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AIDS Incidence in India Far Lower Than Previously Estimated New Study

Early analysis of the figures suggests that India really has between two and three million victims, and not 5.7 as per UN estimates of last year. The survey was carried out under international supervision with American financing.

The lower figure for India would imply that India has managed to keep its epidemic more like that of the United States, in that the virus circulates mostly within high-risk groups. In Indias case, these are prostitutes and their clients especially truckers; men who have sex with men; and people who inject drugs, especially in the northeast, on the borders with Myanmar.

That is exactly what some experts on AIDS surveillance techniques have been arguing for years, saying that Indians do not have the same kind of sexual networks that are common in southern and eastern Africa, in which both men and women often have two or more occasional but regular sexual partners over long periods of time. Also, outside of prostitution, transactional sex between teenage girls and older men in return for money, food or clothes is much less common in Asia than in Africa.

James Chin, a professor of epidemiology at the University of California, Berkeley, has made the case that the typical way of estimating AIDS prevalence rates sampling the blood of pregnant women who come to urban health clinics and the blood of high-risk groups greatly exaggerates national estimates.

Professor Chin has been vindicated by more recent surveys, paid for by the United States, that take blood samples in randomly chosen households in rural and urban areas. One of those, called the National Family Health Survey, produced Indias new figures. Such surveys, country by country, have led the United Nations AIDS program, Unaids, to slowly scale back its world estimates.

This is a replay of what happened in Kenya, said Daniel Halperin, an expert on AIDS infection rates at the Harvard School of Public Health. When Kenya
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