African health workers performing male circumcision in an effort to curb the spread of HIV need better tools and more training to avoid high rates of complications, according to a World Health Organization study published Monday in the WHO Bulletin, Reuters Health reports. The authors conducted the study among 1,007 participants, 298 of whom were physically examined by the authors. The researchers also intervened when they observed complications. According to the study, complications such as bleeding, infection, excessive pain and erectile dysfunction occurred in as many as 35% of males circumcised in Kenya’s Bungoma district by traditional practitioners, with an estimated 6% of patients experiencing lifelong problems.

Although male circumcision is practiced universally in Bungoma, the study said many clinicians in Bungoma were not trained formally and lacked clean and sharp instruments. The study also found that the rate of complications in public clinics was 18%. The study’s findings have “raised questions” about how quickly male circumcision should be included as part of HIV prevention strategies supported by WHO and UNAIDS, according to Reuters Health. The study authors said extensive training and resources are needed to “build the capacity of health facilities in sub-Saharan Africa” before male circumcision can be included in prevention strategies. They added that the high rate of complications “should also serve as an alarm to ministries of health and the international health community that focus cannot only be on areas where circumcision prevalence is low.” The authors concluded that health workers should be provided with training in sterilization techniques, surgical procedures, pain management, post-operative care and counseling about wound care before male circumcision is implemented on a wide scale (MacInnis, Reuters Health, 9/1).

The study is available online.

Reprinted with kind permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation.

© 2008 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

When counseling patients about preventing sexually transmitted diseases (STDs), it’s important for physicians to ask direct questions about both intercourse and noncoital sexual activity, according to a new Committee Opinion issued by The American College of Obstetricians and Gynecologists (ACOG).

Noncoital sexual behavior includes mutual masturbation, and oral and anal sex and is common among adults and adolescents. Despite concerns expressed in the popular media about an increase in oral sex among adolescents and young adults, there is no evidence that this is the case. However, research does show that oral sex is much more common among adolescents who have already had vaginal intercourse, suggesting that these sexual activities occur at about the same time and with the same partner.

“Most people, including adolescents, are unlikely to use condoms during oral sex, which places them at risk for acquiring an STD,” said Richard Guido, MD, chair of ACOG’s Committee on Adolescent Health Care, which issued the opinion along with ACOG’s Committee on Gynecologic Practice. “This unlikelihood is partly because of a greater perceived safety compared with intercourse. Although sexual behavior is a sensitive issue to address for both patients and physicians, it’s important to discuss sexuality frankly and without judgment so that we can help our patients fully protect themselves against STDs.”

The Committee Opinion notes that the risk of getting certain STDs varies depending on the specific disease and the sexual behavior. For instance, the risk of acquiring HIV through oral sex is less than through vaginal sex, with receptive anal sex having the highest risk. Herpes, however, is commonly transmitted through kissing and through oral, vaginal, and anal sex. Herpes simplex virus Type 1 (HSV-1), typically associated with oral herpes (ie, “cold sores”), can be transmitted to the genitals through oral sex. And, herpes simplex virus Type 2 (HSV-2), typically associated with genital herpes, can be transmitted to the mouth through oral sex. Nonviral STDs, including gonorrhea, chlamydia, and syphilis, also can be transmitted through noncoital sexual activity.

“Our lesbian and bisexual patients also need be screened for STDs based on the same risk factors as other women,” Dr. Guido noted. “Most lesbians have been sexually active with men at some point. Even without this sexual history, there are some STDs that can be transmitted between two women during sexual activity.”

According to ACOG, physicians should ask more direct questions about a patient’s sexual behavior so that they can provide counseling on ways to lower the risk for STDs. Since most women who engage in noncoital sexual activity are also having intercourse, clinicians need to consider whether these noncoital behaviors add any additional risks to those already posed by intercourse. Risk-reduction strategies include limiting the number of sexual partners, STD testing before engaging in sexual activity with a new partner, correct and consistent use of condoms, abstinence, and/or mutual monogamy.

Committee Opinion #417, “Addressing Health Risks of Noncoital Sexual Activity,” is published in the September 2008 issue of Obstetrics & Gynecology.

The American College of Obstetricians and Gynecologists is the national medical organization representing over 52,000 members who provide health care for women.

American College of Obstetricians and Gynecologists

Van Andel Institute (VAI) researchers have found that curcumin, a component of the curry spice turmeric, blocks herpes simplex virus (HSV-1) infections that commonly result in facial cold sores. Finding out how curcumin blocks the infections will be key to developing a treatment for cold sore sufferers.

