1.  Title: The economic burden of HIV and AIDS on households in Nigeria. Author: Adedigba MA; Naidoo S; Abegunde A; Olagundoye O; Adejuyigbe E; Fakande I Source: African Journal of AIDS Research. 2009 Apr;8(1):107-114. Abstract: The study estimates the economic burden of HIV and AIDS on households in a Nigerian population. The data derive from a cross-sectional survey of households affected by HIV or AIDS in Ife-Ijesa Zone, Osun State, Nigeria. The sample consisted of 117 purposively selected, consenting adult HIV patients attending a general and teaching hospital. Participants were asked to self-report monetary expenses for HIV-related care, loss of savings, and funeral costs. The data show a significantly sharp drop in the participants' household income as a result of care for HIV-related illnesses, from the time of knowing one's HIV status to the time of illness, among three occupational categories (artisans, civil servants and unemployed; p = 0.02). Mean income among those in the unemployed category fell by 84.1%, income among artisans dropped by 72.6%, and income among civil servants decreased by 44.4%. The monetary loss during the course of HIV-related illnesses was heaviest for the artisan group, followed by the unemployed and the civil servants. Those who had lost a substantial part of their savings to HIV-related care were most numerous among the unemployed, followed by artisans and civil servants. Out of 16 households, 11 (42.3%) had received support from relatives during a funeral ceremony. There was a significant association between the occupational group and working for more hours after illness ( 2 = 9.28, df = 4; p = 0.05). Nearly all orphaned children were distributed to the extended family following the AIDS death of a parent. Among all the occupational groups, borrowing from a cooperative society during the course of HIV-related sickness was the commonest form. The findings add to data showing that despite the extended family support system, adult deaths due to AIDS continue to undermine the viability of sub-Saharan African households. Language: English Keywords: NIGERIA | RESEARCH REPORT | SAMPLING STUDIES | HOUSEHOLDS | AIDS | HIV INFECTIONS | ECONOMIC FACTORS | EXPENDITURES | INCOME | POVERTY | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Studies | Research Methodology | Family and Household | Sociocultural Factors | Viral Diseases | Diseases | Financial Activities | Socioeconomic Factors Document Number: 341292 |
| 2. Title: Evaluation of transmitted HIV drug resistance among recently-infected antenatal clinic attendees in four Central African countries. Author: Aghokeng AF; Vergne L; Mpoudi-Ngole E; Mbangue M; Deoudje N; Mokondji E; Nambei WS; Peyou-Ndi MM; Moka JJ; Delaporte E; Peeters M Source: Antiviral therapy. 2009;14(3):401-11. Abstract: BACKGROUND: The rapid expansion of antiretroviral treatment in resource-limited settings is raising concerns regarding the emergence and transmission of HIV drug resistance (HIVDR). We evaluated the extent of transmission of drug-resistant HIV strains in four Central African countries: the Republic of Congo, Central African Republic, Chad and Cameroon. METHODS: The World Health Organization (WHO) HIVDR threshold survey was implemented in major treatment areas in each country. Pregnant women who were aged <25 years, who were at first pregnancy and who were HIV type-1-positive were enrolled at each site in 2006-2007 for genotyping. HIVDR prevalence was categorized using the WHO threshold survey binomial sequential sampling method. RESULTS: The prevalence of HIVDR in Brazzaville and Bangui sites could not be classified because the eligible sample number was not reached. HIVDR prevalence was low (<5%) in N'Djamena for all drug classes. In Yaounde, we found one individual with the D67D/N mutation and two with K103N. HIVDR prevalence was categorized as low (<5%) for protease inhibitors (PIs) and nucleoside reverse transcriptase inhibitors (NRTIs), and moderate (> or =5-< or =15%) for non-NRTIs (NNRTIs). HIVDR prevalence in Douala was low for PIs and NNRTIs, and moderate for NRTIs as we identified one individual with M184V plus K101E plus G190A mutations and a second with D67D/N. CONCLUSIONS: The moderate HIVDR prevalence found in Yaounde and Douala indicate that efforts should be made in Cameroon to prevent HIVDR; however, additional surveys are needed to confirm this trend. This study highlighted challenges presented by the WHO methodology, such as additional costs, workload, difficulties in acquiring even small sample numbers and the necessity for better quality assurance of HIV testing and record keeping at antenatal clinics. Language: English Keywords: CAMEROON | CENTRAL AFRICAN REPUBLIC | CHAD | REPUBLIC OF THE CONGO | RESEARCH REPORT | SAMPLING STUDIES | PREGNANT WOMEN | PERSONS LIVING WITH HIV/AIDS | HIV TRANSMISSION | ANTIRETROVIRAL DRUGS | DRUG RESISTANCE | PREVALENCE | ANTENATAL CARE | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Africa, Central | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | HIV Infections | Viral Diseases | Diseases | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Measurement | Maternal Health Services | Maternal-Child Health Services | Primary Health Care Document Number: 342346 |
3.  Peer Reviewed Title: HIV prevalence and associated risk factors among individuals aged 13-34 years in rural western Kenya. Author: Amornkul PN; Vandenhoudt H; Nasokho P; Odhiambo F; Mwaengo D Source: Plos One. 2009 Jul;4(7):e6470. Abstract: From a demographic surveillance system, the authors selected a random sample of Asembo, Kenya residents ages 13–34 years, who were contacted at home and invited to a nearby mobile study site. From October 2003 to April 2004, consenting participants were interviewed on risk behavior and tested for HIV and HSV-2. HIV voluntary counseling and testing was offered. Of 2,606 eligible residents, 1,822 (70%) enrolled. Primary reasons for refusal included not wanting blood taken, not wanting to learn HIV status, and partner or parental objection. Females comprised 53% of 1,762 participants providing blood. Adjusted HIV prevalence was 15.4% overall: 20.5% among females and 10.2% among males. HIV prevalence was highest in women ages 25-29 years (36.5%) and men ages 30-34 years (41.1%). HSV-2 prevalence was 40.0% overall: 53% among females, 25.8% among males. In multivariate models stratified by gender and marital status, HIV infection was strongly associated with age, higher number of sex partners, widowhood, and HSV-2 seropositivity. Language: English Keywords: KENYA | RURAL AREAS | RESEARCH REPORT | SAMPLING STUDIES | HIV INFECTIONS | HERPES GENITALIS | PREVALENCE | RISK FACTORS | AGE FACTORS | SEX FACTORS | MIGRATION | VOLUNTARY COUNSELING AND TESTING | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Geographic Factors | Population | Studies | Research Methodology | Viral Diseases | Diseases | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Measurement | Health | Population Characteristics | Demographic Factors | Population Dynamics | HIV Testing | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care Document Number: 339909 |
| 4. Title: Collective violence and attitudes of women toward intimate partner violence: evidence from the Niger Delta. Author: Antai D; Antai J Source: BMC International Health and Human Rights. 2009 Jun 9;9(12):10 p. Abstract: Background: The Niger Delta region of Nigeria has been undergoing collective violence for over 25 years, which has constituted a major public health problem. The objectives of this study were to investigate the predictors of women's attitudes toward intimate partner violence in the Niger Delta in comparison to that of women in other parts of Nigeria. Methods: The 2003 Nigeria Demographic and Health Survey was used for this study. Respondents were selected using a stratified two-stage cluster sampling procedure through which 3725 women were selected and interviewed. These women contributed 6029 live born children born to the survey. Internal consistency of the measure of the women's attitudes towards intimate partner violence against a woman was assessed using Cronbach's alpha (a). Percentage distributions of the relevant characteristics of the respondents were carried out, and multivariable logistic regression analysis was used to measure the magnitude and direction of the relationship between the outcome and predictor variables were expressed as odds ratios (OR) and statistical significance was determined at the 95 percent confident interval level (CI). Results: Tolerance for intimate partner violence among the women in the Niger delta (47 percent) was higher than that