Public Health Commons^™

Hiv/Aids Prevention Guidance For Reproductive Health Professionals In Developing-Country Settings, Helen Epstein, Daniel Whelan, Janneke Van De Wijgert, Purnima Mane, Suman Mehta

HIV and AIDS

While the integration of information, technologies, and services to respond to HIV/AIDS may seem closely related, there are a variety of issues that continue to create obstacles to integration. Among these are the stigmatizing nature of HIV infection and AIDS and discrimination faced by those who are infected or perceived to be infected; sexual practices and identities that remain socially unacceptable; gender roles and relations that make it difficult for women and men to access information, services, and technologies on HIV prevention; reluctance to recognize the special needs of young people; and barriers to service delivery created by broader economic, …

The Female Condom: Dynamics Of Use In Urban Zimbabwe, Horizons Program

HIV and AIDS

In July 1997, Population Services International (PSI), at the request of the Zimbabwe National AIDS Coordination Programme, launched a social marketing program for the female condom in Zimbabwe. The campaign's intended audience was women in long-term relationships. To avoid the stigma associated with condoms and the prevention of sexually transmitted infections, PSI marketed the female condom as a family planning product under the brand name Care™. Approximately one year after the start of the female condom social marketing campaign, the Horizons Program and PSI conducted a descriptive, cross-sectional study of female condom users, male condom users, and nonusers of either …

Estimating The Cost And Effectiveness Of Different Sti Management Strategies For Sex Workers In Madagascar, Horizons Program

HIV and AIDS

In Madagascar, the prevalence of sexually transmitted infections (STIs) is a serious public health problem, particularly among sex workers. A Horizons study conducted in 2000 found approximately two-thirds of female sex workers had an STI, although few were infected with HIV. Since the link between STIs and transmission of HIV has been well established, affordable strategies to manage STIs among sex workers need to be developed. Study investigators also assessed STI management practices in health facilities in two urban areas of Madagascar. Health practitioners were using a syndromic approach, which may be appropriate for managing certain STIs in the general …

Meeting The Sexual Health Needs Of Men Who Have Sex With Men In Senegal, Horizons Program

HIV and AIDS

Research conducted in many countries has highlighted the vulnerability of men who have sex with men (MSM) to HIV and other STIs. Yet in Africa, they receive little attention in HIV/AIDS programming and service delivery because of widespread denial and stigmatization of homosexual behavior. In Senegal, a study conducted by researchers from the National AIDS Control Program, Cheikh Anta Diop University, and the Horizons Program has provided valuable information about the needs, behaviors, knowledge, and attitudes of MSM that has important implications for program managers and policymakers working to stem the spread of HIV/AIDS. The researchers used ethnographic and survey …

Satisfaire Les Besoins De Santé Des Hommes Qui Ont Des Rapports Sexuels Avec D'Autres Hommes Au Sénégal, Horizons Program

HIV and AIDS

No abstract provided.

Microfinance And Households Coping With Hiv/Aids In Zimbabwe: An Exploratory Study, Horizons Program

HIV and AIDS

The widespread prevalence of HIV/AIDS in sub-Saharan Africa adversely affects millions of households. In recent years, microfinance has been proposed as a strategy to help the households of microentrepreneurs respond to the negative economic impacts of HIV/AIDS. This attention to the potential role of microfinance builds upon earlier research that shows that microfinance institutions (MFIs) that charge commercial rates of interest and use sound business practices can become operationally self-sustainable and help improve the lives of the poor and vulnerable nonpoor. This type of MFI generally offers small loans, often combined with savings services. An MFI may also offer business …

Designing Hiv/Aids Intervention Studies: An Operations Research Handbook, Andrew A. Fisher, James R. Foreit, John E. Laing, John E. Stoeckel, John Townsend

HIV and AIDS

This handbook has several objectives and uses. First, it is designed to help HIV/AIDS researchers develop and write a detailed operations research proposal. An appropriate use of the handbook is as a resource in workshops or courses on research design and proposal development. Thus, the organization of the handbook follows that of a research proposal, starting with identifying, defining, and justifying a research problem, and ending with how to prepare a budget. Although the handbook is not an academic textbook on research methods, it does provide a review of many key concepts and important methods essential for conducting HIV/AIDS field …

Greater Involvement Of Plha In Ngo Service Delivery: Findings From A Four-Country Study, Horizons Program

HIV and AIDS

At the conclusion of the Paris AIDS Summit in 1994, 42 governments issued a declaration supporting the greater involvement of people living with HIV/AIDS (PLHA) in policy formulation and service delivery. Despite growing recognition of its importance, there has been little research that examines PLHA involvement in the delivery of prevention, care, and support services in developing countries and its effects on PLHA, others affected by HIV/AIDS, and nongovernmental organizations (NGOs). To address this gap, the Horizons Program and the International HIV/AIDS Alliance conducted a study of PLHA involvement in NGOs in Burkina Faso, Ecuador, Maharashtra State, India, and Zambia …

