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The Pop Reporter®

Volume 4, Number 35
30 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

Hormonal Contraceptive Use, Cervical Ectopy, and the Acquisition of Cervical Infections (research abstract)
Related news article: Injected Contraceptive Raises STD Risk - Study
In this study, use of depot-medroxyprogesterone acetate (DMPA), but not combined oral contraceptives, was significantly associated with increased acquisition of chlamydial and gonococcal infections. The researchers studied about 800 women age 15 to 45 using two clinics in the Baltimore area, one urban, serving mostly black women, and one suburban with a client base of white, college-age women. Most were single. During the study, 45 women acquired a chlamydial or gonococcal infection (6.2 per 100 women-years). DMPA use, but not OC use, was significantly associated with increased acquisition of cervical infections after adjusting for other risk factors.

Trends in the Use of Emergency Contraception: An Epidemiological Study in Barcelona, Spain (1994–2002) (research abstract)
The authors, from the Hospital Universitari del Mar, Universitat Autònoma de Barcelona, Spain, conducted a retrospective review of the medical records of women requesting emergency contraception (EC) at their emergency department over a 9-year period (1994–2002). They found that EC accounted for 5.9% of all visits (n=95,288) and increased from 1.26% in 1994 to 9.82% in 2002. Reasons for EC were condom problems in 79.5% of cases. EC was used only once by 93% of women.

Changing Patterns in Sexually Transmitted Disease Syndromes in Kenya after the Introduction of a Syndromic Management Program (research abstract)
HIV sentinel surveillance among patients with STDs in Kenya found a decline in the proportion of STD syndromes after the introduction of a syndromic management program.

Efficacy of Nonhormonal Vaginal Contraceptives from a Hydrogel Delivery System (research abstract)
This investigation describes the synthesis of a biodegradable hydrogel in a rabbit model.

FAMILY PLANNING/REPRODUCTIVE HEALTH NEWS

Health Round-up:Countdown to ICPD @ 10 (news article)
Related news article: Recalling Cairo Ten Years Later
In September 1994, the United Nations International Conference on Population and Development (ICPD) drew official delegations from 179 countries to Cairo, Egypt. About 11,000 people attended, including government delegations, U.N. agencies, inter-governmental groups, non-governmental organisztions, and the media, making it the largest conference on population and development ever held. Participants negotiated a global Programme of Action that set priorities and time-bound goals to guide national-level policy making for the next 20 years. The international community pledged to make gender equality and human and reproductive rights the foundation of the new agreement and called for universal access to reproductive health services, education, and information, and to lower infant, child, and maternal mortality rates by the year 2015. This year, 2004, marks the 10th anniversary of that halfway mark to 2015. Various activities have taken place at regional levels as a build up to the main event. Tagged "Countdown 2015" to be held from August 31 through September 2, 2004, in London, the event would bring hundreds of invited non-governmental organisations, including the International Planned Parenthood Federation, the largest in the population field, together with government officials and leaders of the United Nations Population Fund, to assess global progress towards goals in women's rights, reproductive health, and poverty allevation.

China Chastises Universities on Sex Education (news article)
Some Chinese universities are being too casual in teaching sex, China's Xinhua state news agency has said. A university class in the southern province of Guangdong had students practising "blowing up condoms like balloons and playing games where the female students pretended to be prostitutes," it said. "We want students to establish a strong knowledge of safe sex so as to avoid sexually transmitted diseases," Xinhua said in its commentary.

Women's Groups in India Call on Men to Take More Active Role in Contraception (news article)
Women's rights activists in India have launched an initiative to improve men's contribution to the country's family planning program.

India: Despite Campaign, Condom Sale Drops (news article)
A decline in sale of condoms in urban and rural areas was recently acknowledged by the Union Health Minister Ambumani Ramadoss.

Uganda: Mrs. Museveni Decries Condom Distribution (news article)
First Lady Mrs. Janet Museveni has lashed out at people who organize get-together parties, invite youth, and distribute condoms to them. "It is like they are pushing them to go into sex. It is not law that our children must have sex," she said.

