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The Pop Reporter®

Volume 3, Number 36
8 September 2003

"The Pop Reporter" (R) Johns Hopkins Bloomberg School of Public Health/Center for Communication Programs INFO Project When you click on any link below, 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 INFO Project, Johns Hopkins University, or the US Agency for International Development. All links were verified at the date of mailing. 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. Did you know that "The Pop Reporter" can now be customized? If you haven't done so already, visit the modify profile page at http://prds.infoforhealth.org/modify.php to customize your edition of Pop Reporter. Simply type in the e-mail address at which you receive "The Pop Reporter", leave the password field blank, and log on. You'll be signed on and ready to customize your account!

Family Planning/Reproductive Health Research

Progress in Reproductive Health Research (resource material)
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This quarterly newsletter, a joint production of UNDP/UNFPA/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction, contains four articles: Effective contraception—more benefits than meet the eye; Reducing the risk of pregnancy—the role of contraception; The link between contraceptive prevalence and abortion; and Do women with unintended pregnancy seek the health care they need?

The Acceptability and Use of Contraception: A Prospective Study of Somalian Women's Attitude (research abstract)
Researchers combined quantitative and qualitative data to understand more fully the Somalian perspective of family planning services. They identified religious teaching, status of men and women, and an oral tradition as fundamental to Somalian conceptualisation of family planning services.

Contraceptive Practices in the Behavioral Risk Factor Surveillance System (BRFSS), 2000 and 2002 (research abstract)
Analyses for this study were conducted using the BRFSS, a population based survey with random digit dialing methodology. The family planning module for 2000 was completed by a representative sample of women aged 18 to 44 from 12 states/territories (approximately 11,000 women). In 2000, 66% of all reproductive age women (ages 18-44) reported currently using some contraceptive method. Women aged 18-19 reported significantly lower use of contraceptives (48%) than women 20-29 years old (67%) and women 30-44 (68%). Among reported contraceptive users, the primary methods were birth control pills (35%), condoms (16%), tubal ligation (27%), and partner vasectomy (13%). For contraceptive non-users, the most common reasons for not using contraceptives were not having sex (53%), wanting a pregnancy (20%) and infertility (13%).

Selection Effects of Source of Contraceptive Supply in an Analysis of Discontinuation of Contraception: Multilevel Modelling When Random Effects are Correlated with an Explanatory Variable (research abstract)
This paper presents an application of a multiprocess multilevel model to assess the difference in rates of discontinuation of contraception between private and government family planning providers, while accounting for the possibility that there may be unobserved individual and community level factors that influence both a couple's choice of provider and their probability of discontinuation.

Experience with an Internet-based, Theoretically Grounded Educational Resource for the Promotion of Sexual and Reproductive Health (news article)
This article reports on the development and utilization of an Internet-based, theoretically-grounded educational resource for the promotion of sexual and reproductive health.

Perceived HIV Risk and Condom Use in the Behavioral Risk Factor Surveillance System (BRFSS), 2000 (research abstract)
This study evaluated the association between perceived risk of acquiring HIV and the use of condoms among women of reproductive age. The authors used data from the 2000 BRFSS telephone survey, limiting their analysis to approximately 10,000 sexually active women aged 18-44 from 12 US states/territories who answered questions in the optional Family Planning module. Most sexually active women in this study reported using some form of birth control (74%); however, only 14% of women using birth control reported using condoms. Six percent of all respondents reported that they had a high or medium risk of acquiring HIV. Of those who perceived a high or medium risk for HIV infection, only 14% reported using condoms. Those who perceived no or low risk reported the same level of condom use (14%).

Family Planning/Reproductive Health News

FDA Approves Seasonale Oral Contraceptive (press release)
The FDA announced its approval of Seasonale, a new choice in oral contraceptives for women for prevention of pregnancy. Seasonale is a 91-day oral contraceptive regimen.

Female-Condom Maker Gets Distribution Deal in India (news article)
Female Health Company, the manufacturer of the world's only female condom, signed a deal with Hindustan Latex Ltd, India's leading male condom manufacturer, to market and distribute its product on the subcontinent. This will pave the way for the US company to broaden distribution of its product in India where reportedly about 4 million people are infected with the HIV virus.

