Town's males could be forced to carry condoms

SERGIO DE LEON
Associated Press

BOGOTA, Colombia - A western Colombian city councilman wants to require everyone in town 14 or older to carry a condom to prevent pregnancy and disease, outraging local priests.

William Pena, a councilman in Tulua, said Wednesday he will present a formal proposal to force all men and women - even those just visiting - to always carry at least one condom. Those caught empty-pocketed could pay a fine of $180 or take a safe sex course, he said.

"Sexual relations are going on constantly," Pena told The Associated Press by telephone. "If you carry a condom, chances are you'll use it during the day. It's not going to be there forever."

Tulua has one of the highest rates of AIDS in Colombia, he said. The proposal will be debated by other town leaders and could go into effect by March, he said.

Roman Catholic priests in the Cauca Valley town, 150 miles southwest of Bogota, were fuming over the plan.

The Rev. Jesus Velasquez said it would only encourage sexual relations and ridiculed it as absurd. The local newspaper El Tiempo on Wednesday quoted him as saying, "I would have to have a condom even though I'm clergy."

Another town priest, Roberto Sarmiento, said he that improved sex education would be a better solution.

"Nobody can force someone to carry a condom in their pocket," he said. "They should instead carry the responsibility of what sexual relations mean."

Ramiro Cano, a 19-year-old laborer in Tulua, said Wednesday that the proposal was the talk of the town, and said most young people he has talked to support it.

"I try to always carry a condom on me, especially if I go to a discotheque, in case I can pick up someone," Cano said.

The proposal is perhaps the most radical in a series of pro-condom efforts across a country where 190,000 people live with AIDS, a figure only surpassed in Latin America by Brazil, according to the World Health Organization.

The capital city of Bogota handed out more than two million free condoms last year as part of a campaign titled "Use it instinctively - make yourself sexy."

In the city of Tunja, where 17 percent of all pregnancies last year were from women under 18 years of age, condom dispensers will be installed in bars and movie theaters starting in February.

Condoms are a good fit for HPV prevention

By Jeff Benson, M.D. Columnist


Dear Dr. Jeff: I keep hearing conflicting information: Do condoms protect against HPV or not?
?L.J.

Dear L.J.: Condoms do protect against the spread of the Human Papilloma Virus (HPV). This has been demonstrated in a number of studies. According to the Centers for Disease Control, laboratory studies have shown that HPV cannot pass through latex barriers like condoms. Condoms protect against cervical HPV infection, the type of HPV infection that can sometimes lead to cervical cancer.

This protection is not absolute, however. Condoms, of course, can only protect the skin that they cover against infection. Studies of the protective efficacy of condoms against HPV, like all "real-life" studies of sexually transmitted infection (STI) prevention, often and unavoidably include significant methodological problems. These methodological shortcomings have not allowed researchers to conclude definitively that this protection is absolute.

These shortcomings, and the fact that condoms cannot prevent the spread of HPV to or from genital areas they literally do not cover, have made some conclude that condoms cannot, in fact, be said to protect against the spread of HPV. The "Abstinence Only" campaigners, in particular, have argued that abstinence is the only "proven" protection against HPV, and that because of the relationship between HPV and cervical cancer, the choice facing young adults has really become one of "Virginity or Death," as Katha Pollit put it at last week's Common Hour. Similarly, commentators at the conservative think tank the Heritage Foundation, like to refer to HPV as "the deadly HPV" ?even though more than 99 percent of people who contract the virus never die from it.

HPV is by far the most prevalent STI. The numbers involved are truly staggering. It is estimated that 75 percent of sexually active people contract HPV at one time or another, and that at any given point in time, 20 million Americans have genital HPV infections that can be transmitted to others. Every year, over 5.5 million people become infected. Very fortunately, however, the great majority of HPV infections are overcome by our immune systems and resolve themselves without further complications.

