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Acceptability of HIV oral self-test among truck drivers and youths: a qualitative investigation from Pune, Maharashtra. BMC Public Health 2021; 21:1931. [PMID: 34689729 PMCID: PMC8543938 DOI: 10.1186/s12889-021-11963-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 10/11/2021] [Indexed: 11/28/2022] Open
Abstract
Background Ending AIDS by 2030 is a global target, to which India is a signatory. HIV-self-test (HIVST) coupled with counselling and AIDS-care, including antiretroviral therapy, has the potential to achieve this. However, national programs are at varying stages of acceptance of HIVST, as discussions around its introduction spark controversy and debates. HIV-self-test, as yet, is not part of the AIDS control program in India. Against this backdrop, we explored acceptability of an HIV oral self-test (HIVOST) among truckers and young men and women. Methods A qualitative investigation with 41 in-depth-interviews and 15 group discussions were conducted in the district of Pune, in the western state of Maharashtra, India. These interactions were built around a prototype HIVOST kit, helped in taking the discussions forward. The software N-vivo (version 11.0) was used to manage the volumes of data generated through the aforementioned process. The study was conducted during June through December, 2019. Results While the truckers belonged to the age bracket 21–67 year, the youths were in the age group 18–24 year. ‘Ease of doing HIVOST’ and ‘fear of needle pricks’ were the reasons behind acceptance around HIVOST by both the study groups. Truckers felt that HIVOST would encourage one to know one’s HIV status and seek help as appropriate. Accuracy of HIVOST result and disposal of the kits following use were concerns of a few. Most of the participants preferred saliva over blood as the specimen of choice. Instructions in local language reportedly would enable test-use by self. The truck drivers preferred undertaking HIVOST at the truckers-friendly ‘Khushi clinics’ or in the vehicle, while youths preferred the privacy of home. Some of the young men mis-perceived the utility of HIVOST by referring to doing a test on a partner immediately prior to sexual encounter. On the other hand, a few truckers had wrong information on HIV cure. Conclusions Overall, the study communities expressed their acceptance towards HIV-self-test. The National AIDS Control Program, India would benefit by drawing upon the findings of the current investigation. Existing myths and misconceptions around HIV test and treatment require program attention. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-11963-7.
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Pundhir A, Shukla A, Goel AD, Pundhir P, Gupta MK, Parashar P, Varshney AM. Exploring unsafe sexual practices among truck drivers at Meerut District, India: a cross-sectional study. Afr Health Sci 2021; 21:547-556. [PMID: 34795707 PMCID: PMC8568232 DOI: 10.4314/ahs.v21i2.9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background Despite implementation of HIV prevention programmes for truck drivers in India, unsafe sex behavior among truck drivers has been documented. Objective The objective of this study was to assess knowledge about HIV Transmission and modes of prevention, pattern of condom use with high risk partners and explore the practice of unsafe sex and its risk factors among truck drivers. Methods This exploratory cross-sectional study design was conducted on a recruited convenient sample of 100 truck drivers above 18 years from March to May 2015. Binary logistic regression was used to compute unadjusted odds ratio [95% Confidence Interval] for establishing association of risk factors with unsafe sex. Results Overall, only 7% had complete knowledge about HIV/AIDS transmission and prevention. 54% of truck drivers have sex with a high risk partner (commercial sexual worker or men having sex with men) and thirty-eight percent reported unsafe sexual practices due to inconsistent condom use with them. The various risk factors found significantly associated with unsafe sex were mean age of first intercourse (OR= 0.92, 95% CI: 0.75 – 0.97), access to pornography (OR = 4.4, 95% CI: 1.8 – 10.7) and conuming psychoactive substance before sex (OR = 4.06, 95% CI: 1.09 – 15.02). Conclusion Socio-demographic, occupational factors, pornography access and consuming psychoactive substances seems to influence the sexual behaviour of truckers.
