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Introduction

There has been a rapid and uncontrolled expansion of HIV in the developing countries during the last two decades. HIV has become a serious problem for India with one of the highest rates of spread in the world (19). The picture in India today has a lot of similarities with the progress of HIV in Africa 15 years ago (23). Many features contribute to India’s vulnerability concerning the transmission of HIV; India is a low income country with a large and young population, low educational and literacy rate and an increasing level of urbanisation (22). Another contributory factor to the rapid spread of the HIV epidemic is lack of adequate knowledge about the disease among the people.

About India The federal republic of India has about 1 027 million inhabitants (according to the latest census in 2001) and is divided into 29 states and six union territories (13). The main religion in India is Hinduism (80.5%) followed by Islam (13.4%), Christianity (2.3%), Sikh (1.9%), Buddhism (0.8%), Jainism (0.4%) and other religions (0.6%). India has 18 official languages of which Hindi is the most common (40%) (14). The literacy rate is 65% (76% for men and 54% for women) (13). Two thirds of the Indian people make their living as agricultural workers (15). Solapur is a city located in the southern part of Maharastra state and has a population of more than 1 million. The main religion in Solapur is Hinduism. The Nannaj area, located 22 km east of Solapur has a total population of 38 342 of which 9 000 lives in the Nannaj village (1,5). The majority of the inhabitants are farmers and the main religion is Hinduism.

Epidemiology According to UNAIDS/WHO AIDS Epidemic Update in December 2004, there is a total of around 39.5 million people living with HIV/AIDS in the world. About 37 million of those are adults and 2.5 million are children under the age of 15 years. During 2004, 5 million were newly infected , and about 3 million died from AIDS.

In the end of 2004, 7.1 million people were estimated to live with HIV/AIDS in South and South-East Asia. About 900 000 were newly infected during 2004 in this area and around 490 000 died due to AIDS.

In India the number of HIV-infected was 5.1 million in 2004 (8). This means that less than one percent of the population is infected. Bearing the huge number of people in mind, India has the second highest number of people living with HIV in the world after South Africa. Globally India accounts for about 10 % of the people living with HIV/AIDS (8). In 2002, the US National Intelligence Council estimated that 20-25 million of the Indian population will be infected with HIV in 2010 (25). NACO (National AIDS Control Organisation) predicts this number to be 9 million (1).

It is though important to mention that there isn’t one epidemic in India , rather there are many localised sub-epidemics due to the great variety in socio-cultural patterns and many vulnerabilities in India. Six states in India; Andhra Pradesh, Karnataka, Maharastra, Manipur, Nagaland and Tamil Nadu have the highest incidence of HIV in the country (80% of the estimated HIV cases in India) (2).

About 85% of the HIV infections in India are transmitted through heterosexual contacts and 15% through other ways such as injecting drugs (2.2%), blood transfusions (2.6%) and

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