Gujarat state is one of the highly industrially developed states in the country. Being an industrialized state, migration of laborers from various parts of India is very high. Mobility and migration of people make them more vulnerable, as a result of separation from spouse and release of social sanctions, leading to high-risk sexual practices and consequently they may contract HIV, which in turn is carried to their spouses and to their children. On the one hand, with an increase in urbanization most of the societies are in transition and the young population is under less social restraint. On the other hand, lower literacy level of rural women, especially in the state and local customs & traditions make women more vulnerable to the infection. Large numbers of women suffer from reproductive tract infections (RTIs), which are mainly due to poor sexual hygiene especially during menstruation and sexually transmitted infections from their spouses.
The first AIDS patient in Gujarat was diagnosed in 1986. Gujarat came into middle level prevalence as early as 1994 along with Tamil Nadu, due to high vulnerability of the State. However Gujarat State is still at medium level prevalence, whereas Tamil Nadu and other states like Maharastra, Andhra Pradesh. Karnataka, Manipur and Nagaland have moved into high prevalence.
To respond to the menace of HIV in the State, State AIDS Cell (SAC) was created in December-1992 for implementation of phase I of National AIDS Control Programme. The implementation of the program was done by the State AIDS Cell in accordance with the guidelines of National AIDS Control Organization and the approval of the State Empowered Committee constituted for the purpose at the State level.
With a view to ensure speedy and effective implementation of the programme through inter - sectoral coordination for AIDS prevention, and also to involve NGOs, the State AIDS Empowered Committee decided to convert the existing State AIDS Cell into a registered society. Government of India had also advised to constitute State AIDS Control Society for effective implementation of the programme, especially the second phase beginning from April 1999. Since then National AIDS Control Programme is being implemented through State AIDS Control Society.
National AIDS Control Programme Phase III (NACP III)
After the discovery of the first HIV infection in 1986, the Government of India initiated programmes of prevention and raising awareness under the Medium Term Plan (1990-92), the first plan (NACP-I, 1992-99) and the second plan (NACP-II, 1999-2006). However, with the growing complexity of the epidemic, there have been changes in policy frameworks and approaches of the NACP. Focus has shifted from raising awareness to behaviour change, from a national response to a decentralized response and an increasing engagement of NGOs and networks of people living with HIV/AIDS.
Based on the lessons learnt and achievements made in Phase I and II, India has now developed the Third National AIDS Programme Implementation Plan (2007-2012). India is committed to achieving Millennium Development Goals (MDGs). Keeping this in view, the primary goal of NACP-III is to halt and reverse the epidemic in India over the next 5 years by integrating programmes for prevention, care, support and treatment.
The specific objective of the NACP III is to reduce new infections as estimated in year 1 of the programme by:
♣ Sixty per cent (60%) in high prevalence states so as to obtain the reversal of the epidemic; and
♣ Forty per cent (40%) in the vulnerable states so as to stabilize the epidemic.
NACP III aims to achieve its goal of halt and reverse the epidemic in India over the next 5 years through four-pronged strategy, namely:
♣ Prevention of new infections in high risk groups and general population through:
♣ Saturation of coverage of high risk groups with targeted interventions (TIs), and Scaled up interventions in the general population
♣ Providing greater care, support and treatment to a larger number of people living with HIV/AIDS.
♣ Strengthening the infrastructure, systems and human resources in prevention, care, support and treatment programmes at the district, state and national levels.
♣ Strengthening a nation-wide Strategic Information Management System.
Guiding principles include the Three Ones, equity, legal, ethical and human rights, PLHA and civil society participation