15th International AIDS Conference Bangkok, Thailand - July 11-16, 2004

Int Conf AIDS 2004 Jul 11-16; 15:(abstract no. ThOrC1431)

Excler JL
International AIDS Vaccine Initiative, New Delhi, India

BACKGROUND: Over 4.58 million people have been HIV-infected in India at the end of 2002. High prevalence rates of HIV infection are reported from southern and northeastern Indian states. AIDS vaccines are considered as a long-term prevention tool to stop the epidemic. Steps were taken to define the feasibility of conducting AIDS vaccine efficacy trials in India.

METHODS: Site assessments were conducted in July 2003 in Maharashtra, Tamil Nadu, Andhra Pradesh, and in January 2004 in Manipur and Nagaland. The goals were to assess infrastructure, epidemiological situation, availability and accessibility of high risk groups for HIV infection, access to VCT, care and treatment, NGO activities and to provide recommendations to Health Authorities for preparing and conducting AIDS vaccine efficacy trials. Assessment tools developed by IAVI were used during the visits.

RESULTS: Southern states benefit from good infrastructure and community networks, and Northeastern states have strong community support but need infrastructure strengthening. High risk groups include STD patients, CSW, MSM, truck drivers, and IDU (mostly northeast). Difficulties anticipated include stigma (especially in MSM), mobility of CSW and truck drivers, security in the northeastern states, poor access to VCT and care and treatment, and uncertainty about the true number of available high risk individuals. No incidence data are available except in STD clinic attendees (with incidence near 2 per 100 person-years).

CONCLUSIONS: Cohort studies must be implemented in southern and northeastern states to determine availability, accessibility, HIV incidence rates and willingness to participate of high risk groups. Strengthening infrastructure, access to VCT, care and treatment will be key to success. Targeted prevention and treatment programs will decrease the incidence of HIV infection in most high risk groups. AIDS vaccine efficacy trials will very likely need to be multicentric in order to enroll sufficient numbers of participants. Political endorsement and community involvement will be pursued.

040711
ThOrC1431

Copyright © 2004 - International AIDS Society (IAS). Reproduction of this abstract (other than one copy for personal reference) must be cleared through the IAS.