Aware of HIV but few in rural areas go for tests

[Guest guest]

Aware of HIV but few in rural areas go for tests

Anuradha Mascarenhas

Posted online: Monday, February 11, 2008 at 0101 hrs Print Email

Pune, February 10: Even though India is among the nations having the

highest number of AIDS cases in the world, very few women in its

rural backyard go for an test during pregnancy to detect the

deadly HIV virus. In fact, very few women are even aware of the

existence of voluntary counselling and testing facilities, despite a

Government policy to expand ante-natal HIV screening and prevention

of mother-to-child transmission of HIV virus.

Approximately 60 per cent of the country's HIV cases occur in rural

areas, and married women of childbearing age are considered a highly

vulnerable population, who generally acquire the virus primarily

through their husbands' pre- and extramarital sexual behaviour.

According to a study conducted jointly by Institute of Health

Management, Pachod, Maharashtra and Hopkins School of Medicine,

USA, awareness among rural women about HIV testing centres is

extremely low.

The study was conducted among 60,000 individuals in Aurangabad

district where at least one per cent of pregnant women have tested

HIV positive in ante-natal clinic sentinnel surveillance sites. The

nearest Government-sanctioned Voluntary Counselling Test Centre is

located 50 kilometres away at the district hospital. Conducted

between January and March 2006, around 400 pregnant women were

questioned regarding HIV awareness, risk and history of antenatal HIV

testing.

While 87 per cent had heard of HIV virus, 84 per cent were aware of

condoms while 72 per cent knew that consistent condom use is an

effective way of preventing AIDS. Around 84 per cent knew that HIV

can be sexually transmitted.

However, despite this knowledge of HIV, only 6 per cent of women in

the study could correctly name an HIV testing facility. Furthermore,

only 8 per cent reported receiving HIV counselling during pregnancy,

and only 3 per cent of women had an HIV test done. However, one

positive thing was that women in the current study had much better

knowledge of HIV than women in the one conducted in 2001. Over the

past several years, community and government efforts have increased

rural women's HIV awareness, says Dr A Dayalchand, Director of IHMP.

Still, two significant barriers exist, namely, lack of discussion by

antenatal care providers about HIV and lack of awareness of HIV

testing services, including VCT.

Few women could correctly name a HIV testing facility or reported

awareness of VCT. Furthermore, only half of HIV test utilizers

reported receiving associated counselling.

http://www.indianexpress.com/story/271617.html

[Guest guest]

Dear FORUM,

I refer to the post from Anuradha Mascarenhas on a survey on awareness on HIV

testing in Aurangabad

/message/8432.

Anuradha writes " 8 per cent reported receiving HIV counselling during pregnancy,

and only 3 per cent of women had an HIV test done " . This implies that more than

half of those who received counselling, refused to test. Could the study

pinpoint the main reasons why so many women refused/ did not take the test?

This is an important issue that local health planners would need to bear in mind

Dr Deepak Batura

E-MAIL: <d_batura@...>

[Guest guest]

Dear Friends,

Re: /message/8432

A HIV Test is not a coercion. It is not that the counselor will convince you to

get yourself tested.

The client and the counsellor will discuss the risk behaviour, do a risk

assessment, and in case they feel that the there is no risk beaviour- the client

may not feel any need for the test- the cousnellor will educate the client on

safe behaviours. I see the gap in counselling and testing as a postive sign.

*Under the PPTCT programme, I have found gynaecologists forcing clients to get

themselves tested- for fear of getting infected form handling HIV positive

deliveries- and openly writing HIV status on the OPD slip- exposing the PLWHA to

discrimination in health system.*

*If this is the objective of testing, the clients should rather refuse

testing and ask for the doctors test instead.*

Rajesh.

e-mail: <drrksood@...>

[Guest guest]

Dear FORUM,

I firmly agree with Mr. Sood's views...counselling is not to convince, but to

explore client's needs, it is not to advise, but to help clients decide what

they want for themselves, it is not ONLY to educate, but ALSO to educate.

However, in the Indian context, especially with regard to HIV/AIDS, the concpet

of counselling has undergone a dramatic change to mean education, advice and

convincing.

I too have seen from my professional experience and in close Interaction with

counsellors that oftentimes, clients are forced to undrgo HIV testing without

understanding the need/meaning of the test.

In cases, where clients refuse testing, the counsellor is 'pulled up' for

inefficiency.

There is a need to redefine counselling or explicitly state our needs with

respect to HIV testing.

Maya Ramachandran

Joint Director

South India AIDS Action Programme (Siaap)

e-mail: <mayu_r@...>