HIV prevalence among blood donors correlates with hospital STD rate in Maharashtra, India.

Maharashtra is one of the 35 states of India with a population of 75 million. The Directorate of Health Services of Government of Maharashtra embarked on an AIDS prevention and control program in 1989. The program has effectively established HIV screening activities for all registered blood banks in the state. The STD control activities namely case diagnosis management case recording and reporting have been established at all the 30 district STD clinics in 1994. Due to a strong private health care sector only 20-30% patients with STD attend the government-run district STD clinics. The STD rate for a selected 10 district clinics was calculated using adult outpatient attendance as the denominator. The HIV prevalence among voluntary blood donors at the districts correlated with the STD rate at all except 2 district hospitals namely Thane and Wardha. Poor STD control activities in the latter 2 districts may explain the lack of correlation of STD rate with HIV prevalence. This suggests that STD rate like HIV prevalence among voluntary blood donors can be used as surrogate for community HIV prevalence in most developing countries in the early phase of HIV epidemic. In the later phase of the epidemic however the declining STD rate may not correlate with the community HIV prevalence. With limited resources in developing countries HIV prevalence is not available for blood donors in rural areas. These results suggest that rural areas with a high STD rate should be considered at risk for high HIV prevalence and targeted for crash AIDS prevention and control activities. (full text)