320 results
Search Results
2. Revolutionizing HIV-1 Viral Load Monitoring in India: The Potential of Dried Blood Spot Analysis for Expanding Access and Improving Care.
- Author
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Chandane Tak, Madhuri, Vaidyanathan, Anuradha, and Mukherjee, Anupam
- Subjects
PREVENTION of infectious disease transmission ,DIAGNOSIS of HIV infections ,HIV prevention ,PUBLIC health surveillance ,REVERSE transcriptase polymerase chain reaction ,HEALTH services accessibility ,DNA ,VIRAL load ,POINT-of-care testing ,BLOOD collection ,PUBLIC health ,RNA ,TREATMENT failure ,QUALITY assurance ,HIV ,RESOURCE-limited settings - Abstract
India continues to grapple with a significant burden of HIV infections. Despite notable progress in prevention and treatment efforts, multiple challenges, such as high-risk populations, inadequate testing facilities, and limited access to healthcare in remote areas, persist. Though the Government of India offers HIV-1 plasma viral load testing at various medical centers, aiding treatment decisions and monitoring antiretroviral therapy effectiveness, enhancing care for individuals living with HIV under the National AIDS Control Program (NACP), the nation's large population and diverse demographics further complicate its outreach and response. Hence, strategic interventions and alternative methods of testing remain crucial to curbing HIV transmission and improving the quality of life for those affected. Dried blood spot (DBS) sampling has emerged as a convenient and cost-effective alternative for HIV-1 viral load testing, revolutionizing the landscape of diagnostic and monitoring strategies for HIV infection. Though the plasma-based viral load remains the gold standard for monitoring HIV-1, DBS-based HIV-1 viral load testing holds immense promise for improving access to care, particularly in resource-limited settings where traditional plasma-based methods may be logistically challenging. DBS entails the collection of a small volume of blood onto filter paper, followed by drying and storage. This approach offers numerous advantages, including simplified sample collection, transportation, and storage, reducing the need for cold-chain logistics. Recent studies have demonstrated the feasibility and accuracy of DBS-based HIV-1 viral load testing, revealing a strong correlation between DBS and plasma measurements. Its implementation can enhance the early detection of treatment failure, guide therapeutic decisions, and ultimately contribute to better clinical outcomes for HIV-infected individuals. Hence, this review explores the principles, advancements, feasibility, and implications of DBS-based HIV-1 viral load testing. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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3. Syndemic effect of COVID-19 outbreak on HIV care delivery around the globe: A systematic review using narrative synthesis.
- Author
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Chakrabarti, Rohini, Agasty, Debdutta, Majumdar, Agniva, Talukdar, Rounik, Bhatta, Mihir, Biswas, Subrata, and Dutta, Shanta
- Subjects
HEALTH services accessibility ,SYNDEMICS ,HIV-positive persons ,MEDICAL care ,HIV infections ,SOCIAL change ,DESCRIPTIVE statistics ,WORLD health ,SYSTEMATIC reviews ,MEDLINE ,ONLINE information services ,QUALITY assurance ,COUNSELING ,PUBLIC health ,COVID-19 pandemic ,AIDS - Abstract
Background: The burden of the COVID-19 pandemic on healthcare systems worldwide has been compromising the progress made in the fight against HIV. This paper aims to determine how the COVID-19 pandemic has impacted HIV comprehensive care service delivery globally as well as to consolidate the evidence and recommendations that may be useful in averting future crisis. Methods: This review adheres to PRISMA guidelines. PubMed, DOAJ, Science Direct and other sources like Google Scholar and citations from included studies were searched methodically to locate studies evaluating the effects of COVID on services for HIV care. The NIH and JBI quality assessment tools were used for the quality assessment of individual studies. Results: In the present review 31 eligible studies were included and the impact on HIV care cascade were summarised under six themes: Lab services, Treatment and allied services, Counselling services, Outreach services, Psycho-social impact and Implementation of sustainable strategies. The studies also presented many innovative alternatives which were lucidly highlighted in the present article. Conclusion: Current evidence depicts multiple factors are responsible for the interruption of HIV care service delivery during the pandemic, especially in low resources settings. The prospective, alternative solutions that have been used to circumvent the threat have also been addressed in this review, in addition to the negative aspects that have been observed. Transition with new innovative, sustainable care paradigms may prove to be the building blocks in removing HIV-AIDS as a public health threat. Registration: Open Science Framework (DOI: 10.17605/OSF.IO/74GHM). [ABSTRACT FROM AUTHOR]
- Published
- 2023
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4. Prevalence of HIV among inmates in four states of north India: findings from the 16th round of HIV sentinel surveillance.
- Author
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Jha, Shreya, Kant, Shashi, Thakur, Nishakar, Kumar, Pradeep, Rai, Sanjay, Haldar, Partha, Kardam, Priyanka, Misra, Puneet, Goswami, Kiran, and Rajan, Shobini
- Subjects
HIV ,HIV infections ,SEX workers ,AIDS ,SEX industry - Abstract
Purpose: Prisoners are at a higher risk of HIV infection compared to the general population. The purpose of this study is to estimate the prevalence of HIV and related risk behaviours among inmates of the Central Prisons in four states of North India. Design/methodology/approach: The HIV sentinel surveillance was conducted in seven Central Prisons in four states of North India from February to April 2019. Four hundred inmates were included from each prison. The interviews were conducted at the Integrated Counselling and Testing Centre located within the prison premises. The Ethics Committee of the National AIDS Control Organization, New Delhi, granted ethical approval before the start of the surveillance. Findings: Overall, 2,721 inmates were enrolled in this study. The mean (SD) age was 38.9 (13.9) years. One-third of prison inmates had comprehensive knowledge about HIV/AIDS. The proportion of convict (54%) and undertrial (46%) inmates was almost equal. The overall prevalence of HIV infection among inmates was 0.96% (95% CI 0.65–1.40). The odds of being HIV positive were significantly higher in never married inmates, undertrials, inmates who were in the prison for more than three months to one year, inmates incarcerated for multiple times, inmates with history of injecting drug use and inmates with history of intercourse with a commercial sex worker. Originality/value: The findings from the very first HIV sentinel surveillance in central prisons in North India have been presented in this paper. This has huge implications for future policy decisions. [ABSTRACT FROM AUTHOR]
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- 2023
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5. Toward Transnational Feminist Methodologies in Global Health: Critical Ethnographies of HIV and Abortion.
- Author
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Suh, Siri and Vijayakumar, Gowri
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WORLD health ,FEMINISTS ,FEMINISM ,HIV prevention ,ABORTION ,HIV - Abstract
Unlike prevailing research methodologies in the interdisciplinary field of global health, feminist methodologies allow researchers to unsettle the premises and assumptions of the field. This paper describes how we mobilize transnational feminist ethnography in our research on HIV in India and postabortion care in Senegal. Transnational feminist perspectives enable us to re-embed HIV prevention and post-abortion care in the politics of gender and sexuality and in postcolonial histories of health governance. They consider the role of gender and sexuality not just in terms of gendered health inequalities, but also in terms of how global health problems are defined, managed, measured, and contested. We outline how our projects put this lens into practice by pushing the methodological boundaries of time, scale, and scope and through a historicized, multisited, and multiscalar approach that triangulates multiple sources of data. Feminist ethnography requires that we turn the critical gaze upon ourselves, reflecting on multiple and shifting personal and professional positionalities during and after fieldwork and our ethical commitments to our interlocutors. While acknowledging the significant personal, institutional, and professional challenges of using feminist methodologies, especially given the dominant modes of research in global health, we urge greater consideration, among both advanced and early scholars, of the possibilities they offer for studying global health problems. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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6. Infections averted by a comprehensive HIV prevention intervention and its cost-effectiveness: a prospective cohort study of persons who inject drugs in Delhi, India.
- Author
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Saraswati, Lopamudra Ray, Dasgupta, Aparajita, Gupta, Indrani, Pulerwitz, Julie, and Sarna, Avina
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HIV prevention ,COST effectiveness ,HIV infections ,COHORT analysis ,LONGITUDINAL method - Abstract
This paper presents the cost-effectiveness of a WHO-recommended harm-reduction programme implemented among a cohort of persons who inject drugs in Delhi, India. We estimate the number of infections averted using Bernoulli process model and calculate cost-effectiveness ratio as the total programme cost per infection averted. The intervention averted 996 HIV infections over 36 months, with a cost-effectiveness ratio of INR 24,763 (US$ 476) per infection averted per year. The first phase, when HIV testing and counselling were initiated, was more cost-effective than the second phase when full intervention package, including needle-syringe exchange, condom distribution, harm-reduction education, etc., was implemented. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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7. Designing Empathetic Service Experiences Using Storytelling Approach: A Case Study.
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Sagar, Priyank, Mahamuni, Ravi, Agrawal, Vasundhara, Darak, Shrinivas, Jori, Vijaya, and Athavale, Sandeep
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- *
QUALITY of service , *SERVICE design , *DESIGN services , *HIV-positive teenagers , *STORYTELLING , *STORYTELLERS - Abstract
Storytelling is a well-known technique to emphasize emotions. This paper explores the integration of storytelling techniques into service design to cultivate empathetic service experiences. Emphasizing the significance of emotional connection in social service contexts, we designed services for Adolescents Living with HIV (ALHIV) in India. Due to a lack of awareness and social stigma, ALHIV are unable to make timely and responsible life decisions around intimacy and HIV status disclosure. We designed services that disseminate essential information and enable ALHIV to make informed life decisions. The solution is an interactive story media where users make decisions around in-design encounters that parallel with possible real-life encounters. As a result, they get to explore multiple possibilities in a safe space, leading to improved real-life decision-making. This paper demonstrates the replicable framework of orchestration of human and technology touchpoints through multiple dynamic and choice-based scenarios. The study examines the synergy between service design and narrative frameworks. Through a detailed case study, the research underscores the pivotal role of storytelling in fostering genuine user engagement by infusing empathy-driven narratives into service encounters. Overall, this research contributes a novel perspective on designing empathetic services, demonstrating the role of storytelling in crafting meaningful service experiences. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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8. Assessing the Effectiveness of Multilevel Intervention Sequences on “<italic>Tension</italic>” Among Men Living with HIV: A Randomized-Control Trial.
- Author
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Ha, Toan, Shi, Hui, Pham, Bang Nguyen, Dsouza, Aidan, Shrestha, Roman, Kuchipudi, Suresh V., Luu, Hung N., Le, Ngoan Tran, and Schensul, Stephen L.
