DR. S.K CHATURVEDI UNICEF HIV/AIDS PREVENTION PROGRAMME PROGRAMME PLAN OF COOPERATION 2003-2007 DR. S.K CHATURVEDI UNICEF

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

Child Mortality as an Indicator of Vulnerability HIV + U5MR

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

Percent women aged 15-49 who know all three modes of vertical transmission of HIV/AIDS MICS-2000

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

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.

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

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 Thrusts l Scaling up to national level of prevention of MTCT Prevention of HIV among young below the age of 25 Building an enabling environment for an expanded response against HIV Results l Scaled up interventions on HIV prevention Replicable models of Life Skills Education Replicable district models Young People Coalition of civil society groups & NGOs VCCT services for pregnant women Evidence based national Operational network of health facilities policy PPTCT Projects l PPTCT Adolescents & Young People Integrated Communication

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 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 3) Learning for Policy Development Expected outputs A Feasibility Study of “PPTCT Plus” Studies on HIV and infant feeding Evidence-based National PPTCT Policy

Scaling up PPTCT to cover the whole country Timing: Cumulative total of medical centres participating: 11 Centers of Excellence Pilot project: 2000-2002 11 81 Medical Colleges in High Prevalence States December 2002 92 159 District Hospitals/ Maternity Hospitals in High Prevalence States June 2003 242 59 Medical Colleges in Low Prevalence States Dec. 2003 301 The going to scale has come about very quickly because of strong and expert lobbying on our part and the part of professional medical associations. It also demonstrates how UNICEF can respond quickly to a crisis - even on a national scale. We have facilitated this expansion, working with a nucleus of advocates - ‘India moves India.’ 450+ District Hospitals/ Maternity Hospitals in Low Prevalence States In 2004 780+

Monitoring and Evaluation Quality assurance of services 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

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 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

School AIDS Prevention Programme: Achievements so far….

Impact of school HIV education Source: AMREF 2001

Integrated Communication Key Results: Partnerships and resources mobilized for scaled up interventions Packages of communication initiatives including innovative approaches 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