Pai Nitika Pant, Joshi Rajnish, Moodie Erica E M, Taksande Bharati, Kalantri S P, Pai Madhukar, Tulsky Jacqueline P, Reingold Arthur
Division of Infectious Diseases and Immunodeficiency Service, Montreal Chest Institute, Montreal, Canada.
AIDS Care. 2009 Mar;21(3):294-300. doi: 10.1080/09540120802183529.
Rural India has an undetected load of HIV-positive individuals. Few rural adults present for HIV testing and counseling due to stigma, discrimination, and fear of social ostracization. In this rural hospital clinic-based study, we document profiles of rural adults seeking voluntary testing and counseling, and analyze correlates of HIV seropositivity. This cross-sectional study was conducted in 450 participants presenting to the outpatient clinics of Mahatma Gandhi Institute of Medical Sciences, Sevagram, Central India. After informed consent, pre- and post-test counseling, HIV testing, and face-to-face interviews were conducted. Data were collected using a structured questionnaire. The median age of the 450 study participants was 34 years (range 18-88 years); the majority (74%) was married. The overall proportion of HIV seropositivity was 32% [95% CI 28%, 37%]. The proportions of HIV seropositivity in married women, married men, and single men were 41%, 37%, 18%, respectively. No single woman was found seropositive in the study. Very few married women were aware of their husbands' HIV status. In a multivariate analysis, correlates of HIV seropositivity in men were: age 30-39 years, being married, having sex with multiple partners, use of alcohol before sex, and testing positive for HIV in the past. In married women, the only predictor of seropositivity was being married. Although limited by the non-random nature of the sampling method, this pilot study is unique in that it is the first from this rural region of Central India. It provides baseline data on marginalized, largely unstudied populations that may aid in designing probabilistic community-based surveys in this neglected population.
印度农村地区存在大量未被检测出的艾滋病毒阳性个体。由于耻辱感、歧视以及对社会排斥的恐惧，很少有农村成年人前来进行艾滋病毒检测和咨询。在这项基于农村医院诊所的研究中，我们记录了寻求自愿检测和咨询的农村成年人的情况，并分析了艾滋病毒血清阳性的相关因素。这项横断面研究是在印度中部塞格拉姆市圣雄甘地医学科学研究所门诊部就诊的450名参与者中进行的。在获得知情同意后，进行了检测前和检测后的咨询、艾滋病毒检测以及面对面访谈。数据通过结构化问卷收集。450名研究参与者的年龄中位数为34岁（范围为18 - 88岁）；大多数（74%）已婚。艾滋病毒血清阳性的总体比例为32%[95%置信区间28%，37%]。已婚女性、已婚男性和单身男性的艾滋病毒血清阳性比例分别为41%、37%、18%。在该研究中未发现单身女性血清阳性。很少有已婚女性知晓其丈夫的艾滋病毒感染状况。在多变量分析中，男性艾滋病毒血清阳性的相关因素为：年龄30 - 39岁、已婚、与多个性伴侣发生性行为、性行为前饮酒以及过去艾滋病毒检测呈阳性。在已婚女性中，血清阳性的唯一预测因素是已婚。尽管该抽样方法的非随机性限制了研究，但这项试点研究具有独特性，因为它是印度中部这个农村地区的首个此类研究。它为边缘化且大多未被研究的人群提供了基线数据，这可能有助于在这个被忽视的人群中设计基于概率的社区调查。
