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Bluetongue (BT) disease poses a constant risk to the livestock population around the world. A better understanding of the risk factors will enable a more accurate prediction of the place and time of high-risk events. Mapping the disease epizootics over a period in a particular geographic area will identify the spatial distribution of disease occurrence. A Geographical Information System (GIS) based methodology to analyze the relationship between bluetongue epizootics and spatial-temporal patterns was used for the years 2000 to 2015 in sheep of Andhra Pradesh, India. Autocorrelation (ACF), partial autocorrelation (PACF), and cross-correlation (CCF) analyses were carried out to find the self-dependency between BT epizootics and their dependencies on environmental factors and livestock population. The association with climatic or remote sensing variables at different months lag, including wind speed, temperature, rainfall, relative humidity, normalized difference vegetation index (NDVI), normalized difference water index (NDWI), land surface temperature (LST), was also examined. The ACFPACF of BT epizootics with its lag showed a significant positive autocorrelation with a month's lag (r = 0.41). Cross-correlations between the environmental variables and BT epizootics indicated the significant positive correlations at 0, 1, and 2 month's lag of rainfall, relative humidity, normalized difference water index (NDWI), and normalized difference vegetation index (NDVI). Spatial autocorrelation analysis estimated the univariate global Moran's I value of 0.21. Meanwhile, the local Moran's I value for the year 2000 (r = 0.32) showed a high degree of spatial autocorrelation. The spatial autocorrelation analysis revealed that the BT epizootics in sheep are having considerable spatial association among the outbreaks in nearby districts, and have to be taken care of while making any forecasting or disease prediction with other risk factors.

Background: A nationwide lockdown in response to the ongoing coronavirus disease 2019 pandemic has disrupted various health surveys. Limited movements due to restricted public-transports, and the need to maintain social-distancing, make data collection at the field site through conventional methods such as face-to-face interviews challenging. Objectives: The objective of the study was to overcome such issues, we document a complete online survey, using mobile technologies, for public health research, and deployable during disasters. Methods: The survey form was uploaded online, and for the 1st time in India, the participant information page, consent, and assent forms were also deployed online. Informed consent forms from participants were captured electronically as hand-drawn signatures. A structured, electronic-questionnaire was shared to the participants’ smartphones, and the collected data were stored in a server using Research Electronic Data Capture, real-time. Results: Within a short span of 10 days, 1985 participants from 31 states and union territories took part in the survey. Among those, 79% had completed the survey, and the rest quit the survey mostly during the “consenting” phase, especially when they were asked to sign the consent/assent forms (16%). About 62.5% of the participant graded the online survey as “much better” followed by 19.5% suggesting “somewhat better,” indicating a positive public perception regarding the online survey. Conclusion: The real-time online survey in health research was perceived to be better than the conventional method. In the digital era, employing mHealth technologies in health research will be a cost-effective methodological approach to obtain the expected research outcome, in a resource and time-limited setting.

Female sex workers (FSWs) who inject drugs (FSW-IDs) have a higher risk of HIV infection and transmission. Understanding the socio-demographic characteristics and other risk behaviours among FSW-IDs will help in strengthening targeted interventions for HIV prevention and management. In the present study, the HIV prevalence, associated socio-demographic characteristics and risk behaviours among FSWs who injected drugs (FSW-IDs) and those who did not ID (FSW-NIDs) was determined in India.The national cross-sectional, community-based, integrated biological and behavioural surveillance was conducted in 2014-2015 at 73 randomly selected FSW domains across 28 States and Union Territories in India. The sample size was fixed at 400 for each domain, and a probability-based sampling method was followed. The data were analyzed by logistic regression methods.Data from 27,007 FSWs were included in the analysis, of which 802 (3%) were FSW-IDs. HIV prevalence among FSW-IDs was significantly higher than that in FSW-NIDs (4.5 vs. 1.9%). Univariate analysis showed that factors significantly associated with higher HIV prevalence among FSW-IDs were older age, sex work as the only source of income, dissolved marriage, living with a sex worker, urban locality of sex work and consumption of alcohol or oral drugs. In multivariable analysis, factors such as older age of FSW-IDs (35 yr and above), having a dissolved marriage and sex work being the only source of income were observed to be independently and significantly associated with higher HIV prevalence.Scaling up the HIV preventive interventions for FSW-IDs, such as facilitating awareness and improved access to needle and syringe exchange programme (NSEP) and opioid substitution therapy (OST), encouraging safe sex and injecting practices, educating on the harmful effects of alcohol and drugs and providing alternative vocation options to secure their financial needs are several strategies that may reduce HIV transmission among FSWs.

