An Overview of HIV/AIDS Epidemic Situation and Programmatic Response in Uttar Pradesh<br />IAPSM Conference Dehradun<br />...
About FHI<br />1971       - The establishment of Institute for Family  Health (IFH) managing research and field activities...
Mission, Values and Beliefs<br />
SAMARTH Project Overview<br />Background:<br />Strengthen Abilities to Manage And Respond effectively To HIV/AIDS (SAMARTH...
Objectives<br />To enhance capacities of government and civil society for effective management of HIV /AIDS program<br />T...
Vulnerability Factors for HIV Epidemic in UP<br />•<br />Population 180-200 million (growth rate 2.5%)<br />•<br />48<br /...
Levels and Trends of HIV in UP<br />
Adult HIV Prevalence in Indian and UP<br />
HIV Prevalence in UP: NFHS-III Estimate<br />
Trend in HIV Prevalence among General Population<br />
Trend in HIV Prevalence among High Risk Groups<br />
HIV prevalence trends at ICTC in Eastern UP and rest of UP<br />
Prevalence of HIV among clients tested at ICTC by region<br />
Prevalence of HIV among clients tested at PPTCT by region<br />
HIV Positivity among HRGs in UP<br />2008 – 2009<br />Data Source:  CMIS -UPSACS<br />
BSS Indicators<br />
Comprehensive knowledge on HIV<br />Percentage of respondents who could correctly identify:<br /><ul><li>Two major ways of...
Comprehensive knowledge about HIV - FSWs<br />By Region<br />Total<br />
Number of different types of clients and partners in the last week<br />
Condom use during last sex with occasional and regular clients<br />
Consistent condom use with occasional & regular clients in last 30 days<br />Base: Those who used condoms during sex<br />
Aware of free Government counseling and testing services<br />Total<br />By Region<br />Base: All<br />
Injecting Drug Users (IDUs)<br />
HIV/ AIDS Knowledge and Prevention- IDU<br />
Sexual behavior of IDU with female partners <br /><ul><li>76% of IDUs ever had sex with a female partner
Mean age at first sex with a female partner was 19 years
8% of IDUs ever had sex with a Female Sex Worker
Mean Age at first sex with a FSW was 21 years
Mean number of sex acts with female partner in the last one week was 4</li></li></ul><li>Sexual Behavior and Condom Use wi...
Men Having Sex With Men (MSM)<br />
Knowledge of HIV/AIDS-MSM <br />Knowledge on transmission of HIV/AIDS among respondents<br />COMPREHENSIVE KNOWLEDGE ABOUT...
Condom Usage with Male Partners<br />Condom use during last sex with male partners<br />Common reasons for not using condo...
 Condoms not available - casual partners
Never heard of a condom, condom not available and decrease in pleasure -  paid partners
 Condoms tear easily - paying partners</li></li></ul><li>Condom Use with Paying Male Partners <br />20 .27 – Mean age when...
23% - condoms not available</li></li></ul><li>Drivers of the Epidemic<br />
FSWs and MSM<br />Estimates distribution of total 22,425 FSWs across 1,496 sites<br />Estimates distribution of total 10,9...
IDUs and Hijras<br />Estimates distribution of total 13,946 IDUs across 1251 sites<br />Estimates distribution of total 4,...
Migrants concentrated in 68 towns with 12.7% reporting high risk behaviour
High proportion of IDUs – Easy accessibility and less expensive
Hijras - a small proportion and even smaller proportion (2.3%) reported risk behaviour</li></li></ul><li>Estimates of High...
Estimates of Female Sex Workers (FSWs) in Uttar Pradesh<br />36<br />
Estimates of Men Having Sex with Men (MSM) in Uttar Pradesh<br />150<br />225<br />96<br />97<br />31<br />516<br />191<br...
Estimates of Injecting Drug Users (IDUs) in Uttar Pradesh<br />142<br />267<br />280<br />118<br />289<br />268<br />484<b...
747<br />615<br />25,786<br />39,037<br />1,333<br />367<br />3,557<br />122,564<br />10,213<br />339<br />1,050<br />616<...
11.97 million people are migrants in Maharashtra<br />
Most of the migrants are from UP<br />Source: Behavioral Surveillance Survey, Maharashtra, 2009<br />
Allahabad, Gorakhpur, Varanasi, Jaunpur, Sultanpur, Kanpur, Faizabad, Pratapgarh, Mughal Saray, Sant Kabir Nagar, Sardar, ...
Challenges and Opportunities<br />Gaps:<br />Being low prevalent state, the number of HSS, ICTC and PPTCT sites are low<br...
Programmatic response to combat HIV/AIDS in Uttar Pradesh <br />
National AIDS Control Programme Phase III (NACP III) <br />Goal:<br />Halt and reverse the epidemic in India over the next...
NACP III - Four pronged strategy<br />Prevent new infections <br />Increase proportion of PLHA receiving care, support, an...
Strategic shift from NACP II to NACP III<br />NACP III<br />NACP II<br />Aims toshift the focus from raising awareness to ...
NACP-III at a glance<br />Care, Support & <br />Treatment<br />Prevention<br />Capacity Building<br />Strategic <br />Info...
Integrated Counselling and Testing including PPTCT
STI care
IEC and social mobilisation
Mainstreaming
Targeted Interventions (TIs)
STI care
 Condom promotion
Enabling environment
ART
HIV-TB            co-ordination
Treatment of OIs
CCCs
Post-Exposure Prophylaxis (PEP)
HIV Sentinel Surveillance
Behavioural Surveillance
Monitoring and Evaluation
Operations research
DAPCU
 Technical resource groups
Enhanced HR at NACO, SACS and districts
Enhanced training activities</li></li></ul><li>Consolidate gains<br />Scale up treatment services <br />Focus on youth and...
