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The Pop Reporter®

Volume 4, Number 21
24 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

Costs and Net Health Effects of Contraceptive Methods (research abstract)
This cost-utility analysis compared 13 methods of contraception to nonuse of contraception with respect to healthcare costs and quality-adjusted life years (QALYs). The base-case analysis applies to women of average health and fertility, ranging from 15 to 50 years of age, who are sexually active in a mutually monogamous relationship; smoking rates observed in women of reproductive age were used. Sensitivity analysis extended the analysis to nonmonogamous status and smoking status. Compared with use of no contraception, contraceptive methods of all types result in substantial cost savings over 2 years, ranging from US$5907 per woman for tubal sterilization to US$9936 for vasectomy and health gains ranging from 0.088 QALYs for diaphragm to 0.147 QALYs for depot medroxyprogesterone acetate. Compared with nonuse, even with a time horizon as short as 1 year, use of any method other than sterilization results in financial savings and health gains. Most of the financial savings and health gains were due to contraceptive effects. The authors conclude that every method of contraception dominates nonuse in most clinical settings, and increasing the use of more effective methods even modestly at the expense of less effective methods will improve health and reduce costs.

Working from Within: Culturally Sensitive Approaches in UNFPA Programming (report)
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Related press release: Cultural Sensitivity Key to Development, New Report Shows
The nine case studies presented in this brochure are drawn from a longer UNFPA report entitled, "Culture Matters: Working with Communities and Faith-based Organizations". It highlights the necessity of mainstreaming cultural analysis and sensitivity in development efforts addressing issues such as gender equality and equity, HIV/AIDS, female genital cutting, gender-based violence, and reproductive health. Programs in Brazil, Ghana, Guatemala, India, Islamic Republic of Iran, Uganda, and Yemen are analyzed.

Long-term Effects of Condom Promotion Programmes for Vaginal and Oral Sex on Sexually Transmitted Infections among Sex Workers in Singapore (research abstract)
Researchers evaluating the long-term impact of condom promotion programs for vaginal and oral sex among female brothel-based sex workers in Singapore found that the interventions produced sustained high levels of condom use with corresponding declines in cervical and pharyngeal gonorrhoea incidence.

Implanon Use in Thai Women Above the Age of 35 Years (research abstract)
This 6-month prospective study of Implanon implant use in 51 women older than 35 (mean age 39.7 years) was conducted in Bangkok, Thailand, to evaluate menstrual patterns and side effects. No accidental pregnancies occurred in 6 months of use. The most common menstrual pattern in these acceptors was irregular bleeding followed by amenorrhea. The major side effect was irregular bleeding. There was no significant change in body weight, body mass index, and diastolic blood pressure.

FAMILY PLANNING/REPRODUCTIVE HEALTH NEWS

World Health Assembly Adopts First Global Strategy on Reproductive Health and Resolution on the Family and Health (press release)
The World Health Organization's first strategy on reproductive health was adopted today by the 57th World Health Assembly. Reproductive and sexual ill-health accounts for 20% of the global burden of ill-health for women, and 14% for men. The strategy targets five priority aspects of reproductive and sexual health: improving antenatal, delivery, postpartum and newborn care; providing high-quality services for family planning, including infertility services; eliminating unsafe abortion; combating sexually transmitted infections, including HIV, reproductive tract infections, cervical cancer and other gynaecological morbidities; and promoting sexual health.

South Africa: Women Rape Men in AIDS Fury (news article)
South Africa, where human rights groups say one in two women risks being raped, is grappling with a new twist to its biggest public health problem: women who rape men, often at gunpoint, in a deliberate attempt to infect them with AIDS. "This is very unusual," said a police inspector, "because we're used to dealing with men raping women." But it is not so unusual, according to Delphine Senumaga, director of People Against Women Abuse. "Men have been rape victims for quite some time," she said. "What has changed is that men are now responding to our rape awareness campaigns - they are coming forward to report the crime, whereas before they would have been shamed into silence."

Bangladesh: Dropout Rate High among Pill Users: Only 4% of Men Use FP Method (news article)
One of the reasons behind stagnant total fertility rate in Bangladesh over the last 10 years is the high discontinuation rate of taking oral contraceptive pills among married women, which is almost 50%. These and other facts were disclosed at a "Meet the Press" forum to mark the 10th anniversary of ICPD '94 at the Press Institute of Bangladesh.

