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The Pop Reporter®

Volume 4, Number 13
29 March 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

Quality Assessment of Family Planning Services in Ife/Ijesa Administrative Health Zone: Clients’ Perspective (research abstract)
The authors, from the Obafemi Awolowo University Teaching Hospitals Complex, Nigeria, used a cross-sectional survey of clients (n=490) at three family planning clinics to assess the quality of our family planning services as perceived by clients. More than half (52.2%) of clients felt satisfied with the competence of the provider, and 94.6% were satisfied with the client-provider relationship. Measures to encourage continuity were maintained in 90.8% of clients. The authors found a high level (94%) of client satisfaction with overall services rendered, while 36.7% received other information apart from family planning services.

Norplant® Insertions at the Zeynep Kamil Gynecologic and Pediatric Training Research Hospital in Istanbul (research abstract)
Researchers conducted this study to determine the sociodemographic characteristics and usage interval according to insertion period, observed side effects, and reasons for discontinuation in 756 patients who had Norplant® inserted and removed since 1994. Mean age of patients was 26.5 ± 4.9 years, mean number of living children was 2 ± 1.2, and just over half had no health insurance. Most used coitus interruptus previously as a contraceptive method and chose Norplant because of its effectiveness. Various side effects were noted in 79.8%. Bleeding problems were seen in 69.8%. Pregnancy occurred in only one case. Mean Norplant usage interval was 3.08 ± 1.68 years.

Assessment of Reproductive and Maternal Health in Ukraine (report)
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This report assesses reproductive health in Ukraine. A four-person team interviewed staff from USAID/Ukraine, the Ministry of Health (MOH), USAID-supported projects, and other donors. The team visited more than 25 health facilities in different regions of the country. Their key findings include: more than half of pregnancies are unintended; the overall level of contraceptive prevalence reached 68% of married women of reproductive age, but only 38% of couples used a modern method; a one-child family is rapidly becoming the norm in Ukraine; virtually all women deliver in MOH hospitals; pregnancy is viewed as a disease, and an excessive number of pregnant women are hospitalized before delivery. Recommendations are presented in four broad areas: policy, integration and linkages, youth, and maternal health.

Gonorrhea Surveillance: Estimating Epidemiologic and Clinical Characteristics of Reported Cases Using a Sample Survey Methodology (research abstract)
The purpose of this study was to implement and evaluate a gonorrhea sample survey surveillance methodology in San Diego, California. Healthcare providers caring for a representative sample of all gonorrhea patients (n=248) were interviewed by telephone about patient demographics, risk factors, and management. Major reasons for testing included symptoms (68%), partner referral (14%), and screening (12%). At minimum, 36% of male gonorrhea patients were men who have sex with men (MSM); MSM with gonorrhea were rarely diagnosed with rectal or pharyngeal gonorrhea outside of STD clinics. Estimated local resources required to conduct this survey were US$12 per completed interview. The authors conclude that healthcare provider telephone interviews regarding recently reported gonorrhea patients are feasible and can provide important additional information to STD programs, which could be used to direct intervention strategies and monitor trends.

FAMILY PLANNING/REPRODUCTIVE HEALTH NEWS

China: People to Enjoy Better Reproductive Care (news article)
The Chinese people are expected to enjoy better reproductive health care in the coming years with the development of three programs in the country, reported the China Daily. The three programs, all started in 2001, are the Program for Improving the Quality of Contraceptive Care, the Reproductive Tract Infection Intervention Program, and the Healthy Baby Promotion Program. The programs have included 19 provinces, autonomous regions and municipalities, and results in some regions are "encouraging", according to a senior official with the National Population and Family Planning Commission.

FAMILY PLANNING/REPRODUCTIVE HEALTH LAW AND POLICY

Debunking the Myths in the U.S. Global AIDS Strategy: An Evidence-Based Anaylsis (report)
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This analysis, from The Center for Health and Gender Equity, aims to evaluate the degree to which the
Bush Administration's Strategy ("President's Emergency Plan for AIDS Relief: U.S. Five-Year Global HIV/AIDS Strategy") fulfills its own stated objectives and to identify existing gaps in efforts to address those at risk of infection and those living with HIV/AIDS. Data and evidence used in the critique are referenced throughout and draw from a range of scientific and public health literature, including scientific journals and evidence collected and disseminated by the Centers for Disease Control, UNAIDS, the Demographic and Health Surveys, among others.

