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The Pop Reporter®

Volume 3, Number 41
13 October 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.

FAMILY PLANNING/REPRODUCTIVE HEALTH RESEARCH

Methodological Challenges in Research on Sexual Risk Behavior: I. Item Content, Scaling, and Data Analytical Options (PubMed abstract)
This paper discusses two assessment approaches in the context of research on HIV risk behavior: absolute frequency measures (also known as counts) or relative frequency measures (eg, rating scales that range from never to always). The authors conclude that these two approaches yield nonredundant information and, more important, that only data yielding information about the absolute frequency of risk behavior have the potential to serve as valid indicators of HIV contraction risk. They identify new and powerful data analytical solutions that have been developed recently to analyze count data and discuss limitations of a commonly applied method.

Achieving the Millennium Development Goals: Population and Reproductive Health as Critical Determinants -- Population and Development Strategies (report)
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The Millennium Development Goals (MDGs), arising from the Millennium Summit in September 2000, are the overarching development objectives of the international community. The International Conference on Population and Development (ICPD) goal of universal access to quality reproductive health services by 2015 is not one of the MDGs. Yet as this publication demonstrates, it is essential for meeting the MDGs. The attainment of reproductive health and reproductive rights are fundamental for development, for fighting poverty, and for meeting the MDG targets. Conversely, reproductive ill-health undermines development by, inter alia, diminishing the quality of women's lives, weakening and, in extreme cases, killing poor women of prime ages, and placing heavy burdens on families and communities. This publication shows by means of analytical graphics, the fundamental importance of addressing population and reproductive health for achieving the MDGs.

Methodological Challenges in Research on Sexual Risk Behavior: II. Accuracy of Self-Reports (PubMed abstract)
The authors review recent studies regarding the accuracy of self-reports of sexual behavior, paying particular attention to a promising new development: the use of computer-assisted assessments. While the collection of sexual risk behavior data with computers has increased dramatically in recent years, little is known about the accuracy of such assessments. They summarize the evidence, discuss methodological issues that arise in studies evaluating the accuracy of self-reports, and offer recommendations for future research.

Understanding Risk: A Randomized Controlled Trial of Communicating Contraceptive Effectiveness (research abstract)
Researchers determined which one of three different approaches increased women's understanding of risk of pregnancy associated with different contraceptive methods.

Health Inequality and Users' Risk-Taking: A Longitudinal Analysis in a French Reproductive Technology Center (research abstract)
The researchers provide demographic analysis of the production of social inequality through IVF trajectories in a reproductive technology center of a French hospital. The researchers found that the production of social inequality in reproductive health can be understood in connection with the social dynamics of lifestyles, resulting in specific medical patterns.

Country Profiles for Population and Reproductive Health (report)
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In 1995, UNFPA published Resource Requirements for Population and Reproductive Health Programmes: Programme Country Profiles for Population Assistance. The current publication is an updated version of that volume, with a greater emphasis on policy and institutional commitments and a broader range of socio-economic, gender, demographic and health indicators. The expanded range of indicators reflects the priorities identified in the five-year review of the Programme of Action and the perspectives from the other international conferences of the 1990s that culminated in the Millennium Summit. Attention is also given to differences within countries. Indicators for ICPD and MDGs are identified by special symbols.

FAMILY PLANNING/REPRODUCTIVE HEALTH NEWS

Pre-nuptial Chastity Goes for a Loop in New China (news article)
Only about a third of Chinese newlyweds enter the bedchamber as virgins, a new government report estimates, underlining the extent of the sexual revolution in a society that once swore by pre-nuptial chastity. Research published by the State Family Planning Association showed that 60% to 70% of men and women engaged to be married had previous sexual experience.

Thailand: Bar Girls Show Their Skills at Miss Condom Pageant (news article)
A bevy of Thai bar girls, health officials and a transvestite blew up condoms and paraded for a different kind of honor, the title of "Miss Condom Asia-Pacific." Featuring 20 contestants from four different nations, the contest aims to promote safe sex in Thailand, a country on the frontline in the war against HIV/AIDS in Asia.

FAMILY PLANNING/REPRODUCTIVE HEALTH LAW AND POLICY

Saudi Arabia: Woman in Labor Must Bring in Man (news article)
Saudi Arabia's Deputy Minister of Health Dr. Qassim Al-Qasabi issued a directive, effective immediately, recommending that all hospitals admit pregnant women only when they are accompanied by men who will take responsibility for the mother and child, reported the Arab News. The action was the direct result of a joint ministries committee meeting addressing findings that children of unmarried mothers accounted for the largest percentage of abandoned children.

