HIV Hurts the Immune System
People who are HIV positive have been tested and found to have signs of the human immunodeficiency virus in their blood. HIV destroys part of the immune (say: ih-myoon) system. Specifically, it affects a type of white blood cell called the T lymphocyte (say: lim-fuh-site), or T cell. T cells are one type of "fighter" cell in the blood that help the body fight off all kinds of germs and diseases.
After HIV enters the body, it piggybacks onto a T cell and works its way inside of that cell. Once inside, the virus completely takes over the T cell and uses it as a virus-making factory to make a lot of copies of itself. The newly made viruses then leave the T cell and go on to infect and destroy other healthy T cells as they continue to multiply inside the body. After the virus invades the T cells, they can no longer properly fight infections.
Someone who is infected with the virus is called HIV positive. But it may take years for the virus to damage enough T cells for that person to get sick and develop AIDS. And thanks to new medications, someone infected with HIV can stay relatively healthy and symptom-free for many years. But these medications are very expensive and not available to everyone in the world.
Although the HIV-positive person may feel fine, the virus is silently reproducing itself and destroying T cells. And during this time, the person is still contagious (say: kon-tay-jus), which means he or she is able to give the disease to others.
When the person's immune system has weakened and more of the blood's T cells have been destroyed by the virus, the person can no longer fight off infections. This is when he or she gets very sick. A doctor diagnoses a person with AIDS when the person has a very low number of T cells and shows signs of a serious infection.
Continue
Monday, December 31, 2012
Welcome to INP+
Welcome to INP+
INP+ is an ISO 9001:2008 certified CBO - a national network for people living with HIV/AIDS. INP+ is a social movement by and for People Living with HIV/AIDS (PLHIV) in enforcing the recognition for Human Rights of PLHIV in India. INP+ has waged a long and intensive struggle against fear, ignorance, prejudice and despair born out of the epidemic and stood to represent courage, insight, acceptance and hope to hundreds and thousands of People Living with HIV/AIDS.
We support PLHIV to form self help groups from the bottom up and foster bonding with intra- and intercommunity groups to gain strength and support.
Our members include besides PLHIV, people from diverse orientation and marginalized sections of the society – MSM (Men having Sex with Men), IDU (Injecting Drug Users), Sex workers etc. The membership is open to all Indians living with HIV irrespective of gender, caste, religion etc.
Browse through our site to learn more about INP+ and how you can contribute!
INP+ is an ISO 9001:2008 certified CBO - a national network for people living with HIV/AIDS. INP+ is a social movement by and for People Living with HIV/AIDS (PLHIV) in enforcing the recognition for Human Rights of PLHIV in India. INP+ has waged a long and intensive struggle against fear, ignorance, prejudice and despair born out of the epidemic and stood to represent courage, insight, acceptance and hope to hundreds and thousands of People Living with HIV/AIDS.
We support PLHIV to form self help groups from the bottom up and foster bonding with intra- and intercommunity groups to gain strength and support.
Our members include besides PLHIV, people from diverse orientation and marginalized sections of the society – MSM (Men having Sex with Men), IDU (Injecting Drug Users), Sex workers etc. The membership is open to all Indians living with HIV irrespective of gender, caste, religion etc.
Browse through our site to learn more about INP+ and how you can contribute!
How often will my doctor want to see me?
How often will my doctor want to see me?
Your doctor will probably want to see you every 6 months as long as your CD4 cell count is higher than 500. Your doctor will probably want to see you every 3 months if your CD4 cell counts are below 500. However, if you take a new medicine, your doctor will want to see you more often, to check your response to the medicine or to see if your HIV infection is getting worse.
Return to top
What else can help me?
Some medicines can help prevent the other infections and complications that come when HIV lowers your body's resistance (makes your immune system weak). Here are some things that can help people with HIV:
* A flu shot every fall helps prevent the flu.
* A shot every 5 to 7 years can prevent pneumonia caused by the bacteria called Streptococcus pneumoniae. It's easier for people who have HIV to get this kind of pneumonia.
* A tuberculosis (TB) skin test every year can tell if you have TB. TB is a very serious illness, especially in people who have HIV.
