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Peer Reviewed

Title: Preventing transfusion-transmitted HIV infection in Latin America and the Caribbean: issues associated with blood donor interviews and sex between men.
Author: Alonso M; Mazin R; Md RM; Cruz JR
Source: Journal of Acquired Immune Deficiency Syndromes. 2009 May 1;51 Suppl 1:S67-72.
Abstract: BACKGROUND: Blood-borne transmission is the most efficient route for acquiring HIV infection, particularly through transfusion. Availability of noninfectious blood units for hemotherapy is a necessary condition for efficient functioning of health services. They have the obligation to ensure that the blood supply is safe, which includes interviewing potential donors to ascertain whether they might be at risk of being HIV infected. The interview procedures demand that blood services staff inquire potential blood donors about sexual practices associated to HIV transmission. Assumptions and misconceptions may unnecessary exclude adequate donors. METHODS: Review of published and unpublished country reports in Latin America regarding blood safety and deferral criteria related to same sexual behavior among males. RESULTS: An analysis of criteria for deferral of potential blood donors shows inconsistencies that may impact the necessary safe blood supply. CONCLUSIONS: The blood donor deferral criteria should be revised according to relevant epidemiological evidence and social legitimacy. Personnel in blood banks and hemotherapy services should be educated to conduct appropriate interviews for accepting or deferring potential donors. Potential donors and the public should be knowledgeable for them to understand the reasons why some individuals may be deferred. Health authorities should work to reduce the stigma associated with HIV, prioritize building strong and meaningful partnerships with civil society, and engage diverse sectors in the national AIDS response.
Language: English
Keywords:
LATIN AMERICA | CARIBBEAN | RESEARCH REPORT | MEN HAVING SEX WITH MEN | HIV INFECTIONS | HIV TRANSMISSION | BLOOD DONORS | SAFETY | STIGMA | HOMOSEXUALS | BLOOD TRANSFUSION | Americas | Developing Countries | Sex Behavior | Behavior | Viral Diseases | Diseases | Blood Supply | Equipment and Supplies | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Public Health | Social Problems | Sociocultural Factors | Treatment
Document Number: 341318

Title: Clandestine induced abortion: prevalence, incidence and risk factors among women in a Latin American country.
Author: Bernabe-Ortiz A; White PJ; Carcamo CP; Hughes JP; Gonzales MA; Garcia PJ; Garnett GP; Holmes KK
Source: CMAJ. 2009 Feb 3;180(3):298-304.
Abstract: BACKGROUND: Clandestine induced abortions are a public health problem in many developing countries where access to abortion services is legally restricted. We estimated the prevalence and incidence of, and risk factors for, clandestine induced abortions in a Latin American country. METHODS: We conducted a large population-based survey of women aged 18-29 years in 20 cities in Peru. We asked questions about their history of spontaneous and induced abortions, using techniques to encourage disclosure. RESULTS: Of 8242 eligible women, 7992 (97.0%) agreed to participate. The prevalence of reported induced abortions was 11.6% (95% confidence interval [CI] 10.9%-12.4%) among the 7962 women who participated in the survey. It was 13.6% (95% CI 12.8%-14.5%) among the 6559 women who reported having been sexually active. The annual incidence of induced abortion was 3.1% (95% CI 2.9%-3.3%) among the women who had ever been sexually active. In the multivariable analysis, risk factors for induced abortion were higher age at the time of the survey (odds ratio [OR] 1.11, 95% CI 1.07-1.15), lower age at first sexual intercourse (OR 0.87, 95% CI 0.84-0.91), geographic region (highlands: OR 1.56, 95% CI 1.23-1.97; jungle: OR 1.81, 95% CI 1.41-2.31 [v. coastal region]), having children (OR 0.82, 95% CI 0.68-0.98), having more than 1 sexual partner in lifetime (2 partners: OR 1.61, 95% CI 1.23-2.09; > or = 3 partners: OR 2.79, 95% CI 2.12-3.67), and having 1 or more sexual partners in the year before the survey (1 partner: OR 1.36, 95% CI 1.01-1.72; > or = 2 partners: OR 1.54, 95% CI 1.14-2.02). Overall, 49.0% (95% CI 47.6%-50.3%) of the women who reported being currently sexually active were not using contraception. INTERPRETATION: The incidence of clandestine, potentially unsafe induced abortion in Peru is as high as or higher than the rates in many countries where induced abortion is legal and safe. The provision of contraception and safer-sex education to those who require it needs to be greatly improved and could potentially reduce the rate of induced abortion.
Language: English
Keywords:
LATIN AMERICA | RESEARCH REPORT | INCIDENCE | PREVALENCE | WOMEN | RISK FACTORS | ABORTION | ABORTION, SPONTANEOUS | SEX EDUCATION | RISK ASSESSMENT | Americas | Developing Countries | Measurement | Research Methodology | Demographic Factors | Population | Biology | Fertility Control, Postconception | Family Planning | Pregnancy Complications | Diseases | Education | Evaluation
Document Number: 330468 Notification

Peer Reviewed

Title: A life course approach to patterns and trends in modern Latin American sexual behavior.
Author: Bozon M; Gayet C; Barrientos J
Source: Journal of Acquired Immune Deficiency Syndromes. 2009 May 1;51 Suppl 1:S4-S12.
Abstract: This article explores trends in sexual behavior in Latin America, envisaged from a life-course perspective, taking into account social differences. It is focused on three main issues: the timing of early sexual and reproductive events, sexual activity during adulthood, and measurement of homosexuality-bisexuality. It draws on general population data from nonspecific surveys, as surveys dealing specifically with sexual behavior are scarce in Latin American countries. A traditional feature in these societies is the huge amount of social inequality, which translates directly into social differences in sexual experience, especially among women. Despite the decline in fertility, an early start of unions and of reproductive experience remains typical of groups with lower education. Another aspect is the diversity of national patterns and gender systems, very far from the image of cultural homogeneity generally associated with this region. Data show a low prevalence of homosexuality/bisexuality, which can be a result of underreporting. The paper eventually stresses the necessity of carrying out more sexual behavior surveys of the general population in the region.
Language: English
Keywords:
LATIN AMERICA | RESEARCH REPORT | REPRODUCTIVE HEALTH | SEX BEHAVIOR | HOMOSEXUALS | CHANGES | VIOLENCE AGAINST WOMEN | Americas | Developing Countries | Health | Behavior | Social Change | Sociocultural Factors | Domestic Violence | Crime | Social Problems
Document Number: 341323

