Volume 7, Number 21
11 June 2007

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FAMILY PLANNING RESEARCH

Postpartum Family Planning Technical Consultation: Meeting report, Washington, D.C., 14 November 2006. Synthesizing lessons learned and building consensus on effective approaches for postpartum family planning
(Report; Global)
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Baltimore, Maryland, JHPIEGO, 2007.
McKaig C | Chase R
Related News Article: Family Planning for Postpartum Women: Seizing a Missed Opportunity
Postpartum family planning (PPFP) as part of a comprehensive maternal, newborn and child health approach has the potential to systematically reach a large number of women with critical, life-saving information and services. In an effort to better understand and thus maximize the opportunity for PPFP that exists during the extended postpartum period, the U.S. Agency for International Development (USAID) and ACCESS-FP organized a technical consultation on PPFP on 14 November 2006, in Washington, D.C. The overall purpose of the meeting was to examine the status of PPFP service delivery through an expert review of key literature, complemented by collective programmatic experience to date, as the basis for further program development. Over 40 experts and leaders in reproductive health and maternal, neonatal and child health from more than 23 global health organizations and programs were brought together to participate in this intensive, all-day event. Throughout the course of the technical consultation, several areas of general consensus became apparent.

The reach and effect of radio communication campaigns on condom use in Malawi
(Abstract; subscription needed for full text; Sub-Saharan Africa)
Studies in Family Planning. 2007 Jun;38(2):113-120.
Meekers D | Van Rossem R | Silva M | Koleros A
This study uses data from the 2004 Malawi Demographic and Health Survey to assess the reach of selected radio programs about family planning and health in Malawi and their effect on condom use and discussion of family planning. The results show that such radio programs in Malawi reach a broad audience: eight of the 12 programs were heard by at least half of the respondents, although women were less effectively reached than men. For both women and men, the radio programs were found to have a significant impact on family planning discussion with one's partner. The programs' effect on condom use was limited, however. A positive association was found with ever use of condoms, but no association was found with condom use at last intercourse. This limited impact suggests that such radio communication campaigns need to be informed by research identifying the specific constraints to current condom use in Malawi.

Effect of female partner age on pregnancy rates after vasectomy reversal
(Abstract; subscription needed for full text; North America)
Fertility and Sterility . 2007 Jun;87(6):1340-1344.
Gerrard ER Jr | Sandlow JI | Oster RA | Burns JR | Box LC
The objective was to determine the effect of female partner age on pregnancy rates after vasectomy reversal. The design of the study was a retrospective review. Two academic infertility practices was the setting of the study. Men undergoing vasectomy reversal and their partners were used in the study. Intervention(s): Microsurgical vasectomy reversal. Main Outcome Measure(s): Patency and pregnancy rates. Two hundred ninety-four patients met the inclusion criteria. Groups were similar with regard to types of procedure performed (vasovasostomy or vasoepididymostomy), obstructive interval, female factors, number of repeat procedures, and quality of vasal fluid. Patency rates were 90%, 89%, 90%, 86%, and 83% for patients with female partners aged 20-24, 25-29, 30-34, 35-39, and 40+ years, respectively. Pregnancy rates were 67%, 52%, 57%, 54%, and 14% for patients with female partners aged 20-24, 25-29, 30-34, 35-39, and 40+ years, respectively. The pregnancy rate for couples with female partner aged 40 or older was lower than for those with the female partner aged 39 or younger (14% vs. 56%). Pregnancy rates for vasectomy reversal were good regardless of female age as long as the partner was 39 years old or younger. Pregnancy rates were lower if the female partner was 40 or more years old.

