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Volume 4, Number 32
9 August 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

Reproductive Consequences of Contraceptive Failure in 19 Developing Countries (research abstract)
The contribution of contraceptive failure in developing countries is much lower than the estimate of 50% in the United States. Despite the substantial increases in contraceptive practice that have occurred in Asia, Latin America, the Middle East, and to a lesser extent, Africa, the level of use is still below the 75% mark achieved in most industrialized countries.

Barriers to Family Planning Service Use among the Urban Poor in Pakistan (research article)
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The type of barrier a woman faces in accessing family planning services is a product of not only her own individual characteristics, but is influenced by the characteristics of her household and other household members.

When Free Condoms and Spermicide Are Not Enough: Barriers and Solutions to Participant Recruitment to Community-based Trials (research abstract)
The authors report their experience of recruiting healthy volunteers to a condom trial, based within primary care and community populations.

FAMILY PLANNING/REPRODUCTIVE HEALTH NEWS

U.S. Researchers Test Free Home Infection Test Kit (news article)
A free kit that allows women to test themselves for an STD in much the same way they can test themselves for pregnancy will be studied across Maryland. The U.S. Centers for Disease Control and Prevention is funding the study at Johns Hopkins University in Baltimore to see if women will use the kit. Many women are left unaware for years that they have an STD because symptoms do not commonly appear for long periods after infection. The kit consists of a packaged, sterile vaginal swab and instructions for using it. The women will have to take a sample and mail it in to a lab using sealed containers and a postage-paid return envelope. They can call a secure telephone number for test results.

Condoms Used to Plug Leaks in Roofs in India (news article)
About 20% to 25% of condoms manufactured in India are used for sexual activity and the rest are used to waterproof roofs, roads, and polish gold embroidered garments, according to a recent study.

Infertility Fear Cripples India's Anti-Polio Drive (news article)
Health workers spearheading an anti-polio drive in Muslim pockets in the impoverished east Indian state of West Bengal where the virus still afflicts many are facing violent opposition due to the popular belief that immunization causes infertility.

Kenya: Condom Crisis Creates Fears (news article)
It is feared that lack of budgetary allocation for contraceptives in the 2004/2005 financial year and the pulling out by international donors from family planning programs could lead to uncontrolled birth rates.

Indonesia: More People Practicing Safe Sex: Survey (news article)
More Indonesians have begun to practice safe sex, with the use of condoms by sexually active people on the rise, according to a new survey. The use of condoms with both regular and nonregular sexual partners increased to 40% and 84%, respectively, among young people last year, from 34% and 75% in 2002, according to a survey by DKT Indonesia, a non-governmental organization dealing with reproductive health.

Turkmenistan: Reproductive Health Shows Signs of Improvement (feature article)
Reproductive health services are improving in Turkmenistan, home to some 6.5 million people, with more women utilising modern methods of contraception, according to officials.

FAMILY PLANNING/REPRODUCTIVE HEALTH LAW AND POLICY

China: Policy Shifts from Punishing Over Births to Encouraging Fewer Births (news article)
Related editorial: At Large: Learning from China
In implementing its family planning policy, China is trying to shift from punishing those who give more births than what the state allows, a practice of more than 30 years, to encouraging those who have fewer children. Beginning this year, rural families who have only one child or two girls will receive award and support from government.

Phillipines: Catholic Church Assails Renewed Family Planning Efforts (news article)
The Philippine Roman Catholic Church assailed yesterday attempts by some legislators to promote family planning, saying the clergy would campaign against them for pushing birth control. The head of the Catholic Bishops' Conference of the Philippines committee on marriage said the bishops would meet with members of Congress to convince them to defeat bills promoting family planning while urging the public not to vote for legislators who are promoting the bill.

