the presentation on the theme the results till 2011-2012: getting to zero,

1. Dr.A.K.Srivastava
Associate Professor, Community Medicine

2. is
at
Wh orld y
W S Da
D
AI
A GLOBAL
DAY
 For ACTION on HIV and AIDS
 To get the FACTS on HIV & AIDS
 To show SUPPORT for people living with HIV
& AIDS
 To get INVOLVED
 To HONOR the victims who died of AIDS
related condition.
12/07/13
Dr A K Srivastava

3. Why is World AIDS Day important?
People do not know the facts
 About how to protect themselves and others
 Stigma and discrimination remain a reality
 Reminds the public and Government
 Vital need to
Raise funds,
Increase awareness,
Fight prejudice and
Improve education.
12/07/13
Dr A K Srivastava

4. Red ribbon - Symbol
Symbol was created by the Visual
AIDS Artists Caucus in 1991.
Consists of
 Sketched image of a red ribbon
and
 The
words
“World
AIDS
Campaign".
The
words
“World"
and
“Campaign" are in black
whereas the word “AIDS" is in
red.
Colour
chosen
for
its
connection to blood and the
ideas of passion
12/07/13
Dr A K Srivastava
World AIDS
Campaign

5. Red Ribbon - Significance
The ends of the ribbon
merge into splashes of
green, blue, purple and
orange.
The
splashes of colour
interpreted often taken to
indicate the diversity of
people living with HIV and
AIDS.
Symbol
to
demonstrate
compassion for people living
with AIDS
12/07/13
Dr A K Srivastava
World AIDS
Campaign

6. 12/07/13
Dr A K Srivastava

7. Through unprotected
Sex
Injection Drug Use
Rarely through blood
transfusion and organ
transplantation
12/07/13
Dr A K Srivastava
Mother-to-Baby

8. Where did it come from
 This is a controversial topic…..
 Some believe it is manmade and was produced by a chemical
weapons lab or medical research gone wrong.
 Generally accepted that it evolved in Sub-Saharan Africa and that it
crossed over from the chimpanzee population (in contaminated
meat/or hunters being exposed to contaminated blood).
 International travel/ blood transfusions/ drug use brought the virus
to the developed world.
 It has been reported to be present in gay men in USA since the mid
70’s- known as the ‘gay plague’.
12/07/13
Dr A K Srivastava

9. N u m b e r o f P e o p le L iv in g w it h H IV /A ID S (in m illio n s )
20 years of HIV/AIDS &
2 0 y e a r s beyondA I D S
o f H IV /
T h e firs t c a s e s o f u n u s u a l
im m u n e d e f ic ie n c y a r e
id e n t ifie d a m o n g
g a y m e n in th e U S A
In A fric a , a
h e te ro s e x u a l
A ID S
e p id e m ic is
r e v e a le d
In t h e U S A , th e
f ir s t H I V a n t i b o d y
te s t is a p p r o v e d b y
th e F o o d a n d D ru g
A d m in is t r a tio n a n d
H I V s c r e e n in g o f
b lo o d d o n a t io n s
s ta rts
H ig h ly A c t iv e A n tir e t r o v ir a l
T h e r a p y ( H A A R T ) is
d is c u s s e d f o r th e f ir s t t im e
T h e fir s t th e r a p y
fo r A ID S
- a z i d o t h y m id in e
( A Z T ) - is
a p p r o v e d fo r
u s e in th e U S A
In 1 9 9 1 -1 9 9 3 , H IV
p r e v a le n c e in y o u n g
p r e g n a n t w o m e n in
U g a n d a b e g in s t o
d e c r e a s e , t h e f ir s t m a j o r
d o w n tu r n in a
d e v e lo p in g c o u n t r y
T h e H u m a n Im m u n o d e f ic ie n c y V ir u s ( H I V ) is
id e n t ifie d a s th e c a u s e o f
A ID S
A t le a s t o n e c a s e o f
H IV /A ID S h a s b e e n
r e p o r te d fr o m e a c h r e g io n
o f th e w o rld
A c q u ir e d I m m u n o d e f ic ie n c y S y n d r o m e
( A ID S ) is d e fin e d f o r th e
f ir s t t i m e
T h e f i r s t e f f i c a c y t r i a l o f a p o t e n t ia l H I V v a c c i n e
i n a d e v e l o p i n g c o u n t r y s t a r t s i n T h a i la n d
T h e W o r ld H e a lt h O r g a n iz a t io n ( W H O )
la u n c h e s th e S p e c ia l P r o g r a m m e o n A I D S
S c i e n t is t s d e v e l o p
t h e f ir s t t r e a t m e n t
r e g im e n to r e d u c e
m o t h e r - to - c h ild
t r a n s m i s s io n
T h e In t e r n a t io n a l C o u n c il o f A ID S S e r v ic e O r g a n iz a tio n s ( I C A S O ) a n d
t h e G lo b a l N e t w o r k o f P e o p le L iv in g w ith H I V / A I D S a r e f o u n d e d
Ju n e 2 0 01
12/07/13
T h e U N S e c u r ity C o u n c il
d is c u s s e s H IV / A I D S fo r
t h e fir s t t im e
U N A ID S
is c r e a te d
A n H IV o u tb re a k
in E a s te r n E u r o p e
is d e te c t e d
( a m o n g in je c t in g
d ru g u s e rs )
R ock H udson becom es
t h e f i r s t p u b l ic f i g u r e t o
d is c lo s e h e h a s A I D S
1st case
identified
India
Dr A K Srivastava
U N S e c re ta ry -G e n e ra l
K o fi A n n a n m a p s a p la n o f a c t io n ,
a n d c a lls f o r t h e c r e a tio n o f a
g lo b a l fu n d o n A ID S a n d h e a lth
B r a z il b e c o m e s th e f ir s t
d e v e lo p in g c o u n t r y to
p r o v id e a n tir e t r o v ir a l t h e r a p y
th r o u g h its
p u b lic h e a lth s y s t e m

