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Volume 3, Number 12
24 March 2003
FAMILY PLANNING / REPRODUCTIVE HEALTH LAW AND POLICY
US:
House Reaches Deal on Fighting AIDS (news article)
House lawmakers have agreed on a $15 billion package to fight the
global AIDS epidemic, compromising on how the money will be used.
US: Senate Panel Delays Africa AIDS Bill (news article)
The Senate Foreign Relations Committee yesterday delayed plans to
consider a bill that would finance efforts to prevent and treat
AIDS worldwide because top Republicans and the White House say it
does not adequately promote abstinence over condom use.
Generating
Political Will for Safe Motherhood in Indonesia (PubMed abstract)
Drawing from literature on agenda setting, this paper identifies
four factors that heighten the likelihood that an issue will rise
to national-level attention and uses Indonesia as a case study to
highlight these factors.
FAMILY PLANNING / REPRODUCTIVE HEALTH RESEARCH
New
Progestogens (research abstract)
A review of technical papers and available trials to ascertain efficacy,
bleeding patterns and tolerability, metabolic characteristics and
receptor binding affinities of the newer progestogens. Progestogen-only
products using new progestogens have potential for significantly
better tolerability due to their lack of androgenic activity.
Factors
Associated with Oral Contraceptive Discontinuation in Rural Bangladesh
(research abstract)
This paper identifies factors associated with discontinuation of
OC use, where discontinuation refers to cessation of OC use in the
6 months prior to the survey. The data for this study were drawn
from a survey on OC compliance in rural Bangladesh. A total of 1600
OC users, current or past, aged 15 to 49 years were interviewed;
of these, 36% discontinued OC use. Of the women who discontinued,
47% reported the experience of side-effects as the main reason for
OC discontinuation. Multivariate analysis identified lack of fieldworker's
visit as the strongest predictor of OC discontinuation; women who
were not visited by fieldworkers had a four-fold risk of discontinuing
OC use. About 70% of the women who were at risk of unintended pregnancy
were not using any method of contraception following OC discontinuation.
Husband's education was positively associated with the substitution
of OCs with another contraceptive method. about 70% of the women
who were at risk of unintended pregnancy were not using any method
of contraception following OC discontinuation. Husband's education
was positively associated with the substitution of OCs with another
contraceptive method.
The
Comparison of Reproductive Health Data in a Rural District in Turkey
(1981-2001) (PubMed abstract)
The authors compared new reproductive and family planning data with
data from the 1981 survey by interviewing all 15-49-year-old married
women living in seven villages of Gemlik and comparing the data
with the 1981 data of the same villages. In 1981, 66.8% used a family
planning method, 6.8% used an intrauterine device, 10.2% used oral
contraceptives, and 10% used condoms. In 2001, these values were
93%, 36.5%, 6%, and 14.8%, respectively. Coitus interuptus was used
by 51.5% in 1981 and by 35.5% in 2001. In 20 years, users of both
current family planning methods and modern methods have increased;
users of traditional methods have decreased.
Implantable
Contraceptives for Women (review abstract)
This review outlines the evidence accumulated on implantable contraceptives
to date. A large body of evidence demonstrates the high contraceptive
effectiveness and safety of the 5-year levonorgestrel-releasing
implants Norplant and Jadelle. Information on the 3-year etonogestrel-releasing
implant Implanon is more limited, but suggests that this implant
has a high contraceptive effectiveness and a satisfactory safety
profile. Information available on levonorgestrel-releasing implants
manufactured and approved in China suggests that their clinical
performance is satisfactory, but was insufficient to allow their
full safety assessment. For all implants, there is insufficient
information on their use by women with medical conditions.
"If
They Don't Ask About Condoms, I Just Tell Them": A Descriptive
Case Study of Latino Lay Health Advisers' Helping Activities
(research abstract)
This article is to report the results of a component of a larger
evaluation of an LHA program for preventing HIV/AIDS among recently
immigrated Mexicans in North Carolina.
Current
Issues in Screening for Chlamydia Trachomatis (research abstract)
This article discusses major research findings related to chlamydial
sc-reening from the past several years and suggests areas in which
additional research is needed.
Relationship
Between Steroid Hormone Contraceptives and HPV, Cervical Intraepithelial
Neoplasia and Cervical Carcinoma (research abstract)
Available data demonstrate an increase in the transcription of high-risk
papillomaviruses by the 16(alpha)-hydroxylation of estrogens, which
is in line with the epidemiologic data showing an increased cervical
carcinogenesis risk for long-term contraceptive-using, HPV-infected
women. No evidence exists for an increase in HPV-negative contraceptive
users.
