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An Overview of HIV/AIDS Epidemic Situation and Programmatic Response in Uttar PradeshIAPSM Conference Dehradun30-31 Oct 2010Dr Pramod GautamDr Sudipta MondalFHI
About FHI1971       - The establishment of Institute for Family  Health (IFH) managing research and field activities (North Carolina)1986       -	The establishment of Institute for HIV/AIDS (IHA) managing  the work on HIV prevention Programs1990        -  FHI Foundation Established1993        -  HIV Prevention Research and Women’s Studies1995        -   PQC Established1999        -    Pharma Link FHI Established2001        -  Youthnet, IFA and IHA2004        -  Malaria Clinical Trials2006         - HPV, Avian Flu, Rotavirus and Unification for Greater Impact
Mission, Values and Beliefs
Dr Pramod Dr Sudipta
SAMARTH Project OverviewBackground: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 2006-2011Goal: Improve the effectiveness of the response of the government and civil society for evidence-based HIV policy and programs in India
ObjectivesTo enhance capacities of government and civil society for effective management of HIV /AIDS programTo strengthen quality of HIV prevention, care and treatment in the public and private sectorTo improve planning, collection analysis, and use of strategic information (SI) at the national, state, and district levelsTo foster bold leadership and visibility of USG-supported programs through strategic communication
Vulnerability Factors for HIV Epidemic in UP•Population 180-200 million (growth rate 2.5%)•48-50% in reproductive age group•Low literacy (rural 36.66%, state 57.2%)•High incidence of poverty•Low status of women & Gender disparity•Large presence of high risk groups* Migrants : 10 million* Truckers : 50,000 (8 national highways)* FSWs: 20000-25000 * IDUs: 10000-12000* MSM: 10000-12000•Long porous Indo-Nepal border
Levels and Trends of HIV in UP
Adult HIV Prevalence in Indian and UP
HIV Prevalence in UP: NFHS-III Estimate
Trend in HIV Prevalence among General Population
Trend in HIV Prevalence among High Risk Groups
HIV prevalence trends at ICTC in Eastern UP and rest of UP
Prevalence of HIV among clients tested at ICTC by region
Prevalence of HIV among clients tested at PPTCT by region
HIV Positivity among HRGs in UP2008 – 2009Data Source:  CMIS -UPSACS
BSS Indicators
Comprehensive knowledge on HIVPercentage of respondents who could correctly identify:Two major ways of preventing the sexual transmission of HIVConsistent condom useHaving one faithful uninfected sex partnerReject the two most common local misconceptions about HIV transmissionTransmission of HIV/AIDS through mosquito bitesSharing of meals with HIV/AIDS patientsKnow that a healthy-looking person can transmit HIV18
Comprehensive knowledge about HIV - FSWsBy RegionTotal
Number of different types of clients and partners in the last week
Condom use during last sex with occasional and regular clients
Consistent condom use with occasional & regular clients in last 30 daysBase: Those who used condoms during sex
Aware of free Government counseling and testing servicesTotalBy RegionBase: All
Injecting Drug Users (IDUs)
HIV/ AIDS Knowledge and Prevention- IDU
Sexual behavior of IDU with female partners 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 4Sexual Behavior and Condom Use with Female Partners
Men Having Sex With Men (MSM)
Knowledge of HIV/AIDS-MSM Knowledge on transmission of HIV/AIDS among respondentsCOMPREHENSIVE KNOWLEDGE ABOUT HIV/AIDS       18% - 2009 UP BSS        16% - 2006 UP BSS
Condom Usage with Male PartnersCondom use during last sex with male partnersCommon reasons for not using condoms with male partnersTrust -  regular male partners
 Condoms not available - casual partners
Never heard of a condom, condom not available and decrease in pleasure -  paid partners
 Condoms tear easily - paying partnersCondom Use with Paying Male Partners 20 .27 – Mean age when first had paying partners6.68 - Mean number of paying male clients in a typical week6.34 -Mean number of anal sex acts with paying male clients in the last week40% – Never used a condom with clientsCommon reasons for not using a condom with clients27%  - condoms tear easily
23% - condoms not availableDrivers of the Epidemic
FSWs and MSMEstimates distribution of total 22,425 FSWs across 1,496 sitesEstimates distribution of total 10,922 MSM across 799 sites
