Volume 5, Number 13
28 March 2005

FAMILY PLANNING/REPRODUCTIVE HEALTH RESEARCH

Chlamydia Trachomatis Infections in Heterosexuals Attending Sexually Transmitted Disease Clinics in Slovenia
(Abstract)
This study assessed the age and gender distribution of Chlamydia trachomatis infections among patients attending two clinics for sexually transmitted diseases (STDs) in Slovenia. The prevalence of C. trachomatis infection was 19.5% for male patients and 10.7% for female patients, with the highest prevalence in the group age 15-30. The prevalence decreased between 2000 and 2003 among female patients. The results support the implementation of routine screening for C. trachomatis genital infection among male and female patients aged less than 30 years attending STD clinics in Slovenia.

Role of Progestins in Contraception
(Abstract)
This article reviews the development of progestins for contraception. Progestins have been used for contraception for more than 30 years. The main goal was to develop a contraceptive method devoid of the metabolic or clinical side-effects associated with the use of estrogens. As a result of this endeavor new methods have been developed: oral progestins, implants, injectables, intrauterine hormonal systems, and vaginal rings. Progestin-only contraceptives may be preferable in some situations, which have absolute or relative contraindications to estrogen.

What Works? What Fails?: Findings from the Navrongo Community Health and Family Planning Project
(Review/Synthesis)
(You need Adobe Acrobat Reader to access this document)
Most international agencies, policymakers, and health providers believe that mobilizing community volunteer operations work will improve health. Results of the Navrongo Experiment challenge some of these assumptions.

Generation of Knowledge for Reproductive Health Technologies: Constraints on Social and Behavioral Research
(Abstract)
Using topical microbicides as an example of a new method to prevent sexually transmitted infections, HIV and/or pregnancy, this study focused on gaps in information to inform reproductive health decision-making, noting in particular the discrepancies between data on clinical efficacy and typical use-effectiveness. Results show constraints on government and private sector support for research, particularly research on aspects of sexual behavior, contribute to problems with the availability of information for decision-making about use of reproductive health technologies.

Critical Issues in Contraceptive and STI Acceptability Research
(Abstract)
This article reviews conceptual issues and theoretical frameworks related to users' acceptability of new technologies designed to protect reproductive health and prevent unwanted pregnancy. Special attention is given to distinctions among different kinds of users' perspectives regarding acceptability, as well as differentiating acceptability from assessments of the efficacy of innovative methods.

Oral Contraceptive Use and Risk of Early-Onset Breast Cancer in Carriers and Noncarriers of BRCA1 and BRCA2 Mutations
(Abstract)
Related News Article: Oral Contraceptives May Protect Against Breast Cancer
This study examines the claim that oral contraceptive use is associated with a small increase in breast cancer risk and a substantial decrease in ovarian cancer risk. In particular it inspects effects on risks for women with germ line mutations in BRCA1 or BRCA2. There was no evidence that use of current low-dose oral contraceptive formulations increases risk of early-onset breast cancer for mutation carriers, and there may be a reduced risk for BRCA1 mutation carriers.

Do Indonesian Medical Practitioners Approve the Availability of Emergency Contraception Over-the-Counter? A Survey of General Practitioners and Obstetricians in Jakarta
(Research Article)
(You need Adobe Acrobat Reader to access this document)
This study examined the level of knowledge, attitudes and practices of medical practitioners in Indonesia about emergency contraception (EC), in particular their attitudes to the availability of EC over-the-counter (OTC), using a questionnaire. Although most participants were familiar with EC, only 22% received a very good knowledge score, while 52% received a poor score. Most participants did not support the OTC availability of EC (70%).

FAMILY PLANNING/REPRODUCTIVE HEALTH NEWS

New Herpes Infections Linked to Sexual Attitudes*
(News Article)
The belief that oral sex is "safe" may explain the increased role of HSV-1 in new genital herpes cases. The herpes virus that causes cold sores around the mouth, HSV-1, now is causing many cases of genital herpes as well--a change that could reflect, in part, a growing acceptance of oral sex, researchers say.
*Web site requires registration (free).

Brazil’s New Family Planning Program Angers Catholic Church
(News Article)
Brazil has launched a new family planning program that distributes free contraceptives through the country's 6,012 hospitals and 63,662 clinics, angering Brazil's Roman Catholic Church.

