Volume 5, Number 29
18 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

Noncontraceptive Health Benefits of Combined Oral Contraception
(Abstract)
This study looked at the noncontraceptive health benefits of combined oral contraception (COCs). The authors find that COCs produce notable effects on the reproductive system, including relief from heavy or painful periods and irregular bleeding. COCs are also associated with reduced acne and hirsutism (excessive hair growth), as well as a reduced risk of developing cancer of the ovary and the endometrium.

Evaluation of a Peer Provider Reproductive Health Service Model for Adolescents
(Research Article)
The use of peer providers in family planning clinics has been proposed as a strategy that could better serve sexually active adolescent populations. Baseline and follow-up survey data from 1,424 female and 166 male adolescent clients of five California community health clinics were analyzed to assess the effectiveness of a peer provider model between 1996 and 1999. Female clients were significantly more likely at their last visit than at their first visit to report consistent birth control use and were significantly less likely to report consistent condom use. There were no significant differences in male birth control or condom use between first and last visits. The authors conclude that a peer provider model appears to be a promising addition to the mix of service delivery models, particularly for certain subgroups of clients. The findings underscore the importance of tailoring programs on the basis of clients' risk profiles.

Sexually Transmitted Diseases in Zimbabwe and Choice of Health Care Facility
(Abstract)
This study examined factors associated with choice of STD health care facility in Zimbabwe among various groups, including sex workers, male factory workers, female adolescents, and mothers of newborns. Among the factors that were considered in choosing a health facility were accessibility and affordability, privacy/confidentiality, health care providers' attitudes, and caring or professionalism. Inter-group differences in health care facility choice are examined.

HIV-1 Disease Progression and Fertility in Dar es Salaam, Tanzania
(Abstract)
This study's objective was to examine the association of HIV-1 disease progression with pregnancy and live birth incidence in a cohort of HIV-1-positive women in Dar es Salaam, Tanzania, and to identify other determinants of fertility in this population. The study concludes that pregnancy and live birth rates decline dramatically with progression of HIV-1 disease and that this decline is not explained by observed social, behavioral, or biologic factors.

Impact on Contraceptive Practice of Making Emergency Hormonal Contraception Available Over the Counter in Great Britain: Repeated Cross Sectional Surveys
(Abstract)
Related News Article: Access to Contraceptive Did Not Alter Practices, Study Says
This study examines the impact on contraceptive practices of reproductive-age women after the availability of emergency hormonal contraception over the counter in Great Britain. The study found that no significant change occurred in the proportion of women using emergency hormonal contraception or having unprotected sex after the contraceptive was made available over the counter. Also, women did not rely on emergency contraception instead of other family planning methods.

Comparison of Vaginal and Oral Administration of Emergency Contraception
(Abstract)
Related News Article: Pharmacokinetics and Endometrial Tissue Levels of Levonorgestrel After Administration of a Single 1.5-mg Dose by the Oral and Vaginal Route
Two studies compare vaginal and oral administration of levonorgestrel, which is used in emergency contraception. The first study found suppression of gonadotropin, hepatic globulin, and androgen levels was similar after vaginal and oral use. The second found oral levonorgestrel achieves higher plasma levels sooner than vaginal, but that plasma levels after vaginal administration are more sustained and likely sufficient for ovarian suppression. Both conclude that vaginally administered levonorgestrel could be an effective alternative for emergency contraception.

FAMILY PLANNING/REPRODUCTIVE HEALTH NEWS

Indonesia: Majority of Married Couples Eschew Condoms Usage
(News Article)
Condom use remains low among couples in Indonesia. Statistics show that only 0.3% of married couples use condoms for contraception.

Azerbaijan: USAID Starts Implementation of Reproductive Health & Family Planning Project
(News Article)
The United States Agency for International Development (USAID) commenced implementation of the USAID-funded reproductive health & family planning project in Azerbaijan. The project is budgeted at US$6 million and is the first USAID-funded project in the country in a health sphere.

Hong Kong Condom Test Reveals Shocking Stats
(News Article)
More than one in 10 condoms sold in Hong Kong is likely to leak or burst, according to a consumer watchdog survey released on Saturday.

Uganda Faces Condom Shortage
(News Article)
As the World Bank suspends it's $7.5 million funding for condom procurement in Uganda next year, the country faces a severe condom shortage. Currently, condoms used nationwide are provided free of charge by the Ministry of Health through funding by the World Bank and social marketing companies, funded by other donors.

