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The Pop Reporter®

Volume 4, Number 14
5 April 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.

GUEST EDITORIAL

Research to Guide Reproductive Health/HIV Prevention Efforts for Youth

by William Finger and Maryanne Pribila

bfinger@fhi.org, mpribila@fhi.org

The reproductive health and HIV needs of youth are increasingly urgent. While most young people become sexually active before the age of 20, few use reliable contraception and many are at risk of unintended pregnancy. Meanwhile, up to half of all new HIV infections occur in many parts of the world in people under 25. In addressing these problems, policymakers, program managers, and providers can benefit from consulting a synthesis of research findings.

The FOCUS on Young Adults Program (1995-2001), funded by USAID, analyzed interventions and evaluations of programs addressing the needs of youth in its final report. FOCUS identified 39 programmatic interventions that had been rigorously evaluated. While new research is building on this work, no updated collection of findings is yet available.

FOCUS found that adolescent reproductive health programs generally did not increase sexual risk-taking behaviors and that the programs influenced knowledge and attitudes about reducing risky behaviors more than risk-reduction behaviors. Below are more specific conclusions based on the interventions, with the number of rigorous studies in parenthesis.

School-based programs (21) offer a chance to reach many youth and often increase knowledge and influence attitudes. Half of the interventions affected short-term behavior, including delaying sexual debut and reducing the number of sexual partners. Sexuality education did not encourage sexual activity. Issues that need more evaluation include what should be taught, by whom, at what age, and how.

Mass media programs (6), including social marketing campaigns, can also reach many youth. They are most effective when combined with personal contact or referrals to health services. The mass media interventions improved knowledge and attitudes and appeared to affect behavior in some cases. Their impact on in-school youth was greater than on out-of-school youth.

Community-based programs (4), which commonly include peer education, appear promising and are popular, but research questions remain unanswered, such as whether these programs are sustainable, cost-effective, or have broad impact. The primary demonstrated impact of peer education is on the peer educators themselves, not on their peer contacts.

Workplace programs (4), which target out-of-school youth employed by the army and factories, improve knowledge and attitudes but have less impact on behavior.

Health facility programs (4) have tried to make clinical services friendly to youth or to add such services to youth centers. These efforts have generally not increased use of clinical services by youth.

The FOCUS program made recommendations based on evaluations of the 39 programs and reviews of qualitative and other research. The recommendations include:

•broad-based advocacy to support reproductive health efforts aimed at youth
•well-designed reproductive health education in schools
•condom promotion for sexually active youth through social marketing programs and mass media
•incorporation of monitoring and evaluation from the start of a program
•targeting different groups of youth with various types of programs
•designing projects with expansion in mind

This article is based on a summary of the FOCUS end-of-program report published by YouthNet, the USAID-funded global program on youth reproductive health and HIV prevention. To request a copy, e-mail youthnetpubs@fhi.org.

William Finger is YouthNet Information Dissemination Coordinator, and Maryanne Pribila is a YouthNet Program Officer, at Family Health International.

FAMILY PLANNING/REPRODUCTIVE HEALTH RESEARCH

Contraceptive Methods Used by Young Women in the Township of Lomé (Togo) (research abstract)
To assess prevalence of contraceptive use in Lomé, Togo, researchers interviewed approximately 500 adolescent girls and young women (aged 10-24 years). Although 93.4% of the interviewees knew about condoms and 68.2% about the calendar (rhythm) method, few of them used these, (respectively 33.6% and 31.8%). The interviewees decided about contraceptive use with their partners (37%) or alone (28%), and rarely asked their parents (1%). Contraceptives were obtained at a health facility by 3.8% of the subjects and at the drugstore or market by 20.6%. The main reason for the low rates of use of health facilities (10.4%) and of medical contraceptive methods (11.2% of all contraceptive methods used) were: lack of means, information, and interest (in such facilities and methods), and finally, lack of sexual activity. The authors speculate that the main reason for the low rate of use of reproductive health services may be that, apart from the condom, women and female teenagers rarely use modern contraceptive methods.