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Affiliation(s)
- Ashish Pundhir
- Department of Community Medicine Rama Medical College, Kanpur ,Uttar Pradesh India - 209217
| | - Arvind Shukla
- Department of Community Medicine and Family Medicine All India Institute of Medical Sciences-Raipur Raipur, Chattisgarh
| | - Akhil Dhanesh Goel
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences Jodhpur, Rajasthan, India
| | - Pooja Pundhir
- Department of Internal Medicine Memorial Hermann Hospital Houston, Texas, USA
| | - Manoj Kumar Gupta
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences Jodhpur, Rajasthan, India
| | - Pawan Parashar
- Department of Community Medicine Subharti Medical College Meerut, Uttar Pradesh, India
| | - Amit Mohan Varshney
- Department of Community Medicine Maharani Laxmibai Medical College Jhansi, Uttar Pradesh
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Sharma M, Rewari BB, Aditama TY, Turlapati P, Dallabetta G, Steen R. Control of sexually transmitted infections and global elimination targets, South-East Asia Region. Bull World Health Organ 2021; 99:304-311. [PMID: 33953448 PMCID: PMC8085629 DOI: 10.2471/blt.20.254003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 11/06/2020] [Accepted: 12/07/2020] [Indexed: 12/30/2022] Open
Abstract
The World Health Organization (WHO) set targets for a 90% reduction in the incidence of syphilis and gonorrhoea between 2018 and 2030. We review trends in sexually transmitted infections in the WHO South-East Asia Region to assess the feasibility of reaching these targets. Myanmar, Sri Lanka and Thailand reported 90% or greater reductions in the incidence or prevalence of syphilis and/or gonorrhoea between 1975 and 2005. Evidence suggests that smaller, more recent reductions in trends in sexually transmitted infections in India have driven regional declines. In other countries, sexually transmitted infections remain high or are increasing or data are not reliable enough to measure change. Sri Lanka and Thailand have strong control programmes for sexually transmitted infections that ensure universal access to services for these infections and targeted interventions in key populations. India and Myanmar have implemented targeted control efforts on a large scale. Other countries of the region have prioritized control of human immunodeficiency virus, and limited resources are available for other sexually transmitted infections. At national and subnational levels, data show rapid declines in sexually transmitted infections when targeted promotion of condom use and sexually transmitted infection services are scaled up to reach large numbers of sex workers. In contrast, recent outbreaks of sexually transmitted infections in underserved populations of men who have sex with men have been linked to rising trends in sexually transmitted infections in the region. A renewed and focused response to sexually transmitted infections in the region is needed to meet global elimination targets.
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Affiliation(s)
- Mukta Sharma
- Department of Communicable Diseases, World Health Organization Regional Office for South-East Asia, New Delhi, India
| | - Bharat B Rewari
- Department of Communicable Diseases, World Health Organization Regional Office for South-East Asia, New Delhi, India
| | - Tjandra Yoga Aditama
- Department of Communicable Diseases, World Health Organization Regional Office for South-East Asia, New Delhi, India
| | | | - Gina Dallabetta
- The Bill and Melinda Gates Foundation, Washington, DC, United States of America
| | - Richard Steen
- Department of Public Health, Erasmus MC, University Medical Centre Rotterdam, Dr Molewaterplein 40, 3015 GD, Rotterdam, Netherlands
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Systematic Review of Interventions to Reduce HIV Risk Among Men Who Purchase Sex in Low- and Middle-Income Countries: Outcomes, Lessons Learned, and Opportunities for Future Interventions. AIDS Behav 2020; 24:3414-3435. [PMID: 32468354 DOI: 10.1007/s10461-020-02915-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Along with other partners of key population groups, men who purchase sex (MWPS) contributed to around 18% of new reported HIV cases in 2018 among people aged 15-49 years worldwide. A systematic review was performed to evaluate interventions conducted to reduce HIV risk among MWPS in low- and middle-income countries (LMICs). A comprehensive search of studies published in Embase, Medline, Global Health, Scopus, and Cinahl was performed. Among 32,115 studies found, 21 studies met the review's inclusion criteria. Only four studies recruited MWPS, while the rest recruited groups often used as proxy populations for MWPS. The interventions were made primarily to increase HIV-related knowledge or perceptions through education and to improve condom usage rates through promotion and distribution. Few studies evaluated the impact of interventions on HIV testing rates and none looked at HIV treatment. Given the important role of testing as a prevention gate, together with UNAIDS' 90-90-90 testing and treatment coverage goals for people infected with HIV, more studies which evaluate the impact of HIV testing and treatment provision among this group are needed.
