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%) Bridge Populations (2008 HSS) ▪ Migrants (2.3%) ▪ Truckers (1.48%)

Trend Analysis of HIV prevalence HSS , India IDU MSM FSW STD ANC Preliminary Results of the HSS

Declining Trends of HIV Epidemic in India (2004 – 2009) Female: 38.7% of PLHA; Children: 4.4% of PLHA Source: HIV Estimations,

Consistently Declining ICTC Positivity Rate ( ), India 10.8% 9.6% 7.16% 4.98% 3.61% 2.98% % positive

Pondichery Gujarat Karnataka Goa Lakshwadeep Dadra Nagar Haveli Maharashtra 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 K W.B. T.N G

Categorization of Districts Category 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