1.  Peer Reviewed Title: Increased access to emergency contraception: why it may fail. Author: Baecher L; Weaver MA; Raymond EG Source: Human Reproduction. 2009 Apr;24(4):815-9. Abstract: BACKGROUND: To explore why increased access to emergency contraception (EC) failed to reduce pregnancies in a recent randomized controlled trial. METHODS: We used multivariable logistic regression to identify risk factors for unintended pregnancy using data from a trial involving sexually active women (n = 1490, aged 14-24 years) randomly assigned to either increased access or standard access to EC. We used predictive modeling to generate estimated pregnancy risk scores for each participant. We then examined EC use among women at low or high baseline risk of pregnancy. RESULTS: Gravidity, recent history of unprotected sex (within 14 days of enrollment to study) and lower aversion to pregnancy predicted unintended pregnancy. Women in the increased access group were more likely than women in the standard access group to use EC repeatedly. This difference was significantly stronger (P = 0.03) among low risk women than high risk women [Relative risk (RR) 10.0, 95% confidence interval (CI) 6.5-15.4 and RR 5.5, 95% CI 3.8-7.9, respectively]. CONCLUSIONS: Increased access to EC had a greater impact on women who were at lower baseline risk of pregnancy. This may explain in part why increased access to EC has had no measurable benefit in clinical trials. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | STATISTICAL REGRESSION | WOMEN | EMERGENCY CONTRACEPTION | CONTRACEPTIVE AVAILABILITY | PREGNANCY, UNPLANNED | INCIDENCE | RISK FACTORS | PSYCHOSOCIAL FACTORS | Developed Countries | North America | Americas | Data Analysis | Research Methodology | Demographic Factors | Population | Contraception | Family Planning | Reproductive Behavior | Fertility | Population Dynamics | Measurement | Health | Behavior Document Number: 341661 |
| 2. Title: Individual- and community-level determinants of social acceptance of people living with HIV in Kenya: Results from a national population-based survey. Author: Chiao C; Mishra V; Sambisa W Source: Health and Place. 2009 Sep;15(3):742-750. Abstract: Using the 2003 Kenya Demographic and Health Survey, we investigated the influence of individual- and community-level factors on accepting attitudes toward people living with HIV (PLHIV) using three outcomes: (1) willingness to care for an infected household member, (2) willingness to buy vegetables from an infected vendor, and (3) willingness to allow an infected female teacher to continue teaching. In multilevel logistic regression models, we found that individuals who expressed greater acceptance of PLHIV were more likely to be male, older, more educated, high AIDS knowledge, and exposed to mass media. At the community level, differences in accepting attitudes were associated with community AIDS knowledge, community education, and community AIDS experience, but not for region, or place of residence. The findings suggest the important role of community factors in determining social acceptance of PLHIV. Programmatic strategies aimed at increasing these accepting attitudes should consider both individual- and community-level factors. Language: English Keywords: KENYA | RESEARCH REPORT | KAP SURVEYS | DEMOGRAPHIC AND HEALTH SURVEYS | COMMUNITY | TEACHERS | PERSONS LIVING WITH HIV/AIDS | SOCIAL DISCRIMINATION | STIGMA | HIV INFECTIONS | PSYCHOSOCIAL FACTORS | ATTITUDES | FAMILY RELATIONSHIPS | ACCEPTANCE PROCESS | FOOD AND BEVERAGE | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Demographic Surveys | Population Dynamics | Demographic Factors | Population | Residence Characteristics | Population Distribution | Geographic Factors | Education | Viral Diseases | Diseases | Social Problems | Sociocultural Factors | Behavior | Psychological Factors | Family Characteristics | Family and Household | Decision Making | Nutrition | Health Document Number: 341072 |
| 3. Title: Is the process of diagnosing and treating incidental medical findings a barrier to contraceptive acceptance and use? Author: Ekabua JE; Ekabua KJ; Ekanem EI; Iklaki CU Source: Journal of Obstetrics and Gynaecology. 2009 Apr;29(3):237-9. Abstract: The objective of this study is to determine the impact of diagnosing and treating incidental medical disorders on contraceptive acceptance/use. The setting was the University of Calabar Teaching Hospital, a tertiary referral centre for the South-South zone of Nigeria and South-west Cameroon. Subjects were apparently healthy women seeking contraceptive counselling at the Teaching Hospital, Calabar (2001-2005). A total of 4,990 women's records were studied for the diagnosis of incidental medical findings. Two levels of missed opportunity for contraceptive uptake were identified. Incidental medical findings were seen in 26.9% of women. Contraceptive acceptance in women with incidental medical findings was 24.8%. Defaults from the screening process and treatment of incidental medical findings were significantly associated with high parity and low social status (p < 0.5). Incidental medical disorders, although uncommon in women desiring contraception were associated with low contraceptive uptake in women with high parity and low social status. Language: English Keywords: NIGERIA | CAMEROON | RESEARCH REPORT | KAP SURVEYS | CLINICAL RESEARCH | WOMEN IN DEVELOPMENT | EXAMINATIONS AND DIAGNOSES | SCREENING | PSYCHOSOCIAL FACTORS | CONTRACEPTIVE USAGE | MULTIPARITY | SOCIAL CLASS | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Surveys | Sampling Studies | Studies | Research Methodology | Economic Development | Economic Factors | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Behavior | Contraception | Family Planning | Parity | Fertility Measurements | Fertility | Population Dynamics | Demographic Factors | Population | Socioeconomic Status | Socioeconomic Factors Document Number: 330945 |
| 4. 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 |
5.  Title: Analyzing the cost-effectiveness of interventions to benefit orphans and vulnerable children: evidence from Kenya and Tanzania. Author: Hutchinson P; Thurman TR Source: Chapel Hill, North Carolina, University of North Carolina at Chapel Hill, Carolina Population Center [CPC], MEASURE Evaluation, 2009 Apr. 26 p. (SR-09-51USAID Cooperative Agreement No. GPO-A-00-03-00003-00) Abstract: To provide insight on the success of programs providing services to orphans and vulnerable children (OVC), this paper analyzes cost-effectiveness of four programs in Kenya and Tanzania by comparing intervention costs to program outcomes. These results provide some evidence that investments in OVC programs-particularly (1) school-based HIV education and counseling for children and (2) savings and internal lending committees for guardians-can help improve the well-being of OVCs at a fairly low cost per beneficiary. Language: English Keywords: KENYA | TANZANIA | RESEARCH REPORT | ORPHANS AND VULNERABLE CHILDREN | HIV INFECTIONS | PSYCHOSOCIAL FACTORS | ANTIRETROVIRAL THERAPY | EDUCATION | HEALTH SERVICES | TREATMENT | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Family and Household | Sociocultural Factors | Viral Diseases | Diseases | Behavior | HIV | Delivery of Health Care | Health | Medical Procedures | Medicine Document Number: 339996 |
