Journal of Medical Society

ORIGINAL ARTICLE
Year
: 2015  |  Volume : 29  |  Issue : 1  |  Page : 8--11

Prevalence of HIV seropositive delivery in a tertiary care hospital, Manipur


Laishram Somenkumar Singh1, Praneshwari RK Devi1, Ebenezer Phesao2, Nabakishore N Singh1, Ajitkumar Y Singh1, Telen Thangkhojam Kom1,  
1 Department of Obstetrics and Gynaecology, Regional Institute of Medical Sciences, Imphal, Manipur, India
2 Department of Community Medicine, Regional Institute of Medical Sciences, Imphal, Manipur, India

Correspondence Address:
Dr. Laishram Somenkumar Singh
Department of Obstetrics and Gynaecology, Regional Institute of Medical Sciences, Imphal - 795 004, Manipur
India

Abstract

Objective: 1) To determine the prevalence of human immunodeficiency virus (HIV) seropositive delivery in Regional Institute of Medical Sciences (RIMS). 2) To determine the associated factors affecting the status of HIV seropositive in pregnant women. Materials and Methods: This is a cross-sectional study and the study period was from January 2007 to December 2011. All pregnant women who were registered, counseled, tested and delivered, and whose pregnancies were beyond the period of viability (28 weeks). Data were collected from PPTCT Centre RIMS, Imphal, from January 2007 to December 2011 from PPTCT ward log book. It included the details of age, parity, occupational status, religion and mode of delivery. Descriptive statistics like mean and percentage were used. Statistical analysis was done using SPSS version 16. Results: A total of 191 seropositive pregnant women delivered from January 2007 to December 2011 were included in the study. The mean age of the participants was 27.4 ± 4.9 years. HIV seropositivity rate was highest in the age group of 26 to 30 years and the age group between 21 and 35 years contributes to 84% of the total cases. More than half of the cases had education up to class 10 (52.9%) and were Hindu by religion (55.5%). Majority of the seropositive pregnant women were housewives (94.8%). HIV seropositivity was higher in multipara (57%) compared to primipara (43%). The overall prevalence rate of HIV seropositivity was 0.41%. The highest rate of seropositivity was in 2007 (0.64%). Most of the deliveries were vaginal delivery (71.2%) compared to cesarean delivery (28.8%). Conclusion: Our study showed that the overall prevalence rate of HIV seropositivity was 0.41%. Even though, our study population was not representative of the general population because of ours being a hospital-based study with limited sample size, data show a decreasing trend of HIV prevalence in pregnant mothers.



How to cite this article:
Singh LS, Devi PR, Phesao E, Singh NN, Singh AY, Kom TT. Prevalence of HIV seropositive delivery in a tertiary care hospital, Manipur.J Med Soc 2015;29:8-11


How to cite this URL:
Singh LS, Devi PR, Phesao E, Singh NN, Singh AY, Kom TT. Prevalence of HIV seropositive delivery in a tertiary care hospital, Manipur. J Med Soc [serial online] 2015 [cited 2020 Jan 29 ];29:8-11
Available from: http://www.jmedsoc.org/text.asp?2015/29/1/8/158918


Full Text

 INTRODUCTION



Human immunodeficiency virus (HIV)/Acquired immunodeficiency syndrome (AIDS) has evolved to become one of the greatest threats to women's health. Every day, more than 3,000 women are newly infected with HIV around the world. [1] There has been a changing pattern of male/female infections. Early cases in many countries were concentrated in male homosexuals and intravenous drug users, but as the epidemic spread there has been a progressive shift toward females through heterosexual transmission. The reality today is that, globally, more women than men are dying of HIV/AIDS, and the age patterns of infection are significantly different for the two sexes. [2]

Manipur is one of the six high prevalence states in India with HIV prevalence rate among pregnant women attending ANC being 1.4% (Sentinel Surveillance 2006). Manipur with hardly 0.2% of India's population is contributing nearly 8% of India's total HIV positive cases. [ 3]

