Gene/Protein Disease Symptom Drug Enzyme Compound
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In Nicaragua, a group of women physicians and health professionals created an alternative health service for women. "Si Mujer" (Yes Woman), which stands for Integrated Services for Women, provides: 1) gynecologic services (comprehensive check-up, early cancer detection, sterility counseling, and AIDS and sexually transmitted disease [STD] prevention); 2) obstetric services (prenatal care, normal and high-risk pregnancy care, and family planning); 3) counseling (for women, couples, and families, and for victims of sexual violence); and 4) sex education and training (in reproductive health, gynecology, and sexuality). The non-profit organization collects fees according to ability to pay (11% pay nothing) and serves approximately 800 clients per month. Special programs provide services to teenagers and to men. While the training program began as a secondary effort, it is now as important as the direct service provision, with training activities reaching more than 1600 people in the first year through courses on such topics as sexuality, gender and power, AIDS and STD prevention, and cancer prevention. Si Mujer is one of more than 52 women's health centers in Nicaragua that have arisen to fill the gap left by the deterioration of public health services and which apply a gender perspective to the manner in which they approach their clients.
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PMID:By and for women. Nicaragua's Si Mujer. 1217 38

World contraceptive prevalence has gone form 9% in 1960-65 to an estimated 50% by 1990. In 1976 there were 97 governments providing direct support for family planning; in 1988 that number grew to 125. To date, the single largest problem facing family planning associations (FPAs) has been too low a level of government funding. FPAs have traditionally only dealt with birth control and pregnancy avoidance,m but as the world has changed, so will the role of FPAs. In developing countries FPAs can either continue providing information, services, research, and advocacy or they can expand into new territory and become facilitators of community based services rather than service providers, become an innovating forced to develop new service strategies, and act as an advocate to increase government's awareness of sexual and reproductive issues. In developed countries the responsibility of contraceptive distribution has been largely taken over by general practitioners (GPs) so FPAs are moving into new territory such as education, STD/AIDS prevention, sexuality training, psychosexual counselling, and handling of sexual abuse and violence cases. Other new strategies for FPAs in developed countries include: public information and education, sexual education for youths, training of health care professionals, organization networking, community based education programs, and raising awareness of policy makers and planners. Eastern Europe provides a unique opportunity for FPAs. In many, democracy is making family planning less available. As market economies replace centrally planned economies, government involvement in people lives is being reduced. In many of these countries contraceptives were unavailable because of their high cost and low priority. In their place women relied upon abortion as their primary method of fertility control. However, abortion is becoming less and less available. The void this creates in terms of fertility control is not being filled which means that FPAs have a tremendous opportunity.
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PMID:Metamorphosis of the FPA. 1222 23

In Brazil, until 1990, the authorities could legally arrest a child found alone in the streets, and put them in prison-like institutions. Their crime? To be poor, usually black and living on the streets. The Brazilian Center for the Defense of the Rights of Children and Adolescents (SOS Crianca) was set up a few years ago with the aim of changing this legislation. Together with other nongovernment organizations, SOS Crianca drew up new legislation, lobbied politicians and policymakers, and publicized the issue at a new Child and Adolescent Statute, based on the International Declaration of Children's Rights, was made law. Lawyers volunteered their services to SOS Crianca, making sure that young people had access to legal support, so that the new law could be put into practiced. AIDS has added to the difficulties of young people living on the streets. In 1988, using a strategy similar to the one above, SOS Crianca started to work with key organizations and the children themselves, to draw up an HIV prevention strategy for street children. As well as being threatened with violence and police arrest, these children lack a basic human right--access to health care. Public health services in Brazil do not reach the 40% of the population who live in absolute poverty, which includes young people on the streets. Preventing AIDS is seen by SOS Crianca to be just a part of promoting better health and providing overall healthcare. Educational activities will not work if children do not have access to treatment, or to basic needs like food and shelter. SOS Crianca does not employ doctors because it is not the role of nongovernment organizations to take over the state's responsibility to provide basic health care. But how can the public clinics, staffed with underpaid professionals and lacking basic equipment meet the needs of street children? Meetings were organized with different health professionals, involving those most sensitive to the problem in setting up a referral system. Little by little we made progress. One day a doctor would make the appointment timetable more flexible, and the next a nurse would come to help develop counselling sessions. This support has helped to change the attitude of other health professionals towards these young people. Now a child on the streets can be told: "Go to this hospital, and you will be well treated." Our street educators try to give the children themselves an awareness of their right to use public health care facilities. The educators work every night on the streets, giving advice and counselling and assessing the children's health problems. In the mornings and afternoons the educators go with them to the clinics or follow up with other types of referrals. SOS Crianca also has an ongoing prenatal care program for girls and an STD diagnosis, counselling and treatment program, which includes HIV/AIDS. How many young people does SOS Crianca reach? The answer is not only to do with the numbers seeking health care, but also how many clinic doors are open to them. More and more young people, not just those living on the streets where SOS Crianca works, but others in poor communities, are using the service. It is called "Health Maloca," because the children call their makeshift homes--shelters made of cardboard and newspaper--"malocas." The name also symbolizes that these young people need to find their own ways of taking more control over their bodies and lives.
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PMID:Taking health promotion on to the streets. 1228 97

