This is an exploratory study to examine the social and cultural determinants of the teaching of HIV/AIDS sex education among secondary school teachers in Eastern Nigeria. The research analyses how teachers perceive passing their knowledge of HIV/AIDS prevention measures to their students in the context of their cultural and social norms, which restrict open discussion of sex. This is a qualitative study based on in-depth interviews with 60 teachers drawn from secondary school teachers in Eastern Nigeria, supplemented with five focus group discussions, and content analysis of teachers’ lesson preparatory notes. The findings show a high level knowledge of HIV/AIDS preventive measures among teachers. However, teachers are not passing on this knowledge because of cultural and social inhibitions. In addition, teachers have not been receiving adequate training and motivation on information, education and communication for HIV/AIDS sex education. The situation calls for serious policy intervention.

This study investigates the ethnic differentials in contraceptive use in the north-eastern Ch’orti area of Guatemala, a region dominated by the Ladino culture. Data come from a household survey and in-depth interviews with service providers carried out in 2001 in the town of Jocotán, and a survey carried out in 1994 in two nearby indigenous villages (aldeas). Descriptive analysis and logistic regression are used to explore the data. Previous DHS surveys have used dress and language to classify ethnic groups. In this paper, an alternative approach based on self-identification is adopted. The results reveal significant differences in contraceptive behaviour among different ethnic groups within the same town and region. The results show that self-identified Ladino women who represented the minority of the population had contraceptive behaviour similar to their counterparts elsewhere in Latin America. The extremely low levels of contraceptive use among indigenous women from the aldeas suggest that the corresponding DHS figures in this region are probably overestimated.

This study set out to investigate the influence of male circumcision and other factors on sexually transmitted infections in Botswana. A syndromic approach, which diagnoses a sexually transmitted infection based on the presence of urethral discharge or genital ulcers rather than on laboratory tests, was used. The data were from the 2001 Botswana AIDS Impact Survey where a nationally representative, randomly selected sample of men and women aged 10–64 years were interviewed in both urban and rural areas. The sample selected for this study consisted of 216,480 men aged 15–64 years who had ever had sexual intercourse. The logistic regression technique was executed to examine the association between male circumcision and self-reported urethral discharge or genital ulcers, while controlling for all other independent variables in the analysis. The main finding of this study was that among men who are circumcised, the odds for self-reported urethral discharge or genital ulcers are significantly lower than for those men who are not circumcised in both urban and rural Botswana. The analysis also showed that the odds in favour of self-reported urethral discharge or genital ulcers, for men who drink alcohol, are twice as large as those for men who do not drink alcohol, controlling for all other independent variables in the analysis. Religion and ethnicity also came through as factors exerting a protective influence against self-reported symptoms of sexually transmitted infections. The conclusion is that while male circumcision appears to be significantly associated with the risk for self-reported urethral discharge or genital ulcers, it is man’s behaviour, irrespective of ethnicity or religious dictates, that continues to play a vital role in protection against self-reported symptoms of sexually transmitted infections in Botswana.

Across 85 countries around the world, Voracek (2004) found a significant positive relation between estimated national intelligence (IQ) and national male and female suicide rate. The relation was not attenuated when countries’ per capita Gross Domestic Product (GDP) and type of national IQ estimation were statistically controlled. Independently, investigating the total national suicide rate only, Lester (2003) arrived at the same conclusion. These two findings are consistent with a corollary of de Catanzaro’s (1981) evolutionary theory of human suicide, namely that a threshold intelligence is necessary for suicidality and that intelligence and suicide mortality should thus be positively related. Here, further evidence for this hypothesis is bolstered by focusing on suicide rates of the elderly. Across 48 Eurasian countries, estimated national IQ was significantly positively related to national suicide rates of people aged 65 years and over. This new ecological-level finding survived statistical controlling for a set of seven variables (type of national IQ estimation, national GDP, stableness and recency measures for suicide rates, and rates of adult literacy, urbanization and Roman Catholics), which thus are not confounding factors for the relation of intelligence and suicide mortality. Based on ecological data, the threshold IQ for suicidality is predicted to be 70 or slightly over, an estimate that is consistent with various suicidological observations.

Brazilian women rely on sterilization as the main source of birth control. Sterilization has been one of the causes of the steep decline in fertility in Brazil, at least since the second half of 1970. It is hypothesized that understanding couples’ relationships might be key to explaining this high rate of female sterilizations. Possible reasons for the higher level of fertility among women in unstable unions than among women in stable ones could be the less effective use of contraceptive methods, or that women in unstable unions tend to use less effective or reversible contraceptive methods. In this paper discrete time modelling of the timing of sterilization according to union histories is presented. The analysis uses the calendar data of the 1996 Brazilian DHS. It is shown that women in second or higher order unions have a lower risk of sterilization. This result should be taken into account in the analysis of the determinants of female sterilization in Brazil.