Singapore Reality TV: 1st Pregnant Couple Wins (news article)
The prize: $100,000 — and a baby. Ten couples from around the world could compete in a reality TV show in Singapore to see who can procreate first.

Germany: Childless Couple Told to Try Sex (news article)
A German couple who went to a fertility clinic after 8 years of marriage have found out why they are still childless - they weren't having sex. The University Clinic of Lubek said they had never heard of a case like it after examining the couple who went to see them last month for fertility tests. Doctors subjected them to a series of examinations and found they were both apparently fertile, and should have had no trouble conceiving. A clinic spokesman said: "When we asked them how often they had had sex, they looked blank, and said: 'What do you mean?'" The spokesman continued: "We are not talking retarded people here, but a couple who were brought up in a religious environment who were simply unaware, after 8 years of marriage, of the physical requirements necessary to procreate."

Singapore: A Baby at Any Age? Many Here Think So - Mistakenly (news article)
A high number of singles and married couples in Singapore are convinced that advances in medical technology can help them have babies at any age, according to the findings of a survey that even has fertility experts surprised. Six out of 10 Singaporeans polled believe procreation can happen at will, and that "fertility can be turned on and off like a tap", said the Ministry of Community Development and Sports, which commissioned the survey. The responses from the 6,000 Singaporeans polled, half of whom were married, reflected an over-confidence placed in technology to overcome problems in conception. The notion, which is at odds with long-standing medical evidence that fertility declines with age, even prompted Community Development and Sports Minister Yaacob Ibrahim to say that "fertility is not on tap".

FAMILY PLANNING/REPRODUCTIVE HEALTH LAW AND POLICY

U.N. Welcomes Drug Approval Guidelines (news article)
Related news article: Views Mixed on U.S. Shift on Drugs for AIDS
U.N. health authorities last week welcomed new U.S. guidelines on drug approvals which they say will make it easier for AIDS sufferers in developing countries to receive lower-cost treatment. The United Nations-administered Global Fund to Fight AIDS, Tuberculosis and Malaria said the fast-track U.S. Food and Drug Administration review process could reduce approval time for generic combinations of drugs to as little as a few weeks.

U.S. Shifts Strategy to Curb HIV's Spread (news article)
In a controversial shift in AIDS strategy, the federal government Friday funded programs to prevent people with HIV from spreading the virus, instead of primarily targeting people at risk who are not infected. The Centers for Disease Control and Prevention announced $49 million in HIV prevention grants to 142 community organizations around the country. The money comes as the disease appears to be on the rise again. It is the first round of annual funding since the CDC launched an initiative last year aimed at keeping people with HIV from infecting others. The effort also tries to make testing more available -- largely through a new rapid HIV test -- so that the 200,000 or more people who have HIV but don't know it become aware of their status and take steps to curb transmission.

Delhi, India High Court Decision Upholds HIV Positive Person's Fundamental Right to ARV Treatment (news article)
The High Court of Delhi pronounced an order upholding an HIV positive person's fundamental right to access treatment and medicines.

Zambia: Mandatory AIDS Testing Coming (news article)
The National AIDS Council (NAC) has called for mandatory HIV/AIDS testing in hospitals and health centers to link at least 100,000 to anti-retroviral drugs by next year. Appearing before the parliamentary committee on health at Parliament last week, the NAC acting director general, Rosemary Musonda, said the current approach of referring sick persons to voluntary counselling and testing was inappropriate.

Gambia, Spain in Circumcision Row As Court Acts to Save Girls From Mutilation (news article)
The Spanish judiciary is currently embroiled in a simmering row with The Gambia over the best way to protect girls from circumcision. The dispute came to a head recently after a Spanish court confiscated the passports of three Gambian girls to stop them being repatriated for surgery.

What's In a Name? Policy Transfer in Mozambique: DOTS for Tuberculosis and Syndromic Management for Sexually Transmitted Infections (PubMed abstract)
Drawing on analytical frameworks developed to study policy transfer between jurisdictions, this paper explores how far two globally promoted infectious disease policies (DOTS for tuberculosis and syndromic management for STIs) were voluntarily or coercively transferred in one particular setting, Mozambique. The paper suggests that guidelines emanating from these policies were not imposed, but evolved in the 1980s through technical networks of national and international experts.

Canada: Lied to Sexual Partner, HIV-positive Man Jailed (news article)
An HIV-positive man in Winnipeg was sentenced to 2 years in prison for lying about his illness and having unprotected sex with a young woman.

