1.  Peer Reviewed Title: Teenagers and emergency contraception in the UK: a focus group study of salient beliefs using concepts from the Theory of Planned Behaviour. Author: Bayley J; Brown K; Wallace L Source: European Journal of Contraception and Reproductive Health Care. 2009 Jun;14(3):196-206. Abstract: OBJECTIVES: To explore teenagers' beliefs about emergency contraception (EC) within a Theory of Planned Behaviour (TPB) framework. METHODS: Six single sex focus groups comprising a total of 25 female and 23 male pupils aged 13-16 years conducted in schools in Central England. RESULTS: Attitudes to emergency contraception (EC) were mainly positive about the rewards of avoiding teenage pregnancy. Participants had positive beliefs about the effectiveness of EC, although knowledge of crucial time limits varied. EC use was more socially acceptable than teenage pregnancy, yet both outcomes were perceived negatively. Motivation to comply with social pressure was influenced by the appraisal of individuals' intentions. Participants reported high self efficacy in accessing EC, but had concerns over confidentiality and access. CONCLUSIONS: Desire to avoid pregnancy was high in this group, but practical factors and attitudes may be more important for those ambivalent about pregnancy. Adolescents perceive accessing EC as difficult, are concerned about confidentiality, and anticipate negative reactions from staff. Data support the TPB as a suitable framework for understanding attitudes to EC use. Further research should apply quantitative TPB measures to EC use in a wider teenage sample in order to identify potential psychological factors to target in an intervention. Language: English Keywords: UNITED KINGDOM | RESEARCH REPORT | FOCUS GROUPS | ADOLESCENTS | STUDENTS | EMERGENCY CONTRACEPTION | ATTITUDES | BELIEFS | KNOWLEDGE | PEER PRESSURE | MOTIVATION | CONTRACEPTIVE USAGE | Developed Countries | Europe, Western | Europe | Data Collection | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Education | Contraception | Family Planning | Psychological Factors | Behavior | Culture | Sociocultural Factors | Psychosocial Factors Document Number: 341801 |
| 2. Peer Reviewed Title: Contraceptive discontinuation and non-use in Santarem, Brazilian Amazon. Author: D'Antona Ade O; Chelekis JA; D'Antona MF; Siqueira AD Source: Cadernos De Saude Publica. 2009 Sep;25(9):2021-32. Abstract: In this paper we discuss the causes of non-adherence to reversible contraceptives, especially hormonal methods, among women in rural Santarem in the Brazilian Amazon. The analysis is based on questionnaires with 398 women and visits to health centers. We consider the motives reported by women who: never used contraception; used some method in the past; and who at the time of the survey were using a different method from the ones they used in the past. The results indicate a rejection of hormonal contraception and a preference for female sterilization, an option possibly influenced by the characteristics of health services in the region. The side effects of hormonal contraceptive use reported by part of the interviewees contribute to a generalized fear of the side effects even among women who have never used such methods. To improve women's health services in the Amazon, we recommend further studies of the relationship between reported side effects and available services and prescriptions, as well as an analysis of women's discourse and perceptions. Language: English Keywords: BRAZIL | RURAL AREAS | RESEARCH REPORT | WOMEN | CONTRACEPTION TERMINATION | CONTRACEPTIVE METHODS CHOSEN | MOTIVATION | CONTRACEPTIVE AGENTS, FEMALE | CONTRACEPTIVE AGENTS, SIDE EFFECTS | FEAR | FEMALE STERILIZATION | CONDOM USE | CONTRACEPTIVE PREVALENCE | PROGRAM ACCESSIBILITY | South America, Eastern | South America | Latin America | Americas | Developing Countries | Geographic Factors | Population | Demographic Factors | Contraception | Family Planning | Contraceptive Usage | Psychological Factors | Behavior | Contraceptive Agents | Emotions | Sterilization, Sexual | Risk Reduction Behavior | Program Evaluation | Programs | Organization and Administration Document Number: 342777 |
| 3. Peer Reviewed Title: HIV vaccine preparedness studies in the non-organization for economic co-operation and development (non-OECD) countries. Author: Dhalla S; Nelson KE; Singer J; Poole G Source: AIDS Care. 2009 Mar;21(3):335-48. Abstract: HIV vaccine development remains an urgent priority. Vaccine preparedness studies to assess feasibility are an important precursor to HIV vaccine trials. Studies such as these have taken place in many non-Organization for Economic Co-operation and Development (non-OECD) countries using diverse cohorts. This article is a systematic review of retention rates and willingness to participate (WTP) in HIV vaccine trials. Studies took place in Brazil, the Democratic Republic of Congo, Haiti, India, Russia, Thailand, and several sub-Saharan African countries. Studies generally reported recruitment of high-risk individuals. Of 33 studies we identified, retention was assessed in 16 studies, and the 12-month retention ranged from 77 to 85%. Willingness to participate was assessed in 21 studies. Willingness to participate ranged from 23 to 100%, and increased knowledge was associated with an increased WTP. Vaccine preparedness studies have taken place using diverse cohorts in the non-OECD countries. In general, retention rates and WTP have been adequate to conduct HIV vaccine trials. Educational programs to improve knowledge about HIV vaccines may contribute to better follow-up and an increased WTP in these countries. Language: English Keywords: DEVELOPING COUNTRIES | LITERATURE REVIEW | CLINICAL TRIALS | RESEARCH ACTIVITIES | HIV PREVENTION | VACCINES | EPIDEMIOLOGY | PARTICIPATION | MOTIVATION | OBSTACLES | Clinical Research | Research Methodology | HIV Infections | Viral Diseases | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Public Health | Social Behavior | Behavior | Psychological Factors | Organization and Administration Document Number: 341856 |
| 4. Peer Reviewed Title: An evaluation of a brief motivational interviewing training course for HIV/AIDS counsellors in Western Cape Province, South Africa. Author: Evangeli M; Engelbrecht SK; Swartz L; Turner K; Forsberg L; Soka N Source: AIDS Care. 2009 Feb;21(2):189-96. Abstract: HIV/AIDS counselling in South Africa covers a range of areas of prevention and treatment with a commonly used model of lay counsellors trained by non-governmental organisations and working alongside professionals in public health settings. This study presents a single group evaluation of a six-session (12-hour) course of Motivational Interviewing (MI) delivered to 17 HIV/AIDS lay counsellors working in peri-urban settings in Western Cape Province, South Africa. Counsellors reported that they used MI techniques both at the start and at the end of the training. In addition, they reported confidence in their ability to influence their clients' motivation at both time points. The results from the ratings of role play performance showed that there was a marked change in emphasis over the group of counsellors from MI non-adherent practice before training (with advice giving, directiveness, control and confrontation) to more MI adherent practice (asking permission before giving advice, emphasising client autonomy, affirming the client and stressing the client's responsibility to change) at the end of the training. Only a small proportion of the counsellors reached the level of beginning proficiency (according to the Motivational Interviewing Treatment Integrity code) on the measure of the ratio of MI adherent to non-adherent responses. The ratio of reflections to questions and the percentage of open questions also showed improvements in performance across the group but generally to levels below that suggesting beginning proficiency in MI. There was no evidence of any change on global therapist ratings (of empathy and the spirit of MI, i.e. collaboration, evocation and autonomy support) or the percentage of complex reflections across the group of counsellors. Possible explanations for the results and public health implications are discussed. Language: English Keywords: SOUTH AFRICA | RESEARCH REPORT | EVALUATION | INTERVIEWS | HEALTH PERSONNEL | COUNSELING | TRAINING ACTIVITIES | MOTIVATION | HIV INFECTIONS | AIDS | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Data Collection | Research Methodology | Delivery of Health Care | Health | Clinic Activities | Program Activities | Programs | Organization and Administration | Training Programs | Education | Psychological Factors | Behavior | Viral Diseases | Diseases Document Number: 330807 |
