Volume 5, Number 28
11 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

Bleeding Patterns After Immediate Initiation of an Oral Compared With a Vaginal Hormonal Contraceptive
(Abstract)
This study compares bleeding patterns in women after immediate initiation of an oral contraceptive with bleeding patterns of women using the contraceptive vaginal ring. The study finds advantageous bleeding patterns for subjects using the contraceptive vaginal ring and confirms previous findings that immediate start of hormonal contraception is an acceptable alternative to waiting for menses.

Oral Contraceptives for Dysmenorrhea in Adolescent Girls: A Randomized Trial
(Abstract)
This study found that a low-dose oral contraceptive relieved dysmenorrhea-associated pain among adolescents more effectively than a placebo.

Attitudes About Sex and Marital Sexual Behavior in Hai Duong Province, Vietnam
(Abstract)
This study examines attitudes concerning sexual relations outside marriage and levels of marital sexual activity using data from married individuals from Hai Duong Province, Vietnam. Among individuals who live in urban areas, have more schooling, and were married after the late 1980s, acceptance is growing concerning intimate behavior without marital commitment and having sex with a future spouse. Schooling, urban residence, and recent marriage have stronger associations with less conservative attitudes among men than among women. The reported level of premarital sex is higher among men than among women, and lower than available estimates from other parts of Asia and the developing world. The reported level of sexual activity within marriage in Hai Duong Province is similar to that observed elsewhere, including Thailand and the United States. The incidence of sexual activity declines with age, and at all ages men are more likely than women to report having sex with their spouse.

Providers' Compliance With the Balanced Counseling Strategy in Guatemala
(Abstract)
This study examined the effect of expansion of the balanced counseling strategy in family planning services in Guatemala. This strategy, developed in Peru, uses a type of algorithm or decision tree in combination with several job aids, or visual memory aids. The balanced counseling strategy has previously been shown to improve clients' knowledge of their contraceptive method choice and quality of care, though it has been adopted by only a few providers. The results of this study show that the strategy was used in 85 percent of the controlled consultations at the experimental clinics. Use of the strategy improved quality of care regardless of the provider's performance at baseline and regardless of ethnic or regional differences. Counseling session length increased by nine minutes, but real-client load did not change. Guatemalan clients can be expected to benefit from the strategy. The increased session length has not yet caused problems, but it may pose policy dilemmas in the future.

Increased Condom Use at Sexual Debut in the General Population of Slovenia and Association with Subsequent Condom Use
(Abstract)
This article describes the extent of condom use at first heterosexual intercourse (FHI) in the general population of Slovenia, identifies associated factors and assesses the association with subsequent use. The authors conclude that most Slovenian men and women use condoms during FHI. The steep increase in condom use over time at FHI suggests that HIV-related condom use promotion has had an impact on preventive behaviours and should be sustained, especially since condom use at FHI predicts subsequent use.

Weight, Fat Mass, and Central Distribution of Fat Increase When Women Use Depot-Medroxyprogesterone Acetate for Contraception
(Research Article)
This study compares longitudinal changes in weight, body fat, and ratio of central to peripheral fat mass among first-time depot-medroxyprogesterone acetate (DMPA) users to changes in these measures of fatness in women using no hormonal contraception, and evaluates user characteristics associated with that change. Results show that women using DMPA had a significantly greater increase in all measures of fatness than women using no hormonal method of contraception.

FAMILY PLANNING/REPRODUCTIVE HEALTH NEWS

Asian Tsunami Has Raised AIDS Risk--United Nations
(News Article)
The devastating tsunami that struck Asia last year has left several countries that were already vulnerable to AIDS at even greater risk of the deadly disease, United Nations officials have said. While HIV rates had not yet been seen to rise in any of the worst-hit regions in Asia, recent surveys have shown an increase in both pregnancies and sexually transmitted diseases.

China to Spend 46 Million Dollars on Birth Control Products in 2005
(News Article)
The Chinese government will spend 46 million dollars on birth-control products this year to meet the demand of 250 million couples of child-bearing age, China's state press said. These funds will procure condoms and intra-uterine devices to meet the growing demand for more contraceptive options for the public.