In 2009-2010, unprotected heterosexual intercourse accounted for roughly 87% of all reported cases of HIV infection, and 5.4% were due to mother-to-child transmission. A great number of women are put at risk of HIV infection as a result of their husbands having unprotected sex with extramarital relationship or injecting drugs. It has been estimated that 90% of women living with HIV in Asia were infected by their husband or long-term partner. Women's enhanced vulnerability to HIV/AIDS in India is directly linked to gender inequality and low economic and social status. The lack of women's equality in the family, workplace and the community bears a direct relationship to the spread of the infection among women in India. [4]

Since the beginning of the epidemic, an estimated 5.1 million children worldwide have been infected with HIV. Mother-to-child transmission is believed to be responsible for more than 90% of these infections. [5]

The PPTCT program was started in 2002 aimed at preventing perinatal transmission of HIV from an HIV infected pregnant mother to her newborn baby. The program entails counseling and testing of pregnant women in Integrated Counseling and Testing Centre [ICTC]. Antenatal screening for HIV should routinely be offered to all pregnant women as early diagnosis and management is important both to prevent transmission to the child and for the mothers health.

Objectives

To determine the prevalence of HIV seropositive delivery in RIMS.To determine the associated factors affecting the status of HIV seropositivity in pregnant women.

 Materials and Methods



Study Design

Cross-sectional study.

Study Setting

Prevention of Parent to Child Transmission (PPTCT) Centre, Regional Institute of Medical Sciences (RIMS), Imphal, Manipur.

Study Period

January 2007 to December 2011.

Sample Size and Sampling

All pregnant women who were registered, counseled, tested and delivered, and whose pregnancies were beyond period of viability (28 weeks).

Methods

Data were collected from PPTCT Centre RIMS, Imphal, from January 2007 to December 2011 from PPTCT ward log book. It included the details of age, parity, occupational status, religion and mode of delivery.

Operational Definition

Primiparas are the women with the first present pregnancy beyond the period of viability. Multiparas are the women who had one or more previous pregnancy beyond the period of viability.

Statistical Analysis

Descriptive statistics like mean and percentage were used. Statistical analysis was done using SPSS version 16.

Ethical Consideration

Approval was sought from Institutional Ethics Sub-Committee RIMS, Imphal. Permission was sought from Medical Superintendent, RIMS, Imphal. Strict confidentiality was maintained.

 RESULTS



A total of 191 seropositive pregnant women delivered from January 2007 to December 2011 were included in the study. The mean age of the participants was 27.4 ± 4.9 years. [Table 1] shows the background characteristics related to the seropositive pregnant women. HIV seropositivity rate was highest in the age group of 26 to 30 years and the age group between 21 and 35 years contributes to 84% of the total cases. More than half of the cases had education up to class 10 (52.9%) and were Hindus by religion (55.5%). Majority of the seropositive pregnant women were housewives (94.8%).{Table 1}

[Table 2] shows parity-wise distributions of HIV seropositivity, which was higher in multipara (57%) compared to primipara (43%).{Table 2}

[Table 3] shows that the overall prevalence rate of HIV seropositivity was 0.41%. The highest rate of seropositivity was in 2007 (0.64%).{Table 3}

[Figure 1] shows that most of the deliveries were vaginal delivery (71.2%) compared to cesarean delivery (28.8%).{Figure 1}

 DISCUSSION



This study was done in a tertiary care hospital of Imphal, Manipur. Our study revealed that 65% of the seropositive pregnant women who delivered were between 21 and 30 years, and the highest prevalence rate of 36.2% was in the age group of 26-30 years. It may be because of the fact that this is the phase of active sexual life. Ukey et al. in their study showed a prevalence rate of 31.29% in the age group of 25-29 years, which is close to our result. [6]

Majority of them (76.4%) were literates. Maximum number of HIV seropositivity was seen in illiterates (23.6%) and in those who studied up to class X (52.9%). These may be due to decreased awareness of HIV transmission among these groups. In a study done by Ashtagi et al., literacy rate of HIV seropositive pregnant women was 64.66%. [7] These differences could be due to the overall higher literacy rate of Manipur state (79.85% literacy rate, census report 2011).

