National AIDS Control Organization (NACO) is a nodal national agency for control of HIV in India. The spread of HIV/AIDS from the high risk groups to general population and from initial hot spots to new areas in India underlines the need for a comprehensive National AIDS Control Policy to effectively control the epidemic in the country. NACO conducts annual HIV surveys in different population groups to know how prevalent HIV is in India among different groups and overall.
The HIV Sentinel Surveillance (HSS) in India involves carrying out facility based and Targeted Intervention (TI) based HIV sero-prevalence surveys at regular intervals among selected population groups. These populations are also referred to as "sentinel groups". Thus HIV Sentinel Surveillance in Karnataka is carried out as per Standard Operating Procedure prescribed by NACO.
Scale-up of Sentinel Sites in Karnataka:
In 1998, NACO formalized annual HIV Sentinel Surveillance (HSS) across the country. Thus, HIV Surveillance in Karnataka started from 1998 (Table 1).The surveillance activities have been scaled up in a phased manner and the network of sentinel sites has expanded from a one site in 1998 to 96 sentinel sites in 2010.
|ANC Urban sites||1||3||6||10||10||28||28||28||28||28||29||30|
|ANC Rural sites||26||26||26||26||26||29||30|
An analysis of Annual Sentinel Surveillance data (2010-11) shows that female sex workers (FSWs) and men-who- have-sex-with-men (MSM) and Truckers have disproportionately higher prevalence of HIV infection. HIV prevalence (as per provisional data of HSS 2010-11) in the general population is 0.70 percent, its prevalence among FSWs is 5.1%, MSM is 5.4%, Truckers is 3.2% , Migrants is 0% and IDUs 0%, (Figure 1). In Karnataka, prevention and control of HIV/AIDS in HRGs will effectively control spread of HIV infections in general population. Thus, there is need of effective Targeted Intervention programme for control of concentrated HIV epidemic in state.
The HIV prevalence among the general population has reduced from 1.5% in 2004 to 0.70 % in 2010. HIV Sentinel Surveillance (HSS) data among pregnant women visiting Antenatal Clinics is considered as proxy indicator for infections in general population.