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The Pop Reporter®

Volume 4, Number 4
26 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

Contraceptive Efficacy of Bioadhesive Nonoxynol-9 Gel: Comparison with Nonoxynol-9 Suppository (PubMed abstract)
This sudy, from the Shanghai Municipal Commission of Population and Family Planning, compared the contraceptive efficacy of a new spermicide, bioadhesive nonoxynol (N-9) gel, with a traditional N-9 suppository. A total of 240 child-bearing aged woman volunteers were randomly divided into two groups: gel for contraception versus suppository. The 6-month gross cumulative pregnancy rates of typical use were 6.39 and 2.95 per 100 women, respectively. The cumulative pregnancy rates at 6 months in perfect use would be 3.71 and 2.03. The authors conclude that the contraceptive efficacy of bioadhesive N-9 gel is the same as the N-9 suppository and that its clinical use is safe.

Emergency Contraception. Has Over the Counter Availability Reduced Attendances at Emergency Departments? (research abstract)
Findings in this short report from the UK suggest that legislation introduced in January 2001 has meant that more women are getting their emergency contraception without prescription from pharmacies as compared with emergency departments.

Marriage in Transition: Evidence on Age, Education, and Assets from Six Developing Countries (working paper)
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This paper examines trends in schooling, age, and assets at marriage for both men and women, and spousal differences in these variables in six countries (Bangladesh, Ethiopia, Guatemala, Mexico, the Philippines, and South Africa) using comparable data sets and methodologies. Descriptive statistics show that the correlation between personal characteristics is increasing compared to the correlation between parental characteristics, indicating greater personal choice in marriage. Multivariate results indicate that both husbands and wives are better educated and older in more recent marriages. Husbands’ assets at marriage increase through time in four countries and remain constant
in two. Wives’ assets at marriage increase in three countries, remain constant in two, and decline in one.

Condom Use Among Low-Income African American Males Attending an STD Clinic (research abstract)
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Related news article: Many Men Prefer STDs to Condom Use
This US study has found that even after receiving treatment for an STD, some men are not willing to use condoms regularly. Two-thirds of the men, primarily low income and African American, with a primary sexual partner and one-third of those without a primary partner said they don't use condoms consistently.

Diaphragm Fitting (review article)
This article reviews diaphragms, their clinical effectiveness, advantages of the diaphragm over other forms of contraception, diaphragm types, proper fitting, and patient education. Color illustrations and photographs demonstrate insertion and fitting technique.

Innate Immunity to Herpes Simplex Virus Type 2 (research abstract)
This review summarizes the current understanding of the innate immune responses to HSV-2 and the mechanisms by which HSV-2 can overcome these barriers. Newly emerging links between products of innate responses and the development of adaptive immune responses are also discussed.

Hepatitis B (review article)
This article reviews hepatitis B virus (HBV), a virus that is 100 times more infectious than HIV and, unlike HIV, can live outside the body in dried blood for longer than a week. The authors review HBV's virologic characteristics, groups at increased risk for HBV infection, acute and chronic infection, diagnostic criteria, natural history and complications, screening for hepatocellular carcinoma, prevention, HBV and pregnancy, and treatments for chronic infection.

FAMILY PLANNING/REPRODUCTIVE HEALTH NEWS

Use of Antibiotic in Contraceptive Trial Sparks Controversy (news article)
A clinical trial in India’s West Bengal state evaluating the antibiotic erythromycin as a female contraceptive has sparked controversy 15 months after the study ended, with doctors accused of pursuing illegal and unethical research.

Condom Plan 'to Conserve Forest' (news article)
A condom factory in northwest Brazil is being built to help prevent the spread of AIDSin the country, and there are hopes it will ease rainforest destruction at the same time.

Durex Withdraws Condom Lubricant (news article)
The makers of Durex condoms have ceased production of condoms containing a controversial lubricant amid doubts about its ability to prevent infection. The lubricant, nonoxynol-9, was originally thought to provide a high level of protection against infections such as HIV. However, recent studies have shown that it may actually increase the risk. Concerns had been raised by the WHO, UNAIDS, and the US CDC.

FAMILY PLANNING/REPRODUCTIVE HEALTH LAW AND POLICY

Italy: Fury as Italians Back Female Mutilation (news article)
Health authorities in Florence triggered an outcry after they accepted a version of female circumcision. A gynacologist in the city is proposing to perform a "light" version of infibulation, the mutilation of the genitalia of young girls which is practiced in many African countries.

