Volume 6, Number 46
20 November 2006

Note: Due to the U.S. Thanksgiving holiday, the next issue of Pop Reporter will be on Wednesday, November 29, 2006.

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FAMILY PLANNING/REPRODUCTIVE HEALTH RESEARCH

Family planning: The unfinished agenda
(Abstract; subscription needed for full text; Global)
The Lancet. 2006 Nov 18-2006 Nov 24;368(9549):1810-1827.
Cleland J | Bernstein S | Ezeh A | Faundes A | Glasier A | Innis J
Promotion of family planning in countries with high birth rates has the potential to avert 32% of all maternal deaths and nearly 10% of childhood deaths. However, in half the 75 larger low-income and lower-middle income countries, contraceptive practice remains low. Historically, the USA has taken the lead, but other governments or agencies are now needed. Most governments of poor countries already have appropriate population and family-planning policies but are receiving too little international encouragement to implement them with vigor.

Trends in protective behaviour among single vs. married young women in Sub-Saharan Africa: The big picture
(Abstract; subscription needed for full text; Sub-Saharan Africa)
Reproductive Health Matters . 2006 Nov;14(28):17-22.
Cleland J | Ali MM | Shah I
Trends in condom use among single and married young women show distinct patterns in sub-Saharan Africa. A large increase in condom use by single young women for pregnancy prevention was witnessed in 18 countries. In contrast, a modest increase in condom use was noted for married or cohabiting young women. Condom promotion in Africa has been, therefore, a success for single women. In contrast, the needs of the married and cohabiting population have been neglected by researchers and program staff alike, despite the fact that more than half of HIV infections in Southern and East Africa are occurring in this group.

A qualitative study of condom use among married couples in Kampala, Uganda
(Abstract; subscription needed for full text; Sub-Saharan Africa)
Reproductive Health Matters. 2006 Nov;14(28):89-98.
Williamson NE | Liku J | McLoughlin K | Nyamongo IK | Nakayima F
This paper reports on a study in Kampala, Uganda, with couples reporting 100% condom use in the previous three months. The women were recruited from among women in a clinical trial who were using condoms and whose partners also agreed to participate. Women convinced partners to use condoms through insistence, refusal to have sex, persuasion, and specifying condom use for family planning or to protect children. Men's reasons for accepting condoms were to please their partner, protect her from HIV, protect their children, and protect themselves. An encouraging environment and condom availability are crucial to increasing condom use by couples in settings such as Uganda.

Dual protection: More needed than practised or understood
(Abstract; subscription needed for full text; Global)
Reproductive Health Matters. 2006 Nov;14(28):162-170.
Berer M
This paper on dual protection draws on a review of the literature in family planning, obstetrics and gynecology, and AIDS-related journals from 1998 to early 2005. Condoms remain the mainstay of dual protection, but the author provides an expanded list of dual protection methods to show that there is a range of options. These include non-penetrative sex and the increasing use of condoms with the backup of emergency contraception. In the long-term, the development of highly efficacious and highly acceptable methods of dual protection is an urgent research priority, starting with a wider range of condoms that will appeal to more people.

"No Party Hat, No Party": Successful condom use in sex work in Mexico and the Dominican Republic
(Abstract; subscription needed for full text; Central America and the Caribbean)
Reproductive Health Matters. 2006 Nov;14(28):53-62.
Garcia SG | Yam EA | Firestone M
This qualitative study aimed to determine attitudes, motivations, and strategies employed by sex workers and their clients who feel positively about condoms and who use them successfully. The authors conducted focus groups with sex workers in Mexico and female sex workers and male clients in the Dominican Republic. Sex workers defined successful condom use as being in agreement with their clients and partners about using condoms, protecting themselves from disease and unwanted pregnancy, and feeling good about using condoms. Condoms were seen to be hygienic, offer protection and provide a sense of security and peace of mind. Specific strategies included always having condoms on hand, stressing the positive aspects of condoms, and eroticizing condom use.

Sex preparation and diaphragm acceptability in sex work in Nairobi, Kenya
(Abstract; subscription needed for full text; Sub-Saharan Africa)
Sexual Health. 2006 Nov 17;3(4):261–268.
Sharma A | Bukusi E | Posner S | Feldman D | Ngugi E | Cohen CR
Researchers conducted interviews on sexual behavior with women in sex work and their clients and held two focus-group discussions. The women described adapting several potentially harmful substances, such as cloth and soapy water, for post-sex vaginal use to ensure personal hygiene, disease prevention, and client pleasure. The diaphragm may have limited acceptability among women in sex work if its effectiveness depends on a 6-hour post-sex wait before removal. The possibility of removing the diaphragm sooner than the recommended 6 hours for contraception should be further studied.