NACP III :  Challenges<br />Infection moving from<br /><ul><li>High risk groups to general population
Urban to rural areas
Adults to vulnerable youth
High prevalence states to all states</li></ul>Evolving a well coordinated response<br /><ul><li>Raising financial resources
Involving a large number of donors /key stakeholders
Avoiding program overlaps and duplication
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Dr Pramod Dr Sudipta

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  • And this shows the new versions of our mission, values and beliefs
  • Dr Pramod Dr Sudipta

    1. 1. An Overview of HIV/AIDS Epidemic Situation and Programmatic Response in Uttar Pradesh<br />IAPSM Conference Dehradun<br />30-31 Oct 2010<br />Dr Pramod Gautam<br />Dr Sudipta Mondal<br />FHI <br />
    2. 2. About FHI<br />1971 - The establishment of Institute for Family Health (IFH) managing research and field activities (North Carolina)<br />1986 - The establishment of Institute for HIV/AIDS (IHA) managing the work on HIV prevention Programs<br />1990 - FHI Foundation Established<br />1993 - HIV Prevention Research and Women’s Studies<br />1995 - PQC Established<br />1999 - Pharma Link FHI Established<br />2001 - Youthnet, IFA and IHA<br />2004 - Malaria Clinical Trials<br />2006 - HPV, Avian Flu, Rotavirus and Unification for Greater Impact<br />
    3. 3. Mission, Values and Beliefs<br />
    4. 4.
    5. 5. SAMARTH Project Overview<br />Background:<br />Strengthen Abilities to Manage And Respond effectively To HIV/AIDS (SAMARTH) is a five-year Technical Assistance (TA) grant under the United States Mission to the India Five-Year Strategic Plan for the PEPFAR during 2006-2011<br />Goal: <br />Improve the effectiveness of the response of the government and civil society for evidence-based HIV policy and programs in India<br />
    6. 6. Objectives<br />To enhance capacities of government and civil society for effective management of HIV /AIDS program<br />To strengthen quality of HIV prevention, care and treatment in the public and private sector<br />To improve planning, collection analysis, and use of strategic information (SI) at the national, state, and district levels<br />To foster bold leadership and visibility of USG-supported programs through strategic communication<br />
    7. 7. Vulnerability Factors for HIV Epidemic in UP<br />•<br />Population 180-200 million (growth rate 2.5%)<br />•<br />48<br />-<br />50% in reproductive age group<br />•<br />Low literacy (rural 36.66%, state 57.2%)<br />•<br />High incidence of poverty<br />•<br />Low status of women & Gender disparity<br />•<br />Large presence of high risk groups<br />* Migrants <br />: 10 million<br />* Truckers <br />: 50,000 (8 national highways)<br />* <br />FSWs<br />: 20000-25000 <br />* IDUs<br />: 10000-12000<br />* MSM<br />: 10000-12000<br />•<br />Long porous Indo<br />-<br />Nepal border<br />
    8. 8. Levels and Trends of HIV in UP<br />
    9. 9. Adult HIV Prevalence in Indian and UP<br />
    10. 10. HIV Prevalence in UP: NFHS-III Estimate<br />
    11. 11. Trend in HIV Prevalence among General Population<br />
    12. 12. Trend in HIV Prevalence among High Risk Groups<br />
    13. 13. HIV prevalence trends at ICTC in Eastern UP and rest of UP<br />
    14. 14. Prevalence of HIV among clients tested at ICTC by region<br />
    15. 15. Prevalence of HIV among clients tested at PPTCT by region<br />
    16. 16. HIV Positivity among HRGs in UP<br />2008 – 2009<br />Data Source: CMIS -UPSACS<br />
    17. 17. BSS Indicators<br />
    18. 18. Comprehensive knowledge on HIV<br />Percentage of respondents who could correctly identify:<br /><ul><li>Two major ways of preventing the sexual transmission of HIV</li></ul>Consistent condom use<br />Having one faithful uninfected sex partner<br /><ul><li>Reject the two most common local misconceptions about HIV transmission</li></ul>Transmission of HIV/AIDS through mosquito bites<br />Sharing of meals with HIV/AIDS patients<br /><ul><li>Know that a healthy-looking person can transmit HIV</li></ul>18<br />
    19. 19. Comprehensive knowledge about HIV - FSWs<br />By Region<br />Total<br />
    20. 20. Number of different types of clients and partners in the last week<br />
    21. 21. Condom use during last sex with occasional and regular clients<br />
    22. 22. Consistent condom use with occasional & regular clients in last 30 days<br />Base: Those who used condoms during sex<br />
    23. 23. Aware of free Government counseling and testing services<br />Total<br />By Region<br />Base: All<br />
    24. 24. Injecting Drug Users (IDUs)<br />
    25. 25. HIV/ AIDS Knowledge and Prevention- IDU<br />
    26. 26. Sexual behavior of IDU with female partners <br /><ul><li>76% of IDUs ever had sex with a female partner
    27. 27. Mean age at first sex with a female partner was 19 years
    28. 28. 8% of IDUs ever had sex with a Female Sex Worker
    29. 29. Mean Age at first sex with a FSW was 21 years
    30. 30. Mean number of sex acts with female partner in the last one week was 4</li></li></ul><li>Sexual Behavior and Condom Use with Female Partners <br />
