TY - JOUR
T1 - HIV testing among pregnant women living with HIV in India
T2 - Are private healthcare providers routinely violating women's human rights?
AU - Madhivanan, Purnima
AU - Krupp, Karl
AU - Kulkarni, Vinay
AU - Kulkarni, Sanjeevani
AU - Vaidya, Neha
AU - Shaheen, Reshma
AU - Philpott, Sean
AU - Fisher, Celia
N1 - Funding Information:
For their generous assistance on this project, the authors would like to thank all the participants in the study. Special thanks to Suvarna Ruchitha and Poornima Jaykrishna from PHRII for assisting on the project. Purnima Madhivanan was a fellow in the Training Program for HIV Prevention Research Ethics at Fordham University funded by the National Institutes for Health/National Institute on Drug Abuse.
Funding Information:
This study was supported by National Institutes of Health/National Institute of Drug Abuse (R25DA031608). The views expressed by the authors do not necessarily reflect the views of National Institute of Drug Abuse or the National Institutes of Health.
PY - 2014/3/24
Y1 - 2014/3/24
N2 - Background: In India, approximately 49,000 women living with HIV become pregnant and deliver each year. While the government of India has made progress increasing the availability of prevention of mother-to-child transmission of HIV (PMTCT) services, only about one quarter of pregnant women received an HIV test in 2010, and about one-in-five that were found positive for HIV received interventions to prevent vertical transmission of HIV. Methods. Between February 2012 to March 2013, 14 HIV-positive women who had recently delivered a baby were recruited from HIV positive women support groups, Government of India Integrated Counseling and Testing Centers, and nongovernmental organizations in Mysore and Pune, India. In-depth interviews were conducted to examine their general experiences with antenatal healthcare; specific experiences around HIV counseling and testing; and perceptions about their care and follow-up treatment. Data were analyzed thematically using the human rights framework for HIV testing adopted by the United Nations and India's National AIDS Control Organization. Results: While all of the HIV-positive women in the study received HIV and PMTCT services at a government hospital or antiretroviral therapy center, almost all reported attending a private clinic or hospital at some point in their pregnancy. According to the participants, HIV testing often occurred without consent; there was little privacy; breaches of confidentiality were commonplace; and denial of medical treatment occurred routinely. Among women living with HIV in this study, violations of their human rights occurred more commonly in private rather than public healthcare settings. Conclusions: There is an urgent need for capacity building among private healthcare providers to improve standards of practice with regard to informed consent process, HIV testing, patient confidentiality, treatment, and referral of pregnant women living with HIV.
AB - Background: In India, approximately 49,000 women living with HIV become pregnant and deliver each year. While the government of India has made progress increasing the availability of prevention of mother-to-child transmission of HIV (PMTCT) services, only about one quarter of pregnant women received an HIV test in 2010, and about one-in-five that were found positive for HIV received interventions to prevent vertical transmission of HIV. Methods. Between February 2012 to March 2013, 14 HIV-positive women who had recently delivered a baby were recruited from HIV positive women support groups, Government of India Integrated Counseling and Testing Centers, and nongovernmental organizations in Mysore and Pune, India. In-depth interviews were conducted to examine their general experiences with antenatal healthcare; specific experiences around HIV counseling and testing; and perceptions about their care and follow-up treatment. Data were analyzed thematically using the human rights framework for HIV testing adopted by the United Nations and India's National AIDS Control Organization. Results: While all of the HIV-positive women in the study received HIV and PMTCT services at a government hospital or antiretroviral therapy center, almost all reported attending a private clinic or hospital at some point in their pregnancy. According to the participants, HIV testing often occurred without consent; there was little privacy; breaches of confidentiality were commonplace; and denial of medical treatment occurred routinely. Among women living with HIV in this study, violations of their human rights occurred more commonly in private rather than public healthcare settings. Conclusions: There is an urgent need for capacity building among private healthcare providers to improve standards of practice with regard to informed consent process, HIV testing, patient confidentiality, treatment, and referral of pregnant women living with HIV.
KW - Antenatal care
KW - Confidentiality
KW - Diagnosis
KW - HIV testing
KW - India
KW - Perinatal transmission
KW - Qualitative research
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U2 - 10.1186/1472-698X-14-7
DO - 10.1186/1472-698X-14-7
M3 - Article
C2 - 24656059
AN - SCOPUS:84898434282
SN - 1471-2458
VL - 14
JO - BMC International Health and Human Rights
JF - BMC International Health and Human Rights
IS - 1
M1 - 7
ER -