This paper investigates the statistical association between teenage births and the physical growth path of these mothers. It draws on data on the height of ever-married women aged 15–49 and their birth histories collected in India’s National Family Health Survey in 1998–99, and shows that there was a negative relationship between final adult height of women and the number of births they had as teenagers. Using multiple regression analysis, it is shown that this negative relationship is robust to confounding factors such as standard of living, urban–rural residence, state of origin in India and age of the women.

Despite the large numbers of displaced persons and the often-lengthy periods of displacement, little is known about the impact of forced migration on long-term under-five mortality. This paper looks at the Brass Method (and adaptations of this method) and the Preceding Birth Technique in combination with a classification of women by their migration and reproductive histories, in order to study the impact of forced migration on under-five mortality. Data came from the Demography of Forced Migration Project, a study on mortality, fertility and violence in the refugee and host populations of Arua District, Uganda and Yei River District, Sudan. Results indicate that women who did not migrate in a situation of conflict and women who repatriated before the age of 15, had children with the highest under-five mortality rates compared with women who were currently refugees and women who repatriated after the age of 15.

as the largest labour flow in human history, the recent rise in migration in china has opened up unprecedented opportunities for millions of chinese to rearrange their lives. at the same time, this process has also posed great challenges to chinese migrants, especially female migrants, who not only face a bias against ‘outsiders’ but also have a greater need for reproductive health-related services in their migratory destinations. based on data collected via multiple sources in shanghai, china’s largest metropolis, this study profiles the changing characteristics of female migrants, presents data on self-reported symptoms of reproductive health-related problems and knowledge on reproductive health issues, compares maternal and child health measures between migrants and local residents, and examines factors related to reproductive health knowledge and migrants’ access to health care in urban china. results of this study show a relatively low level of self-reported reproductive health problems among female migrants, coupled with a relatively high level of ignorance in knowledge related to std. both self-reported health status and knowledge of reproductive health are related to migrants’ educational attainment and length of stay in the urban destination. this study also finds ample evidence that female migrants’ access to urban health care is limited by a number of institutional barriers.

The purpose of this study was to examine the determinants for early discontinuation among IUCD users in a rural district of northern India. Multivariate analysis indicated several significant predictors of early discontinuation of IUCD use. The risk of discontinuation increased more than two times in the presence of factors such as more than usual amount of menstrual flow before insertion and intermenstrual bleeding after insertion. Similarly, residence or alternatively those coming from villages without health centres were nearly two times more likely to discontinue. Menstrual disturbance increased the risk nearly three-fold. If only those women who report normal menstrual cycles had IUCDs inserted, it is very likely that the high discontinuation rate due to menstrual disturbance could be reduced. Knowledge about the IUCD and its effectiveness decreased the risk of early discontinuation but was not a statistically significant factor in multivariate analysis. Validation of the developed model was done by using the bootstrapping method and the model was found to be 18% noisy. These findings may help family planning providers in counselling and practice.

There is growing international interest in the choice of socioeconomic indicators for health research. This study used a combination of standard and novel methods to compare three occupation-based measures of social position in terms of their ability to explain variation and measure inequality in self-assessed health. The recently developed National Statistics Socioeconomic Classification (NS-SEC) is compared with its predecessor, the Registrar General’s Social Class schema (RGSC), and with another occupation-based measure, the Cambridge Social Interaction and Stratification Scale (CAMSIS). With data from two large, independent, nationally representative samples of adults aged 16–64 living in private households in Scotland, logistic regression models are used to compare the classifications' ability to predict self-assessed health. Concentration indices are estimated to compare how well they capture inequality in self-assessed health. The study shows that all three classifications are strongly associated with self-assessed health, though the associations are heavily attenuated by adjustment for one another and for other measures of social position. Despite their differing theoretical bases, the three are closely related. No evidence is found that any of them systematically under- or overstate the extent of inequality in self-assessed health in either men or women, and the extent to which they measure independent dimensions of social inequality is questioned. It is concluded that the availability of the new classifications is unlikely to transform our understanding of the extent or the causes of socioeconomic inequality in health, but provides useful opportunities for sensitivity analysis.

