Health

First the good news: estimates of HIV prevalence in India have halved. The bad news is that between 2 and 3.1 million Indians are infected with HIV. Not quite the 5.7 million estimated before, but still a hefty burden.

"While it's good news that the total number of HIV infections is lower than previously thought, we can't be complacent," says Naresh Dayal, chairman of India's National AIDS Control Board.

Released in New Delhi on 6 July by the National AIDS Control Organization (NACO), the new figures show that HIV affects about 0.36 per cent of India's 1 billion citizens. This compares well with the previous estimate of 0.9 per cent, which was based on data from around 700 "sentinel sites", such as antenatal clinics, sexually transmitted disease clinics and centres used by intravenous drug users and other groups at extra risk of infection.

The new estimate was calculated using data from an expanded network of 1100 sentinel sites, a national health survey of 100,000 individuals, and a behavioural study that looked at HIV transmission among high-risk groups.

Armed with the more accurate figure, NACO has launched a new HIV/AIDS control plan to target treatment and prevention efforts more effectively. At present, antiretroviral treatments are only reaching 10 to 15 per cent of those who need them, for example.

"From the sentinel site data, they've identified about 20 HIV 'hotspots' previously thought to be low-prevalence areas," says Peter Ghys of UNAIDS. For example, the southern state of Andhra Pradesh has now been identified as having almost one-fifth of the country's HIV cases, despite making up just 5 per cent of the population. "Now they can target resources with more precision," says Ghys.

The figures also show that in some high-burden areas, such as Tamil Nadu in the south, HIV prevalence has begun to stabilise or decline.

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