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Volume 6, Number 12
27 March 2006
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Guest Editorials (free with every subscription)
How ready is the education sector to address HIV and AIDS?
Author: Justine Sass, MSc, MPH
jsass@unesco.org
Ministries of education and their civil society counterparts play an important role in building knowledge and skills for prevention, in combating fear and apathy, and in addressing stigma and discrimination against people living with HIV and AIDS. As the largest employer and component of the public service in many countries, the sector is also responsible for addressing the challenges that HIV poses to its systems in terms of HIV-related absenteeism, attrition, disease, and death among its members and learners.
How ready is the education sector to address the challenges posed by HIV and AIDS?
The UNAIDS Inter-Agency Task Team on Education recently released the results of the first international survey to assess national education sector capacity to manage and mitigate the impact of HIV and AIDS.
The report, "Education Sector Global HIV & AIDS Readiness Survey 2004: Policy Implications for Education and Development", synthesizes the assessments of Ministries of Education in 71 countries and civil society in 18 countries regarding national activity, achievements, and planning on HIV and AIDS. The report found that:
• While nearly three-quarters of Ministries of Education surveyed had dedicated HIV and AIDS management structures in place, only one-third had adopted a sector-specific education policy. This is an issue of major concern because the specific needs of the education sector cannot be adequately dealt with by national policy frameworks alone. Moreover, inadequate collection and analysis of HIV- and AIDS-sensitive data continues to hamper efforts to quantify impact.
• Less than one in ten (9%) Ministries of Education had reviewed or amended their human resource policies to minimize sector vulnerability and susceptibility to HIV and AIDS. Guidelines for universal precautions, for example, were available in less than one-fifth of high- prevalence countries.
• HIV and AIDS education components were integrated into curricula at the primary and secondary levels in 79% and 89%, respectively, of participating countries. However, only 29% had monitored the success of prevention messages.
• There was a continuing emphasis on prevention, with comparatively little attention to issues of care and support, workplace issues, and management of the impact of HIV and AIDS. However, many Ministries of Education claimed to be developing a more comprehensive response, which was seen in the recent increase in the number committed to budgetary, organizational, and institutional readiness.
The report concludes with several recommendations for the education sector, in collaboration with its development partners, to better manage and mitigate the impact of HIV and AIDS:
• Establish dedicated, recurrent budgets and adequate resources to meet HIV and AIDS objectives
• Mainstream HIV and AIDS strategic plans into educational policies and other accompanying plans (Education for All, Poverty Reduction Strategy Papers)
• Develop comprehensive workplace and human resource policies
• Identify, monitor, and support children affected by HIV and AIDS
• Put teachers at the center of the response
• Place HIV and AIDS education within a comprehensive sexual reproductive health framework
• Address overall underfunding of the education system and sustainability measures.
Based on
Justine Sass, MSc, MPH, is Coordinator, UNAIDS Inter-Agency Task Team on Education, UNESCO.
References:
United Nations Educational, Scientific and Cultural Organization, 2006. Education sector global HIV & AIDS readiness survey 2004: policy implications for education and development.
FAMILY PLANNING/REPRODUCTIVE HEALTH RESEARCH
Country profiles for population and reproductive health: policy developments and indicators 2005
(Report; Global)
United Nations Population Fund and Population Reference Bureau, 2005.
PRB and the United Nations Population Fund have jointly published the Country Profiles for Population and Reproductive Health: Policy Developments and Indicators 2005. The volume, which updates the 2003 edition, contains national and subnational indicators on the demographic and social situation in 163 countries and subregions. The publication organizes its indicators by the following categories: population, socioeconomic and health conditions, adolescent reproductive health, gender equality, and reproductive health commodity security needs. The Country Profiles for Population and Reproductive Health: Policy Developments and Indicators 2005 also provides data on internal disparities, highlighting differences within countries, between urban and rural areas, between the best and worst performing administrative regions, by education, and among different income groups.
Continuous versus cyclic use of combined oral contraceptives for contraception: systematic Cochrane review of randomized controlled trials
(Abstract; subscription needed for full text; Global)
Human Reproduction. 2006;21(3):573-578.
Edelman A | Gallo MF | Nichols MD | Jensen JT | Schulz KF | Grimes DA
This review compares contraceptive efficacy, compliance, continuation, satisfaction, bleeding profiles, and menstrual symptoms of combined oral contraceptives with continuous dosing (more than 28 days of active pills) versus traditional cyclic dosing (21 days of active pills and 7 days of placebo). Six good quality randomized controlled trials met inclusion criteria and found that contraceptive efficacy satisfaction and compliance were similar between groups, but the continuous-dosing group had greater improvement of menstrual-associated symptoms (headaches, genital irritation, tiredness, bloating, and menstrual pain). However, the variations in pill type and time-interval for continuous dosing make direct comparisons between regimens unfeasible; to allow for comparisons, future studies should choose a previously researched pill and dosing regimen.
Coping with crises: how to meet reproductive health needs in crisis situations
(Technical Report; Global)
(Global Health Technical Brief, No. 27)
Ramchandran D
This Global Health Technical Brief focuses on the urgent reproductive health care needs during crisis situations, which include safe motherhood, protection from and response to sexual and gender-based violence, prevention and treatment of STIs including HIV/AIDS, access to family planning methods, and adolescent reproductive health.
Will period-free hormonal contraception become the norm of the twenty-first century?
(Abstract; subscription needed for full text; Global)
The European Journal of Contraception and Reproductive Health Care. 2006 Mar;11(1):1-5.
