Johns Hopkins Bloomberg School of Public Health: The INFO Project

Your knowledge-sharing resource on family planning and reproductive health

Shopping Basket

The Pop Reporter®

Volume 4, Number 19
10 May 2004

"The Pop Reporter" (R) Johns Hopkins Bloomberg School of Public Health/Center for Communication Programs INFO Project When you click on any link below, your Internet browser will access a Web site not connected to "The Pop Reporter." Information accessed through these links and contained in this issue of "The Pop Reporter" does not necessarily state or reflect the views of the INFO Project, Johns Hopkins University, or the US Agency for International Development. All links were verified at the date of mailing. Your computer and/or network configuration regarding Java script, cookies, and other security issues may not allow you to view certain Web sites. Consult your computer technician if you are having problems.

FAMILY PLANNING/REPRODUCTIVE HEALTH RESEARCH

Unprotected: Sex, Condoms and the Human Right to Health (report)
Related news article: Church No-condom Policy Blasted
Related news article: Philippine Pro-Lifers Stand by Anti-Condom Policy
Related news article: DoH: No Free Condoms
Related press release: Philippines: Anti-Condom Policies Could Spark AIDS Explosion
The Philippine government is risking a "possible explosion" of the AIDS virus by pandering to the Catholic Church's strict birth control policy, according to a new report by Human Rights Watch. The US-based watchdog said that while HIV and AIDS infection was relatively low in the country, failure to promote the use of condoms could bring about disaster. The Department of Health dismissed the report. "They have to think of how prevention (of HIV) works," said Health Secretary Manuel Dayrit. "Saying that using condoms is the best way to prevent the spread of HIV is one thing; saying that giving condoms for free ensures that people would actually use them is another."

Gender Issues in Contraceptive Use among Educated Women in Edo state, Nigeria (research abstract)
This study determined factors that influence the choice of contraceptives among female undergraduates at the University of Benin and Edo State University Ekpoma. Data was collected from a sample of 800 female undergraduates matched ethnic group, socio economic status, religion and rural urban residence. Findings revealed the highest correlation for availability vis a vis the use of various types of artificial contraceptive and cost; next was safety and effectiveness. Others were peer group influence and convenience.

Guide to Sexually Transmitted Disease Resources on the Internet (research abstract)
The authors of this article recommend that both health care professionals and laypersons seeking information about STDs on the world wide web should generally start their search at government-sponsored sites, which tended to have the most reliable, up-to-date, and unbiased information.

Pharmacy Clerks' Prescribing Practices for STD Patients in Porto Alegre, Brazil: Missed Opportunities for Improving STD Control (research abstract)
This study evaluated the prescribing practices by pharmacy clerks for STDs.

A Quasi-Experimental Study to Assess the Performance of a Reproductive Health Franchise in Nepal (research article)
(You need Adobe Acrobat Reader to access this document)
This study examined the performance of a nurse and paramedic network that was established to increase the quality and utilization of reproductive health care services in a district in Nepal. The authors assessed the extent to which there were improvements in client perceptions of the quality of care and an increase in the utilization of reproductive health services offered by network clinics.

Defining Sexual Health: A Descriptive Overview (research abstract)
This paper examines the historical events that have contributed to evolving definitions of sexual health.

FAMILY PLANNING/REPRODUCTIVE HEALTH NEWS

FDA Issues Not Approvable Letter to Barr Labs; Outlines Pathway for Future Approval (press release)
Related resource material: FDA's Decision Regarding Plan B: Questions and Answers
Related resource material: Not Approvable Letter
(You need Adobe Acrobat Reader to access this document)
The Food and Drug Administration (FDA) acknowledged that it has issued a "Not Approvable" letter to the sponsor of an application to make the Plan B emergency contraception product available without a prescription. In its letter to the sponsor, FDA outlined the additional information that would be required to gain approval to market Plan B over-the-counter. FDA based its action primarily on the lack of data concerning OTC use of the product among adolescents younger than 16 years old. The sponsor's application contained no data in subjects under 14 years of age and very limited data in adolescents 14 to 16 years old.

