Eastern J Med. 2011; 16(2): 137-146

Lessons learnt from ongoing counseling during follow-up visits by men and women attending a VCTC

Nita Mawar¹, Rajani Bagul¹, Suvarna Sane¹, Tuman Katendra¹, Srikanth Prasad Tripathy¹, Ramesh Shivram Paranjape¹

Documenting behavior change through ongoing counseling is critical when HIV counseling strategies are being formulated. This study aims to demonstrate risk reduction behavior in a year in the context of HIV related problems in men and women attending ongoing counseling at a Voluntary Counseling and Testing Centre during their regular follow-ups. This is a descriptive study based on one year observation of 253 HIV infected men (112) and women (141) attending a Voluntary Counseling and Testing Centre for ongoing counseling of a research institute in Pune during six-monthly follow-up visits. A face to face interview using a 22 item semi-structured questionnaire administered after an informed consent to collect data on sexual history since last visit, condom use, HIV related problems etc. SPSS and Pearson’s chi-square test Association was used. The HIV infected ever married men (91%) and women (98% married including widows) have significant differences with respect to age, marital status, occupation (p < 0.01), and similarity in education. There is an increase in condom usage with spouse with advancing follow-up i.e. increasing dose effect through ongoing counseling is observed, it being statistically significant for men (P value < 0.004). Consistent condom use with other partners is reported by men and widows. The participants reported problems ranging from health, economic, social, support issues like stigma and concerns of future. Economic problems are reported in those having frequent follow-ups, being more in men than women (34%, 29% resp.).An ongoing counseling of follow-up participants is a useful opportunity to reinforce behavior change, demonstrated by safer behaviors, especially reduction in partners, consistent condom use with spouse and other partners. The problems faced by HIV infected require support of Non- governmental organizations to address their problems like alternative source of incomes, health care, children’s education, and women’s right to property etc. Networking of Non- governmental organizations for support, capacity strengthening including gender sensitivity should go hand in hand with ongoing counseling to bring sustained behavior change when other interventions are planned for HIV infected persons.

Keywords: Behavior change, consistent condom use, dosage effect of counseling, HIV infected widows, human rights, Stigma

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