HIV in rural India: context and healthcare needs

Primary research on HIV/AIDS in India has predominantly focused on known risk groups such as sex workers, STI clinic attendees and long-distance truck drivers, and has largely been undertaken in urban areas. There is evidence of HIV spreading to rural areas but very little is known about the context of the infection or about issues relating to health and social impact on people living with HIV/AIDS. In-depth interviews with nineteen men and women infected with HIV who live in rural areas were used to collect experiences of testing and treatment, the social impacts of living with HIV and differential impacts on women and men. Eight focus group discussions with groups drawn from the general population in the four villages were used to provide an analysis of community level views about HIV/AIDS. While men reported contracting HIV from sex workers in the cities, women considered their husbands to be the source of their infection. Correct knowledge about HIV transmission co-existed with misconceptions. Men and women tested for HIV reported inadequate counselling and sought treatment from traditional healers as well as professionals. Owing to the general pattern of husbands being the first to contract HIV women faced a substantial burden, with few resources remaining for their own or their children’s care after meeting the needs of sick husbands. Stigma and social isolation following widowhood were common, with an enforced return to the natal home. Implications for potential educational and service interventions are discussed within the context of gender and social relations

A single dose of rifampicin to prevent leprosy: Qualitative analysis of perceptions of persons affected, contacts, community members and health professionals towards chemoprophylaxis and the impact on their attitudes in India, Nepal and Indonesia

Introduction: The purpose of this study is to investigate the impact of post-exposure prophylaxis (PEP) and the education given along with PEP on knowledge about leprosy and the attitudes and reported behaviour towards people affected by leprosy. This study is a sub-study of the Leprosy Post-Exposure Prophylaxis (LPEP) programme. Methods: Seventy-two semi-structured interviews and five Focus Group Discussions (FGDs) were conducted in India, Nepal and Indonesia. The study population consisted of i) index patients, ii) contacts, iii) community members and iv) health professionals. The participants were selected purposively. A team of four social scientists analysed the data using a thematic analysis. Results: The participants in this study were mostly positive and sometimes very positive about the possibility to prevent leprosy in close contacts through a single dose of rifampicin. Most respondents reported that there were no changes in their views towards leprosy or people affected by leprosy after the intervention. The study revealed that the incorrect health information that was retained and the wish of some people affected to conceal the illness poses challenges for a PEP programme. Conclusion: The LPEP programme was perceived positively and no negative effects were reported. In this analysis, PEP did not appear to have an effect on the way leprosy or people affected by leprosy were perceived. More research is needed on providing health information that is accurate and understandable for contacts, and on approaches in which disclosure of the index patient is not required

Understanding couple communication in reproductive health by using a Visually Assisted Interview Guide (VAIG)

Learning the process of couple communication, in terms of place, time, duration, content, style, form and barriers, is crucial before developing strategies to improve communication among rural couples in India. Considering the sensitivity of the subject, cultural setting, family dynamics and difficulties in reaching couples, visuals accompanied by an interview guide prove effective. The current article explains the construction and validation of a Visually Assisted Interview Guide (VAIG). The rural context limits the choice of visual forms and thus hand-drawn pictures depicting day-to-day life scenarios were used in the tool. The tool construction was primarily based on adding value to the interview guide and offering ease/comfort to the respondents and researchers when dealing with personal information. Results show that hand-drawn pictures help respondents to replace their own self-conscious identity with that of the illustrated individuals, enabling them to give realistic, impersonal responses to sensitive issues. A VAIG is therefore useful in understanding the process of how couples in rural settings communicate over reproductive health issue

The ins and outs of fibroblast growth factor receptor signalling

FGFR (fibroblast growth factor receptor) signalling plays critical roles in embryogensis, adult physiology, tissue repair and many pathologies. Of particular interest over recent years, it has been implicated in a wide range of cancers, and concerted efforts are underway to target different aspects of FGFR signalling networks. A major focus has been identifying the canonical downstream signalling pathways in cancer cells, and these are now relatively well understood. In the present review, we focus on two distinct but emerging hot topics in FGF biology: its role in stromal cross-talk during cancer progression and the potential roles of FGFR signalling in the nucleus. These neglected areas are proving to be of great interest clinically and are intimately linked, at least in pancreatic cancer. The importance of the stroma in cancer is well accepted, both as a conduit/barrier for treatment and as a target in its own right. Nuclear receptors are less acknowledged as targets, largely due to historical scepticism as to their existence or importance. However, increasing evidence from across the receptor tyrosine kinase field is now strong enough to make the study of nuclear growth factor receptors a major area of interest

RhoC Interacts with Integrin alpha 5 beta 1 and Enhances Its Trafficking in Migrating Pancreatic Carcinoma Cells

This work was funded by an NIHR Clinician Scientist Award to HMK. DAT acknowledges the support of the University of Cambridge, Cancer Research UK and Hutchinson Whampoa Limited