IDUs and HijrasEstimates distribution of total 13,946 IDUs across 1251 sitesEstimates distribution of total 4,673 Hijras across    525 sitesScattered across 612 towns with a density of 0.6 HRG per 1000 male
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 behaviourEstimates of High Risk Groups (HRGs) in Uttar Pradesh6241,0587301,0903371,7416851,1986349536727341,7728281,7059191,0527171741,396238619042677501555342843361,7248962013723771,9382554922357225015765921,3484761,168448803450573,4987592221,0067495619676566291,0166033652,375191371822117354215727731535
Estimates of Female Sex Workers (FSWs) in Uttar Pradesh36
Estimates of Men Having Sex with Men (MSM) in Uttar Pradesh1502259697315161911542072931811781551221382981381067445218020127318135434145912104658823568682997995416511911746512318513059158016102145142823711564120825242015081056463737
Estimates of Injecting Drug Users (IDUs) in Uttar Pradesh142267280118289268484172337743713431232587142023661395606710031640326131433188866130320691512475133724973111195110769190271372466291801559110716914921916616351517581715957231268238
74761525,78639,0371,3333673,557122,56410,2133391,0506162945633246259582143373242766719,6002082,10766078128736,0663891,5021,1165003131,8565092381,52544,9851,6009862408003181,25616318,5213751,8123,640400352308442Estimates of Single Male Circular Migrants in Uttar Pradesh39
11.97 million people are migrants in Maharashtra
Most of the migrants are from UPSource: Behavioral Surveillance Survey, Maharashtra, 2009
Allahabad, Gorakhpur, Varanasi, Jaunpur, Sultanpur, Kanpur, Faizabad, Pratapgarh, Mughal Saray, Sant Kabir Nagar, Sardar, Azamgarh, Faijabad, Basti, Siddharth Nagar & Lucknow
Challenges and OpportunitiesGaps:Being low prevalent state, the number of HSS, ICTC and PPTCT sites are lowThe quality of services statistics in recording and reporting needs improvement in terms of ConsistencyCompletenessCorrectnessChanges:Recently attention has been laid on data quality and data useData Triangulation ExerciseCapacity building of all level of staff are being done
Programmatic response to combat HIV/AIDS in Uttar Pradesh
National AIDS Control Programme Phase III (NACP III) Goal:Halt and reverse the epidemic in India over the next five yearsSpecific Objectives:Reduce new infections by60% in high prevalence states40% in vulnerable states
NACP III - Four pronged strategyPrevent new infections Increase proportion of PLHA receiving care, support, and treatmentStrengthen capacity at district, state and national levelsBuild strategic information management systems
Strategic shift from NACP II to NACP IIINACP IIINACP IIAims toshift the focus from raising awareness to behavior changeThrough interventions, particularly for groups at a high risk of contracting and spreading HIVAims at saturation of coverage of the core target population (80%)Guiding Principles:3  Ones principle Evidence-based planning A & B districts – more focus Decentralization
NACP-III at a glanceCare, Support & TreatmentPreventionCapacity BuildingStrategic Information Management Care & supportMonitoring and EvaluationHigh risk populationsLow risk populationsInstitutional StrengtheningBlood safety
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 activitiesConsolidate gainsScale up treatment services Focus on youth and adolescentsDecentralize  to district & sub-district levelSaturate coverage of High Risk GroupsNormalize use of condomsPriorities under NACP-IIIStigma & Discrimination
NACP III :  ChallengesInfection moving fromHigh risk groups to general population
Urban to rural areas
Adults to vulnerable youth
High prevalence states to all statesEvolving a well coordinated responseRaising financial resources
Involving a large number of donors /key stakeholders
Avoiding program overlaps and duplication

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Dr Pramod Dr Sudipta

  • 1. An Overview of HIV/AIDS Epidemic Situation and Programmatic Response in Uttar PradeshIAPSM Conference Dehradun30-31 Oct 2010Dr Pramod GautamDr Sudipta MondalFHI
  • 2. About FHI1971 - The establishment of Institute for Family Health (IFH) managing research and field activities (North Carolina)1986 - The establishment of Institute for HIV/AIDS (IHA) managing the work on HIV prevention Programs1990 - FHI Foundation Established1993 - HIV Prevention Research and Women’s Studies1995 - PQC Established1999 - Pharma Link FHI Established2001 - Youthnet, IFA and IHA2004 - Malaria Clinical Trials2006 - HPV, Avian Flu, Rotavirus and Unification for Greater Impact
