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The Pop Reporter®

Volume 5, Number 2
10 January 2005

"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

How Family Planning Ideas Are Spread Within Social Groups in Rural Malawi (research abstract)
This study explores how family planning attitudes and practices spread among members of social groups in Malawi. Men "knew" about such practices from their observations of others' family size and child spacing, whereas women's knowledge was based on their conversations with other women. Men spoke about the pros and cons of limiting family size, whereas women spoke in detail about types of contraceptive methods, where to get them, their side effects, and covert contraceptive use. For men and women, the main trigger for family planning discussions was gossip. Whereas, generally, women first heard about family planning at the hospital, men stated that their first source of information was the radio or health-drama group.


Determining an Effective and Replicable Communication-Based Mechanism for Improving Young Couples' Access To and Use of Reproductive Health (research article)
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This paper summarizes the findings of a two-year operations research study by the Center for Research on Environment, Health and Population Activities. The study sought to increase access to and use of reproductive health services by young married couples in Nepal through community-based interventions.


The Sociocultural Context of Condom Use Within Marriage in Rural Lebanon (research abstract)
An analysis of 25 focus-group discussions with married women and men, interviews with service providers, and a survey of 589 women of childbearing age in a rural district of southern Lebanon reveal that a broad and complex set of sociocultural factors influence condom use. In the study area, 7% of married women currently use condoms, 24% reported ever use, and inconsistent use is common. Condoms are preferred primarily for their lack of physiological side effects. Five factors were found to impede method adoption and sustained use. These include various encumbering beliefs, reduced sexual pleasure, adverse experiences, gender-related fears and tensions, and a residual social stigma attached to condoms.


Banking on Reproductive Health (report)
This report examines the World Bank's attention to the Cairo agenda through the lens of its commitment to the Millennium Development Goals. Key challenges and constraints remain, not the least of which is a realistic assessment of current investments and the appropriate place of reproductive health in the broader development agenda. As this report makes clear, it is unlikely that these goals can be met absent significantly increased support and expansion of proven interventions, measurement of progress, commitment of resources and technical expertise, and collaboration between donors and recipient countries.


Condom-Promotion Programme among Slum-Dwellers in Chandigarh, India (research abstract)
This study describes high-risk behavior and condom usage in inhabitants of an urban slum in Chandigarh. A cohort of 375 participants was followed before and after an intervention. Half of the married but only one-eighth of the unmarried slum dwellers were using condoms regularly. One-quarter of the study subjects practiced high-risk behavior and this was higher among unmarried (44.88%) than married participants (18.7%). An intervention involving education on condom use and provision of free condoms increased the condom usage rate from 31.73% in the pre-intervention phase to 60% in the postintervention phase.

FAMILY PLANNING/REPRODUCTIVE HEALTH NEWS

Condom Testing Reveals Best Brands (news article)
Related: report: Condoms: Extra Protection
The nonprofit Consumers Union says in a new guide to contraception that the seven top U.S. types of condoms they studied did not burst despite vigorous testing, and all models met international standards.


Pakistan: Clerics Express Reservations on Use of Contraceptives (news article)
Clerics have expressed their reservation on the use of contraceptives on the basis that they restrict human reproduction and conflict with Islamic injunctions.

FAMILY PLANNING/REPRODUCTIVE HEALTH LAW AND POLICY

The Unfinished Agenda: Meeting the Need for Family Planning in Less Developed Countries (policy brief)
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Family planning programs have yielded dramatically positive gains over the past 50 years, resulting in millions of lives saved and healthier, more educated, and more empowered women and children worldwide. But contraceptive use is still low in places where need for it is greatest--in some of the world's poorest and most populous places. PRB's new policy brief, "The Unfinished Agenda: Meeting the Need for Family Planning in Less Developed Countries," details this need, the challenges in meeting it, and the consequences of failing--not only for world population growth, but for economic and personal development in many developing countries.

HIV/AIDS RESEARCH

Contribution of HIV-1 Infection to Acquisition of Sexually Transmitted Disease: A 10-Year Prospective Study (research abstract)
Data from a prospective cohort study conducted among female sex workers in Mombasa, Kenya between 1993 and 2003 were used to determine the effect of HIV-1 infection on STD susceptibility. HIV-1 infection was associated with a significantly higher incidence of gential ulcer disease (GUD), gonorrhea, and vulvovaginal candidiasis. The risks of GUD and vulvovaginal candidiasis increased with progressive levels of immunosuppression suggesting that the increased incidence of genital-tract infections among HIV-1 seropositive women could promote the spread of both HIV-1 and other STDs.


