UCLA

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.