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The Pop Reporter®

Volume 3, Number 44
3 November 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

Condom Use Promotes Regression of Cervical Intraepithelial Neoplasia and Clearance of Human Papillomavirus: A Randomized Clinical Trial (research abstract)
This study investigated the effect of condom use on regression of cervical intraepithelial neoplasia (CIN) lesions and on clearance of human papillomavirus (HPV). Women with CIN and their male sexual partners were randomized for condom use (condom group n = 72 and noncondom group n = 76). They were conservatively managed and followed every 3-6 months by colposcopy, cytology, and HPV testing. Women in the condom group showed a 2-year cumulative regression rate of 53% vs. 35% in the noncondom group, and the 2-year cumulative rates of HPV clearance were 23% vs. 4%, respectively.

Contraceptive Use in a Changing Service Environment: Evidence from Indonesia During the Economic Crisis (research abstract)
This study examines changes in the contraceptive supply environment and in women's choices regarding contraceptive use in 1997 (prior to the country's economic crisis) and in 1998 (during the crisis). Substantial changes in providers' characteristics during the first year of the crisis produced no statistically significant differences between 1997 and 1998 in levels of prevalence, unmet need, or in method mix, but women's choices regarding source of contraceptive supplies changed considerably over the period.

Condom Use Promotes Regression of Human Papillomavirus-associated Penile Lesions in Male Sexual Partners of Women with Cervical Intraepithelial Neoplasia (research abstract)
This study investigated the natural course and clinical significance of penile HPV-associated lesions. Women with CIN and their male sexual partners were randomized for condom use (condom group n = 68, noncondom group n = 68). Males were screened for the presence of penile lesions, ie, flat lesions, papular lesions, and condylomata acuminata, and of HPV in their penile swabs by PCR testing. Median follow-up time was 13.1 months. The authors found that condom use shortened the median time to regression of flat penile lesions, but this effect was not found for papular lesions. They attributed this effect to the blocking of viral transmission between sexual partners.

Oral Contraception and Cyclic Changes in Premenstrual and Menstrual Experiences (research abstract)
This study examined the cyclic changes of prospectively collected, daily menstrual cycle experiences of two groups of healthy women using monophasic and triphasic OC compared with a group using non-hormonal contraception. A total of 119 healthy women using monophasic, triphasic or non-hormonal contraception for 3 months, made daily ratings over at least two complete menstrual cycles. Cyclic changes of ratings within and between the groups were analyzed. The three groups showed significant cyclic changes in abdominal fullness, abdominal discomfort, breast fullness, general 'premenstrual syndrome-like symptoms' and in at least two mood ratings. Maximal changes in ratings occurred during the late premenstrual and menstrual phases. There were no significant differences between the three groups in cyclic changes for any physical rating, but there were for tiredness or fatigue (non-OC users reported experiencing tiredness or fatigue more frequently than the OC users) and sadness or depression (non-OC users experienced sadness or depression less frequently than OC users during the early part of the cycle, followed by a sharp rise from early premenstrual to the menstrual phase). There were no significant cyclic differences in ratings between the monophasic and triphasic groups.

Models of Health-Related Behavior: A Study of Condom Use in Two Cities of Argentina (research abstract)
This study aimed at determining the relative importance of motivational and control factors in the prediction of condom use in a high-risk heterosexual sample from two cities of Argentina. Participants reported their attitudes, norms, control perceptions, intentions, and condom use with regard to main and occasional partners. Control perceptions was the main predictor for intentions to use condoms and actual condom use with both partners. Furthermore, the norm of the partner predicted condom use with the main partner, whereas the norm of family and friends predicted condom use with occasional partners. There were no differences in condom-use determinants across men and women.

Sexual Partners and Use of Emergency Contraception (research abstract)
This study investigated the role of male sexual partners and relationships in determining whether women seek emergency contraception (EC) when needed. Researchers used a clinic-based sample of sexually active women (n = 497), aged 15 to 30 years, in the San Francisco Bay area. Results showed that factors measuring power dynamics, such as male dominant decision making and pressure for sex, as well as a strong desire to avoid pregnancy on the part of the male partner, have a significant association with the use of EC. However, relationship factors known to be associated with use of other contraceptive methods, such as communication, satisfaction, and commitment, show no association with EC use.