India: TTK LIG Raising Condom Capacity by 330 Million (news article)
India's largest condom maker, TTK LIG Limited, announced plans to build a third plant, which will have the capacity to make 330 million pieces of condoms a year.

Senate Committee Votes to Overturn White House Cuts to Overseas Family Planning Aid (news article)
The Senate Appropriations Committee voted late Thursday to block White House efforts to expand a ban on US assistance to family planning organizations that perform or advocate abortion. US President George W. Bush last week extended a March 2001 order blocking aid from the US Agency for International Development to foreign groups supporting abortion. That ban, sometimes referred to as the Mexico City policy or the global gag rule, would deny US family planning funds to foreign organizations that use their own funds to counsel, perform, or advocate around abortion.

Australia: Pill Register Sparks Outrage (news article)
Women's health and family planning groups are outraged at doctors' calls for a register of women using the morning-after pill. But Australian Medical Association president Bill Glasson has stood by his call for women who buy the morning-after pill, once it becomes available over-the-counter next year, to give their name and contact details to the pharmacist. Dr. Glasson said he did not think women would be put off by such a requirement. "I don't think I'm being belligerent," he said. "For women to be able to just pick something off the counter and disappear and not have someone give them medical attention, that's trivialising the morning-after pill. We are undervaluing women by suggesting we just give them the pill and send them on their way.

India: Any Time Condoms a Big Success in Andhra (news article)
The Any Time Condom machines, which make it easy to get a condom secretly, will soon be available wherever required in the State to check the spread of the dreaded HIV/AIDS. After the successful trial run of ATCs in the city, the Andhra Pradesh State Aids Control Society is planning to expand the services to other major towns.

Telenovelas An Ideal Medium for Health Messages (press release)
Public health experts have discovered that Latin America's popular soap operas - known as telenovelas - are an ideal vehicle for health and quality-of-life messages in the Americas and that they can often trigger significant social change.

Family Planning/Reproductive Health Law and Policy

Parental Involvement Laws and Fertility Behavior (research abstract)
This paper considers the impact of the introduction of state laws in the US requiring parental involvement in a minor's decision to end a pregnancy. It was found that parental involvement laws resulted in fewer pregnancies for minors; there is no statistically significant impact on births.

Medics May Face Death in HIV-trial (news article)
Bulgarian state radio reports that a Libyan prosecutor demanded death sentences for six Bulgarian medics charged with deliberately infecting about 400 Libyan children with HIV through blood transfusions. The Bulgarians (five nurses and a doctor) are charged with infecting the children with the virus that causes AIDS through tainted blood. Twenty-three of the children have reportedly developed AIDS and died. The demand came only days after a French scientist testified that poor hygiene at the hospital likely led to the contamination.

Population Policy: A Concise Summary (working paper)
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Population policies are deliberately constructed or modified institutional arrangements and/or specific programs through which governments influence, directly or indirectly, demographic change. This paper briefly discusses how individual and collective interests were reconciled in traditional societies, summarizes the population policy approaches adopted by the classic liberal state, and sketches government responses to the low-fertility demographic regime that emerged in the West between the two World Wars. In greater detail it considers international population policies after World War II and contemporary population policy responses to below-replacement fertility.

HIV/AIDS Research

Survey of Knowledge, Attitude and Behavior Regarding Safe Injection Among Health Practitioners in Shandong, China (PubMed abstract)
Researchers aimed to assess the knowledge, attitude, and behavior of health practitioners (HPs) about safe injection in Shandong, China, and to clarify risk factors related to unsafe injection and improper handling of used disposable syringes. Factors found to significantly relate to unsafe injection practice included lower than middle level professional grade; thinking that AIDS is not a terrible disease; and thinking that patients would accept the practice of sharing the same syringe for different persons. Factors significantly found to relate to improper handling of used disposable syringes included working in the village; thinking that patients would accept the practice of sharing the same syringe for different persons; and unwillingness to properly handle used disposable syringes. Lack of knowledge about safe injection was a risk factor for both unsafe injection and improper handling of used disposable syringe.

