IRIN/PlusNews Examines Ritual In Guinea-Bissau Believed To Prevent Spread Of HIV

IRIN/PlusNews recently examined a ritual, known as tarbessadu, performed by traditional healers in Guinea-Bissau that many people in the country believe can prevent a woman who has given birth from contracting HIV. According to IRIN/PlusNews, traditional healers use a pig, half a sack of rice, black corn and five liters of sugarcane brandy to perform tarbessadu. Some say if a pregnant woman does not go through the ritual, she will contract HIV and transmit it to her male partner.

Tarbessadu is practiced primarily by the Balanta ethnic group, which accounts for about 20% of the country's 1.4 million residents, according to Ali Hizazi of the Italian nongovernmental organization Ceu e Terra, which works with pregnant HIV-positive women. Hizazi said that rituals, such as tarbessadu, are important to the people in Guinea-Bissau because little is known about HIV. The country's HIV prevalence is about 4%, IRIN/PlusNews reports. According to a 2006 survey, one-third of people in Guinea-Bissau believe HIV/AIDS depends on the will of God.

"People don't accept AIDS as a disease, so they attribute it to something women failed to do, or did wrong, and for which they are being punished," Hizazi said, adding, "Blame is internalized because the man just doesn't accept this responsibility. He thinks that the woman's promiscuity is what has led him to be punished by God by becoming infected." The 2006 survey also found that most Guineans would end a relationship if their partner tested positive for HIV, which makes many pregnant women reluctant to be tested, according to IRIN/PlusNews.

In addition, there are only two health care facilities in the country that offer services to prevent mother-to-child HIV transmission, IRIN/PlusNews reports. Paulo Mendes -- president of the National Secretariat for the Fight Against AIDS, or SNLS -- said, "It's hard for us to plan prophylactic treatment against mother-to-child transmission in a regular manner, due to the hardships we face in terms of human, financial and material resources." It also is difficult to closely monitor women and infants for up to 18 months after delivery, according to IRIN/PlusNews. Ceu e Terra was able to monitor about 800 infants between 2002 and 2006 in Guinea-Bissau, which was less than 50% of the infants born to HIV-positive women during that time period. "Many mothers either become desperate, turn to alternative medicine or simply fail to comprehend the gravity of the situation," Oscar Basisio, president of Ceu e Terra, said.

Additional data from SNLS found that 75% of the 4,124 pregnant women who received information on HIV testing during prenatal visits in the first half of last year agreed to be tested for the virus. The tests results showed that 217 of the women were HIV-positive and that 42% of their partners agreed to be tested (IRIN/PlusNews, 1/28).


Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation© 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

New York Times Analyzes Ford's Decision Not To Challenge Gillibrand For N.Y. Senate Seat

The New York Times on Tuesday examined how former Rep. Harold Ford (D-Tenn.) came to concede that a campaign against Sen. Kirsten Gillibrand (D-N.Y.) in the Democratic primary "would be a brutal fight dominated by endless debates about when he began paying taxes as a New Yorker and the sincerity of his support for gay marriage and abortion rights." After weeks of courting Democratic donors and traveling the state to meet with voters, Ford announced on Monday that he would not challenge Gillibrand in the primary.

According to the Times, "Ford knew that some liberals would attack his relatively conservative voting record but, those he spoke with said, he was taken aback by the depth of the anger he encountered from advocates for abortion rights and gay marriage." Reporters uncovered examples of Ford describing himself as "pro-life" during his time in the House. Ford responded that he has always supported abortion rights, and he hoped to put the matter to rest. However, his earlier statements on abortion continued to attract attention, and Ford "was dumbfounded that it kept tripping him up," a Ford friend told the Times. Some New York officials also questioned Ford's experience in politics and his ability to fund a meaningful campaign against Gillibrand.

Ford met with Kelli Conlin, the president of NARAL Pro-Choice New York, in an attempt to "neutralize a foe," the Times reports. Conlin asked Ford for clarification of his abortion views and legislative history, including his support for a bill to limit abortion later in pregnancy even if the woman's health is in jeopardy. Ford responded by asking why NARAL did not excoriate Gillibrand for supporting the Senate's health reform bill (HR 3590), which includes restrictions on health insurance coverage of abortion. At the meeting's conclusion, Ford said that he hoped to meet with Conlin again to ask for her group's support if he chose to run, to which Conlin replied, "We can never support you if you take these positions." Ford "looked shocked" by her response, according to a person in the room at the time (Barbaro [1], New York Times, 3/2).

