HIV Treatment Cascade Assessment of a Community-Based Test and Start Model for Key Populations in Lagos State Nigeria: Where Are the Gaps?

Background: Community-based test and start (TAS) models have shown the potential to improve clinical outcomes for key populations because early access to treatment will have population level impact by reducing transmission through the promotion and provision of hassle-free quality HIV testing, on the spot ART initiation and unrestricted access to culturally competent health professionals. We assessed the effectiveness of a pioneer community-based test and start (TAS) model for key populations in Lagos along UNAIDS 90/90/90 cascade. Methods: Men who have sex with men (MSM), female sex workers (FSW), and persons who inject drugs (PWID), >14 years of age were recruited through peer-referral for HIV testing services (HTS) at a community-based KP-friendly clinic in Lagos between June 2015 and September 2016. The clinic provides comprehensive HIV services, including HIV treatment. Those who test positive are enrolled and provided with TAS services. Using routine service data, we deployed descriptive cross tabulations at p < 5% to determine the performance along the 90/90/90 cascade. Results: In total, 8812 KPs comprising MSM (51.6%), FSW (32.7%) and PWID (15.7%) were tested during this period. About one-half (46.4%) were young KP (15 - 25 years). The majority (76.1%) were male, single (86.1%), almost all (99%) had at least primary school level education, and about one-quarter (25.1%) were employed. Among MSM, 506 (11.1%) tested positive, 276 (54.5%) were initiated on ART, of whom 155 conducted viral load testing and 88 (56.7%) had achieved viral suppression (<1000 copies per milliliter). Among FSW, 88 (3.1%) tested positive, only 28 (31.8%) were initiated on ART, of whom 15 conducted viral load testing and 9 (60%) achieved viral suppression. Among PWID, of 15 (1.1%) who tested positive, only 2 (13%) were initiated on ART and none had conducted viral load testing. Client satisfaction index was 96.1%. Conclusion: The current community-based model showed excellent capacity to achieve the first 90 goal among target KP communities. However, linkage to care and treatment, adherence, and retention remain major challenges in achieving the second and third nineties at the community level.

An Assessment of Comprehensive Knowledge of HIV/AIDS among Slum and Non-Slum Populations in Delhi, India

In order to design appropriate HIV prevention programs, it is important to examine the perception and knowledge of HIV/AIDS and methods of preventive. This article explores comprehensive knowledge of HIV/AIDS prevention methods among women and men in slum and non-slum areas in the National Capital Territory of Delhi, India. Data were drawn from the National Family Health Survey, 2005-06 (NFHS-3). The sample included 3096 women aged 15 - 49 years and 1321 men aged 15 - 54 years. Pearson Chi-square test and logistic regression analyses were conducted to examine the association between the study variables and the background characteristics of the slum and non-slum populations. Comprehensive knowledge of HIV/AIDS prevention methods was significantly lower among women and men in slum areas as compared with non-slum areas. Compared to men, women had less comprehensive knowledge of HIV/AIDS prevention methods in slum and non-slum areas, even after controlling for various demographic and socio-economic and exposure variables. Findings indicate that comprehensive knowledge of HIV prevention methods is low among women in slum areas. Interventions are needed to build knowledge of HIV transmission and prevention methods in this vulnerable group. Strategies to build awareness of HIV/AIDS could include mass media campaigns HIV/AIDS, and information, education and communication programs (IEC) on HIV/AIDS in slum areas.

中国商环(Shang Ring)男性包皮环切技术临床应用研究进展

男性包皮环切能显著降低男性阴茎-阴道性交获得性HIV感染风险大约60%,被WHO和联合国艾滋病规划署(UNAIDS)推荐作为HIV预防策略中的一个重要干预措施。寻求一种更加安全、有效和可接受的男性包皮环切器械和手术方法,以便能够满足加快执行扩大包皮环切预防HIV感染项目的需求,已经成为相关国际组织,特别是非洲国家政府公共卫生事业的当务之急。2008年中国商环(Shang Ring)包皮环切标准化手术方案的建立,以及应用这个标准化手术方案和手术培训在中国以及2009年和2010年在肯尼亚实施中国商环成人包皮环切手术获得有用的和有意义的临床数据,证明了中国商环包皮环切术的诸多优势。手术培训手册和教学视频的多次修订为培训医护人员提供了更加准确的教学指南。经过多家相关国际机构专家的考察和评估,中国商环包皮环切技术已经成为支持在非洲HIV高发地区扩大包皮环切服务预防HIV感染项目最具潜力的候选包皮环切器械之一。可以预计,中国商环包皮环切技术的成功应用将会在改变数百万非洲人的生活方式的同时,也为中国男科学与泌尿外科学医生在包皮环切与HIV预防和生殖健康相关的临床研究领域提供了丰富的机会。本文报告了2008年2月至2010年底期间中国商环包皮环切技术临床应用的国际和国内研究进展。