Chilean Leader Defends 'Morning-after' Pill Distribution (news article)
Chilean President Ricardo Lagos defended his government's program to hand free "morning-after" contraceptive pills to women who want to prevent a pregnancy. The influential Roman Catholic Church decried Lagos' program, set to start May 15, saying the pill causes the equivalent of an abortion by killing a life at its beginning.

UN Praises Mexico Family Planning Progress (news article)
Mexico has made exemplary progress in the last decade in family planning and educating women in poor communities about their rights to birth control.

Nigerians Buy Hundreds of Millions of Condoms (news article)
Nigerians bought 150 million packets of condoms in the first quarter of this year, according to statistics released on Monday in Lagos by the Society for Family Health. The figure contrasted to the 130 million packets bought during the corresponding period in 2003.

UK: Outrage at Bid to Sell Condoms in Schools (news article)
A plan to sell condoms in schools has caused an outrage. Cheshire businessman Simon Cole says he wants to make cut-price contraceptives available in school shops and vending machines because he believes it could dramatically reduce teenage pregnancies. He plans to ask schools and colleges in Greater Manchester and Cheshire to promote his own brand of condoms, which have bright designs to appeal to pupils as young as 14.

Pakistan: 'MMA Not Blocking Family Planning' (news article)
Peshawar Inayatullah Khan, provincial health and population welfare minister, has said that the Muttahida Majlis-e-Amal government was not obstructing the family planning program and would implement recommendations on family planning if they were not in conflict with religious, social, and cultural values.

Celebrities and Politicians Sign Up for National Condom Week (news article)
National Condom Week is set to begin this week, with support from politicians and celebrities. The annual week, organised by Durex and set to run from the 12th to the 16th, comes as experts at some health groups warn of the "sexual health crisis" in the UK.

FAMILY PLANNING/REPRODUCTIVE HEALTH LAW AND POLICY

Bulgarians Get Death on Charges of Infecting Children with AIDS (news article)
A Libyan court sentenced five Bulgarians and a Palestinian doctor to death after conviction of deliberately spreading AIDS in a children's hospital, a verdict that draw a swift "consternation" from the European Union.

Indonesia: Ministerial Decree on HIV/AIDS Prevention at Workplace Issued (news article)
The government issued a decree on HIV/AIDS prevention and control in the workplace, banning employers from discriminating against workers with the virus. However, the decree's effectiveness is questionable because it fails to spell out the punishment for those who ignore the regulation.

Canadian House of Commons Unanimously Approves Bill to Allow Manufacture of Generic AIDS, Other Drugs for Africa (news article)
Canada's House of Commons on Tuesday unanimously approved a bill that would amend the country's patent laws to permit the government to order the override of patents to allow certain pharmaceutical manufacturers to produce and export generic drugs, including antiretroviral drugs, for use in developing countries.

Chile Legalizes Divorce Despite Church Opposition (news article)
Chile legalized divorce on Friday despite strong opposition from the Catholic Church, which warned the move would be harmful to families. President Ricardo Lagos on Friday signed the bill making divorce legal, although it won't take effect for 6 months to give judges time to study the changes and to enable courts to be set up to hear cases.

US: Judge Orders Couple Not to Have Children (news article)
A couple has been ordered not to conceive any more children until the ones they already have are no longer in foster care. "The facts of this case and the reality of parenthood cry out for family planning education," the judge ruled. "This court believes the constitutional right to have children is overcome when society must bear the financial and everyday burden of care." The mother was found to have neglected her four children, ages 1, 2, 4, and 5. All three children who were tested for cocaine tested positive, according to court papers. Both parents had a history of drug abuse.

Nigeria: No HIV Test, No Wedding - Anglican Church (news article)
Couples seeking to be joined in matrimony in the Anglican Diocese of Osun, in Osun State, will have to produce their HIV and AIDS test results to be qualified, according to the Bishop of the diocese.

Czech Government Backs Plan to Make Sex Trade Legal (news article)
The Czech government took a first step toward legalizing prostitution when cabinet approved a proposal to license sex trade workers. A government spokesman said the next move was approval by parliament, although no timeframe had been set, to make prostitution subject to the control of doctors and the taxman.

