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* [http://aidssupport.aarogya.com aarogya AIDS support group]
* [http://aidssupport.aarogya.com aarogya AIDS support group]
* [http://papers.ssrn.com/sol3/papers.cfm?abstract_id=955723]
* [http://papers.ssrn.com/sol3/papers.cfm?abstract_id=955723]
* [http://www.tkf.org.in/blog/hiv-aids-and-young-india-%e2%80%93-role-of-ngos-and-volunteers/ HIV AIDS and Young India]




Revision as of 08:23, 24 February 2011

India has the world's third-largest population suffering from HIV/AIDS.[1] However, the estimated number of human immunodeficiency virus (HIV) infections in India has declined drastically in recent years—from 5.5 million in 2005 to below 2.5 million in 2007. These new figures are supported by the World Health Organization and UNAIDS.[2][3][4]

Epidemiology

Despite being home to the world's third-largest population suffering from HIV/AIDS, the AIDS prevalence rate in India is lower than in many other countries. In 2007, India's AIDS prevalence rate stood at approximately 0.30%—the 89th highest in the world.[5] The spread of HIV in India is primarily restricted to the southern and north-eastern regions of the country and India has also been praised for its extensive anti-AIDS campaign.[6] The US$2.5 billion National AIDS Control Plan III was set up by India in 2007 and received support from UNAIDS[7] The main factors which have contributed to India's large HIV-infected population are extensive labor migration and low literacy levels in certain rural areas resulting in lack of awareness and gender disparity.[8] The Government of India has also raised concerns about the role of intravenous drug use and prostitution in spreading AIDS, especially in north-east India and certain urban pockets.[8] A recent study published in the British medical journal "The Lancet" in (2006) reported an approximately 30% decline in HIV infections among young women aged 15 to 24 years attending prenatal clinics in selected southern states of India from 2000 to 2004 where the epidemic is thought to be concentrated. The authors cautiously attribute observed declines to increased condom use by men who visit commercial sex workers and cite several pieces of corroborating evidence. Some efforts have been made to tailor educational literature to those with low literacy levels, mainly through local libraries as this is the most readily accessible locus of information for interested parties.[9] Increased awareness regarding the disease and citizen's related rights is in line with the Universal Declaration on Human Rights.

HIV statistics, 2007

State Antenatal clinic HIV prevalence 2007 (%)[10] STD clinic HIV prevalence 2007 (%) [11] IDU HIV prevalence 2007 (%)[12] MSM HIV prevalence 2007 (%)[13] Female sex worker HIV prevalence 2007 (%)[14]
Andhra Pradesh 1.00 17.20 3.71 17.04 9.74
Gujarat 0.25 2.40 ... 8.40 6.53
Karnataka 0.50 8.40 2.00 17.60 5.30
Maharashtra 0.50 11.62 24.40 11.80 17.91
Manipur 0.75 4.08 17.90 16.4 13.07
Mizoram 0.75 7.13 7.53 ... 7.20
Nagaland 0.60 3.42 1.91 ... 8.91
Tamil Nadu 0.25 8.00 16.80 6.60 4.68
Delhi 0.25 5.20 10.10 11.73 3.15
Chandigarh 0.25 0.42 8.64 3.60 0.40

Some areas report an HIV prevalence rate of zero in antenatal clinics. This does not necessarily mean HIV is absent from the area, as some states report the presence of the virus at STD clinics and amongst injecting drug users. In some states and territories the average antenatal HIV prevalence is based on reports from only a small number of clinics.

History

In 1986, the first known case of HIV was diagnosed by Dr. Suniti Solmon amongst female sex workers in Chennai.[15] Later that year, sex workers began showing signs of this deadly disease. At that time, foreigners in India were traveling in and out of the country. It is thought that these foreigners were the ones responsible for the first infections.[16] By 1987, about 135 more cases came to light. Among these 14 had already progressed to AIDS.[17] Prevelance in high risk groups reached above 5% by 1990.[18] As per UNDP's 2010 report, India had 2.39 million (23.95 lakh) people living with HIV at the end of 2009, up from 2.27 million (22.7 lakh) in 2008. Adult prevalence also rose from 0.29% in 2008 to 0.31% in 2009. [19]

Government policies

The apex Government of India body for HIV surveillance is the National AIDS Control Organisation (NACO). The majority of HIV surveillance data collected by the NACO is done through annual unlinked anonymous testing of prenatal clinic (or antenatal clinics) and sexually transmitted infection clinic attendees. Annual reports of HIV surveillance are freely available on NACO's website.

This campaign has been supplemented by awareness efforts in the private sector. HIV/AIDS-related television shows and movies have appeared in the past few years, mostly in an effort to appeal to the middle class.[20] An important component of these programs has been the depiction of HIV/AIDS affected persons interacting with non-infected persons in everyday life.[21] Vilification of infected persons has occurred, as the disease has become more popularly associated with sex workers[22] These efforts have focused on increasing tolerance and awareness among the middle class in an effort to diminish the portion of the population affected by HIV/AIDS by developing public concern and calls for greater governmental action. The HIV/AIDS is one of the greatest killers of human beings on earth. There is no absolute reliable drug so far available that can cure the diseases. Controlling HIV/AID is an alternate best solution. In control measures, large number of stakeholders can play important role. The following paragraphs are excerpts on how Supreme Court of India gave exhaustive recommendations to such stakeholders.[23] Sapovadia, Vrajlal K., Controlling Hiv/Aids - a Judicial Measure, Recommendations by Supreme Court of India. HIV/AIDS e-Conference, 2003. Available at SSRN: http://ssrn.com/abstract=955723