FAMILY PLANNING NEWS

Israel: Permanent, hormone-free birth control now available
(News Article; Middle East)
6 Jun 2007
Siegel-Itzkovich J, The Jerusalem Post

India: Jharkhand Postal Department's novel concept to promote family planning
(News Article; Asia)
6 Jun 2007
Medindia Health Network

Uganda: Family planning will save mothers and children
(Commentary; Sub-Saharan Africa)
7 Jun 2007
Mohtashami H, The New Vision

HIV/AIDS and STIs RESEARCH

The cost effectiveness of antiretroviral treatment strategies in resource-limited settings
(Abstract; subscription needed for full text; Global)
AIDS. 2007 Jun;21(10):1333-1340.
Bishai D | Colchero A | Durack DT
Optimal resource allocation for antiretroviral treatment (ART) in developing countries requires assessment of different strategies for drug treatment and laboratory monitoring. The objectives were to compare costs and outcomes for 10 000 simulated HIV-infected patients followed every 6 months for 10 years in a limited-resource setting. Method: Five nested strategies, with and without the availability of a second-line treatment regimen, were simulated: (a) no ART (NO ART); (b) with ART but without any laboratory markers of HIV other than positive serology (ART ONLY); (c) ART plus total lymphocyte count (TLC); (d) ART plus CD4 cell counts (CD4); and (e) ART plus CD4 cell count plus viral load measurement (VL). Baseline prices of CD4 cell count and viral load measurements were $5.00 and $25.00 per test, respectively. With no second-line treatment available, treating 10 000 patients with ART ONLY compared with NOART would cost $14.49 million [95%confidence interval (CI), 14.45-14.52] and would generate an additional 23 060 quality-adjusted life years (QALYS) (95% CI, 22 770-23 360) for a median incremental cost effectiveness ratio (ICER) of $628/QALY. Median ICER values per QALY for CD4 and VL strategies are $238 and $16 139, respectively, when second-line treatment is unavailable. With second-line ART available, the corresponding median ICER values are $8636, and $14 670. In the absence of second-line ART, the CD4 strategy is a more cost-effective laboratory testing strategy for managing HIV infection than either TLC or VL. Availability of second-line ART plus CD4 cell count and/or viral load measurement would save additional lives, but at high incremental cost.

Monitoring and evaluation of programmes to prevent mother to child transmission of HIV in Africa
(Abstract; subscription needed for full text; Sub-Saharan Africa)
BMJ. British Medical Journal . 2007 Jun 2;334(7604):1143-1146.
Reithinger R | Megazzini K | Durako SJ | Harris DR | Vermund SH
In 2006, an estimated 2.3 million children under 15 years were living with HIV and about half a million babies became infected with HIV before birth, during delivery, or through breast feeding. Prevention of mother to child transmission of HIV is therefore a priority for agencies fighting the global HIV epidemic, but many questions remain about the effectiveness of the current programmes. We use the President's Emergency Plan for AIDS Relief as an example to examine how programmes to prevent mother to child transmission are monitored and evaluated and to highlight the problems.

Surveillance of mother-to-child transmission prevention programmes at immunization clinics: The case for universal screening
(Abstract; subscription needed for full text; Sub-Saharan Africa)
AIDS . 2007 Jun;21(10):1341-1347.
Rollins N | Little K | Mzolo S | Horwood C | Newell ML
Surveillance programmes for prevention of mother-to-child transmission of HIV (PMTCT) fail to quantify numbers of infant HIV infections averted, often because of poor postnatal follow-up. Additionally, infected infants are often not identified early and only gain access to comprehensive HIV care and treatment late in their disease. Anonymous, unlinked, HIV prevalence testing was conducted on dried blood spot (DBS) samples from all infants attending 6 week immunization clinics at seven primary health care clinics offering PMTCT. Samples were tested for HIV antibodies (indicating maternal HIV infection) and those determined to be from HIV-exposed infants were tested for HIV RNA by polymerase chain reaction. Infant and child mortality rates were determined using birth histories. Samples were collected from 2489 infants aged 4-8 weeks. HIV antibodies were identified in 931 infants [37.4%; 95% confidence interval (CI), 35.4-39.4], of whom 188 were HIV RNA positive. The estimated vertical transmission rate (VTR) was 20.2% (95% CI, 17.8-23.1%); 7.5% of all infants at this age were infected. Amongst mothers who reported that they had taken single-dose nevirapine for PMTCT, VTR was 15.0%. Amongst women who reported being HIV uninfected but whose infants had HIV antibodies, VTR was 30.5%. Infant mortality rates in KwaZulu Natal increased from 28/1000 live births in 1990-1994 to 92/1000 in 2000-2004. Anonymous HIV prevalence screening of all infants at immunization clinics is feasible to monitor the impact of PMTCT programmes on peripartum infection; linked screening could identify infected children early for referral into care and treatment programmes.

