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Volume 3, Number 17
28 April 2003
FAMILY PLANNING / REPRODUCTIVE HEALTH RESEARCH
Randomised Controlled Trial Assessing the Acceptability of GyneFix(R) Versus Gyne-T380S(R) for Emergency Contraception (research abstract)
Women requesting an IUD for emergency contraception (EC) were allocated to either the short-term arm (GyneFix(R) versus Nova-T200(R)) or the long-term arm (GyneFix versus Gyne-T380S(R)) and then randomised within each group. Outcomes of interest were pain at insertion and bleeding and pain reported at 6 weeks follow up. Results suggested that although the actual fitting may be more painful, pain is less during the 6 weeks after insertion of GyneFix and fewer women discontinue its use because of pain, as compared with Gyne-T380S. The high overall continuation rate of all emergency IUDs at 6 weeks and low morbidity seen in this study favours more frequent IUD insertion where unprotected intercourse has occurred, given also its higher efficacy over oral hormonal EC.
A 12-month Evaluation of the CMA-containing Oral Contraceptive Belara(R): Efficacy, Tolerability and Anti-androgenic Properties (research abstract)
This article describes a postmarketing surveillance study to assess the long-term efficacy and tolerability of the oral contraceptive Belara((R)) (chlormadinone acetate 2.0 mg/ethinylestradiol 0.03 mg) in a normal outpatient setting. Secondary outcomes of interest were androgen related skin and hair disorders. A total of 2620 women were enrolled in a 12-cycle clinical evaluation. An adjusted Pearl index of 0.04 was calculated. More than two thirds of the women did not experience any bleeding disorder. Patients with intermenstrual bleeding or amenorrhea at study entry reported complete relief in 61.7% and 89.3%, respectively. Women who previously suffered from spots or bad skin showed significant improvement during the observation period (85.6%).
Progesterone Increases Susceptibility and Decreases Immune Responses to Genital Herpes Infection (research abstract)
Related news article: Study Looks at Contraceptive, Herpes Risk in Mice
New research in mice suggests that women who use the injectable contraceptive Depo-Provera may have a higher risk of infection with genital herpes than non-users. Normally, mice will only develop genital herpes if they are exposed to extremely high concentrations of the virus that causes the condition.
Combination Contraceptives: Effects on Weight (Cochrane review)
Related press release: Research Finds No Evidence that Oral Contraceptives Cause Weight Gain
Related news article: Verdict's Still Out on Whether "The Pill" Is Linked to Weight Gain
Many women stop using oral contraceptives early or never even start using them because of concerns about gaining weight. But new research reviewing 39 clinical trials of women using this effective form of birth control found no scientific proof that the pills cause an increase in weight.
Combined Hormonal Versus Nonhormonal Versus Progestin-only Contraception in Lactation (Cochrane review)
This review was conducted to determine the effect of combined oral contraceptives and progestin-only contraceptives on lactation. The reviewers concluded that evidence from randomized controlled trials on the effect of hormonal contraceptives during lactation is limited and of poor quality; and that results should be interpreted with caution. The existing randomized controlled trials are insufficient to establish an effect of hormonal contraception, if any, on milk quality and quantity. Evidence is inadequate to make recommendations regarding hormonal contraceptive use for lactating women.
Estimating the Effectiveness of Emergency Contraceptive Pills (research abstract)
The authors use new estimates of conception probabilities by cycle day of intercourse to examine the absolute effectiveness and the cost-effectiveness of ECPs and whether ECPs are more effective the sooner after unprotected intercourse they are initiated. Their results suggest that the absolute levels of effectiveness for the Yuzpe regimen of emergency contraception and the cost-effectiveness of this regimen have probably been overstated when based on conception probabilities by cycle day relative to day of ovulation.
FAMILY PLANNING / REPRODUCTIVE HEALTH NEWS
Japanese Discover First New Vitamin in 55 Years (news article)
Japanese scientists have discovered a new vitamin that plays an important role in fertility in mice and may have a similar function in humans.
New Contraceptive for Women Helps Prevent HIV (news article)
A new nonhormonal, low-cost birth control device which can also protect women against HIV and other sexually transmitted diseases is now on the market, its manufacturer said. FemCap Inc., a private company based in San Diego, California, said the silicone rubber device called FemCap completely covers the cervix, preventing sperm from entering the uterus.
'Morning After' Pill Maker Asks FDA for OTC Switch (news article)
Women's Capitol Corp., the maker of Plan B emergency contraception, has filed an application with the US Food and Drug Administration seeking permission to sell the drug as an over-the-counter product
Iran: Focus on Family Planning (feature article)
The Islamic Republic of Iran is often perceived by the outside world as a very conservative, closed society when it comes to social issues. However, the country boasts one of the best family planning programmes in the region.
