TAMIL NADU STATE AIDS CONTROL SOCIETY

???????????? The Government continues to accord top priority for HIV/AIDS prevention programmes. Equal emphasis is also given in providing adequate care and support to people living with HIV/AIDS in the State. The Tamil Nadu State AIDS Control Society initiated several measures during the year to strengthen HIV prevention Care and Support programmes. The Sentinel Surveillance Survey and Behavioural Surveillance Survey undertaken during the year indicate that the efforts of the Government are beginning to yield desired results.

??????????? HIV Sentinel Surveillance Survey helps monitor trends in HIV infection among selected groups in the population known as 'sentinel groups' at regular intervals at regular sentinel sites. The Sentinel Surveillance round 2003 was conducted in Tamil Nadu between August 2003 and October 2003 covering 79 sentinel sites spread throughout the State. The sentinel groups covered by the Sentinel Survey are (1) STD Clinic attendees, attending Government Medical Institutions (2) Intravenous Drug Users (IVDU), (3) Female Commercial Sex workers, (4) Men having sex with Men (MSM) and (5) ANC clinic attendees. The Survey indicated that the prevalence of HIV among general population as reflected in the ANC clinics attendees, came down to 0.75% (median) during 2003 as against the prevalence of 0.87% (median) during 2002. The HIV prevalence among the STD attendees also showed a decline from 14.80% in 2002 to 9.20% during 2003. The HIV prevalence among the female commercial sex workers, which was included for the first time in the survey, stood at 8.80%. In respect of IVDUs and MSMs, the prevalence showed an upward trend during the year. The prevalence among IVDUs went up from 33.80% to 83.80% and the prevalence among MSM went up from 2.40% to 4.40%.

AWARENESS CREATION

Awareness creation is the prerequisite for effective HIV prevention programmes. The Society has succeeded in creating sufficient awareness about HIV/AIDS among various sections of the Society. The Behavioural Surveillance Survey indicates that high level of awareness on HIV/AIDS has been created among the high-risk groups as well as the general population. Considerable success has also been achieved in reducing the extent of myths and misconceptions surrounding HIV/AIDS in the society. Further, Information, Education and Communication (IEC) interventions have also been launched to reduce the stigma and discrimination associated with HIV/AIDS and also to safeguard and protect the human rights of People Living with HIV/AIDS (PLWHA).

SCHOOL AIDS EDUCATION PROGRAMME

Tamil Nadu is a pioneering State in introducing HIV/AIDS information in regular school curriculum. Apart from this, the Government of India funded School AIDS Education Programme is also under implementation in the State. During 2003-2004, for the first time, all the 8417 High Schools and Higher Secondary Schools including Matriculation Schools both in the public and private sector have been brought under this programme. UNICEF and the USAID assisted APAC Project have extended their support for the programme in the State.

TARGETED INTERVENTIONS

HIV prevention programmes especially targeted at high-risk groups are called the targeted interventions. Effective targeted interventions are necessary not only to protect high-risk groups from contracting HIV, but also to prevent spread of HIV among the general population. Presently, the Society is implementing 75-targeted interventions, of which, 20 are aimed at Commercial Sex Workers (CSW), 15 at Truckers, 31 at Industrial and Migrant Workers and 2 at MSM. The targeted interventions are implemented through Non-Governmental Organisations (NGO), who plays a crucial role in combating the HIV/AIDS epidemic.

REDUCING THE BURDEN OF SEXUALLY TRANSMITTED DISEASE (STD)

A high burden of Sexually Transmitted Diseases (STD) in the society makes it highly vulnerable to HIV/AIDS. Reduction of burden of STD is therefore, an important strategy in the fight against HIV/AIDS. The Society extends support, through provision of infrastructure facilities, equipments and drugs, to 57 STD clinics in Tamil Nadu. Further, the knowledge and skills of the Medical Officers are improved through CME Programmes. Measures have also been taken to bring about appropriate attitudinal changes among the medical and para-medical staff in the STD clinics to make them patient friendly.

