The reduction was maximum in Karnataka where the fresh infection cases were dipped by 12.7 per cent, thanks to the interventions offered by Avahan— the Indian AIDS initiative of Bill and Melinda Gates Foundation.
Assessing Avahan’s contribution, researchers now claimed as many as 100,178 HIV infections were averted at the population level from 2003 up to 2008 as a result of those steps. The study, published in the journal Lancet on Tuesday, has been funded by the same Bill and Melinda Gates Foundation.
The authors, including a Union Health Ministry Official and a professor at the Public Health Foundation of India, however, declared that they do not have any conflict of interests.
Launched in 2003 with a funding support of $ 258 million from the foundation set up by the Microsoft czar, Avahan’s aim was to slow the rate of HIV transmission in general population by expanding the coverage of interventions in high-risk groups. Its efforts ran parallel to the government’s own programme.
The high-risk groups include female sex workers and their clients and partners, men who have sex with men, injecting drug users, and truck drivers.
One of the highlights of the Avahan’s programme was that it worked along 8,000 km of national highways to reach highly mobile interstate truckers, who account for approximately 10 to 12 per cent of the clients of female sex workers.
The interventions range from peer outreach for safe-sex counselling; clinical services, including treatment for sexually transmitted infections, distribution of free condoms, needle and syringe exchange and community mobilisation and advocacy activities.
“Our analyses suggest a strong association between the large-scale Avahan HIV prevention programme in India and reductions in HIV prevalence at the population level,” the researchers headed by Marie Ng from the University of Seatle, Washington, said.
Avahan programmes were implemented in Andhra Pradesh, Karnataka, Maharashtra, and Tamil Nadu as well as in Manipur and Nagaland. In 2003, these six states with total population of 300 million were estimated to have the highest HIV prevalence in India. As many as 131 districts in the six states received funding from Avahan for HIV prevention.
The efficacy of the Avahan interventions, however, was not uniform. The programme’s influence in reducing HIV was maximum in Andhra Pradesh, Karnataka and Maharashtra. Notwithstanding the success, the foundation decided to quit India and sanctioned an additional $ 80 million so that its ongoing projects can be merged with the government efforts by 2013 without any hitch.
