title: Stigma as experienced by women accessing prevention of parent-to-child transmission of HIV services in Karnataka, India.
abstract: In Karnataka, India only one-third of HIV-infected pregnant women received antiretroviral prophylaxis at delivery in 2007 through the state government's prevention of parent-to-child HIV transmission (PPTCT) program. The current qualitative study explored the role of HIV-associated stigma as a barrier to access PPTCT services in the rural northern Karnataka district of Bagalkot using in-depth interviews and focus group discussions with HIV-infected women who had participated in the PPTCT program, male and female family members, and HIV service providers. Participants discussed personal experiences, community perceptions of HIV, and decision-making related to accessing PPTCT services. They described stigma toward HIV-infected individuals from multiple sources: healthcare workers; community members; family; and self. Stigma-related behaviors were based on fears of HIV transmission through personal contact and moral judgment. Experience and/or fears of discrimination led pregnant women to avoid using PPTCT interventions. Government, cultural, and historical factors are described as the roots of much the stigma-related behavior in this setting. Based on these formative data, PPTCT program planners should consider further research and interventions aimed at diminishing institutional and interpersonal HIV-associated stigma experienced by pregnant women.
authors.affiliation: Department of Obstetrics & Gynecology, University of North Carolina, Chapel Hill, NC, USA. lisa_rahangdale@med.unc.edu
authors.forename: Lisa
authors.initials: L
authors.lastname: Rahangdale
authors.forename: Pradeep
authors.initials: P
authors.lastname: Banandur
authors.forename: Amita
authors.initials: A
authors.lastname: Sreenivas
authors.forename: Janet M
authors.initials: JM
authors.lastname: Turan
authors.forename: Reynold
authors.initials: R
authors.lastname: Washington
authors.forename: Craig R
authors.initials: CR
authors.lastname: Cohen
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003466:Cultural Characteristics; D005260:Female; D015658:HIV Infections / Q000523:psychology / Q000635:transmission*; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D006801:Humans; D007194:India; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000523:psychology; D011314:Preventive Health Services; D036301:Qualitative Research; D019035:Rural Health Services; D057545:Social Stigma; D055815:Young Adult