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Title: The long wait: reproductive health care in Haiti.
Author: John Snow [JSI]. Research and Training Institute, Inc.
Source: Arlington, Virginia, JSI, Research and Training Institute, Inc., 2009. 22 p.
Abstract: The reproductive health status of Haiti's communities contributes to a life expectancy of 62.8 years for women in comparison to 75.5 years in neighboring Dominican Republic or 80.8 years for women in the U.S. According to Haiti's 2005-2006 Demography Health Survey, 37.5% of women have unmet family planning needs. Additionally, youth and rural area residents report greater unmet needs for family planning than the national average. Unmet family planning contributes to a high total fertility rate of 4.79 (5 in rural versus 2.8 in urban areas), a high infant morality (57 deaths per 1000 live births) and the highest maternal mortality rate in the western world-630 deaths per 100,000 live births. These alarming RH indicators prompted a team from JSI Research & Training Institute, Inc. (JSI) to visit Haiti in January 2009. The objectives of the study were: 1) to identify gaps in the availability and accessibility of comprehensive RH services including: Safer motherhood and emergency obstetric care (EmOC), Family planning, HIV/AIDS and sexually transmitted infections (STI) prevention, care and support, Gender-based violence (GBV) prevention, care and support, and Adolescent-focused RH programming for each of the above RH components. 2) to identify community-level responses and opportunities for strengthening the quality and availability of comprehensive RH services. This report presents the findings of this assessment.
Language: English
Keywords:
HAITI | SUMMARY REPORT | MOTHERS | SAFE MOTHERHOOD | REPRODUCTIVE HEALTH | HIV PREVENTION | AIDS PREVENTION | SEXUALLY TRANSMITTED DISEASE PREVENTION | VIOLENCE AGAINST WOMEN | PREVENTION AND CONTROL | FAMILY PLANNING | HEALTH SERVICES | DELIVERY OF HEALTH CARE | PROGRAM ACCESSIBILITY | Developing Countries | Caribbean | Americas | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Maternal Health | Health | HIV Infections | Viral Diseases | Diseases | AIDS | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Domestic Violence | Crime | Social Problems | Program Evaluation | Programs | Organization and Administration
Document Number: 341307

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Title: Sexual and reproductive health and HIV linkages: evidence review and recommendations.
Author: World Health Organization [WHO]; United Nations Population Fund [UNFPA]; International Planned Parenthood Federation [IPPF]; Joint United Nations Programme on HIV / AIDS [UNAIDS]; University of California, San Francisco. Global Health Sciences
Source: Geneva, Switzerland, WHO, 2009 Apr. [8] p.
Abstract: The importance of linking sexual and reproductive health (SRH) and HIV is widely recognized. The international community agrees that the Millennium Development Goals will not be achieved without ensuring universal access to SRH and HIV prevention, treatment, care and support. In order to gain a clearer understanding of the effectiveness, optimal circumstances, and best practices for strengthening SRH and HIV linkages, a systematic review of the literature was conducted. The findings corroborate the many benefits gained from linking SRH and HIV policies, systems and services. (Excerpt)
Language: English
Keywords:
DEVELOPING COUNTRIES | SUMMARY REPORT | CLIENTS | HIV TESTING | COUNSELING | HIV PREVENTION | FAMILY PLANNING | MATERNAL HEALTH | SEXUALLY TRANSMITTED DISEASE PREVENTION | CHILD HEALTH | MANAGEMENT | KNOWLEDGE | ATTITUDES | STIGMA | BEHAVIOR | FEES | HIV/FP INTEGRATION | INTERVENTIONS | Program Activities | Programs | Organization and Administration | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Clinic Activities | HIV Infections | Viral Diseases | Diseases | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Sociocultural Factors | Psychological Factors | Social Problems | Financial Activities | Economic Factors
Document Number: 331466

Title: Condom use for preventing STI/HIV and unintended pregnancy among young men in sub-saharan Africa.
Author: Bankhole A; Singh S; Hussain R; Oestreicher G
Source: American Journal of Men's Health. 2009 Mar;3(1):60-78.
Abstract: The condom is the only known method that provides simultaneous protection against unplanned pregnancy and some sexually transmitted infections (STIs), including HIV, among sexually active people. Using data from the Demographic and Health Surveys from 18 Sub-Saharan African countries, this study examined condom use and reasons for using the method at last intercourse among sexually active young men aged 15 to 29. Most young men were aware of the condom (73%-98%), but its use at last intercourse was quite variable, ranging from 6% in Madagascar to 74% in Namibia. In 10 countries, more young men reportedly used condoms for preventing STIs alone than they did for preventing pregnancy alone. In 6 countries, at least one third of the users used the method for both purposes. Use of the condom at last intercourse was associated with union status, education, residence, and exposure to television in at least two thirds of the countries.
Language: English
Keywords:
AFRICA, SUB SAHARAN | RESEARCH REPORT | KAP SURVEYS | DEMOGRAPHIC AND HEALTH SURVEYS | CROSS-CULTURAL COMPARISONS | YOUTH | MEN | CONDOM USE | SEXUALLY TRANSMITTED DISEASE PREVENTION | HIV PREVENTION | PREGNANCY, UNPLANNED | KNOWLEDGE | CONTRACEPTIVE PREVALENCE | Africa | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Demographic Surveys | Population Dynamics | Demographic Factors | Population | Comparative Studies | Age Factors | Population Characteristics | Risk Reduction Behavior | Behavior | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | HIV Infections | Viral Diseases | Reproductive Behavior | Fertility | Sociocultural Factors | Contraceptive Usage | Contraception | Family Planning
Document Number: 329249

