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The Pop Reporter®

Volume 4, Number 49
6 December 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

Monitoring Trends in Sexual Behaviour in Zambia, 1996–2003 (research abstract)
This paper assesses the evidence of changes in sexual behavior in Zambia with data from five nationally representative household surveys carried out between 1996 and 2003. There is some evidence for an increase in men’s age at first sex. The proportion of people reporting multiple partnerships and not using a condom at last sex has declined since 1996. Unprotected sex with non-cohabiting partners is reported less frequently in the later surveys. The socioeconomic and demographic composition of the survey samples has changed across the years but the declines in behavior remain statistically significant after adjustment for these changes.


Fifty Ways to Leave Your Rubber: How Men in Mombasa Rationalise Unsafe Sex (research abstract)
This research explores the reasons why men who have sex with sex workers in Kenya refuse to use condoms. Analysis of the participant observations revealed at least 50 reasons for not using a condom, which we grouped into six categories: condoms are not pleasurable, condoms are defective, condoms are harmful, condoms are unnecessary, condoms are too hard to use, and external forces prohibit using condoms. The most important conclusion is that men who pay for sex do so because it is pleasurable and many men do not find the male condom pleasurable.


Africa: A Report Card on Sexual Health and Rights (report)
(You need Adobe Acrobat Reader to access this document)
This report from Population Action International examines progress made towards achieving the goal of reproductive health and rights for all by 2015, agreed at the 1994 International Conference on Population and Development (ICPD). Key achievements include a significant increase
in contraceptive use, and higher secondary school enrolment rates among girls. However, significant challenges remain, notably: high unmet need for effective contraception and protection from HIV/AIDS and STIs; continuing high levels of maternal mortality; and an acute and growing resource shortfall.


Monitoring Trends in Sexual Behaviour and HIV/STIs in Peru: Are Available Data Sufficient? (research abstract)
This study reviewed and summarized various types of Peruvian evidence on sexual behaviour, HIV/STI exposure and risk, and discussed how to increase its usefulness for HIV/STI risk trend monitoring in Peru. Data from HIV sentinel surveillance showed very high (8-23%) HIV seroprevalence among men having sex with men, but stable, relatively low figures among female sex workers (1%). single women increased their sexual activity throughout the 1990s but did not raise their contraceptive use accordingly while the contribution of condoms to overall contraceptive protection increased threefold in 1992-2000. Better and more timely data is needed for more accurate results.


Promoting "Dual Protection" From Pregnancy and Sexually Transmitted Disease: A Social Ecological Approach (research abstract)
This study uses a social ecological model to identify causal, contextual, and intervening factors that influence dual protection. Findings from interviews with US women completing a sexually transmitted disease clinic process illustrate the levels where intervention to promote the concept of dual protection and associated behaviors might occur. This framework offers an understanding of complex factors that influence dual protection and also presents an opportunity to consider strategies for promoting dual protection that include interventions at the structural/environmental level, the social/interpersonal level, and the individual level.

FAMILY PLANNING/REPRODUCTIVE HEALTH NEWS

India Introduces Female Condoms to Fight HIV/AIDS (news article)
Women in India can now better protect themselves against HIV/AIDS, with the introduction of the female condom in the country.


Shanghai Installs Smart Condom Machines (news article)
Two hundred smart condom vending machines have been installed in entertainment venues, wet markets, residential buildings, and business centers in Xuhui District and Pudong in recent days to mark World AIDS Day.


Access to Sexual Health Information in Iran (feature article)
Health professionals need access to relevant, reliable sexual health information to prevent and control STDs and HIV/AIDS. Until recently, access to such information has been difficult in Iran, but with the arrival of the Internet, the situation is starting to improve.


China: Premarital Check-up Vital to Family Health (feature article)
The new Marriage Registration Regulation made pre-marriage health check-up optional from October 1 last year dropping the rate of premarital health checks sharply. At the same time, the number of new borns with inherited diseases has been rising steadily.

