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Volume 5, Number 15
11 April 2005

The Pop Reporter is now available in both CD-ROM (past year) and print archives (past 6 months) formats. These items are intended for users in low-resource settings. For print or CD-ROM archives, contact rjacoby@jhuccp.org with your request and complete mailing address.

FAMILY PLANNING/REPRODUCTIVE HEALTH RESEARCH

Atitudes to and Management of Fertility among Primary Health Care Physicians in Turkey: An Epidemiological Study
(Research Article)
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The aim of this study was to determine primary care physicians' opinions about the approach to infertility cases and their place within primary health care services.

How Condom Use, Number of Receptive Anal Intercourse Partners and History of External Genital Warts Predict Risk for External Anal Warts
(Abstract)
Ths study objectives were to classify the relative importance of condom use, receptive anal intercourse (RAI) and prior history of external genital warts (EGWs) on acquisition of external anal warts (EAWs). Men with history of EGWs were more likely than those previously unaffected to have developed EAWs, as were men who reported multiple anoreceptive intercourse partners. Consistent condom usage showed no protective effect for EAWs.

HIV and Syphilis in Young Chinese Adults: Implications for Spread
(Abstract)
This study explored the epidemiology of HIV and syphilis at population level in young Chinese adults. Syphilis prevalence ranged from 0.33% to 0.71% across study sites, with 58% in men. Although syphilis levels suggest that unsafe sexual activity is occurring in all areas, HIV is not yet affecting the general population of Zhejiang or Shaanxi. The epidemic in Yunnan is being driven by injecting drug users, but there may now be transmission in the general population.

Influences on Client Loyalty to Reproductive Health-Care Clinics in the Philippines and Thailand
(Research Article)
(You need Adobe Acrobat Reader to access this document)
This study examined relationships between reproductive health (RH) clients’ cognitions, emotions, and clinic loyalty in two countries: Thailand and the Philippines. In both countries, cognitive evaluations were important predictors of future loyalty. In addition, the experience of negative emotions decreased clinic loyalty in both countries. However, only in Thailand did the experience of positive emotions significantly enhance loyalty. In Thailand, this variable was the strongest predictor. Discussion centers on the significance of this finding and others to clinic managers who wants to increase client loyalty in order to strengthen the positive impacts of their RH programs.

FAMILY PLANNING/REPRODUCTIVE HEALTH NEWS

Egypt Cleric Cautions on Sex Tuition
(News Article)
Egypt's most senior Islamic cleric has denounced attempts to discuss safe sex and abortions in the country's classrooms.

Pope's Ban on Contraception Caused Rift
(News Article)
From Latin America to Asia and Africa, Catholics struggling to care for large families amid grinding poverty and an AIDS pandemic faced a dilemma over Pope John Paul II's opposition to contraception.

FAMILY PLANNING/REPRODUCTIVE HEALTH LAW AND POLICY

Chad: Uproar Over Introducing Law to Make Women Equal
(News Article)
A government plan to give conservative Chad a new family law banning practices such as beating wives has provoked uproar. "At Friday prayers, Muslim preachers have taken to saying that President Idriss Deby and his family will burn in hell because it is against the Koran to say a woman is equal to a man," the weekly newspaper Notre Temps observed.

US: Senate Votes to Restore Funding to International Family Planning Groups that Provide, Counsel on Abortion
(News Article)
The US Senate voted Tuesday to lift restrictions on US family planning aid to health centers abroad that promote or perform abortions.

HIV/AIDS RESEARCH

The Role of Sex Worker Clients in Transmission of HIV in Cambodia
(Abstract)
This study investigated whether clients of sex workers are a bridge for transmission of HIV to the general population of Cambodia. The levels of HIV knowledge and condom use, and prevalence of HIV (9.2%), were high. Almost 40% of those interviewed had sex with women other than sex workers, but rarely used condoms. HIV infection was correlated with a history of STD, having had an HIV test, not living with one's wife, a high level of HIV/AIDS knowledge, and condom slippage/breakage.

HIV/AIDS and the Health Workforce Crisis: What are the Next Steps?
(Abstract)
This article debates the challenge of adequate human resources in the attempt to provide antiretroviral treatment to HIV/AIDS patients in resource-poor settings.

Viral Dynamics of Primary HIV-1 Infection in Senegal, West Africa
(Abstract)
Few studies have addressed primary HIV type 1 infection in sub-Saharan Africa, where the epidemic is of a predominantly heterosexual character and is caused by different subtypes. The present study examines the dynamics of viral replication in subjects infected with various HIV-1 subtypes. The findings in Senegalese women differ from what have been described for primary HIV-1 infection.

