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Volume 3, Number 29
21 July 2003
FAMILY PLANNING / REPRODUCTIVE HEALTH RESEARCH
Report to Congress: US Agency for International Development's Microbicide and Vaccine Research Program 
(report)
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This report describes USAID-funded microbicide research efforts and updates last year's report to Congress related to USAID's support of the vaccine research efforts by the International AIDS Vaccine Initiative.
The Low Acceptability and Use of Condoms within Marriage: Evidence from Nakuru District, Kenya (research article)
In the last two decades, there has been an increase in the prevalence of contraceptive use in Kenya. However, whether couples in marriages or stable relationships will use them is not known. From both quantitative and qualitative results, this study concludes that, not only, is the use of condoms to prevent STIs including HIV low within married and stable sexual relations, but, also, future prospects of condom use in such relations is rather bleak. Apart from using a condom for preventing a pregnancy in sexual relations, the only other reason for using it is because one does not trust the sexual partner.
Does Knowing Someone with AIDS Affect Condom Use? An Analysis from South Africa (PubMed abstract)
Prior research in Africa suggests that personally knowing someone with HIV/AIDS or who died of AIDS (PWA) may positively influence HIV-preventive behaviors such as condom use, by countering denial and increasing perceived risk. This article uses data from the 1998 South Africa Demographic and Health Survey (DHS) of women to examine this hypothesis in South Africa, where AIDS mortality is high. Contrary to previous findings, analyses showed no association between condom use and having known a PWA. Condom use was strongly associated with knowledge that condoms can prevent HIV/AIDS, sex with a non-marital partner, higher education level, younger age, and urban residency.
Risk Perception and Condom Use in Uganda (research article)
This paper examined the risk perception and condom use in Uganda, based on 600 respondents (most over 35 years of age, married, and engaged in subsistence farming) drawn from Kabale, Kampala and Lira districts. HIV risk perception was found to be associated with condom use, religion, educational attainment, marital status, residence, number of sexual partners and having contracted an STD. Predictors of high HIV risk perception were non use of condoms, rural residence, having ever engaged in sex for gain, and ever discussed sex.
The Introduction of Norplant in Cambodia through the Private Sector (PubMed abstract)
Study objectives were to determine whether Norplant would be an acceptable contraceptive method for Cambodian women, given its technology and the socio-cultural context, and whether it could be delivered by a private sector clinic with good quality care. This was a prospective cohort study of the first 966 acceptors. The one-year continuation rate was 90.5%, there were no pregnancies, and client satisfaction was high. In general, the researchers found that Norplant was delivered with high quality of care.
Micronutrients and Reproductive Health Issues: An International Perspective (research abstract)
This paper illustrates the potential effects of micronutrient supplements in reproductive and newborn health by using contemporary studies highlighting evidence on two individual nutrients: zinc and vitamin A. It also examines findings from recent trials of multiple micronutrient supplementation on birth weight and infant survival.
FAMILY PLANNING / REPRODUCTIVE HEALTH NEWS
Recall of Nortrel 7/7/7 Due to Mispackaging Causes Increased Chance of Pregnancy (press release)
The Food and Drug Administration announced that Barr Laboratories is voluntarily recalling three lots of its Nortrel 7/7/7 - 28 day (norethindrone and ethinyl estradiol tablets, USP) oral contraceptive due to packaging errors that could lead to an increased pregnancy risk.
Smoking and Pill Use Increases Heart Risk (news article)
A 35-year study to investigate the health of women taking oral contraceptives has revealed a moderate increase in risk of death from ischaemic heart disease for heavy smokers, compared with non-smokers.
Death Rate Low in Former Oral Contraceptive Users (news article)
The overall death rate is reduced among women who used high-dose oral contraceptives in the 1970s and 1980s, according to findings from the Oxford Family Planning Association contraceptive investigation. In contrast, the lethal effects of smoking are already apparent among women by the age of 35 to 44.
Cutting Edge Contraception (news article)
This article highlights some of the topics discussed at the New Frontiers in Contraceptive Research International Symposium held in Washington, DC, July 15-16.
Vietnam Can't Stomach Condom Ads (news article)
Vietnam has banned all dinner-time radio and television ads for condoms, tampons, and toilet paper, saying they offended Vietnamese sensitivities and cultural traditions. The Ministry of Culture and Information - sometimes disparagingly dubbed the censorship and immorality ministry - said the 6 pm to 8 pm prohibition took immediate effect.
New Mobile Clinics to Carry Out Birth Control Policy in Tibet (news article)
Authorities in the Tibet Autonomous Region have stepped up the implementation of family planning policy with the despatch of 64 specially equipped vehicles to be used in different counties as mobile clinics. But while the clinics will be welcomed in some areas for the provision of contraception, there are also fears among some health workers that they may lead to an increase in pressure on Tibetan women to undergo birth control measures.
