title: Prevention of Parent to Child Transmission (PPTCT) program data in India: an emerging data set for appraising the HIV epidemic.
abstract: BACKGROUND
  Evidence based resource allocation and decentralized planning of an effective HIV/AIDS response requires reliable information on levels and trends of HIV at national and sub-national geographic levels. HIV sentinel surveillance data from antenatal clinics (HSS-ANC) has been an important data source to assess the HIV/AIDS epidemic in India, but has a number of limitations. We assess the value of Prevention of Parent to Child Transmission (PPTCT) programme data to appraise the HIV epidemic in India.
  
  
  RESULTS
  HIV data from PPTCT sites were compared to HSS-ANC and general population level surveys at various geographic levels in the states of Karnataka, Maharashtra and Andhra Pradesh. Chi-square tests were used to ascertain statistical significance. PPTCT HIV prevalence was significantly lower than HSS-ANC HIV prevalence (0.92% vs. 1.22% in Andhra Pradesh, 0.65% vs. 0.89% in Karnataka, 0.52% vs. 0.60% in Maharashtra, p<0.001 for all three states). In all three states, HIV prevalence from PPTCT centres that were part of the sentinel surveillance was comparable to HSS-ANC prevalence but significantly higher than PPTCT centres that were not part of the sentinel surveillance. HIV prevalence from PPTCT data was comparable to that from general population surveys. In all three states, significant declines in HIV prevalence between 2007 and 2010 were observed with the PPTCT data set. District level analyses of HIV trends and sub-district level analysis of HIV prevalence were possible using the PPTCT and not the HSS-ANC data sets.
  
  
  CONCLUSIONS
  HIV prevalence from PPTCT may be a better proxy for general population prevalence than HSS-ANC. PPTCT data allow for analysis of HIV prevalence and trends at smaller geographic units, which is important for decentralized planning of HIV/AIDS programming. With further improvements to the system, India could replace its HSS-ANC with PPTCT programme data for surveillance.
authors.affiliation: HIV Division, Global Health Program, Bill & Melinda Gates Foundation, New Delhi, India. sema.sgaier@gatesfoundation.org
authors.forename: Sema K
authors.initials: SK
authors.lastname: Sgaier
authors.forename: Radhay S
authors.initials: RS
authors.lastname: Gupta
authors.forename: Raghuram
authors.initials: R
authors.lastname: Rao
authors.forename: Ajay
authors.initials: A
authors.lastname: Gaikwad
authors.forename: Sonali
authors.initials: S
authors.lastname: Harangule
authors.forename: Suvidha
authors.initials: S
authors.lastname: Dhamne
authors.forename: Sateesh
authors.initials: S
authors.lastname: Gowda
authors.forename: Sylvia
authors.initials: S
authors.lastname: Jayakumar
authors.forename: Banadakoppa M
authors.initials: BM
authors.lastname: Ramesh
mesh_terms: D003140:Communicable Disease Control / Q000379:methods / Q000706:statistics & numerical data*; D005260:Female; D005843:Geography; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000635:transmission*; D006801:Humans; D007194:India / Q000453:epidemiology; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D011247:Pregnancy; D011296:Prenatal Diagnosis / Q000706:statistics & numerical data; D015995:Prevalence; D018571:Sentinel Surveillance