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THE WORLD

New data lower India's HIV rank

South Africa has the world's largest infected population, U.N. says.

July 07, 2007|Jia-Rui Chong | Times Staff Writer

A new United Nations estimate cuts in half the number of people living with AIDS and HIV in India, which was once ranked as having the largest infected population in the world.

The numbers do not represent an actual decline or a sudden triumph in managing the epidemic, said Karen Stanecki, a UNAIDS epidemiologist in Geneva.

"What we have is a new source of data," Stanecki said. "We have a much narrower, more confident estimate."

The new numbers, released Friday, now rank South Africa as having the largest infected population, followed by Nigeria and then India.

The report found that at the end of 2006, India had 2.5 million infected people. The 2005 estimate reported 5.7 million.

Ron Brookmeyer, a professor of biostatistics at Johns Hopkins University in Baltimore, said the new estimate did not diminish the severity of India's epidemic.

"It was a big problem, and these numbers continue to say it is a big problem," he said.

Previous estimates in India were based on statistics from about 700 prenatal and sexually transmitted disease clinics. Most of the sites were in urban areas. The method skewed estimates for the nation because of the higher rate of infection among city dwellers and those who visited sexually transmitted disease clinics, Stanecki said.

The main source of the new information was a national health survey that for the first time asked about HIV and AIDS.

"Whether these [numbers] are really complete, I don't know," said Dr. John Fahey, a UCLA immunology professor who has worked on AIDS in India for 15 years. "My feeling is, it's not as high as the higher number, but it's not as low as the current number."

Fahey said India has had trouble keeping accurate statistics on HIV and AIDS because the epidemic has spread so unevenly there.

For example, HIV rates vary greatly from state to state, in part because some have not acknowledged having infected people until this year, he said.

About 30 other countries in Asia, Africa and the Caribbean have revised their AIDS figures in the last few years, and almost all of them have shifted their counts down, according to UNAIDS.

The new calculation for India reduces the world HIV estimate to about 37.5 million people, Stanecki said.

She said she did not expect any more revisions from countries with major HIV and AIDS epidemics. "India was the last unknown," she said.

UNAIDS officials plan to recalculate historical figures for India and other countries so estimates can be compared across time.

jia-rui.chong@latimes.com

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