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Mandal B, Pradhan KC, Mohanty P, Muhammad T. Migration status, physical limitations and associated self-rated health: a study of older Indian adults. BMC Geriatr 2023; 23:316. [PMID: 37217859 DOI: 10.1186/s12877-023-04002-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 04/25/2023] [Indexed: 05/24/2023] Open
Abstract
BACKGROUND Migrant status with mobility impairment becomes a double burden for health and wellbeing of older adults. This study examined the independent relationships and multitude effects between migrant status, functional and mobility impairments and poor self-rated health (SRH) among older Indian adults. METHODS This study utilised nationally representative Longitudinal Ageing Study in India wave-1 (LASI) data, including a sample of 30,736 individuals aged 60 years and above. The main explanatory variables were migrant status, difficulty in activities of daily living (ADL), difficulty in instrumental activities of daily living (IADL) and mobility impairments; and the outcome variable was poor-SRH. Multivariable logistic regression and stratified analyses were used to fulfil the study objectives. RESULTS Overall, about 23% of older adults reported poor-SRH. Reporting poor-SRH was more prevalent (28.03%) among recent migrants (less than ten years). The prevalence of reporting poor-SRH was significantly higher among older adults who had mobility impairment (28.65%), difficulty in ADL or IADL (40.82% & 32.57%). Migrant older adults (regardless of duration) who had mobility impairment had significantly greater odds of reporting poor-SRH compared with non-migrant older adults who did not have mobility impairment. Similarly, older respondents who had problems in ADL and IADL with migration status had higher odds of reporting poor-SRH than their non-migrant counterparts with no such problems. CONCLUSIONS The study revealed the vulnerability of migrant older adults with functional and mobility disability, as well as those with limited socioeconomic resources and suffering from multimorbidity on rating their perceived health. The findings can be utilised to target outreach programmes and provision of services for migrating older individuals with mobility impairments and enhance their perceived health and ensure active ageing.
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Affiliation(s)
- Bittu Mandal
- School of Humanities and Social Sciences, Indian Institute of Technology Indore, Khandwa Road, Simrol, 453552, Indore, India.
| | - Kalandi Charan Pradhan
- School of Humanities and Social Sciences, Indian Institute of Technology Indore, Khandwa Road, Simrol, 453552, Indore, India
| | - Parimala Mohanty
- Institute of Medical Sciences & Sum Hospital, Siksha "O" Anusandhan, Bhubaneswar, 751030, Odisha, India
| | - T Muhammad
- Department of Family & Generations, International Institute for Population Sciences, Mumbai, 400088, Maharashtra, India
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Bhat R, Sudhakar K, Kurien T, Rao ASRS. Strengthening India’s Response to HIV/AIDS Epidemic Through Strategic Planning, Innovative Financing, and Mathematical Modeling: Key Achievements over the Last 3 Decades. J Indian Inst Sci 2022; 102:791-809. [PMID: 36093271 PMCID: PMC9449298 DOI: 10.1007/s41745-022-00331-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Accepted: 07/25/2022] [Indexed: 11/30/2022]
Abstract
Indian HIV/AIDS numbers during the 2000s did not reach the high proportion of estimations provided by the WHO and UNAIDS. The number of HIV infections was high around 2.4 million in the 2020s, but given the country’s population of 1.38 billion, the general positivity rate remained very low compared with several countries. There were several reasons for a successful control of the epidemic in India, for example, setting-up of the National AIDS Control Programs, strategic priorities, surveillance and data management, mathematical modeling, and coordinating with the civil society and galvanizing public response. In this review article, we will provide a recollection of India’s response and management of the HIV/AIDS epidemic, challenges, and successful model building, and future challenges that play important role in sustaining the epidemic at a lower level and plan for reducing the future transmissions.
