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Volume 5, Number 7
14 February 2005

FAMILY PLANNING/REPRODUCTIVE HEALTH RESEARCH

Effectiveness of Female and Male Condoms in Preventing Exposure to Semen During Vaginal Intercourse: A Randomized Trial (research abstract)
This study was a comparison of male condom (MC) vs. female condom (FC) with respect to self-reported mechanical and acceptability problems and semen exposure using prostate-specific antigen (PSA) as an objective biological marker and evaluation of the effect of an educational intervention on self-reported problems and semen exposure, by condom type. Research showed the FC was less effective than the MC in preventing semen exposure during use and led more frequently to self-reported user problems. Both devices were highly protective against “high-level” semen exposure, as measured by postcoital PSA levels in vaginal fluid. In-clinic education may reduce user problems and increase acceptability and use of both devices.

Contraceptive Vaginal Rings Releasing Nestorone® and Ethinylestradiol: A 1-Year Dose-Finding Trial (research abstract)
In a multicenter 1-year trial of contraceptive vaginal rings (rings) involving 150 women, three dose combinations of the progestin Nestorone® (NES) and ethinylestradiol (EE) were compared with respect to effectiveness, safety, and acceptability. Clinical performance and adverse event profiles indicate that each of these 1-year NES/EE rings, used on a 21-day-in and 7-day-out regimen, provided women effective, acceptable, and safe long-acting contraception under their own control.

Ukraine Contraceptive Availability Assessment (report)
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A recent assessment by DELIVER of contraceptive availability in Ukraine showed that although a variety of contraceptive methods are widely available through commercial pharmacies, a large segment of Ukrainian couples cannot afford to purchase contraceptives, and the public sector has no supplies to offer them.

Contraceptive Security Index 2003 (resource material)
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Related: news article: Request a Print Copy of the Wallchart
The Contraceptive Security Index is a tool for measuring and monitoring a country's level of contraceptive security. It consists of 17 indicators,such as poverty level, method mix, and forecasting ability, that cover the primary components of contraceptive security (supply chain, finance, health and social environment, access, and utilization). The indicators can be used separately to monitor progress in each component. They are also aggregated to establish a composite index to compare countries at a point in time or to monitor progress over time within a country. DELIVER has published a wall chart and a booklet of the Index, which rates 57 countries.

Creating a Plan for Contraceptive Security in Togo (report)
USAID initiated the West Africa Regional Program (WARP) in 2001 to consolidate its development assistance in 18 countries. Although WARP has improved the impact of USAID's activities in West Africa, one consequence of the program's wide regional approach has been increased competition for contraceptive donations. Togo, in particular, must now create a plan to ensure that it has the contraceptives it needs to confront critical reproductive health challenges and to attain contraceptive security.

FAMILY PLANNING/REPRODUCTIVE HEALTH NEWS

Uganda: Advocates Strike Agreement on the Condom, Virginity (news article)
President Museveni and a team of AIDS experts with divergent views have agreed on how to fight sexual transmission of HIV.

Survey Says Most Filipinos are Receptive to DoH Family Planning Campaign (news article)
About nine in ten or 96% of Filipinos believe that the door-to-door family planning campaign of the Department of Health will help Filipino families, according to a Social Weather Stations survey last December 2004.

China: Cities Consider Free Premarital Health Checks (news article)
Beijing health departments are planning to introduce free premarital health checks to reduce the growing number of birth defects in the nation's capital.

FAMILY PLANNING/REPRODUCTIVE HEALTH LAW AND POLICY

Equity of Family Planning in Developing Countries (policy brief)
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In October 2004, at the 11th Canadian Conference on International Health, DELIVER presented a poster on the distribution of family planning resources and contraceptive prevalence across socioeconomic groups. Developed by DELIVER's Analysis & Research and Resource Mobilization teams, the poster highlighted DELIVER's research, provided country examples with current status by wealth quintile, offered strategies to address inequities to ensure access for the poor, and outlined lessons learned.