HIV/AIDS RESEARCH

HIV and Cancer of the Cervix
(Review/Synthesis)
This article discusses the association of HIV and cervical intraepithelial neoplasia, the treatment of pre-invasive lesions, and invasive cervical cancer in HIV-infected women. The role of screening and the impact of antiretroviral treatment on the progression of pre-invasive and invasive cancer is also discussed.

Hepatitis B Virus and Human Immunodeficiency Virus Co-Infection in Sub-Saharan Africa: A Call for Further Investigation
(Abstract)
A growing body of evidence indicates that HIV-positive individuals are more likely to be infected with hepatitis B virus than HIV-negative individuals, possibly as a result of shared risk factors. This study examines this issue in the context of infection in Sub-Saharan Africa.

Clinical Profile of Pediatric HIV Infection from India
(Abstract)
This study examines the clinical profile of pediatric patients admitted with HIV infection in India. Results show perinatal transmission is the most common mode of acquiring HIV in the pediatric age group. Most patients have protein-energy malnutrition. Tuberculosis is common in HIV-infected children, and patients with HIV-encephalopathy have a poor outcome.

Beliefs, Sexual Behaviours and Preventive Practices with Respect to HIV/AIDS among Commercial Sex Workers in Daulatdia, Bangladesh
(Abstract)
This study explores the HIV/AIDS knowledge, attitudes, behaviors and practices among prostitutes in Daulatdia, Bangladesh. Although most prostitutes had heard of AIDS, correct knowledge of transmission and symptoms was lacking. HIV/AIDS was viewed as a remote threat, over-ridden by immediate economic and survival concerns. Client dissatisfaction was the major reason for not using condoms. Many did not obtain treatment for STDs in a timely fashion, if at all.

Uganda: HIV/AIDS Infection Drops Among Youth
(News Article)
The HIV/AIDS prevalence has shifted from the youth to an older generation, the Ugandan Commissioner of Health Services, Dr. Sam Okware, has said. He said there was a six-fold decline in HIV prevalence in the young age groups and that fewer young people are now infected.

The Challenges of HIV Vaccine Development and Testing
(Review/Synthesis)
This article reviews the challenges in the development and testing of an HIV vaccine. A vaccine against HIV remains the best hope for bringing the epidemic under control. An intensive global effort is underway to develop such a vaccine; however, the challenges are considerable. Several new vaccine technologies that have been developed and shown promise in animal models are now being tested in early phase safety trials in humans. Because there is no laboratory assay that will predict whether an HIV vaccine can protect humans from infection, clinical trials involving thousands of volunteers will need to be conducted to determine the efficacy of HIV vaccines. These trials need to take place in the developing countries that bear the burden of the epidemic, requiring a substantial amount of infrastructure development and capacity building.

HIV Prevention and Sex Workers: An International Lesson in Empowerment
(Abstract)
This article examines the impact and influence of advocacy on HIV prevention efforts among sex workers in India. The Sonagachi Project utilized methods and techniques that empowered this stigmatized, exploited and disenfranchised segment of the population. The impact of this World Bank-aided project was far-reaching; a key benefit is that it can be duplicated in developing countries around the world.

Ethical Issues in HIV
(Review/Synthesis)
This article describes the tensions between the competing goals of HIV testing, third party disclosure, management of the critically ill HIV-infected woman, infertility management in the background of HIV/AIDS, and gender-based violence as cause or result of acquiring HIV infection.

Temperament and Risky Behaviors: A Pathway to HIV?
(Abstract)
Certain sexual behaviors and abuse of substances contribute to the risk of becoming HIV-infected. Because dispositional characteristics are likely to influence this process, this study examined the association between temperament and HIV serostatus in subjects with heavy use of drugs and various sexual risk behaviors. Irritable-explosive, and to a lesser extent, depressive and hyperthymic traits, were associated with substance use, and may place individuals at risk for HIV infection via that mechanism. That current risky sexual practices were not directly linked to temperament may reflect modification in sexual behavior following the acquisition of HIV disease.

Comparison of the Precision and Sensitivity of the Antivirogram and PhenoSense HIV Drug Susceptibility Assays
(Abstract)
To assess the precision of the Antivirogram and PhenoSense assays, researchers examined susceptibility results of HIV-1 isolates lacking drug resistance mutations and containing matching patterns of drug resistance mutations. Findings reveal that the PhenoSense assay is more precise than the Antivirogram assay and superior at detecting resistance to abacavir, didanosine, and stavudine.