How Research Can Affect Policy and Programme Advocacy: Example from a Three-country Study on Abortion Complications in Sub-Saharan Africa (PubMed abstract)
This analysis focused on cross-country comparisons of nurse and doctor attitudes and knowledge about abortion and family planning-related issues. Abortion complication patients in the three countries studied (Zambia, Uganda and Malawi) were on average 24-26 years old with two children. Patients experienced long hospital stays while receiving care for complications, and the average monthly number of post-abortion patients was substantially higher in urban facilities as compared to mixed/rural ones. The paper describes important implications of the findings for policy and program development. The authors write that this research provided some impetus for stakeholders in these countries to put management of abortion complications on their health agenda.

HIV/AIDS RESEARCH

Brief but Efficient: Acute HIV Infection and the Sexual Transmission of HIV (research abstract)
This study provides empirical biological data that strongly support the hypothesis that sexual transmission by acutely infected individuals has a disproportionate effect on the spread of HIV-1 infection. The authors suggest that acute hyperinfectiousness may, in part, explain the current pandemic in heterosexual individuals.

A Randomized Trial on Acceptability of Voluntary HIV Counselling and Testing (research abstract)
Participants in a population-based HIV survey conducted in an urban population in Zambia in 1996 were offered voluntary HIV counselling and testing (VCT). Although 29% of them expressed interest in being tested (readiness), only 4% of this group used the services (ie, acceptability). When the survey was repeated 3 years later, VCT was designed differently to assess acceptability. Readiness varied significantly by age group (47% in age group 20-24 years vs. 18% in age group 40-49 years). There were contrasts between young (15-24 years) and older age groups (25-49 years) regarding the main factors associated with readiness. The acceptability was 11.8% among the group allocated to VCT at the local clinic compared with 55.8% for the group allocated to an optional location.

Rethinking Conceptual Approaches to Behaviour Change: The Importance of Context (research article)
(You need Adobe Acrobat Reader to access this document)
This article critically reviews the concept of behavior change as it has been applied to individual behavior in relation to HIV/AIDS. It notes the limits of cognitive approaches to behavior change when applied within complex contexts and variations of risk to HIV infection. With regard to communication, there is a need to move beyond top-down approaches and to incorporate horizontal and participatory approaches. These include recognizing and resourcing the role of civil society responses to HIV/AIDS.

Contraceptive Measures and HIV Transmission Protection among Women with HIV/AIDS (research abstract)
The purpose of this study was to investigate the use of contraceptive methods that would also guard against HIV/AIDS transmission in women. The study was carried out in 73 HIV/AIDS women in São Paulo, Brazil. Most women were married and had been infected almost exclusively through heterosexual contact. Of them, 35.4% reported having an HIV discordant partner, and 13.7% used inadequate contraceptive methods that failed to protect them against HIV transmission. The authors write that their results call for the need of continuous education on safer sex among HIV/AIDS women to empower them to discuss with their partners alternative options of exercising their sexuality and to raise awareness on their contraceptive choices in a way to protect their own health.

Gender Inequality and Domestic Violence: Implications for Human Immunodeficiency Virus (HIV) Prevention (research abstract)
This article emphasizes the intersection between domestic violence, gender inequality, and HIV infection, especially sub-Saharan Africa.

HIV and Reproduction (PubMed abstract)
This paper reviews the problem of HIV infection in couples who wish to have a child. The authors discuss different methods of reproductive technology, birthing methods, breastfeeding, and antiretroviral therapy.

HIV/AIDS NEWS

China's Cabinet Orders Urgent Measures to Curb AIDS (news article)
China warned Sunday that AIDS was spreading rapidly in the country and ordered urgent measures including school education and public awareness campaigns to help keep the deadly virus in check. The State Council, or cabinet, in a 12-page circular to all levels of government, also said local officials would be judged by their efforts in prevention and control.

