Volume 7, Number 25
9 July 2007

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FAMILY PLANNING RESEARCH

The influence of hormonal contraceptive use on HIV-1 transmission and disease progression
(Research Article; Global)
(You need Adobe Acrobat Reader to access this document)
Clinical Infectious Diseases . 2007 Aug;45(3):360-369.
Baeten JM | Lavreys L | Overbaugh J
Related News Article: Hormonal contraception and the risk of HIV acquisition
Women account for nearly one-half of new human immunodeficiency virus type 1 (HIV-1) infections worldwide, including the majority of infections in Africa. Biological and epidemiological studies suggest that hormonal contraceptive use could influence susceptibility to HIV-1, as well as infectivity and disease progression for those who become infected. However, not all studies have shown this relationship, and many questions remain. Safe and effective contraceptive choices are essential for women with and at risk for HIV-1 infection. Hormonal contraception may have biologically plausible and clinically important effects on susceptibility to HIV-1, infectiousness of HIV-1, and progression of HIV-1 disease, but the data are inconsistent, and many questions remain. Still, it is clear that hormonal contraceptives are not protective against HIV-1 infection, and potentially the most important public health message is that dual protection with condoms should be the goal for women using hormonal contraception. This emphasizes the necessity for cooperation between those working in the fields of reproductive health and prevention of STDs, as well as the needs for increased involvement of men in reproductive health and for novel prevention interventions for women. Policymakers and clinicians must carefully consider how to translate the available data into public health messages that will reach the countries hardest hit by HIV-1 infection and women who are at risk for or who are living with this disease.

Long-acting and permanent contraception: An international development, service delivery perspective
(Abstract; subscription needed for full text; Global)
Journal of Midwifery & Women's Health. 2007 Jul;52(4):361-367.
Jacobstein R
Recent scientific findings about long-acting and permanent methods of contraception underscore their safety, effectiveness, and wide eligibility for individuals who desire them. This has led to new guidance from the World Health Organization to inform national policies, guidelines, and standards for service delivery. Although developing countries have made much progress in expanding the availability and use of family planning services, the need for effective contraception in general (and long-acting and permanent methods in particular) is large and growing because the largest cohorts in human history are entering their reproductive years. More than half a billion people will use contraception in developing countries (excluding China) by 2015, an increase of 200 million over levels of use in 2000. The health, development, and equity rationales that historically have underpinned and energized the international family planning effort remain valid and relevant today. Despite the other compelling challenges faced by the international health community, the need to make family planning services more widely available is pressing and should remain a priority.

FAMILY PLANNING NEWS

Indians wait to lose virginity
(News Article; Asia)
5 Jul 2007;
The Times of India
Related News Article: 25% of virgins 'ignore safe sex'

Bangladeshi advisor stresses use of permanent birth control methods
(News Article; Asia)
4 Jul 2007
People's Daily

Phillipines: Men urged to undergo vasectomy for family’s sake
(News Article; Asia)
4 Jul 2007
GMA News

HIV/AIDS and STIs RESEARCH

Correlates for disease progression and prognosis during concurrent HIV/TB infection
(Abstract; subscription needed for full text; Global)
International Journal of Infectious Diseases. 2007 Jul;11(4):289-299.
Siawaya JF | Ruhwald M | Eugen-Olsen J | Walzl G
Mycobacterium tuberculosis (Mtb) and the human immunodeficiency virus (HIV) are both life-threatening pathogens in their own right, but their synergic effects on the immune system during co-infection markedly enhance their effect on the host. This review focuses on the bidirectional interaction between HIV and Mtb and discusses the relevance of sputum smear examination, CD4+ counts, viral load at baseline and after initiation of anti-retroviral therapy, as well as additional existing and new potential immune correlates of disease progression and prognosis. These markers include beta2-microglobulin, neopterin, tumor necrosis factor receptor II (TNFRII), CD8+/CD38+, soluble urokinase plasminogen activator receptor (suPAR) and CXCL10 (or IP-10).

