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HIV / AIDS EPIDEMIC IN INDIA

HIV / AIDS EPIDEMIC IN INDIA. Lt Col HS Ratti, MD (PSM), DNB. HIV/AIDS Global Pandemic: End 2002. Number of people living with HIV/AIDS 42 million People newly infected with HIV in 2002 5 million AIDS deaths in 2002 3.1 million. First Cluster. 4.57 m. 70. 5%. 1992 1.7 m cases.

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HIV / AIDS EPIDEMIC IN INDIA

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  1. HIV / AIDS EPIDEMIC IN INDIA Lt Col HS Ratti, MD (PSM), DNB

  2. HIV/AIDS Global Pandemic: End 2002 Number of people living with HIV/AIDS 42 millionPeople newly infected with HIV in 2002 5 millionAIDS deaths in 2002 3.1 million First Cluster 4.57 m 70 5% 1992 1.7 m cases 16,000 new HIV infections a day 95% infections in developing countries 20% infections in SE Asia mostly from India

  3. HIV EPIDEMIC: 1986 - 2002 1986 1990 1994 HIV Prevalence reaches over 5% amongst high risk group in Maharashtra and Manipur 1.74 m infected First case of HIV detected in Chennai 4.58 m. Indians living with HIV 1998 2001 2002 3.5 m. infected 3.97 m. infected 4.58 m. infected > 1 % antenatal women > 5 % high risk groups < 5 % high risk groups

  4. HIV Estimates: India

  5. Modes of Transmission

  6. HIV subtypes in regions of India

  7. Modes of Transmission of HIV • Blood • Sexual Activities • Mother to child

  8. Probable Sources of Transmission in AIDS Cases in India

  9. DYNAMICS OF HIV TRANSMISSION Risk Group Population General Population General Population Bridging Population

  10. B.S.S. - 2001 Knowledge on Modes of Prevention Figures in percentage Base = all respondents

  11. Reported Non Regular Sex Partners Overall - 6.6 %

  12. Condom use in last sex with non-regular partner Overall- 49.3 %

  13. Factors that make India vulnerable • Organised commercial sex & casual sex with non-regular sex partners • Migration & cross-border movement • Approx.100 million people migrate per year • Rural to urban migration • Inter-State migration • Sociocultural beliefs & practices • 26.1% below poverty line • 65% literate • Males : 75.8% • Females : 54.2% • High Prevalence of RTIs / STDs 17

  14. Determinants of Transmission From an Infected Person • Duration of infection/stage of disease • Risk of transmission per sexual act • Presence/absence of concurrent STD infection • Condom use • Partner exchange rate • - Mixing pattern • - Concurrent partners vs. serial monogamy • - Patterns of sexual behaviour

  15. Factors Promoting Sexual Transmission • Rate of partner exchange • Multiple concurrent partners vs. serial monogamy • Sexual mixing patterns • Sexual practices(vaginal, anal. Etc.) • Condom use • Willingness to reduce partners/ delay intercourse

  16. Intervention Issues for India • Effective surveillance (geographic, risk group and HIV subtype) • Reduction of stigmatization • Prevention of transmission from risk groups • Prevention of transmission from husbands to wives • Appropriate strategies for prevention of transmission from mother to infant • - Infrastructure for identifying and treating HIV infected pregnant women • - Treating the infant during peripartum and nursing Cont…

  17. Strategies to Prevent HIV Infection and AIDS • Blood • - Reduce use of whole blood • - Screening of blood donors • - Screening of blood donation • - Processing of blood products • - Institutionalization of routine safety procedures for health workers and biomedical laboratory technicians Cont…

  18. Commercial Sex workers • - Education on risk activities • - Use of condoms • - Persuasion of brothel owners/ managers • - Regular screening and effective treatment for STDs • - Regular testing for HIV • - Legalization and regulation of sex workers Cont…

  19. Injecting Drug Users • - Reduce needle sharing • - Use of bleach or boiling • - Needle exchange programs • - Methadone clinics • - Health education/behavioural intervention for intravenous drug users • - Improve access to testing Cont…

  20. Mother to infant • - Screening of women in high-risk groups • - Pre-pregnancy testing • - Routine screening of pregnant women • - Counseling and abortion • - Antiretroviral treatment –prenatal • - PCR/isolation/IgA screening of infants • - Post-natal treatment, including during breast feeding • - Education • - Breast feeding only if no access to clean formula • - Screening and effective treatment of STDs Cont…

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