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Firestone R, Rowe CJ, Modi SN, Sievers D. The effectiveness of social marketing in global health: a systematic review. Health Policy Plan 2016; 32:110-124. [DOI: 10.1093/heapol/czw088] [Citation(s) in RCA: 78] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2016] [Indexed: 12/30/2022] Open
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Botão C, Horth RZ, Frank H, Cummings B, Inguane C, Sathane I, McFarland W, Fisher Raymond H, Young PW. Prevalence of HIV and Associated Risk Factors Among Long Distance Truck Drivers in Inchope, Mozambique, 2012. AIDS Behav 2016; 20:811-20. [PMID: 26395193 DOI: 10.1007/s10461-015-1194-8] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This is the first integrated biological and behavioral surveillance survey among long-distance truck drivers (LDTD) in Mozambique. Using modified time-location sampling in 2012 at a key transportation junction (Inchope), we enrolled 327 male LDTD. HIV prevalence was 15.4 % (95 % confidence interval : 11.4-19.4 %, n = 318 tested). Among HIV-positive LDTD, 83.7 % did not know their status. One-third of LDTD had never tested for HIV and three-quarters had not received free condoms, lubricants or HIV literature in the past 12 months. In that same period, 61.4 % of LDTD had at least four sexual partners and 27.1 % paid for sex. Among sexually-active LDTD, 76.5 % did not use a condom at last sex. HIV was associated (p < 0.05) with primary education or lower (AOR 2.1), residence in Mozambique (AOR 2.3) and never having tested for HIV (AOR 2.2). Our findings reveal that broader coverage of HIV prevention and comprehensive care services for LDTD are urgently needed.
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Affiliation(s)
- Carlos Botão
- National Institute of Health, Ministry of Health-Mozambique, Maputo, Mozambique.
| | - Roberta Z Horth
- Global Health Sciences, University of California San Francisco, San Francisco, CA, USA
| | - Heidi Frank
- Global Health Sciences, University of California San Francisco, San Francisco, CA, USA
| | - Beverley Cummings
- Division of Global HIV/AIDS, Centers for Disease Control and Prevention (CDC), Maputo, Mozambique
| | - Celso Inguane
- International Training and Education Center for Health (I-TECH), Maputo, Mozambique
| | - Isabel Sathane
- International Training and Education Center for Health (I-TECH), Maputo, Mozambique
| | - Willi McFarland
- Global Health Sciences, University of California San Francisco, San Francisco, CA, USA
| | - H Fisher Raymond
- Global Health Sciences, University of California San Francisco, San Francisco, CA, USA
| | - Peter W Young
- Division of Global HIV/AIDS, Centers for Disease Control and Prevention (CDC), Maputo, Mozambique
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Sharma V, Saggurti N, Bharat S. Health care coverage among long-distance truckers in India: an evaluation based on the Tanahashi model. HIV AIDS-RESEARCH AND PALLIATIVE CARE 2015; 7:83-94. [PMID: 25848319 PMCID: PMC4376185 DOI: 10.2147/hiv.s76416] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Long-distance truckers (LDTDs) are vulnerable to human immunodeficiency virus infection and other sexually transmitted infections due to the nature of their work, working environment, and frequent mobility. This paper examines and comments on the health care coverage provisioned under “Kavach” Project. Data from the Integrated Behavioural and Biological Survey, National Highway gathered from 2,066 LDTDs in Round 1 and 2,085 LDTDs in Round 2, who traveled in four extreme road corridors travelled by LDTDs in India, were used for analysis. Analysis reveals that service capacity in terms of socially marketed condoms per thousand LDTDs has increased from Round 1 to Round 2 (4,430 to 6,876, respectively). Accessibility coverage in terms of knowledge about the Khushi clinic has significantly decreased between Rounds 1 and 2 (60.9% to 54.6%; P<0.001). Acceptability coverage has increased between the two rounds (13.8% to 50.6%; P<0.001). Contact coverage has also increased between the rounds (12.7% to 22.3%; P<0.001). Effectiveness coverage for preventive and curative care has also increased significantly. This paper comments on the gaps in accessibility and acceptability of health care coverage and emphasizes the need for further studies to assess the contextual factors that influence the effectiveness and efficiency of interventions designed to address access barriers and to identify what combination of interventions may generate the best possible outcome.
