Messages about Dual Contraception in Areas of High HIV Prevalence are not Heeded

Background : Dual protection is recommended for prevention of unwanted pregnancies and protection against sexually transmitted infections; including HIV. It is critical for HIV-negative women to prevent sero-conversion and HIV transmission to their infants during pregnancy and breastfeeding. Methods: Women were followed post-partum; monthly to 9 months and 3-monthly to 24 months; in a cohort study investigating postnatal HIV transmission. Study nurses discussed family planning; including condom use; at each visit. Contraceptive methods used since the last visit were recorded. All women knew their HIV status; most women breastfed for a minimum of six months.Results : of 1137 HIV-positive and 1220 HIV-negative women the most common contraceptive method was the hormonal injectable; few women used condoms alone or as dual contraception (0-3 months 6.8; 7-12 months 16.3; 19-24 months 14.4). HIV-positive women were more likely to use condoms in years one and two post-partum (AOR 1.72; 95CI 1.38-2.14; pp=0.040). Conclusions. More creative ways of promoting condoms and dual contraception need to be found if new HIV infections; in women and children; are to be prevented

Repair of abdominal incisional hernia

A simple; anatomic extraperitoneal approach for the repair of varying sizes of postoperative ventral abdominal herniae is described. This involves reconstruction of linea alba and repair using interrupted nylon sutures without tension on the edges. 27 patients managed with this technique between 1987 and 1990 with a follow up of one to four years; with neither death nor hernia recurrence are presented