Title: Circumcision and sexual behavior: factors independently associated with human papillomavirus detection among men in the HIM study.
Author: Giuliano AR; Lazcano E; Villa LL; Flores R; Salmeron J; Lee JH; Papenfuss M; Abrahamsen M; Baggio ML; Silva R; Quiterio M
Source: International Journal of Cancer. 2009 Mar 15;124(6):1251-7.
Abstract: There is growing interest in understanding human papillomavirus (HPV) infection and related disease among men. To date there have been numerous studies reporting HPV DNA prevalence among men from several different countries, however, few have incorporated multivariable analyses to determine factors independently associated with male HPV detection. The purpose of this study was to assess the factors independently associated with HPV detection in men ages 18-70 years residing in Brazil (n = 343), Mexico (n = 312), and the United States (US) (n = 333). In samples combined from the coronal sulcus, glans penis, shaft, and scrotum, we evaluated factors associated with any, oncogenic, and nononcogenic HPV infections. In multivariable analyses, detection of any HPV infection was significantly associated with reported race of Asian/Pacific Islander, lifetime and recent number of sexual partners, and having sex in the past 3 months. Oncogenic HPV detection was independently associated with lifetime and recent number of sexual partners, and having sex in the past 3 months. NonOncogenic HPV infection was independently associated with lifetime number of sexual partners. Circumcision, assessed by clinical examination, was associated with reduced risk of HPV detection across all categories of HPV evaluated. HPV detection in men in the current study was strongly related to sexual behavior and circumcision status. Interventions such as circumcision may provide a low-cost method to reduce HPV infection.
Language: English
Keywords:
LATIN AMERICA | UNITED STATES OF AMERICA | RESEARCH REPORT | KAP SURVEYS | MULTIVARIATE ANALYSIS | CLINICAL RESEARCH | EPIDEMIOLOGIC METHODS | MEN | ASIANS | MALE CIRCUMCISION | SEX BEHAVIOR | PREVALENCE | RISK BEHAVIOR | RISK FACTORS | HPV | Americas | Developing Countries | Developed Countries | North America | Surveys | Sampling Studies | Studies | Research Methodology | Data Analysis | Demographic Factors | Population | Ethnic Groups | Cultural Background | Population Characteristics | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Behavior | Measurement | Biology | Viral Diseases | Diseases
Document Number: 330377

Peer Reviewed

Title: The experiences of districts in implementing a national incentive programme to promote safe delivery in Nepal.
Author: Powell-Jackson T; Morrison J; Tiwari S; Neupane BD; Costello AM
Source: BMC Health Services Research. 2009;9:97.
Abstract: BACKGROUND: Nepal's Safe Delivery Incentive Programme (SDIP) was introduced nationwide in 2005 with the intention of increasing utilisation of professional care at childbirth. It provided cash to women giving birth in a health facility and an incentive to the health provider for each delivery attended, either at home or in the facility. We explored early implementation of the programme at the district-level to understand the factors that have contributed to its low uptake. METHODS: We conducted in ten study districts a series of key informant interviews and focus group discussions with staff from health facilities and the district health office and other stakeholders involved in implementation. Manual content analysis was used to categorise data under emerging themes. RESULTS: Problems at the central level imposed severe constraints on the ability of district-level actors to implement the programme. These included bureaucratic delays in the disbursement of funds, difficulties in communicating the policy, both to implementers and the wider public and the complexity of the programme's design. However, some district implementers were able to cope with these problems, providing reasons for why uptake of the programme varied considerably between districts. Actions appeared to be influenced by the pressure to meet local needs, as well individual perceptions and acceptance of the programme. The experience also sheds light on some of the adverse effects of the programme on the wider health system. CONCLUSION: The success of conditional cash transfer programmes in Latin America has led to a wave of enthusiasm for their adoption in other parts of the world. However, context matters and proponents of similar programmes in south Asia should give due attention to the challenges to implementation when capacity is weak and health services inadequate.
Language: English
Keywords:
NEPAL | LATIN AMERICA | RESEARCH REPORT | FOCUS GROUPS | CHILDBIRTH | HEALTH SERVICES | OBSTACLES | ORGANIZATION AND ADMINISTRATION | HEALTH POLICY | IMPLEMENTATION | Developing Countries | Asia, Southern | Asia | Americas | Data Collection | Research Methodology | Pregnancy Outcomes | Pregnancy | Reproduction | Delivery of Health Care | Health | Policy | Political Factors | Sociocultural Factors | Programs
Document Number: 342432

10.
Title: [Study on the clinical and epidemiological characteristics of patients with human immunodeficiency virus at the walk-in service of the teaching hospital of the Federal University of Minas Gerais] Estudo das caracteristicas epidemiologicas e clinicas de pacientes portadores do
Author: Ravetti CG; Pedroso ER
Source: Revista Da Sociedade Brasileira De Medicina Tropical. 2009 Mar-Apr;42(2):114-8.
Abstract: This study had the aim of prospectively analyzing the clinical and epidemiological characteristics that lead adult patients with HIV/AIDS to seek urgent medical care in the walk-in service of the teaching hospital of the Federal University of Minas Gerais. Over a one-year period, all admissions of adult patients with HIV were evaluated. There were 118 admissions involving 99 patients. Their mean age was 39.4 years. The male-to-female ratio was 1.35:1. The length of time from diagnosis to admission was most frequently 0-5 years (40.4% of the cases). Antiretroviral therapy was being regularly used among 56.8% of the admissions. The T CD4+ lymphocyte count was less than 200 cells/mm(3) in 45.7% of the patients. The most frequent complaints were increased body temperature, diarrhea, coughing and dyspnea. The respiratory tract was the region most affected. The most common opportunistic diseases were pneumocystosis, community-acquired pneumonia, diarrheal syndrome and oral candidiasis. The demand for admissions among HIV patients represented 2.8% of all admissions, with an average length of stay of 4.6 days. Most of the patients had low T CD4+ lymphocyte counts, and almost half of them were not taking highly active antiretroviral therapy. There was a tendency towards feminization. AIDS-related diseases continue to be the most frequent occurrences within our setting.
Language: Portuguese
Keywords:
LATIN AMERICA | RESEARCH REPORT | EPIDEMIOLOGY | CLIENTS | PERSONS LIVING WITH HIV/AIDS | HOSPITALS | EMERGENCY SERVICES | UTILIZATION OF HEALTH CARE | SIGNS AND SYMPTOMS | HIV TESTING | AIDS | Americas | Developing Countries | Public Health | Health | Program Activities | Programs | Organization and Administration | HIV Infections | Viral Diseases | Diseases | Health Facilities | Delivery of Health Care | Health Services | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine
Document Number: 342169