* A Pap test for women to check for dysplasia (a pre-cancer condition) and for cancer of the cervix. Both of these conditions occur more often in women who have HIV infection. At first, Pap tests are done every 6 months. After 2 Pap tests in a row are normal, you might only have to get them once a year.
* A hepatitis B test for people who are at risk for hepatitis B infection. You're at risk for this infection if you inject drugs. If the test shows you don't have hepatitis B infection, your doctor might want you to have the hepatitis B vaccine to protect you from getting the infection.
* A medicine called TMP-SMZ can help. This antibiotic would be given to you if your CD4 cell count is less than 200. It helps prevent pneumonia caused by a bacteria called Pneumocystis jiroveci. This antibiotic also helps prevent another infection, called toxoplasmosis.
* Azithromycin, clarithromycin and rifabutin can help when your CD4 cell count is lower than 50 to 75. They keep you from getting an infection caused by a bacteria called Mycobacterium avium.
Return to top
A note about vaccines
Sometimes the amount of a certain vaccine cannot keep up with the number of people who need it. More info...
Return to top
What is the best time to start taking these medicines?
Almost all experts agree that medicines for HIV should be started before the person's CD4 cells fall under 200. Most doctors want their patients to start taking medicines earlier, when the CD4 cell count is between 200 and 500. You and your doctor should talk about which medicines to take and when to start taking them. (See the handout on HIV and Plasma Viral Load Testing for more information on your CD4 cell count and your plasma viral load.)
Return to top
Which are the best drugs for me to use?
Each person should talk to his or her doctor about the medicines for HIV. Most doctors treat their patients with more than one medicine.
Your doctor will test your blood to see when you should start taking medicine. The blood tests can also show how well your medicine is working. The tests will help your doctor decide if your treatment should change.
Return to top
Where can I get more information about HIV treatments?
Many cities have telephone hotlines for both patients and the general public. Look for the number in your telephone yellow pages, under AIDS information.
Return to top
More Information
STIs, HIV and AIDS
* How to Reduce Your HIV and AIDS Risk
* Coping With an HIV Diagnosis
* HIV Infection in Women
* HIV, Pregnancy and AZT
* How to Take HIV Medicines
* HIV and Plasma Viral Load Testing
* Avoiding Infections When You Have HIV
* HIV
* Pneumocystis pneumonia (PCP) and HIV
* Nutrition and Exercise When You Have HIV
* Occupational Exposure to HIV
Return to top
Other Organizations
* CDC HIV/AIDS Information
* HIV/AIDS Treatment Information Service
* The Body: The Complete HIV/AIDS Resource
Return to top
printPrinter-friendly version
Share this page
Make text biggerMake text bigger
spanish buttonSpanish / Español
Source
Written by familydoctor.org editorial staff.
American Academy of Family Physicians
Reviewed/Updated: 12/10
Created: 05/97
Your doctor will probably want to see you every 6 months as long as your CD4 cell count is higher than 500. Your doctor will probably want to see you every 3 months if your CD4 cell counts are below 500. However, if you take a new medicine, your doctor will want to see you more often, to check your response to the medicine or to see if your HIV infection is getting worse.
Return to top
What else can help me?
Some medicines can help prevent the other infections and complications that come when HIV lowers your body's resistance (makes your immune system weak). Here are some things that can help people with HIV:
* A flu shot every fall helps prevent the flu.
* A shot every 5 to 7 years can prevent pneumonia caused by the bacteria called Streptococcus pneumoniae. It's easier for people who have HIV to get this kind of pneumonia.
* A tuberculosis (TB) skin test every year can tell if you have TB. TB is a very serious illness, especially in people who have HIV.
* A Pap test for women to check for dysplasia (a pre-cancer condition) and for cancer of the cervix. Both of these conditions occur more often in women who have HIV infection. At first, Pap tests are done every 6 months. After 2 Pap tests in a row are normal, you might only have to get them once a year.
* A hepatitis B test for people who are at risk for hepatitis B infection. You're at risk for this infection if you inject drugs. If the test shows you don't have hepatitis B infection, your doctor might want you to have the hepatitis B vaccine to protect you from getting the infection.