| 5. Peer Reviewed Title: Understanding women's experiences with medical abortion: In-depth interviews with women in two Indian clinics. Author: Ganatra B; Kalyanwala S; Elul B; Coyaji K; Tewari S Source: Global Public Health. 2009 May 8;:1-12. Abstract: We explored women's perspectives on using medical abortion, including their reasons for selecting the method, their experiences with it and their thoughts regarding demedicalisation of part or all of the process. Sixty-three women from two urban clinics in India were interviewed within four weeks of abortion completion using a semi-structured in-depth interview guide. While women appreciated the non-invasiveness of medical abortion, other factors influencing method selection were family support and distance from the facility. The degree of medicalisation that women wanted or felt was necessary also depended on the way expectations were set by their providers. Confirmation of abortion completion was a source of anxiety for many women and led to unnecessary interventions in a few cases. Ultimately, experiences depended more on women's expectations about the method, and on the level of emotional and logistic support they received rather than on inherent characteristics of the method. These findings emphasise the circumstances under which women make reproductive choices and underscore the need to tailor service delivery to meet women's needs. Women-centred counselling and care that takes into consideration individual circumstances are needed. Language: English Keywords: INDIA | RESEARCH REPORT | KAP SURVEYS | WOMEN IN DEVELOPMENT | POSTPARTUM WOMEN | URBAN POPULATION | ABORTION | PERCEPTION | MOTIVATION | FEAR | EMOTIONS | LOGISTICS | NEEDS ASSESSMENT | DECISION MAKING | Asia, Southern | Asia | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Economic Development | Economic Factors | Puerperium | Reproduction | Population Characteristics | Demographic Factors | Population | Fertility Control, Postconception | Family Planning | Psychological Factors | Behavior | Management | Organization and Administration | Evaluation Document Number: 341474 |
| 6. Peer Reviewed Title: Predicting preparatory behaviours for condom use in female undergraduate students: a one-year follow-up study. Author: Gebhardt WA; van Empelen P; van Beurden D Source: International Journal of STD and AIDS. 2009 Mar;20(3):161-4. Abstract: The objective of this study is to investigate whether the Theory of Planned Behaviour (i.e. attitude, subjective norm, perceived behavioural control and intention), fluctuations in motivation over time, and variables from the Prototype-Willingness Model (i.e. behavioural expectation and behavioural willingness to have unprotected sex) predict preparatory behaviours for condom use. Sixty-two female undergraduates completed baseline and one-year follow-up questionnaires. Having condoms at home and carrying condoms were predicted by behavioural willingness to have unsafe sex at baseline. Having bought condoms was predicted by the behavioural expectation to use condoms with new partners at baseline. Intention and fluctuations in motivation did not emerge as significant predictors of preparatory actions. Female undergraduates, who are more willing to have unprotected sex under risk-conducive circumstances, are also less likely to prepare adequately for condom use, and thereby increase their chances of encountering such situations. Overall, the findings are in support of the Prototype-Willingness Model. Language: English Keywords: NETHERLANDS | RESEARCH REPORT | PROSPECTIVE STUDIES | YOUTH | WOMEN | CONDOM USE | RISK REDUCTION BEHAVIOR | SEX EDUCATION | MOTIVATION | SEX BEHAVIOR | Developed Countries | Europe, Western | Europe | Studies | Research Methodology | Age Factors | Population Characteristics | Demographic Factors | Population | Behavior | Education | Psychological Factors Document Number: 330465 |
| 7. Title: Individual versus household migration decision rules: gender and marital status differences in intentions to migrate in South Africa. Author: Gubhaju B; De Jong GF Source: International Migration. 2009 Jun;47(1):31-61. Abstract: This research tests the thesis that the neoclassical microeconomic and the new household economic theoretical assumptions on migration decision-making rules are segmented by gender, marital status, and time frame of intention to migrate. Comparative tests of both theories within the same study design are relatively rare. Utilizing data from the Causes of Migration in South Africa national migration survey, we analyse how individually held "own-future" versus alternative "household well-being" migration decision rules effect the intentions to migrate of male and female adults in South Africa. Results from the gender and marital status specific logistic regressions models show consistent support for the different gender-marital status decision rule thesis. Specifically, the "maximizing one's own future" neoclassical microeconomic theory proposition is more applicable for never married men and women, the "maximizing household income" proposition for married men with short-term migration intentions, and the "reduce household risk" proposition for longer time horizon migration intentions of married men and women. Results provide new evidence on the way household strategies and individual goals jointly affect intentions to move or stay. Language: English Keywords: SOUTH AFRICA | THEORETICAL STUDIES | SURVEYS | EVER MARRIED | NEVER MARRIED | MIGRATION | MOTIVATION | GENDER ISSUES | MARITAL STATUS | DECISION MAKING | ECONOMIC FACTORS | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Studies | Research Methodology | Sampling Studies | Nuptiality | Demographic Factors | Population | Population Dynamics | Psychological Factors | Behavior | Sociocultural Factors Document Number: 341299 |
| 8. Peer Reviewed Title: The relationship-oriented information-motivation-behavioral skills model: a multilevel structural equation model among dyads. Author: Harman JJ; Amico KR Source: AIDS and Behavior. 2009 Apr;13(2):173-84. Abstract: Transmission rates of HIV infection have increased steadily among heterosexual adults, however current theoretical models have not been tested statistically at the dyadic level in which risk behaviors occur. The purpose of the current study was to test an Information-Motivation-Behavioral skills (IMB) model of HIV risk behavior (IMB) specifically articulated for heterosexual couples in established relationships using data from both members of 75 dyads. The multilevel relationship-oriented information-motivation-behavioral skills (RELO-IMB) model was evaluated at the individual and dyadic level of analysis to examine partner differences on core variables. Results indicated that not only did the RELO-IMB model provide a good fit to the data when analyzed at the dyadic level, but that the structural relations among the core variables were quite different between the individual- and dyadic-level models. This is the first theoretical model of HIV risk behavior to be analyzed at the dyadic level, and the results suggest ways to effectively design intervention strategies for individuals in intimate relationships. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | SURVEYS | HETEROSEXUALS | COUPLES | HIV PREVENTION | MOTIVATION | SEX BEHAVIOR | PSYCHOSOCIAL FACTORS | INTERPERSONAL RELATIONS | CONDOM USE | PARTNER COMMUNICATION | Developed Countries | North America | Americas | Sampling Studies | Studies | Research Methodology | Behavior | Family Characteristics | Family and Household | Sociocultural Factors | HIV Infections | Viral Diseases | Diseases | Psychological Factors | Risk Reduction Behavior Document Number: 342860 |
| 9. Peer Reviewed Title: South African teachers' reflections on the impact of culture on their teaching of sexuality and HIV/AIDS. Author: Helleve A; Flisher AJ; Onya H; Mukoma W; Klepp KI Source: Culture, Health and Sexuality. 2009 Feb;11(2):189-204. Abstract: The authors investigated how teachers respond to perceived cultural differences between the local community and the content of their teaching. Data were collected through interviews with teachers who taught students in grades 8 or 9 in public high schools. The teachers expressed differing viewpoints on the rationale for teaching about HIV/AIDS and sexuality. Many teachers saw teaching these topics as a response to declining moral standards, while others suggested that they were teaching issues that parents failed to address. The teachers were more concerned about young people's sexual behavior than about preventing HIV/AIDS. They perceived that cultural contradictions between what was taught and local cultural values were an issue to which they needed to respond, although they differed in terms of how to respond. Some took an adaptive approach to try to avoid conflicts, while others claimed the moral neutrality of their teaching. Teaching about sexuality was perceived to be challenging in terms of language and communication norms. Teaching about HIV/AIDS was perceived as challenging because teachers often needed to convince students about the reality of AIDS. Language: English Keywords: SOUTH AFRICA | RESEARCH REPORT | KAP SURVEYS | TEACHERS | COMMUNITY | CULTURE | SEX EDUCATION | SEXUALITY | HIV TRANSMISSION | HIV PREVENTION | PERCEPTION | MOTIVATION | VALUE ORIENTATION | LANGUAGE | INTERPERSONAL COMMUNICATION | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Surveys | Sampling Studies | Studies | Research Methodology | Education | Residence Characteristics | Population Distribution | Geographic Factors | Population | Sociocultural Factors | Personality | Psychological Factors | Behavior | HIV Infections | Viral Diseases | Diseases | Communication Document Number: 341086 |
