International Public Health Commons^™

The Qingdao Twin Registry: A Focus On Chronic Disease Research, C. Anderson Johnson, Zengchang Pang, Feng Ning, Jennifer B. Unger, Shaojie Wang, Qian Guo, Weihua Cao, Liming Lee

CGU Faculty Publications and Research

With the changing patterns of morbidity and mortality in China, noncommunicable chronic diseases have become the major threats to the health of the Chinese population. The causes of chronic diseases include genetic factors and behavioral risk factors such as the use of tobacco, alcohol, and other drugs, unhealthy dietary behaviors, and lack of physical activity. Twin studies offer a unique opportunity to disentangle the genetic and environmental risk and protective factors for chronic disease. The Qingdao Twin Registry (QTR) was initiated in 1998 as part of the National Chinese Twin Registry. Over 11,000 pairs of twins and multiples of all …

Girls' Perception Of Physical Environmental Factors And Transportation: Reliability And Association With Physical Activity And Active Transport To School, Kelly R. Evenson, Amanda Birnbaum, Ariane L. Bedimo-Rung, James Sallis, Carolyn C. Voorhees, Kimberly Ring, John P. Elder

Department of Public Health Scholarship and Creative Works

Background

Preliminary evidence suggests that the physical environment and transportation are associated with youth physical activity levels. Only a few studies have examined the association of physical environmental factors on walking and bicycling to school. Therefore, the purpose of this study was (1) to examine the test-retest reliability of a survey designed for youth to assess perceptions of physical environmental factors (e.g. safety, aesthetics, facilities near the home) and transportation, and (2) to describe the associations of these perceptions with both physical activity and active transport to school.

Methods

Test and retest surveys, administered a median of 12 days later, …

Perceived Smoking Environment And Smoking Initiation Among Multi-Ethnic Urban Girls, Tracy R. Nichols, Amanda Birnbaum, Sara Birnel, Gilbert J. Botvin

Department of Public Health Scholarship and Creative Works

Purpose

To examine associations between the perceived smoking environment and smoking initiation among urban multi-ethnic adolescent girls in New York City.

Methods

Self-report surveys completed in grades 7, 8, and 9 assessed girls’ (n = 858) smoking initiation, and perceived smoking environment (family smoking, friends’ smoking, smoking norms, and cigarette availability). Carbon monoxide breath samples were collected from girls using a variation of the bogus pipeline procedure.

Results

Differences were found in smoking prevalence with white girls reporting the highest prevalence of smoking at baseline and the greatest increase in smoking prevalence from seventh to eighth grade. Black girls reported …

Pierce Law Participates In Pandemic Influenza Vaccine Ip Management Meeting, Stanley P. Kowalski

Law Faculty Scholarship

On April 18, 2006 several members of the greater Pierce Law community participated in an important meeting held at the World Intellectual Property Organization (WIPO) in Geneva, Switzerland. Organized by The Centre for the Management of Intellectual Property in Health Research and Development (MIHR), the meeting “Intellectual Property Management Strategies to Facilitate Early Access and Global Health Benefits: Case Studies in Pandemic Influenza and Malaria” had the objective of exploring and discussing IP issues which impact the distribution of vaccines to developing countries, a topic of heightened worldwide importance given the potential threat of a global influenza pandemic. In an …

Strengthening Care And Support Services In The Era Of Treatment: Symposium Report, Horizons Program

HIV and AIDS

Sub-Saharan Africa has been devastated by the AIDS epidemic, with almost 26 million people infected in the region. As international attention continues to focus on sub-Saharan Africa as the region most affected by AIDS, hopeful signs have emerged, such as increased access to antiretroviral therapy (ART). Although the availability of ART has greatly increased in South Africa, care and support services continue to play a critical role in the lives of people infected and affected by HIV. In response to a growing call from program managers and researchers in South Africa to engage in a dialogue with policymakers and donors …

Preparedness For Hiv/Aids Service Delivery: The 2005 Kenya Health Workers Survey, National Aids And Std Control Programme, Ministry Of Health Kenya

HIV and AIDS

Kenya is one of the few countries that has succeeded in changing the course of the HIV/AIDS epidemic, and there is strong evidence of a decline in incidence. However, AIDS-related deaths now exceed new infections, and almost nine out of ten Kenyan adults do not know their HIV status. The expansion of HIV services in Kenya, including voluntary counseling and training and prevention of mother-to-child transmission programs, has enabled more Kenyans to learn their status. However, this leaves out many individuals who could benefit from HIV testing and counseling, such as hospital patients. Patients who present to a health-care facility …

