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NEW DELHI: The HIV demon is loosening its grip on India. The National Aids Control Organisation (NACO)'s HIV sentinel surveillance and estimation figures indicate a decline in adult HIV prevalence in the country from 0.37% in 2006 to 0.34% in 2007. The decline was noticed particularly in high prevalence states like Andhra Pradesh, Karnataka, Tamil Nadu and Maharashtra while Delhi, Bihar and West Bengal showed an increase in numbers.
About 2.31 million people in India had HIV/Aids in 2007, down from 2.41 million in 2006. However, while the percentage of adult population affected by HIV and Aids may have dropped, India's is still the third largest in the world,the largest in Asia.
There was bad news for health minister Ambumani Ramadoss and his effort to change the law, which views homosexuality as a crime. While there was a clear decline in HIV prevalence among anti-natal clinic (ANC) attendees and female sex workers (FSW), it was found to be stable among injecting drug users (IDU) and rising among men who have sex with men (MSM).
Possible impact of interventions was noted in places where HIV was visible and interventions were started earlier, while rising trends were observed in other states.
New pockets of IDU and MSM were identified. These require cognizance and action, the report said.
The 2007 round of HIV Sentinel Surveillance (HSS) was conducted at 1134 sites across the country from October 2007 to January 2008. An overall decline in HIV prevalence among ANC attendees was noted across the country and in high-prevalence states in south and the northeast. Decline was also noted in new infections/ HIV incidence among ANC clinic attendees between 15-24 years. In low prevalence states, HIV trends among ANC attendees was found to be rising, particularly in Gujarat,Bengal, Orissa and Rajasthan.
Forty-eight sites showed more than 5% HIV prevalence among FSW. These included low prevalence states like West Bengal, Bihar and Gujarat. FSW sites in Pune, Mumbai and Thane showed over 30% HIV prevalence but a decline was noticed in the southern states.
HIV prevalence among FSWs was very high in Maharashtra (17.91%), followed by Manipur (13.07%), Andhra Pradesh (9.74%), Nagaland (8.91%) and Mizoram (7.2%). Surveillance among MSM revealed new pockets of epidemic. Among MSM, high HIV prevalence was recorded in Karnataka (17.6%), Andhra Pradesh (17.04%), Manipur (16.4%), Maharashtra (11.80%), Delhi (11.73%), Goa (7.93%) and Gujarat (8.40%).
All the new MSM sites established in Andhra Pradesh and Orissa showed high HIV prevalence, suggesting that there may be many pockets of high prevalence among MSM which need to be detected. Moreover, urban areas of the country such as Delhi, Pune, Bangalore, Surat, Rajkot and Kolkata recorded very high HIV prevalence among MSM.
Among IDU, Maharashtra (24.4%), Manipur (17.9%), Tamil Nadu (16.8%), Punjab (13.8%), Delhi (10.1%), Chandigarh (8.6%), Kerala (7.9%), West Bengal (7.8%), Mizoram (7.5%) and Orissa (7.3%) showed high HIV prevalence. Trends among IDUs were on a decline in Manipur, Nagaland and Chennai but on a steady rise in Meghalaya, Mizoram, West Bengal, Mumbai, Kerala and Delhi.
The total number of People Living with HIV/AIDS (PLHA) in India in 2007 is estimated at 2.31 million. The highest number of PLHA are in Andhra Pradesh and Maharashtra, with nearly half-a-million PLHA each. Besides Tamil Nadu and Karnataka, West Bengal, Gujarat and Uttar Pradesh are estimated to have a higher burden of the epidemic with over 0.1 million PLHA each.
The four south Indian states contribute 60% of all PLHA in the country and along with Bengal, Gujarat and UP, they contribute 80%. Though Manipur and Nagaland have the highest HIV prevalence in the country, due to small population size, the estimated number of PLHA in these two states is less than 25,000.