| 10. Peer Reviewed Title: Women's motivation to participate in contraceptive efficacy trials. Author: Hohmann H; Reid L; Creinin MD Source: Contraception. 2009 Sep;80(3):270-5. Abstract: BACKGROUND: We sought to determine whether there are differences in subject's motivation to participate in hormonal and barrier method contraceptive efficacy studies. STUDY DESIGN: All women presenting for screening appointments for either barrier or hormonal contraceptive efficacy trials were asked to complete a survey including demographic questions and questions which utilized Likert scales to grade the importance of potential motivating factors for research participation. RESULTS: A total of 72 hormonal and 36 barrier method subjects completed the survey. More women in the barrier group cited an altruistic reason as their primary motivator for participation in comparison to the hormonal group (61.2% vs. 31.9%, respectively, p=.004). This difference continued to be statistically significant in multiple logistic regression controlling for demographic variables. The most common primary motivating factor cited by the barrier group was the belief that research is important (30.6%), whereas the most common reason cited by the hormonal group was the desire for free contraception (22.2%). CONCLUSION: Women enrolling in barrier method studies are more likely than women enrolling in hormonal studies to cite an altruistic reason for their participation in these trials. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | CLINICAL TRIALS | WOMEN | SCREENING | CONTRACEPTION | MOTIVATION | PARTICIPATION | Developed Countries | North America | Americas | Clinical Research | Research Methodology | Demographic Factors | Population | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Family Planning | Psychological Factors | Behavior | Social Behavior Document Number: 342574 |
| 11. Title: Confidential inquiries into maternal deaths: Modifications and adaptations in Ghana and Indonesia. Author: Hussein J; D'Ambruoso L; Armar-Klemesu M; Achadi E; Arhinful D; Izati Y; Ansong-Tornui J Source: International Journal of Gynaecology and Obstetrics. 2009 May 8; Abstract: OBJECTIVE: Factors contributing to the limited use of confidential inquiries into maternal deaths include the negative focus and demotivating effect of such inquiries, perceptions of unavailability of sufficient documentation of events, and lack of time and resources. To ascertain whether these problems can be overcome, variations to confidential inquiries into maternal deaths were introduced in Ghana and Indonesia. METHODS: Clinical review panels were set up as part of the usual process of confidential inquiries, and modifications to the confidential inquiries were introduced. In Ghana, the traditional confidential inquiry process focusing on health facility care was modified to introduce the assessment of positive factors. In addition to the assessment of positive factors, adaptations in Indonesia consisted of including cases of obstetric complications, as well as deaths, and the use of interview testimonials as data sources. Information about resource and time needs for conducting confidential inquiries was collected. RESULTS: The introduction of positive aspects to the process provided a balanced and more motivating setting for the inquiry. The data obtained from case notes in district hospitals and interview testimonials provided sufficient information to assess why maternal deaths and severe complications occurred. The costs of conducting the inquiries ranged from US $4000 to US $11000 (per study), and the estimated time required for a panel member to review each case was more than 3 hours. CONCLUSION: This study introduced practical ways to encourage the implementation of maternal death reviews, inquiries, and audits that are context specific and, therefore, acceptable to local practitioners. Language: English Keywords: GHANA | INDONESIA | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | WOMEN IN DEVELOPMENT | PREGNANT WOMEN | CONFIDENTIAL INFORMATION | MATERNAL MORTALITY | PERCEPTION | MOTIVATION | TIME FACTORS | PREGNANCY COMPLICATIONS | ECONOMIC FACTORS | AUTOPSY | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Asia, Southeastern | Asia | Research Methodology | Economic Development | Population Characteristics | Demographic Factors | Population | Ethics | Sociocultural Factors | Mortality | Population Dynamics | Psychological Factors | Behavior | Diseases | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 341454 |
| 12. Peer Reviewed Title: The virus stops with me: HIV-infected Ugandans' motivations in preventing HIV transmission. Author: King R; Lifshay J; Nakayiwa S; Katuntu D; Lindkvist P; Bunnell R Source: Social Science and Medicine. 2009 Feb;68(4):749-57. Abstract: Few Positive Prevention interventions have been implemented in Africa; however, greater attention is now being paid to interventions that include messages of personal responsibility or altruism that may motivate HIV-infected individuals towards HIV prevention behaviors in Africa. We conducted 47 in-depth interviews in 2004 with HIV-infected men and women purposefully sampled to represent a range of sexual activities among clients of an AIDS support organization in Uganda. Qualitative interviews were selected from a cross-sectional survey of 1092 HIV-infected men and women. Clients were interviewed about their concerns around sexual HIV transmission, feelings of responsibility and reasons for these feelings, as well as about the challenges and consequences of actions to prevent HIV transmission. The reasons they provided for their sense of prevention responsibility revolved around ethical and practical themes. Responsibility toward sexual partners was linked to the belief that conscious transmission of HIV equals murder, would cause physical and emotional harm, and would leave children orphaned. The primary reason specific to preventing HIV transmission to unborn children was the perception that they are 'innocent'. Most participants felt that HIV-infected individuals held a greater responsibility for preventing HIV transmission than did HIV-uninfected individuals. Respondents reported that their sense of responsibility lead them to reduce HIV transmission risk, encourage partner testing, disclose HIV test results, and assume an HIV/AIDS educator role. Challenges to HIV preventive behavior and altruistic intentions included: sexual desire; inconsistent condom use, especially in long term relationships; myths around condom use; fear of disclosure; gender-power dynamics; and social and financial pressure. Our finding that altruism played an important role in motivating preventive behaviors among HIV-infected persons in Uganda supports the inclusion of altruistic prevention and counseling messages within Positive Prevention interventions. Language: English Keywords: UGANDA | RESEARCH REPORT | QUALITATIVE RESEARCH | MOTIVATION | PERSONS LIVING WITH HIV/AIDS | PERCEPTION | HIV PREVENTION | COUNSELING | INTERVENTIONS | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Psychological Factors | Behavior | HIV Infections | Viral Diseases | Diseases | Clinic Activities | Program Activities | Programs | Organization and Administration Document Number: 341553 |
| 13. Peer Reviewed Title: Effect of early exclusive breastfeeding on morbidity among infants born to HIV-negative mothers in Zimbabwe. Author: Koyanagi A; Humphrey JH; Moulton LH; Ntozini R; Mutasa K; Iliff P; Black RE Source: American Journal of Clinical Nutrition. 2009 May;89(5):1375-82. Abstract: BACKGROUND: Early exclusive breastfeeding (EBF) is recommended by the World Health Organization, but EBF rates remain low throughout the world. For infants born to breastfeeding HIV-positive mothers, early EBF is associated with a lower risk of postnatal transmission than is feeding breast milk together with other liquids or foods. No studies conducted in Africa have reported any benefits of EBF for infants born to HIV-negative women. OBJECTIVE: The objective was to compare the rate of sick clinic visits by infants aged 43-182 d according to breastfeeding exclusivity [EBF, predominant breastfeeding (PBF), and mixed breastfeeding (MBF)]. DESIGN: We compared rates of all-cause clinic visits and clinic visits related to diarrhea and lower respiratory tract infection (LRTI) among a cohort of 9207 infants of HIV-negative mothers during 2 age intervals: 43-91 and 92-182 d according to exclusivity of breastfeeding. Breastfeeding exclusivity was defined in 2 ways ("ever since birth" and "previous 7 d") and was assessed at 43 and 91 d. RESULTS: EBF between birth and 3 mo was significantly protective against diarrhea between 3 and 6 mo of age with the "ever since birth" definition [incidence rate ratios (IRRs) of 8.83 (95% CI: 1.07, 65.53) and 8.76 (95% CI: 1.13, 68.09) for PBF and MBF, respectively] and with the "previous 7 d" definition [2.04 (95% CI: 1.11, 3.77) and 2.05 (95% CI: 1.13, 3.72) for PBF and MBF, respectively]. The adverse effect of MBF on LRTI visits was weaker, reaching borderline significance only by the "ever since birth" definition during the 43-91-d interval (IRR: 1.91; 95% CI: 0.99, 3.67). CONCLUSION: Early EBF is associated with a significant reduction in sick clinic visits, especially those due to diarrhea. Language: English Keywords: ZIMBABWE | RESEARCH REPORT | CLINICAL RESEARCH | EPIDEMIOLOGIC METHODS | INFANT | BREASTFEEDING, EXCLUSIVE | CHILD SURVIVAL | CLINIC VISITS | DIARRHEA | RESPIRATORY INFECTIONS | TIME FACTORS | PREVALENCE | MOTIVATION | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Breastfeeding | Infant Nutrition | Nutrition | Health | Survivorship | Length of Life | Mortality | Population Dynamics | Service Statistics | Program Activities | Programs | Organization and Administration | Diseases | Infections | Measurement | Psychological Factors | Behavior Document Number: 341153 |
