| HIV According
to government estimates, the recent figures for HIV/AIDS affected
are around 3 million, whereas 8 years ago, the estimate was between
5 million to 10 million people. This is because of better surveillance
system. The number of new annual HIV infections has declined by
more than 60% during the last decade. It is estimated that India
had approximately 1.2 lakh new HIV infections in 2009, as
against 2.7 lakh in 2000.
The primary causes of HIV/AIDS are unprotected paid sex, unprotected
sex between men and intravenous drug use. Delhi, Maharashtra,
Karnataka, Tamil Nadu, Andhra Pradesh, Manipur, Nagaland have
high incidences of HIV/AIDS.
HIV/AIDS is now merely a treatable disease due to anti retroviral
drugs. It costs Rs. 1200 per month for first line anti retroviral
drugs. However government provides anti retroviral drugs free
of cost. Almost 3 lakh people receive free anti retroviral drugs
from government.
Bihar and UP have low incidence of HIV/AIDS.
Anti Retroviral drugs have made HIV/AIDS a treatable disease
rather than fatal disease. Anti Retroviral drugs cost Rs. 1200
per month. However anti retroviral can display resistance, when
second line drugs should be taken. Third line drugs should be
resorted to in case of resistance to second line drugs. Second
line drugs cost between Rs. 5000 – Rs. 15000 per month. Third
line drugs cost between Rs. 15000 and Rs.20000 per month.
Challenges
1. Government is looking for targeting intervention, especially
commercial sex workers
2. In a marriage insisting on condom is almost nearly impossible.
3. There is stigma on HIV AIDS and discrimination against people
with HIV/AIDS
4. Inadequate acknowledgement of homosexuality.
5. India is a hypocritical society that is not honest about its
sexuality.
6. Visibility of HIV/AIDS has gone down.
7. There is less fear of HIV/AIDS due to availability of anti
retrovirals. Central Government
Prioritisation
of districts for programme implementation
Actions taken by Government
The National AIDS Control Program (NACP), launched in 1992, (NACP-II
was launched in 1999) is being implemented as a comprehensive
program for prevention and control of HIV/AIDS in India. Currently
NACP-III is on.
1. Government is providing free anti retroviral drugs to substantial
number.
2. Government has acknowledged HIV/AIDS.
3. Government is promoting condom usage, which if properly used
can provide 100% protection.
4. Government has targeted interventions at high risk populations
– sex workers in particular.
5. Government supports clinics for control of HIV/AIDS.
6. Government has Red Ribbon Express for mass mobilization on
HIV/AIDS.
Advocacy to Government, Media, Political Parties
1. Government needs to move beyond targeting
2. Media should discuss HIV/AIDS more.
3. Anti retroviral drugs must be made universal.
Statistics
Estimated Adult
HIV Prevalence, 2009 (%) Estimated Number of
HIV Infections, 2009
State/UT Estimate Lower Upper Estimate Lower Upper
Andaman & NicobarIslands 0.26 0.19 0.36 395 292 536
Andhra Pradesh 0.9 0.77 1.07 4,99,620 4,24,214 5,96,011
Arunachal Pradesh 0.16 0.12 0.22 1,082 808 1,481
Assam 0.08 0.06 0.12 14,244 10,400 21,599
Bihar 0.22 0.18 0.27 1,20,470 1,00,493 1,47,676
Chandigarh 0.39 0.32 0.47 3,067 2,571 3,716
Chattisgarh 0.28 0.2 0.38 39,774 29,188 53,885
Dadra & Nagar Haveli 0.15 0.11 0.2 285 217 383
Daman & Diu 0.16 0.12 0.21 251 192 336
