Volume 5, Number 27
5 July 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 Ghazaleh Samandari at gsamanda@jhuccp.org with your request and complete mailing address.

FAMILY PLANNING/REPRODUCTIVE HEALTH RESEARCH

Impact of Child Mortality and Fertility Preferences on Fertility Status in Rural Ethiopia
(Abstract)
This study was carried out to determine the effects of child mortality and fertility preference on fertility status in rural Ethiopia. A total of 219 women with number of children ever born alive less than five and 899 women with number of children ever born alive greater or equal to five were included in the study. The study finding implies high fertility status is strongly associated with child death and hence measures that curb child mortality are believed to decrease fertility status besides promoting child survival.

The Acceptability of Self-Administration of Subcutaneous Depo-Provera
(Abstract)
This study looks at the acceptability of a new subcutaneous preparation of Depo-Provera. This preparation is self-administrable and could potentially reduce need for routine annual visits. The study findings suggest that the advent of subcutaneous self-administrable Depo-Provera with appropriate training and a reminder system is likely to be beneficial and popular with many women.

Effect of Norplant Contraceptive on the Bones of Nigerian Women
(Abstract)
This study examined whether long term use of Norplant decreased bone mineral density in Nigerian women between 25 and 50 years of age. The authors conclude that although Norplant decreased overall bone turnover, it had no deleterious effect on the bone quality of women using Norplant implants for up to 4 years.

FAMILY PLANNING/REPRODUCTIVE HEALTH NEWS

Six Months After the Tsunami: UNFPA Helps Restore Reproductive Health Capacity and Promotes Women's Rights
(News Article)
Re-establishing quality reproductive health services is a top priority for UNFPA, the United Nations Population Fund, six months after the Indian Ocean earthquake and tsunami. In Indonesia, Sri Lanka, Maldives, Thailand and India, the Fund is helping health authorities rebuild and re-supply damaged facilities and train staff, so pregnant women can deliver in safe conditions and receive emergency care when needed and couples can plan their families.

FAMILY PLANNING/REPRODUCTIVE HEALTH LAW AND POLICY

UNFPA Reaffirms Advantages of Investing in Reproductive Health
(Report)
According to a new report from the United Nations Population Fund, if modern contraceptive services were available to all 201 million women with unmet need in the developing world, 1.5 million women and children would be saved each year, and the number of unplanned births would be reduced by 72 per cent. "Reducing Poverty and Achieving the Millennium Development Goals: Arguments for Investing in Reproductive Health & Rights" outlines future dividends of investing in reproductive health.

HIV/AIDS RESEARCH

“When the Obvious Brother is Not There”: Political and Cultural Contexts of the Orphan Challenge in Northern Uganda
(Abstract)
It is estimated that two million of Uganda's children today are orphaned primarily due to AIDS. While recognizing the immense impact of HIV/AIDS on the orphan problem, this article calls for the orphan challenge to be put in a broader context. In northern Uganda, armed conflicts, a fall in cotton prices, and other factors have contributed to a dramatic shift in how orphans are fostered. These contributing pressures must be understood in order to appropriately address the orphan crisis.

Age-Related Clinical Manifestations of HIV Infection in Indian Children
(Abstract)
Using reports from 317 HIV-infected children compiled over seven years, this study analyzes the most common clinical manifestations of HIV among Indian children at different ages. It suggests that clinicians should suspect HIV in children who present with such symptoms, in order to make an early diagnosis that may decrease HIV-related complications.

Behind the Veil of a Public Health Crisis: HIV/AIDS in the Muslim World
(News Article)
Related News Article: Muslim Nations Face AIDS Reality Check
This study reports that a growing HIV/AIDS epidemic threatens to sweep the Muslim world -- more than 50 countries where more than 40 percent of the population practices Islam -- unless leaders respond more proactively to the disease. Official figures place the number of HIV cases in Muslim nations at around 1 million, but this number is thought to be a significant underestimate due to poor surveillance data. Many governments have been slow to acknowledge the epidemic, which could destabilize their countries if they do not make significant changes.