China: Shanghai Reworks One-child Policy (news article)
Shanghai People's Congress is debating changes to the city's rules of the "one-child policy" that would allow some couples to have a second child without waiting for four years between births and divorced parents more opportunity to have a child in a second marriage.

Universal Status for Reproductive Rights Pushed (news article)
If populations across Asia are to enjoy the full scope of reproductive and sexual health rights, they must be given new life as one of the many human rights recognised universally, rather than be reduced in significance and treated as specific and different principles. That was a key message that emerged Thursday at the end of a regional conference on reproductive health in Bangkok, Thailand.

India: Just One Child, Say Delhiites (news article)
According to the Delhi government’s department of family welfare, the average fertility rate in Delhi families is 1.6%, well below the national average of 3.2%. This means that most Delhiites are opting for a single child.

Tanzania: Three Get 30 Years after FGM Victim Dies (news article)
The High Court in Singida zone sentenced three women to 30 years in jail after a girl on whom they had performed female genital mutilation died. The women pleaded guilty to a charge of manslaughter; the trio had been accused of causing the death of a teenage girl.

Spain: Doctor Pays for Not Stopping 'Concepcion' (news article)
A court has ordered a Spanish doctor to pay 20-years child support at 240 euros ($281) a month to a woman who gave birth 3 years after he tried to sterilize her. According to the article, the Madrid woman sued for compensation because the doctor did not warn her there was still a chance she could get pregnant after the operation.

Saudi Arabia: Officials Told to Track Down Runaway AIDS Patient (news article)
Makkah Governor Prince Abdul Majeed has instructed local authorities to track down an Arab woman suffering from AIDS who disappeared last Wednesday along with her infant child from a local hospital. According to hospital staff, the woman, who was being treated at the hospital on the eve of her deportation, was last seen asking a nurse to help clean and bandage a cut on her foot. The woman’s husband is also reported to be missing after learning that he too was infected with the HIV virus.

HIV/AIDS RESEARCH

The State of World Population 2003 (report)
Related news article: Half Of World's Youths At Risk
Related press release: Investment in Adolescents' Reproductive Health Is Critical to Fighting Poverty and HIV/AIDS, Says UNFPA Report
Meeting adolescents' reproductive health needs is an urgent priority in the global fight against poverty and HIV/AIDS, emphasizes The State of World Population 2003 report by UNFPA, the United Nations Population Fund. Neglect and under-funding of programmes enabling young people to avoid unwanted pregnancy, unsafe childbirth and sexually transmitted infections are undermining development and spreading HIV/AIDS; investment to correct this will be repaid many times over. These are key findings of UNFPA’s annual flagship report.

Human Immunodeficiency Virus Retesting During Pregnancy: Costs and Effectiveness in Preventing Perinatal Transmission (research abstract)
The purpose of this study was to estimate the incremental societal costs and effectiveness of a second human immunodeficiency virus (HIV) antibody test during the third trimester of pregnancy compared with no second test. Researchers used a decision tree in this cost-effectiveness analysis to model outcomes among pregnant women in high-risk communities and nationwide (US) who received an initial, negative HIV antibody test during the first trimester. The main outcome measure was discounted costs per year of infant life saved. In high-risk communities with estimated HIV incidence of 6.2 per 1000 person-years, a second HIV test compared with no second test would detect 192 infections in women, prevent approximately 37 infant infections, and save 655 infant life-years per 100,000 women tested. Net savings would be $5.2 million.

Overlooked Role of African-American Males' Hypermasculinity in the Epidemic of Unintended Pregnancies and HIV/AIDS Cases with Young African-American Women (PubMed abstract)
This article addresses the role of hypermasculinity in African-American males and how this affects unintended pregnancies and HIV/AIDS in young African-American women.

Stable Incidence Rates of Tuberculosis (TB) among Human Immunodeficiency Virus (HIV) Negative South African Gold Miners during a Decade of Epidemic HIV-Associated TB (research abstract)
Three separate cohort studies, totalling 6,454 HIV-negative participants, were combined and analyzed for time trends. Observed incidence of TB varied between 962 (1991-1994) and 1589 (1999-2000) cases/100,000 person-years. There was, however, a progressive increase in age, and, for each period, older age was associated with increased incidence rates of TB. Having adjusted for age differences, the authors found no significant association between incidence of TB and calendar period.

