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I. PROGRAM RESOURCES
1. Adolescent Maternal Mortality: An Overlooked Crisis
2. Bottom of the Ladder
3. DISHA (Development Initiative on Supporting Healthy Adolescents)
4. Educating All Children: A Global Agenda
5. Getting Girls Out of Work and Into School
6. Improving U.S. Global AIDS Policy for Young People: Assessing the President's Emergency Plan for AIDS Relief
7. Integrating Family Planning and HIV/AIDS Services for Young People: Tools for Programming
8. Myths, Misperceptions and Fears: Addressing Condom Use Barriers
9. New Insights on Preventing Child Marriage: A Global Analysis of Factors and Programs
10. Teacher Absence as a Factor in Gender Inequalities in Access to Primary Schooling in Rural Pakistan
11. YA Magazine
II. RESEARCH SUMMARIES
1. Adult male circumcision outcomes: experience in a developing country setting
2. Association between condom use at sexual debut and subsequent sexual trajectories: a longitudinal study using biomarkers
3. Attitudes of mothers in Da Nang, Vietnam toward a human papillomavirus vaccine
4. Break the silence: HIV/AIDS knowledge, attitudes, and educational needs among Arab university students in United Arab Emirates
5. Experiences of sex trafficking victims in Mumbai, India
6. Factors affecting abortion decisions among young couples in Nepal
7. Immunization of early adolescent females with human papillomavirus type 16 and 18 L1 virus-like particle vaccine containing AS04 adjuvant
8. The impact of female genital cutting on the health of newly married women
9. Nonconsensual sexual experiences of adolescents in urban India
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I. PROGRAM RESOURCES
1. Adolescent Maternal Mortality: An Overlooked Crisis (2007, PDF, 198 KB)
This two-page brief presents an overview of adolescent maternal mortality, including statistical data, causes, prevention, and promising programs and initiatives.
Organization: Advocates for Youth
Contact: information@advocatesforyouth.org
2. Bottom of the Ladder (2007)
This 110-page report focusing on Guinea and Mali documents how girls as young as 8 years old work up to 18 hours a day as domestic workers, frequently without pay. They are often insulted, beaten, and raped by their employers. Domestic work is the largest employment category among children in Guinea. Some girls are victims of trafficking and forced labor.
Organization: Human Rights Watch
Contact: http://www.hrw.org/contact.html
3. DISHA (Development Initiative on Supporting Healthy Adolescents) (2006)
These two documents (each five pages) summarize results of a baseline survey and a project undertaken by the International Center for Research on Women (ICRW) to develop, implement, and test integrated approaches for improving the reproductive health and lives of young people in the Indian states of Bihar and Jharkhand. The project aims to delay marriage and childbearing among youth, provide them with alternatives to early marriage, increase their access to reproductive health information and services, and increase the capacity of local groups in addressing the interconnected needs of young people.
Organization: ICRW plus six local partner organizations
Contact: info@icrw.org
4. Educating All Children: A Global Agenda (2007)
This book, available for purchase, describes how education can improve health outcomes and how sound health and nutrition practices in school can increase attendance and learning. The ability to read, write, and do elementary math is essential if more women are to benefit from micro-enterprise opportunities, engage effectively in the democratic process, develop their full individual potential, and model for their children the importance of knowledge and learning.
Organization: American Academy of Arts and Sciences, MIT Press
Contact: http://mitpress.mit.edu/shared/contact/default.asp
5. Getting Girls Out of Work and Into School (2006, PDF, 1.81 MB)
This 24-page policy brief summarizes the causes and consequences of girls' child labor on their educational opportunities and describes some of the instruments and strategies in place to reduce girls' labor. It describes initiatives in China, India, and the Philippines, setting out key actions to increase girls' participation in education.
Organization: UNESCO Asia and Pacific Regional Bureau for Education
Contact: bangkok@unescobkk.org
6. Improving U.S. Global AIDS Policy for Young People: Assessing the President's Emergency Plan for AIDS Relief (2007, PDF, 1.22 MB)
This 44-page report discusses the implications of U.S. government policies, such as the 33 percent abstinence-until-marriage funding mandate, on the health of young people, and it incorporates findings from field research in South Africa, Kenya, and Malawi.
