The prevalence of HIV in Mumbai is much higher than government estimates, data from random screening camps has indicated. The Mumbai District AIDS Control Society (MDACS) tested the blood samples of 12,000 people across five railway stations in the city, of which 88 tested positive for HIV. This indicates that the HIV rate in Mumbai is 0.73, as opposed to National AIDS Control Organisation (NACO) estimates of 0.22 per cent.
Further tests found that more than 70 people had confirmed HIV, officials said. Those who tested positive were not aware they were infected, officials said.
90:90:90 target for country with highest HIV burden
In 2014, the United Nations Programme on HIV/AIDS and partner countries announced an ambitious 90:90:90 target to reduce the HIV epidemic. The 90:90:90 target means that by 2020, 90 per cent of those infected with HIV should know their HIV status. Of those with HIV, 90 per cent must be on treatment and 90 per cent of those on treatment must show suppression of virus. India has the largest HIV burden in the world and it has a high dropout rate among patients. In 2017, there were 69,000 AIDS-related deaths in India.
HIV prevalence is usually higher among sex workers, transgenders, homosexual men, injectable drug users and those who practice unsafe sex. “But this survey shows that even the general population is at risk and suffers from HIV. None of those who tested positive knew he or she was infected with the virus,” said Dr Shrikala Acharya, project director at MDACS. Most who gave their blood samples at railway stations were daily commuters heading for work.
The five screening camps were held for a week to generate awareness on ‘know your status’ of HIV.The blood samples underwent a rapid antibody test that gives results in a half hour. At least 88 tested positive. These samples underwent an enzyme-linked immunosorbent assay (ELISA) test that found more than 70 confirmed HIV cases. MDACS officials said these patients were linked with government treatment centres.
Mumbai has at least 38,254 HIV patients who are undergoing antiretroviral treatment (ART). Of these, at least 472 are sex workers. With 3.29 lakh people with HIV, Maharashtra has the highest HIV infected population in India. The state has a prevalence rate of 0.33 per cent.
The fresh survey in Dadar, Andheri, Kurla, Borivali and Ghatkopar stations is a warning for Mumbai to aggressively tackle HIV diagnosis and treatment protocol if it hopes to reach the 90:90:90 target set by the government and UN Aids for 2020.
In Mumbai, 83.7 per cent of those diagnosed are under treatment. Viral testing has only been conducted for 15,000 patients and 84 per cent have shown viral suppression. NACO has tied up with the Metropolis laboratory to screen all patients in a phased manner. A new facility for viral testing is also being set up at KEM and JJ hospitals, along with the existing facility at Kasturba Hospital.
“How do we ensure 90 per cent of the infected population knows its HIV status when we ourselves are not sure of the estimated pool?” asked an official from NACO. “In general population, people only come for an HIV test once they show symptoms. These camps were an eye opener for several people. Anyone involved in unsafe sex should test for HIV,” said Dr Padmaja Keskar, executive health officer in BMC.
Across India, an estimated 21.4 lakh suffer from HIV infection. The states of Mizoram, Manipur and Nagaland have the highest estimated rate of HIV infection.
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