Volume 7, Number 33
3 September 2007

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FAMILY PLANNING RESEARCH

Pain and heavy bleeding with intrauterine contraceptive devices
(Editorial; Global)
British Medical Journal. 2007 Sep 01;335:410-411.
Rose S
Related Press Release: Despite their safety, IUDs are underused in developed countries
The two types of intrauterine contraceptive device have very different menstrual side effects. The newer hormonal levonorgestrel intrauterine system (LNG-IUS or Mirena) reduces menstrual flow, whereas the copper bearing devices may induce longer, heavier, and more painful periods. Pain and heavy menstrual bleeding are common reasons for discontinuing use of an intrauterine device within the first year. Non-steroidal anti-inflammatory drugs (NSAIDs) can reduce cramping and blood flow in women with and without devices. A recent Cochrane review by Grimes and colleagues evaluated data from 15 randomised controlled trials investigating the effect of NSAIDs on treatment or prevention of pain and bleeding due to an intrauterine contraceptive device. Trials meeting selection criteria were conducted in 10 countries using a range of treatments (NSAID compared with placebo, another NSAID, or another type of drug) and a variety of quantitative and qualitative outcome measures-factors that precluded a meta-analysis of the data. Although many of the trials had methodological weaknesses, data from treatment trials showed an overall beneficial effect of NSAIDs on pain and bleeding outcomes, but data from prevention trials were inconsistent.

Evaluation of iron deficiency in young women in relation to oral contraceptive use
(Abstract; subscription needed for full text; Global)
Contraception. 2007 Sep;76(3):200-207.
Casabellata G | Di Santolo M | Banfi G | Stel G | Gonano F
The purpose of this study was to identify the optimal measures for diagnosing iron deficiency (ID) in oral contraceptive (OC) users and nonusers, and to estimate ID frequency in relation to OC use. Conventional biomarkers of iron status -- serum ferritin, iron, transferrin (Tf) and transferrin saturation (TfS) -- were compared with serum soluble Tf receptor (sTfR) and the sTfR/log ferritin ratio (sTfR-F index). Two hundred and two healthy menstruating white Italian women (aged 24 plus or minus 4.8 years) were analyzed. Serum ferritin concentrations less than 12 microg/L were considered as ID. ID was detected in 29.7% (60/202) of the study women. Fifty-nine women were OC users (59/202, 29.2%). OC use did not significantly affect ID prevalence (p=.24). However, OC use markedly increased Tf in OC users, who had an odds ratio (OR) of 9.3 (CI 3.8-22.7, p less than .001) for elevated Tf less than 330 mg/dL. No other iron status measure was affected by OC. Of the markers for ID adjunctive to ferritin, an elevated sTfR-F index greater than or equal to 1.5 showed the best performance. Specifically in OC users, the elevated sTfR-F index had better sensitivity (81.0% vs. 33.3%), specificity (94.7% vs. 92.1%), efficiency (89.8% vs. 71.2%), positive predictive value (89.5% vs. 70.0%) and negative predictive value (90.0% vs. 71.1%) than a TfS less than 15%. Additionally, the sTfR-F index allowed the identification of low iron stores in 4.5% (9/202) of women with ferritin greater than or equal to 12 microg/L. Among healthy OC users and non-OC users, the sTfR-F index had the highest performance for diagnosing ID compared with other serum markers adjunctive to ferritin measurements, whereas sTfR by itself had a low sensitivity. We showed that neither the sTfR nor sTfR-F index was affected by third-generation OC use. The sTfR measurement is useful in the diagnosis of ID, especially in women using OC, where Tf and TfS tests may be misleading.

