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Indian Journal of Community Medicine

Trend of HIV infection in police personnel attending VCTC of a tertiary care hospital

Author(s): Jindal Neeraj, Arora Usha

Vol. 32, No. 3 (2007-07 - 2007-09)

SHORT ARTICLE

Year : 2007 | Volume : 32 | Issue : 3 | Page : 201-202

Trend of HIV infection in police personnel attending VCTC of a tertiary care hospital

Jindal Neeraj, Arora Usha
Department of Microbiology, Govt. Medical College, Amritsar, India
Date of Submission 16-May-2006
Date of Acceptance 18-May-2007

Correspondence Address:
Jindal Neeraj
113, Race Course Road, Amritsar - 143 001
India

Source of Support: None, Conflict of Interest: None
How to cite this article:
Jindal N, Arora U. Trend of HIV infection in police personnel attending VCTC of a tertiary care hospital. Indian J Community Med 2007;32:201-2
How to cite this URL:
Jindal N, Arora U. Trend of HIV infection in police personnel attending VCTC of a tertiary care hospital. Indian J Community Med [serial online] 2007 [cited 2007 Nov 30];32:201-2. Available from: http://www.ijcm.org.in/text.asp?2007/32/3/201/36828

Introduction

The HIV/ AIDS global epidemic has the potential to affect all countries and all population groups. In India alone a cumulative total of persons living with HIV infection has reached 5.3 million, and the infection is gradually percolating from high-risk groups and cities to the general population and rural areas.[1] However, the problem area still seems to be the high-risk behavior groups. Police and defense personnel are basically engaged in jobs where physical fitness is a prerequisite, but many of them are involved in high-risk behavior for HIV infection. [2] As it is a matter of serious concern for both the public and the authorities, we report the prevalence of HIV infection and awareness about HIV/ AIDS in this special "high-risk behavior" group. This would help to monitor the trend of infection and plan strategies to keep HIV infection under check in police and defense personnel.

Materials and Methods

Over a period of one year - from January 2005 to December 2005-280 persons from police personnel in the age group of 21-56 years attended VCTC of Govt. Medical College, Amritsar; 61 of them were referred and 219 directly walked in for HIV testing. A detailed history regarding the demographic profile, risk factors and awareness and attitude towards HIV/ AIDS was recorded. Blood samples were collected after obtaining written informed consent and providing pre-test counseling. HIV antibodies were detected by ELISA test, and the reactive samples were subjected to two other simple/ rapid tests based on different principles of assays or different antigen preparations (NACO guidelines).[3] Reports were issued after post-test counseling, and strict confidentiality was observed.

Results

Of the 280 persons studied, 278 (99.3%) were males. Majority 263 (93.9%) of them were married, and 260 (92.8%) gave history of having multiple sex partners outside marriage, including commercial sex workers. There were 4 (1.4%) intravenous drug users (IVDU), and 1 (0.3%) gave history of blood transfusion following a road accident [Table - 1]. Surprisingly, none of them reported homosexual or oral sexual activities.

Of the 280 persons tested for HIV antibodies, 7 were found to be positive for HIV-I and none for HIV-II. This gave the prevalence rate of 2.5% (7/280) for HIV infection in police personnel. Of the 2 females tested, 1 was seropositive and she was a "direct walk-in" client. Six of the 7 (85.7%) seropositive persons seemed to have contracted the infection through heterosexual route [including the one who had received blood transfusion as he was also having multiple sex partners and one (14.3%) through improperly sterilized syringes]. All the 280 persons were aware of the various modes of transmission of HIV infection, but only a small percentage (2.8%) was using safe-sex practices. All the seropositives were married but were not practicing safe sex [Table - 1]. Spouses of four of them (including that of one female) could be tested and were found to be seronegative.

Discussion

In the present study, prevalence of HIV infection amongst the police personnel was found to be 2.5%. This shows that HIV infection amongst this group has increased significantly ( P < 0.01), as prevalence of 0.2% was observed in an earlier study (2001-02).[4] Prevalence of HIV infection in a group is dependent on several factors and varies not only with the geographic area but also with the period of study. Posting of police personnel at places away from their families drives them to seek commercial and casual sex, which increases the risk of HIV infection. Mehta et al. reported prevalence of 3% in State Reserve Police personnel posted at Mumbai.[5] With more than 5,000 HIV-positive personnel in the armed forces, health authorities of the army are already focusing more on sensitization of jawans going abroad on UN missions or posted at vulnerable areas to various aspects of HIV infection.[2]

All the 7 seropositive persons from the police personnel of the current study were in the sexually active and economically productive age group (25-40 years), and 1 was a female. Worldwide, HIV risk for women is rising and 9 out of 10 infected women live in developing countries. It is really a matter of concern, since HIV-infected women are the major source of infection for infants. HIV infection among women can therefore forecast the impact of HIV in children.[3]

In 82.7% (6/7) of the seropositive personnel of our study, the infection was transmitted through heterosexual route. This route accounts for approximately 85% of HIV infections in our country. HIV-infected blood, blood products; and use of improperly sterilized syringes/ needles are the most efficient ways of transmission of HIV infection. Even a small transfusion of infected blood results in virtually 100% seroconversion.[3] It appears that the only seropositive female of our study got infection through the use of improperly sterilized syringes. She was a diabetic and gave history of having frequent injectable medicines from unqualified doctors. This is in spite of the fact that she was aware of this mode of transmission of HIV infection and was economically independent. But she did not ask for the use of sterilized syringes, simply because she did not entertain the idea that even she could get HIV infection by this route.

In the background of extensive AIDS awareness campaign carried out by NACO, awareness about the transmission of HIV infection in our study group was found to be 100%. This is also evident from the large number of persons (219/280) who visited our VCTC as "direct walk-in" clients. Motivation to visit VCTC in most of them was their high-risk behavior and detection of infection in some of their friends who were indulging in similar high-risk behavior. But the alarming fact is that the high-risk behavior continued in them unabated, and a majority (97.2%) of them still did not follow safe-sex practices. Almost similar findings have been reported in other studies.[5] This could be because of social nonacceptance of condoms. The National AIDS Programme may not be able to promote safer sexual practices if they are not culturally acceptable.[3]

Conclusions

Our data thus indicate that there is an upward trend in HIV infection in police personnel. This stresses the need for focused and appropriate education and counseling for behavioral changes and safer sexual practices. Aggressive awareness campaigns, free distribution of condoms and mandatory testing of personnel before posting them in vulnerable areas have already been reported to be very helpful in reducing HIV infection in defense personnel.[2]

References

1. Singh S. Editorial. Abstract Book. International Conference on Opportunistic Pathogens in AIDS. ICOPA-INDIA 2006 and LABCOM-3: March, 2006.
2. Army 'Boards out' 100 AIDS patients in 2 years. NACO protests. Express Network. The Indian Express: January 1, 2006.
3. Specialist's Training and Reference Module. National AIDS Control Organization: New Delhi; 2002.
4. Aggarwal A, Arora U, Khanna S, Devi P, Alfred. Incidence of HIV/AIDS in Punjab armed police. J Lab Med 2003;4:38-40.
5. Mehal P, Ingole N, Desai D, Salvi S. HIV prevalence in SRP personnel. Abstract PV.9, XXVII National Congress of Indian Association of Medical Microbiology: 2003.

Tables

For larger view, please click on image

Table 1: Risk factors and awareness about HIV/ AIDS in police personnel at Amritsar in 2005

Table 1: Risk factors and awareness about HIV/ AIDS in police personnel at Amritsar in 2005

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