    31. 31. Men Having Sex With Men (MSM)<br />
    32. 32. Knowledge of HIV/AIDS-MSM <br />Knowledge on transmission of HIV/AIDS among respondents<br />COMPREHENSIVE KNOWLEDGE ABOUT HIV/AIDS<br /> 18% - 2009 UP BSS <br /> 16% - 2006 UP BSS<br />
    33. 33. Condom Usage with Male Partners<br />Condom use during last sex with male partners<br />Common reasons for not using condoms with male partners<br /><ul><li>Trust - regular male partners
    34. 34. Condoms not available - casual partners
    35. 35. Never heard of a condom, condom not available and decrease in pleasure - paid partners
    36. 36. Condoms tear easily - paying partners</li></li></ul><li>Condom Use with Paying Male Partners <br />20 .27 – Mean age when first had paying partners<br />6.68 - Mean number of paying male clients in a typical week<br />6.34 -Mean number of anal sex acts with paying male clients in the last week<br />40% – Never used a condom with clients<br />Common reasons for not using a condom with clients<br /><ul><li>27% - condoms tear easily
    37. 37. 23% - condoms not available</li></li></ul><li>Drivers of the Epidemic<br />
    38. 38. FSWs and MSM<br />Estimates distribution of total 22,425 FSWs across 1,496 sites<br />Estimates distribution of total 10,922 MSM across 799 sites<br />
    39. 39. IDUs and Hijras<br />Estimates distribution of total 13,946 IDUs across 1251 sites<br />Estimates distribution of total 4,673 Hijras across 525 sites<br /><ul><li>Scattered across 612 towns with a density of 0.6 HRG per 1000 male
    40. 40. Migrants concentrated in 68 towns with 12.7% reporting high risk behaviour
    41. 41. High proportion of IDUs – Easy accessibility and less expensive
    42. 42. Hijras - a small proportion and even smaller proportion (2.3%) reported risk behaviour</li></li></ul><li>Estimates of High Risk Groups (HRGs) in Uttar Pradesh<br />624<br />1,058<br />730<br />1,090<br />337<br />1,741<br />685<br />1,198<br />634<br />953<br />672<br />734<br />1,772<br />828<br />1,705<br />919<br />1,052<br />717<br />174<br />1,396<br />238<br />61<br />904<br />267<br />750<br />155<br />534<br />284<br />336<br />1,724<br />896<br />201<br />372<br />377<br />1,938<br />255<br />492<br />235<br />722<br />501<br />576<br />592<br />1,348<br />476<br />1,168<br />448<br />803<br />450<br />57<br />3,498<br />759<br />222<br />1,006<br />749<br />561<br />967<br />656<br />629<br />1,016<br />603<br />365<br />2,375<br />191<br />371<br />82<br />211<br />735<br />42<br />157<br />277<br />315<br />35<br />
    43. 43. Estimates of Female Sex Workers (FSWs) in Uttar Pradesh<br />36<br />
    44. 44. Estimates of Men Having Sex with Men (MSM) in Uttar Pradesh<br />150<br />225<br />96<br />97<br />31<br />516<br />191<br />154<br />207<br />293<br />181<br />178<br />155<br />122<br />138<br />298<br />138<br />106<br />7<br />445<br />2<br />180<br />20<br />127<br />3<br />18<br />135<br />43<br />414<br />59<br />12<br />104<br />65<br />88<br />23<br />56<br />868<br />299<br />79<br />95<br />41<br />65<br />119<br />117<br />465<br />123<br />185<br />130<br />591<br />580<br />16<br />102<br />145<br />142<br />8<br />237<br />115<br />64<br />120<br />825<br />24<br />20<br />150<br />8<br />10<br />56<br />46<br />37<br />37<br />
    45. 45. Estimates of Injecting Drug Users (IDUs) in Uttar Pradesh<br />142<br />267<br />280<br />118<br />289<br />268<br />484<br />172<br />337<br />74<br />371<br />343<br />123<br />258<br />714<br />202<br />366<br />139<br />560<br />67<br />100<br />3<br />16<br />403<br />2<br />61<br />31<br />43<br />318<br />88<br />66<br />130<br />320<br />69<br />151<br />247<br />5<br />133<br />72<br />49<br />73<br />111<br />195<br />110<br />769<br />190<br />27<br />1372<br />466<br />29<br />180<br />155<br />91<br />107<br />169<br />149<br />219<br />166<br />163<br />51<br />51<br />758<br />17<br />159<br />57<br />23<br />126<br />82<br />38<br />
    46. 46. 747<br />615<br />25,786<br />39,037<br />1,333<br />367<br />3,557<br />122,564<br />10,213<br />339<br />1,050<br />616<br />294<br />563<br />324<br />625<br />958<br />214<br />337<br />324<br />276<br />671<br />9,600<br />208<br />2,107<br />660<br />781<br />287<br />36,066<br />389<br />1,502<br />1,116<br />500<br />313<br />1,856<br />509<br />238<br />1,525<br />44,985<br />1,600<br />986<br />240<br />800<br />318<br />1,256<br />163<br />18,521<br />375<br />1,812<br />3,640<br />400<br />352<br />308<br />442<br />Estimates of Single Male Circular Migrants in Uttar Pradesh<br />39<br />
    47. 47. 11.97 million people are migrants in Maharashtra<br />
    48. 48. Most of the migrants are from UP<br />Source: Behavioral Surveillance Survey, Maharashtra, 2009<br />
    49. 49. Allahabad, Gorakhpur, Varanasi, Jaunpur, Sultanpur, Kanpur, Faizabad, Pratapgarh, Mughal Saray, Sant Kabir Nagar, Sardar, Azamgarh, Faijabad, Basti, Siddharth Nagar & Lucknow<br />
