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1.    Subscription may be needed for full text     
Title: Awareness and views of the law on termination of pregnancy and reasons for resorting to an abortion among a group of women attending a clinic in Colombo, Sri Lanka.
Author: Abeyasinghe NL; Weerasundera BJ; Jayawardene PA; Somarathna SD
Source: Journal of Forensic and Legal Medicine. 2009 Apr;16(3):134-7.
Abstract: In Sri Lanka, induced abortion is a criminal offence except to save the life of the mother. This study determined the awareness and views of the law on abortion among women seeking an abortion. Three hundred and thirteen women were interviewed. The characteristics of the study group are discussed. 65.8% of the respondents stated they knew the current law, 25.6% stated they did not and 8.3% were unsure. On detailed analysis of each respondent's knowledge regarding the situations where abortion is legalized including those who stated that they did not know the law, only 11.2% had an accurate knowledge. More than 75% stated that abortion should be legalized when the mother's life was in danger, where there was pregnancy after rape or incest, when there was psychiatric illness in the mother and when there were fetal anomalies. Reasons for resorting to an abortion are discussed. Although 11.2% were aware of the law, there was no difference in the reasons for resorting to an abortion when compared with those who were unaware of the law. This study highlights the fact that availability of abortion services to women depend not only on the law and its awareness, but on how it is interpreted and enforced.
Language: English

Keywords:
SRI LANKA | RESEARCH REPORT | ABORTION | ABORTION LAW | AWARENESS | INTERVIEWS | ABORTION RATE | ATTITUDES | CONTRACEPTIVE USAGE | Developing Countries | Asia, Southern | Asia | Fertility Control, Postconception | Family Planning | Knowledge | Sociocultural Factors | Data Collection | Research Methodology | Psychological Factors | Behavior | Contraception
Document Number: 342188   Notification

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Peer Reviewed

Title: PMTCT, HAART, and childbearing in Mozambique: an institutional perspective.
Author: Agadjanian V; Hayford SR
Source: AIDS and Behavior. 2009 Jun;13(Suppl 1):S103-S112.
Abstract: Maternal and Child Health (MCH) units, where VCT/PMTCT/HAART have been integrated with traditional services, play a critical role in the connection between the massive HAART rollout and reproductive behavior. In this article, we use data from semi-structured interviews with MCH workers and ethnographic observations carried out in southern Mozambique to explore this role from the institutional perspective. We find that, along with logistical and workload problems, the de facto segregation of PMTCT/HAART clients within the “integrated” MCH system and the simplistic and uncompromising message discouraging further fertility and stressing condom-based contraception may pose serious challenges to a successful formulation and implementation of reproductive goals among seropositive clients. Although the recency of PMTCT/HAART services may partly explain these challenges, we argue that they are due largely to cultural miscommunication between providers and clients. We show how the cultural gap between the two is bridged by community activists and peer interactions among clients.
Language: English

Keywords:
MOZAMBIQUE | RESEARCH REPORT | HEALTH PERSONNEL | SUPPORT GROUPS | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | ANTIRETROVIRAL THERAPY | VOLUNTARY COUNSELING AND TESTING | MATERNAL-CHILD HEALTH SERVICES | INTEGRATED PROGRAMS | HEALTH SERVICES ADMINISTRATION | INTERVIEWS | FERTILITY PREFERENCES | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Delivery of Health Care | Health | Social Networks | Friends and Relatives | Family and Household | Sociocultural Factors | Disease Transmission Control | Prevention and Control | Diseases | HIV | HIV Infections | Viral Diseases | HIV Testing | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Primary Health Care | Programs | Organization and Administration | Management | Data Collection | Research Methodology | Fertility | Population Dynamics | Demographic Factors | Population
Document Number: 341906  

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Title: Spontaneous vesicovaginal fistula caused by genitourinary aspergillosis.
Author: Agarwal N; Seth A; Kulshrestha V; Kochar S; Kriplani A
Source: International Journal of Gynaecology and Obstetrics. 2009 Apr;105(1):63-4.
Abstract: Genitourinary aspergillosis is rare in patients who are not immunocompromised. A 39-year-old woman presented with vaginal urinary leakage with no history of previous trauma, procedure, or fever. The patient's last delivery had been by cesarean 12 years previously and she had no history of difficult labor. Six months prior to presenting, the patient had been scheduled to undergo abdominal hysterectomy for menorrhagia along with repair of a surgical hernia; only the hernia was repaired at that time as dense adhesions prevented the hysterectomy. The patient had been amenorrheic since that surgery and her incontinence began 6 days prior to presentation. (excerpt)
Language: English

Keywords:
INDIA | SUMMARY REPORT | CASE HISTORIES | CLIENTS | FISTULA | AMENORRHEA | VAGINAL ABNORMALITIES | SURGERY | BACTERIAL AND FUNGAL DISEASES | UROGENITAL EFFECTS | Asia, Southern | Asia | Developing Countries | Data Collection | Research Methodology | Program Activities | Programs | Organization and Administration | Diseases | Menstruation Disorders | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Infections | Urogenital System | Physiology | Biology
Document Number: 341383  

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Peer Reviewed

Title: Biological Validation of Self-Reported Condom Use Among Sex Workers in Guinea.
Author: Aho J; Koushik A; Diakite SL; Loua KM; Nguyen VK; Rashed S
Source: AIDS and Behavior. 2009 Aug 13;
Abstract: Self-reported condom use may be prone to social desirability bias. Our aim was to assess the validity of self-reported condom use in a population of female sex workers using prostate specific antigen (PSA) as a gold standard biomarker of recent unprotected vaginal intercourse. We collected data on 223 sex-workers in Conakry, Guinea in order to assess the sensitivity and specificity of self-reported condom use as well as to examine the predictors of discordance between self-report and PSA presence. PSA was detected in 38.4% of samples. Sensitivity of self-reported condom use was 14.6% and its specificity was 94.7%. Self-perceived high risk of HIV infection was the only significant independent predictor of misreported condom use. PSA could be useful to validate self-reported condom use in surveys and to allow a better understanding of factors associated with social desirability in sexual behaviour reporting.
Language: English

Keywords:
GUINEA | RESEARCH REPORT | STATISTICAL REGRESSION | SEX WORKERS | CONDOM USE | BIAS | DATA REPORTING | VALIDITY | VAGINA | SEMEN | ANTIGENS | SEXUALLY TRANSMITTED DISEASES | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Data Analysis | Research Methodology | Sex Behavior | Behavior | Risk Reduction Behavior | Error Sources | Measurement | Data Collection | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Seminal Vesicles | Genitalia, Male | Immunologic Factors | Immunity | Immune System | Reproductive Tract Infections | Infections | Diseases
Document Number: 342486  

