1.  Peer Reviewed Title: Intentional condomless anal intercourse among Latino MSM who meet sexual partners on the Internet. Author: Balan IC; Carballo-Dieguez A; Ventuneac A; Remien RH Source: AIDS Education and Prevention. 2009 Feb;21(1):14-24. Abstract: Data on intentional condomless anal intercourse in risky contexts, also known as "barebacking," among ethnic minority MSM, whose rates of HIV infection continue to rise, are extremely limited. In this study, 31 Latino MSM who seek barebacking partners via the Internet underwent in-depth interviews about bareback sex and its association to pleasure, substance use, HIV concerns, and cultural identity. Participants reported engaging in bareback sex owing to the physical and emotional pleasure they experience. They expressed concern about HIV infection and took steps to reduce risk of infection. Although a majority of participants reported using alcohol or drugs in the context of bareback sex, substance use did not appear to propel the behavior. Crystal methamphetamine use, prevalent only among our HIV-positive participants, was related to very high HIV risk behavior. In this sample, culture did not seem to play a large role in barebacking. Language: English Keywords: NEW YORK | RESEARCH REPORT | KAP SURVEYS | MEN HAVING SEX WITH MEN | SEXUAL PARTNERS | ETHNIC GROUPS | ANAL SEX | CONDOM USE | INTERNET | RISK BEHAVIOR | SEX BEHAVIOR | PARTNER COMMUNICATION | DRUG USE AND ABUSE | HIV TRANSMISSION | PERCEPTION | Developed Countries | United States of America | North America | Americas | Surveys | Sampling Studies | Studies | Research Methodology | Behavior | Cultural Background | Population Characteristics | Demographic Factors | Population | Risk Reduction Behavior | Information Networks | Communication | Interpersonal Relations | HIV Infections | Viral Diseases | Diseases | Psychological Factors Document Number: 330344 |
| 2. Peer Reviewed Title: Assessing motivations to engage in intentional condomless anal intercourse in HIV risk contexts ("Bareback Sex") among men who have sex with men. Author: Bauermeister JA; Carballo-Dieguez A; Ventuneac A; Dolezal C Source: AIDS Education and Prevention. 2009 Apr;21(2):156-68. Abstract: Although condom use is an effective barrier against HIV transmission, some men who have sex with men (MSM) engage in bareback sex (unprotected anal sex in risky contexts) and increase their risk for HIV (re)infection. Understanding MSM's decision to bareback (vis-a-vis condom use) is essential to develop effective HIV/AIDS prevention programs for this population. An ethnically diverse sample of men who bareback (n = 120) was recruited exclusively on the Internet and stratified to include two thirds who reported both unprotected receptive anal intercourse (URAI) and being HIV uninfected. We used exploratory factor analysis to explore the domains within the Decisional Balance to Bareback (DBB) scale, and test the association between DBB and risky sexual behaviors. HIV-positive MSM (n = 31) reported higher costs/losses associated with condom use than HIV-negative men (n = 89). We found two underlying factors in the DBB scale: a Coping with Social Vulnerabilities subscale (eight items; alpha = .89) and a Pleasure and Emotional Connection subscale (five items; alpha = .92). We found a positive association between DBB (i.e. greater gains associated with bareback sex) and URAI occasions, number of partners, and having one or more sero-discordant partners in the past 3 months. We conclude that because MSM may avoid using condoms in order to cope with psychosocial vulnerabilities and create intimacy with other MSM, this population could benefit from alternatives to condoms such as pre/post exposure prophylaxis and rectal microbicides. Language: English Keywords: NEW YORK | RESEARCH REPORT | KAP SURVEYS | MEN HAVING SEX WITH MEN | SEXUAL PARTNERS | FACTOR ANALYSIS | ANAL SEX | CONDOM USE | HIV TRANSMISSION | DECISION MAKING | INTERNET | RISK BEHAVIOR | SEX BEHAVIOR | EMOTIONS | Developed Countries | United States of America | North America | Americas | Surveys | Sampling Studies | Studies | Research Methodology | Behavior | Data Analysis | Risk Reduction Behavior | HIV Infections | Viral Diseases | Diseases | Information Networks | Communication | Psychological Factors Document Number: 331286 |
| 3. Title: Sexual behavior and perceived peer norms: comparing perinatally HIV-infected and HIV-affected youth. Author: Bauermeister JA; Elkington K; Brackis-Cott E; Dolezal C; Mellins CA Source: Journal of Youth and Adolescence. 2009 Sep;38(8):1110-22. Abstract: A large proportion of perinatally HIV-infected (PHIV) children are becoming adolescents and exploring their sexuality. This study explored the prevalence of sexual behaviors (kissing, touching, engaging in oral sex, or having vaginal/anal intercourse) in a sample of predominantly ethnic minority youths (N = 339; 54.1% Black and 30.4% Latino; 51% female; ages 9-16) perinatally exposed to HIV (61% HIV+). Using logistic regression, we tested the association between sexual behavior and HIV status, demographic characteristics, and peer influences regarding sexual behavior. PHIV youth were less likely to be sexually active. Among sexually active youth, PHIV youth were more likely to engage in touching behavior than HIV-negative youth and were less likely to engage in penetrative sex. Youths reporting that a greater number of their peers believed that sexually active boys were "cool" or "popular" were more likely to report sexual behavior. The association between sexual behavior and peers believing sexually active girls were "cool" or "popular" varied by age, gender, and HIV status. Furthermore, friends' sexual activity was associated with sexual intercourse. Prevention programs should strengthen messages addressing peer norms regarding sexuality, as well as address specific issues related to adolescent HIV. Language: English Keywords: UNITED STATES OF AMERICA | NEW YORK | RESEARCH REPORT | COMPARATIVE STUDIES | ETHNIC GROUPS | PERSONS LIVING WITH HIV/AIDS | ADOLESCENTS | PEER GROUPS | VALUE ORIENTATION | HIV INFECTIONS | SEX BEHAVIOR | Developed Countries | North America | Americas | Studies | Research Methodology | Cultural Background | Population Characteristics | Demographic Factors | Population | Viral Diseases | Diseases | Youth | Age Factors | Knowledge Sources | Communication | Psychological Factors | Behavior Document Number: 342389 |
| 4. Peer Reviewed Title: Adolescent Comprehension of Emergency Contraception in New York City. Author: Cremer M; Holland E; Adams B; Klausner D; Nichols S; Scott Ram R; Alonzo TA Source: Obstetrics and Gynecology. 2009 Apr;113(4):840-844. Abstract: OBJECTIVE:: To estimate comprehension of the over-the-counter emergency contraception label among female adolescents aged 12 through 17 years, and to compare the results with a similar study that focused on adults. METHODS:: Surveys were administered to female adolescents in New York City in public venues such as malls, movie theaters, and parks. Participants were asked to read the emergency contraception (levonorgestrel) label before answering survey questions. Comparisons were made in SPSS version 13.0 using chi tests of independence and Fisher exact tests for sparse data. RESULTS:: One thousand eighty-five girls between the ages of 12 and 17 participated in the study. Overall, adolescents demonstrated high comprehension of the key points of emergency contraception: (1) that it is a method of preventing pregnancy 92% (confidence interval [CI] 91-94%); (2) that it has to be taken within the first 72 hours after unprotected intercourse 83% (CI 83-87%); (3) that if you are already pregnant emergency contraception will not be effective 87% (CI 85-89%); (4) that emergency contraception will not protect against human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) 95% (CI 94-96%); and (5) that emergency contraception should not be used as a method of long-term birth control 85% (CI 83-87%). CONCLUSION:: After reading the emergency contraception (levonorgestrel) label, female adolescents aged 12 to 17 understood the information necessary to use emergency contraception safely and effectively as well as their adult counterparts. LEVEL OF EVIDENCE:: III. Language: English Keywords: UNITED STATES OF AMERICA | NEW YORK | RESEARCH REPORT | SURVEYS | ADOLESCENTS, FEMALE | EMERGENCY CONTRACEPTION | INFORMATION | Developed Countries | North America | Americas | Sampling Studies | Studies | Research Methodology | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Contraception | Family Planning Document Number: 330854 |
