Detection of human immunodeficiency virus type 1 (HIV-1) antibody by western blotting and HIV-1 DNA by PCR in patients with AIDS.

The human immunodeficiency virus type 1 (HIV-1) Western blotting (immunoblotting) band patterns and the sensitivity of an HIV-1 DNA PCR assay were determined by testing the blood of patients with AIDS. Plasma and cell pellets processed from the peripheral blood of 199 patients with absolute CD4 cell counts of less than 200 cells per mm3 were tested by a licensed enzyme immunoassay (EIA; Abbott HIV-1) and Western blot assay (Cambridge-Biotech) for HIV-1 antibody. The Roache HIV-1 AMPLICOR DNA PCR assay was used to test cell pellets from 125 of the 199 patients for HIV-1 gag DNA sequences. All plasma samples from these 199 sequential patients were reactive for HIV-1 antibody by EIA and were positive by Western blot assay using the criteria recommended by the Centers for Disease Control and Prevention. The majority of samples (192 of 199; 96.5%) displayed at least six of nine bands characteristic of the virus by Western blotting, with the lowest number of bands characteristic of the virus displayed by any sample being three. However, 39 and 48% of all patients exhibited no bands to p17 and p55 antigens, respectively, whereas 0 to 7.5% of all patients exhibited no bands to the other antigens. HIV-1 gag DNA sequences were detected in 117 (93.6%) of 125 cell pellets processed from the peripheral blood of these same patients. All eight patients initially negative by PCR tested positive when a second pellet which had been produced from the same blood sample was tested. Despite a decrease in antibody reactivity to HIV Gag and Pol proteins, patients with advanced HIV-1 infection remained positive for HIV-1 antibody by EIA and Western blot testing. Confirmation by the HIV-1 Western blot assay still appears to be the more sensitive assay for the diagnosis of HIV-1 infection in those individuals with advanced HIV-1 infection in the United States.

Initiated by the south. South - South Cooperation.

PIP: The UNFPA Deputy Chief of the Asia and Pacific Division explains how relations between representatives of developing countries to the South have often been less than congenial and how efforts have been made to smooth the way for greater cooperation between neighbors in the region. President Soeharto of Indonesia at a G-15 submeeting of Non-Aligned Countries in Malaysia in 1990 made the first overtures to his peers. He offered to work more closely with other interested countries economically and in terms of technical assistance. Prime Minister Von Van Kiet of Vietnam took him up on his offer and visited the President in Indonesia in January 1992 to discuss family planning issues. The subsequent assistance rendered by Indonesia to Vietnam in developing its family planning program was unique in bilateral relations in the region in that it was initiated by the nonaligned countries without outside interference. The author thinks that the UNFPA should play a facilitating role financially and organizationally in what may be the beginning of a trend toward greater South-South cooperation. Any help which developing countries could render to other developing nations will certainly be appreciated in this period of waning resources from developed countries for international population programs. The author also argues that service quality in donor countries is likely to improve.^ieng

Continuation of contraception on Java-Bali: preliminary results from the quarterly acceptor survey.

PIP: Review of recently tabulated contraceptive continuation and pregnancy rates for Java-Bali and the constituent provinces. It was found that IUD continuation rates are higher than those for pill or condom, although considerable variation between provinces occurs. East Java and Bali seem to be recording the most and Jakarta and Yogyakarta least success in use continuation. Older, higher parity acceptors tend to use for longer periods, irrespective of method. Similarly, age and parity do not seem to affect the relationship between pill, IUD and condom continuation rates. Pill acceptors are more likely to terminate for physical, emotional, or health reasons than condom or IUD acceptors. Younger and lower parity groups show a greater likelihood of termination in order to have another child. Sources of bias in the rates were also examined. Using a rough adjustment procedure it was found that women lost to follow-up are not a serious bias in the 1st round results, with the exception of differential response by province. As subsequent rounds of the survey are completed, however, the lost-to-follow-up bias is likely to be a more important source of error in reported continuation rates. Factors to adjust acceptor statistics for women who denied ever using family planning were also presented.^ieng

[A project for small and healthy families]. / El proyecto para una familia pequena y sana.

PIP: Since its beginnings in 1969 the National Indonesian Family Planning Program has helped more than 50% of married women in the country. The planned Project for Small and Healthy Families wants to go beyond the scope of contraception, and help the community in matters of nutrition, education, general health, women's status, and jobs. The project will have the community as its base, and responsibility for the project will stay with the community itself. Particular importance will be given to infants and children below 3, with the purpose of lowering infant and child mortality. Reduction of fecundity will be one of the long-term results of the project. Health services will be distributed by community workers, and serious cases referred to hospitals outside the community, with reimbursement of costs to the family. The project also contemplates setting up courses in nutrition and health education.^ieng

The Indonesian family planning program: its strategy for the future.

PIP: This paper discusses the strategy of the Indonesian national family planning program for the coming 5-10 years, in which communities will be given greater responsibility for their own fertility limitation programs and a stronger alliance with other government programs will be sought in order to assure the long-term success of both family planning and development activities. The article explains why more vigorous fertility limitation efforts will be required in the future despite encouraging results so far, and describes the structure of the Indonesian national family planning program. The rationale behind the move away from clinics as depensers of family planning services is examined, and the community family planning approach in Bali is described and compared to that in Java. The differing approach to service delivery in the Outer Islands is then discussed. The relationship between development and the small family norm is discussed, and efforts underway to maximize cooperation between the family planning and development sector projects are described.^ieng

Contraceptive use effectiveness in Indonesia.

A brief review of recently tabulated contraceptive continuation and pregnancy rates for Java-Bali and their constituent provinces. It was found that IUD continuation rates are higher than those for either pill or condom although considerable variation occurs between provinces. East Java and Bali seem to be recording the most success in use-continuation, while the urban areas of Jakarta and Yogyakarta are having the least success. With respect to age and parity, the older, higher parity acceptors tend to use for longer periods of time irrespective of method used. Similarly, age and parity do not seem to affect the relationship between pill, IUD, and condom continuation rates. Examining reasons for termination, we find pill acceptors more likely to terminate for physical, emotional, or health reasons than either IUD or condom acceptors. When broken down by age and parity, the low age and parity groups show a much greater likelihood of termination in order to have an additional child.