FAMILY PLANNING / REPRODUCTIVE HEALTH NEWS
Ethiopia:
Call for Better Family Planning to Stop Food Aid Dependency
(news article)
An aggressive family planning campaign could help curb massive food
shortages, the UN's Emergencies Unit for Ethiopia (EUE) said recently.
It said it was worth considering how a "reward and punishment"
system could be used to implement family planning strategies and
tackle the deepening recurrent food crises.
Morning-After
Pill Curbs Pregnancy, Not Condom Use (news article)
Teen mothers given a supply of emergency contraception--also known
as the "morning after pill"--have fewer pregnancies and
are no less likely to use condoms, according to new research findings.
South
Africa: State to Create Condom Brand (news article)
The department of health is planning to create a brand for the millions
of free condoms its distributes annually to counter perceptions
they are inferior to their commercially packaged equivalents.
Gel
May Be Sexual Disease Barrier (news article)
Human trials on a vaginal gel that may prevent the transmission
of HIV and other sexual diseases could begin in Melbourne within
months after successful animal trials. The gel was developed by
scientists at Melbourne company Starpharma. It has just been tested
successfully on monkeys by researchers at the University of Washington.
HIV / AIDS RESEARCH
Introduction
of a HIV Vaccine in Developing Countries: Social and Cultural Dimensions
(PubMed abstract)
Using insights from studies on social and cultural aspects of immunization
in Africa and Asia, this paper discusses the introduction of a HIV
vaccine from three perspectives. For successful introduction of
HIV in developing countries, it recommends tailoring of health education
and social marketing to local conditions and local interpretations
of globally provided information. Strong public health programs
with highly motivated and appropriately supported staff are another
necessary condition.
HIV
Knowledge and Risk Behaviors Among Pakistani and Afghani Drug Users
in Quetta, Pakistan (research abstract)
The authors studied HIV knowledge and risk behaviors among 959 male
Pakistani and Afghani drug users between July and November 2001.
None of the sexually active Afghanis had ever used a condom compared
with 5% of the Pakistanis (p=.01). Only 4.3% of Afghans had ever
heard of HIV/AIDS compared with 18.3% of Pakistanis (p<.001).
The authors concluded that interventions to prevent transition to
injection, needle exchange, and drug treatment are urgently required
to prevent blood-borne infections.
HIV / AIDS NEWS
HIV/AIDS
Can 'Empty' Namibia in a Decade (news article)
A Namibian politician has said that Namibia could be "empty"
in a decade if the government fails to take drastic steps to reduce
the number of people dying from the HIV-AIDS pandemic. He was referring
to statistics on a recent assessment of the impact of HIV/AIDS on
the municipalities of Ongwediva, Oshakati, Swakopmund, Walvis Bay
and Windhoek. The report also says Namibia's crude death rate is
expected to "more than triple due to AIDS."
India's
anti-AIDS Drugs Look for More Takers
Y.K. Hamied, chairman of Indian drug firm Cipla, is upset there
are few takers for his dirt-cheap triple drug cocktail to combat
AIDS symptoms. "The sad thing is that in 2001 there were 10,000
patients in Africa on the cocktail but two years later there are
only 34,000...when there are millions suffering."
New
Clues Emerge on How HIV Evades Antibodies (news article)
Scientists in the US said they had found a new way in which the
virus that causes AIDS manages to evade the body's immune system.
In a report in the journal Nature, researchers from the Howard Hughes
Medical Institute at the University of Alabama said
that HIV, the virus that causes AIDS, uses a previously unknown
strategy to evade the human antibodies that attack invading viruses
and bacteria.
Clues
to How Men Exposed to HIV Stay Virus-free (news article)
Men who sleep with HIV-positive women but remain disease-free carry
relatively high levels of antibodies that specifically fight HIV
infection in the tissue that first comes in contact with the virus,
according to researchers. These antibodies may help protect people
exposed to the virus from becoming infected.
UN Report Rejects African AIDS Data (news article)
The primary UN agencies responsible for combating AIDS rejected
evidence in a British medical journal that poor medical hygiene
practices are responsible for most HIV infections in Africa. The
World Health Organization and UNAIDS made the conclusion yesterday
during a meeting in Geneva called to review articles published this
month in the British Royal Society of Medicine's International Journal
of STD & AIDS.
Swaziland:
King's Polygamy Remarks Condemned (news article)
King Mswati III has become embroiled in controversy over statements
he made that the custom of polygamy did not contribute to the spread
of HIV/AIDS, contradicting studies that have established a connection.