FAMILY PLANNING/REPRODUCTIVE HEALTH LAW AND POLICY

New Zealand Man Fined for Removing Condom During Sex
(News Article)
A New Zealand man charged with putting a prostitute's life at risk by removing a condom during sex has been fined in a groundbreaking case. The case is the first of its kind under an unsafe sex law that was part of the 2003 Prostitution Reform Act. Supporters said the NZ$400 (US$272)fine, though minimal, showed the Act was working and would hopefully have a deterrent effect on others.

Asian Parliamentarians Push for Reproductive Health Plans
(News Article)
The importance of reproductive health to achieving government development goals was emphazized during the conference of Asian parliamentarians at the Waterfront-Cebu Hotel in Lahug. Senator Rodolfo Biazon, co-chairman of the Philippine Legislators Committee on Population Development, said that without reproductive health government efforts to combat poverty could not be achieved.

HIV/AIDS RESEARCH

High Incidence of HIV-Associated Mortality Among Black and Hispanic Infants and Women of Childbearing Age in the United States, 1990-2001
(Abstract)
This study examined HIV-associated mortality in infants and in women of childbearing age (15-44 years) in the United States from 1990-2001. HIV-associated deaths were higher in black and Hispanic women than in white women, with similar trends observed in infants. HIV-associated mortality decreased following the availability of highly active antiretroviral therapy, but the decrease was considerably less marked in black women than in women of other racial/ethnic groups.

Participant Retention in Clinical Trials of Candidate HIV Vaccines
(Abstract)
This study aimed to determine predictors of loss to follow-up (LTFU) in trials of candidate HIV vaccines. Using data from HIV vaccine trials that enrolled HIV-negative volunteers, researchers found that of 3033 volunteers enrolled in 48 trials, 282 (9.3%) did not complete follow-up. Younger age and increasing trial duration predicted LTFU. The study discusses the impact of this finding on design of future vaccine trials.

Prevention of Cryptococcosis in HIV-Infected Patients With Limited Access to Highly Active Antiretroviral Therapy: Evidence for Primary Azole Prophylaxis
(Abstract)
Despite advances in the treatment of HIV disease, the incidence and mortality of invasive cryptococcal disease remain significant. A matched, case-control study was performed to examine the impact of highly active antiretroviral therapy (HAART) and azole use on the incidence of invasive cryptococcal disease in HIV-infected patients. Prevalence of HAART use was low in both groups. Results indicate that azole prevents invasive cryptococcal disease. Routine prophylaxis for cryptococcis should be considered, especially in populations with low HAART use.

HIV-1 Disease Progression and Fertility in Dar es Salaam, Tanzania
(Abstract)
This study examined the association of HIV-1 disease progression with pregnancy and live birth rates in a cohort of HIV-1-positive women in Dar es Salaam, Tanzania. Results indicated that both rates decline dramatically with progression of HIV-1 disease. This decline is not explained by observed social, behavioral, or biologic factors such as weight loss, menstrual dysfunction, or nutritional status.

Effectiveness of a Theory-Based Risk Reduction HIV Prevention Program for Rural Vietnamese Adolescents
(Abstract)
This study examined the effectiveness of an HIV prevention program targeting 15-20 year olds in rural Vietnam. The study found that intention to use condoms among these adolescents increased significantly six months after the program. Findings also showed significant improvement in knowledge of severity and vulnerability of HIV/AIDS, perceptions of self-efficacy, and response efficacy for condom use among youth in the program.

Is Sexually Transmitted Infection Management Among Sex Workers Still Able to Mitigate the Spread of HIV Infection in West Africa?
(Abstract)
This study explores the role of STI management in preventing HIV acquisition among sex workers in Burkina Faso. Among STIs, only infection with herpes simplex virus-2 (HSV-2) tended to be associated with HIV acquisition. The authors recommend that, in addition to STI control, HIV prevention strategies focus on nonprofessional sex workers, steady partners, and HSV-2 infection to tackle HIV transmission in this high-risk group.

HIV/AIDS NEWS

HIV/AIDS Training Begins in Cameroon
(News Article)
Community radio practitioners will gather from nations in West Africa to attend a week-long training program that forms the basis of UNESCO’s "Science of HIV and AIDS" media training programme that began in 2003. Community media is largely predominant in francophone West Africa and has the potential to increase health communication outreach to local communities.

Nigeria to Manufacture Anti-AIDS Drugs
(News Article)
Nigeria's federal government reported that the country would begin local manufacturing of anti-retroviral drugs (ARVs) and the Artemisinin-containing therapies for malaria (ACTs).

