Volume 5, Number 24
13 June 2005

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FAMILY PLANNING/REPRODUCTIVE HEALTH RESEARCH

Promoting Healthy Behavior
(Report)
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Technical fixes alone will not solve many of the world's most pressing health problems, according to a new Health Bulletin from the Population Reference Bureau (PRB). Human behavior plays a key role in the leading causes of death and disability, and behavior-change strategies are critical
to their prevention and mitigation. Titled "Promoting Healthy Behavior," this Health Bulletin explains the research-based frameworks behavioral scientists use to understand and influence health-related behaviors and outlines a variety of effective tools that health promotion programs use. By presenting a series of successful case histories and lessons learned, this 29-page Health Bulletin provides concrete examples to help public health and other professionals better integrate behavior-change strategies into their programs and policies at every level.

Teen Sex Health Booklet Attacked
(News Article)
Related News Article: Good Sex Guide for 13-year-olds
Family campaigners have attacked a new sex and relationship guide for teenagers. The Family Planning Association booklet, called Love, Sex and Relationships, is aimed at 13 to 16-year-olds.

Male Tolerance of ACIDFORM Gel
(Abstract)
ACIDFORM gel is being studied as a vaginal contraceptive and microbicide. This study was conducted to make certain that males will not be subjected to an unacceptable risk of penile irritation as a result of exposure to the product in future studies. ACIDFORM gel applied to the penis for 7 consecutive days appears to be at least as safe and well-tolerated as the marketed lubricant K-Y Jelly among healthy low-risk men.

Use of an Internet Program to Facilitate Screening for Chlamydia Trachomatis
(Abstract)
Related News Article: STD Self-test Uses Internet
Researchers have developed a method to help women self-test confidentially for chlamydia and other STDs while providing public-health authorities information on the spread of STDs using the Internet.

Ease of Insertion, Contraceptive Efficacy and Safety of New T-Shaped Levonorgestrel-Releasing Intrauterine Systems
(Abstract)
This study evaluated ease of insertion, contraceptive performance, and safety, in parous and nulliparous women, of two new T-shaped levonorgestrel (LNG)-releasing intrauterine systems (LNG-IUS), Femilis™ (parous women) and Femilis™ Slim (nulliparous women). Results indicate the Femilis LNG-IUS is an effective contraceptive and is easily inserted.

Acceptability of Five Nonoxynol-9 Spermicides
(Abstract)
This study examined the acceptability of five nonoxynol-9 spermicides. Overall, 43% of participants liked their spermicide “very much.” This proportion was higher in the three gel groups than in the suppository and film groups. Difficulty with insertion, messiness, and discontent with timing of insertion were common complaints in all groups. After adjustment for selected baseline factors, acceptability on the first questionnaire was not related to duration or consistency of subsequent spermicide use or to subsequent time to pregnancy.

Factors Influencing Young Women's Decision Making Regarding Hormonal Contraceptives: A Qualitative Study
(Abstract)
This qualitative study used in-depth interviews to explore factors influencing decision making regarding highly effective hormonal contraceptives in women aged 16–25 years. Young women's decision making regarding hormonal contraceptives is not simply determined by the experience of unwanted effects but reflects the meaning of unwanted effects in relation to underlying beliefs regarding the nature of hormones in contraceptives, ‘natural’ menses, menstrual control, and the importance of avoiding pregnancy. When unwanted effects were experienced, women with no concerns about the nature of hormones tended to switch to other highly effective hormonal contraceptives.

FAMILY PLANNING/REPRODUCTIVE HEALTH NEWS

The Philippines: Some Priests Back Contraceptives: Group
(News Article)
A family planning group Saturday said there are priests in the Catholic Church that support the National Government's family planning program even to the extent of agreeing to the use of contraceptives among married couples.

Sexual Disease Second Only to Flu in New Zealand
(News Article)
Chlamydia is now New Zealand's second most common infectious disease behind the flu. Environmental Science and Research's 2004 annual report on sexually transmitted infections shows children as young as 12 are being diagnosed as having sexually transmitted infections, including gonorrhoea and chlamydia, that can have serious long-term consequences including infertility.

