CDC Recommends Anti-HIV Pill for High-Risk Groups

Truvada AIDS Anti-HIV
Bottles of antiretroviral drug Truvada are shown at Jack's Pharmacy in San Anselmo, Calif. on Nov. 23, 2010. Justin Sullivan—Getty Images

The daily medication, sold in generic form as Truvada, could transform AIDS prevention in America. If taken regularly, the drug can reduce risk of infection in high-risk populations by up to 92%, the Centers for Disease Control and Prevention says

The U.S. government has recommended that hundreds of thousands of people at risk for AIDS take a daily drug that is effective in preventing the virus.

The Centers for Disease Control and Prevention issued an official recommendation Wednesday that people at high risk of contracting AIDS take a combination of two medicines called Pre-exposure prophylaxis (PrEP), which is known to help prevent infection of HIV, the virus that causes the deadly, incurable disease.

If taken regularly, the drug can reduce risk of infection in high-risk populations by up to 92%, the CDC says.

PreP comes in a generic version called Truvada and is used widely in AIDS treatment programs in poor countries. The CDC’s recommendation could, if followed widely, increase the number of people taking the drug in the U.S. from fewer than 10,000 to half a million, the New York Times reported.

The CDC recommends the drug, in combination with condom use, to gay men who have sex without using condoms, heterosexuals who sleep with intravenous drug users or bisexuals, and anyone who has sex with someone they know to be HIV-positive, as well as anyone who shares needles or injects drugs.

HIV rates have held stubbornly flat for the past decade, and a sharp decline in condom usage has raised concerns among health officials.


The Problem With Graduation Speaker Purity Tests

The protests forcing some commencement speakers to withdraw are a reminder that students are better at challenging values than maintaining them

These are salad days for organizers of petition drives. Never has it been so easy to circulate demands and collect virtual signatures. Not long ago, ardent activists clutched clipboards outside grocery stores or student unions as apathetic passers-by pretended not to notice them. But social media streamlines the search for the like-minded—a fact the White House discovered recently when more than 270,000 people joined a demand that misbehaving pop star Justin Bieber be deported to his native Canada.

It follows that these are glum times for college presidents. Zealous students at such institutions as Brandeis University, Smith College and Rutgers University have leveraged social media to drive away invited graduation–day speakers. They make it look so easy that students elsewhere will surely be tempted to join in the fun.

So far, the young thought police have used their powers to enforce left-wing purity, amid signs that today’s students have moved beyond identity politics to new orthodoxies. Trustees at Smith, an all–women’s college, probably thought they would be inspiring their students by inviting Christine Lagarde of France, the first woman to head the International Monetary Fund. Hardly. Lagarde bowed out on May 12 after a barrage of complaints about the IMF’s “imperialistic” lending policies (as one petition signer put it).

Earlier this spring, Brandeis rescinded an offer of an honorary degree to the provocative writer Ayaan Hirsi Ali, whose criticism of Islam for antifeminist tendencies was dubbed “hate speech” by petitioners. Former U.S. Secretary of State Condoleezza Rice backed out of the Rutgers commencement ceremony after students denounced her as a “war criminal” for her role in the Bush Administration’s war on terror.

At Haverford College, students demanded an abject apology before an honorary degree could be granted to Robert Birgeneau, the recently retired chancellor of the University of California, Berkeley, and a champion of access to higher education for undocumented immigrants. Birgeneau’s offense was that he presided over Berkeley in 2011, when campus police used rough tactics with students who were protesting state budget cuts. Rather than grovel, Birgeneau withdrew.

Fish swim, birds fly, students protest. Anyone who has been 20 years old surely recalls the fierce clarity of a college student’s mind. The sharp steel of a whetted education, undulled by the nicks and scrapes of experience, makes for the sort of slashing brilliance that breeds innovators and -artists—and revolutionaries. But they are better at challenging values than maintaining them.

As Smith’s president, Kathleen McCartney, put in when announcing Lagarde’s withdrawal, the protesters got what they wanted, “but at what cost to Smith College?”

