Volume 6, Number 48
4 December 2006

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FAMILY PLANNING/REPRODUCTIVE HEALTH RESEARCH

Choice of contraception
(Abstract; subscription needed for full text; Global)
Current Obstetrics & Gynaecology . 2006 Dec;16(6):361-365.
Szarewski A
Many couples know little about contraceptive methods other than the combined pill and the condom, and in particular, knowledge of long-acting methods is very poor. Barriers and natural family planning are very safe but not very effective. Hormonal contraceptives and intrauterine devices are very effective but raise more concerns about health risks and side effects. It is a prescriber's responsibility to ensure that couples are given sufficient and appropriate information to enable them to make informed decisions.

FAMILY PLANNING/REPRODUCTIVE HEALTH LAW AND POLICY

"China not to relax 'one-child' family planning policy"
(News Article; Asia)
1 Dec 2006
The Hindu
China will continue with its 'one child' per couple family planning policy since it aided the nation's fast economic and social growth, the ruling Communist Party of China has said. A Politburo meeting of the party urged continued research on population development strategies, improvement of population quality based on a low birthrate, better technological and service levels in family planning, and reining in a rising gender imbalance.

HIV/AIDS RESEARCH

Identification of a novel circulating recombinant form (CRF33_01B) disseminating widely among various risk populations in Kuala Lumpur, Malaysia
(Abstract; subscription needed for full text; Asia)
Journal of Acquired Immune Deficiency Syndromes. 2006 Dec 15;43(5):523-529.
A molecular epidemiological investigation was conducted among risk populations in Kuala Lumpur, Malaysia, in 2003 to 2005, on the basis of genetic sequences of HIV. In addition to circulating HIV-1 strains, including CRF01_AE (57.1%), subtype B (20.1%), and subtype C (0.5%), the authors detected a candidate with a new circulating form (CRF33_01B). The overall prevalence of CRF33_01B is 19.0%. Although the prevalence of CRF33_01B is particularly high among injecting drug users (42.0%), it is also detected in homo-/bisexual males (18.8%) and heterosexuals (9.8%). This new form seems to be bridging viral transmission between different risk populations in this country.

Integration of antiretroviral treatment within antenatal care in Gauteng Province, South Africa
(Abstract; subscription needed for full text; Sub-Saharan Africa)
Journal of Acquired Immune Deficiency Syndromes. 2006 Dec 15;43(5):577-581.
This research evaluated interventions linking antenatal care with antiretroviral (ARV) treatment services and effectiveness of triple-ARV regimens for reducing Mother-to-Child Transmission (MTCT) in resource-constrained settings. In total, 164 pregnant women initiated ARV treatment and 863 received single-dose nevirapine (sd-NVP). After changes to service delivery, time-to-treatment initiation was reduced from a median of 56 days to 37 days. The risk of MTCT for women receiving ARV treatment was lower than for those given sd-NVP. Strengthening linkages and integrating key components of ARV treatment within antenatal care reduces time-to-treatment initiation. Also, triple-ARV regimens are effective in reducing HIV infection in infants.

Beyond the checklist: Assessing understanding for HIV vaccine trial participation in South Africa
(Abstract; subscription needed for full text; Sub-Saharan Africa)
Journal of Acquired Immune Deficiency Syndromes. 2006 Dec 15;43(5):560-566.
Lindegger G | Milford C | Slack C | Quayle M | Xaba X | Vardas E
This study designed and compared four measures of understanding for potential participants being prepared for enrollment in South African HIV vaccine trials, using detailed operational scoring criteria. There were significant differences across the measures for understanding of five components and for overall understanding. Forced-choice measures such as checklists tend to yield higher scores than open-ended measures such as narratives or vignettes. Consideration should be given to complementing checklists and self-reports with open-ended measures, particularly for critical trial concepts, where the consequences of misunderstanding are potentially severe.

The pediatric AIDS severity score (PASS): A multidimensional AIDS-severity adjustment for pediatric HIV infection
(Abstract; subscription needed for full text; Global)
Journal of Acquired Immune Deficiency Syndromes. 2006 Dec 15;43(15):603-610.
Seage G | Buchacz K | Weinberg G | Patel K | McIntosh K | Dankner W
A pediatric AIDS severity score (PASS) was developed using baseline sociodemographic, clinical, immunologic, and functional measures obtained from 786 perinatally HIV-infected children in the pre-highly active antiretroviral therapy (HAART) era (pre-1996). The most comprehensive model for predicting mortality, termed the "Full" PASS, included CD4% less than 15, CDC category C, Body Mass Index less than 10% , a low (less than 70) neuropsychological score, a general health rating less than 5 (HR = 2.4), and an elevated symptoms score. These determinants were highly predictive of mortality. PASS will be helpful in assessing the effectiveness of ART among children with HIV infection.