Promoting Behavior Change in Botswana: an Assessment of the Peer Education HIV/AIDS Prevention Program at the Workplace (research abstract)
This paper assesses the impact and outcome of the Peer Education HIV/AIDS Prevention Program (PEHAPP), which was implemented to promote sexual behavior change at the workplace. It concludes that the PEHAPP is having a measurable positive impact in the key areas of improving knowledge, attitudes, and practices related to risky sexual behavior which, it is expected, should reduce the incidence of transmission of HIV/AIDS and other STDs over the long-term.

Attitudes of Health Care Providers to Persons Living with HIV/AIDS in Lagos State, Nigeria (research abstract)
Researchers examined the knowledge, beliefs and attitudes of Nigerian nurses and laboratory technologists towards people living with HIV/AIDS (PLWA) and the factors responsible for these attitudes. Respondents' level of knowledge was influenced by the level of formal education attained, length of practice, gender and attendance at refresher courses on HIV/AIDS (p < 0.05). In contrast, respondents' age, occupation and religion did not significantly influence their level of knowledge (p > 0.05). Attitude towards PLWA was poor. Some (55.9%) of the health workers felt that PLWAs are responsible for their illness, while 35.4% felt that they deserve the punishment for their sexual misbehaviors. Only 52.8% of the respondents expressed willingness to work in the same office with a PLWA, while only 18% would accept to visit or encourage their children to visit a PLWA, probably because of the fear of contagion.

A Qualitative Study on HIV Risk Behaviors and Medical Needs of Sex Workers in a China/Myanmar Border Town (research abstract)
This qualitative study was carried out on 89 commercial sex workers in Ruili (a small border town between China and Myanmar where drugs and commercial sex are common) to understand more about their HIV awareness, medical-seeking behaviors, and needs. Researchers found that the sex workers were young and the turnover rates were high. Contrary to common belief, many came from nearby villages or cities, but were probably reluctant to participate in organized activities. Their medical knowledge was very limited. Self-medication was common. The contraception they used was inappropriate, and screening for cervical cancer was nonexistent. Condoms were purchased in small quantities when required and used only if the clients were agreeable.

Structured Treatment Interruption in Patients with Multidrug-Resistant Human Immunodeficiency Virus (research abstract)
Related news article: One AIDS Treatment Plan Found Ineffective
This study found that temporarily stopping AIDS treatment is ineffective and even dangerous as a strategy for controlling drug-resistant HIV.

HIV/AIDS News

Brazil Imports Generic AIDS Drugs from India, China (news article)
Brazil's decision to import generic HIV/AIDS drugs, manufactured in China and India, has gained greater legitimacy with the related agreement approved by the World Trade Organisation last week, but the import policy was never contingent on international consent.

In South Africa, WHO Leader Sees Chance in AIDS Fight (news article)
Jong-Wook Lee, who assumed the leadership of the WHO on July 1, has set an ambitious goal of treating 3 million people with antiretroviral medicines by the year 2005. Now, just 300,000 patients receive the drugs, two-thirds of them are in Latin America. With an estimated 4.5 million people who have the HIV virus, South Africa had steadfastly resisted calls by activists and world leaders to begin more aggressive policies to fight AIDS. But with the government's decision last month to allow the use of antiretroviral drugs, Lee and other international health leaders now see an opportunity in South Africa. It is hoped that antiretroviral treatment will be started by the beginning of next year.

HIV/AIDS Campaign is the Talk of Mumbai (resource material)
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A ground breaking HIV/AIDS campaign has created more than its share of discussion in Mumbai. With the catch phrase "Will Balbir Pasha Get AIDS?" seen on televisions, newspapers and billboards across the city, the USAID-funded project targeted the group most at risk, urban men ages 18-34 in the lower socio-economic groups. The Balbir Pasha campaign sought to dispel HIV/AIDS myths, increase risk perception, generate discussion and motivate people to access HIV/AIDS hotlines and voluntary counseling and testing services, and did so with significant consumer impact. Calls to the Saadhan HIV/AIDS hotline jumped 250% and among research participants risk perception to unprotected sex increased as well.