The Low Gonadotropin-independent Constitutive Production of Testicular Testosterone is Sufficient to Maintain Spermatogenesis (research abstract)
Spermatogenesis is thought to critically depend on the high intratesticular testosterone (T) levels induced by gonadotropic hormones. Strategies for hormonal male contraception are based on disruption of this regulatory mechanism through blockage of gonadotropin secretion. Although exogenous T or T plus progestin treatments efficiently block gonadotropin secretion and suppress testicular T production, only about 60% of treated Caucasian men reach contraceptive azoospermia. The authors report here in a mouse model that full spermatogenesis was achieved despite absent luteinizing hormone action and very low intratesticular T. Their finding that spermatogenesis is possible without a luteinizing hormone-stimulated high level of intratesticular T contradicts the current dogma. They write that, extrapolated to humans, this may indicate that only total abolition of testicular androgen action will result in consistent azoospermia, which is necessary for effective male contraception.

Contraceptive Practice of Women with Opiate Addiction in a Rural Centre (research abstract)
This study aimed to explore the contraceptive practices of women in methadone treatment for opiate use in rural New South Wales and the reasons for those practices. The study has implications for education and counselling of women when they enter drug treatment programs in metropolitan and rural areas.

Re-emerging Syphilis: A Detrended Correspondence Analysis of the Behaviour of HIV Positive and Negative Gay Men (research abstract)
Researchers studied the sexual and other risk behavior of a sample of HIV positive and negative gay men with and without syphilis, subjecting them to a detrended correspondence analysis (DCA). A DCA plot was used to illustrate similarity of individuals in terms of their behaviors, regardless of their infection status. The majority of those with syphilis (78%; 18/23) fell into a high-risk group with more partners, and use of anonymous sex venues and drugs during sex. However, 16% of uninfected controls (8/49) and 62% of HIV positive individuals without syphilis (8/13) also fell into this high-risk group.

ABC of Subfertility: Counseling (review article)
Subfertility may affect a person's capacity to function normally in close personal relationships, socially, and at work. Many couples find that facing the problem of subfertility, and coping with the investigations and treatments can cause anxiety, stress, and depression. This clinical review discusses the role counselors play in helping couples to manage the stress associated with infertility.

FAMILY PLANNING/REPRODUCTIVE HEALTH NEWS

Australia: Condoms That Grow on Trees (news article)
Introduced 2 years ago to combat sexually transmitted disease among the Aborigines of Western Australia's Kimberley region, "condom trees" are among the world's most novel dispensers. Condoms are packed into PVC piping slung from the branches of trees around popular drinking and socializing areas to encourage safe sex. The unique dispensers were devised by health authorities alarmed at the rate of STDs among Aborigines in the region, which represent only 2% of the state's population but 48% of its reported STD cases.

Ghana: Men in Upper East Refuse Family Methods for Their Wives (news article)
A midwife tells in an interview that her health center is finding it difficult to change the perception of the men in the area about family planning. She said the domineering position of the men in the communities is partly responsible for the conservative attitude they have adopted on issues concerning contraceptive use and family planning. Some men in Mirigu and Kandiga communities in the Kassena-Nankana District have vowed never to allow their wives to use any contraceptives to delay child bearing. The irony, however, is that the men do not use condoms during intercourse with their wives but will use them when they meet new girlfriends.

Singapore: Protection During Sex? No Thanks (news article)
Half of a cohort of university students surveyed thinks STDs don't pose a risk, and only a third protect themselves all the time. Many believe that sexually-transmitted diseases like AIDS and gonorrhea do not pose a risk, according to the report. A sex survey last year reported that half of 868 Singaporeans interviewed aged 16 to 30 did not practice safe sex.

FAMILY PLANNING/REPRODUCTIVE HEALTH LAW AND POLICY

Brazil to Offer Massive, Free AIDS Testing (news article)
Brazil will launch a massive, free HIV testing program to find and hopefully help hundreds of thousands of people unaware they have the virus, the health minister said on Thursday, in the latest big step by an AIDS program that is a model for the developing world.