FAMILY PLANNING/REPRODUCTIVE HEALTH LAW AND POLICY

Brazilians Approve of Increased Contraceptive Availability and Free Emergency Pills, Study Shows
(News Article)
Brazilians approve the government's family planning policy, launched by the Ministry of Health in March of this year. More than 90% of those surveyed approved of the increased availability of contraceptive devices offered by the public health system, and close to 80% support the free distribution of emergency contraception pills.

WHO Statement on Hormonal Contraception and Bone Health
(News Article)
WHO convened a technical consultation in June 2005 to review the complete body of evidence regarding the effects of hormonal contraception on bone mineral density and fracture risk. A statement released after the consultation recommends that there should be no restriction on the use of hormonal contraceptives among women age 18 to 45 who are otherwise eligible to use the methods. For women under age 18, the overall risks and benefits should be considered over time with each individual user.

HIV/AIDS RESEARCH

Using Focus Groups to Investigate the Educational Needs of Female Heroin Users in Taiwan in Relation to HIV/AIDS Prevention
(Abstract)
This study used focus groups to investigate the educational needs of imprisoned female heroin users in Taiwan relating to HIV/AIDS prevention. The study concludes that issues of misconceptions, high-risk behaviors, stigma surrounding AIDS and confidentiality of HIV testing must be addressed in appropriate HIV/AIDS education programs targeting female injecting heroin users.

Cost-Effectiveness of a Community-Level HIV Risk Reduction Intervention for Women Living in Low-Income Housing Developments
(Abstract)
This study reports the results of a cost-effectiveness analysis of a multi-site community-level HIV prevention trial that enrolled women living in 18 low-income housing developments in 5 U.S. cities. The authors conclude that the community-level intervention was moderately cost-effective in comparison with other HIV prevention programs for at-risk women.

HIV/AIDS NEWS

Africa: UN Elects Thailand to Assist in Combating AIDS
(News Article)
The UN Development Programme recently launched an initiative to foster partnerships between Thailand and Africa in the fight against HIV/AIDS. Since Thailand is one of the first countries to have achieved the Millennium Development Goal of reversing the spread of HIV by 2015, this new partnership will promote the exchange of experiences, lessons learned and best practices by Thailand with African anti-AIDS campaigns.

Burkina Faso: Government Aims to Put 30,000 On ARVs By 2010
(News Article)
The government of Burkina Faso has announced plans to double the number of people living with AIDS on subsidised antiretroviral (ARV) treatment to 10,000 by the end of this year and increase the number of people receiving the life-enhancing drugs to more than 30,000 by 2010.

Kenya: Ministry Gets Go-Ahead to Buy HIV/AIDS Testing Kits
(News Article)
The Kenyan Ministry of Health has been given approval by the High Court to import rapid HIV/AIDS test kits. The High Court upheld a decision by the Public Procurement Complaints and Appeals Board on May 18, 2005 that the batch which amounts to 30 per cent of the total quantity of the HIV/Aids, Hepatitis and Syphilis test kits be brought in.

Clinical Trial of Second AIDS Vaccine to Begin Aug/Sep
(News Article)
The clinical trial of India's second vaccine against HIV/AIDS, specifically meant for the Indian population, will begin in August or Sepetmber 2005. The vaccine, Modified Vaccinia Ankara (MVA), has been developed under a partnership of the Indian Council of Medical Research (ICMR), the National AIDS Control Organisation and the International AIDS Vaccine Initiative.

Italy Moving Ahead in Human Trials of AIDS Vaccine
(News Article)
Encouraged by an initial trial, Italy wants to launch a larger-scale human test of its AIDS vaccine in Africa in the hope of having it ready for the market by 2011. The vaccine is unique in that it acts on the TAT, a protein essential for the replication of the virus, instead of trying to block the virus itself. The vaccine has been tested in both preventative trials and in therapeutic trials to see if it can be used to treat people already infected with HIV as well as prevent the disease. In the initial tests, the vaccine was safe in 100 percent of volunteers.

