1.  Title: Traveling child-sex offenders in South East Asia: a regional review. Author: Child Wise Source: South Melbourne, Australia, Child Wise, 2009 Mar. 39 p. Abstract: This is the third edition of this compendium of information about the sexual exploitation of children in tourism destinations throughout South East Asia. The report provides a regional overview of child sex tourism in South East Asia along with national reports from all 10 countries in the region. It also provides an update on the successful ASEAN Regional Education Campaign and a brief summary of the key findings from a situational analysis of hotline reporting numbers in the region. Language: English Keywords: ASIA, SOUTHEASTERN | SUMMARY REPORT | TRAVELERS | ORPHANS AND VULNERABLE CHILDREN | STREET KIDS | SEXUAL EXPLOITATION | TRAVEL AND TOURISM | CRIME | SEXUAL ABUSE | PREVENTION AND CONTROL | Asia | Developing Countries | Behavior | Family and Household | Sociocultural Factors | Homeless Persons | Residence Characteristics | Population Distribution | Geographic Factors | Population | Social Problems | Diseases Document Number: 342036 |
2.  Peer Reviewed Title: Factors affecting awareness of emergency contraception among college students in Kathmandu, Nepal. Author: Adhikari R Source: BMC Women's Health. 2009 Sep 17;9(1):27. Abstract: ABSTRACT: BACKGROUND: In Nepal, Emergency Contraception (EC) could play a critical role in reducing unintended pregnancies, but very few people aware about it. This paper aims to investigate the level of awareness and factors influencing awareness of EC among college students. METHODS: A cross-sectional study was carried out in April-May 2006. Structured self-administered questionnaires were administered to 1,137 college students (573 males and 564 females) in Kathmandu district. The association between awareness of EC and the explanatory variables were first assessed in bivariate analysis using the Chi-square test. The associations were further explored using a multivariate logistic analysis. RESULTS: Only about two-thirds of college students (68%) had ever heard about EC. Bivariate analysis shows that males were more aware (72%) of EC than were females (64%). Similarly, the awareness level was significantly higher among younger, unmarried youth who were from outside Kathmandu Valley, who lived with friends, and who had received reproductive health (RH) education in school/college. The study also found that students' sex, permanent place of residence (district), and RH education are significant predictors of awareness of EC. Males are 1.5 times more likely to be aware of EC compared to females. Furthermore, students who lived in Kathmandu Valley were 41% less likely to be aware of EC than were students from outside Kathmandu Valley. On the other hand, those students who received RH education in school/college were almost nine times more likely to be aware of EC compared to those who did not receive such education. CONCLUSIONS: Awareness of the EC is low among college students in Nepal. Health education initiatives should target students as they are more likely to be sexually active. There is a need to further educate students about EC which can help to reduce unintended pregnancies, many of which result in unsafe abortion and take a large toll on women's health. Language: English Keywords: NEPAL | RESEARCH REPORT | STUDENTS | EMERGENCY CONTRACEPTION | AWARENESS | QUESTIONNAIRES | LIVING ARRANGEMENTS | SEX FACTORS | AGE FACTORS | SEX EDUCATION | PREGNANCY, UNPLANNED | Developing Countries | Asia, Southern | Asia | Education | Contraception | Family Planning | Knowledge | Sociocultural Factors | Residence Characteristics | Population Distribution | Geographic Factors | Population | Population Characteristics | Demographic Factors | Reproductive Behavior | Fertility | Population Dynamics Document Number: 342836 |
| 3. Title: The use of home-based therapy with ready-to-use therapeutic food to treat malnutrition in a rural area during a food crisis. Author: Amthor RE; Cole SM; Manary MJ Source: Journal of the American Dietetic Association. 2009 Mar;109(3):464-7. Abstract: When the international community declared a famine in Malawi in January of 2006, emergency food aid reached only populations with pre-existing health care services. To treat the widespread childhood malnutrition in Machinga district, a rural area lacking health care facilities, in February 2006 five outpatient therapeutic programs were implemented that utilized home-based therapy and ready-to-use therapeutic food. Children with severe malnutrition, defined as the presence of edema and/or a weight-for-height less than 70% of the reference standard, were enrolled in the program. Two senior clinical nurses trained village health aides in each of the five communities. Children visited the health aides biweekly. During the visits, health aides collected demographic and anthropometric information and distributed a 2-week supply of ready-to-use therapeutic food, providing 175 kcal/kg/d. Treatment continued for 8 weeks; children were discharged before 8 weeks if they reached a weight-for-height more than 100% of the reference standard, or required admission to the hospital due to systemic infection or recurrence of edema. Of the 826 children enrolled, 775 (93.7%) recovered, 13 (1.8%) remained malnourished, 30 (3.6%) defaulted, and 8 (0.9%) died. Mean weight gained was 2.7+/-3.7 g/kg/d, height gained 0.3+/-0.9 mm/d, and mid-upper arm circumference gained 0.2+/-0.3 mm/d. Home-based therapy with ready-to-use therapeutic food administered by village health aides is an effective approach to treating malnutrition during food crises in areas lacking health services. Language: English Keywords: DEVELOPING COUNTRIES | MALAWI | RESEARCH REPORT | RURAL AREAS | COMMUNITY | CHILDREN | FAMINE | FOOD SECURITY | NUTRITION DISORDERS | ANTHROPOMETRY | BODY WEIGHT | BODY HEIGHT | MALNUTRITION | HOME CARE | TREATMENT | Africa, Southern | Africa, Sub Saharan | Africa | Geographic Factors | Population | Residence Characteristics | Population Distribution | Youth | Age Factors | Population Characteristics | Demographic Factors | Food Supply | Natural Resources | Environment | Diseases | Measurement | Research Methodology | Physiology | Biology | Care and Support | Health Services | Delivery of Health Care | Health | Medical Procedures | Medicine Document Number: 330803 |
| 4. Title: Does where you live influence what you know? Community effects on health knowledge in Ghana. Author: Andrzejewski CS; Reed HE; White MJ Source: Health and Place. 2009 Mar;15(1):228-38. Abstract: This paper examines community effects on health knowledge in a developing country setting. We examine knowledge about the etiology and prevention of child illnesses using a unique 2002 representative survey of communities and households in Ghana. We find that community context matters appreciably, even after adjusting for the anticipated positive effects of an individual's education, literacy, media exposure and household socioeconomic status. The proportion of literate adults and the presence of a market in a community positively influence a person's health knowledge. In other words, even if a person herself is not literate, living in a community with high levels of literacy or a regular market can still positively affect her health knowledge. Our results suggest that social networks and diffusion play a key role in these community effects. In turn, these results offer policy implications for Ghana and sub-Saharan Africa. Language: English Keywords: GHANA | RESEARCH REPORT | KAP SURVEYS | COMMUNITY | CHILDREN | SOCIAL NETWORKS | KNOWLEDGE | LOCALE | CHILD HEALTH | DISEASE PREVENTION | EDUCATIONAL STATUS | LITERACY | MASS MEDIA | SOCIOECONOMIC STATUS | SOCIAL POLICY | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Surveys | Sampling Studies | Studies | Research Methodology | Residence Characteristics | Population Distribution | Geographic Factors | Population | Youth | Age Factors | Population Characteristics | Demographic Factors | Friends and Relatives | Family and Household | Sociocultural Factors | Health | Prevention and Control | Diseases | Socioeconomic Factors | Economic Factors | Communication | Policy | Political Factors Document Number: 330296 |
