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The Pop Reporter®

Volume 4, Number 7
16 February 2004

"The Pop Reporter" (R) Johns Hopkins Bloomberg School of Public Health/Center for Communication Programs INFO Project Get news and research headlines delivered to your website, every day, customized to topics of interest to your webiste visitors. The Pop Reporter Headline Sharing Program is a free service of The INFO Project, with funding from USAID. Complete the form at our sign up page and let us know which news and research topics you want to display on your website. We will contact you to discuss the specific requirements for displaying The Pop Reporter headline box on your website. 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

FDA Updates Hormone Therapy Information for Post Menopausal Women (press release)
The Food and Drug Administration is requesting that manufacturers update labeling for hormone therapy products (estrogen and combination estrogen and progestin products) for use by postmenopausal women with data from WHIMS – The Women's Health Initiative Memory Study. WHIMS reported an increased risk of dementia in women 65 and older and showed that estrogen with progestin (Prempro) failed to prevent mild cognitive impairment (memory loss).

The Acceptability, Efficacy and Safety of Quinacrine Non-surgical Sterilization (QS), Tubectomy and Vasectomy in 5 Provinces in the Red River Delta, Vietnam: A Follow-up of 15,190 Cases (PubMed abstract)
This study compares the safety, efficacy, and acceptability of quinacrine sterilization (QS), tubectomy, and vasectomy in Vietnam. A sample of 9 districts in 5 provinces, where the prevalence of QS was known to be high, was selected. Every person sterilized in these 9 districts between January 1, 1988 and March 31, 1998 was identified and systematically interviewed by family planning clinicians who had received special training for this project. A total of 15,982 sterilization users were identified and 15,190 were interviewed and examined. Of those interviewed, 9,753 used tubectomy, 3,734 used QS and 1,703 used vasectomy. After more than 5 years of follow-up, tubectomy had the lowest failure rate: 1.0%, followed by 4.1% with vasectomy. A pregnancy rate of 13.2% was reported with quinacrine, although only a small fraction of these failures were confirmed. A strong preference for QS was found.

Diffusion of Innovations: Family Planning in Developing Countries (research abstract)
This paper uses the case of family planning in developing countries to illustrate the theory of "diffusion of innovations."

Changing Family Planning Scenario in India: An Overview of Recent Evidence (working paper)
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This paper reviews and synthesises evidence from surveys and studies conducted in the 1990s and thereafter on contraceptive use dynamics and the unmet need for contraception in India. The paper also discusses some of the barriers that hindered the success of the program and sheds light on new initiatives to address these, and assesses their impact if any. The paper makes suggestions for areas that need further program and research attention.

National Baseline Assessment of Sexually Transmitted Infection and HIV services in South African public sector health facilities (report)
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The primary objectives of this survey were to ascertain the current status of quality of care provided at primary health care (PHC) facilities in order to inform Department of Health STI program direction and policy review with regard to development of interventions for improved management of STIs, increasing access to STI/HIV prevention services, and reducing new HIV infections. Data were collected by four tools: Facility-based information was collected through telephonic interviews of 962 randomly selected PHC facilities and by visits to a sub-set of these facilities (n=141) for in-depth surveys. In addition, quality of care was assessed by simulated client visits to facilities (n=139). This survey estimates that about 2 million symptomatic STI clients are treated at public sector PHC facilities in South Africa annually; and that about 8,400,000 symptomatic and asymptomatic STI infections occurred in 2002 in South Africa, among a population (15 years or older) of about 30 million. It was found that 50% of professional nurses at PHC facilities were 'ever trained' in syndromic management of STIs, and hence, in many instances the national STI treatment guidelines are implemented with variable quality.