  • 5. SAMARTH Project OverviewBackground: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 2006-2011Goal: Improve the effectiveness of the response of the government and civil society for evidence-based HIV policy and programs in India
  • 6. ObjectivesTo enhance capacities of government and civil society for effective management of HIV /AIDS programTo strengthen quality of HIV prevention, care and treatment in the public and private sectorTo improve planning, collection analysis, and use of strategic information (SI) at the national, state, and district levelsTo foster bold leadership and visibility of USG-supported programs through strategic communication
  • 7. Vulnerability Factors for HIV Epidemic in UP•Population 180-200 million (growth rate 2.5%)•48-50% in reproductive age group•Low literacy (rural 36.66%, state 57.2%)•High incidence of poverty•Low status of women & Gender disparity•Large presence of high risk groups* Migrants : 10 million* Truckers : 50,000 (8 national highways)* FSWs: 20000-25000 * IDUs: 10000-12000* MSM: 10000-12000•Long porous Indo-Nepal border
  • 8. Levels and Trends of HIV in UP
  • 9. Adult HIV Prevalence in Indian and UP
  • 10. HIV Prevalence in UP: NFHS-III Estimate
  • 11. Trend in HIV Prevalence among General Population
  • 12. Trend in HIV Prevalence among High Risk Groups
  • 13. HIV prevalence trends at ICTC in Eastern UP and rest of UP
  • 14. Prevalence of HIV among clients tested at ICTC by region
  • 15. Prevalence of HIV among clients tested at PPTCT by region
  • 16. HIV Positivity among HRGs in UP2008 – 2009Data Source: CMIS -UPSACS
  • 18. Comprehensive knowledge on HIVPercentage of respondents who could correctly identify:Two major ways of preventing the sexual transmission of HIVConsistent condom useHaving one faithful uninfected sex partnerReject the two most common local misconceptions about HIV transmissionTransmission of HIV/AIDS through mosquito bitesSharing of meals with HIV/AIDS patientsKnow that a healthy-looking person can transmit HIV18
  • 19. Comprehensive knowledge about HIV - FSWsBy RegionTotal
  • 20. Number of different types of clients and partners in the last week
  • 21. Condom use during last sex with occasional and regular clients
  • 22. Consistent condom use with occasional & regular clients in last 30 daysBase: Those who used condoms during sex
  • 23. Aware of free Government counseling and testing servicesTotalBy RegionBase: All
  • 25. HIV/ AIDS Knowledge and Prevention- IDU
  • 26. Sexual behavior of IDU with female partners 76% of IDUs ever had sex with a female partner
  • 27. Mean age at first sex with a female partner was 19 years
  • 28. 8% of IDUs ever had sex with a Female Sex Worker
  • 29. Mean Age at first sex with a FSW was 21 years
  • 30. Mean number of sex acts with female partner in the last one week was 4Sexual Behavior and Condom Use with Female Partners
  • 31. Men Having Sex With Men (MSM)
  • 32. Knowledge of HIV/AIDS-MSM Knowledge on transmission of HIV/AIDS among respondentsCOMPREHENSIVE KNOWLEDGE ABOUT HIV/AIDS 18% - 2009 UP BSS 16% - 2006 UP BSS
  • 33. Condom Usage with Male PartnersCondom use during last sex with male partnersCommon reasons for not using condoms with male partnersTrust - regular male partners
  • 34. Condoms not available - casual partners
  • 35. Never heard of a condom, condom not available and decrease in pleasure - paid partners
  • 36. Condoms tear easily - paying partnersCondom Use with Paying Male Partners 20 .27 – Mean age when first had paying partners6.68 - Mean number of paying male clients in a typical week6.34 -Mean number of anal sex acts with paying male clients in the last week40% – Never used a condom with clientsCommon reasons for not using a condom with clients27% - condoms tear easily
  • 37. 23% - condoms not availableDrivers of the Epidemic
  • 38. FSWs and MSMEstimates distribution of total 22,425 FSWs across 1,496 sitesEstimates distribution of total 10,922 MSM across 799 sites
  • 39. IDUs and HijrasEstimates distribution of total 13,946 IDUs across 1251 sitesEstimates distribution of total 4,673 Hijras across 525 sitesScattered across 612 towns with a density of 0.6 HRG per 1000 male
  • 40. Migrants concentrated in 68 towns with 12.7% reporting high risk behaviour
