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The Pop Reporter®

Volume 4, Number 1
5 January 2004

"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

Once-Daily Valacyclovir to Reduce the Risk of Transmission of Genital Herpes (research abstract)
Related news article: Pill Said to Cut Herpes Transmission; Study Indicates Drug Can Help Protect Partner
Researchers have found that medicine taken to treat herpes outbreaks also cuts the odds of transmitting the disease to a sexual partner nearly in half. The study is also notable because no drug previously has been shown to reduce the transmission of a STD from one partner to another.

Knowledge and Attitudes among Women in the Arab Village Regarding Contraception and Family Planning and the Reasons for Having Numerous Children (PubMed abstract)
The aim of this study was to examine to what extent family planning and use of contraception exist in the Arab population in Israel and to determine the reasons for having children. A detailed questionnaire was completed by clinic staff, who interviewed women (n=303), aged 20-45, who had 5 or more children. Sixty percent of these women were married before the age of 18 and most of them are housewives (96.4%). A total of 18.8% of the women had an education of 0-4 years, 66.5% had an education of 5-8 years, and 14.8% received 9 or more years of education. Most of them (92%) claimed that the decision regarding the number of children was jointly made with their husband; 24.8% thought that breastfeeding prevents pregnancy. Contraceptive pills were being used by 6.9%; IUD, 60.8%; and tubal ligation, 11.2%. A significant correlation was found between the women with a low level of education and more than seven children. As the educational level rises there are fewer children in the family. A significant correlation was also found between the low education of the husband and a number of children greater than seven.

Are Counselor Demographics Associated with Successful Human Immunodeficiency Virus/Sexually Transmitted Disease Prevention Counseling? (research abstract)
This article assesses whether counselor demographics or counselor-client dyad characteristics influenced prevention counseling in Project RESPECT as measured by intervention completion and incident STD after counseling. The authors analyzed data from Project RESPECT, a randomized, controlled trial of HIV counseling interventions in STD clinics. They found no significant association between client failure to complete the intervention and demographic characteristics of the 32 counselors or dyad characteristics. Clients who did not complete the intervention were significantly more likely to acquire a new STD infection by the 12-month visit than those who completed the intervention. There was no significant association between new STDs and counselor characteristics or dyad characteristics.

Sex in Australia: Safer Sex and Condom Use among a Representative Sample of Adults (research abstract)
The object of this study was to provide reliable estimates of the frequency of condom use and correlates of condom use among Australian adults. Computer-assisted telephone interviews were completed by a representative sample of 10,173 men and 9,134 women aged 16-59 years. The response rate was 73.1% (69.4% men, 77.6% women). Although the majority of respondents had used a condom at some time in their lives, fewer than half of the respondents who were sexually active in the year before being interviewed had used a condom in the past year. Condom use in the past year was associated with youth, greater education, residence in major cities, lower incomes, white-collar occupations, being a former smoker, and having more sexual partners in the past year. In the 6 months prior to interview, 7.1% of respondents always used condoms with regular cohabiting partners, 22.5% always used condoms with regular non-cohabiting partners, and 41.4% always used condoms with casual partners. Approximately 20% of respondents used a condom the last time they had vaginal intercourse, and one in eight of these condoms were put on after genital contact.

The Availability of Socially Marketed Condoms in Urban Tanzania, 1997-99 (research abstract)
The objective of this study was to evaluate trends in the availability of socially marketed condoms in urban Tanzania and to assess the effect of changes in the social marketing program’s strategy for distributing condoms to retail outlets. Three retail outlet surveys conducted in urban Tanzania in 1996/97, 1998, and 1999 were analyzed. Multiple Classification Analysis was used to determine changes in availability of condoms. Consistent with the changes in the condom social marketing distribution system, the proportion of condom outlets that were supplied by wholesalers increased from 42% in 1997 to 60% in 1999. The percentage of outlets selling socially marketed condoms increased from 25% to 32% between 1997 and 1998.

Need for Specific & Routine Strategy for the Diagnosis of Genital Chlamydial Infection among Patients with Sexually Transmitted Diseases in India (research abstract)
This study was undertaken to analyze the usefulness of culture and antigen detection by direct fluorescent antibody test for assessing the rate of Chlamydia trachomatis infection in symptomatic patients and feasibility of these tests for routine adoption in Indian setting. Patients (n=143) diagnosed with an STD attending a government general hospital in Chennai were enrolled. C. trachomatis was isolated in 27 of the 143 (18.9%). Culture positivity was seen in 11 of the males (17.5%) and in 16 of the females (20%). The authors write that clinical symptoms alone can be unreliable in specifically predicting infections with C. trachomatis.

