Patterns of migration/mobility and HIV risk among female sex workers: Andhra Pradesh 2007-08

This report presents the findings from the female sex workers study in Andhra Pradesh, India implemented by TNS India Private Limited and the Population Council in New Delhi. Specifically the study was undertaken to assess the volume and patterns of mobility of female sex workers; to describe the characteristics of mobile female sex workers; and too examine the determinants of HIV risk among female sex workers, with particular emphasis on mobility-related characteristics. The report concludes that targeting such highly mobile female sex workers in intervention programs requires a comprehensive understanding of their places of solicitation and sex. Female sex workers who move frequently to different places and who visit other areas for a short time are at greater risk of HIV, and special efforts are needed in HIV-prevention programs to address the needs of such workers

Relationship between reported prior condom use and current self-perceived risk of acquiring HIV among mobile female sex workers in southern India

<p>Abstract</p> <p>Background</p> <p>With the evolution of Health Belief Model, risk perception has been identified as one of several core components of public health interventions. While female sex workers (FSWs) in India continue to be at most risk of acquiring and transmitting HIV, little is known about their perception towards risk of acquiring HIV and how this perception depends upon their history of consistent condom use behavior with different type of partners. The objective of this study is to fill this gap in the literature by examining this relationship among mobile FSWs in southern India.</p> <p>Methods</p> <p>We analyzed data for 5,413 mobile FSWs from a cross-sectional behavioral survey conducted in 22 districts from four states in southern India. This survey assessed participants’ demographics, condom use in sex with different types of partners, continuation of sex while experiencing STI symptoms, alcohol use before having sex, and self-perceived risk of acquiring HIV. Descriptive analyses and multilevel logistic regression models were used to examine the associations between risky sexual behaviors and self-perceived risk of acquiring HIV; and to understand the geographical differences in HIV risk perception.</p> <p>Results</p> <p>Of the total mobile FSWs, only two-fifths (40%) perceived themselves to be at high risk of acquiring HIV; more so in the state of Andhra Pradesh (56%) and less in Maharashtra (17%). FSWs seem to assess their current risk of acquiring HIV primarily on the basis of their past condom use behavior with occasional clients and less on the basis of their past condom use behaviors with regular clients and non-paying partners. Prior inconsistent condom use with occasional clients was independently associated with current perception of high HIV risk (adjusted odds ratio [aOR)] = 2.1, 95% confidence interval [CI]: 1.7-2.6). In contrast, prior inconsistent condom use with non-paying partners was associated with current perception of low HIV risk (aOR= 0.7, 95% CI: 0.5-0.9). The congruence between HIV risk perception and condom use with occasional clients was high: only 12% of FSWs reported inconsistent condom use with occasional clients but perceived themselves to be at low risk of acquiring HIV.</p> <p>Conclusion</p> <p>The association between high risk perception of acquiring HIV and inconsistent condom use, especially with regular clients and non-paying partners, has not been completely internalized by this high risk group of mobile FSWs in India. Motivational efforts to prevent HIV should emphasize the importance of accurately assessing an individual’s risk of acquiring HIV based on condom use behavior with all types of partners: occasional and regular clients as well as non-paying partners; and encourage behavior change based on an accurate self-assessment of HIV risk.</p

District level baseline survey of family planning program in Uttar Pradesh: Jhansi

Baseline surveys in 15 districts of Uttar Pradesh were conducted as part of the USAID-assisted State Innovations in Family Planning Services project. This effort helps create databases at the district level, an essential prerequisite for decentralized planning and strategy development. The Baseline Surveys in Uttar Pradesh (BSUP) were undertaken as part of the Innovations in Family Planning Services Project to reduce the fertility rate in Uttar Pradesh. The project’s objectives were to increase access to family planning (FP) services, improve quality of FP services, and promote contraceptive use. The Population Council was designated as the nodal organization to coordinate various activities and provide technical assistance for the consulting organizations involved in BSUP. The Centre for Population and Development Studies, Hyderabad, was the selected consulting organization for the BSUP in Jhansi district. As stated in this report, general objectives are to provide a baseline against which the effectiveness and success of district-level project activities can be assessed in the future and provide background data at the district level that will assist in the design of appropriate and innovative service-delivery strategies

