National AIDS Control Organisation

According to the National AIDS Control Organization (2019), India has 2.4 million people living with HIV, with 190 new infections reported daily. Shifts in the transport industry, changes the behaviors and locations of sex workers, and emerging anecdotal evidence of HIV risk among short-distance drivers like local taxi and bus drivers and allied populations highlights the need for focused research on short-distance drivers. This study examines the factors contributing to unsafe sexual practices among short-distance drivers in India. Conducted across multiple states from October 2022 to April 2023, the study surveyed 5,357 drivers and allied populations. Risky sexual behavior was defined as having multiple sexual partners or engaging with high-risk individuals without condom use during 12 months preceding the survey date. Data on socio-demographics and knowledge and perceptions regarding STI/HIV were analyzed using STATA 10 through univariate, bivariate, and multivariable logistic regression. The analysis revealed a 30% prevalence of risky behavior among all surveyed drivers. Short-distance truck drivers exhibited a higher risk (AOR: 2.13; 1.64–2.76) compared to long-distance drivers. Those with education beyond graduation were less likely to engage in risky behaviors (AOR: 0.37; 0.28–0.48). Marital status and living arrangements also influenced the likelihood of engaging in risky practices. Respondents with only partial knowledge of HIV transmission had increased odds of exhibiting risky behavior (AOR: 1.26; 1.05–1.45) compared to those with complete knowledge. The study underscores the need for targeted interventions to promote safe practices and condom use among short-distance drivers. Collaborations with sex worker initiatives, updated mapping of solicitation areas, and enhanced STI/HIV awareness campaigns are essential to meet this population’s needs effectively.

India has intensified efforts towards elimination of vertical transmission of HIV (EVTH) as part of National AIDS and STD Control Programme-V (NACP-V). We present the progress in achieving NACP-V’s EVTH goal as of year 2023-24. We analysed the 2023 state level data using Spectrum model in 2023 to measure the coverage of anti-retroviral treatment among pregnant women, annual paediatric HIV case incidence rate and final vertical transmission rate. UNAIDS and WHO definitions for these indicators were used. In 2023, around 2350 new paediatric infections were estimated by vertical transmission. However, 44% of these transmissions resulted from incident HIV infections among pregnant and breastfeeding women. Overall, paediatric HIV incidence per 100,000 live births decreased from 25.2 (14.7–46.6) in 2019 to 10.4 (6.1–19.3) in 2023. During the same reference period, final vertical transmission rate (inclusive of breastfeeding period) decreased from 25.28% (17.06–37.99) in 2019 to 11.75% (7.93–17.66) in 2023. The 2023 India HIV estimates, using recent data and global modelling tools, highlighted progress in eliminating vertical transmission of HIV. Early identification of HIV-positive mothers and starting them on lifelong ART is crucial. Additionally, generating local evidence is needed on interventions like safe practices, repeat testing, and feeding practices to inform policy decisions.

