Int Conf AIDS.

2004 Jul 11-16; 15: abstract no. MoPeC3554

ORIGINAL ARTICLE

HIV/AIDS care in government hospital for thoracic medicine at Tambaram: A family-level approach.

Rajasekaran S, Jeyaseelan L, Paramesh P, Loo V, Warren D.

From Govt. Hospital of Thoracic Medicine, Tambaram Sanatorium, Chennai-600 047.

Abstract

Background: The Government Hospital of Thoracic Medicine (GHTM) admitted its first AIDS patients in 1993. GHTM has specialized in care and treatment services for HIV patients since 1999. To initiate control and treatment of HIV infections at the family level, an HIV family tree information system was established in 2003. Methods: For all HIV patients registered at GHTM, basic demographic data and HIV test results were collected on family members and updated at each visit. Data were abstracted from the GHTM electronic medical record system to describe the dynamics of familial transmission. Results: Of the 77,348 patients who sought care at GHTM during 2003, 35% (N=27,210) of patients were tested for HIV and 50% (N=13,701) were diagnosed as HIV infected according to NACO guidelines. The family tree data set included information on 10,279 families. The median family size was 4 and ranged from 1-12 members. Of the 10,279 families, 8699 (85%) index members (i.e. the first person in a family to be registered at GHTM) were tested for HIV at GHTM (6368 males, 2285 females and 46 eunuchs). The mean age of male index members was 35, compared to 31 among female index members. Overall, 40% of index members reported doing agricultural-related work. Among men, 15% reported being drivers, and 18% worked as manual laborers. A small percentage of index members had lost a spouse: 7% among females, 1% among males. Of the married index males tested at GHTM, 1471 (28%) brought their wives for HIV testing at GHTM and 1006 (68%) of these wives were positive. Of the married index females, 366 (17%) husbands came for testing at GHTM. Of those husbands tested, 264 (72%) were positive. The overall discordance between spouses who were both tested at GHTM was 31%. Conclusion The substantial minority of discordant couples observed suggests opportunities for prevention and early detection programs for spouses of HIV-infected patients. The family tree concept is a useful tool for counseling and care within families in a resource-poor setting.