mainstreaming - a key approach to hiv prevention by dr. a.k. gupta, additional project director cum...

Mainstreaminga key approach to HIV Prevention

(Govt. of NCT of Delhi)Dr. Baba Saheb Ambedkar Hospital,

Dharamshala Block, 1st & 2nd Floor, Rohini, Sector-6, Delhi-110085

As per Guidelines of

Ministry of Health and Family Welfareth9 Floor, Chandralok Building,

36, Janpath, New Delhi

Delhi State AIDS Control Society

National AIDS Control Organization

Mainstreaminga key approach to HIV Prevention

Compiled By :

Dr. A. K. GuptaAdditional Project Director

Ms. Nidhi RawatConsultant (Civil Society & Mainstreaming)

Delhi State AIDS Control Society(Govt. of NCT of Delhi)

Dr. Baba Saheb Ambedkar Hospital, Dharamshala Block,

1st & 2nd Floor, Rohini, Sector-6, Delhi-110085

ACKNOWLEDGEMENT

This document of Mainstreaming Programme of Delhi State AIDS Control Society is an

attempt to summarize and showcase the significant task of mainstreaming HIV/AIDS

programme into various public and private organization. This document would not have

been possible without joint, concerted efforts of many people.

The cooperation, suggestions and inputs of all officers of DSACS, particularly Mr. J.K.

Mishra JD (TI), Mr. Mateen Khan Consultant (Voluntary Blood Donation), Mr. B.C.

Joshi AD(TI), and Mr. Sabya Sachi Chkarborty (Computer Programmer), has been

instrumental in bringing out this document and mandates special thanks. Thanks are also

due to Mr. Kuldeep Rai, CLS cum PA to APD for his valuable assistance.

Special thanks are also expressed to all those who have been directly or indirectly linked

with this document.

Dr. B.S. BanerjeeProject Director

DSACS

INDEX

S.NO TOPIC Page No.

1. HIV/AIDS SCENARIO 1

2. National AIDS Control Programme 2

3. HIV/AIDS intervention in Delhi 2

4. HIV/AIDS Trends in NCT of Delhi 7

5. Challenges under NACP III & strategies of DSACS 9

6. Mapping of Vulnerable Population 11

7. Physical Achievements of year 2007-08 13

8. Achievements of year 2008-09(First Quarter) 16

9. Mainstreaming A Key Approach 22

10. National/Delhi State AIDS Council 23

11. Delhi Mainstreaming - A Glance 25

12. Status of Mainstreaming Intervention in Delhi 26

13. Proposed new Intervention under Mainstreaming in year 2008-09 26

14. Specific Role of each Department 27

15. Role of Civil Society Organisation 31

16. Role of Corporate Sector 32

17. List of Service Outlets 33

18. Contact details of DSACS officers 38

1

HIV /AIDS SCENARIO

Global :

vAbout 33.5 million people living with HIV/AIDS.

vWomen constitute nearly half of the estimated adult population living with HIV/AIDS.

vMore than 20 million people have succumbed to AIDS in the last two decades.

vAlmost half the new infections were among youth in the 15-24 age groups.

India :

vAn estimated 2.5 million people are living with HIV/AIDS.

v39.3% of those living with HIV arewomen.

v86.5% of the reported cases are among people in the 15-49 years age group (27.9 % in 15-29 and 58.6% in 30-49 age groups).

vHIV has been reported from every state and is moving from groups at high risk to the general population and from urban to rural areas.

DELHI:

vTotal population - 16 million.

vLow prevalence state (HIV+ in general population - 0.2%). But highly vulnerable state :

vTotal infected population (estimated)- 32,000 (provisional data)

vTotal high risk groups & bridge population -1.00 Lakh

vThis HRG population is uniformly spread in all nine districts of Delhi.

vHIV is the Human Immuno-Deficiency Virus which gradually affects our immune system and its ability to fight disease/infection.

vAIDS is the Acquired Immune Deficiency Syndrome which is an advanced stage of HIV infection where the immune system gets severely weakened, exposing the infected person to various Opportunistic Infections.

vHIV can be transmitted by:

•Having unprotected sex with an

infected person.

•Transfusion of infected blood and

blood products.

•Sharing the infected needles/

syringes.

•Infected mother to her child during

pregnancy, child birth and via breast feeding.

vHIV does not spread by casual contact like shaking hands, using the same toilet, eating together or through a mosquito bite.

vOn an average, it takes 5-8 years for HIV infection to progress to AIDS.

vPeople living with HIV can lead a healthy and productive life for years without posing a risk to co-workers.

Basic Facts on HIV/AIDSScenario

National AIDS Control Programme

The first phase on National AIDS Control Programme (NACP I) was launched in 1992 with

objectives to slow down the spread of HIV virus in the country and to reduce impact of

HIV/AIDS in the country. State AIDS cells were established in the country including Delhi. A

National AIDS Control Board and National AIDS Control Organization (NACO) were set up. stDelhi State AIDS Control Society was established on 1 November, 1998.

The second phase on National AIDS Control Programme (NACP II) was launched in 1999 with

shifting of focus from awareness to change in behavior, greater involvement of NGOs,

counseling & testing services for general population as well as antenatal women and provision

of care, support and antiretroviral treatment. A National AIDS Council, chaired by Hon' Prime

Minister, was set up.

With the lessons learnt from NACP II, the third phase on National AIDS Control Programme th(NACP III) was launched on 6 July, 2007 with objective to stop & reverse the HIV epidemic in

the country in next 5 years by four pronged strategies viz; (i) Prevention of New Infection in

High Risk Groups (HRGs) & general population by saturating coverage of HRGs & scaling up

interventions for general population; (ii) Providing greater care, support and treatment to large

number of People living with HIV/AIDS (PLHAs); (iii) Strengthening Infrastructure & Human

resources for prevention, care, support & treatment in all districts of the country; (iv)

Strengthening nationwide strategic management information system.

HIV/AIDS Interventions in Delhi

Delhi has been implementing AIDS Control programme since 1992. The Delhi State AIDS

Control Society is an autonomous body of Delhi Govt. which became functional from Ist

November, 1998.

AIMS AND OBJECTIVES :

The Society was established towards fulfillment of following aims and objectives.:

a) To prevent HIV transmission and to control its spread in Delhi.

b) To reduce morbidity associated with HIV infection.

2

a) To reduce the adverse Social and Economic impact resulting from HIV infection.

b) To coordinate and strengthen STD/HIV/AIDS surveillance in Delhi.

c) To provide technical support in HIV/AIDS prevention and control in Government and Non government Organization.

d) To enhance the community awareness about HIV/AIDS for its prevention and control.

e) To develop materials for distribution and adoption by agencies working in AIDS prevention and control.

f) To promote, channelize and integrate the activities of Non government Organizations for AIDS prevention and control.

g) To promote safety of blood and blood products and undertake, support and catalyze voluntary blood donation movement.

h) To provide facilities and to strengthen Sexually Transmitted Diseases control services in Government and Non-government sector and Private Medical Sector.

i) To develop counseling services on the disease of HIV/AIDS and related issues.

j) To mobilize support social, financial or otherwise for management of HIV infected person and AIDS patients.

The Society is entrusted with the task to reduce spread of HIV among all sections of the population. It has evolved a strong multi-sectoral response towards the epidemic by involving Public Sectors and Private Sector, various Govt. Departments and NGOs etc. to seek their co-operation in strengthening the implementation of the programme. The Society is implementing National AIDS Control Programme Phase-II since November 1999, under guidance, supervision and funding from National AIDS Control Organization, Ministry of Health & Family Welfare, GOI. The NACP-II was a 5 year Project implementation Plan (1999-2004) for Delhi which was prepared by the Society and approved by the World Bank/NACO. The project had 5 components namely:

1. Targeted Intervention, STI Control & Condom Promotion.

2. IEC, Blood Safety & VCTC

3. Surveillance, Training, Operational Research and Institutional Strengthening

4. Low Cost Community based Care for HIV/AIDS

5. Inter-Sectoral Collaboration & Coordination.

The key achievements of NACP II were:

1. Involvement of NGOs in the implementation of TIs among HRGs

2. Setting up VCTCs and STD clinics at the district level.

3. State Level Behaviour Sentinel Surveillance (BSS) survey

3

4. Prevention of Parents To Child Transmission Programme

5. Introduction of a Computerized MIS and Project Financial Management System

6. Financial Achievements:

Lessons Learnt from NACP II:

�Potential of youth volunteers in NSS, NCC, Scouts and Guides, NYKS, Youth Clubs, Youth Red Cross and Red Crescent remained underutilised.

�More efforts to tackle sexual transmission as 86% of transmission being sexual with limited access to services to women

�Intensive Participation of the private sector for mainstreaming.

Shortcomings of NACP II:

�Major focus of NACP-II was prevention. Gradually, care, support and treatment got added as new activities.

� A major shortcoming of NACP-II was the inability to link services with prevention, and supply of services with demand.

�Condom supplies were not necessarily linked to STD services and access to these services were not linked with the Targeted Intervention programmes in a coherent way.

To stop and reverse the epidemic in Delhi over the next 5 years, the third phase of National thAIDS Control Programme, a four-pronged strategy, was launched from 6 July, 2007. The

key components of NACP III include:

1. Prevention of New Infection:

a. Targeted Intervention ( for HRGs & Bridge population- truckers, migrant workers): through a net work of NGOs

b. Integrated Counseling & Testing Centers (for general population & antenatal women): through VCTC/PPTCTC/ICTCs

YEAR BUDGET APPROVED (In

lakhs) GIA RECD (In lakhs).