Peer Reviewed

Title: Sexual risk-taking among adult dating couples in the United States.
Author: Billy JO; Grady WR; Sill ME
Source: Perspectives On Sexual and Reproductive Health. 2009 Jun;41(2):74-83.
Abstract: CONTEXT: Knowledge of sexual and contraceptive behaviors as risk factors for STDs is largely based on women's or men's separate reports of their attitudes and behaviors. Little research has been based on couples. METHODS: Data from the 2005-2006 National Couples Survey were used to examine the sexual risk-taking behavior of 335 dating couples. Associations between each partner's characteristics and the couple's probability of recently having had anal sex and of having done something to protect themselves from STDs were assessed using logistic regression analyses. Models included measures of power dynamics and partners' perceptions of who controls sexual and contraceptive decisions. RESULTS: Couples in which the female partner reported that her male partner made the decisions about sex and contraception had increased probability of having had anal sex during the four weeks prior to the interview. In addition, partners' relationship power and their perception of control over sex and contraception moderated associations between couples' behavior and partners' characteristics, experiences and beliefs. For example, although couples in which the male partners had known someone with AIDS were less likely than others to engage in anal sex, that association was much greater for males with high income-and thus greater power-than for those with low income. CONCLUSIONS: Sexual behaviors are not controlled by any one individual in a relationship; characteristics of each partner are important. Couples-based interventions that take into consideration relationship-especially power-dynamics may enable individuals to initiate and sustain safer-sex practices.
Language: English
Keywords:
UNITED STATES OF AMERICA | RESEARCH REPORT | STATISTICAL REGRESSION | ADULTS | COUPLES | SEX BEHAVIOR | POWER | ANAL SEX | CONDOM USE | CONTRACEPTIVE USAGE | SEXUALLY TRANSMITTED DISEASE PREVENTION | PERCEPTION | Developed Countries | North America | Americas | Data Analysis | Research Methodology | Age Factors | Population Characteristics | Demographic Factors | Population | Family Characteristics | Family and Household | Sociocultural Factors | Behavior | Political Factors | Risk Reduction Behavior | Contraception | Family Planning | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Psychological Factors
Document Number: 342624

Peer Reviewed

Title: Potential acceptability of microbicides in HIV prevention in stable marital relationships in Malawi.
Author: Bisika T
Source: Journal of Family Planning and Reproductive Health Care. 2009 Apr;35(2):115-7.
Abstract: BACKGROUND: The XVII International Conference on AIDS held in Mexico City in August 2008 emphasised the importance of dual prevention using both vaccines and microbicides in the fight against HIV and AIDS. Microbicides are important because they constitute one of the potentially important female-controlled methods of HIV and sexually transmitted infection prevention, especially in Malawi where the use of the female condom has not yet been fully embraced. METHODS: A qualitative study utilising focus group discussions was used to assess the acceptability of the microbicide nonoxynol-9 (N-9) as part of the ongoing Preparatory AIDS Vaccine Evaluation (PAVE) studies. RESULTS: The study observed that men oppose the use of N-9, and that although women consider themselves at risk for HIV they caution against the unintended consequence of altering the vaginal environment with the use of microbicides, which can interfere with the men's preference for dry sex. DISCUSSION AND CONCLUSIONS: Although N-9 did not produce the desired results, these can inform the development of other promising microbicide candidates. The study concludes that it is important to pay attention to how new microbicides are formulated rather than just concentrating solely on an individual product's effectiveness.
Language: English
Keywords:
MALAWI | RESEARCH REPORT | FOCUS GROUPS | CURRENTLY MARRIED | HIV PREVENTION | SEXUALLY TRANSMITTED DISEASE PREVENTION | MICROBICIDES | NONOXYNOL-9 | HUSBAND-WIFE COMPARISONS | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Data Collection | Research Methodology | Marital Status | Nuptiality | Demographic Factors | Population | HIV Infections | Viral Diseases | Diseases | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Spermicidal Contraceptive Agents | Contraceptive Agents | Contraception | Family Planning | Comparative Studies | Studies
Document Number: 341651

10.

