Researchers from Canada and India have reported in the online edition of Lancet, that HIV in southern India has seen a significant decline by almost one-third, since the year 2000. This drop in the HIV rates is attributed to the increased use of protection by men visiting sex-workers.
The study monitored the HIV prevalence among 294,050 young women attending pregnancy or antenatal clinics in the Southern and Northern part of India. The basis of current HIV prevalence was compared with the HIV trends between the years 2000 and 2004, to enable a comparative study. HIV rise among 58,790 men attending sexually transmitted infection clinics during the same period was also monitored.The outcome of the study showed that HIV-1 prevalence among women aged 15-24 years in the south dropped from 1.7% to 1.1% from 2000 to 2004, though there was no marked decline observed in women aged between 25-34 years. Among men between ages 20-29 years, frequenting STI clinics in the south, there was a marked decline of 7.6% in HIV rates. The northern part of India did not show any significant change in the HIV rates both among men and women.
The study's co-author, Professor Prabhat Jha of University of Toronto's Department of Public Health Sciences, said 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. 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.
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 broad based -- for example, among urban and rural women and among educated or illiterate women. Moreover, declines in the south are seen also among young men who visit STI clinics and these men represent those who are likely to use sex workers. It all fits.
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.