The Female Condom: Acceptability and Perception among Rural Women in Zimbabwe (PubMed abstract)
This study was conducted to generate data for developing an action plan for accessing the female condom through primary health care centres in Zimbabwe. It used both quantitative and qualitative methods to gather information from sexually active women and men on the perception and acceptability of the female condom among users in rural areas of Zimbabwe. The findings show that very few women had used the female condom prior to the survey. Most women (93%) liked the condom, especially young women aged 20-39 years (83%), compared to women 40 years and older (11%). Both women and men liked the dual role of contraception and protection against STIs, including HIV/AIDS, played by the female condom. Most women (98%) felt that it is important for women to have their own condom. However, both men and women pointed out that it will be difficult to introduce the female condom in married situations due to the stigma associated with condoms in general. More than 80% of women said they will have to seek permission from their partners to use the female condom. Regarding cost, 77% felt that the female condom is too expensive given that the male condom can be obtained free from health centers. The cost of the female condom could hinder its continued use and would encourage women, especially commercial sex workers, to re-use it.

Natural Family Planning Revisited (review article)
This review article, from the Saudi Medical Journal, focuses on the role of natural family planning (NFP) as a component of reproductive health. It distinguishes NFP from the concept of fertility awareness method. The effectiveness of NFP as determined by previous studies is presented, and the advantages and disadvantages of NFP are highlighted. The author also examines factors that influence the use of NFP methods. Finally, delivery strategies and options for mainstreaming NFP into reproductive health services are identified and discussed.

Review of STI and HIV Epidemiological Data from 1990 to 2001 in Urban Burkina Faso: Implications for STI and HIV Control (research abstract)
To better understand STI/HIV dynamics, the authors reviewed STI and HIV epidemiological studies performed over the past decade in Bobo-Dioulasso, Burkina Faso. Trends in STI prevalence among commercial sex workers and the general population were assessed over time through studies that used the same recruitment and laboratory diagnostic procedures. The authors observed a decline of classic bacterial STI such as syphilis, Neisseria gonorrhoea, Chlamydia trachomatis, and Haemophilus ducrey infections in all study groups. HIV infection followed the same trend at the same time, with a significant decline in the 15–19 year age group of pregnant women, suggesting a possible decrease of HIV incidence.

Sensitisation about Condom Use in Gabon (1999): Evaluation of the Impact of a Comic Book (research abstract)
This paper reports the evaluation of the impact of a comic book about condom use distributed to Gabonese high school students in Libreville and Lambarene in 1999. The evaluation was conducted through a self-administered questionnaire completed by 954 students in 11 high schools immediately before distribution of the comic book and by 771 students 15-30 days afterwards. Knowledge about the modes of HIV/AIDS infection improved substantially between the two questionnaires, with knowledge about the mother-child transmission pathway increasing from 47% to 75%. At the same time, and without any significant difference by sex, class or province, individual adhesion to the role of the condom as a means of prevention against AIDS progressed from 64% to 95%. The comic book also had a larger reach than its initial distribution (7.5 readers reported per copy).

Prevalence of Genital Chlamydia Trachomatis Infection in the General Population of Slovenia: Serious Gaps in Control (research abstract)
to estimate the prevalence of and risk factors for genital Chlamydia trachomatis infection in Slovenian adults aged 18–49 years, the authors collected data over 1999–2001 from a probability sample of the general population by face to face interviews and anonymous self administered questionnaires. 1447 individuals contributed first void urine (FVU) specimens (82.6% of survey respondents). C trachomatis infection was diagnosed in 3% of men and 1.6% of women. Prevalence was highest in men and women aged 18–24 years (4.1% for both). Those with a higher prevalence reported first heterosexual intercourse before the age of 16, unprotected sexual intercourse with at least one heterosexual partner during the preceding year, concurrent heterosexual relationships during the preceding year, and five or more lifetime heterosexual partners. The authors write that their results provide support for the introduction of chlamydia screening in Slovenia.