| 5. Title: Inadequate use of prenatal services among brazilian women: the role of maternal characteristics. Author: Bassani DG; Surkan PJ; Olinto MT Source: International Perspectives On Sexual and Reproductive Health. 2009 Mar;35(1):15-20. Abstract: CONTEXT: To improve the uptake of prenatal care, it is important to know how the use of prenatal care varies by maternal attitudes and social and demographic factors. METHODS: Information about social and demographic variables, prenatal care, parity, pregnancy planning, abortion attempts, satisfaction with pregnancy and satisfaction with the relationship with the child's father was collected from 611 postpartum women in Porto Alegre in southern Brazil. Multinomial logistic regression was used to evaluate associations between these variables and whether the women's use of prenatal care was adequate, partially inadequate or inadequate. RESULTS: About 40% of women had inadequate or partially inadequate prenatal care. After adjustment for other covariates, including satisfaction with the pregnancy, women having an unplanned pregnancy were significantly more likely to have had inadequate care than women who had planned their pregnancy (odds ratio, 2.0). Not living with the child's father (2.8) and dissatisfaction with pregnancy (2.1) were also associated with inadequate use of prenatal care. Women having their second or higher order birth were significantly more likely to report inadequate use of prenatal care than women having their first birth (3.9-9.0). Household income was inversely associated with inadequate use of care. CONCLUSIONS: The study suggests that maternal attitudes may be important for adequate prenatal care. Interventions should be created to encourage women with negative maternal attitudes to use prenatal care and to ensure that they have access to the care they need. Language: English Keywords: BRAZIL | RESEARCH REPORT | STATISTICAL REGRESSION | POSTPARTUM WOMEN | ANTENATAL CARE | UTILIZATION OF HEALTH CARE | ATTITUDES | SOCIOECONOMIC STATUS | PARITY | LIVING ARRANGEMENTS | South America, Eastern | South America | Latin America | Americas | Developing Countries | Data Analysis | Research Methodology | Puerperium | Reproduction | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care | Health | Psychological Factors | Behavior | Socioeconomic Factors | Economic Factors | Fertility Measurements | Fertility | Population Dynamics | Demographic Factors | Population | Residence Characteristics | Population Distribution | Geographic Factors Document Number: 341412 |
| 6. Peer Reviewed Title: Women's use of private and government health facilities for childbirth in Nairobi's informal settlements. Author: Bazant ES; Koening MA; Fotso JC; Mills S Source: Studies in Family Planning. 2009 Mar;40(1):39-50. Abstract: The private sector's role in increasing the use of maternal health care for the poor in developing countries has received increasing attention, yet few data exist for urban slums. Using household-survey data from 1,926 mothers in two informal settlements in Nairobi, Kenya, collected in 2006, we describe and examine the factors associated with women's use of private and government health facilities for childbirth. More women gave birth at private facilities located in the settlements than at government facilities, and one-third of the women gave birth at home or with the assistance of a traditional birth attendant. In multivariate models, women's education, ethnic group, and household wealth were associated with institutional deliveries, especially in government hospitals. Residents in the more disadvantaged settlement were more likely than those in the better-off settlement to give birth in private facilities. In urban areas, maternal health services in both the government and private sectors should be strengthened, and efforts made to reach out to women who give birth at home. Language: English Keywords: KENYA | RESEARCH REPORT | KAP SURVEYS | WOMEN IN DEVELOPMENT | PREGNANT WOMEN | REFUGEES | TRADITIONAL BIRTH ATTENDANTS | HOUSEHOLDS | CHILDBIRTH | REFUGEE CAMPS | UTILIZATION OF HEALTH CARE | PRIVATE SECTOR | GOVERNMENT PROGRAMS | HEALTH FACILITIES | DEMOGRAPHIC FACTORS | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Economic Development | Economic Factors | Population Characteristics | Population | Migrants | Migration | Population Dynamics | Health Personnel | Delivery of Health Care | Health | Family and Household | Sociocultural Factors | Pregnancy Outcomes | Pregnancy | Reproduction | Residence Characteristics | Population Distribution | Geographic Factors | Health Services | Macroeconomic Factors | Programs | Organization and Administration Document Number: 341077 |
| 7. Title: Community characteristics, sexual initiation, and condom use among young Black South Africans. Author: Burgard SA; Lee-Rife SM Source: Journal of Health and Social Behavior. 2009 Sep;50(3):293-309. Abstract: Individual and household-level characteristics that influence sexual behavior have been extensively studied in South Africa, but community characteristics have received limited attention. We use multilevel discrete time hazard models and multilevel logistic regression models to analyze data from a representative sample of young people in KwaZulu Natal, and from several sources of community data. Results suggest that, net of individual and household characteristics, higher levels of community concentrated disadvantage are associated with increased hazard of sexual initiation and higher risk of unprotected sex. Social disorder increases the hazard of sexual initiation, while greater community social cohesion is associated with delayed sexual debut, although the latter association appears stronger for young men than for young women. We discuss these results and the ways they vary from predictions based on US. theory in light of conditions prevailing in contemporary South Africa. Language: English Keywords: SOUTH AFRICA | RESEARCH REPORT | DATA ANALYSIS | BLACKS | YOUTH | HOUSEHOLDS | SEX BEHAVIOR | AGE FACTORS | SOCIOECONOMIC FACTORS | RISK FACTORS | EXPOSURE | POPULATION CHARACTERISTICS | COMMUNITY | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Research Methodology | Ethnic Groups | Cultural Background | Demographic Factors | Population | Family and Household | Sociocultural Factors | Behavior | Economic Factors | Health | Residence Characteristics | Population Distribution | Geographic Factors Document Number: 342565 |
| 8. Peer Reviewed Title: Marital and reproductive behavior in Italy after 1995: bridging the gap with Western Europe? Author: Castiglioni M; Dalla Zuanna G Source: European Journal of Population. 2009 Feb;25(1):1-26. Abstract: Despite a delay of 20-25 years, when it comes to cohabitation, Italy has now begun to resemble other Western countries. In addition, the increase in legal separations has accelerated since 1995, although their number still remains far from that observed in countries such as the USA, the UK, and France. Finally, Italy's fertility decline has come to a halt: the cohort of women born in the early 1970s will likely have the same TFR as those born in the mid-1960s (around 1.55). Moreover, in the Centre-North areas, period TFR rose from 1.1 in 1995 to 1.35 children per woman 10 years later. The territorial diffusion of cohabitation, legal separation, out-of-wedlock births, and fertility recovery overlaps closely with that of the decline in births during the first half of the twentieth century. A similar geographical pattern has been observed for the diffusion of school enrolment, industrialization, secularization, and (during the last 20 years) foreign immigration. Language: English Keywords: EUROPE | ITALY | RESEARCH REPORT | COUPLES | LIVING ARRANGEMENTS | SEPARATION | MARRIAGE | FERTILITY CHANGES | REPRODUCTIVE BEHAVIOR | Developed Countries | Europe, Southern | Family Characteristics | Family and Household | Sociocultural Factors | Residence Characteristics | Population Distribution | Geographic Factors | Population | Nuptiality | Demographic Factors | Fertility | Population Dynamics Document Number: 331294 |