The Health in Prostitution Project was launched in 1991 in Rio de Janeiro, Brazil. The project offers a multi-year training program of health education designed to both fight the stigmatization of and violence against commercial sex workers and enhance their self-esteem, self-determination, and access to civil rights. The project therefore promotes individual awareness while influencing public opinion and policies. At first, health agents were recruited among women and transvestites who work in street-based sex work. The program was then gradually expanded to include young male sex workers and other locations, such as private parlors, saunas, and escort services. People of all sexes and sexual orientation now comprise the health agent group. The program has a paid staff of five women, three young men, and three transvestites, and approximately 70 sex workers are trained annually. Basic training includes topics such as human sexuality, personal risk assessment, HIV/STD infection, negotiation of safer sex, and STD referral services. Year two training emphasizes reproductive and women's health issues, while year three courses prioritize street work methodologies. Theatrical performances, speaking English as a second language, and performing Bach flower therapy for clients take place during the fourth year. Program trainers include medical specialists, nurses, psychologists, health educators, lawyers, and university students. At least half of the 350 health agents trained thus far are estimated to be currently engaged in paid or voluntary prevention work. Two surveys with female sex workers in 1991 and 1993 found that reported regular condom use increased from 57% to 73%; the health agents are having an effect. The program is constantly evaluated and revised.
AIDS STD Health Promot Exch 1995
PMID:Country watch: Brazil. 1234 18

The International Community of Women Living with HIV/AIDS (ICW) is the only international network run for and by women living with HIV infection and AIDS. This network of women educates, supports, and advocates for each other on local, national, and global levels. HIV-positive women often report feeling that everyone has an opinion upon how they should behave, especially with regard to pregnancy. Doctors and other health care workers often have moral and discriminating attitudes toward such women which often interfere with the standard of health care and information HIV-positive women receive in order to make informed choices. ICW is planning to explore the experiences of HIV-positive women with regard to their sexual and reproductive rights. Many women have experienced rejection, fear, and ignorance because of their HIV serostatus. Women should therefore not be singled out for HIV testing when they face such risks and violence. The counseling of couples and testing with joint consent could reduce women's vulnerability. Finally, there may be many reasons why a woman does not tell her children that she is HIV-positive. However, without being open about illness, it is very difficult to plan for the future.
AIDS STD Health Promot Exch 1997
PMID:Perinatal HIV transmission and children affected by HIV / AIDS: concepts and issues. 1234 83

The representative from the International Planned Parenthood Federation (IPPF) at the 15th Asian Parliamentarians' Meeting addressed the issue of negative consequences of the failure to meet the goals set at the ICPD. Global statistics on sexual and reproductive health are as follows: millions of women and men do not have access to safe and reliable family planning methods; thousands of women continue to die in pregnancy and childbirth; many suffer pain, ill health and permanent disability as a result of pregnancy and childbirth complications; up to 20 million unsafe abortions are performed on women, of whom 70,000 die every year; many young women and girls become unfactionally pregnant and lose the chance of an education and employment; pregnancy and childbirth are major killers of young women aged 15-19 years; a significant proportion of young women contract an STD; 70% of the world's 1.3 billion people living in absolute poverty are women. These women are also at risk during pregnancy and are least able to protect themselves from violence and rape, STDs and HIV/AIDS, unsafe abortion, and sexual exploitation. In conclusion, all the above concerns need support in moving governments toward better service organization and more frankness in a field where life and death are dangerously close to one another.
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PMID:Failure to meet ICPD goals will affect global stability, health of environment, and well-being, rights and potential of people. 1234 6