MATERNAL AND CHILD HEALTH RESEARCH
Advancing
the State of the World's Newborns 
(commentary)
This article reviews the current state of maternal and neonatal
health worldwide and recommends four key ingredients to achieve
lasting and measurable gains: serious political commitment, a strong
focus on the neonate, realistic and efficient allocation of resources,
and effective implementation with clearly defined supervision.
Infant
Survivorship and Occurrence of Multiplebirths: A Longitudinal Community-based
Study, South West Ethiopia
(research article)
A one year live-birth cohort was studied in 46 urban and 64 rural
'kebeles' in southwest Ethiopia in 1992-1994. There were a total
of 8162 births (8050 singletons, 111 twins and one set of triplets)
of which 856 died, indicating an infant mortality of 104.8/1000
(estimated probability of surviving to 1 year 0.8952, with se 0.004).
The occurrence of multiple -births was 13.6/1000 live births. The
infant mortality among them was 446.8/1000 (estimated probability
of surviving to 364 days 0.5532, with se 0.0034). The authors state
that this study is the first of its kind based on rigorous study
design, larger sample size comprising different population groups,
and wider areas.
Mothers'
Health Services Utilization and Health Care Seeking Behavior During
Infant Rearing: A Longitudinal Community Based Study, South West
Ethiopia
(research article)
This was a longitudinal, community-based study consisting of a cohort
of 8273 live births, their mothers, and families between September
1992 and October 1994 in rural and urban settings in Southwest Ethiopia.
Mothers were interviewed for their health care utilization during
pregnancy and delivery. Mothers' health seeking behavior for ill
babies at the various levels of care showed that less than 50% of
diarrhea, cough, fever, and other illnesses received treatment in
health institutions.
MATERNAL AND CHILD HEALTH NEWS
China:
Stay-at-home Mothers Now Seem Trendy (news article)
As Chinese parents pay more attention to family planning and the
well-being of their only child, a number of white-collar females
in major cities have become stay-at-home mothers so that they can
devote themselves to child rearing.
MEN'S HEALTH RESEARCH
Sexually
Transmitted Diseases in Men Who Have Sex with Men: An Epidemiologic
Review (research abstract)
The rising STD rates and relapses in high-risk sexual behaviors
in men who have sex with men (MSM), both HIV-infected and uninfected
MSM, have profound implications for public health and the clinical
management of these patients. Clinicians should be aware of this
turn of events, and implement new screening and counseling guidelines
that have been issued in response to these alarming reports of loss
of fear of acquiring and transmitting HIV, an increase in high-risk
sex, decreased use of condoms, and a resurgence of gonorrhea and
syphilis in this population.
Sexually
Transmitted Diseases in Men Who Have Sex with Men: A Clinical Review
(research abstract)
This review focuses on recent developments in the epidemiology,
pathogenesis, diagnosis, and management of common STDs in MSM.
Validation
of a Urine-Based PCR-Enzyme-Linked Immunosorbent Assay for Use in
Clinical Research Settings to Detect Trichomonas Vaginalis in Men
(research article)
Related news article: The
Urine-based PCR-ELISA May be Useful for Detection of Trichomoniasis
in Men
Trichomonas vaginalis infection is highly prevalent worldwide and
is associated with urethritis, prostatitis, and urethral strictures
in men. However, the natural history and importance of T. vaginalis
in men are poorly understood, in part because of difficulties in
diagnosing infection. For clinical research settings in which urethral
swabs are not available and culture is not feasible, the urine-based
PCR-ELISA may be useful for detection of trichomoniasis in men.
Safety
and Acceptability of the Reality(TM) Condom for Anal Sex Among Men
Who Have Sex with Men (research abstract)
The objective of this study was to assess safety and acceptability
of Reality(TM) condoms for anal sex among men who have sex with
men. Men reported more frequent problems with Reality condoms than
male latex condoms used for anal intercourse, particularly slippage,
discomfort, and rectal bleeding. It was concluded that design modifications,
training, and research on the clinical significance of safety outcomes
are needed for use of Reality condoms with anal sex.
A
Short-term Evaluation of Semen and Accessory Sex Gland Function
in Phase III Trial Subjects Receiving Intravasal Contraceptive RISUG
(PubMed abstract)
Following the intravasal injection of a new male contraceptive RISUG
(reversible inhibition of sperm under guidance) in volunteers, routine
semen analysis, semen biochemistry, and germ cell morphology were
evaluated in comparison with the corresponding preinjection samples
for a maximum period of 6 months. No pregnancy was reported in these
subjects during the study period. Based on the above findings, the
authors concluded that at least for the present study period, RISUG,
a new male contraceptive, is effective as a partially occluding
agent in the vas deferens.
