Targeting Sex Workers will Control Spread of AIDS in India: World Bank

India's policy of targeting sex workers to control the spread of AIDS by providing contraceptives, treatment for sexually transmitted infections and raising awareness through their peers is expected to avert three million infections over two decades, the World Bank said on World AIDS Day. With 2.3 million reported cases of AIDS, India - like sub-Saharan Africa - is on the frontlines of the fight against the deadly virus.

A study by the World Bank, Cost Effectiveness of Targeted HIV Prevention Interventions for Female Sex Workers in India, said efforts made by India's National AIDS Control Programme -- which focuses on high risk groups such as sex workers - was paying off and an estimated three million HIV infections would be avoided between 1995 and 2015.

There has been a tremendous scale-up of prevention and treatment interventions under this programme, which has led to an overall reduction in new infections and AIDS-related deaths in India, said Sayan Chatterjee, Director General of India's National AIDS Control Organisation, in a statement on Wednesday.

According to UNAIDS, HIV infections vary among sex workers in India -- ranging from around 5 percent for street-based sex workers to up to 29 percent among their brothel-based counterparts in cities like Mumbai, the country's financial capital.

A prevention programme in India's southern state of Kerala has resulted in a drop in HIV prevalence to 13 percent from 25 percent among female sex workers, the report said, while a similar initiative in Mumbai has seen prevalence drop to 13 percent from 45 percent among brothel-based sex workers.

World Bank officials say India's success amongst sex workers can be attributed to numerous factors, including using their peers, who have been trained and are often easier to relate to than health workers.

Sex workers are stigmatized and marginalized in India. They cannot go to normal clinics and hospitals for supply of condoms or treatment of sexually transmitted diseases, said Mariam Claeson, Programme Coordinator for HIV/AIDS at the World Bank, Using face-to-face educators, such as their peers, is what works in this regard.

Claeson said early and bold decisions by the Indian government in the early 1990s, designed to channel resources to curb the disease, as well as an active civil society and a focus on prevention as well as treatment made the country exceptional in its success. However, despite such advances in prevention worldwide, the human and financial costs of HIV/AIDS continue to mount, requiring more support from governments and the international community, World Bank officials warned.

AIDS remains a critical development issue that is reversing decades of human progress. With 34 million people living with HIV, AIDS continues to decimate communities, stymie economic growth, and orphan children, said David Wilson, the Bank's Global HIV/AIDS Programme Director.