Body composition changes during lactation in HIV-infected and HIV-uninfected South African women
(Abstract; subscription needed for full text; Sub-Saharan Africa)
Journal of Acquired Immune Deficiency Syndromes. 2006 Dec 1;43(4):467-474.
Papathakis PC | Loan M | Rollins NC | Chantry C | Bennish ML | Brown KH
Related News Article: HIV-positive South African mothers losing weight when breastfeeding
This study measured the body composition of South African lactating women in relation to HIV status. At 8 weeks, HIV-positive and HIV-negative mothers were not significantly different in height, weight, or body mass index. HIV-positive mothers had a mean weight loss during breastfeeding of 1.4 kg in contrast to a 0.4-kg weight gain in HIV-negative mothers. HIV-positive South African breast-feeding mothers without severe immune suppression lost weight and subcutaneous fat between 8 and 24 weeks postpartum, whereas HIV-negative mothers gained weight. Fat free mass was maintained postpartum in HIV-positive and HIV-negative mothers.

South Africa's "Rollout" of Highly Active Antiretroviral Therapy: A critical assessment
(Abstract; subscription needed for full text; Sub-Saharan Africa)
Journal of Acquired Immune Deficiency Syndromes. 2006 Dec 15;43(5):618-623.
Nattrass N
The number of people on highly active antiretroviral therapy (HAART) in South Africa has risen from less than 2000 in October 2003, to almost 200,000 by the end of 2005. Yet South Africa's performance in terms of HAART coverage is poor both in comparison with other countries and the targets set by the government's own Operational Plan. The National Treasury seems to have allocated sufficient funding to the Department of Health for a larger HAART rollout, but the Health Minister has not mobilized it accordingly. Failure to invest sufficiently in human resources -- especially nurses -- is likely to constrain the growth of HAART coverage.

Effect of isoniazid prophylaxis on mortality and incidence of tuberculosis in children with HIV: Randomised controlled trial
(Abstract; subscription needed for full text; Sub-Saharan Africa)
British Medical Journal. Online access November 3, 2006.
Related News Article: Warning over drug for patients with TB and HIV
Related News Article: South Africa: Anti-TB drug 'could reduce HIV/AIDS deaths'
This study investigated the impact of providing tuberculosis-fighting prophylaxis (isoniazid) to children with HIV. Mortality was lower in the treatment group than in the placebo group (8% vs 21%) by intention to treat analysis. The benefit applied across all Centers for Disease Control clinical categories and in all ages. The incidence of tuberculosis was lower in the treatment group (3.8%) than in the placebo group (9.9%). Prophylaxis may offer an effective public health intervention to reduce mortality in such children in settings with a high prevalence of tuberculosis.

Missing the Target #3: Stagnation in AIDS treatment scale up puts millions of lives at risk
(Report; Global)
(You need Adobe Acrobat Reader to access this document)
Cape Town, South Africa, International Treatment Preparedness Coalition, 2006.
Related News Article: Study finds HIV/AIDS treatment goals for developing world unmet
A report by the International Treatment Preparedness Coalition (ITPC) finds that the urgency and energy that marked HIV treatment scale-up efforts from 2003 to 2005 is dissipating in the absence of clear goals and an all-out mobilization by country governments and international agencies. G8 countries and a special United Nations session on AIDS pledged to come "as close as possible to universal access" to treatment and prevention by 2010. According to ITPC, the world will miss the 2010 universal access goal by five million people.

HIV/AIDS NEWS

Statement on World AIDS Day
(Commentary; Global)
1 Dec 2006
UNFPA
Today on World AIDS Day, it is time to take stronger action to prevent new cases of HIV infection and meet the needs and protect the human rights of people living with HIV/AIDS, said Thoraya Ahmed Obaid, Executive Director, UNFPA. It is time to remember and pay respect to those who have died from AIDS-related illnesses. And it is time to applaud those who continue to speak out and take action to end the suffering, stigma and discrimination associated with AIDS.