Antiretroviral Treatment in Resource-Poor Settings: Public Health Research Priorities
(Abstract)
This article reviews the highly complex prospect of upscaling antiretroviral treatment in the African setting.

Aids, Race and the Limits of Science
(Abstract)
This paper argues that HIV/AIDS is more complicated than biomedicine allows and that the "overmedicalization" of treatment and prevention efforts obscures the significant socio-cultural and political-economic realities that shape the global pandemic, including conceptions of race.

HIV/AIDS NEWS

Brazil: Promoting Abstinence Ineffective Against AIDS
(News Article)
There is no evidence that promoting abstinence or marital fidelity works against AIDS, as the Bush administration argues, a senior Brazilian health official told the United Nations.

UK Funding for Anti-HIV Gel Trial
(News Article)
The UK government is to provide £24 million to fund a trial to assess how well a microbicide gel can prevent HIV infection in women.

Iraq: Focus on Shortage of Medicine for HIV/AIDS Patients
(News Article)
Officials from the AIDS Research Centre in the Iraqi capital, Baghdad, have complained of a shortage of medicines for HIV/AIDS patients under treatment in the country.

Vietnam’s Number of HIV/AIDS Patients Growing
(News Article)
The official number of patients with HIV in Vietnam has reached more than 88,000 in 2004 and is increasing steadily, warned the Health Ministry recently.

Tanzania: HIV/AIDS Knowledge 'On the Rise'
(News Article)
Knowledge of HIV/AIDS transmission and prevention as well as safer sexual behaviour has increased in Tanzania, according to a report released by Tanzania Commission for Aids in Dar es Salaam.

Uganda: Free ARVs for HIV-Positive Civil Servants
(News Article)
Some 10,000 Ugandan government workers living with HIV will receive free antiretroviral drugs, the minister for economic monitoring, Omwony Ojwok, said recently.

Findings From Perinatal HIV Prevention Study in Uganda are Valid, New Review Says
(Press Release)
Related News Article: US Medical Experts Uphold Value of Controversial Drug Shown to Stem Infant HIV
A panel of medical experts has defended a controversial US AIDS study in Uganda that has been attacked for improprieties. The research shows that an AIDS drug can safely reduce an infected mother's ability to transmit the deadly virus to her newborn during childbirth. Allegations had surfaced that the study was flawed.

Ghana: Local Employers Start to Care for Their HIV-Positive Staff
(News Article)
Ghana's National HIV-AIDS and Sexually Transmitted Infections policy, launched last year, mandates the employment ministry, the AIDS Commission and other agencies to develop a comprehensive policy on employment-related HIV/AIDS issues. Several multinational companies operating in Ghana already implement policies to help their HIV-positive employees and their families access proper treatment and lead normal lives.

China: AIDS-Afflicted Province Takes New Measures against Epidemic
(News Article)
Central China's Henan Province, one of the areas in the country most affected by AIDS, is renewing its efforts to fight the epidemic this year with eight new measures, according to the provincial government.

Lesotho: Demand for AIDS Treatment Could Jeopardise Quality of Care
(News Article)
International media reports raised concerns that private doctors in Lesotho were dispensing anti-AIDS drugs without specialised training, putting the lives of many HIV-positive people at risk.

MATERNAL AND CHILD HEALTH RESEARCH

Predictors of Immunologic Long-Term Nonprogression in HIV-Infected Children: Implications for Initiating Therapy
(Abstract)
This study identified early markers of immunologic long-term HIV disease nonprogression. CD8+ HLA-DR+ T-lymphocyte percentage of less than 5% at 1 to 2 months of age might be predictive for immunologic long-term nonprogressors status but should not be used at this time to make treatment-deferral decisions. Immune activation in HIV-infected infants might herald more disease progression.

Inter-state Inequality in Infant Mortality in India, 1981-2000
(Research Article)
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This analysis reveals that with the declining levels of infant mortality, the absolute inter-state inequality in the probability of death during infancy has also decreased for the country and for its rural and urban populations. In terms of relative inter-state inequality, however, the declining trend in inequality could be observed in rural areas only; in urban India, the relative inter-state inequality in infant mortality has tended to increase during the 20 years under reference.

The World Health Report 2005: Make Every Mother and Child Count
(Report)
Related Press Release: WHO Reports Calls for New Approach to Save Lives of Mothers and Children
Hundreds of millions of women and children have no access to potentially life-saving care with often fatal results, the World Health Organization (WHO) says in their World Health Report 2005. The report says the resulting death toll could be sharply reduced through wider use of key interventions and a "continuum of care" approach for mother and child that begins before pregnancy and extends through childbirth and into the baby's childhood.

