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1. AIDS is Everybody's Business: Partnerships with the Private Sector: A Collection of Case Studies from UNAIDS
2. Asia-Pacific Operational Framework for Linking HIV/STI Services with Reproductive, Adolescent, Maternal, Newborn and Child Health Services
3. Baseline Survey Results for the 'Young Men as Equal Partners' Project: 10-24 Year-olds from Arua, Bushenyi, and Hoima Districts in Uganda
4. Cost and Productivity Analysis of Straight Talk Foundation Programs
5. Living on the Edge: Risk, Protection, Behavior, and Outcomes of Argentine Youth
6. My Mum has HIV: A Book for Parents Living with HIV and their Children
7. Paying the Price – The Economic Cost of Failing to Educate Girls
8. Sakhi Saheli – Promoting Gender Equity and Empowering Young Women
9. Sexual Behavior and STI/HIV Status among Adolescents in Rural Malawi: an Evaluation of the Effect of Interview Mode on Reporting
10. Terms of Marriage and Time-use Patterns of Young Wives: Evidence from Rural Bangladesh
11. Trends in Youth Reproductive Health in Ethiopia, 2000 and 2005
12. Youth-led Development – Empowering Youth to Make Poverty History
1. Epidemiology of genital chlamydia trachomatis infection among young women in Costa Rica
2. From affected to infected? Orphanhood and HIV risk among female adolescents in urban Zimbabwe
3. Growth parameters in HIV-vertically-infected adolescents on antiretroviral therapy in Rio de Janeiro, Brazil
4. HIV-related knowledge and stigma among high school students in Libya
5. Home-based sexuality education: Nigerian parents discussing sex with their children
6. Internet influences on sexual practices among young people in Hanoi, Vietnam
7. Predictors of early sexual initiation among a nationally representative sample of Nigerian adolescents
8. Problems related to menstruation amongst adolescent girls
9. Young citizens as health agents: use of drama in promoting community efficacy for HIV/AIDS
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1. AIDS is Everybody's Business: Partnerships with the Private Sector: A Collection of Case Studies from UNAIDS (2007, 32 pages, 1.35 MB)
This report includes several case studies that describe private-sector partnerships focusing on youth. Included are descriptions of partnerships with Levi's, MTV, Kimberly Clark, and other companies; their work addresses vulnerable children, and trafficked girls, among others.
Organization: UNAIDS
Contact: privatesector@unaids.org
2. Asia-Pacific Operational Framework for Linking HIV/STI Services with Reproductive, Adolescent, Maternal, Newborn and Child Health Services (2008, 46 pages, 1.67 MB)
Common underlying causes and shared solutions provide links that can increase the reach of various health services that improve the lives and well-being of young people. The framework discussed in this publication provides information about how to create these links and what factors to take into account. The emphasis of the book is on practical solutions — doing what is possible and advisable given local factors such as epidemiology, skill sets of health care providers, the current organization of the health system, resources available, and use patterns of the local health system.
Organization: World Health Organization/Western Pacific Region
Contact: bookorders@who.int
3. Baseline Survey Results for the 'Young Men as Equal Partners' Project: 10-24 Year-olds from Arua, Bushenyi, and Hoima Districts in Uganda (2007, 42 pages, 391 KB)
The goal of the Young Men as Equal Partners (YMEP) project is to contribute to the improvement of sexual and reproductive health rights of young people. To evaluate the success of the project, researchers conducted two baseline cross-sectional, population-based household surveys among young men in targeted districts in Kenya and Uganda. (For comparison, a follow-up survey will be conducted after the program has ended, in late 2008.) The survey reveals their attitudes toward and knowledge about HIV and AIDS, reproductive biology, and pregnancy prevention; their sexual experiences and behaviors; and their preferred sources of information.
Organization: Family Health International
Contact: publications@fhi.org
4. Cost and Productivity Analysis of Straight Talk Foundation Programs (2007, 22 pages, PDF, 180 KB)
The Straight Talk Foundation (STF) is one of the best-known media outlets reaching youth in Africa with information about sexual and reproductive health. The Horizons Program of Population Council sought to build the capacity of the STF staff so that they could assess the impact of their activities and examine the cost of their programs. Concepts discussed in this document could be useful to other organizations hoping to better document the costs and cost-effectiveness of their programs and to secure donor support for their activities.
Organization: Straight Talk Foundation, FHI, Horizons
Contact: strtalk@straight-talk.or.ug
5. Living on the Edge: Risk, Protection, Behavior, and Outcomes of Argentine Youth (2008)
The authors of this paper use data from a 2005 household survey of youth in four urban areas of Argentina to examine risk factors relating to family and health, education and income, substance abuse, and crime and violence. Almost half of the youth were at an elevated risk level, and one in four was at serious risk of experiencing negative outcomes or already suffering the consequences.