HIV/AIDS RESEARCH

Evaluation of Two Commercially Available, Inexpensive Alternative Assays Used for Assessing Viral Load in a Cohort of Human Immunodeficiency Virus Type 1 Subtype C-Infected Patients from South Africa (research abstract)
This study investigated two commercially available kits for the detection of HIV-1 viral load markers as more affordable alternatives to HIV-1 RNA quantitation.

A Strategy for Developing an HIV Vaccine (research article)
This article reviews the HIV vaccine development process over the past few years.

Completing the Public Health HIV/AIDS Alphabet (research article)
This article outlines critical steps for arresting the HIV/AIDS epidemic, suggesting moving ahead with “ABCs” and with “D” for diagnosis and “R” for responsibility.

The Private Demand for an AIDS Vaccine in Thailand (research abstract)
A contingent valuation survey of Thai adults revealed that private demand for a hypothetical AIDS vaccine that is safe, has no side effects, and lasts 10 years, rises with income, the lifetime risk of HIV infection and vaccine efficacy, and declines with vaccine price and respondent’s age. Demand for both high (95%) and low (50%) efficacy AIDS vaccines is substantial. Nearly 80% of adults would agree to be vaccinated with a free vaccine.

Epidemiology of HIV infection among Israeli Arabs (research abstract)
The objectives of this study were to describe the epidemiology of HIV in Israeli Arab citizens for the first time at a national level, and to identify health promotion and treatment needs. Researchers found that HIV prevalence is lower in Arab Israelis than in non-Arab Israelis and Arabs residing in neighboring countries. Nevertheless, the shorter interval from HIV notification to AIDS diagnosis in Arab Israelis suggests a lower rate of HIV testing and diagnosis at a later stage of infection.

Challenging, Changing, and Mobilizing: A Guide to PLHIV Involvement in Country Coordinating Mechanisms (resource material)
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This handbook is the product of numerous consultations and input of over 400 people living with HIV (PLHIV) from more than 30 countries in every region of the world, with the vast majority of those involved living in developing countries and countries in transition. This handbook was created primarily for PLHIV who are already working on HIV/AIDS issues in their country and who have some prior knowledge of the Global Fund. It is anticipated that many in the target audience will already be involved in some aspect of work that is related to the Global Fund, perhaps through membership on a CCM, as members of networks represented on a CCM, or as sub-recipients of Global Fund grants. Some may not be directly involved at present, but may have an interest in learning more about the Global Fund and in advocating for inclusion of a network or organization on the CCM in a specific country or region.

Kenya's Rapid Response Fund: Turning a Little into a Lot (resource material)
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In this edition of Snapshots from the Field, Family Health International (FHI) examines the role of the Kenya AIDS Project Rapid Response Fund, which is funded by USAID through the IMPACT Project, which is managed by FHI. The Rapid Response Fund allows small, local organizations to initiate innovative HIV prevention, care or support activities. The fund supports only short-term activities (up to three months), including training events, workshops, stigma-reduction efforts, activities by people living with HIV/AIDS (PLHA) organizations and advocacy for these groups. Grants range from a few hundred dollars to US$5,000.

HIV/AIDS NEWS

Cote d' Ivoire: Tackling the 'Illness of Unknown Origin' with 'Pockets of Rubber' (news article)
The Côte d’Ivoire Network of Media Professionals against AIDS recently kicked off its AIDS promotion campaign for an AIDS lexicon in 16 local languages.

Nepal: Number of AIDS Orphans on the Rise (news article)
According to a joint report by the Joint United Nations Programme on HIV/AIDS the United Nations Children's Fund and USAID, it is estimated that there are at least 13,000 orphans as result of the HIV virus in Nepal.

US Health Officials Raise Alarm Over 'New and Untreatable' Strain of HIV (news article)
A virulent strain of HIV that health experts fear could be impossible to treat has been discovered in the United States. The case was diagnosed last week in a New Yorker who regularly used drugs. Health experts were alarmed to find he very rapidly became ill with AIDS, and then found that their drugs were failing to combat the disease.

