EPIDEMIOLOGY OF HIV INFECTION DELHI PERSPECTIVE

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Slide 1 : An Overview of Third Phase of National AIDS Control Programme DELHI STATE AIDS CONTROL SOCIETY
Slide 2 : Global estimates for adults and children, 2007 People living with HIV 33 million [30 – 36 million] New HIV infections in 2007 2.7 million [2.2 – 3.2 million] Deaths due to AIDS in 2007 2.0 million [1.8 – 2.3 million]
Slide 3 : TOTAL 2.0 million [1.8 – 2.3 million] 0.8% [0.7% - 0.9%] 2.7 million [2.2 – 3.2 million] 33 million [30 – 36 million] Adult & child deaths due to AIDS Adult prevalence (15?49) [%] Adults & children newly infected with HIV Adults & children living with HIV The ranges around the estimates in this table define the boundaries within which the actual numbers lie, based on the best available information. Regional HIV and AIDS statistics and features, 2007 North America Eastern Europe & Central Asia Latin America South and South-East Asia Sub-Saharan Africa Oceania Western & Central Europe Caribbean East Asia Middle East & North Africa 23 000 [9100 – 55 000] 58 000 [41 000 – 88 000] 63 000 [49 000 – 98 000] 340 000 [230 000 – 450 000] 1.5 million [1.3 – 1.7 million] 110 000 [67 000 – 180 000] 0.6% [0.4% – 1.0%] 0.8% [0.6% – 1.1%] 0.5% [0.4% – 0.6%] 0.3% [0.2% – 0.4%] 5.0% [4.6% – 5.4%] 54 000 [9600 – 130 000] 140 000 [88 000 – 190 000] 330 000 [150 000 – 590 000] 1.9 million [1.6 – 2.1 million] 1000 [<1000 – 1400] 8000 [4800 – 17 000] 14 000 [11 000 – 16 000] 40 000 [24 000 – 63 000] 27 000 [20 000 – 35 000] 0.4% [0.3% – 0.5%] 0.3% [0.2% – 0.4%] 1.1% [1.0% – 1.2%] 0.1% [<0.1% – 0.2%] 0.3% [0.2% – 0.4%] 13 000 [ 12 000 – 15 000] 27 000 [14000 – 49 000] 20 000 [16 000 – 25 000] 52 000 [29 000 – 84 000] 40 000 [20 000 – 66 000] 22.0 million [20.5 – 23.6 million] 1.2 million [760 000 – 2.0 million] 1.5 million [1.1 – 1.9 million] 1.7 million [1.5 – 2.1 million] 4.2 million [3.5 – 5.3 million] 74 000 [66 000 – 93 000] 730 000 [580 000 – 1.0 million] 230 000 [210 000 – 270 000] 740 000 [480 000 – 1.1 million] 380 000 [280 000 – 510 000]
Slide 4 : Over 7400 new HIV infections a day in 2007 More than 96% are in low and middle income countries About 1000 are in children under 15 years of age About 6300 are in adults aged 15 years and older of whom: almost 50% are among women about 45% are among young people (15-24)
Slide 5 : HIV / AIDS Epidemic in India1986 –2007
Slide 6 : Indian Scenario An estimated 2.31 million PLHAs (2007) 39.3% - women 86.5% -15-49 years age group (27.9 % in 15-29 and 58.6% in 30-49 age groups) All states affected Epidemic moving from groups at high risk to the general population and from urban to rural areas
Slide 7 : Pondichery Gujarat Karnataka Goa Lakshwadeep Dadra Nagar Haveli Maharashtra Madhya Pradesh Kerala Tamil Nadu Andhra Pradesh Punjab Rajasthan Daman & Diu J & K Haryana Uttar Pradesh Himachal Pradesh Delhi Chandigarh Bihar West Bengal Orissa Andaman & Nicobar Mizoram Meghalaya Assam Sikkim Manipur Tripura Arunachal Pradesh Nagaland HIV/AIDS Epidemic in India-2007 >1%in Antenatal mothers >5% in High Risk Groups <5% in High risk groups Total:2.31million
Slide 8 : HIV & Nephrology 23-08-07 States Classified
Slide 9 : DELHI SCENARIO: Total population – 17.2 million Low prevalence state (Gen pop- 0.25%) Estimated PLHAs- 51,000 Highly vulnerable state Total high risk population -1.00 LAKH (HIV prevelance > 2.5 – 11.2%)
Slide 10 : Modes of HIV transmissionBased on data from AIDS cases in DELHI
Slide 11 : HIV Trend Among Ante Natal Cases
Slide 12 :
Slide 13 : CATEGORIZATION OF DISTRICTS IN DELHI B-CAT DISTS
Slide 14 : Status Of AIDS Cases In Delhi TOTAL HIV POSITIVE CASES REGISTERED AT 9 ART CENTRES (TILL DEC 2008): 18501 ADULTS: 92.8%, CHILDREN: 7.2% 44% STARTED ON TREATMENT. 5273 ARE ALIVE & CONTINUING TREATMENT
Slide 15 : IMPACT OF ANTI-RETROVIRAL TREATMENT
