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Department of AIDS Control Ministry of Health & Family Welfare Department of AIDS Control Ministry of Health & Family Welfare Annual Report 2011-12 Department of AIDS Control National AIDS Control Organisation Ministry of Health & Family Welfare Government of India www.nacoonline.org CONTENTS Acronyms v Overview ix Chapter 1 Introduction 1 Chapter 2 Current Epidemiological Situation of HIV/AIDS 4 Chapter 3 Targeted Interventions 7 Chapter 4 Link Worker Scheme 14 Chapter 5 Management of Sexually Transmitted Infections/Reproductive Tract Infections 17 Chapter 6 Information, Education & Communication and Mainstreaming 22 Chapter 7 Condom Promotion 28 Chapter 8 Blood Safety 37 Chapter 9 Laboratory Services 41 Chapter 10 Basics Services 45 Chapter 11 Care, Support & Treatment 56 Chapter 12 Strengthening of DAPCU 67 Chapter 13 Activities in North Eastern States 70 Chapter 14 Strategic Information Management 75 Chapter 15 Capacity Building 87 Chapter 16 Results Framework Document 90 Chapter 17 Administration 91 Chapter 18 Procurement 93 Chapter 19 Financial Management 94 Chapter 20 Way forward - NACP IV 97 Annexures 100 ACRONYMS AEP Adolescence Education Programme AIDS Acquired Immuno-Defi ciency Syndrome ANC Antenatal Clinic ANM Auxiliary Nurse Midwife ART Antiretroviral therapy ASHA Accredited Social Health Activist BCC Behaviour Change Communication BCSU Blood Component Separation Units BFPNI Breast Feeding Promotion Network of India BMGF Bill & Melinda Gates Foundation BSC Blood Storage Centre BSS Behaviour Surveillance Survey CBO Community- Based Organisation CCC Community Care Centre CD4 Cluster of Diff erentiation 4 CDC Centers for Disease Control and Prevention CHC Community Health Centre CLHIV Children Living with HIV CMIS Computerised Management Information System CoE Centre of Excellence CPFMS Computerised Project Financial Management System CPGRAMS Computerised Public Grievance Redress & Monitoring System CSMP Condom Social Marketing Programme CST Care, Support and Treatment CVM Condom Vending Machine DAPCU District AIDS Prevention & Control Unit DCGI Drugs Controller General of India DFID Department for International Development, UK DHR Department of Health Research DIC Drop In Centres DTC Delhi Transport Corporation DWCD Department of Women & Child Development EID Early Infant Diagnosis EQAS External Quality Assessment Scheme Annual Report v 2011-12 ESCM Enhanced Syndromic Case Management FC Female Condom FHI Family Health International FICTC Facility Integrated Counseling & Testing Centre FPA Forum of Parliamentarians on HIV & AIDS FRU First Referral Unit FSW Female Sex Worker GFATM Global Fund for AIDS, Tuberculosis and Malaria GIPA Greater Involvement of People with HIV/AIDS GIS Geographic Information System HIV/TB Human Immunodefi ciency Virus/ Tuberculosis HMIS Health Management Information System HRG High Risk Group HSS HIV Sentinel Surveillance IAP Indian Academy of Pediatrics IAVI International AIDS Vaccine Initiative IBBS Integrated Biological and Behavioural Surveillance ICF Intensifi ed TB Case Finding ICMR Indian Council of Medical Research ICRW International Centre for Research on Women ICTC Integrated Counseling and Testing Centre IDU Injecting Drug User IEC Information, Education and Communication IHBAS Institute of Human Behaviour & Allied Sciences IL&FS Infrastructure Leasing & Financial Services Limited INC Indian Nursing Council IRDA Insurance Regulatory Development Authority JAT Joint Appraisal Team KHPT Karnataka Health Promotion Trust LAC Link ART Centre LFU Lost to Follow-up cases LWS Link Worker Scheme M & E Monitoring & Evaluation MARP Most at Risk Population MCD Municipal Corporation of Delhi MoHFW Ministry of Health and Family Welfare vi Annual Report 2011-12 MoU Memorandum of Understanding MSM Men who have Sex with Men NABH National Accreditation Board of Hospitals & Healthcare Providers NABL National Accreditation Board for Laboratories NACO National AIDS Control Organisation NACP National AIDS Control Programme NARI National AIDS Research Institute NBTA National Blood Transfusion Authority NDMC New Delhi Municipal Corporation NEQAS National External Quality Assessment Scheme NERO North Eastern Regional Offi ce NGO Non-Government Organisation NRHM National Rural Health Mission NRL National Referral Centre NTSU National Technical Support Unit NYKS Nehru Yuva Kendra Sangathan OI Opportunistic Infections ORT Oral Substitution Therapy OST Opioid Substitution Therapy PEP Post-Exposure Prophylaxis PHC Primary Health Centre PLHIV People Living with HIV PPP Public Private Partnership PPTCT Prevention of Parent to Child Transmission PRI Panchayati Raj Institution RBTC Regional Blood Transfusion Centre RCH Reproductive Child Health RFD Result Framework Document RI Regional Institute RNTCP Revised National Tuberculosis