Reproductive Health Matters back issues from November 2008:
Reproductive cancers: high burden of disease, low level of priority.(EDITORIAL)(Editorial)
Nov 01, 2008; ... IT has taken this journal 16 years to focus on reproductive cancers, and there is no excuse for that. There are many others in the field who have equally inexcusably neglected this important health issue for many years in developing countries, where morbidity and mortality are high and ...
Cervical cancer: the route from signs and symptoms to treatment in South Africa.(Clinical report)
Nov 01, 2008; ... Abstract: In South Africa, in 2005-06, 100% of primary health care clinics in South Africa had health professionals trained to conduct Pap smears, yet the screening rate was only 1.3% and one in 26 women develop cervical cancer during their lifetime. Many women admitted to oncology wards ...
Prevention of cervical cancer.(Clinical report)
Nov 01, 2008; ... Abstract: This article reviews the burden of cervical cancer in South Africa and shows that it remains the most common cancer among South African women, particularly women with least access to cervical cancer screening. It explains the rationale behind the South African cervical cancer ...
Achieving effective cervical screening coverage in South Africa through human resources and health systems development.(Clinical report)
Nov 01, 2008; ... Abstract: South Africa's cervical screening policy recommends three free Pap smears at ten-year intervals for all women over 30 years of age, aiming to achieve 70% coverage by 2010 by targeting the age group most at risk of developing pre-cancerous cervical lesions. Attaining wide coverage ...
Cervical cancer: the sub-Saharan African perspective.(Clinical report)
Nov 01, 2008; ... Abstract: Cervical cancer is the second most common cancer in women worldwide and the leading cause of cancer deaths in developing countries. While incidence and mortality rates of cervical cancer have fallen significantly in developed countries, 83% of all new cases that occur annually ...
Social inequality in Pap smear coverage: identifying under-users of cervical cancer screening in Argentina.(Survey)(Clinical report)
Nov 01, 2008; ... Abstract: In Argentina, the unequal distribution of the burden of cervical cancer is striking: the mortality rate of the province of Jujuy (15/100,000) is almost four times higher than that of the city of Buenos Aires (4/100,000). We aimed to establish the socio-demographic profile of ...
A Pan American Health Organization strategy for cervical cancer prevention and control in Latin America and the Caribbean.
Nov 01, 2008; ... Abstract: Cervical cancer is the leading cause of cancer deaths among women in Latin America and the Caribbean, and disproportionately affects poorer women. Mortality rates in the region are seven times greater than in North America. In light of the significant public health burden, the ...
Cervical cancer screening using visual inspection with acetic acid: operational experiences from Ghana and Thailand.(Clinical report)
Nov 01, 2008; ... Abstract: Thailand in 2000 and Ghana in 2001 initiated cervical cancer prevention programmes using a single-visit approach with visual inspection with acetic acid (VIA) with cryotherapy for pre-cancerous lesions. This service was integrated into existing reproductive health services, ...
Development of a visual inspection programme for cervical cancer prevention in Bangladesh.(Clinical report)
Nov 01, 2008; ... Abstract: Cervical cancer is the most common reproductive cancer in women in Bangladesh, and most women come for diagnosis and treatment when it is too late. To support early detection of pre-cancerous conditions and prevent cervical cancer, Bangladesh undertook a screening programme using ...
Benefits, cost requirements and cost-effectiveness of the HPV16, 18 vaccine for cervical cancer prevention in developing countries: policy implications.(Clinical report)
Nov 01, 2008; ... Abstract: Approximately 70% of eases of cervical cancer worldwide are caused by genotypes 16 and 18 of human papillomavirus (HPV), which is sexually transmitted. With the availability of an effective vaccine against these HPV types, there is real hope for reducing the global burden of ...
Human papillomavirus vaccination in the United Kingdom: what about boys?(Clinical report)
Nov 01, 2008; ... Abstract: In September 2008 the UK Department of Health initiated a human papillomavirus (HPV) immunisation programme for girls aged 12-13 for prevention of cervical cancer, which is most often caused by two HPV types. An important question, yet to be addressed, is whether boys should also ...
