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Volume 5, Number 23
6 June 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

Gender Differences in Sexual Behaviours in Response to Genitourinary Symptoms
(Abstract)
This study attempts to understand gender differences in sexual behaviors in response to genitourinary symptoms. Black women altered both coital activity and condom use behaviors in response to vaginal discharge. In contrast, non-black women did not modify coital activity. Men increased condom use when having dysuria but did not alter coital activity.

Effectiveness of Female Controlled Barrier Methods in Preventing Sexually Transmitted Infections and HIV: Current Evidence and Future Research Directions
(Abstract)
This review evaluates evidence for the effectiveness of female controlled physical and chemical barrier methods in preventing STI/HIV transmission, examines recent reviews on microbicide development, and highlights promising research directions.

Knowledge of Sex Partner Treatment for Past Bacterial STI and Risk of Current STI
(Abstract)
This study determined the relation between knowledge of partner treatment for a past STI and current infection in the index patient. Those who knew their partner was treated were less likely to have a current infection, compared to those who did not know.

Improving Access to Services and Interactions with Clients in Guatemala: The Value of Distance Learning
(Abstract)
This study developed and tested a distance-learning program to improve the quality and efficiency of family planning services in Guatemala. The intervention showed a positive impact on reducing the number of contacts before the consultation and client waiting times. More complete services and better quality services were provided at intervention clinics. Some, but not all, of the study objectives were attained. The long-term impact of the intervention is as yet unknown.

Attitudes Towards Family Planning in the Southeast Anatolian Project (SEAP) Region of Turkey
(Abstract)
This study determined attitudes towards family size and last pregnancies in order to improve family planning services in the Southeast Anatolian Project (SEAP) region. For men and women aged 15 years and over the median ideal number of children was three. The rate of unintended last pregnancies (43.1%) in the present study was very high compared to the national average of 18.8%. Some 30.1% of the last pregnancies were unwanted by either partner.

FAMILY PLANNING/REPRODUCTIVE HEALTH NEWS

Africa Short of $700 Mln for Reproductive Health
(News Article)
Africa is faced with a fund gap of over 700 million US dollars to fully operate in the Reproductive Health services, revealed a report presented recently at a regional workshop on reproductive health commodity service in Addis Ababa, Ethiopia.

US: Condom Ads Hit Network TV
(News Article)
Two television networks made history when they broadcast commercials for Trojan condoms during prime-time viewing hours, the first such network exposure for the male contraceptive devices.

India: 'Why Can't People with HIV Marry?'
(Feature Article)
As the authorities and NGOs quibble over AIDS statistics, and the ways and means to combat the proliferation of the dreaded virus, both agree that initiatives such as the marriage bureau for people living with HIV are a step in the right direction.

FAMILY PLANNING/REPRODUCTIVE HEALTH LAW AND POLICY

Indonesia to Ban Female Circumcision
(News Article)
Indonesian health authorities are set to ban doctors and paramedics performing female circumcisions, according to this report.

China Rewards Rural Couples Practicing Family Planning
(News Article)
Starting from 2004, China began to implement a pilot project of "rewarding some rural households practicing family planning."

HIV/AIDS RESEARCH

African Herbal Medicines in the Treatment of HIV: Hypoxis and Sutherlandia. An Overview of Evidence and Pharmacology
(Review/Synthesis)
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This article reviews the evidence and safety concerns related to the use of two specific African herbals, which are currently recommended by the Ministry of Health in South Africa and member states for use in treating HIV: African Potato and Sutherlandia. Despite the popularity of their use and the support of Ministries of Health and NGOs in some African countries, no clinical trials of efficacy exist, and low-level evidence of harm identifies the potential for drug interactions with antiretroviral drugs.

Is Peer Education the Best Approach for HIV Prevention in Schools? Findings from a Randomized Controlled Trial
(Abstract)
This study evaluated the effectiveness of peer education when compared to teacher-led curricula in AIDS prevention programs conducted in schools in Rome, Italy. The only apparent benefit of the peer-led intervention, compared to that led by teachers, was a greater improvement in knowledge of HIV. Neither of the interventions induced changes in sexual behavior.

Assessing the Secular Trends in the Transmission of HIV in Greece
(Abstract)
This study evaluated the current trends in HIV transmission in Greece. After the mid-1990s, the proportion of homosexual males among HIV positive individuals decreased slightly, then was stabilized, but they still remain the dominant population among HIV positive people. On the other hand, heterosexual transmission increased steadily and has become a frequent route for the spread of HIV/AIDS in recent years.