    50. 50. Challenges and Opportunities<br />Gaps:<br />Being low prevalent state, the number of HSS, ICTC and PPTCT sites are low<br />The quality of services statistics in recording and reporting needs improvement in terms of <br />Consistency<br />Completeness<br />Correctness<br />Changes:<br />Recently attention has been laid on data quality and data use<br />Data Triangulation Exercise<br />Capacity building of all level of staff are being done<br />
    51. 51. Programmatic response to combat HIV/AIDS in Uttar Pradesh <br />
    52. 52. National AIDS Control Programme Phase III (NACP III) <br />Goal:<br />Halt and reverse the epidemic in India over the next five years<br />Specific Objectives:<br />Reduce new infections by<br />60% in high prevalence states<br />40% in vulnerable states<br />
    53. 53. NACP III - Four pronged strategy<br />Prevent new infections <br />Increase proportion of PLHA receiving care, support, and treatment<br />Strengthen capacity at district, state and national levels<br />Build strategic information management systems<br />
    54. 54. Strategic shift from NACP II to NACP III<br />NACP III<br />NACP II<br />Aims toshift the focus from raising awareness to behavior change<br />Through interventions, particularly for groups at a high risk of contracting and spreading HIV<br />Aims at saturation of coverage of the core target population (80%)<br />Guiding Principles:<br />3 Ones principle <br />Evidence-based planning <br />A & B districts – more focus <br />Decentralization <br />
    55. 55. NACP-III at a glance<br />Care, Support & <br />Treatment<br />Prevention<br />Capacity Building<br />Strategic <br />Information <br />Management <br />Care & support<br />Monitoring and Evaluation<br />High risk populations<br />Low risk populations<br />Institutional Strengthening<br /><ul><li>Blood safety
    56. 56. Integrated Counselling and Testing including PPTCT
    57. 57. STI care
    58. 58. IEC and social mobilisation
    59. 59. Mainstreaming
    60. 60. Targeted Interventions (TIs)
    61. 61. STI care
    62. 62. Condom promotion
    63. 63. Enabling environment
    64. 64. ART
    65. 65. HIV-TB co-ordination
    66. 66. Treatment of OIs
    67. 67. CCCs
    68. 68. Post-Exposure Prophylaxis (PEP)
    69. 69. HIV Sentinel Surveillance
    70. 70. Behavioural Surveillance
    71. 71. Monitoring and Evaluation
    72. 72. Operations research
    73. 73. DAPCU
    74. 74. Technical resource groups
    75. 75. Enhanced HR at NACO, SACS and districts
    76. 76. Enhanced training activities</li></li></ul><li>Consolidate gains<br />Scale up treatment services <br />Focus on youth and adolescents<br />Decentralize to district & sub-district level<br />Saturate coverage of High Risk Groups<br />Normalize use of condoms<br />Priorities under NACP-III<br />Stigma & Discrimination<br />
    77. 77. NACP III : Challenges<br />Infection moving from<br /><ul><li>High risk groups to general population
    78. 78. Urban to rural areas
    79. 79. Adults to vulnerable youth
    80. 80. High prevalence states to all states</li></ul>Evolving a well coordinated response<br /><ul><li>Raising financial resources
    81. 81. Involving a large number of donors /key stakeholders
    82. 82. Avoiding program overlaps and duplication
    83. 83. Strengthening capacities in states, districts
    84. 84. Energizing program management at all levels</li></li></ul><li>Prioritize Districts for Interventions and optimum utilization of resources <br />UP has only 5 A category districts:<br />Allahabd, Mau, Deoria, Banda & Etawah<br />
    85. 85. UPSACS - HIV/AIDS related services and Interventions<br />
    86. 86. Information, Education, Communication<br />CCTV:<br /><ul><li>HIV/AIDS messages through CCTV at Lucknow and Gorakhpur Railway Station.</li></ul>Print Media:<br /><ul><li>HIV/AIDS related messages on Railway Reservation Form (46 lakh)
    87. 87. HIV/AIDS related messages on Meghdoot Postcards (15 lakh)
    88. 88. VBD posters and WAD posters and manuals for HRG</li></ul>IPC:<br /><ul><li>1300 NCC cadets and 60 Instructors trained.
    89. 89. 200 Gram Sabha Meetings in Banda and Deoria
    90. 90. 70 folk troupes trained
    91. 91. 200 folk media performances</li></li></ul><li>Information, Education, Communication<br />Mass Media<br />All India Radio: <br /><ul><li>Weekly phone-in programme (twice) from Primary and FM channels of AIR
    92. 92. Sensitization of RJs and other staffs of Radio City, Radio Mirchi, Big FM
    93. 93. Sensitization of all Station Directors of AIR</li></ul>Doordarshan: <br /><ul><li>Broadcasting of video spots on HIV/AIDS, Phone-in programme and Youth Quiz on HIV/AIDS.
    94. 94. Participation in Kalyani Health Magazine.</li></ul>Outdoor Media:<br /><ul><li>Installation of Hoardings and Wall writing on prevention, available services and Condom promotion in Medical Colleges and SGPGI
    95. 95. 30 hoardings installed and 30 wall writings done
    96. 96. 52 wall writings by Gram Pradhans – free of cost
    97. 97. 5 Mobile vans by HLFPPT in all ‘A’ districts</li></li></ul><li>Information, Education, Communication<br />Voluntary Blood Donation Day<br /><ul><li>Inter Sectoral meeting chaired by Chief Secretary.