Cost Of Care And Support Services For Plha: Implications For The Financial Sustainability Of Nongovernmental Organizations, Horizons Program

HIV and AIDS

As HIV/AIDS prevalence increases, providers of care and support services will face greater demand for their services. The ability of nongovernmental organizations (NGOs) to help meet this increased demand will be influenced in part by their ability to control the cost of their services while generating sufficient revenue to meet expenses. The Y.R. Gaitonde Centre for AIDS Research and Education (YRG CARE) in Chennai, India, was one of the earliest providers of integrated care and support services in South India and currently serves clients from the four South Indian states. This brief highlights the key findings of a study that …

Allocating Health Care Resources To The Elderly, George P. Smith Ii

Scholarly Articles

Health is not an absolute condition, but is assessed by reference to age and other factors. Therefore, a relative scale is necessary to determine whether an elderly person’s right to health care is being satisfied. Today, older Americans are increasingly affected by the growing need to regulate health care delivery. Since 1900, those over the age of 85 years have become twenty-one times as numerous in society, with an eightfold increase in the number of people over the age of 65. Given the need to curb rising health care costs — particularly the expenses related to caring for older individuals …

Factors Influencing Immunization Status In Primary Care Clinics, David Page, Jan Meires, Amy B. Dailey

Health Sciences Faculty Publications

Background and Objectives: National standards and goals for childhood immunization rates are well established. Yet, despite clear standards and goals, physicians do not achieve the desired rate (90%) for immunization coverage. This study examined factors related to immunization status for 2-year-old children in pediatric and family practice settings.

Methods: Specially trained personnel used computer software to audit 2,552 records from 42 practices in Northeast Florida throughout 1997–1999. Immunization records were judged as either complete or incomplete, and factors related to immunization status were studied. Clinic type and 18 immunization practice standards were reviewed for effect on immunization status.

Results: The …

Participant Blinding And Gastrointestinal Illness In A Randomized, Controlled Trial Of An In-Home Drinking Water Intervention, John M. Colford, Judy R. Rees, Timothy J. Wade, Asheena Khalakdina, Joan F. Hilton, Isaac J. Ergas, Susan Burns, Anne Benker, Catherine Ma, Cliff Bowen, Daniel C. Mills, Duc J. Vugia, Dennis D. Juranek, Deborah A. Levy

Journal Articles: Epidemiology

We conducted a randomized, triple-blinded home drinking water intervention trial to determine if a large study could be undertaken while successfully blinding participants. Households were randomized 50:50 to use externally identical active or sham treatment devices. We measured the effectiveness of blinding of participants by using a published blinding index in which values >0.5 indicate successful blinding. The principal health outcome measured was "highly credible gastrointestinal illness" (HCGI). Participants (n=236) from 77 households were successfully blinded to their treatment assignment. At the end of the study, the blinding index was 0.64 (95% confidence interval 0.51-0.78). There were 103 episodes of …

Satisfaire Aux Besoins De Santé Des Hommes Qui Ont Des Rapports Sexuels Avec D’Autres Hommes Au Sénégal, Cheikh Ibrahima Niang, Moustapha Diagne, Youssoupha Niang, Amadou Moreau, Dominique Gomis, Maye Diouf, Karim Seck, Abdoulaye Sidibe Wade, Placide Tapsoba, Christopher Castle

HIV and AIDS

A study conducted in Dakar, Senegal by researchers from the National AIDS Council, Cheikh Anta Diop University, and the Horizons program obtained information on the needs, behaviors, knowledge, and attitudes of men who have sex with men (MSM). This study offers important insights into the sexuality of MSM, their vulnerability to STI/HIV, and the role of violence and stigma in their lives. The results also highlight the lack of sexual health services and information available to cover the specific needs of MSM. The results of this study were summarized during a meeting held in April 2001 in Dakar and raised …

Jadelle® Levonorgestrel Rod Implants: A Summary Of Scientific Data And Lessons Learned From Programmatic Experience, Irving Sivin, Harold A. Nash, Sandra N. Waldman

Formulation/Product Development

This scientific monograph provides a comprehensive summary of the clinical characteristics of Jadelle levonorgestrel (LNG) rod implants, as observed during clinical trials conducted by the Population Council. The monograph also reviews lessons learned about how to provide Jadelle, based partly on conclusions gleaned from the extensive experience with Norplant, the earlier implant system, and suggests practical ways in which to introduce Jadelle into family planning programs.