| 14. Title: Influencing risk behavior of sexually transmitted infection clinic visitors: efficacy of a new methodology of motivational preventive counseling. Author: Kuyper L; de Wit J; Heijman T; Fennema H; van Bergen J; Vanwesenbeeck I Source: AIDS Patient Care and STDs. 2009 Jun;23(6):423-31. Abstract: A quasi-experimental study was conducted at a Dutch sexually transmitted infection (STI) clinic to compare the effects of educational counseling and motivational interviewing (MI)-based HIV/STI counseling on determinants of condom use and partner notification at 6-month follow-up. It also examined the feasibility of MI-based counseling in a busy real-life clinic. The counseling approaches were historically compared: respondents in the control condition were recruited between April and July 2005, those in the experimental condition between September and December 2005. The study involved 428 participants. These were all high-risk clients of the STI clinic. Their mean age was 33.7 years, and 39.6% were female. The study showed that MI-based counseling had a more positive effect on self-efficacy, intentions to use condoms with casual partners, and long-term condom use with steady partners. It had no adversarial outcomes on other social cognitions or behaviors compared to educational counseling. Furthermore, MI-based counseling is experienced as a more respectful and structured way of counseling. MI-based counseling was relatively easily implemented into the current clinic procedures. In addition to the implementation of the training, neither specialized staff nor additional or longer client visits were needed. However, some nurses indicated that the new method required more personal investment and effort. Limitations of the current study are the low response rates, the high educational level of most participants, and the small sample size regarding partner notification. Nonetheless, we conclude that MI-based counseling was a more effective approach to preventive counseling compared to educational counseling and feasible in the busy real-life setting. Language: English Keywords: NETHERLANDS | RESEARCH REPORT | CONTROL GROUPS | CLIENTS | NURSES AND NURSING | COUNSELING | SAFER SEX | HIV PREVENTION | SEXUALLY TRANSMITTED DISEASE PREVENTION | CONDOM USE | HEALTH EDUCATION | MOTIVATION | PARTNER COMMUNICATION | Europe, Western | Europe | Developed Countries | Research Methodology | Program Activities | Programs | Organization and Administration | Health Personnel | Delivery of Health Care | Health | Clinic Activities | Sex Behavior | Behavior | HIV Infections | Viral Diseases | Diseases | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Risk Reduction Behavior | Education | Psychological Factors | Interpersonal Relations Document Number: 342409 |
| 15. Title: Gender, intimacy, and risky sex: a terror management account. Author: Lam SR; Morrison KR; Smeesters D Source: Personality and Social Psychology Bulletin. 2009 Aug;35(8):1046-56. Abstract: Three studies tested whether mortality salience would lead men to be more sexually risky than women. In Study 1, men reported greater intentions to engage in risky sexual behaviors than did women after a mortality prime, but not after a control prime. In Study 2, men desired more future sexual partners and had a lower need for intimacy than did women, but again, only when mortality was salient. Furthermore, need for romantic intimacy mediated the relationship between mortality salience, gender, and desired number of future partners. Using a behavioral rather than a self-reported dependent measure, Study 3 showed that men primed with mortality were less likely than women to select a package of condoms (versus a pen) as a free gift after the experiment. Implications for gender differences in responses to mortality salience, as well as for how to design effective safe-sex interventions, are discussed. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | CONTROL GROUPS | STUDENTS | MORTALITY | SELF ESTEEM | SELF-PERCEPTION | SEX BEHAVIOR | RISK BEHAVIOR | INTERPERSONAL RELATIONS | MOTIVATION | SEX FACTORS | Developed Countries | North America | Americas | Research Methodology | Education | Population Dynamics | Demographic Factors | Population | Psychological Factors | Behavior | Perception | Population Characteristics Document Number: 342853 |
| 16. Peer Reviewed Title: Reasons for termination of pregnancy in women aged 35 and over [letter] Author: Lee W; Mazza D Source: Medical Journal of Australia. 2009 Aug 3;191(3):188-9. Abstract: This letter speaks about the reasons women aged 35 and over are terminating pregnancy in Melbourne, Australia. In addition to reasons for termination, it also includes the contraceptive methods used by the women prior to the pregnancy and determines that further qualitative research is needed to explore the women's understanding of fertility and pregnancy risk. Language: English Keywords: AUSTRALIA | CRITIQUE | RETROSPECTIVE STUDIES | ABORTION | AGE FACTORS | MOTIVATION | CONTRACEPTIVE METHODS CHOSEN | Oceania | Developed Countries | Studies | Research Methodology | Fertility Control, Postconception | Family Planning | Population Characteristics | Demographic Factors | Population | Psychological Factors | Behavior | Contraceptive Usage | Contraception Document Number: 342939 Notification |
| 17. Peer Reviewed Title: Women’s expectations of treatment and care after an antenatal HIV diagnosis in Lilongwe, Malawi. Author: Levy JM Source: Reproductive Health Matters. 2009 May;17(33):152-161. Abstract: Women in sub-Saharan Africa are increasingly learning their HIV status in prevention of mother-to-child transmission of HIV (PMTCT) programmes in the context of antenatal care. This paper examines women's decisions about HIV testing and their experience of PMTCT and HIV-related care in one clinic in Lilongwe, Malawi. It is based on qualitative, ethnographic research conducted in 2004 and 2005, including interviews and focus group discussions with 55 HIV-positive women participating in a PMTCT programme, and 21 interviews with key informants from the programme and the health system. Women's expectations from testing were consistent with the benefits for their own health and their infants' health, as communicated by nurses. However, the PMTCT programme only poorly met their expectations. Reasons for this disjuncture included the construction of women as still healthy even when they needed treatment, a focus only on infant health, health system weaknesses, lack of integrated care and timely referral, and defining HIV exclusively as a medical issue, while ignoring the social determinants of health. Women's own health was particularly marginalised within the PMTCT programme, yet good models exist for comprehensive care for women, infants and their families that should be implemented as testing is scaled up. Spanish Abstract: Las mujeres en África subsahariana están conociendo cada vez más su estado de VIH en programas de prevención de la transmisión materno-infantil (PTMI) del VIH, en el contexto de la atención antenatal. Este artículo examina las decisiones de las mujeres respecto a las pruebas de VIH y su experiencia con la PTMI y el tratamiento del VIH en una clínica de Lilongwe, en Malaui. Se basa en una investigación etnográfica cualitativa, realizada en 2004 y 2005, con entrevistas y discusiones en grupos focales con 55 mujeres VIH-positivas, que participaron en un programa de PTMI, y 21 entrevistas con informantes clave del programa y el sistema de salud. Las expectativas de las mujeres en cuanto a las pruebas concordaron con los beneficios para su propia salud y la salud de sus bebés, según informaron las enfermeras. Sin embargo, el programa de PTMI no logró satisfacer bien sus expectativas por las siguientes razones: ver a las mujeres como saludables aun cuando necesitaban tratamiento, centrarse sólo en la salud de los bebés, las debilidades del sistema de salud, la falta de