of women from the rest of the country (42 percent). Rural residence, lower household wealth, lower status occupations, and media access (newspaper and radio) were associated with lower risk of justifying IPV among the women in the Niger Delta. In contrast full or partial autonomy in household decisions regarding food to be cooked, and access to television were associated with a lower risk of justifying violence. Conclusion: The increased justification of intimate partner violence among the women in the Niger Delta could be explained by a combination of factors, among which are cognitive dissonance theory (attitudes that do not fit with other opinions they hold as a means of coping with their situation), ecological theory (behaviour or attitudes being shaped by current factors in their neighbourhood, community or family), and gender-role attitudes. Further in-depth studies are required to fully understand women's attitudes toward violence in areas of conflict. Language: English Keywords: NIGERIA | RESEARCH REPORT | DEMOGRAPHIC AND HEALTH SURVEYS | SAMPLING STUDIES | WOMEN | SEXUAL PARTNERS | DOMESTIC VIOLENCE | ATTITUDES | WAR | VIOLENCE | SOCIOECONOMIC STATUS | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Demographic Surveys | Population Dynamics | Demographic Factors | Population | Studies | Research Methodology | Sex Behavior | Behavior | Crime | Social Problems | Sociocultural Factors | Psychological Factors | Political Factors | Socioeconomic Factors | Economic Factors Document Number: 341880 |
| 5. Peer Reviewed Title: Prevalence of tuberculosis, HIV and respiratory symptoms in two Zambian communities: implications for tuberculosis control in the era of HIV. Author: Ayles H; Schaap A; Nota A; Sismanidis C; Tembwe R; De Haas P; Muyoyeta M; Beyers N Author: Peter Godfrey-Faussett for the ZAMSTAR Study Team Source: PloS One. 2009;4(5):e5602. Abstract: BACKGROUND: The Stop TB Partnership target for tuberculosis is to have reduced the prevalence of tuberculosis by 50% comparing 2015 to 1990. This target is challenging as few prevalence surveys have been conducted, especially in high burden tuberculosis and HIV countries. Current tuberculosis control strategies in high HIV prevalent settings are therefore based on limited epidemiological evidence and more evidence is needed from community-based surveys to inform improved policy formulation. METHODS AND FINDINGS: 8044 adults were sampled from 2 sub-districts (wards) in Lusaka province, Zambia. Questionnaires were used to screen for symptoms, respiratory samples were obtained for culture and oral secretions collected for HIV testing. 79 individuals were found to have Mycobacterium tuberculosis in their sputum, giving an adjusted overall prevalence of tuberculosis of 870/100,000 (95% CI 570-1160/100,000). The adjusted overall prevalence of HIV was 28.61% (95% CI 26.04-31.19). HIV- infection was significantly associated with prevalent tuberculosis (Adj OR 2.3, 95% CI 1.42-3.74) and the population attributable fraction of HIV for prevalent tuberculosis was 36%. Symptoms such as prolonged cough (adj OR 12.72, 95% CI 7.05-22.94) and fever (Adj OR 2.04, 95%CI 1.23-3.39), were associated with prevalent tuberculosis, but 8 (10%) individuals with prevalent tuberculosis denied having any symptoms at all and only 34 (43%) would have been classified as a TB suspect by current guidelines. CONCLUSIONS: Undiagnosed tuberculosis is a challenge for tuberculosis control and new approaches are needed if we are to reach international targets. Epidemiological studies can inform screening algorithms for both detection and prevention of active tuberculosis. Language: English Keywords: ZAMBIA | RESEARCH REPORT | SAMPLING STUDIES | ADULTS | TUBERCULOSIS | HIV INFECTIONS | RESPIRATORY INSUFFICIENCY | PREVALENCE | SCREENING | SIGNS AND SYMPTOMS | LABORATORY EXAMINATIONS AND DIAGNOSES | PREVENTION AND CONTROL | ANTIBIOTICS | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Studies | Research Methodology | Age Factors | Population Characteristics | Demographic Factors | Population | Infections | Diseases | Viral Diseases | Pulmonary Effects | Physiology | Biology | Measurement | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Drugs | Treatment Document Number: 342445 |
| 6. Peer Reviewed Title: Domestic violence against women in eastern India: a population-based study on prevalence and related issues. Author: Babu BV; Kar SK Source: BMC Public Health. 2009;9:129. Abstract: BACKGROUND: Violence against women is now widely recognised as an important public health problem, owing to its health consequences. Violence against women among many Indian communities on a regularly basis goes unreported. The objective of this study is to report the prevalence and other related issues of various forms of domestic violence against women from the eastern zone of India. METHODS: It is a population-based study covering both married women (n = 1718) and men (n = 1715) from three of the four states of Eastern India selected through a systematic multistage sampling strategy. Interviews were conducted using separate pre-piloted structured questionnaires for women (victimization) and men (perpetration). Women were asked whether their husband or any other family members committed violent acts against them. And men were asked whether they had ever perpetrated violent acts against their wives. Three principle domestic violence outcome variables (physical, psychological and sexual violence) were determined by response to a set of questions for each variable. In addition, data on socio-economic characteristics were collected. Descriptive statistics, bi- and multivariate analyses were done. RESULTS: The overall prevalence of physical, psychological, sexual and any form of violence among women of Eastern India were 16%, 52%, 25% and 56% respectively. These rates reported by men were 22%, 59%, 17% and 59.5% respectively. Men reported higher prevalence of all forms of violence apart from sexual violence. Husbands were mostly responsible for violence in majority of cases and some women reported the involvement of husbands' parents. It is found that various acts of violence were continuing among majority of women who reported violence. Some socio-economic characteristics of women have significant association with the occurrence of domestic violence. Urban residence, older age, lower education and lower family income are associated with occurrence of domestic violence. Multivariate logistic regressions revealed that the physical violence has significant association with state, residence (rural or urban), age and occupation of women, and monthly family income. Similar associations are found for psychological violence (with residence, age, education and occupation of the women and monthly family income) and sexual violence (with residence, age and educational level of women). CONCLUSION: The prevalence of domestic violence in Eastern India is relatively high compared to majority of information available from India and confirms that domestic violence is a universal phenomenon. The primary healthcare institutions in India should institutionalise the routine screening and treatment for violence related injuries and trauma. Also, these results provide vital information to assess the situation to develop public health interventions, and to sensitise the concerned agencies to implement the laws related to violence against women. Language: English Keywords: INDIA | RESEARCH REPORT | SAMPLING STUDIES | HOUSEHOLDS | DOMESTIC VIOLENCE | PREVALENCE | PHYSICAL ABUSE | PSYCHOLOGICAL ABUSE | SEXUAL ABUSE | SOCIOECONOMIC STATUS | Asia, Southern | Asia | Developing Countries | Studies | Research Methodology | Family and Household | Sociocultural Factors | Crime | Social Problems | Measurement | Violence | Behavior | Aggression | Socioeconomic Factors | Economic Factors Document Number: 341406 |
