The changing social gradient of marriage and cohabitation in seven Latin American countries.

While research shows that cohabitation has increased significantly among highly educated individuals in Latin America, much less is known about how the relationship between educational attainment and first union formation has changed over time and across the region's countries. Accordingly, this paper describes the changes across cohorts in the type of first union (marriage or cohabitation) entered by women from seven Latin American countries. It also analyzes trends in the relationship between women's education and the type of first union within and between these countries. Using Demographic and Health Survey (DHS) data, life tables, discrete-time event history models, and predicted probabilities were estimated to analyze the changing determinants of first-union formation. The results pointed to an overall increase in first-union cohabitation over time, with some important differences across countries. The multivariate analysis suggested that women's education influences the type and sequencing of the first union, with socioeconomically disadvantaged women increasingly likely to transition to early unions and enter cohabitation rather than marriage.

Mortality-fertility synergies during the demographic transition in the developed world.

The classic theory used to explain the demographic transition assumes that mortality is the key explanatory variable influencing the decline in fertility. However, the empirical results obtained in what is known as the Princeton European Fertility Project have led many specialists to question this assumption. Using both national and provincial aggregated data for 25 countries over a long time span, the analysis reported in this paper found that mortality does indeed play a fundamental role in accounting for the main demographic changes that occurred both before and during the transitional period. Others' research based on individual data has shown clearly that the number of surviving children was indeed an important factor for reproductive decisions. My analysis, using aggregated data, reached largely similar conclusions regarding the role of mortality in changing reproductive trends, via its impact on nuptiality and marital fertility at different stages of the demographic transition.

Perturbed nuptiality, delayed fertility: childbirth effects of Covid19.

An aspect of the Covid-19 pandemic that merits attention is its effects on marriage and childbirth. Although the direct fertility effects of people getting the virus may be minor, the impact of delayed marriages due to the first preventive lockdown, such as that imposed in Pakistan from March 14 to May 8 2020, and the closure of marriage halls that lasted till September 14 may be non-negligible. These demographic consequences are of particular import to developing countries such as Pakistan where birth rates remain high, marriage is nearly universal, and almost all child-bearing takes place within marriage. Based on historic marriage patterns, we estimate that the delay in nuptiality during the first wave of the coronavirus outbreak may affect about half of the marriages that were to take place during the year. In Pakistan, childbearing begins soon after marriage, and about 37% of Pakistani married women give birth to their first child within twelve months of marriage. A sizeable number out of these, around 400,000 annual births that occur within twelve months of the marriage, may consequently be delayed. Postponement of marriages due to the accompanying difficult economic situation and employment precariousness will accentuate this fertility effect. The net fertility impact of the Covid-19 outbreak will ultimately depend not only on the delay in marriages but also on the reproductive behavior of existing couples.

Population perspectives and demographic methods to strengthen CRVS systems: introduction.

Civil registration and vital statistics (CRVS) systems and legal identity systems have become increasingly recognized as catalytic both for inclusive development and for monitoring population dynamics spanning the entire life course. Population scientists have a long history of contributing to the strengthening of CRVS and legal identity systems and of using vital registration data to understand population and development dynamics. This paper provides an overview of the Genus thematic series on CRVS systems. The series spans 11 research articles that document new insights on the registration of births, marriages, separations/divorces, deaths and legal residency. This introductory article to the series reviews the importance of population perspectives and demographic methods in strengthening CRVS systems and improving our understanding of population dynamics across the lifecourse. The paper highlights the major contributions from this thematic series and discusses emerging challenges and future research directions on CRVS systems for the population science community.