Sociodemographic Factors Associated with Participation by HIV-1-Positive Pregnant Women in an Intervention to Prevent Mother-to-Child Transmission of HIV in Côte d'Ivoire
(Abstract)
Researchers examined possible sociocultural and economic barriers to participation in antiretroviral prophylaxis interventions at a mother-to-child transmission prevention program in Abidjan, Côte d'Ivoire. The findings suggest that the non-participants were more marginal socioculturally and economically in Ivorian society than participants.

MATERNAL AND CHILD HEALTH NEWS

Burundi: New Health Projects for Women and Children
(News Article)
UN agencies in Burundi announced new measures on World Health Day to improve the health of mothers and children.

Swaziland: HIV Prevalence Rate among Pregnant Women Rises
(News Article)
Swaziland's government said it would act urgently to reverse the rising HIV prevalence rate among pregnant women, currently at 42.6% according to the latest sentinel survey.

Unsafe Motherhood: Maternal Mortality Highest in India
(News Article)
India has the worst record of maternal mortality in the world as it accounts for over 25% of such deaths. Experts have warned of drastic consequences if immediate measures are not taken to check this report card.

MEN'S HEALTH RESEARCH

Reversible, Non-Barrier Male Contraception: Status and Prospects
(Abstract)
In this review article, the authors note that cross-cultural surveys show men's willingness to carry contraceptive responsibility and that clinical trials substantiate that hormonal contraception involving suppression of gonadotropins holds the best promise to provide a male pharmacological contraceptive.

In Utero Exposure to Environmental Estrogens and Male Reproductive Health: A Systematic Review of Biological and Epidemiologic Evidence
(Abstract)
The purpose of this study was to review the endocrine disruption hypothesis, to present the relevant supporting evidence, to summarize the current knowledge, to identify gaps and limitations in the interpretation of published data, and to define future directions in research. The results do not support with certainty the view that environmental estrogens contribute to an increase in male reproductive disorders, neither do they provide sufficient grounds to reject such a hypothesis.

Barriers to Male Participation in Family Planning in West Timor
(Research Article)
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In this study, qualitative methods were used to explain males’ participation in family planning. The research points out that marriage and bride price payment are important elements perpetuating male domination over women. Violence against women and drinking behavior also influence the practice of family planning. Men take major decisions within the family. Although men tend to influence their partners as regards family planning decisions, women still have the opportunity to discuss the options available.

POPULATION RESEARCH

A Model of Underlying Socioeconomic Vulnerability in Human Populations: Evidence from Variability in Population Health and Implications for Public Health
(Abstract)
Drawing from insights into the variability of complex biologic systems, the authors propose that the health of human populations reflects the interrelationship between underlying vulnerabilities and capacities and how populations, shaped by these vulnerabilities and capacities, respond to intermittent stressors and protective events. The results of this analysis are consistent with a theory of underlying socioeconomic vulnerabilities of human populations and suggest that variability in population health may be an important consideration in population health assessment.

POPULATION NEWS

Bulgaria: Disappearing Towns
(News Article)
Bulgaria has the highest mortality rate compared to EU member states, and its average life expectancy is 7 or 8 years shorter than in the EU. It could be said that every year a town of 70,000 or 75,000 people disappears from the map of Bulgaria.

India: Manmohan Promises Aid to Boost Parsi Population
(News Article)
Prime Minister Manmohan Singh promised all governmental help to the Parsi community to check the alarming decline in its population.

India: Population Control - 'Implementation is the Challenge'
(News Article)
The biggest challenge to the success of population and health issues is the implementation by States, health being a State subject, the Union Health and Family Welfare Secretary, P.K. Hota, said recently.

Fall in EU Population Forecast by 2050
(News Article)
Related News Article: Recent Demographic Developments in Europe 2004
The population of the European Union will fall dramatically by 2050, even allowing for the arrival of millions of immigrants, an official survey reported. Deaths would begin to outnumber births across the EU in the next 5 years, it predicted.

WOMEN'S HEALTH RESEARCH

Menstrual Regulation Practices in Bangladesh: An Unrecognized Form of Contraception
(Research Article)
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This paper examines the knowledge and attitude towards menstrual regulation (MR) practice and analyzes the characteristics of MR users in Bangladesh, using both quantitative and qualitative data. It also analyzes the contraceptive use behavior of the MR users and underlies reasons for accepting the method. The findings of the study are expected to have important policy relevance in Bangladesh and other developing countries where pregnancy termination is widely practiced.

