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Objectives: To examine gender differences in sexual behaviour, the prevalence of laboratory-detected sexually transmitted infections (STIs) and self-reported genital symptoms in urban Chennai, Tamil Nadu, India.Study Design: The data were based on a cross-sectional survey (n = 1649) of residents from low-income communities in Chennai. Data were collected during community-wide health camps comprising physical examinations, interviews and laboratory testing between March and June 2001.Results: The population was young, sexually active, with a low prevalence of STI. The most commonly detected STI was Herpes simplex virus type 2 (HSV2; 13.2%). Women had a higher prevalence of HSV2, but were more likely than men to be asymptomatic. Most of the self-reported genital symptoms could not be linked to a laboratory-detected STI. >10% of the cohort had a history of an ulcerative STI and >5% had an inflammatory STI.Conclusions: Given a high prevalence of HSV2 in the study population, interventions targeting HSV2 transmission may be particularly relevant for this population. [ABSTRACT FROM AUTHOR]

This study explores differences in body mass index (BMI), diet, and lifestyle between women of varying socio-economic status in Karnataka, India, using data from the National Family Health Survey 2 (n=4374), in-depth interviews (n=20) and six focus group discussions (n=40) completed in Bangalore. Predictors of overweight (BMI ≥25kg/m2) were modelled using logistic regression. A content analysis of the qualitative data was undertaken to understand behavioural factors affecting overweight. Prevalence of undernutrition was high for rural women (48%) and for overweight, prevalence was high in large urban areas (44%). In Bangalore knowledge of unhealthy foods was higher for richer women, although their diet and activity levels were less healthy than poorer women, who did not have the resources to purchase less healthy diets. Although some knowledge of the need for activity and healthy diets exists for wealthier Bangalore women, this does not translate into healthy behaviour, suggesting a need for obesity prevention programmes.European Journal of Clinical Nutrition (2005) 59, 1217–1220. doi:10.1038/sj.ejcn.1602228; published online 3 August 2005 [ABSTRACT FROM AUTHOR]

OBJECTIVE:: This research investigates the prevalence and determinants of anemia among women in Andhra Pradesh. We examined differences in anemia related to social class, urban/rural location and nutrition status body mass index (BMI). We hypothesized that rural women would have higher prevalence of anemia compared to urban women, particularly among the lower income groups, and that women with low body mass index (BMI; <18.5 kg/m2) would have a higher risk compared to normal or overweight women. DESIGN:: The National Family Health Survey 1998/99 (NFHS-2) provides nationally representative cross-sectional survey data on women's hemoglobin status, body weight, diet, social, demographic and other household and individual level factors. Ordered logit regression analyses were applied to identify socio-economic, regional and demographic determinants of anemia. SETTING:: Andhra Pradesh, a southern Indian state. SUBJECTS:: A total of 4032 ever-married women aged 15–49 from 3872 households. RESULTS:: Prevalence of anemia was high among all women. In all 32.4% of women had mild (100–109.99 g/l for pregnant women, 100–119.99 for non-pregnant women), 14.19% had moderate (70–99.99 g/l), and 2.2% had severe anemia (<70 g/l). Protective factors include Muslim religion, reported consumption of alcohol or pulses, and high socioeconomic status, particularly in urban areas. Poor urban women had the highest rates and odds of being anemic. Fifty-two percent of thin, 50% of normal BMI, and 41% of overweight women were anemic. CONCLUSIONS:: New program strategies are needed, particularly those that improve the overall nutrition status of women of reproductive ages. This will require tailored programs across socio-economic groups and within both rural and urban areas, but particularly among the urban and rural poor. SPONSORSHIP:: Partial support for Margaret Bentley was provided by the Ford Foundation/India and the Carolina Population Center.... [ABSTRACT FROM AUTHOR]