Aubeny E
Many women on birth control by estroprogestative pills and progestative contraception wish to space out useless and unpleasant periods for 3 to 6 months and even for 1 year or more. While the first studies on those “non-periods” contraceptive methods seem to show their harmlessness, the author argues that they must be further evaluated in a more specific way, and additional studies must be pursued in this direction. This new request from women about their periods, while being often undervalued by physicians, must now be taken into account for future contraceptive methods.
Riskier than we thought: revised estimates of noncontracepting women risking unintended pregnancy 
(Research Article; Global | North America)
(You need Adobe Acrobat Reader to access this document)
Public Health Reports. 2006 Mar/Apr;Atlanta, GA, Rollins School of Public Health, Emory University, 2006 121:155-159.
Gaydos L | Rowland Hogue CJ | Kramer MR
The objective of this study was to obtain realistic estimates of risk-taking behavior (non-use of contraception among sexually active women who do not desire pregnancy) in the National Survey of Family Growth (NSFG) by removing sterilized women and women relying on partner sterilization in the statistic. The results indicate that published NSFG percentages of adult women at risk of unintended pregnancy underestimate risk-taking behavior for groups previously thought to be at lower risk of unintended pregnancy.
World Health Organization randomized trial of calcium supplementation among low calcium intake pregnant women
(Abstract; subscription needed for full text; Global)
American Journal of Obstetrics and Gynecology. 2006 Mar;194(3):639-649.
Villar J | Abdel-Aleem H | Merialdi M | Mathai M | Ali MM | Zavaleta N | Purwar M | Hofmeyr J | Nguyen TN | Campodonico L | Landoulsi S | Carroli G | Lindheimer M
This is a double-blinded, randomized placebo-controlled trial of 8,325 nulliparous women with dietary calcium less than 600 mg/d to determine whether calcium supplementation of 1.5 grams per day reduces preeclampsia and preterm delivery. Calcium supplementation did not prevent the primary outcome preeclampsia but did reduce its severity; it also reduced secondary outcomes of maternal morbidity and neonatal mortality.
FAMILY PLANNING/REPRODUCTIVE HEALTH NEWS
Brown cuts VAT on contraceptives
(News Article; Europe)
22 Mar 2006
BBC News
Tax on condoms and other contraceptives has been reduced from 17.5% to 5% in the new UK Budget. The move could also see the cost of over-the-counter emergency contraceptives or morning after pills fall from around £25 to £22. This will bring tax rates on the products to the lowest possible within the European Union.
Birth pill with less cancer risk
(News Article; Global)
27 Mar 2006
BBC
Scientists are developing a contraceptive pill which carries a lower risk of breast cancer than the current combined pill. It is hoped the new pill, currently being tested on women, could be widely available within 5 years.
'Condom-vending machines, a great success'
(News Article; Asia)
24 Mar 2006
NT Bureau
Condom-vending machines have received a positive response from the public in Chennai, India. More than 25,000 condoms were sold in January.
Drought leads to forced marriages
(Feature Article; Sub-Saharan Africa)
26 Mar 2006
Baltimore Sun
This article relates how impoverished fathers in East Africa are increasingly trading their young daughters for dowries.
Depo-Provera under doubt as pregnancy cases reported
(News Article; Asia)
22 Mar 2006
The Rising Nepal
Worries are looming large among the women in Dhanusa district (Nepal) following several reported cases that have shown the failure of Depo-Provera injection for birth control, although they claim to have used it regularly as per the advice of the doctors.
FAMILY PLANNING/REPRODUCTIVE HEALTH LAW AND POLICY
Helping public sector health systems innovate: the strategic approach to strengthening reproductive health policies and programs
(Abstract; subscription needed for full text)
American Journal of Public Health. 2006 Mar;96(3):435-440.
Fajans P | Simmons R | Ghiron L
This study describes the key features of the Strategic Approach to Strengthening Reproductive Health Policies and Programs, a methodological innovation developed by the World Health Organization and its partners to help countries identify and prioritize their reproductive health service needs, test appropriate interventions, and scale up successful innovations to a subnational or national level. It also provides illustrations from country experiences and uses insights from the diffusion of innovation literature to explain the approach’s dissemination and sustainability.
Hungary considers birth control subsidy to cut abortions, costs
(News Article; Europe)
24 Mar 2006
Bloomberg
Hungary may consider subsidizing birth control pills to reduce unwanted pregnancies in a country with one of the highest abortion rates in the European Union.
Namibia: calls for the legalisation of prostitution
(News Article; Sub-Saharan Africa)
24 Mar 2006
Integrated Regional Information Networks
The Legal Assistance Centre (LAC) is campaigning to decriminalize sex work, as this would reduce the levels of violence and abuse associated with prostitution and would help set the stage for an effective HIV/AIDS campaign targeting both sex workers and their clients. The recommendations are based on interviews by LAC with 148 sex workers in five Namibian towns - Windhoek, Grootfontein, Keetmanshoop, Walvis Bay, and Swakopmund.
British schools to assist pregnant girls
(News Article; Europe)
24 Mar 2006
United Press International
New guidelines allow British schools to help pupils get the morning-after pill, pregnancy tests and abortions without parents' knowledge. Statistics recently released revealed that thousands of 13-year-old girls have been handed the morning-after pill by health service staff without their parents' permission.
HIV/AIDS RESEARCH
2005 update on the HIV/AIDS epidemic and response in China
(Report; Asia)
(You need Adobe Acrobat Reader to access this document)
Ministry of Health, People's Republic of China, Joint United Nations Programme on HIV/AIDS, World Health Organization, 2006.
