Public Health Education and Promotion Commons^™

Adults With Greater Weight Satisfaction Report More Positive Health Behaviors And Have Better Health Status Regardless Of Bmi, Christine E. Blake Ph.D., Rd, James R. Hébert Scd, Duck Chul Lee, Swann A. Adams, Susan E. Steck Phd, Mph, Rd, Xuemei Sui M.D., M.P.H., Ph.D., Jennifer L. Kuk, Meghan Baruth, Steven N. Blair

Faculty Publications

Background. Prior studies suggest that weight satisfaction may preclude changes in behavior that lead to healthier weight among individuals who are overweight or obese. Objective. To gain a better understanding of complex relationships between weight satisfaction, weight-related health behaviors, and health outcomes. Design. Cross-sectional analysis of data from the Aerobics Center Longitudinal Study (ACLS). Participants. Large mixed-gender cohort of primarily white, middle-to-upper socioeconomic status (SES) adults with baseline examination between 1987 and 2002 (n = 19,003). Main Outcome Variables. Weight satisfaction, weight-related health behaviors, chronic health conditions, and clinical health indicators. Statistical Analyses Performed. Chi-square test, t-tests, and linear and …

Early Prenatal Food Supplementation Ameliorates Thenegative Association Of Maternal Stress With Birth Size In A Randomised Trial, Amy L. Frith, Ruchira T. Naved, Lars Ake Persson, Edward A. Frongillo Jr.

Faculty Publications

Low birthweight increases the risk of infant mortality, morbidity and poor development. Maternal nutrition and stress influence birth size, but their combined effect is not known.We hypothesised that an early-invitation time to start a prenatal food supplementation programme could reduce the negative influence of prenatal maternal stress on birth size, and that effect would differ by infant sex. A cohort of 1041 pregnant women, who had delivered an infant, June 2003–March 2004, was sampled from among 3267 in the randomised controlled trial, Maternal Infant Nutritional Interventions Matlab, conducted in Matlab, Bangladesh. At 8 weeks gestation, women were randomly assigned an …

Confronting Myths About Household Food Insecurity And Excess Weight, Edward A. Frongillo Jr.

Faculty Publications

No abstract provided.

Indicators Of Family Care For Development For Use In Multicountry Surveys, Patricia Kariger, Edward A. Frongillo Jr., Patrice Engle, Pia M. Rebello Britto, Sara M. Sywulka, Purnima Menon

Faculty Publications

Indicators of family care for development are essential for ascertaining whether families are providing their children with an environment that leads to positive developmental outcomes. This project aimed to develop indicators from a set of items, measuring family care practices and resources important for caregiving, for use in epidemiologic surveys in developing countries. A mixed method (quantitative and qualitative) design was used for item selection and evaluation. Qualitative and quantitative analyses were conducted to examine the validity of candidate items in several country samples. Qualitative methods included the use of global expert panels to identify and evaluate the performance of …

Early Invitation To Food And/Or Multiple Micronutrient Supplementation In Pregnancy Does Not Affect Body Composition In Offspring At 54 Months: Follow-Up Of The Minimat Randomized Trial, Bangladesh, Ashraful Islam Khan, Iqbal Kabir, Sophie Hawkesworth, Eva‐Charlotte Ekström, Shams Arifeen, Edward A. Frongillo Jr., Lars Åke Persson

Faculty Publications

Growth patterns in early life are associated with later health.The effect of nutrition duringin uterodevelopmenton later body composition is unclear. We evaluated whether prenatal early invitation to food and/or multiplemicronutrient supplementation (MMS) in pregnancy has an effect on offspring body composition at 54 monthsof age. In Maternal and Infant Nutrition Interventions in Matlab trial (ISRCTN16581394) in Bangladesh, 4436pregnant women were randomised into six equally sized groups: double-masked supplementation with capsulesof either 30 mg Fe and 400mg folic acid, or 60 mg Fe and 400mg folic acid, or MMS (15 micronutrients), wascombined with a randomised early invitation (around 9 weeks) or …

Prevalence And Predictors Of Giving Birth In Health Facilities In Bugesera District, Rwanda, Shahrzad Joharifard, Stephen Rulisa, Francine Niyonkuru, Andrew Weinhold, Felix Sayinzoga, Jeffrey Wilkinson, Jan Ostermann, Nathan M. Thielman

Faculty Publications

Background The proportion of births attended by skilled health personnel is one of two indicators used to measure progress towards Millennium Development Goal 5, which aims for a 75% reduction in global maternal mortality ratios by 2015. Rwanda has one of the highest maternal mortality ratios in the world, estimated between 249–584 maternal deaths per 100,000 live births. The objectives of this study were to quantify secular trends in health facility delivery and to identify factors that affect the uptake of intrapartum healthcare services among women living in rural villages in Bugesera District, Eastern Province, Rwanda.

