Important note: Information in this article was accurate in 2003. The state of the art may have changed since the publication date.
Associated Press - November 13, 2003
That gives India - with its estimated 4.5 million HIV-infected people - the second-largest number after South Africa, according to a demographer who carried out a study funded by the Bill and Melinda Gates Foundation.
India has shown positive signs in tackling AIDS, though poor record-keeping by local health officials has made it difficult to determine the precise number affected, said Carl Haub of the Washington-based Population Reference Bureau.
"India is doing all the right things," Haub said. "It is a hopeful situation. The problem is the size."
The biggest challenge is reaching out to the some 640,000 villages, spread across three million square kilometers, where most of the country's one-billion-plus citizens live. Other hurdles include dispelling myths.
Haub said, "stigma and lack of knowledge can be as bad as: `You can get AIDS from mosquitos or by sharing a meal'."
The study, using federal and state government data, found that in four of the six hardest-hit states, it was businessmen, men in the service sector and hotel employees who had contracted the virus.
"The spread from the high-risk behavior groups to the general populace is another key indicator that HIV/AIDS in India has reached epidemic proportions," the study said. It said sex workers' clients, "particularly married males, act as the bridge groups aiding (the spread)...into the general population."
The findings differ from the common perception in India that promiscuous truck drivers, away from their families for long periods, and drug users sharing needles were the main contributors to the HIV spread in India.
The study, citing India's National Aids Control Organization, found that more than 85% of India's HIV cases are caused by unsafe sex. Three percent contract it through their mother's milk and another 3% from contaminated syringes.
The worst-hit states are Andhra Pradesh, Karnataka and Tamil Nadu in the south, Maharashtra in the north and Manipur and Nagaland in the northeast.
Last month, the Gates' foundation pledged $200 million for an HIV-prevention program in India.
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