Dr Smita K Panda

Asso. Prof
Department Of Community Medicine
 AIDS
• AIDS (Acquired Immuno-deficiency
Syndrome) is also called as “SLIM
DISEASE”.

• It is a fatal disease caused by a

retro virus called as the HUMAN
IMMUNO DEFICIENCY VIRUS (HIV).
HUMAN IMMUNO VIRUS
• A person suffering from this disease
is vulnerable to life threatening
opportunistic infections due to
breakdown of his immune system.

• Once infected by HIV infection a

person remains infected for the
remaining life time.
• Strictly the term AIDS refers to the
last stage of the HIV infection.

• AIDS can be called as a modern

pandemic affecting both
industrialized and developing
countries.
 PROBLEM STATEMENT
(WORLD)
INDICATOR 2007 2008 2009 2010 2011 2015
NUMBER OF 31.8 32.3 32.9 34 34.2 36.7
PEOPLE LIVING
WITH HIV (in
millions)

NEWLY INFECTED 2.7 2.7 2.7 2.7 2.5 2.1

(in millions)
 PROBLEM STATEMENT
(WORLD)
INDICATOR 2007 2008 2009 2010 2011 2015
PEOPLE DYING 2.1 2.0 1.9 1.8 1.7 1.1
FROM AIDS (in
millions)

% OF PREGNANT 15% 21% 26% 35% -

WOMEN TESTED
FOR HIV (Middle
Income Countries)
(in millions)
 HIV ESTIMATES FOR INDIA
(2015)
Category Estimation
Total population 1.027 billion

HIV prevalence (15-49 years) 0.26%

HIV prevalence among men (15-49
0.30%
years)
HIV prevalence among women (15-49
0.22%
years)
Number of people living with HIV (adults
2.1 million
and children)
Number of Children living with HIV (>15
3.8% of total
years)
With a very high prevalence among
High Risk Groups -:
-IDU (6.3%)
-MSM (2.7%)
-FSW (1.6%) &
-TG (3.1%) and
low prevalence among ANC clinic
attendees (Age adjusted - 0.28%).
 HIV Epidemic
• Low-level HIV epidemic: HIV prevalence is
consistently not exceeded 5% in any define sub-
population.

• Concentrated HIV epidemic: HIV prevalence

consistently over 5% in any defined sub-
population but below 1% in pregnant women in
urban.

• Generalized HIV epidemic: HIV prevalence

consistently over 1% in pregnant women.

10
• HIV was first Identified in 1981 in USA among
homosexual.

• In 1983, French investigator named

Lymphadenopathy associated virus (LAV).

• In 1984 virus was isolated by Gallo and co-

workers from national institute of health in
United States.
They named Human T-cell Lymphotropic virus III
(HTLV-III).

11
 Contd.
• Thailand was the first country in the SEAR to
report a case of AIDS, in 1984.
• In 1986, a new strain of HIV was isolated in West
African patient with AIDS which is called HIV-2.

• In May 1986, international committee on

taxonomy gave a new name called Human
immune deficiency virus.

• Since its identification, HIV/AIDS is devastating

disease of mankind
12
 Etiology

• Human Immuno Deficiency Virus

• Size: 1/10,000 of a millimeter in diameter.
th

• It is a protein capsule containing two short

strands of genetic material (RNA) and enzymes.
• Two types: HIV-1 and HIV-2

13
 Reservoir of infection

• Cases and carriers.

• Once a person is infected, virus remains life-long
• It can be transmitted even if the person is
symptoms less.

14
 Source of infection
• Virus has been found in greatest
concentration in blood, semen and CSF.
• Lower concentration have been detected
in tears, saliva, breast milk, urine, and
cervical and vaginal secretion.
• To date, only blood and semen have been
conclusively shown to transmit the virus.

15
Pathogenesis of HIV infection
HIV Virus

CD4 cells

Uncoating and
reverse transcription

Proviral DNA

Budding of virus particles

and cytopathic phase

16
 Host factors:
1. Age: Most cases have occurred among sexually
active persons aged 20-49

2. Sex: In Africa: both sexes affected equally

• In North America, Europe and Australia, about 51

per cent of cases are homosexual or bisexual men.

