Estimating needs for HIV services: current shortfalls and future forecasts

Information on the health knowledge of migrants in Thailand is still lacking. Routine health intervention programs do not examine the useful analysis to evaluate the effectiveness of health information dissimilation despite the worldwide attempts to develop the comprehensive health information system. This paper studies the exposure to HIV/AIDS, Sexually Transmitted Infections - STIs, and reproductive health knowledge of migrant workers employing the data from an evaluation survey of the HIV/AIDS prevention program among migrant workers in Thailand (PHAMIT). Only one third of migrant workers have ever received information associated to HIV/AIDS, STIs, and reproductive health. Migrant workers in fishery, manufacturing, and construction industries were relatively disadvantage on information exposure since they were commonly bounded by protective fences and high walls which limit their capability to attach the useful information. The design of small group activities in the outreach program performed as a good model to strengthen knowledge of migrant workers.

Understanding of the burden of HIV in populations who are most at risk is poor, largely because these populations are poorly represented in national HIV surveillance systems and are hidden and stigmatized in many settings. Female sex workers have been reported to be at high risk for HIV infection in nearly every setting where they have been studied, yet in 2012 we still have limited understanding of the relative burden of HIV in these women.
Interventions targeting behavioral and structural-level risk factors for HIV among sex workers have proven successful for increasing protective behaviours and decreasing HIV and STI transmission. Despite these promising results, in Russia, the 2010-2011 UNGASS report indicates only 3% of sex workers are reached by HIV programmes across the country.
From 2001 to 2011, the best practices of HIV prevention among sex workers were collected in 75 cities of 50 Russian regions. The projects implemented in the Russian Federation used the comprehensive prevention model aimed at organizing accessible and adequate health services for sex workers.
After project financing stops, 13 organizations are planning to continue HIV/AIDS prevention activities among sex workers . However, it is obvious that without adequate support it would be difficult to maintain sustainability of the programmes.

This paper reports on a collaborative Indo-US project, entitled Research and Intervention in Sexual Health: Theory to Action (RISHTA) focused on prevention of HIV/STI among married men in three low income communities in Mumbai India. The Paper assesses the effectiveness of a brief intervention based on the narrative intervention model (NIM) an ecologically based, cognitive approach, with trained allopathic providers in a public primary care center and non-allopathic private providers based in the experimental communities. Quasi-experimental research design assessed to a systematic random sample of 2710 and a subset of 910 men was administered STI testing. A patient sample of 537 married men who utilized trained and untrained allopathic and non-allopathic. The results at the community level showed a significant drop from baseline (2004) to follow-up (2006) in gonorrhea (3.9 to 1.2%) and in extramarital sex (12.1 to 1.9%). At the patient level, male patients who went to trained providers showed significant improvement in knowledge about STDs, increased gender equitable attitudes, improved communication with spouse, and reduced extramarital sex, sex with sex worker and alcohol use, compared to those patients who went to untrained providers.

Client satisfaction occupies an intermediate step in establishing healthy culture for evaluation of an ongoing programme on HIV/AIDS. However, in India (one of the country where world’s highest number of persons living with HIV/AIDS resides) information on HIV/AIDS client satisfaction is almost non-existent. A qualitative study was carried out to explore issues of client satisfaction in relation to HIV/AIDS counselling services. In-depth interviews were carried out among the (22) counsellors and seven FGDs were carried out among the HIV positive group of male, female and transgender population. The study finds a clear distinction between the clients’ need according to their gender role. Female clients used to seem more satisfied after receiving the counselling services than other. The need for information on HIV/AIDS among the clients was universal among all the clients. All male clients felt satisfied, when counsellors used to clear their doubts and confusion about HIV/AIDS. Maintaining privacy was crucial for making male clients satisfied. Female clients were keen for receiving emotional support and medical treatment. Social acceptance was given highest priority by the transgender clients. The study suggests that to meet the HIV/AIDS clients’ expectations and needs gender specific counselling needs to be practiced.