Breaking Through: A Guide to Sexual and Reproductive Health and Rights (resource material)
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This guide, from The Swedish Association for Sexuality Education, is for all those wanting to better acquaint themselves with the political debate surrounding sexual and reproductive health and rights (SRHR). It is a tool for those who negotiate and advocate on these issues. The reader is provided with a general picture of the Platform of Action, an explanation of controversial SRHR terms, "the opposition", political arguments, and a summary of international treaties and documents relevant to our efforts to reinforce SRHR as a fundamental human right.

Paving the Path: Preparing for Microbicide Introduction; Report of a Qualitative Study in South Africa (report)
This paper presents results from a qualitative study that explored a range of issues likely to influence microbicide introduction--positively or negatively--at three levels: community, health service, and policy. The study identifies critical issues to be addressed in building support for microbicides and facilitating smooth introduction. The study was implemented as a collaboration among EngenderHealth, the University of Cape Town-Women's Health Research Unit, the Population Council, and the International Partnership for Microbicides.

Kenya: AIDS Clause in Draft Bill Tests Insurance Industry's Unity (news article)
Planned legislation by the federal government compelling insurance companies to provide unconditional life insurance and medical cover for HIV/AIDS-positive people is poised to put both the government and the insurers in a difficult position.

Implementing the ICPD Programme of Action: What a Difference a Decade Makes (commentary)
This Viewpoint article, by Marianne Haslegrave, Director, Commonwealth Medical Trust, London, UK, reflects on some of the political and other changes that have taken place during the first 10 years of the Programme of Action and their implications for its implemention in the coming decade.

HIV/AIDS RESEARCH

The Zambia HIV/AIDS Workforce Study: Preparing for Scale-up (report)
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This report presents the findings of a study conducted at 16 healthcare sites in Zambia offering voluntary counseling and testing, prevention of mother-to-child transmission of HIV, and antiretroviral therapy.

Mainstreaming HIV Prevention in the Military: A Case Study from Cambodia (report)
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From the forward: "In response to the HIV threat in the military, the Royal Cambodian Armed Forces, in partnership with local and international non-governmental organizations and international agencies, developed a comprehensive strategy for reducing HIV vulnerability in the military through education, empowerment and capacity-building as part of a larger national HIV prevention strategy. This case study documents the Cambodian defence sector’s effort in building HIV resilience and reflects both constraints as well as lessons learned on factors contributing to an effective HIV prevention programme in the military."

Effect of an HIV Counseling and Testing Program on AIDS-related Knowledge and Practices in Tuberculosis Clinics in Abidjan, Côte d'Ivoire (research abstract)
Researchers found that an HIV pretest counseling program conducted in an out-patient tuberculosis clinic was well accepted and significantly increased the level of HIV/AIDS knowledge and, among men, self-reported condom use.

South African National Household Survey of HIV/AIDS Prevalence, Behavioural Risks and Mass Media Impact--Detailed Methodology and Response Rate Results (PubMed abstract)
This paper describes the methodology used in a recent survey of HIV/AIDS in South Africa and presents the response rates.

HIV/AIDS NEWS

Over 4,500 HIV-infected Russians Die Since 1987 (news article)
More than 4,500 HIV-infected Russians, including over 240 children under 14, have died since 1987, according to this news article from ITAR-TASS news agency.

New HIV Cases Hit Record High in Singapore (news article)
New cases of the virus that causes AIDS hit an historic high in Singapore in 2003, led by middle-aged heterosexual men, the government said. New HIV infections in the wealthy city-state totaled 242 in 2003, the highest since records began in 1985, the Health Ministry said. A total of 2,075 people are infected by the virus. Heterosexuals accounted for 76% of all new cases, with most infections contracted through casual sex or sex with prostitutes, the ministry added.

Jamaica First to Sign for Low-priced AIDS Drugs Under UN and Clinton Initiatives (news article)
Jamaica is the first country to have signed an agreement to receive HIV/AIDS drugs and diagnostic tests at the reduced prices negotiated by the Clinton Foundation and paid for by the United Nations-initiated Global Fund to Fight AIDS, Tuberculosis and Malaria.

India: 20% of Mumbai's Gay Men are HIV+ (news article)
A first-of-its-kind study conducted among 240 homosexual men in the city by Humsafar, an organisation for gay people, and the Indian Market Research Bureau, has shown that 17% to 20% of gay men in Mumbai are HIV positive. But, the good news is that, over the last 4 years, these numbers have remained stable. The study was presented at a seminar on Friday.

