New Delhi: About 100, 000 fresh HIV cases among the general population were averted in India in five years by targeting the most vulnerable section.
A study — conducted jointly by the Institute for Health Metrics and Evaluation, University of Washington, University of Hong Kong and the Public Health Foundation of India (PHFI) — has found that Avahan successfully slowed the transmission of HIV among the general population by raising the coverage of prevention interventions in high-risk groups like female sex workers, their clients and partners, men who have sex with men (MSM), intravenous drug users and truck drivers.
Launched in 2003, Avahan received $258 million from the Bill and Melinda Gates Foundation, and complemented the government’s own efforts on HIV prevention. The programme was implemented in four large states — Andhra Pradesh, Karnataka, Maharashtra and Tamil Nadu — and two small northeastern states of Manipur and Nagaland.
These six states were estimated to have the highest HIV prevalence in India in 2003, and a total population of 300 million.
The study, “Assessment of population-level effect of Avahan, an HIV-prevention initiative in India,” published in the British Medical Journal, The Lancet, says interventions like safe-sex counselling by peers, clinical services like treatment for sexually transmitted infections, distribution of free condoms and needle and syringe exchange programmes among the most-at-risk population prevented the virus from spreading among the general population.
Lead author of the study Professor Lalit Dandona from the PHFI told TOI that HIV mainly spread in India through sexual intercourse. He said, “High-risk population like sex workers would infect their clients who would then spread it to other female partners like their wives. Similarly, MSMs infected each other and then spread it within the general population through unprotected sex. Avahan showed us that by targeting high-risk groups, the virus spread among the general population can be controlled.”
He added, “HIV prevalence among the general population saw a significant reduction in Andhra Pradesh, Karnataka and Maharashtra due to Avahan. There wasn’t a very high difference in Tamil Nadu, while there was no significant change in the two northeastern states.” India has an estimated 2.4 million living with HIV, making it one of the largest infected populations in the world.