South India Faces HIV Surge:54 High-Priority Districts Identified

A recent study conducted by the Indian Council of Medical Research (ICMR) in collaboration with the National Institute of Epidemiology has raised significant concerns over the growing HIV burden in South India. According to the 2023 estimates, India continues to carry a substantial HIV burden, with approximately 25.44 lakh people living with HIV (PLHIV) across the country.

Among these, the five South Indian States and Union Territories collectively account for around 6.35 lakh PLHIV, highlighting a regional concentration of cases. Specifically, Karnataka reports 2.80 lakh, Tamil Nadu 1.69 lakh, and Telangana 1.58 lakh PLHIV—together contributing to nearly 24% of the national HIV burden.

The study has identified 54 high-priority districts—primarily from Karnataka, Telangana, and Tamil Nadu—as areas with significantly high PLHIV loads. These high-priority zones warrant urgent and focused intervention to control and reduce HIV transmission. In 2023, India recorded an estimated 68,450 new HIV infections, of which about 11.5% were reported from Karnataka, Telangana, and Tamil Nadu alone, with seven districts from these states contributing prominently.

A key focus area in HIV control is the Elimination of Vertical Transmission of HIV (EVTH)—which refers to preventing the transmission of HIV from a pregnant woman to her child during pregnancy, childbirth, or breastfeeding. In 2023, an estimated 19,960 pregnant women across India required EVTH-related services. Among them, seventeen districts in Karnataka, Tamil Nadu, and Telangana showed a disproportionately higher need for EVTH interventions, pointing to gaps in maternal health and early diagnosis services.

The district-level HIV estimation conducted in 2023 underscored the urgency of regional action: the 54 high-priority districts collectively account for 77% of the total PLHIV in the region, 43% of annual new infections, and 65% of the total demand for EVTH services. These figures emphasize the critical need to reinforce prevention, diagnostic, and treatment strategies, particularly in the most affected districts. The goal is aligned with India's broader commitment to ending AIDS as a public health threat by 2030.

In addition to HIV-related studies, ICMR is also working on enhancing overall disease monitoring through its Model for Integrated Influenza Surveillance project in Tamil Nadu. This initiative aims to develop a robust, integrated disease surveillance model by strengthening hospital-based and field surveillance mechanisms. The project currently focuses on four Tamil Nadu districts—Coimbatore, Madurai, Salem, and Thiruvarur—and integrates SARS-CoV-2 (COVID-19) monitoring with the existing Pan-India Epidemiological, Virological, and Genomic Surveillance for human influenza and related respiratory viruses.

This model surveillance initiative also includes a future perspective of scaling up testing for nine additional respiratory viruses besides influenza and COVID-19, across all age groups. To ensure effective implementation, epidemiological data analysis training has been provided to at least one stakeholder from each District Surveillance Unit (DSU) in all 38 districts of Tamil Nadu. The program includes situation analysis at the State Surveillance Unit and stakeholder interviews to identify current gaps and strengthen outbreak response systems.

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