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Kumar P, Das C, Das U, Kumar A, Priyam N, Ranjan V, Sahu D, Rai SK, Godbole SV, Arumugam E, PVM L, Dutta S, Devi HS, Pandey A, Reddy DCS, Mehendale S, Rajan S. Augmenting progress on the elimination of vertical transmissions of HIV in India: Insights from Spectrum-based HIV burden estimations. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0002270. [PMID: 37556441 PMCID: PMC10411776 DOI: 10.1371/journal.pgph.0002270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 07/17/2023] [Indexed: 08/11/2023]
Abstract
The government of India has adopted the elimination of vertical transmission of HIV as one of the five high-level goals under phase V of the National AIDS and STD Control Programme (NACP). In this paper, we present the data from HIV estimations 2021 for India and select States detailing the progress as well as the attributable causes for vertical transmissions. The NACP spearheads work on mathematical modelling to estimate HIV burden based on the periodically conducted sentinel surveillance for guiding program implementation and policymaking. Using the results of the latest round of HIV Estimations in 2021, we analysed the mother-to-child transmission (MTCT) during the perinatal and postnatal (breastfeeding) period. In 2021, overall, around 5,000 [3,000-7,800] vertical transmissions were estimated nationally with 58% being perinatal infections and remaining during breastfeeding. MTCT at 6 weeks was around 12.95% [9.45-16.02] with the final transmission rate at 24.25% [18.50-29.50]. Overall, 57% of vertical transmissions were among HIV-positive mothers who did not receive ART during pregnancy or breastfeeding, 19% among mothers who dropped off ART during pregnancy or delivery, and 18% among mothers who were infected during pregnancy or breastfeeding. There were significant variations between States. Depending upon the States, the programme needs to focus on the intervention domains of timely engagement in antenatal care-HIV testing-ART initiation as well as programme retention and adherence support. Equally important would be strengthening the strategic information to generate related evidence for inputting India and State-specific parameters improving the MTCT-related modelled estimates.
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Affiliation(s)
- Pradeep Kumar
- National AIDS Control Organization, Ministry of Health and Family Welfare, New Delhi, India
| | - Chinmoyee Das
- National AIDS Control Organization, Ministry of Health and Family Welfare, New Delhi, India
| | - Udayabhanu Das
- National AIDS Control Organization, Ministry of Health and Family Welfare, New Delhi, India
| | - Arvind Kumar
- National AIDS Control Organization, Ministry of Health and Family Welfare, New Delhi, India
| | - Nidhi Priyam
- National AIDS Control Organization, Ministry of Health and Family Welfare, New Delhi, India
| | - Varsha Ranjan
- Indian Council of Medical Research, National Institute of Medical Statistics, New Delhi, India
| | - Damodar Sahu
- Indian Council of Medical Research, National Institute of Medical Statistics, New Delhi, India
| | - Sanjay K. Rai
- All India Institute of Medical Sciences, New Delhi, India
| | - Sheela V. Godbole
- Indian Council of Medical Research, National AIDS Research Institute, Pune, India
| | - Elangovan Arumugam
- Indian Council of Medical Research, National Institute of Epidemiology, Chennai, India
| | - Lakshmi PVM
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Shanta Dutta
- Indian Council of Medical Research, National Institute of Cholera and Enteric Diseases, Kolkata, India
| | | | - Arvind Pandey
- Indian Council of Medical Research, National Institute of Medical Statistics, New Delhi, India
- Indian Council of Medical Research, New Delhi, India
| | | | - Sanjay Mehendale
- Indian Council of Medical Research, New Delhi, India
- PD Hinduja Hospital and Medical Research Center, Mumbai, India
| | - Shobini Rajan
- National AIDS Control Organization, Ministry of Health and Family Welfare, New Delhi, India
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2
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Sahu D, Kumar P, Chandra N, Rajan S, Shukla DK, Venkatesh S, Nair S, Kumar A, Singh J, Reddy S, Godbole S, Elangovan A, Saha MK, Rai S, Lakshmi PVM, Gambhir T, Ammassari S, Joshi D, Das A, Bakshi P, Chakraborty S, Palkar A, Singh SK, Reddy DCS, Kant S, Pandey A, Vardhana Rao MV. Findings from the 2017 HIV estimation round & trend analysis of key indicators 2010-2017: Evidence for prioritising HIV/AIDS programme in India. Indian J Med Res 2021; 151:562-570. [PMID: 32719229 PMCID: PMC7602920 DOI: 10.4103/ijmr.ijmr_1619_19] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background & objectives: The National AIDS Control Organisation (NACO) and the ICMR-National Institute of Medical Statistics, the nodal agency for