This report was jointly prepared by the Ministry of Health of the People’s Republic of China, the Joint United Nations Programme on HIV/AIDS and the World Health Organization to describe the current status of China’s HIV/AIDS epidemic, progress made over the past year in China’s HIV/AIDS response, and key challenges that need to be addressed to stop the spread of AIDS.
Modelling the impact of antiretroviral use in resource-poor settings
(Research Article; Global)
PLoS Medicine. 2006 Mar 14;3(4):e124.
Baggaley RF | Garnett GP | Ferguson NM
Related News Article: Prevention alongside treatment only way to contain HIV epidemic, scientific modelling finds
Antiretroviral treatment alone will do little to reduce long-term HIV prevalence even if universal treatment access is achieved, accoring to these study findings. Using a mathematical model designed to test the effects of various interventions and different thresholds for treatment, the authors demonstrate that without additional prevention methods such as counselling patients and their communities about safe sex, access to drugs is likely to increase HIV/AIDS prevalence.
Social and psychological factors associated with willingness to test for HIV infection among young people in Botswana
(Abstract; subscription needed for full text; Sub-Saharan Africa)
AIDS Care. 2006 Apr;18(3):201-207.
Fako TT
The study investigates the effects of socio-demographic background variables, family coherence, interpersonal relations, sexual experience and knowledge about sexual health, on willingness to test for HIV infection in 1,294 students from secondary schools and tertiary institutions in Botswana. The results show that willingness to test for HIV infection was negatively associated with being sexually active and having a number of partners. Indicators associated with willingness to test included family, coherence, psychological bonding and personal adjustment such as common residence among parents, emotional support from the family attachment to parents, happiness with life in general, and satisfaction with life as a student. The study highlights the importance of continued education about voluntary counselling and testing among sexually active young people, especially those from poorer backgrounds in rural areas.
Generalizing a model of health behaviour change and AIDS stigma for use with sexually transmitted infection clinic patients in Cape Town, South Africa
(Abstract; subscription needed for full text; Global | Sub-Saharan Africa)
AIDS Care. 2006 Apr;18(3):178-182.
Kalichman SC | Simbayi LC | Cain D | Jooste S | Skinner D | Cherry C
This study tested the Information Motivation Behavioural Skills (IMB) model of AIDS preventive behavior by performing prospective path analyses in 131 men and 60 women with STIs in Cape Town, South Africa. Results showed that IMB constructs collected at baseline predicted risk reduction behavior 3 months later and in a second model, AIDS-related stigmas correlated inversely with AIDS knowledge, and there was a trend toward AIDS stigmas correlating inversely with behavioral intentions. These findings parallel those in US samples and suggest that the IMB model may generalize to South Africa and may therefore be useful in guiding HIV risk reduction interventions.
Education sector global HIV & AIDS readiness survey 2004: policy implications for education and development
(Report; Global)
(You need Adobe Acrobat Reader to access this document)
United Nations Educational, Scientific and Cultural Organization, 2006.
This report documents the outcomes of the first international survey of education sector readiness to manage and mitigate the impact of HIV and AIDS. Ministries of education (MoEs) in 71 countries and civil society organizations in 18 countries were interviewed, in person and electronically, in separate research processes. It synthesises MoE and civil society responses, interprets disagreements, and develops policy implications to inform the future responses of education sectors and their development partners. Specifically, the report identifies both the challenges and opportunities that present themselves and issues of operational importance. Finally, the report concludes by providing a number of recommendations designed to influence future responses in the education sector.
Impact of HIV infection on the epidemiology of tuberculosis in a peri-urban community in South Africa: The need for age-specific interventions
(Abstract; subscription needed for full text; Sub-Saharan Africa)
Clinical Infectious Diseases. 2006 Apr 1;42(7):1040-1047.
Lawn SD | Bekker LG | Middelkoop K | Myer L | Wood R
This study explores the community level epidemiological relationship between HIV and tuberculosis by examining trends (1996-2004) in tuberculosis notifications and their association with HIV prevalence in a peri-urban township in South Africa. TB notification rates increased 2.5-fold and have continued to increase while the prevalence of HIV increased from 6% to 22% and then stabilized. HIV infection is driving the TB epidemic in this population, and use of the directly observed treatment strategy alone is insufficient.
The search for social validation and the sexual behavior of people living with HIV in Rio de Janeiro, Brazil: Understanding the role of treatment optimism in context.
(Abstract; subscription needed for full text; South America)
Social Science & Medicine. 2006 May;62(10):2386-2396.
Kerrigan D | Bastos FI | Malta M | Carneiro-da-Cunha C | Pilotto JH | Strathdee SA
The authors of this study conducted 23 semi-structured, in-depth interviews of heterosexual women, heterosexual men, and men who have sex with men to explore the influence of HIV treatment optimism on the sexual behavior of people living with HIV/AIDS (PLWHA) receiving highly active anti-retroviral therapy at public health clinics in Rio de Janeiro, Brazil. They found that short-term information, education, and communication interventions surrounding treatment optimism, disclosure, and condom use are appropriate and necessary; but that they are not sufficient to address the core challenges to unsafe sex among PLHWA. These deep-rooted psychosocial issues may be better addressed by longer-term individual and group-level opportunities for exploration and critical reflection regarding sense of self and its relationship to social solidarity among PLWHA.
Psychosocial impacts on caregivers of people living with AIDS
(Abstract; subscription needed for full text; Global | Sub-Saharan Africa)
AIDS Care. 2006 Apr;18(3):236-240.
