The National AIDS Control Programme in India has gone through 4 phases since 1987 aimed at reducing HIV transmission and providing treatment. Phase 1 from 1987-1999 focused on awareness campaigns. Phase 2 from 1999-2006 shifted to behavior change interventions. Phase 3 from 2007-2012 integrated prevention, care, support and treatment. Phase 4 from 2012-2017 focused on key populations and reducing stigma. The programme is coordinated by NACO and implemented through state and district societies and ICTCs with nurses playing a role in service delivery.

3. RANKING
1. SOUTH AFRICA
2. NIGERIA
3. INDIA
4. KENYA
5. TANZANIA

4. NATIONAL AIDS CONTROL PROGRAMME
(1987)
GOALS:
• 80% coverage of high risk groups
• 90% coverage of schools and colleges by education
• 80% awareness among rural population
• Reduction of transmission through blood to less than 1%
• Establishment of at least 1 voluntary testing counseling centre for every
district
• Reduction of mother to child transmission
• Achieving zero level increase of HIV/AIDS new infections by the year 2007.

5. PROGRAMME DETAILS:
NACP
PHASE I
(1992-1999)

6. • THE GOVERNMENT OF INDIA LAUNCHED A HIV/AIDS CONTROL
PROJECT ( PHASE I ) FROM 1992 – 1999.
• 100% CENTRALLY SPONSORED PROJECT FOR ALL STATES.

7. PROJECT OBJECTIVES:
• INVOLVE ALL STATES IN PREVENTION ACTIVITIES.
• ATTAIN SATISFACTORY LEVEL OF PUBLIC AWARENESS.
• DEVELOP HEALTH PROMOTION INTERVENTIONS AMONG RISK
BEHAVIOUR GROUPS.
• BLOOD SCREENING.
• DECREASE THE PRACTICE OF PROFESSIONAL BLOOD DONATIONS.

9. • IN 1992 THE MINISTRY OF HEALTH AND FAMILY WELFARE
SETUP A “ NATIONAL AIDS CONTROL ORGANIZATION (NACO) “.
• A SEPARATE WING TO IMPLEMENT AND MONITOR THE
VARIOUS ACTIVITIES OF THE AIDS CONTROL PROGRAMME.

10. ACTIVITIES OF NACO:
• PROMOTION OF CONDOM
• TREATMENT FOR STD
• PREVENTION OF MOTHER TO CHILD TRANSMISSION.
• VCTC SERVICES.
• ACCESS OF SAFE BLOOD.
• TREATMENT OF OPPURTUNISTIC INFECTIONS.
• ART.

11. BLOOD SAFETY POLICY

12. OBJECTIVES
• TO ENSURE ORGANIZED BLOOD BANKING SERVICES
• TO EDUCATE AND MOTIVATE PEOPLE ABOUT VOLUNTARY
BLOOD DONATION
• TO ENFORCE QUALITY CONTROL OF BLOOD BEFORE
INFUSION

13. • BLOOD TRANSFUSION COUNCILS
SET UP AT NATIONAL AND STATE
LEVEL.
• ONLY LICENSED BLOOD BANKS
ARE PERMITTED TO OPERATE.
• ENSURE SAFE BLOOD COLLECTION
AND STORAGE.
• TESTING OF EVERY UNIT OF
BLOOD IS MANDATORY FOR
DETECTING INFECTIONS.

14. • ESTABLISHED BLOOD STORAGE
CENTRES AT FRU’S.
• VOLUNTRY BLOOD DONATION IS
ENCOURAGED.
• ZONAL BLOOD TESTING CENTRES
HAVE BEEN ESTABLISHED.
• HIV TEST KITS ARE SUPPLIED UPTO
DISTRICT LEVEL BLOOD BANKS.

15. ACHIEVEMENT OF PHASE I
• AWARENESS LEVEL INSIGNIFICANT IN URBAN AND
RURAL AREAS.
URBAN : 70 – 80% RURAL 30%

16. NACP
PHASE II
(1999-2006)

17. AIMS OF PHASE II (1999-2006):
• TO SHIFT THE FOCUS FROM RAISING AWRENESS TO CHANGING BEHAVIOUR
THROUGH INTERVENTIONS.
• PROGRAMME DELIVERY SHOULD BE FLEXIBLE, EVIDENCE BASED AND
PARTICIPATORY.
• SUPPORT DECENTRALIZATION.
• ENCOURAGING VOLUNTRY COUNCELLING AND TESTING INSTEAD OF
MANDATORY
• TO ENCOURAGE MANAGEMENT REFORMS (DRUGS AND EQUIPMENTS)

18. OBJECTIVES
• TO PREVENT FURTHER TRANSMISSION OF HIV
• TO DECREASE THE MORBIDITY AND MORTALITY
ASSOCIATED WITH HIV INFECTION.
• TO MINIMIZE THE SOCIO-ECONOMIC IMPACT RESULTING
FROM HIV INFECTION.

19. PROGRAMME STRATEGIES

20. 1. NATIONAL AIDS PREVENTION &
CONTROL POLICY
• IN APRIL 2002 GOVT.OF.INDIA APPROVED THE
NATIONAL AIDS PREVENTION AND CONTROL
POLICY.
OBJECTIVES
• ZERO TRANSMISSION RATE
• PREVENT FURTHER SPREAD OF THE DISEASE.
• IMPROVE SERVICES FOR PLWA.

