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Contributing factors to the epidemic are discussed and suggestions made for its management.
HIV infection in India was first detected in 1986 among female sex workers in Chennai.1 Today, with an estimated 5.134 million infections,2 India is home to the second largest population of people living with HIV and AIDS (PLHA). This article describes the state of the epidemic in India, the main contributing factors, and suggestions for changes that should be made in the management of the epidemic.
The executive director of the Global Fund for AIDS, TB and Malaria, suggested that in 2004, India overtook South Africa in having the largest number of people living with HIV/AIDS in the world.3 The true prevalence of HIV in India is still debatable. Some of the available estimates of incidence have been carried out among sex workers in Maharashtra (22.1 per 100 person years) and drug users in Chennai (4.53%).4,5 There is an urgent need for more studies estimating incidence of HIV in India. The case reporting system for HIV in the country requires improvement as sentinel surveillance has detected HIV in states that had not reported any infections.
AT RISK POPULATIONS
Although the epidemic was initially described among sex workers, the prevalence of HIV among sex workers has more or less stabilised6 because of targeted interventions, increased condom use, and empowerment strategies that encourage sex workers to demand safe sex from clients. Meanwhile, housewives with single partners are gradually accounting for a larger proportion of infections.7,8 These monogamous women are primarily put at risk by the extramarital sexual behaviour of their husband, from whom their infection is most probably acquired. The housewife is becoming the new face of the epidemic in India; a trend that necessitates research on microbicides and other female controlled HIV/STD prevention …