| 5. Peer Reviewed Title: Group a Streptococcus causing necrotizing fasciitis and toxic shock syndrome after medical termination of pregnancy. Author: Daif JL; Levie M; Chudnoff S; Kaiser B; Shahabi S Source: Obstetrics and Gynecology. 2009 Feb;113(2 Pt 2):504-6. Abstract: BACKGROUND: Group A Streptococcus is an aerobic gram-positive bacteria known to cause cutaneous infections. Invasive infections can lead to toxic shock syndrome with multiorgan failure and mortality rates of 25-48%. CASE: A healthy, young woman developed necrotizing fasciitis, myonecrosis, and toxic shock syndrome after an elective medical termination of pregnancy. This patient had confirmed group A Streptococcus on blood cultures and underwent surgical debridement. After aggressive surgical treatment, below-the-knee amputation, and antibiotic therapy, the patient survived. CONCLUSION: This case demonstrates the need for prompt recognition and treatment of necrotizing fasciitis/toxic shock syndrome. Language: English Keywords: NEW YORK | RESEARCH REPORT | CLINICAL RESEARCH | CASE STUDIES | HISPANICS | WOMEN | BACTERIAL AND FUNGAL DISEASES | DERMATITIS | TOXIC SHOCK SYNDROME | ABORTION | GYNECOLOGIC SURGERY | SURGERY | ANTIBIOTICS | Developed Countries | United States of America | North America | Americas | Research Methodology | Studies | Ethnic Groups | Cultural Background | Population Characteristics | Demographic Factors | Population | Infections | Diseases | Fertility Control, Postconception | Family Planning | Urogenital Surgery | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Drugs Document Number: 330358 Notification |
| 6. Peer Reviewed Title: The relationship of sexual dyad and personal network characteristics and individual attributes to unprotected sex among young injecting drug users. Author: Gyarmathy VA; Neaigus A Source: AIDS and Behavior. 2009 Apr;13(2):196-206. Abstract: We examine in the heterosexual partnerships (dyads) of IDUs the correlates of engaging in unprotected sex on three levels: individual attributes, social network characteristics, and dyad characteristics. Unprotected sex was significantly less likely to occur in dyads where the participant injected daily or had high safe-sex attitude scores, and in dyads where both members encouraged each other to use condoms. Unprotected sex was significantly more likely to occur in dyads that smoked crack together, shared needles with each other, and where the participant knew that the sex partner had concurrent sex partners. In the sexual dyads of IDUs there is a combined risk of unsafe injecting and unsafe sex. Both injecting and sexual risk, and their combination need to be addressed in interventions that target the sexual partnerships of IDUs. Such interventions should also aim to reduce injected and noninjected crack and other stimulant use associated with high-risk sex. Language: English Keywords: NEW YORK | RESEARCH REPORT | KAP SURVEYS | SEXUAL PARTNERS | IV DRUG USERS | SOCIAL NETWORKS | COUPLES | HETEROSEXUALS | SEX BEHAVIOR | RISK BEHAVIOR | SAFER SEX | ATTITUDES | CONDOM USE | NEEDLE SHARING | DRUG USE AND ABUSE | Developed Countries | United States of America | North America | Americas | Surveys | Sampling Studies | Studies | Research Methodology | Behavior | Friends and Relatives | Family and Household | Sociocultural Factors | Family Characteristics | Psychological Factors | Risk Reduction Behavior Document Number: 340121 |
| 7. Peer Reviewed Title: Trends in abortion in the United States. Author: Jones RK; Kost K; Singh S; Henshaw SK; Finer LB Source: Clinical Obstetrics and Gynecology. 2009 Jun;52(2):119-29. Abstract: The US abortion rate peaked soon after 1973, remained fairly constant through the 1980s, and began a steady decline to 2005. A substantial drop in the abortion rates of teenagers and women ages 20 to 24 accounts for much of the decline from 1989 to 2004. All race and ethnic groups experienced declines in abortion rates over the past 30 years, but the rate of black, and to a lesser extent Hispanic, women remains higher than that of non-Hispanic whites. The number of abortion providers has declined in recent decades, but the introduction of early medical abortion may have slowed this trend. Language: English Keywords: UNITED STATES OF AMERICA | NEW YORK | RESEARCH REPORT | ETHNIC GROUPS | ABORTION | ABORTION RATE | PREGNANCY, UNPLANNED | Developed Countries | North America | Americas | Cultural Background | Population Characteristics | Demographic Factors | Population | Fertility Control, Postconception | Family Planning | Reproductive Behavior | Fertility | Population Dynamics Document Number: 342252 Notification |
| 8. Peer Reviewed Title: Rates of follow-up and repeat pregnancy in the 12 months after first-trimester induced abortion. Author: Madden T; Westhoff C Source: Obstetrics and Gynecology. 2009 Mar;113(3):663-8. Abstract: OBJECTIVE: To estimate the proportion of women who returned for a routine follow-up visit after elective abortion and to identify factors associated with repeat pregnancy in the subsequent year. METHODS: We performed a historical cohort study of 865 women who underwent first-trimester surgical abortion at a hospital-based family planning clinic between March 2003 and February 2004. We collected demographic and clinical data from procedure notes and a computerized hospital patient database. We used univariable and multivariable logistic regression to analyze associations between patient characteristics and repeat pregnancy within 1 year. RESULTS: There were a total of 865 women in our cohort. Of these, 753 (87%) returned to the medical center for care; 485 women returned on time, 268 women returned late, and 112 had no further visit. There were 161 repeat pregnancies; 87 (17.9%) in the on-time group and 74 (27.6%) in the late group (P<.001). There were 85 repeat abortions; 42 (8.7%) in the on-time group and 43 (16.0%) in the late group (P<.001). Multivariable analysis demonstrated that on-time follow-up was associated with a reduction in repeat pregnancy (odds ratio [OR] 0.54, 95% confidence interval [CI] 0.37-0.77) and repeat abortion (OR 0.53, 95% CI 0.33-0.86). A total of 130 women received injectable depot medroxyprogesterone acetate (DMPA) at the time of abortion. The rates of repeat pregnancy and abortion in these women were 13.7% and 6.2%, respectively. Women who received DMPA had a decrease in rates of repeat pregnancy (OR 0.41, 95% CI 0.23-0.73) and repeat abortion (OR 0.45, 95% CI 0.20-0.99). CONCLUSION: Timely follow-up and immediate administration of DMPA are associated with a decrease in repeat pregnancy in the 12 months after first-trimester elective abortion. Language: English Keywords: NEW YORK | RESEARCH REPORT | CLINICAL RESEARCH | COHORT ANALYSIS | MULTIVARIATE ANALYSIS | WOMEN IN DEVELOPMENT | PREGNANT WOMEN | PREGNANCY, FIRST TRIMESTER | POSTABORTION CARE | TIME FACTORS | PREGNANCY RATE | DEPO-PROVERA | POSTABORTAL PROGRAMS | Developed Countries | United States of America | North America | Americas | Research Methodology | Data Analysis | Economic Development | Economic Factors | Population Characteristics | Demographic Factors | Population | Pregnancy | Reproduction | Health Services | Delivery of Health Care | Health | Population Dynamics | Fertility Measurements | Fertility | Medroxyprogesterone Acetate | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning | Family Planning Programs Document Number: 331068 |