If America’s treasured institutions of higher learning are to remain bastions of free speech and arenas of robust debate, there must be grownups ready to defend those ideals. And those grownups had better brace themselves for their own online denunciations, because the times, they are a-changin’.

TIME Veterans

VA Day of Reckoning: Head Could Roll Over ‘Secret Lists’

Obama Welcomes Wounded Warrior Project's Soldier Ride To White House
VA Secretary Eric Shinseki and President Obama at a veterans' event last year. Win McNamee / Getty Images

Secretary Eric Shinseki faces Congress, and trouble, if woes are widespread

There’s a sword of Damocles hanging by a hair over Veterans Administration chief Eric Shinseki as he heads to Capitol Hill on Thursday to testify on the VA’s expanding secret wait-list mess. It’s an apt place for the retired four-star Army general, himself a veteran wounded in Vietnam. He finds himself in the tightest spot in his five years as secretary of the Department of Veterans Affairs, dealing with the downstream costs of two of the nation’s longest wars.

Charges—and confirmations—about VA double bookkeeping when measuring how long veterans have to wait for appointments are nothing new. But what has given the latest stories more impact are the deaths allegedly linked to the delays, the secret lists designed to hide them, and charges that the secret lists were a way for VA executives to mask shortcomings and thereby maximize their cash bonuses.

Those bonuses come from an annual $150 billion VA budget, triple 2001’s spending.

Congressional Research Service

Whether the sword falls won’t depend so much on what Shinseki tells the Senate Veterans Affairs Committee. He has already said he won’t resign. What’s critical is how Congress and veterans react to what he says, and what a VA-wide inspector general’s probe into the problem turns up. Shinseki will survive if he convinces them he was ignorant of such wrongdoing—he has denounced it as “absolutely unacceptable”—and shouldn’t have been expected to detect it on his own.

But anyone who has paid attention to VA data is aware that there have been persistent efforts inside the agency to make vets’ wait times seem shorter than they actually are. One 14-day limit for getting an appointment was ripe for abuse, and critics say such abuse should have been anticipated and eliminated. Shinseki’s defense becomes weaker with every corroborated story of his subordinates gaming the system. If there’s evidence that the problems are systemic, Shinseki’s days are numbered.

“This is an accountability moment for the VA,” says Phil Carter, who served as an Army officer in Iraq and now champions veterans issues at the nonprofit Center for a New American Security. “The key question is where within the organization to fix accountability: at the secretarial level, the regional level, the hospital level, or some other place.” Only after the IG’s inquiry, Carter says, can the government “decide who should be held accountable for these issues.”

“This is not a new problem,” Paul Rieckhoff, head of the Iraq and Afghanistan Veterans of America, conceded last week. “Veterans have been dying in line for care for decades.” IAVA, like most veterans’ groups, has not called for Shinseki’s ouster.

But others have already made up their minds. “General Eric Shinseki has served his country well,” Daniel Dellinger, the commander of the American Legion, said May 5, when he and his 2.4-million-member organization called on Shinseki to step down. “However, his record as the head of the Department of Veterans Affairs tells a different story. The existing leadership has exhibited a pattern of bureaucratic incompetence and failed leadership that has been amplified in recent weeks.”

There is a baby-bathwater issue, too. “Surveys suggest that patient satisfaction is high among the 6.5 million veterans who get care each year from the VA,” Senator Bernie Sanders, I-Vt., who chairs the veterans committee, said Wednesday. “And while the American Customer Satisfaction Index said VA patients rank their care among the best in the nation, it is clear to me that there are problems within the VA and that the VA has got to do better.”

The VA is the country’s single largest health-care system, with its 300,000 employees spread among 151 medical centers, 820 clinics, and other sites tending to the needs of 230,000 vets a day. “While of course Shinseki is responsible for everything that happens at VA, he’s been fixing serious problems and overall the system is improving,” says Ron Capps, an Army veteran who has sought help from the VA. “So we should give him some more time and space to continue with his plan.”

