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Volume 3, Number 8
24 February 2003
FAMILY PLANNING / REPRODUCTIVE HEALTH LAW AND POLICY
Bush
May Deny Some Overseas AIDS Money (news article)
By restricting the use of federal AIDS-fighting money by organizations
that promote or perform abortions overseas, President Bush is trying
to balance his firm anti-abortion policies with his new commitment
to battle the AIDS epidemic.
UK:
Government Urges Under-16s to Experiment with Oral Sex (news
article)
A government-backed course is encouraging pupils under 16 to experiment
with oral sex, as part of a drive to cut rates of teenage pregnancy.
Family campaigners believe that the course, called "A Pause,"
is having the reverse effect by exciting the sexual interest of
children.
Chinese
Maternal Health in Adjustment: Claim for Life (research abstract)
This study aimed to identify socio-economic variables associated
with utilisation of essential maternal health services and linked
to health sector reforms in China, with a focus on cost recovery.
It confirms a strong association between utilisation of delivery
services and financing variables of amount of savings in the bank,
maternal pre-payment schemes and health insurance. It also shows
the critical importance of out of pocket, fee-for-service payments
for maternity care as a barrier to the utilisation of these services.
Shifting
the Burden: The Private Sector's Response to the AIDS Epidemic in
Africa 
(research article)
As the economic burden of HIV/AIDS increases in sub-Saharan Africa,
allocation of the burden among levels and sectors of society is
changing. The private sector has more scope to avoid the economic
burden of AIDS than governments, households, or nongovernmental
organizations, and the burden is being systematically shifted away
from the private sector. The article suggests that the shift in
the economic burden of AIDS is a predictable response by business
to which a deliberate public policy response is needed. Countries
should make explicit decisions about each sector's responsibilities
if a socially desirable allocation is to be achieved.
Domestic,
Regional, And International Protection of Nigerian Women Against
Discrimination: Constraints and Possibilities (commentary)
This paper approaches questions concerning human rights and discrimination
against women from a perspective that differs from the dominant
view within the human rights literature. The author argues that
the existence and defense of national, regional, and international
rights of Nigerian women against discrimination must necessarily
be located within Nigeria's particular historical experience. The
identification of instances of discrimination and the struggle to
defend and extend women's rights has to be critically examined in
light of the power relations that structure the regime of human
rights worldwide.
Female
Genital Cutting (Mutilation/Circumcision): Ethical and Legal Dimensions
(PubMed abstract)
Related news article: Control
of Female Sexuality Factors into Genital Mutilation
Researchers list the control of female sexuality as a primary reason
for the practice of female circumcision. It is directed to the social
control of women's sexuality, in association with preservation of
virginity and family honor.
FAMILY PLANNING / REPRODUCTIVE HEALTH RESEARCH
Factors
Associated with Oral Contraceptive Discontinuation in Rural Bangladesh
(research abstract)
Despite oral contraceptives (OCs) accounting for half of all modern
contraceptive methods used in Bangladesh, discontinuation remains
fairly high. This paper identifies factors associated with discontinuation
of OC use. A total of 1600 OC users, aged 15 to 49 years, were interviewed;
36% had discontinued OC use. Discontinuation of OC use decreased
with increased duration of use and number of living children. OC
discontinuation was associated with side-effect experiences, lack
of husband's support in OC use, and failure to purchase OCs.
Sexual
Practices Other Than Peno-Vaginal Sex: Perceptions and Practices
in an Urban Community (research article)
This study investigates the perceptions and practices of an urban
community in India about alternative sexual practices. 417 married
couples with the wife within reproductive age group were questioned.
Fifty four percent of respondents experienced homosexual relations,
and 77% of them had it first between 13-18 years. About half of
the respondents who experienced oral sex found it enjoyable. Only
24% of respondents had experience of anal sex.
Evaluation
of the Immunocontraceptive Potential of Escherichia Coli Expressed
Recombinant Non-human Primate Zona Pellucida Glycoproteins in Homologous
Animal Model (PubMed abstract)
Related news article: E.