Zuckerman Will Not Challenge Gillibrand

In related news, billionaire publisher and real estate developer Mortimer Zuckerman announced Tuesday that he will not challenge Gillibrand for the Senate seat this year, despite growing speculation that he would run in November's election. Zuckerman, who likely would have run as a self-financed Republican candidate, considered Gillibrand vulnerable and told friends that he thought his status as a political outsider would be valuable in the election (Barbaro [2], New York Times, 3/2).


Reprinted with kind permission from nationalpartnership. You can view the entire Daily Women's Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women's Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.


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Fast Pharmacy Access To The Morning-after Pill Could Prevent 10% More Unwanted Pregnancies

Pharmacies who provide fast and convenient access to the morning-after pill could be helping to prevent 10 per cent more unwanted pregnancies, according to a study in the latest British Journal of Clinical Pharmacology.


UK researchers from South West Kent Primary Care Trust and the University of Bradford looked at 203 females aged from 13 to 20 who got the medication from family planning clinics and community pharmacies.


They discovered that those who went to a pharmacy to get the morning-after pill obtained it more than twice as quickly as those who went to their local clinic - in 16 hours rather than 41.


Figures from the World Health Organization suggest that taking emergency contraception up to 24 hours after unprotected sex prevents 95 per cent of pregnancies, while taking it between 24 and 48 hours later prevents 85 per cent.


The study also found that:


Older teenagers tended to seek help quicker, with 14 year-olds taking almost four times as long (37 hours) as 20 year-olds (10 hours).


The time it took to get the morning-after pill from family planning clinics was much more consistent, with the majority waiting between 38 and 42 hours.


72 per cent of those who obtained the morning-after pill from clinics were aged between 15 and 17, while 74 per cent who went to pharmacies were between 16 and 18.


25 per cent visited the pharmacy over the weekend and 26 per cent on a Monday.


Two-thirds of girls under 16 said they needed the morning-after pill because they hadn't used any contraception. The other third blamed split condoms.


Two-thirds of those in the 16 plus age group sought the morning-after pill because they had had a contraception failure - either the condom had split or they had missed taking the pill.


"The UK currently has the highest rate of teenage pregnancies in Western Europe and the highest rate of live births among teenagers" says Dr Kay Marshall from the School of Pharmacy at the University of Bradford.


"The morning-after pill - often referred to by health professionals as emergency hormonal contraception - has long been recognised as a safe and effective method of preventing unintended pregnancies.


"The name is a bit misleading, because it can actually be taken within 72 hours of unprotected sex, not just the morning after. But as the effectiveness of the morning-after pill declines significantly with time - it works best if taken within 24 hours - it's essential that it can be obtained as soon as possible.


"We believe that the females in our study were able to access the pill much more quickly from local pharmacists as they tend to be open outside normal working hours and at weekends."


The morning-after pill has traditionally been provided free in the UK by family doctors and family planning clinics. It became available over-the-counter
at pharmacies in 2001.















Selected community pharmacists can now provide it free of charge to females under 20 as long as they feel that all the appropriate conditions have been satisfied and that she is competent to make the decision to take it.


This is an important development, especially for young girls who can't afford to pay the over-the-counter cost, which recently increased to ?25.


Pharmacists providing the item free are required to submit a return to the Primary Care Trust, which includes the age of the client and the number of hours between unprotected sex or contraception failure and dispensing.


The researchers collated data from 116 pharmacy request forms and compared them with 87 requests for emergency contraception from two of the busiest family planning clinics in the Primary Care Trust area.


"Our study suggests that community pharmacists are providing a valuable role in preventing unwanted pregnancies by supplying the morning-after pill and backing this up with advice on contraception and sexual health" says Gaye Lewington from SouthWest Kent Primary Care Trust, which oversees and commissions local health services in the area.


"Recent studies have suggested that allowing pharmacies to supply the morning-after pill does not compromise contraceptive practice or sexual behaviour. This is very important because encouraging females to practice safe sex is just as much a priority as preventing unwanted pregnancies.


"It is essential that the morning-after pill is available promptly if a female feels there is a pregnancy risk, but it is also very important that it continues to be seen as an emergency measure rather than an alternative to using contraception as a matter of routine."


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Many Benefits From Cardiac Rehab, Yet Many Women Don't Participate

People who participate in cardiac rehabilitation cut their chances of dying of heart disease by nearly 30 percent in the subsequent two to five years, according to the August issue of Mayo Clinic Women's HealthSource. Other proven results include less stress, less pain, reduced risk of future heart problems and improved ability to return to work and participate in social activities.


Yet, fewer than one-third of people who are eligible for cardiac rehab actually participate. Women, minorities and older people in particular are under-represented. Women, especially older women, are less likely to be referred for cardiac rehab and, when referred, less likely to attend.


