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Volume 3, Number 16
21 April 2003
FAMILY PLANNING / REPRODUCTIVE HEALTH RESEARCH
Family Planning Providers' Perspectives on Dual Protection 
(research paper)
Through semistructured interviews in 1998, 22 health care providers from a large New York City agency offering contraceptive and STD services described how they balanced STD and pregnancy concerns, viewed risk assessment and assessed various contraceptive methods. The study concluded that training is needed to reduce providers' negative perceptions of the female condom and to reinforce the importance of individualized counseling tailored to women's specific circumstances. Studies are needed on how to encourage family planning providers to promote male and female condoms as effective contraceptive methods.
Evaluation of the Efficacy of a Nonlatex Condom: Results from a Randomized, Controlled Clinical Trial (research article)
In a prospective clinical trial conducted in 1998-2000, 830 monogamous couples were randomized in equal numbers to use either a nonlatex condom or a commercial natural latex condom for 6 months as their only method of birth control. Couples completed detailed reports for the first five condom uses and recorded intercourse and condom use. The nonlatex condom had a higher frequency of breakage or slippage during intercourse or withdrawal. The six-cycle typical-use pregnancy rate did not differ significantly between users of nonlatex and latex condoms The six-cycle consistent-use pregnancy rate was higher for nonlatex condom users than for latex condom users.
Factors Influencing the Choice to Use Modern Natural Family Planning (research abstract)
This article explores the reasons for discrepancies between the interest in modern methods of natural family planning (NFP) and their actual use in developed countries.
A Comparative Randomized Study of Three Different IUDs in Nulliparous Mexican Women (research abstract)
A prospective randomized, single-blind study comparing TCu 380 Nul and ML Cu 375 sl with the standard TCu 380 A, was carried out in 1170 healthy nulliparous women. Continuation rates at the end of the study for TCu 380 A, TCu 380 Nul and ML Cu 375 sl were 29.5%, 85.9%, and 85.4% respectively (p < 0.001). There were six pregnancies during the first 3 months of use, for a failure rate of 1% in the Tcu 380 A group, 0.5% in TCu 380 Nul, and no pregnancy in ML Cu 375 sl (p < 0.05).
Ortho Evra: A New Contraceptive Patch (PubMed abstract)
This article discusses the efficacy and adverse reactions of the new contraceptive patch and compares the safety/effectiveness profile to that of oral contraceptives. Adverse effects with Ortho Evra are similar to those reported with combined oral contraceptives, with the exceptions of mild-to-moderate application-site reactions and an increased frequency of breast symptoms. In clinical studies, the patch appeared to be less effective in women weighing more than 90 kg than in women with lower body weights. In two clinical trials, compliance was greater with the patch than with oral contraceptives.
Diaphragm Versus Diaphragm with Spermicides for Contraception (Cochrane Review)
Relevant electronic databases as well as unpublished studies were reviewed to compare the effectiveness, safety, and acceptability of the diaphragm with and without spermicide. Only one randomized controlled trial comparing women of reproductive age using the diaphragm with and without spermicide as the sole contraceptive method was found. No significant difference was found in the pregnancy rates (with typical use or consistent use) or discontinuation rates between the diaphragm-with-spermicide and diaphragm-without-spermicide groups. There was a trend towards higher pregnancy rates in the diaphragm-without-spermicide group.
Social and Behavioural Factors Associated with Condom Use Among Direct Sex Workers in Siem Reap, Cambodia (research abstract)
Using a structured behavioural questionnaire, interviews were conducted with 140 direct sex workers attending a health centre in Siem Reap, Cambodia. Consistent condom use with their clients was reported by 78% of sex workers compared to only 20% with their non-paying partners. Consistent condom use with clients was significantly higher among higher income than lower income sex workers (adjusted prevalence ratio: 1.91,) and those with good rather than poor negotiation skills (adjusted prevalence ratio: 1.51).
Comparison of STD Prevalences in the Mwanza, Rakai, and Masaka Trial Populations: The Role of Selection Bias and Diagnostic Errors (research abstract)
This paper evaluated the effects of diagnostic error and selection biases on STD prevalence estimates from three community randomised trials of STD treatment for HIV prevention in Masaka and Rakai, Uganda and Mwanza, Tanzania. Age and sex stratified prevalences of gonorrhoea, chlamydia, syphilis, HSV-2 infection, and trichomoniasis observed at baseline in the three trials were adjusted for sensitivity and specificity of diagnostic tests and for sample selection criteria. The authors found that STD prevalences were underestimated in all three populations because of diagnostic errors and selection bias.