Wasting Sperm: The Cultural Context of Condom Use among the Maasai in Northern Tanzania (research article)
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This document reports data drawn from a study conducted in September 2002 that investigated the context of HIV/AIDS knowledge and attitudes among rural Tanzanian Maasai men and women. A primary focus of the work was exploration of the cultural context of condom knowledge and use. The study site was Ngorongoro District in rural northern Tanzania. Low levels of condom knowledge were discovered through questionnaire and focus group research. Given the low levels of condom knowledge, the author argues that it is unsurprising that incorrect beliefs about condoms and their efficacy abound. The association of condoms with non-Maasai, or at least, non-ruralites (and thus non-Maasai), was expressed. The "otherness" of HIV and consequent condom use manifests itself in a variety of ways. For example, the highly ritualised nature of Maasai male circumcision results in a strongly held belief that condoms are unsuitable for penises that have undergone a Maasai circumcision. This paper concludes that there is a rationale for the development of culturally-specific HIV/AIDS programs. This is underscored by the fact that, although human biology is the same everywhere, sexual behaviour in general and condom use in particular are the result of complex socio-cultural values and economic and political conditions, which differ from one society to another and between different groups within a society.

Managing Reproductive Health with a Gender Perspective (report)
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This report, from Marie Stopes International, explores the impact of gender on reproductive health and reproductive health care. It identifies existing gender inequalities in reproductive health care, particularly focusing on Afghanistan, and proposes a methodology to be used by Marie Stopes International in its projects. This methodology, consisting of six tools that answer specific questions regarding quality of care from a gender perspective, serves as a needs assessment for gender analysis and also as a baseline to measure program objectives and activities.

Epidemiology and Etiology of Sexually Transmitted Infection among Hotel-Based Sex Workers in Dhaka, Bangladesh (research abstract)
Researchers present findings from their study of the prevalence of STIs and reproductive tract infections (RTIs) among hotel-based sex workers (HBSWs) in Dhaka, Bangladesh. A total of 400 HBSWs were enrolled in the study: 228 women (57%) were symptomatic and 172 (43%) were asymptomatic; 35.8% were positive for N. gonorrhoeae, 43.5% were positive for C. trachomatis, and 4.3% were positive for T. vaginalis. A total of 8.5% had syphilis, 34.5% were positive for HSV-2, and 86.8% were positive for at least one RTI or STI.

Sexually Transmitted Diseases Symptoms in Adults: Prevalence and Risk Factors (research abstract)
Researchers evaluated the prevalence of STD symptoms and associated risk factors in an adult population in this cross-sectional study conducted among residents of the metropolitan area of Pelotas, Brazil. A self-administered questionnaire was used to gather information about sexual behavior and STD symptoms. They found that the prevalence of STDs was 13.5%. A higher risk of STDs was found in non-white younger women with more sexual partners and who did not use condoms in their last sexual relationship. Among men, early initiation of sexual activity and anal sex were positively associated with the outcome. Higher risks were found among women with lower schooling.

The Combined Contraceptive Vaginal Ring, NuvaRing®, and Tampon Co-usage (research abstract)
The authors investigated the effect of tampon co-usage on systemic exposure to etonogestrel (ENG) and ethinylestradiol (EE) from the combined contraceptive vaginal ring, NuvaRing®. One cycle of ring use consists of 3 weeks of ring use followed by a 1-week ring-free period. Fourteen healthy women were randomized to use both NuvaRing and tampons (Kotex® regular) or NuvaRing alone for one cycle; participants then switched to the alternate treatment regimen for a second cycle of ring use. The first tampon was self-administered on day 8 of the interaction cycle; four tampons a day were used for 3 consecutive days. Tampon co-usage did not result in any changes in serum ENG or EE concentrations and is thus not expected to compromise the ring's contraceptive efficacy.

A Meta-Analysis of the Effect of Mediated Health Communication Campaigns on Behavior Change in the United States (research abstract)
The authors performed a meta-analysis of studies of mediated health campaigns in the United States in order to examine the effects of the campaigns on behavior change. They found that mediated health campaigns have small measurable effects in the short-term. Campaigns with an enforcement component were more effective than those without. To predict campaign effect sizes for topics other than those listed in the paper (eg, seat belt use, oral health, sexual behavior), researchers can take into account whether the behavior in a cessation campaign was addictive, and whether the campaign promoted the commencement of a new behavior, versus cessation of an old behavior, or prevention of a new undesirable behavior.

