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  • Title: Increasing trend of HIV seropositivity in a sexually transmitted diseases centre and epidemiology of HIV seropositive individuals.
    Author: Ray K, Ramesh V, Karmakar SN, Misra RS.
    Journal: Int J STD AIDS; 1996; 7(1):48-50. PubMed ID: 8652712.
    Abstract:
    11,539 STD clinic attenders and 20,897 antenatal clinic (ANC) attenders at a New Delhi hospital were screened for HIV antibodies by ELISA over a 3-year period. Results were confirmed by Western Blot. A low HIV seropositivity rate (1 per 1000) with an increasing trend in 1993 (4 per 1000) was observed in the STD attenders as against 0.1 per 1000 in the normal control populations. Most of the STD attenders including all the HIV seropositives had heterosexual contact with female sex workers. Both the HIV seropositive ANC attenders acquired the infection through blood transfusion. Thirteen of 23 HIV positive STD attenders had genital lesions, 5 having ulcerative and 8 having nonulcerative STD. Their clinical presentation did not differ from the HIV negative cases but the therapeutic response in 4 was altered. None had signs of symptoms of ARC/AIDS. Two out of 6 spouses and a 2-year-old child of HIV seropositive patients were seropositive. Increasing HIV seropositivity observed in this study reflects the changing situation in the country and highlights the importance of improvement of surveillance, early diagnosis and combined approaches to the management and control of STDs and HIV. Although India's Sexually Transmitted Diseases (STD) Control Program has been in existence for 40 years, it was not until the acquired immunodeficiency syndrome (AIDS) epidemic that a serious attempt was made to strengthen the program and collect data on conditions responsible for the spread of human immunodeficiency virus (HIV). In this study, 11,539 individuals attending the Regional STD Teaching, Training, and Research Center in New Delhi during a 3-year period and 20,897 antenatal clinic patients at a New Delhi hospital were screened for HIV. The overall HIV seropositivity rate was 2.0/1000 among STD clinic attenders, but there was an increase from 1.0/1000 in 1990 to 4.1/1000 in 1993. The overall rate for antenatal patients was 0.1/1000. Heterosexual transmission, largely through contact with commercial sex workers, was the source of HIV transmission in almost half of the 23 infected STD clients. The 2 HIV-1 cases involving pregnant women were acquired through blood transfusion. 13 of the HIV-infected STD clients had genital lesions and, in 4 of these cases, the response to treatment was compromised (i.e., no response or a slow response). Two out of 6 spouses and a 2-year-old child of HIV-infected subjects were also seropositive. Although the incidence of HIV was small in this New Delhi study, increasing interactions with Bombay, where HIV incidence is at 35% of commercial sex workers, may change this situation.
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