Objective-To investigate the risk factors for HIV infection in patients attending clinics for sexually transmitted diseases in India.Design-Descriptive study of HIV serology, risk behaviour, and findings on physical examination.
This paper presents findings from a study conducted in 2007 and 2008 in two states in India: Andhra Pradesh and Gujarat. The objectives of the study were to: (i) design effective and appropriate HPV vaccine delivery systems for 10-to 14-year-old girls; (ii) design a communication strategy for HPV vaccine delivery; and (iii) devise an HPV vaccine advocacy strategy.The study populations included girls, parents, and local-, district-, and national-level stakeholders. A mixture of group discussions, visual representation techniques, face-to-face interviews, desk and health facility record reviews, field observations, and consultative workshops were used to collect the data.Study findings showed that the policymakers, health care providers, parents, and adolescents were aware and concerned about cervical cancer; would welcome vaccination if safe, effective, affordable, and accessible. Health systems did not require large infrastructure investments to introduce HPV vaccine; basic cold chain and logistic equipment were available. New outreach systems for adolescent girls need to be tested through demonstration projects. No policies would compromise the introduction of HPV vaccination.An HPV vaccine program, requiring public education and provider training, could be delivered. Policymakers' safety and vaccine efficacy concerns can be addressed through targeted advocacy efforts. Three broad approaches were suggested: (i) merge HPV vaccination with already established immunization services; (ii) package HPV immunization with adolescent health services or as a part of a cancer control service; and (iii) deliver HPV vaccinations through either routine immunization services or a campaign using schools as sites for school-going girls and anganwadi or village health centers for non-school-going girls.
Background & objectives:Improving quality of life (QOL) of healthy people living with HIV (PLHIV) is critical needing home-based, long-term strategy. Sudarshan Kriya yoga (SKY) intervention is acknowledged for its positive impact on health. It is hypothesised that SKY would improve PLHIV's QOL, justifying an evaluation.Methods:In this open label randomized controlled pilot trial, 61 adult PLHIV with CD4 count more than 400 cells/µl and Karnofsky scale score above 70 were enrolled. Those with cardiac disease, jaundice, tuberculosis, or on antiretroviral therapy/yoga intervention were excluded. All were given standard care, randomized to SKY intervention (31: I-SKY) and only standard of care in control (30: O-SOC) arms. The I-SKY participants were trained for six days to prepare for daily practice of SKY at home for 30 min. A validated 31-item WHOQOL-HIVBREF questionnaire was used to document effect in both arms from baseline to three visits at 4 wk interval.Results:Baseline QOL scores, hypertension and CD4 count were similar in both arms. An overall 6 per cent improvement of QOL scores was observed in I-SKY group as compared to O-SOC group, after controlling for baseline variables like age, gender, education and occupation (P =0.016); 12 per cent for physical (P =0.004), 11 per cent psychological (P =0.023) and 9 per cent level of independence (P =0.001) domains. Improvement in I-SKY observed at post-training and in the SKY adherence group showed increase in these two domains.Conclusions:A significant improvement in QOL scores was observed for the three health related QOL domains in SKY intervention arm. This low cost strategy improved physical and psychological state of PLHIV calling for upscaling with effective monitoring for sustainability of quality of life.
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