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A UNAIDS and World Health Organization (WHO) study has found that "poor knowledge of HIV" especially "among homosexual groups," male prostitution, and unsafe drug abuse practices are main drivers of HIV propagation. The study observed patterns of spread of HIV in Delhi, Mumbai, and Chennai and drew largely from data of state-run National AIDS Control
Organization (NACO).
The authors of UNAIDS/WHO 2006 AIDS Epidemic Update point out that even in high-tech cities like Bangalore, "three out of four men have sex with men" are not aware of "how the virus is transmitted" and "a large proportion of them engage in unprotected sex." They differed from NACO guesstimates of infected population of 5.2 million and say that there may be 5.7 million infected people that may include about 5.2 million adults in the age group 15-49.
The study also finds there has been very little research on the role of sex between men and especially male prostitutes who have sex with men for money. HIV prevalence among homosexuals in Chennai is 6.8% and 9.6% in Mumbai and conclude that a "substantial proportion of men who have sex with other men also sell sex." A recent study in Andhra Pradesh (AP) found that one in four homosexuals have sex for money.
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In the North East (especially in Manipur, Mizoram and Nagaland), they cite "Using contaminated injecting drug equipment" as the main risk factor for HIV infection but this feature was also increasingly rapidly in the cities that were studied. In Chennai, 31% of injecting drug users were HIV infected and the number was 12% in Mumbai and a shocking 80% of those who had sex recently (in the past three months) paid for it and 27% of the studied population had sold themselves to have sex with others.
The authors warn that India desperately needs "Harm reduction programmes" and also expansion of existing programs into "those parts of India with serious drug inhecting-related HIV epidemics." Ominously they say that "Failing that, there there is a possibility that the combination of injecting drug use and paid sex could lead to larger HIV epidemics." Currently, needle exchange programs are only available in the NE, West Bengal (WB), and New Delhi. However, even there is only one substitution therapy program in Manipur that is operational and even "interventions among injecting drug users tend to be inconsistent, too small and infrequent to yield demonstrable results."
This is yet another global report pointing out that the extent and effectiveness of India's efforts to increase safe sex practices is inadequate and warning of serious large- scale HIV epidemic that could seriously impact India's ascent in the world as a global player. The Health Ministry has been taking a lackadaisical approach to dealing with this threat and at best only has guesstimates using questionable data collection methods.
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