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 Table of Contents  
ORIGINAL ARTICLE
Year : 2020  |  Volume : 7  |  Issue : 4  |  Page : 209-212

Epidemiological profile of HIV patients attending ARTC of a tertiary care hospital in Jaipur, India


1 Department of Community Medicine, Swai Man Singh Medical College, Jaipur, Rajasthan, India
2 Department of Orthopedics, King George’s Medical College, King George’s Medical University, Lucknow, Uttar Pradesh, India

Date of Submission21-Jun-2020
Date of Decision24-Sep-2020
Date of Acceptance24-Sep-2020
Date of Web Publication09-Dec-2020

Correspondence Address:
Dr. Monika Rathore
Department of Community Medicine, Swai Man Singh Medical College, Gangawal Park, Adarsh Nagar, Jaipur 302004, Rajasthan.
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/mgmj.mgmj_58_20

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  Abstract 

Introduction: District Jaipur of Rajasthan has a high prevalence of Human Immunodeficiency Virus (HIV) and it comes under category B of HIV transmission. The geographical and sociocultural environments of different states of India are different; hence, the profile of HIV cases also differs from place to place. Area-specific data regarding the profile of HIV cases attending the biggest government hospital of Jaipur could be utilized by higher authorities for the implementation of control measures. Objective: The objective was to describe the sociodemographic profile of HIV cases and to find out the comorbidity of TB-HIV cases. Materials and Methods: The hospital-based, observational, and descriptive study was undertaken at a tertiary care teaching hospital of Jaipur from 1 January to 28 February 2019. Primary data were collected from 220 HIV-positive cases through an interview, and secondary data were collected from case records. Results: The maximum cases (40%) were in the age group of 31 to 40 years. Around 30% of cases were unmarried, widows, or divorced. Half of them were from the below poverty line (BPL) families. Only 9% of patients had a college education. Every third case reported was a housewife. Around 13% of cases were not aware of their spouse’s HIV status. HIV-TB coinfection was present in 20% of cases. Conclusion: The majority of cases were from the sexually active age groups and were poor, unmarried, widows, or divorced, and housewives. The spouse of every eighth case was unaware of the HIV status of their partner. Tuberculosis (TB) was the most common coinfection. This basic information would help policymakers formulate better information, education and communication and control measures that are area and population specific.

Keywords: Antiretroviral, human immunodeficiency virus, profile, sociodemographic, treatment center


How to cite this article:
Meena S, Rathore M, Kumawat P, Singh A, Sharma N, Gupta MK. Epidemiological profile of HIV patients attending ARTC of a tertiary care hospital in Jaipur, India. MGM J Med Sci 2020;7:209-12

How to cite this URL:
Meena S, Rathore M, Kumawat P, Singh A, Sharma N, Gupta MK. Epidemiological profile of HIV patients attending ARTC of a tertiary care hospital in Jaipur, India. MGM J Med Sci [serial online] 2020 [cited 2021 Jan 18];7:209-12. Available from: http://www.mgmjms.com/text.asp?2020/7/4/209/302804




  Introduction Top


HIV infection is a global pandemic. India has the third-largest HIV epidemic in the world, with a prevalence of 0.2% (i.e. 2.1 million people living with HIV during the year 2017).[1] It primarily affects the young and the working population of the country; hence, it has severe consequences on socioeconomic development. HIV shares an unfortunate connection with TB, further aggravating gravity and mortality.[2] Migration increases HIV transmission, as migrants are a “bridge population” and they serve as a link between urban and rural areas.[1] Around 0.2% of the estimated 7.2 million migrant workers in India are suffering from HIV. An integrated counseling and testing center was introduced to detect more and more cases and to reduce further transmission of HIV.[3] District Jaipur of Rajasthan is under category B as per the National AIDS Control Program (NACP) III categorization of all districts into four categories, that is, A, B, C, and D on the basis of HIV prevalence.[3] India is a vast country with a different geographical and sociocultural environment; as a result, there are different profiles of HIV-positive cases. It is beneficial to know the profile of HIV cases, the HIV status of their spouses, and the presence of TB comorbidity of cases attending the biggest hospital of District Jaipur. Thus, this basic information could be considered during the decision making for the control of HIV.

Objective

This study was conducted with an objective to describe the sociodemographic profile, HIV status of spouses, and TB-HIV comorbidity of HIV patients attending a tertiary care center in Rajasthan, India.


  Materials and methods Top


A hospital-based observational study was undertaken at the Anti-Retroviral Treatment Centre (ARTC), Sawai Man Singh Hospital, Jaipur, India, which is the biggest tertiary care teaching hospital in the Rajasthan state of India. The study was carried out from 1 January to 28 February 2019.

Sample size

Ten percent of the total HIV cases who reported to the ARTC during the study period were considered for the sample size for this observational, descriptive study. Two hundred twenty-two cases out of a total of 2,197 HIV cases were included in the study by using systematic random sampling. Every 10th case was included in the study after taking the first random number between 1 and 10.

Written informed consent was taken from all cases. Primary data were collected through interpersonal communication, and secondary data were collected from case records.


