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The Pop Reporter®

Volume 4, Number 25
21 June 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

Acceptability of an Existing, Female-controlled Contraceptive Method that Could Potentially Protect against HIV: A Comparison of Diaphragm Users and Other Method Users (PubMed abstract)
This study examined how women who use the diaphragm differ from women using the pill and/or condoms with respect to factors hypothesized to influence the acceptability of contraceptive methods. The authors write that their findings suggest that if the diaphragm protects against HIV, it could be a desirable option for some women.

Family Planning Field Workers In Bangladesh as Influence Agents: Some Policy Implications (research article)
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This study examines, from the fieldworkers' perspectives, the extent of influence they have over their clients and the factors that explain their influence. Policy implications are discussed in view of the findings.

Assessment of Quality of Care in Family Planning Services in Jimma Zone, Southwest Ethiopia (research article)
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This study assessed quality of care in family planning services in Jimma Zone, southwest Ethiopia.

The 2002 Canadian Contraception Study: Part 1 (PubMed abstract)
This study investigated the contraception and sexual health-related awareness, attitudes, and practices of a representative sample of Canadian women of childbearing age (n=3,345 women, aged 15 to 44 years). Responses (n=1,582, 47.3%) were weighted to represent Canadian women by region, age, and marital status on the basis of current census data. Eighty-six percent of women sampled had ever had sexual intercourse, and 78% were currently sexually active. Women's familiarity with oral contraceptives and condoms as methods of contraception was high (96% and 93%, respectively), but familiarity with other methods was much lower (sterilization, 62%; withdrawal, 59%; the morning-after pill, 57%; intrauterine devices, 50%; depot [injectable] medroxyprogesterone acetate, 38%). A very favourable opinion was held by 63% of respondents concerning oral contraceptives, by 38% concerning condoms, and by 39% and 28% concerning male and female sterilization, respectively. Among respondents who have ever had sexual intercourse, the most frequently used current methods were oral contraceptives (32%), condoms (21%), male sterilization (15%),female sterilization (8%), and withdrawal (6%). Nine percent of these respondents reported using no method of contraception at all. The currently reported rate of female sterilization is the lowest ever recorded in Canada.

Training Latin American Ministry of Health Service Providers on Emergency Contraception (report)
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This report outlines the background, objectives, activities, and evaluation of a project designed to raise the awareness and acceptability of emergency contraception among different audiences in Latin America.

Can Assisted Reproduction Technology Compensate for the Natural Decline in Fertility with Age? A Model Assessment (research abstract)
Related news article: Waiting Too Long to Have a Baby May Not Be Wise
Women who delay having a child until their late 30s can't necessarily rely on artificial techniques to help them become pregnant, a new study shows. The author says that assisted reproductive technologies like in vitro fertilization cannot compensate fully for the loss of fertility that occurs with age.

FAMILY PLANNING/REPRODUCTIVE HEALTH NEWS

Morning-After Pill Sparks Controversy in Peru (news article)
A move by Peru's health minister to allow free distribution of the morning-after pill has sparked protests in the Roman Catholic country where abortion is banned and unmarried woman have only been allowed contraception for 20 years.

US: Doctors Put Spotlight on Plan B Pill (news article)
The American Medical Association voiced its support for over-the-counter sales of morning-after birth control, saying the FDA was wrong to reject such sales and urging doctors to write advance prescriptions. "The overwhelming data is that it is safe, effective and usable across age groups," said Vivian Dickerson, president of the American College of Obstetricians and Gynecologists. FDA acting drug chief Dr. Steven Galson overruled his own staff to issue the rejection last month. The FDA cited concerns about young teenagers' use of emergency contraception without a doctor's guidance, but Galson said the agency will reconsider the decision if given more data. The 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 only 29 of the 585 subjects enrolled in the study were 14-16 years of age.

Zambia: I'll Encourage Abstinence, Says Chiluba (news article)
Former president Frederick Chiluba said he will encourage abstinence, chastity, and faithfulness in his HIV/AIDS awareness messages to enhance the moral and biblical standing of the country.