The Provision of Reproductive Health Services in Private Hospitals in Amman, Jordan (report)
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This report summarizes findings from the Hospital Reproductive Health survey that was implemented by the Partners for Health Reformplus project, Amman, Jordan, during the month of July 2002. The survey received responses from 25 of the 30 private acute care hospitals that are located in East and West Amman. The purpose of the survey was to determine the capacity of private sector hospitals to provide comprehensive delivery and newborn care to Ministry of Health patients.

FAMILY PLANNING/REPRODUCTIVE HEALTH NEWS

FDA Delays Decision on Morning-After Pill (news article)
The government is postponing its decision on whether morning-after birth control should be sold without a doctor's prescription. The FDA had been scheduled to decide this week on whether Barr Laboratories' version of emergency contraception, called Plan B, could be sold over the counter. Barr announced late Friday, however, that FDA had extended its deadline for making that decision to May. A Barr spokewoman said the reason was that the FDA requested more explicit information about 16- and 17-year-olds who have used the pills, and the agency now needs additional time to evaluate the data.

India: First Male Herbal Contraceptive Ready for Launch (news article)
With the Indian government adopting various measures to spread awareness about different family planning techniques, the world's first ever herbal contraceptive for men is ready to be formally launched here on February 17. The product, a spermicidal cream, could be commercially available in the open market within the next 2 or 3 months. The main component of the contraceptive is "Reetha" (commonly known as soap nut), which is also the base ingredient of herbal shampoos and soaps.

South Africa: Significant Progress in Treatment of STIs (news article)
South Africa has made significant progress in the detection and treatment of STIs since 1994, with a massive increase in condom distribution, according to Manto Tshabalala-Msimang, the health minister. Speaking at a STIs/Condom Week event in Humansdorp, Eastern Cape, she said condom distribution increased by 80% from 1997 to 2003, and partner notification rates increased from 39% in 2000 to 71% in 2002.

Australia: Under-age Girls Sterilised (news article)
Underage Territory girls in Australia are receiving implants to stop them from becoming pregnant, according to this news article. Australian Medical Association NT president Dr. David Meadows has said that general practitioners were giving children they considered to be at risk of pregnancy implants which temporarily sterilize them for up to 3 years. Dr. Meadows said up to 100 under-age girls had already been fitted with the Implanon implant.

Bush Administration Wants More Funds for Abstinence Programs (news article)
The Bush administration is proposing to double spending on sexual abstinence in US school programs that bar any discussion of birth control or condoms to prevent pregnancy or AIDS, despite a lack of evidence that such programs work.

HIV/AIDS RESEARCH

Diffusion of Innovations and HIV/AIDS (research abstract)
As the HIV/AIDS epidemic continues its relentless spread in many parts of the world, diffusion of innovation (DOI) provides a useful framework for analyzing the difficulties in achieving behavior change necessary to reduce HIV rates. The DOI concepts most relevant to this question include communication channels, the innovation-decision process, homophily, the attributes of the innovation, adopter categories, and opinion leaders. The preventive measures needed to halt the transmission of HIV constitute a "preventive innovation." This article describes the attributes of this preventive innovation in terms of relative advantage, compatibility, complexity, trialability, and observability. It reviews studies that incorporated DOI into HIV/AIDS behavior change interventions, both in Western countries and in the developing world. Finally, it discusses possible reasons that the use of DOI has been fairly limited to date in HIV/AIDS prevention interventions in developing countries.

Mortality and Burden of Disease in a Cohort of HIV-seropositive Adults in Nairobi, Kenya (research abstract)
The purposes of this study were to measure incidence and determine risk factors associated with opportunistic infections (OIs) and mortality among an HIV-infected cohort in Nairobi, Kenya. Three hundred and eighty-one seropositive ambulatory adults in Nairobi, Kenya were followed from 1997 to 2000 with participants visiting the clinic every 2 months and when acutely ill. Acute bronchitis was the most frequent diagnosis, followed by STIs, candida vaginitis (among women), fever, diarrhoea, pneumonia, HIV-associated skin rash, oral candidiasis, and urinary tract infection. Associations between the frequency of these diagnoses including survival and sociodemographic factors and initial CD4 count were assessed. A CD4 count less than 200 cells/mL at recruitment was strongly associated with decreased survival.

