National AIDS Control Program

NATIONAL AIDS CONTROL
PROGRAM
 Guided by: Mrs Kamalini Mohanty
 Tutor, SCB College Of Nursing
 Presented By: Aparna Sahoo(07)
 Sushree Sushama Swaraj Hansda(87)
 Class: Bsc Nursing 4th Year
Contents:
What is AIDS?
Introduction
Sign and symptoms of AIDS
Milestones of NACP
Incidence
Objective
National strategy
Goal of NACP
Prevention
Care, Support and Treatment Services
Types of Facilities for HIV Testing and Counselling
WHO Criteria to Recommend HIV Treatment
Role of community health nurse
Conclusion
What is AIDS?
AIDS stands for Acquired
Immunodeficiency Syndrome. It is the
final stage of infection with HIV. It
happens when the body’s immune system
is badly damaged because of the virus.
Introduction:
.The National AIDS Control Programme was
launched in the year 1987.
.The Ministry Of Health and Family Welfare has set

up National AIDS Control Organization (NACO) as
a separate wing to implement and closely monitor
the components of the programme.
Sign and symptoms of AIDS?
The first signs of HIV infection may be flu like
symptoms:
Fever
Rash
Night sweats
Muscle aches
Sore throat
Fatigue
Swollen lymph nodes
Mouth ulcers
These symptoms may come and go within two to four
weeks. This stage is called acute HIV infection. If the
Milestones of NACP:
1986 First case of HIV detected
Natinal AIDS committee established under Ministry of
Health
1990 Medium term plan launched for four states and four
metros
1992 NACP-I launched to slow down the spread of HIV
infection
National AIDS control board constituted NACO set up
1999 NACP-II Initiated Focousing on behavior change
State AIDS control socities established
2002 National AIDS control policy adopted
National blood policy adopted
2004 Anti retroviral treatment adopted
2007 NACP-III Launched for 5 years (2007-2012)
2014 NACP-IV launched for 5 years (2012-2017)
INCIDENCE:
.HIV is a life threatening infection, claimed 34 millon lives so far. In the
year 2014 alone 1.2 million people died due to HIV and its related causes,
globally.
. AIDS is the most advanced stage of HIV infection. The total no. of
people living with HIV(PLHIV) in India is estimated at 21.17 lakhs in
2015 compared with 22.26 lakhs in 2007.
OBJECTIVES:
.To prevent further transmission of HIV.
.To bring down the morbidity and mortality of the infection.
.To minimize the socioeconomic impact of the disease.
 NATIONAL STRATEGY:
.Establishment of surveillance centers in the country.
.Identification of high risk groups and their screening.
. • Issuing specific guidelines for the management of detected
cases.
• Formulation of guidelines for blood bank,blood product

manufactures, blood donors and dialysis units.
• Research for reduction of personal and social impact of the
disease.
• Control of sexually transmitted diseases.
• Condom programme
 GOAL OF NACP:
NACP-I(1992-1999):
 The objective of NACP-I was to control the spread of HIV
infection. During this period a major expansion of
infrastructure of blood banks was undertaken with the
establishment of 685 blood banks and 40 blood component
separation.
 Infrastructure for treatment of sexually transmitted disease in
district hospitals and medical colleges was created with
establishment of 504 STD clinics.
 The programmed led to capacity development at the state
level with the creation of state AIDS cells in the Directorate
of Health Services in States and Union territories.
NACP-II(1999-2006)
 During NACP-II a number of new initiatives were undertaken and the programme
expanded in new areas. Targeted interventions were started through NGO S, With a
focus on High Risk Groups.
 Commercial Sex Workers(CSWS), men who have sex with men(MSM), injecting
drug users(IDUS), and bridge populations(truckers and migrants).
 The package of services in these interventions includes Behaviour Change
Communication, management of STDS and condom promotion.
 All channels of communication were engaged to spred awareness about
HIV/AIDS, promote safe behaviors and increase condom usage.
• NACP-III(2007-2012)
• The primary goal of NACP-III is to halt and reverse the epidemic in Indiaover the next 5 years
by :-
• Prevention of new infection in high risk groups and general population through saturation of
coverage of high risk groups with targeted interventions and scaled up interventions in
general population
• Providing greater care, support and treatment to a large number of people with HIV infection.
• Strengthening the infrastructure, system and human resources in prevention, care, support and treatment
programmes at district, state, and national levels.
NACP-IV(2012-2017)
• Reduce new infection by 50% (2007 Baseline of NACP III).
• Provide comprehensive care and support to all persons living with HIV/AIDS.
• Prevent new infections by sustaining the reach of current interventions and effectively
addressing emerging and epidemics.
• Prevention of parent to child transmission.
• Focousing on IEC.
• Providing comprehensive care, support and treatment to eligible PLHIV.
• Reducing stigma.
PREVENTION SERVICES:-
 Targeted Interventions for High Risk Groups and Bridge Population.
 Needle syringe exchange program (NSEP) and opioid substitution therapy (OST) for
IDUS.
 Prevention Intervention for migrant population at source, transit and destination.
 Link worker scheme (LWS) for HRGS and vulnerable population in rural areas.
 Prevention and control of sexually transmitted infections / reproductive tract
infections(STD/RTI).
 Blood safety.
 HIV counsellng and testing services.
 Pvention of parent to child transmission.
 Condom promotion.
 Information, education and communication (IEC) and Behavior change

