State AIDS Council, UP June 29, 2009 Uttar Pradesh State AIDS Control Society First Meeting of.

State AIDS Council, UP

June 29, 2009

Uttar Pradesh State AIDS Control Society

First Meeting of


The History…

• 1981 First case reported in USA• 1986 First reported case in a

CSW• 1987 First reported case in U.P.• 1987 National AIDS control

Program launched• 1992 AIDS Cell in UP• 1999 State AIDS Control Society

formed


The Strategy…

• National AIDS Control Program – I, II, III• State AIDS Control Societies• Initially Prevention only• Targeted Interventions• Spread to general population• Management of AIDS – ART • NACP-III : prevention, treatment and care


The Present Scenario

• Estimated HIV+ in India 23.3 lac• Estimated HIV+ in U.P. 1.08 lac• 90% of HIV+ are in the age group of 15-49 (most

productive age group.)• India being the youngest nation in the world

average age being 28 years. • On an average 6000 new infection per day • 2/3 are in the age group of 15-25 years• 75% of this 2/3 are females • 40% of total HIV + population are women.• Some states highly affected, some are vulnerable


Vulnerability of UP

• Population 180 million (growth rate 2.5%)

• Nearly 50% of UP Population in reproductive age group (i.e 15-49 Years)

• Low literacy (rural 36.66%, state 57.2%)

• High incidence of poverty

• Low status of women & Gender disparity

• Large presence of high risk groups

• Migration : very high

• Highway network s : 8 national highways

• FSWs / IDUs / MSMs : high numbers

• Long porous Indo-Nepal border


Saharanpur

MuzaffarnagarBijnor

Baghpat Meerut

Ghaziabad

MoradabadJP

Nag

ar

Rampur

Gautam Buddha Nagar

BulandshaharPilibhit

Bareilly

Budaun

Shahjahanpur Lakhimpur Kheri

HardoiFarrukhabad

Etah

Aligarh

Mathura Hathras

AgraFirozabad

Mainpuri

Etawah

Auraiya

Jalaun

Jhansi

Lalitpur

Sitapur

Mahoba

Hamirpur

Banda

Fatehpur

Chitrakoot

Kanpur Dehat

Kaushambi

Allahabad

Mirzapur

Sonbhadra

Chandauli

Varanasi

Bhad

ohi Ghazipur

BalliaMau

Deoria

Kusinagar

MaharajganjSiddharthnagar

Balrampur

Sharwasti

Bahraich

Bara Banki

Gonda

BastiGorakhpur

Azamgarh

Ambedkar NagarFaizabad

Sultanpur

JaunpurPratapgarh

Rae Bareli

Lucknow

Unnao

Kanpur Nagar

Sant Kabir Nagar

Legend - Up to 100 101 - 300 301 – 500 501 - 1000 1001 - 3000 More than 3000

Cumulative number of persons tested HIV positive in ICTC Up to March 2009

Kannauj

Total no. of persons tested HIV Positive 37995

8788

4359

3513

3610


Number of Patients from different district Alive and on ART - Mar 2009


Role of AIDS Council

• Review of HIV/AIDS transmission and policy formulation for HIV/AIDS programming in the state

• Mainstream HIV/AIDS issue in all the departments and coordinate HIV related programs at all levels

• To include private / corporate / social sectors in the HIV programming under inter-departmental coordination

• Review status of inter-departmental coordination regularly


How HIV/AIDS affects? To Whom?

Person• Destroys immunity• Opportunistic infections

Society• Stigma and discrimination• Association with sex / sin / curse• Costly and life long medicines• Loss of skilled labour force• Burden on health services


Sectoral Impact

• Decline in GDP

– Economic Growth will decline by 0.86% and per capita GDP by 0.55%

• Increase in Health expenditure – 5% increase in Govt. Health spending on HIV will result

in 0.67% Decline in Govt. saving and 1.16% in Investment.

• Unskilled labour sector Hit Hardest– Maximum decline in output will be for sectors

with unskilled labour such as tourism (18.31%), Manufacturing (12.48%).


Contd..

• GDP Loss in Industrial Sector– 4 Sectors will contribute to overall loss in industrial

GDP: Construction, Mining, Quarrying and textile.

• Increase in Household Spending – 10% increase on health expenditure by HIV

household will reduce their expenditure on education and consumption.