Epidemic of inequality: Women's rights and HIV/AIDS in Botswana and Swaziland. An evidence-based report on the effects of gender inequity, stigma and discrimination
(Report; Sub-Saharan Africa)
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Cambridge, Massachusetts, Physicians for Human Rights, 2007
Leiter K
In both Botswana and Swaziland, a substantial percentage of PHR (Physicians for Human Rights) community survey participants who had been tested for HIV reported that they could not refuse the test. The continuing extraordinary prevalence of HIV in Botswana, particularly among women, demonstrates that campaigns, scaled-up HIV testing, including routine testing, and anti-retroviral (ARV) treatment are not enough. Women must be empowered with legal rights, sufficient food and economic opportunities to gain agency of their own lives. Men must be educated and supported to acknowledge women's equal status and throw off the yoke of socially- and culturally-sanctioned discriminatory beliefs and risky sexual behavior. HIV/AIDS interventions focused solely on individual behavior will not address the factors creating vulnerability to HIV for women and men in Botswana and Swaziland, nor protect the rights and assure the well-being of those living with HIV/AIDS. National leaders, with the assistance of foreign donors and others, are obligated under international law to take immediate steps to change the unequal social, legal and economic conditions of women's lives which facilitate HIV transmission and impede testing, care and treatment. Without these immediate and comprehensive reforms, they cannot hope to halt the deadly toll of HIV/AIDS on their populations.

HIV/AIDS and STIs NEWS

Financing the response to AIDS in low- and middle- income countries: International assistance from the G8, European Commission and other donor Governments, 2006
(News Article; Global)
4 Jun 2007
UNAIDS & Kaiser Family Foundation
Related Press Release: New report shows increases in AIDS financing but funding still falls short of estimated need
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Related Report: Financing the response to AIDS in low- and middle- income countries: International assistance from the G8, European Commission and other donor Governments, 2006
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'AIDS cure' in Zambia found to be pesticide
(News Article; Sub-Saharan Africa)
1 Jun 2007
Agence France-Press (AFP)

HIV affecting African democracy
(News Article; Sub-Saharan Africa)
5 Jun 2007
Plaut M, BBC News

New AIDS cases in Africa outpace gains in treatment
(News Article; Sub-Saharan Africa)
6 Jun 2007
LaFraniere S, International Herald Tribune

More women suffer from HIV/AIDS in China
(News Article; Asia)
4 Jun 2007
Xinhua

Mass circumcision to fight Aids
(News Article; Sub-Saharan Africa)
7 Jun 2007
BBC News