| 9. Title: Antiepileptic drugs: are women aware of interactions with oral contraceptives and potential teratogenicity? Author: Pack AM; Davis AR; Kritzer J; Yoon A; Camus A Source: Epilepsy and Behavior. 2009 Apr;14(4):640-4. Abstract: Women with epilepsy (WWE)'s knowledge of the interaction between antiepileptic drugs (AEDs) and oral contraceptives (OCs) and the potential teratogenicity of AEDs has received limited study. We conducted a cross-sectional questionnaire study (English or Spanish) among young WWE (18-44 years) to assess demographic characteristics, current AED use, and knowledge of AED interactions with OCs and teratogenicity. We used the Food and Drug Administration's classification system to categorize each AED's teratogenic potential. Participants (n=148) had a mean age of 32 years (SD 8); 32% spoke Spanish and described themselves as Hispanic. Among women prescribed a cytochrome p450-inducing AED, 65% were unaware of decreased OC efficacy. Forty percent of those prescribed Category D AEDs were unaware of potential teratogenic effects. WWE have limited knowledge of the potential interaction between AEDs and OCs and the teratogenic effects of AEDs. Educational efforts should highlight the reproductive health effects of AEDs in WWE. Language: English Keywords: NEW YORK | RESEARCH REPORT | KAP SURVEYS | CROSS SECTIONAL ANALYSIS | WOMEN | HISPANICS | ORAL CONTRACEPTIVES, SIDE EFFECTS | DRUG INTERACTIONS | CENTRAL NERVOUS SYSTEM EFFECTS | KNOWLEDGE | Developed Countries | United States of America | North America | Americas | Surveys | Sampling Studies | Studies | Research Methodology | Demographic Factors | Population | Ethnic Groups | Cultural Background | Population Characteristics | Contraceptive Safety | Safety | Public Health | Health | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Central Nervous System | Physiology | Biology | Sociocultural Factors Document Number: 341110 |
| 10. Peer Reviewed Title: The free condom initiative: promoting condom availability and use in New York City. Author: Renaud TC; Bocour A; Irvine MK; Bernstein KT; Begier EM; Sepkowitz KA; Kellerman SE; Weglein D Source: Public Health Reports. 2009 Jul-Aug;124(4):481-9. Abstract: In 2005, the New York City Department of Health and Mental Hygiene (DOHMH) made free condoms available to organizations through a Web-based ordering system. In 2006, we interviewed managers and patrons about free condom availability, acquisition, and use in venues where people at high risk for human immunodeficiency virus congregate. DOHMH condom distribution increased from 5.8 million in 2004 to 17.3 million in 2006. Overall, managers reported making condoms available at 76% (309/409) of high-priority venues, but only at 40% of gay bars. Among patrons who saw free condoms, 80% (280/351) reported taking them; 73% (205/280) of those who reported taking them also reported using them. A simple, Web-based ordering system dramatically increased condom distribution. In the venues we sampled, the majority of patrons acquired and used free condoms when available and visible, suggesting that increasing free condom availability may increase use. Special efforts are needed to ensure availability at gay bars. Language: English Keywords: UNITED STATES OF AMERICA | NEW YORK | RESEARCH REPORT | URBAN POPULATION | CONDOMS | PROMOTION | PROGRAM EVALUATION | DISTRIBUTIONAL ACTIVITIES | CLINICAL DISTRIBUTION | COMMUNITY-BASED DISTRIBUTION | INTERNET | CONDOM USE | INTERVIEWS | Developed Countries | North America | Americas | Population Characteristics | Demographic Factors | Population | Barrier Methods | Contraceptive Methods | Contraception | Family Planning | Marketing | Economic Factors | Programs | Organization and Administration | Program Activities | Nonclinical Distribution | Information Networks | Communication | Risk Reduction Behavior | Behavior | Data Collection | Research Methodology Document Number: 342144 |
| 11. Title: Alcohol consumption, drug use, and condom use among STD clinic patients. Author: Scott-Sheldon LA; Carey MP; Vanable PA; Senn TE; Coury-Doniger P; Urban MA Source: Journal of Studies on Alcohol and Drugs. 2009 Sep;70(5):762-70. Abstract: OBJECTIVE: Research on the association between substance use and sexual risk behavior has yielded a complex pattern of findings. Such inconsistent findings may reflect method variance, including factors such as gender of the participant, nature of the sexual event, partner characteristics, and type of substance used. The purpose of this study was to investigate the association between substance use and unprotected sex independently for alcohol, drugs, or combined substance use and to examine partner characteristics as a moderator of this association. METHOD: Participants (N = 1,419; 48% women) were recruited from a publicly funded sexually transmitted disease clinic and were asked to complete an audio computer-assisted self-interview regarding their most recent sexual experience, including nature of the event, substance use, and partner characteristics. RESULTS: Analyses showed that alcohol use was related to condom use when gender and partner type were considered; thus, for women, but not for men, partner type interacted with alcohol consumption such that condom use was less likely when alcohol consumption preceded sex with nonprimary partners (drinking was unrelated to condom use with primary partners). Subsequent analyses examining partner substance use showed that women, but not men, who reported both they and their nonprimary partners were drinking during sex were less likely to use a condom. CONCLUSIONS: At the event level, alcohol consumption among sexually transmitted disease clinic patients is associated with condom use, but this association differs by gender and partner characteristics. Findings suggest the need to strengthen substance-use components in sexual risk reduction interventions for women and their partners. Language: English Keywords: UNITED STATES OF AMERICA | NEW YORK | RESEARCH REPORT | CLIENTS | ADOLESCENTS, FEMALE | ALCOHOL USE AND ABUSE | DRUG USE AND ABUSE | SEXUALLY TRANSMITTED DISEASES | CONDOM USE | GENDER RELATIONS | SOCIOCULTURAL FACTORS | Developed Countries | North America | Americas | Program Activities | Programs | Organization and Administration | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Behavior | Reproductive Tract Infections | Infections | Diseases | Risk Reduction Behavior | Gender Issues Document Number: 342714 |
| 12. Peer Reviewed Title: Pregnancy outcomes after laminaria placement and second-trimester removal. Author: Siedhoff M; Cremer ML Source: Obstetrics and Gynecology. 2009 Aug;114(2 Pt 2):456-8. Abstract: BACKGROUND:: Even after comprehensive counseling, patients change their mind about the decision to terminate a pregnancy. There are few data about the effect of laminaria placement and removal on subsequent pregnancy outcome. CASE:: We describe four cases of laminaria removal at 12-17 weeks of gestation with varying outcomes. Two of the four cases developed cervical dilation and delivered early with documented acute chorioamnionitis. CONCLUSION:: Patients should be counseled that pregnancy termination begins with laminaria placement and that their removal could result in premature delivery. Language: English Keywords: UNITED STATES OF AMERICA | NEW YORK | SUMMARY REPORT | CASE HISTORIES | CLIENTS | LAMINARIA TENTS | PREGNANCY OUTCOMES | FETAL MEMBRANES | SEXUALLY TRANSMITTED DISEASES | ANTIBIOTICS | PREMATURE BIRTH | PREMATURE LABOR | Developed Countries | North America | Americas | Data Collection | Research Methodology | Program Activities | Programs | Organization and Administration | Cervical Dilatation | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Pregnancy | Reproduction | Fetus | Reproductive Tract Infections | Infections | Diseases | Drugs Document Number: 342274 |