Making the case for cervical cancer prevention: what about equity?(Report)
Nov 01, 2008; ... Abstract: Cervical cancer is a major cause of suffering and premature death among women in the developing world, yet it is largely prevented in most higher-income countries. From ah equity perspective, cervical cancer is unequally distributed globally in ways that are unnecessary, ...
Breast cancer in Mexico: a pressing priority.(Report)
Nov 01, 2008; ... Abstract: Breast cancer is a serious threat to the health of women globally, and an unrecognised priority in middle-income countries. This paper presents data from Mexico. It shows that breast cancer accounts for more deaths than cervical cancer since 2006. It is the second cause of death ...
Breast cancer in India and a voluntary organisation in Andhra Pradesh.(LETTER)(Letter to the editor)(Clinical report)
Nov 01, 2008; ... ACCORDING to a study by the International Agency for Research on Cancer, there will be approximately 250,000 new cases of breast cancer in India by 2015. At present, India reports around 100,000 new cases annually. (1) Breast cancer will become an epidemic in India in another 10 years, if ...
The intruder.(breast cancer)
Nov 01, 2008; ... EVERY decade of my adult life has been marked by at least one traumatic event related to my reproductive system. In my 20s I had surgery several times to remove benign fibro-adenomas in my breasts, a consequence of being on the birth control pill, I was told. In my 30s it was the second ...
Experiences of joy and fear.(cancer)
Nov 01, 2008; ... LIFE hit me with its full colours and sounds when I was diagnosed with breast cancer. And the feeling of being alive was so acute, as if it was an entity in itself, like when you are short of breath and breathing becomes a conscious experience. In June 2005 I had a mammogram as ...
I am a woman who lives with breast cancer.(Essay)
Nov 01, 2008; ... I am a woman, and I am a woman who lives with breast cancer, and I am a woman who lives with breast cancer in Mexico. * Being a woman defines much of what I am experiencing, as well as my approach to treatment and the choices I have made. Living the disease in Mexico has allowed me to ...
So far so good.(breast cancer survivor)(Essay)
Nov 01, 2008; ... BECAUSE sexual and reproductive health problems are near-universal experiences, it has always been clear to me that I could expect to go through many of the problems that my work is about. I've used half a dozen brands and types of the contraceptive pill, high- and low-dose, combined and ...
"Losing my chestnut": one gay man's wrangle with prostate cancer.(Essay)
Nov 01, 2008; ... I am a sexuality activist, researcher and theorist, with 35 years of experience working, thinking, writing and debating in sexuality and gender politics, and 25 years of working in HIV/AIDS. I can talk about sex under water! For me, like everyone else the first time--losing my cherry--was ...
Couple-centred testing and counselling for HIV serodiscordant heterosexual couples in sub-Saharan Africa.(Report)
Nov 01, 2008; ... Abstract: In Africa, a large proportion of HIV infections occur within stable relationships, either because of prior infection of one of the partners or because of infidelity. In five African countries at least two-thirds of couples with at least one HIV-positive partner were HIV ...
HIV-positive mothers in Viet Nam: using their status to build support groups and access essential services.(Report)
Nov 01, 2008; ... Abstract: Various support and self-help groups for people living with HIV and their families have developed in Viet Nam in recent years. This paper reports on a case study of Sunflowers, the first support group for HIV positive mothers in Hanoi, begun in 2000, and a sister group begun in ...
Male circumcision for HIV prevention: what about protecting men's partners?(AIDS CONFERENCE PRESENTATION)(Conference notes)
Nov 01, 2008; ... MALE circumcision for HIV prevention has been one of the "hot" topics at the International AIDS Conference in Mexico City this year. I think that's great. Everywhere the subject has been raised, widely differing views have been expressed. It means we can confront all the issues openly in ...
Analysis of socio-political and health practices influencing sex ratio at birth in Viet Nam.(Report)(Brief article)
Nov 01, 2008; ... Abstract: Viet Nam has experienced rapid social change over the last decade, with a remarkable decline in fertility to just below replacement level. The combination of fertility decline, son preference, antenatal sex determination using ultrasound and sex selective abortion are key factors ...