MATERNAL AND CHILD HEALTH RESEARCH

HIV, malaria, and infant anemia as risk factors for postneonatal infant mortality among HIV-seropositive women in Kisumu, Kenya
(Abstract; subscription needed for full text; Sub-Saharan Africa)
Journal of Infectious Diseases. 2007 Jul 1;Online access May 16, 2007. 196(1):30-37.
van Eijk AM | Ayisi JG | Ter Kuile FO | Slutsker L | Shi YP | Udhayakumar V | Otieno JA | Kager PA | Lal RB | Steketee RW | Nahlen BL
Related News Article: Maternal and infant malaria protects against early childhood mortality in offspring of HIV-positive Kenyan women
Background: HIV and malaria in sub-Saharan Africa are associated with poor pregnancy outcome and infant survival. We studied the association of placental malaria, infant malaria and anemia, and infant HIV status with postneonatal infant mortality (PNIM) among infants of HIV-seropositive women. Methods: During 1996-2001, infants born to 570 HIV-seropositive mothers in Kisumu, Kenya were monitored monthly for malaria (parasitemia or clinical malaria) and anemia (hemoglobin level less than 8 g/dL) and vital status. Results: Thirty-nine deaths occurred among 112 HIV-positive infants (420/1000 live births [LBs] [95% confidence interval {CI}, 318-522 LBs]), and 36 occurred among 458 HIV-negative infants (99/1000 LBs [95% CI, 68-130 LBs]) (P less than .001). In multivariate Cox regression analysis among HIV-negative infants, PNIM was associated with infant anemia (adjusted hazard ratio [AHR], 5.03 [95% CI, 1.97-12.81]) but not with placental malaria (AHR, 1.22 [95% CI, 0.50-2.95]) or infant malaria (AHR, 0.35 [95% CI, 0.10-1.21]). Among HIV-positive infants, neither placental malaria (AHR, 0.34 [95% CI, 0.10-1.10]) nor infant malaria (AHR, 0.31 [95% CI, 0.07-1.33]) or anemia (AHR, 1.07 [95% CI, 0.32-3.61]) was significantly associated with PNIM. Conclusion: In this study population, placental malaria and infant parasitemia were not risk factors for PNIM among infants of HIV-seropositive women. The prevention of infant anemia may decrease PNIM among HIV-negative infants of HIV-seropositive women.

The associations between inter-pregnancy interval and maternal and neonatal outcomes in Brazil
(News Article; South America)
Maternal and Child Health Journal. Online access June 6, 2007.
Cecatti JG | Correa-Silva EP | Milanez H | Morais SS | Souza JP
Related News Article: Birth Spacing: 2004 Evidence Supports 3+ Years
Objectives: Global estimates of maternal and perinatal mortality have remained unchanged over the past 20 years, and strategies are being sought to decrease the occurrence of maternal and perinatal death. The objective of this study was to evaluate the association between inter-pregnancy interval and the occurrence of adverse maternal and perinatal outcomes. Methods: Design and Setting: Cross-sectional study of the obstetrical and perinatal records in an intra-hospital obstetrics database between 1986 and 2000 at a tertiary maternity hospital in Brazil. Participants: A total of 14,930 records of parous women who delivered singleton infants. Main outcome measures: Crude and adjusted odds ratio estimates of gestational outcome according to inter-pregnancy intervals. Results: During the period of the study, 34.6% of records referred to women with an inter-pregnancy interval less than 18 months. After the adjustment performed for 11 confounding factors and assuming an inter-pregnancy interval of 18-23 months as reference, short intervals (less than 6 months) were observed to be associated with a greater risk of low birth weight (odds ratio: 1.74; 95% confidence interval: 1.18-2.55), and preterm birth (1.56; 1.01-2.46). On the other hand, long intervals were significantly associated with fewer C-sections (0.69; 0.56-0.82), and a greater risk of premature rupture of membranes (PROM) (1.57; 1.20-2.06) and low birth weight (1.46; 1.03-2.06). Conclusions: Short inter-pregnancy intervals are associated with a higher risk of low birth weight and preterm birth, while long intervals are associated with a higher risk of PROM, low birth weight and a lower risk of C-section.

Association of arsenic exposure during pregnancy with fetal loss and infant death: A cohort study in Bangladesh
(Abstract; subscription needed for full text; Asia)
American Journal of Epidemiology. 2007 Jun 15;165(12):1389-1396.
Rahman A | Vahter M | Ekstrom EC | Rahman M | Haider A
The authors evaluated the effect of arsenic exposure on fetal and infant survival in a cohort of 29,134 pregnancies identified by the health and demographic surveillance system in Matlab, Bangladesh, in 1991-2000. Arsenic exposure, reflected by drinking water history and analysis of arsenic concentrations in tube-well water used by women during pregnancy, was assessed in a separate survey conducted in 2002-2003. Data on vital events, including pregnancy outcome and infant mortality, were collected by monthly surveillance at the household level. The risk of fetal loss and infant death in relation to arsenic exposure was estimated by a Cox proportional hazards model. Drinking tube-well water with more than 50 microg of arsenic per liter during pregnancy significantly increased the risks of fetal loss (relative risk = 1.14, 95% confidence interval: 1.04, 1.25) and infant death (relative risk = 1.17, 95% confidence interval: 1.03, 1.32). There was a significant dose response of arsenic exposure to risk of infant death (p = 0.02). Women of reproductive age should urgently be prioritized for mitigation activities where drinking water is contaminated by arsenic.