11.

Peer Reviewed

Title: Summary of proceedings of the IUSTI Global Challenges Symposium (ISSTDR 2007/10th IUSTI World Congress).
Author: Ross JD; Garcia PJ; Zenilman J; Lewis DA; Chan R; Poder A
Source: International Journal of STD and AIDS. 2009 Feb;20(2):130-4.
Abstract: Working in our own geographical areas it can be easy to take a parochial view of sexually transmitted infection (STI) management and control. But although the problems and challenges faced by STI physicians vary enormously around the world, there are also common themes which can benefit from a common approach. By understanding how health services in different regions identify and address STI control, we can contribute and improve our local services, and contribute to the development of global STI care. At the 17th conference of the International Society for Sexually Transmitted Disease Research (ISSTDR) in Seattle, a symposium on Global Challenges was organized by the International Union against STIs (IUSTI) to provide feedback from physicians around the world on what they consider to be their greatest challenges. Moderated by Angelika Stary and Kit Fairley, the symposium included contributions from North and South America, Africa, Europe and Asia-Pacific regions. In this article, the speakers' have summarized their talks and provide an insight into the many challenges facing global STI control today. (excerpt)
Language: English
Keywords:
LATIN AMERICA | ASIA | AFRICA | SUMMARY REPORT | CONFERENCES AND CONGRESSES | REPRODUCTIVE HEALTH | HEALTH POLICY | REPRODUCTIVE RIGHTS | SEXUALLY TRANSMITTED DISEASES | TRAINING ACTIVITIES | TREATMENT | HEALTH SERVICES | Americas | Developing Countries | Health | Policy | Political Factors | Sociocultural Factors | Human Rights | Reproductive Tract Infections | Infections | Diseases | Training Programs | Education | Medical Procedures | Medicine | Delivery of Health Care
Document Number: 331168

12.

Title: Life expectancy and welfare in Latin America and the Caribbean.
Author: Soares RR
Source: Health Economics. 2009 Apr;18 Suppl 1:S37-54.
Abstract: This paper analyses the recent evolution of life expectancy in Latin American and Caribbean countries, and evaluates how much it has contributed to the overall improvements in welfare. We argue that increases in life expectancy between 1960 and 2000, which were largely independent of income, represented gains in welfare comparable to the ones derived from income growth. For countries in the region, estimates of welfare improvements accounting for health increase the numbers obtained from income alone by 40% on average. The available evidence suggests that improvements in public health infrastructure - such as provision of treated water and sewerage services - and large-scale immunization programs may have been the key factors behind the mortality reductions observed in the period.
Language: English
Keywords:
CARIBBEAN | LATIN AMERICA | CRITIQUE | LIFE EXPECTANCY | SOCIAL WELFARE | PUBLIC HEALTH | IMMUNIZATION | WATER QUALITY | SANITATION | INCOME | INEQUALITIES | MORTALITY DECLINE | Developing Countries | Americas | Length of Life | Mortality | Population Dynamics | Demographic Factors | Population | Economic Factors | Health | Primary Health Care | Health Services | Delivery of Health Care | Water | Natural Resources | Environment | Socioeconomic Factors
Document Number: 341985

13.

14.

