16th International AIDS Conference Toronto, Canada - August 13 - 18, 2006

HOW WELL DO PMTCT PROGRAMS IN INDIA FACILITATE ACCESS TO HIV CARE AND SEXUAL AND REPRODUCTIVE HEALTH (SRH) SERVICES FOR HIV-POSITIVE WOMEN?

Int Conf AIDS. 2006 Aug 13-18;16 Abstract No. ThAc0105

Sharma Mahendra V.¹, Sarna A.¹, Rutenberg N.², Rau A.³, Singh L.B.⁴, Mudoi R.³, Oinam A.⁴, Pakkela V.⁵, Panda S.^6
1 Horizons/Population Council, New Delhi, India, ² Horizons/Population Council, Washington DC, United States, ³ Freedom Foundation, Bangalore, India, ⁴ Social Awareness Service Organization, Imphal, India, ⁵ Freedom Foundation, Hyderabad, India, ⁶ Consultant, Horizons/Population Council, New Delhi, India

BACKGROUND: In India, 21% of the 5.1 million HIV-infected people are women of reproductive age. The national PMTCT program has demonstrated that antenatal care is an effective entry point to HIV prevention for their children. But does the PMTCT program serve as an entry point to HIV care and SRH services for HIV-infected mothers?

METHODS: 300 randomly selected HIV-positive pregnant and postpartum women (0 – 24 months post-delivery) from about 10 PMTCT sites and 30 service providers and program managers of public sector and NGO run PMTCT programs in 3 high HIV prevalence states in India were interviewed. An interim analysis of data from 101 women is presented.

RESULTS: Respondents had a mean age of 25; one-third were primagravida while a majority reported multiple pregnancies (range: 2 – 8). 82% did not want to have another child; for the majority, their HIV-status was the main reason for this decision. When post-partum women (n=80) were asked about condom use, less than half (49%) were currently using condoms to either prevent HIV transmission or prevent pregnancy. Only half of these women stated that they received their condoms from the PMTCT program.

More than 40% of the women were aware of ARV treatment, but only 18% mentioned that their PMTCT provider informed them about it and only one-fifth were told about CD4 testing. Furthermore, only 6% of women mentioned they were currently on ART and only 1 of them mentioned that their PMTCT provider referred them to the ARV facility.

CONCLUSIONS: Interim analysis indicates that linkages between PMTCT programs and HIV care and SRH services are weak. Failure to address the SRH needs of women and to connect them to HIV care is a shortcoming of the PMTCT program. Study results will be used to strengthen linkages between PMTCT and other services vital to meeting the needs of HIV-positive women.

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2006-08-13
ThAc0105

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