Tipos y circunstancias de unión conyugal en la violencia física de pareja en Chiapas, México, 2016

La violencia en contra de las mujeres en la pareja heterosexual, además de ser un tema muy complejo, es un problema de salud pública. Este trabajo contribuye a profundizar no solamente en el tipo de unión conyugal (cohabitación y matrimonio), sino también toma en cuenta las circunstancias en donde ocurre para explicar tanto en mujeres indígenas como no indígenas su relación con la magnitud y la gravedad de las expresiones de maltrato físico en Chiapas, México. El estudio fue realizado a través de un enfoque cuantitativo con base en los datos de la Encuesta Nacional sobre la Dinámica de las Relaciones en los Hogares 2016 (ENDIREH); se incluyeron 2604 mujeres de 15 a 49 años, actualmente unidas, indígenas y mestizas. Los resultados mostraron que la unión libre es más frecuente en las indígenas y se asocia significativamente con una mayor probabilidad de violencia física en sus distintas formas; adicionalmente, las circunstancias en las cuales esta se establece dan cuenta de la variación en la frecuencia de las agresiones, sobre todo cuando las mujeres son forzadas a unirse. La desventaja social de las mujeres subyace al tipo y las circunstancias de unión, destaca su participación o ausencia al decidir y los aspectos normativos que rigen la materia en Chiapas. Se discuten los hallazgos a la luz del cambio reproductivo y el compromiso de los varones en el establecimiento de la unión como elementos constitutivos de la cohabitación y el matrimonio, así como de la violencia íntima de pareja.

Violence against women in heterosexual couples is not only a very complex issue, but also a public health problem. The work contributes to the study not only in the type of conjugal union (cohabitation and marriage) but also taking into account the circumstances in which the union occurs, to explain both in indigenous and non-indigenous women their relationship with the magnitude and severity of the expressions of physical violence against women in Chiapas. The study was conducted through a quantitative approach taking as a basis data from the National Survey on the Dynamics of Household Relationships 2016 (ENDIREH); 2604 women aged 15 to 49 years, currently in union, indigenous and mestizo were included. The results show that free union is more frequent in indigenous women and that this type of union is significantly associated with a higher probability of occurrence of physical violence in its different expressions. Additionally, the circumstances in which the union is established provide evidence of differences in the frequency of physical violence in them, particularly when women are forced to join. The social disadvantage of women underlies the type and circumstances in which the union occurs, highlighting the participation or not of women in the decision to join and the normative aspects that govern unions in Chiapas, Mexico. Results are discussed in light of reproductive change and male involvement in the establishment of the union as elements underlying both cohabitation or marriage and intimate partner violence.

Breast cancer risk factors among screening program participants.

PIP: Data were obtained by mailed questionnaire from 405 breast cancer patients identified during the first 2 years of operation of the Breast Cancer detection Demonstration Project in the U.S. and from a sample of 1156 normal screenees (response rate = 88%) in an attempt to examine whetHer the usual risk indicators for breast cancer apply to individuals participating in screening programs. No substantial differences were found between the respondents and the nonrespondents for the variables on which information had been obtained at the time of the initial screening. Nearly all of t(e recognized risk factors were seen in this population. The relative risk (FF) of breast cancer was 3.9 among women whose mothers were also affected; this finding was statistically significant. Relative risk was increased for women reporting early menarche, late menopause, nulliparity, late age when 1st child was born, and excessive weight. The relative risk was not elevated in women with a prior breast biopsy but was excessive for those with more than 1 biopsy. No association with thyroid medications or menopausal hormones was found. Among women having undergone a natural menopause, a nonstatistically significant elevation in the relative risk was noted for long term oral contraceptive users; this excess relative risk was restricted to those using OCs in the presence of breast cancer risk indicators. The results indicate the need for further study of women with extended periods of OC use, particularly when accompanied by other known risk indicators.^ieng

Cancer mortality among nuns: role of marital status in etiology of neoplastic disease in women.