Pope Rejects Condoms for Africa
(News Article)
The spread of HIV and AIDS in Africa should be tackled through fidelity and abstinence and not by condoms, Pope Benedict XVI has said.

FAMILY PLANNING/REPRODUCTIVE HEALTH LAW AND POLICY

AIDS Discrimination in China Rife - Vice Minister
(News Article)
China has drafted a new law to protect people infected with the AIDS virus in a country where discrimination against those suffering from the condition is rife, a senior Chinese health official said.

Australia: Baby Bonus Helps Birth Rate Jump
(News Article)
The federal government's $3,000 baby bonus has helped to reverse the nation's declining birth rate, with new statistics revealing an increase for the first time in a decade. Australian Bureau of Statistics figures show the number of babies per woman rose to 1.77 last year, breaking a 40 year decline.

China: Official AIDS Intervention on Prostitutes, Drug Addicts Sparks Disputes
(News Article)
Prostitution and drug use are forbidden in China, but a new controversial national Health Ministry plan will intervene to help prostitutes and addicts avoid HIV infection.

Brazil and Access to HIV/AIDS Drugs: A Question of Human Rights and Public Health
(Abstract)
This article explores the relationship between public health and human rights using as an example the Brazilian policy on free and universal access to antiretroviral medicines for people living with HIV/AIDS. The Brazilian response to the HIV/AIDS epidemic, which arose from initiatives in both civil society and the governmental sector, followed the process of the democratization of the country. If the Brazilian experience may not be easily transferred to other realities, the model of the Brazilian response may nonetheless serve as an inspiration to finding appropriate and life-saving solutions in other national contexts.

Russia: Safe Sex Program Guilty of Boosting Sexually Transmitted Diseases
(News Article)
Russian officials are warning that the so-called "safe-sex" message is having the reverse of its intended effect – it is the cause of an epidemic of STDs. According to Russia’s Pravda news source, lawmakers are calling the safe-sex message "propaganda."

China: People Rewarded for Good Family Planning
(News Article)
Related News Article: China: Family Planning Policy Remains Firm
More than 1.35 million rural elderly will benefit from a pilot cash-rewarding program this year.

HIV/AIDS RESEARCH

HIV/AIDS and the Workplace: Perceptions of Nurses in a Public Hospital in South Africa
(Abstract)
This article reports on the perceptions and experiences of nurses caring for people living with HIV/AIDS in the public health sector in South Africa. Seven themes were identified: helplessness, emotional stress and fatigue, fear, anger and frustration, occupational-related concerns, empathy, and self-fulfilment. The author recommends that increased understanding of the stresses and rewards experienced by these nurses can contribute to policy development in this area.

Efficacy of Highly Active Antiretroviral Therapy in HIV-Infected Children Participating in Thailand's National Access to Antiretroviral Program
(Abstract)
This study described the effect of highly active antiretroviral therapy (HAART) in treating HIV–infected children in Thailand's National Access to Antiretroviral Program for People Living with HIV/AIDS. In this resource-limited setting, HAART was found to be safe and effective for HIV-infected children despite initiation of treatment during the advanced stage of disease. The use of generic and nonpediatric drug formulations was also feasible.

HIV/AIDS in Women: An Expanding Epidemic
(Abstract)
Related News Article: Report: Women Are New Face of AIDS
The new face of the AIDS virus is the heterosexual female in a long-term relationship, according to a report from Science magazine. The number of women infected with the AIDS virus in the United States has increased 15% between 1999 and 2003, compared with an increase of only 1% among men. This mirrors the trend globally, where women represent nearly half of the 40 million people living with HIV.

Eyes Wide Open or Eyes Wide Shut? Antiretroviral Therapy in Resource-Poor Countries: Illusions and Realities
(Abstract)
The landscape for antiretroviral (ARV) therapy in resource-poor settings has recently changed considerably with the availability of generic drugs, the drastic price reduction of brand drugs, and the simplification of treatment. However, such cost reductions, while allowing the implementation of large-scale donor programs, have yet to render treatment accessible and possible in the general population. Addressing the problem of HIV treatment in high prevalence/high caseload countries may require redefining the problem as a public health mass therapy program rather than a multiplication of clinical situations.

