20_Part-B NACO

62 Pages·2012·2.12 MB·English

Part-B
National
AIDS
Control
Organization
Part - B
NATIONAL AIDS CONTROL ORGANIZATION
1. INTRODUCTION treatment, expanding IEC services for general
population and high risk groups with a focus on
In order to control the spread of HIV/AIDS, the
behaviour change and demand generation, building
Government of India is implementing the National
capacities at national, state and district levels and
AIDS Control Programme (NACP) as a 100%
strengthening the Strategic Information
Centrally Sponsored Scheme (CSS). The first
Management System.
National AIDS Control Programme was launched
in 1992, followed by NACP-II in 1999. Phase III of The objectives of NACP-IV are to reduce new
National AIDS Control Programme, NACP-III infections and provide comprehensive care and
(2007-2012) launched in July 2007, had the goal to support to all People Living with HIV (PLHIV) and
treatment services for all those who require it. The
halt and reverse the epidemic in the country by
five cross-cutting themes that are being focused
scaling up prevention efforts among High Risk
under NACP-IV are quality, innovation,
Groups (HRG) and general population and
integration, leveraging partnerships and stigma and
integrating them with Care, Support & Treatment
discrimination.
services.
The package of services provided under NACP-IV
Prevention and Care, Support & Treatment form the
includes:
two key pillars of all HIV/AIDS control efforts in
Prevention Services:
India. The programme succeeded in reducing the
estimated number of annual new HIV infections in ● Targeted Interventions (TI) for High Risk
adults by 57% during the last decade through scaled Groups and Bridge Population (Female Sex
up prevention activities. Wider access to ART has Workers (FSW), Men who have Sex with Men
(MSM), Transgenders/Hijras, Injecting Drug
resulted in a decline of the estimated number of
Users (IDU), Truckers & Migrants;
people dying due to AIDS related causes.
● Needle-Syringe Exchange Programme (NSEP)
Consolidating the gains made during NACP-III, the
and Opioid Substitution Therapy (OST) for
National AIDS Control Programme Phase-IV
IDUs;
(2012-17) was launched to accelerate the process
● Prevention Interventions for Migrant population
of reversal and to further strengthen the epidemic
at source, transit and destinations;
response in India through a cautious and well
defined integration process over the period 2012- ● Link Worker Scheme (LWS) for High Risk
Groups and vulnerable population in rural areas;
2017 with key strategies of intensifying and
consolidating prevention services with a focus on ● Prevention & Control of Sexually Transmitted
HRG and vulnerable population, increasing access Infections/Reproductive Tract Infections
and promoting comprehensive care, support and (STI/RTI);
Annual Report 2014-15 403
Part - B
NATIONAL AIDS CONTROL ORGANIZATION
1. INTRODUCTION treatment, expanding IEC services for general
population and high risk groups with a focus on
In order to control the spread of HIV/AIDS, the
behaviour change and demand generation, building
Government of India is implementing the National
capacities at national, state and district levels and
AIDS Control Programme (NACP) as a 100%
strengthening the Strategic Information
Centrally Sponsored Scheme (CSS). The first
Management System.
National AIDS Control Programme was launched
in 1992, followed by NACP-II in 1999. Phase III of The objectives of NACP-IV are to reduce new
National AIDS Control Programme, NACP-III infections and provide comprehensive care and
(2007-2012) launched in July 2007, had the goal to support to all People Living with HIV (PLHIV) and
treatment services for all those who require it. The
halt and reverse the epidemic in the country by
five cross-cutting themes that are being focused
scaling up prevention efforts among High Risk
under NACP-IV are quality, innovation,
Groups (HRG) and general population and
integration, leveraging partnerships and stigma and
integrating them with Care, Support & Treatment
discrimination.
services.
The package of services provided under NACP-IV
Prevention and Care, Support & Treatment form the
includes:
two key pillars of all HIV/AIDS control efforts in
Prevention Services:
India. The programme succeeded in reducing the
estimated number of annual new HIV infections in ● Targeted Interventions (TI) for High Risk
adults by 57% during the last decade through scaled Groups and Bridge Population (Female Sex
up prevention activities. Wider access to ART has Workers (FSW), Men who have Sex with Men
(MSM), Transgenders/Hijras, Injecting Drug
resulted in a decline of the estimated number of
Users (IDU), Truckers & Migrants;
people dying due to AIDS related causes.
● Needle-Syringe Exchange Programme (NSEP)
Consolidating the gains made during NACP-III, the
and Opioid Substitution Therapy (OST) for
National AIDS Control Programme Phase-IV
IDUs;
(2012-17) was launched to accelerate the process
● Prevention Interventions for Migrant population
of reversal and to further strengthen the epidemic
at source, transit and destinations;
response in India through a cautious and well
defined integration process over the period 2012- ● Link Worker Scheme (LWS) for High Risk
Groups and vulnerable population in rural areas;
2017 with key strategies of intensifying and
consolidating prevention services with a focus on ● Prevention & Control of Sexually Transmitted
HRG and vulnerable population, increasing access Infections/Reproductive Tract Infections
and promoting comprehensive care, support and (STI/RTI);
Annual Report 2014-15 403
● Blood Transfusion Services; a proxy for prevalence among the general Uttar Pradesh and Bihar. Prevention strategies for declined from around 0.30% in 2001 to 0.11% in
