Surveillance and Targeted Action to Prevent HIV/AIDS

Epidemiological surveillance has played a key role in the identification of AIDS and its modes of transmission. In India, laboratory-based surveillance of HIV was initiated among most at-risk populations in 1990s, which was later expanded to antenatal clinics. On the basis of surveillance, high risk geographic areas and high risk populations were identified; and preventive behaviour change interventions were targeted among high risk groups in mid1990s. In 2003, analysis of surveillance data revealed a declining trend in HIV. Further analysis, indicated that targeted sexual behaviour change interventions among high risk groups had been responsible for the decline. The targeted behaviour change strategy among high risk groups was also found to be cost-effective. In the era of anti-retroviral therapy (ART), HIV prevalence trends would no longer be useful for tracking the epidemic. Hence, new laboratory essays are needed for tracking HIV incidence. Verbal autopsy method can provide direct estimates of HIV mortality trends to evaluate the effectiveness of ART. Since the number of new HIV infections is showing plateauing trend, further intensification of HIV/AIDS prevention and control efforts is required to achieve the end of HIV transmission and deaths due to AIDS by 2030.Keywords: Public health, epidemiology, public health surveillance, HIV/AIDS prevention, control of AIDS, high risk population, sexual behaviour, anti-retroviral therapy. Â