EXPENSES (In lakhs)

1998 -1999 215.75 110.00 71.93 1999 -2000 638.84 283.00 383.38 2000 -2001 200.00 229.00 168.14 2001 -2002 431.52 354.00 328.97 2002 -2003 432. 51 431.00 241.16 2003 -2004 521.58 460.00 436.79 2004 -2005 888.54 654.00 574.30 2005 -2006 2,273.02 1,150.00 993.68 2006 -2007 2,125.83 1,232.70 1,313.34

4

c. Provision of supply of safe & adequate quantity of blood: through blood banks, blood storage centers, promotion of voluntary blood donations.

d. Prevention of sexually transmitted infections in risky behavior population: through STI Clinics, condom promotion

e. IEC: Mass media, Mid-media, Interpersonal communication, Mainstreaming Govt. departments and Public sector, IEC material development.

2. Care, Support & Treatment of PLHAs: through Anti Retroviral Treatment (ART) centers, Community Care Centers & Drop in centers

3. Strengthening of Infrastructure & Capacity building, Centre for excellence in Pediatric ART at Kalawati Saran Children Hospital, Model Blood bank at one Delhi Govt Blood Bank, Regional STD Lab at S.J. Hospital, Quality Assurance through two National & 4 State Reference Laboratories in Delhi.

4. Strategic Management Information: Computerization of all service outlets, nationwide common reporting format

Programme Implementation:

Delhi State AIDS Control programme is being implemented through following service outlets:

1. Integrated Counseling & Testing Centers: It acts as a key entry point to prevention of HIV infection & for treatment & care of people who are infected with HIV. When availing counseling & testing services , people can access accurate information about HIV prevention & care and undergo an HIV test in a supportive & confidential environment, People who are found HIV negative are supported with information & counseling to reduce risks & remain HIV negative. People who are found HIV positive are provided psychosocial support & linked to treatment and care at community care homes & antiretroviral treatment (ART) centers. It is not the mandate to an ICTC to counsel & test everyone in the general population. There are subpopulations who are more vulnerable or practice high risk behavior. These subpopulations include sex workers & their clients, Men having Sex with Men, trans-genders, injecting drug users, bridge population (truckers, migrant workers), spouses & children of men who are prone to risky behaviors.

2. STI Clinics: The reproductive tract infections RTIs including sexually transmitted infections STIs are recognized as a public health problem, particularly due to their relationship with HIV infection. As per recent STI prevalence study over 6% of adult population in the country suffers from STIs. It is well known that risk of acquiring HIV infection increases many fold in people with current or prior STI. The prevention, control & management of RTI/STI is an important strategy for controlling the spread of HIV. It is important that all clients attending STI/RTI clinics, including Obst. & Gynae OPDs, & those referred through T.I. NGOs(working with High Risk Population), should be referred to ICTCs for counseling & testing.

5

3. Community Care Centers were set up to provide treatment for minor Opportunistic Infections & psychosocial support through sustained counseling. CCCs were intended to function as a bridge between hospital & home care. The introduction of ART has brought about a change in the role played by CCCs. They are being transformed from a standalone short stay home to playing a critical role in enabling PLHAs to access ART as providing monitoring, follow-up, counseling support to those who are initiated on ART, positive prevention, drug adherence, nutritional counseling etc. Under the national programme CCC is a place which facilitates out -patient & inpatient treatment. All patients started on ART are required to be admitted in a CCC for a minimum of 5 days inpatient care. These centers make referral to ICTC for confirmation of HIV status, PPTCTC for care of HIV positive pregnant women, pediatric HIV services, ART centers for CD4 or other tests and DOTS for treatment of TB, the commonest OI.

5. ART Centers: The main objective of Anti Retroviral Therapy is to provide comprehensive services to eligible persons with HIV/AIDS.ART centre identifies eligible persons with HIV/AIDS requiring ART through laboratory services (HIV testing, CD4 Count & other required investigations to rule out/detect any underlying OI). These centers provide free ARV drugs to eligible persons with HIV/AIDS continuously with provision of counseling services before & during treatment for ensuring drug adherence. ART centers are linked to CCC for short duration inpatient care. Presently the ARV drugs are being provided on monthly basis. In order to reduce frequency of visits of patients to ART centers & to reduce the work load of ART centers, Link ART Centers are being identified amongst existing ICTCs in hospitals where ARV drugs will be provided along with screening for minor OIs by trained medical officer.

6. Blood banks: DSACS is supporting 19 blood banks of Delhi to ensure uninterrupted supply of safe blood to the state. Efforts are being made to enhance collections through voluntary blood donations with the help of voluntary organizations, state blood transfusion council, RWAs, NGOs, Colleges and Pvt & Govt departments.

4. Drop in Centers: DICs are meant to promote positive living and build capacity & skills among People Living with HIV/AIDS (PLHAs) to cope with infections. They are run by network of PLHAs as CBOs and help creating an enabling environment & establish linkages with existing health services, NGOs & CBOs and to protect & promote the rights of the infected individuals.

6

Figure 1: HIV Prevalence among ANC clinic attendees

0.31

0.1

0.2

0.12

0.31

0

0.05

0.1

0.15

0.2

0.25

0.3

0.35

2003 2004 2005 2006 2007

Pre

va

lan

ce

Ra

te

HIV+

HIV/AIDS Trends in NCT of DelhiThe first AIDS case in Delhi was reported in 1988. Since then, 6976 AIDS cases reported up to May, 2008. Out of which, 602 cases of deaths have been reported so far. As per estimation of

thAnnual Sentinel Surveillance, 10 round, 2007 (data provisional) of Delhi, the number of HIV cases has reduced to 32,000 from 78464 cases estimated in 2005. At national level, the estimated HIV cases have also reduced to 2.5 million in 2006 from 5.2 million in 2005. The HIV prevalence rate among women attending antenatal clinics in the state is 0.2 percent (figure 1).

ICTCHIV TESTING

COUNSELLING+VE

-VE

PRE- TEST POST-TESTHOME

CARE-HOMES

ART CENTRES

SHORT STAY ARV/OIs

High Risk Population (Targeted Interventions) General PopulationBridging Population

?BROTHEL CSWS

?NON BROTHEL

?CSWS

?MSMS

?IDUS

BCC

STD TREATMENT

CONDOM PROMOTION

ENABLING ENVIRONMENT

NGO s

NGOs

TB CLINICS/ STD CLINICS/ANC/OPD/IPD

?TRUCKERS

?CLIENTS

?MIGRANT LABOURERS

?IEC

?AEP

BLOOD BANKS

PARTNER NOTIFICATION

FOLLOW-UP (ORWS)

MOTHER BABY PAIR

Flow Chart for HIV/AIDS Intervention

Mai

nstr

eam

ing

DROP IN CENTRE

LINK ART CENTRE

7

The HIV prevalence among STD clinic attendees has also risen from 3.4 percent in 2002 to 4.38 percent in 2007. HIV prevalence among IDUs has increased substantially from 7.2 percent in 2002 to 10.2 percent in 2007. Similarly, prevalence among the MSMs has also increased from 6.67 percent in 2003 to 11.73 percent in 2007. The only high-risk group that has registered a decline in HIV prevalence are sex workers. The prevalence in this group declined from was 8 percent in 2004 to 2.64 percent in 2007 (Figure 2).

Figure 2: HIV Trends among STD clinic attendees, IDUs, MSM and CSWs

Routes of Transmission

Majority of the cases reported are in sexually active age group of 15-49 years. The predominant

route of transmission of HIV continues to be sexual (77.02 percent) followed by perinatal (7.22

percent), blood and blood products (4.73 percent), IDUs (2.31 percent), and 'not specified' (8.72

percent) (Fig 3).

HIV Trends among STD clinic attendees, IDUs, MSM and CSWs

4.08

7.6

4.38

9.8

22.8

10.212

20.4

11.73

2.72

5.6

2.64

0

5

10

15

20

25

2005 2006 2007

Pe

rce

nt

po

sit

ive

STD IDUs MSM CSW

7.22

4.732.31

8.72

77.02

Sexual Blood & Blood Products

Injecting Drug Users Perinatal Transmission

OTHERS ( not specified)

8

Fig. 3: Routes of Transmission

AIDS Cases (2000- May 2008) Hospital Data

The status of year wise reporting of AIDS cases based on data furnished mainly by government

hospitals is reported in Table 1.

Table I:

Challenges under NACP III:

The epidemic in the country, which used be patchy & restricted to HRGs is spreading

�From High risk groups to General population

�From the Urban to Rural areas

�From High Prevalence States to all States

�Increasing Feminization

�High vulnerability of youth

Strategies Adopted by DSACS under NACP III:

�Saturating TI coverage for HRGs, TIs for Bridge Population, Intensive IEC

campaigns & Mainstreaming to cover the General population. NACO has provided a

Technical Support Unit, M/S Raman Development, for technical support to DSACS.

�Provision of counseling & testing services in 24 hour PHCs, use of folk media & IEC

campaigns to cover rural areas

�District level implementation of the programme with special focus in category 'B'

Districts of Delhi.