“We found that cells treated with curcumin did not support herpes simplex virus infections very well,” said Michigan State University graduate student Sebla Kutluay, lead author of the findings published in Virology who is completing her thesis research at Van Andel Institute. “Now we need to determine how curcumin blocks the infections.”

There are two types of herpes simplex virus: HSV-1, which commonly results in facial cold sores or fever blisters, and HSV-2, commonly associated with genital herpes. The VAI findings focused on HSV-1, which affects more than half of Americans. Resulting cold sores can be painful, unsightly, and recur frequently.

“This isn’t a recipe for a remedy yet,” said VAI Scientific Investigator and Graduate School Dean Steven J. Triezenberg, Ph.D., head of the laboratory that published the findings. “Applying turmeric or curry to cold sores won’t have an effect. Once we determine what is happening to block the infections at the cellular level, we’ll be closer to developing a treatment.”

Established by Jay and Betty Van Andel in 1996, Van Andel Institute is an independent research organization dedicated to preserving, enhancing and expanding the frontiers of medical science, and to achieving excellence in education by probing fundamental issues of education and the learning process.

Van Andel Institute

Bayer Schering Pharma AG, Germany, will supply up to 110 million cycles of oral contraceptives yearly for family planning programs supported by the U.S. Agency for International Development (USAID) in developing countries worldwide. This will allow more than 8 million women per year to have access to modern and reliable hormonal contraception. The contract was signed with the organization John Snow, Inc. (JSI) that implements international family planning programs for USAID.

Bayer Schering Pharma will provide the high-quality oral contraceptives Microgynon® 30 ED Fe and Microlut®. These products will be distributed in USAID-supported public and social marketing programs in Africa, Asia and Middle East, Europe and Latin America.

“As the market leader in hormonal contraceptive products, Bayer Schering Pharma is especially committed to enabling people to carry out conscious family planning,” said Dr. Ulrich Koestlin, member of the Board of Management of Bayer Schering Pharma AG. “The right to have a baby by choice, not by chance, is crucial to families worldwide. Our company wants to contribute to access to medicines efforts around the world and is, therefore, happy to support USAID with their family planning field programs.”

Conscious family planning is key in the promotion of social and economic progress. It contributes toward reducing the health risk for women in childbirth and pregnancy and toward avoiding unwanted pregnancies and abortions.

“USAID has provided commodities for family planning and reproductive health activities since the mid-1970s. Since then, contraceptive and condom use rates around the world have increased, thanks to USAID and other international donors,” said Bonita Blackburn, Public Health Advisor of USAID. “USAID welcomes Bayer Schering Pharma and its commitment to providing safe, reliable oral contraceptive pills to hundreds of family planning programs worldwide in support of USAID’s global mission.”

Bayer Schering Pharma will deliver up to 50 million cycles per year of Microgynon® 30 ED Fe and Microlut® for public markets and up to 60 million cycles per year for social marketing programs for distribution in more than 50 USAID-supported programs worldwide. Microgynon® 30 ED Fe is the most widely prescribed oral contraceptive for family planning programs worldwide.

Family planning is an important part of Bayer Schering Pharma’s social engagement. For almost 50 years the company has been supporting programs globally in a network of public-private-partnerships. It is active in more than 130 countries, giving people access to a wide range of family planning methods. Since 1961 Bayer Schering Pharma has supplied 2.5 billion cycle packages of oral contraceptives to family planning organizations and programs in developing countries and has provided consultancy in reproductive health matters.

Through its long-term and sustained commitment, Bayer Schering Pharma wants to make a substantial contribution to achieving the United Nations’ Millennium Development Goals: strengthening the position of women, reducing child mortality, and improving maternal health by 2015. In this way the company is also helping to achieve the UN World Population Conference’s target of guaranteeing worldwide access to fertility-control methods by 2015.

A podcast on this topic can be found here: http:// www.podcast.bayer.com.

The Bayer Group is a global enterprise with core competencies in the fields of health care, nutrition and high-tech materials. Bayer HealthCare, a subsidiary of Bayer AG, is one of the world’s leading, innovative companies in the healthcare and medical products industry and is based in Leverkusen, Germany. The company combines the global activities of the Animal Health, Consumer Care, Diabetes Care and Pharmaceuticals divisions. The pharmaceuticals business operates under the name Bayer Schering Pharma AG. Bayer HealthCare’s aim is to discover and manufacture products that will improve human and animal health worldwide. Find more information at http://www.bayerhealthcare.com.

