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Biomedical subjects

J Menken

Publications and source records attributed to J Menken.

At least 19 recordsLinked to original sources
PubMed2001

Population-based HIV testing and counseling in rural Uganda: participation and risk characteristics.

OBJECTIVES: To assess self-selection in a population-based voluntary HIV testing and counseling (VTC) program by comparing the HIV risk characteristics of users and nonusers of VTC in rural Uganda. DESIGN: A 1994 to 1995 community-randomized trial in the Rakai District of Uganda enrolled adults aged 15 to 59 years and ascertained their HIV status, sociodemographic characteristics, risk behaviors, and AIDS-associated symptoms. All subjects were offered confidential individual VTC at no cost. METHODS: We compared users and nonusers of VTC among 10,950 participants (4764 male and 6186 female) enrolled at baseline using multivariate logistic regression. RESULTS: Women were significantly less likely to receive VTC than men (31.5% vs. 34.8%, p <.001). In multivariate analysis, younger age, HIV-positive status, and having no sexual partners in the past 5 years (and, significant for women only, having 2 or more sexual partners) were associated with lower VTC participation for both men and women. Among women, higher VTC participation was associated with symptoms suggestive of AIDS and other illnesses and shopkeeper occupations. CONCLUSIONS: During the initial phase of a population-based free VTC program in rural Uganda, certain high-risk groups were underrepresented among VTC recipients. There is a need to target VTC to ensure participation by high-risk individuals most in need of services.

AIDS Serodiagnosis↗
PubMed1992

Older widow mortality in rural Bangladesh.

Prospective data from rural Bangladesh are used to explore the adverse impact of widowhood on old age female mortality. The results indicate that widows aged 45 and above have significantly higher mortality than their currently married counterparts. Controlling for age and disability status, much of this excess mortality risk can be accounted for by patterns of living arrangements and household assets. An analysis of older widows suggests that the presence of adult male kin in the household (primarily sons), and to a lesser extent household headship (both of which may be interpreted as reflecting individual access to resources in this society) have a substantial impact on mortality risks for this group of women.

Aged↗
PubMed1991

Individual-level sterility: a new method of estimation with application to sub-Saharan Africa.

This paper extends work on measures of population proportions sterile to propose a new estimator of an individual woman's age at sterility and consequently her sterility status at given ages. Accuracy and reliability, examined in a simulation study, appear satisfactory. From World Fertility Survey data for five African countries, the proportions sterile by age estimated by the individual measure and by the population estimator are almost identical. Cameroon and Kenya show substantial variation in prevalence and incidence of sterility across ethnic groups and by number of marriages. Unexpectedly, the evidence suggests that sterility increased from 1960 on in Kenya and remained unchanged in Cameroon.

Adolescent↗
PubMed1989

Measuring sterility from incomplete birth histories.

In this article, methods are presented for measuring the level and age pattern of sterility from incomplete birth histories, such as those that can be collected in demographic surveys of women who may not yet have reached the end of their reproductive span. The characteristics of the methods are examined in a simulation study that demonstrates that estimates based on information about fertility subsequent to a given age are more robust to variations in reproductive determinants, sample size, and sampling variation than the other measures, which include the frequently employed length of the open birth interval. In an illustrative analysis of World Fertility Survey data from sub-Saharan Africa, sterility was found to be high in Cameroon, intermediate in Lesotho and Sudan, and low in Ghana and Kenya relative to an English historical population.

Adult↗
PubMed1989

Birth-interval dynamics in rural Bangladesh and maternal weight.

This article reports on the results of a study conducted in rural Bangladesh on the influence of maternal weight on the components of birth intervals, including gestation and intrauterine mortality, the duration of postpartum amenorrhea, and the duration of waiting time to conception (the menstrual interval). When biological factors (including maternal age, parity, and supplementation practices) and behavioral variables, including religion, education, and occupation, were controlled, maternal weight was found to be related to the risk of intrauterine mortality and to the probability of resuming menses in the postpartum period. The implications of these findings for policies and programs in developing countries are discussed.

Amenorrhea↗
PubMed1986

Age and infertility.

Direct evidence on age patterns of infecundity and sterility cannot be obtained from contemporary populations because such large fractions of couples use contraception or have been sterilized. Instead, historical data are exploited to yield upper bounds applicable to contemporary populations on the proportions sterile at each age. Examination of recent changes in sexual behavior that may increase infecundity indicates that sexually transmitted infections, the prime candidate for hypothesized rises in infertility, are unlikely to have added to infecundity to any great extent. These results imply that a woman in a monogamous union faces only moderate increases in the probability of becoming sterile (or infecund) until her late thirties. Nevertheless, it appears that recent changes in reproductive behavior were guaranteed to result in the perception that infecundity is on the rise.

Adolescent↗
PubMed1981

Proportional hazards life table models: an illustrative analysis of socio-demographic influences on marriage dissolution in the United States.

The proportional hazards life table is a recently developed approach to the analysis of survival data when mortality risks vary among individuals. It assumes that at a given age (or duration since the start of a life) the force of mortality is a constant (specific to that age) multiplied by a proportionality factor which is determined by the characteristics of the individual and does not change unless these covariates do. In this paper, the method is reviewed for the case where the covariates are fixed at the start of the lifetime and illustrated by an application to marital dissolution in the United States.

Actuarial Analysis↗
PubMed1979

Seasonal migration and seasonal variation in fecundability: effects on birth rates and birth intervals.

Seasonal patterns in conception rates have been documented in several recent studies. In this paper, a mathematical model of the reproductive process is developed through which the impact of such variation in conception rates is assessed. It is found that the effect on fertility can be quite substantial, but that the birth rate when seasonal variation is occurring is approximated well by the birth rate calculated when conception rates are constant at their mean. These results indicate that further documentation of seasonality in conception rates and exploration of the causes of these patterns and their change is an important area for demographic research.

Birth Rate↗