Human Papillomavirus Prevalence and Types in Newborns and Parents: Concordance and Modes of Transmission (research abstract)
This study determined the risk of vertical and early contact transmission of human papillomavirus (HPV) in newborn infants based on concordance and sequence match to HPV types in parents. The genitals of pregnant women and newborns and oral cavity of parents and newborns were analyzed using polymerase chain reaction and DNA sequencing. Only one mother/newborn and no father/newborn pair was concordant for an HPV type. All other infected newborns had uninfected or discordant type infected parents. The authors conclude that the risk of vertical transmission to the oral or genital region of newborns is rare, and transmission between parents and the hospitalized newborn does not appear to occur.

FAMILY PLANNING/REPRODUCTIVE HEALTH NEWS

Bangladesh: 80,000 Health Workers Not Paid for 4 Months (news article)
About 80,000 fieldworkers under the family planning wing of the health ministry have not received their salaries for the last 4 months. Sources said the failure of the ministry's planning wing to process the relevant documents in time has led to the non-payment of salaries of these employees working under the development budget.

Australia: Morning-after Pill Now Available Without Prescription (news article)
Related news article: Pill Decision a 'Mistake'
The contraceptive Postinor 2, known as the morning-after pill, is now available from Australian pharmacies without a prescription. However, the decision to make a morning-after contraceptive pill available over the counter at pharmacies has been slammed by the Australian Medical Association (AMA). AMA ethics committee chairwoman Dr. Rosanna Capolingua said the decision was a mistake and called on Health Minister Tony Abbott to reverse it. Dr. Capolingua said pharmacists were not prepared to deal with the sensitive matter of emergency contraception.

Arab Parliamentarians Urge Governments to Meet Reproductive Health Needs (press release)
A lack of funds for population and reproductive health programs is widening the gap between rich and poor countries and increasing maternal deaths and HIV/AIDS infections, Arab parliamentarians declared earlier last month. Meeting in Rabat, Morocco, at the Fourth Arab Parliamentarian Forum on Population and Development, legislators urged their governments to honour commitments to implement the Programme of Action adopted by 179 governments at the 1994 Cairo International Conference on Population and Development. Their Rabat Declaration also called upon donor countries to close the large gap between current support for reproductive health services and the assistance levels agreed to in Cairo.

Barr Launches Generic Version of Ortho Tri-Cyclen(R) Tablets (press release)
Barr Laboratories announced last week that it has begun shipping its generic version of Ortho-McNeil Pharmaceutical's Ortho Tri-Cyclen® oral contraceptive. The Company is marketing its product under the Tri-Sprintec® trademark.

FAMILY PLANNING/REPRODUCTIVE HEALTH LAW AND POLICY

China: Shanghai Eases One-child Law (news article)
The Shanghai People's Congress (SPC) eased family planning laws yesterday, allowing an increased number of local married couples to have more than one child. The Standing Committee of the SPC yesterday passed the new Population and Family Planning Law, allowing some local couples to have a second child without waiting for 4 years between births and giving divorced parents more opportunities to have a child in their second marriage. The new policy, officials say, is aimed at preventing a baby boom in the future. The rules will go into effect on April 15.

UK: Warning Over Immigrant HIV Tests (news article)
Ministers have been urged against introducing mandatory HIV tests for every immigrant arriving in the UK. The Institute for Public Policy Research, a leading left-wing think tank, says such a move could create more problems than it would solve. It warns that testing immigrants could force those most in need of healthcare underground.

Mali: Government Moves Softly Against Female Circumcision (news article)
The government of Mali has agreed to take firm but low profile action to counter the widespread practice of female genital mutilation. Nine out of 10 girls in this poor West African country suffer the total or partial removal of their clitoris before or shortly after they reach puberty in a ceremony that has been part of the social life for centuries. Given the popularity of this custom among Mali's 12 million people, the government has not come forward with a law to ban the practice. However, the government-backed National Programme against Excision and UNICEF held a meeting in Bamako with religious and civil society leaders last week to review progress in combatting the practice and develop new strategies.

