Browsing by Author "Lalit Singh Kharayat"

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Programmatic mapping and population size estimation of key population in India: Method and findings
(Public Library of Science, 2025) Pradeep Vignesh Kumar; Chinmoyee Das; Bhawani Singh Khushwaha; Saiprasad Prabhakar Bhavsar; Shantanu Kumar Purohit; Arvind Kumar; Subrata Biswas; Nidhi Priyam; Lalit Singh Kharayat; Shajan Mathew; Akhilesh Srivastava; Jyotsana Pal; Shreena Ramanathan; Abhina Aher; Deepika Srivastava Joshi; Rajatashuvra Adhikary; Shajy K. Isac; Hanjabam Sanayaima Devi; Pinnaka Venkata Maha Lakshmi; Elangovan Arumugam; Sanjay Kumar Rai; Sheela V. Godbole; S. K. Singh; Himanshu Kumar Chaturvedi; Dr Shanta Dutta; Shashi Kant; Dandu Chandra Sekhar Reddy; Sanjay Madhav Mehendale; Shobini Rajan
India has the world’s second-largest HIV burden. Key populations of female sex workers (FSW), men who have sex with men (MSM), hijra/transgender (H/TG) people, and people who inject drugs (PWID), are disproportionately affected by the HIV epidemic. A community-led programmatic mapping and population size estimation (PMPSE) was carried out in 651 districts of 32 States and Union Territories of India. The goal was to identify the hotspots, network operators, and estimate the size of key population groups. This involved documenting the known hotspots, visiting them for rapid field assessment through key informants’/ network operators interviews, and identifying additional hotspots/ network operators through the snow-balling approach from the existing hotspots. For each identified hotspot, network operator, and village, size of each key population group was estimated after adjusting for the duplications and overlaps. These estimates were then aggregated to arrive at district, State, and ultimately national-level estimates. PMPSE estimated a total of 9,95,499 (9,02,277–10,88,712) FSWs, 3,51,020 (3,13,860–3,88,175) MSM, 2,88,717 (2,53,024-3,24,407) PWIDs, and 96,193 (85,206-1,07,174) H/TG individuals. The number of FSWs per 1000 adult women in different States/Union Territories (UT) varied from 0.34 to 17.25; MSM estimates ranged from 0.07 to 7.35 per 1000 adult men, H/TG persons ranged from 0.03 to 2.75 per 1000 adult men, and PWIDs ranged from 0.01 to 31.30 per 1000 adult men. Additionally, approximately 14% of FSWs, 7% of MSM, and 8% of H/TG individuals were estimated to operate exclusively through network operators. The community-led PMPSE has updated the size estimates for FSWs, MSM, PWIDs, and H/TG individuals at a granular level. This approach has emphatically quantified the presence of network operators. The methodological simplicity of the present round of PMPSE is likely to encourage and facilitate its periodic implementation for better tracking of population level changes in HIV burden based on more reliable denominators. This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication.
Progress and challenges towards eliminating vertical transmission of HIV in India
(Nature Research, 2025) Pradeep Vignesh Kumar; Chinmoyee Das; Vishal Singh Deo; Himanshu Kumar Chaturvedi; Subrata Biswas; Nidhi Priyam; Lalit Singh Kharayat; Sanjay Kumar Rai; Sheela V. Godbole; Elangovan Arumugam; Pinnaka Venkata Maha Lakshmi; Dr Shanta Dutta; Hanjabam Sanayaima Devi; Pankaj Bhardwaj; Arvind Kumar Singh; Rashmi G. Shinde; Damodar Sahu; Shashi Kant; Dandu Chandra Sekhar Reddy; Sanjay Madhav Mehendale; Shobini Rajan
India has intensified efforts towards elimination of vertical transmission of HIV (EVTH) as part of National AIDS and STD Control Programme-V (NACP-V). We present the progress in achieving NACP-V’s EVTH goal as of year 2023-24. We analysed the 2023 state level data using Spectrum model in 2023 to measure the coverage of anti-retroviral treatment among pregnant women, annual paediatric HIV case incidence rate and final vertical transmission rate. UNAIDS and WHO definitions for these indicators were used. In 2023, around 2350 new paediatric infections were estimated by vertical transmission. However, 44% of these transmissions resulted from incident HIV infections among pregnant and breastfeeding women. Overall, paediatric HIV incidence per 100,000 live births decreased from 25.2 (14.7–46.6) in 2019 to 10.4 (6.1–19.3) in 2023. During the same reference period, final vertical transmission rate (inclusive of breastfeeding period) decreased from 25.28% (17.06–37.99) in 2019 to 11.75% (7.93–17.66) in 2023. The 2023 India HIV estimates, using recent data and global modelling tools, highlighted progress in eliminating vertical transmission of HIV. Early identification of HIV-positive mothers and starting them on lifelong ART is crucial. Additionally, generating local evidence is needed on interventions like safe practices, repeat testing, and feeding practices to inform policy decisions. © The Author(s) 2025.
Projected impact of fast-tracking of antiretroviral treatment coverage on vertical transmission of HIV in India
(Public Library of Science, 2024) Pradeep Kumar; Chinmoyee Das; Subrata Biswas; Nidhi Priyam; Lalit Singh Kharayat; Damodar Sahu; Sanjay K. Rai; Sheela V. Godbole; Elangovan Arumugam; P.V.M. Lakshmi; Shanta Dutta; H. Sanayaima Devi; Arvind Pandey; Dandu Chandra Sekhar Reddy; Sanjay Mehendale; Shobini Rajan
One of the five high-level goals under Phase V of the National AIDS and STD Control Programme (NACP) of the Government of India is the elimination of vertical transmission of HIV. In this paper, we estimate the potential impact of maintaining and enhancing the antiretroviral treatment under the NACP in terms of averting new infections and vertical transmission rates vis-à-vis no intervention scenario. We used India’s HIV Estimates 2022 models to create treatment coverage scenarios of no interventions, status quo, business as usual, on-track and fast-track scenarios from 2023 to 2030. Our analysis indicates that fast-tracking scale-up of treatment services would avert almost 41000 child infections from 2023 to 2030 leading to a vertical transmission rate of around 7.70% in 2030 vis-a-vis no interventions scenario. Higher and sustained ART coverage would not only take the country closer to the elimination goals but would also prevent thousands of vertical transmissions, thus bringing a lot of benefits to HIV-positive pregnant women and their families. Supported by efforts for the prevention of new infections in the general population, India is on track for the attainment of elimination of vertical transmission of HIV by 2030. © 2024 Kumar et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.