RESUMO
India has approximately 5.2 million persons infected with HIV. Although antiretroviral therapy (ART) is being widely introduced in public clinics, many HIV-infected persons still seek care via the private sector. A cross-sectional survey was conducted in 2004 at six public and private sites to characterize the knowledge, attitudes, and practices (KAP) of ART among patients with HIV receiving care in India. Of 1667 persons surveyed, 609 (36%) had heard of ART and 19% of these persons reported that ART could cure HIV. Twenty-four percent reported that they were currently taking ART, with 18% of these patients not actually on ART according to their provider. Major barriers to taking ART were cost (33%), lack of knowledge of ART (41%), and deferral by physician (30%). More than half of all public and private patients had not heard of CD4 (57%) or viral load testing (80%), and even fewer had received these tests (32% and 11%, respectively). Private clinic attendees were almost 4 times more likely to be on ART (35% versus 9%, p < 0.0001), more likely to be male, have a higher education, be partnered, have a higher income, and have had a CD4 or viral load (p < 0.0001). Overall, low levels of ART knowledge and access were observed among HIV infected patients, with access to ART being particularly low among patients attending public clinics. In order to make widespread dissemination of ART effective in India, further educational and programmatic efforts are likely needed to optimize access, treatment awareness, and compliance among patients with HIV.
Assuntos
Fármacos Anti-HIV/administração & dosagem , Fármacos Anti-HIV/uso terapêutico , Infecções por HIV/tratamento farmacológico , Conhecimentos, Atitudes e Prática em Saúde , Cooperação do Paciente/estatística & dados numéricos , Adulto , Envelhecimento , Contagem de Linfócito CD4 , Feminino , Infecções por HIV/epidemiologia , Infecções por HIV/psicologia , Humanos , Índia/epidemiologia , Índia/etnologia , Modelos Logísticos , Masculino , Razão de Chances , Cooperação do Paciente/etnologia , Cooperação do Paciente/psicologiaRESUMO
The improved availability and drastically reduced cost of antiretroviral therapy, largely due to generic manufacturing, has enabled an increased number of HIV-positive Indians to undergo antiretroviral therapy. But unless these drugs are used judiciously, treatment failures will cause the emergence of drug-resistant HIV strains. This is a grave danger not only to India but to the entire world. So far, antiretrovirals have had only a limited impact in India. HIV-infected patients require multidimensional care and the success of antiretroviral therapy depends on numerous economic, social, cultural, political, technical and infrastructural factors.