A Critical Analysis of the Brazilian Response to HIV/AIDS: Lessons Learned for Controlling and Mitigating the Epidemic in Developing Countries
(Abstract)
The Brazilian National AIDS Program is widely recognized as the leading example of an integrated HIV/AIDS prevention, care, and treatment program in a developing country. This article critically analyzes the Brazilian experience, distinguishing those elements that are unique to Brazil from the programmatic and policy decisions that can inform the development of similar programs in other low and middle-income and developing countries. Among the critical issues that are discussed are human rights and solidarity, the interface of politics and public health, sexuality and culture, the integration of prevention and treatment, the transition from an epidemic rooted among men who have sex with men to one that impacts increasingly on women, and special prevention and treatment programs for injection drug users.

An Ecological Framing of HIV Preventive Intervention: A Case Study of Non-Government Organizational Work in the Developing World
(Abstract)
Drawing upon a broad notion of frame, researchers focus on the way in which activities such as "intervention", "prevention", "empowerment" and "community" in the HIV field can differ radically from articulation (at a government level) to practice (of NGOs). Further, they argue that framing HIV funding calls primarily in terms of "quality of life" would facilitate the work of NGOs, especially of ecological interventions.

Development of a Brief Scale to Measure AIDS-Related Stigma in South Africa
(Abstract)
The current research reports the development of the nine-item AIDS-Related Stigma Scale. Correlations showed that the AIDS-Related Stigma Scale was moderately inversely correlated with years of education and AIDS knowledge. In addition, individuals who stated that HIV-positive persons should conceal their HIV status had higher AIDS-Related Stigma Scale scores. Also supporting the scale's construct validity, individuals who refused to report whether they had been tested for HIV scored higher on the AIDS-Related Stigma Scale.

Antiretroviral Therapy in Public and Private Routine Health Care Clinics in Cameroon: Lessons from the Douala Antiretroviral (DARVIR) Initiative
(Abstract)
A review of the hospital charts for 788 patients treated in 19 public and private clinics in Cameroon showed that clinical follow-up visits, biologic follow-up visits, and drug supply were irregular and that many patients interrupted treatment. Virological and immunologic effectiveness of therapy was as expected in patients for whom results were available.

Personal History of Voluntary HIV Counseling and Testing (VCT) Among Adults Aged 19–35 Years Living in Peri-urban Communities, Chiang Mai, Northern Thailand
(Abstract)
This study investigates the self-reported history of HIV voluntary counseling and testing (VCT) among adults, aged 19–35 years, in northern Thailand. Of those tested at private clinics, 50% reported not receiving pre- and post-test counseling, compared to 15% of those tested in government clinics. Although VCT is widely available and utilized by the population of northern Thailand, substantial numbers of HIV infected persons have not been tested for HIV and among those tested many have not received comprehensive counseling.

Improving the Use of Data for HIV Prevention Decision Making: Lessons Learned
(Abstract)
There are a variety of barriers to effective use of data in community planning, which include characteristics of data (availability, timeliness, relevance to planning tasks), characteristics of planning group members and providers of data (e.g., skills in understanding and applying data), and social-organizational aspects of community-planning groups (CPGs). Lessons learned from this project illustrate how to create locally relevant sources of data, build data use skills of CPG members and data providers, and address social-organizational aspects of planning, while also better integrating community planning with implementation of prevention plans.

HIV/AIDS NEWS

Yemen: Group Finds 18,000 New HIV Cases in Blood Records
(News Article)
The Chairman of the Yemeni Society for the Protection of AIDS, Taha Hajir, announced that the number of HIV-infected persons had surpassed 20,000, while the number reported by the Ministry of Health was only 2,000. Hajir said that additional cases were discovered by coincidence in records of ordinary blood tests and blood donations at clinics and laboratories.