Seroprevalence of herpes simplex virus-1 and -2 in attendees of a sexually transmitted infection clinic in Singapore
(Abstract; subscription needed for full text; Asia)
Sexual Health. 2006 Nov 17;3(4):269-274.
Theng CTS | Sen PR | Chio TM | Tan HH | Wong ML | Chan RKW
The authors studied the seroprevalence of HSV-1 (herpes simplex virus)and HSV-2 in outpatient attendees in a sexually transmitted infection (STI) clinic in Singapore and examined their knowledge and attitudes towards HSV infection. HSV-1 was positive in 56% of attendees, whereas HSV-2 was positive in 29% of attendees. Most of the respondents (65.8%) were aware that herpes is an STI, whereas only half of them were aware of the possibility of asymptomatic transmission. There is an unsatisfactory level of knowledge among the attendees about HSV infection, and public education programs should be introduced to address this.

Bacterial vaginosis in women of low socioeconomic status living in slum areas in Chennai, India
(Abstract; subscription needed for full text; Asia)
Sexual Health. 2006 Nov 17;3(4):297-298.
Uma S | Balakrishnan P | Murugavel KG | Srikrishnan AK | Kumarasamy N | Anand S | Cecelia JA | Celentano D | Mayer KH | Thyagarajan SP | Solomon S
This study was performed to investigate the prevalence of bacterial vaginosis (BV) and its association with sexually transmitted infections among 487 women of low socioeconomic status in Chennai, India. Of the women screened for BV, 25% were positive and 8.2% were intermediate. BV was significantly associated with age greater than 25 and sexual experience. BV was also related to concurrent infections with T. vaginalis and HSV-2. The role of other possible risk factors needs to be explored.

Fruity, fun and safe: Creating a youth condom brand in Indonesia
(Abstract; subscription needed for full text; Asia)
Reproductive Health Matters. 2006 Nov;14(28):127-134.
Purdy CH
Researchers studied a strategy to heighten understanding of safer sex and increase the availability and use of condoms among sexually active youth in Indonesia. The centerpiece of this campaign was the launch of Fiesta condoms. Distribution has focused on places where young people often congregate and shop. The campaign relies heavily on the media, including TV commercials, radio talk shows, print media, and mobile text messaging. In three years, the Fiesta brand has gained a 10% share of the condom market and helped to increase overall condom sales by 22%.

FAMILY PLANNING/REPRODUCTIVE HEALTH NEWS

Tanzania: Official urges Muslims to adopt family planning to tackle population explosion
(News Article; Sub-Saharan Africa)
14 Nov 2006
International Herald Tribune
Related News Article: Tanzania: Muslim clerics begin meeting on gender violence, HIV/AIDS
African Muslims need to adopt family planning to deal with a population explosion that is threatening development in Africa and the Islamic world, a Zanzibari Cabinet minister told an international gathering of Muslim clerics. The meeting aims to develop ideas on issues such as HIV/AIDS, population control, and domestic violence.

Malaysia: Cover story: Benefits of contraception
(News Article; Asia)
14 Nov 2006
New Straights Times Online
The recently launched Asia Pacific Council of Contraception aims to reduce the high incidence of unsafe abortions through proper education on the use of contraceptives.

Slovenia tightens abortion policy
(News Article; Europe)
16 Nov 2006
MakFax
Slovenian authorities unveiled plans for tightening the policy on abortion, as part of the national strategy for increasing the birth rate.

FAMILY PLANNING/REPRODUCTIVE HEALTH LAW AND POLICY

Azerbaijan: Early marriage causes break-up of a lot of families
(News Article; Asia)
15 Nov 2006
Democracy, Elections, and Human Rights in Azerbajian
Early marriage in Azerbaijan often leads to divorce, especially when the husband goes abroad to find work. The State Committee for Family, Women and Children's Issues, hoping to improve current law on early marriage, is studying government regulations and plans to make suggestions for changes to the Family Code.

