 to learn that they were infected. The researchers stress that "persons who are not in a long-term monogamous relationship and who engage in oral sex should use barrier protection."
1. Ciesielski C, Tabidze I and Brown C, Transmission of primary and secondary syphilis by oral sex—Chicago, Illinois, 1998-2002, Morbidity and Mortality Weekly Report, 2004, 53(41): 966-968.
COST OF NO CONFIDENTIALITY
Laws that restrict the confidentiality of Texas teenagers who wish to obtain reproductive health services could exact substantial health and economic costs.1 Using data from the state health department and publicly funded family planning clinics, analysts projected the effects of teenagers' loss of confidentiality resulting from two laws implemented since 2001, one of which requires those younger than 18 to get parental consent to obtain prescription contraceptives. Assuming that 37% of clinic clients younger than 18 would forgo reproductive health care if they had to tell their parents, the analysts estimate that each year, an additional 5,372 births and 1,654 abortions would occur in this population; medical costs associated with these outcomes would exceed $44 million. Teenagers' failure to seek care also would result in increases in untreated cases of chlamydia (2,243), gonorrhea (521) and pelvic inflammatory disease (501); treating the consequences of these diseases would cost $708,000. A reduction in visits owing to the loss of confidentiality would somewhat offset these costs; still, the state's tab would run $43.6 million.
1. Franzini L et al., Projected economic costs due to health consequences of teenagers' loss of confidentiality in obtaining reproductive health care services in Texas, Archives of Pediatrics and Adolescent Medicine, 2004, 158(12):1140- 1146.
INFANT DEATHS IN THE 'HOOD
Infant mortality varies more by neighborhood in New York City than it does in Paris, London or Tokyo.1 In 1988-1992, the infant mortality rate in high-income neighborhoods of Manhattan was 56% lower than the rate in low-income neighborhoods; the difference grew to 61% in 1993-1997. By contrast, in the later period, high-income neighborhoods in London had a 19% lower rate than low-income ones, and rates in Paris differed only marginally by neighborhood. In Tokyo, rates did not differ by neighborhood income level in either period. According to the analysts, "reducing disparities among neighborhood infant mortality rates will require intense targeting of high-rate neighborhoods."
1. Rodwin VG and Neuberg LG, Infant mortality and income in 4 world cities: New York, London, Paris, and Tokyo, American Journal of Public Health, 2005, 95(1):86-90.
Women and, to a lesser extent, men attending a Seattle sexually transmitted disease (STD) clinic in 2002-2003 were more apt to tell a computer about sensitive behaviors than they were to tell a live interviewer.1 A total of 609 men and women between the ages of 14 and 65 agreed to take an audio computer-assisted self-interview before having their sexual history taken by a clinician. Higher proportions of women told the computer than told the clinician that they had recently had a female partner (20% vs. 12%) or engaged in oral sex (67% vs. 50%), had used amphetamines (5% vs. 1%) or had engaged in transactional sex (21% vs. 10%); a lower proportion reported STD symptoms to the computer than to the clinician (55% vs. 64%). Among men, only reports of ever having had a male partner were more common in the computerized interview than in a face-to-face situation (37% vs. 29%). Fifty-six percent of participants preferred the computerized to the clinician interview, and 49% would favor answering sexual history questions on a computer and then reviewing their answers with a clinician. The researchers conclude that computerized self-interview could help to "expand and enhance behavioral surveillance in STD clinics, standardize sexual history-taking, and...decrease costs associated with clinic visits."
1. Kurth AE et al., A comparison between audio computer-assisted self-interviews and clinician interviews for ob