Male circumcision, religion, and infectious diseases: an ecologic analysis of 118 developing countries. (57/193)

BACKGROUND: Both religious practices and male circumcision (MC) have been associated with HIV and other sexually-transmitted infectious diseases. Most studies have been limited in size and have not adequately controlled for religion, so these relationships remain unclear. METHODS: We evaluated relationships between MC prevalence, Muslim and Christian religion, and 7 infectious diseases using country-specific data among 118 developing countries. We used multivariate linear regression to describe associations between MC and cervical cancer incidence, and between MC and HIV prevalence among countries with primarily sexual HIV transmission. RESULTS: Fifty-three, 14, and 51 developing countries had a high (>80%), intermediate (20-80%), and low (<20%) MC prevalence, respectively. In univariate analyses, MC was associated with lower HIV prevalence and lower cervical cancer incidence, but not with HSV-2, syphilis, nor, as expected, with Hepatitis C, tuberculosis, or malaria. In multivariate analysis after stratifying the countries by religious groups, each categorical increase of MC prevalence was associated with a 3.65/100,000 women (95% CI 0.54-6.76, p = 0.02) decrease in annual cervical cancer incidence, and a 1.84-fold (95% CI 1.36-2.48, p < 0.001) decrease in the adult HIV prevalence among sub-Saharan African countries. In separate multivariate analyses among non-sub-Saharan African countries controlling for religion, higher MC prevalence was associated with a 8.94-fold (95% CI 4.30-18.60) decrease in the adult HIV prevalence among countries with primarily heterosexual HIV transmission, but not, as expected, among countries with primarily homosexual or injection drug use HIV transmission (p = 0.35). CONCLUSION: Male circumcision was significantly associated with lower cervical cancer incidence and lower HIV prevalence in sub-Saharan Africa, independent of Muslim and Christian religion. As predicted, male circumcision was also strongly associated with lower HIV prevalence among countries with primarily heterosexual HIV transmission, but not among countries with primarily homosexual or injection drug use HIV transmission. These findings strengthen the reported biological link between MC and some sexually transmitted infectious diseases, including HIV and cervical cancer.  (+info)

Promises and challenges of faith-based AIDS care and support in Mozambique. (58/193)

OBJECTIVES: We sought to examine the role of religious organizations in the provision of HIV/AIDS-related assistance in Africa. METHODS: We used data collected from Christian religious organizations in southern Mozambique. Bivariate comparisons and logistic regression analysis of survey data were performed. We conducted an analysis of the qualitative data to complement the quantitative results. RESULTS: Our analysis revealed little involvement of religious organizations in provision of assistance. Most assistance was decentralized and consisted of psychological support and some personal care and household help. Material or financial help was rare. Assistance to nonmembers of congregations was reported more often than to members. Members of larger and better-secularly connected congregations were more likely to report assistance than were members of smaller and less-secularly engaged ones. Assistance was reported more in cities than in rural areas. Women were more likely than men to report providing assistance to congregation members, and the reverse was true for assistance provided to nonmembers. The cooperation of religious organizations in provision of assistance was hindered by financial constraints and institutional rivalry. CONCLUSIONS: Policy efforts to involve religious organizations in provision of HIV/AIDS-related assistance should take into account that organization's resources, institutional goals, and social characteristics.  (+info)

Decreased fecundability in Hutterite couples sharing HLA-DR. (59/193)

To study the effects of parental HLA sharing on pregnancy outcome, we initiated population-based studies in the Hutterites. We previously reported longer intervals from marriage to each birth among couples sharing HLA, particularly HLA-DR. In the present report, we present the results of a prospective, 5-year study of fecundability and fetal loss rates in this population. Between April 1986 and April 1991, 154 pregnancies were observed in 104 couples. The median number of months of unprotected intercourse to a positive pregnancy test was significantly longer among couples sharing HLA-DR who stopped nursing prior to the first menses as compared with couples not sharing HLA-DR who stopped nursing prior to the first menses (5.1 vs. 2.0 mo, respectively; P = .016). Fetal loss rates were increased among couples sharing HLA-B as compared with couples not sharing HLA-B (.23 vs. .12, respectively; P = .041, adjusted for age, gravidity, and kinship). These data suggest that our earlier observations of increased birth interval lengths among Hutterite couples sharing HLA were predominantly due to longer intervals until a clinical pregnancy among couples sharing HLA-DR and, to a lesser degree, were due to increased fetal loss rates among couples sharing HLA-B.  (+info)

Attitudes toward genetic testing of Amish, Mennonite, and Hutterite families with cystic fibrosis. (60/193)