The estimated number of people living with HIV (PLHIV) in India in 2023 is 2.54 million (range 2.16-3.03 million). With the initiation of antiretroviral therapy (ART) and the "Test and Treat" policy, the life expectancy of PLHIV on ART has substantially increased, consequently leading to a higher rate of comorbidities among PLHIV. The Joint United Nations Programme on HIV/AIDS (UNAIDS) 2025 targets aim for about 90% of PLHIV to have access to integrated and comprehensive health care services, with a concerted effort to reach the End of AIDS by 2030. Hence, the National Integrated Bio-Behavioral Surveillance (IBBS) among PLHIV (IBBS-PLHIV) has been implemented for the first time in India to establish a baseline understanding of the prevalence of sexually transmitted infections (STIs), noncommunicable diseases (NCDs), and related risk behaviors among PLHIV. The primary aim of IBBS-PLHIV is to estimate the levels of HIV-related risk behaviors and the prevalence of other STIs and NCDs among PLHIV. The specific objectives are identifying the levels of HIV-related sexual and injecting risk behaviors; estimating the prevalence of STIs such as syphilis, hepatitis B virus, and hepatitis C virus; estimating the prevalence of NCDs such as diabetes and hypertension; understanding the lifestyle and behavioral risks associated with NCDs; and assessing the levels of violence, stigma, and discrimination experienced by PLHIV. IBBS-PLHIV will be a cross-sectional, biennial surveillance among PLHIV aged 15 years or older. The first round will be implemented at 120 ART centers across 28 states, accounting for approximately 95% of the total estimated PLHIV. Consenting, eligible PLHIV will be recruited through consecutive sampling. The overall sample size at each ART center is approximately 225, and the surveillance period is 3 months. Behavioral data on demographics, reproductive and sexual health, lifestyle and sexual behaviors, stigma, and discrimination will be collected. Blood samples will also be collected to test for STIs and NCDs. IBBS-PLHIV was initiated on January 1, 2024, in a phased manner. Data collection was carried out over 3 months and completed by June 2024 across all 120 sites. A total of 25,257 PLHIV were recruited for the surveillance, including 11,921 males, 11,855 females, and 1481 hijra/transgender individuals. Data entry, followed by data matching and validation of all records, was completed in December 2024. The data are currently being analyzed, and the final findings are expected to be disseminated by December 2025. Data collected through IBBS-PLHIV will help monitor the levels of HIV-related sexual and injecting risk behaviors among PLHIV. Additionally, it will provide estimates of the prevalence of NCD comorbidities and STI coinfections such as diabetes, hypertension, syphilis, and viral hepatitis. These findings will serve as a baseline and are expected to offer valuable insights for facilitating comprehensive HIV care and management through the effective integration of HIV and broader health service delivery. DERR1-10.2196/58252.

Introduction: Pilonidal sinus is a very common inflammatory disease of the gluteal region. The most common site of occurrence is the natal cleft. It can cause discomfort, absence from work and social embarrassment. There is no single, widely accepted therapy available for this condition. In most cases, the treatment option for this disease is surgical intervention, but recurrences following surgery are common. Case Summary: A 15-year-old male patient reported discharge from the sinus cavity in the natal cleft along with pain and discomfort. Nitric acid, a homoeopathic medicine, was prescribed during the initial consultation and the patient was followed up for four months at regular intervals. The Visual Analog Scale and the Outcome Related to the Impact on Daily Living (ORIDL) scale were used to assess the patient's subjective improvement. The signs of objective improvement were documented through photographs. The score for Modified Naranjo Criteria for Homoeopathy (MONARCH) was +8, which supports the causal attribution of the individualised homoeopathic medicine Nitric acid to the success of this case.

With increasing importance being given to preexposure prophylaxis (PrEP) for human immunodeficiency virus prevention among men who have sex with men (MSM) and transgender persons (TG), we undertook a systematic review and meta-analysis of PrEP awareness and acceptability among these key populations in India, and their sociodemographic and behavioral determinants. The systematic review was registered with PROSPERO (CRD42023390508). Studies were included if they provided quantitative data on PrEP awareness or acceptability among MSM or TG in India. MEDLINE, Scopus, Web of Science, and Embase were searched from inception to February 29, 2024, using keywords and database-specific terms. Relevant websites were also searched. Critical appraisal was done using the Joanna Briggs Institute Checklist for Prevalence Studies. Random-effects meta-analysis was done for common outcomes reported by the studies. Reporting was as per the Preferred Reporting Items for Systematic Reviews and Meta-analyses 2020 statement. Ten studies providing cross-sectional data, mostly from South West India, were included for qualitative synthesis. All were conducted in settings where PrEP was not available. The pooled prevalence among MSM and TG was 18.7% (95% confidence interval [CI] 8.7%, 28.7%) for awareness and 79.8% (95% CI 57.4%, 100.0%) for willingness to use daily oral PrEP. This review highlights the felt need for PrEP among MSM and TG in India. Further research is needed to understand user attitudes in different parts of the country.