Knowledge, Attitude and Practice of Private Medical Practitioners in Calabar Towards Post-abortion Care (PubMed abstract)
This study examined the knowledge, attitude and practice of private medical practitioners in Calabar, Nigeria, on abortion, post-abortion care, and post-abortion family planning. Forty-eight private practitioners who were proprietors of private clinics in the city were interviewed using a structured questionnaire. The results showed that 22.9% of the doctors routinely terminate unwanted pregnancies when requested to do so by women, while 83.3% of them treat women who experience complications of unsafe abortion. The major reasons given by some of the doctors for not terminating unwanted pregnancies were religious, moral and ethical considerations rather than respect for the Nigerian abortion law.

Performance of Routine Syphilis Serology in the Ethiopian Cohort on HIV/AIDS (research abstract)
This study assessed the performance of routine syphilis screening during 5 year follow up of Ethiopian factory workers participating in a cohort study on HIV/AIDS. A total of 540 cohort participants (8.3% HIV positive at enrolment) donated 4,376 blood samples (mean 8.3 per subject). Based on the revised syphilis test results, the 540 cohort participants were classified as having no (70.5%), past (20.6%), prevalent (6.9%), or incident (2%) syphilis. The RPR screening test was difficult to interpret and yielded 8.2% biological false positive (BFP) RPR results, or 3.2% if weak positive results were excluded. There was no correlation between HIV infection and BFP RPR reactions. The authors write that their findings stress the need to develop a syphilis screening assay that is easy to perform and interpret and to implement quality assurance programs.

FAMILY PLANNING/REPRODUCTIVE HEALTH NEWS

Contraceptive Sponge Makes Way Back Into U.S. (news article)
Three weeks ago, Allendale Pharmaceuticals, makers of the contraceptive sponge, submitted the final batch of data needed for approval by the FDA. Allendale now has the spermicide-infused polyurethane sponges made at a factory near Binghamton, N.Y., but only for distribution in Canada.

Switzerland: One in Five Has Genital Herpes (news article)
Switzerland has one of the highest rates of genital herpes in the western world, with an estimated 19% of the population infected with the virus. Researchers say the STD is particularly prevalent in urban areas and among women from more affluent sections of society.

Bangladesh: Acceptance Rate of FP Method to be 62% (news article)
The acceptance rate of family planning will be raised to 62% from the current 54% within the next 3 years, according to the Health and Family Welfare Minister.

Brazilian Scientists Find Something in Rainforest to Help Cut Condom Costs (news article)
Brazilian scientists have given a thumbs-up to a prototype condom made from natural latex found in an Amazonian rain forest reserve, where the government wants to erect a factory in a bid to cut its rising condom import costs.

Australia: Safe Sex Message Being Ignored (news article)
STI rates are still rising in Victoria, according to the latest data from the Department of Human Services. There were 6,485 notifications of chlamydia infection in 2003, up from 4,846 in 2002. Gonorrhoea infected 1,160 Victorians, up from 802. There were only eight notifications of syphilis back in 2000, but the numbers have doubled each year to reach 55 in 2003. The increases suggested that safe sex messages were often forgotten in the heat of the moment.

FAMILY PLANNING/REPRODUCTIVE HEALTH LAW AND POLICY

Debt-for-AIDS swaps (report)
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This policy information brief on debt-for-AIDS swaps comes from the Department of Social Mobilization and Information, UNAIDS. It is intended to provide further insights into debt swaps, along with examples of their use in the context of development projects, and their relative strengths and weaknesses as instruments for financing the scaling-up of HIV/AIDS programs.

China: Government to Pay Bonus to Villagers for Family Planning (news article)
China plans to test a new population control policy by paying at least 600 yuan (about US$72) in extra bonus to rural families who have faithfully followed the one child policy. The central government will select one city from 14 western and central provinces and municipalities for the experiment.

Condom Label Changes Spark Debate (news article)
Related news article: What is Human Papillomavirus, or HPV?
That tiny bit of print on a condom packet is at the center of a raging debate now that President George W. Bush has asked the FDA to modify the current warning to include information about human papillomavirus, commonly called HPV or genital warts. On one side are scientists who believe that condoms should be promoted as a crucial line of defense against several STDs and cervical cancer. On the other are groups that advocate waiting for sex until marriage and who see the dangers of HPV as an argument for their cause.