FAMILY PLANNING / REPRODUCTIVE HEALTH NEWS
South Africa: Condom Billboard Ok, Says Authority (news article)
The Advertising Standards Authority (ASA) has ruled that a Love Life billboard for condoms does not breach the advertising code, despite objections from the Africa Christian Action (ACA) group.
Pill May Increase Pain After Wisdom Tooth Removal (news article)
Oral contraceptives increase the risk of infection and pain following the removal of wisdom teeth, according to research.
UK: Why are Sex Diseases Rising? (news article)
The number of people being diagnosed with sexually transmitted infections is now at record levels.
FAMILY PLANNING / REPRODUCTIVE HEALTH LAW AND POLICY
Bush Administration to Suggest Routine AIDS Testing Procedures (news article)
The nation's top public health doctor, declaring current AIDS prevention programs a major disappointment, announced the Bush administration will begin encouraging doctors to offer routine HIV testing to all their patients, especially pregnant women.
Outrage Over Gypsy Sterilization (news article)
The New York-based Center for Reproductive Rights and the Slovak Center for Civil and Human Rights raised the alarm in a joint report based on interviews last year with 230 women in 40 Gypsy settlements in eastern Slovakia.
Malaysia: No Family Planning Policy for Now (news article)
There is no plan by the government to launch any family planning policy for now. This is because Prime Minister Mahathir Mohamad's target for Malaysia's population to reach 70 million has yet to be reached, Women and Family Development Minister Datuk Seri Shahrizat Abdul Jalil said.
The Effect of Structural Characteristics on Family Planning Program Performance in Cote d'Ivoire and Nigeria (research abstract)
This paper uses Cote d'Ivoire and Nigeria survey data on both supply and demand characteristics to examine how structural and demographic factors influence family planning provision and cost. In both countries, vertical (exclusive family planning) facilities provide significantly more contraception than integrated medical establishments. In the Nigeria sample, larger facilities also offer services at lower average cost.
HIV / AIDS RESEARCH
Epidemiology: Controlling AIDS in Africa (research abstract)
Related news article: Scientists Say Sex the Main Source of HIV in Africa
Despite recent theories that the AIDS epidemic in some African countries arose from unsafe medical injections and blood transfusions, scientists say that the pattern of the disease matches more closely with one primarily spread by unprotected sex.
The UK investigators compared the changing rate of HIV in sub-Saharan African countries -- home to the most people infected with HIV -- to that of hepatitis C, a liver-attacking virus spread mainly through contact with infected blood.
Advancing HIV Prevention: New Strategies for a Changing Epidemic --- United States, 2003 (special report)
Related news article: CDC Announces New Strategy to Fight HIV in US
The CDC, in partnership with other US Departments of Health and Human Services agencies and other government agencies and nongovernment agencies, will launch a new initiative in 2003, Advancing HIV Prevention: New Strategies for a Changing Epidemic. The new initiative is aimed at reducing barriers to early diagnosis of HIV infection and increasing access to quality medical care, treatment, and ongoing prevention services. The HIV initiative emphasizes the use of proven public health approaches to reducing the incidence and spread of disease. As with other sexually transmitted diseases or any other public health problem, principles commonly applied to prevent disease and its spread will be used, including appropriate routine screening, identification of new cases, partner notification, and increased availability of sustained treatment and prevention services for those infected.
HIV Prevalence in Zimbabwean Women: 54-67% Knowledge and Perceived Risk (research abstract)
This study examined the level of knowledge of sexually transmitted infections (STI) and HIV, knowledge of symptoms and potential sequelae of STI and perceived personal risks of infection among urban women in Zimbabwe. Prevalence of both STI and HIV was high 11.4% and 54.5% among women aged 15-19 years, 28.5% and 62.4% among those 20-29 years and was highest among the age group >/=30 years 39.0% and 67.0% respectively. Women aged 15-19 years least perceived their risk of infection. Of the women with the highest rates of STI/HIV infection, less than 30% were aware of their vulnerability to such infection.
