The Pop Reporter®
– Events – Archives – Subscribe – Modify Profile – Headline Sharing Program – The Pop Reporter en Espaņol (Spanish)
Volume 3, Number 22
2 June 2003
GUEST COMMENTARY
Reaching Zambian Rural Youth: The Great Task Ahead
by Holo M. Hachonda IV (holoh@zihp.org.zm)
HIV/AIDS attacks vulnerable populations worldwide, and in Zambia, a very vulnerable population is rural youth. Consider that:
- 58% of the nearly 10 million Zambians are under 19 years old,(1,2)
- 64% of the Zambian population resides in rural areas,(3)
- by the age of 19, only 16% of Zambian youth report that they have never had sex,(4)
- 84% of sexually active youth did not use a condom the last time they had sex,(4) and
- 46% of 14- to 18-year-olds are out of school.(4)
Comparisons of the ZDHS for 1998 and 2000 reveal that observed positive changes (an increase in abstinence and condom use; a reduction in the number of sexual partners) correlate in time with significantly scaled-up behaviour change communication program activity. Surveys by the Society for Family Health of those aged 15 to 19 years in Lusaka also indicate positive changes/practices. Unfortunately, these changes have not been as impressive in rural areas.
Although data reveal a relatively low HIV prevalence rate in rural areas, there are indications that this will soon change if strong measures are not put into place to adequately address the pandemic there. HIV prevalence among those aged 15 to 59 in the rural provinces of Central, Eastern, Luapula, and Western is already between 11% and 15%. Many factors have combined to marginalize youth living in these rural areas from HIV/AIDS prevention programming, including:
- lack of tools to effectively involve youth to ensure relevance of programs,
- poor infrastructure, such as few clinics, no recreation facilities, and no youth centers,
- poor access to mass media (electronic and print),
- low literacy levels and high dropout rate,
- weak commitment from political, religious, traditional, and opinion leaders,
- donors' reluctance to fund youth programs in general, and
- socio-economic mix of poverty, unemployment, unrealistic traditional/religious norms.
In my experience in working with youth, local leadership has a key role to play in ensuring community acceptance and success of a program. Leaders at all levels and in all areas must be educated about HIV/AIDS; without the support of these leaders, access to our audiences becomes even more challenging. The fact that rural youth are less likely to have completed primary school than their urban counterparts makes them more vulnerable. There is virtually no alterative means of accessing youth-specific sexual and reproductive health (SRH) information and services, and this lack of infrastructure makes rural programming almost impossible both in terms of cost and sustainability. Socio-economic factors continue to dominate how communities react to SRH youth programs, and entrenched religious and traditional beliefs/norms can impede SRH programs.
Where can a solution start? I believe a realistic start begins with a focus on those we are serving: the youth. The items I listed above that are impediments to our programs might serve to act as part of the focus of our programs. In other words, we should keep youth in the center of all our activities yet reach out to these challenge areas. Saving a generation of youth from the HIV/AIDS pandemic while addressing those challenges that obstruct our progress is the great task ahead of all of us.
References
- Dissemination of Core Indicators from the 2000 Zambia Census of Population and Housing, Mulungushi International Conference Centre, Lusaka. Central Statistical Office of Zambia, 2002.
- Living Conditions In Zambia (1998): Preliminary Report. Central Statistical Office, Lusaka, Zambia, 1999. Accessed April 11, 2003.
- National Survey Confirms HIV/AIDS Epidemic Still Widespread In Zambia. Accessed April 11, 2003.
- Adolescent sexual & reproductive health. Why focus on youth? Accessed April 17, 2003.
Mr. Hachonda is a youth activist from Lusaka, Zambia, who has been working in the area of reproductive health and AIDS since he was 18.
FAMILY PLANNING / REPRODUCTIVE HEALTH RESEARCH
Condom Availability Programs in Massachusetts High Schools: Relationships With Condom Use and Sexual Behavior (research abstract)
A new study shows that teenagers at high schools where condoms were available were no more likely to have sex than other teens. The study confirms earlier research on the programs developed in the 1990s to stem the spread of HIV and reduce teen pregnancy. It found that students in high schools with condom programs were more likely to use condoms, though students in other high schools were more likely to use other forms of birth control.
The Efficacy of a Relationship-Based HIV/STD Prevention Program for Heterosexual Couples (research abstract)
This study demonstrated the efficacy of a relationship-based prevention program for couples at risk for HIV infection.
