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Volume 5, Number 22
30 May 2005

The Pop Reporter is now available in both CD-ROM (January 2004 to present) 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

An Assessment of USAID Reproductive Health and Family Planning Activities in the Eastern European and Eurasian Region with Special Reference to Armenia, Kazakhstan, and Romania
(Report)
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The objective of this external assessment was to review the extent to which the US Agency for International Development's reproductive health (RH) and family planning (FP) assistance over the past decade in the Eastern European and Eurasian region has been effective in addressing the major RH/FP needs of women and men. The study found that the agency's assistance had been successful in the promoting of modern contraception, training of health care professionals, establishing contraceptive logistics management systems, providing information and education, and conducting mass media campaigns.

Planning a Family: Priorities and Concerns in Rural Tanzania
(Research Article)
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A fertility survey using qualitative and quantitative techniques described a high fertility setting (TFR 5.8) in southern Tanzania where family planning use was 16%. Current use was influenced by rising parity, educational level, age of last born child, breastfeeding status, a preference for longer than the mean birth interval (32 months), not being related to the household head, and living in a house with a tin roof. Findings showed unmet need for family planning services particularly for teenagers, that fear associated with services curtailed use, and that service provision was irregular and did not address fears associated with family planning.

Biological Activity Assessment of a Novel Contraceptive Antimicrobial Agent
(Abstract)
Microbicides are a new category of compounds being developed to prevent transmission of sexually transmitted diseases (STDs), including the human immunodeficiency virus (HIV). Microbicide screening can be initially based on their hyaluronidase-inhibiting (HI) activity, as this enzyme plays a major role in the sperm and microbe penetration into the substrate. Hesperidin has been reported in the literature for its HI effects. Sulphonated hesperidin, a derivative, was found to completely inhibit the sperm enzymes hyaluronidase, resulting in a contraceptive effect. It was also been found to inhibit various sexually transmitted pathogens, including Chlamydia trachomatis, Neisseria gonorrhoea, HIV, and Herpes Simplex virus type 2 (HSV-2). The study concludes that sulphonated hesperidin can be developed as a potential microbicide for a dual prophylaxis of contraception and transmission of STDs and AIDS.

Cambodia: Family Planning Programs and HIV/AIDS Services, Results of Focus Group Discussions
(Report)
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As part of the POLICY Project's investigations into the delivery of family planning (FP) services in the context of high HIV prevalence, six focus group discussions were held in Cambodia in December 2004. The aim of these discussions was to document the views of FP users, service providers, and HIV-infected women on the accessibility and quality of FP services, particularly in light of the HIV/AIDS epidemic in Cambodia. The results of these discussions suggest a need for more male involvement, promotion of better attitudes toward condom use, and improved information, education, and communication campaigns.

Who Is Being Served Least by Family Planning Providers? A Study of Modern Contraceptive Use in Ghana, Tanzania and Zimbabwe
(Research Article)
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This study was conducted to identify the sub-groups being least served by family planning providers in three countries in sub-Saharan Africa--Ghana, Tanzania and Zimbabwe. This region generally has a low but increasing prevalence of modern contraceptive methods. Logistic regression analyses of demographic and health survey data were used to identify the characteristics and areas of residence of women not using modern contraceptive methods. The results show some similarities amongst countries.

Introducing New Contraceptives in Rural China: A Field Experiment
(Research Article)
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A project on Introducing New Contraceptives in Rural China (INCRC) was carried out between 1991 and 1996 in four counties of rural north China. The experimental component involved the random assignment of a multipronged treatment to four townships in each county. Two townships per county served as controls. The three prongs of treatment were, provision of new contraceptives, the institutionalization of informed choice, and better training for family planning providers. The scale of the project made it nearly impossible to maintain the integrity of the experimental model that was at the core of the project's design. However, the study has contributed to knowledge of the Chinese family planning program, and was influential within China.

FAMILY PLANNING/REPRODUCTIVE HEALTH NEWS

Arab Nations: Sexually Spread Diseases in Focus
(News Article)
Representatives from a dozen Arab nations gathered in the Tunisian capital recently for a conference on fighting the spread of sexually transmitted diseases, which infect 20 people in the Arab world every minute. The goal of the four-day meeting, organised by the International Federation of Family Planning and the UN, is to support groups that are working to raise awareness and offer treatment for these diseases, which are still taboo subjects in many Arab countries.

China's Dangerous Sexual Ignorance
(News Article)
China is attempting to improve its population's sexual knowledge, but taboos on the subject are proving difficult to overcome. Young people in China are typically too shy to talk about sex, and finding the right approach to sex education is difficult.

