India is one of the 2nd largest populated countries in the world, with over one billion inhabitants. Of this number, it’s estimated that more or less 7 million Indians are currently living with HIV. HIV emerged later in India than it did in many other countries. Infection rates soared throughout the 1990s, and today the epidemic affects all sectors of Indian society, not just the groups – such as sex workers and truck drivers – with which it was originally associated. The vast size of India makes it difficult to examine the effects of HIV on the country as a whole. The majority of states within India have a higher population than most African countries, so a more detailed picture of the crisis can be gained by looking at each state individually.

In a country where poverty, illiteracy and poor health are rife, the spread of HIV presents a daunting challenge. The Indian epidemic continues to be concentrated in populations with high risk behavior characterized by unprotected paid sex, anal sex, and injecting drug use with contaminated injecting equipment. Several high risk groups have high HIV prevalence, and sexual networks are wide and actively working. According to India’s National AIDS Control Organization (NACO), the bulk of HIV infections in India occur during unprotected heterosexual intercourse. Consequently, and as the epidemic has matured, women account for a growing proportion of people living with HIV (38 percent in 2005), especially in rural areas. The low rate of multiple partner concurrent sexual relationships among the wider community seem to have, so far, protected the larger body of people with 99 percent of the adult Indian population being HIV negative. However, although overall prevalence remains low, even relatively minor increases in HIV infection rates in a country of more than one billion people could translate into large numbers of people becoming infected.

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