Methods Using census data …

Prevalence And Correlates Of Receiving Cigarettes As Gifts And Selecting Preferred Brand Because It Was Gifted: Findings From The Itc China Survey, Li-Ling Huang, Jim Thrasher, Yuan Jiang, Qiang Li, Geoffrey T. Fong, Anne Ck Quah

Faculty Publications

Background: Giving cigarettes as gifts is a common practice in China, but there have been few systematic studies of this practice. The present study was designed to estimate the incidence of receiving cigarettes as gifts, correlates of this practice, and its impact on brand selection in a representative sample of urban adult smokers in China.

Methods: Data were analyzed from Wave 2 of the International Tobacco Control (ITC) China Survey, where 4843 adult urban smokers were interviewed in six major Chinese cities between October 2007 and January 2008. The incidence of most recent cigarette acquisition due to gifting and the …

Maternal Pre‐Pregnancy Body Mass Index Is Not Associated With Infant And Young Child Feeding In Low‐Income Mexican Children 1–24 Months Old, Eva C. Monterrosa, Edward A. Frongillo Jr., Lynnette M. Neufeld, Kelsey A. Egan, Usha Ramakrishnan, Kathleen M. Rasmussen

Faculty Publications

Pre-pregnancy overweight and obesity is associated with shorter breastfeeding (BF) duration. Whether pre-pregnancy overweight and obesity is associated with other aspects of infant and young child feeding (IYCF) hasnot been investigated. We used data from 370 children born January 1999–September 2001 in a semi-urbancommunity in Morelos, Mexico, where information on how they were fed was available at 1, 3, 6, 9, 12, 18 and 24months of age. We modified the World Health Organization’s dietary diversity indicator to assess the quality ofthe complementary foods. An index that included BF, quality of complementary foods and other behaviours wasconstructed to measure IYCF. We …

The Potential Impact Of Plain Packaging Of Cigarette Products Among Brazilian Young Women: An Experimental Study, Christine M/ White, David Hammond, Jim Thrasher, Geoffrey T. Fong

Faculty Publications

Background: Tobacco use is responsible for 5.4 million deaths every year worldwide and is a leading cause of preventable death. The burden of these deaths is rapidly shifting to low and middle-income countries, such as Brazil. Brazil has prohibited most forms of tobacco advertising; however, the cigarette pack remains a primary source of marketing. The current study examined how tobacco packaging influences brand appeal and perceptions of health risk among young women in Brazil.

Methods: A between-subjects experiment was conducted in which 640 Brazilian women aged 16–26 participated in an online survey. Participants were randomized to view 10 cigarette packages …

Correlates Of Poor Health Among Orphans And Abandoned Children In Less Wealthy Countries: The Importance Of Caregiver Health, Nathan Thielman, Jan Ostermann, Kathryn Whetten, Rachel Whetten, Karen O’Donnell, Positive Outcomes For Orphans (Pofo) Research Team

Faculty Publications

Background: More than 153 million children worldwide have been orphaned by the loss of one or both parents, and millions more have been abandoned. We investigated relationships between the health of orphaned and abandoned children (OAC) and child, caregiver, and household characteristics among randomly selected OAC in five countries.

Methodology: Using a two-stage random sampling strategy in 6 study areas in Cambodia, Ethiopia, India, Kenya, and Tanzania, the Positive Outcomes for Orphans (POFO) study identified 1,480 community-living OAC ages 6 to 12. Detailed interviews were conducted with 1,305 primary caregivers at baseline and after 6 and 12 months. Multivariable logistic …

Evaluation Of Lay Support In Pregnant Women With Social Risk (Elsips): A Randomised Controlled Trial, Sara Kenyon, Kate Jolly, Karla Hemming, Lucy Annang Ingram Phd, Nicola Gale, Sophie-Anna Dann, Jacky Chambers, Christine Macarthur

Faculty Publications

BACKGROUND: Maternal, neonatal and child health outcomes are worse in families from black and ethnic minority groups and disadvantaged backgrounds. There is little evidence on whether lay support improves maternal and infant outcomes among women with complex social needs within a disadvantaged multi-ethnic population in the United Kingdom (UK). METHOD/DESIGN: The aim of this study is to evaluate a lay Pregnancy Outreach Worker (POW) service for nulliparous women identified as having social risk within a maternity service that is systematically assessing social risks alongside the usual obstetric and medical risks. The study design is a randomised controlled trial (RCT) in …