HIV incidence, retention rate, and baseline predictors of HIV incidence and retention in a prospective cohort study of injection drug users in Xinjiang, China
(Abstract; subscription needed for full text; Asia)
International Journal of Infectious Diseases. 2007 Jul;11(4):318-323.
Zhang Y | Shan H | Trizzino J | Ruan Y | Beauchamp G
The objective of this study was to determine HIV seroincidence, study participant retention rate, and baseline predictors of HIV incidence and study retention among high-risk injection drug users (IDUs) in Xinjiang, China. A total of 508 eligible seronegative high-risk IDUs were enrolled. Study participants were tested for HIV-1 and counseled at the baseline, 6-month, and 12-month follow-up visits. Sociodemographic and behavioral data were collected during each study visit. The HIV-1 incidence rate and the retention rate were analyzed as a function of sociodemographic, behavioral, and recruitment variables. At 12 months of follow-up, the HIV-1 incidence rate was 8.8 per 100 person-years (95% CI 6.3-12.0%) and the participant retention rate was 93%. Marital status at baseline was the only predictor of HIV incidence. No baseline variables were predictive of study retention.

Immunogenicity of standard-titer measles vaccine in HIV-1-infected and uninfected Zambian children: An observational study
(Abstract; subscription needed for full text; Sub-Saharan Africa)
Journal of Infectious Diseases. 2007 Aug;196(3):347-355.
Moss WJ | Scott S | Mugala N | Ndhlovu Z | Beeler JA
Achieving the level of population immunity required for measles elimination may be difficult in regions of high human immunodeficiency virus type 1 (HIV-1) prevalence, because HIV-1-infected children may be less likely to respond to or maintain protective antibody levels after vaccination. We conducted a prospective study of the immunogenicity of standard-titer measles vaccine administered at 9 months of age to HIV-1-infected and uninfected children in Lusaka, Zambia. From May 2000 to November 2002, 696 children aged 2-8 months were enrolled. Within 6 months of vaccination, 88% of 50 HIV-1-infected children developed antibody levels of greater than or equal to 120 mIU/mL, compared with 94% of 98 HIV-seronegative children and 94% of 211 HIV-seropositive but uninfected children (P=.3). By 27 months after vaccination, however, only half of the 18 HIV-1-infected children who survived and returned for follow-up maintained measles antibody levels greater than or equal to 120 mIU/mL, compared with 89% of 71 uninfected children (P=.001) and in contrast with 92% of 12 HIV-1-infected children revaccinated during a supplemental measles immunization activity. Although HIV-1-infected children showed good primary antibody responses to measles vaccine, their rapid waning of antibody suggests that measles vaccination campaigns may need to be repeated more frequently in areas of high HIV-1 prevalence.

HIV/AIDS and STIs NEWS

Brazil gets cut-price Aids drug
(News Article; South America)
5 Jul 2007
Duffy G, BBC News

Global HIV/AIDS conference opens in Kenya
(News Article; Global)
6 Jul 2007
China Daily

Kenya: Female condom use defended
(News Article; Sub-Saharan Africa)
6 Jul 2007
Wafula C, All Africa
Related News Article: Kenya: Female condoms still out of reach, says delegates

Sri Lanka: Low AIDS figures despite years of conflict
(News Article; Asia)
29 Jun 2007
IRIN

Afghanistan: Government calls for help as HIV rates rise
(News Article; Asia)
2 Jul 2007
IRIN

Indian doctors refuse to help HIV-positive woman deliver: Report
(News Article; Asia)
29 Jun 2007
Agence France-Press (AFP)

Uganda: Free treatment for sex workers in place
(News Article; Sub-Saharan Africa)
3 Jul 2007
Nafula J | Nalugo M, Daily Monitor

MATERNAL AND CHILD HEALTH RESEARCH

Community-based situation analysis of maternal and neonatal care in South Africa to explore factors that impact utilization of maternal health services
(Abstract; subscription needed for full text; Sub-Saharan Africa)
Journal of Midwifery & Women's Health. 2007 Jul;52(4):342-350.
Tlebere P | Jackson D | Loveday M | Matizirofa L | Mbombo M | Doherty T | Wigton A | Tregor L | Chopra M
This community situational analysis determined factors impacting the utilization of maternal health services in South Africa. Quantitative and qualitative research methods were used, including semistructured household interviews, case studies of women with no antenatal care and/or home birth, and verbal/social autopsies of maternal and infant deaths, conducted in three diverse sites across the country. Data analysis used quantitative statistics for the semistructured interviews and a qualitative thematic content approach for the case studies and verbal/social autopsies. Each component was analyzed separately and then triangulated. The following themes emerged: 1) transport and distance to care were the biggest problems, particularly in rural areas; 2) providers' communication with families was very poor; 3) health-seeking behavior was better than anticipated; 4) treatment by health providers and quality of care showed mixed results; 5) HIV/AIDS is a major issue; however, basic maternity and neonatal service quality cannot be overlooked; and 6) families and communities are an untapped resource for improving maternal and neonatal health. Implications for maternal and infant health care in developing countries are discussed, with a particular focus on barriers to utilization and involvement of communities and families in maternity care.

