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Sanjay Mehendale

Publications and source records attributed to Sanjay Mehendale.

13 recordsLinked to original sources
PubMed2006

Correlates of anxiety and depression among HIV test-seekers at a Voluntary Counseling and Testing facility in Pune, India.

OBJECTIVE: We assessed the extent of anxiety/depression/distress using Hospital Anxiety and Depression Scale (HADS) among a cross-section of HIV test-seekers at a Voluntary Counseling and Testing (VCT) facility in Pune, India. METHODS: HADS has 14 items for uniscale with 7 items each for anxiety and depression rated on a four-point Likert scale. Between September 2002 and March 2003, HADS was administered to 150 consecutive HIV tests-seekers attending NARI-Talera VCT facility. Subsequently, HIV testing was done after obtaining informed consent. RESULTS: HADS showed strong internal consistency (Cronbach-alpha 0.77). The prevalence of risk behavior (73.3%) and HIV (45.5%) were high. Education levels influenced anxiety (p = 0.033; 0.008), more so in women (p = 0.044). Repeat test-seekers exhibited significant depression (AOR: 2.9; 95% CI: 1.4-6.1; p = 0.004) and distress (AOR: 2.5; 95% CI: 1.2-5.3; p = 0.017). Marital status influenced the uniscale scores. The HIV positive repeat test-seekers were more anxious (p = 0.035) and depressed (0.037). CONCLUSIONS: Existence of emotional distress among HIV test-seekers, particularly among repeat test-seekers, possibly 'AIDS-anxious' individuals indicates additional counseling needs specifically by introducing gender and education sensitive interventions. VCT staff can be trained to assess emotional distress among HIV test-seekers to formulate long-term intervention.

Adolescent↗
PubMed2006

Correlates and trend of HIV prevalence among female sex workers attending sexually transmitted disease clinics in Pune, India (1993-2002).

In India, substantial efforts have been made to increase awareness about HIV/AIDS among female sex workers (FSWs). We assessed the impact of awareness regarding safe sex in a cohort of FSWs by studying trends in HIV prevalence, sexually transmitted diseases (STDs), and risk behaviors measured from 1993 to 2002 in Pune, India. A total of 1359 FSWs attending 3 STD clinics were screened for HIV infection, and data on demographics, sexual behaviors, and past and current STDs were obtained. The overall HIV prevalence among FSWs was 54%. Not being married (adjusted odds ratio [AOR] = 1.74, 95% confidence interval [CI]: 1.17 to 2.59), being widowed (AOR = 2.10, 95% CI: 1.16 to 3.80), inconsistent condom use (AOR = 1.60, 95% CI: 1.02 to 2.50), clinical presence of genital ulcer disease (GUD; AOR = 1.66, 95% CI: 1.07 to 2.56), and genital warts (AOR = 4.70, 95% CI: 1.57 to 14.08) were independently associated with HIV infection among FSWs. The prevalence of HIV remained stable over 10 years (46% in 1993 and 50% in 2002; P = 0.80). The prevalence of GUD decreased over time (P < 0.001), whereas that of observed genital discharge remained stable. Reported consistent condom use as well as the proportion of FSWs who refused sexual contact without condoms increased over time (P < 0.001). These data collectively suggest that safe sex interventions have had a positive impact on FSWs in Pune, India.

Adult↗
PubMed2005

Correlates of HIV vaccine trial participation: an Indian perspective.

Successful conduct of HIV vaccine trials in a population of great cultural diversity like India could be a challenge. Concerns, knowledge gaps and willingness to participate in future HIV vaccine trials were studied among 349 patients attending three sexually transmitted infections clinics and one reproductive tract infections clinic. Overall willingness to volunteer for HIV vaccine trials was 48%. Women and men at risk of HIV infection were willing to participate in the HIV vaccine trials. Factors associated with increased willingness to participate in these trials were awareness of current HIV vaccine efforts, realization of importance of vaccine for self, concern about adverse events and altruism.