邻苯二甲酸酯类化合物与睾丸源性生殖障碍综合征

流行病学研究显示妇女在怀孕期间接触邻苯二甲酸酯类化合物后,所产男婴易患隐睾、尿道下裂、成年期睾丸肿瘤及精液质量低下等症状。这类症状可统称为睾丸源性生殖障碍综合征(testicular dysgenesis syndrome,TDS)。TDS可能是由男性胎儿睾丸的发育在子宫内受到影响不能发育出具有正常功能的睾丸间质(Leydig)细胞和支持(Sertoli)细胞引起的。例如,睾丸间质细胞接触邻苯二甲酸酯类化合物后,睾丸间质细胞的两种产物———睾酮和胰岛素样生长因子3(INSL3)———受到了抑制,两者对于睾丸下降起关键作用。成年期睾丸的胎儿型间质细胞和支持细胞错位可能是精子生成减少的原因。

梗阻性无精子症显微外科治疗进展和展望

近年来,随着辅助生殖技术,尤其是男性不育显微外科技术的迅猛发展,部分过去无法自然生育的梗阻性无精子症患者可重建精道,进而获得自然妊娠的机会。本文着重介绍梗阻性无精子症的精道重建手术的最新进展,包括腹腔镜技术、机器人技术等新技术在重建精道方面的具体应用;同时分析了显微外科附睾精子抽吸术及精子保存、可吸收缝线显微外科吻合技术和生物缝合带包裹输精管吻合口的显微外科输精管吻合术在梗阻性无精子症中的应用前景等。

显微外科技术治疗梗阻性无精子症的新进展

显微外科技术在最近 5~ 10年的生殖医学发展中扮演了重要角色。显微外科的睾丸取精技术和附睾取精技术 ,与体外受精和卵细胞内单精子注射技术的结合 ,使得过去一直被认为是难以治疗的因生精功能障碍所致的非梗阻性无精子症的治疗成为现实。与此同时 ,显微外科输精管吻合和输精管附睾吻合的技术革命使治疗梗阻性无精子症的效果显著地改善 ,成为治疗梗阻性无精子症的首选方法。本文着重介绍了显微外科输精管吻合术、输精管附睾吻合术、手术指征与手术成功的要素 ,预测了未来的发展方向 ,讨论了显微外科技术的优势 ,强调了显微外科培训对泌尿外科医生治疗男性不育患者的重要意义。

Effects of genistein and equol on human and rat testicular 3β-hydroxysteroid dehydrogenase and 17β-hydroxysteroid dehydrogenase 3 activities

The objective of the present study was to investigate the effects of genistein and equol on 3β-hydroxysteroid de- hydrogenase （3β-HSD） and 17β-hydroxysteroid dehydrogenase 3 （17β-HSD3） in human and rat testis microsomes. These enzymes （3β-HSD and 17β-HSD3）, along with two others （cytochrome P450 side-chain cleavage enzyme and cytochrome P450 17α-hydroxylase/17-20 lyase）, catalyze the reactions that convert the steroid cholesterol into the sex hormone testosterone. Genistein inhibited 3β-HSD activity （0.2 μmol L^-1 pregnenolone） with half-maximal inhibition or a half-maximal inhibitory concentration （IC50） of 87 ± 15 （human） and 636 ± 155 nmol L^-1 （rat）. Genistein＇s mode of action on 3β-HSD activity was competitive for the substrate pregnenolonrge and noncompetitive for the cofactor NAD＋. There was no difference in genistein＇s potency of 3β-HSD inhibition between intact rat Leydig cells and testis microsomes. In contrast to its potent inhibition of 3β-HSD, genistein had lesser effects on human and rat 17β-HSD3 （0.1 μmol L^-1 androstenedione）, with an IC50 〉 100μmol L^-1. On the other hand, equol only inhibited human 3β-HSD by 42%, and had no effect on 3β-HSD and 17β-HSD3 in rat tissues. These observations imply that the ability of soy isoflavones to regulate androgen biosynthesis in Leydig cells is due in part to action on Leydig cell 3β- HSD activity. Given the increasing intake of soy-based food products and their potential effect on blood androgen levels, these findings are greatly relevant to public health.