Nigeria: HIV Prevalence Fell Last Year, But is Set to Resume Growth (news article)
The percentage of Nigeria's population infected with the HIV virus fell for the first time last year, according to a government survey of pregnant women tested in ante-natal clinics. However, the sentinel survey conducted by the Ministry of Health showed that the AIDS epidemic was continuing to grow in some regions of the country. It also predicted that the number of Nigerians infected with the virus that causes AIDS would rise sharply over the next 5 years.

Cambodian Drama to Fight AIDS (news article)
A soap opera with a difference is about to hit Cambodia's TV schedules. "Taste of Life", a medical drama aimed at increasing AIDS awareness, is being launched.

Tanzania: 'Condoms Effective in AIDS Fight' (news article)
Condoms are an effective method in the prevention of HIV/AIDS, according to Deputy Minister for Health, Dr. Hussein Mwinyi, when he launched a new condom brand called Salama Studs in Dar es Salaam.

Nigeria: Cheap AIDS Treatment Scheme Still Has Big Problems (news article)
A Nigerian government pilot program to provide subsidised antiretroviral (ARV) treatment for people living with AIDS is inadequate and under threat from delayed funding and poor organisation, AIDS activists said on Wednesday. The program aims to provide cheap ARV treatment for 10,000 adults and 5,000 children living with AIDS throughout Nigeria. However, the activists, speaking on the sidelines of Nigeria's National AIDS conference in the capital Abuja, said few drugs were available outside Lagos and existing stocks might soon run out.

MATERNAL AND CHILD HEALTH RESEARCH

State of the World’s Mothers 2004 (report)
Related news article: Teen Mothers Face High Death Risk
This year's State of the World's Mothers report focuses on the tens of millions of girls around the world who marry and have babies while they are still children themselves. The results are often tragic: many girls die in childbirth, even greater numbers of their babies die, and young mothers and babies who do survive often struggle to overcome poor health, limited education and grinding poverty. The report recommends ways to help girls delay marriage and motherhood until they are emotionally and physically ready to give birth and raise children. It also suggests programmatic and policy solutions to help child mothers and their babies survive and thrive. A first-ever Early Motherhood Risk Ranking analyzes 50 perilous places where the problem is particularly severe. In addition, Save the Children presents the fifth annual Mothers’ Index, using the latest data on health, nutrition, education and political participation to rank over 100 countries – both in the industrialized and the developing world – showing where it is best and worst to be a mother.

Nepal Child Survival Case Study (resource material)
This case study, from USAID's BASICS II project, is an interactive .pdf, which allows access to overview material, the technical report (including an executive summary and lessons learned), an annotated bibliography of reports and materials on child survival programs, and a selection of tools--timelines, maps, community health worker job aids, registry sheets, and a variety of other materials that could be replicated for use in other country contexts.

Breastfeeding and the Risk of Postneonatal Death in the United States (research abstract)
Related news article: Study: Breast-feeding Cuts Infant Death 20 Percent
Breast-fed children in the United States are 20% less likely to die during the first year of life than those who are not nursed, according to new findings. Researchers at the National Institute of Environmental Health Sciences said they based their finding on a survey that included nearly 9,000 infant deaths in 48 states. It found breast-fed babies were 20% less likely to die between 1 and 12 months of life than those who were not, and that the longer babies were breast-fed, the lower the risk of early death.

Effect of Several Sociodemographic Factors on Measles Immunization in Children of Eastern Turkey (research abstract)
The results of this study show that the level of immunization necessary for measles elimination has not yet been reached in Eastern Turkey.

Madagascar Child Survival Case Study (resource material)
This case study includes an executive summary of the report, an overview of the Madagascar child health program, and a toolkit containing numerous tools used to operationalize the program. The tools are related to policies, program advocacy, and decision-making; the capacity to plan and manage programs; access to quality health services and service delivery; community participation; service utilization and health behaviors; rapid assessment; information-education-communication; and research.

Rofecoxib Versus Magnesium Sulfate to Arrest Preterm Labor: A Randomized Trial (research abstract)
Related news article: Vioxx Helps Stop Premature Labor
This study found that oral rofecoxib for 48 hours is as effective as intravenous magnesium sulfate in arresting acute preterm labor.