AIDS/Death Cases

Up to

2000

2001 2002 2003 2004 2005 2006 2007 2008 (May

08) Cumulative AIDS Cases

498 656 762 881 949 2414 4339 6409 6976

Cumulative Death Cases

142 169 201 230 237 283 363 526 602

9

Categorization of Districts by NACO

Four districts of Delhi namely; North, East, North-East & Central have been categorised under B category whereas the remaining 5 districts are under C category. Consequently, under NACP III special focus is being given to B category Districts in Delhi as regards to opening new ICTCs, Community Care Centres, Drop in Centres, Link ART Centres, STI Services through Govt. & Public Pvt Partnership Service outlets, Deployment of ICTC supervisors & Outreach workers at ICTCs for follow up of HIV positive pregnant women and their babies till 18 months of age. Further, district level ART Review Committees & HIV TB Coordination committees are being constituted for proper monitoring of ART centres & HIV TB cross referrals, respectively.

> 1% ANC/PPTCT prevalence in district in any time in any of the sites in the last 3 years

A

< 1% ANC/PPTCT prevalence in all the sites during last 3 years associated with > 5% prevalence in any HRG group (STD/CSW/MSM/IDU)

B

< 1% in ANC prev alence in all sites during last 3 years with < 5% in all STD clinic attendees or any HRG with known hot spots (Migrants, truckers, large aggregation of factory workers, tourist etc)

C

< 1% in ANC prevalence in all sites during last 3 years with < 5% in all STD clinic attendees or any HRG OR No or poor HIV data With no known hot spots/unknown

D

10

DISTRICTS OF DELHI

North West

West

South West

South

NewDelhi

Central

North

NorthEast

East

�Efforts are being made to counsel & test all ANC clients, especially in B category

Districts of Delhi, under PPTCT programme. Counseling & Testing services are being

provided in maternity homes and maternal & child welfare centers.

�The post of Consultant (Youth Affairs), created under NACP III, has been filled, to tap

the potential of youth volunteers in NSS, NCC, Scouts and Guides, NYKS, Youth Clubs,

Youth Red Cross and Red Crescent. 75 Red Ribbon Clubs are under the process of

constitution in major universities of Delhi.

Mapping of Vulnerable Populations in Delhi

1. The vulnerable populations were mapped in order to identify locations, size, and trends

in movement in 2002. The mapping study has revealed that Delhi state has a fairly large

number of high-risk groups (60,000). This mapping study again updated in 2006, showed

that, the 50 percent increase in the estimated population of core groups (fig 4).

Figure 4: Estimated Core Group Population of 2002 & 2006

35062

61621

14700

28999

10000

17173

0

10000

20000

30000

40000

50000

60000

70000

CSW MSM/Eunuchs IDUs

2002 2006

11

Knowledge and Behavior

2. In 2001, a nationwide Behavioral Sentinel Surveillance Survey (BSS), was conducted,

for both the general population and high-risk groups like sex workers and their clients,

MSM and Injecting Drug Users (IDUs). The end line survey was conducted in 2006. The

comparative key findings for Delhi indicate that almost (93.8 percent) of the general

population had heard about HIV/AIDS. About 69.6 percent of the respondents were

aware about HIV prevention methods. The awareness about STD is less than fifty

percent (45.9 percent).

3. Use of condoms with non-regular sex partners has increased from 47.40 percent in 2001

to 81.30 percent in 2006. Consistent condom use has also increased from 31.60 percent

to 68.70 percent (figure 5).

Figure 5-Condom use with Non regular Partner in Last 12 Month

3.59.6

47.4

81.3

31.6

68.7

0

10

20

30

40

50

60

70

80

90

SEX WITH NRP LAST TIME CONDOM USE CONSISTENT CONDOM USE

BASE LINE END LINE

12

Physical Achievement during 2007-2008

(Table III):

Coverage (2007- 2008): Table IV

S.No.

Components

Physical Targets

Achievement

1

Targeted Interventions for core groups

61

36

Targeted Interventions for bridge population

5 0 2.

ICTC 92 70

5.

STD Clinics 11 11 No. of STI episode Treated

(STI clinics and TI)

34626 26135

6. Blood Component Separation Units

10 5

7. Major Blood Banks 6 6 8. District Blood Banks 5 5

Blood Storage Units 3 1 Voluntary Blood Donation

Camps 250 1088

Community Care Centers 4 4

9.

Drop in Centers for PLHA 3 1

10.

ART Centers 8 9

OI Management and PEP

14000

1763

Trainings

5000

2119

11.

Sentinel Surveillance Sites

20

20

S.NO Activities Target for 2007 -08

Achievement

% of Achievement

High Risk Populations

1

No. of Sex Workers reached by intervention in a year

36000

35526

98.68

2 No. of MSM reached by intervention in a year

16000 12512 78.20

3 No. of IDUs reached by intervention in a year

10000 7258 72.58

13

12.13.14.15.16.

3.4.

*Subject to approval of NACO

Condom Promotion

4 No. of Condoms to be distributed

under free supply 60 Lakhs 61.3

Lakhs 102.16

5

No. of NTOs established under social marketing

350

350

100

6 No. of Social Marketing condoms utilized in TI

15 lakhs 2.59 Lakhs

17.26

Improving STI Management

7 No. of Adults with STI symptoms accessing syndromic management

34626 26135 75.47

Integrated Counseling and Testing

8 Number of vulnerable population tested at ICTC

250000 110140 44.06

9 Number of pregnant women covered through PPTCT testing

150000 59907 39.94

10 Number of HIV infected mother baby pairs receiving prophylaxis ART

180 75

41.67

Blood Safety Measures

11

No . of Blood units for transfusion

320258

320043

99.93

12

Number of Voluntary Blood Units

166534(52%)

103646

62.24

14

High Risk Groups Current coverage Targets for (% HIV +ve) 2008-09

Sex Workers (% HIV +ve) 35,526 ( 2.64 % HIV +ve ) 47,500

Men having Sex with Men (% HIV +ve) 12512 (11.73 %HIV +ve 18,000

Injecting Drug Users(% HIV +ve) 7258 (10.2% HIV +ve 12,000

STI patients (%HIV +ve) 26135 (4.38% HIV +ve) 45,548

Vulnerable population Counselled & Tested for HIV (% HIV +ve) at ICTC 1,25944 ( 4.9% HIV +ve) 2,50,000

15

Service Outlets under DSACS (Existing & Proposed for 2008-09): Table VI

Name Existing Proposed (08-09) Total

T.I.Projects 44 34 78

ICTCs 70 26 96

PPP ICTCs 0 9 09

STI Clinics 11 15 26

ART Centers 9 0 09

Community Care Centers 4 6 10

Link ART Centre 0 9 09

Drop In Centre 1 4 05

Blood Bank 19 0 19

Blood Storage Centre 1 6 07

Regional STD Centre 0 1 01

Centre of Excellence for ART 0 1 01

Model Blood Bank 0 1 01

TOTAL 159 112 271

Achievements (2007-08) & Targets (2008-09): Table VII

Financial Achievements 2007-08: Table V

Approved Budget

Budget released by NACO Expenditure in 2007 -08

2489.00 lakhs 172 2.85 lakhs 1139.92 lakhs

* Subject to approval of NACO

ANC cases counselled & tested for HIV 65,867 ( 0.22% HIV +ve) 2,50,000

No. of People currently on ART 4450 7000

Voluntary Blood Donation Camps 1494 camps 3005 camps (1,32, 736 units) ( 2,00,000 units)

Achievements during Ist Qtr. 2008-09

Dashboard for NACP-III for SACS Performance Monitoring: Ist Qtr (Apr to Jun. 2008): Table VIII

S.No. Indicators Value

1 Number of Districts 9

2 Number of Districts with at least one functional PLHA Network 1

3 Number of Districts with District Unit (DAPCU) established NA

4 Whether Donor Partnership forum constituted (Y/N) NA

5 Whether Donor Partnership Forum met last quarter (Oct.-Dec., 2007) NA

6 Whether Governing Body met during the reporting quarter Y

7 Whether HRG representative included in decision making bodies (Y/N) Y

8 Whether Project Director is sole in-charge of SACS for more than one year (Y/N) Y

9 Whether SACS has approved financial and administrative delegations Y

10 Percentage of funds disbursed relative to target 40.68

11 Percentage of due procurement contracts awarded during original validity period 100

12 Whether NGO advisor's position in SACS filled (Y/N) Y

13 Number of TI,s reporting condom Stock-out in last month 0

14 Number of ICTC,s reporting test kits stock-out during quarter 0

15 Number of ART centers reporting drugs stock-out during quarter 0

16 Number of Districts sending 80% reports on time 9

17 Number of Targeted Intervention Projects (By category)- Total 36

a. FSW 22

b. MSM 3

c. IDUs 4

d. Truckers 0

e. Migrants 0

f. Others (Composite of FSW/MSM/IDUs/Truckers) 7

16

18 Number of ICTC clients tested 65524

19 Number of ICTC clients Receiving Results 61756

20 Number of HIV positive pregnant women (mother & baby) receiving complete course of ART prophylaxis 35

21 Percentage of blood units provided by voluntary blood donors 32.13

22 Number of ART service centers 9

23 Number of eligible persons with advance HIV infection receiving ART (Total)

a. Male 2971

b. Female 1151

c.Trans-gender 40

d. Children 341

ACHIVEMENTS IN FIRST QUARTER (2008-09)

S.NO.