servicios integrados y referencias oportunas, y definir al VIH exclusivamente como un problema médico sin prestar atención a los determinantes sociales de la salud. Aunque la salud de las mujeres fue particularmente marginada en el programa de PTMI, existen buenos modelos de atención integral para las mujeres, sus bebés y sus familias, que deberían implementarse según se vayan ampliando los programas de pruebas del VIH. French Abstract: En Afrique subsaharienne, de plus en plus de femmes connaissent leur statut sérologique grâce aux programmes de prévention de la transmission mère-enfant du VIH (PTME) dans le contexte des soins prénatals. Cet article examine les décisions des femmes sur le test et leur expérience de la PTME et des soins liés au VIH dans un dispensaire à Lilongwe, Malawi. Il est fondé sur une recherche qualitative ethnographique menée en 2004 et 2005 qui comprenait des entretiens et des discussions de groupe avec 55 femmes séropositives participant à un programme de PTME, et 21 entretiens avec des informateurs clés du programme et du système de santé. Les attentes des femmes quant au dépistage cadraient avec les avantages pour leur santé et celle de leur bébé tels que les infirmières les avaient exposés. Néanmoins, le programme de PTME répondait mal à leurs espérances, notamment du fait que les femmes se voyaient encore en bonne santé alors qu'elles avaient besoin d'un traitement. D'autres raisons étaient l'accent mis uniquement sur la santé du nourrisson, les faiblesses du système de santé, le manque de soins intégrés et de transfert ponctuel des patients, et la définition du VIH exclusivement comme une question médicale, au mépris des déterminants sociaux de la santé. La santé des femmes était particulièrement marginalisée dans le programme de PTME. Pourtant, de bons modèles de soins complets existent pour les femmes, les nourrissons et leur famille. Ils devraient être appliqués alors que le dépistage s'étend. Language: English Keywords: MALAWI | RESEARCH REPORT | QUALITATIVE RESEARCH | WOMEN | ANTENATAL CARE | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | HIV TESTING | COUNSELING | INTERVIEWS | DECISION MAKING | MOTIVATION | ANTIRETROVIRAL THERAPY | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Demographic Factors | Population | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care | Health | Disease Transmission Control | Prevention and Control | Diseases | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Clinic Activities | Program Activities | Programs | Organization and Administration | Data Collection | Behavior | Psychological Factors | HIV | HIV Infections | Viral Diseases Document Number: 342024 |
| 18. Title: Theory-based interventions for contraception. Author: Lopez LM; Tolley EE; Grimes DA; Chen-Mok M Source: Cochrane Database of Systematic Reviews. 2009;(1):CD007249. Abstract: BACKGROUND: The explicit use of theory in research helps expand the knowledge base. Theories and models have been used extensively in HIV-prevention research and in interventions for preventing sexually transmitted infections (STIs). The health behavior field uses many theories or models of change. However, educational interventions addressing contraception often have no stated theoretical base. OBJECTIVES: Review randomized controlled trials that tested a theoretical approach to inform contraceptive choice; encourage contraceptive use; or promote adherence to, or continuation of, a contraceptive regimen. SEARCH STRATEGY: We searched computerized databases for trials that tested a theory-based intervention for improving contraceptive use (MEDLINE, POPLINE, CENTRAL, PsycINFO, EMBASE, ClinicalTrials.gov, and ICTRP). We also wrote to researchers to find other trials. SELECTION CRITERIA: Trials tested a theory-based intervention for improving contraceptive use. We excluded trials focused on high-risk groups. Interventions addressed the use of one or more contraceptive methods. The reports provided evidence that the intervention was based on a specific theory or model. The primary outcomes were pregnancy, contraceptive choice, initiating or changing contraceptive use, contraceptive regimen adherence, and contraception continuation. DATA COLLECTION AND ANALYSIS: The primary author evaluated abstracts for eligibility. Two authors extracted data from included studies. We calculated the odds ratio for dichotomous outcomes and the mean difference for continuous data. No meta-analysis was conducted due to intervention differences. MAIN RESULTS: Of 26 trials, 12 interventions addressed contraception (other than condoms), while 14 focused on condom use for preventing HIV or STIs. In 2 of 10 trials with pregnancy or birth data, a theory-based group showed better results. Four of nine trials with contraceptive use (other than condoms) showed better outcomes in an experimental group. For condom use, a theory-based group had favorable results in 14 of 20 trials, but the number was halved in a subgroup analysis. Social Cognitive Theory was the main theoretical basis for 12 trials, and 10 showed positive results. Of the other 14 trials, favorable results were shown for other social cognition models (N=2), motivational interviewing (N=5), and the AIDS Risk Reduction Model (N=2). No major patterns were detected by type of theory, intervention, or target population. AUTHORS' CONCLUSIONS: Family planning researchers and practitioners could apply the relevant theories and effective interventions from HIV and STI prevention. More thorough use of single theories would help inform the field about what works. Better reporting is needed on research design and intervention implementation. Language: English Keywords: UNITED STATES OF AMERICA | METHODOLOGICAL STUDIES | THEORETICAL STUDIES | LITERATURE REVIEW | THEORETICAL MODELS | CLINICAL TRIALS | WOMEN | CONTRACEPTIVE METHODS CHOSEN | CONDOM USE | CONTRACEPTIVE USAGE | MOTIVATION | COUNSELING | HIV PREVENTION | Developed Countries | North America | Americas | Research Methodology | Clinical Research | Demographic Factors | Population | Contraception | Family Planning | Risk Reduction Behavior | Behavior | Psychological Factors | Clinic Activities | Program Activities | Programs | Organization and Administration | HIV Infections | Viral Diseases | Diseases Document Number: 329594 |
| 19. Peer Reviewed Title: Theory-based strategies for improving contraceptive use: a systematic review. Author: Lopez LM; Tolley EE; Grimes DA; Chen-Mok M Source: Contraception. 2009 Jun;79(6):411-7. Abstract: BACKGROUND: Theories and models help explain how behavior change occurs. We systematically reviewed randomized controlled trials that examined theory-based interventions for improving contraceptive use. STUDY DESIGN: We searched electronic databases for eligible trials. Primary outcomes included pregnancy and contraceptive use. We calculated the odds ratio for dichotomous outcomes and the mean difference for continuous data. RESULTS: Of 14 included trials, 10 showed positive results for a theory-based group: 2 of 10 studies with pregnancy or birth data, 4 of 9 addressing contraceptive use (for contraception) and 5 of 9 with condom use (to prevent HIV/sexually transmitted infections). An experimental group had favorable results for six of seven trials based on Social Cognitive Theory, two based on other social cognition models and two using motivational interviewing. Most interventions focused on adolescents and involved multiple sessions. CONCLUSIONS: Effects were not consistent across outcomes and comparisons. The field could benefit from thorough use of single theories and better reporting on intervention implementation. Language: English Keywords: UNITED STATES OF AMERICA | LITERATURE REVIEW | THEORETICAL STUDIES | CASE CONTROL STUDIES | KAP SURVEYS | THEORETICAL MODELS | WOMEN | ADOLESCENTS | CONTRACEPTIVE USAGE | CONDOM USE | CONTRACEPTIVE EFFECTIVENESS | SEXUALLY TRANSMITTED DISEASE PREVENTION | MOTIVATION | TIME FACTORS | PROGRAM DESIGN | Developed Countries | North America | Americas | Studies | Research Methodology | Surveys | Sampling Studies | Demographic Factors | Population | Youth | Age Factors | Population Characteristics | Contraception | Family Planning | Risk Reduction Behavior | Behavior | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Psychological Factors | Population Dynamics | Programs | Organization and Administration Document Number: 341105 |
