Sixty per cent of the estimated 5.2 million HIV-infected adults in India are living in rural areas, according to a WHO report.
Though commercial sex is the major reason behind the prevalence of the pandemic in most parts of the country, injecting drug use (IDUs), especially in north-eastern states, Delhi, Mumbai and Chennai, is fast emerging as a major source of transmission.
"Analysis of surveillance data by place of residence indicates that HIV has been spreading to the rural areas," the report said.
"Of the estimated 5.2 million HIV-infected adults in India, 3.05 million or nearly 60 per cent were residing in rural areas. Of the reported AIDS cases, sexual transmission accounts for 86 per cent in India," the report said.
Apart from several states recording a higher HIV prevalence among rural sentinel surveillance sites than urban sites, the dreaded disease has now started penetrating the low-risk general population, the report pointed out.
"The HIV epidemic of Manipur that was once a concentrated epidemic among IDUs, is now considered a generalised epidemic," the report said.
In 2005, seven of the 10 ante-natal clinic sentinel surveillance sites in Manipur recorded an HIV prevalence of one per cent or above indicating the spread of infection from high-risk to low-risk populations, the report said.
The report said HIV among IDUs increased markedly from seven per cent in 2002 to 23 per cent in 2005.
Increasingly, HIV infection rates are being observed among IDUs in not only the northeastern states, but other urban areas like Delhi, Mumbai and Chennai, it said.