Tajikistan: Focus on Family Planning (feature article)
In Soviet times, mothers with more than five children were awarded gold medals and showered with lucrative benefits such as tax breaks, telephones, substantial child benefits, and fully paid early retirement. Maternity leave could last up to three years, without the risk of losing a job. Some women were even given cars. However, such benefits are a distant dream after the collapse of the centrally-planned Soviet economy. Now the government and aid agencies are backing family planning as a way of improving the health of women and children, and boosting economic stability.
FAMILY PLANNING / REPRODUCTIVE HEALTH LAW AND POLICY
US: House Endorses $31 Billion Foreign Aid Bill (news article)
The US House approved a $31 billion State Department bill that seeks to promote better communication with Muslim countries, outlines a plan to double Peace Corps volunteers and reaffirms the president's authority to deny funds for a UN family planning agency.
Schering Contraceptive Ads Misleading: FDA (news article)
Related letter: http://www.fda.gov/cder/warn/2003/11730.pdf (You will need Adobe Acrobat to access this document) The FDA has warned a Schering AG unit that a television advertisement for Yasmin birth control pills was misleading because it overstated the product's safety and effectiveness and minimized the health risks.
Tanzania: Zanzibaris Want Discriminatory Law Repealed (news article)
Zanzibaris are calling for either an amendment or repeal of the Act Number 4 of 1985, which sentences a woman that becomes pregnant out of wedlock to two years impronment, saying it violates human rights of women and children. Likewise, the law provides a three-year sentence to men found guilty of impregnating a woman out of wedlock.
Australia: Birth Control Could Be Hit by Ruling (news article)
A landmark High Court decision over a botched sterilisation could have serious ramifications for the delivery of birth control in Australia, doctors have warned. The full bench of the High Court yesterday awarded Brisbane woman Kerry Melchior $105,249 for past and future expenses of raising her son Jordan, who was conceived after a failed sterilisation operation.
Population Assistance and Family Planning Programs: Issues for Congress (policy brief)
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This brief summarizes the most recent developments in popuation assistance and family planning programs facing the US Congress. It provides background and analysis into international family planning issues and legislation in the 107th and 108th Congress.
HIV / AIDS RESEARCH
Incorporating HIV Prevention into the Medical Care of Persons Living with HIV (report)
Related press release: New Guidelines Aim to Help Health Care Providers Incorporate HIV Prevention into Ongoing Care of Persons Living with HIV
http://www.cdc.gov/od/oc/media/pressrel/r030717.htm
Related news article: US Officials Offer New HIV Prevention Guidelines
These recommendations have been developed by the CDC, the Health Resources and Services Administration, the National Institutes of Health, and the HIV Medicine Association of the Infectious Diseases Society of America. They are general and apply to incorporating HIV prevention into the medical care of all HIV-infected adolescents and adults, regardless of age, sex, or race/ethnicity. They are intended for all persons who provide medical care to HIV-infected persons (e.g., physicians, nurse practitioners, nurses, physician assistants); they might also be useful to those who deliver prevention messages (eg, case managers, social workers, health educators).
Short Report: Migration among Persons Living with HIV (research abstract)
This study describes the frequency and reasons that persons with HIV move to different communities in the United States. Forty percent of movers said that their HIV status was a very important factor in their decision to move. Major factors in the decision to move included being near caregivers and being in a community with shared needs and interests. Significant numbers of persons also moved to obtain care from a physician knowledgeable in HIV treatment or to get away from discrimination.
Evaluation of a Social Network HIV Prevention Intervention Program for Young Men Who Have Sex with Men in Russia and Bulgaria (research abstract)
This article illustrates and provides evaluation data on a program that recruited 14 intact social networks of young men who have sex with men in St. Petersburg, Russia, and Sofia, Bulgaria.
Gender Differences and Sex-specific Manifestations Associated with Human Immunodeficiency Virus Infection in Women (research abstract)
This paper reviews the current evidence with regard to various aspects of HIV infection in women. Special emphasis is placed on gender-differences as well as sex-specific manifestation of this disease, including epidemiology, viral load determination and disease progression, related morbidity, and anti-retroviral therapy.
HIV Risk among Asian Women Working at Massage Parlors in San Francisco (research abstract)
This paper describes working conditions, health outcomes, social, and psychological factors related to HIV risk among Asian women who work at massage parlors in San Francisco. The researchers found that inconsistent condom use for vaginal sex with customers was positively associated with their fatalistic ideas and weak norms toward practicing safe sex with customers.
