Sivaram Sudha, Saluja Gurcharan Singh, Das Manik, Reddy P Sudhakar, Yeldandi Vijay
Infectious Diseases Program, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Room E6610, Baltimore, MD 21205, USA.
J Health Popul Nutr. 2008 Dec;26(4):431-41. doi: 10.3329/jhpn.v26i4.1885.
This study sought to describe the development of HIV counselling and testing services in a rural private hospital and to explore the factors associated with reasons for seeking HIV testing and sexual behaviours among adults seeking testing in the rural hospital. Data for this study were drawn from a voluntary counselling and testing clinic in a private hospital in rural Andhra Pradesh state in southern India. In total, 5,601 rural residents sought HIV counselling and testing and took part in a behavioural risk-assessment survey during October 2003-June 2005. The prevalence of HIV was 1.1%. Among the two reported reasons for test-seeking--based on past sexual behaviour and based on being sick at the time of testing--men, individuals reporting risk behaviours, such as those having multiple pre- and postmarital sexual partners, individuals whose recent partner was a sex worker, and those who reported using alcohol before sex, were more likely to seek testing based on their past sexual behaviour. Men also were more likely to seek testing because they were sick. The findings from this large sample in rural India suggest that providing HIV-prevention and care services as part of an ongoing system of healthcare-delivery may benefit rural residents who otherwise may not have access to these services. The implications of involving the private sector in HIV-related service-delivery and in conducting research in rural areas are discussed. It is argued that services that are gaining prominence in urban areas, such as addressing male heterosexual behaviours and assessing the role of alcohol-use, are equally relevant areas of intervention in rural India.
本研究旨在描述一家农村私立医院中艾滋病病毒咨询与检测服务的发展情况，并探讨在该农村医院寻求检测的成年人中，与寻求艾滋病病毒检测的原因及性行为相关的因素。本研究的数据来自印度南部安得拉邦农村一家私立医院的自愿咨询与检测诊所。2003年10月至2005年6月期间，共有5601名农村居民寻求艾滋病病毒咨询与检测，并参与了一项行为风险评估调查。艾滋病病毒感染率为1.1%。在报告的两个寻求检测的原因中——基于过去的性行为和基于检测时生病——男性、报告有风险行为的个体，如婚前和婚后有多个性伴侣的人、近期伴侣是性工作者的人以及报告在性行为前饮酒的人，更有可能基于过去的性行为寻求检测。男性也更有可能因为生病而寻求检测。印度农村地区这个大样本的研究结果表明，将艾滋病病毒预防和护理服务作为持续医疗服务体系的一部分提供，可能会使那些原本无法获得这些服务的农村居民受益。文中讨论了私营部门参与农村地区艾滋病相关服务提供和开展研究的意义。有人认为，在城市地区日益受到关注的服务，如解决男性异性性行为问题和评估饮酒的作用，在印度农村同样是相关的干预领域。
