????????????????????????????????????????????TAMIL NADU STATE AIDS CONTROL SOCIETY

Introduction:

??????????? The State AIDS Project Cell formed in 1993 was re-constituted as Tamil Nadu State AIDS Control Society (TNSACS) in 1994, with the Secretary, Health and Family Welfare Department, as the President of this Society and a senior I.A.S. Officer as the Member Secretary cum Project Director, to tackle the problem of AIDS in a more effective manner with the guidance and support of various committees and sub-committees, comprising of experts from different Fields.?

Model State in AIDS Control:

v??????? TNSACS was the first AIDS Control Society formed in the country

v??????? HIV/AIDS Awareness level among the people is very high

v??????? Number of individuals availed testing and care facilities is high.

v??????? First State, which has notified and cared large number of HIV/AIDS, affected.

Activities of TNSACS :

The main components, strategies and interventions implemented by TNSACS under the AIDS Control Programme are as follows:

Information, Education and Communication:

Awareness is the key to the prevention and control of HIV / AIDS. Fear is not likely to solve any of the problems, neither is ignorance. The electronic, print and other media are fully exploited, optimising the use of the resources of TNSACS. The first phase of the IEC campaign has been a resounding success, as independent surveys of professional agencies have indicated. The campaign is already being hailed as a model for other states in the country. The emphasis has now shifted towards interpersonal communication and behaviour change communication (BCC) to ensure positive behavioural changes among the people.? The multi pronged strategy comprises of multi-media campaigns, advocacy programmes, Inter Sectoral Collaboration with all departments like Education, Mahalir thittam, Social welfare, Local panchayat elected Representatives etc and social mobilization activities are implemented centrally and at decentralized level to create an awareness on HIV/AIDS.

The following IEC activities were carried out during the year 2003/2004.?

Partnership with NGOs to reach High Risk Groups:

The involvement of NGOs in HIV/AIDS Prevention and Control Programmes aims at prevention of HIV/AIDS among Marginalised and Vulnerable Population who are at high risk.? As Tamil Nadu reached highest awareness level among General Public during the last couple of years, focus has now been shifted towards bringing behavioural changes through Targetted Interventions involving grass root level NGOs and peer educators/outreach workers/counsellors.

The Tamil Nadu State AIDS Control Society funds 621 NGOs so far.? Currently, there are 107 programmes as under in the State for different risk groups such as Sex Workers, Truckers, Industrial Workers, Prisoners, MSM, Migrant Workers, Networking with people Living with HIV/AIDS, Youth & Adolescents, Tribals & Research Studies.?? Monitoring and evaluation of NGO Programmes is being given top priority to facilitate positive behavioural changes.? Awareness, condom promotion and demonstrations, STD Care, Counselling are the important sub-components of these interventions.?

Blood Safety and Voluntary Blood Donation:

HIV can be transmitted through unscreened blood and blood products. Therefore adequate measures have been taken for the supply of safe and tested blood.? There are 79 Government Blood Banks and also 123 Blood Banks under various sectors such as Quasi-Governmental organisations, Voluntary organisations and Private sector.? These Blood Banks are testing the donor blood for HIV, Hepatitis B, Hepatitis C, Syphilis and Malarial infections.? Tamil Nadu State AIDS Control Society supplies Test kits, consumables and certain equipments to all Government Blood Banks at free of cost. Lab Technicians and Counsellors support to Government Blood Banks are also provided by TNSACS, besides imparting training to personnel handling Blood and Blood products.

The Tamil Nadu State Blood Transfusion Council (TNSBTC) closely monitors the activities of Blood Banks with the association of Drug Control authorities and State Health authorities.? Professional Blood donation has been banned since 1998.? Therefore all the necessary measures are taken by TNSACS to promote voluntary blood donation and ensure safe and adequate blood.? TNSACS has taken several measures for the same such as dissemination of the messages popularising the concept of Voluntary Blood Donation, provision of funds to Universities, District administration, Corporations, Directorates of Collegiate and School Education, Voluntary organisations & Non-Governmental Organisations for promotional activities.? Blood Donor Clubs were formed in the Colleges with the involvement of Universities. Financial Assistance is extended to Government Blood Banks towards refreshments to donars and conduction of camps, processing of Blood components and its usage are being promoted.??