Orner P
This study uses 45 in-depth interviews with primary caregivers of people living with AIDS in South Africa to investigate the psychosocial impact of HIV at household level with reference to gender, program, and policy implications. Caregiving placed considerable demands on caregivers, which was exacerbated by insufficient support, dire poverty, and the added responsibilities of caring for other household members. Lack of basic resources was common and chronic, caregiving impacted negatively on employment and social life, while stigma and prejudice towards caregivers was common and exacerbated stress levels.
HIV/AIDS NEWS
NGOs propose new anti-AIDS model
(News Article; Global | Sub-Saharan Africa)
23 Mar 2006
Integrated Regional Information Networks
Related Press Release: Christian Aid’s HIV unit replaces ABC with SAVE in its comprehensive HIV programmes
African and international NGOs are proposing that the widely used anti-AIDS model of Abstinence, Be faithful and Condom use (ABC) should be replaced. They charge that ABC as a theory is not well suited to the complexities of human life. The new model proposed for a comprehensive HIV response is called SAVE: "S"afer practices, "A"vailable medications, "V"oluntary counselling and testing (VCT), and "E"mpowerment through education.
Women with AIDS need own UN agency: envoy
(News Article; Global)
17 Mar 2006
Reuters
Women and girls are far more vulnerable to AIDS than men and need their own UN agency to defend them, just as the UN children's fund UNICEF protects young people, a top UN envoy said.
ABC AIDS prevention strategy is 'not working'
(News Article; Global | Sub-Saharan Africa)
27 Mar 2006
Sapa-IPS
A former director of the United Nations Commission on HIV and AIDS and governance in Africa has painted a gloomy picture of efforts to bring the pandemic under control across the continent. "There is absolutely nothing optimistic about HIV in Africa, 25 years after the virus was discovered," said Nana Poku, who is now a professor in the department of peace studies at the University of Bradford in the United Kingdom. "The biggest issue we fundamentally got wrong is prevention. The ABC strategy doesn't work."
The Prostitutes' Union
(Feature Article; Asia)
Scientific American. 2006 Apr;
This feature article from the April 2006 issue of Scientific American details the Sonagachi project (named after the red-light district of Kolkata), an HIV intervention program in which sex workers form a collective to ensure condom use.
Brazil to hand out a billion free condoms
(News Article; South America)
23 Mar 2006
IPS
As a key part of its vigorous campaign against the spread of HIV/AIDS, the Brazilian government is planning to distribute over one billion condoms free of charge this year.
Uganda's HIV prevalence rate falls to 6.4 percent
(News Article; Sub-Saharan Africa)
15 Mar 2006
People's Daily Online
Local media quoted a survey of 10,437 randomly selected households, conducted between 2004 and 2005, which showed that the HIV/AIDS prevalence rate in Uganda has dropped from 6.5% to 6.4%. The capital city of Kampala came first in the prevalence by region, the prevalence was greater in women by gender, and Anglicans had the highest prevalence by religion.
HIV infections in Malaysia women on rise
(News Article; Asia)
22 Mar 2006
Associated Press
The number of women infected with HIV in Malaysia is on the rise, and housewives outnumber female sex workers four to one according to the Malaysian AIDS Council. Of the 67,438 people found to be infected with HIV between 1996 and 2004, 4,841 were women, and of these, 1,756 were housewives and 435 were sex workers. The actual number of infected women is believed to be higher because many do not come forward for tests and suffer the disease in silence.
Asia must educate young on HIV
(News Article; Asia)
22 Mar 2006
Reuters UK
Asia must break down taboos about sex and stop discrimination if it is to halt the world's fastest growing HIV rates, an expert warns, with half of all new cases in the continent aged between 14 and 24. The most seriously affected countries are Thailand, Myanmar, Vietnam, Cambodia, and India.
Ugandans report mixed message on AIDS plan
(News Article; Sub-Saharan Africa)
18 Mar 2006
ABC News
Abstinence is a HIV prevention option promoted not just by faith-based US groups but by many Ugandan charities, including one headed by the conservative Christian wife of President Yoweri Museveni. Health activists, and some Ugandan officials, accuse the US of blunting the condom message in favor of abstinence, while the Americans say they are victims of misinformation and have actually increased nearly tenfold the number of condoms they supply to this African nation of 26 million. This article examines both sides of this debate.
New directions in HIV prevention: circumcision and PREP
(Feature Article; Global)
8 Mar 2006
Aidsmap
This article discusses a study from Rakai in Uganda that circumcision may benefit women as well as men and places it in context with the prior literature. It then talks about several other studies on pre-exposure prophylaxis (PREP) which involves the use of oral antiretroviral treatment to prevent HIV infection. It also discusses the design of HPTN052 – a randomised trial designed to study if antiretroviral therapy could reduce transmission of HIV.
The first lady and the HIV moms
(Feature Article; Sub-Saharan Africa)
13 Mar 2006
TIME
Related Tool: The Mothers Programmes Web site
Laura Bush hosted an African group to announce a new AIDS initiative.
New directions in HIV prevention: serosorting and universal testing
(Feature Article; Global)
8 Mar 2006
Aidsmap
This article discusses studies presented at the Thirteenth Conference on Retroviruses and Opportunistic Infections in Denver on the use of HIV testing and information about HIV status as an HIV prevention tool. It is a complex and controversial area of debate, largely due to issues of trust – trust in confidentiality of information, trust that healthcare providers will not test without consent, and trust that partners are telling the truth about their status. For all these reasons prevention experts have shied away from addressing the topic in the developed world, despite the fact that HIV testing is considered an essential ingredient in the prevention mix in low-income countries.