Mexico Approves Use of Morning-after Pill (news article)
Mexico's Department of Health has approved the use of the morning-after contraceptive pill as a family planning method. The authorization was included in an amended version of the country's federal family-planning guidelines that went into effect last week. The norms also list the female condom as another method.

The Philippines: Muslim Decree for Family Planning Endorsed by Grand Mufti (news article)
For the first time, Muslims in the Philippines are formally allowed to use all but two family planning methods in accordance to the fatwa crafted by Filipino Muslim religious leaders espousing responsible parenthood and recently endorsed by the Grand Mufti of Egypt. A fatwa is a religious decree, and a mufti is a jurist who interprets the Muslim law. Under the fatwa, all methods of contraception are allowed as long as they are safe, legal and adhering to the Islam principle. Abortion, meantime, is considered illegal. Vasectomy and tubal ligation are the two methods not allowed under the fatwa, since both are considered self-mutilation.

The Unmentioned AIDS Policy (editorial)
This editorial from the Washington Post says that of the four criticisms often directed against the Bush administration's global HIV/AIDS efforts, two are misconceived, one is premature, and only one is really telling. While critics charge that it's bad to fight AIDS through faith-based groups, a large proportion of medical and social services in poor countries is delivered by mission hospitals and the like; thus, shunning them would be wrong. Likewise, critics object to the administration's emphasis on programs to encourage sexual abstinence. But these account for a third of the proposed AIDS prevention drive (just 7% of the total U.S. effort against international AIDS). The premature critique is that the administration is biased against cheap, non-patented "generic" medicines. Officials insist that the push to get antiretroviral drugs to 2 million patients would involve procurement of generics, provided they prove safe. The telling complaint about the Bush AIDS plan is that it is unilateralist: The administration has decided to create its own new initiative, rather than work through the Global Fund to Fight AIDS, Tuberculosis and Malaria, which the United States helped to create.

The Ghana Community-based Health Planning and Services Initiative: Fostering Evidence-based Organizational Change and Development in a Resource-constrained Setting (working paper)
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This paper reviews features of the Community-based Health Planning and Services initiative that explain its success and constrain future progress.

Mozambique: Reproductive Health in New Curriculum (news article)
Under new curriculum for basic education in Mozambique, pupils will start learning about sexual and reproductive health in the third grade. The National Director of Basic Education, Jafete Mabote, said learning about sex at an early age was key in the fight against AIDS. He noted that a survey undertaken by the National Statistics Institute indicated that Mozambicans begin sexual activity when they are as young as 11. In principle, children enter primary school at the age of six, and so in third grade they will be aged eight. But theory and practice can be very different, and for one reason or another, many Mozambican children start their schooling late. It is not uncommon to find children aged 10 or 11 in third grade. Mabote's answer to those who claim that third grade is too early to start teaching sexual health is that in reality these classes already contain children who are approaching puberty, if not already sexually active.

Brazilian City to Mail the Pill to Needy Women (news article)
The Brazilian city of Rio de Janeiro, notorious for its teeming slums, will mail contraceptive pills free of charge to women, including teenagers, in poor neighborhoods. The city's health secretary said last week that the program, which starts in February, was not intended to push birth control in poor areas but to give low income women the same opportunities enjoyed by richer women.

Kenya: Policy On AIDS Orphans Required Urgently (commentary)
This commentary, written by a member of the Parliamentary Finance Committee, calls for enactment of new policies that would address the social destruction wrought by AIDS in Kenya.

'Gay Orgy' Raid Raises Privacy Questions in Taiwan (news article)
Gay rights and AIDS awareness groups in Taiwan are outraged at the local media's handling of a police raid on what was called a gay orgy. News reports made it seem that casual contact with the men could spread HIV. While police found hundreds of used condoms, health authorities said the men's drug use constituted "dangerous sexual behavior," adding that they would seek the prosecution of 14 of the HIV-positive men for spreading the disease to others. In Taiwan, a conviction under the local anti-AIDS law could send someone to jail or up to 7 years.

