It is estimated that as of the end of 1994 approximately 1,750,000 adults were infected with HIV in India. This estimate is based upon a review of data provided by the National AIDS Control Organization. The methods to reach such estimate are succinctly reviewed and a series of scenarios presented.

A baseline evaluation of the quality of STD case management was conducted in five areas of Madras city in 1992, using HIV prevention indicators recommended by the World Health Organization. Eighty-four interviews and 108 observations of private and public clinic practitioners were conducted. Sixty-one percent of interviewed doctors reported making only specific "clinical" diagnoses and 17% reported making only the WHO recommended syndrome-based diagnoses while 22% reported making both types of diagnosis. The adequacy of treatment was compared against various standards, including the Indian National Guidelines for STD management. Almost half of the health care providers (HCP) reported using a treatment effective against the two main pathogens that may cause male urethritis, while 20% reported using a treatment that was not effective against either. For male ulcers only 12% of HCPs reported using treatment effective against both syphilis and chancroid. Seventy-nine percent of the HCP reported that they advised their patients to use condoms, but in 30% only of observed consultations, condoms were promoted for STD or HIV/AIDS prevention. As information concerning the relative prevalence of pathogens in different areas is unlikely to be available, there is an urgent need for the syndromic approach to STD treatment be adopted by health care providers.

An assessment of the "One Day AIDS Awareness Program" for I.C.D.S. functionaries was done. The pre-training knowledge level scores were 55.3%, 39.3% and 60.4% of the total score, in 24-Parganas (S), Burdwan and Calcutta districts respectively. However, the post-training assessment scores were observed to be 91.9%, 84.9% and 94.8% in 24-Parganas (S), Burdwan and Calcutta districts respectively. The percentage increase in mean scores was found to be 66.5%, 115.8% and 57.1% in 24-Parganas (S), Burdwan and Calcutta districts respectively.

In India, a health education professor conducted a survey of 400 health care professionals at the medical college and hospital in Calcutta, West Bengal, to examine their level of awareness about HIV/AIDS. The health care professionals included surgeons, gynecologists, pathologists, internal medicine specialists, blood bank workers, recent medical school graduates, clinical students, preclinical students, nurses, and technologists. 40-60% of preclinical students knew little about the natural history of HIV infection and its clinical manifestations. An absence of HIV/AIDS education in the undergraduate medical curriculum and no exposure to causes and clinical training in HIV/AIDS may account for this low knowledge level. 20% of students and 40% of physicians knew that there were HIV tests available. 50-60% of paramedical personnel had misconceptions about HIV/AIDS, particularly about utensils, sharing toilets, and bites of mosquitoes and bedbugs. 80-90% of all health personnel had knowledge levels about proper decontamination and precautionary measures against exposure to contaminated blood and body fluids. Preclinical students had the highest mean knowledge score. 66-80% of all health professionals were not satisfied with their current knowledge level on HIV/AIDS. This same proportion thought that they would benefit from HIV/AIDS education and training. The relatively low knowledge scores about HIV/AIDS may be due to the fact that public health authorities do not promote HIV/AIDS education, even though the national policy is to disseminate anti-HIV/AIDS messages.

Nursing students are being identified as a potential risk group for the AIDS spread. Awareness regarding AIDS in this group is crucial for AIDS management and prevention. This cross-sectional study was planned and carried out to assess the awareness of nursing students regarding AIDS and to identify the areas of confusion that might serve as an important target of educational intervention. The study consisted of 204 nursing students selected from Nursing school, Govt. Medical College, Nagpur. The overall knowledge regarding etiology, risk factors, transmission, treatment and prevention of AIDS was confusing among the students. The average knowledge score was estimated to be 17.6 of 28. However, more knowledge was found to be correlated with more positive and fearless attitude towards AIDS patients.

In India, clinicians conducted a cross sectional analysis of 104 HIV-positive intravenous (IV) drug users registered at the ICMR Unit for Research on AIDS in northeastern states of India to examine home-based care of these individuals living in Imphal, Manipur. 10% required referral to a hospital, mainly due to meningitis. 26% were asymptomatic. Tuberculosis (TB) was the most common opportunistic infection (12.5% for pulmonary TB and 6.7% for extrapulmonary TB). Other frequent signs and symptoms were oropharyngeal candidiasis (9.6%), hepatic involvement (9.6%), diarrhea (9.6%), and non-tubercular chest infection (8.7%). Among all 340 IV drug users registered at the unit, 17.1% were referred to either a hospital or an institution. Only 37.9% of those referred were satisfied with institutionalized care. The family extended support in 99.1% of all 340 cases. 25% of the families received counseling support. These findings suggest that families could care for most of the patients in their homes. Since the burden of caring for AIDS patients on the health care delivery system is expected to increase, a home-based care model and an improved referral network are needed.

This study was conducted to know whether prisoners constitute a "high risk group" for HIV transmission in India today. A sero-epidemiological period prevalence survey was conducted in Central Prison, Bangalore, South India covering 1007 undertrials and 107 permanent convicts during January to December 1993. Twenty (1.98%) undertrials and none of the permanent convicts were seropositive for HIV infection. All of them were males and 1.6(80%) of them were in the age group of 20-30 years. Low literacy, poor income, sexual promiscuity and low condom usage were observed among the seropositives. Thus, prisoners constitute a high risk group and routine screening and counselling are recommended.

1802 serum samples from high risk group of persons were tested for sero-positivity for HIV-1 and HIV-2 by using immunocomb bioassay procedure. Out of 16 sero-positive serum samples, 5 (31.25%) was positive for HIV-2 only. It is, therefore, suggested that all kits employed for initial serotesting must include both HIV-1 and HIV-2.

AN overview of the general principles of counselling for HIV/AIDS are overviewed. Relevance of 'shared confidentiality' in Indian context is recommended.

Sonagachi, a red-light area in Calcutta has experienced a successful STD control program. Social issues behind this success and importance of non biological parameters to evaluate the success of the project are highlighted.