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Volume 3, Number 13
31 March 2003
FAMILY PLANNING / REPRODUCTIVE HEALTH RESEARCH
Can
Women's Childbearing and Contraceptive Intentions Predict Contraceptive
Demand? Findings from a Longitudinal Study in Central India
(research article)
Women's childbearing and contraceptive behaviors were compared with
the intentions they had stated in the 1992-1993 NFHS, and logistic
regression was performed to analyze the association between socioeconomic
and demographic variables and inconsistent behavior. Among women
who were fecund and married in 1992-1993, 29% of those who intended
to have children and 61% of those who intended not to have children
failed to adhere to their intentions by 1999. Fifty-one percent
of women who were not practicing contraception at the time of the
NFHS but planned to do so acted against their intention by 1999,
as did 29% of those who planned not to use a method.
Beliefs
as Predictors of Condom Use by Injecting Drug Users in Treatment
(research abstract)
This study was conducted to clarify (1) the extent to which health
beliefs selected from Protection Motivation Theory can combine to
correctly predict condom use in injecting drug users (IDUs) and
(2) which of the beliefs were most influential in this distinction.
Results indicated that these beliefs were significant predictors
of condom use. IDUs were confident of their ability to use condoms,
considered themselves highly vulnerable to HIV infection from casual
partners, and were confident in the efficacy of condoms to protect
them from AIDS. However, the majority of IDUs were not condom users,
particularly with 'regular' partners. Findings suggest that HIV
prevention programmes should target beliefs regarding risks from
known partners, perceived norms, and negative consequences of condom
use in order to increase condom use by IDUs in treatment.
Sponge
Versus Diaphragm for Contraception (Cochrane review)
All randomized controlled trials comparing the vaginal contraceptive
sponge (Today; Collatex) with any diaphragm used with nonoxynol-9
to prevent pregnancy were included in this review. The sponge was
statistically significantly less effective in preventing pregnancy
than was the diaphragm.. Similarly, discontinuation rates at 12
months were higher with the sponge than with the diaphragm (odds
ratio 1.3) Allergic-type reactions were more common with the sponge
in both trials, although the frequency of discontinuation for discomfort
differed in the two trials.
Risks
and Benefits, Advantages and Disadvantages of Levonorgestrel-releasing
Contraceptive Implants (PubMed abstract)
This article reviews the pregnancy rates, side effects, and acceptability
of Norplant ® and Jadelle ®.
Appropriate
Methods for Analyzing the Effect of Method Choice on Contraceptive
Discontinuation (PubMed abstract)
Using data from the 1997 Indonesia Demographic and Health Survey,
the authors apply a multilevel multi-process model to examine the
impact of method choice on three types of contraceptive discontinuation.
They confirm that method choice is endogenous to the processes of
contraceptive abandonment and method switching, but not failure.
Evidence-based
Treatment Guidelines for Sexually Transmitted Infections Developed
with and for Female Sex Workers (research abstract)
Evidence-based STI management guidelines were developed with SW
representatives in Madagascar. At baseline, two of 986 SWs were
HIV+; 77.5% of the SWs in Antananarivo and 73.5% in Tamatave had
at least one curable STI. Two months post-treatment, 64.9% of 458
SWs in Antananarivo and 57.4% of 481 women in Tamatave had at least
one STI.
Contraception
and Society (research abstract)
Discusses the evolution of contraception and how it has shaped current
society.
An
Investigation of the Effectiveness of Testosterone Implants in Combination
with the Prolactin Inhibitor Quinagolide in the Suppression of Spermatogenesis
in Men (research abstract)
This study investigated whether concomitant suppression of prolactin
(PRL) with the non-ergot, dopamine receptor agonist quinagolide
(Q), would enhance the efficacy of testosterone in its inhibition
of spermatogenesis in healthy eugonadal men. The results showed
that inhibition of PRL did not confer additional efficacy in spermatogenic
suppression in men.
FAMILY PLANNING / REPRODUCTIVE HEALTH NEWS
US:
Abstinence Education Gains Record Funding (news article)
The US federal government's investment in abstinence education should
reach a record high of about $120 million this year.
Female Health Announces Proprietary Second Generation Product (news
article)
The Female Health Company announced that it has filed a patent on
a second generation version of its female condom. The company initiated
development to find a product that presented the same physical and
very positive clinical and acceptability performance but that could
be produced at a significantly reduced cost compared to its current
product.
UK:
Contraception and Sexual Behaviour (news article)
In 2001-2002, 75% of women (aged 16 to 49) in Great Britain used
some form of contraception. The pill continued to be the most common
method of contraception, used by 28% of women, followed by the male
condom (21%).