| 6. Peer Reviewed Title: Peer-group support intervention improves the psychosocial well-being of AIDS orphans: cluster randomized trial. Author: Kumakech E; Cantor-Graae E; Maling S; Bajunirwe F Source: Social Science and Medicine. 2009 Mar;68(6):1038-43. Abstract: Accumulating evidence suggests that AIDS orphanhood status is accompanied by increased levels of psychological distress such as anxiety, depression, intense guilt, shame, and anger. However, few studies have examined the possible reduction of psychological distress in AIDS orphans through the help of interventions that promote well-being. The objective of the study was to evaluate the effects of a school-based peer-group support intervention combined with periodic somatic health assessments and treatment on the psychosocial well-being of AIDS orphans in the Mbarara District of southwestern Uganda. In a cluster randomized controlled design, 326 AIDS orphans aged 10-15 years were assigned to either peer-group support intervention combined with monthly somatic healthcare (n=159) or control group (n=167) for follow-up assessment. Baseline and 10 week follow-up psychological assessments were conducted in both groups using self-administered Beck Youth Inventories. Complete data were available for 298 orphans. After adjusting for baseline scores, follow-up scores for the intervention group in comparison with controls showed significant improvement in depression, anger, and anxiety but not for self-concept. This study demonstrated that peer-group support intervention decreased psychological distress, particularly symptoms of depression, anxiety and anger. Thus, the use of peer-group support interventions should be incorporated into existing school health programs. Language: English Keywords: UGANDA | EVALUATION REPORT | KAP SURVEYS | CASE CONTROL STUDIES | ORPHANS AND VULNERABLE CHILDREN | PEER GROUPS | SUPPORT GROUPS | PERSONS LIVING WITH HIV/AIDS | PSYCHOSOCIAL FACTORS | AIDS | STRESS | DEPRESSION | ANXIETY DISORDERS | SELF ESTEEM | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Evaluation | Surveys | Sampling Studies | Studies | Research Methodology | Family and Household | Sociocultural Factors | Knowledge Sources | Communication | Social Networks | Friends and Relatives | HIV Infections | Viral Diseases | Diseases | Behavior | Psychological Factors | Mental Disorders Document Number: 341167 |
| 7. Peer Reviewed Title: Predictors of early first sexual intercourse among adolescents in Cape Town, South Africa. Author: Mathews C; Aaro LE; Flisher AJ; Mukoma W; Wubs AG; Schaalma H Source: Health Education Research. 2009 Feb;24(1):10 p. Abstract: The authors used a social cognition theoretical framework to investigate the predictors of young adolescents' transition to first intercourse. The analyses were based on a longitudinal study of students in schools allocated to the control arm of a cluster-randomized controlled trial to investigate the effect of a school-based HIV prevention program. The study involved 2,360 Grade 8 students in Cape Town. Of the 1,440 students who were virgins at baseline, 1,144 remained virgins 15 months later, and 296 (20.6%) reported having had their first sexual intercourse. Transition to first sexual intercourse was more likely among males, among older students, and among students with a lower socio-economic status. Transition to first sexual intercourse was significantly associated with intentions to have sexual intercourse, poor self-efficacy to negotiate delayed sex, and intimate partner violence. The model predicted 35% of the variance in intentions and 16% of the variance in transition. These findings indicate some of the factors that influence young people to have first sex and that need to be addressed when designing effective interventions. Language: English Keywords: SOUTH AFRICA | RESEARCH REPORT | KAP SURVEYS | THEORETICAL MODELS | LONGITUDINAL STUDIES | ADOLESCENTS | URBAN POPULATION | FIRST INTERCOURSE | AGE FACTORS | RISK FACTORS | PSYCHOSOCIAL FACTORS | SEX FACTORS | SOCIOECONOMIC STATUS | PARTNER COMMUNICATION | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Youth | Population Characteristics | Demographic Factors | Population | Sex Behavior | Behavior | Biology | Socioeconomic Factors | Economic Factors | Interpersonal Relations Document Number: 329524 |
| 8. Title: Breastfeeding self-efficacy in women of African descent. Author: McCarter-Spaulding D; Gore R Source: Journal of Obstetric, Gynecologic, and Neonatal Nursing. 2009 Mar-Apr;38(2):230-43. Abstract: OBJECTIVE: To determine whether breastfeeding self-efficacy predicts the duration and pattern of breastfeeding in a sample of Black women of African descent. DESIGN: Descriptive, longitudinal, cohort study. Participants were recruited during the postpartum hospitalization and followed monthly for 6 months or until complete weaning. Breastfeeding self-efficacy was measured using the Breastfeeding Self-Efficacy Scale--Short Form (BSES-SF) (Dennis, 2003). SETTING: A large urban teaching hospital in New England. PATIENTS/PARTICIPANTS: Women who self-identified as being of African descent with full-term infants who were planning to breastfeed (N=125). MAIN OUTCOME MEASURES: Breastfeeding pattern was determined by the total number of feedings the infant received in the past 24 hours and how many of these were breast milk. Duration of breastfeeding was defined as the number of weeks until complete weaning. RESULTS: Higher levels of breastfeeding self-efficacy predicted longer duration and a more exclusive pattern of breastfeeding at 1 and 6 months postpartum, consistent with prior research (p<.01). Planned pattern of feeding predicted actual pattern of feeding at 1 month postpartum (p<.01). Returning to work after 12 weeks was protective of breastfeeding to 6 months postpartum (p<.01). CONCLUSION: Theory-based interventions to enhance self-efficacy will help improve breastfeeding outcomes. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | LONGITUDINAL STUDIES | BLACKS | WOMEN | BREASTFEEDING | BREASTFEEDING, EXCLUSIVE | TIME FACTORS | WEANING | PSYCHOSOCIAL FACTORS | BELIEFS | EMPLOYMENT STATUS | INTERVENTIONS | Developed Countries | North America | Americas | Studies | Research Methodology | Ethnic Groups | Cultural Background | Population Characteristics | Demographic Factors | Population | Infant Nutrition | Nutrition | Health | Population Dynamics | Behavior | Culture | Sociocultural Factors | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Programs | Organization and Administration Document Number: 341947 |
| 9. Title: Gender differences in intention to remain a virgin until marriage among school pupils in rural northern Tanzania. Author: Njau B; Mtweve S; Manongi R; Jalipa H Source: African Journal of AIDS Research. 2009;8(2):157-166. Abstract: This study was conducted in 10 districts in northern Tanzania in July 2005. Out of 65 villages, four were randomly selected. In total, 953 primary school pupils, ages 10 to 14 years, participated in an interview and questionnaire: about 54% were girls and 41% were ages 12 to 13. Thirty-four percent of boys and 28.5% of girls said they had the intention to remain a virgin until marriage. Among the male respondents, having the intention to remain a virgin until marriage was associated with sharing a bedroom with a brother under age 18 years and with saying that girls have the right to say no to sex. Among the female respondents, having the intention to remain a virgin until marriage was associated with living with both parents and saying that they had the confidence to refuse sex with someone who has authority or power. Language: English Keywords: TANZANIA | RURAL AREAS | RESEARCH REPORT | SAMPLING STUDIES | STUDENTS | ABSTINENCE | VIRGINITY | ATTITUDES | SEX FACTORS | PRIMARY SCHOOLS | INTERVIEWS | LIVING ARRANGEMENTS | PSYCHOSOCIAL FACTORS | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Geographic Factors | Population | Studies | Research Methodology | Education | Family Planning, Behavioral Methods | Family Planning | Sex Behavior | Behavior | Psychological Factors | Population Characteristics | Demographic Factors | Schools | Data Collection | Residence Characteristics | Population Distribution Document Number: 339890 |