| 13. Title: The effects of religious contextual norms, structural constraints, and personal religiosity on abortion decisions. Author: Adamczyk A Source: Social Science Research. 2008 Jun;37(2):657-672. Abstract: Researchers have established that individual religiosity influences abortion attitudes, and that abortion attitudes, in turn, shape abortion restrictions and access. Less clear is whether religion and abortion structural constraints influence abortion decisions. This study examines the several individual, contextual, and structural factors that could shape the abortion decisions of women who conceive before marriage. Special attention is given to the importance of academic aspirations and structural constraints, in contrast to religious beliefs and county religious context, for making an abortion decision. Hierarchical modeling techniques and two waves of data from the National Longitudinal Study of Adolescent Health (Add Health) are employed. Neither generic religiosity nor conservative Protestant religious context appear to influence women's abortion decisions. Conversely, young women's abortion decisions are shaped by academic ambition, identification with a conservative Protestant denomination, proximity to an abortion clinic and the level of public abortion funding in their county of residence. (author's) Language: English Keywords: UNITED STATES OF AMERICA | NEW YORK | RESEARCH REPORT | LONGITUDINAL STUDIES | ADOLESCENTS, FEMALE | WOMEN | RELIGION | BELIEFS | ABORTION | CLINICS | FUNDS | UNIVERSITIES | EDUCATION | DECISION MAKING | Developed Countries | North America | Americas | Studies | Research Methodology | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Sociocultural Factors | Culture | Fertility Control, Postconception | Family Planning | Health Facilities | Delivery of Health Care | Health | Financial Activities | Economic Factors | Schools | Behavior Document Number: 326943 Notification |
| 14. Peer Reviewed Title: Sex risk behaviors of drug users: a dual site study of predictors over time. Author: Deren S; Strauss S; Kang SY; Colon HM; Robles RR Source: AIDS Education and Prevention. 2008 Aug;20(4):325-337. Abstract: Reducing sex risk behaviors among high-risk injection drug users (IDUs) and crack smokers is a continuing challenge for HIV prevention. Based on a longitudinal study of sexually active Puerto Rican IDUs and crack smokers in New York (n = 573) and Puerto Rico (n = 264), baseline predictors of changes in sex risk (number of unprotected sex acts) at 6- and 36-month follow-up interviews were examined. In New York, predictors of higher sex risk were being younger, having primary partners, having more other sex partners, never exchanging sex, having lower self-efficacy for reducing sex risk behaviors and being HIV-negative, and these predictors were significant at both post-baseline periods. In Puerto Rico, short-term predictors included being male, having primary partners, never exchanging sex, lower sex risk norms and lower self-efficacy. However, only having primary partners was significant in longer-term behaviors. Results indicated the need for enhancing self-efficacy and for developing risk reduction strategies related to community differences. (author's) Language: English Keywords: NEW YORK | PUERTO RICO | RESEARCH REPORT | LONGITUDINAL STUDIES | IV DRUG USERS | DRUG USE AND ABUSE | RISK BEHAVIOR | SEX BEHAVIOR | MULTIPLE PARTNERS | HIV INFECTIONS | Developed Countries | United States of America | North America | Americas | Caribbean | Studies | Research Methodology | Behavior | Sexual Partners | Viral Diseases | Diseases Document Number: 327956 |
| 15. Peer Reviewed Title: Initiation of oral contraceptives--start now! Author: Edwards SM; Zieman M; Jones K; Diaz A; Robilotto C; Westhoff C Source: Journal of Adolescent Health. 2008 Nov;43(5):432-6. Abstract: PURPOSE: Conventional practice for initiating oral contraceptive (OC) pills involves waiting to start the pills with the next menstrual period. We investigated whether immediate initiation of OCs would lead to improved continuation rates and therefore decreased pregnancy rates in adolescents aged 12-17 years. METHODS: Study subjects were recruited from adolescent women presenting to 2 inner city clinics requesting OCs. A total of 539 adolescents between 12 and 17 years old were randomized to conventional initiation of the OC pill (Conventional Start [CS]) versus immediate, directly observed OC pill ingestion in the clinic (Quick Start [QS]). At 3 and 6 months the participants completed interviews that questioned them about their OC continuation and pregnancies. RESULTS: In all, 86% of our adolescents completed follow-up interviews at 3 months, and 77% at 6 months. There were 45 pregnancies during the study period. QS was associated with continuing OCs to a second pack (adjusted OR 1.8, 95% CI 1.1-3.3). There was no difference in OC continuation rates at 3 or 6 months. Only 26% of adolescents continued OCs at 6 months and we identified 45 pregnancies during follow-up. CONCLUSION: We conclude that directly observed, immediate initiation of oral contraceptives (QS) with adolescents briefly improves continuation although overall continuation rates are discouraging low. Health care providers could use this simple strategy to start adolescents on OCs at the initial visit. The low 6-month OC continuation rates highlight the need to seek novel ways to provide adolescents with the necessary tools to be successful at contraception. Language: English Keywords: UNITED STATES OF AMERICA | NEW YORK | RESEARCH REPORT | ADOLESCENTS | ORAL CONTRACEPTIVES | CONTRACEPTIVE METHOD ACCEPTABILITY | Developed Countries | North America | Americas | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Contraceptive Methods | Contraception | Family Planning | Contraceptive Usage Document Number: 330086 |
| 16. Title: Parent-adolescent communication about sexual intercourse: an analysis of maternal reluctance to communicate. Author: Guilamo-Ramos V; Jaccard J; Dittus P; Collins S Source: Health Psychology. 2008 Nov;27(6):760-9. Abstract: OBJECTIVE: A unified theory of behavior was applied to parent-adolescent communication about sexual intercourse to understand why some mothers speak less often with their children about not having sexual intercourse. According to the theory, parental decisions or intentions to engage in such conversations are a function of expectancies, social norms, self-concept, emotions, and self-efficacy. DESIGN: Data were collected from a random sample of 668 mother-adolescent dyads recruited from middle schools located in the Bronx community of New York City. Data were collected via self-administered surveys. MAIN OUTCOME MEASURES: Mother and adolescent reports on the frequency of parent-adolescent communication about sexual intercourse were obtained. Adolescents and mothers reported how often the mother had discussed 21 topics related to sexual behavior. RESULTS AND CONCLUSION: Results supported the utility of the framework for understanding parent-adolescent communication about sexual intercourse. Significant maternal correlates included (a) expectancies about lacking knowledge, being embarrassed and encouraging children to think maturely and focus on school; (b) self-concept and perceiving that mothers who didn't talk with their children about sex were irresponsible; (c) emotions about feeling relaxed and comfortable; and (d) self-efficacy about the ease of talking with one's child. Implications for family based prevention programs are discussed. Language: English Keywords: UNITED STATES OF AMERICA | NEW YORK | RESEARCH REPORT | ADOLESCENTS | PARENTAL INVOLVEMENT | SEX BEHAVIOR | RISK BEHAVIOR | ADOLESCENT PREGNANCY | PREVENTION AND CONTROL | RISK REDUCTION BEHAVIOR | Developed Countries | North America | Americas | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Child Rearing | Behavior | Reproductive Behavior | Fertility | Population Dynamics | Diseases Document Number: 329578 |