United States: Abstinence requirement in President's AIDS relief plan questioned
(News Article; North America)
28 Nov 2006
U.S. Medicine
As the United States continues to pour money into helping African countries and others fight the AIDS epidemic, legislators, researchers, and aid groups are debating whether the ways in which they are spending the money may be off target. Several members of the U.S. Congress, such as Rep. Christopher Shays (R., Conn.), have questioned the rationale behind a requirement in the President's Emergency Plan for AIDS Relief (PEPFAR) to spend one third of HIV/AIDS prevention funds on 'abstinence until marriage' and 'be faithful to a single partner' programs (AB). Mark Dybul, the U.S. Global AIDS Coordinator for the state department, testified at a September 6 hearing that PEPFAR's overall ABC (abstinence, be faithful, condom use) approach is effective. He testified that they have tried to be flexible on the 33 percent requirement for abstinence-until-marriage programs.

Israel teaches WHO about circumcision
(News Article; Middle East)
28 Nov 2006
YNet News
A new program being developed by the World Health Organization (WHO) suggests ways and principles for holding a mass circumcision in HIV-infected countries, particularly African countries. Research has found that the removal of the foreskin, an act which is carried out during the circumcision ceremony, reduces the chances of being infected or infecting people with the HIV virus. The issue was discussed in Jerusalem in a meeting between WHO representatives, 20 Israeli physicians, and Jewish and Muslim circumcisers.

South Africa: 'Can a condom protect your heart?'
(Feature Article; Sub-Saharan Africa)
29 Nov 2006
Mail and Guardian Online
The Christian-backed Silver Ring Thing abstinence campaign has already made headlines in the United States and Britain by using savvy, multimedia shows to urge thousands of teenagers to shun sex until they wed. Now South Africans have launched their own version, with a pragmatic but urgent goal -- to help tackle one of the world's highest rates of HIV/AIDS.

Uganda: Condom debate is progressive
(Editorial; Sub-Saharan Africa)
29 Nov 2006
New Vision
President Museveni has expressed concern about the rising rate of HIV infection in Uganda. Museveni told the Joint Clinical Research Center that the vigilance that had seen infection rates fall to a record 6.2 percent last year from a 30 percent high a decade and a half ago, only to shoot up to 7 percent now, must be rediscovered. Experts attribute part of Uganda’s regress to an over-emphasis on abstinence to the detriment of condoms. Yet Uganda’s success was founded on ABC (Abstinence, Being faithful, and Condom use), with each constituent element given its due emphasis.

South Africa: New TB strain chokes life out of Tugela Ferry
(Feature Article; Sub-Saharan Africa)
28 Nov 2006
Business Day
Doctors and nurses in South Africa are grappling with a new, highly drug-resistant form of tuberculosis. The health department said 263 cases of extremely drug-resistant TB (XDR-TB) had been recorded in KwaZulu-Natal, with about 30 new cases being reported each month. Another 40 cases have been recorded in other provinces. Most were HIV-positive and their immune systems were already weakened. The World Health Organization said the new strain could become a major killer in AIDS-hit parts of Africa where governments have been slow to roll out TB control programs.

Clinton launches child HIV drug
(News Article; Global)
30 Nov 2006
CNN
Former U.S. President Bill Clinton and two Indian pharmaceutical companies have struck an agreement to cut prices of HIV and AIDS treatment for children, making the lifesaving drugs far more accessible worldwide, Clinton's foundation's anti-AIDS initiative said.

US scientific chief calls for truce in abstinence vs condoms controversy
(News Article; Global)
1 Dec 2006
Aidsmap
The senior medical scientist at the US government agency at the center of the controversy over US HIV prevention policy has called for a truce in the debate that pits condoms against abstinence as solutions to the spread of HIV.

MATERNAL AND CHILD HEALTH RESEARCH

Rising cesarean delivery rate in primiparous women in urban China: Evidence from three nationwide household health surveys
(Abstract; subscription needed for full text; Asia)
American Journal of Obstetrics and Gynecology. 2006 Dec;195(6):1527-1532.
Tang S | Li X | Wu Z
This research examines the trend in the rate of cesarean delivery in women with their first pregnancy and analyzes socioeconomic factors driving the escalation of cesarean delivery rates in urban China. The cesarean delivery rate in urban cities of China rose from 18.2% in 1990 to 1992 to 39.5% in 1998 to 2002. Cesarean delivery was associated with living in a large city, having university education, and having health insurance.