Japanese Scientists Introduce New HIV Drug
(News Article)
Japanese researchers have developed a durable new drug (code named AK602) that blocks HIV from entering human cells and causes almost no side effects. The drug's main feature is that it shuts out the AIDS virus at the point when it tries to intrude into a human cell.

More than 1.5 million Asian Children Have Been Orphaned by AIDS, UN Says
(News Article)
More than 1.5 million children in Asia and the Pacific have been orphaned by AIDS and many more are living with ill and dying parents, the United Nations Children’s Fund (UNICEF) has told an international congress on AIDS that wound up its sessions in Kobe, Japan, this week.

Zambia: Paediatric AIDS Treatment Numbers Still Low
(News Article)
The UN Children's Fund (UNICEF) expressed concern this week over the poor availability of anti-AIDS medication for HIV-positive children in Zambia. According to a UNICEF Resident Representative, fewer than 15,000 of the 92,000 children living with AIDS have access to child-friendly antiretrovirals (ARVs).

Syria: Raising HIV/AIDS Awareness
(News Article)
A national campaign has recently begun in Syria to develop awareness among non-governmental organizations (NGOs), social workers and staff at Syria's National AIDS Programme.

Uganda: HIV/AIDS Rates Fall
(News Article)
Uganda has reported a sharp decline in HIV/AIDS infections with figures now standing at about 1.1 million, down from 1.6 million, an official from the Ministry of Health has said. Despite this reduction, officials report that HIV/AIDS still remains the leading cause of mortality among Ugandans ages 15 to 49.

Sex Ratio of AIDS/HIV Carriers in China Reaches 2:1
(News Article)
The male to female ratio of HIV/AIDS carriers in China has changed from 5:1 in the 1990's to 2:1, and even 1:1 in certain regions, according to the Ministry of Health.

Africa Welcomes G8 Aid, Questions Implementation
(News Article)
Group of Eight (G8) leaders ended their summit in Scotland announcing members would more than double aid to Africa by 2010. Critics said the promise of new help remained vague, with the aid increase years away and not extensive enough. But many others thought the huge increase in direct aid to Africa would help, particularly in funding crucial efforts to fight the continent's HIV/AIDS pandemic.

Zimbabwe: Forced Evictions Could Aggravate Disease
(News Article)
The Zimbabwe Association of Doctors for Human Rights (ZADHR) is concerned that the ongoing government crackdown on informal settlements and markets is likely to aggravate disease in the country. Of particular concern to ZADHR is the negative impact on children and families infected or affected by HIV/AIDS.

MATERNAL AND CHILD HEALTH RESEARCH

Serum C-Reactive Protein and Chlamydia Trachomatis Antibodies in Preterm Delivery
(Abstract)
When present together, elevated levels of Chlamydia antibodies and elevated highly sensitive C-reactive protein levels increased the estimated risk for preterm delivery by four-fold (odds ratio 4.3, 95% confidence interval 2.0-9.3). The results of this study suggest that chlamydial infection in the first trimester is associated with preterm delivery.

Maternal and Infant Factors and Lymphocyte, CD4 and CD8 Cell Counts in Uninfected Children of HIV-1-Infected Mothers
(Abstract)
This study evaluated the effects of antiretroviral treatment (ART) for mother-to-child transmission of HIV and infant/maternal characteristics on total lymphocytes (TLC) and lymphocyte subsets in uninfected children of HIV-1-infected mothers. The effect of ART exposure in fetal and early life on TLC and CD8 cell counts was prolonged until at least 8 years. These results add to the growing list of adverse effects associated with ART used as prevention of mother-to-child transmission of HIV.

Subclinical Iron Deficiency Is a Strong Predictor of Bacterial Vaginosis in Early Pregnancy.
(Abstract)
Bacterial vaginosis (BV) is the single most common vaginal infection in women of childbearing age and is associated with a sizeable infectious disease burden among both non-pregnant and pregnant women, including a significantly elevated risk of adverse pregnancy outcome. This study compared iron status among pregnant women with and without vaginosis-like microflora. It found that iron deficiency, presumably resulting from inadequate pre-conception iron intake, is strongly and independently associated with vaginosis-like microflora during early pregnancy.

