Re: Lancet article's on India's Declining Prevalence

[Guest guest]

Hi all,

I agree with Vineeta that the details of study should be looked into. Media can

misinterpret results of such studies and spread a wrong message.

Normally for an epidemic like HIV, since measuring incidence is almost

impossible in a context like India, for prevalence to be a good proxy indicator

for incidence it has to be from a well representative sentinal points (which in

India is not the case), it has be serial prevalence of newer cases from younger

age groups (which we dont know about this study).

In general taking any prevalence figures for assessing incidence of HIV in a

diverse and huge context like India could be a very thing. There could be a

variety of reasons for declining prevalence rather than due to decreasing

icidence. It could well be that HIV+ves are dying faster than incidence of new

cases, due to lack of care & support, not necessarily due to fall in incidence

or it could be a combination of many other such reasons.

So I would say that without knowing the details of the study, jumping to a

conclusion on the (mis)-interpretation of result of a prevalence study could be

very misleading.

Best regards,

Stobdan

Dr. Stobdan Kalon

Medecins du Monde-France

E-mail: skalon@...

[Guest guest]

Dear FORUM,

I think that the " title " for these postings " India's declining Prevalance "

should be used with caution.

The Lancet study can only speak for a specific population that it investigated,

and time and again we have seen how these

investigations are frequently proved to have been flawed or inaccurate years

later, (although I have read the Lancet article, and don't know the methodolgy.)

If the prevalence is declining that would be great. But it will take a lot more

than one study to prove it. And even if the prevalence, is declining it would

seem that there is still plenty of work to be done.

I think this study should be taken as only one small piece of a very, very large

puzzle.

Stern.

Stern <rastern@...>

[Guest guest]

Dear FORUM,

In assessing the applicability of the Lancet study's

applicability to the HIV/AIDS situation in India as a

whole, it is necessary to highlight the cautionary

comments made by Rajech Kumar, the principal

investigator and also by Ashok , director of

Avahan, the AIDS prvention initiative in high

prevalence states of India.

Kumar: " We are not saying the epidemic is under contol

yet--we are saying that prevention efforts with high

risk groups thus far seem to be having an effect. "

: " Jha's data shows that the epidemic is not

under control in Andhra Pradesh and Karnataka while

there is more positive trend in Maharashtra and Tamil

Nadu where there has been the longest record of

prevention. "

My contention is that the Lancet study has some

limitations but so far there has been no other study

carried out in India for understanding the HIV/AIDS

prevalence and incidence which can come near to the

Lancet study in terms of scope, comprehensiveness,

period covered and scietific validity. Those who are

familiar with Indian situation would appreciate the

tremendous difficulties in conducting an ideal

empirical survey on HIV/AIDS in India.

Moni Nag

Department of anthropology

Columbia University, New York

e-MAIL: <mn1925@...>