The document discusses World AIDS Day, which is observed annually on December 1st. It provides a history of how the day was established in 1988 to raise awareness about HIV/AIDS. It also discusses common symbols and themes associated with World AIDS Day over the years. The document then summarizes India's HIV sentinel surveillance program and provides key statistics on HIV prevalence, new infections, AIDS-related deaths, and HIV among high-risk groups in India based on 2017 data. It concludes by outlining India's National AIDS Control Program through its various phases and key targets for the future to curb the HIV epidemic.

2. 2019-THEME

3. HISTORY OF WORLD AIDS DAY
• First visualized by Thomas netter and James W bun in the
month of august 1987.
• Later, with the joint idea of Dr. Johnathan mann it was
changed to Dec 1 from the year 1988.
• UNAIDS: A joint united nation programmed came into
force on 1996.

4. RED RIBBON
• Symbol of awareness and support.
• Shows the solidarity with the people living with HIV.
• As per UNAIDS, it is a visual symbol to demonstrate
compassion for people living with HIV and their care
givers.

5. THEMES
YEAR THEME
2018 Know your status
2017 My health, my right
2016 Hands up for HIV prevention
2011-2015 Getting to zero
Zero new infection
Zero discrimination
Zero AIDS related death
2010 Universal acess and human
rights.

6. ACTIVITIES TO BE DONE ON AIDS DAY
• Awareness in the form of speaches , rallies , health fairs, parades etc..
• Wearing red ribbons
• Candle light walk
• Flyers, posters, videos, brochures,etc…

7. OBJECTIVES OF WORLD AIDS DAY
• To guide the member states for globally increasing the
prevention and control measures.
• To offer technical support for implementing plan for
prevention, care, counselling and treatment.
• Awareness for people about ART.
• To involve peer group.
• To encourage involvement of students.
• To decrease and control HIV infection and spread.
• To encourage peer groups for condom usage.

8. WHAT IS A COMMUNITY OR COMMUNITY LED
ORGANIZATION?
“ organization by and for people living with HIV or
TB and organization by and for people affected by HIV,
including gay men and other men who have sex with men,
people who use drugs, prisoners, sex workers, transgendors ,
women and young people”

9. COMMUNITY LED ORGANIZATIONS
• Communities are unique force behind the success of the
HIV response.
• Communities lead and support the delivery of HIV
services, defend human rights and support their peers.
• They are the lifeblood of an effective response and an
important pillar of support.
• They are fighting to keep people at the centre of decision
making and programme implementation and help to
ensure that no one is left behind.

10. • They are the key to achieve sustainable developmental goals but are
too often lacking the resources and recognition they deserve and
need.
• To recognise the role played by communities and community led
organizations, UNAIDS and its partners are highlighting the role of
communities this year.

11. WHY COMMUNITIES MATTER?
“ BECAUSE IT IS COMMUNITIES WHO FACE ADVERSITIES AND
KNOW HOW TO OVERCOME THEM. PEOPLE WANT TO BE A
PART OF CHANGE AND WHEN THEY LEAD THE CHANGE IT IS
MORE EFFECTIVE AND SUSTAINABLE”

12. 1. COMMUNITIES MAKE DIFFERECE
• Helped to ensure that more than 23 million people
accessed HIV treatment in 2018.
• Communities are the best way to reach people living with
HIV and affected by HIV.
• Communities are acting to change laws that discriminates
them: to access HIV and TB health services and to be fully
included in universal health coverage.

13. 2.COMMUNITIES NEED RESOURCES AND
MUST BE RECOGNISED
• Social contracting mechanisms to fund communities are needed
everywhere.
• Ensure that atleast 30% of all service delivery is community led by
2030.
• Ensure that atleast 6% of HIV resources are allocated for social
enabling activities, including community and political mobilization,
community led monitoring, public communication and outreach
programmes for rapid HIV testing.