Scaling Up HIV Voluntary Counseling and Testing in Africa: What Can Evaluation Studies Tell Us About Potential Prevention Impacts?
(Abstract)
It is believed that scaling up HIV voluntary counseling and testing (VCT) programs in Africa will have large prevention benefits through reductions in risk behaviors. The article assesses two common perceptions about VCT in Africa: that a policy of promoting couples-oriented VCT would be more successful than one emphasizing individual testing and that VCT demand and prevention impacts will be enhanced where scaling up is accompanied by the provision of antiretroviral drugs.

Mothers, Midwives, and HIV/AIDS in Sub-Saharan Africa
(Abstract)
This article reviews clinical and program issues in the prevention of mother to child transmission of HIV in sub-Saharan Africa. Topics include prevention of infection, voluntary counseling and testing, prenatal care, labor and birth, postpartum family planning, infant feeding, and the role of traditional birth attendants. The authors conclude that clinical training, leadership skills, salary support, expansion of the nursing workforce, and development of expanded roles for nurses and midwives in AIDS care are needed to help them turn the tide of the epidemic.

Which Patients First? Setting Priorities for Antiretroviral Therapy Where Resources Are Limited
(News Article)
Related News Article: If Global Efforts to Prevent HIV/AIDS Are to Work Long Term, They Must Avoid Suspicions of Being Unfair
The availability of limited funds from international agencies for the purchase of antiretroviral (ARV) treatment in developing countries presents challenges, especially in prioritizing who should receive therapy. This study examines historical precedents for resource allocation in order to inform debate about current ARV programs. The authors stress that the public must be involved in decisions about how to allocate limited resources if distribution programs are to have legitimacy.

Efficacy of Antiretroviral Therapy Programs in Resource-Poor Settings: A Meta-analysis of the Published Literature
(Abstract)
Responding to concerns about the feasibility of providing antiretroviral therapy (ART) in resource-poor settings, this large literature review evaluates the efficacy of ART programs in developing countries. It concludes that ART programs in resource-poor settings have efficacy rates similar to those reported for developed countries. In addition, patients who receive medications free of charge have a significantly increased probability of virologic suppression at months 6 and 12 of ART, compared to patients who pay for all or part of their treatment.

HIV/AIDS NEWS

High Risk for AIDS Epidemic in Asia: Continent Could Face an Explosion of Infections Over Next Decade
(News Article)
Related News Article: AIDS Risk Increasing in Asia, Says New UNAIDS Report
(You need Adobe Acrobat Reader to access this document)
As the 7th Asia-Pacific AIDS Conference begins, experts warn that AIDS could spiral out of control in Asia unless authorities step up their fight against the disease. One in four new infections occurs in Asia, and India has the world’s second-highest number of AIDS/HIV patients after South Africa. The conference will focus on prevention and access to antiretroviral medications.

Africa: MSF Urges UN and G8 AIDS Drug Action
(News Article)
The international medical NGO, Medecins Sans Frontieres (MSF), is urging G8 nations and the UN to push for speedy delivery of the cheapest and latest anti-AIDS drugs to developing countries.

HIV Drug Target 'Will Not Be Met'
(News Article)
Senior figures at the World Health Organization have admitted they will probably fail to meet their target for disseminating HIV drugs to three million people by the end of 2005. The target was announced in December 2003, when just 400,000 people were receiving medications. Now, as the deadline approaches, the WHO reports that while large strides have been made, it is still significantly short of its goal.

South Africa: Slowly Closing the HIV/AIDS Treatment Gap
(News Article)
South Africa is falling short of the AIDS treatment targets set by the World Health Organisation (WHO) '3 by 5' campaign, according to a new report. The report, which covered progress on the initiative to place three million HIV-positive people in the developing world on treatment by the end of 2005, found that between 10 percent and 14 percent of South Africans living with HIV/AIDS were being treated.

Pfizer Abandons Development of HIV Drug
(News Article)
Pfizer Inc. is abandoning development of an experimental HIV therapy after two studies failed to show a significant difference between its capravirine drug and standard treatments for the virus that causes AIDS.

Brazil To Allow Generic Production of Antiretroviral Kaletra Unless Abbott Lowers Price
(News Article)
Brazilian Health Minister Humberto Costa informed Abbott Laboratories that it will break the company's patent on the antiretroviral drug Kaletra unless the company lowers the price of the drug 42% to $1.17 per pill. If the patent is broken, generic drug manufacturers could begin producing versions of the drug, which is a combination of the antiretrovirals lopinavir and ritonavir.

