 |
|
|
ONGOING PROJECT
1. Impact of counseling and behavior change
Brief Description:
This study is based on the enrolled patients at the VCTC coming for follow-ups and ongoing counseling is provided to address their specific problems through supportive counseling.
2. HPV Formative study (no budget study)
Brief Description:
There exists compelling scientific evidence about utility of male circumcisionas HIV prevention strategy. The trials of male circumcision conducted in Kenya and Uganda—provide evidence that male circumcision provided a protective benefit against HIV infection of 53% among the 2784 Kenyan men and 51% among the 4996 Ugandan men enrolled (Gray et al, 2007). The WHO and UNAIDS guidelines emphasize and recommend male circumcision as a potential HIV prevention clinical option within health delivery settings. However, there has been no study to understand community and health care providers’ perspective of male circumcision in India. In India, male circumcision is traditionally and commonly practiced in certain minority community/ies and majority of the male Indian population is non-circumcised. It is practiced within certain religion/communities as part of their religious beliefs and practices. Thus, male circumcision is by and large a religion-directed tradition in India.
This study aims at understanding community and health care providers’ perspectives, concerns and prospective role in relation to male controlled biological option especially the circumcision (MC) in India in the context of HIV prevention and control program. It is a multicentric study, ongoing, at 4 sites in India.
Current status:
Ongoing Project
1. Government Medical College, ART center Nagpur: Lower reported ART adherence
2. Government medical college, ART center Yavatmal: New ART center
3. SRTR medical college Ambejogai, District Beed: Rural ART center
Brief Description:
The study was initiated after consultation with MSACS i.e. Project Director and Project Coordinator of Maharashtra State AIDS Control Society [MSACS], Mumbai. The focus of this consultations was study site selection and development of data collection tools. This was a qualitative study involving In depth interviews with adherent, non adherent patients attending ART centers, Key informant interviews with HCPs of ART centers, Focus Group Discussion with stake holders like patient’s relatives, NGO representatives, and observations of ART center facility. Twenty health care providers and 34 patients participated in this study. The data collection began in January 2009 and was on till March 2009.
Current status:
Qualitative data analysis is on going. Process of report generation is ongoing.
i. Data management : Data transcription, translation and QC
ii. Developing coding scheme
iii. Coding interviews using software
iv. Final data is being analysed
5. Assessing the introduction ofr HPV vaccine: Phase I Formative study
Operational Research PI:
Dr N Mawar (NAI) and PI Dr M Jacob (PATH)
Background:
Broad scale access to a vaccine against Human Papillomavirus infection, a necessary cause for cancer of the cervix, has the potential to reduce cancer of the cervix cases by 500,000 each year.
Objectives:
Access to vaccines in combination with continued strengthening of simple evidence-based screening and treatment approaches can reduce developing country disease rates to the low levels observed in developed countries.
Materials and Methods:
The formative study is the phase I study covers one district each in two states :Andhra Pradesh and Gujarat based on NFHS indicators . The study used qualitative data in both the states to cover varied stakeholders from national to state, district, block to village level official/policy makers and implementers and the community to include adolescent girls, their parents, community leaders and influencers . Data was collected in both states using focus group discussion (120 covering 971 participants), Indepth interviews (131 in two states and at national level),exit interviews (49), health systems immunization session observations (11) and three Immunization Expert Consultations covering 43 participants.
Quality control and assurance: This was maintained in both the states through common training to investigators, and checks during data collection and recording, expansion of notes, translations, electronic copies and coding based on a common code book.
Data analysis:
The study is using the N-6 software for theme analysis and Summarizing through group work. The same is in progress.
Principal Investigator:
Govind Rangrass, U.S. Fulbright Scholar (Public Health)
NARI Supervisor:
Dr. Seema Sahay, NARI
Brief description:
Although there are no official estimates on the number of Indian AIDS orphans, UNICEF estimates that almost 26 million Indian children have been orphaned due to all causes. By comparison, South Africa, a country with similar HIV/AIDS rates, is expected to have 2.3 million AIDS orphans by 2020. Most AIDS affected and infected children might eventually have to look after their homes, fend for themselves or be looked after, with some having a grandparent as a main guardian. Their health, educational opportunities, and survival often depend on an older person who might him/herself be sick or lacking support, information, skills and ability to provide care or run the household. Few studies have been conducted to determine the conditions of these child-headed households. Sub-Saharan studies have found that child-headed households have profoundly impacted kinship structures. India’s adoption programs for HIV-positive children achieve little success. The stigma of HIV/AIDS and the lower social acceptance of positive children deter potential foster parents from adopting them. This situation leaves them to fend for themselves. UNICEF convened a meeting to discuss African children without family care, but India has not yet formulated a comprehensive policy addressing the issues facing the rising number of AIDS orphans. To fill in this gap, comprehensive information is needed to understand the situation and the needs of AIDS affected/ infected children in India. This study is being conducted to understand these issues using qualitative methods. The study has been reviewed; guidelines have been suitably modified and re-reviewed by the Ethics Committee, NARI. After receiving the final approval from NARI-Ethics committee the study participant recruitment activity and pilot test was initiated. The final study is being conducted through NGOs , CBOs and the Community Advisory Board Members. The study has been initiated in Pune.
Lead investigator:
Dr. Seema Sahay, NARI
Brief description:
To ensure the NARI’s commitment to community participation in all aspects of the research process, it is critical that community representatives be included and supported from the concept development stage forward. Community involvement is considered as a major responsibility for the conduct of all NARI projects and it is actively sought on a broader basis under Community involvement Plan (CIP) of NARI. We commit to provide input about community concerns, beliefs and norms through CIP, NARI. This is an ongoing process that follows closely monitored structured / unstructured strategies with in the direct and indirect stakeholders, modifications in strategies based on scientific evaluation with a broad goal of structural changes that aims to facilitate AIDS control.
A Joint collaborative study between NARI and Maharashtra Association of Anthropological science (MAAS), Pune
PI: Dr. Seema Sahay, NARI
Co-PI: Dr. Sheela Rangan (MAAS)
Sponsors: DFID (India)
Brief description:
This is a qualitative study being conducted at two areas in Pune.
Families represent the largest group of care providers for all chronic illnesses, including HIV in India). The maturing HIV epidemic in India coupled with the ARV roll out Programme at the national level has shifted the provision of health care services from institutional to community- and family-based settings and translates into increased number of care providers taking care of their family members having HIV. These care providers from the family are yet far from being recognized as care providers by formal health systems. While the third phase of the National AIDS Control Programme has identified the need to have community and family based response in the care and support agenda through the Community Care Centres, clear strategies for implementation still need to emerge. The proposed study focuses on an understanding regarding the profile of family care providers, the responses of and the dynamics within families due to HIV and their needs with regard to providing care and support to PLHA.
Eight FGDs, 9 KII and 9 Case studies have been completed. The study staff received training in NuDIST N6 software for data analysis. We are expecting to conduct 20 case studies. Data collection is expected to be complete in March 2009.
National AIDS Research Institute, Pune All rights reserved.