HIV/AIDS NEWS

Canada Decides to Lead the Way in Exempting AIDS Drugs from Patent Laws (news article)
Canada’s industry minister says his government will try by Christmas to exempt generic forms of drugs to treat AIDS and other drugs destined for poor countries from patent laws. His announcement was followed by a statement from the organization representing Canada’s manufacturers of brand name drugs, saying it would help Canada "to show international leadership" in implementing last August’s World Trade Organization agreement to give poor countries access to cheap generic medicines to treat life-threatening diseases such as HIV, tuberculosis, and malaria.

Catholic Cardinal Suggests Health Warning on Condom Packets (news article)
Condom packages should carry a health warning similar to that printed on cigarette packets, a Roman Catholic cardinal suggested. The idea was put forward by Colombian Cardinal Alfonso Lopez Trujillo in reply to questions about his statements in a BBC television program that condoms were not a guarantee against catching HIV/AIDS and to say the opposite amounted to "Russian roulette". Asked about the controversy prompted by his statement that "the Church advises against people infected with HIV wearing contraceptives", the cardinal said: "In the one-hour interview I gave to BBC on different questions regarding family and life, one question was dedicated to the theme of 'safe sex'. I affirmed the following: one cannot really speak of 'safe sex', leading people to believe that the use of condoms is the formula to avoid the risk of HIV and thus to overcome the AIDS pandemic. Nor should people be led to believe that condoms provide absolute safety."

Drugs Reduce HIV Transmission to Baby (news article)
Research shows a combination drug therapy given to babies soon after childbirth is effective at preventing HIV transmission from mother to child. The therapy was used because the babies' mothers did not know they were HIV positive until the time of delivery.

AIDS Patients in Zambia Face Stark Choices (feature article)
This feature article from The New York Times addresses the tough choices facing patients and their families, the clinicians trying to treat them, and politicians in Zambia. Medications are expensive and societal stigma is a very real and pervasive problem.

Railways Pose Risk of HIV/AIDS in Tibetan Area, Says U.S. Embassy Report (news article)
A report by the American Embassy in China acknowledges the possibility that the construction of the the Golmud-Lhasa railway could have a "big impact on the prevalence of HIV/AIDS in the Tibet Autonomous Region" due to a thriving sex industry in Golmud, transplanted Chinese workers, and close proximity to an illegal drug transportation route.

Ghana: Commercial Sex Thwarting Anti-HIV/AIDS Efforts in Upper West (news article)
Commercial sex activities by young girls has become a major affront to efforts aimed at reducing the rate of spread of HIV/AIDS in the Upper West Region. The article suggests some underlying dimensions regarding the impact of commercial sex in relation to local attitudes, despite ever- increasing numbers of HIV positive individuals.

Swaziland: Aid Focus Shifts to Mitigate Impact of HIV/AIDS (news article)
The impact of HIV/AIDS on Swaziland's agricultural production has forced aid agencies to adjust their programming in a bid to mitigate the effects on food security.

MEN'S HEALTH RESEARCH

Uncircumcised Men Have Higher HIV Risk - Study (news article)
Uncircumcised men are eight times as likely to become infected with HIV than circumcised men, according to a study of nearly 2,300 men in India released on Thursday. A researcher at Baltimore's Johns Hopkins University School of Medicine suggested that the inner surface of the foreskin does not have the same protective layer as the outside, and is potentially more vulnerable to HIV. The research was part of a larger study investigating risk factors for HIV infection based on men attending one of three sexually transmitted disease clinics in Pune, India, between 1993 and 2000. Results of the study were presented at a San Diego meeting of the Infectious Diseases Society of America.

In Their Own Right: Addressing the Sexual and Reproductive Health Needs of Men Worldwide (report)
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Related press release: Preventing HIV/AIDS and Unintended Pregnancy Worldwide Requires Greater Attention to Men's Health Needs
Although men around the world make considerable efforts to protect their own and their partners' sexual and reproductive health, the majority, particularly in developing countries, are in need of vital information and services to prevent unintended pregnancies and STIs, including HIV, according to a new report from The Alan Guttmacher Institute.

MEN'S HEALTH NEWS

Levitra May Help When Viagra Lets You Down - Study (news article)
Nearly half of men who did not respond to Viagra achieved successful sexual intercourse when given rival drug Levitra, researchers said on Thursday. Results of their 463-patient study, which was sponsored by Bayer AG and GlaxoSmithKline Plc, the makers of Levitra Bayer and GSK, were presented on October 11 at a meeting of Sexual Medicine Society of North America in Denver.