Adjuvant effect of vitamin A on recurrent lower urinary tract infections
(Abstract; subscription needed for full text; Global | Europe)
Pediatrics International. 2007 Jun;49(3):310-313.
Yilmaz A | Bahat E | Yilmaz GG | Hasanoglu A | Akman S
The purpose of the present paper was to investigate the effects of vitamin A supplementation on recurrent lower urinary tract infections (RUTI). Twenty-four patients with non-complicated RUTI were included in a placebo-controlled, double-blinded study. Twelve patients received a single dose of 200 000 I vitamin A in addition to antimicrobial therapy. Patient and control groups (each containing 12 patients) were followed for up to 1 year and were evaluated for eradication and frequency of lower urinary tract infections (UTI). Serum levels of vitamin A and ß-carotene were determined periodically. During the first 6 months follow-up period the infection rate of the vitamin A-supplemented group reduced from 3.58 to 0.75 per 6 months, and in the subsequent 6 months the infection rate was 1.75 per 6 months. These values were calculated as 2.75, 2.83 and 2.66, respectively, in the placebo group. Vitamin A supplementation may have an adjuvant effect on the treatment of RUTI.

MATERNAL AND CHILD HEALTH NEWS

Maternal mortality highest in South Sudan - UN
(News Article; North Africa)
2007 Jun 6;
Sudan Times (Reuters)

Cuba's Las Tunas has record low infant death rate
(News Article; Central America and the Caribbean)
4 Jun 2007
Bosch H, Periodico 26

Analysis - Burma's children still struggling with beri-beri
(News Article; Asia)
4 Jun 2007
Parker C, Democratic Voice of Burma

GENDER and HEALTH RESEARCH

Screening for cervical cancer among female physicians and their relatives in Taiwan: A population-based comparative study
(Abstract; subscription needed for full text; Asia)
Preventive Medicine. 2007 Jun;44(6):531-535.
Chen LS | Huang N | Tsay JH | Wang PJ | Chou YJ
This study compares the practice of having the recommended Pap smear test every 3 years among female physicians, female relatives of physicians, and general women of similar socio-economic background. This population-based cohort study followed a total of 5,815,781 Taiwanese women from January 2001 to December 2003, who were 30 years of age or older in 2001. Of the total study population, 1950 were physicians and 27,441 were female relatives of physicians. Multiple logistical regression models were used. After adjusting for age, ethnic status, physical disability status, and place of residence, of those women whose monthly insurable income was greater than $NT40,000, female physicians (OR 0.54, 95% CI: 0.50-060) were the least likely to have undergone at least one Pap smear test during the three-year study period. The physicians' relatives (OR 0.90, 95% CI: 0.87-0.92) were also significantly less likely to take routine Pap smear tests compared to general women with equivalent socio-economic background. The female physician is a major player in disease prevention with advanced knowledge of the benefits associated with the Pap smear test, but may not adhere any better to the recommendations than the general population.

Silent killers of the night: An exploration of psychological health and suicidality among female street sex workers
(Abstract; subscription needed for full text; Asia)
Journal of Sex and Marital Therapy . 2007 Jul;33(4):281-299.
Ling DC | Wong WC | Holroyd EA | Gray A
This article examines factors that relate to psychological health (as measured by the World Health Organization Quality of Life Instrument) as well as suicide attempts among female street sex workers (FSSWs) in Hong Kong. On average, our sampled FSSWs scored significantly lower on the psychological health domain in comparison to the general Hong Kong female population. Factors associated with the working environment in the sex industry were significantly associated with poor psychological health and suicidality. Greater attention is needed to examine the physical and emotional harm intrinsic to certain occupations and the role of financial needs in the experience of psychological stress.