17
 Risk Groups for HIV infection
⚫ Sex workers
⚫ IDUs
⚫ Clients of sex workers
⚫ Labor migrant / Transport workers
⚫ MSM
⚫ Partners of migrants / house wives
⚫ Street children
⚫ Military, police
⚫ Health care workers 18
 PHASES OF HIV INFECTION

1. Initial infection (3-12 weeks)

• Acute HIV syndrome
• Sore throat
• Fever
• Skin rash
• High viremia

19
 Contd.
2. Asymptomatic carrier State(10-12 years)
• Competition between HIV and host
immune system
• Patient asymptomatic or has mild
symptoms
• Moderate viremia

20
3. AIDS related complex:
• Damage to the immune system
• No opportunistic infections or cancers
• Diarrohea more than 1 month
• Malaise
• Fatigue fever
• Loss of weight
4. AIDS
• Full blown AIDS
• Severe immuno- suppression
• Drop in CD4 count below 200/µl
(normal count: > 950 CD4 cells/µl }
• High viremia
• Opportunistic infections and cancer.

22
 AIDS-signs
⚫
1. Major

⚫ Weight loss >10% body weight

⚫ Chronic diarrhea >1 months duration

Prolonged fever >1 month

⚫
2. Minor

⚫ Recurrent oral-pharyngeal candidiasis

⚫
⚫
Persistent generalized lymphadenopathy
Persistent cough>1 month

⚫ Recurrent herpes zoster

Generalized pruritic dermatitis

Diagnosis is made on the basis of presence of at

least two major and one minor sign

23
Mode of Transmission:

24
 HIV is transmitted:
During sexual contact

• Unprotected sex
Anal (10 times higher risk)
Vaginal
Oral
• transmission from male to female is more (twice) as
compared to female to male.
• STDs facilitate for transmission of HIV.
25
 HIV is transmitted:
Through infected blood

• Sharing
needles

• Use of
contaminated needles
and syringes
26
 HIV is transmitted:

Through infected blood / blood products

• Transfusion of
HIV infected blood
or
blood products

27
 HIV is transmitted:
From mother to child

• During pregnancy
• During child birth
• Through breast
feeding

28
 Lab diagnosis
Direct tests
• ELISA (enzyme-linked-immunosorbent
serologic assay)
• Recombinant DNA techniques
• Viral isolation in culture
• PCR
Indirect Tests
• CD4 counts
• Lymphopenia
• Lymphnode biopsy
29
 Incubation period:
• Current data suggest that the incubation
periods is uncertain, (from a few months to
10 years or even more)

30
 Prevention
• Raising awareness
- To be faithful to partner
- Use of Condom
- IDUs should be informed not to share
needle and syringes.
- Distribution of IEC materials.
- Advertisement from different media or
channels.

31
 Contd.
• Prevention of blood borne HIV Transmission
• People in high-risk groups should be urged to
refrain from donation of blood, body organs,
sperm or other tissues.
• The donors blood should be screened for HIV 1
and HIV 2 before transfusion.
• Strict sterilization techniques should be applied
to the hospitals and clinics.
• Avoid injections unless they are absolutely
necessary.
• Rehabilitation of HIV/AIDS cases,
32
 Classification of States
• High prevalence
– >5% in HRG & >1% in ANC
– MR, TN, Andhra, Manipur, Karnataka, Nagaland
• Moderate prevalence
– >5% in HRG & <1% in ANC
– Gujarat, Puducherry, Goa
• Low prevalence
– <5% in HRG & <1% in ANC
– All other states/UTs

33
 Classification of districts - 1
• Districts are classified into four categories A to D
• Category A:
– More than 1% ANC prevalence in district in any of the sites in the last
3 years.
• Category B:
– Less than 1% ANC prevalence in all the sites during last 3 years
with more than 5% prevalence in any HRG site (FSW/MSM/IDU/STD)
• Category C:
– Less than 1% ANC prevalence in all sites during last 3 years with less
than 5% in all HRG sites, with known hot spots (Migrants, truckers,
large aggregation of factory workers, tourist etc.,)
• Category D:
– Less than 1% ANC prevalence in all sites during last 3 years with less
than 5% in all HRG sites with no known hot spots OR no or poor HIV
data
34
Classification of districts - 2
• Based on
2004-2006 HSS
• Category A; 156
• Category B; 39