population, continues to be low at 0.35% in the IDU in the newer areas have been initiated recently 2011.
● HIV Counselling & Testing Services;
country, with an overall declining trend at the and have been prioritised for further scale-up during
The total number of people living with HIV/AIDS
● Prevention of Parent to Child Transmission;
national level. the coming years.
in India was estimated at around 20.9 lakh in 2011,
● Condom promotion;
The highest prevalence was recorded in Nagaland Analysis of drivers of the emerging epidemic in 86% of whom were in 15-49 years age-group.
● Information, Education & Communication (0.88%), followed by Mizoram (0.68%), Manipur some low prevalence States points towards the Children less than 15 years of age accounted for 7%
(IEC) and Behaviour Change Communication (0.64%), Andhra Pradesh (0.59%) and Karnataka possible role of out-migration from these States to (1.45 lakh) of all infections in 2011. Of all HIV
(BCC) – Mass Media Campaigns through Radio (0.53%). Also, States like Chhattisgarh (0.51%), high prevalence destinations. Low levels of HIV infections, 39% (8.16 lakh) were among women.
& TV, Mid-media campaigns through Folk
Gujarat (0.50%), Maharashtra (0.40%), Delhi among high risk groups in these out-migrant The estimated number of PLHIV in India has
Media, display panels, banners, wall writings
(0.40%) and Punjab (0.37%) recorded HIV districts, large volume of out-migration from rural maintained a steady declining trend from 23.2 lakh
etc., Special campaigns through music and
prevalence of more than the national average. areas to high prevalence urban areas, higher HIV in 2006 to 20.9 lakh in 2011.
sports, Flagship programmes, such as Red
prevalence among ANC attendees in rural than
Ribbon Express; Fig 2.1: National HIV Prevalence (%) for ANC attendees 3. TARGETED INTERVENTIONS (TI)
(2012-13) and key risk groups (2010-11) urban population and higher prevalence among
● Social Mobilization, Youth Interventions and
pregnant women with migrant spouses, noted in As strategized in NACP IV, Prevention will continue
ANC (2012-13) 0.35
Adolescence Education Programme;
Migrants (2010-11) 0.99 these States support this observation. Evidences to be the core strategy as more than 99% of the
● Mainstreaming HIV/AIDS response and Truckers (2010-11) 2.59 about vulnerabilities among migrants highlighted people are HIV negative. The epidemic continues to
FSW (2010-11) 2.67
by other behavioural studies and migrant-corridor
be concentrated in subgroups of population that are
● Work Place Interventions. MSM (2010-11) 4.43
studies further corroborate this possibility. In
IDU (2010-11) 7.14 likely to engage in high-risk behaviour, making
Care, Support & Treatment Services: TG (2010-11) 8.82 addition, long distance truckers also show high
them vulnerable to HIV infection. Such groups are
levels of vulnerability and thus form an important
0.00 2.00 4.00 6.00 8.00 10.00
● Laboratory services for CD4 Testing, Viral Load referred to as HRGs or high risk behavior groups. In
HIV Prevalence (%) part of bridge population.
testing, Early Infant Diagnosis of HIV in infants India, Female Sex Workers (FSW), Men who have
and children up to 18 months age and Considerable decline in HIV prevalence has been The last round of HIV Estimations was conducted in Sex with Men (MSM), Transgender (TG)/Hijras and
confirmatory diagnosis of HIV-2; recorded among Female Sex Workers at national
the country in 2012. The next round of HIV
Injecting Drug Users (IDU) have been identified as
level (5.06% in 2007 to 2.67% in 2011) and in most
● Free First line & second line Anti-Retroviral Estimations is planned to be conducted during 2015
the core HRGs. Further, it has been observed that
of the States where long standing targeted
Treatment (ART) through ART centres and Link to estimate the levels and trends of HIV prevalence,
interventions have focused on behaviour change and two other population groups play a key role in the
ART Centres, Centres of Excellence & ART plus incidence and burden at the National and State levels
increasing condom use. Declines have been spread of HIV infection from HRGs to the general
centres; after availability of data on HIV prevalence from the
achieved among Men who have Sex with Men population. These populations, due to the nature of
ongoing National Integrated Biological and
● Pediatric ART for children; (7.41% in 2007 to 4.43% in 2011) also, though
their work and mobility, are more likely to come in
Behavioural Surveillance for High Risk Groups.
several pockets in the country have shown higher
● Early Infant Diagnosis for HIV exposed infants contact with HRGs and constitute a major
HIV prevalence among them with mixed trends.
and children below 18 months; According to HIV Estimations 2012, the adult (15-
proportion of the clients of sex workers. These risk
49 years) HIV prevalence at national level
● Nutritional and Psycho-social support through In some of the North Eastern States, Injecting Drug groups include long distance truckers and migrant
continued its steady decline from the estimated
Use (IDU) has been identified to be the major
Community and Support Centres; workers and are commonly referred to as bridge
level of 0.41% in 2001 to 0.27% in 2011. Declining
vulnerability fuelling the epidemic. Stable trends
populations owing to their perceived role in passing
● HIV-TB Coordination (Cross-referral, detection trends in adult HIV prevalence were sustained in all
have been recorded among Injecting Drug Users at
the HIV infection from the core groups to general
and treatment of co-infections) and the erstwhile high prevalence States. However,
national level (7.23% in 2007 to 7.14% in 2011).
population. During the NACP IV, it is planned that
some States like Assam, Delhi, Chandigarh,