PIP: To clarify the role of marital status in human carcinogenesis, a 1968 Cancer Institute study analyzed the cancer mortality experience of 31,658 white Catholic nuns from 41 religious orders in the U.S. from 1900-1954. The national white female population was used for cause-specific comparison and both groups were assigned cohorts depending upon the year of birth. When examined by 10-year age groups, rates for cancer at all sites was generally lower for nuns than for controls aged 59 or 69 but were substantially higher at older ages. Postmenopausal nuns (aged 69 and over) displayed a higher rate (38.6%) of cancer of the large intestine than did controls (22.6%) but had a lower proportion of deaths from cancer of the biliary passages and liver (13.0% vs. 22.6%). Nuns displayed a striking excess in breast cancer mortality over the age span of 40-74 years and had consistently higher rates than controls for each age group above 39 years. Lower cervical cancer rates for nuns (10.8%) than for controls (56.6%) seemed related to coital factors. Cancer of the uterus accounted for 63% of the genital cancer deaths among sisters. Overall, the genital cancer mortality rates for nuns were consistent with high mortality rates for the single, white female population of the U.S. The increased risk of breast cancer and cancers of the corpus uteri and ovary would seem to reflect an established link with infertility. Combination of these factors with the excess incidence of cancer of the large intestine among postmenopausal nuns suggests a common pathogenic mechanism of a hormonal nature operating in some women.^ieng

Determinants of genital human papillomavirus infection in young women.

Carcinoma of the cervix has several well-established epidemiologic risk factors, including multiple sexual partners and early age at first intercourse. Human papillomavirus (HPV) infection appears to have an etiologic role in the development of cervical neoplasia, but evidence linking HPV infection to known risk factors for cervical cancer has been inconsistent. The lack of expected correlations may be due to the inaccuracy of HPV assays previously used. A polymerase chain reaction DNA amplification method for the detection of HPV was used to investigate the determinants of genital HPV infection in a cross-sectional sample of 467 women attending a university health service. In contrast to studies using less accurate detection methods, the risk factors for HPV infection found here were consistent with those for cervical neoplasia. The risk of HPV infection was strongly and independently associated with increasing numbers of sexual partners in a lifetime, use of oral contraceptives, younger age, and black race. Age at first intercourse, smoking, and history of a prior sexually transmitted disease were correlated with, but not independently predictive of, HPV infection. These results demonstrate that the key risk factors for cervical carcinoma are strongly associated with genital HPV infection. This correlation suggests that HPV has an etiologic role in cervical neoplasia and reaffirms the sexual route of HPV transmission.

Sposàrsi a Franca: tendências da nupcialidade entre imigrantes italianos no interior paulista, 1885-1930 / Sposàrsi a Franca: nuptial trends among Italian immigrants in the interior of São Paulo, 1885-1930 / Sposàrsi a Franca: tendencias de la nupcialidad entre inmigrantes italianos en el interior de São Paulo, 1885-1930

Em consonância com os estudos em Demografia Histórica e História da Família, este artigo visa a resgatar aspectos relativos à nupcialidade vivenciada pelos italianos e seus descendentes no município de Franca, interior do estado de São Paulo. A reflexão é corroborada pela historiografia recente que aponta a expansão da economia cafeeira no interior paulista como responsável por alterações no panorama demográfico por meio da atração de uma imigração internacional em massa, cujos impactos foram sentidos em diferentes espaços de ação, na família, nas relações matrimoniais, na etnicidade e integração desses grupos na sociedade brasileira entre o final do século XIX e as primeiras décadas do século XX. Combinando metodologias seriais e de microanálise para explorar os dados disponíveis nos registros de matrícula da Hospedaria de Imigrantes de São Paulo e assentos de casamento do Registro Paroquial do Arquivo da Cúria Diocesana de Franca (1885-1930), abre-se caminho para enriquecer o universo de interpretações sobre a nupcialidade nos municípios atingidos pela imigração internacional de italianos. Esse artigo examina os impactos das variáveis imigratórias nos padrões de casamento dos italianos no município e resgata aspectos da endogamia desse grupo, favorecida pelos respectivos contextos e bagagens culturais que conduziram o processo imigratório por eles vivenciado.

In line with studies in Demographic History and Family History, this article aims to rescue aspects related to nuptiality experienced by Italians and their descendants in the municipality of Franca, in the interior of the state of São Paulo. The reflection is corroborated by recent historiography research pointing to the expansion of the coffee-based economy in the interior of São Paulo as responsible for demographic changes through the attraction of mass international immigration. This affected different areas, including family, matrimonial relations, ethnicity and integration of these groups in Brazilian society at the turn of the 20th century. A combination of serial and microanalysis methodologies to explore the data available in the registration records of the São Paulo Immigrant Inn and wedding seats in the Parish Records of the Diocesan Archive of Franca (1885-1930), paves the way to expand the universe of interpretations on nuptiality in municipalities affected by Italian immigration. This article examines the impacts of immigration variables on Italians' marriage patterns in the municipality and retrieves aspects of this groups' inbreeding, favored by the respective cultural contexts and backgrounds that led to the immigration process they experienced.

