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Impact of HIV status on attitudes toward fertility among women living with HIV/AIDS in Karnataka, India
Biradar R.A., Singh D.P., Halli S.S.
Prevalence of HIV and syphilis infections among men who have sex with men attending an integrated counseling and testing centre at Agra: Comparison with studies in other regions of India
Hussain T., Kulshreshtha K.K., Yadav V.S.
Q3
AbstractMen who have sex with men (MSMs) are a group of high-risk individuals in India, who have remained neglected for a long time. Stigma, discrimination and laws criminalizing sex between men undermine access to HIV/AIDS and other health care services.In this study, we determined the seroprevalence and risk factors for HIV and syphilis infections among a group of MSMs attending an Integrated Counseling & Testing Centre (ICTC) at Agra during 2009–11. The results have been compared with those in other regions of the country.There were 277 MSMs registered with a nongovernmental organization (NGO), Khushi, involved in a Targeted Intervention (TI) project, who were tested for HIV and venereal disease research laboratory (VDRL) infections. Sociodemographic profile, risk factors, sexual identity, general health care access, and previous HIV and/or sexually transmitted infection (STI) testing, etc., were documented.The prevalence of HIV and syphilis infections among the MSMs are 11.9% (33/277) and 11.1% (31/27...
Women living with AIDS in rural Southern India: Perspectives on mental health and lay health care worker support
Srivastava N., Nyamathi A.M., Sinha S., Carpenter C., Satyanarayana V., Ramakrishnan P., Ekstrand M.
Q3
In this study, focus groups were conducted with 16 rural Women Living with AIDS (WLA) from Andhra Pradesh, India who had previously participated in a clinical trial wherein 68 WLA were randomized into either an Accredited Social Health Activists (ASHA) - Life (AL) intervention or a Usual Care program. Findings are discussed in terms of: a) mental health issues, b) perceived stressors, c) individual resources for coping with mental health issues, and d) role of Asha support in coping with mental health issues. These findings highlight the salience of mental health issues in the lives of WLA and the role played by Asha in addressing some of these issues. The discussion section makes a case for increased emphasis on mental health care in future community-based interventions for this population.
Understanding low levels of condom use between female sex workers and their regular partners: Timing of sexual initiation in relationships as a differentiating factor in Karnataka, South India
Isac S., Prakash R., Halli S.S., Ramesh B.M., Rajaram S.P., Washington R., Bhattacharjee P., Blanchard J., Moses S.
Q3
ABSTRACTEvidence shows that low condom use is the norm in relationships between female sex workers (FSWs) and their regular partners. We investigated the timing of sexual initiation in a relationship with a regular partner as a critical factor in determining condom use. Three rounds of Integrated Behavioral and Biological Assessment (IBBA) surveys were used to derive whether regular partner relationships began before or after sex work initiation. Of the 7,015 FSWs surveyed, 33% started an intimate partner relationship before sex work initiation, 27% after beginning sex work, and the remaining 40% did not have a regular partner. Condom use was significantly higher in a FSW’s relationship after sex work initiation (p
Relationship dynamics and challenges of safer sex in an HIV serodiscordant couple in India: A case review from the positive Jeevan Saathi study
Patel S.N., Hennink M., Yount K.M., Wingood G., Kosambiya J., McCarty F., Windle M.
Q3
ABSTRACTCurrently, no counseling guidelines exist for HIV serodiscordant couples in India. One-on-one interviews were conducted with married, serodiscordant couples in Western India, from which one couple was selected to explicate the factors that elevated HIV risk, using an intrinsic case study approach. This case study describes the factors that contribute to HIV risk in a married serodiscordant couple, including shifts in spousal roles, history of child sexual abuse, unfulfilled sexual desire, unprotected sex with extramarital relations, intimate partner violence, and inconsistent condom use with marital partner. Although there were improvements in the couple’s relationship after HIV entered their lives, shifts in relationship dynamics and behaviors exacerbated HIV risk. Early and ongoing counseling interventions with couples are key, as relationship dynamics and behaviors can change over time. HIV service providers must be trained appropriately to address the spectrum of risk that may lie in HIV serod...
Family and community level stigma and discrimination among women living with HIV/AIDS in a high HIV prevalence district of India
Halli S.S., Khan C.G., Moses S., Blanchard J., Washington R., Shah I., Isac S.
Mobility as a Differential Factor of HIV Among Female Sex Workers in Belgaum District, Karnataka, India
Kummarikunta G., Mathapati C.R., Halli S.S.
Q3
Mobility among female sex workers (FSWs) contributes to increased sexual risk behaviors. Previous studies about the correlation between HIV status and mobility in India are rare. The present authors explore the association between mobility and HIV status among FSWs. Data were obtained from a cross-sectional study conducted in 2008 among FSWs (N = 405) in Belgaum who participated in an integrated biological and behavioral assessment. Analysis was conducted with HIV prevalence as an outcome variable and mobility status as a predictor after controlling for sociodemographic characteristics. A logistic regression model indicates that FSWs who were mobile were more likely to have HIV infection than a local group (odds ratio 1.93, 95% confidence interval 1.17 to 3.22, p
HIV Status Disclosure and Condom Use Among HIV-Positive Men Who Have Sex With Men andHijras(Male-to-Female Transgender People) in India: Implications for Prevention
Chakrapani V., Shunmugam M., Newman P.A., Kershaw T., Dubrow R.