Epidemiological aspects of pregnant women with human immunodeficiency virus in Brazil
(Abstract; subscription needed for full text; South America)
Archives of Medical Science. 2007;3(2):142-144.
Galao EA | de Goody JM | Bagarelli LB | Perea LS | Oliani AH
The aims of the current study are to report on preliminary epidemiological data of pregnant women with human immunodeficiency virus (HIV). HIV tests of 4653 pregnant women from Sao Jose do Rio Preto, Brazil between May 1995 and May 1997 were assessed, and the following epidemiological aspects were noted: age, ethnic background, number of gestations, marital status, type of delivery, and the patients' knowledge about the disease including: forms of transmission, diseases associated with positive cases, and the difficulties in and evolution of the approach to the disease in Brazil. Statistical analysis used percentages with means and standard deviation. HIV tests were positive in 48 (1.03%) of the pregnant women. The mean age was 24.3 +or- 0.6 years. 35 (72.9%) of the individuals were married and 13 (27.1%) had been pregnant one to four times previously. 52.0% knew they were HIV positive and in 23 (48.0%), diagnoses was made during the consultations for this pregnancy. In 25 (52.0%) the form of transmission was unknown; events and gravid diseases occurred in 4 (31.2%) cases. In 38 (79.2%) cases delivery occurred before the 36th week of gestation, with delivery being vaginal in 38 (79.2%) cases, and there were puerperal complications in 8 (16.7%). The routine examination to test for HIV during pregnancy allows the identification of women who are unaware of infection by the virus and performance of medicinal prevention for these pregnant.

Impact of packaged interventions on neonatal health: A review of the evidence
(Abstract; subscription needed for full text; Global)
Health Policy and Planning. 2007 Jul;22(4):193-215.
Haws RA | Thomas AL | Bhutta ZA | Darmstadt GL
At present, the empirical evidence for the impact of neonatal health care packages is a weak base on which to build effective programmes An evidence-based approach to packaging interventions is clearly needed but requires substantial investment in high-quality research and programme learning. Intervention packages should employ multiple service delivery modes along the continuum of care spanning the periconceptual to the postnatal periods, and facilitate linkages between communities and available health care facilities. Significant research is needed regarding scaling up the delivery of interventions to large populations (i.e. the national level, or the state level in large countries with diverse populations) and measuring their impact. Care should be taken that efficacy and effectiveness trials are conducted in settings, and using delivery strategies and resources that render scale-up feasible. An analysis of the impact of successful neonatal health interventions at scale, including careful documentation of processes (e.g. project management), is the next logical step in developing evidence-based packages of interventions to save newborn lives.

Violence against women and the perinatal period: The impact of lifetime violence and abuse on pregnancy, postpartum, and breastfeeding
(Abstract; subscription needed for full text; Global)
Trauma, Violence & Abuse. 2007 Jul;8(3):344-353.
Kendall-Tackett KA
Violence against women affects millions of women, including women who are pregnant or have recently given birth. During pregnancy, a woman's history of past abuse increases her risk of depression and posttraumatic stress disorder. And these increase the risk of pregnancy and neonatal complications. Women who have experienced past or current abuse are also at high risk for postpartum depression, which can affect their relationships with other adults and their babies. Violence against women can also affect women's ability to breastfeed, although abuse survivors often express an intention to breastfeed and are more likely to initiate breastfeeding than their nonabused counterparts. Current abuse, depression, posttraumatic stress disorder, social isolation, lack of social support, and cessation of breastfeeding all have negative health effects for mothers and babies.