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Affiliation(s)
| | | | - Thomas Kurien
- Pondicherry Institute of Medical Sciences, Kalapet, Pondicherry India
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Krishnamoorthy Y, Majella MG, Rajaa S, Bharathi A, Saya GK. Spatial pattern and determinants of HIV infection among adults aged 15 to 54 years in India - Evidence from National Family Health Survey-4 (2015-16). Trop Med Int Health 2021; 26:546-556. [PMID: 33449438 DOI: 10.1111/tmi.13551] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To assess the spatial pattern and determinants of HIV infection in India. METHODS We conducted a secondary data analysis using the National Family Health Survey-4 data obtained from the Demographic Health Survey programme. We accounted for clustering and stratification in the sampling design using the svyset command. Spatial analysis was performed by generating the Moran's I statistic and local indicators for spatial association (LISA) maps. Logistic regression was performed to identify the determinants of HIV infection. RESULTS 230 213 individuals were included. Prevalence of HIV infection in India was 0.24% (95% CI: 0.21%-0.28%). Being separated/widowed/divorced (aOR = 2.58, 95% CI: 1.22-5.40), living in an urban area (aOR = 2.46, 95% CI: 1.79-3.37), being resident in the North-Eastern (aOR = 4.25, 95% CI: 2.60-6.93), Southern (aOR = 3.13, 95% CI: 1.99-4.91) or Western region (aOR = 2.17, 95% CI: 1.08-4.33), having a history of multiple sexual partners (aOR = 1.99, 95% CI:1.42-2.79), a suspected STI (aOR = 2.32, 95% CI: 1.38-3.90) or self-reported TB (aOR = 7.80, 95% CI: 2.52-24.05) were significantly in association with HIV infection. Moran's I was 0.377, suggesting positive spatial autocorrelation. The LISA cluster map indicated 60 hotspot districts in India, mostly in southern states such as Karnataka, Andhra Pradesh and Telangana followed by north-eastern states such as Nagaland, Manipur, Mizoram, Tripura and Assam. CONCLUSION HIV infection among adults aged 15-54 years in India is spatially clustered with the majority occurring in southern and north-eastern states. Hence, region- or district-specific strategies with focused interventions should be adopted.
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Affiliation(s)
- Yuvaraj Krishnamoorthy
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Marie Gilbert Majella
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Sathish Rajaa
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Arivarasan Bharathi
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Ganesh Kumar Saya
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
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Pei R, Ji-Ke C, Yu G, Yang Y, Nan L, Liao Q, Wang J, Liu D, Yang S. Sexual behaviors related to HIV infection in Yi women of childbearing age in rural areas of southwest China. AIDS Care 2020; 32:1388-1392. [PMID: 32583673 DOI: 10.1080/09540121.2020.1784445] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Liangshan Prefecture, the highest HIV-affected epidemic region in China, has more than 2.5 million Yi people. We firstly investigated the sexual behaviors and the related social determinants of health for HIV infection in Yi women of childbearing age in this area. A total of 800 Yi women of childbearing age were enrolled. Path analysis of the risk factors revealed that casual sex (0.152) and number of sex partners (0.152) were directly associated with HIV infection. Furthermore, education level (0.057), out-migrating for work (0.032), sense of self-worth (0.024) and number of sex partners (0.079) were indirectly related to HIV infection and mediated by casual sex and multiple sexual partners. The epidemic of HIV infection among Yi women of childbearing age in Liangshan Prefecture is serious, future promotion should increase their knowledge about condom and modify their perceptions of sexual behaviors.
