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Volume 3, Number 7
17 February 2003
FAMILY PLANNING / REPRODUCTIVE HEALTH LAW AND POLICY
UK:
Immigrants May Face HIV Tests (news article)
The UK government is considering plans to test all immigrants for
HIV. At present, there are no rules on screening immigrants to the
UK for HIV. Immigration officers can refer people who appear in
poor physical or mental health to the port medical inspector. People
who test positive for HIV would not be barred from entering the
UK. However, their access to free medical care on the NHS could
be restricted.
Transferring
Policies for Treating Sexually Transmitted Infections: What's Wrong
with Global Guidelines? (research abstract)
This paper uses a case study of the development of syndromic management
for treating sexually transmitted infections (STIs) and subsequent
policies recommending worldwide use of syndromic management guidelines.
The authors' analysis focuses on two parts of the process of policy
transfer: the organic development of scientific and medical consensus
around a new policy for the treatment of STIs; and the formulation
and subsequent dissemination of international policy guidelines.
Using a political science approach, they analyze the transition
from clinical tools to global guidelines, and the associated debates
that accompanied their use.
Cost
and Cost-effectiveness of HIV/AIDS Prevention Strategies in Developing
Countries: Is There an Evidence Base? (review abstract)
This article reviews the cost and cost-effectiveness evidence base
of HIV/AIDS prevention programmes in low- and middle-income countries.
The costing methods applied and results obtained in this review
give rise to questions of reliability, validity, and transparency.
The study concludes that available cost and cost-effectiveness evidence
base on HIV/AIDS prevention strategies to guide decision-makers
is limited, and there is an urgent need for the generation of this
knowledge for planning and decision-making.
South
African Wins Payout after Catching HIV in Prison (news article)
An ex-convict, who sued South Africa's prison authorities after
catching HIV, has clinched a landmark payout - the first time the
government has been held accountable for the spread of HIV in overpopulated
prisons.
AIDS
Experts Call for Rethinking of Testing Policy (news article)
AIDS experts in the United States have called for a rethinking of
public HIV testing policy, saying new technology to diagnose the
AIDS virus could streamline the procedure and reduce the spread
of the disease.
Women's
Reproductive Health in the Middle East and North Africa 
(policy brief)
This report assess the current situation with respect to women's
reproductive health in Middle East and North African countries.
FAMILY PLANNING / REPRODUCTIVE HEALTH RESEARCH
Efficacy
of the Female Condom as a Barrier to Semen During Intercourse
(research abstract)
Women at low risk of sexually transmitted diseases were recruited
and trained to use the female condom, sample vaginal fluid before
and after condom use and to report problems during each use. Semen
exposure was assessed by comparing pre- and postcoital prostate-specific
antigen levels in vaginal fluid. The rate of semen exposure ranged
from 7% to 21% of condom uses, depending on the exposure criterion.
Exposure was more likely and more intense if participants reported
a mechanical problem versus other or no problems.
Partner
Characteristics, Intensity of the Intercourse, and Semen Exposure
during Use of the Female Condom (research abstract)
This study assessed how characteristics of the intercourse and the
couple related to semen exposure during use of the female condom.
210 women were trained to use the female condom and follow study
procedures during a group session and individually practiced inserting
the device. Semen exposure was assessed comparing pre- and postcoital
prostate-specific antigen levels in vaginal fluid. Risk factors
for semen exposure included: women with low-income levels and/or
a relationship of less than 2 years, couples with a large disparity
in vaginal fundus size and penis size, and engaging in very active
intercourse.
Bleeding
Patterns after Immediate vs. Conventional Oral Contraceptive Initiation:
A Randomized, Controlled Trial (PubMed abstract)
This randomized controlled trial compared bleeding patterns after
immediate vs. conventional oral contraceptive (OC) initiation. The
authors noted no significant difference in the number of bleeding-spotting
days between the immediate and conventional starters, concluding
that immediate start of OCs does not induce bleeding patterns different
from conventional starting regimens. Concern about adverse bleeding
patterns should not be considered a justification for instructing
women to wait until menses before starting OCs.
Bayesian
Spatial Analysis of Demographic Survey Data: An Application to Contraceptive
Use at First Sexual Intercourse
(research article)
The authors analyze the spatial patterns of the risk of unprotected
sexual intercourse for Italian women during their initial experience
with sexual intercourse. Their results show that substantial geographical
variation exists within Italy, and they argue that spatial analysis
can give useful insights on unmet reproductive health needs.
Pseudoporphyria
Induced by Oral Contraceptive Pills (case report)
The authors report a case of pseudoporphyria associated only with
the use of oral contraceptive pills and natural sun exposure.
