Expanding Access to HIV Testing & Counseling & Exploring Vulnerabilities among Spouses of HIV-Positive Men Who Inject Drugs in Pakistan

Objectives

To explore the utility of home and community-based HIV testing and counseling (HTC) to increase detection of undiagnosed HIV among female spouses and children of HIV-positive PWID in Punjab province, Pakistan.

Design

Between March 2014 and March 2015, home-based HTC was provided by a local NGO to spouses of HIV-positive PWID in Lahore, Faisalabad, and Sargodha. Convenience sampling was used to identify 2400 married, HIV-positive men who inject drugs and who were currently registered and receiving harm reduction services from the NGO ‘Roshan Rasta’ and seek consent to approach their wives.

Method

Trained outreach teams conducted HTC and administered a short sociodemographic and behavioral questionnaire to consenting spouses in their homes. HIV-exposed children were also tested with parental consent.

Results

of the 2400 married HIV positive male-injecting drug users, only 1959 spouses were approached and 1896 agreed to HTC (96.8%). HIV prevalence was 5.3% (n = 101) among spouses and they had very low level of HIV-related knowledge and protective behaviors

Conclusion

Home and community-based HTC was effective in identifying undiagnosed HIV among spouses of PWID, the majority of whom reported low rates of prior HIV testing and low HIV-related knowledge. Expansion of HIV prevention services and linkages to treatment and care including PMTCT are urgently needed for this group.

Below:  Ability of spouses to either identify correct responses or reject misconceptions regarding routes of HIV transmission. ^∗There was some confusion about how to administer this question in the survey by field teams, resulting in a substantial amount of incomplete data, which was subsequently excluded. Consequently, the number of respondents for each mode of transmission varies. We calculate ‘all correct’ based only on spouses that provided a response to all seven modes.

Full article at:   http://goo.gl/ZBUQl8

By:  Salman Shahid,a Mohammad Faisal Majeed,a Ahmad Bakhsh Awaan,b Humayun Mirza,b Nasir Sarfraz,c and Vanessa Veronesed

^aPunjab AIDS Control Program, Department of Health, Government of Punjab, Lahore

^bRoshan Rasta, Lahore

^cHealth Section, UNICEF Pakistan, Islamabad, Pakistan

^dHIV and AIDS Section, UNICEF Regional Office for South Asia, Kathmandu, Nepal

Correspondence to Salman Shahid, 7-B, LDA Flats, Huma Block, Allama Iqbal Town, Lahore 2060, Pakistan. Tel: +092 42 3780 2425

Curr Opin HIV AIDS. 2016 Mar; 11(Suppl 1): S6–S12.

Published online 2016 Mar 10. doi:  10.1097/COH.0000000000000263

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