communication(BCC).
 Social mobilization, youth interventions and adolescent education program.
 Mainstreaming HIV/AIDS response.
 Work place interventions.

CARE, SUPPORT AND TREATMENT
SERVICES:-
 Laboratory services for CD4 testing and other investigations.
 Free first line and second line antiretroviral treatment (ART) through ART centers
and link ART centers (LACS), centers of excellence (COE) and ART plus centers.
 Pediatric ART for children.
 Early infant diagnosis for HIV exposed infants and children below 18 months.
 HIV-TB coordination (Cross- referral, detection and treatment of co-infections).
 Treatment of opportunistic infections.
TYPE OF FACILITIES FOR HIV
TESTING AND COUNSELING:-
 The ICTCS are located inside the hospital or health center. Services delivered in two ways:
(a) Facility- based services and
(b)Community- based service
 Facility- based services (screening or confirmation) are offered to individuals accessing

healthcare facilities functioning as per the OPD timings of the institution where the center is
located.
 Community- based screening is conducted by the ANMS in Health Subcenters.

COUNSELING AND TESTING
CENTERS(ICTC):-
 It is of two types. Client oriented on his own will and provider initiated which the doctor
advises.
 Functions of the center includes early detection of the disease, providing information on modes
of transmission and prevention, treatment and care process.
STAND ALONE(SA-ICTC):
• The SA-ICTC facility should be located at an easily accessible place with direction signs to guide
people to the location. Usually located in medical colleges, district hospitals etc. The SA-ICTC
facility should consist of at least two rooms, one for counselling and other for testing.
• Full time counselor and laboratory technician provides counselling and testing respectively.
• MOBILE ICTC:
• The activities provided as mobile services in a van. It is mainly to serve hard to reach places. A
paramedical team consisting of a counselor, health educator, ANM and a laboratory technician
function to provide mobile services.
PPTCT PROGRAM:
• The Prevention of Parent to Child Transmission of HIV/AIDS (PPTCT) program
was started in the country in the year 2002. Currently, there are 15,000 integrated
counseling and testing centers (ICTCS) in the country, most of these in government
hospitals, which offer PPTCT services to pregnant women. These are functioning
with aim of universal coverage of all pregnant women to prevent transmission of
HIV from mother to child. PPTCT provides HIV diagnostic, prevention, care and
treatment to all pregnant women.
PACKAGE OF PPTCT SERVICES IN
INDIA:
• HIV testing and counselling.
• Provision of lifelong ART pregnant and HIV infected lactating women
regardless of CD4 count.
• Promotion of institutional deliveries for HIV infected mothers.
• Provision of care of associated conditions like STI/RTI, TB and other
opportunistic infections.
• Provision of nutrition, counseling, and psychological support to HIV infected
pregnant women.
• Provision of counseling to initiate breastfeeding within 30 minutes of birth and
continue for 6 months.
• Provision of ART prophylaxis for infants until 6 months.
• Follow- up of HIV exposed infants into routine health care services.
• Cotrimoxazole prophylaxis therapy for infants.
WHO CRITERIA TO RECOMMEND
HIV TREATMENT:
• HIV treatment recommended when the CD4 test shows less than 500cells/mm3
2013. -(WHO)
COMBINATION THERAPY:
• Treating with two or more antiretroviral drugs at a time is called combination
therapy. Taking a combination of three or more anti- HIV drugs is referred to as
highly active antiretroviral therapy (HAART).
RECOMMENDATIONS-ANTIRETROVIRAL
TREATMENT(WHO, 2013)
• For adults and adolescents, they recommend starting on a first line therapy of two
nucleoside reverse transcriptase inhibitors (NRTIS) plus a non- nucleoside reverse-
transcriptase inhibitors (NNRTI). The favored recommendation is a fixed dose
combination (just one pill) of:
TDF – Tenofovir
3TC – Lamivudine or FTC – Emtricitabine
EFV – Efavirenz
FIRST- AND SECOND- LINE THERAPY:
• At the commencement of treatment, the combination of drugs that a person is
given is called first- line therapy. In case of resistance or any serious drug
effects person will be changed to second- line therapy.
• Second- line therapy recommendations by WHO suggest two NRTIS and a