Coli-expressed Zona Pellucida Glycoproteins have Contraceptive Properties
Researchers in India have evaluated the immunocontraceptive potential
of zona pellucida (ZP) lipoproteins and concluded that the block
of fertility subsequent to immunization with r-bmZP1 and r-bmZP2,
in a homologous non-human primate model, may be mediated due to
ovarian dysfunction.
Acceptability
of the Long-term Contraceptive Levonorgestrel-releasing Intrauterine
System (Mirena(R): a 3-Year Follow-up Study (PubMed abstract)
This Austrian study investigated the long-term acceptability of
a levonorgestrel-releasing intrauterine system (LNG-IUS). It concluded
that LNG-IUS is a well-accepted contraceptive method, without negative
influences on the sexual relationship between users and their partners,
and is suitable for women requiring long-term reversible contraceptive
protection.
Motivations
for Condom Use and Nonuse (PubMed abstract)
This exploratory study investigates the motivations for condom use
and nonuse among a sample of drug users and nonusers. The authors
found that a peer norms motivation and a relationship motivation
(caring) supported both condom use and nonuse.
FAMILY PLANNING / REPRODUCTIVE HEALTH NEWS
Ugandan
Government to Import 120 Million Condoms (news article)
Uganda will import about 120 million condoms this year to help reduce
the spread of HIV/AIDS and other sexually transmitted diseases.
'Condom'
Ban Stalls Malaysian Ads
A ban on the word "condom" on Malaysian airwaves is hampering
AIDS awareness campaigns on local television and radio.
HIV / AIDS RESEARCH
Is
Use of Antiretroviral Therapy among Homosexual Men associated with
Increased Risk of Transmission of HIV Infection? (research abstract)
There is concern that use of highly active antiretroviral therapy
(HAART) may be linked to increased sexual risk behavior among homosexual
men. In a cross sectional study of 420 HIV-positive homosexual men
attending a London outpatient clinic, behavioral and clinical risk
factors for HIV transmission were consistently lower in men on HAART
than men not on HAART.
Review
of Human Immunodeficiency Virus Type 1 Related Opportunistic Infections
in Sub-Saharan Africa (research abstract)
This study undertakes a systematic review of the literature on HIV-1
infectionin sub-Saharan Africa to assess data from recent cohorts
and selected cross-sectional studies to delineate rates of opportunistic
infections, associated CD4 cell counts, and associated mortality.
Tuberculosis, bacterial infections, and malaria were identified
as the leading causes of HIV-related morbidity across sub-Saharan
Africa. Of the few studies that reported CD4 cell counts, the range
of cell counts at the time of diagnosis of opportunistic infections
was wide.
HIV / AIDS NEWS
Vaccine
Failure Shows Long AIDS Fight Remains (news article)
The failure of the first AIDS vaccine to ever be tested in people
shows the battle against the deadly virus will go on for years,
but it also offers some hope to patients.
HIV/AIDS
Vaccine Trials Begin in Uganda (news article)
Uganda has started trials of a potent AIDS vaccine, which combats
the A strain of the HIV virus, the type that is prevalent in East
Africa.
Dirty
Needles 'Spread Africa AIDS' (news article)
Related news article: Dirty
Needles Research Rejected
The first news items recounts how research published by US experts
indicates that the spread of HIV infections in Africa may be more
closely linked to unsafe medical care than previously thought. This
report challenges widely held scientific views on the spread of
the virus that can cause AIDS. However, the second news item reports
that the United Nations has disputed the findings of these researchers.
Launch
of First Comprehensive Gender and HIV/AIDS Web Portal (press
release)
A new gender and HIV/AIDS web portal will provide researchers, policy-makers,
and practitioners access to cutting edge information at their fingertips.
Developed by the United Nations Development Fund for Women (UNIFEM),
in collaboration with the Joint United Nations Programme on HIV/AIDS
(UNAIDS), the portal is a one-stop online resource center on the
gender dimensions of the HIV/AIDS epidemic. The new web portal is
at http://www.GenderandAIDS.org.
