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Enzyme-linked immunosorbent assay and Western blot analysis of dried blood spots (DBS) on filter paper have been shown to be as sensitive and specific as analysis of serum, and therefore may be a cost-effective and culturally appropriate HIV seroprevalence tool in remote areas. This study examines the acceptability of DBS in a tropical, rural population from an outpatient clinic in Andhra Pradesh, India, where participation was offered to every fifth patient seeking general medical care between March and April 2001. All 1413 patients approached for the study agreed to participate and provide a DBS for examination. The overall HIV seroprevalence in this sample was 2.8%. Of the participants, 51.7% were male, 93.2% were between the ages of 18 and 40, 85.3% were married, 29.7% were employed, 47.6% had no education and 73.1% resided in a rural setting. In the univariate analysis, history of genital warts (P = 0.01), sexually transmitted disease (P = 0.001), premarital sexual intercourse (P = 0.002), sexual contact with a commercial sex worker (P = 0.003), being employed (P = 0.011) and having more than 10 injections for medical purposes (P = 0.006) all correlated with being HIV-infected. Given the uniform willingness of these clinic attendees to be tested, we conclude that DBS is a useful, cost-effective tool in HIV serosurveillance in a rural, tropical setting. [ABSTRACT FROM AUTHOR]

In this study, the spatial distribution of HIV/AIDS is investigated with several socioeconomic variables. Results of exploratory analysis of correlations have been reported between the prevalence of HIV/AIDS as it is the dependent variable against a range of socioeconomic and demographic measures in Andhra Pradesh, India. The state ranks among the top six states for HIV prevalence in the country. This study offers an insight to the distribution of HIV prevalence and the potential impacts of the epidemic on the high-, medium- and low-risk groups determined through cluster analyses of population and cumulative HIV infections. The impacts have been addressed through selective social and economic measures as HIV/AIDS is considered more of a social epidemic. These results help in identifying factors that are contributing more towards the spread of HIV and so guide policies to counteract dominant factors in order to control the disease. Future investigations are necessary to elucidate characterization of the rates of infection according to gender, age groups and regions. [ABSTRACT FROM AUTHOR]

The relationships between hygiene, sexual behaviour and HIV infection are poorly understood. We examine these relationships in Indian truck drivers, a group at high risk for HIV infection. Truck drivers (n = 189) were recruited into an integrated HIV and hygiene Information Motivation (IM) programme. Sociodemographic characteristics, sexual and hygiene behaviour and HIV prevalence were determined. Multivariate logistic regression and linear generalized estimating equation models were utilized. At baseline, 2.1% of drivers were HIV infected and 34% who reported having contact with female sex workers (FSWs) had contact within the previous six months. Those who washed their hands postdefecation were less likely to report genital symptoms (OR 0.02; P = 0.01) and have sex with an FSW (OR [odds ratio] 0.21; P = 0.05). After an IM intervention, there were no changes in sexual risk-taking behaviour (coefficient 20.15 to 20.02; P = 0.13-0.75); however, hygiene behaviour improved from baseline (coefficient 0.09-0.31; P, 0.01 to P = 0.03). Personal hygiene habits, like handwashing, seem to be a modifiable behaviour after a modest intervention, whereas HIV risk-taking behaviour was not. The association between hygiene and HIV risk-taking suggests the need for further evaluation of the relationship and that of other hygiene practices in high-risk men in India. [ABSTRACT FROM AUTHOR]