The overall prevalence of the human immunodeficiency virus in India has reduced, the HIV Sentinel Surveillance 2016-2017 said on Wednesday. However, states like Gujarat, Punjab, Rajasthan, Haryana, Uttar Pradesh, and Bihar have shown a rise in the prevalence of the virus, “indicative of continuing rising epidemic”, among pregnant women.

The prevalence of HIV among pregnant women in the country has dropped negligibly from 0.29% of the population in 2014-’15 to 0.28% in 2016-’17. Numbers of HIV cases among pregnant women are considered a proxy for the prevalence in general population.

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The North Eastern states of Mizoram (1.19%), Nagaland (0.82%), Meghalaya (0.56%) Tripura (0.56 %) and Manipur (0.47%) have the highest prevalence of HIV among pregnant women in the country. Except Manipur, all these North Eastern states display higher prevalence of the virus than before.

But the other states, which have prevalence rates among antenatal women higher than the national average, were Gujarat (0.44%), Chhattisgarh (0.35%), Delhi (0.38%). These states do not traditionally have high HIV rates.

The states which have earlier had more cases of the virus include Andhra Pradesh, Telangana, Karnataka, Maharashtra, Tamil Nadu, and Telangana. The Aids Control Programme has traditionally concentrated on these states.

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Of the high risk populations of female sex workers, men having sex with men, transgenders, truckers, and injectable drug users, the highest prevalence is among injectable drug users. The prevalence of HIV among female sex workers tested is 1.56%, among the MSM is 2.69%, injectable drug users is 6.26, transgenders is 3.14%, and truckers is 0.86%. While the prevalence rates of HIV among pregnant women in these states is still high, it has shown a declining trend over the years.

The report said that in Meghalaya and Manipur, the high prevalence of HIV “points to an epidemic largely fuelled by injecting drug behaviour but also supported through commercial exchange of sex,” said the report. Besides the North Eastern states, “injecting drug behaviour” is also fuelling the epidemic in north India, mainly Punjab, Delhi, Haryana, Uttarakhand and Uttar Pradesh.

The higher prevalence of HIV among single migrant men and long-distance truckers is also adding to the burden. The report said that analysis has shown that pregnant women with a migrant spouse have shown higher rates of contracting HIV in some states such as Bihar, Uttar Pradesh, Rajasthan, Odisha, Manipur and Nagaland. In Manipur and Nagaland, pregnant women with a migrant spouse were two to three times more likely to be HIV positive than the pregnant women with non-migrant spouse, the report said.