The Philippines: "Pill Uusers are Empowered, Condom Users Pick Up Girls" (feature article)
A study by a family planning advocacy group showed that Filipinos believe that a person's character is revealed by the family planning method he or she uses.

Ghana: MOWAC to Import One Million Female Condoms (news article)
The Ministry of Women and Children Affairs (MOWAC) is to use part of its HIPC fund allocation to import one million female condoms as part of efforts to help in protecting women from HIV/AIDS and other STDs.

Relaxing a Taboo with Intimate Sex Survey (news article)
China is relaxing strict taboos to conduct its first nationwide female sex survey, asking intimate questions about women's sex lives. The 2004 China Female Sex Survey is being organized by the Chinese Institute of Sexology and the Chinese Medical Association via the popular Internet site Sina.com, Xinhua news agency said.

FAMILY PLANNING/REPRODUCTIVE HEALTH LAW AND POLICY

Zimbabwe: The Blind Beggars and Birth Control (commentary)
In this "Lifestyle" article in The Financial Gazette, South Africa's Leading Business and Financial newspaper, the writer carefully constructs an argument for the sterilization of certain segments of society.

The Philippines: Population and Development Debate (feature article)
The Philippines has 1.2 more children per woman than what she desires, or an unwanted fertility rate of 16%. This, and the actual fertility rate of 19% desired by most Filipino women, will impact future population growth. The author sees both sides of the development debate in this feature article.

What Policymakers Should Know About Drug Resistance and Adherence in the Context of Scaling-up Treatment of HIV Infection (research abstract)
The authors address concerns about drug resistance and adherence and note that experience in developing countries suggests that greater treatment access will help alleviate HIV-related stigma and provide major new incentives for individuals to learn their serostatus, thus strengthening prevention efforts.

Malaysia: 'Marital Rape' Row Erupts Over Call for Husbands' Rights (news article)
A row erupted over comments made by Muslim leaders in Malaysia that a husband could not be guilty of raping his wife. The Malaysian Human Rights Commission (Suhakam) had urged the government to make marital rape a crime, but Perak state mufti Harussani Zakaria said the move went against Islam. "A husband has the right to be intimate with his wife and the wife must obey," he said. "If the wife refuses, then the rule of nusyuz (disobedient) applies and the husband is not required to provide financial assistance to her."

HIV/AIDS RESEARCH

HIV/AIDS Treatment and Prevention in India: Modeling the Cost and Consequences (report)
As the Government of India takes stock of its first four months of distributing free antiretroviral medications for HIV/AIDS, the World Bank has released a study of various public funding options for the months and years ahead, designed to help the government maximize the positive impact of the drugs on the growing epidemic. The study, "HIV/AIDS Treatment and Prevention in India: Costs and Consequences of Policy Options", focuses on ways the government can provide sustainable antiretroviral therapy to the greatest number of people while avoiding dangerous pitfalls such as the development of drug-resistant strains of HIV and a surge in risky behavior by people who mistakenly assume the drugs are a cure for HIV/AIDS. A PowerPoint presentation developed by the report team is also available.

Rural Perspectives on HIV/AIDS Prevention: A Comparative Study of Thailand and Ghana (research abstract)
This paper compares rural perspectives in Thailand and Ghana on the level of condom acceptance in sexual relations, willingness to test oneself for HIV before and in marriage, and sources of information on HIV/AIDS. Results indicate that in the villages studied in Thailand, all single men and most of the single women were in favor of using condoms in sexual relations. This group also showed a positive attitude to HIV/AIDS test before and in marriage. However, married men in rural Thailand disapproved of the use of condoms with their wives but married women in the sample population were open to the possibility of using condoms. Both married men and women were strongly against HIV/AIDS test in marriage.

Improving on Success: What Treating the Urban Poor in America Can Teach Us about Improving Antiretroviral Programmes in Africa (research abstract)
New treatment delivery programs designed to address the concerns for the urban poor in the USA may represent models that can achieve high levels of treatment success in resource-limited countries.