Bayer Schering Pharma is a worldwide leading specialty pharmaceutical company. Its research and business activities are focused on the following areas: Diagnostic Imaging, General Medicine, Specialty Medicine and Women’s Healthcare. With innovative products, Bayer Schering Pharma aims for leading positions in specialized markets worldwide. Using new ideas, Bayer Schering Pharma aims to make a contribution to medical progress and strives to improve the quality of life. Find more information at http://www.bayerscheringpharma.de.

Forward-Looking Statements

This release may contain forward-looking statements based on current assumptions and forecasts made by Bayer Group or subgroup management. Various known and unknown risks, uncertainties and other factors could lead to material differences between the actual future results, financial situation, development or performance of the company and the estimates given here. These factors include those discussed in Bayer’s public reports which are available on the Bayer website at www.bayer.com. The company assumes no liability whatsoever to update these forward-looking statements or to conform them to future events or developments.

A team of researchers is examining how different perceptions of masculinity can influence HIV prevention messages in Central America, the Columbia State reports. The team, which is supported by USAID and Population Services International, has held focus groups with 1,200 men from El Salvador, Guatemala, Nicaragua and Panama to learn about different perceptions of masculinity and how the men see themselves. The men completed 11-point surveys on issues such as what motivates them, what is important in life and what word best describes them. Using the surveys, the researchers developed six primary categories to which HIV/AIDS prevention messages can be customized, according to the State. “It’s another approach for behavioral change messages,” Susana Lungo, program director for the initiative, said.

The six primary categories are powerful, men to whom researchers should stress that they have the power to choose condom use; energetic, who can be reached by emphasizing that they can make a contribution to the fight against HIV/AIDS; protector, who should be given messages about fidelity and condom use for the sake of protecting their families; relaxed, who tend to be receptive to condom use because of generally open attitudes; searchers, to whom condom use has to be presented in interesting and engaging ways; and passionate, men who are receptive to fidelity and condom use messages out of respect for their partners.

According to the researchers, although the categories were developed to promote HIV prevention, they also can be used for teenage pregnancy prevention and other health issues (Reid, Columbia State, 8/21).

Reprinted with kind permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation.

© 2008 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

A bill seeking to promote the development of microbicides to prevent HIV and other sexually transmitted infections has been introduced in the Philippines, the Philippines News Agency reports. The legislation was filed by Rep. Narciso Santiago and states that the Department of Health and its components should increase research into the initial mechanism of infection by STIs. The bill also mandates that the health department evaluate the safety and efficacy of microbicides in animal models; research the design of contraceptive and non-contraceptive microbicides; examine the development of a mucosal delivery system; and create clinical trials and behavioral research on the use, acceptability and compliance of microbicides.

According to Santiago, the social, health and economic effects of STIs are particularly severe in developing countries such as the Philippines, where women ages 15 to 49 are most affected. Santiago said the STIs that could be prevented by the use of microbicides “impose high human costs in pain, diminished quality of life, disability and death,” adding that STIs “substantially enhance susceptibility to HIV infection.” According to Santiago, he hopes the legislation will “lessen if not totally stop” the spread and impact of STIs. Hepatitis B, herpes, HIV and human papillomavirus represent two-thirds of new STIs recorded in the country, Santiago said (Philippines News Agency, 8/21).

Reprinted with kind permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation.

© 2008 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

Planned Parenthood Southwest Ohio Region on Wednesday launched a campaign called the “A-Word” in an effort to educate the public that the organization provides more than abortion services, the AP/Huntington Herald-Dispatch reports. Becki Brenner, chief executive of PPSWO, said, “People automatically associate the A-Word with abortion, but we are about so much more than that,” adding, “It’s difficult to communicate that to people when you are defined by one small piece of what you do.” Brenner said that abortions account for only about 2% of the organization’s services in the 22 southwest Ohio counties served by its 10 clinics.

The ads, which will run for about six weeks in the Cincinnati Enquirer and other Enquirer publications, focus on the “A-Words” of abstinence, access, affordability and advocacy and how they relate to what PPSWO says are its main goals of family planning and reproductive health care, according to the AP/Herald-Dispatch. The group also has launched a Web site that aims to start public discussion on its services and promote dialogue on strategies of abortion prevention. Brenner said, “There is always a core group out there where we will never be able to change minds, but we hope to find some common ground with other members in the public.”