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Affiliation(s)
- Varun Sharma
- School of Health Systems Studies, Tata Institute of Social Sciences, Mumbai, India
| | | | - Shalini Bharat
- School of Health Systems Studies, Tata Institute of Social Sciences, Mumbai, India
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Matovu JKB, Ssebadduka NB. Knowledge, attitudes & barriers to condom use among female sex workers and truck drivers in Uganda: a mixed-methods study. Afr Health Sci 2013; 13:1027-33. [PMID: 24940328 DOI: 10.4314/ahs.v13i4.24] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND There is limited documentation on knowledge, attitudes and barriers to condom use among female sex workers (FSWs) and truck drivers (truckers). OBJECTIVE To explore knowledge, attitudes and barriers to condom use among FSWs and truckers operating along major transport corridors in Uganda. METHODS Structured questionnaires were administered to explore FSWs' and truckers' knowledge of and attitudes towards condom use among 259 FSWs and 261 truckers. Qualitative data were collected on barriers to condom use using focus group discussions. Quantitative data were analyzed using SPSS while qualitative data were audio-recorded, transcribed and thematically analyzed. RESULTS Condom knowledge was high with 97% of FSWs and 95% of truckers agreeing with the statement, "using condoms properly and consistently reduces risk of HIV infection". Attitudes towards condom use were generally favorable with 91% of FSWs and 82% of truckers agreeing with the statement, "condom use is the best method of HIV prevention". Qualitative findings show that poverty, refusal to use condoms by male partners, alcohol use before sex and beliefs that condoms 'kill the mood for sex' remain key barriers to consistent condom use. CONCLUSIONS Consistent condom use among FSWs and truckers is still hampered by economic and relationship factors.
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Prem Kumar S, Kumar GA, Poluru R, Schneider JA, Dandona L, Vemu L, Sudha T, Mayer KH, Dandona R. Contact with HIV prevention programmes & willingness for new interventions among truckers in India. Indian J Med Res 2013; 137:1061-71. [PMID: 23852287 PMCID: PMC3734711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND & OBJECTIVES Systematic data on existing coverage and willingness for HIV prevention strategies among truckers are not readily available in India. The present study aimed to further the understanding on contact of truckers with existing HIV prevention services and to assess willingness for new HIV prevention strategies. METHODS A total of 1,800 truck drivers and helpers aged 16-65 yr passing through Hyderabad were approached to assess contact made with HIV prevention programmes, history of previous HIV testing and their acceptance for circumcision, oral HIV testing, new medications to control HIV (PrEP) and telephonic counselling. Dried blood samples were collected on filter paper and tested for HIV. Multiple logistic regression was performed for analysis of association between contact with HIV prevention programme and socio-demographic, sexual risk behaviour variables and work characteristics. RESULTS A total of 1,602 (89%) truckers gave interview and provided blood sample. Forty five truckers tested positive for HIV resulting in HIV prevalence of 2.8 per cent (95% CI 2.0-3.6%). Only 126 truckers (7.9%; 95% CI 6.5-9.2%) reported ever being contacted by staff providing HIV prevention interventions. Previous HIV testing was reported by19 per cent (95% CI 17.3-21.2%). Those reporting contact with HIV prevention programmes ever were more likely to have undergone HIV testing (odds ratio 3.6, 95% CI 2.4-5.4). The acceptance for pre-exposure prophylaxis (PrEP) was 87 per cent, oral HIV testing 98 per cent, and telephonic counselling 82 per cent, but was only 9 per cent for circumcision.Truckers who reported having sex with a man and those who halted regularly at dhabas were significantly more willing to undergo circumcision for HIV prevention (odds ratios 2.7, 95% CI 1.4-5.4 and 2.1, 95% CI 1.3-3.2, respectively). INTERPRETATION & CONCLUSIONS Our findings showed that truckers had low contact with HIV prevention programmes, suggesting a need for urgent measures to reach this population more effectively. The willingness for new HIV interventions was high except for circumcision. These findings could be used for further planning of HIV prevention programmes for truckers in India.