Big Jump in S African HIV Cases
(News Article)
South Africa's Ministry of Health has released figures suggesting that HIV infection rates in the country may be greater than previously thought. Results from the study indicate that between 6.29 and 6.57 million South Africans are infected, up from 5.6 million in 2003. The health department published the new findings only days after the opposition Democratic Alliance launched a legal bid to obtain a copy of the report.

HHS/FDA Tentatively Approves Another First-Time Generic AIDS Drug Associated with the President’s Emergency Plan for AIDS Relief
(Press Release)
The Food and Drug Administration within the US Department of Health and Human Services (HHS/FDA) announced the tentative approval of zidovudine tablets. This approval allows zidovudine to be considered for purchase and use outside the US under the President's Emergency Plan for AIDS Relief (PEPFAR).

South Africa: Nurses to Fill the Gaps
(News Article)
South Africa continues to lose skilled healthcare professionals as it rolls out the national AIDS treatment program, leaving severe shortages in an already overstretched public health system. To alleviate the situation, researchers are calling on the government to build existing capacity by giving nurses greater responsibility in dispensing antiretrovirals (ARVs) to AIDS patients.

MATERNAL AND CHILD HEALTH RESEARCH

"She Would Help Me From the Heart": An Ethnography of Egyptian Women in Labor
(Abstract)
Researchers conducted an ethnographic study of the intrapartum care of women expecting normal births in an Egyptian hospital. Data were synthesised into three themes: the epistemology of hospital care, characterised by "technical touch"; women's experience of hospital childbirth, which was contrasted unfavorably with home birth experiences; and women's epistemology of birth, which was characterized by "helping from the heart." This latter concept expresses the participants' preferred way of doing birth. The researchers propose an approach to the provision of childbirth care in Egypt and beyond which combines the clinical safety of evidence based and experientially developed technical skills with the emotional safety of trusting, respectful, loving relationships.

Nutritional Status and Poverty Assessment of Vulnerable Population Groups in Armenia
(Abstract)
Researchers studied nutritional status of mothers and children under five in both rural and urban zones of Armenia. The study concluded Armenian children and women do not have major problems with calorie intake, but follow inadequate diets that lead them to a low micronutrient status. Drought earlier in the decade compromised the possibility of improving the general nutritional status.

Mortality Among HIV-1-Infected Women According to Children's Feeding Modality: An Individual Patient Data Meta-Analysis
(Abstract)
A study of HIV-1-infected women found those with lower CD4+ counts were less likely to initiate breast-feeding. Mothers' mortality during the 18-month period after delivery did not differ significantly according to children's feeding modality (ever vs. never breast-fed). Of those women who initiated breast-feeding, the lower mortality risk among those still breast-feeding compared with those not breast-feeding likely represents better overall maternal health (with healthier women being able to breast-feed longer).

MATERNAL AND CHILD HEALTH NEWS

Mali Bucks Africa's Dismal Vaccine Record
(News Article)
Boosting children's access to basic vaccines was folded into new G8 commitments toward Africa. This task is daunting: While vaccination rates increased in most parts of the world during the 1990s, they fell dramatically in Africa. But Mali is bucking that dismal trend. Vaccination coverage in the country almost doubled to 86% last year compared to about 45% in 1999. Malian officials hope to boost coverage to 90% over the next decade.

Nepal: Only 18 Percent of Births are Attended by Health Personnel
(News Article)
Related News Article: Nepal: Progress in Control of TB Substantial
Nepal has one of the world's highest maternal death rates (539 per 100,000 live births), according to a senior United Nations official. Trained health personnel attend only 18% of births, and many women have children at a young age. Better education improves maternal health, the official said. This message was echoed by others at a workshop discussing reproductive rights in Nepal's Millenium Development Goals. While Nepal has made progress in maternal and infant mortality, speakers said the country lacks clear targets for increasing access to reproductive health information and services.

Fighting Unsafe Childbirth in Russia
(News Article)
Russian activists have published a new guidebook on safe childbirth, saying the government is refusing to give truthful maternal mortality statistics. The book, along with an accompanying Web site (www.lulka.com), describes what women can demand in obstetric clinics, how to choose the right maternity hospital, mistakes during childbirth that can be avoided, and other issues. The group says more than 900,000 women suffered birth-related complications during 2003 and that many deaths could have been prevented had women known their rights.

India: Women Demand Withdrawal of Two-Child Norm
(News Article)
Women in the Indian state of Maharashtra are demanding that the government retract policies that keep women with more than two children from receiving services or contesting elections. They allege that several hospitals in the city of Mumbai are coercing women to be sterilized and are denying pre- and postnatal maternal care to women who have more than two children.