Risk of Cleft Lip or Palate More Likely in the Offspring of Obese Women
(Abstract)
Related News Article: Cleft Lip More Likely in Babies of Overweight Moms
Women who are obese during the first trimester of pregnancy are more likely than normal-weight women to have an infant with a cleft lip or cleft palate, according to a study in Sweden. Researchers estimate that maternal obesity accounts for 23 percent of all cases of cleft lip and cleft palate among children of obese mothers. They suggest that undetected type 2 diabetes or improper nutrition could be responsible for the increased risk.

Child Morbidity and Healthcare Utilization in the Slums of Nairobi, Kenya
(Abstract)
Researchers visited households in Nairobi to track child morbidity and health care utilization. The study found familiies were more likely to report sickness in children who were younger than 1 year or who had a working mother. About half of the mothers sought proper medical care for their sick children, mostly from health institutions located outside the slum. Working mothers sought medical care more often than non-working mothers, and infants got priorities compared to older sick children.

Factors Associated with Infant Feeding Practices After Hospital Discharge
(Research Article)
A Brazlian study of 209 women examined infant feeding practices on the first day home after hospital discharge. Teenage mothers giving birth for the first time were more likely to exclusively breastfeed. Infants born in the municipal public hospital, as opposed to another type of facility, were also more likely to be exclusively breastfed.

MATERNAL AND CHILD HEALTH NEWS

Bangladesh: Focus on Eclampsia to Lower Maternal Deaths
(News Article)
In order to attain millennium development goals for reducing maternal mortality by 2015, Bangladesh will have to pay serious attention to preventing eclampsia, experts say. A study carried out in seven districts of Bangladesh, which sought to know how many women with serious delivery complications actually reach emergency obstetric care facilities in time, found that other major causes of maternal deaths are post-partum bleeding, abortion, antepartum hemorrhage, infection, ruptured uterus and obstruction.

Maternal Deaths Increasing in Tanzania
(News Article)
Deaths of mothers due to pregnancy complications have increased in Tanzania, according to the country's Ministry of Health. The maternal mortality rate increased from 529 per 100,000 in 1996 to 578 per 100,000 last year, with a disproportionate amount of deaths in rural areas.

Giving Birth Often Means Death for Bolivia's Women
(News Article)
Bolivia has the highest rate of maternal deaths during pregnancy and childbirth and the highest infant mortality rate of any other country in the Americas except Haiti and the third highest rate of cervical cancer deaths in the Western Hemisphere. The government has made preventive women's health programs a major priority, but cultural resistance to cervical exams and prenatal care is high in a country where most people are Indian, and many prefer to go to traditional healers and consider modern medicine invasive or foreign.

US: HIV Test Recommended for All Pregnant Women
(News Article)
Related Research Article: Screening for HIV: Recommendation Statement
An HIV test should be given to every woman in the US during pregnancy, according to new guidelines issued by the U.S. Preventive Services Task Force. The new guidelines update 1996 recommendations that called for HIV screening only of high-risk pregnant women and those in areas with high rates of HIV-infected newborns. Researchers say they revised the guidelines in light of research that shows treatment can reduce the odds of an HIV-infected mother passing the virus along to her infant.

Pakistan: Government Urged to Work on Cutting Maternal Mortality
(News Article)
A woman dies in Pakistan due to pregnancy complications every 20 minutes and the government, civil society and media must do more to reduce the maternal mortality rate, said Dr Yasmin Raashid, professor at King Edward Medical College and project director of the Punjab Safe Motherhood Initiative Project. "About 15 percent of all pregnancies end up in complications," she told reporters in connection with the Punjab Safe Motherhood Initiative Project in Sheikhupura district.

MEN'S HEALTH RESEARCH

Operating Characteristics of Prostate-Specific Antigen in Men With an Initial PSA Level of 3.0 ng/mL or Lower
(Abstract)
Related News Article: Prostate Cancer Test Questioned
Tests for prostate-specific antigen (PSA), used by millions of men each year to screen for prostate cancer, are not very accurate, a study has found. Usually, a biopsy is not recommended until a man's PSA levels exceed 4 nanograms per milliliter. But the study performed a biopsy on all participants and found that some men with much lower PSA levels had prostate cancer. The researchers conclude that the screening test results in many false positives and false negatives and that even the best result does not ensure that a man is cancer-free.