35
 CURRENT SCENARIO
• HIV situation in the country is assessed
and monitored through regular annual
sentinel surveillance established since
1992.
• There are 2.1 million people living with
HIV/AIDS at the end of 2015. The
estimated adult prevalence in the
country is 0.26% and it is greater
among males (0.30%) than among
females (0.22%).
 NATIONAL AIDS CONTROL
PROGRAMME
• The National AIDS Control Programme
was launched in the year 1987.

• The Ministry of Health & Family Welfare

has set up National AIDS Control
Organization (NACO) as a separate wing to
implement & closely monitor the
components of the programme.
 MILE STONES OF NACP
• 1986 – First Case detected &
National Aids Committee
Established.

• 1990 – Medium Term Plan launched

for four states & four metros.
• 1992 - NACP-I launched.
• 1999 - NACP-II launched.
• 2002 - National Aids Control Policy
adopted.
• 2004 - Anti retroviral treatment
initiated.
• 2006 - National Council on AIDS
constituted.
• 2007 – NACP III launched.
 NACO
VISION AND VALUES
- NACO envisions an India where every
person living with HIV has access to
quality care and is treated with dignity.
- Effective prevention, care and support
for HIV/AIDS is possible in an
environment where human rights are
respected and where those infected or
affected by HIV/AIDS live a life without
stigma and discrimination.
NACO envisions:
• Building an integrated response by reaching
out to diverse populations

• A National AIDS Control Programme that is

firmly rooted in evidence-based planning.

• Achievement of development objective

• Regular dissemination of
transparent estimates on the spread and
prevalence of HIV/AIDS
• Building an India where every person is
safe from HIV/AIDS

• Building partnerships

• An India where every person has

accurate knowledge about HIV and
contributes towards eradicating stigma
and discrimination
• An India where every pregnant woman
living with HIV has the choice to bring an
HIV free baby into the world

• An India where every person has access

to Integrated Counselling & Testing
Centers (ICTCs)

• An India where every person living with

HIV is treated with dignity and has
access to quality care
• An India where every person will
eventually live a healthy and safe life,
supported by technological advances

• An India where every person who is

highly vulnerable to HIV is
heard and reached out to
 NACP
The aim of the programme is to
prevent further transmission of
HIV infection & to minimize the
socio-economic impact resulting
from HIV infection.
 THE NATIONAL STRATEGY
To achieve the programme objectives
the following components are enlisted.

• Establishment of Surveillance centers

in the country.
• Identification of high-risk groups &
their screening.
• Issuing specific guidelines for the
management of detected cases
• Formulation of guidelines for
blood bank, blood product
manufacturers, blood donors &
dialysis units.

• IEC activities involving mass media.

• Research for reduction of personal

& social impact of the disease.
• Control of sexually transmitted
diseases.

• Condom programme.
INITIATIVES OF GOVT OF INDIA
• The Govt of India has initiated
programmes of prevention & raising
awareness under the Medium-Term Plan .
(1992 -99) NACP-I
(1999-2006) NACP -II
(2007-2012) NACP-III
(2012-2017) NACP-IV
(2017-2024) National Strategic Plan
 NACP-I (1992-1999)
The objective of was to control the spread
of HIV infection. During this period a
major expansion of infrastructure of
blood banks was undertaken with the
establishment of 685 blood banks and 40
blood component separation.
Infrastructure for treatment of sexually
transmitted diseases in district hospitals
and medical colleges was created with
the establishment of 504 STD clinics.
• HIV sentinel surveillance system was
also initiated. NGOs were involved in
the prevention interventions with the
focus on awareness generation.

