Guwahati: While HIV prevalence in India has significantly decreased since 2000 and currently stands at 0.20% in 2022, the latest HIV Estimates for 2022 highlight an alarming situation in the Northeast region.
The NE States of Mizoram (2.34%), Nagaland (1.34%) and Manipur ( 0.94%) are estimated to have the highest adult HIV prevalence, followed by Andhra Pradesh, Telangana, Karnataka, Meghalaya, and Delhi, with prevalence ranging between 0.70% and 0.30%. Meghalaya is the other state in the Northeast which has an adult HIV prevalence rate of 0.39%.
Tripura has an adult HIV prevalence of 0.22%, followed by 0.13% of Arunachal Pradesh, Assam at 0.11%, and Sikkim at 0.08%.
The 2022 HIV burden estimates provide the most recent and comprehensive information on India’s HIV epidemic, aiding authorities in grasping key indicator trends for efficient program planning at the State/UT levels. Most States/UTs have witnessed a decline in the HIV epidemic, with reduced annual new HIV infections and AIDS-related deaths observed from 2010 to 2022.
In Mizoram, the estimated adult HIV prevalence has risen sharply over previous years, while Arunachal Pradesh, Meghalaya and Tripura have lower levels but indicate an upward trend. In contrast, the prevalence appears stable in Nagaland, Assam and Sikkim,” the report says.
“HIV Estimates 2022 shows that the national AIDS response continues to be successful in preventing new infections, AIDS-related deaths, and vertical HIV transmission. It does, however, also demonstrate rising new infection trends in some States, which is a matter of concern. Despite the decline, the vertical transmission rate is still too high. Clearly, there is no room for complacency, and we must constantly push ourselves to broaden the horizon for integrated AIDS response at the most local level to accelerate the country’s progress towards ending the AIDS epidemic as a public health threat,” says Ms V. Hekali Zhimomi, Additional Secretary & Director General at NACO in the foreword to the report.
“The goal of National Aids Control Programme-V is to achieve an 80% reduction in annual new HIV infections and AIDS-related deaths from 2010 to 2025–2026. India has also adopted the United Nations Sustainable Development Goal (SDGs) to end the Global AIDS epidemic by 2030,” says the report.
Many officials shared their comments in the report.
“At the state level, the epidemic is highly diverse, for which tailored state and district-level action planning is ever critical. For instance, three states with the highest adult HIV prevalence are in the north-eastern part of India (Mizoram, Nagaland and Manipur),” says David Bridger UNAIDS Country Director for India in the report.
“The level and trend of HIV prevalence and incidence in the northeastern States is alarming” says Sankalak: Status of National AIDS & STD Response report (2023).
The trend for adult HIV prevalence is declining in Andhra Pradesh, Chhattisgarh, Goa, Karnataka, Kerala, Madhya Pradesh, Maharashtra, Tamil Nadu and Telangana since the epidemic’s peak. Other States with HIV prevalence higher than the national average of 0.20% are Andhra Pradesh (0.64%), Telangana (0.45%), Karnataka (0.43%) in the Southern region; in the NE region; and Delhi (0.32).
The sub-national HIV incidence rate provides insight into the epidemic trend and dynamics across geographical divisions within the country, informing the success and effect of the different preventive activities under NACP. Mizoram (0.86), Nagaland (0.48), Meghalaya (0.31), Manipur (0.27) and Tripura (0.18) are the top five States with the highest HIV incidence per 1000 uninfected population in 2022.
Delhi (0.14), Arunachal Pradesh (0.11), Andhra Pradesh (0.10), Assam and DNH&DD (0.08) along with Bihar, Goa, Haryana and Punjab (each with 0.07 HIV incidence per 1000 uninfected population), had HIV incidence rate between 0.15 to 0.07 per 1000 uninfected population.
The number of People Living with HIV(PVHIV) per Million Population (or per Ten Lakh Population) explains the PLHIV burden relative to the total population size. States with the highest PLHIV number per million population are the three NE States of Mizoram, Nagaland and Manipur, along with Andhra Pradesh, with more than 5,000 PLHIV.
On the number of People Living with HIV( PLHIV), States/UTs estimated to have the highest number of PLHIV at more than 1 lakh each are Maharashtra (3.88 lakh), Andhra Pradesh (3.22 lakh), Karnataka (2.74 lakh), Uttar Pradesh (1.95 lakh), Tamil Nadu (1.65 lakh), Telangana (1.59 lakh), Bihar (1.56 lakh) and Gujarat (1.15 lakh).
In the case of young people (15–24 years), the PLHIV burden has been estimated at over 15,000 in Maharashtra (21.500), Andhra Pradesh (18,850), Karnataka (18,420), Uttar Pradesh (17,920) and Bihar (16,110). In Telangana, Tamil Nadu, Gujarat, Rajasthan and West Bengal, this estimate is in the range of 5,000 to 10,000; while in Madhya Pradesh, Punjab, Haryana, Odisha, Chhattisgarh, Delhi, Assam, Manipur, Nagaland, Jharkhand, Mizoram and Meghalaya, PLHIV among this age group is between 1,000 and 5,000.
The top five States that are estimated to have more than 3 thousand Annual New Infections (ANI) in 2022 are Uttar Pradesh (9.88 thousand), Bihar (9.18 thousand), Andhra Pradesh (5.24 thousand), Maharashtra (4.46 thousand) and Karnataka (3.42 thousand), collectively representing 48% of the nation’s total ANIs.
This is followed by Delhi, Assam, West Bengal, Gujarat, Rajasthan, Tamil Nadu, Haryana, Punjab, Telangana, Odisha, Chhattisgarh, Madhya Pradesh, Jharkhand, Nagaland, Mizoram and Meghalaya, which are estimated to have between 1 thousand to 3 thousand ANIs per year, accounting for 47% of the overall HIV incidence burden in 2022.
“It is crucial to scale up prevention interventions under NACP-V to reduce the annual new infections effectively,” the report says.
The primary mission of the National Aids Control Programme( NACP) is to reduce AIDS-related mortality across the country by increasing the coverage of PLHIV who get lifesaving ART. Manipur has the highest mortality rate per 1,00,000 population at 18.24, followed by Andhra Pradesh (12.70), Nagaland (12.07), Karnataka (9.82) and Mizoram (9.24).
While among prisoners, migrants and truckers, the annual seropositivity in select northeastern States was much higher than the national average. Among prisoners, the seropositivity in Assam, Tripura, Nagaland and Mizoram was 5-12 times more than the national average. In Assam and Manipur, the seropositivity among migrants was 7-8 times the national average. In Assam, Nagaland and Tripura, the seropositivity among truckers was 2-3 times of the national average. For Injecting Drug Users, the seropositivity noted in Assam, Tripura and Arunachal Pradesh was 7-8 times the national average. Assam, Tripura and Arunachal Pradesh also noted higher seropositivity among MSM than the national average.
“While the varying seropositivity noted in the programme may also be the outcome of the coverage and testing practices being followed in a particular State, however, the seropositivity provides a context to the epidemiological scenarios being seen in a State or a region” says Sankalak: Status of National AIDS & STD Response (2023).
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