21. CARE OF PLWA
• Protection of their rights
• Proper care and support in the hospitals and community
• Keeping confidentiality
• Formation of self help groups
• Encouragement for the participation of NGO
• Sensitization of medical and Para medical people
• Proper counseling of HIV positive mothers
• Clinical management of HIV/AIDS

22. 2. STI TREATMENT
• The objective is to reduce STI s and there by control HIV transmission
and to prevent morbidity and mortality due to STIs
• Development of adequate and effective management
• Promoting IEC activities
• Comprehensive care management
• Increasing access to health care by creating new structures

23. 2. COUNCILLING AND TESTING

24. • Early detection of HIV by rapid
diagnostic tests.
• Providing basic information on modes of
transmission and prevention of
HIV/AIDS
• Linking people with other HIV
prevention , care and treatment services.

25. 4. CONDOM PROMOTION

26. • Sensitizing the clients and CSW to use
condoms
• Availability of low cost and good quality
GOAL:
• QUALITY CONTROL OF CONDOMS
• SOCIAL MARKETING OF CONDOMS
• INVOLVEMENT OF NGO’S AND PRIVATE
ORGANIZATIONS.

27. 5. HIV SURVEILLANCE
• DIFFERENT TYPE OF
SURVEILLANCE ACTIVITIES ARE
CARRIED OUT TO IDENTIFY THE
CASES.
• HIV SENTINEL SURVEILLANCE,
STD SURVEILLANCE, AIDS CASE
SURVEILLANCE etc…

28. SENTINEL SURVEILLANCE
• MONITOR THE TRENDS OF HIV INFECTION.
• REGULAR SURVEILLANCE IN 1200 SENTINEL SITES.
• TARGET POPULATION
• 15-45 YEARS, ANC MOTHERS, C.S.W ETC…

30. 6. TARGET INTERVENTIONS

33. 7. SCHOOL AIDS AWARNESS PROGRAMME

35. 8. IEC ACTIVITIES

36. • RED RIBBON EXPRESS
• RED RIBBON CLUB IN SCHOOLS AND COLLEGES.
• ADOLESCENT HEALTH EDUCATION PROGRAMME.
• BEHAVIOUR CHANGE COMMUNICATION (BCC)
• MASS MEDIA INVOLVEMENT.

37. 9. FAMILY HEALTH AWARENESS
CAMPAIGN ( FHAC )
• PERIOD OF CAMPAIGN IS OF 15
DAYS AND DAYS ARE DECIDED
BY THE STATES AS PER THEIR
CONVENIENCE.
• MAINLY ADDRESSING THE
REPRODUCTIVE HEALTH.

38. 10. PREVENTION OF MOTHER TO CHILD
TRANSMISSION (PMTCT)

39. • Among 100 HIV positive
women:
• 5 to 10 infants will be infected
during pregnancy
• 10 to 20 infants will be infected
during labor and delivery
• 20 to 30 infants will be infected
during breast feeding

40. • NEVIRAPINE SINGLE DOSE TO MOTHER AND
CHILD HAS BEEN STARTED FROM OCTOBER
2001.
• REFERAL TO PPTCT CENTRES.
• MODIFIED MIDWIFERY PRACTICES.
• SAFE INFANT FEEDING.
• FAMILY PLANNING SERVICES.

41. 11.POST EXPOSURE PROPHYLAXSIS

42. • POST-EXPOSURE PROPHYLAXIS
SHOULD BE GIVEN WITHIN FOUR
HOURS.
• THE COMBINATION OF
ANTIRETROVIRAL DRUGS,
ZIDOVUDINE (AZT), LAMIVUDINE
(3TC), AND INDINAVIR.
• FOLLOW-UP OF AN HIV EXPOSED FOR
1 YEAR FOR SEROLOGICAL
INVESTIGATIONS.

43. 12. NATIONAL AIDS HELPLINE

44. • TOLL FREE NO
• 1097
• INFORMATION AND
COUNSELLING
SERVICES.

45. PHASE III (2007 – 2012)
GOAL:
• HALT AND REVERSE THE EPIDEMICS OF HIV IN INDIA OVER
THE NEXT FIVE YEARS BY INTEGRATING PROGRAMMES
FOR PREVENTION CARE, SUPPORT AND TREATMENT.

46. PROGRAMME STRATEGY
• Prevention of new infections in high risk groups
• Prophylactic treatment for HIV infected people to prevent
opportunistic infections
• Providing greater care and support PLWHA
• Strengthening infrastructure development
• Nation wide HMIS

47. PHASE IV (2012 – 2017)
• Funded by global fund fight against HIV/AIDS and world bank.
• Main focus on:
– transgender
–Prevention of new infections
–PPTCT
–Reducing social stigma

48. PROGRAMME STRATEGIES
• Promotion of female condoms
• Scaling up of second line drugs in ART
• Social protection for ending discrimination

49. ANTI RETROVIRAL TREATMENT
• HAART:
– CD4 CELL COUNT< 350
• ZIDOVUDINE 500 mg
• TENOFOVIR 300 mg
• RITONAVIR 600 mg
• NEVIRAPINE 200 mg

50. PROGRAMME ACHIEVEMENT
Annual HIV infection rate reduced up to 57%
• In 2000 HIV infection rate : 2,74,000
• In 2011 HIV Infection rate : 1,16,000
• Prevalence rate of HIV in 2000 : 0.41%
• Prevalence rate of HIV in 2011 : 0.27%

51. WORLD AIDS DAY THEME (DEC.1)
• “GETTING TO ZERO”
• ZERO NEW HIV INFECTIONS
• ZERO DISCRIMINATION
• ZERO AIDS RELATED DEATHS

52. Organizational pattern:
• NACO
• STATE AIDS CONTROL SOCIETY
• DISTRICT SOCIETY
• ICTC

53. ROLE OF NURSE