Did Inclusion of informed consent affect the observed hiv prevalence rate among injecting drug users during hiv sentinel surveillance 2017 in Delhi, Uttar Pradesh, Uttarakhand, and Jharkhand States of Central Zone of India?
Sanjay Kumar Rai1, Farhad Ahamed2, Shashi Kant3, Partha Haldar4, Shreya Jha5, Shobini Rajan6
1 Professor, Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
2 Assistant Professor, Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Kalyani, West Bengal, India
3 Professor and Head, Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
4 Associate Professor, Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
5 Consultant, Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
6 Assistant Director General, National AIDS Control Organization, MoHFW, GOI, New Delhi, India
Dr. Farhad Ahamed
Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Kalyani, West Bengal
Source of Support: None, Conflict of Interest: None
Background: In 2017, the sampling procedure for HIV sentinel surveillance (HSS) among all high-risk groups was changed from the consecutive sampling to random sampling along with the introduction of linked anonymous testing strategy with informed written consent. Objective: The objective of this study was to assess whether the inclusion of informed consent affects the HIV positivity rate among the participants and nonparticipants injecting drug users (IDU) in HSS 2017 in four states of Central Zone of India. Methods: This study was a cross-sectional study. All sentinel sites from Delhi, Uttar Pradesh, Jharkhand, and Uttarakhand located at targeted intervention facilities in 2017 were included in the study. Information about the participation and nonparticipation of each high-risk individual at the sentinel site was gathered from the master list, respective registers, and website portal of the National AIDS Control Organization. A total of 8639 individuals were included in the analysis. Results: Overall, 16 sites in four states were included in the study. Overall, the nonparticipation rate of IDUs was 14.3%; highest being for Delhi (17.2%), followed by Uttar Pradesh (14.6%), Uttarakhand (10.9%), and Jharkhand (4.4%). Overall, the HIV-positivity rate among nonparticipants (9.6%) was significantly higher (P = 0.009) compared to the participants (6.7%). Conclusion: Change in methodology and seeking written informed consent might have an effect on the nonparticipation in all four states. This, in turn, could have led to the underestimation of HIV-positivity rates among IDU in the states.