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National AIDS Control Programme

National AIDS Control Programme. National AIDS Control Programme (NACP). National AIDS Control Programme (NACP) launched under Ministry of Health & Family Welfare in 1992 NACP I (1992 – 1999) NACP II (1999 – 2006) NACP III (2007 – 2012). NACP I & II. NACP I (1992 – 1999)

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National AIDS Control Programme

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  1. National AIDS Control Programme

  2. National AIDS Control Programme (NACP) • National AIDS Control Programme (NACP) launched under Ministry of Health & Family Welfare in 1992 • NACP I (1992 – 1999) • NACP II (1999 – 2006) • NACP III (2007 – 2012)

  3. NACP I & II • NACP I (1992 – 1999) • Understanding the trends of HIV infection • Establishing blood banks – provide safe blood transfusion • Raising awareness in the general community • NACP II (1999 – 2006) • Establishing Targeted Interventions • Increasing sentinel surveillance • Raising awareness on HIV • Conducting behavioural surveillance surveys

  4. NACP III (2007–2012) • Goal: To halt and reverse HIV epidemic in India over five years • Objectives • Preventing new infections • Care, support and treatment • Strengthening capacities • Building strategic information management systems Contd…

  5. NACP III (2007–2012) • Continued emphasis on prevention • Significant scaling-up of activities (increased targets) • TIs with greater focused approach (sex workers, IDU and MSM interventions) • Empowering and capacity building to manage TIs Contd…

  6. Care, Support & Treatment Prevention Capacity Building Strategic Information Management High risk populations Low risk populations Care & support Monitoring and Evaluation Institutional Strengthening • Blood safety • Integrated Counselling and Testing including PPTCT • STI care • IEC and social mobilisation • Mainstreaming • Targeted Interventions • STI care • Condom promotion • NSEP • Enabling environment • ART • HIV-TB co-ordination • Treatment of opportunistic infections • Community care centres • Post-Exposure Prophylaxis • HIV Sentinel Surveillance • Behavioural Surveillance • Monitoring and Evaluation • Operations research • DAPCU • Technical resource groups • Enhanced HR at NACO, SACS and districts • Enhanced training activities NACP III (2007–2012)

  7. TARGETED INTERVENTIONS

  8. Targeted Interventions Under NACP-III 1. More focused approach • Bridge Population • Truckers • Migrant Workers • Core Groups • FSWs • IDUs • MSM 2. Specific package of services for HRGs

  9. Components of TI Management of STIs Condom Promotion Behaviour Change Communication Needle Syringe Exchange Programmes (NSEP) HRGs Referrals & Linkages Enabling Environment Community Mobilization

  10. TARGETED INTERVENTIONS FOR IDUs

  11. Routes of HIV Transmission HIV infection in India is mostly through sexual route. Just 2 out of 100 HIV positive people are IDU. Why bother with IDU programmes when the ratio is less as compared to sexual route? NACO Annual Report 2010-11

  12. HIV Prevalence – Various Groups 9 out of 100 IDUs are infected with HIV (HIV Sentinel Surveillance, 2008-09). This is the average for the country. However, high rate of HIV (>5%) among IDUs in many sites/ cities ensures a high chance of spread of HIV from IDU to IDU as well as to the general community

  13. IDUs & HIV RISK RINGS Wives and Wives and girlfriends of girlfriends of substance users Clients clients of FSWs Female Sex Workers (FSWs) IDU IDUs HIV Husbands and boyfriends of FSWs Substance Users HIV among IDUs is not confined to IDU group alone; it spreads from IDUs to other population groups, thus generalising the HIV epidemic

  14. IDU TIs in NACP III • Estimates: 190,000 IDUs in the country • Objective: prevent transmission of HIV • Approach: harm reduction (incorporated in the National AIDS Prevention and Control Policy, 2002) • Service delivery • Targeted Interventions • Delivery by NGOs • Provision of services at doorstep of IDU • Service recipients: IDUs & sexual partners

  15. Harm Reduction Services • There would be 3 tiers of harm reduction services offered to IDUs through TI. Tier 1 & 2 would be offered by NGOs; Tier 3 would be provided through linkage/referral Direct service delivery Linkage services Tier 1 Tier 2 Tier 3 • NSEP • Outreach and counselling • Condoms • Basic STI services • Advocacy Oral Linkages Substitution Therapy Services (OST)

  16. Tier 1: Outreach Activity • Delivered through ORW and PE • Services • Needle Syringe Exchange Programmes (NSEP) • Condoms - free distribution & social marketing • Primary health care, STI and abscess management • Behaviour Change Communication (BCC) • Advocacy

  17. Tier 2: Opioid Substitution Treatment • Delivery by NACO accredited agencies • Substitution agents: Buprenorphine, Methadone • Initiated by a trained physician and administered by trained personnel • Psychosocial services • Follow-up by PM and ORW/PE • Provision/link to Tier 1 Services • Strict record maintenance

  18. Tier 3: Linkage Services • Linkages • ICTC (voluntary informed consent) • ART, DOTS, RCH • Accompanied referrals by ORW/ PE • Established referral networks with medical, legal and welfare schemes • Linkage with detoxification and rehabilitation centres

  19. Enabling Environment ‘To create a milieu where IDUs are able to access services freely without interference’ Advocacy with • Law enforcement agencies • Community leaders • Health workers • General population

  20. Thank you!

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