FAMILY PLANNING/REPRODUCTIVE HEALTH LAW AND POLICY

New UNICEF Chief Says No Condom Policy Change
(News Article)
The new head of UNICEF, has tried to calm fears that the agency would adopt more conservative policies on AIDS prevention, sexual health and condoms under her leadership. Some aid workers had voiced concern that Executive Director Ann Veneman might limit UNICEF's work promoting reproductive and sexual health as it tries to tackle the AIDS pandemic, and that she might oppose condom promotion.

HIV/AIDS RESEARCH

Expanding the Frontiers of Existing Antiviral Drugs: Possible Effects of HIV-1 Protease Inhibitors Against SARS and Avian Influenza
(Abstract)
In this report, evidence is presented that HIV-1 protease inhibitors (PIs) currently used in anti-HIV-1 therapies might exert some effects on SARS and perhaps on avian influenza. Evidence for the potential benefits of PIs against the SARS coronavirus is provided by empirical clinical studies, among other things. Although this evidence is still far from being definitive, the results so far obtained suggest that PIs should be seriously taken into consideration for further testing as potential therapeutic agents for SARS and avian influenza.

Relationship between Adherence and the Development of Resistance in Antiretroviral-Naive, HIV-1-Infected Patients Receiving Lopinavir/Ritonavir or Nelfinavir
(Abstract)
Relationships between adherence to protease inhibitor (PI)-based therapy and resistance development were explored in this study. A total of 653 patients were enrolled at 93 clinical sites in 13 countries on 5 continents. Bell-shaped relationships between adherence and resistance were observed. Irrespective of adherence level, the risk of detectable HIV-1 RNA loads or of PI or lamivudine resistance was significantly higher in nelfinavir-treated patients than in lopinavir/ritonavir-treated patients.

An Electronic Medical Record System for Ambulatory Care of HIV-Infected Patients in Kenya
(Abstract)
This article reports on the use of electronic medical records (EMRs)in administering and monitoring HIV/AIDS therapy in a low-resource setting such as Kenya. The article describes the development and structure of an EMR system and plans for future development that include wireless connections, tablet computers, and migration to a Web-based platform.

Sexual Exposure to Blood and Increased Risks for Heterosexual HIV Transmission in Cape Town, South Africa
(Abstract)
In this study, men and women were interviewed on sexual behavior including sexual contact that involved blood, lifetime history of STI diagnoses and STI symptoms, and HIV prevention knowledge. Results showed that sexual exposure to blood is prevalent and may be a facilitating factor for HIV transmission in South Africa. Thirty six per cent of the men and 28% of women experienced sexual contact involving blood in the past three months. Researchers concluded that modern medical care providers as well as traditional healers should be encouraged to advise their clients to refrain from sexual intercourse during menstruation and other types of genital bleeding.

HIV/AIDS NEWS

Drugs, AIDS Evade Clampdown in India's Northeast
(News Article)
Rampant drug use, and rapidly spreading HIV/AIDS is a growing problem in northeast India. Official figures show the number of HIV sufferers increased five-fold in the past four years.

Africa Lagging on AIDS Drug Goals--UNAIDS Head
(News Article)
Efforts to speed distribution of life-saving AIDS drugs in poor countries are making progress, but many areas in Africa are still moving too slowly, the U.N. AIDS chief said recently. Among the factors identified as hampering progress are creaky health systems and the delayed launch of anti-retroviral (ARV) drug treatment programmes in many African countries.

Botswana: Red Tape Stymies Media Spreading Anti-AIDS Message
(News Article)
Journalists in Botswana say the government's lack of cooperation with the media is threatening to undermine ongoing efforts to reduce the spread of HIV/AIDS. Reporters allege that it is difficult to gauge the success of anti-AIDS strategies because of the reluctance of the authorities to release information to the media.

World Must Save Africa's Children from AIDS--UNICEF
(News Article)
Rich countries must do more to protect African children from HIV/AIDS, the new head of the United Nations children's agency said recently. Ann Veneman said she chose southern Africa for her first foreign trip since taking over at UNICEF three weeks ago to highlight the devastation AIDS has wreaked on the region and to push the killer epidemic to the top of the world agenda.

South Africa: Doctors Blast DIY AIDS Test Kit
(News Article)
Doctors blasted a supermarket franchise for selling HIV/AIDS kits, saying self-testing without counselling would be disastrous and lead to possible misuse by employers, insurers and even state officials.

