Of 5883 patients screened during 1986 to 1993 in the sexually transmitted diseases (STD) clinic at a hospital in Vellore, south India, 105 (1.79%) were positive for human immunodeficiency virus (HIV) antibody. The prevalence of HIV infection increased from 0.26 per cent in 1986 to 2.64 per cent in 1993. In 1992 the prevalence was even higher, namely 3.94 per cent. The overall prevalence in these 8 yr was 1.98 per cent among men (n = 4392) and 1.21 per cent among women (n = 1491), the difference being statistically significant (P < 0.05). The prevalence in men rose from 0.36 per cent in 1986 to 4.24 per cent in 1992, and in women from 0 to 3.04 per cent during the same period. The major source of infection in men was female commercial sex workers, but among women it was mostly their husbands. The increase in prevalence of HIV infection is alarming, and indicates that the massive educational campaigns and other preventive measures have not resulted in decreased transmission.
PIP: In Vellore, India, health workers collected blood samples from 5883 new attendees at the sexually transmitted disease (STD) clinic of the Christian Medical Hospital to screen for HIV infection. 105 (1.79%) STD patients were confirmed positive for HIV infection (Western blot test). HIV prevalence increased between 1986 and 1992 (0.26-3.94%). It was 2.64% in 1993. The male:female ratio among the HIV-positive STD patients was 4.8:1 (1.98% vs. 1.21%; p 0.5). The age of the 87 HIV-positive men ranged from 19 to 55. All but three had unprotected sex with multiple partners who were commercial sex workers. The other three men were homosexuals. All but two of the HIV-positive women had sex only with their husbands. Clinicians and paramedical staff in STD clinics have already been trained in counseling and in screening contacts. They should continue to apply this training. They should strongly promote condom use among STD patients, especially since it is becoming a more and more acceptable method of preventing STDs. Early diagnosis and treatment and control of STDs would also be an intervention to control HIV infection.