FAMILY PLANNING / REPRODUCTIVE HEALTH NEWS
Focus
on Growing Interest in the Female Condom (news article)
National Condom Week kicked off in South Africa with an announcement
that the government had distributed one million female condoms at
200 sites last year. Compared to the 220-million free male condoms
distributed in the same period, this number seems like a drop in
the ocean, but interest in the female condom is growing.
HIV / AIDS RESEARCH
Breast-Milk
Infectivity in Human Immunodefiency Virus Type 1-Infected Mothers
(research abstract)
The authors evaluated the probability of breast-milk transmission
of HIV-1 per liter of breast milk ingested and per day of breast-feeding
in children born to infected mothers. They found that the probability
of HIV-1 infection per liter of breast milk ingested by an infant
is similar in magnitude to the probability of heterosexual transmission
of HIV-1 per unprotected sex act in adults.
Knowledge
and Practice of Condom in Preventing HIV/AIDS Infection Among Commercial
Sex Workers in Three Small Towns of Northwestern Ethiopia (research
abstract)
A cross-sectional study was conducted in three rural towns. Data
were collected from 317 commercial sex workers regarding knowledge
of HIV/HIV prevention and condom use. The level of knowledge of
commercial sex workers about HIV/AIDS (97.2%) and condoms (96.2%)
was stated to be very high compared to their experience of using
condoms (32.5%) in general and frequent use of condoms (12.8%),
in particular.
HIV / AIDS NEWS
Hepatitis
Drug Effective for Early HIV (news article)
Researchers announced that a long-acting type of interferon usually
used to treat hepatitis C also could be a potent treatment for early
HIV infections.
Promising
New AIDS Drugs on the Horizon (news article)
A variety of highly effective new AIDS drugs are on the horizon,
easing worries that the fast-mutating virus will outstrip doctors'
ability to treat it.
Scientists
Link Harmless Virus to Slowing of HIV's Effects (news article)
Infection with a common harmless virus, known as GBV-C, seems to
slow the progress of HIV and prolong the survival of AIDS patients,
according to new evidence reported by American scientists.
Uganda:
Leading User of Antiretrovirals (news article)
One third of the 30,000 antiretroviral users in sub-Saharan Africa
are in Uganda, the ministry of health announced this week.
Drug-resistant
HIV Passed through Breast Milk (news article)
HIV-infected women given a single dose of the anti-AIDS drug nevirapine
during labor to prevent perinatal virus transmission to their baby
harbor HIV in their breast milk that is resistant to the drug.
Ethiopia
"Dramatic effect" of HIV/AIDS Prevention Programmes
(news article)
A study, carried out among 1,500 factory workers in Ethiopia and
started in 1997, showed a marked drop in casual sex and an increase
in condom use. Prevalence rates of the virus also plummeted, investigators
attributing this to HIV/AIDS prevention programs.
HIV
Drug's Effect on Moms Studied (news article)
One dose of a drug that may soon be used to prevent mother-to-child
transmission of HIV in thousands of pregnant women in Africa and
other poor regions that causes the virus to mutate and concentrate
in breast milk, a small study found.
MATERNAL AND CHILD HEALTH RESEARCH
Risk
Factors for Ectopic Pregnancy: A Comprehensive Analysis Based on
a Large Case-Control, Population-based Study in France (research
abstract)
Related news article: Smoking,
Pelvic Infections Up Tubal Pregnancy Risk
Smoking and sexually transmitted pelvic infections can more than
triple a woman's risk of having an ectopic pregnancy. In terms of
public health, increasing awareness of the role of smoking may be
useful in the formation of ectopic pregnancy prevention policies.
Risk
Factors for Depression in Postnatal First Year, in Eastern Turkey
(research abstract)
In this cross-sectional, multi-centre study, the sample was selected
from five eastern provinces of Turkey. Among 2602 randomly selected
women who gave birth within the last year, 2514 women were included
in the analysis. Excess risk of depression was associated with unemployment,
low education, poverty, poor family relations, low marital age,
lack of medical services, and mental health problems.
Cervical
Stitch (Cerclage) for Preventing Pregnancy Loss in Women (Cochrane
review)
This review aims to assess the effectiveness and safety of prophylactic
cerclage, emergency cerclage and to determine whether a particular
technique of stitch insertion is better than others. Six trials
with a total of 2175 women were analysed. Prophylactic cerclage
was compared with no cerclage in four trials. There was no overall
reduction in pregnancy loss and preterm delivery rates, although
a small reduction in births under 33 weeks' gestation was seen in
the largest trial. Two trials examined the role of therapeutic cerclage
when ultrasound examination revealed short cervix. Pooled results
failed to show a reduction in total pregnancy loss, early pregnancy
loss, or preterm delivery in women assigned to cervical cerclage.