HIV/AIDS NEWS

Uganda: AIDS--Another Face of War in the North
(News Article)
Statistics show northern Uganda as having the highest HIV/AIDS prevalence in the country due to nearly 20 years of conflict. Statistics show northern Uganda as having the highest HIV/AIDS prevalence in the country; 9.3% in Kitgum and 13% in Gulu, compared to the national average at 6%.

Scientists Urge Africa to Fund Disease Research
(News Article)
Cash-strapped African states should spend more money on research and training to tackle diseases like AIDS, malaria and tuberculosis, international scientists said recently.

New Method May Stop HIV Spreading
(News Article)
Chinese and American scientists say they may have discovered a way to prevent the HIV virus from spreading through the body. Experts from the University of Science and Technology of China say that their most important finding is a small-molecule compound that can occupy a gap in a human cell ordinarily attacked by the HIV virus. Usually the HIV virus enters a cell through this gap and begins duplicating itself immediately. The result is that cells die and the immune system breaks down. This finding provides a new method for further clinical research of HIV/AIDS, said the experts.

Counseling Vital for Conquering AIDS: UN Official
(News Article)
Counseling for the HIV/AIDS infected is crucial for controlling the deadly virus, a UNICEF AIDS expert said recently. Wing-Sie Cheng, regional adviser of the East Asia and Pacific Regional Office of the United Nations Children's Fund (UNICEF EAPRO), urged governments in the region to engage their whole community to face the HIV/AIDS issue in an open and non-discriminatory atmosphere.

India: "Patent Law Would Deprive Millions of AIDS Treatment"
(News Article)
India's new patent law will make it illegal to copy patented drugs, a practice that has made cheaper medicines available to hundreds of thousands of AIDS and cancer patients across the globe. Medicines Sans Frontiers (MSF), a grouping of voluntary organisations fighting for HIV/AIDS prevention is furious with the Centre government for rushing through with the controversial law.

China Shuts Down Blood Dealers to Curb AIDS Spread
(News Article)
China's health ministry has closed 147 illegal blood collection agencies and arrested dozens of people since last May to prevent the spread of the virus that causes AIDS.

MATERNAL AND CHILD HEALTH RESEARCH

Postpartum Hemorrhage: A Prospective, Comparative Study in Angola Using a New Disposable Device for Oxytocin Administration
(Abstract)
The aim of this study was to introduce Uniject (a new disposable device for administration of oxytocin) as part of active management of the third stage of labor (ATML) and to try to reduce postpartum hemorrhage (PPH). Uniject was well tolerated and offers an alternative for oxytocin administration. PPH was reduced from 40.4 to 8.2% and severe PPH from 7.5 to 1% in the AMTL group.

Antenatal Care in the Capital City of Cambodia: Current Situation and Impact on Obstetric Outcome
(Abstract)
This study analyzed the situation of antenatal care (ANC) attendance in the capital of Cambodia, Phnom Penh, and the effect of ANC attendance on delivery and newborn outcome, in order to establish a strategy for ANC in the national reproductive health program in Cambodia. Results show that Phnom Penh residents have good access to ANC and delivery care. Low socioeconomic factors are risk factors to ANC. The number of ANC visits had no association with poor perinatal outcome, but further study on quality of ANC and its impact on obstetric outcome is needed.

The Risk of Preeclampsia Rises with Increasing Prepregnancy Body Mass Index
(Abstract)
This study explored the dose-dependent relation between prepregnancy body mass index (BMI) and the risk of preeclampsia after adjusting for measured confounders. Results indicate that preeclampsia risk rises through most of the BMI distribution.

Strategies to Address Nutritional Problems in African Children Caused by Poverty and the HIV/AIDS Epidemic
(Abstract)
This article explores the relationship between poverty, HIV/AIDS and nutritional deficiencies among African children. It argues that strategies to address nutrition problems must factor in additional contributing elements.

MATERNAL AND CHILD HEALTH NEWS

Thailand: Women's Health 'Key to Solving Infant Deaths'
(News Article)
More than a million children under five die each year in the Asia-Pacific region because too little money is spent ensuring pregnant women and infants are healthy, says Unicef's regional health adviser. Dr Steve Atwood said yesterday too many children die before their first birthday because governments don't care about the mother-to-be's health or the environment in which the newborn lives. Speaking at the East Asia and Pacific Ministerial Consultation on Children in Siem Reap, he said of the 1.1 million deaths of children under five in the region each year, 45% were related to problems during pregnancy, and more than half of those were related to poor nutrition.