Title: Estimates of health care system costs of unsafe abortion in Africa and Latin America.
Author: Vlassoff M; Walker D; Shearer J; Newlands D; Singh S
Source: International Perspectives on Sexual and Reproductive Health. 2009 Sep;35(3):114-121.
Abstract: Each year, 19 million unsafe abortions occur in developing countries, and an estimated five million women are treated for the resulting serious medical complications. Meanwhile, the economic impact of postabortion care on health care systems in Africa and Latin America is poorly understood (data for Asia are lacking). METHODS: Two main approaches were used to estimate the cost of postabortion care: calculating the average cost of care per patient, as represented in 20 empirical studies, and analyzing treatment costs using the WHO Mother-Baby Package model, which enumerates the costs of specific components of treatment related to postabortion complications. The average cost estimates from each approach were multiplied by the annual number of cases of hospitalization for postabortion care to generate regional cost estimates. Three methods (low severity, weighted severity, and inclusion of overhead and capital costs) were used to generate a range of per-patient and regional cost estimates. RESULTS: The average per-patient cost of postabortion care ranged from $83 in Africa to $94 in Latin America (2006 US$); estimates based on the WHO Mother-Baby Package model were between $57 and $109 per case. The health system costs of postabortion care in the two regions combined ranged from $159 million to $333 million per year. The average estimates from the two approaches were similar: $280 million and $274 million, respectively. CONCLUSIONS: The costs of treating medical complications from unsafe abortion constitute a significant financial burden on public health care systems in the developing world, and postabortion complications are a significant cause of maternal morbidity.
Spanish Abstract: Contexto: Cada a�o ocurren 19 millones de abortos inseguros en los pa�ses en desarrollo y se estima que cincomillones de mujeres reciben tratamiento por complicaciones m�dicas graves resultantes. Entretanto, es poco lo que se conoce sobre el impacto econ�mico de la atenci�n postaborto en los sistemas de salud en �frica y Am�rica Latina (en Asia no hay estudios).M�todos: Dos enfoques principales fueron utilizados para estimar el costo de la atenci�n postaborto: calcular el costo promedio de atenci�n por paciente, como se describe en 20 estudios emp�ricos; y analizar los costos de tratamiento con el modelo de PaqueteMadre-Beb� de la OMS, el cual enumera los costos de componentes espec�ficos de tratamiento relacionados con las complicaciones postaborto. Las estimaciones de costo promedio de cada enfoque se multiplicaron por el n�mero anual de casos de hospitalizaci�n por atenci�n postaborto para generar estimaciones regionales de costo. Tresm�todos (severidad baja, severidad ponderada e inclusi�n de costos administrativos y de capital) fueron usados para generar una gama de estimaciones de costo por paciente y por regi�n. Resultados: El costo promedio de la atenci�n postaborto por paciente. en US d�lares de 2006, vari� de $83 en �frica a $94 en Am�rica Latina; las estimaciones basadas en el modelo de Paquete Madre-Beb� de la OMS fueron entre $57 y $109 por caso. Los costos de la atenci�n postaborto para el sistema de salud en las dos regiones combinadas variaron entre $159 millones y $333 millones por a�o. Las estimaciones centrales de los dos enfoques fueron similares: $280 millones y $274 millones, respectivamente. Conclusiones: Los costos del tratamiento de las complicacionesm�dicas derivadas del aborto inseguro constituyen una significativa carga financiera para los sistemas de salud p�blica en elmundo en desarrollo; y las complicaciones postaborto son una causa significativa de morbilidad materna.
French Abstract: Contexte: Chaque ann�e, 19 millions d�avortements non m�dicalis�s sont pratiqu�s dans lemonde en d�veloppement et on estime � cinq millions le nombre de femmes trait�es pour les complications m�dicales graves qui en r�sultent. L�impact �conomique des soins apr�s avortement sur les syst�mes de soins de sant� d�Afrique et d�Am�rique latine est cependantmal compris (aucune �tude n�est disponible pour l�Asie). M�thodes: Deux grandes approches ont �t� adopt�es pour estimer le co�t des soins apr�s avortement: le calcul du co�t moyen des soins par patiente, tel que repr�sent� dans 20 �tudes empiriques, et l�analyse des co�ts de traitement selon le mod�le du Dossier m�re-enfant de l�OMS, qui �num�re les co�ts des composants sp�cifiques du traitement des complications de l�avortement. Les estimations de co�ts moyens obtenues de chaque approche ont �t� multipli�es par le nombre annuel de cas d�hospitalisation pour soins apr�s avortement dans le but de produire des estimations de co�ts r�gionales. Troism�thodes (faible gravit�, gravit� pond�r�e et inclusion des frais g�n�raux et co�ts en capital) ont �t� utilis�es pour g�n�rer une plage d�estimations des co�ts par patiente et r�gionaux. R�sultats: Le co�t moyen par patiente des soins apr�s avortement varie entre 83 dollars en Afrique et 94 dollars en Am�rique latine (en dollars am�ricains de 2006). Les estimations bas�es sur le mod�le du Dossier m�re-enfant de l�OMS varient entre 57 et 109 dollars par cas. La charge sanitaire des soins apr�s avortement dans les deux r�gions combin�es varie entre 159 et 333millions de dollars par an. Les deux approches produisent des estimations centrales similaires: 280 millions et 274 millions de dollars, respectivement. Conclusions: Les co�ts du traitement des complications m�dicales de l�avortement non m�dicalis� repr�sentent une charge financi�re consid�rable pour les syst�mes de soins de sant� publique du monde en d�veloppement. Les complications de l�avortement repr�sentent en outre une cause significative de morbidit� maternelle.
Language: English
Keywords:
AFRICA | LATIN AMERICA | RESEARCH REPORT | WOMEN | CLIENTS | IMPACT | POSTABORTION CARE | TREATMENT | MORBIDITY | Developing Countries | Americas | Demographic Factors | Population | Program Activities | Programs | Organization and Administration | Communication | Health Services | Delivery of Health Care | Health | Medical Procedures | Medicine | Diseases
Document Number: 343001

15.

Peer Reviewed

Title: HIV/AIDS in Latin America and the Caribbean [editorial]
Source: Lancet. 2008 Jul 26;372(9635):263.
Abstract: The amalgam of cultures and populations, socioeconomic disparities, languages, and sexual proprieties means the HIV epidemic is not homogeneous and it is hard to make generalisations from one country to the next. In this region the subject of HIV/AIDS is often swept under the carpet. Some of the common factors that characterise this region and prohibit an effective response include: generalised poverty, homophobia, gender inequality, lack of access to health-care and educational services, immigration and emigration, the absence of leadership in some countries, the lack of research into patterns of transmission, pressure from the Catholic Church that hinders prevention efforts, and laws that are inadequate in the context of the epidemic. One of the major themes at the 2008 Mexico City conference will be tackling stigma and discrimination, which is particularly pervasive in the region but also happens elsewhere. For too long the needs of vulnerable populations have been neglected. In Mexico the adoption of a rights-based perspective to address the challenge of HIV/AIDS globally needs to reaffirm that universal access to prevention, treatment, and care is a human right and that no form of stigma and discrimination will be tolerated. There is still an enormous amount to do to bring about the large reductions in HIV prevalence in the high-risk groups. The global-health architecture needs to put Latin America in their plans. Not to do so is unfair and shortsighted, because there are likely to be good returns on investment. At the meeting, people from Latin America and the Caribbean will have the chance to show the world the reality of the different epidemics the region is confronting, the responses in place, and the obstacles to overcome. Garnering the world's attention for 5 days must have a lasting impact and re-energise the HIV community in the region. (excerpt)
Language: English
Keywords:
LATIN AMERICA | CARIBBEAN | SUMMARY REPORT | CONFERENCES AND CONGRESSES | PREVALENCE | SEX WORKERS | IV DRUG USERS | HETEROSEXUALS | MEN HAVING SEX WITH MEN | HIV INFECTIONS | AIDS | STIGMA | ANTIRETROVIRAL DRUGS | PROGRAM ACCESSIBILITY | Americas | Developing Countries | Measurement | Research Methodology | Sex Behavior | Behavior | Drug Use and Abuse | Viral Diseases | Diseases | Social Problems | Sociocultural Factors | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Program Evaluation | Programs | Organization and Administration
Document Number: 328462

16.

