Globally there are 40 million people living with human immunodeficiency virus (HIV)/ acquired immunodeficiency syndrome (AIDS). According to latest estimates based on National Family Health Survey (NFHS), released by National AIDS Control Organization (NACO), the National adult HIV prevalence in India is approximately 0.36% which corresponds to an estimated 2 to 3.1 million people living with HIV in the country.

The new lower estimates are due to difference in surveillance method and do not mean a sharp decline in the epidemic. HIV prevalence has begun to decline in Tamil Nadu and other southern states with high HIV burden. There has been feminization of epidemic with an estimated 38.4% of infected adults being female. Eighty-six percent of the Indian population is unaware of their HIV status with only 57% population being aware of the preventive methods.

There are more than 4000 integrated counseling and testing centers (ICTCs) in the country. About 80,000 patients are accessing free antiretroviral treatment (ART) in 127 centers. PPTCT program has been scaled up in the county with Nevirapine as the regimen of choice. It has an efficacy rate of 48% in prevention of HIV transmission in the mother baby pair; there are chances of increased drug-resistance to ART in mothers who were treated with prophylactic single-dose Nevirapine.

These patients face a lot of stigma and discrimination. A 2006 study found that 25% of people living with HIV in India had been refused medical treatment on the basis of their HIV-positive status.

Global Estimates of HIV/AIDS
The 40 million people now living with human immunodeficiency virus/ acquired immunodeficiency syndrome (HIV/AIDS), along with the families of the 20 million who have already died, are a stinging indictment of the world’s collective failure to forestall a major and preventable epidemic. Over 15 million children - more than the total number of children in France or Germany or the United Kingdom - are orphans, their parents taken away from them at the most vulnerable point in their young lives.

History of HIV/AIDS in India
India’s first cases of HIV were diagnosed among sex workers in Chennai, Tamil Nadu. Most of the initial cases had occurred through heterosexual sex; but at the end of the 1980s, a rapid spread of HIV was observed among injecting drug users in Manipur, Mizoram and Nagaland.  In 1987, a National AIDS Control Programme was launched to coordinate national responses. Its activities covered surveillance, blood screening and health education.  In 1992, the government set up NACO (National AIDS Control Organisation), to oversee the formulation of policies, prevention work and control programs related to HIV and AIDS. In 2001, the government adopted the National AIDS Prevention and Control Policy.  NACP III was launched formally on 6 th July 2007.

Marfatia YS, Sharma Archana, Modi Megha
Department of Skin and VD, Medical College and SSG Hospital, Vadodara, India

Correspondence Address:
Marfatia Y S
Department of Skin and VD, Medical College and SSG Hospital, Vadodara
India
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References

<sub>1. Report on the global AIDS epidemic, 2006. UNAIDS. [Cited on 2007 Mar 9]. Available from: http:// www. unaids.org/en/HIV_data/2006GlobalReport/default.asp.
2. The World Bank’s global HIV/AIDS program of action. [Cited on Dec 2005:8,v,19,vi].
3. Panda S. The HIV/AIDS epidemic in India: An overview. In : Panda S, Chatterjee A, Abdul-Quader AS, editors. Living with the AIDS virus: The epidemic and the response in India. London: Sage Publications; 2002. p. 20.
4. UNGASS India report: Progress report on the declaration of commitment on HIV/AIDS. NACO; 2006. [Cited on 2007 Mar 9] Available from: http:// data.unaids.org/pub/Report/2006/2006_country_progress_report_india_en.pdf.
5. Mangla B. India disquiet about AIDS control. Lancet 1992;340:1533-4.
6. Health minister launches third phase of NACP, Friday 6 th July 2007. Ministry of health and family welfare. [Cited 2007 Jul 10]. Available from: http:// pib.nic.in/release/release.asp?relid=29036.
7. From Ray K. DH News Service: New Delhi; [Cited on 2007 Jul 10]. Available from: http:// www. samachar.com/showurl.php.
8. WHO news release, 2007. [Cited on 2007 Jul 10]. Available from: http:// www. who.int/entity/mediacentre/news/releases/2007/pr37/en/index.html.
9. Monthly updates on AIDS, NACO; August 2006. [Cited on 2007 Jul 1]. Available from: http:// www. nacoonline.org/facts_reportaug.ht.
10. HIV/AIDS epidemiological surveillance and estimation report for the year 2005, NACO; April 2006. [Cited on 2007 Mar 9]. Available from: http:// www. nacoonline.org/fnlapil06rprt.pdf.
11. Overview of HIV/AIDS in India. [Cited on 2007 Mar 9]. Available from: http:// www. avert.org/aidsindia.htm.
12. World Health Organization and UNAIDS. Progress on global access to HIV antiretroviral therapy. A report on “3 by 5” and beyond. Geneva: WHO; 2006. 
13. Clinton Foundation HIV/AIDS Initiative. 2006: Module 4: p. 54.
14. McIntyre JA, Martison N, Gray GE, et al . Addition of short course Combivir to single dose Viramune for prevention of mother-to-child transmission of HIV-1 can significantly decrease the subsequent development of maternal NNRTI resistant virus. XV International AIDS Conference, July 11-16, 2004; Bangkok, Thailand. Abstract LBOrBO9.
15. IAVI India Newsletter, April-May 2007: Vol 6(2).</sub>