District level baseline survey of family planning program in Uttar Pradesh: Meerut

The Government of India and USAID began the Innovations in Family Planning Services Project (IFPS) in Uttar Pradesh under the State Innovations in Family Planning Services Agency (SIFPSA). The goal was to reduce the fertility rate in India’s most populous State of Uttar Pradesh by accelerating family planning (FP) services at the district level through innovative approaches. IFPS’s main objectives were to increase access to FP services, improve quality of FP services, and promote contraceptive use. Initially 15 districts were selected for the Baseline Surveys in Uttar Pradesh (BSUP). The baseline information collected will be used to plan FP interventions and will be employed as the reference for the measurements in contraceptive use. SIFPSA designated the Population Council, India, as the nodal organization, responsible for providing coordination and technical support for the BSUP. As noted in this report, the Centre for Management of Development Programmes, a nongovernment research organization in New Delhi, was assigned the responsibility for conducting the baseline survey in the Meerut district

District level baseline survey of family planning program in Uttar Pradesh: Lalitpur

Baseline surveys in 15 districts of Uttar Pradesh were conducted as part of the USAID-assisted State lnnovations in Family Planning Services project. This effort helps create databases at the district level, an essential prerequisite for decentralized planning and strategy development. The Baseline Surveys in Uttar Pradesh (BSUP) were undertaken as part of the innovations in Family Planning Services Project, which aimed to reduce the fertility rate in Uttar Pradesh. The specific objectives of the project were to increase access to family planning (FP) services, improve quality of FP services, and promote contraceptive use. The Population Council has been designated as the nodal organization to coordinate various activities and to provide necessary technical assistance for the consulting organizations involved in BSUP. The Centre for Population and Development Studies, Hyderabad, was the selected consulting organization for the BSUP in Lalitpur District. As stated in this report, general objectives are to provide a baseline against which the effectiveness and success of district-level project activities can be assessed in the future and provide background data at the district level that will assist in the design of appropriate and innovative service-delivery strategies

Patterns of migration/mobility and HIV risk among female sex workers: Tamil Nadu 2007-08

In past years, considerable research has been undertaken on the role of female sex workers (FSWs) in the transmission of HIV infection. FSWs have been seen as a major “source” of infection, and consequently, have been extensively targeted to prevent its spread. There is, however, a gap in our understanding of the dynamics of sex work, sex workers\u27 patterns of mobility, and the relationship of such mobility with risk of HIV infection and gender-based violence. The Population Council collaborated with its local partner, TNS, to carry out a study in Tamil Nadu to examine the patterns of mobility of FSWs and to study its links with HIV risk. The goal was to provide research-based evidence to inform the formulation of policies and to improve the implementation of programs. Results presented here describe the patterns and drivers of sex workers\u27 migration at their destination points, intermediate points, and points of origin, and their connection to high-risk activities in Tamil Nadu

Migration/mobility and vulnerability to HIV among male migrant workers: Andhra Pradesh 2007-08

The Population Council, in collaboration with TNS India Pvt. Ltd., undertook a study in Andhra Pradesh, India, to examine the patterns of male migration and its links with HIV risk. The goal was to provide evidence to inform the design and implementation of HIV interventions for male migrant workers. The study documented the volume and patterns of mobility, including the social dynamics within the contract system that employs these men as laborers, and the sexual risk behaviors and addictive behaviors of male migrants. The results suggest a predominance of interdistrict movements of men within Andhra Pradesh with a strong positive association between individuals\u27 degree of mobility and their sexual behavior. Moreover, an increase in degree of mobility is linked to inconsistent or nonuse of condoms, and there is limited knowledge of HIV infection among these recent male migrants. The study shows that there is a clear need for implementing interventions to prevent HIV infection in migrant workers and the authors of this report recommend the use of work-contract systems for delivering HIV-prevention interventions