Malaysia: Compulsory HIV/AIDS Test for Muslim Couples in Kelantan Soon
(News Article)
An increase of HIV/AIDS cases among young Muslims has compelled the Kelantan Government in Malaysia to now make it compulsory for Muslim couples intending to get married to undergo an HIV/AIDS test first.

Doubt Over India's HIV Claims
(News Article)
Related News Article: India 'Slows Down HIV Infections'
Health campaigners dismissed claims by the Indian government that the country had shrunk the growth rate of new HIV infections by 95%. Some 526,000 people were infected in India in 2003, but the latest official figures showed an increase last year of just 28,000. India has the second largest number of people in the world living with HIV and was widely expected to overtake South Africa this year.

Tanzania: Local Firm to Produce ARVs Starting Next Year
(News Article)
A local Tanzania pharmaceutical company will begin producing generic anti-retroviral drugs in mid-2006 from a factory in the northern town of Arusha.

Zambia: Provinces Left Behind in ARV Rollout
(News Article)
Although an estimated 25,000 Zambians are currently receiving anti-AIDS medication, the government has to scale up treatment in rural areas. In remote areas of the country, getting hold of anti-AIDS drugs is a major struggle for those living with the virus.

Pak HIV/AIDS Drugs to be Imported from India
(News Article)
Pakistan will begin importing anti-retroviral drugs from India for HIV/AIDS beginning in July, Pakistan officials said.

MATERNAL AND CHILD HEALTH RESEARCH

Bone Mineral Density and Calcium Metabolism of Hong Kong Chinese Postpartum Women
(Abstract)
This paper reports longitudinal changes in bone mineral density (BMD), calcium homeostasis and dietary calcium intake in a group of Hong Kong breastfeeding women during the first year postpartum. Results showed that increased calcium requirement during early lactation is affected through mobilisation of bone and renal calcium conservation. Bone mineral loss during lactation is temporary.

Antenatal HIV Screening and Treatment in South Africa: Social Norms and Policy Options
(Research Article)
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In this paper, the author analyses the likely implications of antenatal testing and treatment of pregnant women in South Africa in light of the socio-economic and cultural status of women in that society. The article concludes that the most significant option must continue to be primary prevention because the best way to ensure that an infant is not infected is to protect the mother herself. Aside from cost-effectiveness, issues to consider in the introduction of antenatal HIV screening, antiretroviral therapy and substitute feeding interventions into the South African health care system include affordability, availability of human resources and infrastructure, equity and acceptability.

Community Satisfaction with the Quality of Maternal and Child Health Services in Southeast Nigeria
(Abstract)
The objective of this study was to assess community perception, practices and satisfaction with the quality of maternal and child health services and the willingness and ability to pay for the services, after the introduction of the Bamako initiative programme. A cross sectional study using pre-tested questionnaire and focus group discussions was undertaken in May 1999. Results showed that most respondents (90.6%) rated the services to be at least good. Another 95.9%, 94.3% and 95.8% of the respondents were, satisfied with the childhood immunisation, antenatal care and childbirth services respectively. Eighty nine percent of respondents were willing to pay for health services if drugs were readily available, while 92.4% would pay if there is overall improvement in quality.

MATERNAL AND CHILD HEALTH NEWS

Bhutan: MCH Rule to Streamline Maternal Health Care
(News Article)
Expectant mothers visiting the maternal and child health (MCH) unit of hospitals in Bhutan will have to specify where they would prefer to deliver and what means of transportation they would use in an emergency, and make arrangement for three blood donors. The new rule is aimed at streamlining MCH care and reducing stress on the health workers.

Southern Africa: HIV Treatment Just Beginning for Children
(News Article)
Age offers little protection against AIDS, and children are often the disease's unwitting victims. Yet for children in Southern Africa, treatment is only just beginning. The long-term health implications are still largely unknown while lack of child-specific dosages presents another major challenge.

MEN'S HEALTH RESEARCH

A Multicenter Phase IIb Study of a Novel Combination of Intramuscular Androgen (Testosterone Decanoate) and Oral Progestogen (Etonogestrel) for Male Hormonal Contraception
(Abstract)
In this study, the effect of a novel combination of oral etonogestrel (ENG) and im testosterone decanoate (TD) on suppression of gonadotropins and spermatogenesis as a potential lead for male contraception was investigated. Healthy male volunteers were randomized into two groups receiving 300 µg ENG daily and 400 mg TD every 4 or 6 weeks for 48 weeks. Results showed that the combination of 300 µg ENG with 400 mg TD every 4 weeks was superior in terms of efficacy, hormone profiles, and safety than 6 weeks. This represents a promising approach to male hormonal contraception.