Yaari Dosti: Young Men Redefine Masculinity, A Training Manual, Horizons Program, Coro For Literacy, Mamta, Instituto Promundo

HIV and AIDS

This training manual, developed by the Population Council in collaboration with Instituto PROMUNDO, CORO for Literacy, MAMTA, and DAUD promotes gender equity and addresses masculinity as a strategy for the prevention of HIV. Adapted from the “Program H: Working with Young Men Series” developed in Brazil by Instituto PROMUNDO, it promotes the positive aspects of masculinity, encourages men’s participation in sexual and reproductive health, promotes respect for sexual diversity, and improves understanding of the body and sexuality. In this manual, HIV prevention is addressed within the larger framework of gender roles and relationships. Gender disparity, widely prevalent in Indian society …

Shifting Support For Inequitable Gender Norms Among Young Indian Men To Reduce Hiv Risk And Partner Violence, Ravi K. Verma, Vaishali Sharma Mahendra, Julie Pulerwitz, Sujata Khandekar, Gary Barker, P. Fulpagare, S.K. Singh

HIV and AIDS

India accounts for the second largest population of people living with HIV/AIDS (5.1 million), and almost half of new infections occur in young men below age 30. While there are multiple factors influencing young men’s HIV risk in India, one that is receiving increasing attention is early socialization about masculinity. Young men in India mature and develop in a male-dominated context, having little contact with female peers and virtually no sex education. In this context, most boys develop a sense of masculinity characterized by male dominance in the sexual arena and other areas. Although there is increasing awareness of the …

Day Of Dialogue On Public Sector Pricing Of Pharmaceutical Products, Population Council

Formulation/Product Development

For decades, patients, doctors, ethicists, and other interested parties have debated the economics of the pharmaceutical industry. What is the best way to get medications and related products to the people who need them, regardless of their ability to pay? Can prices be lowered without jeopardizing basic research for new drugs? Are pharmaceutical company pricing practices monopolistic? What are the legal and ethical obligations related to drugs developed—partially or fully—with public funds? The Population Council convened a daylong meeting of academics, scientists, representatives from the nonprofit sector, the pharmaceutical industry, foundations, and government donor agencies, and practicing lawyers and doctors. …

Reducing Aids-Related Stigma And Discrimination In Indian Hospitals, Vaishali Sharma Mahendra, Laelia Gilborn, Bitra George, Luke Samson, Rupa Mudoi, Sarita Jadav, Indrani Gupta, Shalini Bharat, Celine Daly

HIV and AIDS

People living with HIV/AIDS in India, as elsewhere, face stigma and discrimination in a variety of contexts. Research in India has shown that stigma and discrimination against HIV-positive people and those perceived to be infected are common in hospitals and act as barriers to seeking and receiving critical treatment and care services. Recognizing the need to move beyond documentation of the problem, three New Delhi hospitals; SHARAN, an Indian NGO; and the Horizons program, with support from the National AIDS Control Organisation (NACO), carried out an operations research project to develop and test responses to hospital-based stigma and discrimination against …

Promoting More Gender-Equitable Norms And Behaviors Among Young Men As An Hiv/Aids Prevention Strategy, Julie Pulerwitz, Gary Barker, Marcio Segundo, Marcos Nascimento

HIV and AIDS

The Population Council and the Promundo Institute studied the effectiveness of interventions in Brazil designed to change the attitudes of young men in relation to gender norms and reducing the risk of contracting HIV/STIs. One conclusion of the study was the recognition of the importance of engaging young people (men and women) in the issue of gender relations and the risks of HIV contamination. The results of the study indicate that addressing inequitable gender norms, particularly those that define masculinity, can be an important element of HIV prevention strategies. These findings suggest that group education interventions can successfully influence young …

Abc Messages For Hiv Prevention In Kenya: Clarity And Confusion, Barriers And Facilitators, Julie Pulerwitz, Tiffany Lillie, Louis Apicella, Ann P. Mccauley, Tobey C. Nelson, Simon Ochieng, Peter Mwarogo, Karusa Kiragu, Edward Kunyanga