    98. 98. Chief Secretary addressed all the DMs & CMOs </li></ul>World AIDS Day<br /><ul><li>Mass Media campaign through 9 Mobile vans with 135 folk troupe performances
    99. 99. Rally on 1 Dec, 09 with support of CMO, Lko. Approx. 7000 participants
    100. 100. Inter Colleges street play competition with support of IIM,LKO
    101. 101. Awareness campaign in slums with support of Rotary Club and Lucknow University
    102. 102. HIV/AIDS awareness activities in 85 colleges through Red Ribbon Clubs</li></li></ul><li>Information, Education, Communication<br />Mela and Mahotsav:<br /><ul><li>Folk troups performances in Magh Mela and Ganga Mahotsav
    103. 103. Activities in Kanpur IIT, Antaragini 09. Approximate 350 youth get tested themselves in Antaragini.
    104. 104. Different activities for HIV/AIDS awareness in IIM Lucknow, and in Babu Banarasi Das College, Lucknow.</li></ul>National Youth Day<br /><ul><li>Rally in collaboration with CMO Allahabad.
    105. 105. Street Play and debate competition</li></li></ul><li>Youth Affairs and Mainstreaming<br /><ul><li>127 Red Ribbon Clubs opened
    106. 106. Antyodaya Anna Yojana / BPL card for PLHIV in all dist
    107. 107. Bar Association in 3 districts providing free legal aid to HIV+
    108. 108. NREGA providing employment to HIV+ without stigma
    109. 109. 1 orphanage functional in Lucknow for PLHIV and children.
    110. 110. Grievance redressal mechanism in UPNP+ active
    111. 111. Govt. officials oriented on HIV in 15 districts
    112. 112. PRI members trained in 5 districts (1700 Nos)
    113. 113. 2059 ASHA & 2176 AWW trained in 5 ‘A’ category districts
    114. 114. 56 Pradhans did wall paintings from their development funds
    115. 115. SIRD includes HIV session in all their training programs of ICDS and PRI</li></li></ul><li>Targeted Interventions (2010-11)<br />
    116. 116. District Wise Distribution of *Core Tis –Uttar Pradesh<br /> LEGEND - Distribution of Core TIs<br /> FSW MSM & IDU<br /> FSW & MSM <br /> FSW & IDU<br /> FSW (F) <br /> IDU (I)<br /> MSM (M)<br />Nos. in circles indicates no. of Tis in the respective district<br />Saharanpur<br />Bijnor<br />Muzaffarnagar<br />Meerut<br />I-350<br />Baghpat<br />1<br />1<br />JP Nagar<br />Rampur<br />3<br />Ghaziabad<br />Moradabad<br /> I-200<br />1<br />Pilibhit<br /> (F-500<br />+M-600<br />+I-500)<br />GB Nagar<br /> (F-500+M-1000+I-200)<br />2<br />Bareilly<br /> I-250<br />Bulandshahar<br />Lakhimpur <br /> Kheri<br />Budaun<br />Shahjahanpur<br />I-500+I-200<br />Aligarh<br />Sharwasti<br />Sant Kabir Nagar<br />Bahraich<br />Etah<br />Balrampur<br />Hathras<br />2<br />Mathura<br />Sitapur<br />Farrukhabad<br />Siddharthnagar<br />Hardoi<br />Maharajganj<br />F-500+M-300<br />1<br />3<br />Firozabad<br />1<br />Gonda<br />Mainpuri<br />Kannauj<br />Kusinagar<br /> F-250<br />Agra<br />1<br />Bara Banki<br />4<br />Basti<br /> F-300+I-250<br />Etawah<br />Gorakhpur<br /> I-750<br />Lucknow<br />Faizabad<br />Unnao <br />(F-500+M-350+I-300)<br />1<br />I-200<br />Ambedkar Nagar<br /> F-250<br />Kanpur Nagar<br />Auraiya<br />Deoria<br />Kanpur <br />Dehat<br />Rae Bareli<br /> F-250<br />1<br />1<br />Sultanpur<br />Jalaun <br /> Mau<br />M-550<br />2<br />Azamgarh<br />Ballia<br /> I-250<br />Pratapgarh<br />Fatehpur<br />1<br />1<br />M-200<br />Jaunpur<br />1<br />1<br />Hamirpur<br />Jhansi<br />Ghazipur<br />F-500<br />Banda<br /> I-200<br />Varanasi<br />Kaushambi<br />Mahoba<br />Bhadohi<br />(F-500+M-400+I-500)<br />3<br />Allahabad<br />Chitrakoot<br />4<br />Chandauli<br />1<br />Mirzapur<br />Lalitpur<br /> F-250<br />(F-500+M-900+I-500+F-250)<br />Total Nos. Of Core Tis 37<br />(FSW 13, MSM 8, IDU 16) <br />Sonbhadra<br />
