WHARF Presentations at the Mexico AIDS Conference

[Guest guest]

Dear FORUM,

WHARF, had presented this data at the recently concluded International

AIDS conference in Mexico-published in the proceedings of the

conference.

Dr Deepak Batura

Receptiveness to HIV counselling and testing during antenatal care

amongst Mumbai women

D. Batura1, K. D'Souza1, C. Kushwah1, D. Dongaonkar1, R. Powrie2, H.J.

Makadon2

1Wockhardt- Harvard Medical International HIV/AIDS Education and

Research Foundation (WHARF), Mumbai, India, 2Wockhardt- Harvard Medical

International HIV/AIDS Education and Research Foundation (WHARF),

Boston, United States

Background: Evaluating and improving receptiveness to HIV counselling

and testing during antenatal care.

Methods: First visit antenatal women attending a municipal hospital in

Mumbai were surveyed. Recruitment was by consecutive consenting

sampling. Questionnaires were administered orally in vernacular.

Results: 169 pregnant women with a mean age of 25.8 years [sD±5.4]

enrolled. 95.9% were married, 88.2% were housewives. Median gestational stage

was 7 months; 62.1% had had 1-4 previous pregnancies; and 61.5% would return for

further antenatal care.

Mean education was 5.9 years [sD ± 3.8 years]; 58.6% had heard of

HIV/AIDS, 49.7% about sexual transmission, 26% about blood transmission, 39.1 %

knew of ART but only 18.3% knew about Mother to Child Transmission [MTCT]. 40.8%

had undergone previous HIV testing. However, a large percentage [50.3%] refused

to test, most frequently because of the need to consult family heads [33.7%].

Education level correlated positively with willingness to test

[spearman's ratio (rs) 0.315]. Most respondents dependent on family

consent were uneducated. Knowledge of MTCT and education correlated

poorly [rs 0.151]. This notwithstanding, uneducated women had least

knowledge of MTCT.

The number of pregnancies and knowledge of MTCT correlated positively

[rs 0.213], likewise knowledge of MTCT and willingness to undergo

testing [rs 0.213].

Conclusions: MTCT awareness was very low, irrespective of education.

Instead, MTCT knowlege increased with the number of pregnancies,

presumably due to greater contact with healthcare.

Refusal to test was high, especially during first pregnancies and among least

educated women, for whom testing decisions were dependent on family heads.

Expectedly, greater MTCT knowledge led to increased

willingness to test.

Late timing of the first antenatal visit and reluctance towards return

visits compounds the difficulty in providing post test counselling and

timing preventive therapy.

Findings indicate the need to improve MTCT awareness. Counselling should factor

education level and the powerlessness of many to make choices. Encouraging

family heads to accompany is crucial.

_____________________________

Identifying preparedness and bringing HIV/AIDS education to the

clinicians and people of District India

D. Batura1, H.J. Makadon2, R. Nair1, L. Varghese1

1Wockhardt- Harvard Medical International HIV/AIDS Education and

Research Foundation (WHARF), Mumbai, India, 2Wockhardt- Harvard Medical.

International HIV/AIDS Education and Research Foundation (WHARF), Boston, United

States

Issues: Bringing comprehensive HIV/AIDS education to the district level in

India.

Description: Aurangabad, a central India district with a large

industrial base and migrant labour population, is at high-risk for

HIV/AIDS. To understand awareness and attitudes towards HIV/AIDS amongst the

community and their doctors, our study sampled 10,000 people in both rural and

urban areas and 1,000 allopathic doctors (700 urban, 300 rural). Jan Shikshan

Sansthan, a Human Resources Development Ministry organisation, helped conduct

the survey.

Lessons learned: Whilst 85% of community respondents had heard about

HIV/AIDS, 22% were unaware that it can be life threatening, 49% felt

that it could be cured, and 38% believed that HIV was not sexually

transmitted; misconceptions that can lead to High Risk Behaviour .

Approximately 25% were unaware of vertical transmission, 40% felt HIV

could spread through mosquitoes eand 55% felt that sharing food with

positive people could cause transmission.

Amongst doctors, only 22% would see HIV+ patients and 26% felt they

should charge PLHA extra. About 38 % felt that PLHA should be segregated and 44%

believed they could contract HIV/AIDS from their patients. Merely 15% knew that

monotherapy is not an accepted form of ART, 71% opined that PEP could be

administered more than 72 hours after viral exposure and nearly 60% believed

that abortion was the only option for HIV+ pregnant women. About 42% had updated

themselves on the disease through self-learning, 65% had not received any formal

training and 76% wanted additional information and training.

Next steps: In partnership with Aurangabad Network of Positive People,

our Indian and Boston faculty have started prevention awareness,

destigmatising and treatment preparedness programs to educate the

community, industrial workers, their families and college students.

Simultaneously, we have begun training clinicians in the holistic

treatment and care of PLWHA. These programs are planned on a sustainable basis.

Deepak Batura

E-MAIL: <d_batura@...>