Evaluation of a partial day treatment realimentation program for malnourished children in the Dominican Republic
(Abstract; subscription needed for full text; Central America and the Caribbean)
Journal of Tropical Pediatrics. 2006 Dec;52(6):394-398.
McLennan JD | Mills RM
The study determined the growth rates and clinical attendance patterns of malnourished children treated at an partial day treatment feeding program. Mean rate of weight gain up to 4 weeks following admission was 3.9 g/kg/day with only 27% of the children achieving a minimum recommended rate of 5.0 g/kg/day. Children attended 80% of the possible clinic days during the first 4 weeks of treatment. Though some children may have benefited from the partial day treatment program, alternative strategies should be considered at this clinic to improve resource utilization and outcomes, including the use of a home recovery option and an enhanced day treatment program.

Sickle cell disease in pregnancy
(Abstract; subscription needed for full text; Europe)
Current Obstetrics & Gynaecology. 2006 Dec;16(6):353-360.
Oteng-Ntim EO | Cottee C | Bewleya S | Anionwu EN
With advances in management, many women with sickle cell disease now survive to have children. The high risk of fetal and maternal problems mandates multidisciplinary management involving an obstetrician, a hematologist, an anaesthetist and a haemoglobinopathy specialist nurse. Exchange transfusion may be indicated in women with a serious obstetric or hematological complications. In those with sickle cell disease, the entire pregnancy is a high-risk period that warrants close monitoring. It is thus important for every obstetrician to be familiar with the condition.

Bacterial safety of flash-heated and unheated expressed breastmilk during storage
(Abstract; subscription needed for full text; Global)
Journal of Tropical Pediatrics. 2006 Dec;52(6):399-405.
Israel-Ballard K | Coutsoudis A | Chantry CJ | Sturm AW | Karim F | Sibeko L | Abrams B
The authors investigated the ability of flash-heat to eliminate bacteria and to prevent growth over time compared with unheated breastmilk, while still giving the benefit of reducing mother-to-child transmission of HIV. Unheated samples had a significantly higher number of samples positive for bacterial growth at each time point measured, as well as mean colony-forming units (CFU)/ml in those samples that were positive at each time point. No pathogenic growth was observed in the flash-heated samples, while the unheated samples showed growth of E. coli and S. aureus. Our data suggest that storage of flash-heated breastmilk is safe at room temperature for up to 8 hours.

The state of the world's breastfeeding: South Asia report card - 2006
(Report; Asia)
(You need Adobe Acrobat Reader to access this document)
New Dehli, India, World Breastfeeding Trends Initiative, 2006.
Related News Article: South Asian nations reiterate commitment to reduce infant mortality
The report card assesses and rates the practices, policies, and programs related to Infant and Young Child Feeding (IYCF) in eight countries in south Asia and ranks them on their performance in promoting IYCF. The countries are Afghanistan, Bhutan, Bangladesh, India, Maldives, Nepal, Pakistan, and Sri Lanka. The report reveals that the region has barely reached the halfway mark in creating the enabling environment for optimal infant and young child nutrition. Sri Lanka is closest to the half way mark, followed by Bangladesh.

MATERNAL AND CHILD HEALTH NEWS

Vietnam: First int’l women and children’s hospital breaks ground
(News Article; Asia)
29 Nov 2006
Thanh Nien News
Work has started on an international-standard hospital for women and children, the first of its kind in Vietnam, reported the chairman of the hospital. Speaking at the ground breaking ceremony, Chairman Nguyen Van Minh said the construction was scheduled for completion within 24 months, with commercial operations ready to commence by 2009.

Philippines: Community support to boost breastfeeding drive
(News Article; Asia)
29 Nov 2006
The News Today
Community support for the campaign on breastfeeding is vital to realize the implementation of Executive Order No. 51, the Milk Code of the Philippines. Dr. Raoul Bermejo III, Medical Coordinator for Maternal and Child Health in the Provincial Health Office of Capiz, said that they continue to promote exclusive breastfeeding in order to boost the well-being of babies and mothers.

Child, maternal mortality rates shoot up in Zimbabwe
(News Article; Sub-Saharan Africa)
28 Nov 2006
People's Daily Online
Child and maternal mortality rates in Zimbabwe have shot up considerably owing to prohibitive service fees charged by some hospitals, shortage of equipment and skilled personnel.