En línea con los estudios en Demografía histórica e Historia familiar, este artículo tiene como objetivo rescatar aspectos relacionados con la nupcialidad vivida por los italianos y sus descendientes en el municipio de Franca, en el interior del estado de San Pablo. La reflexión es corroborada por la historiografía reciente, que apunta a la expansión de la economía cafetera en el interior del estado como responsable de cambios en el panorama demográfico mediante la atracción de la inmigración internacional masiva, cuyos impactos se sintieron en diferentes espacios de acción, en la familia, en las relaciones matrimoniales, en la etnicidad y en la integración de estos grupos en la sociedad brasileña entre fines del siglo XIX y las primeras décadas del XX. Al combinar metodologías seriadas y de microanálisis para explorar los datos disponibles en los registros de la Posada de Inmigrantes de San Pablo y en los asientos de boda del Registro Parroquial del Archivo de la Curia Diocesana de Franca (1885-1930) se abre el camino para enriquecer el universo de interpretaciones sobre nupcialidad en los municipios afectados por la inmigración internacional de italianos. Este artículo examina los impactos de las variables de inmigración en los patrones matrimoniales de los italianos en el municipio y recupera aspectos de la endogamia de este grupo, favorecida por los respectivos contextos culturales y antecedentes que llevaron al proceso de inmigración que vivieron.

Breast carcinoma etiological factors.

PIP: This review of breast carcinoma etiological factors considers the following: heritage; menses, marital state, and parity; breastfeeding; contraceptives; benign epithelial diseases of the breast; hormonal factors; cancer; iatrogenic factors; immunological factors; viral aspects of human breast cancer; dietary factors; and psychosomatic factors. Breast carcinoma is the most prevalent type of cancer in American women. 8% of American women can expect to be stricken with this disease. The rate in men is 1% that in women. The causes or reasons for a woman being afflicted with this disease remain equivocal. An abundance of evidence exists that the incidence of breast carcinoma varies greatly from 1 population to another throughout the world and that in most populations it is increasing. Due to earlier detection, improved medical care, and possible other factors, the death rate is not increasing as rapidly as the incidence rate. In general, the incidence is greatest in populations with the highest standards of living, such as those of Northwestern Europe and North America. Thus, a woman's heritage is usually a large factor in determining her low risk of developing mammary carcinoma. Heritage includes family, race, country of origin, religion, and any component of lifestyle that is firmly passed on from 1 generation to the next. These factors seem to have a great influence on the incidence of breast cancer, but there is little agreement on which components of heritage are most important and how they operate. Many publications report insignificant or no effect of menarchal age on breast cancer risk. Many reports mention breastfeeding along with other data in breast cancer etiological studies, but its influence on the disease seems to be insignificant. Possibly there is some synergistic influence, but available data is not strong enough to establish the direction. Many reports seem to suggest that oral contraceptives (OCs) increase risk in nulliparous women and may promote the growth of malignant neoplasia, but in parious women, if there is no incipient cancer present, OCs do not appear to increase risk and may even decrease risk. Benign epithelial lesions can be harbingers of breast carcinoma, but from the literature it is not easy to conclude the nature of the most risky lesions nor their relative risks. A familial or personal history of cancer in any location or tissue may increase the risk of breast cancer. Ionizing radiation, oophorectomy, hysterectomy, and hormone therapy are the principal iatrogenic factors that influence the incidence of breast cancer. Radiation is known to be a most powerful carcinogen and is probably responsible for more cancer than any other iatrogenic factor. None of the factors so far studied is of great importance singly, but in a situation where several act together, any one may appear to be significant.^ieng

Risk factors for intravenous drug use and sharing equipment among young male drug users in Longchuan County, south-west China.

