Shri Ghulam Nabi Azad,
Union Minister of Health & Family Welfare released HIV Estimations 2012 at
New Delhi today.
features of the estimations are as follows:
(1) 57% REDUCTION IN NEW HIV INFECTIONS
DURING LAST DECADE
(2) 1.5 LAKH LIVES SAVED DUE TO SCALE
UP OF FREE ART SERVICES SINCE 2004
(3) SUSTAINING THE INTENSITY OF
INTERVENTIONS TO CONSOLIDATE GAINS
(4) EMERGING EPIDEMICS GIVEN THE
HIGHEST PRIORITY IN THE NEXT FIVE YEARS
(5) BALANCING PREVENTION AND TREATMENT
IS A KEY CHALLENGE
National AIDS Control Programme in India
has been recognised globally as a success story. This programme rests on two
key pillars – prevention for those who are not infected and care, support &
treatment for those who have been infected. Since large proportion
of the population are not infected with HIV, prevention remains the
cornerstone of the programme. The strategies for prevention include targeted
interventions for high risk groups, condom promotion and strong IEC campaigns
for general population. Care, support and treatment aim at increasing access to
testing and treatment services.
In order to refine these strategies
and to evaluate the impacts of the interventions, National AIDS Control Organisation conducts HIV Sentinel Surveillance and HIV
Estimations at regular intervals. The latest round of HIV Sentinel Surveillance
was completed in 2011. The data generated there has been used for estimation of
HIV burden and projection of HIV epidemic trends in the country. The HIV
estimations 2012 indicate an overall continuing reduction in adult HIV
prevalence, new HIV infections and AIDS-related deaths in India.
Improved methodology & customised
models to generate HIV estimates
The India HIV estimates 2012 utilised
improved methodology and updated epidemiological data from the latest round of
HIV Sentinel Surveillance, Census 2011 and other information on High Risk
Groups for more accurate understanding of the Indian epidemic. Spectrum model
has been customised with Indian data to allow robust projections for each
state. The entire process is supported by national and international experts,
epidemiologists and demographers from National Institute of Medical Statistics,
UNAIDS, WHO, CDC and other public health institutes of India.
Key findings of HIV Estimations 2012
Adult (15–49 years) HIV Prevalence (%)
Number of Persons Living with HIV
Number of Adult New HIV Infections
Number of Annual AIDS-related Deaths
India is estimated to have an adult
(15-49 years) HIV prevalence of 0.27% in 2011. Adult HIV prevalence among males
and females is estimated at 0.32% and 0.22% respectively.
In 2011, among the states, Manipur has
shown the highest estimated adult HIV prevalence of 1.22%, followed by Andhra
Pradesh (0.75%), Mizoram (0.74%), Nagaland (0.73%), Karnataka (0.52%), Goa
(0.43%) and Maharashtra (0.42%). Besides these, Odisha,
Gujarat, Tamil Nadu, and Chandigarh have shown estimated adult HIV prevalence
greater than national prevalence (0.27%).
Adult HIV Prevalence
The adult HIV prevalence at national
level has continued its steady decline from estimated level of 0.41% in 2001
through 0.35% in 2006 to 0.27% in 2011. Similar consistent declines are noted
among both males and females at national level. Declining trends in adult HIV
prevalence are sustained in all the high prevalence states (Andhra Pradesh,
Tamil Nadu, Karnataka, Maharashtra, Manipur &
It is estimated that around 1.16 lakh new HIV infections among adults and around 14,500 new
infections among children occurred during 2011. Of the 1.16 lakh
estimated new infections in 2011 among adults, the six high prevalence states
account for 31% of new infections.