India: Ahmedabad Police Stations Double Up as Condom Banks (news article)
At least 21 of Ahmedabad's 29 police stations have become condom banks. Three years ago, a program was started by NGOs and the National Aids Control Organisation (NACO), which distributed condoms among policemen and to any visitor who might ask for them. Folowing a meeting of an NGO, sex workers, and the Police Commissioner, it was decided to educate Ahmedabad policemen on safe sex and AIDS control, and to use them to spread the message of AIDS prevention and safe sex. NGOs are planning to replicate the project in other cities.

Zambia: Abstinence, Condoms Help Cut HIV (press release)
A combination of abstinence and condom use has helped Zambia either stabilize or reduce HIV prevalence among young adults through a youth-centered communication campaign employing such catchphrases as "Abstinence is cool" and "Virgin Power, Virgin Pride." The campaign was implemented by Population Services International and the Johns Hopkins University Center for Communication Programs with the active participation of Zambian young adults.

Maternal and Child Health Research

Mother-to-Child HIV Transmission Prevention in Thailand: Physician Zidovudine Use and Willingness to Provide Care. (research abstract)
The purpose of this mail survey of Thai physicians involved in obstetric care was to assess attitudes and practices regarding zidovudine use during pregnancy, and willingness to provide care for HIV-infected women. The survey results indicated an increasing willingness of Thai physicians to use antiretroviral therapy to prevent mother-to-child HIV transmission and to provide obstetric care to HIV-infected women. Availability and affordability remained major barriers to more widespread antiretroviral use.

Impact of Face-to-face Counseling on Duration of Exclusive Breast-feeding: A Review (research abstract)
Researchers reviewed the scientific literature for studies of face-to-face counseling for the promotion of exclusive breast-feeding. They found that face-to-face counseling, given during different time periods, led to significant, positive changes in the rate of exclusive breast-feeding.

Vitamin A Deficiency in Poor, Urban, Lactating Women in Bangladesh: Factors Influencing Vitamin A Status. (PubMed abstract)
This study investigated the prevalence of vitamin A deficiency among lactating women in a poor urban population of Bangladesh. Examination of the relationship between various factors and vitamin A status revealed that a significant proportion of poor, urban, lactating women in Bangladesh have vitamin A deficiency. Education level of the women, number of living children, duration of lactation, and dietary intake of vitamin A all appear to be important in influencing the vitamin A status of these women.

Implementing a community-based participatory intervention to improve essential newborn care in Rural Nepal. (PubMed abstract)
This study addresses the effectiveness of community-based action research interventions with mothers and other key members of the community in improving perinatal health outcomes. The intention is to improve essential maternal and newborn care. Outcomes assessed are neonatal and perinatal mortality rates, changes in patterns of home care, health care seeking, and referral.

Labour Complications Remain the Most Important Risk Factors for Perinatal Mortality in Rural Kenya (research article)
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Findings of this study indicate that in a hospital setting, labor complications pose the greatest risk for perinatal mortality. Even where labor care is provided, high risks are associated with complications such as obstructed labor and hemorrhage.

The Silent Burden of Anaemia in Tanzanian Children: A Community-based Study (research article)
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This survey was the baseline household survey of the WHO Multi-Country Evaluation of the Integrated Management of Childhood Illness in the United Republic of Tanzania. It documented the prevalence, age-distribution, and risk factors for anemia in Tanzanian children less than 5 years old, thereby assisting in the development of effective strategies for controlling anemia. Researchers found that, overall, 87% of children under 5 years of age had some level of anemia. But they found surprisingly few differences between anemic and non-anemic children (apart from anemia affecting relatively poor and malnourished children), making it hard to identify them as a group for targeted interventions.

