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September 3rd, 2010 Epidemiological studies in the United States (US), Europe, Australia, and Africa have documented standardized incidence ratios (SIR) of AIDS related and non-AIDS related cancers using data from linked Cancer and AIDS registries (4-13). In a population-based registry linkage in New York State, Gallagher et al. (10) reported significant SIR for KS, NHL, invasive cervical cancer, and several non-AIDS related cancers affecting the tongue, mouth, rectum, anus, trachea, bronchus, and lung. In Italy, Dal Maso, Serraino and Franceschi (7) reported a SIR of 302 (95% CI, 253-357) for NHL in AIDS patients. In a linkage of AIDS and cancer registries from 11 US regions, Engels et al. (4) reported important declines in KS and NHL after the introduction of HAART in people with AIDS, no change in cervical cancer, and increased risk of non-AIDS related cancers, particularly Hodgkin lymphoma, anus, liver, and lung cancer. An AIDS-Cancer linkage was also conducted in Africa, where the incidence of all AIDS related cancers and some non-AIDS related cancers (Hodgkin lymphoma, conjunctiva, kidney, thyroid, and uterus) were found to be higher among people with AIDS (9). In a more recent prospective cohort study, Patel et al. (5) also reported a reduction in AIDS related malignancies except for cervical cancer, and a significant increase risk of non-AIDS related malignancies in a cohort of adults living with HIV compared to the general population in the US. The most important types of non-AIDS related malignancies were: anal, vaginal, Hodgkin lymphoma, liver, lung, melanoma, oropharyngeal, leukemia, colorectal and renal. These results suggest that the incidence of non-AIDS related cancers has increased more than the incidence of AIDS related cancers, and that the influence of HAART in the development and prognosis of various cancers is still not clear. Biological, environmental and behavioral risk factors must also be explored to better define the long-term cancer risk in people living with HIV/AIDS (14). Puerto Rico (PR) is one of the top ten US States and territories with the highest cumulative number of AIDS cases, and Puerto Ricans are the second largest group of Hispanics in the US with higher cancer mortality rates (15-16). However, little information is available regarding AIDS related and non-AIDS related malignancies among Hispanics with HIV/ AIDS in the US or PR. In one retrospective cohort study in Southern California, Levine et al. (17) reported that from 1982 to 1998 the prevalence of AIDS-related lymphoma decreased significantly in whites but increased in Hispanics. In another study, Fordyce et al. (18) conducted a population-based AIDS-Cancer linkage analysis of women from New York City diagnosed with AIDS between 1981 and 1994, and reported that 47% of all cancer cases were among African Americans, 36% among Hispanics, and 16% among non-Hispanic whites. Mayor et al. (19) conducted a cross-sectional analysis of 3,576 HIV/AIDS patients attending an outpatient clinic in PR from 1992 to 2005. Of these patients, 171 (4.8%) were diagnosed with cancer at some point in their lives: 51.5% AIDS related and 48.5% non-AIDS related cancers. Because no population-based studies have been conducted in PR, the risk of AIDS related and non-AIDS related cancers in PR compared to the general population is still unknown. The purpose of this study was to estimate the risk of AIDS related and non-AIDS related cancers among Hispanics with AIDS in PR using the Puerto Rico Central Cancer Registry and the Puerto Rico AIDS Surveillance Program Registry. Both are population-based registries that receive support from the Centers for Disease Control and Prevention. We hypothesized that the risk of all AIDS related cancers and the risk of many non-AIDS related cancers will be higher in the AIDS group compared with the general population in PR. The results of this study will provide the basis for future epidemiological studies to characterize the natural history of specific cancers in HIV infection and other important biological, environmental, and behavioral risk factors.
Women in Kenya remain disadvantaged, with opportunities for educational, social, and economic advancement inferior to those of men. Women are underrepresented in modern sector wage employment, political and judicial decision making, and all major public service appointments. Numerous social, economic, and cultural barriers limit womens participation in these areas. But womens underrepresentation in education is a primary factor. The benefits of womens education to women and to society in general are immense. In the workplace, education increases skills needed for job entry, improves chances of vertical mobility, and enhances overall labor market productivity. It also has positive consequences at home, including improved health, increased child survival rates, reduced fertility rates, lower infant mortality rates, and better protection against HIV and AIDS (Tembon and Fort 2008). Education of women and girls is therefore not only a moral and human rights issue, but also an economic and development issue. Given the significant benefits of womens education, equity in education is essential to improving circumstances for all Kenyans. As the leading provider of education, the government should acknowledge that compensatory mechanisms may be required to level the playing field for disadvantaged girls, and it should adopt an approach that uses these mechanisms. Making education equitable means adopting policies and initiatives that support equal provisions across genders. Female Education in Kenya Education in Kenya has four basic levels: preschool (ages 4-6), primary (ages 7-14), secondary (ages 15-18), and tertiary. Since attaining political independence from Great Britain in 1963, the Kenyan government has emphasized educations importance to economic development. It has also increased the number of schools at all levels, from about six thousand primary and 150 secondary schools in 1963 to almost twenty thousand primary and four thousand secondary schools in 2004. As a result, the student population has increased substantially, with over 700 percent growth at the primary level and almost 3,000 percent growth at the secondary level (Ministry of Education 2007). But this total expansion in education hides disparities by gender and region.