Organization: Advocates for Youth
Contact: information@advocatesforyouth.org
7. Integrating Family Planning and HIV/AIDS Services for Young People: Tools for Programming (2007)
This report summarizes four interrelated aspects of an integrated approach to the delivery of reproductive health services, and provides examples and tools for each: developing youth friendly services, training providers, supporting providers with job aids, and promoting services in the community.
Organization: The INFO Project
Contact: infoproject@jhuccp.org
8. Myths, Misperceptions and Fears: Addressing Condom Use Barriers (2007, PDF, 652 KB)
This booklet provides evidence-based information that shows consistent use of male or female condoms is highly effective at preventing unintended pregnancy and the transmission of HIV and other sexually transmitted infections.
Organization: UNFPA, IPPF
Contact: martinez@unfpa.org
9. New Insights on Preventing Child Marriage: A Global Analysis of Factors and Programs (2007)
This 60-page booklet examines factors associated with risk of, or protection against, child marriage, as well as action strategies and the effectiveness of current approaches to preventing child marriage in developing countries.
Organization: ICRW
Contact: info@icrw.org
10. Teacher Absence as a Factor in Gender Inequalities in Access to Primary Schooling in Rural Pakistan (2007, PDF, 924 KB)
This report examines the educational system in Pakistan, where primary school enrollment among girls in rural areas is substantially lower than among children in urban areas and among boys in rural areas, owing to lack of access to government girls' schools. The focus is on teacher absence as a further barrier to schooling for girls.
Organization: Population Council
Contact: pubinfo@popcouncil.org
11. YA Magazine (2007, PDF, 1.02 MB)
YA Magazine is a quarterly youth publication by IPPF/Africa Region. This issue features issues related to youth and the Millennium Development Goals as well as stories from Kenya, Tanzania, Malawi, Burundi, Ghana, and other countries.
Organization: IPPF Africa Region
Contact: info@ippfaro.org
II. RESEARCH SUMMARIES
1. Adult male circumcision outcomes: experience in a developing country setting. Krieger JN, Bailey RC, Opeya JC, et al. Urol Int 2007;78(3).
The authors examined male circumcision outcomes among healthy, sexually active, uncircumcised, HIV-seronegative African males aged 18-24 years. The main outcomes measured included complications, healing, satisfaction, and resumption of activities. Of 1,475 procedures, 26 (1.8%) were associated with 27 adverse events, most commonly wound disruption/delayed healing (0.6%), wound infection (0.4%), and bleeding (0.3%). Adverse events per clinician averaged 3.8 and 2.1% for procedures 1-100 and 101-200, respectively, and <1% for procedures 201-300, 301-400, and >400, respectively (p<0.001). Participants resumed normal general activities after a median of 1 postoperative day, and 93% with regular employment resumed working within 1 week. After 30 days, 99% of participants reported being very satisfied. After 90 days, 65% reported having had sex, 45% reported that their partners had expressed an opinion, 92% of whom were very satisfied with the outcome.
2. Association between condom use at sexual debut and subsequent sexual trajectories: a longitudinal study using biomarkers. Shafii T, Stovel K, Holmes K. Am J Public Health 2007;97(6).
This paper compares subsequent sexual behaviors and risk of sexually transmitted infections among adolescents who did and did not use a condom at their sexual debut. The authors derived data from the U.S. National Longitudinal Study of Adolescent Health, which followed a sample of 4,018 sexually active adolescents between 1994 and 2002. During waves I, II, and III of the study, data on sexual behavior were gathered, and at wave III, urine specimens were collected to test for sexually transmitted infections. Among interviewed adolescents, those who reported condom use at their debut were more likely than those who did not use condoms at their debut to report condom use at their most recent intercourse (on average 6.8 years after sexual debut), and they were only half as likely to test positive for chlamydia or gonorrhea (adjusted odds ratio=0.50; 95% confidence interval=0.26, 0.95). Reported lifetime numbers of sexual partners did not differ between the two groups. The article concludes that adolescents who use condoms at their sexual debut do not report more sexual partners, are more likely to engage in subsequent protective behaviors, and experience fewer sexually transmitted infections than do adolescents who do not use condoms at their sexual debut.
