NATIONAL AIDS

CONTROL
PROGRAMME
AMINA.S
2020 BATCH
 INTRODUCTION
• National AIDS Control Programme (NACP) was launched in India in
the year 1987. Ministry of Health and Family Welfare has set up
National AIDS Control Organization (NACO) as a separate wing to
implement the various components of the programme .
• Aim of the programme is
To prevent further transmission of HIV
To decrease morbidity and mortality associated with HIV infection
To minimize the socio-economic impact resulting from HIV infection
 INITIATIVES OF GOVT OF
INDIA
• Medium term plan (1990-92)
• NACP-1(1992-1999)
• NACP-2(1999-2006)
• NACP -3(2007-2012)
• NACP-4(2012-2017)
 PREVENTION SERVICES UNDER
NACP -4
• Target on high risk groups(female sex workers,men who have multiple
sexual partners .drug abusers ,bridge population(truckers and migrants)
• Needle syringe exchange programme
• Line worker scheme for HRGs and vulnerable population
• Prevention control of STDs/RTI
• Blood safety
• HIV counselling and testing services
• Prevention of parent to child transmission
• Condom promotion
• Information ,education and communication and behavioural
change communication
• Social mobilization ,youth interventions and adolescence
education programme
• Mainstreaming HIV /AIDS response
• Workplace interventions
 CARE ,SUPPORT AND
TREATMENT SERVICES
• Lab services for CD4 testing and other investigation
• Free first line and second line Anti –Retroviral Therapy (ART)
• Paediatric ART for children
• Eraly infant diagnosis for HIV exposed infants and children below 18
months
• Nutritional and psycho-social support
• HIV /TB coordination
• Treatment of opportunistic infections
• Drop in centers for PLHIV networks
 HIV SURVEILLANCE
To detect spread of disease and to make appropriate strategy for
prevention and control
Objectives are
• To determine level of HIV infection among general as well as
high risk population
• To understand trends of HIV epidemic among general as well as
high risk groups
• To understand the geographical spread of HIV infection
• To provide information prioritization of programme resources
• To estimate HIC prevalence and HIV burden of the country
 COUNSELLING AND HIV
TESTING SERVICES
• Integrated Counselling and Testing Centres (ICTC)
• Prevention of parent – to child transmission of HIV
(PPTCT)
• HIV /tuberculosis collaborative activities
 PREVENTION OF PARENT TO CHILD
TRANSMISSION OF HIV (PPTCT)
• Routine offer of HIV counselling and testing to all pregnant
women enrolled into antenatal care with an “opt out” option
• Ensuring involvement of spouse and other family members and
move from an ANC centric approach to family centric approach
• Provision of lifelong ART (TDF +3TC+EFV) to all pregnant and
breastfeeding HIV infected women regardless of CD4 count and
clinical stage of HIV progression
• Promotion of institutional deliveries of all HIV infected pregnant
women
• Provision of care for associated conditions (STI/RTI,TB )
• Nutrition ,counselling and psychosocial support
• Counselling and support for initiation of exclusive breast feeds
within an hour of delivery and continued for 6 months
• ARV prophylaxis to infants from birth upto 6 months
• Integrating follow up of HIV exposed infants into routine
healthcare services including immunization
• Cotrimoxazole prophylactic therapy (CPT) and early infant
diagnosis (HIV DNA PCR)
• Strengthening community follow up and outreach through local
community networks to support HIV positive pregnant women
 CARE ,SUPPORT AND
TREATMENT
• Aim is to provide comprehensive services to (PLHIV)
• Free universal access to life long standardized (ART)
• Free lab diagnostic services
• Long term retention in care
• Prevention ,diagnosis and management of opportunistic
infection
• Linkage to social protection scheme
HIV TESTING IN TB
PATIENTS
 MANAGEMENT OF
OPPORTUNISTIC INFECTION
• Screening prophylaxis should be done
• HIV TB –ART and anti TB
• HIV HEP B – ART containing tenofovir and NRTI
• HIV HEP C- ART +SOFOSBUVIR GRAZOPREVIR
