Very high levels of patient adherence (greater than 95 percent) are required for antiretroviral therapy (ART) to be effective and to prevent the emergence of resistant viral strains (Paterson et al. 2000; Ickovics et al. 2002). Since 1997, antiretroviral (ARV) medications have been available in India through the private sector and some employer-supported health insurance programs. It is estimated that India has 5.1 million HIV-infected persons (NACO 2004), some of whom have been on ART for several years. However, very little information is available on the levels of adherence to ART among people living with HIV/AIDS in India. With increased availability of ART, HIV-positive individuals are living healthier lives and continuing or resuming sexual activity. But, optimism related to ART's success in slowing disease progression, reducing viral load, and improving health status may lead to more risky sexual practices and a possible increase in transmission of infections. Determining the sexual behavior of HIV-positive persons on ART is therefore an area of special interest and concern. To meet these knowledge gaps, the Horizons Program, in collaboration with research partners in Delhi and Pune, conducted a study to assess current levels of adherence to ART among a sample of people living with HIV/AIDS, identify the factors that influence their adherence to treatment, and determine their sexual risk behaviors. The study also examined the economic burden of ART on the household. Findings from the study provide important insights that are immediately relevant to the scale-up of the national ART program, which was launched in April 2004. Methods Three hundred and ten HIV-positive patients currently on ART and attending one private and three public sector health facilities in Pune and Delhi were interviewed between May and August 2004. The sample of clients from the private clinic was mostly paying out-of-pocket for their treatment (n = 252/263). The remaining private clinic clients (n = 11) and those using the public sector facilities (n = 47) were receiving free ARVs through employer-provided, government-supported health insurance programs. A semi-structured questionnaire adapted from adherence instruments developed by the Adult AIDS Clinical Trials Group (AACTG) was used for data collection. Adherence was measured using a 4-day patient self-report. Mean 4-day adherence was calculated by dividing the number of pills actually taken by the number of pills prescribed for 4 days x 100. Higher adherence was defined as a mean 4-day adherence of ≥ 90 percent and lower adherence as a mean 4-day adherence of < 90 percent. Other measures of adherence included (a) the number of missed doses over the last week, (b) the last time a full day of medication was missed, (c) the number of times treatment was stopped for more than one week, and (d) the frequency of following the medication dosage schedule. The key themes of analysis for sexual risk behavior were type of partners, knowledge of partner's status, disclosure of one's own HIV s...

found in 4.4% of hospital admissions and 6% of general practitioner consultations. [2] The increase in the antibiotic-resistant strains of bacteria, mainly in hospitals and in the community, poses a serious issue worldwide, thereby, causing difficulty in the control measures and necessitating abundant resources and expenditure for the same. [3] Pseudomonas aeruginosa is a gram-negative aerobic rod, which belongs to the family Pseudomonadaceae. It is an opportunistic pathogen and the predominant causative agent in nosocomial infections. It is also considered as the most challenging pathogen worldwide, because of its high rate of resistance to antimicrobial agent. [4] P. aeruginosa is an opportunistic pathogen with inherent resistance to many antibiotics and disinfectants, including antipseudomonal penicillins, ceftazidime, carbapenems, aminoglycosides, and ciprofloxacin. Globally, the multidrug-resistant bacterial strains prevalent in hospitals and community create Background: Pseudomonas aeruginosa is an opportunistic human pathogen and is the predominant causative agent in nosocomial infections. Resistance to nearly all the available antibiotics has been shown by P. aeruginosa, and multidrug-resistant P. aeruginosa (MDRPA) is the most important source of concern in hospital-acquired infections. Objective:To determine the prevalence of bacterial infection and the antibiotic sensitivity pattern of P. aeruginosa isolated from patients with lower respiratory tract infection. Materials and Methods:This study comprised 270 patients (151 treated as inpatients and 119 as outpatients). Sputum and bronchoalveolar lavage samples were subjected to gram staining, bacterial culture, and antibiotic sensitivity for bacterial isolates as per standard techniques.Result: The growth of pathogens was obtained from 55.9% of inpatients and 44% of outpatients. P. aeruginosa (25.2%) was the major organism isolated from hospitalized patients, whereas Moraxella catarrhalis (6.93%) was the most common pathogen isolated from outpatients. Imipenem was found to be the most effective antibiotic against P. aeruginosa.Conclusion: These findings focused on careful consideration for monitoring of antimicrobial use in order to reduce the occurrence and spread of antimicrobial-resistant pathogen.

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