itself: people living between genders in a country moving between doctrines,” Allen writes. The women she documents are grateful for the increasing tolerance, but they still suffer from entrenched stigmas. Natalie, for example, was denied a factory job because of her appearance. She began hooking to make ends meet, and picked up HIV at age 18. She also had a run-in with police that escalated, at which point an officer “hit her until he didn’t feel like it anymore.” She was imprisoned for inciting violence.

Allen’s other protagonists share similar tales of woe. Amanda, a 36-year-old prostitute with HIV, tried twice to get to the United States, and twice failed. She was taken to Guantánamo Bay, where she begged her English-speaking captors to return her to the streets of Havana.

Another subject, Alsola, spent two years studying psychology and medicine at a school in Santiago de Cuba, the country’s second largest city. School policy mandated that students respect the dress code of their birth gender, so she dropped out rather than conform. “My life is nothing special,” she says now.

Allen’s portraits are moving proof to the contrary. TransCuba follows her two previous photobooks—Transformations (1989) and The Gender Frontier (2003)—capping a loose trilogy that is one of contemporary photography’s most poignant explorations of gender identity. Her portraits, whether shot in Cuba or the United States, remind us that looking is a political act, and seeing a revolutionary one. Although Allen’s subjects face the camera instead of a jury or a firing squad, their expressions bear the same frank entreaty for compassion. To quote Yanet, another Allen subject: “We all have implausible dreams, things that make no sense, we all have fantasies.” TransCuba is a testament to the difficult, intoxicating, sometimes tragic work of realizing who we are.

Alsola, Santiago de Cuba Mariette Pathy Allen

Charito at home with her week-old piglet, Camagüey. Mariette Pathy Allen

Paloma with her boyfriend at Mi Cayito beach, near Havana. Mariette Pathy Allen

Partners Nomi and Miguel at Malu’s apartment, Havana. Mariette Pathy Allen

Laura at home, Havana. Mariette Pathy Allen

Erika at home, Cienfuegos. Mariette Pathy Allen

The view from Natalie’s window in Havana. Mariette Pathy Allen

Continued – 

New Photobook Documents the Travails of Transgender Cubans

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