Effects of luteinizing hormone and androgen on the development of rat progenitor Leydig cells in vitro and in vivo

Progenitor Leydig cells are derived from stem cells. The proliferation and differentiation of progenitor Leydig cells significantly contributes to Leydig cell number during puberty. However, the regulation of these processes remains unclear. The objective of the present study was to determine whether luteinizing hormone （LH） or androgen contributes to the proliferation and differentiation of progenitor Leydig cells. Fourteen-day-old male Sprague-Dawley rats were treated for 7 days with NalGlu, which is a gonadotropin- releasing hormone antagonist, to reduce the secretion of LH in the pituitary and thus, androgen in the testis. Rats were co-administered with LH or 7a-methyl-nortestosterone （MENT）, which is an androgen resistant to metabolism by 5a-reductase 1 in progenitor Leydig cells, and the subsequent effects of LH or androgen were measured. 3H-Thymidine was also intravenously injected into rats to study thymidine incorporation in progenitor Leydig cells. Progenitor Leydig cells were examined. NalGlu administration reduced progenitor Leydig cell proliferation by 83%. In addition, LH or MENT treatment restored Leydig cell proliferative capacity to 73% or 50% of control, respectively. The messenger RNA levels of proliferation-related genes were measured using real-time PCR. The expression levels of Igfl, Lifr, Pdgfra, Bcl2, Ccnd3and Pcnawere upregulated by MENT, and those of Pdgfra, Ccnd3and Pcnawere upregulated by LH. Both LH and MENT stimulated the differentiation of progenitor Leydig cells in vitro. We concluded that both LH and MENT were involved in regulating the development of progenitor Leydig cells.

CLONING AND IDENTIFICATION OF A RABBIT SPERM MEMBRANE PROTEIN GENE

Antibodies raised against rabbit sperm membrane protein(rSMP-B)interacted with a rattestis cytosolic protein with an estimated molecular weight of 70 kD.The clone expressingrSMP-B was isolated by epitope selection from a rat testis,λgt11 vector cDNA library,An Eco Rl-eut 2.0 kb cDNA fragment encoding rSMP-B was identified.The cDNA fragment(RSD-1)was isolated,subcloned and restriction mapped.Dot hybridization analysis of mRNAprepared from human,rabbit and rat testes showed that the gene encoding rSMP-B is ex-pressed in the testes of all three mammals.

11β-hydroxysteroid dehydrogenase types 1 and 2. in postnatal development of rat testis： gene express,on, localization and regulation by luteinizing hormone and androgens

11β-hydroxysteroid dehydrogenase type 1 （11β-HSD1） and type 2 （11β-HSD2） are expressed in rat testis, where they regulate the local concentrations of glucocorticoids. Here, we investigated the expression and localization of 11β-HSD in rat testis during postnatal development, and the regulation of these genes by luteinizing hormone （LH） and androgens, mRNA and protein levels were analyzed by quantitative real-time-polymerase chain reaction and western blotting, respectively, in testes collected from rats at postnatal day （PND） 7, 14, 21, 35, and 90, and from rats treated with LH, 7α.methyl-19-nortestosterone （MENT） and testosterone at PND 21 and PND 90. Immunohistochemical staining was used to identify the localization of the 11β-HSD in rat testis at PND 7, 14, and 90. We found that 11β-HSD1 expression was restricted to the interstitial areas, and that its levels increased during rat testis development. In contrast, whereas 11β-HSD2 was expressed in both the interstitial areas and seminiferous tubules at PND 7, it was present only in the interstitial areas at PND 90, and its levels declined during testicular development. Moreover, 11β-HSD1 mRNA was induced by LH in both the PND 21 and 90 testes and by MENT at PND 21, whereas 11β-HSD2 mRNA was induced by testosterone and MENT in the PND 21 testis and by LH in the PND 90 testis. In conclusion, our study indicates that the 11β-HSD1 and 11β-HSD2 genes have distinct patterns of spatiotemporal expression and hormonal regulation during postnatal development of the rat testis.