Policy Implications of the Variations in Ghana's Fertility Transition (research abstract)
This paper examines the policy implications of the variations found in the fertility transition in three consecutive (1986, 1993, and 1998) Demographic and Health Surveys of Ghana. The transition is associated mainly with urbanization and education, particularly of mothers. The authors write that the differentials are explained by increasing economic inequalities among the socioeconomic subgroups of the population and the administrative regions. They argue that policies that seek to remove the disparities in the fertility transition in the country must therefore address this underlying factor.

South Africa: Put on the Pill Without Permission (news article)
This article relates the stories of young girls who have been administered contraceptive injections without a parents' informed consent. Health workers find themselves "in a catch-22 situation" when girls younger than 14 approach them for contraceptives without their parents' knowledge or consent.

Support for Organizational Reproductive Health Policies: Is Sexism a Problem? (research abstract)
This study focuses on the realities of organizational policies and practices for women’s reproductive health in Nigeria. It examines the relationship between sexism and several indices of support for organizational reproductive health policies. Data was collected from 419 (63.5%) female and 241 (36.5%) male employees from private and public organizations in Lagos, Nigeria. Using a series of tests of differences and association, it was found that (1) there are sex differences in the respondents’ support for organizational reproductive health policies for female employees; (2) within each gender category, those with higher levels of benevolent sexism exhibited higher levels of support for family friendly policies; (3) hostile sexism more than benevolent sexism related to lower levels of support for the policies, and (4) there were gender differences in hostile and benevolent sexism scores.

Legislation Becomes Urgent Issue in China's HIV/AIDS Prevention (news article)
At a symposium on HIV/AIDS prevention held in Beijing last week, experts and leaders from concerned departments all agreed that the most urgent issue in China's HIV/AIDS prevention is legislation. China has made laws and regulations on HIV/AIDS prevention, local or national, since 1985 when the first AIDS patient was reported in the country. However, these regulations were flawed and tried to stop the epidemic through attacking HIV victims.

South Korea: Government to Subsidize Child Birth Expenses (news article)
In a bid to boost the country's falling birth rate, the government said on Friday it will subsidize 50% of the expenses needed for an individual to give natural birth to her second child, and all of the expenses in case of the third and subsequent children.

HIV/AIDS RESEARCH

Prevalence of HIV in Workforces in Southern Africa, 2000 - 2001 (research abstract)
The authors surveyed workforces in southern Africa to determine HIV prevalence among formally employed, largely male populations. Voluntary, anonymous, unlinked seroprevalence surveys of 34 workforces with 44 000 employees were carried out in South Africa, Botswana, and Zambia in 2000-2001. Average HIV prevalence for the entire sample was 16.6%. Country-wide prevalence was 14.5% in South Africa, 17.9% in Zambia, and 24.6% in Botswana. Among industrial sectors, mining (18%) and metal processing (17.3%) had the highest infection rates. Males, who comprised 85% of participants of known sex, were more likely (16.3%) to be infected than were females (10.7%). Contract (23%), unskilled (18.3%), and semi-skilled workers (18.7%) were much more likely to be infected than were skilled workers (10.5%) and managers (4.5%).

Impact of Various Sources of AIDS Information among Ever Married Men and Women in Bangladesh (research article)
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This study examined the impact of various sources of AIDS information among ever married men and women in Bangladesh using nationally representative data. Logistic regression analysis identified that television, radio, and newspaper/magazines were the effective way to disseminate AIDS-related information. Exposure to two or more sources of AIDS information were found highly effective compared with only one source. The authors write that this study underscores the need for disseminating suitable AIDS messages from multiple sources simultaneously.

Prevalence of HIV among Women with Vaginal Discharge in a Gynecological Clinic (research article)
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This study, from the Lagos University Teaching Hospital, Nigeria, determined the prevalence of HIV in patients with vaginal discharge. Mean age of the 140 included in the study was 31.1±6.9 years (range 18–50 years). In 31 (22.1%), Candida albicans was isolated, in 26 Gardnerella vaginalis (18.8%), in 17 Staphylococcal spp. (12.1%); and E. coli, Trichomonas vaginalis, and Neisseria gonococcus in 7.9%, 4.3%, and 1.4%, respectively. Four (2.9%) of the 140 patients were HIV seropositive, and all had Candida albicans isolated. The prevalence of HIV among patients with Candida albicans was 12.9%. The association between HIV seropositivity and Candida albicans infection was found to be significant.

