Risk factors for HIV transmission in India.

Abstract

HIV was introduced in India much later than in other parts of the world, but is spreading with unprecedented rapidity and is becoming a public health problem with enormous social and economic implications. HIV in India is spread mainly through heterosexual intercourse, moving from high-risk behavior populations to the general population as indicated by the growing HIV prevalence among voluntary blood donors and women attending antenatal clinics. The main risk behaviors and practices associated with a higher risk of HIV transmission in India include unprotected sexual intercourse, IV drug use, and transfusion of contaminated blood and blood products. Factors affecting the sexual transmission of HIV include the presence of ulcerative STDs, irregular use of condoms, frequency of sexual contact, and age at sexual initiation. Knowledge, attitudes, and beliefs about sexual practices, low literacy, and economic conditions also affect high-risk sex behaviors. The authors discuss the historical perspective on HIV/AIDS in India, heterosexual transmission, IV drug use, blood transfusion and blood products, transmission in the healthcare system, perinatal transmission of HIV, homosexuality, and homosexual and bisexual behavior. Though openly tolerated by society, sex between men is common in India. There are few data on HIV prevalence among homosexual men. The risk of HIV transmission among homosexual men could be high because only 0-21% use condoms. Homosexual liaisons are short-lived, especially among bisexuals.