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By James F. Blanchard, Han Kang, Faran Emmanuel, Sushena Reza Paul,

South Asia's HIV epidemic is extremely heterogeneous. therefore, knowledgeable, prioritized, and potent responses necessitate an figuring out of the epidemic variety among and inside nations. extra unfold of HIV in South Asia is preventable. the longer term dimension of South Asia's epidemic is dependent upon an efficient two-pronged technique: to start with, at the scope and effectiveness of HIV prevention courses for intercourse staff 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 deal with the underlying socio-economic determinants of the epidemic, and to lessen stigma and discrimination in the direction of humans carrying out excessive danger behaviors, frequently 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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AIDS in South Asia: Understanding And Responding to a Heterogenous Epidemic (Health, Nutrition and Population Series)

South Asia's HIV epidemic is extremely heterogeneous. hence, trained, prioritized, and powerful responses necessitate an knowing of the epidemic variety among and inside of nations. extra unfold of HIV in South Asia is preventable. the long run measurement of South Asia's epidemic is dependent upon a good two-pronged procedure: to start with, 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 lessen stigma and discrimination in the direction of humans accomplishing excessive threat behaviors, frequently marginalized in society, in addition to humans residing with HIV and AIDS.

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3 schematically depicts a generalizing epidemic. Generalizing epidemics occur in many countries of Sub-Saharan Africa, but as we discuss subsequently, many locations in South Asia do not exhibit the defining conditions—such as substantial transmission beyond the high-risk networks—to sustain and amplify this kind of epidemic. Possible exceptions may include some localized areas in southern India, particularly in the states of Andhra Pradesh, Karnataka, and Maharashtra, as well as in parts of northeast India, particularly in the states of Manipur, Mizoram, and Nagaland.

For example, in Manipur, 19 percent of female SWs and 11 percent of clients reported injecting drugs in the past year. For female SWs and their clients, injecting drug use appears to occur more frequently outside of brothel settings. By state, Manipur has the highest proportion of female SWs and clients who reported injecting drugs. Among MSM, those in Karnataka and Tamil Nadu–Pondicherry accounted for most of the injecting drug use behavior observed overall (NACO 2001b for FSWs and their clients; NACO 2001c for MSM).

CHAPTER 2 Analytic Framework Between and within South Asian countries, the diversity of biological, behavioral, and structural factors can explain the substantial heterogeneity in HIV epidemiology and transmission dynamics (MAP 2005). Formulating strategies to curb the region’s HIV epidemic necessitates a comprehensive understanding of this diversity. Despite the large gaps in data and information necessary to complete this task thoroughly, we believe that an analysis of the extant data is sufficient to provide broad strategic guidance.

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