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Affiliation(s)
- Rong Pei
- Sichuan University of Arts and Science, Dazhou, People's Republic of China.,West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Chunnong Ji-Ke
- Liangshan Center for Disease Control and Prevention, Xichang, People's Republic of China
| | - Gang Yu
- Liangshan Center for Disease Control and Prevention, Xichang, People's Republic of China
| | - Yihui Yang
- Sichuan Center for Disease Control and Prevention, Chengdu, People's Republic of China
| | - Lei Nan
- Liangshan Center for Disease Control and Prevention, Xichang, People's Republic of China
| | - Qiang Liao
- Liangshan Center for Disease Control and Prevention, Xichang, People's Republic of China
| | - Ju Wang
- Liangshan Center for Disease Control and Prevention, Xichang, People's Republic of China
| | - Danping Liu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Shujuan Yang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, People's Republic of China.,International Initiative on Spatial Lifecourse Epidemiology (ISLE), Hong Kong, People's Republic of China
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Ferrandiz-Mont D, Chiao C. Is left-behind status related to differences in sexual health of Armenian mothers? Evidence from the Demographic and Health Survey in 2010 and 2015. PLoS One 2020; 15:e0228344. [PMID: 32012185 PMCID: PMC6996842 DOI: 10.1371/journal.pone.0228344] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Accepted: 01/13/2020] [Indexed: 11/28/2022] Open
Abstract
Background Migration caused by poverty is a growing public health issue around the world. Migrants are at heightened risk of HIV/STIs and yet the vulnerability to poor sexual health of their left-behind partners, in relation to their household wealth, remain understudied. This investigation examines differences in sexual health from 2010 to 2015 among Armenian mothers, with a specific focus on their left-behind migration status and household wealth. Methods and findings Using the population-based Demographic and Health Surveys from Armenia, multilevel logistic models were used to examine the various relationships between sexual health, left-behind status, and household wealth. The multivariate analysis results showed that self-reported sexually transmitted infection (STI) symptoms (AOR = 1.45; p<0.01) and intimate partner violence (IPV) (AOR = 1.45; p<0.01) increased from 2010 to 2015; furthermore, negotiation power over sex (AOR = 0.77; p<0.01) declined among Armenian mothers. Left-behind mothers (LBMs) were more likely to report STI symptoms than their non-LBM counterparts (AOR = 1.61; p<0.01). In addition, significant differences in sexual health between LBMs and non-LBMs with different levels of household wealth were observed. The poorest wealth quintiles were associated with a higher likelihood of self-reported STI symptoms (AOR = 1.74; p<0.05) and IPV (AOR = 1.78; p<0.01), as well as a lower likelihood of utilizing HIV testing (AOR = 0.48; p<0.01) and negotiating power over sex (AOR = 0.47; p<0.01). Conclusions This study strives to fill gaps in the literature related to the relationship between left-behind status, household wealth, and sexual health among Armenian mothers in a context of economic expansion. Among these mothers, poor sexual health outcomes increased from 2010 to 2015. Both low household wealth and a left-behind status were associated with adverse sexual health outcomes. These findings suggest future campaigns aimed at improving the sexual health of Armenian mothers need to be migration-status appropriate and socioeconomic-sensitive.
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Affiliation(s)
- David Ferrandiz-Mont
- Institute of Public Health, International Health Program, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Chi Chiao
- Institute of Health and Welfare Policy, Institute of Public Health, School of Medicine, National Yang-Ming University, Taipei, Taiwan
- * E-mail:
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Joshi RK, Mehendale SM. Determinants of consistently high HIV prevalence in Indian Districts: A multi-level analysis. PLoS One 2019; 14:e0216321. [PMID: 31063471 PMCID: PMC6504102 DOI: 10.1371/journal.pone.0216321] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Accepted: 04/19/2019] [Indexed: 01/12/2023] Open
Abstract
INTRODUCTION Factors associated with persistently high Human Immunodeficiency Virus (HIV) prevalence levels in several districts of India are not well understood. This study was undertaken to determine the association of socio-demographic characteristics, economic factors, awareness about HIV and Sexually Transmitted Infections (STIs), and condom use with consistently high HIV prevalence in the Indian districts and to ascertain whether these associations differed across various regions of India. METHODS This study was carried out including all 640 districts of India. Secondary analysis of data obtained from the Census of India-2011, HIV Sentinel Surveillance in India and District Level Household Survey-III was done. Population profile, socio-economic characteristics, levels of HIV/STI/condom awareness and condom use, were compared between the districts with and without consistently high HIV prevalence. Due to the presence of collinearity among predictor variables, we used principal component analysis and the principal component scores were included as covariates for further analysis. Considering the districts at level 1 and the regions at level 2, multi-level analysis was done by generalised linear mixed models. Variance partition coefficient and median odds ratio were also calculated. RESULTS Sixty-three districts with consistently high HIV prevalence were found clustered in the South and the North-east regions of India. Population size, density and urbanisation were found to be positively associated with consistently high HIV prevalence in these districts. Higher levels of literacy, better socio-economic status, higher proportion of population in reproductive age group and late marriages were positively associated with consistently high HIV prevalence in all regions of India except in the Southern region. Higher levels of knowledge about the role of condoms in HIV prevention and condom use were associated with low HIV prevalence at the district level. CONCLUSIONS Considerable heterogeneity among factors associated with consistently high HIV prevalence at the district level in different regions of India necessitates special region-specific strategies for HIV control. Increasing awareness about HIV alone is not sufficient for controlling the HIV epidemic and there is a need to raise knowledge levels about preventive measures against HIV and promote the use of condoms amongst population.