Ghana
Gold Workers 'Paid in Condoms' (news article)
A gold-mining company in Ghana says it has managed to reduce AIDS
and HIV infection rates among its workers by over 75%, by giving
staff condoms in their pay packets.
Gender
Equality Key to Fighting AIDS in Third World (news article)
Fostering gender equality is one of the most important strategies
for fighting HIV and AIDS in the developing world, along with existing
campaigns, including promoting condom use. In a lecture at the National
Women's Education Center in Saitama Prefecture, Suman Mehta, Global
HIV/AIDS coordinator of the United Nations Population Fund, said
the social, economic and biological vulnerability of women is one
of the reasons the disease has spread so rapidly.
Uganda's
Successful AIDS Program Deserves Notice (feature article)
The author writes that Uganda's war on HIV/AIDS, initiated long
before most other countries even acknowledged the threat posed by
the virus, is "the only success story in the medical wasteland
of sub-Saharan Africa. Even more remarkably, its relatively unheralded
success is almost exclusively centered on a return to the dewy-eyed
moralistic climate most commonly associated with 1950s American
suburbia. You see, Uganda is fighting AIDS by promoting abstinence
and fidelity."
MATERNAL AND CHILD HEALTH RESEARCH
Community-based
Monitoring of Safe Motherhood in the United Republic of Tanzania
(research article)
Maternal mortality in the United Republic of Tanzania was monitored
by sentinel demographic surveillance of more than 77,000 women of
reproductive age and by prospective monitoring of mortality in an
urban site; a wealthier rural district; and a poor rural district.
The proportion of deaths of women of reproductive age (15-49 years)
due to maternal causes compared with all causes was between 0.063
and 0.095. The use of sentinel registration areas may be a cost-effective
and accurate way for developing countries to monitor mortality indicators
and causes, including for maternal mortality.
Changing
Obstetric Practices in the Context of HIV: An Evaluation of Service
Provision in the National PMTCT Learning Sites (report)
This report is based on a rapid assessment of the effects of the
introduction of prevention of mother-to-child-transmission (PMTCT)
on the overall provision of obstetric services in South Africa,
and to evaluate changes in clinical obstetric practice made in response
to concerns about transmission of HIV. The study concentrated on
labour and delivery practices, and did not evaluate antenatal care.
Twenty-one PMTCT facilities in eight provinces were visited. Staff
were given a questionnaire and medical records were reviewed. Each
facility was evaluated in terms of service patterns. Results highlight
issues related to clinical obstetric care, human resources, quality
of care and operational aspects of the program.
Maternal
Consumption of Coffee During Pregnancy and Stillbirth and Infant
Death in First Year of Life: Prospective Study (research article)
Related News Story: Mom-To-Be's
High Coffee Intake Linked to Stillbirth
Pregnant women who drink eight or more cups of coffee a day may
triple their risk for having a stillborn child.
Averting
Maternal Death and Disability: Using UN Process Indicators to Assess
Needs in Emergency Obstetric Services in Morocco, Nicaragua and
Sri Lanka
(report)
The UN process indicators for monitoring obstetric services are
used to identify the availability, use, and, to some extent, quality
of emergency obstetric care. The indicators are also useful at monitoring
changes in availability, utilization and quality. This report present
the data from the needs assessments in Morocco, Nicaragua and Sri
Lanka undertaken in 2000, 2001 and 2002. A needs assessment was
the first step in carrying out the Averting Maternal Death and Disability
(AMDD) Program in these three countries. It concludes that the achievements
of these countries are considerable, but difficult regional challenges
persist.