Background: The human immunodeficiency virus (HIV) epidemic in India is generally considered to be more concentrated, with the focus on high-risk groups including female sex workers (FSWs). The Integrated Biological and Behavioral Surveillance (IBBS), the first nationwide surveillance conducted during 2014-2015, collected many key indicators, including indicators related to HIV/STI transmission. The purpose of this study was to develop an index score for each domain surveyed and to identify focus areas for interventions among FSWs. Methods: The study population consisted of 27,007 FSWs. Forty high-risk related covariates of HIV/STI transmission, demographic characteristics, sexual history, condom practices, knowledge of HIV/STI and biological variables were considered. The original data set was examined using the correlation matrix and was reduced to 15 highly-correlated factors using principal component analysis. The factors were further improved using varimax rotation and the percentage of variation was used as weights to obtain the initial score for each domain, which were then standardized for comparison. Bartlett’s test of sphericity was examined before the factor extraction. Results: Six factors were extracted, which together explained about 73% of the total variation. The factors were: (1) more number of clients; (2) younger FSW and started selling sex at younger age; (3) experiencing condom breakage; (4) having occasional clients and poor HIV/AIDS knowledge; (5) illiteracy; and (6) a longer period of sex work. Six domains with an index score of above 80, from the states of Maharashtra, Rajasthan, Arunachal Pradesh, Uttar Pradesh, and Jharkhand need greater intervention. Conclusion and Implications for Translation: FSWs’ current age, age at commencement of sex work, and the number of clients were the indicators most-associated with HIV infection. Therefore, program and policy interventions should focus on FSWs who are younger than 10 clients. Key words: • Female Sex Worker • Kriged Map • Factor Analysis • Principle Component Analysis • HIV • Sexually Transmitted Infections Copyright © 2021 Elangovan et al. Published by Global Health and Education Projects, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in this journal, is properly cited.

This study describes the spatial and temporal patterns of bluetongue (BT) outbreaks with environmental factors in undivided Andhra Pradesh, India. Descriptive analysis of the reported BT outbreaks (n = 2,697) in the study period (2000-2017) revealed a higher frequency of outbreaks during monsoon and post-monsoon months. Correlation analysis of Normalized Difference Vegetation Index (NDVI), Normalized Difference Water Index (NDWI), rainfall and relative humidity (RH) displayed a significant positive correlation with BT outbreaks (p < .05). Retrospective unadjusted space-time, adjusted temporal and spatial analysis detected two, five and two statistically significant (p < .05) clusters, respectively. Time series distribution lag analysis examined the temporal patterns of BT outbreaks with environmental, biophysical factors and estimated that a decrease in 1 unit of rainfall (mm) was associated with 0.2% increase in the outbreak at lag 12 months. Similarly, a 1°C increase in land surface temperature (LST) was associated with 6.54% increase in the outbreaks at lag 12 months. However, an increase in 1 unit of wind speed (m/s) was associated with a 16% decrease in the outbreak at lag 10 months. The predictive model indicated that the peak of BT outbreaks were from October to December, the post-monsoon season in Andhra Pradesh region. The findings suggest that environmental factors influence BT outbreaks, and due to changes in climatic conditions, we may notice higher numbers of BT outbreaks in the coming years. The knowledge of spatial and temporal clustering of BT outbreaks may assist in adopting proper measures to prevent and control the BT spread.