India:
Condom Vends in MCD's Toilets (news article)
The Municipal Corporation of Delhi (MCD), as part of its AIDS awareness
campaign, will introduce condom vending machines in its BOT (Build
Operation and Transfer) toilets, in the capital. The Delhi government
during this year's budget session will also be introducing an AIDS
awareness and prevention bill.
HIV/AIDS: Muslims Say No to Condom Use (news article)
Muslim scholars have called for committed effort between the government
and religious bodies to fight the HIV/AIDS scourge. The Kenya Council
of Imams and Scholars denied earlier reports appearing in a section
of the press that Muslims supported the use of condoms as a way
to curb the spread of HIV. The council of Imams and scholars said
sex outside marriage is criminal and attracts a very stiff penalty.
FAMILY PLANNING / REPRODUCTIVE HEALTH LAW AND POLICY
US:
Billboards Promise Addicts Money for Birth Control (news article)
The group Project Prevention says its mission is to reduce the number
of drug-affected pregnancies, and to do it, they're offering $200
to any addict after the person proves they begun long-term birth
control.
Unmet
Need for Family Planning: Recent Trends and Their Implications for
Programs 
(policy brief)
Obstacles other than physical access to services prevent many women
from using family planning. This unmet need for contraception can
lead to unintended pregnancies, which pose risks for women, their
families, and societies.
HIV / AIDS RESEARCH
Condom
Use and the Accuracy of AIDS Knowledge In Côte d'Ivoire
(research article)
Data from the 1994 Côte d'Ivoire Demographic and Health Survey
were analyzed and logistic regressions performed separately by sex
to determine whether the accuracy of men's and women's knowledge
about AIDS predicted condom use at their most recent sexual intercourse.
Accuracy of knowledge about AIDS did not significantly predict condom
use.
Evaluating
Two Adjustment Methods to Extrapolate HIV Prevalence from Pregnant
Women to the General Female Population in Sub-Saharan Africa
(research abstract)
HIV prevalence among ANC attendees in areas of Uganda, Tanzania,
and Zambia were adjusted by using (1) a method that accounts for
differences in age-specific fertility by HIV serostatus and by (2)
a method that accounts for differences in HIV prevalence by fertility
risk category and parity. The HIV prevalence among women in the
general population could be estimated fairly accurately by these
methods in settings with mature epidemics.
Human
Immunodeficiency Virus Type 1 Infection and Replication in Normal
Human Oral Keratinocytes (research abstract)
Related news article:
Study Looks at How HIV May Spread Through Oral Sex
Laboratory studies of mouth tissue suggest that unprotected oral
sex does have the potential to transmit HIV, but an expert said
it is still less risky than other routes of transmission.
Assessing
the Magnitude of the HIV/AIDS Epidemic in Burma (research abstract)
Using data from the 1999 national HIV sentinel surveillance and
available population data, the authors generated estimates of Burma's
HIV burden in 1999. HIV prevalence was estimated to be at least
3.46% among adults aged 15-44 years; 5700 infants were born with
HIV infection in 1999.
Women
Living with HIV: Does Sex and Gender Matter? A Current Literature
Review (PubMed abstract)
The authors reviewed abstracts from the 9th Conference on Retroviruses
and Opportunistic Infections in Seattle and the XIV World AIDS Conference
in Barcelona in 2002, complemented by further Internet research.
They found that if women die faster of AIDS, it is a matter of gender,
but not sex. Providing access to treatment, psychosocial and behavioural
aspects of adherence are mediated as a function of gender. Missing
data on side effects and pharmacokinetic profiles of various treatments
in women may be explained by the lack of regulatory requirements
for statistically meaningful participation of women and sex-specific
analysis as licensing criteria for drug approval.
A
Community Randomized Controlled Trial to Investigate Impact of Improved
STD Management and Behavioural Interventions on HIV Incidence in
Rural Masaka, Uganda: Trial Design, Methods and Baseline Findings
(research abstract)
The authors used a three-arm community randomized controlled trial
of 18 rural communities (approximately 96,000 adults) in southwest
Uganda, with standardized behavioral intervention in arms A and
B. Arm C communities received routine government health service.
Approximately 15,000 adults (72% of the eligible population) were
enrolled at baseline. HIV baseline prevalence rates were 9% to 10%
in all arms; demographic and behavioural characteristics and STD
prevalence were also similar.
HIV / AIDS NEWS
Despite
HIV/AIDS Danger, Casual Sex Remains the Name of the Game for Namibian
Men (news article)
A report by a private social research firm has revealed that almost
half of Namibian men have more than one casual sexual partner, although
94% of them are aware of the fact the HIV-AIDS is transmitted through
sex.