HIV and AIDS

The Horizons Program and FHI/IMPACT developed a collaborative research study to explore how adults and youth in Kenya define and perceive the ABC (abstinence/being faithful/consistent condom use) terms and behaviors. Additional objectives of the study were to identify attitudes and norms around the ABC behaviors that influence perceptions of them, and the role of important actors in transmitting messages about them. Findings highlight potential challenges in promoting each of the ABC behaviors, as well as some positive elements that can be built upon when developing programs. HIV prevention programs that incorporate ABC messages—both in Kenya and elsewhere—should consider a number …

Examining Adherence And Sexual Behavior Among Patients On Antiretroviral Therapy In India, Avina Sarna, Indrani Gupta, Sanjay Pujari, A.K. Sengar, Rajiv Garg, Ellen Weiss

HIV and AIDS

With increased availability of ART, HIV-positive individuals are living healthier lives and continuing or resuming sexual activity. However, optimism related to ART’s success in slowing disease progression, reducing viral load, and improving health status may lead to more risky sexual practices and a possible increase in transmission of infections. To determining the sexual behavior of HIV-positive persons on ART, the Horizons program, in collaboration with research partners in Delhi and Pune, conducted a study to assess current levels of adherence to ART among a sample of people living with HIV/AIDS, identify the factors that influence their adherence to treatment, and …

Orphans And Vulnerable Youth In Bulawayo, Zimbabwe: An Exploratory Study Of Psychosocial Well-Being And Psychosocial Support, Laelia Gilborn, Louis Apicella, Jonathan Brakarsh, Linda Dube, Kyle Jemison, Mark Kluckow, Tricia Smith, Leslie M. Snider

HIV and AIDS

This Population Council Horizons report presents findings from an exploratory study by the Regional Psychosocial Support Initiative and Catholic Relief Services’ Support to Replicable, Innovative Village/Community-level Efforts Program of vulnerable youth living in and around Bulawayo, Zimbabwe. It describes their demographic characteristics, exposure to stress and trauma, and psychosocial well-being. The report also highlights the relationships between psychosocial well-being outcomes and exposure to stress and trauma, and the differences in psychosocial well-being between males and females, orphaned and nonorphaned youth, and younger and older adolescents. The report concludes with program and research implications.

Understanding Barriers And Challenges To Effective Community Participation In The Rollout Of Hiv/Aids Treatment And Care Services: Report On Research Results Dissemination Meetings, Population Council, Health Systems Trust

HIV and AIDS

The Population Council and Health Systems Trust conducted national, provincial, and community dissemination meetings in 2006 in KwaZulu Natal (KZN), Limpopo, and Gauteng provinces to share results from a 2005 research study: “Understanding barriers and challenges to effective community participation in the rollout of HIV/AIDS treatment and care services.” The objectives were to share the research findings with the communities and organizations that participated in the study; solicit participants’ input in understanding and utilizing the findings; facilitate interaction and exchange between stakeholders including community and facility-based providers involved in ART services; develop key strategies to operationalize findings and for development …

Understanding Barriers To Community Participation In Hiv And Aids Services: Final Report, Ashnie Padarath, Catherine Searle, Eka Esu-Williams

HIV and AIDS

In 2003, South Africa announced its intention to roll out possibly the largest HIV and AIDS treatment program in the world. Much attention is currently focused on supply-side issues, particularly drug procurement and pricing. Far less attention has been paid to demand for and delivery of treatment, care, and support services. Further, although the role of the community and community organizations is articulated in government policy there has been little active engagement with NGOs on the development of these roles or how to encourage community organizations to support and participate in the antiretroviral (ARV) rollout. As noted in this final …

Understanding Barriers To Community Participation In Hiv And Aids Services: Summary Report, Population Council, Health Systems Trust

HIV and AIDS

In 2003, South Africa announced its intention to roll out possibly the largest HIV and AIDS treatment program in the world. Much attention is currently focused on supply-side issues, particularly drug procurement and pricing. Far less attention has been paid to demand for and delivery of treatment, care, and support services. Further, although the role of the community and community organizations is articulated in government policy there has been little active engagement with NGOs on the development of these roles or on how to encourage community organizations to support and participate in the antiretroviral (ARV) rollout. This study collected data …

Reducing Stigma And Discrimination In Hospitals: Positive Findings From India, Vaishali Sharma Mahendra, Laelia Gilborn, Bitra George, Luke Samson, Rupa Mudoi, Sarita Jadav, Indrani Gupta, Shalini Bharat, Celine Daly