On Family Planning, US vs. Much of the World (news article)
The world's rising disapproval of US foreign policy stems in part from opposition to the war in Iraq and the "with us or against us" tone of the world's only superpower. But beneath the focus on geopolitics, such hot-button social issues as family planning and women's reproductive rights are also demonstrating America's shifting stature in the world.

India: 'Only 3 pc of City Firms Have AIDS Policy' (news article)
Only 3% of respondents (employers and employees of companies) to a recent survey reported having a policy to deal with HIV/AIDS. The findings are part of a survey of over 1,600 member companies of the Bombay Chamber of Commerce and Industry.

Greater Regulation of Fertility Encouraged (news article)
The federal government should more aggressively oversee the burgeoning and largely unregulated fertility business, and Congress should set aside the contentious issue of human embryo cloning for research and quickly ban other embryo experiments that virtually everyone deems unethical, President Bush's Council on Bioethics said last week.

South Korea: Plummeting Birth Rate Calls for Drastic Measures (news article)
With the dramatically falling birth rate in South Korea, the country’s population is projected to diminish by two-thirds in the next century, dropping to 16 million from 48 million, and creating a national economic and labor-shortage disaster. To head off the crisis, the government's National Strategy for a Low-Birth Rate and Ageing Society has proposed offering cash incentives and child-care subsidies to parents.

HIV/AIDS RESEARCH

Correlates of National HIV Seroprevalence: An Ecologic Analysis of 122 Developing Countries (research abstract)
Researchers performed regression analyses for 81 variables obtained primarily from United Nation agencies for 122 developing countries. Variable measures were compared between highest and lowest tertiles of HIV seroprevalence. Geography, religion, and income inequality were independently associated with HIV seroprevalence. Countries with earlier ages at first sex, higher teenage birth rates, and higher fertility rates had higher HIV seroprevalence. Countries with high HIV seroprevalence had fewer women using contraceptives, more persons with casual sex partners, and higher herpes simplex virus 2 seroprevalence. Male circumcision and Muslim religion were colinearly associated with lower HIV seroprevalence. Countries with high HIV seroprevalence had fewer doctors, more midwives, and less access to essential medications, but health spending differences were minor. The authors write that ecologic analyses support population-level behavioral approaches, such as delaying sexual debut and discouraging casual sex partners, and reinforce biologic measures, such as controlling sexually transmitted infections and promoting male circumcision, for HIV prevention.

The Impact of HIV/AIDS on the Health Sector (report)
This report emanates from the results of a study that examined the impact of HIV/AIDS on the public and private health facilities in South Africa, and outlines the subsystems that are affected. Both public and private sector health facilities have reported an increase in the number of patients seeking clinical care for people living with HIV/AIDS, leading to increased admissions to medical and paediatric wards and increased workloads. This study addresses these issues and makes recommendations for managing the HIV/AIDS case load.

ART Treatment Access and Effective Responses to HIV and AIDS - Providing New Momentum for Accessible, Effective and Sustainable Health Systems (report)
(You need Adobe Acrobat Reader to access this document)
Related news article: Southern Africa: Treatment Programmes Skewed in Favour of Urban Males
In 2003, the Regional Network for Equity in Health in Southern Africa (EQUINET) and Oxfam GB with government and civil society partners initiated a program of research, policy analysis, and intervention on equity in health sector responses to HIV and AIDS. The program commissioned review papers on equity in health sector responses to HIV and AIDS in Malawi, South Africa, Tanzania , Zimbabwe, southern Africa and in relation to health personnel and nutrition. This briefing outlines the major findings and issues from work carried out in southern Africa on equity in health sector responses to HIV and AIDS, particularly in terms of access to antiretroviral treatment. It presents options drawn from the evidence and experience in the region of how to strengthen equity and include low income or more vulnerable communities in treatment access programs.

