Profile of adults seeking voluntary HIV testing in rural India

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Profile of adults seeking voluntary HIV testing and counseling in rural Central

India: results from a hospital-based study

Authors: Pai, Nitika Pant1; Joshi, Rajnish2; Moodie, a3; Taksande, Bharati4;

Kalantri, S. P.4; Pai, Madhukar5; Tulsky, 6; Reingold, Arthur5

Source: AIDS Care, Volume 21, Number 3, March 2009 , pp. 294-300(7)

Abstract:

Rural India has an undetected load of HIV-positive individuals. Few rural adults

present for HIV testing and counseling due to stigma, discrimination, and fear

of social ostracization. In this rural hospital clinic-based study, we document

profiles of rural adults seeking voluntary testing and counseling, and analyze

correlates of HIV seropositivity.

This cross-sectional study was conducted in 450 participants presenting to the

outpatient clinics of Mahatma Gandhi Institute of Medical Sciences, Sevagram,

Central India. After informed consent, pre- and post-test counseling, HIV

testing, and face-to-face interviews were conducted. Data were collected using a

structured questionnaire.

The median age of the 450 study participants was 34 years (range 18-88 years);

the majority (74%) was married. The overall proportion of HIV seropositivity was

32% [95% CI 28%, 37%]. The proportions of HIV seropositivity in married women,

married men, and single men were 41%, 37%, 18%, respectively. No single woman

was found seropositive in the study.

Very few married women were aware of their husbands' HIV status. In a

multivariate analysis, correlates of HIV seropositivity in men were: age 30-39

years, being married, having sex with multiple partners, use of alcohol before

sex, and testing positive for HIV in the past.

In married women, the only predictor of seropositivity was being married.

Although limited by the non-random nature of the sampling method, this pilot

study is unique in that it is the first from this rural region of Central India.

It provides baseline data on marginalized, largely unstudied populations that

may aid in designing probabilistic community-based surveys in this neglected

population.

Affiliations: 1: Division of Infectious Diseases and Immunodeficiency Service,

Montreal Chest Institute, Montreal, Canada 2: Department of Medicine, Mahatma

Gandhi Institute of Medical Sciences, Sevagram, India,University of California,

Berkeley, CA, USA 3: Department of Epidemiology & Biostatistics, McGill

University, Montreal, Canada 4: Department of Medicine, Mahatma Gandhi Institute

of Medical Sciences, Sevagram, India 5: University of California, Berkeley, CA,

USA 6: University of California, San Francisco, CA, USA