title: Screening for HIV infection by health professionals in India.
abstract: BACKGROUND
  Stigma and discrimination, particularly in access to healthcare, remains a major problem for people Infected with HIV in most parts of India.
  
  
  METHODS
  We did a multicentre study (n = 10) with a cross-sectional survey design using a standardized, interviewer-administered questionnaire.
  
  
  RESULTS
  A total of 2200 healthcare providers participated. The knowledge, attitude and practice (KAP) related to HIV service delivery were very poor with a mean overall KAP score of only 49.7% (CI: 49.1-50.3). Only 5%, 5% and 1% of the participants scored more than 75% separately for the dimensions of knowledge, attitude and practice, respectively. Only 24.4% and 36.7% of responders knew that HIV screening was not recommended prior to surgery and pre-employment check-up. Many doctors (19.4%) had refused treatment to people living with HIV/AIDS (PLHA) at least some of the time and nearly half (47.2%) identified and labelled them; 23.9% isolated them in separate care areas and 13.3% postponed or changed treatment based on the patient's HIV status. Screening for HIV prior to elective surgery was done by 67% of providers. While 64.7% of responders were aware of the existence of national guidelines on and recommendations for HIV testing, only 38.4% had read the policy document.
  
  
  CONCLUSIONS
  There is a growing need to provide care, support and treatment to a large number of PLHA. The capacity of healthcare providers must be urgently built up so as to improve their knowledge of and attitude to HIV to enable them to deliver evidence-based and compassionate care to PLHA in various healthcare settings.
authors.affiliation: Coordinating Centre, Christian Medical College, Vellore 632004, Tamil Nadu, India.
authors.forename: M
authors.initials: M
authors.lastname: Kurien
authors.forename: K
authors.initials: K
authors.lastname: Thomas
authors.forename: R C
authors.initials: RC
authors.lastname: Ahuja
authors.forename: A
authors.initials: A
authors.lastname: Patel
authors.forename: P R
authors.initials: PR
authors.lastname: Shyla
authors.forename: N
authors.initials: N
authors.lastname: Wig
authors.forename: M
authors.initials: M
authors.lastname: Mangalani
authors.lastname: Sathyanathan
authors.forename: A
authors.initials: A
authors.lastname: Kasthuri
authors.forename: B
authors.initials: B
authors.lastname: Vyas
authors.forename: A
authors.initials: A
authors.lastname: Brogen
authors.forename: A
authors.initials: A
authors.lastname: Brojen
authors.forename: T D
authors.initials: TD
authors.lastname: Sudarsanam
authors.forename: A
authors.initials: A
authors.lastname: Chaturvedi
authors.forename: O C
authors.initials: OC
authors.lastname: Abraham
authors.forename: P
authors.initials: P
authors.lastname: Tharyan
authors.forename: K G
authors.initials: KG
authors.lastname: Selvaraj
authors.forename: J
authors.initials: J
authors.lastname: Mathew
mesh_terms: D015492:AIDS Serodiagnosis; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D002983:Clinical Competence; D016000:Cluster Analysis; D015658:HIV Infections / Q000175:diagnosis* / Q000517:prevention & control / Q000628:therapy; D019538:Health Care Surveys; D006291:Health Policy; D006761:Hospitals / Q000592:standards; D006801:Humans; D007194:India; D008403:Mass Screening / Q000592:standards* / Q000706:statistics & numerical data; D016134:Organizational Policy; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011287:Prejudice; D011320:Primary Health Care / Q000592:standards; D017149:Private Sector / Q000592:standards; D017150:Public Sector / Q000592:standards; D016079:Refusal to Treat; D013240:Stereotyping; D011795:Surveys and Questionnaires; D016635:Universal Precautions