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    ABSTRACT: A recent report suggesting declining HIV transmission rates in southern India has been based on HIV seroprevalence data to estimate HIV incidence. We analyzed HIV incidence rates among 3 cohorts (male, female non-sex worker, female sex worker [FSW]) presenting to sexually transmitted infection (STI) clinics in Pune, India over 10 years. Between 1993 and 2002, consenting HIV-uninfected individuals were enrolled in a prospective study of the risks for HIV seroconversion. Standardized HIV incidence estimates were calculated separately for the 3 cohorts. HIV acquisition risk declined by more than 70% for FSWs (P = 0.02) and men (P < 0.001) attending the STI clinics. There was no significant reduction in HIV incidence among women attending STI clinics (P = 0.74). The decline in HIVacquisition risk among male patients with STIs was associated with an increase in reported condom use with recent FSW contact and a decrease in genital ulcer disease. We report the first direct evidence for a decline in HIV incidence rates in FSWs and male patients with STIs over time. The lack of change in HIV infection risk among non-sex worker women highlights the need for additional targeted HIV prevention interventions.
    JAIDS Journal of Acquired Immune Deficiency Syndromes 08/2007; 45(5):564-9. DOI:10.1097/QAI.0b013e3180d0a6ba · 4.39 Impact Factor
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    ABSTRACT: Objectives: To estimate HIV and sexually transmitted infection (STI) prevalence within the general population of Mysore district, and to examine differences in the distribution of risk factors associated with HIV prevalence stratified by sex. Methods: A community-based study was conducted in Mysore, Karnataka state, southern India, between October 2005 and November 2006; final sample size 4653. A face-to-face interview was conducted, and blood and urine specimens collected to measure HIV and STI prevalences. Risk factors for HIV among men and women were examined using weighted and clustered logistic regression. Results: Weighted HIV prevalence was 0.8% [95% confidence interval (CI) 0.52-1.09] overall and 0.7% (0.35-1.08) and 0.9% (0.51-1.37) in rural and urban populations, respectively. The prevalence of syphilis, gonorrhoea and chlamydial infection was 2.8% for men and 1.8% for women. In multivariate analysis, higher HIV prevalence was associated with ever having used a condom [odds ratio (OR) 2.75, 95% CI 1.01-7.47] and number of lifetime partners for men (OR 6.9, 95% CI 2.18-21.91). For women, HIV infection was associated with condom use at last sexual intercourse (OR 10.51, 95% CI 2.05-53.79), number of lifetime partners and reporting 'don't know' for whether ever had anal sex (OR 9.10, 95% CI 1.14-72.34). Conclusions: HIV prevalence in the general population of Mysore was found to be comparable to recent prevalence estimates for Karnataka state, and also similar to recent prevalence estimates from antenatal clinic attenders for the district. Few modifiable risk factors for HIV infection were identified. There is evidence from this study that high-risk behaviour may have been underreported, but the prevalence of STI was generally low.
    AIDS 11/2008; 22:S117-S125. DOI:10.1097/01.aids.0000343770.92949.0b · 6.56 Impact Factor
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    ABSTRACT: Background: Despite increasing availability of HIV-1 testing, education, and methods to prevent transmission, Indian women and their children remain at risk of acquiring HIV. We assessed the seroprevalence and awareness about HIV among pregnant women presenting to a private tertiary care hospital in South India. METHODS: Seroprevalence was determined via enzyme-linked immunosorbent assay (ELISA) testing, and questionnaires were analyzed using chi-square statistics and odds ratios to look for factors associated with HIV positivity. RESULTS: A total of 7956 women who presented for antenatal care were interviewed. Fifty-one women of the 7235 women who underwent HIV testing (0.7%) were found to be HIV positive. Awareness of mother-to-child transmission (MTCT) of HIV (64%), HIV transmission through breast milk (42%), and prevention of MTCT (13%) was low. Conclusions: There is a need to educate South Indian women about HIV to give them information and the means to protect themselves and their unborn children from acquiring HIV.
    Journal of the International Association of Physicians in AIDS Care (JIAPAC) 08/2010; 9(4):206-13. DOI:10.1177/1545109710371132