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Scholarly Works (5 results)

  • Thesis
  • Peer Reviewed
UCLA Electronic Theses and Dissertations (2016)

Objectives

To estimate the prevalence and socio-demographic and behavioral correlates of HIV and Hepatitis B among ANC attendees in a public tertiary care center in Kolkata, West Bengal, India

Methodology

A cross-sectional study was conducted involving consenting adult pregnant women attending the antenatal clinic of a public-sector tertiary care hospital in Kolkata, between January and June, 2016. Anonymous data was collected from 1670 randomly selected subjects, using a color-coded, audio-integrated, tablet-PC assisted, pre-recorded, self-interview system developed in an algorithm based android platform with a non-response rate of 3%.

Findings

Among participants. 1.66% were HIV-positive while 2.74% had Hepatitis-B. Having extra-marital relationship was associated with Hepatitis B infection. Higher age, poor education, higher parity, alcohol consumption by husbands before sex, history of syphilis/genital ulcer or swelling and higher self-perceived HIV risk were associated with HIV sero-positivity. Higher age at marriage and graduation or higher education were the factors negatively associated with ever having sex with someone who consumed alcohol. Relatively older participants had higher while high-school or more educated subjects had lower odds of having extra-marital sexual relationship. Rural respondents were more likely to engage in paid sex. Rural-living husbands, those having high-school or more education and business-owners were less likely to have sex with the respondents always after consuming alcohol. Higher age of respondent was negatively and graduation or above education was positively associated with husband having vaginal sex during respondent’s pregnancy. Odds of verbal abuse/bad behavior during sex by husband was positively associated with wife’s age and lower among high school-educated husband, and wives. Physical abuse during sex was more likely experienced by respondents with higher age of respondent, Muslim religion and less likely among high-school or more educated.

Conclusions and Recommendations

HIV/STI related counseling strategy need revisit and re-orientation to shift the focus from individual perspective to couples’ joint responsibilities so that concurrent counseling/treatment of partners receive priority especially the high-risk group. Proper management of STIs during pregnancy needs multifaceted approach which includes quality epidemiological data, good evidence of effectiveness of ongoing interventions, increase accessibility to reproductive health care services, stronger advocacy and commitment to get them implemented.

    Cover page: A cross sectional study to measure prevalence of Hepatitis B and HIV and explore the potential risk factors for the acquisition of these and other sexually transmitted infections among antenatal care attendees in a tertiary care center of West Bengal, India
    • Article
    • Peer Reviewed
    UCLA Previously Published Works (2014)
    Job strain results from a combination of high workload and few decision-making opportunities in the workplace. There is inconsistent evidence regarding the association between job strain and hypertension, and methodological shortcomings preclude firm conclusions. Thus, a meta-analysis of observational studies on hypertension among occupational groups was conducted to determine whether job strain was associated with hypertension. In January 2012, we carried out a comprehensive, topic-specific electronic literature search of the Ovid MEDLINE, EMBASE and PsychoINFO databases complemented by individual help from non-communicable disease experts. Experimental/interventional studies and studies on personality disorders were excluded. Nine of 894 identified studies met the eligibility criteria and were included in the meta-analysis. The pooled OR of the nine studies was 1.29 (95% CI 1.14 to 1.47; p<0.001), of case–control studies 2.88 (95% CI 1.63 to 5.09; p<0.001) and of cohort studies 1.24 (95% CI1.09 to 1.41; p<0.001), all of which indicated statistically significant positive associations between job strain and hypertension [corrected]. In a subgroup analysis, cohort studies of good methodological quality showed significant associations between job strain and hypertension, while those of poor methodological quality showed no association or subgroup differences. We conclude that despite methodological differences, case-control and cohort studies of good methodological quality showed positive associations between hypertension and job strain.
      Cover page: Is hypertension associated with job strain? A meta-analysis of observational studies
      • Article
      • Peer Reviewed
      UCLA Previously Published Works (2015)

      Background

      Behavioral interventions (BIs) remained the cornerstone of HIV prevention in resource-limited settings. One of the major concerns for such efforts is the loss-to-follow-up (LTFU) that threatens almost every HIV control program involving high-risk population groups.