3. Attitudes of mothers in Da Nang, Vietnam toward a human papillomavirus vaccine. Dinh TA, Rosenthal SL, Doan ED, et al. J Adolesc Health 2007;40(6).
Vietnamese women who were the primary caregiver of a girl 10-18 years old completed a survey addressing general vaccine attitudes, attitudes toward an HPV vaccine, beliefs about sexuality, recommendations from others, and likelihood of having their daughter vaccinated against human papilloma virus (HPV). A total of 194 surveys were returned; 181 (93%) contained analyzable data. Eleven percent of mothers were aware of an HPV vaccine. Ninety-four percent believed that the HPV vaccine will be effective, and 90% disagreed that their daughter would have sex early if she was vaccinated. Beliefs regarding premarital sex, such as "girls who have sex before marriage are not respected" and "it would be hard to find a husband," were held by 76% and 62% of mothers, respectively. Despite this, over 90% were in favor of their daughter receiving the HPV vaccine. Ninety-five percent indicated that a recommendation from their doctor would be very important in their decision-making, and 78% indicated that the media would be very important.
4. Break the silence: HIV/AIDS knowledge, attitudes, and educational needs among Arab university students in United Arab Emirates. Ganczak M, Barss P, Alfaresi F, et al. J Adolesc Health 2007;40(6).
A cross-sectional survey on knowledge and attitudes about HIV was conducted among randomly selected first-year, gender-segregated Arab students at the national university in Al Ain in 2005. Response was 89%; 119 males and 148 females. Knowledge scores about HIV/AIDS were low for 75%, moderate for 24%, and high for <1%. Although 90% knew main routes of infection, there were misconceptions about transmission, and only 31% knew there is no vaccine and 34% no cure. Religion was stated as a reason to avoid extramarital relationships by 91% and sexually transmitted diseases (STDs) by 38%; 94% favored premarital testing. Attitudes toward people living with HIV (PLH) were neither friendly nor tolerant, including 97% who felt all people entering UAE should be tested, 53% that PLH should be forced to live apart, and only 27% who felt children with HIV should be allowed to attend school. Ninety-six percent stated that young people should be taught how to protect themselves and 57% that teaching at school was insufficient. Main information sources were books/media; preferred sources were media, schools, and health professionals. Males scored higher on knowledge and were more susceptible to fear of STDs, society, and family; females showed greater compassion and interest in premarital testing and education to protect themselves.
5. Experiences of sex trafficking victims in Mumbai, India. Silverman JG, Decker MR, Gupta J, et al. Int J Gynaecol Obstet 2007;97(3).
This article explores mechanisms and contexts related to sex trafficking victimization among South Asian women and girls rescued from brothels in Mumbai, India. Records of residents at a major nongovernmental organization providing rescue, shelter, and care of minor girls and of women held against their will in brothels in Mumbai were systematically reviewed (n=160). Descriptive statistics were calculated, and demographic differences in trafficking mechanisms and pre-disposing contexts were explored. The majority of victims (51.9%) were trafficked as minors and by individuals previously known to them (59.7%). Traffickers most commonly lured victims via promises of economic opportunity (55.0%) or kidnapped individuals via use of drugs or force (26.3%). Victims were most often trafficked from public settings (e.g., markets, train stations; 50.9%) and via public transportation (94.9%). Almost half (49.4%) reported some type of family disruption as directly leading to their being trafficked; violence involving husbands or other family members (38.0%) and marital separation or abandonment (32.9%) were the most common forms of disruption reported. Differences in experiences of trafficking were identified based on age, nationality, education, and marital status; no differences were found based on religion.
6. Factors affecting abortion decisions among young couples in Nepal. Puri M, Ingham R, Matthews Z. J Adolesc Health 2007;40(6).
This article explores, using both survey data and case studies, factors that are associated with abortion decisions among young couples in the context of recently legalized abortion in Nepal. The article draws primarily on data collected in detailed case histories of 30 participants selected from a sample of the respondents to a survey of 997 married women aged 15 to 24 years and 499 men aged 15 to 27 years collected in 2003. Bivariate analyses of the survey data are presented in summary form to provide some general contextual background, with the key themes that emerged from analysis of the case histories being described. Data revealed that almost half of the young women in the survey reported that they had ever experienced an unintended pregnancy. A considerable proportion of these couples thought about abortion but the majority of them did not take any action. Some of them had attempted abortion but only a few had succeeded. Multiple factors, including socio-cultural beliefs, affect the decision-making phase, making the process dynamic and situation-specific. Husbands and health service providers play a major role in the decision-making process.