Organization: World Bank
Contact: pic@worldbank.org
6. My Mum has HIV: A Book for Parents Living with HIV and their Children (2007, 17 pages, 2.91 MB)
This edutainment book is intended for HIV-positive parents and their children. It supports parents in disclosing their status to their children, thereby eventually improving adherence to antiretroviral drugs. Set in Zambia, the book tells the story of a family affected by HIV, showing how the infected family members disclose their status to their family, seek treatment, and live positively with HIV.
Organization: Treatment Advocacy & Literacy Campaign (TALC)
Contact: http://www.talczambia.org/TALCweb%2097%20contact%20us.htm
7. Paying the Price – The Economic Cost of Failing to Educate Girls (2008; also available in French and Spanish)
Based on World Bank research and economic data and UNESCO education statistics, this report estimates the economic cost to 65 low- and middle-income countries of failing to educate girls to the same standard as boys is US$92 billion each year. This is just less than the US$103 billion annual overseas development aid budget of the developed world.
Organization: Plan International
Contact: info@plan-international.org
8. Sakhi Saheli – Promoting Gender Equity and Empowering Young Women (2008, 136 pages, 3.89 MB)
This training manual was prepared through a two-year-long participatory process undertaken in Mumbai, India. Young women were engaged as leaders in the design and implementation of program activities, which were subsequently validated through community-based research in selected urban slum communities in India. The manual promotes critical reflection among young women, so they can recognize and understand how gender normative attitudes and behaviors affect their everyday lives and can result in increasing their vulnerability to HIV and other reproductive health problems.
Organization: Population Council/HORIZONS, CORO, Instituto Promundo
Contact: publications@popcouncil.org
9. Sexual Behavior and STI/HIV Status among Adolescents in Rural Malawi: an Evaluation of the Effect of Interview Mode on Reporting (2008, 34 pages, 750 KB)
This paper represents an effort to investigate young people's reporting of sexual behavior. It summarizes the results from an interview-mode experiment conducted with unmarried young women aged 15-21 in which respondents were randomly assigned to either an audio computer-assisted self-interview (ACASI) or a conventional face-to-face (FTF) interview. The authors conclude that while conventional wisdom would have us believe that computerized interviewing improves the quality of data on sensitive behavior among African adolescents, their analysis raises as many questions as it answers and shows that more research on this topic is needed.
Organization: Population Council
Contact: publications@popcouncil.org
10. Terms of Marriage and Time-use Patterns of Young Wives: Evidence from Rural Bangladesh (2008, 23 pages, 437 KB)
This paper explores the relationship between marriage arrangements and daily activities of young married women, using data from an adolescent study in rural Bangladesh. Measures of marriage arrangement are payment of dowry and the relative wealth status of natal and marital families. The results show that those who paid dowry spent more time in domestic work and less time in self-care and socializing than those who did not pay dowry. These patterns of association are similar to those the authors found in an earlier study between marriage arrangements and domestic violence, where paying dowry and "marrying up" are associated with greater violence.
Organization: Population Council
Contact: publications@popcouncil.org
11. Trends in Youth Reproductive Health in Ethiopia, 2000 and 2005 (2008)
Data collected from the 2000 and the 2005 Demographic and Health Surveys show that Ethiopia has made great progress in various reproductive health indicators over the past five years. This report discusses trends in youth reproductive health, including sexual experience and marriage, contraceptive knowledge and use, fertility and childbearing, maternal and child health, and HIV/AIDS and other sexually transmitted infections.
Organization: Macro International
Contact: reports@measuredhs.com
12. Youth-led Development – Empowering Youth to Make Poverty History (2007, 44 pages, 1.45 MB)
This briefing explains why youth issues comprise a promising field for overseas development assistance. It argues that youth should be at the center of all development policy and offers examples of where young people's interventions are most effective.
Organization: Green Books, The Schumacher Society
Contact: greenbooks@gn.apc.org
1. Epidemiology of genital chlamydia trachomatis infection among young women in Costa Rica. Porras C, Safaeian M, Gonzalez P, et al. Sex Transm Dis 2008;35(5):461-8.