India: Patna HC Asks NHRC to Probe Irregularities in Family Planning Scheme (news article)
This article reports on allegations that government doctors and the medical staff in many villages of West Champaran were tampering with the cash book and embezzling incentive money provided to the beneficiaries as part of the family planning plan.

Italy to Pass New Law on Assisted Reproduction (news article)
Italy's Senate has passed a law on assisted reproduction that makes it a crime to freeze or destroy human embryos or to use donated sperm and eggs. The new rules, which will need an additional, formal approval by the lower house but are expected to come into effect in early 2004, limit the number of oocytes that can be fertilized to three. They also state that all the embryos created must be transferred into the woman's womb.

HIV/AIDS RESEARCH

Recommendations for Incorporating Human Immunodeficiency Virus (HIV) Prevention into the Medical Care of Persons Living with HIV (research abstract)
Related news article: Americans Publish Guidelines on How to Incorporate HIV Prevention into HIV Medical Care
The Centers for Disease Control and Prevention, the Health Resources and Services Administration, the National Institutes of Health, and the HIV Medicine Association of the Infectious Diseases Society of America have recently collaborated to develop evidence-based recommendations for incorporating HIV prevention into the medical care of persons living with HIV. This article summarizes key aspects of the recommendations.

Intravenous Drug Use Among Street-Based Sex Workers: A High-Risk Behavior for HIV Transmission (research abstract)
This study examined whether injecting drug use among street-based sex workers (SSWs) in Ho Chi Minh City is a high-risk factor for HIV infection. A cross-sectional study was conducted among SSWs in Ho Chi Minh City during December 2000. The SSWs were interviewed and tested for HIV-1. HIV-1 seroprevalence was 16.3%. Regression analysis indicated that injecting drugs and being younger than 25 years of age were independently associated with HIV seropositivity.

HIV, Sex, and Social Change: Applying ESID Principles to HIV Prevention Research (research abstract)
This paper illustrates how Experimental Social Innovation and Dissemination (ESID) principles were used to develop, test, and disseminate an innovative social model and discusses the challenges of applying ESID methodology in the midst of a public health emergency.

Global Situation of the HIV/AIDS Pandemic, End 2003 (news article)
(You need Adobe Acrobat Reader to access this document)
This issue of the Weekly Epidemiological Record from the WHO has an article titled "Global situation of the HIV/AIDS pandemic, end 2003," in both English and French.

HIV/AIDS NEWS

FDA OKs U.S. Sale of 10-Minute HIV Test (news article)
The FDA has approved a 10-minute HIV test. Trinity Biotech PLC, the company that makes the test, plans to market the test to government programs, physicians, and hospitals for quick testing of health workers who accidentally prick their fingers with bloody needles. Traditional laboratory tests can take days or weeks to return results.

Ukranian Woman Infects HIV to 1350 Men in 3 Months (news article)
This article reports how a Ukranian prostitute with HIV said she had sex with more than 1,350 men without a condom for the last 3 months in eastern Turkish province of Erzurum, and the ensuing panic among her clients.

Nigeria: Survey Identifies Factors Against Success of War On HIV/AIDS (news article)
A low perception of risk amongst Nigerians to contracting HIV, as well as apathy to screening tests, are major factors against the success of on-going efforts aimed at curbing the spread of the HIV/AIDS epidemic in the country. Findings from the 2003 National HIV/AIDS and Reproductive Health Survey showed that 72% of men and women in both rural and urban areas of the country believe they are at no risk to being infected with the AIDS virus, while only 41% of respondents had the desire to be tested for HIV.

Papua New Guinea: HIV/AIDS Gossip a National Shame (editorial)
This editorial addresses the subject of discrimination against people living with AIDS in Papua New Guinea.

China: HIV/AIDS Spreads in Guangdong (news article)
One hundred and ten of Guangdong's 122 counties and cities have reported HIV-positive carriers, sources from the province's health department has said.

US: Mass. Woman Sues Over HIV Misdiagnosis (news article)
A woman who received 9 years of HIV treatments after she was misdiagnosed with the virus is suing the doctors and clinics who treated her.

