TANSACS: An introduction

[Guest guest]

TAMIL NADU STATE AIDS CONTROL SOCIETY (TANSACS)

The Government continues to accord top priority for HIV/AIDS

prevention programmes. Equal emphasis is also given to providing

adequate Care and Support to People Living with HIV/AIDS in the

State. The Tamil Nadu State AIDS Control Society (TANSACS) initiated

several measures during the year to strengthen HIV prevention and

Care and Support programmes. The Sentinel Surveillance Survey and

Behavioural Surveillance Survey undertaken during the year 2004

indicate that the efforts of the Government are beginning to yield

desired results.

HIV Prevalence

HIV Sentinel Surveillance Survey helps monitor trends in HIV

infection among selected groups in the population known as sentinel

groups at regular intervals at regular sentinel sites. The Sentinel

Surveillance 2004 was conducted in Tamilnadu between August 2004 and

October 2004 covering 85 sentinel sites spread throughout the State.

The sentinel groups covered by the Sentinel Survey are (1) STD

Clinic attendees, (2) Intravenous Drug Users (IVDUs), (3) Female

Commercial Sex workers, (4) Men having Sex with Men (MSM) and (5)

ANC clinic attendees. The Survey indicated that the prevalence of

HIV among the general population as reflected in the ANC clinic

attendees came down to 0.65% during 2004 as against the prevalence

of 0.75% during 2003. The HIV prevalence among the STD attendees

also showed a decline from 9.20% in 2003 to 8.40% during 2004. The

HIV prevalence among the female Commercial Sex Workers is found to

be declining from 8.80% to 4.0%. There is a decline among

Intravenous Drug Users (IVDUs) to 39.92%. The prevalence among Men

having Sex with Men (MSMs) has gone up from 4.40% to 6.80%.

Information, Education and Communication (IEC)

Awareness creation is the prerequisite for effective HIV prevention

programmes. TANSACS has succeeded in creating awareness about

HIV/AIDS among various sections of the Society. Further, it is in

the process of creating HIV/AIDS awareness among the adolescent

population. The Behavioural Surveillance Survey (BSS) indicates that

a high level of awareness on HIV/AIDS has been created among the

high-risk groups as well as in the general population. Considerable

success has been achieved in reducing the myths and misconceptions

surrounding HIV/AIDS in our society. IEC interventions have also

been launched to reduce stigma and discrimination associated with

HIV/AIDS and also to safeguard and protect the human rights of

People Living with HIV/AIDS (PLHA's).

Sensitisation of Self Help Groups on HIV/AIDS

Various studies have established that women are the silent victims

of HIV/AIDS. In order to equip them with adequate " Knowledge,

Attitude and Life Skills " , to prevent them from HIV infection,

mitigate their risk, promote " Care and Support " and enable them to

enjoy reproductive rights, it is proposed to sensitize SHGs which is

an established development base in the State of Tamil Nadu, at a

cost of Rs.1.54 Crores.

Formation of Red Ribbon Clubs

Tamil Nadu State AIDS Control Society has proposed to form Red

Ribbon Clubs in all the Universities, Arts and Science Colleges,

Engineering Colleges and Polytechnics in the State. It is also

proposed to form Red Ribbon Clubs for out of School and College

Youth in collaboration with Nehru Yuva Kendra. A sum of Rs.80 lakhs

is proposed in the Annual Action Plan 2005-06.

School AIDS Education Programme

Tamil Nadu is a pioneering State in introducing HIV/AIDS information

in the regular school curriculum. Apart from this, the Government of

India funded School AIDS Education Programme is also under

implementation in the State.

During 2004-2005, 8417 High School and Higher Secondary Schools

including Matriculation Schools have been brought under this

programme. UNICEF and the USAID assisted Aids Prevention and Control

Project (APAC) have extended their support for the programme in the

State. During the current year corporation, municipal and private

schools will also be brought under the programme.

Targeted Intervention

Programmes specifically designed for implementation in areas where

the High Risk Group population is prevalent is called the Targeted

Interventions. Effective targeted interventions are mandatory not

only to protect the high-risk groups from contracting the fatal

epidemic of HIV, but also prevent the spread among the general

population. TANSACS has adopted the method of supporting certain Non-

Governmental Organisations (NGOs) and Community Based Organisations

(CBOs) to implement targeted interventions among selected

communities who are prone to be victimized due to socio-economic

factors.

Presently, TANSACS is implementing 66 Targeted Interventions, of

which, 12 interventions cover Commercial Sex Workers (CSWs), 15

interventions cover Truckers, 16 interventions cover Industrial

Workers, 12 interventions cover Migrants, 3 interventions cover

Tribal Groups, 2 interventions cover Men having Sex with Men (MSM),

3 interventions cover Prison Inmates, 1 intervention covers Youth

and Adolescents and 2 Research Studies pertain to HIV/AIDS

treatment. Another 11 NGOs have been identified for carrying out

Targeted Interventions for the year 2005 – 06 thereby increasing the

number of Targeted Interventions to 77 and thereby covering all the

high-risk groups in the State.