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- *
COUNSELING , *SECONDARY analysis , *ART centers , *HIV-positive persons , *DEMOGRAPHIC characteristics - Abstract
Background:
Tension (often times called “Tenshun ” in Hindi) is a cultural expression used to convey feelings of distress and common mental disorders in India and among South Asia communities. This study compared the effectiveness of different intervention sequences in reducingtension among alcohol-consuming men living with HIV in India.This secondary data analysis paper utilized data from a randomized trial study titled “Alcohol and Antiretroviral Therapy (ART) Adherence: Assessment, Intervention, and Modeling in India.” The multilevel interventions, including individual counseling (IC), group intervention (GI), and collective advocacy (CA), were conducted sequentially over three cycles at three ART centers. Additionally, another ART center, serving as a pilot site, received all three interventions simultaneously in the final cycle. Participants completed surveys assessing demographic characteristics,tension , and other variables including HIV stigma, a 4-day ART adherence, HIV symptoms, and depressive symptoms at four time points: baseline, 9 months, 18 months, and 24 months. General linear mixed models were employed to assess the intervention effects ontension. Out of 940 participants, 666 reported experiencingtension , including 54% reporting hightension. At site 1, the GI-CA-IC sequence resulted in a slope of −0.06, indicating that this sequence reducedtension from T1 to T4 compared to the control group (p < 0.01). Additionally, the pilot site where the intervention package was conducted simultaneously had a slope of −0.06, indicating that the intervention package also reducedtension compared to the control group (p < 0.01). Conversely, the CA-IC-GI sequence resulted in a slope of 0.07, indicating that this sequence resulted in significantly highertension levels than the control group (p = 0.008) contrary to the expectation that the sequence would reducetension. This study contributes valuable insights on the issue oftension among alcohol-consuming men living with HIV. The significant reduction intension observed at the site using the GI-CA-IC sequence, which began with a group intervention, underscores the importance of intervention order and the importance of group intervention within multilevel intervention programs fortension reduction. Further research is needed to validate these observations and broaden our understanding of effectivetension management strategies among people living with HIV in diverse settings.URL: clinicaltrials.gov. Registration number: NCT03746457.Method:Tension (often times called “Tenshun ” in Hindi) is a cultural expression used to convey feelings of distress and common mental disorders in India and among South Asia communities. This study compared the effectiveness of different intervention sequences in reducingtension among alcohol-consuming men living with HIV in India.This secondary data analysis paper utilized data from a randomized trial study titled “Alcohol and Antiretroviral Therapy (ART) Adherence: Assessment, Intervention, and Modeling in India.” The multilevel interventions, including individual counseling (IC), group intervention (GI), and collective advocacy (CA), were conducted sequentially over three cycles at three ART centers. Additionally, another ART center, serving as a pilot site, received all three interventions simultaneously in the final cycle. Participants completed surveys assessing demographic characteristics,tension , and other variables including HIV stigma, a 4-day ART adherence, HIV symptoms, and depressive symptoms at four time points: baseline, 9 months, 18 months, and 24 months. General linear mixed models were employed to assess the intervention effects ontension. Out of 940 participants, 666 reported experiencingtension , including 54% reporting hightension. At site 1, the GI-CA-IC sequence resulted in a slope of −0.06, indicating that this sequence reducedtension from T1 to T4 compared to the control group (p < 0.01). Additionally, the pilot site where the intervention package was conducted simultaneously had a slope of −0.06, indicating that the intervention package also reducedtension compared to the control group (p < 0.01). Conversely, the CA-IC-GI sequence resulted in a slope of 0.07, indicating that this sequence resulted in significantly highertension levels than the control group (p = 0.008) contrary to the expectation that the sequence would reducetension. This study contributes valuable insights on the issue oftension among alcohol-consuming men living with HIV. The significant reduction intension observed at the site using the GI-CA-IC sequence, which began with a group intervention, underscores the importance of intervention order and the importance of group intervention within multilevel intervention programs fortension reduction. Further research is needed to validate these observations and broaden our understanding of effectivetension management strategies among people living with HIV in diverse settings.URL: clinicaltrials.gov. Registration number: NCT03746457.Results:Tension (often times called “Tenshun ” in Hindi) is a cultural expression used to convey feelings of distress and common mental disorders in India and among South Asia communities. This study compared the effectiveness of different intervention sequences in reducingtension among alcohol-consuming men living with HIV in India.This secondary data analysis paper utilized data from a randomized trial study titled “Alcohol and Antiretroviral Therapy (ART) Adherence: Assessment, Intervention, and Modeling in India.” The multilevel interventions, including individual counseling (IC), group intervention (GI), and collective advocacy (CA), were conducted sequentially over three cycles at three ART centers. Additionally, another ART center, serving as a pilot site, received all three interventions simultaneously in the final cycle. Participants completed surveys assessing demographic characteristics,tension , and other variables including HIV stigma, a 4-day ART adherence, HIV symptoms, and depressive symptoms at four time points: baseline, 9 months, 18 months, and 24 months. General linear mixed models were employed to assess the intervention effects ontension. Out of 940 participants, 666 reported experiencingtension , including 54% reporting hightension. At site 1, the GI-CA-IC sequence resulted in a slope of −0.06, indicating that this sequence reducedtension from T1 to T4 compared to the control group (p < 0.01). Additionally, the pilot site where the intervention package was conducted simultaneously had a slope of −0.06, indicating that the intervention package also reducedtension compared to the control group (p < 0.01). Conversely, the CA-IC-GI sequence resulted in a slope of 0.07, indicating that this sequence resulted in significantly highertension levels than the control group (p = 0.008) contrary to the expectation that the sequence would reducetension. This study contributes valuable insights on the issue oftension among alcohol-consuming men living with HIV. The significant reduction intension observed at the site using the GI-CA-IC sequence, which began with a group intervention, underscores the importance of intervention order and the importance of group intervention within multilevel intervention programs fortension reduction. Further research is needed to validate these observations and broaden our understanding of effectivetension management strategies among people living with HIV in diverse settings.URL: clinicaltrials.gov. Registration number: NCT03746457.Conclusion:Tension (often times called “Tenshun ” in Hindi) is a cultural expression used to convey feelings of distress and common mental disorders in India and among South Asia communities. This study compared the effectiveness of different intervention sequences in reducingtension among alcohol-consuming men living with HIV in India.This secondary data analysis paper utilized data from a randomized trial study titled “Alcohol and Antiretroviral Therapy (ART) Adherence: Assessment, Intervention, and Modeling in India.” The multilevel interventions, including individual counseling (IC), group intervention (GI), and collective advocacy (CA), were conducted sequentially over three cycles at three ART centers. Additionally, another ART center, serving as a pilot site, received all three interventions simultaneously in the final cycle. Participants completed surveys assessing demographic characteristics,tension , and other variables including HIV stigma, a 4-day ART adherence, HIV symptoms, and depressive symptoms at four time points: baseline, 9 months, 18 months, and 24 months. General linear mixed models were employed to assess the intervention effects ontension. Out of 940 participants, 666 reported experiencingtension , including 54% reporting hightension. At site 1, the GI-CA-IC sequence resulted in a slope of −0.06, indicating that this sequence reducedtension from T1 to T4 compared to the control group (p < 0.01). Additionally, the pilot site where the intervention package was conducted simultaneously had a slope of −0.06, indicating that the intervention package also reducedtension compared to the control group (p < 0.01). Conversely, the CA-IC-GI sequence resulted in a slope of 0.07, indicating that this sequence resulted in significantly highertension levels than the control group (p = 0.008) contrary to the expectation that the sequence would reducetension. This study contributes valuable insights on the issue oftension among alcohol-consuming men living with HIV. The significant reduction intension observed at the site using the GI-CA-IC sequence, which began with a group intervention, underscores the importance of intervention order and the importance of group intervention within multilevel intervention programs fortension reduction. Further research is needed to validate these observations and broaden our understanding of effectivetension management strategies among people living with HIV in diverse settings.URL: clinicaltrials.gov. Registration number: NCT03746457.Trial Registration:Tension (often times called “Tenshun ” in Hindi) is a cultural expression used to convey feelings of distress and common mental disorders in India and among South Asia communities. This study compared the effectiveness of different intervention sequences in reducingtension among alcohol-consuming men living with HIV in India.This secondary data analysis paper utilized data from a randomized trial study titled “Alcohol and Antiretroviral Therapy (ART) Adherence: Assessment, Intervention, and Modeling in India.” The multilevel interventions, including individual counseling (IC), group intervention (GI), and collective advocacy (CA), were conducted sequentially over three cycles at three ART centers. Additionally, another ART center, serving as a pilot site, received all three interventions simultaneously in the final cycle. Participants completed surveys assessing demographic characteristics,tension , and other variables including HIV stigma, a 4-day ART adherence, HIV symptoms, and depressive symptoms at four time points: baseline, 9 months, 18 months, and 24 months. General linear mixed models were employed to assess the intervention effects ontension. Out of 940 participants, 666 reported experiencingtension , including 54% reporting hightension. At site 1, the GI-CA-IC sequence resulted in a slope of −0.06, indicating that this sequence reducedtension from T1 to T4 compared to the control group (p < 0.01). Additionally, the pilot site where the intervention package was conducted simultaneously had a slope of −0.06, indicating that the intervention package also reducedtension compared to the control group (p < 0.01). Conversely, the CA-IC-GI sequence resulted in a slope of 0.07, indicating that this sequence resulted in significantly highertension levels than the control group (p = 0.008) contrary to the expectation that the sequence would reducetension. This study contributes valuable insights on the issue oftension among alcohol-consuming men living with HIV. The significant reduction intension observed at the site using the GI-CA-IC sequence, which began with a group intervention, underscores the importance of intervention order and the importance of group intervention within multilevel intervention programs fortension reduction. Further research is needed to validate these observations and broaden our understanding of effectivetension management strategies among people living with HIV in diverse settings.URL: clinicaltrials.gov. Registration number: NCT03746457. [ABSTRACT FROM AUTHOR]- Published
- 2024
- Full Text
- View/download PDF
9. Multilevel and Multifactorial Interventions to Reduce Alcohol Consumption and Improve ART Adherence and Related Factors Among HIV Positive Men in Mumbai, India.
- Author
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Schensul, Stephen L., Ha, Toan, Schensul, Jean J., Grady, James, Burleson, Joseph A., Gaikwad, Sushma, Joshi, Kavita, Malye, Rupal, and Sarna, Avina
- Subjects
PREVENTION of mental depression ,PREVENTION of alcoholism ,EVALUATION of human services programs ,COUNSELING ,PATIENT advocacy ,VIRAL load ,SOCIAL stigma ,DRUGS ,PATIENT compliance ,CROSSOVER trials ,PSYCHOLOGY of HIV-positive persons ,GROUP process ,BEHAVIOR modification - Abstract
Copyright of AIDS & Behavior is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2021
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10. Structure and agency in long-distance truck drivers' lived experiences of condom use for HIV prevention.
