This document summarizes the National AIDS Control Programme (NACP) in India. It discusses the four phases of NACP from 1992 to 2024, which aim to prevent new HIV infections and provide treatment. Key aspects of NACP include targeted interventions for high-risk groups, integrated counseling and testing centers, prevention of parent-to-child transmission, post-exposure prophylaxis, coordination with tuberculosis programs, and World Health Organization treatment guidelines. The document also outlines the structure of the National AIDS Control Organization.

1. NACP
Chairperson: Presented By:
Dr.Annapurna.K Shubhechchha B. &
Lecturer Dr. Spurthi.S.M
Dept. of Public Health MPH I Sem
JNMC,Belagavi Dept. of Public Health
JNMC , Belagavi

2. CONTENTS
 Introduction
 Global & Indian Scenario
 AIDS Control Programmes in India(NACP I -
NACPIV)
 NACO Structure
 ICTC
 PPTCT
 PEP
 HIV & TB
 WHO Treatment guidelines
 References

3. INTRODUCTION
 AIDS(Acquired Immuno Deficiency Syndrome)
 HIV(Human Immuno deficiency Virus) retrovirus
 Destroys CD4+ T cells ,which fight back
 No cure for HIV infection
 Mode of Transmission:
1. Sexual transmission: MSM, FSW, Hetrosexual sex
2. Blood contact: Injecting drug use
3. Maternal-Foetal transmission
 Incubation Period: Few months to 10yrs
 Test : ELISA ,Western blot
 Treatment: ART

6. Global Scenario Of HIV Prevalence

10. MILE STONES IN AIDS CONTROL IN
INDIA
2017-2024 NACP IV extended (National Stratergic plan for
HIV/AIDS and STI’s)

11. NACP I
 Aims:
-Prevent HIV transmission
- Decrease mortality & morbidity associated with HIV
-Minimize socio-economic impact
 NAC headed by Health minister
 NACO established in June1992
 National AIDS Control Board was consituted for
approval of NACO policies
 State AIDS Cells were established in all 32 states & UT’s.But the
programme was hinderedby administrative & financial
bottelenecks.

13. NACP II
 Aims:
-Reduce the spread through behaviour change
-Increase capacity to respond to HIV on a long term basis
 National AIDS Prevention & Control Policy(2002)
 Scale up targeted interventions for HRG’s in High prevalence states
 National Blood Policy
 Greater Involvement of people with HIV/AIDS(GIPA)
 National Adolescent Education Programme(NAEP)
 Introduction to Conselling, testing & PPTCT
 National ART Programme
 National Council on AIDS
 Setting up State AIDS Control socities in all states
 Inter – Ministerial group involvement

18. •Prevalence of HIV cases in Karnataka 0.47%
•PLHIV = 2.47 lakh
•No. ART Centres in Karnataka 63
•No. ART Centres in Belagavi 6
•No. PLHIV in Belgavi 32,000 Acc. to KSAPS/undp.org

19. NACP III
 Goal: Halting & reversing the epidemic by end of
theproject.
 Aims:
-Prevention among HRG’s & general population
- Care Support & Treatment
 Prevention – Targeted interventions(TI), ICTC, Blood
safety, communication, advocacy & mobilization &
Condom promotion
 Strengthing the capacities of SAC’s & DAPCU’s
 Technical support units estb.
 State traning resource centres (STRC) set up.
 Stratergic Information Manangement System(SIMS)
estb.

22. NACP IV
 Aims:
-Reduce new infections by 50%
-Comprehensive Care, support & treatment to all with
HIV/AIDS
 Preventive services:
-Targeted Interventions for HRG’s & Bridge Population
-Needle-syringe Exchange Programme(NSEP)
-Line Worker Scheme
-Prevention & Control of STI’s & RTI’s
-Blood Transfusion Services
-ICTC,PPCT, HIV & TB collaborative activities
-Condom Promotion
-IEC & BCC(Mass media,Folk media,Flagship programmes
like RED Ribbon Express)

