Transcript HIV/AIDS Present Scenario

First Meeting of
State AIDS Council, UP
June 29, 2009
Uttar Pradesh State AIDS Control Society
The History…
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1981
1986
1987
1987
• 1992
• 1999
First case reported in USA
First reported case in a CSW
First reported case in U.P.
National AIDS control
Program launched
AIDS Cell in UP
State AIDS Control Society
formed
State AIDS Council, UP
The Strategy…
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National AIDS Control Program – I, II, III
State AIDS Control Societies
Initially Prevention only
Targeted Interventions
Spread to general population
Management of AIDS – ART
NACP-III : prevention, treatment and care
State AIDS Council, UP
The Present Scenario
• Estimated HIV+ in India 23.3 lac
• Estimated HIV+ in U.P. 1.08 lac
• 90% of HIV+ are in the age group of 15-49 (most
productive age group.)
• India being the youngest nation in the world
average age being 28 years.
• On an average 6000 new infection per day
• 2/3 are in the age group of 15-25 years
• 75% of this 2/3 are females
• 40% of total HIV + population are women.
• Some states highly affected, some are vulnerable
State AIDS Council, UP
Year wise estimated HIV+ in lacs
60
51
57
51.3
50
38.6
39.7
40
41.2
32
30
23.3
25
20
10
0
1999
2000
2001
2002
2003
2004
2005
2006
2007
State AIDS Council, UP
Vulnerability of UP
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Population 180 million (growth rate 2.5%)
Nearly 50% of UP Population in reproductive age
group (i.e 15-49 Years)
Low literacy (rural 36.66%, state 57.2%)
High incidence of poverty
Low status of women & Gender disparity
Large presence of high risk groups
• Migration : very high
• Highway network s : 8 national highways
• FSWs / IDUs / MSMs : high numbers
Long porous Indo-Nepal border
State AIDS Council, UP
Cumulative number of persons tested HIV positive in ICTC
Up to March 2009
Legend Up to 100
101 - 300
301 – 500
501 - 1000
1001 - 3000
More than 3000
Bijnor
Baghpat Meerut
Ghaziabad
Gautam
Buddha
Bulandshahar
Nagar
Pilibhit
Bareilly
Lakhimpur
Kheri
Budaun
Aligarh
Mathura Hathras
Agra
Etah
Sitapur
Farrukhabad
Hardoi
Firozabad
Gonda
Kannauj
Etawah
4359
Auraiya
Jalaun
Kanpur
Dehat Kanpur
Nagar
Hamirpur
Jhansi
Mahoba
Faizabad
Unnao
Ambedkar Nagar
Rae Bareli
Fatehpur
Deoria
Jaunpur
Allahabad
Total no. of persons tested
HIV Positive 37995
Mau
Azamgarh
Pratapgarh
3610
Banda
3513
Sultanpur
Chitrakoot
Lalitpur
Kusinagar
Basti
Ballia
Ghazipur
Varanasi
8788
Mirzapur
Chandauli
Sonbhadra
State AIDS Council, UP
Number of Patients from different district Alive and on ART - Mar 2009
State AIDS Council, UP
Role of AIDS Council
• Review of HIV/AIDS transmission and policy
formulation for HIV/AIDS programming in the
state
• Mainstream HIV/AIDS issue in all the
departments and coordinate HIV related
programs at all levels
• To include private / corporate / social sectors
in the HIV programming under interdepartmental coordination
• Review status of inter-departmental
coordination regularly
State AIDS Council, UP
How HIV/AIDS affects? To Whom?
Person
• Destroys immunity
• Opportunistic infections
Society
• Stigma and discrimination
• Association with sex / sin / curse
• Costly and life long medicines
• Loss of skilled labour force
• Burden on health services
State AIDS Council, UP
Sectoral Impact
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Decline in GDP
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Increase in Health expenditure
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Economic Growth will decline by 0.86% and per capita
GDP by 0.55%
5% increase in Govt. Health spending on HIV will result
in 0.67% Decline in Govt. saving and 1.16% in
Investment.
Unskilled labour sector Hit Hardest
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Maximum decline in output will be for sectors
with unskilled labour such as tourism (18.31%),
Manufacturing (12.48%).
State AIDS Council, UP
Contd..
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GDP Loss in Industrial Sector
– 4 Sectors will contribute to overall loss in industrial
GDP: Construction, Mining, Quarrying and textile.
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Increase in Household Spending
– 10% increase on health expenditure by HIV
household will reduce their expenditure on
education and consumption.