Whether or not the fudged wait lists are widespread, warning lights highlighting them have been flashing for years:

  • The VA’s “method of calculating the waiting times of new patients understates the actual waiting times,” the agency’s inspector general said in a 2007 report on outpatient visits. “Because of past problems associated with schedulers not entering the correct desired date when creating appointments, [the VA] uses the appointment creation date as the starting point for measuring the waiting times for new appointments.”
  • In 2012, the IG said that when it came to getting a mental-health appointment within the VA goal of 14 days, the agency claimed it met that target 95% of the time. But after drilling deeper into VA data, the IG concluded only 49% got their appointments within two weeks.
  • That same year, the IG reported that patients at a VA facility in Temple, Texas, had “prolonged wait times for GI [gastroenterology] care [that] lead to delays in diagnosis of colorectal and other cancers…staff indicated that appointments were routinely made incorrectly by using the next available appointment date instead of the patient’s desired date.”
  • Not surprisingly, the longer the wait for care, the worse the result. “Long-term outcomes, such as death and preventable hospitalizations, are more common for veterans who seek care at facilities that have longer wait times than for veterans at facilities that have shorter wait times,” the federal Institute of Medicine said last year.



TIME justice

Arkansas Voter ID Law Rescued by State Supreme Court

The high court overruled a decision from a lower court judge that struck down the law requiring voters to show an ID before casting a ballot

In a 5-2 ruling issued Wednesday, the Arkansas Supreme Court reversed a lower court decision that had struck down the state’s voter ID law as unconstitutional.

The decision means the law, which requires voters to display a valid identification card in order to cast a ballot, survives for the time being. However, the justices declined to rule on the constitutionality of the measure, instead holding that Pulaski County Circuit Judge Tim Fox, who struck down the law, did not have the authority to do so, noting that no such request had been made in the case.

Fox ruled the voter ID law unconstitutional in another case as well, but that ruling is being appealed and will not take effect before the state hold’s a primary Tuesday.

The high court decision comes as similar laws are being challenged in states across the country. Proponents argue the laws prevent voter fraud, while detractors, chiefly Democrats, argue that they put an unfair burden on the poor and minorities, who are less likely to have official IDs and who tend to vote Democratic.




TIME Disaster

California Wildfires Still Raging After Burning Homes

The latest wildfire that broke out in Carlsbad on Wednesday is one of several fires dotting Southern California. At least 30 homes were engulfed in flames, causing thousands of evacuations, including from Legoland, the popular amusement park

Updated: May 15, 2014, 7:30 a.m. E.T.

Wildfires whipped along by blustering winds during a massive drought have burned at least 30 homes and forced thousands to flee in southern California, where several blazes continue to burn as of Thursday morning.

At least 15,000 people have been ordered to evacuate their homes in Carlsbad, California, among the towns hardest hit by the wildfires. The Carlsbad fires also forced park officials on Wednesday to shut down Legoland, a local LEGO-themed amusement park.

Cal State San Marcos, a San Diego County college with approximately 10,000 students, and Camp Pendleton, an area Marine Corps base, have also been evacuated.

California Governor Jerry Brown declared a state of emergency late Wednesday after local county officials urged him to do so as firefighting resources ran thin in the face of spreading fires.

The cause of the fires is not known, but officials say temperatures reaching into the 100s and the ongoing drought in the region make the area ripe for wildfires.

Two firefighters have been injured fighting the blazes, one with a heat-related injury and another due to smoke inhalation.

[LA Times]

TIME Media

Top Editor Departs New York Times

Jill Abramson New York Times
Jill Abramson, executive editor of The New York Times, listens during a panel discussion on the sidelines of the Republican National Convention (RNC) in Tampa on Aug. 26, 2012. Andrew Harrer—Bloomberg/Getty Images

Jill Abramson, who became the first woman to take the newspaper's leading post in 2011, will be replaced by her deputy, Dean Baquet, who will become the first African-American editor to the lead the 163-year-old publication

Updated 5:25 p.m. E.T.

