Introduction To determine the rates of death and infection from HIV in India in a nationally-representative survey of deaths among 1.1 million homes.
Methods Survey of 123 000 deaths at all ages from 2001 to 2003. Main outcome measures HIV mortality and infection.
Results HIV accounted for 8.1% (99% CI 5.0% to 11.2%) of all deaths among adults aged 25–34 years. In this age group, about 40% of deaths from HIV were due to AIDS and 26% were due to tuberculosis. Nationally, HIV infection accounted for about 100 000 (59 000 to 140 000) deaths or 3.2% (1.9% to 4.6%) of all deaths among people aged 15–59 years. Deaths from HIV were concentrated in the states and districts with higher HIV prevalence and in men. The mortality results imply an HIV prevalence at age 15–49 years of 0.26% (0.13% to 0.39%) in 2004, comparable to results from a 2005/2006 household survey that tested for HIV (0.28%). Collectively, these data suggest that India had about 1.4–1.6 million HIV infected adults aged 15–49 years in 2004–2006, about 40% lower than the official estimate of 2.3 million for 2006. All cause mortality in men aged 25–34 years in the states with higher HIV prevalence has declined since 2002. HIV mortality and prevalence may have fallen further since our study as prevalence among young women attending antenatal clinics has declined from 2000 to 2007.
Conclusion HIV attributable death and infection in India is substantial, although it is lower than previously estimated.
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