Is Delivery by Cesarean Section a Risk Factor for Food Allergy? (research abstract)
Related news article: C-Section May Increase Risk for Food Allergy
Investigators have identified a relationship between cesarean section delivery and subsequent food allergy in children of mothers with allergies. Cesarean delivery might delay the growth of normal intestinal flora--bacteria that normally line the intestine--in the newborn infant which may increase the risk of allergic disease.

Maternal and Child Health News

Ghana: Country Still Below 20% Over Breastfeeding (news article)
Ghana is still ranked among countries with high rates of bottle-feeding in the West African sub-region, despite years of campaigns and educational programs on the need to breastfeed babies. According to a recent survey, four out of every five babies in the country today are inappropriately fed during the crucial period of their growth.

Men's Health Research

An Eight-month Clinical Study of LA-2575 30.0 mg: A New 4-month, Subcutaneous Delivery System for Leuprolide Acetate in the Treatment of Prostate Cancer (research abstract)
Related news article: Prostate Cancer Treatment Gets under the Skin
A new method of delivering a prostate cancer drug under the skin is useful in maintaining low levels of testosterone, a hormone that can cause frustrating symptoms and promote the growth of cancer cells, new research shows.

Male Infertility and Genital Chlamydial Infection: Victim or Perpetrator? (research abstract)
This paper reviews and summarizes data from the medical literature that supports and opposes the case for the role of C. trachomatis in male infertility.

Population Research

The Epidemiologic Transition among Adolescents in Mexico (research abstract)
Researchers attempted to identify the health status of adolescents in Mexico in their demographic, social, and economic context. A literature search and review of vital statistics, and opinion surveys were performed in order to asses the impact of the epidemiologic transition on the availability and priority of health services for adolescents. The findings reveal a sequence of variables that can no longer be addressed in the traditional problem- oriented approach and strongly suggest a need to profile the health needs of adolescents in an integrated, holistic fashion with emphasis in health promotion and healthy life styles.

Completing the Fertility Transition in the Developing World: The Role of Educational Differences and Fertility Preferences (working paper)
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This study summarizes patterns of educational differentials in wanted and unwanted fertility at different stages of the fertility transition based on data from DHS surveys in 57 less developed countries. As the transition proceeds, educational differentials in wanted fertility tend to decline and differentials in unwanted fertility tend to rise. An assessment of fertility patterns in more and less developed countries with low fertility concludes that these differentials are likely to remain substantial when less developed countries reach the end of their transitions. This finding implies that the educational composition of the population remains a key predictor of overall fertility in late transitional countries and that low levels of schooling can be a cause of stalling fertility.

How Well Do Desired Fertility Measures for Wives and Husbands Predict Subsequent Fertility?: Evidence from Malaysia (report)
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The authors examine responses to two fertility preference questions (regarding whether more children are wanted and desired total family size compared to actual family size) that were asked of women and their husbands as part of the First Malaysian Family Life Survey fielded in 1976-77 and see how well these preferences (and the consistency between them) predict the women's subsequent fertility, as reported in the Second Malaysian Family Life Survey, fielded 12 years later. Women who said (and whose husbands said) in 1977 that they wanted more children were much more likely to have a birth than those who said they did not want more. If there was disagreement between spouses, the husband's preferences appear to play a stronger role in predicting the likelihood of a subsequent birth. The authors investigate how events during the 12-year period between the surveys, eg, the death of a child, affect the relationship between fertility preferences and subsequent fertility outcomes.

Population News

Hong Kong Issues Report on Future Population Distribution (news article)
The artcle describes a report recently released by the Hong Kong Population Planning Department. The report, entitled "Projections of Population Distribution, 2003-2012," was developed to project the total local population of Hong Kong. According to the findings, the population of Hong Kong will decline considerably, while adjacent territories are anticipated to grow.

India: Website on Bengal Census Data (news article)
Related resource material: Census of India
According to the article, information collected in the 2001 census of West Bengal is now available online. The site uses a geographical information system tool to present the data and is a part of the Indian census project under the ministry of home affairs of the government of India.