Majority of them were Hindus (55.5%) followed by Christians (34.6%) and Muslims (9.9%). The reason could be the highest percentage of Hindu respondents in Manipur followed by Christians and lastly Muslims.

Total 94.8% of HIV seropositive women were housewives. Women are sexually and biologically more vulnerable to acquire HIV infection; this shows their economic vulnerability in taking good care of their needs on their own. Ashtagi et al., also reported HIV seropositivity in 87.01% housewives in their study, which was also very high. [7]

The present study showed that HIV seropositivity was more common in multipara (57%) compared to primipara (43%). Ashtagi et al., reported 36.17% primipara and 63.83% multipara HIV seropositive patients in their study which is almost similar to our results, [7] while Goswami et al., found 55.33% multipara and 44.67% primipara HIV seropositive patients in their study. [8]

Of the 45,988 pregnant women delivered in five years, 0.41% women were found to be HIV seropositive. Dash et al., found 0.66% HIV seropositive pregnant women in their study. [9]

Our results showed a decrease in prevalence rates from 0.64% in 2007 to 0.29% in 2011. This dip in prevalence could be the result of effective awareness programs and education regarding HIV especially in young adults after the implementation of national AIDS control program (NACP-II, 1999-2006). The NACP-II sought to shift focus from raising awareness to changing behavior through interventions in high-risk groups. Therefore, it is understandable why over a period of 4 years, HIV seroprevalence showed a decline in mothers.

Most of the deliveries were vaginal delivery (71.2%) compared to cesarean delivery (28.8%). As ours is a resource-constrained country, most of the HIV seropositive women are delivered vaginally unless there are obstetrical indications. Kumar et al., in their study found 75% of HIV seropositive women delivered vaginally. [10]

 CONCLUSION



Our study showed that the overall prevalence rate of HIV seropositivity was 0.41%. Even though our study population was not representative of the general population because of ours being a hospital-based study with limited sample size, data show a decreasing trend of HIV prevalence in pregnant mothers.

References

12009 AIDS Epidemic Update, UNAIDS/WHO;2009.
2Expert Group Meeting on "The HIV/AIDS Pandemic and its Gender Implications" Division for the Advancement of Women (DAW), World Health Organization (WHO), Joint United Nations Programme on HIV/AIDS (UNAIDS); Windhoek, Namibia, 13-17 Nov 2000.
3Manipur State AIDS control society. Available from: http://manipursacs.nic.in/ [Last accessed on 2013 Aug].
4Available from: www.unicef.org/aids/files/IndiaFactsheet_PMTCT Factsheet_2010 [Last accessed on 2013 Jul].
5UNAIDS. Preventing mother-to-child transmission: Technical experts recommend use of antiretroviral regimens beyond pilot projects Geneva: UNAIDS 2000 Br Med Bull 2001;58:73-8
6Ukey PM, Akulwar SL, Powar RM. Seroprevalence of human immunodeficiency virus infection in pregnancy in a tertiary care hospital. Indian J Med Sci 2005;59:382-7.
7Ashtagi GS, Metgud CS, Walvekar PR, Naik VA. Prevalence of HIV among rural pregnant women attending PPTCT services at KLE Hospital, Belgaum. Al Ameen J Med Sci 2011;4:45-8.
8Goswami S, Chakravorty PS. Prevention of parent to child transmission of HIV (PPTCT): An effort of 4 years in a tertiary centre. Obstet Gynaecol India 201;61:394-8.
9Dash M, Mohanty I, Sahu S, Narasimham M, Padhi S, Panda P, et al. Declining HIV seroprevalence among pregnant women in South Odisha, India: A six and half year tertiary care hospital based study. Int J Biomed Advance Res 2012;3:546-51.
10Kumar KJ, Reddy M, Seran K, Sekhar K, Kumar DS, Krishna CB. A profile of HIV positive antenatal women at PPTCT centre, Kadapa. Indian J Public Health Res Dev 2011;2.