Africa's Anglicans repent on AIDS "curse" stance
(News Article; North Africa | Sub-Saharan Africa)
24 Mar 2006
Reuters
Although Africa's Anglican church has come a long way from the days it preached AIDS was God's punishment for the promiscuous, activists and top clergy say Anglicans must do more to right past wrongs. After 20 years of official silence, the Anglican church confessed in 2002 it was complicit in stigmatizing those with HIV and launched a campaign of support and education. But while the Anglican leadership in Africa is largely on board with the softer approach, it concedes there are still pockets of conservatism, and says the new policy needs to filter down to rank-and-file clergy across the continent.
MATERNAL AND CHILD HEALTH RESEARCH
Unmet need for essential obstetric services in a rural district in northern Ghana: complications of unsafe abortions remain a major cause of mortality
(Abstract; subscription needed for full text; Sub-Saharan Africa)
Public Health. Online access March 23, 2006.
Baiden F | Amponsa-Achiano K | Oduro AR | Mensah TA | Baiden R | Hodgson A
This study reviewed 4 years of hospital data (at the district hospital in the Kassena-Nankana district of rural northern Ghana) on antenatal services, deliveries, and maternal deaths as the baseline evaluation for a program to improve care. Descriptive analyses were made of data extracted from the monthly returns charts and clinical notes on all maternal deaths from January 2001 to December 2003. The majority (56.6%) of women first attended an antenatal clinic during the second trimester. The prevalence of female genital cutting was 21.4%. Twenty-four maternal deaths were recorded, giving a hospital maternal mortality ratio of 759 per 100,000 live births. Complications of unsafe abortion (29.1%) and haemorrhage (20.8%) were the leading causes of death. Seventy-one percent of deaths occurred in women living within 15km of the district hospital, and 50% occurred within 24h of arrival.
Quality and quantity of antenatal HIV counselling in a PMTCT programme in Mombasa, Kenya
(Abstract; subscription needed for full text; Sub-Saharan Africa)
AIDS Care. 2006 Apr;18(3):189-193.
Delva W | Mutunga L | Quaghebeur A | Temmerman M
The quality and quantity of antenatal HIV counselling in a routine setting were appraised by means of the VCT assessment tools published by UNAIDS in a total of 14 group educational sessions, 66 pre-test counselling sessions, and 50 post-test counselling sessions. In general, the frequency and duration of the counselling was low, and crucial topics such as window period and partner involvement and follow-up support were covered haphazardly. The limited time dedicated to women receiving antenatal VCT contrasts with the heavy and comprehensive load of health information and advice they are supposed to receive; ample pre- and post-test counselling including follow-up should be pursued for optimal effectiveness of PMTCT.
The effects of economic instability on infant, neonatal, and postneonatal mortality rates: Evidence from Taiwan
(Abstract; subscription needed for full text; Asia)
Social Science & Medicine. 2006 May;62(9):2137-2150.
Lin SJ
This paper uses a panel data set comprising 23 cities for the years 1979–2002 in Taiwan and a fixed-effects model to find evidence of the effect of economic instability, income, demographic factors, and the availability of medical resources on infant, neonatal, and postneonatal mortality rates. The most important finding is that infant, neonatal, and postneonatal mortality rates move counter-cyclically with the city unemployment rate; the provision of national health insurance was also found to have a positive impact on the health of infants. Finally, the impact of economic instability on the infant, neonatal, and postneonatal mortality rates was found to be the strongest in the eastern part of Taiwan, which is the region with the fewest health care resources.
Factors predicting uptake of voluntary counselling and testing in a real-life setting in a mother-and-child center in Ouagadougou, Burkina Faso
(Abstract; subscription needed for full text; Sub-Saharan Africa)
Tropical Medicine & International Health. 2006 Mar;11(3):350-357.
Pignatelli S | Simpore J | Pietra V | Ouedraogo L | Conombo G | Saleri N | Pizzocolo C | De Iaco GD | Tall F | Ouiminga A | Carosi G | Castelli F
This study examined factors predicting uptake of voluntary HIV counselling and testing in 6,639 pregnant women receiving ante-natal group health education at St. Camille Medical Center, Ouagadougou, Burkina Faso. Less than one-fifth of pregnant women accepted voluntary HIV counselling and testing, the HIV seroprevalence rate was 10.6%, and the uptake rate was independently associated with age, the number of previous pregnancies, and the number of previous miscarriages. The independent value of age and previous obstetrical episodes show how important social factors are in influencing the voluntary HIV counselling and testing uptake rate.
Improved knowledge and practices among end-users of mother-to-child transmission of HIV prevention services in rural Zimbabwe
(Abstract; subscription needed for full text; Sub-Saharan Africa)
Tropical Medicine & International Health. 2006 Mar;11(3):341-349.
Orne-Gliemann J | Mukotekwa T | Perez F | Miller A | Sakarovitch C | Glenshaw M | Engelsmann B | Dabis F
This study reports the influence of a prevention of mother-to-child transmission of HIV advocacy and mobilization campaign on awareness and knowledge levels in 351 women attending healthcare services in rural Zimbabwe. The proportion of women aware of the service increased from 48% in 2002 to 82.8% in 2004. Exclusive breastfeeding was identified as a mother-to-child transmission risk factor by 27.1% in 2002 and by 55.8% in 2004. Prevention of mother-to-child transmission of HIV strategies at both individual and community level were still insufficiently understood, and applied and targeted educational messages and communication for social change need to be combined.
MEN'S HEALTH RESEARCH
HIV/AIDS risks among South African men who report sexually assaulting women
(Abstract; Sub-Saharan Africa)
(You need Adobe Acrobat Reader to access this document)
American Journal of Health Behavior. 2006;30(2):158-166.