AIDS Vaccines↗
PubMed2005

Cervical squamous intra-epithelial changes and human papillomavirus infection in women infected with human immunodeficiency virus in Pune, India.

In view of the dual burden of HIV infection and cervical cancers in India, this study was undertaken to estimate the prevalence of Pap smear abnormalities and human papillomavirus infection among HIV-infected women. Consecutive HIV-infected women attending voluntary counseling testing clinics were enrolled. Written informed consent, demographic information, Pap smears, cervical swabs for HPV typing and a blood sample for CD4+ cell count were collected. Treatment for opportunistic and sexually transmitted infections and reproductive tract infections was provided. Women with Pap smear abnormality were referred for further intervention. Between January 2003 and May 2004, 287 HIV-infected women were enrolled. Pap smear abnormalities were seen in 6.3% women and were more common among women aged 30 and above (P=0.042) and those who had suffered from opportunistic infections (P=0.004). In multivariate analysis, Pap smear abnormalities were associated independently with opportunistic infections (P=0.02, AOR 3.8, 95% CI 1.2--11.5). Of the 100 random cervical specimens screened for HPV 16 and 18 genotypes, 33% (95 CI 23.9--43.1) were positive for HPV 16/18. Of the 122 patients who returned for a follow-up visit, 5 patients (4.1%) who did not have Pap smear abnormality at baseline, had developed Pap smear abnormality. The incidence of Pap smear abnormalities was 5.5 per 100 person year of follow-up. In order to prevent thousands of deaths due to cervical cancer in India, there is a need for strengthening the Pap smear screening program and HPV vaccine development.

AIDS-Related Opportunistic Infections↗
PubMed2005

Phase I safety study of Praneem polyherbal vaginal tablet use among HIV-uninfected women in Pune, India.

Praneem polyherbal formulations containing purified extracts of Azadirachta indica (neem tree) have shown activity against HIV and sexually transmitted disease pathogens in studies in vitro. The product also has contraceptive properties. This has prompted its development as a possible microbicide. We evaluated the safety of Praneem polyherbal tablet use among HIV-uninfected women. Twenty eligible women were enrolled in a Phase I open-label study requiring 14 days of consecutive intravaginal use of Praneem polyherbal tablets. Nine (45%) participants experienced 17 episodes of genital irritation. Transient genital itching was reported by eight (40%) participants, burning micturation by two (10%) and lower abdominal pain, genital burning and intermenstrual spotting by one (5%) each. On colposcopy, petechial haemorrhage was observed in two participants, one on day 7 and the other on day 14, and both were resolved without any treatment. There were no serious adverse events. Praneem polyherbal tablets were found to be safe for once daily intravaginal use for 14 consecutive days in sexually active HIV-uninfected women and a Phase II study may be taken up as a priority.

Administration, Intravaginal↗
PubMed2005

Drug resistance pattern of Mycobacterium tuberculosis in seropositive and seronegative HIV-TB patients in Pune, India.

BACKGROUND & OBJECTIVE: Tuberculosis is the commonest opportunistic disease in persons infected with human immunodeficiency virus (HIV). Emergence of drug resistant isolates of M. tuberculosis highlights the need for continuous monitoring of drug resistance to antituberculosis drugs. Considering the reported high prevalence of drug resistance in HIV infected tuberculosis patients, we studied the anti-tuberculosis drug resistance pattern of M. tuberculosis in HIV seropositive and seronegative tuberculosis patients in Pune, Maharashtra, India. METHODS: A total of 70 M. tuberculosis isolates, 30 from HIV seropositive and 40 from HIV seronegative tuberculosis patients with no previous history of anti-tuberculosis treatment, were isolated from sputum samples on Lowenstein-Jensen (LJ) medium, confirmed by conventional biochemical tests and stored at -70 degrees C. They were revived by subculturing on LJ medium and tested for drug resistance against four first-line antitubercular drugs by BACTEC Mycobacterial growth indicator tube 960 (MGIT 960) system. RESULTS: Of the 30 isolates from HIV infected patients, 10 per cent were resistant to isoniazid (H), 6.6 per cent to streptomycin (S), 6.6 per cent to ethambutol (E) and 10 per cent were multi drug resistant (MDR). Of the 40 M. tuberculosis isolates from HIV uninfected individuals, 10 per cent were resistant to H, 2.5 per cent to S, 2.5 per cent to E, and 2.5 per cent isolates were MDR. INTERPRETATION & CONCLUSION: The prevalence of drug resistant M. tuberculosis isolates among HIV seropositive tuberculosis patients was similar to that of HIV seronegative TB patients, indicating HIV infection may not be associated with drug resistant tuberculosis. However, considering the results from other studies and a high prevalence of HIV-TB infection in the country, monitoring of drug resistance in M. tuberculosis isolates needs prioritization to ensure success in national tuberculosis control programme.

