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.
Highlights
India today stands at the crossroads in its battle against Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS)
A total of 18329 clients were counseled by Integrated Counselling and Testing Centres (ICTCs) counselors during 2007 from six districts of Tamilnadu state, and among them for 17958 (98%) HIV serology was available and the overall HIV seroprevalence was 4.1%
ICTCs are important for prevention, detection, and care of HIV infection
Summary
India today stands at the crossroads in its battle against Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS). Responding to the immense challenge of the HIV/AIDS threat, National AIDS Control Programme (NACP) has articulated a clear and effective response to increase access to services and communicate effectively for behaviour change. The overall goal of NACP is to halt and reverse the epidemic in India over the five years by integrating programmes for prevention, care and support, and treatment. Voluntary counselling and testing services provide an entry point for prevention and care. The concept of integrating the preventive and care services was initiated through the initiation of Integrated Counselling and Testing Centres (ICTCs) in Tamilnadu from 2005. The ICTCs provide pretest counseling, testing, retesting, posttest counseling, and support services. Clients (including general population, high risk groups, and referrals) utilize the services of these centres on voluntary basis
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