HIV high alert in Meghalaya, Manipur

Health Ministry report says intravenous drug, paid sex fuelling cases

From CK Nayak

NEW DELHI: The high prevalence of HIV positive cases in Meghalaya and Manipur points to an epidemic largely fuelled by intravenous drug use but also supported through commercial exchange of sex, said a report by the Health Ministry.
Though the overall prevalence of the human immunodeficiency virus in India has reduced according to the HIV Sentinel Surveillance 2016-2017 on Wednesday, the report on northeastern states has raised concerns.
Mizoram (1.19 per cent), Nagaland (0.82 per cent), Meghalaya (0.56 per cent), Tripura (0.56 per cent) and Manipur (0.47%) have the highest prevalence of HIV among pregnant women in the country, the report said.
Except Manipur, all these states display higher prevalence of the virus than before. Besides the northeastern states, “injecting drug behaviour” is also fuelling the epidemic in north India, mainly Punjab, Delhi, Haryana, Uttarakhand and Uttar Pradesh.
States like Gujarat, Punjab, Rajasthan, Haryana, Uttar Pradesh and Bihar have shown a rise in the prevalence of the virus among pregnant women, which indicates “continuing rising epidemic”.
The prevalence of HIV among pregnant women in the country has dropped negligibly from 0.29 per cent of the population in 2014-15 to 0.28 per cent in 2016-17. The number of HIV cases among pregnant women is considered a proxy for the prevalence in general population.
But other states which have prevalence rates among antenatal women higher than the national average are Gujarat (0.44 per cent), Chhattisgarh (0.35 per cent), Delhi (0.38 per cent). These states do not traditionally have high HIV rates, the report said.
The states which have earlier had more cases include Andhra Pradesh, Telangana, Karnataka, Maharashtra and Tamil Nadu. The AIDS control programme has traditionally focused on these states.
Of the high risk population of female sex workers, men having sex with men (MSM), transgenders, truckers and intravenous drug users, the highest prevalence is among the last group. The prevalence of HIV among female sex workers tested is 1.56 per cent, MSM is 2.69 per cent, intravenous drug users 6.26 per cent, transgenders 3.14 per cent and truckers 0.86 per cent. While the prevalence rate of HIV among pregnant women in these states is still high, it has shown a declining trend over the years.
The higher prevalence of HIV among single migrant men and long-distance truckers is also adding to the burden. The report said analysis has shown that pregnant women with migrant spouses have shown higher rates of contracting HIV in some states like Bihar, Uttar Pradesh, Rajasthan, Odisha, Manipur and Nagaland.
“In Manipur and Nagaland, pregnant women with migrant spouses are two to three times more likely to be HIV positive than those with non-migrant spouses,” the report added.