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

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

Child Mortality as an Indicator of Vulnerability HIV +U5MR

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

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

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

Reported Data in 2001 Over 50% of all new infections occurring among young people aged below % 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 years are living with HIV/AIDS 120,000 AIDS orphan children and 160,000 AIDS children living in the country. Who Are Now Infected & Affected by HIV/AIDS?

ICO HIV/AIDS Programme Strategy Phased approach: Initial focus on four high prevalence states : High Prevalence : Concentrated : 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

Projects PPTCT Adolescents & Young People Integrated Communication Thrusts 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 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 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

PMTCT 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 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

Scaling up PPTCT to cover the whole country Timing : Cumulative total of medical centres participating: 11 Centers of Excellence Pilot project: Medical Colleges in High Prevalence States December District Hospitals/ Maternity Hospitals in High Prevalence States June Medical Colleges in Low Prevalence States Dec District Hospitals/ Maternity Hospitals in Low Prevalence States In

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

Adolescents & Young People 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 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

School AIDS Prevention Programme: Achievements so far….

Impact of school HIV education Source: AMREF 2001

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