HIV/AIDS NEWS

Kenya: Government to Expand HIV/AIDS Treatment (news article)
The Kenyan government plans to provide anti-retroviral treatment to 181,000 people living with HIV by 2005, a government statement said. The number of beneficiaries would rise to 250,000 by 2010, it added.

Swaziland: New Rapid HIV Test Makes Determining Status Easier (news article)
The University of Swaziland became the first site of a new rapid HIV testing procedure that allows a greater number of people to be tested. The approach of "Negative Determination" is designed to make it easy for those who may still be negative to find that out without having to go to hospitals or special voluntary counselling and testing centers. The "Negative Determination" initiative was tested on about 1,000 new university students last week, using a pinprick technique to draw a drop of blood, which is then placed on a card that detects the presence of HIV antibodies. If a line fails to appear on the card within an hour, no antibodies exist and the person is deemed HIV-negative.

Zimbabwe: With ARVs Beyond Reach, Rural Folk Resort to Herbs (news article)
A subsistence farmer in rural Madlambuzi, western Zimbabwe, painfully retrieves a bunch of thin brown roots from under his pillow, which he breaks into tiny fragments and chews, followed by a cupful of an analgesic herbal concoction that also acts as a sedative. He is among a growing number of HIV/AIDS patients in rural Zimbabwe who resort to traditional medicine because they have no direct access to antiretroviral therapy.

Zambia: Go for Voluntary HIV/AIDS Testing -- First Lady (news article)
The First Lady of Zambia has encouraged people to undergo voluntary counselling and testing to know their HIV/AIDS status and receive proper medication. Speaking in Masaiti and Ndola districts when she visited women clubs, she also advised people not to stigmatize and discriminate against those infected with the disease.

Vietnam's President Visits HIV/AIDS Ward (news article)
Vietnam's president visited an HIV/AIDS hospital ward in Hanoi in a bid to reduce the stigma surrounding the disease and prove that the communist country's leaders are committed to tackling it. The president spoke with several HIV/AIDS patients in Bach Mai Hospital before addressing a room full of medical workers and international representatives about the need for HIV/AIDS prevention, care, and education. The Minister of Health said discrimination and fear surrounding HIV/AIDS have become so widespread in Vietnam that hospital workers are afraid to tell their friends and families that they care for patients infected with the virus. The disease has largely been confined in Vietnam to high-risk groups such as sex workers and intravenous drug users. However, health experts say the epidemic is on the brink of exploding into the general population with infections on pace to increase eightfold to 1 million by 2010.

MATERNAL AND CHILD HEALTH RESEARCH

A Prospective Study of Pregravid Oral Contraceptive Use in Relation to Fetal Growth (PubMed abstract)
Researchers examined whether pregravid oral contraceptive use affects fetal growth and pregnancy hormone levels. They followed 269 women through pregnancy; 79% of the women were pregravid oral contraceptive users. Adjusting for confounders, pregravid oral contraceptive use increased birthweight and placental weight compared with never use. Women with prior oral contraceptive use had higher levels of serum progesterone and oestriol at the 27th gestational week measurement. The effect on birthweight, placental weight and hormones was stronger among those using oral contraceptives in the previous year and those using a high progestin/high oestrogen potency preparation.

Pelvic Floor Morbidity Up to One Year after Difficult Instrumental Delivery and Cesarean Section in the Second Stage of Labor: A Cohort Study (research abstract)
Related news article: C-section Less Likely to Cause Painful Sex Problem
When a pregnant woman's labor is difficult, doctors often must choose between performing a c-section or using instruments to delivery the baby through the birth canal. Now, new research suggests that a cesarean is less likely to cause sexual and urinary problems for the mother.

MATERNAL AND CHILD HEALTH NEWS

UK Boost for Iraq Maternity Care (news article)
A team of UK doctors has helped reduce infant and maternal mortality in Iraq following a pioneering project to improve midwifery practices in the war-ravaged country.