The Relationship Between Prevention of Mother to Child Transmission of HIV and Stakeholder Decision Making in Uganda: Implications for Health Policy (research abstract)
This was an exploratory study that surveyed a selection of stakeholders' use of evidence and other reasons in the relative ranking of the prevention of mother to child HIV transmission with nevirapine in a setting of extreme resource scarcity (Uganda). Participants included people living with HIV/AIDS, people from the general population, planners, health workers, and people with hypertension. Participants were asked to rank prevention of vertical HIV transmission with nevirapine compared to nine other interventions for different conditions. Prevention of vertical HIV transmission with nevirapine was ranked as number five compared to the other eight conditions. In the final ranking, treatment for childhood diseases and highly active anti-retroviral treatment (HAART) for HIV/AIDS were ranked higher. The authors emphasize that key stakeholders are prepared to set priorities between different interventions competing for scarce resources and that they are sensitive to evidence when setting such priorities.

HIV/AIDS RESEARCH

The Impact of AIDS (report)
(You need Adobe Acrobat Reader to access this document)
"The Impact of AIDS," a report prepared by the Population Division of the Department of Economic and Social Affairs of the United Nations Secretariat, documents the effects of HIV/AIDS on families and households, agricultural sustainability, business, the health sector, education and economic growth. More than 42 million people worldwide are now living with HIV/AIDS. To combat the spread of the disease, the report calls for strong national leadership, increased resources, prevention services and improved strategies for treatment and care of the afflicted.

Cases of HIV Infection and AIDS in the United States, 2002 (report)
The HIV/AIDS Surveillance Report contains tabular and graphic information about US AIDS and HIV case reports, including data by state, metropolitan statistical area, mode of exposure to HIV, sex, race/ethnicity, age group, vital status, and case definition category.

Imagining HIV/AIDS: Morality and Perceptions of Personal Risk in Nigeria (research abstract)
The author writes that the disparity between people's knowledge about HIV/AIDS and the extent to which they take measures to protect themselves is one of the most vexing issues for public health workers and social science analysts. His paper aims to explain some of this discrepancy, using survey and ethnographic data collected among young rural-urban migrants in Aba and Kano, two cities in Nigeria. He argues that many young Nigerian migrants do not perceive significant personal risk because they construct the risk of AIDS in ethical and moral terms, projecting immorality and danger onto imaginary others. To understand the way young Nigerians interpret risk, the paper focuses on four related issues: (1) the organization and meaning of sexual relationships; (2) the intersection of gender and ideas about reproduction; (3) the perception of AIDS as a disease without hope; and (4) the importance of religion in young people's framing of moralities and ethical choices about sexuality and HIV/AIDS.

When HIV-Prevention Messages and Gender Norms Clash: The Impact of Domestic Violence on Women's HIV Risk in Slums of Chennai, India (PubMed abstract)
This paper examines how marital violence affects women's ability to protect themselves from HIV/AIDS. In-depth interviews (n = 48) and focus groups (n = 84, 3-7 per group) were conducted among men and women in two randomly selected slums of Chennai, India. The study showed that community gender norms tacitly sanction domestic violence that interferes with adopting HIV-preventive behaviors. Given the choice between the immediate threat of violence and the relatively hypothetical specter of HIV, women often resign themselves to sexual demands and indiscretions that may increase their risk of HIV acquisition.

HIV Infection and Risk Factors among Bangkok Prisoners, Thailand: A Prospective Cohort Study (research abstract)
This study collected data on HIV risk factors of inmates during incarceration in Thailand. A prospective cohort of 689 male inmates in a Bangkok central prison was studied during 2001-2002. Follow-up visits were conducted for 5 months, with testing for HIV and other infections and interviewing of demographics and risk behaviors. Among 689 male inmates, half were drug injectors. About 49% of the injectors had injected drugs during incarceration. Most (94.9%) of the injectors had shared injection paraphernalia with others. Successful follow up rate was 98.7% after 2,581 person-months observation. HIV incidence was 4.18 per 100 person - years among all inmates, and 11.10 per 100 person - years among the injection inmates. Multivariate analysis identified variables associated with HIV prevalence: history of injection, positive urine opiate test, history of attendance to drug withdrawal clinics, and presence of tattoos on the body.

Genital Ulcers Increase During and After HIV Infection (press release)
Findings of a soon-to-be-released study suggest treatment of herpes important in treating HIV and preventing transmission. Genital ulcer disease symptoms increase both during and after acquiring HIV. The study also found that participants with newly acquired HIV infections who also had pre-existing Herpes Simplex 2 virus (HSV-2), a cause of genital ulcers, had higher HIV viral load levels than those without herpes virus. The researchers suggest that suppressing HSV-2 and genital ulcer disease could be an important element in treating HIV and preventing transmission to partners.