COMPONENT

ALLOCATION IN LAKHS

GLOBAL FUND Rd

VI

PHYSICAL ACHIEVEMENTS

ACHIEVEMENTS

POOL FUND

GLOBAL

FUND Rd IV

EXISITING

NEW APPROVED

PHYSICAL

FINANCIAL(la

khs)

1 Prevention of New infection

967.4

314.36

Targeted Intervention

1.1.1 HRG

1.1.1 a

FSW

476

22

12

1.1.1 b

MSM

196

3

11

1.1.1 c

IDU

162

4

5

1.1.1 d

COMPOSITE

7

Joint Appraisal Team

completed visits on 19th July, TI

contracting will be completed by 30th July, 08

1.1.1 e

CBO

46

2

Transitioning process for formation of CBO at GB Road started in support with DMSC Project of Sonagachi, Kolkata.

17

1.1.2

BRIDGE POPULATION

1.1.2 a TRUCKERS 22.5 5

1.1.2 b

MIGRANTS

Care India through NACO is implementing TI at 4 places in Delhi- Okhla Ind Area, Mayapuri Ind

area, Shastri park, Wazirpur

Mapping Field work completed in Delhi by I.M.R.B - report to be submitted. DSACs has started

consultation process to establish TIs in collaboration with Transport Unions & Transport Dept, GNCTD

1.1.3

MAPPING & OTHER RELATED ACTIVITIES

14.9

Mapping already done in 2006. The fund will be used for Evaluation & JAT Visits

1.1.4 EVALUATION & JAT

Completed in March 08, Voucher audit completed in May 08, All existing TIs extended for 2 months (till may 08) & re-contracting of existing

TIs from June 08 -April 09 done.

1.1.6

TRAINING

50

Training of outreach planning & delivery of basic services completed for all TI staff , Training of Annual Strategic planning completed, Induction Training of 10 New TIs completed for all

staff,

1.2

IEC, SOCIAL MOBILIZATIUON, & MAINSTREAMING

363.52

3 days IEC Campaigns each in 3 Universities of Delhi in July 2008, IEC campaigns for all JJ Clusters & slums in July-August 2008

15.21

1.2.1

MASS MEDIA

51.6

1.2.2

IEC MATERIAL PRODUCTION

40

1.2.3

OUTDOOR & MID MEDIA

70

1.2.4

IVRS HELPILE

15

1.2.5

EVENTS

20

1.2.6

M&E & DOCUMENTATION

10

1.2.7

CREATIVE AGENCY

5

1.2.8

ADOLESCENT EDUCATION PROGRAM

34

SCERT Contacted for submitting UC of funds released in 2005-06

1.2.9

RED RIBBON CLUBS IN 75 COLLEGES

50

16 Universities, 16 Polytechnics, 6 NSS coordinators contacted for setting 75 RRCs

1.2.10

MAINSTREAMING & TRAINING

41.27

Mainstreaming started in CISF, ICDS ( Anganwadi ) Workers, Dept of Social Welfare GNCT of Delhi & Prison staff (Tihar Jail). Already in action in Railway Coolies & Hawkers/Vendors, New Delhi Rly Station, NDPL, Paharpur Buisness Centre, DJB, Seelampur embroidery workers & construction workers in collaboration with trade unions & ILO.

4.25 Lakhs (included in 15.21 lakhs

above)

1.2.11 DROP IN CENTRES

26.65

1 (Jagriti HIV AIDS

Organization)

4

Meeting with +ve men & women

networks held on 14th July 08 to set

up 4 DICs in Category B /C

districts of Delhi.

18

1.4 STD CLINICS 55.6 Convergence with NRHM under

NACP III.

0.59

1.4.1

STRENGHTEMNEING INFRASTRUCTURE

30

An agency Parivar Seva deployed by NACO to identify Pvt STI/RTI service providers

@ 100 / category B district X 4 districts

Mapping underway, report awaited

11

15

Of 11 existing STI clinics 2 at

dispensary level will be

reallocated to hospitals & 4 new clinics identified in hospitals viz;

LBSH, Shastri Park, SGMH, HAS,

RTRM, BSAH, BJRM.

1.4.3 TRAINING

2.8

State Resource Team generated

to train various STI/RTI service

outlets

in Delhi

1.4.4

SUPERVISORY VISITS

2.8

Completed in ist Qtr

1.4.5

COUNSELOR/CENTRE

8.2

Recruited , Under posting

1.4.6

CONSUMABLES

2.8

Consumables under supply

1.4.7

COMPUTER

9

Installed at 9 STD clinics

1.5

BLOOD SAFETY

231.28

Salary released up to June 08 in

all BBs

5.27

1.5.3

MAJOR Blood Bank with Blood Component Separation Units (AIIMS-main, RMLH,LHMC,GTBH,IRCS)

28.9

5

0

1.5.4 MBB UPGARDED TO BCSU (GB Pant, LNH, SJH, AIIMS-CNC)

11.56

0

4

contingency grant under

release @ Rs. 1.0 lakh /BCSU X

9 centres

1.5.5

MBBs (DDUH, Hindu rao, Kasturba, SDNH, ESIH)

20.79

5

0

tender for procuring 25% consumables

(rest by NACO) in final stage

1.5.6

OTHER BBs

5.45

5

0

1.5.7 RBTCs (GTBH, Hindurao,LNH,AIIMS-LHMC, SJH,RMLH)

main,IRCS, 12.48 8 01 LT & 1 counsellor deputed in each RBTCs

19

1.5.8 BLOOD STORAGE CENTERS(Aruna Asaf Ali Hosp, GuruGovindSingh Hosp, LBSH, Shastripark Hosp, Bhagwan Mahavir Hosp, RTRMH)

0.6

1

5

NRHM has released funds for equipments to 6 hospitals

1.5.9 BLOOD TRANSPORATION VANS

9.54

To be provided by NACO

1.5.11 TRAINING

14.9

Training load (180 induction trainings, 47 refresher trainings , 24 for BSC, 40 for donor

motivation, 72 on rational use of blood) sent to NACO, Proposed for August

1.5.12 PRCUREMENTS FOR BCSU

30.46

Technical bids opened on 09-07

1.5.13 AMC

15

in final stage

1.5.15 VBD CAMPS

75

3005 camps

179 camps & Blood Donor's day observed

14th June

Funds yet to be released from SBTC,

GTB Hospital, GNCT of

Delhi

1.52.2 ARG TO SRL (MAMC, SJH, LHMC, GTB)

6

4

0

UC only submitted by MAMC & SJH

SRL, grant under release.

Qtrly Supervisory Visits for Blood Banks

0.6

19

0

Ist Qtr Visits completed for 18

BBs

1.3

INTEGRATED COUNSLEING & TESTING CENTRES

273.9

70

26 + 2 PHCs

17 + 2 (PHCs)

64.02

Salary

Consumables

Equipments

under process

TV/DVD

T.V. Supplied, DVD under process

Computers

Under supply

Training

Counsellors: Induction- 60, Refresher-71; LT-

Induction- 36, Refresher-55,

Counsellors: in July -Aug 8- 40 Induction, 40 refresher, LT-

completed 20 & refresher 40 I

Full Site ICTC sensitization-90

Under process at Hindu Rao Hospital & AIIMS

PPTCT training-16

Under process

HIV-TB-RNTCP - 200 staff

Under process

ORWs-24 under process

20

2 CARE, SUPPORT & TREATMENT

2.1 ART CENTRES 148.5 9 0 32.62

Salary

75

Contigency & operational Costs

13.5

Universal Work Precautions

9

1lakh/ART centre

TRAINING & CAPACITY BLD

21 staff to be trained in ART,(1SMO, 3 MO, 6LT, 2

Data manager, 1 Counsellor, 5 Nurses, 1 pharmacist & 2

Community Care Coordinator

3 M.O.s of CCCs trained

Qtrly Supervisory Visits

Ist Qtr completed

2.3

OI MANAGEMENT & PEP

94.5

2.4

CENTRE OF EXCELLELNCE

50

2.5

COMMUNITY CARE CENTRES (Ashrya, Akansha, BPS, Chlesea)

177.5

322

4

5

20 proposals recd-18 shortlisted for JAT VISIT, PROCESS, NEW CCCs maybe contracted by 30th July

14.73

Link ART Centres(Subject toapproval ofNACO)

0

18

No fund released by NACO. 9 Existing ICTCs maybe made LARTC with provision of ART medicines & trained M.O. for screening OIs

3

INSTITUTIONAL STRENGTHENING

115

49.23

3.1

TRAINING & CAPACITY BLD

6

3.2

ADMN COST DSACS

109

3.3

SALARY (Vacant posts- JD (Blood safety), JD (IEC), JD (TI)-Interview conducted at NACO, Quality manager, AD(Procurement, Fin. Offr), Steno

& PA to PD

43 of 56 posts filled

4

STRENGTHENING STRATEGIC INFORMATION

12

nil

4.1

SURVEILLANCE

2.01

GRAND TOTAL

1744.8

148.5

595.9

20

0

GRAND ALLOCATION VS EXPENDITURE

2489.2 498.04

21

Key Strategies for HIV Prevention:

vBehaviour Change Communication (BCC) to address specific vulnerabilities of key populations.

vPositioning condoms for triple protection, viz., STI, HIV and contraception and promoting usage, especially among youth.

vEarly diagnosis and treatment of sexually transmitted infections (STI).

vFostering an enabling environment to reduce stigma and discrimination.

MAINSTREAMING - A KEY APPROACH

What is Mainstreaming?

1. Mainstreaming is a process that enable government , public /private sector businesses and civil society organizations to address issues of HIV and AIDS through their usual work and within their work place in a sustained manner,.