Jamaica:
Employers Urged to Distribute Condoms at the Workplace (news
article)
Presenters at a workshop suggested that local businesses look at
condom distribution and the use of condom vending machines in the
workplace to help stem the spread of HIV/AIDS in the island.
East
Africa: Traditional Culture Spreading HIV/AIDS (feature article)
Elements of traditional culture and subservient female roles in
Kenya, Uganda, and Tanzania are pushing HIV/AIDS infection rates
up to unprecedented levels.
MATERNAL AND CHILD HEALTH RESEARCH
Maternal
Oral Contraceptive Use and Atopic Diseases in the Offspring
(research abstract)
A total of 2754 children aged 5 to 14 years participated in a cross-sectional
survey in 1998-1999. Maternal oral contraceptive (OC) use before
birth was associated with a higher risk of atopic diseases in the
offspring compared with children of mothers who had never taken
OC [asthma: odds ratio (OR) 1.6; 95% confidence interval (CI): 0.9-3.0;
allergic rhinitis: OR 1.5; CI: 0.96-2.2; atopic eczema: OR 2.6;
CI: 1.6-4.3; atopic sensitization: OR 1.5; CI: 0.97-2.2]. The authors
conclude that the results of their study raise doubts in a true
biological association between OC use and atopic diseases.
Maternal
Mortality in Pakistan: Compilation of Available Data (PubMed
abstract)
The author compiled available information (both hospital and community
based) on the maternal mortality ratios (MMRs) and the causes of
maternal deaths in Pakistan from varioius sources. MMRs reported
from hospitals varied between 17 in a private tertiary hospital
to 2,736 in a government tertiary hospital. In the community the
range was from 160 to 673, depending upon the region. The most common
cause of death was hemorrhage, followed by eclampsia and sepsis.
The
Male Disadvantage and the Seasonal Rhythm of Sex Ratio at the Time
of Conception (research abstract)
Related news article: How
Nature Protects Fragile Men
Scientists believe that men are more likely to be conceived so that
they are born during warmer months, to give them a better chance
of survival.
Effect
of Maternal Confidence on Breastfeeding Duration: An Application
of Breastfeeding Self-Efficacy Theory (research abstract)
A prospective survey was conducted with 300 women in the last trimester
of pregnancy recruited from the antenatal clinic of a large metropolitan
hospital in Brisbane, Australia. Telephone interviews were conducted
at 1 week and 4 months postpartum to assess infant feeding methods
and breastfeeding confidence using the Breastfeeding Self-Efficacy
Scale. Although 92% of participants initiated breastfeeding, by
4 months postpartum almost 40% of mothers discontinued and only
28.6% were breastfeeding exclusively. Mothers with high breastfeeding
self-efficacy were significantly more likely to be breastfeeding,
and doing so exclusively, at 1 week and 4 months postpartum. The
authors conclude that integrating self-efficacy enhancing strategies
may improve the quality of care that health care professionals deliver
and may increase a new mother's confidence in her ability to breastfeed,
and to persevere if she does encounter difficulties.
Magnitude
of Maternal Morbidity During Labor and Delivery: United States,
1993-1997 (research abstract)
Related news article: More
than a Third of Mothers Suffer Health Problems During Labor and
Delivery
An analysis of more than 19 million deliveries that occurred between
1993 and 1997 revealed that nearly 1.2 million women annually, or
31% of those who gave birth, suffered an obstetric complication,
a pre-existing medical condition, or both.
MATERNAL AND CHILD HEALTH NEWS
Suitcases
Packed with 28 Chinese Babies for Sale (news article)
Police in southwestern China discovered 28 baby girls hidden in
nylon suitcases on a long-distance bus, apparently destined to be
sold, police and a state-run newspaper said.
MEN'S HEALTH RESEARCH
The
Male Contraceptive Regimen of Testosterone and Levonorgestrel Significantly
Increases Lean Mass in Healthy Young Men in 4 Weeks, but Attenuates
a Decrease in Fat Mass Induced by Testosterone Alone (research
abstract)
This study assessed the effect of testosterone-progestin combinations
on body composition in healthy, young, eugonadal men who were randomized
into four combinations of exogenous Testosterone (T) and the progestin,
levonorgestrel (LNG). Results showed that in young eugonadal men
1) T alone rapidly increases lean mass and decreases fat mass in
4 to 8 weeks; 2) T+LNG rapidly increases lean mass, but has no effect
on fat mass; and 3) LNG alone increases fat mass. The authors conclude
that these findings suggest that androgen-based male hormonal contraceptives
might have favorable effects on body composition.
