Changing epidemiology of HIV in Mumbai: An application of the Asian epidemic model
Background: Mumbai is one of the most populous and high HIV prevalence cities in India. It has witnessed substantial changes in HIV-risk behaviors and a decline in HIV prevalence among high-risk groups during the past decade. Aim: To examine the changing pattern in the number of new HIV infections by transmission routes in Mumbai during 2000–2017. Methods: We used the Asian Epidemic Model by dividing the adult population (aged 15 and above) into seven subgroups: brothel-based and non-brothel based female sex workers (FSWs), heterosexual clients of FSWs, men who have sex with men/transgendered people (MSM), injecting drug users (IDUs), general women and general men. The MSM subgroup included homosexual and bisexual men. Results: New HIV infections among adults reduced by 86% during 2000–2010. The highest decline was among FSWs and their heterosexual clients (95%–98%), followed by MSM (82%), general women (77%), IDUs (51%) and general men (42%). Most new HIV infections during 2011-2017 are expected to occur among general women (1666) and general men (977) followed by MSM (715). Bisexual men were estimated to contribute about 14% of the new HIV infections among general women in 2010 and this proportion was estimated to increase to 19% in 2017. Discussion: HIV prevention programs for MSM and the general population need to be strengthened. Ensuring early detection of HIV, and higher levels of consistent condom use by HIV-infected men and women are essential to prevent new HIV infections in future.
Mishra, Ram Manohar, Madhulika Dube, Damodar Sahu, Niranjan Saggurti, and Arvind Pandey. 2012. "Changing epidemiology of HIV in Mumbai: An application of the Asian epidemic model," Global Journal of Health Science 4(5): 100–112.
Documenting and Disseminating Lessons from Avahan, the India AIDS Initiative