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Volume 3, Number 35
2 September 2003

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Family Planning/Reproductive Health Research

Sexual Behavior in Travelers Visiting Cuzco (research abstract)
Researchers studied the sexual behavior and risk factors for acquiring sexually transmitted diseases (STDs) among travelers and among local people sexually interacting with travelers to Cuzco, Peru. Of the travelers, 5.6% engaged in sexual activity with a new partner during their stay in Cuzco. Sexual intercourse with other travelers was most common (54.3%), followed by sex with local partners (40.7%), and with commercial sex workers (2.15%). Consistent condom use was reported by 69.3%.

Obstacles to Modern Contraceptive Use Among Married Women in Southern Urban Maldives (research abstract)
The aim of this study was to examine the current state of, and factors associated with, modern contraceptive use among married women in the Maldives. Those interviewed were found to have a good knowledge of, availability and accessibility to contraceptives and social support for contraceptive use. Some had husbands who disapproved of modern contraceptive practices, or had difficulty communicating with their husbands. Others were afraid of side effects, or were dissatisfied with sexual sensation when using modern contraceptives, or preferred to have larger families.

Bringing Emergency Contraception Over the Counter: Experiences of Nonprescription Users in France, Norway, Sweden and Portugal (research abstract)
During focus groups, participants expressed mixed reviews of the counseling given by the providing pharmacists, but reported that they knew how to use the method safely and properly, indicating that the package insert was easy to understand and adequately answered the majority of their questions. Participants described the emergency contraceptive experience as a factor that has led to more consistent use of regular contraceptive methods.

An Agenda for Future Research on HIV and Sexual Behaviour among African Migrant Communities in the UK (research article)
The authors advocate that a broad range of qualitative techniques be deployed both to uncover the empirical details of specifically African sexual behaviors and to highlight and explore the 'relational' nature of sexual decision-making. Their proposed research agenda would contribute to interventions and service provision. They propose that researchers seek ways to work with, not on, African communities in order to facilitate their own informed management of sexual health.

The Effects of a Skill-Based Intervention Promoting Consistent and Correct Use of the Male Condom Among High-Risk Women (research abstract)
A randomized, controlled trial was conducted to examine the effectiveness of an educational intervention in increasing condom use among high-risk women attending STD clinics in Birmingham, Alabama. The intervention seemed to have more impact among women at high STD risk.

Participation by Clients and Nurse Midwives in Family Planning Decision Making in Indonesia (research abstract)
In order to enhance understanding of the quality of decision making during family planning consultations in developing countries, provider competencies and client behaviors during 179 randomly selected consultations in Indonesia were assessed. Results showed that family planning clients made a significant contribution to the quality of the decision-making process. The quality of decision making could be improved by increasing client involvement during consultations and by making providers aware of the opportunities for decision making.

Family Planning/Reproductive Health News

FDA Backs Marketing of Herpes Pill as Preventative (news article)
Valtrex, a drug widely used to treat genital herpes, is now being promoted as a way to help prevent the virus' spread. About 45 million people are infected with herpes simplex virus type 2, the primary cause of sexually transmitted genital herpes.

Survey Shows Tibet Women Intend to Have Less Children (news article)
A recent government survey shows that women in southwest China's Tibet Autonomous Region are having less children as the standard of living has increased in the Tibet Autonomous Region.

Family Planning/Reproductive Health Policy

Russia: Woman Sentenced for Donating HIV-infected Blood (news article)
A 26-year-old woman was sentenced to six months in a penal colony for donating blood knowing that she was HIV-positive.

Bangladesh: Cabinet Okays Proposal to Amend Bar Council Order '72 (news article)
The cabinet of Bangladesh approved a draft of the administrative proposals to strengthen the activities of family planning programs.

Phillipines: Read Reproductive Health-Care Bill First -- Solon (news article)
Proponents of the controversial House Bill 4110, or the proposed Reproductive Health Care Act, are urging opponents to read the bill first before allowing themselves to be swayed by imagined apprehensions from the Catholic Church.