● Treatment of Opportunistic Infections. Besides North Eastern States where declines have
Chhattisgarh, Jharkhand, Odisha, Punjab and 90% of HRGs will be covered through Targeted
been achieved, newer pockets of high HIV
2. OVERVIEW OF HIV EPIDEMIC IN INDIA Uttarakhand showed rising trends in adult HIV Interventions (TI) implemented by Non-
prevalence among IDU have emerged over the past
prevalence. At national level HIV prevalence Governmental Organisation (NGOs) and
According to HSS 2012-2013, the overall HIV few years in the States of Punjab, Chandigarh,
among the young (15-24 years) population also Community Based Organisation (CBOs).
prevalence among ANC clinic attendees, considered Delhi, Mumbai, Kerala, Odisha, Madhya Pradesh,
404 Annual Report 2014-15 Annual Report 2014-15 405
● Blood Transfusion Services; a proxy for prevalence among the general Uttar Pradesh and Bihar. Prevention strategies for declined from around 0.30% in 2001 to 0.11% in
population, continues to be low at 0.35% in the IDU in the newer areas have been initiated recently 2011.
● HIV Counselling & Testing Services;
country, with an overall declining trend at the and have been prioritised for further scale-up during
The total number of people living with HIV/AIDS
● Prevention of Parent to Child Transmission;
national level. the coming years.
in India was estimated at around 20.9 lakh in 2011,
● Condom promotion;
The highest prevalence was recorded in Nagaland Analysis of drivers of the emerging epidemic in 86% of whom were in 15-49 years age-group.
● Information, Education & Communication (0.88%), followed by Mizoram (0.68%), Manipur some low prevalence States points towards the Children less than 15 years of age accounted for 7%
(IEC) and Behaviour Change Communication (0.64%), Andhra Pradesh (0.59%) and Karnataka possible role of out-migration from these States to (1.45 lakh) of all infections in 2011. Of all HIV
(BCC) – Mass Media Campaigns through Radio (0.53%). Also, States like Chhattisgarh (0.51%), high prevalence destinations. Low levels of HIV infections, 39% (8.16 lakh) were among women.
& TV, Mid-media campaigns through Folk
Gujarat (0.50%), Maharashtra (0.40%), Delhi among high risk groups in these out-migrant The estimated number of PLHIV in India has
Media, display panels, banners, wall writings
(0.40%) and Punjab (0.37%) recorded HIV districts, large volume of out-migration from rural maintained a steady declining trend from 23.2 lakh
etc., Special campaigns through music and
prevalence of more than the national average. areas to high prevalence urban areas, higher HIV in 2006 to 20.9 lakh in 2011.
sports, Flagship programmes, such as Red
prevalence among ANC attendees in rural than
Ribbon Express; Fig 2.1: National HIV Prevalence (%) for ANC attendees 3. TARGETED INTERVENTIONS (TI)
(2012-13) and key risk groups (2010-11) urban population and higher prevalence among
● Social Mobilization, Youth Interventions and
pregnant women with migrant spouses, noted in As strategized in NACP IV, Prevention will continue
ANC (2012-13) 0.35
Adolescence Education Programme;
Migrants (2010-11) 0.99 these States support this observation. Evidences to be the core strategy as more than 99% of the
● Mainstreaming HIV/AIDS response and Truckers (2010-11) 2.59 about vulnerabilities among migrants highlighted people are HIV negative. The epidemic continues to
FSW (2010-11) 2.67
by other behavioural studies and migrant-corridor
be concentrated in subgroups of population that are
● Work Place Interventions. MSM (2010-11) 4.43
studies further corroborate this possibility. In
IDU (2010-11) 7.14 likely to engage in high-risk behaviour, making
Care, Support & Treatment Services: TG (2010-11) 8.82 addition, long distance truckers also show high
them vulnerable to HIV infection. Such groups are
levels of vulnerability and thus form an important
0.00 2.00 4.00 6.00 8.00 10.00
● Laboratory services for CD4 Testing, Viral Load referred to as HRGs or high risk behavior groups. In
HIV Prevalence (%) part of bridge population.
testing, Early Infant Diagnosis of HIV in infants India, Female Sex Workers (FSW), Men who have
and children up to 18 months age and Considerable decline in HIV prevalence has been The last round of HIV Estimations was conducted in Sex with Men (MSM), Transgender (TG)/Hijras and
confirmatory diagnosis of HIV-2; recorded among Female Sex Workers at national
the country in 2012. The next round of HIV
Injecting Drug Users (IDU) have been identified as
level (5.06% in 2007 to 2.67% in 2011) and in most
● Free First line & second line Anti-Retroviral Estimations is planned to be conducted during 2015
the core HRGs. Further, it has been observed that
of the States where long standing targeted
Treatment (ART) through ART centres and Link to estimate the levels and trends of HIV prevalence,
interventions have focused on behaviour change and two other population groups play a key role in the
ART Centres, Centres of Excellence & ART plus incidence and burden at the National and State levels
increasing condom use. Declines have been spread of HIV infection from HRGs to the general
centres; after availability of data on HIV prevalence from the
achieved among Men who have Sex with Men population. These populations, due to the nature of
ongoing National Integrated Biological and
● Pediatric ART for children; (7.41% in 2007 to 4.43% in 2011) also, though
their work and mobility, are more likely to come in
Behavioural Surveillance for High Risk Groups.
several pockets in the country have shown higher
● Early Infant Diagnosis for HIV exposed infants contact with HRGs and constitute a major
HIV prevalence among them with mixed trends.
and children below 18 months; According to HIV Estimations 2012, the adult (15-
proportion of the clients of sex workers. These risk