South African Military Fights 'War' on AIDS
(News Article)
South African military officials say they are fighting a "human war" against the "formidable enemy" of HIV/AIDS. Some 23% of South Africa's troops are infected with HIV - a similar rate to the adult population at large.

PEPFAR-funded NGOs Present Progress at 2nd South African AIDS Conference
(News Article)
A diverse group of non-governmental organizations being funded by the United States Presidents Emergency Plan for AIDS Relief (PEPFAR) presented their first year’s progress at a satellite conference of the 2nd South African AIDS Conference in Durban. Funded projects focused on providing aid to orphans and vulnerable children, faith-based HIV prevention services, voluntary counselling and testing services, collaborations with traditional healers, operational research into the long-term success of PMTCT programs, nurse-driven antiretroviral therapy, and antiretroviral treatment delivery in an antenatal clinic.

More than a Million Americans Now Living with HIV
(News Article)
For the first time since the height of the AIDS epidemic in the 1980s, more than a million Americans are believed to be living with the virus that causes AIDS, the government said.

China's Migrant Workers a High AIDS Risk
(News Article)
China faces a tragic surge in HIV/AIDS cases unless it curbs the spread of the disease among the vast country's transient rural workforce, a Chinese health expert warns.

S.Africa Warned of "National Wipe-Out" from AIDS
(News Article)
South Africa faces "national wipe-out" unless it steps up its war on HIV/AIDS, a business leader said recently as a study showed education caving under the epidemic.

Africans Wonder Whether Live 8 Will Help
(News Article)
They'll be grooving to Coldplay in London, rapping along with Will Smith in Philly, dancing mbalax with Youssou N'Dour in Paris. But in African cities and villages, they'll be worrying about day to day survival -- and questioning whether Western extravaganzas like the Live 8 concerts, however well intentioned, can help.

Kenya: Catholic Bishop Calls on Government to Give Out Free Anti-retrovirals
(News Article)
The Catholic Episcopal Conference Chairman Bishop Cornellius Korir has asked the government to provide free of charge anti-retroviral drugs to those infected with HIV.

Swazi King Weds 18-year-old as 12th Wife
(News Article)
Swaziland's King Mswati III took an 18-year-old former Miss Teen Swaziland finalist as his 12th wife at the weekend, barely two weeks after marrying his 11th, media in the tiny African kingdom said. Mswati, 37, has drawn criticism for spending money on luxury cars while many of his 1.1 million subjects struggle by on food aid, ravaged by the world's highest rate of HIV/AIDS which affects around two in every five adults.

China: Better Co-Ordination Needed for AIDS War
(News Article)
The Ministry of Health published guidelines detailing how to deal with groups that have more exposure to HIV/AIDS.

Zambian Army Wins Praise for Battle against AIDS
(Feature Article)
Success for the Zambian army in fighting AIDS has been the result of a combination effort, including education efforts and aggressive treatment.

MATERNAL AND CHILD HEALTH RESEARCH

Emergence of Drug-Resistant HIV-1 after Intrapartum Administration of Single-Dose Nevirapine Is Substantially Underestimated
(Abstract)
Conventional sequence analysis detects HIV–1 drug resistance mutations in ∼40% of women shortly after they receive intrapartum single-dose nevirapine (SD-NVP). Findings indicate that resistant mutations emerged in at least 65% of the women after SD-NVP; these findings emphasize the importance of further research to determine clinical implications.

Pediatric Adherence: Perspectives of Mothers of Children with HIV
(Abstract)
This study approached pediatric adherence practices from the perspective of mothers of children with HIV. Four themes of dealing with medication on a daily basis that impacted mothers’ adherence practices emerged from the analysis: (1) Mothers’ attitudes and feelings related to adherence practices; (2) the impact of the medications on adherence practices; (3) interactions of mothers and children related to adherence practices; and (4) developmental issues and responsibility for medication adherence. Adherence practices were impacted in a positive way by mothers’ commitment to adherence, and in a negative way by feelings of stigma and guilt, by the effects of bereavement on children, and by children adopting their mothers’ attitudes about medications.

