Moving down south

For years India8217;s southern states were known as the epicentre of HIV/AIDS in the country. But Maharashtra, Tamil Nadu, Andhra Pradesh and Karnataka are now shaking off the tag. HIV/AIDS figures in these states dipped by 35 per cent between 2000-2004.

For years India8217;s southern states were known as the epicentre of HIV/AIDS in the country. But Maharashtra, Tamil Nadu, Andhra Pradesh and Karnataka are now shaking off the tag. HIV/AIDS figures in these states dipped by 35 per cent between 2000-2004. Surprisingly, this data wasn8217;t showcased by the government; it came from the West. Reported in the British journal Lancet, the study is a collaborative effort of an Indo-Canadian team of scientists. The report says that prevalence of HIV-1 the most common variant of the virus in India fell in the southern states from 1.7 per cent to 1.1 per cent8212;a relative reduction of 35 per cent.

We all agree but8230;

UNAIDS, World Health Organisation and the Government of India all agree than an estimated 5.134 million people infected with HIV live in India8212;75 per cent of them in the southern states. The Lancet agrees on this number.

Now the southern states have some reason to be upbeat but look beyond the surface and the figures are not all that rosy. The NACO figures released for 2004 in April last year, show Andhra Pradesh as the epicentre of HIV in India. According to it, about 2.25 pregnant women attending the Ante Natal Clinics in the state, tested positive for HIV. The figures however have reached a plateau in other southern states8212;Karnataka 1.25 and Maharashtra 1.25.

There is a slight difference between the Lancet study and government figures on Tamil Nadu. According to NACO, the state has done a complete turnaround and from 1.13 percent in 2001, the prevalence percentage has gone down to 0.50.

No news is not good news

While all agree that the south8217;s developed healthcare system has much to do with its new, improved figures, there8217;s little light on the North. The data coming in from these states is questionable as they have non-existent infrastructure and practically no trained manpower. While Tamil Nadu has about 30 Ante Natal Clinics used as sentinel sites for data collection, Uttar Pradesh despite its population, has just 17 such sites. The situation is even worse in Bihar, the second most populous state in the country, which has just 7 ANC sites.

Drawing a zero

North Indian states have all the high risk factors for transmission of HIV/AIDS, but still a few of them have the distinction of having 8216;8216;no HIV prevalence8217;8217;. Leading the table is Bihar, which inspite of the high rates of migration, shows 8216;8216;zero per cent prevalence8217;8217;. Meghalaya and Sikkim are other states that have scored zero. Also on this list are Jharkhand, Haryana, Chhattisgarh and Rajasthan. Uttar Pradesh is one of the low prevalence states8212;0.25 per cent.

The government, however, has re-christened these states as 8216;8216;highly vulnerable8217;8217; since they have all the accompanying risk factors.

What does this mean?

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HIV still remains a huge problem and India just can8217;t afford to let up its vigil. The HIV/AIDS Prevention strategies need to be followed strictly. The epidemic is under control, yes8212; but the study just says that prevention efforts with high-risk groups seem to be having an effect. India needs to keep working at it.

Following HIV

raquo; The first case of HIV infection in India was diagnosed among commercial sex workers in Chennai in 1986. Soon, a number of screening centres were set up through the country.

raquo; The focus initially was on screening foreigners, especially students. Screening blood banks came next. By early 1987, efforts were on to get in place a national network of HIV screening centres in major urban areas.

raquo; A National AIDS Control Programme was launched in 1987. It covered surveillance, screening blood and blood products and health education.

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raquo; In 1992, the National AIDS Control Organization NACO was set up.

raquo; India has seen a sharp increase in the estimated number of HIV infections, from a few thousand in the early 1990s to about 5.134 million children and adults living with HIV/AIDS in 2004.

raquo; The spread of HIV within the country is as diverse as the societal patterns between its different regions, states and metropolitan areas. In fact, India8217;s epidemic is made up of a number of strains, and in some places they occur within the same state. The epidemics vary, from states with mainly heterosexual transmission of HIV, to some states where injecting drug use is the main route of HIV transmission.

raquo; Globally India is second only to South Africa 5.4 million in terms of overall number of people living with HIV.

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raquo; Although the HIV prevalence rate in India is low 0.9 per cent, the overall number of people with HIV infection is very high according to estimates by UNAIDS. This is simply because India8217;s population is so large that even a small percentage of it translates into large numbers. So, even a mere 0.1 per cent increase in the prevalence rate would increase the number of adults living with HIV/AIDS by over half a million people. The percentage of people living with HIV is the highest in Botswana: a frightening 37.3.

raquo; In 2001 the number of HIV/AIDS orphans was an estimated at 1.2 million.

raquo; There are a number of states where the HIV prevalence in antenatal women is 1 per cent or more, and these are considered to be high prevalence states8212;Karnataka, Tamil Nadu, Andhra Pradesh, Goa, Maharashtra and Manipur.