Peer Reviewed

Title: Political feasibility of scaling-up five evidence-informed HIV interventions in Pakistan: a policy analysis.
Author: Buse K; Lalji N; Mayhew SH; Imran M; Hawkes SJ
Source: Sexually Transmitted Infections. 2009 Apr;85(Suppl 2):ii37-ii42.
Abstract: Background: Drawing on policy theories, an assessment was made of the perceived political feasibility of scaling-up five evidence-based interventions to curb Pakistan's HIV epidemic: needle and syringe exchange programmes; targeted behaviour change communication; sexual health care for male and transgender sex workers; sexual and reproductive health care for female sex workers; and promoting and protecting the rights of those at greatest risk. Method: A questionnaire was emailed to 40 stakeholders and completed by 22. They expressed their level of agreement with 15 statements for each intervention (related to variables associated with policy success). Semi-structured interviews were conducted with 12 respondents. Results: The interventions represent considerable change from the status quo, but are perceived to respond to widely acknowledged problems. These perceptions, held by the HIV policy elite, need to be set in the context of the prevailing view that the AIDS response is not warranted given the small and concentrated nature of the epidemic and that the interventions do not resonate closely with values held by society. The interventions were perceived to be evidence-based, supported by at least one donor and subject to little resistance from frontline staff as they will be implemented by contracted non-government organisations. The results were mixed in terms of other factors determining political feasibility, including the extent to which interventions are easy to explain, exhibit simple technical features, require few additional funds, are supported and not opposed by powerful stakeholders. Conclusion: The interventions stand a good chance of being implemented although they depend on donor support. The prospects for scaling them would be improved by ongoing policy analysis and strengthening of domestic constituencies among the target groups.
Language: English
Keywords:
PAKISTAN | RESEARCH REPORT | THEORETICAL MODELS | KAP SURVEYS | POLICYMAKERS | IV DRUG USERS | SEX WORKERS | HIV PREVENTION | BEHAVIOR CHANGE COMMUNICATION | POLICY DEVELOPMENT | HEALTH POLICY | INTERVENTIONS | CAPACITY BUILDING | SEXUALLY TRANSMITTED DISEASE PREVENTION | SYRINGE | NEEDLE SHARING | SOCIAL POLICY | Developing Countries | Asia, Southern | Asia | Research Methodology | Surveys | Sampling Studies | Studies | Administrative Personnel | Organization and Administration | Drug Use and Abuse | Behavior | Sex Behavior | HIV Infections | Viral Diseases | Diseases | Communication Programs | Communication | Behavior Change | Planning | Policy | Political Factors | Sociocultural Factors | Programs | Program Sustainability | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Equipment and Supplies | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Risk Behavior
Document Number: 340114

11.

Peer Reviewed

Title: Sexual behaviour among Italian adolescents: Knowledge and use of contraceptives.
Author: Capuano S; Simeone S; Scaravilli G; Raimondo D; Balbi C
Source: European Journal of Contraception and Reproductive Health Care. 2009 Apr 18;:1-5.
Abstract: Background Comprehensive data concerning the sexual behaviour of Italian adolescents are lacking; the planning of prevention programmes is therefore difficult. Methods The current study evaluates the knowledge of Italian adolescents about sexuality and their use of methods to prevent pregnancy and sexually transmitted infections. The age at first intercourse in the current sample was compared to that found in past samples to ascertain whether sex education was needed at an earlier age. The efficacy of one school-based sex education programme was analysed. Results Overall 630 students in three Italian cities were surveyed. Just over half the students were sexually active. Among these, the mean age at first intercourse was 15.6 years (SD +/- 1.3). The contraception most widely used was the condom although 'coitus interruptus', 'natural family planning' and 'no method' were also mentioned. The knowledge among students from Latina, after they had received sex education, was significantly better. Conclusion Our data show a lower mean age at first intercourse than has been reported for earlier periods by other authors. School-based sexual education is effective in improving knowledge. Sexual health services for young people must be available and counselling services improved.
Language: English
Keywords:
ITALY | RESEARCH REPORT | KAP SURVEYS | ADOLESCENTS | KNOWLEDGE | SEX BEHAVIOR | CONTRACEPTIVE USAGE | CONTRACEPTION | SEXUALITY | SEXUALLY TRANSMITTED DISEASE PREVENTION | FIRST INTERCOURSE | AGE FACTORS | SEX EDUCATION | PROGRAM EVALUATION | Developed Countries | Europe, Southern | Europe | Surveys | Sampling Studies | Studies | Research Methodology | Youth | Population Characteristics | Demographic Factors | Population | Sociocultural Factors | Behavior | Family Planning | Personality | Psychological Factors | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Education | Programs | Organization and Administration
Document Number: 331123

12.

Peer Reviewed

Title: Integration of STI and HIV prevention, care, and treatment into family planning services: a review of the literature.
Author: Church K; Mayhew SH
Source: Studies in Family Planning. 2009 Sep;40(3):171-186.
Abstract: The last comprehensive literature review to examine the effectiveness of family planning (FP) services in delivering STI and HIV prevention and care was published in 2000. This review updates that report by examining evidence of the impact of integrating any components of STI or HIV prevention, care, and treatment into a family planning setting in developing countries. Forty-four reports were identified from a comprehensive search of published databases and �grey literature.� The weight of evidence demonstrates that integrated services can have a positive impact on client satisfaction, improve access to component services, and reduce clinic-based HIV-related stigma, and that they are cost-effective. Evidence of FP services reaching men and adolescents and of their impact on health outcomes is inconclusive. Several studies found that providers frequently miss opportunities to integrate care and that the capacity to maintain the quality of care is also influenced by many programmatic challenges. The range of experiences indicates that managers need to determine appropriate health-care service-delivery models based on a consideration of epidemiological, structural, and health-systems factors.
Language: English
Keywords:
DEVELOPING COUNTRIES | RESEARCH REPORT | LITERATURE REVIEW | EPIDEMIOLOGY | FAMILY PLANNING | SEXUALLY TRANSMITTED DISEASE PREVENTION | HIV PREVENTION | HIV INFECTIONS | SEXUALLY TRANSMITTED DISEASES | TREATMENT | PROGRAM EFFECTIVENESS | Public Health | Health | Reproductive Tract Infections | Infections | Diseases | Viral Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Program Evaluation | Programs | Organization and Administration
Document Number: 339700

13.