| 17. Peer Reviewed Title: The impact of metformin, oral contraceptives, and lifestyle modification on polycystic ovary syndrome in obese adolescent women in two randomized, placebo-controlled clinical trials. Author: Hoeger K; Davidson K; Kochman L; Cherry T; Kopin L; Guzick DS Source: Journal of Clinical Endocrinology and Metabolism. 2008 Nov;93(11):4299-306. Abstract: CONTEXT: Polycystic ovary syndrome (PCOS) presents in adolescence, and obesity is a common finding. The benefits and risks of alternate approaches to the management of PCOS in obese adolescent women are not clear. OBJECTIVE: We investigated the effects of metformin, oral contraceptives (OCs), and/or lifestyle modification in obese adolescent women with PCOS. DESIGN: Two small, randomized, placebo-controlled clinical trials were performed. PATIENTS AND PARTICIPANTS: A total of 79 obese adolescent women with PCOS participated. INTERVENTIONS: In the single treatment trial, subjects were randomized to metformin, placebo, a lifestyle modification program, or OC. In the combined treatment trial, all subjects received lifestyle modification and OC and were randomized to metformin or placebo. MAIN OUTCOME MEASURES: Serum concentrations of androgens and lipids were measured. RESULTS: Lifestyle modification alone resulted in a 59% reduction in free androgen index with a 122% increase in SHBG. OC resulted ina significant decrease in total testosterone (44%) and free androgen index (86%) but also resulted in an increase in C-reactive protein (39.7%) and cholesterol (14%). The combination of lifestyle modification, OC, and metformin resulted in a 55% decrease in total testosterone, as compared to 33% with combined treatment and placebo, a 4% reduction in waist circumference, and a significant increase in HDL (46%). CONCLUSIONS: In these preliminary trials, both lifestyle modification and OCs significantly reduce androgens and increase SHBG in obese adolescents with PCOS. Metformin, in combination with lifestyle modification and OC, reduces central adiposity, reduces total testosterone, and increases HDL, but does not enhance overall weight reduction. Language: English Keywords: NEW YORK | RESEARCH REPORT | CLINICAL TRIALS | ADOLESCENTS, FEMALE | SUPPORT GROUPS | OBESITY | OVARIAN CYSTS | LIFE STYLE | ORAL CONTRACEPTIVES | ANDROGENS | LIPIDS | RISK REDUCTION BEHAVIOR | TESTOSTERONE | SERUM PROTEIN EFFECTS | ANTHROPOMETRY | Developed Countries | United States of America | North America | Americas | Clinical Research | Research Methodology | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Social Networks | Friends and Relatives | Family and Household | Sociocultural Factors | Body Weight | Physiology | Biology | Diseases | Behavior | Contraceptive Methods | Contraception | Family Planning | Hormones | Endocrine System | Hematological Effects | Hemic System | Measurement Document Number: 329306 |
| 18. Peer Reviewed Title: Microbicide acceptability: Insights for future directions from providers and policy makers. Author: Hoffman S; Cooper D; Ramjee G; Higgins JA; Mantell JE Source: AIDS Education and Prevention. 2008 Apr;20(2):188-202. Abstract: To help fill the gap concerning health care providers' and policymakers' knowledge of and views concerning microbicides, we compared data from one U.S. study and two South African studies that explored these issues. Frontline providers in South Africa were enthusiastic about any method that would have the potential to slow the HIV/AIDS epidemic, whereas providers in New York City and policy makers in South Africa balanced their enthusiasm with more concerns. Across all studies, participants wanted timely and accurate scientific information, and they raised issues about safety, "messiness," and cost. Many had difficulty understanding that promoting a partially effective method can reduce risk if a client uses it more often than a highly effective method. Microbicide advocates need to effectively communicate to providers the evidence-based findings from microbicide trials and find approaches to introduce concepts such as "harm reduction" and "prevention equation" perspectives in client counseling. Developing these approaches will maximize the positive influence that providers can exert on user acceptability of microbicides once they become available. (author's) Language: English Keywords: NEW YORK | SOUTH AFRICA | RESEARCH REPORT | CROSS-CULTURAL COMPARISONS | CLINICAL TRIALS | POLICYMAKERS | HEALTH PERSONNEL | MICROBICIDES | HIV PREVENTION | ADVOCACY | SAFETY | PRICES | COUNSELING | Developed Countries | United States of America | North America | Americas | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Comparative Studies | Studies | Research Methodology | Clinical Research | Administrative Personnel | Organization and Administration | Delivery of Health Care | Health | Drugs | Treatment | Medical Procedures | Medicine | Health Services | HIV Infections | Viral Diseases | Diseases | Communication | Public Health | Commerce | Macroeconomic Factors | Economic Factors | Clinic Activities | Program Activities | Programs Document Number: 326440 |
| 19. Title: Hormonal contraception and blood lead levels in inner-city adolescent girls. Author: Iglesias EA; Coupey SM; Markowitz ME Source: Journal of Pediatric and Adolescent Gynecology. 2008 Oct;21(5):269-73. Abstract: STUDY OBJECTIVE: Physiological states of estrogen deficiency can lead to bone demineralization. Lead is stored in bone and may be released into blood during demineralization. The contraceptive injection depomedroxyprogesterone acetate (DMPA) is associated with estrogen deficiency and bone demineralization and, we hypothesized, may be associated with toxic blood lead levels in adolescents at high risk for lead exposure. We sought to compare blood lead levels in inner-city adolescent girls using DMPA with levels in those using oral contraceptive pills (OCP) and those taking no hormones and to examine the influence of lead exposure and reproductive history on blood lead levels in the total sample. DESIGN: Cross-sectional survey of a clinical convenience sample. SETTING: Inner-city adolescent clinic in an academic medical center. PARTICIPANTS: 174 females aged 13-21 years; 86% minority ethnicity. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Measurement of blood lead levels and an 82-item questionnaire examining lead exposure and reproductive history. RESULTS: 28 subjects were using DMPA, 25 used OCPs, and 121 used no hormones. Mean blood lead level in the total sample of 174 was 1.6 mug/dL, SD = 1.1. Many subjects had environmental risk factors for lead exposure and 15% reported one or more past pregnancies. Mean blood lead levels for subjects with the various environmental and reproductive risk factors ranged from 1.2 microg/dL to 2.0 microg/dL and were not different from levels for subjects without such risk factors. Mean blood lead levels for subjects in the 3 hormonal groups were significantly different (2.1 vs. 1.2 vs.1.5 microg/dL in DMPA, OCP, and no hormone groups respectively, P = 0.007). We dichotomized the blood lead levels into "High" > or =4 microg/dL, or "Low" <4 microg/dL. We found that a significantly higher proportion of girls using DMPA (4/28) than those not using any hormone (2/121) had "High" levels (P = 0.012). CONCLUSIONS: Despite reported high-risk exposure to lead and the possibility of long-term accumulation of lead in bone, we did not find elevated blood levels in our sample. However, DMPA-treated girls were significantly more likely to have higher mean blood lead levels than OCP users and non-hormone users. In addition, DMPA users were more likely to have blood lead levels more than two standard deviations above the mean for the sample as a whole than untreated girls. Further studies are needed to examine low-level lead poisoning in adolescents and the consequences of contraceptive choices on bone health. Language: English Keywords: UNITED STATES OF AMERICA | NEW YORK | RESEARCH REPORT | ADOLESCENTS, FEMALE | CONTRACEPTION | SKELETAL EFFECTS | POISON | MEDROXYPROGESTERONE ACETATE | Developed Countries | North America | Americas | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Family Planning | Physiology | Biology | Toxicity | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents Document Number: 329585 |
