THURSDAY, Jan. 26 (HealthDay News) -- The rate of home births in the United States has made a dramatic upturn since 2004, reversing a trend of decline throughout the 1990s, government health officials said Thursday.

Births taking place outside of the traditional hospital setting increased 29 percent between 2004 and 2009, from 0.56 percent of all births to 0.72 percent -- almost 30,000 births -- according to a new report from the U.S. Centers for Disease Control and Prevention.

"The increase has been driven by non-Hispanic white women," said lead report author Marian MacDorman, a statistician at CDC's National Center for Health Statistics. "For non-Hispanic white women, home births increased 36 percent."

Although it isn't clear why the rate is increasing, MacDorman thinks it has a lot to do with individual preference.

"A lot of women really like the idea of home birth because they want a lower-intervention birth. A lot of women are worried about higher C-section rates and other types of intervention that happen once you go to the hospital," she said.

The report uses data from the National Vital Statistics System, Natality Data Files for 1990 to 2009, which include all births in the United States, with a range of demographic and health information on mothers and their infants.

Highlights of the report include:

• Among white women, home births increased 36 percent, from 0.80 percent in 2004 to 1.09 percent in 2009.
• For white women, home births account for one in every 90 births.
• In other racial and ethnic groups, home births are less common.
• Home births are more common among women aged 35 and over, and among women who have had other children.
• Births that occur in the home more often involve lower-risk pregnancies, with fewer among teenagers or unmarried women, and fewer preterm, low birth weight or multiple births.
• In 2009, home births varied from a low of 0.2 percent in Louisiana and the District of Columbia, to a high of 2 percent in Oregon and 2.6 percent in Montana.

Saraswathi Vedam, chair of standards and practice for the Home Birth Section of the American College of Nurse-Midwives, thinks more women are making informed decisions about where to give birth.

"Women and families have started to question the widespread use of obstetric interventions and want to control the environment they give birth in," she said.

Some of the benefits of home birth are privacy, comfort and continuing care from someone who they feel a more personal relationship with, such as a midwife, she said.

"Home birth was seen as a counterculture thing, but it's becoming more mainstream. People understand it's not home birth at all costs -- one can always change their mind and go to the hospital," Vedam said.

The biggest objection to home birth has been concerns about safety of the mother and infant should something go wrong.

"Everybody is concerned with safety," Vedam said. "Women who are healthy and have a profile of having a good outcome for them and their babies have come to understand that the equipment and personnel a hospital has to offer is not necessary for all women. It's most appropriate for women and infants who have medical indications that could benefit from what the hospital offers."

More information

The New York State Department of Health offers this guide on childbirth.

THURSDAY, Jan. 19 (HealthDay News) -- The number of Americans who practice behaviors that put them at risk for HIV infection has declined significantly, federal health officials reported Thursday.

The ranks of those engaging in a risky sexual or drug-related behavior dropped from 13 percent of men and 11 percent of women in 2002 to 10 percent and 8 percent, respectively, in 2010, according to the U.S. Centers for Disease Control and Prevention.

"Generally, these are behaviors that are studied in higher risk populations, but by looking in the household population we can get a better sense of the level of risk that may exist in the general population that you don't normally think about," said report author Anjani Chandra, a health scientist at the CDC's National Center for Health Statistics.

Some of the risk factors the researchers looked at were gay and bisexual sex, illicit drug use and having several sexual partners or a partner who injects illegal drugs, she said.

"For women, we don't really see that the decline is due to any variation in sexual risk behaviors, whereas for men we see substantial difference by race," she said.

The reasons for the decline in risk behaviors is not clear, Chandra said. Some of the public health messages might be getting through. It also could be that people are reluctant to disclose that they engage in risky behaviors, she said.

"But, it could be real and reflect actual changes in behavior," she said.

The data in the report was collected on almost 23,000 men and women aged 15 to 44 in households throughout the country and represents 6.5 million men and 4.9 million women.

The decline seems to be due to a drop in risky behaviors such as having unprotected sex and having sex with multiple partners, Chandra said.

There were, however, differences in behaviors in different groups. For example, men who had recently been in prison were more likely to report engaging in one or more HIV risk behaviors, compared with other men, the researchers found.

There were also significant variations based on race and income level, they reported.

Sixteen percent of young black men ages 15 to 24 reported at least one HIV risk-related sexual behavior, compared with 8.7 percent of Hispanic men and 6.5 percent of young white men. Poorer men were also more likely to engage in risky behaviors.

The HIV risk in households is not something one usually thinks about when one thinks about HIV risk, Chandra said.

"In household populations, where you may think these behaviors are nonexistent or very rare, they are occurring and they may be placing people at risk of HIV and other sexually transmitted diseases," Chandra said. "Just focusing on high-risk populations may not take care of the concerns that we have."

Dr. Sten Vermund, director of the Institute of Global Health at Vanderbilt University School of Medicine in Nashville, said that the data used was "a highly valid sample of the American population."