Applying the Transtheoretical Model to Pregnancy and STD Prevention: A Review of the Literature (PubMed abstract)
The use of the transtheoretical model (TTM) to reduce risk of pregnancy and STDs is a relatively new, but important, area of research. The authors reviewed 32 articles, including 9 intervention studies, 11 population studies, and 12 validation studies. They found that age, partner type, gender, reasons for engaging in safer sex behaviors (i.e., pregnancy vs. disease prevention), self-efficacy, sexual assertiveness, and perceived advantages and disadvantages of condom use were related to stage of change.
Testing a Model for Delivery of Emergency Obstetric Care and Family Planning Services in the Bolivian Public Health System 
(report)
This report summarizes the operations research carried out from May 1999 through August 2001. A non-experimental design with pre- and post-intervention measurements was implemented in three major maternity hospitals. The authors found that improvements were made in the following areas: informing women of their health status after the uterine evacuation procedure, elements of the procedure itself (instrument to be used, pain control, possible risks), and informing women where to seek care in case of
problems after leaving the hospital.
Acceptability for the Use of Postpartum Intrauterine Contraceptive Devices: Assiut Experience (research abstract)
The purpose of this study was to evaluate the acceptance of postpartum intrauterine contraceptive devices (PPIUCD) among the inhabitants of Assiut governorate, Egypt and to study the factors that influence this acceptance. The authors found that both the acceptance and actual insertion of IUCD were low, probably because the use of IUCD is a new concept in the community. For these women, the only opportunity to receive information about contraceptives is during childbirth when they are in contact with medical personnel. They suggest that family planning should be integrated with maternal and child-care services to effectively promote the use of contraceptive devices in these women who otherwise would not seek the use of such a device.
Human Papillomavirus Infection and Use of Oral Contraceptives (research abstract)
The authors reviewed 19 epidemiological studies on the risk of genital HPV infection and oral contraceptive use. They found no evidence for a strong positive or negative association between HPV positivity and ever use or long duration use of oral contraceptives.
New Approaches to Integrating STIs, HIV/AIDS, Family Planning and Reproductive Health in Bazega, Burkina Faso (report)
The goal of this study was to develop a knowledge base for designing approaches to improving reproductive health in rural Burkina Faso.
Introducing DMPA Injectable Contraceptives to Private Medical Practitioners in Urban Gujarat (report)
This operations research study was designed to demonstrate the feasibility of providing injectable contraceptives in private medical practices and to contribute to the body of scientific literature on the acceptability of this method in India.
Future Contraceptive Technology (resource)
This power point presentation was presented by Regine Sitruk-Ware, M.D., Executive Director of Product Development, Center for Biomedical Research, Population Council, on May 19, 2003, in Washington, DC, at a briefing titled "The Well-being of Women and Families: The Role of Contraceptive Development."
FAMILY PLANNING / REPRODUCTIVE HEALTH NEWS
Condom Use Remains Low Among US Adults: Report (news article)
Despite years of HIV-education campaigns encouraging safe sex, condom use among US adults has shown no increase in recent years. National survey data show that in 2000, 20% of adults said they had used a condom the last time they had sex, a figure unchanged since 1996.
Chance Discovery Could Lead to Male Pill (news article)
Scientists have discovered a genetic mutation that prevents the production of sperm, a chance find that could lead to the development of a male contraceptive pill.
Recent Fertility and Family Planning Trends in Cambodia (feature article)
In Cambodia, contraceptive use has increased and fertility rates have declined over the past decade. Nevertheless, many women who say they would prefer to stop having children or to delay their next birth are not using contraception. Meeting the reproductive needs of men and women will require continued political and financial commitment from the Royal Government of Cambodia to increase access, improve quality of services, and minimize costs of family planning services.
Ghana: NADMO to Form Virgins and Abstinence Clubs (news article)
The Eastern Regional Office of the National Disaster Management Organisation (NADMO) is to form Virgins and Abstinence Clubs in first and second cycle institutions in the New Juaben North Constituency as a pilot programme to create awareness on the HIV/AIDS and sexual abstinence among school children.
Ghana: Female Condom has Low Patronage (news article)
The female condom has low patronage in this country as compared to the male condom, a baseline study shows. The study attributed the low patronage to the low level of sensitization on the product when it was introduced to the Ghanaian market some years ago.
FAMILY PLANNING / REPRODUCTIVE HEALTH LAW AND POLICY
Acting on Our Compassion (press release)
Related news article: Campaigners Welcome US AIDS Plan
On May 27, 2003, President Bush signed into law H.R. 1298, the U.S. Leadership Against HIV/AIDS, Tuberculosis and Malaria Act of 2003. This bill authorizes the US to provide up to $5 billion to the Global Fund over the next 5 years. International AIDS campaigners have broadly welcomed the plan.
