By Somrita Ghosh
New Delhi: Privacy of patients who go for HIV testing and counselling in the national capital’s government hospitals remains a prime concern as many of them don’t have separate counselling rooms for males and females, a study has found.
The study, titled “Integrated Counselling and HIV Testing Centres of Delhi: An Evaluation”, by Dr Anita Khokhar, Director Professor, Community Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, along with Dr Vinoth Gnana Chellaiyan of the Department of Community Medicine at Chettinad Hospital and Research Institute, Kelambakkam, Chennai, revealed that a majority of the Integrated Counseling and HIV Testing Centres (ICTCs) in the national capital lacked separate rooms for male-female counselling and nor was there adequate space inside the allocated room.
According to the National AIDS Control Organisation (NACO), 93 medical facilities under the Centre and the state governments in Delhi have ICTCs.
Eleven medical facilities provide Anti-Retroviral Therapy (ART). These include AIIMS, Safdarjung Hospital, National Institute of Tuberculosis and Respiratory Diseases, Lok Nayak Hospital, RML Hospital and GTB Hospital, among others.
“There is a guideline by NACO for the ICTCs. Ideally and logically, if there are two persons from both genders, they can neither sit together nor can be made to wait and go in one after the other. There have to be two counsellors from both genders and two rooms,” Dr Chellaiyan told IANS.
This IANS correspondent visited the premier AIIMS medical institute and the adjacent Safdarjung Hospital to check out the counselling rooms for ICTC.
At AIIMS, only one small room to seat two people at a time was assigned for ICTC counselling. There were no directions to the ICTC centre anywhere on the AIIMS campus and posters related to HIV/AIDS awareness were lacking even inside the counselling space.
“The counsellor sits inside the room depending upon the patient’s gender. If a female patient comes in then the male counsellor doesn’t sit inside. But yes, this often consumes time (due to the changeover),” an AIIMS counsellor, who did not wish to be named, admitted.
However, Safdarjung Hospital has two separate ICTC counselling rooms and sufficient wall posters related to awareness.
The study also found that of the 20 ICTC centres surveyed, only 12 had both male and female counsellors. It says the majority of counsellors were found deficit in skills like greeting patients and introducing themselves.
“Many-a-times, it is the lab technicians who are seen to be doing the counselling in the absence of proper counsellors and, therefore, confidentiality is not maintained. They don’t know how to counsel. Infrastructure also remains an issue at most of the hospitals in the city,” Nandini Mazumder, who was earlier associated with India HIV/AIDS Alliance, a non-for-profit Indian NGO, told IANS.
“Training is satisfactory, but the counsellors are appointed on a contractual basis by NACO and not by the hospitals. And many times it has been seen that the seats remain empty at hospitals as the counsellors usually join for a year and then leave,” Dr Chellaiyan pointed out.
It was also observed that the information about other sexually transmitted infections (STIs) was given only by 6.2 per cent of the counsellors out of the 20 surveyed during the pre-test counselling sessions.
The study also revealed that awareness among people and awkwardness to talk about HIV and AIDS still remains a major concern. A majority of the patients were facility-referred and walk-ins constituted only 10 per cent of the 291 surveyed.
“Every day around 100 people come in and the first thing that a patient visiting the ICTC centres here says is, ‘I have not done anything wrong.’ Most of the patients at AIIMS are youths aged between 20 and 40 with cases also coming from the neighbouring towns like Mathura or Faridabad, where they cannot talk about undergoing an HIV test.
“Talk on HIV is sensitive. We try to make the patients as comfortable so that they are able to express or narrate in a better way,” the counsellor from AIIMS added.
According to NACO, HIV counselling and testing services were started in India in 1997.
The main functions of an ICTC are conducting HIV diagnostic tests, providing basic information on the modes of HIV transmission, and promoting behavioural changes to reduce vulnerability and link people with other HIV prevention, care and treatment services.