MATERNAL AND CHILD HEALTH RESEARCH

Congenital Syphilis: Identification of Two Distinct Profiles of Maternal Characteristics Associated With Risk (research abstract)
This study investigated maternal risk factors for congenital syphilis. The study population consisted of live-born infants and their mothers from the maternity ward of Sao Lucas Hospital, Brazil. The maternal characteristics independently associated with congenital syphilis were monthly per capita income under US $30, single status, and less than 6 prenatal visits.

Pathways of the Determinants of Unfavourable Birth Outcomes in Kenya (research abstract)
This paper explores the pathways of the determinants of unfavorable birth outcomes, such as premature birth, the size of the baby at birth, and Caesarean section deliveries, in Kenya using graphical log-linear chain models. The results show that a number of factors that do not have direct associations with unfavorable birth outcomes contribute to these outcomes indirectly through intermediate factors. Marital status, the desirability of a pregnancy, the use of family planning, and access to health facilities have no direct associations with poor birth outcomes, such as premature births and the small size of the baby at birth, but are linked to these outcomes through antenatal care. Antenatal care is identified as a central link between various sociodemographic or reproductive factors and birth outcomes.

Prenatal HIV Testing and Antiretroviral Prophylaxis at an Urban Hospital --- Atlanta, Georgia, 1997--2000 (research summary)
Related news article: Prenatal Care Key to Stopping HIV Spread to Infants
While rates of mother-to-infant HIV spread have dropped dramatically in industrialized countries like the US, when it does occur a lack of prenatal care is largely to blame, findings from new research suggest.

MEN'S HEALTH RESEARCH

Effectiveness of Self-Referral for Male Patients With Urethral Discharge Attending a Sexually Transmitted Disease Clinic in China (research abstract)
This study assessed the acceptability and outcome of self-referral for male patients with urethral discharge and identified the characteristics associated with successful outcome based on a specialized STD clinic in China. Of 723 eligible index patients, 294 (40.7%) who returned for follow up identified 534 sexual partners and 429 (59.3%) who did not return for follow up identified 759 sexual partners. Of the total named 1,293 sexual partners, 301 (23.3%) were notified by index male patients and 265 (20.5%) presented at the clinic. Of the 265 partners tested, 165 (62.3%) were infected with gonorrhea, chlamydia, or both; of them, 78 (47.3%) were asymptomatic. When the partnerships were married and steady, the informed rate was higher than that when the partnership was casual. For commercial sexual partnerships, only 1.8% of the partners were informed. In multivariate analysis, a prior STD history and condom use during the last sexual contact were associated with successful outcome of notification.

Male Circumcision and Sexually Transmitted Infections in Botswana (research abstract)
This study set out to investigate the influence of male circumcision and other factors on STIs in Botswana. A syndromic approach, which diagnoses an STI based on the presence of urethral discharge or genital ulcers rather than on laboratory tests, was used. The data were from the 2001 Botswana AIDS Impact Survey. The sample selected for this study consisted of 216,480 men aged 15-64 years who had ever had sexual intercourse. The main finding of this study was that among men who are circumcised, the odds for self-reported urethral discharge or genital ulcers are significantly lower than for those men who are not circumcised in both urban and rural Botswana. The analysis also showed that the odds in favor of self-reported urethral discharge or genital ulcers, for men who drink alcohol, are twice as large as those for men who do not drink alcohol, controlling for all other independent variables in the analysis. Religion and ethnicity also came through as factors exerting a protective influence against self-reported symptoms of STIs.

POPULATION RESEARCH

Fertility Transition in Bangladesh: Understanding the Role of the Proximate Determinants (news article)
This paper critically analyzes the fertility levels in Bangladesh and explores the possible explanations of fertility decline in the 1990s and then its stabilization. The main focus of the study is to examine the role of the major proximate determinants of fertility in bringing about the change in fertility level in Bangladesh. The data for the study come from a series of nationally representative surveys over the period of 1975 to 1999-2000. The analysis indicates that fertility has temporarily ceased to decline in recent years due to the 'tempo' effect of high past fertility, but in general a declining trend in fertility is underway. The analysis suggests that the fall in fertility is consistent with the underlying trends in most important proximate determinants of fertility.

Recent Trends and Components of Change in Fertility in Nepal (research abstract)
This article provides improved estimates of recent fertility levels and trends in Nepal and analyzes the components of fertility change.

POPULATION NEWS

Slide in Fertility Rate Raises Alarm in Singapore (news article)
Pro-fertility programs to create more babies in Singapore through subsidies and even a state-run dating service have failed to stop a plunge in the nation's birth rate, a senior official has said. In a bid to boost fertility, town-hall style "marriage and procreation" forums will be held this year.