Afghanistan: Child Marriage Still Widespread
(News Article)
Nearly 60% of marriages in Afghanistan involve girls below the legal age of 16, according to reports. Some girls are married as young as nine. Health activists say that such marriages increase the maternal mortality rate and deny young women an education or any kind of independent life.

Tanzania: One-Tenth of Zanzibar’s Children Die
(News Article)
For every 1,000 children born in Tanzania's semi-autonomous islands of Zanzibar and Pemba, 102 of them die before they reach the age of five years, according to the United Nations Children's Fund (UNICEF). Officials attribute the deaths to malnutrition, malaria, poverty, poor immunization rates, and ignorance. By contrast, on the Tanzanian mainland, infant mortality had fallen from 99 for every 1,000 live births in 1996 to 68 deaths in 2005, largely due to improved immunization rates.

MEN'S HEALTH NEWS

Rwanda: Men Use Condoms More than Women
(News Article)
Although the empowerment of women has been highlighted in various aspects in Rwanda, women have failed to outpace men in the use of condoms. During a validation meeting held recently at KIST Conference Hall, it was revealed that Rwandan women who do not like using condoms are 23.9%, compared to 20% for men. An expert attributed the state of affairs to the Rwandan culture, where females hardly exercise free will in sexual relationships.

India: Many Women Choose Sterilization—But Few Men Willing
(News Article)
In India, many women opt for sterilization, but the number of men undergoing vasectomies has declined steadily in recent years. The oldest government-recognized clinic in Mumbai has seen the number of vasectomies performed drop from 960 in 1968 to nine last year. Doctors say many men fear the procedure will make them impotent or interfere with sexual pleasure.

Phillipines: Cebu Men's Club Stands Firm on Vasectomy
(News Article)
In Cebu province, a club of vasectomized men--believed to be the Phillipines' first--has launched a campaign to persuade others to undergo the procedure. The Bisayang Maginoo Club has 130 members and is set to launch an education and information campaign among Cebuano husbands, using personal testimony and "rave reviews from their happy wives." The campaign, an effort to curb population growth, aims to overcome the widespread perception that vasectomies are not "macho" or cause impotence.

POPULATION NEWS

Deputy UN Secretary-General Congratulates Winners of Population Award
(News Article)
United Nations Deputy Secretary General Louise Fréchette said reproductive rights and access to relevant health services must be defended as keys to sustainable development as he congratulated this years' winners of the UN Population Award, Dr. Mercedes Concepcion, Professor at the University of the Philippines, and Asociación Pro Bienestar de la Familia de Guatemala (APROFAM), a leading non-governmental provider of reproductive health services in Guatemala.

India: South Delhi Records Poor Sex Ratio
(News Article)
South Delhi, home to many educated and well-to-do families, has a worse-than-average ratio of girls to boys, a study shows. A 2004 survey by the Municipal Corporation of Delhi found that the citywide sex ratio at birth was 819 girls for 1,000 boys, while in South Delhi it was 762 girls for 1,000 boys. Many families use pre-natal sex determination tests and abort female fetuses, likely due to concerns over property and inheritance matters. "Family planning for the rich and the elite is about making sure that you don't have too many daughters who can stake claim to your property," said sociologist Radhika Chopra. Studies showing the dismal sex ratio in the country clearly paint a grim and embarrassing picture.

India's Growing Population Seen as an Asset Rather Than Liability
(News Article)
India’s billion plus population, slated to overtake that of China by 2050, is being increasingly regarded by policy planners not as a liability but as an asset that could drive economic growth. The government says 402 million Indians are aged between 15 and 59, the working age, and that this number will grow to 820 million by 2020.

Bangladesh: Growing Population Eating Up Most of Successes
(News Article)
Bangladesh's growing population is keeping it from meeting development targets, officials said at a forum. As a result, the government wants to increase contraceptive use to 62% from the existing 58.1 and decrease the fertility rate to 2.8 from 3 by 2006. It has also fixed the target to reduce maternal mortality rate to 2.7 from 3.2 and child mortality to 48 from 65 per 1,000 live births. The country currently has a population growth rate of 1.48%.

Angola Says High Birth Rate Will Strain Resources
(News Article)
Angola's population will surge by more than 30% to 20 million by 2015, straining a country recovering from decades of war, the planning ministry said. UNFPA in Angola reports that the country has the highest fertility rate on the continent--7.2 children for every woman of reproductive age, compared with an African average of 5.3.

World Population Day 2005: Observances Around the World
(News Article)
Related News Article: Gender Equality Essential for Stronger Families, Communities and Countries, Says UNFPA
Related News Article: UN Chief Calls for Gender Equality as Way to Defeat Poverty
The United Nations Population Fund (UNFPA) marked World Population Day on July 11. A number of events around the world worked to raise awareness of population and development issues. Activities revolved around this year's theme of gender equality, which UNFPA says is a "cornerstone of development."

