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Biomedical subjects

M Caraël

Publications and source records attributed to M Caraël.

18 recordsLinked to original sources
PubMed1997

Change in sexual behaviour and decline in HIV infection among young pregnant women in urban Uganda.

OBJECTIVE: To describe sexual behaviour that may partly explain a decline in HIV seroprevalence in pregnant women in urban settings in Uganda, East Africa. SETTINGS: Two major urban districts in Uganda. METHODS: Repeated population-based behavioural surveys in 1989 and 1995, and repeated HIV serological surveys in consecutive pregnant women attending antenatal clinics from 1989 to 1995. RESULTS: During the study period, a 2-year delay in the onset of sexual intercourse among youths aged 15-24 years and a 9% decrease in casual sex in the past year in male youths aged 15-24 years were reported. Men and women reported a 40% and 30% increase in experience of condom use, respectively. In the same study area, over the same period, there was an overall 40% decline in the rates of HIV seroprevalence among pregnant women attending antenatal clinics. It can be hypothesized that the observed declining trends in HIV correspond to a change in sexual behaviour and condom use, especially among youths. CONCLUSIONS: This is the first report of a change over a period of 6 years in male and female sexual behaviour, assessed at the population level, that may partly explain the observed decline in HIV seroprevalence in young pregnant women in urban Uganda. This result should encourage AIDS control programmes to pursue their prevention activities.

Adolescent↗
PubMed1996

Baseline for the evaluation of an AIDS programme using prevention indicators: a case study in Ethiopia.

Strategies for preventing transmission of human immunodeficiency virus (HIV) include ensuring that individuals have adequate knowledge of how HIV infection can be prevented and encouraging behaviours that decrease risk of HIV infection. In addition, there is evidence that early and appropriate management of other sexually transmitted disease is effective in reducing HIV transmission. Programmes and projects promoting prevention of HIV transmission should be evaluated periodically for their effectiveness. Between March and September 1995, ten prevention indicators developed by the WHO Global Programme on AIDS were used to establish a baseline measure for evaluating the effectiveness of the Ethiopian AIDS control programme. The indicators were measured using a structured population survey, through record review and key informants, structured observation and interview in health care facilities, and through a serosurvey among antenatal clinic attenders. The following results were found: promoting knowledge of preventive practices was successful; a relatively high proportion of young male adults had sexual risk behaviour; poor condom availability outside Addis Ababa, the capital; and very weak STD case management. The prevalence of syphilis and HIV were 8.8% and 13.6%, respectively, among pregnant women aged 15-49 years. These results should serve as a baseline for repeat surveys to assess the effectiveness of HIV prevention programmes in Ethiopia.

Acquired Immunodeficiency Syndrome↗
PubMed1995

Sexual behaviour in developing countries: implications for HIV control.

OBJECTIVE: To provide basic information on pre- and extramarital sex in the general population and other factors related to HIV transmission. DESIGN: Cross-sectional household survey in 18 countries of the developing world, mainly in Africa and Asia. RESPONDENTS: Representative samples of 1300-6995 individuals aged 15-49 years, interviewed in 1989-1993. METHODS: Face-to-face interviewing. RESULTS: We observed a huge variability between study sites, with the proportion of men reporting sexual contact outside regular partnerships in the last year ranging from 4 to 47%. Contacts with sex workers range from 1 to 25%. Women were much less likely to report non-marital sex than men. CONCLUSIONS: This first cross-cultural attempt to examine aspects of sexual lifestyles suggests that broad generalizations about multiple-partner sexual networking in particular regions are misleading. Gender, marital status, age and a few other demographic correlates were disclosed as powerful determinants of sexual behaviour, although the strength of associations varied greatly between specific locations. Condom use was very low in most study sites.

Adolescent↗
PubMed1995

Validating population surveys for the measurement of HIV/STD prevention indicators.