| 20. Peer Reviewed Title: Understanding job satisfaction amongst mid-level cadres in Malawi: the contribution of organisational justice. Author: McAuliffe E; Manafa O; Maseko F; Bowie C; White E Source: Reproductive Health Matters. 2009 May;17(33):80-90. Abstract: The migration of doctors and nurses from low- to high-income countries has left many countries relying on mid-level cadres as the mainstay of their health delivery system, Malawi being an example. Although an extremely important resource, little attention has been paid to the management and further development of these cadres. In this paper we use the concept of organisational justice – fairness of treatment, procedures and communication on the part of managers – to explore through a questionnaire how mid-level cadres in jobs traditionally done by higher-level cadres self-assessed their level of job satisfaction. All mid-level health workers present on the day of data collection in 34 health facilities in three health districts of Malawi, one district each from the three geographical regions, were invited to participate; 126 agreed. Perceptions of justice correlated strongly with level of job satisfaction, and in particular perceptions of how well they were treated by their managers and the extent to which they were informed about decisions and changes. Pay was not the only important element in job satisfaction; promotion opportunities and satisfaction with current work assignments were also significant. These findings highlight the important role that managers can play in the motivation, career development and performance of mid-level health workers. Spanish Abstract: Debido a la emigración de médicos y enfermeras de países de bajos ingresos a países de altos ingresos, muchos países, como Malaui, tienen que depender de los prestadores de servicios de nivel intermedio como el pilar del sistema de salud. Aunque son un recurso sumamente importante, no se ha prestado mucha atención al manejo y desarrollo de este grupo de profesionales. En este artículo se utiliza el concepto de justicia organizacional – en el trato, los procedimientos y la comunicación por parte de los administradores – para explorar mediante un cuestionario cómo los profesionales de nivel intermedio en trabajos realizados tradicionalmente por profesionales de nivel superior autoevaluaron su nivel de satisfacción laboral. Se invitó a participar a todos los trabajadores de salud de nivel intermedio presentes el día de la recolección de datos en 34 establecimientos de salud, en tres distritos de salud de Malaui, uno de cada región geográfica; 126 accedieron. Las percepciones de justicia estaban muy correlacionadas con el nivel de satisfacción laboral, en particular las percepciones de cuán bien eran tratados por sus supervisores y hasta qué grado se les informaba sobre las decisiones y los cambios. La paga no era el único elemento importante en la satisfacción laboral; las oportunidades de ascenso y la satisfacción con las asignaciones laborales también eran significativas. Estos hallazgos resaltan el importante papel que pueden desempeñar los administradores en la motivación, el desarrollo profesional y el desempeño de los trabajadores de salud de nivel intermedio. French Abstract: La migration de médecins et d'infirmières de pays pauvres vers des pays à revenu élevé oblige beaucoup de pays, dont le Malawi, à s'appuyer sur des cadres moyens comme pivot de leur système de santé. Bien qu'il s'agisse d'une ressource extrêmement importante, la gestion et le développement ultérieur de ces cadres n'ont guère reçu d'attention. Dans cet article, nous utilisons le concept de justice organisationnelle – traitement, procédures et communications équitables de la part des superviseurs – pour étudier au moyen d'un questionnaire comment les cadres moyens occupant des emplois traditionnellement dévolus aux cadres supérieurs évaluent leur satisfaction professionnelle. Tous les soignants de niveau intermédiaire présents le jour du recueil des données dans 34 établissements de santé du Malawi, sélectionnés dans un district pour chacune des trois régions géographiques, ont été invités à participer; 126 ont accepté. La manière de concevoir la justice était fortement corrélée avec le niveau de satisfaction professionnelle, en particulier dans quelle mesure les cadres moyens estimaient être bien traités par leur superviseur et être informés des décisions et des changements. Le salaire n'était pas le seul élément déterminant: les possibilités d'avancement et la satisfaction quant aux tâches professionnelles actuelles avaient aussi une influence. Ces conclusions soulignent le rôle important que les superviseurs peuvent jouer dans la motivation, les perspectives de carrière et les performances des soignants de niveau intermédiaire. Language: English Keywords: MALAWI | RESEARCH REPORT | SAMPLING STUDIES | NURSES AND NURSING | PARAMEDICAL PERSONNEL | HEALTH SERVICES ADMINISTRATION | ATTITUDES | SATISFACTION | PERCEPTION | MOTIVATION | PERFORMANCE IMPROVEMENT | JOB DESCRIPTION | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Studies | Research Methodology | Health Personnel | Delivery of Health Care | Health | Management | Organization and Administration | Psychological Factors | Behavior | Personnel Management Document Number: 342017 |
| 21. Peer Reviewed Title: Demographic and personality factors as predictors of HIV/STD partner-specific risk perceptions: implications for interventions. Author: Mehrotra P; Noar SM; Zimmerman RS; Palmgreen P Source: AIDS Education and Prevention. 2009 Feb;21(1):39-54. Abstract: Although risk perception as a motivator of precautionary behavior is a key component of several health behavior theories, this motivational hypothesis has found mixed support in the HIV/AIDS area. This may be, in part, because risk perceptions are more complex than they are treated in many studies of the motivational hypothesis. The current study examines demographic, personality, and sexual risk factors as predictors of partner-specific (main vs. casual) HIV/STD risk perceptions in a sample of 1,489 young adults. As expected, perceptions of HIV/STD risk were higher in the context of "casual" as compared with "main" partnerships. Although univariate analyses demonstrated that gender, race/ethnicity, sensation seeking, impulsivity, number of partners, and condom use all influenced HIV/STD risk perceptions, only gender, condom use, and race/ethnicity remained significant in multivariate analyses. Implications of these results for the design of efficacious HIV prevention interventions are discussed. Language: English Keywords: KENTUCKY | RESEARCH REPORT | KAP SURVEYS | THEORETICAL MODELS | SEXUAL PARTNERS | YOUTH | DEMOGRAPHIC FACTORS | PERSONALITY | HIV PREVENTION | PERCEPTION | RISK ASSESSMENT | SEXUALLY TRANSMITTED DISEASE PREVENTION | SEX BEHAVIOR | MOTIVATION | RISK BEHAVIOR | Developed Countries | United States of America | North America | Americas | Surveys | Sampling Studies | Studies | Research Methodology | Behavior | Age Factors | Population Characteristics | Population | Psychological Factors | HIV Infections | Viral Diseases | Diseases | Evaluation | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections Document Number: 331082 |
| 22. Title: Induced abortion amongst undergradute students of University of Port Harcourt. Author: Oriji VK; Jeremiah I; Kasso T Source: Nigerian Journal of Medicine. 2009 Apr-Jun;18(2):199-202. Abstract: BACKGROUND: Induced abortion is the termination of pregnancy through a deliberate intervention intended to end the pregnancy. This practice is widespread in Nigeria despite the restrictive abortion laws in Nigeria. Many women still undergo induced abortion every year and endanger their health and lives as induced abortion can only be procured illegally in Nigeria. We hope to determine the proportion of undergraduate students who had induced abortion in the past and the contributing factors. To determine the proportion of the undergraduate students who support the restrictive abortion laws in Nigeria. METHOD: A cross sectional questionnaire survey of undergraduate students of the University of Port Harcourt was done through a cluster sampling method along with focus group discussion with some of the respondents. 451 out of 500 administered questionnaires were retrieved and analyzed. RESULT: The incidence of induced abortion amongst the respondents was 47.2%. About 40% had never used an effective form of contraception in the past and 13% were unaware of contraception. 77.9% of the induced abortion was by dilation and curettage and 1% by manual vacuum aspiration. Up to two third of the respondents were against legalization of abortion. CONCLUSION: Up to 47% of these undergraduates had performed abortion in the past. Protecting educational career was the single most important reason for this. Although most of these undergraduates are against legalizing abortion, they highly patronize unsafe abortion. Improving contraceptive awareness and usage will reduce unwanted pregnancy and induced abortion. This option appears next to total abstinence in reducing the morbidity and mortality from induced abortion in this country. Language: English Keywords: NIGERIA | RESEARCH REPORT | SAMPLING STUDIES | FOCUS GROUPS | STUDENTS | ABORTION | ABORTION LAW | CONTRACEPTIVE USAGE | QUESTIONNAIRES | MOTIVATION | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Studies | Research Methodology | Data Collection | Education | Fertility Control, Postconception | Family Planning | Contraception | Psychological Factors | Behavior Document Number: 342594 Notification |
