HIV Sentinel Surveillance

Objectives of the Research:

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.

The objectives of HIV Sentinel Surveillance are:

  1. To determine the level of HIV infection among general population as well as high risk groups in different states.
  2. To understand the trends of HIV epidemic among general population as well as high risk groups in different states.
  3. To understand the geographical spread of HIV infection and to identify emerging pockets of HIV epidemic.
  4. To provide information for planning the programme in different states and districts, for prioritization of programme resources and evaluation of programme impact.
  5. To estimate HIV Prevalence and HIV burden in the country besides HIV incidence, Mortality due to AIDS and ART needs.

Sentinel Groups: The sentinel groups in Karnataka are:

  1. Antenatal Cases (pregnant women)
  2. Patients with Sexually Transmitted Diseases
  3. Female Sex worker (FSW)
  4. Male having Sex with Male (MSM)
  5. Injecting drug Users(IDU)
  6. Single Male Migrant (SMM)
  7. Long Distance Truckers (LDT)

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.

Table 1: Scale up of HIV Sentinel Surveillance sites in Karnataka

1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 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
IDU 0 1 1 0 1 1 1 0 1 1 1 1
MSM 1 1 1 1 1 3 7
FSW 1 3 4 6 26
Migrant 1
Trucker 1

HSS 2010-11 (Provisional data):

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.

HSS 2010-11 (Provisional data):

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.

Suervillence Publication