| 9. Title: Individual- and community-level determinants of social acceptance of people living with HIV in Kenya: Results from a national population-based survey. Author: Chiao C; Mishra V; Sambisa W Source: Health and Place. 2009 Sep;15(3):742-750. Abstract: Using the 2003 Kenya Demographic and Health Survey, we investigated the influence of individual- and community-level factors on accepting attitudes toward people living with HIV (PLHIV) using three outcomes: (1) willingness to care for an infected household member, (2) willingness to buy vegetables from an infected vendor, and (3) willingness to allow an infected female teacher to continue teaching. In multilevel logistic regression models, we found that individuals who expressed greater acceptance of PLHIV were more likely to be male, older, more educated, high AIDS knowledge, and exposed to mass media. At the community level, differences in accepting attitudes were associated with community AIDS knowledge, community education, and community AIDS experience, but not for region, or place of residence. The findings suggest the important role of community factors in determining social acceptance of PLHIV. Programmatic strategies aimed at increasing these accepting attitudes should consider both individual- and community-level factors. Language: English Keywords: KENYA | RESEARCH REPORT | KAP SURVEYS | DEMOGRAPHIC AND HEALTH SURVEYS | COMMUNITY | TEACHERS | PERSONS LIVING WITH HIV/AIDS | SOCIAL DISCRIMINATION | STIGMA | HIV INFECTIONS | PSYCHOSOCIAL FACTORS | ATTITUDES | FAMILY RELATIONSHIPS | ACCEPTANCE PROCESS | FOOD AND BEVERAGE | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Demographic Surveys | Population Dynamics | Demographic Factors | Population | Residence Characteristics | Population Distribution | Geographic Factors | Education | Viral Diseases | Diseases | Social Problems | Sociocultural Factors | Behavior | Psychological Factors | Family Characteristics | Family and Household | Decision Making | Nutrition | Health Document Number: 341072 |
| 10. Title: Guinea. Village health committees drive family planning uptake: communities play lead role in increased acceptability, availability. Author: Diakite O; Keita DR; Mwebesa W Source: Washington, D.C., Core Group, [2009]. 8 p. Abstract: This document highlights the Village Health Committee (VHC), a vital player in the child survival project and the integration of family planning work within Save the Children's portfolio in Guinea. The document briefly describes the committee's purpose, membership, and tasks. It focuses on a handful of the people and activities that exemplified the VHCs' unique role in ensuring that family planning was not only accessible but acceptable to the villagers they served. The document concludes with some outcomes of Save the Children's family planning component in Mandiana and Kouroussa. In effect, the VHCs' stellar success in building demand for contraception (when coupled with modest investments in existing health workers' ability to supply modern methods) resulted in a sustained increase in the use of contraception in the project zone. Language: English Keywords: GUINEA | PROGRESS REPORT | EVALUATION | COMMUNITY | RURAL POPULATION | USAID | COMMUNITY HEALTH SERVICES | DELIVERY OF HEALTH CARE | PROGRAM ACCESSIBILITY | QUALITY OF HEALTH CARE | PERFORMANCE IMPROVEMENT | RURAL HEALTH SERVICES | FAMILY PLANNING | HEALTH SERVICES EVALUATION | PROGRAM ACCEPTABILITY | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Residence Characteristics | Population Distribution | Geographic Factors | Population | Population Characteristics | Demographic Factors | Government Agencies | Organizations | Political Factors | Sociocultural Factors | Primary Health Care | Health Services | Health | Program Evaluation | Programs | Organization and Administration | Management Document Number: 325193 |
| 11. Peer Reviewed Title: Saving mother's lives: programs that work. Author: Fortney JA; Leong M Source: Clinical Obstetrics and Gynecology. 2009 Jun;52(2):224-36. Abstract: Maternal mortality is a complex problem requiring complex responses. Nevertheless, every intervention must operate through one of 3 pathways: preventing pregnancy, preventing complications, or preventing death when obstetric complications occur. We describe interventions following each pathway and assess their evidence base. In general, the more specific the intervention (such as procedures) the stronger the evidence. Broad interventions ("programs" for example) have a weaker evidence base although evidence is accumulating. The potential for robust evidence for effective programs is limited by epidemiologic design-the logistic difficulties of randomization, blinding, and single impact variables. Language: English Keywords: GLOBAL | RECOMMENDATIONS | POLICYMAKERS | COMMUNITY | SAFE MOTHERHOOD | MATERNAL MORTALITY | INTERVENTIONS | PREGNANCY COMPLICATIONS | OBSTETRICS | EMERGENCY SERVICES | MATERNAL HEALTH SERVICES | PROGRAM EFFECTIVENESS | FAMILY PLANNING PROGRAMS | Administrative Personnel | Organization and Administration | Residence Characteristics | Population Distribution | Geographic Factors | Population | Maternal Health | Health | Mortality | Population Dynamics | Demographic Factors | Programs | Diseases | Medicine | Health Services | Delivery of Health Care | Maternal-Child Health Services | Primary Health Care | Program Evaluation | Family Planning Document Number: 342175 |
| 12. Peer Reviewed Title: What does access to maternal care mean among the urban poor? Factors associated with use of appropriate maternal health services in the slum settlements of Nairobi, Kenya. Author: Fotso J; Ezeh A; Madise N; Ziraba A; Ogollah R Source: Maternal and Child Health Journal. 2009 Jan;13(1):130-7. Abstract: Objectives: The study seeks to improve understanding of maternity health seeking behaviors in resource-deprived urban settings. The objective of this paper is to identify the factors which influence the choice of place of delivery among the urban poor, with a distinction between sub-standard and "appropriate" health facilities. Methods: The data are from a maternal health project carried out in two slums of Nairobi, Kenya. A total of 1,927 women were interviewed, and 25 health facilities where they delivered, were assessed. Facilities were classified as either "inappropriate" or "appropriate". Place of delivery is the dependent variable. Ordered logit models were used to quantify the effects of covariates on the choice of place of delivery, defined as a three-category ordinal variable. Results: Although 70% of women reported that they delivered in a health facility, only 48% delivered in a facility with skilled attendant. Besides education and wealth, the main predictors of place of delivery included being advised during antenatal care to deliver at a health facility, pregnancy "wantedness", and parity. The influence of health promotion (i.e., being advised during antenatal care visits) was significantly higher among the poorest women. Conclusion: Interventions to improve the health of urban poor women should include improvements in the provision of, and access to, quality obstetric health services. Women should be encouraged to attend antenatal care where they can be given advice on delivery care and other pregnancy-related issues. Target groups should include poorest, less educated and higher parity women. Language: English Keywords: KENYA | RESEARCH REPORT | KAP SURVEYS | SLUMS | URBAN POPULATION | WOMEN IN DEVELOPMENT | MATERNAL HEALTH SERVICES | UTILIZATION OF HEALTH CARE | PROGRAM ACCESSIBILITY | QUALITY OF HEALTH CARE | CHILDBIRTH | EDUCATIONAL STATUS | PROMOTION | ANTENATAL CARE | MULTIPARITY | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Urbanization | Urban Population Distribution | Population Distribution | Geographic Factors | Population | Population Characteristics | Demographic Factors | Economic Development | Economic Factors | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care | Health | Program Evaluation | Programs | Organization and Administration | Health Services Evaluation | Pregnancy Outcomes | Pregnancy | Reproduction | Socioeconomic Status | Socioeconomic Factors | Marketing | Parity | Fertility Measurements | Fertility | Population Dynamics Document Number: 308031 |
