Lakshmi Prasad

Publications (3)5.37 Total impact

• Article: Sexual risk behaviors among HIV-infected South Indian couples in the HAART era: implications for reproductive health and HIV care delivery.

  Kartik K Venkatesh, A K Srikrishnan, Steven A Safren, Elizabeth W Triche, E Thamburaj, Lakshmi Prasad, Mark N Lurie, M Suresh Kumar, N Kumarasamy, Suniti Solomon, Kenneth H Mayer
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  ABSTRACT: The current study examines sexual behaviors among HIV-infected Indians in primary care, where access to highly active antiretroviral therapy (HAART) has recently increased. Between January and April 2008, we assessed the sexual behaviors of 247 HIV-infected South Indians in care. Multivariable logistic regression models were used to determine predictors of being in a HIV-seroconcordant primary relationship, being sexually active, and reporting unprotected sex. Over three-fourths (80%) of participants were HAART-experienced. Among the 58% of participants who were currently in a seroconcordant relationship, one-third were serodiscordant when enrolling into care. Approximately two-thirds (63.2%) of participants were sexually active; 9.0% reported unprotected sex. In the multivariable analyses, participants who were in a seroconcordant primary relationship were more likely to have children, use alcohol, report unprotected sex, and have been enrolled in care for >12 months. Sexually active participants were more likely to be on HAART, have a prior tuberculosis diagnosis, test Herpes simplex type 2 antibody seropositive, and have low general health perceptions. Participants who reported unprotected sex were more likely to be in a seroconcordant relationship, be childless, want to have a child, and use alcohol. We did not document an association between HAART and unprotected sex. Among HIV-infected Indians in primary care, predictors of unprotected sex included alcohol use and desire for children. Prevention interventions for Indian couples should integrate reproductive health and alcohol use counseling at entry into care.
  AIDS Care 02/2011; 23(6):722-33. · 1.60 Impact Factor
• Article: Predictors of nonadherence to highly active antiretroviral therapy among HIV-infected South Indians in clinical care: implications for developing adherence interventions in resource-limited settings.

  Kartik K Venkatesh, A K Srikrishnan, Kenneth H Mayer, N Kumarasamy, Sudha Raminani, E Thamburaj, Lakshmi Prasad, Elizabeth W Triche, Suniti Solomon, Steven A Safren
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  ABSTRACT: In light of the increasing availability of generic highly active antiretroviral therapy (HAART) in India, further data are needed to examine variables associated with HAART nonadherence among HIV-infected Indians in clinical care. We conducted a cross-sectional analysis of 198 HIV-infected South Indian men and women between January and April 2008 receiving first-line non-nucleoside reverse transcriptase inhibitor (NNRTI)-based HAART. Nonadherence was defined as taking less than 95% of HAART doses in the last 1 month, and was examined using multivariable logistic regression models. Half of the participants reported less than 95% adherence to HAART, and 50% had been on HAART for more than 24 months. The median CD4 cell count was 435 cells per microliter. An increased odds of nonadherence was found for participants with current CD4 cell counts greater than 500 cells per microliter (adjusted odds ratio [AOR]: 2.22 [95% confidence interval {CI}: 1.04-4.75]; p = 0.038), who were on HAART for more than 24 months (AOR: 3.07 [95% CI: 1.35-7.01]; p = 0.007), who reported alcohol use (AOR: 5.68 [95%CI: 2.10-15.32]; p = 0.001), who had low general health perceptions (AOR: 3.58 [95%CI: 1.20-10.66]; p = 0.021), and who had high distress (AOR: 3.32 [95%CI: 1.19-9.26]; p = 0.022). This study documents several modifiable risk factors for nonadherence in a clinic population of HIV-infected Indians with substantial HAART experience. Further targeted culturally specific interventions are needed that address barriers to optimal adherence.
  AIDS patient care and STDs 12/2010; 24(12):795-803. · 2.68 Impact Factor
• Article: HIV transmission transcends three generations: can we prevent secondary transmission in India?

  Kartik K Venkatesh, Lakshmi Prasad, Kenneth H Mayer, N Kumarasamy
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  ABSTRACT: This case history documents four instances of HIV secondary transmission within a single family, which could have been stopped at multiple points by timely prevention. These cases of HIV secondary transmission that have occurred since the scale-up of HIV testing, prevention and clinical services in India raises the question whether the current HIV prevention infrastructure is sufficient and comprehensive in resource-limited settings.
  International Journal of STD & AIDS 07/2008; 19(6):418-20. · 1.09 Impact Factor