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Volume 3, Number 10
10 March 2003
FAMILY PLANNING / REPRODUCTIVE HEALTH LAW AND POLICY
Emerging
Trends in International Law Concerning Global Infectious Disease
Control (commentary)
The author examines emerging trends in international law concerning
global infectious disease control.
Planning
Other Families: Negotiating Population and Identity Politics in
the Peruvian Amazon (research abstract)
This article examines the ways in which globally driven population
policies are experienced by rural, indigenous women in Amazonian
communities on the periphery of formal, political power.
The
Philippines: Dayrit in Hot Water over IUD 'Ban' (news article)
Related letter to the editor: Dayrit's
Stand on IUDs is Mistaken
A women's group yesterday demanded that Health Secretary Manuel
Dayrit resign for proposing a ban on the intra-uterine device (IUD),
a popular contraceptive.
A
Framework for a New Approach to Antenatal Care (research abstract)
A framework for a new approach to antenatal care (ANC) is presented
to improve maternal health. Based on evaluations of ANC, safe motherhood
programs, gender and social theory, it suggests that managers should
draw upon existing family and community support systems, and develop
partnerships beyond the health service.
Fury
at Zambia Army HIV Test (news article)
The Zambian army's decision to turn away HIV positive applicants
has been angrily criticised. But Health Minister Brian Chituwo said
the new policy was introduced because "with the excessive physical
military activity recruiting HIV positive staff would be sending
them to the grave faster."
US:
Workers Sue Railroad Company for Birth Control Coverage (news
article)
Three women workers at Union Pacific Corp. on Tuesday sued to try
to force it to add contraception coverage to its healthcare plan.
Involuntary
Sterilization of Persons with Mental Retardation: An Ethical Analysis
(research abstract)
Legitimate concerns on the part of caretakers may lead to requests
for sterilization of a mentally retarded person. At the same time,
mentally retarded persons must be protected from actions that do
not serve their best interests. This paper reviews the history of
involuntary sterilization in the United States and evaluates the
ethical arguments that are relevant to decisions about involuntary
sterilization.
Speaking
Out Over Jordan 'Honour Killings' (news article)
A new book exposes the "honor" killing of women in Jordan,
which is permitted under Jordanian law, articles 340 and 98, the
two articles that sanction honour killings and excuse those who
perform them (usually the father or brother of victim). The book
is "Honor
Lost: Love and Death in Modern-Day Jordan."
How
Will HIV/AIDS Transform African Governance? (article abstract)
This article examines different models for social and political
mobilization against the HIV/AIDS pandemic and sketches a unified
framework for understanding its impact.
FAMILY PLANNING / REPRODUCTIVE HEALTH RESEARCH
Techniques
for the Interruption of Tubal Patency for Female Sterilisation
(Cochrane Review)
The reviewers' conclude that electrocoagulation was associated with
less morbidity when compared with tubal ring and other methods.
However, the risk of burns to the small bowel might be a serious
criticism of the approach. The small sample size and the relative
short period of follow-up in the studies reviewed limited the power
to show clinical or statistical differences for rare outcomes such
as failure rates. Training, costs, and equipment maintenance may
be important factors in deciding which method to choose.
Use
of Prostate-specific Antigen (PSA) to Measure Semen Exposure Resulting
from Male Condom Failures: Implications for Contraceptive Efficacy
and the Prevention of Sexually Transmitted Disease (research
abstract)
Eight hundred and thirty couples enrolled in this condom efficacy
study. They were asked to collect a baseline sample of ejaculate
from the inside of the first study condom they used and to collect
a postcoital vaginal sample whenever a study condom broke or slipped
off during intercourse. All samples were quantitatively tested for
prostate-specific antigen (PSA), a substance found only in human
semen. The PSA results indicated an 80% reduction in semen exposure
compared to baseline levels (p = 0.0001). The results suggest that
even condoms that fail reduce the risk of pregnancy and the transmission
of sexually transmitted disease compared to unprotected intercourse.
