Officials estimate around 1.24 lakh people in Telangana are currently living with HIV. All of them are receiving free antiretroviral therapy (ART) through government centres.
Published Jun 02, 2025 | 7:00 AM ⚊ Updated Jun 02, 2025 | 7:00 AM
Health officials say the 2022 data may have overstated the problem.
Synopsis: Telangana has achieved a dramatic drop in HIV positivity rate – from 1.64 percent in 2022 to 0.49 percent in 2024 – by adopting a targeted, data-driven testing strategy. A 2024 state-wide screening campaign tested over 19 lakh people and identified 9,415 positive cases, while improved data verification helped eliminate duplication from earlier years.
Telangana has sharply reduced its HIV positivity rate, from 1.64 percent in 2022 to 0.49 percent in 2024 – an impressive three-fold drop.
A statewide HIV screening drive in 2024 tested 19.02 lakh people, identifying 9,415 positive cases.
In 2022, Telangana had one of the highest HIV positivity rates among India’s larger states, according to the National Health Profile 2023.
With a rate of 1.64 percent, it ranked fifth nationally, behind only four northeastern states – Mizoram (3.18 percent), Arunachal Pradesh (1.70 percent), Nagaland (1.67 percent), and Meghalaya (1.66 percent) – where injectable drug use is a key factor.
That year, 6.63 lakh people were tested in Telangana, and 10,887 were found positive. The state’s positivity rate was more than three times the national average of 0.50 percent, raising serious concern.
It was also among the top ten states for total number of HIV cases.
Officials estimate around 1.24 lakh people in Telangana are currently living with HIV. All of them are receiving free antiretroviral therapy (ART) through government centres.
But the distribution of cases remains uneven. Thirteen districts each report over 5,000 HIV patients. Another 13 have between 2,000 and 5,000 cases.
At a recent review meeting, Health Minister Damodara Rajanarasimha reiterated the state’s target to bring HIV/AIDS under control by 2030, aligning with both national and global goals.
He called for intensified testing across the 26 most affected districts, with a focus on high-risk groups and targeted awareness campaigns. He also asked TSACS to closely monitor the work of NGOs involved in HIV response.
“We must treat HIV/AIDS patients with compassion and avoid discrimination,” the minister stated, urging patients to follow medical advice and maintain regular medication schedules.
Health officials say the 2022 data may have overstated the problem.
“The evaluation of the 2022 data had some discrepancies, as the positivity rate was counted multiple times in some cases,” a Telangana Health Department official told South First.
“For example, if an individual tested positive at one centre but doubted the result, they often went to another centre for confirmation. When they tested positive there as well, both centres would report the case separately, leading to duplication in the data. Now, we are thoroughly verifying records across all centres before compiling the data. That’s why the number of tests has increased, while the number of reported positive cases has gone down.”
Experts say the high positivity rate wasn’t necessarily a sign of uncontrolled spread.
“In fact, a high positivity rate can often be a sign that the state is doing the right thing by focusing on targeted testing,” said Dr Monalisa Sahu, an infectious disease specialist at Yashoda Hospital, Hyderabad, speaking to South First.
“Telangana is currently directing its testing efforts toward high-risk groups – migrant workers, truck drivers, sex workers, and people with a history of drug use. So while the total number of tests might be lower, the tests are being conducted among those most likely to test positive.”
She added that behaviour plays just as much of a role as economics.
“It’s about more than just income or access. High-risk sexual behaviour, for instance, is a major factor. People from all kinds of backgrounds can engage in risky behaviour, and if they believe they might be exposed, they’re more likely to seek testing. So really, both behavioural and economic factors contribute to the trends we’re seeing.”
Some groups, she noted, are simply easier to reach.
“We often see fewer cases among younger individuals or those involved in drug use – not necessarily because the cases aren’t there, but because these groups are less likely to come forward for testing. Meanwhile, migrant labourers and similar populations are more reachable through public health initiatives, so they appear more frequently in the data.”
Telangana’s HIV surveillance system is robust and involved a coordinated approach between private and public sectors.
“The system here is quite robust. The state isn’t just testing random people from the general population – it’s making a conscious decision to test those most at risk. That’s a smart and resource-efficient approach,” Dr Sahu said.
“There’s good coordination between private practitioners and government health services in Telangana. So if someone gets tested at a private facility, they’re still linked to the public system for confirmation and free antiretroviral treatment. That kind of partnership is essential.”
But surveillance still misses some cases.
“That’s a limitation everywhere, not just in Telangana,” she said.
“Unless asymptomatic individuals voluntarily seek out testing, it’s very difficult to catch those cases. Active surveillance does cover asymptomatic people within high-risk groups – like commercial sex workers, who are regularly monitored – but reaching asymptomatic individuals in the broader population is much harder.”
She continued: “You can’t find what you don’t know exists. That’s why targeted testing continues to be the most effective strategy.”
In 2022, over 3.13 crore individuals were tested for HIV at counselling centres across India. Of these, 1,57,693 tested positive.
Among southern states, Andhra Pradesh remains a concern. In 2022, it reported 15,335 HIV-positive cases from 18.34 lakh tests – a positivity rate of 0.84 per cent, nearly twice the national average.
Karnataka tested over 30 lakh people and identified 12,714 positive cases. It has the fourth-highest number of HIV cases nationwide, but a relatively moderate positivity rate of 0.42 per cent.
In contrast, Tamil Nadu has been a model in HIV control. With 38 lakh tests – the second highest nationwide – it found only 7,444 positive cases, a rate of just 0.20 per cent.
Early intervention, consistent political support, and widespread ART access are credited with the success.
Kerala (0.15 per cent) and Puducherry (0.16 per cent) have also maintained low positivity rates. Lakshadweep reported zero cases in 2022.
But low positivity does not always mean low numbers. Maharashtra, for example, conducted more than 42 lakh tests – the most in the country – and detected 17,595 cases. Uttar Pradesh reported more than 14,500 cases.
(Edited by Dese Gowda)