India's Parsi Population on Verge of Extinction (news article)
The article describes the dwindling Parsi population in India. The Parsis control more than 15% of the market capitalization on India's main stock exchange, but account for a miniscule 0.000076% of its billion people. The Parsi population has always been small but census figures show it fell a third to 76,000 in 1991 from a peak of 114,000 in 1941. At the current rate, the number could shrink to about 20,000 within 20 years.

French Polynesia's Population on the Rise (news article)
According to the article, new statistics show French Polynesia's population is now more than 245,000. The figure, based on the 2002 census, represents an increase of 11%, or 26,000 people, from the last census carried out in 1996.

Women's Health Research

Limited Pap Screening Associated with Reduced Risk of Cervical Cancer in South Africa (research abstract)
The study investigates the effect of Pap smear screening on the incidence of invasive cancer of the cervix in the Western Cape, South Africa where screening is limited. Data were collected from a case-control study of the association of hormonal contraceptives and invasive cervical cancer. The data suggest that even limited Pap smear screening reduces the risk of cervical cancer.

Health Care Providers’ Perceptions on Harmful Traditional Health Practices in Ethiopia (research abstract)
The frequency of traditional surgical health practices such as female genital mutilation, uvulectomy, and uterus massage have adverse physical health effects in various regions of Ethiopia, and call for preventive strategies where the health sector can play an important role. Most of these traditional surgical procedures resulted in frequent and sometimes fatal complications.

IUD-Related Knowledge, Attitudes and Practices Among Navajo Area Indian Health Service Providers. (research abstract)
The IUD once accounted for about half of contraceptive use among Navajo women but is now little used in this population, which has a high rate of unintended pregnancy. Identifying barriers to use--including those stemming from providers' IUD-related knowledge, attitudes, and practices--could help expand use of the method. The main reasons providers cited for not recommending the IUD were concerns about its safety and about side effects. Researchers suggest that provider education and training should focus on insertion techniques and on the safety of available IUDs. They also recommend that training should be targeted not only to women's health providers, but to family practice physicians, nurse practitioners and other providers who offer family planning counseling and services.

Cervical Cytological Studies in Women Inserted with Norplant-I Contraceptive (research abstract)
The study was carried out by the Human Reproduction Research Centre of the Indian Council of Medical Research at Lucknow and Kanpur, India, as part of a multicenter study to ascertain the oncogenic potential of Norplant-I, a progestational contraceptive, by periodic cytological evaluation of cervical smears. A total of 278 fertile healthy women were inserted with Norplant-I and followed for periods ranging from 1 to 5 years. The accumulated data indicate the safety of long-term use of Norplants up to 5 years.

Women’s Denial of Having Experienced Female Genital Cutting in Northern Ghana: Explanatory Factors and Consequences for Analysis of Survey Data (working paper)
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This paper reports on a longitudinal study of women aged 15 to 49 in rural northern Ghana. The self-reported circumcision status of women interviewed in 1995 was compared with the status they reported when they were interviewed again in 2000 after the government began enforcing a law banning the practice and public information campaigns against it were launched. In all, 13% of respondents who reported in 1995 that they had been circumcised denied that they were circumcised in the 2000 reinterview, although denial rates were as high as 50% in the youngest age group. Analysis shows that women who denied being circumcised are significantly younger, more likely to be educated, and less likely to practice traditional religion than are women who reported that they were circumcised. Factors that may explain these correlates of denial are discussed, and implications for research are reviewed.

Women's Health News

Uganda: UN Body to Fight Female Circumcision (news article)
The United Nations Fund for Population Activities (UNFPA) has resumed its campaign to fight female genital mutilation in Uganda. According to the article, the Reproductive Educative and Community Health-Reach Project has focused on recruiting advocacy teams to sensitize communities about the dangers and legal implications of forcing women and girls into the practice. The campaign is also to include the arrest of those who perform the mutilation.

Youth Health Research

La Uniendo de Fronteras: Collaboration to Develop HIV Prevention Strategies for Mexican and Latino Youth. (PubMed abstract)
This article describes collaborative efforts between nurse researchers in the United States and Mexico to decrease the risk of sexually transmitted HIV infection among adolescents. The shared border and continued migration between Mexico and the United States as well as shared concerns about HIV/AIDS are compelling reasons to promote AIDS prevention as an important public health endeavor for both countries.