Nutrition research in India has previously focused on the serious problem of undernutrition related to nutrient deficit and high rates of infection. Recent data from the National Family Health Survey 1998/99 (NFHS 2), however, identified a significant proportion of Indian women as overweight, coexisting with high rates of malnutrition. This paper examines the emerging nutrition transition for women living in rural and urban communities of Andhra Pradesh, India. NFHS 2 provides nationally representative data on women's weight and height. In this paper, we examine representative data from the state of Andhra Pradesh (n = 4032 women). Logistic regression analyses are applied to the data to identify socioeconomic, regional and demographic determinants of overweight and thinness. The major nutrition problem facing women continues to be undernutrition, with 37% having a low body mass index [(BMI) < 18.5 kg/m(2)]; 8% of these women are severely malnourished (BMI < 16 kg/m(2)). However, 12% of the women can be classified as overweight (BMI > 25 kg/m(2)) and 2% are obese (BMI > 30 kg/m(2)). Furthermore, in the large cities of the state in which 4% of the sample live, 37% of women are overweight or obese, whereas in the rural areas in which 74% reside, 43% have a low BMI. Women from lower socioeconomic groups are also significantly more likely to have a low BMI. Findings from the logistic regression models reveal socioeconomic status to be a more important predictor of both over- and underweight than location of residence. [ABSTRACT FROM AUTHOR]

Child stunting, an outcome of chronic undernutrition, contributes to poor quality of life, morbidity and mortality. In South Asia, the low status of women is thought to be one of the primary determinants of undernutrition across the lifespan. Low female status can result in compromised health outcomes for women, which in turn are related to lower infant birthweight and may affect the quality of infant care and nutrition. Maternal autonomy (defined as a woman's personal power in the household and her ability to influence and change her environment) is likely an important factor influencing child care and ultimately infant and child health outcomes. To examine the relationship between maternal autonomy and child stunting in Andhra Pradesh, India, we analysed data from National Family Health Survey (NFHS)-2. We used cross-sectional demographic, health and anthropometric information for mothers and their oldest child <36 months (n = 821) from NFHS-2. The main explanatory variables of autonomy are presented by four dimensions - decision making, permission to travel, attitude towards domestic violence and financial autonomy - constructed using seven binary variables. Logistic regression models were used to test associations between indicators of female autonomy and the risk of having a stunted child. Women with higher autonomy {indicated by access to money [odds ratio (OR) = 0.731; 95% confidence interval (CI) 0.546, 0.981] and freedom to choose to go to the market [OR = 0.593; 95% CI 0.376, 0.933]} were significantly less likely to have a stunted child, after controlling for household socio-economic status and mother's education. In this south Indian state, two dimensions of female autonomy have an independent effect on child growth, suggesting the need for interventions that increase women's financial and physical autonomy.

While data on perceived morbidity often correlate poorly with clinical morbidity, they can provide an indicator for how women's concepts of health change in the context of larger transitions in gender and health systems. Drawing on multiple sources of data on perceived morbidity among women in a peri-urban settlement of Maharashtra, India, this article examines variations in women's thresholds for articulating illness conditions. Data on women's health were collected from married women aged 15-49, using four different instruments: focus group discussion guides; general illness narrative guidelines; individual open-ended questions about morbidity; and a highly structured checklist. Comparing the data and the assumptions underlying these instruments, the article identifies four different thresholds relating to situational, agency, prototypical and dimensional aspects of women's experience and subsequent reporting of morbidity.

Background & Objectives: Though nonoxynol-9 (N-9) is available in India as a spermicidal pessary, data on its safety as a potential microbicide among Indian women are not available. Nonoxynol-9 containing compounds have shown anti-HIV activity in in vitro studies and protection against cervical infections. Nonoxynol-9 is being extensively evaluated as a vaginal microbicide world-wide. We assessed the safety and preliminary acceptability of nonoxynol-9 pessary as a vaginal microbicide in women at low risk for human immunodeficiency virus (HIV) infection and sexually transmitted diseases (STDs)., Methods: Twenty three HIV seronegative women enrolled in the study were given Today pessarys containing 5 per cent of nonoxynol-9 for vaginal use at bedtime for 14 days. Colposcopy was done at enrollment and on day 14 and speculum examination on day 7 to assess the local toxicity., Results: Most of the women (16/23, 69.6%) did not experience any symptoms of genital irritation. The remaining 7 (30.4%, 95% CI 11.6-49.2) women reported 11 episodes of mild irritative symptoms of short duration. On clinical examination, three adverse events were reported of which one could have been product related. Eight (34.8%) women showed willingness to use the product for protection against HIV transmission if it was approved., Interpretation & Conclusion: Nonoxynol-9 vaginal pessary was found to be safe and acceptable in once daily dose in low risk women after consecutive use for 14 days. Willingness for future use, if found safe and effective for HIV prevention was shown by 8 (34.8%) women.

