The epidemiologic data for India (estimates of the number of infected persons range from 3.4 million to 9.4 million) are far less precise than for South Africa (4.9 million to 6.1 million). The estimate for India is based primarily on anonymous testing data from public clinics for prenatal care and for patients in high-risk groups or with sexually transmitted infections. Although the number of surveillance sites is expanding, the data may still be skewed and inadequate.2,3 In 2005, no data were available for many of India's more than 600 districts. The estimated HIV prevalence among people 15 to 49 years old in India is 0.5 to 1.5%, whereas in South Africa it is 16.8 to 20.7%. Moreover, HIV prevalence among 15-to-24-year-old women attending prenatal clinics in 4 southern Indian states decreased by 35% between 2000 and 2004; it was unchanged among women 25 to 34 years old in these states and in 14 northern states. These data suggest a slowing of any overall increase in prevalence. Nevertheless, the 2006 estimates have served as a wake-up call. In January 2007, Sujatha Rao, director general of India's National AIDS Control Organization, said at a Mumbai conference on HIV–AIDS therapy, "We have come a long way from complete denial of the HIV epidemic when it was first discovered in 1986 to a complete acceptance of the fact that we have a problem." India is a nation of contrasts. The economy is modernizing, but the culture is largely traditional. There are multiple religions and languages and long-standing patterns of behavior in relationships between the sexes. Violence against women is common and is "the most important structural issue" for HIV prevention, according to Ashok Alexander, director of Avahan, the India AIDS initiative of the Bill and Melinda Gates Foundation. Discrimination by health care professionals against people with HIV also remains "a big problem," according to Soumya Swaminathan, deputy director of the Tuberculosis Research Center in Chennai. And many adults still say they have never heard of AIDS.).
quinta-feira, 15 de março de 2007
Aids na India
Nada preocupa mais do que o avanço da aids na China e na India, os dois países mais populosos. The New England Journal of Medicine dedica um texto elucidativo sobre a situação indiana. O acesso é livre em http://www.nejm.org. Abaixo, trecho inicial do artigo