The
Combined Contraceptive Vaginal Ring, NuvaRing(R): An International
Study of User Acceptability (PubMed abstract)
Women completed a questionnaire about the ring's clarity of instructions,
ease of use, sexual comfort, cycle-related characteristics, and
satisfaction after 3, 6, and 13 cycles of use. At baseline, 66%
of participants preferred oral contraceptives, but after three cycles
of ring use, 81% preferred the ring. On study completion, 97% agreed
that the instructions for use were clear; 85% of women and 71% of
their partners never/rarely felt the ring during intercourse, and
94% of partners never/rarely minded that the woman was using the
ring.
Immediate
Post-partum Insertion of Intrauterine Devices (Cochrane Review)
The reviewers concluded that the immediate post-partum insertion
of IUDs appeared safe and effective, though direct comparisons with
other insertion times were lacking. Advantages of immediate post-partum
insertion include high motivation, assurance that the woman is not
pregnant, and convenience. However, expulsion rates appear to be
higher than with interval insertion. The popularity of immediate
post-partum IUD insertion in countries as diverse as China, Mexico,
and Egypt support the feasibility of this approach.
Differences
in the Use of Combined Oral Contraceptives Amongst Women With and
Without Acne (research abstract)
Using the General Practice Research Database, utilization patterns
of cyproterone acetate combined with ethinyl estradiol (CPA/EE)
and conventional oral contraceptives were compared in women aged
15-39 years, with or without acne, hirsutism, or polycystic ovary
syndrome (PCOS). Between 1994 and 1998, CPA/EE accounted for an
increasing proportion of all OC use. The proportion of CPA/EE prescribed
to women with acne declined between 1994 and 1998, whereas that
prescribed to women with PCOS remained constant.
Effectiveness
of the Yuzpe Regimen of Emergency Contraception by Cycle Day of
Intercourse: Implications for Mechanism of Action (PubMed abstract)
This study shows results of an analysis that included eight studies
that present the number of women treated and outcome of treatment
by cycle day of unprotected intercourse relative to expected day
of ovulation. In 36 of the 45 pairs of estimates of effectiveness,
based on separate and combined study results and conception probabilities
by cycle day, effectiveness was higher when intercourse occurred
on or before the second day before ovulation (day -2) than when
it occurred later. When data were stratified by whether intercourse
occurred on or before the day before ovulation (day -1), effectiveness
was greater when intercourse occurred early.
The
Effects of Seven Monophasic Oral Contraceptive Regimens on Hemostatic
Variables: Conclusions from a Large Randomized Multicenter Study
(PubMed abstract)
In this multicenter, randomized, comparative study, 707 healthy,
nonsmoking, nulliparous women were treated for six cycles with one
of seven monophasic oral contraceptives. All noted changes in hemostatic
variables were within the normal range and have not been associated
with an increased risk of venous thromboembolic event (VTE). The
authors noted, however, that raised levels of these variables are
associated with prothrombotic states such as pregnancy.
NP-1,
a Rabbit -Defensin, Prevents the Entry and Intercellular Spread
of Herpes Simplex Virus Type 2 (research abstract)
Related news article: Rabbit
Protein Fights Herpes in Cells
A new study reveals a germ-fighting protein made by rabbit immune
cells can prevent genital herpes infections nearly 100% of the time
in human and monkey cells.
FAMILY PLANNING / REPRODUCTIVE HEALTH NEWS
UK:
Explosion of Sex Infections Overwhelms Health Service (news
article)
Soaring rates of sexually transmitted infections are overwhelming
the NHS and threatening the health of a generation of young people.
Many
Underestimate Partner's Past Sex History (news article)
New research shows that people tend to underestimate their partner's
sexual experience and overestimate how well a long-term relationship
protects them from sexually transmitted diseases.
