AIDS in South Asia: Understanding And Responding to a by James F. Blanchard, Han Kang, Faran Emmanuel, Sushena Reza

By James F. Blanchard, Han Kang, Faran Emmanuel, Sushena Reza Paul,

South Asia's HIV epidemic is very heterogeneous. for this reason, knowledgeable, prioritized, and powerful responses necessitate an realizing of the epidemic variety among and inside international locations. extra unfold of HIV in South Asia is preventable. the longer term measurement of South Asia's epidemic depends upon a good two-pronged method: first of all, at the scope and effectiveness of HIV prevention courses for intercourse employees and their consumers, injecting drug clients and their sexual companions, and males having intercourse with males and their different sexual companions; and secondly, at the effectiveness of efforts to handle the underlying socio-economic determinants of the epidemic, and to minimize stigma and discrimination in the direction of humans accomplishing excessive hazard behaviors, usually marginalized in society, in addition to humans dwelling with HIV and AIDS. This evaluation used to be undertaken to supply a foundation for rigorous, evidence-informed HIV coverage and programming in South Asia.

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Reports of consistent condom use from clients generally match those reported by female SWs, except in Andhra Pradesh, Karnataka, and Tamil Nadu–Pondicherry, where clients’ reports exceed female SW reports by about 10 percent. Behavioral surveillance data from India again highlights a variation in consistent condom use by the type of sex partner. Analogous to female SWs using condoms less frequently among noncommercial partners, consistent use of condoms by clients of female SWs is less likely with more regular female partners who are not engaged in sex work, perhaps because clients perceive sex with them as less risky.

1 HIV Sentinel Surveillance Sites in India Type of site Year Prenatal patient STI patient IDU MSM Female SW Total sites 1998 1999 2000 2001 2002 2003 2004 94 94 118 173 173 271 272 77 77 104 131 166 166 166 9 9 8 12 13 13 13 0 0 2 2 3 3 3 0 0 0 2 2 2 2 180 180 232 320 384 450 670 Source: NACO 2005. HIV and Related Surveillance in the South Asia Region • 17 All of the behavioral and HIV prevalence data in this report are drawn from available national and state BSSs and from other sources where available.

The scale and heterogeneity of the country’s HIV epidemic can be appreciated by considering how India’s size and complexity resemble those of a continent in which some states and even districts are larger than many African countries. India’s epidemic is concentrated in eight states with over 1 percent HIV prevalence in prenatal clinics (NACO 2005): • Tamil Nadu, Karnataka, and Andhra Pradesh in the south • Maharashtra and Goa in the west • Manipur, Nagaland, and Mizoram in the northeast.

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