HIV/AIDS RESEARCH

Effectiveness of an HIV prevention program for secondary school students in Mongolia
(Abstract; subscription needed for full text; Asia)
Journal of Adolescent Health. 2006 Dec;39(6):925.e9-925.e16.
Cartagena RG | Veugelers PJ | Kipp W | Magigav K | Laing LM
This research evaluated the effectiveness of a 3-year school-based HIV prevention program for adolescents in Mongolia. Students of schools with the program were statistically significantly more knowledgeable and had less traditional attitudes about sex. Students from schools with the peer education program were more likely to practice safer sex. Peer education programs, particularly those that are managed by small teams, appear effective and should be implemented more broadly.

The 100% condom use programme in Asia
(Abstract; subscription needed for full text; Asia)
Reproductive Health Matters. 2006 Nov;14(28):41-52.
Rojanapithayakorn W
The most significant effort to promote condom use in sex work is the 100% Condom Use Program. The main principle is to promote the practice of “No condom – No sex” in all types of sex work. Sex workers are empowered when they are able to refuse sex without a condom. In Thailand, the program has increased the use of condoms in sex work from 14% in early 1989 to over 90% since 1992. The 100% Condom Use Programs in Thailand and Cambodia, which are being implemented on a nationwide basis, are the main reason for the decline in the HIV epidemic.

Unsafe condoms and other unsafe sex accessories
(Abstract; subscription needed for full text; Asia)
Reproductive Health Matters. 2006 Nov;14(28):171-173.
Ditmore M | Neth C
Condoms remain the sole effective method of prevention of HIV. However, in some places – including Cambodia and China – condoms have been modified to add so-called pearls, hard rubber studs or even bristles that are painful and dangerous to the receptive partner, causing injury to the vagina and anus. Such injuries contribute to the transmission of disease, so these condoms are not useful for prevention of STIs or HIV. Public health officials have outlawed the sale of unsafe condoms in Thailand, a step that should be taken in all places where both they and other unsafe accessories are available.

Condoms become the norm in the sexual culture of college students in Durban, South Africa
(Abstract; subscription needed for full text; Sub-Saharan Africa)
Reproductive Health Matters. 2006 Nov;14(28):104-112.
Maharaja P | Cleland J
This study aimed to examine the factors contributing to the increase in condom use among college students in Durban, South Africa. Condoms had become "part of sex" and acceptable to the majority, and were easily accessible. They were primarily used for preventing pregnancy. Almost 75% of sexually active students surveyed reported condom use at last sexual intercourse, but consistent condom use, reported by only a quarter, remains the main challenge. It may be more effective to promote condoms for contraception among sexually active young people than for HIV prevention.

Media messaging: A synthesis of lessons from the literature to inform HIV
(Abstract; subscription needed for full text)
Journal of Child and Adolescent Mental Health. 2006;18(2):61-72.
Selikow T | Flisher A | Mathews C | Ketye T
The authors provide a number of challenges and lessons to inform HIV-prevention media messaging initiatives for the youth. When designing initiatives, it is imperative that the unique needs of the youth are taken into account, although youth should not be seen as a one group. External evaluators and implementers should work together and draw on many different methodologies to produce the most useful evaluations. A key challenge is working with communities who may be divided over approaches to HIV prevention. Messaging is most successful when it uses a multimedia approach and is combined with interpersonal communication.

Preventing HIV with young people: A case study from Zambia
(Abstract; subscription needed for full text; Sub-Saharan Africa)
Reproductive Health Matters. 2006 Nov;14(28):68-69.
Gordon G | Mwale V
This paper summarizes PEPFAR's guidelines, describes how they are being implemented in Zambia, and what the community response to them has been. The authors argue that if PEPFAR guidelines and implementation were changed, organizations and communities would be able to use US funds more effectively to create empowered young people, health-promoting institutions and enabling environments to support young people's sexual and reproductive well-being and prevent more infections and unwanted pregnancies.

HIV/AIDS and disability: A pilot survey of HIV/AIDS knowledge among a deaf population in Swaziland
(Abstract; subscription needed for full text; Sub-Saharan Africa)
International Journal of Rehabilitation Research. 2006 Dec;29(4):319-324.
Groce N | Yousafzai A | Dlamini P | Zalud S | Wirz S
This study sought to establish whether there were measurable differences in the level of knowledge about HIV/AIDS between hearing individuals and individuals who identified themselves as deaf sign language users in Swaziland. Significant differences in levels of knowledge about HIV/AIDS were identified between the hearing and deaf respondents. The deaf population was significantly more likely to believe in incorrect modes of HIV transmission and HIV prevention. Almost all of the deaf respondents (99%) reported difficulties in communicating with health care facility staff, which may result in less use of HIV voluntary counseling and testing services.