  • 41. High proportion of IDUs – Easy accessibility and less expensive
  • 42. Hijras - a small proportion and even smaller proportion (2.3%) reported risk behaviourEstimates of High Risk Groups (HRGs) in Uttar Pradesh6241,0587301,0903371,7416851,1986349536727341,7728281,7059191,0527171741,396238619042677501555342843361,7248962013723771,9382554922357225015765921,3484761,168448803450573,4987592221,0067495619676566291,0166033652,375191371822117354215727731535
  • 43. Estimates of Female Sex Workers (FSWs) in Uttar Pradesh36
  • 44. Estimates of Men Having Sex with Men (MSM) in Uttar Pradesh1502259697315161911542072931811781551221382981381067445218020127318135434145912104658823568682997995416511911746512318513059158016102145142823711564120825242015081056463737
  • 45. Estimates of Injecting Drug Users (IDUs) in Uttar Pradesh142267280118289268484172337743713431232587142023661395606710031640326131433188866130320691512475133724973111195110769190271372466291801559110716914921916616351517581715957231268238
  • 47. 11.97 million people are migrants in Maharashtra
  • 48. Most of the migrants are from UPSource: Behavioral Surveillance Survey, Maharashtra, 2009
  • 49. Allahabad, Gorakhpur, Varanasi, Jaunpur, Sultanpur, Kanpur, Faizabad, Pratapgarh, Mughal Saray, Sant Kabir Nagar, Sardar, Azamgarh, Faijabad, Basti, Siddharth Nagar & Lucknow
  • 50. Challenges and OpportunitiesGaps:Being low prevalent state, the number of HSS, ICTC and PPTCT sites are lowThe quality of services statistics in recording and reporting needs improvement in terms of ConsistencyCompletenessCorrectnessChanges:Recently attention has been laid on data quality and data useData Triangulation ExerciseCapacity building of all level of staff are being done
  • 51. Programmatic response to combat HIV/AIDS in Uttar Pradesh
  • 52. National AIDS Control Programme Phase III (NACP III) Goal:Halt and reverse the epidemic in India over the next five yearsSpecific Objectives:Reduce new infections by60% in high prevalence states40% in vulnerable states
  • 53. NACP III - Four pronged strategyPrevent new infections Increase proportion of PLHA receiving care, support, and treatmentStrengthen capacity at district, state and national levelsBuild strategic information management systems
  • 54. Strategic shift from NACP II to NACP IIINACP IIINACP IIAims toshift the focus from raising awareness to behavior changeThrough interventions, particularly for groups at a high risk of contracting and spreading HIVAims at saturation of coverage of the core target population (80%)Guiding Principles:3 Ones principle Evidence-based planning A & B districts – more focus Decentralization
  • 55. NACP-III at a glanceCare, Support & TreatmentPreventionCapacity BuildingStrategic Information Management Care & supportMonitoring and EvaluationHigh risk populationsLow risk populationsInstitutional StrengtheningBlood safety
  • 56. Integrated Counselling and Testing including PPTCT
  • 58. IEC and social mobilisation
  • 64. ART
  • 65. HIV-TB co-ordination
  • 67. CCCs
  • 73. DAPCU
  • 75. Enhanced HR at NACO, SACS and districts
  • 76. Enhanced training activitiesConsolidate gainsScale up treatment services Focus on youth and adolescentsDecentralize to district & sub-district levelSaturate coverage of High Risk GroupsNormalize use of condomsPriorities under NACP-IIIStigma & Discrimination
  • 77. NACP III : ChallengesInfection moving fromHigh risk groups to general population
  • 80. High prevalence states to all statesEvolving a well coordinated responseRaising financial resources
  • 81. Involving a large number of donors /key stakeholders
  • 82. Avoiding program overlaps and duplication
  • 83. Strengthening capacities in states, districts
  • 84. Energizing program management at all levelsPrioritize Districts for Interventions and optimum utilization of resources UP has only 5 A category districts:Allahabd, Mau, Deoria, Banda & Etawah
  • 85. UPSACS - HIV/AIDS related services and Interventions
  • 86. Information, Education, CommunicationCCTV:HIV/AIDS messages through CCTV at Lucknow and Gorakhpur Railway Station.Print Media:HIV/AIDS related messages on Railway Reservation Form (46 lakh)
  • 87. HIV/AIDS related messages on Meghdoot Postcards (15 lakh)
  • 88. VBD posters and WAD posters and manuals for HRGIPC:1300 NCC cadets and 60 Instructors trained.