• The programme led to capacity

development at the state level with the
creation of State AIDS Cells in the
Directorate of Health Services in states
and union territories.
 NACP-II (1999-2006)
• During a number of new initiatives were
undertaken and the programme expanded in
new areas. Targeted Interventions were
started through NGOs, with a focus on High
Risk Groups (HRGs) viz.
• commercial sex workers (CSWs), men who
have sex with men (MSM), injecting drug
users (IDUs), and bridge populations
(truckers and migrants).
• The package of services in these
interventions includes Behaviour
Change Communication,
management of STDs and condom
promotion.
The School AIDS Education
Programme was conceptualized to
build up life skills of adolescents
and address issues relating to
growing up.
All channels of communication
were engaged to spread awareness
about HIV/AIDS, promote safe
behaviors and increase condom
usage.
 NACP – III
• Goals
– Halt and reverse the epidemic in India over the next five
years by four pronged strategy
1. Prevent new infections
2. Increasing CST for PLHA
3. Strengthen the infrastructure, systems and human
resources
4. Strengthening strategic information systems (SIMS)
• Objective
– Reduce the rate of incidence by 60% in the first year of the
programme in high prevalence states to obtain the reversal
of the epidemic,
– And by 40% in the vulnerable states to stabilise the
epidemic.
 NACP – III Guiding principles
• Unifying credo of 3 ones (one agreed Action Framework, one
National HIV/AIDS Coordinating Authority, one agreed National
Monitoring and Evaluation)
• Equity is to be monitored by relevant indicators in both prevention
and impact mitigation strategies i.e. percentage of people
accessing services disaggregated by age and gender.
• Respect for the rights of PLHA
• Civil society representation
• Creation of an enabling environment wherein PLHA can lead a life
of dignity.
• Provide universal access to HIV prevention, care, support and
treatment services.
• HRD strategy of NACO and SACS is based on qualification,
competence, commitment and continuity
 PROGRAMME PRIORITIES
• Considering that more than 99% of the population in the
country is free from infection , NACP-III has placed the
highest priority on prevention efforts while, at the same
time , seeking to integrate prevention with care ,support
and treatment.
• Sub-population that have the highest risk of exposure
to HIV will receive the highest priority for intervention.
These include sex worker, men who have sex with men
and injecting drug user. The next priority will be those
groups which have high levels of exposure to HIV
infection such as long distance truckers,prisoners,
migrants and street children.
• General population who have greater need for
accessing prevention services, treatment,
voluntary counseling & testing & condom will
be in the next line of priority.
• NACP-III ensured that all persons who need
treatment would have access to prophylaxis &
management of opportunistic infections &
persons needing anti retro viral treatment
(ART) will get first line of ARV drugs.
• Provision of services for prevention
of parent to child transmission of
disease & assured access to
pediatric ARV for children having
HIV.
• Impact if HIV will be mitigated
through welfare agencies providing
nutritional support, opportunities
for income generation.
• NACP-III invested in community care
centers to provide psycho social
support, outreach services, referrals &
palliative care.

• Socio economic determinants that

make a person vulnerable also
increases the risk of exposure to HIV,
NACP worked with agencies such as
women’s group & trade unions to
integrate HIV prevention into their
activities.
 PROGRAMME COMPONENTS OF NACP III
PREVENTION CARE, CAPACITY STRATEGIC
SUPPORT & BUILDING INFORMATION
TREATMENT
MANAGEMEN
T
Targeted ART Establishment, Monitoring &
interventions support & Evaluation
among HRG, capacity
CSW. strengthening