HIV/AIDS NEWS

Cameroon: AIDS still unchecked in African children
(Feature Article; Sub-Saharan Africa)
13 Nov 2006
International Herald Tribune
The children of Africa are still not getting AIDS prevention or treatment drugs, experts are realizing, even though the drugs have become affordable and available across the continent. In Cameroon, the government started providing drugs to prevent the transmission of AIDS from mothers to their newborns in 2000. It now offers the full spectrum of AIDS medicine free to children. But Africa's systems to treat children and pregnant women are weak and overwhelmed by other diseases -- and diagnosing HIV infection in young children can be tough. So children may go without lifesaving drugs, even when they are available in the country.

South Africa: Circumcision 'reduces' HIV transmission rate
(News Article; Sub-Saharan Africa)
14 Nov 2006
Independent Online
Male circumcision has been demonstrated to be an effective method of cutting down on female to male transmission of HIV, said Serigne Gueye, a urologist at the Cheikh Anta Diop University in Dakar, Senegal, where the prevalence of HIV is the lowest in Africa. Clinical research suggested that circumcision under the age of 13 resulted in a 61 percent reduction in HIV prevalence and a 54 percent reduction between the ages of 13 and 20. After the age of 20, there was no difference, he said.

Hunger seen as big enemy in war on AIDS
(Feature Article; Global)
11 Nov 2006
Forbes
The U.N. World Food Program has launched nutrition programs in Haiti and 50 other countries with the worst HIV rates, providing monthly food supplements for patients and their families. Without adequate nutrition, AIDS sufferers cannot absorb the drugs needed to slow the virus. Side effects from taking the pills without food can lead patients to neglect treatment. "When you have the meds and don't have the food ... then the bigger problem becomes food security," said Harvard University professor Dr. Paul Farmer.

South Africa: Insuring HIV patients can be decent business for life
(News Article; Sub-Saharan Africa)
16 Nov 2006
Gulfnews.com
AllLife is specifically targeting customers carrying HIV, offering them affordable life insurance for up to three million rand ($410,000). They are now able to protect their loved ones and get mortgages. This is changing perceptions of a disease often considered to be a death sentence. AllLife only covers South African residents now, but is planning to expand into neighboring Namibia next year.

Three things you don't know about AIDS in Africa
(Feature Article; Sub-Saharan Africa)
Dec 2006
Esquire
At just twenty-six, economist Emily Oster may have the highest controversies-generated-to-years-in-academia ratio of anyone in her field. That's because, as a Ph.D. student at Harvard, she chose to hop the fence and explore a topic already claimed by doctors, social scientists, and policy wonks: the AIDS epidemic in Africa. Her studies suggest some uncomfortable possibilities -— not least that the so-called experts have gotten their approach to the crisis dead wrong.

South Africa: Govt AIDS programme on course but people still dying
(News Article; Sub-Saharan Africa)
14 Nov 2006
Reuters AlertNet
South Africa's Ministry of Health has confirmed that close to 6,000 HIV-positive people had died while receiving antiretroviral drugs since the government rollout began in 2004.

More Malawian HIV/AIDS patients receive free drug
(News Article; Sub-Saharan Africa)
10 Nov 2006
People's Daily Online
Malawi has managed to increase the number of HIV/AIDS-infected people receiving free life-prolonging drug to 70,000 by the end of September 2006, Malawi's National Aids Commission (NAC) revealed. "We are set to reach this year's target of putting 80,000 infected people on free anti-retroviral drug (ARVs) by the end of December [2006]," NAC Executive Director Bizwick Mwale told journalists in the capital Lilongwe.

Nigerian military gets free HIV/AIDS treatment
(News Article; Sub-Saharan Africa)
17 Nov 2006
Voice of America
Military personnel in Nigeria are getting free HIV/AIDS treatment under an initiative funded by the U.S. government. Authorities are hoping service personnel will now be encouraged to take voluntary HIV tests.

Kenya: Saving lives -- A half-world away
(Feature Article; Sub-Saharan Africa)
12 Nov 2006
Indy Star
The Indiana University School of Medicine's partnership with a Kenyan university and hospital, a model for treating HIV/AIDS victims, has the potential to save millions of lives across Africa.

