Grant-in-Aid for Scientific Research (B)
|Allocation Type||Single-year Grants |
Public health/Health science
|Research Institution||International Medical Center of Japan |
WAKASUGI Naomi International Medical Center of Japan, Department of Epidemiology Research Institute, Director, 疫学統計研究部, 部長 (20118459)
IKEDA Noriaki International Medical Center of Japan, Department of Epidemiology Research Institute, Researcher, 疫学統計研究部, 研究員 (30150791)
TERUNUMA Hiroshi Yamanashi Medical School, Department of Microbiology, Lecturer, 微生物学, 講師 (50217436)
|Project Period (FY)
2000 – 2003
Completed (Fiscal Year 2003)
|Budget Amount *help
¥15,200,000 (Direct Cost: ¥15,200,000)
Fiscal Year 2003: ¥2,300,000 (Direct Cost: ¥2,300,000)
Fiscal Year 2002: ¥3,400,000 (Direct Cost: ¥3,400,000)
Fiscal Year 2001: ¥4,100,000 (Direct Cost: ¥4,100,000)
Fiscal Year 2000: ¥5,400,000 (Direct Cost: ¥5,400,000)
|Keywords||HIV infection / AIDS / Africa / Reproductive Health / Socio-economic and Cultural state of women / Empowerment / Maternal and child health / Condom use / Mother to Child transmission of HIV / リプロダクテイブヘルス / HIV感染者・エイズ / 女性性器切除|
Summary of the results
1. The role of women's empowerment as a factor facilitating condom use.
BACKGROUND : The increasing burden of HIV on women and children has led to an urgent need to identify factors that help women avoid the risk of HIV infection. Women's empowerment, such as by education and economic independence, has been suggested as a factor facilitating condom use but the data are inconclusive.
METHOD : Cross-sectional questionnaire surveys were conducted on the women in Madagascar, Mali, and Zambia, and analyzed.
RESULTS : Multivariate analysis showed that women's own earning significantly increased condom use (OR in Mali 4.00 (95%CI 1.28-12.5) ; Zambia, 1.73(95%CI 1.00-3.00) ; Madagascar, 1.69(95%CI 1.19-2.40)). However, women's education had not significant positive association with condom use in these countries. The chi-square test showed variable significances (Mali, p<0.05 ; Zambia, p=0.05 ; Madagascar, p<0.01), but meta-analysis using Mantel-Haenszel test showed a signifi
cant association between own earning and condom use (p<0.001). The t test showed variable results (Mali, p=0.37, Zambia, p=0.33 ; Madagascar, p<0.05), but meta-analysis using Fisher's method :
-2Σlog(pi)〜X^22k showed no significant association between education and condom use (p>0.1).
CONCLUSION : Women's own earning was shown as an important factor facilitating condom use. Inefficacy of education suggested in this study indicated the need to further investigate what is lacking in education in-and-outside school, such as concrete and effective education regarding HIV and sex.
2. Increased risk of intrauterine transmission of HIV-1 associated with granulocyte elastase in the endocervical mucous.
Background : One of the remaining challenges in the prevention of mother-to-child transmission of HIV is to reduce the risk of the transmission during pregnancy.
It remained to be investigated what factors are affecting intrauterine HIV transmission and how they can be identified and intervened during pregnancy.
Methods : Granulocyte elastase in the endocervical mucous of HIV-positive pregnant women in Zambia were measured, and its association with intrauterine transmission of HIV 1 from mother to fetus was investigated.
Results : The intrauterine transmission rate determined by polymerase chain reaction assay of DNA from neonates at birth was 15.3%. The risk for intrauterine transmission was 8.65 fold higher in women positive for granulocyte elastase than in those who were negative.
Conclusions : We suggest that the women showing positive granulocyte elastase at delivery are strongly suspected to have and to have had chorioamnionitis during pregnancy, and it could affect the intrauterine transmission of HIV. Less