Other Pediatric ART Training Surveillance

interventions
(Truckers,
Prison
inmates)
PREVENTION CARE, CAPACITY STRATEGIC
SUPPORT & BUILDING INFORMATION
TREATMENT MANAGEMENT
Integrated Center of Managing Research
Counseling Excellence programme
& testing implementa
Centers tion &
contracts
Blood Care & Mainstream
Safety Support ( ing /
Community private
care centers sector
& impact partnership
mitigation) s
PREVENTION CARE, CAPACITY STRATEGIC
SUPPORT & BUILDING INFORMATION
TREATMENT MANAGEMENT
Communicati- Nil Nil Nil
on, Advocacy
& social
mobilization
 NACP- IV
• The strategy and plan for NACP-IV (2012-2017) was
developed through an elaborate and extensive process.
• The thematic working groups that deliberated on
several aspects of NACP-IV are listed below:
a. Programme Implementation and Organizational
Restructuring
b. Finance Management /Innovative Financing
c. Procurement
d. Laboratory Services
e. Sexually Transmitted Infections (STI)/ Reproductive
Tract Infections (RTI)
f. Condom Programming
g. Communication Advocacy and Community Mobilization
h. Greater Involvement of People Living with HIV/AIDS
(GIPA), Stigma, Discrimination and Ethical issues
i. Mainstreaming and Partnerships
j. Blood Safety
k. Integrated Counselling and Testing Centres (ICTC)/
Prevention of Parent to Child Transmission (PPTCT)
l. Care, Support and Treatment
m. Strategic Information
- Management (SIMS)
n. Gender, Youth and Adolescence
o. Targeted Interventions (TI)
- Female Sex Workers (FSW)
- Injecting Drug Users (IDU)
- Capacity Building
- Migrants
- Link Workers
- Transgender/ Hijras
- Truckers Men having Sex with Men (MSM)
 The key steps in the NACP- IV
preparation process included
- Collating inputs from the Working Groups and subgroups
consultations
- Consultations with civil society
- Consultations at the state level with SACS and partners
- Regional consultations with communities, PLHIVs, public
sector, private sector and other key stakeholders
- E-consultations / discussions on specific topics to enrich
the project development process and strategic
approaches.
- Commissioning of assessments
- Collaboration with development partners
- Preparation of draft strategic plan
- Reviews, clearances
NATIONAL AIDS
PREVENTION &
CONTROL POLICY
 BLOOD SAFETY PROGRAMME
• Regular voluntary non-remunated blood donors constitute the
main source of blood supply through phased increase in donor
recruitment and retention.
• Establishing blood storage centers in the primary health care
system for availability of blood in far-flung remote areas.
• Promoting awareness for appropriate use of blood,
blood components and blood products among the
clinicians, Capacity building of staff involved in BT
services through an organized training programme
• Safe procedures
• Zonal blood storage & testing centers at FRU’s
 COUNSELLING
- Pre and post test counseling-to monitor the
trend of HIV infection in a population or sub
group, to test blood, organ or tissue for
ensuring safety of the recipient and to identify
an individual with HIV infection on voluntary
testing basis.
• In 2006-07 voluntary counseling testing and
prevention of parents to child
transmission(PPTCT) services were merged to
form Integrated Counseling and Testing
Centers(ICTCs) to expand the coverage.
HIV TESTING
 STD CONTROL
PROGRAMME

• Syndromic
approach

• Integrate
treatment of RTIs
& STDs
 CONDOM
• NACO-significant
PROMOTION
progress in 3 major
areas

1. Quality control of
condoms

2.Social marketing of
condoms

3.Involvement of
NGOs in the
 HIV
SURVEILLANCE
• OBJECTIVE
To identify trends
of seropositivity in
specific high risk
groups & low risk
groups
 TARGETTED
INTERVENTIONS
• Behavior change

• Communication

• Treatment of STD

• Creating an environment that ‘ll

facilitate behaviour changes
 SCHOOL AIDS
EDUCATION
PROGRAMME

• Learning for life

• University talk AIDS

project
 INFORMATION
EDUCATION
COMMUNICATION
SOCIAL MOBILISATION
• OBJECTIVES

1. To raise awareness
2. To promote desirable
practice such as use of
condom
3. To create a
supportive environment
for care of persons with
HIV
 Contd..
• Awareness
campaign through
multimedia
• Print media,
electronic media,
press campaign,
field publicity
 FAMILY HEALTH
AWARENESS
CAMPAIGN
• Period:15 days

• OBJECTIVES
- To raise awareness in
rural & slum areas

-To facilitate early

detection and prompt
treratment
 Contd..
-To strengthen the
capacity of medical
& paramedical
professionals

