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Prevention
Targeted Intervention (As on March’12)

Gujarat is in a moderate HIV prevalence state with 6 out of 25 districts falls in category ‘A’ and other four being in ‘B’ category. The recent trend of epidemic indicates that the epidemic has moved to the generalized population as well. For these reasons, the principle strategy for TI is total saturation of High Risk Groups (HRG) in the state.

This will be achieved through expanding the reach of Targeted Interventions (TI) through

♣ NGOs and CBOs for urban areas and for places with high concentration of HRB and
♣ Link Workers and Village Level Volunteers for villages having 5000 population.

Targeted Intervention activities have been the major activity carried out by Gujarat Sate AIDS Control Society (GSACS) to prevent the spread of HIV/AIDS infection. High risk population like Female Sex Worker (FSW), Man having Sex with Man (MSM), Trans Gender (TG) and bridge population like Truckers, Single Male Migrants (SMM) are main groups targeted for various preventive interventions. The targeted intervention activities have been driven primarily by non-Governmental Organizations (NGOs) and Community based Organizations (CBOs). Currently GSACS / AMCACS implementing 115 TIs out of which 79 are working with core population while remaining 36 are working with bridge population. (Core group includes Female Sex Worker, Male having Sex with Male & Injected Drug Users and Bridge includes Male Migrant & Truckers)

Following are the major activities carried out by these NGO partners:

♣ Inter personal behavior change communication (BCC)
♣ Promotion/ distributions of condoms
♣ Provision of services for Sexually Transmitted Infections (STIs)
♣ Linkages to Integrated Counseling and Testing Services (ICTC)
♣ Advocacy for Enabling Environment
♣ Community Mobilization


Best practices by TI Division-GSACS:
  • Quarterly region wise review of TI projects in presence of senior GSACS officials and District Programme Officer (DPO) of concerned District AIDS Prevention and Control Unit (DAPCU).
  • Quarterly grading of TI projects performance and feedback system between TI NGOs and TI Division of GSACS.
  • Developed E- group between SACS and TI partners – used for monthly feedback
  • Developed Information panels to be put up at DIC.
  • Liasoning with district health system to extend STI/RTI screening and treatment; HIV/RPR test services.
  • Start up Opioid Substitution Therapy (OST) at Government Medical College, Surat
  • Liaisoning with Gujarat Women Economic Development Corporation Ltd for FSWs rehabilitation by Vocational training in various trade.

Integrated Counselling and Testing Center (ICTC) (As on March’12)

The Vatsyayan Kendra & Mamta Clinic (VKMC) provides people an opportunity to learn and accept their HIV sero status in a confidential enabling environment. VKMC-ICTC has become an integral part of HIV prevention programme, as it is a relatively cost-effective intervention in preventing HIV transmission. At the end of March 2012, there are 1209 ICTCs (Integrating Counseling and Testing Centre) in the Gujarat out of which 305 stand alone ICTCs, 901 Facility-ICTC (Private Partnership - PPP model, PHCs, CHCs & Sub Centre) and 3 mobile ICTC Under ICTC General, 767528 clients tested of which 13179 found positive (1.7%) during the 2011-12.

Prevention of Parents of Child Transmission (PPTCT): In the year 2011-12, 609964 pregnant women tested, out of which 877 (0.15%) found positive. The number of positive live birth which received Mother Baby (MB) Pairs is 674.

STI Care Services (As on March’12)

Current Situation:

Gujarat state estimated an annual incidence of 1.8 million STI/RTI episodes in the state (population of 6 million with 50 % of it as adult & with a rate of 6 % of STI episodes per year among adult population).

Aim and Objectives:

To reduce the prevalence of STI by Syndromic case management, involvement of private doctors under public private partnership scheme and treatment facility for RTI/STI will be extended up to PHC level.

Service Delivery:

There are a total 60 functional STI clinics established in Medical Colleges, district hospitals, some sub-district and trust hospitals. Counsellors cum Coordinators have been appointed in each such clinic to ensure proper counseling of STI patients.

Finance and Consumable Support:

There is provision of one time grant for new STI clinics for infrastructure strengthening and recurring grant every year for all centres for procurement of consumables, training and TA/DA of STI clinic staff, supportive supervision of STI clinics and salary of STI counsellors. Computers and clinic signage boards to all the centres have been allotted. Colour coded STD drug kits and RPR test kits are distributed to all STI clinics supplied by NACO.

Capacity Building:

Each STI clinic has designated STI clinic incharge and recruitment of STI counsellor cum coordinator at each STI clinic. Training of STI clinic staff (doctors, STI counsellors, staff nurses and laboratory technicians) have been arranged by GSACS as per NACO modules regularly. There is regular review meeting of STI counsellor (quarterly) and STI clinic incharges and faculties of Supportive Supervisory Teams (biannually).

Supportive Supervision:

Faculties of medical colleges have been trained as members of Supportive Supervisory Teams (SSTs) from dept. of Skin, Obs. & Gynec, PSM and Microbiology.