Context: A high prevalence of human immunodeficiency virus (HIV) infection in female sex workers (FSWs) and men who attend sexually transmitted disease (STD) clinics poses a risk for spread of infection to other populations., Objective: To examine spread of HIV to a low-risk population by comparing prevalence of, and risk factors for, HIV and STDs in FSWs and non-FSWs., Methods: Women attending STD clinics in Pune, India, were assessed for STDs and HIV from May 13, 1993, to July 11, 1996. Demographic and behavioral information was collected, and clinical and laboratory assessment was performed., Main Outcome Measure: Prevalence and risk determinants of HIV infection., Results: Of 916 women enrolled, 525 were FSWs and 391 were non-FSWs. Prevalence of HIV in FSWs and non-FSWs was 49.9% and 13.6%, respectively (P<.001). In multivariate analysis, inconsistent condom use and genital ulcer disease or genital warts were associated with prevalent HIV in FSWs. History of sexual contact with a partner with an STD was associated with HIV in non-FSWs., Conclusions: Infection with HIV is increasing in non-FSWs, previously thought to be at low risk in India. Since history of sexual contact with their only sex partner was the only risk factor significantly associated with HIV infection, it is likely that these women are being infected by their spouses. This underscores the need for strengthening partner-notification strategies and counseling facilities in India.

The present study attempts to understand the awareness, knowledge and risk to HIV/AIDS among two groups of women: one reporting sex-work (FSW) and second reporting other work (FOW) from two clinics in Pune. The patients are screened for HIV and enrolled in the study. This paper includes 711 women covered between May 1993 and April 1995, 409 FSW and 302 FOW women, who differed by several characteristics. The FSW are older, less educated, unmarried, staying away from home, speak Kannada with 60 per cent using condoms for preventing pregnancy. FOW are ever-married women and among Family Planning method users only 7 per cent used condoms and 84 per cent had tubal ligation. At enrollment 47 per cent FSW and 14 per cent FOW were HIV positive with less than one third of all the women reporting AIDS knowledge. Among the knowledgeable women, 82 per cent understood the sexual route, half knew of transmission by blood and a third understood the vertical route of transmission; 77 per cent FSW and 48 per cent FOW knew that condom was protective. FSW reporting consistent condom use in past three months had greater knowledge of AIDS transmission, were more likely to have used condoms as contraceptive or had tubal ligation and less likely to have history of STD. This suggests the HIV/AIDS awareness and educational programs are having a limited effect specially among the married women who do not perceive of the risk of STD/HIV from their spouses and requires urgent preventive measures through innovative approaches that focus on female controlled methods. It is of critical importance that family planning and STD/HIV programs be integrated.

Objectives: To investigate whether supplementation of zinc in preschool children is associated with improvement in observed activity levels., Methods: On 2 consecutive days, we performed 5-hour observations with momentary time sampling (instant activity every 10 minutes) in children selected from an ongoing double-blind, randomized trial of zinc supplementation. The study was conducted in Kalkaji, a low-socioeconomic urban population of New Delhi with high diarrheal incidence and rates of malnutrition. A total of 93 children (48 zinc and 45 control) 12 to 23 months of age from an ongoing community-based, randomized, controlled trial received supplements for at least 1 month before study; 71% had received supplementation for more than 120 days. Zinc gluconate (10 mg of elemental zinc) was given daily, with both zinc and control groups receiving vitamins A, B1, B2, B6, D3, and E and niacinamide in addition., Results: Outcomes were percentages of time spent in each of five activity levels and two groups representing high and low movement and overall rating by two activity scores. Children in the zinc group spent 72% more time performing activities in the high-movement group. Among the zinc-supplemented children, the activity rating by the children's activity rating score was 12% higher and by the energy expenditure score was 8.3% higher than in the control group., Conclusions: In conclusion, zinc supplementation, given along with selected vitamins, was associated with significantly greater activity levels in children. The relationship between the activity increase and locomotor development needs to be investigated, as do the long-term implications of zinc supplementation in terms of developmental status and school performance.