conducting HIV estimations in India, have been generating HIV estimates regularly since 2003. The objective of this study was to describe India's biennial HIV estimation 2017 process, data inputs, tool, methodology and epidemiological assumptions used to generate the HIV estimates and trends of key indicators for 2010-2017 at national and State/Union Territory levels. Methods: Demographic Projection (DemProj) and AIDS Impact Modules (AIM) of Spectrum 5.63 software recommended by the United Nations Programme on HIV and AIDS Global Reference Group on HIV Estimates, Modelling and Projections, were used for generating HIV estimations on key indicators. HIV sentinel surveillance, epidemiological and programme data were entered into Estimation Projection Package (EPP), and curve fitting was done using EPP classic model. Finally, calibration was done using the State HIV prevalence of two rounds of National Family Health Survey (NFHS) -3 and -4 and Integrated Biological and Behavioural Surveillance (IBBS), 2014-2015. Results: The national adult prevalence of HIV was estimated to be 0.22 per cent in 2017. Mizoram, Manipur and Nagaland had the highest prevalence over one per cent. An estimated 2.1 million people were living with HIV in 2017, with Maharashtra estimated to have the highest number. Of the 88 thousand annual new HIV infections estimated nationally in 2017, Telangana accounted for the largest share. HIV incidence was found to be higher among key population groups, especially people who inject drugs. The annual AIDS-related deaths were estimated to be 69 thousand nationally. For all indicators, geographic variation in levels and trends between States existed. Interpretation & conclusions: With a slow decline in annual new HIV infections by only 27 per cent from 2010 to 2017 against the national target of 75 per cent by 2020, the national target to end AIDS by 2030 may be missed; although at the sub-national level some States have made better progress to reduce new HIV infection. It calls for reinforcement of HIV prevention, diagnosis and treatment efforts by geographical regions and population groups.
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Affiliation(s)
- Damodar Sahu
- ICMR-National Institute of Medical Statistics, Chennai, Tamil Nadu, India
| | - Pradeep Kumar
- Division of Strategic lnformation - Surveillance and Epidemiology, National AIDS Control Organisation, Ministry of Health & Family Welfare, Government of India, Chennai, Tamil Nadu, India
| | - Nalini Chandra
- Joint United Nations Programme on HIV/AIDS, New Delhi, India
| | - Shobini Rajan
- Division of Strategic lnformation - Surveillance and Epidemiology, National AIDS Control Organisation, Ministry of Health & Family Welfare, Government of India, Chennai, Tamil Nadu, India
| | - D K Shukla
- ICMR-National Institute of Medical Statistics, Chennai, Tamil Nadu, India
| | - S Venkatesh
- Principal Advisor to Board of Governors, Medical Council of India, New Delhi, India
| | - Saritha Nair
- ICMR-National Institute of Medical Statistics, Chennai, Tamil Nadu, India
| | - Anil Kumar
- ICMR-National Institute of Medical Statistics, Chennai, Tamil Nadu, India
| | - Jitenkumar Singh
- ICMR-National Institute of Medical Statistics, Chennai, Tamil Nadu, India
| | - Srikanth Reddy
- ICMR-National Institute of Medical Statistics, Chennai, Tamil Nadu, India
| | - Sheela Godbole
- ICMR-National AIDS Research Institute, Pune, Maharashtra, India
| | - A Elangovan
- Computing and Information Sciences, ICMR-National Institute of Epidemiology, Chennai, Tamil Nadu, India
| | - M K Saha
- Department of Virology, ICMR-National Institute of Cholera & Enteric Diseases, Kolkata, West Bengal, India
| | - Sanjay Rai
- Centre for Community Medicine, All India Institute of Medical Sciences, Chennai, Tamil Nadu, India
| | - P V M Lakshmi
- Department of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - T Gambhir
- Department of Community Medicine, Regional Institute of Medical Sciences, Imphal, Manipur, India
| | | | | | - Amitabh Das
- Odisha State AIDS Control Society, Bhubaneswar, Odisha, India
| | - Poonam Bakshi
- Chandigarh State AIDS Control Society, Chandigarh, India
| | | | - Amol Palkar
- Mumbai District AIDS Control Society, Maharashtra, India
| | - S K Singh
- Department of Mathematical Demography and Statistics, International Institute for Population Sciences, Mumbai, India
| | - D C S Reddy
- Department of Community Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Shashi Kant
- Centre for Community Medicine, All India Institute of Medical Sciences, Chennai, Tamil Nadu, India
| | - Arvind Pandey
- ICMR-National Institute of Medical Statistics, Chennai, Tamil Nadu, India