- Author
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Sastry, Shaunak
- Subjects
TRUCK drivers ,HIV ,CONDOM use ,PREVENTION of sexually transmitted diseases ,MALE contraception - Abstract
Copyright of Culture, Health & Sexuality is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2016
- Full Text
- View/download PDF
11. Overview and research agenda arising from the 7th World Workshop on Oral Health and Disease in AIDS.
- Author
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Tappuni, AR and Shiboski, C
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ORAL diseases ,IMMUNE system physiology ,HIV infection complications ,ANTIRETROVIRAL agents ,ORAL manifestations of general diseases ,DENTAL care ,DIFFUSION of innovations ,GASTROINTESTINAL system ,HEALTH promotion ,HEALTH services accessibility ,HEALTH status indicators ,HIV infections ,ORAL hygiene ,PRIORITY (Philosophy) ,RESEARCH evaluation ,RESEARCH ethics ,VIRUS diseases ,ADULT education workshops ,WORLD health ,COMORBIDITY ,AIDS-related opportunistic infections ,ETHICS ,PREVENTION - Abstract
The Research Agenda generated by the 7th World Workshop on Oral Health and Disease in AIDS (WW7) is delivered in this paper. Panels of international experts presided over nine workshops that constituted the conference held in November 2014 in Hyderabad, India. The main goal of the Workshop was to bring together clinician and scientists interested in the subject to debate with world-wide perspectives current issues related to the oral manifestations in HIV/AIDS. The workshops were structured around three themes; basic science, clinical/translational science and social science and were attended by 135 participants from 31 countries. The research questions debated at the workshops are presented in nine consensus papers published in this issue and are summarised in this paper along with an outline of the identified research needs in the field. [ABSTRACT FROM AUTHOR]
- Published
- 2016
- Full Text
- View/download PDF
12. Dried blood spots (DBS): a valuable tool for HIV surveillance in developing/tropical countries.
- Author
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Solomon, Sunil S., Solomon, Suniti, Rodriguez, Irma I., McGarvey, Stephen T., Ganesh, A. K., Thyagarajan, S. P., Mahajan, Anish P., and Mayer, Kenneth H.
- Subjects
HIV ,LABORATORY equipment & supplies ,MEDICAL screening ,VIRAL antibodies ,HIV-positive persons ,BLOOD testing ,WESTERN immunoblotting ,DIAGNOSIS of HIV infections ,BLOOD collection ,CLIMATOLOGY ,COMPARATIVE studies ,DEVELOPING countries ,ENZYME-linked immunosorbent assay ,HIV infections ,RESEARCH methodology ,MEDICAL cooperation ,PUBLIC health surveillance ,RESEARCH ,TIME ,EVALUATION research ,AIDS serodiagnosis - Abstract
Dried blood spots (DBS) on filter paper have been used as a practical method of sample collection in sero-surveillance studies of numerous diseases. DBS may be particularly useful for HIV screening in remote areas, in which unrefrigerated transfer time to a laboratory may take a number of days. In this study, we evaluate the ability to detect human immunodeficiency virus (HIV) type-1 antibodies from DBS that have been subjected to a tropical climate in southern India for 6 days. DBS were prepared from blood samples of 59 known HIV-positive individuals and 30 known HIV-negative individuals. ELISA and Western blot results from DBS that were subjected to a mean temperature of 35.8 degrees C and humidity of 73% for 6 days had a sensitivity of 100% and 92%, respectively, and a specificity of 100% and 100%, respectively. Based on these findings, we conclude that DBS sampling could serve as a cost-effective and convenient tool for widespread HIV sero-surveillance in remote areas within tropical countries. [ABSTRACT FROM AUTHOR]
- Published
- 2002
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13. Fractional-order deterministic epidemic model for the spread and control of HIV/AIDS with special reference to Mexico and India.
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Mangal, Shiv, Misra, O.P., and Dhar, Joydip
- Subjects
- *
HIV , *AIDS , *BASIC reproduction number , *INFECTIOUS disease transmission , *EPIDEMICS , *IMMUNOLOGICAL deficiency syndromes - Abstract
This paper introduces a deterministic fractional-order epidemic model (FOEM) for studying the transmission dynamics of the human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS). The model highlights the substantial role of unaware and undetected HIV-infected individuals in spreading the disease. Control strategies, such as wielding condoms, level of preventive measures to avoid infection, and self-strictness of susceptibles in sexual contact, have been incorporated into the study. The basic reproduction number ℛ 0 α has been derived, which suggests the conditions for ensuring the persistence and elimination of the disease. Further, to validate the model, actual HIV data taken from Mexico and India separately have been used. The disease dynamics and its control in both countries are analyzed broadly. The values of biological parameters are estimated at which numerical solutions better match the actual data of HIV patients in the case of fractional-order (FO) instead of integer-order (IO). Moreover, in the light of ℛ 0 α , our findings forecast that the disease will abide in the population in Mexico, and at the same time, it will die out from India after a long time. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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14. Education, skill development and sustainable livelihoods: Situation assessment of India's drug treatment and rehabilitation centres.
- Author
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Reid, G., Tellis, E., Kumar, S., and Higgs, P.
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EDUCATION ,HEALTH education ,VOCATIONAL education ,HIV ,SOCIAL integration ,SUBSTANCE abuse treatment ,TREATMENT programs - Abstract
BACKGROUND: Research into education and skill development of drug users to facilitate social and economic inclusion has not previously occurred in India. OBJECTIVE: This paper examines education and skill development in government, NGO and private drug treatment and rehabilitation facilities of India. METHODS: A mapping exercise was undertaken to identify drug treatment and rehabilitation facilities. A total of 119 responses received and one-third of drug users were described as illiterate or had achieved primary school only. RESULTS: The majority of facilities did not provide basic education but virtually all provided HIV and drug education. A majority of facilities did not provide vocational education and livelihood skills and referrals to others for education and skills development were not common. CONCLUSION: To ensure and promote the social and economic re-integration of drug users into the community the provision of vocational education and skill development opportunities compatible with the needs of the society should be encouraged. [ABSTRACT FROM AUTHOR]
- Published
- 2017
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15. 'Empowered Criminals and Global Subjects': Transnational Norms and Sexual Minorities in India.
- Author
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Lakkimsetti, Chaitanya
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HOMOSEXUALITY ,SEX workers ,SEXUAL minorities ,HIV ,LGBTQ+ people ,SODOMY - Abstract
In this paper, I comparatively examine the influence of transnational advocacy on legal struggles around sex work and homosexuality in contemporary India. While transnational scholars of sexuality understand globalization as a contradictory and uneven process, there has been little attention to how this unevenness is manifest in the realm of sexual rights and law. Based on qualitative research, I show how transnational discourses on health-in particular, HIV/AIDS interventions-and on human rights interact unevenly with national discourses on sexuality. Whereas discourses regarding HIV/AIDS enable sex workers to mobilize at the national level, global anti-trafficking discourses effectively reduce sex workers to 'victims.' For Indian LGBTQ groups, discourses regarding the HIV/AIDS epidemic and global human rights enable these groups to problematize the anti-sodomy law in national politics. However, national legal discourses effectively reduce LGBQ individuals to 'criminals,' and legal advancements in this arena are uneven. Focusing on this unevenness produced by transnational advocacy this paper highlights how sexual rights are articulated in context of asymmetric and uneven globalizations. [ABSTRACT FROM AUTHOR]
- Published
- 2016
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16. Factors affecting the vulnerability of female slum youth to HIV/AIDS in Delhi and Hyderabad, India.
- Author
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Wadhwa, Vandana, Ghosh, Jayati, and Kalipeni, Ezekiel
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PSYCHOLOGICAL vulnerability ,HIV ,AIDS ,YOUNG women ,HEALTH - Abstract
This paper builds upon the theoretical framework advanced by the growing literature on vulnerability. The paper explores how vulnerability to HIV/AIDS applies to young women living in the slum areas of New Delhi and Hyderabad. This circumscription of scope is based on a study on AIDS awareness levels in these two Indian cities conducted during summer of 2006. Using a qualitative approach, the paper offers insightful narratives from a sample of 26 women about their cultural and socio-economic circumstances with reference to HIV/AIDS. The excerpts from these women give a poignant view of their precarious circumstances with reference to lack of female autonomy, economic vulnerability, low AIDS awareness, and lack of access to pertinent information about HIV. The female youth were highly susceptible to the double bind of age and gender based hierarchies present in the patriarchal Indian social system. [ABSTRACT FROM AUTHOR]
- Published
- 2012
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- View/download PDF
17. Impact of Health Care Sector on Indian Economic Growth and Challenges: A Socio-Legal Analysis.
- Author
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Talukdar, Rubi and Pattnaik, Prabir Kumar
- Subjects
AIDS prevention ,HEALTH care industry ,LEGISLATION ,LIFE expectancy ,MEDICAL care costs ,SOCIOECONOMIC factors ,INFANT mortality ,PUBLIC spending ,HIV - Abstract
A large quantity of India's population is reduced to destitution because of high coverage health-care expenses and also suffering from antagonistic consequences of poor health care services. India has accomplished several gains in the field of Health since the new millennium, such as, life expectancy at birth has increased, the infant mortality and maternal mortality ratio has fell down and the spread of contagious diseases such as HIV/AIDS has been controlled etc. Again WHO, recently officially declared India free from maternal and neonatal tetanus and also polio free. But at the same time, among the five BRICS Nations, namely (Russia, Brazil, South Africa, China and India), India is considered as the poorest performer on the health indicators. India has failed to sufficiently protect its citizens against poor quality of health care as well as financial risks associated with health expenditure. Health Care Industries of a Country can play crucial roles not only in providing quality care and improving access to medicines for the citizens, but also in developing economic growth of the Country. Again, as it is universally accepted that Health is magnificent and efficacious investment for the economic growth of a Nation, this paper will analyze several major challenges that India need to be addressed, most notably the poor and ineffective regulation of the country, the rapid growth of commercialization of health care services, inadequate public expenditure along with very low level of public expenditure. Here the approach of Judiciary towards the various challenges surrounding the health care services in India will also be discussed. [ABSTRACT FROM AUTHOR]
- Published
- 2020
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18. Cost of antiretroviral treatment for HIV patients in two centres of North India.
- Author
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Sharma, Atul, Prinja, Shankar, Sharma, Aman, Gupta, Aditi, and Arora, Sunil K
- Subjects
HIV-positive persons ,THERAPEUTICS ,ANTIRETROVIRAL agents ,DRUG prices ,MEDICAL care costs ,HIV infection epidemiology ,MEDICAL care cost statistics ,HIV infections ,COST analysis ,HIGHLY active antiretroviral therapy ,ANTI-HIV agents ,AIDS serodiagnosis - Abstract
There is paucity of evidence on cost of antiretroviral therapy (ART) delivered through the public sector in India. Moreover, the Government of India is considering changing the criteria for introduction of ART to HIV patients, which is likely to have significant economic implications. In this paper, we assess the health system cost of ART services at two levels of health care delivery. Bottom-up costing was used to collect data on capital and recurrent resources consumed over a period of one year (April 2014–March 2015). Capital costs were annualized and shared costs apportioned to calculate annual and unit costs of providing ART care. Sensitivity analysis was undertaken to measure the extent of uncertainty in input prices. The annual per capita cost of ART therapy was INR 48,975 (USD738) in the Centre of Excellence (COE) and INR 24,954 (USD376) in the ART centre. Drugs contributed around 70% and 65% of total annual cost, followed by human resource (19% each) and capital cost (7%; 12%) in COE and ART centres, respectively. These provide a comprehensive assessment of the cost of ART care in India. The study estimates could be used for planning of services, as well as undertaking further cost-effectiveness studies. [ABSTRACT FROM AUTHOR]
- Published
- 2019
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- View/download PDF
19. Depression Among Alcohol Consuming, HIV Positive Men on ART Treatment in India.
- Author
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Ha, Toan, Schensul, Stephen L., Irving, Mitchell, Brault, Marie A., Schensul, Jean J., Prabhughate, Priti, and Vaz, Melita
- Subjects
ANTIRETROVIRAL agents ,CONFIDENCE intervals ,MENTAL depression ,ALCOHOL drinking ,PSYCHOLOGY of HIV-positive persons ,INTERVIEWING ,MEN'S health ,SOCIAL stigma ,SURVEYS ,CROSS-sectional method ,HIV seroconversion ,ODDS ratio - Abstract
Copyright of AIDS & Behavior is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2019
- Full Text
- View/download PDF
20. Unsafe injecting practices, sexual risk behaviours and determinants of HIV among men who inject drugs: Results from Integrated Biological and Behavioural Surveillance in India.
