INVITED COLUMN ON TOPICS OF PUBLIC HEALTH IMPORTANCEA decade of field epidemiology training in India
Manoj Murhekar and FETP-India Team
COLUMN ON TOPICS OF ACADEMIC INTERESTBASICS OF SPATIAL STATISTICS - Dr. Vasna Joshua, NIE
APPLICATIONS OF TECHNOLOGY IN PUBLIC HEALTHNanoparticle based drug delivery system for tuberculosis chemotherapy
- Dr. Sriram Selvaraju, MBBS,MPH
HealthlinesHEALTH NEWS ITEMS FROM LEADING NEWSPAPERS
- Dr. Chitra Grace
SCIENTIFIC REPORTS & CAREER EXPERIENCES BY SCHOLARSMy first national public health conference
- Dr.Latika Nath, MPH Scholar cohort-4
HEALTH MESSAGES FROM THE SCRIPTURESFood and health – wisdom from Thirukkural
ASSORTED ARTICLES BY NIE STAFF/SCHOLARSSANITATION WITH A CIVIC SENSE -- Dr.M.Karthikeyan, MPH Scholar, 4th Cohort, NIE
SWAMI VIVEKANANDA -- A. Murugarasan, PS to Director, NIE
Impact of behaviour change communication targeting the bridging population of clients of female sex workers in India
---- Dipak Suryawanshi (TISS, Mumbai), Pushpanjali Swain (NIHFW, Delhi), Reena Kumari (NIMS (ICMR), Delhi), Tarun Bhatnagar (NIE (ICMR), Chennai), Weiwei Zhou (LSHTM, London), Shalini Bharat (TISS, Mumbai), M Bhattacharya (NIHFW, Delhi), Arvind Pandey (NIMS (ICMR), Delhi), Martine Collumbien(LSHTM, London)
BACKGROUND: Clients of female sex workers (FSW) are a key group in India’s HIV prevention programme due to their bridging role in HIV transmission to women in the general population. Our objective was to determine the impact of condom promotion and STI messages on consistent condom use with sex workers and other partners among clients of FSWs.
METHODS: We analyzed data from 2009 Integrated Biological and Behavioral Assessment IBBA
RESULTS: Clients of street- based FSWs were older (31 vs 29.5 yrs, p < 0.05) and better educated (77% vs 61% secondary and above, p < 0.001) than clients at brothels. Exposure to messages on condoms (95%) was too high to detect an association with condom use. Exposure to STI messages was 77% among street-soliciting clients compared to 51% among those frequenting brothels. Only among the brothel-soliciting clients could we demonstrate an effect: 44% of exposed clients used condoms consistently vs 30% among the matched controls [p < 0.001]. The observed differential is most likely due to the local environment: more intense and varied exposure to safer sex messages at brothels including stronger interpersonal communication with FSWs more effectively negotiating condom use.
CONCLUSIONS: : Like sex workers the population of clients is quite heterogenous. Consistent condom use is lowest among clients soliciting brothel-based FSWs but STI messages have impact. Consistent condom use is higher among clients soliciting FSWs from public places but we did not find any effect of exposure to STI messages. Among clients soliciting home-based FSWs consistent condom use was highest but with no effect of STI messages when considering all partner groups. Characteristics of clients soliciting different types of FSWs may influence their risk perception and thus condom use. FSWs’ negotiating power for condom use also differs by typology. Our data suggests that STI messages may get reinforced at brothels. Media messages are important but not sufficient to increase condom use with FSWs. Clients have a lot of other partners and messages should more explicitly address condom use with all partners.
Sexual behaviours and HIV-related issues among truck drivers and their wives: Implications for HIV prevention in South India
---- Tarun Bhatnagar (NIE(ICMR), Chennai), PS Saravanamurthy (VHS-CHARTERED, Chennai), Roger Detels (UCLA, USA)
BACKGROUND: Women constituted 39% of the 2.4 million people living with HIV/AIDS in India in 2009. Marriage makes Indian women more vulnerable to HIV infection, more so those married to men from bridge population such as truck drivers. We explored the sexual behaviors, knowledge, and risk perception related to HIV/AIDS among the truck drivers and their wives.
METHODS: We conducted semi-structured open-ended interviews with 15 couples in a district of Tamil Nadu in south India in 2010. Interviewers of same gender digitally recorded the interviews. We did a content analysis of the interview transcripts and organized the statements into major themes to describe the pattern of responses.
RESULTS: The wives of truck drivers expressed gratifying sexual relationship with their husbands. However, they reported that “wives of other men” were involved in extra-marital relationships and paid sex. There was perceived ability by the wives to communicate with their husbands about their own sexual desires (or lack thereof), and husband’s risk of HIV infection from indiscriminate heterosexual relationships. Condom use with spouse was infrequent, and identified with contraception and mutual trust by both the truck drivers and their wives. The wives expressed concern for their husbands acquiring HIV infection but had low self risk perception. Concern translated into faith or warnings for the husbands to not indulge in illicit sexual relationships. Although truck drivers were highly aware of the risk for HIV infection for themselves and their families, indulgence in commercial sex was commonly reported by them.
CONCLUSIONS: The study underscores the need to inform wives of the risk of HIV infection from their husband and to develop culturally acceptable strategies which wives can implement themselves.
Copyright : National Institute of Epidemiology, Ayapakkam, Chennai