FDA
to Consider Birth Control Pills that Suppress Menstruation (news
article)
The FDA is considered likely to approve a birth control pill that
reduces a woman's menstrual cycles from 13 to four a year.
Company
Relaunches Today Sponge in Canada (news article)
Allendale Pharmaceuticals Inc., of Allendale, New Jersey, has begun
marketing the Today Sponge contraceptive in Canada, 8 years after
the product was withdrawn from the US market.
Experts
to Police Sexual Health Strategy (news article)
The new Independent Advisory Group on Sexual Health and HIV will
monitor progress and advise the government on its national plan
to tackle England's steep rise in cases of sexually transmitted
infections.
Latex
Condoms Have Slight Edge for Pregnancy Rates (news article)
Researchers find that although pregnancy rates for both types of
condoms were close (similar to that of other barrier methods of
protection such as a diaphragm) the latex condoms had a 4% higher
protection rate.
HIV / AIDS RESEARCH
Variability
in the Incidence of Human Immunodeficiency Virus, Hepatitis B Virus,
and Hepatitis C Virus Infection among Young Injecting Drug Users
in New York City (research abstract)
Cohort studies of young injecting drug users in the Harlem and Lower
East Side were used for this study. The authors found that HIV incidence
was low: 0.8/100 person-years at the Harlem site and 0/100 person-years
at the Lower East Side site. In contrast, HBV incidence was moderate
(12.2/100 person-years) at the Harlem site and high (30.7/100 person-years)
at the Lower East Side site. Similarly, HCV incidence was moderate
(9.3/100 person-years) at the Harlem site and high (34.0/100 person-years)
at the Lower East Side site, showing there is no strong correlation
between HBV, HCV, and simultaneous HIV infection.
Human
Immunodeficiency Virus (HIV) Seropositivity among Uninfected HIV
Vaccine Recipients (research abstract)
To determine the frequency of vaccine-induced HIV antibody among
uninfected HIV vaccine trial participants and to identify factors
associated with these results, serum samples from HIV-uninfected
participants from selected phase I/II HIV-1 vaccine trials were
tested with 6 serologic screening tests. 20.4% reacted on at least
1 serologic test, and 13% were determined to be positive by Western
blot. The potential for vaccine recipients being misclassified as
HIV infected increased with vaccine complexity.
A
Multicenter Randomized Controlled Trial of Nevirapine Versus a Combination
of Zidovudine and Lamivudine to Reduce Intrapartum and Early Postpartum
Mother-to-Child Transmission of Human Immunodeficiency Virus Type
1 (research abstract)
HIV-infected pregnant women were screened at 11 maternity health
institutions in South Africa and were enrolled in an open-label
short course ARV regimen of either nevirapine (Nvp) or multiple-dose
zidovudine and lamivudine (Zdv/3TC). The overall estimated HIV-1
infection rates in 1307 infants by 8 weeks were 12.3% for Nvp and
9.3% for Zdv/3TC. The results confirm the efficacy and safety of
short-course ARV regimens in reducing mother-to-child transmission
rates in developing countries.
Cost
and Cost-effectiveness of HIV/AIDS Prevention Strategies in Developing
Countries: Is There an Evidence Base? (research abstract)
This paper reviews the cost and cost-effectiveness evidence base
of HIV/AIDS prevention programmes in low- and middle-income countries
(LMICs). After reviewing relevant literature, the authors conclude
that the extent to which the available cost and cost-effectiveness
evidence base on HIV/AIDS prevention strategies can provide guidance
to decision-makers is limited.
HIV / AIDS NEWS
USAID
to Review Research on African AIDS Pandemic (news article)
The US Agency for International Development announced that it plans
to review research published in the International Journal of STD
and AIDS that suggested contaminated needles used for vaccinations
and medical treatment are more to blame for Africa's AIDS pandemic
than heterosexual sex.