Effectiveness of the levonorgestrel-releasing intrauterine system in the treatment of adenomyosis diagnosed and monitored by magnetic resonance imaging
(Abstract; subscription needed for full text; Global)
Contraception. 2007 Sep;76(3):195-199.
Bragheto AM | Caserta N | Bahamondes L | Petta CA
This study was conducted to evaluate the effect of the levonorgestrel-releasing intrauterine system (LNG-IUS) on adenomyotic lesions diagnosed and monitored by magnetic resonance imaging (MRI). LNG-IUS was inserted during menstrual bleeding in 29 women, 24 to 46 years of age, with MRI-diagnosed adenomyosis associated with menorrhagia and dysmenorrhea. Clinical evaluations were carried out at baseline and at 3 and 6 months postinsertion. MRI was performed at baseline and at 6 months postinsertion and was used to calculate junctional zone thickness (in mm), to define the junctional zone borders, to identify the presence of high-signal foci on T2-weighted images and to calculate uterine volume (in mL). A significant reduction of 24.2% in junctional zone thickness was observed (p less than .0001); however, no significant decrease in uterine volume was observed (142.6 mL vs. 136.4 mL; p = .2077) between baseline and the 6-month evaluation. A significant decrease in pain score was observed at 3 and 6 months after insertion (p less than .0001); however, six women continued to report pain scores less than 3 at 6 months of observation. At 3 months of use, the most common bleeding pattern was spotting, and at 6 months of observation, oligomenorrhea was the most common pattern observed, although spotting was present in one third of the women. The insertion of an LNG-IUS led to a reduction in pain and abnormal bleeding associated with adenomyosis. MRI was useful for monitoring response of adenomyotic lesions to the LNG-IUS.

Effect of an oral contraceptive containing 30 microg ethinylestradiol plus 3 mg drospirenone on body composition of young women affected by premenstrual syndrome with symptoms of water retention
(Abstract; subscription needed for full text; Global)
Contraception. 2007 Sep;76(3):190-194.
Fruzzetti F | Lazzarini V | Ricci C | Quirici B | Gambacciani M
This study was conducted to evaluate body weight and composition during oral contraception with 30 microg ethinylestradiol plus 3 mg drospirenone (30EE+DRSP) in women affected by premenstrual syndrome (PMS) with somatic symptoms related to water retention. This prospective study was performed using multifrequency bioelectrical impedance analysis in 18 normally cycling PMS patients (mean age, 28.8 years) evaluated at baseline, during the luteal phase of the menstrual cycle and after 3 and 6 cycles of 30EE+DRSP. Total body water (TBW), intracellular water (ICW), extracellular water (ECW), fat mass and fat-free mass were evaluated. Body weight, waist-to-hip ratio and blood pressure were also determined at each visit. Basal values were compared with those measured in 31 healthy females without PMS (controls). PMS patients have higher levels of TBW and ICW than controls. After 6 months of 30EE+DRSP, TBW and ECW were significantly lower than before treatment. No significant variations in ICW or in the other parameters were observed. In women with PMS, 30EE+DRSP reduces the concentrations in TBW and ECW. This effect is likely due to the antimineralocorticoid activity of DRSP. Whether these changes may account for the improvement of premenstrual fluid-related symptoms reported with this formulation is discussed.

FAMILY PLANNING NEWS

India: Teenage pregnancies, a matter of concern
(News Article; Asia)
27 Aug 2007
Ahmedi F, Merinews

Brazil: Controversial bill to sterilize younger women
(News Article; South America)
22 Aug 2007
Frayssinet F, Inter Press Service (IPS)

HIV/AIDS and STIs RESEARCH

Men's circumcision status and women's risk of HIV acquisition in Zimbabwe and Uganda
(Abstract; subscription needed for full text; Sub-Saharan Africa)
AIDS. 2007 Aug 20;21(13):1779-1789.
Turner AN | Morrison CS | Padian NS | Kaufman JS | Salata RA
The objective was to assess whether male circumcision of the primary sex partner is associated with women's risk of HIV. Data were analyzed from 4417 Ugandan and Zimbabwean women participating in a prospective study of hormonal contraception and HIV acquisition. Most were recruited from family planning clinics; some in Uganda were referred from higher-risk settings such as sexually transmitted disease clinics. Using Cox proportional hazards models, time to HIV acquisition was compared for women with circumcised or uncircumcised primary partners. Possible misclassification of male circumcision was assessed using sensitivity analysis. At baseline, 74% reported uncircumcised primary partners, 22% had circumcised partners and 4% had partners of unknown circumcision status. Median follow-up was 23 months, during which 210 women acquired HIV (167, 34, and 9 women whose primary partners were uncircumcised, circumcised, or of unknown circumcision status, respectively). Although unadjusted analyses indicated that women with circumcised partners had lower HIV risk than those with uncircumcised partners, the protective effect disappeared after adjustment for other risk factors [hazard ratio (HR), 1.03; 95% confidence interval (CI), 0.69-1.53]. Subgroup analyses suggested a non-significant protective effect of male circumcision on HIV acquisition among Ugandan women referred from higher-risk settings: adjusted HR 0.16 (95% CI, 0.02-1.25) but little effect in Ugandans (HR, 1.33; 95% CI, 0.72-2.47) or Zimbabweans (HR, 1.12; 95% CI, 0.65-1.91) from family planning clinics. After adjustment, male circumcision was not significantly associated with women's HIV risk. The potential protection offered by male circumcision for women recruited from high-risk settings warrants further investigation.