Validation of a Chinese Version of the Sign and Symptom Checklist for Persons with HIV Diseases (research abstract)
The purpose of this study was to validate a Chinese version of the Sign & Symptom Checklist for Persons with HIV (SSC-HIV-C). The Checklist first was translated from the English version into a Chinese version and then was back translated to examine accuracy. Both face and construct validity were used to examine overall validity of the instrument. Tests for internal consistency and test-retest reliability were used to examine the reliability of the instrument. The results indicated that the Chinese version of the SSC-HIV yielded highly acceptable parameters of validity and reliability.
Study of the Effect of Information, Motivation and Behavioural Skills (IMB) Intervention in Changing AIDS Risk Behaviour in Female University Students (PubMed abstract)
Purposive sampling was used to select 200 participants; pre-testing of these participants revealed that they did not have adequate information on issues related to HIV transmission and prevention. Further, neither were they motivated nor possessed appropriate behavioural skills to engage in HIV preventive behaviours. Following this, 100 participants were assigned to the experimental groupand the remaining 100 to the control group. Post-testing showed a significant increase in the level of information, motivation and behavioural skills of the experimental group participants who underwent the three-session intervention programme.
Social Representations of HIV/AIDS in Central and Eastern Europe (research abstract)
In the study reported in this paper, the authors interviewed 511 business people and health professionals in five Central and Eastern European nations, deriving questions primarily from a Social Representations perspective. Respondents also freely completed their associations with the stimulus word 'AIDS'. Findings indicate that, although there is considerable agreement about the threat posed by the epidemic, there are also notable cultural differences in attributions about the origin and spread of the virus and the nature of those groups at risk of infection.
HIV / AIDS NEWS
Ethiopia: Anti-HIV/AIDS Drugs to be Produced Locally (news article)
Ethiopia is to become one of the first countries in Africa to produce its own drugs to tackle the devastating HIV/AIDS crisis.
Low Rate of AIDS Virus in Philippines Is a Puzzle (news article)
Public health officials say they are stumped by a paradox in the Philippines, where a very low rate of condom use and a very low rate of human immunodeficiency virus (HIV) infection seem to be going hand in hand.
MATERNAL AND CHILD HEALTH RESEARCH
Where is the "E" in MCH? The Need for an Evidence-based Approach in Safe Motherhood (research abstract)
Measuring the impact of obstetric interventions on maternal mortality and/or morbidity is especially difficult in developing countries, where most maternal deaths occur. Therefore, program planning has been based on theory rather than proved effectiveness. The investigators highlight reasons why rigorous criteria for the selection and evaluation of interventions should be adopted
Morbidity and Mortality from Birth Before Arrival at Siriraj Hospital (PubMed abstract)
This prospective case-control study identifies maternal and infant morbidity and mortality from birth before arrival at a tertiary care hospital in Thailand. Three hundred and twenty patients, who had delivered at Siriraj Hospital, were divided into two groups. The study group consisted of 160 patients, who gave birth before admission to the labor room of Siriraj Hospital. The control group consisted of 160 patients, who had normal deliveries in the labor room of Siriraj Hospital. The study showed that the mothers in the study group had to stay in the hospital longer than the control group. The infants in the study group also had to stay in the hospital longer than the control group. The birth weights of infants in the study group were significantly lower than in the control group. There was no difference in morbidity between the mothers of both groups.
The FIGO Save the Mothers Initiative: The Ethiopia-Sweden Collaboration (research abstract)
The Ethiopian Society of Obstetricians and Gynecologists launched the Save the Mothers Project in West Showa Zone, Ethiopia, in 1998 to implement and test a demonstration project and evaluate the feasibility and impact of the Save The Mothers Fund interventions. The article describes the results from these projects.
Congenital Syphilis in the Russian Federation: Magnitude, Determinants, and Consequences (research abstract)
This paper reports the frequency, risk factors, and consequences of delivering an infant with congenital syphilis among pregnant women with active syphilis in a retrospective record review using consecutive sampling of logs at maternity hospitals in five geographic areas in the Russian Federation. Data were abstracted for 850 women with active syphilis during pregnancy who had completed 20 weeks' gestation. A total of 64% (n=544) of syphilis-infected women delivered an infant with confirmed or probable congenital syphilis; 40% of the sample had no prenatal care.
