October 2008 AJPH Highlights: Reproductive and Sexual Rights

Newswise — The articles below will be published online August 13, 2008, at 4 p.m. (ET) by the American Journal of Public Health under "First Look" at http://www.ajph.org/first_look.shmtl, and they are currently scheduled to appear in the October 2008 print issue of the Journal. "First Look" articles have undergone peer review, copyediting and approval by authors but have not yet been printed to paper or posted online by issue. The American Journal of Public Health is published by the American Public Health Association, http://www.apha.org, and is available at www.ajph.org.

HIV stigma may be lessened by access to antiretroviral therapy

Researchers examined HIV stigma in a population-based study of 1,268 adults in Botswana in 2004, after the introduction of a national program of universal access to antiretroviral therapy (ART) in 2002. Results showed 38 percent of participants had at least one stigmatizing attitude; 23 percent would not buy food from a shopkeeper with HIV and 5 percent would not care for a relative with HIV. Fifty-four percent anticipated being ostracized after testing positive for HIV ("anticipated stigma" ). When comparing these figures to a 2001 study that used similar measures of stigmatizing attitudes, researchers found a decrease, suggesting that HIV stigma may have lessened since the 2002 policy of universal ART. The study's authors found that perceived access to ART was strongly associated with decreased odds of holding stigmatizing attitudes and of anticipated stigma.

"HIV stigma represents a widespread and significant barrier to HIV prevention, testing, and treatment," the study's authors said. "Universal access to ART may play a critical role in the reduction of HIV stigma in sub-Saharan Africa." However, the authors continue, this cannot be the only approach to tackling the issue of HIV stigma, but rather should be part of a multimodal strategy including educational initiative, community mobilization and social and legal reform.

[From: "The Impact of Universal Access to Antiretroviral Therapy on HIV Stigma in Botswana." ]

U.S. women significantly increase use of contraceptive services

Using nationally representative survey data, researchers examined the patterns and trends in the use of sexual and reproductive health care services in U.S. women aged 15 to 44 between 1995 and 2002. The results conclude that the receipt of contraceptive services (a birth control method or a prescription) among American women rose significantly during the time of this study (1995-2002) from 36 percent to 41 percent; however the overall receipt of sexual and reproductive health care services remained constant, with 74 percent of U.S. women reporting receipt of such services.

"Possible explanations for this trend include both increased demand for contraceptive services (e.g., because of changing contraceptive use patterns) and improved financial accessibility of contraceptive care within the private sector (e.g., because of better insurance coverage of contraceptive services)," the study's author inferred.

[From: "Trends in U.S. Women's Use of Sexual Reproductive Health Care Services, 1995-2002" . ]

Breastfeeding varies dramatically by State in initiation and duration

States in the West and Northwest had higher breastfeeding initiation estimates than other parts of the United States. Using data from a nationally representative study of 33,121 children from six to 71 months, researchers attempted to account for the wide state variations of breastfeeding rates in the United States and the impact of socio-demographic and behavioral factors and state legislation on these differences. They found that children in states with multiple pieces of breastfeeding promotion legislation were more likely to have ever been breastfed.

"Breastfeeding interventions and promotion efforts must take into consideration changing cultural norms, hopefully this will lead to an environment that is more supportive of breastfeeding, thereby helping us move toward attainment of the Healthy People 2010 breastfeeding goals." the study's authors said.

[From: "Multivariate Analysis of State Variation in Breastfeeding Rates in the United States." ]

Female condom skills training reduces unprotected sex acts among women

Using a randomized trial with a sample of 409 U.S. women recruited from family planning clinics in northern California, researchers tested the hypothesis that female condom skills training would successfully lead to an increase in sustained use of female condoms and protected sex. Participants were randomly placed in the experimental four-session female condom skills training intervention or the comparison four-session women's general health promotion intervention and were followed for six months. Compared to the comparison group, women in the experimental group reported increased female condom use but no reduction in male condom use. Therefore, researchers concluded that skills training can increase female condom use and the overall level of protected sexual acts.

"These results suggest that our intervention has the potential to reduce HIV risk among women and can be an effective supplement to other HIV prevention strategies currently available for women and their sexual partners," the study's authors inferred.

[From: "The Efficacy of Female Condom Skills Training in HIV Risk Reduction Among Women: A Randomized, Controlled Trial." ]

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