Systematic Review Of Peer Support For Breastfeeding Continuation: Metaregression Analysis Of The Effect Of Setting, Intensity, And Timing, Kate Jolly, Lucy Annang Ingram Phd, Khalid S. Khan, Jonathan J. Deeks, Nick Freemantle, Christine Macarthur

Faculty Publications

OBJECTIVE: To examine the effect of setting, intensity, and timing of peer support on breast feeding. DESIGN: Systematic review and metaregression analysis of randomised controlled trials. DATA SOURCES: Cochrane Library, Medline, CINAHL, the National Research Register, and British Nursing Index were searched from inception or from 1980 to 2011. Review methods Study selection, data abstraction, and quality assessment were carried out independently and in duplicate. Risk ratios and 95% confidence intervals were calculated for individual studies and pooled. Effects were estimated for studies grouped according to setting (high income countries, low or middle income countries, and the United Kingdom), intensity …

Effects Of Prenatal Food And Micronutrient Supplementation On Child Growth From Birth To 54 Months Of Age: A Randomized Trial In Bangladesh, Ashraful Islam Khan, Iqbal Kabir, Eva-Charlotte Ekström, Kajsa Åsling-Monemi, Dewan Shamsul Alam, Edward A. Frongillo Jr., Md Yunus, Shams Arifeen, Lars-Åke Persson

Faculty Publications

Background: There is a lack of information on the optimal timing of food supplementation to malnourished pregnant women and possible combined effects of food and multiple micronutrient supplementations (MMS) on their offspring's growth. We evaluated the effects of prenatal food and micronutrient interventions on postnatal child growth. The hypothesis was that prenatal MMS and early invitation to food supplementation would increase physical growth in the offspring during 0-54 months and a combination of these interventions would further improve these outcomes.

Methods: In the large, randomized MINIMat trial (Maternal and Infant Nutrition Interventions in Matlab), Bangladesh, 4436 pregnant women were enrolled …

Food Insecurity And Sexual Risk In An Hiv Endemic Community In Uganda, Cari L. Miller, David R. Bangsberg, David M. Tuller, Jude Senkungu, Annet Kawuma, Edward A. Frongillo Jr., Sheri D. Weiser

Faculty Publications

Food insecurity has been linked to high-risk sexual behavior in sub-Saharan Africa, but there are limited data on these links among people living with HIV/AIDS, and on the mechanisms for how food insecurity predisposes individuals to risky sexual practices. We undertook a series of in-depth open-ended interviews with 41 individuals living with HIV/AIDS to understand the impact of food insecurity on sexual-risk behaviors. Participants were recruited from the Immune Suppression Clinic at the Mbarara University of Science and Technology in Mbarara, Uganda. Interviews were recorded, transcribed verbatim, translated, and coded following the strategy of grounded theory. Four major themes emerged …

Validity Of Estimating Minute-By-Minute Energy Expenditure Of Continuous Walking Bouts By Accelerometry, Erin E. Kuffel, Scott E. Crouter, Jere D. Haas, Edward A. Frongillo Jr., David R. Bassett Jr

Faculty Publications

Background: Objective measurement of physical activity remains an important challenge. For wearable monitors such as accelerometer-based physical activity monitors, more accurate methods are needed to convert activity counts into energy expenditure (EE).

Purpose: The purpose of this study was to examine the accuracy of the refined Crouter 2-Regression Model (C2RM) for estimating EE during the transition from rest to walking and walking to rest. A secondary purpose was to determine the extent of overestimation in minute-by-minute EE between the refined C2RM and the 2006 C2RM.

Methods: Thirty volunteers (age, 28 ± 7.7 yrs) performed 15 minutes of seated rest, 8 …

Consumption Of Single Cigarettes And Quitting Behavior: A Longitudinal Analysis Of Mexican Smokers, Jim Thrasher, Victor Villalobos, Joaquin Barnoya, Raul Sansores, Richard O’Connor

Faculty Publications

Background: Previous cross-sectional research has suggested single cigarettes could either promote or inhibit consumption. The present study aimed to assess the effects of single cigarette availability and consumption on downstream quit behavior.

Methods: We analyzed population-based, longitudinal data from adult smokers who participated in the 2008 and 2010 administrations of the International Tobacco Control Policy Evaluation Survey in Mexico.