| 10. Title: Community-based psychosocial intervention for HIV-affected children and their caregivers: evaluation of the Salvation Army's Mama Mkubwa Program in Tanzania. Author: Nyangara F; Obiero W; Kalungwa Z; Thurman TR Source: Chapel Hill, North Carolina, University of North Carolina at Chapel Hill, Carolina Population Center [CPC], MEASURE Evaluation, 2009 Mar. 29 p. (SR-09-50USAID Cooperative Agreement No. GPO-A-00-03-00003-00) Abstract: This report presents the post-test findings from an outcome evaluation of the Mama Mkubwa community-centered psychosocial support program implemented by the Salvation Army, Tanzania Command, that provides assistance to OVC and their families and communities. In addition, the paper discusses the programmatic implications of the findings for program implementers and policy-makers to help them make informed decisions on how to meet OVC needs and reduce their vulnerabilities. Language: English Keywords: TANZANIA | SUMMARY REPORT | YOUTH | ORPHANS AND VULNERABLE CHILDREN | PSYCHOSOCIAL FACTORS | SUPPORT GROUPS | PROGRAM DESIGN | PROGRAM ACTIVITIES | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Age Factors | Population Characteristics | Demographic Factors | Population | Family and Household | Sociocultural Factors | Behavior | Social Networks | Friends and Relatives | Programs | Organization and Administration Document Number: 339997 |
| 11. Title: Effects of programs supporting orphans and vulnerable children: Key findings, emerging issues, and future directions from evaluations of four projects in Kenya and Tanzania. An evaluation. Author: Nyangara F; Thurman TR; Hutchinson P; Obiero W Source: Chapel Hill, North Carolina, University of North Carolina at Chapel Hill, Carolina Population Center, MEASURE Evaluation, 2009 Jun. 49 p. (SR-09-52USAID Cooperative Agreement No. GPO-A-00-03-00003-00) Abstract: This report summarizes findings from evaluations of four programs, two in Kenya and two in Tanzania, that support orphans and other vulnerable children (OVC). The report focuses on the outcomes, emerging issues, and lessons learned. Implications of the findings are offered to provide guidance to OVC service providers, donors, and policy-makers. Language: English Keywords: TANZANIA | KENYA | SUMMARY REPORT | ORPHANS AND VULNERABLE CHILDREN | CHILD HEALTH | HEALTH SERVICES | ADVOCACY | SOCIAL MOBILIZATION | NUTRITION | PSYCHOSOCIAL FACTORS | CARE AND SUPPORT | EDUCATION | SOCIAL PROTECTION | PROGRAM EVALUATION | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Family and Household | Sociocultural Factors | Health | Delivery of Health Care | Communication | Social Change | Behavior | Political Factors | Programs | Organization and Administration Document Number: 331821 |
| 12. Title: SAWAKA Jali Watoto Program supporting most-vulnerable children, Tanzania. A case study. Author: Nyangara F; Matiko C; Kalungwa Z Source: Chapel Hill, North Carolina, University of North Carolina at Chapel Hill, Carolina Population Center, MEASURE Evaluation, 2009 Jul. 25 p. Abstract: In 2007-2008, the MEASURE Evaluation project evaluated the Jali Watoto (Care for Children) project in Tanzania. Jali Watoto is a child- and community-centered program that provides support to most-vulnerable children and their caregivers. The evaluation assessed the effectiveness of the program model in improving the well-being of most-vulnerable children and their caregivers in communities affected by HIV / AIDS. In addition, the paper outlines the programmatic implications of the findings for service providers and other stakeholders and makes recommendations regarding effective, replicable interventions. Language: English Keywords: TANZANIA | SUMMARY REPORT | ORPHANS AND VULNERABLE CHILDREN | HIV INFECTIONS | AIDS | PSYCHOSOCIAL FACTORS | CARE AND SUPPORT | NEEDS | LANGUAGE | NUTRITION | EDUCATION | MALNUTRITION | RECOMMENDATIONS | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Family and Household | Sociocultural Factors | Viral Diseases | Diseases | Behavior | Health Services | Delivery of Health Care | Health | Economic Factors | Communication | Nutrition Disorders Document Number: 331827 |
| 13. Title: Facial lipoatrophy: appearances are not deceiving. Author: Sanches RS; Mill J; Machado AA; Donadi EA; Morais Fernandes AP Source: Journal of the Association of Nurses In AIDS Care. 2009 May-Jun;20(3):169-75. Abstract: Lipodystrophy syndrome (LS) has been reported as visible markers that can identify HIV status. Changes in body shape are detrimental in terms of psychological welfare and may affect well-being and increase the stigma associated with HIV disease. In the current study, the psychosocial impact of LS was evaluated. A total of 84 HIV-infected patients receiving antiretroviral therapy and exhibiting dyslipidemia were interviewed in an urban hospital setting in Brazil in 2006 using a standardized questionnaire. Of the 84 patients exhibiting dyslipidemia, 40 patients also exhibited body changes, and of these, 25 had facial lipoatrophy. From a psychosocial perspective, patients presenting with facial lipoatrophy reported alterations in self-image and self-esteem and believed that other people noticed their body changes. The results are relevant for nurses who need to be well-prepared to recognize lipodystrophy, to implement nursing interventions including lifestyle changes, and to provide psychosocial support to patients with LS. Language: English Keywords: BRAZIL | RESEARCH REPORT | PERSONS LIVING WITH HIV/AIDS | PSYCHOSOCIAL FACTORS | SELF ESTEEM | LIFE STYLE | CHANGES | South America, Eastern | South America | Latin America | Americas | Developing Countries | HIV Infections | Viral Diseases | Diseases | Behavior | Psychological Factors | Social Change | Sociocultural Factors Document Number: 342071 |