FAMILY PLANNING/REPRODUCTIVE HEALTH LAW AND POLICY

Building Knowledge for Better Aid: A New Trend? (news article)
Many donor agencies are beginning to emphasise the importance of knowledge for development. This refers to the knowledge that organisations gain through their own and others experiences of developing and implementing projects. Donors claim to be interested both in learning from others as well as spreading their own knowledge to other development practitioners. Despite this, a key question is whether aid organisations focus on their own needs rather than those of developing countries. “Without any real exchange of knowledge, it is likely that aid agencies could focus just on becoming better at learning from their partners or just emphasise on a ‘one-way transfer’ of their knowledge to partners in developing countries.”


Uganda Takes Control of Its Relationships with Donors (feature article)
Uganda is a low-income country with low levels of domestic revenue: 48% of the government’s expenditure is provided through donor aid. Despite this high level of dependency, networks of trust between government officials and their donors have allowed the Ugandan government to have a control over the country’s development process. Uganda’s growing reputation for sound economic management and commitment to poverty reduction has also helped to achieve this. Can other countries draw lessons from this experience?

HIV/AIDS RESEARCH

AIDS Epidemic Update 2004 (report)
The annual AIDS epidemic update, issued by UNAIDS and the WHO, reports on the latest developments in the global HIV/AIDS epidemic. With maps and regional summaries, the 2004 edition provides the most recent estimates of the epidemic's scope and human toll, explores new trends in the epidemic's evolution, and features a special section on women and AIDS. The report is available in English, Spanish, French, and Russian.


Does STI Treatment Prevent HIV? Reconciling Trial Results in Uganda and Tanzania (research review)
STIs enhance HIV transmission, but trials of STI treatment to prevent HIV in Tanzania and Uganda gave contradictory results. A collaborative project funded by the Department for International Development suggests that the stage of the epidemic and reductions in risky sexual behavior in Uganda could explain these differences.


Going to Scale in Ethiopia: Mobilizing Youth Participation in a National HIV/AIDS Program (report)
(You need Adobe Acrobat Reader to access this document)
This case study describes a collaboration between the Ministry of Youth, Sportsand Culture, and the YouthNet and IMPACT Projects of Family Health International that was supported with funding from USAID. The study documents a successful youth-adult partnership that used youth-led Participatory Learning and Action as an effective methodology for empowering young people to communicate with each other and with adults about their sexual and reproductive health needs.


The Health Sector Gap in the Southern Africa Crisis in 2002/2003 (research abstract)
The southern Africa crisis represents the first widespread emergency in a region with a mature HIV/AIDS epidemic. It provides an example for understanding and responding to the complex interactions between the epidemic and the causes and the effects of this crisis. The authors argue that the over-emphasis on food aid delivery occurred at the expense of other public health interventions, particularly preventative and curative health services. Health service needs were not sufficiently addressed despite the early recognition that ill-health related to HIV/AIDS was a major vulnerability factor.


Community, Care, Change, and Hope: Local Responses to HIV in Zambia (report)
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This case study describes The Salvation Army response to HIV in Zambia. It specifically examines a current partner, the Lusaka Change Programme, in order to portray the response in action, to assess its challenges and successes, and to depict the people and communities involved.


Prevalence of HCV Coinfection in HIV-infected Individuals in Nigeria and Characterization of HCV Genotypes (research abstract)
While prevalence studies on HIV/HCV coinfection have been performed in the U.S. and in some European countries, little is known about coinfection rates in Africa. This study collected specimens from 146 confirmed HIV-positive individuals in Nigeria and found that 8.2% were HCV positive. Coinfected individuals were more likely to be male, older, and have lower CD4+ cell counts than HIV-monoinfected individuals, although none of the differences reached statistical significance.


Developing a Participatory Monitoring and Evaluation Plan: Case Study of an NGO Capacity Building Project in Mexico (report)
(You need Adobe Acrobat Reader to access this document)
This case study provides a record of how a group of leading Mexican NGOs participated in the development of a project planning matrix designed to represent International HIV/AIDS Alliance activities in Mexico and set indicators and collect data required to show project results. The project reached 64 different groups in three priority states in its first year and results show the organizations established a foundation for a more strategic, community-based response to the AIDS epidemic
in Mexico.