FAMILY PLANNING/REPRODUCTIVE HEALTH LAW AND POLICY

India: Centre to Give Licences to Sex Workers (news article)
In a move of far reaching import, the Congress-led United Progressive Alliance government at the centre is planning to introduce a license system for sex workers across India.

Battle Against Sexual Violence: Female Lawyers Bank On President's Hand (news article)
The Female Lawyers Association of Zambia and Women in Law and Development in Africa Zambia have expressed confidence that the battle against sexual and gender-based violence against women and children will be won with the participation of President Mwanawasa.

Colin L. Powell: U.S. Won't Stand by while Humans Are Being Trafficked (commentary)
This column, authored by US Secretary of State Colin L. Powell, explains the Bush administration's stance on human trafficking.

US: House Moves to Help AIDS Orphans (news article)
The House directed the government to increase its help for orphans and vulnerable children in developing countries and moved to set up a new office concentrating on children who lose their parents to AIDS.

HIV/AIDS RESEARCH

Knowledge about AIDS and HIV Risk-related Sexual Behavior among Nigerian Naval Personnel (research article)
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Related news article: Secrecy About HIV in Nigerian Navy Could Be Fueling AIDS Epidemic
Related news article: AIDS 'Killing Africa's Soldiers'
AIDS is now the leading cause of death in military and police forces in some African countries, accounting for more than half of in-service mortality, according to new research. Almost a third of those interviewed admitted having had sex with prostitutes, with nearly a half saying they did not use a condom. Many knew how HIV was transmitted, but more than 50% thought a cure for Aids was already available.

Traditional Beliefs about the Cause of AIDS and AIDS-related Stigma in South Africa (research abstract)
This study examined associations among the belief that AIDS is caused by spirits and supernatural forces, AIDS-related knowledge and AIDS-related stigmas. A street intercept survey with 487 men and women living in a Black township in Cape Town, South Africa showed that 11% (n=54) believed that AIDS is caused by spirits and supernatural forces, 21% (n=105) were unsure if AIDS is caused by spirits and the supernatural, and 68% (n=355) did not believe that AIDS is caused by spirits and supernatural forces. Multiple logistic regression analyses controlling for participant age, gender, years of education and survey venue showed that people who believed HIV-AIDS is caused by spirits and the supernatural demonstrated significantly more misinformation about AIDS and were significantly more likely to endorse repulsion and social sanction stigmatizing beliefs against people living with HIV-AIDS.

The Mass Media and HIV/AIDS Prevention in Ghana (research article)
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The study uses logistic regression to examine how exposure to HIV/AIDS information in the mass media influences knowledge of the disease and risk behaviors in Ghana. It finds that mass media exposure increases awareness of partner fidelity, condom use, and avoidance of parenteral threats as ways of preventing infection and promotes condom use and partner fidelity as likely behavioral responses to the epidemic. Exposure to multiple channels reinforces media messages about safe sex and HIV/AIDS. Radio media seem to be the most powerful sources of information about the epidemic. However, mass media exposure has no impacts on awareness and interest in abstinence and avoidance of commercial sex, which means that they fail to address the needs of the poor women and the young who are the core sources of infection in the Ghanaian epidemic.

Case Study on Estimating HIV Infection in a Concentrated Epidemic: Lessons from Indonesia (report)
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This document focuses on the process that Indonesia undertook in developing its HIV infection estimates and discusses some of the challenges faced, the decisions made, and the lessons learned.

Evaluation of a Brief Computer-mediated Intervention to Reduce HIV Risk among Early Adolescent Females (research abstract)
This study evaluated the efficacy of a brief computer-mediated intervention, relative to no intervention, in altering HIV/AIDS-related knowledge, protective attitudes, and self-efficacy for risk reduction among early adolescent females aged 11 through 14 years in New York City.

HIV/AIDS NEWS

Estimates on HIV Called Too High: New Data Cut Rates for Many Nations (news article)
Estimates of the number of people with the AIDS virus have been dramatically overstated in many countries because of errors in statistical models and a possible undetected decline in the pandemic, according to new data and specialists on the disease. In many nations, analysts are cutting the estimates of HIV prevalence by half or more. Rwanda, for instance, a new United Nations estimate due out next month will put HIV prevalence at about 5%, according to Rwandan officials, down from more than 11% 4 years ago. In Haiti, a recent unpublished study by the Centers for Disease Control and Prevention has found HIV prevalence was less than 3%, compared with the UN's most recent estimate of 6%. And the numbers in India are coming under increasing scrutiny because surveys in AIDS hot spots are indicating a prevalence rate that is much lower than the national average.