14. 3.COMMUNITIES ARE KEY TO ACHIEVING THE
SUSTAINABLE DEVELOPMENTAL GOALS:
• Communities are ensuring that no one is left behind.
• SDG 5: gender equality
• SDG 16: peace, justice and strong instituitions
• SDG 10: decreased inequalities
• Communities are essential part of a modern health
system.
• Torchbearers of human rights.
• They use technology and online platforms to serve the
needs of the people most in need.

15. UNAIDS AND COMMUNITIES
• Meaningful partnership with communities are at the
centre of UNAIDS work.
• Ensuring atleast 30% HIV delivery services by
communities.
• Ensuring atleast 6% of HIV resources to be allocated to
communities.
• Engages with communities to improve policies and
programmes.
• Supports civil society, especially people living with HIV and
key population in advocacy to promote and protect
human rights and gender equality.

17. GLOBAL AIDS UPDATE 2019- UNAIDS FACT
SHEET
1. People globally living with HIV 37.9 million
2. People accessing ART 23.3 million (2010=7.7million)
3. Newly infected HIV cases 1.7million ( 2010=2.1million)
Reduced by 40%
4. People died from AIDS related illness 770,000 (2010= 1.2 million)
Reduced by 33%
5. People infected with HIV since
epidemic(1997)
74.9million
6. People who have died from AIDS since
epidemic
32.0 million

18. PEOPLE GLOBALLY LIVING WITH HIV
1. Adults 36.2million
2.Children (<15yrs) 1.7million
3. Knew their status 79%
4. Did not know their status 8.1 million

24. HIV / TB
1. Leading cause of death in people living with HIV = TB
2. 1 in 3 AIDS related deaths is due to TB
3. In 2017, out of 10 million TB cases, 9% had HIV
coinfection
4. People living with HIV and no TB c/f require TB
preventive therapy
5. 49% of people who have HIV+TB are unaware of their
coinfection.

26. HIV SENTINEL SURVEILLANCE

27. HSS: BACKGROUND
• Initiated by ICMR in 1985.
• 1st HSS (1993-1994) done in 52 sites
• 15th HSS (2017) done in 650 districts, 1323 sentinel sites, 829 ANC
sites and 494 HRG .
• Plays a crucial role in monitoring the level and trend of HIV epidemic
across different population group and locations in country.
• Tracked biennially .
• Technical support: 2 national and 6 regional instituites
• Sequence: national->regional->state->district->testing lab->sentinel
sites.

28. NATIONAL LEVEL
• NACO: nodal agency for each round of HSS
• 2 NATIONAL INSTITUITES: National institute of health and family
welfare (NIHFS) and National institute of medical statistics (NIMS).
• Also helped by WHO, UAIDS, CDC(US).
• Technical resource group: experts from epidemiology, demography,
surveillance, biostatistics and lab services.
• Function: prepare strategy for HIV surveillance and estimations.

29. REGIONAL LEVEL
• 6 public health institutes
• Core team : 2 epidemiologist , 1 microbiologist, 1 project co-
ordinator, 2 research officers, 1 computer assistant/data manager, 4-
10 data entry operators.
• Function: identify new sites, training, monitoring, supervision, data
quality check and analysis.

30. STATE LEVEL
• SACS: state AIDS control society
• SACS: primary agency
• State surveillance team: public health experts and microbiologists.
• Function: training, supervision and monitoring.

31. DISTRICT LEVEL AND LABS
• Functional district AIDS prevention and control unit.
• Co-ordination of HSS activities at sentinel sites and testing labs.
• LABS: network of testing and reference labs.