Evaluation of HIV Drug Interaction Web Sites (research abstract)
Nine websites met the authors' criteria for review of HIV drug interaction. The websites from Toronto General Hospital (Canada), HIVinSite (beta version) (US), and the University of Liverpool (UK) ranked highest for total mean scores and for content usefulness. Other websites were found to be reliable, accessible, and easy to navigate; however, they did not consistently include unpublished data or data on herbal preparations, recreational drugs, or multiple interactions.

HIV/AIDS NEWS

Cuban AIDS Strategy Praised, Criticized (feature article)
Using a strategy that critics have called excessive but that some health experts praise as effective, Cuba has managed to control the spread of the AIDS virus more successfully than most nations. But the approach is grounded in the kind of coercion that only a one-party state can wield. Most Cubans who test positive are required to stay in a sanitarium for at least three months. Once there, they can leave only with the permission of the staff. Those who are considered high risk to spread the infection could stay much longer. Some even make it a permanent home.

AIDS Infects 13 British Hospital Workers (news article)
Thirteen British health employees have been infected with HIV or AIDS in hospital accidents and at least four have died, it was revealed last week. This was the first time details of HIV or AIDS infections from workplace accidents had been published. The figures were contained in a report by the Health Protection Agency and passed to the House of Commons Public Accounts Committee, which has been investigating needle injuries to health workers.

Finally, Those Living with AIDS in Laos Get Drugs (news article)
Laos has taken a small yet symbolic step to join the ranks of its Southeast Asian neighbors, Thailand and Cambodia, in providing hope to its citizens living with HIV/AIDS. For the first time, a Laotian with HIV/AIDS was treated with a cocktail of anti-AIDS drugs.

Uganda: Married Couples at Risk of HIV Spread (news article)
Married women have been encouraged to use microbicides because they are vulnerable to HIV/AIDS infection. The article describes recommendations from the AIDS Control Programme, which aim to address gender-based social norms that lead men to seek multiple partners, exposing the couple to infection.

MATERNAL AND CHILD HEALTH RESEARCH

Young Maternal Age and Preterm Birth (research abstract)
The connection between young maternal age and preterm birth (PTB) remains controversial. This study examines the connection in São Luís, Northeast Brazil.

Maternal Mortality: Only 42 Days? (research abstract)
Where living conditions are harsh, pregnancy and delivery affect the health of the woman for more than 42 days as pregnancy related anemia, vaginal haemorraghing, and infections can persist for longer. Using the WHO definition may result in an under-estimation of the pregnancy-related part of the reproductive age mortality. Extending the definition of maternal death to include all deaths within 3 months of delivery may increase current estimates of maternal mortality by 10% to 15%. Duration of excess mortality after delivery was examined in rural Guinea-Bissau.

The Place of Birth: Childbearing and Kinship in Calcutta Middle-Class Families (research abstract)
This article examines Caesarean section delivery in the context of specific marital and residential patterns and cross-generational accounts of birth among middle-class women in Calcutta. By paying close attention to affinal relations and the meaning of kinship for birthing women, this paper challenges assumptions regarding the positive aspects of previous, less medicalized, modes of birth and explore how the shift towards Caesarean sections does not merely signify an unquestioning acceptance of an alienating allopathic regime. The ethnographic accounts of different experiences of childbirth show that the medicalization of childbirth should be situated within the context of wider kin and class relations that affect women's choice and their sense of agency.

Loss of Hepatitis C Virus RNA after Parturition in Female Patients with Chronic HCV Infection (research abstract)
Related news article: Pregnancy Can be Good for Women with Hepatitis C
The aim of this study was to investigate the relationship between pregnancy and parturition with HCV viremia levels and the natural resolution of HCV RNA. The study included 22 pregnant patients and 120 nonpregnant control female patients, both positive for anti-HCV and HCV RNA. Of the pregnant group, two females whose HCV RNA was negative continuously for more than 6 months lost HCV RNA permanently after parturition, and one female whose level of HCV core protein was intermittently under the limit of detection level lost HCV RNA intermittently. In the control group, only one female lost HCV RNA persistently, and one lost HCV RNA intermittently after she developed liver cirrhosis. Considering the size of both groups, this means that 14% of pregnant women cleared the virus, compared with only 2% of non-pregnant women. The authors write that these findings suggest that pregnancy and parturition appear to influence the clinical course of HCV infection.