OBJECTIVES: To identify the risk factors for intravenous drug use and sharing of equipment in Longchuan County in south-west China. METHODS: Demographic information and sexual and drug-use-related behavior between 1 January 1991 and 1 August 1994 were collected retrospectively from a cohort of young male drug users aged 18-29 years in 82 villages. RESULTS: A total of 433 drug users were identified. The cumulative incidence of intravenous drug use was 40.0% during the 3.7-year study period. The annual incidence increased from 10% in 1991 to over 30% in 1994. Risk factors for intravenous drug use among drug users, according to the multivariate model, included having had premarital/extramarital sex [odds ratio (OR), 1.5; 95% confidence interval (CI), 1.01-2.3], having a family member who used drugs in 1991 (OR, 1.8; 95% CI, 1.1-2.9), and currently not married (OR, 1.6; 95% CI, 0.98-2.7). Being Buddhist protected against intravenous drug use (OR, 0.4; 95% CI, 0.2-0.9). The population attributable fraction was 30% for not being currently married, 17% for having had premarital/extramarital sex and 14% for having a family member who used drugs. The risk factor for sharing of equipment was being of Jingpo ethnicity (OR, 5.8; 95% CI, 2.5-13.8). The average incidence of sharing equipment was 19.6% per year. The population attributable fraction for sharing equipment was 58.5% for being Jingpo. CONCLUSIONS: The incidence of intravenous drug use and sharing equipment is increasing. Therefore, it is urgent that vigorous, effective intervention programs be initiated in southern Yunnan. Unmarried, sexually promiscuous Jingpo drug users with a family history of drug use should be especially targeted. Given the problems of transport and communication in this remote area of China, intervention programs which use existing social, governmental and community networks should be implemented.

PIP: To identify the risk factors for intravenous drug use and sharing of equipment in Longchuan County in south-west China, information was collected on demographics, as well as on sexual and drug-use-related behavior between January 1, 1991 and August 1, 1994, from a cohort of young male intravenous drug users (IDU) 18-29 years old residing in 82 villages. A total of 433 drug users were identified, 121 of whom were interviewed at rehabilitation centers; 192 were IDU. After excluding 3 immigrants and 28 IDU who began injecting before 1991, 402 drug users (241 non-IUD and 161 new IDU) were included for the non-concurrent cohort study of IDU. The cumulative incidence of intravenous drug use was 40.0% during the 3.7-year study period. The annual incidence increased from 10% in 1991 to over 30% in 1994. Risk factors for intravenous drug use among drug users, according to the multivariate model, included having had premarital or extramarital sex [odds ratio (OR), 1.5; 95% confidence interval (CI), 1.01-2.3], having a family member who used drugs in 1991 (OR. 1.8; 95% CI, 1.1-2.9), and currently not married (OR, 1.6; 95% CI, 0.98-2.7). Being Buddhist protected against intravenous drug use (OR, 0.4; 95% CI, 0.2-0.9). The population attributable fraction was 30% for not being currently married, 17% for having had premarital or extramarital sex, and 14% for having a family member who used drugs. The risk factor for sharing of equipment was being of Jingpo ethnicity (OR, 5.8; 95% CI, 2.5-13.8). The average incidence of sharing equipment was 19.6% per year. The population attributable fraction for sharing equipment was 58.5% for being Jingpo. The incidence of intravenous drug use and sharing equipment is increasing. Therefore, it is urgent that vigorous, effective intervention programs be initiated in southern Yunnan. Unmarried, sexually promiscuous Jingpo drug users with a family history of drug use should be especially targeted. Given the problems of transport and communication in this remote area of China, intervention programs that use existing social, governmental and community networks should be implemented.

Sustaining safe sex: a longitudinal study of a sample of homosexual men.