Gender
Differences in Healthcare-seeking during Common Illnesses in a Rural
Community of West Bengal, India
(research article)
This follow-up study examined gender disparities in seeking healthcare
and in home management of common illnesses among 530 children aged
less than five years in a rural community of West Bengal. Qualified
health professionals were consulted more often and sooner for boys
than for girls for which parents also traveled longer distances.
Expenditure per treated episode differed significantly with logistic
regression showing that chance of spending more money was 4.2 higher
for boys.
Prevalence
of Anaemia Amongst Pregnant Women and Its Socio-Demographic Associates
in a Rural Area of Delhi (research article)
This study was conducted in two villages in Northern India. A total
of 114 pregnant women with gestational period between 12-20 weeks
were registered. A high prevalence (96.5%) of anaemia (Hb <11
gm/dl) was observed. The overall prevalence of anaemia was found
to be almost similar in different age groups, income, and caste
groups. The prevalence of severe anaemia was found significantly
higher in those older than 25 years, educated till high school or
less, nuclear family, no history of abortions, and birth interval
of >36 months.
WHO
Indicators for Evaluation of Maternal Health Care Services, Applicability
in Least Developed Countries: A Case Study from Eritrea (news
article)
This study was conducted to know if the process indicators recommended
by the WHO to monitor the effect of health care programs on maternal
mortality are useful also in the least developed countries. The
study revealed that the indicators were helpful to follow the coverage
of obstetric care and to identify problems within the health care
system. However, in countries where the coverage of assisted deliveries
is low with few obstetric complications seen within the health care
system, the indicators cannot be used as a tool to monitor the effect
of maternal health care programmes on maternal mortality.
MATERNAL AND CHILD HEALTH NEWS
Unsafe
Birth Claims One Woman Every Two Hours in Nepal (news article)
A woman dies every two hours in Nepal due to birth complications.
Maternal mortality in the country is put at 539 per 100,000 births,
one of the highest in South Asia. About 4,000 women lose their lives
during child birth every year in Nepal.
MEN'S HEALTH RESEARCH
Prevalence
of Cardiovascular Risk Factors in Erectile Dysfunction (research article)
Several studies have shown a correlation between erectile dysfunction
and risk factors for coronary artery disease.This study attempts
to find the prevalance of CAD risk factors in men with erectile
dysfunction. Men who had had symptoms of erectile dysfunction for
at least six months were recruited from the Center for Sexual Function.
Of the 154 men evaluated, 44% had hypertension; 23% had diabetes
mellitus; 16% used tobacco; 79% had a body mass index of > 26
kg/m2; and 74% had a low-density lipoprotein cholesterol level of
> 120 mg/dL.
Prostate
Cancer and Exposure to Pesticides in Agricultural Settings (research
abstract)
In this study, 124 patients with prostate cancer interviewed, along
with 659 cancer controls. A team of agronomists assessed past exposure
to pesticides by using a checklist of 100 chemical families and
217 compounds applied from 1950-85 in the areas considered. Having
ever been employed in agriculture was associated with a 40% increased
risk. The analyses carried out to estimate the association between
different types of pesticides and prostate cancer showed increased
risks among farmers exposed to organochlorine insecticides and acaricides.
MEN'S HEALTH NEWS
Survey
Links Internet "Dating" and High Risk Sexual Behavior
(news article)
An online survey of 2,934 men suggests that those who seek male
sex partners through websites are likely to engage in high risk
sexual behavior, usually preceded by recreational drug use or drinking.
POPULATION RESEARCH
An
Overview of Population and Development in Vietnam (review report)
The rate of growth of Vietnam's population has been slowing dramatically.
By the end of the 1990s, the growth rate declined to its lowest
point since reunification of the north and south in 1975: 1.4 percent
per year in 2000.
The
Impact of the Changing Marital Structure on Fertility of Hong Kong
SAR (Special Administrative Region) (PubMed abstract)
Hong Kong SAR has experienced an especially rapid fall in fertility
over the course of just two decades. An important question is whether
the dramatic decline in the TFR results from a decline in the fertility
of married women or from changes in the proportion ever married.
This study shows that the large decline in the TFR between 1981
and 1999 was in great part distorted by tempo effects, distortions
caused by changes in the timing of childbearing and the changing
marital structure.
Determinants
of Human Population Growth (PubMed abstract)
This paper tries to summarize what factors lie behind the extraordinary
expansion of the human population and what population growth we
can expect for the future. It discusses the concept of demographic
transition and the preconditions for a lasting secular fertility
decline
POPULATION NEWS
Immigration
Continues, World Population Soars (news article)
Despite the ravages of AIDS the world's population continues to
grow.
