The overall goal of the fourth Phase of the NACP
(2012-2017) is to reduce new infections by 50% (2007 Baseline of NACP III) and
Comprehensive care, support and treatment to all persons living with HIV/AIDS.
NACP IV has adopted an approach to consolidate the gains made in high prevalent
states and intensify the response in low prevalent but highly vulnerable state.
The most cost-effective means of reducing HIV spread is through the
implementation of Targeted Intervention (TIs) amongst persons most vulnerable to
HIV/AIDS, such as sex workers, men who have sex with men, and injecting drug
users known as core groups and truck drivers, migrants known as bridge
population or bridge group. Both NACO and the State AIDS Control Societies place
a high priority upon full coverage of the state with TIs and other prevention
activities such as expanding access to STI services
It is estimated that more than 90% of HIV transmission in India is related to unprotected sexual intercourse or sharing of injecting equipment between an infected and an uninfected individual. Given this pattern of epidemic transmission, it is most effective and efficient to target prevention to the HRG members to keep their HIV prevalence as low as possible, and to reduce transmission from them to the bridge population.
is through differentiated outreach/communication based on risk and typology. Focus is also on interpersonal behaviour change communication (IPC).
• Condom Promotion
Every person should have access to condoms when he/she needs it. Through its Primary Strategy provision is for free supply of condoms to HRGs through TI NGOs/CBOs and in the secondary Strategy stress is on promoting social marketing of condoms through Social Marketing Organizations.
• Community Mobilization
Building community’s ownership of the TI objectives through collectivisation, emphasis is on collective decision-making and creation of a space for the community events. Building capacity of community groups to assume ownership of the programme through formation of various committees like DIC Management Committee and Clinic Committee.
• Referrals & Linkages
Linkages to STI and health services with strong referral and follow-up Promotion/distribution of commodities including free condoms, lubricants, needles/syringes Linkages to other health services (e.g. for TB) and integrated counseling and testing centers (ICTCs). Provision of safe spaces (DICs).
• Management of STIs
STI services: an opportunity for prevention education to the individual as well as to his/her partner. Planning for STI services is done with the HRGs. Availability of services is ensured as per the needs of the community (for e.g. late-night access).It is emphasized that there is Accessibility of services at optimal locations (i.e. not too far from the major sex work sites) and Clinicians have an attitude of respect towards the community.
• Enabling environment
Through this component stress is on creating a crisis response/management system and conducting advocacy with key stakeholders/power structures response system and promoting legal rights education.
Uttarakhand State AIDS control Society is implementing the targeted intervention program through 36 NGOs in the state in 11 districts. There are 11 Targeted Intervention program are being implemented for FSW, 6 TI program for Injecting Drug Users, 1 for MSM and 7 core composite for FSW and MSM-TG. While for migrant population there are 8 bridge group interventions while 3 Intervention programs are being implemented among Truckers for Prevention of HIV/ AIDS.
The targets allocated to the partner NGOs are
based on the mapping study done by the Raman Development consultants (RDC). The
estimation given by the RDC for FSW was 7103 and against this estimation the
coverage by our TI partners is 7250. Similarly MSM were estimated to be 2826 and
the coverage is 1920 and for IDU the estimation is 2480 and coverage is 1826.
Under the bridge group intervention 95000 migrants and 40000 truckers are being
TI Staff Positions of the TI NGOs is as per the NACO HR policy guidelines, TIs ngo have the following staff members:
• Project Manager/Coordinator
• Accountant cum M&E
• Outreach Worker
• Doctor (part-time)/ Preferred Provider
There are Peer Educators/Peer Leaders who are integral part of peer education program and recruited from community on honorary basis to link the community members with HIV/AIDS prevention and care services.
Together with support from the SACS and the technical support unit the partner NGOs are implementing the program in the state.
Opioid Substitution Therapy (OST) Center:
There are five OST centers in the State situated in Haldwani, Rudrapur, Dehradun , Kashipur and Haridwar. These OST centers are established in the Government Health Facilities. The Injecting Drug Users (IDUs) are provided with OST medicines on daily basis based on DOT strategy. The purpose of provisioning the oral medicines is to switch the Injecting mode of drug intake of the IDUs and prevent transmission of HIV infection which they often share. Through OST the drugs are provided on prescription of a trained Doctor. Thus the IDUs take medicines and lead a quality life and contribute economically to the family income.
Technical Support Unit
Uttarakhand has a Technical Support Unit Future group International Pvt. Ltd. to provide technical support to the SACS and the NGOs. The program officers in the TSU regularly visit the NGOs and provide required support and handholding to the NGOs. There is strong team of 7 program officers and team leader including a medical officer to look after STI Management.