Risk, Morality & Blame: A Critical Analysis of Government and U.S. Donor Responses to HIV Infections Among Sex Workers in India (report)
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The paper examines whether targeted interventions, the main component of India's National AIDS Control Program, have effectively addressed the HIV prevention needs of women sex workers in Tamil Nadu and Maharashtra. Gender inequities play a critical role in fueling the epidemic and need to be addressed in programs and strategies focused on women, including female sex workers. An increasing body of program experience with sex workers reviewed for this analysis highlights the limitations of models that fail to address the broader needs and rights of sex workers as human beings.

HIV/AIDS Risk Perception, Attitudes and Sexual Behaviour in Portugal (research abstract)
In this study, 1,000 individuals aged 18 to 69 were selected for a multistage nationwide random sample in Portugal. Of the interviewees, 68.3% were of the opinion that the risk of AIDS, in Portugal, is considerably high and 37.1% stated that they had feared being infected by HIV; 28% established a connection between being afraid and the fact that AIDS is a serious/incurable disease; 31.5% believed that there are risks inherent to the health services; only 7.8% expressed fear of AIDS because of an infected partner. Only 42.6% regarded extramarital sexual relations as either partially or totally acceptable. Sexual relations between youths were seen as totally acceptable by 11.9% and partially acceptable by 51.1%. Homosexual relations between men were seen as either totally or partially acceptable by 38%. Of the interviewees, 7.8% thought that recent treatments can definitely cure AIDS, and 6.5% believed that with recent treatments HIV transmission would no longer be possible.

Oral Human Papillomavirus Infection in Adults Is Associated with Sexual Behavior and HIV Serostatus (research abstract)
In this study, oral samples from HIV-seronegative (n=396) and HIV-seropositive (n=190) adults were tested for HPV DNA. High-risk HPV infections were present in 2.1% of tonsil and 6.3% of oral-rinse specimens. The prevalence of oral high-risk HPV infection was greater in HIV-seropositive individuals (13.7% vs. 4.5%). In multiple logistic regression, odds of oral HPV infection increased with age, male sex, and herpes simplex virus-2 seropositivity in HIV-seronegative individuals and with CD4 cell count less than 200 cells/mL, HSV-2 seropositivity, oral mucosal abnormalities, and more than one oral sex partner during the previous year.

Trade, Development, and HIV/AIDS Prevention (report)
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This background paper was prepared for the Plenary Session on HIV/AIDS, AGOA Forum, Washington, DC, December 10, 2003. It relates what part the AGOA (Africa Growth and Opportunity Act) plays in development and HIV/AIDS.

HIV/AIDS NEWS

As if AIDS isn't Bad Enough (editorial)
This editorial calls into question reporting statistics on the HIV/AIDS epidemic in Africa and the global response to it.

One in 100 New York City Residents Said to Have HIV/AIDS (news article)
More than 75,000 people in New York City have been reported infected with HIV/AIDS, a rate so high it puts the city in the same league as Third World nations according to research released Thursday at the 11th Annual Retrovirus Conference in San Francisco. Researchers noted about 3.9% of men living in New York City who are between the ages of 40 and 49 have HIV/AIDS, with 2.8% of all men dealing with the later stages of infection. But that rate could be higher: Researchers believe about 25% of New Yorkers who are infected with HIV do not know it yet.

Ghana: Shun Cultural Practices that Promote HIV/AIDS- Health Director (news article)
Speaking at the launch of Lawra district HIV/AIDS activities, Miss Melany Bokuma, Lawra District Director of Health Services, appealed to Ghanaians to do away with cultural practices that could spread the HIV/AIDS. Practices whe mentioned were inheritance of widows of deceased relatives, female circumcision, and polygamy. Miss Bokuma reported that out of 959 blood donors in the district last year, 82 were found to be HIV positive after screening. She added that out of 117 males who were clinically screened at the Nandom and Lawra hospitals, 60 were HIV positive.