33. STUDY POPULATION
HRG
•MSM
•FSW
•IDU
•H/TG
BRIDGE
POPULATION
•Single male
migrant
•Long distance
truckers
GENERAL
POPULATION
•Pregnant
females

34. BLOOD COLLECTION
1. ANC SITES: 2. OTHERS:
Through serum samples through DBS

35. LAB TESTING
• By RAPID ELISA KIT
• 2 step protocol
• Syphilis also tested

36. DATA COLLECTION
• Paper based
• By ANM/ nurse/ counsellor
• Checked by incharge in daily basis
• Also checked by field supervisor
• SIMS: double data entry by 2 data
Operators.
Sentinel site
RI
Checked for
completeness and
accuracy
DATA ENTRY
HSS module of SIMS

37. RECENT HIV- INDIA STATISTICS: 2017

38. HIV PREVALENCE: 2017
1.ADULTS (15-49) 0.225
2. MALES 0.255
3. FEMALES 0.19%

39. • Steady decline in the overall prevalence of HIV since 2000.
• 2001-2003: 0.38
• 2007: 0.34
• 2012: 0.28
• 2015: 0.26
• 2017: 0.22

40. STATE WISE PREVALENCE OF HIV-2017

41. NO OF NEW CASES OF HIV: 2017
• INDIA: 87,580 new cases
• 2010-2017: 10% decline
• 1995-2017: 85% decline
• 2017: women account for 40% of annual new infection.
• TOP 3 STATES: Assam, Mizoram and Meghalaya.
• Decline less than 10% in last 7 years

42. AIDS RELATED DEATH:
• Decline : 71%
• 2017: 69.11 thousand deaths
HIV POSITIVE MOTHER:
• 2017: 22.67 thousand mothers
• Prevention of mother to child transmission most needed in
Maharshtra, UP, Bihar, AP, Karnataka and Telangana.

43. 1.SEX WORKERS:
1. Population estimate 6,57,800
2. HIV prevalence 1.6%
3. Knowledge about status 68.6%
4. Condom use 90.8%
5. Condoms distributed through national
programme
208
6. Active syphilis 0.1%

44. 2. MEN WHO HAVE SEX WITH MEN:
1. Population estimate 2,38,200
2. HIV prevalence 2.7%
3. Known status 64.8%
4. Condom use 83.9%
5. Condoms distributed 173
6. Active syphilis 0.5%

45. 3.PEOPLE WHO INJECT DRUGS:
1. Population estimate 1,27,500
2. HIV prevalence 6.3%
3. Known status 49.6%
4.Safe injecting practice 86.4%
5.Needles and syringes distributed per
person who inject drugs
366
6. Coverage of opiod substituition
therapy
19.5

46. 4. TRANSGENDERS:
1. Population estimate 26,000
2. HIV prevalence 3.1%
3. Known status 67.6%
4. Condoms use 79.7%

47. NATIONAL AIDS CONTROL PROGRAMME
• Launch : 1992
• Comprehensive programme for Prevention and control of HIV/AIDS in
India.
• FOCUS: shifted from awareness to behaviour change, from a national
response to a more decentralized response and to increasing involvement
of NGO and networks of PLHIV.
• PHASES:
I : 1992-1999
II: 1999-2004
III: 2007-2012
IV: 2012-2017

48. PHASE I (1992-1999)
• National AIDS control project was developed.
• PRIMARY OBJECTIVE:
“slow the spread of HIV to reduce future morbidity and mortality.”
• ACHIVEMENTS:
1. Awareness level: urban-70-80% and rural -30%
2. Modernization and strengthening of blood banks
3. Introduction of license for blood banks
4. Availability of good quality condoms through social marketing has made
a significant increase in its use.

49. PHASE II (1999-2004)
• 100% centrally sponsored scheme
• Implemented in 32 states/Uts and 3 municipal corporations namely
Ahmedabad, Chennai and Mumbai.
• KEY OBJECTIVES:
1. To reduce the spread of HIV infection in India
2. To increase India’s capacity to respond to HIV/AIDS on a long term
basis.
• INITIATIVES:
1. Adoption of national AIDS prevention and control policy(2002)

50. 2. Scale up of targeted interventions of high risk groups in high
prevalence states
3. Adoption of national blood policy
4. Strategy for greater involvement of people with HIV/AIDS
5. Launch of national adolescent education programme
6. Introduction of counselling, testing and PPTCT programmes
7. Launch of national ART programme
8. Setting up national council on AIDS and state AIDS council society in
all states