AIDS Cases Increasing in Pakistan: USAID (news article)
The number of reported HIV infections and AIDS cases has been steadily rising in Pakistan since 1987 and spreading throughout the country, said Lisa Chiles, director of the United States Agency for International Development (USAID), on Tuesday.

UN Roundtable Looks at Rapid Spread of HIV/AIDS in Prisons (news article)
The rapid spread of HIV/AIDS in prisons and practical measures to curb the spread of the disease in this section of society was the subject of a roundtable organized by the United Nations Office on Drugs and Crime and attended by high-level international experts. The roundtable took place as a side event during the thirteenth session of the Commission on Crime Prevention and Criminal Justice in Vienna.

MATERNAL AND CHILD HEALTH RESEARCH

An Evaluation of the Quality of Counselling Provided to Mothers in Three PMTCT Pilot Sites in South Africa (report)
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This study assessed the quality of counselling provided to mothers through the program to prevent mother-to-child transmission of HIV in South Africa.

"The Cut Above" and "the Cut Below": The Abuse of Caesareans and Episiotomy in São Paulo, Brazil (research abstract)
This paper describes the impact of the intervention model on women's birth experience and discusses how the organization of public and private maternity services in Brazil influences the quality of obstetric care.

Immunization Safety Review: Vaccines and Autism (report)
Related press release: MMR Vaccine and Thimerosal-Containing Vaccines Are Not Associated With Autism, IOM Report Says
Based on a thorough review of clinical and epidemiological studies, neither the mercury-based vaccine preservative thimerosal nor the measles-mumps-rubella (MMR) vaccine are associated with autism, says a new report from the Institute of Medicine of the National Academies. Furthermore, the hypotheses regarding how the MMR vaccine and thimerosal could trigger autism lack supporting evidence and are theoretical only.

MATERNAL AND CHILD HEALTH NEWS

Indonesia's Maternity Care Under Fire (news article)
More than 300 out of every 100,000 pregnancies end in the woman's death - far higher than other countries in the region, and six times higher than in neighbouring Malaysia. The Indonesian Government is trying hard to reduce this statistic, with a series of new policies designed to improve prenatal care. But so far they have had limited success.

US: Debate Revived on Mother's Rights (news article)
Several cases in US courts in recent months have revived a debate about whether mothers have an absolute right to choose when, where, and how they give birth — even if the health of their babies is at stake. Some women's advocates said the cases illustrate a newfound willingness by legal officials to interfere with women's choices about their pregnancies.

Clinicians Can Influence Women's Ideas About Pregnancy and Postpartum Exercise (news article)
Clinicians can influence women's ideas about pregnancy and postpartum exercise, new study findings show.

MEN'S HEALTH RESEARCH

Main Presentations of Sexually Transmitted Infections in Men (review article)
This review article from the British Medical Journal focuses on infections of the male urethra, epididymis, testis, and prostate. Anal and oral symptoms are also covered because these are encountered more often among men, especially men who have sex with men.

Sexual Practices and Psychosocial Correlates of Current Condom Use Among Chinese Gay Men in Hong Kong (research article)
This study examined sexual practices, condom use, and psychosocial correlates of condom use in a convenience sample of 187 Chinese gay men in Hong Kong. Among those who were sexually active and answered the item on condom use (n=164), 22% never used condoms, 39% were inconsistent condom users, and 39% used condoms every time they engaged in sexual activities in the past 6 months. Compared to inconsistent and noncondom users, consistent condom users had more positive feelings toward condom use, perceived greater vulnerability to STD/AIDS infections, showed greater self-acceptance and disclosure of their homosexual sexual orientation, were more involved with local gay communities, endorsed more favorable attitudes toward coming out, and had a lower level of perceived discrimination because of their homosexual sexual orientation.

Sexual Torture of Men in Croatia and Other Conflict Situations: An Open Secret (research abstract)
This paper describes the circumstances in which sexual torture occurs, its causes and consequences, and the development of international law addressing it. It presents data from a study in 2000 in Croatia, where the number of men who were sexually tortured appears to have been substantial and included evidence of rape and other forced sexual acts, full or partial castration, genital beatings and electroshock. The authors note that few men admit being sexually tortured or seek help, and professionals may fail to recognize cases.