| 20. Peer Reviewed Title: Prior pill experiences and current continuation among pill restarters. Author: Kalmuss D; Koenemann S; Westhoff C; Heartwell S; Edwards S; Zieman M; Cushman L; Robilotto C; Stuart G Source: Perspectives on Sexual and Reproductive Health. 2008 Sep;40(3):138-43. Abstract: CONTEXT: Discontinuation of oral contraceptives often puts women at risk for unintended pregnancies. Understanding why a woman discontinued pill use can provide insight into her risk of discontinuation if she restarts use. METHODS: Women younger than 25 obtaining oral contraceptives at three university health centers in 2003-2005 were recruited to participate in a randomized trial; 628 former users were interviewed about their previous experience with the method, and were followed up three months after restarting use. Bivariate and multinomial logistic regression analyses were used to assess the relationship between prior reasons for stopping pill use and method continuation. RESULTS: Women who had discontinued using oral contraceptives because of side effects were less likely to be very sure about restarting the pill at baseline (73%) than were those who had stopped for logistical or fertility-related reasons (88-94%). They also were less likely to have been satisfied with the pill in the last use interval (49% vs. 95-98%) and less likely to be satisfied with it in the three months after restarting (76% vs. 89-93%). These women were more likely to report a short duration of use than an intermediate duration or continuous use during follow-up (odds ratios, 2.5 and 4.5). CONCLUSIONS: When counseling women who are restarting pill use, providers should ask about their experiences with the method and reasons for discontinuation; counseling for women who discontinued because of side effects should address their risk factors for early discontinuation and informing them about other contraceptive choices. Language: English Keywords: TEXAS | NEW YORK | RESEARCH REPORT | KAP SURVEYS | STATISTICAL REGRESSION | MULTIVARIATE ANALYSIS | WOMEN | ORAL CONTRACEPTIVES | CONTRACEPTION TERMINATION | CONTRACEPTION CONTINUATION | MOTIVATION | ORAL CONTRACEPTIVES, SIDE EFFECTS | FERTILITY | LOGISTICS | SATISFACTION | United States of America | North America | Americas | Developed Countries | Surveys | Sampling Studies | Studies | Research Methodology | Data Analysis | Demographic Factors | Population | Contraceptive Methods | Contraception | Family Planning | Contraceptive Usage | Psychological Factors | Behavior | Contraceptive Safety | Safety | Public Health | Health | Population Dynamics | Management | Organization and Administration Document Number: 329168 |
| 21. Title: Emergency contraception: are pediatric residents counseling and prescribing to teens? Author: Lim SW; Iheagwara KN; Legano L; Coupey SM Source: Journal of Pediatric and Adolescent Gynecology. 2008 Jun;21(3):129-134. Abstract: Study Objectives: (1) To assess pediatric residents' attitudes and practices related to counseling about and prescribing emergency contraceptive pills (ECPs) for teens. (2) To determine whether attitudes, counseling, and prescribing practices vary among different levels of residency training. Design: Questionnaire. Setting: Two large inner-city academic medical centers in New York City. Participants: Pediatric residents (PGY 1-3). Main Outcome Measures: Attitudes, counseling and prescribing patterns of ECPs by the pediatric residents Results: 101/120 residents participated in the survey; 35% PGY1, 38% PGY2, 28% PGY3. Less than a third (26%) reported counseling teens about the availability of ECPs during routine non-acute care visits and just over half (56%) provided ECP counseling during visits for contraception. Only 6% of pediatric residents reported that they prescribed ECPs often, while 42% never prescribed ECPs. The majority of the residents did not think that prescribing ECPs would encourage teens to practice unsafe sex or would discourage compliance with other contraceptive methods (70% and 68%, respectively). However, the majority (67%) also reported that they did not think that ECPs should be available over the counter, without prescription. Further analysis by year of training showed that more junior and senior residents than interns counseled adolescents about ECPs at both routine health care maintenance visits and at visits for contraception (32% vs 15%; 62% vs 42%, respectively), would provide adolescent girls with ECPs to have on hand prior to an episode of unprotected sex (52% vs 31%), and thought that ECPs should be available over the counter (39% vs 20%), P < 0.05. Conclusions: Pediatric residents are missing opportunities to prevent unintended teenage pregnancy but they become more likely to counsel about and prescribe ECPs as they progress through residency training. Language: English Keywords: UNITED STATES OF AMERICA | NEW YORK | RESEARCH REPORT | QUESTIONNAIRES | ADOLESCENTS | ATTITUDES | COUNSELING | EMERGENCY CONTRACEPTION | PRESCRIPTIONS | Developed Countries | North America | Americas | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Psychological Factors | Behavior | Clinic Activities | Program Activities | Programs | Organization and Administration | Contraception | Family Planning | Distributional Activities Document Number: 308022 |
| 22. Peer Reviewed Title: The effect of consolidation of abortion services on patient outcomes. Author: Masch R; Cabrera I; Abder R; Baecher L; Cremer M Source: Contraception. 2008 Jan;77(1):60-63. Abstract: In 2001, a service dedicated to family planning was created within a large public hospital to improve patient care services. This retrospective chart review demonstrates the benefit of focusing these services in a specialty clinic. A power analysis was performed and determined that a minimum of 136 charts were needed in each arm of the study to determine if, following an elective abortion, there was a significant increase in attendance at the scheduled postoperative visit. Secondary variables included analysis of contraceptive choice, incidence of continuation of injectable contraception and incidence of repeat pregnancy. After counseling services were initiated, there was a 27% increase in the number of patients returning for the postoperative clinic appointment within 8 weeks [32% (61/191) in 1998 vs. 59% (80/136) in 2001; p < .0001]. There was also a significant decrease in patients without a plan for contraception, 29% in 1998 vs. 11% in 2001, and a decrease in repeat pregnancies from 9% in 1998 to 1.5% in 2001. There was no difference in patient adherence with injectable contraception. Consolidation of abortion services improves subsequent use of contraception and reduces incidence of repeat pregnancy. (author's) Language: English Keywords: UNITED STATES OF AMERICA | NEW YORK | RESEARCH REPORT | INCIDENCE | ABORTION | COUNSELING | CONTRACEPTION | USER COMPLIANCE | POSTOPERATIVE PROCEDURES | HEALTH SERVICES | Developed Countries | North America | Americas | Measurement | Research Methodology | Fertility Control, Postconception | Family Planning | Clinic Activities | Program Activities | Programs | Organization and Administration | Behavior | Surgery | Treatment | Medical Procedures | Medicine | Delivery of Health Care | Health Document Number: 323062 Notification |