China Sends Officials to Villages to Fight AIDS (news article)
Related news article: Henan Reports 11,844 HIV-positive Cases
China will send government officials to AIDS-stricken villages in central Henan province to help victims and their families in the latest official commitment to fight the disease. China has been criticised for its slow response to a disease that has infected more than 800,000 people. Health agencies say China could have 10 million AIDS victims by 2010 if it fails to take the scourge seriously.

Batch of New HIV Drugs Looks Promising (feature article)
This article features new AIDS drugs that are "in the pipeline." Half a dozen medicines, including some that attack the virus in new ways, are poised to get their first real-world tests, and a larger number are in the preliminary stage of laboratory and animal studies.

UK: More Unsafe Sex Sends HIV Infections Soaring (news article)
Increases in unsafe sex have sent HIV infection rates in Britain soaring, a government agency said last week. New HIV infections increased by 20% between 2002 and 2003 and are expected to rise to more than 7,000, the highest yearly total.

Ukraine Appeals to West for Help to Fight AIDS (news article)
Ukraine appealed to Western groups last week to boost assistance to the impoverished country's fight against Europe's fastest growing AIDS epidemic after the Global Fund to Fight AIDS, Tuberculosis and Malaria halted financing over poor management. Ukraine, under scrutiny in the West as three of its neighbours join the European Union in May, has seen the number of AIDS case rise quickly since independence in 1991. With about 62,000 HIV cases registered, experts fear the real figure in the country of 48 million could reach about 400,000, or about one percent of the adult population. Some 3,500 people have died of AIDS, the health ministry said.

Kenya: 140,000 to Get Free AIDS Drugs (news article)
About 140,000 people infected with HIV/AIDS will be receiving free-life prolonging drugs by next year. The anti-retrovirals will be made available through funds already allocated to Kenya by the American Government.

Estonia: HIV Catches Tradition-bound Nation Off Guard (feature article)
This feature article describes Estonia's struggle with coming to terms with its HIV/AIDS epidemic. The country has the highest known infection rate among Baltic countries and is in the grips of a "concentrated" HIV epidemic among intravenous drug users that has migrated south and west to the country's medieval capital, Tallinn, and is threatening to spread still wider through unprotected sex.

Germany Launches AIDS Vaccine Trial (news article)
Scientists in Germany today launched the country's first test of an HIV vaccine, a yearlong program that will involve up to 50 volunteers and is backed by the New York-based International AIDS Vaccine Initiative. The trial will be conducted at university clinics in Bonn and Hamburg, and also at Belgian hospitals in Brussels and Antwerp.

MATERNAL AND CHILD HEALTH RESEARCH

Breastfeeding among Teenage and Adult Mothers in Brazil (research abstract)
This study estimates the prevalence of breastfeeding among teenage (younger than 20 years old) and adult mothers of six-month-old children and identifies factors associated with weaning. The authors used a cross-sectional study of a sample of 237 teenage mothers and 239 adult mothers living in the city of Montes Claros, Brazil. Breastfeeding prevalence in children aged 6 months was 71.3% among teenage mothers and 77.4% among adult mothers, but after adjusting for control variables the role of adolescence added considerable weight to weaning. Factors associated with weaning were marital status, mother's occupation after delivery (both showed interaction with teenage years), difficulty to breastfeeding in the first days after delivery, and exclusive breastfeeding at the time of hospital discharge.

Prevalence of Sexually Transmitted Diseases and Human Immunodeficiency Virus among Women Attending Prenatal Services in Apia, Samoa (research abstract)
This prevalance study was conducted to gather information on pregnant women in Apia, Samoa. Of 427 pregnant women tested from two prenatal hospital clinics, 30.9% (132) had chlamydia; 20.8% had trichomoniasis; 3.3% had gonorrhoea; 0.5% had syphilis; and none had HIV. Overall 42.7% had at least 1 STD. Young women aged (under 25 years) were three times more likely to have an STD than older women.

