Volume 5, Number 19
9 May 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

Bacterial Vaginosis Transmission, Role in Genital Tract Infection and Pregnancy Outcome: An Enigma
(Abstract)
This review focuses on whether or not bacterial vaginosis (BV) should be regarded as an STI, its role in postoperative infections and pelvic inflammatory disease (PID), and on whether treatment of BV during pregnancy to reduce preterm delivery should be recommended. The reviewed studies do not lend unequivocal support to an endogenous or exogenous transmission of the bacteria present in BV.

Evaluating the Sexual Behaviour, Barriers to Condom Use and its Actual Use by University Students in Nigeria
(Abstract)
This research quantified the barriers to condom use of a sample of university students in Nigeria. Results indicated both men and women reported that condoms hindered their sexual satisfaction, caused health problems for them, and reduced their sexual interest. The findings also showed that obtaining condoms from clinics and perception that condoms do not cause health problems predicted the likelihood of condom use for both sexes.

Intramuscular Testosterone Enanthate Plus Very Low Dosage Oral Levonorgestrel Suppresses Spermatogenesis Without Causing Weight Gain in Normal Young Men: A Randomized Clinical Trial
(Abstract)
High-dosage parenteral testosterone (T) esters alone or in combination with a progestogen have been shown to confer effective and reversible male contraception in clinical trials, but these regimens are associated with weight gain and suppression of serum high-density lipoprotein cholesterol (HDL) levels. This study hypothesized that intramuscular T enanthate 100 mg weekly plus a very low dosage of oral levonorgestrel would effectively suppress spermatogenesis in normal men without inducing weight gain or HDL suppression. There were no clinically significant adverse events or significant changes in hematology or chemistry profiles in either group during the study.

The Risk of Menstrual Abnormalities After Tubal Sterilization: A Case Control Study
(Research Article)
(You need Adobe Acrobat Reader to access this document)
The existence of the post-tubal-ligation syndrome of menstrual abnormalities has been the subject of debate for decades. In a cross-sectional study, 112 women with a history of Pomeroy type of tubal ligation achieved by minilaparatomy as the case group and 288 women with no previous tubal ligation as the control group were assessed for menstrual abnormalities. Menstrual abnormalities were not significantly different between the case and control groups, indicating that tubal sterilization does not cause menstrual irregularities.

FAMILY PLANNING/REPRODUCTIVE HEALTH NEWS

Uganda: Family Planning Strategy Launched
(News Article)
The Government has launched the National Family Planning Advocacy strategy to check population growth.

Uganda: Iganga Fails to Utilize Condoms
(News Article)
Sexually active people in Iganga district are failing to use the abundant supply of free condoms, an official has said. A recent survey indicated that only 5% of the population used condoms.

Uganda: WHO Chief Raps Condom Critics
(News Article)
The out-going World Health Organization country representative has criticized people who campaign against condom use in the fight against HIV/AIDS.

Colombia Pilots Free Voluntary Sterilization Program
(News Article)
Colombian health institutions launched a controversial voluntary sterilization program that provides free surgical birth control procedures for men and women in Cucuta and Roncesvalles municipalities. Expectations are that 500 operations will be performed by July.

BEIKS Introduces Woman Calendar, Ovulation Tracker for Natural Family Planning, to Windows Mobile Pocket PCs and Updates Windows PC Version
(Press Release)
BEIKS announces it has launched a version of its popular Woman Calendar fertility tracker for Windows Mobile PDAs and an updated version for desktop PCs with several new features. Woman Calendar enables women to accurately predict fertility and period cycles and offers a means to efficiently manage a "natural family planning lifestyle."

FAMILY PLANNING/REPRODUCTIVE HEALTH LAW AND POLICY

Pakistan Presses Religious Conservatives to Support Family Planning
(News Article)
Pakistan is urging Islamic scholars to help promote birth control to slow the country's strong population growth. But the message is in danger of being lost in the deeply conservative Islamic nation.

FDA Wants Sperm Banks to Bar Donors Who've Had Gay Sex
(News Article)
The Food and Drug Administration is about to implement new rules recommending that any man who has engaged in homosexual sex in the previous five years be barred from serving as an anonymous sperm donor. The FDA has rejected calls to scrap the provision, insisting that gay men collectively pose a higher-than-average risk of carrying the AIDS virus.

HIV/AIDS RESEARCH

AIDS-Related Discrimination in Asia
(Abstract)
This project was an action-based, peer-implemented study that aimed to develop an understanding of the nature, pattern, and extent of AIDS-related discrimination in several Asian countries. A considerable number of respondents were refused treatment after being diagnosed with HIV, and many experienced delayed provision of treatment or health services. Breaches of confidentiality by health workers were common. Within the family and the community, women were significantly more likely to experience discrimination than men, including ridicule and harassment, physical assault, and being forced to change their place of residence because of their HIV status.