Cardiac rehab programs are tailored to meet individual needs, but typically include medical evaluation, counseling, training and support to adopt the lifestyle changes that will help prevent future heart problems. Elements typically include:


Increasing exercise: Exercise strengthens heart muscles, so it can pump more blood with less effort. An optimal goal for most people is 45 to 60 minutes of exercise a day, with strength training two to three times a week.


Modifying risk factors: Patients develop a plan to address the risks that contribute to heart disease, including smoking, obesity, diabetes, high blood pressure or high cholesterol.


Nutrition: Patients work with a dietitian to learn about heart-healthy meal planning and eating, with an emphasis on plenty of fruits and vegetables and foods low in saturated fats, trans fats, cholesterol, refined sugar and salt.


Psychological health: Cardiac rehabilitation often includes treatment for mental health concerns, as well as emotional support. Depression is very common after a heart attack or other cardiac event, and women are particularly vulnerable. Patients also may experience anxiety, anger and social isolation; all can contribute to further heart problems.


Cardiac rehab is most often recommended for patients who've had a heart attack. It's also helpful for those who have had coronary bypass surgery, angioplasty, stents or pacemaker placement, heart valve surgery, or a heart or lung transplant. People with heart failure, chest pain (angina), peripheral artery disease or congenital cardiovascular disease also can benefit.


Source:

Mayo Clinic Women's HealthSource

Adolescent Girls More Active If Neighborhoods Have Parks

Adolescent girls who live within half a mile of a public park are significantly more physically active than other girls, University of North Carolina at Chapel Hill researchers have found.



The study found that physical activity was higher for girls who lived within a mile of parks and showed highest levels among girls who lived less than one-half mile from a park, said Dr. Diane Catellier, a study investigator and research associate professor of biostatistics in the UNC School of Public Health. The researchers found that girls only got about 114 minutes a week of intense physical activity outside of school hours, or about 16 minutes a day.



Dr. Deborah Cohen, a senior natural scientist at RAND Corporation and lead author of the study, said the U.S. surgeon general recommends that all children and adolescents get at least 60 minutes of exercise a day. "We still have a long way to go in encouraging girls to be active."



The results appear in the November 2006 issue of Pediatrics. The study was led by the RAND Corporation, a nonprofit research organization. Researchers from UNC-Chapel Hill, the University of Arizona, the University of South Carolina and San Diego State University participated. Funding was provided by the National Heart, Lung and Blood Institute, part of the National Institutes of Health.



In the wake of growing national concern about increasing rates of obesity and health problems brought about by Americans' diets and sedentary lifestyles, the study findings could have implications for both males and females in other age groups as well, Catellier said.



"The study suggests that having access to parks in neighborhoods and communities can make a significant difference in the level of physical activity girls get," Catellier said. "More research may show that the trend is also true for boys and others in a neighborhood. We believe neighborhood parks are particularly important for adolescents who are too young to drive."



To examine the relationship between parks and physical activity, the researchers used baseline data from the Trial of Activity for Adolescent Girls. The trial is a national research study led by the UNC School of Public Health focusing on middle school girls.



The study team tracked 1,556 girls in the sixth grade in six cities and counted the average number of public parks within a half-mile radius of the homes of girls in the cities. The girls were fitted with accelerometers - devices that measure physical activity - and were monitored for six days.



The study sites include Minneapolis, Minn. (2.2 parks within a half-mile radius of participants); Baltimore, Md. and Washington, D.C. (1.8 parks); San Diego, Calif. (1.2 parks); New Orleans, La. (0.9 parks); Columbia, S.C. (0.7 parks); and Tucson, Ariz. (0.34 parks).



The researchers found that parks with active amenities such as basketball courts, playgrounds and walking paths were associated with more physical activity than parks with passive amenities, such as picnic areas and lawn games.



The study suggests that communities should make parks a higher priority, particularly ones with amenities like running tracks or walking paths, Catellier said. Previous studies have shown that girls become less physically active once they reach adolescence, and that girls are generally less physically active than boys, she said.







Study authors include: Dr. Kelly R. Evenson, research associate professor of epidemiology at the UNC School of Public Health, J. Scott Ashwood, Molly M. Scott and Adrian Overton, of RAND; Dr. Lisa Staten, co-director of the Southwest Center for Community Health Promotion and associate professor of family and child health at the Mel and Enid Zuckerman College of Public Health at the University of Arizona; Dr. Dwayne Porter, associate professor and graduate director of environmental health sciences at the Arnold School of Public Health, University of South Carolina; and Dr. Thomas L. McKenzie, professor emeritus of exercise and nutritional sciences at San Diego State University.



Contact: Becky Oskin


University of North Carolina at Chapel Hill