| 7. Peer Reviewed Title: HIV-1 genetic diversity and transmitted drug resistance in health care settings in Maputo, Mozambique. Author: Bartolo I; Casanovas J; Bastos R; Rocha C; Abecasis AB; Folgosa E; Mondlane J; Manuel R; Taveira N Source: Journal of Acquired Immune Deficiency Syndromes. 2009 Jul 1;51(3):323-31. Abstract: OBJECTIVES: To characterize HIV-1 diversity and transmitted drug resistance in persons with access to care and treatment in Maputo, Mozambique. METHODS: Samples were collected in 2002-2004 from 144 drug-naive patients attending public hospitals and private clinics. Plasma viremia, CD4, and CD8 cell counts were determined for each patient. The Stanford Algorithm was used for resistance genotyping on pol sequences. Subtyping was done by phylogenetic analysis. RESULTS: Most patients had high viral load (mean, 5.0 log copies/mL) and low CD4 cell counts (median, 260 CD4 cells/microL). Protease and/or reverse transcriptase sequences were obtained from 104 (72%) samples. Patients harbored subtypes C (80.8%), G (3.8%), CRF37_cpx (6.7%), untypable (U) (1.0%), and recombinant strains (7.7%) comprising the A, C, D, F, and U clades. There were no major protease inhibitor resistance mutations. Mutations conferring resistance to the nucleoside/nucleotide reverse transcriptase inhibitors and/or nonnucleoside reverse transcriptase inhibitors were found in 4 (4/68; 5.9%) patients. Phylogenetic analysis suggested an imported origin for 2 resistant variants. CONCLUSIONS: The HIV-1 epidemic in Maputo is evolving rapidly in genetic complexity due to the recent introduction of all major subtypes and recombinant forms. Continued surveillance of drug resistance in treated and untreated populations is needed to prevent further transmission of HIV drug-resistant variants and maximize the efficacy of antiretroviral therapy in Maputo. Language: English Keywords: MOZAMBIQUE | RESEARCH REPORT | SAMPLING STUDIES | CLIENTS | PERSONS LIVING WITH HIV/AIDS | HIV INFECTIONS | GENETICS | ANTIRETROVIRAL THERAPY | ANTIRETROVIRAL DRUGS | DRUG RESISTANCE | MONITORING | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Studies | Research Methodology | Program Activities | Programs | Organization and Administration | Viral Diseases | Diseases | Biology | HIV | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Evaluation Document Number: 342148 |
| 8. Title: Exposure to information and communication about HIV/AIDS and perceived credibility of information sources among young people in northern Tanzania. Author: Bastien S; Leshabari MT; Klepp KI Source: African Journal of AIDS Research. 2009;8(2):213-222. Abstract: A structured face-to-face interview was completed by 993 young people out of school, between the ages of 13 and 18, in Kilimanjaro, Tanzania; additionally, the questionnaire was self-administered by 1,007 students attending either their last year of primary or first year of secondary school. Significant factors associated with the frequency of exposure to HIV/AIDS information and frequency of communication about HIV/AIDS included urban/rural location, sex, socio-economic status, and educational attainment. Both groups ranked the radio as the most frequent source of HIV/AIDS information. The in-school group reported significantly more frequent exposure to all sources of HIV/AIDS information, and they communicated more frequently about the topic than did the out-of-school group. The in-school group gave high credibility ratings to medical doctors, the radio, and parents as sources of information, whereas the out-of-school group attributed the most credibility to the mass media. Irrespective of school attendance, the young people ranked friends, parents, and doctors as preferred communicators of sexual and reproductive health information. Language: English Keywords: TANZANIA | RESEARCH REPORT | SAMPLING STUDIES | COMPARATIVE STUDIES | OUT-OF-SCHOOL YOUTHS | STUDENTS | HIV INFECTIONS | INFORMATION SOURCES | INTERPERSONAL COMMUNICATION | INTERVIEWS | KNOWLEDGE | MASS MEDIA | SOCIOECONOMIC STATUS | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Studies | Research Methodology | Educational Status | Socioeconomic Factors | Economic Factors | Education | Viral Diseases | Diseases | Information | Communication | Data Collection | Sociocultural Factors Document Number: 339889 |
| 9. Title: Predictors of Condom Use Among Israeli Soldiers. Author: Ben Natan M; Danilov S; Evdokimovitz Y Source: American Journal of Men's Health. 2009 Jul 14; Abstract: Only a small percentage of young people aged 18 to 20 years use condoms regularly. Thus, the younger population has an increased risk of contracting sexually transmitted diseases. This study examines the underlying determinants of condom use among soldiers based on the theory of planned behavior as well as the influence of soldiers' social circumstances and prior sexual experience. A correlational design using an exploratory survey method was used. Participants were sampled in a convenience sample of 113 male soldiers from the Israel defense forces. A total of 70.1% of soldiers use condoms in their first sexual experience, however, this percentage subsequently decreases. The study indicates that soldiers are not familiar with the risks of frequent oral and anal sex. Behavioral intentions and self-control are significant predictors of condom use. Condom use among soldiers from one-parent families was lower than among soldiers from two-parent families. The theory of planned behavior seems to be a helpful method of predicting condom use among soldiers. Accordingly, efforts should be channeled at attempts to generate changes in soldiers' views of condom use, intensifying normative pressures operated by their social milieu, and increasing their self-control in the use of condoms. Language: English Keywords: ISRAEL | RESEARCH REPORT | SAMPLING STUDIES | MILITARY PERSONNEL | MEN | CONDOM USE | ATTITUDES | BELIEFS | SEX BEHAVIOR | SAFER SEX | PERCEPTION | Developed Countries | Middle East | Studies | Research Methodology | Government | Political Factors | Sociocultural Factors | Demographic Factors | Population | Risk Reduction Behavior | Behavior | Psychological Factors | Culture Document Number: 342123 |
| 10. Peer Reviewed Title: Is education the link between orphanhood and HIV/HSV-2 risk among female adolescents in urban Zimbabwe? Author: Birdthistle I; Floyd S; Nyagadza A; Mudziwapasi N; Gregson S; Glynn JR Source: Social Science and Medicine. 2009 May;68(10):1810-1818. Abstract: This study explored the role of education in explaining the excess sexual risk previously documented among unmarried female orphans in urban Zimbabwe. School attendance and attainment were assessed by type of orphanhood, and for their association with markers of sexual risk (HIV and/or HSV-2 infection) among 743 participants drawn from a random sample of 15- to 19-year-old girls identified in a cross-sectional survey in Highfield, Harare in 2004. Multivariable logistic regression was used to assess the role of educational status in explaining the higher prevalence of adverse sexual outcomes among unmarried orphans compared to non-orphans, adjusting for possible confounders. Double orphans had significantly lower educational attendance and attainment than non-orphans. Maternal orphans had higher odds of school drop-out, although this association disappeared when adjusted for recent mobility. Educational status was strongly associated with HIV/HSV-2 risk, but explained only a small part of double orphans' sexual risk and did not explain the HIV/HSV-2 risk of maternal and paternal orphans. High overall levels of secondary school participation and school fee assistance provided to vulnerable families may have reduced the schooling disparities between orphans and non-orphans in Highfield. However, further efforts are needed to rectify the schooling inequities that persist, while additional research is needed to identify other socioeconomic and emotional factors driving orphans' sexual risk so that prevention and support programs can meet the needs of this growing population. Language: English Keywords: ZIMBABWE | URBAN AREAS | RESEARCH REPORT | SAMPLING STUDIES | ADOLESCENTS, FEMALE | ORPHANS AND VULNERABLE CHILDREN | HIV INFECTIONS | HERPES GENITALIS | EDUCATIONAL STATUS | SEX BEHAVIOR | RISK FACTORS | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Geographic Factors | Population | Studies | Research Methodology | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Family and Household | Sociocultural Factors | Viral Diseases | Diseases | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Behavior | Health Document Number: 341411 |