* A medicine called TMP-SMZ can help. This antibiotic would be given to you if your CD4 cell count is less than 200. It helps prevent pneumonia caused by a bacteria called Pneumocystis jiroveci. This antibiotic also helps prevent another infection, called toxoplasmosis.
* Azithromycin, clarithromycin and rifabutin can help when your CD4 cell count is lower than 50 to 75. They keep you from getting an infection caused by a bacteria called Mycobacterium avium.
Return to top
A note about vaccines
Sometimes the amount of a certain vaccine cannot keep up with the number of people who need it. More info...
Return to top
What is the best time to start taking these medicines?
Almost all experts agree that medicines for HIV should be started before the person's CD4 cells fall under 200. Most doctors want their patients to start taking medicines earlier, when the CD4 cell count is between 200 and 500. You and your doctor should talk about which medicines to take and when to start taking them. (See the handout on HIV and Plasma Viral Load Testing for more information on your CD4 cell count and your plasma viral load.)
Return to top
Which are the best drugs for me to use?
Each person should talk to his or her doctor about the medicines for HIV. Most doctors treat their patients with more than one medicine.
Your doctor will test your blood to see when you should start taking medicine. The blood tests can also show how well your medicine is working. The tests will help your doctor decide if your treatment should change.
Return to top
Where can I get more information about HIV treatments?
Many cities have telephone hotlines for both patients and the general public. Look for the number in your telephone yellow pages, under AIDS information.
Return to top
More Information
STIs, HIV and AIDS
* How to Reduce Your HIV and AIDS Risk
* Coping With an HIV Diagnosis
* HIV Infection in Women
* HIV, Pregnancy and AZT
* How to Take HIV Medicines
* HIV and Plasma Viral Load Testing
* Avoiding Infections When You Have HIV
* HIV
* Pneumocystis pneumonia (PCP) and HIV
* Nutrition and Exercise When You Have HIV
* Occupational Exposure to HIV
Return to top
Other Organizations
* CDC HIV/AIDS Information
* HIV/AIDS Treatment Information Service
* The Body: The Complete HIV/AIDS Resource
Return to top
printPrinter-friendly version
Share this page
Make text biggerMake text bigger
spanish buttonSpanish / Español
Source
Written by familydoctor.org editorial staff.
American Academy of Family Physicians
Reviewed/Updated: 12/10
Created: 05/97
What happens during a routine office visit?
What happens during a routine office visit?
Your doctor will check several things to find out how strong your HIV infection has become. Your doctor will ask you about your symptoms. He or she will look for any signs that the HIV infection is getting worse. Your doctor will also do a blood test to check your CD4 cell count and your viral load. Some of the things that might tell your doctor that your HIV infection has gotten worse since your last visit are the following:
* New symptoms of nausea, vomiting, fatigue, fever, headache, chills, night sweats, cough, shortness of breath or diarrhea.
* Signs of weight loss, mouth sores (such as thrush, which is a yeast infection) or bigger lymph nodes (glands located in your neck, armpits and hip area).
* A drop in the CD4 cell count in your blood.
* A rise in the viral load in your blood.
Your doctor will check several things to find out how strong your HIV infection has become. Your doctor will ask you about your symptoms. He or she will look for any signs that the HIV infection is getting worse. Your doctor will also do a blood test to check your CD4 cell count and your viral load. Some of the things that might tell your doctor that your HIV infection has gotten worse since your last visit are the following:
* New symptoms of nausea, vomiting, fatigue, fever, headache, chills, night sweats, cough, shortness of breath or diarrhea.
* Signs of weight loss, mouth sores (such as thrush, which is a yeast infection) or bigger lymph nodes (glands located in your neck, armpits and hip area).
* A drop in the CD4 cell count in your blood.
* A rise in the viral load in your blood.
How does the doctor tell if the medicines are workin
How does the doctor tell if the medicines are working?
Three tests can measure the amount of the virus in your blood. Your doctor can use this information to find out how your body is responding to the medicine.
* The CD4 cell count. CD4 cells are a kind of white blood cell (sometimes called T-lymphocytes, or T-cells) in your blood. CD4 cells are important because they help your body fight infections. Unfortunately, these cells are also the main target of the virus that causes HIV infection. This virus cripples the CD4 cells. In people who don't have HIV, the CD4 level is between 500 and 1,200 cells per mm3 (cubic millimeter). Your doctor will probably give you medicine to fight HIV when your CD4 cell count drops below a certain level. One goal of treatment for HIV infection is to keep your CD4 cell count as high as possible.