| 23. Title: Promoting environmental justice through community-based participatory research: The role of community and partnership capacity. Author: Minkler M; Vasquez VB; Tajik M; Petersen D Source: Health Education and Behavior. 2008 Feb;35(1):119-137. Abstract: Community-based participatory research (CBPR) increasingly is being used to study and address environmental justice. This article presents the results of a cross-site case study of four CBPR partnerships in the United States that researched environmental health problems and worked to educate legislators and promote relevant public policy. The authors focus on community and partnership capacity within and across sites, using as a theoretical framework Goodman and his colleagues' dimensions of community capacity, as these were tailored to environmental health by Freudenberg, and as further modified to include partnership capacity within a systems perspective. The four CBPR partnerships examined were situated in NewYork, California, Oklahoma, and North Carolina and were part of a larger national study. Case study contexts and characteristics, policy-related outcomes, and findings related to community and partnership capacity are presented, with implications drawn for other CBPR partnerships with a policy focus. (author's) Language: English Keywords: UNITED STATES OF AMERICA | NEW YORK | CALIFORNIA | OKLAHOMA | NORTH CAROLINA | RESEARCH REPORT | CASE STUDIES | ENVIRONMENTAL POLLUTION | INEQUALITIES | COMMUNITY PARTICIPATION | RESEARCH ACTIVITIES | PROGRAM EVALUATION | PUBLIC HEALTH | Developed Countries | North America | Americas | Studies | Research Methodology | Environmental Degradation | Environment | Socioeconomic Factors | Economic Factors | Organization and Administration | Programs | Health Document Number: 324662 |
| 24. Title: Predicting sexual risk behaviors among adolescent and young women using a prospective diary method. Author: Morrison-Beedy D; Carey MP; Feng C; Tu XM Source: Research In Nursing and Health. 2008 Aug;31(4):329-40. Abstract: We describe the sexual risk behaviors, psychological distress, and substance use of 102 late adolescent girls and identify predictors of protected and unprotected vaginal sex. Participants completed questionnaires assessing hypothesized predictors and then daily behavioral diaries for 12 weeks. Protected intercourse was predicted by baseline sexual behavior, greater knowledge, positive condom attitudes, lower perceived condom-use difficulty, greater condom-use intentions, more drinking days, less binge drinking, less Ecstasy use, and lower psychological distress. Unprotected intercourse was predicted by baseline sexual behavior, binge drinking, Ecstasy and opiate use, fewer drinking days, and fewer daily drinks. These findings suggest that psychological distress, substance use, and sexual risk behavior are interconnected and should be considered collectively in interventions for adolescent females. Language: English Keywords: UNITED STATES OF AMERICA | NEW YORK | RESEARCH REPORT | QUESTIONNAIRES | COMPARATIVE STUDIES | ADOLESCENTS, FEMALE | DEPRESSION | SEX BEHAVIOR | SAFER SEX | RISK BEHAVIOR | RISK REDUCTION BEHAVIOR | HIV INFECTIONS | STRESS | ALCOHOL USE AND ABUSE | INTERVENTIONS | Developed Countries | North America | Americas | Studies | Research Methodology | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Mental Disorders | Diseases | Behavior | Viral Diseases | Psychological Factors | Programs | Organization and Administration Document Number: 328389 |
| 25. Title: Understanding sexual abstinence in urban adolescent girls. Author: Morrison-Beedy D; Carey MP; Cote-Arsenault D; Seibold-Simpson S; Robinson KA Source: Journal of Obstetric, Gynecologic, and Neonatal Nursing. 2008 Mar-Apr;37(2):185-195. Abstract: The objectives were to gain insight into the context of sexual abstinence and identify potential determinants of abstinence in this population. Four focus groups were used for the design. Twenty-four, predominantly African American (88%) girls aged 14 to 19 years were recruited from urban health centers and youth development programs in Rochester, New York, between September and December 2006. Content analysis was used to analyze the four verbatim transcripts. Using analytic induction, groups were compared and contrasted at the micro (within-group) and macro (between-group) levels to identify themes. Four themes were identified that provided insight into how and why these girls remain abstinent despite being in sexually active social climates. They focused on the following: self-respect (I'm worth it), impact of mothers (Mama says . . . think before you let it go), influence of boys and other peers (Boys will be boys), and potential negative consequences of sex (Hold on, there's a catch) . Developing interventions to maintain abstinence, delay onset of sexual activity, and promote protected first and subsequent sexual contact in abstinent girls are key to decreasing future sexual risk. These findings suggest opportunities to develop HIV prevention strategies tailored to the needs of abstinent girls. (author's) Language: English Keywords: UNITED STATES OF AMERICA | NEW YORK | RESEARCH REPORT | FOCUS GROUPS | DATA ANALYSIS | BLACKS | ADOLESCENTS, FEMALE | URBAN POPULATION | ABSTINENCE | BEHAVIOR | RISK REDUCTION BEHAVIOR | PARENTAL INVOLVEMENT | Developed Countries | North America | Americas | Data Collection | Research Methodology | Ethnic Groups | Cultural Background | Population Characteristics | Demographic Factors | Population | Adolescents | Youth | Age Factors | Family Planning, Behavioral Methods | Family Planning | Child Rearing Document Number: 325341 |
| 26. Peer Reviewed Title: The emerging crisis of drug-resistant tuberculosis in South Africa: Lessons from New York City. Author: Murphy RA Source: Clinical Infectious Diseases. 2008;46:1729-1732. Abstract: Multidrug-resistant tuberculosis and extensively drug-resistant tuberculosis have emerged as important infections in South Africa among patients infected with human immunodeficiency virus (HIV). In the face of this new epidemic, South Africa must rededicate itself to the task of tuberculosis control and treatment with a rapid, multifaceted approach. Priorities include expansion of second-line treatment capacity, investment in clinical laboratories, a system to ensure supervised treatment for all patients, and enhancement of infection control procedures. In New York City, where drug-resistant tuberculosis emerged 2 decades ago-also in the context of a large HIV-infected population and an underfunded public health infrastructure - similar steps were successful in leading to the rapid decrease in rates of drug resistance among tuberculosis isolates. With refinements based on local resource constraints, urgent measures could potentially arrest the alarming increase in multidrugresistant and extensively drug-resistant tuberculosis cases in South Africa. Unlike many countries in sub-Saharan Africa, South Africa has the capacity to mount a rapid and large-scale response before drug-resistant tuberculosis envelops a much larger and far poorer region. (author's) Language: English Keywords: SOUTH AFRICA | NEW YORK | UNITED STATES OF AMERICA | RESEARCH REPORT | CLINICAL RESEARCH | PERSONS LIVING WITH HIV/AIDS | TUBERCULOSIS | DRUG RESISTANCE | TREATMENT | LABORATORY PROCEDURES | PERFORMANCE IMPROVEMENT | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Developed Countries | North America | Americas | Research Methodology | Persons Living With HIV/AIDS | HIV Infections | Viral Diseases | Diseases | Infections | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Management | Organization and Administration Document Number: 326635 |