Trends of HIV
Incidence (New Infections)
India has demonstrated an overall
reduction of 57% in estimated annual new HIV infections (among adult
population) during the last decade from 2.74 lakhs in
2000 to 1.16 lakhs in 2011. This is one of the most
important evidence on the impact of the various interventions under National
AIDS Control Programme and scaled-up prevention strategies. Major contribution
to this reduction comes from the high prevalence states where a reduction of
76% has been noted during the same period. However, rising trends of new
infections are noted in the some of the low prevalence states. Programme has
evolved focused prevention strategies to address these emerging
due to high risk groups and bridge population
Considerable declines in HIV prevalence
have been recorded among Female Sex Workers at national level (5.06% in 2007 to
2.67%) and in most of the states, where long-standing targeted interventions
have focussed on behaviour change and increasing condom use. Declines have been
achieved among Men who have sex with Men (7.41% in 2007 to 4.43% in 2011) also,
though several pockets in the country show higher HIV prevalence among them
with mixed trends.
Stable trends have been recorded among
Injecting Drug Users at national level (7.23% in 2007 to 7.14% in 2011).
Besides North Eastern states where declines have been achieved, newer pockets
of high HIV prevalence among IDU have emerged over the last few years, in the
states of Punjab, Chandigarh, Delhi, Mumbai, Kerala, Odisha,
Madhya Pradesh, Uttar Pradesh & Bihar.
Prevention strategies for IDU in the
newer areas have been initiated recently and are prioritised for further scale
up during the next five years.
In certain North Indian states, evidence
indicates the possible role of migration in fueling
HIV epidemics. Besides high risk migrants, long distance truckers also show
high levels of vulnerability and form an important part of bridge population.
with HIV/AIDS (PLHIV)
The total number of people living with
HIV/AIDS (PLHIV) in India is estimated at 21 lakh in
2011. Children (<15 yrs) account for 7% of all infections, while 86% are in
the age –group of 15-49 years. Of all HIV infections, 39% (8.16 lakh) are among women.
Using globally accepted methodologies
and updated evidence on survival to HIV with and without treatment, it is
estimated that about 1.48 lakh people died of AIDS
related causes in 2011 in India. Deaths among HIV infected children account for
7% of all AIDS-related deaths. Wider access to ART has led to 29% reduction in
estimated annual AIDS-related deaths during NACP-III period (2007-2011).
Greater declines in estimated annual deaths are noted in states where
significant scale up of ART services has been achieved.
Due to ART
It is estimated that the scale up of
free ART since 2004 has saved over 1.5 lakh lives in
the country till 2011 by averting deaths due to AIDS-related causes. At the
current pace of scale up of ART services, it is estimated to avert around
50,000 – 60,000 deaths annually in the next five years.
Sustained action needed for ‘Getting to
Above evidence shows that India is on
track to achieve the global targets of ‘Zero New Infections, Zero AIDS-related
deaths & Zero discrimination’. However, sustaining prevention focus and
intensity in the areas where significant declines have been achieved, is highly
critical to consolidate the gains, while effectively addressing the emerging
epidemics. With increasing coverage of treatment & decreasing AIDS-related
mortality, a significant number of people are likely to require first and
second line ART treatment in the coming years. Major challenge for the
programme will be to ensure that the treatment requirements are fully met
without sacrificing the needs of prevention.
NACO has taken cognisance of these
emerging challenges and have focussed on region specific prevention strategies
and evidence-based scale up.
1. Scale up
of Opioid Substitution Therapy and other harm
reduction strategies are given focus in the North Western states where
injecting drug use is identified as the major driver of the epidemic.
2. On the
other hand, in the eight states of North India, where migration is increasingly
being identified as playing role in HIV transmission, revised migrant strategy
is being implemented with focus at source, transit as well as destination
certain pockets of high prevalence states where HIV prevalence among FSW and
MSM continues to be high, emphasis is given to sustain the higher coverage of
targeted interventions and improve the quality of outreach.
Interventions to provide HIV prevention services to long distance truckers are
being scaled up at the trans-shipment locations and truck halt points across
efficacious PPTCT regimen has been rolled out in high prevalence areas where
number of HIV positive pregnancies is higher and where the impact on reducing
new child infections will be maximum.
6. In the
states that account for a larger share of HIV burden, treatment services are
being scaled up through expansion of ART and Link ART centres. Second line ART
and paediatric ART are being provided at greater number of centres across the
campaigns have been strengthened through multi-media approach involving TV,
Radio and innovative strategies such as Red Ribbon Express, National folk media
campaign and North East campaign involving music and sports.