By Ken Moritsugu, Knight Ridder Newspapers
NEW DELHI – India seemed to have all the ingredients for an Africa-like AIDS explosion: relatively low condom use, an uneven public health system and a large population of truckers and migrant workers — a natural client base for prostitution.
But experts' worst fears have not panned out.
What they overlooked was the apparently crucial importance of one factor: Indian women often don't have sex outside marriage.
HIV did sweep through the ranks of sex workers. They passed the virus to their customers, who in turn infected their wives. But then the disease came to a halt.
Only 2 percent of Indian women reported having sex with people other than their husbands in the past year, according to a government survey.
A study last month in the Lancet found a significant decline in new infections in four Indian states hit hard by AIDS. It was led by Dr. Rajesh Kumar, head of the School of Public Health at the Post Graduate Institute of Medical Education and Research in Chandigarh, India.
Kumar said studies show that increased condom use contributed to the drop in new infections.
Those results suggested new infections might be peaking nationwide.
That's not to say that AIDS is no longer a problem. HIV is still spreading, and in a country as large as India, the estimated 1 percent infection rate translates to 5.7 million people — the largest number of infected people in the world.
The good news is that the multibillion-dollar global prevention effort finally is bearing fruit.
“For the first time ever,'' said Peter Piot, executive director of the Joint U.N. Program on HIV/AIDS, in a speech in Washington in March, “I believe that we have a real potential to get ahead of this epidemic.''