An Appraisal of Sexual Behaviors, STI/HIV Prevalence, and HIV Prevention Programs among Truckers in India: A Critical Literature Review

Background: A systematic review portraying the changing pattern of sexual behaviors, STI and HIV prevalence and key strategies curb HIV and STI among truckers in India is lacking. This paper therefore aims to present a chronological review of literature regarding sexual behaviors, STI/HIV prevalence, and various HIV prevention programs implemented among truckers in India. Methodology: Published and unpublished studies (1990-2011) were identified through electronic databases, and hand searching. Results: Most studies on sexual behaviors and STI/HIV prevalence among truckers focused only on drivers and ignored their helpers. Evidences suggest that consistent condom use by truckers with both paid and non-paid female partners has increased during the past decade. Many recent studies suggest that the HIV prevalence among truckers is about 2% and it has been declining slowly during the past decade. The HIV prevention programs among truckers which started with the aim of raising awareness about HIV during early 1990s, have grown multi-folds to encompass not only the standard strategies like mid-media events, interpersonal counselling and STI care for HIV prevention, but also innovations such as the use of business franchisee models, and integrated research and evidence based planning in the program. The possibilities of using new approaches such as male circumcision and the use of pre-exposure prophylaxes are underway. Conclusion: More studies are needed to explore helpers’ vulnerabilities to HIV. Very few studies have attempted to examine the impact of large-scale prevention programs among truckers. Efforts are required to examine the impact of different components of such programs to guide the HIV prevention efforts among truckers in India.

Protein profiles in various epididymal segments of normal and castrated rats

Aim: Epididymal proteins are known to play an important role in the maturation of spermatozoa, we ougnt to deter-mine if there are regional differences in androgen-dependent epididymal proteins. Methods: A group of adult rats wascastrated and epididymides were removed three days following castration. The epididymides were dissected into caput,corpus and cauda segments, homogenized, and proteins were fractionated by anion exchange HPLC. Proteins in select-ed fractions were resolved by SDS-PAGE and visualized by silver staining. Results: It was observed that the levels ofmultiple proteins drastically reduced in the various regions of epididymis of the orchiectomized rats. Conclusion: Theepididymal proteins appear to be useful markers to study androgenic action in the epididymis.

Breast cancer resistance protein （Bcrp） and the testis--an unexpected turn of events

Breast cancer resistance protein （Bcrp） is an ATP-dependent efflux drug transporter. It has a diverse spectrum of hydrophilic and hydrophobic substrates ranging from anticancer, antiviral and antihypertensive drugs, to organic anions, antibiotics, phytoestrogens （e.g., genistein, daidzein, coumestrol）, xenoestrogens and steroids （e.g., dehydroepiandrosterone sulfate）. Bcrp is an integral membrane protein in cancer and normal cells within multiple organs （e.g., brain, placenta, intestine and testis） that maintains cellular homeostasis by extruding drugs and harmful substances from the inside of cells. In the brain, Bcrp is a major component of the blood- brain barrier located on endothelial cells near tight junctions （TJs）. However, Bcrp is absent at the Sertoli cell blood-testis barrier （BTB）; instead, it is localized almost exclusively to the endothelial TJ in microvessels in the interstitium and the peritubular myoid cells in the tunica propria. Recent studies have shown that Bcrp is also expressed stage specifically and spatiotemporally by Sertoli and germ cells in the seminiferous epithelium of rat testes, limited only to a testis-specific cell adhesion ultrastructure known as the apical ectoplasmic specialisation （ES） in stage VI-early VIII tubules. These findings suggest that Bcrp is equipped by late spermatids and Sertoli cells to protect late-stage spermatids completing spermiogenesis. Furthermore, Bcrp was found to be associated with F （filamentous）-actin and several actin regulatory proteins at the apical ES and might be involved in the organisation of actin filaments at the apical ES in stage VII-VIII tubules. These findings will be carefully evaluated in this brief review.

INHIBITION OF ZYGOTE FORMATION AND EMBRYO DEVELOPMENT IN MICE IMMUNIZED WITH MONOCLONAL ANTISPERM ANTIBODIES

Passive immunization of female mice by the intraperitoneal administration of ascitic fluidscontaining monoclonal antisperm antibodies blocked the development of mouse zygotes tomorulae and blastocysts when cultured in vitro.Radioiodinated YWK-I monoclonal anti-bodies were prepared and administered intraperitoneally to Jemale mice.Significant radioac-tivity was found in washes of the oviductal lumens.The results suggest that antispermantibodies block fertilization and may have a deleterious effect on early developing embryos.

