New Delhi: With over two million infected individuals, India is home to one-third of the world’s HIV-affected population. Although national-level data shows a downward trend in this number, the decline is not uniform across states and districts.
A new study has found that the factors behind the epidemic vary across regions, and local strategies may be necessary for HIV control.
HIV is particularly prevalent in 63 districts in the south and northeast of the country, the study has found. Of them, “better developed, urbanised districts with large population size, better socio-economic status of population are more likely to have consistently high HIV prevalence levels.” This means that while planning HIV control strategies, the focus should be on districts with signs of rapid urbanisation and socio-economic development.
The factors responsible for the epidemic are complex and can vary between regions. A single national approach on HIV control, then, may have limited impact. Continuous monitoring for prevalence and causes of the disease at the district level is necessary for making control programmes more effective.
Researchers used data from the 2011 Census, HIV Sentinel Surveillance programme and District Level Household Survey-III and analysed trends from 2007 to 2012 in 640 districts. They correlated HIV prevalence with 14 factors broadly falling into the categories of population profile, socio-economic factors, HIV and sexually transmitted infections, awareness and condom usage.
Also read: Study Muffles Uncertainty Over Hormonal Contraceptive Increasing HIV Risk
The analysis revealed that districts with high literacy, better socio-economic status, higher proportion of population in the reproductive age group and late marriages consistently had high HIV prevalence in all regions except the southern states.
Elaborating on this trend, researchers explained that often, young educated individuals move to urban areas for better opportunities and are separated from their families. They have higher incomes, and often have sexual encounters with multiple partners before marriage, increasing chances of contracting HIV. Researchers believe that since south India was the first to face an upsurge in the number of HIV cases, the epidemic here has evolved over time and is therefore not affected by factors like better socio-economic indicators.
“Our study has highlighted inter-regional variations in factors responsible for HIV prevalence. While implementing common strategies for prevention and control of HIV/AIDS at the national level, additional regional approaches may also be necessary,” explained Dr Rajneesh Joshi, who conducted the study at the Pune-based ICMR-National AIDS Research Institute while on a study leave from the Indian Army, where he is working as a public health specialist.
The study also found that higher knowledge levels about the role of condom use for HIV prevention as well as the use of condoms correlates with reduced number of HIV cases in districts.
However, high literacy and awareness about HIV/AIDS alone does not mean low HIV prevalence. Only supplementing this knowledge with HIV prevention methods reduces the number of HIV cases.
Also read: The Anti-HIV Treatments That Could Be Actually Revolutionary
“Results of this study have been communicated to the National AIDS Control Organisation (NACO). We will continue our analysis to track the scenario following the introduction of test and treat policy by the program,” Joshi told India Science Wire.
The study has highlighted that districts which are rapidly urbanising and witnessing socio-economic development may see an increase in the number of HIV cases. It further advocates the need to raise awareness on HIV prevention and the use of condoms, along with HIV in general.
The research team included Dr Sanjay M. Mehendale of Indian Council of Medical Research, New Delhi in addition to Dr Rajneesh Joshi. The research was published in the journal Plos One.
(India Science Wire)