POPULATION NEWS

Viet Nam's Population to Reach 80.78 Million by Year's End (news article)
Viet Nam's population is likely to reach 80.78 million by the end of this year, a 1.3% increase from last year, according to the General Statistics Office. The Central Highlands and the Southeast region have the highest growth rates (1.8%), followed by the Northwest region (1.6%); the Southern-Central Coast (1.4%); the Mekong Delta (1.2%); and the Northeast region (1.1%). The figures show that areas with less-developed economies have a higher rate of population growth. This means that although Viet Nam has in recent years made significant progress in family planning and reproductive health care services, the birth rate remains unstable, threatening a population boom.

Experts Warn Nigeria on Population Growth (news article)
In Nigeria, population experts are warning against the increasing growth rate. The country,which has more than 120 million people, is growing at about 2.9%, one of the highest rates in the world. Experts are calling on the National Assembly to urgently enact legislation to limit the number of children Nigerian men can have. Proponents of the legislation say they hope this will discourage men from marrying more than one wife, and having large families. They say that despite family planning campaigns men continue to add more wives - and thus more children. They also say that women should not marry until age 18.

Bangladesh Total Population Will be 254.6 million in 2050 (news article)
With average growth rate of 2% per year, Bangladesh’s total population will be 254.6 million in 2050 if the current trend continues. According to the article, despite a high growth rate, Bangladesh has achieved success in controlling total fertility among the region where the rate has remained 3.46%.

The Philippines: 4 babies for every 4 minutes in Phils (news article)
Four babies are born every minute in the Philippines, up sharply from a rate of three every minute in 2000, the government's Commission on Population said last week. Tomas Osias, executive director of the commission, said in a statement that this amounted to an annual population growth rate of 2.36%. The country already has a population of 82 million people, making it the 12th most populated country in the world.

Taiwan: Population Policy Catches Flak (news article)
Experts on women's rights said yesterday that government policies to arrest the decline in the birth rate were failing. The birth rate for this year will probably be below 1%, the lowest in 50 years, according to the Ministry of Interior.

Ethiopia: Rapid Birth Rate "Undermining" Economic Recovery (news article)
The Ethiopian government has been compelled to step up the distribution of contraceptives to help curb its growing population. Reeling from a humanitarian crisis affecting 13 million people, Ethiopia has the third largest population in Africa. By 2050 it is estimated it will have reached 171 million.

WOMEN'S HEALTH RESEARCH

A Randomized Trial of Letrozole in Postmenopausal Women after Five Years of Tamoxifen Therapy for Early-Stage Breast Cancer (research article)
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Related news article: Study: Drug cuts risk of breast cancer return
Related editorial: Beyond Tamoxifen — Extending Endocrine Treatment for Early-Stage Breast Cancer
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Related editorial: Letrozole after Tamoxifen for Breast Cancer -- What Is the Price of Success?
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Breast cancer patients who follow up tamoxifen treatment with letrozole, an estrogen suppressor, cut risk of recurrence by nearly half, according to a study published online Thursday by the New England Journal of Medicine. The study, involving more than 5,000 women with the most common form of breast cancer, was suspended halfway through its planned five-year timespan because of the surprisingly strong results.

Reproductive Factors and Epithelial Ovarian Cancer Risk by Histologic Type: A Multiethnic Case-Control Study (research abstract)
In this study, a structured questionnaire was administered to 558 histologically confirmed epithelial ovarian cancer cases and 607 population controls. Factors suppressing ovulation, including pregnancy and oral contraceptive use, were inversely associated with the risk of all histologic types. Among all tumor types, endometrioid tumors were the most strongly related to pregnancy and tubal ligation, while clear cell tumors were the only type that was associated with noncontraceptive hormone use.

WOMEN'S HEALTH NEWS

Liberia: Many Women Dying from Pregnancy Related Problems, UNFPA Says (news article)
The situation of women in Liberia has been steadily undermined by civil war over the last two decades. According to the article, the number of displaced Liberian women who have contracted reproductive tract infections and those dying from pregnancy related complications that could be treated is alarming.

Reproductive Rights Make for Sustainable Human Development (interview)
The article provides extended excerpts from an interview with Rebecca Cook of the Faculty of Law, Toronto University, Canada, during a recent conference on women’s role in development and health. In the interview, women’s empowerment and reproductive rights are discussed in the context of larger social change.