Protecting Young People from HIV and AIDS: The Role of Health Services (resource material)
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This 40-page report is based on a consultation between WHO, UNICEF, UNFPA, and YouthNet and is aimed at policy-makers and programmers. It outlines key health services activities and strategies in terms of information and
counseling; the diagnosis, treatment, and care of HIV/AIDS and STIs; and risk reduction.


Premarital Sex, Procreation, and HIV Risk in Nigeria (research abstract)
In Nigeria, research has documented a significant disparity between people's knowledge of HIV/AIDS and the extent to which they act to protect themselves. Data from adolescents show that young migrants appear to make sexual and contraceptive decisions in relation to gender norms and attitudes concerning procreation at least as much as in relation to fear of disease. Assessments of current and potential partners, choices about whether or not to have sex, and decisions about whether or not to use condoms are influenced by shared cultural values regarding the importance of parenthood, which put men and women in different negotiating positions with regard to sex and contraception.


The Impact of HIV/AIDS on the Education Sector in Uganda (report)
The overall objective of this study was to investigate the impact of HIV/AIDS on governance in the education sector with respect to operational effectiveness, budgetary implications, staff morale and productivity and decision-making at Ministry of Education and Sports (MoES) headquarters, semi-autonomous institutions, and district level education governance structures.


Beliefs, Sexual Behaviours and Preventive Practices with Respect to HIV/AIDS among Commercial Sex Workers in Daulatdia, Bangladesh (research abstract)
This study explores sexual knowledge, attitudes, behaviors and practices amongst commercial sex workers (CSW) in Bangladesh. Correct knowledge of AIDS transmission and symptoms was lacking. HIV/AIDS was viewed as a remote threat, over-ridden by immediate economic and survival concerns. Although the majority of CSWs knew that condoms afforded protection against STDs/AIDS, only one-third of sex acts on the last day of work were protected through condom use. Client dissatisfaction was the major reason for not using condoms. Many did not obtain treatment for STDs in a timely fashion, if at all.


Therapeutic Response of HIV-1 Subtype C in African Patients Coinfected with either Mycobacterium tuberculosis or Human Herpesvirus8 (research abstract)
This study examined the confounding effects of oppostunistic infections in HIV patients. Treatment outcomes for patients dually infected with HIV-1 and Mycobacterium tuberculosis or HIV-1 and human herpesvirus (HHV)8 were assessed. Patients with HIV-1 and Kaposi sarcoma (KS) received generic nevirapine, stavudine, and lamivudine (3TC); patients with HIV-1 and tuberculosis (TB) received standard commercial didanosine, 3TC, and efavirenz. These treatment regimens were found to be highly effective in clearing rapidly replicating (phase I) virus in African patients dually infected with HIV-1 and either TB or KS.

HIV/AIDS NEWS

Scientists Discover Key Genetic Factor in Determining HIV/AIDS Risk (press release)
People with more copies of a gene that helps to fight HIV are less likely to become infected with the virus or to develop AIDS than those of the same geographical ancestry, such as European Americans, who have fewer copies of the gene, according to a study funded by the National Institute of Allergy and Infectious Diseases.


Breaking Taboo, Mandela Says Son Died of AIDS (news article)
South Africa's Nelson Mandela, one of Africa's most committed campaigners in the battle against AIDS, announced recently that his only surviving son had succumbed to the disease.


India to Step Up AIDS Fight (news article)
India's prime minister has vowed to step up government efforts to fight HIV/AIDS as top media firms pledged to start a campaign against the disease in the country with the world's second-highest number of infections.


Indian Media to Boost AIDS/HIV Efforts (news article)
Top Indian media executives agreed to launch a massive public information campaign across India to create awareness about the country's growing HIV/AIDS crisis -- often described as a time bomb.


Namibia: Free Aids Drugs Amid Global Fund (news article)
Namibians are still waiting for the release of more than $170 million awarded by the Global AIDS Fund almost 2 years ago to tackle AIDS, tuberculosis, and malaria.


Burkina Faso: Government Needs Help to Increase Numbers on ARV, Aid Workers Say (news article)
Health authorities in Burkina Faso have already admitted they will not be able to meet global goals for providing antiretroviral (ARV) drugs to people living with AIDS, but aid workers say even the government's scaled-down target will be under threat if grassroots groups are not drafted into the fight.

