According to a preliminary analysis published in the UK-based Lancet, a Bill & Melinda Gates Foundation initiative to reduce HIV transmissions in India may have prevented more than 100,000 new infections over a five-year period, the Associated Press reports.
The foundation's Avahan initiative, which was funded to the tune of $258 million between 2003 and 2008 and received an additional $80 million in 2009, targets high-risk groups such as female sex workers and their clients, truck drivers, men who have sex with men, and intravenous drug-users. The program focuses on a variety of preventative measures, including educational campaigns, needle exchanges, safe-sex counseling, and free condom distribution.
Despite encouraging progress, the authors of the report, led by Institute for Health Metrics and Evaluation fellow Marie Ng, noted that results were mixed across the six states targeted by the initiative and found that data and methodology limitations prevented the impact of the program from being fully understood. Reductions in HIV prevalence were most evident in the southern states of Andhra Pradesh and Karnataka, with Maharashtra and Tamil Nadu showing more modest reductions and the small northeastern states of Manipur and Nagaland showing no improvement at all.
"The results of our analysis suggest a strong association between the large-scale Avahan HIV prevention program in India and reductions in HIV prevalence at the population level, which is the ultimate goal of the program," the report's authors noted. "This beneficial effect of Avahan is encouraging, but the heterogeneity in the effect across the states indicates the need for better understanding of which aspects of Avahan have been successful for adoption on a larger scale."