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Affiliation(s)
- Rajneesh Kumar Joshi
- Symbiosis International University, Pune, India
- National AIDS Research Institute (ICMR), Pune, India
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Fehrenbacher AE, Chowdhury D, Jana S, Ray P, Dey B, Ghose T, Swendeman D. Consistent Condom Use by Married and Cohabiting Female Sex Workers in India: Investigating Relational Norms with Commercial Versus Intimate Partners. AIDS Behav 2018; 22:4034-4047. [PMID: 30006793 DOI: 10.1007/s10461-018-2219-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
This study examines determinants of consistent condom use (CCU) among married and cohabiting female sex workers (FSW) in India. Although CCU with clients is normative in the study area, most FSW do not consistently use condoms with intimate partners. Multiple logistic regression models indicated that condom use with intimate partners was associated with relationship status, cohabitation, HIV knowledge, STI symptoms, and being offered more money for sex without a condom by clients. Additionally, more days of sex work in the last week, serving as a peer educator, and participating in community mobilization activities were associated with higher odds of CCU across all partner types. Although improving economic security may increase CCU with clients, mobilization to reduce stigma and promote disclosure of sex work to non-cohabiting partners may be necessary to increase CCU overall.
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Affiliation(s)
- Anne E Fehrenbacher
- Department of Psychiatry & Biobehavioral Sciences, Semel Institute, University of California, Los Angeles, 10920 Wilshire Blvd., Suite 350, Los Angeles, CA, 90024, USA
| | - Debasish Chowdhury
- Public Health Foundation of India (PHFI), Sector-44, Plot No-47, Gurgaon, 122003, India
| | - Smarajit Jana
- Sonagachi Research & Training Institute, Durbar Mahila Samanwaya Committee, 12/5 Nilmoni Mitra Street, Kolkata, West Bengal, India
| | - Protim Ray
- Sonagachi Research & Training Institute, Durbar Mahila Samanwaya Committee, 12/5 Nilmoni Mitra Street, Kolkata, West Bengal, India
| | - Bharati Dey
- Durbar Mahila Samanwaya Committee, 12/5 Nilmoni Mitra Street, Kolkata, West Bengal, India
| | - Toorjo Ghose
- School of Social Policy & Practice, University of Pennsylvania, 3701 Locust Walk, Caster D17, Philadelphia, PA, 19104, USA
| | - Dallas Swendeman
- Department of Psychiatry & Biobehavioral Sciences, Semel Institute, University of California, Los Angeles, 10920 Wilshire Blvd., Suite 350, Los Angeles, CA, 90024, USA.
- University of California Global Health Institute's Center of Expertise in Women's Health, Gender, and Empowerment, 550 16th Street, 3rd Floor, San Francisco, CA, 94158, USA.
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Kusuma YS, Babu BV. Migration and health: A systematic review on health and health care of internal migrants in India. Int J Health Plann Manage 2018; 33:775-793. [PMID: 30074640 DOI: 10.1002/hpm.2570] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Accepted: 06/14/2018] [Indexed: 01/20/2023] Open
Abstract
The objective of this paper is to review published studies on various health conditions and health care access of internal migrants in India. The guidelines under PRISMA Statement for Reporting Systematic Reviews and Meta-Analysis were followed. We searched 3 databases-Web of Science, Medline (PubMed), and Google Scholar. By applying selection criteria, we identified a total of 42 papers to include in the review. These studies reported various health problems/morbid conditions, and some studies reported health care access. Major health issues of poor migrants included work-related injuries, noncommunicable diseases like diabetes and hypertension, and communicable diseases like malaria and HIV. In addition, behavioural risks such as the use of tobacco and alcohol are reported. Information on health care seeking and poor access to government health care system are available. This review demonstrates the need to improve the health status and health care access of poor migrants. As health systems-related factors also influence the health care seeking behaviour, they are to be considered along with improving the living conditions of this population. Thus, a comprehensive migrant-sensitive health care should be the part of the urban health care system.
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Affiliation(s)
- Yadlapalli S Kusuma
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Bontha V Babu
- Division of Socio-Behavioural & Health Systems Research, Indian Council of Medical Research, New Delhi, India
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