Estimating HIV Evolutionary Pathways and the Genetic Barrier to Drug Resistance
(Abstract)
This study reviewed the evolution of drug-resistant viruses in the management of HIV infections. Researchers found both the mode and the rate of development of resistance to be heterogeneous. The genetic barrier to zidovudine resistance was increased if lamivudine was added to zidovudine but was decreased for didanosine. The barrier to lamivudine resistance was maintained with zidovudine plus didanosine, whereas the barrier to didanosine resistance was reduced most with zidovudine plus lamivudine.

Couple-Focused Support to Improve HIV Medication Adherence: A Randomized Controlled Trial
(Abstract)
This study assessed the efficacy of a couple-based intervention to improve medication-taking behavior in a clinic population with demonstrated adherence problems. The intervention significantly improved medication adherence over usual care, although the level of improved adherence, for many participants, was still suboptimal and the effect was attenuated over time.

HIV/AIDS in South Africa: A Review of Sexual Behavior among Adolescents
(Abstract)
This paper is a comprehensive analytical review of available research concerning the sexual behavior of adolescents in South Africa. It offers insight into HIV infection among adolescents and provides an important base for educational interventions aimed at behavior change and reducing further transmission. The most important conclusion is that, despite the research (however limited) that has been done, there has been no significant change in the rate of infection among adolescents in South Africa.

Gender, Religious Involvement, and HIV/AIDS Prevention in Mozambique
(Abstract)
Using survey and semi-structured interview data collected in various religious congregations in urban and rural areas of Mozambique, this study analyzes how gender differences in perceptions of HIV/AIDS and preventive behavior are mediated by religious involvement. The analysis detects women's disadvantage on several measures of knowledge and prevention but also suggests that gender differences are less pronounced among members of "mainline" churches. The semi-structured interview data further highlight how gender differences are shaped in different religious environments. Although the potential of faith-based institutions in combating the HIV/AIDS pandemic is undeniable, policy-makers need to heed important differences among these institutions when devising ways to harness this potential.

Using Prevalence Data from the Programme for the Prevention of Mother-to-Child-Transmission for HIV-1 Surveillance in North Uganda
(Abstract)
This study validated the use of data from a program for the prevention of mother-to-child transmission (PMTCT) in estimating HIV-1 prevalence in North Uganda. It showed that the prevalence estimated based on the VCT data collected as part of the PMTCT program could be used for HIV-1 surveillance in North Uganda. At the national level, however, it needs to be evaluated whether PMTCT data could replace, or instead be combined with, the data from sentinel surveillance.

A Method for the Quantitative Analysis of the Layering of HIV-Related Stigma
(Abstract)
The stigma of HIV infection is layered with other stigmas, such as those associated with the routes of transmission (e.g., sex work and injecting drug use) and personal characteristics (e.g., race, religion, ethnicity and gender). In developing programs and policies to overcome HIV-related stigma, cognisance needs to be taken of all the sources of stigma and how they may interact. A novel method is described for examining the layers of HIV/AIDS-related stigma, and secondary data are adapted to illustrate this.

Stress, Appraisal, and Coping: A Comparison of HIV-Infected Women in the Pre-HAART and HAART Eras
(Abstract)
A sample of 79 women living with HIV/AIDS in the pre-HAART era (1994–1996) were compared with a matched sample of 79 women with HIV/AIDS from the HAART era (2000–2003) on measures of stress, illness appraisals, and coping strategies. Contrary to expectations, HIV-infected women in the HAART era were significantly more likely than women in the pre-HAART era to report health-related stress, to report stress from stigma and disclosure, to view HIV as having caused them harm, to report that their health is due to chance, and to report more use of maladaptive forms of coping.

HIV/AIDS NEWS

Trade Deal Won't Hit Thai Generic AIDS Drugs - U.S.
(News Article)
The United States assured Thailand that a bilateral free trade deal under negotiation will not prevent Thai companies making cheap, copycat AIDS drugs, which are being used to treat thousands of patients.

Mozambique: Workers in the Forefront of Fight Against HIV/AIDS
(Feature Article)
The role workers can play in the fight against HIV/AIDS came into sharp focus during May Day celebrations in Mozambique.

Uganda: Adult HIV Infections Rise to Seven Percent
(News Article)
An estimated 7% of Uganda's adult population is living with HIV/AIDS, up from previous estimates of 6.2%, the ministry of health said.

