HIV epidemic in Punjab, India: time trends over a decade.

Although Bombay (Mumbai) appears to be the main focus for acquired immunodeficiency syndrome (AIDS) in India, rapid spread has occurred through other major cities as well. The first AIDS patient in the northern state of Punjab was reported in May 1987. The present study, spanning a decade, shows that the incidence in high-risk groups increased from 3 per 1000 in 1987 to 59 per 1000 in 1997, 73% of the cases being in the third and fourth decades of life, i.e. the most productive years. The male to female ratio was 3.1:1, and 29% of the patients had the full-blown disease. A total of 80.5% acquired the infection heterosexually and only 2% of the patients were intravenous drug users. The percentage of patients acquiring infection through blood, blood products, and haemodialysis dropped from 20% in 1987 to 5% in 1997, but the cumulative figure was still 12%. The intervention programme launched by the National AIDS Control Organization (NACO) appears to have had little impact on the epidemic. There is an urgent need therefore for more interactive programmes that include education concerning the modes of spread, course, financial implications and fatal outcome of the disease, instead of passive dissemination of information by posters and the media.