Researcher Boasts Breakthrough in AIDS Test (news article)
A new test for the AIDS virus that detects proteins inside the microbe may be more sensitive than existing tests, U.S. researchers said.

WHO Statement on Removal of Two AIDS Medicines from List of Prequalified Products (press release)
Related news article: WHO Removes Indian Generics from AIDS Drugs List
The World Health Organisation said on Thursday its decision to remove two Indian generics against HIV/AIDS from its list of recommended drugs should not harm the UN agency's bid to boost treatment in poor countries.

Zimbabwe AIDS Conference Ends (news article)
Zimbabwe's first national conference on AIDS ended Friday with a series of recommendations on dealing with the disease. The meeting brought together more than 700 delegates from governments, the private sector and civic groups.

Botswana: Message in AIDS program faulted (news article)
The country's success in providing the latest medicine to treat AIDS patients in villages of dirt-floor huts hides a darker reality — the deadly disease continues to spread at alarming rates.

AIDS Treatment: Striving for Universal Access in the Americas (press release)
Today Latin America and the Caribbean lead the developing world in providing HIV/AIDS treatment, accounting for more than half of all people on antiretrovirals in developing countries, according to this press release from the Pan American Health Organization (PAHO). These life-saving drugs have changed the face of AIDS, and the region is striving to provide universal access to them, according to "Casting the AIDS Lifeline," an article in the latest issue of PAHO's magazine, Perspectives in Health.

Viet Nam Strives to Keep HIV/AIDS Rate Below 0.3 Percent by 2010 (news article)
Measures to achieve the target of keeping HIV/AIDS infection rate below 0.3% by 2010 were discussed at a conference to launch a national strategy on HIV/AIDS control until 2010 and the vision 2020 in Ha Noi at a conference that was co-organised by the National Committee for AIDS, Drugs and Prostitution Control and the Public Health Ministry.

MATERNAL AND CHILD HEALTH RESEARCH

Maternal Heath-Care Service Use among Rural-Urban Migrants in Mumbai, India (research article)
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The objective of this study is to identify and compare the nature, prevalence, and typology of maternal and child health service utilization by rural-urban migrant and non-migrant populations in Maharashtra, India. In addition, the research aims to identify key social, cultural, and economic influences on service utilization and suggest possible ways to increase the use of maternal health-care services among recent migrants to Mumbai.

Perinatal HIV-1 Transmission among Low Income Women Participants in the HIV/AIDS Control Program in Southern Brazil: A Cohort Study (research abstract)
Researchers determined the rate and factors associated with perinatal transmission among women infected with HIV-1. Perinatal transmission was assessed in 343 children; overall, the transmission rate was 3.2%. In multivariate analyses, the only independent risk factor for perinatal transmission was the maternal viral load at baseline.

Patterns and Determinants of Utilization of Maternal Health Services: Implications for Reducing Maternal Mortality and Morbidity in SouthEast, Nigeria (research abstract)
This paper determined the patterns of utilization of Maternal Health Services (MHS), (antenatal clinic, delivery and post-natal services), and willingness to stay in a maternity waiting home (MWH) by women. A pre-tested questionnaire was used to collect information from 393 adult women from rural and urban communities on their experiences at last pregnancy and delivery. The authors found that most women used MHS; explanatory indicators were age, educational level, parity, social class, and place of residence. Long waiting hours, perceived high cost of services, lack of drugs, negative staff attitude, and inaccessibility were common reasons given for non-utilization of MHS.

Analysis of Postpartum Complications in Relation to Selected Delivery Characteristics in Rural Bangladesh (research article)
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This paper identifies the possible risks of occurring postnatal complications among the rural women of Bangladesh in relation to their selected delivery characteristics.

MATERNAL AND CHILD HEALTH NEWS

Angola Moves to Cut Infant, Maternal Mortality (news article)
The Angolan government has unveiled a strategic plan to reduce the third highest infant mortality in the world with one in four children in the country dying before the age of five.

