Targeted Intervention

National AIDS Control Organization (NACO),MoH&FW, GOI has been implementing National AIDS Control Programme (NACP) through State AIDS Control Societies (SACS) across the country to work with High Risk Groups (HRGs) including: Female Sex Workers(FSW),Men having Sex with Men(MSM),Transgender(TS/TG),Injecting Drug Users(IDU) and Bridge Population (BP) viz., Migrants and Truckers

SACS have been implementing Targeted Intervention(TI) projects engaging Non Governmental Organizations (NGO)Community Based Organizations (CBO) to reach out to HRGs and BP with HIV prevention services including Clinical services.

The prevention of new infections in high risk groups is a major thrust in National AIDS Control Programme. The most effective means of controlling the spread of HIV in India is through the implementation of Targeted Interventions (TIs) amongst persons most vulnerable to HIV/AIDS,
Targeted interventions are aimed at offering prevention and care services to high risk populations and Bridge population (Female Sex Workers- FSW, Male having Sex with Male- MSM and Injecting Drug Users- IDUs and Migrant) within communities by providing them with the information, means and skills they need to minimize HIV transmission and improving their access to care, support and treatment services. These programmes also improve sexual and reproductive health (SRH) among these populations and improve general health by helping them reduce the harm associated with behaviour such as sex work.

TI PROGRAMME

High Risk Groups(HRG) are line-listed and examined for STI / HIV status and prevention activities are carried out by condom promotion to bring behavioral change among the High Risk Groups.

Components of TI

	Name of TI	Typology	Place of Intervention
1	Society for Development of Research and Training (SfDRT)	Female Sex Workers	Puducherry
2	Sahodaran Community Oriented Development Society (SCOHD)	Men who have Sex with Men (MSM) / Transgender’s (TG’s)	Puducherry
3	Bharatiya Adim Jati Seva Sangh (BAJSS)	Migrants	Puducherry
4	Village beneficiaries education and Development Society (VBEDS)	Core Composite	Karaikal
5	Woman Initiative and Sustainable Empowerment (WISE)	Core Composite	Yanam

TARGETED INTERVENTION

Performance indicators along with component wise Budgetary Provision and Physical Targets given to TI NGOs /CBOs
Review of performance and Monitoring the activities of NGOs/CBOs every month, both physical and Financial.
Assessment of Training Need for TIs.
Monthly and Quarterly reports shared with NACO.
Joint Evaluation of the performance of TI NGOs/CBOS at all the Districts with the consultant from NACO, once in two years.
Health camps have been conducted for migrants workers from Construction, Hotel and Industrial Workers.
MOU/LOI signed by Industries Under Employer Led Module for implementation of HIV Intervention at industry level.
HIV intervention implemented at other closed setting i.e Jail and women living homes.

ACTIVITIES UNDER TI DIVISION

TI to ART referral

HRG clients who were confirmed as HIV positive, were accompanied to the ART Centre immediately for pre-registration and for baseline CD4. Thereafter, they were regularly followed-up appropriate as per the guidelines and management of OIs. 100% documented referral of all HRG – PLHAs to ART centre.

⦁ Periodic follow-up as advised by the ART center.
⦁ Accompanied referral (to be insisted) can be planned depending on the feasibility and local customization of the program.

Condom Promotion Programme in TI

Consistent condom use has been one of the most critical aspects of NACO’s prevention strategy for HIV/AIDS control. To this effect, NACO started its Condom Promotion Programme under National AIDS Control Program (NACP)

The specific Condom Promotion objectives are:
⦁ To increase the demand for condoms among high risk, bridge and general population
⦁ Maximize access of free condoms with most vulnerable groups
⦁ Increase sales in rural areas and expand availability through condom sales through non-traditional outlets (stores and petty shops etc.,)
⦁ Introduce brand management innovations and demand generation activities to promote correct and consistent condom use
⦁ To increase the accessibility of condoms to make it available.

NACO’s Condom Promotion strategy focuses on two aspects: ensuring availability and creating demand for condoms. The availability of condoms is addressed through distribution of Free Condom and Socially Marketed Condom (Paid-subsidized).
80% of the condoms are direct distribution to the community by peer educators and the rest through ORWs and outlets.

Social Marketing Condom

Socially marketed condoms are distributed by NACO through its Social Marketing Organizations (SMOs) under Targeted Condom Social Marketing Programme (CSMP). The Programme also focuses on expansion of condom availability of hitherto underserved areas such as rural markets and increasing the numbers and types of outlets stocking and selling condoms and make it a ubiquitous product.

Employer Led Model

Employer Led Model (ELM): The ELM has been designed to provide HIV/AIDS prevention to care services to informal laboueres including migrants and truckers, who are linked to the industries directly or indirectly. Under this model, efforts are made to involve major industries and associations to integrate comprehensive HIV/AIDS prevention to care programme within their existing structure. MoUs are signed by the SACS with the respective employers. SACS/ TSU build the capacity of the employers and support them to conduct different activities for the informal laboureres. Around 5 MoUs are signed with the industries..

One state level and one regional level meeting were conducted for industries with the support of Labour department in coordination with Mainstreaming division of PACS.

Jail intervention and other closed setting

People living in prisons and other closed settings are particularly vulnerable to increased risk of HIV infection. Lifestyle of many inmates prior to incarceration includes unprotected sexual intercourse, drug and alcohol abuse, poverty, homelessness, under-education and unemployment, all of which are associated with risk of HIV/AIDS. Drug users are often over-represented in prison populations, usually incarcerated for drug-related crimes, and may continue to use drugs during their incarceration. Frequent sharing of contaminated drug injection equipment is the predominant mode of HIV transmission among prisoners. HIV is also transmitted in prisons through unsafe sexual behaviour, sometimes associated with sexual violence . High turnover of prison inmates fuels the spread of HIV and other infections such as TB. After their release, infected prisoners return to their social networks in the general community, facilitating the spread of HIV and TB infection in the non-incarcerated community. Reducing transmission of HIV and TB in prisons is crucial for reducing the spread of these infections in the general community.
Pondicherry AIDS Control Society has established One Facility Integrated Counseling and Testing Centre (F-ICTC), at Jail Hospital, Kalapet, for conduct of the testing of HIV,STI,Heparitis and TB for prisoners regularly. In Yanam and Mahe region HIV/TB and conduct of voluntary testing by ICTC counsellors, appointed by Pondicherry AIDS Control Society who are working in the respective General Hospitals of Mahe and Yanam region.