Kenya:
Health Ministry to Give Out Six Million Condoms (news article)
The Ministry of Health will distribute six million condoms in market
places in Nakuru District to help contain the spread of HIV/AIDS.
AIDS
Therapy: 48-week Study Results Presented Comparing 908 to Nelfinavir
(news article)
Study results were presented at the 10th Conference on Retroviruses
in Boston. In the trial, 66% of 166 HIV-positive patients achieved
an undetectable viral load (vRNA) with 908, compared to 51% of patients
taking nelfinavir.
AIDS
Panic at Botswana School (news article)
A senior nurse has been suspended after using a single needle to
vaccinate 83 schoolchildren in northwestern Botswana.
MATERNAL AND CHILD HEALTH RESEARCH
Perinatal
and Neonatal Mortality and Morbidity in Iraq (research abstract)
Related news article: Perinatal
Mortality in Iraq More Than Tripled Since Sanctions
More than 3000 children are dying every week in Iraq as a result
of the decade long embargo that was enforced on the country after
its invasion of Kuwait, according to a new report.
Association
of Maternal Caffeine Consumption with Decrements in Fetal Growth
(research abstract)
2,291 mothers were evaluated after their first prenatal visit and
were questioned about caffeine consumption and possible confounders.
Mothers were followed throughout pregnancy to monitor changes in
consumption and pregnancy outcomes were obtained from medical records.
The small decrease in birth weight, attributable to maternal caffeine
consumption, is unlikely to be clinically important except for women
consuming more than 600 mg of caffeine daily (approximately six
10-ounce cups of coffee).
Urinary
Incontinence after Vaginal Delivery or Cesarean Section (research
abstract)
Related news article: Delivery,
Not Pregnancy, Causes Incontinence
Women who give birth by Cesarean section are far less likely to
develop bladder control problems later in life than those who deliver
the old-fashioned way.
Exposure
to Air Pollution During Different Gestational Phases Contributes
to Risks of Low Birth Weight (research abstract)
The authors evaluated the relationships between LBW and air pollution
exposure levels in Seoul, Korea. Using the air pollution data, exposure
during each trimester and also during each month of pregnancy was
estimated on the basis of the gestational age and birth date of
each newborn. The monthly analyses suggested that the risks for
LBW tended to increase with carbon monoxide (CO) exposure between
months 2-5 of pregnancy, with exposure to particles <10 µm
in months 2 and 4, and for sulphur dioxide (SO2) and nitrogen dioxide
(NO2) exposure between months 3-5.
The
Effect of Dual Infection with HIV and Malaria on Pregnancy Outcome
in Western Kenya (PubMed abstract)
Data on obstetric and neonatal characteristics, maternal and placental
parasitaemia, and postpartum haemoglobin levels were collected from
women enrolled in a cohort study of the interaction between malaria
and HIV during pregnancy. Malaria was associated with both intrauterine
growth retardation and preterm delivery, resulting in a reduction
in mean birthweight of 145 g among HIV-seronegative and 206 g among
HIV-seropositive primigravidae.
Multiple
Micronutrient Supplementation During Pregnancy Does Not Lead to
Greater Infant Birth Size Than Does Iron-only Supplementation: A
Randomized Controlled Trial in a Semirural Community in Mexico
(research abstract)
Pregnant women (n = 873) were recruited before 13 wk of gestation
and received supplements 6 d/wk at home, as well as routine antenatal
care, until delivery. Both supplements contained 60 mg Fe, but the
multiple micronutrient (MM) group also received 1-1.5 times the
recommended dietary allowances of several micronutrients. In intent-to-treat
analyses, mean birth weight (2.981 ± 0.391 and 2.977 ±
0.393 kg in the MM and iron-only groups, respectively) and birth
length (48.61 ± 1.82 and 48.66 ± 1.83 cm in the MM
and iron-only groups, respectively) did not differ significantly
between the groups.
