ABSTRACT
BACKGROUND Systematic data on mental health issues among adults awaiting cataract treatment are not readily available in India. We explored the prevalence and predictors of depressive and generalized anxiety (GA) symptoms in a cohort of adults awaiting cataract surgery. METHODS Our study is based on data from baseline assessments which were conducted as part of a multicentre prospective, longitudinal cohort study. Subjects were recruited from four eye hospitals to assess depression and GA and associated risk factors using standardized scales, i.e. Center for Epidemiologic Studies–Depression Scale (CES-D) and Generalised Anxiety Disorder (GAD-7). Variation in the intensity of depression and GA was assessed using multiple classification analysis (MCA). RESULTS A total of 813 adults awaiting cataract surgery participated, of whom 456 (56.1%) were men. The mean (SD) CES-D and GAD-7 scores were 24.6 (7.8) and 6.3 (SD 4.2) for men and 25.8 (8.9) and 6.9 (4.4) for women, respectively. The overall prevalence of depression score of >16 was 87.4% (95% confidence interval [CI] 84.7%– 89.6%), and GA score of >10 was 57.1% (95% CI 53.5%–60.7%). The prevalence of comorbid depressive and anxiety symptoms was 56.6% (95% CI 52.9%– 60.2%). MCA showed that being neglected and mistreated by family/friends because of vision condition and facing difficulty and requiring help with daily tasks had the highest effect on the intensity of both depression (beta=0.254 and 0.238, respectively) and GA (beta=0.219 and 0.211, respectively). CONCLUSION The majority of adults with untreated cataract had both depressive and GA symptoms. These findings could be used for planning mental health interventions for adults awaiting cataract surgery.
ABSTRACT
Background & objectives: Systematic data on existing coverage and willingness for HIV prevention strategies among truckers are not readily available in India. The present study aimed to further the understanding on contact of truckers with existing HIV prevention services and to assess willingness for new HIV prevention strategies. Methods: A total of 1,800 truck drivers and helpers aged 16-65 yr passing through Hyderabad were approached to assess contact made with HIV prevention programmes, history of previous HIV testing and their acceptance for circumcision, oral HIV testing, new medications to control HIV (PrEP) and telephonic counselling. Dried blood samples were collected on filter paper and tested for HIV. Multiple logistic regression was performed for analysis of association between contact with HIV prevention programme and socio-demographic, sexual risk behaviour variables and work characteristics. Results: A total of 1,602 (89%) truckers gave interview and provided blood sample. Forty five truckers tested positive for HIV resulting in HIV prevalence of 2.8 per cent (95% CI 2.0-3.6%). Only 126 truckers (7.9%; 95% CI 6.5-9.2%) reported ever being contacted by staff providing HIV prevention interventions. Previous HIV testing was reported by19 per cent (95% CI 17.3-21.2%). Those reporting contact with HIV prevention programmes ever were more likely to have undergone HIV testing (odds ratio 3.6, 95% CI 2.4-5.4). The acceptance for pre-exposure prophylaxis (PrEP) was 87 per cent, oral HIV testing 98 per cent, and telephonic counselling 82 per cent, but was only 9 per cent for circumcision.Truckers who reported having sex with a man and those who halted regularly at dhabas were significantly more willing to undergo circumcision for HIV prevention (odds ratios 2.7, 95% CI 1.4-5.4 and 2.1, 95% CI 1.3-3.2, respectively). Interpretation & conclusions: Our findings showed that truckers had low contact with HIV prevention programmes, suggesting a need for urgent measures to reach this population more effectively. The willingness for new HIV interventions was high except for circumcision. These findings could be used for further planning of HIV prevention programmes for truckers in India
ABSTRACT
Background. HIV testing is a key component of HIV control efforts. We examined the distribution of HIV testing in a population-based sample from Guntur district in Andhra Pradesh, which is estimated to have one of the highest prevalence rates of HIV in India. Methods. A total of 12 994 persons (15–49 years of age) were interviewed in Guntur district. We assessed associations with the uptake of HIV test, place and reasons for undergoing HIV testing and awareness of voluntary counselling and testing centres (VCTC) among sexually active adults. Results. The age-, sex-, urban- and rural-adjusted prevalence of HIV testing was 21.1% (95% CI: 19.1–23.2). The uptake of HIV test was higher in women (27.2%) than in men (18.8%). Increasing education level, urban area residence and being in an occupation requiring mobility were significantly associated with uptake of the HIV test. A previous test for HIV was reported by 37.8% of men and 30.3% of women. The adjusted prevalence of VCTC awareness was 5.4% (95% CI: 4.3–6.4), being higher in men (9.2%) than in women (3.5%). Among those who had undergone HIV testing, 83.9% of men and 76.2% of women did so at a private sector health facility. Women were significantly more likely to under-go testing at VCTC/public sector facility (23.5%) than men (15%). More men (47.6%) than women (3.3%) reported undergoing testing voluntarily (p<0.001). Women reported pregnancy (57.4%) as the most common reason for undergoing the test. Conclusion. These population-based data highlight the patterns of HIV testing and their associations. The high proportion of HIV testing in the private sector suggests the need to strengthen counselling in this sector to enhance HIV prevention activities.