South Africa Defends AIDS Progress
(News Article)
Related News Article: AIDS Groups Condemn South Africa's 'Dr. Garlic'
Stressing the benefits of olive oil, garlic, and beetroot, South Africa's health minister recently said good nutrition was just as important as anti-retroviral medicines for people infected with the AIDS virus and that her government would not be pressured into meeting UN treatment targets.

AIDS Funds Refused Over Prostitution Clause
(News Article)
Brazil won't accept some $40 million (euro30.88 million) in U.S. funding to fight AIDS unless Washington drops a clause condemning prostitution, the Health Ministry said Wednesday.

Only 7% of Ghanaians Have Tested for HIV Status
(News Article)
Only 7% of the total Ghanaian population has opted for voluntary counselling and testing to know their HIV/AIDS status, according to the Manager of the National AIDS/Sexually Transmitted Infections Control Programme.

MATERNAL AND CHILD HEALTH RESEARCH

Maté Drinking during Pregnancy and Risk of Preterm and Small for Gestational Age Birth
(Abstract)
To assess the effect of maté drinking during pregnancy on preterm and small for gestational age (SGA) birth, a cross-sectional study was done. After controlling for confounders, the significance of the association with SGA birth no longer held and the lack of association with prematurity remained unchanged. In conclusion, prevalence of daily maté drinking was high among pregnant women and, contrary to the hypothesis, no harmful effect on intrauterine growth or duration of pregnancy was detected.

Use of Population-Specific Infant Mortality Rates to Inform Policy Decisions Regarding HIV and Infant Feeding
(Abstract)
This paper presents an analysis of the impact of WHO infant feeding recommendations in different settings characterized by infant mortality rate (IMR). These simulations suggest that in settings where IMR is less than 25/1,000 live births, replacement feeding results in the greatest HFS to 24 mo; exclusive breastfeeding produces the best outcome where IMR is greater than 25/1,000 live births. IMR-based analyses can help to guide government policy decisions about which infant feeding strategies to invest in and emphasize for HIV-positive mothers in different settings.

Exploring Socio-Economic Conditions and Poor Follow-Up Rates of HIV-Exposed Infants in Johannesburg, South Africa
(Abstract)
This study examined socio-economic circumstances of women attending a prevention of mother-to-child transmission (PMTCT) of HIV program in South Africa. Socio-economic factors such as poverty, geographical relocation, and a lack of paternal support may affect the capacity of families to comply with the PMTCT follow-up program.

Neonatal Measles Immunity in Rural Kenya: The Influence of HIV and Placental Malaria Infections on Placental Transfer of Antibodies and Levels of Antibody in Maternal and Cord Serum Samples
(Abstract)
Researchers investigated predictors of levels of measles antibodies in newborns in rural Kenya. Infants born to HIV-infected mothers were more likely to be seronegative and had 35.1% lower levels of measles antibodies than did those born to HIV-uninfected mothers. Preterm delivery, early maternal age, and ethnic group were also associated with reduced levels of measles antibodies. There was little evidence that placental malaria infection was associated with levels of measles antibodies in newborns.

Micronutrient Deficiencies in Early Pregnancy Are Common, Concurrent, and Vary by Season among Rural Nepali Pregnant Women
(Abstract)
This study investigated the prevalence and seasonal variation of multiple micronutrient deficiencies in pregnant women as part of a baseline assessment in a population-based, maternal micronutrient supplementation trial conducted in the rural Southeastern plains of Nepal. Micronutrient status varied by season; it was generally best during the winter months, except for serum vitamin D concentration, which peaked during the hot summer and monsoon months.

Nelfinavir and Nevirapine Side Effects During Pregnancy
(Abstract)
This study assessed and compared tolerability, safety, and efficacy of nelfinavir- or nevirapine-containing HAART in a cohort of pregnant and non-pregnant HIV-infected women. Findings show that nelfinavir- or nevirapine-containing HAART regimens during pregnancy are well tolerated. Side effects of antiretroviral therapy are more frequent in pregnant than in non-pregnant women.

Factors Asociated with Eclusive Breastfeeding in Accra, Ghana
(Abstract)
This study assessed factors associated with exclusive breast-feeding (EBF) in Accra, Ghana. Although 99.7% of mothers were currently breastfeeding (BF), only half (51.6%) of them EBF their infants. EBF was associated with delivery at hospital/polyclinic, having secondary school education, intention to EBF prior to delivery, owning a home, and having a positive attitude to EBF.

MATERNAL AND CHILD HEALTH NEWS

Africa: Mothers and Children Facing Dire Conditions
(News Article)
Several African countries performed poorly in a study of 110 nations worldwide that details health and educational opportunities for mothers and children, the NGO Save the Children said in a new report.