  • 89. 200 Gram Sabha Meetings in Banda and Deoria
  • 90. 70 folk troupes trained
  • 91. 200 folk media performancesInformation, Education, CommunicationMass MediaAll India Radio: Weekly phone-in programme (twice) from Primary and FM channels of AIR
  • 92. Sensitization of RJs and other staffs of Radio City, Radio Mirchi, Big FM
  • 93. Sensitization of all Station Directors of AIRDoordarshan: Broadcasting of video spots on HIV/AIDS, Phone-in programme and Youth Quiz on HIV/AIDS.
  • 94. Participation in Kalyani Health Magazine.Outdoor Media:Installation of Hoardings and Wall writing on prevention, available services and Condom promotion in Medical Colleges and SGPGI
  • 95. 30 hoardings installed and 30 wall writings done
  • 96. 52 wall writings by Gram Pradhans – free of cost
  • 97. 5 Mobile vans by HLFPPT in all ‘A’ districtsInformation, Education, CommunicationVoluntary Blood Donation DayInter Sectoral meeting chaired by Chief Secretary.
  • 98. Chief Secretary addressed all the DMs & CMOs World AIDS DayMass Media campaign through 9 Mobile vans with 135 folk troupe performances
  • 99. Rally on 1 Dec, 09 with support of CMO, Lko. Approx. 7000 participants
  • 100. Inter Colleges street play competition with support of IIM,LKO
  • 101. Awareness campaign in slums with support of Rotary Club and Lucknow University
  • 102. HIV/AIDS awareness activities in 85 colleges through Red Ribbon ClubsInformation, Education, CommunicationMela and Mahotsav:Folk troups performances in Magh Mela and Ganga Mahotsav
  • 103. Activities in Kanpur IIT, Antaragini 09. Approximate 350 youth get tested themselves in Antaragini.
  • 104. Different activities for HIV/AIDS awareness in IIM Lucknow, and in Babu Banarasi Das College, Lucknow.National Youth DayRally in collaboration with CMO Allahabad.
  • 105. Street Play and debate competitionYouth Affairs and Mainstreaming127 Red Ribbon Clubs opened
  • 106. Antyodaya Anna Yojana / BPL card for PLHIV in all dist
  • 107. Bar Association in 3 districts providing free legal aid to HIV+
  • 108. NREGA providing employment to HIV+ without stigma
  • 109. 1 orphanage functional in Lucknow for PLHIV and children.
