Re: NACO rejects HIV infection claim. Mr Feachem'sclaimwas nonsense.

April 22, 2005

Dear FORUM,

Let me give just one example from my experience to illustrate what happens on

ground.

I was sent to one of the states some time back.(on a NACO evaluation but that’s

apart from the subject matter of this example). When I reached there, I hired a

taxi to a sex worker intervention site. The

driver cautioned me that " in our state the HIV infection is 50%.

Every other person on the street could be HIV positive. So be careful " I asked

him where he got the information that there is 50% prevalence?. He said

" newspapers " . Apparently he had misunderstood sentinel surveillance reports

about sex workers. In any case a 50% prevalence even among sex workers is not

realistic data in any place (imagine if the data was true....) .

I went to the NGO I was visiting and during a casual conversation with the peer

educators there, I asked them if they knew about the reported 50% prevalence. A

peer educator said, " of course, the testing was done at the clinic right here

and we were involved in recruiting sex workers for the surveillance " . Another

peer educator said " we were very careful to recruit only those sex workers who

were likely to be HIV + but unfortunately only 51% turned out to be HIV+ " .

A third peer educator added " Actually this happened year before last. In the

next year another NGO was involved in recruiting sex workers for surveillance

tests. Those peer educators were not as experienced as we are (in identifying

HIV+ sex workers) and that year the prevalence was only 25%! " .

I leave it to you all to judge the quality of surveillance data and sampling

bias. And Sentinel surveillance is among the most important data used to

estimate HIV prevalence in the country. It is my opinion that the so called

scientific methodology used to estimate HIV prevalence will not stand any

impartial scrutiny.

I must say however that the quality of the surveillance system could have

improved of recent but does the WHO or UNAIDS certify

surveillance systems as the NACO PD says?

Regards

C. R. Gunashekar

Options for Development

21, Padmavati Nagar, Opp. i Nagar

Station Road, Agraharam

Korattur, Chennai - 600 076 INDIA

Ph: +91 44 26512584 Mob: +91 944 440 9954

Email: development@...

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