A Portable Detector for HIV-AIDS, Measles and other Infectious Diseases (news article)
A portable device similar to today's home pregnancy tests that can quickly detect the presence of infectious diseases, including HIV-AIDS and measles, as well as biological agents such as ricin and anthrax, is the object of a new university/industry research project.

Papua New Guinea Facing Major HIV/AIDS Epidemic (news article)
Papua New Guinea is facing a major HIV/AIDS epidemic, with annual increases of 15% to 30%.

Letter From Gurue: A Tiny African Town That Outshines the U.S. in AIDS Education (news article)
In rural Mozambique, savvy marketing of a condom brand is saving lives.

UN Envoy On Ending HIV/AIDS in Africa Says Child Treatments Possible in 18 Months (news article)
The UN children's and public health agencies may be able to develop and market anti-HIV/AIDS formulations for children within 18 months.

Iranian Society Uptight Over AIDS (feature article)
While today the threat of an AIDS epidemic via drug use is somewhat openly discussed in Iran, sexual relations and sexually transmitted diseases are still a taboo topic, despite an explosion in the rate of high-risk sexual behavior among the youth across the country.

12,000 AIDS Patients in Uganda to Receive Free Drugs (news article)
Over 12,000 AIDS patients in Uganda will receive free anti-retroviral drugs (ARVs) this month, according to a Uganda Global Fund project.

MATERNAL AND CHILD HEALTH RESEARCH

The MNPI Study: Measures of Strength for Maternal Health Programs in 55 Developing Countries (working paper)
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The research reported here concerns the Maternal and Neonatal Program Effort Index (MNPI), a standardized assessment instrument applied in both 1999 and 2002. Previous reports cover the detailed methodology and the results from the 1999 study, as well as the relation of the MNPI ratings to maternal mortality ratios (Ross, Campbell, and Bulatao, 2001; Bulatao and Ross, 2002; Bulatao and Ross, 2003a). The MNPI instrument is designed to measure the strength and character of government programs to improve maternal health. It contains items for the most proximate determinants of maternal survival, including those related to emergency obstetric and abortion cases, as well as the less proximate determinants of the policies and institutional arrangements necessary to build treatment capacities. Capturing these program features can document the low effort levels that now exist and create a baseline against which to trace future improvements. The overall purpose is to measure program inputs and strength of effort for the reduction of maternal mortality and morbidity and closely related neonatal items.

Effect of Postpartum Maternal or Neonatal Vitamin A Supplementation on Infant Mortality among Infants Born to HIV-Negative Mothers in Zimbabwe (research abstract)
The objective was to measure the effect on infant mortality of supplementing neonates and their HIV-negative mothers with single, large doses of vitamin A during the immediate postpartum period. The data indicate no overall effect. Postpartum maternal or neonatal vitamin A supplementation may not reduce infant mortality in infants of HIV-negative women with an apparently adequate vitamin A status.

Maternal-perinatal Morbidity and Mortality Associated with Adolescent Pregnancy in Latin America: Cross-Sectional Study (research abstract)
This study determined whether adolescent pregnancy is associated with increased risks of adverse pregnancy outcomes. Adolescents aged 15 years or younger had higher risks for maternal death, early neonatal death, and anemia compared with women aged 20 to 24 years. Moreover, all age groups of adolescents had higher risks for postpartum hemorrhage, puerperal endometritis, operative vaginal delivery, episiotomy, low birth weight, preterm delivery, and small-for-gestational-age infants. All adolescent mothers had lower risks for cesarean delivery, third-trimester bleeding, and gestational diabetes. In Latin America, adolescent pregnancy is independently associated with increased risks of adverse pregnancy outcomes.

MATERNAL AND CHILD HEALTH NEWS

Sumatra: Pregnancy Becomes More Complicated (news article)
Expectant mothers in impoverished Sumatra have been beset by a host of new risks since tsunami.

Fiji: Infant Deaths Put at 40% (news article)
Over 40% of infant deaths every year were due to avoidable causes.