* Viral load. The viral load is the number of copies of HIV in your blood. A person who doesn't have HIV infection has a viral load of 0. Medicine that lowers the amount of HIV in the body is usually given when your viral load measures more than 10,000 to 30,000 viral copies per mL (milliliter) of blood. A second goal of treatment is to make the viral load as low as possible.
* CBC. The complete blood count (also called the CBC) measures the number of red and white cells in your blood. Red blood cells carry oxygen from your lungs to all the tissues of your body. White blood cells fight infections. They keep your body's immune system strong. A large drop in red blood cells and a large drop in white blood cells can occur when HIV infection is getting worse. This drop can also be caused by the same medicines that you take to fight HIV (medicines like zidovudine). Your doctor uses the CBC to help decide when to change your medicines. Your doctor wants to keep your red and white blood cell counts high enough to keep you healthy.
Three tests can measure the amount of the virus in your blood. Your doctor can use this information to find out how your body is responding to the medicine.
* The CD4 cell count. CD4 cells are a kind of white blood cell (sometimes called T-lymphocytes, or T-cells) in your blood. CD4 cells are important because they help your body fight infections. Unfortunately, these cells are also the main target of the virus that causes HIV infection. This virus cripples the CD4 cells. In people who don't have HIV, the CD4 level is between 500 and 1,200 cells per mm3 (cubic millimeter). Your doctor will probably give you medicine to fight HIV when your CD4 cell count drops below a certain level. One goal of treatment for HIV infection is to keep your CD4 cell count as high as possible.
* Viral load. The viral load is the number of copies of HIV in your blood. A person who doesn't have HIV infection has a viral load of 0. Medicine that lowers the amount of HIV in the body is usually given when your viral load measures more than 10,000 to 30,000 viral copies per mL (milliliter) of blood. A second goal of treatment is to make the viral load as low as possible.
* CBC. The complete blood count (also called the CBC) measures the number of red and white cells in your blood. Red blood cells carry oxygen from your lungs to all the tissues of your body. White blood cells fight infections. They keep your body's immune system strong. A large drop in red blood cells and a large drop in white blood cells can occur when HIV infection is getting worse. This drop can also be caused by the same medicines that you take to fight HIV (medicines like zidovudine). Your doctor uses the CBC to help decide when to change your medicines. Your doctor wants to keep your red and white blood cell counts high enough to keep you healthy.
Sunday, December 30, 2012
HIV Treatment
HIV Treatment
What is HIV?
The human immunodeficiency virus (HIV) attacks the body's immune system. A healthy immune system is what keeps you from getting sick.
Because HIV damages your immune system, you are more likely to get sick from bacteria and viruses. It is also harder for your body to fight off these infections when you do get them, so you may have trouble getting better. HIV is the condition that causes acquired immunodeficiency syndrome (AIDS).
HIV can only be passed from person to person through body fluids, such as blood, semen and vaginal fluid. Children born to infected mothers can also become infected during pregnancy. The most common ways HIV is passed are:
* By having unprotected anal, vaginal or oral sex with an infected person.
* By sharing needles and syringes for injecting drugs with an infected person.
Return to top
How can my doctor tell if I have HIV or AIDS?
First your doctor tests to see if you have HIV infection. Your blood is tested with an ELISA (enzyme-linked immunosorbent assay) test. If this test is positive for HIV, your blood is tested again with the Western blot test. If both tests are positive, you are diagnosed with HIV infection.
Three things show that a person who has HIV infection has developed AIDS. If any one or more of the following are present, the person has AIDS:
* A CD4 cell count (discussed below) of less than 200
* A CD4 cell percentage of less than 14%
* An AIDS-indicator illness
An AIDS-indicator illness is a physician-diagnosed medical problem that occurs in people who have advanced HIV infection. About 25 medical problems are considered AIDS-indicator illnesses. They include conditions like Pneumocystis pneumonia, Kaposi's sarcoma and wasting syndrome. If a person who is infected with HIV gets an AIDS-indicator illness, that person has AIDS.