India: Odd UP Sterilization Method Angers Alva (news article)
Cycle pumps were being used to carry out sterilisation of women in Uttar Pradesh due to lack of funds, a senior Congress MP said in the Lok Sabha today. Quoting media reports, Margaret Alva said she had written to Chief Minister Mayawati and the Union Health Ministry drawing their attention towards the state of affairs in the family planning programme in UP, but had not received any response.
FAMILY PLANNING / REPRODUCTIVE HEALTH LAW AND POLICY
UN Call for Special Support for African Women Draws Condemnation (news article)
A UN proposal to give special assistance to women as part of the effort to relieve southern Africa's humanitarian crisis would unjustly discriminate against African men, who are disproportionately affected by illnesses and war-related injuries, a group of health organizations said.
Polygamy, Disrupted Reproduction, and the State: Malian Migrants in Paris, France (research abstract)
This article discusses the cultural dynamics of Malian refugees affecting their reproductive behavior and how antinatalist policies for immigrants may be shaping their reproductive goals.
Public-private Partnerships for Health Require Thoughtful Evaluation 
(editorial)
This editorial discusses the genesis, impact, and future potential of public-private partnerships for health.
Ghana: Can Rape Take Place in Marital Home? (news article)
Following the introduction of the Domestic Violence Bill in Parliament last year, most women's and men's groups in the country have expressed optimism that at last, domestic violence cases that went unreported in most homes will be dealt with now that a legal framework has been provided. The bill has created controversy, especially when the bill further states that any domestic violence, including rape in the marriage setting, will be treated as a criminal offence.
China: SARS and AIDS: What the People Don't Know (commentary)
The histories of both HIV and SARS in China have one striking shared characteristic: the government's suppression of all relevant information out of fear of damaging China's economic growth. Last year in a Chinese poll of university students, far fewer than half of those polled knew how HIV was transmitted. Most of the people in Henan's AIDS villages had not heard the word "AIDS" until the past couple of years. It is this countrywide lack of information that makes a nationwide spread of HIV all too likely.
SA's Mr. Condom to Help the World (news article)
A South African man, dubbed Mr. Condom by the SA Bureau of Standards, is to play a leading role in laying down international standards for condoms.
HIV / AIDS RESEARCH
Recent Herpes Simplex Virus Type 2 Infection and the Risk of Human Immunodeficiency Virus Type 1 Acquisition in India (research abstract)
Stored serum samples from a cohort of 2732 HIV-1seronegative patients attending three sexually transmitted infection clinics and one reproductive tract infection clinic in Pune, India, were screened for HSV-2specific antibodies. The prevalence of HSV-2 at enrollment was 43%. The HSV-2 incidence was 11.4 cases/100 person-years, and the HIV-1 incidence was 5.8 cases/100 person-years. The adjusted hazard ratios of HIV-1 acquisition from exposure to HSV-2 infection were 1.67 for prevalent HSV-2, 1.92 for remote incident HSV-2, and 3.81 for recent incident HSV-2.
Estimation of "Needs" and "Probable Uptake" for HIV/AIDS Preventive Vaccines Based on Possible Policies and Likely Acceptance (a WHO/UNAIDS/IAVI Study) (PubMed abstract)
Once an effective HIV vaccine is discovered, a major challenge will be to ensure its world wide access. The authors estimated "needs" adjusted for "accessibility" and "acceptability" in target populations to arrive at an estimate of "probable uptake", ie, courses of vaccine likely to be delivered. With a high efficacy vaccine, global needs are in the order of 690 million full immunization courses, targeting 22% and 69%, respectively, of the 15-49 years old, world wide and in sub-Saharan Africa, respectively. With a low/moderate efficacy vaccine targeted to populations at higher risk of HIV infection, the global needs were estimated to be 260 million full immunization courses, targeting 8% and 41%, respectively, of the world and sub-Saharan African population aged 15-49 years.
Why HIV-1 Has Diffused So Much More Rapidly in Sub-Saharan Africa than in North America (research abstract)
The author presents micronutrient deficiency (specifically, lack of selenium) as a possible explanation for the difference.
HIV / AIDS NEWS
Circumcision Shown to Deter HIV Spread (news article)
Circumcised men are at least 50% less likely to contract the virus that causes AIDS during unprotected sex than uncircumcised men, according to a soon-to-be released report by the US Agency for International Development (USAID). Based on a systematic review of 28 scientific studies published by the London School of Hygiene and Tropical Medicine, the USAID report "found that circumcised males are less than half as likely to be infected by HIV as uncircumcised men." The researchers concluded that if all males in Africa were circumcised, the HIV/AIDS prevalence rate could be reduced from 20% in some regions to below 5%.