African Corruption is a Crime Against Humanity (commentary)
From the commentary in the August 09, 2004 edition of The Christian Science Monitor: "As long as corruption exists at its current levels in Africa, and as long as donors continue to look the other way, foreign aid will simply serve to keep African kleptocrats in power. Consider this: Sub-Saharan Africa has received an estimated $114 billion in bilateral and multilateral aid from 1995-2002. Yet African countries have consistently ended up at the bottom of the United Nations Development Program's Human Development report, which measures life expectancy, gross domestic product per person, and literacy. So you may ask the billion-dollar question: Where did the money go? Perhaps the British high commissioner to Kenya, Edward Clay, was asking the same question about official graft last month when - suggesting donor aid to Kenya could be suspended - he publicly accused unnamed Kenyan officials of behaving so gluttonously at the aid trough that they are now 'vomiting on the shoes' of donors."

UK: Asylum Policy Sparks HIV Concern (news article)
Doctors are concerned that the UK policy of dispersing asylum seekers may lead to increased HIV transmission. More than 100,000 asylum seekers have been dispersed from London and the South East to alternative locations to try to spread the cost of care. But doctors responding to a British Medical Journal survey warned that the policy was disruptive and may compromise HIV care.

Uganda: Law on Malicious AIDS Spread Coming (news article)
The Ugandan Parliament has instituted a committee to establish a law on the malicious spread of HIV/AIDS. This follows a survey by the Uganda AIDS Commission and the World Bank indicating that men with the virus intentionally infected their multiple partners. The survey found that women with the virus were insisting on condom use whereas most men wanted unprotected sex.

HIV/AIDS RESEARCH

Transactional Sex Among Women in Soweto, South Africa: Prevalence, Risk Factors and Association with HIV Infection (research abstract)
Sex workers have long been considered a high-risk group for HIV infection, but to date little quantitative research has explored the association between HIV risk and exchange of sex for material gain by women in the general population. The objective of this study was to estimate the prevalence of such transactional sex among women attending antenatal clinics in Soweto, South Africa, to identify demographic and social variables associated with reporting transactional sex, and to determine the association between transactional sex and HIV serostatus.

Optimizing the HIV/AIDS Informed Consent Process in India (research article)
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Related press release: How Well Informed are Volunteers Giving 'Informed Consent'?
While the basic ethical issues regarding consent may be universal to all countries, the consent procedures required by international review boards which include detailed scientific and legal information, may not be optimal when administered within certain populations. The time and the technicalities of the process itself intimidate individuals in societies where literacy and awareness about medical and legal rights is low. In this study, the authors examined pregnant women's understanding of group education and counseling (GEC) about HIV/AIDS provided within an antenatal clinic in Maharashtra, India. They enhanced the GEC process with the use of culturally appropriate visual aids and assessed the subsequent changes in women's understanding of informed consent issues. Results showed that the use of visual aids during group counseling sessions increased women's overall understanding of key issues regarding informed consent from 38% to 72%. Moreover, if these same visuals were reinforced during individual counseling, improvements in women's overall comprehension rose to 96%.

Decreased HIV Transmission after a Policy of Providing Free Access to Highly Active Antiretroviral Therapy in Taiwan (research abstract)
Related news article: AIDS Drugs 'Can Curb HIV Spread'
Medical research from Taiwan has found that giving AIDS drugs to people infected with HIV can reduce transmission of the virus.

HIV/AIDS NEWS

Preventing Vertical HIV Transmission (news article)
It is now possible to reduce the risk of mother-to-child HIV transmission to below the 2% threshold, as demonstrated by a clinical trial conducted in Thailand by a team of Thai, American, and French researchers as part of the international Perinatal HIV Prevention Trial.

Rwanda to Offer Free Generic AIDS Drugs (news article)
Rwanda will use international aid to offer free generic drugs by year's end to 90,000 people infected with HIV and AIDS, a 20-fold increase in the number of people receiving treatment.