2. It is a strategy to operationalize a multi-sectoral response.

3. Mainstreaming involves growing organizational consciousness and culture towards addressing HIV both within the organization (internal) and as part of the field level activities of the organization (external).

4. This requires persistent advocacy with key decision makers to build commitment at the highest level.

Need of Mainstreaming:

1. HIV/AIDS interventions under National AIDS Control programme (Phase I &II) focused primarily on High Risk Groups (Sex Workers, Intravenous Drug Users & Men having Sex with Men) & Bridge Population (Truck drivers & Migrant workers). With the spread of epidemic to general population and from urban to rural areas, soon it was realized that HIV/AIDS interventions should be done for general population as well. Since approximately >85% of HIV/AIDS infections occur in the age group 15-49 Years, which constitute the working population, the strategy of mainstreaming was launched under NACP III.

2. Also, HIV/AIDS is not a mere health issue as its occurrence is influenced by a number of socio-economic factors. Therefore, health interventions alone cannot lead to its prevention. Its prevention requires a concerted collaborative effort from all organisations in public life through their work and programmes. This integrated, inclusive and multi-sectoral approach transfers the ownership of HIV/AIDS issues – including its direct and

22

indirect causes, impact and response to various stakeholders, including the government, the corporate sector and civil society organisations. The focus of all organisations in mainstreaming is to adapt their core business to respond to the challenges of HIV/AIDS.

2. Impact of HIV/AIDS on individuals, employers /enterpriseS & government.

?Loss of skilled employees

?Large expenditure on healthcare, orphan care and social welfare

?Negative impact on programmes relating to education, livelihood, social welfare, women and child health

?Reduced revenues and lower returns on social investment.

The National Council on AIDS

A National Council on AIDS (NCA), consisting of 31 Central Ministries, has been set up under Chairmanship of the Hon'ble Prime Minister to review the mainstreaming process through the collective action of different ministries, Private Sector Organizations and Civil Society Organizations(CSOs)

Mainstreaming of HIV and AIDS is desirable in every ministry. However, based on the outreach and access to vulnerable populations, NACO has identified following key government ministries for priority attention in the initial phase:

?Tribal Affairs

?Rural Development

?Urban Development

?Tourism

?Panchayati Raj

?Home Affairs

?Labour and Employment

?Human Resource Development

?Railways

?Youth Affairs and Sports

?Social Justice and Empowerment

23

?

?Road Transport, Highway & Shipping

?Information and Broadcasting.

Delhi State AIDS Council

Delhi State has constituted Delhi State AIDS Council under chairpersonship of Hon' Chief Minister of Govt. of NCT of Delhi to provide leadership at the highest level for a multi-sectoral response to combat HIV and AIDS in the State. Govt of NCT of Delhi has identified following 6 key Delhi Govt ministries for mainstreaming HIV/AIDS intervention:

?Health & Social Welfare

?Finance, Planning & Power

?Education and Tourism

?Industries, Labour, Employment, Election and Land & Building

?Development, Revenue & Irrigation, Flood Control, Welfare SC, ST & Urban Development

?Transport and Food & Civil Supplies

Objective of State AIDS Council:

?Provide policy direction to the HIV and AIDS programme in the State;

?Demonstrate commitment at the highest level to address the challenges of HIV/AIDS through a multi-sectoral response.

?Catalyze the involvement of public and private sector stakeholders in a statewide response to HV through a framework for mainstreaming HIV/AIDS into their ongoing work.

?The Council should meet on a bi-annual basis to review the actions taken on mainstreaming as well as to provide further directions.

Women and Child Development

24

DELHI MAINSTREAMING AT A GLANCE

Focusing on HIV/AIDS an

ãemployment / Reduced revenues and lower returns on soc ia l inves tment / Decreased Savings)

ãD e v e l o p m e n t i s s u e ( N e g a t i v e i m p a c t o n p r o g r a m s r e l a t i n g t o Education, livelihood, Social Welfare, Women and Child health/ Reduced revenues and lower returns on social investment)

ãBehavioral issue (Fall out of High Risk behaviors)

ãHealth Issue (Treatment and Care)

Economic Issue (Loss of

Mainstreaming –A strategy to operationalize multi-sectoral response

In the context of Delhi the following Departments have the largest outreach and access to vulnerable populationLabour

• 90% infected people are in age groups of 15-49 years which is working population.

• The AIDS policy of the Govt. of India stresses that organized and unorganized sector of industry needs to be mobilized for taking care of the health of the productive sections of their workforce

• HIV/AIDS is a workplace issue and the workplace has a vital role to play in the wider struggle to limit the spread of the virus

Women and Child Development• 39.3% of those living with HIV are women• Low socio-economic status and limited

educational opportunities, women and girls often lack basic information about HIV/AIDS

• Almost 85% of infections in women result from sex with their husbands or partners

• Majority are monogamous women• Department has greater outreach among

women

Home• Large employee base• Long working hours• Large section of the employees stays

M a i n s t r e a m i n g process that enables G o v e r n m e n t , public/private sector business and civil society organizations to address issues of H I V / A I D S i n a sus t a ined manner through their usual work

25

Status of Mainstreaming Intervention in Delhi

?Workplace Intervention Projecttechnical as well as financial support from International Labor Organization (ILO). WPI is presently a part of Mainstreaming under National AIDS Control Programme (Phase III), with technical & financial support from NACO, GOI.

?Stakeholder's Meeting was organized in May 2006 at Delhi Secretariat wherein posters prepared by ILO were launched. The meeting was attended by 41 stakeholders from industries, trade unions, employers associations, Public Sector Units and NGOs. .Representatives from NDPL, DJB, Indian National Trade Union Congress (INTUC), Confederation of Indian Industries (CII), Federation of Indian Chamber of Commerce & Industries (FICCI), Hind Majdoor Sabha (HMS) & All India Organization of Employers gave their consent for starting HIV/AIDS intervention in their organizations.

?The Sensitization Meeting for members of Employer Association - FICCI (Federation Of Indian Chamber Of Commerce & Industries) was organized & attended by 8 companies. Intervention was initiated in Paharpur Business centre having workforce of 500.

?Labor Department: Three one day HIV/AIDS sensitization programs were organized to cover the staff of labor Department.

?Intervention with Trade Unions: INTUC: Intervention for 300 Embroidery & 250 Construction Workers of Seelampur has started, HMS: Intervention for 500 railway coolies, hawkers & vendors of New Delhi Railway Station has started.

?Sensitization Programme for Delhi Secretariat staff was organized for 192 participants.

?Enterprise Based Approach (PSUs): NDPL: Intervention started in workforce of 3750, DJB: Intervention started in workforce of more than 25000.

?Department of Social Welfare: Intervention has started in more than 5000 Anganwadi Workers of Integrated Child Development Scheme.

?Sensitization for DC office staff: DSACS has conducted Sensitization program for the staff of DC office of East, West , Central and North East

?Positive Public Speaking for People Living with HIV/AIDS (PLHAs): PLHA can share their experience more effectively with the Workforce. The training was attended by 31 PLHAs from various networks like DNP+, NAZ Foundation, Modi care foundation, Love Life Society and Sahara. In all training programmes, PLHAs are invited for experience sharing and tackling the problem of stigma & discrimination.

?Department of Industries: Intervention has been initiated with sensitization programme of staff of Tool Room Training Centre, Wazirpur Industrial area.

Proposed New Interventions under Mainstreaming in 2008-09

1. Department of Home Affairs:

(WPI) was launched by DSACS in the year 2006 with

26

a. 20 Sensitization programs for 600 wardens of Tihar jail.

b. Training of 30 wardens as master trainers for creating internal resource

c. Provision of HIV Counseling & Testing Services in Tihar Jail.

d. Central Industrial Security Force (CISF): Training of 30 peer educators, sensitization programs for work force of 3000, Condom Vending Machines would be installed

2. Department of Industries: Training Program for peer educator of Tool Room Training Centre of Okhla Industrial area. Training of the staff of Society of Self Employment.

3. IEC program for Migrant workers: 5 Migrant Information Centers would be opened in industrial zones with the help of NGOS or employer associations wherein IEC material of different language would be made available and frequent health camps and HIV/AIDS documentary film projections would be conducted.

4. Civil Society Organizations: Intervention will be started with Bhartiya Majdoor Sangh (BMS) & CITU.

Specific Role of Each Department:

1. Department of Urban Development

Key areas of HIV/AIDS Mainstreaming:

The Ministry could mainstream HIV in its programmes through:

?Identify a focal person in the department for coordinating with Delhi State AIDS Control Society.

?HIV/AIDS sensitization programmes of staff working with the department.

?Identification of sites for installation of Condom vending machines.

?Providing wage employment to HIV positive persons and their families living below the poverty line within the jurisdiction of urban development department.

?Including training on HIV/AIDS for trainers, elected representatives, functionaries of Urban Local Bodies and field functionaries like project officers, community organizers, etc., under the IEC component.

?Ensuring access to condoms in all these areas; free condom supply to vulnerable groups such as rag pickers.

?Providing space at strategic locations like markets, public parks, bus stations, etc. for putting up hoardings about HIV.

?Advocacy programmes for elected representatives and other opinion makers in the local bodies.

2. Department of Tourism

Key areas of HIV/AIDS mainstreaming

?Identify a dedicated nodal/focal person in the department to work on mainstreaming HIV/AIDS in coordination with DSACS.

27

?

?HIV messages on hoardings erected at Delhi Tourism Transportation Development Corporation Ltd wine shops, offices, hotels etc with technical & financial support of DSACS.