MEN'S HEALTH RESEARCH

Delayed Vasectomy Success in Men with a First Postvasectomy Semen Analysis Showing Motile Sperm
(Abstract)
This study determined the frequency of and factors associated with delayed vasectomy success in men with first postvasectomy semen analysis showing motile sperm. Delayed vasectomy success occurs in more than half of men with a first postvasectomy semen analysis showing motile sperm. Significant independent factors associated with delayed vasectomy success were lower sperm count in the first postvasectomy semen analysis and shorter interval between vasectomy and first postvasectomy semen analysis.

WOMEN'S HEALTH RESEARCH

Epidemiologic Profile of Type-Specific Human Papillomavirus Infection and Cervical Neoplasia in Guanacaste, Costa Rica
(Abstract)
This study estimated the risk factors for infection and the associations between type-specific HPV infections and cervical intraepithelial neoplasia (CIN) and cancer in 8514 sexually active women who had not undergone a hysterectomy. Sexual behaviors were the main determinants of oncogenic and nononcogenic infections; age at first sexual intercourse was not independently associated with infection. Barrier contraceptive use was somewhat protective against infection.

WOMEN'S HEALTH NEWS

Afghanistan: Woman Executed for Adultery
(News Article)
It's less than a week since the tiny Afghan village community witnessed the execution of 25-year-old Bibi Amena for adultery, but life appeared to have returned to normal. Bibi was sentenced to death by local religious leaders in the Spingul valley in the isolated northeastern province of Badakhshan.

Nigeria: Government to Expand VVF Hospital
(News Article)
Jigawa State Vesico Virgina Fistula (VVF) hospital is to be expanded, due to challenges posed by the number of victims reporting for treatment at the hospital.

China: Anti-AIDS Campaign Spotlights Sex Workers
(News Article)
China's campaign to fight AIDS and safeguard public health has finally spotlighted sex workers, a group who some view as sinners and earners of undeserved income.

YOUTH HEALTH RESEARCH

Children with HIV: Improved Mortality and Morbidity with Combination Antiretroviral Therapy
(Review/Synthesis)
This review article suggests that improvements in mortality and morbidity from HIV-1 infection following combination antiretroviral therapy are extremely encouraging. It also examines the emergence of data on the timing of initiation of antiretroviral therapy, the optimization of drug combinations and the clinical interpretation of genotypic resistance testing and therapeutic drug monitoring.

Home-Based Care for Orphaned Children Infected with HIV/AIDS in Uganda
(Abstract)
The primary aim of this paper is to describe an outreach program from a main state hospital in sub-Saharan Africa, which has been running for 3 years. This program is based in Mulago Hospital, Kampala, Uganda and cares for up to 200 children infected with HIV/AIDS in their home. It describes the clinic and how families are met and enrolled, the infrastructure of the program, and the personnel involved.

HIV Testing and Counseling Among Adolescents Attending Family Planning Clinics
(Abstract)
This study examined whether an assessment tool combining HIV-related risk behaviors and symptoms would increase HIV testing and return for post-test counseling among adolescents attending family planning clinics. The results indicated that adolescents who reported risk behaviors and symptoms were not more likely than those who reported no risk behaviors and symptoms to request testing and return for post-test counseling.

The Impact of Social Environments on the Effectiveness of Youth HIV Prevention: A South African Case Study
(Abstract)
This paper is a case study of the impact of social context on a participatory peer education program involving young people in a peri-urban community in South Africa. Three interacting dimensions of context undermine the likelihood of effective HIV-prevention. Symbolic context includes stigma, the pathologization of youth sexuality (especially that of girls), and negative images of young people. Organizational/network context includes patchy networking amongst NGOs, health, welfare and education representatives and local community leaders and groups. This is exacerbated by different understandings of the causes of HIV/AIDS and how to manage it.

YOUTH HEALTH NEWS

Laotian Youth Teach Peers to Protect Their Reproductive Health
(News Article)
In three of this country’s poorest provinces, the Reproductive Health Initiative for Youth in Asia collaborates with the Lao Youth Union and local health authorities to provide information, counselling, and services to youth, who make up a third of the rural population.

US: Foster Kids Used to Test AIDS Drugs
(News Article)
To gain access to hundreds of HIV-infected foster children, federally funded researchers promised in writing to provide an independent advocate to safeguard the kids' well-being as they tested potent AIDS drugs. But most of the time, that special protection never materialized, an Associated Press review has found.

BOOKS/BOOK REVIEWS

HIV/AIDS in South Africa
(Book)
This definitive textbook covers all aspects of HIV/AIDS in southern Africa, from basic science to medicine, sociology, economics, and politics.

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Editor, The Pop Reporter

Johns Hopkins Bloomberg School of Public Health: The INFO Project

Volume 5, Number 19 9 May 2005