Background and Objectives: The purpose of this study was to analyze trends in HIV prevalence and risk factors associated with HIV infection among pregnant women attending antenatal clinics in Odisha State, India. Methods: Data were from the HIV Sentinel Surveillance (HSS) among pregnant women, a descriptive cross-sectional study using consecutive sampling method and conducted in India. Data and samples were collected from pregnant women attending select antenatal clinics that act as designated sentinel sites in Odisha State, India, during the three months surveillance period and in three surveillance years: 2013, 2015, and 2017. All eligible pregnant women aged between 15 and 49 years, attending the sentinel sites for the first time during the surveillance period, were included. Information on their socio-demographic characteristics and blood samples were also collected. Results: In total, 38,384 eligible pregnant women were included in the survey. Of these, 107 women were HIV positive, with an overall prevalence of 0.28%. HIV prevalence indicated a stabilizing trend between 2013 and 2017. However, pregnant women whose spouses were non-agricultural laborers, truck drivers, or migrants were significantly at higher risk of being infected. Likewise, HIV prevalence significantly increased over the years among pregnant women whose spouses were in the service sector (government or private). District-wise fluctuations in HIV prevalence was observed, with the district of Cuttack recording the highest prevalence among the districts. Conclusion and Global Health Implications: Women who are spouses of non-agricultural laborers, truck drivers or migrants need focused interventions, such as creating awareness on HIV and its prevention. Migration, due to poverty and its impact on sexually transmitted diseases among migrants from low and middle-income countries, have been documented globally. Single male migrant specific interventions are recommended to halt the disease progression among pregnant women and general population in Odisha, India. Key words: • HIV sentinel surveillance • Pregnant women • HIV prevalence • Socio-demographic factor • Odisha • India Copyright © 2020 Santhakumar et al. Published by Global Health and Education Projects, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0) which permits unre-stricted use, distribution, and reproduction in any medium, provided the original work, first published in this journal, is properly cited.

People who inject drugs (PWID) are India's third-largest vulnerable population to human immunodeficiency virus (HIV) infection. PWID in India are confined to certain geographic locations and exhibit varying injecting and sexual risk behaviors, contributing considerably to increasing HIV trends in specific regions. Spatial heterogeneity in risk factors among vulnerable PWID influences HIV prevalence, transmission dynamics, and disease management. Stratified analysis of HIV prevalence based on risk behaviors and geographic locations of PWID will be instrumental in strategic interventions. To stratify the male PWID based on their risk behaviors in each state and determine the HIV prevalence for each stratum. The behavioral data and HIV prevalence of the national integrated biological and behavioural surveillance (IBBS), a nationwide cross-sectional community-based study conducted in 2014 to 2015, was analyzed. Data from 19,902 men who inject drugs across 53 domains in 29 states of India were included. Women who inject drugs were excluded at the time of IBBS, and hence PWID in this study refers to only men who inject drugs. PWID were categorized based on their risk profile, and the corresponding HIV prevalence for each state was determined. HIV prevalence was the highest (29.6%) in Uttar Pradesh, with a high prevalence of risk behaviors among PWID. High HIV prevalence ranging between 12.1% and 22.4% was observed in a few states in East and North-East India and most states in central and North India. Unsafe injecting and sexual practices were significantly (P .05) associated with higher HIV prevalence and more significantly in National Capital Territory of Delhi (P .001). Unsafe injecting practices among PWID were proportionally higher in Western and Central India, whereas unsafe sexual behaviors were widespread among most states. Unsafe sexual practices among male PWID were common. The high prevalence of unsafe injecting had significant HIV infection and transmission risks in Western and Central India. The results emphasize the need for stratified, region-specific interventions and combination approaches for harm reduction among PWID. Strengthening the measures that facilitate the reduction of high-risk behaviors, adoption of safe practices, and utilization of HIV services will positively impact HIV prevention measures among PWID.

Background and Objective: Periodic tracking of the trends and the levels of HIV prevalence at regional and district levels helps to strengthen a state’s HIV/AIDS response. HIV prevalence among pregnant women is crucial for the HIV prevalence estimation of the general population. Karnataka is one of the high HIV prevalence states in India. Probing regional and district levels and trends of HIV prevalence provides critical insights into district-level epidemic patterns. This paper analyzes the region- and district-wise levels and trends of HIV prevalence among pregnant women attending the antenatal clinics (ANC) from 2003 to 2019 in Karnataka, South India. Methods: HIV prevalence data collected from pregnant women in Karnataka during HIV Sentinel Surveillance (HSS) between 2003 and 2019 was used for trend analysis. The consistent sites were grouped into four zones (Bangalore, Belgaum, Gulbarga and Mysore regions), totaling 60 sites, including 30 urban and 30 rural sites. Regional and district-level HIV prevalence was calculated; trend analysis using Chi-square trend test and spatial analysis using QGIS software was done. For the last three HSS rounds, HIV prevalence based on sociodemographic variables was calculated to understand the factors contributing to HIV positivity in each region. Results: In total, 254,563 pregnant women were recruited. HIV prevalence in Karnataka was 0.22 (OR: 0.15 95% CI: 0.16 - 0.28) in 2019. The prevalence was 0.24, 0.32, 0.17 and 0.14 in Bangalore, Belgaum, Gulbarga, and Mysore regions, respectively. HIV prevalence had significantly (P< 0.05) declined in 26 districts. Conclusion and Global Health Implications: HIV prevalence among pregnant women was comparatively higher in Bangalore and Belgaum regions. Analysis of contextual factors associated with the transmission risk and evidence-based targeted interventions will strengthen HIV management in Karnataka. Regionalized, disaggregated, sub-national analyses will help identify emerging pockets of infections, concentrated epidemic zones and contextual factors driving the disease transmission. Copyright © 2021. Arumugam et al. Published by Global Health and Education Projects, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution License CC BY 4.0.