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Affiliation(s)
| | | | | | - John A. Schneider
- University of Chicago, Department of Medicine & Department of Health Studies, Chicago, USA
| | - Lalit Dandona
- Public Health Foundation of India, New Delhi, India,Institute for Health Metrics & Evaluation, University of Washington, Seattle, WA, USA
| | - Lakshmi Vemu
- Department of Microbiology, Nizam's Institute of Medical Sciences, Hyderabad, India
| | - T. Sudha
- Department of Microbiology, Nizam's Institute of Medical Sciences, Hyderabad, India
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Swendeman D. Are mobile phones the key to HIV prevention for mobile populations in India? Indian J Med Res 2013; 137:1024-6. [PMID: 23852282 PMCID: PMC3734706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Dallas Swendeman
- Global Center for Children & Families (GCCF), Center for HIV Identification, Prevention & Treatment Services (CHIPTS), Department of Psychiatry & Biobehavioral Sciences, David Geffen School of Medicine at UCLA, 10920 Wilshire Blvd., Suite 350, Los Angeles, CA 90024, USA
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Hasan AH, Hassan R, Khan ZR, Nuzhat E, Arefin U. Influence of socio-demographic factors on awareness of HIV/AIDS among Bangladeshi garment workers. SPRINGERPLUS 2013; 2:174. [PMID: 23710426 PMCID: PMC3661035 DOI: 10.1186/2193-1801-2-174] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/24/2013] [Accepted: 04/13/2013] [Indexed: 11/10/2022]
Abstract
The study was conducted to assess the level of awareness on HIV/AIDS (Acquired Immune Deficiency Syndrome) and the Influence of different socio-demographic factors among the garment workers in Bangladesh. This cross sectional study was carried out among 303 workers in three selected garment factories in Dhaka city from July 2010 to June 1011. Data were collected by face to face interview through a predesigned questionnaire containing desired information. The majority of workers (76.6%) were within the 17–19 years age group. The female respondents predominated (55.1%). A considerable number of the sample population (39.3%) completed the primary education. But majority belonged to low income group (68.4%), followed by the very low income group (22.4%). Almost everyone (98.3%) except five of the respondents heard the word HIV/AIDS and most of them (90.6%) knew that the disease is transmissible from person to person and mainly by sexual intercourse (78.9%). Only 28.2% had some idea about the sign symptoms of HIV. About (64.4%) thought that persons having heterosexual partners (including prostitutes) are high-risk groups. Though many (74.2%) of the respondents thought that HIV/AIDS is preventable, only 45% said HIV/AIDS is not curable. But 70.5% answered that death is the ultimate fate. The main source of information was radio/TV, newspaper. Unfortunately, 76.9% of the respondents had poor awareness while only 10.6% had good awareness. The level of awareness increased with age (p = <0.05). Though the male were slightly more aware than the female, the relationship is not statistically significant (p= > 0.05). Awareness among S.S.C. passed and above is quite more than the awareness of illiterate (p = <0.01). But there was no relation (p= > 0.05) of level of family income and living pattern with level of awareness. Even being a risk group the garment workers not much aware of HIV/AIDS. The level of awareness increased with age and literacy, which shows the window of opportunity for the policymakers that educational intervention program, may be effective for them.
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Abstract
This paper examines the impact of three components of an HIV prevention program (mid-media, interpersonal communication, and project-run clinics) on consistent condom use by long distance truckers with paid and non-paid female partners in India. Data from 2,723 long distance truckers were analyzed using the propensity score matching approach. Based on utilization of services, the following categories of intervention exposure were derived: no exposure, exposure only to mid-media, exposure only to mid-media and interpersonal communication, exposure only to mid-media and project-run clinics, and exposure to all three intervention components. Compared to those who were not exposed to any intervention, exposure to mid-media alone increased consistent condom use with paid female partners by about ten percent. Exposure to mid-media and visits to project-run clinics increased consistent condom use with non-paid female partners by 26 %. These findings suggest that mid-media events and clinics were the most effective package of services to increase consistent condom use among the long distance truckers.
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Dandona L, Benotsch EG. Evaluation of the Avahan HIV prevention initiative in India. BMC Public Health 2011; 11 Suppl 6:I1. [PMID: 22376043 PMCID: PMC3287546 DOI: 10.1186/1471-2458-11-s6-i1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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