Zambia: 40,000 to Be Born HIV Positive
(News Article)
Health Minister Brian Chituwo says as many as 40,000 children will be born infected with HIV every year if intervention measures are not put in place. Dr Chituwo said that the mother-to-child transmission rate stood at 40 per cent and that of the 500,000 babies born every year, one out of every five pregnant women was infected with HIV.

Vitamin A Deficiency a Cause of High Child Mortality Rate in Ghana
(News Article)
The Ghana Demographic and Health Survey (GDHS) has revealed unacceptably high levels of malnutrition among children in the country. Briefing the media last Friday, Dr. Agyeman Badu Akorsah, the Director General of Ghana Health Services said the proportion of children below five years who are underweight has risen between 22 and 28 percent in 1993 and 2003, resulting in stunted growth among children. "This means that close to one out of every three children in this country is suffering from the effects of long term or periodic inadequate food intake", Dr. Akorsah lamented.

MEN'S HEALTH NEWS

Namibia: Do Men Talk About HIV/Aids? Are They Entitled to Sex?
(News Article)
Catholic AIDS Action (CAA)in the Omusati region of Namibia recently held a meeting for men to discuss the importance of male involvement in the fight against HIV/AIDS. CAA chief operator, Godwin Chisenga, said men need to be involved because they hold more key decision-making positions than women and their actions were likely to be seen as right because of the "pre-dominant male society we live in". He said if men got more involved, Namibia would move a step forward in the fight against the pandemic.

POPULATION NEWS

UK: Parents 'Could Pick Babies' Sex'
(News Article)
Related News Article: Uproar over British Report over Freedom to Choose Sex of Child
Couples undergoing in vitro fertilization could be allowed to select the sex of their baby under proposals put forward in the UK. A controversial Commons Science and Technology Committee report said more decisions on fertility treatment should be made by patients and their doctors. The MPs also called for the regulator, the Human Fertilisation and Embryology Authority, to be disbanded. And they said "taboo" research, such as implanting human cells into animals, should be considered, with regulation.

Most Tsunami Dead Female--Oxfam
(News Article)
More women than men were killed by the Asian tsunami, Oxfam figures from India, Indonesia and Sri Lanka suggest. In some regions the disaster claimed four times as many women as men. The charity says women were worst-hit because they were waiting on beaches for fishermen to return, or were at home looking after children at the time.

WOMEN'S HEALTH RESEARCH

Reproductive Health in Women with Eating Disorders
(Abstract)
This article provides an overview of anorexia nervosa and bulimia nervosa, identifies the reproductive health issues that may occur in women with these disorders, and discusses the associated clinical implications.

Incidence of Cervical Squamous Intraepithelial Lesions Associated With HIV Serostatus, CD4 Cell Counts, and Human Papillomavirus Test Results
(News Article)
Related News Article: HIV Women Should get 3-year Pap Smears
This study determined the incidence of squamous intraepithelial lesions (SIL) in HIV-seropositive women with normal cytology results, by baseline HPV DNA results. The similar low cumulative incidence of any SIL among HIV-seronegative and HIV-seropositive women with CD4 counts greater than 500/µL and who had normal cervical cytology and HPV-negative test results suggests that similar cervical cancer screening practices may be applicable to both groups.

Accuracy of Visual Inspection with Acetic Acid (VIA) for Early Detection of Cervical Dysplasia in Tehran, Iran
(Abstract)
This study evaluated the accuracy of visual inspection with 5% acetic acid (VIA) when used to detect cervical cancer and its precursors. The results of this study indicate that although VIA is a sensitive screening test for detection of cervical dysplasia, it can not be used by itself. Applying VIA along with Pap smears helps to detect a higher number of cases with cancer precursor lesions.

Factors and Temporal Trends Associated with Highly Active Antiretroviral Therapy Discontinuation in the Women's Interagency HIV Study
(Abstract)
This study characterized factors and temporal trends associated with discontinuation of highly active antiretroviral therapy (HAART) among 936 HIV-infected women enrolled in the Women's Interagency HIV Study. A multivariate analysis of post-HAART initiation exposures found that high HIV RNA levels and high depressive symptom scores were associated with HAART discontinuation.