UK: NHS Plans 'Ignore Sex Diseases' (news article)
Most strategic plans for the NHS make no mention efforts to improve sexual health, or tackle the rise of HIV. Analysis by sexual health charities found that only two in five health authorities made mention of the issue in their official plans for the future.

Bush Cuts Overseas Family Planning Aid (news article)
Related press release: Memorandum for the Secretary of State: Assistance for Voluntary Population Planning
President Bush ordered the State Department to withhold US family-planning help from overseas groups that promote or perform abortions with their own money. The decision expands an order issued 2 years ago that applied only to family-planning money administered by the US Agency for International Development, a division of the State Department.

Birth Control in Russia (editorial)
For 50 years, Russian women relied on state-financed abortions as the main form of birth control. With pills, condoms, and other contraceptives often in short supply, most women in Russia expected to face at least one and sometimes more than a dozen trips to the abortion clinic over their childbearing years. Now the Russian government is attempting to slow the abortion rate by limiting Russian women's access to abortion.

US Ends Funds for African AIDS Programme (news article)
The US government has cut off funds to an AIDS program for refugees in Africa - 6 weeks after President Bush toured the continent promising to fight the disease - because it objects to the activities of one of the aid agencies involved, Marie Stopes International.

HPV in the United States and Developing Nations: A Problem of Public Health or Politics? (commentary)
Through comparative perspective in the U.S. and developing countries, the author argues that rather than a focus upon HPV, a more realistic campaign against cervical cancer deaths would focus on increasing access to cervical cancer screening among women around the world.

HIV/AIDS Research

Community-Based Organizations in HIV/AIDS Prevention, Patient Care and Control in Ethiopia (research article)
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This review evaluates the suitability of community-based organizations to contribute to HIV/AIDS prevention, care/support, and control programs in Ethiopia.

HIV/AIDS News

WHO Director-General Calls for “Urgent Treatment” for People with AIDS in Africa (press release)
HIV/AIDS is a “catastrophe” and people affected need urgent access to treatment, said Dr. Lee Jong-wook, Director-General of the World Health Organization. Dr Lee Jong-wook stressed safe births for mothers and improved survival for children.

Cote d’Ivoire: Condom Machines Placed in Internet Cafes to Combat AIDS (news article)
The government of Cote d'Ivoire has started to place condom dispensing machines in internet cafes as part of its drive to control HIV/AIDS infection among young people.

Merck Testing AIDS Vaccines on Humans (news article)
Scientists at Merck & Co.'s vaccine research headquarters in suburban Philadelphia are testing two experimental AIDS vaccines in early human trials. In previous tests, the vaccines prevented laboratory monkeys from acquiring full-blown AIDS, although they contracted a version of HIV.

UN AIDS Specialist Sees Asian Crisis Looming (news article)
A United Nations envoy is urging Asian governments to take quick and decisive action against the AIDS epidemic, before it ravages economic and social development in the region.

WTO Drug Deal Close After African Plea (news article)
An African plea to fellow World Trade Organization nations seemed to have been heard last week, with envoys seeing overwhelming support for a deal to let poor states import life-saving drugs against AIDS and other scourges.

Maternal and Child Health Research

Morbidity in Children Born to Women Infected with Human Immunodeficiency Virus in South Africa: Does Mode of Feeding Matter? (PubMed abstract)
Researchers studied a population of infants born to HIV-infected women in South Africa who were participating in a vitamin A intervention trial to prevent MTCT of HIV. Women chose to breastfeed or formula feed their infants according to UNAIDS guidelines. HIV-infected infants who were never breastfed had a poorer outcome than those who were breastfed. During the first 2 months of life, never-breastfed infants (regardless of HIV status) were nearly twice as likely to have had an illness episode than breastfed infants.