HIV Drugs Block Malaria in Tests
(News Article)
Powerful drugs used to treat HIV can also block malaria, researchers say they have shown for the first time.

Gates Targets Global Health Crisis
(News Article)
The Bill and Melinda Gates Foundation has awarded $450 million to 43 projects aimed at fighting diseases, including HIV, in the developing world. The grant proposals were submitted after the Foundation called for scientists to propose solutions to 14 serious health threats. Projects will work on rapid testing for bacterial and HIV-related infections, improving nutritional content of staple food crops, creating childhood vaccines that do not require refrigeration, and more.

Bristol Myers Squibb to Cut Price of Two HIV Drugs for Children
(News Article)
Bristol Myers Squibb will cut the cost of its pediatric formulations of stavudine (Zerit) by 44% and didanosine (Videx) by 90% in least developed countries. The pharmaceutical company will also partner with Baylor College in Texas to send more than 250 pediatricians to countries severely affected by HIV, where they will spread knowledge about treating HIV-infected children.

MATERNAL AND CHILD HEALTH RESEARCH

Outcomes of Planned Home Births with Certified Professional Midwives: Large Prospective Study in North America
(Abstract)
This study evaluated the safety of home births in North America involving direct entry midwives in jurisdictions where the practice is not well integrated into the healthcare system. The researchers found that planned home birth for low-risk women in North America using certified professional midwives was associated with lower rates of medical intervention but similar intrapartum and neonatal mortality to that of low-risk hospital births in the United States.

Health Systems Factors Influencing Maternal Health Services: A Four-Country Comparison
(Research Article)
This study provides an example of how a health systems approach can benefit the understanding of maternal health services. A comparative analysis was conducted based on extensive case studies of maternal health and health systems in Bangladesh, Russia, South Africa, and Uganda. A number of cross-cutting health system characteristics affecting maternal health were identified by comparing these diverse settings.

Temperature Monitoring in Newborns Using Thermospot
(News Article)
Related News Article: Fading Smile Could Save Babies
Hypothermia is a common problem in newborns, especially in low-birth-weight and preterm babies. This study was conducted using a liquid crystal temperature monitoring device that has a smiling face that dissapears when a baby's temperature drops too low. The smile is seen on a disc stuck onto the skin which monitors temperature. This was compared with the measurement of rectal temperature using a rectal thermometer. The Thermo Spot was in agreement with the rectal temperature in 310 out of 313 measurements. It correctly identified hypothermia in every case.

Pregnancy Outcomes, Site of Delivery, and Community Schisms in Regions Affected by the Armed Conflict in Chiapas, Mexico
(Abstract)
The study objective was to measure maternal and perinatal mortality ratios and utilization of pregnancy-related health services in the region affected by the Zapatista conflict, and to describe associations between these primary outcome measures, socioeconomic and demographic factors, and factors associated with inter-party and intra-community conflict. Observed maternal and perinatal mortality ratios were substantially higher than those officially reported for Mexico or Chiapas.

Breastfeeding May Help Prevent Myopia in Children
(News Article)
The increasing prevalence of myopia, especially among urban Asian children, suggests that early lifestyle factors may play a role. In this cross-sectional study, breastfeeding was independently associated with decreased likelihood of myopia after controlling for known risk factors. Breastfeeding has been linked with neurodevelopment, affecting visual acuity in young children.

National Maternal Mortality Ratio in Egypt Halved Between 1992–93 and 2000
(Research Article)
Two surveys of maternal mortality conducted in Egypt, in 1992–93 and in 2000, collected data from a representative sample of health bureaus covering all of Egypt, except for five frontier governorates which were covered only by the later survey, using the vital registration forms. Results showed that the maternal mortality ratio (MMR) had dropped by 52% within that period (from 174 to 84/100 000 live births).

Breastfeeding Prevalence and Practices Among Singaporean Chinese, Malay and Indian Mothers
(Abstract)
This study established the prevalence of breastfeeding among Chinese, Malay and Indian mothers and identified factors influencing breastfeeding. Results of this study show higher breastfeeding prevalence rates compared to past studies in Singapore. Factors such as ethnicity, age, educational attainment, religion and baby's sex were found to influence mothers' decision to breastfeed.

