HIV and AIDS
Complex Role for Marriage in HIV Risk, Studies Find
If present patterns
continue, in the next decade more than 100 million girls will be child
brides, that is, married before the age of 18, according to Council research.
“In some cultures, girls are married off at very young ages due to poverty,
custom, and in some cases the idea that it provides protection from HIV and
other threats. But our research clearly shows that marriage per se, and
child marriage especially, cannot be assumed to be a sexual safety zone,”
explains Council researcher Judith Bruce. “Girls married at a young age are
actually at a higher risk than unmarried girls for HIV infection in some
settings.” Delaying marriage, however, does not improve safety. “Delaying
marriage until the mid- to late-twenties often results in a period of
high-risk sex involving multiple or serial partners,” says Council
demographer John Bongaarts.
Reproductive Health
Partner-Delivered Therapy Viable in Resource-Poor
Areas
In South Africa and Brazil, the Population Council has
recently studied alternative methods of notifying partners of women with
sexually transmitted infections (STIs) that they need treatment. These
studies have verified that offering women with STIs the option of
bringing medicines to their partners, rather than requiring partners to
come to the clinic, results in high treatment rates.
HIV and AIDS
Unsafe Behaviors Most Common Among Poor Women
Around the world, HIV infects about 1 percent of
15–24-year-olds, but in KwaZulu-Natal, South Africa, more than 14
percent of people in this age group are infected, according to a 2003
population-based survey by Lovelife and the Reproductive Health Research
Unit in Johannesburg. Young women are at particularly high risk of
infection. South Africa has three infected 15–24-year-old females for
every infected male of the same age. Poverty may play a key role in HIV
risk. Population Council health economist Kelly Hallman investigated the
effect of socioeconomic disadvantage on the sexual behaviors of young
women and men in KwaZulu-Natal, the most populated South African
province. She found that poverty is more consistently correlated with
unhealthy sexual behaviors among females than among males.
HIV Prevention
Education Improves Breastfeeding Practices in Zambia
Last year 800,000
children became infected with HIV, most of them during their mother’s
pregnancy, childbirth, or through breastfeeding. In antenatal clinics in
Ndola, Zambia, the Population Council’s Horizons program, in collaboration
with three nongovernmental organizations and two government agencies,
tested the introduction of infant feeding counseling to inform women about
ways to reduce the risk of HIV transmission during breastfeeding and to
support them in their infant feeding choices. Research showed that women
receiving infant feeding counseling maintain healthier breastfeeding
practices in the first six months of their infants’ lives but that more
work is needed to increase community use of HIV counseling and testing
services and to promote behavior change.
Epidemiology
What Factors Affect the Prevalence of HIV in Sub-Saharan Africa?
Population Council researchers
participated along with several other investigators in a recent study on
HIV. The findings of the investigation, known as the multicentre study of
factors determining the different prevalences of HIV in sub-Saharan
Africa, were presented in a special supplement to the journal AIDS. The
research findings indicate that changes in HIV-prevention policy are
urgently needed.
Epidémiologie
Quels facteurs affectent la prévalence du VIH en Afrique subsaharienne?
Plus de 3 des 5 millions de personnes
nouvellement infectées par le VIH en 2001 vivent en Afrique subsaharienne
selon l’ONUSIDA. La majorité des adultes infectés par le VIH en Afrique
ont acquis leur infection à travers des rapports hétérosexuels. Au cours
des décennies, depuis que l’épidémie du SIDA a été remarquée pour la
première fois, des chercheurs ont observé que la prévalence de l’infection
à l’intérieur de l’Afrique variait considérablement. Tandis que de
nombreux endroits en Afrique de l’Est et australe connaissent des taux
élevés d’infection, les régions d’Afrique de l’Ouest et du centre ont
généralement des taux d’infection plus faibles. Un certain nombre de
théories visant à expliquer ces disparités ont été avancées. Mais jusqu’à
présent, il n’y a pas eu d’étude systématique pour examiner directement la
question.
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HIV Prevention
More Data Needed Before Male
Circumcision Is Advocated
A growing body of research shows that uncircumcised men
in certain parts of Africa are twice as likely as circumcised men
to be HIV-infected. These findings suggest that male circumcision
may offer a measure of protection against HIV infection, and public
health experts have begun to debate the possibility of encouraging
male circumcision as an anti-HIV intervention. To explore this issue,
the Population Council’s Horizons Project organized a two-day meeting
of scientists from around the world. The meeting’s participants
identified several cultural, medical, and ethical issues that should
be explored before the procedure is recommended as an intervention.
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Prévention du VIH
Il faut encore plus de données pour
pouvoir plaider en faveur de la circoncision masculine
Un volume croissant de recherches indique que les hommes incirconcis
dans certaines parties d’Afrique présentent deux fois plus de
probabilités d’être infectés par le VIH que les hommes circoncis. Ce
résultat semble indiquer que la circoncision masculine pourrait
offrir une certaine mesure de protection contre l’infection par le
VIH et des experts de santé publique ont commencé à discuter de la
possibilité de promouvoir la circoncision masculine comme
intervention anti-VIH. Afin d’élucider la question, le programme
Horizons du Population Council a organisé pendant deux jours une
réunion d’experts provenant des quatre coins du monde. Les
participants ont identifié plusieurs questions culturelles,
médicales et éthiques qui devraient être étudiées avant que la
procédure ne puisse être recommandée comme intervention.
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