Simbayi LC | Kalichman SC | Jooste S | Mathiti V | Cain D | Cherry C
This study conducted anonymous surveys among 412 South African men to examine HIV risks in those who report having been sexually assaultive. Twenty-three percent reported a history of sexual assault; these men were younger, reported more sex partners, more likely to have a history of genital ulcers, more likely to have exchanged money for sex, and also more likely to endorse rape myths. The authors conclude that interventions that target men as the agents of change in reducing sexual assaults and HIV transmission are urgently needed.
POPULATION RESEARCH
Child mortality, poverty and environment in developing countries
(Working Paper; Global)
(You need Adobe Acrobat Reader to access this document)
School of Economics and Finance, University of Edinburgh, Scotland, 2006.
Franz J | FitzRoy F
This paper studies child mortality and fertility in 61 developing countries, including the Central Asian Republics. To control for simultaneity, an estimated value of fertility was used in the mortality equation and a final specification included only exogenous socio-economic, health, and environmental variables. The authors confirm the importance of female literacy in explaining both fertility and mortality and also find a measure of consumption for the poorest share of the population to be significant, while controlling for nutrition, health expenditure, and income distribution.
A joint model of marriage and partner choice
(Working Paper; Global)
(You need Adobe Acrobat Reader to access this document)
Center for Studies in Demography and Ecology, 2006.
Rose E
This paper models the effect of own and parents’ education and race on the decision to marry and the education of a partner, conditional on marriage. In the theoretical model, individuals choose their optimal feasible spouse type in the marriage market and will marry if utility from marriage to that spouse is greater than the utility from being single. The author estimates the implied selection model and finds positive selection into marriage in terms of unobservables.
Ages of origin and destination for a difference in life expectancy
(Research Article; Global)
(You need Adobe Acrobat Reader to access this document)
Demographic Research. 2006 Mar 16;14:217-236.
Carlson E
Decomposition of a difference in life expectancies may identify ages at which the difference originates in mortality differences, or may identify ages at which the difference results in different values of person-years lived (life table population). This study shows that the two approaches are orthogonally related to each other, and derives an origin-destination decomposition matrix in which summing in one direction produces Andreev's origin-decomposition results, while summing in the other direction
produces destination-decomposition corresponding to directly-observed differences in nLx values.
POPULATION NEWS
Family planning policy helps prevent 400 mln births
(News Article; Asia)
21 Mar 2006
Xinhua
Related News Article: China says 'one child' policy is a success, but problems loom
According to the minister in charge of the National Population and Family Planning Commission, the family planning policy has helped China prevent 400 million births in the past three decades. The one-child policy will continue despite concerns about abuses and warnings from economists about the ramifications for China of a rapidly aging and gender-skewed population.
Tibet's resident population reaches 2.76 mln
(News Article; Asia)
21 Mar 2006
Xinhua
The resident population of Tibet Autonomous Region in southwestern China had reached 2.76 million by November 1, 2005, up 5.73% on the figure five years ago according to the regional statistics bureau.
Demographics: saying goodbye to the burbs
(Feature Article; North America)
27 Mar 2006
Newsweek
People aren't just fleeing the cities. They're fleeing the suburbs, migrating to the outermost metropolitan fringes, according to new Census Bureau population estimates detailing growth patterns for the first half of the decade.
Experts warn sex is a threat v. food security
(News Article; Asia)
26 Mar 2006
Sun Star
Population management experts warned that the Philippines' food security is under threat from a galloping population that could reach 147.3 million 45 years from now from the current 83.7 million. The warning came at the opening day of the two-day workshop training on "Communicating Reproductive Health through Integrated Population-Environment Approaches" for selected media practitioners and information officers from six provinces in the Visayas at Bethel Guest House on March 22 to 23.
The EU's baby blues
(Feature Article; Global | Europe)
27 Mar 2006
BBC
EU states are trying to understand why the birth rate is falling - and if anything can be done to stem the decline. All this week, the BBC News Web site is asking women in various countries how they feel about being asked to have more babies, and how easy or difficult it is to combine motherhood and work. Here, the BBC News website's Clare Murphy asks why governments are so concerned about the size of their populations.
WOMEN'S HEALTH RESEARCH
Awareness of and attitude toward hormonal emergency contraception among married women in Kuwait
(Abstract; subscription needed for full text; Middle East)
Journal of Women's Health. 2006 Mar;15(2):194-201.
Ball DE | Marafie N | Abahussain E
This cross-sectional survey was conducted among married women at obstetrics/gynecology outpatient clinics at the government Maternity Hospital in Kuwait. One hundred three questionnaires were completed. Respondents were mostly Kuwaiti (78%) and non-Bedouin (78%). Bedouin women were more likely than non-Bedouins to use breastfeeding as a contraceptive measure. Ten women reported having heard of hormonal emergency contraception, mostly from informal sources, 1 had used it, and 7 knew of other women who had used it. Only 8 respondents were willing to use or inform a friend about hormonal emergency contraception, but 89.3% thought it should be available in the health system.
Oral contraceptive use and risk of fractures
(Abstract; subscription needed for full text; Global)
Contraception. Online access March 13, 2006.
Vestergaard P | Rejnmark L | Mosekilde L
This is a case-control study of increased fracture risk in patients on oral contraceptives (OCs). Study subjects were all women with a fracture in the year 2000 in Denmark (n=64,548), three age-matched controls randomly drawn from the general population (n=193,641), and exposure of OCs between January 1, 1996, and December 31, 2000. In the unadjusted analysis, use of OCs in low dose was associated with a small increase in overall fracture risk, but upon adjustment, no increase in fracture risk could be demonstrated in any age or dose group. Oral contraceptives are not associated with an increase or a decrease in fracture risk, and any change in fracture risk may be due to confounders.