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Pandiselvam S, Jena NN, Ghatak‐Roy A, Dreyer N, Naik N, Blanchard J, Davey K. Prevalence of undiagnosed HIV, hepatitis B, and hepatitis C among patients in an Indian emergency department. J Am Coll Emerg Physicians Open 2021; 2:e12328. [PMID: 33521780 PMCID: PMC7819266 DOI: 10.1002/emp2.12328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 11/13/2020] [Accepted: 11/20/2020] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES HIV, hepatitis B, and hepatitis C remain significant causes of morbidity and mortality in low resource settings. Emergency department (ED)-based screening has proven effective in decreasing the spread of undiagnosed disease, although such programs are rare in low-middle income countries. METHODS A prospective, cross sectional study of all adult patients presenting to the ED in a 600-bed teaching hospital in Tamil Nadu, India. This study used an opt-in strategy in which patients were offered testing at the end of their ED visit. Costs of testing were paid out of pocket by patients. Patients with known HIV, hepatitis B, or hepatitis C were excluded from the study. RESULTS During the study period 26,465 patients presented to the ED, and 18,286 patients consented to participate (68.9%). Among the 18,286 patients tested, 174 were positive for either HIV (39, 0.21%), hepatitis C (52, 0.28%), or hepatitis B (83, 0.45%). Three patients tested positive for both HIV and hepatitis C, and 1 patient tested positive for both HIV and hepatitis B. A total of 69.2% of patients with HIV, 61.2% of patients with hepatitis B, and 83% of patients with hepatitis C presented for reasons unrelated to their underlying diagnosis. CONCLUSION Although limited to only 1 hospital in southern India, this study represents the largest ED-based screening program for HIV, hepatitis B, and hepatitis C ever conducted in India or any other low-middle income countries. The majority of patients presented for reasons unrelated to their underlying diagnosis. Future research is needed on implementation strategies, cost feasibility, and linkage to care.
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Affiliation(s)
- Sathishkumar Pandiselvam
- Meenakshi Mission Hospital and Research CenterInstitute of Emergency MedicineMaduraiTamil NaduIndia
| | - Narendra N. Jena
- Meenakshi Mission Hospital and Research CenterInstitute of Emergency MedicineMaduraiTamil NaduIndia
| | - Aditi Ghatak‐Roy
- Department of Emergency MedicineGeorge Washington UniversityWashington DCUSA
| | - Nicholas Dreyer
- Department of Emergency MedicineGeorge Washington UniversityWashington DCUSA
| | - Nehal Naik
- Department of Emergency MedicineGeorge Washington UniversityWashington DCUSA
| | - Janice Blanchard
- Department of Emergency MedicineGeorge Washington UniversityWashington DCUSA
| | - Kevin Davey
- Department of Emergency MedicineGeorge Washington UniversityWashington DCUSA
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Malkani R, Ahuja H, Tare A, Setia MS. Should we start looking at the elderly for human immunodeficiency virus infections? A study of trends of human immunodeficiency virus, hepatitis B virus, and hepatitis C virus in Mumbai, Maharashtra, India. Indian J Sex Transm Dis AIDS 2020; 41:169-175. [PMID: 33817589 PMCID: PMC8000678 DOI: 10.4103/ijstd.ijstd_60_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 09/13/2019] [Accepted: 12/20/2019] [Indexed: 11/04/2022] Open
Abstract
Background There is limited information on the trends of human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) co-infections in India - particularly from private health-care settings. We designed the present research to estimate the prevalence of HIV, HBV, and HCV over a period of 7 years and study the factors associated with them. Materials and Methods The present study is a secondary data analysis of data from the laboratory records of 24,086 individuals who were tested over a period of 7 years (2009-2015). We estimated the proportion and 95% confidence intervals (CIs) for HIV, hepatitis B surface antigen (HBsAg), and HCV antibodies. Results The overall seroprevalence of HIV was 0.35% (95% CI: 0.27%, 0.44%), HBsAg was 1.65% (95% CI: 1.48%, 1.82%), and HCV was 1.73% (95% CI: 1.56%, 1.90%). The prevalence of HIV among those who were more than 70 years of age was 0.14% (95% CI: 0.04%, 0.32%). The prevalence of HBsAg was highest in those aged 30-39 years (2.27%, 95% CI: 1.74%, 2.92%) (P = 0.008). The prevalence of HIV/HBsAg co-infection was 0.019% (95% CI: 0.005%, 0.050%), HIV/HCV co-infection was 0.005% (95% CI: 0.000, 0.027%), and HBsAg/HCV co-infection was 0.059% (95% CI: 0.030%, 0.102%). We did not encounter even a single case of all the three infections. Conclusions HIV infection is relatively high in those who were aged 50 years of more; thus, they need to be included in the National AIDS Control Programme. HIV/HBV/HCV co-infections should be regularly monitored in surveillance programs, and antiretroviral therapy officers and counselors should be trained on the management of HIV in those who are co-infected.