Health Providers' Counselling of Caregivers in the Integrated Management of Childhood Illness (IMCI) Programme in Uganda (research abstract)
This study assessed Integrated Management of Childhood Illness (IMCI)-trained health providers' counselling of caregivers and determined factors that facilitate or constrain counselling. A cross-sectional study utilizing quantitative and qualitative methods was carried out in 2000 in 19 health units in Mukono District. The study involved 37 health providers in 161 IMCI counselling sessions. The researchers found that the performance of health providers was good in 9 out of 20 IMCI counselling items, and cadre of health provider, IMCI experience, number of supervisory visits, and praise of health provider were associated with IMCI counselling.

Evaluation of an Algorithm for Integrated Management of Childhood Illness in an Area of Vietnam with Dengue Transmission (research abstract)
This study determined whether nurses, using the WHO/UNICEF algorithm for integrated management of childhood illness (IMCI), modified to include dengue infection, satisfactorily classified children in an area endemic for dengue haemorrhagic fever.

MEN'S HEALTH RESEARCH

Gender and Aging in the Developing World: Where Are the Men? (research abstract)
The authors write that the assumed relative disadvantage of elderly women is commonly attributed to gender differences in earlier life experiences, but they ask: Are older women truly disadvantaged globally with respect to all or most essential aspects of well-being? The authors provide empirical evidence that clearly shows that older women are not invariably disadvantaged vis-à-vis men. In particular, they call into question the wisdom and equity of a virtually exclusive emphasis on the needs of women when incorporating gender concerns into policies and programs related to aging.

Vasectomy by Ligation and Excision, with or without Fascial Interposition: A Randomized Controlled Trial (research article)
Related press release: Modifying Vasectomy Technique Improves Effectiveness
Modifying a simple ligation and excision technique commonly used in developing countries to perform male sterilization reduces vasectomy failures by about a half, according to a new study. Final analysis of a vasectomy study conducted among 841 men in seven countries showed that the modification – called fascial interposition – also reduced the time it took for vasectomized men to achieve low sperm counts.

POPULATION RESEARCH

Fertility Levels and Trends in the Asian and Pacific Region (research article)
(You need Adobe Acrobat Reader to access this document)
This paper presents fertility levels and trends over the past 50 years in the Asian and Pacific region and examines the shifts in age patterns of fertility in countries at different levels of fertility. In this context the paper discusses fertility transition theories. It then highlights factors contributing to fertility decline in low fertility and intermediate fertility countries, and assesses the factors hindering fertility decline in high fertility countries. The paper concludes with a discussion of future prospects for fertility decline in high fertility and intermediate fertility countries and underlines the need for policies and programs to be implemented by low fertility countries.

Fertility and Public Policies - Evidence from Norway and Finland (research article)
(You need Adobe Acrobat Reader to access this document)
The author states that relatively high and rising fertility rates of Nordic countries in the late 1980s and early 1990s sparked a renewed research interest in the possible pronatalistic effects of generous family policy programs. While several studies have addressed this issue, few have tried to model policy effects explicitly. The existing evidence so far is mainly from Sweden, where policy indicators have been incorporated in economic fertility models that also control for female wages. This paper complements previous Swedish analyses with evidence from Norway and Finland. The results corroborate earlier findings of a negative effect of female wages. There are also indications of a positive policy impact, as maternity leave extensions are estimated to raise birth rates, although mainly higher parity births and mainly in Finland.

Population and Poverty in Asia and the Pacific (review article)
(You need Adobe Acrobat Reader to access this document)
This paper analyses the linkages between demographic dynamics and various dimensions of poverty and suggests population-related policy options to minimize the adverse impact of demographic dynamics on socio-economic development, including poverty reduction. The size and growth of the population in countries of the region are briefly analysed. Linkages of population with different dimensions of poverty are then examined. While the main focus is on income/consumption poverty, implications for labour force and employment, education, and health are also assessed. The concluding section provides population-related policy suggestions.

