National AIDS Research Institute, Pune, India

This 13-page document describes the state of HIV/AIDS infection risk and its spread in India and focuses on the national response to prevention and control. As stated in the report, based on 2005 data, both serotypes are present; sexual transmission is the predominant type of transmission, with transmission due to drug use being localised in the northeast and metropolitan areas. Parent-child transmission is rising. Dual epidemics of HIV and tuberculosis (TB), increase in the number of infected women, stigma, and discrimination are the main concerns in the Indian HIV/AIDS scenario.

As reported here, increasing political will and commitment to prevention and control make possible the use of a multi-disciplinary approach combining targeted interventions. Antiretroviral drugs (ART) are now manufactured in India and provided to (at the date of publication, 2005) 100,000 people. Due to a Supreme Court ban on paid blood donations, there has been a decline in HIV transmission through transfusion. The perinatal transmission rate has also declined due to antenatal testing and use of ART-related drug treatment.

Because the trajectory of the HIV epidemic is distinct from some African countries, the document recommends a focus on vulnerable groups, enhancing access to care and treatment for people living with HIV/AIDS, and decentralisation of the programme financially and operationally by supporting states and districts to develop critical capacities. With dual infections of HIV and TB rising, strategies and clinician training for medical management need to address both infections. As stated here, "India’s experience shows that DOTS [Directly Observed Treatment, Short-course] can achieve high cure rates, however, its effectiveness needs to be critically evaluated [based] on the background of ongoing HIV epidemic."


According to the authors, there is a need for more accurate HIV disease estimates and for the inclusion of private healthcare clinics in implementation of both testing and treatment. HIV-infected people need anti-discrimination efforts to address their rights to treatment, meaning increased training and treatment facilities with a focus on primary care and home-based care. There is a need to address prevention also. Short-term strategies for prevention include like early identification and treatment of sexually transmitted infections (STIs), condom promotion, blood safety, drug addiction treatment programmes, and expanding and strengthening voluntary counselling and testing centres (VCTCs). Long-term strategies need to address the circumstances of vulnerable populations, young people, and women, and
include the following: awareness oriented to behavioural change; steps towards improvement of literacy, status of women, and overall development; reduction in poverty; and development of primary prevention interventions like vaccines and microbicides.