Peer Reviewed

Title: Beneficial effects of offering prenatal HIV counselling and testing on developing a HIV Preventive attitude among couples. Abidjan, 2002-2005.
Author: Desgrees-Du-Lou A; Brou H; Djohan G; Becquet R; Ekouevi DK; Zanou B; Viho I; Allou G; Dabis F; Leroy V
Source: AIDS and Behavior. 2009 Apr;13(2):348-355.
Abstract: Prenatal HIV counselling and testing is mainly an entry-point to the prevention of mother-to-child transmission of HIV, but it may also play an important role in triggering the development of spousal communication about HIV and sexual risks and thus the adoption of a preventive attitude. In Abidjan, Co�te d'Ivoire, we investigated couple communication on STIs and HIV, male partner HIV-testing and condom use at sex resumption after delivery among three groups of pregnant women who were offered prenatal counselling and HIV testing: HIVinfected women, uninfected women, and women who refused HIV-testing. The proportion of women who discussed STIs with their regular partner greatly increased after prenatal HIV counselling and testing in all three groups, irrespective of the women's serostatus and even in the case of test refusal. Spousal communication was related to more frequent male partner HIV-testing and condom use. Prenatal HIV counselling and testing proposal appears to be an efficient tool to sensitize women and their partner to safer sexual practices.
Language: English
Keywords:
COTE D'IVOIRE | RESEARCH REPORT | KAP SURVEYS | WOMEN IN DEVELOPMENT | PREGNANT WOMEN | COUPLES | VOLUNTARY COUNSELING AND TESTING | HIV PREVENTION | ANTENATAL CARE | ATTITUDES | PARTNER COMMUNICATION | SPOUSAL SUPPORT | CONDOM USE | SEXUALLY TRANSMITTED DISEASE PREVENTION | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Surveys | Sampling Studies | Studies | Research Methodology | Economic Development | Economic Factors | Population Characteristics | Demographic Factors | Population | Family Characteristics | Family and Household | Sociocultural Factors | HIV Testing | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | HIV Infections | Viral Diseases | Diseases | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Psychological Factors | Behavior | Interpersonal Relations | Microeconomic Factors | Risk Reduction Behavior | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections
Document Number: 340128

15.

Peer Reviewed

Title: Mobilizing men as partners: the results of an intervention to increase dual protection among Nigerian men.
Author: Exner TM; Mantell JE; Adeokun LA; Udoh IA; Ladipo OA; Delano GE; Faleye J; Akinpelu K
Source: Health Education Research. 2009 Apr 9;
Abstract: This quasi-experimental, proof-of-concept study evaluated the effects of an intervention designed to help Nigerian men decrease risk for HIV/sexually transmitted infections and unintended pregnancy. The intervention was delivered in groups during two 5-hour workshops, with a monthly 2-hour check-in session. A comparison condition consisted of a group-based half-day didactic workshop. Based on recruitment area, 149 men were assigned to the intervention and 132 to the comparison. Men were evaluated at baseline and 3-month post-intervention. At follow-up, men assigned to the intervention were almost four times more likely than comparison men to report condom use at last intercourse (P < 0.001) and to report fewer unprotected vaginal sex occasions, greater self-efficacy for negotiation, a more egalitarian power dynamic in their primary relationship, more positive expectations for condom use and greater intention for future consistent condom use (all P values < 0.05). Findings suggest that this intervention is both feasible and effective.
Language: English
Keywords:
NIGERIA | RESEARCH REPORT | KAP SURVEYS | CASE CONTROL STUDIES | MEN | SEXUAL PARTNERS | MEN'S INVOLVEMENT | HIV PREVENTION | SEXUALLY TRANSMITTED DISEASE PREVENTION | CONDOM USE | CONTRACEPTIVE USAGE | WORKSHOPS | PARTNER COMMUNICATION | PROGRAM EVALUATION | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Surveys | Sampling Studies | Studies | Research Methodology | Demographic Factors | Population | Sex Behavior | Behavior | Programs | Organization and Administration | HIV Infections | Viral Diseases | Diseases | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Risk Reduction Behavior | Contraception | Family Planning | Education | Interpersonal Relations
Document Number: 341487

16.

Peer Reviewed

Title: How much could a microbicide's sexually transmitted infection efficacy contribute to reducing HIV risk and the level of condom use needed to lower risk? Model estimates.
Author: Foss AM; Vickerman PT; Alary M; Watts CH
Source: Sexually Transmitted Infections. 2009 Aug;85(4):276-82.
Abstract: OBJECTIVE: This study explores the potential contribution of a microbicide's sexually transmitted infection (STI) efficacy in reducing a female sex worker's (FSW) risk of STI and HIV infection. The study then investigates whether the threshold for the reduction in condom use following microbicide introduction that can be tolerated without increasing HIV risk is affected by STI efficacy. METHODS: A dynamic model describing the transmission of a bacterial STI between FSW and their clients was coupled with a static HIV model. The model uses data from Cotonou, Benin (1998-9), for illustration, to estimate the change in risk following the introduction of 50% HIV efficacious microbicides of different STI efficacies, used in 50% of sex acts when a condom is not used. The condom migration thresholds were estimated. The degree to which the findings are influenced by STI prevalence was explored. RESULTS: For highly transmissible STI, there is a non-monotonic relationship between STI prevalence and microbicide impact on HIV with the relative reduction in HIV risk first increasing, due to the proportion of HIV risk attributable to the STI increasing, but then decreasing at high prevalences as the STI becomes harder to control. A less transmissible STI can still be impacted upon with a moderate/high STI efficacy microbicide even at high STI prevalences. This relationship is also reflected in the condom migration thresholds. CONCLUSIONS: A microbicide's STI efficacy may have a substantial impact on STI and HIV incidence among high-risk groups. The variation in the condom migration thresholds for different STI efficacies and STI prevalences may be difficult to measure accurately.
Language: English
Keywords:
BENIN | RESEARCH REPORT | PREVALENCE | SEX WORKERS | WOMEN | MICROBICIDES | CONDOM USE | SEXUALLY TRANSMITTED DISEASE PREVENTION | HIV INFECTIONS | Africa, Western | Africa, Sub Saharan | Africa | Developing Countries | Measurement | Research Methodology | Sex Behavior | Behavior | Demographic Factors | Population | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Risk Reduction Behavior | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Viral Diseases
Document Number: 342720

17.