| 13. Peer Reviewed Title: Vulnerability to HIV/AIDS among women of reproductive age in the slums of Delhi and Hyderabad, India. Author: Ghosh J; Wadhwa V; Kalipeni E Source: Social Science and Medicine. 2009 Feb;68(4):638-42. Abstract: This report explores how vulnerability to HIV/AIDS applies to women in the reproductive age range living in the slum areas of Delhi and Hyderabad. The paper is based on a qualitative study of AIDS awareness levels conducted during the summer of 2006. It offers insightful narratives from a sample of 32 women, providing an in depth view of their vulnerability to HIV/AIDS due to their precarious socioeconomic conditions and low AIDS awareness. The women cited lack of education, low empowerment in expressing and accessing information related to sexual matters, and poverty as key factors to vulnerability. Language: English Keywords: INDIA | RESEARCH REPORT | QUALITATIVE RESEARCH | WOMEN | SLUMS | CONTRACEPTIVE METHODS | AWARENESS | REPRODUCTIVE AGE | RISK FACTORS | POVERTY | INFORMATION | PROGRAM ACCESSIBILITY | Asia, Southern | Asia | Developing Countries | Research Methodology | Demographic Factors | Population | Urbanization | Urban Population Distribution | Population Distribution | Geographic Factors | Contraception | Family Planning | Knowledge | Sociocultural Factors | Reproduction | Health | Socioeconomic Factors | Economic Factors | Program Evaluation | Programs | Organization and Administration Document Number: 341554 |
| 14. Peer Reviewed Title: Community-based promotional campaign to improve uptake of intermittent preventive antimalarial treatment in pregnancy in Burkina Faso. Author: Gies S; Coulibaly SO; Ky C; Ouattara FT; Brabin BJ; D'Alessandro U Source: American Journal of Tropical Medicine and Hygiene. 2009 Mar;80(3):460-9. Abstract: Malaria preventive strategies in pregnancy were assessed in a health center randomized trial comparing intermittent preventive treatment with sulfadoxine-pyrimethamine (IPTp-SP) with and without community based promotional activities in rural Burkina Faso. The study involved 2,240 secundigravidae and secundigravidae and evaluated factors associated with antenatal clinic (ANC) attendance and uptake of IPTp-SP. With promotion, 64.2% completed > or = 3 ANC visits compared with 44.7% without (P = 0.05). Complete uptake of IPTp-SP was 71.8% with and 49.1% without promotion (P = 0.008). The IPTp-SP uptake was lowest in adolescents delivering during high malaria transmission with (29%) or without promotion (30%). Uptake of SP was higher during the low transmission season than in the high transmission season (adjusted odds ratio = 2.17, 95% confidence interval = 1.59-3.03). Community sensitization increased ANC attendance and IPTp-SP uptake. Adolescents were the most difficult to reach, particularly during the high malaria transmission period. The impact of IPTp-SP will be limited unless this high risk group is protected. Language: English Keywords: BURKINA FASO | RESEARCH REPORT | CASE CONTROL STUDIES | PREGNANT WOMEN | WOMEN IN DEVELOPMENT | COMMUNITY | ANTIMALARIAL DRUGS | PROMOTION | CAMPAIGNS | COMMUNITY HEALTH SERVICES | ANTENATAL CARE | PREVENTIVE MEDICINE | UTILIZATION OF HEALTH CARE | AGE FACTORS | SEASONAL VARIATION | Africa, Western | Africa, Sub Saharan | Africa | Developing Countries | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Economic Development | Economic Factors | Residence Characteristics | Population Distribution | Geographic Factors | Malaria | Parasitic Diseases | Diseases | Marketing | Communication Programs | Communication | Primary Health Care | Health Services | Delivery of Health Care | Health | Maternal Health Services | Maternal-Child Health Services | Medicine | Population Dynamics Document Number: 331127 |
| 15. Title: HIV behavioural surveillance among refugees and surrounding host communities in Uganda, 2006. Author: Harrison KM; Claass J; Spiegel PB; Bamuturaki J; Patterson N; Muyonga M; Tatwebwa L Source: African Journal of AIDS Research. 2009 Apr;8(1):29-41. Abstract: We used a standardised behavioural surveillance survey (BSS), modified to be directly relevant to populations in conflict and post-conflict settings as well as to their surrounding host populations, to survey the populations of a refugee settlement in south-western Uganda and its surrounding area. Two-stage probability sampling was used to conduct 800 interviews in each population. The BSS questionnaire adapted for displaced populations was administered to adults aged 15-59 years. It collected information on HIV knowledge, attitudes and practices; issues before, during and after displacement; level of interaction and sexual exploitation among the refugees and host communities (i.e., nationals). Population parameters were compared and 95% confidence intervals were calculated for core HIV indicators. The demographic characteristics were similar (except for educational achievement), and HIV awareness was very high (>95%) in both populations. The refugees reported more-accepting attitudes towards persons with HIV than did nationals (19% versus 13%; p < 0.01). More refugees than nationals reported ever having had transactional sex (10% versus 6%; p < 0.01), which mostly occurred post-displacement. Five percent of females among both the refugees and nationals reported experiencing forced sex, which mostly occurred post-displacement and after the arrival of refugees, respectively. Nationals reported more frequent travel to refugee settlements than reported by refugees to national villages (22% versus 11%; p < 0.01). The high mobility and frequent interactions of these two populations suggest that integrated HIV programmes should be developed and would be an efficient use of resources. Evidence suggesting that female refugees may be at elevated risk for HIV infection, due to forced sex, transactional sex and other vulnerabilities, warrants further examination through qualitative research. The findings indicate a need for additional, focused HIV-prevention programmes, such as youth education, for both refugees and Ugandan nationals. Language: English Keywords: UGANDA | REFUGEE CAMPS | RESEARCH REPORT | SAMPLING STUDIES | REFUGEES | HIV PREVENTION | AIDS PREVENTION | ATTITUDES | KNOWLEDGE | SEXUAL EXPLOITATION | SEX BEHAVIOR | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Residence Characteristics | Population Distribution | Geographic Factors | Population | Studies | Research Methodology | Migrants | Migration | Population Dynamics | Demographic Factors | HIV Infections | Viral Diseases | Diseases | AIDS | Psychological Factors | Behavior | Sociocultural Factors Document Number: 341285 |
| 16. Peer Reviewed Title: South African teachers' reflections on the impact of culture on their teaching of sexuality and HIV/AIDS. Author: Helleve A; Flisher AJ; Onya H; Mukoma W; Klepp KI Source: Culture, Health and Sexuality. 2009 Feb;11(2):189-204. Abstract: The authors investigated how teachers respond to perceived cultural differences between the local community and the content of their teaching. Data were collected through interviews with teachers who taught students in grades 8 or 9 in public high schools. The teachers expressed differing viewpoints on the rationale for teaching about HIV/AIDS and sexuality. Many teachers saw teaching these topics as a response to declining moral standards, while others suggested that they were teaching issues that parents failed to address. The teachers were more concerned about young people's sexual behavior than about preventing HIV/AIDS. They perceived that cultural contradictions between what was taught and local cultural values were an issue to which they needed to respond, although they differed in terms of how to respond. Some took an adaptive approach to try to avoid conflicts, while others claimed the moral neutrality of their teaching. Teaching about sexuality was perceived to be challenging in terms of language and communication norms. Teaching about HIV/AIDS was perceived as challenging because teachers often needed to convince students about the reality of AIDS. Language: English Keywords: SOUTH AFRICA | RESEARCH REPORT | KAP SURVEYS | TEACHERS | COMMUNITY | CULTURE | SEX EDUCATION | SEXUALITY | HIV TRANSMISSION | HIV PREVENTION | PERCEPTION | MOTIVATION | VALUE ORIENTATION | LANGUAGE | INTERPERSONAL COMMUNICATION | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Surveys | Sampling Studies | Studies | Research Methodology | Education | Residence Characteristics | Population Distribution | Geographic Factors | Population | Sociocultural Factors | Personality | Psychological Factors | Behavior | HIV Infections | Viral Diseases | Diseases | Communication Document Number: 341086 |