Challenges faced by health workers in implementing the prevention of mother-to-child HIV transmission (PMTCT) programme in Uganda
(Abstract; subscription needed for full text; Sub-Saharan Africa)
Journal of Public Health. 2007 Sep;29(3):269-274.
Nuwagaba-Biribonwoha H | Mayon-White RT | Okong P | Carpenter LM
The objective was to report the experience of health workers who had played key roles in the early stages of implementing the prevention of mother-to-child HIV transmission services (PMTCT) in Uganda. Interviews were conducted with 15 key informants including counsellors, obstetricians and PMTCT coordinators at the five PMTCT test sites in Uganda to investigate the benefits, challenges and sustainability of the PMTCT programme. Audio-taped interviews were held with each informant between January and June 2003. These were transcribed verbatim and manually analysed using the framework approach. The perceived benefits reported by informants were improvement of general obstetric care, provision of antiretroviral prophylaxis for HIV-positive mothers, staff training and community awareness. The main challenges lay in the reluctance of women to be tested for HIV, incomplete follow-up of participants, non-disclosure of HIV status and difficulties with infant feeding for HIV-positive mothers. Key informants thought that the programme's sustainability depended on maintaining staff morale and numbers, on improving services and providing more resources, particularly antiretroviral therapy for the HIV-positive women and their families. Uganda's experience in piloting the PMTCT programme reflected the many challenges faced by health workers. Potentially resource-sparing strategies such as the 'opt-out' approach to HIV testing required further evaluation.

HIV/AIDS and STIs NEWS

PEPFAR to begin providing funds for male circumcision programs in some African countries, officials say
(News Article; Sub-Saharan Africa)
22 Aug 2007
Medical News Today
Related News Article: Anti-AIDS program to fund circumcision

AIDS vaccine field moves toward larger-scale efficacy trials: Volunteers?
(News Article; Sub-Saharan Africa)
24 Aug 2007
Science Daily

MATERNAL AND CHILD HEALTH RESEARCH

Effectiveness of the WHO/UNICEF guidelines on infant feeding for HIV-positive women: Results from a prospective cohort study in South Africa
(Abstract; subscription needed for full text; Sub-Saharan Africa)
AIDS. 2007 Aug 20;21(13):1791-1797.
Doherty T | Chopra M | Jackson D | Goga A | Colvin M
The World Health Organization (WHO) and UNICEF recommend that HIV-positive women should avoid all breastfeeding only if replacement feeding is acceptable, feasible, affordable, sustainable and safe. Little is known about the effectiveness of the implementation of these guidelines in developing country settings. The objective was to identify criteria to guide appropriate infant-feeding choices and to assess the effect of inappropriate choices on infant HIV-free survival. The method was a prospective cohort study of 635 HIV-positive mother-infant pairs across three sites in South Africa to assess mother to child transmission of HIV. Semistructured questionnaires were used during home visits between the antenatal period and 36 weeks after delivery to collect data concerning appropriateness of infant feeding choices based on the WHO/UNICEF recommendations. Three criteria were found to be associated with improved infant HIV-free survival amongst women choosing to formula feed: piped water; electricity, gas or paraffin for fuel; and disclosing HIV status. Using these criteria as a measure of appropriateness of choice: 95 of 311 women who met the criteria (30.5%) chose to breastfeed and 195 of 289 women who did not meet the criteria (67.4%) chose to formula feed. Infants of women who chose to formula feed without fulfilling these three criteria had the highest risk of HIV transmission/death (hazard ratio, 3.63; 95%confidence interval, 1.48-8.89). Within operational settings, the WHO/UNICEF guidelines were not being implemented effectively, leading to inappropriate infant-feeding choices and consequent lower infant HIV-free survival. Counselling of mothers should include an assessment of individual and environmental criteria to support appropriate infant-feeding choices.