MATERNAL AND CHILD HEALTH NEWS

'AIDs declining among pregnant women in S Africa'
(News Article; Sub-Saharan Africa)
6 Jul 2007
The Hindu

India: A new campaign for safe motherhood
(News Article; Asia)
4 Jul 2007
Jha M, The Hindu

14 pct of Vietnamese population suffer from hepatitis B
(News Article; Asia)
2 Jul 2007
Xinhua

African First Ladies campaign to reduce mother to child transmission of HIV
(News Article; Sub-Saharan Africa)
7 Jul 2007
Salinas E, The Statesman

The challenge of improving the health of mothers and newborns
(Feature Article; Sub-Saharan Africa)
3 Jul 2007
Eagle W, VOA News

UNICEF doctor steps in to perform emergency caesarean at a rural hospital
(News Article; Asia)
3 Jul 2007
Henrich C

Ethiopia's fistula hospital - 30,000 women treated
(Feature Article; Sub-Saharan Africa)
3 Jul 2007
Beauchemin E, Radio Netherlands Worldwide
Related News Article: Obstetric Fistula: Ending the Silence, Easing the Suffering

GENDER and HEALTH RESEARCH

Influences on uptake of reproductive health services in Nsangi community of Uganda and their implications for cervical cancer screening
(Research Article; Sub-Saharan Africa)
Reproductive Health. 2007 Jun 26;4(1):[24] p.
Mutyaba T | Faxelid E | Mirembe F | Weiderpass E
Cervical cancer is the most common female cancer in Uganda. Over 80% of women diagnosed or referred with cervical cancer in Mulago national referral and teaching hospital have advanced disease. Plans are underway for systematic screening programmes based on visual inspection, as Pap smear screening is not feasible for this low resource country. Effectiveness of population screening programmes requires high uptake and for cervical cancer, minimal loss to follow up. Uganda has poor indicators of reproductive health (RH) services uptake; 10% postnatal care attendance, 23% contraceptive prevalence, and 38% skilled attendance at delivery. For antenatal attendance, attendance to one visit is 90%, but less than 50% for completion of care, i.e. three or more visits. A qualitative study was conducted using eight focus group discussions with a total of 82 participants (16 men, 46 women and 20 health workers) to better understand factors that influence usage of available reproductive health care services and how they would relate to cervical cancer screening, as well as identify feasible interventions to improve cervical cancer screening uptake. Barriers identified after framework analysis included ignorance about cervical cancer, cultural constructs/beliefs about the illness, economic factors, domestic gender power relations, alternative authoritative sources of reproductive health knowledge, and unfriendly health care services. We discuss how these findings may inform future planned screening programmes in the Ugandan context. Knowledge about cervical cancer among Ugandan women is very low. For an effective cervical cancer-screening programme, awareness about cervical cancer needs to be increased. Health planners need to note the power of the various authoritative sources of reproductive health knowledge such as paternal aunts (Sengas) and involve them in the awareness campaign. Cultural and economic issues dictate the perceived reluctance by men to participate in women's reproductive health issues; men in this community are, however, potential willing partners if appropriately informed. Health planners should address the loss of confidence in current health care units, as well as consider use of other cervical cancer screening delivery systems such as mobile clinics/camps.

Human papillomavirus subtype 16 is common in Pakistani women with cervical carcinoma
(Abstract; subscription needed for full text; Asia)
International Journal of Infectious Diseases. 2007 Jul;11(4):313-317.
Khan S | Jaffer NN | Khan MN | Rai MA | Shafiq M
Human papillomavirus (HPV) is recognized as a major causative agent for cervical carcinomas. Based on their oncogenic potential, HPV subtypes have been divided into high- and low-risk. In Pakistan, screening for HPV in female patients is not commonly practiced, and as a consequence, the degree of HPV prevalence and its correlation with cervical cancer is unknown. In this study, we have attempted to estimate the prevalence of HPV infection, and also the HPV subtype profile, among Pakistani women with cervical cancer from varied geographical, racial, and social backgrounds within Pakistan. Women visiting two tertiary care hospitals in Karachi, diagnosed with carcinoma of the cervix within the past 15 years, were analyzed for HPV subtypes in their cancer specimens. Retrospectively, 60 paraffin-embedded cervical cancer biopsies were examined for the presence of HPV DNA. After DNA extraction from these samples, polymerase chain reaction (PCR) was used to amplify the HPV L1 gene using the consensus (general) primers, and primers specific for subtypes 16 and 18. Of the 60 samples analyzed, only one sample was HPV negative; the rest of the samples were positive for the presence of HPV. Of the 59 HPV positive samples, 56 showed the presence of HPV16 and one sample was positive for HPV18; HPV subtype could not be determined in two samples. Our results show a strong relationship between HPV infection and cervical cancer among Pakistani women. These results underscore the need to implement regular HPV screening for Pakistani women. An early diagnosis of HPV infection will allow better health management to reduce the risk of developing cervical cancer.