MATERNAL AND CHILD HEALTH RESEARCH

Obstetric and neonatal outcomes in women who live in an urban resettlement area of Delhi, India: A cohort study
(Abstract; subscription needed for full text; Asia)
Journal of Obstetrics and Gynaecology Research. 2006 Dec;32(6):567-573.
Chhabra P | Sharma AK | Tupil KA
This research studied pregnancy outcomes in an urban resettlement area of Delhi, India, and determined factors that affect the outcome. Approximately two-thirds of deliveries took place at home. Primigravida mothers, mothers with short stature, mothers with non-cephalic presentation or other complications had caesarean and forceps delivery more often. A perinatal mortality rate of 74.5 per 1000 live births was observed. The majority of deliveries in the underprivileged sections in urban Delhi take place at home and the perinatal mortality remains high.

Analysis of uterine rupture in a tertiary center in Eastern Nepal: Lessons for obstetric care
(Abstract; subscription needed for full text; Asia)
Journal of Obstetrics and Gynaecology Research. 2006 Dec;32(6):574-579.
Chuni N
This research studied clinical presentation, management, and fetomaternal outcome in cases of uterine rupture in Eastern Nepal and proposed preventive measures. There were 126 cases of uterine rupture with incidence of one in 112 deliveries. Twenty-five patients (19.8%) had a cesarean scar. Obstructed labor was a common factor in the unscarred group (46.5%) and use of oxytocics accounted for maximum ruptures (44%) in the scarred category. Maternal mortality was 13.5% and perinatal mortality 83.3%; these were both higher in the unscarred uterus. Regular antenatal care, hospital deliveries, and vigilance during labor with quick referral to a well-equipped center will reduce uterine rupture.

Urban–rural differentials in child malnutrition: Trends and socioeconomic correlates in sub-Saharan Africa
(Abstract; subscription needed for full text; Sub-Saharan Africa)
Health & Place. 2007 March;13(1):205-223.
Fotso JC
This paper examines levels and trends of urban–rural differentials in child malnutrition. Using data from Demographic and Health Surveys of 15 sub-Saharan African countries, it shows that urban–rural differentials are considerable in all countries, that they have narrowed in most countries due to an increase in urban malnutrition, and have widened in few countries as a result of a decline in urban malnutrition. These urban–rural gaps are abolished in almost all countries when socioeconomic status is controlled. Policies and programs contributing to the attainment of the Millenium Development Goals should pay particular attention to the urban poor.

Hypertension and maternal–fetal conflict during placental malaria
(Research Article; Sub-Saharan Africa)
PLoS Medicine. 2006 Nov 14;3(11):e446.
Muehlenbachs A | Mutabingwa TK | Edmonds S | Fried M | Duffy PE
This research studied the relationship between hypertension and placental malaria. The rate of hypertension was similar in placental malaria (PM)-positive and PM-negative individuals. However, the authors found that PM was associated with hypertension in first-time mothers 18–20 years old, but not other mothers. Levels of a preeclampsia biomarker were elevated in first-time mothers with either PM, hypertension, or both. The data suggest that maternal–fetal conflict occurs during PM.

MATERNAL AND CHILD HEALTH NEWS

Conference blames culture, poverty, war for African maternal deaths
(News Article; Sub-Saharan Africa)
15 Nov 2006
Voice of America
A conference of African population experts in Ghana says unless deep-rooted cultural practices, ignorance, and war are addressed, efforts to save the lives of thousands of women who die each year from complications of pregnancy and childbirth, will be wasted.

India: Infant mortality rate falls again in Tamil Nadu
(News Article; Asia)
16 Nov 2006
The Hindu
The infant mortality rate in Tamil Nadu has once again fallen, from 41 per 1,000 live births in 2004 to 37 in 2005. The Government had introduced comprehensive emergency obstetric and newborn care centers to improve the quality of care and access to it for mothers and babies.

MEN'S HEALTH RESEARCH

A male contraceptive targeting germ cell adhesion
(Abstract; subscription needed for full text; Global)
Nature Medicine. 2006 Nov;12(11):1323-1328.
Mruk DD | Wong CH | Silvestrini B | Cheng CY
Related News Article: Male contraception: One door opens, another closes
Researchers in Italy and at the Population Council in New York have announced a breakthrough on a non-hormonal compound known as Adjudin. By injecting the compound as an attachment to a modified hormone that seeks out the testes, researchers have found that a low dose is both safe and effective in rats. Without this targeting mechanism, only much higher doses are effective -- but they are harmful to the body's organs. The next step is to find a more appealing delivery system than shots; both a gel and a matchstick-sized implant have been discussed.