Energy
Stress during Pregnancy and Lactation: Consequences for Maternal
Nutrition in Rural Bangladesh (research abstract)
This study assessed the relationship of energy stress during pregnancy
and lactation to maternal body stores in marginally nourished rural
Bangladeshi women. It concluded that the rural Bangladeshi women
studied failed to gain sufficient weight during the last half of
pregnancy to maintain body weight during lactation when the energy
demand is high. Poor growth of their primarily breastfed infants
raises concern about the adequacy of lactation in this community.
MATERNAL AND CHILD HEALTH NEWS
Pregnant Mom's Emotional Response may Affect Fetus (news article)
Preliminary research suggests that feelings of anxiety and stress
throughout pregnancy may contribute to subtle changes in fetal development.
MEN'S HEALTH RESEARCH
Married
Men's Opinions and Involvement Regarding Family Planning in Rural
Areas (PubMed abstract)
The objective of this Turkish study was to determine the attitudes
and behavior of married men concerning family planning. It concluded
that mass media and continual training programs could be very useful
to try to reach both men and women in order to encourage men's involvement
in family planning.
Prospective
Study of Antioxidant Micronutrients in the Blood and the Risk of
Developing Prostate Cancer (research abstract)
The authors examined the associations between prediagnostic blood
levels of micronutrients and prostate cancer risk in two nested
case-control studies (CLUE I and II). Each of the 182 cases from
CLUE I and 142 cases from CLUE II were matched for age and gender
with two controls. A strong inverse association between gamma-tocopherol
and prostate cancer risk was observed in CLUE II. Study findings
do not replicate previous reports of a protective association between
lycopene and prostate cancer, but they suggest potential chemopreventive
effects of gamma-tocopherol on prostate cancer.
Pregnancy
Course and Health of Children Born after ICSI Depending on Parameters
of Male Factor Infertility (research abstract)
Data from a multicentric prospective, controlled cohort study in
Germany were analysed to look for differences in pregnancy course
and outcome following the use of either ejaculated, epididymal,
or testicular sperm. A total of 2809 pregnancies were originally
included in the study. For 2545 pregnancies with 3199 fetuses/children,
data of sperm count and origin were available. Regarding pregnancy
course and complications, there was no influence of the origin of
sperm. No higher risk of pre-eclampsia was associated with the use
of surgically obtained sperm. The birth data of children were similar
between the three groups. The risk of major malformation in abortions,
stillbirths, livebirths, and induced abortions was not significantly
different between the three groups
A
Simple, Low Cost and Non-invasive Method for Screening Y-chromosome
Microdeletions in Infertile Men (research abstract)
The aim of this study was to compare DNA collection using a cytobrush
to collect buccal cells as a source of DNA versus a multiplex PCR
kit to define a reliable and efficient method to detect Y-chromosome
deletions in infertile men. The test population consisted of 18
infertile male patients (with a known Y-deletion). Both buccal and
blood cells were used for DNA extraction. Between 4-10 µg
of DNA were retrieved per brush, allowing for several PCR attempts.
The commercial kit failed to detect an AZFa deletion. Furthermore,
markers sY130, sY133 and sY153, included in the kit, are not reliable.
MEN'S HEALTH NEWS
New
Erectile Dysfunction Drug has Interaction with HIV Protease Inhibitors
(news article)
Cialis (tadalafil), the recently licensed anti-impotence drug, interacts
with protease inhibitors, meaning that the chance of experiencing
side-effects and their severity is increased.
POPULATION RESEARCH
The
Prevalence and Correlates of Consanguineous Marriages in Yemen:
Similarities and Contrasts with Other Arab Countries (research
abstract)
Using data on 9,762 women from the 1997 Yemen Demographic and Maternal
and Child Health Survey, this paper examines the prevalence and
socioeconomic correlates of consanguineous marriages in Yemen. The
results indicate that 40% of marriages are consanguineous, over
85% of which are between first cousins. The study confirms the inverse
association between consanguineous marriages and women's education
and occupation, age at marriage, and economic status. However, higher
educated men and those working in the modern sector of the economy
were more likely to be married to cousins.
