The Telegraph
Since 1st March, 1999
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Study springs HIV surprise

New Delhi, Aug. 17: India has grossly overestimated the number of people infected with the HIV, says a study released today at the 16th international conference on AIDS in Toronto.

This is the first study to call for a major downward revision of India’s HIV burden. While the National AIDS Control Organisation (Naco) has estimated that India has about 5.2 million HIV-infected people, the study suggests the actual number may be 3.5 million or lower.

The findings imply that the government might be infusing limited resources into a problem whose magnitude is not quite as large as it has been assumed.

“We think there’s been a massive overestimation of numbers,” said Lalit Dandona, the director of the Centre for Human Development at the Administrative Staff College in Hyderabad and principal investigator of the study.

“India may need to substantially revise its HIV estimates downwards,” Dandona told The Telegraph over telephone from Toronto.

The overestimation springs from what health experts say is an imperfect method of estimating the total number of HIV-infected people. Under the existing sentinel surveillance method, HIV rates detected at antenatal clinics and sexually transmitted disease clinics in selected large government hospitals are extrapolated to the entire population.

Although sentinel surveillance has been used by India to estimate the HIV burden for more than five years, it has never really been proved to be accurate through population-based studies.

Dandona and his colleagues from the Nizam Institute of Medical Sciences sampled 12,600 people from rural and urban areas in Guntur district of Andhra Pradesh. Their population-based scan for HIV led to a number significantly lower than the estimate from sentinel surveillance.

While the sentinel surveillance method estimated 112,000 adults with HIV in Guntur, their population-based study led to a number of about 46,000. “We’re not being critical of the existing method. The estimates made so far were based on the best available data. But the time has come to modify the method of estimation,” Dandona said.

But scientists caution even with a 3.5-million burden, there is no space for complacency.

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