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Affiliation(s)
- Ram Malkani
- Jaslok Hospital and Research Centre, Mumbai, Maharashtra, India
| | - Harish Ahuja
- Department of Immunology, Jaslok Hospital and Research Centre, Mumbai, Maharashtra, India
| | - Aditya Tare
- Department of Immunology, Jaslok Hospital and Research Centre, Mumbai, Maharashtra, India
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Santhakumar A, Mathiyazhakan M, Jaganathasamy N, Ganesh B, Manikandan N, Padmapriya VM, Monika A, David JK, Kumar A, Arumugam E. Prevalence and Risk Factors Associated with HIV Infection among Pregnant Women in Odisha State, India. Int J MCH AIDS 2020; 9:411-420. [PMID: 33163290 PMCID: PMC7604763 DOI: 10.21106/ijma.366] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The purpose of this study was to analyze trends in HIV prevalence and risk factors associated with HIV infection among pregnant women attending antenatal clinics in Odisha State, India. METHODS Data were from the HIV Sentinel Surveillance (HSS) among pregnant women, a descriptive cross-sectional study using consecutive sampling method and conducted in India. Data and samples were collected from pregnant women attending select antenatal clinics that act as designated sentinel sites in Odisha State, India, during the three months surveillance period and in three surveillance years: 2013, 2015, and 2017. All eligible pregnant women aged between 15 and 49 years, attending the sentinel sites for the first time during the surveillance period, were included. Information on their socio-demographic characteristics and blood samples were also collected. RESULTS In total, 38,384 eligible pregnant women were included in the survey. Of these, 107 women were HIV positive, with an overall prevalence of 0.28%. HIV prevalence indicated a stabilizing trend between 2013 and 2017. However, pregnant women whose spouses were non-agricultural laborers, truck drivers, or migrants were significantly at higher risk of being infected. Likewise, HIV prevalence significantly increased over the years among pregnant women whose spouses were in the service sector (government or private). District-wise fluctuations in HIV prevalence was observed, with the district of Cuttack recording the highest prevalence among the districts. CONCLUSION AND GLOBAL HEALTH IMPLICATIONS Women who are spouses of non-agricultural laborers, truck drivers or migrants need focused interventions, such as creating awareness on HIV and its prevention. Migration, due to poverty and its impact on sexually transmitted diseases among migrants from low and middle-income countries, have been documented globally. Single male migrant specific interventions are recommended to halt the disease progression among pregnant women and general population in Odisha, India.