Quality of life of Lithuanian women with early stage breast cancer
(Research Article; Europe)
BMC Public Health. 2007 Jun 26;7(1):[14] p.
Bulotiene G | Veseliunas J | Ostapenko V
In the last decades, there have been no studies carried out in Lithuania on the quality of life of breast cancer patients. The aim of the present study was to evaluate changes in the quality of life of Lithuanian women with the early stage of breast cancer nine months after surgery and its dependence on surgical strategy, adjuvant chemotherapy and the social and demographic status of the patients. Seventy-seven patients with early stage breast cancer filled in the FACT-An questionnaire twice: one week and nine months after the surgery. The main age of the patients was 53.1 +or- 10.6 years. We distinguished the mastectomy group and breast conserving treatment (BCT) group with/without chemotherapy. The groups were identical in their social and demographic status (age, education, occupation and marital status). Changes in the quality of life in these groups were compared nine months after surgery. Nine months after surgery, the overall quality of life was found worse in both mastectomy and BCT groups. Changes were induced by the worsening of the emotional and social well-being. The quality of life became worse in the mastectomy plus chemotherapy sample. No changes were detected in the mastectomy group without chemotherapy. In addition, the multivariate analysis showed that the marital status was quite a significant determinant of the functional well-being. Nine months after surgery, the study revealed a worsening of the overall quality of life in both groups of patients - those who had undergone mastectomy and BCT. The quality of life became considerably worse in the mastectomy plus chemotherapy group. Marital status was found to exert the most considerable influence on the women's quality of life in comparison with other social and demographic factors.

GENDER and HEALTH NEWS

Kenya: Women unable to negotiate for safe sex
(News Article; Sub-Saharan Africa)
1 Jul 2007
Godia J, East African Standard (Nairobi)

Sudan rape laws 'need overhaul'
(News Article; North Africa)
29 June 2007
Henshaw A, BBC News

Civil society leaders announce new global call to stop cervical cancer
(News Article; Sub-Saharan Africa)
6 Jul 2007
Global Health Strategies (New York)

POPULATION/FERTILITY/DEMOGRAPHY RESEARCH

Birth spacing perceptions of rural Filipinos
(Abstract; subscription needed for full text; Asia)
Journal of Transcultural Nursing. 2007 Jul;18(3):238-246.
de Vera NZ
The purpose of this study was to explore the perceptions of rural Filipinos concerning the various factors influencing birth spacing. The Household Production of Health nested in the Ecological Model was used to provide the conceptual framework for this study. Analysis of ethnographic data produced one domain of meaning, Factors Influencing Birth Spacing, and six categories: (a) gender relations, (b) religion and the Catholic Church, (c) contraceptive technology, (d) media, (e) family and friends, and (f) family planning education. Understanding the factors influencing birth spacing in different cultures may provide health care providers with a broader scope for providing culturally competent care.

POPULATION/FERTILITY/DEMOGRAPHY NEWS

South Africa: Slowing population is good news for economy
(News Article; Sub-Saharan Africa)
4 Jul 2007
Hazelhurst E, Business Report

South African population reaches 47.9 million
(News Article; Sub-Saharan Africa)
3 Jul 2007
IC Publications

China's current low birth rate facing challenges
(News Article; Asia)
5 Jul 2007
Zee News

ADOLESCENT HEALTH RESEARCH

Impact of education in promoting the knowledge of and attitude to HIV/AIDS prevention: A trial on 17,000 Iranian students
(Abstract; subscription needed for full text; Middle East)
International Journal of STD and AIDS. 2007 Jun;18(6):407-409.
Jodati AR | Nourabadi GR | Hassanzadeh S | Dastgiri S | Sedaghat K
The aim of this study was to assess the impact of an educational course on knowledge and attitude of students regarding HIV/AIDS prevention in Tabriz, Iran. The study was conducted by self-assessment technique among university students before and after an educational training programme. The findings showed that the knowledge of students increased significantly (P less than 0.05). The attitude to the problem also improved positively in the subjects (P less than 0.05). It is concluded that short-term training courses and continuous educational programmes (e.g., peer education) should be provided to young students through the course materials in the universities and schools promoting the awareness and attitude to this ever increasing health problem.