Links among paroxetine-induced sexual dysfunctions, gender, and CYP2D6 activity
(Abstract; subscription needed for full text; Global)
Journal of Sex and Marital Therapy. 2007 Jul;33(4):343-355.
Zourkova A | Ceskova E | Hadasova E | Ravcukova B
The aim of the study was to compare the distribution of therapeutic efficacy and sexual dysfunction during maintenance paroxetine treatment in 17 males and 38 females genotyped and phenotyped to determine their CYP2D6 metabolic status. Clinical results were monitored on scales Clinical Global Impression-Severity of Illness Scale (CGIS) and Arizona Sexual Experience Scale (ASEX). The phenotype procedure showed 7 males and 12 females with extensive metabolic status (EM) and 10 males and 26 females with poor metabolic status (PM). No variation in therapeutic efficacy between male and female subjects classified as PM and those marked as EM was found. A significantly higher rate of sexual dysfunction (p = 0.01) was recorded among females with a PM phenotype.

Correction of congenital penile curvature using modified tunical plication with absorbable sutures: The long-term outcome and patient satisfaction
(Abstract; subscription needed for full text; Global)
European Urology . 2007 Jul;52(1):261-267.
Hsieh JT | Liu SP | Chen Y | Chang HC | Yu HJ
Although plication of the tunica albuginea with nonabsorbable sutures is an effective method in correcting congenital penile curvature (CPC), suture-related complications may happen. We investigated the long-term outcome and patient satisfaction of a modified tunical plication technique using absorbable sutures. From January 1999 to July 2005, 114 consecutive patients with CPC treated with a modified tunical plication technique by a single surgeon were retrospectively reviewed. With the modified corporeal plication technique, two, interrupted, U-shaped sutures with 2-zero polyglactin were applied to create bumps on the tunica albuginea. The long-term outcome and patient satisfaction were assessed by a post hoc questionnaire interview. Among the 114 patients, complete straightness of the penis was achieved in 65 (57%) patients, and 33 (29%) patients reported a 15-degree or less residual or recurrent curvature at 6mo postoperatively. Although 32 (28%) patients experienced suture failure (median time: 38.5 d), only half of them had a residual or recurrent curvature greater than 15 degrees. Younger patients (less than 24 yr) had a higher chance of suture failure than elder patients (p = 0.03). Among the 103 patients completing the questionnaire, no palpable suture knots, suture granuloma, erectile discomfort, or erectile dysfunction was reported (median follow-up time: 41.5 mo). Eighty-three (81.5%) patients were either very or moderately satisfied with the surgical outcome. The modified technique using double, interrupted, U-shaped sutures and absorbable suture material is a simple and effective method for treating CPC. Suture-related complications rarely happen. The long-term outcome is satisfactory, and most patients are pleased with the procedure.

GENDER and HEALTH NEWS

Zambian activists encourage male circumcision to fight HIV infection
(News Article; Sub-Saharan Africa)
4 Jun 2007
Kaunda D, Voice of America

Ghana: Parliament widens net on perpetrators of FGM
(News Article; Sub-Saharan Africa)
1 Jun 2007
Public Agenda (Accra)

Namibia: Most rape victims know the rapist
(News Article; Sub-Saharan Africa)
4 Jun 2007
UN Integrated Regional Information Networks

