This document summarizes India's National AIDS Control Programme (NACP). It recommends treating all HIV patients with antiretroviral therapy (ART) regardless of disease stage or CD4 count. First line ART combines two nucleoside reverse-transcriptase inhibitors (NRTIs) with a non-nucleoside reverse-transcriptase inhibitor (NNRTI). Alternative and second line ART are used if first line treatment fails or causes toxicity. It also describes management of opportunistic infections, sexually transmitted diseases (STDs), and education programs for adolescents and college students to increase HIV/AIDS awareness and prevention.

1. NACP
(NATIONAL AIDS CONTROL
PROGRAMME)

32. Treatment services
ART initiation -
•Current recommendation is to treat all (regardless of clinical stage or
CD4 count)
First line ART
•For treatment of naive adults & adolescent patients
•Triple drug combination is used
•NRTI backbone (preferably Tenofovir + Lamivudine)
+
•One NNRTI (preferably Efavirenz)
•Counselling regarding treatment adherence, nutrition, positive
prevention &living and follow-up is provided.

33. Alternative First line ART -
•Prescribed in case when Patient experiences drug toxicity or he is
intolerant to first line ARV drugs
•Recommendation - Substitution are made within the groups
- In severe toxicity, ART is stopped till patient
recovers
Second line ART
•Initiated after First line treatment fails
•Recommendations – A new class of ARV , a ritonavir boosted PI is
used
Supported by at least one new /unused NRTI
Continued Lamivudine administration
•State AIDS Clinical Expert Panel (SACEP) at CoE & ART plus centres
takes decision regarding switch and substitution of therapy

34. Third line ART -
•Initiated after second line treatment fails
•Raltegravir (INSTI) & a new boosted PI is used
•Only nodal officer at CoE can initiate third line therapy
Opportunistic Infections Management
•OI's should be treated or stabilised before commencing ART

37. STD Control Programme
•STD Control is linked to HIV/AIDS Control as behaviour
resulting in transmission of STD and HIV are same
•HIV is transmitted more easily in the presence of another STD
Management of STD -
•Through syndromic approach
•NACO has branded the STI/RTI services as Suraksha Clinic
and has developed a communicationstrategy for generating
demand for these services

38. PRE- PACKED STI/RTI COLOUR CODED KITS
KIT-1 Grey For urethral discharge, anorectal discharge
and cervicitis
KIT-2 Green For vaginitis
KIT-3 White For genital ulcers
KIT-4 Blue For genital ulcers
KIT-5 Red For genital ulcers
KIT-6 Yellow For lower abdominal pain
KIT-7 Black For inguinal bubo

41. Adolescent education program:
•Aims to build up lifeskill among adolescent to cope with
physical and psychological changes associated with
growing up
•Under the program 16 hour session scheduled during
the academic terms of class 9th and 11th
Red ribbon clubs:
•The purpose of red ribbon club formation in colleges is
to encourage peer to peer messaging of HIV prevention
and to seek clarification of their doubts and myths
surrounding HIV-AIDS.
•It also promote voluntarily blood donations among
youth.