Results: At baseline, 30% of smokers saw single cigarettes for sale on a daily basis, 17% bought singles at their last purchase, and 7% bought singles daily. Smokers who most frequently purchased singles, both in general and specifically to control their …

Consumption Of Single Cigarettes And Quitting Behavior: A Longitudinal Analysis Of Mexican Smokers, Jim Thrasher, Victor Villalobos, Joaquin Barnoya, Raul Sansores, Richard O'Connor

Faculty Publications

Background: Previous cross-sectional research has suggested single cigarettes could either promote or inhibit consumption. The present study aimed to assess the effects of single cigarette availability and consumption on downstream quit behavior.

Methods: We analyzed population-based, longitudinal data from adult smokers who participated in the 2008 and 2010 administrations of the International Tobacco Control Policy Evaluation Survey in Mexico.

Results: At baseline, 30% of smokers saw single cigarettes for sale on a daily basis, 17% bought singles at their last purchase, and 7% bought singles daily. Smokers who most frequently purchased singles, both in general and specifically to control their …

Who Tests, Who Doesn't, And Why? Uptake Of Mobile Hiv Counseling And Testing In The Kilimanjaro Region Of Tanzania, Jan Ostermann, Elizabeth A. Reddy, Meghan M. Shorter, Charles Muiruri, Antipas Mtalo, Dafrosa K. Itemba, Bernard Njau, John A. Bartlett, John A. Crump, Nathan M. Thielman

Faculty Publications

Background: Optimally, expanded HIV testing programs should reduce barriers to testing while attracting new and highrisk testers. We assessed barriers to testing and HIV risk among clients participating in mobile voluntary counseling and testing (MVCT) campaigns in four rural villages in the Kilimanjaro Region of Tanzania.

Methods: Between December 2007 and April 2008, 878 MVCT participants and 506 randomly selected community residents who did not access MVCT were surveyed. Gender-specific logistic regression models were used to describe differences in socioeconomic characteristics, HIV exposure risk, testing histories, HIV related stigma, and attitudes toward testing between MVCT participants and community residents who …

Child Work And Labour Among Orphaned And Abandoned Children In Five Low And Middle Income Countries, Rachel Whetten, Lynne Messer, Jan Ostermann, Kathryn Whetten, Brian Wells Pence, Megan Buckner, Nathan Thielman, Karen O’Donnell, The Positive Outcomes For Orphans (Pofo) Research Team

Faculty Publications

Background

The care and protection of the estimated 143,000,000 orphaned and abandoned children (OAC) worldwide is of great importance to global policy makers and child service providers in low and middle income countries (LMICs), yet little is known about rates of child labour among OAC, what child and caregiver characteristics predict child engagement in work and labour, or when such work infers with schooling. This study examines rates and correlates of child labour among OAC and associations of child labour with schooling in a cohort of OAC in 5 LMICs.

Methods

The Positive Outcomes for Orphans (POFO) study employed a …

The Use Of Insecticide-Treated Nets For Reducing Malaria Morbidity Among Children Aged 6-59 Months, In An Area Of High Malaria Transmission In Central Côte D'Ivoire, Benjamin G. Koudou, Hala Ghattas Ph.D., Clémence Essé, Christian Nsanzabana, Fabian Rohner, Jürg Utzinger, Brian E. Faragher, Andres B. Tschannen

Faculty Publications

Background

Long-lasting insecticidal nets (LLINs) are an important tool for controlling malaria. Much attention has been devoted to determine both the effect of LLINs on the reduction of Plasmodium infection rate and on clinically-confirmed malaria cases in sub-Saharan Africa. We carried out an epidemiological study to investigate whether LLINs impact on Plasmodium prevalence rate and the proportion of clinically-confirmed malaria cases, in five villages in the district of Toumodi, central Côte d'Ivoire.

Methods

From April 2007 to November 2008, a community-based malaria control programme was implemented in the study villages, which involved large-scale distribution of LLINs, and training and sensitization …

Food Insecurity As A Barrier To Sustained Antiretroviral Therapy Adherence In Uganda, Sheri D. Weiser, David M. Tuller, Edward A. Frongillo Jr., Jude Senkungu, Nozmu Mukiibi, David R. Bangsberg

Faculty Publications

Background: Food insecurity is emerging as an important barrier to antiretroviral (ARV) adherence in sub-Saharan Africa and elsewhere, but little is known about the mechanisms through which food insecurity leads to ARV non-adherence and treatment interruptions.