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Lower Labour Productivity
– Lower labour productivity of HIV Infected and
effected workers will affect the overall productivity of
all sectors
Source:- National Council of Applied Economic Research (NCAER)
State AIDS Council, UP
Socio- Economic Impact
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Household Income Decreases
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Illness with in household results in loss of
income.66.25% income lost when PLHIV workers were
not working and 9.24% lost due to leave/absence from
work.
Unemployment Increases
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within the HIV households increased from 3.6% to
9.8%- own illness most important reason.
Borrowing Increase
46% of HIV households borrowed compared to 27% of
non-HIV households.
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Greater Expenditure
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Per capita monthly expenditure Four Times Higher than
non HIV households due to increase medical expenses.
State AIDS Council, UP
Contd..
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Drop out Rate Increase
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Greater Hospitalization
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33.3% in 6-14 age group from HIV Households
Dropped out to take a job and 22.3% to take care of
siblings /household work.
Five times more hospitalization in HIV Household
than non-HIV household. More illnesses left
untreated for women.
Fear of Disclosure at workplace
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74% of PLHIV did not disclose their status at
workplace for fear of losing jobs
Source:- National Council of Applied Economic Research (NCAER)
State AIDS Council, UP
Gender Impact
Greater Burden of Care
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Poor Health seeking Behavior
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70% of Care givers for HIV households were women of
which 20% were living with HIV
Expenditure per illness episode for HIV households were
more for men (Rs 796) than women (Rs 487). More
women (70.4%) used Govt. hospitals than men (59.7%)
Lower Enrolment Levels
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In 15-18 age group current enrolment for girls from HIV
households (64.81%) was lower than girls from non HIV
households (79.54%)
Source:- National Council of Applied Economic Research (NCAER)
State AIDS Council, UP
Contd
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Girls Withdrawn from School
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In 6-14 age group, 32.1% of girls from HIV households
were withdrawn from school
Higher Disclosure to spouse
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83% of the women informed their husbands
immediately of their HIV status compared to only
69.3% of men.
Lower Awareness among Women
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52% men knew where to go for voluntary testing in
comparison to 36% of Women
Source:- National Council of Applied Economic Research (NCAER)
State AIDS Council, UP
Contd.
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Greater Stigma Faced by Women
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Greater Stigma Faced by Women
More women living with HIV (5.5%) were asked to leave home after
testing positive than men (1.9%)
95% of new infections in women were among married and
monogamous
Widows denied Right to Property
– Widows represented a third of the sample and face stigma on 3
counts
– As women
– PLHIV
– Widows
– 90% were forced to leave marital home and 79% denied share in
Husband’s property. 43% live alone and economically worse off
than HIV households.
Source:- National Council of Applied Economic Research (NCAER)
State AIDS Council, UP
Mainstreaming
“process of analyzing how HIV and AIDS impacts on all sectors now
and in the future, both internally and externally to determine how each
sector should respond based on its comparative advantage.”
Becoming PART OF…
…& NOT An ADD-ON Activity
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Reduces large expenditure on health care & social
welfare.
Minimizes negative impact on programmes related to
education, livelihood, social welfare, Women and Child
Health.
Saves loss of skilled employees.
State AIDS Council, UP
Expectations From Various
Ministries, Industries & CBO/NGO
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Prevention
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Display of Information Panels & Posters
Provide Free space for Hoardings at public places
Training of Departmental officials on HIV Issues
Free space for Installation of Condom Vending Machines
(CVMs)
Each Department to identify nodal officers to address HIV
issues at state and Dist level
Instructions to training institute to include HIV in curriculum
Preventive and Treatment Services
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Clinics for counseling & Testing, STD Treatment, referral
linkages.
Treatment of Opportunistic Infection and ART.
State AIDS Council, UP
Contd..
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Enabling Environment
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Disseminating knowledge about HIV through outreach
programme
Implementing workplace policies in each and every
establishment
Providing free transport facilities to PLHAs to treatment
sites
Providing employment opportunities to PLHIVs in existing
employment schemes
Providing soft/ cheap credit facilities to PLHIVs
Subsidized grains for nutritional support
Providing free legal aid to PLHAs to ensure
implementation of their rights
State AIDS Council, UP
To Start with …
Proposed activities for approval by State AIDS Council
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One Day orientation of District Magistrates and Chief Medical
Officers of all district.
Sensitization Programme for Police Officers of all Districts
One Day Sensitization Programme from Special Secretaries to
section officers of Secretariat
Installation of Posters on HIV/AIDS in Secretariat premises
Inclusion of HIV-AIDS related information in the websites of all
the departments and to provide a link to UPSACS / NACO
website on all the departmental websites.
Special Attention to be given to Varanasi and Allahabad Dist.
May like to approve the above activity by State
AIDS Council
State AIDS Council, UP
State AIDS Council, UP
Thank You
State AIDS Council, UP