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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]

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Background Exposure to fine particulate matter (PM2.5) and black carbon (BC) have been linked to negative health risks, but exposure among professional taxi drivers is unknown. This study measured drivers' knowledge, attitudes, and beliefs (KAB) about air pollution compared to direct measures of exposures. Methods Roadside and in-vehicle levels of PM2.5 and BC were continuously measured over a single shift and compared to central site monitoring. Participants completed an air pollution KAB questionnaire. Results Taxicab PM2.5 and BC concentrations were elevated compared to central monitoring. Average PM2.5 concentrations per 15-minute interval were 4 - 49 μg/m3; 1-minute peaks measured up to 452 μg/m3. BC levels were also elevated; reaching > 10 μg/m3. 56 of 100 drivers surveyed believed they were more exposed than non-drivers; 81 believed air pollution causes health problems. Conclusions Air pollution exposure among drivers likely exceeds EPA recommendations. Future studies should focus on reducing exposures and increasing awareness among taxi drivers.

ObjectiveTo assess the risk factors associated with heterosexual HIV transmission among South Indian discordant couples enrolled in clinical care. MethodsA nested matched case-control study of serodiscordant couples in which the HIV-infected partner (index case) was enrolled in care. Demographic and clinical characteristics, sexual behaviours, CD4 cell count and plasma HIV-1 RNA loads were measured at enrolment and longitudinally over 12 months of follow-up. The study included 70 cases who seroconverted during study follow-up and 167 matched controls who remained persistently serodiscordant. ResultsThe incidence of HIV infection among the initially seronegative partners was 6.52 per 100 personyears. Persistently discordant patients were more likely to have initiated highly active antiretroviral therapy (HAART) than patients in seroconverting relationships (62.9% vs. 42.9%) (P50.001). Patients in seroconverting relationships had significantly higher plasma viral loads (PVLs) than patients in discordant relationships at enrolment, at 6 months and at 12 months (Po0.05). Patients in seroconverting relationships were less likely to use condoms with their primary partners than patients in discordant relationships (Po0.05). Patients in relationships that seroconverted between 6 and 12 months were diagnosed more often with genital Herpes simplex than patients in discordant relationships (P50.001). In the univariate and multivariate logistic regression, the following variables were associated with seroconversion: PVL 4100 000 [odds ratio (OR): 1.82; 95% confidence interval (CI): 1.1-2.8], non-disclosure of HIV status (OR: 5.5; 95% CI: 4.3-6.2) and not using condoms (OR: 2.8; 95% CI: 2.4-3.6). ConclusionsCouples-based intervention models are crucial in preventing HIV transmission to seronegative spouses. Providing early treatment for sexually transmitted infections, HAART and enhancing condom use and disclosure could potentially decrease the risk of HIV transmission within Indian married couples. IntroductionAn increasing focus of HIV preventive strategies has been to move away from solely reducing the risk-taking behaviours of HIV-uninfected individuals to focusing on HIV-infected individuals who may continue to practice HIV risk-taking behaviours [1]. Studies from the developed and developing world have documented that a sizeable number of HIV-infected individuals continue to engage in unprotected sexual intercourse with HIV-serodiscordant partners [2][3][4][5][6]. Unprotected intercourse may be more common among HIV-infected individuals in steady or regular relationships than in casual or non-regular sexual *The first two authors contributed equally to this manuscript. [19]. The typical route of HIV transmission has been through unprotected heterosexual intercourse [20]; however, data about the incidence and risk factors associated with HIV transmission through heterosexual intercourse in India remains very limited [21]. The social construct of gender in India, which has evolved over many centuries, makes women highl...