POPULATION/FERTILITY/DEMOGRAPHY RESEARCH

A conceptual model of HIV/AIDS stigma from five African countries
(Abstract; subscription needed for full text; North Africa | Sub-Saharan Africa)
Journal of Advanced Nursing. 2007 Jun;58(6):541-551.
Holzemer WL | Uys L | Makoae L | Stewart A | Phetlhu R
This paper is a report on the development of a conceptual model delineating contexts and processes of HIV/AIDS stigma as reported by persons living with HIV/AIDS and nurses from African countries. It is part of a larger study to increase understanding of HIV/AIDS stigma. Researchers have defined stigma, explored determinants and outcomes of stigma and attempted to measure its multiple dimensions. This literature is difficult to synthesize, and often does not distinguish adequately between experiences of stigma and its causes and outcomes. Forty-three focus groups were held with persons living with HIV/AIDS and nurses in five African countries in 2004. Focus group recordings were transcribed and coded. The data were organized into a conceptual model of HIV/AIDS stigma. Two components were identified in the data: contextual factors -- environment, healthcare system, agents -- that influence and affect stigma and the stigma process itself. The stigma process included four dimensions: triggers of stigma, stigmatizing behaviours, types of stigma and the outcomes of stigma. A conceptual model is presented that delineates the dynamic nature of stigma as reported by study participants. The model may be used to identify areas appropriate for the design and testing of stigma reduction interventions that have a goal of reducing the burden of HIV/AIDS stigma.

The value of children in African countries: Insights from studies on infertility
(Abstract; subscription needed for full text; North Africa | Sub-Saharan Africa)
Journal of Psychosomatic Obstetrics and Gynecology . 2007 Jun;28(2):69-77.
Dyer SJ
A number of studies have explored motives for parenthood in the Western industrialized world. These studies have documented that children are mostly desired for reasons relating to happiness and personal well-being. To date, limited data pertaining to parenthood motives in African countries exist. Insight into the value of children can, however, be derived from studies on infertility, as the negative repercussions of involuntary childlessness reflect the value of children to parents and the community. According to these studies children secure conjugal ties, offer social security, assist with labour, confer social status, secure rights of property and inheritance, provide continuity through re-incarnation and maintaining the family lineage, and satisfy emotional needs. Parenthood therefore appears to have more and, arguably, deeper roots in African communities when compared to industrialized countries.

Emotional distress and infertility: Turkish migrant couples compared to Dutch couples and couples in Western Turkey
(Abstract; subscription needed for full text; Europe)
Journal of Psychosomatic Obstetrics and Gynecology . 2007 Jun;28(2):87-95.
Van Rooij FB | Van Balen F | Hermanns JM
The present study investigates cultural differences in the effects of infertility on emotional distress. The study compares emotional distress among infertile people in three samples: Turkish migrants (n=58), Turkish people living in Western Turkey (n=46), and Dutch people (n=199). Participants answered structured questionnaires on self-image, blame-guilt, sexual problems, depression, anxiety, and anger-hostility. Separate analyses were conducted for men and women. In general, the levels of emotional distress were higher for infertile Turkish migrant women and infertile Turkish women than they were for infertile Dutch women. Turkish migrant women reported more self-image problems and fewer feelings of blame-guilt than did Turkish women. Among men, Turkish migrant men showed the highest overall levels of emotional distress, and Dutch men showed the lowest. Our results indicate that the experience of infertility among Turkish migrants is more similar to those of Turkish people than it is to that of Dutch people, especially among women. The importance of having children in the different cultures may offer a possible explanation for these findings.

POPULATION/FERTILITY/DEMOGRAPHY NEWS

Russia: Zurabov reports demographic improvement to Putin
(News Article; Asia)
4 Jun 2007
Kommersant

Syria's population tops 19mn
(News Article; Middle East)
5 Jun 2007
Middle East Times

India's North East population higher than national average
(News Article; Asia)
4 Jun 2007
New Kerala