HIV/AIDS RESEARCH

Lay Diagnosis of Causes of Death for Monitoring AIDS Mortality in Addis Ababa, Ethiopia (research abstract)
Lay diagnoses of death collected at burial sites were validated against two 'gold standards': the hospital discharge diagnosis of causes of death obtained by a surveillance of hospital deaths (including autopsy results) and the physician review of verbal autopsies (VAs) that were carried out for a sample of cemetery records. The diagnostic indicators of the lay diagnoses were then used to provide estimates of the share of AIDS-attributable mortality. The VA results provide an independent estimate of the percentage of AIDS deaths. From a total of 21,274 burial records, 2,546 hospital discharge diagnoses, 1,480 outcomes of autopsies and 200 adult verbal autopsies were gathered. Independent of the gold standard, lay diagnoses such as 'lung disease' and 'cold' have a specificity of about 90% and a combined sensitivity of about 55% in determining AIDS mortality. Without a significant loss in specificity, the sensitivity increases to 60-65% when diarrhoea, TB, herpes zoster, and mental or nerve problem are included. The authors conclude that even in the presence of a reluctance to talk of HIV/AIDS, lay diagnosis of causes of death can be used for monitoring AIDS mortality.

Predictors of HIV/AIDS among Individuals with Tuberculosis: Health and Policy Implications (research abstract)
The purpose of this report was retrospectively to assess the application of clinical predictors (ie, signs and symptoms) for the diagnosis of the HIV infections, including AIDS, among TB-positive subjects enrolled within an urban heterosexual sero-discordant couple (one partner HIV-positive and the other HIV-negative) cohort study at an HIV prevention and research center in Lusaka, Zambia. The report documents the relative effectiveness of the WHOCCDA in predicting HIV/AIDS cases and discusses the health and policy implications.

The Onset of HIV Infection in the Leningrad Region of Russia: A Focus on Drug and Alcohol Dependence (research abstract)
This paper examines the prevalence of HIV infection among drug- and alcohol-dependent patients in a regional narcology hospital and in the general population in Leningrad.

Does Increased General Schooling Protect against HIV Infection? A Study in Four African Cities (research abstract)
The authors investigated the associations between general schooling and both HIV and herpes simplex-2 infection using data from the multicentre study on factors determining the differential spread of HIV in four African cities. Cross-sectional general population studies were conducted in 1997-1998 in Cotonou (Benin), Yaoundé (Cameroon), Kisumu (Kenya), and Ndola (Zambia), including about 2,000 adults in each city. In all the cities those with more education tended to report less risky sexual behavior.

An Electronic Medical Record System to Support HIV Treatment in Rural Haiti (PubMed abstract)
In this paper, the authors describe a prototype electronic medical record system to support treatment of HIV and tuberculosis in remote and impoverished areas.

HIV/AIDS NEWS

Ghana Gives Free Anti-retrovirals to AIDS Victims (news article)
Ghana has begun supplying free anti-retroviral drugs to some AIDS sufferers and is considering producing the life-prolonging medicines locally, health officials said on Thursday.

Fight Against AIDS Needs Much More Money: Aid Groups (news article)
The fight against AIDS, malaria, and tuberculosis may be at risk if billions of dollars needed to fight the killer scourges are not raised quickly, aid organizations said on Saturday. "We need $1.6 billion in 2004, and we're close to that. But in 2005 we need $3.6 billion and by 2007 and 2008 we need to be at a cruising altitude of $7 to $8 billion a year. These numbers are well above current thinking," Richard Feacham, executive director of the Global Fund to Fight AIDS, Tuberculosis and Malaria said at the World Economic Forum.

Uganda: Government to Count HIV/AIDS Victims, Says Mike Mukula (news article)
The government has concluded plans to conduct a sero status survey geared at establishing the actual number of HIV/AIDS victims in the country. Capt. Mike Mukula, the health state minister, said this at the launch of a Staying Alive CD, with presentations by Ugandan activists against AIDS. Mukula said the government was tired of making estimates when planning for people infected with HIV/AIDS. "We have to act now, and plan ahead for our people," he said. He said Uganda would be the first country in sub-Saharan Africa to conduct such a survey, which is expected to reflect the prevalence rate of the whole region.

India: Discrimination, Not AIDS, is the Killer (news article)
Health activist Manoj insists that AIDS is not a killer. "It is not the disease which is wiping out people but the discrimination," he says. "With the kind of medicines available today, people can live in a healthy way for 20 years. But if you don't get a job, how will you survive?" The issue of job discrimination against persons with HIV/AIDS came to the fore last week when the Bombay High Court directed the New India Assurance company to give permanent employment to an HIV-positive woman. The court ruled that denying people jobs on the grounds of their HIV status was discriminatory and a violation of their fundamental rights.