    117. 117. District Wise Distribution of FSWs <br />Reached & Mapped<br />Saharanpur<br />Legend - Based on FSWs reached<br />Nos. in colour indicates FSWs reached <br /> No. Tis in the districts<br /> Up to 199<br /> 200 to 299<br /> 300 to 399<br /> 400 & more<br />Nos. in colour indicates FSWs mapped <br />Muzaffarnagar<br />Bijnor<br />Moradabad<br />Meerut<br />JP Nagar<br />Rampur<br />Bagpat<br />Pilibhit<br />Ghaziabad<br />Bulandshahar<br />Bareilly<br />Budaun<br />GB Nagar<br />Bahraich<br />Sant Kabir Nagar<br />Aligarh<br />Lakhimpur Kheri<br />Sharwasti<br />Mathura<br />Shahjahanpur<br />Balrampur<br />Hathras<br />Etah<br />Siddharthnagar<br />Farrukhabad<br />Sitapur<br />Maharajganj<br />Firozabad<br />Hardoi<br />Agra<br />Kannauj<br />Bara Banki<br />Gonda<br />Gorakhpur<br />Unnao <br />Basti<br />Kusinagar<br />Faizabad<br />Lucknow<br />Auraiya<br />Etawah<br />Ambedkar Nagar<br />Deoria<br />Rae Bareli<br />Sultanpur<br />Kanpur <br />Dehat<br />Mau<br />Kanpur<br /> Nagar<br />Azamgarh<br />Jaunpur<br />Pratapgarh<br />Ballia<br />Jalaun <br />Fatehpur<br />Hamirpur<br />Jhansi<br />Ghazipur<br />Allahabad<br />Bhadohi<br />Varanasi<br />Mahoba<br />Kaushambi<br />Banda<br />Mirzapur<br />Chitrakoot<br />Chandauli<br />Lalitpur<br />Sonbhdra<br />TSU, UPSACS<br />
    118. 118. District Wise distribution of MSMs Reached & Mapped<br />Saharanpur<br />Legend - Based on MSMs reached<br />Nos. in colour indicates MSMs reached <br /> No. Tis in the districts<br /> Up to 199<br /> 200 to 299<br /> 300 to 399<br /> 400 & more<br />Nos. in colour indicates MSMs mapped <br />Legend - <br /> No. Tis in the districts<br /> <=200<br /> <=300<br /> <=400<br /> >400<br />Muzaffarnagar<br />Bijnor<br />Moradabad<br />Rampur<br />Meerut<br />JP Nagar<br />Bagpat<br />Ghaizabad<br />Pilibhit<br />Bulandshahar<br />Bareilly<br />Budaun<br />Shahjahanpur<br />GB Nagar<br />Bahraich<br />Aligarh<br />Lakhimpur Kheri<br />Sant Kabir Nagar<br />Sharwasti<br />Sitapur<br />Mathura<br />Balrampur<br />Etah<br />Hathras<br />Farrukhabad<br />Maharajganj<br />Siddharthnagar<br />Mainpuri<br />Firozabad<br />Hardoi<br />Agra<br />Gonda<br />Kannauj<br />Kusinagar<br />Gorakhpur<br />Basti<br />Unnao <br />Bara Banki<br />Etawah<br />Kanpur <br />Dehat<br />Faizabad<br />Lucknow<br />Auraiya<br />Ambedkar Nagar<br />Deoria<br />Jalaun <br />Sultanpur<br />Kanpur<br /> Nagar<br />Rae Bareli<br />Pratapgarh<br />Mau<br />Ballia<br />Azamgarh<br />Kaushambi<br />Fatehpur<br />Jaunpur<br />Jhansi<br />Hamirpur<br />Ghazipur<br />Allahabad<br />Bhadohi<br />Banda<br />Varanasi<br />Mahoba<br />Chitrakoot<br />Mirzapur<br />Chandauli<br />Lalitpur<br />Sonbhadra<br />TSU, UPSACS<br />
    119. 119. District Wise distribution of IDUs Reached & Mapped <br />Saharanpur<br />Legend - Based on IDUs reached<br />Nos. in colour indicates IDUs reached <br /> No. Tis in the districts<br /> Up to 199<br /> 200 to 299<br /> 300 to 399<br /> 400 & more<br />Nos. in colour indicates IDUs mapped <br />Muzaffarnagar<br />Bijnor<br />Moradabad<br />Bagpat<br />Meerut<br />Rampur<br />JP Nagar<br />Ghaziabad<br />Pilibhit<br />GB Nagar<br />Bulandshahar<br />Bareilly<br />Budaun<br />Shahjahanpur<br />Bahraich<br />Aligarh<br />Lakhimpur Kheri<br />Sant Kabir Nagar<br />Mathura<br />Sitapur<br />Balrampur<br />Hathras<br />Sharwasti<br />Etah<br />Farrukhabad<br />Siddharthnagar<br />Maharajganj<br />Hardoi<br />Firozabad<br />Bara Banki<br />Mainpuri<br />Agra<br />Gonda<br />Kusinagar<br />Kannauj<br />Gorakhpur<br />Basti<br />Etawah<br />Unnao <br />Kanpur <br />Dehat<br />Faizabad<br />Lucknow<br />Ambedkar Nagar<br />Auraiya<br />Jalaun <br />Sultanpur<br />Deoria<br />Rae Bareli<br />Mau<br />Kanpur<br /> Nagar<br />Pratapgarh<br />Ballia<br />Azamgarh<br />Kaushambi<br />Fatehpur<br />Jaunpur<br />Hamirpur<br />Jhansi<br />Ghazipur<br />Allahabad<br />Banda<br />Bhadohi<br />Varanasi<br />Mahoba<br />Mirzapur<br />Chitrakoot<br />Chandauli<br />Sonbhadra<br />Lalitpur<br />TSU, UPSACS<br />