In 2010, NACO approved the TeachAIDS educational materials[24] marking the first time HIV/AIDS education could be provided decoupled from sex education. Later that year, the Government of Karnataka approved the materials for their state of 50 million and committed to distributing them in 5,500 government schools.[25]

Second-line treatment issue

Responding to a petition made by NGO's, in December 2010, the Supreme Court of India directed Indian government to provide second-line Antiretroviral Therapy (ART) to all AIDS patients in the country, by warning the government against abdicating its constitutional duty of providing treatment to HIV positive patients on grounds of financial constraint, as it was issue of the right to life guaranteed under Article 21 of the Indian Constitution. Previously in an affidavit before the Supreme Court, NACO had said second-line ART treatment for HIV patients, costing Rs 28,500 each, could not be extended to those who had received "irrational treatment" by private medical practitioners for the first round, which costs around Rs 6,500. The court rejected both the arguments of financial constrains and only 10 viral load testing centres needed for test patients for migrating from first line of treatment to the second line being are available, raised by the Solicitor General representing the government. The court further asked the government to give a clear-cut and "workable" solution response within a week's time.[26][27]

Number of ART centres and patients alive and on ART by state, January 2010

State No. of ART Centres Total (Adult) Total (Paediatric) Total
Andhra Pradesh 31 60,328 3,304 63,832
Karnataka 33 36,220 3,003 39,223
Maharashtra 43 65,409 5,102 70,511
Tamil Nadu 36 36,947 2,439 39,586
Gujarat 9 12,765 669 13,678
Uttar Pradesh 10 10,039 594 10,633
Grand Total 2,81,453 18,889 3,00,743

Litigation for access to treatment

  • Voluntary Health Association of Punjab v. Union of India[28]
  • Love Life Society v. Union of India & Others[29]
  • Wahengbam Joykumar v. Union of India & Others[30]
  • Delhi Network of Positive People & Another v. Union of India & Others[31]

See also

References

  1. ^ http://www.unicef.org/india/hiv_aids_156.htm (UNICEF)
  2. ^ "2.5 million people in India living with Aids, according to new estimates" (PDF). New York Times. Retrieved 2007-06-08.
  3. ^ 'Sharp drop' in India Aids levels, BBC
  4. ^ [http://www.who.int/med iacentre/news/releases/2007/pr37/en/index.html "2.5 million people in India living with HIV, according to new estimates"]. World Heath Organization. Retrieved 2007-06-08. {{cite web}}: Check |url= value (help); line feed character in |url= at position 23 (help)
  5. ^ CIA World Factbook publication - AIDS prevalence rates
  6. ^ Clinton lauds India Aids campaign
  7. ^ India: Driving forward an effective AIDS response
  8. ^ a b Source of Infections in AIDS cases in India, Embassy of India
  9. ^ Ghosh, Maitrayee 2007 ICT and AIDS Literacy: A Challenge for Information Professionals in India. Electronic Library & Information Systems 41(2):134-147
  10. ^ http://www.avert.org/india-hiv-aids-statistics.htm
  11. ^ http://www.avert.org/india-hiv-aids-statistics.htm
  12. ^ http://www.avert.org/india-hiv-aids-statistics.htm
  13. ^ http://www.avert.org/india-hiv-aids-statistics.htm
  14. ^ http://www.avert.org/india-hiv-aids-statistics.htm
  15. ^ Sternberg, Steve (2005-02-23). "HIV scars India". USA Today.
  16. ^ Overview of HIV and AIDS in India. Retrieved from http://www.avert.org/aidsindia.htm.
  17. ^ http://www.avert.org/aidsindia.htm
  18. ^ www.aids2006.org/Web/TUSY0903.ppt
  19. ^ "Health care fails to reach migrants". Hindustan Times. December 01, 2010. {{cite news}}: Check date values in: |date= (help)
  20. ^ Pathak, Prachee 2005 “Sterling Towers”: A Soap Opera for HIV Awareness Among the Middle Class in Urban India. Dissertations and Theses 2005.
  21. ^ Bourgault, Louise M. 2009 AIDS Messages in Three AIDS-Themed Indian Movies: Eroding AIDS-Related Stigma in India and Beyond. Critical Arts: A South-North Journal of Cultural & Media Studies 23(2):171-189.
  22. ^ Bourgault, Louise M. 2009 AIDS Messages in Three AIDS-Themed Indian Movies: Eroding AIDS-Related Stigma in India and Beyond. Critical Arts: A South-North Journal of Cultural & Media Studies 23(2):171-189.
  23. ^ http://papers.ssrn.com/sol3/papers.cfm?abstract_id=955723
  24. ^ "National AIDS Control Organisation of India approves TeachAIDS curriculum". TeachAIDS. 15 January 2010. Retrieved 9 January 2011.
  25. ^ "Karnataka government to implement TeachAIDS tutorials in 5,500 schools". TeachAIDS. 7 June 2010. Retrieved 9 January 2011.
  26. ^ "SC forces govt to agree to second-line ART to all AIDS patients". The Times of India. Dec 11, 2010.
  27. ^ "SC cautions govt over HIV treatment". Hindustan Times. December 11, 2010.
  28. ^ Writ Petition (Civil) No. 311 of 2003, Supreme Court of India
  29. ^ Writ Petition (Civil) No. 8700 of 2006, High Court of Delhi
  30. ^ Writ Petition (Civil) No. 7 of 2005, Gauhati High Court
  31. ^ Writ Petition (Civil) No. 2885 of 2007, High Court of Delhi


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