South Africa: PMTCT Continues Despite Nevirapine Controversy (news article)
A program for the prevention of mother-to-child transmission of HIV (PMTCT) will continue in South Africa's Gauteng province. Use of the anti-AIDS drug Nevirapine as a single dose in PMTCT programs is currently under further research following claims by the Medicines Control Council (MCC) that the drug could create resistance in some HIV-positive expectant mothers. The MCC suggested that a combination of antiretrovirals be used for PMTCT instead and the Ministry of Health is expected to make a final recommendation to cabinet on future HIV/AIDS treatment methods as soon as the research is concluded.

MEN'S HEALTH RESEARCH

Male Tolerance Study of 1% C31G (research abstract)
This study was conducted to ensure that male partners of the women in future trials of C31G, which is being studied as a vaginal contraceptive and microbicide, will not be subjected to an undue risk of penile irritation, safety, and acceptability of seven consecutive daily doses of 1% C31G compared with a marketed spermicide, Extra Strength Gynol II® (3% nonoxynol-9) (ES Gynol II). This was a randomized, double-blinded, single-center Phase I study in circumcised and uncircumcised men. Each participant was instructed to apply the study product to his penis at bedtime, to wash it off 6–10 h later, and to record any symptoms on a diary card. Of the 36 men enrolled, 12.5% of C31G users and 16.7% of Extra Strength Gynol II users reported product-related adverse events (AEs). All product-related AEs were considered mild by the investigator, except for one in the ES Gynol II group. Both products were acceptable.

Prevalence and Risk Behaviors of Hong Kong Males Who Seek Cross-Border Same-Sex Partners in Mainland China (research abstract)
A population-based survey of 15,230 respondents found that Chinese male homosexuals crossing the border to search for same-sex partners had a high likelihood of practicing risk behaviors.

MEN'S HEALTH NEWS

Kenya: Local Study Advocates Male 'Cut' in AIDS War (news article)
The 2003 Kenya Demographic and Health Survey reinforces earlier studies across the world that found high levels of HIV/AIDS prevalence in communities where male circumcision is not carried out. The survey found that among circumcised men, three out of every 100 are HIV positive, compared to 13 in every 100 uncircumcised men. The Planning and National Development Minister asked the Ministry of Health to up the campaign nationally for men to get cut and help reduce HIV infection rates.

POPULATION NEWS

'Population Bomb' Is a Dud (feature article)
Remember the population bomb, the fertility explosion set to devour the world's food and suck up or pollute all its air and water? Its fuse has by no means been plucked. But over the last three decades, much of its Malthusian detonation power has leaked out. Birthrates in developed countries from Italy to South Korea have sunk below the levels needed for their populations to replace themselves; the typical age of marriage and pregnancy has risen, and the use of birth control has soared beyond the dreams of Margaret Sanger and the nightmares of the Vatican. The threat is now more regional than global, explosive only in places like India and Pakistan. Ever since 1968, when the UN Population Division predicted that the world population, now 6.3 billion, would grow to at least 12 billion by 2050, the agency has regularly revised its estimates downward. Now it expects population to plateau at 9 billion.

South Korea: Baby-less Society (news article)
Should current trends continue, Korea's population would cease to grow by 2020, shrinking to one third of the present level by 2100. According to the National Statistical Office, the number of newborn babies hit a record low of 493,500 last year, less than half of the 1 million in 1970. The fertility rate, at 1.19 births per couple, is the lowest among OECD member countries.

Singapore Unveils $175 Million Package to Boost Babies (news article)
Singapore announced a S$300 million (US$175 million) baby-boosting package in hopes of reversing an alarming slide in its birth rate to record lows and countering rapid ageing of the population. Measures include bigger housing grants to encourage singles to marry, cash payments of up to S$18,000 if the baby is a third or fourth child, babycare subsidies, tax rebates for working mothers, longer maternity leave, and more leave days for working parents.

Asian Women Lose Faith in Marriage (feature article)
Asia's increasingly well-educated women have lost faith in marriage and more of them are staying single and childless to pursue their careers. "The number of unmarried women in their 30s and 40s in Asia is skyrocketing," Gavin Jones, a professor at Singapore’s Asia Research Institute, told a conference on marriage trends. Twenty-five percent of ethnic Chinese women in Singapore and Malaysia were still single by the time they hit 30. In Thailand, the figure was 20%, he said. The long-term trend has triggered official concern about aging populations that could even shrink in the future.