Rapid Increase in HIV Rates: Orel Oblast, Russian Federation, 1999-2001 (report)
The findings in this report confirm recent increases in HIV in Orel Oblast, affecting primarily young male intravenous drug users.
The Feasibility, Demand, and Effect of Integrating Primary Care Services with HIV Voluntary Counseling and Testing: Evaluation of a 15-Year Experience in Haiti, 1985-2000 (research abstract)
This report demonstrates the feasibility, demand, and effective synergy of integrating on-site primary care services into HIV voluntary counseling and testing (VCT) in Haiti. The authors write that VCT is a good entry point for people in need of services for communicable diseases and reproductive health, and, reciprocally, services attract more people to VCT, including populations that are at high risk for HIV infection.
HIV / AIDS NEWS
Hormonal Contraceptives Increase Risk of HIV Infection (news article)
Hormonal contraceptives increase the risk of a woman becoming infected with HIV, according to research conducted amongst Kenyan sex workers and presented to the Second International AIDS Society Conference on HIV Pathogenesis and Treatment in Paris on July 14th. Investigators were presenting the results of a 10-year prospective study from a cohort of commercial sex workers in Mombasa, Kenya. Previously published 4-year data from the same cohort demonstrated that the injectable contraceptive medroxyprogesterone was associated with a two-fold increased risk of HIV infection.
Ghana: Ambiguous Messages on AIDS Complicating Fight (news article)
A researcher presented his finding that the ambiguous messages on abstinence and martial infidelity had increased the prevalence of the HIV-AIDS pandemic in the Asante-Mampong area of Ghana.
Pakistan's Increase in Needle-sharing Raises HIV Fears (news article)
Medical researchers are warning that HIV could be spreading more rapidly in Pakistan following the beginning of the US-led war in Afghanistan in 2001 as a result of increase needle-sharing among drug users.
Zambia: 'Lack of HIV Infection Awareness May Mask Prevalence Levels' (news article)
The lack of awareness of the disease and supplies for detecting HIV infection may mask prevalence levels in some areas of the country, a UNICEF resident representative has said.
Haryana to Impart AIDS Education in Schools (news article)
The Haryana AIDS Control Society is to conduct AIDS education programmes in 1,200 schools across the state to make students aware of the epidemic.
MATERNAL AND CHILD HEALTH RESEARCH
An Evaluation of a Community-based Approach to Safe Motherhood in Northwestern Tanzania (research abstract)
This article presents an evaluation of the Community Capacity Building and Empowerment initiative, undertaken by the Community-Based Reproductive Health Project, which was designed to address high maternal morbidity and mortality. The authors found that community participation and support for VHW activities and the transport systems have led to better care for pregnant women and sustained links between the communities and health facilities, which may reduce maternal and infant morbidity and mortality.
Community Based Retrospective Study of Sex in Infant Mortality in India (research abstract)
The authors state that the excess number of unexplained deaths and deaths due to treatable conditions such as diarrhoeal disease in girls may be because girls are regarded and treated less favourably in India."
MEN'S HEALTH RESEARCH
The Role of Men in Family Planning: An Examination of Men's Knowledge and Attitude to Contraceptive Use among the Yorubas (research article)
This study examined the role of men in family planning with particular emphasis on men's sexuality, knowledge and attitude to contraceptive use among the Yorubas. Data for the study were obtained from a survey conducted in three states of South Western region of Nigeria in 1998. The study shows (i) that men play important roles in decisions pertaining to reproductive matters among the Yorubas; (ii) that knowledge of contraceptive use is high among men in the areas, however, usage is generally low.
MEN'S HEALTH NEWS
Masturbating May Protect against Prostate Cancer (news article)
Frequent masturbation, particularly in the 20s, helps prevent prostate cancer later in life, according to new research. Australian scientists have shown that the more men masturbate between the ages of 20 and 50, the less likely they are to develop the disease that kills more than half a million men each year.
POPULATION RESEARCH
The Dynamics of Fertility, Family Planning, and Female Education in Pakistan (research abstract)
This study presents an analysis of the dynamics of fertility and its determinants in a country at very low levels of socio-economic development.
The Relationship of Long Term Global Temperature Change and Human Fertility (research abstract)
Changes in temperature are well known to influence fertility. The authors of this study sought to determine if a statistical relationship existed between long-term changes in global air temperatures and birth rates. The most complete and reliable birth rate data in the 20th century was available in 19 industrialized countries. Using bivariate and multiple regression analysis, they compared yearly birth rates from these countries to global air temperatures from 1900 to 1994. In general, birth rates declined markedly throughout the century except during the baby boom period of approximately 1940 to 1964. Controlling for the linear yearly decline in birth rates over time, this relationship remained statistically significant for all the 19 countries in aggregate and in seven countries individually (p.05).
