Researchers explored the barriers to AIDS care for rural women living with AIDS, and investigated alternative delivery models to increase the women’s adherence to anti-retroviral therapy. Community-based participatory research focus groups were conducted by the researchers with a convenience sample of 39 women living with AIDS from a Primary Health Center near Chennai, India and with nurses, physicians and Accredited Social Health Activists (Ashas), lay health care workers. The most prevalent barriers expressed by the women were sickness-related, psychological, financial issues with childcare, and distance and/or transportation to the site. Women living with AIDS reviewed Ashas favorably.

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 Support for this research was provided by grant MH82662 from the National Institute on Mental Health.Address correspondence to Adeline M. Nyamathi, ANP, PhD, FAAN, UCLA, School of Nursing, Room 2-250, Factor Building, Los Angeles, CA 90095-1702, USA. E-mail: anyamath@ sonnet.ucla.edu Services, 9:385-404, 2010 Copyright # Taylor & Francis Group, LLC ISSN: 1538-1501 print=1538-151X online DOI: 10.1080DOI: 10. /15381501.2010 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. Journal of HIV/AIDS & SocialKEYWORDS accredited social health activists (ASHAs), HIV= AIDS, rural India, women Approximately 2.3 million adults are living with HIV=AIDS in India, of whom 38% are women (Joint United Nations Programme on HIV=AIDS [UNAIDS], 2008). The state of Andhra Pradesh has the second highest HIV adult prevalence rate in all of India (0.97% total; 0.75% for women and 1.22% for men), according to the National Family Health Survey (NFHS, 2008). Data from antenatal clinics indicate that almost half of 23 districts in Andhra Pradesh have HIV prevalence rates for women above 2% to 2.5% (National AIDS Control Organization [NACO], 2007), indicating a feminization of the epidemic in this area. Indeed, 85% of HIV transmission in India is sexual, and 75% of women living with HIV=AIDS (WLA) become positive within the first few years of marriage (Solomon, Chakraborty, & Yepthomi, 2004).In India there exist gender-specific disparities in HIV prevention and treatment. One of the main factors influencing India's HIV epidemic is a high rate of gender stratification, in which women experience extreme social disadvantage (Bloom & Griffiths, 2007). Indian women suffer disproportionate vulnerability to HIV=AIDS (Kambou, Magur, Hora, & Mukherjee, 2007), often because they often lack HIV awareness, live in conditions of poverty, and experience gender inequity (Van Rompay et al., 2008). WLA have been found to have low levels of psychosocial well-being (Solomon et al., 2008), which is confounded by the fact that many women live in rural areas and are socially and physically distant from help and government resources (NFHS, 2008).The purpose of this study is to assess the benefits and challenges related to engaging HIV-trained accredited social health activists (ASHAs) in the care of WLA in the rural district of Nellore, Andhra Pradesh. Our goal is to determine the utility and acc...

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