Sexually Transmitted Diseases/Reproductive Tract Infection (STD/RTI)

The persons suffering from STDs/RTIs like Syphilis, Gonorrhoea,

Herpes Genitalis, Chancroid, Warts, Trichomoniasis etc., are more

vulnerable to the HIV/AIDS infection. Hence, control of STD among

the general population is essential. There are 57 STD Clinics in

Tamil Nadu covering the entire state. TANSACS provides drugs and

other infrastructural facilities to these 57 STD clinics. It is

planned to strengthen the 57 STD clinics during the year 2005-2006.

Condom Promotion

Condoms are being distributed free of cost among the general

population, irrespective of the risk status, to prevent spread of

STD/HIV infection through the sexual route. Social marketing of

condom is effected through NGOs and Fair Price Shops all over the

State.

Blood Safety

Presently there are 86 licensed Government Blood Banks and 26

Government blood storage centres functioning in Tamil Nadu.

Computerized net – working facility has been provided to 11 major

Blood Banks at a cost of Rs.6.56 lakhs. It is proposed to cover

another five Blood Banks for the year 2005 –06, after approval by

National AIDS Control Organisation (NACO).

To motivate Voluntary Blood Donations, Voluntary Blood Donors were

invited on the National Voluntary Blood Donors Day on 01.10.2004, in

which 23 donors who had donated blood more than 50, 75, 100, 125 and

more times were presented with Gold Medals and Certificates to

recognize their contribution. The share of Voluntary Blood Donation,

which was 64.05% in 2003-04, has gone up to 78% in 2004-05 and the

sero prevalence remains at 0.18%.

At present 6 Blood Component Separation units are functioning - two

at Chennai, one each at Thanjavur, Tirunelveli, Coimbatore and

Madurai Medical College Hospitals. In such places patients are

treated with specific blood components required for their treatment

thereby rationalizing the use of blood.

Integrated PPTCT and VCCTC Centres

To prevent the vertical transmission of HIV infection from the

mother to child, Prevention of Parent to Child Transmission of HIV

(PPTCT) Programme is under implementation in Tamil Nadu. The PPTCT

programme is functioning in 65 centres, which include Government and

Private Medical College Hospitals, District Head Quarters Hospitals,

Private Maternity Centres and Corporation Health Centres. The total

number of attendees in the PPTCT Centres has gone up from 2,23,508

in 2003-04 to 2,63,808 in 2004-05.

The Voluntary Confidential Counseling and Testing Centres (VCCTC)

function as a bridge between prevention and care and support

interventions.

The special features of VCCTCs are:

1. Counseling and testing high – risk groups.

2. Behavioural changes among high – risk groups.

3. Identifying sero positive persons.

4. Psychosocial support to positive persons.

5. Identifying HIV/TB Co–infection in them.

6. Referring Sero positive persons for appropriate medical care

wherever necessary.

The total number of attendees in the VCCTC Centres has risen from

85,000 in 2003-04 to 1,16,250 in 2004-05.

The PPTCT and VCCTC centres have been integrated to improve their

functionality and cost effectiveness. This will be the first step in

opening the gateway for the general public for effective primary

prevention. At present there are 65 PPTCT and 45 VCCTC centers,

which are being integrated. It is proposed to open new Integrated

Counseling and Testing Centres in 68 Taluk level hospital located in

high prevalence areas.

Care and Support

The Government accords high priority for providing quality medical

care and treatment to the PLHAs in the State. TANSACS extends

financial support for the purchase of drugs for opportunistic

infections and post exposure prophylaxis. TANSACS also assists the

net working of PLHAs in running day care centres and community care

centres. TANSACS is presently extending support to 13 private

Institutional care centres, five community care centres and eight

drop-in-centres. Further, the Government has waived sales tax on

Anti Retroviral Therapy (ART) drugs with a view to minimize the cost

incurred by the PLHAs. It has been decided to start eight more

community care centres during the year 2005 –06.

Anti Retroviral Therapy (ART)

The Government of India have taken a policy decision to make Anti

Retroviral drugs available in the Public Health System. Under this

initiative, the first phase of the ART programme was launched in

Tamilnadu in the Government Hospital for Thoracic Medicine, Tambaram

(GHTM) with effect from 01.04.2004. ART programme in three more

centres, namely, Government Rajaji Medical College Hospital,

Madurai, Madras Medical College Hospital, Chennai and Government

District Head Quarters Hospital, Namakkal have also been commenced.

So far 2400 eligible AIDS patients have been extended free ART.

Greater Involvement of People living with HIV/AIDS (GIPA)

The Government is committed to the concept of GIPA in HIV/AIDS

programmes. The Positive Networks are actively involved in the

decision making process of TANSACS at various levels. Importantly,

the Government have ordered inclusion of a positive women member in

all the Hospital Advisory Committees in the State.

Training

Training for 50,000 Government and Private Doctors, Nurses,

Technicians and Village Level Health/Nutrition Care functionaries

has been planned for 2005-06.

Funding for the year 2005- 06

TANSACS has proposed a sum of Rs.63 crores in the Annual Action Plan

2005–06 and forwarded it to NACO for its approval to implement the

various activities.

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