| 14. Peer Reviewed Title: The 'problem' of Asian women's sexuality: public discourses in Aotearoa/New Zealand. Author: Simon-Kumar R Source: Culture, Health and Sexuality. 2009 Jan;11(1):1-16. Abstract: Public health research in New Zealand views Asian health - particularly, Asian women's sexual health issues - as a priority problem. In recent years, high rates of abortion and the growing incidence of unsafe sex among younger age Asian migrants have been publicized as a health concern. Public health research implicates migrant experiences and cultural factors as responsible for these trends. Loneliness and isolation among international students, inability to communicate effectively in English and lack of knowledge of available services are highlighted as reasons for the growing sexual ill-health in the Asian population in New Zealand. Extending from these, public health measures aim at improving culture-sensitive services, including targeted education. The present paper offers a critical commentary on these accepted public health perceptions that inform policy in New Zealand. It takes a Third World feminist approach to critique dominant public health discourses on Asian women's sexuality and questions the construction of knowledges about what are 'normal' and 'pathological' sexual practices. The paper revisits the data used to describe the 'problem' of Asian sexuality and argues that in order to understand sexual practices, it is important to query the cultural lenses that are used to describe and define them. Language: English Keywords: NEW ZEALAND | CRITIQUE | EVALUATION | ASIANS | WOMEN | IMMIGRANTS | ETHNIC GROUPS | SEXUALITY | SEX BEHAVIOR | RISK BEHAVIOR | ABORTION RATE | CULTURE | PSYCHOSOCIAL FACTORS | PUBLIC OPINION | FEMINISM | Oceania | Developed Countries | Cultural Background | Population Characteristics | Demographic Factors | Population | Migrants | Migration | Population Dynamics | Personality | Psychological Factors | Behavior | Fertility Control, Postconception | Family Planning | Sociocultural Factors | Attitudes Document Number: 341121 |
| 15. Peer Reviewed Title: Psycho-social impact and quality of life of people living with HIV/AIDS in South India. Author: Subramanian T; Gupte MD; Dorairaj VS; Periannan V; Mathai AK Source: AIDS Care. 2009 Apr;21(4):473-81. Abstract: This study examines psycho-social impact of HIV and quality of life of 646 HIV-infected persons from a major government sexually transmitted disease (STD) clinic in South India. In this cross-sectional study, data was collected using interview schedule and scales. Nearly 70% had problems in parenting their children after acquiring the infection. Most (88%) of the respondents reported of seeking help from their family members, relatives or close friends at the time of their illness. Among the four categories of stigma, most of them (96%) reported perceived stigma whereas actual stigma was mentioned by only 33%. All four categories of stigma were experienced on a higher proportion by females than males (p<0.05). Each type of stigma was significantly associated with each domain of quality of life of the respondents (p<0.005). Respondents who reported of actual stigma (33%) had significantly good quality of life in their physical domain (49%), psychological domain (48%) and environmental domain (44%). Multivariate analysis showed that gender and marital status had significant association with quality of life. The findings of the study underscore the need for enabling environment through "human force" to uplift their social status and to have a better quality of life. Language: English Keywords: INDIA | RESEARCH REPORT | ADULTS | PERSONS LIVING WITH HIV/AIDS | PSYCHOSOCIAL FACTORS | QUALITY OF LIFE | STIGMA | SEX FACTORS | MARITAL STATUS | INTERVIEWS | Asia, Southern | Asia | Developing Countries | Age Factors | Population Characteristics | Demographic Factors | Population | HIV Infections | Viral Diseases | Diseases | Behavior | Social Welfare | Economic Factors | Social Problems | Sociocultural Factors | Nuptiality | Data Collection | Research Methodology Document Number: 341825 |
| 16. Peer Reviewed Title: Unseen and unheard: predictors of sexual risk behavior and HIV infection among men who have sex with men in Chennai, India. Author: Thomas B; Mimiaga MJ; Menon S; Chandrasekaran V; Murugesan P; Swaminathan S; Mayer KH; Safren SA Source: AIDS Education and Prevention. 2009 Aug;21(4):372-83. Abstract: In India men who have sex with men (MSM) are stigmatized, understudied, and at high risk for HIV. Understanding the impact of psychosocial issues on HIV risk behavior and HIV infection can help shape culturally relevant HIV prevention interventions. Peer outreach workers recruited 210 MSM in Chennai who completed an interviewer-administered psychosocial assessment battery and underwent HIV testing and counseling. More than one fifth (46/210) reported unprotected anal intercourse in the past 3 months, 8% tested positive for HIV, and 26% had previously participated in an HIV prevention intervention. In a multivariable logistic-regression model controlling for age, MSM subpopulation (kothi, panthi, or double-decker), marital status, and religion, significant predictors of any unprotected anal intercourse were being less educated (adjusted odds ratio [AOR] = .54; p = .009), not having previously participated in an HIV prevention program (AOR = 3.75; p = .05), having clinically significant depression symptoms (AOR = 2.8; p = .02), and lower self-efficacy (AOR = .40; p < .0001). Significant predictors of testing positive for HIV infection were: being less educated (AOR = .53; .05) and not currently living with parent(s) (AOR = 3.71; p = .05). Given the prevalence of HIV among MSM, efforts to reach hidden subpopulations of MSM in India are still needed. Such programs for MSM in India may need to address culturally-relevant commonly cooccurring psychosocial problems to maximize chances of reducing risk for infection. Language: English Keywords: INDIA | RESEARCH REPORT | PREVALENCE | MEN | MEN HAVING SEX WITH MEN | PSYCHOSOCIAL FACTORS | HIV TESTING | HIV INFECTIONS | COUNSELING | RELIGION | MARITAL STATUS | INTERVENTIONS | Asia, Southern | Asia | Developing Countries | Measurement | Research Methodology | Demographic Factors | Population | Sex Behavior | Behavior | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Viral Diseases | Diseases | Clinic Activities | Program Activities | Programs | Organization and Administration | Sociocultural Factors | Nuptiality Document Number: 342725 |
| 17. Title: Social and cognitive variables predicting voluntary HIV counseling and testing among Tanzanian medical students. Author: Vermeer W; Bos AE; Mbwambo J; Kaaya S; Schaalma HP Source: Patient Education and Counseling. 2009 Apr;75(1):135-40. Abstract: OBJECTIVE: The present study aimed to predict Tanzanian medical students' Voluntary Counseling and Testing (VCT) participation intention using the Health Belief Model (HBM) as a theoretical framework. Further, differences between respondents who had previously participated in VCT and respondents who had not were assessed. METHODS: Cross-sectional data were gathered from 186 Tanzanian medical students using a self-administered questionnaire. RESULTS: Almost half of the respondents (43.3%) reported having been tested for HIV. A prediction model containing HBM and demographic variables explained 31% of the variance in VCT-participation intention. Self-efficacy, fear of being HIV-positive, and perceived susceptibility contributed significantly to the final regression model. In addition, respondents who had previously participated in VCT expressed less fear of being stigmatized and being HIV-positive than respondents who had not. CONCLUSION: Fear of being HIV-positive, self-efficacy, perceived susceptibility and fear of being stigmatized were associated with either VCT-participation intention or previous participation. Further, the HBM accounted for a limited proportion of the explained variance in Tanzanian students' intention to participate in VCT. This suggests that the validity of the HBM in explaining HIV-preventive behavior in Sub-Saharan Africa should be questioned. PRACTICE IMPLICATIONS: Interventions promoting VCT should incorporate program elements targeting self-efficacy, fear of being HIV-positive, perceived susceptibility and fear of being stigmatized. Language: English Keywords: TANZANIA | RESEARCH REPORT | MEDICAL STUDENTS | VOLUNTARY COUNSELING AND TESTING | PSYCHOSOCIAL FACTORS | BELIEFS | PERCEPTION | FEAR | STIGMA | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Students | Education | HIV Testing | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Behavior | Culture | Sociocultural Factors | Psychological Factors | Emotions | Social Problems Document Number: 341697 |