Rates, Barriers and Outcomes of HIV Serostatus Disclosure among Women in Developing Countries: Implications for Prevention of Mother-to-child Transmission Programmes (research article)
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This paper synthesizes the rates, barriers, and outcomes of HIV serostatus disclosure among women in developing countries. The authors identified 17 studies from peer-reviewed journals and international conference abstracts (15 from sub-Saharan Africa and 2 from south-east Asia) that included information on the rates, barriers, or outcomes of HIV serostatus disclosure among women in developing countries. The rates of disclosure reported in these studies ranged from 16.7% to 86%, with women attending free-standing voluntary HIV testing and counselling clinics more likely to disclose their HIV status to their sexual partners than women who were tested in the context of their antenatal care. Barriers to disclosure identified by the women included fear of accusations of infidelity, abandonment, discrimination, and violence. The authors write that the low rates of HIV serostatus disclosure reported among women in antenatal settings have several implications for prevention of mother-to-child transmission of HIV programs, as the optimal uptake and adherence to such programs is difficult for women whose partners are either unaware or not supportifve of their participation. They discuss these implications and offer some strategies for safely increasing the rates of HIV status disclosure among women.

HIV/AIDS NEWS

U.S. Official Defends AIDS Drug Policy (news article)
A U.S. official Wednesday denied charges that the United States supports pharmaceutical giants in a dispute over whether the government should help provide cheaper generic AIDS drugs.

S. Africa Begins Giving Free AIDS Drugs to Patients (news article)
South Africa has begun giving free AIDS drugs to patients in five public hospitals in Johannesburg and Pretoria. This is the first step in the long-awaited rollout of a national AIDS treatment program.

India's AIDS Drug Strategy Gets Mixed Reaction (news article)
The Indian government started last week to supply free antiretroviral drugs to 100,000 HIV-positive patients in six high-prevalence states. Many have welcomed the move, which was announced last year on the eve of World AIDS Day, for seeking to provide AIDS drugs to those who urgently need but cannot afford them. But some experts fear that the country's weak public health system is ill-equipped to handle the program and that the initiative may backfire as a result.

Trials of Two Microbicides to be Launched in Africa (news article)
Large scale, phase III clinical trials of two promising HIV microbicides will begin in Africa in the second half of this year, British researchers told a conference in London last week. A total of 12,000 women in South Africa, Zambia, Tanzania, Uganda, and Cameroon will take part in the 3 year studies.

China Announces List of 51 AIDS Pilot Zones (news article)
China's Health Ministry Monday announced a list of 51 county-level regions which served as pilot zones for AIDS prevention and treatment. The 51 pilot zones, set up by the Health Ministry in 2003, had relatively heavier AIDS problems among China's more than 2,000 counties. The ministry intended to work out an effective AIDS preventative and treatment mechanism through pilot programs.

MATERNAL AND CHILD HEALTH RESEARCH

Breast-feeding Practices in Mexico: Results from the Second National Nutrition Survey 1999 (research article)
This study assessed breast-feeding (BF) practices and determinants of exclusive BF (EBF) at less than 4 months and 6 months among women and infants under 23 months of age in the National Nutrition Survey-1999. Prevalence of EBF in the less than 4 month group was 25.7% and in the less than 6 month group, 20.3%. The overall rate of continued BF (second year) was 30.9% (median duration of BF 9 months), and the national proportion of children ever breast-fed was 92.3%. The researchers conclude that EBF rates and duration are low in Mexico and have improved only slightly in the last 20 years, and if improvements in infant health are a national priority, aggressive interventions to promote and protect BF are urgently needed.

Reconsidering Empirical Cotrimoxazole Prophylaxis for Infants Exposed to HIV Infection (research article)
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Infants with HIV infection are vulnerable to Pneumocystis carinii pneumonia (PCP) during their first year of life. WHO and the Joint United Nations Programme on HIV/AIDS now recommend that all children of HIV-positive mothers receive prophylactic cotrimoxazole against PCP from 6 weeks of age and continue this therapy until exposure through breast milk ceases and the infant is confirmed to be HIV-negative (rarely before one year of age). Empirical prophylaxis invokes a trade-off between possible benefit to the infant versus the risk of resistance to antibiotics and antimalarials. From a critical anyalysis of the literature, the authors offer a conceptual model demonstrating how, under certain circumstances, a policy of mass cotrimoxazole prophylaxis may be counterproductive.