This review was focused on global data analysis and risk factors associated with morbidity and mortality of coronavirus disease 2019 from different countries, including Bangladesh, Brazil, China, Central Eastern Europe, Egypt, India, Iran, Pakistan, and South Asia, Africa, Turkey and UAE. Male showed higher confirmed and death cases compared to females in most of the countries. In addition, the case fatality ratio (CFR) for males was higher than for females. This gender variation in COVID-19 cases may be due to males' cultural activities, but similar variations in the number of COVID-19 affected males and females globally. Variations in the immune system can illustrate this divergent risk comparatively higher in males than females. The female immune system may have an edge to detect pathogens slightly earlier. In addition, women show comparatively higher innate and adaptive immune responses than men, which might be explained by the high density of immune-related genes in the X chromosome. Furthermore, SARS-CoV-2 viruses use angiotensin-converting enzyme 2 (ACE2) to enter the host cell, and men contain higher ACE2 than females. Therefore, males may be more vulnerable to COVID-19 than females. In addition, smoking habit also makes men susceptible to COVID-19. Considering the age-wise distribution, children and older adults were less infected than other age groups and the death rate. On the contrary, more death in the older group may be associated with less immune system function. In addition, most of these group have comorbidities like diabetes, high pressure, low lungs and kidney function, and other chronic diseases. Due to the substantial economic losses and the numerous infected people and deaths, research examining the features of the COVID-19 epidemic is essential to gain insight into mitigating its impact in the future and preparedness for any future epidemics.

Purpose: To analyze the morphological changes in the iris-knot complex configuration using spectral-domain optical coherence tomography (SD-OCT) following the single pass four throw (SFT) pupilloplasty. Methods: In this retrospective case series, eyes with SFT pupilloplasty were examined by SD-OCT (Optovue). Iris morphology compared to the normal iris, presence of specific patterns (single hump, double humps, peaks and valleys, tethering), prolene suture, knot complex (length and orientation), and intraocular lens (IOL) vault were evaluated. Results: Overall, 41 knots of 26 patients with a mean time duration of 3.1 ± 2 months from surgery were analyzed. Iris configurations seen were single hump (n = 28, 63.8%), double humps (n = 7, 17%), loop (n = 2, 4.8%), flat (n = 3, 7.3%), and mulberry (n = 1, 2.4%). The mean length and the height of the knot complex was 784.1 ± 433.7 μm and 317.7 ± 110.4 μm, respectively. Knot positions were at 3 clock hours in 9 eyes (21.9%), 9 in 8 eyes (19.5%), and others in 24 eyes (58.5%). Cut end of the prolene suture was detectable in 26 eyes (63.4%) as hyper-reflective line, and the mean cut length was 465.8 ± 321.1 μm. The suture was predominantly vertically oriented (80.6%) to the iris with a mean distance of 3.6 ± 0.3 mm (2.6–4 mm) away from corneal endothelium. The mean distance from the knot complex and the IOL was 289.2 ± 146 μm and the mean anterior chamber depth was 4.1 ± 0.1 mm. Conclusion: A significant change in iris configuration was noted after SFT pupilloplasty, and vertically oriented retained prolene suture was predominant with good endothelial vault.