Rates of Suppression and Recovery of Human Sperm Output in Testosterone-based Hormonal Contraceptive Regimens
(Abstract)
Reliable time estimates for a hormonal male contraceptive of time to onset and offset of reliable contraception and of resumption of normal male fertility are required. The researchers utilized the sperm output data from three male contraceptive efficacy studies to define quantitative estimates of suppression and recovery rates from an androgen alone and an androgen/progestin study. The findings of the study provide large sample estimates of the suppression and recovery rates from an androgen-alone hormonal male contraceptive regimen as a basis for comparison with other second-generation combination androgen/progestin regimens that are the most promising approach to developing practical male hormonal regimens.

POPULATION RESEARCH

Fertility Trends and Patterns in a Rural Area of South Africa in the Context of HIV/AIDS
(Abstract)
This study presents trends and patterns of fertility observed in a rural South African population. Various demographic and statistical techniques were used to examine fertility patterns among women in rural KwaZulu-Natal. These are compared with patterns seen in another South African rural population, and with data from the 1998 South Africa Demographic and Health Survey. Results showed that if current trends continue in the future--below replacement fertility, together with high mortality due to AIDS--it could soon lead to population decrease in rural South Africa.

POPULATION NEWS

Philippines: Freedom to Choose is Key to Family Planning
(News Article)
Pangasinan’s success in family planning has been due to the provincial government ensuring that couples are free to choose which contraceptive method they want to use.

WOMEN'S HEALTH RESEARCH

Sidestream Smoking is Equally as Damaging as Mainstream Smoking on IVF Outcomes
(Abstract)
Related News Article: Others' Smoking Harms IVF Success
Related News Article: Study: Secondhand Smoke May Damage Women's Fertility
The objective of this study was to measure the effects of cigarette smoking on the fertility of mainstream or sidestream smoke-exposed women compared to their non-smoking counterparts. Results showed that despite similar embryo quality there was a striking difference in implantation and pregnancy rates of mainstream and sidestream smokers when compared with non-smoking. Our data demonstrate that the effects of sidestream smoking are equally as damaging as mainstream smoke on fertility.

WOMEN'S HEALTH NEWS

Can Taking the Pill Dull a Woman's Desire?
(News Article)
Oral contraceptives (OCs) free women to have sex without fear of getting pregnant, but they could also diminish sexual desire in some women by decreasing testosterone levels. It is unclear how common diminished sexual desire is among OC users.

UK: Female Circumcision Law Extended
(News Article)
Westminster made it illegal in 2003 to aid and abet genital mutilation, even if it is carried out overseas. The Prohibition of Female Genital Mutilation (Scotland) Bill extends that to cover the children of asylum seekers and other non-UK citizens.

Sudan: Living with the Trauma of FGM
(News Article)
According to the UN Children's Fund (UNICEF), almost 90 percent of Sudan’s women undergo “the cut” - especially in the north. In many cases it is practised in its most extreme form: infibulation or pharaonic circumcision. Although it is widely known that FGM can have devastating and harmful consequences for a woman throughout her life, the practice continues in poor communities, most of which do not have access to modern health facilities. Medical emergencies arising from FGM are common and often lead to death.

Violence Against Women Rampant in Asia
(News Article)
Violence and systematic discrimination against women was rampant in Asia last year, ranging from acid attacks for unpaid dowries in Bangladesh to forced abortion in China, rape by soldiers in Nepal and domestic beatings in Australia, Amnesty International said.

YOUTH HEALTH RESEARCH

Semantics or Substance? Towards a Shared Understanding of Terminology Referring to the Sexual Abuse and Exploitation of Children
(Report)
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This document, produced by the Child Rights Information Network, highlights the need for increased understanding and clarity when certain terms are used to describe sexual harm against children. It first provides definitions which are used by international instruments--intergovernmental organisations, NGOs, etc.; and second, cites international instruments in which these terms are found--convention, protocol to convention, covenant, declaration and resolution.

Predictors of Contraceptive Knowledge and Use Among Postpartum Adolescents in El Salvador
(Abstract)
This study was undertaken to investigate knowledge and use of contraceptives among postpartum adolescents in El Salvador. Eighty-four percent of the women reported knowledge of contraceptives and 18% reported contraceptive use. After delivery and postpartum contraception education, 58% of the subjects said they intended to use contraception. Having a partner and living with him were predictors of intent to use contraception. The authors concluded that education and literacy predicted contraceptive knowledge; however, contraceptive knowledge did not predict contraceptive use.