Title: Improving youth education and services.
Author: Family Health International [FHI]
Source: Research Triangle Park, North Carolina, FHI, 2008. [2] p. (FHI Briefs: Menu of PracticesUSAID Cooperative Agreement No. GPO-A-00-05-00022-0)
Abstract: Young people are a critically important population group to address when considering education and services for better reproductive health options. Youth are at significant risk of unintended pregnancy and exposure to sexually transmitted infections (STIs). Inside or outside of marriage, more than half of young women in sub-Saharan Africa and a third in Latin America and the Caribbean deliver their first child before age 20. Every day, 5,000 young people ages 15 to 24 become infected with HIV, representing almost two million new infections each year. Strategies to improve reproductive health and family planning services for young people can address these growing problems and improve their sexual and reproductive health. These supportive strategies should also segment educational activities to the appropriate age group, ensure that program activities address desired outcomes, reduce gender inequities, and reinforce protective factors such as parental involvement and education.
Language: English
Keywords:
LATIN AMERICA | CARIBBEAN | AFRICA, SUB SAHARAN | RECOMMENDATIONS | YOUTH | PARTICIPATION | REPRODUCTIVE HEALTH | HIV PREVENTION | MASS MEDIA | COMMUNICATION STRATEGY | PROMOTION | PEER EDUCATORS | Americas | Developing Countries | Africa | Age Factors | Population Characteristics | Demographic Factors | Population | Social Behavior | Behavior | Health | HIV Infections | Viral Diseases | Diseases | Communication | Marketing | Economic Factors | Education
Document Number: 331522

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18.

Title: [Safeguarding contraceptive security in Latin America and the Caribbean] Salvaguardando la disponibilidad asegurada de insumos anticonceptivos en America Latina y El Caribe.
Author: Futures Group International. Health Policy Initiative
Source: Washington, D.C., Futures Group International, Health Policy Initiative, 2008 Sep. 4 p. (USAID Contract No. GPO-I-01-05-00040-00) This brief is also available in English: Safeguarding contraceptive security in Latin America and the Caribbean at: http://www.healthpolicyinitiative.com/index.cfm?ID=publications&get=pubID&pubID=604
Abstract: This is the Spanish version of "Safeguarding Contraceptive Security in Latin America and the Caribbean," a brief that describes HPI's contributions to the work of USAID's Regional Initiative on Contraceptive Security in Latin America and the Caribbean. It highlights key approaches and activities, outcomes to date, and provides an extensive list of resources. A CD-ROM companion to this brief is available. It contains all the resources, as well as supplemental materials.
Language: Spanish
Keywords:
LATIN AMERICA | CARIBBEAN | SUMMARY REPORT | CONTRACEPTIVE SECURITY | EDUCATIONAL METHODS | Americas | Developing Countries | Contraceptive Availability | Contraception | Family Planning | Educational Activities | Education
Document Number: 308949

19.

Title: Semi-annual report, Task Order 1, April 1, 2008-September 30, 2008. Contract No. GPO-I-01-05-00040-00.
Author: Futures Group International. Health Policy Initiative
Source: Washington, D.C., Futures Group International, Health Policy Initiative, 2008 Sep. 170 p. (USAID Contract No. GPO-I-01-05-00040-00)
Abstract: The purpose of this task order is to exercise global leadership and provide field-level programming in policy development and implementation. The assistance provided under this procurement is expected to improve the enabling environment for health, making it possible for men and women around the world to obtain and use information and services they need for better health, especially in the areas of family planning and reproductive health, HIV/AIDS, and maternal health. Task Order 1 implements a comprehensive and challenging set of corefunded activities with funding from the Office of Population and Reproductive Health, Office of HIV/AIDS, and the Office of Health, Infectious Diseases, and Nutrition. To date, the project has received field support funds from 36 country or regional programs. The bureaus for Africa, Asia and the Near East, Eastern Europe and Central Asia, and Latin America and the Caribbean also provide funds for HPI to support their regional activities in health, HIV/AIDS, family planning, and contraceptive security. For the period from April 1, 2008 to September 30, 2008, we report 72 results in 16 country and regional programs. (Excerpt)
Language: English
Keywords:
AFRICA | ASIA | EUROPE | LATIN AMERICA | CARIBBEAN | SUMMARY REPORT | MATERNAL HEALTH | HIV INFECTIONS | AIDS | HEALTH POLICY | FAMILY PLANNING | REPRODUCTIVE HEALTH | Developing Countries | Developed Countries | Americas | Health | Viral Diseases | Diseases | Policy | Political Factors | Sociocultural Factors
Document Number: 331368

20.