?Identification of suitable sites for installation of Condom Vending machines.

?Arrange for free HIV IEC stall to be run by DSACS during fairs at Delhi HAAT

?Arrange for HIV/AIDS sensitization for students & staff of institutes conducting management courses for tourism & hotel industry under Delhi Tourism Department such as Delhi Institute of Hotel Management & Catering Technology, Institute of Tourism & Travel Management etc.

?Arrange for HIV/AIDS sensitization of 800 guides registered with the department.

?Display of HIV/AIDS IEC material at Airport outlets under Tourism Department.

?Display of HIV/AIDS prevention messages on Tourist Buses & tickets.

3. Department of Home Affairs:



?The Department of Home could mainstream HIV in its policies and cadres/forces by including/expanding HIV prevention education, including new recruits and strengthening care for HIV positive personnel.

?Include HIV and AIDS in training curriculum in partnership with Training Departments

?Advocate & sensitize prison wardens and prisoners

?Advocate & sensitize home-guards deployed at the state levels

?Establish ICT Centers

?Establish a support groups for people living with HIV.

?Identify and train jawans living with HIV in positive speaking

?Design and implement campaigns to reduce stigma and discrimination by identifying AIDS Ambassadors

4. Department of Labour and Employment



?Training of Labour Inspectors & Factory Inspectors to initiate HIV/AIDS Intervention in different private units existing in the state.

?Legislation to mandate workplace policies on HIV/AIDS and effective prevention programmes, with focus on sectors employing migrant/mobile groups (e.g. construction, highways etc.) to enforce HIV/AIDS code of conduct within workplaces.

Advocacy with representatives of Hotel federations/ hotel owners and ancillary industry.

28

?

integrate HIV messages/interventions within their sectors.

?Mandatory prevention, care and support of HIV and HIV treatment in ESI hospitals.

5. Department of Education


?Identify a dedicated nodal/focal person in the department to work on mainstreaming HIV/AIDS

?Arrange district level seminar for Principals of Schools & Colleges to sensitize them for effective implementation of School AIDS Education Programme by teachers.

?Constitute Red Ribbon Clubs with a minimum membership of 30-40 students in every school and college over a period of two years.

?Make one question on HIV/AIDS compulsory in all board exams (/CBSE/ISCE).

?Orientation of Programme Officers (NSS and NYK coordinators) at State/District level to initiate special interventions for young people in vulnerable circumstances and risk prone settings/areas including counseling facilities/centers where youth/adolescents could receive necessary information, counseling , legal advice on various issues including substance abuse, sexual harassment and abuse, which could be set up in partnership with civil society and connected departments like police, legal affairs, Women and Child Development, Social Justice and Empowerment, etc.

?Support interventions at the grassroots level, which includes mobilization of especially vulnerable women/young people, strengthening accurate knowledge on sexuality, gender and HIV/AIDS, training community volunteers, helping reduce stigma and assisting affected community members to cope with the epidemic, increasing access to condoms and encouraging communities to avail free testing facilities and early treatment of STIs.

?Promote leadership skills among youth to enable them to play a proactive role for the elimination of stigma and discrimination against marginalized communities in vulnerable circumstances and PLWHA.

?Integrate peer education interventions on HIV prevention through Youth Clubs and

?Youth Development Centers after training and orientation of motivated members and volunteers.

6. Department of Social Welfare


?Identify a dedicated nodal/focal person in the department to work on mainstreaming HIV/AIDS in coordination with DSACS

?Integrate HIV and access to comprehensive services package into anti-trafficking initiatives.

?Incorporate HIV/AIDS in all Women and Child Development training programmes.

Advocate with public sector undertakings, business community and Labour unions to

29

?

Officers, Supervisors and Anganwadi workers, in the training content on HIV prevention integrated in the State Training Institutions curriculum.

?Scale up essential services on nutrition, care and support for women and children affected and infected by HIV/AIDS.

?Orientation of NGOs functionaries working with the department on HIV/AIDS and relevant issues to mainstream discussion on HIV during women SHG meetings.

?Support establishment of Red Ribbon Clubs among adolescent girls and provide them access to life skills and to HIV/AIDS prevention education focusing on rural communities in particular.

?HIV/AIDS Sensitization & display of IEC material at night shelters, women hostels,

?HIV/AIDS Sensitization in Juvenile Observation Homes at Delhi gate, Majnu ka Tila & Kingsway camp etc. in collaboration with DSACS.

7. Department of Transport



?State road transport authorities to ensure HIV messages carried on all medium and heavy vehicles in both public and private sector.

?HIV/AIDS prevention and control unit to operate in association with the Associations of Truckers focus on prevention of HIV among FSWs and truck drivers and promote condoms social marketing.

?To display HIV/AIDS messages at all Bus Queue shelters /Hoardings at major DTC Terminus in the state.

?Sensitization of employees / workforce on HIV/AIDS and provide them a comprehensive package of services.

8. Department of Health

?HIV /AIDS prevention message on OPD cards in all hospitals & dispensaries under Delhi Govt, MCD, NDMC & Cantonment Board.

?All govt. health outlets be directed to coordinate with DSACS for smooth functioning & timely reporting of service outlets under DSACS such as ICTCs, ART centers, STI clinics, Blood banks etc

?Sensitization programs for medical, paramedical & ancillary staff in coordination with DSACS.

?Identification of suitable sites for installation of Condom Vending machines.

?Ensure proper biomedical waste management, universal work, precautions & availability of PEP drugs round the clock to protect health manpower.

Integrate HIV/AIDS in the ICDS Schemes for Community Development Project

30

9. Finance, Planning & Power

?

?Identification of suitable sites for installation of Condom Vending machines

10. Industries, and Land & Building,


?HIV/AIDS Sensitization of staff in coordination with DSACS

?Training of staff of different training institutes under department of Industries

?Identification of suitable sites for installation of Condom Vending machines

?Initiating interventions for workers in different industrial areas with the help of existing employer associations

Role of Civil Society Organisations

A large number of NGOs are working in non-HIV sector. Efforts should be made to mainstream HIV and AIDS issues into their existing programmes.

Activities that can be taken up by non health NGOs/ CBOs include the following:

Depending on the size of the NGO/CBO, its key mandate and sphere of influence, the following broad activities may be undertaken by the NGOs/ CBOs:

1. For NGOs with a large membership having a Workplace Policy may be useful. This must also ensure that infected employees and their immediate dependants if also infected receive Anti Retro Viral Therapy and medical monitoring.

2. For NGOs with a cadre of outreach workers it may be useful to:

a. Build their capacity to spread HIV prevention and care message within their communities.

b. Strengthen their knowledge about existing services so that they in turn can refer community members to the right service provider.

c. Provide them access to the condoms so that they may promote it during their interaction with communities.

d. Provide pamphlets, handouts, IEC material for wider dissemination within communities.

3. For NGOs with the specific mandates, customized programmes must be develope based on their strengths and the needs of the state response e.g.:

a. Those working on RCH must be given relevant training and information to identify expectant mothers and educate them on PPTCT, encourage them to go for voluntary testing and seek prevention facilities. This will help SACS achieve its target of reducing PPTCT.

b. Those working on economic empowerment and vocational training could be sensitized so that their community programmes may benefit PLHA and

HIV/AIDS Sensitization of staff in coordination with DSACS

31

vulnerable communities.

c. Training concerned NGOs to see the linkages between HIV/AIDS and the drivers of the epidemic such as gender inequality, poverty and unsafe migration.

d. NGOs working with PRI institutions must be trained on role of PRI leaders in HIV response, provided pamphlets that they can share with PRI leaders at various levels and training material for sensitizing PRI leaders on HIV/AIDS.

e. Organizations working with youth and adolescents on life skills education must be trained on how to integrate relevant HIV related information into their ongoing life skills education.

f. Building capacity of NGOs to work as advocacy groups with local governance and political leadership through various committee at national, state, district, and village levels

g. Organizing youth camps on Healthy Sexual Behavior, SHG Women's Campaign on gender, HIV and AIDS and Women's rights.

4. Set up Family Counseling and Shelter Homes, if feasible, for infected Women and their children.

5. Set up integrated Counseling and Testing Centers (ICTCs) and other service provisions, if feasible, in collaboration with SACS and NACO.

6. Work with Faith-Based organizations to sensitize faith leaders to integrate HIV and AIDS prevention messages in their discourse and activities.

Role of Corporate Sector

Corporate or private sector has a significant stake in the well-being of the nation. Since the majority of HIV affected people in our country are in the productive age group of 15-49, workplace interventions are significant both in the prevention of infection, and treatment and care for the infected.

Workplace Interventions

One of the most effective ways of reaching out to the workforce is through instituting the practice of information dissemination on prevention. A number of companies across India have taken up such campaigns and programmes within their corporate and field locations. Corporate sector also plays a major role in removing stigma and discrimination as most people spend most of their time at work.