Challenging and changing gender attitudes among young men in Mumbai, India
(Abstract; subscription needed for full text; Asia)
Reproductive Health Matters. 2006 Nov;14(28):135-143.
Verma RK | Pulerwitz J | Mahendra V | Khandekar S | Barker G | Fulpagare P | Singh SK
This article presents findings from a pilot intervention in 2005–6 to promote gender equity among young men from low-income communities in Mumbai, India. The program of activities was adapted from a Brazilian intervention. Interviews showed that attitudes towards gender and sexuality, as reported behavior in relationships, had often changed. A survey also showed a decrease in support for inequitable gender norms and harassment of women. The results suggest that the pilot was successful in helping young men critically discuss gender dynamics and health risk, and in shifting key gender-related attitudes.

Medical implications of the male biological clock
(Abstract; subscription needed for full text; Global)
Journal of the American Medical Association. 2006 Nov 15;296(19):2369-2371.
Lewis BH | Legato M | Fisch H
The phrase "biological clock" is most commonly used by physicians to refer to the declining fertility, increasing risk for fetal birth defects, and altered hormone levels experienced by women as they age. Abundant scientific evidence suggests that men also may have a biological clock. Men and their physicians must therefore understand the effects of the male biological clock on sexual and reproductive health, as well as its potential contributions to major medical consequences such as diabetes, cardiovascular disease, and the metabolic syndrome.

Promoting condoms in Brazil to men who have sex with men
(Abstract; subscription needed for full text; South America)
Reproductive Health Matters. 2006 Nov;14(28):63-67.
Darden C
DKT International (a non-profit social marketing enterprise) introduced a condom called Affair(R) to Brazil as part of its work in family planning and STI/HIV prevention. Sales were initially low, but Affair was well liked by some men who have sex with men (MSMs), so DKT positioned the condom for MSMs. Two new products -–- a baggy condom called Affair Sensation and a complimentary lubricating gel called Affair Personal Lubricant -– with new packaging and a promotional campaign were launched in February 2006. DKT's overall experience has been positive, sales are up, and DKT has received messages of support for the products and their promotion from consumers.

POPULATION RESEARCH

Estimation of mortality from vital registrations in South Africa
(Abstract; subscription needed for full text; Sub-Saharan Africa)
Current HIV Research. 2006 Oct;4(4):469-474.
Udjo EO
The use of vital registration in monitoring HIV related mortality has been largely unexplored. This study used data on registered deaths for the period 1997-2001 to estimate trends in mortality and TB/HIV related death rates in South Africa. The results indicate that coverage of registration of deaths in South Africa has increased over time, but the completeness of registration of female deaths lags behind completeness of registration of male deaths. The absolute number of deaths is estimated to have increased from about 400,000 in 1997 to about 565,000 in 2002. The crude HIV-related plus TB-AIDS death rate is estimated to have increased from about 9.6 per 10,000 in 1997 to about 19.1 per 10,000 in 2002. The increase in the number of deaths could not be attributed to population growth.

POPULATION NEWS

China: Family planning policy prevents 400 million births
(News Article; Asia)
9 Nov 2006
China Daily
China would by now have 400 million more people if a family planning policy ordering most couples to have just one child had not been put in place, said a top population official in Beijing.

Does Rwanda benefit from a big population?
(Commentary; Sub-Saharan Africa)
12 Nov 2006
The New Times
A close analysis of early motherhood in Rwanda is very important, as it is likely to pose social and economic problems. According to the 2002 population census, Rwanda's fertility rate is the highest on the continent. Unless there are birth controls in place and increased campaigns for family planning, Rwanda is heading for a very high population density.

Indonesian population growth alarming
(News Article; Asia)
12 Nov 2006
The Hindu
Indonesian President, Susilo Bambang Yudhoyono, said that the country's population growth reaching 1.3 per cent per year was alarming, and must soon be lowered by the promotion of family planning programs.

Vietnam: Hanoi to meet birth rate target
(News Article; Asia)
16 Nov 2006
VietnamNet Bridge
Hanoi, Vietnam's previous failure to come in under birth rate quotas is likely to change this year as the capital looks likely to meet mandated targets. As planned, the proportion of families giving birth to a third child will see a decrease of 0.1% this year in comparison to last year's figure.

Russian lawmakers pass maternity bill in first reading
(News Article; Asia)
20 Nov 2006
RIA Novosti
A maternity incentive bill on payouts for women who give birth to more than one child was passed by lawmakers in Russia's State Duma in its first reading. The president-sponsored bill, aimed at reversing the current decline in the nation's birth rate, will provide for one-off payouts to women who give birth to or adopt a second child after January 1, 2007, and for subsequent births.

