National AIDS
Control
Program
introduction
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According to the HIV Estimations 2012,the estimated number of
people living with HIV/AIDS in India was 20.89 lakh in 2011.
The adult (15-49 age-group)HIV prevalence at national level has
continued its steady decline from estimated level of 0.41% in 2001
to 0.27% in 2011. But still, India is estimated to have the third
highest number of estimated people living with HIV/AIDS, after
South Africa and Nigeria (UNAIDS Report on the Global AIDS
epidemic 2010).
Milestone
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1986 : first case of HIV detected , AIDS task force set by ICMR.
1990 : medium term plan launched for 4 states & 4 metro
1992 : NACP 1 launched & NACB constituted.
1999 : NACP 2 begins , SACS established
2002 : NACP adopted.
2004 : ARV Treatment started.
2007 : NACP 3 launched for 5 years .
2012 :NACP 4 launched for next 5 year .
Current epidemiology of HIV/AIDS
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The PLHIV in India is estimated at around 20.9 lakh in 2011.
Children <15 years of age account for 7% (1.45 lakh) of all infections; while
86% are in the age-group of 15-49 years.
Of all HIV infections, 39% (8.16 lakh) are among women.
declining trend from 23.2 lakh in 2006 to 20.9 lakh in 2011.
The four high prevalence States of South India (Andhra Pradesh, Karnataka,
Maharashtra and Tamil Nadu) account for 53% of all HIV infected population
in the country.
India is estimated to have around 1.16 lakh annual new HIV infections among
adults and around 14,500 new HIV infections among children in 2011.
the previously high HIV prevalence States of Andhra Pradesh, Karnataka,
Maharashtra, Tamil Nadu, Manipur and Nagaland account for 31% of new
infections, whereas, some low prevalence States (Odisha, Jharkhand, Bihar,
Uttar Pradesh, West Bengal, Gujarat, Chhattisgarh, Rajasthan, Punjab &
Uttarakhand) together account for around 57% of new infections.
Key Strategies under NACP-IV
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Intensifying and consolidating prevention services, with a focus on
HRGs and vulnerable population.
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Increasing access and promoting comprehensive care, support and
treatment
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Expanding IEC services for general population and high risk groups
with a focus on behaviour change and demand generation.
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Building capacities at national, state, district and facility levels
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Strengthening Strategic Information Management system
New Initiatives under NACP-IV
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Differential strategies for districts based on data triangulation with
due weightage to vulnerabilities
Scale up of programmes to target key vulnerabilities
Scale-up of Opioid Substitution Therapy for IDUs
Scale-up and Strengthening of Migrant Interventions at Source,
Transit & Destinations
Female Condom Programme
Multi-Drug Regimen for PPTCT in keeping with international
protocols
Social protection for marginalised populations through earmarking
budgets for HIV among concerned government departments
Establishment of Metro Blood Banks and Plasma Fractionation
Centre
Demand promotion strategies specially using midmedia, e.g.
National Folk Media Campaign & Red
Ribbon Express and buses (in convergence with NRHM)
Scale up of Second Line ART
Package of services provided under NACP-IV
Care ,support &treatment
Preventive services
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Targeted Interventions for High
Risk Groups
Needle-Syringe Exchange
Programme and Opioid
Substitution Therapy for IDUs
Prevention Interventions for
Migrant population at source,
transit and destination
Link Worker Scheme for HRGs and
vulnerable population in rural
areas
Prevention & Control of STI/RTI
Blood Safety
HIV Counseling & Testing Services
Prevention of Parent to Child
Transmission
Condom promotion
Information, Education &
Communication, and Behaviour
Change Communication.
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Laboratory services for CD4 Testing
and other investigations
Free First line & second line AntiRetroviral Treatment through ART
centres and Link ART Centres,
ART Plus centres.