51. PHASE III(2007-2012)
• Launch: july, 2007
• GOAL: halting and reversing the epidemic by the end of project
• AIMS:
1. Scaling up prevention efforts among high risk groups and general
population.
2. Integrating them with care, support and treatment services.
• 2 pillars of AIDS control efforts in India : prevention and care, support
and treatment(CST)

52. • ACHIEVEMENTS :
1. Substantial scale up of coverage of high risk group through target
intervention
2. Link worker scheme was established in 159 districts
3. Increase in condom distribution
4. Scale up of counselling and testing services.
5. Provided nevirapine phrophylaxis to 11,981 mother-baby infected
pairs at time of delivery
6. Scale up of coverage of STI services
7. Started to provide 2nd line ART in a phased manner
8. 3rd phase of red ribbon express launched on Jan 12,2012 covered
162 halt stations in 23 states and reached out to 1.14crore people
and trained over one lakh district resource person.

53. PHASE IV( 2012-2017)
• OBJECTIVE:
1. Reduce new infection by 50%
2. Comprehensive care, support and treatment to all persons living
with HIV/AIDS.
• COMPONENTS:
1. Intensifying and consolidating prevention services with a focus on
HRG and vulnerable population.
2. Expanding IEC services for general population and HRG with focus
on behaviour change

54. 3. Comprehensive care, support and treatment
4. Strengthening institutional capacities
5. SIMS strengthening .
• KEY PRIORITIES:
1. Preventing new infection by sustaining the reach of current
intervenitons.
2. Prevent parent to child transmission
3. Focus on IEC strategies
4. Provide comprehensive care, support and treatment.
5. Reduce stigma through GIPA
6. De centralizing roll out of services through technical support.

55. 7. Effective use of strategic information at all levels of programme
8. Building capacities of NGO and civil society partners at areas of
emerging epidemics
9. Integrating HIV services with health system in a phased manner
10. Social protection and insurance mechanism for PLHIV will be
strengthened.

56. • SERVICES BEING PROVIDED IN PHASE IV:
PREVENTIVE SERVICES
CARE, SUPPORT AND TREATMENT.
NEW INITIATIVES

57. PREVENTIVE SERVICES:
1. Target intervention for HRG
2. Needle syringe exchange programme
3. Opioid substitution therapy
4. For migrant population
5. Link worker scheme
6. Prevention and control of STI/RTI
7. Blood safety
8. HIV counselling and testing
9. IEC
10. Parent to child transmission prevention

58. CARE, SUPPORT AND TREATMENT SERVICES
1. Lab services for CD4 testing
2. Free 1st and 2nd line ART
3. Pediatric ART
4. Early infant diagnosis
5. HIV-TB co ordination
6. Treating opportunistic infection
7. Drop in centres for PLHIV networks

59. NEW INITIATIVES
1. Differential strategies for districts
2. Scale up programmes to target key vulnerabilities
3. Scale up of multi drug regimen for prevention of parent to child
transmission
4. Social protection of migrants
5. Establish metro blood bank
6. Launch 3rd line ART and scale up 1st and 2nd line
7. Demand promotion strategies using media

60. NACO-UPDATES

61. HIV KEY TARGETS FOR FUTURE
1. TARGET FOR 2020: “90-90-90”
• 90 % people living with HIV knowing their HIV status
• 90% of people who know their status on treatment
• 90% on treatment with supressed viral loads
• Reduce the annual no of new infection among adults to 500,000
• Achieving zero discrimination

63. 2. TARGET FOR 2030: “ 95-95-95”
• 95 % people living with HIV knowing their HIV status
• 95% of people who know their status on treatment
• 95% on treatment with supressed viral loads
• Reduce the annual no of new infection among adults to 200,000
• Achieving zero discrimination

64. NATIONAL STRATEGIC PLAN 2017-2024