India: Government isn't a genie
(Editorial; Asia)
19 Nov 2006
The Pioneer
Some Government functionaries have expressed concern over the fact that minorities are lagging behind other communities according to many socio-economic indicators. In India, minorities include Muslims, Sikhs, Buddhist, Jains, Christians, Zoroastrians, and a few others. Out of the total population of one billion, Hindus constitute 80.5 percent of the population of the country. The Muslim population comprises 13.4 percent of the population. The next in size are Christians, followed by Sikhs, Buddhists, Jains, and those following other religions and persuasions including the tribal religions.

WOMEN'S HEALTH RESEARCH

Promoting female condoms in HIV voluntary counselling and testing centres in Kenya
(Abstract; subscription needed for full text; Sub-Saharan Africa)
Reproductive Health Matters. 2006 Nov;14(28):99-103.
Mung'ala L | Kilonzo N | Angala P | Theobald S | Taegtmeyer M
This paper argues that there is an urgent need to promote the female condom in Kenya through Voluntary Counseling and Testing (VCT) centers. In a study in five VCT centers, counselors reported that most people believed female condoms were "not as good" as male condoms. Counselors' felt constrained by lack of experience and had many doubts about female condoms. VCT counselors in Kenya already promote male condoms as a routine part of risk reduction counseling alongside HIV testing. This cadre has the potential to champion female condoms as well, to better support sexual and reproductive health.

Sex, life and the female condom: Some views of HIV positive women
(Abstract; subscription needed for full text; Global)
Reproductive Health Matters. 2006 Nov;14(28):32-40.
Welbourn A
This article offers some insights into the experiences of HIV-positive women with the female condom, based on the author's experience and an e-mail survey. Major barriers to female condom use reported were cost and sporadic or very limited access. All respondents talked about needing to negotiate the use of female condoms with their sex partners. Most felt more in control and more confident during sex when using the female condom than with the male condom or unprotected sex. Concerns about female condoms appear to be common. For HIV-positive women and girls, using a condom is more than protection against pregnancy, but a matter of life and death greater than the risks pregnancy can bring.

WOMEN'S HEALTH NEWS

Another vaccine to come
(News Article; Global)
19 Nov 2006
The Star
There is another candidate cervical cancer vaccine currently awaiting approval in the United States. This vaccine, developed by GlaxoSmithKline, fights the two types of HPV that typically cause cancer, as well as other, less common, types of HPV. The vaccine would be appropriate not only for young or adolescent women, but also for older women over the age of 26.

Dead by 34: How AIDS and starvation condemn Zimbabwe's women to early grave
(Feature Article; Sub-Saharan Africa)
17 Nov 2006
Independent Online
Zimbabwe now has the lowest life expectancy for women anywhere in the world: 34. Little more than a decade ago life expectancy was 65. Zimbabwe has found itself at the nexus of an AIDS pandemic, a food crisis, and an economic meltdown that together are killing an estimated 3,500 people every week.

YOUTH HEALTH RESEARCH

Sexual abstinence, contraception, and condom use by young African women: a secondary analysis of survey data
(Abstract; subscription needed for full text; Sub-Saharan Africa)
The Lancet. 2006 Nov 18-2006 Nov 24;368(9549):1788-1793.
Cleland J | Ali MM
Related News Article: Condom use increasing in Africa: Study
The authors did a secondary analysis of public-access data sets in 18 African countries and calculated changes in a set of behavioral indicators over time. Between 1993 and 2001, median percentage of women reporting secondary abstinence increased from 43·8% to 49·2%. Use of condoms for pregnancy prevention rose from 5·3% to 18·8%. Condom promotion campaigns in sub-Saharan Africa have affected the behavior of young single women. Thus continuing efforts to promote condom use with emphasis on pregnancy prevention are justified.

Romance and sex: Pre-marital partnership formation among young women and men, Pune District, India
(Abstract; subscription needed for full text; Asia)
Reproductive Health Matters. 2006 Nov;14(28):144-155.
Alexander M | Garda L | Kanade S | Jejeebhoy S | Ganatra B
This paper describes patterns of pre-marital romantic partnerships among young people in India. 25–40% of young men and 14–17% of young women reported opposite-sex friends. For those who engaged in sexual relations, the time from the onset of the partnership to having sexual relations was short. Sex most often took place without protection or communication, and for a disturbing minority of young women only after persuasion or without consent. Findings call for programs that inform youth in non-threatening, non-judgmental and confidential ways, and equip them to make safe choices.

