HIV in India - A Downsized Epidemic

This week's New England Journal of Medicine has an article on HIV in India and speaks to the recent controversy and disputed numbers of people living with HIV in India. In 2006, the UNAIDS and WHO estimated that 5.7 million people in India were infected with HIV suggesting that India had more people infected with HIV than any other country.

In 2007, however, the estimate was revised downward to 2.5 million (range, 2.0 million to 3.1 million) — a revision so large that it reduced by nearly 10% the estimated number of people living with HIV globally and reinforced ongoing concerns about the validity of methods for producing such epidemiologic estimates.

The revised numbers for India suggest that the epidemic is less generalized than originally thought and thus allowing for the opportunity for it to be more controlled. Most importantly,

The new estimate changes little, however, in terms of prevention efforts geared toward persons at high risk for infection, such as injection-drug users, men who have sex with men, sex workers and their clients, and long-distance truckers. Nevertheless, it should now be easier and less costly than was previously anticipated to provide treatment, including second-line regimens, to those who need it

As in most developing countries, previous estimates were based upon pregnant women attending government prenatal clinics capturing high prevalence areas. The new estimates were based on a National Family Health Survey which examined a nationally representative sample of households.