Factors Associated with Mental Depression among Men Who Have Sex with Men in Southern India

Background: Mental health has been a largely neglected issue among Men Who Have Sex with Men (MSM) across the world. This study examines the prevalence and correlates of depression among MSM. Data and Methods: Data for this study are used from a cross-sectional Behavioral Tracking Survey—2012 conducted among 1176 MSM from Andhra Pradesh (undivided), a southern state of India. Depression of MSM was assessed using Patient Health Questionnaire-2 scale. Descriptive statistics, bivariate and multivariate logistic regression techniques were used for analysis. Results: More than one-third of MSMs (35%) in the survey reported to have depression. The likelihood of experiencing depression was 5 times higher among MSM who were mobile for sex work outside their place of residence (55% vs 17%, AOR: 5.2, 95% CI: 3.7 - 7.3) and had experienced physical or sexual violence (82% vs 33%, AOR: 6.0, 95% CI: 2.1 - 17.4) than their respective counterparts. Rates of depression were significantly higher among MSM who had experienced Sexually Transmitted Infections symptoms;knowledge of their HIV positivity;who didn’t use condoms during anal sex with any clients/partners;those who consumed alcohol and were in financial debt at the time of survey than others. Those who were associated with any community groups have significantly less chances of reporting depression. Discussion: The study certainly highlighted that the HIV prevention efforts with MSM in India require an integrated approach on addressing the mental health issues. To support this, programs and research-based evidence will be highly needed to ensure that mental health issues are properly addressed among MSM and other high risk groups.

Attrition from care after the critical phase of severe pre-eclampsia and eclampsia: Insights from an intervention with magnesium sulphate in a primary care setting in northern Nigeria

Background: Evidence has shown that Magnesium Sulphate (MgSo4) is the gold standard for treating severe pre-eclampsia and eclampsia (SPE/E), and calls for its widespread use at all levels of health service delivery, including the primary care level. Objective: To determine if administering loading dose of MgSo4 on pregnant women with severe preeclampsia and eclampsia at primary care level would improve maternal and fetal outcomes. Method: Two sets of Primary Health Care (PHC) facilities were identified;one served as experimental one and the other as control. The community health extension workers (CHEWs) and the community health officers (CHOs) at the experimental PHCs were trained to administer the loading dose of MgSo4 for patients with SPE/E, in addition to other supportive treatments, before making a referral while the control PHCs did not give MgSo4, and neither administered diazepam as an alternative or no anti-convulsant at all, before making a referral to higher centers. Patients from the experimental and control facilities were prospectively monitored for fetal and maternal outcomes, namely maternal and fetal deaths, and for toxic effects of MgSo4 in the experimental arm. Results: Of the 150 patients recruited, 82 (55%) were in the experimental group and 68 (45%) were in the control group. 90% of the patients in the experimental group defaulted after receiving the loading dose of MgSo4 while the remaining 10% completed the referral process. 44% of those in the control group completed the referral process. There were 3 maternal and 3 perinatal deaths, all in the control group. No adverse outcome (maternal or fetal death) or toxic effect was recorded among the recipients of MgSo4. Conclusion: This study suggests that lower-cadre health care professionals at PHCs can administer the loading dose of MgSo4 to SPE/E patients to improve maternal and fetal survival in critical states, without significant risk of adverse effects. However, the lack of compliance with referral processes remains a huge challenge.

Impact of an HIV Prevention Intervention on HIV Risk Behavior and Sexually Transmitted Infection among Female Sex Workers in Tamil Nadu, India

Background: In 2003 a large-scale HIV prevention program was launched for key populations in six high HIV prevalence states of India. This paper assesses the effect of exposure to the intervention on condom use with commercial clients and experiences of sexually transmitted infection (STI) among female sex workers (FSWs) in Tamilnadu, a southern Indian state, between 2006 and 2009. Methods: Data were drawn from two rounds of cross-sectional surveys conducted in 2006 (N = 2010) and 2009 (N = 2500) among FSWs in Tamilnadu, recruited through probability-based sampling. A series of multivariate logistic regression models were constructed to examine the association between exposure to the intervention and change over time with condom use and self-reported STI. All the analyses were performed using STATA 11.1. Results: Overall, 48% of FSWs in 2006 and 90% in 2009 reported exposure to the intervention. Compared to 2006, there was a considerable increase in the proportion of FSWs reporting consistent condom use with regular and occasional clients at follow-up (2009). Further, the increase in consistent condom use over time with occasional (adjusted OR = 3.53, 95% CI: 2.47 - 5.05) and regular clients (adjusted OR = 4.97, 95% CI: 3.43 - 7.16) was significantly higher among FSWs exposed to the intervention than those not exposed. Additionally, a significant decline was observed in self-reported STI overtime among FSWs exposed to the intervention compared to their counterparts (adjusted OR = 0.39, 95% CI: 0.26 - 0.59). Conclusion: The HIV prevention program in Tamilnadu resulted in increased consistent condom use and a decrease in self-reported STI among FSWs exposed to intervention. These findings suggest that HIV prevention programs should aim to saturate coverage among key populations to sustain the gains achieved.