Title: Social marketing final report: three country overview.
Author: Georgetown University. Institute for Reproductive Health. AWARENESS Project
Source: Washington, D.C., Georgetown University, Institute for Reproductive Health, 2008 Mar. [40] p. (USAID Cooperative Agreement No. HRN-A-00-97-00011-00)
Abstract: While unmet need is growing in sub-Saharan Africa, where contraceptive prevalence is lowest, unmet need remains even in countries where contraceptive prevalence is high, such as in Latin America. Due to rapid growth in the population and increase in the numbers of couples interested in planning and spacing births, reproductive health programs in developing countries face a major challenge: to provide a greater variety of products and services to a rapidly increasing number of users. This challenge must be met in the context of stagnant or decreasing donor funding for contraception. Thus, efforts to meet this unmet need must involve cost-effectively expanding options and access to couples. Social marketing concepts have been successfully applied to increase access and use of many modern contraceptives. The present study was conducted to research the potential of socially-marketing the Standard Days Method� (SDM) in three countries: Ecuador, Benin and the Democratic Republic of the Congo (DRC). The impact of mass media campaigns on knowledge, sales and distribution of the SDM, quality of information provided by pharmacists and providers, and correct use by pharmacy and clinic SDM users was assessed. The aim of the study was to answer the following research questions: What is the impact of a mass media campaign on knowledge, attitudes, sales and free distribution of the SDM?; Can pharmacists and health providers provide high quality information about the SDM?; How do characteristics of women who purchase the SDM from pharmacies compare with those obtain it at a lower or no cost from a clinic?; Can women who purchase the SDM from a pharmacy use the method correctly? (excerpt)
Language: English
Keywords:
AFRICA, SUB SAHARAN | LATIN AMERICA | EVALUATION REPORT | CROSS-CULTURAL COMPARISONS | KAP SURVEYS | WOMEN IN DEVELOPMENT | SOCIAL MARKETING | FERTILITY AWARENESS | COST EFFECTIVENESS | MASS MEDIA | FAMILY PLANNING EDUCATION | PHARMACY DISTRIBUTION | CLINICAL DISTRIBUTION | CONTRACEPTIVE EFFECTIVENESS | Africa | Developing Countries | Americas | Evaluation | Comparative Studies | Studies | Research Methodology | Surveys | Sampling Studies | Economic Development | Economic Factors | Marketing | Family Planning | Evaluation Indexes | Quantitative Evaluation | Communication | Education | Nonclinical Distribution | Distributional Activities | Program Activities | Programs | Organization and Administration | Contraception
Document Number: 327650

21.

Title: Using geographic information system tools to address disparities in access to family planning services and commodities in Latin America and the Caribbean. Technical brief.
Author: John Snow [JSI]. DELIVER
Source: Arlington, Virginia, JSI, DELIVER, 2008 Dec. [8] p. (Technical Brief)
Abstract: This analysis shows that the Guatemalan departments with the greatest disparities in access to FP are Alta Verapaz, Quetzaltenango, Totonicap�n, and Solol�. To reduce unmet need for target populations in these departments, as well as to increase overall access to FP services and commodities, various approaches may be taken simultaneously. Some approaches and interventions may involve service delivery providers, particularly the MOH and community-based NGOs. Other strategies may be taken by advocacy and interest / community groups and local religious leaders who can explain the benefits of FP in improving family well-being and prosperity. Such strategies might include working on advocacy and community engagement; information, education, and communication; quality of service delivery; and organizational strengthening. Using GIS as a planning tool for policymakers demonstrates how existing data sources can be leveraged to gain new information about the complex issue surrounding health inequities and poverty. Approaching the problem from an inherently geographic perspective allows detailed variations in health and demographic data to be examined for spatial trends, and using GIS tools facilitates an integrated analysis of multiple variables to identify priority areas for future targeted initiatives to reduce inequity in access to FP.(Excerpts)
Language: English
Keywords:
LATIN AMERICA | CARIBBEAN | SUMMARY REPORT | USAID | INFORMATION PROCESSING | GEOGRAPHIC FACTORS | FAMILY PLANNING PROGRAMS | INEQUALITIES | CULTURE | PROGRAM ACCESSIBILITY | Americas | Developing Countries | Government Agencies | Organizations | Political Factors | Sociocultural Factors | Information | Population | Family Planning | Socioeconomic Factors | Economic Factors | Program Evaluation | Programs | Organization and Administration
Document Number: 331437

22.

23.
Title: Infection control attitudes and perceptions among dental students in Latin America: implications for dental education.
Author: Acosta-Gio AE; Borges-Yanez SA; Flores M; Herrera A; Jeronimo J
Source: International Dental Journal. 2008 Aug;58(4):187-93.
Abstract: Latin American dental schools are at diverse stages in the continuum of implementation of infection control (IC) programmes that comply with evidence-based recommendations. Poor IC training may result in low compliance and negative attitudes against patients infected with blood borne pathogens (BBP). OBJECTIVE: To evaluate students' knowledge on IC and attitudes toward occupational BBP risks, in six dental schools in Latin America. METHODS: This survey was administered to convenience samples of dental students at one school in Costa Rica; four schools in Mexico, and one in Venezuela. The questionnaire included Likert-type scale evaluations of agreement with statements. Study variables included knowledge about and confidence in recommended IC procedures, degree of concern about HIV and HBV transmission in dental settings, and attitudes toward patients infected with BBP. Possible associations between variables were analysed using Pearson's Chi square and Kruskal Wallis tests. RESULTS: Substantial numbers of students had incomplete knowledge and often lacked confidence on IC and procedures; believed that HIV and HBV could be transmitted during clinical procedures; felt worried about occupational exposure to BBP, and held prejudices towards HIV and HBV infected individuals. CONCLUSIONS: Educational efforts are needed to enhance IC teaching and compliance. Diverse educational resources and international networks for research collaboration are available from organisations specialised in IC, hopefully paving the way to harmonising regional standards.
Language: English
Keywords:
LATIN AMERICA | RESEARCH REPORT | STUDENTS | DENTISTS | MEDICAL SCHOOLS | TEACHERS | KNOWLEDGE | AIDS | HEPATITIS | HIV INFECTIONS | INFECTIONS | SAFETY | TRAINING PROGRAMS | OCCUPATIONAL HEALTH | HEALTH EDUCATION | EXPOSURE | BLOOD | Americas | Developing Countries | Education | Health Personnel | Delivery of Health Care | Health | Schools | Sociocultural Factors | Viral Diseases | Diseases | Public Health | Risk Factors | Hemic System | Physiology | Biology
Document Number: 329033

24.