Long-acting injectable progestin contraception and risk of type 2 diabetes in Latino women with prior gestational diabetes mellitus
(Abstract; subscription needed for full text; Global)
Diabetes Care. 2006;29(3):613-617.
Xiang AH | Kawakubo M | Kjos SL | Buchanan TA
Related News Article: Depo Provera may up diabetes risk in some women
This paper reports an observational cohort study from January 1987 to October 1997 of 526 Hispanic women with prior gestational diabetes mellitus (GDM) to investigate the impact of a long-acting injectable progestin, depo-medroxyprogesterone acetate (DMPA), compared with combination oral contraceptives (COCs) on the risk of diabetes. Annual diabetes incidence rates were 19% in the DMPA group and 12% in the COC group, with an unadjusted hazard ratio (HR) of 1.58, but adjustment for baseline imbalances and weight gain during follow-up reduced the HR to 1.07. DMPA use was associated with an increased risk of diabetes that appeared to be explained by three factors: 1) use in women with increased baseline diabetes risk, 2) weight gain during use, and 3) use with high baseline triglycerides and/or during breastfeeding.
WOMEN'S HEALTH NEWS
Period misery for Kenya schoolgirls
(News Article; Sub-Saharan Africa)
17 Mar 2006
BBC
A large number of girls in rural Kenya skip school at the time of their menstruation because they cannot afford to buy sanitary towels or tampons. The cost of these monthly necessities has been highlighted by women campaigners in Zimbabwe, where the economic crisis has led to shortages and prohibitive prices. But it is a problem experienced by many across Africa, and Kenya in particular, where 54% of people live on less than $1 a day.
South Africa rape trial worries activists
(News Article; Sub-Saharan Africa)
24 Mar 2006
Associated Press
Related News Article: 'This mama is speaking lies'
Related News Article: Key trial forces South Africa to confront rape
The day the trial opened, the woman who accuses a former South African deputy president of rape was hustled in under heavy guard, her face hidden under a cloth. The politician's supporters have burned photographs of her outside the courtroom - even though her identity was meant to be a secret - and depicted her as a traitor and a tramp. Inside, the 31-year-old HIV-positive AIDS activist has been subjected to aggressive questioning by the defense about her sexual history. Already, most of South Africa's many alleged rape victims do not press charges. Women's rights activists worry even more victims will be too frightened to come forward after watching Jacob Zuma's rape trial. The related article focuses on the protesters outside court vouching for the embattled Jacob Zuma, who are largely female.
YOUTH HEALTH RESEARCH
Adolescence in Pakistain: sex, marriage and reproductive health
(Report; Asia)
(You need Adobe Acrobat Reader to access this document)
Marie Stopes International, 2006.
Related Press Release: New MSI report on sex, marriage and reproductive health among Pakistani adolescents
This report presents findings from a baseline knowledge, attitude and knowledge survey in four districts in Pakistan. Researchers found that the study respondents had very little sexual and reproductive health information to equip them as they went through the changes of adolescence.
The mass media are an important context for adolescents’ sexual behavior
(Abstract; subscription needed for full text; North America)
Journal of Adolescent Health. 2006 Mar;38(3):186-192.
L'Engle KL | Brown JD | Kenneavy K
Related News Article: Underage sex 'link' to media
This study in the Southeastern United States compared influences from the mass media (television, music, movies, magazines) on 1,011 adolescents' sexual intentions and behaviors to other socialization contexts, including family, religion, school, and peers. Media explained 13% of the variance in intentions to initiate sexual intercourse in the near future, and 8-10% of the variance in light and heavy sexual behaviors, which was comparable to other contexts. Mass media are an important context for adolescents' sexual socialization, and media influences should be considered in research and interventions with early adolescents to reduce sexual activity.
Oral sex and condom use among young people In the United Kingdom
(Research Article; Europe)
Perspectives on Sexual and Reproductive Health. 2006 Mar;38(1):6-12.
Stone N | Hatherall B | Ingham R | McEachran J
This was a study of oral sex in the UK; 1,373 students, between 2003 and 2005, aged 16–18, completed questionaires about their knowledge, attitudes, and experiences related to sexual behavior and health. Fifty-six percent of survey respondents had experienced fellatio or cunnilingus, including 22% of those who had not yet engaged in penetrative intercourse, and of young people who had had vaginal intercourse, 70% had previously had oral sex. Greater efforts are needed to publicize the risk of exposure to STDs that many young people face because of unprotected noncoital sexual activities before, as well as after, they enter into relationships involving intercourse.
Friends' influence on adolescents' first sexual intercourse
(Research Article; North America)
Perspectives on Sexual and Reproductive Health. 2006 Mar;38(1):13-19.
Sieving RE | Eisenberg ME | Pettingell S | Skay C
This study analyzed data on 2,436 participants in the National Longitudinal Study of Adolescent Health (Add Health) who were sexually inexperienced at Wave 1 (1994–1995) to examine whether sexual attitudes and behaviors of their friends predicted initiation of vaginal intercourse by Wave 2 (1996). In analyses controlling for gender, family structure, and romantic relationships, the higher the proportion of a youth's friends who were sexually experienced, the greater the odds of sexual debut (odds ratio, 1.01); the odds also were elevated among youth who believed that they would gain their friends' respect by having sex (1.2). The researchers write that, to maximize the likelihood of success, programs focused on delaying teenage sexual intercourse should address norms for sexual behavior among adolescents' close friends as well as the perceptions, skills, and behaviors of individual youth.