Second Births and the Second Shift: A Research Note on Gender Equity and Fertility (news article)
Related news article: Housework Clue to Size of Family
The way couples divide up the household chores may give a clue as to whether they are likely to have a second baby. US scientists have discovered that 81% of couples in which the husband does at least half the housework will have a second child. This drops to 74% if the woman does the bulk, and those who split the chores with no clear plan of action are least likely to have a second child.

Brief Review of World Basic Demographic Trends (resource material)
This review, from The Global Social Change Research Project, provides an outline of major world demographic characteristics and changes. Data is provided for more than 100 countries, and most cover time periods of 20 years or more. Specific characteristics include population size and growth (1960, 1980, and 2001 data from the US Census Bureau, International Data Base); infant mortality rate (1960 to 2000 data from UNICEF and 1980 and 2001 data from US Census Bureau, International Data Base); percent of population age 60 or over (1990 and 2000 data from WHO Statistical Annex and US Census Bureau, International Data Base); fertility (1980 and 2001 data from US Census Bureau, International Data Base).

Ageing Trends and Policy Responses in the ESCAP Region (research article)
(You need Adobe Acrobat Reader to access this document)
This paper examines various interrelationships among population change, the well-being of the elderly, and economic development. The first half of the paper deals with trends and prospects of population ageing and the demographic profile of the elderly in the Economic and Social Commission for Asia and the Pacific (ESCAP) region. The second half discusses some of the policies that have been formulated in recent years by certain governments and that are available to ESCAP countries as future program options to enable them to cope with population ageing.

POPULATION NEWS

China: 12.7 Million More Boys than Girls Under 9 (news article)
China's population will reach 1.557 billion in 2043 and after that the country will approach a zero population growth rate, officials and experts recently announced at a forum at Beijing University. China's newborn gender ratio of girls to boys was 100:117, according to the fifth national census. The number of boys under 9 years old was 12.77 million more than that of girls.

Falling Japanese Birth Rate Worries (news article)
The number of children in Japan has shrunk for the 23rd year in a row, reflecting a falling birth rate that policymakers say will affect the nation's ability to support its ageing population in the coming decades.

South Korea: Population under 18 Years of Age Accounts for 25 Percent of Total Population (news article)
According to the "2004 Adolescent Statistics" announced by the Department of Statistics on May 6, the number of those under the age of 18 is estimated to be 12.099 million, comprising 25.1% of the total population (48.199 million) of South Korea.

Australia's Aged Population is Increasing Faster Than the Government Realises (news article)
Forecasting expert Professor Rob Hyndman, from the Department of Econometrics and Business Statistics, Monash University, said the number of elderly people was increasing faster than official estimates and warned that the Australian Bureau of Statistics (ABS) was underestimating the future number of people aged over 85. "The ABS forecast of that sector of the population for 2031 is 660,000, while ours is 845,000 -- a difference of 180,000, or 28%."

WOMEN'S HEALTH RESEARCH

Drug Use and Sexual Risk Behaviours among Female Russian IDUs Who Exchange Sex for Money or Drugs (research abstract)
This study examined the prevalence of sex trading among female Russian IDUs and their drug use, sexual behavior, and perceived vulnerability. Female IDUs (n=100) in St. Petersburg, Russia participated; 37% reported a history of sex trading; 44% reported sharing injection equipment with others. This group reported a mean of 49.5 male sexual partners in the previous month and an average of 15.4 unprotected vaginal intercourse acts in the previous 30 days. Mathematical models to calculate risk estimates for HIV seroconversion indicated that participants were at significant risk of contracting HIV and infecting sexual partners. Despite significant rates of risk behaviors, most participants perceived themselves to be at little risk of contracting HIV.

The Vulnerability of Brazilian Female Prisoners to HIV Infection (research article)
This study determined the vulnerability to HIV infection of women in a São Paulo State Penitentiary. The authors interviewed and obtained a blood sample from 290 females who agreed to enter the study. The overall prevalence data were: 13.9% for HIV (37 of 267), 22.8% for syphilis (66 of 290), and 16.2% for HCV (47 of 290). Sexual partnership variables were significantly related to HIV infection and included HIV-positive partners, casual partners, injectable drug user partners, and history of sexually transmitted disease. In addition, a relationship was detected between HIV infection and drug use and injectable drug use.