| 23. Title: Extending the purview of the risk perception attitude framework: findings from HIV/AIDS prevention research in Malawi. Author: Rimal RN; Bose K; Brown J; Mkandawire G; Folda L Source: Health Communication. 2009 Apr;24(3):210-8. Abstract: The risk perception attitude (RPA) framework posits that efficacy beliefs moderate the relationship between risk perception and health outcomes. To extend the purview of the theory, this central hypothesis was tested in the context of HIV/AIDS-prevention behaviors. Data (N = 890) were collected from 8 districts in Malawi in southern Africa as part of a baseline research effort to obtain benchmark measures on key behavior-change indicators. Results pertaining to 2 behaviors, use of condoms and remaining monogamous, are reported in this study. Relationships between risk perception and behavioral intentions were not significant, but those between efficacy beliefs and behavioral intentions were. Furthermore, efficacy beliefs were found to moderate the relationship between risk perception and intentions to remain monogamous, but not between risk perceptions and intentions to use condoms. The model was able to explain approximately 40% of the variance in intentions to use condoms, and 19% of the variance in intentions to remain monogamous. Implications for health campaigns, particularly the need to strengthen efficacy beliefs and the need to be careful in enhancing risk perceptions without simultaneously strengthening efficacy beliefs, are also discussed. Language: English Keywords: MALAWI | RESEARCH REPORT | SAMPLING STUDIES | ADOLESCENTS | ADULTS | AIDS PREVENTION | HIV PREVENTION | RISK FACTORS | PERCEPTION | ATTITUDES | BEHAVIOR CHANGE | MOTIVATION | CONDOM USE | MONOGAMY | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Studies | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | AIDS | HIV Infections | Viral Diseases | Diseases | Health | Psychological Factors | Behavior | Risk Reduction Behavior | Marriage Patterns | Marriage | Nuptiality Document Number: 342172 |
| 24. Peer Reviewed Title: In search of sexual pleasure and fidelity: vaginal practices in KwaZulu-Natal, South Africa. Author: Scorgie F; Kunene B; Smit JA; Manzini N; Chersich MF; Preston-Whyte EM Source: Culture, Health and Sexuality. 2009 Apr;11(3):267-83. Abstract: Vaginal practices, such as intra-vaginal cleansing, drying and tightening, are suspected of placing women at higher risk of acquiring HIV and STIs. Yet, there is limited understanding of what these practices entail, what motivates women to undertake them and what their socio-cultural and historical meanings are. This paper explores the range of vaginal practices used by women in KwaZulu-Natal, South Africa and locates these within the context of local patterns of migration and understandings of sexual health and pleasure. Study activities took place at an urban and rural site employing qualitative research techniques: semi-structured interviewing and an additional ethnographic component in the rural site. Vaginal practices were believed to be ubiquitous and a wide range of substances and procedures were described. Strong motivations for vaginal practices included women's desire to enhance men's sexual pleasure, ensure men's fidelity and exercise agency and control in their relationships. The common use of traditional medicines in this quest to maintain stable relationships and affect the course of love, suggests a complexity that cannot be captured by simple terms like 'dry sex'. We argue instead that any interventions to change women's reliance on vaginal practices must recognise and attend to the broader social contexts in which they are embedded. Language: English Keywords: SOUTH AFRICA | RESEARCH REPORT | QUALITATIVE RESEARCH | ADULTS | SEXUAL INTERCOURSE | VAGINA | SOCIOCULTURAL FACTORS | TRADITIONAL HEALTH PRACTICES | FIDELITY | SEXUALITY | MOTIVATION | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Research Methodology | Age Factors | Population Characteristics | Demographic Factors | Population | Reproduction | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Culture | Sex Behavior | Behavior | Personality | Psychological Factors Document Number: 341437 |
| 25. Title: Pregnancy and protection: perceptions, attitudes and experiences of Australian female adolescents. Author: Skinner SR; Smith J; Fenwick J; Hendriks J; Fyfe S; Kendall G Source: Women and Birth. 2009 Jun;22(2):50-6. Abstract: BACKGROUND AND PURPOSE: Despite decades of research, development and evaluation of educational and promotional strategies to prevent teenage pregnancy, we have only a limited understanding of the strategies that are effective and why. This study sought to explore female teenagers' attitudes, perceptions and experiences of contraceptive use, and describe the influence of this on pregnancy risk. METHODS: A qualitative approach was used to explore the contraceptive behaviour in a purposive sample of sexually active Australian females aged 14-19 years. Teenagers were drawn from three sub-groups: antenatal and postnatal services (pregnant-continuing); termination services (pregnant-terminating); and sexual health clinics (never-pregnant). Sixty-eight individual, semi-structured interviews were conducted. Thematic analysis was employed to analyse the data and generate a rich, description of contraceptive behaviour. RESULTS: Whilst participants were familiar with contraception, many used it inconsistently. Commitment to pregnancy prevention was firmly located within participants' attitudes toward teenage pregnancy and parenthood, perceptions of pregnancy risk and perceptions of the costs and benefits of using contraception. Further, motivation to use contraception fluctuated in different contexts, such as romantic relationships. CONCLUSIONS: Our research highlights the importance of attitudes toward contraception, pregnancy and parenthood in shaping teenagers' motivation to use contraception. Educational and prevention programs must address the spectrum of attitudes underlying teenagers' contraceptive and reproductive decisions in order to alter pathways to teenage pregnancy and early parenting. Language: English Keywords: AUSTRALIA | RESEARCH REPORT | QUALITATIVE RESEARCH | ADOLESCENTS, FEMALE | CONTRACEPTIVE USAGE | CONDOM USE | ADOLESCENT PREGNANCY | ATTITUDES | PERCEPTION | INTERVIEWS | ALCOHOL USE AND ABUSE | CONTRACEPTIVE USAGE DETERMINANTS | MOTIVATION | Oceania | Developed Countries | Research Methodology | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Contraception | Family Planning | Risk Reduction Behavior | Behavior | Reproductive Behavior | Fertility | Population Dynamics | Psychological Factors | Data Collection Document Number: 342480 |
| 26. Title: Evidence for improvement in the quality of care given during emergencies in pregnancy, infancy and childhood following training in life-saving skills: a postal survey. Author: Zaeem-ul-Haq; Qureshi F; Hafeez A; Zafar S; Mohamud BK; Southal DP Source: JPMA. Journal of the Pakistan Medical Association. 2009 Jan;59(1):22-6. Abstract: OBJECTIVES: To assess the motivational level and use of skills amongst the graduates of training courses on maternal and newborn healthcare in emergency settings. METHODS: Postal survey involving Doctors and Nurses from public sector hospitals who attended training courses on Essential Surgical Skills with emphasis on Emergency Maternal and Child Health. RESULTS: Ninety percent of respondents reported the use of acquired skills and the structured Airway, Breathing, Circulation (ABC) approach in handling emergencies. Instances were described where this approach helped to improve practice, simplify treatment and save lives in all age groups, especially mothers and newborns. Lack of equipment and lack of support from higher levels were the common barriers yet many graduates managed to obtain equipment and 81% of respondents reported that these training courses had resulted in better availability or use of supplies at their facilities. Efforts were made by the graduates for institutionalizing the trainings and discussions (88%) were found to be the most common mode followed by formal teaching of the skills (66%). Hand washing was the most commonly used skill followed by the use of bag valve and mask resuscitation in the newborn at birth. Those catering for neonates expressed their confidence in obstetric procedures, while obstetricians described themselves as being self-assured now in neonatal resuscitation. CONCLUSIONS: The introduction of a structured training programme in a resource-constrained healthcare system has improved the emergency management of patients. ESS-EMCH trainings should be incorporated into the district health systems to enhance emergency care handling capacities of healthcare staff, to help them contribute to achieve the MDGs and also for sustainable improvement in maternal, neonatal and child healthcare. Language: English Keywords: DEVELOPING COUNTRIES | RESEARCH REPORT | HEALTH PERSONNEL | PHYSICIANS | NURSES AND NURSING | MATERNAL HEALTH | CHILDBIRTH | MOTIVATION | EMERGENCY SERVICES | TRAINING ACTIVITIES | Delivery of Health Care | Health | Pregnancy Outcomes | Pregnancy | Reproduction | Psychological Factors | Behavior | Health Services | Training Programs | Education Document Number: 330498 |