Family Health Awareness Campaign (FHAC)

The Family Health Awareness Campaign (FHAC) is an important strategy to identify and treat Sexually Transmitted Diseases among general public. FHACs have been conducted in Tamil Nadu from 1999 to 2003 every year with the support from National AIDS Control Organisation, Govt. of India. During 2003, FHAC camps were conducted in as many as 14,889 locations covering the entire State with adequate multimedia publicity and as a result, the number of persons with STD identified and treated in these camps went up from 6,63,330 in 2002 to 11,05,047 in 2003, of which, 8,31,986 were women.

Condom Promotion

??????????? Top priority has been given to promote condom usage among people, both high risk and low risk, to prevent transmission of HIV through sexual route of transmission.? NGOs have been involved in social marketing of condoms. Condoms are also now available in the fair price shops in the State.

Blood Safety

HIV/AIDS can be transmitted through blood and blood products.? Therefore adequate measures have been taken for the supply of safe and tested blood.? The Tamil Nadu State Blood Transfusion Council closely monitors the activity of the Blood Banks with the association of the Directorate of Drugs Control. Voluntary donors play a major role in ensuring supply of safe blood. As a result of various efforts taken up to increase the share of voluntary donation, the share of voluntary donors went up from 59.40% to 64.05% during the year and the zero prevalence among the blood donors went down from 0.21% to 0.18% during the year.

PREVENTION OF PARENT TO CHILD TRANSMISSION PROGRAMME

??????????? To prevent the vertical transmission of HIV from the mother to child, Prevention of Parent to Child Transmission of HIV (PPTCT) Programme is under implementation in Tamil Nadu.? The PPTCT programme is functioning in 65 centres, which include Government and Private Medical College Hospitals, District Head Quarters Hospitals, Private Maternity Centres and Corporation Health Centres.? The special features of the PPTCT programme are counselling to all the pregnant women and their husbands attending ANC Centres, testing for HIV, administration of ART prophylaxis to the identified positive pregnant women and their children and improvements in general ANC practices.

??????????? The Voluntary Confidential Counselling and Testing Centres (VCCTC) function as a bridge between prevention and care and support interventions. An effective network of VCCTCs can succeed in (i) drawing and counseling the high-risk groups, (ii) bringing about desired changes in their behaviour, (iii) identification of sero positive persons, (iv) extending psychological support to sero positive persons and (v) referring sero positive persons for appropriate medical treatment wherever necessary. There are 43 VCCT Centres at present supported by the Society. During the year about 85,000? persons benefited from the services rendered by these? VCCTCs.

??????????? The Government accords high priority for making quality medical care and treatment available to the people living with HIV/AIDS in the State.? The Society extends financial support for the purchase of drugs for opportunistic infections and for Poor Exposure Prophylaxis? (PEP) drugs.? The Society also assists the association of People Living with HIV/AIDS towards running Day Care Centres and Community Care Centres. The Society is presently extending support to 12 private Institutional Care Centres, five Community Care Centres and seven Drop-in-Centres. Further, the Government has waived Sales Tax on ART drugs with a view to help the People Living with HIV/AIDS.

The Government of India have taken a policy decision to make Anti Retroviral drugs available in the public health system in the country. Under this initiative, the ART programme was launched as the first phase in Tamil Nadu in Government Hospital for Thoracic Medicine, Tambaram (GHTM) with effect from 01.04.2004. So far 100 eligible AIDS patients have been extended free Anti Retroviral Therapy.

The Government is committed to the concept of Greater involvement of people living with HIV/AIDS programmes. The Positive Networks are actively involved in the decision making process of TANSACS at various levels. More importantly, the Government has ordered including a women member of Positive Networks in all the Hospital Advisory Committees in the State.

Tamil Nadu State AIDS Control Society has proposed to implement its schemes during the year 2004 - 05 at a total cost of Rs.15 Crores with the approval of National AIDS Control Organisation (NACO), New Delhi, Government of India.?