Sociodemographic Characteristics of HIV-positive Mother-child Pairs in Ile-Ife, Nigeria (research abstract)
This study identifies sociodemographic characteristics of HIV-positive mother-child pairs in the southwest of Nigeria. The aim was to identify factors that will be helpful in designing initiatives for preventing mother to child transmission (MTCT). Eligible mother-child pairs identified at the paediatric department, at the Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigeria, were interviewed using semi-structured questionnaires and screened for HIV seropositivity. Of 199 mother-child pairs, 93 (46.7%) were HIV positive. When compared with 106 HIV-negative mothers, the HIV-positive mothers were younger, unemployed, had earlier sexual exposure, had lower education, and were married to polygynous spouses. The authors recommend that initiatives designed to reduce MTCT of the HIV virus in the southwest of Nigeria include education and improvement of the economic status of female adolescents and promotion of cultural practices such as virginity until marriage, while discouraging polygyny and early marriage.

Envelope-Constrained Neutralization-Sensitive HIV-1 After Heterosexual Transmission (research abstract)
Related news article: HIV in Just-Infected May be Vulnerable to Vaccines
Newly transmitted HIV may be particularly vulnerable to vaccines, according to findings in Zambia by University of Alabama researchers.

HIV Risk and Condom Use in the Adult Heterosexual Population in France between 1992 and 2001: Return to the Starting Point? (research abstract)
Researchers measured changes in protection behaviors from 1992 to 2001, in assessing trends in condom use over time in a heterosexual population aged 18-54 years in France. National telephone surveys were conducted in 1992, 1994, 1998 and 2001. Two temporal phases are highlighted in condom use. The first shows an increase in both condom use at first sexual intercourse from 1985 to 1998, and in condom use during the 12 months prior to the surveys between 1992 and 1998, suggesting that sexual health promotion messages may have increased HIV/AIDS preventive behaviors. The second phase shows a decrease in condom use. Compared with 1998, condom use at first sexual intercourse in the 2001 survey still remains high; however, condom use in the 12 months prior to the survey is clearly decreasing, particularly among those with multiple sexual partners during the past 12 months.

Impact of Peer Group Education on HIV Prevention among Women in Botswana (research abstract)
For this study, a peer group HIV prevention intervention based on social/cognitive learning theory, gender inequality, and the primary health care model for community-based health promotion was developed and tested for more than 300 urban employed women in Botswana. Compared with women in the delayed control group, women in the intervention group had significantly higher postintervention levels of knowledge of HIV transmission, STDs, and HIV prevention behaviors; positive condom attitudes and confidence in condom use; personal safer sex behaviors; and positive attitudes toward persons living with HIV/AIDS and community HIV/AIDS-related activities. The authors conclude that peer groups are a low-cost and sustainable intervention that can change HIV prevention knowledge, attitudes, and behaviors for ordinary urban employed women in sub-Saharan Africa.

HIV-1 Disease Progression and Fertility: The Incidence of Recognized Pregnancy and Pregnancy Outcome in Uganda (research abstract)
The aim of this study was to estimate the association between HIV disease progression and the incidence of recognized pregnancy and to estimate the risk of subsequent fetal loss. A total of 191 women (92 HIV seropositive and 99 HIV seronegative at enrolment) aged 15-49 years in an HIV clinical cohort were invited to attend routine clinic visits every 3 months. There were 2,524 eligible visits and 216 recognized pregnancies. The reported frequency of sexual intercourse diminished with advancing HIV disease. The adjusted odds ratio for pregnancy when the woman was in WHO stage 1 compared with HIV seronegatives was 0.58; stage 2, 0.47; stage 3, 0.43; and stage 4, (AIDS) 0.14. The findings were similar for CD4 cell count, time from seroconversion, and time before AIDS. There was an increase in fetal loss from the early stages of HIV infection.