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Affiliation(s)
- Aridoss Santhakumar
- ICMR-National Institute of Epidemiology, R-127, 2 Main Road, TNHB, Ayapakkam, Chennai - 600 077, Tamil Nadu, India
| | - Malathi Mathiyazhakan
- ICMR-National Institute of Epidemiology, R-127, 2 Main Road, TNHB, Ayapakkam, Chennai - 600 077, Tamil Nadu, India
| | - Nagaraj Jaganathasamy
- ICMR-National Institute of Epidemiology, R-127, 2 Main Road, TNHB, Ayapakkam, Chennai - 600 077, Tamil Nadu, India
| | - Balsubramanian Ganesh
- ICMR-National Institute of Epidemiology, R-127, 2 Main Road, TNHB, Ayapakkam, Chennai - 600 077, Tamil Nadu, India
| | - N Manikandan
- ICMR-National Institute of Epidemiology, R-127, 2 Main Road, TNHB, Ayapakkam, Chennai - 600 077, Tamil Nadu, India
| | - V M Padmapriya
- ICMR-National Institute of Epidemiology, R-127, 2 Main Road, TNHB, Ayapakkam, Chennai - 600 077, Tamil Nadu, India
| | - Angel Monika
- ICMR-National Institute of Epidemiology, R-127, 2 Main Road, TNHB, Ayapakkam, Chennai - 600 077, Tamil Nadu, India
| | | | - Arvind Kumar
- National AIDS Control Organization, Ministry of Health Family Welfare, Government of India, 36 Janpath Road, New Delhi-110 001, India
| | - Elangovan Arumugam
- ICMR-National Institute of Epidemiology, R-127, 2 Main Road, TNHB, Ayapakkam, Chennai - 600 077, Tamil Nadu, India
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6
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Arya BK, Bhattacharya SD, Harigovind G, Das RS, Khan T, Ganaie F, Niyogi SK, Ravikumar KL, Manoharan A, Bhattacharyya S, Panda S, Mandal S, Acharya B. Streptococcus pneumoniae Acquisition and Carriage in Vaccine Naïve Indian Children with HIV and their Parents: A Longitudinal Household Study. Indian J Pediatr 2019; 86:1002-1010. [PMID: 31222554 DOI: 10.1007/s12098-019-02995-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 05/22/2019] [Indexed: 02/01/2023]
Abstract
OBJECTIVES To investigate the difference in pneumococcal carriage, acquisition, antibiotic resistance profiles and serotype distribution, in human immunodeficiency virus (HIV) affected and unaffected families. METHODS A prospective cohort study was conducted in children with and without HIV in West Bengal from March 2012 through August 2014, prior to 13-valent pneumococcal conjugate vaccine (PCV-13) immunization. One thousand four hundred forty one nasopharyngeal swabs were collected and cultured at five-time points from children and their parents for pneumococcal culture, and serotyping by Quellung method. RESULTS One hundred twenty five HIV infected children and their parents, and 47 HIV uninfected children and their parents participated. Two hundred forty pneumococcal isolates were found. In children under 6 y, the point prevalence of colonization was 31% in children living with HIV (CLH) and 32% in HIV uninfected children (HUC), p = 0.6. The most common vaccine type (VT) serotypes were 6A, 6B and 19A. All isolates from parents and 71% from children in the HIV uninfected cohort were PCV-13 representative, compared to 33% of isolates from CLH and their parents. Acquisition rate in children was 1.77 times that of parents (OR = 1.77, 95%CI: 1.18-2.65). The HIV status of child or parent did not affect acquisition. Isolates from CLH were more frequently resistant to multiple antibiotics (p = 0.02). CONCLUSIONS While the rate of pneumococcal carriage and acquisition did not differ between CLH and HUC, HIV affected families had exposure to a wider range of serotypes including non-vaccine type serotypes and antibiotic resistant serotypes, than HIV unaffected families.
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Affiliation(s)
- Bikas K Arya
- School of Medical Science & Technology, Indian Institute of Technology-Kharagpur, IIT Kharagpur Campus, Kharagpur, West Bengal, 721302, India
| | - Sangeeta Das Bhattacharya
- School of Medical Science & Technology, Indian Institute of Technology-Kharagpur, IIT Kharagpur Campus, Kharagpur, West Bengal, 721302, India.
| | - Gautam Harigovind
- School of Medical Science & Technology, Indian Institute of Technology-Kharagpur, IIT Kharagpur Campus, Kharagpur, West Bengal, 721302, India
| | - Ranjan S Das
- School of Medical Science & Technology, Indian Institute of Technology-Kharagpur, IIT Kharagpur Campus, Kharagpur, West Bengal, 721302, India
| | - Tila Khan
- School of Medical Science & Technology, Indian Institute of Technology-Kharagpur, IIT Kharagpur Campus, Kharagpur, West Bengal, 721302, India
| | - Feroze Ganaie
- Department of Microbiology, Kempegowda Institute of Medical Sciences, KR Road, VV Puram, Bengaluru, Karnataka, India
| | - Swapan K Niyogi
- National Institute of Cholera and Enteric Diseases (NICED)/Indian Council of Medical Research (ICMR), P- C.I.T. Scheme XM, Beleghata, 33, CIT Rd, Subhas Sarobar Park, Phool Bagan, Beleghata, Kolkata, West Bengal, India