  Results Top


In the current study, more number of males (125/220, 57%) reported to ARTC than females (95/220, 43%). The age of the youngest case was 18 years and that of the oldest case was 68 years. The mean age of cases was 38.46 (+/-9.9) years. The mean age of female and male cases was almost similar, that is, 38.74 (+/-10) years and 38.58 (+/-9.98) years, respectively. The majority of cases (70%) were married, 18% were widows, 3% were divorced, and 9% were unmarried. The majority of cases (90%) were Hindu by religion. The cases were slightly more in rural areas (56%) than in urban areas (44%). The study showed that half of the cases belong to the BPL class (51%) [Table 1]. Around 65% patients were literate. The maximum number of patients (63/220, 28%) was educated up to the eighth standard. Around 9% of patients had a college education [Table 2]. Every third case (33%) reported was a housewife, followed by skilled workers (13%) and truck drivers (10%). Very few cases (1%) were unemployed [Table 2]. Spouses were also seropositive in the majority (61%) of cases reported. Around 13% of cases were not aware of their spouse’s HIV status [Table 3]. HIV-TB coinfection was present in 20% (45/220): 29 out of these 45 cases were cured of TB, and 16 (35.56%) were under treatment at the time of the study [Table 3]. The majority of the study cases (84%) exhibited clinical improvement after starting antiretroviral treatment (ART), but a few (5%) patients did not show any clinical improvement [Table 4]. Only 25% had a history of migration, that is, 18% after HIV diagnosis and 7% before HIV diagnosis. The majority of individuals (75%) were satisfied with the ARTC counseling session, 17% did not respond to the counseling session, and only 9% were not satisfied with the ARTC counseling session [Table 4].
Table 1: Sociodemographic profile of the patients

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Table 2: Sociodemographic characteristics of patients

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Table 3: HIV status of patients and their spouses

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Table 4: Distribution of patients as per details of ART and ARTC

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  Discussion Top


In this study, 57% were males and 43% were females; the majority of the cases were in the age group of 26 to 40 years, which is a sexually active age group. This was similar to a study conducted by Deshpande JD et al.,[4] who observed that male patients (53.4%) outnumbered female patients (46.6%). The majority of their cases (80.38%) belonged to the age group of 15 to 45 years. The majority of the patients in our study belonged to the rural population (56.37%), whereas 43.63% belonged to the urban population. This is similar to a study conducted by Sudhir et al.,[5] in which 59.20% of patients were from rural areas. This may be due to the migration of the rural population for the purpose of employment, thus exposing them to the risk of getting HIV. The majority of the patients were married (70%) and 18% were widows; these were supported by the studies conducted by Baig et al.,[6] where 75% of cases were married, and Dutta et al.,[7] where 72% of the male patients were married and 92% of the female patients were married. Almost all the widows were infected by their husbands who had died due to the disease. Similarly, Joge US et al.[8] also reported that 70% of the cases in their study were married. The majority (90%) of the cases in the current study were Hindus and 8% were Muslims, similar to Saha et al.,[9] who observed in West Bengal that 89% of the cases were Hindus and 11% were Muslims. In the current study, 65% of the participants were literate and 35% were illiterate. Around 30% of literates were educated only up to the eighth standard, 17% were educated to secondary level, and 6% were graduates. These findings were similar to the study conducted by Baig et al.,[6] in which 69% were literates. The majority of the patients in the current study were illiterate and were educated up to the upper eighth standard. Thus, it may be assumed that people become more aware of increasing education quality and of protecting themselves against HIV. The current study showed that 34% of study participants were housewives, followed by 15% of agricultural laborers, 13% of skilled workers, and 10% of truck drivers. Rajasekeran et al.[10] reported that the majority of their patients were from the farming profession, and transporters accounted for a smaller proportion. The studies conducted by Sharma et al.[11]in north India revealed that 39.6% were laborers and 10.4% cases were drivers. In their study conducted in Puducherry, Balasundaram et al.[12] found that 76.92% of the subjects were agriculture workers, whereas 6.16% were housewives. These studies indicated that the majority of the infected individuals are either housewives or bread earners of the family. In the current study, the history of migration was present in 25.46% of patients for the purpose of employment or marriage.

More than half (62%) of the patients in the current study knew about the HIV status of their sexual partner. Among them, the majority of the patients (57%) were diagnosed after their spouse and 41% were diagnosed before their spouse; 13% of the study participants did not know about the HIV status of their partner. This might indicate that HIV is associated with high social stigma. There might be poor communication between partners due to traditional beliefs prevailing in our society, and there is difficulty in discussing sensitive subjects such as sex. Raising awareness about HIV and the use of condoms/ safe sex in the community can reduce the risk of transmission of HIV to spouses/ partners of HIV-infected people. In our study, HIV-TB coinfection was present in 20.45% patients; similar findings (18.9%) were also reported by Kamath R et al.,[13] Dutt et al.[7] reported a slightly higher proportion (27%) of cases with HIV-TB coinfection. TB is the most common opportunistic infection among HIV patients, and it is associated with high morbidity and mortality.[14] In the current study, three-fourth (75%) of the patients were satisfied with the counseling done at ARTC. A study conducted in Madhya Pradesh by Chourasiya et al.[15] reported that 85.5% of the study participants were satisfied with the counseling. Sood et al.[16] reported that 61.6% and Kishore et al.[17] reported that all 100% of the patients were satisfied with the services provided.