Uganda Takes Measures to Help Children Orphaned by HIV/AIDS (news article)
The Ugandan Minister of Youth and Children Affairs has said that the government is to take measures to help children orphaned by HIV/AIDS.

MEN'S HEALTH RESEARCH

Men Who Have Sex with Men in Cambodia: HIV/AIDS Vulnerability, Stigma, and Discrimination (report)
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This report consists of a literature review, key informant interviews focusing on the programmatic environment, focus group discussions to gain some indication of the target population’s perceptions of unmet needs regarding HIV and sexual health, and limited mapping of current MSM sexual and social sites and networks. The report aims to promote increased attention to the issues of MSM and HIV vulnerability in Cambodia as well as collaboration between agencies addressing these issues.

Contraceptive Practice among Married Market Men in Nigeria (research abstract)
Using a cross-sectional survey, researchers investigated the contraceptive knowledge, attitude and practice among 450 married market men in llesa Main Market, Osun State, Nigeria. All the men were aware of family planning, and 60.9% were currently using a form of contraception with their spouse. Reasons for non-contraceptive use by 39.1% of the respondents included family size not yet complete, religious opposition, and fear of contraceptive failure. Christianity and education were significantly associated with contraceptive use and knowledge.

Ectoplasmic Specialization, a Testis-specific Cell-cell Actin-based Adherens Junction Type: Is This a Potential Target for Male Contraceptive Development? (research abstract)
This review highlights recent advances in the areas of research for potential male contraceptive.

Studies on the Membrane Integrity of Human Sperm Treated with a New Injectable Male Contraceptive (research abstract)
This study evaluates the integrity of sperm surface characteristics in the presence of a new male contraceptive, RISUG.

MEN'S HEALTH NEWS

Canada: 27 Per Cent of HIV Positive Gay and Bisexual Men May Not Know They are Infected (news article)
Up to 27% of gay and bisexual men in Ontario who are HIV positive may not know they are infected, says a University of Toronto study. The newly released Ontario Men's Survey is a socio-behavioural and HIV prevalence study of self-identified gay and bisexual men, conducted by a team of researchers from U of T’s HIV Social, Behavioural and Epidemiological Studies Unit.

POPULATION RESEARCH

Fertility Transition and Female Rational Choices in Egypt (research article)
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This study used the 1995 Egypt DHS and the probit maximum likelihood method to study the relationships among three related fertility desires. Findings indicate that future fertility desires and contraceptive use are becoming endogenous to each other. The relationship between female employment and fertility desires is not typical of a country at post-transitional stage of fertility. The idea of wife's opportunity cost and rational choices is not yet valid. A dramatic decline in fertility should not be expected.

Increasing Ethnic Differences in Mortality in Estonia after the Collapse of the Soviet Union (research abstract)
This study examined the change in ethnic differences in mortality in Estonia 1989–2000.

A Spatial Analysis of Childhood Mortality in West Africa (research abstract)
This study estimates the risk of infant and child death in 10 West African countries attributable to individual, household, and spatially explicit geographical factors; 120,000 births occurring in the 10 years prior to the 1997-2001 Demographic and Health Survey dates are evaluated. Results from a generalized linear model show that spatial variables explain away a good deal of the country-specific variation in mortality, and that they are associated with (and may be mediated by) the household characteristics. Implications for research and policy are addressed.

WOMEN'S HEALTH RESEARCH

Early Age of First Sex: A Risk Factor for HIV Infection among Women in Zimbabwe (research abstract)
This study explores the relationship between early age of coital debut (15 years of age or younger) and risk for HIV infection among sexually active urban women (18-35 years) who were recruited from public sector family planning clinics in and around Harare, Zimbabwe. Of the 4675 women screened, 4393 (94%) had complete data on sexual behaviors and HIV serostatus; the HIV prevalence in this sample was 40.1%. The median age of coital debut was 18 years and 11.8% of women reporting having experienced coital debut at age 15 or younger. Women with early coital debut had a significantly higher risk profile, including multiple lifetime partners and not completing high school.