| | - K L Ravikumar
- Department of Microbiology, Kempegowda Institute of Medical Sciences, KR Road, VV Puram, Bengaluru, Karnataka, India
| | - Anand Manoharan
- Medicine Unit I & ID, Christian Medical College & Hospital, Vellore, Ida Scudder Road, Vellore, Tamil Nadu, India.,CHILDS Trust Medical Research Foundation, Chennai, India
| | - Subhasish Bhattacharyya
- Department of Pediatrics, Midnapore Medical College and Hospital, Vidyasagar Road, Paschim Medinipur, Medinipur, West Bengal, India.,Department of Pediatrics College of Medicine and Sagore Dutta Hospital, Kamarhati, Kolkata, India
| | - Samiran Panda
- National Institute of Cholera and Enteric Diseases (NICED)/Indian Council of Medical Research (ICMR), P- C.I.T. Scheme XM, Beleghata, 33, CIT Rd, Subhas Sarobar Park, Phool Bagan, Beleghata, Kolkata, West Bengal, India.,National AIDS Research Institute Pune (NARI/ICMR), Plot No 73, G-block, M I D C, Bhosari, Pune, Maharashtra, India
| | - Sutapa Mandal
- National Institute of Cholera and Enteric Diseases (NICED)/Indian Council of Medical Research (ICMR), P- C.I.T. Scheme XM, Beleghata, 33, CIT Rd, Subhas Sarobar Park, Phool Bagan, Beleghata, Kolkata, West Bengal, India
| | - Banuja Acharya
- School of Medical Science & Technology, Indian Institute of Technology-Kharagpur, IIT Kharagpur Campus, Kharagpur, West Bengal, 721302, India
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Salem BE, Bustos Y, Shalita C, Kwon J, Ramakrishnan P, Yadav K, Ekstrand ML, Sinha S, Nyamathi AM. Chronic Disease Self-Management Challenges among Rural Women Living with HIV/AIDS in Prakasam, Andhra Pradesh, India: A Qualitative Study. J Int Assoc Provid AIDS Care 2019; 17:2325958218773768. [PMID: 29756550 PMCID: PMC6713225 DOI: 10.1177/2325958218773768] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Rural women living with HIV/AIDS (WLHA) in India experience challenges self-managing HIV/AIDS in their rural communities. The purpose of this qualitative study was to explore factors influencing their care and antiretroviral treatment (ART) adherence. Themes that emerged from the qualitative focus groups among WLHA (N = 24) in rural Prakasam, Andhra Pradesh, India, included: (1) coming to know about HIV and other health conditions, (2) experiences being on ART, (3) challenges maintaining a nutritious diet, (4) factors affecting health care access and quality, and (5) seeking support for a better future. Chronic disease self-management in rural locales is challenging, given the number of barriers which rural women experience on a daily basis. These findings suggest a need for individual- and structural-level supports that will aid in assisting rural WLHA to self-manage HIV/AIDS as a chronic illness.
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Affiliation(s)
- Benissa E Salem
- 1 School of Nursing, University of California, Los Angeles, Los Angeles, CA, USA
| | - Yvita Bustos
- 1 School of Nursing, University of California, Los Angeles, Los Angeles, CA, USA.,2 Psychology Department, Loyola University, Chicago, IL, USA
| | - Chidyaonga Shalita
- 1 School of Nursing, University of California, Los Angeles, Los Angeles, CA, USA.,3 Biology Department, Macalester College, Forest Lake, MN, USA
| | - Jordan Kwon
- 1 School of Nursing, University of California, Los Angeles, Los Angeles, CA, USA.,4 School of Nursing, Azusa Pacific University, Montebello, CA, USA
| | | | - Kartik Yadav
- 6 School of Nursing, University of California, Irvine, Irvine, CA, USA
| | - Maria L Ekstrand
- 7 University of California, San Francisco School of Medicine, San Francisco, CA, USA
| | - Sanjeev Sinha
- 8 All India Institute of Medical Sciences (AIIMS), Ansari Nagar, New Delhi, India
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Ghys PD, Williams BG, Over M, Hallett TB, Godfrey-Faussett P. Epidemiological metrics and benchmarks for a transition in the HIV epidemic. PLoS Med 2018; 15:e1002678. [PMID: 30359372 PMCID: PMC6201869 DOI: 10.1371/journal.pmed.1002678] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Peter Godfrey-Faussett and colleagues present six epidemiological metrics for tracking progress in reducing the public health threat of HIV.
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Affiliation(s)
- Peter D. Ghys
- Joint United Nations Programme on HIV/AIDS, Geneva, Switzerland
| | - Brian G. Williams
- South Africa Centre for Epidemiological Modelling and Analysis, Stellenbosch, South Africa
| | - Mead Over
- Center for Global Development, Washington, DC, United States of America
| | - Timothy B. Hallett
- Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom
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