Misconceptions, Folk Belief, Denial Hinder Risk Perception among Young Zambian Men (research summary)
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A research brief by Population Services International reveals that misconceptions, folk beliefs and denial are responsible for young Zambian men's low personal risk perception for STIs and HIV/AIDS. Survey results show that misinformation is spread through gossip and hearsay, and that young men fear retribution or are too shy to ask for clarification from friends or family. Folk-belief explanations for transmission included attributing
infection to sorcery or to the strength of a person's blood. Many respondents cited promiscuous-looking females as the most frequent transmitter of STIs/HIV and therefore avoid such women as a precautionary method. Most did not realize that all sexually-active people are at risk for HIV/AIDS. The research brief and corresponding working paper offer suggestions for programs working in communities
where folk beliefs may conflict with fact.

Youth Sexuality and Social Change: The Case of Portugal (research abstract)
This paper presents results of an investigation of whether new generations are creating new social values in Portugal. A survey of more than 2,000 residents was used to collect data on values and generations of the Portuguese population. Findings showed that Portuguese youngsters are depicted as a generation with hedonistic and experimental values regarding love and sex life. However, youngsters are at the same time characterized by both their vulnerability and risk behaviors.

Birth Rates and Reproductive Risk in Adolescents in Chile, 1990-­1999 (research abstract)
Researchers studied trends in birth rates and reproductive risk for Chilean teenage mothers under 15 years old and from 15 to 19 years old for the period of 1990 to ­1999. They found that teenage mothers faced greater reproductive risk than did women who were 20 to ­34 years old. Also, the number of live births among teenage mothers tended to rise during the study period, but the change was significant only for the mothers under age 15.

Masculinity and Sexual and Reproductive Health: A Case Study among Adolescents of Mexico City (research abstract)
The study was carried out in an underserved and a popular area of Mexico City. Eighteen focal groups and 18 individual interviews were applied to a sample of males from three age groups: 10 to 14, 15 to 19, and 20 to 24 years. Findings indicate that the traditional model of masculinity characteristic of both social settings involves poor communication about sexuality in couple relationships, which results in infrequent protection and exposure to sexually transmitted infections and unwanted pregnancies. On the other hand, the researchers write, their economic living conditions prevent them from fully practicing central elements of their own concept of masculinity, such as being a hard worker, a provider, and a responsible person. These unmet needs may cause frustration, aggression, and domestic violence.

Youth Health News

Youth Unite Against Russian HIV Epidemic (feature article)
Realizing that youth frequently acquire information on sexuality and sexual health from same-age friends, Population Services International's (PSI) Samara, Russia program is training peer educators and young volunteers to reach out to young people with HIV prevention messages.
PSI/Samara's peer educators reach out to youth at concerts, sports events, beaches, hostels and schools. UNAIDS has emphasized school-based HIV/AIDS education as an essential component of prevention interventions in low- and middle-income countries, and studies conducted in various countries have shown that peer education is one of the most effective ways to spread information about health. But in Russia there is a lack of sex education in schools. Often PSI's peer education is the first time youth in Samara have the opportunity to learn about sexual health and to ask questions of someone who understands the situation technically and emotionally.

Japan: AIDS Threat is Explosive among Young, Expert Says (news article)
The threat of HIV/AIDS in Japan, especially among young people, is far more alarming than the government may want to think, an expert warned during a symposium last week. Kunio Kitamura, director of the Japan Family Planning Association, cited the behavioral patterns of youths and a lack of sex education as the main factors behind this assertion.

China: Sex Education Urged to Prevent Teenage Pregnancy (news article)
While a little bit of knowledge may be a dangerous thing, when it comes to teenage sexuality, it can be devastating. The article explains that, as the number of teen pregnancies rises in China, arguments for lifting the taboos surrounding sex and educating youngsters are gaining ground.