BACKGROUND: We had the unique opportunity to study families with cystic fibrosis (CF) from an interrelated Amish-Mennonite kindred and from an isolated Hutterite kindred. METHODS: While obtaining blood for DNA linkage analysis to help find the CF gene, we asked family members to answer a questionnaire about attitudes and feelings toward genetic testing. The questionnaire was also administered to families receiving care at the University of Rochester. After DNA-based CF carrier testing was developed, we asked the families whether they wanted to know the results. RESULTS: Each cultural group felt differently about many issues. Between 31% and 78% approved of CF-carrier testing and 14% to 78% approved of prenatal diagnosis. The majority (59%) of Hutterite parents and siblings were opposed to carriers marrying carriers and most (82%) of the CF families wanted to know the results of carrier testing. CONCLUSIONS: Cultural differences need to be understood before genetic services are offered. Also, most CF mutations and their clinical correlates (phenotypes) will need to be defined. There are as few as three CF mutations in the Hutterite population. It will be possible to offer them the option to choose accurate genetic counseling. It will be difficult to offer genetic services to other populations with more heterogeneous attitudes and many more identified and yet-to-be-identified CF mutations.  (+info)

Examining the actions of faith-based organizations and their influence on HIV/AIDS-related stigma: a case study of Uganda. (61/193)

BACKGROUND: Stigma and discrimination are widely recognized as factors that fuel the HIV/AIDS epidemic. Uganda's success in combating HIV/AIDS has been attributed to a number of factors, including political, religious and societal engagement and openness - actors that combat stigma and assist prevention efforts. OBJECTIVES: Our study aimed to explore perceptions of Uganda-based key decision-makers about the past, present and optimal future roles of FBOs in HIV/AIDS work, including actions to promote or dissuade stigma and discrimination. METHODS: We analyzed FBO contributions in relation to priorities established in the Global Strategy Framework on HIV/AIDS, a consensus-based strategy developed by United Nations Member States. Thirty expert key informants from 11 different sectors including faith-based organizations participated in a structured interview on their perceptions of the role that FBOs have played and could most usefully play in HIV/AIDS prevention, care and support. RESULTS: Early on, FBOs were perceived by key informants to foster HIV/AIDS-related stigma and discrimination. Respondents attributed this to inadequate knowledge, moralistic perspectives, and fear relating to the sensitive issues surrounding sexuality and death. More recent FBO efforts are perceived to dissuade HIV/AIDS-related stigma and discrimination through increased openness about HIV status among both clergy and congregation members, and the leadership of persons living with HIV/AIDS. CONCLUSIONS: Uganda's program continues to face challenges, including perceptions among the general population that HIV/AIDS is a cause for secrecy. By virtue of their networks and influence, respondents believe that FBOs are well-positioned to contribute to breaking the silence about HIV/AIDS which undermines prevention, care and treatment efforts.  (+info)

Anesthetic management of Jehovah's Witness patients. (62/193)

When a Jehovah's Witness patient rejects transfusion because of his religious doctrine, the anesthesiologist is required to make an important decision. Each doctor must approach his patient respecting the patient's wishes as much as possible, while still taking into account his own ethical criteria, moral judgement of the patient, and knowledge of medicine. This writer briefly examined the basis of the religious doctrine of a Jehovah's Witness advocate and consulted a scholar of the criminal court about the legal interpretation of the doctor's behavior in our present situation where no detailed judicial precedent was available. I summarized medical solution here by referring to foreign records of medical studies and case reports in the hopes that it may aid in anesthetic management of Jehovah's Witness patients.  (+info)

Understanding the relationship between knowledge and African Americans' donation decision-making. (63/193)

OBJECTIVE: To explore the association between different types of knowledge related to donation and transplantation and the expression of donation intentions via one's driver's license, a donor card, or sharing one's wishes with family. METHODS: Cross-sectional data were gathered via self-administered questionnaire from 425 Black adults, age 18 years and older who were recruited from nine churches in a large metropolitan area in the southeast United States. RESULTS: Results indicate that knowledge of the allocation system and experiential knowledge of a transplant recipient are associated with donation intentions after controlling for age, gender, and highest level of education. However, the following types of knowledge were unrelated to donation intentions: donation-related statistics (including an understanding of African Americans' overrepresentation among those in need), the donation process, the process for determining medical suitability, and religious institutions' support for donation. CONCLUSIONS: Findings suggest that the relationship between donation-related knowledge and donation intentions is complex and may depend on the specific type of knowledge being measured. PRACTICE IMPLICATIONS: Knowledge of the allocation system and experiential knowledge of a recipient may be critical aspects of the donation decision-making process. Research findings suggest the need for an educational approach that seeks to improve the specific types of knowledge that are most strongly associated with donation intentions.  (+info)

The threat from creationism to the rational teaching of biology. (64/193)

Most biologists outside the USA and a few other countries, like Australia and Canada, are under the impression that the threat to the teaching of biology represented by creationism does not concern them directly. This is unfortunately no longer true: the recent growth of creationism, especially in its pseudo-scientific manifestation known as "intelligent design", has been obvious in several countries of Western Europe, especially the UK, Germany and Poland, and it is beginning to be noticeable in Brazil, and maybe elsewhere in Latin America. The problem is complicated by the fact that there are not just two possibilities, evolution and creationism, because creationism comes in various incompatible varieties. Turkey is now a major source of creationist propaganda outside the USA, and is especially significant in relation to its influence on Muslim populations in Europe. The time for biologists to address the creationist threat is now.  (+info)