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      Prevalence and Risk Factors of HIV Infection among Clients Attending ICTCs in Six Districts of Tamilnadu, South India

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          Abstract

          Objective. To assess the HIV serostatus of clients attending integrated counseling and testing centres (ICTCs) in Tamilnadu, south India (excluding antenatal women and children), and to study its association with demographic, socioeconomic, and behavioral risk factors. Design. In a prospective observational study, we interviewed clients attending 170 ICTCs from six districts of Tamilnadu during 2007 utilizing a standard pretest assessment questionnaire. All the clients were tested for HIV with rapid test kits. Multiple logistic regression analysis was used to identify determinants of HIV infection. Results. Of 18329 clients counseled, 17958 (98%) were tested for HIV and 732 (4.1%; range 2.6 to 6.2%) were tested positive for HIV. Median age of clients was 30 years; 89% had never used condoms in their lives and 2% gave history of having received blood transfusion. In multivariate analysis HIV seropositivity was associated with HIV in the family (adjusted odds ratio) (AOR 11.6), history of having sex with sex workers (AOR 2.9), age ≥31 years (AOR 2.8); being married (AOR 2.5), previously tested for HIV (AOR 1.9), illiteracy (AOR 1.7), unemployment (AOR 1.5), and alcoholism (AOR 1.5). Conclusion. HIV seroprevalence being high in ICTC clients (varied from 2.6 to 6.2%), this group should also be included in routine programme monitoring of sero-positivity and risk factors for better understanding of the impact of the National AIDS Control Programme. This would help in evolving appropriate policies and strategies to reduce the spread of HIV infection.

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          Sexual behavior among men who have sex with women, men, and Hijras in Mumbai, India--multiple sexual risks.

          We describe the same-sex partnerships and sexual risk behavior of men attending sexually transmitted infection (STI) clinics in Mumbai, India. The HIV prevalence among 2,381 men sampled was 14%; 62% had a documented STI. Almost all men reported sex with women; additionally, 13% also reported having sex with other men, 13% reported sex with Hijras (male-to-female transgenders), and 11% had sex with all 3 genders. Men who had sex with men and/or Hijras as well as women, reported having greater numbers of partners, including female sex workers (FSW), and were more likely to engage in insertive anal and oral sex with women. The prevalence of HIV was higher among men having sex with Hijras (14%) or with all 3 genders (13%) than among men having sex with men and women (8%). A high proportion of men who attend STI clinics in Mumbai are behaviorally bi- or tri-sexual and have multiple partners with whom they engage in risky sex. STI/HIV prevention programs should not assume that men only have sex with women.
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            Mobility, sexual behavior, and HIV infection in an urban population in Cameroon.

            Several studies, notably from rural areas, have shown an association between mobility and HIV infection. However, reasons for this association are poorly documented. In this study, we examined the relationship between mobility, sexual behavior, and HIV infection in an urban population of Cameroon. A representative sample of 896 men and 1017 women were interviewed and tested for HIV infection and other sexually transmitted infections in Yaoundé in 1997. Mobile and nonmobile people were compared with respect to sociodemographic attributes, risk exposure, condom use, and prevalence of HIV infection, using descriptive statistics and multivariate logistic regression. Seventy-three percent of men and 68% of women reported at least 1 trip outside of Yaoundé in the preceding 12 months. Among men, the prevalence of HIV infection increased with time away from town. Men who declared no absence were 5 times less likely to be infected than were those away for >31 days (1.4% vs. 7.6%, respectively; adjusted odds ratio, 0.23; 95% confidence interval, 0.07-0.82). Furthermore, mobile men reported more risky sexual behaviors (ie, more partners and more one-off contacts). For women, the pattern was less clear: differences in the prevalence of HIV infection were less marked for nonmobile than for mobile women (6.9% vs. 9.8%, respectively; P > 0.1). This study suggests that characteristics of male mobility may be an important feature of the HIV epidemic in Cameroon.
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              Correlates and trend of HIV prevalence among female sex workers attending sexually transmitted disease clinics in Pune, India (1993-2002).

              In India, substantial efforts have been made to increase awareness about HIV/AIDS among female sex workers (FSWs). We assessed the impact of awareness regarding safe sex in a cohort of FSWs by studying trends in HIV prevalence, sexually transmitted diseases (STDs), and risk behaviors measured from 1993 to 2002 in Pune, India. A total of 1359 FSWs attending 3 STD clinics were screened for HIV infection, and data on demographics, sexual behaviors, and past and current STDs were obtained. The overall HIV prevalence among FSWs was 54%. Not being married (adjusted odds ratio [AOR] = 1.74, 95% confidence interval [CI]: 1.17 to 2.59), being widowed (AOR = 2.10, 95% CI: 1.16 to 3.80), inconsistent condom use (AOR = 1.60, 95% CI: 1.02 to 2.50), clinical presence of genital ulcer disease (GUD; AOR = 1.66, 95% CI: 1.07 to 2.56), and genital warts (AOR = 4.70, 95% CI: 1.57 to 14.08) were independently associated with HIV infection among FSWs. The prevalence of HIV remained stable over 10 years (46% in 1993 and 50% in 2002; P = 0.80). The prevalence of GUD decreased over time (P < 0.001), whereas that of observed genital discharge remained stable. Reported consistent condom use as well as the proportion of FSWs who refused sexual contact without condoms increased over time (P < 0.001). These data collectively suggest that safe sex interventions have had a positive impact on FSWs in Pune, India.
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                Author and article information

                Journal
                AIDS Res Treat
                ART
                AIDS Research and Treatment
                Hindawi Publishing Corporation
                2090-1240
                2090-1259
                2011
                19 July 2011
                : 2011
                : 650321
                Affiliations
                1Tuberculosis Research Centre, Indian Council of Medical Research, Chennai 600 031, India
                2Tamilnadu State AIDS Control Society, Health and Family Welfare Department, Chennai 600 008, India
                Author notes
                *Rajeswari Ramachandran: rajerama@ 123456yahoo.com

                Academic Editor: Guido Poli

                Article
                10.1155/2011/650321
                3140188
                21799947
                092adbdf-0119-4319-9631-c5b82ba5c84c
                Copyright © 2011 Rajeswari Ramachandran et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 22 January 2011
                : 15 May 2011
                Categories
                Research Article

                Infectious disease & Microbiology
                Infectious disease & Microbiology

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