ABSTRACT
We conducted a randomized, controlled, three-armed trial to assess whether training in syndromic management, with provision of packets, could improve the quality of STD services provided among non-formal care providers. The quality of STD case management service, observed by "incognito patients" in both intervention groups, improved substantially compared to the control group (p < 0.05). The training-and-packets group performed better in service delivery, HIV-testing referral, and condom provision when compared to the training-only group (all p < 0.05). The training-and-packets group also retained more knowledge and practiced more skillfully at six months post-intervention when compared to the training-only group (p < 0.05). Exit interviews of clients suggested that 81% of providers in the intervention groups offered advice on condom use when compared to none of those in the control group (p < 0.001). Syndromic management training and free syndrome packets for non-formal providers had a positive impact on the quality of STD care among the trained providers.
Subject(s)
Female , Health Personnel/education , Humans , Inservice Training/methods , Male , Pakistan , Program Evaluation , Quality Assurance, Health Care , Sexually Transmitted Diseases/physiopathology , Syndrome , Treatment OutcomeABSTRACT
The National AIDS Committee was formed in 1985 to develop and support policies that prevent transmission of human immunodeficiency virus (HIV). In 1990, the Institute of Epidemiology, Disease Control and Research in the Ministry of Health began sero-surveillance for AIDS/HIV infection. Convenience sampling was conducted among prisoners, sailors, truckers, antenatal attendees, repatriated Bangladeshi workers, and brothel-based prostitutes in Dhaka. In 1994, commercial sex workers in other high-risk areas were included in surveillance activities. Among over 75,700 HIV tests through 1998, 119 have been confirmed positive for HIV. While the cumulative HIV prevalence rate was only 1.5/1,000 tests, it was significantly higher among men (p < 0.0001) than among women. The rates among men were as high as 28/1,000 tests in 1996 and 21/1,000 tests in 1997. Almost 50% of the reported HIV cases are from cities on the border of India and Myanmar. It is anticipated that HIV transmission will increase further given the high prevalence of risk behaviors, core high-risk groups, and extreme poverty.
Subject(s)
Acquired Immunodeficiency Syndrome/epidemiology , Adolescent , Adult , Bangladesh/epidemiology , Child , Child, Preschool , Female , HIV Infections/epidemiology , Humans , Infant , Male , Middle Aged , Pregnancy , Risk Factors , Seroepidemiologic Studies , Sex DistributionABSTRACT
The HIV/AIDS epidemic in India is expanding rapidly. The present study is a pre-test-post-test evaluation of a school-based HIV/AIDS educational program. The pre-test was administered to 2,919 students regarding modes of transmission and prevention of HIV/AIDS. An education program was instituted for one half school day at ten secondary schools. Principals of two schools refused to participate. One month later, the post-test was administered to 2,400 students. Before the educational intervention only 50% of the students knew that HIV/AIDS is transmitted sexually, only 34% knew that there are no medicines that cure HIV/AIDS and 24% thought that HIV is transmitted by mosquito bites. After the intervention, 95% of the students knew that HIV/AIDS is transmitted sexually, 92% knew that there is no HIV/AIDS cure and 76% knew that HIV/AIDS is not transmitted by mosquitos. There was a substantial increase in correct knowledge about HIV/AIDS among students after our single educational program. This suggests that school-based educational programs for adolescents in India can succeed in providing basic information regarding HIV/AIDS.