| "Analysis of a recent in-depth survey reveals a lower number -- 2.5 million people instead of 5.7 million people -- living with HIV in India today. The new estimate moves India down from being the most populous HIV-positive nation in the world to being the third -- after South Africa and Nigeria. " " As an epidemiologist and a former consultant to the World Bank for AIDS in India, I have experienced the perplexing task of estimating and projecting HIV in a population. In 1996, my Indian colleague and I made a bold and dismal prediction in the prominent medical journal Lancet. We wrote, "We fear there will be over 10 million infected persons by the end of the decade (year 2000)." " "I am not embarrassed to say we were wrong. In fact, I am elated to discover that we had grossly overestimated the numbers. But our logic and reasoning was sound. The question we wrestled with while estimating the number of people with HIV in a nation is whether HIV would enter the general population including middle-class shopkeepers, housewives and civil servants; or if it would remain on the fringes among high-risk groups, such as commercial sex workers (prostitutes) and their clients. " "I spent several years researching the HIV epidemic in India a decade ago. On a dusty one-lane highway connecting Madras (now Chennai) to Bangalore, I watched trucks zoom by. Young lanky men with dark complexions, wearing colorful lungis (a loincloth wrapped around the waist) stopped at truck stops for meals, rest and a commercial sexual encounter. " "The rate of HIV among commercial sex workers (CSWs) had already risen to 30 percent by 1992 with a potential parallel rise among the truck drivers. As we doctored patients in the sexually transmitted disease and HIV clinic, we began to see young women -- the wives of the truck drivers -- present with HIV. " "A few cases of HIV among rural women, whose only risk factor was sexual contact with their husbands, was like a canary-in-a coal mine. We feared HIV was spreading into the general population -- from the CSWs to their male clients, to the clients' wives, and then to their children. We dreaded that a calamity was in the making in India -- as has happened in Africa. " "Imagine if HIV enters the general population of 1 billion people. If 1 percent of the population became infected, this would translate to 10 million people with HIV. In Africa, men and women have two or more occasional but regular sexual partners, and the speed at which HIV spread was alarming. If the pattern were to repeat in India the virus would
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