MATERNAL AND CHILD HEALTH RESEARCH

Prevalence of Low Birth Weight and its Determinants in an Urban Resettlement Area of Delhi (research abstract)
This study was conducted to study the prevalence and determinants of low birth weight (LBW) in an urban resettlement area of Delhi. The prevalence of LBW was 39.1%. Occurrence of LBW was related to age, parity, weight and height of the mother. Analysis indicated mother’s weight and parity as significant variables. After adjusting for age, parity and birth weight were associated for the 20-35-year age group only.


Antiretroviral Drugs for Treating Pregnant Women and Preventing HIV Infection in Children: Guidelines for Women Living with HIV/AIDS and Their Children in Resource-Constrained Settings (resource material)
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These World Health Organization guidelines review existing evidence on the use of antiretroviral drugs for preventing mother-to-child transmission (PMTCT) of HIV and recommend specific ARV regimens according to different clinical situations. They recommend that women who need it for their own health should be given ARV treatment, as this will both benefit the woman's health and decrease the risk of HIV transmission to the infant. While the authors note that expanding access to programs to prevent MTCT presents many challenges and that single-dose maternal and infant NVP is the simplest regimen to deliver, they recommend that programs consider introducing more complex ARV regimens where possible.


The Importance of Quality of Care in Perinatal Mortality: A Case-Control Study in Chiapas, Mexico (PubMed abstract)
This study ascertained the relative importance of different risk factors for perinatal mortality (PM) in a community of Chiapas, Mexico. Cases were stillbirth and early neonatal death. Two children born in the same hospital and/or day as the case were randomly selected as controls. Socioeconomic, cultural, maternal, pregnancy, delivery, product and medical care factors were recorded. Results support the idea that insufficient prenatal care and failure to comply with the standards of care for labor, delivery and for the care of the newborn are strong predictors of PM.

MATERNAL AND CHILD HEALTH NEWS

Ghana: Zero Tolerance for Pregnancy Related Deaths for Brong-Ahafo (news article)
The Brong-Ahafo Regional Directorate of the Ghana Health Service (GHS) has said the directorate would ensure a "zero tolerance" for pregnancy related deaths in the region in 2005.


Test May Predict Pregnancy Complication (news article)
A simple urine test during pregnancy could someday predict which women are likely to develop dangerously high blood pressure known as preeclampsia.


Taiwan: Free AIDS Tests During Pregnancy to Kick off Nationwide (news article)
On Jan. 1, 2005, the government began providing AIDS tests at no cost to pregnant women nationwide in an effort to prevent mother-to-child HIV transmission, the Department of Health reported.


Cuba Claims Latin America's Lowest Infant Mortality Rate (news article)
Cuba's infant mortality rate has fallen to less than six deaths per thousand babies born, the lowest in Latin America, according to government figures.

MEN'S HEALTH RESEARCH

Erectile Dysfunction is a Signal of Risk for Significant Medical Comorbidities: A Primary Care View (research abstract)
The organic etiologies that cause ED often impact concurrently on other body systems, thus multiple comorbidities have been noted that occur more frequently among men with ED than among men without ED. This suggests a correlation with psychosocial problems, endocrine imbalances, neurologic disorders, and, most notably, cardiovascular risk factors and/or disease. The role of the presence of ED as a "screening test" for increased cardiovascular disease risk is a potentially promising area.

MEN'S HEALTH NEWS

Saudi Arabia: Man With 58 Wives Stirs Debate (news article)
Although Islamic laws permit a man to have four wives at a time, most Muslim men today take one wife, because it has become the cultural norm and polygamy is costly. Saleh Al-Sayeri, a 64-year-old shepherd-turned-businessman, says in 50 years he has married 58 women and has forgotten the names of most of them. He knows he has had 10 sons, but ask about daughters and he counts on his fingers: 22. No, no, 28. No, that’s too many. He settles on 25.

POPULATION RESEARCH

The Role of Conflict in the Rapid Fertility Decline in Eritrea and Prospects for the Future (research abstract)
The large fertility decline observed in Eritrea between the mid-1990s and the early part of the new century is examined using data from two detailed national household surveys. Results indicate that one of the outcomes of the military mobilization and displacement associated with the 1998-2000 border conflict with Ethiopia was a steep reduction in the proportion of women exposed to the risk of pregnancy. Part of this reduction was due to delayed age at marriage, but it came about largely because married women were less likely to be living with their husbands in 2002 than in 1995. The health system may be facing an increased demand for child health services over the next several years, following a possible post-war "baby boom".