How Early is the Timing of Family Formation in Rural Cameroon? (research article)
This article investigates the timing of family formation in rural Cameroon. The researchers found that polygyny is not only a socially accepted form of marriage, it is also widely practiced and has been maintained at a reasonable level (or same level) for a considerable length of time. Based on the 1991 CDHS, about 42.6% of the currently married women were in polygynous unions. Only 10% of the ever married women reported having gone through their teenage years in the single status.
Migration and Fertility Relationship: A Case Study of Kenya (research article)
This paper examines how migration patterns in Kenya affect fertility levels, patterns, and behaviour. Examples from Africa in general and Kenya in particular are used to examine and explain the association between migration and fertility.
POPULATION NEWS
Europe's Population Implosion (feature article)
Fertility rates across Europe are now so low that the continent's population is likely to drop markedly over the next 50 years. The UN, whose past population predictions have been fairly accurate, predicts that the world's population will increase from just over 6 billion in 2000 to 8.9 billion by 2050. During the same period, however, the population of the 27 countries that should be members of the EU by 2007 is predicted to fall by 6%, from 482 million to 454 million. For countries with particularly low fertility rates, the decline is dramatic.
India: Population Growth Leveling Off (news article)
The growth of India's billion-plus population is slowing and southern parts of the country are approaching fertility rates close to those of European nations, according to a top official of the United Nations.
WOMEN'S HEALTH RESEARCH
Women's Empowerment and Fertility Decline among the Pare of Kilimanjaro Region, Northern Tanzania (research abstract)
This research was designed to explore the connection between the empowerment of women and fertility outcomes, through an ethnographic study, a community-based survey and in-depth interviews in a rural area of Kilimanjaro Region, Tanzania. Researchers found that in this population age at first birth increased and the progression from having one child to the next child declined. This pattern was evident during the 1980s and was stronger in the 1990s. The factors associated with this phenomenon are those related to the status of women, particularly, free partner choice, women's education, and wealth of the family.
WOMEN'S HEALTH NEWS
New Technique May Improve Breast Cancer Diagnosis (news article)
Swedish and British scientists are pioneering a new technique that may improve the diagnosis of breast cancer and determine how it will respond to treatment.
Tanzania: Activists Challenge Gender Inequality as Women Marry Women (news article)
Tanzania still has a long way to go in achieving gender equality: cultures in some communities continue to force women to "marry" another woman in order to bear a son for inheritance purposes. This culture exists among the Kurya tribe in the country's North Western region of Mara bordering Kenya. In this tribe an elderly woman without children will pay a bride price to the parents of a girl in order for a "marriage" to take place between them.
YOUTH HEALTH RESEARCH
Harnessing the Senga Institution of Adolescent Sex Education for the Control of HIV and STDs in Rural Uganda (PubMed abstract)
Senga (father's sister) is a traditional channel of communication about sexual behaviour for adolescent females in rural Uganda.
Researchers evaluated a modification of this approach as an intervention for HIV and STDs in a pilot study in rural Uganda.
Residential Density and Adolescent Reproductive Health Problems in Ibadan, Nigeria (research article)
Researchers found that the three most common sexually transmitted infections among adolescents in the study area were gonorrhea, candidiasis, and non-specific urethritis. The incidence was highest among adolescents in the high density but low class residential areas than their counterparts in the medium and low density areas. Prevalent rates were found to be highest among adolescents in the 17 to 24 ages; male adolescents were more affected in all cases than their female counterparts.
YOUTH HEALTH NEWS
Nigeria: Sexuality Education for Schools (news article)
A national sexuality education curriculum is soon to be introduced from upper primary grades through secondary school in Nigeria.
PROFILES / SPECIAL REPORTS / RESOURCES
Multisectoral Responses to HIV/AIDS: A Compendium of Promising Practices from Africa (report)
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This document brings together promising practices identified by the USAID-Private Voluntary Organization community. This includes many ideas and experiences of different organizations that seem likely to combat HIV/AIDS successfully. Several of these practices are new and as such, do not yet have hard evidence to show that they work. However, rather than wait for documented success, they are published here to to share all the practices available to spur ideas and action. This compendium is aimed at any person or program interested in mitigating the spread of HIV/AIDS, though the emphasis is on those in Africa seeking new ways to act.
Where There's a Will There's a Way: Nursing and Midwifery Champions in HIV/AIDS Care in Southern Africa (report)
(You will need Adobe Acrobat to access this document) This Best Practices Collection publication from USAID highlights and honors several individual nursing and midwifery champions working in HIV/AIDS in southern Africa.
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