Costing the Cascade: Estimating the Cost of Increased Obstetric Intervention in Childbirth Using Population Data (research abstract)
The study estimates the cost of obstetric interventions introduced during labor for low risk women. Using a population sample of 171,157 women having a live baby during 1996 and 1997 in New South Wales, Australia, a cost model was constructed using the known age-adjusted rates for low risk women having one of three birth outcomes following these pre-specified interventions. The researchers found that the initiation of a cascade of obstetric interventions during labor for low risk women is costly to the health system. Private obstetric care adds further to the cost of care for low risk women.

Levels of Antibodies Against Cytomegalovirus and Chlamydophila Pneumonia are Increased in Early Onset Pre-eclampsia (research abstract)
The origins of pre-eclampsia/eclampsia lie in a mismatch between feto-placental demands and utero-placental supply, a situation that also arises in normotensive intrauterine growth restriction. The researchers consider whether reactivated chronic infection can trigger differential maternal responses to the same underlying pathology, and whether a link between pre-eclampsia and its attendant lifelong risks of arteriosclerosis can be derived.

Influence of Socio-Economic Background and Antenatal Care Programs on Maternal Mortality in Surabaya, Indonesia (research abstract)
The study examines risk factors, such as socio-economic background, quality of antenatal care, and availability of family planning, responsible for high maternal mortality in Surabaya, Indonesia. Using a case-control design to compare 59 maternal deaths and 177 women survivors in the referral hospital, from 1996 to 1999, the researchers found that low socio-economic background and the availability of antenatal care have a significant influence on maternal mortality in Surabaya, Indonesia.

The Global Problems of Child Malnutrition and Mortality in Different World Regions (PubMed abstract)
This study explores the effect of the social, demographic, economic, and health factors on child malnutrition and mortality rates among different regions. The study includes ten regions of the whole world compared to other studies that covered only one or two regions. The results of descriptive analysis show that the highest mean rate of child malnutrition was found in South Asia region (57 children per 100), while the smallest mean rate was found in Europe region (just 1 child per 100). The results also suggest that there were negative associations between GNP, household income, protein consumption, and child malnutrition and mortality in all world regions except Europe and Central Asia regions.

Clinical and Cervical Cytokine Response to Treatment with Oral or Vaginal Metronidazole for Bacterial Vaginosis during Pregnancy: A Randomized Trial (research abstract)
Related news article: Topical Gel As Good As Pills for Vaginal Infection
When women become pregnant, they are more prone to bacterial vaginal infections. Now a new study suggests that women can take their pick of an oral pill or a vaginal suppository containing metronidazole, because either one works just as well.

Promoting Safe Motherhood through the Private Sector in Low- and Middle-income Countries (research article)
(You need Adobe Acrobat Reader to access this document)
This paper reviews evidence on health care from low- and middle-income countries in an attempt to assess the contribution of formal, professionally qualified private for-profit providers (doctors, midwives, nurses) to delivery care. The authors review the limited evidence on technical quality, appropriateness, and responsiveness of such services, and evaluate the potential of available mechanisms or leverages for policy-makers to work with
the for-profit private sector. Their aim is to identify what private sector policy interventions could assist in achieving safe motherhood goals in different contexts.

Maternal and Child Health News

China Strives to Control High Congenital Birth Defect Rate (feature article)
China has the highest congenital birth defect rate in the world, but a Population and Family Planning Commission congenital birth defect prevention project aims to train pregnant women on prenatal care and provide nutrient supply and fetal examinations.

Kazakhstan: Disturbing Health Statistics from Nuclear Semipalatinsk (news article)
A former nuclear testing area in Semipalatinsk, a town in northern Kazakhstan, continues to adversely affect the health of the local population, particularly pregnant women, new figures show. Nine out of ten pregnant women in the town and in some rural areas nearby are suffering from various diseases due to their immunity system being weak.

Men's Health Research

Regulation of Testicular Function in Men: Implications for Male Hormonal Contraceptive Development (research abstract)
This paper discusses the current understanding of the endocrine regulation of testicular function, focusing on the central role of FSH and LH, and examines efforts to use this knowledge to create a safe and effective form of reversible hormonal contraception for men.