• Lower Labour Productivity – Lower labour productivity of HIV Infected and

effected workers will affect the overall productivity of all sectors

Source:- National Council of Applied Economic Research (NCAER)


Socio- Economic Impact

• Household Income Decreases– Illness with in household results in loss of

income.66.25% income lost when PLHIV workers were not working and 9.24% lost due to leave/absence from work.

• Unemployment Increases– within the HIV households increased from 3.6% to

9.8%- own illness most important reason. – Borrowing Increase– 46% of HIV households borrowed compared to 27% of

non-HIV households.• Greater Expenditure– Per capita monthly expenditure Four Times Higher than

non HIV households due to increase medical expenses.


Contd..

Drop out Rate Increase– 33.3% in 6-14 age group from HIV Households

Dropped out to take a job and 22.3% to take care of siblings /household work.

Greater Hospitalization – Five times more hospitalization in HIV Household than

non-HIV household. More illnesses left untreated for women.

Fear of Disclosure at workplace– 74% of PLHIV did not disclose their status at

workplace for fear of losing jobs Source:- National Council of Applied Economic Research (NCAER)


Gender Impact

• Greater Burden of Care– 70% of Care givers for HIV households were women of

which 20% were living with HIV

• Poor Health seeking Behavior – Expenditure per illness episode for HIV households were

more for men (Rs 796) than women (Rs 487). More women (70.4%) used Govt. hospitals than men (59.7%)

• Lower Enrolment Levels – In 15-18 age group current enrolment for girls from HIV

households (64.81%) was lower than girls from non HIV households (79.54%)Source:- National Council of Applied Economic Research (NCAER)


Contd..

Girls Withdrawn from School – In 6-14 age group, 32.1% of girls from HIV households

were withdrawn from school

Higher Disclosure to spouse– 83% of the women informed their husbands immediately

of their HIV status compared to only 69.3% of men.

Lower Awareness among Women – 52% men knew where to go for voluntary testing in

comparison to 36% of Women Source:- National Council of Applied Economic Research

(NCAER)


Contd..

Greater Stigma Faced by Women More women living with HIV (5.5%) were asked to leave home after

testing positive than men (1.9%) 95% of new infections in women were among married and monogamous Widows denied Right to Property

– Widows represented a third of the sample and face stigma on 3 counts

– As women – PLHIV – Widows

– 90% were forced to leave marital home and 79% denied share in Husband’s property. 43% live alone and economically worse off than HIV households.

Source:- National Council of Applied Economic Research (NCAER)

Greater Stigma Faced by Women


Mainstreaming

“process of analyzing how HIV and AIDS impacts on all sectors now

and in the future, both internally and externally to determine how each sector should respond based on its comparative advantage.”

Becoming PART OF…

…& NOT An ADD-ON ActivityReduces large expenditure on health care & social welfare.Minimizes negative impact on programmes related to education, livelihood, social welfare, Women and Child Health.Saves loss of skilled employees.


Expectations From Various Ministries, Industries & CBO/NGO

Prevention – Display of Information Panels & Posters – Provide Free space for Hoardings at public places – Training of Departmental officials on HIV Issues– Free space for Installation of Condom Vending Machines (CVMs)– Each Department to identify nodal officers to address HIV issues at state and Dist

level – Instructions to training institute to include HIV in curriculum

Preventive and Treatment Services– Clinics for counseling & Testing, STD Treatment, referral linkages.– Treatment of Opportunistic Infection and ART.


Contd..

Enabling Environment – Disseminating knowledge about HIV through outreach

programme – Implementing workplace policies in each and every

establishment– Providing free transport facilities to PLHAs to treatment

sites– Providing employment opportunities to PLHIVs in existing

employment schemes– Providing soft/ cheap credit facilities to PLHIVs– Subsidized grains for nutritional support– Providing free legal aid to PLHAs to ensure

implementation of their rights


To Start with … Proposed activities for approval by State AIDS Council

One Day orientation of District Magistrates and Chief Medical Officers of all district. Sensitization Programme for Police Officers of all DistrictsOne Day Sensitization Programme from Special Secretaries to section officers of Secretariat Installation of Posters on HIV/AIDS in Secretariat premisesInclusion of HIV-AIDS related information in the websites of all the departments and to provide a link to UPSACS / NACO website on all the departmental websites.Special Attention to be given to Varanasi and Allahabad Dist.

May like to approve the above activity by State AIDS Council


Thank You

State AIDS Council, UP June 29, 2009 Uttar Pradesh State AIDS Control Society First Meeting of.

Documents

Transcript of State AIDS Council, UP June 29, 2009 Uttar Pradesh State AIDS Control Society First Meeting of.