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Title: Intimate partner violence and contraception use among women in Sub-Saharan Africa.
Author: Alio AP; Daley EM; Nana PN; Duan J; Salihu HM
Source: International Journal of Gynaecology and Obstetrics. 2009 May 28;
Abstract: OBJECTIVE: To determine the association between contraceptive use and intimate partner violence (IPV) in Sub-Saharan African women. METHOD: The data analyzed were from national Demographic Health Surveys conducted between 2003 and 2006 in 6 Sub-Saharan African countries: Cameroon, Kenya, Malawi, Rwanda, Uganda, and Zimbabwe. Women of childbearing age completed surveys regarding the use of contraception and about their experience of physical, emotional, and sexual violence inflicted by their partners. Analyses were conducted using logistic regression. RESULTS: Of the 24311 women who responded to the violence modules, 39.8% reported that they had experienced IPV. Women who had experienced IPV were significantly more likely to report that they had used contraception compared with women who had not experienced IPV (odds ratio 1.30; 95% confidence interval, 1.22-1.38). CONCLUSION: Intimate partner violence appears to be associated with increased contraception use in the African setting. Among women who have experienced IPV, modern contraception is used more commonly than traditional and folkloric contraceptive methods.
Language: English

Keywords:
AFRICA, SUB SAHARAN | RESEARCH REPORT | DEMOGRAPHIC AND HEALTH SURVEYS | WOMEN | DOMESTIC VIOLENCE | CONTRACEPTIVE USAGE | INTERVIEWS | PHYSICAL ABUSE | PSYCHOLOGICAL ABUSE | Africa | Developing Countries | Demographic Surveys | Population Dynamics | Demographic Factors | Population | Crime | Social Problems | Sociocultural Factors | Contraception | Family Planning | Data Collection | Research Methodology | Violence | Behavior | Aggression
Document Number: 341449  

6.
Title: Women's perspective in the evaluation of the Program for the Humanization of Antenatal Care and Childbirth.
Author: Almeida CA; Tanaka OY
Source: Revista De Saude Publica. 2009 Feb;43(1):98-104.
Abstract: OBJECTIVE: To analyze the importance of inclusion, from women's perspective, in the evaluation of the Program for the Humanization of Antenatal Care and Childbirth, carried out by the Brazilian Ministry of Health. METHODOLOGICAL PROCEDURES: This qualitative study was based on primary data collected in 2003 in an evaluation of the Program conducted in seven towns spread out among Brazil's five geographic regions. These sites were selected from a Federal Government data base utilized for quantitative analysis. Women attended by the Program were considered key informants when primary data was collected. Sixteen focal groups were performed in the primary care units. The Collective Subject Speech (CSS) method was used for qualitative analysis. The theoretical concepts of accessibility and Paideia Health within the framework of public health were used to interpret the findings. ANALYSIS OF RESULTS: The Program standardizes procedures to be taken in antenatal care and childbirth for all health services in the country, including the flow among these services. However, analysis of women's discourse in the focal groups elucidated the existence of dissonances between their needs and desires and many of the program's recommendations. Pregnant women thus choose among available services and professionals and try to set up their own schedules which, in turn, do not correspond to those set up by the program. This discrepancy damages the bond women establish with the health services and creates obstacles for the control of the activities actually provided by the health services to the women. CONCLUSIONS: Analysis of the Program based on women's perspective identified aspects that might result in more humanized and effective antenatal care, if they are taken into account in the redefinition or correction of the Program schedule Miolo abstract Miolo abstract Miolo abstract.
Language: EnglishPortuguese

Keywords:
BRAZIL | RESEARCH REPORT | FOCUS GROUPS | PREGNANT WOMEN | ANTENATAL CARE | MATERNAL-CHILD HEALTH SERVICES | DELIVERY OF HEALTH CARE | NEEDS | PROGRAM EVALUATION | South America, Eastern | South America | Latin America | Americas | Developing Countries | Data Collection | Research Methodology | Population Characteristics | Demographic Factors | Population | Maternal Health Services | Primary Health Care | Health Services | Health | Economic Factors | Programs | Organization and Administration
Document Number: 341988  

7.
Title: [Vulnerabilities in the use of contraceptive methods among youth: intersections between public policies and healthcare] Vulnerabilidades no uso de metodos contraceptivos entre adolescentes e jovens:
Author: Alves CA; Brandao ER
Source: Ciencia and Saude Coletiva. 2009 Mar-Apr;14(2):661-70.
Abstract: This article discusses the moments of vulnerability in the utilization of contraceptive methods in the affective-sexual relations in adolescence and youth. The analyzed material consists of 17 semi-structured interviews with young people between 18 and 24 years (9 females and 8 males) of the middle-class of the city of Rio de Janeiro that had passed though at least one episode of pregnancy during adolescence. We also discuss the recent implementation of public policies focused on the sexuality and reproductive health of adolescents and the position of health professionals with respect to this subject within the scope of the Program of Integrated Healthcare for Women, Children and Adolescents (PAISMCA/SES-RJ). The results of the study show discontinuities in the use of contraceptive methods due to the strong gender hierarchy in the relationships between adolescents and the absence of appropriate sexual education in the family and school environments. There is little space for dealing with the sexual questions of the young in health services and schools. There are also cultural barriers that make it difficult for the society to approach the subject in a less prejudicial way, thus turning sexual initiation into a process full of silence and moral disapproval.
Language: Portuguese

Keywords:
BRAZIL | RESEARCH REPORT | INTERVIEWS | YOUTH | PRIMARY HEALTH CARE | HEALTH POLICY | CONTRACEPTIVE METHODS | ADOLESCENT PREGNANCY | Developing Countries | South America, Eastern | South America | Latin America | Americas | Data Collection | Research Methodology | Age Factors | Population Characteristics | Demographic Factors | Population | Health Services | Delivery of Health Care | Health | Policy | Political Factors | Sociocultural Factors | Contraception | Family Planning | Reproductive Behavior | Fertility | Population Dynamics
Document Number: 330130  

8.
Peer Reviewed

Title: HIV testing rates and outcomes in a South African community, 2001-2006: implications for expanded screening policies.
Author: April MD; Walensky RP; Chang Y; Pitt J; Freedberg KA; Losina E; Paltiel AD; Wood R
Source: Journal of Acquired Immune Deficiency Syndromes. 2009 Jul 1;51(3):310-6.
Abstract: BACKGROUND: Revised World Health Organization recommendations seek to increase HIV testing. We assessed the need for expanded testing in South Africa by examining current testing and treatment trends among a high prevalence population. METHODS: We determined the numbers of adults receiving HIV testing and antiretroviral treatment (ART) during 2001-2006 using testing registers linked to patient records from 2 health care facilities believed responsible for virtually all HIV services available to the population. We evaluated annual population testing rates using census population counts; proportions of clients testing seropositive (yield); CD4 counts and World Health Organization stage at diagnosis; and ART initiation rates. RESULTS: HIV testing rates rose from 4% in 2001 to 20% in 2006 (P < 0.001) and were highest among pregnant females receiving provider-initiated testing. Yield for first-time testers decreased from 47% in 2001 to 28% in 2006; annual incidence of seroconversion among initially HIV-negative retesters was 1.9%. Median CD4 counts and World Health Organization stage distributions for newly diagnosed clients remained stable. HIV-infected clients receiving ART within 6 months of eligibility increased from 0% in 2001 to 68% in 2006 (P < 0.001). CONCLUSIONS: Population testing and ART initiation rates rose dramatically during 2001-2006. Yet, yield remained high, and HIV-infected persons continued to receive late diagnoses. These findings highlight the continuing need for expanded testing and linkage to care.
Language: English

