title: Changing epidemiology of HIV in Mumbai: an application of the Asian epidemic model.
abstract: BACKGROUND
  Mumbai is one of the most populous and high HIV prevalence cities in India. It has witnessed substantial changes in HIV-risk behaviors and a decline in HIV prevalence among high-risk groups during the past decade.
  
  
  OBJECTIVE
  To examine the changing pattern in the number of new HIV infections by transmission routes in Mumbai during 2000-2017.
  
  
  METHODS
  We used the Asian Epidemic Model by dividing the adult population (aged 15 and above) into seven subgroups: brothel-based and non-brothel based female sex workers (FSWs), heterosexual clients of FSWs, men who have sex with men/transgendered people (MSM), injecting drug users (IDUs), general women and general men. The MSM subgroup included homosexual and bisexual men.
  
  
  RESULTS
  New HIV infections among adults reduced by 86% during 2000-2010. The highest decline was among FSWs and their heterosexual clients (95%-98%), followed by MSM (82%), general women (77%), IDUs (51%) and general men (42%). Most new HIV infections during 2011-2017 are expected to occur among general women (1666) and general men (977) followed by MSM (715). Bisexual men were estimated to contribute about 14% of the new HIV infections among general women in 2010 and this proportion was estimated to increase to 19% in 2017.
  
  
  CONCLUSIONS
  HIV prevention programs for MSM and the general population need to be strengthened. Ensuring early detection of HIV, and higher levels of consistent condom use by HIV-infected men and women are essential to prevent new HIV infections in future.
authors.affiliation: Population Council, New Delhi, India. rammanohar7@yahoo.co.in
authors.forename: Ram Manohar
authors.initials: RM
authors.lastname: Mishra
authors.forename: Madhulika
authors.initials: M
authors.lastname: Dube
authors.forename: Damodar
authors.initials: D
authors.lastname: Sahu
authors.forename: Niranjan
authors.initials: N
authors.lastname: Saggurti
authors.forename: Arvind
authors.initials: A
authors.lastname: Pandey
mesh_terms: D000293:Adolescent; D000328:Adult; D058872:Epidemics; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000635:transmission; D006306:Health Surveys / Q000706:statistics & numerical data*; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D012307:Risk Factors; D021841:Safe Sex / Q000706:statistics & numerical data; D012737:Sex Factors; D060386:Sex Workers / Q000706:statistics & numerical data; D012725:Sexual Behavior / Q000706:statistics & numerical data*; D055815:Young Adult