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Programmatic and research considerations for hormonal contraception for women at risk of HIV and women living with HIV.
Geneva, Switzerland, WHO, Department of Reproductive Health and Research, 2012 May.  p. (Policy Implications; WHO/RHR/12.09)Between 31 January and 2 February 2012, the World Health Organization (WHO) convened a meeting of experts to discuss recent research on use of hormonal contraception by women at high risk of HIV and those currently living with HIV and its implications. The purpose of the meeting was to review all available published evidence on the relationship between the use of hormonal contraceptives and the risk of HIV acquisition, HIV disease progression, and HIV transmission to uninfected partners, and to determine whether any change in the WHO recommendations on hormonal contraceptive use by women at high risk of, or living with, HIV-infection was needed. During the discussion on the balance of risks and benefits of hormonal contraceptive use among women at high risk of, or living with, HIV infection, multiple programmatic and research issues emerged, including priority knowledge gaps. This brief serves to highlight actions that programmes providing sexual and reproductive health and HIV-prevention services should undertake, in order to complement the Consultation’s recommendations. Directions for future research to address current gaps are noted. (Excerpts)
CONTRACEPTIVE TECHNOLOGY UPDATE. 1989 Jun; 10(6):77-81.Although generic oral contraceptives (OCs) are bioequivalent to brand-name formulations, many family planning professionals do not prescribe the significantly lower-priced generics. The Planned Parenthood Federation of America, for example, has refused to approve generic OCs for use in the organization's clinics, presumably because of concerns about their equivalent efficacy and safety. However, much of this skepticism may be fueled by misleading marketing by brand-name OC manufacturers. Sales representatives have reportedly told clinicians that generic OCs can be as much as 20% different from brand-name formulations, despite evidence collected by the US Food and Drug Administration confirming that there is virtually no difference except in terms of inert ingredients. In the case of many formulations, the variability between the generic and brand-name products is no different than the variability found between different lots of the same brand-name drug. Another obstacle to wider use of generic OCs is that discounts for large volume purchases make brand-name OCs the best buy for family planning clinics. Clinicians also note that clients complain of minor side effects whenever OC brands are changed, even if the compounds are the same. As the price of medication continues to rise, the more widespread availability of generic OCs will be especially important for teenagers and other low-income clients.
ECONOMIC AND POLITICAL WEEKLY. 1987 Jul 11; 22(28):1099.India's family planning program has been restructured from a massive effort, using multimedia promotion and 2 million volunteers and designed to convey the "small family message" directly to the families concerned, to a smaller scale program emphasizing child survival, delayed marriage, village infrastructure, and birth spacing. The change is due to 2 factors: 1) The terminal approach failed to achieve lower birth rates because people will not accept the small family unless they can rely on the survival of the children; and 2) The terminal approach contained an element of coercion which caused the US to reduce support to the US Agency for International Development (USAID) and the UN Fund for Population Activities (UNFPA). The new scaled-down approach should be more effective, since more couples are now practicing family planning and birth spacing, oral contraceptives, IUDs, and longterm hormonal contraceptives are more appropriate than terminal methods to the present demographic picture.
International Planned Parenthood Federation adds Norplant implants to its commodities list of approved contraceptives. News release.
New York, New York, Population Council, 1985 Oct 5. 3 p.On December 5, 1985, the Population Council announced that the International Planned Parenthood Federation (IPPF) has approved the inclusion of Norplant implants on its commodities list of contraceptives available to its affiliates. This action means that the Norplant method will be available to the 120 IPPF-affiliated national family planning associations once the contraceptive has been approved for distribution by regulatory authorities in each country. IPPF has indicated that it will supply the implants to agencies that: 1) have a sufficient number of health workers who have been formally trained in Norplant insertion, removal, and counseling techniques; 2) have suitable clinic facilities and adequate back-up and referral systems; and 3) can arrange training so that additional health workers will qualify to use this method. The Norplant method was approved by the IPPF Advisory Panel on September 8, 1985, following an 18-month period of review of all available scientific data. The Norplant system has been used in clinical trials in 25 countries involving over 25,000 acceptors. The Population Council has cited the inclusion of Norplant implants in the IPPF program as an important step in the worldwide availability of this contraceptive method. The Population Council has established regional training centers in Indonesia, Egypt, Chile, Brazil, and the Dominican Republic where health care personnel can be trained in techniques of insertion and removal of the impants as well as in counseling potential acceptors.