Sexual Violence Against Intimate Partners in Cape Town: Prevalance and Risk Factors Reported by Men (research article)
(You need Adobe Acrobat Reader to access this document)
This study describes the prevalence of and risk factors for the perpetration of sexual violence by men against female intimate partners. Researchers conducted a cross-sectional study on 1,368 men working in three Cape Town municipalities. The perpetration of physical violence against intimate partners in the past 10 years was reported by 15.3% of the men. The risk of being sexually violent was associated with the use of violence to solve problems in other settings, having more than one current partner, alcohol abuse, and verbally abusing a partner.

Quality of Sexually Transmitted Infections Services for Female Sex Workers in Abidjan, Côte d'Ivoire (research abstract)
This study assessed the quality of STI care in health care facilities in Abidjan attended by female sex workers. A cross-sectional study was conducted in 29 health care facilities and 10 pharmacies. The researchers found that private health care facilities were more expensive, had fewer clients, and had less equipment and medical staff than public facilities, with the exception of a special female sex worker clinic. Overall scores for correct treatment were lowest for the pharmacists. Researchers observed 513 provider-client interactions, of which 161 related to STIs or genital problems in women. Questions about recent sexual contacts were asked in only 20% and preventive messages were given in only 9% of the cases with STI/genital problems. Of 161 clients interviewed, 44% complained about a long waiting time, and 39% thought the health care provider had adequately explained the problem to them. The authors conclude that the opportunity for improvement of STI case management in health care facilities in Abidjan where female sex workers go for STI care is enormous.

Armenia: Improving Health Sector Response to Violence Against Women (resource material)
(You need Adobe Acrobat Reader to access this document)
This 2-page publication provides the initial positive results seen from a pilot program launched by the PRIME II Project in 2002, which is expanding the role of the reproductive health sector in helping Armenian women overcome violence.

Gender-based Violence, Relationship Power, and Risk of HIV Infection in Women Attending Antenatal Clinics in South Africa (PubMed abstract)
The authors did a cross-sectional study of 1,366 women presenting for antenatal care at four health centers in Soweto, South Africa. After adjustment for age and current relationship status and women's risk behavior, they found that intimate partner violence and high levels of male control in a woman's current relationship were associated with HIV seropositivity. Factors not associated with HIV serostatus included child sexual assault, forced first intercourse, and adult sexual assault by non-partners.

Treatment for Cervical Intraepithelial Neoplasia and Risk of Preterm Delivery (research abstract)
Related news article: Some Cervix Treatments Up Pregnancy Risk
Certain treatments for a precancerous lesion of the cervix significantly increase the odds of premature rupture of membranes occurring during a subsequent pregnancy, a new study shows. Specifically, the risk applies to women with cervical intraepithelial neoplasia (CIN) who undergo a so-called loop electrosurgical excision procedure or laser cone therapy to remove the abnormal tissue on the cervix. The investigators reported that "careful consideration should be given to treatment of CIN in women of reproductive age, especially when treatment might reasonably be delayed or targeted to high-risk cases."

WOMEN'S HEALTH NEWS

Nigeria: Women Lament Spate of Unwanted Pregnancies in Schools (news article)
This article relates how girls' education is being threatened with the increasing incidence of unwanted/early pregnancy among female pupils and students in primary, secondary, and tertiary institutions in the country. It is estimated that more than 30% of girls enrolled in basic education drop out of schools after becoming pregnant.

Thousands of Women in Argentina Turn to Selling Sex to Survive Recession (news article)
This feature article from the Washington Post relates how far women in Argentina are willing to go to survive poor economic times.

New Zealand: New PNG Strategy to Counter AIDS in Sex Workers (press release)
World Vision has clinched a deal with the University of Papua New Guinea's (PNG) Medical School to kick-off a radical new pilot project to combat AIDS amongst sex workers and their clients. It's the first time the strategy has been applied in PNG and it has been trialed in only a handful of countries around the world. The technique, known as "periodic presumptive treatment", involves the immediate regular supply of a range of antibiotics to high-risk groups before the results of testing for STDs is known. It presumes the target patient will almost certainly be infected with one or more STDs.