Male
Involvement in Family Planning in Rural Vietnam: An Application
of the Transtheoretical Model (research abstract)
Transtheoretical Model of behavior change was used in this study,
carried out in rural Vietnam with 201 eligible participants, to
examine men's involvement in general contraception and intrauterine
device (IUD) use by their wives. The study tested whether the constructs
of the model, decisional balance and self-efficacy, are sensitive
to differences in stages of change. Disadvantages of IUD use for
men in precontemplation stage were significantly higher than those
in the action/maintenance stages, while the reverse was true for
self-efficacy for convincing their wives to use an IUD. Interventions
that are targeted to stage of change, that seek to reduce cons,
and that increase self-efficacy have the potential to influence
male involvement in IUD adoption by their wives.
Responses
of Male Inmates to Primary Partner Requests for Condom Use: Effects
of Message Content and Domestic Violence History (research abstract)
This study investigated how domestically violent and nonviolent
men reacted to various condom negotiation approaches. Scenarios,
in which the partner provides a justification for a condom request
or the context suggests one, were presented to 84 randomly selected
male inmates from a county jail in New Jersey (US). The results
suggest that creative strategies that do not call into question
the fidelity or commitment of either partner may be more effective
in getting men to use condoms and/or to not react violently.
HIV
Prevalence and Sexual Behaviour of Male Clients of Brothels' Prostitutes
in Dakar, Senegal (research abstract)
This study reports the results of research designed to determine
the prevalence of HIV infection in a group of male clients of brothel
prostitutes, and to describe characteristics associated with HIV
infection in Dakar, Senegal. HIV prevalence in clients appeared
to be much higher than the prevalence in the general population,
and HIV-infected clients were older than HIV-negative clients.
MEN'S HEALTH NEWS
Prostate
Cancer May Raise Risk for Breast Cancer (news article)
Men diagnosed with prostate cancer are slightly more likely than
other men to develop another type of cancer, including breast cancer.
Sperm
May "Smell" Their Way to the Egg (news article)
Human sperm may literally sniff their way to an egg in their quest
for fertilisation
British
Firm Tests Inhaled Anti-Impotence Drug (news article)
A British drug delivery company has said it was starting Phase II
clinical trials to test the effectiveness of an inhaled drug for
treating impotence.
POPULATION RESEARCH
An
Overview of Population and Development in Vietnam (research
article)
This article reviews the dramatic population changes that have taken
place in Vietnam.
POPULATION NEWS
Europe
Shrinking as Birthrates Decline (news article)
Europe's population will continue to decline for decades even if
birthrates improve significantly, researchers have calculated. Trends
towards smaller families and later motherhood mean that there are
too few women of childbearing age to reverse the decline in the
near future, according to a new Austrian study. At present, 1.5
babies are born for every European Union woman, when two births
are required for the population "replacement rate" to
be maintained. The year 2000 marked a turning point, with the population's
"momentum" becoming negative.
Pakistan's
Population Could Double by 2035 (news article)
Population planners here on Saturday said the country's population
is likely to double by 2035, prompting policy makers to take a string
of sustained measures for revitalizing the social, health and education
sectors to meet the forthcoming challenges.
Nepal:
Migration - Boon Or Bane? (news article)
Amid an increase in mobility and migration, a growing number of
young villagers are finding new ways of improving their livelihood.
As most of the migrant population are illiterate and unaware, however,
the HIV virus is fast spreading through this group into the rural
hinterland as well as in urban areas. The economic benefits generated
by greater mobility and migration are immense, but they risk being
doomed by a growth in HIV infections. Considered an economic boon
for rural areas, migration could turn into a bane in terms of its
long-term economic implications for the country.
Chile:
New Census Indicates Closing Gap with Developed Countries (news
article)
With an aging population, a burgeoning middle class, and smaller
families, Chile's population is starting to resemble those of developed
countries, according to the recent national census. Chilean living
standards over the past decade have improved, and average yearly
economic growth was about 7% during the 1990s.
Australia: Birth Rates at Record Low (news article)
Australian women give birth to an average 1.75 children, compared
with 2.9 children in the 1970s, according to the Reproductive Health
Indicators Australia 2002 report.
WOMEN'S HEALTH RESEARCH
Evaluation
of the Care of Women Living with HIV/AIDS in São Paulo, Brazil
(PubMed abstract)
Patients from HIV/AIDS reference clinics answered a questionnaire
on circumstances of HIV testing, health personnel's attitudes at
diagnosis, adherence to follow-up, services provided by care centers,
and access to laboratory monitoring. 1,068 women were interviewed.