HIV/AIDS Threatens Democracy (news article)
The impact of HIV/AIDS could reverse democratic gains in Southern Africa, according to a report by the Institute for Security Studies.
Famine and Aids: A Lethal Mixture (news article)
The twin onslaught of disease and hunger has dire consequences for families, communities, and production systems.
'Sperm Washing' Hope for HIV Patients (news article)
HIV-positive men who underwent a "sperm washing" treatment have fathered children without risking their partner's health.
Immunitor Ban Backed by NGOs (news artice)
NGOs working with AIDS and people living with AIDS/HIV yesterday backed the Food and Drug Administration's ban on the food additive V1-Immunitor.
MATERNAL AND CHILD HEALTH RESEARCH
Mothers' Health Post-partum and Their Patterns of Seeking Vaccination for Their Infants (research abstract)
A cohort of 159 mothers were recruited post-partum and followed for 7 months. Vaccination records for infants were obtained from a state-wide database. Only 44% of the mothers had maintained all age-appropriate vaccinations for their infant up to 6 months of age. Mothers who had two or more older children were four times more likely to have an infant who was not age-appropriately vaccinated at 6 months. Women experiencing mental health problems including anxiety and depression, 7 months following the birth, were between three to five times more likely to have started the vaccination schedule late or not at all.
A Study of Feeding Patterns in Young Infants (research abstract)
The authors interviewed 451 mothers attending the children's clinic in two university hospitals in the north of Tehran. The rate of full breastfeeding at 6 months of age, with no introduction of the bottle, was 83%; approximately 6.5% of infants were fed on breast and bottle concomitantly, and in about 10.5% breastfeeding had been discontinued before 6 months and the babies were fed on bottle only. Low birthweight, especially birthweight less than 2 kg, was a risk factor for early termination of breastfeeding. Caesarean delivery and hospitalization of the infant during the neonatal period was also associated with a higher rate of bottlefeeding.
MATERNAL AND CHILD HEALTH NEWS
Mother's Nutrition Linked to Premature Births (news article)
A mother's poor diet just before conception could be a cause of premature birth.
MEN'S HEALTH RESEARCH
The Contribution of Steady and Casual Partnerships to the Incidence of HIV Infection among Homosexual Men in Amsterdam (research abstract)
This study assessed the relative contribution of steady and casual partnerships to the incidence of HIV infection among homosexual men in Amsterdam and determined the effect of increasing sexually risky behaviors among both types of partners in the era of highly active antiretroviral therapy. The study concluded that most new HIV infections among homosexual men in Amsterdam occur within steady relationships and thus prevention measures should address risky behavior, specifically with steady partners, and promote HIV testing.
MEN'S HEALTH NEWS
Bid to Use Dogs in Prostate Cancer Screening (news article)
Scientists are hoping to train dogs to sniff out signs of prostate cancer in urine samples. A Cambridge-based research group wants to test whether dogs can distinguish between the odor of urine from men with malignant prostate tumors and other men with no malignancy. If successful, the simple method of screening could be used on a routine basis for men, potentially saving many lives.
POPULATION RESEARCH
Impact of Mass Treatment on Syphilis Transmission: A Mathematical Modeling Approach (research abstract)
Since 1997 Vancouver (British Columbia, Canada) has experienced an outbreak of heterosexually transmitted infectious syphilis, which prompted a mass treatment campaign in early 2000 in an attempt to control the disease. By 1 year post-intervention, syphilis cases had rebounded significantly. Using a mathematical model to describe the transmission dynamics of syphilis in a population, the researches observed that post-intervention rebound was related to the mass treatment intervention; and concluded that mass treatment may not be an optimal strategy to control the transmission of syphilis if complete coverage of high-frequency transmitters cannot be achieved and if population mobility is relatively high.
Continuity and Changing Configurations of Migration to and from the Republic of South Africa (research abstract)
This paper focuses on the transfixing configurations of migration dynamics in a new South Africa, while examining the context of migration and migration dynamics with an emphasis on the historical and institutional setting; the role of immigrants, including those doing the dirty and dangerous jobs, even when they are unwanted; the dynamics of replacement; and policy responses to fashion out appropriate migration regimes in the country.
POPULATION NEWS
Russia's Population Declines Sharply (news article)
Since 1989, Russia's population shrank by 1.3% (about 1.8 million people) and now stands at 145.5 million.