Pre-cancer Can Occur After Many Normal Pap Tests (news article)
Older women who've had consistently normal Pap smears still have a slight risk of having an abnormal result in the future, new research indicates. For this reason, it seems, women should continue to be screened for cervical cancer.

Afghanistan: UNFPA Workshop Promotes Women Leaders (news article)
This article relates the struggles facing womein in a post-conflict Afghanistan. The focus event was a UNFPA-initiated five-day international training workshop to address issues of women in leadership, which was attended by dozens of women from NGOs, civil society groups, and heads of departments of the Afghan Ministry of Women's Affairs.

YOUTH HEALTH RESEARCH

Sex Education as Health Promotion: What Does It Take? (research abstract)
This paper addresses the realities faced by sexual health programs in school-based sex education.

YOUTH HEALTH NEWS

UK: Oral Sex Lessons to Cut Rates of Teenage Pregnancy (news article)
Related research summary: Evaluation of the A PAUSE Sex and Relationships Education Programme
Encouraging schoolchildren to experiment with oral sex could prove the most effective way of curbing teenage pregnancy rates, a government study has found. Pupils under 16 who were taught to consider other forms of "intimacy" such as oral sex were significantly less likely to engage in full intercourse, it was revealed.

Namibia: Orphan Crisis a Disaster Greater than Floods/Drought (feature article)
This feature article relates the troubling tale of orphans and how they and their communities are coping in the face of a crisis that is unlike anything they have ever seen. It is estimated that in just 15 years time, by 2021, some 10 percent of Namibia's entire population will be made up of children orphaned by AIDS.

Former Captives Recount the Crime of Boy Rape in Sudan (news article)
This feature article relates the horrific tales of slave boys who have been raped by government soldiers and/or their masters in Sudan. Here, strict taboos surround sex, especially male-to-male sex. In fact, male-to-male sex is considered such an egregious act in South Sudan that if two males are found guilty of having consensual sex with each other they are killed by a firing squad, according to an appelate court judge interviewed by the reporter.

SPECIAL REPORTS/PROFILES/RESOURCES

Uganda National Expanded Program on Immunization (UNEPI) Standards (resource material)
(You need Adobe Acrobat Reader to access this document)
As part of its revitalization plan for immunization services, the Uganda National Expanded Program on Immunization (UNEPI) refined its policies and standards governing immunization delivery. These standards are derived from Uganda's EPI objectives, which are to increase access to immunization services, to provide save and potent vaccines, to create and sustain demand for services, and to prevent disease. The standards provide managers and providers with performance guidelines for planning, managing, implementing, and monitoring immunization programs at national, district, health sub-district, and health facility levels. They also serve as a useful reference for technical support supervision, on-the-job training, and quality improvement of EPI services.

Safeguarding Investment in PMTCT Programs by Incorporating Essential Newborn Care (resource material)
(You need Adobe Acrobat Reader to access this document)
Vast resources have been committed to the prevention of mother-to-child transmission (PMTCT) of HIV/AIDS. This brief urges PMTCT programs to safeguard their investments not just by preventing transmission of HIV but also by ensuring that newborns survive. Incorporating essential newborn care into PMTCT programs will help ensure that babies who escape HIV transmission do not die from infection, birth asphyxia, or other conditions that can be prevented and treated with simple, cost-effective interventions.

---

Problems and comments can be addressed to rjacoby@jhuccp.org. Archives available at http://www.infoforhealth.org/popreporter/. Subscribe at http://prds.infoforhealth.org/signup.php. Modify your account at http://prds.infoforhealth.org/modify.php. Have an item to contribute for consideration in The Pop Reporter? E-mail the URL and description to rjacoby@jhuccp.org. Forward this message to a friend who could benefit from INFO project activities! Sincerely, Robert Jacoby, rjacoby@jhuccp.org Editor, The Pop Reporter

Disclaimer: The information provided on this web site is not official U.S. Government information and does not represent the views or positions of the U.S. Agency for International Development, the U.S. Government or The Johns Hopkins University.