Methodology: We conducted in-depth, open-ended interviews with 47 individuals (30 women, 17 men) living with HIV/ AIDS recruited from AIDS treatment programs in Mbarara and Kampala, Uganda to understand how food insecurity interferes with ARV therapy regimens. Interviews were transcribed, coded for key themes, and analyzed using grounded theory.

Findings: Food insecurity was common and an important barrier to accessing medical care and ARV …

Who Guidelines For Antimicrobial Treatment In Children Admitted To Hospital In An Area Of Intense Plasmodium Falciparum Transmission: Prospective Study, Behzad Nadjm, Ben Amos, George Mtove, Jan Ostermann, Semkini Chonya, Hannah Wangai, Juma Kimera, Walii Msuya, Frank Mtei, Denise Dekker, Rajabu Malahiyo, Raimos Olomi, John A. Crump, Christopher J. M. Whitty, Hugh Reyburn

Faculty Publications

Objectives To assess the performance of WHO’s “Guidelines for care at the first-referral level in developing countries” in an area of intense malaria transmission and identify bacterial infections in children with and without malaria.

Design Prospective study.

Setting District hospital in Muheza, northeast Tanzania.

Participants Children aged 2 months to 13 years admitted to hospital for febrile illness.

Main outcome measures Sensitivity and specificity of WHO guidelines in diagnosing invasive bacterial disease; susceptibility of isolated organisms to recommended antimicrobials.

Results Over one year, 3639 children were enrolled and 184 (5.1%) died; 2195 (60.3%) were blood slide positive for Plasmodium falciparum …

Trends In Body Fat, Body Mass Index And Physical Fitness Among Male And Female College Students, Peter Pribis, Carol A. Burtnack, Sonya O. Mckenzie, Jerome Thayer

Faculty Publications

There have been many publications in recent years reporting on the quantity of physical activity among college students using indirect indicators such as steps walked per day or time spent on physical activities. The purpose of this study was to describe the trends of physical fitness related to BMI and body fat among university students between 1996 and 2008. The results showed a significant decline in the average fitness levels measured as an estimation of VO2max for male and female students (p < 0.001 for both sexes). The linear trend for BMI by years was not significant for both sexes (p for males = 0.772, p for females = 0.253). On average, in the last 13 years, % body fat was increasing 0.513%/year for males and 0.654%/year for females. There is a significant indirect correlation between the student's VO2max levels and % body fat, r = -0.489; p < 0.001 for males; and r = -0.416, p < 0.001 for females. Approximately 23.9% of the variance in the VO2max levels in males and 17.3% in females can be explained by the variance in % body fat. The results support recent findings that physical fitness among college students is declining and body fatness is increasing. © 2010 by the authors.

A Comparison Of The Wellbeing Of Orphans And Abandoned Children Ages 6–12 In Institutional And Community-Based Care Settings In 5 Less Wealthy Nations, Kathryn Whetten, Jan Ostermann, Rachel A. Whetten, Brian W. Pence, Karen O'Donnell, Lynne C. Messer, Nathan M. Thielman, The Positive Outcomes For Orphans (Pofo) Research Team

Faculty Publications

Background

Leaders are struggling to care for the estimated 143,000,000 orphans and millions more abandoned children worldwide. Global policy makers are advocating that institution-living orphans and abandoned children (OAC) be moved as quickly as possible to a residential family setting and that institutional care be used as a last resort. This analysis tests the hypothesis that institutional care for OAC aged 6–12 is associated with worse health and wellbeing than community residential care using conservative two-tail tests.

Methodology

The Positive Outcomes for Orphans (POFO) study employed two-stage random sampling survey methodology in 6 sites across 5 countries to identify 1,357 …

Quality Health Information On The Internet: Developing A Diabetes Pathfinder For The Chinese Population, Ana D. Cleveland, Jodi Philbrick, Xuequn Pan, Xinyu Yu, Jiangping Chen, Marty O'Neill, Lisa Smith

Faculty Publications

A Web-based bilingual diabetes information pathfinder was created to help the Chinese population access quality health information on the Internet as part of a collaborative outreach project in the Dallas-Fort Worth area. A survey was conducted to identify the demographics, Internet usage, health information needs, and preferences for training sessions of the Chinese population. Breast cancer, diabetes, and hepatitis B were the top three diseases of interest. The process of developing the pathfinder is described from start to finish, and it can serve as a model for the development of others. Pathfinder training sessions also were held. Taylor & Francis …

Food Insecurity Among Homeless And Marginally Housed Individuals Living With Hiv/Aids In San Francisco, Sheri D. Weiser, David R. Bangsberg, Susan Kegeles, Kathleen Ragland, Margot B. Kushel, Edward A. Frongillo Jr.

