Opportunity for ‘More Effective’ HIV Prevention, Treatment in India ‘Should Not Be Lost,’ NEJM Perspective Says
UNAIDS and the World Health Organization in 2006 estimated that 5.7 million people in India were living with HIV -- a "figure that captured wide attention and raised the possibility that India had more" HIV-positive people "than any other country" -- Robert Steinbrook, a national correspondent for the New England Journal of Medicine, writes in an NEJM perspective piece. However, the country in July 2007 released a revised estimate that 2.5 million people in the country are living with HIV, Steinbrook writes, adding that the revision was "so large that it reduced by nearly 10% the estimated number of people living with HIV globally and reinforced ongoing concerns about the validity of methods for producing such epidemiologic estimates."According to Steinbrook, the new estimate indicates that India's HIV epidemic is "less generalized" than previously thought and that "there are greater opportunities to control it." Although the new estimate "changes little" in prevention efforts targeted toward those at high risk of the disease -- including injection drug users, commercial sex workers and their clients, long-distance truck drivers and men who have sex with men -- it "should now be easier and less costly than was previously anticipated to provide treatment," including second-line antiretroviral drugs, to those in need, according to Steinbrook.
Although the revised estimate is "obviously good news," the "unfortunate reality" is that India's HIV/AIDS epidemic accounts for about 25% of the estimated 10.7 million people outside sub-Saharan Africa who are living with the disease, Steinbrook writes, concluding that the "opportunity for better control" of the epidemic and "more effective targeting of resources for prevention and treatment should not be lost" (Steinbrook, NEJM, 1/10).
The perspective is available online. This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