  • 110. Grievance redressal mechanism in UPNP+ active
  • 111. Govt. officials oriented on HIV in 15 districts
  • 112. PRI members trained in 5 districts (1700 Nos)
  • 113. 2059 ASHA & 2176 AWW trained in 5 ‘A’ category districts
  • 114. 56 Pradhans did wall paintings from their development funds
  • 115. SIRD includes HIV session in all their training programs of ICDS and PRITargeted Interventions (2010-11)
  • 116. District Wise Distribution of *Core Tis –Uttar Pradesh LEGEND - Distribution of Core TIs FSW MSM & IDU FSW & MSM FSW & IDU FSW (F) IDU (I) MSM (M)Nos. in circles indicates no. of Tis in the respective districtSaharanpurBijnorMuzaffarnagarMeerutI-350Baghpat11JP NagarRampur3GhaziabadMoradabad I-2001Pilibhit (F-500+M-600+I-500)GB Nagar (F-500+M-1000+I-200)2Bareilly I-250BulandshaharLakhimpur KheriBudaunShahjahanpurI-500+I-200AligarhSharwastiSant Kabir NagarBahraichEtahBalrampurHathras2MathuraSitapurFarrukhabadSiddharthnagarHardoiMaharajganjF-500+M-30013Firozabad1GondaMainpuriKannaujKusinagar F-250Agra1Bara Banki4Basti F-300+I-250EtawahGorakhpur I-750LucknowFaizabadUnnao (F-500+M-350+I-300)1I-200Ambedkar Nagar F-250Kanpur NagarAuraiyaDeoriaKanpur DehatRae Bareli F-25011SultanpurJalaun MauM-5502AzamgarhBallia I-250PratapgarhFatehpur11M-200Jaunpur11HamirpurJhansiGhazipurF-500Banda I-200VaranasiKaushambiMahobaBhadohi(F-500+M-400+I-500)3AllahabadChitrakoot4Chandauli1MirzapurLalitpur F-250(F-500+M-900+I-500+F-250)Total Nos. Of Core Tis 37(FSW 13, MSM 8, IDU 16) Sonbhadra
  • 117. District Wise Distribution of FSWs Reached & MappedSaharanpurLegend - Based on FSWs reachedNos. in colour indicates FSWs reached No. Tis in the districts Up to 199 200 to 299 300 to 399 400 & moreNos. in colour indicates FSWs mapped MuzaffarnagarBijnorMoradabadMeerutJP NagarRampurBagpatPilibhitGhaziabadBulandshaharBareillyBudaunGB NagarBahraichSant Kabir NagarAligarhLakhimpur KheriSharwastiMathuraShahjahanpurBalrampurHathrasEtahSiddharthnagarFarrukhabadSitapurMaharajganjFirozabadHardoiAgraKannaujBara BankiGondaGorakhpurUnnao BastiKusinagarFaizabadLucknowAuraiyaEtawahAmbedkar NagarDeoriaRae BareliSultanpurKanpur DehatMauKanpur NagarAzamgarhJaunpurPratapgarhBalliaJalaun FatehpurHamirpurJhansiGhazipurAllahabadBhadohiVaranasiMahobaKaushambiBandaMirzapurChitrakootChandauliLalitpurSonbhdraTSU, UPSACS
  • 118. District Wise distribution of MSMs Reached & MappedSaharanpurLegend - Based on MSMs reachedNos. in colour indicates MSMs reached No. Tis in the districts Up to 199 200 to 299 300 to 399 400 & moreNos. in colour indicates MSMs mapped Legend - No. Tis in the districts <=200 <=300 <=400 >400MuzaffarnagarBijnorMoradabadRampurMeerutJP NagarBagpatGhaizabadPilibhitBulandshaharBareillyBudaunShahjahanpurGB NagarBahraichAligarhLakhimpur KheriSant Kabir NagarSharwastiSitapurMathuraBalrampurEtahHathrasFarrukhabadMaharajganjSiddharthnagarMainpuriFirozabadHardoiAgraGondaKannaujKusinagarGorakhpurBastiUnnao Bara BankiEtawahKanpur DehatFaizabadLucknowAuraiyaAmbedkar NagarDeoriaJalaun SultanpurKanpur NagarRae BareliPratapgarhMauBalliaAzamgarhKaushambiFatehpurJaunpurJhansiHamirpurGhazipurAllahabadBhadohiBandaVaranasiMahobaChitrakootMirzapurChandauliLalitpurSonbhadraTSU, UPSACS