Crowding
in a Traditional Rural Housing ("Tukul") in Ethiopia
(research abstract)
Poor housing condition is one of the major public health concerns
in many developing nations due to its association with health status.
During a census enumeration, 5,113 rural housing units were physically
assessed. According to WHO literature for a dwelling units, about
85% of the "Tukuls" in a rural area are crowded and far
behind to satisfy the physiological needs of a resident. Nearly
95% of housing units had only one room. The high magnitude of overcrowding
in rural housing units indicates the poor living and sanitation
conditions.
Invited
Commentary: Monitoring Fecundity over Time-If We Do It, Then Let's
Do It Right (commentary)
A number of investigators have pointed to the possibility of a secular
decline in human fecundity due to changes in sperm concentration.
It is unlikely that any historical trends will be definitively quantified,
but a good case can be made for more precise monitoring of this
phenomenon in the future.
POPULATION NEWS
Russian
Population Shrinks by 857,000 in 2002 (news article)
Russia's population decreased by about 856,700 people (0.6%) in
2002 to 143.1 million.
`Old
Europe' Is Getting Older as Population Ages (news article)
Europe is old, and growing older. Across the continent children
are increasingly scarce. Fertility rates (the number of children
per woman in the population) have fallen to 1.2 percent in Germany
and Italy. The rate is even lower in Spain -- in fact, the lowest
in Europe. Spain is still a young society, but a society without
children is doomed.
Africa: Census Compares Well Where It Counts: Cost and Speed (news article)
The author performs a comparative assessment of the logistics, cost,
and efficiency of censuses in various African countries.
World
Population Increased Four-Fold in 20th Century (news article)
The world population quadrupled in the 20th century in what the
United Nations terms unprecedented growth. India, China, Pakistan,
Nigeria, Bangladesh, and Indonesia will account for one half the
entire world's population growth over the next 50 years.
WOMEN'S HEALTH RESEARCH
Relation
Between Hormone Replacement Therapy and Ischaemic Heart Disease
in Women: Prospective Observational Study (research article)
19,898 nurses aged 45 and over completing a questionnaire on lifestyle
and use of hormone replacement therapy in 1993 were followed up
for the outcome of interest (cases of death and incident cases of
ischaemic heart disease and myocardial infarction) until the end
of 1998. In current users compared with never users, hormone replacement
therapy had no protective effect on ischaemic heart disease or myocardial
infarction, whereas current users with diabetes had an increased
risk of death ischaemic heart disease (and myocardial infarction
compared with never users with diabetes.
Effects
of Tamoxifen on Benign Breast Disease in Women at High Risk for
Breast Cancer (research abstract)
The authors examined the effect of tamoxifen treatment on the incidence
of benign breast disease and the number of breast biopsies in more
than 13,000 women with follow-up who participated in the NSABP Breast
Cancer Prevention Trial. They found that tamoxifen treatment reduced
the risk of benign breast disease by 28%.
Spontaneous
Loss of Early Pregnancy and Risk of Ischaemic Heart Disease in Later
Life: Retrospective Cohort Study (research article)
Related News Article: Researchers
Link Miscarriages, Heart Disease
Women who experience multiple miscarriages may have an elevated
risk of heart disease.
The
Temporal Reliability of Serum Estrogens, Progesterone, Gonadotropins,
SHBG and Urinary Estrogen and Progesterone Metabolites in Premenopausal
Women (research article)
Using data from a longitudinal study of 34 women with a mean age
of 42.3 years, the authors calculated the minimum number of measurement
occasions required to obtain reliable estimates of 12 analytes (8
in blood, 4 in urine). Only 2 of the 12 analytes examined, SHBG
and estrone sulfate (E1S), could be adequately estimated by a single
measurement using a minimum reliability standard of having the potential
to account for 64% of true variance.