OBJECTIVE: TO assess the maintenance of safe sexual practice. (We use the term 'safe' sex throughout the paper, since 'safe' is the term adopted by the Australian National Committee on AIDS). DESIGN: Maintenance was assessed by comparing sexual behaviour with both regular and casual partners reported in a 1986/1987 survey (time 1) with behaviour reported in a second survey in 1991 (time 2). METHOD: The 145 homosexually active participants were a non-clinical sample recruited in 1986/1987 by advertisement and followed-up in 1991. A structured questionnaire was administered at both times. Items included questions about the nature of the men's sexual relationships and their sexual practices. RESULTS: Our findings indicate that the majority of men had sustained safe sex practices. HIV prevention strategies adopted included condom use, avoidance of anal intercourse and negotiated safety (i.e., the negotiated practice of unprotected anal intercourse within regular partnerships of concordant serostatus). CONCLUSIONS: Negotiated safety is not the same as relapse.

PIP: This study assesses the extent to which safe sex practices are being maintained in a longitudinally followed cohort of 145 homosexually active men. The nonclinical sample was recruited in 1986/87 by advertisements and followed-up in 1991 with questionnaires on the nature of their sexual relationships and their sexual practices. Sex behavior with regular partners was compared with sex behavior with casual partners over the time period. The majority had sustained safe sex practices including condom use, avoidance of anal intercourse, and negotiated safety. This latter practice refers to the negotiated practice of unprotected anal intercourse with regular partners of concordant serostatus and should not be considered a relapse to unsafe sex.

Safer sex maintenance among gay men: are we moving in the right direction?

PIP: Public health messages aimed at checking the sexual spread of HIV call for an end to unsafe sex practices. This goal, is however, unrealistic. The position is neither sustainable nor epidemiologically necessary, but is an unnecessary restriction on the desire and action of individuals and couples trying to create a sustainable combination of safety and pleasure based on a thorough understanding of what is safer sex. Focusing exclusively upon the practice of anal intercourse between men who have sex with men, the author argues that while unprotected anal intercourse is unsafe, it is not always and in every circumstance equally unsafe. For example, 2 men may be regular sex partners who enjoy an honest, trusting, and steady relationship. When and if 1 of the men has casual sex with a 3rd men, he does not engage in anal sex. While this behavior is not absolutely safe, it is safer than having, for example, unprotected anal sex with both his regular partner an casual partners. Humans function under heuristic rules where risk tends not to be eliminated but simply minimized. This behavior is an extremely deep feature of human interaction and should be encouraged instead of condemned. A high proportion of recent returns to unsafe sex among these men involves this sort of negotiated instead of absolute safer sex. These emergent strategies of negotiated safety must be encouraged and facilitated instead of condemned as irresponsible. Finally, the author recommends caution in translating epidemiological markers into prescriptions for individual behavior; he also recommends trying to reflect the complexity of what is happening in study populations in epidemiological categories and recognizing the robust humanity of men under study instead of seeking out their weaknesses.^ieng

Female partners of AIDS patients in Uganda: reported knowledge, perceptions and plans.

OBJECTIVE: To assess reported knowledge of a partner's AIDS diagnosis, perceived risk of HIV infection, need for HIV testing and future support plans among women partners of male Ugandan AIDS patients. SUBJECTS AND METHODS: A cross-sectional descriptive survey was conducted at New Mulago Hospital, Kampala, Uganda. The subjects were women partners of consecutive male AIDS patients admitted to medical wards. RESULTS: Only 12% reported their partner's AIDS diagnosis; women who reported knowing were less likely to be financially dependent on the partner. Most women (76%) reported being at risk of HIV; in general, these women were older, in a newer relationship, had less children and were in customary rather than civil or cohabiting marriages. More than half (56%) of the women reported a need for HIV testing, though few (5%) had been tested. Those who stated the need for HIV testing were in a newer relationship, had less children and were more financially independent of their husbands; women in a cohabiting type marriage were less likely to report their need for testing than those in a civil or customary marriage. About half (56%) reported plans for future support if their husbands did not recover; these women were more likely to be in an older relationship and to have more children. CONCLUSIONS: Most women partners of AIDS patients in New Mulago Hospital reported no knowledge of their husbands' diagnosis. Over half perceived a need to be tested but very few reported having been tested, and only half reported having planned for the future of their families. Interventions are urgently needed to address barriers to knowledge and to acknowledgement of a partner's AIDS diagnosis, to HIV testing and to planning for the future.

