TRENDS AND MEASUREMENT OF HIV PREVALENCE IN TRIBAL AREAS OF NORTH ANDHRA PRADESH, INDIA.

Most data on HIV prevalence among tribal communities come from rural areas of North Andhra Pradesh surveillance. HIV prevalence and risk factors were measured using population-based data to assess the accuracy of ANC surveillance, Tribal communities and changes in prevalence and risk factors for HIV over time. HIV prevalence was measured in 2000-2002 and 2003-2005 in tribal community controls from casecontrol studies of mycobacterial disease in Adilabad District, Andhra Pradesh. ANC surveillance studies in the district began in 2003. Age and area-standardized HIV prevalence in women age 15-49 years in the tribal community was 2.5% in 2000-2002 and 13.9% in 2003-2005. HIV prevalence in men was 9.2% and 11.4% in the same periods. In 2000-2002 HIV positivity was associated with occupations other than farming, with increased schooling and being born outside Adilabad District. In 2003-2005. non-farmers were still at higher risk but the other associations were not seen. The age and area-adjusted HIV prevalence in the ANC in 20032005 was 9.2%. The underestimate can be explained largely by marriage and mobility. Reduced fertility in HIV positive individuals was demonstrated to both ANC and tribal community populations. HIV prevalence has increased and continues to be higher in non-farmers. The increase is particularly marked in those with no education. ANC surveillance underestimated HIV prevalence in the female population in all but the youngest age group. Although there were differences in Sociodemographic factors, a parity-based adjustment gave a reasonable estimate of female HIV prevalence.