Declining HIV incidence among patients attending sexually transmitted infection clinics in Pune, India

Sanjay M. Mehendale, Nikhil Gupte, Ramesh S. Paranjape, Radhika G. Brahme, Rewa Kohli, Neelam Joglekar, Sheela V. Godbole, Smita N. Joshi, Manisha V. Ghate, Seema Sahay, B. Kishore Kumar, Raman R. Gangakhedkar, Arun R. Risbud, Ronald Brookmeyer, Robert C. Bollinger

Research output: Contribution to journalArticlepeer-review


OBJECTIVE: A recent report suggesting declining HIV transmission rates in southern India has been based on HIV seroprevalence data to estimate HIV incidence. We analyzed HIV incidence rates among 3 cohorts (male, female non-sex worker, female sex worker [FSW]) presenting to sexually transmitted infection (STI) clinics in Pune, India over 10 years. METHODS: Between 1993 and 2002, consenting HIV-uninfected individuals were enrolled in a prospective study of the risks for HIV seroconversion. Standardized HIV incidence estimates were calculated separately for the 3 cohorts. RESULTS: HIV acquisition risk declined by more than 70% for FSWs (P = 0.02) and men (P < 0.001) attending the STI clinics. There was no significant reduction in HIV incidence among women attending STI clinics (P = 0.74). The decline in HIV acquisition risk among male patients with STIs was associated with an increase in reported condom use with recent FSW contact and a decrease in genital ulcer disease. CONCLUSIONS: We report the first direct evidence for a decline in HIV incidence rates in FSWs and male patients with STIs over time. The lack of change in HIV infection risk among non-sex worker women highlights the need for additional targeted HIV prevention interventions.

Original languageEnglish (US)
Pages (from-to)564-569
Number of pages6
JournalJournal of Acquired Immune Deficiency Syndromes
Issue number5
StatePublished - Aug 2007


  • HIV
  • High-risk groups
  • Incidence
  • Patients with sexually transmitted infections
  • Risk factors
  • Trends

ASJC Scopus subject areas

  • Infectious Diseases
  • Pharmacology (medical)


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