Impact of Mass Media Campaigns on the Knowledge and Attitudes of Pregnant Nigerian Women Towards HIV/AIDS
(Abstract)
A total of 508 women coming for antinatal care had a structured interview about the risk factors for HIV/AIDS. While most knew about HIV and that it could be transmitted sexually, knowledge of mother-to-child transmission was poor. Only 23% knew that HIV could be transmitted by breast milk. In all, 85% would not care for a relative with AIDS.

MATERNAL AND CHILD HEALTH NEWS

Nepal: Nine Percent of Women Suffer from Uterine Prolapse: Study
(News Article)
Nine percent of Nepalese women are suffering from uterine prolapse, reports the Safe Motherhood Network Federation.

Nepal: Domestic Violence Seriously Affecting Pregnant Women
(News Article)
Violence against pregnant women is emerging as a serious health concern in Nepal. Violence during pregnancy has serious consequences for the mother, fetus and the newborn.

MEN'S HEALTH RESEARCH

International Patterns and Trends in Testicular Cancer Incidence
(News Article)
Related News Article: Testicular Cancer on the Rise in Much of the World
The incidence of testicular cancer has risen markedly in many Western populations over the past half-century, but it is not clear whether rates in other populations also have increased. In this study, testicular cancer incidence rates were examined over the 25-year time period of 1973-1997 for selected populations around the world.

Safety, Acceptability, and Potential Efficacy of a Topical Penile Microbicide Wipe
(Abstract)
Use of a topical microbicide wipe for penile cleaning before and after sex might be effective in preventing STIs. However, evaluation of this simple method has not been done. Two small studies were conducted in Malawi to determine the safety, acceptability, and potential efficacy of a benzalkonium chloride topical penile microbicide wipe. Results indicate the penile wipe is safe and acceptable and can decrease the frequency of penile colonization with microorganisms. Larger clinical trials are needed.

Wealth and Extramarital Sex Among Men in Zambia
(Abstract)
This study examined whether wealth was correlated with extramarital sex among men in Zambia. Though education, occupation and household wealth index were not associated with extramarital sex, living in Southern and Western Provinces of Zambia were. The report concludes that cultural norms specific to regions play an important part in sexual behavior and that socially defined sexual behavior patterns can shed light on extramarital sex and the spread of STIs and HIV.

POPULATION RESEARCH

Geographical Diversity of Cause-of-Death Patterns and Trends in Russia
(Research Article)
(You need Adobe Acrobat Reader to access this document)
This paper performs a systematic analysis of all currently available Russian data on mortality by region, census year (1970, 1979, 1989, and 1994) and cause of death. It investigates what links may be found between these geographical variations in cause-specific mortality, the negative general trends observed since 1965, and the wide fluctuations of the last two decades.

POPULATION NEWS

Health Minister: “Low Birth Rate Problem Is a Disastrous Situation”
(News Article)
This article reports that, because of an aging population and low birth rates, South Korea’s index for population competitiveness is expected to plunge from the current number one to last among the member nations of the Organization for Economic Cooperation and Development (OECD).

WOMEN'S HEALTH RESEARCH

Hormone Replacement Therapy and Ovarian and Uterine Cancer Risk
(News Article)
Related News Article: Hormone Replacement Therapy Safe for Women with Menopause & Cancer Survivors
This article focuses on the effects of hormone replacement therapy on coronary heart disease, stroke, venous thromboembolism, breast cancer, and colorectal cancer. Data from other relevant trials, including the most recent data on ovarian and uterine cancer risk and on gynecologic cancer patients, are also discussed to provide some guidelines on prescribing hormone replacement therapy in clinical practice, particularly in gynecologic cancer survivors. Research shows that short-term hormone replacement therapy (HRT) is appropriate for peri- and postmenopausal women.

Women's Attitude and Perceptions Towards Menopause in Different Cultures
(Abstract)
This study looked at cross-cultural and intra-cultural differences between the perception and experience of menopause in pre- and post-menopausal German and Papua New Guinean women. The study found that expectations as well as experiences of menopause differed significantly between women of both cultures. The article concludes that perception and concepts concerning illness and health are based on culturally produced patterns.

Combined Contraceptive Vaginal Ring and Bone Mineral Density in Healthy Pre-Menopausal Women
(Abstract)
The aim of this study was to assess the effects of a vaginal contraceptive ring on bone mineral density in pre-menopausal women. The study concludes that in healthy pre-menopausal women, 2 years of contraceptive ring use produced no changes in bone mineral density.