HIV/AIDS NEWS

FDA Approves First Oral Fluid Based Rapid HIV Test Kit (press release)
Related news article: Rapid Oral HIV Test Wins FDA Approval
The US government approved last week the first rapid test, which collects material from a swab from the mouth, to detect the presence of the virus that causes AIDS. Food and Drug Administration officials said the test can provide results within 20 minutes by using a swab to collect oral mucosal transudate from the mouth. In the past, rapid HIV tests required blood samples.

Trials to Begin on Anti-HIV Gel (news article)
Large scale human trials of two gels designed to combat the Aids virus are being planned by British scientists to be carried out in Africa. Millions of people around the world could soon protect themselves against the HIV virus with the simple dosage. Experts say around 60 gels, known as microbicides, are now in development with about 14 in clinical trials. Women could be the main beneficiaries, international development secretary Hilary Benn said on Saturday.

USAID HIV/AIDS E-Newsletter March 2004 (resource material)
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This monthly update on activities of the US Agency for International Development Office of HIV/AIDS includes the following items: "POLICY Project Supports New Workplace Initiative in Zambia", "Postal Campaign Spreads AIDS Awareness in Nepal", and "USAID and Coca Cola Bring Television Drama to West and Central Africa".

AIDS Fighters Hear Good News from Haiti (news article)
While AIDS still claims 30,000 lives a year in Haiti and has left 200,000 children orphaned, innovative treatment and prevention programs have cut Haiti's HIV rate by 50% since 1993, Dr. Jean Pape, of the Cornell Weill Medical College and director of Les Centres Gheskio in Haiti, told the National HIV/AIDS Update Conference in Miami yesterday.

U.S.: Access to Generic HIV/AIDS Drugs at Risk (news article)
The U.S. government is threatening to obstruct low-income countries’ access to generic HIV/AIDS drugs approved by the World Health Organization, Human Rights Watch said today. The United States will convene a conference in Botswana on Monday that may challenge the WHO’s approval of generic copies of patented AIDS drugs.

Botswana: Few Women Using HIV Prevention Services (news article)
Few pregnant mothers in Botswana are accessing free HIV/AIDS related services, including free anti-retrovirals being provided by the state, according to a recent BOTUSA study. The survey of 504 women at ante-natal clinics and in post-natal wards countrywide, revealed that although 95% were accessing the health care provided at these facilities the utilization of free Prevention of Mother-To-Child Transmission of HIV services and voluntary testing was still low, though it had increased from 38% in 2002 to 58% in 2003.

GSK Cuts AIDS Drug Price for Poor (news article)
GlaxoSmithKline, the world's largest maker of HIV/AIDS drugs, said on Monday it had nearly halved the price of its leading Combivir treatment in poor countries to 90 US cents a day. The move is the latest sign the international pharmaceutical industry is bowing to pressure to improve access to life-saving antiretroviral medicines in Africa and other parts of the developing world where AIDS has hit hardest.

MATERNAL AND CHILD HEALTH RESEARCH

Global Strategy for Infant and Young Child Feeding (report)
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Related press release: UNICEF and WHO Call for Increased Commitment to Appropriate Feeding Practices for All Infants and Young Children
Calling on governments to promote and protect breastfeeding, UNICEF and WHO jointly launched the "Global Strategy for Infant and Young Child Feeding". The document, developed over 2 years of global consultation, pinpoints the main problems affecting infant and young child feeding and identifies approaches to their solution.

Improving the Management of Obstetric Emergencies in Uganda through Case Management Maps (report)
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Case management maps (CMMs) are a type of job aid: a sheet of paper with information that guides healthcare providers in treating patients. Each patient has his or her own condition-related CMM, which is maintained in the patient’s chart or on the wall near the patient’s hospital bed to inform providers of the treatment protocol, what treatment was provided when and by whom, what to do should a critical event occur, etc. This report describes a study that implemented two CMMs that were introduced about a year apart in a 500-bed hospital where such job aids had not previously been used. Planning and implementing the CMMs, the results from their implementation, and recommendations for further use of CMMs in developing countries are discussed. Appendices include the CMMs; one is for pregnancy-induced hypertensive disorders and the other is for postpartum hemorrhage.

