Chapter 1: Introduction Chapter 2: Research Methods Chapter 3: Village Life Chapter 4: Children's Relationships with Parents, Peers and Teachers Chapter 5: Contradictory Sexual Norms and Expectations Case Study Series 1: We'll Have Sex Again When the Opportunity Arises: Typical Young People's Lives and Premarital Sexual Relationships Chapter 6: Unmarried Young People's Sexual Relationships Chapter 7: Sexual Negotiation, Exchange, and Coercion Chapter 8: Sexual Practices Case Study Series 2: He told me, 'Just come and live at my home': Typical Young People's Experience of Marriage and Divorce Chapter 9: Married Young People's Sexual Relationships Chapter 10: Contraception, Abortion, and Fertility Chapter 11: HIV/AIDS and Other Sexually Transmitted Infections Case Study Series 3: The Fever Went Away But Always Returned: HIV-Positive Young People's Lives and Sexual Relationships Chapter 12: Barriers and Facilitators of Sexual Risk Reduction

CDC0862 A process evaluation of the MEMA kwa Vijana adolescent sexual health intervention in rural Tanzanian primary schools M. Plummer, D. Wight, J. Wamoyi, G. Mshana, A. Obasi, B. Mazige, M. Makokha, R. Hayes, D. Ross London School of Hygiene and Tropical Medicine, Infectious and Tropical Diseases, London, UK, Medical Research Council, Social and Public Health Sciences Unit, Glasgow, UK, National Institute for Medical Research, Mwanza, Tanzania, Liverpool School of Tropical Medicine, Liverpool, UK, African Medical and Research Foundation, Mwanza, Tanzania Background: This study is a process evaluation of the school component of the adolescent sexual and reproductive health (ASRH) programme MEMA kwa Vijana (MkV), which was implemented in 62 primary schools in rural Mwanza, Tanzania from 1999-2001. Methods: Process evaluation methods included training observation, routine monitoring and supervision, and annual surveys and group discussions with implementers, as well as group discussions and 158 person-weeks of participant observation with pupil participants. Results: The extent of curriculum delivery was very good. Teachers were consistent in teaching information about sexual and reproductive biology, but sometimes had difficulty adopting new teaching styles in place of existing hierarchical methods. Class peer educators were consistent in performing carefully scripted dramas, but their ability to be informal educators and behavioural models was limited. The intervention appears to have been successful in addressing some SLT cognitions, e.g. knowledge of risks and benefits of ASRH-related behaviours, but not others, e.g. participants’ perceived susceptibility to risk, perceived self-efficacy, and perceived social and structural facilitators and impediments to behaviour change. Conclusions: MkV shared the characteristics of other school-based ASRH programmes in sub-Saharan Africa which have been evaluated as successful, and similarly found significant improvements in self-reported attitudes and behaviours in surveys. However, a substantial proportion of MkV survey self-reports were inconsistent at an individual level, there was no consistent impact on biological markers, and extensive process evaluation found that several key theoretical determinants of behaviour had not improved. This study suggests that improvements in self-reported survey data alone may provide only a very limited – and perhaps invalid – indication of ASRH programme success. On-going process evaluation and a planned 2006-2007 biological marker and self-report survey will assess whether greater time and population exposure has had an impact on participant ASRH.

Background/objectives: There is an urgent need for effective interventions to improve the sexual and reproductive health of adolescents. Reliable data on the sexual health of adolescents are needed to guide the development of such interventions. The aim was to describe the sexual health of pupils in years 4 to 6 of 121 rural primary schools in north western Tanzania, before the implementation of an innovative sexual health intervention in 58 of the schools.Methods: A cross sectional survey of primary school pupils in rural Tanzania was carried out. The study population comprised pupils registered in years 4 to 6 of 121 primary schools in 20 rural communities in 1998. Basic demographic information was collected from all pupils seen. Those born before 1 January 1985 ( aged approximately 14 years and over) were invited to participate in the survey, and asked about their knowledge and attitudes towards sexual health issues, and their sexual experience. A urine specimen was requested and tested for HIV, Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG) and, for females, pregnancy.Results: 9283 pupils born before 1 January 1985 were enrolled and provided demographic information and a urine sample. Male pupils were significantly older than females ( mean age 15.5 years v 14.8 years, p< 0.001), but all other demographic characteristics were similar between the sexes. 14 (0.2%) of the enrolled pupils ( four male and 10 female) were HIV positive, 83 (0.9%) were positive for CT, and 12 (0.1%) for NG. 32 female pupils (0.8%) were positive by pregnancy test. Sexual experience was reported by one fifth of primary school girls, and by almost half of boys. Only 45/114 (39%) girls with biological markers of sexual activity reported having had sex.Conclusions: HIV, CT, NG, and pregnancy were present though at relatively low levels among pupils in years 4 to 6 of primary school. A high proportion of pupils with a biological marker of sexual activity denied ever having had sex. Alternative ways of collecting sensitive data about the sexual behaviour of school pupils should be explored.

At a press conference on 27 July, the National Marine Fisheries Service (NMFS) released a long-awaited plan to save the Columbia River's endangered salmon by restoring fish habitat, overhauling hatcheries, limiting harvest, and improving river flow. What the plan did not do, however, was call for immediate breaching of four dams on the Snake River, the Columbia's major tributary--an option that has been the subject of a nationwide environmental crusade. The NMFS will hold that option in abeyance while it sees whether the less drastic measures will do the trick. Responses from both sides were immediate and outraged.

Four woody angiosperm species representing an evergreen tree (Castanopsis chrysophylla (Dougl.) A.DC), a deciduous tree (Acer macrophyllum Pursh), an evergreen shrub (Rhododendron macrophyllum G.Don), and a deciduous shrub (Acer circinatum Pursh) were sampled to assess the relation of cross-sectional area of conducting tissue in the stem to leaf area. For the first three species listed, a linear relation between conducting area and leaf area was obtained with r2 values ranging from 0.89 to 0.96. For Acer circinatum the relation only approached linearity with a log transformation of both axes with r2 = 0.80.