Uganda: No Condoms in New Attack on AIDS (news article)
Uganda will not promote condom use in the new phase of its fight against HIV/AIDS, the Minister of Information, Dr. James Nsaba Buturo, has announced. Debate was sparked when President Yoweri Museveni at an AIDS conference in Bangkok favoured abstinence over condoms in tackling the pandemic. Despite a recent call by the UN that condoms should remain central to tackling HIV/AIDS, the minister defended Museveni's position and took a swipe at multinational companies cashing in on the promotion of condom use.

Togo: Battling Third Highest HIV-Rate in West Africa (news article)
According to government statistics, 6% of Togo's 5 million people are HIV positive, putting the country just behind Cote d'Ivoire with 10% and Liberia with an estimated 8%. But one bright spot is condom use. Packets of six can be found by the bedside in many a hotel room and according to Togo's national AIDS program, there are now some 11 million condoms being sold a year compared to just 7 million in 2002.

Anti-Retroviral Drugs: From Dream to Reality (news article)
The largest AIDS treatment program in Mozambique, that funded by the Italian NGO, the Sant'Egidio Community, claims a spectacular success rate, with 95% of its patients still alive and enjoying a good quality of life.

UN Health Agency De-lists Certain Generic HIV/AIDS Drugs Pending Further Tests (news article)
Three generic HIV/AIDS medicines have been removed from the international list of medicines available to developing countries because manufacturer had not ensured the drugs were equivalent to the original medicines they were supposed to copy.

HIV Vaccine Trial Spat in Cambodia (news article)
Prime Minister Hun Sen on Tuesday urged Cambodians to opt out of a Bill Gates-funded HIV vaccine trial claiming Asia's worst-hit nation was not a test bed for "out-of-date" technologies. Hun Sen's intervention was the latest blow to a troubled study that has already been hit by a delay and a sex industry boycott in a country with the worst infection rate in Asia.

MATERNAL AND CHILD HEALTH RESEARCH

Toxoplasmosis in Pregnant Women in Sanliurfa, Southeastern Anatolia City, Turkey (PubMed abstract)
Blood samples from 1149 pregnant women (age 26.9 +/- 5.3 years; mean 20 weeks gestation) on their first prenatal visit to Obstetrics and Gynecology Department and analyzed for Toxoplasma-specific immunoglobulin (IgM) and immunoglobulin (IgG) by ELISA. 694 (60.4%) of the women were IgG-positive, indicating previous maternal infection, while 35 (3%) were IgM-positive, indicating recent infection, and 420 (38.9%) were sero-negative. The high sero-positive rate may be linked to traditional raw meat consumption.

Clinical Outcomes of Near-Term Infants (research abstract)
Related news article: Warning of Near-term Birth 'Risk'
The purpose of this study was to test the hypothesis that near-term infants have more medical problems after birth than full-term infants and that hospital stays might be prolonged and costs increased. Data from 90 near-term and 95 full-term infants were analyzed. The researchers concluded that near-term infants had significantly more medical problems and increased hospital costs compared with contemporaneous full-term infants. Near-term infants may represent an unrecognized at-risk neonatal population.

Subjective Life Expectancy Predicts Offspring Sex in a Contemporary British Population (research abstract)
Related news article: Optimists More Likely to Have Boys
There is evidence that women who are in poor physical condition or who reside in deprived environments are more likely to give birth to daughters than to sons. Under deprived environmental conditions, or when in poor physical health, it has been hypothesized that parents should take into account the available resources and manipulate the sex of any children born. Using subjective life expectancy (SLE) as a measure of how an individual views their future health and environment, the author demonstrates that there is an association between the sex of the first child and SLE in a sample of mothers from a contemporary British population (Gloucestershire, UK). SLE was a significant predictor of offspring sex: women who believed that they had longer to live were more likely to have had a male birth than women who thought they would die earlier.

