By James F. Blanchard, Han Kang, Faran Emmanuel, Sushena Reza Paul,
South Asia's HIV epidemic is extremely heterogeneous. for that reason, proficient, prioritized, and potent responses necessitate an realizing of the epidemic range among and inside of international locations. extra unfold of HIV in South Asia is preventable. the long run measurement of South Asia's epidemic is determined by an efficient two-pronged process: first of all, at the scope and effectiveness of HIV prevention courses for intercourse employees and their consumers, injecting drug clients and their sexual companions, and males having intercourse with males and their different sexual companions; and secondly, at the effectiveness of efforts to handle the underlying socio-economic determinants of the epidemic, and to minimize stigma and discrimination in the direction of humans undertaking excessive possibility behaviors, usually marginalized in society, in addition to humans dwelling with HIV and AIDS. This evaluate used to be undertaken to supply a foundation for rigorous, evidence-informed HIV coverage and programming in South Asia.
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Additional resources for AIDS in South Asia: Understanding And Responding to a Heterogenous Epidemic (Health, Nutrition and Population Series)
The scale and heterogeneity of the country’s HIV epidemic can be appreciated by considering how India’s size and complexity resemble those of a continent in which some states and even districts are larger than many African countries. India’s epidemic is concentrated in eight states with over 1 percent HIV prevalence in prenatal clinics (NACO 2005): • Tamil Nadu, Karnataka, and Andhra Pradesh in the south • Maharashtra and Goa in the west • Manipur, Nagaland, and Mizoram in the northeast.
First, crosssectional studies from Bangladesh (Gibney and others 2002) and Pakistan (Baqi and others 1999; Khan 1996; Mirza and Hasnain 1995), as well as BSS data from India (NACO 2001c), reveal that clients of female SWs also have sex with men. In Bangladesh, 7 percent of rickshaw pullers and truck drivers reported sex with a male SW in the past year, and 21 percent of them reported sex with a male SW at least once in their lifetime. Similarly, in Pakistan, 39 percent of clients of 26 • AIDS in South Asia female SWs are also clients of male SWs, and 30 percent of male STI patients have sex with males.
Although injecting drug use is mainly an urban problem, drug use is widespread in both urban and rural areas. Between 1989 and 2005 the Central Blood Bank, Kabul, reported 67 HIV-positive cases out of 125,832 blood samples screened at central and provincial levels (Islamic Republic of Afghanistan 2006). In one community profile of drug users in Afghanistan, almost half of all heroin users started their practices while in Iran or Pakistan (GTZ 2005). Few harm reduction programs, including needle exchange, are in place to break transmission of HIV/AIDS.