MEN'S HEALTH NEWS
Clues
to How Men Exposed to HIV Stay Virus-Free (news article)
Men who sleep with HIV-positive women but remain disease-free carry
relatively high levels of IgA antibodies that specifically fight
HIV infection in the tissue that first comes in contact with the
virus. These antibodies may help protect people exposed to the virus
from becoming infected. Adapting this natural defense system could
one day lead to a vaccine that prevents HIV altogether.
POPULATION RESEARCH
Global
Population and Water
(report)
Related press release: Investments in Reproductive Health Can Reduce
Water Insecurity, Says UNFPA Report
http://www.unfpa.org/news/2003/pressroom/water.htm
Population growth is a driving factor in the world's growing water
crisis. Under current trends, two thirds of the world's population
may face moderate to high water shortages in 2025. Investments in
reproductive health, including family planning, can help slow population
growth and reduce water insecurity, according to a new report.
POPULATION NEWS
UN
Projects Slower Population Growth (news article)
Related editorial: Humanity's
Slowing Growth
According to a UN report issued recently, most advanced countries
could, in effect, slowly turn into old-age homes. For example, by
2050, the median age in Japan and Italy will be over 50. Fertility
rates in nearly all well-off countries have already fallen below
2.1 babies per woman, the rate at which a population remains stable.
In the developing world, fertility rates average three children,
down from six a half-century ago, and the UN projects that the rate
will dip below the replacement level in most poor countries later
this century.
Resisting
Birth Control, the Philippines Grows Crowded (news article)
The population in this overwhelmingly Roman Catholic country has
doubled in the last half-century, to 80 million, and could double
again in less time than that. Under the influence of the powerful
church, the Philippine government has done little to curb population
growth and has taken a stand against modern methods of birth control.
WOMEN'S HEALTH RESEARCH
Turkish
Women's Satisfaction with Family Planning Services (PubMed abstract)
This study included 406 women who were selected by random sampling
from the population who used current family planning methods. Data
were collected using the satisfaction with family planning services
scale from April to June 2002. Women were reasonably satisfied with
family planning services. This study provided a standardized scale
of women's satisfaction with family planning services.
Frequency
and Predictive Value of a Mammographic Recommendation for Short-Interval
Follow-Up (research abstract)
Related news article: Study Questions Mammogram Protocol
A new study challenges the medical protocol of advising women whose
mammograms show questionable-but-benign lumps to return for follow-up
examinations. Nearly all such women fail to develop breast cancer
from such lumps, researchers said.
Human
Papillomavirus Infection Among Women in South and North Vietnam
(research abstract)
Major risk factors for HPV DNA detection were indicators of sexual
habits, most notably the presence of HSV-2 antibodies, and the current
use of oral contraceptives. Women in Hanoi showed the lowest HPV
prevalence ever reported so far, suggesting that HPV has not spread
widely in this population. As expected, HPV prevalence in a population
seemed to be closely correlated with invasive cervical carcinoma
incidence rates.
Advances
in Cervical Cancer Management from North American Cooperative Group
Clinical Trials (PubMed abstract)
Related news article: Cervical
Cancer: Underdeveloped Countries Lack Effective Screening
Despite effective screening methods for detecting premalignant diseases
of the cervix, cervical cancer remains a leading cause of cancer
mortality in women globally.
WOMEN'S HEALTH NEWS
Vaginal
Ring Gets US Approval (news article)
The US Food and Drug Administration (FDA) approved a vaginal estrogen
ring to treat hot flashes and other menopausal symptoms. Femring,
a slow-release intravaginal hormone replacement treatment, will
go on sale in the United States in June after
getting the nod from the FDA.
Japan
Only Now Confronting Rising HIV Rate: Women in Sex Trade Most at
Risk (news article)
During 2002, Japan set new highs of reported AIDS cases with 301
new cases of AIDS and 595 cases of HIV infection. Health experts
predict the number of infected adults nationwide will jump to as
many as 50,000 by 2010 because of a booming sex trade, declining
condom use, increased sexual activity among young people, the lack
of an effective government AIDS awareness program, and the low status
of women in Japanese society.
YOUTH RESEARCH
Adolescents'
Contraceptive Use and Pregnancy History: Is There A Pattern?
(PubMed abstract)
To examine the association between pregnancy experience and adolescents'
contraceptive use, a retrospective study of 920 sexually active
adolescents not desiring pregnancy was conducted. A significant
proportion of adolescents were found to use noneffective methods
(ie, condoms inconsistently or no method) and, thus, are at risk
for repeat teenage pregnancies.