UK: Young are Getting Help with Sexual Health (news article)
Open access Contraceptive Services at Sexual Health Clinics are now available across the South Staffordshire region. The clinics are aimed at young men and women under the age of 25 as part of the National Sexual Health Strategy, in order to reduce teenage pregnancies and sexually transmitted infections. The article explains that the clinics provide contraceptive advice, cytology screening, and counseling on all aspects of sexuality and sexual health.

Jamaica: HIV/STI Prevention Program for Teens (news article)
The article describes a new HIV/STI prevention program to be implemented in schools to address the increasing trend of sexually transmitted infections among teenagers. The new policy, which is in the final stages of drafting, will have to get the Cabinet's approval.

Books/Book Reviews

The Global Threat of New and Reemerging Infectious Diseases: Reconciling U.S. National Security and Public Health Policy (book)
This study offers a more comprehensive analysis of the security implications of the spread of infectious diseases than has been done to date. The study examines the impact of the HIV/AIDS epidemic in South Africa, highlighting this particular crisis as a graphic example of the devastating effects that infectious disease can have on virtually every aspect of a state's functioning viability. It also makes a detailed analysis of the United States, delineating the threat posed by specific diseases; assessing the effectiveness of the existing public health infrastructure; and offering specific actions that can be taken to improve the country's ability to meet this emerging challenge.

Special Reports/Profiles/Resources

WHO's FP Guidelines Now Available Online in French (resource material)
The WHO's two evidence-based family planning guidelines - "Medical Eligibility Criteria for Contraceptive Use" and "Selected Practice Recommendations for Contraceptive Use" - are now available online in French.

Gender, Health and Development in the Americas 2003 (resource material)
This data sheet profiles gender differences in health and development in 48 countries in the Americas, focusing on women's reproductive health, access to key health services, and major causes of death. Its objective is to raise awareness of gender inequities in the region and to promote the use of sex-disaggregated health statistics for policies and programs. The data sheet also provides basic population and development indicators and information on other factors that influence health, including education, employment, political participation, and risk factors. The Pan American
Health Organization and the Population Reference Bureau compiled this information using data from official national sources as well as data collected by specialized international agencies.

Population and Development: An Introductory View (working paper)
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This working paper from the Population Council is a brief overview of the relationships between population change and economic development, written for readers unfamiliar with the subject. The paper touches on the scale and pace of world development, the economic consequences of population size and rate of growth, patterns of demographic transition, and the scope for policy measures aimed at speeding that transition.

IPPF Medical Bulletin (resource material)
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This issue of the IPPF Medical Bulletin contains four articles: Tools for assessment of STI risk in family planning settings; Acceptability of amenorrhoea associated with contraception; Progestogen-only emergency contraception and risk of ectopic pregnancy; and IMAP recommendation on single-dose levonorgestrel for emergency contraception.

"Interactive Reproductive Health Training = Interesting and Innovative Training" (resource material)
This workshop presentation was created by Family Health International for the "Training in Africa: Best Practices, Lessons Learned, and Future Directions" conference held in Lusaka, Zambia in August 2003. The presentation, titled "Interactive Reproductive Health Training = Interesting and Innovative Training," will help you learn how to maximize learning energy and make training more interesting and innovative in e-learning, distance-learning, multiple-day, and shorter intervention settings.

Global Fund to Fight AIDS, TB and Malaria Has Advanced in Key Areas, but Difficult Challenges Remain (report)
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Established in January 2002, the Global Fund (the Fund) aims to rapidly disburse grants to augment existing spending on the prevention and treatment of HIV/AIDS, tuberculosis, and malaria while maintaining sufficient oversight of financial transactions and program effectiveness. As of April 1, 2003, the United States had pledged $1.65 billion to the Fund and is expected to remain its single largest donor. In this study, the US Government Accounting Office was asked to assess (1) the Fund’s progress in developing governance structures; (2) the systems that the Fund has developed for ensuring financial accountability, monitoring and evaluating grant
projects, and procuring goods and services; (3) the Fund’s efforts to raise money; and (4) its grant-making process.

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