Mukesh Shukla

High-risk sexual behavior among people living with HIV/AIDS attending tertiary care hospitals in district of Northern India

Context: Prevention with a positive approach has been advocated as one of the main strategies to diminish the new instances of HIV and the target are those who are engaged in high-risk sexual behavior. Therefore, understanding the risky behaviors of the HIV-infected individual is important. Aims: This study aimed to assess the prevalence and the predictors of high-risk sexual behavior among people living with HIV/AIDS (PLHA). Settings and Design: A hospital-based cross-sectional study was conducted at antiretroviral therapy centers of two tertiary care hospitals in Lucknow. Materials and Methods: A total of 322 HIV-positive patients were interviewed about their sexual behaviors during last 3 months using a pretested questionnaire. Statistical Analysis Used: Probability (p) was calculated to test for statistical significance at 5% level of significance. Association between risk factors and high-risk sexual behavior was determined using bivariate analysis followed by multivariate logistic regression. Results: Prevalence of high-risk sexual behavior was 24.5%. Of these patients, multiple sexual partners were reported by 67.3% whereas about 46.9% were engaged in unprotected sex. Multivariate logistic regression analysis revealed that high-risk sexual behavior was significantly associated with nonsupporting attitude of spouse (odds ratio [OR]: 18; 95% confidence interval [CI]: 1.4–225.5; P = 0.02) and alcohol consumption (OR: 9.3; 95% CI: 2.4–35.4; P = 0.001). Conclusions: Specific intervention addressing alcohol consumption and encouragement of spouse and family support should be integrated in the routine HIV/AIDS care and treatment apart from HIV transmission and prevention knowledge.

Assessment of knowledge, attitude and practice about diabetes among diabetic patients of tertiary care centre in central India

Diabetes mellitus (DM) is one of the major fast growing non-communicable disease (NCD) and causes threats to global public health. Progression of diabetes in most cases results in chronic complications, which lowers patients’ quality of life and increases their morbidity and mortality; it also leads to a great economic burden on our health systems. It has been proved that self-care is the cornerstone of diabetes management, since this has been proven in various studies and populations. Prior to initiating an educational program or interventions for diabetic patients, their current level of knowledge (K), attitude (A), and practice (P) should be evaluated. As per International federation (IDF) atlas seventh edition 2015, there are 415 million people worldwide and 69.2 million in India people with type 2 diabetes and, and these numbers are projected to increase to 642 million and 123.5 101 million by the year 2040.

Predictors of depression among people living with HIV/AIDS on antiretroviral therapy attending tertiary care hospitals in the Capital of Uttar Pradesh: A cross-sectional study

Introduction: HIV/AIDS is one of the most devastating illnesses that humanity has ever faced. Depression in HIV/AIDS patients is very common but the factors affecting it are not well studied. Therefore, the present study aims to assess the prevalence and the predictors of depression among people living with HIV/AIDS (PLHA). Methods: A cross-sectional study was conducted from November 2013 to March 2014 at antiretroviral therapy centers of two tertiary care hospitals in Lucknow and a total of 322 adult HIV patients on antiretroviral treatment for at least 6 months were interviewed with the help of a predesigned and pretested schedule. Systematic random sampling was used to recruit the patients. Becks depression inventory was used to measure depression. Results: About one-fifth (18.6%) of the patients were having depressive symptoms. Multivariate logistic regression analysis revealed that depression was significantly associated with female gender (odds ratio [OR]: 3.45; 95% confidence interval [95% CI]: 1.50–7.90; P = 0.00), counseling gap more than 3 months (OR: 2.06; 95% CI: 1.14–4.21; P = 0.04), nonadherence to treatment (OR: 2.66; 95% CI: 1.47–6.19; P = 0.02), and socioeconomic status upper lower and below (OR: 2.08; 95% CI: 1.12–4.21; P = 0.04). Conclusions: Low socioeconomic status, female gender, long counseling gaps more than 3 months, and nonadherence to treatment were found to be important predictors of depression. Therefore, there is a need of timely assessment of the PLHA for depression to ensure early detection and management to maintain optimal adherence to the treatment.

Assessment of quality of Life of HIV-Positive People on Antiretroviral Therapy

Background: HIV/AIDS has adverse impact not only on physical but also mental, social, and financial aspects of the infected individual. Quality of life (QOL) among these individuals is therefore becoming crucial for measuring commonly used endpoints. Objective: To study the quality of life (QOL) of HIV-positive people on antiretroviral therapy. Material and Methods: A hospital-based cross-sectional study was conducted among 100 adult HIV-positive patients at two tertiary care hospitals of Lucknow. Systematic random sampling was used to recruit patients. Quality of Life was assessed using WHOQOL-BREF scale. Results: Mean age of the PLHAs was 39.08±9.72 and majority (73.0%) of the study participants were male. QOL score were highest for physical health domain (10.45±1.35) followed by psychological domain (9.38±1.33), environmental domain (8.73±1.11) and social relationship domain (8.05±1.90) respectively. A significant difference (p<0.05) was observed in mean score for social relationship domain with subjects counselled within the last three months and those who were adherent to the treatment had a higher mean score of QOL mean score. Conclusions: The present study revealed intermediate level scores for quality of life for PLHAs. Therefore for improving each and every facet of quality of life all the psychological, emotional and medical needs should be properly addressed through combined efforts by health care providers as well as the community.

Nonadherence to antiretroviral therapy among people living with HIV/AIDS attending two tertiary care hospitals in district of northern India

Introduction: Adherence to antiretroviral therapy is a principal predictor for the success of human immunodeficiency virus (HIV) treatment. It remains as a challenge to acquired immunodeficiency syndrome (AIDS) treatment and care with the widespread of the associated risks. Therefore, study aims to assess nonadherence level and factors associated with nonadherence to ART among people living with HIV/AIDS (PLHA). Materials and Methods: A hospital-based, cross-sectional study was conducted at two tertiary care hospital of Lucknow. A total of 322 adult HIV-positive patients registered in the ART center were included. Systematic random sampling was used to recruit patients. Nonadherence was assessed on the basis of pill count method. Results: A total of 10.9% of patients were found to be nonadherent to ART. Principal causes cited were being busy with other work (40.0%), felt sick or ill (28.5%), not having money (14.2%), and being away from home (11.4). Multivariate logistic regression analysis revealed that nonadherence was significantly associated with nonbeneficial perceptions towards ART (odds ratio (OR) 18.5; 95% confidence interval (CI) 3.2-106.6; P = 0.001), being counseled for adherence for more than 3 months (OR 13.9; 95% CI 1.6-118.9; P = 0.01), presence of depression (OR 2.6; 95% CI 1.0-6.7; P = 0.04), and those who were not satisfied with healthcare facilities (OR 5.63; 95% CI 1.88-16.84; P = 0.00). Conclusion: Although adherence to ART varies between individuals and over time, the factors that affect nonadherence can be addressed with proper periodic counseling and motivation of patients and their family members. Adherence to highly active antiretroviral therapy (HAART) could delay the progression of this lethal disease and minimize the risk of developing drug resistance.