WOMEN'S HEALTH RESEARCH

Attitudes and Behavior Towards Contraception among Greek Women during Reproductive Age: A Country-wide Survey (research abstract)
Researchers in Greece explored current contraceptive behavior of Greek women during reproductive age. Data were drawn from a country-wide survey conducted with the use of a self-administered questionnaire (n=797 women 16–45 years old). The most common contraceptive method reported was the male condom (MC) (33.9%) followed by coitus interruptus (CI) (28.8%), oral pill (4.8%), and coil (3.6%). Other methods accounted for 5%, and no use of contraception was 23.8%. The majority of respondents (52%) stated that contraception use is the responsibility of men. The probability of reporting that women should be responsible for contraception was higher in women aged 25–34 years, in those with a higher level of knowledge about contraception issues, and in those who had an abortion.

Management of Vaginal Discharge Syndrome: How Effective is Our Strategy? (research abstract)
The authors, from the University of Natal, Durban, South Africa, discuss the syndromic management of STDs in highly endemic areas.

WOMEN'S HEALTH NEWS

Niger: Battle Against Fistula Moves Ahead (feature article)
This article relates the work of NGOs in Niger to combat the terrible consequences of obstetric fistula.

Domestic Violence Plagues Russia (feature article)
This feature article from the BBC addresses domestic violence in Russia, the extent of the problem, how women are coping, and what are local organizations are doing to help.

Uganda: 77% Nebbi Females Prone to Sex Work (news article)
About 77% of women in Nebbi district are likely engaged in commercial sex, according to findings in a new socio-demographic study. The survey revealed that about 17% of the males and 19% of the girls had had sex without condoms.

Kenya: More Females Dying Than Males (news article)
According to the results of a new survey, there are more adult deaths now than 10 years ago, with women bearing the brunt. "The overall mortality rates derived from our data are higher among females than males, which is unusual, since male mortality typically exceeds female mortality during the most productive ages," says the report. The study says that AIDS has altered the age and sex mortality patterns. HIV prevalence in women of reproductive age is nearly twice as much as that of men in the similar age group.

Kenya a Nation of Wifebeaters, Survey Shows (news article)
More than half of the women in Kenya have experienced violence since they were 15 years old, according to a new survey conducted by the Central Bureau of Statistics with the Ministry of Health and other associations. Most of the violence comes from husbands, which accounts for 60% of the beatings reported. And most attacks in the home are fuelled by drink and drugs, the survey found. Husbands who are high on alcohol or drugs are three times more likely to hurt their wives than those who are not.

YOUTH HEALTH RESEARCH

Associations among Condom Use, Sexual Behavior, and Knowledge about HIV/AIDS. A Study of 13,293 Public School Students (research abstract)
This school-based study explored associations between Mexican young people's condom use, other sexual behaviors, and HIV/AIDS knowledge. Students (n = 13,293, 11–24 years of age) from a random sample of public schools in the central Mexican state of Morelos completed a self-administered questionnaire. Average age at sexual debut was 13.6 ± 1.9 years among young men and 14.2 ± 2.2 years among young women; 34.5% of sample participants reported using condoms during their first sexual intercourse. Students knew more concerning HIV transmission than about prevention of HIV infection. Among young men, high levels of HIV/AIDS knowledge increased likelihood of condom use, while among young women high levels of knowledge decreased likelihood of using condoms.

Correlates of Sexual Behaviors with Health Status and Health Perception in Chinese Adolescents: A Cross-Sectional Survey in Schools (research abstract)
In 1999, researchers used a cross-sectional, self-report survey to determine youth risk behaviors in 8,382 students 15-18 years of age from 48 schools in Hong Kong. Three hundred seventy-seven (4.69%) reported that they had had sexual intercourse. Among them, forced sex (16.94%) was common, most often happening to boys (52.38%). The sexually active female students were 6.70 times more likely to attempt suicide than the other group and were more likely to take sick leave.