| 18. Peer Reviewed Title: Attitude and behavior effects in a randomized trial of increased access to emergency contraception. Author: Weaver MA; Raymond EG; Baecher L Source: Obstetrics and Gynecology. 2009 Jan;113(1):107-16. Abstract: OBJECTIVE: To explore the effects of providing unrestricted access to emergency contraception in advance of need on various psychosocial outcomes and pregnancy. METHODS: In the trial, women were randomly assigned to either increased access to emergency contraception (two free packs at enrollment with unlimited free resupply) or standard access. Participants were evaluated for 1 year for pregnancy and other outcomes. Psychosocial data were collected at enrollment and at 6 and 12 months. We applied exploratory factor analysis for data reduction. We compared the resulting psychosocial factors (including factors related to "aversion to pregnancy" and to the perceived "relative benefit" and "accessibility" of emergency contraception), two items directly assessing substitution, and pregnancy between randomization groups over time. RESULTS: On average, women in the increased access group had significantly stronger perceptions of both the "relative benefit" and "accessibility" of emergency contraception (P<.001 for each). Women in the increased access group were significantly more likely to report that they had ever used emergency contraception because they did not want to use either condoms or another contraceptive method (P<.001). Regarding pregnancy, we noted a significant interaction between randomization group and "aversion to pregnancy" (P=.010): among the least "averse" women, increased access had a protective effect (hazard ratio 0.64, 95% confidence interval 0.39-1.04); among the most "averse" women, increased access had a deleterious effect (hazard ratio 1.73, 95% confidence interval 1.01-2.98). CONCLUSION: As a result of having unrestricted access, some women substituted emergency contraception for their usual contraceptive methods. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, www.clinicaltrials.gov, NCT00060463 LEVEL OF EVIDENCE: I. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | KAP SURVEYS | CLINICAL TRIALS | FACTOR ANALYSIS | WOMEN | EMERGENCY CONTRACEPTION | CONTRACEPTIVE AVAILABILITY | PSYCHOSOCIAL FACTORS | PERCEPTION | CONDOM USE | CONTRACEPTIVE USAGE | PREGNANCY RATE | ATTITUDES | CONTRACEPTIVE METHODS CHOSEN | Developed Countries | North America | Americas | Surveys | Sampling Studies | Studies | Research Methodology | Clinical Research | Data Analysis | Demographic Factors | Population | Contraception | Family Planning | Behavior | Psychological Factors | Risk Reduction Behavior | Fertility Measurements | Fertility | Population Dynamics Document Number: 330375 |
| 19. Peer Reviewed Title: HIV-1 viral load monitoring: an opportunity to reinforce treatment adherence in a resource-limited setting in Thailand. Author: Wilson D; Keiluhu AK; Kogrum S; Reid T; Seriratana N; Ford N; Kyawkyaw M; Talangsri P; Taochalee N Source: Transactions of the Royal Society of Tropical Medicine and Hygiene. 2009 Jun;103(6):601-6. Abstract: This paper describes a program to increase patients' treatment literacy regarding viral load (VL) monitoring through patient education materials and a counseling protocol, implemented by peer counselors, in order to reinforce adherence to first-line treatment. VL monitoring and second-line antiretroviral treatment were introduced into an established first-line treatment program in a rural district hospital in Thailand. All patients (171 adults and 14 children) taking antiretroviral treatment for more than 6 months participated and those with detectable VL were targeted for additional adherence support. The main outcome measure recorded was the number of detectable results becoming undetectable after counseling. Four adults and one child had a persistently high VL and switched to second-line treatment. Of 51 adults (30%) with an initial low detectable VL, 47/51 identified likely explanations, usually linked with poor adherence. Following counseling, VL became undetectable in 45/51 cases and some patients could resolve long-standing psychosocial problems. We conclude that HIV-1 VL monitoring together with targeted counseling for patients with detectable VL can promote adherence to treatment, providing an opportunity to delay onset of HIV-1 resistance. When implemented with a patient-centered approach, it can be a very useful tool for psychosocial support. Language: English Keywords: THAILAND | RESEARCH REPORT | PERSONS LIVING WITH HIV/AIDS | CLIENTS | HIV | PSYCHOSOCIAL FACTORS | CARE AND SUPPORT | USER COMPLIANCE | COUNSELING | ANTIRETROVIRAL THERAPY | MONITORING | TREATMENT | Developing Countries | Asia, Southeastern | Asia | HIV Infections | Viral Diseases | Diseases | Program Activities | Programs | Organization and Administration | Behavior | Health Services | Delivery of Health Care | Health | Clinic Activities | Evaluation | Medical Procedures | Medicine Document Number: 342749 |
| 20. Peer Reviewed Title: Wellness programmes for persons living with HIV/AIDS: experiences from Eastern Cape province, South Africa. Author: Worley S; Didiza Z; Nomatshila S; Porter S; Makwedini N; Macharia D; Hoos D Source: Global Public Health. 2009 Apr 3;:1-18. Abstract: Columbia University's International Centre for AIDS Care and Treatment Programmes (ICAP) supports the establishment of HIV prevention, care and treatment programmes, in resource-limited countries, through the President's Emergency Plan for AIDS Relief. In South Africa (SA), ICAP has collaborated with the Eastern Cape Department of Health since 2004, to support HIV treatment and care programmes at public healthcare facilities in rural and urban areas. Adherence, psychosocial and other supportive services have been combined into Wellness Programmes that have been situated within hospital-based Wellness Centres in two rural regions, and integrated within primary healthcare facilities in a third. This paper reviews components of wellness services for people living with HIV/AIDS including: voluntary counselling and testing, disclosure and prevention, ongoing counselling, health literacy and peer education, community- and home-based care, adherence support, and associated comprehensive care continuums. It also describes local context in which the Wellness Programmes were established. Finally it describes processes, successes and challenges, with programme development, and useful indicators monitored, lessons learned and strategies to strengthen and expand such programmes. Insights provided may inform other efforts to create sustainable systems of interdisciplinary care and accessible psychosocial support for HIV-infected persons within public facilities in resource-constrained settings. Language: English Keywords: SOUTH AFRICA | PROGRESS REPORT | EVALUATION | PERSONS LIVING WITH HIV/AIDS | RURAL POPULATION | PEER EDUCATORS | USER COMPLIANCE | AIDS PREVENTION | PSYCHOSOCIAL FACTORS | HOSPITALS | HOME CARE | COMMUNITY HEALTH SERVICES | VOLUNTARY COUNSELING AND TESTING | PROGRAM EVALUATION | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | HIV Infections | Viral Diseases | Diseases | Population Characteristics | Demographic Factors | Population | Education | Behavior | AIDS | Health Facilities | Delivery of Health Care | Health | Care and Support | Health Services | Primary Health Care | HIV Testing | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Programs | Organization and Administration Document Number: 341475 |
