Transmission of HIV/AIDS

Objectives

In India, the number of HIV positive women increases every year. Therefore, the prevention of mother to child transmission of HIV (PMTCT) is a priority for national and international public health authorities. The aim of this programme is to study the social, cultural and psychological dynamics of the mother to child transmision of HIV (MTCT) process in South India.

The research programme has 3 main objectives:

• To understand the behaviors and perceptions of women regarding PMTCT (pregnancy, delivery, breast-feeding).

• To find out the social, cultural and medical factors that mark the process of MTCT and PMTCT.

• To list and understand the strategies that the health care system offers (public, private and NGO settings) to prevent MTCT.

Materials and Methods

Different researches have been launched on the HIV/AIDS transmission from the mother to the baby in two main directions: 1) researches focused on breastfeeding, 2) researches focused on delivery practices and birth giving. They are conceived on integrative frameworks taking into account the complexity of the individual, social and medical components of these questions.

Giving birth and breastfeeding are the most important stages of the maternity defined by a number of factors (economic, psychological, cultural, relation to health). But according to national and international studies the HIV positive mother can infect their own baby by these routes bringing these life events to risk of disease and death. The social construction of the behaviours oh the HIV positive mothers are questioned in the context of their family and community and in respect to the message and actions of prevention. So different domains are studied:

(1) The role of the health and prevention stakeholders in building social and individual behaviours: Evolution and application of the national PMTCT policy, Patterns of prevention: public versus private/NGO sector, Role of the political and health care system in building risk perceptions, Patterns of health professional behaviour regarding PMTCT

(2) The situation of the women toward the risk to be infected and to the risk of transmission to their baby: Social and family contexts of the women infection, Consequences of HIV positive women perceptions (stigmatisation, exclusion, solidarity, compassion) in the PMTCT process Behaviours or situations increasing or decreasing the risk of MTCT, Patterns of breast feeding in family, community and social settings, Role of the counselling methods in building choices regarding the PMTCT, Factors defining infant food intake by HIV positive women after counselling, Choices and accessibility to free-risk setting of delivery, Role of the delivery place in the PMTCT (in community or medical institutions).

These approaches intend to bring a reflection on the adequate responses to the risk of MTCT of HIV in South India.

The program has been divided into 2 phases:

• Phase 1: A multidisciplinary work (social sciences and public health) based on preliminary ethnographic data, book and article review, seminars and collective reflection and publication (2001-2002).
• Phase 2: A Multicentric fieldwork (Tamil Nadu and Pondicherry) in anthropology and social psychology focusing on the social, cultural, political and psychological management of prevention of HIV through delivery and breast-feeding (2002-2006).

These researches are based on qualitative research methods (ethnographic fieldwork, observation, interviews) in anthropology and in social psychology.

Data have been collected in different strategic sites (community settings, NGO settings, hospitals, clinics....)

Partners

• University of Rouen, Group of Research Innovations and Societies (GRIS), Department of Sociology, France, for the programme "Socio-anthropological approach to HIV transmission from mother to child in India: The case of breast-feeding"
• YRG Centre for AIDS Research and Education (YRG CARE) Chennai, India, for the programme "Socio-anthropological approach to HIV transmission from mother to child in India: The case of breast-feeding"
• University of Aix-Marseille, Centre de Recherche Cultures, Santé, Société (CeReCSS), France, for the programme "HIV Transmission and delivery practices in South-India : an anthropological approach".
• Pondicherry Institute of Linguistic and Culture (PILC), Pondicherry, India for the programme "HIV Transmission and delivery practices in South India : an anthropological approach"

Funding

• Sidaction, France
• Agence Nationale de Recherche sur le Sida / National Agency for AIDS Research, France
• Ministry of Foreign Affairs, France
• French Institute of Pondicherry

Team

Download research abstracts (.pdf)

Main Outputs

Organization of international seminar

Cohen, P. & S. Solomon (eds), 2002. HIV/Aids Mother to Child Transmission in India: Social Sciences Perspectives, Indo-French Round Table, organised by French Institute of Pondicherry and YRG CARE, Pondicherry, April, 9-10 th 2002,

Books CD-ROM

• Aids and maternity in India. From public health to social sciences perspectives. Emerging themes and debates

Edited by Patrice Cohen & Suniti Solomon, 2004, 279 p. (PDSS n°8)
Language: English. 350 Rs (13 €)

This collective book – with contributions from Indian and French specialists - seeks to define and shape the role of the social sciences in studying HIV/AIDS transmission from the mother to the child in India. The prevention of this transmission is a priority of the Indian public health policy and of international organisations. This issue is explored here through the understanding of medical, public health and social sciences perspectives.

Based on the status of maternity and its behaviour - pregnancy, delivery and breast-feeding are routes of transmission – the understanding of this transmission and its prevention is built here on a progressive and multidisciplinary exploration of the issue.

Keywords: AIDS, maternity, social sciences, anthropology, delivery, breast-feeding

Various publications

Download list of selected publications by team members (pdf).