- Author
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Kumar, Pradeep, Sangal, Bhavna, Ramanathan, Shreena, Ammassari, Savina, and Venkatesh, Srinivasa Raghavan
- Subjects
HIV infection risk factors ,DIAGNOSIS of HIV infections ,HIV prevention ,INJECTIONS ,HIV-positive men ,HIV status ,PHYSIOLOGICAL effects of drug abuse? ,HIV infections & psychology ,SEXUALLY transmitted disease diagnosis ,PREVENTION of sexually transmitted diseases ,EPIDEMIOLOGY of sexually transmitted diseases ,HIV infection epidemiology ,INTRAVENOUS drug abuse ,NEEDLE sharing ,RISK-taking behavior ,HUMAN sexuality ,SEXUALLY transmitted diseases ,DISEASE prevalence ,CROSS-sectional method ,ODDS ratio - Abstract
In India, while an overall reduction in HIV is achieved among most key populations, the continued higher prevalence among people who inject drugs (PWIDs) is an area of concern. This paper analyses unsafe injecting and sexual risk behaviours in male PWIDs according to HIV status and also examines the determinants of HIV infection in this high-risk group. Data from India's Integrated Biological and Behavioural Surveillance, conducted across 29 Indian states and Union Territories among 19,902 male PWIDs, were used. Informed consent was obtained and men aged 15 years or more, who used psychotropic substances or drugs in the past three months for non-medical reasons were recruited for the survey. Results from the multivariable analysis suggest that drug use debut at age 25 years or above (adjusted odds ratio [AOR]: 1.41, confidence interval [CI]: 1.05-1.88), engagement in drug use for a longer duration (AOR: 1.81, CI: 1.32-2.48), injecting three times or more per day (AOR: 1.53, CI: 1.1-2.12), sharing of needle/syringes (AOR: 1.34, CI: 1.02-1.76), self-reported sexually transmitted infections (AOR: 1.55, CI: 1.12-2.14) and higher self-risk perception for exposure to HIV (AOR: 2.08, CI: 1.58-2.75) increase the likelihood of HIV infection. Sustained higher prevalence, unsafe injecting and risky sexual practices are major challenges which may prevent India from reaching the 'end of AIDS' by 2030. This underscores the need for adoption of a tailored, evidence-driven HIV prevention approach that adequately addresses local needs to limit the spread of HIV within this population, and thereby prevents the onward transmission of HIV to the general population. [ABSTRACT FROM AUTHOR]
- Published
- 2018
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21. India's Accession to TRIPS: The IP Legislation Reform (2005) and its Reflections on India's Foreign Policy on HIV/AIDS Matters.
- Author
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Souza, Manoela A.
- Subjects
- *
INTERNATIONAL relations , *ACTIVISM , *WORLD health , *HIV , *AIDS - Abstract
This paper will discuss the relevance of India's accession to the TRIPS-mandated regime for its foreign policy on HIV/AIDS matters. This study will investigate whether the formal accession to WTO's norms regarding patents, through 2005's third amendment, eventually brought about a new background for its foreign policy on HIV/AIDS. With concern for Doha's flexibilities, this work intends to show how India's pharma industry and local/global activism might have influenced, respectively, a watershed on the country's advocacy on international health (especially with regard to anti-retroviral drugs). ..PAT.-Unpublished Manuscript [ABSTRACT FROM AUTHOR]
- Published
- 2008
22. HIV Stigma in India: A Gendered Experience?
- Author
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Chaudhuri, Tanni
- Subjects
HIV ,SOCIAL context ,WOMEN - Abstract
This paper explores the gendered dimension of HIV stigma within the particular social context of India. Building up on the multiple status contingencies of women in India based on class, caste or geographical location, women's lived experiences with HIV is not the same. Using John Braithwaite's "Shaming Theory" and Pierre Bourdieu's notion of "Cultural Capital" this paper introduces the gendered, culture and community aspects of lived experiences of HIV within a local milieu, therefore providing foundation for fundamental analogies and contrasts with the global parlance for future research. ..PAT.-Unpublished Manuscript [ABSTRACT FROM AUTHOR]
- Published
- 2007
23. The Toronto-New Delhi Community-Based HIV/AIDS Project: Lessons Learned from a Bilateral Health Education Pilot.
- Author
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Harrington, Andrea
- Subjects
- *
HIV , *AIDS , *HEALTH education , *ABILITY , *MEDICAL care , *WORLD citizenship - Abstract
The Toronto-New Delhi Community-Based HIV/AIDS Project was a three-year pilot project initiated by an Indian non-governmental organization, Society for the Promotion of Youth and Masses (SPYM), and its Canadian Partner, Canada World Youth (CWY). The project, funded primarily by the Canadian International Development Agency, was intended to develop the professional skills of young Indian and Canadian health care and community development workers and to build the capacity of SPYM to integrate HIV/AIDS care and support within the existing health care system in Northern India. This paper analyses the accomplishments and limitations of the initiative as both a development education project and a program aimed at improving service delivery. It also considers the potential applicability of the model developed by this project to other bilateral HIV/AIDS initiatives. Finally, it examines the impact of the program on participants and stakeholders and considers the effectiveness of the project as an informal education initiative intended to encourage young health and development workers to consider the meaning of active global citizenship. [ABSTRACT FROM AUTHOR]
- Published
- 2005
24. Association Between Alcohol Use and HIV-Related Sexual Risk Behaviors Among Men Who Have Sex with Men (MSM): Findings from a Multi-Site Bio-Behavioral Survey in India.
- Author
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Yadav, Diwakar, Chakrapani, Venkatesan, Goswami, Prabuddhagopal, Ramanathan, Shreena, Ramakrishnan, Lakshmi, George, Bitra, Sen, Shrabanti, Subramanian, Thilakavathi, Rachakulla, Harikumar, and Paranjape, Ramesh
- Subjects
HIV infection risk factors ,ANALYSIS of covariance ,CHI-squared test ,CLUSTER analysis (Statistics) ,CONFIDENCE intervals ,ALCOHOL drinking ,GAY men ,MEDICAL cooperation ,QUESTIONNAIRES ,RESEARCH ,RESEARCH funding ,RISK-taking behavior ,STATISTICAL sampling ,STATISTICS ,MULTIPLE regression analysis ,SECONDARY analysis ,CROSS-sectional method ,DATA analysis software ,DESCRIPTIVE statistics - Abstract
This paper examines the association between alcohol use and HIV-related sexual risk behaviors among men who have sex with men (MSM). A cross-sectional bio-behavioral survey was conducted among 3,880 MSM, recruited using time-location cluster sampling from cruising sites in three Indian states. Nearly three-fifths of the participants reported alcohol use. Among frequent users (40 % of the sample), defined as those who consumed alcohol daily or at least once a week, 66 % were aged 25 years and above, 53 % self-identified as kothi (feminine/receptive), and 63 % consistently used condoms with male paying partners. Multivariate logistic regression demonstrated that frequent users were more likely to be aged 25 years and above, less likely to self-identify as kothi, and less likely to consistently use condoms with male paying (AOR = 0.7; 95 % CI 0.5-0.9) and male regular (AOR = 0.7; 95 % CI 0.6-0.9) partners. HIV prevention interventions for MSM need to provide tailored information on alcohol use-related sexual risk, especially for MSM in sex work and MSM with male regular partners. [ABSTRACT FROM AUTHOR]
- Published
- 2014
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- View/download PDF
25. Addressing vulnerabilities of female sex workers in an HIV prevention intervention in Mumbai and Thane: experiences from the Aastha project.
- Author
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Ranebennur, Virupax, Gaikwad, Sanjeevsingh, Ramesh, Sowmya, and Bhende, Amrita
- Subjects
HIV prevention ,SEX workers ,SEXUALLY transmitted diseases ,DISEASES - Abstract
Background: It is important for targeted interventions to consider vulnerabilities of female sex workers (FSWs) such as poverty, work-related mobility, and literacy, for effective human immunodeficiency virus (HIV) prevention. This paper describes and examines the association of the Aastha HIV/sexually transmitted infection (STI) prevention project in Mumbai and Thane, India, on the relationship between vulnerability and behavioral outcomes. Materials and methods: Data were drawn from the Behavioural Tracking Survey, a crosssectional behavioral study conducted in 2010 with 2,431 FSWs recruited in Mumbai and Thane. The key independent measures used were program exposure and "vulnerability index", a composite index of literacy, factors of dependence (alternative livelihood options, current debt, and children), and aspects of sex work (mobility and duration in sex work). Dependent measures included service uptake, self-confidence, self-identity, and individual agency. Logistic regression analysis was used to examine the study objectives. Results: Of the analytical sample of 2,431 FSWs, 1,295 (53.3%) were categorized as highly vulnerable. Highly vulnerable FSWs who were associated with the Aastha program for more than a year were more likely to have accessed crisis-response services in the past 6 months (adjusted odds ratio [AOR] 2.2, 95% confidence interval [CI] 1.4-3.6; P,0.001), to have visited a clinic to get a checkup for STI symptoms (AOR 2.4, 95% CI 1.2-4.8; P,0.015), not to be ashamed to disclose identity as an FSW to health workers (AOR 2.1, 95% CI 1.2-3.5; P,0.008), and to be confident in supporting a fellow FSW in crisis (AOR 1.7, 95% CI 1.0-2.8, P,0.033) compared to those less vulnerable with similar exposure to the Aastha program. Conclusion: It is critical for HIV/STI interventions to consider vulnerabilities of FSWs at project inception and address them with focused strategies, including a segmented servicedelivery model and community involvement, in order to strengthen the structural response to HIV prevention. [ABSTRACT FROM AUTHOR]
- Published
- 2014
- Full Text
- View/download PDF
26. Heterosexual Anal Sex among Female Sex Workers in High HIV Prevalence States of India: Need for Comprehensive Intervention.
