Fertility goal-based counseling increases contraceptive implant and IUD use in HIV-discordant couples in Rwanda and Zambia.

Background: HIV-discordant heterosexual couples are faced with the dual challenge of preventing sexual HIV transmission and unplanned pregnancies with the attendant risk of perinatal HIV transmission. Our aim was to examine uptake of two long-acting reversible contraceptive (LARC) methods--intrauterine devices (IUD) and hormonal implants--among HIV-discordant couples in Rwanda and Zambia.

Study Design: Women were interviewed alone or with their partner during routine cohort study follow-up visits to ascertain fertility goals; those not pregnant, not infertile, not already using LARC, and wishing to limit or delay fertility for ≥3 years were counseled on LARC methods and offered an IUD or implant on-site.

What immunizations should I offer to my patients? A primer on adult immunizations.

Despite the cost-effectiveness and widespread availability of vaccines, vaccine-preventable diseases remain an important cause of morbidity and mortality worldwide. We present the indications, contraindications and administration of adult vaccinations, as well as the strategies for improving the rate of outpatient adult vaccination as an effective means of disease prevention. Although immunizations have altered the course of many infectious diseases worldwide, there is a significant chasm in what we know is best for our patients versus what reaches our patients.

A longitudinal analysis of total workload and women's health after childbirth.

Objectives: To examine the association of women's postpartum health with total workload (TWL), work and personal factors in the year after childbirth.

Methods: Employed women from Minneapolis and St Paul, Minnesota, were recruited while hospitalized for childbirth. Longitudinal analyses, using fixed effects regression models, estimated the associations of TWL, job satisfaction and stress, social support, perceived control, breastfeeding and infant characteristics with women's health at 5 weeks, 11 weeks, 6 months, and 12 months postpartum.

Workplace hazards to women's reproductive health.

Women make up nearly half of Minnesota's workforce. Thus, many women, including those of reproductive age, are exposed to workplace hazards. These hazards may be chemical-toxicants such as heavy metals, pesticides, and endocrine disruptors; physical--the result of activities or proximity to something in the environment; or biological-infectious agents.