Antitubercular Agents↗
PubMed2005

HIV/AIDS epidemic in India: risk factors, risk behaviour & strategies for prevention & control.

Since the first report of HIV infection in India in 1986, the virus has spread all over the country although there is geographic variation. There are estimated 5.1 million people infected with HIV with an overall estimated adult prevalence below 1 per cent. Surveys carried out in different sub-populations have yielded prevalence estimates, but data on HIV incidence are limited. Both HIV serotypes 1 and 2 exist in India and HIV-1 C is the commonest subtype reported. Sexual transmission of HIV is most predominant. Spread of HIV in intravenous drug use settings is localized mostly in the north eastern region and metropolitan cities and parent to child transmission is on the rise. Dual epidemics of HIV and tuberculosis, increase in the number of infected women, stigma and discrimination are the main concerns in the Indian HIV/AIDS scenario. There is an increasing political will and commitment for HIV prevention and control efforts in India. A multi-disciplinary approach combining targeted interventions like early identification and treatment of STDs, condom promotion, blood safety, drug de-addiction programs and expanding and strengthening VCTCs and long-term strategies like awareness oriented to behavioural change especially among vulnerable populations, young people and women, steps towards improvement of literacy, status of women and overall development, reduction in poverty and development of primary prevention interventions like vaccines and microbicides will have to be considered for effective prevention and control of AIDS in India.

Female↗
PubMed2005

Preparing for efficacy trials of vaginal microbicides in Indian women.

Vaginal microbicides are topical compounds that are expected to protect women against vaginal transmission of HIV and other sexually transmitted pathogens. A large number of compounds are being evaluated as possible microbicides. Considering the spread of the HIV epidemic among women in India, clinical trials on microbicides starting from the Phase I safety and acceptability studies to Phase III efficacy trials are important. Conducting efficacy trials is a major endeavour and this review discusses challenges and issues and the preparatory steps to make such efficacy trials possible in India.

Anti-Infective Agents, Local↗
PubMedDate not supplied

Examining the context of microbicide acceptability among married women and men in India.

Married women in India are increasingly at risk of HIV, often due to their husbands' extramarital sexual behaviour. Topical microbicides may provide protection to women who are unable to negotiate condom use. During the formative phase of a study to develop measures related to microbicide acceptability, we conducted in-depth interviews with 14 'high-risk' and 16 'low-risk' married women and 15 husbands. Some participants had recently completed a 2-week microbicide safety trial. A sequence of in-depth interviews with each participant explored the context of microbicide acceptability, including perceptions of couple harmony, vulnerability to HIV, sexual power, and ability to control life events. Women's perceptions of control and sexual power influenced attitudes towards microbicide use. HIV risk was most commonly associated with partner infidelity and easily detected, according to both men and women, by a lack of marital harmony. Despite this, high-risk women denied perceiving HIV risk until confronted with specific evidence of a husband's positive HIV or STI diagnosis. This study provides an in-depth examination of HIV risk for Indian married women, identifying potential determinants of microbicide use, and providing guidance for the development of psychometric scales to measure couple harmony, HIV risk perception, and sexual power and control.

Administration, Intravaginal↗