Patterns of Sex Worker-Client Contacts and Their Implications for the Persistence of Sexually Transmitted Infections (research abstract)
The authors developed an individual-based simulation model to explore how variation in number of client contacts per sex worker (SW), whether clients repeatedly visited the same SW, and the relative sizes of the SW and client populations influence the endemic prevalence of gonorrhea and herpes simplex virus type 2 infection. They found that persistence of either infection was more likely if clients visited many different SWs, regardless of variation in the SW-client contact rate, and also resulted in a higher endemic prevalence in both populations and a greater likelihood of persistence of infection at lower levels in the general population.


Determinants and Consequences of Sexual Networks as They Affect the Spread of Sexually Transmitted Infections (research abstract)
This article provides a brief background on the design and assessments of studies of social networks to illustrate how these methods have been applied to understanding the distribution of STIs and to inform the development of interventions for STI control.


Integrating Demographic and Epidemiological Approaches to Research on HIV/AIDS: The Proximate-Determinants Framework (research abstract)
This article presents a conceptual framework for the study of the distribution and determinants of HIV infection in populations, by combining demographic and epidemiological approaches. In HIV research, biological mechanisms are the components that determine the reproductive rate of infection. The proximate-determinants framework can be used in study design, in the analysis and interpretation of risk factors or intervention studies that include both biological and behavioral data, and in ecological studies.

POPULATION NEWS

China's Population Passes 1.3 Billion (news article)
A baby boy delivered in a Beijing maternity ward early on January 6th became China's 1.3 billionth citizen, the government said, using the occasion to tout its contentious one-child policy.


Japan: No. of Births in 2004 Hits Record Low for 4th Straight Year (news article)
The number of newborns in Japan is projected to drop by 17,000 in 2004 from the previous year to 1,107,000, an all-time low for the fourth year in a row, data released by the health ministry shows.

WOMEN'S HEALTH RESEARCH

Influence of Sex Hormones, HIV Status, and Concomitant Sexually Transmitted Infection on Cervicovaginal Inflammation (research abstract)
The impact of demographic characteristics, phase of the menstrual cycle, use of hormonal contraceptives, and concomitant lower genital-tract infections on cervicovaginal inflammatory cells was assessed in 967 women, 654 of whom were infected with HIV-1. Younger age and use of progesterone-based hormonal contraceptives were independently associated with increased numbers of inflammatory cells in Cervicovaginal lavage fluid. HIV-1 infection was not associated with statistically significant differences in numbers of inflammatory cells in CVL fluid except in a group of HIV-1 infected women with Chlamydia trachomatis.


Sexual Violence in Conflict Settings and the Risk of HIV (report)
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This brief, from the Global Coalition on Women and AIDS, explores the nature of sexual violence in conflict settings and the risk of HIV. It outlines why it is important to focus on violence against women (VAW) in conflict settings and HIV. It then explores where and how VAW and HIV/AIDS intersect in these settings. The third section looks at how VAW in conflict settings can be addressed.


Does Dowry Improve Life for Brides? A Test of the Bequest Theory of Dowry in Rural Bangladesh (working paper)
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Using panel data from an adolescent study in rural
Bangladesh, this working paper from the Population Council explores the association between dowry and the prevalence of domestic abuse to test the bequest theory of dowry. The authors find that, contrary to the prediction of the bequest theory, married females who paid dowry at marriage have a higher likelihood of reporting domestic violence compared to those who did not. In addition, the relation between dowry and abuse is highly level-specific: respondents who paid small dowries report much higher levels of abuse than those who paid large dowries. In fact, paying no dowry is just as protective, if not more so, in terms of preventing abuse as the largest dowry payments.


Development of a Screening Instrument to Detect Physical Abuse and its Use in a Cohort of Pregnant Women in Sri Lanka (research abstract)
The objective of this study was to develop and validate a screening instrument to estimate the prevalence of physical abuse in a cohort of pregnant women in a district of Sri Lanka. The reliability and validity (sensitivity 85.7%; specificity 89.7%) of the screening instrument proved to be high. The prevalence of physical abuse in categories ‘ever-abuse’, ‘current abuse’ and ‘current pregnancy’ were 18.3%, 10.6% and 4.7% respectively. In addition, ‘current sexual abuse’ was reported by 2.7% of women. The prevalence rates indicate that the physical abuse of women is a significant public health problem.


