Private providers and HIV testing in Pune, India: challenges and opportunities

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Private providers and HIV testing in Pune, India: challenges and opportunities

KABIR SHEIKH1, SHEELA RANGAN1, KARINA KIELMANN2, SUCHETA DESHPANDE1, VINITA

DATYE1, & JOHN PORTER2

1Maharashtra Association of Anthropological Sciences, Pune, and

2London School of Hygiene and Tropical Medicine,

AIDS Care, August 2005; 17(6): 757_/766

Abstract

We explored HIV testing practices of private medical providers in an

urban Indian setting in Pune, western India. 215 private

practitioners (PPs) and 36 persons-in-charge of private laboratories

were interviewed in separate surveys. 77% of PPs had prescribed HIV

tests and 94% of laboratories had performed HIV tests, or collected

samples for HIV testing. Among those providers who had

prescribed/performed tests, practices which violated national policy

guidelines were found to be common. 55% of PPs and 94% of

laboratories had not prescribed/performed confirmatory HIV tests,

82% of PPs had conducted routine HIV screening tests, 53% of PPs and

47% of laboratories had never counselled patients before testing,

and 39% of laboratories reported breaching confidentiality of

test results. PPs' knowledge about HIV tests was also inadequate,

with 28% of PPs who had prescribed HIV tests being unable to name

the tests they had advised.

Prolific HIV testing in the private medical sector is accompanied by

inappropriate practices and inadequate knowledge, reflecting

deficiencies in the implementation of policy guidelines. The

perspectives and needs of private providers, the major source of

health care in India, need to be acknowledged.

Supportive and regulatory mechanisms can be used to involve private

providers in the delivery of better HIV testing services.

Correspondence: Kabir Sheikh, Department of Public Health and

Policy, London School of Hygiene and Tropical Medicine, Keppel

Street, London WC1E 7HT, UK. Tel: (44) 207 927 2139. E-mail:

kabir.sheikh@...

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