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India has had a sharp increase in the estimated number of HIV infections, from a few thousand in the early 1990s to around 5.1 million children and adults living with HIV-AIDS in 2003.1 With a population of over one billion, the HIV epidemics in India will have a major impact on the overall spread of HIV in Asia and the Pacific and indeed worldwide.
The spread of HIV within the country is as diverse as the societal patterns between its different regions, states and metropolitan areas. In fact, India's epidemic is made up of a number of epidemics, and in some places they occur within the same state. The epidemics vary from states with mainly heteroloveual transmission of HIV, to some states where injecting drug use is the main route of HIV transmission. Both tracking the epidemic and implementing effective programs poses a serious challenge to the authorities and communities in India.
It would be easy to underestimate the challenge of HIV-AIDS in India. India has a large population and population density, low literacy levels and consequently low levels of awareness, and HIV-AIDS is one of the most challenging public health problems ever faced by the country.2
"How do you talk to about HIV-AIDS to someone who does not know the basics about health and hygiene?" - Ratna Gaekwad, an outreach coordinator with the Delhi NGO Prayatna.3
The Early Years of the Response to HIV-AIDS in India The first case of HIV infection in India was diagnosed among commercial love workers in Chennai, Tamil Nadu, in 1986. Soon after, a number of screening centres were established throughout the country. Initially the focus was on screening foreigners, especially foreign students. Gradually, the focus moved on to screening blood banks. By early 1987, efforts were made up to set up a national network of HIV screening centres in major urban areas.4
A National AIDS Control Programme was launched in 1987 with the program activities covering surveillance, screening blood and blood products and health education. In 1992 the National AIDS Control Organization (NACO) was established.5 NACO carries out India's National AIDS Programme, which includes the formulation of policy, prevention and control programmes.
The same year that NACO was established, the Government launched a Strategic Plan for HIV-AIDS prevention under the National AIDS Control Project.6 The Project established the administrative and technical basis for programme management and also set up State AIDS bodies in 25 states and 7 union territories. The Project was able to make a number of important improvements in HIV prevention such as improving blood safety.7
MOTHER TERESA: WHERE ARE HER MILLIONSForwarded message The Following Feature Appeared in Germany's STERN magazine on September 10, 1998 on occasion on Mother Teresa's first rest anniversary. It is...
Number of people affected by HIV-AIDS in India Current Estimates & Future Projections Globally India is second only to South Africa in terms of the overall number of people living with the disease.8
NACO estimated that there the number of Indians living with HIV increased by 500,000 in 2003 to 5.1 million. Around 38 percent of these people were women.
By the end of May 2005, the total number of AIDS cases reported in India was 109,349 of whom 31,982 were women. These data also indicated that 37% of reported AIDS cases were diagnosed among people under 30. Many more AIDS cases go unreported.
The UN Population Division projects that India's adult HIV prevalence will peak at 1.9% in 2019. The UN estimates there were 2.7 million AIDS rests in India between 1980 and 2000. During 2000-15, the UN has projected 12.3 million AIDS rests and 49.5 million rests during 2015-50.9
A 2002 report by the CIA's National Intelligence Council predicted 20 million to 25 million AIDS cases in India by 2010, more than any other country in the world.10 HIV-AIDS surveillance The number of HIV infections in India is difficult to determine. India's prevalence estimates are based solely on sentinel surveillance conducted at public sites. The country has no national information system to collect HIV testing information from the private sector, which provides 80% of health care in the country.
Although the HIV prevalence rate is low (0.9%), the overall number of people with HIV infection is very high according to estimates by UNAIDS. Given India's large population, with most of the Indian states having a population greater than a majority of the countries in Africa, a mere 0.1 percent increase in the prevalence rate would increase the number of adults living with HIV-AIDS by over half a million people.11
HIV-AIDS orphans Obtaining data on the number of children orphaned by AIDS is difficult. It is believed that the proportion of children in India orphaned by AIDS is far lower than in sub-Saharan Africa but because of India's huge population the actual number of children already orphaned by AIDS is very high. In 2001 the number of orphaned children was already estimated at 1.2 million.12
Although children are not yet being orphaned by HIV-AIDS on a large scale in most cities, studies have shown that the problem of orphans in some urban slum areas of India is already severe.13
The HIV-AIDS situation in different states There are a number of states where the HIV prevalence in antenatal women is 1% or more, and these are considered to be high prevalence states. The prevalence rates are from data collected during screening of women attending antenatal clinics (ANC), meaning that these prevalence rates are only relevant to loveually active women. However, these rates can provide a reasonable estimate of HIV prevalence within the general population in each state.14
Andhra Pradesh Andhra Pradesh has one of the fastest increasing HIV-AIDS prevalence rates in India. In 2002 the ANC prevalence rate was 1.25% and NACO estimated that more than 400,000 people were living with HIV in Andhra Pradesh, the second highest number after Maharashtra state. This is 10% of the total HIV cases in India and ninety percent of the infections in the state occur through loveual transmission.15 Andhra Pradesh is a Hindu state in the southeast of the country with a total population of 75.7 million.
Goa Goa is in the southwest of India and is best known as a tourist destination. and tourism is so prominent that the number of tourists almost equals the population of the state which is 1.34 million. HIV infections have increased noticeably in Goa in the past couple of years. The ANC prevalence rate increased from 0.5% in 2001 to 1.38% in 2002.
Karnataka In Karnataka the mean prevalence among ANCs was 1.13 in 2001 and 1.75 percent in 2002. In 2001 there were four districts with an ANC prevalence of 2 percent or more, and these are located in the southern part of the state, in and around Bangalore, on the border with Tamil Nadu, or in northern Karnataka's "devadasi belt." Devadasi women are a group of women, who historically, have been dedicated to the service of gods. These days, this has evolved into sanctioned prosbreastution- as a result many women from this part of the country are supplied to the love trade in big cities such as Mumbai.16 Karnataka has a population of 52.7 million and is a diverse state in the southwest of India.
Maharashtra & Mumbai Mumbai (plantay) is the capital city of Maharasthra state and is the second most populated city in India with a population of 16.4 million people. Maharastra is a very large state of three hundred thousand square kilometres and it has a total population of 96.8 million. The 2002 ANC prevalence rate for the state of Maharasthra was 1.25% and the prevalence for the city of Mumbai 0.75%.
Manipur Manipur, a small state of 2.4 million people in the north east of India, has the highest concentration of HIV-AIDS infection in India. The geographical nearness of Manipur to Burma and therefore to the Golden Triangle drug trail, has made it a major transit route for drug smuggling, with drugs easily available. However, the transmission route of HIV-AIDS in the state is no longer confined to injecting drug users. It has spread further to the female loveual partners of IDUs and their children.17 The ANC prevalence in Manipur in 2002 was 1.12% and among injecting drug users at three surveillance sites the HIV prevalence was an extremely high 39.06%.
THE SAGA OF ISLAMIC ATROCITIES IN AHMEDABAD SummaryMarch 16, 2002" 2002, what should we remember? I have great admiration for Hinduism. Historically, Hinduism had been the most tolerant and peaceful faith. The pracbreastioners of Hinduism were never aggressive...
In some parts of India, particularly the states that are reporting the higher prevalence, the tipping point is long past. I think there is absolutely no doubt that the virus is moving into the general population." - Dr. R. Feachem, executive director of the Global Fund to Fight AIDS, Tuberculosis & Malaria.
"gradually spreading into rural areas and the general population."
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