A bold new beginning for midwifery in Afghanistan
(Abstract; subscription needed for full text; Asia)
Midwifery. 2007 Sep;23(3):226-234.
Currie S | Azfar P | Fowler RC
Nowhere, perhaps, is the need to improve the health of women and children more apparent -- or more challenging to address -- than in post-conflict Afghanistan. Yet it is precisely in the context of such challenges that unique opportunities for Afghan midwives have emerged. Once it had been established that midwives would likely be the sole health care providers for most Afghan women for some time to come, midwifery was virtually given carte blanche to develop, expand and become stronger. Afghanistan's government worked with local and international partners to implement a comprehensive approach to developing and supporting this much needed cadre, which involved: strengthening and expanding midwifery education; creating policies to ensure the pivotal role of midwives in the provision of essential obstetric and newborn care; supporting the establishment of a professional association for midwives; and developing initiatives to increase access to skilled care during childbirth. Although much remains to be done in improving health outcomes for Afghan women and children, efforts to date have succeeded in expanding and strengthening midwifery in Afghanistan, and have paved the way for the professionalisation of Afghan midwives -- which may ultimately enable them to be what they need to be to have a significant and sustainable impact on the MMR. These efforts have also underscored the need for strategic decisions in implementing complementary programmes to reduce the country's unacceptable maternal and newborn mortality statistics.

Preserving breastfeeding practice through the HIV pandemic
(Abstract; subscription needed for full text; Global)
Tropical Medicine and International Health. 2007 Sep;12(9):1-18.
Coovadia HM | Bland RM
Breastfeeding, particularly for the first 6 months of life, is unquestionably the ideal way to feed most infants. However, the human immunodeficiency virus (HIV) pandemic has caused debate and confusion about the best way for HIV-positive mothers to feed their children. This review provides recent key findings and opinions around making breastfeeding safer for HIV-positive women, and argues for preservation of breastfeeding, as opposed to complete avoidance of breastfeeding for all HIV-positive women.

MATERNAL AND CHILD HEALTH NEWS

Sudan: Darfur women fear giving birth at night, without midwives to help
(Feature Article; North Africa)
30 Aug 2007
UNFPA

A nightmare for Malawian women
(Feature Article; Sub-Saharan Africa)
30 Aug 2007
Banda PS, The Daily Times

GENDER and HEALTH RESEARCH

The Power of TV: Cable Television and Women's Status in India
(Abstract; subscription needed for full text; Asia)
2007 Aug;(NBER Working Paper No. 13305)
Jensen R | Oster E, National Bureau of Economic Research
Related News Article: India: Where TV is good for you
Cable and satellite television have grown rapidly throughout the developing world. The availability of cable and satellite television exposes viewers to new information about the outside world, which may affect individual attitudes and behaviors. This paper explores the effect of the introduction of cable television on gender attitudes in rural India. Using a three-year individual-level panel dataset, we find that the introduction of cable television is associated with improvements in women's status. We find significant increases in reported autonomy, decreases in the reported acceptability of beating and decreases in reported son preference. We also find increases in female school enrollment and decreases in fertility (primarily via increased birth spacing). The effects are large, equivalent in some cases to about five years of education in the cross section, and move gender attitudes of individuals in rural areas much closer to those in urban areas. We argue that the results are not driven by pre-existing differential trends. These results have important policy implications, as India and other countries attempt to decrease bias against women.