HIV and AIDS

People living with HIV (PLHIV) in India face stigma and discrimination in a variety of contexts. Stigma and discrimination against HIV-positive people is common in hospitals and acts as a barrier to seeking and receiving critical treatment and care services. Three New Delhi hospitals, SHARAN, and the Horizons Program collaborated on an operations research project to assess responses to hospital-based stigma and discrimination against PLHIV. A baseline survey to measure HIV/AIDS-related attitudes, knowledge, and practices was conducted in 2000 with a random sample of 884 health workers from four departments: medicine, STD and skin, obstetrics and gynecology, and surgery. Based …

Expanding Pediatric Access To Antiretroviral Therapy In South Africa, Desiree Michaels, Brian Eley, Lewis Ndhlovu, Naomi Rutenberg, Hena Khan

HIV and AIDS

In sub-Saharan Africa, AIDS has become one of the leading causes of death among children under the age of five years. Yet, despite increased availability of antiretroviral therapy (ART), children have been largely ignored or excluded from treatment initiatives. While efforts to get more children on treatment are increasing, important information is lacking to guide program and policy implementation. To address these gaps, the Horizons Program and the University of Cape Town conducted a rapid situational analysis in 2005 of pediatric HIV treatment sites in South Africa. In 2003, the South African government approved a plan for a national HIV …

Yaari Dosti: Young Men Redefine Masculinity, A Training Manual [Hindi], Horizons Program, Coro For Literacy, Mamta, Instituto Promundo

HIV and AIDS

This training manual, developed by the Population Council in collaboration with Instituto PROMUNDO, CORO for Literacy, MAMTA, and DAUD promotes gender equity and addresses masculinity as a strategy for the prevention of HIV. Adapted from the “Program H: Working with Young Men Series” developed in Brazil by Instituto PROMUNDO, it promotes the positive aspects of masculinity, encourages men’s participation in sexual and reproductive health, promotes respect for sexual diversity, and improves understanding of the body and sexuality. In this manual, HIV prevention is addressed within the larger framework of gender roles and relationships. Gender disparity, widely prevalent in Indian society …

Context And Dynamics Of Same-Sex Behavior Among Long-Distance Truckers In India: Findings From Qualitative Research, Vaishali Sharma Mahendra, Ravi K. Verma, Pertti J. Pelto, Sarat Chandra Pradhan, Vibha Singh, Asha Rao, Tarun Vij

HIV and AIDS

It is well established that truckers (drivers and helpers) have higher rates of nonmarital sex than any other occupational group. Because of this multipartner sexual activity, truckers form a key group of prevention efforts for HIV and sexually transmitted infections (STIs). Thus far, HIV/STI prevention interventions for truckers have been geared to providing risk-reduction information and services within a heterosexual context. Recent evidence suggests that a significant number of truckers engage in male-to-male (MSM) sexual activity that has implications for HIV/STI transmission. Therefore, information on the nature and extent of MSM activity among these populations is urgently needed for the …

Context And Dynamics Of Male-To-Male Sexual Behavior Of Truckers In India: Findings From A Multi-Site Qualitative Research Study, Ravi K. Verma, Vaishali Sharma Mahendra, Pertti J. Pelto, Sarat Chandra Pradhan, Vibha Singh

HIV and AIDS

It is well established that truckers (drivers and helpers) have higher rates of nonmarital sex than any other occupational group. Because of this multipartner sexual activity, truckers form a key group for HIV/STI prevention efforts. Thus far, HIV/STI prevention interventions for truckers have been geared to providing risk-reduction information and services within a heterosexual context. Recent evidence suggests that a large number of truckers engage in male-to-male (MSM) sexual activity that has serious implications for HIV/STI transmission. Therefore, information on the nature and extent of MSM activity among these populations is urgently needed for the design and implementation of comprehensive …

Facts About Adolescents From The Demographic And Health Survey—Statistical Tables For Program Planning: Nigeria 2003, Population Council

Poverty, Gender, and Youth

The Population Council initiated its work on adolescents in the mid-1990s. At that time, those advocating greater attention to adolescent issues were concerned about adolescent fertility—particularly outside of marriage—and adolescent “risk-taking” behavior. As an international scientific organization with its mandate centered around the needs of developing countries, the Council sought a more nuanced and context-specific understanding of the problems confronting adolescents in the developing world. In working with colleagues inside and outside the Council, it became clear that information on adolescents, and the way data are organized, were limiting the ability to understand the diversity of their experiences or to …

Exploring Current Practices In Pediatric Arv Rollout And Integration With Early Childhood Programs In South Africa: A Rapid Situation Analysis, Desiree Michaels, Brian Eley, Lewis Ndhlovu, Naomi Rutenberg