MEN'S HEALTH RESEARCH

The ABCs of HIV prevention in men: Associations with HIV risk and protective behaviors
(Abstract; subscription needed for full text; Sub-Saharan Africa)
Journal of Acquired Immune Deficiency Syndromes. 2006 Dec 15;43(5):571-576.
Steele M | Bukusi E | Cohen C | Shell-Duncan B | Holmes K
This research examined associations between beliefs in abstinence, fidelity, and condom use and associated risk behaviors among 500 Kenyan men. Younger age, single marital status, and higher education were associated with beliefs in abstinence and condom use as "best" prevention methods; and older age and marriage were associated with belief in fidelity. Beliefs in abstinence, fidelity, or condom use were associated with life stages and other demographic factors and with corresponding risk and preventive behaviors. Context-specific and selective educational promotion of individual ABC components rather than comprehensive education from an early age ignores the relative utility of different educational approaches throughout the life course.

Same-sex behavior and high rates of HIV among men attending sexually transmitted infection clinics in Pune, India (1993-2002)
(Abstract; subscription needed for full text; Asia)
Journal of Acquired Immune Deficiency Syndromes. 2006 Dec 1;43(4):483-490.
Gupta A | Mehta S | Godbole SV | Sahay S | Walshe L | Reynolds SJ | Ghate M | Gangakhedkar RR | Divekar AD | Risbud AR | Mehendale SM | Bollinger RC
This research determined HIV/sexually transmitted infection (STI) prevalence, trends, and risk behaviors of men who have sex with men (MSM) attending STI clinics in Pune, India. Of the MSM, 18.9% were HIV-positive, 21.5% had genital ulcer disease (GUD), 5.8% had syphilis, and 4.3% had gonorrhea. Compared with non-MSM, MSM were more likely to initiate sexual activity at age less than 16 years, to have greater than 10 lifetime partners, and to use condoms regularly. Independent factors associated with HIV among MSM were employment, history of GUD, and syphilis. Same-sex and high-risk sexual behaviors are prevalent among men attending STI clinics in India. Although syphilis and GUD rates decreased, HIV prevalence remained high during the decade, highlighting the importance of additional targeted efforts to reduce HIV risk among all men, including MSM, in India.

Sexual assault, sexual risks and gender attitudes in a community sample of South African men
(Abstract; subscription needed for full text; Sub-Saharan Africa)
AIDS Care. 2007 Jan;19(1):20-27.
Kalichman S | Simbayi L | Cain D | Cherry C | Henda N | Cloete A
This study examined hostile attitudes toward women, acceptance of violence against women and masculine ideological beliefs in relation to sexual assault history among 435 men in South Africa. More than one in five men who completed an anonymous survey reported having threatened to use force or used force to gain sexual access to a woman. Men with a history of sexual assault were at higher risk for HIV transmission. Interventions are needed to address hostile attitudes toward women, sexual assault, and sexual risks for HIV among South African men.

MEN'S HEALTH NEWS

United Kingdom: Male pill still a decade away despite research
(Feature Article; Europe)
2 Dec 2006
Sunday Herald
It has been more than four decades since the pill revolutionized life for women, but an equivalent form of contraception for men could still be a decade away. Researchers at King's College in London are developing a hormone-free male contraceptive pill which works in a single dose and allows fertility to return to normal within a few hours.

POPULATION RESEARCH

A country on the move: International migration in post-communist Albania
(Abstract; subscription needed for full text; Europe)
International Migration Review. 2006 Dec;40(4):767-785.
Carletto C | Davis B | Stampini M | Zezza A
Albania is a country on the move. With the relaxing of controls on emigration at the beginning of the 1990s, international migration has exploded, becoming the single most important political, social, and economic phenomenon in post-communist Albania. The authors estimate that over 600,000 Albanians live abroad, mostly in nearby Greece and Italy. This article also identifies clear patterns of temporary migration, with Greece being by far the most important destination.

POPULATION NEWS

Islam thrives as Russia's population falls
(Feature Article; Asia)
3 Dec 2006
The Star
Russia is in the midst of startling transformation. Islamic faith is thriving across the country. If current trends continue, experts say, more than half of Russia's population will be Muslim by mid-century.