Metaanalysis and Metaregression in Interpreting Study Variability in the Impact of Sexually Transmitted Diseases on Susceptibility to HIV Infection
(Abstract)
This study reviewed studies examining the effect of other STDs on HIV-1 susceptibility and correlated their effect estimates with type of "other STD," study design, and population characteristics. Of 31 studies included, 4 contained direct data on exposure to HIV-1. Three of these were inconclusive, the fourth indicating a strong relationship between STDs and transmission of HIV. Pooled effect estimates using all studies are statistically significant and indicate a 2- to 3-fold increase in risk of HIV-1 acquisition. Effect estimates corresponding some of the "other STD" categories exhibit heterogeneity, but no significant associations with study characteristics were found.

Beer Halls as a Focus for HIV Prevention Activities in Rural Zimbabwe
(Abstract)
This article is an assessment of the role of beer halls in the HIV epidemic of rural Zimbabwe as part of the ongoing identification of risky places for the targeting of prevention activities. Results show beer hall attendance is associated with high-risk behavior for HIV infection and cofactor for STIs.

HIV/AIDS NEWS

HIV/AIDS Drugs May also be Effective Against Malaria
(News Article)
Researchers at The Queensland Institute of Medical Research have found that drugs used to treat HIV Aids may also be effective against the biggest killer in the world - malaria.

Chinese Government Reveals Plan to Combat AIDS
(News Article)
AIDS and HIV are to be fought on three fronts, prevention, intervention, and treatment, the central government announced recently.

Indian Reduction in HIV Figures No Miracle
(News Article)
India, home to the second largest number of people infected with the HIV virus, dropped a bombshell last week when it declared that new cases fell by 95% in just a year. As it turns out, it was not a miracle - just mathematics.

US & Latin American AIDS Advocates Blast CAFTA's Anti-Generic Drug Provisions
(News Article)
AIDS advocates with expertise on the HIV crisis among Latin Americans called on Congress to protect access to low-cost generic HIV medications now available in Central America but threatened by the proposed Central American Free Trade Agreement (CAFTA).

Annan Calls for Action on AIDS
(News Article)
Related News Article: UN Says Goal to Reverse AIDS by 2015 Won't Be Met
Related News Article: AIDS Epidemic Still Outpacing Response
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Related Report: UN Secretary-General's Report
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The UN Secretary-General has called on governments around the world to do more to tackle HIV/AIDS.

HIV/AIDS Affects Over Half of African Businesses: Survey
(News Article)
More than half of African businesses felt the impact of HIV/AIDS on their revenues, and this proportion shot to more than 90% in sub-Saharan Africa, the epicenter of the global epidemic, a survey showed recently.

Japan Confronts a Surge in AIDS Cases
(News Article)
A rapid spread of AIDS over the past decade has reached a level that has confounded and alarmed the health establishment in Japan, a country that has long felt protected by a first-rate health system and widespread condom use.

New Zealand: HIV/AIDS Crisis Faces Pacific
(News Article)
The government is concerned that HIV/AIDS is one of the biggest battles facing the Pacific.

Malaysia to Start Anti-HIV Program
(News Article)
Related News Article: Government Wants Public Views on Needle Plan
Malaysia will distribute free needles and condoms to drug addicts in a potentially controversial pilot project aimed at curbing HIV infections.

India: Milkmen to Help Fight AIDS
(News Article)
Milkmen and newspaper delivery boys have been enlisted to distribute condoms in southern India to tackle the growing threat of AIDS.

MATERNAL AND CHILD HEALTH RESEARCH

Health Consequences of Breast-feeding: Doctors' Visits and Hospitalizations During the First 18 Months of Life in Hong Kong Chinese Infants
(Abstract)
This study examined the effects of breast-feeding on health services utilization in Hong Kong Chinese infants. Results indicate that breast-feeding in Hong Kong Chinese infants reduces doctor visits overall, but increases both outpatient visits and hospitalizations for jaundice.

Improvement in Maternal Health Literacy Among Pregnant Women who did not Complete Compulsory Education: Policy Implications for Community Care Services
(Abstract)
This paper examined factors that influence the improvement in maternal health literacy among pregnant women in Paraguay, including those who did not complete compulsory education but participated in a community-based antenatal care program. Higher capabilities of healthcare personnel and better living environment were significantly related to gains in the maternal health knowledge.

HIV and Mortality of Mothers and Children: Evidence From Cohort Studies in Uganda, Tanzania, and Malawi
(Abstract)
This study calculated excess risks of child mortality as the result of maternal HIV status. Analysis shows that the excess risk of death associated with having an HIV-positive mother is 2.9, and this effect lasts throughout childhood. The excess risk associated with a maternal death is 3.9 in the 2-year period centered on the mother's death, with children of both infected and uninfected mothers experiencing higher mortality risks at this time.

