In India, 2.47 million people are infected with HIV/AIDS; more than half are women and nearly 20% of HIV+ people live in Andra Pradesh state. Researchers from UCLA and India found that training lay women in rural Andra Pradesh to provide support to PLHAs significantly improved their adherence to antiretroviral therapy and boosted their immune-cell counts and nutrition levels.
The women were trained by the research team to serve as accredited social health activists (ASHAs) and were supervised by rural nurses and physicians. The ASHAs provided counseling and support to the women with HIV/AIDS. "For rural women living with AIDS in India, stigma, financial constraints and transportation challenges continue to exist, making lifesaving antiretroviral therapy difficult to obtain," said lead researcher Adey Nyamathi, professor and associate dean of international research and scholarly activities at the UCLA School of Nursing.
For the intervention study, women with HIV/AIDS in Andra Pradesh were randomly selected to participate either in the intervention, called ASHA-LIFE (AL), or in a control group. Over a six-month period, the ASHA visited the women in the AL group to monitor and help them address barriers in accessing health care and adhering to ART and counseling them on strategies for dealing with discrimination. The intervention group received monthly supplies of high-protein foods, such as black gram and pigeon pea and participated in six education sessions covering topics, such as HIV and AIDS, ART adherence, coping, stigma, and good nutrition. The control group attended the education sessions and received standard protein supplementation but no visits or supportive services from the ASHA.
The women in the AL group had significant increases in therapy adherence and CD4+ T-cell levels, better coping and fewer depressive symptoms, compared with the control group. They also had significant increases in body mass index, muscle mass and fat mass.
The pilot study holds promise for rural women and other populations impacted by HIV/AIDS. Findings from the study are currently available on online in two journals: the Western Journal of Nursing Research, and AIDS Education and Prevention. The study was funded by the National Institute of Mental Health, part of the National Institutes of Health.
Photo courtesy of UCLA Newsroom website.