49 years) HIV prevalence at national level
● Nutritional and Psycho-social support through In some of the North Eastern States, Injecting Drug groups include long distance truckers and migrant
continued its steady decline from the estimated
Use (IDU) has been identified to be the major
Community and Support Centres; workers and are commonly referred to as bridge
level of 0.41% in 2001 to 0.27% in 2011. Declining
vulnerability fuelling the epidemic. Stable trends
populations owing to their perceived role in passing
● HIV-TB Coordination (Cross-referral, detection trends in adult HIV prevalence were sustained in all
have been recorded among Injecting Drug Users at
the HIV infection from the core groups to general
and treatment of co-infections) and the erstwhile high prevalence States. However,
national level (7.23% in 2007 to 7.14% in 2011).
population. During the NACP IV, it is planned that
some States like Assam, Delhi, Chandigarh,
● Treatment of Opportunistic Infections. Besides North Eastern States where declines have
Chhattisgarh, Jharkhand, Odisha, Punjab and 90% of HRGs will be covered through Targeted
been achieved, newer pockets of high HIV
2. OVERVIEW OF HIV EPIDEMIC IN INDIA Uttarakhand showed rising trends in adult HIV Interventions (TI) implemented by Non-
prevalence among IDU have emerged over the past
prevalence. At national level HIV prevalence Governmental Organisation (NGOs) and
According to HSS 2012-2013, the overall HIV few years in the States of Punjab, Chandigarh,
among the young (15-24 years) population also Community Based Organisation (CBOs).
prevalence among ANC clinic attendees, considered Delhi, Mumbai, Kerala, Odisha, Madhya Pradesh,
404 Annual Report 2014-15 Annual Report 2014-15 405
Targeted Intervention Projects: Targeted (STRCs) to conduct capacity building activities for
Fig 3.2: STI Clinic visits during 2014-15 (upto Sept, 2014)
Interventions are preventive interventions working the TI programme. In August 2014, 12 agencies 90
with high risk groups in a defined geographic area. were contracted as STRCs for 21 states. The
77.4
80 76.02
NGOs/CBOs implementing the TI projects report to
Key characteristics of Targeted Intervention
SACS on standard monthly reporting formats 69.01
Projects include: Peer-led approach - People from 70 66.75
developed by NACO which form a part of the
the high risk community are engaged to deliver
national Monitoring & Evaluation framework. 60 57.05
services and act as agents of change, targeting high-
risk behaviours and practices and not Performance of TI Programme during 2014-15 50
43.34
identities/individual choices, linking with services (upto Sept, 2014)
40
and commodities provision, dissociating risk from
Coverage of Core HRG: The key performance of
behaviours e.g. risk of STI and HIV infection from
30
TIs with respect to the coverage of core HRGs
sex work, involving communities and their issues
during 2014-15 is depicted in Figure 3.1. This data
within the broader framework of interventions, 20
based on reports received at NACO, shows that
adapting to the cultural and social milieu of the 8.53
FSW coverage compared to the estimates, has 10 7.11
target audience. TI projects provide a package of 2.8 1.95 2.1 1.92
already crossed 80%.
prevention, support and linkage services to HRGs 0
through an outreach-based service delivery model. FSW MSM TG IDU Migrants Truckers
Fig 3.1: Coverage of Core HRGs (FSW, MSM, IDU)
Which includes, Screening for and treatment of % Clinic Visits % STI/RTI Trated
during 2014-15 (upto Sept, 2014)
wClmSueoibatxmhrruik cmaeacltlunoyintmn Tigcdmr aiasutnitonorsfiinmb ty,u icC tttoiireonnednvad Iotoianlnmmvfgeeo scma,tnn iego en Bnntcs eao, habrFnealri dvneg eigor p Coeuanuorrvpt niiscdrC,io ophnSmaamot niacoenignnadetl, HRG Estimates & Coverage 1864200 8.68 80.168.96 3.572.6484.35 02.57.710.18 1.771.7342.58 64028100.0000....000000.000000% Coverage of HRG Esttimates dbNHeeAIp tVeiCcs Otttsee dgstht ufieiond rnge Hu liamInnVebds eo srnAp oceRefc TiHefv yIelV tirhny atk esta siaxtgls lem cpso oearrnefmto hHrosmR.n FeGgid gsH aushmRreoGo u3nl.s3dg: 1HpH5rIRo.V jGIen pcs at otslshl. i grtToirvhouieugty phg s rrr,aae HtpfeeIh rVf roda prel osep saificcrtothisvm tiHyt ytpIa Vroregl moetegtaesyitdn id nsiu gnlro tiedwnrogv.n e2en0 ta1ino4dn-
Linkages to Integrated Counselling and Testing FSM MSM TG IDU Fig 3.3: HRGs tested for HIV at ICTCs during 2014-15 (upto, Sept, 2014)
Estimates Current Coverage %coverage of estimates
Centres for HIV testing, Linkages with care and 80
69.93 70.96
66.81
support services for HIV positive HRGs,
70
Management of STI/RTI: Clinical services
Community mobilization and ownership building,
including regular medical check-up is one of the 60 52.92
Specific Interventions for IDUs, Distribution of
core components of TI project services. NACO’s
clean needles and syringes, Abscess prevention and 50
guideline suggests that HRGs from core group,
management, Opioid Substitution Therapy, Linkage 40
especially MSM and FSW, should visit STI clinics
with detoxification/rehabilitation services.
every quarter, i.e., four times in a year, for regular 30
These projects are contracted, funded and medical checkups and for treatment of Sexually 14.93
20
8.68
monitored by the State AIDS Control Societies Transmitted Infection (STI)/Reproductive Tract
10
(SACS). Technical Support Units (TSUs) have been Infection (RTI). Figure 3.2 depicts the number of 0.19 0.28 1.11 0.83 0.29 0.5
engaged to provide technical assistance to SACS in clinic visits made by HRGs during 2014-2015 (up 0
FSW MSM TG IDU Migrants Truckers
mentoring and ensuring quality of TI projects. to, Sept, 2014). Figure 3.2 also shows the proportion
Currently there are 17 TSUs along with North of STI clinic attendees diagnosed and treated for % ICTC Trsting % Positivity Rate