HIV and AIDS

This Horizons program report describes the status of pediatric HIV treatment in selected sites in South Africa, identifies gaps in service delivery, and proposes recommendations for strengthening services and expanding children’s access to treatment. The study provides much needed information on critical issues of pediatric HIV care, especially regarding health service and contextual issues surrounding the expansion of access to treatment for HIV-infected children, and key factors that facilitate sustainability of treatment by young children. The aims of the study were to identify successful program strategies in pediatric HIV treatment in South Africa and to determine priority knowledge gaps to …

Abcs For Hiv Prevention In Kenya: Messages, Beliefs, And Barriers, Julie Pulerwitz, Tiffany Lillie, Louis Apicella, Ann P. Mccauley, Tobey C. Nelson, Simon Ochieng, Peter Mwarogo, Karusa Kiragu, Edward Kunyanga

HIV and AIDS

A great deal of attention has been focused recently on promoting the “ABCs” of HIV prevention— abstinence or delaying sex, being faithful to one sexual partner or reducing the number of sexual partners, and consistently using condoms during sex. Yet even as programs that focus on the ABCs to prevent sexual HIV transmission are rolled out, questions remain about how well different groups in varied cultural contexts understand the terms, as well as how best to address challenges to adopting the ABC behaviors. The Horizons Program and FHI/IMPACT developed a collaborative research study in 2004 to explore how adults and …

Informed Consent In Hiv Prevention Trials: Report Of An International Workshop, C. Elizabeth Mcgrory, Barbara Friedland, Cynthia Woodsong, Kathleen M. Macqueen

HIV and AIDS

This report summarizes key themes and issues on informed consent in HIV prevention trials as part of an international workshop co-hosted by Population Council and Family Health International in May 2005.

Promoting Gender Equity Among Young Brazilian Men As An Hiv Prevention Strategy, Julie Pulerwitz, Gary Barker, Marcio Segundo, Marcos Nascimento

HIV and AIDS

There is growing evidence that social norms that promote unequal gender roles increase young men and women’s risk of HIV/STIs and partner violence. Thus, changing gender norms is increasingly recognized as an important strategy to prevent the spread of HIV infection. Few interventions to promote gender-equitable norms and behaviors among young men have been systematically implemented or evaluated, and little is known about how best to measure changes in gender norms and their effect on HIV/STI protective and risk behaviors. To address these gaps, the Horizons Program and Instituto Promundo examined the effectiveness of interventions designed to improve young men’s …

Understanding The Hiv/Sti Prevention Needs Of Men Who Have Sex With Men In Kenya, Washington Onyango-Ouma, Harriet Birungi, Scott Geibel

HIV and AIDS

Understanding the sexual behaviors of populations who are vulnerable to HIV is an important component in the battle against AIDS. Yet policymakers in developing countries, particularly in Africa, have often overlooked men who have sex with men (MSM) as a vulnerable group because of stigmatization of homosexual behavior and denial of the existence of MSM and the role they may play in HIV transmission. A growing body of literature not only documents the presence of this population in Africa but also the importance of reaching them with information and services to prevent HIV and other sexually transmitted infections (STIs). In …

Pregnancy-Related School Dropout And Prior School Performance In South Africa, Monica J. Grant, Kelly Hallman

Poverty, Gender, and Youth

Using data collected in 2001 in KwaZulu-Natal, South Africa, this working paper examines the factors associated with schoolgirl pregnancy, as well as the likelihood of school dropout and subsequent re-enrollment among pregnant schoolgirls. This analysis triangulates data collected from birth histories, education histories, and data concerning pregnancy to strengthen the identification of young women who became pregnant while enrolled in school and to define discrete periods of school interruption prior to first pregnancy. Given the increasing levels of female school participation in sub-Saharan Africa, our findings suggest that future studies will benefit from exploring the causal relationships between prior school …

Female Genital Mutilation In Kenya: Evidence Links Health Workers To Fgm, Population Council, Gtz

Reproductive Health

Female genital mutilation (FGM) is a traditional practice that affects women and girls in several African countries. It is practiced in a variety of ways, classified by WHO into four broad types all found in Kenya. In some communities it is associated with passage into maturity; in others, it is considered a symbol of ethnic identity, a religious obligation, or a necessary prerequisite for marriage, either through symbolizing attainment of womanhood or as a means of preserving and demonstrating virginity. FGM is considered a harmful traditional practice because it may be associated with a variety of short- and long-term health …