Hypertensive Diseases of Pregnancy and Risk of Hypertension and Stroke in Later Life: Results from Cohort Study (research abstract)
Related news article: >High Blood Pressure in Pregnancy Tied to Later Ills
Women who develop high blood pressure in pregnancy appear to have an elevated risk of high blood pressure and stroke later in life.
MATERNAL AND CHILD HEALTH NEWS
Indonesia's Infant, Mother Mortality Rates Up (news article)
The Indonesian government has expressed concern over the infant mortality rate, which has increased from 47 babies per 1,000 births in 1997 to 51 babies in 2001. Mr S. Soemantri of the Research and Development Unit at the Ministry of Health said last week: "We predict the infant mortality rate will be about 50 per 1,000 births in 2004."
MEN'S HEALTH RESEARCH
Human Papillomavirus Infection in Men Attending a Sexually Transmitted Disease Clinic (research abstract)
Related news article: Genital Wart Virus Common in Men Seeking STD Care
A new study shows that almost one-third of men visiting a single clinic for sexually transmitted diseases were infected with the human papillomavirus (HPV), which can cause genital warts and, in women, cervical cancer. However, most of the HPV detected in the men was in forms of the virus that appear unrelated to cancer. In contrast, in women, HPV infection more commonly involves potentially cancer-causing types of the virus than other forms -- although most HPV infections never result in cervical cancer.
Validity of a Rapid Assay for Antisperm Antibodies in Semen (research abstract)
The objective of this research study was to determine the validity of a rapid assay for antisperm antibodies in semen. Couples who presented for infertility evaluation were subjected to semen analysis and measurement of antisperm antibodies in semen using a standard and a rapid immunobead binding test (IBT). Sensitivity, specificity, positive and negative predictive values of the rapid assay were studied using the standard assay as a gold standard. On the basis of the results, it was concluded that a rapid IBT for antisperm antibodies is valid, reliable, and more cost and labor effective than the standard IBT.
Empiric Risk of Prostate Carcinoma for Relatives of Patients with Prostate Carcinoma - A Meta Analysis (research abstract)
Related news article: Dad's Prostate Cancer Ups Son's Risk of the Disease
A large research review confirms that having a father or brother with prostate cancer is a major risk factor for the disease -- and lends support to regular and early screening for the cancer in men with a family history, according to researchers. Their study found that men with an affected first-degree relative (a father or brother) had a 2.5 times greater risk of prostate cancer than those without a family history. Having an affected brother conferred the greatest risk: These men had about a three-fold increase in cancer risk, while those with affected fathers had about twice the risk of men with no family history.
POPULATION RESEARCH
The Measurement and Meaning of Unintended Pregnancy (commentary)
This commentary discusses the conclusions reached after a review of literature and meetings with experts on an adequate definition of and methodology for measuring what constitutes an "unintended" pregnancy.
Oldest Old Mortality in China (research paper)
The research concludes that that the Kannisto model, a two-parameter logistic formula, fits Han Chinese death rates at oldest-old ages better than the Gompertz and four other models. Chinese death rates appear to be roughly similar to Swedish and Japanese rates after age 97 for both males and females. Because reports of age seem to be serviceably reliable up to age 100 and perhaps age 105 in China, the authors think that this convergence may be mainly due to mortality selection in the heterogeneous Chinese population. They show that in China, as in developed countries, the rate of increase in mortality with age decelerates at very old ages.
Conception, Early Pregnancy Loss, and Time to Clinical Pregnancy: A Population-based Prospective Study (research abstract)
The article describes a prospective observational study that follows a population-based cohort in China. Five hundred eighteen healthy newly married women who intended to conceive were followed. Upon stopping contraception, daily records of vaginal bleeding and daily first-morning urine specimens were obtained for < or =1 year or until a clinical pregnancy was achieved. The conception rate per cycle was 40% over the first 12 months.
POPULATION NEWS
Average Malawi Woman Has Six Kids (news article)
The average Malawian woman bears on average 6.3 children, contributing to growing population pressures in the landlocked African country. Acting deputy director of the department of population services said 47% of the population was also very young and therefore contributed to rising population figures. She said family planning was being promoted at the grassroots level, while school curricula were beginning to include sex education and family planning. The national family planning campaign has already resulted in an increase in the use of contraceptives, like condoms and the pill, from 14% in the early 1990s to 26% in 1998, she said.