      Methods

      To evaluate the factors associated with LTFU during BIs and HIV testing among men who have sex with men (MSM), 410 HIV sero-negatives MSM were recruited using respondent driven sampling (RDS) in Nanjing, China during 2008, they were further followed for 18 months. At baseline and each follow-up visits, each participant was counseled about various HIV risk-reductions BIs at a designated sexually transmitted infection (STI) clinic.

      Results

      Among 410 participants recruited at baseline, altogether 221 (53.9%) were LTFU at the 18-month follow-up visit. Overall, 46 participants were found to be positive for syphilis infection at baseline while 13 participants were HIV sero-converted during the follow-up period. Increasing age was less (Adjusted Odds Ratio(aOR) of 0.90, 95% confidence Interval (CI) 0.86-0.94) and official residency of provinces other than Nanjing (AOR of 2.49, 95%CI 1.32-4.71), lower level of education (AOR of 2.01, 95%CI 1.10-3.66) and small social network size (AOR of 1.75, 95%CI 1.09-2.80) were more likely to be associated with higher odds of LTFU.

      Conclusion

      To improve retention in the programs for HIV control, counseling and testing among MSM in Nanjing, focused intensified intervention targeting those who were more likely to be LTFU, especially the young, less educated, unofficial residents of Nanjing who had smaller social network size, might be helpful.
        Cover page: Factors Associated with Loss-to-Follow-Up during Behavioral Interventions and HIV Testing Cohort among Men Who Have Sex with Men in Nanjing, China
        • Article
        • Peer Reviewed
        UCLA Previously Published Works (2016)
        Antiretroviral drugs are being tried as candidates for the pre-exposure prophylaxis (PrEP) against HIV for a considerable period, due to their potential for immediate inhibition of viral replication. Discrepancies in the findings called for a critical review of the relevant efforts and their outcomes. A systematic literature search identified 143 eligible articles of which only 5 reported complete findings while another 11 were still on-going. Observed moderate efficacy and good safety profile seemed to identify PrEP as a promising step for minimizing the spread of HIV to relatively unaffected population and controlling the epidemic among high risk population groups. But the duration of this efficacy was found to depend heavily on the availability, adherence and other related issues like cost, political commitment, ethical consideration etc. To prevent potential cultural and behavioral modifications, proper pre-administration counseling also seemed critical for the success of PrEP as a cost-effective intervention with adequate coverage.
          Cover page: Pre-exposure prophylaxis of HIV: A right way to go or a long way to go?
          • Article
          • Peer Reviewed
          UCLA Previously Published Works (2015)
          BACKGROUND: Behavioral interventions (BIs) remained the cornerstone of HIV prevention in resource-limited settings. One of the major concerns for such efforts is the loss-to-follow-up (LTFU) that threatens almost every HIV control program involving high-risk population groups. METHODS: To evaluate the factors associated with LTFU during BIs and HIV testing among men who have sex with men (MSM), 410 HIV sero-negatives MSM were recruited using respondent driven sampling (RDS) in Nanjing, China during 2008, they were further followed for 18 months. At baseline and each follow-up visits, each participant was counseled about various HIV risk-reductions BIs at a designated sexually transmitted infection (STI) clinic. RESULTS: Among 410 participants recruited at baseline, altogether 221 (53.9%) were LTFU at the 18-month follow-up visit. Overall, 46 participants were found to be positive for syphilis infection at baseline while 13 participants were HIV sero-converted during the follow-up period. Increasing age was less (Adjusted Odds Ratio(aOR) of 0.90, 95% confidence Interval (CI) 0.86-0.94) and official residency of provinces other than Nanjing (AOR of 2.49, 95%CI 1.32-4.71), lower level of education (AOR of 2.01, 95%CI 1.10-3.66) and small social network size (AOR of 1.75, 95%CI 1.09-2.80) were more likely to be associated with higher odds of LTFU. CONCLUSION: To improve retention in the programs for HIV control, counseling and testing among MSM in Nanjing, focused intensified intervention targeting those who were more likely to be LTFU, especially the young, less educated, unofficial residents of Nanjing who had smaller social network size, might be helpful.
            Cover page: Factors associated with loss-to-follow-up during behavioral interventions and HIV testing cohort among men who have sex with men in Nanjing, China.
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