WOMEN'S HEALTH RESEARCH

Sex in Australia: Contraceptive Practices among a Representative Sample of Women (PubMed abstract)
This study documented the use of contraception in a representative sample of Australian women (n=9,134; aged 16-59 years) contacted with computer-assisted telephone interviews (response rate 77.6%). Nearly 71% of respondents were using a method of contraception; among those apparently at risk of unplanned pregnancy, the most common reasons for non-use were experience of side-effects or contraindications (23%), leaving it to chance (20.2%), forgetting/not caring (18.9%), breast feeding (16.5%), and believing it unnatural/unhealthy (13.7%). The most used methods were oral contraceptives (33.6% of users), tubal ligation/hysterectomy (22.5%), condom (21.4%), and vasectomy of partner (19.3%). Tubal ligation rates were higher and condom use lower in regional and remote areas.

Sex in Australia: Reproductive Experiences and Reproductive Health among a Representative Sample of Women (PubMed abstract)
This study documents the reproductive experiences of a representative sample of Australian women. Computer-assisted telephone interviews were completed by a representative sample of 10,173 men and 9,134 women aged 16-59 years. The response rate was 73.1% (69.4% men, 77.6% women). Of the women surveyed, 15.5% reported having experienced difficulty in becoming pregnant and 76.1% had been pregnant at least once. Substantial minorities of women reported having experienced a miscarriage (33.4%) or a termination of pregnancy (22.6%). The percentage of women who reported becoming pregnant the first time as a teenager declined from 22.8% among women aged 50-59 to 16.9% among women aged 20-29.

Oral Sex Ups Risk of Recurrent Yeast Infection (news article)
Contrary to popular belief, women who experience symptoms of recurrent yeast infection are not being repeatedly re-infected by their male partners, new research suggests. Rather, the risk of developing multiple episodes of itching and burning from yeast appears to be higher in women who receive oral sex. Although sexual partners can pass the same bugs back and forth to each other, investigators found that whether or not male partners were infected with yeast had no influence on women's risk of developing multiple bouts of symptoms from yeast infections.

Prevalence and Risk Factors for Infection With Herpes Simplex Virus Type-1 and -2 Among Lesbians (research abstract)
Related news article: Herpes Infections Common Among Lesbians
Herpes simplex virus (HSV) infections are common among women who have sex with other women, though most are unaware of their infection, according to a new study. Nearly half the women (46%) who participated in the study were positive for HSV-1, which is the usual cause of "cold sores," the report indicates, and 7.9% were positive for HSV-2, which causes genital infections. The study is the first to report on HSV prevalence in this group specifically.

Angiogenic Factors and the Endometrium Following Long Term Progestin Only Contraception (research abstract)
This review article summarizes current findings related to the endometrial dysregulation of angiogenic/hemostatic agents following treatment with long-term progestin-only contraception.

YOUTH HEALTH RESEARCH

High Prevalence of Sexually Transmitted Diseases in Young Women Seeking HIV Testing in Rio de Janeiro, Brazil (research abstract)
This study determined the prevalence of HIV infection and other STDs in Brazilian women who seek HIV testing, investigated risk factors for these infections, and assessed the feasibility of screening in HIV test clinic settings. The authors conducted a cross-sectional study of 200 women (aged 14 to 29 years) who attended an HIV testing site in Rio de Janeiro. HIV and other STDs were common (HIV 8%, syphilis 6.5%, chlamydial infection 8%, and gonorrhea 9.5%). HIV was significantly associated with lower education and with having an HIV-infected partner. Other STDs were significantly associated with younger age at first intercourse, heavy alcohol consumption, and marijuana use. The authors suggest that HIV testing sites in Brazil should consider offering screening and treatment for STDs and substance abuse as part of their HIV prevention services.

YOUTH HEALTH NEWS

Report: China to Teach Sex Ed to Teens (news article)
China's largest cities have begun offering sex education to younger teenagers, as healthier diets push children toward earlier puberty, a newspaper reported Friday. Rapid economic growth has fueled huge changes in Chinese society. Medical experts say improved diets in China's big cities means girls are entering puberty around the age of 11, about 2 years earlier than in the past, the Shanghai Daily reported.

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