Ghana: Some 2.9 Billion Cedis for Maternal Exemptions in W/R (news article)
Joseph Aidoo, the Western Regional Minister, said the government had released 2.9 billion cedis (US$321,000) for the implementation of free delivery plan for pregnant women in the region.

MEN'S HEALTH RESEARCH

Simply Modified No-Scalpel Vasectomy (Percutaneous Vasectomy) — A Comparative Study Against the Standard No-Scalpel Vasectomy (research abstract)
The simply modified no-scalpel vasectomy (SMNSV; percutaneous vasectomy) technique was reported to simplify the standard no-scalpel vasectomy (SNSV) procedure. This article reports on experiences with SMNSV in comparison with the SNSV. The time required for the SMNSV technique was less than that for the SNSV technique. There were no significant differences between the two groups with respect to incision length, postoperative pain, pain at coitus, time of return to work, time of resuming intercourse, self-reported satisfaction in sexual life, postoperative psychological status, postoperative body weight change, and postoperative complications.

Steroid Hormones for Contraception in Men: Systematic Review of Randomized Controlled Trials (research abstract)
Researchers conducted a systematic review of all randomized controlled trials of male hormonal contraception and azoospermia. Few significant differences emerged from these trials and no male hormonal contraceptive is ready for clinical use. All trials published to date have been small exploratory studies. As a result, their power to detect important differences has been limited and their results have been imprecise.

MEN'S HEALTH NEWS

South Africa: Unique AIDS Programme Brings New Hope for Rural Men (news article)
A unique HIV/AIDS awareness program aimed at mainly young men from a rural area of KwaZulu-Natal has brought new hope to a community hard-hit by the epidemic.

Health Crisis Ravages Russia's Men (news article)
Government statistics show that the average Russian man lives 58.6 years, compared with 73 years for the average Russian woman. In 1990, life expectancy for men was 63.4 years. "Normally, only during wartime do we see the kind of decreases in men's longevity that we've seen recently in Russia," said Vladimir Simanenkov, the head of the department of internal diseases at the St. Petersburg Medical Academy and a senior official with the city's Public Health Committee.

POPULATION NEWS

Philippines: CBCP Opposes 4 Population-Control Bills (news article)
Related: news article: Scientists Back Bill on Population
Catholic Bishops Conference of the Philippines described the act of four congressmen who filed separate bills seeking a radical policy on population control to spur economic development as reckless and irresponsible.

For India's Daughters, a Dark Birth Day (feature article)
This feature article from The Christian Science Monitor addresses India's gender imbalance, which has worsened in recent years.

Tsunami Refugee Camps May Yield Baby Boom, Bring Health Concerns (news article)
Indonesia, the country most devastated by the Dec. 26 earthquake and killer waves, is girding for a baby boom in Aceh's squalid refugee camps and villages

WOMEN'S HEALTH RESEARCH

Effects of Prolonged Use of Injectable Hormonal Contraceptive on Serum Lipid Profile (PubMed abstract)
The current study was carried out to determine serum levels of total cholesterol, triacylglycerol (TG), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) in human female volunteers taking injectable hormonal contraceptives. The mean serum total cholesterol and mean serum triacylglycerol levels of the DMPA users were significantly elevated in comparison to that of the non-users. The mean serum HDL-cholesterol was decreased in subjects using DMPA in comparison to that of the control group, but the decrease was not significant.

Use of Exogenous Hormones by Women and Colorectal Cancer: Evidence from the Royal College of General Practitioners' Oral Contraception Study (research abstract)
This study assessed the risk of colorectal cancer among women who have used oral contraception or hormone replacement therapy (HRT), especially those exposed to both classes of exogenous hormones. Results show that ever users of oral contraceptives do not benefit from a long-term reduction in colorectal cancer, although current and recent use may confer some protection. Women who have ever used HRT appear to have important reductions in their risk of colorectal cancer, especially while using these hormones. Further study is needed in order to determine how long any benefits last and whether these are stronger in women exposed to both classes of exogenous hormones.

WOMEN'S HEALTH NEWS

U.N. Sharply Rebukes Iran Over Women's Rights (news article)
The United Nations painted a damning portrait of women's rights in Iran, saying they had insufficient right of appeal against violence and were being sentenced to death on flimsy evidence.

