AIDS in South Asia: Understanding And Responding to a Heterogenous Epidemic (Health, Nutrition and Population Series)

Contents......Page 7
Figures, Tables, and Boxes......Page 11
Foreword......Page 13
Acknowledgments......Page 15
Abbreviations......Page 17
Executive Summary......Page 19
1. Background and Rationale......Page 25
Rationale......Page 26
Epidemic Potential......Page 31
Biological Factors......Page 35
Behavioral and Structural Factors......Page 37
India......Page 39
Pakistan......Page 41
Sri Lanka......Page 42
Afghanistan, Bhutan, and the Maldives......Page 43
Female Sex Workers......Page 45
Clients of Female Sex Workers......Page 47
Men Having Sex with Men......Page 49
General Population......Page 50
Injecting Drug Users......Page 51
Female Sex Workers, Clients, and MSM Who Also Inject Drugs......Page 53
IDUs Who Also Have Risky Sex......Page 54
Female Sex Workers......Page 55
Men Having Sex with Men......Page 56
Injecting Drug Users......Page 57
5.1 Variations in HIV Infection in Seven Neighborhoods in Bangladesh......Page 59
5.3 HIV among Truckers in Selected Indian Sites, 1994–97......Page 60
India......Page 65
6.14 Condom Use among Clients and Sex Partners of Female SWs in Tamil Nadu, India, 1996–2004......Page 84
6.3 Steps toward a Stronger Institutional Response to HIV/AIDS in Nepal......Page 88
Bangladesh......Page 92
Sri Lanka......Page 95
Afghanistan......Page 98
The Maldives......Page 101
Distribution of High-Risk Networks......Page 103
7.1 Program Coverage at District (macro) and Local (micro) Levels......Page 104
General Considerations......Page 106
Recommendation 1: Build Capacity......Page 107
Recommendation 3: Devote Resources to Condom Use and Needle Exchange......Page 108
Recommendation 6: Expand Mapping of High-Risk Populations......Page 109
Recommendation 8: Reduce Stigma......Page 110
Recommendation 9: Improve Coordination by Expanding Cooperation......Page 111
Appendix A: The World Bank Response to AIDS in South Asia......Page 113
Appendix B: Definition of Targeted and General Population Interventions......Page 115
Appendix C: Country Analysis Summaries......Page 119
References......Page 125
Index......Page 133
2.1 Truncated Epidemic......Page 32
2.2 Local Concentrated Epidemic......Page 33
2.3 Generalizing Epidemic......Page 34
2.4 Phases of an Epidemic......Page 36
5.2 HIV Infection among Male and Female IDUs and Male Heroin Smokers in Central District in Bangladesh......Page 58
5.4 Prenatal Clinic and Population-Based HIV Prevalence in Tamil Nadu, India......Page 61
5.6 HIV Prevalence in Bagalkot, Karnataka, India......Page 62
6.2 HIV Prevalence in State Clusters in India, 1999–2004......Page 66
6.4 Sexual Partners in Previous Year among Women Reporting at least One Sex Partner in State Clusters in India......Page 67
6.5 HIV Prevalence among Pregnant Women in Districts of Karnataka-Maharashtra Corridor, India, 2003–2004......Page 68
6.7 HIV Prevalence among Pregnant Women and Voluntary Blood Donors in Northeastern States, India......Page 69
6.8 HIV Prevalence in Three Talukas in Bagalkot from a Population-Based Survey......Page 71
6.9 Distribution of Female Sex Workers in Villages of Three Talukas, Bagalkot, Karnataka, India, 2004......Page 72
6.11 Proportion of Men Who Reported Ever Having a Nonmarital Sexual Partner, Bagalkot, Karnataka, India, 2004......Page 73
6.12 Coverage of High-Risk Groups in South and Southeast Asia, 2004......Page 81
6.13 HIV Trends in Tamil Nadu, 1998–2003......Page 83
3.1 HIV Sentinel Surveillance Sites in India......Page 40
A.1 World Bank HIV/AIDS Lending Portfolio in South Asia......Page 114
C.1 Summary of HIV Epidemic Dynamics and Program Recommendations......Page 120
6.1 Declining HIV Prevalence in South India but Not in North India......Page 75
6.2 The Sonagachi Project, West Bengal, India......Page 85
6.4 Sri Lanka Rapid Results Initiative to Jump-Start Implementation of HIV/AIDS Prevention Project......Page 99