The New York Times announced Wednesday that it had dismissed Jill Abramson from the newspaper’s top post.

Abramson, who became the newspaper’s first female editor in 2011, will be replaced by her deputy Dean Baquet, who will become the first African-American editor to the lead the 163-year-old publication. Publisher Arthur Sulzberger Jr. cited “an issue with management in the newsroom” in announcing the unexpected change to staffers, the Times reports.

“I’ve loved my run at the Times,” Abramson, 60, a former Washington editor and investigative correspondent, said in a statement. “I got to work with the best journalists in the world doing so much stand-up journalism.”

Baquet, 57, is a Pulitzer Prize-winning reporter and former editor of the Los Angeles Times. Baquet has been managing editor at the Times since 2011. “It is an honor to be asked to lead the only newsroom in the country that is actually better than it was a generation ago,” he said, “one that approaches the world with wonder and ambition every day.”

The precise reasons for Abramson’s departure were not immediately clear. Some news reports had previously said Abramson butted heads with other editorial staff in the newsroom.


Chelsea Manning Doesn’t Want Move to Civilian Prison

Artist rendering of how Chelsea Manning sees herself. Alicia Neal—Chelsea Manning Support Network

A lawyer for the convicted WikiLeaks source says the Pentagon is trying to force his client to drop her request for transgender hormone therapy

Updated at 5:36 p.m.

Chelsea Manning, the transgender soldier serving a 35-year sentence for leaking state secrets to WikiLeaks, has rejected a Pentagon plan to move her to a civilian facility in order to receive the hormone therapy she requested 10 months ago.

The Department of Defense was considering transferring Manning, formerly known as Bradley, from a military prison at Fort Leavenworth to a facility run by the civilian Federal Bureau of Prisons, the Associated Press reported earlier Wednesday, citing two anonymous “defense officials.” In the past, inmates in the Bureau of Prisons system have received hormone therapy for gender identity disorder.

For almost a year, the military declined to act on the request for hormone therapy, standard medical treatment for transgender individuals. Military prisoners have not requested such treatment in the past, according to the AP, and transgender individuals are unaffected by the repeal of Don’t Ask, Don’t Tell and barred from serving openly in the armed forces.

In a strongly-worded statement released Wednesday, Manning’s attorney David Coombs blasted what he called “the Pentagon’s strategic leak,” calling it “a transparent attempt to pressure Chelsea into dropping her request for needed treatment under the artificial guise of concern for her medical needs.”

Coombs said his client would be unsafe in a civilian federal prison.

“The Pentagon’s leak,” he said, “is intended to strong-arm Chelsea into backing down in her requests for medical treatment, ironically using the same method (leaking information) that sent Chelsea to prison for 35 years.” Manning was sentenced in 2013 for leaking more than 700,000 military and diplomatic documents to WikiLeaks while stationed as an Army intelligence analyst near Baghdad.

The Pentagon’s position on transgender personnel has garnered attention in recent days, after Defense Secretary Chuck Hagel said Sunday he’s open to re-evaluating the military’s ban on openly transgender servicemembers. AP reports that the military is considering transferring Manning. If true, that could suggest that such a review should not be expected any time soon.

On Tuesday, Hagel told reporters there is nothing concrete in the works about reconsidering the policy.

“I’ve not asked for a specific task force. I’ve not asked for a specific study,” he said. “I would want to hear more from individuals who are close to this issue, know this issue, who I would value their judgment and their direction on.

TIME animals

Las Vegas Police Track Down Escaped Large, Predatory Cat

A large cat was out of its cage and on the prowl for chickens in a Las Vegas residential neighborhood Wednesday morning

Who let the cats out?

A large predatory cat escaped from its cage in Las Vegas on Wednesday morning, running loose in a residential neighborhood and sending local police on a cat hunt.