Mainstreaming the Gender Issues (news article)
For women’s issues to be recognized as the issue that touches everybody’s lives, there needs to be a clear link between them and the national and international development plans.

YOUTH HEALTH RESEARCH

Evaluation of Lipid Profile in Adolescents During Long-Term Use of Combined Oral Hormonal Contraceptives (research abstract)
The study evaluated the effects of the long-term use of a combined oral hormonal contraceptive containing 30 micrograms ethinyl estradiol and 75 micrograms gestodene in adolescents. Thirty-three volunteers, aged from 14 to 19 years, who used the oral contraceptive for three consecutive years, were studied. Evaluation of total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and triglycerides was made before use and after 1, 2 and 3 years. During the 3-year study period, total cholesterol, HDL-C, LDL-C and triglyceride levels were significantly higher than previous measurements, but average values did not exceed the normal range.

Change in Bone Mineral Density Among Adolescent Women Using and Discontinuing Depot Medroxyprogesterone Acetate Contraception (research abstract)
Related: news article: Teens' Bones Recover After Ending Depo-Provera
This study evaluated bone mineral density changes in adolescents using and discontinuing use of DMPA contraception. Use of DMPA contraception in adolescents was associated with significant continuous losses of bone mineral density at the hip and spine. However, significant gains postdiscontinuation provide evidence that the loss of bone mass is apparently reversed.

Double-Blinded Randomized Controlled Trial of Estrogen Supplementation in Adolescent Girls Who Receive Depot Medroxyprogesterone Acetate for Contraception (research abstract)
This clinical trial evaluated the effect of estrogen supplementation on bone mineral density in adolescent girls who received depot medroxyprogesterone acetate for contraception. Results suggest that estrogen supplementation is protective of bone in adolescent girls who receive depot medroxyprogesterone acetate injections.

Risk Behaviors of Youth Living With HIV: Pre- and Post-HAART (PubMed abstract)
This study examined the transmission behavior among youth living with HIV (YLH), pre- and post-HAART. Post-HAART YLH were more likely to engage in unprotected sex and substance use, to be more emotionally distressed, and to have lower quality of life than were pre-HAART YLH.

Parental Attitudes about Sexually Transmitted Infection Vaccination for Their Adolescent Children (research abstract)
Related: news article: Parents Comfortable with the Idea of Vaccination for Sexually Transmitted Infections for Their Adolescent Children
This study evaluated parental attitudes about adolescent vaccination as a function of vaccine characteristics, including whether the vaccine prevented an STI, and explored possible sociodemographic predictors of acceptability of STI vaccines. It found that parents were accepting of the idea of vaccinating their adolescent children against STIs. The most salient issues were severity of infection and vaccine efficacy, not sexual transmissibility. Parents also favored vaccines for infections that had no method of behavioral prevention available.

YOUTH HEALTH NEWS

Indonesia: Teens Open Up to Peer Counselors (news article)
A senior at SMK 3 vocational high school in East Jakarta carries out her task as a counselor on HIV/AIDS, reproduction health, and STDs by involving her school mates in "girl talk".

BOOKS/BOOK REVIEWS

Youth: Choices and Change (book)
This just-released publication by PAHO on adolescent health and positive behavior change greatly enhances the knowledge base on this important public health issue. It presents the first ever systematic collection and reporting of the application of behavioral change theories and models specifically geared to adolescents. At the same time, it represents the first attempt to incorporate a developmental perspective in the conceptual analysis of these classical theoretical constructs when applied to the various stages of adolescence.

SPECIAL REPORTS/PROFILES/RESOURCES

Access Contraceptive Supply Information on the RHInterchange Website (resource material)
The Supply Initiative, a global effort to address reproductive health supply issues, has launched the RHInterchange, a web-accessible database that coordinates donor-supported reproductive health supply information. Users can access reports on contraceptive supplies for the country, regional, or global level.

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Volume 5, Number 714 February 2005