Mother to Child Transmission of HIV in China
(Editorial)
As the number of people with HIV infection increases in China, the potential for the epidemic to spread from high risk groups to the general population, including children, is a concern. An HIV prevalence of more than 1% among pregnant women has been considered an indicator of a generalised epidemic. Whether that rate is currently being seen in any parts of China is of great public health importance. Here researchers review the current state of mother to child transmission in China. [Subscription is required for full-text article.]

MATERNAL AND CHILD HEALTH NEWS

New Numbers Show Africa Will Fall Far Short of Meeting U.N. Goals on Child Mortality
(News Article)
Africa has fallen so far behind in efforts to reach key U.N. development goals that about 3 million more children on the continent will die in the year 2015 than if the targets were reached, according to figures released recently.

Far Too Many Women Risking Death to Give Life, UNFPA Leader Says, As UN Unveils Progress Report on Development Goals
(News Article)
Related Report: The Millennium Development Goals Report 2005
(You need Adobe Acrobat Reader to access this document)
A world in which a woman risks death each minute in order to bring new life must be transformed, Thoraya Ahmed Obaid, the Executive Director of UNFPA, the United Nations Population Fund, said in New York at the release of The Millennium Development Goals Report 2005.

POPULATION RESEARCH

The Use of Flexible Parametric Duration Functions in Modelling the Tempo of Fertility: Applications to the Analysis of Birth Intervals in Rural China
(Abstract)
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This paper focuses on the tempo of fertility where covariates act multiplicatively on the duration itself so that their effect is to accelerate or decelerate the transition time between successive births relative to that of a reference category. The authors use the flexibility of a family of parametric duration models to select a statistically appropriate model for a given birth interval using data from rural China. The results show that the distributional shape of birth intervals depends on the birth order of the index child and that inferences concerning covariate effects on birth intervals are
sensitive to model choice.

Confronting the Emergence of Drug-Resistant HIV Type 1: Impact of Antiretroviral Therapy on Individual and Population Resistance
(Abstract)
Data on antiretroviral resistance rates, gleaned from the growing HIV-1-infected population treated with a continuously increasing number of antiretroviral drugs and drug combinations, provide insights into patient management approaches for delaying the emergence of resistance and minimizing the degree of resistance.

POPULATION NEWS

No Babies Please, We're German
(News Article)
While figures released by the French government this month showed France's population could balloon from its current level of 60.2 million to 75 million by 2050, the UN predicts that Germany's is set to plummet from 82 million to 70.8 million in the same period.

One in 7 Americans is Hispanic, Census Says
(News Article)
One of every seven people in the United States falls into the census category of Hispanic, a record number that probably will keep rising because of immigration and a birth rate outstripping nonHispanic blacks and whites, according to a new Census Bureau report.

WOMEN'S HEALTH RESEARCH

Nevirapine (NVP) Resistance in Women with HIV-1 Subtype C, Compared with Subtypes A and D, after the Administration of Single-Dose NVP
(Abstract)
In the HIV Network for Prevention Trials (HIVNET) 012 trial in Uganda, 6–8 weeks after single-dose nevirapine (SD-NVP), NVP resistance mutations were detected at a higher rate in women with HIV-1 subtype D than in women with subtype A. Here, researchers evaluated the rate of NVP resistance mutations in women with subtype C and found that NVP resistance mutations after SD-NVP was significantly higher in women with HIV-1 subtype C than in women with subtype A or D.

The Role of HIV-Related Knowledge and Ethnicity in Determining HIV Risk Perception and Willingness to Undergo HIV Testing Among Rural Women in Burkina Faso
(Abstract)
Researchers conducted a random community based survey of 300 young (15–29 years old) rural women in Nouna, Burkina Faso. Only one-third of women were aware that a person could have HIV without having symptoms, and these women were significantly more likely to classify themselves to be at high risk for getting HIV. Furthermore, multiple partners, Bwaba ethnicity, and having mentioned a health worker as a source of HIV information were significantly associated with perceived high personal risk. Perceived willingness to participate in VCT was high (69%).