HIV/AIDS NEWS

China: HIV Cases Rising, True Figure Unknown (news article)
More than 20,000 new HIV positive cases have been officially reported in China since 2002, but estimates of a far greater number of still unknown carriers present a huge challenge in quelling the epidemic.


Groups Says Condom Limits Sap AIDS Fight (news article)
Related: resource material: Access to Condoms and HIV/AIDS Information
Criticism of condoms and restrictions on access to them are undercutting the fight against HIV/AIDS in countries ranging from Nigeria to Peru to the United States, Human Rights Watch said in a recent report.


South African Firms Hire Expert Help to Battle AIDS (news article)
South African companies battling one of the world's worst HIV caseloads are turning to a growing battalion of professional AIDS managers to help stop the deadly pandemic ravaging their workforces.


Southern Africa: HIV/AIDS May be Undermining Democracy (news article)
Between 1999 and 2003 almost 1.5 million of about 20 million registered voters in South Africa were removed from the voters’ roll because they had died – most, it appears, from AIDS-related diseases.


Democratic Republic of Congo: HIV - The Longest Lasting Scar of War (news article)
Mass rape in the DRC has contributed to the spread of HIV, which is predicted to have a catastrophic future effect on the health of the country.


World Marks AIDS Day, China Gets Tough (news article)
On World AIDS Day, China, criticized for its slow initial response to HIV/AIDS, put on a public display of commitment to fighting a disease which the United Nations fears could infect 10 million Chinese by 2010.


HIV Laws Around the World (news article)
In Africa, many countries that have been affected by HIV/AIDS have HIV-related clauses inserted in their laws.


HIV Infections Mount in Uzbekistan as Prostitution Rises (news article)
There are an estimated 32,000 Central Asians between the ages of 15 and 49 infected with HIV and AIDS. In Kazakhstan, Kyrgyzstan, and Uzbekistan, nearly one-third of them are women, many of them prostitutes.


Texts Aim to Fight AIDS in Kenya (news article)
A new mobile phone text message service is joining the battle against HIV/Aids in Kenya. People will be able to text questions on the subject to a special number and receive a prompt answer for free.

MATERNAL AND CHILD HEALTH RESEARCH

The Effect of Maternal Education on Gender Bias in Care-seeking for Common Childhood Illnesses (PubMed abstract)
This paper assessed gender bias within hospitalization rates to ascertain whether differential care-seeking practices significantly contribute to excess female mortality. It then examined the impact of socio-economic factors, particularly maternal education and economic status, on gender bias. Results show that gender bias is highest amongst highly educated mothers, and decreases as education decreases. Economic status was not found to affect the association of gender and hospitalization and neither did paternal education.


Association between Maternal Age and the Likelihood of a Cesarean Section: A Population-based Multivariate Logistic Regression Analysis (PubMed abstract)
This study uses population-based data from Taiwan to explore the relationship between maternal age and the likelihood of a CS. CS rates for the age groups <20, 20-29, 30-34 and >34 years were 17.7, 27.4, 37.4 and 47.5%, respectively. The regression analyses consistently showed that the likelihood of a CS significantly increased with advancing maternal age within each category of complication after adjusting for medical institution characteristics and characteristics of the attending physician.

MATERNAL AND CHILD HEALTH NEWS

Angola: HIV Infection Rate for Pregnant Women at 2.8 Percent (news article)
The rate of HIV infection among pregnant women in Angola is 2.8%, half earlier estimates, according to a new national study.


China: Ministry Announces Major Gap in Rural, Urban Maternal Mortality Rates (news article)
The Chinese Ministry of Health said recently that the rate of rural women dying in childbirth in 2003 was 2.4 times that of the urban women.