Keywords:
SOUTH AFRICA | RESEARCH REPORT | DATA LINKAGE | STATISTICAL STUDIES | HIV TESTING | ANTIRETROVIRAL THERAPY | VOLUNTARY COUNSELING AND TESTING | SCREENING | HEALTH POLICY | CENSUS | HIV INFECTIONS | PREVALENCE | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Data Collection | Research Methodology | Studies | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | HIV | Viral Diseases | Diseases | Policy | Political Factors | Sociocultural Factors | Population Statistics | Measurement
Document Number: 342149  

9.
Title: HIV-infected African parents living in Stockholm, Sweden: disclosure and planning for their children's future.
Author: Asander AS; Bjorkman A; Belfrage E; Faxelid E
Source: Health and Social Work. 2009 May;34(2):107-15.
Abstract: In Sweden, most HIV-infected parents are of African origin. The present study explored the frequency of HIV-infected African parents' disclosure of their status to their children and custody planning for their children's future to identify support needs among these families. Semistructured interviews were conducted with 47 parents (41 families). The study population included first-generation immigrants, with a total of 87 children less than 18 years of age. Only women had disclosed their HIV status, and only to eight of 59 children older than six. Half of the parents had talked to someone about future custody arrangements. These parents had more contact with a social worker at the social welfare office and with a medical social worker at the HIV clinic. Most parents (30) wanted their children to be cared for by a relative in Sweden or by their HIV-negative partner. Neither disclosure nor custody planning was associated with clinical status or antiretroviral treatment. This study highlights the low HIV-disclosure rate to children of HIV-infected African immigrant parents and the importance of support from social workers.
Language: English

Keywords:
SWEDEN | AFRICA | RESEARCH REPORT | PARENTS | PERSONS LIVING WITH HIV/AIDS | IMMIGRANTS | CHILD CUSTODY | PLANNING | INTERPERSONAL COMMUNICATION | INTERVIEWS | Developed Countries | Europe, Northern | Europe | Developing Countries | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | HIV Infections | Viral Diseases | Diseases | Migrants | Migration | Population Dynamics | Demographic Factors | Population | Child Rearing | Behavior | Organization and Administration | Communication | Data Collection | Research Methodology
Document Number: 341675  

10.    Full text document

Title: Promoting and protecting the health of orphans and vulnerable children in Monkey Bay, Malawi.
Author: Asibu W; Chingoni J; Majawa D; Jambo H; Kambewankako T
Source: Harare, Zimbabwe, EQUINET, 2009. 32 p.
Abstract: This report presents results from participatory action research (PRA) that focused on coordinating support from service providers and community organizations working to improve the sexual and reproductive health of orphans and vulnerable children in Monkey Bay, Malawi.
Language: English

Keywords:
MALAWI | SUMMARY REPORT | ACTION RESEARCH | FOCUS GROUPS | ORPHANS AND VULNERABLE CHILDREN | CHILD HEALTH | AIDS | PRIMARY HEALTH CARE | QUALITY OF HEALTH CARE | PROGRAM ACTIVITIES | IMPACT | IMPLEMENTATION | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Data Collection | Family and Household | Sociocultural Factors | Health | HIV Infections | Viral Diseases | Diseases | Health Services | Delivery of Health Care | Health Services Evaluation | Program Evaluation | Programs | Organization and Administration | Communication
Document Number: 342033  

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Title: Experience with side effects among users of injectables, the IUD, and oral contraceptive pills in four urban areas of Honduras.
Author: Barden-O'Fallon J; Speizer I; Rodriguez F; Calix J
Source: Health Care For Women International. 2009 Jun;30(6):475-83.
Abstract: Contraceptive side effects are often the most commonly reported reason for method discontinuation, particularly of modern methods. We use data from eight focus groups and 800 exit interviews to examine women's experiences with contraceptive side effects in four urban areas of Honduras. Ease of treatment and differences in motivation to avoid pregnancy are suggested explanations for why side effects cause some women to continue and others to discontinue. Although side effects are a common reason for discontinuation in this population, less than half of the surveyed women were informed about potential side effects by a health worker on the day of the interview.
Language: English

Keywords:
HONDURAS | RESEARCH REPORT | FOCUS GROUPS | URBAN AREAS | HEALTH PERSONNEL | WOMEN | ORAL CONTRACEPTIVES, SIDE EFFECTS | INJECTABLES | IUD SIDE EFFECTS | PROGRAM ACCEPTABILITY | Developing Countries | Central America | Latin America | Americas | Data Collection | Research Methodology | Geographic Factors | Population | Delivery of Health Care | Health | Demographic Factors | Contraceptive Safety | Safety | Public Health | Contraceptive Methods | Contraception | Family Planning | IUD | Program Evaluation | Programs | Organization and Administration
Document Number: 341018  

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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  

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Peer Reviewed

Title: Teenagers and emergency contraception in the UK: a focus group study of salient beliefs using concepts from the Theory of Planned Behaviour.
Author: Bayley J; Brown K; Wallace L
Source: European Journal of Contraception and Reproductive Health Care. 2009 Jun;14(3):196-206.
Abstract: OBJECTIVES: To explore teenagers' beliefs about emergency contraception (EC) within a Theory of Planned Behaviour (TPB) framework. METHODS: Six single sex focus groups comprising a total of 25 female and 23 male pupils aged 13-16 years conducted in schools in Central England. RESULTS: Attitudes to emergency contraception (EC) were mainly positive about the rewards of avoiding teenage pregnancy. Participants had positive beliefs about the effectiveness of EC, although knowledge of crucial time limits varied. EC use was more socially acceptable than teenage pregnancy, yet both outcomes were perceived negatively. Motivation to comply with social pressure was influenced by the appraisal of individuals' intentions. Participants reported high self efficacy in accessing EC, but had concerns over confidentiality and access. CONCLUSIONS: Desire to avoid pregnancy was high in this group, but practical factors and attitudes may be more important for those ambivalent about pregnancy. Adolescents perceive accessing EC as difficult, are concerned about confidentiality, and anticipate negative reactions from staff. Data support the TPB as a suitable framework for understanding attitudes to EC use. Further research should apply quantitative TPB measures to EC use in a wider teenage sample in order to identify potential psychological factors to target in an intervention.
Language: English

