This study assessed the feasibility of a group-based couples intervention to increase condom use in HIV serodiscordant couples in three countries (India, Thailand and Uganda). The intervention focused on communication, problem solving, and negotiation skills. Forty-three couples enrolled in the intervention (15 in India, 14 in Thailand, and 14 in Uganda) and 40 couples completed all study activities. Participants were interviewed at baseline and at one and three months post- intervention. The intervention consisted of two same sex sessions and two couples sessions with 'homework' to practice skills between sessions. The same intervention modules were used at each site, tailored for local appropriateness. Participants at each site were enthusiastic about the intervention, citing information about HIV serodiscordancy and the opportunity to meet couples 'like us' as important features. Participants reported increased comfort discussing sex and condoms with their partner, although some participants remain concerned about situations when condoms might not be used (e.g. when drunk). At three-month follow up 90% of the participants reported having been able to use the skills from the intervention with their partner. Our results highlight the feasibility of this couples group-based intervention and the need for ongoing support for discordant couples.

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The caesarean section rate in England and Wales has practically doubled from 5.6% in 1974 to 10.6% in 1982. Because most statistical reports are based on the practice of individual hospitals and do not reflect what is occurring in a particular community, a retrospective study of the incidence of, and reasons for, caesarean section performed in residents of the geographically defined Health District of Central Manchester was carried out for 1974 and 1982. The caesarean section rate in this community increased from 7% in 1974 to 16% in 1982. Caesarean sections performed for (i) failure to progress in labour, (ii) previous caesarean section and (iii) preterm fetal compromise before labour accounted for three quarters of the increase. Breech presentation was not a significant contributor to the increase. The reasons for the increase in caesarean sections performed for failure to progress in the first stage of labour were not clarified in the records, and is the subject of prospective investigation.

Introduction: This study aimed to explore experienced barriers to seek human immunodeficiency virus (HIV) treatment and care among youth living with HIV and acquired immunodeficiency syndrome (AIDS) in Uganda. Given that this population remains at the center of HIV epidemic, the study's ultimate goal was to contribute to improvement of effectiveness of HIV prevention interventions for youth in Uganda. Twenty in-depth interviews were conducted with HIV-infected youth aged between 18 and 24, who had entered care within one year upon receipt of results and referral for free care. In addition, key-informant interviews were conducted with 30 health service providers. The study used thematic content analysis to analyze its' findings. The study demonstrated that barriers to using HIV care included fear of stigma and HIV disclosure, young men and women's lack of support from their families, demanding work schedules, and high transport costs. Programmatic barriers included fear of stigma, antiretroviral drug side effects, long waiting and travel times, and inadequate service providers' respect for patients. The study recommends targeted interventions to combat stigma, strengthen couple counseling and health education programs, and address gender inequalities among other things. Material and methods:We conducted 20 in-depth interviews among HIV-infected individuals aged between 18 and 24 years and key-informant interviews.Results: Barriers to using HIV care included, among others, fear of stigma and HIV disclosure, and young men and women's lack of support.Conclusions: Targeted interventions to combat stigma, strengthen couple counseling and health education programs, focus on gender inequalities as well as implement youth-friendly and flexible clinic service hours are all needed to address barriers to using care of HIV patients.