Better Survival in Female Patients With Hepatocellular Carcinoma: Oral Contraceptive Pills Related?
(Abstract)
This study determined the influence of gender on survival in Hepatocellular carcinoma (HCC) patients and identified factors that may account for the difference. A survival benefit was observed in females. History of using oral contraceptive is associated with a better long-term survival in female patients.

WOMEN'S HEALTH NEWS

Afghan President Authorizes Body to Eliminate Violence Against Women
(News Article)
Related Press Release: UNIFEM-supported MOWA Workshop Results in Task Force for Combating Violence Against Women
Following the signing of a decree by President Karzai on Monday, a new inter-ministerial Task Force to Eliminate Violence Against Women will be initiated. This move enacts a major recommendation arising from the workshop “Governmental Task Force: Combating Violence Against Women”, which was led by the Ministry of Women’s Affairs, and supported by UNIFEM and the Government of Italy in November, 2004.

Kenya: A Woman's Approach to Ending a Perilous Rite of Passage
(Feature Article)
Local Masai women hope to stop the practice of female circumcision. According to one campaigner, the international anti-FGM movement is ineffective, and sometimes drives the practice underground, further endangering girls, because of a lack of understanding of and respect for Masai culture.

YOUTH HEALTH RESEARCH

Predictors of Contraception Knowledge and Use among Postpartum Adolescents in El Salvador
(Research Article)
This study determined contraceptive familiarity and use among postpartum adolescents in El Salvador. 84% of the subjects (median age 17) were nulliparous, 80% had partners, and 6% were married. 84% reported contraception knowledge and 18% reported contraception use. Education and literacy predicted contraceptive knowledge; however, contraceptive knowledge did not predict contraceptive use.

AIDS-Related Knowledge, Attitudes and Behavior Among Adolescents in Zambia
(Abstract)
AIDS-related knowledge, attitudes, self-efficacy, and behavior were examined among 3,360 adolescents aged 10–19 years old in Zambia, including in-school and out-of-school, rural and urban, and married and unmarried adolescents. The adolescents reported a moderate to high AIDS knowledge; positive attitudes towards prevention; and low to moderate self-efficacy about AIDS prevention. Although these factors were significantly related to adolescents engagement in high-risk behavior, the results indicated that these variables add only 3% of explained variance beyond the socio-demographic variables, which explains 14% of the variance.

Preventing HIV Transmission in Adolescents: An Analysis of the Portuguese Data from the Health Behaviour School-Aged Children study and focus groups
(Abstract)
This study examined psychosocial and ecological determinants contributing to both risk and protective factors related to adolescents' sexual behavior and HIV/AIDS. Female gender, older age, reporting easy to talk with father, not getting drunk, and not getting involved in fights are significantly associated with protected sexual behavior (using condom during last sexual intercourse). Despite HIV/AIDS knowledge, young people underestimate their own risk of becoming infected with HIV.

YOUTH HEALTH NEWS

Egypt: Long Battle Ahead to End Female Circumcision
(Feature Article)
Deeply entrenched cultural and traditional norms continue to hamper efforts to end the practice of female genital mutilation in parts of Egypt.

SPECIAL REPORTS/PROFILES/RESOURCES

Microbicides: Quick Guide Through the Key Issues
(Tool)
Related News Article: Invisible 'Condom' for Women Available Soon
This HRC/ELDIS key issues guide provides an in-depth introduction to microbicides. It outlines how microbicides are likely to work, their potential benefits and the important issues in their development, distribution and promotion. This guide also provides links to summaries of research and other key resources.

The Millenium Development Goals Report 2005
(Report)
(You need Adobe Acrobat Reader to access this document)
This report is an evelauation of the current status of the Millenium Development Goals issued by the United Nations.

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Editor, The Pop Reporter

Johns Hopkins Bloomberg School of Public Health: The INFO Project

Volume 5, Number 2413 June 2005