This study assessed hypotheses that measures of power and control over male condom (MC) use would predict use of the female condom (FC) among women with main partners from two public STD clinics (n = 616). The women (mean age 24 years, 87% African American) were enrolled in an intervention study to promote barrier contraceptive use and were interviewed at baseline and at 6 monthly follow-up visits. Seven baseline predictor variables were assessed: her having requested MC use, his having objected, her having wanted a MC used but not asking, percentage of MC use, perceived control over MC use, anticipated consequences of refusing unprotected sex, and physical violence. In the first Poisson regression analysis, none of the hypothesized predictors was significantly associated with FC use during follow up. In the second regression analysis, which assessed the influence of the hypothesized set of predictors on follow-up FC use in situations when MCs were not used, we found two effects. Either no or inconsistent MC use before study entry was associated with less subsequent FC use; women who reported, at study entry, having more control over MC use were more likely to use FCs during follow up. We found no evidence of adoption of the FC by women in relationships marked by history of conflict over the MC, circumstances in which alternatives are most needed. On the contrary, we found that women with a history of control and consistent use of MCs were the most likely users of FCs when MCs were not used.
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PMID:Do main partner conflict, power dynamics, and control over use of male condoms predict subsequent use of the female condom? 1453 5

We examined attrition from an HIV/STD group counselling intervention in two ways: quantitative analyses of the entire sample (n=287) and structured interviews of a subset of 30 women with low attendance. In the interviews, the most common reasons for low attendance were time conflicts and enrolling primarily to obtain the monetary incentives given for completing research questionnaires. Latent class statistical analysis of the full sample identified two subgroups that differed from each other in the number of psychosocial problems recently experienced. Relative to the 'non-distressed' class, the 'distressed' class members had higher probabilities of psychological distress, low incomes, heavy substance use, sex for trade, relationship violence, and unstable housing. This group had higher HIV/STD risk, but lower intervention attendance. Members also had less education and less knowledge about HIV/STD. A higher proportion of the distressed group was African-American. Study findings suggest that in interventions for women at HIV/STD risk, it is not necessarily enough to ensure cultural relevance and to provide food, childcare, and transportation. To increase retention, interventionists should consider (1) the use of strategies to support attendance (such as monetary incentives and attention to group process factors) and (2) intervention formats that are brief, matched to participants' stage of change, population-specific, and/or maximally accessible.
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PMID:The influence of psychosocial difficulties on women's attrition in an HIV/STD prevention program. 1461 2

This study describes the types of intimate partner violence (IPV) and sexual HIV-risk factors reported by a sample of 139 African American and Latina women ages 50 and older receiving care in outpatient clinics of an urban medical center. Additionally, we obtained estimates of the associations between experiencing IPV in a primary heterosexual relationship and the following HIV-risk behaviors among our sample of older minority women: (a) having multiple sexual partners, (b) STD history, (c) partner-related risk (i.e., having a partner who has multiple sexual partners, is HIV-infected, injecting drugs, and/or has an STD), and (d) self-perception of risk for HIV infection. Results indicate that many of these women are engaged in sexual risk behaviors, and such behaviors are associated with increased likelihood of IPV for this cohort. Implications for health care professionals are discussed.
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PMID:Considering HIV risk and intimate partner violence among older women of color: a descriptive analysis. 1500 82

This study analyzes the concepts displayed by rural men in the Zona da Mata region in the State of Pernambuco, Brazil, concerning their sexual practices and STD/AIDS prevention. The study adopts a qualitative methodology, having interviewed 22 men According to the interviews, their first sexual intercourse is characterized as a learning experience and is sometimes marked by violence. They make a distinction between the "woman at home" and "street women"; they acknowledge women's sexual desire and value reciprocity in sexual relations, differentiating between the kinds of sex they have with different categories of women. Seven men report homoerotic experiences during adolescence, which they ascribe to immaturity, not affecting their heterosexual identity. Condom use, perceived in a negative light, is inconstant and irregular, inversely proportional to knowing the female partner. STDs in general inspire little fear, while AIDS is associated with death; the interviewees do not see themselves at risk of acquiring HIV. Ambiguities in the men's discourse, together with a basically ineffective approach by health services and preventive campaigns, reveal a high level of exposure to the risk of contracting STDs/AIDS among the interviewees and their female or male partners.
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PMID:[Sexuality and STD/AIDS prevention: social representations by rural men in a county in the Zona da Mata region in Pernambuco, Brazil]. 1502 62


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