New Zealand: Fear on Plan to Make All Sex Diseases Notifiable (news article)
Plans to add sexually transmitted infections to the government's list of notifiable diseases could deter people from seeking medical treatment, health workers say.
Improving the Quality of Reproductive Health Care: How Much Does It Cost? (policy brief)
This brief focuses on various aspects of costs and examines information about the cost of improving quality (as opposed to the cost of quality of care in general), and outlines some ways to improve quality while containing costs.
Increasing Male Involvement in Family Planning through No-scalpel Vasectomy (report)
More than half of married women of reproductive age in The Philippines do not use any family planning method. This report focuses on a programmatic effort to increase demand for no-scalpel vasectomy.
Update from the Field (Best Practices): Fertility, Contraception, and Population Policies (report)
This publication begins with a global overview of current government views and policies on fertility and providing access to contraceptive methods. It then briefly summarizes the five phases in the evolution of population policies, from the founding of the United Nations to the beginning of the 21st century. It examines the various policy recommendations concerning contraception adopted at the three United Nations international population conferences, and it discusses the role of regional population conferences in shaping the policies of developed and developing countries.
HIV / AIDS RESEARCH
Sex Without Disclosure of Positive HIV Serostatus in a US Probability Sample of Persons Receiving Medical Care for HIV Infection (research abstract)
Related news article: Non-disclosure of HIV Status Common in US
More than 10% of American men and women who are HIV-positive and sexually active fail to disclose their status before engaging in unprotected high-risk sex with partners whose HIV status is unknown or negative.
An Individually Tailored Intervention for HIV Prevention: Baseline Data from the EXPLORE Study (research abstract)
This paper describes the intervention tested in EXPLORE, an HIV prevention trial aimed at men who have sex with men (MSM), and tests the empirical basis of the individually tailored intervention.
Hepatitis C Transmission and HIV Post-exposure Prophylaxis after Needle- and Syringe-sharing in Australian Prisons (research article)
Related news article: Breakthrough on HIV in Jails
In a world first, Australian researchers have produced evidence that treating people who have been exposed to HIV in jail with anti-viral drugs could prevent them getting infected. The drugs, which are used in combination, are already available to members of the public for use in the 72 hours after exposure to HIV if they are deemed at high risk by a specialist doctor.
HIV / AIDS NEWS
AIDS Paper Should Be Countered with Facts, Not Blasphemy Charge (letter to the editor)
Related news article: Recent Meet Showed True Muslim Spirit
The letter writer responds to an article about a controversial paper by Dr. Amina Wadud, Virginia Commonwealth University's associate professor of Islamic Studies, being voluntarily retracted from the Second International Muslim Leaders' Consultation on HIV/AIDS conference. At the conference, Dr. Wadud courted controversy when she spoke of Islam's failure to combat AIDS and said that in Islam women were sex objects.
Generic Versions of HIV Drug Pass Test (news article)
Analyses of generic forms of the HIV drug nevirapine sold in Africa and elsewhere reveal that the drugs contain roughly the advertised amount of the active drug -- and the same amount found in the brand-name product.
HIV Rates Climb in Australia (news article)
New HIV infections are rising throughout Australia, with some states reporting increases of up to 20% over a one-year span. More than 700 Australians tested positive for HIV antibodies in 2002, with most of the new infections occurring among gay and bisexual men.
Botswana: A Model for Combating HIV/AIDS (news article)
Botswana is the first country in Africa to implement widespread distribution of antiretroviral drugs through its public health system under a programme aptly named 'Masa' ("new dawn"), a symbol of hope for those living with HIV/AIDS.
HIV Sneaks Up on Indonesia after Suharto: Growing Heroin Addiction Spreads Virus (feature article)
As recently as 1999, Indonesia idled in the AIDS slow lane. In a nation of 210 million, fewer than 1,000 were known to be HIV-positive. At the time, health officials attempted to curb the spread of the disease by concentrating on the nation's premier high-risk group: sex workers and their clients. But soon after the collapse of the authoritarian regime of Gen. Suharto in 1998, illegal drug trafficking rose dramatically. As a result, AIDS workers are now targeting the latest group most apt to acquire the virus: heroin addicts who share infected needles.
MATERNAL AND CHILD HEALTH RESEARCH
Working with the Private Sector for Child Health (research abstract)
This article assesses the actual and potential contributions of the private sector to child health, and classifies and evaluates public sector strategies to promote and rationalize the contributions of private sector actors.