Your faith of mine: a pregnancy spacing intervention in an ultra-orthodox Jewish community in Israel.(Report)
Nov 01, 2008; ... Abstract: Ultra-orthodox (haredi) Jews in Israel have an exceptionally high fertility rate of 7.7. As most fathers spend their days studying the Bible, the women struggle to support their large families under severe economic pressures. Some women experience maternal exhaustion coping with ...
Risk of cancers and the oral contraceptive pill.(ROUND UP: Reproductive cancers)
Nov 01, 2008 ... The safety of the pill could not be known until observations had been made of women who had used the pill for many years. Between 1968 and 1969, 45,590 women in the UK were enrolled in a study and followed up for a mean of 24 years. On balance, no higher risk of cancer was found in pill ...
Ovarian cancer and oral contraceptives.(ROUND UP: Reproductive cancers)(Brief article)
Nov 01, 2008 ... The use of oral contraceptives is known to reduce the incidence of ovarian cancer, but the eventual public-health effect depends on how much the reduced risk persists after oral contraceptive use ceases. To assess this effect, a collaborative group brought together data on over 23,000 ...
Fall in HRT use associated with fall in breast cancer, Australia.(ROUND UP: Reproductive cancers)(hormone replacement therapy)(Brief article)
Nov 01, 2008 ... Results from the Women's Health Initiative in 2002, showing that the use of hormone replacement therapy (HRT) was associated with an increased risk of breast cancer, led to a rapid drop in HRT use. In the USA, an 11% reduction in breast cancer incidence between 2001 and 2004 was largely ...
Environmental risk of breast cancer, diverse beliefs and evidence.(ROUND UP: Reproductive cancers)
Nov 01, 2008 ... There is a significant degree of disagreement between various stakeholders about breast cancer causation, and a lack of effective dialogue among them. This paper reports on a project which explored the different standpoints taken up by various players, and actively intervened to create ...
Three-dimensional technique boosts breast cancer identification.(ROUND UP: Reproductive cancers)(Brief article)
Nov 01, 2008 ... Stereomammography, a new technique for detecting breast cancer which allows doctors to view breast tissue in three dimensions, missed 40% fewer cases of the disease, and resulted in half as many false positives, according to preliminary results of a US trial. 1,093 women with an increased ...
Human papillomavirus detection by penile site in young men, Kenya.(ROUND UP: Reproductive cancers)(Clinical report)
Nov 01, 2008 ... As part of a randomised clinical trial, 98 young, HIV-negative, uncircumcised men in Kisumu, Kenya, provided penile exfoliated cells from three anatomical sites. Penile HPV prevalence varied by site: 50% in the glans, coronal sulcus and inner foreskin tissue; 43% on the shaft and external ...
HPV testing for primary cervical cancer screening.(ROUND UP: Reproductive cancers)
Nov 01, 2008 ... The Dutch POBASCAM trial aimed to determine whether the effectiveness of cervical screening improves when HPV DNA testing is added to cytological testing. 17,000 women participating in a regular cervical screening programme in the Netherlands were randomly assigned to combined cytological ...
Human papillomavirus (HPV) vaccination, UK.(ROUND UP: Reproductive cancers)(Brief article)(Clinical report)
Nov 01, 2008 ... A prospective cohort study involving 2,817 school-gifts from 36 secondary schools in Manchester, UK assessed the feasibility and acceptability of delivering the HPV vaccine. Parents were sent information, consent forms and reminders. 20.3% of parents did not reply to the invitation letter, ...
Anal cytology screening for lesions among HIV-positive patients.(ROUND UP: Reproductive cancers)(Brief article)(Clinical report)
Nov 01, 2008 ... Anal carcinoma is relatively rare although its incidence is increasing, particularly among HIV-positive men who have sex with men. Anal carcinoma shares many similarities with cervical cancer, and based on the cervical cancer screening programme, many experts have suggested that routine ...
Cervical intraepithelial neoplasia and higher long-term risk of cancer.(ROUND UP: Reproductive cancers)(Brief article)(Clinical report)
Nov 01, 2008 ... In some countries, such as the UK, women have long-term intensive surveillance after conservative treatment for cervical intraepithelial neoplasia grade three (CIN III), whereas in others, such as the Netherlands and Finland, they return to regular screening after a few years. New evidence ...