Infant
Sleeping Position and the Risk of Sudden Infant Death Syndrome in
California, 1997-2000 (research abstract)
Related news story:
Higher SIDS Risk Found in Infants Placed in Unaccustomed Sleeping
Position
Infants accustomed to sleeping on their backs who are then placed
to sleep on their stomachs or sides are at an increased risk for
SIDS.
MEN'S HEALTH RESEARCH
Beyond
Stereotypes of Brazilian Male Sexuality: Qualitative and Quantitative
Findings from São Paulo, Brazil (research abstract)
The findings of this study show evidence for some aspects of traditional
stereotypes, but also evidence of more gender-liberal and sexually
monogamous traits among many men in São Paulo. The authors
recommend care be taken against over-generalization regarding male
sexuality in Brazil.
Effect
of Diltiazem and Methylene Blue on Human Sperm Motility, Viability
and Cervical Mucus Penetration: Potential Use as Vas Irrigants at
the Time of Vasectomy (research abstract)
Related press release: Researchers
Identify Candidates to Help Speed Up Time to Vasectomy Success
Two chemicals already commonly used in the medical field also effectively
inhibit sperm function, a new study confirms. This makes them good
candidates to both inhibit and help wash away residual sperm after
a vasectomy, which could decrease the time between vasectomy and
sterility.
Changes
in Semen Quality in Jerusalem Between 1990 and 2000: A Cross-sectional
and Longitudinal Study (research abstract)
A total of 2638 male partners in couples that underwent treatment
by intrauterine insemination participated in this cross-sectional
investigation. A significant downward trend in sperm count and motility
was observed.
Sexual
Behavior and Sexually Transmitted Infections in Men Living in Rural
Madagascar: Implications for HIV Transmission (PubMed abstract)
Of 401 men evaluated in this cross-sectional study, 6.5% had used
a condom and 45.6% reported having multiple partners in the previous
3 months. Symptoms of urethritis during the previous 7 days were
reported by 128 men (31.9%). The authors conclude that several risk
factors for HIV propagation exist in the studied rural areas in
Madagascar and that young men in particular should be targeted for
HIV/STI prevention.
Teaching
Testicular Self-Examination: Education and Practices in Pediatric
Residents (research abstract)
Related news article: US
Study Finds Testicular Exams Lagging
Less than half of US pediatricians teach patients how to examine
their testicles, even though testicular cancer is the most common
malignancy for young men.
MEN'S HEALTH NEWS
Smoking
Linked to Impotence (news article)
Men who smoke more than a pack of cigarettes a day had a 60 percent
higher risk of impotence than those who never smoked, according
to new research presented at an American Heart Association conference
in Miami.
A
Doctor Fights for New Warnings on Viagra Labels (feature article)
Two years ago, Dr. Klausner, San Francisco's director of sexually-transmitted-disease
prevention, began to wonder whether Pfizer Inc.'s impotence drug
was contributing to unsafe sexual behavior and fueling a rise in
AIDS and other diseases. Now, he insists, he has his answer. Since
last year, 43 new cases of syphilis and 14 new HIV infections have
been diagnosed in Viagra users in San Francisco.
POPULATION RESEARCH
Migration
as a Source of Growth: The Perspective of a Developing Country
(research abstract)
This paper analyses the dynamics of migratory flows and growth in
a developing economy. Worker mobility can have an expansionary effect
on the developing economy. The authors show that in the long-run,
as the sending economy develops, fewer natives are likely to emigrate
and more migrants are likely to return.
Self-Assessed
Health Expectancy Among Older Asians: A Comparison of Sullivan and
Multistate Life Table Methods. 
(research abstract)
This paper estimates expectancies in self-assessed health and compares
these among older adults across four Asian settings (the Philippines,
Taiwan, Singapore, and Indonesia). Results suggest that despite
differences in the proportion reporting negative health across settings,
patterns by age and sex are similar.