Regional STI Centre:

Government Medical College and SSG General Hospital, Vadodara has been identified as ‘Regional STD Centre’. It has to provide evidence based input to STI control programme by conducting high quality etiologic testing for STIs, operation research, training and other research based evidence for improving the quality of STI/RTI service delivery. It has to act as the nodal agency for providing etiologic diagnosis for the difficult and treatment failure cases in the region. It works in close coordination of the departments of microbiology, Skin & V.D., Obs. & Gynecology and PSM (Public Health). It receives samples/ patients from the linked State Reference Centers (SRC). B. J. Medical College, Ahmedabad and Government Medical College, Surat have been identified as State Reference Centers.
Blood Safety Programme (As on March’12)

Goal:

To make adequate and safe blood available in all parts of Gujarat

Objectives:

Promote voluntary blood donation.
Increase appropriate use of blood/ blood components.
Ensure quality of blood and blood banking services.
Support blood storage centres/ reorganize blood transfusion services in the remote areas.

Gujarat is doing well both in the terms of total blood collection as well as blood collection from voluntary donors. Gujarat is one of the leading states in the country in terms of total collection of blood units against the requirements as our last year’s (2011-12) per capita blood donation was 1.32%.

In our state the total blood collection is 7.95 lakhs units and voluntary blood donation has increased from 71.4% in 2008-09 to 82% in financial year (April-11to March-12).

In Gujarat, the availability of blood is ensured through a network of 143 functional blood banks.

The State will continue to maintain a high proportion of voluntary blood collection with a target to achieve voluntary blood collection as 90% in current year. The focus must be on promotion of repeat voluntary blood donation, as the same is safest in terms of transfusion transmitted infections (TTIs) and other blood transfusion related complications.

Similarly in remote areas where limited blood requirement does not justify establishing blood banks, Govt. of Gujarat supports the establishment of storage centres. Currently, 42 storage centres are functional catering the remote rural and tribal areas while another 66 centres are in the process of implementation.

Information, Education & Communication
(As on March’12)

The State is a medium prevalence state with concentrative type of HIV epidemic. Providing Information Education and Communication (IEC) to the masses, mainstreaming and Behavior Change Communication (BCC), to the vulnerable population are the key approaches in the state. For creating awareness about prevention and control of HIV/AIDS through various IEC activities are organized in Gujarat viz. displaying messages in Mass Media/Mid Media, printing and distribution of brochures, flip-charts, posters etc.

Red Ribbon Club Programme

Red Ribbon Clubs are envisaged to instill among all the students in the educational institutions values of service, develop healthy life styles, and increase access to safe and adequate quantities of blood to all the needy by promotion of Regular voluntary blood donation. Through this programme 5 important Health issues like drug addiction, good eating habits, reproductive & sexual health including RTI/STI and HIV/AIDS, voluntary blood donation promotion and Stress & Strain free Enviournment are being covered.

Health Education and Lifeskill Programme (HELP)

Health Education and Lifeskill Programme (HELP) has been sanctioned with the ultimate aim of wholesome development of the adolescent keeping health at the core through increasing the capacity of the adolescent so that they can control their health by State Coordination Committee (SCC) chaired by Principal Secretary (Education), GoG. Gujarat Council of Educational Research and Training’ (GCERT) is the Nodal Agency for this programme. A comprehensive module for HELP has been already developed for teachers.

Link Worker Scheme (LWS)
  • The scheme is generating a cadre of trained local personnel as Link Workers and volunteers to work with High Risk Groups (HRGs) and vulnerable young people and women towards the following:
  • Create an enabling environment for PLHAs and their families by reducing stigma and discrimination through work with existing community structures/groups, e.g. Village Health Committees, SHG, PRI, etc.
  • Reach out to HRGs and vulnerable young people (men and women) in rural areas with information, knowledge and skills on STI/HIV prevention and risk reduction.
  • Establish inter linkages between gender, sexuality and HIV and bring into focus factors that enhance vulnerability of young people and women, both in HRGs and the general population.
  • Promote increased and consistent use of condoms to protect against STIs and unwanted pregnancy.
  • Generate awareness and enhance utilization of prevention, care and support programmes and services (especially STI, ICTC, PPTCT, ART, DOT and other health services).
  • Facilitate the delivery of youth friendly health and counseling services through existing public health services/service delivery points.
  • Facilitate the reintegration of HRGs into the community and work with families against trafficking of women and children.
As on March’12, the LWS is being implemented in 11 districts in Gujarat viz; Valsad, Surat, Vadodara (Funded by UNICEF), while funded by Global Fund Round 7 in Dahod, Surendranagar, Navsari, Banaskantha , Mehsana, Ahmedabad, Rajkot and Bhavnagar.

Red Ribbon Express 2012

The Red Ribbon Express, a special train which travels across the country to spread awareness on HIV/AIDS, tuberculosis, malaria, reproductive and child health services, general health and hygiene, was launched on the National Youth Day 12th January 2012. During its 14-day journey in Gujarat from 17th February 2012 to 2nd March 2012, a total of 2,13,074 persons visited the on-board exhibitions at the 7 railway stations, viz. Vadodara, Patan, Surendranagar, Hapa-Jamnagar, Bhavnagar, Ahmedabad and Valsad. This reflects a spectacular rise over the total number of visitors during 35 days at 15 railway-stations in RRE-I (1,27,588 ) in 2007-08 and 13 days at 6 railway-stations in RRE-II (1,20,122) in 2009-10.
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