Evidence-based Obstetric Care in South Africa — Influencing Practice through the 'Better Births Initiative' (research abstract)
The aim of this research was to use a focused change program (the Better Births Initiative) to influence obstetric practice at 10 hospitals in Gauteng, South Africa. The findings show some important improvements in practice following the implementation of the BBI; providers at some sites reduced the use of enemas, shaving and episiotomy, and increased use of oral fluids and companionship during labor. Qualitative data suggest that an interactive approach to implementing evidence-based practice can influence health professionals' decisions to change practice.

The Importance of Maternal Schooling for Child Morbidity and Mortality and Maternal Health Behavior in Southeastern Uganda (research article)
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A survey conducted in southeastern Uganda revealed that, contrary to findings from other studies, maternal schooling did not protect young children born in this area from malnutrition and morbidity. Half the children in the study were stunted and most of them (82%) were reported to have been ill during the 2 weeks prior to the survey. Mortality, however, was more common among children of mothers without any schooling, as was the increased risk of incomplete immunization.

Use of Maternal Health Services in Rural China (research abstract)
Data from the nationally representative 1997 Demographic and Reproductive Health Survey indicate that roughly 60% of women had at least one prenatal visit, while 40% had a professionally assisted birth over the period 1988-1997. Despite China's shift from a more socialist to a more privatized health care system, use of maternity services increased over this period. The authors write that these increases are consistent with the push toward integration of reproductive health into family planning that emerged after the 1994 International Conference on Population and Development and the 1995 Fourth World Women's Conference held in Beijing. They found indirect evidence that the target-based population policy may well have exerted downward pressure on use of maternity services; differences by parity are marked and multilevel models predicting use of maternity services indicate underdispersion at the individual level.

MEN'S HEALTH RESEARCH

The Role of Men in Contraceptive Decision-Making in Fanshekara Village, Northern Nigeria (research abstract)
The aim of this study was to investigate the role men played in contraceptive decision making in a rural northern Nigerian community. Using systematic sampling, 120 married men in a rural area of Northern Nigeria were selected and interviewed using a semi-structured questionnaire. Among the respondents, 65% disapproved of the very concept of contraception. Disapproval was higher among those with low education. Reasons for the men’s disapproval were mainly based on religious and cultural factors. More than two-thirds (68%) of the men felt that family size determination and contraceptive decision-making was entirely their responsibility, while 73% had never discussed these issues with their wives. A positive attitude in the husband was significantly associated with current use of contraception.

Male Circumcision and HIV Infection: An International Debate with No Brazilian Participation (research abstract)
The full text of this article is available only in Portuguese. The authors discuss male circumcision as a protective factor against HIV transmission. The absence is noted of Brazilian data published in the international literature regarding this issue. Finally, they emphasize that self-declared circumcision status is subject to substantial misclassification with the generation of biased risk estimates.

MEN'S HEALTH NEWS

Circumcision Protects Against HIV (news article)
Related news article: Report: Circumcision Likely to Decrease HIV Infection in Men
A new study in the latest issue of The Lancet finds that uncircumcised men did not have higher rates of syphilis, gonorrhea, and the virus that causes genital herpes, three STDs linked to higher risk of HIV infection. Independent of condom use or sexual activities, HIV infection occurs six to eight times more often in uncircumcised men than in those who have been circumcised. In fact, despite their lower infection rates, circumcised men were more likely to report they didn't wear condoms during sex.

HRT Could Hold Key to Male Pill (news article)
Hormone replacement therapy (HRT) could hold the key to creating a male contraceptive pill, a team of scientists from Manchester and Leeds (UK) revealed last week. Researchers looked at compounds used in HRT and the female contraceptive pill and their effects on men when used alongside testosterone. They found that tibolone and nomegestrol acetate - synthetic progestins used in HRT - appeared to have a contraceptive effect in men. But the team, from the University of Manchester and Leeds General Infirmary, warned it could be more than 10 years before they were available for use. A number of trials are currently under way into alternatives to the limited contraception choices available to men: condoms, vasectomy, and abstinence.