Title: Should healthcare professionals be advocating long-acting reversible contraception? [editorial]
Author: Glasier A
Source: Women's Health. 2009 Jan;5(1):1-4.
Abstract: The author comments on the reasons healthcare professionals should advocate long-acting reversible contraception (LARC). The three issues discussed are: cost--some providers and program managers find long-acting methods expensive; coercion--excessive enthusiasm for any method of contraception may risk potential users being pressured or coerced into using it; and STIs--some argue that increasing the use of LARC will decrease the use of condoms and so will put more people at risk of STIs.
Language: English
Keywords:
GLOBAL | SUMMARY REPORT | HEALTH PERSONNEL | PREGNANCY, UNPLANNED | CONTRACEPTION | PROMOTION | SEXUALLY TRANSMITTED DISEASE PREVENTION | Delivery of Health Care | Health | Reproductive Behavior | Fertility | Population Dynamics | Demographic Factors | Population | Family Planning | Marketing | Economic Factors | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases
Document Number: 330873

18.

Title: Condom use among married women at risk for sexually transmitted infections and HIV in rural China.
Author: Hong H; Qin QR; Li LH; Ji GP; Ye DQ
Source: International Journal of Gynaecology and Obstetrics. 2009 Apr 13;
Abstract: OBJECTIVE: To assess factors associated with condom use among married women in rural China, and provide evidence for implementing education strategies to prevent sexually transmitted infections and HIV. METHODS: A total of 737 sexually active married rural women who were aged between 18 and 49 years and had heard of AIDS were selected by cluster sampling and interviewed in 8 villages of Anhui province, China. RESULTS: The rate of condom use was only 5.4%.There were no significant differences in sexual behavior and condom use between married women whose husbands were away as migrant workers and the wives of nonmigrant men, except in knowledge of free condom sources. Significant factors associated with condom use included age, level of education, knowledge about condoms, training about condoms, sources of condoms, and husbands' attitude toward condoms. CONCLUSIONS: More educational interventions are needed to increase condom knowledge and promotion, especially among less educated women and married women left behind by migrant husbands.
Language: English
Keywords:
CHINA | RESEARCH REPORT | CONTRACEPTIVE PREVALENCE SURVEYS | WOMEN IN DEVELOPMENT | RURAL POPULATION | CURRENTLY MARRIED | MIGRANT WORKERS | SPOUSE | CONDOM USE | HIV PREVENTION | SEXUALLY TRANSMITTED DISEASE PREVENTION | AGE FACTORS | EDUCATIONAL STATUS | ATTITUDES | KNOWLEDGE | Asia, Eastern | Asia | Developing Countries | Family Planning Surveys | Family Planning | Economic Development | Economic Factors | Population Characteristics | Demographic Factors | Population | Marital Status | Nuptiality | Labor Force | Human Resources | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Risk Reduction Behavior | Behavior | HIV Infections | Viral Diseases | Diseases | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Socioeconomic Status | Socioeconomic Factors | Psychological Factors
Document Number: 341460

19.

20.

Title: The spermostatic and microbicidal actions of quinones and maleimides: towards a dual purpose contraceptive agent.
Author: Hughes LM; Griffith R; Carey A; Butler T; Donne SW; Beagley KW; Aitken RJ
Source: Molecular Pharmacology. 2009 Mar 31;
Abstract: There is an urgent need to develop safe, effective dual-purpose contraceptive agents that combine the prevention of pregnancy with protection against sexually transmitted disease. Here we report the identification of a group of compounds that on contact with human spermatozoa induce a state of 'spermostasis', characterized by the extremely rapid inhibition of sperm movement without compromising cell viability. These spermostatic agents were more active and significantly less toxic than the reagent in current clinical use, nonoxynol 9, giving therapeutic indices (ratio of spermostatic to cytotoxic activity) that were orders of magnitude greater than this traditional spermicide. Although certain compounds could trigger reactive oxygen species generation by spermatozoa, this activity was not correlated with spermostasis. Rather, the latter was associated with alkylation of two major sperm tail proteins that were identified as A Kinase Anchoring Proteins (AKAP3 and AKAP4) by mass spectrometry. As a consequence of disrupted AKAP function, the abilities of cAMP to drive PKA-dependent activities in the sperm tail such as the activation of SRC and the consequent stimulation of tyrosine phosphorylation, were suppressed. Furthermore, analysis of microbicidal activity using Chlamydia, revealed powerful inhibitory effects at the same low micromolar doses that suppressed sperm movement. In this case, the microbicidal action was associated with alkylation of MOMP, a major Chlamydial membrane protein. Taken together, these results have identified for the first time a novel set of cellular targets and chemical principles capable of providing simultaneous defense against both fertility and the spread of sexually transmitted disease.
Language: English
Keywords:
AUSTRALIA | RESEARCH REPORT | CLINICAL RESEARCH | WOMEN | MICROBICIDES | SPERM IMMOBILIZING AGENTS | CONTRACEPTIVE AGENTS, FEMALE | SEXUALLY TRANSMITTED DISEASE PREVENTION | NONOXYNOL-9 | SPERMICIDAL CONTRACEPTIVE AGENTS | Oceania | Developed Countries | Research Methodology | Demographic Factors | Population | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Contraceptive Agents | Contraception | Family Planning | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases
Document Number: 330928

21.

