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Country Profile

The first cases of HIV were diagnosed amongst sex workers in Chennai, India in 1986. Since then, the national HIV prevalence has steadily grown, not only affecting most high-risk groups such as men having sex with men (MSM), sex workers and people who inject drugs (PWID) but also spreading into the general population in some States of India.

In 2008, the adult (15-49) prevalence was estimated at 0.36% and an estimated 2.47 million people were living with HIV. This puts India behind South Africa and Nigeria in numbers of persons living with HIV.

The decrease in HIV estimates in India from 2006 to 2007 was based on an expanded and improved surveillance system and a review of data from the 2005-2006 National Family Health Survey III.

According to the 2006 sentinel surveillance report, HIV was mainly transmitted via sexual routes (87.4%); other routes of transmission by order of proportion includes perinatal (4.7%), unsafe blood and blood products (1.7%), infected needles and syringes (1.8%) and unspecified and other routes of transmission (4.1%). Injecting drug use is also emerging as an important mode of transmission in some parts of the country. With a concentrated HIV epidemic, India’s HIV prevalence continues to be high amongst high risk groups (6 to 8 times that of the general population). Higher HIV prevalence amongst people who inject drugs (PWID) is found in North Eastern States. But in 2006, new sites of high HIV prevalence among PWID have been identified in the states of Punjab, Tamil Nadu, West Bengal, Kerala and Maharashtra indicating dual nature of the epidemic in the country. The heterogeneous distribution of HIV epidemic is evident as many isolated pockets of high prevalence are identified in several districts of the country.

Overall, 118 districts in the country have HIV prevalence >1% in lower-risk populations represented by women attending antenatal clinics (ANCs); 81 districts have HIV prevalence >5% in one or more of the high-risk groups (HRGs). The dual HIV epidemic in the northeast, driven by people who inject drugs and sex workers, remains unabated.

Overall, more men (33%) than women (17%) within the 15-49 age groups have a comprehensive HIV knowledge, i.e. who both correctly identify ways of preventing the sexual transmission of HIV and who reject major misconceptions about the HIV transmission. Also, more men than women have higher levels of knowledge of HIV prevention, particularly on the three ABC methods as well as on knowledge of prevention of mother-to-child HIV transmission. However, there is negligible difference in levels of knowledge between sexes on use of special medicine (ARV). Overall, 2006 Behavioural Surveillance Survey (BSS) data reveals an increase in percentage of young women and men aged 15-24 who had a comprehensive HIV knowledge - from 22% in 2001 to 28% in 2006.

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. It also found strong evidence of stigma in the workplace, with 74% of employees not disclosing their status to their employees for fear of discrimination. Of the 26% who did disclose their status, 10% reported having faced prejudice as a result. People in marginalized groups – female sex workers, hijras (transgender) and gay men – are often stigmatized not only because of their HIV status, but also because they belong to socially excluded groups.