- Author
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Alexander, Mallika, Mainkar, Mandar, Deshpande, Sucheta, Chidrawar, Shweta, Sane, Suvarna, and Mehendale, Sanjay
- Subjects
HETEROSEXUAL women ,ANAL sex ,SEX workers ,HIV infection transmission ,DISEASE prevalence ,BEHAVIORAL assessment - Abstract
Introduction: Role of vaginal sex in heterosexual transmission of HIV has been investigated but that of heterosexual anal sex (HAS) is not fully understood. This paper examines practice of HAS among Female Sex Workers (FSWs) and its correlates in India where the HIV epidemic is being primarily driven by core groups like FSWs. Methods: Data for this paper are drawn from Round I survey of 9667 FSWs in the Integrated Biological and Behavioral Assessment (IBBA) from 23 districts of 4 high HIV prevalent states of India. Bivariate and multivariate analysis identified factors associated with HAS. Results: Ever having anal sex was reported by 11.9% FSWs (95% CI: 11.3%–12.6%). Typology (AOR 2.20, 95% CI 1.64–2.95) and literacy (AOR 1.28, 95% CI 1.10–1.49) were positively associated with practice of HAS. Longer duration in sex trade (AOR 1.69, 95% CI 1.44–1.99), entertaining larger number of clients the previous week (AOR 1.78, 95% CI 1.47–2.15), alcohol consumption (AOR 1.21, 95% CI 1.03–1.42) and inability to negotiate condom use (AOR 1.53, 95% CI 1.28–1.83) were also correlated with HAS. Self-risk perception for HIV (AOR 1.46, 95% CI 1.25–1.71) did not impede HAS. Although symptoms of sexually transmitted infections (STIs) in the last 12 months were associated with anal sex (AOR 1.39, 95% CI 1.13–1.72) there was no significant association between laboratory confirmed HIV and other STIs with HAS. Conclusion: Practice of HAS by FSWs might significantly contribute to HIV transmission in India. This study also shows that despite self-risk perception for HIV, even literate FSWs with longer duration in sex work report HAS. General messages on condom use may not influence safe HAS. FSWs need to be targeted with specific messages on HIV transmission during anal sex. Women controlled prevention methods, such as rectal microbicides and vaginal microbicides are needed. [ABSTRACT FROM AUTHOR]
- Published
- 2014
- Full Text
- View/download PDF
27. Stated preferences for new HIV prevention technologies among men who have sex with men in India: A discrete choice experiment.
- Author
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Cameron, Michael P., Newman, Peter A., Chakrapani, Venkatesan, Shunmugam, Murali, Roungprakhon, Surachet, Rawat, Shruta, Baruah, Dicky, Nelson, Ruban, Tepjan, Suchon, and Scarpa, Riccardo
- Subjects
MEN who have sex with men ,HIV prevention ,HIV ,ANAL sex ,UNSAFE sex ,AT-risk behavior - Abstract
Introduction: India has the second largest HIV epidemic in the world. Despite successes in epidemic control at the population level, a concentrated epidemic persists among gay and other men who have sex with men (MSM). However, India lags in implementation of biomedical prevention technologies, such as HIV pre-exposure prophylaxis (PrEP). In order to inform scale-up of new HIV prevention technologies, including those in the development pipeline, we assessed willingness to use oral PrEP, rectal microbicides, and HIV vaccines, and choices among product characteristics, among MSM in two major Indian cities. Methods: A cross-sectional survey was conducted with a discrete choice experiment (DCE), an established methodology for quantitively estimating end-user preferences in healthcare. Survey participants were randomly assigned to one of three questionnaire versions, each of which included a DCE for one prevention technology. Participants were recruited using chain-referral sampling by peer outreach workers, beginning with seeds in community-based organizations and public sex environments, in Chennai and Mumbai. DCE data were analyzed using random-parameters (mixed) logit (RPL) models. Results: Among participants (n = 600), median age was 25 years, with median monthly income of INR 9,000 (~US$125). Nearly one-third (32%) had completed a college degree and 82% were single/never married. A majority of participants (63%) reported condomless anal sex in the past month. The acceptability of all three products was universally high (≥90%). Across all three products, four attributes were significant predictors of acceptability—with efficacy consistently the most important attribute, and in decreasing order of preference, side-effects, dosing schedule, and venue. MSM varied in their preferences for product attributes in relation to their levels of education and income, and engagement in sex work and HIV risk behavior. Conclusion: This study provides empirical evidence to facilitate the integration of end users' preferences throughout design, testing, and dissemination phases of HIV prevention technologies. The findings also suggest action points and targets for interventions for diverse subgroups to support the effectiveness of combination HIV prevention among MSM in India. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
28. Hepatitis B Virus in People who Inject Drugs and Men who Have Sex With Men With HIV in India: A Cross-sectional Study.
- Author
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Loeb, Talia A, Gunaratne, Mihili P, Iqbal, Syed, Anderson, Mark, McFall, Allison M, Amrose, Pradeep, Rodgers, Mary A, Srikrishnan, Aylur K, Balagopal, Ashwin, Lucas, Gregory M, Mehta, Shruti H, Thomas, David L, Cloherty, Gavin, Thio, Chloe L, and Solomon, Sunil S
- Subjects
HEPATITIS associated antigen ,DRUG abuse ,HEPATITIS B virus ,MEN who have sex with men ,HEPATITIS B - Abstract
Background People with HIV (PWH) who are coinfected with hepatitis B virus (HBV) have a higher risk of mortality compared with PWH alone. Populations such as people who inject drugs (PWID) and men who have sex with men (MSM) are particularly at high risk for HBV acquisition; yet, limited epidemiological data from these populations exist on HBV prevalence from low- and middle-income country settings (LMICs). Methods We characterized the prevalence and correlates of HBV serological markers in a sample of PWID and MSM with HIV recruited across 15 Indian cities using hepatitis B surface antigen (HBsAg), hepatitis B core antibody (anti-HBc), and hepatitis B surface antibody (anti-HBs). Testing of stored specimens for the presence of these markers was performed on the Abbott ARCHITECT i1000 as per the manufacturer's instructions. Correlates of ever being infected with HBV (reactive for anti-HBc and/or HBsAg) and chronic HBV (reactive for HBsAg) among those ever infected were assessed using univariable and multivariable multilevel logistic regression models accounting for site-level clustering. Results A total of 2198 (95%) of the 2314 participants recruited for the trial were screened for HBV markers. The median age among the PWID and MSM participants was 30 and 32 years, respectively. The prevalence of ever being infected with HBV was 75.6% vs 46.9% in PWID vs MSM, respectively (P <.01); prevalence of chronic infection was also higher in PWID vs MSM (14.1% vs 9.5%; P <.01). Correlates of ever being infected with HBV among PWID included unstable housing (adjusted odds ratio [aOR], 5.02) and sharing injection paraphernalia (aOR, 2.70), and among MSM, correlates included history of injection drug use (aOR, 4.87) and gender identity. The prevalence of isolated core (anti-HBc in the absence of anti-HBs) was 34.7% vs 29.4% in PWID vs MSM (P <.05). Vaccination serostatus was <10% in both populations. Conclusions In this large sample of PWID and MSM with HIV, we observed a high prevalence of serology consistent with HBV infection and low vaccination, highlighting the need for routine screening and catch-up vaccination. The high prevalence of isolated anti-HBc reactivity highlights the need to understand the risk of reactivation with this serological pattern. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
29. Labor Pains: Work-Related Barriers to Access to Health Care for People Living with HIV in Hyderabad, India.
- Author
-
Azhar, Sameena, Dean, Casey, Lerner, Riya, Gandham, Sabitha, Oruganti, Ganesh, and Yeldandi, Vijay
- Subjects
HIV infection epidemiology ,HEALTH services accessibility ,GENDER-nonconforming people ,SOCIAL determinants of health ,RESEARCH funding ,SOCIOECONOMIC status ,INTERVIEWING ,STATISTICAL sampling ,HIV infections ,JUDGMENT sampling ,DESCRIPTIVE statistics ,DECISION making ,PSYCHOLOGY of HIV-positive persons ,THEMATIC analysis ,CISGENDER people ,CONCEPTUAL structures ,RESEARCH methodology ,QUALITY of life ,TRANS women ,WOMEN'S health ,HEALTH equity ,COMPARATIVE studies ,SOCIAL classes ,MANAGEMENT - Abstract
To explore themes regarding work-related barriers to access to health care, we conducted 32 interviews, 16 with third gender people and 16 with cisgender women, all of whom were all living with HIV in Hyderabad, India. Most respondents were members of Dalit castes and had been living with HIV for several years at the time of the interview. Using thematic content analysis, interviews were coded by two researchers using a social determinants of health conceptual framework. Themes highlighted in this study include the burden of taking time off from work, the loss of pay associated with missing work, and the interruption of gendered care work responsibilities that respondents faced when seeking treatment. Findings from this study support the claim that equitable work policies and practices for marginalized laborers can increase access to medical care for people living with HIV. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
30. What makes a structural intervention? Reducing vulnerability to HIV in community settings, with particular reference to sex work.
- Author
-
Evans, C., Jana, S., and Lambert, H.
- Subjects
HIV prevention ,SEX work ,AIDS ,SEX workers - Abstract
Increasing emphasis is being placed on the need for 'structural interventions' (SIs) in HIV prevention internationally. There is great variation in how the concept of SI is defined and operationalised, however, and this has potentially problematic implications for their likely success. In this paper, we clarify and elucidate what constitutes a SI with particular reference to the structured distribution of power and to the role of communities. We summarise the background to the growing emphasis being placed on the concept of SIs in HIV prevention policy, and present ethnographic case-study material from a sex worker's HIV project in Kolkata, India, to illustrate the nature of HIV vulnerability and its implications for the design and targeting of successful SIs. The paper draws attention to the dual importance of (1) attending to local complexities in the micro and macro-level structures that produce vulnerability; and (2) clarifying the meaning and role of communities within SIs. [ABSTRACT FROM AUTHOR]
- Published
- 2010
- Full Text
- View/download PDF
31. Ethnographic Mapping of Alcohol Use and Risk Behaviors in Delhi.
- Author
-
Tripathi, B. M., Sharma, H. K., Pelto, P. J., and Tripathi, S.
- Subjects
HUMAN sexuality ,DRUG abuse ,ALCOHOL drinking ,SEXUALLY transmitted diseases ,GROUP sex ,CONDOM use - Abstract
This paper examines mapping and related data-gathering at geographical locations of vulnerable urban groups with regard to risky sexual behaviors and alcohol/drug use in the capital city of Delhi. The aim is to describe the situations of special geographic locations and sub-groups in relation to alcohol/drug use and risks of HIV/STI infections. The study was part of a community program for alcohol and drug users in slum communities in West and East Delhi carried out by the National Drug Dependence Treatment Centre (NDDTC) of the All India Institute of Medical Science (AIIMS), New Delhi, India. As part of a WHO multi-centered qualitative study among selected groups, mapping was done at different sites concerning alcohol use, social contexts, involvement in sexual risk behavior, availability of sex partners and related factors. Easy access to alcohol and drugs, accompanied by availability of sex workers appeared as compound risk factors in the study sites. Reported risky sexual behaviors included nonuse or irregular use of condoms, multiple sex partners, group sex, and anal sex with hijras (eunuchs). [ABSTRACT FROM AUTHOR]