According to the AP/Herald-Dispatch, the campaign comes amid efforts by Rep. Steve Chabot (R-Ohio) to prevent PPSWO from relocating one of its clinics to another Cincinnati neighborhood. Chabot’s re-election campaign recently submitted a petition with nearly 1,100 signatures calling for the organization to stop the move, Katie Fox, spokesperson for Chabot’s campaign, said. Right to Life of Greater Cincinnati also opposes the move because the new location would be near four high schools. Paula Westwood, the group’s executive director, said, “The true ‘A-Word’ for Planned Parenthood is abortion, and setting up near high schools is an easy way to get business.” Brenner said that the organization does not target teenagers and that 90% of those served by the clinic in question are older than age 18. She added that the clinic will go ahead with its move in October as planned (Cornwell, AP/Huntington Herald-Dispatch, 8/20).

Reprinted with kind permission from http://www.nationalpartnership.org. 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.

© 2008 The Advisory Board Company. All rights reserved.

In order for Namibia to increase access to male circumcision in an effort to curb the spread of HIV in the country, resources need to be mobilized and health facilities nationwide better prepared, Minister of Health and Social Services Richard Kamwi said recently, the New Era/AllAfrica.com reports. According to the New Era/AllAfrica.com, a two-day workshop to examine issues associated with rolling out a male circumcision campaign opened in Namibia on Tuesday. Speaking at the workshop, Kamwi said that health services are not ready “[a]t this stage” to increase circumcision efforts. Brian Pazvakavambwa — United Nations AIDS team leader for the Inter-Country Support Team for Eastern and Southern Africa — said that male “circumcision requires resources, hence the need for a well-calculated plan” (Sibeene, New Era/AllAfrica.com, 8/20).

According to the New Era/AllAfrica.com, a nationwide assessment recently was conducted in Namibia to examine attitudes, perceptions, potential effects and resource implications of a male circumcision campaign. According to the assessment, about 21% of adult men in the country are circumcised. It also found that although many respondents understood the potential health benefits of circumcision, they also reported being concerned about risks associated with the procedure. Physician Nelao Amagulu said that health experts are concerned that circumcised men might believe they are immune to HIV and engage in unsafe sex practices. She added that male circumcision should be viewed as “a tool within a comprehensive package” of HIV prevention measures. According to the New Era/AllAfrica.com, experts estimate that 80,000 new HIV cases can be prevented between 2008 and 2025 by strategically targeting male circumcision at adolescent and adult men. Discussions held during the two-day conference will help in the development of a national plan on male circumcision (Sibeene, New Era/AllAfrica.com, 8/19).

Reprinted with kind permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation.

© 2008 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

Despite “overwhelmingly negative” responses and “rampant noncompliance” of some Roman Catholics to Pope Paul VI’s 1968 Humanae Vitae, which condemns contraception use, some Catholic leaders in the Detroit area are increasingly promoting the encyclical, the Detroit News reports. Some priests in the area said church members are expressing a growing interest in the document’s teachings (Krupa, Detroit News, 8/20). “Humanae Vitae,” which translates to “On Human Life,” is a document that says most Catholics should refrain from using “artificial birth control” (Daily Women’s Health Policy Report, 5/12).

A conference on Humanae Vitae is scheduled for next month at Sacred Heart Major Seminary in Detroit. Janet Smith, a professor at the seminary, said, “Our purpose is to deepen the understanding of the teaching, so that it will be accepted by Catholics, and to make them better defenders of it.” She added that the seminary also is “trying to meet those who have rejected it to reconsider and hopefully to accept it.”

Some surveys have shown that more than 90% of sexually active Catholic women have used some form of birth control, and about the same percentage of Catholics believe the church should permit members to use condoms and oral contraception. However, Robert McClory, chancellor of the Archdiocese of Detroit, said the younger generations “not involved with the intensity of the introduction of Humanae Vitae” view the document as a “new approach” to sexuality. He said that the topic most often is raised in marriage preparation courses, adding that some young couples are beginning to show a willingness to follow the encyclical (Detroit News, 8/20).

Reprinted with kind permission from http://www.nationalpartnership.org. 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.

© 2008 The Advisory Board Company. All rights reserved.

“HIV Prevention Among Vulnerable Populations: The Pathfinder International Approach” (.pdf), Pathfinder International: The report provides information about the risks faced by populations that are particularly vulnerable to HIV/AIDS, including commercial sex workers, injection drug users and men who have sex with men. It also examines effective prevention strategies aimed at such groups, including peer education, comprehensive health services and treatment, referral networks and other training (Pathfinder release, 8/20).

Reprinted with kind permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation.

© 2008 Advisory Board Company and Kaiser Family Foundation. All rights reserved.