Gender relations in the context of HIV/AIDS in rural South Africa
(Abstract; subscription needed for full text; Sub-Saharan Africa)
AIDS Care. 2007 Aug;19(7):844-849.
Ndinda C | Uzodike UO | Chimbwete C | Pool R
As part of the Microbicides Development Programme, we conducted formative research to explore gender relations at a site in rural KwaZulu-Natal. We were interested in gender relations and in assessing their implications for emerging female initiated and controlled HIV prevention methods in the form of microbicides. Eleven focus group discussions were conducted with men and women in the community. Participants were asked about decision making about sex, family planning and the use of condoms in heterosexual relationships. Findings suggest that gender relations in the context of HIV are complex. The findings suggest that both men and women feel that the final decision about child-bearing and the use of contraceptives rests with women since they are the ones who bear the burden of child care. This implies that it is feasible for couples to use women-initiated and controlled methods of HIV prevention.

Relationship between female sexual difficulties and mental health in patients referred to two public and private settings in Tehran, Iran
(Abstract; subscription needed for full text; Middle East)
The Journal of Sexual Medicine. 2007 Sep;4(5):1262-1268.
Azar M | Noohi S | Kandjani ARS
Introduction: Sexual difficulty has various effects on patients suffering from this condition that can impact interpersonal and marital relationships. Sexual function may be adversely affected by stress of any kind and emotional disorders. There have been limited studies focusing on the mental health of those suffering from this problem. Aim: To determine the relationship between sexual difficulties and mental health in female patients seeking help in psychiatric clinics. Methods: The study was based on the case–control design methodology in which the case group consisted of 165 outpatients of two psychiatric clinics who were diagnosed with different mental disorders such as depression, anxiety, phobia, aggression, and somatic complaints (33 subjects for each type of disorder). The 33 subjects in the control group were chosen among the patients’ relatives and visitors who had no history of either seeking psychiatric help or taking psychiatric drugs. The subjects of both case and control groups were selected based on a convenience sampling method. Moreover, the data were collected based on two techniques of "interview" and "questionnaire:" the latter was of three different subcategories, each dealing with demographic characteristics, sexual difficulties, and a Symptom Check-List-90-Revised. Main Outcome Measure: Assessing female sexual difficulties associated with mental health and differences between women with and without psychiatric problems. Results: The obtained results indicated that there was a significant difference between the prevalence of sexual difficulties (e.g., sexual desire and orgasm disorders) in the case group and that of the control group. It was also revealed that there was a significant difference between the depressed and aggressive, as well as those with somatic complaints, and their control group counterparts. Conclusions: In Iran, sexual difficulties seem to be more frequent in those seeking psychiatric help in clinics than in those within the normal population.

Prevalence and risk factors for erectile dysfunction in Korean men: Results of an epidemiological study
(Abstract; subscription needed for full text; Asia)
Journal of Sexual Medicine. 2007 Sep;4(5):1269-1276.
Ahn TY | Park JK | Lee SW | Hong JH | Park NC | Kim JJ | Park K | Park H | Hyun JS
The prevalence of erectile dysfunction (ED) and associated risk factors has been described in many countries, but there are still only a few studies from Asia. We investigated the prevalences of ED and premature ejaculation (PE) in Korean men and the impact of general health, lifestyle, and psychosocial factors on these conditions. To assess ED and PE, 1,570 Korean men aged 40-79 years were interviewed with a self-administered questionnaire on sexual function and the International Index of Erectile Function (IIEF)-5. In addition, blood chemistry was analyzed for each subject. The prevalences of ED and PE were obtained from self-reported ED, IIEF-5 scoring, EF (erectile function) domain scoring, and self-reported intravaginal ejaculatory latency time (IELT). The data were analyzed for the presence of risk factors and the relationship of general health, lifestyle, and psychosocial factors with ED. The prevalences of ED among Korean men were 13.4% (self-reported ED) and 32.4% (IIEF-5 score less than or equal to 17), and PE prevalences were 11% (IELT less than or equal to 2-min) and 33.1% (IELT less than or equal to 5-min). ED was more prevalent in the subject groups with older age, lower income, or lower education, and in subjects without a spouse. ED prevalence was positively associated with risk factors such as diabetes, hypertension, heart disease, psychological stress, and obesity. Levels of serum hemoglobin (Hb) A1c, triglycerides, testosterone, or dehydroepiandrosterone sulfate (DHEA-S) were significantly different between the ED and non-ED groups. The prevalences of ED and PE in Korean men were 13.4% (self-reported ED) and 11% (IELT less than or equal to 2-min), respectively. Risk factors and other socioeconomic and mental health factors were associated with ED prevalence. Biochemical factors such as HbA1c, triglycerides, testosterone, and DHEA-S were significantly related to ED prevalence.