Influence of gender and parental migration on IYCF practices in 6-23-month-old tribal children in Banswara district, India: findings from the cross-sectional PANChSHEEEL study

BACKGROUND: The interdisciplinary Participatory Approach for Nutrition in Children: Strengthening Health, Education, Engineering and Environment Linkages (PANChSHEEEL) study used a participatory approach to develop locally-feasible and tailored solutions to optimise Infant and Young Child Feeding (IYCF) practices at an individual, household, community, and environmental level. This paper aims to evaluate the influence of gender; migration; and Health, Education, Engineering and Environmental (HEEE) factors on IYCF practices, with the primary outcomes being three key complementary-feeding practices of Minimum Dietary Diversity (MDD), Minimum Meal Frequency (MMF) and Minimum Acceptable Diet (MAD). METHODS: A cross-sectional survey of 325 households with children aged 6-23 months was conducted in nine purposively selected villages in two blocks of Banswara district, Rajasthan, India. A survey tool was developed, translated into the local language, pre-tested, and administered in a gender-sensitive manner. Data-collection processes were standardized to ensure quality measures. Association of the primary outcome with 27 variables was tested using a Chi-square test (Mantel-Haenszel method); backward stepwise regression analysis was conducted to assess the impact of effect modifiers (gender, parental migration). RESULTS: Half of the surveyed children were of each gender, and fathers from half of the households were found to have migrated within the previous year to search for additional income. Parental literacy ranged from 60 to 70%. More than half of the households had access to milk-producing animals. Consumption of each of the seven food groups, eggs (4.7% vs 0.7%; p < 0.02), MDD (10.5% vs 3.2%; p < 0.02) and MAD (9.4% vs 2.6%; p < 0.02) were higher for boys than for girls. After controlling for contextual factors, a male child was 4.1 times more likely to get a diet with MDD and 3.8 times more likely to get a diet with MAD. A child from a non-migrant household was 2.0-2.1 times more likely to get a diet with MDD and MAD as compared to a child from a migrant household. However, this association was not found to be statistically significant after regression. Presence of milk-producing animals in households and consumption of milk/milk products by children in the previous 24 h were the other two strong predictors of MDD and MAD, although access to animal milk in the house did not translate to an increase in consumption of milk/milk products by a child. CONCLUSION: Gender discrimination in diet diversity and complementary-feeding practices starts early in childhood with boys having a distinct advantage over girls. In the case of parental migration, further research is required to establish if it has an adverse impact on feeding practices. Emphasis needs to be given to gender issues and other contextual factors when developing strategies to optimise complementary feeding practices. TRIAL REGISTRATION: With UCL ethics [Ethics ID 4032/002] in United Kingdom and with Sigma IRB [10,025/IRB/D/17-18] in India

MRI image segmentation and volume extraction for clinical study

Image segmentation aims to separate objects of interests from the background in an image. It has an important role in image processing, with a variety of applications such as image visualization, object detection, and volumetric measurement. In clinical applications, tumor volume measurement plays an important role in which physicians need to quantify tumor growth over a period of time. This volume measurement is done by segmenting the tumor from its surroundings in a sequence of 2D images. Due to the fact that growing number of patients or increase in medical data, manual segmentation becomes a difficult task as it needs more time and the accuracy of segmentation depends on the expertise. For this reason, we need automatic or semi-automatic techniques for segmentation and analysis of medical images. This work has been focusing on automatic segmentation of the tumor in Magnetic Resonance (MR) images and its quantitative volume measurement, which depends strongly on the accuracy of the segmentation result. Accurate segmentation can be achieved by using an improved level set method which utilizes the image information in local regions for doing segmentation slice-by-slice. The resultant volume is compared with the ground truth volume obtained by manual segmentation. The performance evaluation is done by using statistical measures such as positive predictive value, Jaccard similarity index, and tumor volume accuracy measurement and the results are promising.Master of Scienc