MEN'S HEALTH RESEARCH

Sexual Patterning and Condom Use among a Group of HIV Vulnerable Men in Thika, Kenya (research abstract)
A composite sample of 37 peer educators and 215 members of self help groups of male informal sector workers in Thika, Kenya, targeting HIV/AIDS prevention, were interviewed about their sexual behaviour. The men reported a range of 0–16 partners, and an average of just under two partners. Condom use increased significantly with reduced intimacy of partner. Younger, single men had significantly more partners, but were more likely to use condoms. Duration of membership in self help groups was also strongly associated with exclusive use of condoms with casual or FSW partners.


HIV Related Behaviours and Attitudes among Chinese Men Who Have Sex with Men in Hong Kong: A Population Based Study (research abstract)
This study was conducted in order to determine the prevalence of men having sex with men (MSM) and their HIV related behaviors and attitudes among Chinese men in Hong Kong. A randomized telephone survey showed that among anal sex MSM, consistent condom use was 42.9% with male non-commercial sex partners and even lower with male commercial sex partners (35.7%). Active MSM in Hong Kong are at high risk of HIV infection. The belief of low vulnerability to HIV is prevalent among active MSM in Hong Kong with only 2% believing that their chances of HIV infection as being "very likely."


Male Genital Hygiene Beliefs and Practices in Nairobi, Kenya (research abstract)
This study examines knowledge and behaviors related to hygiene, genital hygiene, circumcision and hygiene, and to genital hygiene before and after sex among men in Nairobi, Kenya. Interviews with 463 men revealed that genital hygiene before the most recent sexual encounter was uncommon and negatively associated with HIV risk perception, bathroom crowding, and ethnicity. Genital hygiene after sex was associated with education, religion, and having inside tap water. Overall, genital hygiene behaviors were associated with resource access factors and are modulated by interactions in sexual partnerships.

MEN'S HEALTH NEWS

Togo: Truckers Know the Risks but Spurn Condom Use (news article)
The busy highway of Sanvee Kondji on the Abidjan-Lagos corridor is viewed by health experts as the single largest transmission belt of HIV/AIDS infection in West Africa because of high numbers of truckers having unprotected sex.

POPULATION RESEARCH

Measuring Sexual Behaviour in the Era of HIV/AIDS: The Experience of Demographic and Health Surveys and Similar Enquiries (research abstract)
This paper reviews the sexual behavior data collected in the Demographic and Health Surveys (DHS) and other similar national surveys from the perspective of data quality. Two indicators of premarital and higher risk sexual behavior were analyzed for 31 surveys in 10 countries in sub-Saharan Africa and Latin America and the Caribbean. The authors found fluctuating trends in premarital sex in sub-Saharan Africa but consistent increases in Latin America and the Caribbean. These results caution against placing heavy emphasis on short term changes in sexual behavior between individual surveys and highlight the need for attention to quality in data collection.

POPULATION NEWS

Africa Needs a Million More Health Care Workers, Report Says (news article)
Africa needs to nearly triple the number of its health workers if it is to reverse plummeting life expectancies and combat pandemics of disease, a research group of more than 100 scholars and experts said in a recent report.


Japan Sounds Alarm on Birth Rate (news article)
The Japanese government says urgent policy changes are needed to persuade women to have more children.

WOMEN'S HEALTH RESEARCH

Women and HIV/AIDS: Confronting the Crisis (report)
(You need Adobe Acrobat Reader to access this document)
This report, published by UNIFEM, UNAIDS and UNFPA, is a call to action to address the triple threat of gender inequality, poverty, and HIV/AIDS. It highlights the work of the Global Coalition on Women and AIDS, a UNAIDS initiative that supports programs that mitigate the impact of HIV/AIDS on women and girls worldwide. The report focuses on six areas of action: prevention, treatment, caregiving, education, violence, and women's rights.


Divorced from Justice: Women’s Unequal Access to Divorce in Egypt (report)
Related: press release: Egypt: Ensure Women's Equal Right to Divorce
This 62-page report from Human Rights Watch documents serious human rights abuses stemming from discriminatory family laws that have resulted in a divorce system that affords separate and unequal treatment to men and women.