Infertility and Preterm Delivery, Birthweight, and Caesarean Section: A Study Within the Danish National Birth Cohort (research abstract)
Related news article: Longer Conception and Pre-mature Birth Linked
Using data from the Danish National Birth Cohort, the researchers examined delivery and adverse birth outcomes related to women’s reported waiting time to pregnancy. The researchers found that among couples with an over one year waiting time, infertility treatment was associated with added birth risk. Infertile women are at higher risk of adverse birth outcomes even if they conceive without treatment.

MATERNAL AND CHILD HEALTH NEWS

70% of African Communities Prefer Home Deliveries - Study (news article)
According to the results of a WHO survey, an average of 70% of deliveries in communities in Nigeria, Angola, Ethiopia and Senegal occur in the home rather than in health facilities. Objectives of the study were to investigate the practice of home deliveries, determine the linkage between the practice of deliveries at home and in health facilities, and document the positive and negative aspects of home deliveries. Further research is being called for to determine policy and implementation issues regarding home deliveries in the region.

Thailand: Infanticide is Very Often a Result of Health Issues (news article)
The article links recent incidents of infant death after abandonment by parents to a general social trend in the lack of reproductive health care services and information.

MEN'S HEALTH RESEARCH

Relative Risk of Prostate Cancer for Men with Affected Relatives: Systematic Review and Meta-analysis (research abstract)
This study identified and summarized published reports on the relationship between risk of prostate cancer and family history. The authors write that the meta-analysis presented in their paper confirms that risk of prostate cancer is associated with family history of disease and improves the quantification of this risk.

MEN'S HEALTH NEWS

China: Men's Health Issues Underlined (news article)
Last Tuesday, to mark National Men's Health Day, publicity activities were carried out nationally on male-centred reproductive health care issues and the roles played by men in family planning and social development were also discussed.

POPULATION RESEARCH

Age-structured Population Growth Rates in Constant and Variable Environments: A Near Equilibrium Approach (research abstract)
In this paper, the authors propose general measures summarizing the shapes of mortality and fecundity schedules.

Urban Sprawl: Metrics, Dynamics and Modelling Using GIS (research abstract)
This paper focuses on the extent of urban sprawl taking place over a period of nearly three decades using GIS and Remote Sensing. The study also attempts to describe some of the landscape metrics required for quantifying sprawl. The importance of mapping sprawl is evident in developing countries like India, where the population is over one billion, one-sixth of the world's population, in which urban sprawl is taking its toll on the natural resources at an alarming pace. Urban planners require information related to the rate of growth, pattern and extent of sprawl to provide basic amenities such as water, sanitation, electricity, etc. In the absence of such information, most of the sprawl areas lack basic infrastructure facilities.

POPULATION NEWS

India: Sex Ratio Skewed in Mumbai (news article)
The article describes findings from a new report, ‘Missing: Mapping the Adverse Child Sex Ratio in India,’ from the Indian Ministry of Health and Family Welfare and the UNFPA. It studies the decline in the number of girls as compared to boys in India between 1991 and 2001. According to the report, Mumbai is only slightly better than the northern cities. Yet it falls 52 points short of the ideal ratio of 950 girls to 1,000 boys.

Malaysia: Population at 25 Million and Increasing by 2% (news article)
According to the article, Malaysia’s population has reached 25.08 million this year, up from 23.49 million last year. Projected to grow at an average of 2.1% for the remaining period of the Eighth Malaysia Plan, the population is expected to hit 26.16 million in 2005.

France and Italy Address Fertility Crisis (news article)
The article considers several decades of change within and between nations, and how earlier perspectives and approaches to fertility were shaped by Paul Ehrlich's 1968 book, The Population Bomb, which foretold of rapidly expanding human populations leading to rapidly diminishing natural resources, famines, and other major problems. Ehrlich's book, though provably wrong at the time it was written, was embraced by much of the Western world's intelligentsia and media, followed by politicians, as most western countries adopted policies of zero population growth. Now, however, European nations are facing a real crisis of major proportions: their populations are ageing, and there are simply too few children to keep their societies going.

WOMEN'S HEALTH RESEARCH

The Acceptability of an Investigational Vaginal Microbicide, PRO 2000 Gel, among Women in a Phase I Clinical Trial (PubMed abstract)
In this study, the acceptability of an investigational microbicide, PRO 2000 Gel (Indevus Pharmaceuticals, Inc., Lexington, MA), was assessed, and women's opinions about microbicides and their potential for real world use were gathered.