32

List of Service Outlets of DSACS:

Integrated Counseling and Testing Centers

S. No.

Name of the Hospital/ Centre Address District

1. LOK NAYAK JAYPRAKASH HOSPITAL JAWAHAR LAL NEHRU MARG, NEW DELHI Central

2. MAULAN AZAD MEDICAL COLLEGE BAHADHUR SHA JAFAR MARG, NEW DELHI Central

3. LAL BAHADUR SHASTRI HOSPITAL (PPTCT)

GYN OPD , ROOM NO -40, KHICHRIPUR, DELHI East

4. LAL BAHADUR SHASTRI HOSPITAL ROOM -40, KHICHRIPUR, DELHI East

5. ST JOHN AMBULANCE BRIGADE (ANAND VIHAR)

FIRST AID POST ICTC, ISBT ANANDVIHAR, DELHI East

6. DR HEDGEWAR AROGYA SANSTH AN (PPTCT)

KARKARDOOMA, DELHI East

7. CHACHA NEHRU BAL CHIKTSALAY GEETA COLONY, DELHI East

8. DR HEDGEWAR AROGYASANSTHAN KARKARDOOMA, DELHI East

9. RAM MANOHAR LOHIA HOSPITAL((PPTCT)

GYNAE OPD , ROOM NO -11, BABA KHADAK SINGH MARG, NEW DELHI

New Delhi

10. MRS GIRDHAR LAL MATERNITY HOSPITAL

ROOM NO -1 , FIRST FLOOR NEAR KAMLA MARKET THANA , AJMERI GATE , NEW DELHI

New Delhi

11. SUCHETA KRIPLANI HOSPITAL (PPTCT) PANCHKUIAN ROAD, NEW DELHI New Delhi

12. RAM MANOHAR LOHIA HOSPITAL BABA KHADAK SINGH MARG, NEW DELHI New Delhi

13. LADY HARDING MEDICAL COLLEGE PANCHKUIAN ROAD, NEW DELHI New Delhi

14. NDMC POLYCLINIC 37, SHAHEED BHAGAT SINGH MARG, NEW DELHI New Delhi

15. HINDU RAO HOSPITAL (PPTCT) GYNAE OPD, III FLOOR , 323 ROOM, BARA HINDU

RAO, DELHI-110007 North

16. SANJAY GHANDHI TRANSPORT NAGAR (DSSW)

PORTA CABIN , OPPOSITE CW -544 , SANJAY GANDHI TRANSPORT NAGAR, DELHI -110042

North

17. MITWA -10 DELHI STATE AIDS CONTROL, ROHINI SECOTOR -6 North

18. MITWA-13

CHHAVI HEALTH AND EDUCATION SOCIETY, 256 , 1ST FLOOR , DHIR PUTR , MAIN ROAD, NIRANKARI COLONY

North

19. WUS HEALTH CENTRE , DELHI UNIVERSITY

CHHATRA MARG, DELHI UNIVERSITY, DELHI -7 North

20. ISBT KASHMIRI GATE(ST JOHN AMBULANCE)

ISBT , KASHMIRI GATE, DELHI-110006 North

21. ARUNA ASAF ALI HOSPITAL RAJPURA ROAD, DELHI-110054 North

22. KASTURBA HOSPITAL DARYA GANJ, JAMA MASZID, DELHI -110006 North

23. DAD DISPENSARY (WAZIRPUR) WAZIRPUR, DELHI North

24. DAD DISPENSARY(ASHOK VIHAR) ASHOK VIHAR PHASE 3, DELHI North

25. DAD DISPENSARY (TIMARPUR) TIMARPUR, DELHI-110054 North

26. HINDU RAO HOSPITAL BARA HINDU RAO, DELHI-7 North

27. RANJAN BABU TB HOSPITAL KINGSWAY CAMP, DELHI -110009 North

28. NICD 22, SHAMNATH MARG, DELHI-110054 North

29. GURU TEG BAHADUR HOSPITAL(PPTCT) GYN OPD ROOM NO -708,DHARAMSHALA

BUILDING, SHAHADARA, DELHI North East

30. MITWA-9 DILSHAD GARDEN , DAD DISPENSARY, A 13 F, DDA

MIG FLATS, DELHI North East

31. MITWA -11 DILSHAD GARDEN, DAD DISPENSARY,A 13F, DDA

MIG FLAT, DELHI North East

32. SWAMI DAYANAND HOSPITAL SHAHADARA, DELHI North East

33. UNIVERSITY OF MEDICAL COLLEGE SHAHADARA, DELHI North East

34. MITWA -4 SATYAVADI RAJA HARISH CHANDRA

HOSPITAL,NARELA, DELHI North West

33

34

35. MITWA-6

DELHI ADMINISTRATION DISPENSARY, DDA BULIDING , B BLOCK , PRASHANT VIHAR, SECTOR -14 , ROHINI, DELHI-110085.

North West

36. MITWA- 7 PRASHANT VIHAR DISPENSARY , DAD BUILDING, B BLOCK , PRASHANT VIHAR, SECTOR -14 , ROHINI

North West

37. BABA SAHEB AMBEDKAR HOSPITAL ROHINI, SECTOR-6, DELHI-110085. North West

38. SANJAY GHANDHI MEMORIAL HOSPITAL MANGOLPURI. DELHI. North West

39. BABA SAHEB AMBEDKAR HOSPITAL (PPTCT) ROHINI, SECTOR-6, DELHI-110085. North West

40. BABU JAGJIVEN RAM HOSPITAL JAHANGIRPURI, DELHI North West

41. BHAGWAN MAHBIR HOSPITAL PITAMPURA, OPP. SAINIK VIHAR, DELHI-34 North West

42. MAHARISHI BALMIKI HOSPITAL POOTH KHURD, DELHI North West

43. SATAYAWADI RAJA HARISH CHADER HOSPITAL NARELA, DELHI North West

44. MITWA - 1 SAFDARJUNG HOSPITAL, RING ROAD, NEW DELHI South

45. MITWA -3 BER SARAI , DAD DISPENSARY, NEW DELHI South

46. MITWA -12 BER SARIA , DAD DISPENSARY BUILDING , 1ST

FLOOR, NEW DELHI South

47. AIIMS (PPTCT)

ANSARI NAGAR, RING ROAD, NEW DELHI-29 South

48. SAFDARJUNG HOSPITAL(PPTCT)

RING ROAD, NEW DELHI South

49. AIIMS HOSPITAL

ANSARI NAGAR, RING ROAD, NEW DELHI-29 South

50. SAFDARJUNG HOSPITAL

RING ROAD, NEW DELHI South

51. JAMIA MILLIA ISLAMIA UNIVERSITY

JAMIA NAGAR, NEW DELHI

South

52. SPYM

ICD LAL KUAN, TUGLAKABAD, NEW DELHI

South

53. SARAI KALA KHAN (ST JOHN AMBULANCE)

SARAI KALA KHAN, NEW DELHI South

54.

CGHS MATERNITY HOME

R.K.PURAM, SECTOR-12, DELHI

South

55.

DAD DISPENSARY (DHAKHINPURI)

DHAKHINPURI, NEW DELHI

South

56.

DAD DISPENSARY (KHANPUR)

KHANPUR, NEW DELHI

South

57.

LALA RAM SWARUP HOSPITAL MEHRAULI ROAD, NEAR QUTUB MINAR, NEW

DELHI South

58.

D.F.I.T (CENTRE ) GOYELA DAIRY MARGARET LEPROSY & TB CENTRE ,QUTUB VIHAR

PHASE-I,GOYELA DAIRY MAIN ROAD,NEAR POLICE CHECK POST, NAJAFGARH, NEW DELHI

South West

59.

RAO TULA RAM MEMORIAL HOSPITAL ROOM NO 101A NEAR GROUND FLOOR,JAFFARPUR,

DELHI South West

60.

JAWAHARLAL NEHRU UNIVERSITY

JAWAHARLAL NEHRU UNIVERSITY, NEW DELHI

South West

61.

ARMED FORCE TRANSFUSION CENTRE

AFTC, DELHI CANT, DELHI-10

South West

62.

RAO TULA RAM MEMORIAL HOSPITAL(PPTCT)

ROOM NO 101A NEAR GROUND FLOOR,JAFFARPUR, DELHI-10

South West

63.

ST JOHN AMBULANCE BRIGADE(BRIJWASAN)

FIRST AID POST & DOT CENTRE OPP RAILWAY STATION , NEAR PLATE FORM NO -2, BRIJWASAN, NEW DELHI

WEST

64.

MITWA -5

VIKASPURI DAD DISPENSARY,BLOCK KG-1, DDA FLATS , NEAR SAGAR RATNA, NEW DELHI

WEST

65.

DEEN DAYAL UPADHAYA HOSPITAL(PPTCT)

HARI NAGAR, NEW DELHI-110068

WEST

66.

ACHARYA SHREE BHIKSHU HOSPITAL

MOTI NAGAR, NEW DELHI

WEST

67.

SARDAR VALLABH BAI PATEL HOSPITAL

PATEL NAGAR, NEW DELHI

WEST

68.

DFIT(NGO) DWARKA PURI

VIJAY ENCLAVE DRARKAPURI, NEW DELHI

WEST

69.

DEEN DAYAL UPADHYA HOSPITAL

HARI NAGAR, NEW DELHI

WEST

70.

GURU GOVIND SINGH HOSPITAL

RAGHUBIR NAGAR, NEW DELHI

WEST

ART CENTRES

S. No.


1. Ram Manohar Lohia Hospital Room No. 4, 1st Floor, Casualty Block, Dr. Ram Manohar Lohia, Hospital, Baba Kharak Singh Marg, New Delhi-110001, Tel:23404621, 23404610, Email: rmlhart_jp @ yahoo.com , 9811629462

New Delhi

2. Lok Nayak Hospital Room No. 32, OPD Block, Gate No. – 4, LNJP Hospital, Delhi Gate, Delhi – 110002, Tel:23232794, 23234200, Extn. – 4357, Email:[email protected],

Central

3.

