CC BY-NC-ND 4.0 · Ann Natl Acad Med Sci 2016; 52(04): 183-191
DOI: 10.1055/s-0040-1712734
Original Article

Surveillance and Targeted Action to Prevent HIV/AIDS

Rajesh Kumar
Professor of Community Medicine, Head, School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh
› Author Affiliations

ABSTRACT

Epidemiological surveillance has played a key role in the identification of AIDS and its modes of transmission. In India, laboratory-based surveillance of HIV was initiated among most at-risk populations in 1990s, which was later expanded to antenatal clinics. On the basis of surveillance, high risk geographic areas and high risk populations were identified; and preventive behaviour change interventions were targeted among high risk groups in mid1990s. In 2003, analysis of surveillance data revealed a declining trend in HIV. Further analysis, indicated that targeted sexual behaviour change interventions among high risk groups had been responsible for the decline. The targeted behaviour change strategy among high risk groups was also found to be cost-effective. In the era of anti-retroviral therapy (ART), HIV prevalence trends would no longer be useful for tracking the epidemic. Hence, new laboratory essays are needed for tracking HIV incidence. Verbal autopsy method can provide direct estimates of HIV mortality trends to evaluate the effectiveness of ART. Since the number of new HIV infections is showing plateauing trend, further intensification of HIV/AIDS prevention and control efforts is required to achieve the end of HIV transmission and deaths due to AIDS by 2030.

DR. R.V. RAJAM ORATION delivered during NAMSCON 2016 at the All India Institute of Medical Sciences, Raipur.




Publication History

Article published online:
07 May 2020

© .

Thieme Medical and Scientific Publishers Private Ltd.
A-12, Second Floor, Sector -2, NOIDA -201301, India

 
  • REFERENCES

  • 1 Ghosh TK (1986). AIDS: a serious challenge to public health. Journal of Indian Medical Association. 84:29-30.
  • 2 Kakar DN and Kakar SN (2001). Combating AIDS in the 21st century Issues and Challenges. New Delhi: Sterling Publishers Private Limited, p.32.
  • 3 Nath LM (1998). The epidemic in India: An overview. In: The looming epidemic: The impact of HIV & AIDS in India. Godwin P (Ed). Hurst and Company, London, 28-61.
  • 4 Rao CN, Srivenkataramana T (2001). Projection of HIV infections in India: An alternative to back-calculation. Current Science 81:1302-1307.
  • 5 Kumar R, Jha P, Arora P, Dhingra N, Indian Studies of HIV/AIDS Working Group (2005). HIV-1 trends, risk factors and growth in India. In: NCMH Background Papers. Burden of Disease in India. New Delhi: National Commission on Macroeconomics and Health, Ministry of Health & Family Welfare, Government of India, pp58-73.
  • 6 Kumar R, Jha P, Arora P, et al. (2006). Trends in HIV-I in young adults in south India from 2000 to 2004: a prevalence study. The Lancet 367:1164-1172.
  • 7 Gupte MD, Mehendale SM, Pandav CS, Paranjape RS, Suresh Kumar M (2006). HIV-1 prevalence in young adults in south India. Lancet 368:114.
  • 8 Arora P, Kumar R, Bhattacharya M, Nagelkerke NJD, Jha P (2008). Trends in HIV incidence in India from 2000 to 2007. Lancet 372:289-290.
  • 9 Kumar R, Mehendale SM, Panda S, et al. (2011). Impact of Targeted Interventions on Heterosexual Transmission of HIV in India. BMC Public Health 11:549.
  • 10 Prinja S, Bahuguna P, Rudra S, et al. (2011). Cost Effectiveness of Targeted HIV Prevention Interventions for Female. Sexually Transmitted Infections 87:354-361.
  • 11 National AIDS Control Organisation (2015). India estimation report 2015: Technical Report. New Delhi: National AIDS Control Organisation & National Institute of Medical Statistics (ICMR), Ministry of Health and Family Welfare, Government of India.
  • 12 Kumar R, Thakur JS, Rao BT, Singh MM, Bhatia SP (2006). Validity of verbal autopsy in determining causes of adult deaths. Indian Journal of Public Health 50: 90-94.
  • 13 Jha P, Gajalakshmi V, Gupta PC, et al. (2010). Prospective study of one million deaths in India: Rationale, Design, and validation results. PLoS Med 3:e18.
  • 14 Jha P, Kumar R, Khera A, et al. (2010). HIV mortality and infection in India: estimates from a nationally-representative mortality survey of 1.1 million homes. BMJ 340:c621.
  • 15 United Nations (2016). On the fast track to ending the AIDS epidemic: Report of the Secretary-General. Agenda Item 11. http://sgreport.unaids.org/pdf/20160423_SGreport_HLM_en.pdf.
  • 16 Kumar R, Virdi NK, Lakshmi PVM, Garg R, Bhattacharya M, Khera AK (2010). Utility of Prevention of Parent-to-Child Transmission (PPTCT) Programme Data for HIV Surveillance in General Population. Indian J Med Res 132:256-259.
  • 17 National AIDS Control Organisation (2015). National Integrated Biological and Behavioural Surveillance (IBBS), India 2014-15. New Delhi: National AIDS Control Organization, Ministry of Health and Family Welfare, Government of India.
  • 18 GBD 2015 HIV Collaborators (2016). Estimates of global, regional, and national incidence, prevalence, and mortality of HIV, 1980-2015: the Global Burden of Disease Study 2015. The Lancet HIV 3: e361-e387.