Keywords:
UNITED KINGDOM | RESEARCH REPORT | FOCUS GROUPS | ADOLESCENTS | STUDENTS | EMERGENCY CONTRACEPTION | ATTITUDES | BELIEFS | KNOWLEDGE | PEER PRESSURE | MOTIVATION | CONTRACEPTIVE USAGE | Developed Countries | Europe, Western | Europe | Data Collection | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Education | Contraception | Family Planning | Psychological Factors | Behavior | Culture | Sociocultural Factors | Psychosocial Factors
Document Number: 341801  

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Peer Reviewed

Title: Women's perspectives on family planning service quality: an exploration of differences by race, ethnicity and language.
Author: Becker D; Klassen AC; Koenig MA; LaVeist TA; Sonenstein FL; Tsui AO
Source: Perspectives On Sexual and Reproductive Health. 2009 Sep;41(3):158-65.
Abstract: CONTEXT: Despite calls to make family planning services more responsive to the values, needs and preferences of clients, few studies have asked clients about their experiences or values, and most have used surveys framed by researchers', rather than clients', perspectives. METHODS: Forty in-depth interviews exploring lifetime experiences with and values regarding services were conducted with 18-36-year-old women who visited family planning clinics in the San Francisco Bay Area in 2007. Women were categorized as black, white, English- or Spanish-speaking Latina, or of mixed ethnicity to allow examination of differences by racial, ethnic and language group. Interviews were audiotaped, transcribed and coded thematically; matrices were then used to compare the themes that emerged across the subgroups. RESULTS: Eight themes emerged as important to women's views of services: service accessibility, information provision, attention to client comfort, providers' personalization of care, service organization, providers' empathy, technical quality of care and providers' respect for women's autonomy. Women reported that it was important to feel comfortable during visits, to feel that their decision-making autonomy was respected, to have providers show empathy and be nonjudgmental, and to see the same provider across visits. The only notable difference among racial, ethnic and language groups was that Spanish-speaking Latinas wanted to receive language-appropriate care and contraceptive information. CONCLUSIONS: Future surveys of family planning service quality should include measures of the factors that women value in such care, and efforts to improve providers' communication and counseling skills should emphasize the personalization of services and respect for clients' autonomy.
Language: English

Keywords:
UNITED STATES OF AMERICA | CALIFORNIA | RESEARCH REPORT | INTERVIEWS | FAMILY PLANNING SURVEYS | WOMEN | CLIENTS | ETHNIC GROUPS | FAMILY PLANNING | LANGUAGE | HEALTH SERVICES | QUALITY OF HEALTH CARE | COMMUNICATION | COUNSELING | Developed Countries | North America | Americas | Data Collection | Research Methodology | Demographic Factors | Population | Program Activities | Programs | Organization and Administration | Cultural Background | Population Characteristics | Delivery of Health Care | Health | Health Services Evaluation | Program Evaluation | Clinic Activities
Document Number: 342713  

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Peer Reviewed

Title: The persistence of induced abortion in Cuba: exploring the notion of an "abortion culture".
Author: Belanger D; Flynn A
Source: Studies in Family Planning. 2009 Mar;40(1):13-26.
Abstract: Cuba's annual induced abortion rate persistently ranks among the highest in the world, and abortion plays a prominent role in Cuban fertility regulation despite widespread contraceptive prevalence and state promotion of modern contraceptives. We explore this phenomenon using the concept of an "abortion culture," typically used in reference to Soviet and post-Soviet countries. We synthesize existing literature to provide a historical account of abortion and contraception in Cuba. We also provide a qualitative analysis of abortion and contraceptive use based on in-depth interviews conducted in 2005 in Havana with 24 women who have had an abortion and 10 men whose partners have had an abortion. Information gained from a focus-group discussion with medical professionals also informed the study. Our four principal findings are: (a) longstanding awareness of abortion, (b) the view of abortion as a personal decision, (c) the influence of economic constraints on the decision to induce an abortion, and (d) general skepticism toward contraceptives. We discuss our results on abortion in Cuba in relation to the notion of social diffusion, an approach commonly used to explain the spread of fertility control throughout a population.
Language: English

Keywords:
CUBA | RESEARCH REPORT | KAP SURVEYS | FOCUS GROUPS | WOMEN IN DEVELOPMENT | MEN | ABORTION RATE | CULTURE | COMMUNISM | PERCEPTION | ATTITUDES | KNOWLEDGE | MICROECONOMIC FACTORS | DECISION MAKING | CONTRACEPTIVE USAGE | Caribbean | Americas | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Data Collection | Economic Development | Economic Factors | Demographic Factors | Population | Fertility Control, Postconception | Family Planning | Sociocultural Factors | Socialism | Political Systems | Political Factors | Psychological Factors | Behavior | Contraception
Document Number: 341079  

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Peer Reviewed

Title: Can sex workers regulate police? Learning from an HIV prevention project for sex workers in southern India.
Author: Biradavolu MR; Burris S; George A; Jena A; Blankenship KM
Source: Social Science and Medicine. 2009 Apr;68(8):1541-7.
Abstract: There is an argument that policing practices exacerbate HIV risk, particularly for female sex workers. Interventions that mobilize sex workers to seek changes in laws and law enforcement practices have been prominent in India and have received considerable scholarly attention. Yet, there are few studies on the strategies sex worker advocates use to modify police behavior or the struggles they face in challenging state institutions. This paper draws upon contemporary theories of governance and non-state regulation to analyze the evolving strategies of an HIV prevention non-governmental organization (NGO) and female sex worker community-based organizations (CBOs) to reform police practices in southern India. Using detailed ethnographic observations of NGO and CBO activities over a two year period, and key informant interviews with various actors in the sex trade, this paper shows how a powerless group of marginalized and stigmatized women were able to leverage the combined forces of community empowerment, collective action and network-based governance to regulate a powerful state actor, and considers the impact of the advocacy strategies on sex worker well-being.
Language: English

Keywords:
INDIA | RESEARCH REPORT | NONGOVERNMENTAL ORGANIZATIONS | POLICE | SEX WORKERS | HIV PREVENTION | INTERVENTIONS | ADVOCACY | POWER | INTERVIEWS | Asia, Southern | Asia | Developing Countries | Organizations | Political Factors | Sociocultural Factors | Corrections Officers | Government | Sex Behavior | Behavior | HIV Infections | Viral Diseases | Diseases | Programs | Organization and Administration | Communication | Data Collection | Research Methodology
Document Number: 341691  

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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  

18.
Title: [Assessment of adherence to antiretroviral drugs in a municipality in southern Brazil] Avaliacao da adesao aos anti-retrovirais em um municipio no Sul do Brasil.
Author: Blatt CR; Citadin CB; Souza FG; Mello RS; Galato D
Source: Revista Da Sociedade Brasileira De Medicina Tropical. 2009 Mar-Apr;42(2):131-6.
Abstract: The aim of this research is to assess predicting factors and adherence levels to antiretrovirals through self-report and the date of drug retrieval. It is a transversal study in which 67 patients were interviewed. Patients who used more than 90% of doses were considered to have complied with the treatment. Results of adherence were: self-reports (72.7%); calculated using dosage forgotten on the last day (70%); in three (76.1%) days; in seven (80.5%) days; and in fifteen (80.5%) days; calculated using the date of drug retrieval in a period of three (53.7%) months; and in six (47.8%) months. Variables significantly associated with adherence were: educational level, living with the family, refer good adherence, positive assessment of the antiretroviral therapy, a diagnosis of an opportunistic disease, NADIR greater than 200 cells/mm(3) and being in first-time treatment. To improve adherence rates individual and collective strategies should be elaborated taking into account factors which have been identified as negatively effecting adherence.
Language: Portuguese