Control Programme RRC Red Ribbon Club RRE Red Ribbon Express RSBY Rashtriya Swasthya Bima Yojna RTI Reproductive Tract Infection SAARC South Asian Association for Regional Cooperation SACS State AIDS Control Society Annual Report vii 2011-12 SBTC State Blood Transfusion Council SIMS Strategic Information Management System SIMU Strategic Information Management Unit SMO Social Marketing Organisation SRL State Reference Laboratory STD Sexually Transmitted Disease STI Sexually Transmitted Infection STRC State Training & Resource Centre TAC Technical Advisory Committee TB Tuberculosis TG Transgender THP Truckers’ Halting Point TI Targeted Interventions TRG Technical Resource Group TSG Technical Support Group TSU Technical Support Unit UN United Nations UNDP United Nations Development Programme UNICEF United Nations Children’s Fund USAID United States Agency for International Development UT Union Territory VBD Voluntary Blood Donation VCTC Voluntary Counseling and Testing Centre WG Working Group WHO World Health Organisation viii Annual Report 2011-12 OVERVIEW he fi rst National AIDS Control Programme (NACP) was launched in 1992 for prevention and control of HIV/AIDS in India. This was followed by TNACP II in 1999 and NACP III in 2007. During diff erent phases of the programme, the focus shifted from raising HIV/AIDS awareness to behaviour change, from a national response to a more decentralised response and to increasing involvement of NGOs and networks of people living with HIV/AIDS (PLHIV). Based on the lessons from NACP I and II, the government designed and implemented NACP III. NACP Phase-III (2007-2012) has the overall goal of halting and reversing the epidemic in India. This phase has, therefore, placed the highest priority on preventive eff orts by integrating prevention with care, support and treatment through a four-pronged strategy: 1. Preventing new infections in high risk groups and general popula- tion through saturation of coverage of high risk groups with targeted interventions and scaled up interventions in the general population, 2. Providing greater care, support and treatment to larger number of PLHIV, 3. Strengthening the infrastructure, systems and human resources in prevention, care, support and treatment programmes at the district, state and national levels, and 4. Strengthening the nationwide Strategic Information Management System. The HIV surveillance highlights an overall reduction in adult HIV prevalence. The analysis of epidemic projections has revealed that the estimated annual HIV incidence (new infections) has declined by about 56 percent over the last decade (2000-2009). Wider access to ART has resulted in decline of the number of people dying due to AIDS-related causes. This is one of the most important evidences of the impact of various interventions and scaled-up prevention strategies under the National AIDS Control Programme (NACP). While declining HIV trends are evident at national level as well as in most of the States, some low prevalence and vulnerable states have shown rising trends in HIV epidemic, warranting focused prevention eff orts in these States. HIV prevalence is showing declining trends among Female Sex Workers both at national level and in most of the states. However, other High Risk Groups such as ‘Men who have Sex with Men’ , ‘Injecting Drug Users’ and Bridge Population such as ‘Single Male Migrants’ are emerging as important risk groups in many states. Annual Report ix 2011-12 Key Achievements during 2011-12 Management of Sexually Transmitted nfections: The Sexually Transmitted Infections (STI)/ Targeted Interventions for High Risk Behaviour Reproductive Tract Infection (RTI) services based Group: Targeted Interventions main objective is on the Syndromic Case Management are being to improve health seeking behavior of high risk provided through 1,112 designated STI/RTI clinics, behavior groups and reducing their vulnerability including 79 new clinics established during 2011- and risk to acquire STIs and HIV infections. TI provides 12. Around 3,942 private preferred providers were services such as behaviour change communication, identifi ed for providing STI services to high risk condom promotion and safe needle and syringe for behaviour groups. Overall, 74.57 lakh STI episodes people who inject drugs, STI care, referrals for HIV were treated during 2011-12 (till December 2011). and Syphilis testing and Anti-Retroviral Treatment. Seven regional STI training, reference and research Targeted Interventions are implemented through centres have been strengthened. NACO has non-government organisations and community- branded the STI/RTI service centres as “Suraksha based organizations. Currently, there are 1,785 TIs Clinics” and has developed a communication providing prevention services covering 81
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