An Evaluation of Effects of Intervention on Maternal and Child Health in the Rural Areas of China (PubMed abstract)
The authors, from the West China School of Public Health, Sichuan University, evaluate the impact of training maternal and child health care providers in the rural areas of China on improvement of health care to pregnant and puerperal women. The abstract is in English, the article is available only in Chinese.

MATERNAL AND CHILD HEALTH NEWS

Death of a Disease: Polio Eradication Project Nears End (news article)
By the end of this year, health experts believe they could have eradicated polio from every country around the globe. But experts are now warning that one of the greatest public health achievements of this century could be hindered by a combination of Islamic radicals and a reluctance on the part of some of the richest countries in the world to put their money where their mouths are.

US Launches 'Talking' Book to Help Afghan Women (news article)
The US has launched a talking book in an effort to reduce war-torn Afghanistan's high infant and maternal mortality rates. The book is a joint venture between a leading American developer of technology-based educational products and the US Department of Health and Human Services. They published 20,000 copies of the battery-powered book at a cost of 1.2 million dollars for distribution throughout the country.

Battered Women at Three-fold Risk of Miscarriage: Survey (news article)
A survey published in the Australia and New Zealand Journal of Public Health has revealed that young women exposed to violence are up to three times as likely to have a miscarriage, and are more likely to have a stillbirth, premature birth or an abortion than those free of violence.

MEN'S HEALTH RESEARCH

AIDS-talk in Everyday Life: the Presence of HIV/AIDS in Men's Informal Conversation in Southern Malawi. (PubMed abstract)
Malawi is one of the world's most AIDS-afflicted countries. In order to cope with the AIDS pandemic, we must know what the people most at risk think about it, how they evaluate their situation and that of their community, and what actions they would consider adopting to lower their risk. This paper analyzes journals in order to see how men talk about AIDS in naturalistic settings, what they perceive as the impact of the AIDS epidemic, and how they understand AIDS risk.

Patterns of Use of Sildenafil Among Commercially Insured Adults in the United States: 1998-2002 (research abstract)
Related news article: Recreational Use of Viagra on the Increase
Sildenafil is increasingly being marketed to younger healthcare consumers. The purpose of this study was to profile sildenafil use in commercially insured, adult beneficiaries. Annual ambulatory prescription claims data from 1998 to 2002, for a nationwide, random sample of over 5 million life-years of commercially insured adults (aged 18 y), were examined retrospectively. The overall prevalence of sildenafil use increased from 0.8% (1998) to 1.4% (2002), an 84% increase. While the growth in use slowed in older males, use became more pronounced in younger males and females and decreased in older females.

Determinants of Inconsistent Condom Use with Female Sex Workers among Men Attending the STD Clinic in Singapore (research abstract)
This study assessed the sociodemographic, behavioral, and psychological factors associated with inconsistent condom use among clients of sex workers. Male patients (n=229) attending the STD clinic in Singapore who reported paying for sex in the previous 6 months were interviewed. Overall, 45% used condoms inconsistently; these clients were more likely to have poor STD knowledge, visit sex workers five or more times in the past 6 months, have lower self efficacy, less favorable social norms for condom use, and more likely to forget condom use when intoxicated (alcohol impaired decision making).

MEN'S HEALTH NEWS

Oral Sex Between Men a 'Small but Real Risk' for HIV Transmission, Survey Shows (news article)
Oral sex probably acounts for almost 3% of HIV infections in men who have sex with men, according to the results of a survey of newly diagnosed patients in England, Wales, and Northern Ireland.

POPULATION RESEARCH

Dynamics of Poverty, Development and Population Mobility: The Bangladesh Case (research article)
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The author argues that, contrary to conventional wisdom, which often views permanent migration as a hindrance to rural development, migration (with the help of urban resources) actually expands rural land and labor markets by making more rural land available for tenancy.