Franchised Youth Clinics Motivate Behavior Change in Madagascar (research summary)
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A new Research Brief examines survey analysis of Population Services International (PSI)/Madagascar's TOP Réseau adolescent reproductive health program and reveals an increase in healthy behavior during the PSI intervention period. Youth exposed to the PSI program were more likely to know where to find family planning services or STI treatment, to correctly identify STI symptoms, and to have used a condom.

Reproductive Health Needs of Adolescent Males in Rural Pakistan: An Exploratory Study (research abstract)
This exploratory study obtained qualitative information on existing knowledge and perceptions on puberty and reproductive health needs and identified effective communication channels for imparting reproductive health education to adolescent males.

YOUTH HEALTH NEWS

China's AIDS Orphans in Dire Need of Efficient Medication (news article)
China's 76,000 AIDS orphans -- children who have lost one or both of their parents and are suffering from the lethal condition themselves -- are in dire need of medication. No anti-AIDS drugs for children are produced in China, and there are also no systematic imports of from abroad. Under the current circumstances, local hospitals have no choice but to give the children AIDS drugs meant for adults in smaller dosages, even though the practice is sometimes considered dangerous.

Swaziland: New Survey Shows Much Lower HIV Infection among Youth (news article)
A dramatically lower number of Swazi teenage girls are being infected by HIV than was previously estimated, suggesting a turning point in the battle against HIV/AIDS in a country with the world's highest HIV infection rates, a new report has revealed.

Using Entertainment-Education to Reach Youth in Mexico (feature article)
Poverty and overpopulation are two of Mexico's biggest challenges. In Mexico, Population Media Center is working with the Adolescent Orientation Center of Mexico to produce a series of radio mini-serials mixed with talk shows in the five states of Mexico with the highest fertility rates. These programs have been developed by young people and are aimed at youth audiences.

Namibia: MAG Condemns Learners' Involvement in Condom Demos (news article)
The leadership of the Monitor Action Group (MAG) has strongly deplored the use of school learners in the demonstration of condom use to communities during this year's International Condom Day celebration in the Erongo Region.

SPECIAL REPORTS/PROFILES/RESOURCES

Health and Social Services to Address the Needs of Orphans and Other Vulnerable Children in the context of HIV/AIDS in South Africa: Research Report and Recommendations (report)
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This research was commissioned by the South African National Department of Health to inform an appropriate and co-ordinated response to the needs of children made vulnerable in the context of the HIV/AIDS pandemic in South Africa. The project was designed as a multi-site qualitative research project, based in 6 research sites across 5 of South Africa's 9 provinces. Information was collected through a combination of participatory research activities, interviews, focus group discussions, and observation with a range of research participants, including members of 118 households (130 caregivers and 65 children between the ages of 7 and 18 years), and more than 70 service organizations. The research documented the impact of AIDS-related morbidity and mortality on: household form and care arrangements; types and level of responsibility that children assume for domestic chores and caregiving; children's access to basic services; school drop out and attendance rates; and on service providers.

Health in an Age of Globalization (report)
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Disease has traveled with goods and people since the earliest times. Armed globalization spread disease, to the extent of eliminating entire populations. The geography of disease shaped patterns of colonization and industrialization throughout the now poor world. Many see related threats to public health from current globalization. Multilateral and bilateral trade agreements do not always adequately represent the interests of poor countries, the General Agreement on Trade in Services may restrict the freedom of signatories to shape their
own health delivery systems, and it remains unclear whether current arrangements for intellectual property rights are in the interests of citizens of poor countries with HIV/AIDS. However, to the extent that globalization promotes economic growth, population health may benefit, and there has been substantial reductions in poverty and in international inequalities in life-expectancy over the
last 50 years. Although there is a strong inverse relationship between the poverty and life-expectancy in levels, gains in life expectancy have been only weakly correlated with growth rates and, in the last decade,
the HIV/AIDS epidemic has widened international inequalities in life expectancy.

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