Sexual behavior, sexually transmitted diseases, male circumcision and risk of HIV infection among women in Nairobi, Kenya.

OBJECTIVE: To study risk factors for HIV infection among women in Nairobi, Kenya, as the epidemic moves beyond high-risk groups. DESIGN: A cross-sectional case-control study among women attending two peri-urban family planning clinics. METHODS: A total of 4404 women were enrolled after giving written informed consent. Information on risk factors was obtained by interview using a structured questionnaire. Blood was taken for HIV and syphilis testing, and genital specimens for gonorrhea and trichomoniasis screening. RESULTS: Two hundred and sixteen women (4.9%; 95% confidence interval, 4.3-5.5) were HIV-1-positive. Although risk of HIV was significantly increased among unmarried women and among women with multiple sex partners, most seropositive women were married and reported only a single sex partner in the last year. Women with a history or current evidence of sexually transmitted disease were at significantly increased risk; however, the prevalence of these exposures was low. Women whose husband or usual sex partner was uncircumcised had a threefold increase in risk of HIV, and this risk was present in almost all strata of potential confounding factors. Only 5.2% of women reported ever having used a condom. CONCLUSIONS: These data suggest that, among women who are not in high-risk groups, risk of HIV infection is largely determined by their male partner's behavior and circumcision status. Interventions designed to change male sexual behavior are urgently needed.

Impact of maternal HIV infection on obstetrical and early neonatal outcome.

In a case-control study of 177 HIV-seropositive and 326 seronegative women and their newborns in Nairobi, Kenya, maternal HIV infection at term was independently associated with travel to other African countries [odds ratio (OR) 4.9, P less than 0.0001], history of a blood transfusion since 1980 (OR 3.5, P = 0.01), history of more than one sexual partner in the previous 5 years (OR 1.8, P = 0.02) and unmarried status (OR 1.8, P = 0.02). Neonates of HIV-positive and HIV-negative women differed little with respect to occurrence of congenital malformations, stillbirths, in-hospital mortality, sex, APGAR score, or gestational age. However, the mean birth weight of singleton neonates of HIV-positive women was significantly lower than that of controls (3090 versus 3220 g, P = 0.005), and birth weight was less than 2500 g in 9% of cases and 3% of controls (OR 3.0, P = 0.007). Among neonates of HIV-seropositive women, birth weight was less than 2500 g in 17% if mothers were symptomatic and 6% if mothers were asymptomatic (OR 3.4, P = 0.08).

Heterosexual transmission of HIV-1 among employees and their spouses at two large businesses in Zaire.

To better understand the reasons why up to 80% of all HIV-1 infections in Zaire, but less than 5% in North America and Europe, are acquired through heterosexual transmission, and to assess the impact of HIV-1 infection on a large urban African workforce, we enrolled 7068 male employees, 416 female employees and 4548 female spouses of employees at two large Kinshasa businesses (a textile factory and a commercial bank) in a prospective study of HIV-1 infection. The HIV-1 seroprevalence rate was higher in male employees (5.8%) and their spouses (5.7%) at the bank than among male employees (2.8%) and their spouses (3.3%) at the textile factory. At both businesses HIV-1 seroprevalence was higher among employees in managerial positions (5.0%) than among workers in lower-level positions (3.0%; P less than 0.0001). In a multivariate analysis of male employees, receipt of a transfusion, a history of genital ulcer disease, working at the bank, urethritis, or being divorced or separated were independently associated with HIV-1 infection. During 1987 and 1988, AIDS was the most common cause of death among recently employed workers, accounting for 20 and 24% of all deaths at the textile factory and the commercial bank, respectively. The HIV-1 seroprevalence rate was higher among female workers (7.7%) than among the spouses of male workers (3.9%; P = 0.001). In multivariate analysis of the wives of workers, having an HIV-1-seropositive spouse, receipt of a blood transfusion, or a history of genital ulcer disease were independently associated with HIV-1 infection.(ABSTRACT TRUNCATED AT 250 WORDS)

Gender differences in mate selection preferences: a test of the parental investment model.