10. Deadlines for:
United Nations Millennium
Declaration
MDG 6a. Have halted by
2015 and begun to reverse
the spread of HIV/AIDS.
Political
Declaration
on
HIV/AIDS
2000
12/07/13
2001
2006
Dr A K Srivastava
Intensifying Our
Efforts to
Eliminate
HIV/AIDS
2011
United Nations
Millennium Development
Goals
Targets and elimination
2015

11. Theme World AIDS Day 2011 -15
Theme "Getting to zero”: highlights continued progress
towards achieving the global vision of zero new HIV
infections, zero discriminations and zero AIDS related
deaths
The World AIDS Campaign focus on "Zero AIDS related
deaths" signifies a push towards greater access to
treatment for all.
A call for governments to act and honour promises.
To at least hit targets for domestic spending on health
and HIV.
12/07/13
Dr A K Srivastava

12. 12/07/13
Dr A K Srivastava

13. IV
H
w n
ne tio
o c
er nfe
Z i
1
26 countries on
track but others not
Efforts to reduce
transmission among
MSM and CSW not
fruitful
12/07/13
Dr A K Srivastava
Not on
Track
Trends in sexual
behaviour show decrease
condom use/ increase in
sexual partners

14. IV
H
ew ion
n
o e ct
e r nf
Z i
2
Not on
Track
NO country is on track
HIV prevalence still high – 28% in ASIA
Sterile injecting Equipment – 2 countries
Opioid Substitution therapy – 4 countries
Access to HIV testing and counseling and ART –
needs boost up
Dr A K Srivastava

15. V
HI
w
ne ion
ro
Ze nfect
i
3
Not on
Track
62 % pregnant women living with
HIV received ART as against 90%
Reduction by 35% As compared
to 2009
Other preventive strategies like
access to contraception
12/07/13
Dr A K Srivastava
Linking pregnant women
and children to ART and
care

16. 12/07/13
Dr A K Srivastava

17. 1
VISION
Zero Discrimination
Laws to protect women
and girls from Gender
discrimination, Sexual
Violence and
Disinheritance
Providing Universal
Access To
Comprehensive Sex
Education
12/07/13
Dr A K Srivastava
Not on
Track
Increase The Capacity
of Women And Girls
Independent Access
Points For Needed
Services
Providing Social
Protection Services.

18. Vision: Zero Discrimination
2
Not
on
Track
Battling stigma and discrimination
is the main obstacle to beating HIV
once and for all
12/07/13
Dr A K Srivastava

19. Society discriminates by:
Ostracism
Rejection
Avoidance of HIV infected people
Compulsory HIV testing without prior consent
or protection of confidentiality
Violence against HIV infected individuals or
people who are perceived to be infected with
HIV
12/07/13
Dr A K Srivastava

20. 12/07/13
Dr A K Srivastava

21. The best gift to AIDS Patient
Be kind
Sometimes I have a terrible
feeling that I am dying not
from the virus, but from
being untouchable.
Amanda Heggs
12/07/13
Dr A K Srivastava

22. 12/07/13
Dr A K Srivastava

23. To g
ero Di
t to Z
e
a t io n
crimin
s
Only 8 Countries
Eliminated Travel
Restrictions Since 2010
Discriminatory Laws
Prevail In 44 Countries
3
Improving Public Attitudes
About
People Living With HIV And
About Migrants
Not
on
Track
12/07/13
Galvanizing Commitment To HIV
Programmes That Reach People
On The Move
Dr A K Srivastava

24. 12/07/13
Dr A K Srivastava

25. lated
DS r e
1
o AI
r
Ze
eath
d
On
track
World on track of reaching 15 million
people with ART by 2015
61% of people received ART as per
WHO HIV treatment guidelines
However 34 % in low and middle
income countries receive treatment
12/07/13
Dr A K Srivastava

26. lated
e
IDS r
A
ero
Z
h
deat
2
by 50 %
12/07/13
Dr A K Srivastava
Slowed
down in
recent
years

27. Vision: Zero AIDS Related Death
3
Not
on
Track
Domestic resources account for the majority of
spending for HIV treatment and care
International spending financed the majority of
HIV prevention efforts
12/07/13
Dr A K Srivastava

