2^nd International Conference on
Worldwide Infectious Diseases

Biography:

Abstract:

Introduction: HIV epidemic in India is concentrated. Surveillance data shows that with high prevalence of HIV is among High Risk Groups. High risk groups include paid sex work by females, homosexuals, injecting drug users and transgender.  Moderate prevalence of HIV is among bridge population which includes single male migrants and long distance truckers. Low prevalence of HIV is among general population.  The pregnant women are proxy for general population. The drivers of the epidemic includes unprotected paid sex with Female Sex Workers (FSW), unprotected anal sex between Men who have Sex with Men (MSM) and Hijra/transgender (H/TG) people and Injecting Drug Use (IDU). Based on these transmission dynamics, India’s HIV epidemic pattern is monitored among the high-risk groups, bridge populations as well as the general population. Sentinel surveillance is being undertaken in India annually since 1998 to assess trends of HIV infection, estimate the HIV prevalence and disease burden. Based on these transmission dynamics, India’s HIV epidemic pattern is monitored among the high-risk Groups, bridge populations as well as the general population. India is committed to end HIV/AIDS as public threat by 2030.

 

Objective of the study is to determine plausible factors for declining trends of HIV infection of India among general population, bridge population and high risk groups.

Methodology: The study is based on secondary sources of information from National Family Health Surveys of various rounds and HIV sentinel Surveillance reports, which are available in public Domain

Findings: 15^th  round of HIV sentinel surveillance shows that the estimate of HIV prevalence of general population is 0.28%, (95%CI: 0.26-0.29), 0.51% (95 CI: 0.34-0.68) among single male migrants (SMM), 0.86%(95% CI: 0.64-1.07) among long distance truckers (LDT), 1.56% (95% CI: 1.46-1.66) among FSW, 2.69% (95% CI: 2.47-2.91) among MSM, 3.14% (95% CI:2.61-3.66) among H/TG and 6.26% (95% CI: 5.92-6.59) among IDUs. Over the years, there has been decline of HIV prevalence of general population and high risk group; however, the trend appeared to be stable at a high level among IDUs. Trends among different population groups at national are derived using moving average method at sites consistent since 2003-07. At the national level, trends continue to be declining among ANC

clinic attendees from 0.8% in 2003  to 0,28% in 2017 , FSW  from 10.33% in 2003 to 1,56% in 2017 and MSM from 8.47% to 2.69% during the same period; while the trend appeared to be stable after 2006 at high level I,e,, 6.92% in 2006 to 6.26% in 2017 among IDUs. In India, HIV epidemic continues to be heterogeneous, with varied levels of HIV prevalence by location and population. Each state has a different dynamics of epidemic .In the high prevalence states located in southern and western part of India among FSW, MSM and H/TG indicates an epidemic primarily driven through unprotected sexual intercourse while in many of the north-eastern states, high prevalence among IDU, FSW and MSM, as well as in ANC populations, indicates an epidemic fuelled by multiple, possibly interrelated, risk behaviours. Prevalence of HIV among migrants and truckers is 2- 3 times higher than that of ANC clinic attendees, giving weight to the hypothesis that migration is playing an important role in the high outmigration States.

 

With robust monitoring system developed in the country to prevent and sustained intervention planning and implementation helped in declining HIV prevalence in the country. Mass media program in the country through electronic and print media, educating the people about HIV infection and methods of prevention. However, one of the major challenges of the HIV prevention program in India is the ignorance and denial of HIV risk. Study shows that to obtain information on HIV testing, all respondents were asked whether they had ever been tested for HIV/AIDS. Study indicates that only 10% of respondents had ever been tested for HIV.

 

Conclusion: India is committed to the goal of “End of AIDS” as a public health threat by 2030. While the programme has been hugely successful in the past, the current challenge is to understand the diversity of this HIV epidemic, having complex and multiple drivers and therefore require a multi dimensional approach. It requires strengthened prevention programmes among high risk populations and their clients like migrants and truck drivers with high-risk behaviour, as well as among spouses/partners of these populations. Epidemiological findings need to be taken into consideration for tailoring the national programme’s responses and treatment must be complemented.