India has sharply reduced new HIV infections and AIDS-related deaths but longer survival is bringing new challenges. Infectious disease expert Dr Sanjay Pujari explains why ageing, chronic diseases, emerging transmission hotspots and newer prevention tools will shape the country’s next phase of HIV response.

 India’s HIV programme is often held up as a public health success story. New infections and AIDS-related deaths have fallen sharply over the past decade, millions of people are receiving life-saving antiretroviral therapy and viral suppression rates are among the highest in the world. But as people with HIV live longer, the country’s battle against the epidemic is entering a new phase.
Doctors are now grappling with an ageing population living with HIV, many of whom are developing diabetes, hypertension, heart disease and other non-communicable diseases that require integrated care. At the same time, fresh HIV transmission hotspots linked to injecting drug use have emerged in states such as Assam, Arunachal Pradesh, Tripura and Punjab, underscoring that the epidemic continues to evolve.
Dr Sanjay Pujari, Director and Chief Consultant at the Institute of Infectious Diseases, Pune, will be speaking on clinical strategies for integrating HIV, tuberculosis (TB) and non-communicable diseases at the International AIDS Conference being held in Rio de Janeiro. He spoke to The Indian Express about India’s changing HIV landscape, the country’s role in the global response and the priorities for ending AIDS as a public health threat by 2030.
What is the current burden of HIV in the country, and what concerns you the most?
India’s HIV response has come a long way. By the end of 2023, an estimated 2.54 million people were living with HIV, with an adult prevalence of 0.20%. Over the past decade, we’ve seen encouraging progress; new HIV infections have fallen by 44.2% since 2010, while AIDS-related deaths have dropped by 79.2%. Today, around 1.8 million people receive free antiretroviral therapy (ART) through the national programme, with 94% treatment retention and 97% viral suppression, which is a significant public health achievement.