  • 119. District Wise distribution of IDUs Reached & Mapped SaharanpurLegend - Based on IDUs reachedNos. in colour indicates IDUs reached No. Tis in the districts Up to 199 200 to 299 300 to 399 400 & moreNos. in colour indicates IDUs mapped MuzaffarnagarBijnorMoradabadBagpatMeerutRampurJP NagarGhaziabadPilibhitGB NagarBulandshaharBareillyBudaunShahjahanpurBahraichAligarhLakhimpur KheriSant Kabir NagarMathuraSitapurBalrampurHathrasSharwastiEtahFarrukhabadSiddharthnagarMaharajganjHardoiFirozabadBara BankiMainpuriAgraGondaKusinagarKannaujGorakhpurBastiEtawahUnnao Kanpur DehatFaizabadLucknowAmbedkar NagarAuraiyaJalaun SultanpurDeoriaRae BareliMauKanpur NagarPratapgarhBalliaAzamgarhKaushambiFatehpurJaunpurHamirpurJhansiGhazipurAllahabadBandaBhadohiVaranasiMahobaMirzapurChitrakootChandauliSonbhadraLalitpurTSU, UPSACS
  • 120. District Wise Distribution of HRGs Reached& MappedSaharanpurLegend – Nos. in colores indicates HRGs reached Up to 500 501 - 750 751 - 1000 More than 1000 Nos. in colores indicates HRGs mapped BijnorMuzaffarnagarMoradabadMeerutRampurBaghpatPilibhitGhaziabadBareillyJP NagarLakhimpur KheriShahjahanpurBulandshaharGB NagarBahraichAligarhBudaunEtahSharwastiSant Kabir NagarBalrampurSitapurMathuraHardoiHathrasFarrukhabadMaharajganjSiddharthnagarMainpuriBara BankiFirozabadGondaAgraKannaujGorakhpurBastiKanpur NagarEtawahKusinagarFaizabadLucknowUnnao AuraiyaAmbedkar NagarRae BareliDeoriaKanpur DehatSultanpur MauPratapgarhBalliaJalaun FatehpurAzamgarhJhansiBandaHamirpurGhazipurJaunpurKaushambiVaranasiMahobaBhadohiAllahabadChitrakootChandauliMirzapurLalitpurSonbhadra
  • 121. ICTCGovt. ICTC: 250PPP-ICTC: 27Mostly ICTCs are in District Hospitals and in Medical CollegesIn ‘A’ category districts up to sub-district level
  • 122. SaharanpurLegend - Up to 100 101 - 300 301 – 500 501 - 1000 1001 - 3000 More than 3000MuzaffarnagarBijnorBaghpatMoradabadMeerutJP NagarRampurGhaziabadPilibhitGautam Buddha NagarBareillyBulandshaharLakhimpur KheriBudaunSant Kabir NagarShahjahanpurBahraichAligarhSharwastiEtahMathuraBalrampurSitapurHathrasFarrukhabadMaharajganjSiddharthnagarHardoiFirozabadAgraMainpuriGondaAgraKannauj3570KusinagarBara BankiBastiLucknowEtawahGorakhpurFaizabadUnnao Auraiya5016Kanpur Dehat4267DeoriaAmbedkar NagarSultanpurRae BareliJalaun Kanpur NagarAzamgarhMauBalliaPratapgarhFatehpurJaunpurHamirpurGhazipurJhansiKaushambiBandaBhadohiVaranasiMahoba8788AllahabadChandauliChitrakoot4084MirzapurLalitpurTotal no. of persons tested HIV Positive 44212 (2002-Aug. 2008)SonbhadraCumulative number of persons tested HIV positive in ICTC 2002-2009Total no. of test found HIV Positive = 55,596
  • 123. Persons tested in ICTCsGeneral Clients 1992 - 2009
  • 124. No. of Tests HIV+ in ICTCs and Sero-positivity2005 – 2010
  • 125. Persons tested in ICTCsPregnant Women 2005 - 2009
  • 126. STITotal SACS supported STI clinics: 86In District Hospitals and in Medical CollgesMedicine kits received from NACO and distributed through STI Clinics Doctors, paramedic and counselors trainedPrivate Health Care Providers (TI-NGOs) trained - 353
  • 127. Basic Services - STISTI attendance and treatment 2005-2010
  • 128. Condom Promotion41,132 condom outlets formed against the target of 39,000 in 31 districts (105%)
  • 129. Initiated Condom distribution through Fair Price shops in 10 districts & distributed 147658 pcs of condom.
