Context: This paper examined the clustering of pregnancy wastage among HIV-infected pregnant women, particularly focusing on the outcomes of abortions and stillbirths, from a large sample of HIV-positive women to brid...Context: This paper examined the clustering of pregnancy wastage among HIV-infected pregnant women, particularly focusing on the outcomes of abortions and stillbirths, from a large sample of HIV-positive women to bridge the existing information gap. Methods: Data from a cross-sectional survey conducted among currently married HIV positive women aged 15-29 years in Bagalkot district, Karnataka, India were used. Further to assess the clustering of pregnancy wastage, the binomial distribution was used. Results: The study shows that 2% of the women account for 32% of the total pregnancy wastages and 7% of all the interviewed HIV positive women account for 62% of the total pregnancy wastages. The study further shows that a higher percent observed (29.6%) than expected (15.5%) who had experienced 2 pregnancy wastages suggesting 14.1% more women experienced 2 pregnancy wastages than expected. Again, a positive deviant of 19.2 among women with at least 3 pregnancy wastage also suggests a higher observed than expected pregnancy wastages, and suggests clustering of pregnancy wastages among HIV-positive women. After adjusting for the socio-economic characteristics, the variance of the observed and expected has reduced only marginally. Conclusions: Clustering of pregnancy wastages among HIV positive women suggests for an increased attention on reproductive health of this marginalized group. The findings will be useful for the interventions working with WLHA in India, particularly the knowledge of clustering would help policy makers and program implementers to focus on high risk women who are likely to experience multiple pregnancy losses.展开更多
Traditional Devadasi system based sex work (dhandha) is practiced inIndia. The communities that practice this system are affected severely by AIDS epidemic. Through this paper we present the views of gharwalis (brothe...Traditional Devadasi system based sex work (dhandha) is practiced inIndia. The communities that practice this system are affected severely by AIDS epidemic. Through this paper we present the views of gharwalis (brothel madams) regarding the impact of AIDS on the traditional system (Devadasi system) of initiating girls as sex workers (Devadasis) and on the practice of sex work (dhandha) associated with that system. Qualitative in-depth interviews were conducted with twelve gharwalis as a follow-up of a cohort study, which investigated the patterns and determinants of sex worker migration from northern Karnataka to southern Maharashtra, in India. According to gharwalis, the disease (AIDS) consequences;death, fear and stigma affected dhandha operations, changed the attitude of the Devadasi community against the practice of dhandha and the Devadasi system, besides, influenced the community to take actions to stop the practice of dhandha and the Devadasi system. The findings suggest that the interplay between the disease consequences and the community’s response to those consequences contribute to transition dhandha and the Devadasi system. We discuss our findings, describe the transition and the consequent risk enhancing conditions. Finally, highlight the need to address these conditions to reduce Devadasis risk and vulnerability to HIV infection.展开更多
文摘Context: This paper examined the clustering of pregnancy wastage among HIV-infected pregnant women, particularly focusing on the outcomes of abortions and stillbirths, from a large sample of HIV-positive women to bridge the existing information gap. Methods: Data from a cross-sectional survey conducted among currently married HIV positive women aged 15-29 years in Bagalkot district, Karnataka, India were used. Further to assess the clustering of pregnancy wastage, the binomial distribution was used. Results: The study shows that 2% of the women account for 32% of the total pregnancy wastages and 7% of all the interviewed HIV positive women account for 62% of the total pregnancy wastages. The study further shows that a higher percent observed (29.6%) than expected (15.5%) who had experienced 2 pregnancy wastages suggesting 14.1% more women experienced 2 pregnancy wastages than expected. Again, a positive deviant of 19.2 among women with at least 3 pregnancy wastage also suggests a higher observed than expected pregnancy wastages, and suggests clustering of pregnancy wastages among HIV-positive women. After adjusting for the socio-economic characteristics, the variance of the observed and expected has reduced only marginally. Conclusions: Clustering of pregnancy wastages among HIV positive women suggests for an increased attention on reproductive health of this marginalized group. The findings will be useful for the interventions working with WLHA in India, particularly the knowledge of clustering would help policy makers and program implementers to focus on high risk women who are likely to experience multiple pregnancy losses.
文摘Traditional Devadasi system based sex work (dhandha) is practiced inIndia. The communities that practice this system are affected severely by AIDS epidemic. Through this paper we present the views of gharwalis (brothel madams) regarding the impact of AIDS on the traditional system (Devadasi system) of initiating girls as sex workers (Devadasis) and on the practice of sex work (dhandha) associated with that system. Qualitative in-depth interviews were conducted with twelve gharwalis as a follow-up of a cohort study, which investigated the patterns and determinants of sex worker migration from northern Karnataka to southern Maharashtra, in India. According to gharwalis, the disease (AIDS) consequences;death, fear and stigma affected dhandha operations, changed the attitude of the Devadasi community against the practice of dhandha and the Devadasi system, besides, influenced the community to take actions to stop the practice of dhandha and the Devadasi system. The findings suggest that the interplay between the disease consequences and the community’s response to those consequences contribute to transition dhandha and the Devadasi system. We discuss our findings, describe the transition and the consequent risk enhancing conditions. Finally, highlight the need to address these conditions to reduce Devadasis risk and vulnerability to HIV infection.