Return to top
What is HIV?
The human immunodeficiency virus (HIV) attacks the body's immune system. A healthy immune system is what keeps you from getting sick.
Because HIV damages your immune system, you are more likely to get sick from bacteria and viruses. It is also harder for your body to fight off these infections when you do get them, so you may have trouble getting better. HIV is the condition that causes acquired immunodeficiency syndrome (AIDS).
HIV can only be passed from person to person through body fluids, such as blood, semen and vaginal fluid. Children born to infected mothers can also become infected during pregnancy. The most common ways HIV is passed are:
* By having unprotected anal, vaginal or oral sex with an infected person.
* By sharing needles and syringes for injecting drugs with an infected person.
Return to top
How can my doctor tell if I have HIV or AIDS?
First your doctor tests to see if you have HIV infection. Your blood is tested with an ELISA (enzyme-linked immunosorbent assay) test. If this test is positive for HIV, your blood is tested again with the Western blot test. If both tests are positive, you are diagnosed with HIV infection.
Three things show that a person who has HIV infection has developed AIDS. If any one or more of the following are present, the person has AIDS:
* A CD4 cell count (discussed below) of less than 200
* A CD4 cell percentage of less than 14%
* An AIDS-indicator illness
An AIDS-indicator illness is a physician-diagnosed medical problem that occurs in people who have advanced HIV infection. About 25 medical problems are considered AIDS-indicator illnesses. They include conditions like Pneumocystis pneumonia, Kaposi's sarcoma and wasting syndrome. If a person who is infected with HIV gets an AIDS-indicator illness, that person has AIDS.
Return to top
India has 53,000 HIV positive children: Govt
India has 53,000 HIV positive children: Govt
IANS, Jul 29, 2009, 07.46pm IST
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NEW DELHI: Nearly 53,000 children in the country are HIV positive, with Tamil Nadu topping the list with new 2,650 cases, health minister Ghulam Nabi Azad told the Lok Sabha on Wednesday.
The minister said in 2006, about 2,253 cases were reported, while the following year 24,977 were registered. In November 2008, the figure touched 19,116.
"The cumulative total among children now stands at 52,973 in May 2009," Azad said.
India has 2.5 million HIV/AIDS cases.
The minister said the major source of the HIV infection in children is vertical transmission from their infected pregnant mothers.
"To arrest this trend, the Prevention of Parent to Child Transmission (PPTCT) programme is being implemented since 2002," he said.
"In the year 2008, a total of 4.1 million pregnant women were counselled and tested, of whom 19,986 were found positive and 10,179 mother-baby pairs received prophylactic treatment to prevent transmission from infected mother to infant," he added.
Till May this year, Tamil Nadu reported the maximum new cases among children with 2,651 cases, as compared to 2,446 cases in 2008. It is followed by Maharashtra where 1,269 cases were reported till May as compared to 2008 when it topped the list of new cases at 4,714.
Andhra Pradesh, which had recorded the highest number of new cases among children in 2007 with 6,460 cases, this time till May showed a decline with 748 cases.
Last year, Delhi recorded 3,807 new cases and since then it has registered 748 cases.
Only Arunachal Pradesh and Sikkim reported no cases this year.
Azad said the number of Integrated Counselling and Testing Centres have been increased from 1,476 to 5,155, while facilities providing treatment increased from 52 to 217 over the three year period.
He further said nearly 758,600 HIV positive people were being provided services under the National AIDS Control Programme's third phase. The National AIDS Control Organisation (NACO), a state-run anti-AIDS agency, provides quality health care for people living with HIV/AIDS.
"Treatment facilities are available in 217 medical facilities where treatment is being provided with anti-retroviral drugs to 232,908 patients, of whom 14,474 are children," the minister added.
Read more: India has 53,000 HIV positive children: Govt - The Times of India http://timesofindia.indiatimes.com/life-style/health-fitness/India-has-53000-HIV-positive-children-Govt/articleshow/4834663.cms#ixzz19UW4piPu
IANS, Jul 29, 2009, 07.46pm IST
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NEW DELHI: Nearly 53,000 children in the country are HIV positive, with Tamil Nadu topping the list with new 2,650 cases, health minister Ghulam Nabi Azad told the Lok Sabha on Wednesday.