POPULATION NEWS
World
Seen Straining to Double Food Output by 2050 (news article)
The world will need to double food output in the next 50 years to
feed a fast-growing population, but water shortages and China's
likely dependence on grain imports will intensify competition for
supplies.
Pakistan:
Population Could Rise by 3.9%
The population welfare ministry has failed to evolve a mechanism
to tighten controls on the spiraling population that is swelling
up to 282.4 million by 2020.
Auckland
Growth Issues: Population Policy Needed (press release)
The ongoing urban sprawl issue in Auckland highlights the need for
a population policy and an effective Sustainable Development Strategy.
WOMEN'S HEALTH RESEARCH
Parallel
Observation of Four Methods for Screening Women Under 25 Years of
Age for Genital Infection with Chlamydia Trachomatis (PubMed
abstract)
The authors compared four methods of screening women for Chlamydia
trachomatis. Each underwent parallel testing of endocervical specimens
by enzyme immunoassay (EIA) and ligase chain reaction (LCR), vulval
swabs by LCR, and urine by LCR. Both urine and vulval swab methods
were highly sensitive, acceptable, and not affected by pregnancy
status. The authors write that, due to pragmatic issues surrounding
the urine method, screening by vulval swabs deserves wider recognition.
Sexual
Behavior of Older Women: Results of a Random-Digit-Dialing Survey
of 2000 Women in the United States (PubMed abstract)
This study involved a random-digit-dialing survey (N = 2000) of
women aged 18-94 years living in the continental United States.
Researchers found that frequency and occurrence of sexual activity
decreased with age and that married women in every age group were
more likely to have engaged in recent sexual activity. Condom use
decreased, and lubricant use increased, with age.
WOMEN'S HEALTH NEWS
South
Africa: The Home Most Common Place for Abuse (news article)
As women around the world prepared to mark International Women's
Day, a survey conducted in South Africa has shown that the home
is the most common place for abuse against women. The survey, published
by the Institute for Security Studies, found that half the women
who experienced economic, emotional, and physical abuse said the
perpetrator was a spouse or partner.
African
Women Cry Out for Condoms on Women's Day (news article)
The average African women gives birth to six children during her
life, but she'd gladly use contraceptives to lower that number.
YOUTH HEALTH RESEARCH
Feelings
About Risk and the Epidemic Diffusion of Adolescent Sexual Behavior
(PubMed abstract)
This research examined the initiation of sexual behavior in adolescents
living in high-poverty urban environments. The authors found that
adolescents with less favorable feelings toward sex were less susceptible
to the diffusion of sexual initiation and those with more favorable
feelings toward condoms were more likely to use them consistently.
PROFILES / SPECIAL REPORTS / RESOURCES
Double
Standards: Women's Property Rights Violations in Kenya
(report)
Related press release: Women
Stripped of Property in Kenya
Women throughout Kenya lose their homes, land, and other property
due to discriminatory laws and customs. Property rights abuses in
sub-Saharan Africa perpetuate women's inequality, doom development
efforts, and undermine the fight against HIV/AIDS, according to
this new report.
A
Framework To Identify Gender Indicators For Reproductive Health
and Nutrition Programming
(report)
This paper introduces a framework developed for incorporating gender
into the design and evaluation of Population, Health, and Nutrition
(PHN) programs and provides a large set of examples as a tool for
PHN program planners. The focus is at the level of interventions,
not changes in behavior or health status at the population level,
such as would be measured in a Demographic and Health Survey.
AIDS
in Ethiopia
(Fourth Edition) (report)
This edition is an update on the current information available on
the HIV/AIDS situation in Ethiopia. The database upon which this
edition is based has doubled in the past year. The third edition
of "AIDS in Ethiopia" (2000) used 15 surveillance sites.
The
current version is based on data from 34 sites, of which 28 are
urban sites and 6 are rural sites.
Stop
AIDS Love Life in Ghana "Shatters the Silence"
(report)
Client-centered
quality : clients' perspectives and barriers to receiving care
(report)
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