Eastern Regional Office (NERO) which serves as STI/RTI during 2014-2015 through TIs. In all the Condom distribution among HRGs: As per NACP distributed to HRGs as per their requirement. Fig. 3.4
the TSU for the North East. In addition, various risk groups except bridge population (migrant and strategy, all sexual encounters of HRGs should be shows the typology-wise number of condoms (free
organisations/institutions of repute have been truckers), the number of STI/RTI episodes has protected by consistent and correct usage of condoms. and social marketing) distributed to the HRGs during
engaged as State Training and Resource Centres remained low. To ensure this, it is imperative that condoms are 2014-15 (upto Sept, 2014).
406 Annual Report 2014-15 Annual Report 2014-15 407
Targeted Intervention Projects: Targeted (STRCs) to conduct capacity building activities for
Fig 3.2: STI Clinic visits during 2014-15 (upto Sept, 2014)
Interventions are preventive interventions working the TI programme. In August 2014, 12 agencies 90
with high risk groups in a defined geographic area. were contracted as STRCs for 21 states. The
77.4
80 76.02
NGOs/CBOs implementing the TI projects report to
Key characteristics of Targeted Intervention
SACS on standard monthly reporting formats 69.01
Projects include: Peer-led approach - People from 70 66.75
developed by NACO which form a part of the
the high risk community are engaged to deliver
national Monitoring & Evaluation framework. 60 57.05
services and act as agents of change, targeting high-
risk behaviours and practices and not Performance of TI Programme during 2014-15 50
43.34
identities/individual choices, linking with services (upto Sept, 2014)
40
and commodities provision, dissociating risk from
Coverage of Core HRG: The key performance of
behaviours e.g. risk of STI and HIV infection from
30
TIs with respect to the coverage of core HRGs
sex work, involving communities and their issues
during 2014-15 is depicted in Figure 3.1. This data
within the broader framework of interventions, 20
based on reports received at NACO, shows that
adapting to the cultural and social milieu of the 8.53
FSW coverage compared to the estimates, has 10 7.11
target audience. TI projects provide a package of 2.8 1.95 2.1 1.92
already crossed 80%.
prevention, support and linkage services to HRGs 0
through an outreach-based service delivery model. FSW MSM TG IDU Migrants Truckers
Fig 3.1: Coverage of Core HRGs (FSW, MSM, IDU)
Which includes, Screening for and treatment of % Clinic Visits % STI/RTI Trated
during 2014-15 (upto Sept, 2014)
wCmlSueoibatxmhrruik cmaeacltulnoyintmn iTgcdmr aiasutnitonorsfiinmb ty,u icC tttoiireonnednvad Iotoianlnmmvfgeeo scma,tnn iego en Bnntcs eao, habrFnealri dvneg eigor p Coeuanuorrvpt niiscdrC,io ophnSmaamot niacoenignnadetl, HRG Estimates & Coverage 1864200 8.68 80.168.96 3.572.6484.35 02.57.710.18 1.771.7342.58 64028100.0000....000000.000000% Coverage of HRG Esttimates dbNHeeAIp tVeiCcs Otttsee dgstht ufieiond rnge Hu liamInnVebds eo srnAp oceRefc TiHefv yIelV tirhny atk esta siaxtgls lem cpso oearrnefmto hHrosmR.n FeGgid gsH aushmRreoGo u3nl.s3dg: 1HpH5rIRo.V jGIen pcs at otslshl. i grtToirvhouieugty phg s rrr,aae HtpfeeIh rVf roda prel osep saificcrtothisvm tiHyt ytpIa Vroregl moetegtaesyitdn id nsiu gnlro tiedwnrogv.n e2en0 ta1ino4dn-
Linkages to Integrated Counselling and Testing FSM MSM TG IDU Fig 3.3: HRGs tested for HIV at ICTCs during 2014-15 (upto, Sept, 2014)
Estimates Current Coverage %coverage of estimates
Centres for HIV testing, Linkages with care and 80
69.93 70.96
66.81
support services for HIV positive HRGs,
70
Management of STI/RTI: Clinical services
Community mobilization and ownership building,
including regular medical check-up is one of the 60 52.92
Specific Interventions for IDUs, Distribution of
core components of TI project services. NACO’s
clean needles and syringes, Abscess prevention and 50
guideline suggests that HRGs from core group,
management, Opioid Substitution Therapy, Linkage 40
especially MSM and FSW, should visit STI clinics
with detoxification/rehabilitation services.
every quarter, i.e., four times in a year, for regular 30
These projects are contracted, funded and medical checkups and for treatment of Sexually 14.93
20
8.68
monitored by the State AIDS Control Societies Transmitted Infection (STI)/Reproductive Tract
10
(SACS). Technical Support Units (TSUs) have been Infection (RTI). Figure 3.2 depicts the number of 0.19 0.28 1.11 0.83 0.29 0.5
engaged to provide technical assistance to SACS in clinic visits made by HRGs during 2014-2015 (up 0
FSW MSM TG IDU Migrants Truckers
mentoring and ensuring quality of TI projects. to, Sept, 2014). Figure 3.2 also shows the proportion
Currently there are 17 TSUs along with North of STI clinic attendees diagnosed and treated for % ICTC Trsting % Positivity Rate