The minister said in 2006, about 2,253 cases were reported, while the following year 24,977 were registered. In November 2008, the figure touched 19,116.
"The cumulative total among children now stands at 52,973 in May 2009," Azad said.
India has 2.5 million HIV/AIDS cases.
The minister said the major source of the HIV infection in children is vertical transmission from their infected pregnant mothers.
"To arrest this trend, the Prevention of Parent to Child Transmission (PPTCT) programme is being implemented since 2002," he said.
"In the year 2008, a total of 4.1 million pregnant women were counselled and tested, of whom 19,986 were found positive and 10,179 mother-baby pairs received prophylactic treatment to prevent transmission from infected mother to infant," he added.
Till May this year, Tamil Nadu reported the maximum new cases among children with 2,651 cases, as compared to 2,446 cases in 2008. It is followed by Maharashtra where 1,269 cases were reported till May as compared to 2008 when it topped the list of new cases at 4,714.
Andhra Pradesh, which had recorded the highest number of new cases among children in 2007 with 6,460 cases, this time till May showed a decline with 748 cases.
Last year, Delhi recorded 3,807 new cases and since then it has registered 748 cases.
Only Arunachal Pradesh and Sikkim reported no cases this year.
Azad said the number of Integrated Counselling and Testing Centres have been increased from 1,476 to 5,155, while facilities providing treatment increased from 52 to 217 over the three year period.
He further said nearly 758,600 HIV positive people were being provided services under the National AIDS Control Programme's third phase. The National AIDS Control Organisation (NACO), a state-run anti-AIDS agency, provides quality health care for people living with HIV/AIDS.
"Treatment facilities are available in 217 medical facilities where treatment is being provided with anti-retroviral drugs to 232,908 patients, of whom 14,474 are children," the minister added.
Read more: India has 53,000 HIV positive children: Govt - The Times of India http://timesofindia.indiatimes.com/life-style/health-fitness/India-has-53000-HIV-positive-children-Govt/articleshow/4834663.cms#ixzz19UW4piPu
The HIV/AIDS situation in different states
The HIV/AIDS situation in different states
Map of India Map of India showing the worst affected states.
The vast size of India makes it difficult to examine the effects of HIV on the country as a whole. The majority of states within India have a higher population than most African countries, so a more detailed picture of the crisis can be gained by looking at each state individually.
The HIV prevalence data for most states is established through testing pregnant women at antenatal clinics. While this means that the data are only directly relevant to sexually active women, they still provide a reasonable indication as to the overall HIV prevalence of each area.23
The following states have recorded the highest levels of HIV prevalence at antenatal and sexually transmitted disease (STD) clinics over recent years.
Andhra Pradesh
Andhra Pradesh in the southeast of the country has a total population of around 76 million, of whom 6 million live in or around the city of Hyderabad. The HIV prevalence at antenatal clinics was 1% in 2007. This figure is smaller than the reported 1.26% in 2006, but remains the highest out of all states.24 HIV prevalence at STD clinics was very high at 17% in 2007. Among high-risk groups, HIV prevalence was highest among men who have sex with men (MSM) (17%), followed by female sex workers (9.7%) and IDUs (3.7%).25
Goa
Goa, a popular tourist destination, is a very small state in the southwest of India (population 1.4 million). In 2007 HIV prevalence among antenatal and STD clinic attendees was 0.18% and 5.6% respectively.26 The Goa State AIDS Control Society reported that in 2008, a record number of 26,737 people were tested for HIV, of which 1018 (3.81%) tested positive.27
Karnataka
Karnataka, a diverse state in the southwest of India, has a population of around 53 million. HIV prevalence among antenatal clinic attendees exceeded 1% from 2003 to 2006, and dropped to 0.5% in 2007.28 Districts with the highest prevalence tend to be located in and around Bangalore in the southern part of the state, or in northern Karnataka's "devadasi belt". Devadasi women are a group of women who have historically been dedicated to the service of gods. These days, this has evolved into sanctioned prostitution, and as a result many women from this part of the country are supplied to the sex trade in big cities such as Mumbai.29 The average HIV prevalence among female sex workers in Karnataka was just over 5% in 2007, and 17.6% of men who have sex with men were found to be infected.30