The Impact of Childhood Mortality on Fertility in Six Rural Thanas of Bangladesh
(Working Paper)
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This paper examines the causal structure of the relationship between child mortality events and subsequent fertility with an analysis of prospective longitudinal data on births and childhood deaths occurring to nearly 8,000 mothers observed in Bangladesh over the 1982-93 period. Results show that childhood mortality increases the hazard of birth-interval closure if the death occurs in the index interval, representing the combined effect of biological and volitional replacement.

MATERNAL AND CHILD HEALTH NEWS

Japan: Survey Reveals High Child Mortality Rate
(News Article)
The mortality rate for Japanese children between the ages of 1 and 4 is the highest among 14 of the world's most developed countries, a survey shows.

MEN'S HEALTH RESEARCH

The Effects of Smoking on the Reproductive Health of Men
(Abstract)
This article discusses the impact smoking can have on men's sexual and reproductive health. There is evidence to suggest that smoking can result in alterations of the male sex hormones and is a key cause of and contributor to erectile dysfunction. Smoking can therefore endanger the man's ability to have a family and enjoy sexual activity. A reduction in sperm quality and a reduced response to fertility treatments has also been linked with those men who smoke.

POPULATION RESEARCH

Education of Adult Children and Mortality of Their Elderly Parents in Taiwan
(Working Paper)
(You need Adobe Acrobat Reader to access this document)
This study employs 14 years of longitudinal data from Taiwan to examine the combined effects of education of older adults and their adult children on mortality outcomes of older adults. Results indicate that educational levels of both parent and child are associated with older adult mortality, but the child's education is more important when a) controlling for the health of the older adult, and b) when examining only those older adults who already report a serious chronic condition, suggesting different roles for education in onset versus progression of a health disorder that may lead to death.

Assessment of Fertility Behaviour Change in the Sociocultural Context of Pakistan: Implications for the Population Programme
(Research Article)
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This article examines changes in fertility behavior in the sociocultural context of Pakistan’s population. The analysis reveals that the fertility transition has been slow-paced and resistant to change, reflecting a large unmet need for family planning in all population strata. The serious constraints to effecting changes in reproductive behavior appear to be gender inequities in the social system, reflected by women’s low autonomy, lack of educational attainment, limited participation in family decision-making, a preference for male children and fatalistic attitudes towards the use of family planning.

Why are Population and Development Issues not Given Priority?
(Commentary)
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This article summarizes the three main reasons why population issues seem to have fallen in priority: 1) political reasons, 2) the perceived recession of the population issue, and 3) a lack of dialogue between those in population and those working in other areas of development.

Estimating the Impact of Establishing Family Housing on the Annual Risk of HIV Infection in South African Mining Communities
(Abstract)
This study determined the HIV-related epidemiologic impact of establishing family-style housing in mining communities in South Africa. The results indicate that family housing could decrease HIV transmission among HIV-negative concordant couples.

POPULATION NEWS

The Search for 100 Million Missing Women: An Economics Detective Story
(Feature Article)
In 1990, economist Amartya Sen claimed that that there were some 100 million "missing women" in Asia. While the ratio of men to women in the West was nearly even, in countries like China, India, and Pakistan, there were far more men than women. Sen charged these cultures with gravely mistreating their young girls, perhaps by starving their daughters at the expense of their sons or not taking the girls to doctors when they should have. New evidence suggests that hepatitis B, and not misogyny, played a greater role in the numbers. In the populations of China, India, Pakistan, Egypt, Bangladesh, and other countries where mothers gave birth to an unnaturally high number of boys, the regions with the most hepatitis B were the regions with the most "missing" women.

India: Rajasthan to Try TN Model for Checking Population
(News Article)
The Raje government plans to do a Tamil Nadu in Rajasthan to check the spiralling population. Raising the average age of marriage of girls, going for a 3-year gap between children and sterlisation in the reproductive years will be some of the key components of this strategy unveiled at the launch of the National Rural Health Mission.

RP Population to Hit 85.2M This Year
(News Article)
The Philippines are expected to balloon to 85.2 million this year, said the Commission on Population, citing projections from the National Demographic and Health Survey.

Vietnam to Spend Big on Population Control, Quality
(News Article)
Vietnam plans to pour some 3.5 trillion Vietnamese dong (US$221.5 million) into curbing population growth and improving population quality from 2006 to 2010.

WOMEN'S HEALTH RESEARCH

The Many Faces of Sex Work
(Abstract)
A Medline search and review of 681 "prostitution" articles was conducted. In addition, the investigators pooled their 20 years of collected papers and monographs, and their observations in more than 15 countries. Arbitrary categories were developed to compile a workable typology of sex work. The authors identified at least 25 types of sex work according to worksite, principal mode of soliciting clients, or sexual practices. The authors note that public health implications of sex work vary widely.

