NEW DELHI: The total number of people living with the Human Immunodeficiency Virus (HIV) has reached its highest level, with about 40.3 million people suffering from the infection globally. Close to 5 million new infections were reported in 2005.

According to `AIDS: Epidemic Update,' brought out by UNAIDS and the World Health Organisation, despite improved access to antiretroviral treatment and care in many regions of the world, Acquired Immunodeficiency Syndrome (AIDS) claimed 3.1 million lives in 2005, of which more than half a million were children.

In India, an estimated 5.1 million people were living with HIV in 2003. Although levels of prevalence of HIV appear to have stabilised in some States such as Tamil Nadu, Andhra Pradesh, Karnataka and Maharashtra, it is still increasing in at-risk population groups in several other States as a result of which overall HIV prevalence continued to rise.

Pointing out that relatively little was known about the role of sex between men in India's various epidemics, the report quotes a few studies that have found that significant numbers of men do have sex with other men. One study, undertaken among residents of slum areas in Chennai, has shown that 6 per cent of men had had sexual intercourse with another man. Almost 7 per cent of the men who had sex with other men were HIV-positive, and more than half of them were married.

The report, released at 13 places across the world, suggests that HIV prevalence of over 1 per cent has been found in pregnant women in four of the industrialised western and southern States (Andhra Pradesh, Karnataka, Tamil Nadu and Maharashtra) and in the north-eastern states of Manipur and Nagaland. Transmitted mainly through unprotected sex in the south and injecting drug use in the north-east, HIV is spreading beyond urban areas.

In Karnataka and Nagaland, more than 1 per cent of pregnant women in rural areas tested HIV-positive in 2003. A significant proportion of new infections occur in women who are married and have been infected by husbands who (either currently or in the past) frequented sex workers. Commercial sex (along with injecting drug use in Nagaland and Tamil Nadu) serves as a major driver of the epidemics in most parts of the country. Surveillance in 2003 found that 14 per cent of commercial sex workers in Karnataka and 19 per cent in Andhra Pradesh were infected with HIV. A recent finding that 26 per cent of sex workers in Mysore were HIV-positive is not surprising given that just 14 per cent of the women used condoms with clients and 91 per cent never used condoms with their regular partners, the report points out.

The well-known achievements among sex workers of Kolkata's Sonagachi red-light area have shown that safer sex programmes that empower sex workers can curb the spread of HIV. Condom use in Sonagachi has risen as high as 85 per cent and HIV prevalence among commercial sex workers declined to under 4 per cent in 2004 (having exceeded 11 per cent in 2001). In Mumbai, by contrast, available data suggests that sporadic and piecemeal efforts to promote condom use have not been effective.

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