Punjab State AIDS Control SocietyDated-06/10/2009

National AIDS Control

Programme, Punjab

State Advisory Committee

State wise Estimated Adult HIV Prevelance, 2006 & 2007

0.11

0.13

0.12

0.11

0.17

0.15

0.22

0.27

0.3

0.28

0.27

0.43

0.3

0.58

0.74

0.81

1.05

1.26

1.67

0.09

0.1

0.11

0.11

0.16

0.17

0.18

0.2

0.26

0.26

0.3

0.38

0.44

0.44

0.67

0.75

0.97

1.2

1.57

0 0.5 1 1.5 2

Uttar Pradesh

Punjab

Madhya Pradesh

Jharkand

Rajasthan

Bihar

Orissa

Haryana

Kerela

Chattisgarh

Delhi

Gujrat

West Bengal

Tamil Nadu

Maharastra

Karnatka

Andhra Pradesh

Nagaland

Manipur

Adult HIV Prevelance (%)

2007

2006

Patterns of HIV Epidemic at National and Punjab State Level

HIV Prevalance among Different Population Groups, India and Punjab 2007 (% of Estimated cases)

0.34

3.61

7.23 7.41

5.13.61

2.51

01.6

13.79

1.22 0.65

02468

10121416

ANC STD IDU MSM FSW Migrants Truckers

Perc

ent P

ositi

vity

India Punjab

Districts with HIV prevelance > 15 % among IDUs, 2007

27.2

30.4

24.4

16.06

18

20

0 5 10 15 20 25 30 35

Chennai

Amritsar

Mumbai Suburban

Aizawl

Churachandpur

Delhi North

Percent positivity

1.8 1.94.3

5.9

85.6

Sexual IDUsBlood and Blood Products PerinatalUnidentified

Routes of HIV Transmission

1986-1990 : MARKED BY DENIAL OF THE THREAT OF HIV TO INDIA

1990-1992 : MEDIUM TERM PLAN WITH WHO COLLABORATION

1992-1997 :National AIDS Control Programme Phase I – Extended up to 1999

1999-2004: National AIDS Control Programme Phase II - Extended up to 2007

2007-2011: National AIDS Control Programme Phase III

1986 First Reported Case In CSW

To halt and reverse the epidemic in India over the next five years

Specifically reducing new infections by

60% in High Prevalence States 40% in Vulnerable States

Objectives:

• Prevention of new infections (saturation of HRG coverage and scale up of interventions for General population)

• Increased proportion of PLHA receiving care, support and treatment• Strengthening capacities at district, state and national levels• Building Strategic information management systems

Districts of PunjabDistricts of Punjab

• 1 Case in year 1986 • 23 lakhs in 2007

61.1% Male39 % Female3.5 % Children below 15 years

• HIV prevalence among adult population at 0. 34%0.40 % of total Male population0.27 % of total Female population

HIV/AIDS SCENARIO PunjabHIV/AIDS SCENARIO PunjabEstimated HIV Cases in Punjab (As per HIV Sentinel Surveillance-2007)

18566

Estimated HIV Prevalence (of estimated cases)

0.11%

HIV cases detected in ICTC (G) (since 1993 till July 2009)

16564

AIDS cases ever started treatment in ART centres

6225

HIV data (District wise) (From Inception 1993 to till July 2009)

DistrictNo. of ICTCs

Total clients tested

HIV Positive

% positivity

Amritsar 7 85872 5906 6.88Patiala 6 64418 2208 3.43Jalandhar 4 17261 1927 11.16Ludhiana 9 65156 1128 1.73Gurdaspur 3 16252 714 4.39Faridkot 2 12288 546 4.44Tarn Taran 2 11173 536 4.80Hoshiarpur 4 15628 526 3.37Rupnagar 3 18675 524 2.81Sangrur 4 20852 485 2.33

DistrictNo. of ICTCs

Total clients tested

HIV Positive

% positivity

Moga 1 8688 375 4.32Bathinda 3 15913 324 2.04Ferozepur 4 14284 309 2.16Kapurthala 3 15274 288 1.89Nawanshahr 3 8622 225 2.61Mohali 4 16790 131 0.78Fatehgarh Sahib

27725 116 1.50

Muktsar 4 10417 111 1.07Mansa 2 7301 105 1.44Barnala 1 15832 80 0.51State Total 71 448421 16564 3.69

AIDS Data (District wise) (Till July 2009)

S. No. DistrictAdults

TS/TG Children TotalMale Female1 Amritsar 524 294 0 58 8762 Patiala 369 293 0 50 7123 Tarntaran 413 252 0 35 7004 Gurdaspur 351 233 0 36 6205 Hoshiarpur 300 198 3 30 5316 Jalandhar 286 182 3 24 4957 Sangrur 230 145 0 25 4008 Ludhiana 259 119 2 22 4029 Ferozepur 126 78 0 10 214

10 Kapurthala 123 84 0 10 21711 Roopnagar 87 63 0 17 167

S. No. District

Adults

TS/TG Children TotalMale Female12 Moga 101 48 0 7 15613 Bathinda 79 32 0 13 12414 Nawanshahr 62 38 0 15 115

15 Fatehgarh Sahib 63 23 0 6 92

16 Mansa 48 27 0 10 8517 Others 54 39 0 6 9918 Mohali 36 24 0 3 6319 Faridkot 37 30 0 3 7020 Barnala 31 18 0 2 5121 Muktsar 19 14 0 3 36

  Total 3598 2234 8 385 6225

Financial Status: Details of Expenditure (As on 24-08-09)

Sr. No

Year Approved Action Plan

Opening Balance Cash

Opening Balance of Advance

Grant Released by NACO during the Year + Other Receipt

Total Fund Available

Expenditure

Advances Total Expenditure + Released of Advances (6+7)