Raven’s Standard Progressive Matrices test was administered to a representative sample of 920 white, Mestizo and Native Mexican Indian children aged 7–10 years in Mexico. The mean IQs in relation to a British mean of 100 obtained from the 1979 British standardization sample and adjusted for the estimated subsequent increase were: 98·0 for whites, 94·3 for Mestizos and 83·3 for Native Mexican Indians.

Child mortality (the mortality of children less than five years old) declined considerably in the developing world in the 1990s, but infant mortality declined less. The reductions in neonatal mortality were not impressive and, as a consequence, there is an increasing percentage of infant deaths in the neonatal period. Any further reduction in child mortality, therefore, requires an understanding of the determinants of neonatal mortality. 209,628 birth and 2581 neonatal death records for the 1998 birth cohort from the city of São Paulo, Brazil, were probabilistically matched. Data were from SINASC and SIM, Information Systems on Live Births and Deaths of Brazil. Logistic regression was used to find the association between neonatal mortality and the following risk factors: birth weight, gestational age, Apgar scores at 1 and 5 minutes, delivery mode, plurality, sex, maternal education, maternal age, number of prior losses, prenatal care, race, parity and community development. Infants of older mothers were less likely to die in the neonatal period. Caesarean delivery was not found to be associated with neonatal mortality. Low birth weight, pre-term birth and low Apgar scores were associated with neonatal death. Having a mother who lives in the highest developed community decreased the odds of neonatal death, suggesting that factors not measured in this study are behind such association. This result may also indicate that other factors over and above biological and more proximate factors could affect neonatal death.

the objective of the study was to investigate the relationship between childhood iq of parents and characteristics of their adult offspring. it was a prospective family cohort study linked to a mental ability survey of the parents and set in renfrew and paisley in scotland. participants were 1921-born men and women who took part in the scottish mental survey in 1932 and the renfrew/paisley study in the 1970s, and whose offspring took part in the midspan family study in 1996. there were 286 offspring from 179 families. parental iq was related to some, but not all characteristics of offspring. greater parental iq was associated with taller offspring. parental iq was inversely related to number of cigarettes smoked by offspring. higher parental iq was associated with better education, offspring social class and offspring deprivation category. there were no significant relationships between parental iq and offspring systolic blood pressure, diastolic blood pressure, cholesterol, glucose, lung function, weight, body mass index, waist hip ratio, housing, alcohol consumption, marital status, car use and exercise. structural equation modelling showed parental iq associated with offspring education directly and mediated via parental social class. offspring education was associated with offspring smoking and social class. the smoking finding may have implications for targeting of health education.

This analysis demonstrates the application of a data duplication technique in linear regression with censored observations of the waiting time to third pregnancy ending in two outcome types, using data from Malaysia. The linear model not only confirmed the results obtained by the Cox proportional hazards model, but also identified two additional significant factors. The method provides a useful alternative when Cox proportionality assumption of the hazards is violated.

A geographically stratified cross-sectional survey was conducted in 2002 to investigate household-level factors associated with use of mosquito control measures and self-reported malaria in Malindi, Kenya. A total of 629 households were surveyed. Logistic regressions were used to analyse the data. Half of all households (51%) reported all occupants using an insecticide-treated bed net and at least one additional mosquito control measure such as insecticides or removal of standing water. Forty-nine per cent reported a history of malaria in the household. Of the thirteen household factors analysed, low (OR=0·23, CI 0·11, 0·48) and medium (OR=0·50, CI 0·29, 0·86) education, mud–wood–coral (OR=0·0·39, CI 0·24, 0·66) and mud block–plaster (OR=0·47, CI 0·25, 0·87) wall types, farming (OR=1·38, CI 1·01, 1·90) and travel to rural areas (OR=0·48, CI 0·26, 0·91) were significantly associated with the use of mosquito control, while controlling for other covariates in the model. History of reported malaria was not associated with the use of mosquito control (OR=1·22, CI 0·79, 1·88). Of the thirteen covariates analysed in the second model, only two household factors were associated with history of malaria: being located in the well-drained stratum (OR=0·49, CI 0·26, 0·96) and being bitten while in the house (OR=1·22, CI 0·19, 0·49). These results suggest that high socioeconomic status is associated with increased household-level mosquito control use, although household-level control may not be enough, as many people are exposed to biting mosquitoes while away from the house and in areas that are more likely to harbour mosquitoes.