Delhi 0.3 0.25 0.36 34,216 28,735 41,076
Goa 0.49 0.31 0.73 5,440 3,584 8,027
Gujarat 0.37 0.3 0.55 1,36,875 1,09,952 2,00,826
Haryana 0.1 0.09 0.13 15,852 13,189 19,122
Himachal Pradesh 0.19 0.16 0.24 8,878 7,105 11,069
Jammu & Kashmir 0.08 0.06 0.11 5,403 3,971 7,444
Jharkhand 0.13 0.11 0.17 23,574 19,133 29,301
Karnataka 0.63 0.46 0.88 2,45,522 1,79,205 3,35,119
Kerala 0.19 0.15 0.24 40,060 32,654 49,352
Madhya Pradesh 0.19 0.16 0.24 84,803 69,916 1,03,540
Maharashtra 0.55 0.44 0.71 4,19,789 3,31,891 5,48,366
Manipur 1.4 1.16 1.64 26,773 22,113 32,374
Meghalaya 0.08 0.06 0.12 1,332 1,002 1,921
Mizoram 0.81 0.6 1.12 6,025 4,448 8,361
Nagaland 0.78 0.66 0.93 13,120 11,005 15,578
Orissa 0.29 0.24 0.37 71,813 58,879 90,117
Puducherry 0.28 0.22 0.36 2,254 1,768 2,860
Punjab 0.32 0.26 0.39 56,928 47,077 67,967
Rajasthan 0.19 0.16 0.23 76,316 63,998 92,466
Sikkim 0.06 0.05 0.08 231 173 296
Tamil Nadu 0.33 0.26 0.41 1,54,742 1,21,000 1,94,611
Tripura 0.15 0.1 0.21 3,425 2,381 4,845
Uttar Pradesh 0.09 0.08 0.11 1,09,352 90,199 1,37,193
Uttarakhand 0.1 0.07 0.15 5,539 3,893 8,597
West Bengal 0.29 0.24 0.35 1,67,994 1,38,348 2,06,930
India 0.31 0.25 0.39 23,95,444 19,33,994 30,42,981
Source : NACO
Year HIV Prevalence(lakhs)
2002 27.3
2003 26.7
2004 26.1
2005 25.4
2006 24.7
2007 23.1
2008 22.7
Source : NACO
Heterosexual route of transmission accounts for 87% of HIV AIDS.
Parent to child transmission leads to 5.4 % of HIV. Homosexual
route is responsible for 1.5% of infections. Injecting drug use
causes 1.6% of HIV/AIDS. Blood products are responsible for 1%
of infections.
Government targets high risk groups. Female sex workers are biggest
high risk groups – estimated at 12.63 lakh. Men having sex with
men are another high risk group at 3.5 lakh. Intravenous drug
users are estimated at 1.86 lakh. HIVAIDS infections transmit
from high risk group to normal population through bridge population.
Bridge population comprises of 80 lakh migrant workers and 30
lakh truckers.
Using globally accepted methodologies and updated evidence on
survival to HIV with and without treatment, it is estimated that
about 1.72 lakh people died of AIDS related causes in 2009 in
India.
As per national Behavioural Surveillance Survey in 2006, 2.4
percent of adult males, i.e., around 73.5 lakh adult males have
visited commercial sex worker during the year prior to the survey.
Men who buy sex, i.e., clients of sex workers are the single most
powerful driving force in India’s HIV epidemics and constitute
the largest infected population group in the country. These men
then transmit
HIV to their wives, affecting several low risk women in the society.
The overall HIV prevalence among different population groups
in 2008-09 continues to portray the concentrated epidemic in India,
with a very high prevalence among High Risk Groups – Intravenous
Drug Users (9.2%), Men who have sex with men (7.3%), Female Sex
Workers (4.9%)
Number of High Risk Group people treated
Year Number(million)
2006 0.18
2007 0.16
2008 0.63
2009 1.05
Coverage of targeted intervention
High Risk Group Estimated Population Coverage with percentage
in bracket (%)
Female Sex Workers 1,263,000 6,74,000 (53.1)
Men who have sex with Men 3,51,000 2,75,000 (78)
Intravenous Drug Users 1,86,000 1,38,000 (74)
Migrant Population 84,00,000 18,00,000 (21.4)
Truckers 24,00,000 16,00,000 (66.6)
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