| 11. Title: The association of serotonin transporter genotypes and selective serotonin reuptake inhibitor (SSRI)-associated sexual side effects: possible relationship to oral contraceptives. Author: Bishop JR; Ellingrod VL; Akroush M; Moline J Source: Human Psychopharmacology. 2009 Apr;24(3):207-15. Abstract: OBJECTIVE: To study the relationship between functional variants in the serotonin transporter gene (SLC6A4) and selective serotonin reuptake inhibitor (SSRI)-associated sexual dysfunction. METHODS: One hundred fifteen subjects aged 18-40 years and currently being treated with an SSRI for depression were assessed for clinical variables known to affect sexual well-being. SSRI-associated sexual difficulties were assessed with the Changes in Sexual Functioning Questionnaire (CSFQ). Subjects were subsequently genotyped for the SLC6A4 promoter region (5HTTLPR) insertion/deletion variant and a variable number of tandem repeats (VNTR) in the second intron. RESULTS: The 5HTTLPR insertion/deletion variant was associated with sexual dysfunction in this study sample [odds ratio (OR) = 2.7; 95% confidence interval (CI) 1.2, 6.4; p = 0.02]. The relationship between promoter genotypes and sexual well-being differed in males and females and was related to whether females were taking an oral contraceptive (OC) medication. Females with the ll genotype were nearly eight times more likely to be categorized as having sexual dysfunction if they were taking OCs, while no relationship was observed in those not taking OCs. CONCLUSIONS: These results suggest that a functional variant in the serotonin transporter gene is associated with sexual difficulties in persons taking an SSRI for depression. This relationship may differ by sex and be dependent on OC status in females. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | SAMPLING STUDIES | CLIENTS | DEPRESSION | DRUGS | ADMINISTRATION AND DOSAGE | SEROTONIN | SIDE EFFECTS | DECREASED LIBIDO | ORAL CONTRACEPTIVES | GENETICS | Developed Countries | North America | Americas | Studies | Research Methodology | Program Activities | Programs | Organization and Administration | Mental Disorders | Diseases | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Physiology | Biology | Sex Behavior | Behavior | Contraceptive Methods | Contraception | Family Planning Document Number: 341959 |
| 12. Title: Emergency contraception - knowledge and attitudes in a group of Australian university students. Author: Calabretto H Source: Australian and New Zealand Journal of Public Health. 2009 Jun;33(3):234-9. Abstract: OBJECTIVE: To explore first year Australian university students' knowledge and attitudes about emergency contraception and their understanding of the risk for pregnancy. METHOD: A self-report questionnaire was completed by a convenience sample of 627 first year on-campus students from both health and non-health disciplines. RESULTS: Knowledge about emergency contraception (EC) was generally poor including misunderstanding that it can only be used the 'morning after', as well as where it may be accessed. Its potential use was, however, more highly accepted as a preventative measure after unprotected sexual intercourse than abortion in the event of unplanned pregnancy. Women had better knowledge than men, and on a number of measures there were significant differences between these groups. CONCLUSIONS: Poor knowledge about the timing, accessibility, action and side effects of EC may act as a barrier to its use in the event of unprotected sexual intercourse. Although EC has been available in Australia as a Schedule 3 medication since 2004, its availability from pharmacies is not well known, nor is access from other primary health care providers. Implications: The lack of knowledge about EC may lead to its underutilisation and underlines the need for future educational strategies about EC as well as the need for health professionals who provide contraceptive services to discuss EC with clients. Health promotion campaigns which are both general as well as gender-specific may improve overall community knowledge about this method of contraception. Language: English Keywords: AUSTRALIA | RESEARCH REPORT | SAMPLING STUDIES | STUDENTS | UNIVERSITIES | EMERGENCY CONTRACEPTION | KNOWLEDGE | ATTITUDES | ABORTION | QUESTIONNAIRES | CONTRACEPTIVE METHOD ACCEPTABILITY | Oceania | Developed Countries | Studies | Research Methodology | Education | Schools | Contraception | Family Planning | Sociocultural Factors | Psychological Factors | Behavior | Fertility Control, Postconception | Contraceptive Usage Document Number: 342310 Notification |
| 13. Peer Reviewed Title: Evaluation of uptake and attitude to voluntary counseling and testing among health care professional students in Kilimanjaro region, Tanzania. Author: Charles MP; Kweka EJ; Mahande AM; Barongo LR; Shekalaghe S; Nkya HM; Lowassa A; Mahande MJ Source: BMC Public Health. 2009 May;9(128):1-9. Abstract: A structured questionnaire was used among health care professional students aged 18-25 years who were enrolled in degree, diploma, and certificate courses at Kilimanjaro Christian Medical College and all other allied health schools. A total of 309 students were recruited; among these 197 (63.8%) were females. All respondents were aware of the benefits of voluntary counseling and testing (VCT). Only 107 (34.6%) of students had previously gone to VCT. Risk perception among the students was low (37.2%) even though they were found to have higher risk behaviors that predisposed them to becoming infected with HIV. Language: English Keywords: TANZANIA | RESEARCH REPORT | SAMPLING STUDIES | STUDENTS | HEALTH PERSONNEL | VOLUNTARY COUNSELING AND TESTING | AWARENESS | PROGRAM ACCEPTABILITY | SEX BEHAVIOR | RISK BEHAVIOR | ATTITUDES | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Studies | Research Methodology | Education | Delivery of Health Care | Health | HIV Testing | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Knowledge | Sociocultural Factors | Program Evaluation | Programs | Organization and Administration | Behavior | Psychological Factors Document Number: 341407 |
| 14. Title: Impact of a peer-group intervention on occupation-related behaviors for urban hospital workers in Malawi. Author: Chimango JL; Kaponda CN; Jere DL; Chimwaza A; Crittenden KS; Kachingwe SI; Norr KF; Norr JL Source: Journal of the Association of Nurses In AIDS Care. 2009 Jul-Aug;20(4):293-307. Abstract: Using a pre- and posttest design with no control group, the authors evaluated the impact of a peer-group intervention on work related knowledge and behavior for health workers at an urban hospital in Malawi. The authors surveyed unmatched random samples of health workers, observed workers on the job, and interviewed clients about hospital services at baseline and at 6 months after the intervention. Universal precautions knowledge, reported hand washing, and reported client teaching were significantly higher at the final evaluation. The outcome differences remained robust in multivariate analyses with controls for demographic factors of age, gender, education, food security, and job category. Observations reported consistently greater use of universal precautions, more respectful interactions, and more client teaching at final evaluation. Patient surveys reported more discussion with health workers about HIV at the final evaluation. Peer-group interventions can prepare health workers in Malawi for HIV prevention and offer a potential model for other African countries. Language: English Keywords: MALAWI | RESEARCH REPORT | SAMPLING STUDIES | URBAN POPULATION | HEALTH PERSONNEL | PEER EDUCATORS | HIV PREVENTION | INTERVENTIONS | HOSPITALS | TRAINING PROGRAMS | UNIVERSAL PRECAUTIONS | KNOWLEDGE | HANDWASHING | INTERPERSONAL RELATIONS | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Delivery of Health Care | Health | Education | HIV Infections | Viral Diseases | Diseases | Programs | Organization and Administration | Health Facilities | Safety | Public Health | Sociocultural Factors | Hygiene | Behavior Document Number: 342814 |
| 15. Peer Reviewed Title: Estimating HIV prevalence and risk behaviors among high-risk heterosexual men with multiple sex partners: use of respondent-driven sampling. Author: Chopra M; Townsend L; Johnston L; Mathews C; Tomlinson M; O'bra H; Kendall C Source: Journal of Acquired Immune Deficiency Syndromes. 2009 May 1;51(1):72-7. Abstract: OBJECTIVES: To collect HIV data from high-risk men who have multiple, younger, female sex partners in a periurban township in South Africa. DESIGN: Unlinked anonymous cross-sectional survey using respondent-driven sampling. METHODS: Survey conducted among men aged 18 years or older who reported having had sex with more than 1 female partner in the previous 3 months (one of whom was either 3 or more years younger than the participant or below the age of 24) and lived in the area of recruitment. RESULTS: The median age of the 421 recruited men was 28 years (range: 18-62 years). They reported a median of 6 sexual partners (range: 2-39) during the past 3 months, and 51% (confidence interval: 45.0 to 59.6) reported inconsistent condom use with their casual partners. During the 3 months before the survey, 98% of men reported having concurrent sexual relationships. HIV prevalence was 12.3% (confidence interval: 8.3% to 16.9%). Being older than 24 years and not using a condom during the last sexual intercourse with a 1-time sexual partner were significantly associated with HIV infection. CONCLUSIONS: This group of heterosexual urban men practice high levels of risky sexual behavior and are an important group that require more targeted HIV surveillance and prevention interventions. Language: English Keywords: SOUTH AFRICA | RESEARCH REPORT | SAMPLING STUDIES | HETEROSEXUALS | MEN | URBAN POPULATION | HIV INFECTIONS | PREVALENCE | MULTIPLE PARTNERS | CONDOM USE | RISK BEHAVIOR | SEX BEHAVIOR | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Studies | Research Methodology | Behavior | Demographic Factors | Population | Population Characteristics | Viral Diseases | Diseases | Measurement | Sexual Partners | Risk Reduction Behavior Document Number: 342370 |