Despite Birth Bonuses, Zoroastrians in India Fade (news article)
This nation of one billion plus has tried just about every population disincentive known to man, including paying people to stop having children. So how to explain that one community here is paying its members to have more? The Parsi (Zoroastrians) council has been offering money (1,000 rupees, or about $21, a month until the child turns 18) to any Parsi family that has a third child.
Karanchi: Chief Minister Says Population Growth Rate Must Be Checked (news article)
The Chief Minister of Karachi has expressed his deep concern over the increasing rate of population growth in the province and emphasized the need for a concerted effort to improve the health and education sectors as well as for generating employment opportunities. He also underscored the need for concerted efforts to restrict the annual population growth rate to 1.9%and to achieve the target by the year 2004.
Polygamous Families Fading Gradually in Tibet (news article)
After Tibet's 'peaceful liberation' in 1951, the People's Congress of the Tibetan Autonomous Region issued a regulation in compliance with the country's Marriage Law and declared polygamy illegal. Today, many young Tibetans are foregoing the polygamous tradition of their parents and grandparents in favor of "Miss or Mr. Right".
Iraqi Population Outlook Uncertain (news article)
Three wars in the last quarter century and 12 years of international economic sanctions have demolished much of Iraq's social-welfare system and have created major uncertainties around the country's demographic estimates. Life expectancy at birth, which was 65 years for the period 1985-1990, is now 58 years. The United Nations Population Fund reports that maternal mortality has more than tripled since the late 1980s. The infant mortality rate (the annual number of deaths of children under age 1 for every 1,000 live births) was 64 prior to the 1991 gulf war, compared with 103 today.
WOMEN'S HEALTH RESEARCH
Prevention of Sexually Transmitted Diseases (STDs) in Female Sex Workers: Prospective Evaluation of Condom Promotion and Strengthened STD Services (research abstract)
This study assessed the impact of technically improved periodic STD services on STD prevalence and on consistent condom use (CCU) among female sex workers (FSWs) in Peru. The study involved monthly follow-up of 917 FSWs at two STD clinics, with evaluations before and during implementation of strengthened STD services, which included periodic screening and treatment for gonorrhea, chlamydial infection, trichomoniasis, bacterial vaginosis (BV), and syphilis; counseling; and supply of condoms. During 7908 person-months of observation, the prevalence of gonorrhea, chlamydial infection, trichomoniasis, and BV declined significantly and CCU increased significantly. The authors concluded that strengthened periodic screening for and treatment of confirmed STD, in addition to condom promotion and provision, represent feasible, effective interventions in commercial sex, and time series analyses can provide a useful approach to evaluating new interventions.
Attitudes Towards HPV Testing: a Qualitative Study of Beliefs Among Indian, Pakistani, African-Caribbean and White British Women in the UK (research abstract)
Related news article: The Sexually Transmitted Aspect of Disease May Create Psychosocial Problems
This study from Australia examined attitudes to human papillomavirus (HPV) testing among a purposively selected sample of women from 4 ethnic groups: white British, African Caribbean, Pakistani, and Indian. The findings indicate that some women were not fully aware of the sexually transmitted nature of cervical cancer and expressed anxiety, confusion, and stigma about HPV as a sexually transmitted infection. Testing positive for HPV raised concerns about women's sexual relationships in terms of trust, fidelity, blame and protection, particularly for women in long-term monogamous relationships. The researchers concluded that HPV testing has the potential to cause psychosocial harm to women and their partners and families.
Increase in Cancer Detection and Recall Rates with Independent Double Interpretation of Screening Mammography (research abstract)
Although screening mammography is used to detect occult breast cancer, its sensitivity and specificity are limited. Double interpretation of screening mammograms is one proven method used to improve detection. This study reports the increase in cancer detection that resulted from independent double interpretation of screening mammography. Two radiologists independently double-interpreted 25,369 screening mammograms performed from November 1998 to April 2000. The outcome of each case was determined. The authors concluded that relative increase in cancer detection as a result of the second reviewer is 6.3%, similar to the 5% to 15% reported in the literature. All but one of the nine additional cancers detected were in the early stages.
Effect of Lifetime Lactation on Beast Cancer Risk: A Korean Women's Cohort Study (research abstract)
This study examined the effect of lifetime lactation on breast cancer risk among premenopausal women. The data were from a prospective cohort study with a follow-up period of 6 years in Korea (1995-2000). The cohort was composed of 110,604 premenopausal parous Korean women, aged 20 years and older. Compared to parous women who had no history of lactation, a period of lactation of 13-24 months decreased the risk of breast cancer, and this risk was decreased even further for those who breastfed for more than 24 months. There was a clear trend of decreasing breast cancer risk with the duration of lactation. This study provides additional empirical evidence to current theoretical conjecture that lactation decreases the risk of breast cancer among premenopausal women.