-To create awareness

among mothers with
HIV
 INTEGRATED
COUNSELLING&
TESTING CENTERS

• Prevention of
parent to child
transmission

• National
paediatric AIDS
initiatives
Thank you

83
 SATURATION OF COVERAGE OF
HIGH RISK GROUP THROUGH
TARGETED INTERVENTIONS
• Essential elements of targeted interventions
are:
Access to behavior change
communication
Treatment services( STI services, drug
substitution for IDU
Creation of enabling environment at
project sites.
 SCALING UP INTERVENTIONS
AMONG GENERAL POPULATION

• STD control program

• Voluntary counseling and testing
• PPTCT program.
• Blood safety.

• Improved access to quality

condoms.

• Universal precautions and Post

exposure prophylaxis
• Focused efforts on women,
children and Young people.

• Expanding HIV/AIDS response at

workplace.

• Focused efforts on migrants,

mobile populations and in cross
border areas.
 STD CONTROL PROGRAM
• An estimated five percent adult
population affected by STDs, also has HIV
infection.. Limited diagnostic facilities to :

• manage complicated STDs and drug

resistance to major STDs are the other
issues of concern that NACP-III addresses
• Under NACP-III, a demand for STD
services is generated through its
awareness on one hand and on the
other STD services are expanded .........

• Through its integration with the

Reproductive and Child Health
Programme..
OTHER STRATEGIES
 VOLUNTARY COUNSELING
AND TESTING
• HIV counselling and testing services
were started in India in 1997. There
are now more than 4000
Counselling and Testing Centres,
mainly located in government
hospitals.
• Under NACP-III, Voluntary Counselling and
Testing Centres (VCTC) and facilities
providing Prevention of Parent to Child
Transmission of HIV/AIDS (PPTCT) services
are remodelled as a hub or ‘Integrated
Counselling and Testing Centre’ (ICTC) to
provide services to all clients under one roof.

• An ICTC is a place where a person is

counselled and tested for HIV, of his own
free will or as advised by a medical provider.
The main functions of an ICTC are:
 PPTCT PROGRAM

• The Prevention of Parent to Child

Transmission of HIV/AIDS (PPTCT)
programme was started in the country
in the year 2002 following a feasibility
study in 11 major hospitals in the five
high HIV prevalence states.
• Presently, there are more than 4000
Integrated Counselling and Testing
Centres (ICTCs) in the country, most of
these in government hospitals, which
offer PPTCT services to pregnant
women.

• 502 are located in Obstetrics and

Gynaecology Departments and in
Maternity Homes where the client load
is predominantly comprised of
pregnant women
 BLOOD SAFETY
NACO is committed to bridge the gap in
the availability and improve quality of
blood under NACP-III. To achieve these
objectives NACO plans to:

1. Raise voluntary blood donation to

90%
2. Establish blood storage centres in
Community Health Centres.

3. Expand external quality assessment

services for blood screening .

4. Quality management in blood

transfusion services.

5. Sensitise clinicians on optimum use of

blood, blood components and products.
6. Add 39 blood banks in districts that
do not have blood transfusion
facility.

7. Establish blood storage centres in

3222 community care centres .

8. Provide refrigerated vans in 500

districts for networking with blood
storage centres.
9. Establish additional model blood banks
in 22 states; 10 are functional
already.

10. Set up additional Blood Component

Separation Units (BCSU) in 80 tertiary
care hospitals and separate at least 50
percent of the collection at all BCSUs
(162) into components .

11. Promote autologous blood donation

12. Establish one additional plasma
fractionation facility in the country.

13. Establish four Centres of Excellence

in blood transfusion services in the
four metros in order to cater to any
region of the country in time of a
crisis.

14. Introduce accreditation of blood

banks
13. Liaise with Indian Red Cross Society
and Ministry of Youth Affairs and Sports
to promote voluntary blood donation
among the youth.

14. Set up 32 model blood banks in various

states .

