Queen of hills in HIV grip

New Delhi, July 28: Darjeeling, known as the queen of the hills, has emerged as a new HIV hotspot with two persons infected in every 100, according to the latest snapshot of Indias HIV epidemic from the National AIDS Control Organisation (Naco).

The northern Bengal district is among nine across India newly identified by Naco as emerging hotspots with HIV prevalence rates of more than 1 per cent – a cut-off public health experts say indicates that the infection is spreading from high-risk groups into the general population.

“Nine new districts (with a prevalence of over 1 per cent) have popped up,” Naco director-general Kanuru Sujatha Rao said today. Patna, Banka and Sitamarhi in Bihar, Indore (Madhya Pradesh), Deogarh (Orissa), Kasargod (Kerala), Amreli (Gujarat), and Jangir-Champa in Chhattisgarh are the other additions to the club of 87 such high-burden districts.

G.S. Mudur, for The Telegraph

The new figures based on surveillance during 2007 suggest that the prevalence in Darjeeling has jumped from a level below 1 per cent last year, but Naco officials and public health specialists say the reasons for the climb remain unclear.

“Each district is likely to have its own tale,” said Ashok Alexander, director of Avahan, the Bill and Melinda Gates Foundations HIV prevention initiative in India.

“An increase in migration is something you might look for. The question to be asked is whether it (Darjeeling) has seen a greater influx of migrant labour or tourists,” he said.

Darjeeling, which has been a tourist spot ever since the British developed it, also sees a constant movement of people across the Nepal border.

“But the rise to a level above 1 per cent indicates a spillover from high-risk groups into the general population,” Alexander said.

Public health experts believe that it is harder to contain the spread of the HIV virus after it has moved into the general population than when it is confined to high-risk groups such as commercial sex workers or injecting drug users.

Health sector analysts tracking the HIV infection believe Indias big problem is that certain high-risk groups remain “hidden” from interventions – actions that will allow them to learn and access steps to prevent infections.

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