Keywords:
BRAZIL | RESEARCH REPORT | INTERVIEWS | CLIENTS | PERSONS LIVING WITH HIV/AIDS | ANTIRETROVIRAL DRUGS | ANTIRETROVIRAL THERAPY | USER COMPLIANCE | TREATMENT | ADMINISTRATION AND DOSAGE | PROGRAM EFFECTIVENESS | South America, Eastern | South America | Latin America | Americas | Developing Countries | Data Collection | Research Methodology | Program Activities | Programs | Organization and Administration | HIV Infections | Viral Diseases | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | HIV | Behavior | Drugs | Program Evaluation
Document Number: 342167  

19.
Title: Acquiring allergen information from condom manufacturers: a questionnaire survey.
Author: Blyumin ML; Rouhani P; Avashia NJ; Jacob SE
Source: Dermatitis. 2009 May-Jun;20(3):161-70.
Abstract: BACKGROUND: Allergic contact dermatitis from condoms is a problem that carries significant morbidity and that has been increasingly reported due to the use of condoms to prevent sexually transmitted diseases as well as for birth control. OBJECTIVE: The purpose of the study is to evaluate the process by which condom manufacturing companies divulge product allergen information to health care professionals. METHODS: An interviewer-administered telephone questionnaire eliciting the staff member's knowledge of condom allergens was utilized. Eligible respondents were condom manufacturers' service staff over 18 years of age. RESULTS: Complete surveys were obtained regarding 36 (85.7%) of the 42 subtypes of condoms. Telephoning was the primary (75%) method of obtaining allergen information. The majority (63.9%) of the information was obtained within minutes to hours of the initial contact. Nearly two-thirds of the interviews evaluated the condom manufacturers' service staff as good and effective in their knowledge base and in providing product information. CONCLUSION: The study determined that the extent of knowledge, helpfulness, and effectiveness of the customer service personnel in relaying product allergen information to clinicians were generally good. The study additionally generated a reference table outlining the common allergens in major manufactured condoms.
Language: English

Keywords:
UNITED STATES OF AMERICA | RESEARCH REPORT | SURVEYS | HEALTH PERSONNEL | FAMILY PLANNING PERSONNEL | CONDOMS | ALLERGIC REACTION | DERMATITIS | INFORMATION | KNOWLEDGE | INTERVIEWS | Developed Countries | North America | Americas | Sampling Studies | Studies | Research Methodology | Delivery of Health Care | Health | Family Planning Programs | Family Planning | Barrier Methods | Contraceptive Methods | Contraception | Signs and Symptoms | Diseases | Sociocultural Factors | Data Collection
Document Number: 341311  

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Title: [Assessment of factors associated with patients' comprehension of treatment at the start of antiretroviral therapy] Evaluacion de factores asociados a la comprension del tratamiento en pacientes
Author: Braga Ceccato MG; Acurcio Fde A; Vallano A; Comini Cesar C; Crosland Guimaraes MD
Source: Enfermedades Infecciosas Y Microbiologia Clinica. 2009 Jan;27(1):7-13.
Abstract: OBJECTIVE: The aim of this study was to evaluate factors associated with patients' comprehension of antiretroviral therapy (ART). METHOD: Cross-sectional analysis in which patients at 2 HIV/AIDS public referral centers (Belo Horizonte, Brazil) were interviewed after initiating ART. Information was recorded on variables related to the patient's characteristics, the treatment prescribed, and the healthcare professional involved. A score indicating the patients' level of comprehension regarding the medications prescribed was obtained using a latent trait model estimated by the item response theory. RESULTS: A total of 406 patients were interviewed. Mean (SD) age was 35 (10) years, 227 were men (56%), 302 of Afro-American ethnicity (77%), and 213 had <8 years of education (53%). The regression model determined that 52.25% of the variability of comprehension was explained by the individual's characteristics. Variables associated (P<0.05) with poorest understanding about ART were lower education (<8 years), lack of knowledge about treatment duration and clinical severity, inadequate information provided by physicians, inability to understand pharmaceutical information, daily number of tablets, and the ART regimen prescribed. CONCLUSION: Comprehension of information about the ART regimen prescribed varies considerably between individuals. Nonetheless, several factors were found to be associated with the level of understanding: characteristics of the patient (education, clinical severity), characteristics of treatment (daily number of tablets, ART regimen prescribed), and contribution of healthcare professionals (information from physicians and pharmacists). Strategies to reinforce information about ART should be a priority for patients with a low level of understanding.
Language: Spanish

Keywords:
BRAZIL | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | INTERVIEWS | CLIENTS | ETHNIC GROUPS | PRESCRIPTIONS | EDUCATIONAL STATUS | KNOWLEDGE | TREATMENT | INFORMATION | PHYSICIAN-PATIENT RELATIONS | South America, Eastern | South America | Latin America | Americas | Developing Countries | Research Methodology | Data Collection | Program Activities | Programs | Organization and Administration | Cultural Background | Population Characteristics | Demographic Factors | Population | Distributional Activities | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Sociocultural Factors | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Interpersonal Relations | Behavior
Document Number: 341238  

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Title: What do sexually active adolescent females say about relationship issues?
Author: Bralock A; Koniak-Griffin D
Source: Journal of Pediatric Nursing. 2009 Apr;24(2):131-40.
Abstract: Many sexually active teenagers face risk for contracting sexually transmitted infections (STIs) including HIV. The purpose of our study was to gain an understanding about influences on condom use among sexually active adolescents in relationships. Data were collected through semi-structured openended interviews. The findings of this study suggest that many adolescents desired the love of a male partner, and were willing to concede to his request of practicing unprotected sex. Findings support the urgent need for interventions that will promote skill-building techniques to negotiate safer sex behaviors among youth who are most likely to be exposed to STIs through risky behaviors.
Language: English

Keywords:
UNITED STATES OF AMERICA | RESEARCH REPORT | INTERVIEWS | ADOLESCENTS | COUPLES | BLACKS | SEX BEHAVIOR | SEXUALLY TRANSMITTED DISEASES | NEEDS | CONDOM USE | RISK REDUCTION BEHAVIOR | RISK BEHAVIOR | Developed Countries | North America | Americas | Data Collection | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Family Characteristics | Family and Household | Sociocultural Factors | Ethnic Groups | Cultural Background | Behavior | Reproductive Tract Infections | Infections | Diseases | Economic Factors
Document Number: 342095  