Safe Motherhood Perspectives and Social Support for Primigravidae Women in Lusaka, Zambia (PubMed abstract)
This study was conducted to explore low-risk Zambian primigravidae's preparation for pregnancy including contraceptive use, content of antenatal care, preparation for childbirth and the extent of social support. Healthy primigravidae (n=299) who attended the antenatal clinic at the University Teaching Hospital (UTH), Lusaka, Zambia, were interviewed. The women's mean age was 20.7 years; 41% were adolescents. The adolescent group had significantly less years of education. In total, 78% had never used any contraceptive method. The main source of information on sexual issues was friends and the mass media. Only 2% of the women had received information on sexual and reproductive health matters from health staff. Nearly half did not want the pregnancy. Sixty three per cent of the women had made their first antenatal visit during the second trimester. There had been no antenatal preparation of the women for parturition and their parenting role. Eighty five per cent of the pregnant women had identified a social support person to assist them during pregnancy and after childbirth. The authors, from the School of Nursing, University Teaching Hospital, Lusaka, write that the results suggest that preparation for parenthood had a low priority as part of the antenatal care.

Ectopic Pregnancy in Africa: A Population-Based Study (research abstract)
This study found that the population-based ectopic pregnancy incidence rate is estimated at 0.79% (0.72%, 0.88%) in Yaounde, the capital of Cameroon (Central Africa).

Risk Factors of Infant and Child Mortality in Rural Burkina Faso (research article)
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The authors performed a survival analysis of births within a population under demographic surveillance from 1992 to 1999 based on data from a demographic surveillance system in 39 villages around Nouna, western Burkina Faso, with a total population about 30,000. All children born alive from 1 January 1993 to 31 December 1999 in the study area (n=10,122) followed-up until 31 December 1999 were included. In the observation time, 1,340 deaths were recorded. In a Cox regression model a simultaneous estimation of hazard rate ratios showed death of the mother and being a twin as the strongest risk factors for mortality. Other factors associated with mortality included age of the mother, birth spacing, season of birth, village, ethnic group, and distance to the nearest health center. The authors reported an overall decrease in childhood mortality during the study period.

Domestic Abuse on Women in China Before, During, and After Pregnancy (research article)
Researchers from the National Center for Women and Children Health, Beijing, conducted a community-based face-to-face survey of a representative group of women who had a child aged 6 to 18 months in 32 communities of 4 provinces. They found that the prevalence of domestic abuse (emotional, sexual, or physical) occurring in any period (before, during, or after pregnancy) was 12.6%. The prevalence of abuse during the approximate 9 months of pregnancy (4.3%) was relatively lower compared with the prevalence of abuse during the 12 months before pregnancy (9.1%) and after delivery (8.3%) during the mean 11-month postpartum period studied. Abuse before pregnancy was a strong risk factor for abuse during pregnancy and abuse after pregnancy, and abuse during any previous period was a strong risk factor for subsequent abuse. Many women who suffered abuse of any kind generally experienced multiple acts over time, and most acts were not severe. The results of logistic regression analysis showed that the factors associated with abuse during pregnancy included women previously witnessing domestic violence, a poor relationship with the partner, socioeconomic level, alcohol consumption, and smoking.

Trends in Pregnancy Rates Among Women With Human Immunodeficiency Virus (research abstract)
Pregnancy rates among human immunodeficiency virus-infected women significantly increased during the era of highly active antiretroviral therapy, underscoring the need for comprehensive health care services among this population.

Effect of Maternal Mental Health on Infant Growth in Low Income Countries: New Evidence from South Asia (review article)
In this "Education and Debate" from the British Medical Journal, the authors write that impaired infant growth, a major problem in South Asia, may require interventions to improve maternal mental health in addition to current interventions targeting infant nutrition.

Integrating Health Care for Mothers and Children in Refugee Camps and at District Level (review article)
In this "Education and Debate" article from the British Medical Journal, the authors write that health care for mothers and children is inadequate in most refugee situations and in poorly resourced countries. They argue that, as well as providing primary (home based) care for basic health care, there is a need to integrate primary care with adequately functioning hospital based care for a healthcare system to succeed.

