The study examined alternative explanations but changes in testing or in deaths from AIDS don't appear to explain the decline. "The first question we ask as scientists is if our findings are real and it appears they are," adds Jha, who is also the director of U of T's Centre for Global Health Research and a Canada Research Chair in health and development.
Paul Arora, a research fellow at the Centre for Global Health Research, says, "A key implication of the study is the need to scale up highly effective prevention efforts in the north, especially in hot-spot urban and rural districts -- not just for female sex workers but also for men having sex with men."
Kumar cautions that while the findings are good news, the battle is far from over. "HIV remains a huge problem in India and we have to remain vigilant," he says. "We're not saying the epidemic is under control yet -- we are saying that prevention efforts with high-risk groups thus far seem to be having an effect."
The study -- the world's largest examination yet of antenatal clinic attendees --also recommends that enhancing routine surveillance, including more questions on risk factors, pregnancy history, husband's history and additional STI testing via antenatal clinics and other sites, is a powerful and cost-effective way to monitor the growth of India's large and heterogeneous HIV epidemic.
"Understanding the correlation between peer-based education programs and HIV rates will contribute to this worldwide effort to reduce the incidence of HIV," says Alan Bernstein, president of the Canadian Institutes of Health Research, which is among the study's funders.
'"/>
Contact: Elizabeth Monier-Williams
elizabeth.monier.williams@utoronto.ca
416-978-5948
University of Toronto
29-Mar-2006