  Conclusion Top


Cases were more from the sexually active age group. The majority were poor, unmarried, widows, or divorced, and housewives. Patients should be encouraged to reveal their HIV status to their spouses and family members so that they have a better support system, as the spouse of every eighth case is unaware of the HIV status of their partner. TB was the most common coinfection, with every fifth case of HIV suffering from TB as well. This basic information would help policymakers formulate better information, education and communication and control measures that are area and population specific.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
National AIDS Control Organization. Annual Report 2018–19. Chapter 24. pp. 499-513. Available from: https://mohfw.gov.in/sites/default/files/24Chapter.pdf. [Last accessed on 2019 Jan].  Back to cited text no. 1
    
2.
UNAIDS. ‘AIDSinfo’; 2019. (http://aidsinfo.unaids.org/) [Last accessed on 2019 Jan].  Back to cited text no. 2
    
3.
Operational Guidelines for Integrated Counselling and Testing Centers. Government of India. Ministry of Health & Family Welfare. National AIDS Control Organization. 2007;1:2. [Google Scholar]. [Last accessed on 2019 Jan].  Back to cited text no. 3
    
4.
Deshpande JD, Giri PA, Phalke DB Clinico-epidemiological profile of HIV patients attending ART centre in rural Western. South East Asia J Public Heal 2012;2:16-21.  Back to cited text no. 4
    
5.
Arti S, Rathee R, Kumar D, Yadav V Socio demographic profile of HIV seropositive patients at ART centre, PGIMS, Rohtak. Int J Med Health Res 2017;3:32-6.  Back to cited text no. 5
    
6.
Baig V, Swarnkar M, Bhardwaj A, Rathore M, Kasyap A A study on socio-demographic profile and risk factors present in HIV infected patients attending ART centre in tertiary care hospital in Rajasthan, India. Nat J Com Med 2012;3:339-43.  Back to cited text no. 6
    
7.
Dutt RG, Patil D Sociodemographic profile of HIV positive clients. Bombay Hospital J 2011;1:25-9.  Back to cited text no. 7
    
8.
Joge US, Deo DS, Lakde RN, Choudhari SG, Malkar VR, Ughade HH Sociodemographic and clinical profile of HIV / AIDS patients visiting to ART Centre at a rural tertiary care hospital in Maharashtra state of India. Int J Biol Med Res 2012;3:1568-72.  Back to cited text no. 8
    
9.
Saha R, Saha I, Sarkar AP, Das DK, Misra R, Bhattacharya K, et al. Adherence to highly active antiretroviral therapy in a tertiary care hospital in West Bengal, India. Singapore Med J 2014;55: 92-8.  Back to cited text no. 9
    
10.
Rajasekaran S, Uma A, Kamakshi S, Jeyaganesh D, Senthamizhchelvan A, Savithrr S, et al. Trend of HIV infection in patients with TB in rural India. Ind J Tub 2000;47:223-6.  Back to cited text no. 10
    
11.
Sharma SK, Kadhiravan T, Banga A, Goyal T, Bhatia I, Saha PK Spectrum of clinical disease in a series of 135 hospitalised HIV-infected patients from North India. BMC Infect Dis 2004;4:52.  Back to cited text no. 11
    
12.
Balasundaram A, Sarkar S, Hamide A, Lakshminarayanan S Socioepidemiologic profile and treatment-seeking behaviour of HIV/AIDS patients in a tertiary-care hospital in South India. J Health Popul Nutr 2014;32:587-94.  Back to cited text no. 12
    
13.
Kamath R, Sharma V, Pattanshetty S, Hegde MB, Chandrasekaran V HIV-TB coinfection: Clinico-epidemiological determinants at an antiretroviral therapy center in Southern India. Lung India 2013;30:302-6.  Back to cited text no. 13
    
14.
Lawn S, Churchyard G Epidemiology of HIV associated tuberculosis. CurrOpin HIV AIDS 2009;4:325-33.  Back to cited text no. 14
    
15.
Chourasiya SK, Saroshe S, Dixit S, Swami SS, Sakalle S A cross sectional study to assess the client’s satisfaction with services provided at integrated counselling and testing centers for HIV/AIDS in selected districts of Madhya Pradesh. Int J Community Med Public Health 2016;3:781-6.  Back to cited text no. 15
    
16.
Sood A, Mazta S, Sharma A, Bhardwaj A, Raina SK, Chander V Scoring satisfaction among patients, attending ART centre of a medical college in North-West India. AIDS Care 2013;25:1477-80.  Back to cited text no. 16
    
17.
Kishor BV, Pal DK, Lodha Rama S, Bankwar V Clients satisfaction with Anti retroviral therapy services at Hamidia Hospital Bhopal. National J Community Med 2011;2:241-3.  Back to cited text no. 17
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4]



 

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