Publications

Adolescence is a formative time of transition to adulthood, roughly concurrent with the second decade of life. What happens between ages 10 and 19 shapes how girls and boys live out their lives as women and men—not only in the reproductive arena, but also in the social and economic realms. Throughout the world, girls and boys are treated differently from birth onward, but at puberty this gender divide widens. Boys enjoy new privileges, while girls endure new restrictions (Mensch, Bruce & Greene, 1998). In Pakistan, boys gain autonomy, freedom of movement, opportunity, and power (including power over sexual and reproductive lives of girls), while girls are systematically deprived of freedom and independent action. Only recently have the sexual and reproductive health needs of adolescents received attention in Pakistan. As part of an initial situation analysis, investigators conducted a study to explore unmarried adolescents’ knowledge, attitudes and sources of information about sexual and reproductive health, as well as to assess levels of physical and sexual abuse. 

HIV/AIDS is a children’s issue. In Vietnam, as elsewhere, the highest incidence of HIV infection occurs in the 20 – 30 age group, as well as the fastest growing rate of increase. Mother to child transmission is also increasing. And by the end of 2002, more than 10% of reported cases of HIV infection were under 19. This particular study therefore seeks to contribute to a greater understanding of how the HIV/AIDS epidemic impacts on children. The conceptual framework is based on the Convention on the Rights of the Child, signed and ratified by Vietnam and almost all other countries in the world. 

Begun in May 2000, USAID-funded and FHI supported decentralized and comprehensive Behavior Change Communication (BCC) work reaches four provinces: Hai Phong, Can Tho, Quang Ninh and Binh Dinh. Targeted BCC work in Ha Noi, Dong Nai and Thai Binh began mid-2002. Provincial AIDS Standing Bureaus (PASB) designed the projects with FHI support. The local governments, PASBs and mass organizations implement the interventions, under the guidance of FHI. Basic, intensive and advanced BCC training and ongoing technical support from FHI are key to building local capacity in BCC work. The IEC centers of Provincial Health Services play a key role in the development of materials and for training for interpersonal communication through peer and health educators. Local artists and writers tailor messages and images to reflect local realities and target populations. FHI is encouraging use of private advertising agencies and marketing firms to develop effective media products for dissemination.

In 1997, after several years of informal co-operation and following the development and testing of a pilot program, the Pakistan Girl Guides Association (PGGA) and UNICEF launched a Girl Child Shield Project. The goal of this project is to improve the status of women and girl children in Pakistan. By May 2001, the project had involved an estimated 100,000 girls in over 800 schools in lower and middle income urban and rural communities, trained them as role models on girl child issues, child rights, affirmative communication and team building. It had also reached an impressive number of peers (1,000,000) and families (100,000). The overall goal of the project is to improve the status of girls and women in Pakistan. It seeks to increase the Girl Guides' awareness of the problems girls face in their communities, raise their self esteem, confidence, communication skills and increase their ability to engage in community service. The acquisition of new knowledge and skills by girls is intended to demonstrate to peers, families and communities the potential of girls and their abilities to act as role models and change agents, and thus to positively influence attitudes towards girls and reduce gender discrimination.

One method to obtain an accurate information on number of HIV cases is to do an estimation by using available data. Therefore, in 2002 the Indonesian Ministry of Health, with ASA/FHI/USAID conducted a National Estimates of Adult HIV Infection. Those estimates were a great step to estimate the magnitude of burden diseases in the future. The results for conducting reliable estimates could be used into further development of policies and programs related to HIV/AIDS problems.

The 2003 Technical Report provides the facts and figures gathered by the National HIV/AIDS Sentinel Surveillance System (NHSSS) from 1993. It includes data from the AIDS Registry, the Serologic Surveillance and the Behavioral Surveillance. This report also features the data from the newly setup Sentinel STI Etiologic Surveillance System. To keep track of the epidemiology of HIV/AIDS in the Philippines, the Department of Health (DOH) established passive and active surveillance systems. The passive surveillance system, the HIV/AIDS Registry, was established in 1987. It continuously logged Western Blot-confirmed HIV cases reported by hospitals, laboratories, blood banks and clinics.

The Adolescent Peer Organised Network (APON) project grew out of a large Bangladesh Rural Advancement Committee (BRAC) programme aimed at providing basic education to underprivileged children, especially girls, who have not previously attended primary school.

Sri Lanka, with a population of 19 million, had a relatively small number of HIV-infected people—about 4,800 adults and children—as of the end of 2002, according to UNAIDS. Since 1986, only 415 cases have been officially reported, however, with underreporting due mainly to limited availability of counseling and testing and a prevailing fear of facing social stigma after being identified as HIV positive. The HIV infection rate among adults between the ages of 15 and 49 is estimated by UNAIDS to be less than 0.1 percent.

National HIV/AIDS programmes world wide comprise a variety of interventions or actions aimed at reducing spread of HIV, providing care & support to the affected and alleviating socio-economic and human impact. Resources are always limited, and being able to decide which interventions are most appropriate and cost-effective (and thus to be given highest priority) is of critical importance. Different types of trials or operational research have been used to demonstrate effects of a given intervention conducted in a particular setting (efficacy).

Male sex workers (MSWs) comprise an important group at risk of HIV infection in South Asia. There are few published studies about their HIV or STD prevalence, numbers, socio-demographic characteristics or risk behaviors, although there is a growing literature on the more general category of men who have sex with men (MSM) in South Asia. Most published studies are concerned with describing behavioural risk and issues of identity and gender, but we have found none that evaluates or describes HIV prevention interventions. In Bangladesh, however, considerable progress has been made in research, prevention, HIV/syphilis and behavioral surveillance surveys (BSS) among MSM in general and among MSWs in particular. BSS are repeated quantitative surveys carried out in specific populations to track changes in the frequency of behavioural risk factors associated with the spread of HIV infection. The methodology of BSS is semi-standardized and allows comparison across countries and between samples within a country. Probability sampling, once established in sentinel populations, permits comparisons across years and can examine the effects of exposure to an intervention or to a package of interventions in a particular location. Data from the Bangladesh behavioural surveillance demonstrate the impact of a behavioural intervention on MSWs in Dhaka. Nonetheless, overall condom use remains low. MSWs in Bangladesh remain at high risk in an environment with high levels of syphilis, but continuing low HIV prevalence. This paper presents selected results of several studies on MSWs in Dhaka, Bangladesh conducted between 1998 and 2000.