Australia: Fertility Rate Falling
(News Article)
Australia's fertility rates dropped to below replacement levels in 1976 and have been falling ever since, a new Bureau of Statistics report says. The report--which examined fertility trends from 1993 to 2003--said in the five years to 1998, Australia experienced a drop in the total fertility rate from 1.86 to 1.76 babies per woman. Rates remained relatively stable between 1998 and 2003, varying between 1.73 and 1.76 babies per woman. Officials attributed low fertility levels to the fact that women are starting families later in life.

WOMEN'S HEALTH RESEARCH

Symptom Experience After Discontinuing Use of Estrogen Plus Progestin
(Abstract)
Related News Article: Menopause Symptoms Found to Return When Hormones Stopped
Related News Article: Hormone Pills May Only Delay Menopause Symptoms
Hormone replacement therapy (HRT) may only postpone symptoms of menopause, not prevent them, according to a new study. Researchers surveyed women who had stopped taking HRT following reports in 2002 that the therapy could increase risk of heart disease and breast cancer. Many experienced a return of menopausal symptoms such as hot flashes, in some cases at later ages than previously thought possible. The findings call into question a longstanding belief that HRT might help women avoid symptoms altogether by simply waiting it out.

WOMEN'S HEALTH NEWS

India: Delhi Girls Sexually More Aware than Bhopal
(News Article)
Young people in Delhi are more informed on issues of sexuality and sexual health as compared to their counterparts in Bhopal and majority of them feel that pre-marital sex is okay, according to a recent survey.

Mixed Progress for Thai Women in Meeting Development Goals, UN Finds
(News Article)
Women in Thailand enjoy better reproductive health than 10 years ago, thanks to policies recognizing the links between health and poverty alleviation. Maternal mortality has fallen sharply, and fertility has continued to decline, according to a United Nations report launched on World Population Day. But violence against women and gaps in health coverage pose significant challenges to attaining gender equality, the report adds. While the number of women coming to crisis centers is growing, gender-based violence is not sufficiently recognized or addressed.

Djibouti: Women Fight Mutilation
(News Article)
Djibouti's health ministry estimates that 98% of all Djiboutian women are circumcised--the highest rate of any country in the world. Though Djibouti made female genital mutilation (FGM) a crime in 1994, the law has not been enforced. Earlier this year, however, Muslim Imams conceded the practice is not required by the Koran, a change that anti-FGM activists consider a breakthrough in changing cultural norms. Activists are also working to improve prosecution of those who perform female circumcisions.

YOUTH HEALTH RESEARCH

Perception of Peers' Behaviour in Sexual Health Decision-Making Among Females in Nigeria
(Abstract)
This study aimed to assess the perception of Nigerian female undergraduates about sexual behaviours of their peers and the type of influence their peers tend to exert on them. Almost half of respondents indicated that they were under pressure from friends to engage in pre-marital sex. However, close to 65% of respondents indicated that they would receive moderate or lots of support for their friends if they made the decision to abstain from sex.

Exploring Older Adolescents' and Young Adults' Attitudes Regarding Male Hormonal Contraception: Applications for Clinical Practice
(Abstract)
This study examined the attitudes of adolescent minority males in the US toward male hormonal contraceptive methods (HCM), methods that are currently in Phase I of clinical trials in the US. The study found that participants had positive impressions about male HCM (67% male; 67% female) and female partner trust of males' use was high (85%), as were males' intentions (60%).

YOUTH HEALTH NEWS

SWAZILAND: A Message to Teenagers -- Take Charge!
(News Article)
A new advertising campaign aimed at curtailing teenage HIV rates by promoting abstinence is using a combination of traditional and modern values in its appeal to Swazi youth.

High Rate of Chlamydia Found Among US Teens
(News Article)
As many as 1 in 20 teenage girls and women and more than 2% of the general population in the US are infected with chlamydia, the Centers for Disease Control and Prevention reports. Pregnant women attending publicly funded clinics and economically disadvantaged youth are especially at risk of the bacterial infection, which can cause serious problems, including infertility, if untreated.

Fiji: Ministry of Health Revises Sex Education Program
(News Article)
Fiji's adolescent reproductive health education program has been revised for the first time in 20 years, in an effort to reach primary and secondary school students. The changes include more health education on issues such as HIV/AIDS, condom use, and family planning issues.

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Johns Hopkins Bloomberg School of Public Health: The INFO Project

Volume 5, Number 2918 July 2005