Q3
This mixed-methods investigation combines a quantitative survey, focus groups, and in-depth interviews to examine sexual risk behaviors and HIV status disclosure among HIV-positive hijras (male-to-female transgender people) and HIV-positive men who have sex with men (MSM) in Chennai and Mumbai, India. From the survey results, the authors found a relatively high prevalence of inconsistent condom use for anal sex with male partners—about one-fifth to almost one-half, depending on the type of partner (regular, casual) and sexual role (receptive, insertive). One-quarter of MSM and two-fifths of hijras reported having disclosed their HIV status to their male regular partner. The qualitative data helped in understanding social and structural factors that created barriers to disclosure of HIV status and to condom use. Disclosure was not uniformly followed by safer sex, and nondisclosure did not always lead to unprotected sex. Implications for practice and policies and potential interventions are discussed.
Quality of Life Correlates in HIV-Positive People in a City in South India
Stanley S., Sethuramalingam V., Sathia S.
Q3
The authors explored the quality of life (QOL) and psychological distress of HIV-positive persons in a city in South India. The 309 HIV-positive adults were administered the World Health Organization Quality of Life–BREF and the Depression Anxiety and Stress Scale (DASS). Data analysis revealed no significant sex-based difference on all dimensions of QOL but significantly higher depression and stress scores for female respondents. Further, all subdimensions of QOL showed highly significant negative correlations with the overall DASS score and its subdimensions. Following regression analysis, the total DASS score emerged as a significant predictor of QOL. Findings indicate areas for intervention that merit attention.
Social Construct of Sex Work in India: Implications for HIV Prevention
Sen S., Aguilar J., Heng L., Gambhir S.
Q3
In India, while female sex workers (FSWs) are one of the groups most susceptible to HIV/AIDS transmission, research and interventions typically sidestep FSWs’ stories. The authors use interviews with 20 FSWs to reflect a more recent trend of research that encourages FSWs to tell their stories. Based on the findings that suggest both individual and structural factors influencing women's involvement in sex work, the authors suggest a theoretical framework for designing more comprehensive and culturally grounded intervention strategies targeting this population.
AIDS at 30: A History
Joshi S.
Q3
Sex Work in Asia: Update on Issues, Treatment, and Prevention of HIV/AIDS
Land H., Prabhughate P.
Exploring the Role of Community-Based Peer Support in Improving Access to Care and Antiretroviral Treatment for Sex Workers in Mysore, India
Lazarus L., Reza-Paul S., Pasha A., Jairam S., Hafeez Ur Rahman S., O'Neil J., Lorway R.
Q3
To meet the HIV prevention needs of sex workers in India, some community-based organizations have begun integrating peer education and community mobilization into community-led structural interventions. As the role of community-based organizations continues to expand into new service areas, it is important to understand how these new interventions are received. This agency assessment was done in collaboration with Ashodaya Samithi in 2009. Ashodaya Samithi is a community-based organization led by female, male, and transgendered sex workers. In the past year, HIV-positive sex workers of Ashodaya have registered their own organization, known as Ashraya. Based on qualitative findings, this study describes how community-based organizations can play an important role in improving access to care and antiretroviral treatment for sex workers. The rapid growth of Ashraya and its success at fostering social solidarity and large-scale structural interventions hold valuable lessons for community-based organizations a...
The Extent and Nature of Fluidity in Typologies of Female Sex Work in Southern India: Implications for HIV Prevention Programs
Jain A.K., Saggurti N.
Q3
These authors examine the nature and extent of fluidity in defining the typology of female sex work based on the place of solicitation or place of sex or both places together, and whether sex workers belonging to a particular typology are at increased risk of HIV in southern India. Data are drawn from a cross-sectional survey conducted during 2007-2008 among mobile female sex workers (N = 5301) in four Indian states. Findings from this study address an important policy issue: Should programmatic prevention interventions be spread to cover all places of sex work or be focused on a few places that cover a large majority of sex workers? Results indicate that most female sex workers, including those who are usually hard to reach such as those who are mobile or who use homes for soliciting clients or sex, can be reached programmatically multiple times by concentrating on a smaller number of categories, such as street-, lodge-, and brothel-based sex workers.
Perceptions of Women Living with AIDS in Rural India Related to the Engagement of HIV-Trained Accredited Social Health Activists for Care and Support
Nyamathi A.M., William R.R., Ganguly K.K., Sinha S., Heravian A., Albarrán C.R., Thomas A., Greengold B., Ekstrand M., Ramakrishna P., Rao P.R.
Q3
A community-based participatory research study was conducted using focus groups with 39 women living with AIDS (WLA) in the rural setting of Andhra Pradesh, India. In addition, three nurses, two physicians, and five reproductive health accredited social health activists (ASHAs) took part in focus groups. The WLA offered insight into the benefits of HIV-trained ASHAs including emotional support, assistance with travel to health care providers and antiretroviral therapy medication adherence. Health care providers also identified benefits of using HIV-trained ASHAs and suggested modalities for how to train these individuals. These findings will contribute to the design of a future program of care involving HIV-trained ASHAs.