MEN'S HEALTH NEWS

Zimbabwe: Men Break With Tradition to Become AIDS Caregivers (news article)
Zimbabwean men have become increasingly involved in caring for AIDS patients, challenging the stereotype that caring for the terminally ill is women's work.

POPULATION RESEARCH

Shortage of Girls in China Today (research abstract)
This article evaluates data on sex ratios in China since before the founding of the People's Republic and shows that the relative dearth of girls has become more extreme during the last two decades and that the problem is real and not merely due to undercounting of girls. The discussion includes what the People's Republic of China has done to ameliorate life-threatening discrimination against girls and what further steps might be taken to improve the situation.

Sexual Selection and the Male:Female Mortality Ratio (research article)
This paper extends the evolutionary understanding of sex differences in mortality rates by quantifying and graphically examining the overall Male to Female Mortality Ratio for 11 specific leading causes of death across age groups in the USA, over the course of the lifespan in 20 different countries, and across the past 70 years in 5 countries. The results confirmed the author's expectations of higher mortality rates for men than for women, especially in early adulthood, where three men died for every woman who died. The authors write that being male is now the single largest demographic risk factor for early mortality in developed countries.

POPULATION NEWS

Swaziland: Life Expectancy to Drop to 40 Years by 2010 - Report (news article)
The Swaziland Vulnerability Assessment Committee predicts that the high HIV/AIDS prevalence rate will lower life expectancy to just 40 years by 2010. The first large-scale survey of Swazi homes to determine the impact of HIV/AIDS found a reversal of the decade-long trend of lower mortality rates, due to the pandemic. "Swaziland has entered uncharted territory", concluded the VAC's findings for 2003.

Malta: Population Grows 5.8% Since Last Census (news article)
The total population in the Maltese islands has grown by 5.8% since the last national census was carried out in 1995. A set of demographic results released by the National Statistics office last week shows that at the end of 2003, the Maltese population stood at 388,867 and consisted of 192,934 males and 195,933 females.

Canada: Education, Migration, Divorce Cause Fall in Birth Rate (news article)
According to Statistics Canada data released last month, Canada's birth rate fell to its "all time low" in 2002, with just 10.5 births recorded for every 1,000 people in the country. That rate is down by some 25% in the last decade alone.

WOMEN'S HEALTH RESEARCH

Sex Workers in Kenya, Numbers of Clients and Associated Risks: An Exploratory Survey (research abstract)
In Kenya in 1999, an estimated 6.9% of women nationally said they had exchanged sex for money, gifts, or favors in the previous year. The authors conducted an exploratory survey among 475 sex workers in four rural towns and three Nairobi townships. Most of the women (88%) worked from bars, hotels, bus stages and discos; 57% lived with a stable partner and almost 90% had dependent children. In the previous month, 17% had been assaulted and 35% raped by clients. Unwanted pregnancy was common; 86% had had at least one abortion. Compared with women in rural towns, township sex workers were younger (median age 22 vs. 26), saw more clients (median 9 vs. 4 per week), and earned more from sex work.

Women's Autonomy, Education and Employment in Oman and their Influence on Contraceptive Use (research abstract)
This study defines baseline data on ever-married women's empowerment in Oman from a national study in 2000 and analyses the correlates of women's empowerment and the effect of empowerment on unmet need for contraception. The authors found that unmet contraceptive need for women exposed to pregnancy was nearly 25%, but decreased significantly with educational level and paid employment. While empowered women were more likely to use contraception, women's education was a better predictor of "met need" than autonomy, as traditional factors and community influence remain strong. For nearly half the 1,830 women in the study, the husband decided whether contraception was used.

Searching for Justice for Body and Self in a Coercive Environment: Sex Work in Kerala, India (research abstract)
This paper documents the environment in which women have been selling sex in Kerala since 1995, and their efforts to claim their rights. It is based on sex workers' own reports and experiences, a situation analysis, and a needs assessment study by the Foundation for Integrated Research in Mental Health.

Trafficking in Human Beings, Especially Women and Children, in Africa (report)
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This report from the UNICEF Innocenti Research Centre looks at information from 53 African countries and provides an analysis of the patterns, root causes, and existing national and regional policy responses and effective practices against human trafficking.

Sexuality and Women's Rights in Armed Conflict in Sri Lanka (research abstract)
This paper explores the complex sexual choices women in Sri Lanka have had to negotiate, particularly widows and sex workers, within a context of ethnic conflict, militarisation and war.