YOUTH HEALTH NEWS
Act now to stop HIV/AIDS in children, UN says
(News Article; Global)
24 Mar 2006
Reuters
The United Nations called on governments to take immediate steps to better protect children from HIV/AIDS and ensure better treatment for those infected.
Strait-laced hem in straight talk for Uganda teens
(Feature Article; Sub-Saharan Africa)
26 Mar 2006
Women's eNews
Thirteen years ago, two female anti-AIDS activists in Uganda started Straight Talk, a frank and pioneering sex education forum for African teens. It is now known as one of the most successful anti-AIDS groups in Uganda, among the countries first and hardest hit by the disease. Today, while not officially censored, it copes with a sense of being hemmed in.
Chinese college students have poor knowledge of AIDS: survey
(News Article; Asia)
23 Mar 2006
Xinhua
Just over 67% of Chinese college students have accurate knowledge of HIV/AIDS, according to survey results released by the Ministry of Health. The survey, conducted recently by a research institute at the request of the ministry, collected answers from 1,919 respondents in 24 colleges of 19 cities, said the ministry's information office.
Calendar of Events
April 1, 2006Involving men in the campaign to end violence against women
This free conference brings together speakers from organizations that have pioneered work involving men in campaigning, education, and action to end the suffering caused by violence against women.
Event Location: London
April 3, 2006
Young Males and Masculinity in Sub-Saharan Africa: HIV/AIDS, Conflict, and Violence
Development policies and programs often use gender as an analytical framework, largely focusing on the disadvantages of women and young girls and ultimately leaving untouched the gender issues facing men and young boys. Drawing on literature and interviews with young men in Botswana, Nigeria, South Africa, and Uganda, a new report from Instituto Promundo in Brazil examines masculinity in Africa within the context of conflict, violence, and HIV/AIDS. Please join Gary Barker, Instituto Promundo's executive director, to explore how widely varying ideas of masculinity are shaped by social constructions including rites of passage, sexual experience, financial independence, employment, and family status. While stressing the need to better integrate a youth and gender perspective into programs, Barker will also argue that the best chances for the peaceful, healthy change of gender norms in sub-Saharan Africa come from within existing African contexts.
E-Mail: ecsp@wilsoncenter.orgEvent Location: Washington, DC
April 5, 2006
The President's Emergency Plan for AIDS Relief: New Partners Initiative Outreach Workshop (Los Angeles)
This 1-day Information Session will familiarize participants with the President's Emergency Plan for AIDS Relief, the role of community and faith-based organizations in the plan, federal regulations, and how to submit a grant application.
Event Location: Los Angeles
May 16, 2006 - May 18, 2006
The President's Emergency Plan for AIDS Relief: New Partners Initiative Outreach Workshop (Denver)
This 3-day Training Workshop will familiarize participants with the President's Emergency Plan for AIDS relief, the role of community and faith-based organizations in the plan, federal regulations, and how to submit a high quality grant application.
Event Location: Denver, Colorado, USA
May 23, 2006 - May 25, 2006
The President's Emergency Plan for AIDS Relief: New Partners Initiative Outreach Workshop (Washington, DC)
This 3-day Training Workshop will familiarize participants with the President's Emergency Plan for AIDS relief, the role of community and faith-based organizations in the plan, federal regulations, and how to submit a high quality grant application.
Event Location: Washington, DC
August 1, 2006 - August 8, 2006
10th International Summer School STOP AIDS
Contact's Name: Dejan Tomaševiæ / E-Mail: isssa@jazas.org.yu
Event Location: Serbia and Montenegro, Belgrade and Kopaonik
August 15, 2006 - August 20, 2006
Challenging the HIV Today
"Challenging the HIV Today" is a 5-day workshop that would reunite youth and youth organizations working in the domain of HIV/AIDS prevention. Participants will throughout the workshop seek innovative ways of mobilizing youths and their communities to adopt better and risk-free lifestyles and seek the means to equip them with the capacities of taking informed decisions about their sexual lives. The workshop centers on CRVM (Community Based Risk and Vulnerability Mapping), Life Skills, and presentations of best practices.
Contact's Name: Abongta Shu Moncha / E-Mail: oflic@hotmail.com
Event Location: Yaounde, Cameroon
October 18, 2006 - October 21, 2006
7th IUHPE European Conference on Health Promotion and Health Education
This conference will focus on different aspects of globalization and of inequalities in health. A major goal of the conference is to provide a platform for review, analysis and discussion of tackling health inequalities at the global and community levels to key players in health promotion and health education from across Europe. Over the course of four days, participants and attendees will have the chance to share information about health promotion policy issues, on-going research, existing evidence and practical experience.
Event Location: Budapest
November 6, 2006 - November 18, 2006
The Public Health in Complex Emergencies Training Program
The Public Health in Complex Emergencies training program is a two-week residential course that focuses on critical public health issues faced by NGO/PVO personnel working in complex emergencies. The goal of the course is to enhance the capacity of humanitarian assistance workers and their organizations to respond to the health needs of refugees and internally displaced persons affected by these emergencies.
Contact's Name: Ms. Prima Nalubega Wasukira / E-Mail: P_nalubega@yahoo.co.uk
Event Location: Makerere University Institute of Public Health, Uganda
December 10, 2006 - December 13, 2006
The Third International Jerusalem Conference on Health Policy
The main topics of this conference are the control of chronic diseases in the 21st century, innovative ideas for reform, efficiency of contracts and competition in health care, and the role of the physician.
Event Location: Jerusalem
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