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Researchers have predicted that India will see major increases in HIV-1 prevalence. Rajesh Kumar (Post Graduate Institute of Medical Education and Research, Chandigarh, India), Prabhat Jha (University of Toronto, Canada) and colleagues investigated the prevalence of HIV-1 in young people attending antenatal and STI (sexually transmitted infection) clinics in four southern states and 14 northern states in India. The study used data from around 294 000 women and 59 000 men aged 15-34 years.

The investigators found that HIV-1 prevalence among women in the south fell from 1.7% to 1.1% from 2000 to 2004 (absolute decline 0.6%; relative decline 35%). For men aged 20-29 years attending STI clinics in the south there was an absolute reduction of 7.6% (relative reduction 36%) in HIV-1 prevalence. No significant change in HIV-1 prevalence was seen among women or men in the north. The fall in the south was seen in rural and urban areas and in educated and illiterate men. The authors conclude that the most plausible reason is increased condom use in sex work or abstinence from sex work by males.

"Strategies that focus on high coverage and quality of peer interventions of high-risk populations--with condoms, education, and negotiation skills--offer the best hope to reduce the growth of HIV-1 in India," states Dr Jha. "Such strategies are partly in place in the south, but must be extended to high coverage in each southern district. Equally important, sex-worker interventions must be replicated in the north, " he adds. (Quote by e-mail; exact version does not appear in published paper)

See also accompanying Comment.

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Contact: Joe Santangelo
j.santangelo@elsevier.com
212-633-3810
Lancet
29-Mar-2006