THE INITIAL DETECTION OF HUMAN IMMUNODEFICIENCY VIRUS-1 AND ITS SUBSEQUENT SPREAD IN PROSTITUTES IN TAMIL-NADU, INDIA

To determine the prevalence of HIV-1 antibody and risk factors associa ted with a positive test in a heterosexually promiscuous female popula tion, we initially screened 412 prostitutes in remand homes in three c ities and three towns in Tamil Nadu state (southern India) and then te sted all new entrants to one home in Vellore from 1986 to 1990. The pr oportion of women infected (10 of 102) from the port city of Madras wa s greater than from all other cities or towns combined (four of 310, p = 0.0002). The only significant risk factor for development of HIV-1 antibody was exposure to foreigners (odds ratio: 7.71; 95% confidence interval 4.2-11.2; p = 0.0004), after correcting for the influence of city. In Vellore the prevalence of HIV-1 antibody increased from 1.8% in 1986 to 28.6% in 1990, with a doubling time of 0.95 years. We hypot hesize that HIV-1 infection has been introduced into India relatively recently into the heterosexually promiscuous population, where there h as been some spread. Preventive measures should be urgently directed t oward this population to prevent spread in the general population.