The study, which appears online in the Lancet's March 30 issue, tracked HIV prevalence among young women attending pregnancy or antenatal clinics in India's southern and northern states. Researchers used HIV trends among young women attending antenatal clinics as a proxy to monitor trends in new infections among the general population. Male use of female sex workers is the main reason for the spread, which subsequently puts wives in a vulnerable position. In recent years, the Indian government, the World Bank and other external agencies have aimed intervention and awareness programs at the sex industry and their efforts appear to have contributed to a drastic decline.
"There have been many predictions, mostly based on guesswork, that India's AIDS problem will explode -- as it did in southern Africa -- but we now have direct evidence of something positive," says the study's co-author, Professor Prabhat Jha of U of T's Department of Public Health Sciences. "The good news is that HIV in young adults appears to be declining in the south -- most likely or perhaps only due to males using sex workers less or using condoms more often when they do. The not-so-good news is that trends in the north remain uncertain and poorly studied."
More than five million people are living with HIV in India, 75 per cent of them in the southern states. Researchers studied HIV prevalence data from 294,050 women attending 216 antenatal clinics and 58,790 men attending 132 sexually transmitted infection (STI) clinics in the north and south from 2000 to 2004. Lead author Professor Rajesh Kumar at the Postgraduate Institute of Medical Education and Research in Chandigarh, India, says, "The declines in young women in the south are
Contact: Elizabeth Monier-Williams
University of Toronto