- Published
- 2010
- Full Text
- View/download PDF
32. The Use of Qualitative Comparative Analysis for Critical Event Research in Alcohol and HIV in Mumbai, India.
- Author
-
Schensul, Jean J., Chandran, Devyani, Singh, S. K., Berg, Marlene, Singh, Sharad, and Gupta, Kamla
- Subjects
AIDS research ,SEXUAL behavior surveys ,INTERVIEWING ,ALCOHOLISM ,UNSAFE sex - Abstract
In this paper we use Qualitative Comparative Analysis (QCA) in critical event analysis to identify under what conditions alcohol is necessary in contributing to unprotected sex. The paper is based on a set of in-depth interviews with 84 men aged 18 = 29 from three typical low income communities in Mumbai who reported using alcohol and having sex with at least one nonspousal partner once or more in the 30 days prior to the interview. The interviews included narratives of critical events defined as recent (past 30–60 day) events involving sexual behavior with or without alcohol. The paper identifies themes related to alcohol, sexuality and condom use, uses QCA to identify and explain configurations leading to protected and unprotected sex, and explains the differences. The analysis shows that alcohol alone is not sufficient to explain any cases involving unprotected sex but alcohol in combination with partner type and contextual factors does explain unprotected sex for subsets of married and unmarried men. [ABSTRACT FROM AUTHOR]
- Published
- 2010
- Full Text
- View/download PDF
33. ICT and AIDS literacy: a challenge for information professionals in India.
- Author
-
Ghosh, Maitrayee
- Subjects
DIGITAL libraries ,INFORMATION technology ,INFORMATION professionals ,HIV ,AIDS - Abstract
Purpose -- The purpose of this paper is to describe the use of ICT to disseminate preventive health care information to combat the AIDS epidemic in India. The role of information professionals in various libraries and information centres and the challenges they are facing to increase HIV/AIDS awareness are discussed. Finally, recommendations are given and the conclusion is drawn that libraries and information professionals must develop AIDS literacy programmes to cater to the growing health information needs of the community. Design/methodology/approach -- Literature search, web site information and personal interaction with the key persons associated with various HIV/AIDS awareness projects. Findings -- lack of knowledge about AIDS, its modes of transmission and ways to avoid infection, are major challenges in India. Staff in ICT-based library and information centres can make a high impact on the local community by developing community-based AIDS literacy programmes and hopefully save the society from an AIDS epidemic. There is a perceived need for providing health information services through public libraries to the illiterate rural population who are increasingly making themselves vulnerable to HIV/AIDS. However, awareness of e-channels is low, especially in rural India; one solution is to increase take-up and run AIDS awareness campaigns through electronic media. Originality/value -- A summary is provided of ICT-based projects and initiatives by libraries and other agencies to disseminate AIDS information. Few multi-type consortia have been formed in the USA and UK to develop AIDS databases and e-learning modules are listed. These can be used as examples by Indian libraries with limited resources wishing to enhance community awareness through ICT. The concerted efforts amongst stakeholders are emphasized with the objectives of enhancing information professionals' skill in the AIDS information dissemination process. [ABSTRACT FROM AUTHOR]
- Published
- 2007
- Full Text
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34. Dried blood spots are an acceptable and useful HIV surveillance tool in a remote developing world setting.
- Author
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Solomon, S. S., Pulimi, S., Rodriguez, I. I., Chaguturu, S. K., Satish Kumar, S. K., Mayer, K. H., and Solomon, S.
- Subjects
ENZYME-linked immunosorbent assay ,WESTERN immunoblotting ,HIV infections - Abstract
Enzyme-linked immunosorbent assay and Western blot analysis of dried blood spots (DBS) on filter paper have been shown to be as sensitive and specific as analysis of serum, and therefore may be a cost-effective and culturally appropriate HIV seroprevalence tool in remote areas. This study examines the acceptability of DBS in a tropical, rural population from an outpatient clinic in Andhra Pradesh, India, where participation was offered to every fifth patient seeking general medical care between March and April 2001. All 1413 patients approached for the study agreed to participate and provide a DBS for examination. The overall HIV seroprevalence in this sample was 2.8%. Of the participants, 51.7% were male, 93.2% were between the ages of 18 and 40, 85.3% were married, 29.7% were employed, 47.6% had no education and 73.1% resided in a rural setting. In the univariate analysis, history of genital warts (P = 0.01), sexually transmitted disease (P = 0.001), premarital sexual intercourse (P = 0.002), sexual contact with a commercial sex worker (P = 0.003), being employed (P = 0.011) and having more than 10 injections for medical purposes (P = 0.006) all correlated with being HIV-infected. Given the uniform willingness of these clinic attendees to be tested, we conclude that DBS is a useful, cost-effective tool in HIV serosurveillance in a rural, tropical setting. [ABSTRACT FROM AUTHOR]
- Published
- 2004
- Full Text
- View/download PDF
35. Stigma, violence and HIV vulnerability among transgender persons in sex work in Maharashtra, India.
- Author
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Ganju, Deepika and Saggurti, Niranjan
- Subjects
HIV-positive transgender people ,HIV infection transmission ,VIOLENCE ,SEX workers ,EMPLOYMENT discrimination ,DISEASES ,HIV infection epidemiology ,ADAPTABILITY (Personality) ,INTERVIEWING ,HUMAN sexuality ,SOCIAL stigma ,QUALITATIVE research ,AT-risk people - Abstract
Copyright of Culture, Health & Sexuality is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2017
- Full Text
- View/download PDF
36. Making global health knowledge: documents, standards, and evidentiary sovereignty in HIV interventions in South India.
- Author
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Lorway, Robert
- Subjects
HIV prevention ,DOCUMENTATION standards ,COMMUNITY health workers ,INTERVIEWING ,THEORY of knowledge ,RESEARCH funding ,HUMAN sexuality ,WORLD health ,ETHNOLOGY research ,EVIDENCE-based medicine ,FIELD research ,COMMUNITY-based social services ,HEALTH literacy ,PSYCHOLOGY - Abstract
This paper explores how an array of HIV epidemic responders became embroiled in producing quantitative evidence for HIV interventions in India. Based upon extensive ethnographic fieldwork in Karnataka State, I examine the life history of the Gates-funded AIDS initiative in India known as Avahan as a case study to consider the social and political implications of large-scale, standardizing knowledge regimes enacted in the era of global health. Specifically, I analyze a sample of the key material artifacts that are implicated in the production of standardized knowledge in an attempt to illuminate the workings of what I refer to as ‘evidentiary sovereignty’. I argue that documents, forms, and other paperwork used to generate evidence in global health interventions neither merely reflect expert knowledge nor convey information about scientific standards but, rather,are integral to the re-instantiation of sovereignty.The effects of evidentiary sovereignty not only narrow the aperture of global health interventions to overlook the on-the-ground realities that shape health problems, but they also transform the very ground upon which communities responding to HIV epidemics conceive of and enact politics. As highly HIV-affected communities struggle with the bureaucratic demands of intensive form-filling and query agreed upon standards and systems of classification, a form of politicization of knowledge unfurls that pertains to the documents themselves. [ABSTRACT FROM PUBLISHER]
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- 2017
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37. Mainstreaming Human Immunodeficiency Virus (HIV) Insurance in India: Opportunities and Challenges.
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Trivedi, M.
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POVERTY ,HEALTH insurance ,HIV ,HIV-positive persons ,MEDICAL care - Abstract
Millions of Indians fall into poverty because of the private high Out of Pocket pattern of health financing, due to the absence of insurance coverage. Conditions like HIV and AIDS also influence poverty due to a lifelong treatment requirement. Access to insurance coverage (commercial or voluntary) has been denied to People Living with HIV (PLHIV) through various clauses. However lately, there have been certain experiments on inclusion of HIV into new or existing schemes. This paper provides a systematic review of coverage, managerial and financial systems of selected cases of HIV insurance pilots in India with an objective to explore its sustainability and ability to be replicated. A cross-sectional descriptive analysis of existing literature and in-depth case studies of relevant health insurance schemes were used for the review. Data was compiled using qualitative data collection tools such as in-depth interviews with officials. The schemes were analysed using two frameworks viz. managerial ability and coverage ability. The managerial ability was analysed through a Strength-Weakness-Opportunity- Threat (SWOT) analysis. The coverage ability was analysed through three dimensions viz. a) breadth b) depth and c) height. In India, there are two types of insurance policies vis-à-vis HIV coverage. These were categorised as HIV-specific and HIV-sensitive policies. Of the seven pilot schemes reviewed, the small-scale health insurance schemes show limited success owing to smaller pool and limited managerial capabilities. The large schemes offer avenues for mainstreaming but pose issues of governance as well as marketing among PLHIVs. The findings of the research identify a specific set of issues and challenges for sustainability and replication from three perspectives viz. a) market, b) cost recovery and sustainability and c) equitable coverage. [ABSTRACT FROM AUTHOR]
- Published
- 2017
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38. Vulnerability to Sexually Transmitted Infections (STI) / Human Immunodeficiency Virus (HIV) among adolescent girls and young women in India: A rapid review.
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Paul, Sohini, Sharma, Anupam, Dayal, Radhika, Mehta, Mahika, Maitra, Sudeshna, Seth, Kuhika, Nagrath, Monal, Ramesh, Sowmya, and Saggurti, Niranjan
- Subjects
HIV ,INDIAN women (Asians) ,TEENAGE girls ,SEXUALLY transmitted diseases ,YOUNG women ,QUALITY control ,HUMAN sexuality - Abstract
Limited evidence is available on the vulnerability of Adolescent Girls and Young Women (AGYW) to sexual risk behaviour and STI/HIV. Though there are almost no statistics available on vulnerability, related literature suggests that AGYW have low awareness about sexual risk behaviour/ transmission and the prevalence of STI/HIV, making them vulnerable. We conducted a rapid review of peer-reviewed studies addressing transmission network, prevalence, incidence awareness, common determinants of sexual risk behaviour/STI/HIV, health-seeking behaviour and existing interventions addressing the situation among AGYW (age 15–24) to inform the evidence gap in this crucial area of research. We registered the study in PROSPERO (CRD42023403713). We developed detailed inclusion/exclusion criteria, searched JSTOR, PubMed, Google Scholar, Science Direct and Population Council Knowledge Commons databases and followed the guidance from Cochrane Rapid Review to develop the rapid review. We also searched the bibliography of the included studies. We included the English language peer-reviewed quantitative, qualitative, mixed method studies published from Jan 1 2000 to Mar 31 2023. Six reviewers extracted data, and the seventh reviewer independently assessed the quality. Ninety-six studies met the inclusion criteria. We used descriptive statistics and narrative synthesis methods for data analysis. We also conducted a Risk of Bias Assessment (RoB) to check the quality of the included studies. Inadequate literature was found on the transmission network. Prevalence and awareness of STI/HIV are low among AGYW. However, Female Sex Workers, sex-trafficked women or drug users in this age group suffer more. Age, education, income, relationship dynamics with spouses/partners, multiple partners, and substance use are crucial in determining STI/HIV. Traditional sources of health seeking are more popular than formal sources because of social stigma. Mass media campaigns, community mobilization programs, and life skills training programs increase awareness about HIV, condom use and self-efficacy. The inclusion of only English language studies and not conducting meta-analysis because of high heterogeneity are some of the limitations of the study. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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39. Clinical Abacavir Hypersensitivity Reaction among Children in India.