Blood Collection data in Tamil Nadu:

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The numbers of Voluntary Blood Donors have gone up and consequently HIV Positivity among blood donors has come down to 0.18% which is less than national average.??? About 64.05% of Blood is collected from Voluntary Blood donors and proposed to increase further.?

Control of Sexually Transmitted Diseases (STD):

The risk of transmission and spread of HIV/AIDS among STD patients is much higher than the general population.? Therefore priority is given to STD/RTI Care and outreach activities.? There are 57 STD clinics in various Institutions including Medical College Hospitals (11), District Headquarter Hospitals (26) and Taluk Hospitals (20).? All these STD clinics are strengthened with necessary equipment and laboratory support, including Counselling facilities.? The Drugs are supplied for the effective treatment of the patients attending these STD clinics.? Counselling is provided to the attendees in outreach camps and also at STD clinics.? Condoms are supplied to the clinic attendees free of cost.? Partners of the patients are notified for improving effectiveness of the treatment and follow up services and to reduce the risk of transmission.

Condom Promotion:

Top Priority is being given to promote condom usage among people, both high-risk and low risk, to prevent transmission of HIV through sexual route of transmission and unprotected sex.? Three different strategies are adopted by TNSACS as indicated below:

???? Distribution of Free condoms (Nirodh) to the people through Health Care Institutions, STD clinics, Outreach camps and also through Non-Governmental Organisations. (NGOs)

???? Promotion of subsidised or low priced condoms (Deluxe Nirodh) among the people in Targetted Intervention areas and non-intervention areas with the support of Non-Governmental Organisations.

???? Promotion of condom usage and popularising the concept of safe sex and condom use through awareness and behavioural change communication.

???? Condoms are available in all the fair price shops in the state.

Training and Capacity Building:

In order to have better service delivery system and to have institutional strengthening in private and public sector, training activities has been given due importance by making adequate provision in Action Plan to impart training on HIV/AIDS to Medical, Para-medical and personnel of different sectors and departments.? This will positively bring capacity building among the various stake holders for a better performance in AIDS Control efforts and also to face challenges in future.?

Training Performance During 2003-2004:

Facilities to Find out HIV Infection:

Screening of HIV status of any individual is important to assess the case load in the community. Informed consent, pre test - counselling and post test counselling, confidentiality etc. are important conditions insisted upon before the results are made known to the individuals.? For this purpose, there are 43 VCTCs centres established in all Government Head Quarters Hospital and Government Medical Colleges.

Surveillance System to assess Trends:

Surveillance system is essential to assess the trend in the spread of HIV infection among both High risk and low risk population and the same is being strengthened every year.? There are 79 sentinel surveillance survey sites in the State during 2003.? The latest survey reveals that the HIV sero-positivity among STD patients is 9.2% and among antenatal mothers it is 0.75%.? HIV prevalence among Injecting Drug Users (IDUs) and Homosexuals are 63.8% and 4.4% respectively.? In order to obtain more reliable information about the trend of infection in all the areas the number of sentinel sites will be increased further during this year with the requisite supply of equipment.? Behavioural Surveillance Survey done by TNSACS reveals increased condom usage, increased risk perception and reduced sexual risk behaviour.

Care and Support for HIV/AIDS affected:

??????????? The Government accords high priority for making quality medical care and treatment accessible for opportunistic infections to the People Living with HIV/AIDS in the State.? The society is conducting training programmes for the medical and para-medical staff to sensitise them to the needs of PLWHAs and also on the need to adopt universal precautions.? The Society extends financial support for the purchase of drugs for opportunistic infections and for Post Exposure Prophylaxis (PEP) drugs. Apart from this, Private Sector has also been involved in providing care and support to PLWHAs.? At present, these Private Hospitals have been extended support from the Society.? The Society also assists the associations of People Living with HIV/AIDS with a view to provide them access to care and psycho-social support.

