Evaluation of the Needs of People Living with HIV/AIDS--论文代写范文精选

这是一个儿童教育计划,在医院调查。PLHA参与卫生项目是最小的,对信息披露和缺乏机会的恐惧。受访者表示,政府政策有积极影响，改变了社会对艾滋病患者的看法。下面的report代写范文进行详述。

Abstract
Introduction: Evaluating the needs of People Living with HIV / AIDS (PLHA) and providing them with adequate care and support is important in combating the Acquired Immunodeficiency Syndrome (AIDS) epidemic. Objectives: The study was conducted to ascertain the needs of PLHA, the support obtained and required, extent of involvement in programs related to HIV and evaluate the impact of Government programs as perceived by PLHA. Methods: A cross sectional study was conducted on 150 PLHA in the districts of Indore, Neemuch and Ujjain in the state of Madhya Pradesh (India) using semi-structured interview schedules. The data was analyzed using SPSS version 12.0. Results: The major support available to the patients is the free Anti-Retroviral Therapy (ART) available at Government health care centers. The other supports obtained from self help groups and NGOs were medicines for opportunistic infections, nutritional supplements, traveling allowance to ART center for monthly doses, free monthly ration and school fees for one child in the family.

The major support required were an educational plan for children, free investigations at hospitals, decentralization of ART centers and adequate employment opportunities. Involvement of PLHA in health programs was minimal: the reasons for non-involvement being unwillingness, fear of disclosure and lack of opportunity. The respondents stated that Government policies have had a positive impact and changed the perception of the society towards HIV patients. Conclusion: PLHA have a number of unmet needs and a collaborative attempt from the government and support groups is needed to meet the needs of PLHA.

Introduction
Evaluating the immediate and long term needs of People Living with HIV / AIDS (PLHA) and providing them with adequate care and support has a special significance in combating the Acquired Immunodeficiency Syndrome (AIDS) epidemic. Mainstreaming PLHA is also needed to effectively evaluate their needs. The fact has been envisaged by Policy makers around the world. In 1994, leaders of 42 countries signed the Paris AIDS Summit Declaration acknowledging the central role of positive people in the formulation and implementation of national and international policies and programmes (1). This declaration was then adopted by the Joint United Nations Programme for HIV / AIDS (UNAIDS) as the Greater Involvement of People Living with HIV / AIDS (GIPA) principle (2).

Even the National AIDS Control Program (NACP) Phase III of Government of India, goes a long way in addressing the issue. It has been clearly stated in the guiding principles of the programme that “Particular focus is on the Fundamental rights of PLHA and their active involvement in prevention, care, support and treatment initiatives” (3). Inspite of all the existing guidelines and policies not much research has been carried out to know the felt needs of PLHA and even their involvement in policy making remains mere tokenistic in both governmental and non-governmental organizations. The findings reported here are a part of a bigger study which was done to evaluate such needs of PLHA along with their perception towards HIV and the Stigma and Discrimination faced by them. The findings try to evaluate gaps concerning various issues related to PLHA and suggest measures to rectify them.

Methodology
The infection in the state of M.P shows a preferential geographical distribution with it being concentrated in some select districts. As per the official data for the state Indore reports the maximum number of AIDS cases. It is essentially the HIV Capital of Madhya Pradesh. The neibouring districts of Dewas and Ujjain are close seconds. A second peak is witnessed in the border districts of Neemuch, Mandsaur and Burhanpur. The state has presently 3 functional ART centers at Indore, Jabalpur and Bhopal. A cross sectional study was conducted on 150 PLHA in the districts of Indore, Neemuch and Ujjain in the state of Madhya Pradesh during the months of February- March 2008 in collaboration with Madhya Pradesh Voluntary Health Association (MPVHA), a Non Governmental Organization (NGO) working on HIV in the state of Madhya Pradesh .

Results
Socio-demographic profile of respondents: Of the 150 respondents 73 (48.66%) were males while 77 (51.33%) were females. All the respondents in the study were in the age group of 15-60 years, 52 respondents (34.7%) were illiterates while graduates formed 5.3% of the study sample. 132 subjects (88%) had a monthly family income of less than Rs 5000. 53% informants were employed as labourers, farmers or servicemen while 11(7.33%) respondents were presently employed in various Non Governmental Organizations working in the field of HIV / AIDS. In Neemuch 16 (32%) informants were working as Commercial Sex Workers (CSWs), all of them still involved in the trade inspite of being seropositive.

130 out of 150 interviewed (86.67%) in the study had been diagnosed as positive, in the last 5 years with 50% cases in Neemuch testing positive within the last 1 year. 123 (82%) respondents were ever married, out of 77 (51.33%) presently married patients 58 (75%) were using condoms regularly, 10.40% did not use condoms regularly while the rest 15.6% of patients didn’t use condoms during sexual intercourse with their spouses. 41 respondents were widowed at the time of the study, 35(85.37%) of widowed patients were females while 6 (14.63%) were males. At least one child was positive in 10.60% of families studied.

Discussion
The major support available to the study subjects is the free ART available at Government Health Care Centers. 19 (38%) respondents at Neemuch used to get Traveling allowance for coming to Indore to get their monthly doses of ART. Neemuch is situated around 250 kms from Indore and a round trip costs between Rs 300-400. This sort of innovative help is highly commendable and indirectly helps in improving the compliance rates for ART. Consequently establishment of an ART Center at Neemuch itself was one of the foremost requirements stated by the interviewees.

Evaluation of the Needs of People Living with HIV/AIDS in Selected Districts of State of Madhya Pradesh, India: Findings from a Preliminary Study bors, eventually leading to disclosure of serostatus of the patient: hence the need for decentralization of ART Centers. Link ART Centers (LAC) have been proposed in the state of Madhya Pradesh under NACP-III and efforts should be undertaken to operationalize LACs in high prevalence districts as early as possible.(4) 101 (67.33%) respondents in the study were receiving support from various NGOs and self help groups. Initial support is very essential; the reaction following diagnosis of HIV infection is generally of depression and this is the time when support is most required. PLHA should be educated about the support groups operational in their area and counseled to get registered with these networks. Capacity building of PLHA should be encouraged. Developing counselling skills in PLHA and employing them as peer educators at care centers and NGOs will definitely have a positive impact on newly diagnosed patients referred to these set-ups.

The major forms of support required were social, medical, nutritional and financial i.e. adequate employment opportunities. Similar findings were observed in a study done to evaluate the palliative care needs of PLHA in Rwanda. (5)Though the support required varied among the three districts: the major concern for PLHA was the future of their children. Providing adequate employment opportunities to the PLHA and setting up an insurance fund for PLHA at support groups from pooling a part of their income can be taken up. This fund can then be used to provide help for their family members and children. Providing vocational training to the children of PLHA while the parents are still alive should be definitely undertaken. Adequate and quality nutritional supplementation is extremely necessary for PLHA. This has been envisaged by the Addis Ababa study.(6) 28 (18.67%) of study subjects were receiving free nutritional supplements from support groups. 132 (88%) participants in the study had a monthly income less than Rs 5000. The importance of a balance and nutritious diet for PLHA is well established. PLHA from lower socio-economic groups can’t obtain the required diet further compounding their problems. The quality of supplements being provided to patients from support groups is also to be monitored. Appointing a dietician at support groups and ART centers and provision of free nutritional supplements at the ART centers itself is a viable option. This will also ensure the quality of supplements being provided.(论文代写)

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