Access To Treatment For Hiv/Aids: Report Of A Meeting Of International Experts, Johannes Van Dam, Sherry Hutchinson

HIV and AIDS

As of December 2001, the number of people living with HIV/AIDS is estimated at 40 million, and most live in the developing world. Advances in the development and availability of antiretroviral (ARV) drugs have led to a paradigm shift in most of the industrialized world, where highly active ARV therapy has resulted in a significant reduction in the prevalence of AIDS-related morbidity and mortality. In most of the developing world, however, the focus of national programs and international support continues to be on prevention and care in the absence of ARV treatment. While the moral imperative to provide the best …

Ndola Demonstration Project: A Midterm Analysis Of Lessons Learned, Horizons Program

HIV and AIDS

This report summarizes baseline and midterm findings of an intervention pilot study conducted by Horizons, LINKAGES, National Food and Nutrition Commission, District Health Management Team, Hope Humana, and the Zambia Integrated Health Program in Ndola District, Zambia. The aim of the research is to investigate how integrating services for the prevention of mother-to-child transmission (PMCT) of HIV into low-resource maternal and child health (MCH) and antenatal care (ANC) settings influences women’s ability to make and implement informed decisions about HIV. The intervention strengthened routine services and introduced HIV voluntary counseling and testing and PMCT counseling and services into the MCH/ANC …

Frontiers Capacity Building: An Overview, James R. Foreit

Reproductive Health

The Population Council’s Frontiers in Reproductive Health Program is a cooperative agreement with USAID to improve family planning and reproductive health service delivery through operations research (OR). Frontiers builds on more than 20 years of research to improve family planning service delivery programs. A major goal of Frontiers is to transfer skills in OR so that public and private agencies in developing countries can conduct OR and apply research findings to reproductive health programs and policies. OR addresses problems in operational effectiveness, access, quality, and efficiency by investigating facets of programs that managers can control and change. As concluded in …

Social Networks And Hiv Transmission: The Contextual Dynamics Of Hiv Risk Behaviors, Karen L. Robinson

International Journal of Global Health

Despite advances in public health, biomedical, and social sciences, the Human Immunodeficiency Virus (HIV), which causes Acquired Immune Deficiency Syndrome (AIDS), continues to proliferate. HIV is spread by exposure to infected blood, semen, or vaginal secretions. HIV transmission most commonly occurs because of sexual activities, through the sharing of contaminated needles and other drug paraphernalia, and less frequently, from infected mothers to their newborns (CDC, 2001). From the first reported in case in June 1981 through June 2001, the Center for Disease Control and Prevention (CDC) has reported 793,026 cases of AIDS. The CDC estimates that 650,000 to 900,000 Americans …

Assessment Of Validity Of The National Public Health Performance Standards: The Local Public Health Performance Assessment Instrument., Joyce Beaulieu, F. Douglas Scutchfield

Preventive Medicine and Environmental Health Faculty Publications

The National Public Health Performance Standards Program (NPHPSP) has developed performance standards measurement instruments, based on the 10 "Essential Services of Public Health" that are being tested in several states. This article is a report on the face and content validity of the instrument designed for local public health systems. Judgments about the face validity of the standards were obtained in a survey of local public health systems that had used the instrument in a test state. The validity of each standard was addressed along the following dimensions: the importance of the standard as a measure of the Essential Service; …

Report On A Formative Evaluation Conducted For The Youth Against Tobacco Counter Marketing Campaign, Lorelei Cropley, F Mitchell, Peter B. Anderson

Educational Leadership, Counseling, and Foundations

This paper reports the formative evaluation findings of a tobacco counter-marketing campaign and recommendations based on those findings. Focus groups were used w determine reactions to four messages for the Youth Against Tobacco (YAT) campaign. Participants aged eleven to eighteen years old, who resided in the metropolitan New Orleans area. were selected from area schools usiNg convenience sampling. Results indicated that while reactions w the messages were positive overall, some aspects of the messages seemed too complex to be used effectively in the campaign. These results helped to guide modification and selection of messages prior to use in the campaign.

Safety Behaviour In The Construction Industry, Nick Macdonald, Victor Hrymak

Reports

The influences on safety standards and employee safety behaviour was analysed on 18 large construction sites on the island of Ireland. The safety management and documentation of these sites was also analysed. The results are discussed at length together with comprehensive recommendations for the industry.

Introduction To Written Symposium On Public Health And International Law, David P. Fidler

Articles by Maurer Faculty

No abstract provided.

Bioterrorism, Public Health, And International Law, David P. Fidler

Articles by Maurer Faculty

No abstract provided.

