New reports: Fewer HIV cases in India

By SAM DOLNICK, Associated Press WriterFri Jul 6, 1:03 PM ET

The experts' consensus was that India had the most HIV cases in the world — 5.7 million — and that number could rise if aggressive measures weren't adopted.
On Friday, that consensus changed dramatically when international AIDS experts and Indian health officials revealed new data showing India to have less than half of that number — 2.5 million people — infected with HIV.
Despite the lower number of HIV cases, the government and the international community are paying more attention — and more money — to fighting AIDS in India. The Indian health minister on Friday announced a new phase of the federal AIDS control program, with the Indian government pledging $1.95 billion — nearly 40 times what it spent in the last round.
This new plan has an expected budget of $2.8 billion, and has attracted high-profile donors, including the Bill & Melinda Gates Foundation, the Clinton Foundation and the U.N. Development Program. The previous plan, announced in 1999, had a budget of less than $350 million.
The inflated HIV numbers were actually good for India, said Health Minister Anubani Ramadoss. "This has helped us. This has put more pressure on us. Due to this pressure, now I have got a healthy budget."
And the epidemic is far from over, he said.
"It doesn't make a difference whether it's 1 million or 10 million," Ramadoss said. "The fact of the matter is there's a problem with HIV in India."
The reduced numbers come from expanded surveys and an improved methodology, providing a far more accurate — and more encouraging — portrait of India's HIV epidemic, said Ramadoss. Experts from the United Nations and the World Health Organization endorsed the new data.
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.
The new estimates 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.
While the new HIV estimates were a result of 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.
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. In addition to the Indian government, it will be funded by 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.