HIV Spread Via Female Sex Workers in India Set to Increase Significantly by 2005
Originally published by Reuters Health, December 26, 2001
DELHI — If preventive measures fail, the number of cases of HIV infection spread through commercial sex networks in India may more than double by the year 2005, Indian researchers warn.
Since the first case of AIDS was described in India in 1986, there has been an exponential increase in HIV infection, second only to the African continent, writes Dr. Chitta Venkataramana of the Johns Hopkins School of Hygiene and Public Health, Baltimore, USA, and a colleague, in the December issue of Tropical Medicine and International Health. Heterosexual contact accounts for 85% of HIV cases in India, and the study was conducted to estimate the impact of female sex workers on the spread of HIV in India.
Dr. Venkataramana and Dr. P. V. Sarada, with the governmental Reproductive and Child Health Project in the southern Indian province of Andhra Pradesh, used available data to develop a model to predict the estimated number of HIV cases spread through networks involving female sex workers.
In 1999, there were approximately two million female sex workers, 15.52% of whom were infected with HIV, averaging two client visits per day. There were approximately 30 million clients of sex workers in 1999, with an HIV infection rate of 7.27%,and a condom usage rate of approximately 24.5%.
Based on existing studies, the researchers assumed that while regular use of condoms is fully protective, the risk of infection during unprotected sexual contact is between 0.067% and 0.6%.
There were 2.491 million cases of HIV infection in India among female sex workers, their clients and families in 1999. Using the data they collected, the researchers estimate that in a best-case scenario, the number of HIV infections among female sex workers, their clients and families would be 3.93 million by the year 2005. If intervention programs fail to achieve desired results, they predict that the number could be as high as 6.87 million.
Dr. Venkataramana told Reuters Health that the most important measures in preventing the spread of HIV would be "promoting condom usage and large scale treatment of sexually transmitted infections." He also urged a change in society's attitude toward sex workers, with provision of better health services and condom distribution.
