Magnitude of HIV/AIDS in India - Overview of HIV/AIDS in India

According to the last year's estimates, India had 5.206 million HIV/AIDS patients (people aged between 15 and 49 years) in 2005. The UNAIDS later put it at 5.7 million, including the pediatric AIDS cases. For the first time, National Family Health Survey (NFHS), India's largest health survey, had specific questions on AIDS in its door-to-door survey conducted on 230,000 people. [7] The number of sentinel sites had gone up to 1,122 from 702. [7] Both sentinel site and NFHS data were integrated and a new internationally validated methodology was used to arrive at the new estimate. These new estimates released by the National AIDS Control Organization (NACO), supported by UNAIDS and WHO, indicate that national adult HIV prevalence in India is approximately 0.36%, which corresponds to an estimated 2.0-3.1 million people living with HIV in the country. [6] The new lower estimates do not mean a sharp decline in the epidemic.

In Tamil Nadu and other southern states with high HIV burden, where effective interventions have been in place for several years, HIV prevalence has begun to decline or stabilize. The 2006 surveillance data [Table - 2] has identified selected pockets of high prevalence in the northern states. There are 29 districts with high prevalence, particularly in the states of West Bengal, Orissa, Rajasthan and Bihar. [8] India's highest prevalence of HIV/AIDS cases has been observed in the Dharwad district of Karnataka.

Feminization of the HIV/AIDS epidemic

The HIV/AIDS epidemic is increasingly affecting women and young girls, especially where heterosexual sex is the main mode of transmission. [9] Out of the estimated adults living with HIV, 38.4% were females. [10] Women are less educated, more overworked, underpaid and financially dependent on men. They fail to make use of protective measures (condoms) which are male driven, and also they lack the power to negotiate with their partner. Ironically, they are faithful but are infected by their single partner.

The greatest boon of nature to women is the capacity to conceive, and the greatest curse is her inability to control the same.

Trend of HIV prevalence among different population groups in India

The vast majority of infections occur through heterosexual sex, and most of those who become infected would not fall into the category of high-risk groups [Figure - 1]. HIV prevalence was >1% among antenatal mothers in 95 districts, including 9 districts in the low-prevalence states. Similarly, HIV prevalence was >10% in 34 STD sites across the country, indicating multiple heterogeneous epidemics. Year-wise trend of HIV prevalence in different population groups is shown in [Figure - 2]. [10]

The HIV/AIDS situation in different states[11]

The vast size of India makes it difficult to examine the effects of HIV on the country as a whole. The HIV prevalence data for each state [Figure - 3] is established through antenatal clinics, where pregnant women are tested. The following states have recorded the highest levels of HIV prevalence at antenatal and sexually transmitted disease (STD) clinics over recent years.