| 27. Peer Reviewed Title: Survey of motivation for use of voluntary counseling and testing services for HIV in a high risk area of Shenyang, China. Author: Zhou L; Guo J; Fan L; Tian J; Zhou B Source: BMC Health Services Research. 2009;9:23. Abstract: BACKGROUND: HIV voluntary counseling and testing (VCT) is considered an effective prevention method of HIV infection. In order to understand the VCT environment and enhance the effective delivery of VCT services in a country, an accurate assessment of the current status of VCT services is very important. METHODS: From July 2006 to June 2007, we conducted a cross-sectional survey using a face to face interview among 2676 VCT clients from a high risk area in Shenyang city, China. RESULTS: The major demographic characteristics among 2,676 VCT clients were: 41.1% were in the age range 20 to 30 years; 73.1% were males; and 67.1% had attained the level of junior high school education. The primary information source for VCT services was mass media like television (TV) and newspaper in 88.9%. 34.3% were afraid of the result of infection which was the main barrier to accept VCT services among 540 participants answering the question. 75.2% were motivated by recently acquired knowledge about HIV. 47.9% had 3 or more male sex partners, 62.3% had used condoms sometimes, and 14.5% had been infected with a STD. 2.8% of the participants identified themselves as men who have sex with men (MSM). The main demographic characteristics of MSM did not differ from the total group of participants except with respect to age: 63.5% reported having one male sex partner in the preceding 12 months, 44.6% reported never using condoms in the preceding 12 months, and only 2.7% reported a history of sexually transmitted disease. CONCLUSION: Public education offered by health workers in hospitals, private clinics and other medical institutions needs to be strengthened. Given the results from this study, we recommend: (1) making VCT a routine part of health services, especially in areas where many high-risk individuals live; (2) improving the information sources and increasing the understanding of HIV and HIV-infected individuals; (3) enhancing international collaboration in strategic planning, technical assistance, and protocols to translate policy into effective action; (4) supporting Chinese non-government organizations (NGOs) in playing a significant role in the battle against AIDS. Language: English Keywords: CHINA | RESEARCH REPORT | KAP SURVEYS | CROSS SECTIONAL ANALYSIS | MEN HAVING SEX WITH MEN | MULTIPLE PARTNERS | MOTIVATION | VOLUNTARY COUNSELING AND TESTING | MASS MEDIA | INFORMATION SOURCES | FEAR | KNOWLEDGE | CONDOM USE | Asia, Eastern | Asia | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Sex Behavior | Behavior | Sexual Partners | Psychological Factors | HIV Testing | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Communication | Information | Emotions | Sociocultural Factors | Risk Reduction Behavior Document Number: 330989 |
28.  Title: Technical report: Behavioral and social science support to CONRAD Phase III clinical trial of cellulose sulfate 6% gel. Author: Family Health International [FHI] Source: Research Triangle Park, North Carolina, FHI, 2008 Jun. [96] p. (USAID Cooperative Agreement No. HRN-A-00-98-000200-00) Abstract: The successful implementation of Phase III clinical trials requires careful planning and management. In order to plan and monitor the CONRAD multi-site Phase III clinical trial of the topical microbicide cellulose sulfate 6% (Ushercell) in preventing transmission of HIV, behavioral and social science (BSS) research was applied. This report documents the process, findings, and recommendations from the BSS activities. Language: English Keywords: AFRICA | TECHNICAL REPORT | DATA COLLECTION | INFORMED CONSENT | RESPONDENTS | PERSONS LIVING WITH HIV/AIDS | HIV TESTING | SEX BEHAVIOR | VAGINAL GEL | ATTITUDES | KNOWLEDGE | MOTIVATION | Developing Countries | Research Methodology | Health Services | Delivery of Health Care | Health | Surveys | Sampling Studies | Studies | HIV Infections | Viral Diseases | Diseases | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Behavior | Vaginal Spermicides | Contraceptive Methods | Contraception | Family Planning | Psychological Factors | Sociocultural Factors Document Number: 331500 |
| 29. Title: Central Asia (2008): Family planning TRaC study evaluating use of modern contraceptive methods among women of reproductive age in rural areas of Tajikistan and Kyrgyzstan. First round. Author: Population Services International [PSI]. Research and Metrics Source: Washington, D.C., PSI, 2008. 27 p. (Social Marketing Research SeriesPSI Dashboard) Abstract: PSI / Central Asia is implementing a 2-year USAID-funded program to improve maternal health among underserved, low-income women in rural Tajikistan and Kyrgyzstan. The program aims to address the lack of access to affordable family planning products, insufficient knowledge of modern contraceptives, and misconceptions about the safety and effectiveness of modern contraceptive methods. Follow-up studies are planned for 2008. The main objectives of this study are: 1. To obtain and provide both comprehensive and detailed data to support PSI’s interventions with women of reproductive age (WRA) in rural areas. 2. To obtain information for monitoring the key indicators, behavior change, and OAM determinants associated with use of modern contraceptives. A multi-stage probability sampling strategy was used to recruit 2007 women of reproductive age, 15-49 years old living in target sites (small villages) of Kyrgyzstan and Tajikistan. The questionnaire collected information on background characteristics, opinions about sexual behavior, oral and injectable contraceptives, intrauterine devices, and condoms, beliefs and knowledge about modern contraceptive methods and exposure to maternal health improvement intervention. Multivariate analyses were performed to identify significant factors associated with current use of modern contraceptive method and use of modern contraceptive methods (oral and injectable contraceptives, intra uterine device, and condoms) during last 6 months. Simple frequencies were run on descriptive data to permit monitoring of project indicators. Less than half of respondents were current users of modern contraceptives (47% in Kyrgyzstan and 37% in Tajikistan), and only a slightly higher proportion reported using any modern contraceptives in the past 6 months. (Excerpts) Language: English Keywords: TAJIKISTAN | KYRGYZSTAN | RURAL AREAS | RESEARCH REPORT | SAMPLING STUDIES | LOW INCOME POPULATION | CONTRACEPTIVE USAGE | CONTRACEPTIVE USAGE DETERMINANTS | CONTRACEPTIVE AVAILABILITY | KNOWLEDGE | MOTIVATION | BELIEFS | Asia, Central | Asia | Developing Countries | Geographic Factors | Population | Studies | Research Methodology | Social Class | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Contraception | Family Planning | Sociocultural Factors | Psychological Factors | Behavior | Culture Document Number: 331650 |
| 30. Title: Acupuncture use among people living with HIV / AIDS in northern Thailand: Motives, barriers, and attitudes. Author: Arbisi A; Panpanich R Source: Journal of the Medical Association of Thailand. 2008 Apr;91(4):533-541. Abstract: The present cross-sectional, qualitative study examined attitudes toward and motives for acupuncture use and disuse among people with HIV/AIDS (PHA) in Northern Thailand. Over a seven-day period, interviews were conducted in Thai by two research assistants and two PHA volunteers on 20 patients. The social support, psychological well-being, clinical symptoms, and analgesic avoidance were the primary motives for use among acupuncture users. Among non-acupuncture users, better health status, instrument aversion, lower effectiveness, high perceived risk of deleterious interactions with antiretroviral therapy, inferiority to conventional medicine, and lack of time and knowledge were the main reasons for disuse. Nineteen out of twenty patients expressed positive or neutral attitudes toward acupuncture. Further study is recommended to explore long-term benefits and ramifications of acupuncture as a substitute for pharmacological pain interventions. Though acupuncture is not a panacea that is recommended for everyone, health care providers should educate patients about acupuncture's prophylactic benefits, offer services at more convenient times, and be aware of the potential barriers of acupuncture use. (author's) Language: English Keywords: THAILAND | RESEARCH REPORT | QUALITATIVE RESEARCH | PERSONS LIVING WITH HIV/AIDS | ACUPUNCTURE | MOTIVATION | OBSTACLES | ATTITUDES | INTERVIEWS | Asia, Southeastern | Asia | Developing Countries | Research Methodology | HIV Infections | Viral Diseases | Diseases | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Psychological Factors | Behavior | Organization and Administration | Data Collection Document Number: 326959 |
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