C h a p t er
24 National AIDS Control
Organization (NACO)
Chapter - 24
24.1 INTRODUCTION (IDU), Truckers & Migrants; Needle-Syringe
Exchange Programme (NSEP) and Opioid
In order to control the spread of HIV/AIDS, the Substitution Therapy (OST) for IDUs; Migrant
Government of India is implementing the National population at source, transit and destinations;
AIDS Control Programme (NACP) as a 100% centrally Link Worker Scheme (LWS) for High Risk
sponsored scheme. Prevention and Care, Support Groups (HRGs) and vulnerable population in
& Treatment (CST) form the two key pillars of all rural areas; Prevention & Control of Sexually
HIV/AIDS control efforts in India. The programme Transmitted Infections/Reproductive Tract
succeeded in reducing the estimated number of annual Infections (STI/RTI); Blood Transfusion
new HIV infections in adults by 57% during the last Services; HIV Counseling & Testing Services;
decade through scaled up prevention activities. Wider Prevention of Parent to Child Transmission;
access to ART has resulted in a decline of the estimated Condom promotion; Information, Education
number of people dying due to AIDS related causes. & Communication (IEC) and Behaviour
Launched in 1992, followed by NACP-II in 1999, Change Communication (BCC) – Mass Media
NACP-III in 2007 and NACP-IV in 2012, the focus Campaigns through Radio & TV, Mid-media
of the National AIDS Control Programme is on campaigns through Folk Media, display
achieving the seventy five percent (75%) reduction in panels, banners, wall writings etc., Special
new HIV infections; 90-90-90 (90% of those who are campaigns through music and sports, Flagship
HIV positive in the country know their status and that programmes, such as Red Ribbon Express;
90% of those who know their status are on treatment Social Mobilization, Youth Interventions
and 90% of those who are on treatment experience and Adolescence Education Programme;
effective viral load suppression); elimination of Mainstreaming HIV/AIDS response; Work
mother-to-child transmission of HIV and syphilis Place Interventions.
and elimination of discrimination and stigmatization
• Care, Support & Treatment Services
of people living with HIV in the next three years and
Laboratory services for CD4 Testing, Viral
within seven years will reduce the new HIV infections
by 80% and 95% of those who are HIV positive in the Load testing, Early Infant Diagnosis of HIV in
country know their status and that 95% of those who infants and children up to 18 months age and
know their status are on treatment and 95% of those confirmatory diagnosis of HIV-2; Free First
who are on treatment experience effective viral load line & second line Anti-Retroviral Treatment
suppression. (ART) through ART centres and Link ART
Centres, Centres of Excellence & ART plus
The package of services includes two types of services centres; Paediatric ART for children; Early
i.e. Prevention services and Care Support & Treatment Infant Diagnosis for HIV exposed infants and
services. children below 18 months; Nutritional and
• Prevention services Targeted Interventions Psycho-social support through Community
(TI) for High Risk Groups and Bridge and Support Centres; HIV-TB Coordination
Population (Female Sex Workers (FSW), (Cross-referral, detection and treatment of co-
Men who have Sex with Men (MSM), infections; Treatment of Opportunistic
Transgenders/Hijras, Injecting Drug Users Infections).
annual report | 2017-2018 355
ChApteR - 24
24.2 OVERVIEW OF HIV PREVALENCE IN 24.2.1) showed the HIV prevalence among Antenatal
INDIA Care attendees and high risk groups:
As per 2015 HIV Estimation report, the adult (15–49
Figure 24.2.1: HIV Prevalence (%) among ANC Client
years) HIV prevalence was estimated at 0.26% (Male- (HSS 2014-15), FSW, MSM, IDU, TG (IBBS 2014-
0.30% and Female-0.22%) in 2015 in India. The 2015), Migrants and Truckers (HSS 2010-11), India
adult HIV prevalence at national level has continued
its steady decline from an estimated peak of 0.38%
in 2001-03 through 0.34% in 2007 to 0.26% in ANC 0.29
Migrants 0.99
2015. Similar consistent declines were noted among
FSW 2.2
men and women at the national level. Among the Truckers 2.59
States/UTs, in 2015, Manipur has shown the highest MSM 4.3
estimated adult HIV prevalence (1.15%), followed TG 7.2
by Mizoram (0.80%), Nagaland (0.78%), Andhra IDU 9.9
Pradesh & Telangana (0.66%), Karnataka (0.45%), 0 2 4 6 8 10 12
Gujarat (0.42%) and Goa (0.40%). Besides these HIV Prevallence (%)
States, Maharashtra, Chandigarh, Tripura and Tamil
Nadu have shown an estimated adult HIV prevalence
greater than the national prevalence (0.26%), while 24.3 TARGETED INTERVENTIONS
Odisha, Bihar, Sikkim, Delhi, Rajasthan and West Considering the concentrated nature of the HIV
Bengal have shown an estimated adult HIV prevalence epidemic in the country, NACO has targeted its
in the range of 0.21– 0.25%. All other States/UTs have preventive efforts towards sub-groups of population
adult HIV prevalence below 0.20%. identified to be at high risk of acquiring HIV infection.
These High Risk Groups (HRGs) are provided with a
The total number of people living with HIV (PLHIV) in
number of preventive services through NGO/CBO led
India was estimated at 21.17 lakhs (17.11 lakhs–26.49
Targeted Interventions (TIs).
lakhs) in 2015 compared with 22.26 lakhs (18.00
lakhs-27.85 lakhs) in 2007. Children (< 15 years) At present, around 1500 such interventions are
accounted for 6.54%, while women contributed around providing HIV prevention, treatment, care and support
two fifth (40.5%) of total HIV infections. Undivided services to various High Risk Groups including
Andhra Pradesh and Telangana have the highest Female Sex Workers (FSWs), Men who have Sex
estimated number of PLHIV (3.95 lakhs) followed with Men (MSM), Injecting Drug Users (IDU), Hijra
by Maharashtra (3.01 lakhs), Karnataka (1.99 lakhs), and Transgenders (HTG), and Bridge Populations
Gujarat (1.66 lakhs), Bihar (1.51 lakhs) and Uttar such as Migrants and Long Distance Truckers. Target
Pradesh (1.50 lakhs). These seven States together Interventions (TIs) projects provide a package of
account for two thirds (64.4%) of total estimated prevention, support and linkage services to HRGs
PLHIV. Rajasthan (1.03 lakhs), Tamil Nadu (1.43 through drop-in-centre (DIC) and outreach-based
lakhs) and West Bengal (1.29 lakhs) are other States service delivery model which includes screening for
with estimated PLHIV numbers of 1 lakh or more. In and treatment of Sexually Transmitted Infections
India, the estimated number of new HIV infections in (STI), free condom and lubricant provision among
2015 were around 86 (56 – 129) thousand. core groups, Social Marketing of condoms, Behaviour
Change Communication (BCC), creating an enabling
Since 2007, when the number of AIDS related deaths
environment with community involvement and
(ARD) started to show a declining trend, the annual
participation, linkages to Integrated Counselling and
number of AIDS related deaths had declined by 54%.
Testing Centres (ICTC) for HIV testing, linkages
In 2015, an estimated 67.6 (46.4 –106.0) thousand
with care and support services for HIV positive
people died of AIDS-related causes nationally. This
HRGs, community mobilization, ownership building
decline is consistent with the rapid expansion of access
and specifically for IDUs, free distribution of
to ART in the country. The given below figure (fig.
sterile needles and syringes, abscess prevention and
356 AnnuAl RepoRt | 2017-2018
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