indian scenario of hiv/aids dr. a. k. gupta md (pediatrics) additional project director delhi state...

Indian Scenario of HIV/AIDS

Dr. A. K. Gupta MD (Pediatrics)Additional Project Director

Delhi State AIDS Control Society

HIV Epidemic in India

Country Profile:• Low HIV prevalence (0.31%)• Nearly 2.3 million people infected by HIV (7.2% of Global burden)- India

carries the largest burden of HIV behind South Africa and Nigeria. • HIV Transmission predominantly through heterosexual route (87%)• Heterogeneous epidemic • A wide variation in HIV prevalence between states, districts and intra

districts even within the states • Concentrated Epidemic focused in HRGs (FSWs, MSMs, IDUs) :

High Risk Groups (2008 HSS) Female Sex Workers (4.77%) Men who have sex with men (6.9%) Injecting Drug users (9.86%)

BridgePopulations (2008 HSS)▪ Migrants (2.3%)▪ Truckers (1.48%)

Trend Analysis of HIV prevalence HSS 2003-2008, India

IDU

MSM

FSW

STD

ANC

Preliminary Results of the 2008-09 HSS

Declining Trends of HIV Epidemic in India (2004 – 2009)

Female: 38.7% of PLHA; Children: 4.4% of PLHA

Source: HIV Estimations, 2008-09

2005-06 2006-07 2007-08 2008-09 2009-10 2010-110

2000000

4000000

6000000

8000000

10000000

12000000

0

50000

100000

150000

200000

250000

300000

350000

1304885

21091552715812

5618013

8263420

9545232

141992

202485194504

280244298957 284257

GC Tested GC Positives

Consistently Declining ICTC Positivity Rate (2005-2010), India

10.8%9.6%

7.16%

4.98%

3.61%

2.98%

% positive

Pondichery

Gujarat

Karnataka

Goa

Lakshwadeep

Dadra Nagar HaveliMaharashtra

Madhya Pradesh

Kerala

Tamil Nadu

Andhra Pradesh

Punjab

Rajasthan

Daman & Diu

J & K

Haryana

Uttar Pradesh

Himachal Pradesh

Delhi

Chandigarh

Bihar

West Bengal

Orissa

Andaman & Nicobar

Mizoram

Meghalaya

Assam

Sikkim

Manipur

Tripura

Arunachal Pradesh

Nagaland

HIV/AIDS Epidemic in India-2008

>1%in Antenatal mothers

>5% in High Risk Groups

<5% in High risk groups

Total:2.3 million

Distribution of PLHAs by States (2007)

A.P

M

KW.B.

T.N

G

Categorization of DistrictsCategory of 609 Districts

A More than 1% ANC/PPTCT prevalence in district in any time in any of the sites in the last 3 years

B Less than 1% ANC/PPTCT prevalence in all the sites during last 3 years Associated with More than 5% prevalence in any HRG group (STD/CSW/MSM/IDU)

C Less than 1% in ANC prevalence and Less than 5% in all STD clinic attendees or any HRG WITH KNOWN HOT SPOTS (Migrants, Truckers, Large aggregation of, Factory workers, Tourist etc)

D Less than 1% in ANC prevalence in all sites during last 3 years with Less than 5% in all STD clinic attendees or any HRG OR No or Poor HIV Data With No Known Hot Spots/Unknown

Districts by category:

A – 156

B – 39

C – 296

D – 118

A+B= 195 (32%) districts