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Volume 4, Number 48
29 November 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 Levonorgestrel Subdermal Implants Versus Tubal Ligation for Long-Term Contraception in a Rural Population of Zimbabwe (research abstract)
This prospective cohort study of 257 rural Zimbabwean women was designed to compare patient satisfaction with levonorgestrel subdermal implants (Norplant) versus tubal ligation (TL) as a method of long-term contraception. Women were equally satisfied with both methods. At 1 year, 96% of Norplant users and 97% of the TL group reported being “satisfied” or “very satisfied,” and 98% of Norplant users and 99% of the TL cohort would recommend their chosen method to a friend or relative. Selecting the most appropriate method depends primarily on the potential desire of the woman to have more children.

An Evaluation of Sexually Transmitted Infection Case Management in Health Facilities in 4 Border Provinces of Cambodia (research abstract)
A study of public health facilities providing STI care in four border provinces in Cambodia showed both a high coverage and high standard of care in direct female sex workers attending heath centers with integrated STI services.

Gender and Sexual Health in Clinical Practice in Lebanon (research abstract)
This study examines the readiness of Ob/Gyns in Lebanon to provide sexual consultation, their degree of comfort when discussing issues of sexual health, and their attitudes regarding assessment, treatment, and referral. Most Ob/Gyns reported feeling comfortable discussing sexuality during consultations, however, only one-third of Ob/Gyns nearly always take the initiative in asking patients about their sexual health. Moreover, almost 45% of participating Ob/Gyns did not recognize a strong relationship between reproductive health and sexual functioning.

FAMILY PLANNING/REPRODUCTIVE HEALTH NEWS

India: Delay in Contracts Hits Rural Condom Market (news article)
The delay on the part of the government in finalizing rate contracts for condoms almost every year has caused serious problems for organizations involved in social marketing.

UK Launches Massive Sexual Health Campaign (news article)
The UK government has announced the biggest sexual health campaign since the early days of AIDS in a bid to tackle the rise in STDs.

India: Awareness Up, Spread of STDs Down (news article)
An awareness campaign undertaken among the sex workers of Ahmedabad has shown results. While the spread of STDs among them has been reduced by 50% over the past 4 years, the HIV infection rate has been maintained at 11% to 12%.

India Offers Safe Sex Cocktail (news article)
India, home to the world's second-largest HIV population, may have found a perfect cocktail for safe sex -- a free condom with every bottle of alcohol sold at liquor shops. The southern state of Andhra Pradesh has made it mandatory for liquor shops to hand out a free condom with every bottle of alcohol they sell from December 1, World AIDS Day.

FAMILY PLANNING/REPRODUCTIVE HEALTH LAW AND POLICY

Time to End Dispute Over ABC and Condoms, Say International Experts (news article)
A consensus statement signed by more than 140 HIV/AIDS experts from 36 countries has called for ideological disputes over HIV prevention programs to be replaced by a consensus based on the best available scientific evidence. The statement is published in the November 27th edition of The Lancet.

Singapore May Make HIV Testing for Pregnant Women Compulsory (news article)
The Health Ministry is reviewing the requirements for pregnant women to undergo compusory screening for HIV/AIDS, according to the Senior Minister of State for Health.

HIV/AIDS RESEARCH

AIDS and “Shared Sovereignty” in Tanzania from 1987 to 2000: A Case Study (research abstract)
This case study used the frame of “shared sovereignty” between nation-states and official development assistance agencies to analyze 13 years of technical assistance for HIV/AIDS programs in Tanzania from 1987 to 2000. The study draws on 21 key informant interviews and a systematic review of key program documents. The analysis revealed an uneven and inconsistent level of technical assistance to the NACP with a rotation of multilateral and bilateral donors over the period of study. The Tanzanian government was often ambivalent toward agencies providing assistance towards its HIV/AIDS programs and toward its own NACP.

Theory-Based HIV Risk Reduction Counseling for Sexually Transmitted Infection Clinic Patients in Cape Town, South Africa (research abstract)
A randomized clinical trial of a single session theory-based risk reduction counseling intervention demonstrated positive behavior change effects in a sexually transmitted infections clinic in Cape Town, South Africa.