Evolutionary-related hypotheses about gender differences in mate selection preferences were derived from Triver's parental investment model, which contends that women are more likely than men to seek a mate who possesses nonphysical characteristics that maximize the survival or reproductive prospects of their offspring, and were examined in a meta-analysis of mate selection research (questionnaire studies, analyses of personal advertisements). As predicted, women accorded more weight than men to socioeconomic status, ambitiousness, character, and intelligence, and the largest gender differences were observed for cues to resource acquisition (status, ambitiousness). Also as predicted, gender differences were not found in preferences for characteristics unrelated to progeny survival (sense of humor, "personality"). Where valid comparisons could be made, the findings were generally invariant across generations, cultures, and research paradigms.

Trends in breast feeding among American mothers.

PIP: The primary source of data for this study of trends in breast feeding among American mothers was Cycle 1 of the National Survey of Family Growth (NSFG) conducted in 1973. Interviews were held with a nationwide, area probability sample of 9797 women aged 15-44 years who had ever been married or who had children of their own living in the household. Study focus was on trends and differentials in the proportion of women who breastfed their babies, not the proportion of babies who were breastfed. With this focus, the findings presented in this report show the comparative frequency with which mothers in different groups have breastfed their infants. Both the NSFG and the 1965 National Fertility Study data show the marked decline in the incidence of breastfeeding in recent generations of American women. Trends by birth cohorts of women show that 2/3 of the women born in the 1920s breastfed their 1st infant, but only 1/4 of the women born in the late 1940s and early 1950s did so. Over 70% of 1st born infants in the 1930s were breastfed, but less than 30% in the late 1960s and early 1970s. The decline leveled off in the early 1970s, but it is too soon to tell if this is an indication of a rise in the rate of breastfeeding. More than 2/3 of the women breastfed their infants in recent years had stopped by the time the child was 3 months old. 2nd born infants were considerably less likely than 1st born to be breastfed. The level and trend in breastfeeding varied widely across various socioeconomic and cultural categories. Among the groups that had experienced the most precipitous declines in breastfeeding levels over the past 2 decades were black women, women with less than 12 years of education, and women who never worked outside the home.^ieng

Working women and childbearing: United States.

PIP: This report presents statistics on age at marriage, number of children ever born, length of interval between births, and expected completed family size according to indicators of women's participation in the U.S. labor force, such as employment, occupation, and earnings. The statistics, presented in tables, are based on personal interviews with a nationally representative sample of currently married women 15-44 years of age, conducted in 1976. Generally, labor force participation was associated with a later age at 1st marriage, a smaller number of children ever born, longer birth intervals, and a lower expected family size. These associations between employment and family formation were not equally strong or even consistent across all combinations of age, race, education, and other demographic and socioeconomic variables. Approximately 73% of all currently married women had been employed for 6 months or more prior to their 1st marriage, and this premarital employment was strongly associated with a later age at 1st marriage. For all races, ages, and educational levels combined nearly 3/4 of premaritally employed women married after reaching 19 years of age compared with less than 2/5 of nonpremaritally employed women. The most marked differences in age at marriage occurred between wives with low educational levels and no premarital employment and wives with a college education who were employed prior to marriage. About 84% of wives had been employed at some time since their 1st marriage. In the aggregate, these women had borne an average of 2.0 children compared wth an average of 2.3 children ever born to wives with no work experience outside the home. The sharpest fertility differentials by this employment measure were found among women 30-44 years of age. The overall difference in the average number of children ever born to women currently in the labor force (1.8) versus those not in the labor force (2.3) was 0.5. Variations in cumulative fertility by labor force participation were greatest among younger women (15-29 years) with a college education. For white wives, those who earned less than 25% of their family incomes had borne 1 more child on the average than those who earned 50% or more. Labor force participation in the intervals between births was related to lower levels of childbearing. Generally, women who worked during any particular birth interval had lower subsequent fertility than women who did not.^ieng