| 21. Title: Symposium Proceedings. Health Outcomes Research: How Can It Assist Decision-Making for the Prevention of Cervical Cancer and Other HPV Disease in Asia and the Pacific? Bangkok, Thailand, 12 February 2008. Author: Symposium on Health Outcomes Research: How Can It Assist Decision-Making for the Prevention of Cervical Cancer and Other HPV Disease in Asia and the Pacific? (2008: Bangkok) Source: Bangkok, Thailand, Family Health International [FHI], Asia / Pacific Regional Office, 2008. 50 p. Abstract: While cervical cancer is the second most common cancer worldwide and the most common among women in developing countries, it is among the most preventable and treatable of all cancers. Global guidance on comprehensive programs for cervical cancer control as well as for introduction of HPV immunization has been issued by WHO, and review of the guidance has begun in the Asia-Pacific region. However, initial costs of large-scale HPV immunization have made decision-makers in developing countries of the region reluctant to develop strategies to incorporate HPV immunization vaccines into their programs. Without advocacy efforts and a significant reduction in the price of the vaccine, HPV immunization will not feature prominently on the policy agenda in the region. This report documents the proceedings of an FHI-hosted regional workshop highlighting the role of health outcomes research data and modeling for future decision-making. Language: English Keywords: ASIA | CONFERENCES AND CONGRESSES | CERVICAL CANCER | PREVENTION AND CONTROL | DECISION MAKING | HPV | PREVALENCE | VACCINES | IMMUNIZATION | SCREENING | COST EFFECTIVENESS | FINANCIAL ACTIVITIES | PSYCHOSOCIAL FACTORS | PRODUCT APPROVAL | Developing Countries | Cancer | Neoplasms | Diseases | Behavior | Viral Diseases | Measurement | Research Methodology | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Primary Health Care | Examinations and Diagnoses | Evaluation Indexes | Quantitative Evaluation | Evaluation | Economic Factors | Legislation | Political Factors | Sociocultural Factors Document Number: 331754 |
| 22. Title: HIV risk behaviors of Latin American and Caribbean men who have sex with men in Miami, Florida, USA. Author: Akin M; Fernandez MI; Bowen GS; Warren JC Source: Revista Panamericana de Salud Pública / Pan American Journal of Public Health. 2008 May 20;23(5):341-348. Abstract: The goal of this study is to describe the sexual practices, drug use behaviors, psychosocial factors, and predictors of unprotected anal intercourse (UAI) in a sample of Hispanic men who have sex with men (MSM) born in Latin American and Caribbean (LAC) countries who currently reside in Miami-Dade County, Florida. Hispanic MSM (N = 566) recruited from community and Internet venues completed a computer-assisted self-interview assessing sociodemographic factors, drug use, sexual behaviors, and psychosocial factors. We focused on the 470 men who were born in LAC countries, including Puerto Rico. We first examined separately, by country of origin, the sexual practices, drug use behaviors, and psychosocial factors of the sample. We then collapsed the groups and examined the factors associated with UAI in the previous 6 months for the entire sample of Hispanic MSM from LAC countries. In the previous 6 months, 44% of the sample engaged in UAI, and 41% used club drugs. At the multivariate level, psychological distress, higher number of sexual partners, club drug use, HIV-positive status at the time of immigration, and greater orientation to American culture were significantly associated with UAI in the previous 6 months. Many MSM born in LAC countries engage in HIV-related risk behaviors in the AIDS epicenter of Miami-Dade County, Florida. Culturally appropriate interventions should address these risk behaviors in this underserved population. (author's) Language: English Keywords: FLORIDA | CARIBBEAN | RESEARCH REPORT | KAP SURVEYS | MEN HAVING SEX WITH MEN | HISPANICS | IMMIGRANTS | MULTIPLE PARTNERS | URBAN POPULATION | PSYCHOSOCIAL FACTORS | SEX BEHAVIOR | RISK BEHAVIOR | DRUG USE AND ABUSE | STRESS | CULTURAL BACKGROUND | Developed Countries | United States of America | North America | Americas | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Behavior | Ethnic Groups | Population Characteristics | Demographic Factors | Population | Migrants | Migration | Population Dynamics | Sexual Partners | Psychological Factors Document Number: 326968 |
| 23. Title: The psychosocial profile of Bedouin Arab women living in polygamous and monogamous marriages. Author: Al-Krenawi A; Slonim-Nevo V Source: Families in Society. 2008 Jan-Mar;89(1):139-149. Abstract: This study examining the psychosocial profile of Bedouin Arab Women living in polygamous and monogamous marriages found that women in polygamous marriages reported lower levels of self-esteem and higher levels of somatization, depression, anxiety, hostility, paranoid ideation, more problematic family functioning, less marital satisfaction, and more problematic mother-child relationships than women in monogamous marriages. The sample consisted of 315 women, 156 from polygamous and 159 from monogamous families. The respondents completed the Self-Esteem scale (SE), The Brief Symptom Inventory (BSI), The McMaster Family Assessment Device (FAD), The Enrich questionnaire and the Index of Parental Attitudes. The polygamous family structure and the economic difficulties widespread, apparently constitutes a substantial contribution to the polygamous household's impaired family functioning. (author's) Language: English Keywords: ISRAEL | RESEARCH REPORT | QUESTIONNAIRES | WOMEN | ETHNIC GROUPS | MARRIAGE PATTERNS | POLYGAMY | MONOGAMY | CULTURE | SOCIAL CHANGE | PSYCHOSOCIAL FACTORS | MENTAL HEALTH | QUALITY OF LIFE | Developed Countries | Middle East | Demographic Factors | Population | Cultural Background | Population Characteristics | Marriage | Nuptiality | Sociocultural Factors | Behavior | Health | Social Welfare | Economic Factors Document Number: 325388 |