Prevalence and Risk Factors of Chlamydia and Gonorrhea Among Rural Nepali Women
(Abstract)
This study estimated the prevalence and risk factors of Neisseria gonorrhoeae and Chlamydiatrachomatis in a female population in rural Nepal. Rates of N gonorrhoeae and C trachomatis were found to be low among women in this rural population of Nepal.

Diagnostic Accuracy of Self Collected Vaginal Specimens for Human Papillomavirus Compared to Clinician Collected Human Papillomavirus Specimens: A Meta-Analysis
(Abstract)
This review determines summary estimates from analyses of reported findings of the sensitivity, specificity, and summary receiver operating characteristic curves (SROC) for self-collected vaginal specimens for HPV testing compared to the reference standard, clinician collected HPV specimens. Findings indicate that self-collected HPV-DNA swabs may be an appropriate alternative for low resource settings or in patients reluctant to undergo pelvic examinations.

Bacterial Vaginosis in Relation to Menstrual Cycle, Menstrual Protection Method, and Sexual Intercourse in Rural Gambian Women
(Abstract)
This study examined the occurrence of bacterial vaginosis (BV) over the menstrual cycle and in relation to menstrual protection materials and sexual intercourse in a rural African setting. Similar transient fluctuations over the menstrual cycle were found to those in industrialized countries. There was no evidence that sexual intercourse was associated with increased frequency of BV. The data do not support hypotheses that menstrual hygiene materials might explain the high prevalences of BV found in sub-Saharan Africa compared to industrialized countries.

Comparison of Non-Invasive Sampling Methods for Detection of HPV in Rural African Women
(Abstract)
This community based study compares two self-administered techniques for detecting human papillomavirus (tampons and self-administered swabs) with a clinician-directed technique, the cervical cytobrush. Using the cervical cytobrush as the gold standard, self-administered swabs (SAS) showed a sensitivity of 63.9%, and tampons showed a sensitivity of 72.4%. The acceptability of these two tests was 97.1% and 84.6%, respectively.

Expanding Family Planning Options: Offering the Standard Days Method™ to Women in Istanbul
(Abstract)
This study introduced the Standard Days Method™ (SDM), a fertility awareness-based method of family planning, to couples in a region of Istanbul, Turkey who were using a method of low effectiveness or no family planning method. The objective was to determine potential demand for, and satisfaction with, the SDM. Some 47% of the participants were satisfied with the method and intended to continue using it.

WOMEN'S HEALTH NEWS

EU Urged to Act Over Female Circumcision
(News Article)
The Donors Working Group on Female Genital Mutilation/Cutting (FGM/C), a network of public and private international agencies campaigning against the practice, and members of the European Parliament are urging the European Commission to increase its financial commitment to stop the practice of FGM/C, also known as female circumcision.

Kenya: Violence Against Women Widespread - New Report
(News Article)
Related Report: Amnesty International Report 2005
Violence against women in Kenya remains widespread despite efforts to increase public awareness by the authorities and civil society, Amnesty International said in its 2005 global annual report on human rights.

YOUTH HEALTH RESEARCH

The Impact on Condom use of the "100% Jeune" Social Marketing Program in Cameroon
(Abstract)
Related Tool: 100% Jeune Web Site
This study measured the reach of the “100% Jeune” social marketing campaign and assessed its impact on condom use and on the predictors of condom use in Yaoundé and Douala, Cameroon. The campaign aims to improve condom use through intensive youth-oriented mass media and interpersonal communications and widespread distribution of subsidized condoms. Exposure to campaign activities was high. During the course of the intervention, there were significant changes in perceived condom attributes and access, self-efficacy, and perceived social support.

Early Sexual Debut Among Young Men in rural South Africa: heightened vulnerability to sexual risk?
(Abstract)
This report examines early sexual debut (less than age 15) among young men in rural South Africa including (1) risk behaviors at first sexual experience, and (2) age at first sex as a predictor of later sexual risk. Men who initiate sex before age 15 form a distinct risk group in this setting.

YOUTH HEALTH NEWS

Mali: Drawing Up a National Care Plan for Kids at Risk
(Feature Article)
Malian health authorities are trying to devise a national policy to cater for the country's AIDS orphans and vulnerable children.

AIDS, Pregnancy and Poverty Trap Ever More African Girls
(Feature Article)
Africa claims the world's highest adolescent birthrate and the world's lowest share of girls enrolled in primary school. Orphaned and impoverished by the deaths of parents, girls here are being propelled into sex at shockingly early ages to support themselves, their siblings and, all too often, their own children.

Zambia: HIV/AIDS Affecting Quality of Education
(News Article)
Related Report: Teacher Shocks and Student Learning : Evidence from Zambia, Vol. 1 of 1
HIV/AIDS is having an impact on teacher absenteeism in Zambia, which in turn is affecting the quality of education, according to a new World Bank study.

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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 23 6 June 2005