Pediatric ART for children
Early Infant Diagnosis for HIV
exposed infants and children
below 18 months
Nutritional and Psycho-social
support through Community Care
Centres (CCC)
HIV-TB Coordination (Crossreferral, detection and treatment
of co-infections)
Treatment of Opportunistic
Infections
TARGETED INTERVENTION
Key risk groups covered under the Targeted
Intervention programme
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Core High Risk Groups
 Female Sex Workers
 Men who have Sex with Men
 Transgenders & Hijras
 Injecting Drug Users & their spouses
Bridge Populations
 Long Distance Truckers
 High Risk Migrants
Services offered under the Targeted Intervention
Programme
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Detection and treatment for Sexually Transmitted Infections
(STIs)
Condom distribution
Condom promotion through social marketing
Behaviour change communication
Creating an enabling environment with community
involvement and participation
Linkage to Integrated Counseling and Testing Centres
Linkage with care and support services for HIV positive
HRGs
Community organisation and ownership building
Specific Interventions for IDUs
Specific Interventions for MSM / TGs
Specific Interventions for FSWs
LINK WORKER SCHEME
 Convergence with NACO
 Convergence with health department
 Convergence with non health & social protection
department
Management of STD/RTI
Provision of RTI/STI in high risk group
population includes:
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Free consultation and treatment for their symptomatic STI
complaints
Quarterly medical check-up
Asymptomatic treatment (presumptive treatment)
Bi-annual syphilis and HIV screening
Condom promotion
Blood Safety
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Increasing regular voluntary non-remunerated blood donation to
meet the safe blood requirements of safe blood in the country
Promoting component preparation and availability along with
rational use of blood in health care facilities and building capacity
of health care providers to achieve this objective
Enhancing blood access through a well networked
regionally coordinated blood transfusion services
Establishing Quality Management Systems to ensure Safe and
quality Blood
Building implementation structures and referral linkages
BASIC SERVICES
Integrated counseling & testing center
PPTCT
Mother baby pair coverage
Counseling & testing of HRGs & STI clinic attendee
HIV testing of presumptive cases
Intensified TB case finding at ART centre
Treatment of TB/HIV cases
ICTC & ITS LINKAGE
Care support & treatment
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ART center
link ART center
link ART plus center
center of excellence
ART plus center
community care center
Pediatric center of excellence
pediatric second line ART
Early infant diagnosis
LINKAGE FOR CARE SUPPORT & TREATMENT
Secondary
Health
Care
Primary
Health
Care
District
Hospitals
HIV Clinics
Integrated
Counselling
Testing
The entry
point
Specialised
Care facilities
ART
Centres
Tertiary
Health
Care
PLH
A
Link ART
CENTRES
NGO &
Peer
Groups
Community
Care
Centres
Home
care
IEC & Mainstreaming
Mass media campaign
 Long formal radio or TV program
 Red ribbon express project
 Advertisement through newspaper
 Hoarding
 Folk media
Mainstreaming activities
Inter Ministerial conference
Training of frontline worker
Greater involvement of PLHIV
Social protection
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capacity building
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In order to provide uniform, quality training to different categories
of staff working with NGOs/CBOs, like program managers,
counsellors, finance accountants, outreach workers, peer
educators and link workers, NACO has institutionalized the training
and capacity building process with the establishment of the State
Training and Resource Centres (STRC).
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STRCs function with the objectives of 1) ensuring need based training of TIs as per NACP III’s technical
and operational guidelines;
2) enhancing the capacity of NGOs and civil society organizations
in proposal development for NACP funded targeted intervention
projects;
3) undertaking operational research and evaluation of TIs.
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STRCs have been established in 14 states and 6 more are being
established. Training modules for programme managers have been
developed and modules for rest of project staff are in process
Monitoring & evaluation
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HIV sentinel surveillance system: Information gathered through HIV sentinel
surveillance, AIDS case surveillance and STD surveillance helps in tracking the
epidemic and provides the direction to the programme.
• A nationwide computerised management information system (CMIS)
provides programme monitoring and evaluation.
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Strategic Information Management Unit (SIMU)
To maximize effective use of all available information and implement evidence
based planning, to address strategic planning, monitoring and evaluation,
surveillance and research.
SIMU assists NACP in tracking the epidemic and the effectiveness of the
response and help assess how well NACO, SACS and all partner organizations
are fulfilling their commitment to meet agreed objectives.
NACP envisages a robust Strategic Information Management System (SIMS)
which focuses on programme monitoring, evaluation and surveillance, and
knowledge gathering.