New Delhi, December 1
The HIV epidemic in India continues to be concentrated in high-risk groups including transgenders, injecting drug users (IDUs), men having sex with men (MSMs) and female sex workers (FSWs), who have the highest HIV prevalence rates nationally.

The latest assessment by the government on the spread of HIV epidemic reveals that nationally the HIV prevalence rate among adults (15 to 49 years) has dropped marginally from 0.31 per cent in 2009-2010 to 0.27 per cent in 2010-2011. In high risk groups, the HIV prevalence is much higher at 8.82 pc in transgenders, 7.14 pc in injecting drug users, 4.43 pc in MSMs and 2.67 pc in female sex workers.

Analysis of data by the National AIDS Control Organisation (NACO) and National Institute of Medical Statistics reveals overall decline in HIV prevalence among general populations, female sex workers and MSMs. It is stable in IDUs but transgenders are at high risk with data inadequate to interpret trends among them.

Overall HIV prevalence among female sex workers has dropped from 5.92 pc in 2009-2010 to 2.67 pc in the latest HIV Sentinnel Surveillance by NACO. Data shows that in FSWs, three states Maharashtra (6.89 pc), Andhra Pradesh (6.86 pc) and Karnataka (5.10 pc) reported more than 5 pc HIV prevalence rate. Among the low prevalence states, Bihar and West Bengal have over 5 pc HIV prevalence in FSWs — a matter of concern.

A graver concern is the growing problem of injecting drug use in Punjab which is fuelling the HIV epidemic in this high risk group.

Against the national average of 7.14 pc HIV rate in IDUs, Punjab has the highest HIV prevalence of 21.1 pc in IDUs nationally. “The trend among IDUs has been stable at the national level. Among Northe Eastern states, declining trends of HIV prevalence in IDUs are observed in Nagaland and Manipur. Rising trends at high levels are seen in Chandigarh, Punjab and Mizoram,” experts say.

Following Punjab on HIV prevalence rates in IDUs is Delhi (18.3 pc), Maharashtra (14.2 pc), Manipur (12.9 pc), Mizoram (12 pc), Chandigarh (7.2 pc), Odisha (7.2 pc), Meghalaya (6.4 pc) and MP (5.1 pc).

Expanded surveillance among MSMs has revealed more than 5 pc HIV prevalence in nine states -- Chhattisgarh, Nagaland, Manipur, Andhra, Maharashtra, MP, Karnataka, Delhi and West Bengal. The positive part is this -- since the first year of National AIDS Control Programme (NACP III) in 2007, all states have for the first time shown less than 1 per cent HIV prevalence among antenatal clinics attendees - considered a reflection of general population.