| 17. Peer Reviewed Title: Traces of the second demographic transition in four selected countries in Central and Eastern Europe: union formation as a demographic manifestation. Author: Hoem JM; Kostova D; Jasilioniene A; Muresan C Source: European Journal of Population. 2009 Aug;25(3):239-255. Abstract: Using data from the first round of the national Gender and Generations Surveys of Russia, Romania, and Bulgaria, and from a similar survey of Hungary, which were all collected in recent years, we study rates of entry into marital and non-marital unions. We have used elements from the narrative of the Second Demographic Transition (SDT) as a vehicle to give our analysis of the data from the four countries some coherence, and find what can be traces of the SDT in these countries. The details vary by country; in particular, latter-day developments in union formation patterns did not start at the same time in all countries, but in our assessment it began everywhere before communism fell, that is, before the societal transition to a market economy got underway in 1990. Language: English Keywords: RUSSIA | EUROPE | ROMANIA | HUNGARY | BULGARIA | RESEARCH REPORT | DEMOGRAPHIC TRANSITION | DATA ANALYSIS | MARRIAGE | LIVING ARRANGEMENTS | MARRIAGE AGE | Developing Countries | Asia, Northern | Asia | Developed Countries | Europe, Southeastern | Europe, Central | Population Dynamics | Demographic Factors | Population | Research Methodology | Nuptiality | Residence Characteristics | Population Distribution | Geographic Factors | Marriage Patterns Document Number: 339896 |
| 18. Peer Reviewed Title: HIV-related risk behaviours and the correlates among rickshaw pullers of Kamrangirchar, Dhaka, Bangladesh: a cross-sectional study using probability sampling. Author: Hoque HE; Ono-Kihara M; Zamani S; Ravari SM; Kihara M Source: BMC Public Health. 2009;9:80. Abstract: BACKGROUND: National HIV serological and behavioural surveillance of Bangladesh repeatedly demonstrated a very high proportion of rickshaw pullers in Dhaka city, having sex with female sex workers (FSWs) and using illicit substances. However, no study has been conducted to identify the correlates of having sex with FSWs among this population. This study aimed to describe behavioural profile of rickshaw pullers in Dhaka city using probability samples and to identify the correlates for having sex with FSWs in order to focus HIV prevention intervention. METHODS: Six hundred rickshaw pullers were randomly selected from rickshaw garages in the Kamrangirchar area, the single largest slum cluster of Dhaka, Bangladesh, during March-April 2008 using the Proportion Probability to Size method. Participants were interviewed, with a response rate of 99.2% (n = 595), using a structured questionnaire and asked about illicit substance use, sexual behaviour and risk perception for HIV and sexually transmitted diseases. Independent predictors of having sex with FSWs were analysed by multivariate analysis. A qualitative study was subsequently conducted with 30 rickshaw pullers to supplement the findings of the initial survey. RESULTS: The proportion of survey respondents who had sex with FSWs and those who used illicit substances in the previous 12 months period were 7.9% and 24.9%, respectively, much lower than the results achieved in the 2003-04 behavioural surveillance (72.8% and 89.9%, respectively). Multivariate analysis revealed the characteristics of younger age, being never married, living alone with family remaining in other districts and using illicit substances in the previous 12 months were significantly associated with having sex with FSWs. CONCLUSION: HIV-related risk behaviour of our study population of the rickshaw pullers was lower than what has been suggested by the results of behavioural surveillance. While this discrepancy should be addressed in further studies, our study emphasizes the importance of focused HIV prevention programs for rickshaw pullers as high-risk behaviour is displayed at an unacceptable level and concentrated in identifiable sub-populations. Language: English Keywords: BANGLADESH | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | LABOR FORCE | SLUMS | SEX BEHAVIOR | SAMPLING ERRORS | Developing Countries | Asia, Southern | Asia | Research Methodology | Human Resources | Economic Factors | Urbanization | Urban Population Distribution | Population Distribution | Geographic Factors | Population | Behavior | Error Sources | Measurement Document Number: 341351 |
| 19. Peer Reviewed Title: Stopping HIV/AIDS - can China succeed? [letter] Author: Horng CT; Agoramoorthy G Source: International Journal of STD and AIDS. 2009 Jan;20(1):72. Abstract: Language: English Keywords: CHINA | RECOMMENDATIONS | EVALUATION | INTERDISCIPLINARY STUDIES | PEER EDUCATORS | CELEBRITIES | HIV PREVENTION | SEXUALLY TRANSMITTED DISEASE PREVENTION | RESIDENTIAL MOBILITY | SEX EDUCATION | MASS MEDIA | BILLBOARDS AND SIGNS | COUNSELING | CAMPAIGNS | Asia, Eastern | Asia | Developing Countries | Studies | Research Methodology | Education | Influentials | Knowledge Sources | Communication | HIV Infections | Viral Diseases | Diseases | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Residence Characteristics | Population Distribution | Geographic Factors | Population | Clinic Activities | Program Activities | Programs | Organization and Administration | Communication Programs Document Number: 330711 |
| 20. Peer Reviewed Title: Fragile, threatened, and still urgently needed: family planning programs in Sub-Saharan Africa. Author: Jacobstein R; Bakamjian L; Pile JM; Wickstrom J Source: Studies in Family Planning. 2009 Jun;40(2):147-154. Abstract: Many family planning (FP) programs in sub-Saharan Africa are fragile; recent performance has fallen off and future performance is challenged. Yet robust and wellfunctioning FP programs are still urgently needed if countries are to meet their health, equity, poverty-alleviation, and economic development goals. In support of these observations, we present data on FP parameters in sub- Saharan Africa overall and in eight of its countries, including Nigeria, the most populous African country; Kenya, a long-time leader in FP in the region; and Uganda, with fertility among the highest in Africa and a population projected to more than triple in the next 40 years to become sub-Saharan Africa's fourth-most-populous country. We also draw upon findings of individual case studies of the contraceptive programs of Ghana (Solo et al. 2005c), Malawi (Solo et al. 2005a), Senegal (Wickstrom et al. 2006), Tanzania (Pile and Simbakalia 2006), and Zambia (Solo et al. 2005b), as well as a synthesis of some of these case studies (ACQUIRE Project 2005). All eight of these countries, which together comprise 40 percent of the population of sub-Saharan Africa, are facing the same difficult dynamics in terms of threat and need. Language: English Keywords: AFRICA, SUB SAHARAN | CRITIQUE | DEMOGRAPHIC AND HEALTH SURVEYS | FAMILY PLANNING PROGRAMS | NEEDS | CONTRACEPTIVE USAGE | TOTAL FERTILITY RATE | FERTILITY PREFERENCES | DECENTRALIZATION | FUNDS | URBANIZATION | POVERTY | FOOD SECURITY | Africa | Developing Countries | Demographic Surveys | Population Dynamics | Demographic Factors | Population | Family Planning | Economic Factors | Contraception | Fertility Rate | Birth Rate | Fertility Measurements | Fertility | Political Factors | Sociocultural Factors | Financial Activities | Urban Population Distribution | Population Distribution | Geographic Factors | Socioeconomic Factors | Food Supply | Natural Resources | Environment Document Number: 341898 |
