HIV mortality and infection in India: estimates from nationally representative mortality survey of 1.1 million homes

BMJ. 2010 Feb 23;340:c621. doi: 10.1136/bmj.c621.

Abstract

Objective: To determine the rates of death and infection from HIV in India.

Design: Nationally representative survey of deaths.

Setting: 1.1 million homes in India. Population 123,000 deaths at all ages from 2001 to 2003.

Main outcome measures: HIV mortality and infection.

Results: HIV accounted for 8.1% (99% confidence interval 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, 26% were due to tuberculosis, and the rest were attributable to other causes. 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 2005/6 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 2004-6, about 40% lower than the official estimate of 2.3 million for 2006. All cause mortality increased in men aged 25-34 years between 1997 and 2002 in the states with higher HIV prevalence but declined after that. HIV prevalence in young pregnant women, a proxy measure of incidence in the general population, fell between 2000 and 2007. Thus, HIV mortality and prevalence may have fallen further since our study.

Conclusion: HIV attributable death and infection in India is substantial, although it is lower than previously estimated.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Cause of Death
  • Female
  • HIV Infections / mortality*
  • Humans
  • India / epidemiology
  • Male
  • Middle Aged
  • Pregnancy
  • Pregnancy Complications, Infectious / mortality
  • Prevalence
  • Survival Rate
  • Young Adult