The Government hospital for Thoracic Medicine, is catering to a large number of patients suffering from HIV/AIDS.? The Centres for Disease Control and Prevention, Atlanta, USA has come forward to upgrade this Institution as a Regional Institute for Treatment and Research for HIV/AIDS Related Diseases.? The Government has signed a Memorandum of Understanding (MoU) with CDC, Atlanta for improving laboratories, upgrading the information systems and providing additional training facilities at the Hospital at a cost of Rs. 4.7 crores.

Programmes for Youth/adolescence and Vulnerable:

1.????? School AIDS Education Programme is conducted with the objective of creating an awareness of HIV/AIDS among School students and Teachers.? All the students studying in 9^th and 11^th standard are covered under the School AIDS Education Programme.

2.????? Peer Educators from 9^th and 11^th standard students were selected and given training to educate other students in the Schools.

3.????? During last year (2003-04),? 5216 Government and Government aided High Schools and Higher Secondary Schools and 3201 Matriculation Schools were covered under the School AIDS Education Programme.

4.????? Teachers Training modules and Flip Charts were supplied to all the Schools.? Students booklets were distributed to all the Students studying in 9^th and 11^th standards.

5.????? More than 15 lakhs students were benefited out of this School AIDS Education Programme.

Family Health Awareness Campaigns:

??????????? TNSACS has implemented 4^th round of Family Health Awareness Campaign (FHAC) in the State with the support from NACO, Govt. of India to identify the STD and RTI cases and to treat them with syndromic management, basically to eliminate aggravating factors such as STD and RTI which contributes for faster spread of HIV/AIDS.? The campaign mode approach adopted by TNSACS to reach the needy at their doorsteps has paved a way for identifying the vulnerable groups in rural and urban areas.

??????????? Total No. of? STD cases identified and treated from round 1 to round 4 are given below:

Family Health Awareness Campaign:

Voluntary Counselling and Testing Centres:

??????????? There are 43 Voluntary Counselling and Testing Centres (VCTCs) established in all Government Headquarters Hospitals and Government Medical Colleges.? They serve as Entry point for prevention and care.? Counselling and testing facilities are made available with qualified Counsellors.? Lab Technicians and these centres are under the control of Medical Officers.

??????????? Clients are encouraged to seek the facility of Counselling and Testing for HIV through NGO networks.? Post test counselling facilities are also provided.

Prevention of Parent To Child Transmission Programme:

The Prevention of Parent to Child Transmission of HIV Programme (PPTCT) is being implemented in 65 centres in Tamil Nadu including 14 Government Medical Colleges, 6 Private Medical Colleges, 28 District Government Head Quarters Hospitals, 8 Private Hospitals and 9 Corporation MCH Centres.

The goals of the PPTCT Programme are

1.????? Prevention of HIV among young people.

2.????? Prevention of unwanted pregnancies in general and especially among positive women or women whose husbands are positive.

3.????? Prevention of transmission of HIV infection from mother to her infant.

4.????? Care and support of HIV affected families.

PPTCT Programme Training is imparted to PPTCT team members in all the centres and in-house training was also given to all the hospital staff.? Counselling services are provided through Group Education, Group Counselling and individual Pre-test and Post-test counselling.? Single Window System is followed in relation to laboratory facilities for all AN where PPTCT services are available.? The beneficiaries are nearly almost 1500 mothers with HIV positive and information on Primary prevention of HIV was given to nearly 4.5 lakh mothers and almost 1.25 lakhs spouse s in our 65 PPTCT centres.

Financial Performance:

??????????? The Grant in aid received from National AIDS Control Organisation, Ministry of Health & Family Welfare and expenditure incurred are given below.

Component-wise expenses during 2003 - 04 are given below:

(Rs. in Lakhs)

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