| 24. Title: The implications of objectification theory for women's health: Menstrual suppression and "maternal request" cesarean delivery. Author: Andrist LC Source: Health Care for Women International. 2008 May;29(5):551-565. Abstract: Menstrual suppression with oral contraceptives and cesarean delivery on maternal request (CDMR) are relatively new options for women and increasingly are available, particularly in developed countries, around the world. In this article, I explore these issues using objectification theory as a framework for deconstruction. I offer a provocative hypothesis: Women who objectify their bodies are not only interested in menstrual suppression, but also in surgicalized childbirth at their request. I argue that because patriarchal societies have aligned women's reproductive functions with nature, disinterest in menstruation and vaginal childbirth has become another way for women to separate themselves from their "earthly" nature and transform or maintain their bodies as idealized cultural symbols (author's) Language: English Keywords: GLOBAL | CRITIQUE | WOMEN | WOMEN'S HEALTH | CESAREAN SECTION | MENSTRUAL REGULATION | ORAL CONTRACEPTIVES | WOMEN'S STATUS | PSYCHOSOCIAL FACTORS | CULTURE | Demographic Factors | Population | Health | Obstetrical Surgery | Surgery | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Fertility Control, Postcoital | Family Planning | Contraceptive Methods | Contraception | Socioeconomic Factors | Economic Factors | Behavior | Sociocultural Factors Document Number: 326447 |
| 25. Title: Gender-based violence in Tanzania: an assessment of policies, services, and promising interventions. Author: Betron M Source: Washington, D.C., Futures Group International, Health Policy Initiative, 2008 Aug. (USAID Contract No. GPO-I-01-05-00040-00) Abstract: Gender-based violence is a grave reality in the lives of many women in Tanzania. Based on key informant interviews and focus group discussions, this assessment provides a snapshot of the current GBV policy environment, and the state of services for those affected by GBV in Tanzania. It highlights some of the most promising GBV interventions and identifies the most important gaps and opportunities. Findings indicate that many forms of GBV, including intimate partner violence and rape, are seen as normal and are met with acceptance by both men and women. While there are signs of support and progress at the policy level to address GBV, the volume and quality of services and resources available to survivors of GBV is minimal. Health services in particular are weak, as there are no proper protocols or training for health professionals to respond to cases of GBV. A handful of promising interventions have been or are being implemented by NGOs, yet, they are limited in scope and number. Key recommendations include: advocacy for a specific law on domestic violence; incorporation of GBV in HIV and reproductive health policies; formation of a multi-sectoral GBV network; reforming health centers systematically to address GBV, starting with how-to policies, protocols, and guidelines; and linking GBV and HIV in HIV awareness-raising programs and mass media campaigns. Language: English Keywords: TANZANIA | RESEARCH REPORT | FOCUS GROUPS | VIOLENCE AGAINST WOMEN | SOCIAL WELFARE | POVERTY | BEHAVIOR CHANGE | HARMFUL TRADITIONAL PRACTICES | SOCIAL MOBILIZATION | HEALTH | PSYCHOSOCIAL FACTORS | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Data Collection | Research Methodology | Domestic Violence | Crime | Social Problems | Sociocultural Factors | Economic Factors | Socioeconomic Factors | Behavior | Traditional Health Practices | Culture | Social Change Document Number: 329507 |
| 26. Peer Reviewed Title: Menarche and father absence in a national probability sample. Author: Bogaert AF Source: Journal of Biosocial Science. 2008 Jul;40(4):623-636. Abstract: The relation between women's timing of menarche and father absence was examined in a national probability sample of Great Britain (NATSAL 2000; N greater than 5000). Current body mass index (as a proxy for childhood weight) was examined as a potential mediator of this relationship, along with the potential moderating role that siblings (e.g. number of older brothers) had on this relationship. As in a number of previous studies, an absent father (but not an absent mother) during childhood predicted an earlier age of puberty (i.e. an early menarche). There was no evidence that weight mediated this relationship or that siblings moderated it. Both a lower body mass index and more siblings (e.g. more younger sisters and brothers) were independent predictors of a later timing of puberty. The results confirm that certain psychosocial factors (i.e. father absence; presence of siblings) may affect the timing of sexual maturation in adolescent girls. (author's) Language: English Keywords: CANADA | RESEARCH REPORT | PROBABILITY | MOTHERS | ADOLESCENTS, FEMALE | MENARCHE | AGE FACTORS | TIME FACTORS | ONE PERSON HOUSEHOLD | FAMILY RELATIONSHIPS | SIBLINGS | PSYCHOSOCIAL FACTORS | North America, Northern | Americas | Developed Countries | Statistical Studies | Studies | Research Methodology | Parents | Family Characteristics | Family and Household | Sociocultural Factors | Adolescents | Youth | Population Characteristics | Demographic Factors | Population | Menstruation | Reproduction | Population Dynamics | Households | Behavior Document Number: 327239 |
| 27. Title: [Factors associated with access to health services prior to pregnancy by pregnant adolescents] Fatores associados ao acesso anterior a gestacao a servicos de saude por Author: Carvacho IE; Mello MB; Morais SS; Silva JL Source: Revista de Saude Publica. 2008 Oct;42(5):886-94. Abstract: OBJECTIVE: To assess determinants of access to primary care services prior to pregnancy by pregnant adolescents. METHODS: Theory-based cross-sectional study conducted to examine access to heath services at five dimensions: geographic, economic, administrative, psychosocial and information. There were included in the study 200 first-time pregnant adolescents (aged 10 to 19 years) who attended a primary care unit in the municipality of Indaiatuba, Southeastern Brazil, in 2003. Data was collected using a semi-structured questionnaire applied in face-to-face interviews conducted just before their first pre-natal care visit. Data analyses were performed through Person's chi-square or Fisher's exact test, and by a multivariate logistic regression model including all five dimensions of access. RESULTS: More than half (63.7%) of the adolescents utilized some gynecological care service. Information (43.8%) or psychosocial feelings of embarrassment or fear (37.0%) barriers were the most frequent reasons given for not having sought care before. The main barrier to health service access was related to the psychosocial dimension, reported by 77.0% of the adolescents studied. CONCLUSIONS: Among all barriers to health service access, the most important were those related to the psychosocial dimension. There is a need for new strategies to facilitate access to health services by adolescents, including actions to reduce gender-based barriers taking into consideration sociodemographic characteristics of this population and the relationship they have with their partners. Language: Portuguese Keywords: BRAZIL | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | ADOLESCENT PREGNANCY | PRIMARY HEALTH CARE | UTILIZATION OF HEALTH CARE | ANTENATAL CARE | GYNECOLOGY | PSYCHOSOCIAL FACTORS | HEALTH SERVICES | PROGRAM ACCESSIBILITY | South America, Eastern | South America | Latin America | Americas | Developing Countries | Research Methodology | Reproductive Behavior | Fertility | Population Dynamics | Demographic Factors | Population | Delivery of Health Care | Health | Maternal Health Services | Maternal-Child Health Services | Medicine | Behavior | Program Evaluation | Programs | Organization and Administration Document Number: 331158 |
