A Review of the HIV Epidemic in India

Abstract

India has a population of more than 1 billion people. Although only about 0.7% of its population is infected with HIV, it has more cases than any other country in the world, with more than 4.5 million HIV-seropositive patients. The epidemic of HIV/AIDS in India is distributed between the urban and rural populations mainly in the southern and western states of the country (APAC-VHS, Community Prevalence of Sexually Transmitted Diseases in Tamil Nadu-A Report, 1998; Solomon, Kumarasamy, Ganesh, & Amalraj, 1998, International Journal of Medical Research, 85; 335-338). India has several different epidemics in various parts of the country. The epidemic in the western and southern states is primarily heterosexual. The northeastern states of India, being in geographical proximity to the Golden Triangle of Asia, initially experienced HIV in the injection drug user population and their sexual partners, but spread to the heterosexual population has been increasing. At present, the northern states, which are the most densely populated, appear to remain largely unaffected by the HIV epidemic. India has mounted a broad intervention program, including the government, and international, nongovernmental, and community-based organizations. The main barriers to effective control are insufficient resources, illiteracy, and stigma. Antiretroviral drugs are manufactured in the country and exported elsewhere, but their affordability (despite a drastic reduction in costs) and the feasibility of monitoring patients on drugs are in question. Starting April 1, 2004, the government of India has announced free provision of ART drugs to all who need it in the six most prevalent states of India.

Prevalence and Contexts of Inconsistent Condom Use Among Heterosexual Men and Women Living with HIV in India: Implications for Prevention

“…Although the desire to have a child was manifest on the individual level, it was often motivated by family and societal pressure to have children, particularly boys, which is especially intense in India. [35][36][37] Finally, condoms were sometimes not available at home due to fear of embarrassment if they were discovered by children or family members, as also reported in a previous qualitative study among PLHIV in South India. 17 While this was an individual-level fear, it was motivated by social stigma associated with condoms, which has been observed previously in India.…”

A comparison in HIV-associated stigma among healthcare workers in urban and rural Gujarat

“…Instead, patients are tested based on lack of response to 'marker diseases' such as tuberculosis, diarrhoea, and persistently swollen lymph nodes (Zelaya et al, 2007). Despite extraordinary past initiatives, outside of the antiretroviral therapy centres of both hospitals there is a great need for a review of HIV/AIDS treatment and care, specifically with emphasis on the need for consent and confidentiality; when it is appropriate to test for HIV; and protocol in relation to patient turnover (Solomon, Chakraborty & Yepthomi, 2004). Moreover, to advocate good medical practice yet lack supplies evidently forces doctors to push medical costs onto patients, thereby discouraging testing for HIV and treatment.…”

“…Moreover, to advocate good medical practice yet lack supplies evidently forces doctors to push medical costs onto patients, thereby discouraging testing for HIV and treatment. Much of this cost is for fumigating operation theatres or labour rooms; double and triple-gloving for staff; and AIDS kits for all staff assisting in surgical procedures (Solomon et al, 2004). Such procedures are not required and amount to discriminatory practice.…”

“…She often chooses the former. As a result, three quarters of HIV-positive women in India were found to be infected within a few years of marriage (Pallikadavath et al, 2005;Solomon et al, 2004). Such attributes of traditional Gujarat are in many ways contributing to secrecy around HIV, where testing is either discouraged or unknown among many inhabitants (Zelaya et al, 2007).…”

Prevalence of HIV, Hepatitis B, Syphilis, and Chlamydia Among Adults Seeking Treatment for a Mental Disorder in Southern India

“…One developing country that may be particularly vulnerable to the epidemic is India, where concern about HIV is high. Estimates suggest that 4-5 million people are living with HIV/AIDS in India (Solomon, Chakraborty, & Yepthomi, 2004).…”