Abstract
Background:Mumbai is one of the most populous and high HIV prevalence cities in India. It has witnessed substantial changes in HIV-risk behaviors and a decline in HIV prevalence among high-risk groups during the past decade.Aim:To examine the changing pattern in the number of new HIV infections by transmission routes in Mumbai during 2000-2017.Methods:We used the Asian Epidemic Model by dividing the adult population (aged 15 and above) into seven subgroups: brothel-based and non-brothel based female sex workers (FSWs), heterosexual clients of FSWs, men who have sex with men/transgendered people (MSM), injecting drug users (IDUs), general women and general men. The MSM subgroup included homosexual and bisexual men.Results:New HIV infections among adults reduced by 86% during 2000-2010. The highest decline was among FSWs and their heterosexual clients (95%-98%), followed by MSM (82%), general women (77%), IDUs (51%) and general men (42%). Most new HIV infections during 2011-2017 are expected to occur among general women (1666) and general men (977) followed by MSM (715). Bisexual men were estimated to contribute about 14% of the new HIV infections among general women in 2010 and this proportion was estimated to increase to 19% in 2017.Discussion:HIV prevention programs for MSM and the general population need to be strengthened. Ensuring early detection of HIV, and higher levels of consistent condom use by HIV-infected men and women are essential to prevent new HIV infections in future.
Highlights
Mumbai is the capital of Maharashtra, which is one of the six high HIV prevalence states in India (National AIDS Control Organization, 2010)
It may be noted that the scale for the figures for female sex workers (FSWs), men/Transgendered (D) ANC Women People (MSM) and injecting drug users (IDUs) was identical whereas the scale for the figure for general women ranged from 0% to 5%
The reduction in the number of new HIV infections has been more among FSWs and their heterosexual clients than that among MSM and IDUs
Summary
Mumbai is the capital of Maharashtra, which is one of the six high HIV prevalence states in India (National AIDS Control Organization, 2010). Being the financial hub of the country, Mumbai has been a preferred destination for employment for thousands of young men from low HIV prevalence states (Jain et al, 1994; Saggurti, Verma, Jain, Achyut, & Ramarao, 2008; Singh, 2006). Many of these migrant men stay alone in the city away from their family, and a substantial proportion visit FSWs (Saggurti, Schensul, & Verma, 2009; Saggurti et al, 2008; Verma, Saggurti, Singh, & Swain, 2010). Ensuring early detection of HIV, and higher levels of consistent condom use by HIV-infected men and women are essential to prevent new HIV infections in future
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