Motherhood in Malagasy Society: A Major Component in the Tradition vs. Modernity Conflict (research article)
The paper considers the role of motherhood in traditional Malagasy society. An analysis of the onslaughts on the status of mothers in traditional Malagasy society through the rise of the state, evangelisation, and colonization are presented. The role of the mother in "modern" society is questioned, and the paper concludes that in Malagasy society, as in many African societies, women's capacity for procreation is their primary source of power. Motherhood as a very high-ranking value is deeply inlaid in Malagasy culture, but this source of power has been eroded by the successive shocks of modernity such as the rise of the State, evangelisation, colonization, and urbanization. However, the author notes that it is still very much present in people's minds as well as in the law. The question now is how to adjust to new circumstances, such as the present economic conditions, the control of HIV/AIDS, and other issues linked to the status of women.

Effect of Socio-demographic Factors on Infant Mortality in Purworejo, Central Java, Indonesia (research abstract)
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Researchers studied the effect of socio-demographic factors on infant mortality and survival in Purworejo district, Central Java, Indonesia. They identified an infant mortality rate of 51.8 per 1,000 person years. Males had a higher mortality rate than females, and most mortality occurred before 1 month of age. Infant mortality was lowest (23.1 per 1,000 person-years) among females who were born after older brothers and increased among males with older brothers. Significant contributors to higher infant mortality was lack of education, a low education level of the mother, occupation of farming, and living in highland areas.

MEN'S HEALTH RESEARCH

Update on the Impact of Chlamydia Trachomatis Infection on Male Fertility (research abstract)
This article reviews both the economic and health costs of C. trachomatis infection.

Evaluation of Genital Sites and Sampling Techniques for Detection of Human Papillomavirus DNA in Men (research abstract)
The purpose of this study was to evaluate methods for detection of genital human papillomavirus (HPV) DNA in men. Samples were obtained from three consecutive groups of 10 men attending an STD clinic in the US. HPV DNA was detected in samples from 104 men (33%): 24% from the penile shaft, 16% from the glans, 28% from the foreskin, 17% from the scrotum, and 6% in urine. The HPV prevalence was similar for circumcised and uncircumcised men.

Distress and Depression in Men Who Have Sex With Men: The Urban Men's Health Study (research abstract)
This study estimates the prevalence of depression and describes the correlates and independent associations of distress and depression among US men who have sex with men. A household-based probability sample of men who have sex with men (n=2,881) was interviewed between 1996 and 1998 in four large American cities. The 7-day prevalence of depression in men who have sex with men was 17.2%, higher than in adult US men in general. Both distress and depression were associated with lack of a domestic partner; not identifying as gay, queer, or homosexual; experiencing multiple episodes of antigay violence in the previous 5 years; and very high levels of community alienation.

MEN'S HEALTH NEWS

'Most Thai Men Tend to Stray' (news article)
A new survey has revealed that 75% of Thai husbands are unfaithful to their wives.

POPULATION NEWS

The Emptying of Russia (feature article)
This article reports how Russia is on the brink of a steep demographic decline. The article explores the powerful forces that have shaped this path of depopulation and debilitation.

More Abortions than Births in Romania (news article)
The Romanian health ministry said that abortions in the country continued to exceed live births in 2003.

'Vanishing Oil and Gas Could Prompt Birth Rate Nosedive' (news article)
Dwindling oil and natural gas reserves could cause birth rates to plummet over the coming decades, it is claimed. US anthropologist Virginia Abernethy believes there is an indivisible link between the availability of oil and gas, the economy, and fertility rates. Speaking at the annual meeting of the American Association for the Advancement of Science in Seattle, she said, "The availability of energy has been a major factor in population growth. In the modern context, energy use per capita affects economic activity. So a prolonged decline in energy use per capita will tend to depress the economy which, in turn, will cause a decline in the fertility rate."