African Infections Take Scots HIV to Record Levels (news article)
HIV cases have rocketed to an all-time high in Glasgow, Scotland because of the number of people recently arriving in the city from Africa either as asylum seekers or immigrants. But health chiefs are deliberately failing to collect and publish detailed figures on the record increase because they fear they will fuel prejudice towards groups of people coming from the areas of Africa which are currently rife with HIV and AIDS.

Montreal Police Recruits to be Tested for HIV (news article)
The city of Montreal says it will start screening new police recruits to see whether they are HIV-positive. The new rule comes into effect on March 1. News of the change comes just two days after a Montreal hospital announced it is contacting more than 2,600 patients who may have come into contact with a doctor who was HIV-positive. Earlier in January, controversy erupted when the Grand Seminary of Montreal said incoming students would be tested for HIV. Police recruits who test positive for the virus related to AIDS will not be hired for the police department. Officers already on the force will not be tested.

MATERNAL AND CHILD HEALTH RESEARCH

Pregnancy Interval and Delivery Outcome among HIV-seropositive and HIV-seronegative Women in Kisumu, Kenya (PubMed abstract)
The authors of this paper write that public health efforts to ensure "adequate" birth spacing may run contrary to family planning decisions to replace a deceased child and may be spent on prenatal issues like prevention of anaemia and vertical HIV transmission.

Use of Antenatal Care Services and Intermittent Preventive Treatment for Malaria among Pregnant Women in Blantyre District, Malawi (research abstract)
This paper presents results from a cluster sample survey that studied the use of sulfadoxine-pyrimethamine (SP) for intermittent preventive treatment (IPT) among recently pregnant women in February 2000 in Blantyre District, Malawi. Among 391 women in the sample, 98.6% had attended antenatal clinic at least once and 90.2% knew that SP/IPT was recommended during pregnancy. Overall, only 36.8% received the full recommended two-dose regimen of SP/IPT. Using data from 187 women with antenatal clinic cards, the authors found that residence location, housing type, and gender/age/education of the head of household were not associated with failure to receive SP/IPT. Adjusting for education, multigravid women were more likely not to receive the recommended SP/IPT regimen.

The Use of Non-prescribed Medication in the First 3 Months of Life in Rural South Africa (research abstract)
This paper describes the use of non-prescribed medications given to a cohort of infants in the first 3 months of life in a rural South African district.

Analysis of the Relative Factors of the Onset of Repeated Ectopic Pregnancy (PubMed abstract)
Researchers at The Capital Airport Hospital, Beijing, China, anaylzyed clinical data of first time ectopic pregnancy of 28 women with repeated ectopic pregnancy and compared those with 56 women with non-repeated ectopic pregnancy during the same period. Risk factors from the multivariate analysis were determined as follow: anastomosis of the tube, positive evidence of inflammation of the tube, no contraception, and contraception with condom occasionally.

Clinical Value of a Single Serum CA-125 Level in Women with Symptoms of Imminent Abortion During the First Trimester of Pregnancy (PubMed abstract)
Related news article: Blood Marker Rises Before Miscarriage
An increased blood level of CA-125, a recognized cancer marker, is also associated with a high likelihood of miscarriage in pregnant women with abdominal pain or vaginal bleeding, according to a new report. The finding may help doctors decide which women with symptoms that suggest imminent miscarriage are at high risk.

MATERNAL AND CHILD HEALTH NEWS

Study Supports Prenatal Testing for All Women (news article)
Doctors in the US generally reserve prenatal testing for Down syndrome and other chromosomal abnormalities for mothers-to-be who are 35 or older. That threshold, established in the 1970s, was chosen largely because it represents the approximate age at which a woman's risk of miscarriage from having amniocentesis, a needle extraction of amniotic fluid, is roughly equal to her chance of giving birth to a child with Down syndrome. But a study in the latest issue of The Lancet finds prenatal diagnostic testing is cost-effective and should be available to all women, regardless of their age or risk of bearing a Down syndrome child.

MEN'S HEALTH RESEARCH

Is There Age Bias in the Treatment of Localized Prostate Carcinoma? (research abstract)
Related news article: Age Bias May Affect Treatment for Prostate Cancer
Age bias among urologists and other doctors may account for the undertreatment of older men with early prostate cancer, new research suggests. Several previous studies have reported that older men receive potentially curative therapy less often than do younger men, the authors explain, but none of these studies determined whether age or other diseases were appropriately considered in the treatment decisions.

