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India
India can be a roadmap to reduce HIV infections: expert
By IANS
Mar 30, 2006, 15:06

India's success in reducing new HIV infections in the southern region through awareness and condom-use campaigns could well serve as a roadmap for other countries, says an expert from the University of Toronto.

'There have been many predictions, mostly based on guesswork, that India's AIDS problem will explode - as it did in southern Africa - but we now have direct evidence of something positive,' says Prabhat Jha, director of the University of Toronto's department of public health sciences.

Jha is co-author of 'HIV Study in Young Adults in India', which appears Thursday in the online issue of Lancet. The Canadian government, the Bill and Melinda Gate Foundation, and the National Commission on Macroeconomics and Health have funded the study.

The study with Rajesh Kumar of the Post Graduate Institute of Medical Education and Research in Chandigarh has revealed that HIV among young women in the age group of 15 and 24 in the hot spots - Tamil Nadu, Andhra Pradesh, Maharashtra and Karnataka - appears to be declining.

The four states are estimated to account for 75 percent of the 5.1 million HIV/AIDS cases in India, which is next highest after South Africa.

'The good news is that HIV in young adults appears to be declining in the south - most likely or perhaps only due to males using sex workers less or using condoms more often,' said Jha.

'Indian experiences can serve as a roadmap on how to reduce HIV worldwide. Modest public health effort has turned around what was a worsening HIV epidemic. Globally this lesson could serve countries like China and Vietnam. In fact a large part of the world can be served to avoid the catastrophe seen in Africa,' Jha told IANS.

From a prevalence rate of 1.7 percent in 2000, it has declined to 1.1 percent in 2004, said Jha.

Overall, the HIV prevalence rate in India is 1.6 percent of the population, with a lower estimated prevalence of 0.3 percent in most other parts of the country barring the northeast, where the incidence of HIV transmission due to drug abuse continues to be a cause of worry.

Jha said the not-so-good news is that 'trends in the north remain uncertain and poorly studied.'

'North is not immune to the infection. Unless the government puts in place an effective peer intervention as has been done by the state governments of Maharashtra and Tamil Nadu in particular, there is a risk of the infection spreading in the northern region,' said Jha.

'Our study shows with condom use and awareness programmes, the country's AIDS epidemic is far from hopeless.'

The study has tracked HIV prevalence among young women attending pregnancy or antenatal clinics as also men attending sexually transmitted infection clinics in southern and northern states during 2000-2004 as an indicator of infection among young people.

Indicative of the trend among the general population, the study is based on the premise that male use of female sex workers is the main reason for the spread, which subsequently puts wives in a vulnerable position.

In recent years, the Indian government, the World Bank and other external agencies have aimed intervention and awareness programmes at the sex industry and their efforts appear to have contributed to a drastic decline.

Co-author Rajesh Kumar cautions that while the findings are good news, the battle is far from over.

'HIV remains a huge problem in India and we have to remain vigilant,' he says.

'We're not saying the epidemic is under control yet - we are saying that prevention efforts with high-risk groups thus far seem to be having an effect.'

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