The authors investigated chlamydia trachomatis (Ct) epidemiology among 5,829 women 18 to 25 years old, in Costa Rica, using data from a community-based human papillomavirus vaccine trial. Before randomization, eligible women who reported previous sexual activity were interviewed and tested for Ct DNA by Hybrid Capture 2 and polymerase chain reaction-based genotyping. Multivariate models were developed. The authors conclude that it is a high-prevalence population, and they confirmed the strong link between Ct and sexual behavior of women and their partners. The establishment of a screening program in the age group included in this study should be considered. More studies are needed in developing countries to further investigate the role of intrauterine devices and the lack of protection by condoms, in addition to the interplay between Ct and other STIs, ectopy, inflammation, and epithelial abnormalities.
2. From affected to infected? Orphanhood and HIV risk among female adolescents in urban Zimbabwe. Birdthistle IJ, Floyd S, Machingura A, et al. AIDS 2008;22(6):759-66.
A random sample of 1,283 15- to 19-year-old girls in a high-density suburb of Harare was identified in a cross-sectional survey in 2004. A total of 863 agreed to be interviewed, and 839 provided a specimen for HIV and herpes simplex virus type-2 (HSV-2) testing. Sexual health outcomes, sexual behaviors, and marriage were assessed by type and timing of orphanhood. Half of the participants were single or double orphans. Prevalence of HIV and HSV-2 was higher among orphans than non-orphans [17 versus 12%; age-adjusted odds ratio (aOR) = 1.5; 95% confidence interval (CI) 1.0-2.3]. Associations with orphan status were only significant among the 743 never-married participants. In comparison with non-orphaned peers, increased sexual risk (defined as HSV2-positive, HIV-positive or ever pregnant) was seen among maternal orphans (aOR = 3.6; 95% CI, 1.7-7.8), double orphans (aOR = 2.4; 95% CI, 1.2-4.9), and girls who lost their father before age 12 (aOR = 2.1; 95% CI, 0.9-4.8) but not later (aOR = 0.8; 95% CI, 0.3-2.2). Maternal and double orphans were most likely to initiate sex early and to have had multiple partners. Maternal orphans were least likely to have used a condom at first sex, and to have a regular sexual partner. Experience of forced sex was high in all groups. The authors conclude that in urban Zimbabwe, female adolescent orphans are at increased risk of HIV and HSV-2 infection. Infection rates vary by type and age of orphanhood and marital status, and are associated with high-risk sexual behaviors.
3. Growth parameters in HIV-vertically-infected adolescents on antiretroviral therapy in Rio de Janeiro, Brazil. Buonora S, Nogueira S, Pone MV, et al. Ann Trop Paediatr 2008;28(1):59-64.
This study assesses the impact of HIV infection on growth parameters of adolescents who acquired HIV vertically. This retrospective, longitudinal study involved adolescents aged 10-20 years with vertically-acquired HIV infection who were followed up in one of the three main referral centers for pediatric HIV/AIDS in Rio de Janeiro, Brazil. Length, weight, and variables related to demographic, clinical, and laboratory issues were analyzed. Median age of the 108 youth enrolled was 12.7 years, 61 (56.5%) were female, and median duration of follow-up was 97.2 months. The difference between the baseline and final weight Z-scores was -0.31 (p=0.02). Patients with final weight Z-scores < -2 used more ART regimens (average 4.13) than those with Z-scores > -2 (average 2.90, p < 0.01) and also had a lower final CD4+ cell percentage — average 19% vs. 24% (p < 0.01), respectively. The difference between baseline and final-height Z-scores was -0.27 (p < 0.01). Several factors were associated with a final-height Z-score < -2: clinical stage C during follow-up (RR 1.60, 95% CI 1.11-2.31), chronic diarrhea during follow-up (RR 2.02, 95% CI 1.04-3.90), HAART use (RR 1.41, 95% CI 1.16-1.71), number of ART regimens (p < 0.01), and final CD4+ cell percentage (p < 0.01). In multivariate analysis, presentation in clinical stage C during follow-up was the only significant variable (OR 4.04, 95% CI 1.23-13.28). The authors conclude that, even on HAART, HIV-infected adolescents have lower growth parameters than the normal population, and that this is associated with a worse prognosis.
4. HIV-related knowledge and stigma among high school students in Libya. El-Gadi S, Abudher A, Sammud M. Int J STD AIDS 2008;19(3):178-83.
This study was part of a large knowledge, attitude, beliefs, and practice survey, for which a self-administrated questionnaire was used. The response rates were 83-92%. Despite a high level of stigma shown by both boys and girls in the study, 91% of students supported providing free care to HIV-infected individuals. The HIV intervention programs for young people should operate within a comprehensive strategy to combat HIV/AIDS. The stigmatizing and the discriminatory perceptions of HIV-infected individuals should be addressed as part of the education campaign.