| 16. Peer Reviewed Title: Is phosphodiesterase type 5 inhibitor use associated with condom breakage? Author: Crosby R; Yarber WL; Sanders SA; Graham CA Source: Sexually Transmitted Infections. 2009 Sep;85(5):404-5. Abstract: We tested the hypothesis that phosphodiesterase type 5 inhibitor (PDE5i) use would be associated with increased likelihood of condom breakage using an event-specific analysis. A convenience sample of 440 men completed an internet-based questionnaire that assessed variables pertaining to the last time they used condoms for penile-vaginal intercourse (PVI). A bivariate (screening) analysis was performed to identify covariates for a multivariate analysis using logistic regression. Altogether, 5.9% of the men reported breakage and 9.5% reported PDE5i use during the last time a condom was used for PVI. Among men who had used PDE5i during the last condom-protected occasion of PVI, 11.9% reported breakage compared with 5.3% of those not reporting PDE5i use. Adjusting for men's age, ethnic minority status, marital status, reported duration of PVI and alcohol use at last PVI, those using PDE5i were about four times more likely to also report condom breakage (AOR 4.02; 95% CI 1.20 to 13.48; p = 0.04). Of note, duration of PVI was independently associated with breakage (AOR 1.36; CI 1.02 to 1.83; p = 0.04). Findings suggest that PDE5i use may potentially be associated with increased odds of condom breakage among some men. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | SAMPLING STUDIES | STATISTICAL REGRESSION | MEN | CONDOM FAILURE | RISK FACTORS | DRUGS | GENITAL EFFECTS, MALE | ALCOHOL USE AND ABUSE | MARITAL STATUS | Developed Countries | North America | Americas | Studies | Research Methodology | Data Analysis | Demographic Factors | Population | Condoms | Barrier Methods | Contraceptive Methods | Contraception | Family Planning | Health | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Genitalia, Male | Genitalia | Urogenital System | Physiology | Biology | Behavior | Nuptiality Document Number: 342845 |
| 17. Title: Reliability of reported breastfeeding duration among reproductive-aged women from Mexico. Author: Cupul-Uicab LA; Gladen BC; Hernandez-Avila M; Longnecker MP Source: Maternal and Child Nutrition. 2009 Apr;5(2):125-37. Abstract: Breastfed children have lower risk of infectious diseases, post-neonatal mortality and chronic diseases later in life. Because epidemiologic studies usually rely on reported history of previous breastfeeding, data on the accuracy and precision of recalled histories allow improved interpretation of the epidemiologic findings. We evaluated the reliability of two reported breastfeeding durations in 567 reproductive-aged women from Mexico using information obtained from nearly identical sets of questions applied at different times after weaning. We compared differences between reports, and examined the intraclass correlation coefficient (ICC) for any and for exclusive breastfeeding (EBF). Logistic regression was used to evaluate the determinants of poor recall (difference between reports of >20%). The reliability of duration of any breastfeeding was high (ICC 0.94). Overall, differences between reports of duration were usually <1 month, and for 385/567, the difference was < or =0.5 months. Predictors of poorer recall were having > or =4 children, and time between reports of >2 months. The only predictor of better recall was greater age of the baby at weaning. The reliability of EBF duration was lower (ICC 0.49). In this population with a relatively long duration of breastfeeding, reliability of any breastfeeding duration was high. Age, education and previous breastfeeding were not important predictors of recall, in contrast to findings in earlier studies. Consistent with previous reports, however, parity and length of recall were associated with poorer recall of duration of any breastfeeding. Future studies that use reported breastfeeding duration may want to consider the effect of these variables on recall. Language: English Keywords: MEXICO | RESEARCH REPORT | SAMPLING STUDIES | MEASUREMENT | MOTHERS | BREASTFEEDING | BREASTFEEDING, EXCLUSIVE | TIME FACTORS | RELIABILITY | SOCIOECONOMIC STATUS | North America | Americas | Developing Countries | Studies | Research Methodology | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Infant Nutrition | Nutrition | Health | Population Dynamics | Demographic Factors | Population | Socioeconomic Factors | Economic Factors Document Number: 341786 |
| 18. Title: Sex trafficking, violence victimization, and condom use among prostituted women in Nicaragua. Author: Decker MR; Mack KP; Barrows JJ; Silverman JG Source: International Journal of Gynaecology and Obstetrics. 2009 Jul 2; Abstract: The present study concerning disempowerment-related STI/HIV vulnerabilities among prostituted women in Nicaragua identified extensive experiences of trafficking, as well as violence and powerrelated barriers to condom use. Findings strongly indicate the need for further efforts to evaluate and address these forms of disempowerment and their implications for STI/HIV risk among prostituted women in the region. Language: English Keywords: NICARAGUA | RESEARCH REPORT | SAMPLING STUDIES | SEX WORKERS | SEXUAL TRAFFICKING | VIOLENCE AGAINST WOMEN | CONDOM USE | OBSTACLES | POWER | SEXUALLY TRANSMITTED DISEASES | HIV INFECTIONS | Developing Countries | Central America | Latin America | Americas | Studies | Research Methodology | Sex Behavior | Behavior | Crime | Social Problems | Sociocultural Factors | Domestic Violence | Risk Reduction Behavior | Organization and Administration | Political Factors | Reproductive Tract Infections | Infections | Diseases | Viral Diseases Document Number: 341975 |
| 19. Peer Reviewed Title: Malaria-related perceptions and practices of women with children under the age of five years in rural Ethiopia. Author: Deressa W; Ali A Source: BMC Public Health. 2009 Jul 23;9(1):259. Abstract: ABSTRACT: BACKGROUND: Malaria remains to be the major cause of morbidity and mortality among pregnant women and children in Ethiopia. The aim of this study was to investigate the local perceptions, practices and treatment seeking behaviour for malaria among women with children under the age of five years. METHODS: This community-based study was conducted in 2003 in an area of seasonal malaria transmission in Adami Tulu District, south-central Ethiopia. Total samples of 2087 rural women with children less than five years of age from 18 rural kebeles (the smallest administrative units) were interviewed about their perceptions and practices regarding malaria. In addition, focus group discussions and in-depth interviews were conducted on similar issues to complement the quantitative data. RESULTS: Malaria, locally known as busaa, is perceived as the main health problem in the study area. Mosquitoes are perceived to be the main cause of the disease, and other misperceptions were also widespread. The use of prevention measures was very low. Most mothers were familiar with the main signs and symptoms of mild malaria, and some of them indicated high grade fever, convulsions and mental confusion as a manifestation of severe malaria. Very few households (5.6%) possessed one or two nets. More than 60% of the mothers with recent episodes of malaria received initial treatment from non-public health facilities such as community health workers (CHWs) (40%) and private care providers (21%). Less than 40% of the reported malaria cases among women were treated by public health facilities. CONCLUSION: Malaria was perceived as the main health problem among women and children. The use of malaria preventive measures was low. A significant proportion of the respondents received initial malaria treatments from CHWs, private care providers and public health facilities. Concerted effort is needed to scale-up the distribution of insecticide-treated nets and improve the knowledge of the community about the link between malaria and mosquitoes. Effective antimalarial drugs should also be available at the grassroots level where the problem of malaria is rampant. Language: English Keywords: ETHIOPIA | RESEARCH REPORT | SAMPLING STUDIES | FOCUS GROUPS | MOTHERS | RURAL POPULATION | MALARIA | PERCEPTION | KNOWLEDGE | BED NETS | UTILIZATION OF HEALTH CARE | ANTIMALARIAL DRUGS | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Studies | Research Methodology | Data Collection | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Population Characteristics | Demographic Factors | Population | Parasitic Diseases | Diseases | Psychological Factors | Behavior | Parasite Control | Public Health | Health | Health Services | Delivery of Health Care Document Number: 342286 |