ADOLESCENT HEALTH RESEARCH

Nonconsensual sexual experiences of adolescents in urban India
(Abstract; subscription needed for full text; Asia)
Journal of Adolescent Health. 2007 Jun;40(6):573.e7-573.e14.
Jaya J | Hindin MJ
Purpose: Research from developing countries suggests that nonconsensual sexual experiences are common, yet these experiences remain understudied. Methods: We describe the prevalence and factors associated with nonconsensual sexual experiences of unmarried adolescents (583 boys and 474 girls), ages 15-19 years, from economically disadvantaged neighborhoods in Delhi, India. We also describe their reports of perpetrators. Results: Thirty-two percent of boys and 42% of girls reported being touched against their will. After multivariate adjustment, both boys and girls who had ever worked (odds ratio [OR] = 1.76, p = .05 and OR = 1.79, p = .004, respectively) and those who had a friend of the opposite gender (OR = 3.64, p = .0001 and OR = 2.19, p = .0001, respectively) were more likely to report the experience. The most commonly reported perpetrators were female friends for boys (60%) and strangers for girls (93%). Fifteen percent of boys and 3% of girls reported that someone forcibly tried to have a physical relationship with them. Boys who had ever worked (OR = 3.73, p = .007) were more likely to report the experience. Both boys and girls who had a friend of the opposite sex were more likely to report attempted forced physical relationship (OR = 3.73, p = .0001 and OR = 3.41, p = .03, respectively). The most commonly reported perpetrators were female friends for boys (72%) and neighbors (60%) for girls. Conclusions: Nonconsensual sex is a common experience for these adolescents and there are important gender differences in experience and type of perpetrator. The findings underscore the need to develop programs that enable young people to prevent and cope with nonconsensual sexual experiences.

Women's Education and the Timing of Marriage and Childbearing in the Next Generation: Evidence from Rural Bangladesh
(Abstract; subscription needed for full text; Asia)
Studies in Family Planning. 2007 Jun;38(2):101-112.
Bates LM | Maselko J | Schuler SR
In traditional settings where early marriage and early childbearing persist, decisions about age at marriage are often made by parents, and mothers-in-law tend to have considerable influence in hastening the initiation of childbearing. This study analyzes data from a 2002 survey in six villages in rural Bangladesh to test the hypothesis that daughters of women with more education marry later and that daughters-in-law of more educated women initiate childbearing at a slower rate. Using Cox proportional hazard models, we find significant associations between the educational level of mothers and the age at marriage of their daughters and between the educational level of mothers-in-law and the timing of first birth among their daughters-in-law, although the association between the former attenuates when controlling for other variables. We also find that these associations do not appear to be mediated by the senior women's level of empowerment. We conclude that in rural Bangladesh there is a significant relationship between female education in one generation and the timing of marriage and childbearing in the next.

Prevalence and correlates of adolescent dating violence: Baseline study of a cohort of 7960 male and female Mexican public school students
(Abstract; subscription needed for full text; Central America and the Caribbean)
Preventative Medicine. 2007 Jun;44(6):477-484.
Rivera-Rivera L | Allen-Leigh B | Rodríguez-Ortega G | Chávez-Ayala R | Lazcano-Ponce E
Introduction: Factors correlated with adolescent dating violence have yet to be documented in most developing countries; this study assesses the prevalence and correlates of victimization with and perpetration of dating violence among Mexican youth. Methods: This was the baseline measurement (1998-1999) of a cohort of 7960 public school students (11-24 years) developed to explore various health behaviors in Mexican youth. Multinomial logistic regression models were constructed with adolescent dating violence as the dependent variable. Results: Prevalence of dating violence victimization was 9.37% (female) and 8.57% (male) for psychological violence; 9.88% (female) and 22.71% (male) for physical violence, and 8.63% (female) and 15.15% (male) for both psychological and physical violence. Prevalence of perpetration was 4.21% (female) and 4.33% (male) for psychological violence; 20.99% (female) and 19.54% (male) for physical violence; and 7.48% (female) and 5.51% (male) for both types of violence. Factors associated with dating violence victimization for both genders included: two or more lifetime sexual partners and intra-familial violence. Higher age, alcohol use and illegal drug use were significantly associated with victimization only among girls. The following were significantly associated with perpetration of dating violence in both genders: gang membership, illegal drug use, two or more lifetime sexual partners and intra-familial violence. Higher age and alcohol use were significantly associated with perpetration only among girls. High or middle socio-economic status was associated with perpetration only in boys. Conclusions: Future research on adolescent dating violence in Mexico should further explore severity and frequency of violent behaviors, include a focus on severe dating violence and take into account the context and meaning of dating violence. A longitudinal design that allows determination of causality will also be needed in order to develop prevention strategies.

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Volume 7, Number 2111 June 2007