Spread of HIV infection in married monogamous women in India
ABSTRACT A high prevalence of human immunodeficiency virus (HIV) infection in female sex workers (FSWs) and men who attend sexually transmitted disease (STD) clinics poses a risk for spread of infection to other populations.
To examine spread of HIV to a low-risk population by comparing prevalence of, and risk factors for, HIV and STDs in FSWs and non-FSWs.
Women attending STD clinics in Pune, India, were assessed for STDs and HIV from May 13, 1993, to July 11, 1996. Demographic and behavioral information was collected, and clinical and laboratory assessment was performed.
Prevalence and risk determinants of HIV infection.
Of 916 women enrolled, 525 were FSWs and 391 were non-FSWs. Prevalence of HIV in FSWs and non-FSWs was 49.9% and 13.6%, respectively (P<.001). In multivariate analysis, inconsistent condom use and genital ulcer disease or genital warts were associated with prevalent HIV in FSWs. History of sexual contact with a partner with an STD was associated with HIV in non-FSWs.
Infection with HIV is increasing in non-FSWs, previously thought to be at low risk in India. Since history of sexual contact with their only sex partner was the only risk factor significantly associated with HIV infection, it is likely that these women are being infected by their spouses. This underscores the need for strengthening partner-notification strategies and counseling facilities in India.
Full-textDOI: · Available from: Sanjay M Mehendale, Aug 07, 2014
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ABSTRACT: Though the continuum of care model has been adopted in HIV/AIDS intervention, there is little empirical work documenting the experiences of caregiving families. Addressing this gap, a study on family caregiving and care receiving was undertaken in Mumbai, India. In-depth interviews were conducted with seven seropositive caregivers, seven seropositive care receivers and five seronegative caregivers. Thematic analysis of the data was conducted, yielding a number of key themes. This paper discusses the key theme of the family context of care which includes the caregiving system, family values, perceived mode of infection, gender of the seropositive person, and class. Implications of the findings for policy and program planning are discussed.
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ABSTRACT: Background. The emerging human immunodeficiency virus (HIV) epidemics in rural areas of India are hypothesized to be linked to circular migrants who are introducing HIV from destination areas were the prevalence of HIV infection is higher. We explore the heterogeneity in potential roles of circular migrants in driving an HIV epidemic in a rural area in north India and examine the characteristics of the “sustaining bridge population”, which comprises individuals at risk of HIV acquisition at destination and of HIV transmission into networks at origin capable of sustaining an epidemic. Methods. Results of a behavioral survey of 639 male migrants from Azamgarh district, India, were analyzed using χ2 tests and logistic regression. Results. We estimated the size of various subgroups defined by specific sexual behaviors across different locations and over time. Only 20% fit our definition of a sustaining bridge population, with the majority making no apparent contribution to geographical connectedness between high- and low-prevalence areas. However, we found evidence of sexual contacts at origin that could potentially sustain an epidemic once HIV is introduced. Variables associated with sustaining bridge population membership were self-perceived HIV risk, current migrant status, and age. Conclusions. Circular migrants represent a heterogeneous population in terms of their role as a bridge group. Self-perception of heightened risk could be exploited in designing prevention programs.The Journal of Infectious Diseases 12/2014; 210(suppl 2):S556-S561. DOI:10.1093/infdis/jiu432 · 5.78 Impact Factor
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ABSTRACT: T he first case of HIV in India was detected in 1986. 1 Since then, over five million adults in India have been infected with HIV. 2 While this number in a population of over a bil-lion individuals translates to a low overall prevalence rate, the epidemiology of HIV infection suggests the need for focused prevention interventions that can avert large numbers of new infections. India is a country with a population of 1.02 billion individuals residing in thirty-five states and union territories. 3 Of these residents, 82% reside in rural areas. HIV infections have been reported in all states and territories, with the highest numbers reported from the southern states of Tamil Nadu and Karnataka and from the western state of Maharashtra. Heterosexual transmission is the dominant mode of transmission, accounting for 85% of infections. 2 Het-erosexual risk is reported from all Indian states, and data from sexually transmitted disease (STD) clinics in the community suggest an increasing prevalence of HIV among STD patients. National HIV pre-vention campaigns focus on messages ap-pealing to individuals to adopt safe sexual behaviors. 2% of infections nation-wide are attributed to injecting drug use. 2 While Sudha Sivaram, DrPH, MPH, is an Assistant Scientist with the Department of Epidemiology at the Johns Hopkins Bloomberg School of Public Health. She has been involved in HIV research and program implementation in India for over 15 years. Carl Latkin, PhD, is Professor of Social and Behavioral Sciences, Department of Health, Behavior and Society at the Johns Hopkins Bloomberg School of Public Health. Dr. Latkin is a social psychologist with extensive experience in HIV prevention interventions, network analysis and high-risk communities (drug and alcohol users). Suniti Solomon, MD, is Founder and Director of the YR Gaitonde Center for AIDS Research and Education (YRGCARE), which is a leading provider of education, care and support for persons and families living with HIV/AIDS in India. David D. Celentano, ScD is Professor and Director of the Infectious Disease Epidemiology program in the Department of Epidemiology of the Johns Hopkins Bloomberg School of Public Health with joint appointments in International Health, Environmental Health Sciences and Health Policy & Management. His research integrates behavioral science theory and research with epidemiology, in the study of behavioral and social epidemiology.