The cat, reported to be either an Ocelot or an Africa Serval, was tracked down and put back in its cage, the local ABC affiliate reports. But not before it jumped into a nearby woman’s yard and killed one of her chickens.

An African Serval can stand as tall as 3 ft. and weigh 40 lb.0, and an Ocelot is usually between 10 and 18 inches, weighing up to 40 pounds. No details were given about the cat’s owner, or why the feline wanted to bust loose so badly.


TIME Crime

Victims Who Get Rape Exam More Likely to Tell Police, Study Says

In a study on a 2005 amendment to the 1994 Violence Against Women Act, the Urban Institute found that sexual assault victims with access to free medical exams were more likely to report the crime, but barriers with the police still exist

Victims of sexual assault are increasingly given access to free medical exams after the crime without facing pressure to report the matter to police, according to a new study. But barriers to access remain, especially for minority women, and the close correlation between medical exams and reporting to police raises the prospect that federal efforts to de-couple the two haven’t been fully realized.

The Urban Institute study, funded by the Department of Justice and released Wednesday, sought to assess whether a 2005 amendment to the 1994 Violence Against Women Act is succeeding in funding rape exams and ensuring victims aren’t pushed to report crimes as a condition. Researchers largely gave the six states and 19 jurisdictions studied high marks on this front. But the study also found that victims who do obtain the exams are more likely to report the crime. And researchers expressed doubt that the funding is succeeding in increasing the total number of victims seeking help.

“Most victims who access the exam, according to our respondents, report to police,” said Janine Zweig, the lead author of the report. But Zweig said “the spirit of the law has not come to pass.”

“The ability to get the exam for free without reporting to police does not seem to have translated into a much larger number of victims getting the exam and participating in the criminal justice process,” she said.

Rape exams—which can include treatment of injuries, collection of blood and urine, testing for pregnancy and sexually transmitted diseases, and referrals to counseling services—are an opportunity to collect evidence that can potentially lead law enforcement to identify perpetrators. But the uniqueness of the crime—the majority of sexual assault victims know their attackers and many victims don’t recognize that an assault has occurred—has been shown lead some victims to completely shy away from help.

Before the 2005 amendment was passed, some law enforcement agencies were found to have required victims of sexual assault to report the crimes when receiving a rape exam. Congress clarified that victims are not obligated to report to police when they receive the exam. The idea was that victims could take their time when considering whether or not to report to police, while allowing for the collection of evidence that could be used during a later investigation. In the meantime, they would have access to a plethora of medical services to aid in their recovery.

But only three localities reported that more than a quarter of victims received exams without reporting to police, according to the report. The majority of localities estimated that only between 5 to 10% of victims didn’t report their assault.

What’s more, victims in some groups face additional barriers to accessing the exams altogether. More than half of providers surveyed said non-English speakers had increased difficulty receiving an exam, partly because of language barriers. In one location, victims who were undocumented immigrants reported forgoing help to avoid the risk of deportation or arrest. Those in rural areas and Native Indians face difficulties traveling to the limited number of providers in their state.

Some victims even reported not receiving exams because they did not want to report to police, showing there remains a gap in public knowledge around the requirements of these exams.

“When someone chooses to forgo the exam for whatever reason, everyone loses,” Zweig said.


North Dakota Pushes ‘Heartbeat’ Abortion Ban to Higher Court

More than 60 North Dakota lawmakers demanded a higher court revisit an overturned state law that would have banned abortions on fetuses with a detectable heartbeat

North Dakota’s Attorney General will appeal a court’s decision to strike down a state law banning the vast majority of abortions.

U.S. District Judge Daniel Hovland overturned the ban last month, calling the law “invalid and unconstitutional.” It would make abortions illegal from the time the fetus develops a heartbeat, which can often be detected six weeks into a pregnancy. Attorney General Wayne Stenehjem filed an appeal on Wednesday, the Associated Press reports.

The motion was supported by more than 60 North Dakota lawmakers.


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