For more information:

The White House–
"President Bush Discusses HIV/AIDS Initiatives in Philadelphia":

Journal of the American Medical Association–
"Cervical Cancer Screening Among Women Without a Cervix":








In a speech that was music to the ears of many people outside his traditional support base, President Bush last Wednesday added a new word to his political lexicon: Condoms.

The president appeared before a church-affiliated group in Philadelphia largely to announce some modest changes to government anti-retroviral drug financing, but his speech made headlines when he endorsed condom use to prevent the spread of AIDS.

Using the example of Uganda, a nation with a high success in reducing the rate of HIV infection, Bush endorsed the so-called A.B.C. approach to AIDS prevention.

"That stands for: Abstain, Be faithful in marriage, and, when appropriate, use Condoms," he said.

Last week’s speech is believed to be the first time the president has mentioned condom use in a domestic context. He has discussed it at least once before, in Entebbe, Uganda, last July, according to press reports.

Bush was quick to reiterate his strong support of abstinence as the only certain way to avoid contracting HIV. He has long avoided delving into the sensitive issue of condom use, as many of the conservative groups he counts on for votes have fought the adoption of any strategy that does not revolve around abstinence.

Many in the field of AIDS research and activism applauded the president’s new, more inclusive prevention approach, though some lamented that it had taken until just months before the November elections.

Dr. Zena Stein, co-director of the HIV Center for Clinical and Behavioral Studies at The New York State Psychiatric Institute, took time out of a speech she gave the morning after Mr. Bush’s talk to herald what she called "a real step forward."

"I’d just like to point out that Bush used the C-word," Stein said. "This is big news. It’s a little word, but it carries a lot of weight."

In addition to his discussion of AIDS prevention methods, Bush used the Philadelphia event to urge Congress to speed financing of his plan to spend $15 billion to fight AIDS both at home and in 16 other countries around the world. He also said his administration would be moving $20 million into a program to obtain drugs for AIDS patients in 10 of the poorest states in the country, including Alabama, Colorado and South Carolina.




As many as 10 million women who have undergone hysterectomies may be receiving unnecessary Pap smears, according to a study published last week.

The Pap test screens for precancerous cells on a woman’s cervix and is often part of a woman’s standard annual pelvic exam. Women whose cervixes have been removed during hysterectomy procedures are not at risk of cervical cancer and, in most cases, Pap smears are costly–between $20 and $40–uncomfortable and unneeded, said Dr. Brenda E. Sirovich, a research associate at the Outcomes Group at the Veterans Affairs Medical Center in White River Junction, Vt., and the study’s lead author. The study appears in the current issue of the Journal of the American Medical Association.

Dr. Sirovich and other medical experts were quick to point out, however, that women who have undergone hysterectomies without cervix removal or as a result of cancer should continue to be screened for cervical cancer.

Among women who have had their cervixes removed, the Pap smear tests instead for vaginal cancer, which is extremely rare and has a high rate of false positives. The unnecessary test can result, therefore, in cancer treatment for a cancer that is not even there, according to The New York Times.

Twenty-two million women, or one in five over the age of 18, have had hysterectomies, according to News-Medical.Net. In 1996, the U.S. Preventative Services Task Force declared that Pap tests were no longer necessary for women who have undergone hysterectomies.

Dr. Sirovich said she was shocked by the study’s findings.

"We were actually quite surprised," she told The New York Times. "These women are being screened for cancer in an organ that they don’t have."

Rather than a sign of medical foul play, Dr. Sirovich said the situation is likely a reflection of women’s expectations, doctors’ habits and the extreme caution brought on by the ever-rising number of medical malpractice lawsuits.

— Robin Hindery.