Four of the over 30 sexually transmissible strains of the virus, though, cause cellular changes which can lead to cancer. In particular, cervical cancer is virtually always associated with untreated HPV Type 16 or Type 18. These are called "the high risk" sub-types, and they are "high risk" not because they always or even often cause cervical cancer, but because almost all cervical cancers can be traced back to them. To be perfectly clear: even the great majority of women with high-risk HPV on their cervices will never develop cervical cancer.

Cancer of the cervix occurs in nearly 16,000 women each year, and causes some 5,000 deaths in the U.S. annually. These are, of course, very significant numbers. They are also several orders of a magnitude smaller than the HPV numbers cited above. Cancer of the cervix is one of the most treatable and preventable cancers. Micro-invasive carcinoma of the cervix is nearly always curable surgically. It has a long pre-clinical phase, which permits early detection. In fact, regular screening Pap smears very effectively pick up early, pre-cancerous changes, and treatment at these early stages is curative.

More than half of women newly diagnosed with invasive cervical cancer have never had a Pap smear, and another ten percent have not had one in the previous five years. Cervical cancer may indeed be an HPV-related "STD," but it is most importantly a disease of medical neglect.

Back to condoms! The studies reviewed by the National Institute of Health and compiled by the CDC in a January, 2004 report, conclude that regular use of condoms is associated with lower rates of HPV-associated diseases AND cervical cancer (for the complete report, please see http://www.cdc.gov/std/HPV/2004HPV%20Report.pdf at the CDC's web site.)

These same studies show that condoms offer very effective protection against the spread of HIV, an STI that has claimed almost 500,000 American lives over the past 20 years, and which threatens to kill untold tens of millions more around the world. Condoms also offer very effective protection against chlamydia, an STI which infects over three million people in this country each year. And, finally, condoms also offer reasonably effective protection (about 85 percent) against unwanted pregnancies. From a public health standpoint, it is simply criminal to discourage condom use.

Total abstinence does presumably offer nearly 100 percent protection against STIs and unplanned pregnancies. And for some people, abstinence remains the best choice. For others, however, it is not, and those individuals need useful, scientific information to make their own best choices.

If that choice is safer sex, they need condoms! And we have plenty to hand out at the Health Center?and plenty of appointments for Pap tests, too.

Be well!

Jeff Benson, MD
Dudley Coe Health Center

Flour in condoms sent her to jail

A college student spent 3 weeks in jail after a field test said she was carrying drugs. She filed a lawsuit.
By John Shiffman
Inquirer Staff Writer

She was a freshman on an academic scholarship at Bryn Mawr College, preparing to fly home to California for Christmas, sleep-deprived, with questions from a calculus exam still racing through her head.

In the space of a few hours on Dec. 21, 2003, Janet Lee landed in a Philadelphia jail cell, where she would remain for three weeks, held on $500,000 bail and facing 20 years in prison on drug charges.

All over flour found in her luggage.

"I haven't let myself be angry about what happened, because it would tear me apart," Lee said. "I'm not sure I can bear to face it... . I'm amazed at how naive I was."

That naivete, she said, began when screeners at Philadelphia International Airport inspecting her checked luggage found three condoms filled with white powder. Lee laughed and told city police they were filled with flour. It was just part of a phallic gag at a women's college, she told them, a stress-reliever, something to squeeze while studying for exams.

The police didn't find it funny. They told her a field test showed that the powder contained opium and cocaine.

A lab test later proved the substance was flour - and no one now disputes that Lee is innocent, including the prosecutor.

But the case returned to the courts last week as Lee filed a federal civil-rights lawsuit against city police. The lawsuit seeks damages for pain and suffering, financial loss, and emotional distress.

Capt. Benjamin Naish, a spokesman for the Police Department, declined to comment, noting that the department rarely comments on litigation. Cathie Abookire, a spokeswoman for the District Attorney's Office, also declined to comment.

Lee's lawsuit seeks to answer a central question: Why did the police field test initially conclude that the white powder contained drugs?

Her lawyers, former prosecutors David Oh and Jeremy Ibrahim, say there are two possibilities: Either the field test was faulty or someone fixed the results.

Ellen Green-Ceisler, who directed the Police Department's Office of Integrity and Accountability from 1997 to 2005, called Lee's case highly unusual. Field tests are rarely wrong.