22.    Full text document

Title: [Challenges of youth contraception: intersections between gender, sexuality and health] Desafios da contracepcao juvenil: intersecoes entre genero, sexualidade e saude.
Author: Brandao ER
Source: Ciencia and Saude Coletiva. 2009 Jul-Aug;14(4):1063-71.
Abstract: This qualitative paper discusses some of the difficulties young people have when dealing with contraception and also identifies circumstances in which they tend not to use contraceptive methods. The authors conducted 73 in-depth interviews with young men and women, ages 18 to 24, living in three state capitals in Brazil (Salvador, Rio de Janeiro, Porto Alegre), who went through at least one experience of teenage pregnancy. Data were analyzed by theme in order to assemble similar and repeated elements in the testimonies. The reasons young people have difficulty adopting continued use of contraceptive methods were listed according to the following themes: relationship context; relationship with the family regarding sexuality; side effects of hormonal contraceptive methods; negligence with contraception; problems with health services; failure of contraceptive methods; a strong sense of fatherhood; use of condoms with unknown female partners; and use of withdrawal with no knowledge of the partner’s menstrual cycle.
Language: Portuguese

Keywords:
BRAZIL | RESEARCH REPORT | QUALITATIVE RESEARCH | INTERVIEWS | YOUTH | SEXUALITY | ADOLESCENT PREGNANCY | CONTRACEPTION | ORAL CONTRACEPTIVES, SIDE EFFECTS | INTERPERSONAL RELATIONS | SEX BEHAVIOR | South America, Eastern | South America | Latin America | Americas | Developing Countries | Research Methodology | Data Collection | Age Factors | Population Characteristics | Demographic Factors | Population | Personality | Psychological Factors | Behavior | Reproductive Behavior | Fertility | Population Dynamics | Family Planning | Contraceptive Safety | Safety | Public Health | Health
Document Number: 342619  

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Peer Reviewed

Title: Longitudinal antiretroviral adherence in HIV+ Ugandan parents and their children initiating HAART in the MTCT-plus family treatment model: role of depression in declining adherence over time.
Author: Byakika-Tusiime J; Crane J; Oyugi JH; Ragland K; Kawuma A; Musoke P; Bangsberg DR
Source: AIDS and Behavior. 2009 Jun;13(Suppl 1):S82-S91.
Abstract: The authors conducted a study to assess the effect of family-based treatment on adherence amongst HIV-infected parents and their HIV-infected children attending the Mother-To-Child-Transmission Plus program in Kampala, Uganda. Adherence was assessed using home-based pill counts and self-report. Mean adherence was over 94%. Depression was associated with incomplete adherence on multivariable analysis. Adherence declined over time. Qualitative interviews revealed lack of transportation money, stigma, clinical response to therapy, drug packaging, and cost of therapy may impact adherence. Our results indicate that providing ART to all eligible HIV-infected members in a household is associated with excellent adherence in both parents and children. Adherence to ART among new parents declines over time, even when patients receive treatment at no cost. Depression should be addressed as a potential barrier to adherence. Further study is necessary to assess the long-term impact of this family treatment model on adherence to ART in resource-limited settings.
Language: English

Keywords:
UGANDA | RESEARCH REPORT | FOCUS GROUPS | PARENTS | CHILDREN | PERSONS LIVING WITH HIV/AIDS | ANTIRETROVIRAL THERAPY | USER COMPLIANCE | QUESTIONNAIRES | DEPRESSION | PACKAGING | STIGMA | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Data Collection | Research Methodology | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | HIV Infections | Viral Diseases | Diseases | HIV | Behavior | Mental Disorders | Marketing | Economic Factors | Social Problems
Document Number: 341904  

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Peer Reviewed

Title: Ectopic pregnancy following levonorgestrel emergency contraception [letter]
Author: Cabar FR; Pereira PP; Zugaib M
Source: Contraception. 2009 Aug;80(2):227; author reply 227-8.
Abstract:
Language: English

Keywords:
BRAZIL | CRITIQUE | CASE HISTORIES | CLIENTS | EMERGENCY CONTRACEPTION | LEVONORGESTREL | PREGNANCY, ECTOPIC | PREGNANCY, TUBAL | LAPAROSCOPY | FALLOPIAN TUBES | South America, Eastern | South America | Latin America | Americas | Developing Countries | Data Collection | Research Methodology | Program Activities | Programs | Organization and Administration | Contraception | Family Planning | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Pregnancy Complications | Diseases | Endoscopy | Physical Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology
Document Number: 342302  

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Title: Early diagnosis, follow-up, and prenatal treatment of a case of TRAP sequence occurring in a dichorionic triamniotic triplet pregnancy.
Author: Cavoretto P; Serafini A; Valsecchi L; Lanna M; Rustico MA
Source: Journal of Clinical Ultrasound. 2009 Jul-Aug;37(6):350-3.
Abstract: We are reporting a case of twin reversed arterial perfusion (TRAP) sequence occurring in a dichorionic triamniotic triplet pregnancy with successful percutaneous prenatal treatment and excellent neonatal outcome. TRAP sequence was diagnosed at 11 weeks in a spontaneous dichorionic-triamniotic triplet. Sonographic assessment showed persistent arterial flow and development of hydrops in the acardiac twin. Percutaneous cord interstitial laser coagulation was performed, and the co-twin subsequently developed growth restriction. The 9-month-old twins have a normal developmental course. This report confirms that fetal intervention is indicated in cases of TRAP sequence in which the acardiac twin presents a significant enlargement on follow-up sonographic examinations.
Language: English

Keywords:
ITALY | SUMMARY REPORT | CASE HISTORIES | PREGNANT WOMEN | FETUS | MULTIPLE BIRTH | FETAL MEMBRANES | VASCULAR DISEASES | GROWTH | EXAMINATIONS AND DIAGNOSES | ULTRASONICS | AMNIOCENTESIS | PREGNANCY OUTCOMES | Developed Countries | Europe, Southern | Europe | Data Collection | Research Methodology | Population Characteristics | Demographic Factors | Population | Pregnancy | Reproduction | Diseases | Child Development | Biology | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Genetic Techniques | Laboratory Examinations and Diagnoses
Document Number: 342793  

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Peer Reviewed

Title: [Child health in poor areas: findings from a population-based study in Caracol, Piaui, and Garrafao do Norte, Para, Brazil] Saude infantil em areas pobres: resultados de um estudo de base populacional nos municipios de Caracol, Piaui, e Garrafao do Norte, Para, Brasil.
Author: Cesar JA; Chrestani MA; Fantinel EJ; Goncalves TS; Neumann NA
Source: Cadernos de Saude Publica. 2009 Apr;25(4):809-818.
Abstract: The aim of this study was to evaluate child health indicators in the municipalities (counties) of Caracol, Piauí State, and Garrafão do Norte, Pará State, Brazil. Through household visits using systematic sampling, previously trained interviewers applied a standard questionnaire to mothers of under-five children, investigating socioeconomic status, housing and environmental sanitation, demographic characteristics, disease patterns, and prenatal and childbirth care. The analysis used the t-test and chi-square test to compare indicators between the two municipalities. Of the 1,728 children studied, 60% were from families with incomes less than one monthly minimum wage (approximately U$200), 41% had no type of sewage treatment or disposal, 10% of mothers reported zero prenatal visits, 30% of the children were born in the same municipality, and 30% had been taken to a pediatric consultation in the previous 3 months; 20% had a height-for-age deficit > 2 standard deviations. All target indicators were deficient in both the municipalities (especially in Garrafão do Norte). Expanding health care supply and improving housing and sanitation conditions are priorities in both municipalities.
Language: Portuguese