| 28. Peer Reviewed Title: Saving 'face' and 'othering': getting to the root of barriers to condom use among Chinese female sex workers. Author: Chapman J; Estcourt CS; Hua Z Source: Sexual Health. 2008 Aug;5(3):291-298. Abstract: China has one of the most rapidly expanding HIV epidemics in the world with sexual transmission between female sex workers (FSW) and clients accounting for a rising fraction of new infections. Successful HIV prevention relies on the delivery of relevant, culturally appropriate messages to influence behaviour change. However, the cultural systems that give rise to barriers to condom use among Chinese FSW have been poorly examined. A better understanding of these barriers is fundamental to global HIV prevention efforts particularly considering increasing international migration of Chinese women who go on to engage in sex work in their migrant country. We conducted semistructured interviews with 23 FSW incarcerated in a re-education and detention centre in Shenzhen, China in July to August 2004. All respondents were internal economic migrants who had entered the sex industry in pursuit of greater financial reward. Respondents explained that they would 'lose face' if they returned from their migration penniless. Women's distinction between commercial and non-commercial partners was very subtle; the nature of 'boyfriend' relationships was diverse and these were often transactional. Condom use was influenced by gender norms, familiarity, a desire to 'save' and 'give' face and, in transactional relationships, whether more money was offered. Women felt HIV was a disease of 'others'; only two women felt personally at risk. The present study has highlighted the importance of unique cultural structures in Chinese FSW sexual decision-making, an understanding of which will enhance the success of HIV-prevention efforts globally. Language: English Keywords: CHINA | RESEARCH REPORT | KAP SURVEYS | SEX WORKERS | WOMEN IN DEVELOPMENT | PRISONERS | MIGRANTS | INTERNAL MIGRATION | CONDOM USE | SELF ESTEEM | HIV PREVENTION | CULTURE | PSYCHOSOCIAL FACTORS | GENDER RELATIONS | MICROECONOMIC FACTORS | Asia, Eastern | Asia | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Sex Behavior | Behavior | Economic Development | Economic Factors | Crime | Social Problems | Sociocultural Factors | Migration | Population Dynamics | Demographic Factors | Population | Risk Reduction Behavior | Psychological Factors | HIV Infections | Viral Diseases | Diseases | Gender Issues Document Number: 322962 |
| 29. Title: Individual- and community-level determinants of social acceptance of people living with HIV in Kenya: Results from a national population-based survey. Author: Chiao C; Mishra V; Sambisa W Source: Calverton, Maryland, Macro International, Demographic and Health Research Division, MEASURE DHS, 2008 Aug. 32 p. (DHS Working Papers No. 50USAID Contract No. CPO-C-00-03-00002-00) Abstract: Using data from the 2003 Kenya Demographic and Health Survey, we investigated the influence of individual- and community-level factors on accepting attitudes toward people living with HIV (PHLIV) using three outcomes: willingness to care for an infected household member, willingness to buy vegetables from an infected vendor, and willingness to allow an infected female teacher to continue teaching. Multilevel logistic regression models, with individuals at the first level and community variables at the second level, were performed. We found that males were more likely than females to have higher social acceptance attitudes toward PLHIV. Respondents who were older, had higher education, had high knowledge of AIDS, knew someone with HIV or someone who had died of AIDS, or who were exposed to mass media expressed greater acceptance of PLHIV. The percentage of the total variance that was explained by the community of residence ranged between 14 percent and 23 percent among females and between 14 percent and 32 percent among males across all three outcomes. At the community level, differences in accepting was attitudes were associated with community AIDS knowledge, community education, and community AIDS experience, but not with region or place of residence. The findings suggest that community level factors play a significant role in determining social acceptance of PLHIV. Programmatic strategies aimed at increasing accepting attitudes toward PLHIV should take into consideration both individual- and community-level factors. Language: English Keywords: KENYA | RESEARCH REPORT | KAP SURVEYS | DEMOGRAPHIC AND HEALTH SURVEYS | COMMUNITY | TEACHERS | PERSONS LIVING WITH HIV/AIDS | SOCIAL DISCRIMINATION | STIGMA | HIV INFECTIONS | PSYCHOSOCIAL FACTORS | ATTITUDES | FAMILY RELATIONSHIPS | ACCEPTANCE PROCESS | FOOD AND BEVERAGE | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Demographic Surveys | Population Dynamics | Demographic Factors | Population | Residence Characteristics | Population Distribution | Geographic Factors | Education | Viral Diseases | Diseases | Social Problems | Sociocultural Factors | Behavior | Psychological Factors | Family Characteristics | Family and Household | Decision Making | Nutrition | Health Document Number: 341073 |
| 30. Peer Reviewed Title: Sex trade in a male-to-female transgender population: psychosocial correlates of inconsistent condom use. Author: Clements-Nolle K; Guzman R; Harris SG Source: Sexual Health. 2008 Feb;5(1):49-54. Abstract: Research suggests that because of economic necessity, many male-to-female (MTF) transgender individuals trade sex for money, drugs, housing, and other things they may need. To date, no studies have quantitatively assessed psychosocial correlates of condom use with this population. The authors conducted a cross sectional study with 190 MTF transgender individuals involved in sex trade in San Francisco, California. Multivariate logistic regression was used to determine factors independently associated with inconsistent condom use during receptive anal sex with exchange partners. About one fifth of our participants reported inconsistent condom use during receptive anal sex in the past 6 months. In the multivariate model, low self-esteem [adjusted odds ratio (AOR)=3.09; 95% confidence interval (CI) (1.28, 7.47)], a history of forced sex or rape [AOR=2.91; 95% CI (1.06, 8.01)], and use of crack-cocaine [AOR=2.59; 95% CI (1.09, 6.13)] were independently associated with inconsistent condom use. Findings highlight an urgent need for multilevel risk reduction interventions for MTF transgender individuals involved in sex trade. Such interventions will be most effective if they address the psychosocial context of sexual risk taking by focusing on issues such as low self-esteem, sexual violence, and illicit drug use. Language: English Keywords: CALIFORNIA | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | KAP SURVEYS | MULTIVARIATE ANALYSIS | MEN HAVING SEX WITH MEN | SEX WORKERS | PSYCHOSOCIAL FACTORS | CONDOM USE | ANAL SEX | SELF ESTEEM | RAPE | DRUG USE AND ABUSE | CONTRACEPTIVE USAGE DETERMINANTS | United States of America | North America | Americas | Developed Countries | Research Methodology | Surveys | Sampling Studies | Studies | Data Analysis | Sex Behavior | Behavior | Risk Reduction Behavior | Psychological Factors | Crime | Social Problems | Sociocultural Factors | Contraceptive Usage | Contraception | Family Planning Document Number: 322848 |
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