Treatment and Care for Women with HIV/AIDS

Uraiwan Kanungsukkasem of Thailand spoke of a survey of 101 HIV positive women, aged 15 to 47 that was recently conducted in Chiangrai Province. The demographics of the survey participants showed 89 percent to be Buddhists, 76 percent to work in agriculture, 19 percent unemployed and a very high level of 65 percent being widows. 72 percent of the participants were members of local PLWHA support groups. Only 17 percent of the participants in the survey had accessed antiretrovirals (ARVs) through drug trials, their only source of ARV's, as none could afford to pay for them. Only 57 percent of participants self-assessed their present health as good and 76 percent reported that they had been ill in the last three months. Most (79 percent) had sought care in public hospitals or clinics, while 17 percent accessed health centres or nurses at PLWHA groups and surprisingly only seven percent went to traditional healers. Uraiwan reported that 75 percent of participants were satisfied with the public health services they received, mainly due to friendly staff, effective treatment, good advice and no discrimination.

Sanjeevanee Kulkarni of the Prayas organisation in India reported on a series of in-depth interviews that were recently conducted to examine the adequacy of Reproductive Health Programs. Sanjeevanee noted that marriage was the only risk factor for many of the HIV positive women and that most women in India are extremely vulnerable to HIV. The objective of the interviews was to document issues, concerns and problems for women living with and affected by HIV/AIDS. The interviews were conducted with 61 HIV positive women, 6 women from sero-discordant relationships, 11 key informants, 22 health care workers and a knowledge and attitudinal survey of 403 community members. The interviews of the HIV positive women found that 37 of them were currently married, 18 widowed and many of the women married at a young age to older men. Most of the women were tested (diagnosed) when their partner or child had been tested HIV positive or when they were having an antenatal check up. Often consent was not obtained when ante-natal HIV testing was carried out, counselling was not provided and the women's confidentiality was also often breached by the health care workers. Sanjeevanee noted that most of the HIV positive women did not receive support from their in-laws once they were diagnosed as HIV positive and they faced increased levels of violence and unsafe sex from their partners. Sanjeevanee also provided some results from the key informant interviews that included the belief that alcohol and other addictions were fuelling the HIV epidemic in India and health care facilities were currently inadequately equipped to provide effective care. It was also stated that educative and socio-economic status was not protective for HIV. It was felt that for Reproductive Health Programs to be effective they needed to shift towards providing comprehensive sexual health services and to move to secondary and tertiary health care that is based on broad community based interventions.