| 20. Peer Reviewed Title: Gender factors associated with sexual abstinent behaviour of rural South African high school going youth in KwaZulu-Natal, South Africa. Author: Dlamini S; Taylor M; Mkhize N; Huver R; Sathiparsad R; de Vries H; Naidoo K; Jinabhai C Source: Health Education Research. 2009 Jun;24(3):450-60. Abstract: The cross-sectional study investigated South African rural high school learners' choice of sexual abstinence in order to be able to develop tailored health education messages. All Grade 9 learners from one class at each of 10 randomly selected rural high schools participated. The Integrated Model for Motivational and Behavioural Change was used to elicit attitudes, social influences, self-efficacy and intentions towards sexual abstinence. Chi-square and t-tests were used for bivariate analysis. In total, 454 learners, mean age 16.7 years (standard deviation 1.41) range 14-20 years, participated, of whom 246 (54.2%) were female. When comparing learners reporting abstinence (n = 252) with those not abstinent (n = 202), abstinent learners were significantly more often females (P < 0.005), younger (16.5 years versus 17.1 years, P < 0.005) and drank less alcohol (P < 0.005). Abstaining girls believed that their friends and parents think that they should abstain from sex, that their friends abstained from sex and that abstinence helped them to mature emotionally. Abstinent boys expressed intentions to abstain from sex until marriage. Targeted intervention research is required to encourage South African rural high school learners to delay their sexual initiation to reduce their risk of human immunodeficiency virus infection. Different abstinent messages are needed for boys and girls to address the different patterns of behaviour observed. Language: English Keywords: SOUTH AFRICA | RESEARCH REPORT | SAMPLING STUDIES | RURAL POPULATION | STUDENTS | ABSTINENCE | PREVALENCE | ATTITUDES | SEX FACTORS | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Education | Family Planning, Behavioral Methods | Family Planning | Measurement | Psychological Factors | Behavior Document Number: 341430 |
| 21. Peer Reviewed Title: The influence of changes in women's religious affiliation on contraceptive use and fertility among the Kassena-Nankana of Northern Ghana. Author: Doctor HV; Phillips JF; Sakeah E Source: Studies in Family Planning. 2009 Jun;40(2):113-122. Abstract: Religious affiliation is undergoing major changes in rural Sahelian Africa, with profound consequences for customs that are grounded in traditional belief systems. This study examines the influence of women's religious affiliation on contraceptive use and fertility among the Kassena-Nankana of northern Ghana. Analysis of longitudinal data for women in 1995 and 2003 shows that 61 percent of women changed their religion, with shifts from traditional beliefs to Christianity being dominant. Moreover, women were more likely than men to make such a change. Regression results show that, compared with those who did not change, switching from traditional religion to Christianity or Islam is associated with increased contraceptive use and decreased fertility. The more rapid change in religious affiliation among women than men may have social consequences for the status of women, signaling a trend toward greater autonomy in the family and new aspirations, values, and behavior as evidenced by the proportion of people adopting contraceptives. Language: English Keywords: GHANA | RESEARCH REPORT | LONGITUDINAL STUDIES | SAMPLING STUDIES | ETHNIC GROUPS | WOMEN | RELIGIOUS ASPECTS | CONTRACEPTIVE USAGE | REPRODUCTIVE BEHAVIOR | BELIEFS | CHRISTIANITY | ISLAM | SOCIAL CHANGE | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Studies | Research Methodology | Cultural Background | Population Characteristics | Demographic Factors | Population | Religion | Sociocultural Factors | Contraception | Family Planning | Fertility | Population Dynamics | Culture Document Number: 341895 |
| 22. Peer Reviewed Title: Attitudes towards the male contraceptive pill in men and women in casual and stable sexual relationships. Author: Eberhardt J; van Wersch A; Meikle N Source: Journal of Family Planning and Reproductive Health Care. 2009 Jul;35(3):161-5. Abstract: BACKGROUND AND METHODOLOGY: Men's and women's attitudes towards the male contraceptive pill and their trust in the effective use of the male pill were investigated, as well as the associated variables of reported health behaviours, perceived self-efficacy and type of sexual relationship, using a questionnaire survey. RESULTS: Although both sexes had a favourable attitude towards the male pill, females had a more positive attitude than men. Conversely, women had less trust that men would use the male pill effectively. Males in stable sexual relationships were more positive about the male pill than those in casual sexual relationships. Gender, relationship type and trust in the effective use of the male pill reliably predicted attitude towards the male pill. High perceived self-efficacy was related to engaging in more health behaviours, and in men a positive association between health behaviours and attitude towards the male pill has been found. DISCUSSION AND CONCLUSIONS: A positive attitude towards the male pill does not automatically imply that the individual is confident about its effective use. Once the male pill is widely available, promotional campaigns could target not only men but also their female partners, as the latter tend to come into contact with health services more frequently. In order to increase confidence in effective implementation, a variety of presentations of the male pill should be made available in line with individual needs and lifestyles. Language: English Keywords: UNITED KINGDOM | RESEARCH REPORT | SAMPLING STUDIES | MALE CONTRACEPTION | ORAL CONTRACEPTIVES | ATTITUDES | BELIEFS | QUESTIONNAIRES | MALE ROLE | SEX FACTORS | AGE FACTORS | Developed Countries | Europe, Western | Europe | Studies | Research Methodology | Contraception | Family Planning | Contraceptive Methods | Psychological Factors | Behavior | Culture | Sociocultural Factors | Social Behavior | Population Characteristics | Demographic Factors | Population Document Number: 342138 |
| 23. Title: Prevalence of Chlamydia trachomatis among women attending gynecology and infertility clinics in Gaza, Palestine. Author: El Qouqa IA; Shubair ME; Al Jarousha AM; Sharif FA Source: International Journal of Infectious Diseases. 2009 May;13(3):334-41. Abstract: BACKGROUND: Chlamydia trachomatis is an obligate intracellular bacterium characterized by a biphasic developmental cycle of replication. The organism is recognized as one of the major causes of sexually transmissible human bacterial infection throughout the world. Since there have been no previous studies dealing with chlamydial diagnosis in Palestine, this study was conducted to determine the prevalence of C. trachomatis infection among women attending gynecology and infertility clinics. METHODS: Endocervical swabs were collected from 109 women, aged 18-52 years (median 29 years), attending gynecology and infertility clinics in Gaza. These specimens were processed using molecular (polymerase chain reaction, PCR) and enzyme immunoassay (EIA; IDEIA PCE Chlamydia) techniques. RESULTS: The results obtained show that the overall prevalence rate of C. trachomatis was 20.2%. The sensitivity was 73% for the EIA, 86% for the MOMP (major outer membrane protein gene)-based PCR, and 100% for the plasmid-based PCR. Meanwhile the specificity was 94% for the EIA, 98% for the plasmid-based PCR, and 100% for the MOMP-based PCR. In multivariate analysis, only cervical discharge was significantly associated with positivity for C. trachomatis (adjusted odds ratio 5.6, 95% confidence interval 2.0-15.5; p=0.001). CONCLUSIONS: The study revealed that a significant proportion of Palestinian women expressed evidence of exposure to C. trachomatis. Women with cervicitis are more likely to have been previously infected or exposed to Chlamydia infection. Furthermore, PCR proved to be superior and more efficient in the diagnosis of C. trachomatis than EIA. Language: English Keywords: GAZA | RESEARCH REPORT | CLINICAL RESEARCH | SAMPLING STUDIES | CLIENTS | WOMEN | CHLAMYDIA | PREVALENCE | INFERTILITY | CERVICAL EFFECTS | LABORATORY PROCEDURES | SIGNS AND SYMPTOMS | Middle East | Developing Countries | Research Methodology | Studies | Program Activities | Programs | Organization and Administration | Demographic Factors | Population | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Measurement | Reproduction | Cervix | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 342115 |