The Mpondombili project: Preventing HIV/AIDS and unintended pregnancy among rural South African school-going adolescents
(Abstract; subscription needed for full text; Sub-Saharan Africa)
Reproductive Health Matters. 2006 Nov;14(28):113-112.
Mantell JE | Harrison A | Hoffman S | Smit JA | Stein ZA | Exner TM
The Mpondombili Project is a school-based intervention in rural KwaZulu-Natal that aims to promote delay in the onset of sexual activity and condom use as strategies for both sexually experienced and inexperienced youth. Issues covered included HIV/STI transmission, risk behaviors, HIV testing, pregnancy and contraception, gender inequality, sexual communication and negotiation, managing abusive situations, fear of AIDS, stigma, and sexual rights. The diversity of young people's vulnerability to sexual risk call for the promotion of both risk avoidance (delay in sexual initiation) and risk reduction (condom use) strategies.

School-based sex education in Western Nepal: Uncomfortable for both teachers and students
(Abstract; subscription needed for full text; Asia)
Reproductive Health Matters. 2006 Nov;14(28):156-161.
Pokharel S | Kulczycki A | Shakya S
The authors interviewed eight teachers responsible for teaching sex education, collected survey data from 451 students, and held four focus group discussions with 26 of them. Adolescents in these schools did not appear to be getting the information they needed. Most of the teachers did not want to deal with sensitive topics and feared censure by their colleagues and society. Some lacked the skills to give such instruction. Many students also felt uncomfortable with the topics. Their challenge is to make sex education appropriate for the students and ensure that teachers are comfortable in giving the instruction.

YOUTH HEALTH NEWS

Learn to prevent: Armenian youth lacking in knowledge about HIV
(News Article; Asia)
17 Nov 2006
ArmeniaNow
The number of reported HIV-positive people in Armenia has nearly doubled in the last five years, and there are believed to be many more unreported cases. As the country moves from the initial to a second-stage level epidemic, a key vulnerable group is being ignored: teenagers. According to survey nearly 25% of unmarried girls have their first sexual intercourse at 14-19, while 40% of boys start their sexual life between 13-17. Yet many of them are totally unaware of the way HIV and other sexually transmitted diseases are spread. And few educational programs exist for students to learn about AIDS.

Chinese teenagers turn to Internet for sex education
(News Article; Asia)
18 Nov 2006
People's Daily Online
Curious Chinese teenagers are turning to school websites when it comes to learning about sex -- much to the relief of traditionally-minded parents. In fact a middle school has opened Hunan Province's first website to provide students with advice on sex and reproduction health. "Sex topics, often too difficult for the Chinese teachers and parents to broach in the past, can be discussed with experts available for students on-line queries," said the vice-director of the school's Teaching Affairs Department.

Guam: Final thoughts -- Did it work?
(Editorial; Oceania)
20 Nov 2006
Pacific Daily News
This article reviews a nine-month community project organized by the Pacific Daily News to provide information on ways to help lower Guam's teenage pregnancy rate. The aim of "Project RAP," or Real Alternatives to Teen Pregnancy, has been to help parents and teenagers understand the personal and social consequences of teenage pregnancy, and ultimately reduce Guam's rate of teenage pregnancy.

Cyprus: Who’s teaching our children about sex?
(Editorial; Middle East)
17 Nov 2006
Cyprus Mail
According to a new study, a quarter of youth under 16 in Cyprus have had sex but only half are using contraception. The results of this report on the sexual behavior of Cypriot youth has raised alarm bells over the level of sex education being given in schools. According to the report, which was published in the Greek language daily Politis, almost half the respondents also said that they knew a girl who had had an abortion.

Cyprus: Promise to upgrade sex education
(News Article; Middle East)
18 Nov 2006
Cyprus Mail
Cyprus Health Minister Charis Charalambous yesterday promised to make better sex education a top priority after two studies presented by the Cyprus Family Planning Association (CFPA) revealed a serious lack of knowledge among Cyprus youth about contraception and sexually transmitted diseases.

South Africa: Young girls resort to abortions as contraception
(Feature Article; Sub-Saharan Africa)
14 Nov 2006
SABC News
An investigation by the South African Broadcasting Corporation has revealed that underaged girls in South Africa are using abortion as a means of contraception. This may have serious repercussions in the fight against HIV/AIDS. It also shows a failure on the part of the South African government to change behavior among young people.

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Johns Hopkins Bloomberg School of Public Health: The INFO Project

Volume 6, Number 4620 November 2006