15. Co-ordinate with the Indian Medical

Council (IMC) to mandate the
requirement of a department of
transfusion medicine in all medical
colleges & appropriate transfusion
practices in the MD/MS Curriculum
 POST EXPOSURE
PROPHYLAXIS
• Post exposure prophylaxis (PEP) refers
to comprehensive medical
management to minimise the risk of
infection among Health Care Personnel
(HCP) following potential exposure to
blood-borne pathogens (STDs).
• Prophylactic measures include,
counselling, risk assessment, relevant
laboratory investigations based on
informed consent of the source.

• follow up and support of exposed

person, first aid and depending on the
risk assessment, the provision of short
term (four weeks) of antiretroviral drugs
 PROMOTION OF CONDOM
• Under NACP-III condom promotion
continues to be an important prevention
strategy. The programme AIMS :

1. Increase condom use during sex with non-regular

partner, which is the key to limiting HIV spread
through sexual route.
2. Promote condoms distributed by social
marketing programmes.

3. Increase the distribution of free

condoms distributed through STI and
STD clinics, reaching those who are at
the highest risk of acquiring or
transmitting HIV.

4.Increase access to condoms, especially

to men who have sex with non-regular
partners.
5. Increase the number of commercial
condoms sold.

6. Increase the number of non-

traditional outlets for socially
marketed condoms, e.g., paan shops,
lodges, etc. in strategically located
hotspots of solicitation
CARE, SUPPORT & TREATMENT
• Integration of prevention with care,
support .

• Community care and support

programs.
COMMUNITY SUPPORT PROG
• Improved treatment access for
opportunistic infections and
continuation of care.

• Special focus on children affected and

infected by HIV.

• Impact mitigation and linking it with

livelihood support.
 COMMON ANTIVIRALS
DRUG DOSE
ABACAVIR 300 mg /twice daily
DIDANOSINE 600 mg /once daily
ZIDOVUDINE 250-300 mg /twice
daily
 COMMON ANTIVIRALS
DRUG DOSE
STAVUDINE 30 mg /twice daily
NEVIRAPINE 200 mg/once daily
for 14 days
followed by 200
mg/twice daily
 COMMON ANTIVIRALS
DRUG DOSE
TENOFOVIR 300 mg /once daily
ETRAVIRINE 200 mg / twice daily
LAMIVUDINE 300 mg/once daily
STRENGTHEN THE INFRASTRUCTURE,
SYSTEMS AND HUMAN RESOURCES

1. Capacity building.

2. Sustained technical training support to

public and private agencies.

3. Convergence with RCH, TB and MoHFW.

4. Coordination and partnership with

donors.
NATIONAL AIDS TELEPHONE HELPLINE

• Toll free number has been set up to

provide access to information &
counselling on HIV/AIDS related
issues.

• This is a computerized four digit

number : 1097
 ACHIEVEMENTS UNDER NACP

• Promotion of voluntary blood donation

has enabled reducing transmission of
HIV infection through contaminated
blood from about 6.07% (1999), 4.61%
(2003), 2.07% (2005), 1.96% (2006) to
1.87% (2007).
• The number of integrated counseling and
testing centres increased from 982 in 2004,
1476 in 2005, 4027 in 2006, 4567 in 2007 and
4817 in 2008.

• The number of persons tested in these

centres has increased from 17.5 lakh in 2004
to 37.9 lakhs in 2008-09 (August, 2008).
• The number of STI clinics being
supported by NACO has increased from
815 in 2005 to 895 in 2008.

• The reported number of patients

treated for STI in 2005 was 16.7 lakh, in
2006, 20.2 lakh and 25.9 lakh in 2007
• A total of 3.2 million pregnant women
accessed PPTCT services at ICTCs across
the country of which 18449 pregnant
women were diagnosed to be HIV +ve.

• Of these 11460 (62%) pregnant women

and the infants born to them received
prophylactic single dose Nevirapine.
• As of September 2008, 5,61,981
patients have been registered at ART
centers and 1,77,808 clinically eligible
patients are receiving free ART in Govt.
& inter-sectoral health facilities.
• The Targeted Intervention (TI) projects
aiming to interrupt HIV transmission is
implemented among highly vulnerable
populations.

• They include - commercial sex workers,

injecting drug users, homosexuals,
truckers and migrant workers.