| 24. Peer Reviewed Title: Factors associated with an explosive HIV epidemic among injecting drug users in Sargodha, Pakistan. Author: Emmanuel F; Archibald C; Razaque A; Sandstrom P Source: Journal of Acquired Immune Deficiency Syndromes. 2009 May 1;51(1):85-90. Abstract: BACKGROUND: During a routine surveillance round, an extremely high prevalence of 51.3% was found among injecting drug users (IDUs) in Sargodha, a small town in Pakistan. This sharp increase of HIV among this group warranted an urgent need to explore the factors leading toward this explosion of HIV infection among IDUs at this very location to direct the policy makers in designing preventive activities, especially in the context of HIV prevention. METHODS: In 2007, 400 current IDUs were recruited through multistage cluster sampling based on mapping studies. Participants provided dried blood spot samples for HIV testing and completed a questionnaire on demographic characteristics and sexual/drug injecting behaviors. Logistic regression was used to examine the independent association of multiple variables with HIV infection. RESULTS: Of the 400 IDUs tested, 205 (51.3%) were HIV positive confirmed through enzyme-linked immunosorbent assay and Western blot. In multivariate analysis, geographical location of IDUs [adjusted odds ratio (aOR) 2.4 for IDUs located in the northern zone vs southern zone, 95% confidence interval (CI) 1.5 to 3.7], injected in groups (aOR 1.8, 95% CI 1.1 to 3.1), and sharing injecting paraphernalia with other IDUs (aOR 1.5, 95% CI 1.0 to 2.4) were strong correlates of HIV infection. CONCLUSIONS: Effective outreach programs need to be developed to provide a comprehensive package of HIV prevention services to IDUs not reached by existing services, entry into drug abuse treatment and medical care needs to be facilitated, and essential legal and social services need to be provided with community participation. Language: English Keywords: PAKISTAN | RESEARCH REPORT | SAMPLING STUDIES | STATISTICAL REGRESSION | IV DRUG USERS | HIV INFECTIONS | EPIDEMICS | PREVALENCE | RISK FACTORS | NEEDLE SHARING | SEX BEHAVIOR | QUESTIONNAIRES | KNOWLEDGE | Developing Countries | Asia, Southern | Asia | Studies | Research Methodology | Data Analysis | Drug Use and Abuse | Behavior | Viral Diseases | Diseases | Measurement | Health | Risk Behavior | Sociocultural Factors Document Number: 342369 |
| 25. Title: Urinary screening abnormalities in antiretroviral-naive HIV-infected outpatients and implications for management--a single-center study in South Africa. Author: Fabian J; Naicker S; Venter WD; Baker L; Naidoo S; Paget G; Wadee S Source: Ethnicity and Disease. 2009 Spring;19(1 Suppl 1):S1-80-5. Abstract: Few urinary screening studies have been performed to determine the incidence of urinary abnormalities in antiretroviral therapy-naive, HIV-infected outpatients. From published data, the incidence appears to be high, particularly when compared with populations outside sub-Saharan Africa. In South Africa, urinary screening in antiretroviral therapy clinics is not routinely practiced. The aim of this descriptive study was to screen antiretroviral therapy-naive, HIV-infected outpatients attending the HIV clinic for urinary abnormalities, namely leukocyturia, microscopic hematuria, and microalbuminuria/proteinuria. This study showed that 84% of the screened population had AIDS (CD4 count < 200 cells/ mm3), and the incidence of abnormalities on urinary dipstick testing was high: 30% had leukocyturia, 33% had microscopic hematuria, and 44% had microalbuminuria/proteinuria. In patients with leukocyturia, an infective organism was cultured in only 29.1% of cases, predominantly Escherichia coli (70%) with sterile leukocyturia comprising the remainder. There may be an association with tuberculosis (TB) or sexually transmitted infections (STI) in the sterile leucocyturia group, but this remains to be confirmed. In those with a culture positive result the most common organism was E. coli (70%), which exhibited 90% resistance to cotrimoxazole, demonstrating that cotrimoxazole prophylaxis is not effective to prevent urinary tract infection in this group. On the basis of these findings, it has been proposed that urinary screening be considered standard of care in HIV clinics in South Africa. An algorithm has been proposed for use in antiretroviral therapy clinics in South Africa to guide clinicians regarding the cost-effective management of urinary dipstick abnormalities. Language: English Keywords: SOUTH AFRICA | RESEARCH REPORT | SAMPLING STUDIES | CLIENTS | PERSONS LIVING WITH HIV/AIDS | RENAL EFFECTS | UROGENITAL EFFECTS | SCREENING | AIDS | PREVALENCE | CLINIC ACTIVITIES | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Studies | Research Methodology | Program Activities | Programs | Organization and Administration | HIV Infections | Viral Diseases | Diseases | Urogenital System | Physiology | Biology | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Measurement Document Number: 341942 |
| 26. Peer Reviewed Title: High HIV prevalence detected in 2006 and 2007 among men who have sex with men in China's largest municipality: an alarming epidemic in Chongqing, China. Author: Feng L; Ding X; Lu R; Liu J; Sy A; Ouyang L; Pan C; Yi H; Liu H; Xu J; Zhao J Source: Journal of Acquired Immune Deficiency Syndromes. 2009 Sep 1;52(1):79-85. Abstract: BACKGROUND: Data from many large cities in China show HIV prevalence among men who have sex with men (MSM) increasing dramatically over the recent years, making HIV transmission among MSM in China a growing concern. To facilitate targeted HIV prevention among MSM in Chongqing, surveys were conducted to examine HIV prevalence and its associated factors in 2006 and in 2007. METHODS: Surveys were conducted in 2006 and 2007 in 3 districts of Chongqing at venues and cruising areas where MSM frequent. Univariate and bivariate analysis were conducted on demographic, behavioral, and biological data. RESULTS: HIV prevalence was 19.7% in 2006 and 26.5% in 2007 among recruitees from bathhouses and saunas, more than 2 times higher than recruitees from other venues for both years. HIV prevalence increased from 10.4% in 2006 to 12.5% in 2007. HIV prevalence was more than 20% among those older than 40 years of age, much higher than HIV prevalence in younger age groups. HIV prevalence among married MSM was 15.9% in 2006 and 20.9% in 2007, compared with nonmarried MSM at 7.6% in 2006 and 9.2% in 2007. DISCUSSION: Urgent attention for prevention services is required to address the overall high HIV prevalence among MSM in the city, with special focus on subgroups as older, married MSM, and those recruited from bathhouses and saunas. Language: English Keywords: CHINA | RESEARCH REPORT | SURVEYS | SAMPLING STUDIES | MEN HAVING SEX WITH MEN | HIV INFECTIONS | PREVALENCE | EPIDEMICS | SYPHILIS | SEX BEHAVIOR | AGE FACTORS | MARITAL STATUS | Asia, Eastern | Asia | Developing Countries | Studies | Research Methodology | Behavior | Viral Diseases | Diseases | Measurement | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Population Characteristics | Demographic Factors | Population | Nuptiality Document Number: 342907 |