Eastern Regional Office (NERO) which serves as STI/RTI during 2014-2015 through TIs. In all the Condom distribution among HRGs: As per NACP distributed to HRGs as per their requirement. Fig. 3.4
the TSU for the North East. In addition, various risk groups except bridge population (migrant and strategy, all sexual encounters of HRGs should be shows the typology-wise number of condoms (free
organisations/institutions of repute have been truckers), the number of STI/RTI episodes has protected by consistent and correct usage of condoms. and social marketing) distributed to the HRGs during
engaged as State Training and Resource Centres remained low. To ensure this, it is imperative that condoms are 2014-15 (upto Sept, 2014).
406 Annual Report 2014-15 Annual Report 2014-15 407
Table 3.1 Status of Quarterly Performance Assessment of Targeted Interventions conducted in
Fig 3.4: Typology-wise Condom pieces distributed to HRGs during 2014-15 (upto, Sept., 2014)
April, 2014
1000
865.2 Name of the State Grading of Tis for Jan 2014-March 2014 (Quarter)
s) Poor Below Average Above Good Very Excellent Total
h
ak Average Average Good TIs
L
n
(i Andhra Pradesh 0 0 1 16 25 83 44 169
s
e
c 500 Chhattisgarh 0 2 0 13 19 8 1 43
e
pi
m Goa 0 0 0 0 1 4 11 16
o
nd 237.7 Karnataka 8 0 10 8 23 27 59 135
o
C Kerala 0 2 6 11 10 19 4 52
26 38.3 Maharashtra 8 11 13 22 46 53 44 197
0 Madhya Pradesh 0 17 13 14 8 11 0 63
FSW MSM TG IDU
Punjab 0 0 1 7 16 29 7 60