The majority had been referred to testing without counseling. Post-test
counseling was provided depending on the testing center. Some patients
reported having felt indifference, discrimination or criticism at
diagnosis, depending on where testing
occurred. Compliance to medical follow-up was associated to adherence
to antiretrovirals and to shorter time since diagnosis.
Effects
of Estrogen Plus Progestin on Health-Related Quality of Life
(research abstract)
Related news article: Hormone
Pills Should be Used Only for Menopause Symptoms
Hormone replacement pills should not be used for any reason other
than as brief treatment to help women through the worst symptoms
of menopause, new research concludes.
Leaving
sex work: barriers, facilitating factors and consequences for female
sex workers in northern Thailand (research abstract)
This paper presents findings from a qualitative study about factors
affecting women's ability to leave sex work and influencing their
lives after leaving. We interviewed 42 current and former female
sex workers (FSWs) drawn from a cohort study of 500 FSWs in northern
Thailand. All but one of the participants had quit sex work at least
once. The majority experienced one or more quit-re-entry-quit cycles.
Women's ability and decisions to leave sex work were determined
primarily by four factors: economic situation, relationship with
a steady partner, attitudes towards sex work, and HIV/AIDS experience.
WOMEN'S HEALTH NEWS
Mali:
Rights organisation concerned about violence against women (news
article)
The World Organisation Against Torture (OMCT) expressed grave concern
over reports of violence against women in Mali. Apart from forced
marriages and polygamy, which are common, 24% of Malian women marry
before the age of 15 years and 94% undergo female genital mutilation,
OMCT said in a report to the UN Human Rights Committee.
YOUTH RESEARCH
Reproductive
Health Risk and Protective Factors Among Unmarried Youth in Ghana
(research article)
A nationally representative sample of 3,739 unmarried 12-24-year-olds
were surveyed to assess the effects of individual and contextual
factors on sexual behavior and condom use. Forty-one percent of
female and 36% of male youth reported being sexually experienced.
Although Ghanaian youth are knowledgeable about condoms, only 24%
of sexually experienced males and 20% of females reported consistent
condom use with their current or most recent partner.
Postnatal
Home Visits in Teenage Mothers: A Randomised Controlled Trial
(research abstract)
Teenage pregnancies are associated with negative socioeconomic effects.
The aim of this Australian study was to ascertain whether a postnatal
home-visiting service for teenage mothers younger than age 18 years
could reduce the frequency of adverse neonatal outcomes and improve
knowledge of contraception, breastfeeding, and infant vaccination
schedules in this parent group. The authors concluded that postnatal
home-visiting services by nurse-midwives reduce adverse neonatal
events and improve contraception outcomes among teenage mothers,
but do not affect breastfeeding or infant vaccination knowledge
or compliance.
YOUTH NEWS
China:
Sex-ed VCDs Debut in Hainan (news article)
China's first VCD series on sex education for primary and middle
school students was recently issued in Hainan Province. The VCDs,
showing a series of TV lectures on sex education for youngsters,
have different editions targeted at students in primary, junior
middle, and high schools. The series focuses on self protection,
AIDS prevention, and sexual psychology.
BOOKS / BOOK REVIEWS
Population:
New UN Demographic Yearbook Released (book)
The UN Department of Economic and Social Affairs Statistics Division
released the Demographic Yearbook 2000, a source of information
on national population statistics for 233 countries. Among the subjects
covered are population size and composition, fertility, mortality,
marriages, and divorces. One of the highlights of this year's issue
is the inclusion of elderly support ratios -- the number of working
age persons (15-64 years) per elderly persons (age 65 and over).
PROFILES / SPECIAL REPORTS / RESOURCES
Youth-Adult
Partnerships Show Promise
(report)
Anecdotal evidence suggests that youth involvement can go beyond
program interventions to include collaborations with adults in policy,
management, and evaluation areas as well.
Condoms and Sexually Active Youth (report)
Condom use among sexually active youth varies widely, due to issues
including risk perception, social support, gender, and knowledge
gaps.
Multisectoral
Programs Link Intervention Efforts
(report)
In Haiti, a coordinated effort addresses health, agriculture, education,
and income generation needs of young people through a single project.
Men
in Maternity Study: A Summary of the Findings from Pre-Intervention
Interviews with Women and Their Husbands Attending Antenatal Clinics
at ESIC Facilities in Delhi
(report)
A report from the 3-year study that began in March 2000, called
Men in Maternity, which is collaborating with the Employees State
Insurance Corporation (ESIC) in New Delhi and uses a quasi-experimental
study design to examine the effects of the intervention.
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