| 27. Title: The prevalence of motor delay among HIV infected children living in Cape Town, South Africa. Author: Ferguson G; Jelsma J Source: International Journal of Rehabilitation Research. 2009 Jun;32(2):108-14. Abstract: Children living with HIV often display delayed motor performance owing to HIV infection of the central nervous system, the effects of opportunistic infections and, indirectly, owing to their social environments. Although these problems have been well documented, the impact of the virus on the development of South African children is less well known. The aim of this study was to document the motor performance of a group of HIV infected children in Cape Town, South Africa. The Bayley Scales of Infant Development Second Edition were administered to 51 HIV infected children [mean age 15.8 months (SD=7.5, range 6.2-31.7 months)] of whom 34 were receiving antiretroviral therapy. Their performance was compared with an age-matched reference sample (n=35), whose HIV status was unknown. The HIV infected sample and the age-matched sample were comparable with regard to caregiver's level of education (P=0.42), employment status (P=0.35) and income (P=0.28). However, the HIV infected sample had significantly more hospital admissions (P<0.01), their caregivers were mostly single (P=0.04) and most lived in formal houses (P<0.01). The prevalence of significant motor delay was 66.7% in the HIV infected sample compared with 5.7% in the age-matched sample. As expected, the performance of the HIV infected sample was significantly poorer than the age-matched sample. However, the extent of the delay is a cause of concern as so many children presented with significant motor delay. Unexpectedly, a significant number of healthy children also displayed delayed performance. It is recommended that the developmental performance of HIV infected children be monitored over an extended period to determine whether the developmental delay can be reduced with treatment. In the interim, there is a need to provide stimulation and treatment to the large number of children who are developmentally delayed as a result of HIV infection, including those uninfected children in the community who are at risk owing to their socio-economic status. Language: English Keywords: SOUTH AFRICA | RESEARCH REPORT | SAMPLING STUDIES | PERSONS LIVING WITH HIV/AIDS | CHILDREN | ANTIRETROVIRAL THERAPY | CHILD DEVELOPMENT | CENTRAL NERVOUS SYSTEM EFFECTS | PREVALENCE | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Studies | Research Methodology | HIV Infections | Viral Diseases | Diseases | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | HIV | Biology | Central Nervous System | Physiology | Measurement Document Number: 342451 |
| 28. Peer Reviewed Title: Evaluating nurses' implementation of an infant-feeding counseling protocol for HIV-infected mothers: The Ban Study in Lilongwe, Malawi. Author: Ferguson YO; Eng E; Bentley M; Sandelowski M; Steckler A; Randall-David E; Piwoz EG; Zulu C; Chasela C; Soko A; Tembo M; Martinson F; Tohill BC; Ahmed Y; Kazembe P; Jamieson DJ; van der Horst C Source: AIDS Education and Prevention. 2009 Apr;21(2):141-55. Abstract: A process evaluation of nurses' implementation of an infant-feeding counseling protocol was conducted for the Breastfeeding, Antiretroviral and Nutrition (BAN) Study, a prevention of mother-to-child transmission of HIV clinical trial in Lilongwe, Malawi. Six trained nurses counseled HIV-infected mothers to exclusively breastfeed for 24 weeks postpartum and to stop breastfeeding within an additional four weeks. Implementation data were collected via direct observations of 123 infant feeding counseling sessions (30 antenatal and 93 postnatal) and interviews with each nurse. Analysis included calculating a percent adherence to checklists and conducting a content analysis for the observation and interview data. Nurses were implementing the protocol at an average adherence level of 90% or above. Although not detailed in the protocol, nurses appropriately counseled mothers on their actual or intended formula milk usage after weaning. Results indicate that nurses implemented the protocol as designed. Results will help to interpret the BAN Study's outcomes. Language: English Keywords: MALAWI | EVALUATION REPORT | SAMPLING STUDIES | NURSES AND NURSING | MOTHERS | PERSONS LIVING WITH HIV/AIDS | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | IMPLEMENTATION | COUNSELING | BREASTFEEDING, EXCLUSIVE | COMMUNICATION | USER COMPLIANCE | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Evaluation | Studies | Research Methodology | Health Personnel | Delivery of Health Care | Health | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | HIV Infections | Viral Diseases | Diseases | Disease Transmission Control | Prevention and Control | Programs | Organization and Administration | Clinic Activities | Program Activities | Breastfeeding | Infant Nutrition | Nutrition | Behavior Document Number: 341680 |
| 29. Peer Reviewed Title: Association of age at first sex with HIV-1, HSV-2, and other sexual transmitted infections among women in northern Tanzania. Author: Ghebremichael M; Larsen U; Paintsil E Source: Sexually Transmitted Diseases. 2009 Sep;36(9):570-576. Abstract: The authors examined the association between age at first sex and the prevalence of sexually transmitted infections (STIs), including HIV-1 and HSV-2, in women in Moshi urban district, northern Tanzania. A total of 2,019 women aged 20 to 44 were randomly selected in a two-stage sampling, and they provided information on demographics and sexual behaviors. Blood and urine samples were drawn for STI testing. Women who had their first sexual intercourse between ages 18 and 19 (OR = 0.66; 95% CI = 0.50-0.86) or 20+ (OR = 0.46; 95% CI = 0.36-0.60) were less likely to have STIs, including HIV-1 and HSV-2, than were women who had their first intercourse before their 18th birthday. Early age at first sex was associated with having a regular noncohabiting partner, female circumcision, and coercion at first intercourse. Language: English Keywords: TANZANIA | RESEARCH REPORT | SAMPLING STUDIES | WOMEN | FIRST INTERCOURSE | HIV INFECTIONS | SEXUALLY TRANSMITTED DISEASES | INCIDENCE | SIGNS AND SYMPTOMS | LABORATORY EXAMINATIONS AND DIAGNOSES | RISK FACTORS | FEMALE GENITAL CUTTING | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Studies | Research Methodology | Demographic Factors | Population | Sex Behavior | Behavior | Viral Diseases | Diseases | Reproductive Tract Infections | Infections | Measurement | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Harmful Traditional Practices | Traditional Health Practices | Culture | Sociocultural Factors Document Number: 339905 |
| 30. Title: HIV seroprevalence and associated risk factors among male inmates at the Belize Central Prison. Author: Gough E; Edwards P Source: Revista Panamericana de Salud Pública / Pan American Journal of Public Health. 2009 Apr;25(4):292-299. Abstract: To determine the seroprevalence of HIV and identify associated risk factors among inmates at the Belize Central Prison, managed by the Kolbe Foundation, Belize. METHODS: A voluntary sample of 623 participants was obtained from the male inmate population incarcerated during the period from 15 January to 5 March 2005. HIV serostatus was determined on location using the Abbott Determine Assay for HIV-1/2 for screening, and the MedMira MiraWell Rapid HIV-1/2 Test for confirmatory testing. Remaining serum was tested by ELISA at the Central Medical Laboratory, Belize. Demographic and risk behavior data were collected using an interviewer administered pre-tested questionnaire. A multivariate logistic regression was used to adjust for potential confounders and to identify independent associations with HIV seropositivity. RESULTS:Of the 623 inmates in the sample, 25 tested positive for HIV-1/2 antibody for a seroprevalence of 4.0% (95% Confidence Interval 2.7, 6.0). After adjustment for confounding, HIV serostatus was positively associated with male-to-male sexual activity outside prison, age, and district of residence before current incarceration. CONCLUSIONS: The seroprevalence in the Central Prison was almost twice that estimated for the adult population of Belize in 2004 (2.4%). However, the social variables of importance to inmates appeared to reflect the epidemic in the general population, with the exception that male-to-male sex outside prison is likely more important to the male inmate population in Belize. The findings suggest that HIV is likely contracted by most inmates before their incarceration, largely due to same-sex activity. Language: English Keywords: BELIZE | RESEARCH REPORT | SAMPLING STUDIES | PRISONERS | MEN | HIV INFECTIONS | PREVALENCE | RISK FACTORS | VOLUNTARY COUNSELING AND TESTING | SEX BEHAVIOR | CONDOM USE | DRUG USE AND ABUSE | Developing Countries | Central America | Latin America | Americas | Studies | Research Methodology | Crime | Social Problems | Sociocultural Factors | Demographic Factors | Population | Viral Diseases | Diseases | Measurement | Health | HIV Testing | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Behavior | Risk Reduction Behavior Document Number: 341875 |
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