POPULATION RESEARCH

Global Population Profile: 2002 (report)
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Related report: The AIDS Pandemic in the 21st Century
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Related executive summary: Global Population at a Glance: 2002 and Beyond
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Related press release: Global Population in 2002 Tops 6.2 Billion
Related news article: AIDS and Fewer Fertile Women Slow World Population Growth Rates
The world’s population increased by 1.2% in 2002 to total more than 6.2 billion, the US Census Bureau said in a report on global population trends. The rate of increase translated into a net addition of about 200,000 people per day and 74 million per year, roughly equivalent to the population of Egypt in 2002. According to the report, the pace of global population growth peaked just over a decade ago. The increase of 74 million in 2002 is substantially below the annual high of 87 million people added in 1989-90. The rate of growth is well below the high of about 2.2 percent a year experienced 40 years ago. The slowdown in global population growth is linked primarily to declines in fertility. Projections indicate a number of African countries will experience levels of mortality during this decade that will lower the average life expectancy at birth to around 30 years by 2010, a level not seen since the beginning of the 20th century. The report is accompanied by a special report on HIV/AIDS, "The AIDS Pandemic in the 21st Century", and a four-page summary, "Global Population at a Glance: 2002 and Beyond."

World Urbanization Prospects: The 2003 Revision (report)
Related news article: U.N. Projects Historic City Populations by 2007
This revision presents estimates and projections of the total, urban and rural populations of the world, its 21 regions and five major areas for the period 1950-2030, as well as for the 228 countries or areas of the world. It also provides estimates and projections of the population of urban agglomerations with 750,000 inhabitants or more in 2000. The population figures for the total population are consistent with the size of each country as estimated or projected with the 2002 Revision of World Population Prospects. The results of the 2003 Revision of World Urbanization Prospects are summarized in two press releases (English and French), highlights, and two wall charts. A complete set of data tables is also available.

Why Women Live Longer Than Men (news article)
Related letter to the editor: Fitness Benefits of Prolonged Post-reproductive Lifespan in Women
New research from Finland sheds light on the mystery of why women live longer than men.

POPULATION NEWS

Soaring Population Drags India Towards Abyss (feature article)
This feature article describes the realities faced by the citizens of India, whose population is set to overtake China as the most populous on the planet by 2050. The article also explains the historical controversy surrounding family planning in India during the brief time forced sterilizaions were in effect in the 1970s.

Girls Want Guys With Degree of Success (news article)
Researchers from Monash University's Centre for Population and Urban Research in Australia argue for a new focus in the debate about declining fertility levels. Men with a good education and a well-paying job have a much greater chance of finding a mate, while men with no tertiary qualifications are more likely to be single. Data showed that only 41% of 30 to 34-year-old men earning less than $16,000 had partners, compared with 71% of their peers who earned more than $52,000.

WOMEN'S HEALTH RESEARCH

Clinical Outcomes and Costs With the Levonorgestrel-Releasing Intrauterine System or Hysterectomy for Treatment of Menorrhagia (research abstract)
Related press release: Studies Compare Hysterectomy vs. Other Medical Treatments for Abnormal Uterine Bleeding
In the treatment of heavy menstrual bleeding, levonorgestrel-releasing intrauterine system (LNG-IUS) or hysterectomy improves equally health related quality of life, but the costs after 5 years are significantly lower in women whose treatment was started with IUS. Women (n=236) referred for complaints of heavy menstrual bleeding to Finland's five university hospitals were randomly assigned to treatment with LNG-IUS (n=119), or hysterectomy (n=117). The patients (99%) were monitored for 5 years to compare outcomes, quality of life issues, and costs. The LNG-IUS and hysterectomy groups did not differ substantially in terms of health related quality of life or psychosocial wellbeing (depression, anxiety and sexuality). Although 42% of the women assigned to the LNG-IUS group eventually underwent hysterectomy, the discounted direct and indirect costs in the LNG-IUS group (US$2,817), remained substantially lower than in the hysterectomy group (US$4660). Satisfaction with treatment was similar in both groups (more than 90%).

Study: Abortion, Breast Cancer Not Linked (news article)
A miscarriage or abortion does not increase a woman's risk of breast cancer, according to a study published last week in The Lancet that analyzed data from more than 50 previous studies. Some of those studies had suggested a possible connection, but the authors of the new report said that was the result of an error in methodology.