The
Benefits and Costs of Tamoxifen for Breast Cancer Prevention
(research abstract)
The incremental cost-effectiveness ratio of tamoxifen therapy relative
to placebo was estimated using decision analysis with Markov modelling
of health states, outcomes, and costs for a simulated cohort of
women at high risk for breast cancer. Tamoxifen therapy over five
years reduces the incidence of breast cancer by approximately 1.4%,
which is offset by an increase in endometrial cancer of 0.7% and
pulmonary embolism of 0.2%. If the reduction is permanent (preventing
new breast cancers emerging over five years and no further treatment
effect hereafter), the model estimates an increase in life expectancy
of 0.057 QALYs and an extra cost of $2,193; or $38,271/QALY gained.
Association
of Volume and Volume-Independent Factors With Accuracy in Screening
Mammogram Interpretation (research abstract)
Related news article: Recent
training may affect accuracy of mammograms
A study has found that the most recently trained radiologists did
best in a test of cancer-detection accuracy.
WOMEN'S HEALTH NEWS
X-ray
Picks Out Tiny Tumours (news article)
A research team from University College London developed their technique
after finding that tumour cells scatter X-rays in a number of directions.
By measuring this effect, the researchers found it far easier to
pinpoint tumour cells among healthy cells.
YOUTH HEALTH RESEARCH
Intervention Strategies that Work for Youth: Summary of FOCUS on Young Adults
End of Program Report (report)
This paper reports on programs that have helped young people in
developing countries practice healthier behaviors, including delaying
sexual debut, reducing the number of sexual partners, and increasing
the use of methods for preventing pregnancy and STIs, including
HIV/AIDS. It is addressed to program planners, administrators, policy-makers,
and donors interested in developing evidence-based strategies and
programs to promote better health for youth.
Factors
Associated with Adolescent Pregnancy: A sample of Taiwanese Female
Adolescents (PubMed abstract)
Sexually experienced but never-pregnant female adolescents were
selected from two vocational high schools. Pregnant adolescents
were recruited by convenience sampling from obstetric clinics and
health stations in Tainan City. Multiple logistic regression analysis
identified six factors associated with pregnancy: poor contraceptive
knowledge, poor contraceptive self-efficacy, low socioeconomic status,
low effective contraceptive use scores, more frequent sexual intercourse,
and older age.
PROFILES / SPECIAL REPORTS / RESOURCES
Guide to
European Population Assistance (resource)
The fourth edition of this publication gives access to funding from
all major European budget lines in the field of sustainable development.
The Guide is a reference work for development organisations and
provides an overview of available public funding from 15 European
countries and the European Community (amounting to over Euro 33
billion of funds available for development work, including SRH,
HIV/AIDS etc.). The Guide focuses on budget lines for sustainable
development, specifically on sexual and reproductive health, family
planning, HIV/AIDS, and population. To obtain a password which will
enable you to access the complete website, please contact the German
Foundation for World Population: e-mail: order@euroresources.org.
HIV,
Health and Your Community
(resource)
This comprehensive, accessible, and easy-to-understand guide for
health workers confronting the HIV epidemic emphasizes successful
prevention and treatment efforts around the world. The book is designed
as a manual for people confronting the HIV epidemic in their communities,
and is easily accessible to those without prior training in the
prevention of HIV and the care of those living with AIDS.
Male
Latex Condoms and Sexually Transmitted Diseases
(resource)
This fact sheet by the CDC is for public health personnel on male
latex condoms and sexually transmitted diseases. It is based on
the workshop convened in June 2000 to evaluate the published evidence
establishing the effectiveness of latex male condoms in
preventing STDs, including HIV.
"34
Million Friends" Campaign (resource)
The "34 Million Friends" campaign is a grass-roots movement
that was independently initiated by two American women, Lois Abraham
of New Mexico and Jane Roberts of California. Although they had
never met, Lois and Jane were both outraged by the United States
withdrawal of $34 million approved for UNFPA and they decided to
take action. Each woman started her own email campaign, urging men
and women across the United States to donate $1 or more to help
bridge the funding gap. Their goal is to find 34 million friends
to help UNFPA continue its invaluable work as the largest multilateral
provider of family planning and maternal health care.
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