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Surveillance
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bridge population and High risk
Surveillance
The
first HIV infection in India was reported in 1986 and the
Epidemic continues to grow since then. India has the third
highest burden of HIV in the world with an estimated 2.5
million people living with HIV with Maharashtra accounting for
20% (4.95 lakh) of the PLHA burden of the country.
Data
generated through Sentinel surveillance have led to better
understanding of the heterogeneous nature of the epidemic.
There are multiple diverse sub epidemics in the state .
Prevalence among ANC clinic attendees which is taken as proxy
for prevalence in general population is showing a declining
trend over the years (0.6% in 2007), however HIV prevalence is
very high among sex workers, clients of sex workers, MSM and
IDUs ranging from 5% to 60%. There are geographical variations
with some of the districts having HIV prevalence among ANC
clinic attendees as low as 0.1% (Sindhudurg, Gadchiroli) and
with some districts with HIV prevalence ANC clinic attendees
as high as above 2% ( Sangli, Satara, Chandrapur)
HIV
sentinel surveillance is being carried out in Maharashtra
since 1998. Over the years the numbers of sentinel sites have
increased from 9 in 1998 to 97 in 2008.
Till
2007, HSS was conducted at 87 Sentinel sites in Maharashtra.
In
each district there are two ANC sites located at Urban and
Rural areas. The Urban sites are situated
at the Medical colleges and Civil Hospitals and the
ANC- Rural sites are situated at the FRUs. There are 9 STD
sites in 9 districts.
There
were total 11 HRG
sites, 10 FSW sites in 10 districts and 1 MSM site in Pune
district, at the NGOs carrying out the TI projects funded by
MSACS.
Taking
into account the nature of the epidemic , surveillance among
High risk group needs to be undertaken with each district
having at least one sentinel site among high risk group.
Accordingly in 2008 state has increased the number of HRG
sites with the help of other partners of MSAC. Thus 11 new
sites (8 new FSW, 2 MSM and 1 Migrant) have been added this
year.
For
the year 2009-10, state plans to further increase the number
of sentinel sites in geographical area with high number of
people with high risk behavior (both the core group and bridge
population). Conducting surveillance at these sites can signal
the potential for an emerging epidemic. It can also provide
information about where new infections can emerge and
potential for spread of new infections in that geographical
area. Thus 3 new FSW sites in Sangli and Satara district and 1
in Mumbai among Bargirls are proposed for 2009-10 and 12 new
sites in other districts with more than 10,000 Migrant
population are proposed. These districts are Nasik (2 sites),
Pune (2 sites), Chandrapur (2 sites), Mumbai (2 sites), Raigad
, Amrawati, Thane and Latur one site each.
Thus
monitoring the trend among population with high risk behaviour
will be useful for describing the current epidemic trajectory
and predict what will be the situation in that geographical
area in coming years.
Click
here for The district wise positivity among Antenatal women,
bridge population and High risk
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