Influence of Customized Demand Generation as a Strategy to Increase Uptake of Voluntary Counseling and Testing Services amongst Sex Workers in Mumbai and Thane

Background: To demonstrate that customized demand generation leads to increased voluntary HIV counseling and testing (VCT) among Sex Workers (SWs). Methods: FHI 360 Aastha implemented Vivek intervention among SWs in Mumbai and Thane, India using customized demand generation through outreach services for VCT. Program monitoring data and integrated counseling and testing center tracking sheets were used to assess the intervention effect. Results: Higher proportion of registered SWs tested during: 1) Vivek months than other months (17% vs. 5%, p < 0.001);2) Post-initiation non-Vivek months than pre-Vivek months (4.7%, vs. 1.5% p < 0.001). Conclusions: Customized demand generation approach is successful in increasing HIV testing.

Degree of Male Mobility as a Risk Factor for HIV in High In-Migration Districts of Maharashtra, India

Background: Mobile males are vulnerable to HIV and are potential bridge for HIV transmission to their sex partners, including spouses. To understand how mobility accentuates vulnerability to HIV, we assessed the association of degree of male mobility with paid sex, alcohol use and condom use at all places visited by migrants in past two years. Methods: A cross-sectional survey was done among male migrant workers [n = 2991] in five high in-migration districts of Maharashtra in India during 2007-08. Results: Multivariate logistic regression analysis revealed that higher mobility [moving 3+ places in the past two years] was associated with “sexual debut” in paid sex [3.7% Vs 6.9%, AOR = 1.70, p < 0.001] and having sex with sex worker at the current place of destination [8.7% Vs 16.9%, AOR = 2.10, p < 0.001], at the previous place of destination [7.2% Vs 15.1%, AOR = 2.05, p < 0.001], and at the place of origin [0.6% Vs 1.6%, AOR = 2.31, p < 0.001]. However, higher mobility was associated with unpaid sex with non-marital female partners [28.4% Vs 37.2%, AOR = 1.48, p < 0.001] and less consistent condom use at the current place [26.6% Vs 23.4%, AOR = 0.45, p < 0.05] as well as at place of origin [12.2% Vs 7.2%, AOR = 0.48, p < 0.01]. In addition, alcohol use prior to sex was more among more mobile migrants relative to less mobile migrants at current place [6.1% Vs 11.2%, AOR = 1.82, p < 0.001] and previous place [7.0% Vs 13.0%, AOR = 1.77, p < 0.001] of destination. Conclusion: Findings suggest that compared to the less mobile, highly mobile men report higher HIV risk behaviours: paid sex, alcohol use prior to paid sex and inconsistent condom use, at all locations along the routes of mobility. Interventions need to target men who are highly mobile along the routes of mobility and not at destination sites alone.

An Assessment of Association between Neighborhood Socioeconomic Status and Infant Mortality in High Focus States in India

Neighbourhood characteristics influence infant mortality above and beyond individual/household factors. In India, there are very few studies discussing the effects of neighbourhood characteristics on infant mortality. This study examined the effect of neighbourhood socioeconomic characteristics on infant mortality using data from the India’s Third District Level Household Survey conducted in 2007-2008. Multilevel analyses applied on the representative sample of 168,625 nested within 14,193 communities using MCMC procedure. Results established that place of residence, neighbourhood socio-economic factors as important determinants of infant mortality. Overall, being born in affluent (OR: 0.79, p < 0.01), more educated (OR: 0.86, p < 0.01) and socially disadvantaged caste (OR: 0.83, p < 0.01) neighbourhood was associated with the significant reduction in hazards of infant death. The finding of this study suggests that effort should be made to reduce infant mortality in these high focus states by including policies which aim at improving infant survival in the neighbourhood that is economically and socially deprived.