| 21. Peer Reviewed Title: Exploring health stakeholders' perceptions on moving towards comprehensive primary health care to address childhood malnutrition in Iran: a qualitative study. Author: Javanparast S; Coveney J; Saikia U Source: BMC Health Services Research. 2009;9:36. Abstract: BACKGROUND: Due to the multifaceted aspect of child malnutrition, a comprehensive approach, taking social factors into account, has been frequently recommended in health literature. The Alma-Ata declaration explicitly outlined comprehensive primary health care as an approach that addresses the social, economic and political causes of poor health and nutrition. Iran as a signatory country to the Alma Ata Declaration has established primary health care since 1979 with significant progress on many health indicators during the last three decades. However, the primary health care system is still challenged to reduce inequity in conditions such as child malnutrition which trace back to social factors. This study aimed to explore the perceptions of the Iranian health stakeholders with respect to the Iranian primary health care performance and actions to move towards a comprehensive approach in addressing childhood malnutrition. Health stakeholders are defined as those who affect or can be affected by health system, for example health policy-makers, health providers or health service recipients. METHODS: Stakeholder analysis approach was undertaken using a qualitative research method. Different levels of stakeholders, including health policy-makers, health providers and community members were interviewed as either individuals or focus groups. Qualitative content analysis was used to interpret and compare/contrast the viewpoints of the study participants. RESULTS: The results demonstrated that fundamental differences exist in the perceptions of different health stakeholders in the understanding of comprehensive notion and action. Health policy-makers mainly believed in the need for a secure health management environment and the necessity for a whole of the government approach to enhance collaborative action. Community health workers, on the other hand, indicated that staff motivation, advocacy and involvement are the main challenges need to be addressed. Turning to community stakeholders, greater emphasis has been placed on community capabilities, informal link with other social sectors based on trust and local initiatives. CONCLUSION: This research provided a picture of the differences in the perceptions and values of different stakeholders with respect to primary health care concepts. The study suggests that a top-down approach, which still exists among health policy-makers, is a key obstacle that delays, and possibly worse, undermines the implementation of the comprehensive strategy codified by the Alma-Ata Declaration. A need to revitalize primary health care to use its full potential and to combine top-down and bottom-up approaches by narrowing the gap between perceptions of policy makers and those who provide and receive health-related services is crucial. Language: English Keywords: IRAN | RESEARCH REPORT | KAP SURVEYS | COMPARATIVE STUDIES | CHILDREN | POLICYMAKERS | COMMUNITY | COMMUNITY WORKERS | HEALTH PERSONNEL | PRIMARY HEALTH CARE | CHILD NUTRITION | MALNUTRITION | PERCEPTION | HEALTH POLICY | COMMUNITY HEALTH SERVICES | Middle East | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Administrative Personnel | Organization and Administration | Residence Characteristics | Population Distribution | Geographic Factors | Delivery of Health Care | Health | Health Services | Nutrition | Nutrition Disorders | Diseases | Psychological Factors | Behavior | Policy | Political Factors | Sociocultural Factors Document Number: 331083 |
| 22. Peer Reviewed Title: On population growth near protected areas. Author: Joppa LN; Loarie SR; Pimm SL Source: PLoS One. 2009;4(1):e4279. Abstract: BACKGROUND: Protected areas are the first, and often only, line of defense in efforts to conserve biodiversity. They might be detrimental or beneficial to rural communities depending on how they alter economic opportunities and access to natural resources. As such, protected areas may attract or repel human settlement. Disproportionate increases in population growth near protected area boundaries may threaten their ability to conserve biodiversity. METHODOLOGY/PRINCIPAL FINDINGS: Using decadal population datasets, we analyze population growth across 45 countries and 304 protected areas. We find no evidence for population growth near protected areas to be greater than growth of rural areas in the same country. Furthermore, we argue that what growth does occur near protected areas likely results from a general expansion of nearby population centers. CONCLUSIONS/SIGNIFICANCE: Our results contradict those from a recent study by Wittemyer et al., who claim overwhelming evidence for increased human population growth near protected areas. To understand the disagreement, we re-analyzed the protected areas in Wittemyer et al.'s paper. Their results are simply artifacts of mixing two incompatible datasets. Protected areas may experience unusual population pressures near their edges; indeed, individual case studies provide examples. There is no evidence, however, of a general pattern of disproportionate population growth near protected areas. Language: English Keywords: GLOBAL | RESEARCH REPORT | POPULATION GROWTH | ENVIRONMENTAL PROTECTION | NATURAL RESOURCES | URBANIZATION | Population Dynamics | Demographic Factors | Population | Environment | Urban Population Distribution | Population Distribution | Geographic Factors Document Number: 331218 |
| 23. Title: Sexual violence against women and children in Chinese societies. Author: Ko Ling Chan Source: Trauma, Violence and Abuse. 2009 Jan;10(1):69-85. Abstract: This article provides a comprehensive overview of the reported patterns of sexual violence against women and children in China. It reviews the prevalence of and risk factors for various types of sexual violence and discusses community knowledge and perceptions of these violent acts. It also critically examines three major problems of sexual violence research in China. First, the diversity of findings and study methods reported by surveys and criminal reports reflects the problems in obtaining accurate figures on the scope of the problem. Second, precautions must be taken in reading studies on Chinese culture-specific risk factors for domestic violence. Third, the study of culture-specific factors should not focus solely on cultural factors in a vacuum but rather, should examine traditional culture in the context of modern societies and consensus international standards of human rights. Recommendations for future research are also discussed. Language: English Keywords: CHINA | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | KAP SURVEYS | WOMEN IN DEVELOPMENT | CHILDREN | COMMUNITY | CHILD ABUSE | SEXUAL ABUSE | VIOLENCE AGAINST WOMEN | PREVALENCE | RISK FACTORS | RAPE | DOMESTIC VIOLENCE | KNOWLEDGE | PERCEPTION | Asia, Eastern | Asia | Developing Countries | Research Methodology | Surveys | Sampling Studies | Studies | Economic Development | Economic Factors | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Residence Characteristics | Population Distribution | Geographic Factors | Crime | Social Problems | Sociocultural Factors | Measurement | Biology | Psychological Factors | Behavior Document Number: 330270 |
| 24. Peer Reviewed Title: Relationship between intestinal parasitic infection in children and soil contamination in an urban slum. Author: Korkes F; Kumagai FU; Belfort RN; Szejnfeld D; Abud TG; Kleinman A; Florez GM; Szejnfeld T; Chieffi PP Source: Journal of Tropical Pediatrics. 2009 Feb;55(1):42-5. Abstract: PURPOSE: Urban slums are well known for their high infant mortality and morbidity rates, and parasitic infections seem to be a common problem among these children. The aim of the present study was to determine protozoa and nematodes prevalence among children of a selected community located in Sao Paulo, Brazil, and access the relation between soil and children infection. METHODS: Soil contamination samples from 15 strategic locations in the slum area as well as stool samples (examined for protozoa and nematodes through five different methods) from 120 children aged 2-14 years (49% M: 51% F, mean +/- SD = 7.9 +/- 3.8 years) were assessed in a cross-sectional study. Children's domicile locations were determined, and a comparative analysis was undertaken to correlate children and soil infection. RESULTS: Overall infection rate was 30.8% (n = 37), without difference between genders. The most frequent intestinal protozoa were Endolimax nana (20.8%), Entamoeba coli (15.8%) and Giardia lamblia (16.7%). Frequencies of Ascaris lumbricoides and Enterobius vermicularis in stool samples were 2.5 and 1.7%, respectively. No cases of hookworms, Schistosoma mansoni or Tricuris trichiura were identified. Polyparasitism occurred in 10.8% of the children, while 69.2% were free of parasitic infections. Out of the 15 soil samples analyzed, Ascaris sp. eggs were found in 20% and hookworm eggs in 6.7%. CONCLUSION: Helminth infection is not as prevalent as previously reported in urban slums in Sao Paulo, neither as clinical disease nor in soil samples. Protozoa intestinal infection, however, is still frequent in some marginalized populations in Sao Paulo. Improvement in living standards, mostly sanitation might decrease the prevalence of these diseases. Language: English Keywords: BRAZIL | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | CROSS SECTIONAL ANALYSIS | CHILDREN | SLUMS | PREVALENCE | SOIL QUALITY | ENVIRONMENTAL POLLUTION | PARASITIC DISEASES | GASTROINTESTINAL EFFECTS | SCHISTOSOMIASIS | Developing Countries | South America, Eastern | South America | Latin America | Americas | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Urbanization | Urban Population Distribution | Population Distribution | Geographic Factors | Measurement | Environment | Environmental Degradation | Diseases | Physiology | Biology Document Number: 330412 |