    120. 120. District Wise Distribution of HRGs Reached& Mapped<br />Saharanpur<br />Legend – <br />Nos. in colores indicates HRGs reached <br /> Up to 500<br /> 501 - 750<br /> 751 - 1000<br /> More than 1000 <br />Nos. in colores indicates HRGs mapped <br />Bijnor<br />Muzaffarnagar<br />Moradabad<br />Meerut<br />Rampur<br />Baghpat<br />Pilibhit<br />Ghaziabad<br />Bareilly<br />JP Nagar<br />Lakhimpur <br /> Kheri<br />Shahjahanpur<br />Bulandshahar<br />GB Nagar<br />Bahraich<br />Aligarh<br />Budaun<br />Etah<br />Sharwasti<br />Sant Kabir Nagar<br />Balrampur<br />Sitapur<br />Mathura<br />Hardoi<br />Hathras<br />Farrukhabad<br />Maharajganj<br />Siddharthnagar<br />Mainpuri<br />Bara Banki<br />Firozabad<br />Gonda<br />Agra<br />Kannauj<br />Gorakhpur<br />Basti<br />Kanpur <br />Nagar<br />Etawah<br />Kusinagar<br />Faizabad<br />Lucknow<br />Unnao <br />Auraiya<br />Ambedkar Nagar<br />Rae Bareli<br />Deoria<br />Kanpur <br />Dehat<br />Sultanpur<br /> Mau<br />Pratapgarh<br />Ballia<br />Jalaun <br />Fatehpur<br />Azamgarh<br />Jhansi<br />Banda<br />Hamirpur<br />Ghazipur<br />Jaunpur<br />Kaushambi<br />Varanasi<br />Mahoba<br />Bhadohi<br />Allahabad<br />Chitrakoot<br />Chandauli<br />Mirzapur<br />Lalitpur<br />Sonbhadra<br />
    121. 121. ICTC<br />Govt. ICTC: 250<br />PPP-ICTC: 27<br />Mostly ICTCs are in District Hospitals and in Medical Colleges<br />In ‘A’ category districts up to sub-district level<br />
    122. 122. Saharanpur<br />Legend - <br /> Up to 100<br /> 101 - 300<br /> 301 – 500<br /> 501 - 1000<br /> 1001 - 3000<br /> More than 3000<br />Muzaffarnagar<br />Bijnor<br />Baghpat<br />Moradabad<br />Meerut<br />JP Nagar<br />Rampur<br />Ghaziabad<br />Pilibhit<br />Gautam <br />Buddha <br />Nagar<br />Bareilly<br />Bulandshahar<br />Lakhimpur<br /> Kheri<br />Budaun<br />Sant Kabir Nagar<br />Shahjahanpur<br />Bahraich<br />Aligarh<br />Sharwasti<br />Etah<br />Mathura<br />Balrampur<br />Sitapur<br />Hathras<br />Farrukhabad<br />Maharajganj<br />Siddharthnagar<br />Hardoi<br />Firozabad<br />Agra<br />Mainpuri<br />Gonda<br />Agra<br />Kannauj<br />3570<br />Kusinagar<br />Bara Banki<br />Basti<br />Lucknow<br />Etawah<br />Gorakhpur<br />Faizabad<br />Unnao <br />Auraiya<br />5016<br />Kanpur <br />Dehat<br />4267<br />Deoria<br />Ambedkar Nagar<br />Sultanpur<br />Rae Bareli<br />Jalaun <br />Kanpur<br /> Nagar<br />Azamgarh<br />Mau<br />Ballia<br />Pratapgarh<br />Fatehpur<br />Jaunpur<br />Hamirpur<br />Ghazipur<br />Jhansi<br />Kaushambi<br />Banda<br />Bhadohi<br />Varanasi<br />Mahoba<br />8788<br />Allahabad<br />Chandauli<br />Chitrakoot<br />4084<br />Mirzapur<br />Lalitpur<br />Total no. of persons tested <br />HIV Positive 44212 (2002-Aug. 2008)<br />Sonbhadra<br />Cumulative number of persons tested HIV positive in ICTC <br />2002-2009<br />Total no. of test found HIV Positive = 55,596<br />
    123. 123. Persons tested in ICTCs<br />General Clients 1992 - 2009<br />
    124. 124. No. of Tests HIV+ in ICTCs and Sero-positivity<br />2005 – 2010<br />
    125. 125. Persons tested in ICTCs<br />Pregnant Women 2005 - 2009<br />
    126. 126. STI<br />Total SACS supported STI clinics: 86<br />In District Hospitals and in Medical Collges<br />Medicine kits received from NACO and distributed through STI Clinics <br />Doctors, paramedic and counselors trained<br />Private Health Care Providers (TI-NGOs) trained - 353<br />
    127. 127. Basic Services - STI<br />STI attendance and treatment 2005-2010<br />
    128. 128. Condom Promotion<br /><ul><li>41,132 condom outlets formed against the target of 39,000 in 31 districts (105%)
    129. 129. Initiated Condom distribution through Fair Price shops in 10 districts & distributed 147658 pcs of condom.