Background. The main aim of survey in 2010-2011 was to gather information about the problems of people living with HIV (PLHIV) in Russia.
Methods. The sample size was 660 people living with HIV aged 18 and over in 11 major towns in Russia. PLWHIV were involved in conducting of survey at all stages.
Results. 35 % of respondents encountered any form of discrimination or stigmatisation due to HIV status . 21 % encountered some form of discrimination from organisations or. 78 % of PLWHIV experienced negative feelings towards themselves. Human rights of 12 % had been violated, 28 % could not say with certainty whether their rights had been violated or not. Only 18 % of those whose rights had been violated, took some kind of action to protect them. 60 % made the decision to be tested for HIV independently and voluntarily. 43 % did not receive any kind of pre – and post testing counselling. 36% say that public health workers displayed discrimination . 23% had received advice from public health workers not to have children at least once since their diagnosis of HIV was confirmed. 4 % of survey participants mentioned that healthcare workers had forced them to have a sterilisation.
The survey became an instrument for protecting the rights of people living with HIV. The results were presented and discussed at the State Duma hearings

Background:India housing world’s largest rural population of around 0.8 billion (UN Report 2006) is estimated to have over 57% of HIV positive persons living in rural areas (HSS India 2007). Paper describes findings from study of Link Worker Scheme (LWS) in rural areas of 219 highly vulnerable districts across India.
Methods:Evaluation involved qualitative appraisal of LWS processes & quasi-experimental study of programme among High Risk Groups (HRG) across study and comparison districts in 12 Indian states selected on the basis of their vulnerability using HSS, 2006 data. Sample size was calculated using point estimation formula: n=t2 X p (1-p) X f /d2. Total sample of 15194 was covered in the survey conducted in July 2012 and analyzed using SPSS.
Results:Qualitative insights emerged for policy & strategy, financial systems, IEC, and linkages. Logistic regression using quantitative data generated predictors for enhancing knowledge, attitude and consistent condom use. HRGs in study districts received significantly (p<0.5) better care increasing their knowledge and reducing risky behaviour. Proportion confirming consistent condom (programme outcome) was higher in study district than comparison districts (88% vs 38%; p<.001).
Conclusion:Improvement in span of 3 years was possible by planned utilization of local resources.

Consent rates for HIV testing in population surveys are often low, which may cause a bias in prevalence estimates if refusal to test is correlated with HIV status. Interviewer identity represents a plausible variable that affects testing, but not HIV status, and can be used in a Heckman-type selection model that provides consistent prevalence estimates. We innovate by adopting an interviewer random effects estimator which improves on the existing interviewer fixed effect approach in three respects. Firstly, using our model allows the effects of interviewer identity to be estimated even for those whose interviewers conducted a small number of interviews. Secondly, this methodology facilitates the use of bootstrapped standard errors which are necessary to correct for regression parameter uncertainty in the correlation between consent and HIV status. Thirdly, we propose a Bayesian model averaging approach that gives estimates that are consistent and unbiased. We report results for Zambia and Ghana. For Zambia we estimate a prevalence rate of 32% among males who refuse consent compared with 12 % among those who agree to test, substantially increasing the estimated population prevalence rate.

In India, though the prevalence rate is low (0.39%) (NFHS-III), yet due to her population size, it is important for the authorities to provide adequate provisions and healthcare in response to HIV. Response to HIV not only includes accessibility to affordable healthcare to needy but preventive actions to curtail new cases. Public spending on HIV is primarily comes from budgetary allocation. This paper attempts to investigate the benefit incidence of public spending i.e. the distributional incidence of benefit for different group of interest of public spending on HIV/AIDS. Data pertaining to government spending is obtained from the budget expenditure 2004-05 of Ministry of Health and Family Welfare, which gives directions and implementation of programmes directed in response to HIV. Individual or household level data from household survey on usage of public service is obtained from NFHS-III data. In an attempt to know how many HIV positive households/ individuals opt public health facilities. In an attempt to know how many HIV positive households/ individuals opt public health facilities for healthcare quintile wise distribution of HIV positive population accessing healthcare is obtained. Based on this information, paper investigates the distributional incidence of public spending on HIV/AIDS in India.

Life expectancy (at birth) is an estimate of the number of years a baby born in a certain year will expected to live, based on the mortality rates measured in that year. Demographers use the symbol e00 for life expectancy at birth (age 0). However, the index is heavily influenced by the rate of infant mortality. The main objectives of the paper are to estimate life expectancy for sub provinces population using IMR only.
Secondary data were used for the study. This study is to estimate the life expectancy of sub population. IMR is available for combined, males and females separately.
To estimate the life expectancy regression models were used. We have to fit a regression equation. With the help of this observed life expectancy and infant mortality rate we fit a regression equation. The regression equation is e00: a + (b*IMR) + (c*IMR2).
We used the estimated IMR values for the major provinces for 2010. According to data Esfahan, females had high IMR , Kordestan and Sistan Baloghestan have the lowest life expectancy. Razavi khorasan and Esfahan had high IMR. Golestan had the least difference for the combined and females life expectancy, but for males the least values are in Khozestan and Semnan. The T- Test was also applied and the values are significant.