Evolutionary theory guides an investigation of foster parent selection in two northern Thai villages with different biosocial environments: one village has high levels of labour migration and divorce, and growing numbers of parental death due to HIV/AIDS, while the other village has lower migration, divorce and parental mortality levels. Focus groups examine mothers’ and fathers’ motivations and ideals regarding foster caretaker selection, and quantitative family surveys examine real fostering outcomes: specifically, the laterality (matrilateral versus patrilateral) and genetic distance of the foster caretakers of all ever-fostered children in these two villages. As predicted, in environments of high marital stability and paternity certainty, parents seem to prefer close genetic kin from either side as foster parents for their children. In low marital stability and paternity certainty environments, parents trust their own lateral kin, regardless of genetic distance, over close genetic kin from the other side. The striking exception to this pattern, however, occurs in the case of parental death, in which case children are fostered to the deceased parent’s kin, regardless of the child’s sex or other factors. In general, the foster parents for girls are selected with more care, reflecting the daughter/female preference expected in traditionally matrilineal, matrilocal societies. An ordered decision-making pathway for foster parent selection is proposed, taking into consideration the key factors of (a) the circumstances driving the fostering decision, (b) the gender of the child, (c) the gender of the key decision-making parent, and (d) the degree of marital and population fluidity (and subsequent paternity certainty) in the village.

Are risk behaviours in adolescence differentiated according to same-sex vs opposite-sex interest? For all respondents a five-point scale of interest in each sex used information from both of the first two in-home waves of the National Longitudinal Study of Adolescent Health (Add Health). Logistic regression predicted the probability of experiencing each risk behaviour from the same-sex and opposite-sex interest scores. Same-sex interests have more effect on emotional risk, and opposite-sex interests have more effect on substance use. Nevertheless, all risk variables except boys’ depression are responsive to both same-sex and opposite-sex interest. The same-sex interest component of risk is attributed to the emotional strain of living with an anomalous sex interest in a heterosexual society.

Religion holds unique importance in people’s lives, and has been cited as an important factor in reproductive health. Pakistan has a Muslim majority and the character of the country is strongly marked by Islam. In rural areas, where the majority of the population reside, religious leaders are considered as opinion makers. The perception of adult males regarding the influence of the ‘religious factor’ in their use of modern contraceptive methods, and their views on the role of religious leaders in community education, were explored through a cross-sectional survey conducted in twelve rural districts of Pakistan in 2000. A sample of 180 married adult males participated in the study through consecutive sampling. The study was qualitative, utilizing tools such as in-depth and key-informant interviews. The majority of men interviewed considered that religious leaders were against fertility control, and 29% cited religion as a reason for their non-use of modern contraceptives. Respondents also suggested that the involvement of religious leaders in reproductive health programmes is essential for the programmes’ effectiveness in rural areas. They thought that religious leaders could contribute positively to community education, and suggested ways in which they could educate the community in reproductive health issues. They also suggested various channels through which religious leaders could be approached to convince them to cooperate in reproductive health programmes. The study concludes that involving religious leaders in rural settings could enable reproductive health programmes and services to reach more conservative groups in society, and thus contribute effectively to bringing about positive change in the attitudes of Pakistani society towards reproductive health.

This paper explores family formation and dissolution in the Aegean island of Paros over the period 1894–1998. The examined issues are: trends in age at marriage, age gap between spouses, age differentials among different occupational groups, age at widowhood, remarriage, illegitimacy and bridal pregnancy. The main findings confirmed that certain characteristics of the ‘Mediterranean’ marriage pattern, such as low age at marriage for females, high for males and large age gap between spouses, were present in the study population up until the 1980s. The feature of the family cycle that has changed most dramatically over the examined period is age at widowhood, which has increased spectacularly owing to the impressive progress in adult, and especially maternal, mortality that took place in Greece in the post-war years.

primary research on hiv/aids in india has predominantly focused on known risk groups such as sex workers, sti clinic attendees and long-distance truck drivers, and has largely been undertaken in urban areas. there is evidence of hiv spreading to rural areas but very little is known about the context of the infection or about issues relating to health and social impact on people living with hiv/aids. in-depth interviews with nineteen men and women infected with hiv who live in rural areas were used to collect experiences of testing and treatment, the social impacts of living with hiv and differential impacts on women and men. eight focus group discussions with groups drawn from the general population in the four villages were used to provide an analysis of community level views about hiv/aids. while men reported contracting hiv from sex workers in the cities, women considered their husbands to be the source of their infection. correct knowledge about hiv transmission co-existed with misconceptions. men and women tested for hiv reported inadequate counselling and sought treatment from traditional healers as well as professionals. owing to the general pattern of husbands being the first to contract hiv women faced a substantial burden, with few resources remaining for their own or their children’s care after meeting the needs of sick husbands. stigma and social isolation following widowhood were common, with an enforced return to the natal home. implications for potential educational and service interventions are discussed within the context of gender and social relations.