AEGiS-13IAC: Low perceived morbidity associated with STI symptoms, and its role in health-seeking behavior among women in rural India: implications for treatment and prevention of STI/HIV.

13th International AIDS Conference

Durban, South Africa - July 9-July 14, 2000

Low perceived morbidity associated with STI symptoms, and its role in health-seeking behavior among women in rural India: implications for treatment and prevention of STI/HIV.

Int Conf AIDS 2000 Jul 9-14; 13:(abstract no. ThOrC730)

Amin A, Sweat M
A. Amin, 30 Cottage Street, Apt. 2, New Haven, CT 06511, United States, Tel.: +1 203 562 7356, Fax: +1 203 562 7356, E-mail: aamin@jhsph.edu

BACKGROUND: Prompt and effective treatment of STIs is an important intervention for STI and HIV control in India, which is experiencing a rapidly growing HIV epidemic. Among women there is low or delayed treatment-seeking for STIs because they are asymptomatic, or there is low perceived need for treatment. Therefore it is critical to understand how women label as serious, and decide to seek treatment for STI symptoms. Such information will enable the design of culturally appropriate interventions / policies that address barriers women face in seeking prompt treatment for STIs.

METHODS: A survey on STI symptom history and treatment-seeking behavior was conducted among 573 ever married women of reproductive age group in 4 villages of the State of Gujarat, and included all women residing there.

RESULTS: Of the 47% women who reported at least one symptom, only 21% with vaginal discharge, 28% with lower abdominal pain and 15% with sexual intercourse pain ranked their symptoms to be very severe. Multivariate analysis of predictors of very severe perceived vaginal discharge show that discharge > 15 days a month, presence of both menstrual disorder and female literacy are significant with adjusted odds ratios of 8.5 and 37.5 respectively. A high level of NGO participation has an odds ratio of 6.0 for perceiving discharge to be at least somewhat severe.

CONCLUSIONS: The study points to the need for interventions/policies at multiple levels addressing health services, female education and gender inequities. Effective interventions to increase women's recognition of STI symptoms as needing treatment have to address levels of female literacy, and provide STI education to all in the community. The NGO can play an important role by focusing its activities on both issues. STI screening in different types of health facilities that women access routinely needs to be promoted since women will not specifically seek treatment for STIs unless they are very severe.

Keywords: AEGIS, HIV Infections, Morbidity, Prevalence, HIV Seropositivity, Patient Acceptance of Health Care, Vaginal Discharge, Odds Ratio, India, Human, Female, prevention & control, therapy, epidemiology, diagnosis
000709
ThOrC730