Elevated Seroprevalence of Human Herpesvirus 8 among Men with Prostate Cancer (research abstract)
Related news article: Virus Found in Men with Prostate Cancer
Up to 40% of men with prostate cancer have a virus in their blood that, until now, has been linked to relatively rare cancers, new research shows. Previous reports have tied human herpesvirus 8 (HHV-8) to Kaposi's sarcoma, a cancer usually seen in AIDS patients, and to a rare type of lymphoma. This latest report is the first to link HHV-8 in the blood with prostate cancer, a very common type of cancer.

MEN'S HEALTH NEWS

Drugmakers Step Up Work Toward 'Male Pill' (news article)
German drugmaker Schering AG said last week it and Dutch firm Organon had started mid-stage trials on a contraceptive injection for men that could be the next step toward the elusive "male pill." Schering said trials of the drug, which is a combination of an implant and an injection, would be conducted on 350 men at 14 centers across Europe, and would be completed by December 2005.

POPULATION RESEARCH

Fertility Assumptions for the 2002-based National Population Projections (research article)
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One of the key components of national population projections is the assumed level of fertility, which determines the number of future births in the projections. Assumptions are made in terms of the average number of children women will have over their lifetime. For the 2002-based projections this average is assumed to ultimately be 1.75 for England and for Wales, 1.60 for Scotland, and 1.80 for Northern Ireland, leading to a United Kingdom assumption of 1.74. This article explains how these overall assumptions, which are the same as assumed in the 2000-based and interim 2001-based projections, are derived. It also explains why these levels are higher than current 'period' indicators of fertility. Finally, information on more detailed age specific fertility rates, and implications for family size distributions, is given.

Estimating Mean Lifetime (working paper)
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The life expectancy implied by current age–specific mortality rates is calculated with life table methods that are among the oldest and most fundamental tools of demography. The authors demonstrate that these conventional estimates of period life expectancy are affected by an undesirable "tempo effect." The tempo effect is positive when the mean age at death is rising and negative when the mean age is declining. Estimates of the effect for females in three countries with high and rising life expectancy range from 1.6 years in the United States and Sweden to 2.4 years in France for the period 1980–95.

Evaluating Disease Management Program Effectiveness: An Introduction to Time-Series Analysis (research abstract)
This paper presents a non-technical introduction to time-series analysis (using disease-specific utilization measures) as an alternative, and more appropriate, approach to evaluating disease management program effectiveness than the current total population approach.

POPULATION NEWS

New Europe: Moldova's Death Rate Outstrips Birth Rate By 13% (news article)
Moldova's death rate was 13% higher than its birth rate in 2003, the country's Statistics and Sociology Department reported. A total of 37,000 children were born in Moldova last year, which is 2,000 more than in 2002. The maternal death rate decreased in 2003.

Singapore: Fresh Perks for Parents in Store as Birth Rate Plunges (news article)
New incentives to have babies could be on the cards for couples as the birth rate has plunged alarmingly, Deputy Prime Minister Lee Hsien Loong has said. Speaking at a Chinese New Year dinner at Teck Ghee Community Club, Mr. Lee listed boosting the low birth rate as one of three priorities for Singapore. Citing last year's figures, which were a record low, Mr. Lee said live births had been only 1.37 babies per woman.

WOMEN'S HEALTH RESEARCH

Impact of Oral Contraceptive Pill Use on Premenstrual Mood: Predictors of Improvement and Deterioration (research abstract)
Related news article: The Pill Doesn't Usually Alter Premenstrual Mood
Of 658 Massachusetts women who were using oral contraceptive pills, 16.3% of the women reported oral contraceptive pill–related premenstrual mood deterioration, and 12.3% of the women reported premenstrual mood improvement. In adjusted models, previous depression was the only significant predictor of mood deterioration; early-onset premenstrual mood disturbance and dysmenorrhea were significant predictors of oral contraceptive pill–related mood improvement. The authors conclude that oral contraceptive pills do not influence premenstrual mood in most women and that premenstrual mood is most likely to deteriorate in women with a history of depression and to improve in women with early-onset premenstrual mood disturbance or dysmenorrhea.