Breast Cancer and Serum Organochlorine Residues (research abstract)
Related news article: Pesticides are Linked to Breast Cancer
Belgian doctors have found a new link between breast cancer and pesticides. They found that women with breast cancer are at least five times more likely to have residues of the pesticide organochlorines (DDT), and nine times more likely to have HCB residues in their blood than those who do not have breast cancer. When DDT breaks down, it forms another chemical, DDE, which behaves like the female hormone oestrogen. DDT was banned in most developed countries following a lead by America in 1972, but research has shown that it can remain active in tissues for 50 years. HCB continues to be used.
WOMEN'S HEALTH NEWS
Study Confirms Life-saving Benefit of Mammograms (news article)
The largest study to date into the benefits of mammograms shows that the screening technique reduces deaths from breast cancer by around 28% in women between the ages of 40 and 69. In a study of 210,000 Swedish women, international researchers found that those who had mammograms during the 20 years after a screening program began in 1978 were 44% less likely to die from breast cancer than women in the years before screening. Thanks to improvements in drugs for the disease, even women who did not go to the screening sessions were 16% less likely to die of breast cancer, suggesting around 28% of the reduction was due to the mammography. They found a similar reduction in deaths among those between 40 and 49 years of age as in older women.
Changing Tradition to Safeguard Women: Villagers Join Campaigns Against FGM (news article)
Villagers in hundreds of locations across Africa are now openly discussing and debating FGM, once a taboo topic. Although still on a modest scale, they are increasingly giving up the practice.
In War-Riddled Congo, Militias Rape with Impunity (news article)
As the 5-year conflict rages on in the Democratic Republic of the Congo, women and girls continue to be sexually assaulted by members of the many warring militias, most of whom are infected with HIV/AIDS.
At-home Urine Test to Evaluate Risk for Breast Cancer (news article)
A company has introduced a new urine test to help women evaluate risk for breast cancer. The home urine test, known as "The Healthy Estrogen Test," is a measurement of estrogen metabolites in determination of an estrogen metabolism ratio, known as the "2/16 ratio." A low ratio has been associated with increased breast cancer risk in major research studies. This ratio of distinct estrogen metabolites now offers women objective laboratory data regarding their risk for breast cancer.
YOUTH RESEARCH
Risk Factors for Sexually Transmitted Diseases in Northern Thai Adolescents: An Audio-Computer-Assisted Self-Interview with Noninvasive Specimen Collection (research abstract)
Previous studies of sexual behavior and sexually transmitted diseases (STDs) in Thai adolescents may have been limited by participation bias and underreporting of stigmatized behaviors. The goal of this study was to increase knowledge about risk behaviors and STDs among youths in Thailand. Students aged 15 to 21 years completed an audio-computer-assisted self-interview. Oral fluid was tested for HIV antibodies and urine was tested for Chlamydia trachomatis and Neisseria gonorrhoeae nucleic acids with polymerase chain reaction. The researchers concluded that these adolescents had high rates of unprotected intercourse and are at risk for STDs. Prevention programs should emphasize use of effective contraceptive methods, including condom use; reducing the number of sex partners (stressing the risk a partner of older age may pose to female adolescents); and reducing engagement in commercial sex.
YOUTH NEWS
UK: Birth Control Game Up for Award (news article)
A board game that is helping to reduce teenage pregnancies all over the world has earned for its creator a nomination as the country's top woman inventor.
PROFILES / SPECIAL REPORTS / RESOURCES
Learning Through Practice: Integrating HIV/AIDS into NGO Programmes: A Guide (resource)
This booklet is intended to be used as a resource tool for NGOs on how to apply for and make efficient use of funding for HIV/AIDS programmes and activities.
Safe Motherhood: Promoting Health for Women Before, During, and After Pregnancy (report)
In the United States, two to three women die of pregnancy complications each day. From 1900 to 1982, deaths from pregnancy complications declined dramatically. Studies indicate that as many as half of all deaths from pregnancy complications could be prevented if women had better access to health care, received better quality of care, and made changes in their health and lifestyle habits.
Policy Launches a Human Rights and Reproductive Health Tool (tool)
The Policy Project Human Rights and Reproductive Health Matrix is an interactive internet-based tool that lists international human rights treaties and consensus statements relevant to reproductive and maternal health, family planning, and HIV/AIDS. The Matrix permits access to information on over 40 developing countries' international human rights obligations.
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