Sexually transmitted infections: progress and challenges since the 1994 International Conference on Population and Development (ICPD)

AbstractBackgroundDespite being recognized as an important challenge at the 1994 International Conference on Population and Development (ICPD), sexually transmitted ınfections (STIs) other than HIV are one of the most neglected dimensions of sexual and reproductive health. STIs, often undiagnosed and untreated, have especially harmful consequences for women and their neonates.Progress since ICPDDuring the last two decades, substantial knowledge and experience have accumulated in behavior change programming during the global response to the HIV epidemic which can also be used for prevention of STIs. There has been progress in development and implementation of vaccines against certain STIs such as hepatitis B and the human papilloma virus. Development of a rapid, point-of-care test for syphilis has opened the door to control this infection.ChallengesThe estimated annual incidence of non-HIV STIs has increased by nearly 50% during the period 1995–2008. The growth in STIs has been aggrevated by a combination of factors: lack of accurate, inexpensive diagnostic tests, particularly for chlamydia and gonorrhea; lack of investment to strengthen health systems that can deliver services for diagnosis and management of STIs; absence of surveillance and reporting systems in the majority of countries; political, socioeconomic and cultural barriers that limit recognition of STIs as an important public health problem; and failure to implement policies that are known to work.RecommendationsGovernments, donors and the international community should give higher priority to preventing STIs and HIV; fully implementing behavior change interventions that are known to work; ensuring access of young people to information and services; investing in development of inexpensive technologies for STI diagnosis,treatment and vaccines; and strengthening STI surveillance, including of microbial resistance

Why Iranian married women use withdrawal instead of oral contraceptives? A qualitative study from Iran

<p>Abstract</p> <p>Background</p> <p>Withdrawal as a method of birth control is still used in Iran. The aim of this study was to explore married women's perspectives and attitudes on withdrawal use instead of oral contraceptive (OC) in Tehran, Iran.</p> <p>Methods</p> <p>This was a qualitative study. Participants were 50 married women, not currently pregnant, not desiring pregnancy and who had been using withdrawal for contraception. Face-to face interviews were conducted to collect data. Content analysis was performed to analyze the data.</p> <p>Results</p> <p>Four major themes were extracted from the interviews: advantages, disadvantages, barriers for OC use, and husband-related factors. Advantages of withdrawal use were identified as: easy to use, convenient, ease of access, natural. Even those participants who had experienced unwanted pregnancy while using withdrawal, relied on withdrawal as their contraceptive method. Disadvantages of OC included concerns about side effects. Barriers related to use of OC included the need for medical advice, vaginal examination and daily use. Husband-related factors included: the husband wanted to be the primary decision maker on the number of children and that he preferred withdrawal.</p> <p>Conclusion</p> <p>Health providers should address misunderstandings that exist about OC and highlight the non-contraceptive health benefits of OC to balance the information provided for women. We suggest that not only women but also their spouses be advised in family planning programs.</p

Acceptability and Use of the Diaphragm and Replens® Lubricant Gel for HIV Prevention in Southern Africa

The acceptability and use of the diaphragm and lubricant gel were assessed as part of a large randomized controlled trial to determine the effectiveness of the methods in women’s HIV acquisition. 2,452 intervention-arm women were enrolled at five Southern African clinics and followed quarterly for 12–24 months. Acceptability and use data were collected by face-to-face interviews at Month 3 and Exit. Participants were “very comfortable” with the physical mechanics of diaphragm use throughout the trial, and approval of the gel consistency, quantity and the applicator was high. At Exit, consistent disclosure of use (AOR 1.97, 95% CI: 1.10–3.55); an overall high diaphragm rating (AOR 1.84, 95% CI: 1.45–2.34) and perception of partner approval (AOR 1.75, 95% CI: 1.35–2.26) were the most significant acceptability factors independently associated with consistent use. Despite being female-initiated, disclosure of use to male partners and his perceived approval of the products were factors significantly associated with their consistent use

Reports and considerations of Ismail Bey Gasprinskii in Tercüman on Central Asia

Ilber Ortayli, Reports and considerations of Ismail Bey Gasprinskii in Tercüman on Central Asia. A detailed study of Ismail Bey Gasprinskii's newspaper Tercüman allows to note various features and dimensions of his political thought and attitude towards Russia. His clear views as regard the solidarity of Islamic peoples did not hinder his plea in favor of the adoption of Western institutions. He also emphasized the civilizing mission of Russia in the Asiatic provinces of the Empire. Gasprinskii - who was an official of the Russian Empire - tended to cooperate with Russian liberal intellectuals and officials and attacked vehemently in his articles the pan-Slavist Russian circles. Unlike the Young Turks, he professed to admire the regime of Sultan Abdulhamid II because of the educational reforms it introduced which he supported by word and deed.liber Ortayli, Rapports et réflexions ď'Ismail Bey Gasprinskij sur l'Asie Centrale dans Tercüman. Une étude détaillée de Tercuman, le journal d'Ismail Bey Gasprinskij révèle les diverses facettes de sa pensée politique et de son attitude envers la Russie. Il a clairement exprimé son attitude politique à propos de la solidarité des peuples islamiques. Cela ne l'empêcha pas cependant de préconiser l'adoption des institutions occidentales. Il souligna également la mission civilisatrice de la Russie dans les provinces asiatiques de l'Empire. Gasprinskij qui était un fonctionnaire de l'Empire russe tendait à coopérer avec les intellectuels et les fonctionnaires russes libéraux et attaquait violemment dans ses articles les cercles russes pan-slavistes. A la différence des Jeunes Turcs il professait son admiration pour le régime du sultan Abdulhamid II parce qu'il avait introduit des réformes de l'éducation qu'il soutenait en paroles et en action.Ortayli Ilber. Reports and considerations of Ismail Bey Gasprinskii in Tercüman on Central Asia. In: Cahiers du monde russe et soviétique, vol. 32, n°1, Janvier-mars 1991. En Asie Centrale soviétique Ethnies, nations, États. pp. 43-46