The Church, the State and Women's Bodies in the Context of Religious Fundamentalism in the Philippines (research abstract)
This article reflects on which advocacy methods will best serve the goals of sexual and reproductive rights when conservative church interests dominate state policy, as is currently the case in the Philippines. Religious fundamentalists argue for religious accommodation of their views by the state on the grounds of religious freedom but refuse to entertain a plurality of views on women's sexuality. Thus, it is not enough to base a case in support of sexual and reproductive rights on the separation of church and state since, even though the State claims it is secular, it still manages to impose restrictions and control over women's bodies.


Rural Indian Women Face Heightened Cervical Cancer Risks (report)
More than 130,000 new cases-—roughly one-fourth of the global total—-are reported in the country every year. In addition, an estimated 74,000 Indian women die annually from the disease. This report details the phenomenon.

WOMEN'S HEALTH NEWS

Chileans Facing Up to Domestic Violence (feature article)
The government has launched a campaign to raise awareness of domestic violence, including several new laws, which are awaiting approval in Congress and would make abuse of a spouse a crime.

YOUTH HEALTH RESEARCH

The Effect of a Livelihoods Intervention in an Urban Slum in India: Do Vocational Counseling and Training Alter the Attitudes and Behavior of Adolescent Girls? (research article)
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This paper examines whether an experimental intervention for girls aged 14-19 that provided reproductive health information, vocational counseling and training, and assistance with opening savings accounts in slum areas of Allahabad in Uttar Pradesh, India had an effect on their attitudes and behaviors. The project had only a minimal impact on the behavior and attitudes of adolescent girls in the slums. Girls exposed to the intervention were significantly more likely to have knowledge of safe spaces, be a member of a group, score higher on the social skills index, be informed about reproductive health, and spend time on leisure activities than were the matched control respondents.


At the Crossroads: Accelerating Youth Access to HIV/AIDS Interventions (resource material)
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From the UNAIDS Inter-Agency Task Team on Young People, this brief summarizes data and intervention approaches for youth AIDS.


Communities, Opportunities, and Adolescents' Sexual Behavior in KwaZulu-Natal, South Africa (news article)
This study uses data collected from a representative sample of young people living in KwaZulu-Natal, South Africa, to explore the effects of opportunities for schooling, work, and other community activities on sexual behavior. For girls, higher levels of education reduced the probability of having had sex in the 12 months prior to the survey, and average wages were positively associated with condom use. Greater participation in community sports increased risk-taking behaviors among boys but decreased them among girls. Within the household, education of adults had a positive effect on condom use for both boys and girls.


HIV/AIDS Prevention and Care among Especially Vulnerable Young People (resource material)
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This collaboration between the WHO and the DFID-sponsored Safe Passages to Adulthood program focuses on the needs of especially vulnerable youth, including migrants and refugees, sex workers, and injecting drug users.


Post-Abortion Care for Adolescents: Results from Research in the Dominican Republic and Malawi (research article)
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With less access to medical services than adults, adolescents are more likely to face complications of abortion. This summary of studies in Malawi and the Dominican Republic discusses how hospitals can provide better post-abortion care to adolescents.

YOUTH HEALTH NEWS

Iraq: Survey Suggests Widespread Female Circumcision in North (news article)
A ground-breaking survey done by a German NGO of 40 villages in the rural Germian region of Kurdish-controlled northern Iraq has revealed that nearly 60% of the area's women have undergone circumcision.


Syria: Girls' School Attendance in Rural Areas Decreasing (news article)
Although access to schools for girls and boys has improved significantly throughout Syria, statistics from the Ministry of Education show that the rate of girls' attendance is falling, compared to previous years, especially in rural areas.

BOOKS/BOOK REVIEWS

Where There Is No Doctor (book)
Related: news article: Ordering Other Translations
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Related: news article: Donde No Hay Doctor
This handbook has been written primarily for those who live far from medical centers, in places where there is no doctor. This book has been written in fairly basic English, so that persons without much formal education (or whose first language is not English) can understand it. Where There Is No Doctor is available in more than 80 languages, including French, Russian, Hindi, Bengali, Chinese, Creole, Dari, German, Quechua, Shuar, Sindhi, Sinhala, Tamil, and Thai.

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