Can
the Internet be Used to Improve Sexual Health Awareness in Web-wise
Young People? (research abstract)
The authors assessed Internet use among young people to determine
whether it would be a practical way to provide sex education and
information. Students aged 14-15 years from North Nottinghamshire,
UK, schools participated in focus groups to discuss the Internet.
Researchers found that the Internet would be a practical and accessible
way of delivering sexual health education to young people, particularly
if it is incorporated into activities and websites they enjoy.
YOUTH NEWS
Morning-After
Pill Curbs Pregnancy, Not Condom Use (news article)
Teen mothers given a supply of emergency contraception--also known
as the "morning after pill"-- in this study in Los Angeles,
California were found to have fewer pregnancies, but were no less
likely to use condoms. These findings suggest that emergency contraception
may lower the rate of unwanted pregnancies without raising the risk
that women will substitute the method for others that protect against
sexually transmitted disease
US:
Parents Want More Say in Teens' Reproductive Health (news article)
Two thirds of parents are unaware that teens can give consent for
sexually transmitted disease treatment, and nearly half do not know
their children can obtain contraception without parental involvement,
according to a survey conducted in the states of Minnesota and Wisconsin.
US:
Teens' Confusion About Pap Test May Delay Care (news article)
Many teenage girls don't know the difference between a Pap smear
and a pelvic exam, a confusion that could lead them to put off necessary
gynecologic care.
World Body Gives a Mixed Report on Arab Children (news article)
Arab children have, on average, a higher chance of surviving birth
and living to see their 5th birthday than children in the rest of
the world, a new report has found. But Arab women have a lower chance
of surviving pregnancy and childbirth.
BOOKS / BOOK REVIEWS
The
Well-Being of the Elderly in Asia: A Four-Country Comparative Study
(book)
The Well-Being of the Elderly in Asia provides a comparative examination
of the welfare of the elderly and their sources of support across
four Asian societies that differ culturally and in terms of their
economic development.
WHO
Releases New Tool to Boost Access to Quality Medicines and Detect
Counterfeits (guidebook)
To improve the quality and efficacy of medicines, facilitate control
of counterfeit and substandard drugs and address problems of drug
resistance, the World Health Organization (WHO) releases a new edition
of the International Pharmacopoeia (IntPh). The IntPh provides specifications
for the content, purity and quality of active ingredients and pharmaceutical
products according to internationally approved standards. While
a practical tool for all settings, it is aimed especially at those
countries where national regulatory authorities may not have enough
funds or staff to function effectively.
PROFILES / SPECIAL REPORTS / RESOURCES
New
Online CIRE System Offers Latest Findings Related to Family Planning
Guidance (resource)
This online service offers access to new research findings potentially
relevant to World Health Organization's (WHO) international family
planning guidance. The service - Continuous Identification of Research
Evidence (CIRE) - is a collaborative effort of WHO's Department
of Reproductive Health and Research, the Centers for Disease Control
and Prevention, and the Johns Hopkins Bloomberg School of Public
Health's Center for Communication Programs (CCP).
The
Singapore Tuberculosis Elimination Programme: The First Five Years
(research
article)
This paper reviews The Singapore Tuberculosis Elimination Programme
(STEP), launched in 1997 because the incidence of the disease had
remained between 49 and 56 per 100 000 resident population for the
preceding 10 years.
"Without
My Consent": Women and HIV-Related Stigma in India
For millions of Indian women, sexual intercourse is not a question
of choice but rather one of survival and duty. Married before she
has grown beyond adolescence, her fertility and her relationship
to her husband are often the source of an Indian woman's social
identity, notes the study "Living Under a Shadow: Gender and
HIV/AIDS in Delhi".
AIDS
is Now Among the Most Devastating Diseases in Human History
(report)
Expanding and improving condom promotion and distribution are absolutely
vital to success in the fight against the spread of AIDS. Prevention
efforts that do not include condoms are therefore incomplete and
will ultimately be ineffective.
Asylum
for Abused Women (feature article)
Not every women who suffers domestic violence should be able to
escape to America. But some need to. The current rules offering
the possibility of asylum to those who cannot find safety at home
are both tough and humane. These rules are being reconsidered. Anti-immigrant
groups argue that if America grants refuge to those endangered by
private citizens, it will be flooded by asylum claims. Experience
says otherwise. After the United States decided to grant asylum
to women fleeing female genital mutilation, there was no increase
in claims on this basis.
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