Adverse pregnancy outcomes after cervical intraepithelial neoplasia treatment.(ROUND UP: Reproductive cancers)(Clinical report)
Nov 01, 2008 ... Premalignant lesions of cervical cancer detected by screening are often treated by excision or ablation. Excisional techniques include cold knife conisation, laser conisation, and large loop excision of the transformation zone. Commonly used ablative techniques include laser ablation and ...
Fertility preservation in cancer patients and physician--patient communication.(ROUND UP: Reproductive cancers)(Clinical report)
Nov 01, 2008 ... With cancer survival rates increasing, the new focus is on survivorship and quality of life. Infertility is an expected consequence following treatment of most cancers, with sustained infertility developing in 50-95% of cancer survivors. Although medical options for fertility preservation ...
Health insurance and cervical cancer screening in Latin America and Caribbean.(ROUND UP: Reproductive cancers)(Report)(Brief article)
Nov 01, 2008 ... A cross-sectional study of 6,357 women aged over 60 from seven cities used data from the Health, Well-Being and Aging in Latin America and the Caribbean Study. Prevalence of Pap smear during the previous two years ranged from 21% in Bridgetown to 45% in Mexico City. Excluding Havana which ...
HIV treatment as prevention.(ROUND UP: HIV/AIDS and International AIDS Conference 2008)(Conference notes)
Nov 01, 2008 ... The use of HIV treatment as prevention was one of the main topics discussed at the International AIDS Conference. Because HIV treatment lowers viral load, often to undetectable levels, the risk of HIV transmission is greatly reduced. In early 2008, Swiss researchers issued a statement that ...
State of the epidemic and the response 2008.(ROUND UP: HIV/AIDS and International AIDS Conference 2008)(Report)(Brief article)
Nov 01, 2008 ... A million more people were on antiretroviral therapy (ART) by the end of 2007 than a year before, most of them in Africa. In 2007, 33% of pregnant HIV-positive women received PMTCT drugs--up from 10% in 2004. The numbers of children receiving ART increased from 75,000 in 2005 to almost ...
Criminalisation of HIV exposure or transmission is bad public policy.(ROUND UP: HIV/AIDS and International AIDS Conference 2008)(Report)(Brief article)
Nov 01, 2008 ... Recent years have seen increased prosecutions for HIV exposure or transmission, particularly in Europe and North America. In parts of Africa, Asia, Latin America and the Caribbean, legislators have created new HIV-specific criminal offences and prosecutions are rising. The push to apply ...
Declaration on sex education in Latin America and Caribbean.(ROUND UP: HIV/AIDS and International AIDS Conference 2008)(Report)(Brief article)
Nov 01, 2008 ... At the first meeting of health and education ministers to stop HIV in Latin America and the Caribbean, the "Prevention with Education" declaration was signed by representatives of 29 Latin American countries. Prior to the AIDS conference, where the declaration was made public, at drafting ...
Latin American countries launch programmes to improve health care for sexual minorities.(ROUND UP: HIV/AIDS and International AIDS Conference 2008)(Report)(Brief article)
Nov 01, 2008 ... Several Latin American countries launched new programmes in late 2007 and early 2008 to improve health care for sexual minorities, including homosexuals and transsexuals. Programmes focus on reducing stigma and discrimination and are part of larger efforts to boost HIV prevention and ...
Uganda tests pill to prevent HIV infection.(ROUND UP: HIV/AIDS and International AIDS Conference 2008)(Brief article)
Nov 01, 2008 ... An antiretroviral drug taken in a single pill before unprotected sex to reduce HIV transmission will be tested by 3,900 discordant couples having unprotected sex in a Phase III trial in Uganda soon. The plan is to follow ...
Keeping Kenyan girls in school lowers future HIV levels.(ROUND UP: HIV/AIDS and International AIDS Conference 2008)(Report)(Brief article)
Nov 01, 2008 ... Up to 13,000 Kenyan girls drop out of school every year due to pregnancy, and around 17% of gifts have sex before age 15. The 2004 Demographic and Health Survey found that better educated girls were less likely to marry early, more likely to practise family planning, less likely to ...