Keywords:
BRAZIL | RESEARCH REPORT | INTERVIEWS | MOTHERS | CHILD HEALTH | SOCIOECONOMIC STATUS | HOUSEHOLDS | SANITATION | POPULATION CHARACTERISTICS | ANTENATAL CARE | BEHAVIOR | UTILIZATION OF HEALTH CARE | INCOME | South America, Eastern | South America | Latin America | Americas | Developing Countries | Data Collection | Research Methodology | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Health | Socioeconomic Factors | Economic Factors | Public Health | Demographic Factors | Population | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care
Document Number: 341867  

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Title: Male perceptions on female sterilization: a community-based study in rural central India.
Author: Char A; Saavala M; Kulmala T
Source: International Perspectives on Sexual and Reproductive Health. 2009 Sep;35(3):131-138.
Abstract: CONTEXT: Use of modern contraceptive methods has increased fourfold in India since the 1970s, characterized by a predominance of female sterilization. There has been considerable investigation about women's choice of female sterilization, but little from the male perspective. METHODS: Seven focus group discussions were conducted among 58 men currently married to women aged 15-45, followed by a cross-sectional survey among 793 men currently married to same-aged women. Bivariate analysis was used for the survey data, and content analysis was used for the qualitative data. RESULTS: Men's primary source of reproductive health information was mass media, although they expressed interest in getting information through discussion with knowledgeable sources. Men understood family planning and contraception to be two separate issues: Men viewed "family planning" as synonymous with female sterilization, whereas they saw "contraception" as referring to spacing methods, knowledge of which was limited. Thirty-four percent of men reported that their wives had been sterilized; 79% of men who did not rely on any permanent method said they wanted their wives to be sterilized. In focus group discussions, most men reported themselves as their family's sole decision maker about reproductive health; however, only one-third of survey respondents did so. CONCLUSION: Men are interested in acquiring family planning information, but lack knowledge about available information sources, which hampers their ability to make informed family planning choices. Family planning service providers and program planners need to be aware of males' knowledge and perceptions pertaining to family planning, and make appropriate modifications to communication strategies.
Spanish Abstract: Contexto: El uso de métodos anticonceptivos modernos se ha cuadruplicado en India desde los años setenta y se ha caracterizado por el predominio de la esterilización femenina. Ha habido considerables esfuerzos de investigación sobre la elección de la esterilización femenina que hacen las mujeres, pero existen pocos estudios desde la perspectiva masculina. Métodos: Siete sesiones de grupos focales se condujeron con 58 hombres actualmente casados con mujeres en edades de 15-45 años, seguidas por una encuesta transversal aplicada a 793 hombres actualmente casados con mujeres del mismo grupo de edad. Se usó análisis bivariado para los datos de la encuesta y análisis de contenido para los datos cualitativos. Resultados: Para los hombres, la fuente primaria de información sobre salud reproductiva fue los medios masivos, aunque ellos expresaron interés en obtener información a través de charlas con gente informada en el tema. Los hombres encuestados entendieron la planificación familiar y la anticoncepción como dos temas separados: los hombres percibieron la "planificación familiar" como sinónimo de esterilización femenina, mientras que se refirieron a la "anticoncepción" como métodos de espaciamiento, cuyo conocimiento fue limitado. Treinta y cuatro por ciento de los hombres reportaron que sus esposas habían sido esterilizadas; 79% de los hombres que no dependían de algún método permanente dijeron que querían que sus esposas fueran esterilizadas. En las sesiones de grupo, la mayoría de los hombres se identificó como el único tomador de decisiones en su familia respecto a la salud reproductiva; sin embargo, solamente un tercio de los hombres encuestados se identificó de esa forma. Conclusión: Los hombres están interesados en obtener información sobre planificación familiar, pero desconocen las fuentes disponibles que pueden consultar, lo cual limita su capacidad para tomar decisiones informadas sobre planificación familiar. Los prestadores de servicios y planificadores de programas de planificación familiar deben estar conscientes del conocimiento y percepciones de los hombres en relación con la planificación familiar, y realizar las modificaciones apropiadas a sus estrategias de comunicación.
French Abstract: Contexte: La pratique de la contraception moderne a quadruplé en Inde depuis les années 1970. Elle se caractérise par une prédominance de la stérilisation féminine. De nombreuses études ont été menées sur le choix féminin de la stérilisation. La perspective masculine n'est en revanche guère connue. Méthodes: Sept réunions de groupe ont été organisées avec 58 hommes mariés à des femmes de 15 à 45 ans. Une enquête transversale a ensuite été menée auprès de 793 hommes mariés à des femmes de la même tranche d'âge. L'analyse bivariée a été utilisée pour les données d'enquête, et l'analyse de contenu pour les données qualitatives. Résultats: Pour les hommes, les médias représentent la principale source d'information sur la santé génésique. Ils expriment cependant un certain intérêt à s'informer par discussion auprès de sources compétentes. Les hommes voient dans la planification familiale et la contraception deux questions distinctes: la «planification familiale» est pour eux synonyme de stérilisation féminine, tandis que la «contraception» désigne les méthodes d'espacement, au sujet desquelles ils ne sont guère informés. Trente-quatre pour cent des hommes ont déclaré que leur femme était stérilisée; 79% de ceux qui n'avaient pas eu recours à une méthode permanente ont indiqué désirer que leur femme se fasse stériliser. Lors des discussions de groupe, la plupart des hommes se sont déclarés les seuls décideurs de leur famille en matière de santé génésique, par rapport à un tiers seulement des répondants à l'enquête. Conclusion: Les hommes désirent s'informer sur la planification familiale mais ils ignorent les sources d'information disponibles, ce qui entrave leur aptitude à opérer des choix éclairés en la matière. Les prestataires de services et les planifi- cateurs de programmes de planification familiale doivent être sensibles aux connaissances et aux perceptions masculines et ajuster en conséquence leurs stratégies de communication.
Language: English

Keywords:
INDIA | RESEARCH REPORT | FOCUS GROUPS | CROSS SECTIONAL ANALYSIS | MEN | CURRENTLY MARRIED | REPRODUCTIVE HEALTH | PERCEPTION | FEMALE STERILIZATION | INFORMATION SOURCES | Asia, Southern | Asia | Developing Countries | Data Collection | Research Methodology | Demographic Factors | Population | Marital Status | Nuptiality | Health | Psychological Factors | Behavior | Sterilization, Sexual | Family Planning | Information
Document Number: 343003  