Faculty Publications

Food insecurity is a risk factor for both HIV transmission and worse HIV clinical outcomes. We examined the prevalence of and factors associated with food insecurity among homeless and marginally housed HIV-infected individuals in San Francisco recruited from the Research on Access to Care in the Homeless Cohort. We used multiple logistic regression to determine socio-demographic and behavioral factors associated with food insecurity, which was measured using the Household Food Insecurity Access Scale. Among 250 participants, over half (53.6%) were food insecure. Higher odds of food insecurity was associated with being white, low CD4 counts, recent crack use, lack of …

Religion And Hiv In Tanzania: Influence Of Religious Beliefs On Hiv Stigma, Disclosure, And Treatment Attitudes, James Zou, Yvonne Yamanaka, Muze John, Melissa Watt, Jan Ostermann, Nathan Thielman

Faculty Publications

Background

Religion shapes everyday beliefs and activities, but few studies have examined its associations with attitudes about HIV. This exploratory study in Tanzania probed associations between religious beliefs and HIV stigma, disclosure, and attitudes toward antiretroviral (ARV) treatment.

Methods

A self-administered survey was distributed to a convenience sample of parishioners (n = 438) attending Catholic, Lutheran, and Pentecostal churches in both urban and rural areas. The survey included questions about religious beliefs, opinions about HIV, and knowledge and attitudes about ARVs. Multivariate logistic regression analysis was performed to assess how religion was associated with perceptions about HIV, HIV treatment, and …

Antenatal Peer Support Workers And Initiation Of Breast Feeding: Cluster Randomised Controlled Trial, Christine Macarthur, Kate Jolly, Lucy Annang Ingram Phd, Nick Freemantle, Cindy-Lee Dennis, Ros Hamburger, Julia Brown, Jackie Chambers, Khalid Khan

Faculty Publications

OBJECTIVE: To assess the effectiveness of an antenatal service using community based breastfeeding peer support workers on initiation of breast feeding. DESIGN: Cluster randomised controlled trial. SETTING: Community antenatal clinics in one primary care trust in a multiethnic, deprived population. PARTICIPANTS: 66 antenatal clinics with 2511 pregnant women: 33 clinics including 1140 women were randomised to receive the peer support worker service and 33 clinics including 1371 women were randomised to receive standard care. INTERVENTION: An antenatal peer support worker service planned to comprise a minimum of two contacts with women to provide advice, information, and support from approximately 24 …

Health Literacy In The Mathematics Classroom: The Iowa Core Curriculum As An Opportunity To Deepen Students’ Understanding Of Mathematics, Elana Joram, Susan Roberts-Dobie, Nadene Davidson

Faculty Publications

By 2012, all high schools in Iowa will be required to incorporate the new Iowa Core Curriculum, followed by elementary and middle schools in 2014 (Iowa Department of Education, 2009). The Iowa Core Curriculum addresses the question: "How is Iowa's educational system preparing our youth for successful lives in the 21st-century global environment?" (Davidson, 2009). It consists of core content standards, and identifies essential concepts and skills for content areas. The Iowa Core Curriculum also includes the ―21st Century Skills‖ of ―health, financial, technology, and civic literacy, and employability skills. These skills are to be infused into existing subject matter …

Gender Differences In The Risk Of Hiv Infection Among Persons Reporting Abstinence, Monogamy, And Multiple Sexual Partners In Northern Tanzania, Keren Z. Landman, Jan Ostermann, John A. Crump, Anna Mgonja, Meghan K. Mayhood, Dafrosa K. Itemba, Alison C. Tribble, Evaline M. Ndosi, Helen Y. Chu, John F. Shao, John A. Bartlett, Nathan M. Thielman

Faculty Publications

Background: Monogamy, together with abstinence, partner reduction, and condom use, is widely advocated as a key behavioral strategy to prevent HIV infection in sub-Saharan Africa. We examined the association between the number of sexual partners and the risk of HIV seropositivity among men and women presenting for HIV voluntary counseling and testing (VCT) in northern Tanzania.

Methodology/ Principal Findings: Clients presenting for HIV VCT at a community-based AIDS service organization in Moshi, Tanzania were surveyed between November 2003 and December 2007. Data on sociodemographic characteristics, reasons for testing, sexual behaviors, and symptoms were collected. Men and women were categorized by …