Over 25L People Living with HIV in India

  • December 02, 2025
  • Geography & Environment

Morning Standard

Over 25L People Living with HIV in India

1. Key Arguments Presented in the Article

a. India’s HIV burden remains large but stable

  • India has 25.61 lakh PLHIV (People Living with HIV) in 2024 – the second highest globally, after South Africa.
  • Annual HIV incidence is very low at 0.05 per 1,000 uninfected people, indicating controlled spread.

b. Most new infections transmitted heterosexually

  • 73% of newly detected HIV cases were from heterosexual transmission.
  • Injecting drug use led to 11.5% of cases.
  • Homosexual/bisexual transmission: 5.4%.
  • Vertical transmission: 3.5%.

c. Geographical concentration

Six states—Maharashtra, Andhra Pradesh, Karnataka, Tamil Nadu, Uttar Pradesh, Gujarat—account for 74% of India’s total HIV burden.

d. Improvements under India’s public health programmes

  • New HIV infections dropped 48.7% (2010–2024).
  • AIDS-related deaths fell 81.4%.
  • Mother-to-child transmission declined 74.6%.
  • Treatment access increased from 14.94 lakh to 18.60 lakh.
  • Viral load testing rose to 15.98 lakh tests.

e. Continued policy emphasis

Union Health Minister highlights:

  • “Rights-based, stigma-free, inclusive” approach.
  • Expansion of NACP (National AIDS Control Programme).
  • Need to maintain long-term momentum.

2. Author’s Stance

The article adopts a data-driven, neutral, and mildly optimistic stance:

  • Highlights India’s successes (declining incidence, expanded testing).
  • Acknowledges that India still carries a heavy burden.
  • Emphasises geographic concentration and persistent vulnerabilities (drug use, marginalised groups).

3. Possible Biases

a. Overemphasis on official success

While reductions in infections/deaths are real, the article:

  • Relies solely on government figures.
  • Avoids discussing data quality or underreporting.
  • Does not critique gaps in awareness, stigma, and access.

b. Limited engagement with structural barriers

Marginalised groups (sex workers, LGBTQ+ communities, migrants) face:

  • Stigma
  • Discrimination
  • Delayed treatment

The article underplays these systemic issues.

c. Absence of independent public health perspectives

Academic or civil society evaluations are missing, giving a one-dimensional view.

4. Pros and Cons of India’s HIV Response (As Derived from the Article)

Pros

  • Significant decline in incidence and mortality over a decade.
  • Strong policy commitment under NACP.
  • Increasing access to testing, ART treatment, and viral load monitoring.
  • High risk groups’ treatment coverage improving.
  • India exceeds global average reductions in several metrics.

Cons

  • India still has the second largest HIV population globally.
  • HIV prevalence remains concentrated in high-burden states.
  • Heterosexual transmission dominant—indicating gaps in:
    • Education
    • Condom use
    • Counselling
  • Injecting drug use continues as a substantial cause.
  • Health system stressors (funding gaps, workforce shortages) not mentioned.
  • Social stigma remains pervasive.

5. Policy Implications

a. Strengthening public health systems

  • Need for targeted HIV programmes in high-burden states.
  • Expansion of preventive programmes (safe sex education, harm reduction).

b. Social inclusion measures

  • Address stigma through:
    • School-based education
    • Community engagement
    • Workplace sensitisation

c. Addressing drug use

  • Scale up needle-exchange programmes and opioid-substitution therapies.

d. Maternal and child health integration

  • Strengthen prenatal ART coverage to further reduce vertical transmission.

e. Data improvement

  • Enhance surveillance systems and community-based reporting.

6. Real-World Impact

Positive

  • Decline in deaths indicates better ART access and improved survival.
  • Greater viral load testing ensures treatment efficacy.
  • India’s HIV strategy increasingly aligned with UN-AIDS 95-95-95 targets.

Negative / Remaining Challenges

  • HIV remains a chronic disease requiring long-term financing.
  • Vulnerable populations still under-reached.
  • Gendered aspects of HIV risk (marital transmission, antenatal gaps) remain under-discussed.

7. Mapping to UPSC GS Papers

GS2 (Governance, Health, Welfare Schemes)

  • National AIDS Control Programme
  • Rights-based health response
  • Government health data and monitoring

GS1 (Society)

  • Gender relations and heterosexual transmission patterns
  • Stigma and social exclusion

GS3 (Science & Tech, Disaster Management, Health)

  • Epidemiology
  • Public health systems
  • Infectious disease surveillance

GS4 (Ethics)

  • Public health ethics
  • Equity, justice and non-discrimination
  • Duty of the state to protect vulnerable citizens

8. Balanced Summary

India continues to face a high HIV burden, with over 25 lakh people living with the virus—second only to South Africa. Yet, strong policy interventions under the National AIDS Control Programme have significantly reduced deaths, new infections, and mother-to-child transmission. Increased viral load testing and treatment access demonstrate progress.

However, the epidemic remains geographically concentrated, socially driven, and shaped by systemic vulnerabilities such as stigma, drug use, and gender inequities. While the data highlights India’s progress, sustaining gains will require continued public health investment, community engagement, and targeted interventions for high-risk groups.

9. Future Perspectives

  • Achieve UNAIDS 95-95-95 goal by 2030.
  • Expand digital health and telemedicine for PLHIV.
  • Ensure every district has viral load testing facilities.
  • Improve ART adherence through community-led models.
  • Integrate HIV services with TB, maternal health, and mental health.
  • Increase funding for harm-reduction programmes.