Coronavirus disease (COVID-19) caused by SARS-CoV-2 was notified from Wuhan city, Hubei province, China in the mid of December 2019. The disease is showing dynamic change in the pattern of COVID-19 confirmed cases and death toll in these low and middle-income countries (LMICs). In this study, exponential growth (EG) method was used to calculate the reproductive rate (Rt) for initial and current stage of epidemic in South Asian Association for Regional Cooperation (SAARC) member countries (April 2020 – December 2020). Time dependent (TD) method was used to calculate the weekly reproduction number. We also presented the observations on COVID-19 epidemiology in relation with the health expenditure, poverty, and BCG vaccination, literacy, in comparison with the reproduction number, population density for understanding the current scenario, trends, and expected outcome of the disease in SAARC countries. A significant positive correlation was noticed between COVID-19 deaths and health expenditure (% GDP) (r = 0.58, P

PURPOSE To quantify corneal backscattering by densitometry analysis after pre-Descemet endothelial keratoplasty (PDEK). DESIGN This is a prospective observational case series. METHODS Setting: Tertiary care hospital. PARTICIPANTS Postoperative PDEK eyes with best-corrected visual acuity (BCVA) ≥20/40 without comorbidity. OBSERVATION PROCEDURE Slit-lamp examination, Scheimpflug imaging (Pentacam; Oculus, Wetzlar, Germany), endothelial cell density (cells/mm), and central corneal thickness (Visante; Carl Zeiss AG, Oberkochen, Germany) were performed. Corneal densitometry values for the entire depth of the cornea were compared between post-PDEK eyes and fellow eyes (non-PDEK). MAIN OUTCOME MEASURES Mean densitometry (grayscale units, GSUs) of the anterior, posterior, central, total depth and concentric zones (0-2, 2-6, 6-10, and 10-12 mm) of the cornea. RESULTS Overall, 35 eyes (21 PDEK eyes and 14 control eyes) were evaluated. The mean total densitometry values in the anterior, central, and posterior corneas were 40.7 ± 7.6 GSU, 25.3 ± 4.8 GSU, and 20.9 ± 3.4 GSU, respectively. On inter-zone comparison between central and peripheral cornea, there was a statistically significant difference (P < 0.05) between 0 to 2 mm and 6 to 12 mm zones. There was no correlation between endothelial cell density and central corneal thickness with densitometry. However, there was a significant correlation of BCVA with corneal densitometry in 0 to 2 mm (r = 0.519, P = 0.016) and 6 to 2 mm (r = 0.556, P = 0.009) zones. In eyes with BCVA 20/20, there was no significant difference between PDEK and control eyes in the total corneal densitometry in the entire depth of the cornea (P = 0.662). CONCLUSIONS Clinically clear corneas with visual acuity 20/20 showed no difference in the total corneal densitometry as compared to their fellow eye. Corneal backscatter was higher in the anterior cornea and in the central 0 to 6 mm zone.

To evaluate the results of pinhole pupilloplasty in cases with high astigmatism and higher-order aberrations (HOAs).Dr. Agarwal's Eye HospitalResearch Centre, Chennai.Case series.Pinhole pupilloplasty was performed based on the Purkinje 1 (P1) images formed from the light source of a Lumera surgical microscope; the images served as a reference marker for centration. A single-pass 4-throw technique was used to achieve a pinhole pupil. The preoperative and postoperative pupil diameter, uncorrected (UDVA) and corrected (CDVA) distance visual acuities, simulated keratometry (K), and chord length mu (μ) were assessed, the latter using a Pentacam rotating Scheimpflug camera.Pinhole pupilloplasty was performed in 8 eyes (8 patients). There was a statistically significant reduction in the mean horizontal and vertical pupil diameters and in the mean pupil diameter from preoperatively to postoperatively (both P .001). Although the improvement in UDVA was statistically significant (P .001), the change in CDVA was not. The mean simulated K and mean chord length μ values were significantly lower postoperatively (P = .024 and P .001, respectively). The reduction in pupil size was more apparent than the reduction in chord length μ. The correlation between the change in chord length μ and the change in pupil size was not significant (r = -0.067, P = .874). The pupil was well centered on the P1 images. No major adverse events or complications occurred postoperatively.Postoperative results showed a correlation between the improvement in visual acuity and the decrease in pupil size and chord length μ.

Background: Stone quarrying activities generate dust and fine particulate matters of silica and heavy metals. The prolonged exposure to suspended particulates leads to fatal respiratory complications. Occupational pulmonary complications are poorly characterized among quarry workers in Tamil Nadu. Objectives: This study aims to assess pulmonary function and determine the associated risk factors among quarry workers. Materials and Methods: A comparative, cross-sectional study was conducted from April 2014 to January 2015 among workers at seven stone quarries in Chennai and residents within a 5 Km radius. Pulmonary function tests (PFT) and sputum analysis were done. Results: Overall, 670 participants were enrolled in the study, with a median age of 37 years. Comparatively, the mean PFT measures were significantly lower in quarry workers with a higher proportion of airflow obstruction and tuberculosis infection. Conclusion: The risk of airflow obstruction among quarry workers increased with smoking and longer duration of work years in quarry.