Title: A test that won't die: the serologic test for syphilis [editorial]
Author: Katz LM
Source: Transfusion. 2009 Apr;49(4):617-9.
Abstract: We (the blood community and the regulators) are unable to articulate an answer to the question "how safe is safe enough?" for the set of blood safety measures we have already implemented.We must address this fundamental policy issue to establish priorities for our menu of potential future threats and interventions and to move solutions through development and deploy them with the urgency their importance demands. The experience of four decades with no recognized transfusion-transmitted syphilis, during which we have implemented a manylayered approach to blood safety addressing a substantial proportion of the risk of T. pallidum infection in the donor base, suggests that the time is ripe to reconsider the use of STS. (excerpt)
Language: English
Keywords:
IOWA | CRITIQUE | RECOMMENDATIONS | CLINICAL RESEARCH | BLOOD DONORS | SYPHILIS | TESTING | SEROCONVERSION | BLOOD TRANSFUSION | SEXUALLY TRANSMITTED DISEASE PREVENTION | United States of America | North America | Americas | Developed Countries | Research Methodology | Blood Supply | Equipment and Supplies | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Measurement | Immunity | Immune System | Physiology | Biology | Treatment
Document Number: 331247

22.

Peer Reviewed

Title: Adding the female condom to the public health agenda on prevention of HIV and other sexually transmitted infections among men and women during anal intercourse.
Author: Kelvin EA; Smith RA; Mantell JE; Stein ZA
Source: American Journal of Public Health. 2009 Jun;99(6):985-7.
Abstract: Legal barriers to conducting public health research on methods of protection for anal intercourse were lifted in the United States in 2003 when the US Supreme Court invalidated all state antisodomy laws. Although research funding has been available for the development of rectal microbicides, the female condom, which has already been approved for vaginal use, has not been evaluated for anal use. Although there is no evidence that the female condom is safe for anal intercourse, it has already been taken up for off-label use by some men who have sex with men. This demonstrates the urgent need for more protection options for anal intercourse and, more immediately, the need to evaluate the safety and efficacy of the female condom for anal intercourse.
Language: English
Keywords:
UNITED STATES OF AMERICA | CRITIQUE | PUBLIC HEALTH | COURT DECISION | ANAL SEX | HIV PREVENTION | SEXUALLY TRANSMITTED DISEASE PREVENTION | FEMALE CONDOMS | SAFETY | MICROBICIDES | Developed Countries | North America | Americas | Health | Litigation | Political Factors | Sociocultural Factors | Sex Behavior | Behavior | HIV Infections | Viral Diseases | Diseases | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Vaginal Barrier Methods | Barrier Methods | Contraceptive Methods | Contraception | Family Planning | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care
Document Number: 341644

23.

Peer Reviewed

Title: A Systematic Review of Epidemiologic Studies Assessing Condom Use and Risk of Syphilis.
Author: Koss CA; Dunne EF; Warner L
Source: Sexually Transmitted Diseases. 2009 Dec;36(12):1-5.
Abstract: BACKGROUND:: Although systematic reviews of epidemiologic studies have been conducted for condom use and the risk of several sexually transmitted diseases, there have been no such reviews for condom use and syphilis. METHODS:: A systematic literature review of epidemiologic studies published from 1972 to 2008 was conducted to evaluate study methods and measures of association reported for condom use and risk of syphilis. RESULTS:: All 12 included studies had significant methodologic limitations. Nine (75%) studies were cross-sectional. Although 11 (92%) studies assessed consistent condom use, no studies assessed correct use or condom use problems, nor did any document exposure to a partner infected with syphilis. Ten studies had insufficient information to distinguish prevalent from incident infections. Two studies that assessed both incident infection and consistent condom use suggested a reduced risk of syphilis with consistent condom use; 1 study was statistically significant. CONCLUSIONS:: Significant methodologic limitations exist for all reviewed studies of syphilis and condom use. Among the 2 most rigorously designed studies, both suggested a reduced risk of syphilis with consistent condom use. Additional studies incorporating rigorous methods are needed to further assess the effect of condom use on risk of syphilis.
Language: English
Keywords:
UNITED STATES OF AMERICA | RESEARCH REPORT | LITERATURE REVIEW | MEN | CONDOM USE | SYPHILIS | SEXUALLY TRANSMITTED DISEASE PREVENTION | RISK FACTORS | Developed Countries | North America | Americas | Demographic Factors | Population | Risk Reduction Behavior | Behavior | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Health
Document Number: 341252

24.