Smoking and Female Fecundity: The Effect and Importance of Study Design (research abstract)
This review evaluates the evidence for a link between smoking and female fertility. The authors identified 22 primary papers and two reviews. All but three indicated a detrimental effect of smoking on reproduction despite varying considerably in their approach, definitions used, and populations studied. The strength of association is small but statistically significant and a dose response relationship suggested the theory that smoking is causative. Poor design in particular and the failure to assess confounders weakened the value of many studies.

Using an Electrocautery Strategy or Recombinant Follicle Stimulating Hormone to Induce Ovulation in Polycystic Ovary Syndrome: Randomised Controlled Trial (research abstract)
Researchers used a randomised controlled trial to compare the effectiveness of an electrocautery strategy with ovulation induction using recombinant follicle stimulating hormone in patients with polycystic ovary syndrome. Of 168 patients with clomiphene citrate resistant polycystic ovary syndrome, 83 were allocated electrocautery and 85 were allocated recombinant follicle stimulating hormone. The cumulative rate of ongoing pregnancy after recombinant follicle stimulating hormone was 67%. With only electrocautery it was 34%, which increased to 49% after clomiphene citrate was given. Subsequent recombinant follicle stimulating hormone increased the rate to 67% at 12 months. No complications occurred from electrocautery with or without clomiphene citrate. Patients allocated to electrocautery had a significantly lower risk of multiple pregnancy.

The Prevalence of Female Sexual Dysfunction and Potential Risk Factors That May Impair Sexual Function in Turkish Women (research abstract)
This paper presents findings from a study showing that prevalence of female sexual dysfunction including desire, arousal, lubrication, orgasm, satisfaction and pain problems increases with age. In addition, the authors found that presence of a lower educational level, unemployment status, chronic diseases, multiparity and menopause status are important risk factors that may cause sexual dysfunction.

WOMEN'S HEALTH NEWS

New Advances in the Fight Against Cervical Cancer (feature article)
January is Cervical Cancer Screening Month in the US, and this feature article reviews the advances made in the fight against cervical cancer.

YOUTH HEALTH RESEARCH

Consistency in the Reporting of Sexual Behavior among Adolescent Girls in Kenya: A Comparison of Interviewing Methods (working paper)
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This paper explores the consistency in reporting of sexual behavior in a household survey of adolescents aged 15–21 in the Kisumu district of Kenya. The analysis focuses on the reporting of sexual behavior by adolescent girls in the face-to-face and audio computer-assisted self-interviewing (ACASI) modes and compares responses to a variety of questions about sexual activity, including sexual initiation, risky sexual behavior, and coerced sex.

YOUTH HEALTH NEWS

Malawi: Family Planning Contributing to HIV/AIDS Infection in Young People (news article)
In Malawi, A survey carried out by a family planning provider recently indicated that most young single women prefer contraceptive methods other than condoms because their boyfriends are not willing to use a condom and are also not prepared to marry them if they become pregnant.

Continuous Identification of Research Evidence (CIRE) Related to Family Planning Guidance

Barrington JW, Arunkalaivanan AS, and Abdel-Fattah ME. Comparison between the levonorgestrel intrauterine system (LNG-IUS) and thermal balloon ablation in the treatment of menorrhagia. European Journal of Obstetrics, Gynecology and Reproductive Biology. 2003 May 1;108(1):72-74. (CIRE)
Findings in this article have been found relevant to WHO Method: Levonorgestrel IUDs and Condition: Vaginal bleeding patterns

Trussell J, Guilbert E, and Hedley AJ. Sterilization failure, sterilization reversal, and pregnancy after sterilization reversal in Quebec. Obstetrics and Gynecology. 2003 Apr;101(4):677-684. (CIRE)
Findings in this article have been found relevant to WHO Method: Female Sterilization and Condition: Age/Life-stage

Grigorieva V, Chen-Mok M, Tarasova M, and Mikhailov A. Use of a levonorgestrel-releasing intrauterine system to treat bleeding related to uterine leiomyomas. Fertility and Sterility. 2003 May;79(5):1194-1198. (CIRE)
Findings in this article have been found relevant to WHO Method: Levonorgestrel IUDs and Condition: Uterine fibroids

Siritho S, Thrift AG, McNeil JJ, You RX, and Davis SM. Risk of ischemic stroke among users of the oral contraceptive pill. The Melbourne Risk Factor Study (MERFS) Group. Stroke. 2003;34:1575-1580. (CIRE)
Findings in this article have been found relevant to WHO Method: Combined OCs and Condition: Ischemic heart disease

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