Predicting cervical smear abnormalities in HIV-positive women, Thailand.(ROUND UP: HIV/AIDS and International AIDS Conference 2008)(Report)(Brief article)
Nov 01, 2008 ... With HIV-positive women living longer, it is important to identify those at risk for abnormal Pap smears who might benefit from early treatment. A cross-sectional study of 385 HIV-positive women in Bangkok found that the only significant predictors of Pap smear abnormalities were a CD4+ ...
One-stop reproductive health clinic for HIV positive women, UK.(ROUND UP: HIV/AIDS and International AIDS Conference 2008)(Report)(Brief article)
Nov 01, 2008 ... HIV-positive women may be reluctant to attend gynaecology or family planning clinics for fear of divulging their condition. A specialist clinic was opened within an HIV clinic in London. Retrospective case-notes of 197 new patients were reviewed. Patients were aged 14-52, the majority ...
Breastfeeding, antiretroviral prophylaxis and HIV.(ROUND UP: HIV/AIDS and International AIDS Conference 2008)(Report)(Brief article)
Nov 01, 2008 ... Kuhn and colleagues found no significant difference in HIV-free survival in Zambia at 24 months between children whose mothers were encouraged to do abrupt weaning at four months and those encouraged to continue breastfeeding for as long as they liked. The authors conclude that early, ...
HIV screening during labour is feasible but is it acceptable?(ROUND UP: HIV/AIDS and International AIDS Conference 2008)(Brief article)
Nov 01, 2008 ... Testing pregnant women for HIV at the time of labour and delivery is the last opportunity for prevention of mother-to-child transmission (PMTCT), particularly in settings such as India where many women present for delivery without prior antenatal care. Researchers investigated the impact ...
Traditional Xhosa male circumcision in South Africa.(ROUND UP: HIV/AIDS and International AIDS Conference 2008)(Report)(Brief article)
Nov 01, 2008 ... Ritual male circumcision is a secretive and sacred rite practised by the Xhosa of South Africa. Recently, the alarming rate of death and injury among initiates has led to media attention and government regulation. In both years 2007 and 2008, five boys died while attending initiation ...
Costing the scale-up of adult male circumcision, Mozambique.(ROUND UP: HIV/AIDS and International AIDS Conference 2008)(Report)(Brief article)
Nov 01, 2008 ... This article estimates the cost in terms of public finance and human resources of a rapid scale-up in Mozambique of adult male circumcision, a country with a low male circumcision rate and high HIV prevalence. There are three principal findings. First, even the most modest programme would ...
Male circumcision and human papillomavirus risk.(ROUND UP: HIV/AIDS and International AIDS Conference 2008)(Report)(Brief article)
Nov 01, 2008 ... Male circumcision was an important topic at the conference. Dirk Taljaard, an investigator in the South African randomised controlled trial in Orange Farm, presented a substudy of the effect of circumcision on three STIs--gonorrhoea, trichomoniasis and human papillomavirus (HPV). Men were ...
Does circumcision protect gay men against HIV?(ROUND UP: HIV/AIDS and International AIDS Conference 2008)(Report)(Brief article)
Nov 01, 2008 ... Randomised controlled trials and meta-analyses have demonstrated that male circumcision reduces men's risk of contracting HIV during heterosexual intercourse but less is known about its protective effect among men who have sex with men (MSM). 15 studies were included in this meta-analysis, ...
Men who have sex with men and HIV.(ROUND UP: HIV/AIDS and International AIDS Conference 2008)(Clinical report)
Nov 01, 2008 ... A presentation outlined the epidemiology, response and human rights issues in the context of HIV among men who have sex with men (MSM). The same results are seen in every HIV prevalence study among MSM, with rates much higher than the general population. A systematic review carried out in ...
Condom vending machines in Brazzaville, Congo.(ROUND UP: Condoms)(Brief article)
Nov 01, 2008 ... The availability of condoms in the Republic of Congo has increased due to strategically placed vending machines selling three-packs of Ami 3 condoms for 100 CFA francs (US$0.28). Condom dispensers are now found in most of Congo's busiest towns as a result of an initiative by the National ...