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Peer Reviewed

Title: The prevention of mother-to-child HIV transmission programme in Lilongwe, Malawi: why do so many women drop out.
Author: Chinkonde JR; Sundby J; Martinson F
Source: Reproductive Health Matters. 2009 May;17(33):143-151.
Abstract: Mother-to-child transmission of HIV constitutes a substantial burden of new HIV infections in sub-Saharan Africa, and losses to follow-up continue to undermine prevention of mother-to-child transmission of HIV (PMTCT) programmes. This qualitative study sought to clarify why some women who were enrolled in a PMTCT programme in Lilongwe, Malawi, did not fully participate in follow-up visits in the first six months after testing HIV-positive. Twenty-eight women, 14 who participated fully in the programme and 14 who dropped out, were purposively selected for in-depth interview at two clinics. Focus group discussions with 15 previously interviewed and 13 newly recruited women were also conducted. Discussions with 12 of the women's husbands were also carried out. Although the proportion of women being tested has reportedly increased, losses to follow-up have shifted and are occurring at every step after testing. Major emerging themes associated with dropping out of the PMTCT programme within six months after delivery were to avoid involuntary HIV disclosure and negative community reactions, unequal gender relations, difficulties accessing care and treatment, and lack of support from husbands. The whole approach to the delivery of the PMTCT programme and home visits must be reconsidered, to improve confidentiality and minimise stigmatization. Women need to be empowered economically and supported to access HIV treatment and care with their partners, to benefit their whole family.
Spanish Abstract: En África subsahariana, gran parte de nuevas infecciones por VIH se deben a la transmisión materno-infantil, y las pérdidas de seguimiento continúan socavando los programas de prevención de la transmisión materno-infantil del VIH (PTMI). El objetivo de este estudio cualitativo era aclarar por qué algunas de las mujeres inscritas en un programa de PTMI en Lilongwe, Malaui, no participaron al máximo en las consultas de control durante los primeros seis meses posteriores a haber sido diagnosticadas VIH-positivas. Se seleccionaron 28 mujeres para entrevistas a profundidad en dos clínicas: 14 participaron al máximo en el programa y 14 lo abandonaron. Además, se realizaron discusiones en grupos focales con 15 mujeres entrevistadas anteriormente y 13 recién reclutadas, así como discusiones con 12 de los esposos. Aunque la proporción de mujeres que se someten a la prueba del VIH ha aumentado, las pérdidas de seguimiento continúan ocurriendo en cada paso posterior a las pruebas. Los principales motivos emergentes asociados con abandonar el programa de PTMI dentro de los seis meses posteriores al parto fueron: para evitar la divulgación involuntaria del estado de VIH y reacciones negativas de la comunidad, relaciones desiguales entre los sexos, dificultades accediendo a los servicios y el tratamiento, y la falta de apoyo del esposo. Para mejorar la confidencialidad y minimizar el estigma, es necesario reconsiderar la estrategia de ejecución del programa y las visitas a domicilio. Las mujeres necesitan autonomía económica y apoyo para poder acceder al tratamiento y los servicios de VIH con sus parejas, a fin de beneficiar a toda su familia.
French Abstract: La transmission mère-enfant du VIH représente une part importante des nouvelles infections en Afrique subsaharienne et les pertes du suivi continuent de saper les programmes de prévention de la transmission mère-enfant (PTME). Cette étude qualitative souhaitait déterminer pourquoi certaines participantes d'un programme de PTME à Lilongwe, Malawi, avaient manqué des visites de suivi les six premiers mois après avoir découvert leur séropositivité lors d'un dépistage. Vingt-huit femmes – 14 participant pleinement au programme et 14 l'ayant abandonné – ont fait l'objet d'un entretien approfondi dans deux dispensaires. Des discussions en groupe avec 15 femmes interrogées précédemment et 13 nouvelles recrues ont aussi été organisées, de même qu'avec 12 conjoints des femmes. Bien que la proportion déclarée de femmes se faisant dépister ait augmenté, les pertes pour le suivi ont évolué et se produisent désormais à toutes les étapes après le test. Les principales raisons de l'abandon du programme de PTME dans les six mois après l'accouchement étaient la crainte d'une révélation involontaire de la séropositivité et des réactions communautaires négatives, le manque de parité entre les sexes, les difficultés d'accès aux soins et au traitement, et le soutien insuffisant des maris. Toute l'approche de l'application du programme de PTME et des visites à domicile doit être revue, pour améliorer la confidentialité et minimiser la stigmatisation. Il faut donner aux femmes les moyens économiques de s'autonomiser et les aider à avoir accès au traitement et aux soins du VIH avec leur partenaire et leurs enfants ce qui profitera à toute la famille.
Language: English

Keywords:
MALAWI | RESEARCH REPORT | FOCUS GROUPS | PREGNANT WOMEN | DROPOUTS | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | INTERVIEWS | HOME VISITS | FEAR | STIGMA | CONFIDENTIAL INFORMATION | GENDER RELATIONS | PROGRAM ACCESSIBILITY | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Data Collection | Research Methodology | Population Characteristics | Demographic Factors | Population | Programs | Organization and Administration | Disease Transmission Control | Prevention and Control | Diseases | Communication | Emotions | Psychological Factors | Behavior | Social Problems | Sociocultural Factors | Ethics | Gender Issues | Program Evaluation
Document Number: 342023  

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Peer Reviewed

Title: The 1991-2004 evolution in life expectancy by educational level in Belgium based on linked census and population register data. L'evolution de l'esperance de vie par niveau d'instruction en Belgique de 1991 a 2004 sur la base de donnees de recensement liees au registre de la population.
Author: Deboosere P; Gadeyne S; Oyen HV
Source: European Journal of Population. 2008 May;25(2):175-196.
Abstract: The aim of this study is to determine trends in life expectancy by educational level in Belgium and to present elements of interpretation for the observed evolution. The analysis is based on census data providing information on educational level linked to register data on mortality for the periods 1991-1994 and 2001-2004. Using exhaustive individual linked data allows to avoid selection bias and numerator-denominator bias. The trends reveal a general increase in life expectancy together with a widening social gap. Summary indices of inequality based on life expectancies show, however, a more complex pattern and point to the importance to include the shifts in population composition by educational level in an overall assessment of the evolution of inequality by educational level.
Language: English

Keywords:
BELGIUM | RESEARCH REPORT | DATA LINKAGE | LIFE EXPECTANCY | EDUCATIONAL STATUS | HEALTH | INEQUALITIES | MORTALITY | DEATH RECORDS | CENSUS | Europe, Western | Europe | Developed Countries | Data Collection | Research Methodology | Length of Life | Population Dynamics | Demographic Factors | Population | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Vital Statistics | Population Statistics
Document Number: 340174  

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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