WOMEN'S HEALTH RESEARCH

Acquisition of High-Risk Human Papillomavirus Infections and Pap Smear Abnormalities among Women in the New Independent States of the Former Soviet Union (research abstract)
This study analyzed the rates of acquisition and the times of incident high-risk (HR) human papillomavirus (HPV) infections and Pap smear abnormalities and their predictive factors in women participating in a multicenter screening study in three countries of the New Independent States of the former Soviet Union.

Treatment of Endometriosis and Chronic Pelvic Pain with Letrozole and Norethindrone Acetate: A Pilot Study (research abstract)
Related news article: Breast Cancer Drug May Ease Endometriosis
A drug used to help prevent breast cancer from coming back may also ease the pain and suffering of endometriosis in women who can't get relief from other treatments. This new study shows the drug Femara, in combination with progestin, significantly slowed the progression of endometriosis as well as reduced the pain associated with the disease.

Symptoms Related to the Reproductive Tract and Mental Health among Women in Rural Southern India (PubMed abstract)
This study aimed to determine the association, if any, between symptoms related to the reproductive tract and mental health among women in rural southern India. Researchers conducted a cross-sectional survey with a nested case-control study, in a community setting. Of the 622 subjects recruited, 150 (24.4%) complained of at least one symptom related to the reproductive tract. The most common symptom was vaginal discharge (17.5%). The presence of a symptom related to the reproductive tract for more than 1 month and a history of similar symptoms over the past year were risk factors for the development of common mental disorders. Higher education and being currently married were protective factors.

Social and Sexual Risk Factors for Bacterial Vaginosis (research abstract)
In this study, researchers purposed to clarify potential sexual and non-sexual risk factors for bacterial vaginosis (BV): 890 women with BV and 890 controls were included for study. Factors that were independently associated with BV were 3 or more male sexual partners in the past 12 months, at least one female sexual partner in the past 12 months, a past pregnancy, and smoking. In contrast, women with BV were significantly less likely to have used hormonal contraception or to have used condoms consistently than controls.

WOMEN'S HEALTH NEWS

Female Condoms Officially Launched in India (news article)
India officially launched female condoms last week as part of its campaign against HIV/AIDS. Female condoms are currently the only female-initiated method that offers women protection against the infection and unplanned pregnancy.

YOUTH HEALTH RESEARCH

AIDS in Africa during the Nineties: Young People in Kenya (report)
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This summary report brings together and examines existing information about adolescent sex in Kenya during the 1990s. The report examines evidence for the success of major prevention strategies: what do young people know about HIV and how to avoid it? What proportion of them are abstaining, and until what ages? Once they do start having sex, is it within marriage or outside it? Are they sticking to one partner? Are they using condoms? And have any of these factors changed over time? Current information about HIV prevalence rates in young people is presented, and the implications of the patterns of knowledge, behavior, and infection are summarized.

Actions That Protect: Promoting Sexual and Reproductive Health and Choice among Young People in India (working paper)
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This paper synthesises the evidence on the sexual and reproductive health situation of young people in India and explores what is known about underlying factors that place them at risk of or protect them from unsafe and unwanted sexual and reproductive health experiences. The picture that emerges suggests that substantial proportions of young people experience risky or unwanted sexual activity, do not receive prompt or appropriate care, and experience adverse reproductive health outcomes. Contextual factors such as poverty, gender imbalances, and lack of education or livelihood opportunities clearly increase the vulnerability of youth. Other factors at the family, community, and facility level may also exacerbate risk. While young people's knowledge and awareness about sexual and reproductive health is increasing, much of this knowledge remains superficial and ridden with myths, misperceptions, and a sense of invulnerability.

Youth Reproductive Health in Nepal: Is Participation the Answer? (report)
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This report documents the processes and results of a project that tested the effectiveness of the participatory approach in defining and addressing the reproductive health concerns of adolescents. The project was set up with a quasi-experimental study design utilizing the participatory approach for research, intervention, monitoring, and evaluation at two study sites (one rural and one urban), together with more traditional reproductive health research and interventions at two control sites. The evaluation reveals that with regard to outcomes of interest, the participatory approach did indeed yield more positive results. Although the effect is only marginally more positive in terms of basic indicators of youth reproductive health (YRH), it is substantially more positive in terms of the broader, more contextual factors that influence YRH, as well as capacity building, empowerment, and sustainability.