Knowledge, Attitude and Practice of Breast Self-examination in Health Centers (research article)
The present study was carried out to assess knowledge, attitude, and practice of breast self-examination among patients attending health centers in Brazil. The results showed that knowledge and practice of breast self-examination were adequate in 7.4% and 16.7%, respectively. However, attitude was adequate in 95.9% of the women interviewed. The study also showed that 58.1% of the women interviewed referred that forgetfulness was the main barrier for not performing self-examination.

Who Continues Using the Diaphragm and Who Doesn't: Implications for the Acceptability of Female-controlled HIV Prevention Methods (research abstract)
This study examined the acceptability of the diaphragm with the aim of facilitating the development of female-controlled HIV prevention methods.

WOMEN'S HEALTH NEWS

Dangerous STD is Common But Rarely Publicized: Trichomoniasis (news article)
The article discusses recent findings that college age women experience higher rates of infection from trichomoniasis than other sexually transmitted diseases such as chlamydia or gonorrhea.

Ethiopian Women Face Struggle for Equality (feature article)
This article relates how Ethiopian women are still subjected to genital mutilation and arranged marriages, and suffer a lack of access to education - infringements of women's basic human rights which are denying them the opportunity to improve their lives in one of the world's poorest countries.

YOUTH HEALTH RESEARCH

The Effectiveness of Adolescent Reproductive Health Interventions in Developing Countries: a Review of the Evidence (research abstract)
This article review and synthesizes the emerging body of evidence on adolescent reproductive health (ARH) interventions. Database searched yielded a total of 41 evaluation studies in which there was a sufficient scientific basis for making inferences concerning causality. The available evidence suggests that interventions tend to be successful in influencing adolescent knowledge and attitudes, but less consistently so with regard to behaviors.

Parental Presence and Adolescent Reproductive Health Among the Nairobi Urban Poor (research article)
This article's purpose was to investigate whether the presence of parents constitute a protective factor against adverse reproductive health outcomes for adolescents living in slums of Nairobi, Kenya. A random sample of 4,564 households, representative of all Nairobi slums, in February–June 2000, were canvassed by means of structured questionnaires. When the father is present in the household (ie, father only or both parents present), adolescent girls are 42% less likely to have ever had sex (p < .05), 45% less likely to have been sexually active in the most recent 4-week period (p < 0.1), and 59% less likely to have ever experienced an unwanted pregnancy (p < .05) than when neither parent, or only the mother, is present in the household. In the slums of Nairobi, father's presence, unlike that of the mother, is associated with stronger resilience among adolescents.

Knowledge, Attitude, and Behavior of Female Students Concerning Contraception in Athens, Greece (research abstract)
This paper investigated the knowledge, attitudes, and behavior of female high school and university students concerning contraception. The study was performed at the Alexandra University Hospital in Athens, and a total
of 297 female students participated via questionnaire. The findings suggest students have a defective knowledge of contraception. Their main source of information were friends, but the majority would prefer to receive information from doctors. The most popular contraceptive method was the male condom.

Social Capital as a Predictor of Adolescents' Sexual Risk Behavior: A State-level Exploratory Study (PubMed abstract)
This exploratory study assessed the state-level association between social capital, poverty, and income inequality and adolescents' sexual risk and protective behaviors. Seven outcome measures from the national 1999 Youth Risk Behavior Surveillance Survey were used. For females and males, social capital was significantly associated with five of the seven outcome measures. For females, the amount of variance explained by these correlations ranged from 23% to 45%; the range for males was 20% to 52%. Poverty was not a significant predictor of any outcome variable. Income inequality was a significant predictor of birth control usage among females, but in multivariate regression analyses, only social capital retained significance. The findings provide preliminary evidence that social capital may have a profound influence of adolescents' sexual risk and protective behaviors.

Adolescent Women Underestimate Their Susceptibility to Sexually Transmitted Infections (research abstract)
Adolescent females are at significant risk for sexually transmitted infections (STI) and may not accurately incorporate indicators of risk into their perceptions of susceptibility. Here, the researchers examine the relation between perceived susceptibility and indicators of risk in relation to actual STI diagnosis. From data collected from 209 sexually active adolescent females, the researchers found that the women interviewed did not accurately perceive their susceptibility to STI.

