Transcript HIV/AIDS and children with special reference to India’s response for Prevention of Mother to Child Transmission of HIV/AIDS, Treatment & Care Dr.

HIV/AIDS and children with special reference to
India’s response for Prevention of Mother to Child
Transmission of HIV/AIDS, Treatment & Care
Dr. S.K CHATURVEDI
Dr. KANUPRIYA CHATURVEDI
OBJECTIVES
To have an understanding of the issues
problem of HIV in women and children
To have an understanding of India’s
response to these problems and issues
To have knowledge of the scale up
strategy for services
Global HIV/AIDS IN 2005
• Effect on Children
• 40.3 million people are living with HIV/AIDS
• 2.3 million are children under 15 years
• 700,000 children< 15 years were newly infected with HIV
• 5,70,000 children died of HIV
• More than 14 million children <15yrs have lost one or
both parents to AIDS
ADULT HIV PREVALENCE
High Prevalence States
Rationale for PPTCT in India
27 million pregnancies per year*
1,89,000 infected pregnancies per year
Cohort of 56,700 infected newborns per
year
SCALE UP STRATEGY
 The National Prevention of mother to child transmission
of HIV (PPTCT) Programme was launched by
Government of India in December 2002 in the country in
a phased manner by adopting a multisectoral,
decentralized, phased and incremental approach
 In the first phase of the programme the medical colleges
of the six high prevalence states were covered followed
by district hospitals Care in high prevalence of these
states and medical colleges of the vulnerable and highly
vulnerable states
 In the second phase the programme was scaled up to
the district hospitals of the low prevalence states and
sub district level in high prevalence states.
PMTCT Policy and Guidelines/Targets
 National Guidelines on PPTCT were formulated in 20012002. These guidelines give directions for establishing a
PPTCT centre in ante-natal clinics, capacity building of
health care providers, implementation of PPTCT
package, M&E of the program etc.
 National AIDS Control Organisation (NACO) had set the
target to reduce HIV prevalence among pregnant women
age 15-49 yrs to below 3% in the six high prevalence
states and below 1% in the other states by 2007).
Government of India has adopted the UNGASS goals
for the PPTCT program. i.e. Reduced transmission of
Mother To Child Transmission (MTCT) of HIV to <20% by
2005 and <10% by 2010
PPTCT Intervention Package
 Group Education/ante natal care
 Pre and Post Test Counseling /partner
Counseling
 Institutional delivery and safe birthing practices
 Administration Of Nevirapine to Mother & Baby
 Counseling of mothers on Infant Feeding
Options, STIs ,Family Planning
 Follow up, Care and Support (Linkages with Vats,
ART clinics, Community Care Centers and
Hospitals for Opportunistic Infections
ARV TREATMENT
 The free ARV treatment was started in April 2004 in the 8
government hospitals.
 Currently, 54 government-funded health facilities, 9 state
government supported centres, 4 intersectoral partners and
4 NGO’s centres are providing ART in the country.
 A total of 26,485 patients are taking ART through NACO
supported 54 ART centres out of which 8323 are women
and 125 are children below 15 years of age group
ARV ( CONTD)
 11 ART centres out of above 54 have also been identified
under PMTCT programme for providing ART facilities to the
beneficiaries referred from PPTCT centres under GFATM
Project Round II. 3563 AIDS affected mothers and children
are getting ART treatment from these centres till February,
2006.
 In addition, ART services are also being provided through 3
NGO partners supported under GFATM Round-II project which
are ARCONS, Mumbai; YRG Care, Chennai; and Freedom
Foundation, Bangalore.
 These NGOs are providing ART to 4095 AIDS affected mother
and children through their 4 identified sites.
 The National ART scheme plan to scale up free ART services
to 100,000 patients by 2007 and 1,80,000 patients till August,
2010.
TREATMENT OF
OPPORTUNISTIC INFECTIONS
 The National AIDS Control Programme is
providing facility for treatment of opportunistic
infections in all the government medical college
hospitals and district hospitals in the country.
 Free treatment for tuberculosis is provided
through DOT centres throughout the country.
COMMUNITY CARE CENTRES
 A total of 85 community care centres are also
supported by the programme across the country
for providing services to critically ill AIDS
patients and for AIDS patients who do not have
anyone to look after them in the family.
 The beneficiaries also include mother and
children. All of these centres are implemented
through NGOs.
OTHER MEASURES
(a) Prevention of trafficking of women and girl
child:
UNDP in partnership with NACO and DWCD
and with support from DFID has launched a
project “Prevention of trafficking, HIV/AIDS in
women and girls (TAHA)” in June 2005 for
implementation in 11 states.
The project aims to reduce vulnerability to
trafficking and HIV by addressing underlying
causes with participatory right and gender
sensitive framework by promoting integrated
multisectoral response
CONTD.
(b) School AIDS Education Programme and
other Interventions with Young People:
School AIDS Education Programme has covered
90,000 schools of higher secondary level out of
1.50 lac schools.
 Besides this 1.5 lac students have been covered
through the “University Talk-AID” Programme being
run under the aegis of the Ministry of Youth Affairs
and Sports.
For sensitization of non-school going mostly rural
youth, “Village Talks AIDS” Programme has been
implemented covering 11,550 villages in 385
districts.
CONTD.
 (c) Targeted Intervention Projects are being
implemented for commercial sex workers, street children,
injecting drug users, migrant labour population. These
project provides services for STI clinic, condom
promotion, counselling for behavioural changes through
peer education and are operated by NGOs. Currently
1088 TI projects are functioning
 d) An intensive awareness campaign was launched on
World AIDS Day, 2004 with the theme “Women, Girls &
HIV/AIDS”. Subsequently total HIV/AIDS awareness
campaign was launched for one month duration during
2005/06which was implemented by 35 States/UTs
except Lakshadweep, Meghalaya, Daman & Diu.
CONCLUSIONS
 HIV/AIDS awareness activities, PPTCT scheme and
provision of free ART treatment has been scaled up in
India and it has helped in reduction of mother to children
transmission of HIV.
 There is still further scope for improving the coverage
and expansion of the programme at the peripheral level,
bringing greater awareness about prevention of HIV and
increasing demand for PPTCT services and expansion
of free ART scheme
 Government of India is totally committed to prevention of
HIV infection in children and for care & support of those
already infected. NACP-III is being finalized in the
current year for implementation in next 5 years. It is
planned to increase the coverage under PPTCT scheme
in high prevalence and other states. It is also planned to
extend free ART facilities to 1,80,000 patients till August,
2010.