Fattening "Nkuho" as Instrument of Women Empowerment and Fertility Control Among Calabar Women in Nigeria (research abstract)
This study was conducted to explore and describe the experiences of women on the fattening room practices as an instrument of empowering women's reproductive rights.

Ovarian Reserve and Reproductive Age May Be Determined from Measurement of Ovarian Volume by Transvaginal Sonography (research abstract)
Related news article: Scientists 'Predict Menopause Age'
Scientists have developed a method that aims to predict how fast a woman's biological clock is ticking and when she is likely to go through menopause. They say the test will also help women who are considering whether to delay having children, for professional or personal reasons.

WOMEN'S HEALTH NEWS

Gulf Women Pushing Ahead on Education, Vote (news article)
Saudi Arabia has begun a national discussion of women's rights. It's one of the signs of women's rapid advancement in the six-country Gulf Cooperation Council, one of the most male-dominated regions of the Arab world.

Mali: Excision Practiced Where Pre-Islamic Traditions Strongest (news article)
The overwhelming majority of women in Mali still undergo female circumcision in their youth, but attitudes are changing, and now a US$2 million public awareness campaign by Plan International is set to change them even faster.

Senegal's Husband Worshippers (news article)
Cases of domestic violence against women are common in Senegal's southern region of Casamance. Yet it is rare for a woman in the Casamance to reveal publicly that her husband is abusing her. One of the reasons is that most women believe that it is only their husbands who can bless them.

Indonesia: STDs Rise among Sex Workers (news article)
More than 1,900 prostitutes operating in the two red-light districts of Dolly and Jarak have contracted STDs, a health official has said. The Surabaya health agency's head of communicable diseases said poor attention to safe sex had caused the rise in STD cases.

Indonesia: Violence against Women Up in NTB (news article)
The incidence of domestic and other forms of violence against women has increased significantly in West Nusa Tenggara (NTB) province during the past year. More than 3,500 complaints were filed with various institutions, including the provincial social affairs office and nongovernmental organizations, in the period from last year to this month, compared with only 729 cases reported in 2002.

Kenyan Men Reject 'Mutilated' Women (news article)
A new generation of men from western Kenya, where female genital mutilation is widely practised, say they are abandoning their "mutilated" wives and girlfriends for sexual partners across the border in Ugandan.

Over 70 Sex Slaves Freed in Russian Far East (news article)
Law enforcement services have freed 72 girls in the Primorsky territory in the Russian Far East, saving them from their transfer abroad to serve as sex slaves.

YOUTH HEALTH RESEARCH

Behavioural Responses of South African Youth to the HIV/AIDS Epidemic: A Nationwide Survey (research abstract)
The present study investigated the behavioural responses of South African youth to the HIV/AIDS epidemic. A multi-stage stratified cluster sample of 2,430 youths aged 15-24 was selected, 46.9% of them males and 53.1% females. The median age of sexual debut for both sexes was 16.5 years; most of the youths were sexually experienced with no variation by sex; sexual experience was highest among Africans living in informal urban areas; partner turnover was low and multiple partners were more common among African males living in urban informal settings; sexual frequency among sexually active youth was relatively low; secondary abstinence during the past 12 months was 24%; condom use at last sexual intercourse was high, at 52.8% for males and 47.6% for females, especially among Africans living in urban informal settings; and the majority of youths (74%) indicated that they had discussed HIV prevention with their partners during the past 12 months.

The Development and Pilot-testing of a Training Curriculum in Adolescent Medicine and Health (research abstract)
This paper outlines the development, content, and field testing of a training curriculum in adolescent health and medicine, which is freely available on the Internet (www.euteach.com).

Evaluation of a School-based Intervention for HIV/AIDS Prevention among Belizean Adolescents (research abstract)
This study evaluates the impact of a cognitive-behavioral peer-facilitated school-based HIV/AIDS education program on knowledge, attitudes, and behavior among primary and secondary students (n=150) from six schools in Belize City. A quasi-experimental research design was used to assess the impact of a 3-month intervention. Seventy-five students received the intervention and 75 students served as controls. At the follow-up assessment, the intervention group showed higher HIV knowledge, were more likely to report condom use, had more positive attitudes toward condoms, and were more likely to report future intentions to use condoms than the students in the control group. Overall, the findings indicate that the intervention had a positive impact on participants.