Listening to "Felt Needs": Investigating Genital Prolapse in Western Nepal (research abstract)
This paper presents findings of two studies, one ethnographic and one clinic-based, in western Nepal about genital prolapse. The clinic-based study was conducted among 2,072 women who presented with gynaecological complaints and received a diagnosis. One in four of them had genital prolapse, of whom 95% had self-reported the prolapse.

WOMEN'S HEALTH NEWS

A Worldwide Gender Gap (news article)
This article from Newsweek claims that women suffer countless disadvantages compared with men. Even after decades of progress, they make up two thirds of the world's 880 million illiterate adults and up to 70% of its poorest citizens. But health remains the cruelest of all inequalities.

Saudi TV Host's Beating Raises Taboo Topic: Domestic Violence against Muslim Women (commentary)
This commentary from The Christian Science Monitor declares that the brutal beating of Saudi Arabian television host, Rania al-Baz, by her husband last month, serves as a wake up call to all Arab and Muslim women in the Middle East and the West.

In Pakistan, Those Who Cry Rape Face Jail (news article)
As Pakistan's president stalls on repealing the country's controversial Hudood Ordinances, female rape victims here continue to face the risk of being legally treated as adulterers, punishable by stoning.

Unprotected Early Sex Fuels Gynecological Cancers in Nepal (news article)
Gynecological cancers comprise a significant 13% of the 50,000 cases of the disease in Nepal, with a new study warning that increasing promiscuity among the youth and early pregnancies is increasing the risk.

Turkey: 'Honour Killing' Backlash (news article)
Anger is slowly building in Turkey toward the cold-blooded murders of pubescent girls and young women by their own families for the sake of the family's "honor".

Burkina Faso: Circumcisers Are Operating On Baby Girls to Evade Law (news article)
An apparent decline in the number of circumcision operations carried out on young women in Burkina Faso masks a growing trend to circumcise younger and younger girls, according to a new survey by the World Health Organisation and the Burkina based National Committee Against the Practice of Circumcision. Sometimes baptism ceremonies are used as a cover for cutting out the clitoris, it said, because the baby is expected to cry at the baptism anyway.

YOUTH HEALTH RESEARCH

"Peer" Educator Initiatives for Adolescent Reproductive Health Projects in Indonesia (research abstract)
This paper describes a pilot project carried out in Central and East Java to train peer educators, coordinated by the National Family Planning Coordinating Board (BKKBN).

Youth InfoNet 6 - April/May 2004 (resource material)
Youth InfoNet, a publication of Family Health International, is presented in two parts. Part I contains program resources, such as summaries of tools, curricula, program reports, unpublished research findings, and other items that may be useful for youth programming. Part II contains summaries of peer-reviewed research papers published in the last month on developing country research.

Youth, Sexuality and Sex Education Messages in Indonesia: Issues of Desire and Control (research abstract)
This article reflects upon current discourses on youth sexuality in Java as against the actual sexual behavior of young people. Using examples from popular magazines and educational publications, and focus group discussions with young men and women in Surabaya, East Java, the authors argue that the dominant prohibitive discourse in Java denounces youth sexuality as unhealthy, reinforced through intimidation about the dangers of sex.

Meeting the Contraceptive Needs of Unmarried Young People: Attitudes of Formal and Informal Sector Providers in Vientiane Municipality, Lao PDR (research abstract)
This study explored the attitudes of formal and informal sector providers in serving the contraceptive needs of unmarried youth in Vientiane Municipality, their perceptions of quality of care, confidentiality and privacy, level of comfort in discussing sexual matters, and any differences between providers in the two sectors. The authors found ambivalence and discomfort among providers in communicating with unmarried youth and providing contraceptives to them, and low priority placed on their right to privacy and confidentiality. Providers tended to attribute difficulties almost entirely to young people's inhibitions and unwillingness to listen. Less than 60% of formal sector providers would supply contraceptives to unmarried youth, compared to 80% of informal providers, but the latter were more likely to charge a fee for supplies.

Youth Risk Behavior Surveillance --- United States, 2003 (report)
Related news article: More Teen Girls Having Sex, Study Shows
Teen sexual activity has stabilized, although more teenage girls are saying they have had intercourse, according to a new study by the CDC.

