HIV/AIDS in India Complex, ‘Overwhelming,’ NEJM Perspective Says
HIV/AIDS in India is complex and "overwhelming," national correspondent Robert Steinbrook writes in a New England Journal of Medicine perspective. According to Steinbrook, "whatever success" India has in controlling HIV/AIDS will "immediately have an impact on the overall world situation" because India has a large number of HIV-positive people (Steinbrook, NEJM, 3/15). According to the "2006 Report on the Global AIDS Epidemic" released in May 2006 by UNAIDS, India has the highest number of HIV-positive people in the world, with 5.7 million people living with the virus. Despite the high number of HIV-positive people in India, the country's HIV prevalence is less than 1% because of its large population (Kaiser Daily HIV/AIDS Report, 12/21/06). According to Steinbrook, the UNAIDS report has "served as a wake-up call" to India. Steinbrook writes that Sujatha Rao, director-general of India's National AIDS Control Organization, in January at a conference on HIV/AIDS treatment said, "We have come a long way from complete denial of the HIV epidemic when it was first discovered in 1986 to a complete acceptance of the fact that we have a problem." India in 2006 spent $129 million on HIV/AIDS services, with the majority of the funding from outside donors, according to Steinbrook. Six of India's 35 states and territories in 2005 recorded a high HIV prevalence; however, only 10% to 20% of HIV-positive people in the country know their status, Steinbrook writes. He adds that commercial sex workers, men who have sex with men, injection drug users and migrant workers are at a high risk of contracting HIV, and the virus also is transmitted vertically and through breast-feeding. According to Steinbrook, HIV prevention efforts in India are "hampered by gaps in knowledge and by cultural, legal and medical factors." Although India is "so populous and complex that it is easy to despair that the task of controlling HIV within its borders is hopeless and overwhelming," the country has "substantial resources" and has been successful in fighting other diseases -- such as polio, smallpox and tuberculosis -- Steinbrook says. He adds that "an effective, multifaceted response" in preventing and treating HIV/AIDS "could avert an even more catastrophic epidemic" (NEJM, 3/15).
The perspective is available online. More information about HIV/AIDS in India is available online at GlobalHealthReporting.org.