GENDER and HEALTH NEWS

Kenya: Rape in marriage a crime, says Ndung'u
(News Article; Sub-Saharan Africa)
30 Aug 2007
Mwaniki M, The Nation (Nairobi)

POPULATION/FERTILITY/DEMOGRAPHY RESEARCH

Abandonment, adoption and reproductive disruption: Transitions in child circulation in Mexico City, 1880 - 1910
(Abstract; subscription needed for full text; Central America and the Caribbean)
Childhood. 2007 Aug;14(3):321-338.
Blum AS
To explore meanings attached to children in Mexican society, this article examines two changing aspects of child circulation, a widespread reproductive disruption to the families of Mexico City's working poor. In the late 1890s, a rapid rise in admissions to the public foundling home was matched by a striking increase in retrievals. At the other end of the social spectrum, growing preference for adopting infants and young children indicates that adoption was becoming an acceptable means of forming families among the middle and upper classes. Changes in welfare policy encouraged both trends. This convergence of family practice and public policy illuminates transitions in concepts of infancy and early childhood informed by a consolidating ethic of protected childhood. These dynamics prefigured the emergence of child protection legislation in the 1910s and the expansion of welfare services in the 1920s and 1930s.

POPULATION/FERTILITY/DEMOGRAPHY NEWS

India & China to help Asia make up 30% of world GDP by '20
(News Article; Asia)
28 Aug 2007
Economic Times

HIV/AIDS impact on Zimbabwe population growth less than expected
(News Article; Sub-Saharan Africa)
28 Aug 2007
Mwakalyelye N, VOA News

Pakistan: Contraceptive use has increased to 36pc, says Shahzadush Sheikh
(News Article; Asia)
28 Aug 2007
Daily Times

ADOLESCENT HEALTH RESEARCH

Youth in Sub-Saharan Africa
(Abstract; subscription needed for full text; Sub-Saharan Africa)
Journal of Adolescent Health. 2007 Sep;41(3):230-238.
Blum RW
Sub-Saharan Africa is going through rapid social, political, and economic transformations that have a profound impact on youth. The present review explores trends and outcomes as they relate to education, family formation and sexual and reproductive health and the interrelationships among these areas. It is based on both published and unpublished reports. Over the past 20 years, school enrollment has increased for much of the subcontinent; although the gender gap has narrowed, females remain educationally disadvantaged. Likewise, marriage is occurring later today than a generation ago, posing new challenges of out-of-wedlock births and an increased likelihood of engaging in premarital sex. So, too, although there has been a slowing of the population growth in much of the region, in many countries of sub-Saharan Africa, the population is doubling every 30 years. Although acquired immunodeficiency syndrome is the predominant cause of death among youth, maternal mortality remains a major risk of death for youth -- in some countries 600 times greater than that of peers in the industrialized world.

The impact of maternal experience of violence and common mental disorders on neonatal outcomes: A survey of adolescent mothers in Sao Paulo, Brazil
(Research Article; South America)
BMC Public Health. 2007 Aug 16;7(1):209.
Ferri CP | Mitsuhiro SS | Barros MC | Chalem E | Guinsburg R
Both violence and depression during pregnancy have been linked to adverse neonatal outcomes, particularly low birth weight. The aim of this study was to investigate the independent and interactive effects of these maternal exposures upon neonatal outcomes among pregnant adolescents in a disadvantaged population from Sao Paulo, Brazil. 930 consecutive pregnant teenagers, admitted for delivery were recruited. Violence was assessed using the Californian Perinatal Assessment. Mental illness was measured using the Composite International Diagnostic Interview (CIDI). Apgar scores of newborns were estimated and their weight measured. 21.9% of mothers reported lifetime violence (2% during pregnancy) and 24.3% had a common mental disorder in the past 12 months. The exposures were correlated and each was associated with low education. Lifetime violence was strongly associated with Common Mental Disorders. Violence during pregnancy (PR= 2.59(1.05-6.40) and threat of physical violence (PR=1.86(1.03-3.35) and any common mental disorders (PR=2.09 (1.21-3.63) (as well as depression, anxiety and PTSD separately) were independently associated with low birth weight. Efforts to improve neonatal outcomes in low income countries may be neglecting two important independent, but correlated risk factors: maternal experience of violence and common mental disorder.