Australia:
Babies 'a Vote of Confidence' (news article)
An analysis of birth rates from 1975 to 2000 revealed that fertility
rates dipped sharply during periods of recession and rose once economic
conditions improved.
India:
Where Have All the Girls Gone? (feature article)
The preference for sons is creating a desperate shortage of females
in India's population of more than 1 billion. A national "shortfall"
of about 40 million women is disproportionately high in some regions.
WOMEN'S HEALTH RESEARCH
Interventions
for the Physical Aspects of Sexual Dysfunction in Women Following
Pelvic Radiotherapy (Cochrane review)
The aim of this review was to evaluate the evidence for treatment
options addressing the physical components of sexual dysfunction
arising from pelvic radiotherapy. Any study describing the therapeutic
trial of a treatment to relieve the physical aspects of female sexual
dysfunction, which had developed following pelvic radiotherapy,
was considered. The strongest evidence (grade IC) of benefit was
for data in the topical oestrogens and benzydamine sections which
describes the treatment of acute radiation vaginal changes. The
use of vaginal dilators to prevent the development of vaginal stenosis
is supported by grade IIC evidence.The value of hyperbaric oxygen
therapy and surgical reconstruction is supported by the much weaker
grade IIIC evidence.
Risk
Factors Associated with Peri- and Postmenopausal Bone Loss: Does
HRT Prevent Weight Loss-related Bone Loss? (research abstract)
The study population, 940 peri- and postmenopausal women, was selected
from a random sample of the OSTPRE study cohort. Bone mineral density
(BMD; g/cm2) at the lumbar spine and femoral neck, and body weight,
were measured at baseline and 5-year follow-up. According to multiple
regression analysis HRT use, years since menopause and weight increase
significantly predicted lower annual bone loss at both the lumbar
spine and femoral neck (p < 0.005). HRT and weight change are
the most important determinants of bone loss at both the lumbar
spine and femoral neck. Furthermore, HRT seems to be effective in
prevention of weight loss related bone loss.
WOMEN'S HEALTH NEWS
To
Save Africa, We Must Save Africa's Women (opinion)
A combination of famine and AIDS is threatening the backbone of
Africa - the women who keep African societies going and whose work
makes up the economic foundation of rural communities.
YOUTH HEALTH RESEARCH
Adolescent
Childbearing in Sub-Saharan Africa: Can Increased Schooling Alone
Raise Ages at First Birth?
(research article)
This article examines whether increased years of schooling exercised
a consistent impact on delayed childbearing in sub-Saharan Africa.
The authors used data from Demographic and Health Surveys conducted
in eight countries from 1987-1999. Multiple logistic regressions
were used to assess trends and determinants in the probability of
first birth during adolescence. Girls' education from about the
secondary level onwards was found to be the only consistently significant
covariate.
Strategies
for Resolving Aboriginal Adolescent Pregnancy in Eastern Taiwan
(PubMed abstract)
This article discusses the various strategies adopted in tackling
the issue of adolescent pregnancies among Aborigines in Eastern
Taiwan.
YOUTH HEALTH NEWS
Developing
World Has Most Cases of Child Cancer (news article)
British cancer experts called for an international campaign to improve
the treatment of childhood cancers in the developing world, where
72,000 youngsters die of the illness each year.
India's
Youth Programs to Combat AIDS Must Be Diverse and Widespread
(feature article)
A 2001 study conducted in Delhi and Lucknow shows that some 15 percent
of young people engage in premarital sex. The study, which included
grade school and college students, also revealed that despite a
growing HIV/AIDS epidemic, many young people have unprotected sex.
PROFILES / SPECIAL REPORTS / RESOURCES
PAHO
Publications Available Online (resource)
PAHO has just launched a quick way for its readers to go straight
to the source of what they are looking for in electronic format.
They can now access one or more chapters of the organization's most
popular publications, such as Health in the Americas and Control
of Communicable Diseases (Spanish version), among others, in a minimum
of keystrokes. With this new service, readers can select only those
chapters on the diseases that most interest them or select the chapter
on a country for which they need the latest mortality or morbidity
data.
Estimating
the Size of Populations at Risk for HIV: Issues and Methods (report)
This document includes a discussion of the major methods available
for population size estimation, with their strengths and weaknesses,
and gives examples. It explores how best to choose the right method
for a given country situation and sub-population.
Training
and Support of Developing-Country Population Scientists
(report)
Contains a detailed assessment of the current situation with respect
to recruitment, training, funding, and employment of population
scientists in developing countries. Gaps and areas of need are identified
and specific recommendations are made.
Pathways
to Contraceptive Security Workshop Report
(report)
This report summarizes a workshop held by the Turkish Ministry of
Health and the POLICY Project, "Pathways to Contraceptive Security,"
October 31 and November 1, 2001, in Konya, Turkey.
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