Tackling low condom use in Swaziland.(ROUND UP: Condoms)(Brief article)
Nov 01, 2008 ... An initiative led by the National Emergency Council on HIV/AIDS is getting Swazi men to open up about their condom use (or lack thereof) and attitudes towards sexual health. In 2007 Swaziland's HIV prevalence was 26% among the sexually active, and nearly half of survey participants ...
Violence and condom failure among female sex workers in China.(ROUND UP: Condoms)(Brief article)
Nov 01, 2008 ... The vulnerability of female sex workers to STIs suggests the importance of examining sexual risk behaviour. Through face-to-face questionnaires, this research examined factors associated with condom slippage or breakage among 200 female sex workers in a city in south-western China with a ...
Condom breakage among African-American men.(ROUND UP: Condoms)(Brief article)
Nov 01, 2008 ... African-American men are at high risk of HIV acquisition. Condom breakage is an understudied aspect of their sexual protective behaviour. This study identified user errors leading to condom breakage among 264 young, African-American men newly diagnosed with an STI at an STI clinic in a ...
Condoms catching on in Sao Tome and Principe.(ROUND UP: Condoms)(Brief article)
Nov 01, 2008 ... With funding from the UN Population Fund and the Global Fund to Fight AIDS, Tuberculosis and Malaria, small wooden boxes containing 144 condoms each are now placed in highly visible locations such as restaurants, night clubs and stores on Sao Tome and Principe. Condoms have traditionally ...
Philippines endorses condoms despite church.(ROUND UP: Condoms)(Brief article)
Nov 01, 2008 ... The Philippine Health Department will promote the use of condoms to prevent the spread of HIV despite disapproval from the Roman Catholic church. "The use of condoms to prevent the spread of HIV/AIDS is different from their use for birth control," Health Undersecretary ...
Cappuccino with condom, Ethiopia.(ROUND UP: Condoms)(Brief article)
Nov 01, 2008 ... A newly opened cafe, Bellissima, in Addis Ababa, is linking business with a message. Each order comes with a packet of Sensation condoms and is served in Sensation cups by staff wearing Sensation T-shirts. Bellissima's owner, Hayat Ahmed, 26, is a former beauty queen and has been involved ...
Searching for Dr Condom.(ROUND UP: Condoms)(Brief article)
Nov 01, 2008 ... Little is known about the origins of the condom and the identity of Dr Condom--if such a medic ever existed--has remained sheathed in mystery. Records from Asia document condoms made from oiled paper, animal membrane, tortoiseshell or animal horn, used before the 15th century. The ...
Using census data to study maternal mortality, South Africa.(ROUND UP: Maternal mortality)
Nov 01, 2008 ... The 2001 South African census included a question on deaths in the previous 12 months and questions on external causes and pregnancy-related deaths. A microdata sample from the census permitted researchers to assess maternal mortality. The maternal mortality ratio increased dramatically ...
Free maternity care in Ghana to reduce maternal mortality.(ROUND UP: Maternal mortality)(Brief article)
Nov 01, 2008 ... Ghana's maternal mortality ratio, estimated by WHO to be 560 per 100,000 live births, is one of the lowest in the region but has been declared a national emergency. Only 35% of deliveries are supervised by a skilled birth attendant, partly due to a shortage of doctors and midwives, with ...
Economic disparities widening in Asia-Pacific region.(ROUND UP: Maternal mortality)(Brief article)
Nov 01, 2008 ... The divide between rich and poor is rising within sub-regions of Asia and the Pacific, according to UNICEF's report Asia-Pacific's Children 2008, covering 37 countries. Pakistani boys are more likely to be immunised than girls and have better access to health care, while one in every three ...
Sex crimes by aid workers and combatants under-reported.(ROUND UP: Advocacy)(Report)
Nov 01, 2008 ... Two recent reports highlight the problem of sexual violence in conflict situations, perpetrated not only by combatants but also by aid workers and United Nations peacekeepers. (1) The extent of sexual abuse by aid workers and peacekeepers is under-estimated, the British NG0 Save the ...