| 25. Peer Reviewed Title: High fertility in city suburbs: compositional or contextual effects? La fecondite elevee dans les banlieues urbaines: effets de composition ou de contexte? Author: Kulu H; Boyle PJ Source: European Journal of Population. 2009 May;25(2):157-174. Abstract: Fertility rates are known to be higher in city suburbs. One interpretation is that the suburban 'context' influences the behaviour of individuals who reside there while an alternative is that the 'composition' of the suburban population explains the higher fertility levels. Furthermore, suburban in-migrants who intend to have children may have a significant influence on suburban fertility rates. Using Finnish longitudinal register data we show that fertility rates are higher in the suburbs and rural areas and lower in the cities. Fertility variation across these residential contexts decreases significantly after controlling for women's demographic and socio-economic characteristics. However, it does not disappear entirely suggesting that the local context may have some influence on fertility. While movers to suburbs do display higher fertility levels than non-migrant residents, their overall impact is not great because they form a small share of the suburban population. Language: English Keywords: FINLAND | RESEARCH REPORT | EVENT HISTORY ANALYSIS | WOMEN | REPRODUCTIVE BEHAVIOR | FERTILITY DETERMINANTS | GEOGRAPHIC FACTORS | SOCIOECONOMIC STATUS | INTERNAL MIGRATION | RESIDENTIAL MOBILITY | RESIDENTIAL SELECTION | Developed Countries | Europe, Northern | Europe | Demographic Analysis | Research Methodology | Demographic Factors | Population | Fertility | Population Dynamics | Socioeconomic Factors | Economic Factors | Migration | Residence Characteristics | Population Distribution Document Number: 340173 |
| 26. Peer Reviewed Title: HIV/AIDS and the health of older people in the slums of Nairobi, Kenya: results from a cross sectional survey. Author: Kyobutungi C; Ezeh AC; Zulu E; Falkingham J Source: BMC Public Health. 2009 May 27;9(1):153. Abstract: ABSTRACT: BACKGROUND: The proportion of older people is increasing worldwide. Globally, it is estimated that older people (those 60 years or older) constitute more than 11% of the population. As the HIV/AIDS pandemic rages in sub-Saharan Africa (SSA), its impact on older people needs closer attention given the increased economic and social roles older people have taken on as a result of increased mortality among adults in the productive age groups. Few studies have looked at older people and their health in SSA or indeed the impact of HIV/AIDS on their health. This study aims to assess the effect of being directly or indirectly affected by HIV/AIDS on the health of older people in two Nairobi slums. METHODS: Data were collected from residents of the Nairobi Urban Health and Demographic Surveillance area, who on 1st October 2006, were 50 years and older. Health status was assessed using the short SAGE (Study on Global AGEing and Adult Health) form and two outcome measures - self-rated health and a composite health score - were generated. To assess HIV/AIDS affected status, respondents were asked: Have you personally been affected by HIV/AIDS? If yes, a follow up question: "How have you been personally affected by HIV/AIDS?" was asked. Ordinal logistic regression was used in models with self-rated health and linear regression in models with the health score. RESULTS: About 18% of respondents reported being affected by HIV/AIDS in at least one way, although less than 1% reported being infected with HIV. Nearly 60% of respondents reported being in good health, 27% in fair health and 14% in poor health. The overall mean health score was 70.6 (SD: 13.9). Females reported worse health outcomes than males. Respondents directly or indirectly affected by HIV/AIDS reported worse health outcomes than those not affected: mean health score: 68.5 and 71.1 respectively (t=3.21), and an adjusted odds ratio of reporting "poor health" of 1.42 (95%CI: 1.12-1.80). CONCLUSION: Poor health outcomes among older people affected by HIV/AIDS highlight the need for policies that target them in the fight against HIV/AIDS if they are to play their envisaged care giving and other traditional roles. Language: English Keywords: KENYA | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | STATISTICAL REGRESSION | KAP SURVEYS | HEALTH SURVEYS | OLDER ADULTS | SLUMS | PERSONS LIVING WITH HIV/AIDS | HEALTH STATUS INDEXES | SEX FACTORS | SELF-PERCEPTION | AIDS | HIV INFECTIONS | HEALTH POLICY | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Data Analysis | Surveys | Sampling Studies | Studies | Health | Adults | Age Factors | Population Characteristics | Demographic Factors | Population | Urbanization | Urban Population Distribution | Population Distribution | Geographic Factors | Viral Diseases | Diseases | Perception | Psychological Factors | Behavior | Policy | Political Factors | Sociocultural Factors Document Number: 341484 |
| 27. Peer Reviewed Title: Emerging discourse: Islamic teaching in HIV prevention in Kenya. Author: Maulana AO; Krumeich A; Van Den Borne B Source: Culture, Health and Sexuality. 2009 May 12;:1. Abstract: Islamic values portraying sex outside of marriage as sinful are often believed to contribute to HIV transmission as they reject safe-sex practices. Moreover, stigma associated with sinful behaviour is frequently assumed to interfere with access to care for those infected. In contrast, adherence to religious values such as abstinence is viewed as an explanation for the relatively low incidence of HIV infection in Islamic populations. Inspired by this debate, a study was conducted into the possibilities of using Islamic texts as a starting point for health promotion addressing HIV infection and HIV/AIDS-related stigma in Lamu, a Muslim community in Kenya. The study also explored the potential role of Lamu's Islamic leaders in the delivery of that health promotion. In collaboration with Islamic leaders, texts were identified that applied to sexual conduct, health, stigma and the responsibilities of Islamic leaders towards their congregations. In spite of the association of HIV with improper sexual behaviour, Islamic texts offer a starting point for tackling HIV transmission and HIV/AIDS-related stigma. Under particular conditions, the identified Islamic texts may even justify the promotion of safer-sex methods, including condom use. Language: English Keywords: KENYA | RESEARCH REPORT | EVALUATION | COMMUNITY | HIV PREVENTION | ISLAM | EXTRAMARITAL SEX BEHAVIOR | STIGMA | UTILIZATION OF HEALTH CARE | VALUE ORIENTATION | ABSTINENCE | LEADERSHIP | SEX BEHAVIOR | RISK BEHAVIOR | SAFER SEX | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Residence Characteristics | Population Distribution | Geographic Factors | Population | HIV Infections | Viral Diseases | Diseases | Religion | Sociocultural Factors | Behavior | Social Problems | Health Services | Delivery of Health Care | Health | Psychological Factors | Family Planning, Behavioral Methods | Family Planning | Organization and Administration Document Number: 341496 |