MATERNAL AND CHILD HEALTH NEWS
Breastfeeding Counters Harm of Smoking in Pregnancy (news article)
New research suggests that the benefits of breastfeeding on infants' mental development might offset some of the harm posed by smoking during pregnancy.
MEN'S HEALTH RESEARCH
Male Circumcision: Current Epidemiological and Field Evidence -- Program and Policy Implications for HIV Prevention and Reproductive Health, September 18 and 19, 2002: Conference Report (report)
This report summarizes a 2-day technical meeting between USAID and its partner organizations AIDSMark and JHPIEGO to examine the relationship between male circumcision and HIV transmission and other health concerns, including penile
and cervical cancer.
High-Risk Behaviors Among Men Who Have Sex With Men in 6 US Cities: Baseline Data From the EXPLORE Study (research abstract)
This article describes the prevalence of risk behaviors at baseline among men who have sex with men (MSM) who were enrolled in a randomized behavioral intervention trial conducted in 6 US cities. Among 4295 men, 48% and 54.9%, respectively, reported unprotected receptive and insertive anal sex in the previous 6 months. Unprotected sex was significantly more likely with one primary partner or multiple partners than with one nonprimary partner. Drug and alcohol use were significantly associated with unprotected anal sex.
POPULATION RESEARCH
Population Dynamics and Life-cycle Consumption (research abstract)
This paper presents a model where aggregate consumption depends on both the level of wealth and the age structure of population. The explicit consideration of an endogenous rate of time preference permits to analyze the important role of population ageing as a determinant of aggregate saving.
Shortage of Girls in China: Causes, Consequences, International Comparisons, and Solutions (resource)
This powerpoint presentation was given by Dr. Judith Banister, a demographer specializing in the People's Republic of China and other Asian countries, at a PRB policy seminar, "Shortage of Girls in China," on April 24, 2003. Dr. Banister analyzes the causes of these losses of daughters in China. She shows how female fetuses, babies, and young girls are selectively aborted or die prematurely and what leads families to dispose of some daughters in these ways. She demonstrates the consequences of these actions for China and the world and compared China's "missing girl" situation with that in other countries, in particular East Asian, South Asian, Muslim, and other developing countries. Also discussed is how China and other countries might go about solving this abnormal shortage of girls.
POPULATION NEWS
Saudi Arabia Faces Population Pressures (feature article)
The recent bombings in Saudi Arabia have drawn new attention to the kingdom and new pressure on the government of Crown Prince Abdullah to crack down on militant religious forces and root out their influence in schools and other key sectors. At the same time, however, the powerful Gulf kingdom is grappling with many other problems, including a number of demographic challenges. High among these challenges are a large, young population; fertility rates of almost 6 children per woman; high population growth; and a large expatriate population.
WOMEN'S HEALTH RESEARCH
Meeting the Reproductive Health Needs of Women in the Developing World (resource)
This power point presentation was presented by John A. Ross, Senior Fellow, The Futures Group International, on May 19, 2003, in Washington, DC, at a briefing titled "The Well-being of Women and Families: The Role of Contraceptive Development."
Factors Related to the Practice of Breast Self Examination (BSE) and Pap Smear Screening among Malaysian Women Workers in Selected Electronics Factories (research abstract)
This paper examines the practice of two screening tests among women production workers in electronics factories and identifies factors related to practice.
WOMEN'S HEALTH NEWS
A Battle is on Against Genital Mutilation in Egypt (feature article)
FGM has been identified by the government as not only a major health issue but also a human rights issue; the overall physical and psychological effects of the procedure have now officially been accepted as negative. The author writes, however, that the truth of the matter is that FGM and other forms of violence against girls and women are part of a larger system of which gender and non-gender-based brutality are defining aspects.
Delhi Girls Rebel Over Dowries (news article)
In a rare and bold gesture, three middle-class Delhi girls have refused marriage in the last 10 days.
YOUTH HEALTH RESEARCH
Emergency Contraception for Prevention of Adolescent Pregnancy (research abstract)
This article discusses the critical role that nurses can play in providing education about emergency contraceptive pills (ECPs) to parents, other healthcare providers and community members, and advocating for political and legal changes that will ease restrictions on ECP distribution.
Adolescents and Youth in Viet Nam (report)
This chartbook provides an overall picture of Vietnamese young persons, with an additional focus on the reproductive health of youth ages 15 to 19.