Prophylactic Quadrivalent Human Papillomavirus (Types 6, 11, 16, and 18) L1 Virus-like Particle Vaccine in Young Women: A Randomised Double-blind Placebo-controlled Multicentre Phase II Efficacy Trial
(Abstract)
Related News Article: Vaccine Promising Against Disease-Causing HPV
Registration (free) is required to view this abstract from The Lancet Oncology. While it is known that certain strains of the virus responsible for causing genital warts (human papillomavirus or HPV) are also likely to trigger cervical cancer, now comes news that a vaccine designed to combat four of these strains can dramatically reduce persistent infection and the risk of developing warts and cancer.

Risk Factors for HIV Infection among Sex Workers in Johannesburg, South Africa
(Abstract)
This study determined the prevalence and risk factors for HIV infection among female sex workers in Johannesburg, South Africa. Increasing frequency of condom use was significantly negatively associated with HIV infection. Older women in the Johannesburg sex industry may have adaptive behavioral strategies besides condom usage that reduce their risk of acquiring HIV. However, older sex workers with gonorrhea constitute a high-risk subgroup.

WOMEN'S HEALTH NEWS

Zimbabwe: Ministry Seeks to Combat Gender Violence
(News Article)
The Ministry of Youth Development, Gender and Employment Creation has embarked on a project to combat gender-based violence, which is prevalent in many families.

Africa Spurns Female Circumcision
(Feature Article)
Senegal is part of a swelling movement against the long-held but controversial practice of female circumcision.

YOUTH HEALTH RESEARCH

Increasing the Screening and Counseling of Adolescents for Risky Health Behaviors: A Primary Care Intervention
(Abstract)
This study determined whether a systems intervention for primary care providers resulted in increased preventive screening and counseling of adolescent patients, compared with the usual standard of care. Screening and counseling rates increased significantly in each of the 6 areas in the intervention sites, compared with rates of delivery using the usual standard of care. Findings offer strong support for an intervention to increase clinicians' delivery of preventive services to a wide age range of adolescent patients.

Oral Versus Vaginal Sex Among Adolescents: Perceptions, Attitudes, and Behavior
(Abstract)
Related News Article: Study: Teens View Oral Sex as Less Risky
This study is the first to investigate adolescents' perceptions of the health, social, and emotional consequences associated with having oral sex as compared with vaginal sex, as well as whether adolescents view oral sex as more acceptable and more prevalent than vaginal sex. Adolescents evaluated oral sex as significantly less risky than vaginal sex on health, social, and emotional consequences. Adolescents also believed that oral sex is more acceptable than vaginal sex for adolescents their own age in both dating and nondating situations oral sex is less of a threat to their values and beliefs.

YOUTH HEALTH NEWS

China: Sex Survey on Campus Gets Cold Shoulder
(News Article)
A survey on the reproductive health of Shanghai students launched last July is being obstructed by university authorities, some of whom object to the idea that their undergraduates might think "too much" about sex.

South Africa: Children Exposed to HIV in Hospitals
(News Article)
Research into the exposure of young Free State children to HIV has uncovered shocking neglect of infection-control procedures in state hospitals, with almost a quarter of the surgical instruments used in paediatric and dental units found to be contaminated with blood.

UNICEF to Fight AIDS with Sports Authority of India
(News Article)
Unicef is joining hands with the Sports Authority of India (SAI) to create an HIV/AIDS coaching manual for games like cricket and football interspersed with AIDS awareness lessons targeted at those most vulnerable to the disease - the youth.

Namibia: Children Seen As Window of Hope for HIV Prevention
(News Article)
Namibia has identified the need to strengthen sexual health education in school curriculum in response to the threat being posed by the HIV/AIDS pandemic.

BOOKS/BOOK REVIEWS

Countering Gender Violence: Initiatives Towards Collective Action in Rajasthan
(Book)
The book provides a theoretical framework by analyzing gender violence in the changing perspectives of development, health and human rights; examines the ways in which violence against women as been studied; and draws links between gender violence and power relations.

SPECIAL REPORTS/PROFILES/RESOURCES

Adolescent Sexual Decision-making Counselling Protocol
(Tool)
(You need Adobe Acrobat Reader to access this document)
This manual was developed to assist counsellors to identify the factors that influence sexual decision-making in adolescents aged 10–19 years. It also enables the counsellors to explore with the adolescents the possible situations that could put them at risk of forced or coerced sexual activity. It has been developed as a result of a research project conducted in March 2002 that investigated the factors that affect sexual decision-making in adolescent females 10–14 years old in St. James, Jamaica. Though the research was conducted with adolescent females aged 10 to 14 years, inclusive, the counselling protocol has been designed to be applicable to male and female adolescents up to 19 years old.

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

Johns Hopkins Bloomberg School of Public Health: The INFO Project

Volume 5, Number 1511 April 2005