Peer Reviewed

Title: Effects of HIV-prevention interventions for samples with higher and lower percents of Latinos and Latin Americans: a meta-analysis of change in condom use and knowledge.
Author: Albarracin J; Albarracin D; Durantini M
Source: AIDS and Behavior. 2008 Jul;12(4):521-43.
Abstract: This meta-analysis (N=110,092) assessed the efficacy of HIV-prevention interventions across samples with higher and lower concentrations of Latinos/Latin Americans. Findings indicated that groups with higher percents of Latinos increased condom and HIV-related knowledge to a lesser extent than groups with lower percents of Latinos/ Latin Americans. Moreover, groups with greater percents of Latinos/Latin Americans only benefited from intervention strategies that included threat-inducing arguments, whereas groups with lower percents of Latinos/Latin Americans benefited from numerous strategies. In addition, groups with greater percents of Latinos/Latin Americans increased condom use when interventions were conducted by a lay community member, whereas groups with lower percents of these groups increased condom use the most in response to experts. Not surprisingly, there were important differences among Latinos/Latin Americans with different education levels, different genders, and US/Latin American nationality. (author's)
Language: English
Keywords:
UNITED STATES OF AMERICA | LATIN AMERICA | RESEARCH REPORT | LITERATURE REVIEW | HISPANICS | HIV PREVENTION | INTERVENTIONS | PROGRAM EFFECTIVENESS | CONDOM USE | KNOWLEDGE | PROGRAM EVALUATION | HEALTH EDUCATION | Developed Countries | North America | Americas | Developing Countries | Ethnic Groups | Cultural Background | Population Characteristics | Demographic Factors | Population | HIV Infections | Viral Diseases | Diseases | Programs | Organization and Administration | Risk Reduction Behavior | Behavior | Sociocultural Factors | Education
Document Number: 328395

25.

Peer Reviewed

Title: AIDS in Latin America: assessing the current status of the epidemic and the ongoing response.
Author: Bastos FI; Caceres C; Galvao J; Veras MA; Castilho EA
Source: International Journal of Epidemiology. 2008 Aug;37(4):729-737.
Abstract: Background: This article provides a summary of the current status of the HIV/AIDS epidemic in Latin America, as well as an outline of the diverse responses to it. Methods: A search of international databases (Pubmed and ISI-Web of Science), regional databases (Scielo and Lilacs), regional and national documents and UNAIDS reports. Data are presented according to subregion. Results: In Mexico HIV remains concentrated among urban men who have sex with men (MSM), and has been growing among injecting drug users (IDU) and in rural areas in relation to migration. An increasing proportion of women among those affected is observed in all countries in Central America, the most affected region, as well as increasing the impact on other vulnerable groups, such as indigenous populations. The Andean Countries have urban epidemics concentrated among MSM. In Peru, non-traditional vulnerable populations were identified. In the Southern Cone heterosexual transmission became more relevant, probably in connection with IDU epidemics and is increasingly affecting lower income groups. Incidence rates have been declining since 2002 in Brazil, the first country to guarantee free, universal access to antiretrovirals, where one-third of drug-naive patients are still initiating treatment at an advanced stage. Generally, access to treatment has improved as a result of support from the Global Fund and other initiatives, but there are concerns regarding coverage, equity and sustainability. Conclusions: HIV is still concentrated among MSM in Latin America. Nontraditional vulnerable groups such as migrants and lower income populations, usually considered part of the general population, deserve attention. Programmes confronting sexual exclusion are still needed. Access to treatment has improved over time, but inequalities persist. (author's)
Language: English
Keywords:
LATIN AMERICA | RESEARCH REPORT | DATA ANALYSIS | MEN HAVING SEX WITH MEN | IV DRUG USERS | MIGRANT WORKERS | RURAL POPULATION | INDIGENOUS POPULATION | HIV INFECTIONS | AIDS | INEQUALITIES | GENDER ISSUES | ANTIRETROVIRAL THERAPY | TREATMENT | PROGRAM ACCESSIBILITY | Americas | Developing Countries | Research Methodology | Sex Behavior | Behavior | Drug Use and Abuse | Labor Force | Human Resources | Economic Factors | Population Characteristics | Demographic Factors | Population | Viral Diseases | Diseases | Socioeconomic Factors | Sociocultural Factors | HIV | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Program Evaluation | Programs | Organization and Administration
Document Number: 327798

26.

Peer Reviewed

Title: Optimizing resource allocation for HIV/AIDS prevention programmes: an analytical framework.
Author: Bautista-Arredondo S; Gadsden P; Harris JE; Bertozzi SM
Source: AIDS. 2008 Jul;22 Suppl 1:S67-74.
Abstract: INTRODUCTION: Although investment in HIV/AIDS prevention has increased worldwide, it remains uncertain how the additional resources can be most efficiently allocated to maximize the number of infections averted, especially at the country, regional and local levels. METHODS: Data from developing countries in Africa, Asia and Latin America were reviewed on the allocation of HIV/AIDS prevention funds in relation to the prevalence of infection, as well as budgetary allocations for specific population groups at high risk of infection, such as sex workers, intravenous drug users and men who have sex with men. The variation in unit costs of voluntary counselling and testing in five countries was also examined. RESULTS: Evidence was found of three distinct sources of inefficiency in the allocation of HIV/AIDS prevention resources: inefficiency in the mix of interventions selected; inefficient targeting of key populations; and technical inefficiency in the production of HIV prevention services. CONCLUSION:A general conceptual framework for evaluating the efficiency of HIV/AIDS prevention programmes at the country, regional and local levels is proposed. This framework stresses three equally important components of programme efficiency: cost-effectiveness (the choice of the mix of interventions); targeting (the choice of the mix of target populations); and technical efficiency (the delivery of prevention services at least cost).
Language: English
Keywords:
AFRICA | ASIA | LATIN AMERICA | HIV INFECTIONS | HIV PREVENTION | COST BENEFIT ANALYSIS | DEVELOPING COUNTRIES | PROGRAM EVALUATION | RESOURCE ALLOCATION | HEALTH SERVICES | PREVENTIVE MEDICINE | FUNDS | POPULATION AT RISK | SEX WORKERS | IV DRUG USERS | MEN HAVING SEX WITH MEN | Americas | Viral Diseases | Diseases | Quantitative Evaluation | Evaluation | Programs | Organization and Administration | Financial Activities | Economic Factors | Delivery of Health Care | Health | Medicine | Research Methodology | Sex Behavior | Behavior | Drug Use and Abuse
Document Number: 328239

27.