Rajasthan 0 0 0 0 0 0 0 0

Needle-syringe distribution patterns among IDUs: and needles to IDUs and reduces possibility of sharing
TamilNadu 0 0 0 20 25 24 9 78

As part of preventive services, Targeted Interventions injecting equipment, thus decreasing risk for HIV
Uttarakhand 0 0 1 3 4 22 3 33
for IDUs distribute free syringes and needles to transmission. Figure 3.5 depicts the number of
Injecting Drug Users through peer educators and syringes and needles distributed to IDUs and the Uttar Pradesh 1 4 3 9 9 35 23 84

IDUs are encouraged to return the used syringes and number of used syringes and needles returned by Total 17 36 48 123 186 315 205 930

needles. This ensures availability of sterile syringes them during 2014-15 (up to, Sept, 2014).
No. of TIs (in %) 2% 4% 5% 13% 20% 34% 22% 100%

Distribution of Targeted Interventions and Coverage of HRGs
Fig 3.5: Distribution and Return of Syringes and Needles, 2014-15 (upto Sept., 2014) Table 3.2 State-wise and Typology wise distribution of Targeted Interventions (TIs) supported by
NACO, 2014-15
20,000,000
17,268,760 S. Name of the No of TIs FSW MSM IDU Transgender Core Migrant Trucker
No. SACS/MACS functional Composite ( Destination)
15,000,000
1 Ahmedabad 22 3 4 1 1 0 11 2
12,563,905 11,146,475
9,045,106 (64%) 2 Andhra 158 37 5 5 0 90 17 4
10,000,000 (71%) Pradesh
3 Arunachal 23 4 1 3 0 9 6 0
Pradesh
5,000,000
4 Assam 55 31 5 6 0 8 3 2
5 Bihar 30 5 0 8 0 16 0 1
0
6 Chandigarh 13 4 2 2 0 1 3 1

Syringes distributed Syringes returned Needles Distributed Needles returned
7 Chhattisgarh 55 13 0 9 0 20 8 5

8 D & N Haveli 0 0 0 0 0 0 0 0

Performance grading of Targeted Interventions: quarterly performance assessment of TIs. A summary
9 Daman Diu 7 0 0 0 0 2 4 1
The Technical Support Units (TSUs) conduct of the assessments conducted is given in Table 3.1.
10 Delhi 96 37 14 17 8 0 16 4

408 Annual Report 2014-15 Annual Report 2014-15 409
Table 3.1 Status of Quarterly Performance Assessment of Targeted Interventions conducted in
Fig 3.4: Typology-wise Condom pieces distributed to HRGs during 2014-15 (upto, Sept., 2014)
April, 2014
1000
865.2 Name of the State Grading of Tis for Jan 2014-March 2014 (Quarter)
s) Poor Below Average Above Good Very Excellent Total
h
ak Average Average Good TIs
L
n
(i Andhra Pradesh 0 0 1 16 25 83 44 169
s
e
c 500 Chhattisgarh 0 2 0 13 19 8 1 43
e
pi
m Goa 0 0 0 0 1 4 11 16
o
nd 237.7 Karnataka 8 0 10 8 23 27 59 135
o
C Kerala 0 2 6 11 10 19 4 52
26 38.3 Maharashtra 8 11 13 22 46 53 44 197
0 Madhya Pradesh 0 17 13 14 8 11 0 63
FSW MSM TG IDU
Punjab 0 0 1 7 16 29 7 60

Rajasthan 0 0 0 0 0 0 0 0

Needle-syringe distribution patterns among IDUs: and needles to IDUs and reduces possibility of sharing
TamilNadu 0 0 0 20 25 24 9 78

As part of preventive services, Targeted Interventions injecting equipment, thus decreasing risk for HIV
Uttarakhand 0 0 1 3 4 22 3 33
for IDUs distribute free syringes and needles to transmission. Figure 3.5 depicts the number of
Injecting Drug Users through peer educators and syringes and needles distributed to IDUs and the Uttar Pradesh 1 4 3 9 9 35 23 84

IDUs are encouraged to return the used syringes and number of used syringes and needles returned by Total 17 36 48 123 186 315 205 930

needles. This ensures availability of sterile syringes them during 2014-15 (up to, Sept, 2014).
No. of TIs (in %) 2% 4% 5% 13% 20% 34% 22% 100%

Distribution of Targeted Interventions and Coverage of HRGs
Fig 3.5: Distribution and Return of Syringes and Needles, 2014-15 (upto Sept., 2014) Table 3.2 State-wise and Typology wise distribution of Targeted Interventions (TIs) supported by
NACO, 2014-15
20,000,000
17,268,760 S. Name of the No of TIs FSW MSM IDU Transgender Core Migrant Trucker
No. SACS/MACS functional Composite ( Destination)
15,000,000
1 Ahmedabad 22 3 4 1 1 0 11 2
12,563,905 11,146,475
9,045,106 (64%) 2 Andhra 158 37 5 5 0 90 17 4
10,000,000 (71%) Pradesh
3 Arunachal 23 4 1 3 0 9 6 0
Pradesh
5,000,000
4 Assam 55 31 5 6 0 8 3 2
5 Bihar 30 5 0 8 0 16 0 1
0
6 Chandigarh 13 4 2 2 0 1 3 1

