Infant and Atenatal Healthcare
Prenatal care promotes healthier pregnancies and offers screening for several different health concerns, tailored to the region of establishment.About 84% of women in the United States from different socio-economic backgrounds received appropriate prenatal care in 2011, meaning that the individuals of the cohort were screened for health concerns specific to region and were educated on how to go about pregnancy in a healthy manner (U.S. Department of Health, 2013). In the United States, there are approximately 1.1 million individuals who are infected with Human Immunodeficiency Virus (HIV), out of those 1.1 million, 24% are women ("Women and HIV/AIDS in the United States", 2014). In a study conducted by The American College of Obstetricians and Gynecologist, it was found that among a cohort of individuals insured with Medicare, 96.3% were screened for Syphilis, 96.3% for hepatitis B, and 82.4% were screened for HIV; for the cohort of women with commercial insurances, the screening for Syphilis was slightly higher, 97.8%, 96.8% for Hepatitis B, and 85.4% for HIV (Ross, 2015). There was higher screening for Syphilis and Hepatitis B than HIV screening among Medicare insured and commercially insured pregnant women. Considering that 24% of women in the US are infected with HIV, this 25% gap for HIV screening may be detrimental to the health of the mother and fetus, if those women become pregnant, contributing to the HIV/AIDS worldwide concern.When children are born in the US, by an established protocol, blood specimens from the heel of the foot are collected and sent to laboratories for screening of certain disease; in 1988, blood specimen of the newborns were anonymously sent to public health labs and were used for HIV population surveying purposes. It was found that from 1988 to 1990, there were 1824 HIV cases of mother-to-child HIV transmission out of 6079 cases of HIV positive mother giving birth (Gwinn et al., 1991). Like in the United States, HIV among women in India is also prevalent, the only difference is the discrepancy between prenatal care and prenatal HIV screening between both Countries. There are about 2.5 million individuals who are infected with HIV in India, 40% of those individuals are women (Mothi, Lala, & Tappuni, 2016). In the Summer of 1999, 666 pregnant women in Mysore, India were interviewed at medical facilities in regards to prenatal HIV screening; it was found that although 78% of the participants had some knowledge on what HIV was, 64% of the women were not aware that screening could offer the possibility to prevent mother-to-child transmission (Brown et al., 2001). Another study revealed that in order for women to consider being screened for HIV while pregnant, 46% of the participants had to ask their husbands for permission; only 56% of the participants in the experiment opted to be screened (Rogers et al., 2006). There is clearly a gap between prenatal care and prenatal HIV screening when comparing the United States and India.As a global citizen, I would like investigate what are the many causes that have established this gap. In efforts of establishing a research in regards towards this initiative, I would interview a cohort of randomly chosen pregnant females in the city of Mysore, India. While being in Mysore, India, I understand that I will be exposed to many experiences different from any that can be experienced in the United States, but as a participant of the Study Abroad Global Health Program, I am open to learning to view the world through different lenses. The participants would have assurance of confidentiality, they would be asked questions about their views on their role in their marriages, motherhood experience, and in their social circle; these questions would then be used to transition into the topic of prenatal HIV screening, where the knowledge on HIV of each participant would be scaled from 0-5, 0 being no knowledge and 5 being well informed. Questions about HIV screening and the effect it would have on the participants’ family would also be asked. I would also like to meet women who are HIV positive mothers and investigate how they perceive themselves in terms of motherhood and womanhood. With supporting data, it would be inappropriate to assume that the cohort of participants in India would be the same as those in previous studies done in the US. Social, economic, and cultural difference are main influences for both cohorts, therefore it would be unrealistic to expect similar responses if the research was also conducted in the US. As an aspiring physician, it is important to be aware of health concerns that affect the world as a whole, not just of the region in which one resides; it is important to understand that global health is the key to the evolution and better understanding of medicine. Medicine is field that invites those who are compassionate and willing to investigate, a field that allows for there to be endless questioning, and a field that invites trial and error. Although there is no cure for HIV yet, there has been development of many medications in order to manage the symptoms that patients experience, despite there being various strands of HIV, these medications have changed lives; HIV management in todays day and age is a product of the collective effort of individuals who have questioned this virus and its mechanisms. Not only is medical management important in moving forward with the initiatives to combat HIV, but also psychological management and education on the matter, which is why this would be the area of focus of the research. Some challenges that I may face during the course of this research would be the social stigmas of HIV prenatal screening, the language and cultural barrier, and recruiting HIV positive participants who are willing to proceed with the interview process.
Works Cited:
Brown, H., Vallabhaneni, S., Solomon, S., Mothi, S., McGarvey, S., Jackson, T., et al. (2001). Attitudes towards prenatal HIV testing and treatment among pregnant women in southern india. International Journal of STD & AIDS, 12(6), 390-394.
Gwinn, M., Pappaioanou, M., George, J. R., Hannon, W. H., Wasser, S. C., Redus, M. A., & Curran, J. W. (1991). Prevalence of HIV Infection in Childbearing Women in the United States. JAMA: Journal Of The American Medical Association, 265(13), 1704.
Mothi, S., Lala, M., & Tappuni, A. (2016). HIV/ AIDS in women and children in India. Oral Diseases, 2219-24.
Rogers, A., Meundi, A., Amma, A., Rao, A., Shetty, P., Antony, J., & ... Shetty, A. K. (2006). HIV-Related Knowledge, Attitudes, Perceived Benefits, and Risks of HIV Testing Among Pregnant Women in Rural Southern India. AIDS Patient Care & Stds, 20(11), 803-811.
Ross, C. (2015). Screening for human immunodeficiency virus and other sexually transmitted diseases among U.S. women with prenatal care. Obstetrics and Gynecology (New York.1953), 125(5), 1211; 1211-1216; 1216.
U.S. Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau. Child Health USA 2013. Rockville, Maryland: U.S. Department of Health and Human Services, 2013.
Women and HIV/AIDS in the United States. (2014).