  • 130. 600 Condom Vending Machines installed in Kanpur and Lucknow towns.Blood SafetyGovt. Blood Banks: 66
  • 137. Model BB: 1No. of Blood Units Tested and Positivity2002 – 2009
  • 138. AnnualRegistrations in HIV-care - 2005 to 2010Total Registered till July 2010 – 32,760Alive and on ART till July 2010– 13,018
  • 139. Number of Patients registered on ART from different district Up to March 2009SaharanpurLegend - Up to 100 101 - 300 301 – 500 501 - 1000 More than 1000MuzaffarnagarBijnorBaghpatMoradabadMeerutRampurJP NagarGhaziabadPilibhitGautam Buddha NagarBareillyBulandshaharLakhimpur KheriBudaunSant Kabir NagarShahjahanpurBahraichAligarhSharwastiMathuraEtahSitapurHathrasBalrampurFarrukhabadHardoiSiddharthnagarMaharajganjGondaMainpuriFirozabadBara BankiAgraKusinagarKannaujBastiLucknowGorakhpurEtawahUnnao FaizabadAuraiyaAmbedkar NagarDeoriaRae BareliSultanpurKanpur NagarKanpur DehatJalaun MauAzamgarhBalliaPratapgarhFatehpurJaunpurGhazipurHamirpurJhansiBandaKaushambiVaranasiAllahabadMahobaBhadohiChandraliChitrakootMirzapurLalitpurSonbhadra Total number of persons registered in HIV Care 17885ART Centre‘A’ Category District * Note: Total no. of patients registered in HIV care up to march 09 is 18447 (from CMIS), out of these, 562 patients registered in HIV care but no specification about districts/origin. TSU, UPSACS
  • 140. No. of Patients registered on ART From Different District Up to March 2010Saharanpur 110Bijnor 169Muzaffarnagar 266Bagpat 106Rampur 64Meerut 893Moradabad 169JPNagar 72Gaziabad 358Pilibhit 26 Bareilly 108Gautam Buddha Nagar 39Buland Shahar 178Lakhimpur Kheri 53Sant Kabir Nagar 673Badaun46Shahjahanpur 49Aligarh 350Bhraich 141Sarawasti 65Sidharthnagar 631Hathras 210Sitapur 84Mathura 275Etah 144Farrukhabad 42Balrampur 349Maharajganj 626Mainpuri 53Hardoi 43Gonda 417Firozabad 170Kannuaj 68Kusinagar 829Agra 1091Bara Banki 132Etawah 86Lucknow 472Basti 747Unnao 258Auraiya 41Faizabad 262Kanpur Nagar 515Gorkhpur 1808Kanpur Dehat 0 A.N.Nagar 285Sultanpur 544Deoria 1238Rai Bareli 254Mau 433Azamgarh 1219Jalaun 88Fatehpur 178Pratapgarh 1048Gazipur 644Hamir Pur 41Jhansi 66Ballia 434Varanasi 858Jaunpur 1505Kaushambi 215Banda 148Allahabad 1734Mahoba 13Chandauli 241Chitrakoot 89Mirzapur 299Lalit Pur 24Sonbhadra 15225238
  • 141. Cumulative no. of Persons on ART – District wise13018
  • 142. Persons on ARTAdded every year 2005 - 2010
  • 143. Support to UPSACS and TSU by FHI/USAID SAMARTH projectHRG Mapping and BSS-2009Training of Govt. Health Care Providers across 71 districts within a short period – 2009 and 2010Training of UPSACS and TSU staff on DocumentationCoordination and facilitation of UPSACS Classroom training and exposure visit Annual report preparationDeveloping at least one TI in each region which demonstrate good quality program interventionsand process documentation to develop these TIs as learning sitesData Triangulation Developing two Districts Gorakhpur and Agra as learning sites for district-level HIV service decentralization.
  • 144. AAP and % Funds Utilization(Fiscal Year wise 2005 - 2010)
  • 145. Gaps IdentifiedAwareness about disease still lowStigma still persists, though situation is betterAwareness about testing and care facilities still lowWide gap between estimates and actual testedWide gap between tested and enrolled in care Target populations yet to be reached fully
  • 146. Gaps IdentifiedCare and support activities need to be expandedHome based care to be increasedReach for PPTCT can be increased- social and cultural barriersIssues related to Nutrition Outreach activities for patients LFU / Missed Reaching out to young and too youngIssue of orphans, infected and affected children

Editor's Notes

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