Fertility, Gonadal and Sexual Function in Survivors of Testicular Cancer
(Abstract)
This study looks at the fertility, gonadal and sexual function of long-term survivors of testicular cancer. The study finds that most patients retain their fertility, but the risk of infertility is likely to be increased by chemotherapy and concludes that screening for gonadal dysfunction should be considered in the follow-up of testicular cancer survivors.

POPULATION NEWS

Spotlight on Korea's Baby Shortage
(News Article)
Broadcaster MBC will air an in-depth look at Korea's low birth rate on the UN's World Population Day. The birth rate is expected to drop this year to 1.15 children per woman from 1.17 in 2002. Last year, 481,085 children were born in Korea, the lowest figure since the National Statistics Office started compiling numbers in 1970.

WOMEN'S HEALTH RESEARCH

Services for Women Victims of Sexual Violence: A Qualitative Study
(Abstract)
This article assesses the availability and quality of public health services for female victims of sexual violence in the city of Sao Paulo, Brazil. The results confirm the importance of these services and the need for their decentralized expansion. The researchers recommend introducing the discussion of sexual violence at the undergraduate level.

Vitamin E in the Primary Prevention of Cardiovascular Disease and Cancer
(Abstract)
Neither low-dose aspirin nor vitamin E supplements prevent cancer in women, and vitamin E also does little or nothing to prevent heart disease in them, according to findings from the large-scale, decade-long Women's Health Study.

Higher-Risk Behavioral Practices Associated With Bacterial Vaginosis Compared With Vaginal Candidiasis
(Abstract)
It is not clear whether bacterial vaginosis (BV) is a sexually transmitted infection or simply associated with specific sexual practices. This study compared behavioral associations in women with BV and women with vaginal candidiasis. BV was associated with indicators of high-risk sexual behavior, such as a greater number of male partners in the last year. Candidiasis was not associated with these risk behaviors and was instead related to practices such as receptive oral sex and douching. These results suggest a possible sexually transmitted cause for BV.

WOMEN'S HEALTH NEWS

Ghana: Social Justice--Female Circumcision Still Going On
(News Article)
Female genital mutilation (FGM) has decreased in Ghana, but is still practiced in many villages. Many people may not realize that FGM is against the law, said those who are working to educate and advocate against the practice.

YOUTH HEALTH RESEARCH

Sex Work, Drug Use, HIV Infection, and Spread of Sexually Transmitted Infections in Moscow, Russian Federation
(Abstract)
This study examined sexually transmitted infections (STIs), HIV infection, and drug use in street youth at a juvenile detention facility, adults at homeless detention centres, and women and men awaiting trial in Moscow. The study found a high prevalence of STIs among this population and concluded that this population may make a disproportionately high contribution to the HIV epidemic unless targeted interventions are implemented in the Russian Federation.

Predicting Adolescents' Longitudinal Risk for Sexually Transmitted Infection: Results From the National Longitudinal Study of Adolescent Health
(Abstract)
This study assesses whether family, school, and individual factors associated with increased duration of virginity also protect against sexually transmitted infections (STIs) in young adulthood. The study concludes that perceived parental disapproval of sexual intercourse and higher grades in school during adolescence have protective influences on the trajectory of risk for acquiring STIs, primarily among female adolescents. Most factors associated with increased duration of virginity in adolescence do not influence the trajectory of STI risk.

YOUTH HEALTH NEWS

U.S. Pediatricians' Group Says Teens Need Access to Birth Control
(Abstract)
Related Abstract: Adolescent Pregnancy: Current Trends and Issues
The American Academy of Pediatrics, a leading medical organization, says teenagers need access to birth control and emergency contraception, not just the abstinence-only approach to sex education favored by religious groups and President Bush. The recommendations are part of the group's updated teen pregnancy policy. Representatives said that "the evidence does not support abstinence-only interventions as the best way to keep young people from unintended pregnancy."

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Volume 5, Number 2811 July 2005