HIV Infection in India Much Lower Than Estimated, Experts Say

NEW DELHI – India has roughly 2.5 million people infected with HIV, less than half the number of cases that previous studies estimated, the health minister and international AIDS experts said Friday.

The drastically reduced numbers come from expanded surveys and an improved methodology, providing a far more accurate portrait of India's HIV epidemic, said Health Minister Anubani Ramadoss.

An earlier U.N. study estimated 5.7 million HIV cases, which would have been the highest total in the world. According to the new data, India, which has a population of 1.1 billion, has fewer HIV cases than South Africa and Nigeria.

AIDS experts from the United Nations, the World Health Organization, and the Bill & Melinda Gates Foundation concurred with the new estimates, which were compiled after greatly expanding the number of clinics surveyed and incorporating data from a far-reaching national household survey.

"We are today a lot more confident that what is being presented to you is closer to the true prevalence as it exists in the population," said Peter Ghys, manager of epidemic and impact monitoring at UNAIDS.

Ramadoss said the inflated HIV rate had brought criticism on the Indian government that it wasn't doing enough to fight the epidemic, but now that the new figurs show fewer AIDS victims, he did not expect any apologies from those critics.

"This has helped us," he said. "This has put more pressure on us. Due to this pressure, now I have got a healthy budget."

To make clear that the lower number of cases would not mean fewer government funds to fight HIV, Ramadoss also announced the third phase of the federal AIDS control program, which will have a budget of $2.8 billion, compared with the second phase, announced in 1999, which had a budget of less than $350 million.

While the new HIV estimates were due to statistical breakthroughs more than medical ones, Ramadoss said that India's HIV-infection rate showed cause for optimism with a decline from about .38 percent of the population in 2002 to about .36 percent now.

Most encouragingly, HIV rates in southern states, where the disease was most prevalent, have stabilized or begun to decline, Ramadoss said, crediting targeted interventions and education outreach programs.

The infection rate remains above 1 percent in several southern states, including Andhra Pradesh and Karnataka, although it is less than 1 percent in Tamil Nadu. Rates remain high among sex workers, their customers, and men who have sex with men.

Ramadoss said the epidemic was far from over.

"It doesn't make a difference whether it's 1 million or 10 million," he said. "The fact of the matter is there's a problem with HIV in India."

The new HIV estimates come from an expanded survey of prenatal clinics, sexually transmitted infection clinics and public hospitals. The figures also incorporate data from the government's National Family Health Survey, which covers about 200,000 people ages 15 to 54, and was conducted through face-to-face interviews across India between December 2005 and August 2006.

The third phase of India's AIDS control program set forth a strategy for fighting HIV and AIDS in the next five years. The Indian government will pay $1.95 billion toward the $2.8 billion budget, with the rest coming from the U.S. government, the Gates Foundation, the Clinton Foundation, WHO, and other groups.

The plan will focus on AIDS education, promotion of the use of condoms, and the establishment of an improved blood transfusion system, among other areas.

The program focuses more on HIV prevention than treatment for HIV patients, a deliberate choice that Ramadoss said was critical for the country.

"We have about 600 million youths below 25, so first we need to save them," he said.