Title: Influencing risk behavior of sexually transmitted infection clinic visitors: efficacy of a new methodology of motivational preventive counseling.
Author: Kuyper L; de Wit J; Heijman T; Fennema H; van Bergen J; Vanwesenbeeck I
Source: AIDS Patient Care and STDs. 2009 Jun;23(6):423-31.
Abstract: A quasi-experimental study was conducted at a Dutch sexually transmitted infection (STI) clinic to compare the effects of educational counseling and motivational interviewing (MI)-based HIV/STI counseling on determinants of condom use and partner notification at 6-month follow-up. It also examined the feasibility of MI-based counseling in a busy real-life clinic. The counseling approaches were historically compared: respondents in the control condition were recruited between April and July 2005, those in the experimental condition between September and December 2005. The study involved 428 participants. These were all high-risk clients of the STI clinic. Their mean age was 33.7 years, and 39.6% were female. The study showed that MI-based counseling had a more positive effect on self-efficacy, intentions to use condoms with casual partners, and long-term condom use with steady partners. It had no adversarial outcomes on other social cognitions or behaviors compared to educational counseling. Furthermore, MI-based counseling is experienced as a more respectful and structured way of counseling. MI-based counseling was relatively easily implemented into the current clinic procedures. In addition to the implementation of the training, neither specialized staff nor additional or longer client visits were needed. However, some nurses indicated that the new method required more personal investment and effort. Limitations of the current study are the low response rates, the high educational level of most participants, and the small sample size regarding partner notification. Nonetheless, we conclude that MI-based counseling was a more effective approach to preventive counseling compared to educational counseling and feasible in the busy real-life setting.
Language: English
Keywords:
NETHERLANDS | RESEARCH REPORT | CONTROL GROUPS | CLIENTS | NURSES AND NURSING | COUNSELING | SAFER SEX | HIV PREVENTION | SEXUALLY TRANSMITTED DISEASE PREVENTION | CONDOM USE | HEALTH EDUCATION | MOTIVATION | PARTNER COMMUNICATION | Europe, Western | Europe | Developed Countries | Research Methodology | Program Activities | Programs | Organization and Administration | Health Personnel | Delivery of Health Care | Health | Clinic Activities | Sex Behavior | Behavior | HIV Infections | Viral Diseases | Diseases | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Risk Reduction Behavior | Education | Psychological Factors | Interpersonal Relations
Document Number: 342409

25.

Peer Reviewed

Title: Lack of knowledge about sexually transmitted infections among women in North rural Vietnam.
Author: Lan PT; Lundborg CS; Mogren I; Phuc HD; Chuc NT
Source: BMC Infectious Diseases. 2009;9:85.
Abstract: BACKGROUND: The serious long-term complications of sexually transmitted infections (STI) in women and newborns are well-documented. Particularly, STI imply considerable social consequences for women. Low STI knowledge has been shown to be associated with unsafe sex. In Vietnam, misconceptions regarding STI exist, and rural women delay seeking care for STI. The aim of the study was to investigate knowledge of STI among women aged 15 to 49 years in a rural district of Vietnam and to evaluate possible associations between socioeconomic factors and STI knowledge. METHODS: A cross-sectional population-based study using face-to-face interviews was carried out between March and May 2006 in a demographic surveillance site in rural Vietnam. In total, 1805 women aged 15-49 years were randomly selected to participate in the study. The interviews were based on a structured questionnaire including questions on sociodemographic characteristics of the women and their knowledge about STI. Each correct answer was scored 1, incorrect or do not know answer was scored 0. Multivariate analyses were applied to examine associations between socio-economic conditions and STI knowledge. Intra-cluster correlation was calculated to examine similarities of STI knowledge within clusters. RESULTS: Of the 1,805 respondents, 78% (73% married vs. 93% unmarried, p < 0.001) did not know any symptoms of STI, 50% could not identify any cause of STI, 59% (54% married vs. 76% unmarried, p < 0.001) did not know that STI can be prevented. Only 31% of the respondents (36% married vs. 14% unmarried, p < 0.001) answered that condom use could protect against STI, and 56% considered partner treatment necessary. Of 40 possible correct answers, the mean knowledge score was 6.5 (range 0-26, median 6). Young, unmarried women and women who lived in the highlands or mountainous areas demonstrated very low levels of STI knowledge (regression coefficients -1.3 and -2.5, respectively, p < 0.001). Experience of an induced abortion was significantly associated with a higher level of knowledge. CONCLUSION: The low levels of STI knowledge found among women of reproductive age in a rural district of Vietnam indicate an urgent need of health education interventions, of which, young and unmarried women should be specifically targeted.
Language: English
Keywords:
VIETNAM | RESEARCH REPORT | INTERVIEWS | RURAL POPULATION | WOMEN | UNMARRIED | TARGET POPULATION | KNOWLEDGE | SEXUALLY TRANSMITTED DISEASES | PREGNANCY | TREATMENT | SEXUALLY TRANSMITTED DISEASE PREVENTION | NEEDS | Asia, Southeastern | Asia | Developing Countries | Data Collection | Research Methodology | Population Characteristics | Demographic Factors | Population | Marital Status | Nuptiality | Program Design | Programs | Organization and Administration | Sociocultural Factors | Reproductive Tract Infections | Infections | Diseases | Reproduction | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Economic Factors
Document Number: 342063

26.