POPULATION NEWS

Health Reforms May Reduce Birth Rate (news article)
German health reforms have increased fertility treatment costs and threaten to lower the dwindling annual birth rate, already one of the lowest in the world, by a further 10,000. The reforms, which took affect in January, are an attempt to reduce state spending on the health care system by making patients pay for more drugs and treatment. But doctors at the Federal Association for Reproductive Medicine Centers said higher costs were having a negative effect on Germany's demographics. Fewer couples feel they can afford fertility treatments, which are now among the most expensive in Europe, they added.

Kenya: Fears of Population Upsurge (news article)
Kenya's population growth rate is likely to rise substantially because fewer Kenyans are using contraceptives. Unless the Government provides funds for a campaign to push for greater use of birth control methods, the population - currently growing at 2.5 per cent - would increase significantly. At a workshop on fertility and contraceptive prevalence, population experts attributed the problem to poverty and called for a rescue package to boost family planning programmes.

Iran's Population Growth Rate Falls to 1.5 percent: UNFP (news article)
Iran's government has managed to decrease the rate of population growth significantly to a current rate of 1.5%.

China's Population to Grow by 10 Million a Year in Next Two Decades (news article)
According to the chairman of China's Population and Family Planning Commission, China's total population will continue to grow at a rate of about 10 million a year in the next 20 years. He noted that the rate of growth might only hit zero once the total population has reached close to 1.6 billion. The current population rate in China is estimated to be around 1.3 billion.

WOMEN'S HEALTH RESEARCH

Serum High-Density Lipoprotein Cholesterol, Metabolic Profile, and Breast Cancer Risk (research abstract)
Related news article: Low 'Good' Cholesterol May Flag Breast Cancer Risk
The prevalence of metabolic syndrome (obesity, glucose intolerance, low serum high-density lipoprotein cholesterol [HDL-C], high serum triglycerides, hypertension) is high and increasing in parallel with an increasing breast cancer incidence worldwide. The authors conducted two population-based screening surveys during 1977–1983 and 1985–1987, serum HDL-C was assayed enzymatically among 38,823 Norwegian women aged 17–54 years. Height, weight, blood pressure, serum lipids, fat and energy intake, physical activity, parity, oral contraceptive use, hormone therapy use, alcohol intake, and tobacco use were also assessed. Authors concluded that low HDL-C, as part of the metabolic syndrome, is associated with increased postmenopausal breast cancer risk.

Surgical Repair of Genital Fistulae (research abstract)
Genital fistula is one of the serious childbirth injuries that can occur among women in the developing countries. Complex fistulae still represent a challenging management problem. We report our experience of managing genital fistulae at the Aga Khan University Hospital, Karachi, Pakistan. With an experienced uro-gynecologic team using conventional approach and meticulous repair, a high percentage of patients with genital fistulae can be rendered dry and continent.

WOMEN'S HEALTH NEWS

Sexual Violence in Sudan Camps Often Preventable, Insists UNFPA (press release)
Every night, women leave the relative safety of the Aboushok internal refugee camp to collect firewood. During the day they sell the wood to buy food for their families. The unlucky ones are abducted by marauding militias known as Janjaweed, who beat and rape them repeatedly before setting them free. UNFPA and partners are helping communities organize women’s groups to support victims of sexual violence and help their families and communities cope with broader social aspects, from stigmatization of victims to trauma suffered by their families. The women's groups can also serve as an entry point for treating victims who are initially reluctant to visit hospitals or clinics.

South Africa: Saluting the Courage of Women (feature article)
"...Poverty, abuse and the stigma related to HIV and AIDS are but a few of the factors contributing to the feeling of hopelessness that is so prevalent amongst African women," says Mandisa Kalako-Williams the President of the South African Red Cross Society. In South Africa, Women's Day commemorates the courage of the thousands of women who marched to the Union Buildings in 1956 to protest against the pass laws.