'Almost never happens'

"I've looked at thousands of these cases, and in the context of trained narcotics officers, it almost never happens," she said. "The whole issue will come down to the field test. Was the officer trained? Was the test contaminated?"

Ibrahim said he waited to file the lawsuit until last week, on the eve of the end of the two-year statute of limitations, because Lee needed time to process what happened.

"She was devastated emotionally," Ibrahim said, noting that the event became a minor scandal among her Korean American family and friends. "She lost significant face with this event."

Many records in the case are still confidential, not yet accessible even to Lee's lawyers. What is undisputed is that she was detained at the airport shortly before she was to board a plane to Los Angeles. Court records confirm her arrest and three-week detention on drug charges. Records also confirm why prosecutors dropped the charges.

Lee, who is now a junior comparative-literature major at Bryn Mawr, gave the following account in an interview this week.

Just before she was to board the plane, someone called her name on the public-address system, and she reported to the ticket counter.

An officer told her that she had something in her luggage that shouldn't be there.

"I was like, 'Is it my curling iron? Because it's metal?' He was like, 'No, something else.' "

The officer asked about the white powder in the condoms.

They were filled with flour, she said, and were silly stress-relief contraptions that she had made with classmates as part of a freshman rite of passage in her Main Line dorm.

'It's a girl thing'

"I tried to explain that it was a joke, a gag gift for friends. It's a girl thing. I said, 'You squeeze them to reduce stress.' "

Police stared skeptically. They took her to the Southwest Detective Division, where they tested the powder. Lee figured it would be sorted out soon.

"Mostly, I was worried because I had missed my flight, and now I had to make up an excuse to tell my parents."

When the detective returned, he said the powder tested positive for opium. Police returned her to her cell. "I started hyperventilating," Lee recalled. "The detective was very nice, and said he would test again."

The result was the same.

She said that someone came by her cell and read her an arrest warrant, which mentioned amphetamines. Then police fingerprinted and photographed her. She called her father but couldn't quite express herself through her tears and panic.

"A detective gave me a hug because I was crying so hard," she said.

Police put her into a van for the trip to court. She said she overheard talk about "a kilo."

"Up to that point, I still thought it was a joke, that someone was trying to teach me a lesson," she said. "I was telling everyone my story, and no one believed me - except the people locked up inside with me."

Because the amount of powder was so large, Lee faced 20 years in prison. A judge set bail at $500,000. He also mentioned something about cocaine.

"That's when it sunk in that they were serious," she said. "I said, 'I didn't do it. It's flour.' No one listened."

At that point, having just finished her finals, she had been up for four straight days, she said. "I'm the kind of person who can sleep anywhere or eat anything, but I stopped eating and sleeping," she said.

Later, she hit a bit of luck. A prison guard recognized her from a Bryn Mawr volunteer job at Overbrook High School and took pity on her. The guard told Lee that she believed her and that the whole thing was probably racial. The guard got her a trashy romance novel to help kill time.

Lee acted tough to protect herself. She did modern-dance moves to keep limber. Inmates saw this and gossiped: "Everyone thought I knew karate because I'm Asian." She certainly didn't discourage the stereotype.

Inmates saw the high volume of visitors and figured she was important. Again, she did not discourage the notion. She did not tell her cell mates that the visitors were actually volunteers from Catholic churches in Philadelphia who had taken up her cause.

The volunteers helped her hire Oh.

"I believed her story because things just didn't add up," Oh said. For one thing, Oh said, the field tests were odd because they detected the presence of not one drug but three.

"People don't mix drugs like that," Oh said.

First, Oh contacted Bryn Mawr and confirmed that Lee's dorm mates had, in fact, made the condoms together during a pre-exam session they call a "hall tea."

Then, Oh said, he called Assistant District Attorney Charles Ehrlich, who agreed to expedite laboratory tests. Ehrlich also agreed to help seek reduced bail, Oh said. A day after the new test came back and confirmed that the substance was flour, Lee was released.

She flew home first class.