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Chakravarty, Jaya, Sharma, Saurabh, Johri, Anuradha, Chourasia, Ankita, and Sundar, Shyam
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DRUG allergy ,HIV infections ,ANTI-HIV agents ,DEOXYRIBONUCLEOSIDES - Abstract
Abacavir is currently recommended as a part of first line regimen by National AIDS Control Organization. The objective of this study was to observe the incidence of clinically diagnosed abacavir Hypersensitivity reaction (HSR) among children on abacavir based therapy in the National program. In this observational study, all children started on abacavir were included and HSR reaction was diagnosed clinically as per National guidelines. HLA- B*5701 testing was done in children diagnosed with clinical abacavir HSR. Among 101 children started on abacavir during the study period, 8 [7.9 % (95 % CI 3.5-15.0 %)] children developed clinically diagnosed abacavir HSR. All children with concomitant illness (4/8) were HLA-B*5701 negative. Only 2 (25 %, 2/8) carried HLA-B*5701 allele. Fever with abdominal symptoms as compared to respiratory symptoms were more common in HLA-B*5701 positive cases. Overdiagnosis of clinically diagnosed abacavir HSR is common and could be decreased by treating concomitant illness before starting abacavir. [ABSTRACT FROM AUTHOR]
- Published
- 2016
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40. Towards ‘reflexive epidemiology’: Conflation of cisgender male and transgender women sex workers and implications for global understandings of HIV prevalence.
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Perez-Brumer, Amaya G., Oldenburg, Catherine E., Reisner, Sari L., Clark, Jesse L., and Parker, Richard G.
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HIV prevention ,HIV infection epidemiology ,CINAHL database ,CONFIDENCE intervals ,EPIDEMIOLOGICAL research ,GENDER identity ,MEDICAL information storage & retrieval systems ,PSYCHOLOGY information storage & retrieval systems ,HEALTH policy ,MEDLINE ,META-analysis ,ONLINE information services ,PRACTICAL politics ,SEX work ,RESEARCH funding ,HUMAN sexuality ,SEX distribution ,SYSTEMATIC reviews ,TRANSGENDER people ,SECONDARY analysis ,DISEASE prevalence ,MEN who have sex with men ,DESCRIPTIVE statistics - Abstract
The HIV epidemic has had a widespread impact on global scientific and cultural discourses related to gender, sexuality, and identity. ‘Male sex workers’ have been identified as a ‘key population’ in the global HIV epidemic; however, there are methodological and conceptual challenges for defining inclusion and exclusion of transgender women within this group. To assess these potential implications, this study employs self-critique and reflection to grapple with the empiric and conceptual implications of shifting understandings of sexuality and gender within the externally re-created etic category of ‘MSM’ and ‘transgender women’ in epidemiologic HIV research. We conducted a sensitivity analysis of our previously published meta-analysis which aimed to identify the scope of peer-reviewed articles assessing HIV prevalence among male sex workers globally between 2004 and 2013. The inclusion of four studies previously excluded due to non-differentiation of cisgender male from transgender women participants (studies from Spain, Thailand, India, and Brazil: 421 total participants) increased the overall estimate of global HIV prevalence among ‘men’ who engage in sex work from 10.5% (95% CI 9.4–11.5%) to 10.8% (95% CI 9.8–11.8%). The combination of social science critique with empiric epidemiologic analysis represents a first step in defining and operationalising ‘reflexive epidemiology’. Grounded in the context of sex work and HIV prevention, this paper highlights the multiplicity of genders and sexualities across a range of social and cultural settings, limitations of existing categories (i.e. ‘MSM’, ‘transgender’), and their global implications for epidemiologic estimates of HIV prevalence. [ABSTRACT FROM AUTHOR]
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- 2016
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41. ‘No one was there to care for us’: Ashodaya Samithi's community-led care and support for people living with HIV in Mysore, India.
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Chevrier, Claudyne, Khan, Shamshad, Reza-Paul, Sushena, and Lorway, Robert
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HIV prevention ,ATTITUDE (Psychology) ,HEALTH promotion ,PSYCHOLOGY of HIV-positive persons ,INTERVIEWING ,MEDICAL personnel ,SEX work ,SOCIAL stigma ,WORK environment ,ETHNOLOGY research ,FIELD research ,SOCIAL support ,COMMUNITY-based social services - Abstract
Under the umbrella of the Bill and Melinda Gates-funded HIV initiative in India, the Mysore-based sex workers’ (SWs) collective Ashodaya Samithi focused on improving its members’ living and working conditions through community-led structural interventions, including community mobilisation, advocacy, peer-led support, and health promotional activities. Based on four months of ethnographic fieldwork, this article examines the care and support activities of one of its sub-wings, Ashraya, which specifically focuses on people living with HIV and AIDS (PLHIV). We first discuss the stigma-related perceptions and experiences of participants in relation to health-care settings and work environment, families and communities, and within varied HIV support networks. We then explore how Ashraya's community-led interventions attempt to challenge the structural forces feeding on and creating stigma. We argue that the current policy focus on the involvement of SWs’ collectives in sexually transmitted infection (STI) prevention in India is rather limited and should be expanded along the continuum of care and support offered to PLHIV. As suggested in this paper, SWs’ organisations may have greater potential to contribute to more than STI prevention work, both within and outside their communities, than currently recognised. [ABSTRACT FROM PUBLISHER]
- Published
- 2016
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42. The social impact of HIV/AIDS in India.
- Author
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Solomon, S, Kumarasamy, N, and Challacombe, SJ
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AIDS & psychology ,DIAGNOSIS of HIV infections ,HIV prevention ,HIV infections & psychology ,MEDICAL research ,AIDS ,DISCRIMINATION (Sociology) ,FEAR ,HEALTH services accessibility ,HOMOSEXUALITY ,LEADERSHIP ,MARRIAGE ,PHYSICIANS ,PREJUDICES ,SEX education ,SOCIAL classes ,SOCIAL stigma ,HEALTH & social status ,ATTITUDES toward illness ,SOCIETIES - Abstract
This paper is based on the last public lecture given by Dr Solomon at the 7th World Workshop on Oral Health & Disease in HIV/AIDS, held in Hyderabad, India, in November 2014. It examines the social impact of HIV in India and the founding of the Y.R. Gaitonde Center for AIDS Research and Education (YRG CARE) clinic in Chennai, India, by Dr Suniti Solomon and her colleagues. This is a story of prejudice and ignorance throughout the various social levels in India. Reports of India's first AIDS case surfaced in 1986, when female sex workers were found to be HIV positive. The first voluntary counseling and testing center, part of a sexually transmitted diseases (STD) clinic, was set up to increase awareness about the epidemic. To address the rapid spread of HIV infection in Tamil Nadu and the existing stigma in society and hospitals, Dr Solomon established YRG CARE in 1993. She recognized that fear and panic about HIV led to widespread social prejudice against HIV-positive patients, even within hospitals. By the end of 2014, over 34 000 patients had accessed these services and 20 000 HIV+ patients had been registered, nearly 40% of whom were females. The team embarked on a statewide awareness program on HIV and sexuality, covering over two hundred schools and colleges educating them about prevention strategies and combating the social stigma attached. The grass-root work of YRG CARE in the management of HIV infections revealed a widespread prejudice, due largely to the lack of awareness about the subject. It is estimated that even in 2015, as little as 40% of HIV-infected people are formally diagnosed and have access to care. In a country as socially and culturally diverse as India, there is much more to be carried out to build on the pioneering work of Dr Solomon. [ABSTRACT FROM AUTHOR]
- Published
- 2016
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43. Epidemiological study of syndromic diagnosis cases of HIV positive in Government General Hospital, Nizamabad.
- Author
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Rao, Poola Ramachnadra and Narayana, S. Surya
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HIV-positive persons ,SEXUALLY transmitted diseases ,HOSPITALS ,DIAGNOSIS - Abstract
Sexually transmitted diseases (STD) consist of different group of endemic diseases of varying clinical presentation, characterized epidemiologically as sexually transmitted infections. Sexually transmitted diseases in individuals have far reaching health, social and economic consequences. Sexually transmitted infections are very important because of their potential complication and interaction with HIV/AIDS. Recognition of HIV/STI cases has tremendous contribution for targeted intervention in the hospital. By evaluating the HIV/STI cases it will be a signal to know the affected groups and major determinants. In this Paper, the study was conducted to evaluate the clinical, epidemiological and laboratory characteristics of the sexually transmitted diseases (STD) found in the government general Hospital, Nizamabad in the year 2013. [ABSTRACT FROM AUTHOR]
- Published
- 2016
44. ‘I am doing fine only because I have not told anyone’: the necessity of concealment in the lives of people living with HIV in India.
- Author
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George, Mathew Sunil and Lambert, Helen
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PSYCHOLOGY of HIV-positive persons ,SOCIAL stigma ,HIV prevention ,PERSONAL secrets ,PATIENT compliance - Abstract
Copyright of Culture, Health & Sexuality is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2015
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45. Consumption patterns and levels among households with HIV positive members and economic impoverishment due to medical spending in Pune city, India.
- Author
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Sharma, Varun, Krishnaswamy, Divya, and Mulay, Sanjeevanee
- Subjects
POVERTY ,PSYCHOLOGICAL adaptation ,CHI-squared test ,HIV-positive persons ,RESEARCH methodology ,MEDICAL care costs ,RESEARCH funding ,SEX distribution ,STATISTICS ,T-test (Statistics) ,DESCRIPTIVE statistics - Abstract
HIV infection poses a serious threat to the economy of a household. Out of pocket (OOP) health spending can be prohibitive and can drag households below poverty level. Based on the data collected from a cross-sectional survey of 401 households with HIV+ members in Pune city, India, this paper examines the consumption levels and patterns among households, and comments on the economic impoverishment resulting from OOP medical spending. Analysis reveals that households with HIV members spend a major portion of their monthly consumption expenditure on food items. Medical expenditure constitutes a large portion of their total consumption spending. Expenditure on children's education constitutes a minor proportion of total monthly spending. A high proportion of medical expenditure has a bearing on the economic condition of households with HIV members. Poverty increases by 20% among the studied HIV households when OOP health spending is adjusted. It increases 18% among male-headed households and 26% among female-headed households. The results reiterate the need of greater support from the government in terms of accessibility and affordability of health care to save households with HIV members from economic catastrophe. [ABSTRACT FROM AUTHOR]
- Published
- 2015
- Full Text
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46. HIV epidemic among men who have sex with men in India: national scenario of an unfinished agenda.
- Author
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Jha, Ugra Mohan, Raj, Yujwal, Venkatesh, Srinivas, Dhingra, Neeraj, Paranjpe, Ramesh S., and Saggurti, Niranjan
- Subjects
EPIDEMICS ,HIV-positive persons ,MEN who have sex with men ,SOCIODEMOGRAPHIC factors - Abstract
Background: Although India has demonstrated success in the overall reduction of human immunodeficiency virus (HIV) incidence by 57% in the past 10 years, its control among men who have sex with men (MSM) remains a critical challenge. This paper describes the current status, geographic variability, and factors associated with HIV among MSM from the national perspective. Methods: Data on the levels and trends of HIV seropositivity and associated risk behaviors among MSM were analyzed and presented from the following data sources: 1) annual HIV Sentinel Surveillance (HSS) conducted during 2003-10, 2) two rounds of the high-risk group size estimation conducted in 2005 and 2009, 3) two rounds of the Behavioral Surveillance Survey conducted in 2006 and 2009, and 4) the Integrated Bio-behavioral Assessment Round 2. Data were analyzed according to selected sociodemographic characteristics and sexual identities of MSM to understand the factors associated with high HIV prevalence. Results: HSS data indicate that at the national level, HIV prevalence among MSM overall is declining (from 12.3% in 2003 to 4.43% in 2010). However, marginal increasing trends were observed in Chandigarh (from 1.4% in 2004 to 2.8% in 2008) and Haryana (from 0% in 2006 to 3.2% in 2008). HSS data indicate high (.5%) levels and increasing trends in HIV prevalence among MSM in eight states of India during 2003-10. Analysis of 2010 HSS data indicates that HIV prevalence was .10% in seven states. The factors associated with high HIV prevalence among MSM were being a kothi (the receptive partner in oral and anal sex, and typically with effeminate mannerisms) or a double-decker (both penetrative and receptive partner) rather than being a panthi (the penetrative partner in oral or anal sex) (8% vs 4.3%; P,0.05), being older than 25 years in age than their younger counterparts (9% vs 4.5%; P,0.05), illiterate rather than literate MSM (9.5% vs 6.9%; P,0.05), and employed versus unemployed MSM (9.1% vs 7.8%; P,0.05). Conclusion: While HIV prevalence among MSM at the national level is declining, it continues to remain high in some states and cities. Programs need to build on the successes in reducing HIV among female sex workers in order to control the high HIV prevalence among MSM in India. [ABSTRACT FROM AUTHOR]
- Published
- 2014
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47. Engagement of vulnerable communities in HIV prevention research in India: a qualitative investigation.