Peer Reviewed

Title: Theory-based strategies for improving contraceptive use: a systematic review.
Author: Lopez LM; Tolley EE; Grimes DA; Chen-Mok M
Source: Contraception. 2009 Jun;79(6):411-7.
Abstract: BACKGROUND: Theories and models help explain how behavior change occurs. We systematically reviewed randomized controlled trials that examined theory-based interventions for improving contraceptive use. STUDY DESIGN: We searched electronic databases for eligible trials. Primary outcomes included pregnancy and contraceptive use. We calculated the odds ratio for dichotomous outcomes and the mean difference for continuous data. RESULTS: Of 14 included trials, 10 showed positive results for a theory-based group: 2 of 10 studies with pregnancy or birth data, 4 of 9 addressing contraceptive use (for contraception) and 5 of 9 with condom use (to prevent HIV/sexually transmitted infections). An experimental group had favorable results for six of seven trials based on Social Cognitive Theory, two based on other social cognition models and two using motivational interviewing. Most interventions focused on adolescents and involved multiple sessions. CONCLUSIONS: Effects were not consistent across outcomes and comparisons. The field could benefit from thorough use of single theories and better reporting on intervention implementation.
Language: English
Keywords:
UNITED STATES OF AMERICA | LITERATURE REVIEW | THEORETICAL STUDIES | CASE CONTROL STUDIES | KAP SURVEYS | THEORETICAL MODELS | WOMEN | ADOLESCENTS | CONTRACEPTIVE USAGE | CONDOM USE | CONTRACEPTIVE EFFECTIVENESS | SEXUALLY TRANSMITTED DISEASE PREVENTION | MOTIVATION | TIME FACTORS | PROGRAM DESIGN | Developed Countries | North America | Americas | Studies | Research Methodology | Surveys | Sampling Studies | Demographic Factors | Population | Youth | Age Factors | Population Characteristics | Contraception | Family Planning | Risk Reduction Behavior | Behavior | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Psychological Factors | Population Dynamics | Programs | Organization and Administration
Document Number: 341105

27.

Title: Self-reported and P3 event-related potential evaluations of condoms: does what we say match how we feel?
Author: Lust SA; Bartholow BD
Source: Psychophysiology. 2009 Mar;46(2):420-4.
Abstract: Research consistently reveals positive self-reported condom evaluations, yet such evaluations often do not predict condom use. Whereas positive self-reports likely reflect social norms regarding prevention of diseases and pregnancy, psychophysiological measures might better assess spontaneous condom evaluations. Here, participants completed a visual oddball task in which condoms and alcoholic beverages were infrequent targets among neutral, positive, and negative context images. Although self-reported condom evaluations were very positive, condom images presented in a negative context produced a smaller P3 than condom images presented in a neutral or positive context, suggesting that spontaneous condom evaluations were more negative than positive. The P3 elicited by alcohol images indicated positive evaluations. The findings underscore the multifaceted nature of evaluations and point to the utility of ERPs for assessing health-related attitudes.
Language: English
Keywords:
MISSOURI | RESEARCH REPORT | KAP SURVEYS | STUDENTS | CONDOM USE | UNIVERSITIES | SELF-PERCEPTION | ALCOHOL USE AND ABUSE | VALUE ORIENTATION | SEXUALLY TRANSMITTED DISEASE PREVENTION | CONTRACEPTION | ATTITUDES | PHYSIOLOGY | CENTRAL NERVOUS SYSTEM EFFECTS | Developed Countries | United States of America | North America | Americas | Surveys | Sampling Studies | Studies | Research Methodology | Education | Risk Reduction Behavior | Behavior | Schools | Perception | Psychological Factors | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Family Planning | Biology | Central Nervous System
Document Number: 331226

28.

Title: A pooled analysis of the effect of condoms in preventing HSV-2 acquisition.
Author: Martin ET; Krantz E; Gottlieb SL; Magaret AS; Langenberg A; Stanberry L; Kamb M; Wald A
Source: Archives of Internal Medicine. 2009 Jul 13;169(13):1233-40.
Abstract: BACKGROUND: The degree of effectiveness of condom use in preventing the transmission of herpes simplex virus 2 (HSV-2) is uncertain. To address this issue, we performed a large pooled analysis. METHODS: We identified prospective studies with individual-level condom use data and laboratory-defined HSV-2 acquisition. Six studies were identified through a review of publications through 2007: 3 candidate HSV-2 vaccine studies, an HSV-2 drug study, an observational sexually transmitted infection (STI) incidence study, and a behavioral STI intervention study. Study investigators provided us individual-level data to perform a pooled analysis. Effect of condom use was modeled using a continuous percentage of sex acts during which a condom was used and, alternatively, using absolute numbers of unprotected sex acts. RESULTS: A total of 5384 HSV-2-negative people at baseline contributed 2 040 894 follow-up days; 415 persons acquired laboratory-documented HSV-2 during follow-up. Consistent condom users (used 100% of the time) had a 30% lower risk of HSV-2 acquisition compared with those who never used condoms (hazard ratio [HR], 0.70; 95% confidence interval [CI], 0.40-0.94) (P = .01). Risk for HSV-2 acquisition increased steadily and significantly with each unprotected sex act (HR, 1.16; 95% CI, 1.08-1.25) (P < .001). Condom effectiveness did not vary by gender. CONCLUSIONS: To our knowledge, this is the largest analysis using prospective data to assess the effect of condom use in preventing HSV-2 acquisition. Although the magnitude of protection was not as large as has been observed with other STIs, we found that condoms offer moderate protection against HSV-2 acquisition in men and women.
Language: English
Keywords:
GLOBAL | RESEARCH REPORT | LITERATURE REVIEW | PROSPECTIVE STUDIES | DATA ANALYSIS | CONDOM USE | HIV PREVENTION | SEXUALLY TRANSMITTED DISEASE PREVENTION | SEX BEHAVIOR | RISK BEHAVIOR | Studies | Research Methodology | Risk Reduction Behavior | Behavior | HIV Infections | Viral Diseases | Diseases | Sexually Transmitted Diseases |