New Zealand Population Set to Hit 4 Million (news article)
New Zealand's population will reach 4 million at approximately 5:30 pm on April 24, Statistics New Zealand estimates.
WOMEN'S HEALTH RESEARCH
Prevalence of and Risk Factors for Viral Infections among Human Immunodeficiency Virus (HIV) Infected and High-Risk HIV-Uninfected Women (research abstract)
Viruses that can persist in the host are of special concern in immunocompromised populations. In multivariate analyses, viral infections were independently associated not only with behaviors such as injection drug use and commercial sex but also with low income, low levels of education, and black race. Disadvantaged women and women who engage in high-risk behaviors are more likely to be coinfected with HIV and other viruses and, thus, may be at high risk of serious disease sequelae.
A Multigene Test for the Risk of Sporadic Breast Carcinoma (research abstract)
Sporadic breast carcinoma is polygenically inherited. One of the demographic risk factors for breast carcinoma is an early age of onset of menarche. The current study was based on the hypothesis that genes that play a role in demographic risk factors may be breast carcinoma risk genes in their own right. The authors hypothesized that six genes relevant to the timing of the onset of menarche and related risk factors might be candidate genes for breast carcinoma. They examined 67 women with postmenopausal sporadic breast carcinoma and 145 gender and race-matched controls. The results of the study demonstrated a potentially powerful method of evaluating the additive effect of multiple breast carcinoma risk genes to form a potentially clinically useful assessment of women's risk for sporadic breast carcinoma.
WOMEN'S HEALTH NEWS
Women's Lack of Control Over STI Risks Drives Microbicide Search (feature article)
As powerlessness and poverty heighten the HIV risks for millions of women worldwide, the need for a female-controlled method of HIV prevention that does not rely on the cooperation of a male partner is driving the effort to produce new products for women. To this end, the health community has intensified the search for a vaginal microbicide: a cream, gel, suppository, or other product that can protect against HIV and other sexually transmitted infections.
YOUTH HEALTH RESEARCH
Interventions to Reduce Sexual Risk for the Human Immunodeficiency Virus in Adolescents, 1985-2000. A Research Synthesis (research abstract)
This paper summarizes studies that have tested the efficacy of human immunodeficiency virus (HIV) sexual risk-reduction interventions in adolescents. The authors conclude that intensive behavioral interventions reduced sexual HIV risk, especially because they increased skill acquisition, sexual communications, and condom use and decreased the onset of sexual intercourse or the number of sexual partners.
Gender Differences in Cues that Affect Condom Use Among Adolescents in Lome, Togo (research abstract)
A population-based sample study of adolescent women and men from Lome, Togo, was conducted to examine their responses to personal experiences with AIDS. Multivariate results demonstrate that an important factor that distinguishes adolescent male condom users from non-users of condoms is the knowledge of someone who died of AIDS. Conversely, personal experience with AIDS was unrelated to reported condom use among adolescent women.
YOUTH HEALTH NEWS
HIV/AIDS Affecting Girls Education (news article)
HIV/AIDS pandemic is affecting girls' education, as it is contributing to the increase in girls drop out rate. In most cases it is the girls who are forced out of school to help take care of HIV/AIDS victims, or to take care of orphans whenever someone has died leaving children behind.
Survey Shows Family Planning Awareness High Among Youths (news article)
The results of a recent survey show there is a high level of awareness of family planning methods among Tanzanian youths. Modern family planning methods are more frequently used than traditional methods, and female youths in urban areas depend on pharmacies and private medical stores for their contraceptive requirements while those in rural areas obtain contraceptives from government health centres and dispensaries.
BOOKS / BOOK REVIEWS
Infectious Diseases Manual (book)
The Infectious Diseases Manual is a concise and up-to-date guide to infectious diseases, medical microbiology and antibiotic prescribing. It brings together information about all aspects of infectious diseases into one accessible volume and balances practical information with scientific content.
PROFILES / SPECIAL REPORTS / RESOURCES
Adolescent Reproductive and Sexual Health CD-ROM (resource)
This CD-ROM presents the information contained in the Internet website of the UNESCO Regional Clearing House on Population Education and Communication entitled, "Adolescent Reproductive and Sexual Health". The CD-ROM contains over 1,000 dynamic pages dealing with the adolescents' demographic profile, programmes, policies, strategies and approaches as well as lessons learned and guidelines in promoting reproductive health messages to the youth.
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