Nonoxynol-9 100 mg Gel: Multi-site Safety Study from Sub-Saharan Africa (research abstract)
This study evaluates the safety of 100 mg nonoxynol-9 (N-9) gel, a vaginal microbicide, on the genital mucosa of women from Malawi and Zimbabwe in preparation for a phase III efficacy study. HIV-uninfected women (180) were enrolled and randomized to either N-9 or placebo gel and instructed to insert gel into the vagina twice daily for 14 days. N-9 gel 100 mg caused a significant increase in the rate of genital symptoms and epithelial disruptions compared with placebo. Although these findings alone were not sufficient to cancel the planned phase III study, when considered together with the negative results from the COL-1492 effectiveness trial of 52.5 mg N-9 gel, the decision was made to cancel the planned phase III trial of 100 mg N-9 gel.

Perceptions of Risk and Strategies for Prevention: Responses to HIV/AIDS in Rural Malawi (research abstract)
This paper combines quantitative and qualitative data to investigate changes in perceived risk of contracting HIV/AIDS in rural Malawi.

Hormonal Contraception and Risk of Cervical Infections among HIV-1-seropositive Kenyan Women (research abstract)
Related: news article: Hormonal Contraceptives Increase Cervical Infections in HIV-positive Women: Implications for Disease Progression and HIV Transmission
Researches conducted a prospective cohort study of 242 commercial sex workers in Mombasa, Kenya, and followed subjects from the time of HIV-1 infection. After adjustment for demographic factors and sexual behavior, women using the injectable contraceptive depot medroxyprogesterone acetate were at increased risk of Chlamydia trachomatis infection and cervicitis compared with women using no contraception. The use of oral contraceptive pills was associated with an increased risk of cervicitis. Hormonal contraception was not associated with an increased risk of infection with Neisseria gonorrhoeae.

HIV/AIDS NEWS

Violence Against Women Fuels Spread of HIV/AIDS (news article)
This Amnesty International press release reports on the significant link between sexual violence and the spread of HIV/AIDS among women.

Indonesia: Condom Use Still a Major Challenge to Preventing HIV (news article)
Despite continuous campaigning, awareness among high-risk groups of the benefit of using condoms remains a cause for concern among activists fighting the spread of HIV/AIDS here.

South Africa: Partner Violence Puts Women at Greater Risk of HIV/AIDS (news article)
South African women with violent or controlling male partners run a higher risk of HIV infection, according to a study published in the Lancet medical journal.

53,000 Adults Living with HIV in the UK (news article)
There are now 53,000 adults living with HIV/AIDS in the UK, over a quarter of whom (14,300) remain unaware of their infection.

China Approves Testing for Potential AIDS Vaccine (news article)
China has approved human testing of a locally developed potential AIDS vaccine, the official Xinhua news agency reported.

Do Antiretrovirals Make a Difference? (resource material)
The BBC news service is conducting an online poll about the use of antiretroviral drugs.

China to Start HIV Test on Prison Population (news article)
China will start testing the country's prison population this month to identify HIV-positive prisoners, the Ministry of Health said recently.

MATERNAL AND CHILD HEALTH RESEARCH

Prevention of Mother to Child Transmission of HIV: Evaluation of a Pilot Program in a District Hospital in Rural Zimbabwe (research abstract)
This study looks at the pilot implementation of the first program for prevention of mother to child transmission of HIV in rural Zimbabwe. Voluntary counselling and testing services for HIV were provided in the hospital antenatal clinic. 2,298 pregnant women received pretest counselling, and the acceptance of HIV testing reached 93%. Of all 2,137 women who had an HIV test, 1,588 (74.3%) returned to collect their result and 104 (24%) mother-child pairs received nevirapine prophylaxis. This program contributed to the design of the national expansion strategy for PMTCT of HIV in Zimbabwe.

MATERNAL AND CHILD HEALTH NEWS

US: 2003 Sees Highest Caesarean Birth Rate (news article)
More than 27% of the babies born in the United States last year were delivered by Caesarean section, a record high for the surgical method that is a controversial subject among both obstetricians and mothers.

MEN'S HEALTH RESEARCH

Male Reproductive Health: A Village Based Study of Camp Attenders in Rural India (research article)
(You need Adobe Acrobat Reader to access this document)
This study highlights the interest of men in their reproductive health (RH) but also highlights the high proportion of men with RH problems. In addition, a number of men with clinically diagnosed problems had not reported them in the interviews, illustrating either the reticence to report or the lack of knowledge about symptoms of RH problems.

Age-Specific Prevalence of Anal Human Papillomavirus Infection in HIV-Negative Sexually Active Men Who Have Sex with Men: The EXPLORE Study (research abstract)
Related: news article: Prevalence of Human Papillomavirus Infection Differs for Men and Women
The age-specific prevalence of sexually transmitted human papillomavirus infection in women differs substantially from that in men who have sex with men, according to a recent study. The study indicates a high prevalence of anal human papillomavirus infection in all age groups of men who have sex with men.