7. Immunization of early adolescent females with human papillomavirus type 16 and 18 L1 virus-like particle vaccine containing AS04 adjuvant. Pedersen C, Petaja T, Strauss G, et al. J Adolesc Health 2007;40(6).
In females 15-25 years of age, the AS04-containing human papillomavirus (HPV)-16/18 vaccine is highly immunogenic and provides up to 100% protection against HPV-16/18 persistent infection and associated cervical lesions up to 4.5 years. Optimal cervical cancer prevention will require prophylactic vaccination against oncogenic HPV 16 and 18 before the onset of sexual activity in early adolescent girls. To establish the feasibility of vaccination in girls 10-14 years of age, this article compares the immunogenicity and safety in early adolescent females to those 15-25 years in whom vaccine efficacy has been demonstrated. The authors enrolled 773 female participants aged 10-14 years and 15-25 years to receive the HPV-16/18 L1 VLP AS04 vaccine, which was administered at months 0, 1, and 6. Serum samples were collected at months 0 and 7; antibodies to HPV 16 and 18 VLPs were measured by enzyme-linked immunosorbent assay. Vaccine safety was assessed at 7 or 30 days after each dose; serious adverse events were recorded during the entire study period. Both age groups achieved 100% seroconversion for HPV 16 and 18. Participants in the group aged 10-14 years were not only noninferior to those 15-25 years in terms of HPV 16 and 18 seroconversion rates but also had approximately twice as high geometric mean titers. The vaccine was generally safe and well tolerated. These findings suggest that HPV vaccination during early adolescence is generally safe, well tolerated, and highly immunogenic. The observed higher antibody titers in the group 10-14 years of age are likely to result in longer antibody persistence. Overall, these data support the implementation of prophylactic HPV vaccination in this age group.
8. The impact of female genital cutting on the health of newly married women. Elnashar A, Abdelhady R. Int J Gynaecol Obstet 2007;97(3).
The authors randomly selected 264 newly married women in Benha City, Egypt to detect the rate of female genital cutting and compare long-term health problems between circumcised and non-circumcised women. The circumcised group constitutes 75.8% of the sample. All non-circumcised women were living in an urban area. Dysmenorrhea was more common among circumcised women, with a statistically significant difference (p<0.01). Marital problems (dyspareunia, loss of libido, failure of orgasm, and husband's dissatisfaction) had statistically different levels of significance among circumcised women. Obstetric problems such as tears, episiotomy, and consequently distressed babies were more common among circumcised mothers. Circumcised females had significant mental problems such as somatization, anxiety, and phobia (p<0.001).
9. Nonconsensual sexual experiences of adolescents in urban India. Jaya J, Hindin MJ. J Adolesc Health 2007;40(6).
This article describes the prevalence and factors associated with nonconsensual sexual experiences of unmarried adolescents (583 boys and 474 girls), ages 15-19 years, from economically disadvantaged neighborhoods in Delhi, India. It also describes their reports of perpetrators. Thirty-two percent of boys and 42% of girls reported being touched against their will. After multivariate adjustment, both boys and girls who had ever worked (odds ratio [OR]=1.76, p=0.05 and OR=1.79, p=0.004, respectively) and those who had a friend of the opposite gender (OR=3.64, p=0.0001 and OR=2.19, p=0.0001, respectively) were more likely to report the experience. Fifteen percent of boys and 3% of girls reported that someone forcibly tried to have a physical relationship with them. Boys who had ever worked (OR=3.73, p=0.007) were more likely to report the experience. Both boys and girls who had a friend of the opposite sex were more likely to report attempted forced physical relationship (OR=3.73, p=0.0001 and OR=3.41, p=0.03, respectively). The most commonly reported perpetrators were female friends for boys (72%) and neighbors (60%) for girls. The findings underscore the need to develop programs that enable young people to prevent and cope with nonconsensual sexual experiences.