Obstetric Fistula: A Preventable Tragedy
(Abstract)
This article reviews the social etiologies of obstetric fistula that must be addressed by prevention campaigns. Direct prevention of fistula can occur during delivery when skilled providers identify women and girls at risk for obstetric fistula and link them with innovative interventions, such as Fistula Prevention Centers, through which they can more readily access emergency obstetric care, and by setting strict time limits for laboring at home without progress.

Factors Associated With Breast Cancer Screening Behaviours in a Sample of Turkish Women: A Questionnaire Survey
(Abstract)
The purpose of this study was to identify breast self-examination (BSE) and mammography rates and to examine variables related to the breast cancer screening behaviors in a sample of Turkish women. Data were collected from a convenience sample of 656 women, attending three health centers and two maternal and health centers. Higher seriousness of breast cancer, higher benefits of having mammography, having heard/read about mammography, and having a gynecologist as a regular physician were significantly associated with having mammography.

YOUTH HEALTH RESEARCH

The Potential of Comprehensive Sex Education in China: Findings From Suburban Shanghai
(Abstract)
This study examined the impact of a comprehensive sex education program carried out in a Shanghai suburb with unmarried 15–24 year-olds. Though participation in the intervention was not associated with delayed sexual initiation, it was associated with increased odds of contraceptive use and condom use, and decreased odds of sexual coercion during the intervention period. The proportion of youth reporting pregnancy involvement during the intervention period was significantly lower in the intervention group than among controls.

Living the Reality of Forced Sex Work: Perspectives From Young Migrant Women Sex Workers in Northern Vietnam
(Abstract)
Young women are often lured or forced into selling sex as a result of migrating from rural to urban areas to find work. In this setting, they are exposed to high-risk situations, which may leave them vulnerable to exploitation. Using interviews with young migrant women currently working as sex workers in northern Vietnam, we recorded the perspectives of their initiation into sex work and life as a sex worker. The study found that high levels of forced sex and sexual exploitation were experienced by the majority of the young women interviewed. The young women describe their entry into sex work, first sexual experience (intercourse), violence, and condom negotiation and use. Although access to health care was available, the young women perceived the stigma attached to sex work as a barrier to receiving health care, and thus, preferred health education and care from peers. Health education programs focusing on peer education and support are essential for protecting and empowering these young women. In addition, policies and programs must work toward effective strategies to protect young migrant women.

Reciprocal Associations Between Adolescent Sexual Activity and Quality of Youth-Parent Interactions
(Abstract)
This article examines differences in adolescents' relationships with their parents before and after adolescent first sexual activity. Results confirm that increased problem-focused interactions and decreased parental closeness and shared activities both precede and follow adolescent sexual activity. Maintaining positive parental relations after adolescent first sexual activity is discussed as a means to reduce risks associated with sex.

YOUTH HEALTH NEWS

Namibia: Evangelical Lutheran Church Not Promoting Condoms Among Single Youth
(News Article)
The Evangelical Lutheran Church in Namibia (EL-CIN)'s Youth HIV and Aids Prevention Project (EYAPP) recently held a workshop to sensitise church leaders about HIV/AIDS and how they can participate in its prevention among youth. At the workshop, EYAPP decided they would not promote the use of condoms among youth, insisting that the ELCIN constitution prohibits the use and promotion of condoms among the youth. A church spokesperson said EYAPP would only promote and encourage condom use between married couples.

Nigeria: UN Begins Using Youth Corps to Fight HIV/Aids
(News Article)
The United Nations International Children's Emergency Fund (UNICEF) says it has commenced the process of using youth corpers--members of the National Youth Service Corps (NYSC)--in HIV/AIDS prevention in all the local council areas of Nigeria. In explaining why UNICEF chose to collaborate with NYSC, a UNICEF project manager said "the youth corpers operate in virtually all the nooks and crannies of the country", stressing that "if every serving youth corper joins in the crusade against HIV/AIDS, the spread of the deadly scourge would either be eradicated or reduced to the minimum level in Nigeria".

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Editor, The Pop Reporter

Johns Hopkins Bloomberg School of Public Health: The INFO Project

Volume 5, Number 27 5 July 2005