Obstetric practices related to HIV in Kerala

Lp, Choudhury; Vr, Kutty

doi:10.20529/ijme.2007.005

Cited by 3 publications

(4 citation statements)

References 2 publications

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“… 20 – 23 A number of studies reported staff reluctance to use RDT/POCT, citing reasons such as distrust of their results and apprehension about the reaction of clients to a rapid test result, as well as staff not being aware of RDT/POCT availability or not having the time to attend training for them. 24 – 29 In summary, a lack of interest, poor investment in training, negative perceptions regarding its benefits, reluctance due to change posed in their workflow, and resultant attitudes impeded their implementation. Other barriers were high costs, preference, and mistrust in accuracy.…”

Section: Resultsmentioning

confidence: 99%

Barriers to Implementation of Rapid and Point-of-Care Tests for Human Immunodeficiency Virus Infection

Pai¹,

Wilkinson²,

Deli-Houssein³

et al. 2015

Point of Care: The Journal of Near-Patient Testing &Amp; Technology

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Section: Resultsmentioning

confidence: 99%

Barriers to Implementation of Rapid and Point-of-Care Tests for Human Immunodeficiency Virus Infection

Pai¹,

Wilkinson²,

Deli-Houssein³

et al. 2015

Point of Care: The Journal of Near-Patient Testing &Amp; Technology

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“…It is possible to offer systemic HIV education and increase voluntary counseling and testing (VCT) acceptance by increasing antenatal testing facilities, improving the knowledge and sensitization of health care providers (Choudhury & Kutty, 2007;Sinha et al, 2008).…”

Section: Discussionmentioning

confidence: 99%

“…Since it may take time to cover the entire antenatal population for identification of HIVpositive pregnant mothers and initiate PMTCT for them, a simpler method needs to be evolved whereby pregnant women who are at high-risk for HIV infection can be profiled, and focused services provided for this population. Studies have assessed HIV awareness, attitudes, acceptance and barriers to perinatal testing, risk of mother to child transmission, and prevalence of abuse among pregnant women in India (Brown et al, 2001;Choudhury & Kutty, 2007;Kunte et al, 1999;Purwar, Jeyaseelan, Varhadpande, Motghare, & Pimplakute, 1999;Rahbar, Garg, Tripathi, Gupta, & Singh, 2007;A. Rogers et al, 2006;Samuel et al, 2007;Shrotri et al, 2003;Singh, Fukuda, Ingle, & Tatara, 2002) (Johnson, Dorrington, Bradshaw, du Plessis, & Makubalo, 2009;Kipp et al, 2009;Lemos, Gurgel, Rivas, & de Souza, 2009).…”

Section: Please Scroll Down For Articlementioning

confidence: 99%

Predictors of HIV positivity among pregnant women presenting for obstetric care in South India – a case-control study

et al. 2011

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Feminization of the HIV epidemic in India has increasingly burdened the public health infrastructure to provide prevention of mother-to-child transmission (PMTCT) services. A mere 20% of pregnant women in the country receive HIV counseling and testing. One of the strategies, for expansion of PMTCT services is to ascertain an accurate identification of HIV-positive pregnant women. Thus, we sought to characterize a demographic profile of pregnant women at high-risk for HIV infection. We performed a retrospective case-control study. We included as cases, all HIV-positive women identified in a PMTCT program implemented in 23 charitable faith-based hospitals in four states in South India over a period of 75 months, starting in January 2003. Thus a total of 320 HIV-positive cases were frequency matched using stratified random sampling to 365 HIV-negative pregnant women presenting for antenatal care during the same time period. Cases and controls were compared using Chi-square test for categorical variables and Student's t-test for continuous variables. Multivariate step-wise logistic regression analysis was performed. On multivariate analysis, following factors were independently predictive of HIV positivity: age ≤25 years (odds ratio [OR] 0.50; confidence interval [CI] 0.33-0.76; p = 0.001); illiteracy (OR 4.89; CI 2.79-8.57; p <0.0001); woman holding a service and/or professional job (OR 0.27; CI 0.14-0.53; p <0.0001); spouses holding a service or higher job (OR 3.13; CI 2.13-4.59; p <0.0001); being married ≤5 years (OR 2.89; CI 1.68-4.95; p <0.0001); late gestational age at presentation (OR 3.06; CI 2.04-4.59; p <0.0001); history of fetal and/or live born loss (OR 2.36; CI 1.51-3.67; p <0.0001). To our knowledge this is the first large study to evaluate factors predictive of HIV positivity among women presenting for antenatal care in the Indian setting. This type of profiling of HIV-positive pregnant women may help expand PMTCT services in a focused and cost-effective manner in India.

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“…For example, Richardson and Bolle [11] and Green and Platt [10] report the case of a doctor requiring that an HIV patient use a separate toilet in a hospital to control the transmission of infection. Other studies [10,[12][13][14] report that people with HIV, admitted to health institutions for treatment, are isolated, even when it involves the use of eating utensils. Such experiences discourage people with HIV from seeking care from health providers.…”

Section: Introductionmentioning

confidence: 99%

Disparity in health care: HIV, stigma, and marginalization in Nepal

Jha

Madison

2009

Journal of the International AIDS Society

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BackgroundThe provision of effective health care to people with HIV and those from usually marginalised backgrounds, such as drug users and sex workers is a growing concern in Nepal, because these populations often do not seek health care, as willingly as the general population. Exploration of the factors, which hinder them seeking health care is crucial. The 'lived' experiences of the usually marginalized participants in this research will reflect on the constraining factors, and contribute to the development of appropriate strategies, which will facilitate people with HIV and other marginal populations to seek more readily appropriate health services.MethodsThis study explored the healthcare-seeking experiences of 20 HIV-positive participants in Nepal, as well as 10 drug-using participants who had never had an HIV test and did not know their HIV status. Using grounded theory, this study investigated the perceptions and experiences of HIV-positive persons, or those perceived to be at risk for HIV, as they sought health care services in locations around Kathmandu Valley.ResultsHealth professionals were perceived to lack knowledge and sensitivity in providing health care to often marginalized and stigmatized injecting drug users, sex workers and HIV-positive people. Stigma and marginalization seem to interfere with doctors' and other health professionals' decisions to voluntarily treat persons who they perceive to be at high risk for HIV infections. Doctors and other health professionals appear suspicious, even unaware, of contemporary biomedical knowledge as it relates to HIV. The fear that certain marginalized groups, such as injecting drug users and sex workers, would be infected with HIV has further intensified stigma against these groups.ConclusionThe study identified the beginning of a change in the experiences of HIV-positive people, or those at risk of HIV, in their seeking of health care. With focused, contemporary HIV education and training, the beginning of positive changes in the knowledge base and attitude of health providers seemed to be apparent to some participants of this study.

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Obstetric practices related to HIV in Kerala

Cited by 3 publications

References 2 publications

Barriers to Implementation of Rapid and Point-of-Care Tests for Human Immunodeficiency Virus Infection

Barriers to Implementation of Rapid and Point-of-Care Tests for Human Immunodeficiency Virus Infection

Predictors of HIV positivity among pregnant women presenting for obstetric care in South India – a case-control study

Disparity in health care: HIV, stigma, and marginalization in Nepal

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