28. Global adult prevalence of HIV
12/07/13
Dr A K Srivastava

29. Down from 2.3 million
Decline of 33%
60% increase in therapy
12/07/13
Dr A K Srivastava

30. 12/07/13
Dr A K Srivastava

31. 12/07/13
Dr A K Srivastava

32. 12/07/13
Dr A K Srivastava

33. 12/07/13
Dr A K Srivastava

34. The HIV epidemic in India,
The HIV epidemic in India,
first reported in 1986,
first reported in 1986,
now just 27 years old,
now just 27 years old,
is counted among the
is counted among the
most serious public
most serious public
health problem in the
health problem in the
country.
country.
It has the third largest
number of people living
with HIV/AIDS
after South Africa and
Nigeria
12/07/13
Dr A K Srivastava

35. 12/07/13
Dr A K Srivastava
Adult HIV prevalence
Source NACO

36. Routes of Transmission of HIV, India , 2010-11
12/07/13
Dr A K Srivastava

37. Declining Trends of HIV Epidemic in India, 2007 - 2011
12/07/13
Dr A K Srivastava

38. Declining trends of new HIV infections & AIDS –
related deaths, India
12/07/13
Dr A K Srivastava

39. Categorization of districts based on the levels of
HIV infection
 Category A: -
women.
More than 1% among pregnant
 Category B : - Less than 1% among pregnant women
but more than 5% in any high risk group.
 Category C : - Less than 1% among pregnant women
and less than 5% in any high risk group but with
hot spots.
 Category D : - Less than 1% among pregnant women
and less than 5% in any high risk group . No known
hot spots or poor data.
12/07/13
Dr A K Srivastava

40. Categorization of districts on the basis of
HIV prevalence
A districts & B Districts : None
C districts: Nainital, Dehradun, Hardwar, Pauri,
Udham Singh Nagar, Uttarkashi
Almora, Chamoli and Champawat
 D districts: Bageshwar and Rudraprayag
12/07/13
Dr A K Srivastava

41. Key Activities by NACO, SACS and HIHT
(NACP –III)
Targeted
Interventions
LL ink worker
IEC and
Mainstreamin
g
Management of STI/RTIs
Blood
Safety
Condom
Promotion
12/07/13
Dr A K Srivastava
Laboratory
Laboratory
Services
Services

42. HIV Fact file Uttarakhand
(Toll free no: 1800-180-1200)
 Total HIV positive cases (cumulative till
Oct.2013)
– 5276
 HIV +ve patient registered on ART
- 2688
 HIV positive cases reported (Jan - Oct 2013)
- 733
 AIDS reported death in state from 2002 to
Oct 2013
– 455
 HIV Prevalence Rate
12/07/13
Dr A K Srivastava
– 0.1%

43. USACS at a glance
 Types of ICTC



Fixed-facility ICTCs : 49 (Stand-alone)
Mobile ICTCs: 01 (Stand Alone)
PPP : 01 (SGRR MC)
 ART centres (2) – Doon hospital and GMC & H, Haldwani
 Link ART centres – 13 (SPS Govt. Hospital, Rishikesh)
 Community care centres -2 (Dehradun, Haldwani )
 Designated RTI/STI clinics – 23 (HIHT, Haldwani and Srinagar)
 Blood banks – 27 (17 state Govt. 4 Central Govt. and 5 private and 1
PPP mode)
 Blood components separation units – 4 {HIHT, Doon, IMA,
Haldwani}
12/07/13
Dr A K Srivastava
(www.usacs.org and microbiology)

44. 12/07/13
Dr A K Srivastava

45. Reduction
in HIV
infection
2012
Faster scale up of
HIV treatment
Community
engagement
12/07/13
Reaching
pregnant
women
Fewer
deaths
Countries like
India & SA scale
up services
Results
for
People
Call for elimination
of new HIV infection
in children
Dr A K Srivastava
More
investment
Young
people
leadership
Countries
increase
investments by
50%

46. Gaps to
fill by
2015
Result for
people
HIV
prevention
services
needed
Low HIV
testing
uptake
HIV
treatment
needed
50% of the people
living with HIV do
not know their status
12/07/13
Marginalization
Key populations
not reached
6.8 million people
waiting for
treatment
Dr A K Srivastava

47. How do you fight ! It’s matter
12/07/13
Dr A K Srivastava

48. As no vaccine available
till date
and ART has to be taken life long
Scale up
12/07/13
Dr A K Srivastava

49. 12/07/13
Dr A K Srivastava

50. Create Awareness
12/07/13
Dr A K Srivastava

51. Show Support & Solidarity
12/07/13
Dr A K Srivastava

52. 12/07/13
Dr A K Srivastava

53. 12/07/13
Dr A K Srivastava

54. “History will surely judge us harshly if we
do not respond with all the energy and
resources that we can bring to bear in the
fight against AIDS.”
“Ask yourselves what you can do as a global
citizen in the fight against HIV & AIDS.”
“We must never forget our own
responsibilities.”
Nelson Mandela
18/07/1918 – 05/12/2013
12/07/13
Dr A K Srivastava

55. 12/07/13
Acknowledgment
Department of Community Medicine
&
Department of Microbiology
Dr A K Srivastava