Title: Doctors on record: Uruguay's infant mortality stagnation and its remedies, 1895-1945.
Author: Birn AE
Source: Bulletin of the History of Medicine. 2008 Summer;82(2):311-54.
Abstract: Circa 1900 Uruguayan medical authorities prided themselves on their country's health achievement: the lowest recorded infant mortality rate in Latin America and one of the lowest rates in the world. Over the next three decades, however, these doctors' pride suffered blow after blow as Uruguay's infant mortality stagnated at roughly the same 1900 rate, while other countries experienced sustained mortality declines. Even more frustrating was the apparent inadequacy of the measures that physicians themselves had advocated and implemented. This paper explores Uruguay's infant mortality dynamics during the first half of the twentieth century through the observations, acerbic debates, analyses, policy-making, and administrative perspectives of the country's pediatricians and public health experts. Only after infant health began to be addressed as an integral part of Uruguay's burgeoning welfare state in the 1930s did infant mortality rates start to decline once again.
Language: English
Keywords:
URUGUAY | LATIN AMERICA | LITERATURE REVIEW | HISTORICAL DEMOGRAPHY | INFANT MORTALITY | PUBLIC HEALTH | INFANT HEALTH | LEGISLATION | HEALTH POLICY | Developing Countries | South America, Southern | South America | Americas | Demography | Social Sciences | Science | Sociocultural Factors | Mortality | Population Dynamics | Demographic Factors | Population | Health | Child Health | Political Factors | Policy
Document Number: 328441

28.

Peer Reviewed

Title: The medical profession and the defense and promotion of sexual and reproductive rights.
Author: Briozzo L; Fa�ndes A
Source: International Journal of Gynecology and Obstetrics. 2008 Mar;100(3):291-294.
Abstract: The values of the medical profession and other healthcare providers allow assessment of the relationship between physicians, healthcare teams, patients, and healthcare networks regarding the defense and promotion of sexual and reproductive health and rights. This paper questions the traditional model of the relationship between healthcare professionals and patients, based on the classic paternalistic role of the physician. It describes the tools available to the medical profession and healthcare teams for the promotion of sexual and reproductive rights, and proposes specific actions that would lead to improvements for women and communities. (author's)
Language: English
Keywords:
LATIN AMERICA | PHILOSOPHICAL OVERVIEW | PHYSICIANS | PROVIDERS WITH CLIENTS | REPRODUCTIVE RIGHTS | VALUE ORIENTATION | HUMAN RIGHTS | PHYSICIAN-PATIENT RELATIONS | CLIENT-STAFF RELATIONS | STAFF ATTITUDE | Americas | Developing Countries | Health Personnel | Delivery of Health Care | Health | Health Services | Political Factors | Sociocultural Factors | Psychological Factors | Behavior | Interpersonal Relations | Attitudes
Document Number: 324882

29.

Peer Reviewed

Title: Migration to the Maya Biosphere Reserve, Guatemala: Why place matters.
Author: Carr DL
Source: Human Organization. 2008 Spr;67(1):37-48.
Abstract: Most migration research examines international migration or urbanization. Yet understudied rural migrants are of critical concern for environmental conservation and rural sustainable development. Despite the fact that a relatively small number of all migrants settle remote rural frontiers, these are the agents responsible for perhaps most of the tropical deforestation on the planet. Further, rural migrants are among the most destitute people worldwide in terms of economic and human development. While some research has investigated deforestation resulting from frontier migration and frontier development, this article explores the necessary antecedent to tropical deforestation and poverty in agricultural frontiers: emigration from origin areas. The data come from a 2000 survey with community leaders and key informants in 16 municipios (municipalities) of migrant origin to the Maya Biosphere Reserve (MBR), Peten, Guatemala. A common denominator among communities of migration origin to the Peten frontier was unequal resource access, usually land. Nevertheless, factors driving resource scarcity were widely variable. Land degradation, land consolidation, and population growth prevailed in some communities but not in others. Despite similar exposure to community and regional level push factors, most people in the sampled communities did not emigrate, suggesting that any one or combination of factors is not necessarily sufficient for emigration. (author's)
Language: English
Keywords:
GUATEMALA | LATIN AMERICA | RESEARCH REPORT | RURAL POPULATION | RURAL POPULATION DISTRIBUTION | MIGRANT WORKERS | MIGRATION | NATURAL RESOURCES | POPULATION GROWTH | ENVIRONMENTAL DEGRADATION | ENVIRONMENTAL IMPACT | Central America | Americas | Developing Countries | Population Characteristics | Demographic Factors | Population | Population Distribution | Geographic Factors | Labor Force | Human Resources | Economic Factors | Population Dynamics | Environment
Document Number: 326533

30.

Title: The violence against women campaigns in Latin America: new feminist alliances.
Author: Cole S; Phillips L
Source: Feminist Criminology. 2008 Apr;3(2):145-168.
Abstract: This article urges caution in reading the backlash against gender-sensitive policies as a global phenomenon. Drawing inspiration from Latin America, the authors consider how international agreements for nation-states to adopt measures to prevent violence against women have been taken up in proactive ways through the collaboration of international organizations, national governments, and expanding and evolving women's movements. The push for the development of democratic citizenship in Latin America has opened up possibilities for bringing awareness of violence against women to a public that is in the process of engaging with a range of social justice issues and collaborating on multiple fronts. The authors argue that strategic coalitions across difference have been central to the success of the efforts to combat violence against women. They show how new feminist alliances have not only helped denormalize and deprivatize gender violence but revitalized feminist issues as part of a broad front to build progressive societies. (author's)
Language: English
Keywords:
LATIN AMERICA | BRAZIL | ECUADOR | CRITIQUE | VIOLENCE AGAINST WOMEN | POLICY DEVELOPMENT | INTERNATIONAL COOPERATION | GOVERNMENT PROGRAMS | WOMEN'S EMPOWERMENT | WOMEN'S GROUPS | GENDER ISSUES | FEMINISM | SOCIAL CHANGE | SOCIAL MOBILIZATION | Americas | Developing Countries | South America, Eastern | South America | South America, Western | Domestic Violence | Crime | Social Problems | Sociocultural Factors | Planning | Organization and Administration | Political Factors | Programs | Women's Status | Socioeconomic Factors | Economic Factors | Interest Groups
Document Number: 307972


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