AIIMS

Room No. 30, New Medicine Block , All India Institute of Medical , Sciences, Ansari Nagar (Ring Road), New Delhi – 110029, 26588700, 26588900, Extn.:3378

South

4.

Lala Ram Swaroop Instt.

Room No. 112, Ist Floor, Lala Ram Swaroop Instt. Of TB and , Respiratory Diseases, Sri Aurobindo Marg, (Near Kutab Minar), New Delhi – 110030, Tel:26854922, Extn.-551, Email:[email protected]

South

5.

Deen Dayal Upadhyay Hospital

ART Room, Skin Dept, 1st Floor, OPD-5, Deen Dayal Upadhayaya Hospital, Hari Nagar, New Delhi – 110064, Tel:25494402 – 08, Exten. – 355

West

6.

Guru Tegh Bahadur Hospital

Room No.- 4, Ground Floor, OPD Block, Guru Teg Bahadur Hospital , UCMS, Taharpur Road, GTB Enclave, Sahadara, Delhi – 110095, Tel:22586262, 22581864m, Extn. – 167,

North East

7. Safadarjang Hospital

ROOM #557(smo room), 556, 544, 545. FLOOR-V, MAIN OPD, SAFDARJANG

HOSPITAL NEW DELHI – 110029,

South

8. Kalawati Sharan Children Hospital

ART center, Department of pediatrics, Kalawati Saran Children Hospital, Bangla Sahib Road, New Delhi - 110001

New Delhi

9. Baba Saheb Ambedkar Hospital

Baba Saheb Ambedkar Hospital , Sec 6, Rohini , New Delhi 110085

North West

COMMUNITY CARE CENTERS

S. No.

Name of the Centre Address District

1. Akankshya Care And Support Home

B - 17/4, West Jyoti Nagar, Shahadara, East

2. Bhartiya Parivardhan Sanstha

H.No 3 ,daroga Markets Wali Gali,burari Chowk,

North

3. Child Survival India

Multipurpose Community Centre, Village Khera Khurd,

North West

4. Ashraya Holistic Care Centre

Multi Purpose Community Centre, Village Rajokari

South West

35

STI CLINICS

TARGETED INTERVENTION PARTNERS

36

S. No.


1. Lal Kuan Dispensary MCD Lal Kuan Central

2. Lok Nayak Jayaprakash Hospital Department of Dermatology & STD, Bahadurshah Zafar Marg

Central

3. Lady Hardinge Medical College, Dermatology & STD, Central

4. Ram Manohar Lohia Hospital Baba Khadak Singh Marg, New Delhi

5. G. L. Maternity Hospital Department of Dermatology & Std, Azmari Gate

New Delhi

6. Hindu Rao Hospital

Department of Dermatology & STD, Bara Hindu Rao North

7. MCD Dispensary Roshanara Road North

8. Guru Teg Bahadur Hospital Department of Dermatology & STD, UCMS, Shahdara North East

9. Safdarjung Hospital Department of Dermatology & STD, Ring Road South

10. AIIMS Department of Dermatology & STD, Ansari Nagar South

11. Deen Dayal Upadhayay Hospital VD Clinic, Association For Social Health in India, Rouse

Avenue West

S. Name of the Hospital/Centre Address DistrictNo.

1. BARD 8445, 3rd Floor, Gali No. 1, Arya Nagar, CentralMSM Paharganj

2. Womens Action Group Chelsea B17/4, West Jyoti Nagar, Shahdara CentralNon Brothel Based CSWMSM

3. Indian Medicine Development 106, Pathak Bans, Sirkiwalan, Lala Kuan CentralTrust Delhi-6

4. Shakti Vahini 2510, Hudson Lane, Kingsway Camp, CentralDelhi-9

5. Anchal Charitable Trust A-1/24, Near Kamini Photo Studio, EastNon Brothel Based CSW Rani Garden, Geeta Colony

6. Advantage India 9511/1, Gali No. 12, Pahar Ganj, New DelhiNon Brothel Based CSW Multani Dhaba

7. ASEED ASEED House, C-8/8007, Vasant Kunj, New DelhiIDU

8. Delhi School of Social Work 3, University Road NorthSocietyNon Brothel Based CSW, MSM

9. SPYM (Society for the B-3/3054, Vasant Kunj NorthPromotion of Youth & Masses)Non Brothel Based CSWMSM

10. Sharan 1 Ghat No. 2, Yamuna Bazar, Gali B. NO. 2 NorthDelhi-110006

11. Child Survival, India 33C-2-1, Dilshad Garden North EastNon Brothel Based CSWIDU

37

12. Anchal Charitable Trust Flat No. 167-A, Mansarovar Park, North EastNon Brothel Based CSW ShahdaraMSM

13. Social Action with Your 61-B, Surya Apt., Kalkaji Extn. North EastAssistance (SAYA)Non Brothel Based CSW

14. Jagriti Yuva Manch (Regd.) Sunder Nagri, Development Project, North EastNon Brothel Based CSW F-2, Park Sunder Nagri, Nand Nagari Extn.

15. Maa Ratni Harpat Memorial Public School, North EastMSM Opp. C-Block, Gokal Puri,

16. Bhartiya Parivardhan Sanstha Basti Vikas Kendra, D/1, Nand Nagri North EastNon Brothel Based CSW

17. BPS D.D.A. Market, H.No.-55 A, Shastri Park North East

18. All India Center for Urban 16, Bhai Veer Singh Marg, Gole Market North Westand Rural DevelopmentNon Brothel Based CSW

19. Society for Social Service D-464-64, Jahangirpuri North WestNon Brothel Based CSW

20. Aradhya 15, Bhalsva Village, New Delhi-110018 North WestMSM

21. Sharan II C-Block 1988, Jahangir Puri North WestIDU

22. Drishtikon D-4/273/274, Sultanpuri, Jagdamaba Chowk North WestNon Brothel Based CSW

23. SOSVA 1st Floor,Community Centre (Near Fire SouthNon Brothel Based CSW Station) Hari Nagar Ashram

24. PHD Family Welfare Foudation PHD House, Ramakrishna Dalmia Marg, SouthNon Brothel Based CSW

25. PRAYATN 552/1, Tuglakabad Extension, SouthNon Brothel Based CSW Tara Apartment Kalkaji

26. ISDO IInd Floor, MCD Community Centre, SouthNon Brothel Based CSW Sunlight Colony-I, Near DESU Colony

27. Nav Jyoti Development Society Gali No. 6/106, Dakshin Puri SouthNon Brothel Based CSW

28. EFRAH B1-163, (243), J.J. Colony, SouthNon Brothel Based CSW Madanpur Khadar

29. Kamath A-23, 24, Phase-II, Shyam Vihar, South WestNon Brothel Based CSW Najafgarh

30. Model Rural Youth Development 80-A, B-Block, Phase-III, Prem Nagar, South WestOrganisation (Non Brothel Based NajafgarhCSW)

31. Nirmana 484, Millenium Apt., Sector 18,Rohini South WestNon Brothel Based CSW

32. Urida WZ-33A, Dayalsar Marg, Uttam Nagar South WestNon Brothel Based CSW

34. JEET F-9/63, Sector-15, Rohini South WestNon Brothel Based CSW

35. ALAMB 205F, Near Anupam Restaurant, South WestMunirka, New Delhi

36. Prayas C-8/8053, Vasant Kunj, New Delhi-70 South West

Contact Details

Ph.: 27055722, 27055724, 27055725. Fax: 27055720 E-mail: [email protected]

Sr. No.

Officer/Official Direct No. Mobile No. Extn. No.

1. Dr. B.S. Banerjee, Project Director 27055717 9999434400 215

2. Dr. A.K. Gupta, Addl. Project Director 27055650 9868082740 213

3. Dr. Somashekhar, Joint Director (Basic Service) 9968116977 216

4. Dr. P.N. Hans, JD (S&T) 9811112592 212

5. Dr. Atul Chand Gupta /

Dr. Neena Gambhir DD (STD)

9312374467 /9868212274

207

6. Dr. I.C. Sharma , DD (Surveillance, M&E) / JD

(Blood Safety)

9350743868 231

7. Mr. Mateen Khan , Consultant (VBD)/ JD (IEC) 9899443939 233

8. Ms. Nidhi Rawat, Consultant (Main Streaming) 9868620041 220

9. Sh. J.K. Mishra, M&EO/ TI 9818360797 221

10. Dr. Subhra Raina , AD(STD) 233

11. Sh. Bipin Chand Joshi, AD (TI) 9868786757 226

12. Ms. Richa Jha, AD (ICTC) 9311677782 224

13. Ms. Shikha S. Saha , AD (Nursing) 9868257140 227

14. Mr. Abhishek , AD (Youth Affairs) 9868595098 225

38

DROP IN CENTRE

S. No.


1. Jagriti HIV/AIDS organization (support group)

WZC – 28, Om Vihar, Uttam Nagar, New Delhi -110059

South West

HIV hits hardest at the most productive age groupHIV hits hardest at the most productive age group

33.5 million people in the world are living with HIV/AIDS (end of 2007)

mil

lio

n

0

10

20

30

40

Dr. Baba Saheb Ambedkar Hospital, Dharamshala Block, 1st & 2nd Floor, Rohini, Sector-6, Delhi-110085

Ph. 27055724-25, Fax 27055720E_mail : [email protected]

Delhi State AIDS Control Society

mainstreaming - a key approach to hiv prevention by dr. a.k. gupta, additional project director cum...

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