HIV testing among pregnant women living with HIV in India: are private healthcare providers routinely violating women’s human rights?

Authors

Purnima Madhivanan, Department of Epidemiology, Florida International University; Public Health Research InstituteFollow
Karl Krupp, Public Health Research Institute of India; Health Promotion and Disease Prevention, Florida International UniversityFollow
Vinay Kulkarni, Prayas, Amrita Clinic
Sanjeevani Kulkarni, Prayas, Amrita Clinic
Neha Vaidya, Prayas, Amrita Clinic
Reshma Shaheen, Public Health Research Institute of India
Sean Philpott, Union Graduate College
Celia Fisher, Fordham University

Date of this Version

3-24-2014

Document Type

Article

Abstract

Background

In India, approximately 49,000 women living with HIV become pregnant and deliver each year. While the government of India has made progress increasing the availability of prevention of mother-to-child transmission of HIV (PMTCT) services, only about one quarter of pregnant women received an HIV test in 2010, and about one-in-five that were found positive for HIV received interventions to prevent vertical transmission of HIV.

Methods

Between February 2012 to March 2013, 14 HIV-positive women who had recently delivered a baby were recruited from HIV positive women support groups, Government of India Integrated Counseling and Testing Centers, and nongovernmental organizations in Mysore and Pune, India. In-depth interviews were conducted to examine their general experiences with antenatal healthcare; specific experiences around HIV counseling and testing; and perceptions about their care and follow-up treatment. Data were analyzed thematically using the human rights framework for HIV testing adopted by the United Nations and India’s National AIDS Control Organization.

Results

While all of the HIV-positive women in the study received HIV and PMTCT services at a government hospital or antiretroviral therapy center, almost all reported attending a private clinic or hospital at some point in their pregnancy. According to the participants, HIV testing often occurred without consent; there was little privacy; breaches of confidentiality were commonplace; and denial of medical treatment occurred routinely. Among women living with HIV in this study, violations of their human rights occurred more commonly in private rather than public healthcare settings.

Conclusions

There is an urgent need for capacity building among private healthcare providers to improve standards of practice with regard to informed consent process, HIV testing, patient confidentiality, treatment, and referral of pregnant women living with HIV.

Comments

© 2014 Madhivanan et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

DOI: 10.1186/1472-698X-14-7

Recommended Citation

Madhivanan et al.: HIV testing among pregnant women living with HIV in India: are private healthcare providers routinely violating women’s human rights? BMC International Health and Human Rights 2014 14:7.