| 27. Title: Controversies in contraception. Author: Pitts SA; Emans SJ Source: Current Opinion in Pediatrics. 2008 Aug;20(4):383-9. Abstract: PURPOSE OF REVIEW: New research is constantly being published regarding hormonal contraceptives and bone health, migraine headaches, thrombosis risk, hypertension, weight gain, and obesity, as well as emergency contraception. At times, these studies can be clarifying, but they can also raise new controversies and questions. It is important for providers to be aware of the emerging issues regarding contraceptive care for adolescent patients. RECENT FINDINGS: Research suggests that Depo-Provera (depot medroxyprogesterone acetate; Pfizer, New York City, New York, USA) and, perhaps, low-dose oral contraceptive pills can have adverse effects on adolescent bone health, although the data demonstrating reversibility of bone loss after discontinuation of these contraceptives are reassuring. Additionally, estrogen-containing contraceptives pose risks for patients, including the onset of or exacerbation of migraine headaches, venous thromboembolism, and hypertension. Depo-Provera has been implicated in weight gain, especially in girls who are already overweight. Obesity may decrease the efficacy of some hormonal contraceptives. Finally, the mechanism of action of emergency contraception is still unknown, although studies continue to suggest that it has primarily preovulatory, not postovulatory, effects. SUMMARY: Adolescent health providers need to be aware of the new research and controversies in contraceptive care in order to counsel and care for patients effectively. Language: English Keywords: UNITED STATES OF AMERICA | NEW YORK | RESEARCH REPORT | ADOLESCENTS, FEMALE | DEPO-PROVERA | MEDROXYPROGESTERONE ACETATE | EMERGENCY CONTRACEPTION | ORAL CONTRACEPTIVES, SIDE EFFECTS | SKELETAL EFFECTS | Developed Countries | North America | Americas | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning | Contraceptive Safety | Safety | Public Health | Health | Physiology | Biology Document Number: 328563 |
| 28. Title: Antibody responses to Cryptococcus neoformans in Indian patients with cryptococcosis. Author: Saha DC; Xess I; Zeng WY; Goldman DL Source: Medical Mycology. 2008 Aug;46(5):457-63. Abstract: An important element of the host response to cryptococcosis is humoral immunity. Specific antibody responses in patients with cryptococcosis however, have not been extensively studied. We analyzed the antibody responses of 22 Indian patients with cryptococcosis, including both HIV+ and HIV- individuals. Sera from 10 Indian patients with AIDS and without cryptococcosis were studied as controls. Antibody responses to cryptococcal proteins were detected by immunoblot, while antibodies to glucuronoxylomannan (GXM), the main component of the cryptococcal capsular polysaccharide were measured by ELISA. Our results indicate that cryptococcosis elicits antibodies to a specific pattern of cytoplasmic proteins. Further, we find that antibody responses to both cytoplasmic proteins and GXM are less robust in HIV+ patients when compared with HIV- patients. Language: English Keywords: UNITED STATES OF AMERICA | NEW YORK | RESEARCH REPORT | PERSONS LIVING WITH HIV/AIDS | CLIENTS | ANTIBODIES | AIDS | PROTEINS | Developed Countries | North America | Americas | Persons Living With HIV/AIDS | HIV Infections | Viral Diseases | Diseases | Program Activities | Programs | Organization and Administration | Immunologic Factors | Immunity | Immune System | Physiology | Biology Document Number: 328564 |
| 29. Peer Reviewed Title: S-adenosylmethionine levels in the diagnosis of Pneumocystis carinii pneumonia in patients with HIV infection. Author: Skelly MJ; Holzman RS; Merali S Source: Clinical Infectious Diseases. 2008 Feb 1;46(3):467-471. Abstract: BACKGROUND: S-adenosylmethionine (AdoMet) is a key molecule involved in methylation reactions and polyamine synthesis. Pneumocystis carinii are unable to synthesize this molecule and have been shown to scavenge this metabolic intermediate from the plasma of rats during active infection. A prior study involving humans strongly suggested that low levels of plasma AdoMet are sensitive and specific indicators of acute infection. METHODS: From March 2004 through January 2006, we collected plasma AdoMet levels from patients with human immunodeficiency virus (HIV) infection and either confirmed Pneumocystis carinii pneumonia (PCP), confirmed pulmonary tuberculosis, or confirmed bacterial pneumonia. We compared levels in patients with PCP with those in patients with other diseases and also monitored changes in levels during treatment of PCP. RESULTS: Initial AdoMet levels were significantly lower in patients with PCP, and there was no overlap between the groups. Among patients with PCP, levels of AdoMetincreased with successful treatment. CONCLUSIONS: Measurement of plasma AdoMet levels in patients with HIV infection who have pulmonary infections can identify those with PCP. Language: English Keywords: NEW YORK | RESEARCH REPORT | CLINICAL RESEARCH | COMPARATIVE STUDIES | PERSONS LIVING WITH HIV/AIDS | PNEUMONIA | TUBERCULOSIS | VIRAL DISEASES | BACTERIAL AND FUNGAL DISEASES | LABORATORY EXAMINATIONS AND DIAGNOSES | HIV INFECTIONS | COMPLICATIONS | HISTOCHEMICAL EFFECTS | Developed Countries | United States of America | North America | Americas | Research Methodology | Studies | Persons Living With HIV/AIDS | Diseases | Pulmonary Effects | Physiology | Biology | Infections | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Cytologic Effects Document Number: 325751 |
| 30. Peer Reviewed Title: Two distinct oral routes of misoprostol in mifepristone medical abortion: a randomized controlled trial. Author: Winikoff B; Dzuba IG; Creinin MD; Crowden WA; Goldberg AB; Gonzales J; Howe M; Moskowitz J; Prine L; Shannon CS Source: Obstetrics and Gynecology. 2008 Dec;112(6):1303-10. Abstract: OBJECTIVE: To study the efficacy, safety, and acceptability of oral immediately swallowed and buccal misoprostol 800 mcg after mifepristone 200 mg for terminating pregnancy through 63 days since the last menstrual period (LMP). METHODS: This seven-site study randomly assigned 966 women seeking abortions to oral or buccal misoprostol 800 mcg 24-36 hours after mifepristone 200 mg with 7-14-day follow-up. RESULTS: Success rates in the oral and buccal groups were 91.3% (389 of 426) and 96.2% (405 of 421), respectively (P=.003; relative risk [RR] 0.95, 95% confidence interval [CI] 0.92-0.98). Ongoing pregnancy occurred in 3.5% (15 of 426) of women who took oral misoprostol compared with 1.0% (4 of 421) of women in the buccal group (P=.012; RR 3.71, 95% CI 1.24-11.07). Through 49 days since the LMP, oral and buccal regimens performed similarly, but success with oral misoprostol decreased as pregnancy advanced. In pregnancies of 57-63 days since the LMP, success with oral misoprostol fell below 90%, whereas that with buccal remained high (oral 85.1% [97 of 114], buccal 94.8% [109 of 115], P=.015, RR 0.90, 95% CI 0.82-0.98). Furthermore, in this gestational age group, there were significantly more ongoing pregnancies among women who took misoprostol orally (7.9% [9 of 114]) compared with buccally (1.7% [2 of 115]; P=.029, RR 4.54, 95% CI 1.0-20.55). Adverse effect profiles were similar, although fever and chills were reported approximately 10% more often among women who took buccal misoprostol. Satisfaction and acceptability were high for both methods. CONCLUSION: Buccal misoprostol 800 mcg after mifepristone 200 mg is a good option for medical abortion through 63 days since the LMP. Oral misoprostol 800 mcg is also a safe and effective alternative, although success rates diminish with increasing gestational age. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, www.clinicaltrials.gov, NCT00386867 LEVEL OF EVIDENCE: I. Language: English Keywords: NEW YORK | UNITED STATES OF AMERICA | RESEARCH REPORT | WOMEN | ABORTION | SAFETY | MISOPROSTOL | RU-486 | CONTRACEPTIVE METHOD ACCEPTABILITY | Developed Countries | North America | Americas | Demographic Factors | Population | Fertility Control, Postconception | Family Planning | Public Health | Health | Prostaglandins, Synthetic | Prostaglandins | Endocrine System | Physiology | Biology | Hormone Antagonists | Hormones | Contraceptive Usage | Contraception Document Number: 330014 Notification |
 |
||
 |
Information & Knowledge for Optimal Health (INFO) Project 111 Market Place Suite 310, Baltimore, MD 21202 Phone: 410-659-6300 Fax: 410-659-6266 Security & Privacy Policy |  |