Effects of Occupational Solvent Exposure on Reproductive Hormone Concentrations and Fecundability in Men (research abstract)
This study examines the effects of organic solvents on male reproductive health. To assess fertility and reproductive endocrine function in solvent-exposed men, researchers investigated time-to-pregnancy using a retrospective cohort design and cross-sectionally measured reproductive hormone concentrations in painters and millwrights compared to a reference group of carpenters. There was no significant association between time-to-pregnancy and any of the solvent exposure indices, but FSH concentrations increased significantly with increasing exposure indices for all solvents and for chlorinated solvents, suggesting adverse effects on men's RH.

Condom Use in Multi-partnered Males: Importance of HIV and Hepatitis B Status (research abstract)
Research from Australia shows that a small number of HIV positive men report unsafe sex with multiple partners.

Duration of Sexual Abstinence: Epididymal and Accessory Sex Gland Secretions and Their Relationship to Sperm Motility (PubMed abstract)
To discover the association between the abstinence period and sperm motility ejaculates from 422 men assessed for infertility were analyzed according to WHO guidelines. Seminal plasma neutral alpha-glucosidase, prostate-specific antigen, zinc and fructose were measured. Three groups were defined according to the length of sexual abstinence: 2-3 days, 4-5 days and 6-7 days. Within the time interval recommended by the WHO (2-7 days), the length of the abstinence period is associated with sperm characteristics and should be taken into consideration when interpreting results of semen analysis.

MEN'S HEALTH NEWS

Niger: Enlisting Men in the Fight Against Fistula (news article)
A number of groups in the country are targeting men in campaigns to rid Niger of obstetric fistulas.

Most Singaporean Men Not Practising Safe Sex Abroad: Survey (news article)
A local study has shown Singaporean men are practicing safe sex at home but are less likely to do so abroad. The study, unveiled at the 4th Singapore AIDS Conference, has shown that as many as 8 in 10 men do not use condoms when they have sex with prostitutes overseas. But when they are in Singapore, almost 9 in 10 men practice safe sex.

POPULATION RESEARCH

Some Strategic Implications of Asian/Eurasian Demographic Trends (working paper)
(You need Adobe Acrobat Reader to access this document)
From the Harvard Center for Population and Development Studies, this working paper examines several questions in the context of the world's most populous, and most economically dynamic, region: Asia. How do human numbers affect the capability of governments to influence events beyond their borders or affect the disposition of a country's interactions with outside actors? And how can population indicators be used to anticipate, with some reasonable hope of accuracy, the impact of yet unfolding
demographic forces on the balance of international power? This paper focuses on the impact of prospective changes over the period 2000 to 2025. The inquiry suggests that demographic trends must be assessed very carefully if their actual strategic significance is to be divined. Not infrequently, the geopolitical import of population trends appears negligible or at best highly debatable. Nevertheless, population forces can be seen altering the realm of the possible. Three broad, but unevenly experienced, demographic changes are identified as having particular potential for influencing the balance of power in Asia: 1) rapid population aging; 2) sustained health setbacks; and 3) rising gender imbalances as reflected in sex ratios at birth.

Marital Coitus Across the Life Span (research abstract)
This study determined if there is consistency in the life course pattern of degradation in frequency of marital coitus. Datasets were drawn from nineteen countries in Asia, Africa and the Americas. It is found that declining coital frequency over time seems a shared demographic feature of human populations, but whether marriage duration, wife’s age or husband’s age is most responsible for that decline varies by country. In many cases, coital frequency actually increases with women’s age into their thirties, but in most cases coital frequency declines with husband’s age and marital duration.

POPULATION NEWS

Uganda: We Need to Regulate Our Population Growth Levels (news article)
The fertility rate of 6.9 children per woman makes Uganda one of the fastest growing populations in Africa, yet the country has the highest levels of unmet needs.

Doomsday Demographics (news article)
Russia is sliding into a demographic abyss, compromising its long-term economic, health, development and security prospects, according a recent report from the National Bureau of Asian Research.

WOMEN'S HEALTH RESEARCH

Refugee Women’s Reproductive Health in Early Resettlement (research abstract)
This paper describes the reproductive health needs and screening rates for breast and cervical cancer for newly arrived (less than 90 days) refugee women in the United States. Patients included refugee women (n=283) newly arrived from Cuba (31.1%), Bosnia (26.1%), Vietnam (24.7%), and other countries (18.0%); age range 18 to 74 years, mean age 34.4 years. Twenty-five percent of women in the sample were pregnant or had a reproductive health problem. A significant percentage older than 40 (86%) had never had a mammogram when compared to American women of the same age (33%).