5. Home-based sexuality education: Nigerian parents discussing sex with their children. Izugbara CO. Youth Soc 2008;39(4):575-600.
This article explores how and why parents in rural Nigeria discuss sexuality-related matters with their adolescent children. The data presented demonstrate that parents portray sexuality as dangerous, unpleasant, and unsavory while speaking to their children about it. Many Nigerian parents who discuss sexuality issues with their adolescent children compound the difficulties young people encounter in accessing accurate and adequate sexuality information and in developing their own sexual identity. Interventions that will enable parents to both give and allow their children early access to quality information on matters of sexuality are urgently needed.
6. Internet influences on sexual practices among young people in Hanoi, Vietnam. Ngo AD, Ross MW, Ratliff EA. Cult Health Sex 2008;10(Suppl 1):S201-S213.
The authors conducted a qualitative study to examine how young people (aged 15-19 years) in Hanoi, Vietnam used the Internet to develop sexual practices and identities. Their analysis of texts from focus groups, in-depth interviews, chat scripts, and field notes reveals how the Internet is used to assemble sexual information that was not available from other sources such as the family and school. Young people's narratives also show how they use the Internet as a medium for expressing sexual identities and desires. In light of these findings, the authors suggest expanding sex education to include issues that are important to young people, such as emotions and relationships, rather than simply focusing more narrowly on reproduction, public health, and other interests of the state.
7. Predictors of early sexual initiation among a nationally representative sample of Nigerian adolescents (PDF, 14 pages, 299 KB). Fatusi AO, Blum RW. BMC Pub Health 2008;8(Article No. 136).
Interviewer-collected data of 2,070 never-married adolescents aged 15-19 years was analyzed to determine association between age of sexual debut and demographic, psychosocial, and community factors. Analysis was carried out with two different models — one with and the other without psychosocial factors. A fifth of respondents (18% males; 22% females) were sexually experienced. In the south, 24.3% of males and 28.7% of females had initiated sex, compared to 12.1% of males and 13.1% of females in the north (p < 0.001). In the first model, only region was significantly associated with adolescent sexual initiation among both males and females; however, educational attainment and age were also significant among males. In the second (psychosocial) model, factors associated with adolescent sexual debut for both genders included more positive attitudes regarding condom efficacy and more positive attitudes to family planning use. A greater perception of condom access and alcohol use among males and positive gender-related attitudes among females were also associated with increased likelihood of adolescent sexual initiation. Conversely, personal attitudes in favor of delayed sexual debut were associated with lower sexual debut among both males and females. Additionally, higher level of religiosity was associated with lower sexual debut rates among females. Understanding the factors that are associated with premarital sexual debut will assist programs in developing more effective risk-prevention interventions.
8. Problems related to menstruation amongst adolescent girls (PDF, 7 pages, 78 KB). Sharma P, Malhotra C, Taneja DK, et al. Indian J Pediatr 2008;75(2):125-9.
Data were collected from 198 girls ages 13-19 in New Delhi, India who had had menarche for at least one year at the time of the study. The data collection method was personal interviews on a pre-tested, semi-structured questionnaire. The questions covered menstrual problems, regularity of menses in last three cycles of menstruation, and the effect of these problems on the daily routine. Percentages were calculated for drawing inferences. Dysmenorrhea (67.2%) was the most common problem, and 63.1% of the participants had symptoms of pre-menstrual syndrome. Other related problems were present in 55.1% of participants. The daily routine of 60% of the girls was affected due to prolonged bed rest, missed social activities, disturbed sleep, and decreased appetite. About 17% had to miss a class, and 25% had to abstain from work. Mothers and friends were the most common source of information on the issue. The authors conclude that adolescent girls should be screened for menstruation-related problems and provided with counseling services and relevant information on possible treatment options. Moreover, there is a need to design menstrual health programs for adolescents.
9. Young citizens as health agents: use of drama in promoting community efficacy for HIV/AIDS. Kamo N, Carlson M, Brennan RT, et al. Am J Public Health 2008;98(2):201-4.
A community-based cluster randomized control trial in a medium-sized municipality in Tanzania was designed to increase local competence to control HIV/AIDS through actions initiated by children and adolescents aged 10 to 14 years. Representative groups from the 15 treatment communities reached mutual understanding about their objectives as health agents, prioritized their actions, and skillfully applied community drama ("skits") to impart knowledge about the social realities and the microbiology of HIV/AIDS. In independently conducted surveys of neighborhood residents, differences were found between adults who did and did not witness the skits in their beliefs about the efficacy of children as HIV/AIDS primary change agents.
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