Both sexual and drug-related risk behaviors declined in the study period, and that is a positive trend, he said.

"Risk behaviors remain high and the likelihood of encountering an HIV-infected person has never been higher," Vermund noted. "Nonetheless, there is a strong indication that prevention programs are working or cultural norms are shifting, or both."

Philip Alcabes, an associate professor in the School of Health Sciences at Hunter College/City University of New York, is critical of the report as another example of how the government still avoids the real problem of HIV.

"What a waste of time and taxpayer dollars," he said. "Having failed to advocate for structural changes that would actually reduce risk of HIV acquisition and having failed to implement widespread, easily accessible syringe exchange programs, federal agencies instead spend their time studying personal behavior. It's a shame."

"Even though our officials don't have a clear concept of what really happened 30 years ago, they are still looking at AIDS through the same moralizing lens that was common in 1981. That's sad, and disturbing," he said.

More information

For more on HIV/AIDS, visit the AIDS.gov.

FRIDAY, Dec. 23 (HealthDay News) -- Fears about the emotional, financial, social and legal consequences of divorce explain why the percentage of married adults in the United States has reached an all-time low, researchers report.

The study of 122 people in cohabitating couples found that 67 percent said they worried about having to deal with the fallout of divorce, the University of Central Oklahoma and Cornell University researchers said in a Cornell news release.

Compared to working-class people, their middle-class counterparts had a more favorable view of marriage and regarded cohabitation as a natural stepping stone to marriage.

Lower-income women were especially likely to have doubts about the "trap" of marriage. Many believed it would lead to more domestic responsibilities with few benefits or that it could hard to get out of a marriage if things go wrong.

The researchers also found that cohabitating working-class couples were more likely to view marriage as "just a piece of paper," that would be nearly the same as their existing relationship.

These couples were twice as likely to have fears about being stuck in a bad marriage once they became reliant on their partner's share of income.

The study was published in the December issue of the journal Family Relations.

The findings could help premarital counselors devise lessons that ease fears of divorce and address the specific concerns of various socioeconomic classes, the researchers said.

More information

The American Association for Marriage and Family Therapy offers advice about marriage  .

WEDNESDAY, Jan. 4 (HealthDay News) -- A potential vaccine for genital herpes has shown only limited effectiveness in thwarting one type of the sexually transmitted virus and no ability to stop a second type from spreading, a new study shows.

A group of American and Canadian researchers conducted a randomized trial on more than 8,300 women aged 18 to 30 who tested negative for both forms of the herpes simplex virus, known as HSV-1 and HSV-2. Half of the women were given the experimental vaccine while the other half were given the hepatitis A vaccine.

The experimental vaccine was 58 percent effective at preventing genital warts stemming from HSV-1, but completely ineffective against HSV-2.

"We were disappointed it did not meet the primary [goal], which was protection against all types of genital herpes," said study author Dr. Robert B. Belshe, a professor of medicine, pediatrics and molecular microbiology at Saint Louis University. "Herpes is a complex organism and has ways of escaping the immune system, so we have to figure out a way of overcoming those mechanisms."

The study is published Jan. 5 in the New England Journal of Medicine.

Genital herpes affects about 16 percent of Americans aged 14 to 49, according to the U.S. Centers for Disease Control and Prevention. Both types of the virus are released from their resulting sores but can also be transmitted between outbreaks, and the infection is potentially fatal in newborns who acquire it from their mothers during birth.

Fifty clinical sites in both the United States and Canada followed the women -- who reported their own sexual risk behaviors -- between 2003 and 2007. A heightened risk for HSV-1 infection was associated with six or more lifetime sexual partners and more than one partner in the previous 12 months, while those who were 23 or older were less likely to contract HSV-1 than those between 18 and 22.

Factors not associated with an increased likelihood of HSV-1 included race, condom use, oral sex, a history of any sexually transmitted infection or ever having a partner with herpes. Men weren't tested in this study, though prior research showed investigational herpes vaccines to be ineffective in men and HSV-1 positive women.

"I was very disappointed there wasn't more of a benefit," said Dr. Bruce Hirsch, an attending physician in infectious diseases at North Shore University Hospital in Manhasset, N.Y., who wasn't involved in the study. "I think we're asking that a vaccine provide better immunity than an actual infection provides. I'm concerned if we'll ever find a vaccine effective for HSV-2."

"I think what we tell patients is ... there are antiviral medications that can make a difference and can give people comfort, and the availability of treatment is encouraging," he added.

While other potential vaccines are in the pipeline, Belshe said, the one that works probably needs to be "more complex" than the one recently studied, which contained a single surface protein of the herpes virus. The chicken pox vaccine, which has been widely used in the past decade, is a good example of a herpes-related virus that has been brought under control, he said.

"Something like that is what we need to come up with for HSV," he said. "I think this is a very important study, and the result is an incredibly important step in figuring out what will work."

More information

The U.S. Centers for Disease Control and Prevention has more on genital herpes.