YOUTH HEALTH RESEARCH

Mortality in a Cohort of Street Youth in Montreal. (research abstract)
Related news article: Street Kids at Increased Drug and Suicide Risk-Study
Current heavy substance use and homelessness were factors associated with death among street youth. HIV infection was also identified as an important predictor of mortality; however, its role remains to be clarified. These findings should be taken into account when developing interventions to prevent mortality among street youth.

Dating Violence and Associated Sexual Risk and Pregnancy Among Adolescent Girls in the United States (research abstract)
The objective of this study was to assess the annual prevalence of physical violence from dating partners among a representative sample of sexually experienced adolescent girls attending US public and private high schools, as well as sexual risk behaviors and pregnancy among this population.Female students (9th through 12th grade) (N = 6864) participating in the 2001 National Youth Risk Behavior Survey completed measures of physical dating violence during the previous year, as well as assessments of health risk behaviors. Annual rates of physical dating violence were estimated for sexually experienced (n = 3085) and inexperienced girls. Authors concluded that dating violence is prevalent among US adolescent girls, especially those reporting having had sexual intercourse. Adolescent girls intentionally hurt by a date in the previous year are more likely to experience sexual health risks, including those increasing vulnerability to human immunodeficiency virus infection and other sexually transmitted infections, and to have been pregnant.

Attitudinal and Contextual Factors Associated with Discussion of Sexual Issues During Adolescent Health Visits (PubMed abstract)
The purpose of this study was to examine attitudinal and contextual factors associated with the occurrence of sexual health assessments during adolescent primary care visits. A total of 313 primarily African-American youth aged 11-21 years from 16 community-based organizations in suburban Maryland and in New York City completed questionnaires focusing on sexually transmitted diseases (STD) and health care.The analysis examined the relationship of sexual activity, attitudes, and presence of the parent at the health care visit with discussion of three sexual health topics and testing for STD at the most recent health care visit. The authors concluded that although relatively large numbers of adolescents in the sample received sexual health assessments, the proportion was below recommended guidelines. The opportunity to speak privately with a clinician and having positive attitudes about discussing sex with a doctor appear to be important influences on the receipt of sexual health assessments.

YOUTH HEALTH NEWS

Uganda: Anti-Aids Website for Youth (news article)
The AIDS organisation, Africa Alive Uganda, is targeting the youth with reproductive health messages on behavioural change on its website.

Peer Educators Network Works to Prevent Spread of HIV/AIDS Among Youth in Eastern Europe and Central Asia (news article)
HIV infection rates are rising faster in Central and Eastern Europe and Central Asia than anywhere else in the world. In 2003, there were 230,000 new infections in the region, bringing the total number of people living with HIV to 1.5 million. The worst-affected countries are the Russian Federation, Ukraine and the Baltic States. Worldwide, about half of the 5 million new HIV infections every year occur to young people aged 15-24. Increased awareness of how to avoid HIV infection and promotion of behaviour change are crucial steps in reversing the epidemic. UNPFA and its partners have worked to build the capacity of national non-governmental organizations and government agencies to implement, supervise, monitor and evaluate peer education programmes for young people in the region. The project, which began in the second half of 2000, emphasizes training of trainers along with the development of special education and communication tools.

Kenya: Discussing Sexuality Still Taboo (news article)
In Kenya, discussing sexuality is still taboo. While many adolescents find it hard to come to terms with their sexuality, there are few avenues for them to openly discuss issues affecting them. A leading organisation, Network for Adolescents and Youth of Africa, is actively contributing towards the creation of an enabling environment for adolescents' reproductive health rights.

10,000 Nepalese Children Abused in Six Months (news article)
As Nepal battles a violent insurgency, political instability and development crisis, the worst hit have been children, with over 10,000 minors being affected in the last six months alone. Besides being directly affected by the Maoist movement, children have also been at the receiving end of child marriages, child labor, child deaths and trafficking and prostitution.

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Johns Hopkins Bloomberg School of Public Health: The INFO Project

Volume 4, Number 32 9 August 2004