Unspent Cash in Hand (5-8)

1 2 3 4 5 6 7 8 10

1 2006-07 936.82 166.23 410.02 727.90 1304.15 547.70 379.78 927.48 376.67

2 2007-08 1038.18 376.66 379.78 468.12 1224.56 768.04 424.82 1192.86 31.70

3 2008-09 1341.85 31.70 424.82 1063.37 1519.89 789.52 542.92 1332.45 187.44

4 2009-10 1815.13 187.44 542.92 1270.13 2000.49 314.18 498.10 812.28 1188.20

Facilities for Treatment: 1. Anti Retroviral Therapy Centres:

Facilities like Anti retroviral drugs, Medicines for Opportunistic Infections, HIV testing facilities, Estimation of CD4 counts and Counseling facilities are provided are provided free of cost to AIDS patients in these centers:

There are three ART centres functioning in the State of Punjab at: Govt. Medical College, Amritsar Civil Hospital, Jalandhar Govt. Medical College Patiala.

2 ART Centres will be opened at Ludhiana and Pathankot in 2009-10.

2. Linked ART Centres (LAC):

These centres has been established at: Civil Hospital Ludhiana and Civil Hospital Ferozepur.

This Year 8 More LAC Centres will be opened at districts Tarn Taran, Hoshairpur, Nawanshahr, Sangrur, Bathinda, Moga, Faridkot and Ropar

Facilities for Care & Support:1. Community Care Centre (CCC):

CCC has been opened at the following districts for providing counseling, ART Monitoring, Drug adherence and support to People Living With HIV/AIDS:

Guru Nanak Dev Hospital Complex, Amritsar Red Cross, Saket Hospital, Patiala

3 more CCC will be opened at Jalandhar, Ludhiana and Pathankot in 2009-10.

2. Drop In Centre: Presently there are 2 Drop In centre functional in the

State of Punjab are being run by registered Community Based Organizations (CBOs) of People Living With HIV/ AIDS (PLHAs) group.

Amritsar (Positive Network) Jalandhar (Koshish Network).

Other Facilities:1. HIV Testing & Counseling Facilities:

Well established 73 Integrated Counseling and Testing Centres (ICTCs) are functional in the State of Punjab.

2. STD Services:

Well established 23 STD clinics are functioning in the 19 district hospitals and 3 Govt. Medical Colleges & Christian Medical College, Ludhiana. Free Medicine Kits are provided to STD patients through these clinics.

3. Blood Safety:

There are 93 licensed Blood Banks in the State out of which 45 are in Govt. Sector. NACO has taken 44 Govt. and 8 Charitable Blood Banks under the modernization Scheme.

Contd-4. Targeted Intervention Projects:

23 Targeted Intervention Projects have been started in the State through NGO’s in High Risk Groups like Female Sex Workers (FSW), Men having sex with Men (MSM), Injectable Drug Users (IDUs).

6 more Projects will be started in 2009-10.

5. Information Education Communication:

All available medias is used for disseminating the message of HIV/ AIDS to General population.

6. Adolescence Education Programme:

This programme is run for the schools. This year 1500 schools will be covered under this programme for which the funds have been released to Education Deptt., Punjab.

Staff Position  Sanctioned Filled VacantPSACS

(Headquarter)56 42 14 *

Integrated Counseling and Testing CentresA. Counselor 74 74 -B. LT 76 76 -Blood BankA. Counselor 08 08 -B. LT 57 49 08STD ClinicA. Counselor 23 23 -ART Centres  44 30 14 **DAPCU (Amritsar & Ludhiana)  08 07 01 *

Contd-Sanctioned Filled Vacant

NGO (TI)

For 22 TI Projects 159 157 02

Community Care Center For 2 Community Care Centers

32 32 -

Drop In CenterFor 2 Drop In Centers

10 10 -

Grand Total 547 508 39

* Interview for the vacant posts have already been conducted and list of selected candidates has been sent to National AIDS Control Organization (NACO) for approval on 11/08/09.** For 2 new ART centres total 14 posts have been sanctioned out of which 2 posts have been re-advertised and candidates have been selected for the remaining 12 posts. Appointment letter will be issued after receiving approval from NACO. A letter has been sent to National AIDS Control Organization (NACO) for approval on 18/08/09

Challenges• High risk groups to general people• From the urban to rural areas• From High Prevalence areas to other populations• Feminization • Youth vulnerability high• Besides transmission of HIV through main route i.e

Sex, the major concern of transmission of HIV in Punjab is through Injecting Drug Users (IDU) which is one of the highest in the country

• Blood Banks the postivity rate in HCV is 1.4 % against 0.4 % All India.

• Low Voluntary Blood Collection

Vision:Major Challenge: Increasing HIV Positivity among Injecting Drug Users (IDU)

To tackle the increasing HIV positivity among IDUs, vision of PSACS is to:• To saturate the IDU population in Punjab through Targeted intervention Projects • Shifting from unsafe injecting practices (sharing of Needles/syringes) to safe injecting practices through counseling services and Needle Syringe exchange Programme• Shifting from injecting drug to oral drug through OST (Oral Substitution Treatment)• Referral to Drug de- addiction centres• In case IDU is HIV positive referral to ART centre.

Continuing……..

•Inter sectoral collaboration and active participation of following departments to address the issues of IDU in holistic manner in the State:

Department of Police Public Relation department i.e. Media persons

– for honest reporting and promoting positive environment

Department of Social Welfare Department of Panchayati Raj and Rural

Development NRHM – Referral services for STI and also

advocacy with Adolescent Education Programme (AEP)

PSACS-2007