Draw the Line/Respect the Line: A Randomized Trial of a Middle School Intervention to Reduce Sexual Risk Behaviors (research abstract)
Related news article: School Program Helps Boys Say No to Sex: Study
A middle-school program aimed at changing kids' attitudes toward sex helped keep boys, but not girls, from having sex for the first time.

YOUTH HEALTH NEWS

'Child Prisoners Face Abuse in Asian Jails' (news article)
Child prisoners in Asia are experiencing inhumane treatment and are at risk of sexual exploitation and drug abuse, UNICEF warned as it called for a regional judicial overhaul for the young.

UK: Should Schools Permit Condom Machines? (news article)
This article addresses the sensitive subject of sexuality among schoolchildren.

Uganda: NGOs Deny Condom Claim (news article)
Organizations working on HIV/AIDS prevention denied distributing condoms to pupils. President Yoweri Museveni while in Rakai had said that some organizations and people were distributing condoms to primary schools and described the act as dangerous.

UK: Decline in 12-15 Year Olds' Knowledge about the Dangers of HIV/AIDS (news article)
New data from surveys across the UK reveal a decline in 12-15 year olds' knowledge about the dangers of HIV/AIDS. Figures from 1995-2001, using a sample of 142,281 young people, show a declining trend of youngsters who think that HIV can be passed on by drug taking (sharing needles), receiving blood via a blood transfusion in the UK, contact with blood in first aid, and sex without condoms.

BOOKS/BOOK REVIEWS

Minilaparotomy for Female Sterilization: An Illustrated Guide for Service Providers (book)
This illustrated guide is an easy-to-use reference for providers interested in learning about minilaparotomy. It presents a detailed description of the procedure and also illustrates the step-by-step surgical technique to follow in performing a suprapubic or subumbilical minilaparotomy under local anesthesia, with or without sedation. In addition, the guide reviews basic requirements that are essential to ensure the safety and effectiveness of any female sterilization procedure. Experienced providers of female sterilization who want to change from other surgical techniques to minilaparotomy, providers who have never performed female sterilization services and who want to begin to do so using minilaparotomy, and trainers and trainees will all find this illustrated guide to be useful.

No-Scalpel Vasectomy: An Illustrated Guide for Surgeons, Third Edition (news article)
This easy-to-use reference for surgeons describes each step of the no-scalpel approach and is useful both as a supplement during no-scalpel vasectomy training and as a reference while surgeons develop competency. The latest edition incorporates updated content and revised and improved illustrations. In particular, this edition of the illustrated guide contains an expanded description of ligation and excision with fascial interposition, the technique that is now regarded as offering the highest effectiveness.

Vaccines: Preventing Disease and Protecting Health (book)
This book relates successful efforts to fight disease with vaccines, including the eradication of polio from the Americas and the potential contribution of new measles vaccine formulations to reducing measles mortality worldwide. It also looks at the challenges posed in using vaccines to cope with emerging and re-emerging diseases, such as HIV/AIDS and bioterrorism. The authors examine innovative efforts underway to test the efficacy of vaccines against diseases such as meningococcal infection in Africa, Haemophilus influenza type b, varicella, and hepatitis A, and look at efforts to develop a new generation of vaccines against cholera and typhoid, shigella, and Helicobacter pylori. The advances in influenza vaccine development and Hepatitis C are also presented. The book includes sections on the quest for vaccines against tuberculosis, HIV/AIDS, dengue, malaria, and hookworm.

SPECIAL REPORTS/PROFILES/RESOURCES

COPE® for Reproductive Health Services: A Toolbook to Accompany the COPE® Handbook (resource material)
In 2003, EngenderHealth revised their original COPE (client-oriented, provider-efficient) handbook to include additional information about how to conduct COPE and began producing a set of accompanying toolbooks. The new toolbook, the first in the series, addresses a full range of topics reflecting a reproductive health approach to services. This toolbook is designed to be used in conjunction with the new edition of the COPE handbook, which is also available on their website.

HIV and Its Treatment: What You Should Know (resource material)
AIDSinfo, a service of the US Department of Health and Human Services, has released an updated version of the consumer brochure "HIV and Its Treatment: What You Should Know" on its website.

PATH's RHO website: Spring 2004 edition (resource material)
Section updates to the website of Reproductive Health Outlook include the following: Adolescent Health, Gender and Sexual Health, HIV/AIDS, Older Women, Safe Motherhood, and RH Resources (including new annotated conference and course listings).

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