16th International AIDS Conference


Toronto, Canada - August 13 - 18, 2006

KNOWLEDGE, ATTITUDES, AND PRACTICES OF HIV CARE AND ANTIRETROVIRAL THERAPY AMONG HIV-INFECTED ADULTS ATTENDING PRIVATE AND PUBLIC CLINICS IN INDIA

Int Conf AIDS. 2006 Aug 13-18;16 Abstract No. ThAb0204

Vaidya S.B.1, Ramchandani S.R.2, Saple D.G.3, Mehta S.H.4, Pandey V.P.5, Vadrevu R.6, Rajasekaran S.7, Bhatia V.P.8, Chowdhary A.8, Bollinger R.C.9, Gupta A.9
1 KJ Somaiya Medical College and Research Center, Department of Pharmacology, Mumbai, India, 2 National Naval Medical Center, Department of Internal Medicine, Bethesda, United States, 3 G.T Hospital, Grant Medical College, Department of Dermatology, STD, and AIDS, Mumbai, India, 4 Johns Hopkins University Bloomberg School of Public Health, Department of Epidemiology, Baltimore, United States, 5 M.Y. Hospital, Department of Internal Medicine, Indore, India, 6 Sai Sudha Hospital, Kakinada, India, 7 Tambaram Sanitorium, Chennai, India, 8 AIDS Research and Control Centre, Mumbai, India, 9 Johns Hopkins University - Center for Clinical Global Health Education, Division of Infectious Diseases, Baltimore, United States

BACKGROUND: Approximately 5.1 million persons are HIV-infected in India. Access to HIV care and antiretroviral therapy (ART) can occur via the private or public health care system. Little is known regarding HIV care and ART knowledge, attitudes, and practices (KAP) among patients in these settings in India.

METHODS: From February – June 2004, we performed a cross-sectional survey to compare the KAP regarding HIV care and treatment among HIV-infected persons attending three public and three private clinic sites in India.

RESULTS: Of 1,667 respondents, 53% were private and 47% were public clinic attendees. 609 (33%) had heard of ART and 19% of these persons reported that ART could cure HIV. Major barriers to taking ART were cost (33%), lack of knowledge of ART (41%) and deferral by the patient´s physician (30%). More than half of all public and private patients had not heard of CD4 (57%) or viral load testing (80%), or received these tests (32% and 11% respectively). Private clinic attendees were approximately 4 times more likely to be on ART (35% vs. 9%, p<0.0001). In multivariate analyses, care in the private sector (adjusted OR [AOR] 4.88, 95%CI 3.53 – 6.75), older age (AOR 1.60, 95%CI 1.36 – 1.89), having heard of ART (AOR 2.78, 95%CI 2.07 – 3.73), and having had a CD4 cell count (AOR 3.69, 95%CI 2.77 – 4.92) were associated with increased ART use, whereas female gender (AOR 0.62, 95%CI 0.48 – 0.81) and distance from clinic (AOR 0.49, 95%CI 0.33 – 0.71) were associated with decreased ART use.

CONCLUSIONS: Knowledge and access to ART were greater for patients attending private clinics, but overall levels were low in both private and public settings. Further educational and programmatic efforts are needed to improve treatment awareness and access for HIV-infected persons in both public and private settings in India.

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2006-08-13
ThAb0204

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