A Guide to Indigenous Women's Rights under the International Convention on the Elimination of All Forms of Discrimination Against Women (resource material)
(You need Adobe Acrobat Reader to access this document)
This practical guide explores the procedures by which indigenous women can use the Convention on the Elimination of All forms of Discrimination Against Women (CEDAW) to hold states accountable for human rights violations.

WOMEN'S HEALTH NEWS

Women are Key to Reversing AIDS Epidemic (news article)
Any effort to battle the AIDS epidemic must focus on changing the fate of women by educating them, helping them own property, and giving them the power to stand up to men, experts have said.


Women Wait to be Heard - World AIDS Day (news article)
This year's World AIDS Day campaign focuses on women and girls, but, as the latest figures from this year's AIDS Epidemic Update illustrate, the number of women living with the virus has risen in each region of the world.


Indian Women Band Together to Fight HIV Discrimination (feature article)
A group of about 20 women in Madras, capital of southern Tamil Nadu state, who were infected by their husbands, are fighting back after being shunned by their own communities, spurned by their own families and seeing their children thrown out of school.

YOUTH HEALTH RESEARCH

Depot Medroxyprogesterone Acetate, Oral Contraceptives and Bone Mineral Density in a Cohort of Adolescent Girls (research abstract)
This study a compared bone mineral density (BMD) in 370 adolescent girls, aged 12–18, who self-selected depot medroxyprogesterone acetate (DMPA) or an oral contraceptive (OC) containing 20ìg ethinyl estradiol/100ìg levonorgestrel with that in girls who received no hormonal treatment. Lumbar spine and femoral neck BMD measurements taken at baseline and 12 months showed a negative impact of DMPA on bone health in young women. Additional findings suggest a potential adverse effect of an OC containing 20ìg ethinyl estradiol/100ìg levonorgestrel on bone health in adolescents.


Reducing Risk, Increasing Protective Factors: Findings from the Caribbean Youth Health Survey (research abstract)
This survey was to identify the prevalence of health-compromising behaviors, and the risk and protective factors associated with them among youth in the Caribbean, and to predict the likelihood of these outcomes given the presence or absence of the risk and protective factors. Analyses were done on the results of a 1997–98 survey of over 15,500 young people in nine countries of the Caribbean Community. The four health-compromising behaviors studied included violence involvement, sexual intercourse, tobacco use, and alcohol use. Rage was the strongest risk factor for every health-compromising behavior for both genders, and across all age groups, and school connectedness was the strongest protective factor.

YOUTH HEALTH NEWS

'Why We are Failing African Girls' (commentary)
Africa is in the death grip of HIV/AIDS, and a generation of African girls is standing on the frontline of the carnage.


India: Girl-trafficking Hampers AIDS Fight (news article)
The trafficking of young girls who are forced to work as prostitutes has been identified as a key factor in the steep rise in AIDS in India.


Turkey Tells Its Girls: 'Let's Go to School' (feature article)
Many Turkish girls are going to school for the first time, thanks to a push by UNICEF and the government.

BOOKS/BOOK REVIEWS

Scaling Up Treatment for the Global AIDS Pandemic: Challenges and Opportunities (book)
This books reports on the clinical, financial, and epidemiological effects of implementing widespread HIV/AIDS ART treatment and prevention programs around the world and ways in which rational methods for informing such efforts can be developed.


The Macroeconomics of HIV/AIDS (book)
To mark World AIDS Day, December 1, 2004, the IMF will be
publishing a new book, The Macroeconomics of HIV/AIDS. Through its demographic effects and its social and economic consequences, HIV/AIDS is a major threat to economic development in many countries. The volume brings together contributions by experts from a variety of international organizations and other institutions, which formulate and implement policy responses to the epidemic or deal with its social and economic consequences.

SPECIAL REPORTS/PROFILES/RESOURCES

Renewing Our Voice: Code of Good Practice for NGOs (resource material)
(You need Adobe Acrobat Reader to access this document)
This Code, managed by the International Federation of Red Cross and Red Crescent Societies and with over 160 NGO signatories world wide, provides NGOs with common guidelines for organizational planning, program and
advocacy work, and resource allocation.

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