Alcohol Use and HIV Risk Behaviors among Rural Adolescents in Khanh Hoa Province Viet Nam (research abstract)
As part of a randomized control effectiveness trial for an HIV prevention program, 480 Vietnamese youth (15-20 years old) living in eight rural communes in Khanh Hoa Province were administered a paper and pencil baseline evaluation. While young men were significantly more likely to drink than young women, those young women who did drink were as likely to report intoxication. Alcohol use was significantly associated with engagement in sexual behaviors and intention to engage in sexual behaviors.

Determinants of Teenage Pregnancy in Rural Communities of Abia State, South East Nigeria (research abstract)
Researchers investigated the determinants of teenage pregnancies in a rural community. Of 359 girls (aged 10-19 years), 263 (73.2%) were single, 210 (58.5%) were currently enrolled in schools. The mean age at first sexual intercourse was 14.3 years and rate of ever-use of the male condom by their sex partners was 40.9%. The prevalence of teenage pregnancy was 163(45.4%). Teenage pregnancy was significantly associated with age, occupation, no education, early marriage, religion, and practice of "Osu" caste system.

Does Knowledge about Sexually Transmitted Infections Increase the Likelihood of Consistent Condom Use? (research abstract)
This study assessed the association between knowledge about STIs and consistent condom use among university students at the University of Tirana, Albania, controlling for selected socio-demographic factors. There was an overall association of knowledge about STIs with consistent condom use. There was evidence for an interaction between knowledge and parental education: there was a positive association among students with highly educated parents, and particularly so among students with low-and-middle educated parents.

YOUTH HEALTH NEWS

Swaziland: Pregnant School Girls No Longer Face Expulsion (feature article)
High school girls who fall pregnant will no longer be expelled from their schools, the Swaziland Schools Headteachers Association resolved last week. The policy change overturns what has been standard practice since before independence, when Christian missionaries established schools in Swaziland.

South Africa: Youth Get Wrong Message On AIDS (news article)
Many South African teenagers are engaging in anal sex in the belief it will protect them from HIV/AIDS and keep their virginity intact. The youngsters also favour the high-risk practice over conventional sex because it avoids unwanted pregnancies. Despite the fact that anal sex carries the highest risk of HIV infection, at least 15% of 800 Grade 8 to 12 pupils surveyed at four urban and rural high schools in KwaZulu-Natal considered it a safe alternative.

Slavery of Children and Women in Persian Gulf Countries (feature article)
This feature article from Persian Journal reports on the slavery of children and women throughout the gulf region.

HIV/AIDS Takes Hold in Russia, Devastating Youngsters (feature article)
HIV already has taken hold among Russian prisoners, prostitutes, and hard-drug injectors. The groups now under siege are teenage girls and young women, leading to horrifying spikes in the number of children born with HIV.

SPECIAL REPORTS/PROFILES/RESOURCES

Victims of Trafficking and Violence Protection Act of 2000: Trafficking in Persons Report (report)
This year's report focuses more attention on sex tourism and the demand it creates for children exploited by traffickers in commercial sex settings. It represents an up-to-date and comprehensive look at the nature and scope of modern-day slavery, and the broad range of actions being taken in the global campaign for its elimination.

Guidelines for Assessment of Skilled Providers after Training in Maternal and Newborn Healthcare (resource material)
This manual contains tools for assessing provider knowledge, clinical decision-making, and skill competence on the job. The assessment tools are based on the World Health Organization international guidelines Managing Complications in Pregnancy and Childbirth: A Guide for Midwives and Doctors (2000) and the JHPIEGO reference manual entitled Basic Maternal and Newborn Care: A Guide for Skilled Providers (2004). The assessment tools consist of knowledge questionnaires, skills checklists, and case studies in the areas of antenatal care, normal labor, childbirth, and immediate newborn care, postpartum care (mother and baby), and management of complications. There are also tools for data collection, and a section on analyzing and using data collected during the followup visit. The Guidelines were field-tested in Burkina Faso, Guatemala, Haiti, Indonesia, and Nepal.

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