Letter to the Editor Comment on HIV/AIDS Awareness among...
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Letter to the Editor Comment on (HIV/AIDS Awareness among VCT Clients: A Cross-Sectional Study from Delhi, India) Siddharudha Shivalli 1 and Soujanya Kaup 2 1 Department of Community Medicine, Yenepoya Medical College, Yenepoya University, Mangalore, Karnataka 575018, India 2 Department of Ophthalmology, Yenepoya Medical College, Yenepoya University, Mangalore, Karnataka 575018, India Correspondence should be addressed to Siddharudha Shivalli; [email protected] Received 17 October 2015; Accepted 22 October 2015 Academic Editor: Luenda Charles Copyright © 2015 S. Shivalli and S. Kaup. is is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. We read the article titled “HIV/AIDS awareness among VCT clients: a cross-sectional study from Delhi, India” by Mehra et al. [1], with curiosity. is study emphasizes the poor knowledge and prevailing misconceptions about HIV/AIDS among the clients of a VCT facility in Delhi, India. However, the following issues and concerns need to be addressed. e authors have conducted a cross-sectional analysis at the VCT facility of a tertiary care health centre situated in Delhi, India. Two hundred consecutive clients who were ≥18 years of age and consenting for participation were included. However, the following should have been mentioned: How was the sample size calculated? When VCT monthly atten- dance is 1100, do 200 consecutive clients represent the VCT clients attending the study setting? Study sample adequacy and representativeness are the prerequisites to ensure the internal validity of the study findings. Hence, authors should have calculated the sample size based on the published literature or hypothesis and, instead of consecutive clients, systematic random sampling (e.g., every fiſth VCT client) should have been adopted. VCT centre [now renamed as Integrated Counseling and Testing Centre (ICTC)] is a place where a person is counseled and tested for HIV, of his own free will or as advised by a medical provider [2]. However, it is not the mandate of a VCT centre to counsel and test everyone in the general population [2]. But the authors mention that 31.5% of the VCT clients had never heard of HIV/AIDS. If they had never heard of HIV/AIDS, then how come they were in VCT for HIV/AIDS Counseling and Testing? Whom did the authors consider as a “VCT client”? In Table 5 of the study by Mehra et al. [1], chi-square ( 2 ) calculation for age and education is questionable as the sample size in “unaware” categories was very small. How many cells had an expected count less than 5? Did the authors consider Yates’s correction or any other apt correction for chi-square ( 2 )? Authors should have clearly addressed this in Materials and Methods. Authors could have reduced the degree of freedom by logically clubbing the age and education subgroups. e authors conclude that a significant proportion of Indian population is unaware of HIV/AIDS to the extent that they have not even heard of it and the prevalence of misconceptions regarding HIV transmission is also high in the Indian population. However, VCT clients do not represent the general population and extrapolating the findings of single VCT centre based study to Indian population is highly questionable [3]. In fact, authors should have stated it as a limitation. Nonetheless, we must applaud the authors for investigat- ing an important public health problem. Conflict of Interests e authors declare that there is no conflict of interests about the publication of this paper. Hindawi Publishing Corporation BioMed Research International Volume 2015, Article ID 649426, 2 pages http://dx.doi.org/10.1155/2015/649426
Transcript of Letter to the Editor Comment on HIV/AIDS Awareness among...
Letter to the EditorComment on (HIV/AIDS Awareness among VCT Clients:A Cross-Sectional Study from Delhi, India)
Siddharudha Shivalli1 and Soujanya Kaup2
1Department of Community Medicine, Yenepoya Medical College, Yenepoya University, Mangalore, Karnataka 575018, India2Department of Ophthalmology, Yenepoya Medical College, Yenepoya University, Mangalore, Karnataka 575018, India
Correspondence should be addressed to Siddharudha Shivalli; [email protected]
Received 17 October 2015; Accepted 22 October 2015
Academic Editor: Luenda Charles
Copyright © 2015 S. Shivalli and S. Kaup. This is an open access article distributed under the Creative Commons AttributionLicense, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properlycited.
We read the article titled “HIV/AIDS awareness among VCTclients: a cross-sectional study from Delhi, India” by Mehraet al. [1], with curiosity. This study emphasizes the poorknowledge and prevailing misconceptions about HIV/AIDSamong the clients of a VCT facility in Delhi, India. However,the following issues and concerns need to be addressed.
The authors have conducted a cross-sectional analysis atthe VCT facility of a tertiary care health centre situated inDelhi, India. Two hundred consecutive clients who were ≥18years of age and consenting for participation were included.However, the following should have been mentioned: Howwas the sample size calculated? When VCT monthly atten-dance is 1100, do 200 consecutive clients represent the VCTclients attending the study setting? Study sample adequacyand representativeness are the prerequisites to ensure theinternal validity of the study findings. Hence, authors shouldhave calculated the sample size based on the publishedliterature or hypothesis and, instead of consecutive clients,systematic random sampling (e.g., every fifth VCT client)should have been adopted.
VCT centre [now renamed as Integrated Counseling andTesting Centre (ICTC)] is a place where a person is counseledand tested for HIV, of his own free will or as advised by amedical provider [2]. However, it is not themandate of a VCTcentre to counsel and test everyone in the general population[2]. But the authors mention that 31.5% of the VCT clientshad never heard of HIV/AIDS. If they had never heard ofHIV/AIDS, then how come they were in VCT for HIV/AIDS
Counseling and Testing? Whom did the authors consider asa “VCT client”?
In Table 5 of the study by Mehra et al. [1], chi-square(𝜒2) calculation for age and education is questionable as thesample size in “unaware” categories was very small. Howmany cells had an expected count less than 5? Did the authorsconsider Yates’s correction or any other apt correction forchi-square (𝜒2)? Authors should have clearly addressed thisin Materials and Methods. Authors could have reduced thedegree of freedomby logically clubbing the age and educationsubgroups.
The authors conclude that a significant proportion ofIndian population is unaware of HIV/AIDS to the extentthat they have not even heard of it and the prevalence ofmisconceptions regarding HIV transmission is also high inthe Indian population.However,VCTclients donot representthe general population and extrapolating the findings ofsingle VCT centre based study to Indian population is highlyquestionable [3]. In fact, authors should have stated it as alimitation.
Nonetheless, we must applaud the authors for investigat-ing an important public health problem.
Conflict of Interests
The authors declare that there is no conflict of interests aboutthe publication of this paper.
Hindawi Publishing CorporationBioMed Research InternationalVolume 2015, Article ID 649426, 2 pageshttp://dx.doi.org/10.1155/2015/649426
2 BioMed Research International
References
[1] B. Mehra, S. Bhattar, P. Bhalla, and D. Rawat, “HIV/AIDSawareness among VCT clients: a cross-sectional study fromDelhi, India,” BioMed Research International, vol. 2014, ArticleID 269404, 8 pages, 2014.
[2] Naco.gov.in. NACO, National AIDS Control Organisation,Ministry of Health & Family Welfare, MoHFW, HIV/AIDS,Condom Promotion, SIMS, Blood Bank, Blood Transfusion,STI, 2015, http://naco.gov.in/NACO/National AIDS ControlProgram/Services for Prevention/Integrated Counselling andTesting ICT/.
[3] STROBE Statement, Checklists, August 2015, http://www.strobe-statement.org/index.php?id=available-checklists.
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