Maternal and Child Health: Is South Asia Ready for Change? (review article)
In this "Education and Debate" article from the British Medical Journal, the authors conclude that South Asia still has a long way to go to meet the United Nations' millennium development goals for maternal and child mortality.

MEN'S HEALTH NEWS

Even If Reversed, Vasectomy Lowers Sperm Count (news article)
Vasectomies may not be as reversible as doctors had previously thought. New research presented at a meeting of the British Fertility Society on Wednesday shows that the operation has a long-lasting effect on sperm count. Men who have had a vasectomy, even if it has been reversed, produce less sperm and have poorer success rates when their partners have fertility treatments.

Viagra Does Not Decrease Fertility Says Pfizer (news article)
In response to recent studies indicating that Viagra reduces a man’s fertility, Pfizer announced that it does not reduce a man’s fertility. Daniel Watts, Pfizer’s spokesman told Reuters "There's no evidence that Viagra decreases fertility in men. There have been many clinical trials as well as use by 23 million men in six years of use around the world, and there's been no evidence that Viagra affects fertility, so we don't put a lot of stock in that study."

POPULATION NEWS

Niger: Young Population Booms as Family Size Increases (news article)
The average woman in Niger now gives birth to eight children during her lifetime, more than her counterparts anywhere else in the world, according to a joint demographic study conducted by the government and the World Bank. The study, which was published on Monday, shows that family sizes are increasing in this desperately poor West African country, while the use of modern birth control methods has decreased in recent years.

Czech Republic: Chernobyl Blamed for Birth Drop (news article)
A team of Czech researchers has concluded that fallout from the 1986 Chernobyl nuclear disaster may have altered the country's birth pattern, causing a loss of more than 450 male babies after their mothers were exposed to radiation. The study, by a team at the Institute of Experimental Medicine at the Academy of Sciences in Prague, indicates a substantial drop in the number of male births in Bohemia and Moravia in November 1986, roughly 6 months after an explosion at the Ukrainian reactor sent radioactive clouds across Europe. The number of female births that month was normal.

Why Birth Rate in China Keeps Dropping (news article)
According to the latest statistics from the China Population Information and Research Center, from 2000 to April 2003, China's birth rate has witnessed a continuous decrease from 1.403% in 2000 to 1.241% in 2003.

WOMEN'S HEALTH RESEARCH

Cost-Effectiveness of Human Papillomavirus DNA Testing for Cervical Cancer Screening in Women Aged 30 Years or More (research abstract)
For women aged 30 years or more, screening at 2- or 3-year intervals using either human papillomavirus DNA testing in combination with cytology or liquid-based cytology with reflex human papillomavirus DNA testing reserved for the management of atypical squamous cells of undetermined significance is more effective and less costly than annual conventional cytology.

WOMEN'S HEALTH NEWS

Summer Sun May Increases Women's Chance of Papilloma Virus Infection (news article)
Researchers using data from Holland found that detection of papilloma virus infection during routine cancer screening peaks during August. Their theory: sunlight suppresses women's immune system defences.

YOUTH HEALTH RESEARCH

Study Stirs Birth Control Debate (news article)
Teenagers who have emergency "morning-after" birth control pills at home are no more likely than other young people to have unprotected sex, a study has found. University of Pittsburgh researchers questioned women ages 15 to 20 who had immediate access to the pills and those who did not. The study, published in the April issue of the Journal of Pediatric and Adolescent Gynecology, was conducted between 1997 and 2001. At the end of the 6 months, 26 teenagers who were given the pills reported using them 38 times. In the group that was not given the pills but had to go out and get them, 20 teenagers reported using them 24 times.

Bone Mineral Density in Adolescent Females Using Depot Medroxyprogesterone Acetate (research abstract)
In this non-randomized prospective study, researchers studied adolescent females who were new users of DMPA injection (N = 58, age12–21) or the oral contraceptive pill (N = 71, age 11–19) and normal menstruating girls (N = 19, age 15–18). Baseline and 6-monthly measures of lumbar vertebral bone mineral density (BMD) using dual-energy X-ray absorptiometry were done over a 2-year period. They found a statistically significant decrease in BMD between DMPA users and controls at 6 months (-3.02% change) 12 months (-3.38% change), 18 months (-4.81% change), and 24 months (-6.81% change). There was no statistical difference between pill users and controls. The authors conclude that there is a relationship between DMPA use and a decrease in BMD compared to normal menstruating controls that seems to persist up to 24 months.