Maharashtra
Maharashtra is a very large state of three hundred thousand square kilometres, with a total population of around 97 million. The capital city of Maharashtra - Mumbai (Bombay) - is the most populous city in India, with around 14 million inhabitants. The HIV prevalence at antenatal clinics in Maharashtra was 0.5% in 2007.31 At 18%, the state has the highest reported rates of HIV prevalence among female sex workers.32 Similarly high rates were found among injecting drug users (24%) and men who have sex with men (12%).33
Tamil Nadu
With a population of over 66 million, Tamil Nadu is the seventh most populous state in India. Between 1995 and 1997 HIV prevalence among pregnant women tripled to around 1.25%.34 The State Government subsequently set up an AIDS society, which aimed to focus on HIV prevention initiatives. A safe-sex campaign was launched, encouraging condom use and attacking the stigma and ignorance associated with HIV. Between 1996 and 1998 a survey showed that the number of men reporting high-risk sexual behaviour had decreased.35
In 2007 HIV prevalence among antenatal clinic attendees was 0.25%.36 HIV prevalence among injecting drug users was 16.8%, third highest out of all reporting states. HIV prevalence among men who have sex with men and female sex workers was 6.6% and 4.68% respectively.37
Manipur
Manipur is a small state of some 2.4 million people in northeast India. Manipur borders Myanmar (Burma), one of the world's largest producers of illicit opium. In the early 1980s drug use became popular in northeast India and it wasn't long before HIV was reported among injecting drug users in the region.38 Although NACO report a state-wise HIV prevalence of 17.9% among IDUs, studies from different areas of the state find prevalence to be as high as 32%.39
HIV is no longer confined to IDUs, but has spread further to the general population. HIV prevalence at antenatal clinics in Manipur exceeded 1% in recent years, but then declined to 0.75% in 2007.40 Estimated adult HIV prevalence is the highest out of all states, at 1.57%.41
Mizoram
The small northeastern state of Mizoram has fewer than a million inhabitants. In 1998, an HIV epidemic took off quickly among the state's male injecting drug users, with some drug clinics registering HIV rates of more than 70% among their patients.42 In recent years the average prevalence among this group has been much lower, at around 3-7%.43 HIV prevalence at antenatal clinics was 0.75% in 2007.44
Nagaland
Nagaland is another small northeastern state where injecting drug use has again been the driving force behind the spread of HIV. In 2003 HIV prevalence among IDUs was 8.43%, but has since declined to 1.91% in 2007. HIV prevalence at antenatal clinics and STD clinics was 0.60% and 3.42% respectively in 2007.45
The Punjab
The Punjab, a state in northern mainland India, has shown an increase in prevalence among injecting drug users (13.8% in 2007) in recent years.46 One of the richest cities in the Punjab, Ludhiana, has an HIV prevalence of 21% among IDUs while the HIV prevalence among IDUs in the capital of the state, Amritsar, has reached 30%.47 Denis Broun, head of UNAIDS in India has stated, "the problem of IDUs has been underestimated in mainland India, as most of the problem was thought to be in the northeast." 48
Map of India Map of India showing the worst affected states.
The vast size of India makes it difficult to examine the effects of HIV on the country as a whole. The majority of states within India have a higher population than most African countries, so a more detailed picture of the crisis can be gained by looking at each state individually.
The HIV prevalence data for most states is established through testing pregnant women at antenatal clinics. While this means that the data are only directly relevant to sexually active women, they still provide a reasonable indication as to the overall HIV prevalence of each area.23
The following states have recorded the highest levels of HIV prevalence at antenatal and sexually transmitted disease (STD) clinics over recent years.