Vietnam: Ha Noi to meet birth rate target
(News Article; Asia)
16 Nov 2006
Viet Nam News
Hanoi, Vietnam will likely meet its mandated targets for births this year. The proportion of families giving birth to a third child will decrease by 0.1% this year in comparison to last year’s figure. An increase in the number of women of child-bearing age and the number of married couples has been a driving factor behind higher birth rates in the past.

Population in their 30s and 40s to fall next year
(News Article; Asia)
3 Dec 2006
The Korea Times
The percentage of the South Korean population in their 30s and 40s, who are the biggest component of the labor force and consumers, will start to diminish next year. The number of senior citizens aged 60 and over will surpass 7 million in 2008, and make up 15% of the population in 2010.

Survey shows S. Korean workforce aging
(News Article; Asia)
27 Nov 2007
Yonhap News
A government survey showed that South Korean employees in their 40s made up the largest proportion of the nation's workforce in 2005, reflecting the country's rapid transition into an aging society.

WOMEN'S HEALTH RESEARCH

HIV prevalence and predictors among rescued sex-trafficked women and girls in Mumbai, India
(Abstract; subscription needed for full text; Asia)
Journal of Acquired Immune Deficiency Syndromes. 2006 Dec 15;43(5):588-593.
Silverman J | Decker M | Gupta J | Maheshwari A | Patel V | Raj A
This study examines the prevalence and predictors of HIV infection among sex-trafficked women and girls rescued from brothels in Mumbai, India. Approximately one quarter (22.9%) of trafficked individuals tested positive for HIV. Girls trafficked as minors reported longer periods of brothel confinement as compared to those trafficked at older ages. Longer duration in brothels was associated with greater likelihood of HIV infection; a 3% to 4% increased risk for HIV was observed for each additional month of brothel captivity. Findings demonstrate the need for increased attention to HIV among young victims of sex trafficking in research and practice and to the rescue of sex trafficking victims as a form of HIV prevention.

Women’s health in a rural community in Kerala, India: Do caste and socioeconomic position matter?
(Abstract; subscription needed for full text; Asia)
Journal of Epidemiology and Community Health . 2006 Dec;60(12):1020-1026.
Mohindra K | Haddad S | Narayana D
This paper examines the social patterning of women's self-reported health status in India in relation to caste and socioeconomic conditions. A cross-sectional household survey was completed by 4196 non-elderly women in Kerala, India, in 2003. Results showed that caste and socioeconomic position are two inter-related sources of inequality that can reinforce each other; being from an upper caste can buffer women from the poor health effects related to low socioeconomic status, whereas being from a lower caste can magnify these effects. This study shows that both being from a lower caste and of low socioeconomic status can trap people into poor health more than either inequality on its own.

Addressing Taiwan's high incidence of cervical cancer: Factors associated with the Nation's low compliance with Papanicolaou screening in Taiwan
(Abstract; subscription needed for full text; Asia)
Public Health. 2006 Dec;120(12):1170-1176.
Liao CC | Wang HY | Lin RS | Hsieh CY | Sung FC
This research investigated the factors associated with women's cancer screening practices. Among 1021 survey respondents, 51.6% self-reported no Papanicolaou (Pap) examination received within their lifetime. The analysis revealed that cancer knowledge was the most significant factor associated with screening practice compliance. Women aged 40–49 years had the best cancer knowledge scores. Unmarried women were at an elevated risk for no Pap examination. Women in Taiwan should be targeted for intervention to promote cancer knowledge and screening compliance.

Repair of obstetric vesicovaginal fistulas in Africa
(Abstract; subscription needed for full text; Sub-Saharan Africa)
American Journal of Obstetrics and Gynecology. 2006 Dec;195(6):1748-1752.
Roenneburg ML | Genadry R | Wheeless CR
The purpose of this study was to show the outcomes of primary surgical repair of obstetric vesicovaginal fistula repairs in Niger, Africa. Successful primary closure was achieved in 56% of patients. Incontinence, despite fistula closure, was present in 9 patients. Common features of failure and/or incontinence included larger size, involvement of the urethrovesical junction, and scarring.
The initial repair of vesicovaginal fistulas has the highest probability of success. The successful closure is dependent on size, site, and associated scarring.