    130. 130. 600 Condom Vending Machines installed in Kanpur and Lucknow towns.</li></li></ul><li>Blood Safety<br /><ul><li>Govt. Blood Banks: 66
    131. 131. NACO supported Blood Bank: 68
    132. 132. Private Blood Bank: 106
    133. 133. Military Blood Bank: 8
    134. 134. DLBB: 44
    135. 135. MBB with BCSU: 14
    136. 136. MBB without BCSU: 6
    137. 137. Model BB: 1</li></li></ul><li>No. of Blood Units Tested and Positivity<br />2002 – 2009<br />
    138. 138. AnnualRegistrations in HIV-care - 2005 to 2010<br />Total Registered till July 2010 – 32,760<br />Alive and on ART till July 2010– 13,018<br />
    139. 139. Number of Patients registered on ART from different district <br />Up to March 2009<br />Saharanpur<br />Legend - <br /> Up to 100<br /> 101 - 300<br /> 301 – 500<br /> 501 - 1000<br /> More than 1000<br />Muzaffarnagar<br />Bijnor<br />Baghpat<br />Moradabad<br />Meerut<br />Rampur<br />JP Nagar<br />Ghaziabad<br />Pilibhit<br />Gautam <br />Buddha <br />Nagar<br />Bareilly<br />Bulandshahar<br />Lakhimpur<br /> Kheri<br />Budaun<br />Sant Kabir Nagar<br />Shahjahanpur<br />Bahraich<br />Aligarh<br />Sharwasti<br />Mathura<br />Etah<br />Sitapur<br />Hathras<br />Balrampur<br />Farrukhabad<br />Hardoi<br />Siddharthnagar<br />Maharajganj<br />Gonda<br />Mainpuri<br />Firozabad<br />Bara Banki<br />Agra<br />Kusinagar<br />Kannauj<br />Basti<br />Lucknow<br />Gorakhpur<br />Etawah<br />Unnao <br />Faizabad<br />Auraiya<br />Ambedkar Nagar<br />Deoria<br />Rae Bareli<br />Sultanpur<br />Kanpur Nagar<br />Kanpur <br />Dehat<br />Jalaun <br />Mau<br />Azamgarh<br />Ballia<br />Pratapgarh<br />Fatehpur<br />Jaunpur<br />Ghazipur<br />Hamirpur<br />Jhansi<br />Banda<br />Kaushambi<br />Varanasi<br />Allahabad<br />Mahoba<br />Bhadohi<br />Chandrali<br />Chitrakoot<br />Mirzapur<br />Lalitpur<br />Sonbhadra<br /> Total number of persons registered in HIV Care 17885<br />ART Centre<br />‘A’ Category District<br /> * Note: Total no. of patients <br /> registered in HIV care up to <br /> march 09 is 18447 (from CMIS), out of these, 562 patients registered in HIV care but no specification about districts/origin. <br />TSU, UPSACS<br />
    140. 140. No. of Patients registered on ART From Different District Up to March 2010<br />Saharanpur 110<br />Bijnor 169<br />Muzaffarnagar 266<br />Bagpat 106<br />Rampur 64<br />Meerut 893<br />Moradabad 169<br />JPNagar 72<br />Gaziabad 358<br />Pilibhit 26 <br />Bareilly 108<br />Gautam Buddha Nagar 39<br />Buland Shahar 178<br />Lakhimpur Kheri 53<br />Sant Kabir Nagar 673<br />Badaun46<br />Shahjahanpur 49<br />Aligarh 350<br />Bhraich 141<br />Sarawasti 65<br />Sidharthnagar 631<br />Hathras 210<br />Sitapur 84<br />Mathura 275<br />Etah 144<br />Farrukhabad 42<br />Balrampur 349<br />Maharajganj 626<br />Mainpuri <br />53<br />Hardoi 43<br />Gonda 417<br />Firozabad 170<br />Kannuaj 68<br />Kusinagar 829<br />Agra 1091<br />Bara Banki 132<br />Etawah 86<br />Lucknow 472<br />Basti 747<br />Unnao 258<br />Auraiya 41<br />Faizabad 262<br />Kanpur Nagar 515<br />Gorkhpur 1808<br />Kanpur Dehat 0 <br />A.N.Nagar 285<br />Sultanpur 544<br />Deoria 1238<br />Rai Bareli 254<br />Mau 433<br />Azamgarh 1219<br />Jalaun 88<br />Fatehpur 178<br />Pratapgarh 1048<br />Gazipur 644<br />Hamir Pur 41<br />Jhansi 66<br />Ballia 434<br />Varanasi 858<br />Jaunpur 1505<br />Kaushambi 215<br />Banda 148<br />Allahabad 1734<br />Mahoba 13<br />Chandauli 241<br />Chitrakoot 89<br />Mirzapur 299<br />Lalit Pur 24<br />Sonbhadra 152<br />25238<br />
    141. 141. Cumulative no. of Persons on ART – District wise<br />13018<br />
    142. 142. Persons on ARTAdded every year 2005 - 2010<br />
    143. 143. Support to UPSACS and TSU by FHI/USAID SAMARTH project<br />HRG Mapping and BSS-2009<br />Training of Govt. Health Care Providers across 71 districts within a short period – 2009 and 2010<br />Training of UPSACS and TSU staff on Documentation<br />Coordination and facilitation of UPSACS Classroom training and exposure visit <br />Annual report preparation<br />Developing at least one TI in each region which demonstrate good quality program interventionsand process documentation to develop these TIs as learning sites<br />Data Triangulation <br />Developing two Districts Gorakhpur and Agra as learning sites for district-level HIV service decentralization.<br />
    144. 144. AAP and % Funds Utilization(Fiscal Year wise 2005 - 2010)<br />
    145. 145. Gaps Identified<br />Awareness about disease still low<br />Stigma still persists, though situation is better<br />Awareness about testing and care facilities still low<br />Wide gap between estimates and actual tested<br />Wide gap between tested and enrolled in care <br />Target populations yet to be reached fully<br />
    146. 146. Gaps Identified<br />Care and support activities need to be expanded<br />Home based care to be increased<br />Reach for PPTCT can be increased- social and cultural barriers<br />Issues related to Nutrition <br />Outreach activities for patients LFU / Missed Reaching out to young and too young<br />Issue of orphans, infected and affected children<br />
    147. 147. Thank You<br />

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