25. NACP IV
 CARE, SUPPORT & TREATMENT
-Lab services for CD4 testing, Viral Load testing,
Early Infant Diagnosis, confirmatory diagnosis of
HIV-2
-Free First & Second line treatments through Anti
Retroviral Treatment through ART centres
-Pediatric ART for Children
-Nutritional & Psycho-Social Support through
community & support centres.
-HIV-TB coordination
-Treatment of Opportunistic Infections

28. NACO Structure

29. ICTC
 Integrated Counselling and Testing Centre
 HIV counselling and testing services were started in India in
1997. As on 31st August 2016 in India, there are 20,756 ICTC
mainly in Govt. Hospitals
 Functions:
 Conducting HIV diagnostic tests.
 Providing basic information on the modes of HIV transmission, and
promoting behavioural change to reduce vulnerability.
 Link people with other HIV prevention, care and treatment services.

30. PPTCT
 Prevention of Parent to Child Transmission
 PPTCT programme was launched in the country in the year
2002
 The PPTCT services cover about 47 percent annual estimated
pregnancies in the country. In the year 2015-16, 12.7 million
pregnant women accessed this service. Of these, 11,918
pregnant women were HIV positive.
 Functions:
 Conselling & testing of pregnant women in ICTC’s.
 HIV positive cases are initiated on lifelong ART treartment
 The Newborns of these positive mothers are immediately put
on the ART treatment to prevent the transmission of HIV to the
newborn.

31. PEP
 Post-Exposure Prophylaxis
 It means taking antiretroviral medicines (ART)
after being potentially exposed to HIV to prevent
becoming infected.
 PEP must be started within 72 hours after a recent
possible exposure to HIV, but the sooner you start
PEP, the better. Every hour counts. If you’re
prescribed PEP, you’ll need to take it once or twice
daily for 28 days. PEP is effective in preventing HIV
when administered correctly, but not 100%.

32. HIV-TB COORDINATION
 Launched in 2001
 HIV infection make an individual more prone to TB
disease.
 HIV positive TB infected person has 50-60%
chances of lifetime risk of developing TB when
compared to a negative TB pt. who has risk of 10%
 RNTCP & NACO deviced Joint Action Plan for HIV-
TB cood.
 Its main objective as to reduce morbidity & mortality
in PLHIV by TB diseases.

33. WHO TREATMENT GUIDELINES
WHO Clinical Staging Recommendations
HIV Infected Adults & Adolescents
Clinical Stage I and II Start ART if CD4 ≤ 500
Clinical Stage III and IV Start ART irrespective of CD4 count
All Pregnant / Breast Feeding Women
All clinical Stages Start ART irrespective of CD4 count
HIV-TB Co-Infected Patients
Patients with HIV and TB co-infection (Pulmonary or
Extra Pulmonary)
Start ART irrespective of CD4 count Start ATT rst, initiate ART as early
as possible between 2 weeks-2months. For patients with CD4 below
50, ART might be initiated simultaneously with ATT with strict clinical
and laboratory monitoring
HIV-Hepatitis B/C Co-Infected Patients
HIV and HBV / HCV co-infection – without any
evidence of severe chronic liver disease
Start ART if CD4 ≤ 500
HIV and HBV / HCV co-infection – with evidence of
severe chronic liver disease
Start ART irrespective of CD4 count
HIV-Visceral Leishmaniasis (KalaAzar) Co-Infected
Patients
Patients with HIV-Visceral Leishmaniasis co-infected Start ART irrespective of CD4 count

34. NATIONAL STRATEGIC PLAN FOR HIV/AIDS
AND STI 2017 – 2024
 Paving Way for AIDS free India
 HIV and STI Prevention
 HIV Testing and Counselling Services(ICTC)
 HIV Care, Support and Treatment (CST)
 Elimination of Mother to Child Transmission of HIV
and Syphilis (EMTCT)
 Laboratory Services
 Blood Transfusion Services
 Information Education and Communication (IEC)
 Monitoring, Evaluation and Surveillance
 Research and Evaluation

38. REFERENCES
 Preventive & Social Medicine by K.Park
 Textbook of Public Health & Community Medicine
by AFMC, Pune
 Websites:
www.naco.gov.in
www.who.int/hiv/
www.evert.org
www.ksaps.gov.in
www.undp.org.in