YOUTH HEALTH RESEARCH

Changing Youth Behavior through Social Marketing: Program Experiences and Research Findings from Cameroon, Madagascar, and Rwanda (report)
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This report describes the implementation, evaluation, and impact of the 100% Jeune, Top Réseau and Centre Dushishoze programs, three Population Services International (PSI) youth-oriented programs, and offers a thorough lessons learned section. The PSI programs, funded by the Bill and Melinda Gates Foundation, bring "youth-friendly" reproductive health services to young people and use mass media campaigns to improve self-efficacy, healthy behavior, and correct and consistent condom use.

Cameroon: Peer Education and Youth-Friendly Media Reduce Risky Sexual Behavior (research summary)
To assess strategies to encourage abstinence, increase contraceptive use, and reduce STI rates among sexually active youth, Cameroonian researchers conducted an operations research project between July 2000 and February 2002. The intervention combined peer education strategies with a series of media campaigns to promote healthy behavior among youth in the Mokolo neighborhood of Yaoundé. They used formal and informal educational talks, one-on-one counseling sessions, conferences, and cultural and athletic events, and also produced comic books, brochures, and a magazine. Approximately 200,000 adolescents received reproductive health information directly from the campaign. Abstinence increased in the intervention site and decreased in the control site. After the campaign, 62% of intervention site youth reported abstaining, compared to 50% before. In the control site, 56% reported abstaining after the project, down from 60% before. Fidelity also increased, with fewer youth reporting multiple sexual partners. Condom use during last intercourse with a regular partner increased in the intervention site from 42% to 62% among boys and 31% to 42% among girls.

Mexico: Strengthen Education on Adolescent Reproductive Health (research summary)
This report summarizes the results of interventions introduced through MEXFAM’s Young People Program. Eight cities were selected as intervention sites, and four similar cities served as control sites. Awareness of contraception was increased over time, with the proportion of youth knowing about family planning rising from 57% to 66%. However, knowledge of how to use a method was mixed; only 20% knew that pills must be taken every day. Knowledge of HIV/AIDS increased from 63% to 85%; similar increases took place at both intervention and control sites.

Senegal: Involve Community Networks in Adolescent Reproductive Health (research summary)
This report summarizes an intervention to improve adolescent reproductive health, which increased community awareness and improved young people’s knowledge. Use of safer sexual practices such as abstinence increased, but condom use decreased among sexually active couples.

Bangladesh: Link Adolescent Reproductive Health Resources to Increase Access (research summary)
This report summarizes how school and community education interventions increased young people’s understanding of reproductive health, and the establishment of links between schools and adolescent-friendly clinics increased the use of reproductive health services. It describes how several organizations are successfully using project materials in programs for adolescents and other vulnerable groups.

Kenya: Communities Support Adolescent Reproductive Health Education (research summary)
This summary relates the activities of a program in community, health, and school interventions in rural Kenya, which increased understanding and discussion of adolescent reproductive health, including prevention of HIV/AIDS, and encouraged safer sexual behavior among young people. The Kenyan government plans to scale-up select activities.

The Influence of Peer versus Adult Communication on AIDS-Protective Behaviors among Ghanaian Youth (research abstract)
This paper explores interpersonal communication about reproductive health information among Ghanaian youth and the association of this communication with different types of reported AIDS-preventive behaviors.

SPECIAL REPORTS/PROFILES/RESOURCES

Fall 2003 Update to Reproductive HealthOutlook (RHO) Website (resource material)
The Reproductive Health Outlook (RHO) website Fall 2003 edition is designed for reproductive health program managers and decision-makers working in developing countries and low-resource settings. RHO provides up-to-date summaries of research findings, program experience, and clinical guidelines related to key reproductive health topics. Expanded sections include adolescent reproductive health (including a new Key Issue on the reproductive health needs of married adolescents and a new Program
Example from Nicaragua), gender and sexual health (including a new Key Issue on trafficking), HIV/AIDS, older women (including a new Key Issue on healthy aging), safe motherhood (including a new Program Example from the Philippines), and RH resources (including descriptions and links for many new conferences and short courses).

What Is the Role of UNFPA’s India Chapter in Development? (news article)
Francois M. Farah, UNFPA Representative (India) answered questions on the role of the UNFPA (United Nations Population Fund) in India. The article looks at priority areas set by UNFPA in India, examining a range of activities from strengthening and making accessible quality reproductive health and counselling services to reducing maternal morbidity and mortality. The article also describes the need to provide adolescents with information on reproductive health.

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