Young People's Relationships with Sugar Daddies and Sugar Mummies: What do We Know and What do We Need to Know?
(Abstract)
This paper critically evaluates available research on young people's relationships with sugar daddies and mummies. The review compares and contrasts the experiences of young people in a variety of settings in developing countries versus developed countries, and identifies key associated factors perpetuating those relationships.

Gender and Sexuality of Youths in Bafoussam and Mbalmayo, Cameroon
(Abstract)
This paper outlines, the social factors that predispose young people to risky sexual practices using data from a survey of culture, gender, sexual behaviour and STD/AIDS carried out in Cameroon, at Bafoussam and Mbalamayo. The data revealed that knowledge of the modes of transmission of AIDS and other STDs and the degree of acceptability of condoms in this group is greater among boys than girls. It was also found that boys were more inclined than girls to be unfaithful to their regular partners and that boys were more inclined to use condoms than girls. Data also showed that age and other characteristics of the regular sexual partners of young people influence the probability of being engaged in risky sex, especially among girls.

Reproductive Health Education and Sexual Risk Among High-Risk Female Adolescents and Young Adults
(Abstract)
This study explored the associations of sources, content, and timing of reproductive health education with cognitive and behavioral sexual risk in a sample of high-risk female adolescents and young adults. Early reproductive health education and education from both parental and formal sources is associated with reduced sexual risk among high-risk adolescent girls. Interestingly, receiving parental education is also associated with more sexual partners, suggesting that parental educational efforts may be reactive to their daughters' increasing sexual risk behavior.

Adolescents' Experience with the Combined Estrogen and Progestin Transdermal Contraceptive Method Ortho Evra
(Abstract)
This study examined adolescents' experience with the new combined estrogen & progestin contraceptive patch Ortho Evra. Results show Ortho Evra provides excellent cycle control in adolescents. Most adolescents are satisfied with this method. Only 15% of those in the study reported using condoms consistently, however, and intensive efforts should be made to increase condom use by adolescents on Ortho Evra to prevent sexually transmitted infections.

YOUTH HEALTH NEWS

Scotland to End Female Mutilation Loophole
(News Article)
Moves to block a loophole in the law banning female circumcision in Scotland are expected to be passed by MSPs today. Although the practice is illegal in Scotland, it is not an offence to send a girl overseas for the procedure.

Swaziland: AIDS Orphans also Stigmatised by Poverty at School
(News Article)
In an effort to curb discrimination against poor students, the Swaziland Ministry of Education has launched an initiative to encourage schools to do away with expensive uniforms and costly school trips that usually leave indigent students behind, creating unhappiness and resentment. The ministry has also been fighting to keep a number of orphans and vulnerable children (OVC) sponsored by government bursaries from being expelled for failing their exams.

New Zealand: Teens More Worried about Pregnancy than STIs
(News Article)
Although half of teenagers in Christchurch, New Zealand are sexually active, only 44% of them say they use condoms every time they have sex. They also don’t feel it’s important to use condoms to prevent sexually transmitted infections such as chlamydia.

Fiji: Giving Young Life Skills
(News Article)
A two-year project on adolescent health and development of Pacific youth by providing information, education, life skills and services relevant to adolescent development has started. The joint initiative between the United Nations Population Fund, United Nations Childrens Fund and the Secretariat of the Pacific Community will cost over $1.68million. UNICEF representative Gillian Mellsop said they would be emphasizing responsible behaviour and practices to prevent teenage pregnancy, sexually transmitted infections including HIV/AIDS and related reproductive issues.

Swaziland: New UNICEF Head Sees Extent of Orphans Crisis
(News Article)
The new executive director of UNICEF, Ann Veneman, wrapped up her first official visit to Swaziland, having seen at first hand the scope of the tiny country's poverty and the magnitude of its AIDS orphan problem.

Zambia: Parents Can Convince Their Children to Abstain From Sex
(News Article)
The World Health Organization representative to Zambia has said that parents can succeed in convincing their children to abstain from sex before marriage. Speaking at the professionals' conference, Dr Anyangwe said parents could convince their children if the children know that their parents had done so when they were younger.

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Editor, The Pop Reporter

Johns Hopkins Bloomberg School of Public Health: The INFO Project

Volume 5, Number 2230 May 2005