Syringes distributed Syringes returned Needles Distributed Needles returned
7 Chhattisgarh 55 13 0 9 0 20 8 5

8 D & N Haveli 0 0 0 0 0 0 0 0

Performance grading of Targeted Interventions: quarterly performance assessment of TIs. A summary
9 Daman Diu 7 0 0 0 0 2 4 1
The Technical Support Units (TSUs) conduct of the assessments conducted is given in Table 3.1.
10 Delhi 96 37 14 17 8 0 16 4

408 Annual Report 2014-15 Annual Report 2014-15 409
Table 3.3 State-wise and Typology wise coverage of Key Risk under the programme, 2014-15
S. Name of the No of TIs FSW MSM IDU Transgender Core Migrant Trucker
No. SACS/MACS functional Composite (Destination) S. Name of the FSW MSM IDU TG Migrant Trucker
No. SACS/MACS (Destination)
11 Goa 18 6 3 2 0 1 4 2
1 Ahmedabad 4519 4494 380 400 165000 40000
12 Gujarat 103 13 13 2 1 33 35 6
2 Andhra Pradesh 136794 31105 1936 0 217072 70020
13 Haryana 62 11 10 15 0 6 18 2
3 Arunachal Pradesh 3367 439 1928 0 30000 0
14 Himachal 32 15 1 3 0 3 8 2 4 Assam 20679 2963 3237 0 30000 15000
Pradesh
5 Bihar 13676 2159 4279 0 0 10000

15 Jammu & 17 7 1 4 0 0 3 2 6 Chandigarh 3776 2422 1081 34 30000 10000

Kashmir 7 Chhattisgarh 16114 2542 2895 280 80000 62500

16 Jharkhand 33 22 3 3 0 1 1 3 8 D & N Haveli 0 0 0 0 0 0

17 Karnataka 135 66 31 4 2 4 21 7 9 Daman Diu 709 587 0 0 60000 10000

10 Delhi 42138 14265 10725 6095 220000 50000
18 Kerala 66 20 14 7 8 0 15 2
11 Goa 3900 2934 509 0 15000 10000
19 Madhya 84 23 5 9 0 34 7 6

12 Gujarat 28022 27677 656 881 371000 80000
Pradesh
13 Haryana 13952 8206 5319 0 180000 15000
20 Maharashtra 169 56 9 3 0 28 62 11

14 Himachal Pradesh 8853 459 790 0 94000 12516

21 Manipur 65 6 2 48 0 7 2 0
15 Jammu & Kashmir 1292 106 315 0 21000 20000

22 Meghalaya 9 3 0 4 0 1 1 0 16 Jharkhand 12744 1396 897 50 10000 45000

23 Mizoram 37 1 1 23 0 8 4 0 17 Karnataka 86386 25735 1851 1535 210000 80000

18 Kerala 25468 16001 3969 0 80835 20000
24 Mumbai (MC) 49 18 8 3 5 0 13 2

19 Madhya Pradesh 24684 8375 6225 0 82000 85000
25 Nagaland 53 2 3 30 0 16 1 1

20 Maharashtra 64087 20316 830 1325 765000 180000
26 Odisha 54 12 2 6 1 22 9 2
21 Manipur 5749 872 20126 0 15000 0
27 Puducherry 5 1 1 0 0 2 1 0
22 Meghalaya 1420 307 1383 0 10000 0

28 Punjab 69 16 0 24 0 20 5 4 23 Mizoram 892 512 9625 0 25000 0

29 Rajasthan 51 15 4 6 2 11 10 3 24 Mumbai 21329 11723 1161 4395 130000 15000

25 Nagaland 3094 1119 16206 0 5000 5000
30 Sikkim 7 3 0 4 0 0 0 0
26 Odisha 9558 4272 2113 0 92000 0
31 TamilNadu 78 13 11 1 2 41 6 4
27 Puduch erry 1812 1861 0 0 12000 0
32 Tripura 13 7 0 2 0 1 3 --
28 Punjab 19738 2549 12404 89 65000 35000

33 Uttar 100 13 4 13 2 54 6 8 29 Rajasth an 13786 3877 1693 274 100000 20000

Pradesh
30 Sikkim 861 0 1415 0 0 0

34 Uttarakhand 36 11 1 6 0 7 8 3 31 TamilN adu 43543 32754 488 584 60000 47000

35 West Bengal 36 21 0 4 1 0 4 6 32 Tripura 4124 788 490 0 15000 0

33 Uttar Pr adesh 21488 9416 13717 1639 60000 105000
INDIA 1840 515 158 277 33 446 315 96
34 Uttarakhand 6694 1836 1801 62 95000 40000
35 West Bengal 31235 0 1366 222 40000 60000
INDIA 696484 244066 131809 17867 3384907 1142036
410 Annual Report 2014-15 Annual Report 2014-15 411