DR. S.K CHATURVEDI UNICEF

1. DR. S.K CHATURVEDIUNICEF HIV/AIDS PREVENTION PROGRAMME PROGRAMME PLAN OF COOPERATION 2003-2007

2. HIV Prevalence in India > 1% Antenatal Women 3.82-4.5 Million adults J & K < 1% Antenatal Women Himachal Pradesh Punjab Chandigarh Delhi Haryana Arunachal Pradesh Sikkim Uttar Pradesh Rajasthan Assam Nagaland Meghalaya Bihar Manipur Tripura Mizoram Madhya Pradesh Gujarat West Bengal Daman & Diu Orissa Dadra Nagar Haveli Maharashtra Andhra Pradesh Goa Pondichery Karnataka Andaman & Nicobar Tamil Nadu Source: NACO, 2002 Lakshwadeep Kerala

3. Child Mortality as an Indicator of Vulnerability HIV + U5MR

4. Percent women aged 15-49 who have heard of HIV/AIDS MICS-2000

5. Percent women aged 15-49 who know all threemodes of vertical transmission of HIV/AIDS MICS-2000

7. HIV/AIDS Awareness among Adolescents< 20 years - FHAC 2000 53 32 6.3 3.4 Correct knowledge about benefits of condom use to prevent STI/HIV Source: FHAC Coverage Evaluation AIIMS/INCLEN/USAID 2000 Used condom during last intercourse

9. Who Are Now Infected & Affected by HIV/AIDS? Reported Data in 2001 • Over 50% of all new infections occurring among young people aged below 25. • 25% of all HIV infection fall in women, with an accompany increase in vertical transmission and pediatric HIV. • Reported median of HIV prevalence among pregnant women exceed 2% in most high prevalence states. • Already about 660,000 young women and 345,000 young men aged between 15-24 years are living with HIV/AIDS • 120,000 AIDS orphan children and 160,000 AIDS children living in the country.

10. ICO HIV/AIDS Programme Strategy • Phased approach: Initial focus on four high prevalence states - 2002-3: High Prevalence 2004-5: Concentrated 2006-7: Low - AP, Mah, TN & Nagaland + Karnataka and Manipur (PPTCT) • Modeling scaled-up actions in support of the National Programme • Strong emphasis on building evidence-based approaches

11. Thrusts Projects Results PPTCT VCCT services for Scaling up to national PPTCT l l l pregnant women level of prevention of Adolescents & Young l Operational network of health facilities MTCT l People Prevention of HIV Integrated l Evidence based national l l among young below the Communication policy age of 25 Building an enabling Replicable district models l l Young People environment for an expanded response Scaled up interventions l against HIV on HIV prevention Replicable models of l Life Skills Education Coalition of civil society l groups & NGOs Programme Goal: To reduce the prevalence of HIV/AIDS among children and to alleviate the impact of AIDS on children, adolescents and families affected by HIV/AIDS

12. 1) Scaling up Expected outputs An operational network of health facilities providing quality PPTCT services established PPTCT used as an opportunity to strengthen MCH services. 2) District Models Expected outputs A comprehensive, integrated and sustainable distrit- based PPTCT programme Pre and in-service training modules for care providers to integrate youth friendly services PMTCT • Key results: • Operational network of health facilities for PPTCT established • A National Policy for PPTCT • Replicable district PPTCT models • Partnerships and resources mobilized for scaled up 3) Learning for Policy Development Expected outputs • A Feasibility Study of “PPTCT Plus” • Studies on HIV and infant feeding • Evidence-based National PPTCT Policy

13. Timing: Cumulative total of medical centres participating: Pilot project: 2000-2002 11 Centers of Excellence 11 81 Medical Colleges in High Prevalence States 92 December 2002 159 District Hospitals/ Maternity Hospitals in High Prevalence States 242 June 2003 59 Medical Colleges in Low Prevalence States 301 Dec. 2003 450+ District Hospitals/ Maternity Hospitals in Low Prevalence States 780+ In 2004 Scaling up PPTCT to cover the whole country

14. UNICEF’ s Role in PPTCT Monitoring and Evaluation Quality assurance of services Research Infant Feeding Study design Counseling PPTCT “Plus” Data Training District Models Dissemination of results Drugs

15. 1) Preventive & Peer Education in School Expected outputs Effective intervention models for scaling up in schools State-led sustainable response plan Linkages of life skills education to other key strategies 2) Young People as Agents of Change Expected outputs Increased participation of young people in HIV/AIDS prevention Peer Education Package for out-of-school adolescents and young people A Youth forum for public debate and dialogue about HIV/AIDS and related issues Adolescents & Young People • Key results: • Scaled up interventions on HIV prevention in school • Replicable models of skills-based prevention education for young people out of school • Coalition of civil society groups and NGOs on YP and HIV/AIDS

16. School AIDS Prevention Programme: Achievements so far….

17. Impact of school HIV education Source: AMREF 2001

18. 1) Advocacy and Mobilization for Social Change Expected outputs Documentation on the impact of HIV/AIDS and data analysis to sensitize key stakeholders for policy formulation and increased resource allocation Communication Strategies to reduce risks, increase demand for health services, and address stigma and discrimination among health care providers and the general population Expanded partnerships and alliances with civil society & private sector 2) Behavior Development and Change Expected outputs Increased participation of communities, families, individuals, and service providers in responding to HIV/AIDS prevention. Effective communication packages for behavior change, focusing in safe behaviors and health care services Communication strategy to support PPTCT and Young People interventions Integrated Communication • Key Results: • Partnerships and resources mobilized for scaled up interventions • Packages of communication initiatives including innovative approaches