WOMEN'S HEALTH NEWS

Ethiopia: Fistula Hospital Continues Services for Young Women
(News Article)
Every year 100,000 women across the developing world find their lives destroyed by fistula. Dr Catherine Hamlin, a local gynecologist, performs relatively simple, cheap operations that radically change women's outcomes.

YOUTH HEALTH RESEARCH

Dutch Commission Recommends More Checks to End Female Genital Mutilation
(News Article)
The Dutch government considers making reporting of female genital mutilation mandatory for all health and youth workers, health minister Hans Hoogervorst said.

Assessing the Health Status of Young AIDS and Other Orphans in Kampala, Uganda
(Abstract)
This study reports findings from a cross-sectional survey on associations between orphan status and health and nutrition parameters in young children of urban Uganda. A high prevalence of orphans was reported from a central Kampala community, with 41% being attributed to HIV/AIDS. Although there was a higher prevalence of self-reported morbidity in orphans than non-orphans, there were no differences in reported treatment-seeking behavior and measured anthropometric parameters. Hence it seems that the extended family system still manages to care for young orphans.

Behavioral Risk in Early Adolescents with HIV+ Mothers
(Abstract)
This study examined the effect of maternal HIV infection on sexual and drug use risk behavior, delinquency, and general behavior problems in early adolescents. Findings suggest that maternal HIV status did not significantly add to the risk for problem behaviors in a sample of urban ethnic minority early adolescents.

YOUTH HEALTH NEWS

Ugandan Children Face Unspeakable Horrors in 'Silent Crisis'
(News Article)
With the surge in violence, rebel atrocities that many believed were a thing of the past have made a grisly comeback. More than 20,000 children have been abducted by the notorious Lord's Resistance Army to serve as fighters, porters or sex slaves.

Kenya: A Case Study of Modern Legislation Against Cultural Identity
(News Article)
Every year an estimated two million girls around the world are at risk of undergoing the removal of all or part of their genitalia, a procedure referred to as female genital mutilation, female circumcision or female genital cutting. Kenya is one of 28 countries in Africa in which FGM is widely practiced. "Female genital mutilation and cutting is a violation of the basic rights of women and girls," Carol Bellamy, executive director of the UN's Children's Agency (UNICEF), said on 7 February 2005, the International Day of Zero Tolerance of FGM.

Sierra Leone: Five Years Old and Learning to Circumcise Other Girls
(News Article)
Young girls in Sierra Leone, who were traditionally circumcised at puberty, are having their clitoris cut out by secret societies at a younger and younger age, especially in the remote north of the country. The women who perform the crude operation with a long-bladed knife are also getting younger.

UK: 'One in Five Girls Aged 14 Has Had Sex'
(News Article)
More than one-fifth of all 14-year-old girls in Britain have had sex--and with an average of three partners--according to a recent survey. But half of those girls regret their experience and 70% of all 14-year-olds say they need more information about love and sex, a report for Bliss Magazine reveals.

SPECIAL REPORTS/PROFILES/RESOURCES

Global Tuberculosis Control--Surveillance, Planning, Financing
(News Article)
Related News Article: Africa: HIV/AIDS Adds New Dimension to TB Threat
In most areas of the world, the battle against tuberculosis is being successfully fought, but in Africa the disease has reached alarming proportions with a growing number of TB cases and deaths linked to HIV, the World Health Organization has said.

"The Pop Reporter" (R) Johns Hopkins Bloomberg School of Public Health/Center for Communication Programs INFO Project. When you click on any link, 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.

Problems and comments can be addressed to rjacoby@jhuccp.org.

Archives available at http://www.infoforhealth.org/popreporter/.

Subscribe at http://prds.infoforhealth.org/signup.php.

Modify your account at http://prds.infoforhealth.org/modify.php.

Have an item to contribute for consideration in The Pop Reporter? E-mail the URL and description to rjacoby@jhuccp.org. Forward this message to a friend who could benefit from INFO project activities!

Sincerely,

Robert Jacoby, rjacoby@jhuccp.org
Editor, The Pop Reporter

Johns Hopkins Bloomberg School of Public Health: The INFO Project

Volume 5, Number 1328 March 2005