Targeted Intervention (TI) and Link Workers Scheme (LWS) with NACO
India has the third-highest number of people living with HIV in the world with 2.1 million Indians accounting for about four out of 10 people infected with the deadly virus in the Asia—Pacific region, according to a UN report.
Targeted InterventionThe report by UNAIDS, the United Nations programme on HIV/AIDS, said that 19 million of the 35 million people living with the virus globally do not know their HIV—positive status and so ending the AIDS epidemic by 2030 will require smart scale—up to close the gap.
The first—ever UNAIDS ‘Gap Report’ said after sub—Saharan Africa, the region with the largest number of people living with HIV is Asia and the Pacific.
At the end of 2013, there were an estimated 4.8 million people living with HIV across the region. Six countries - China, India, Indonesia, Myanmar, Thailand, and Vietnam - account for more than 90 percent of the people living with HIV in the region.
It said HIV treatment coverage is only 36 per cent in India, where 51 per cent of AIDS—related deaths occur. In India, the numbers of new HIV infections declined by 19 per cent, yet it still accounted for 38 per cent of all new HIV infections in the region. The proportions of people who do not have access to antiretroviral therapy treatment are 64 per cent in India.
In Asia and the Pacific, the number of AIDS—related deaths fell by 37 per cent between 2005 and 2013, the report said.
India recorded a 38 per cent decline in AIDS—related deaths between 2005 and 2013. During this period, there was a major scale up of access to HIV treatment with more than 700,000 people were on antiretroviral therapy, the second largest number of people on treatment in any single country.
In India, HIV prevalence among female sex workers dropped from 10.3 per cent to 2.7 per cent but it increased in the states of Assam, Bihar and Madhya Pradesh, the report said.
India has a large population and population density coupled with low literacy level and low level of awareness of HIV/AIDS making it is one of the most challenging health problem ever faced by the country. More than 90% of HIV transmission in India is related to unprotected sexual intercourse or sharing of injecting equipment between an infected and uninfected individual. The core high risk groups of individuals are most at risk female sex workers, MSM, Injecting drug users. HIV transmission dynamics in India are such that unless effective targeted HIV prevention saturates the most at risk HRGs of FSWs, MSMs/ TGs and IDUs, the epidemic will not be controlled. But the positive implication is that if HIV prevention is successful among these HRGs, the epidemic will be substantially curtailed.
Intensifying and Consolidating Prevention services with a focus on High Risk Groups (HRG) will support the scaling up of Targeted Interventions (TIs). Targeted Interventions (TI) are a specific set of Intervention in HIV/AIDS Control Programme meant specifically to reach out to groups seen to practice high-risk behavior (HRG). High Risk Groups comprise of Female Sex Worker (FSW). The goal of NACP-3 is to saturate coverage of high- risk groups through TIs. It is estimated that if 80% of the high risk groups are reached, it would effectively lead to saturation coverage of HRGs.
FSWs have many sexual partners concurrently. Generally, full-time FSWs have at least one client per day, or at least 30 clients per month, and nearly 400 per year. Some FSWs have more clients than others, having several clients per day and 100 or more clients in a month. The higher risk of FSWs is reflected in a substantially higher prevalence of HIV among them than in the general population. In India, sentinel surveillance data has shown that the HIV prevalence is generally 10-20% or more, which is more than ten times higher, among FSWs than among pregnant women attending antenatal clinics. The principles guiding the implementation of Core High Risk Group TIs are:-
- District level mapping of HRGs and planning.
- Focus on coverage of clients of sex workers.
- Linkages between TI and continuum of care
- Focus on enabling environment (including equitable access to services).
- Forming CBOs to represent the community.
ARD is implementing TI in Bhopal District with a target of 800 FSWs. The target area is entire Bhopal town with a separate team of Project Director, Project Manager, Counsellor, M&E officer and ORW’s. CARD has opened a separate office in Subhash Nagar locality exclusively for the TI project.
The fight against HIV/AIDS particularly in rural in areas becomes more pronounced in view of stigma and discrimination surrounding HIV, resulting in poor access to health care, gender inequality etc.. The existing primary health care system has limited scope and capacity to deal with the sensitive issues like HIV, sexuality and drug use. Keeping this in mind, LWS has been conceived for building the capacity of the rural community in fights with HIV by NACO.
Centre for Advanced Research and Development (CARD) therefore, rightly decide to work for the cause and has been selected as Lead NGO for CGSAC for Link Worker Scheme in Chhattisgarh to implement the various schemes and campaigns of the NACO. The NGO partners include; Samarthan in Raipur, Pratigya Vikas Sansathan in Durg and Jan Kalyan Samajik Samsathan in Rajnandgaon. Link Workers Scheme is the rural base scheme with district level interventions with the formation of dedicated cadre of village level link workers. Link workers generate awareness and enhance utilization of prevention, care and support programs and services in an enabling environment. It contributes in reducing stigma and discrimination by working with the existing village community structural groups like village health committees. The scheme develops a cadre of trained local personals as link workers and volunteers to work with HRGs vulnerable young people and woman in selected districts of the Chhattisgarh. The objectives of the programme are as follows:
- To reach out to high risk groups and vulnerable young people (man & woman in rural areas) with information, knowledge and skills on STI/HIV prevention risk reduction.
- To promote increased and consistent use of condom with casual and regular partner.
- To generate awareness and enhance utilization of prevention, care and support programs and services (especially STI, ICTC, PPTCT, ART and DOT).
- To create an enabling environment through involvement PLHAs reducing stigma and discrimination that facilitates the recognition of HRGs into the community and recognition of their right.
- To promote information and enhance utilization of care and support programmes and services by individual living with HIV.
Statistical Information (LWS) (Table):
|Introduction of LWS||Please click here for details|
|Link Worker Guideline||Please click here for details|
|Activities||Please click here for details|
|List of Villages||Please click here for details|
|Latest Report||Please click here for details|
|List of Staff||Please click here for details|