Slide 16 : NATIONAL AIDS CONTROL PROGRAMME NACP I- 1992-1999, Objectives - slow down the spread of HIV virus & reduce impact of HIV/AIDS in the country. State AIDS cells, National AIDS Control Board and National AIDS Control Organization (NACO) were set up. Main Focus- Awareness NACP II-1999- 2007-Shifting of focus from awareness to change in behavior, Greater involvement of NGOs, Counseling & Testing & Care, Support and Antiretroviral treatment. A National AIDS Council, chaired by Hon’ Prime Minister, was set up. NACP III- Launched on 6th July, 2007- Objective to stop & reverse the HIV epidemic in the country in next 5 years by four pronged strategy 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.
Slide 17 : Targeted intervention-65 STI Diagnosis & treatment-15 Condom promotion Blood Safety-19 ICTC-84 PPP ICTCs-10 IEC and social mobilisation AEP PEP Mainstreaming ART Centres-9 CCCs-7 DICs-5 Holistic Approach Prevention Care, Support & Treatment Institutional Strengthening Capacity building Strategic Management Information system COE for ART -1 Model Blood bank-1 Regional STD Lab-1 Training EQAS-4 SRLs Operational Research Programme management (CMIS & CPFMS) Surveillance M & E Computerization Common National reporting format
Slide 18 : GENERAL POPULATION (0.25% HIV +VE) BRIDGE POPULATION NO DATA FOR DELHI HIGH RISK POPULATIUON CORE POPULATION (5-12% HIV +VE) IEC, CONDOM PROMOTION, STI SERVICES, ICTC, BLOOD SAFETY, MAINSTREAMING IEC, CONDOM PROMOTION, TRUCKERS INTERVENTION, MIGRANT INTERVENTION, CLIENTS OF HRGs THROUGH TI PROJECTS IEC, CONDOM PROMOTION, TI PROJECTS, STI MANAGEMENT, CBO FORMATION, REFERALS TO ICTC PREVENTION OF NEW INFECTION
Slide 19 : HIV POSITIVE CLIENTS ART CENTRES CARE, SUPPORT & TREATMENT MEDICAL FUNCTION: Diagnosis & Treatment Of O.I. Screen PLHA For Eligibility To Start ART Monitor Patients On Art & Manage Side Effects Provide In-patient Care When Necessary Facilitate Linkage Between Other Service Providers PSYCHOLIOCAL FUNCTIONS: Provide Psychological Support To PLHAs Provide Counseling For Drug Adherence Educate PLHAs On Proper Nutrition Advise For Risk Reduction Behavior & Use Of Condoms SOCIAL FUNCTIONS: Facilitate PLHAs To Access Available Govt & NGO Resources Facilitate Linkage Between Other Service Providers Educational Help For Children & Income Generation Programmes. COMMUNITY CARE CENTRES Monitoring, follow-up, counseling support to those who are initiated on ART. Positive prevention, drug adherence, nutritional counseling, 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. Referral to PPTCTC for care of HIV positive pregnant women, pediatric HIV services, ART centers for CD4 or other tests and DOTS for treatment of TB. LINK ART CENTRE DROP IN CENTRES
Slide 20 : DROP-IN CENTERS To promote positive living and build capacity & skills among People Living with HIV/AIDS cope with infections. To create an enabling environment for PLHAs To establish linkages with existing health services, NGOs & CBOs and To protect & promote the rights of the infected individuals
Slide 21 : Physical Coverage During 2007-08
Slide 22 :
Slide 23 :
Slide 24 : NEW HIV POSITIVES EXPECTED TO BE IDENTIFIED IN 2008-09 New PLHAs- Needing ART - Estimates for 2008-09
Slide 25 : New Initiatives Proposed Under NACP-III.
Slide 26 : District wise planning with special Focus on 4 category B Districts of Delhi namely; Central, North, east & North east. Where HIV prevalence is reported to be higher than other districts of Delhi. Mainstreaming of HIV / AIDS Control Programme with Social Welfare Dept, Education Dept, Labour Dept, Industries, Trade Unions, Employer Associations and Prisons. Focus would be to involve public representatives through State AIDS Council CBO: Core Population would be involved in implementation of Target Intervention Projects by building up Community Based Organizations. J.J. Clusters: Spreading HIV/AIDS Awareness in underprivileged sector through series of IEC campaigns in J.J. Clusters. Tackling Lost to Follow Up of Patients on ART: Involvement of People Living with HIV/AIDS for outreach activities for follow-up of HIV-positive clients including pregnant ladies for institutional delivery & NVP Prophylaxis Setting up Youth Friendly Health Services at ICTC/WUS, Health centre, Delhi University.

 


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