In 2012, UNAIDS estimated that 2,100,000 people in India were living with HIV/AIDS, a prevalence rate of 0.3%. Of these, approximately 750,000 women over age 15 are living with HIV. With funding from the United Methodist Committee on Relief (UMCOR), the Comprehensive Rural Health Project is studying HIV/AIDS among women in our project villages. Alyssa Dilly explains how we are contributing to the World AIDS Day 2013 campaign by testing for and teaching rural women about HIV/AIDS.
Do you know what HIV/AIDS is?
Can HIV/AIDS be transmitted by sexual intercourse?
Can coughing transmit HIV/AIDS?
Can HIV/AIDS be transmitted by mosquito bite?
Would you invite someone with HIV/AIDS into your house for tea?
Would you share food with someone with HIV/AIDS?
Those are the six simple questions our social worker asks village women who volunteer to participate in a current research study at CRHP. We are investigating the rates of HIV/AIDS among women between ages 18-45 in our project villages, as well as exploring their understanding and attitudes towards the disease.
In the early 1990s, CRHP and the National AIDS Research Institute in Pune, India, partnered to determine the overall prevalence rate of HIV/AIDS among pregnant women in the population served by CRHP. The research revealed that CRHP’s rural population had a prevalence rate of 0.75% as compared to the urban Maharashtra prevalence rate of 3-5%. CRHP has been able to contain the epidemic within our project villages through implementation of programs aimed at HIV/AIDS health awareness, prevention and promotion in a non-stigmatizing manner.
Many risk factors for HIV/AIDS are associated with living in rural India, where stigma-associated silence, heavily trafficked truck-driver crossroads and lack of education threaten low prevalence rates. Although testing kits are cheaper at government hospitals than private clinics, a major barrier to getting tested is villagers’ distrust in government hospitals due to poor reputations for untimely and inadequate care; furthermore, an individual test kit is unaffordable for most villagers. HIV-related stigma discourages those who are affected by HIV from seeking treatment, for fear of being scorned by their communities and rejected by their families.
The project began this past September with our research team comprised of social workers and lab technicians going to individual villages and collecting blood samples, demographic information and survey responses of women. Our work greatly relies on the Village Health Worker, a concerned and confident role model and health educator, who convinces women to be tested. It is the VHW who sits by the women’s sides as they wince at the sight of our needle, who omnisciently relays demographic information about each woman to us, and who will teach her village about HIV/AIDS in the next stage of the research study.
Over the past three months, we have tested fourteen villages for a total of 1,083 women, 77 of who are pregnant. The Village Health Worker and our social workers discuss HIV statuses with the women once the blood tests are completed. Expecting mothers receive a certificate from CRHP’s hospital confirming their HIV-free status. This certificate was an innovative idea of Mr. Chandu Mama, one of our lab technicians; it saves families 300 rupees since they will not need to repeat the test in a hospital facility.
The impact of our project is not limited to these women. When our Mobile Health Team visited the village of Khandvi to meet with participants in the Adolescent Girls Program (AGP), they asked what had been happening in their village recently, if they had learned anything new since their last meeting. The girls excitedly talked about how CRHP had come to take women’s blood and test for HIV, opening a door to discuss the disease with the girls.
Examples of ‘knowledge is power’ in action are numerous in our history, and this study is no exception. We look forward to continuing research and expanding this study to also include education in HIV/AIDS, as well as sexually transmitted infections (STIs), for our VHWs and Women’s Groups members. We are grateful for the generous support from UMCOR that has enabled us to impact so many women and families and to play a role in the reduction of HIV/AIDS, and furthermore the reduction of HIV/AIDS stigma, in rural India.