| 28. Title: Concurrent sexual partnerships and HIV infection: Evidence from national population-based surveys. Author: Mishra V; Bignami-Van Assche S Source: Calverton, Maryland, Macro International, Demographic and Health Research Division, MEASURE DHS, 2009 Mar. 129 p. (DHS Working Papers No. 62USAID Contract No. CPO-C-00-03-00002-00) Abstract: Knowing the prevalence and correlates of multiple and concurrent sexual partnerships is important for understanding the dynamics of HIV transmission, and thus for developing effective prevention interventions. Although at least a few theoretical models of multiple and concurrent partnerships have been developed, there is little agreement about how to derive empirical measures and how to assess the relationship of multiple and concurrent sexual partnerships with HIV infection. This study takes advantage of self-reported data on sexual partnerships and biomarker data on HIV serostatus that have been collected in recent years from adult women and men (age 15-49) by nationally representative Demographic and Health Surveys (DHS) and AIDS Indicator Surveys (AIS). Using information on up to three of the respondents' most recent sexual partners, we evaluate and compare the prevalence of concurrent sexual partnerships across countries-defining concurrent partnerships as having two or more sexual partners that overlapped in time in the year preceding the survey. We also examine key characteristics of respondents reporting concurrent partnerships in pooled samples for sub-Saharan Africa, and we evaluate the association between concurrency and HIV serostatus at the individual level, after controlling for educational level, wealth status, condom use, male circumcision, and other factors. Finally, we assess the relationship between prevalence of concurrency and HIV prevalence at the community and country levels. We find that men are much more likely than women to have concurrent partners. Our analysis also shows that many reported multiple partnerships in the 12 months preceding the survey interview were not concurrent ones. Finally, very few men had overlapping partners for one year or longer. In the pooled samples for sub-Saharan Africa, we find that urban, more-educated, and wealthier women and men are more likely to have concurrent partnerships than their rural, less-educated, and poorer counterparts. Circumcised men are also more likely to have concurrent partners than uncircumcised men. Those who had concurrent partners are more likely to report using condoms than those who did not have concurrent partners; yet only one-fifth of women and less than one-tenth of men with concurrent partners reported using condoms at last sex. In most countries, at the individual level women and men who had concurrent sexual partners in the previous 12 months were more likely to be HIV-positive than those who had only one lifetime partner, or those who had multiple lifetime partners but no overlapping partners in the previous 12 months. Yet the duration of overlap in concurrent sexual relationships does not seem correlated with the likelihood of HIV infection. At the individual level, in the pooled samples for sub-Saharan Africa, a positive and significant relationship between concurrent sexual partnerships and HIV-positive status is observed for both women (aOR=3.32; 95%CI: 2.22-4.97) and men (aOR=2.87; 95%CI: 1.85-4.45), after adjusting for other factors such as educational level, wealth status, urban/rural residence, and condom use. Among men, controlling for male circumcision has virtually no effect on the adjusted association between sexual concurrency and HIV serostatus (aOR=2.85; 95%CI: 1.84-4.42). In multivariate models, associating one's concurrency behavior with his/her HIV serostatus reveals that the likelihood of HIV infection is only slightly greater among individuals with concurrent partnerships in the previous 12 months (aOR=3.32 for women; aOR=2.87 for men) than among those with multiple lifetime partnerships that were not concurrent in the previous 12 months (but could have been previously) (aOR=2.86 for women; aOR=2.63 for men). This is to be expected because having concurrent partners increases the risk of transmitting HIV infection to the partners, not necessarily one's own risk of infection above the risk of having multiple serial partners. One's own risk may be greater only to the extent his/her concurrency behavior is a proxy for partners' concurrency behavior or belonging to a higher-risk sexual network. The prevalence of sexual concurrency does not seem correlated with HIV prevalence at the community level or at the country level, neither among women nor among men. The associations are even weaker when the prevalence of HIV among women is correlated with the prevalence of concurrency among men, and when the prevalence of HIV among men is correlated with the prevalence of concurrency among women. The lack of a relationship between the prevalence of concurrency and HIV prevalence among men at the community level does not seem due to varying prevalence levels of male circumcision. However, at the country level a stronger association between prevalence of concurrency among men and HIV prevalence emerges in countries with lower prevalence of male circumcision. The study identifies a number of measurement issues and data constraints that limited the scope of our analysis and that should be kept in mind when interpreting the findings and planning future studies. Some of the major limitations of the study include the cross-sectional and self-reported nature of the survey data, the lack of data on complete sexual histories, and the lack of data on sexual networks. Some of these data limitations have already been addressed in more recent DHS and AIS surveys by systematically including questions about the number of the respondent's lifetime sexual partners, and about consistent condom use with all partners (up to three) in the previous 12 months. The measurement of concurrency could be further improved by collecting information on the duration of the sexual relationship with each of the respondent's sexual partners in the previous 12 months, including his/her spousal partners, and by collecting information on the frequency of sexual intercourse during each relationship. Despite the limitations inherent to the measurement of concurrency using self-reported data from cross-sectional population-based surveys, the findings of this study shed new light on the prevalence and correlates of concurrency, as well as on the association between concurrency and HIV. Language: English Keywords: AFRICA, SUB SAHARAN | RESEARCH REPORT | KAP SURVEYS | DEMOGRAPHIC AND HEALTH SURVEYS | EPIDEMIOLOGIC METHODS | MULTIPLE PARTNERS | PERSONS LIVING WITH HIV/AIDS | COMMUNITY | HIV INFECTIONS | PREVALENCE | POLYGAMY | TIME FACTORS | CONDOM USE | Africa | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Demographic Surveys | Population Dynamics | Demographic Factors | Population | Sexual Partners | Sex Behavior | Behavior | Viral Diseases | Diseases | Residence Characteristics | Population Distribution | Geographic Factors | Measurement | Marriage Patterns | Marriage | Nuptiality | Risk Reduction Behavior Document Number: 341092 |
| 29. Peer Reviewed Title: Attribution of malnutrition to cause-specific diarrheal illness: evidence from a prospective study of preschool children in Mirpur, Dhaka, Bangladesh. Author: Mondal D; Haque R; Sack RB; Kirkpatrick BD; Petri WA Jr Source: American Journal of Tropical Medicine and Hygiene. 2009 May;80(5):824-6. Abstract: We examined whether malnutrition (underweight [WAZ] < -2) increased the risk of diarrhea equally for all enteropathogens. The study was conducted prospectively between January 1999 and July 2002 in Mirpur, an urban slum in Dhaka. Two hundred eighty-nine Bangladeshi children (147 male and 142 female) 2-5 years of age were included in the study. Malnutrition was present in 39% of the children at the time of enrollment. The parents and children were visited and interviewed every other day by health care workers for details about any diarrheal episodes. Stool samples were successfully collected from 62% of episodes of diarrhea. Of the identified enteropathogens, only enterotoxigenic Escherichia coli (ETEC), Cryptosporidium sp., and Entamoeba histolytica were significantly more prevalent in malnourished children. We concluded that the malnutrition attributed risk is not equal for enteric pathogens associated with diarrheal illness. Language: English Keywords: BANGLADESH | RESEARCH REPORT | PROSPECTIVE STUDIES | URBAN POPULATION | SLUMS | CHILDREN | DIARRHEA | |