Human Rights Abuses and Concerns About Women's Health and Human Rights in Southern Iraq (research abstract)
The authors of this study found that nearly half of participating households in three southern cities in Iraq reported human rights abuses among household members between 1991 and 2003, including torture, killings, disappearance, forced conscription, beating, gunshot wounds, kidnappings, being held hostage, and ear amputation, among others. The households surveyed supported a government that will protect and promote human rights, including the rights of women. However, currently, neither men nor women appear to support a full range of women's human rights.

Widening the Cervical Cancer Screening Net in a South African Township: Who Are the Underserved? (research abstract)
For this study, a household survey in a predominantly Black African population living in a low-income township on the outskirts of Cape Town was undertaken to ascertain the characteristics of women reporting never having been screened. Of 664 representatively sampled women, 45% of women reported having had a cervical screening test. However, in what appears to be a fairly homogeneous population, there were significant differences in the types of women who access and who do not access cervical smear services. The underserved tend to be the older, poorer, less educated, and unemployed (or working in the informal sector). They tend to live in nonpermanent dwellings without a partner, they do not know anyone else who has had a cervical smear, and they have not recently sought care for other ailments, or used contraception.

Millennium Development Goals: China's Progress (report)
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Related news article: Chinese Women Suffer "Alarming Gender Issues," U.N. Says
Discrimination against women is widespread in China in all arenas, not least in education, work, and politics, according to a new UN report that said China needs to address its "alarming gender issues." Thirteen percent of China's 600 million women are illiterate, compared to 5% of its men, and only 22% of members of the country's top legislature are women, the report said.

WOMEN'S HEALTH NEWS

Dowries Blamed for Ugandan Wife Beatings (news article)
The Ugandan practice of wedding dowries, known as the bride price, is to blame for much of the country's domestic violence, experts say.

YOUTH HEALTH RESEARCH

The Sexual and Reproductive Health of Young People in Adjumani District, Uganda: Qualitative Study of the Role of Formal, Informal and Traditional Health Providers (research abstract)
This qualitative study of young people and health care workers in Adjumani, northern Uganda, found that young people are generally very knowledgeable about STD spread and prevention as well as methods for prevention of pregnancy.

To Change or Not to Change: Obstacles and Resistance to Sexual Behavioural Change among the Youth in Ghana in the Era of AIDS (research abstract)
This paper is based on data collected from in- and out-of-school youth at the national and regional levels in Ghana on their perceptions and reactions to the AIDS epidemic. The issues covered included their current attitudes and behaviors related to HIV/AIDS, their reaction to the need for change, and their perceived constraints/barriers to behavior change. The authors write that HIV/AIDS education messages have not taken the specific concerns of young people into consideration. They write that the source of, and the agents for, change must be seen to be credible and the effort must be reinforced and sustained.

YOUTH HEALTH NEWS

Book Throws Harsh Questions on Chinese Sex Education (news article)
A recent book portraying 13 high school students as "roses concealed in a school bag" for being brave to have sex but lacking knowledge and intimidated to share their stories has raised questions about China's sex education.

SPECIAL REPORTS/PROFILES/RESOURCES

Contraceptive Security: Ready Lessons (Overview) (resource material)
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Related resource material: Contraceptive Security: Ready Lessons -- 2, Doing a Joint Assessment
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Related resource material: Contraceptive Security: Ready Lessons -- 3, Taking a Whole Market Approach
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Related resource material: Contraceptive Security: Ready Lessons -- 5, Using Data for Decision Making
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Related resource material: Contraceptive Security: Ready Lessons -- 4, Advocating for Sustained Commitment
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Related resource material: Contraceptive Security: Ready Lessons -- 1, Raising Awareness and Commitment
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Contraceptive Security: Ready Lessons suggests some practical steps USAID Missions and their partners can
take to promote and support country-led programs for
contraceptive security. Ready Lessons draws from the experiences of country partners, technical agencies, and donors to provide USAID Missions and their partners with a better understanding of the challenges faced in trying
to achieve contraceptive security and some suggested approaches on how to overcome them. Each brief describes a "ready lesson" for use by Missions, with practical "how to" information, country examples, and annotated lists
of further reading.

The Rediff Interview/Professor Robert Cassen (interview)
In an e-mail interview with Professor Robert Cassen, co-author of the book "21st Century India: Population, Economy, Human Development and the Environment," he says China's "one child family" program cannot be a kind of model for India because it has had unfortunate consequences for China itself.

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