Does Father Absence Place Daughters at Special Risk for Early Sexual Activity and Teenage Pregnancy? (research abstract)
Related news article: Father's Absence Increases Daughter's Risk of Teen Pregnancy
Fathers who leave their families may increase their daughters' risk for early sexual activity and teenage pregnancy, suggest the results of long-term studies in the United States and in New Zealand. The association between father absence and early teenage sexual activity and pregnancy has long been noted, but many researchers have attributed it to factors associated with divorce including poverty, family conflict, and erosion of parental monitoring. But the new findings suggest a more direct link between a father's absence and his daughter's early teenage sexual activity and pregnancy.
YOUTH HEALTH NEWS
Small Successes, Big Ideas: Jamaica's Adolescent Reproductive Health Focus (feature article)
This article discusses the successes and challenges facing programs in Jamaica.
Namibia Research Shows Most Youth Don't Understand the Terms "Abstinence" or "Faithfulness" for HIV Prevention (press release)
Terms used to describe some HIV prevention strategies, such as "abstinence" or "faithfulness," are not understood by a large majority of young adults in Namibia, a country where current HIV/AIDS prevalence is approximately 22%.
BOOKS / BOOK REVIEWS
Combating AIDS: Communicaton Strategies in Action (book)
This book focuses on communication strategies that could mobilize political action, target high-risk groups, and overcome stigma. The authors have also described and analyzed the value of entertainment-education strategy in HIV prevention and care, highlighting the use of popular, long-running television and radio soap operas to engage audiences emotionally and create a forum for public debate and discussion.
Media and Health (book)
This book provides a thorough review of research literature on media representations of health, illness and health care, covering their production, characteristic forms and relationships with the everyday lives of media audiences. It brings together both well known and lesser-known studies in the context of an integrated, sociological argument about media and health.
PROFILES / SPECIAL REPORTS / RESOURCES
No-scalpel Vasectomy: An Illustrated Guide for Surgeons (handbook)
This third edition contains updated content and illustrations, more detailed representations of anatomy, and expanded descriptions of ligation and excision with fascial interposition. There is also an expanded discussion of cautery and an updated Appendix, reflecting eligibility criteria for vasectomy published by WHO in 2000.
Online Course: Epidemiology, Internet and Global Health (resource)
Web site developed by Profesor Ronald Laporte of University of Pittsburg's. "The Supercourse is an Internet-based distance learning material for health-related (medical, nursing, dental, veterinary, etc.) students who are beginners in Epidemiology, Global Health and the Internet. You can utilize the Supercourse for training your students. You can contribute to the Supercourse as reviewer, lecture developer, or translator as well."
Nyumbani Village International (resource)
A unique project is unfolding in Kenya that will focus on serving the needs of children orphaned by the AIDS pandemic, and the elderly who have lost grown children to the disease. The project, called Nyumbani Village, is a self-sustaining community to assist elders and children left homeless by the AIDS pandemic.
'Literacy And Gender Equality Are Vital Population-Management Tools' (interview)
J. Bill Musoke, Country Representatives of the United Nations Population Fund (UNFPA), has been in Nepal for more than a couple of years. Musoke, who has been involved in the implementation and execution of the UNFPA's major programs there, spoke to Nepal News about various population-related issues.
Sexuality Education On-line for Health Professionals (research paper)
This paper describes the development, implementation and evaluation of an on-line (web-based) sexuality education program for health professionals.
AMANITARE Voices (newsletter)
AMAMITARE Voices, the thematic bi-annual newsletter of AMANITARE, the African Partnership for the Sexual and Reproductive Health and Rights of Women and Girls, offers articles and analyses on key issues around sexual and reproductive health and rights as well as news regarding AMANITARE activities. The theme of the second edition of the newsletter is "reaching out to new generations."
Why the World's Taps are Running Dry (news article)
Two-fifths of the world's people already face serious shortages, and water-borne diseases fill half its hospital beds. People in rich countries use 10 times more water than those in poor ones. The present is dire: the future looks so grim it must be entirely unmanageable. Cut it how you will, the picture that emerges from today's data and tomorrow's forecasts is so complex and appalling it can leave you feeling powerless.
When you click on any link, your Internet browser will access a Web site not connected to "The Pop Reporter." Information accessed through these links and contained in this issue of "The Pop Reporter" does not necessarily state or reflect the views of the Population Information Program, Johns Hopkins University, or the United States Agency for International Development (USAID).
All links were verified at the date of posting. Your computer and/or network configuration regarding Java script, cookies, and other security issues may not allow you to view certain Web sites. Consult your computer technician if you are having problems.
Information & Knowledge for Optimal Health (INFO) Project
111 Market Place Suite 310, Baltimore, MD 21202
Phone: 410-659-6300 Fax: 410-659-6266 Security & Privacy Policy