The Knowledge, Attitude and Use of Contraception among Secondary School Girls in Port Harcourt (PubMed abstract)
In this study, gave a self-administered questionnarie to 534 students selected from a female only secondary school in Port Harcourt Local Government Area of Rivers State. Students were aged 8-23 years (mean 15.6 years). Two hundred ninety five (55.2%) of the respondents had heard of at least one contraceptive method. Age and not the academic level significantly influenced the knowledge. Condom was the most common method known. Less than 10% of students had knowledge of modern contraceptive methods; 25% believed that contraceptives could be harmful. Among the sexually active girls, only 45.3% had ever used any method of contraception.

Non-consensual Sexual Experiences of Young People: A Review of the Evidence from Developing Countries (working paper)
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This review synthesizes the evidence about non-consensual sexual experiences of young people in developing countries, its magnitude, and correlates. The profile depicted here relies on a few pioneering studies, drawn on selected sub-populations of youth. Findings may not be representative and comparability limited and, for obvious reasons, responses in standard surveys are not always reliable. Findings suggest that non-consensual sexual experiences are not unknown and that for considerable minorities, including boys, sexual debut itself was coerced. Leading factors that place young people at risk of non-consensual sexual relations or inhibit them from seeking care, taking action against a perpetrator, or withdrawing from a coercive relationship include gender double standards and a lack of (a) communication and negotiation on sexual matters, (b) a supportive environment, and (c) trusted adults and peers to consult on sexual health matters.

Applying Social Franchising Techniques to Youth Reproductive Health/HIV Services (news article)
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This Youth Issues Paper from FHI examines what role social franchising might have in expanding reproductive health and HIV services for youth. In addition to summarizing the social franchising research available, the paper describes four types of social franchising models for youth programs: joint venture, community, private provider and governmental. It also examines case studies of programs in Egypt, Kenya, Madagascar, Mexico and the Philippines that have put these models into practice.

Reproductive and Sexual Health Education, Care and Counseling for Married Adolescents in Rural India (research summary)
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This document presents evaluation findings from an intervention that tested the feasibility of providing high-quality, community-based integrated health care for married adolescent couples in a poor rural area of India.

YOUTH HEALTH NEWS

School Sex CD Too Hot Even for the Danes (news article)
The Danish government halted the distribution of 60,000 CD-ROMs for school sex education classes last week because some of the content crossed the line of what the health minister deemed acceptable. The 60,000 discs contained information about threesomes, bestiality, and partners urinating and defecating on each other while having sex. Distribution of the material was scheduled to start this week. The leader of the Danish Family Planning Association regretted the government's decision.

Safe Sex Awareness Rises among Young Bulgarians (news article)
Young people in Bulgaria are getting better informed about HIV and AIDS and the ways of contracting the disease, experts from the Prevention and Health Promotion Department say, making comparisons with surveys over the last several years. Mass media are the major source of information about AIDS, followed by specialized lectures, printed materials, books, brochures, conversations with parents, and friends.

SPECIAL REPORTS/PROFILES/RESOURCES

Local Government Responses to HIV/AIDS: A Handbook (resource material)
This handbook is written for local government authorities (LGA) that are interested in developing or strengthening local responses to HIV/AIDS. It provides information, examples and illustrative tools that guide users through the steps of recognizing and publicly acknowledging the importance of addressing HIV/AIDS, assessing the impact of HIV/AIDS on the locality, identifying key stakeholders to initiate and coordinate a Local Government (LG) HIV/AIDS Response Strategy. The handbook also focuses on the implementation process and suggests ways to mobilize new and existing resources, develop productive relationships with civil society organizations, private sector and government agencies, and establish systems of monitoring, learning, and evaluation.

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