Recent Research on Vasectomy Techniques (review article)
This review summarizes recent research on vasectomy conducted by Family Health International, USA.

Age at Immigration and Duration of Stay in Relation to Risk for Testicular Cancer Among Finnish Immigrants in Sweden (research abstract)
Related news article: Testicular Cancer Risk Set Early in Life
The risk of testicular cancer is established in large part by environmental exposures early in life, results of a new study suggest, although the researchers admit that at this point they aren't exactly sure what type of exposures increase the risk.

Men's Health News

Will Men Ever Be On the Pill? (feature article)
Thirty years ago, the male pill was imminent, yet we're still waiting. And it's not just science, but men's attitudes that are to blame.

Malta: Expert Pleads for Sexual Health to be Tackled More Seriously (news article)
The article describes the importance of a focus on sexual health to address increasing numbers of sexually transmitted infections, particularly in the male population.

Population Research

Lumping and Splitting: The Health Policy Agenda in India (research abstract)
India’s population is undergoing transitions in the demographic, epidemiologic and social aspects of health. Disparities in life expectancy, disease, and access to health care, as well as protection from financial risks have increased. By analyzing inter- and intra-state differences in contexts and processes, the authors of the study argue that more ‘splitting’ of India’s health policy at the state level would better address their health problems, and would open the way to innovation and local accountability.

Norms in Tension: Democracy and Efficiency in Bangladeshi Health and Population Sector Reform (research abstract)
This paper draws on political science and public administration theory to evaluate the Bangladeshi reform experience. The authors argue that with the increase in donor money globally, a number of developing countries are in the midst of fundamental health and population sector reform; with reform comes changes and challenges to the sovereignty of nations.

Population News

Indonesia Burdened by Population Ills, Political and Social Pressures (feature article)
Still reaping the repercussions of the Asian financial crisis, Indonesia has in recent years struggled with numerous difficulties ranging from social unrest, political instability, and ethnic and sectarian violence to a decline in access to health care and other public services. More recent events, including the bomb blast in Jakarta — which followed other deadly bombings in 2002 — have increased fears that the sprawling archipelago may be facing new political and population pressures.

Asian Fertility Decline Reflects Changing Lifestyles (news article)
South Korea is the latest Asian country to release statistics illustrating the regional trend towards declining fertility, the result of family planning programs and changing lifestyles.

China: The Land of 70 Million Bachelors (news article)
China has 70 million bachelors unable to find wives. Men outnumber women as a result of a one-child policy that led to many girls, who are traditionally discriminated against, being aborted. The imbalance had become "one of the most serious problems in Chinese rural areas", Xinhua news agency quoted Deputy Minister of State Commission for Population and Family Planning.

Women's Health Research

Determinants of Clearance of Human Papillomavirus Infections in Colombian Women with Normal Cytology: A Population-based, 5-Year Follow-up Study (research abstract)
Little is known about the factors that influence clearance of human papillomavirus (HPV), the primary cause of cervical carcinoma. In this study, a total of 227 women cytologically normal and HPV positive at baseline were identified from a population-based cohort of 1,995 women in Bogotá, Colombia. The women in the cohort were between 13–85 years old and were followed between 1993 and 2000 (mean follow-up, 5.3 years). The researchers found faster clearance of HPV in users of oral contraceptives.

Update on Contraceptive Vaginal Rings (research abstract)
Studies of women's attitudes show that many regard daily pill use as a drawback to the use of the oral contraception and would prefer a monthly contraceptive option. Though vaginal rings were first developed in the 1970s, a combined contraceptive vaginal ring that releases 15 g of ethinylestradiol and 120 g of the progestogen etonogestrel/24 h has recently been introduced.