- Author
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Chakrapani, Venkatesan, Loganathan, Vijayalakshmi, Saha, Paromita, Bose, Devi Leena, Khan, Nabeela, Aurora, Tiara, Narayan, Jyoti, Mukherjee, Joyeeta, Hadi, Saif ul, and Dewan, Chitrangna
- Subjects
HIV prevention ,TRANSGENDER youth ,HIV ,FIELD research ,QUALITATIVE research ,FOCUS groups ,TRANS women - Abstract
Background: Meaningful community engagement (CE) in HIV prevention research is crucial for successful and ethically robust study implementation. We conducted a qualitative study to understand the current CE practices in HIV prevention research and to identify expressed and implicit reasons behind translational gaps highlighted by communities and researchers. Methods: For this exploratory qualitative study, we recruited a purposive sample of participants from Indian government-recognised key populations such as men who have sex with men, transgender women, people who inject drugs and female sex workers; general population adults and adolescents/youth; and researchers. We conducted 13 virtual focus groups (n = 86) between July and October 2021. Data were explored from a critical realist perspective and framing analysis (i.e., examining how the participants framed the narratives). Results: Participants reported that study communities, especially those from key populations, were primarily involved in data collection, but not necessarily with optimal training. Involvement of communities before the start of the study (e.g., obtaining feedback on the study's purpose/design) or once the study is completed (e.g., sharing of findings) were highlighted as priorities for meaningful engagement. Participants suggested meaningful CE in all stages of the study: (1) before the study—to get inputs in finalising the study design, drafting comprehensible informed consent forms and culturally-appropriate data collection tools, and deciding on appropriate monetary compensation; (2) during the study—adequate training of community field research staff; and (3) after the study—sharing the draft findings to get community inputs, and involving communities in advocacy activities towards converting evidence into action, policy or programs. Timely and transparent communications with communities were explicitly stated as critical for gaining and maintaining trust. Mutual respect, reciprocity (e.g., appropriate monetary compensation) and robust community feedback mechanisms were considered critical for meaningful CE. Conclusions: The findings highlighted the translational gaps and priority areas for capacity building to strengthen CE in HIV prevention research. It is not only important to engage communities at various stages of research but to understand that trust, dignity, respect, and reciprocity are fundamentally preferred ways of meaningful community engagement. Plain English summary: Engaging communities in HIV prevention research enhances the rigour and impact of research. We sought to understand the current community engagement practices and to identify how communities preferred to get involved in research. We explored these topics with key and general populations and researchers, by conducting 13 focus group discussions with 86 participants. We found that there was limited involvement of communities before the start of the study and after its completion, although trained community members were involved in data collection. Participants strongly suggested that the community should be involved throughout—before initiation, during the study and after study completion. Participants' preferred ways of engaging communities reflected that mutual respect, reciprocity and transparent communications are critical for meaningful and successful community engagement. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
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48. Caregivers' experiences of accessing HIV Early Infant Diagnosis (EID) services and its barriers and facilitators, India.
- Author
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Nikhare, Kalyani, Gawde, Nilesh, Kamble, Suchit, Goel, Noopur, Kamble, Sushmita, Pawar, Swapna, More, Pratik, Kapoor, Neha, Verma, Vinita, Kushwaha, Bhawani Singh, Das, Chinmoyee, and Rajan, Shobini
- Subjects
CAREGIVER attitudes ,CAREGIVERS ,HIV ,EARLY diagnosis ,HIV infections - Abstract
Background: India has rolled out Early Infant Diagnosis (EID) program for HIV infection in all states. EID program consists of testing of Infants exposed to HIV periodically over 18 months of age which is a multi-step complex testing cascade. Caregivers represent the primary beneficiary of EID program i.e., infants exposed to HIV and face multiple challenges to access EID services. As part of national EID program outcome assessment study, this study narrates caregivers' perspectives on barriers and facilitators to access and utilize EID services. Methods: The study was conducted in 31 integrated counselling and testing centres (ICTCs) located in 11 high burden HIV states. A total of 66 in-depth interviews were conducted with caregivers' of infants enrolled in EID program. Thematic analysis was carried out to help identify themes underlying barriers and facilitators to access EID services and utilization from caregivers' perspectives. Results: The stigma and discrimination prevalent in society about HIV remains a key demand side (caregiver-level) barrier. Non-disclosure or selective disclosure of HIV status led to missed or delayed EID tests and delayed HIV diagnosis and initiation of Anti-Retroviral Therapy (ART) for infants exposed to HIV. On supply side (health system-level), accessibility of healthcare facility with EID services was reported as a key barrier. The distance, time and cost were key concerns. Many caregivers faced difficulties to remember the details of complex EID test schedule and relied on a phone call from ICTC counsellor for next due EID test. Delayed EID test results and lack of communication of test results to caregiver were reported as primary barriers for completing the EID test cascade. Discussion: The study reports caregiver-level and health system-level barriers and facilitators for access to EID services from the caregivers' perspectives. While, decentralisation and single window approaches can improve the access, timely communication of test results to the caregiver also need to be built in with appropriate use of technology. A holistic intervention including PLHIV support networks and the peer-led support mechanisms would be useful to address societal factors. Conclusion: The study findings have high significance for developing program implementation strategies to improve access and to build right-based and patient-centred EID services. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
49. Extrapulmonary tuberculosis - A cross-sectional study comparing the utility of Ziehl-Neelsen stain and immunohistochemistry.
- Author
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Gurusamy, Veera Raghavan, Sundararajan, Kanimozhi, Prakasam, Gowri, and T. M., Vincy
- Subjects
EXTRAPULMONARY tuberculosis ,MYCOBACTERIUM tuberculosis ,CROHN'S disease ,HISTOPLASMOSIS ,RESOURCE-limited settings ,HIV - Abstract
Background: Tuberculosis (TB) continues to be a significant global health issue despite known causes and effective treatments. Factors such as virulent strains, drug resistance, and the human immunodeficiency virus pandemic, especially in India, contribute to its prevalence. Mycobacterium tuberculosis, the TB agent, can evade immune responses, persisting within host cells. A distinct feature of TB, granuloma formation, can also appear in diseases such as leprosy, histoplasmosis, and non-infectious conditions like Crohn's disease. Proper diagnosis is vital, as in resource-limited countries, TB treatment often relies on presumptive diagnoses based on imaging and symptoms, leading to high false positive rates. Aims and Objectives: This study aims to compare the utility of Ziehl-Neelsen (ZN) staining and immunohistochemistry (IHC) staining in suspected extrapulmonary TB lesions. Materials and Methods: This is a retrospective cross-sectional study conducted at the Institute of Pathology, Rajiv Gandhi Government General Hospital, Chennai, over a 2-year period from August 2015 to July 2017. Fifty cases out of the 198 suspected extrapulmonary TB lesions were selected for the study. Results: About 12% of cases were positive for acid-fast bacilli by ZN staining, whereas 82% of cases were positive for acid-fast bacilli by IHC staining. P value was found to be <0.001 by McNemar test which was statistically significant. Conclusion: Diagnosing extrapulmonary TB can be challenging because the disease presents with various clinical manifestations and the bacterial load may be low. Immunohistochemistry is superior to ZN staining for localization of the tubercle bacilli and thus can serve as an effective ancillary technique in diagnoses of extrapulmonary TB in formalin-fixed paraffin embedded tissue sections. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
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50. HIV risk perception among pregnant women in western India: Need for reducing vulnerabilities rather than improving knowledge!
- Author
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Darak, Shrinivas, Gadgil, Mukta, Balestre, Eric, Kulkarni, Maitreyee, Kulkarni, Vinay, Kulkarni, Sanjeevani, and Orne-Gliemann, Joanna
- Subjects
HIV prevention ,HIV infection risk factors ,CONFIDENCE intervals ,EPIDEMIOLOGY ,SENSORY perception ,PRENATAL care ,PSYCHOLOGY of Spouses ,DATA analysis ,MULTIPLE regression analysis ,HARM reduction ,INTIMATE partner violence ,HEALTH literacy ,DATA analysis software ,PSYCHOLOGICAL vulnerability ,DESCRIPTIVE statistics - Abstract
Since the beginning of the HIV/AIDS epidemic in India, pregnant women attending antenatal clinics (ANC) have been considered as a low HIV risk population. Yet, a substantial proportion of new HIV infections are occurring among stable heterosexual couples. This paper sought to investigate the proportion and profile of women who, within the low-risk population, are potentially at higher risk of HIV infection. HIV risk perception of pregnant women enrolled within the ANRS 12127 Prenahtest trial was described and associated socio-behavioral characteristics, husband's characteristics, and HIV-related characteristics were analyzed using univariate and multivariate logistic regression models. Among 484 women enrolled, baseline data were collected for 479 women and 460 women with completed data were considered for the present analysis (96%). Eighty-nine (19.4%) women perceived themselves at risk of HIV. Women with educational level <11years (Adjusted Odds Ratio, AOR = 2.4 [CI = 1.28–4.53]), who stayed in joint families (AOR = 1.89 [CI = 1.12–3.12]), who had experienced insult or hurt from the partner (AOR = 1.91 [CI = 1.11–3.27]) and whose partner were alcoholic (AOR = 2.19 [CI = 1.31–3.66]) were significantly more likely to perceive themselves at risk of HIV. Women who had heard about sexually transmitted infections were also more likely to report HIV risk perception (AOR = 3.36 [CI = 1.83–6.18]). Substantial proportion of women (one out of five) perceived themselves at risk of HIV and most of these have reported some form of vulnerability in their couple relationship such as intimate partner violence, alcoholic partner, lack of communication, and spaces for communication with partner. Though awareness and knowledge is the first step for prevention, considering the vulnerabilities associated with HIV risk perception, HIV prevention interventions in India should target overall sources of vulnerability to HIV. Targeted risk reduction for women in ANC should be considered for primary HIV prevention among couples. [ABSTRACT FROM AUTHOR]
- Published
- 2014
- Full Text
- View/download PDF
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