Prophylaxis is co trimoxazole
TARGETED INTERVENTION FOR
HIGH RISK GROUPS (HRGs)
• High risk groups such as female sex workers men with multiple sexual
partners ,drug abusers ,bridge population
• Services provided are
• Detection and treatment for STI
• Condom distribution
• Condom promotion
• Behaviour change communication
• Integrated counselling and testing services
• Care and support services for HIV positive HRGs
• Specific interventions for injecting drug users (IDUs)
Distribution of clean needles and syringes
Abscess prevention and management
Opioid substitution therapy
Detoxification / rehabilitation services
• Provision of project based STI clinics
 LINK WORKER SCHEME
• Community based out reach strategy to address HIV
prevention and care needs of HRGs
• Information and knowlrdge on prevention of HIV and STI
• Condom promotion and distribution
• Counselling ,testing and treatment of STI and
opportunistic infection through link workers
 BLOOD TRANSFUSION
SERVICES
• Integral part of health care system
• National and state levels
• Only licensed blood banks are permitted to operate
• Ensure safe collection ,processing ,storage and distribution of blood
and blood products
• Zonal blood testing centers – public ,private and voluntary sectors
• Detects infections like HIV ,HEP B
• ,HEP C, malaria and syphilis
• Access to safe blood –primary responsibility of NACO
• Installation of BCSU (blood component separation units)
• Procurement of equipment ,test kits and reagents
• To ease the situation of shortage of availability of blood in rural
areas where it is not feasible to operate a blood bank ,Govt has
decided to establish first referral units (FRUs)
STD CONTROL PROGRAMME
• STD control is Linked to HIV/AIDS control as transmission for
both are same
• HIV transmitted more easily than STD
• Management of STDs through syndromic approach
• STD clinics in all district hospitals medical colleges and other
centers
• Massive orientation training programme would be undertaken
to train all the medical and paramedical workers
 SURAKSHA CLINIC
• Prepacked STI /RTI colour coded kits
• Color codes are
• Kit 1- grey for urethral discharge ,anorectal discharge and cervicitis
• Kit 2 – green for vaginitis
• Kit 3- white for genital ulcers
• Kit 4- blue for genital ulcers
• Kit 5 – red for genital ulcers
• Kit 6 – yellow for lower abdominal pain
• Kit 7 – black for inguinal bubo
NATIONAL STRATEGIC PLAN (NSP)
FOR HIV /AIDS AND STI(2017 -2024)
• Goal is to achieve zero infection ,zero AIDS related deaths
and zero AIDS related stigma and discrimination
• Most critical intervention include prevention ,outreach,
testing and counselling ,treatment ,PPTCT ,viral load
suppression ,care and support as well as social protection
• Programmatic support components like monitoring and
evaluation surveillance ,research ,laboratory services .
 OBJECTIVES OF NSP
• Reduce 80% new infections by 2024
• Ensure 95% of estimated PLHIV know their status by 2024
• Ensure 95 % of PLHIV have ART initiation and retention by 2024
–for sustained viral suppression
• Eliminate mother to child transmission of HIV and syphilis by
2020
• eliminate HIV /AIDS related stigma and discrimination by 2020
• Facilitate sustainable NACP service delivery by 2024
 INFORMATION EDUCATION
AND COMMUNICATION
• To increase knowledge among general population on safe
sexual behaviour
• To sustain behaviour change in HRGs
• To generate demand for care ,support and treatment
services
• Appropriate changes in societal nprms that reinforce
positive attitude ,beliefs and practices to reduce stigma
and discrimination
 ADOLESCENCE EDUCATION
PROGRAMME
• Runs in secondary and senior secondary schools
• Life skills of adolescents to cope with physical and
psychological changes with growing up
• RED RIBBON CLUBS
• In colleges to encourage peer to peer messaging on HIV
prevention and to provide a safe space for young people
to seek clarifications of their doubts and myths
surrounding HIV
THANK YOU