Living Arrangements And Socio-Demographic Conditions Of Older Adults In Cambodia, Zachary Zimmer, Sovan Kiry Kim

Poverty, Gender, and Youth

Since the takeover of Cambodia by the Khmer Rouge in 1975, analysis of social conditions in the country has been lacking. Only recently has dependable socio-demographic data become available. We use some of these data to examine living arrangements and other socio-demographic conditions among Cambodia’s older population and compare results to those recently found in Thailand and Vietnam. On balance, living arrangements in Cambodia are similar to those in neighboring countries. Older adults are likely to be living with a grown child and in a variety of arrangements involving different family members. To determine gender preference for coresident children we …

Sustainability Of Postabortion Care In Peru, Janie Benson, Victor Huapaya

Reproductive Health

The goal of this study was to determine the sustainability of the postabortion care (PAC) training and service delivery intervention introduced in the Hospital Nacional Daniel Alcides Carrión in Lima, Peru, and the extent to which the outcomes of the intervention have continued. The objectives of the study were to assess changes over time in the following outcomes: the use of manual vacuum aspiration for incomplete abortion, provision of family planning information to postabortion patients, acceptance of contraception by postabortion patients prior to discharge, provision of medical care information to patients, length of hospital stay, and resources used by the …

Capacitación Y Apoyo De Científicos En Población De Países En Desarrollo: Un Informe De Panel—Resumen Y Recomendaciones, Jane Menken, Ann K. Blanc, Cynthia B. Lloyd

Poverty, Gender, and Youth

Desde su inicio, el Population Council ha reconocido la importancia y el valor que tiene la capacitación del científico en población de países en desarrollo. A partir de 1952, el programa de becas en ciencias sociales del Council ha logrado mantener sus objetivos habiéndo otorgado aproximadamente 1500 becas hacia la capacitación pre- y pos-doctoral en estudios de población. Aunque la demanda de científicos en población continúa firme, el campo ha cambiado considerablemente desde aquellos primeros años, de modo que una reevaluación del programa se tornó necesaria. La Fundación Mellon en el año 2000 otorgó fondos para un proyecto de evaluación …

Changes In Functional Limitations And Survival Among The Elderly In Taiwan: 1993, 1996, And 1999, Zachary Zimmer, Linda G. Martin, Ming-Cheng Chang

Poverty, Gender, and Youth

This paper focuses on changes in the prevalence of functional limitations among nationally representative samples of adults aged 65 and older in Taiwan as measured in 1993, 1996, and 1999. Using data from the Survey of Health and Living Status of the Elderly in Taiwan, we investigate changes in difficulties walking and climbing stairs, two tasks that represent basic lower body movements that are less likely to be influenced by changes in living environments and social roles than are activities of daily living and instrumental activities of daily living. Results are shown for both unadjusted prevalence rates and rates adjusted …

How Community Structures Of Time And Opportunity Shape Adolescent Sexual Behavior In South Africa, Carol E. Kaufman, Shelley Clark, Ntsiki Manzini, Julian May

Poverty, Gender, and Youth

Recently, South Africa has led the world in rates of HIV/AIDS infection. Particularly among young adults, the prevalence of HIV has soared, now reaching 25 percent. The statistics suggest a high level of unprotected sex and risky sexual behavior even in the midst of high levels of knowledge. Research has focused on the dynamics of individuals’ and partners’ sexual decisionmaking. Little is known, however, about the larger context in which those decisions are made. What are the everyday experiences that influence risk-taking? Are young people with little to do more likely to engage in risky behavior? Do community opportunities of …

The Elderly And Aids: Coping Strategies And Health Consequences In Rural Tanzania, Julia Dayton, Martha Ainsworth

Poverty, Gender, and Youth

The elderly are often especially likely to be adversely affected by the death from AIDS of prime-aged adults. The authors use a longitudinal survey of households from northwestern Tanzania in 1991-94 to compare the activities and wellbeing of the elderly in households before and after the death of a prime-aged adult with those of the elderly in households that did not experience the death of an adult. A significant proportion of adults suffering from AIDS return to their parents’ home shortly before death. Time spent by the elderly performing household chores rises following an adult’s death, and their participation in …

Pregnant Or Positive: Adolescent Childbearing And Hiv Risk In South Africa, Naomi Rutenberg, Carol E. Kaufman, Kate Macintyre, Lisanne Brown, Ali Mehyrar Karim

Poverty, Gender, and Youth

In communities where early age of childbearing is common and HIV prevalence is high, adolescent boys and girls may place themselves at risk of HIV to realize their childbearing preferences. In this paper, we analyze survey data from Kwa-Zulu-Natal province that explores whether an association exists between pregnancy preferences and behavioral and perceptual measures of HIV risk among adolescents in South Africa. Our analysis is based on data from 1,426 sexually active respondents aged 14-22 who participated in wave 1 of the “Transitions to Adulthood in the Context of AIDS in South Africa” study. We use logistic regression to model …