Diversity among clients of female sex workers in India: comparing risk profiles and intervention impact by site of solicitation. implications for the vulnerability of less visible female sex workers.

BACKGROUND: It seems generally accepted that targeted interventions in India have been successful in raising condom use between female sex workers (FSWs) and their clients. Data from clients of FSWs have been under-utilised to analyse the risk environments and vulnerability of both partners. METHODS: The 2009 Integrated Biological and Behavioural Assessment survey sampled clients of FSWs at hotspots in Andhra Pradesh, Maharashtra and Tamil Nadu (n=5040). The risk profile of clients in terms of sexual networking and condom use are compared across usual pick-up place. We used propensity score matching (PSM) to estimate the average treatment effect on treated (ATT) of intervention messages on clients' consistent condom use with FSW. RESULTS: Clients of the more hidden sex workers who solicit from home or via phone or agents had more extensive sexual networks, reporting casual female partners as well as anal intercourse with male partners and FSW. Clients of brothel-based sex workers, who were the least educated, reported the fewest number/categories of partners, least anal sex, and lowest condom use (41%). Consistent condom use varied widely by state: 65% in Andhra Pradesh, 36% in Maharashtra and 29% in Tamil Nadu. Exposure to intervention messages on sexually transmitted infections was lowest among men frequenting brothels (58%), and highest among men soliciting less visible sex workers (70%). Exposure had significant impact on consistent condom use, including among clients of home-based sex workers (ATT 21%; p=0.001) and among men soliciting other more hidden FSW (ATT 17%; p=0.001). In Tamil Nadu no impact could be demonstrated. CONCLUSION: Commercial sex happens between two partners and both need to be, and can be, reached by intervention messages. Commercial sex is still largely unprotected and as the sex industry gets more diffuse a greater focus on reaching clients of sex workers seems important given their extensive sexual networks

Does Landscape Fragmentation Influence Sex Ratio of Dioecious Plants? A Case Study of Pistacia chinensis in the Thousand-Island Lake Region of China

The Thousand-Island Lake region in Zhejiang Province, China is a highly fragmented landscape with a clear point-in-time of fragmentation as a result of flooding to form the reservoir. Islands in the artificial lake were surveyed to examine how population sex ratio of a dioecious plant specie Pistacia chinensis B. was affected by landscape fragmentation. A natural population on the mainland near the lake was also surveyed for comparison. Population size, sex ratio and diameter at breast height (DBH) of individuals were measured over 2 years. More than 1,500 individuals, distributed in 31 populations, were studied. Soil nitrogen in the different populations was measured to identify the relationship between sex ratio and micro-environmental conditions. In accordance with the results of many other reports on biased sex ratio in relation to environmental gradient, we found that poor soil nitrogen areas fostered male-biased populations. In addition, the degree of sex ratio bias increased with decreasing population size and population connectivity. The biased sex ratios were only found in younger individuals (less than 50 years old) in small populations, while a stable 1∶1 sex ratio was found in the large population on the mainland. We concluded that the effects of landscape fragmentation on the dioecious population sex ratio were mainly achieved in relation to changing soil nitrogen conditions in patches and pollen limitation within and among populations. Large populations could maintain a more suitable environment in terms of nutrient conditions and pollen flow, subsequently maintaining a stable sex ratio in dioecious plant populations. Both micro-environmental factors and spatial structure should be considered in fragmented landscape for the conservation of dioecious plant species

Factors associated to breastfeeding cessation before 6 months

O objetivo da pesquisa foi identificar os fatores associados ao abandono do aleitamento materno (AM) e do aleitamento materno completo (AMC). Foram acompanhadas 248 mães que fizeram visita pós-parto. Os dados foram coletados mediante entrevista pessoal durante o primeiro mês pós-parto e, pelo telefone, aos quatro e seis meses seguintes. A análise se realizou mediante a Regressão de Cox. Os resultados mostram associação entre o abandono da AMC e do AM com o fato de não se ter amamentado anteriormente, com AM anterior ≤4 meses, e, com pior avaliação da experiência anterior. O menor nível de estudos se relaciona com maior abandono do AM e das chupetas, ou suplementos no hospital com o abandono da AMC. A educação pré-natal é fator protetor para o AMC e o AM. Conclui-se que o apoio ao AM deveria intensificar-se nas mães: sem experiência anterior, com experiência negativa, e, com pior acesso à informação; também deveria ser controlado o uso da chupeta e dos suplementos de leite artificial (LA) não indicados.El objetivo de la investigación fue identificar los factores asociados al abandono de la lactancia materna (LM) y de la lactancia materna completa (LMC). Fueron acompañadas 248 madres que acudieron a la visita posparto. Los datos fueron recolectados mediante entrevista personal durante el primer mes posparto y por teléfono a los cuatro y seis meses siguientes. El análisis se realizó mediante la Regresión de Cox. Los resultados muestran una asociación con el abandono de la LMC y de la LM con no haber amamantado anteriormente, con LM anterior ≤4 meses, y, con una peor valoración de la experiencia anterior. El menor nivel de estudios se relaciona con un mayor abandono de la LM y los chupetes o suplementos en el hospital con el abandono de la LMC. La educación prenatal es un factor protector para la LMC y la LM. Se concluye que el apoyo a la LM debería intensificarse las madres: sin experiencia anterior, con experiencia negativa, y, con peor acceso a la información; también debería controlarse el uso de chupetes y suplementos de leche artificial (LA) no indicados.This research aimed to identify the determinants of full breastfeeding (FBF) and any breastfeeding (ABF) cessation before 6 months, through a six-month follow-up of 248 mothers going a postpartum visit. Data were collected by personal interview during the first month and telephone interviews at four and six months postpartum. Cox’s proportional hazards model was used. Not having previous ABF experience, previous ABF duration ≤4 months and worse evaluation of previous experience were associated with cessation of ABF and FBF. Lower educational level was associated with cessation of ABF and the use of pacifiers or occasional breast-milk substitutes with cessation of FBF. Attending childbirth education was a protective factor against early FBF or ABF cessation. Activities supporting breastfeeding should be intensified for mothers with poorer access to information and with negative or without ABF previous experience. The use of pacifiers and not-medically indicated breast milk substitutes should be controlled