Strategies for Resolving Aboriginal Adolescent Pregnancy in Eastern Taiwan (research abstract)
This study's aim was to explore aboriginal nurses' perspectives on strategies for resolving the high prevalence rate of Aboriginal adolescent motherhood in eastern Taiwan. Health care providers plan to design appropriate intervention programmes, and to train Aboriginal nurses to execute these programmes in an effort to decrease teenage pregnancy rates in the future.

YOUTH HEALTH NEWS

Kenya School Shelters Girls from Forced Marriages (feature article)
For many students, the African Inland Church Girls Primary School is just a regular boarding school. But for some Masai girls, it's a refuge from family plans to marry them off despite Kenyan law.

BOOKS/BOOK REVIEWS

Running After Pills: Politics, Gender, and Contraception in Colonial Zimbabwe (book)
The author examines the ways that "modern" contraceptive technologies, such as the pill and the Deop-Provera injection, became embroiled in gender and generation conflicts and in the national liberation struggle in Zimbabwe during the 1960s and 1970s. Based on extensive oral and archival research, the book shows the ways in which fertility and control over reproduction within marriage and the family influenced the development of the "imagined community" of the nascent Zimbabwean nation.

Effective Sexual Health Interventions: Issues in Experimental Evaluation (book)
This book provides an analysis of the methodological and practical issues involved in evaluating sexual health interventions. The book will appeal to trial enthusiasts through discussion of specific issues in trial design, and also to those with a sceptical interest in the potential of experimentation and its appropriateness or feasibility. It is concerned with methodology rather than the substantive findings of research, and considers the requirements of research in both developed and developing countries.

The Male Pill: A Biography of a Technology in the Making (book)
The Male Pill is the first book to reveal the history of hormonal contraceptives for men. Nelly Oudshoorn explains why it is that, although the technical feasibility of male contraceptives was demonstrated as early as the late 1970s, there is, to date, no male pill. Ever since the idea of hormonal contraceptives for men was introduced, Oudshoorn stresses, scientists, feminists, journalists, and pharmaceutical entrepreneurs have questioned whether men and women would accept a new male contraceptive if one were available. Providing a richly detailed examination of the cultural, policy, and scientific work around the male pill from the 1960s through the 1990s, she advances work at the intersection of gender studies and the sociology of technology.

A Broken Landscape: HIV & AIDS in Africa (book)
This book is an illustrated compilation of brief (1-4 paragraph), first-person narratives by victims, family, and workers in the HIV/AIDS epidemic in southern Africa.

SPECIAL REPORTS/PROFILES/RESOURCES

Disentangling HIV and AIDS Stigma in Ethiopia, Tanzania and Zambia (report)
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In many developing countries, stigma and discrimination together pose one of the most significant challenges to stemming the spread of HIV and AIDS. People known to have HIV often are isolated and the targets of gossip and name-calling. They can lose status and decision-making power in the household and community, many are shunned by family and friends, and they frequently lose their jobs and sometimes their housing. As a result, it is not surprising that people often go to great lengths to hide their HIV status or deny that they might have it-—fueling the spread of the epidemic. Some people avoid getting tested to learn their status, those who know they have the virus often fail to change their behavior, and pregnant women might avoid treatment that could help protect their children from contracting HIV. The same fear also intensifies the suffering of those with HIV or AIDS because they delay treatment, services, and support that could help them physically and emotionally. This report discusses these and other findings, based on a 3-year study of HIV and AIDS-related stigma conducted by the International Center for Research on Women and partners in Ethiopia, Tanzania, and Zambia.

Supply Initiative Website Launches Text-only Version (resource material)
The Supply Initiative has launched a text-only version of its website for easier access and printing in low-technology settings. The Supply Initiative is a newly established global focal point for supply issues related to sexual and reproductive health services. Based in Brussels, the Initiative brings together diverse reproductive health actors and facilitates a constructive dialogue and a greater coordination of supply related activities.

Synergy "Advances Through HIV/AIDS Research" Series (resource material)
The goal of the series is to disseminate key research findings and expert analyses to practitioners and policy makers working in the field. Each paper places significant, new, or controversial research findings in a broader context and explores their practical and policy implications for those working on the frontlines. An internationally recognized expert frames each paper, identifying key issues, recommending the most pertinent and recent publications, and describing significant ongoing research.

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