Prevalence and risk factors of HIV-1 and HIV-2 infection in urban and rural areas in Tamil Nadu, India

Abstract

We aim to study the factors associated with the prevalence of HIV-1 and HIV-2 infection in the urban and rural areas of Tamil Nadu, India. The population of Tamil Nadu is approximately 60 million. Between April 94 and March 95, 992 samples from 5 representative urban centres and 1071 samples from 5 representative rural centres were collected and studied. A questionnaire was administered privately and it preceded collection of each sample. Samples were screened using ELISA and antibodies to HIV-1 and HIV-2 were confirmed using Western blot. The study was anonymous and unlinked. The prevalence of HIV infection in urban and rural areas was 7.2% (95% CI=6.1 to 8.31%); HIV-1 antibodies were found in 7.4% (95% CI=5.8 to 9.2%) of urban and 7.0% (95% CI=5.6 to 8.7%) of rural population; HIV-2 antibodies were found in 0.8% of urban and 0.3% of rural population. Heterosexual transmission, more so among those with multiple partner sex, was the main mode; higher prevalence of HIV infection among divorced/single individuals both in urban (21.1%) and rural (26.1%) was found. HIV infection among housewives stood at 4.1% (urban) and 3.8% (rural). The strength of association between STDs and HIV was observed to be greater in rural subjects (OR=8.89; 95% CI=5.11 to 15.57) than in urban subjects (OR=1.9; 95% CI=1.14 to 3.18). The prevalence of condom use was found to be less than 2% in the study subjects. HIV-2 is not as widely prevalent in Tamil Nadu as HIV-1. In our study the most common risk factors for HIV infection that emerged were (a) having multiple sexual partners, and (b) history of STDs or Venereal Disease Research Laboratory (VDRL) reactivity. Mobility of individuals between urban and rural areas has furthered the dissemination of HIV infection. Low condom usage among study subjects questions the effectiveness of the existing AIDS awareness and education programme. The study indicates the importance of placing equal emphasis on HIV prevention in rural India. HIV infection among housewives in urban and rural areas is indicative of gender inequalities and the importance of empowering women to prevent infection from spouse.

A Study on the Modes of Transmission of Hiv From January 2009 to December 2012 at Jawaharlal Nehru Hospital, Jnims, Manipur

“…[6] Heterosexual contact was the commonest mode of transmission (54.75%) of all HIV cases and is consistent with other studies in India. [7,8] This study also showed an increase in heterosexual route of transmission from 48.22% in 2009 to 60.62% in 2012. IDU once a major cause of HIV in Manipur was the second most common cause of HIV comprising 36.33% of all HIV infection showing gradual decline with from 42.44% in 2009 to 30.97% in 2012.Thus from our study we found that there was a shifting trend from IDU (once the major cause of HIV) to sexual route.…”

HIV - 2 Infections from a Tertiary Care Hospital in India - A Case Report

“…Murugan and Amburajan observed a prevalence of 0.29% of HIV-2 in south Tamil Nadu, and Solomon et, al. reported a prevalence rate of 0.9% with HIV-2 among urban population [11,12] There are various reports of HIV -2 infection from South India but data from North India is much limited. It was seen that more discordant couples exist with HIV-2 infection than HIV-1 infection as was seen in our case and his spouse in spite of having regular unprotected sex.…”

HIV/AIDS in Bangladesh: a national surveillance

“…India is in the phase of rapidly rising prevalence of HIV with an estimated 4 million cases. Most cases in India are reported from Moombai (Bombay), the largest seaport, Pune (near Moombai), Tamil Nadu, the south coastal province, and Manipur, the province bordered by Myanmar [10][11][12][13] . However, the number of cases varied from none to an increasing figure in other states [14][15][16][17] .…”

“…It is worth noting that approximately 12% of CSWs from Bangladesh crossed the border into India and engaged in prostitution in Calcutta 21 . A very low rate of condom usage (1% to 21%) among the clients of CSWs, and the low literacy of CSWs were observed as being risk factors for the transmission of HIV and other STDs in several studies 6,7,12,21,22 . Among the long-distance truck drivers in our survey, 60% had sex with CSWs at least twice a month, and they almost always had sex without using a condom.…”