Burden of Gynaecological Disease in a Tertiary Hospital: Two Years Audit of Outpatient Department at PIMS (research article)
This hospital-based study from the Pakistan Institute of Medical Sciences Islamabad evaluated the extent and nature of gynecological morbidity by women's self reported experiences as well as on findings from clinical and laboratory examinations.

Rich Fools, Spare Tyres and Boyfriends: Partner Categories, Relationship Dynamics and Ivorian Women's Risk for STIs and HIV (research abstract)
This study describes partner categories common to young women in Abidjan, Côte d'Ivoire, the underlying domains of their sexual partnerships, and relationship dynamics that contribute to their risk for STIs and HIV.

Prolonged Lactation Reduces Ovarian Cancer Risk in Chinese Women (research abstract)
This study investigates the effect of lactation on the risk of ovarian cancer for Chinese women. Cases were 275 patients with histologically confirmed epithelial ovarian cancer. Controls were 623 women without neoplasm. Information was collected on total months of lactation, number of children breastfed, and average duration of lactation per child. The adjusted odds ratios were 0.51 and 0.44 respectively for women with more than 12 months of lactation and at least three children breastfed, compared with those with 4 months or less lactation and one child breastfed.

Immediate Complications of Laparoscopic Tubal Sterilization: 11 Years of Experience (research article)
(You need Adobe Acrobat Reader to access this document)
This study reviews and evaluates the complications of laparoscopic tubal sterilization at Maharaj Nakorn Chiang Mai Hospital, Chiang Mai University, Thailand.

WOMEN'S HEALTH NEWS

Breaking the Silence over Violence against Women in Colombia (news article)
A series of recent reports which have brought attention to the horrific violence suffered by women and girls in the context of Colombia's prolonged internal conflict. According to the reports, all sides in the conflict have been guilty of atrocious crimes against women and girls, including rape, murder, torture, kidnapping and sexual mutilation.

Activist Warns Against Genital Mutilation (news article)
Many of Europe's African immigrants are subjecting their young daughters to ritual genital mutilation, and authorities are doing little to discourage it, a leading women's rights activist has warned.

US: More and More Women Over 40 Giving Birth (news article)
A new report by the Centers for Disease Control and Prevention found the number of women over 40 giving birth exceeded 100,000 for the first time in 2003. It also found there were 1,512 first-time mothers between the ages of 45 and 54 last year.

YOUTH HEALTH RESEARCH

The Impact of Cultural Context on Brazilian Adolescents' Sexual Practices (PubMed abstract)
This paper reports on findings from an HIV prevention program in Salvador, Brazil, using Levinson's Condom Self-Efficacy Scale. The data are derived from six focus groups totaling 76 teenagers from three high schools. The focus group discussions explored cultural and psychological issues involved in condom use. Researchers report on the gender dynamics of condom use as revealed by these urban Brazilian teenagers. Three focal points for behavioral change are identified: (1) issues of masculinity, (2) issues of femininity, and (3) condom use skills.

Tolerability of Levonorgestrel Emergency Contraception in Adolescents (news article)
Related: news article: Morning-After Pill Well Tolerated by Teen Girls
This research evaluated the tolerability of emergency contraception in adolescents. In this descriptive study, 1 0.75 mg levonorgestrel tablet was administered to 52 females aged 13-16 with instructions to take the second tablet 12 hours later. Participants kept diaries of side effects and menstrual patterns. Researchers assessed correct use, side effects caused by treatment, and impact on menstrual cycle and found that adolescents tolerated the medication well, experiencing transient side effects.

YOUTH HEALTH NEWS

Zimbabwe: HIV/AIDS Scourge Increases Child-Headed Families (news article)
It is estimated that about 171,000 children between the ages of 0-14 were orphaned last year in Zimbabwe as a result of the AIDS pandemic and the figure is set to rise as the country continues to record more new infections.

BOOKS/BOOK REVIEWS

Global Public Health Communication: Challenges, Perspectives and Strategies (book)
Public health officials are constantly dispensing important health information to the masses through various media outlets. This new book teaches readers important skills and techniques to communicate public health issues effectively, including: health communication in emergency preparedness; the importance of social marketing techniques; public-private partnerships; building direct links between communication and health service delivery by way of pragmatic strategies; maximizing information reach through interdisciplinary planning; and much more.

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Johns Hopkins Bloomberg School of Public Health: The INFO Project

Volume 4, Number 4829 November 2004