Saturday, 31 December 2011

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HIV prevalence down in high-risk states, but up in low-risk ones

NACO's latest sentinel survey and estimation figures show slightly lower HIV prevalence in high-prevalence states, new pockets of the epidemic among IDUs and MSM, and an increase in HIV prevalence in states like Delhi, Bihar and West Bengal, considered to be low-prevalence states

The National AIDS Control Organisation’s (NACO’s) latest sentinel survey and estimation figures indicate a decline in adult HIV prevalence in India, from 0.37% in 2006 to 0.34% in 2007.

Overall, the number of people with HIV/AIDS in India stands at 2.31 million. It was 2.41 million in the last survey, in 2006.

At the national level, overall HIV prevalence among different population groups in 2007 continues to portray the concentrated form of the epidemic in India, with very high prevalence among high-risk groups -- injecting drug users (IDUs) (7.2%), men who have sex with men (MSM) (7.4%), female sex workers (FSWs) (5.1%) and STD clinic attendees (3.6%).

New pockets of the epidemic among injecting drug users identified during 2006 continue to show high HIV prevalence in 2007. Expanded surveillance among men who have sex with men has shown new pockets of high HIV prevalence in 2007.

States with high prevalence of HIV such as Andhra Pradesh, Maharashtra, Karnataka and Tamil Nadu have registered a drop in HIV prevalence, while Delhi, Bihar and West Bengal have registered an increase.

The survey finds a drop in HIV cases among those attending anti-natal clinics (ANCs) and among female sex workers. HIV prevalence among anti-natal clinic attendees across the country, particularly in the high-prevalence northeastern states, has witnessed a drop. There has also been a drop in HIV cases among ANC attendees in the 15-24 age-group. But in low- and moderate-prevalence states such as Gujarat, West Bengal, Orissa and Rajasthan, HIV prevalence among ANC attendees is rising.

HIV prevalence among female sex workers was very high in Maharashtra (17.91%), Manipur (13.07%), Andhra Pradesh (9.74%), Nagaland (8.91%) and Mizoram (7.25%).

Among MSM, high prevalence was recorded in Karnataka (17.6%), Andhra Pradesh (17%), Manipur (16.4%), Maharashtra (11.8%), Delhi, Goa and Gujarat.

New sites in Andhra Pradesh and Goa showed high prevalence among MSM, indicating that better detection is required. Urban areas registered much higher rates of HIV among MSM, particularly Delhi, Pune, Bangalore, Surat, Rajkot and Kolkata.

Among IDUs, 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%) have shown a high HIV prevalence of approximately 5%. Trends among IDUs are on the decline in Manipur, Nagaland and Chennai while there is a steady rise in Meghalaya, Mizoram, West Bengal, Mumbai, Kerala and Delhi.

Estimated HIV prevalence among males (0.40%) continues to be higher than among females (0.27%).

Of the total number of people living with HIV/AIDS (PLHA) in India, estimated to be 2.31 million (1.8-2.9 million), women constitute around 39% (0.9 million). Children below 15 years of age constitute 3.5% of the estimated number of PLHA.

Another observation of the survey is that where HIV interventions are visible in the community, or where they were started earlier, the results are much better, indicating a positive impact of the interventions.

The HIV sentinel surveillance is an annual exercise conducted to monitor trends and levels of the HIV epidemic among different population groups across the country. It was conducted at 1,134 sentinel sites -- 646 sites among the general population and 488 sites among high-risk populations (FSWs, MSM, IDUs, migrants and truckers). A total of 358,797 samples were tested during the survey.

Source: HIV Sentinel Surveillance and HIV Estimation in India 2007 technical brief, November 2008