Economic Empowerment and Reproductive Behaviour of Young Women in Osun State, Nigeria (PubMed abstract)
This paper, from the AIDS Prevention Initiative in Nigeria, utilizes qualitative data collected as part of an intervention program designed to increase access to reproductive health information/services and economic resources among young women in Osogbo, Nigeria. The aim was to provide reproductive health information and training in basic business skills and micro-credit facilities to enable beneficiaries to establish private businesses. Findings from the study highlight the importance of the relationship between female education and access to economic resources as a means of furthering empowerment of women, especially in terms of their reproductive behavior. The authors argue that increased access to resources is a major factor toward ensuring this empowerment.

Community Group Participation: Can It Help Young Women to Avoid HIV? An Exploratory Study of Social Capital and School Education in Rural Zimbabwe (research abstract)
Researchers used cross-sectional data from a large-scale, population-based survey in rural eastern Zimbabwe to describe the relationships between membership of different forms of community group and young women's chances of avoiding HIV. Their results show that participation in local community groups is often positively associated with successful avoidance of HIV, which, in turn, is positively associated with psychosocial determinants of safer behavior.

Do Family-planning Workers in China Support Provision of Sexual and Reproductive Health Services to Unmarried Young People? (research article)
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The purpose of this study was to acertain the perspectives of family-planning service providers in eight sites in China on the provision of sexual and reproductive health services to unmarried young people. Data were drawn from a survey of 1,927 family-planning workers and 16 focus group discussions conducted in 8 cities in China. Family-planning workers recognized the need to protect the sexual health of unmarried young people; perceptions about the appropriate age for and content of such education remained conservative. While about 70% of family-planning workers were willing to provide contraceptives to unmarried young people, and about 60% approved government provision of contraceptive services to unmarried young people, only one quarter agreed that the services could be extended to senior high schools.

Emergency Department Management of Sexually Transmitted Infections in US Adolescents: Results from the National Hospital Ambulatory Medical Care Survey (research abstract)
Related news article: Teens' STDs Often Not Treated Properly in ER
A substantial number of teenagers diagnosed with STIs in emergency rooms may not receive appropriate treatment, according to a new report.

YOUTH HEALTH NEWS

UK: Clinics 'Don't Stop Sex Diseases' (news article)
Related news article: Teenage Sexual Infections Double in 10 Years
Related news article: Policy Fuels Teenage Pregnancy
Expanding family planning services has had little impact on teenage pregnancy rates. A study by a Nottingham economist says providing extra clinics may even lead to increase in rates of STIs. Professor David Paton, examining how people behave with a "safety net," suggested that knowing there was easier access to the morning after pill and treatment for STIs may encourage teenagers to take more risks.

BOOKS/BOOK REVIEWS

Sexual Abuse of Young Children in Southern Africa (book)
Related press release: First Integrated Account of Child Sexual Abuse in Southern Africa
This book is in five parts. The opening section confronts the reader with the realities of sexual abuse in pre-pubertal children and proceeds to a discussion of the way abuse is represented in the press. The second section of the book presents the main findings concerning the individual, socio-economic, and socio-cultural correlates of child sexual abuse. Section three covers South African legal and policy responses to the problem, while the fourth section presents accounts of interventions on behalf of abused children drawn from South Africa, Mozambique, and Zimbabwe. The book concludes with critical reflections on the state of knowledge in the field and suggests priorities for policy and research. The authors and editors make the point that one of the primary roots of sexual abuse, rape, and related violence against women and children is because many men assume that women and children are naturally subordinate to them and duty-bound to meet their needs. As long as such attitudes prevail and are reinforced by culture, politics, economics, and interpersonal relations, the potential for violence and sexual abuse to women and children will remain.

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