Effect of a structural intervention for the prevention of intimate-partner violence and HIV in rural South Africa: A cluster randomised trial
(Abstract; subscription needed for full text; Sub-Saharan Africa)
The Lancet. 2006 Dec 2-2006 Dec 8;368(9551):1973-1983.
Pronyk PM | Hargreaves JR | Kim JC | Morison LA | Phetla G | Watts C | Busza J | Porter JD
HIV infection and intimate-partner violence share a common risk environment in much of southern Africa. The aim of the Intervention with Microfinance for AIDS and Gender Equity (IMAGE) study was to assess a structural intervention that combined a microfinance programme with a gender and HIV training curriculum. Loans were provided to poor women who enrolled in the intervention group. In addition, a participatory learning and action curriculum was integrated into loan meetings. Experience of intimate-partner violence was reduced by 55%. A combined microfinance and training intervention can lead to reductions in levels of intimate-partner violence in program participants.

WOMEN'S HEALTH NEWS

Empowering oppressed women to battle HIV/AIDS
(Editorial; Global)
1 Dec 2006
Seattle Times
Dr. Helene Gail discusses the status of women in developing countries. Women lack power for many reasons. Social norms place the disgrace of rape on women; the stigma of being a sex worker denies women their basic human rights; and economies are so frail and assets so easily lost that many women are forced into "survival sex." These women also have a high vulnerability to HIV -- because they are powerless, or feel powerless, to protect themselves.

Sex abuse of girls is stubborn scourge in Africa
(Feature Article; Sub-Saharan Africa)
1 Dec 2006
International Herald Tribune
In much of Africa, perpetrators of sexual abuse are shielded by the traditional low status of girls, a lingering view that sexual abuse should be dealt with privately, and justice systems that constitute obstacle courses for victims. South African police reports give an inkling of the extent of child victimization. In the 12 months ending in March 2005, the police reported more than 22,000 cases of child rape. In contrast, England and Wales, with nine million more people than South Africa, reported just 13,300 rapes of women and girls in the most recent 12-month period.

YOUTH HEALTH RESEARCH

Explaining recent declines in adolescent pregnancy in the United States: The contribution of abstinence and improved contraceptive use
(Abstract; subscription needed for full text; North America)
American Journal of Public Health. Online access November 30, 2006.
Santelli J | Duberstein Lindberg L | Finer L | Singh S
Related News Article: Birth control credited with drop in teen pregnancy
This study explored the relative contributions of declining sexual activity and improved contraceptive use to the recent decline in pregnancy rates among women 15 to 19 years old in the United States. The overall pregnancy risk index declined 38%, with 86% of the decline attributable to improved contraceptive use. Among adolescents aged 15 to 17 years, 77% of the decline in pregnancy risk was attributable to improved contraceptive use.

HIV/Sexual and reproductive health program for HIV prevention: The youth-adult partnership with schools approach
(Abstract; Asia)
Journal of the Medical Association of Thailand. 2006 Oct;89(10)
Fongkaew W | Fongkaew K | Muecke M
This study described the development and evaluation of a program designed to prevent HIV/AIDS. A participatory action research (PAR) approach was used in collaboration with ten schools in Thailand to develop a youth-adult partnerships with schools (YAPS) model. Results showed that the YAPS model was effective in leadership role preparation and in empowering youth leaders to undertake activities on their own, initiate creativity, and share knowledge on sexuality education and HIV prevention messages with students in schools.

YOUTH HEALTH NEWS

Malta: ‘Sex education does not encourage promiscuity’
(News Article; Europe)
1 Dec 2006
Malta Independent Online
Global research has shown that sex education does not encourage promiscuity, but instills responsibility, according to health promotion officer Elaine Dutton. She also said that statistics compiled by UNAIDS show that up to the end of November, there were 40 million people infected with HIV worldwide.

Georgia: South Caucasus Youth Festival is held in Tbilisi on World AIDS Day
(News Article; Asia)
1 Dec 2006
Regnum News Agency
The South Caucasus Youth Festival, dedicated to the World AIDS Day, opened in Tbilisi on December 1st. The festival is organized by UNFPA, United Nations Population Fund and by the Reproductive Health Initiative for Youth in the South Caucasus (RHIYC).

Philippines: Survey shows more males in Biliran engage in premarital sex than females
(News Article; Asia)
30 Nov 2006
Philippines Information Agency
Results of the 2006 Biliran Adolescent Sexuality and Reproductive Health Baseline Survey (BASRHBS) show that more than 30% of young males in the province are engaging in premarital sex. Only about 20% of young females in the province of Biliran engage in premarital sex.

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Volume 6, Number 48 4 December 2006