Andhra Pradesh
Andhra Pradesh in the southeast of the country has a total population of around 76 million, of whom 6 million live in or around the city of Hyderabad. The HIV prevalence at antenatal clinics was 1% in 2007. This figure is smaller than the reported 1.26% in 2006, but remains the highest out of all states.24 HIV prevalence at STD clinics was very high at 17% in 2007. Among high-risk groups, HIV prevalence was highest among men who have sex with men (MSM) (17%), followed by female sex workers (9.7%) and IDUs (3.7%).25
Goa
Goa, a popular tourist destination, is a very small state in the southwest of India (population 1.4 million). In 2007 HIV prevalence among antenatal and STD clinic attendees was 0.18% and 5.6% respectively.26 The Goa State AIDS Control Society reported that in 2008, a record number of 26,737 people were tested for HIV, of which 1018 (3.81%) tested positive.27
Karnataka
Karnataka, a diverse state in the southwest of India, has a population of around 53 million. HIV prevalence among antenatal clinic attendees exceeded 1% from 2003 to 2006, and dropped to 0.5% in 2007.28 Districts with the highest prevalence tend to be located in and around Bangalore in the southern part of the state, or in northern Karnataka's "devadasi belt". Devadasi women are a group of women who have historically been dedicated to the service of gods. These days, this has evolved into sanctioned prostitution, and as a result many women from this part of the country are supplied to the sex trade in big cities such as Mumbai.29 The average HIV prevalence among female sex workers in Karnataka was just over 5% in 2007, and 17.6% of men who have sex with men were found to be infected.30
Maharashtra
Maharashtra is a very large state of three hundred thousand square kilometres, with a total population of around 97 million. The capital city of Maharashtra - Mumbai (Bombay) - is the most populous city in India, with around 14 million inhabitants. The HIV prevalence at antenatal clinics in Maharashtra was 0.5% in 2007.31 At 18%, the state has the highest reported rates of HIV prevalence among female sex workers.32 Similarly high rates were found among injecting drug users (24%) and men who have sex with men (12%).33
Tamil Nadu
With a population of over 66 million, Tamil Nadu is the seventh most populous state in India. Between 1995 and 1997 HIV prevalence among pregnant women tripled to around 1.25%.34 The State Government subsequently set up an AIDS society, which aimed to focus on HIV prevention initiatives. A safe-sex campaign was launched, encouraging condom use and attacking the stigma and ignorance associated with HIV. Between 1996 and 1998 a survey showed that the number of men reporting high-risk sexual behaviour had decreased.35
In 2007 HIV prevalence among antenatal clinic attendees was 0.25%.36 HIV prevalence among injecting drug users was 16.8%, third highest out of all reporting states. HIV prevalence among men who have sex with men and female sex workers was 6.6% and 4.68% respectively.37
Manipur
Manipur is a small state of some 2.4 million people in northeast India. Manipur borders Myanmar (Burma), one of the world's largest producers of illicit opium. In the early 1980s drug use became popular in northeast India and it wasn't long before HIV was reported among injecting drug users in the region.38 Although NACO report a state-wise HIV prevalence of 17.9% among IDUs, studies from different areas of the state find prevalence to be as high as 32%.39
HIV is no longer confined to IDUs, but has spread further to the general population. HIV prevalence at antenatal clinics in Manipur exceeded 1% in recent years, but then declined to 0.75% in 2007.40 Estimated adult HIV prevalence is the highest out of all states, at 1.57%.41
Mizoram
The small northeastern state of Mizoram has fewer than a million inhabitants. In 1998, an HIV epidemic took off quickly among the state's male injecting drug users, with some drug clinics registering HIV rates of more than 70% among their patients.42 In recent years the average prevalence among this group has been much lower, at around 3-7%.43 HIV prevalence at antenatal clinics was 0.75% in 2007.44
Nagaland
Nagaland is another small northeastern state where injecting drug use has again been the driving force behind the spread of HIV. In 2003 HIV prevalence among IDUs was 8.43%, but has since declined to 1.91% in 2007. HIV prevalence at antenatal clinics and STD clinics was 0.60% and 3.42% respectively in 2007.45
The Punjab
The Punjab, a state in northern mainland India, has shown an increase in prevalence among injecting drug users (13.8% in 2007) in recent years.46 One of the richest cities in the Punjab, Ludhiana, has an HIV prevalence of 21% among IDUs while the HIV prevalence among IDUs in the capital of the state, Amritsar, has reached 30%.47 Denis Broun, head of UNAIDS in India has stated, "the problem of IDUs has been underestimated in mainland India, as most of the problem was thought to be in the northeast." 48
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