At greatest risk: Pre- and early adolescent Bahamian youth experiencing anal intercourse
(Abstract; subscription needed for full text; Central America and the Caribbean)
International Journal of STD and AIDS. 2007 Jun;18(6):396-401.
Yu S | Deveaux L | Lunn S | Liu H | Brathwaite N
Although anal intercourse carries great risk for HIV transmission, little research has focused on it among the general population, particularly pre- and early adolescents. This study describes the prevalence of anal and vaginal intercourse among Bahamian pre- and early adolescents and associations with other risk behaviours, family interactions and intrapersonal correlates. Data were from 1274 sixth-grade students aged 9-14 years who completed self-administered questionnaires at baseline of a larger school-based behavioural intervention study. Youth who reported having had anal intercourse engaged in significantly higher rates of several risk behaviours and were significantly more likely to engage in risk behaviours over the next six months, compared with youth with a history of vaginal intercourse only, who in turn were more likely than virgin adolescents. Youth indulging in anal intercourse also perceived significantly lower levels of parental monitoring. Multivariate analyses revealed that anal intercourse, vaginal intercourse, reduced parental monitoring, depression and perceived friend high-risk involvement were associated with both past involvement and future intention to engage in other risk behaviours. Anal intercourse poses a direct threat to the health of these children and is a flag for a constellation of other risks.

Personal values and involvement in problem behaviors among Bahamian early adolescents: A cross-sectional study
(Research Article; Central America and the Caribbean)
BMC Public Health. 2007 Jul 2;7(1):[30] p.
Liu H | Yu S | Cottrell L | Lunn S | Deveaux L
Few studies, particularly in developing countries, have explored the relationship between adolescents and parental values with adolescent problem behaviors. The objectives of the study are to (1) describe adolescents' personal values, their problem behaviors, and the relationships thereof according to gender and (2) examine the relationship between parental values, adolescent values, and adolescents' problem behaviors among sixth-grade students and one of their parents. The data used in these analyses were from the baseline assessment of a school-based HIV risk reduction intervention being conducted and evaluated among sixth grade students and one of their parents across 9 elementary schools in The Bahamas. Personal values were measured by the Portrait Values Questionnaire (PVQ). Seven reported problem behaviors were queried from the students, which included physical fight with a friend, drank alcohol, beer, or wine, smoked a cigarette, pushed or carried any drugs, carried a gun, knife, screwdriver or cutlass to use as a weapon, had sex and used marijuana or other illicit drugs over the past 6 months. Multilevel modeling for binary data was performed to estimate the associations between adolescent and parental values and adolescent problem behaviors. Among 785 students, 47% of the students reported at least one problem behavior. More boys (54%) reported having one or more problem behaviors than girls (41%, p less than 0.01). Boys compared to girls expressed a higher level of self-enhancement (means score: 36.5 vs. 35.1; p = 0.03), while girls expressed a higher level of self transcendence (42.3 vs. 40.7; p = 0.03). The results of multilevel modeling indicates that boys with a higher level of self-enhancement and girls with a higher level of openness to change and a lower level of conservation were more likely to report engagement in problem behaviors. Only two parental values (self-transcendence and conservation) were low or modestly correlated with youth' values (openness to change and self enhancement). Parental-reported values documented limited association on adolescents' reported values and behaviors. In designing interventions for reducing adolescents' problem behaviors, it may be important to understand the values associated with specific problem behaviors. Further exploration regarding lack of association between adolescent and parental values and problem behaviors is needed.

ADOLESCENT HEALTH NEWS

Poor attitude towards HIV among Jamaican youths
(Feature Article; Central America and the Caribbean)
1 Jul 2007
Wisdom T, Jamaica Gleaner

Jamaica: Senator calls for abstinence education
(News Article; Central America and the Caribbean)
30 Jun 2007
Moxam E, Jamaica Gleaner

India: Birds and bees
(Commentary; Asia)
1 Jul 2007
The Times of India

Bahamas: CARICOM empowering youth in region
(News Article; Central America and the Caribbean)
2 Jul 2007
Williamson D, The Bahama Journal

Uganda: Amref Keeps Youth Away From Sex
(News Article; Sub-Saharan Africa)
4 Jul 2007
Kiwanuka F, All Africa

South Africa: Mixed reaction to children's act
(News Article; Sub-Saharan Africa)
3 Jul 2007
Mail & Guardian Online

Uganda: Kayunga girls sexually active at 10 years - survey
(News Article; Sub-Saharan Africa)
4 Jul 2007
Muzaale F, The Monitor (Kampala)

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Johns Hopkins Bloomberg School of Public Health: The INFO Project

Volume 7, Number 25 9 July 2007