ritonavir – boosted protease inhibitor (PI).
ROLE OF COMMUNITY HEALTH NURSE:
• Explain the mode of transmit of HIV virus to the peoples, especially eligible
couples by using different images, videos etc.
• Explain how to use condoms properly every time during intercourse
the individual should use condom separately.
• Understand the impact of pregnancy and breastfeeding for the HIV women.
• Identify high risk groups and educate them regarding HIV spread and its
consequences.
• Identify sex workers and motivate them to use condoms every time during
intercourse.
• Nurse also have to explain about pre- prophylaxis for high risk groups.
• Screening for pregnant mothers at least twice during pregnancy time.
• Explain the virus spread and preventive measure to illiterate peoples
continuously.
• Motivate not to have multipartners for sex.

• Teach the couples that they should try to be faithful towards their partner.
• Communicate with youths and motivate talk regarding their sexual problems or
STDS.
CONCLUSION:
• To reduce the spread of HIV infection in India.
• Strengthen India capacity to respond to HIV/AIDS on a long term basis.
• State level AIDS control socities and improve drug and equipment practice.
• Q/A SECTION:
1. First case of HIV detected in which year?
2. NACP-I launched in which year?
3. Anti retro viral treatment adopted in which year?
4.What is the blood test for AIDS?

SUMMARY:
The presentation includes what is AIDS, sign and symptoms, milestone
of NACP, incidence, objective, national strategy, goal of NACP,
prevention, care, support and treatment services, types of facilities for
HIV testing and counseling, WHO criteria to recommend HIV treatment,
role of community health nurse, conclusion.
BIBLIOGRAPHY:
• D shyamala manivannan, Text book of community health nursing – 2 for BSC
Nursing, CBSPD, chapter 6 , page no – 243-245
• https://www.ncbi.nlm.nih.gov
• https://www.slideshare.net/TriptiSharma
74/national-aids-control-programme
• https://www.slideshare.net/national-aids-control-programme

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NATIONAL AIDS CONTROL

.The Ministry Of Health and Family Welfare has set

• Formulation of guidelines for blood bank,blood product

 Information, education and communication (IEC) and Behavior change

 Social mobilization, youth interventions and adolescent education program.

 Mainstreaming HIV/AIDS response.

 Work place interventions.

 Facility- based services (screening or confirmation) are offered to individuals accessing

 Community- based screening is conducted by the ANMS in Health Subcenters.

• Second- line therapy recommendations by WHO suggest two NRTIS and a

• Motivate not to have multipartners for sex.

2. NACP-I launched in which year?

3. Anti retro viral treatment adopted in which year?

4.What is the blood test for AIDS?

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