OBJECTIVE: To validate the World Health Organization/Global Programme on AIDS (GPA) protocol for measuring HIV/sexually transmitted disease prevention indicators pertaining to knowledge and sexual practices of the general population. METHODS: Data were collected in Uganda during 1993. Three different interview strategies were complemented with qualitative methods, including observations at visits and key-informant interviews. Two interview strategies consisted of structured questionnaires which were applied to 460 randomly selected people aged 15-49 years and 60 intentionally selected women who were known prostitutes. The third strategy involved in-depth interviewing and was applied to a random subset of all respondents (n = 75). RESULTS: The three interview strategies generated similar results for demographic characteristics. The strategies using structured questionnaires gave similar results with regards to the number of reported sex partners and the prevalence of condom use, but differed from in-depth interviews on these aspects. The high numbers of casual sex partners of female prostitutes was confirmed by in-depth interviews but not via the questionnaires. CONCLUSION: The GPA questionnaire may not be optimal to capture people at high risk and to assess sexual behaviour, especially of people at high risk. Nevertheless, the questionnaire provides the most realistic option, since in-depth interviews are expensive and not as objective in assessing trends over time. Evaluation studies of HIV interventions in the general population should therefore be complemented with small qualitative studies to detect and iron out biases in interpreting results.

Adolescent↗
PubMed1987

Seroepidemiological study on sexually transmitted diseases and hepatitis B in African promiscuous heterosexuals in relation to HTLV-III infection.

A seroepidemiological study was performed on HTLV-III, T. pallidum, C. trachomatis and Hepatitis B virus (HBV), in Butare, Rwanda, among 33 female prostitutes, 25 male customers of prostitutes, and 60 male and female controls. As compared with female controls the prostitutes had a higher prevalence of antibodies to HTLV-III (29/33 versus 4/33, p less than 0.001), T. pallidum (TPHA: 27/33 versus 6/33, p less than 0.001; RPR: 19/33 versus 2/33, p less than 0.001; FTA-Abs: 27/33 versus 5/33, p less than 0.001) and C. trachomatis (IgG IF: 31/33 versus 13/33, p less than 0.001). HBV serological markers were more often detected in the prostitutes than in the female controls (31/33 versus 18/33, p less than 0.001) although HBs antigen carriage rate was similar in both groups. As compared with male controls, the male customers of prostitutes had more frequently detectable antibodies to HTLV-III (7/25 versus 2/27, p = 0.05), and a positive RPR (10/25 versus 1/27, p less than 0.01). Among the 118 individuals studied, odds ratios and trend analysis disclosed a significant association between HTLV-III seropositivity and a positive TPHA, RPR, FTA-Abs, Chlamydia IgG IF test and serological markers to HBV. No association was found between HTLV-III seropositivity and HBs Ag carriage. This study suggests that HTLV-III has to be considered as an infectious agent transmitted among promiscuous Central African heterosexuals by sexual contact and/or parenteral contact with unsterile needles used for STD treatments.

Acquired Immunodeficiency Syndrome↗
PubMed1983

Promotion of birth spacing on Idjwi Island, Zaire.

Idjwi Island in Lake Kivu in eastern Zaire supports approximately 50,000 largely subsistence farmers, the Bani-Iju. Rapid population growth, a declining economy, and a deteriorating environment have already converged to produce significant malnutrition in this isolated community. The highly structured and traditional social order, particularly regarding reproductive mores, is examined here in its relevance to an intervention program for reducing the demographic pressure by increasing birth spacing. The mean birth interval of approximately three years appears to be shrinking, and is far too brief to prevent rapid population growth. The program, which included films about contraception, did not lead to a longer birth interval among the Bani-Iju, but did succeed in informing women about family planning. It is concluded that no intervention program for promotion of family planning is likely to be effective without substantial improvement in the economy.

Adolescent↗
PubMed1975

The health of mother and child in rural Central Africa.

In the Great Lakes Region of Central Africa, the population suffers from severe proteo-caloric malnutrition, with adverse affects on maternal and child health. Improvement of maternal nutrition would lead to rapid consecutive pregnancies, reducing the length of time each child could be breastfed and reducing the protein available to each child. Hence, the authors recommend modern birth spacing methods in combination with programs to improve the health of mother and child.

Adolescent↗