Oral Contraceptives, Tubal Sterilization, and Functional Ovarian Cyst Risk (research abstract)
Researchers wanted to determine whether current contraceptive methods affect ovarian cyst risk, with emphasis on oral contraceptives (OCs) and tubal sterilization. Findings suggested that low-dose OC use has little or no effect on ovarian cyst likelihood.

Weight Variation in a Cohort of Women Using Copper IUD for Contraception (research abstract)
The objective of this study was to assess weight changes over time in reproductive-age women using nonhormonal contraception [copper intrauterine device (IUD)]. Lower and middle class Brazilian copper IUD users tended to gain weight during their reproductive life, independent of other factors. These observations may improve counseling of women regarding the prevention of age-related obesity.

15-49 Aged Married Women's Health in European Section of Istanbul (research abstract)
The aim of this study was to investigate the occurrence of sexually transmitted diseases, and other public health issues of importance among married women aged 15-49 who resided in the European section of Istanbul. Results showed that the use of condoms and hormonal contraceptives reduced sexually transmitted diseases, but use of IUDs increased STDs.

Occurrence of Cervical Infection with Multiple Human Papillomavirus Types is Associated with Age and Cytologic Abnormalities (research abstract)
The goal of the study was to document the prevalence and incidence of infection with multiple HPV types and the distribution of HPV types in coinfections. 2,075 Brazilian women's cervical specimens were collected for cytology and HPV detection. It was observed that occurrence of HPV coinfection was dependent both on age and on the presence of cytologic abnormalities and may have implications for vaccine development and vaccination programs.

The Effect of a Novel Vaginal Ring Delivering Oestradiol Acetate on Climacteric Symptoms in Postmenopausal Women (research abstract)
The study evaluates the efficacy and acceptability of a novel vaginal ring delivering oestradiol acetate (Menoring) versus oral oestradiol for relief of climacteric symptoms in postmenopausal women. The findings suggest that the oestradiol vaginal ring significantly improved climacteric symptoms with no increased risk to users.

Gender-based Barriers to Primary Health Care Provision in Pakistan: The Experience of Female Providers (research abstract)
The Pakistan government health system has introduced cadres of community-based female health and family planning workers as a response to gender-based constraints on women’s access to services. However, the recruitment, training and retention of such female workers has been difficult. Using qualitative methods, the authors of the study assess gender-based constraints such as abusive hierarchical management structures; disrespect from male colleagues; lack of sensitivity to women’s gender-based cultural constraints; conflict between domestic and work responsibilities; and poor infrastructural support.

Women's Health News

Period Piece (feature article)
This article, from the British magazine The Economist, discusses the impact of Seasonale, a new drug designed to reduce the number of menstrual cycles a woman undergoes from 13 a year to four.

Kenyan Woman Circumcises Herself to Please In-laws (news article)
According to a newspaper report, a Kenyan woman circumcised herself with a razor blade to win the approval of her husband's parents who rejected her for not undergoing the rite.

Youth Health Research

Zimbabwean Adolescents' Condom Use: What Makes a Difference? Implications for Intervention (research abstract)
This study examined risk and resilience factors at multiple levels related to Zimbabwean adolescents' practice of protected or unprotected sex. Data were collected from adolescents in eight secondary schools in Zimbabwe. The instrument designed by the authors assessed adolescent perceptions, behaviors, and attitudes. Both boys and girls were found to need medically correct sexuality education, including education on HIV/AIDS and sexually transmitted diseases. Gender differences and multiple ecological levels raised further issues for intervention.

Safer Sexual Decision Making in Adolescent Women: Perspectives from the Conflict Theory of Decision-making (PubMed abstract)
In this article, the Conflict Model of Decision Making is presented and discussed as a framework for enhanced understanding of safer sexual decision making by adolescent women.

Books/Book Reviews

The State of the World Atlas (book)
This visual survey of current events and social trends, now in its seventh edition, displays worldwide trends on such topics as refugees, the sex trade, malnutrition, urbanization, population, and world trade.

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Volume 3, Number 35 2 September 2003