Background: The HIV sentinel surveillance (HSS) serves to estimate the levels and trend of HIV prevalence among high-risk, bridge, and general population and monitors HIV management at national, state, and district levels. Data from HSS are valuable in understanding the risk factors associated with HIV transmission with particular demographic characteristics. Objectives: The objective was to analyze the sociodemographic profile of the pregnant mothers attending the antenatal care (ANC) clinics in Karnataka, in order to understand the dynamics of HIV within the general population in Karnataka. Materials and Methods: Study design: this was a cross-sectional study conducted using consecutive sampling method. Study setting: the surveillance was conducted at select antenatal clinics, in Karnataka, India, between January and March, in the years 2013, 2015, and 2017. Methodology: in total, 74,278 eligible pregnant women aged between 15 and 49 years, attending the sentinel sites for the first time during the surveillance period, were included in the study. Information on their sociodemographic characteristics and blood samples was collected. Results: HIV prevalence among the ANC clinic attendees has significantly declined, reaching a recent stabilization. The risk factors significantly associated with HIV among pregnant women were age, education, occupation, and marital status. HIV is highly concentrated in the northern and southern districts of Karnataka. Conclusion: Despite the declining trends of HIV prevalence in Karnataka, the epidemic is heterogeneous and concentrated within the state, calling for decentralized region-specific interventions.

Supplemental Digital Content is available in the text, HIV prevalence is higher among Men who have Sex with Men (MSM), owing to their unsafe sexual behavior. Further, MSM indulge in behaviors such as consumption of alcohol/oral drugs and/or injecting during/before sex that poses the risk of unsafe behaviors, thereby increasing their vulnerability to HIV. The study aims to analyze the factors associated with HIV infection among the multi-risk MSM using any substances with those MSM who do not use substances. Community-based cross-sectional survey design using probability-based sampling between October 2014 and November 2015. For the nation-wide Integrated Biological and Behavioral Surveillance (IBBS), 23,081 MSM were recruited from 4067 hotspots in 108 districts across India. Information on demographics, sexual behaviors, substance use, sexual partners, and awareness on HIV and its management was collected from the consented respondents using computer-assisted personal interview (CAPI) by trained personnel. Blood samples were tested for HIV. Statistical analyses were done, to study the associations between substance use and its influence on high-risk sexual behaviors and HIV infection. One in 3 MSM (33.88%) in India were substance users, thus exhibiting “multi-risk” (MR) behaviors. Significantly higher HIV prevalence (3.8%, P

Background: HIV/AIDS is a global public health issue and its transmission in a defined geographic region is influenced by the interplay of sociodemographic and behavioral factors. Better understanding of sociodemographic characteristics of HIV-positive individuals is required to prevent the spread of HIV among the general population. Objectives: The objective of the study was to find the association between HIV prevalence and sociodemographic characteristics of pregnant women aged 15–49 years attending the antenatal clinics (ANCs) in six Southern states of India. Methods: The data from the latest round of HIV sentinel surveillance, a cross-sectional study, conducted during January–March 2017 among ANC attendees were considered for this analysis. Blood samples along with other relevant information were collected from 98,634 pregnant women from 248 sites across the states. The association between HIV prevalence and sociodemographic variables was examined using multivariable logistic regression. Results: The highest HIV prevalence was reported in Karnataka (0.38%) and Andhra Pradesh (0.38%), followed by Telangana (0.33%), Odisha (0.28%), Tamil Nadu (0.27%), and Kerala (0.05%). In all states, the prevalence was highest among illiterate pregnant women exception being Kerala, wherein the prevalence was highest in pregnant women with schooling up to primary education. A significant association was found between HIV prevalence and spouse occupation in Karnataka and Odisha and spouse migration in Andhra Pradesh and Karnataka. Conclusions: Need for improvising the interventions for the young, illiterates, having a migrant spouse, and spouse occupation as truckers/hotel staff is recommended to the stakeholders involved in HIV management of the six southern states of India.