Using the theory of planned behaviour to understand the motivation to learn about HIV/AIDS prevention among adolescents in Tigray, Ethiopia
(Abstract; subscription needed for full text; Sub-Saharan Africa)
AIDS Care. 2007 Aug;19(7):895-900.
Hadera HG | Boer H | Kuiper WA
Various studies indicate that school- or university-based HIV prevention curricula can reduce the prevalence of sexual risk behaviour among adolescent youth in Sub-Saharan Africa. However, effective HIV/AIDS prevention education may be problematic if the needs of youth are not served adequately. To date, little attention has been given to the motivation of youth to learn about HIV/AIDS and about their preferences for HIV/AIDS curriculum design options. The aim of this study was to get insight into the determinants of the motivation of youth to learn about HIV/AIDS prevention and to assess their curriculum design preferences. Students from a university in Tigray, Ethiopia, filled out a structured questionnaire, which assessed demographics, variables that according to the Theory of Planned Behaviour are related to the motivation to learn, and their preferences for independent, carrier and integrated HIV/AIDS curriculum designs. On average, participants were highly motivated to learn about HIV/AIDS. Motivation to learn was primarily related to social norms and was not related to self-efficacy to discuss HIV/AIDS in class. The often discussed reluctance to discuss sexuality and condom use in curricula in Sub-Saharan Africa, seems to be more related to existing negative social norms, than to lack of self-efficacy. Participants revealed a high preference for the independent, carrier and integrated curriculum design options. However, students with a higher motivation to learn about HIV/AIDS were more attracted to the independent course design.

ADOLESCENT HEALTH NEWS

Mali: Child marriage a neglected problem
(Feature Article; Sub-Saharan Africa)
30 Aug 2007
IRIN

Health: No sex education please - We're Indian
(Commentary; Asia)
30 Aug 2007
Bahuguna NJ, IPS

Peer education could help young people in Yemen fight AIDS
(News Article; Middle East)
28 Aug 2007
Ghaleb T, Yemen Observer

Calendar of Events

See All Events

October 22, 2007 - November 9, 2007
Course: Promoting gender and rights in reproductive health and HIV/AIDS
The Centre for African Family Studies (CAFS) is a regional collaborating centre of the World Health Organisation (WHO) in its worldwide effort to improve the quality and scope of reproductive health. Launched in 1996, "Operationalising Cairo and Beijing: A Training Initiative in Gender and Reproductive Health" is a collaboration of the WHO Secretariat, Women’s Health Project of the University of Witwatersrand and the Harvard School of Public Health. The Initiative offers a three-week core curriculum in gender and rights in reproductive health and HIV/AIDS for senior programme managers, planners, and policy-makers. The course uses a unique format of core modules and regional case-material. The content has been adapted to highlight regional priorities and current controversies in diverse countries in relation to the MDGs and the ICPD and Beijing Plans of Action in the context of HIV/AIDS. The course will run from 22 October to 9 November in Nairobi, Kenya. Tuition is US$ 2800. For further information see www.cafs.org or email courses@cafs.org. Course focus: The course is structured into eight modules as follows: - The gender concept and reproductive health - Gender analysis - Gender policy approaches - Social determinants of health - Gender mainstreaming in RH and HIV/AIDS programmes - Health systems analysis
E-Mail: courses@cafs.orgEvent Location: Nairobi, Kenya

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Volume 7, Number 33 3 September 2007