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

Solomon, Eileen; Visnegarwala, Fehmida; Philip, Philimol; Alexander, Glory

doi:10.1080/09540121.2011.564351

Cited by 3 publications

(1 citation statement)

References 28 publications

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“…In a previous case-control study also performed in South India, but not in a specific rural population, holding a service or professional job was a protective factor for having HIV infection among pregnant women. 12 However, we found that women who worked in a field not related to the agriculture sector were at higher risk for HIV infection in our rural setting. This apparent contradiction between the studies supports the need for stronger research on HIV in rural areas of India because of the important socio-demographic differences with urban areas.…”

Section: Discussioncontrasting

confidence: 51%

Trends and risk factors for HIV infection among young pregnant women in rural India

Alvarez-Uria¹,

Midde²,

Naik³

2012

International Journal of Infectious Diseases

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These results indirectly indicate that the incidence of HIV infection is decreasing in this rural setting. However, an increase in the HIV prevalence in women from forward castes was observed. In rural areas, HIV testing of pregnant women who have only completed primary education or who are working in a field not related to agriculture should be encouraged, because of their higher risk of HIV infection.

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Section: Discussioncontrasting

confidence: 51%

Trends and risk factors for HIV infection among young pregnant women in rural India

Alvarez-Uria¹,

Midde²,

Naik³

2012

International Journal of Infectious Diseases

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HIV risk perception among pregnant women in western India: Need for reducing vulnerabilities rather than improving knowledge!

et al. 2013

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Since the beginning of the HIV/AIDS epidemic in India, pregnant women attending antenatal clinics (ANC) have been considered as a low HIV risk population. Yet, a substantial proportion of new HIV infections are occurring among stable heterosexual couples. This paper sought to investigate the proportion and profile of women who, within the low-risk population, are potentially at higher risk of HIV infection. HIV risk perception of pregnant women enrolled within the ANRS 12127 Prenahtest trial was described and associated socio-behavioral characteristics, husband's characteristics, and HIV-related characteristics were analyzed using univariate and multivariate logistic regression models. Among 484 women enrolled, baseline data were collected for 479 women and 460 women with completed data were considered for the present analysis (96%). Eighty-nine (19.4%) women perceived themselves at risk of HIV. Women with educational level <11years (Adjusted Odds Ratio, AOR = 2.4 [CI = 1.28-4.53]), who stayed in joint families (AOR = 1.89 [CI = 1.12-3.12]), who had experienced insult or hurt from the partner (AOR = 1.91 [CI = 1.11-3.27]) and whose partner were alcoholic (AOR = 2.19 [CI = 1.31-3.66]) were significantly more likely to perceive themselves at risk of HIV. Women who had heard about sexually transmitted infections were also more likely to report HIV risk perception (AOR = 3.36 [CI = 1.83-6.18]). Substantial proportion of women (one out of five) perceived themselves at risk of HIV and most of these have reported some form of vulnerability in their couple relationship such as intimate partner violence, alcoholic partner, lack of communication, and spaces for communication with partner. Though awareness and knowledge is the first step for prevention, considering the vulnerabilities associated with HIV risk perception, HIV prevention interventions in India should target overall sources of vulnerability to HIV. Targeted risk reduction for women in ANC should be considered for primary HIV prevention among couples.

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Multilevel Analysis of the Predictors of HIV Prevalence among Pregnant Women Enrolled in Annual HIV Sentinel Surveillance in Four States in Southern India

Thamattoor¹,

Thomas²,

Banandur

et al. 2015

PLoS ONE

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BackgroundHeterogeneity of the HIV epidemic across districts of south India is reflected in HIV positivity among antenatal clinic (ANC) attendees. Along with individual factors, contextual factors also need consideration for effective HIV interventions. Thus, identifying district and individual level factors that influence ANC HIV positivity assumes importance to intervene effectively.MethodsData on HIV sentinel surveillance among the ANC population were obtained from the National AIDS Control Organization (NACO) between years 2004 and 2007. Data from serial cross-sectional studies among female sex workers (FSWs) conducted during this time period in 24 districts were used to generate district level variables corresponding to parameters concerning this high risk population. Other district level data were obtained from various official/governmental agencies. Multilevel logistic regression was used to identify individual and district level factors associated with ANC-HIV positivity.ResultsThe average ANC-HIV prevalence from 2004 to 2007 in the 24 integrated biological and behavioural assessments (IBBA) districts ranged from 0.25 to 3.25%. HIV positivity was significantly higher among ANC women with age≥25 years [adjusted odds ratio (AOR):1.49; 95% confidence interval (95%CI):1.27 to 1.76] compared to those with age<25 years; illiterate (AOR:1.62; 95%CI:1.03 to 2.54) compared to literate; employed in agriculture (AOR:1.34; 95%CI:1.11 to 1.62) or with occupations like driver/helper/industry/factory workers/hotel staff (AOR:1.59; 95%CI:1.26 to 2.01) compared to unemployed. District level HIV prevalence among FSWs (AOR:1.03; 95%CI:1.0 to 1.05) and percentage women marrying under 18 years were significantly associated with ANC-HIV positivity (AOR:1.02; 95%CI:1.00 to 1.04).ConclusionIlliteracy of the woman, higher HIV prevalence among FSWs and early marriage were associated with HIV positivity among pregnant women in southern India. In addition to targeted HIV preventive interventions among FSWs, studying and changing the behavior of FSW clients and addressing structural drivers of the epidemic might indirectly help reduce HIV infection among women in southern India.

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

Cited by 3 publications

References 28 publications

Trends and risk factors for HIV infection among young pregnant women in rural India

Trends and risk factors for HIV infection among young pregnant women in rural India

HIV risk perception among pregnant women in western India: Need for reducing vulnerabilities rather than improving knowledge!

Multilevel Analysis of the Predictors of HIV Prevalence among Pregnant Women Enrolled in Annual HIV Sentinel Surveillance in Four States in Southern India

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